Thumbs up, fetus! and a grab bag of other Ob topics

by chelseajin

Last Wednesday was Ob clinic day. So far, one lesson is ingrained in my head. I’m seeing these women every other week, I should just say anything to them (within reasonable limits of course). Because it’s about building rapport, and I’m in a great position to have a good relationship with them. It would make taking a history easier and my Spanish better, because they wouldn’t feel like I’m the intermittent stranger who’s stumbling over words and won’t get their story straight.

So fun highlight of the day, the doctor and resident were going through their chart review and they were curious about one patient and the position of her fetus. The notes said that she was a possible breech and when they looked in the ultrasound notes, they found that fetal position was notated as “Great”.

That made for some laughs.

They were thinking that there was a typo or error in dictation. Dictation, as I later found out, is just an audio recording of a radiologist’s findings. I can’t imagine anyone would just put down “great” with no questions, so maybe there’s a machine that automatically transcribes the audio. That was an obvious item for the list of things we had to check out today.

We also told one patient that she had a horseshoe kidney. She had no idea. You normally have two kidneys, in this case, they’re fused in a vague horseshoe shape, usually connected at the lower poles, but they function just fine.

from the Department of Pathology in the Virginia Commonwealth University

I learned that sexual intercourse is the #1 reason for preterm labor. Is it improper to laugh a little? It certainly gives some credence to the myth that having sex with a pregnant woman could poke the baby.

On a more serious note, we had someone else who had a “possible history of HSV (aka herpes)”. What a strange note. I thought we would send for titers even though on questioning, they didn’t recall anything related to an outbreak. But there’s also the problem of no/little insurance, and this isn’t a test included in the prenatal package. I was a little on the fence, maybe because I’m used to double-checking things and having insurance. But with no supporting history except for the mysterious note, it was thought best to just treat it as a mistake.

Afterwards, Lorenia, the MA, took me out to a carretera (the Mexican version of the Korean 포장마차) to eat some Sonoran hotdogs. It’s a food cart, sometimes with tarps, in a parking lot.

She thought it was hilarious that I said “I need to try Sonoran hotdogs” versus “those sound good”– some of my type A New Yorker tourist personality leaking through. I should have taken a picture of them, but I was so hungry I just swallowed them whole. They’re hotdogs loaded with all kinds of Mexican toppings like salsa, cheese, and jalapenos. I feel like an old man saying this, but the first one did a number on my stomach and as much as I wanted to put some more hot stuff on, I had to stop myself. Lorenia also got some horchata, which can be a variation of a rinsed rice or nut-water drink with cinnamon. It was pretty good, and a great spice-tamer. Next time, I’m going to order some of that.

Lorenia has actually been amazing to me. She’s given me rides to the clinic and back everyday without any kind of complaints, she’s really friendly, and is extremely organized. Things I can be in deficit of. She even paid for my lunch! I wanted to bring some baked goods to thank her. The 2 things stopping me are my catastrophic cinnamon failure and thinking about how this is going to support diabetes.