Wednesday, November 29, 2006

Circle of life

So, I spent my day with Doc (the MD I am working with right now...they actually call her Doc) at a very nice nursing home, and it reminded me how much I love old people! Geriatrics does have some depressing aspects to it, but most of it is actually very rewarding. I spent an entire month training in geritriac inpatient care 2 months ago and really enjoyed a lot! It is very challenging since so many of them have a lot of health issues, but it is very interesting, too. Plus, I love to be challenged. It made me realize just how much our elders really are amazing people. Most of them are very grateful for your help, and many just enjoy having someone around who will listen. They have been through so much & have many great stories to tell. I have met several who cracked me up & made me smile with their great sense of humor & great spirit. It's hard to not get close to some of them & their families. During my month in geri, one of my patients passed away, and it was emotionally tough. I tried so hard to be strong when I was talking to the family, but the HUMAN WITH FEELINGS came out and I sat down & cried a little with the family. I think that they were actually glad to see how much I cared. I realized it is ok to be human when being a caretaker. It's ok to show emotion. It was a tough experience, but I think these experiences make me a stronger person. They also teach me about life & death issues, which in turn will help me help my future patients and their families. I've already dealt with death a few times just in my short time in my clinicals, BUT I have also seen many more people get well.....babys be born....and even got to deliver one baby....and help with many others......that circle of life we always talk's amazing.

I'm still not sure what area I will work in, but family/internal medicine will be at the top of my list of possibilities....that way I can work with all ages from kiddos to elders AND I get to be involved in many aspects of medicine. We shall see....

It is starting to annoy me....

I am started to get annoyed with people asking me when I am going to medical school. I know they mean no harm by it, but I really want people to know that being a PA does not make one a lesser person than someone who is a physician. Also, like my other post about "What exactly is a PA?"states, people don't apply to PA school b/c they can't get into med school or failed out of med school. As a matter of fact, it is incredibly difficult to get into PA school and is HIGHLY competitive....some say even more so then med school. Anyway, we choose the profession for various other reasons. It is a great profession in its own right. There are some PAs that do eventually go to med school, but the majority are very happy with being a PA. IN FACT, I have had several MDs tell me that they wished that they had become a PA instead.

Ok. That's my vent for the day. ;) Now I have to post a positive note.....

Tuesday, November 28, 2006

Good Grief!

Nothing like A Charlie Brown Christmas to get you in the spirit! I love it!!!

They even sell the tree!!!! That's awesome!!!!

Here is our Charlie Brown Tree. "Merry Christmas Charlie Brown!"

What exactly is a PA?

PA stands for Physician Assistant (no " 's " after Physician). Not to be confused with a nurse, medical assistant or someone who gets the doc his/her coffee. :O) Here are some common questions....

Q: What is a physician assistant? What can a P.A. do?
A: A physician assistant (P.A.) is a licensed health professional who practices medicine under the supervision of a physician. A physician assistant provides a broad range of health care services that were traditionally performed by a doctor. As part of the physician/P.A. team, a physician assistant exercises considerable autonomy in diagnosing and treating illnesses.
What a physician assistant does varies with training, experience, and state laws. In general, P.A.'s can provide approximately 80 percent of the services typically provided by a family physician. They perform physical exams, diagnose illnesses, develop and carry out treatment plans, order and interpret lab tests, suture wounds, assist in surgery, provide preventive health care counseling, and in 39 states, including Maine, can write prescriptions. A P.A. can do whatever is delegated to him/her by the supervising physician and allowed by law. In most states, a P.A. can treat patients when the physician is away from the practice.
The scope of the P.A.'s practice corresponds to the supervising physician's practice. For example, the P.A. working with a surgeon would be skilled in surgical techniques in the operating room, perform pre- and post-operative care, and be able to perform special tests and procedures.

Q: What is the difference between a P.A. and a physician?
A: Physician assistants are trained in the medical model. In some schools they attend many of the same classes as medical students. One of the main differences between P.A. education and physician education is not the core content of the curriculum but the amount of time spent in school. The length of a P.A. program is about two thirds that of medical school. Physicians also are required to do an internship, and the majority also complete a residency in a specialty; P.A.'s do not have to undertake an internship or residency. A doctor has complete responsibility for the care of the patient; P.A.'s share that responsibility with the doctors. Doctors are independent practitioners; P.A.'s practice medicine under the supervision of a physician.

Q: How did the physician assistant profession begin?
A: In the mid-1960s, physicians and educators recognized a shortage and an uneven distribution of primary care physicians. To expand the delivery of quality medical care, Dr. Eugene Stead of the Duke University Medical Center in North Carolina put together the first class of P.A.'s in 1965. He selected Navy corpsmen who had received considerable medical training during their military service and during the war in Vietnam but who had no comparable civilian employment. He based the curriculum of the P.A. program in part on his knowledge of the fast-track training of doctors during World War II.

Q: What areas of medicine can P.A.'s work in? Do P.A.'s specialize?
A: Physician assistants are found in all areas of medicine. Today, approximately 50 percent of all physician assistants practice what is known as primary care medicine, that is, family medicine, internal medicine, and pediatrics. About 23 percent are in surgery or the surgical subspecialties. Physician assistants receive a broad education in primary care medicine. Their education is ongoing after graduation through continuing medical education programs that are required and through continual interaction with physicians and other health care providers.

Q: Where do P.A.'s draw the line in what they can treat and what a physician can treat?
A: What a physician assistant does varies with training, experience, and state law. In addition, the scope of the P.A.'s practice corresponds to the supervising physician's practice. In general, a physician assistant will see many of the same types of patients as the physician. The cases handled by physicians are generally the more complicated medical cases or those cases requiring care that is not a routine part of the P.A.'s scope of work. Referral to the physician, or close consultation between the patient, P.A., and physician, is done in unusual or hard to manage cases. Physician assistants are taught to know their limits and refer to or consult with physicians appropriately. It is an important part of P.A. training.

Q: Can P.A.'s prescribe medications?
A: Most states and the District of Columbia and Guam allow P.A.'s to write and sign prescriptions without a physician cosignature. These prescriptions will be filled by pharmacists.

Q: How much education and training does a P.A. receive?
A: Most P.A. education programs require applicants to have previous health care experience and some college education. The typical applicant already has a bachelor's degree and more than four years of health care experience. Nurses, EMTs, and paramedics often apply to P.A. programs. P.A. programs look for students who have a desire to study, work hard, and be of service. On average, an accredited P.A. program lasts 25 months. P.A. programs are accredited by an independent organization sponsored in part by the American Medical Association. All PA programs must meet the same standard curriculum essentials.
P.A. students typically study anatomy and physiology, pharmacology, microbiology, internal medicine, pediatrics, emergency medicine, obstetrics and gynecology, geriatrics, surgery, and psychology. These classes are taught as both lectures and lab sessions. P.A. students also spend at least one year in clinical rotations. During this period, they treat patients in each of the major disciplines of medicine and perform additional course work on campus.
A P.A.'s education doesn't stop after graduation. P.A.'s are required to take ongoing continuing medical education classes and to be retested on their clinical skills on a regular basis.

Q: What does P.A.-C. stand for? What does the C mean?
A: Physician assistant-certified. It means that the person who holds the title has met the defined course of study and has undergone testing by the National Commission on Certification of Physician Assistants (NCCPA). The NCCPA is an independent organization, and the commissioners represent a number of different medical professions. It is not a part of the P.A. professional organization, the American Academy of Physician Assistants (AAPA). To maintain the C after P.A., a physician assistant must log 100 hours of continuing medical education every two years and take the recertification exam every six years.

Q: When are you going to be a doctor?
A: P.A. training is demanding in its own right. This route to a medical career is neither a short cut, nor an easy way out. P.A.'s are not people who didn't get into or who flunked out of medical school. They decided to become a P.A. for a number of personal reasons. They enjoy what they are doing and get great satisfaction from providing quality, affordable, and accessible health care.

Q: What do doctors think about P.A.'s?
A: Most physicians who have worked with physician assistants like having P.A.'s on staff. The American Medical Association, the American College of Surgeons, the American Academy of Family Physicians, the American College of Physicians, and other medical groups support the physician assistant profession by actively supporting the P.A. certifying commission and the P.A. program accrediting agency. Studies done by the federal government show that P.A.'s provide care that is comparable to physician care. The Eighth Report to the President and Congress on the Status of Health Personnel in the United States (released in 1992) states that physician assistants have demonstrated their clinical effectiveness both in terms of quality of care and patient acceptance

Monday, November 27, 2006

Workin' at the car wash!

We had a nice four-day holiday full of family, yummy food, spending time with the pets, sleeping, & football. We also fit in some cleaning & Christmas decorating (our little Charlie Brown tree which I will include pics of later), some studying for me (exam in less than 2 weeks...eek!!!), and some shopping. We actually braved the shops & traffic on Black Firday!!! It was MADNESSS! I must admit..... the shopping ended up being some business suit jackets for me & some stuff for our ski trip. We have yet to start our Christmas shopping!!! It's going to be here before we know it! Ack!

We finished off the warm, beautiful weekend (70s - low 80s) with some car washing. It was a great, restful weekend, man, I could use four more days!!!

Thursday, November 23, 2006

Thankful for

I am most thankful for my family & friends.

I have to post some pics of my cutie nephews.....

Give Thanks

Happy Thanksgiving!

An Empty Place at the Table
By Gary Palmer
Thanksgiving, as an official United States holiday, is inextricably linked to our nation’s founding and to its times of war.
The first official thanksgiving proclamation was issued in 1777 by the Continental Congress after the American victory in the Battle of Saratoga. The proclamation asked God to “…smile upon us in the prosecution of a just and necessary war, for the defense and establishment of our unalienable rights and liberties.”
Later, on October 3, 1789, eight years after the surrender of the British army at Yorktown, President George Washington issued a proclamation “to recommend to the people of the United States a day of public thanksgiving and prayer, to be observed by acknowledging with grateful hearts the many and signal favors of Almighty God, especially by affording them an opportunity peaceably to establish a form of government for their safety and happiness.”
President Washington assigned “…Thursday, the 26th day of November next, to be devoted by the people of these States to the service of that great and glorious Being who is the beneficent author of all the good that was, that is, or that will be; that we may then all unite in rendering unto Him our sincere and humble thanks for His kind care and protection of the people of this country previous to their becoming a nation.”
Not until President Abraham Lincoln began issuing a proclamation for a national day of thanksgiving did it become the custom of U.S. presidents. In the midst of the worst war in our nation’s history, Lincoln established a permanent observance by calling on the American people “…to set apart and observe the last Thursday of November next as a day of thanksgiving and praise to our beneficent Father who dwelleth in the heavens.”
Since then, every U.S. president has issued a proclamation calling for a national day of thanksgiving each November. However, it was not until 1941 that Thanksgiving became an official national holiday.
As the war in Europe and the Pacific escalated, along with growing fears that America would soon be involved, Congress established the last Thursday in November as our national day of Thanksgiving. On October 6, 1941, just two months before the Japanese surprise attack on Pearl Harbor, the House passed a joint resolution declaring the last Thursday in November to be the legal Thanksgiving Day. The Senate, however, amended the resolution establishing the holiday as the fourth Thursday, which would take into account those years when November has five Thursdays.
President Franklin D. Roosevelt signed the resolution on December 26. In his accompanying proclamation, President Roosevelt said, “The final months of this year, now almost spent, find our Republic and the nations joined with it waging a battle on many fronts for the preservation of liberty.” He added, “It is fitting that we recall now the reverent words of George Washington, “Almighty God, we make our earnest prayer that Thou wilt keep the United States in Thy holy protection,” and that every American in his own way lift his voice to Heaven.”
Given that our national day of Thanksgiving is inseparably linked to the sacrifices of so many of our fellow Americans, past and present, it seems appropriate to give thanks to God for their service and to remember them in a more obvious way.
It is customary at formal military dinners to set an empty table representing all the members of our armed forces that have not returned home. The empty places are a visible reminder to everyone present of their comrades-in-arms that are not with them, especially those that will never be with them again on this earth. When American families gather on Thanksgiving Day, outside of the families with loved ones deployed or lost in battle, probably a relative few will have any visible acknowledgment of our men and women in uniform when they gather at their tables.
Perhaps it is time to establish a new tradition in every American home this Thanksgiving by setting a place at our dinner table that will remain empty as a visible reminder of those that serve and of those who wait anxiously for their return.
As we bow our heads in prayer, thankful for the many blessings that we enjoy, let us give thanks that we live in a free land that is so faithfully defended by free people, who, of their own choosing, voluntarily put on our nation’s uniform and leave hearth and home to defend us. Pray for the peace and security of our nation and that every plan our enemies make against us will fail. Pray for blessings on the suffering people in the lands of our enemies and for those people that are bravely and at great price, defending their new found liberty. And pray for the safety and security of every soldier, sailor and marine in our armed forces and for the families they left behind.
Finally, say a special prayer of gratitude and comfort for those families who now have a place at their table that will forever remain empty.
Gary Palmer is president of the Alabama Policy Institute, a non-partisan, non-profit research and education organization dedicated to the preservation of free markets, limited government and strong families, which are indispensable

Also, a quick, easy, & yummy dessert for any holiday:

Pistachio Salad (also known as Watergate Salad)
1/2 package of Miniature Marshmallows
1 pkg. (4-serving size) JELL-O Pistachio Flavor Instant Pudding
1 can (20 oz.) Pineapple tidbits drained
1/2 cup chopped Pecans
16-oz. tub thawed COOL WHIP Whipped Topping

MIX marshmallows, dry pudding mix, pineapple and pecans in large bowl until well blended. ADD whipped topping; stir gently until well blended.
REFRIGERATE 1 hour or until ready to serve.

Sunday, November 19, 2006

It's a good life

Well, the good thing about the hubby & I being sick is that it gave us an excuse to be lazy all day Saturday. We slept in (meaning past 7am) & watched football and movies all day! It was so nice! AND I actually got to place house-wifie for a chance....made some rice-crispy treats and a yummy Italian chicken dinner with a nice glass of red vino. The hubby is usually the one who plays "house-husband" since I have been in school. Pre-PA school, the house work and cooking was pretty evenly spread between us, but he has been so awesome at taking on the tough role of house-hubby (and still working full-time of course). I try to help out as much as I can when I can, and some medical rotations allow for more time than others. Anywho, it was a nice, lazy day!

So, when did our nation decide to jump straight from Halloween to Christmas??? Has anyone else noticed this insanity. I swear, as soon as Nov 1 hits (and some places before that), Santa and other Christmas stuff is everywhere! Um, what happended to Thanksgiving???? Oh, that's right, a holiday of "just giving thanks" doesn't bring retailers money unlike Christmas where we actually physically GIVE STUFF to others and big retail chains can make money off of us. Quite sad, isn't it. The other sad thing that I am hearing is that some stores are feeling FORCED to say "Merry Christmas" now. I was one of those people that was sad to see the lack of "Merry Christmas" in stores, etc, but now that I hear that they feel obligated to say it b/c they were losing customers doesn't make me feel any better. Sheesh. Well, we live in a money-driven world. Atleast I know that it still means something sacred to my family members and friends.

On a lighter note, we are starting to get the holiday bug. We actually started to watch Christmas movies already!!! Yesterday it started with Home Alone and then.............. that's right........ National Lampoon's Christmas Vacation. In our household it is a nightly ritual to fall asleep during Christmas time to this movie. AND we still laugh every time we watch it. It's hysterical!!! We have watched it so many times, I bet we could say all the lines in our sleep. Here are some great quotes from the movie:

Bethany: Is your house on fire, Clark?
Clark: No, Aunt Bethany, those are the Christmas lights.

[Todd and Margo Chester, the Griswold's yuppie neighbors, appear]
Todd: Hey Griswold. Where do you think you're gonna put a tree that big?
Clark: Bend over and I'll show you.
Todd: You've got a lot of nerve talking to me like that Griswold.
Clark: I wasn't talking to you. [Todd's wife Margo gasps]

Clark: Burn some dust here. Eat my rubber.
Rusty Griswold: Dad, I think you mean burn rubber and eat my dust.
Clark: Whatever, Russ. Whatever.

Great movie! :o)

So, today we went shopping looking for stuff for our upcoming ski trip (and only got some gloves ha!) and trying to get ideas for Christmas gifts. The funny thing was the hubby was pointing out things I got him for his upcoming birthday. I couldn't take it anymore and actually gave him his birthday gifts when we got home....a week and a half early!!! He loved it! ;p Now I have to get him like a pair of socks or something to actually be able to hand him something on his birthday. heehee. Perhaps next year I should wait until a little bit closer to his birthday to buy gifts. :)

Well, I better get back to watching the Simpsons, and then get some studying done.

YEAH!!! .... A three day week. It's almost Turkey Day!!! Gobble Gobble!

Thursday, November 16, 2006

November is Lung Cancer Awareness Month

From the M.D. Anderson website:

According to the American Cancer Society, more than 174,000 new cases of lung cancer are expected to occur in 2007.

Lung cancer is one of the most preventable cancers. Smoking is responsible for 87% of all lung cancer cases in the United States. Eliminating tobacco use is the key to reducing the impact of this disease.

Lung cancer occurs when cells in the lung grow and multiply uncontrollably, damaging surrounding tissue and interfering with the normal function of the lung.

The five-year survival rate for localized lung cancer is 50%, while the five year survival rate for lung cancer for all stages combined is 15%. Even though breast cancer is the most commonly diagnosed cancer in women, since 1987, more women have died each year of lung cancer than from breast cancer.

Ok! I'll try it!!!

I never thought that I would do this blogging thing. Why do we post our lives all over the web? Well, sounds like so many people have fun with it, so I thought I would try it. So here goes.....

Unfortunately, today I am home with a nasty upper respiratory infection. Ah, the joys of being a PA student during the clinical to so many bugs!!! bleh! "SNIFF - COUGH!"

I am currently in my second year of PA school, and am almost half way through my clinical year. The rotation that I am on right now is at a family & internal medicine clinic in Alvin. I work with a physician, a PA, and their staff. As a student, I go in and see the patient first and then present to the physician or PA with my assessment and plan for the patient. Then we go in together to see the patient again, and the physician/PA creates their own or agrees with my A&P. So far I have completed OB/GYN, Pediatrics, and LBJ pedi ER, Geriatrics inpatient, and community/underserved internal medicine in Nacogdoches. After this medicine rotation, I will have my primary care block in which I will be doing more family medicine in Port Arthur, cardiology in Texas City, and psychiatry in Kingwood. My last block is general surgery in Victoria, emergency medicine, and my last rotation is my surgery elective at MD Anderson. I end my clinicals in June of 2007, and then I spend the rest of the year on research, practice issues classes, and studying for the board exam. I think we finish up in October, but don't graduate until mid-December 2007. I'll probably take my board exam in January 2008, and hopefully quickly have a job soon after that. PHEW! Well, that's a synopsis of what I have instore for the rest of my time in school.

"SNIFF!" Man, I hate being sick!!! Time to go rest and sniff & cough some more..... grrrr.

More later...

~ Alli - AKA: " the tired PA student"