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What a week! I just started in clinic and it was been great. Of course it's been hard too but I love it.
On Tuesday, I waited with eager anticipation in Teen Clinic for my first patient. Would it be a normal glasses update? Would it be a kid getting glasses for the first time? Eye infection? The minutes ticked by until finally they came....a mother and her 2 kids....ages 5 and 2. Ah!! In Teen Clinic?!? I looked at them both. The 2 year old little boy was bouncing off the ceiling and the 5 year old looked quiet and reserved. The doctor looked at me and my friend and asked, "Who wants the 2 year old?" I thought to myself, "I have 2 kids and he doesn't. I should do it." In a moment of "bravery" I volunteered.
My doctor and I took a few moments to discuss relevant tests, but largely she gave me a lot of freedom in my approach. After his mom brought him into my exam room, I asked a few quick questions and found out that he was just there for his first eye exam. No problems that she was aware of. Whew. After that, I played with the kid and snuck in tests as I could. After a while, I could tell the kid needed a break so I stepped out to report to my staff doctor. She sent me back in to try a few more tests, but he didn't respond well to them. At that point my staff doctor came in for a few more tests. Then the fun began.
It was time to dilate him so that I could check the health of the inside of his eyes . The mother held him on her lap while I put a drop in one eye. The kid started to cry and kick. Then, he opened his eyes to see where I was. His mistake. In went the other drop before he knew it. Then, I had him go out to the waiting room to separate him and the expensive motorized exam chair that he was so fond of. Half hour later, I called him back in so we could look inside his eyes. He came back in with his mouth covered in Cheetos cheese and still clutching the source.
Now, because he was a wiggly kid, my doctor wanted me to use my BIO (head mounted microscope) to look into his eyes instead of the usual slit lamp. Now kids don't like bright lights in their eyes so their parents usually need to hold them still while we do it. That was definitely true here. With his mother holding him on her lap, I tried to get a look inside his eyes. He fought back enough that mom's friend and my doctor helped hold him. With the 4 of us holding him, the little boy changed his volume setting from crying to screaming. After few minutes, I had only managed a quick view of the bottom half of his retina. The doctor switched me out so that she could try. Now this kid was really upset. I could just imagine people all poking their heads out of their exam rooms to see what was going on. After a few minutes of eternity, my doctor was able to see what she needed to see. My lens was smeared with Cheetos and forehead grease, my ears were ringing, and I was thrilled. I had seen a patient.
Wednesday I was in Vision Therapy all day. I paired up with various 4th year students and learned a lot. I was able to see 4 patients and was so tired by the time I went home. Nothing unusual, just a great opportunity to help some people.
Thursday I jumped right back into testing my limits. My first patient that day was a new patient just wanting to update her glasses. As I started asking questions, it quickly became more than that. As we went along, she mentioned something about having had a thyroid surgery. A thought occured to me so I looked a little closer at her eyes. Sure enough her eyes were bulging forward a bit. It went from there to dry eye, sleeping with her eyes open, and a few other things that tend to be associated. One of my favorite parts of the exam was getting to use the exophthalmometer to measure how far her eyes came forward. I tell you what, when I learned that technique in lab I sure didn't think I'd be using it on one of my first patients.
After that patient I was mentally exhausted. I needed a breather. It must have been my lucky day because in walked a young lady that had broken her glasses the week before and just wanted to get them replaced. :-)
My week in a nutshell: New. Challenging. Discouraging. Rewarding. Amazing. Intense. Routine. So many different feelings that occurred from moment to moment and patient to patient. And my time in clinic is just getting started.