I actually started in the peds clinic at NNMC (Bethesda) on Friday, after returning from C4 on Thursday (and I'll start posting entries from C4 as soon as I'm done with this one), but nothing really exciting happened then, and I didn't think anyone would want to read about the kid with the scraped nose or the other kid with the flu.
Anyway, the way peds clinic works for transition year interns is that we aren't assigned patients (as the pediatrics interns/residents are), but choose an attending and work with them. Today I tagged along with a pulmonologist, because the idea of doing well-baby checks was really boring to me. The morning was mostly asthma patients (not that exciting), but we did CF (cystic fibrosis) clinic in the afternoon.
Depending on the patient's age and how he or she is doing clinically, patients are seen either quarterly (every three months), semi-annually, or annually. Overall, it's a pretty simple appointment--ask them (or parents) how they're doing, if they get short of breath, energy level, any GI symptoms, and what kinds of medications they're taking.
The first two patients were siblings, a 22-month-old boy and his eight-month-old sister. Both of them were doing really well, so that was good. Like I said, pretty simple appointment, and we ended up just telling the father to keep doing what they're doing and come back in three months. The third patient, on the other hand, is not doing so well. She's seven and has been pretty sick (pneumonia, diarrhea, etc) for about five weeks. At some point in there, she had the flu (don't know if it was seasonal flu or H1N1) and had a course of Tamiflu, which definitely didn't help the nausea and such. Then her cultures came back as a bacteria in the Mycobacterium family (same family as TB), which automatically buys her at least a year of four more antibiotics, in addition to the other medications she was already taking.
All sorts of fun. Really.
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