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Shadowed today

Discussion in 'Pre-Podiatry Students' started by Shinobiz11, 05.02.12.

  1. Shinobiz11

    Shinobiz11 A boy has the right to dream

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    I shadowed for the first time today, it was pretty chill. Just wanted to share some funny things that happened.
    While the DPM and I were seeing a patient, he was sitting and I was standing, I leaned back on the wall for second; 5 minutes later, I feel something wet on my back and notice I leaned on the hand sanitizer dispenser and had it all over my shirt lol. Luckily that stuff dries fast.
    Also, the doctor was performing an ingrown toenail removal. Something about the clicking noise that the clippers were making was really bothering me. Along with that, I was getting really claustrophobic and dizzy. I almost passed out lol. I'm still not sure what happened. I've seen tons of surgeries and even much worse things (internet :(), but I guess its different in real life. Excused myself and went outside to get some fresh air. One of the medical assistants came out to check on me lol, afterwards they all had some jokes.
    It was fun though, really enjoyed it. The doctor was a cool guy and offered to write me a letter of rec without me even saying anything. But man, type II diabetes patients...are they always this ignorant?
  2. bobdolerson

    bobdolerson

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    If I've seen one consistent frustration across the board among practicing podiatrists, it seems to be their difficulty getting diabetic patients to comply.

    Seen case study after case study of progressive amputations of a patient that...they just wouldn't change! They wouldn't listen, wouldn't follow directions, just kept making the problem worse and worse.

    I think, by and large, there are a lot of ignorant people regarding health and medicine, but that's where you come in. I don't think everyone disregards orders, and the majority of them are ignorant of something because they've just never been told before (it's not like our education system does much in the way of teaching healthy eating or balancing a checkbook....).

    I recall being in undergrad and debating with someone for a good half hour because they didn't believe that alcohol had calories. I don't know where that fits in, but hey...even college-edumacated folks can be ignorant.
  3. SuperFeisty

    SuperFeisty

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    Don't worry bro! The first time I saw that procedure... My conscious mind was thinking, damn that's cool! But something inside was screaming. Oh HELL NO! You DON'T CUT THAT WAY! AAAAH, WTF U JUST CUT TOO FAR! And yea, if you spend all your time shadowing, you WILL start to feel a little light headed on your first few shadows.
  4. MaxillofacialMN

    MaxillofacialMN Osteopathic Foot Dentist

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    I felt similar during a toe amp, it passed after a few moments, but I definitely got light headed and I thought I might pass out. If you hadn't eaten, or if it was your first surgery, these things happen. I've found that after that situation I've gotten over that feeling and I haven't gotten dizzy/light-headed since.

    I'm actually going to shadow tomorrow because all my finals are over and it's fun to see some stuff. I got to feel a stress fracture on someone's ankle and cause a Muldur's click in a Morton's Neuroma - it was sweet. :D
  5. Shinobiz11

    Shinobiz11 A boy has the right to dream

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    Haha, I thought I was going to have to explain myself, this is exactly what I meant. There were a number of obese patients that came in today who just don't listen. Almost all of their foot problems were due to simple changes in lifestyle. The doctor told me that they are the hardest to work with because they usually just don't listen to anything he says and he sees their feet progressively get worse and worse.

    Yeah, that was pretty much exactly what I was feeling, mad cool, just mad wrong at the same time. I did however enjoy how happy the patients came out afterwards. Everyone is always talking about the immediate fix that podiatry offers when you go in; it's real and it really put smiles on people's faces.

    That's pretty sweet man. I'm in the process of getting into the OR in a couple of weeks with the same doctor. Can't wait!

    By the way feel free to share your own experiences too!
  6. bmhsacosta

    bmhsacosta

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    Sounds like quite a first experience!
    The first time I met the podiatrist I shadow we were in his orthotic lab and he says, "You know what I always tell my patients who golf? I always tell them to wear two socks." I responded asking why and he said, "Just in case they get a hole in one". Pretty much sums up our relationship, he's the nicest guy. I remember reading that nail avulsions were a doosey, so I braced myself when I happened to watch one. Turns out it wasn't so bad for me, but maybe the posts warning about it were actually about performing the operation.
    Anyway it's great that you get to see an operation! Be sure to update us with your experience.
  7. g squared 23

    g squared 23 is keeping his head down

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    Diabetics commonly get calcification of the vessel walls which is clearly seen on foot radiographs. I rotated with a vascular surgeon who said that those people certainly have that same calcification in all of their vessels, including their brain which makes them so stubborn, stupid, and noncompliant.
  8. Shinobiz11

    Shinobiz11 A boy has the right to dream

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    Really?:eek: That's amazing lol.
  9. PADPM

    PADPM

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    I don't know if it's fair to call these patients ignorant, stupid, stubborn, etc. Many of these patients simply are in denial and don't understand the potential ramifications of their non-compliance. Many have trouble losing weight because they simply like to eat, similar to any overweight person. But in a diabetic there are greater complications.

    It's not your job to judge these patients, but it's your job to educate these patients. You don't know their personal circumstances, etc. All you can do is TRY to teach them and document your conversations. But ultimately you can lead a horse to water, but you can't make him drink.

    Concentrate on those who DO listen and understand that lack of patient compliance is not unique to diabetic patients.

    Of all the procedures I perform, whenever someone watches/observes a nail procedure, it causes problems. There is something about sticking an instrument under the nail plate to perform an avulsion that creeps people out. I've had many students, residents, etc., get nauseous, dizzy, etc.

    It often happens when draining an abscess and that pleasant odor hits your nostrils. A horrid odor on top of the "visual" is enough for many to toss their cookies.

    When I teach residents, it's always a right of passage to have a new resident or student hold onto the amputation site as I'm cutting. Then, when I make the final "cut", the amputated portion gives way, and the resident/student is standing there holding it in his/her hand. Freaks 'em out everytime.

    When I was a resident, the orthopedic surgeon did that with me during an above knee amputation. I was holding the leg up and he made his final cut and I moved back due to the lack of resistance and was standing there with an entire leg in my hands. Oh, the memories........
  10. bobdolerson

    bobdolerson

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    When I say ignorant, i mean it in it's purest form. Not stupid, not a moron, just unaware.

    I've watched my dad smoke since I was born, and the discussion comes up all the time about him stopping, and it always frustrates me.

    Know this: they don't want to die, they don't want to lose their limb, they aren't doing these things hoping they'll be worse for it. Sometimes the ramifications aren't closely enough attached to the action to give someone's brain a push to stop them.

    Kids that rob a store and get away are going to be more likely to rob another than a person who was caught during the act, and goes to jail for 10 years.

    Someone that eats a bowl of ice cream and their leg gets blown off will have a tendency to avoid ice cream in the future.

    It's a tougher connection to make, especially when the immediate consequences are things that take years to develop, and often aren't even seen by the naked eye.

    Anyway...sorry if I started the trend of using derogatory terms to describe patients, I didn't mean it to go that way. I just wanted to use the word the way it's defined, and illustrate that patients haven't gone to school for these things, haven't seen picture after picture of diabetic ulcers and amputations, so the ramifications of their actions are harder to stress and get them to understand.

    Thanks for changing the direction of the thread, PADPM.

    Btw, the way my brain works, I only realized now that your name had "DPM" in it...I always figured it was "PAD" something or other and split the letters that way...now I feel dumb.
  11. SuperFeisty

    SuperFeisty

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    An evil genius at work? On the other hand, I'm looking forward very much to these rites of passage. Onward Class of 2016!
  12. PADPM

    PADPM

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    Your points are well taken. However, it is pretty funny (or scary) that you just realized my name includes a DPM. As I've stated on this forum many times and in response to many PM's that I receive, the name PADPM is not based on what most assume.

    The name is actually a longstanding private joke between friends. So, there are actually only 2 people that know what it stands for, but I can assure you it's pretty comical and NOT what most are thinking.
  13. MaxillofacialMN

    MaxillofacialMN Osteopathic Foot Dentist

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    FUNKY!!! I thought the same thing for the LONGEST time!!
  14. BlueRhino

    BlueRhino

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    Woooooooaaaaaah, my mind is blown right now. The only question left is what does the PA part stand for...we must get to the bottom of this!
  15. unitix

    unitix

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    I can watch resections or worse all day, but something about nail avulsions didn't rub me right the first few times I saw em lol but then it was normal
  16. MaxillofacialMN

    MaxillofacialMN Osteopathic Foot Dentist

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    hahaha we shouldn't question it!! Either Physicians assistant, Pennslvania, or Patronus Accident, I'd say, but anywho, I'll let it be!
  17. PADPM

    PADPM

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    Nah, remember I said it's not what most people presume, and it's a private joke between two people. It has to do with an experience we had MANY years ago, and it involved some very attractive females.
  18. Shinobiz11

    Shinobiz11 A boy has the right to dream

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    Penis Attractors :confused:
  19. MaxillofacialMN

    MaxillofacialMN Osteopathic Foot Dentist

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    Bahahaha this thread has become ridiculous
  20. PADPM

    PADPM

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    :eek:.........I believe we were attracting FEMALES and the name is based on THAT attraction and it involved that experience.. I should have known one of you degenerates would come up with something absurd.
  21. bobdolerson

    bobdolerson

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    I'm gonna go do some crazy things that make for incredible stories, and then tell you how many awesome stories I have, and how great you'd think they are, PADPM.

    And then I'm going to not tell you any of them.
  22. MaxillofacialMN

    MaxillofacialMN Osteopathic Foot Dentist

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    :laugh::laugh:

    Bob, will you tell me those stories?
  23. PADPM

    PADPM

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    Sorry that I'm not going to provide you with personal/private information that has been shared among 2 friends for many years. I was simply trying to let the curious know how PADPM was derived, and that it wasn't the obvious.
  24. bobdolerson

    bobdolerson

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    Haha, I didn't expect you to. I just like a good story, and you've got the carrot on the string right in front of my face...
  25. PADPM

    PADPM

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    Getting back on track regarding shadowing, in addition to non compliant patients, you will also encounter patients who you simply don't like, patients who are rude, obnoxious, etc. Granted, you don't have to tolerate rude or obnoxious patients, but when you decide to render care, you must do it without bias and with objectivity.

    Years ago, a moron came into our office and starting yelling about gays and was using the word that rhymes with maggot. He then began to rant using the N word. I walked over to him, got right in his face and TOLD him (didn't ask) to leave our office immediately and never look back. He asked for his copay back and I basically told him to shove it up his ass. He left the office screaming and calling me an N lover and fa....ot lover. Idiots are idiots, period.

    I was/am very proud of our newest associate. He/she is Jewish and was treating patients in one of our offices and when he/she walked into the room, the patient had a large swastika tattooed on his forehead and other Aryian sayings all over his arms and neck. Our associate kept his/her cool and dignity and treated the patient as he/she would any other, despite the guys comments and attitude. I'm not sure I would have been as cool and collected if I was in our associate's position.

    So, in practice you will end up treating a WIDE variety of patients. Some you form long term relationships with and become almost family, and there will be others you simply can't stomach, but you really need to treat them all the same. You are the one who ultimately ends up the better person.
  26. RockFoot

    RockFoot

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    and boy is there ever a surplus of ignorant people out there. some days they seem to be in the majority.:bang:

    Sent from my SPH-D600 using SDN Mobile
  27. Shinobiz11

    Shinobiz11 A boy has the right to dream

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    Great advice. Props to you for your epicness

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