Medicine – Page 14 – CA Work Experience Program

Day 3 Update – Huff Orthopedics

Day three was fantastic! Like day one and two we met bright and early in front of the hospital to then change into our scrubs. Today was filled with many highlights and memorable moments!

The first two procedures that were conducted were knee scopes. Like I have mentioned in previous blogs before, the knee scopes are done instead of an actual replacement if possible. This is because the recovery time for a knee scope is much less than for a full replacement. However, the second knee scope was particularly interesting. In this case, there was a lesion, or a missing piece of bone, due to impact trauma on the femur. As a result, the patient was limping and in a great deal of pain. To help, Dr. Huff used his camera and variety of tools to find the lesion. After a great deal of perseverance, Dr. Huff finally found the lesion inside of the knee joint. While it was a success to actually find the separate piece of bone in the joint, there was no way for Dr. Huff to successfully attach the piece of bone to the femur. So, to compensate, Dr. Huff drilled holes into the femur in the location of the lesion. The holes went all the way to the marrow. Since he went to the marrow, the marrow would then be able to create new bone tissue around the lesion and successfully heal.

Another interesting procedure done today was on an ankle fracture. Since the fracture could not be healed from wearing a boot, a plate and screws were necessary for the operation. In the operation, Dr. Huff drilled a guide wire into the ankle of the patient. He then used the guide wire, to help direct the screws into a proper position. The reason why I have found the past surgeries to be so intriguing is because of how simple the concept is. If you actually, use your brain and think about what the main goal of the surgery is, then you will be able to figure out the main steps needed to complete the surgery. Sure, this is much easier said than done, but I do believe that it is very beneficial to have an outline of the surgery in your mind.

To wrap up the day, Dr. Huff and I went to his office across the street like on Day 1 and 2. We then met with a variety of patients with a mix of needs. Another reason why I have found Dr. Huff’s orthopedic practice to be fascinating is because of the variety of patients and cases that he sees. Since he is the only doctor in his practice and covers all of Sampson and two of the surrounding counties, he has a constant flow of cases. He sees everything which is what makes his job so interesting. The surgeries on Day 1 were completely different than the surgeries done today.

It was a great week shadowing Dr. Huff, and I am already looking forward to what lies in the schedule for next week!

Day 3

Today was a more low-key day. We started at around 8:30am by looking at some crazy x-rays from a patient who had fidgeted with their pacemaker (which lies under the skin underneath the collarbone) and caused the wires, which were attached to the heart in specific locations, to become coiled up and removed from their original positions. This can be very bad, especially if the patient is relying on this device to keep their heart beating. After looking at these x-rays, we watched 4 very quick procedures in the cath lab. The cath lab is where minimally invasive procedures are done with catheters. The first procedure was placing a micra pacemaker in a patient. A picture of this pacemaker can be seen in the post from day 1 (it is the very small device next to the larger one). The second procedure was called a linq. It is a 10 minute procedure in which the patient is awake the entire time. This particular patient was young and had a stroke. The doctors didn’t know why, so they completed this procedure which inserts a small device right under the skin and detects when the heart is having irregular rhythms. It then sends data to the doctor to look at in the morning. The third procedure was replacing the battery in a pacemaker that a patient had. The batteries themselves cannot be replaced, the entire pacemaker has to be replaced for a new battery. In this surgery the leads were unscrewed from the old pacemaker and screwed into a new pacemaker with the new battery. The next procedure was similar to the first procedure we saw on day 1, where a regular pacemaker with wires/leads were placed into a patient. After this 4th surgery, we took a quick lunch break then watched our final surgery of the day which was seeing if a patient needed a stent or bypass surgery. To do this, the patient is lightly sedated and a catheter is brought into the heart through an artery in the arm. Contrast is injected and x-rays are used to see where the blockages are. The picture below is an example of what a blocked artery looks like. This picture is from the internet and not from the actual patient we saw.

After this procedure we called it a day at around 2pm after having two back to back long work days (as high school students).

Day 3- Like Husband, Like Wife

Today I had the opportunity to shadow Dr. Timothy Harris. Dr. Harris is a trauma surgeon who specializes in total joint replacements, specifically knees and hips. When he’s not doing this, he also often performs operations on most any bone fractures.

While shadowing Dr. Harris, I saw a plethora of patients, most with hip and knee injuries. While most patients that saw Dr. Chappell on Tuesday were initial meeting, the multitude of patients today with Dr. Harris were patients meeting either pre or post operation. Although a few were there for initial meetings, most had already had previous encounters with Dr. Harris.

Although because of Wake Orthopedics policy I am unable to go into the OR until I am 18, today I was able to watch Dr. Harris inject cortisone shots into 3 different patients. My favorite injection was a woman who was regularly scheduled for a second cortisone shot since her initial wore off, and her husband, in the same room, at the same time, in both of his knees. I couldn’t help but chuckle at how cute the older couple was, and how well joyfully they both took the shots despite the immense pain.

Day 3 – WakeMed Hospital

First, I saw a procedure done by two surgeons. They placed a micra pacemaker and then performed an ablation. Next we saw a link procedure. In this a small device records the heart rhythms for up to three years. This was done because the patient had a stroke and they didn’t know why. After this, we saw a pace maker replacement. The battery had died after 10 years, so they left the leads in and changed the device. Then we saw a procedure where the doctor wanted to put the leads in the atrium and the his bundle; however, he could not, so the leads were placed in the normal position. Lastly, we saw a procedure to determine if a patient needed bypass or a stent. The patient had a clogged artery that could not be safely solved with a stent and will need bypass surgery.

No pictures could be obtained for today due to privacy violations; therefore, above is a picture of fluoro with contrast to show a blocked artery.

Day 3 – A Slow Start, but a Strong Finish

Day 3 was off to a slow start but picked up after my lunch break. Upon my arrival, Mrs. Bridges and I examined the patient schedule to plan which visits I could sit-in on. She pointed out various “difficult” patients and explained that many of the patients today were rather complicated. For me, that meant that I would only be able to sit-in on a few office visits. Below were the two patients that I encountered in the morning…

9:45am patient (40 year old female): This patient came to the office for an urgent visit, regarding a potential stress fracture of her foot. Mrs. Bridges assessed her pain while showing her to the exam room. The patient explained how she had a running injury, which started hurting about a week ago. She has pain along the top of her foot, especially when she bends her big toe. The pain doesn’t radiate up her leg, but rather stays within her foot. When she sits and rests, the pain wanes; however, it progresses again during exercise. Mrs. Bridges then sent her to receive an x-ray, where three scans were taken from various standing positions. When Dr. Bloom entered the exam room, he asked various questions regarding her injury. The patient explained how she has been running for the past 2 months, but eased into her exercise by walking first. She runs 4 times a week for 2 miles and considers herself to be a “hard-runner,” in the sense that she pounds the pavement. Dr. Bloom then felt around her foot, pressing in various areas and bending her toes. She was in pain whenever he pressed on her tarsals and metatarsals. He then detailed how her x-rays looked normal and recommended a recovery plan. He suggested that she goes back to walking for the next 10 days. After those 10 days, she should only run 2 times a week for the first week. For the second week, she can increase her running to 3 times a week (every other day). Dr. Bloom also recommended that she checks her shoes to see if she needs more supportive ones.
11:00am patient (22 year old male): This patient was here for his physical. I witnessed Mrs. Bridges administer a tetanus shot in his right deltoid. Upon receiving the correct vial with the solution, she placed the needle into the tube and shook the vial. She cleaned the patient’s right arm with a small alcohol pad, squeezed the skin around his arm, and quickly injected the needle. Mrs. Bridges then covered the point of injection with a small band aid.

After taking my lunch break from 12:00pm to 1:15pm, the afternoon schedule was much busier and I was able to visit with more patients…

1:15pm patient (61 year old male): This patient came to the office for an urgent visit, regarding a knee injury. He injured his right knee 10-12 days ago when he was walking up a long flight of stairs. He explained to Dr. Bloom that he has pain in the back of his knee and towards the sides, as well as some pain down his calf. After assessing his condition, Dr. Bloom pressed various areas around the patient’s knee; the patient was sensitive along the knee cap. When the patient lied down, Dr. Bloom tested his resistance and movement, to which the patient was pain-free. Dr. Bloom ordered for him to get an x-ray so he could examine the joint space. The patient was asked to change into special shorts for the x-ray by the x-ray technician. His first 2 scans were done standing up, while the next two were done lying down and sitting down respectively. Upon reviewing his x-ray, Dr. Bloom explained that the x-rays look good. There is some slight “wear-and-tear,” which is normal for someone of the patient’s age. Dr. Bloom also stated that the source of the patient’s inflammation is some irritation between the knee cap and femur. He recommended that the patient only does light-impact activity for the next 10 days. He should ice for 20 minutes, 3-4 times a day, with a 30 minute break between each icing session. He also suggested taking an anti-inflammatory (800mg of Ibuprofen) twice a day. Dr. Bloom stated that if the patient is still in pain within the next few weeks, he should come back and Dr. Bloom will administer a cortisone shot into the knee.
2:30pm patient (16 year old male): This patient came to the office for an urgent visit, regarding ankle pain. He injured his foot/ankle about 3 weeks ago while he was playing basketball; he jumped in the air and when he landed, he rolled his ankle. His current pain level was at a 6 or 7 out of 10. The patient also explained that most of his pain comes from lateral movements, rather than sprinting in a straight line. Upon Dr. Bloom’s entry, he felt around the patient’s foot. He then asked the patient to squat in various positions, including single-legged, on his toes, and then single-legged on his toes. The patient only felt slight pain in the last squat. Dr. Bloom declared that the patient has sinus tarsi, which is nothing too serious and often occurs after an ankle sprain. He recommended that the patient take 800mg of Ibuprofen twice a day for the next 10 days, a break from playing basketball, ice 3 times a day for 20 minutes, and do physical therapy exercises for the next 3 weeks. During workouts and practices, the patient can also wear a lace-up brace if needed. The patient’s mom was concerned about the popping that occurs while the patient walks; however, Dr. Bloom reassured her that it is normal. If he is still in pain within a month, Dr. Bloom will administer a cortisone shot.
4:15pm patient (14 year old female): This patient was here for a follow-up on her concussion. May 5th was the day when she was hit in the head while playing lacrosse; however, she was not taken to the doctor’s until 10 days later. Mrs. Bridges explained to me that previously she had been taking a lot of Advil and Aleve which Dr. Bloom had limited, and she was not performing her vestibular exercises, hence her failure to improve. The patient arrived 30 minutes early to take the ImPACT test and to perform the other vision tests. Today she felt about 70% normal; she said should would feel 100% normal if it weren’t for her headaches. She has been participating in physical activity (bike rides, walking, running, etc.), performs her vestibular exercises twice a day, and sleeps 7-9 hours a night. She is mostly caught up with her school work and has been taking EOGs the past week; her concussion has not impaired her thinking abilities. Mrs. Bridges then listed off a bunch of symptoms, asking for a severity ranking from 0 to 6. The only symptoms the patient felt were headache (2), fatigue (1), sensitivity to light (2), sensitivity to noise (2), and neck pain (1). Other symptoms that Mrs. Bridges asked about included nausea, vomiting, balance problems, dizziness, drowsiness, anxiousness, and irritability, but the patient experienced none of these. She then proceeded to take the 20 minute ImPACT test. After completing the test, Mrs. Bridges went through a series of vision tests with the patient, measuring when objects became blurry, when the patient became cross-eyed, etc.

Despite today starting out slowly, I ended up encountering various patients with unique conditions. Hopefully day 4 will be just as insightful, with even more patients!

Day 3- The Summer Cold

Today began at 8:30. I waited for Dr. Willey to arrive. We immediately began seeing the sick patients. There were still a lot of kids coming in with illnesses from traveling over the long weekend. At around 10 we began seeing scheduled patients for check ups and long term fevers. I’ve learned it can be very sad to see sick kids who only want to sleep and cry. However, Dr. Willey does an amazing job of working with the patient to help them feel better. She continues to use her magic to cure patients and lift their spirits, drawing a smile from stubborn toddlers and 6 month old patients.

Thus far, we have seen a few ear infections, swimmer’s ear, coughs, and persistent fevers. I learned that swimmer’s ear differs from a regular ear infection because with a swimmer’s ear, the ear canal will appear inflamed with a white/yellow coating. On the other hand, a typical ear infection features fluid behind the eardrums. Regardless of the ear illness, you sometimes have to flush the ear of earwax when the child cannot hear. Loosening up the earwax after it piles up can relieve clogged hearing.

Apart from ear aches, I learned about fevers, coughs, and pink eye. Specifically, mild pink eye can be treated with antibiotic eye drops. To put the eyedrops in a child, or even yourself, Dr. Willey recommends laying down with your eyes closed, placing the eye drop on the inside corner of the eye. Then, you open your eyes and let the medicinal fluid run into the eye.

Apart from eyes and ears, a lot of kids also come in with sore throats and coughs. The picture I’ve attached to today’s post depicts the pamphlet source in each exam room. From puberty to colds, parents love to take a look at the information on the pamphlets. The area also includes a book with basic images of child anatomy. Dr. Willey will use those pictures to help explain colds and fevers to parents. Overall, those resources prove informational and useful!

Today was an amazing day at the office. From newborns to younger kids, i’ve learned so much about kids. A typical pattern in the office is to see younger kids in the morning and teenagers in the afternoon. I think that is because teenagers are usually free after school while babies have more free time! I have seen many dads come with their kids. Today, a dad phoned in the mom at work so they could both participate in the child’s visit. I think this is a great way to stay informed while dividing up responsibilities! I can’t wait to see what tomorrow brings in.

Fun Facts:
– Pale/white lines on the palm side of your fingers (where the fingers bend) can indicate anemia.
– Fever reducers can bring a fever down by 2 degrees.
– If not caught early, lazy eyes can result in a loss of vision in that eye.
– Some kids cough to get attention!
– Vaseline can help remove a bandaid without pain.
– Your body begins to respond to strep throat when you’re three years old.
– Scoliosis is most easily recognized between 9 and 10 years of age.

Day 2

Today we started again at around 8am. After getting into scrubs and getting our official ID badges, we headed into surgery.

I saw two surgeries today, both performed by Dr. Boulton. The first one was another valve replacement, but it was a little bit more invasive than the TAVR I saw twice yesterday. The patient went on general anesthesia and the chest was opened by sawing through the sternum and exposing the heart. The aortic valve was being replaced so the patient had to go on bypass. This is when a machine works as the heart and lungs so that the heart can stop beating while the surgery is taking place. This procedure lasted about 2 1/2 hours. After the surgery ended, we took a quick lunch break, then headed back to the OR to watch another of Dr. Boulton’s surgeries. This second surgery was a triple coronary artery bypass. Again, the patient was placed on general anesthesia and the chest was opened to expose the heart. The coolest thing about this procedure was the heart never stopped beating as it was being operated on. The artery used for the bypass was harvested from the leg which I also got to see. This surgery lasted about 4 1/2 hours, and we stayed for the whole thing. In both of Dr. Boulton’s surgeries, he wore a camera on his head so that when he looked down, everything that he saw displayed on a screen which we could see from inside the OR. After this surgery ended, we called it a day and left around 5:30.

Day 1

This morning, we met Dr. Hamrick in the Heart Center at the WakeMed Hospital in Raleigh. After a brief introduction, we quickly got into scrubs and headed in to watch a surgery that he had at around 9 am. Before going into the O.R. (operating room), Dr. Hamrick gave us a quick overview of his surgery and basically how the heart works. This surgery was adding in an additional lead/wire to an existing pacemaker/defibrillator that this patient had in order to increase the amount of blood that is pushed out of the heart with each squeeze. We were allowed to stand in the OR to watch the opening and the closing of the incision, but we could not stand in the OR during the operation due to radiation from the x-rays. The nurses and other people in the room were so good about explaining everything to us and answering our questions in ways that we could understand. The company that made this specific pacemaker had a representative in the OR to code it specifically to the patient. This representative showed us the pace maker that this patient had, but also showed us a newer pacemaker that had just been developed.

After the surgery, we updated the family, did some rounds on patients, then we went into another doctors surgery which was called a TAVR. This is a minimally invasive procedure which replaces the aortic valve in the heart through a catheter. The replacement valve takes the old valves place and the old valve is not removed. After this procedure we did more rounds with a different doctor, Dr. Wood. We were then given a tour of the ER by a nurse, then we watched a stress test. Normally, these are completed by putting the patient on a treadmill and watching their EKG (electrical activity of the heart) and their bpm (beats per minute). This particular patient was very old and too fatigued to be able to go on a treadmill, so they did it chemically where a medication is introduced to the body which makes your blood pressure drop and your bpm to increase almost as if you’re exercising. After this stress test, we watched another TAVR, then called it a day around 5pm.

Day 2: In the Groove

I arrived promptly at 8am, to learn about the new plethora of patients we would be seeing today. Although there were a smaller amount of walk-in patients, there was a great amount of already scheduled appointments. Most of the morning appointments consisted of physicals, and most of them for toddlers. With younger children, Dr. Dupuy asks that the parents bring their child in more regularly to record their development. These physicals consist of checking the throat, eyes, nose, ears, hips, pulses, and private parts. Of course, the toddlers hated when the stethoscope was placed to their chest, an unfamiliar person and an unfamiliar instrument. However, with Dr. Dupuy’s incredible experience, he knew exactly how to handle these precautious babies. With one particular baby, he allow them to touch the instrument, play with it, and then touch it to himself. Then when Dr. Dupuy went to listen to the baby’s heartbeat, there was minimal squirming.

Most of his patients were within the 2-4 range today, but two patients were less than a week old. After being discharged from the hospital, Dr. Dupuy likes for mothers to bring their child in for a postnatal checkup. These babies were incredible fragile and were incredibly cautious to everything that Dr. Dupuy used; they cried a lot. What I thought was the most interesting was that there was a black, red bulb inside the babies belly button, the umbilical cord. Dr. Dupuy assured the parents that these umbilical cords would fall off within 10-15 days after the babies birth. Including this information, Dr. Dupuy was very thorough in describing everything about this babies journey and what the parents should be expecting. With a particular patient he offered detailed expectations of breastfeeding for the mother. He explained to her how it was normal for the baby to not latch on, have incredible energy, or feed very often in the first few days after birth. This is because the babies system is full of waste and excess liquid, also explaining why babies decrease in weight their first week after birth.

Before and after each patient, Morgan and Doctor Dupuy would look and fill out medical charts. Before the appointment, Doctor Dupuy would scan through past medical records and history of the patient, to familiarize himself. After each appointment, he would fill in the observations, symptoms, diagnosis, and treatment for each patient. A picture of the area in which these were completed, is picture below.

I had a great day today, and am continuing to learn more about this field and medicine in general

Day 2 – Another Day in the Life of a Doctor

Work Experience Day #2 was a success; I saw even more patients than the first day and spent a large portion of time with Dr. Bloom, rather than his assistant. The following were some of today’s highlights…

Follow-up on the 75 year old male from yesterday: Upon examining this patient’s x-rays, I was very concerned for him, as the x-ray technician explained to me that something definitely didn’t look right. Mrs. Bridges told me that the patient has Chronic Obstructive Pulmonary Disease (COPD) and that yesterday he was seen in the office for an acute exacerbation. He was prescribed prednisone, which is a steroid, as well as an antibiotic, in case he has a contagious infection.
9:30am patient (57 year old male): I went with Mrs. Bridges to look at his vitals and go over his medications. He was here for an office visit, specifically his annual physical. His pulse was 79bpm and the following were some of the medications he is taking: Calcium, multivitamin, fish oil, and Allegra. He explained how he has switched to only taking Calcium every other day, for he read an article revealing how calcium can destroy your kidneys.
9:45am patient (46 year old female): This patient had an urgent appointment, for she had poison ivy in her eye and on her hands from weeding over the weekend. She explained her situation, starting with how she was working outside on Sunday and Monday when she must have touched some poison ivy. She washed her hands after weeding, but did not think about washing her eyes, which she had been rubbing. Yesterday was when her eye first started swelling and today the symptoms were much more severe. Her eye consistently tears up, which affects her vision. She has not tried any home remedies to cure her poison ivy, but did take some Benadryl last night to help the swelling. Prednisone was prescribed for treatment.
10:00am patient (10 year old male): This patient was here for a “well child” check, which is simply a physical for a child between the ages of 0 and 18 years. He measured 4’7″ for his height and had a pulse of 76bpm. I then watched Mrs. Bridges administer an eye test for him. He was instructed to cover his left eye first and then his right and read whichever row of letters he could see clearly. He was able to read the 9th row out of 12 rows. He then indicated both colors on the sign test, which were green and red. His physical went smoothly; however, he does need to receive his tetanus shot (that was the only injection missing from his immunization record).
10:00am patient (55 year old female): This patient was at the office for her annual exam. Mrs. Bridges measured her height of 5’2″, reviewed her current medications (fish oil, multivitamin, metformin, calcium, aspirin, Tylenol as needed, and culturelle), and assessed her pain level today, which was none. The patient has had no falls recently, wishes to sleep better at night, has not been feeling down or depressed, learns best visually, and lives in a safe home. The past facts were all questions that Mrs. Bridges asked the patient. Upon Dr. Bloom’s entry into the room, he went through the patient’s family history. All of her siblings have high blood pressure and high cholesterol, which means that this patient has a genetic predisposition to those conditions. However, she exercises everyday for 1 hour and 45 minutes and eats a healthy diet, which is why she is in great health. The patient was concerned about her lab results, which were higher than normal for her cholesterol levels. Dr. Bloom eased her worries by saying they are actually looking fine and have been great the past 6 weeks. He also added that her electrolytes and blood count look great. After discussing the lab results, Dr. Bloom examined her vision with a light and then felt around her lymph nodes. He checked her breathing with a stethoscope, bent her legs to check movement, and checked her reflexes. He then asked the patient if she had any other concerns, to which she replied with a bump on her inner leg and a toe nail that had fallen off. Dr. Bloom explained that the bump on her leg was likely a little fatty tumor, that won’t go away, but has no ominous features. He advised her to check periodically for changes or pain. He then examined her toenail and explained that the nail may look deformed now, but it will grow back in another 3-5 months. All in all, Dr. Bloom was very impressed with the patient’s health.
11:00am patient (15 year old male): This patient had an urgent appointment, for he had lost 22 pounds within the last 3 weeks and only eats one meal per day. He was diagnosed with depression and was recommended to a therapist.
11:30am patient (46 year old male): This patient was in the office for a new pair of orthotics. His old pair disintegrated after 6 months. Compared to yesterday, I was able to watch the entire process of how orthotics are fit and made. Dr. Bloom positioned the man to stand on a wooden stand with rubber blocks at the bottom. He leaned the patient’s knees against a wooden bar, which had been adjusted for the patient’s height. Dr. Bloom ensured that the patient’s weight was distributed evenly between his ankles, shins, and knees, which is known as sub-taylor neutral position. The patient has heel problems so Dr. Bloom was designing soles with arches. Dr. Bloom selected flat soles that were a size 12 (the man’s shoe size) and warmed them in an oven. The patient then stepped on the soles when they were warm so they would mold to his feet. Dr. Bloom added cotton stuffing to the rubber blocks to create the arch. He then selected blanks for the soles and marked the spot to which they should be glued to. Mrs. Bridges finished the process by placing glue on the bottom of the soles and the blanks. She heated the blanks and then stuck them to the soles. Once both had cooled down, she cut off the excess blank and then used a grinder to shape them. Dr. Bloom returned to make any final touches. He then watched the patient walk and run with the orthotics to make sure they fit nicely.
The patient stepped on this stand to shape his orthotics.

This worn-down orthotic was the patient’s.

This is the patient’s new orthotic.
1:45pm patient (45 year old female): This patient was here for a follow-up for her Urinary Tract Infection (UTI). Her medical history includes leukemia and kidney cancer, as well as the removal of her right kidney, which was why it was important her health was monitored closely. She was prescribed antibiotics for her last visit, which was when she was diagnosed with a UTI. During this visit, she took a blood test which revealed that her white blood cell count was higher than the normal range (13.8). After her antibiotics were finished, she repeated the blood test; however, her blood count was even higher, which was the reason she was in the office today. Upon Dr. Bloom’s entry into the room, she detailed her concerns. She still had pain from her UTI, was running a low-grade fever, had tenderness in her stomach and lower back, has been urinating more frequently, and began to vomit and feel nauseous last night. Dr. Bloom felt around her lower back, asking where the tender areas were, and then listened to her breathing. When she laid flat on her back, Dr. Bloom proceeded to listen to her breathing and then felt around her stomach. He explained to me that he must be more aggressive in his plan for this patient because she only has one kidney left. He ran a dip UA urine test and an abdominal x-ray. For the dip UA, Mrs. Bridges dipped a pH indicator into the patient’s urine and entered it into a machine. Within a minute, the results were printed on a tiny receipt-like piece of paper. She explained to me that a key indicator of a health condition is if the urine has leukocytes present, which this patient did not have. The urine did have slight traces of blood; however, Mrs. Bridges said that this was not concerning. Dr. Bloom returned to the patient’s room, explaining that her urine was clean and she doesn’t need antibiotics. He said that the microscopic blood hinted at a kidney stone that was blocking her urinary tract and was preventing the infection from going away. He scheduled for her to have a CT scan tomorrow, which would reveal a kidney stone. The patient’s husband was very concerned for his wife’s health, so Dr. Bloom stated that if her symptoms are severe tonight or if her leukocyte blood count is very high, then she should go to the ER; however, as of now, she is stable.
This machine was used to analyze the urine sample.

A thin slip of paper from this bottle was dipped into the urine sample for testing purposes.

All in all, I am really enjoying my work experience so far and looking forward to the see what new types of patients I will encounter the next few days.