a day as an outpatient peds doc

I spent my day yesterday from 9-5 in an outpatient clinic. I'm actually in outpatient clinic all week - 2 full days and 3 1/2 days. I still see newborns and inpatient's in the mornings. I enjoyed my day today and think that I'm meant for something outpatient. I know, I know - I'm supposed to keep an open mind and I am trying my best, but I feel good at the end of a day in an outpatient clinic, be it family or peds (my only 2 experiences yet). The rest of the year is yet to come and we shall see how it all pans out. Next week I'm on inpatient all week - so I will let you know how that goes.

But my day yesterday:

Your typical well child checks - 4 mo, 12 mo, 18 mo, etc. Those are just run of the mill - answer any questions parents might have. Make sure the kids are hitting all of their milestones - can they sit up, are they walking, talking, eating solid foods.
One specific cute 18mo old knew a little bit of sign language and made the best faces when I pushed on his belly and touched him with my cold hands. Another parent was worried about bubbles in their baby's poop. Dr. H calls them poop watchers, which most parents are. You only have to worry about it if it's red, watery, or black. Those are Dr. H's rules to poop. Personally, I think the baby is just making fart bubbles in her diaper.

Then we had a kid come in for a refill on his ADHD meds. Seemed like your normal quick visit for some amphetamines to help control the child. Some parental counseling about not letting this kid have a tv in his room, since mom is concerned because the child has a hard time falling asleep at night. Interesting part about this child is...as he is checking out he decides to turn around and vomit all over the floor. He seemed fine when I saw him. I asked...do I have to write that in his chart? Dr. H says pretend you didn't see it. Most likely viral illness. He'll be back in a few days if he's not feeling better.

Then a few 10 year olds came in for nausea, vomiting, and sore throat. Apparently in children usually 10 and under this is how Strep throat can present - with the nausea and vomiting. I saw one of the kids and Dr. C saw the other one. This boy had the best posterior palate petechiae I have ever seen! picture perfect - see below red dots on posterior palate!
this pic was taken from www.strepthroatinformation.com

So we did a throat swab. Rapid strep test came back negative. We thought this was rather unlikely seeing as his history and exam made it seem extremely likely. Dr. C did the next throat swab and definitely got a good sample - gagging and tears coming out of his eyes. We really wanted to treat him if this test was positive to quicken the course of the illness. Her swab came back negative too! The swabs are also sent out for culture which is more sensitive at picking it up. If it's positive then we'll treat. Otherwise for now it's most likely viral.

Followup Emergency Department visit for a child with a history of asthma and cough/cold. Kid also had epistaxis (bloody nose) 2x's yesterday am. This child's lungs sounded fine, he looked well - happy 15mo old interactive, alert, etc. Dr. H has seen this patient before and most likely a case of overly worried mom. So we talked to her some - the kid just has a cold.

That's all I remember for now. This is getting to be pretty long. So there you go - a typical day. May sound boring to you, but I enjoyed myself (minus the 4mo well child check where the baby didn't stop crying for the entire visit!).
Ok off to eat lunch and then back to clinic this afternoon!