Tuesday, November 07, 2006


I had endocrine clinic all day today. I was with the attending and a fellow in the morning, and towards the end the attending let me see patients by myself—always better than merely shadowing. In the afternoon I just shadowed the nurse practitioner. One of the patients was a seven year old girl whose parents were concerned that she was beginning puberty. The father was an OB/GYN who turned out to be one of the doctors who had seen the fellow when she was pregnant with twins—she mentioned to me after the family left that it was stressful enough treating other physicians and their families let alone a physician she had gone to. The father was concerned about an adrenal or ovarian tumor, but the endocrinologist reassured them that those problems would cause different symptoms and the girl’s condition is most likely benign.

In the afternoon we saw a 14 year old boy with Crohn disease who has been 4’7” for the last three years. He looked like he was 11 or 12, but the father seemed to be a lot more concerned than he did. The NP saw him first and spoke to the parents about possible treatments, then the attending came to see him. He had normal growth hormone levels, but the bone age of an 11 year old—this is actually a good sign because it means that he will likely eventually gain back some of the inches he missed the last three years. The doctor recommended that he get testosterone injections for three months followed by monitoring for another three.


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