What Now, Internship

I'm on my third week of the daily grind of internship, my first rotation is Pedia-NICU where we catch babies at the delivery room, doing rounds at the ward and on the last four days of our NICU rotation, we served as manongs (meaning, running all the errands) at the neonatal intensive care unit. Here, we are practicing the Essential Newborn Care (ENC) advocated by the World Health Organization wherein there is delayed cord clamping (to prevent anemia), skin to skin contact with the mother and early latching on. Apparently, this provides closer mother-child bonding. Sweet. :) Although, I don't get to read as much as I can (oh well, I don't actually read at all! crazy!), the residents here are not selfish of their knowledge. You ask anything and everything and they will totally exhaust whatever they know to teach you. All you need is to be inquisitive. At first I was hesitant to ask because I get used to the culture of getting your questions thrown back at you with that "hindi mo alam?" look. It's so different here, residents say a lot of thank yous which they're not actually obliged to because it is our job to do the work. They're that courteous. I am not saying that people from where I came from are not courteous enough, they're just different, probably in the manner of speaking (?). On my first catcher duty, I didn't know it was High Risk day, which means that all high-risk pregnancies are scheduled to deliver. We got two congenital hydrocephalus, one nasoethmoidal meningocoele, one 24 weeker (we considered abortion because the baby weighed only 450 g), another 28 weeker and babies of preeclamptic mothers. We got 16 catches that night. 

At the NICU, where I had hard time studying how mechanical ventilators work (yeah, shame on me, right? wala kaya kami dun, bow.), we still had cases of hydrocephalus, mostly preterm babies on sepsis, hyaline membrane diseases, cases of craniosynostosis like pfeiffer syndrome and we also had cases of abandoned babies!! No kidding! There's an 8-month old twin girls there! Nananawagan po kami sa nanay nila, balikan niyo po mga anak niyo!

*I want to share photos of them but to avoid legal issues, whatever it is, wag na lang. :)

We are now posted at the Pedia ER where the cases continue to amaze me. We got rare cases (rare from where I came from, but they seem to be uncommon here, LOL) such as:

a. posterior fossa tumor probably astrocytoma vs. medullastoma with hydrocephalus (5 year old, male)

b. sacrococcygeal teratoma (3 year old, female)

c. hereditary spherocytosis

d. aplastic anemia vs. acute leukemia (9 year old, male)

e. congenital heart disease, cyanotic; transposition of great arteries (7 month old)

f. nasoethmoidal meningocoele (3 year old, female)

g. chronic idiopathic thrombocytopenic purpura 

h. congenital heart disease, cyanotic with severe infundibular valvular pulmonary stenosis (3 year old, female)

i. congenital adrenal hyperplasia in crisis

j. acute lymphoid leukemia

There are also cases that seemed to have no place in the ER like:

a. kerosene ingestion, accidental

b. paracetamol overdosage, non-accidental

c. mr. muscle ingestion, non-accidental

d. acute appendicitis

People are asking me how toxic PGH can get, I say toxic is an understatement, yet it is only in the mind! *winks* :) 

P.S.
I got merit during the Pedia-Neuro teaching rounds last night for being able to trace the CSF pathway. What now, Dr. L? HAHA. :)