Wednesday, September 16, 2009

Sex, Lies, and Madness!

Case 1: 24 y/o female presents to clinic for lab review. She had her annual exam and pap smear last week. Very sweet girl, in a long term relationship with her boyfriend of 3 years. On birth control.

Tested positive for gonorrhea.

"I don't understand how that happened..."

Unprotected sex. Case closed.

Case 2: 16 year old female presents to clinic with nausea, vomiting, stomach virus' x 2 weeks. History positive for smoking 1ppd and occasional marijuana use.

Last menstrual period: 2 months ago.

"Do you think you could be pregnant? Did you take a pregnancy test?" I ask.

"I did a few weeks ago and i was positive, but turned negative so I figured I wasn't pregnant."

"Well it is positive today. Congratulations."

She looks at me stunned.

"Do you think you can stop smoking?"

"Yes, I want to do all I can. I don't want to have a miscarriage like last time."

A tear falls from her eyes. I hand her kleenex.

"Is everything okay?"

"Yes it will be, just a little stunned."

"Is the father still in the picture?"

"No we broke up a few weeks ago."

I proceed to counsel her and give her a script for prenatal vitamins and some recommendations for her morning sickness.

Case 3: 55 y/o male presents to clinic with pain during urination. Urinalysis is negative for urinary tract infection.

While getting the basic history, I ask if he is sexually active. He looks down and says, "I lost my wife a few years ago and was not sexually active...until a few weeks ago. I met this girl and we really clicked. I thought we'd be together for a while. We did not plan to have sex but it just happened. Since it wasn't planned, we did not use protection. We are not together anymore. Do you think I may have caught something?"

So we test him for gonorrhea and chlamydia. A few days later he returns for results - he is positive for chlamydia...and treated. "I have learned my lesson" he says. I certainly hope so.

Sex, lies and madness. Sex can be such a beautiful precious thing - but boy can it be dangerous and life altering.

As always, some details are changed to maintain confidentiality.

Friday, September 11, 2009

A New Chapter Begins...

It has been almost 3 months since I completed my Residency in Family Medicine and started my new job - a small town Family Practice Physician. I absolutely love it! I work in a town with a population of about 1500 people, but services about 3000 including surrounding areas - and just 20 minutes from where I live! Staff of three at the moment, a nurse (RN), the office manager / receptionist,

I enjoy the patients - variety of ages and pathology. Ofcourse the bread and butter of medicine - Diabetes, High Blood Pressure, Heart Disease, but even the rare like a young girl with Phenylketonuria, a teeager with Von Hippel-Lindeau, and a few with Lupus, Rheumatoid Arthritis, and other ailments. The staff is absolutely great. And at the moment, I am doing clinic work only with no hospital call which has many benefits! I have a regular consistent schedule, enough time for a few activities with the church, and time to spend with my young daughter.

I am in the process of applying for hospital privileges so that I can follow a few patients in the hospital (20 minutes away but in the town where I live), but I won't have to take call. A new chapter in my life has begun.

Oh, and I passed my Family Practice Boards! Yay!

So professional wise things are going great. The family and I are preparing to move to a nicer neighborhood in the next few weeks. We closed on our first home a week and a half ago.

And my baby girl is just getting bigger and bigger! 18 months old now! Excellent speech skills and overall a very bright baby - of course I am biased. But even the daycare workers say so. She knows her body parts, even her eyebrows. She can say her name, knows her age and she is sooo loving and playful. She is my absolute joy!