Wednesday, July 16, 2008

Politics, Sweet Politics

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The Crazy Dream

A few nights ago I had this dream. Normally I don't remember my dreams but this one stuck and after telling a few people about it I was encouraged to share it here. So here it is.

In my dream a very pregnant Katrina and I woke up one morning and her first words to me were, "My water just broke!" She immediately started contracting so I remembered that I had some left over unused, non-latex rubber gloves from Anatomy lab last year which I found and put on. I checked her cervix and found her to be fully dilated and the baby descending. Knowing at that point that we were going to have to deliver the baby right there in our bed I went on a scavenger hunt for supplies in our apartment. Somehow my limited 1st year medical training and my experience delivering a couple robot babies in the sim lab came out. Here is a list of what I picked up.

1. The hand pump from our exercise ball. It has a reverse pump to do suction (which I would use to suction the baby's nose and mouth.
2. Potato Chip Bag Clips. I would use these to clamp the umbilical cord before cutting.
3. Scissors from our knife block. To cut the umbilical cord
4. A shirt of mine to wipe down the baby

With all that gathered I began the process of delivering the baby. Doing cervical and vaginal swipes with fingers to help the baby's head clear the "ring of fire". I assessed the presentation of the baby to prepare my hand placement. When the head crowned I held it in extension (heads flopping down cause tears in mom). Then I delivered the head, anterior shoulder, posterior shoulder, grasp the neck and pull baby all the way out, suction nose then mouth. I handed the baby to Katrina, never looked at the gender (and she didn't say either) and then proceeded to clamp and cut the umbilical cord. Then I went through the process of uterine fundus massage to deliver the placenta and checked the placenta to make sure of its cotyledons were intact.

And then... I woke up. Crazy huh?

And I never saw the gender... but the baby was pink, healthy, and crying.

Thursday, July 10, 2008

The Patient Viewpoint

As you know, this blog is often a forum for health policy and other similar issues. On occasion though I do desire to get personal and share with you something from the heart. Today is one of those days as I have spent much of the day reflecting on a current health battle. To be honest, I must say that I am a little scared but also a bit relieved...

For those who know me personally you are likely aware that my gastrointestinal tract leaves much to be desired. Throughout my teenage years and adult life I've had a wide range of chronically moderate to acutely severe GI problems. Over the past year though I've experienced a slow, steady increase in heartburn and acid reflux, to the point that now I have a constant, dull burning sensation at all times. All foods, yawning, laying, coughing, etc exacerbate the symptoms and over-the-counter treatment has become virtually useless to me. Now, reflux just happens randomly every few minutes. The level of discomfort and type of discomfort, coupled with my medical knowledge is what finally scared me enough to see a doctor since I've been trying to deal with the discomfort with pending pregnancy/labor/delivery costs on the horizon.

So I did see the doctor yesterday who did a phenomenal job taking my history and giving me some treatment options. What she did though that has not been done for me yet in life is offer to actually go in and take a look around. What I have been wanting for some time is to know the actual cause of my health issues, not simply to treat symptoms. So sometime soon I'm going to get scoped which is a relief to me.

There is a lot of discussion in the medical community about the ordering of expensive diagnostic tests that may not be necessary. This is called defensive medicine which doctors practice to avoid lawsuits. Anyhow, my case could be argued either way and for me at this moment, I'm glad I have a doctor who wants to take the cautious road. Maybe that is because I know more now than I did before about my risks with these symptoms. What I think my doctor picked up on (whether she realized it or not) was a patient who historically does not take great care of himself actually seeking care, and thus must be pretty concerned and in need of detailed answers.

Ultimately I feel comforted. I feel like I received quality care. That's why I want to be a doctor, and now why I'm happy to be this doctor's patient.