Ob-Gyn Patient Logs

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I have described some patient encounters that have resonated with me. Although I have chosen to write about some tragic cases, this is not reflective of my overall experience. There have also been countless happy and healthy women of all ages with whom I have had the privilege of interacting.

Patient A: I found myself in an exam room attempting to take the history of a patient who only spoke and understood Spanish. She was in her late 50?s, extremely thin, and walked with the aid of a cane. Through many elaborate hand gestures paired with clumsy utterances of Spanish phrases (on my part), I managed to gather that she recently underwent open heart surgery, and during her hospital stay, had fallen and broken her hip; hence, the cane. She was so patient with my foreign language fumbles and we shared frequent giggles.

Her last pap smear to screen for atypical cervical cells was over 5 years ago. Upon pelvic exam, her cervix was irregularly shaped and bore noticeable discoloration. When I tried to collect cells, the instrument caused her cervix to bleed more than normal. My preceptor spent several minutes controlling the bleeding as well as taking biopsies. I stood next to her and held her hand as she silently cried in pain and fear. She had just gone through 2 major life-altering surgeries and now she had overt cervical cancer. I had gotten used to performing routine pap smears day after day, knowing that this screening test had helped push cervical cancer from the most prevalent to the 5th most prevalent cancer in this country, that I wasn?t expecting to see a patient with it, and especially not so far apparently advanced.

I wish I could?ve said something to comfort her when I was standing at the head of the exam table. I hope that just being there with her in that moment helped even a little. She still has a long and hard journey ahead of her.

Patient B: A sophisticated young woman came into the office with a desire to become pregnant. She was well-dressed, wearing tasteful jewelry, and had not a hair was out of place. In the past, she had been pregnant 3 times, but all had unfortunately ended in miscarriage during the 2nd trimester. As we prepared to do her pelvic exam, we explained to her that one possible cause of her recurrent miscarriages could be something called ?incompetent cervix? ? a condition where the cervix painlessly dilates resulting in the loss of the pregnancy.

The bimanual exam derailed our train of thought completely. Instead of feeling soft and healthy tissue, a large, solid mass was felt in the upper right portion of her vagina. It wasn?t bulging out, which would signify vaginal cancer, but the wall felt hard. Biopsies were immediately taken and she was sent for a stat CT scan. The report showed an extensive mass from her vaginal wall extending up to and blocking one of her ureters causing her right kidney to be backed up with urine. Due to the complexity of the problem, she was urgently referred to a gynecological oncologist.
She came into the office healthy and hopeful for a pregnancy. She left with a veil of uncertainty and a likely diagnosis of invasive cancer. She is only 28 years old.

Patient C: The midwife and I were reading the chart of the next patient waiting in the Labor and Delivery Triage area. I had to read the first page twice; the date of birth meant this patient was 13 years old. Her brief history read that she was also a rape victim. A man who was renting a room in her parents? house was the perpetrator and she hadn?t come to the clinic for obstetric care until she was 30 weeks pregnant.

As I caught my first glimpse of her in a triage bed with a full 38-week belly, I thought she could be 18 years old at the oldest. But as soon as she spoke, it was as if I was hearing the voice of a child ? soft, hesitant, and slightly higher pitched. I couldn?t help but think that if I had had a baby at 13 years old, this patient here would be my daughter, pregnant with my grandchild, and I would?ve been a grandmother at 26. This girl, who hadn?t even finished going through puberty, had the rest of her childhood and adolescence stolen from her.

And yet, she was a graceful new mother. After she bore her child, she cried joyful tears calling her baby her ?treasure? and ?angel? and vowed to take care of him as best as she could, even though she didn?t ask for him. Young in so many ways, but at that moment, she radiated maturity beyond her years.

Source: http://blogs.palmbeachpost.com/becoming-a-doctor/2011/03/15/ob-gyn-patient-logs/

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Police seek help identifying robbery suspect

Authorities are asking for help identifying a suspect wanted for robbery. A release by the Palm Beach County Sheriff's Office states the suspect approached a man, around 18-25 years of age, on his bicycle around 12:15 Wednesday morning near West Palm Beach and asked for the time.

Source: http://www.palmbeachpost.com/news/crime/police-seek-help-identifying-robbery-suspect-1502975.html?cxtype=rss_crime_1341

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Destination Dining: Lips, in Oakland Park

Having brunch with some girlfriends on a Sunday isn?t considered a ‘drag? by any stretch of the imagination. Unless you?re having the Sunday Gospel Brunch at Lips in Oakland Park, where drag is a way of life. The ‘Sisters of Sequins,? who host the gospel brunch at Lips, serve up diva impersonations that channel their [...]

Source: http://www.pbpulse.com/dining/restaurants-dining/2011/05/25/destination-dining-lips-in-oakland-park/

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The end of an era at John G?s

On Sunday, Elaine and Morty Hyman could have spent the morning of their anniversary having a leisurely breakfast at an oceanside table at the luxurious Four Seasons Resort, where they were spending the weekend. Instead, the Lake Worth couple memorialized 45 years together with an hour’s wait in the hot sun, so they could have [...]

Source: http://www.pbpulse.com/dining/2011/05/26/the-end-of-an-era-at-john-g-s/

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Four of Ponzi schemer Scott Rothstein's associates charged

Four of Ponzi schemer Scott Rothstein's associates were charged Friday with conspiracy to commit wire fraud, the first public indication that federal prosecutors are nearing the end of their expansive investigation into the largest investment fraud in Florida history.

Source: http://www.palmbeachpost.com/news/crime/four-of-ponzi-schemer-scott-rothsteins-associates-charged-1502309.html?cxtype=rss_crime_1341

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Wine Events: From May 25 to May 31

TODAY Winesdays Wine Tastings: 6 p.m., Russell’s Blue Water Grill, 2450 PGA Blvd. (at the corner of Prosperity in the TJ Maxx plaza) in Palm Beach Gardens. Complimentary tastings, along with a selection of passed hors d’oeuvres. (561) 318-6344. SATURDAY Everything You Wanted to Learn About Wine: 10:30 a.m., Hoke Library, Community Room, 1150 N.W. [...]

Source: http://www.pbpulse.com/dining/2011/05/25/wine-events-from-may-25-to-may-31/

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Regular teeth checkup, X-rays a must for all dogs

Question: Hello, I have two mini poodles, both 8 years old. They are having their teeth cleaned, and the vet said they have periodontal disease. He recommended X-rays as well, but are these really necessary? Are they harmful? — Lynne

Answer: Congratulations on doing the best to keep your dogs healthy. Dogs that get regular dental care live much longer than dogs that don?t. Small breed dogs are prone to dental disease. Routine dental cleanings every six to 12 months are very important for keeping the mouth healthy.

Since it is difficult to properly examine your dog?s mouth when he is awake, the pet is placed under general anesthesia for the diagnostic exam, cleaning, polishing, and fluoride treatment. It is during this time that X-rays are taken. It is even more important to take X-rays in dogs than it is with people.

People can tell you which tooth is hurting them and dogs can?t. Often even teeth that look perfectly normal will have disease that can only be detected by X-rays. X-rays will show the internal structure of the tooth and the surrounding bone.

Infection in the gums and supporting structures of the tooth can lead to loss of bone in the tooth socket. The tooth then begins to get loose and will eventually be lost if treatment is not started early.

Bacteria and plaque begin to build up as early as 12 hours after a cleaning. Then minerals in the food begin to turn the plaque layer into a hard substance called tartar.

Therefore, it is very important to brush your dog?s teeth regularly to remove plaque before it becomes tartar. Infection in the mouth leads to bad breath. The bacteria that cause the infection can get into the blood stream and settle in the kidneys, liver, and heart valves. Approximately 85 percent of dogs over the age of 4 years have periodontal disease. Kidney disease commonly occurs secondary to the periodontal disease. Most veterinarians recommend whole mouth X-rays every two years and X-rays of teeth that are abnormal at each dental cleaning in between.

Dr. Baker

Dr. Baker

Dr. Susan Baker
Baker Veterinary Clinic
1801 S. Congress Ave.
West Palm Beach, FL 33406
Read more articles by Dr. Baker | Ask her a question

Source: http://blogs.palmbeachpost.com/pawshere/2011/05/03/regular-teeth-checkup-x-rays-a-must-for-all-dogs/

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Palm Beach County property values sink, further depleting tax coffers

Palm Beach County's tax base shrunk by less than three percent in 2010, as the hemorrhaging real estate values that have defined recent years appear to be healing.

Source: http://www.palmbeachpost.com/money/real-estate/palm-beach-county-property-values-sink-further-depleting-1499601.html?cxtype=rss_real-estate_25296

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Commentary: Don't let bells, whistles and Big 3 fool you, NBA could follow NFL into limbo

Two months into the NFL lockout and it's starting to get scary. How much longer before somebody steals a mournful snapshot of Roger Goodell skulking around some Manhattan soup kitchen, his fancy suits pawned and his limo driver released to seek employment elsewhere?

Source: http://www.palmbeachpost.com/sports/dolphins/commentary-dont-let-bells-whistles-and-big-3-1485922.html?cxtype=rss_dolphins

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