First Day on Peds!

Hi everyone!

It's been a while since I've posted, and I'm LONG overdue for a post about what I've been doing at the hospital. Lucky for you, I'm planning on writing two posts today...one about the weekend and my day at the hospital today, and one about the week I spent with the Gynecology Dept. The notes I took last week are currently in our hotel room, which I am currently locked out of (Thanks Alexis and Jen! JK), so look for that one a little bit later tonight :-)

So we all had an very exciting Friday night of watching a Twilight double feature on TV and ordering room service! Like Alexis mentioned, we get pretty geeked up when American movies are playing on the TV...even though they tend to censor a lot of the best parts of every movie...

On Saturday, Rasika headed to Chennai to visit her uncle, Alexis spent the day in bed rewatching Twilight (she's feeling under the weather), and the rest of us went on shopping sprees across Vellore. Jen, Sarah, Shivani and I headed to the fabric/sari store to check out the South Indian style saris for sale. The fabrics were AMAZING! While we were looking for a bookstore, we stumbled across a super cool local market where lots of people were selling fruit (mangos and jackfruit) and veggies and assorted household items. One alleyway off the main strip was home to an amazing flower market with lots of locals buying jasmine and lilys to give as offerings when they went to the temple on Sunday. The flower sellers loved the "American girls" and gifted us with some flowers to wear in our hair. Yinan got the best deals of the day with two pairs of shoes and a boxful of bangle bracelets. She is totally the queen of bargaining, but we already knew this from watching her do her thing at the Jan Path market in Delhi.

I was asked yesterday by my wonderful boyfriend Eoghan what the nightlife in Vellore is like. Well, there really isn't much! Besides, when the temperature low for the day is 83 F, staying in the A/C hotel sounds wayyyy better. Which explains why we all spent Saturday night in Vellore camped in front of the TV watching "He's Just Not That Into You", gossiping, and ordering room service again! Had some issues ordering Sweet and Sour Chicken (just ask Jen!), but it was really delish.

On Sunday, Jen, Yinan, Sarah and I headed to Vellore Fort in the center of town to check it out. Really sticky and humid weather, so we didn't last long there. Lots of cricket matches going on inside the fort, and we checked out a temple that was on site too (can't spell the name haha). Shivani headed over to the Vellore Institute of Technology to meet up with some old family friends. At night we started trying to plan our upcoming weekend, which we hope will include visits to a backpacker beach town called Mamallapuram and the somewhat big city Chennai. :-)

Today, all of us started new postings at the hospital. I am posted in Child's Health II, a pediatric unit with a special focus on rheumatology and nephrology. The first part of the day included a case discussion with one of the residents (they call them post-grads in India) about a little boy with LCH, which stands for Langerhan's Cell Histiocytosis. It's basically an immunosuppressive disease, with a characteristic three symptom triad of diabetes insipidus, exopthalmos (protruding eyeballs), and lytic (holey) bone lesions. It sounds like its really rare, and when I just Wikipedia-ed it, I found out it was featured on an episode of House!

After that we had rounds on the Pediatric unit with all of the attendings, residents, and interns. After lunch, we followed up all of the cases we saw on rounds with a radiology conference, which totally tied it all together for me! I was kind of lost up until that point, no matter how many questions I asked. It was cool because a lot of the cases related well to the stuff we just covered at the end of our first year of med school (Genetics and Neuroscience).

One case was a 7 year old little girl who had been experiencing a lot of back pain (she won't sit up or walk any more)and had high blood calcium levels. Turns out she had hyperparathyroidism. On X-Ray you could see very obvious bone loss in many bones, and there was characteristic "scalloping" of her distalmost finger bone that gave it away for the radiologist. One of the attendings told me that the treatment is to remove 2 or 3 of the 4 parathyroid glands in the body.

The second case was a little 3 year old boy with severe hydrocephalus ("water on the brain"). For our med school friends reading this, the ventricles were HUGE in horizontal cross sections (you know you miss Rafols' Atlas!). The neurosurgeons had put in a shunt previously to relieve the pressure and drain cerebrospinal fluid (CSF), but it didn't work. The radiologists found a malformation in one of the veins in the brain that collects and drains CSF (Galen's vein) and believe that to be the cause. Alternatively, the pediatricians think it may be a complication of tuberculosis, even though the patient's parents said he hadn't been exposed to TB. On the MRI you could see that his brain had begun to atrophy and there were mineralized regions, so he will never be able to fully recover from the disease. The doctors had to have the difficult discussion of whether or not to consult the neurosurgeons, since very often in India, the financial aspect of medicine must be balanced with potential outcomes.

We also talked about a severe case of encephalitis (inflammation of the brain) with an accompanying hematoma, as well as a child with hypophosphatasia. I don't know what that means (yet), but maybe I will next year when I'm a second year.

All in all, it was a really good day at the CMC :-)

Thanks for reading this super long post, and look for another from me later tonight!