Night Owl

So second year is here....and what a welcome it has been! I was lucky enough to have a smooth transition from intern to senior and felt I had a good handle on things...until night float started. Night float consists of working 6 nights a week ( yes only 1 day off ) for 12 hours; admitting patients,managing those currently in the hospital, and running any codes that occur overnight. 1 week would drive anyone crazy- I did 3 in a row!

Source

Night float is draining...physically, mentally, and emotionally. Humans are not meant to be nocturnal, so sleeping during the day and working at night is very demanding. At first I had no problem sleeping throughout the day but as the days wore on I found myself sleeping less and less; sometimes only for 3 hours. I tried everything- sleep masks to block the sunlight, ear plugs to block outside noise, sleeping pills to stay asleep- nothing helped. I woke up feeling like a zombie, and trust me working off of 3 hours of sleep is hell!

There were times  I was able to get a little sleep overnight, but nothing compares to sleeping in your own bed without the sound of a pager going off in the background. And nothing is more painful then being woken up right when you're heading into that good sleep ( y'all know what I'm talking about). 

Trying to keep a smile on my face after a rough night

At my program each morning you have to present an interesting case you admitted overnight. The intern describes the history and physical , labs, and any imaging done ( X-ray, CT scan), and the senior has to explain the assessment and plan. The most challenging part is defending your management and decisions; why you placed the patient on a certain medication, why you felt this patient warranted admission, or why you did or did not do one thing or another . It can be quite an anxiety inducing experience especially in front of 10 plus people and especially if there is a tough attending facilitating. There were days when I walked away feeling very low; I made a mistake or mismanaged someone wrong or just plain didn't have the answer. The worse part was feeling as if everyone thought I wasn't smart or capable of taking care of patients. But there was no time for feeling sorry for myself, I had to go home and (attempt to) sleep so I could come back to work that night.

Looking back I don't know how I made it through- it was simply the grace of God. I do believe I managed patients as best I could and I learned a lot from a myriad of cases. I'm grateful to my night float team who were fun to work with and helped make the time go quicker.

Needless to say nocturnal medicine is not in my future- I enjoy being in the land of daytime living way to much!

5 Things I Learned in the ICU

We apologize for the lack of posts! April (and May) were hectic months for Jemina and I but we never forgot about you guys! Intern year is almost over (yikes!) and we're slowly transitioning into being seniors (double yikes!!).

 I recently finished a stint in the Intensive Care Unit and boy was it an experience.. If you don't know much about the ICU, it's the part of the hospital where the sickest of the sickest patients are, or patients who need close monitoring. Residents like to sometimes call it " the dungeon"; once you go in in the morning to work, you don't leave until the end of your shift. The hours are long, the cases can be quiet complex, and the emotions run high.  I started the ICU with the expectation that I would be run ragged- and I left 10 pounds lighter and with a breath of knowledge. Here's what I learned:

                 
 Dr. William Mosenthal (head of the bed on right) created the first ICU in the USA

1. You Can't Save Everyone
  Death is inevitable for all of us and the patients in the ICU are no exception. When I began I would get very emotional when we lot a patient especially if they were very young or had small children. Then a much wiser senior sat me down and explained that sometimes there is a point where
the human body is so sick that no matter what we do, we can't save a person from the natural cycle of life and death. At times death is even welcomed, especially if the individual has been suffering for quite some time.

2. Crack is Wack
Somebody lied to me when they said America had won the war against drugs. The number of patients coming in with cocaine or other inhalants in their lungs (chemical pneumonitis), heart attacks from cocaine use, or overdosing on heroine is alarming . I find myself asking "did these people not watch the after school specials on drugs?!"  Local and state wide governments need to increase their efforts to combat the alarming drug issue in this country.

3. The Will to Live is Amazing
 To see people on the brink of death walk out of the hospital is a testimony to the resilience and strength of the human body. I remember times where I would wonder if certain patients would be alive when I came to work the next day and lo and behold  I would walk in and they would be wide awake and responding.

 

Modern Day ICU

4. Breathing is a Gift
When you can wake up and not have a machine breathing for you, you are blessed. I never realized how much we take for granted taking in breaths on our own until I entered the ICU and had to deal with ventilator machines. And from what I hear, having that tube down your throat is no fun. So go ahead, take a deep breath!

5. I'm Alot Stronger Than I Thought
 I initially dreaded the ICU for the long hours I would have to work and the non stop action I would be facing. When I look back, I don't know HOW I worked 14 hours daily with sometimes only 2 bathroom breaks and 20 minutes to eat lunch. It truly is only the grace of God that got me through and will get me through the next time I'm in The Unit.

Stay tuned for more posts and the Ohemaa's MD recap of Intern Year of residency!

Women's Health Screening Series: Cervical Cancer

Cervical cancer

Let's continue our series by discussing a major public health problem here and abroad: cervical cancer. The cervix is the lower, narrow end of the uterus that connects the uterus and vagina.  A common cause of cervical cancer is human papillomavirus (HPV) which is actually a type of sexually transmitted disease.
 
WHO should get screened for cervical cancer?

•  All women with a cervix should get screened for cervical cancer no matter your race or ethnicity!

WHAT does cervical cancer screening entail?

•  Well...let's just say it involves stirrups lol. No one likes to get a pap smear. No one. However, it is very important that women do not run away from this test. During a Pap smear, your doctor scrapes some cells off your cervix and sends them to a lab for analysis. If anything unusual comes back from the lab, your doctor will let you know. (I always tell my patients to relax and scootch down to the edge of the examining table, that usually makes things go a lot faster :-)

 
WHEN should women get screened for cervical cancer?

•  The United States Preventive Task Force recommends screening for cervical cancer in women ages 21 to 65 years with a Pap smear every 3 years.
•  Women ages 30 to 65, who want to lengthen the screening interval, should be screened with a combination of Pap smear and HPV testing every 5 years.
• If you have an immune deficiency, such as HIV, have a history of a high-grade precancerous cervical lesion, cervical cancer, or were exposed to diethylstilbestrol while your mother was pregnant with you, these recommendations do not necessarily apply to you and you should ask your doctor for specific recommendations.
  

WHERE can women get screened for cervical cancer?

• Primary care doctor
• OB/GYN
• The CDC's National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screenings and diagnostic services to low-income, uninsured, and underinsured women across the United States. For more info click here.

 

 
WHY should women get screened for cervical cancer?

• Cervical cancer used to be the #1 cause of cancer death for women in the United States. However, in the past 40 years, the number of cases of cervical cancer and the number of deaths from cervical cancer have decreased significantly because of PAP SMEARS!
• Here is the most recent information from the CDC. In 2009:
• 12,357 women in the United States were diagnosed with cervical cancer.
• 3,909 women in the United States died from cervical cancer.

HOW can I prevent myself from getting cervical cancer?

• The most important thing you can do to help prevent cervical cancer is to have regular screening tests.
• Two HPV vaccines are available to protect females against the types of HPV that cause most cervical, vaginal, and vulvar cancers. Both vaccines are recommended for females 11 to 26 years of age (but can be given to girls as young as 9). It is important to note that even women who are vaccinated against HPV need to have regular Pap tests to screen for cervical cancer.
• Men can also get HPV leading to genital warts, penile cancer, anal cancer and cancers of the head and neck. The CDC recommends the HPV vaccine for men 11 to 26. It is important to note that gay and bisexual men are at a higher risk for HPV.
  
• Don't smoke. If you are going to have sex, use condoms and limit your number of sexual partners.

 

 

Decrease your risk of getting cervical cancer! Don't be afraid of needles and pap smears!!!

Women's Health Screening Series: Breast Cancer

                         
 We are happy to embark on a new series! The Women's Health Screening Series will be a 3 part series that explains the WHO, WHAT, WHEN, WHERE and WHY of important health screenings for today's woman. (For our male readers: don't worry this pertains to you too because you can share your new found knowledge with the women in your life!) Screenings are a vital part of leading a healthy lifestyle because your doctor can catch a disease in the early stages when there is still a good chance to cure it. There is a lot of different information out there on who should get screened for what and when. Most of the information will be based on the United States Preventative Task Force recommendations (USPSTF). We will break it down for you in a way that is both short and sweet.

First up is the most widely discussed female cancer, BREAST CANCER.

 

WHO should get screened for breast cancer?

•  All Women should get screened for breast cancer no matter your race or ethnicity!

WHAT does breast cancer screening entail?

•  Breast cancer screening entails self breast exams, clinical breast exams and mammography.
• Self breast exams: I personally do not discourage women from doing monthly breast self exams (BSE), although it is no longer recommended that doctors teach their patients to do self breast exams because adequate evidence suggests that BSE do not reduce breast cancer mortality.
• Clinical breast exams: these are exams preformed by your doctor.
• Mammography: mammograms are low-dose X-rays that can find a lump before you even know it's there, though normal results don’t completely rule out cancer. Mammograms are the BEST way to screen for breast cancer.

WHEN should women get screened for breast cancer?

• While you are in your 20s and 30s, your doctor may preform clinical breast exams once every 1-3 years.
• Women 40 and above should have a mammogram yearly, however some women who have family members with breast cancer may be at a higher risk. These women should talk to their doctors about the possibility of starting screening mammography at a younger age.
• The USPSTF recommends screening mammography for women aged 50 to 74 years every 2 years.

WHERE can women get screened for breast cancer?

• Your primary care physician's office is a great resource and often a 1 stop shop for many screenings.
• If you do not have insurance here are some other options:
• CDC's National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides access to breast and cervical cancer screening services to underserved women in all 50 states, the District of Columbia, 5 U.S. territories, and 11 tribes.
• Also, look out for health fairs in your area that may offer free breast cancer screenings
• Contact your local health department to see if they offer any free screening resources.

WHY should women get screened for breast cancer?

• Breast cancer is the 2nd most common cancer in women in the USA, only coming in second to non-melanoma skin cancer. It is also one of the leading causes of cancer death among women of all races. 
• Here is the most recent data we have from the CDC, in 2009:

• 211,731 women in the United States were diagnosed with breast cancer.
• 40,676 women in the United States died from breast cancer.

So please tell your mother, daughters and friends to get screened and if you are a mother, daughter or friend don't forget to get yourself screened too!

Gel Manicures: Dazzling, Durable and Dangerous?

Your regular run of the mill manicure is cute but you're fortunate if it lasts 2 whole days without smudging, chipping or peeling - and that means you have to be extra careful when you do the dishes, scrub the kitchen or wash your hair! Gel manicures are dazzling, durable, and in most cases they can last anywhere from 10-12 days...but are they dangerous? Now don't get me wrong, I love a good gel manicure, but if you frequently get gel manicures...


 Here are a few things to consider the next time you think of getting another one:

• Gel manicures leave your nails brittle. This may be due to the gel nail polish itself, but it is also definitely due to the amount of acetone it takes to soak the polish off of your nails. Acetone can dry out your skin and lead to irritant dermatitis - inflammation and irritation of the skin around the nail.
• If the skin around your nail is irritated and inflamed it can predispose you to infections, because the skin barrier is easily broken.
• In order for most salon offered gel manicures to set properly, the drying process involves UV-light. Regular UV-light exposure has been associated with early skin aging and skin cancer.
• Finally, if you always have polish on your nails you may miss some skin changes, such as a tumor or an infection that could be brewing underneath the pretty polish. 

        

 
Not to fret, here are some tips for good nail hygiene: 

From aafp.org "Evaluation of nail abnormalities"

 

• Make sure the nail salon you patronize practices good sterilization techniques for all their equipment to minimize the chances of you getting a fungal infection from another customer. Some nail salons actually use one set of equipment per customer, they put your name on the box of tools that they use only for you. Or if you frequent nails salons a great deal, you can bring your own nail equipment from home.  
• When getting a gel manicure, wear sunscreen on your hands to minimize your exposure to the UV light during the curing process. Also, go to salons that use LED lights- a good alternative to UV lights.
• Ask your manicurist not to push your cuticle too far back during the manicure- this dries out your nail, leads to inflammation and could introduce infection. Your cuticles were made for a purpose, they are good for you!
• Try to keep your nails hydrated with lotion, oils and Vaseline to fight against brittleness and chipping.
• Don't chip your gel manicure off with your nails or anything else!
• Soak your nails, not your entire hand in the acetone. Or better yet, use acetone and toluene-free polish removers to prevent completely drying out your nails.
• Finally, makes sure you take some time between manicures to let your nails breathe and to take a good look at them. If you see anything strange, go see your doctor right away.

       

Like almost everything in life, use gel manicures in moderation so you can look and feel as fabulous on the inside as you do on the outside!

What Should I Ask My Doctor? (And Pics of Trailblazers:)

Susan McKinney Steward was the first black female doctor in the state of New York and the third in the nation. She started a successful medical practice in Brooklyn, New York, serving a variety of people.

When is the last time you went to the doctor for a check up? We are all guilty of being very busy and putting other people or responsibilities before our own well being, but the truth is NONE of us can afford to put aside our own health. Truthfully speaking everyone should go to the doctor at least 1 time a year for a check up. But once you get to the doctor, what are you going to talk about? Firstly, there is no need to be nervous, embarrassed or shy when you visit the doctor. Feel empowered to take charge of your health by asking the really tough questions. That thing that you're wondering about, yeah... ask us that!

Doctor Patricia Bath, an ophthalmologist from New York, was living in Los Angeles when she received her first patent, becoming the first African American female doctor to patent a medical invention. Patricia Bath's patent (#4,744,360) was for a method for removing cataract lenses that transformed eye surgery by using a laser device making the procedure more accurate.

Some Tips 

• If you take any medicines, bring a list of your meds with you -include the dose and frequency.
• Bring a notepad with questions that you thought to ask before your visit.
• If it makes you feel more comfortable, bring a friend, spouse or your adult child with you. They can help you remember what the doctor said once you get home and ask the questions you may have forgot to ask.

Now that you are at the doctor's office, what are you going to ask her? 

The U.S. Department of Health and Human Services has come up with 10 questions we should all keep in mind depending on the situation.

1. What is the test for?
2. How many times have you done this procedure?
3. When will I get the results?
4. Why do I need this treatment?
5. Are there any alternatives?
6. What are the possible complications?
7. Which hospital is best for my needs?
8. How do you spell the name of that drug?
9. Are there any side effects?
10. Will this medicine interact with medicines that I'm already taking?

Susie King Taylor was a regimental nurse with the Union army during the Civil War. She was famous for using both conventional and folk techniques in helping the sick and wounded, and using the same techniques for her own health.

There is also a Health Question Builder that can help you come up with questions based on your specific medical needs. Remember, be empowered, take charge of your health and ask ask away!!!
 If you have family members or friends who go to the doctor often, share this post with them by copying it from here:  http://ohemaasmd.blogspot.com/2013/03/what-should-i-ask-my-doctor-and-pics-of.html

Vampire Facial- Safe? Worth It?

Being the reality TV junkie I pretend not to be, this week I watched a few minutes of  Kourtney and Kim Take Miami. In the beginning of the episode we watch as Kim Kardasian subjects herself to a "Vampire Facial".

US Weekly

The Vampire Facial, also known as Dermal Blood Fillers, is a new trend meant to revitalize skin and produce firmer, younger looking skin. The procedure involves removing the patient's blood from his arm, placing it in a centrifuge to spin and allowing the blood parts to separate.

Source

The plasma is then injected into various parts of the patient's face in the hopes that it will give a more youthful appearance to the skin; the cells within the plasma should support collagen production and an abundance of growth cells. The injection should be YELLOW, not red which makes me believe Kim's blood wasn't centrifuged enough to produce a good amount of plasma.

Source

                                                      

There has not been statistically significant scientific evidence to support this "age-defying" remedy and it's efficacy. However plasma, which is rich in nutrients and antioxidants has been shown to aid in skin regeneration. The real anomaly here is, if blood already circulates throughout the body and is essentially already under all skin (including the face), it is necessary to add more blood/plasma to the skin in an effort to combat aging?

Do understand that this procedure does have some risk, as using needles always carries a risk of infection. If it is done at a medical spa it does not have to be done by a doctor, so long as the spa is licensed under a physician. Also be prepared to pay as much as $1,000-$1,500 with each session, more if you add extra fillers to the package.....unless of course you're an Oscar nominee and scored a free session in your swag bag! Results vary from a few days to months depending on the person.

Kim Kardasian is only 32 so I am not sure why she is already subjecting herself to procedures in attempts to defy aging. She has already Botoxed, Lipoed, and God knows what else. One thing's for sure, it keeps people talking about her.

Would you consider getting a Vampire Facial?
Watch the clip below

The Bravest Girl in the World

Malala Yousafzei
Nobel Peace Prize Winner
Comic Illustration by Gavin Aung Than

Stylin in Scrubs

I remember when the movie "Two Can Play that Game" came out in the 90's (showing my age) and my goal in life was to be a rocking business woman like the one Vivica Fox played. From the luxurious apartment to the fast sports car she drove,  I thought she had it all. What I envied the most were the fly business suits she would wear to work. I loved how stylish and put together she looked, always commanding respect when she entered a room.

Soon after, these chicks entered the television world and my obsession with glamorous work attire became even worse. 

Then I got this crazy idea that I wanted to be a doctor, never considering the fact that sexy suits just might not be suitable for the work place. When I began my clinical rotations in medical school I tried to add a bit of flare with my short white coat, always planning out my outfits the night before. Then my surgery clerkship started and I was introduced to a new way of life.

Aah, the scrub! The all-telling uniform of the hospital worker. I was now succumbed to two choices of outfit colors, blue or green. And I didn't even attempt to augment my look with jewelry; dangling earrings and Forever 21 necklaces are not an option in the OR.

Since starting residency I've since learned to embrace the scrub way of life and have come to appreciate the awesomeness of the scrub. Not only do I no longer have to iron in the morning, but I can snooze for an extra 10 minutes knowing that I just have to throw on a matching top and bottom and head to work. Granted being the fashionista that I (believe) I am, I still try to hook up my plain scrubs. 

♪ Gold all in my chain! ♪

One of the  major down sides to the scrub way of life is the facade it leads you to believe. Since they are drawstring and very roomy, you never realize how your weight is changing as you devour late night pizza, midnight ice cream, and coffee while on call.When you finally return to regular clothes.....well what do we have here, my pants won't zip!

Sadly, it's unconventional for doctors to wear the multi-colored, multi-patterned scrubs nurses are privileged to wear. Trust and believe if I could I'd wear cartoon scrubs all day like this I would.

So for now I'll wear my scrubs with pride! I may not be a smashing Carrie from Sex and the City, but I think I'm a pretty smashing doctor in my all cotton glory. One day I will be at the attending physician level where I'll be expected to dress nicely everyday. Until then I'll just have to add my best accessory to my scrubs- my smile :).

 

Ghana, Our Beloved Country

As Ghana celebrates it's 56th anniversary as an independent nation today, we'd like to share some of our amazing moments captured on camera Ghana last year.

Presidential Castle

Jollof Sushi- only in Africa!

Our favorite Gelato spot in OSU!

Rice all day, every day!

Kwame Nkrumah University of Science & Technology
Kumasi, Ghana