Godspeed, Bernard

Tuesday, October 20, 2009

One thing I hate about my job is the fact that I would be dealing with death on a regular basis.

The problem is that I get overly attached to some of my patients, like Bernard.

He was 92 years old, married for 67 years to his beautiful wife, a WWII Veteran, and worked for one of the Big Three automakers for 43 years. He recently passed away.

When I first met him, almost a year ago, I immediately took a shine to him and him to me. Due to throat cancer he no longer had a voice but that didn't matter because we had our own form of communication. My favorite form of his "communication" was hearing him laugh hysterically at my funny stories.

I kept a constant watch on the schedule so when he was in for an appointment I could be the one to care for him. He became my "buddy". On the rare occasions where I was not available to handle his care I would seek him out and poke my head into his exam room. He never failed me. Not once. His whole body lit up like the Rockefeller Center Christmas tree everytime he saw my face. He'd laugh and slap his knee and we would exchange a huge hug. What a very dear man he was.

The week before he passed away he had been in the hospital and I visited him several times. His son and Bernard's wife, who always brought Bernard in for his appointments, would be there and we would sit and talk while Bernard slept.

Bernard definitely had a full life and I will miss him dearly.

Godspeed, Bernard.

Giving Up

Saturday, September 12, 2009

Last week I crossed paths again with a patient I've written about before. She was in our office for her weekly coumadin (blood thinner) check and was still in a relatively poor mood, even though the doctor put her on 50mg's of Zoloft approximately six weeks ago.

I cannot recall the list of her diagnoses, because it's long, but I can tell you that she has a PEG (percutaneous endoscopic gastrostomy) tube that is used to feed her. (This random picture, downloaded from the web, is what it looks like.)

My particular patient is in her 70's, weighs approximately 90 pounds, has a terrible odor about her and is not very nice to be around. Were it not for her husband and daughter at this visit she would have been unbearable. In short, she thinks everybody thinks she's crazy, and what we've learned about her, even though she has valid health reasons, is that she is a drug seeker. Her husband alerted me to this fact when he recounted a recent event of her attempt to overdose on sleeping pills.

During her most recent visit she was complaining about pain around her PEG tube and asked the doctor to look at it. After the female doctor and I gloved up, she started to gently remove the neat dressing covering it. (Later the doctor and I shared the same thoughts that we had expected it to be a pus-filled, open sore because of her unfortunate odor.)

What we found astonished both of us and is a HUGE testament to how well the patient's husband takes care of her. The entry point of and around her PEG tub was meticulous. Not even a hint red skin that would indicate an infection. Were it not for the PEG tub exiting her belly, her skin looked like that of a baby. It was amazing!

What we also know is that this patient has completely given up and would rather die than continue living in this condition.

*****************************************

One of my most favorite patients is an 80-something year old female, diabetic, coumadin dependent, and is showing signs of dementia.

When I started my externship at this facility ten months ago, she was able to walk. Now, due to severe edema of her lower extremities, she is pretty much confined to a wheelchair. In addition to the severe swelling in her legs, she also has a large open sore on her left shin and other smaller, not quite as bad, bedsores.

At her recent visit the doctor requested chest x-Rays and we had to do them while she sat in her wheelchair because she is not able to stand for more than a few seconds.

While a co-worker finished the x-Rays I stopped by the patient's room to talk to her daughter, a very sweet lady who brings her mother to every appointment.

I could tell by the look on her face how weary she was and, perhaps, in need of someone to talk to so I opened the dialogue by asking her how she was doing. As the tears welled up in her eyes she explained to me how her father deteriorated in the same way as her mother is and that five years ago on Christmas eve, he passed away.

She went on to tell me that on the day they were burying her father, one of our doctor's called to tell her that all of her dad's blood tests were normal.

The daughter also admitted that, as much as she doesn't want to lose her mother, she knows she won't get any better because her mother, too, has just given up.

Hit the Floor

Saturday, September 5, 2009

A recent patient encountered a series of unfortunate events as she prepared to leave her home for our office.

Shutting her electric garage door from inside it, she decided to do something many people have done ~ quite successfully I might add ~ run underneath it to the outside world.

Instead of flying unscathed underneath the closing door, it hit her on the forehead (causing a bruise and slight abrasion), which knocked her to the floor (giving her a knot on the back of her head).

I wouldn't have dared laugh during her intake if she weren't already laughing hysterically at herself. Honest!

15 Years

Patient: "I figure I have another 15 good years left."

CMA: "You have more than that."

Patient: "My family only lives to 80."

CMA: "You'll be the first to beat them."

Patient: "One did, but she didn't know who she was. I want to know who I am when I die!"

How to Save a Life

On Wednesday, September 2nd, I put to use a skill I learned through lecture, book work and a few (pretend) practice moves.

The Heimlich Maneuver.

As a rule, when lunchtime rolls around at the office, I prefer to leave the building and eat lunch elsewhere. I am a firm believer in the change of scenery doing a body good and I even take it to a higher degree by walking around one of the two large chain department stores nearby.

On Wednesday, however, I changed my routine. Although I left the building with the intention of having lunch outside of it, I wound up buying my lunch and returning to the office to eat it in our break room.

Initially I was eating lunch with three co-workers; two front desk staff and another Medical Assistant but we were soon joined by one of seven physicians in our practice. She, too, had purchased her lunch and brought it back to the break room to eat it.

As we talked about this and that ~ complete with laughing and giggling ~ the physician, who was sitting next to me, made what the rest of us thought was a laughing-with-soda-coming-out-of-her-nose kind of sound.

Grasping at her neck, we very quickly learned she was in serious trouble with something lodged in her throat.

As Dr. H scrambled toward the wastebasket and started wildly grabbing for the door to open it, I jumped up from my seat, wrapped my arms around her middle and gave her two quick thrusts dislodging the object (a piece of chicken) from her throat and onto the floor. (Later the Office Manager would describe it as a "text book" Heimlich.)

After the crisis was over the five of us returned to the table in an effort to resume eating our respective lunches. Sitting next to each other again, Dr. H quietly picked at her food as we glanced at each other several times. Neither one of us could believe what just occurred but we tried to make small talk anyway. Rubbing my arm, and in between quiet coughs, she thanked me for my help.

I was still overwhelmingly stunned, and the massive adrenaline rush was still flying through my body at warp speed, and I sat there with my body visibly shaking. I shook the rest of the day.

Soon, lunch ended and we were back to the craziness of another busy day. Every time Dr. H and I were near each other that afternoon, a look passed between us that spoke volumes without a word being said.

Once, she hugged me tightly and thanked me again saying she would like to take me out to lunch. I told her that that wasn't necessary and that although I preferred she didn't do that (choke) again, I had her back if she did.

Another life saved.

Stride

Wednesday, August 19, 2009

I haven't quite hit my stride with this blog yet. I always have things to share it's just that by the time I arrive home from work and get dinner out of the way I'm spent!

Many of the elderly patients we see bring a spouse, a sibling, or one of their children with them to their appointments. This is usually a good thing because it's another set of ears to hear the doctor's recommendation for treatment or to hear any changes to the patients medication.

I am always pleased to see a grandchild, or great-grandchild, accompanying their grandparent to their appointment because it reminds me of my own grandparents and how, if they were still alive today, I would have done the same thing.

Something I cannot stress enough is the having a current list of medications. It doesn't matter which doctor prescribed the medication, we just need a current list of every tablet, capsule, inhaler, and liquid ~ including over the counter vitamins, minerals, and calcium ~ that crosses the patients lips. It is extremely difficult for us to check for contraindications for a medication if we do not have an up-to-date list of drugs.

Unimaginable

Friday, July 31, 2009

Yesterday one of our doctors had to do the unimaginable; tell a patient she has lung cancer.

Since then, one of our front office gals has been trying to schedule a PET scan for this patient in order to determine which stage she is in. The insurance company, however, is not making that task easy to accomplish.

The entire approval hinges upon one, three-letter word: non. If the front office had listed the diagnosis as "NON small-cell carcinoma" the approval would have gone through without a hiccup. Instead it appears that our doctor may have to participate in a "peer-to-peer review" with the insurance company to discuss it.

Today, a delightful set of 87 year-old twins were in our office. (Only one needed to be seen.) The older sister (by 20 minutes), who was not being seen, whispered to me to make sure the doctor tells her sister to stop smoking. The patient even admitted to not taking her regular medication the past two days because the non-smoking medication she is taking makes her throw-up.

It didn't occur to me at the time to ask her if she was still smoking while taking the non-smoking medication because I am certain that is what was causing her to become so ill.

I am looking forward to my first four-day weekend. See ya next week!

Dementia, Lavage and a Yellow Hat

Monday, July 27, 2009

I drew blood from an 80-something, very funny, outgoing woman who was in our office today with her two adult daughters for a check-up.

When I see an order for labs, x-Rays, breathing treatments, EKG, etc. the first thing I do is poke my head in the room, introduce myself to the patient and explain to them what needs to be done. Then I excuse myself to gather equipment and paperwork.

With this particular patient, my introduction and explanation was met with a big grin and laughter. "Cool," I thought to myself, "this is going to be a fun draw!" Boy was I right!

After I gathered my supplies and paperwork and returned to the room the laughter and joking continued to flow. As I was finishing up paperwork I handed the patient her encounter form (which tells the front desk, among other things, what the patients diagnosis is) and explained that she needed to take that to the front desk, as she was leaving, and they would schedule her next appointment.

I was startled when the patient asked me "What is dementia?" I'm pretty certain my nervous laughter didn't hide the fact that I was caught off guard by this question and told the patient that her daughters could explain it to her. I truly didn't know what to say. When she asked me again she was laughing and she added "Does that mean I'm not right in the head?" I replied "You're perfectly fine in the head, Ms. Patient!"

Open mouth, insert foot.


Today I did my very first ear lavage BY MYSELF! It honestly wasn't as difficult as I have been thinking it was because one of the other MAs showed me how to use an apparatus the attaches to the sink. It provides a non-stop flow of water that is expelled through a gun by pulling the trigger. Additionally, if inserted in the ear correctly, the pressure of the water from the faucet provides a slight suction action that helps pull the impacted wax into the outer ear and, sometimes, sucks it right out and directly down the drain.


As I was walking by an occupied patient room, with the door open, I recognized a patient that I have cared for on a few different occasions. She looked very summery with her bright yellow hat and I told her she looked marvelous. As she and I were catching up, her doctor walked in and explained to me that she had cancer and is becoming healthier every day and showed me the patients fingernails. There was a clear ridge across each of her nails between where the chemotherapy destroyed part of them and the part that her body is regenerating new ones. The doctor also slightly lifted the patients hat to show me her new hair growth. The patient was so sweet in allowing me a glimpse into the ways chemotherapy ravages the body.


Today went by in warp speed!

Cancer

Thursday, July 23, 2009

In the past two days I have worked with two different female patients and each is actively battling a different type of cancer. Yesterday, it was oral cancer and today it was brain cancer.

The brain cancer patient, in her late 80's, was delightful to work with and that mischievous twinkle in her eye was unmistakable! It seems that ever since her (recent) brain operation she has struggled with constipation and, as she and her daughter explained, they had tried several different remedies in the hopes that one of them would consistently alleviate this uncomfortable problem.

One of the remedies ~ recounted by the patient, with wink and a look on her face that told me I was going to laugh hysterically ~ is a tea called "Smooth Move". Of course I started laughing and turned to the daughter and asked "Are you serious?!?". To which she replied, "Yep, it's actually called 'Smooth Move'!"

For several additional minutes, and everytime I caught a glimpse of her through the open exam room door, I felt like I was part of an exclusive club ~ like a secret handshake was required for admittance kind of club. I was truly blessed to have crossed paths with this elderly woman and her daughter today.

Today was absolutely nuts. From beginning to end. Although we had only 41 patients, there were only three medical assistant's ~ instead of four or five. It's enormously amazing the difference in work load between having four or five MAs instead of three.

When I first arrived at the office this morning there was already a patient in the waiting room. I instantly recognized it to be the widower of my beloved patient. After I put my purse away I walked into the waiting room to give him a hug, pay my condolences and tell him how sad I was that his wife passed away. When I asked him how he was doing he veered off into a different subject so I didn't press him. He, to me, looked so terribly sad and lost without his beautiful wife...

Numerous times times today charts were backed up at the front counter while the three of us were completing intakes, labs, nebulizer treatments or x-Rays ~ and we had no place to put the incoming patients anyway because the exam rooms were all full. Being that I am the new kid on the block I am not as quick at completing my intakes and it often frustrates the other MAs.

I wreck my brain trying to come up with ways to make my process more efficient, yet I refuse to take shortcuts that might reduce the quality of care my patients receive from me. One of the biggest pains we are feeling has to do with rewriting the patient's medication list. If a patient has a long list of medications he is currently taking, and I had several today, it can easily use up ten or more minutes of my time.

When I started this blog I told myself I would not use it to complain about my co-workers, yet today was the most frustrating day I have had so far with them and I wish to write about them ~ only to share how totally different the dynamics can be in an office and how I am personally trying to overcome them.

Our office has five MAs. One works part-time, two days a week, and the rest of us are full-time. The part-timer and I pretty much keep to ourselves, we don't complain, we have positive attitudes and are always heads-down and working. If a physician or a phone call interrupts our workflow, or a patient needs additional assistance, we're there. Without complaint. Without question. (See where this is going?)

Not so for the other three. Unfortunately, the ringleader likes to get the other two all stirred up and it causes unprofessional chaos wherever they have gathered, or crossed paths. These three feed off each other's complaining and negativity and some of the language, and conversations, used within earshot of the patients is completely unacceptable.

The ringleader feels everyone is out to "get her", she hates her job ~ I know this because I've heard it come directly out of her mouth. From what I gather, after listening to her ranting, she is just a miserable person altogether ~ and you can see it in the way she cares for her patients. I know this, too, because I've actually witnessed it AND intervened a few times and taken over the care of her patients.

Recently I was stunned beyond words when a patient told me she was glad I was drawing her blood instead of the ringleader. That says a lot.

The fact that she antagonizes the other two MAs to the point that they are acting just like she is, is disgusting.

Today my Teflon coat wasn't quite as thick as it usually is and I was having a little bit of difficulty trying to let their usual complaining roll off my back.

It could have started first thing this morning when I was filing charts and the "follower" yelled out my name. When I exited the file room she wanted to know why I didn't grab the one chart that was up and bring the patient back. I explained to her that I was filing and didn't see it.

Or maybe it started when the two of them, at different intervals, were yelling my name down the hallways? (How unprofessional is that?) When I stepped out of whichever exam room I was in at the time to acknowledge them they let me know charts were backed up and I needed to bring patients back. Couldn't they SEE I was with a patient?

Maybe it was the way the "ringleader" asked me to pull voicemails off our phone? Although she asked "please", was it the usual negative, rude tone of her voice that just rubbed me the wrong way?

Mostly I believe it was because of her constant complaining. Today I just couldn't shake it off. I am smart enough to never engage with any of the three when they are in one of "those moods" because, unfortunately, there is nothing to be gained by it. They have everything to lose.

Tomorrow, thankfully, is another day.

Wednesday, Wednesday!

Wednesday, July 22, 2009

Although today's patient load was middle of the road (41), the morning was the busiest part of my day.

Our office recently went online with e-Scripts and although it is currently slowing us down dramatically (as we continue to learn how to use it, and learn its idiosyncrasies), it will definitely save us time and effort in the long run.

Right now we are essentially "feeding" the system with each prescription we write. At some point we will be able to pull up the patient information and have the ability to view previous prescriptions and, with a few clicks of the mouse we will be able to refill that prescription instead of tedious task of searching the database for the correct drug, selecting it, choosing which dose, SIG, dispense and refills, etc., because we had previously "fed" that information into patient's profile.

e-Scripts is not just more efficient, it will also reduce the number of errors made when prescriptions are called in or faxed to the pharmacy.

I had the pleasure of working with two patients today, husband and wife, both in their 70's, that I had previously assisted around Thanksgiving. Not assisted as in they were my patients on that particular day, but physically assisted from the office to their car because the husband was so sick he was not able to walk and needed a wheelchair. The wife admitted to me today that she thinks about me often and how it was such a blessing I was there that day to help her and her husband and thanked me generously for my time. (It turns out her husband had a severe bacterial infection that took several months to resolve.)

Today they came in for their regular follow-up appointments which included determining their INR (coumadin/warfarin) levels. Being that coumadin/warfarin are blood thinners it is enormously important that these levels are checked on a regular basis.

The husband also received a B12 injection while the wife received a gynecological exam. I mention this specifically because I had both patients in the same room to do their intake and the husband cracked that he needed the "man's exam". The three of us really chuckled when I asked him if he meant the "finger wave?".

A third patient, female and 90 years-of-age, was clearly frustrated from the time she heard me call her name until I finished her intake. She was so distressed that her blood pressure was 186/92, when it usually falls within normal limits. Instead of waiting for the patient to tell me what was wrong I told her it was clear to me she was very frustrated. That broke the ice and she went on to explain how several phone calls had not been returned on the day she was admitted to the hospital ~ which was the same day as her last appointment, three weeks ago.

A fourth patient, who had been a patient of ours several years ago, had been referred back to our office by another doctor. During her intake she mentioned that 13 years ago one of our female doctors was the one who diagnosed her breast cancer.

I also had the opportunity of drawing blood on a new, younger patient, a 35 year-old man. (Our patient demographic leans heavily toward the over 65 crowd so it is refreshing to work with a patient near my own age.) I will be so brazen as to admit out loud that this patient was a quiet flirt, with amazing light blue eyes, and actually flirted with me.

Another young patient, a female around 30 years-of-age, also needed labs drawn today. Although she doesn't mind the needle itself, she hates the pain that the needle inflicts ~ which makes her loathe having her blood drawn. I told her I would do my absolute best to keep the pain minimal and set to work. I had already inserted the needle and was on my second tube of four when she asked me if that was all (the pain)? I told her it was and she said it was awesome and told me I was the best!

Recently our office changed the medication list (form) that is included in all of our patient charts (the list includes the medication, dosage, and instructions) so our intakes are taking longer than they used to. Any old medication lists (that are not on the new form) must be rewritten on the new form.

It's not a problem, per se, to do this, it's just that a generous amount of our patients are on more than a dozen prescriptions, from various physician's, and it is time consuming to translate all that information to the new form. For instance, a patient that was in our office today brought in a copy of his medication list that filled an entire 8 1/2 x 11 sheet of paper. It took me more than 20 minutes to copy all that information to the new form.

The afternoon was much more quiet and all the patients had been seen and checked-out by 3 p.m. so it was time to catch up on entering e-Scripts, pulling charts, and catching up on charting.

Crazy Monday!

Monday, July 20, 2009

Today was off-the-wall crazy-busy! We saw approximately 70 patients today and it seemed like 75% of them needed labs and/or x-Rays.

Two patients of note:

The first is a beautiful 95 year-old woman, who looked and acted 60, in our office for a regular check up. She is intelligent and funny with just a tiny bit of sassy thrown in for good measure. Not including vitamins, her medication list contained only three prescriptions.

The second is an 81 year-old man who, like the 95 year-old woman, did not look nor act his chronological age. Although his medication list was much longer and it appeared he had had a stroke, he is still very mobile. This patient is also very proud of the fact that one of his daughters is celebrating her 50th wedding anniversary. How cool is that?

Weird Week

Friday, July 17, 2009

This week was, in a word, weird. Two of the days we were totally slammed with patients and a third day was so light that we were able to get lower priority things done. (I only worked three days this week.)

We had two ear lavage's, which were nothing like the one I wrote about here, several EKGs and several chest x-Rays. The days just flew.

Today I drew a patient who dislikes needles in the worst way. Of course I didn't know this until after I poked him the first time and his pale white skin turned an odd shade of gray. The patient had nice veins but the first one rolled away from my needle so I had to poke him again. (It goes without saying that the patient was not happy about this but he didn't say anything.)

I gave him a few moments to breathe while I assembled my gear for a second try. Thank goodness I nailed it because I think he really may have passed out if I had to try a third time.

Note: I use the exam table extension, covered in table paper, as my work area. Doing so has three benefits: it's a large work surface, is the perfect height and, most importantly, if a patient becomes ill and passes out, they won't hit the floor.

Sad News

While I was on medical leave I was afraid one of my patients would pass away before I had a chance to see him/her again.

Well, my fear was realized when I found out today that one of my most beloved patients did just that. (I wrote about her here.)

I am so very sad...

Health Update II

Wednesday, July 15, 2009

It appears the most serious of my health issues have been resolved.

On June 4th, surgeons removed the plate and six screws that had been installed in my left foot and on June 24th, surgeons removed the wonky, overachieving parathyroid gland.

Three surgeries in almost exactly three months was more than enough and everything appears to be healing appropriately.

Thank goodness the parathyroid gland was removed in a "minimally" invasive procedure yet it took almost three hours in which to do it.

Another thing I struggled with, besides my health, was the fact that I was a brand new employee and the last thing I wanted ~ or needed ~ was to take a 5 + month medical leave.

Although I was reassured every step of the way that the practice wanted me back, I was still slightly fearful that that wouldn't happen. Today my fears were put completely to rest when I was told the doctors wanted me back in no uncertain terms.

Shaving the Inside of Your Skull

(A friend recently sent this to me. I hope you enjoy it.)

"You must become who you are. A life lived willy-nilly and at the whims of fashionable beliefs, is a life not lived at all, but a role inhabited by a stranger.

It is a life on route to a head-on conclusion with regret, rage and deception. By treating your life as an accident and therefore worthless and to be lived unmindfully, you deceive yourself most profoundly.

Only when you understand this will you experience rage and regret at the forces in you and outside of you that have kept your potential and true self locked away like a dirty secret you had no right to know.

It is not only your right, it is also your obligation to reclaim your true self from the scene of the accident and inhabit it fully, no matter the cost or outcry.

All the survivors of this accident have the same potential to recover from the trauma of the discovery that we're alive and it's not going to last.

All of us have the resources to wake up from the anesthesia of our "beliefs" and fears and to claim the health and growth that we paid for in full through our births and eventual deaths.

We had no choice in terms of payment and collection. We do have a choice in how we will spend what is left."

~ Mel Ash, from "Shaving the Inside of Your Skull"

Waiting to Die

Friday, July 10, 2009

Being away from the office for 5 + months meant I was also away from my patients. I like to call them "my" patients even though there are now five Medical Assistants in our office who care for them, too, because each ~ especially the frequent fliers ~ has earned a special place in my heart.

My first week back also brought the opportunity for me to see patients I have blogged about before. For example, the patient whose oxygen saturation and blood pressure were so far in the basement and her difficulty breathing was so clearly audible that she left our office in an ambulance. Her husband was so upset about the state of his wife that day that he cried and I wrapped my arms around him to console him.

Although it was nice to see them, as they are a pleasant couple, it saddened me to see her health had not improved in the least. I could tell by the look on the husband's face that he had resigned himself to losing his wife. Even though he was not happy that it would be on her terms.

I had hoped that the next time I saw this particular patient she would have gained some weight and that her health had improved. Even slightly. Instead, her weight was down from 100 pounds to 90 pounds and her daughter called our office the same day wanting to know why we couldn't see something was terribly wrong with her mother because she continues to lose weight. Before our front-desk person could respond the daughter had hung up on her.

This gave me an opportunity to explain to our confused front-desk person that the patient has refused every treatment offered to her. From psychiatric to pulmonary to home health care, and everything in between. She has simply made up her mind to die and she fully intends to have her own way on this.

Sadly, it won't be much longer.

Back to Work!

Monday, July 6, 2009

I returned to work on Monday, July 6th after 5 + months on a medical leave of absence. I have to admit that I was quite nervous about returning. My biggest fear having to do with venipuncture and whether or not I would "remember" how to do it properly. In as few pokes as possible.

I could not have been given a bigger confidence booster than to draw the same patient on my first day back from medical leave, as the patient I drew on the very first day of my externship, back in November.

The first time I drew this patient, in November, was disastrous. Of course I was nervous, and I had the voice of my instructor in my head taking me through the steps of the draw. Finding out the patient was a pediatric RN ~ before I drew her ~ only increased my nervousness 100-fold. She was also a difficult draw.

I believe I poked her three times (with her permission, otherwise I would have stopped at failure number 1!) before I asked the senior MA, who was overseeing my first few days, to take over.

I was thrilled ~ and much more confident than I had been last November ~ to be able to draw her again. Especially on my first day back.

I got her on the very first try. YES!

Health Update

Saturday, May 9, 2009

To bring everyone up to speed I broke my left foot on January 25th. The ER doc called the fractures "funky" and referred me to a Podiatrist.

After 8 weeks of casts, and absolutely zero signs of healing, my foot doc scheduled surgery for March 19th to install a plate and six screws. I immediately went to my personal physician and asked her to do a complete blood work up -- which is how we discovered my parathyroid glands are master overachievers. Not only were my parathyroid hormone levels through the roof but so were my blood calcium levels.

Until today I have been dealing with three diagnoses: fractured foot, 'hyperparathyroidism' and 'hypercalcemia'. The only way to correct hyperparathyroidism is via surgery to remove the gland that is causing the hypercalcemia.

These two conditions -- Hyperparathyroidism and Hypercalcemia -- kind of go hand-in-hand; the former causing the latter. In my case, these conditions are severe enough to cause me to have either a heart attack or complete heart failure.

Last week I visited the Nuclear Medicine department where they performed several scans of my parathyroid glands. Today I learned the results of those scans from my endocrinologist and it appears that only one of the four glands is affected and a surgical consult has been scheduled for June 1st. Hopefully surgery will be scheduled shortly after that. So far I was hearing everything I expected to hear from the endocrinologist.

What I had not planned on was hearing that I may have to have two surgeries to remove the messed-up parathyroid gland. The first surgery will be "minimally invasive" (outpatient, local anesthetic, very small incision on my neck.) I also was not expecting the doc to tell me there was a high probability that they would have to do a second, invasive surgery (under general anesthesia, large incision), to remove it. At that point I'm thinking, "WTF. Why not."

Then it gets better.

The last set of blood work the endocrinologist ordered shows that my immune system is attacking my thyroid (not parathyroid - although named similarly, they have nothing to do with the functions of the other) -- a condition called 'Hashimoto's Disease' (an autoimmune disease).

What this means is my immune system is essentially eating my thyroid gland and will continue to do so until there is nothing left of it.

[Note: The thyroid helps set the rate of metabolism - the rate at which the body uses energy. Hashimoto’s Disease prevents the gland from producing enough thyroid hormones for the body to work correctly.]

Thankfully Hashimoto's Disease can be helped with synthetic thyroid hormone replacement therapy. An ultrasound of my thyroid gland has been scheduled for Monday, May 11th to determine its size.

In two years I have broken three bones (elbow, nose, foot) and, so far, have had two surgeries (nose and foot). Soon I will be having a third surgery. Possibly a fourth.

Does it get any better than this? (That's a rhetorical question, by the way.)

Certified Medical Assistant!

Monday, May 4, 2009

I passed in the top 6% of those taking the January 2009 exam.

Carrie, CMA (AAMA) passed the CMA (AAMA) Certification Examination in January 2009, thereby earning the prestigious Certified Medical Assistant (AAMA) credential.

Mrs. Carrie is a December 2008 graduate of the medical assisting program at (redacted) and is employed by a multi-physician, multi-disciplinary practice.

The CMA (AAMA) Certification Examination, administered by the Certifying board of the American Association of Medical Assistants (AAMA), tests clinical and administrative knowledge needed for competent medical assisting practice. The CMA (AAMA) Examination is the only medical assisting exam that requires all of its candidates to be graduates of an accredited post secondary medical assisting program. The National board of Medical Examiners -- responsible for many national examinations for physicians -- serves as test consultant for the examination. As a result, the reliability, validity and security of the examination are of the highest order.

According to the U.S Department of Labor Bureau of Labor Statistics, "employment of medical assistants is expected to grow 35 percent from 2006 to 2016, much faster than average for all occupations...particularly for those with formal training or experience, and certification." Greater numbers of employers are preferring (or even insisting) that their medical assistants be CMAs (AAMA) due to the reputation of the credential as being the gold standard for the profession. Thus, CMAs (AAMA) comprise the majority of credentialed medical assistants in the work force today.

The American Association of Medical Assistants is a professional association headquartered in Chicago, Illinois. In addition to sponsoring the CMA (AAMA) Certification Examination, the AAMA provides continuing education programs and other benefits for medical assistants.

New Job!

Wednesday, January 28, 2009

The past three weeks at my new "job" have been crazy, to say the least.

I am still doing something I have been dreaming about for years, and I am loving every minute of it. But there are days (a lot of them) when I wonder why a few of my peers continue to do patient care when it is quite obvious they would rather be doing anything BUT...It not only makes me very sad, but there have been several incidents that have truly disgusted and significantly angered me to my core.

I have no intention of quitting this profession. In fact, I am steadfast in my resolve that as long as I'm around, all of my patients will receive the best care and the most compassionate MA in the universe. Bar none.