Archive for the Category "The Medical Connection"
Yesterday was an interesting day in the fact that everyone had about the same illness.
You know the allergies with a slight touch of a sore throat, mixed with a few ear infections.
Several of the patients absolutely felt miserable because of the congestion and sinus pressure.
It is definitely not a comfortable feeling when your normally clear sinus passages are clogged, swollen and tender.
I enjoy seeing the healthy sick.
That is what I call them.
Some come in because their parents brought them and others because they just can’t stand feeling bad anymore.
My sole purpose is to give them treatment without antibiotics and give education when it is viral.
When it is bacterial we treat and stop the infection in it’s tracks.
I had one patient that presented to the clinic that was different from the pack.
Basically he was returning for follow up.
He had self medicated himself with antibiotics.
Different antibiotics over the course of 6-8 weeks because he could not seem to stop the supposedly bacterial infection.
This patient presented with severe intractable diarrhea, up to 20 times per day, to include severe abdominal pain, bloating, lack of appetite and fever.
I knew I would be longer with this patient so I sat down and listened closely.
You know, in any business you do, you must learn to listen.
If people think you are listening, then you get there attention.
This patient had a history of chronic infections, was a smoker, thus I knew the infections this patient was getting were being caused by more resistant bacteria.
The problem was the persistent diarrhea that would not resolve.
Finally, we tested the patient for a particular colitis called C. Difficile Toxin, which was positive for this patient.
We treated the patient with Flagyl, an antibiotic that treats bacteria that do not like the air, called anaerobic bacteria.
The good news was that the patient did slowly recover and had an outstanding outcome.
The reason for this story was to hone in on the issue of patients treating their infections on their own.
I will repeat, never, never, never treat your infections on your own.
Why am I telling you about this?
Well about 5 years ago, I remember being called in for a consult (when I worked for an infectious disease specialist) for a very healthy 23 year old college graduate. The patient had developed C.difficile colitis because he kept taking antibiotics anytime he felt a hint of a sore throat infection. He would only take the antibiotics for a 2-3 day period and then he would stop.
He had been doing this practice for the last 5 years. His mom was an office manager for a large family practice clinic locally, so it was no problem for him to get samples of antibiotics.
This young man required surgery to remove part of his large intestine, because of his past self medicating.
This theory is exactly why your MD requires to see you when you get ill, instead of just calling out a script to your local pharmacy.
It is along these same guidelines often I recommend live culture yogurt to replenish the normal flora in your intestine while you are taking your recommended antibiotics.
This post is really here to help folks that get upset with their medical doctors when they are forced to make an office visit for a simple sore throat.
Your MD/PA/NP are just doing his/her job to provide you the best of medical care.
I have more stories to bring you so stay tuned.
Kathy Marshall PA-C, MS
Category: The Medical Connection
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This is a recent video that I did about a recent experience in my family practice clinic in Southern Texas. Just Making a difference, one patient at a time.
Happy Holidays to everyone.
God Bless you.
Kathy Marshall.
Category: The Medical Connection
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Come hear about “The Book” that changed my life.
“Hearts”
by Thomas Thomas.
Biography about the Heart transplantation era focused on
the Texas Medical Center in Houston, Texas.
Two surgeons battled to be the best.
Dr Michael Debakey
Dr. Denton Cooley.
They both Won the Race.
This book inspired me during my high school years to reach my goals.
Finding this book again recently inspired me to create this video.
To talk about my inspiration and what is motivating my power of intent.
Kathy Marshall
“The Medical connection”
Category: The Medical Connection
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Hey it is Kathy here with another post for “The Medical Connection.”
Yesterday I saw another one of my favorite patients. He was returning for a follow up from last week. Mr. C, was complaining last week of an itchy rash along his right ankle and slightly on the left. He had tried multiple “over the counter” cremes with no improvement.
Mr. C about 4 weeks ago had a bout of C. difficile colititis, due to the antibiotic he was given to treat an upper respiratory infection. This type of colon inflammation is induced by your common broad spectrum antibiotics. You see, C. difficile is a normal anaerobic (doesn’t like oxygen) bacteria in your colon in small numbers.
When your Doctor gives you a broad spectrum antibiotic like Amoxicillin, Levaquin, Augmentin, etc. the treatment effects not only at the site of your infection, but also the normal flora in your large intestine. So when you are taking your broad spectrum antiobiotic it will decrease the normal good bacteria in your colon and allow the C. difficile to multiply and gain strength. When that happens you have the colitis symptoms which will begin to develop like abdominal cramping, nausea, uncontrolled diarrhea,…………Yes, I know this is TMI, but people need to understand this. This is why you never take antibiotics on your own. Healthy people have lost colons because of this problem.
Prevention Hint** Eat yogurt 3x/day while on Antibiotics or take a good Probiotic while on your antibiotic and for at least 7 days after completing your antibiotic.
Now back to Mr. C.
So when I saw Mr. C last week with the rash on his right ankle, I recommended an antibiotic creme and not an oral antibiotic.
The last thing he needed was another antibiotic. People that get C. difficile tend to be frequent flyers with enhanced recurrence if you are not careful.
I scheduled Mr. C for a follow up visit in 5 days because cellulitis can worsen quickly, lead to blood clots, sepsis (infection in the blood) if you are not careful.
Mr. C, presented yesterday with with a major improvement of his ankle rash. When I looked closely he did have a significant change, but I noticed the rash was only where his socks covered.
Upon noticing this, I recommended to the patient he may want to not wear socks throughout the day, maybe even wear flip flops to allow air to help heal his rash. I recommended he may even have an allergic response to his socks he was wearing.
Mr. C looked up at me very concerned and said, “But, I can’t stop wearing these socks. When my wife died I started wearing these socks to keep my feet warm at night. No way, can I stop wearing these socks.” He smiled at me and I said nothing because I knew he had more to say. “Anyway, I can’t give up my holey socks. I wear these to church.”
Mr. C proceeded to take off his shoes and illustrate very proudly his toes protruding from holes in his socks.
He smiled even bigger, causing his lines around his eyes to wink at me. ” Twenty years ago, my wife bought me these socks and I can never let them go.”
Just keeping it real.
Kathy Marshall
The “Medical Connection”
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Category: The Medical Connection
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November 6, 2009
Hello to you all. It is a beautiful friday afternoon in Friendswood, Texas. I have a great story to share today.
During this journey of creating my home based business dynasty I do still work as a Physician Assistant. I really enjoy what I do as a health care provider. You just never know when the patient or a family member comes back to say thank you for helping them.
Back in time, about 2 weeks ago a nice man stopped at my desk where I work in a retail clinic. I could tell he really didn’t want to be speaking with me and probably was not a frequent flyer with his primary care physician. He held out his right hand to me and showed a swollen red thumb that was really hurting him. He did have a minor scratch on the thumb, which he said was done while working on his boat.
I asked him to roll up his arm sleeve and yes, I saw the hint of a small linear red streak going up his lower right arm. He did not have a fever and other than the pain on his right hand he did not really feel very bad. He told me he was presenting to our clinic for antibiotics because he was a busy man and did not have time to wait for his primary MD in his clinic.
So, as I spoke with him he was sort of nervous and I could tell he wanted to split because the whole medical thing was just overwhelming to him. I next sat down and asked him to do the same. I removed the stethoscope around my neck and gave him a smile.
His wife had showed up by then. My reply was to the both of them, that the patient would need emergent care and referred him to the closest emergency room for evaluation, probable IV antibiotics and hospitalization.
The patient kept saying but “It is only a small scratch?”
Similar scenes occurred while I was a student at Baylor College of Medicine, during our student training in the ER. I promise to not get graphic but we saw numerous patients losing limbs, getting bacteria in their blood or chronic heart problems because they thought “It is only a small scratch”.
I slowed the patient down, the busy man and shared a few stories of my memories. Speaking slow and sure I told him he needed to take care of himself now and go to the ER immediately. He listened , thanked me and left on a mission to visit the ER.
Today his wife stopped at the desk to thank me for helping with her husband. He actually was not a regular patient with his MD and often would not follow medical advice. His wife told me he was hospitalized for 3 days, was treated with 3 different IV antibiotics. He recovered quite nicely with full function of his right hand and arm. He was told upon admission his recovery was good because he listened and followed instructions. Because he took immediate action his outcome yielded awesome results.
This story should speak to all of us that are getting training for our online and offline adventures. Not following good instruction, getting mislead or not listening can yield poor and often devastating results. Listening to your heart, following instructions and doing the right things can lead to success. But where do you go for such knowledge with so much being sold and marketed to the thousands of visionary people. Like in medicine if we take the time to explain and educate, patients can have great outcomes. Your future and business can be successful and we would like to help you get to that point.
But first and most important action is required.
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Category: The Medical Connection
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October 30, 2009
Today, I spent about 6 hours in one of my favorite clinics on the planet. A small southern Texas town, where people will stop to help you when your car breaks down. These patients are just amazing. We have several in their 90’s still busting a move because they remain active. One gentleman in his late 90’s still does his own garden, yard work and fixes his fence when it breaks. He has less body fat than most 14 year old males. He probably could outrun most of them on one of his bad days.
One day about 2 years ago he showed up at the front desk with a towel around his right side of this face. He presented to our clinic with half of his ear torn, from his tractor. We immediately triaged him to the Emergent care just across the street, with nursing escort. About 10 days later he returned to me for suture removal of over 150 stitches from his right ear. We had a suture removing party for about 45 minutes, because they were extremely tiny. I had to use a lighted headset with magnification glasses to see them properly. He healed extremely fast and had no problems afterwards.
When the patients like you they bring you food, hand crafts or big hugs. Patients come to this clinic from all over Texas and many drive across Houston, to be seen by us. I can’t explain the satisfaction when you help these people, because they make sure you feel appreciated. So lots of love flowing in this special place where people still care about people.
This same rhythm and flow I use to work with people in my online and offline adventures. This essence is why I am good with talking with people and one of the secrets to my success.
Back to good customer support equals referrals without advertising.
See you back soon for more “Medical Connection”.
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October 29, 2009
Simple day in the clinic. The hype and scare of the H1N1 illness has people running around with the “deer in the headlights look”. You really can’t blame them with so many cases of Swine Flu being reported. I decided to not take the vaccine, since I am not surrounded by multiple sickly patients, thus I will not be a huge threat to spread the virus. Also, in my work environment, I see others that were in higher need to be vaccinated.
You can always tell the patients with serious anxiety disorder. They walk up to the desk and can’t quit moving. They play with the business cards, the scanner to pay, they smell like cigarettes and they can’t look you straight in the eye.
I understand these people and let them run themselves to the point of exhaustion. Some just won’t stop. My focus is to help them leave with a tool to help them. I find laughter is the key with most of these patients.
Now, dealing with the angry patient is my favorite. Yes, I love working with hard cases. My goal is to take the angry ones and have them leaving the clinic laughing their ………..off. Laughter is seriously the best medicine. Often as they leave I say a secret prayer for them. 
Another day of keeping it real as a health care provider that cares.
Kathy
Category: The Medical Connection
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