Doing it for the kids

Woah, this thing still exists? Who knew.

So I"ve started working again. Which is fun, scary and more than a little frustrating, because now I"m working in paediatric emergency.

Fun because kids are so gosh darned cute.
For example, I had a 4 year old boy present with "excessive blinking". Now, taking a look at him, I saw nothing wrong, but decided that a visual acuity would be a good start.
I asked him if he knew his ABCs.
He excitedly replied, "Yes! I do!"
So over I took him to the Snellen chart, and stood him 6 metres away, covering one eye and asked him to read from the top.
He stood there happily and called out loudly "A, B, C, D, E, F..."
I laughed and had to keep myself from hugging him.
So darned cute.

Scary because kids are kids.
How do you assess cranial nerves in a 17 month old with blunt traumatic head injury with loss of consciousness?
How do you get a 28 month old to sit still enough to attempt to remove lice from eyelashes?
How do you convince a 16 year old boy that the dental abscess is probably a little bit more important than the play time he"s missing out on his Xbox?

Frustrating because parents.
Oh my goodness parents.

So yeah, fun times :)

On things to come...

Because everybody else is doing it, I thought I might as well too.

So most people in my year have just found out their rotations (well, "just" being 2 days ago) but I"ve been one of the totally lucky ones who knew over a week ago. I was one of many who was left with a missing term 1 due to the totally fair and perfect algorithm the magical School of Medicine computer uses to allocation rotations. Working fast, I managed to get what I thought was the best of the worst, but others were not so lucky. My heart weeps for the two people who had to do Chronic Condition Self Management, and my Respected Associate who had to do Neurological Rehabilitation.

Outlined below is what I like to call (for the first time) The Grand Plan:

Term 1: Musculoskeletal Rehabilitation
Location: Repatriation General Hospital
Probable job description: Fractured hips, femurs (heads, necks) and knee replacements I should think.
Personal thoughts: Could be hit or miss but its ok, I have company for this term and we"ll make the most of it. *sigh* At least the year can only get better...
Career opportunities: Physiotherapist, Masseuse

Term 2: Urban (Legend) General Practice
Location: My new favourite GP's practice. 
Probable job description: Being Awesome!
Personal thoughts: Very excited about this one, I"ve been having my GP placement here and from previous posts, you can probably tell I enjoy it very much.
Career opportunities: GP, Batman

Term 3: Critical Care Medicine
Location: Flinders Medical Centre Intensive Care Unit
Probable job description: Watching and waiting. Then waiting more. Also watching. 
Personal thoughts: Should get some good physiology and medicine knowledge here. Maybe do some management things.
Career opportunities: Intensive Care Specialist, Dr Robert Chase

Term 4: Emergency Medicine
Location: Flinders Medical Centre Emergency Department
Probable job description: Running around like a headless chicken.
Personal thoughts: If rotation quality was proportional to number of people wanting to do it, this would probably be the best rotation ever. It should hopefully be exciting. Alternatively, this could be so much work I might lose my mind. We"ll see.
Career opportunities: Alcoholic, George Clooney

Term 5: Unconfirmed
Location: Hopefully, Singapore General Hospital
Probable job description: Messenger boy
Personal thoughts: Hopefully I"ll be doing anaesthetics and general surgery.
Career opportunities: National Service, Ending sentences with "la"... la.

Term 6: Cambodia
Location: National Pediatric Hospital
Probable job description: Picking on little kids, stealing pocket money, etc.
Personal thoughts: This one should be fun! I like paediatrics :)
Career opportunities: Paediatrician, Nobel Peace Prize Laureate

Term 7: Vacation
Location: Asia
Probable job description: Being on holiday
Personal thoughts: This will be a lot of fun, aiming to go to China, Hong Kong, Taiwan and Japan.
Career opportunities: Dumpling King, Communist

Term 8: General Surgery
Location: Mt Gambier
Probable job description: Generally surgerising. Some surgery on generals?
Personal thoughts: Surgery is the topic I"m least excited about, but who knows, rural general surgery may be more exciting than urban general surgery (which consists of hernia, hernia, laparoscopic cholecystectomy, hernia, colonoscopy, colonoscopy, colonoscopy, colonoscopy, endoscopy, endoscopy AND colonoscopy).
Career opportunities: Obnoxious Pretentious Twat Surgeon

There we go. The plan is out.

So who"s excited?

Darwin Day 1 and 2

Day 1:
Finally in Darwin! For those that missed the news, I"ve come up to Darwin with a colleague for 4 weeks of our paediatric rotation. It will be grand!

Arrived at 2:05am Saturday morning, it was a nice cool 26 with about 70% humidity, it was wonderful!
Made it back to our holiday house (well, not ours...) and got shown to our rooms with nice big queen sized beds and airconditioning. We decided that it was time to crash (rightly so, it was about 3am...) and so we did.
Saturday morning (part 2) started with waking up to a beautiful day, mid-20s and of course, very high humidity. Our host took us out for a drive and tour of the area and the hospital, eventually leading to Casuarina, where we went shopping and picked up the essentials (chocolate and snacks...). Came back home and realised we forgot to grab some coldies! Silly us...

Another colleague of ours picked us up after his dance class (which he teaches, so talented...) for a late lunch on the wharf. Took the scenic route there and I spent my time trying to remember any of it from when I lived here. Since I left in 1995, this place has expanded so much! I had me some crocodile meat (delicious, very much a fusion of chicken and fish) which was great, my a colleague had camel burger (sounds meaty!) and our Darwinian colleague had a boring laksa... Hah.
Following the nice lunch, we went on for a big Darwinian tour and picked up a few more essentials (bike locks, beer) and came home to just kick back. I started/finished a book gifted by a funny accented colleague which was good, but kind of sad because of finishing a book I brought up in day 1... John Steinbeck Of Mice and Men, a wonderful book, well told story with amazing description and atmosphere.

Finished off the day with a nice light dinner and then some phone calls to family and friends.

Day two began early, as we decided to accompany the host to the Rapid Creek Markets. A nice busy market with fresh vegetables of the more asian variety, and a lot of food. We decided to pop by the Nightcliff Markets as well and found some more things (mostly food!) and then went to the Nightcliff jetty to eat up and relax.


We spent the remainder of the afternoon relaxing with drinks and reading.

The evening was spent at a beautiful place called the Darwin Ski Club (photos to come later!) where we relaxed (recurring theme here...) and enjoyed some cheap Coronas. We then went back to our colleagues place and had a delicious barramundi green curry.

Overall,the water is a beautiful colour here, a nice aqua/light blue which tempts you to go in, but unfortunately, there is way too many things here wanting to kill you. Swim at your own risk!

The weather is absolutely perfect at this time of year. Not too humid (well, probably too humid for some) and not too hot (again, mid-20s to low 30s, so possibly too hot...) and with a nice breeze most of the time. I love it! Since we"re just at the end of the wet season too, everything is wonderfully green and lush. We may see that all change before we leave though...


So thats all from me for now, things may be a little quiet from my end as the internet isn"t very accessible at the moment. Not that I need any excuse not to blog...

Ciao for now!

Oops!

So its been nearly two weeks since I last blogged... My bad.

But seriously, its my blog, meaning that in theory, I can blog whenever I damn well want to and should not have people bugging me about not blogging right?

Unfortunately not, it would seem.


Anyway.

So 2 weeks of paediatrics down, and I still love playing with children and distracting them and receiving that little look of gratefulness from the doctor. It almost makes me feel like there is a point to me sitting in the corner of a little clinic room, sneakily asking questions to the mother/father when the doctor needs to go out to find something or clumsily poking and prodding a small child when the doctor asks me to perform an examination or take blood pressures.

Children have such small arms, yet they manage to make so much noise with them. Curious isn"t it?

The past week has been a lot of fun, with another week in clinics.

I sat in on the Child Assessment Team ( or the CAT team if you wanted to make use of the silly way in which people like to make use of silly repetition in such acronymerised names, such as like in ATM machine or BAT team - Brain Attack Team for you people not in the business.) which seemed interesting. Interesting in that it seemed like the most expensive play session you could organise with your child without actually investing in diamonds or a circus. 6-8 specialists sitting in to watch a child play with toys and draw.

I also sat in on a less expensive version in which the child was assessed by the speech therapist, physiotherapist and occupational therapist.

I was lucky to sit in on a Renal clinic as well, which happens only once a month at FMC. The consultant was a hilarious man with a very relaxed attitude and amusing manner. His questions to me were straightforward and naturally difficult (especially to me, as I discovered that I had managed to forget just about everything about the kidneys...) but was quite willing to teach me when there was time.

The most exciting thing about the past week is that my daddy was here!
Lots of good home made food (which were I less lazy, I could also make, but the laziness usually pulls me to quicker, just as delicious meals...) as well as a restocking of my freezer. I should be set if the Australian Army decide to come over for dinner.

This weekend was quite a bit of fun as well as Friday afternoon started off with a feast put together by my dad, and continued with the celebration of the birthday of a Britannian/Prydein colleague in true boozer style starting at some bar and leading on to some indie bands, most notably Flat One which stars a current intern of Flinders. Very inspiring and really ruins my excuse of not having time to do anything...
This was very enjoyable but the late nights and moderate alcohol consumption made the next day quite troublesome. Pancakes (with bacon, caramelised bananas and real maple syrup) on Sunday was thoroughly enjoyable as I didn"t even need to go anywhere as another fellow colleague (this one from Canadia) brought everything over to my house to make!
Definitely fun as we poor sAdelaide residers were graced with the presence of a very much loved colleague who usually resides where the general human population is probably outmatched by the population of horses and livestock.

So yes, a thoroughly enjoyable weekend to top off a quite enjoyable week!

This week: Inpatients!
Ward rounds and history taking seems to be on the menu.

Which reminds me, what should I make for dinner?

Kids

I am thoroughly enjoying paediatrics so far (so far being Day 4 has been completed) and have decided that it is definitely in my shortlist of future specialities.
The last few days have been clinic after clinic, which has been good to see the range of paediatric disorders coming in.

Day 1: Introduction to paediatrics

Day 2: General paediatrics clinic
 - Hemangioma follow-up (infant)
 - Constipation follow-up + thalassaemia concerns (adolescent)
 - Pertussis (whooping cough) follow-up (infant)

Day 3: Neonatal clinic
 - 6 week (corrected) checkup (twins, one still in NICU, 10ish weeks premature)

Day 4: General paediatrics clinic
 - Developmental delay and unknown disorder with left sided abnormalities in the left ear, left eye, left kidney, left brachial artery (child)
 - Failure to thrive/coeliac follow-up (child)
 - Night terrors and language assessment (child)
 - ADHD medication reassessment (pre-adolescent)
 - Trisomy 21 follow-up (infant)
 - Sotos syndrome check-up (pre-adolescent)

Grand Round = Free food. It"s great!

Tomorrow will be an immunology clinic and then another general paediatric clinic with the Paediatric Super Consultant.

Its been a great few days, especially as I"ve been asked to do simple things like taking blood pressure and listen to breath sounds or heart sounds. They actually go quite well, it seems children seem to like me. I base it on my funny eyes.

Anyway, most of the time I"m just playing the part of a fly on the wall, but quite often I"ll have to step up to play the part of "clown" in order to distract the patient. It works surprisingly well. I may have missed my calling in life.

Paediatrics

Looks like I"m falling back into my poor blogging habits... Gotta get on top of that.

So I"ve just started paediatrics.
First day down and I"m quite liking the fact that paediatrics is so organised.
Surgery was a poorly organised and poorly maintained rotation in my opinion. Sure, the coordinator is very nice, but as stated by another surgeon "JW needs to learn to email and stop living in the 70s".
We"ve got plenty of teaching sessions in paediatrics and the first day was buffed with introduction to history taking and examination in the paediatric patient, as well as community health. Both lectures were quite interesting and very relevant.

Anyway, I should probably go get ready. I don"t want to be late on my second day!