Wednesday, September 19, 2012

Soul Food and African-Americans - ABC News


Yum Yummy Hypertension! Where's my Amlodipine ??
Hello MedGirl MD family,
While interning at ABC News, we are allowed to write articles about the studies we vet for significance from time to time.

So I thought I would write more about my experiences in residency with my Grady patients.

When offered the chance to write about a subject that hits close to home, I did just that.

Hypertension is a MAJOR issue. It leads to stroke, heart attacks, heart failure, kidney disease and... lions, tigers and hypertensive crisis , OH MY !!!

Seriously,  soul food looks tasty and warms our hearts but it also can wear them out. Check out a study that shows that even when given the option for lower blood pressure with diet alone, some people just could not put the SALT down.

So hit the link and check out my article below.

Soul Food Stymies African-Americans' Low-Salt Efforts - ABC News

-MedGirl, MD

Thursday, September 13, 2012

Do you really know how your patient feels? Really?

Dr. Racquel Reid
Guest Blogger in all of her PsyGirl Glory!!

Drum roll please...
Please welcome our first guest blogger and fashionista, Dr.Racquel Reid, 2nd yr  Psychiatry resident at MSM.


     I was surroundedby adults, leaning back on my elbows on a procedure table in a cold, brighthospital room. To be honest, I don’t even remember them placing me there.  How long did I sit there before they startedthe procedure? Was my mother at my side? Did they tell me what they were goingto do? To this day, I am unsure. But what I can remember is this- my tears, mywailing, my utter distress as they pulled a long screw out of my left foot. Irecall a frustrated nurse pushing a children’s book into my hands when mysquirming got too much. I suppose my movement risked me hurting myself whilethey removed it, but I was eight and I didn’t understand. I also remember beingheld down at some point. Later they showed me the screw. Some of this memorymay be pure childhood fabrication, but I think it was bloody, and I passed outfrom terror and exhaustion soon after.

    In my mind’s eye,the rest of the hospitalization is a blur. I can remember my mother sleeping onthe little cot built into the wall in the corner of the room. I remember theBeach Barbie I played with as often as I could, as well as the fact that I wasannoyed I lost one of her high heels.  Irecall how much I hate the smell of anesthesia, especially the bubblegum kind,and involuntarily retch at the memory. I can still feel the pinch of the IV onthe back of my hand. However, I am relieved that my mind also kept pieces ofthe sweet, tender moments: mounds of teddy bears, visitors with smiles andkisses, and the PCA pump infusing sweet relief with the push of a button. 

      Oddly, I stillfeel scared from time to time. Frightened for this little girl, for myself,lying in a hospital bed. Going through so much so early.  You see, I was born with bilateral club feet.It was an isolated case, idiopathic, and luckily not part of a congenitalsyndrome. I was splinted immediately after my birth and then underwent a numberof surgical corrections to improve my ability to move my feet normally suchthat I may be able to eventually walk without difficulty. From what Iunderstand, the screw placement during that hospitalization in 1993 was part ofa routine foot reconstruction, and they didn’t want to put me back underanesthesia to take it out.

      Ironically, evennow I couldn’t tell you the name and number of my procedures, but I do have ascope. My mother kept all of the “certificates” from my hospitalizations. Theywere little paper awards that the hospital put over your bed congratulating youfor being brave during your surgeries. I look through them occasionally andfeel overwhelmed; there are about 15 of them, spanning from October of 1985(the year of my birth) to 1993. My mother told me once that the ones I saw werejust the ones she remembered to keep.

     The rest of mychildhood was serial castings, serial bracings, and doctor’s appointments wherethey always wanted to construct or reconstruct something else. My parentseventually decided to stop taking me to orthopedic surgeons and focus onphysical therapy instead to avoid my missing any more schooling. On a whimduring my first year of residency, I actually attempted to obtain my medicalrecords from Milwaukee’s Children Hospital, only to find that the cost ofgathering and shipping the documents reached almost $300.00. I was flabbergastedbecause I was told by Medical Records there that my documents would cost anaverage of $0.15 per page, meaning I had almost 2,000 pages worth of medicaldocumentation! I declined receiving them.

     I guess the goodpart of all this is in spite of scary screw-pulling, the surgeries thatpreceded them, and the panic-inducing cast removals that followed, my doctorsand nurses did their best to make the hospital less of a haunting place. Iremember being in awe by them. As early as I can remember, I wanted to be aphysician, because even with the pain and the tears, they treated me like aperson. An incredibly special person deserving of the best care that can begiven. And I wanted to carry that forward for every scared child like myself,lying in a hospital bed surrounded by beeping machines and concerned faces. Itry to remember that every day- that patients, adult or child, are frequentlyscared and overwhelmed. Often they are in pain- physically or mentally- andthey want us to remember that they are a special person and absolutelydeserving of the care we provide them.

      Nobody reallywants to hear physicians rehash the reasons we became doctors, often thereasons often sound like surreptitious self-praise. But the only reason I writethis is to remind us that we all can be patients, or were patients at sometime. We need to remember that in whatever branch of medicine we practice andhopefully perfect, we are in theory treating ourselves. If we can rememberthat, we can only be our best.





Racquel Reid, MD is a 2nd year psychiatryresident at Morehouse School of Medicine.

 She attended Medical College ofGeorgia (Georgia Health Sciences University) School of Medicine.
 She likesreading and no longer has a fear of screws. 

Monday, September 10, 2012

Surfing the Net...

Names have been changed to protect the innocent...


          What resident blogs ,who has trained at Grady Memorial Hospital, without the obligatory Grady story! Like to hear it ?? Here it goes!! So... it's my clinic day which tends to be pretty full. My ususal 8 patients had shown up. However, the most memorable part of my day was Ms. ummmm let's call her  "Ms. Georgia." She was a forty-something year old, who had a one year history of high blood pressure that was controlled on a medication that she took daily. The conversation...
Ms. Georgia: You my doctor honey? I never met you before!
Me: Yes mam, I am.  I'm Dr. (MedgirlMD) and we will be working together on your health! What brings you in today?
Ms. Georgia: Well, I got pressure (high blood pressure) but that ain't it girl! See I have a rash or something on my thigh. It doesn't itch now but it did a few months ago.
Me:  Can you describe the rash more, such as when  you noticed it and have you had anything like it before?

        We go over more history and description of her rash.We go over her medications. We discuss allergies. I ask whether it was painful or if she had contact with anything in that area of her thigh. I then ask her to disrobe of her pants only and cover herself with the provided gown. I step out of the room to give her privacy. On my return I examine the area of her medial left thigh where she said this rash would be. I found hyperpigmentation (darkening of the skin)  in the area with no exact shape and no depth. No evidence of scratching,  no bumps ... nada! I reassure her that I found nothing there. Given that her description did not yield anything I could suspect as a past rash, I gave her my impression. I tell her that I need to quickly discuss her overall management with my supervising physician and that she could get dressed. I leave the room , do as I planned. I knocked and announced myself...
Ms. Georgia: " Sure honey! Come in !"
I walk in and she is sitting in my chair , on my computer and in her underpants!!  
Me: "Ms. Georgia... what are you doing and why haven't you gotten dressed?"
Ms. Georgia:"I was surfing the net girl! I was checking Bossip! (an internet gossip site) What? I have internet, I just wanted to check something while I waited.

        I then asked her politely to get dressed while I stepped outside the room. I quickly returned to reassure her about her lack of a rash. Refilled her blood pressure medication. I then asked her why she was really on my computer? She said that actually she wanted to look at her medical records and see what I wrote about her. Interesting method aside ... I can understand the effects of these times where patients want access to their medical records on-line. I make sure how to tell her how she can properly access her medical records. Grady is one the few hospitals in the country that actually has electronic medical records for medical personnel to use but not for patients. At least not yet. Who knows what the future will hold. This does raise the question "How can we make our patients feel more informed and empowered?" What I am sure of is that I would rather that my patient not surf the net on my computer in her undies during her medical visit. Oh well! We can learn from anything ! SMH

Any interesting occurrences at your job??


Wednesday, September 5, 2012

I think I miss my pager... Nahh

     Being the new kid is never easy. However, if you want to do great things, you just might have to do something different. So I've packed it up and landed in Manhattan at ABC NEWS on 47 W 66th Street. I must admit, Atlanta has grown on me and I miss my beloved Highland Bakery. (Sweet potato diabetes pancakes!!)Despite my living in the NYC before, I have been lost!!! I've been walking in the wrong direction, taking the wrong train and ended up on Broadway!! (check out the pic) However, I made it to work in one piece.
 
      The ABC NEWS building is huge, the people are laid back, and the news guy Sam Champion is in jeans... chilling!! Where is Diane Sawyer?? One of my bosses who happens to be one of the senior producers for the medical unit, is a tall and brutally honest gent. "So.. you are Khaalisha?? Did you read my Residents Guide? (All 38 pages?? um..)  Yes? Okay, lets get you a desk so you can get to work." Gulp...  Many people wonder what in the world am I doing at ABC? Well, every month the Medical News Unit hosts a group of 4-6 residents from any discipline to come in and assess new medical journal articles before release to public and help decide if these new findings are applicable to the world audience. I'm not in front of a camera. Thank goodness! I probably would forget what a teleprompter even is!! My history of performing poetry would not help. My job? I simply vet articles for stories and if they are approved ... write some up and others might go to T.V.  Not so fabulous? Well for a nerd like me ?? Super fab! Too bad pre-released articles come to my email every two minutes all day!!! I am working with 4 other residents from Mt. Sinai , UIC , Univ of Arizona and University of Minnesota. One member of the team was even an attending. An all girl crew! And we are all fab, grateful and driven. 
 
      Sometimes I feel as a physician, that while on this rotation I am one of the gate keepers for public knowledge and safety. While I don't control public knowledge, I am proud to help to keep dissemination responsible ! Thank goodness for journal club because my job at ABC is like journal club on steroids!!  Dr. Harris, of Morehouse Cardiology, taught some great lessons in her journal club that I still keep with me! (Thank you!!)  Sometimes, articles that we all may read in the New England Journal of Medicine, and alike, will excite the press and consequently excites our patients. They will google a topic or see it on the nightly news and then come to our clinic and request a test that won't change the current standard of care! Sometimes the test has a risk of being unnecessary or harmful. However , they saw it, so they want it! It's about being informed and educating others about there health, responsibly!  
I am falling in love with NYC all over again!
I'm exhausted but excited! Today, I will get to visit the Good Morning America and World News set! Its also fashion week and my friends are here. This weekend belongs to me!


 

I will leave with a question? When was the last time you were the new kid and it took some getting used to ??