Real stories of the Branson ER

I have noticed that the patient population is a bit different up here in Branson vs Tyler ER. Yeah we used to get a crazy one every night or two at Mother Frances but this place is so much different. I would venture to say that half of my patients are crazy. By crazy, I mean what they come to the ER for is not their real problem. For instance, I had a 26 year old guy who came in because he suddenly got short of breath and he has these strange pains on his legs and arms. Well his real problem is that he shoots up meth, morphine, dilaudid, fentanyl and anything else he can get his hands on. He also had some other problems secondary to his drug abuse. I really did feel bad for this guy because he got the standard drug addict treatment: make sure nothing bad is wrong, give some fluids, kick them back out on the street. This is a guy who just has an addiction problem unfortunately. Another lady came in for an "asthma attack" that suddenly started when she went out into the heat(it is actually cold air that can trigger asthma). Well she started hyperventilating(because she was having an anxiety attack) and "rolled" her ankle getting into her car to come to the ER. She was CRAZY. I breathed on her ankle and she winced in pain. She wouldn't take a deep breath so we couldn't hear her normal breath sounds. She was whispering and panting like a dog but was not in any respiratory distress. I had a feeling she had played this game plenty before.

On a brighter node, I drained an abscess in a guys mouth and another one on another guys butt and they were both very relieved and appreciable. I performed a dental block on another guy with severe pain that was also appreciable. My favorite patients last night were a 15 year old kid with a dislocated shoulder and another guy with an irregular heart beat we call Afib. I helped reduce the kids dislocated shoulder which he was very thankful for and I shocked the other guys heart back into a normal rhythm and he said he didn't feel a thing(because we doped him up).

So all in all, the good overcomes the bad and it is all about having the right attitude toward everyone no matter what there underlying problem is. On that note, I am going to take today off and spend a little time with my wonderful family. I can't wait until our trip back to Texas next week for a little R&R.

ER Day 1

I thought I would go ahead a post a little something about my first day down in Branson. Alcohol is the word of the day. My first 3 patients consisted of 2 really drunk guys and one guy who needed to be drunk. Well that is of course because he had a seizure since he hasnt had a drink of alcohol in 2 days. That's strange you say, giving a guy alcohol because he had a seizure? Well yes, because this guy has been drinking at least a pint of vodka a day for 6 years. His body is used to a certain level of alcohol and therefore reacts oddly (seizure) when he doesn't drink. I saw how alcohol has destroyed the lives of these three men. One of whom has been drinking an insane amount daily since he was 11 years old! No joke.

On the brighter side, I really liked the ER and docs I worked with today. They just let me have at it and do my thing. I am really exhausted for some reason. I left the house a little after 7 this morning and got home about 7 this evening. Tomorrow I will probably work 11-11. My shifts will be long, but I can come and go as I please for the most part. Unfortunately for Aubrey, since this is my specialty of choice, I will probably work much more than I should just to learn as much as possible. Therefore, pray for Aubrey that she can make it through this next month of me being gone all the time. Well I am tired and I have to look some stuff up so I will shut this one down. Later.

Saturday Night Fever

Emergency room, Branson, Missouri here I come. Yes, I did in fact make it through that unsatisfactory surgical rotation I once spoke of. My last week was probably actually the best one. Not just because it was my last, but also because it was relatively more relaxing due to a lower patient load. I did however have the pleasure of assisting on a 4 hour double mastectomy on Tuesday. The problem was, our patient had very, very large breast. To give you an idea, the incision to remove each breast was about 12 inches long. We removed one and I closed/sutured the incision while he started on the other side. As you could imagine, this took me a while. I wanted to make sure I got a good cosmetic result since that is all the patient notices after a surgery like this. I finished my test on Thursday and did okay. Now I just have to finish my rough draft for my research/thesis project. I know my readers are dying to know the topic so I will share. Approach to Nephropathy in the Type 2 Diabetic Population. Riveting for all you non-medical junkies.

The family had an outing to Branson last night and enjoyed our favorite mexican food in the area, Cantina Laredo. Today we did the usual around the house stuff. Tomorrow we are going to take a trip to Joplin to see one of my classmates and his wife who have a 3 month old boy. Then, Monday I begin my almost daily driving back and forth to Branson to crash the ER. I will try to post more frequently on my encounters from the ER for all you adrenaline junkies.

Tomorrow will be day 40 of our countdown to The Missouri Exodus of 2011. We are excited to say the least. I'm hoping Lydia will be walking by then so she can help load the moving truck. We will be having our first ever garage sale in a few weeks to help lighten the load hopefully. Well I am now going to wrap this Saturday night diatribe up. To God be the glory, great things he has done!

8 weeks away

After one the the most physically exhausting weeks of the year for me, I decided to sleep in today until after 10. Of course we went to bed kind of late and I was severely lacking sleep/rest since Monday. I only got to see Lydia yesterday for 20 min or so. That was a bummer because I really enjoy my father-daughter time. I inherited tickets to a musical at the Springfield Little Theatre last night so we decided to get a sitter and go out as just a married couple. I was not all that excited to see a musical but it was actually very good and laced with talented youngsters. It was nice to spend some time with the wife and we hope to do some more of that when we get back to Texas. Speaking of that, we are 8 weeks away(hence the title) from moving out of this humble abode in Missouri. That seems very much within reach and I can't believe our time here is already coming to an end. That being said, it's not a moment too soon.

So I have just completed 4 weeks of a 6 week rotation in surgery. Fortunately my preceptor is on vacation all next week. Therefore I am taking the opportunity to complete a required 1 week rotation in palliative care/hospice. That means I will only have 3 more awful days of surgery until I finish this rotation. One thing I have learned is that I do not particularly care for working in surgery. This is the only field where as a PA, you really are more like an assistant. You are at the mercy of the surgeon you work with and I don't like it. I prefer to work autonomously and make the final decision on my patients. Of course my disdain probably has a lot to do with my current overinflated, arrogant, never wrong, sinless, only fellowship trained breast surgical oncologist in the region, curer of cancer surgeon that I have the pleasure of working with. He literally makes me laugh and sick all at the same time as I listen to his arrogance all day long. I will now bless you with a quote said in all seriousness during a surgery this past week. "I don't have a good feeling about these (lymph) nodes, I just hope that I'm wrong for once in my life." And boom..there you have it folks. Reminds me of a book titled "When People are Big and God is Small." Lord have mercy on me and forgive me for any arrogance that I feel inside and display outwardly as well.

I should now eat something(because I feel malnourished from the past week) and work on some school work. Really and truly I will probably play with Lydia for a while and then piddle around the house. Adios y vaya con Dios.

Update

Update: I am currently doing my surgery rotation and the hours are rather horrible. Got home after 10 pm last night after doing what we thought was going to be a routine appendectomy. Come to find out when we got in the belly, the guy actually had a rare complication from a rare problem called a meckel's diverticulum. Had to do a small bowel resection but everything turned out okay. We are also on call today. Fortunately I don't have to be in until 11 but I probably won't be home until late into the night. My saving grace is that my preceptor is on vacation next week. Therefore I am going to complete a required 1 week rotation in hospice in the interim. Morbid, yes. Hours are great though. That will give me time to catch up on studying and write a research paper that is due in a couple of weeks. My next rotation which starts in less than 3 weeks is emergency medicine in Branson. I have really been looking forward to this one. It feels like I am going home to my comfort zone.

Another exciting thing going on in life right now is the fact that we will be moving out of Springfield in 8 1/2 weeks. Seems unbelievable yet overwhelmingly exciting as well. Before we move out we would like to do a few things as a family. We want to go visit St. Louis together and the last free zoo in the Country. Also, take Lydia to the Buffalo river since we are so close. I would like to visit Kansas City also because I hear it is kind of pretty. Unfortunately we are limited on funds and at the moment, time to complete these missions.

That is all for my current update and on a side note..Don't go visit a surgeon unless you want your gallbladder taken out. KSkinn out