Kristina Anderson, PA-S, diagnoses and treats her first patients

......with help of course. Last night was my first night as a PA! I got to see my very own patients. IT WAS SO MUCH FUN! Once a semester we are required to work at the Essential Health Clinic, which is a clinic providing free care to those who would otherwise be unable to afford it. It was a really great experience and I wish I could go EVERY night. It's connecting the dots, you know, from what we learn in school. Actually seeing things first hand and doing allows you to REALLY learn. I saw 2 patients of my own and then was paired up with another student while she went and saw her 2 patients. Thus, I got to see 4 patients total. And bonus.....I got to use my Spanish! And I realized just how much work it really needs. Not speaking it for 6 months is a huge detriment and I regret not keeping up on it.

The cases I saw myself were pyelonephritis, which is a UTI that has moved up into the kidneys, and then otitis externa, an ear canal infection. The latter case was a Spanish speaker and they had translators available, but I was able to see the patient on my own. Booyah! I struggled with "cutip" and "puss," but was able to see and treat the patient adequately. He left w/ some ear drops and strict commands not to use cutips any more.

With the other patients I saw rosacea, tinea corporis, pitting edema, GERD, and neurofibromas. The pitting edema was insane! It can be a sign of many things from heart failure to lung problems. So this guy came in for a rash and then was like, "oh by the way, look at this. I push my skin in and it leaves a dent." He thought it was pretty cool, but that type of edema is not normal. We sent for some lab tests and will mostly likely refer him to primary care. Then the neurofibromas are what we call "zebras" - the very rare diseases that you are unlikely to see in your whole career. This guy had cyst all over his back. The problem is they compress nerves and he loses feeling (mostly to his legs), causing tingling and even shooting pain like being stabbed w/ pins & needles. You all know what it's like to have a foot wake up from "falling asleep" I imagine it feels like that, but much worse. Anyway, it's pretty crippling for him. He's had it since he was 5 yrs. old and has already had 15 of them removed. There's not really a cure either, just symptomatic treatment.

Anyway I saw some cool stuff. I was also put on the spot a lot, being asked questions like what do you think the diagnosis is and what do we do to treat it. Oh man, I struggled remembering things we've learned in class that long ago. But after seeing patients with these conditions, I will never forget it. That's what the whole clinical year is for, but when my preceptor starts "pimping" me as they call it (asking questions to test my knowledge), I might be stumbling as much as I was last night. It's all about the short term memory at this point. One class at a time.

Something's happening to me...... I said I NEVER wanted to work in primary care, EVER. But as I've been in school learning about SO many different cool things and really learned how important patient care is, I think that's what I might actually want to do. I mean, who doesn't want variety in their job? This is where the real challenge is. And I love a challenge! I'm thinking 3 days in primary care and 2 days in the ER. How exciting!