It has been a month since I started my new position. Some days I feel great and other days, I feel totally stupid. Cirrhosis and NASH and the inflammatory bowel diseases are still a bit daunting. The physicians seem to be accepting me now, an are very willing to teach me the nuances of gastroenterology. There was about a week of “let’s see what this chick can do”, where I felt very scrutinized and alone. Evidently, I passed that little test and now I even hear an occasional “good job”.
Yesterday, I walked into an exam room and asked the patient my usual “What brings you here today?” He kind of gave me the stink-eye and said “Oh great, another uninformed health care person”. To which I replied “Sir, I always ask that question so I get a good idea of the patient’s expectations for the visit”.
After looking over his EGD results which showed gastritis and the pathology report which was negative for H Pylori, he asked me what reasons other than H Pylori could cause the gastritis. Seeing aspirin on his med list, I asked how much he was taking. Turned out, it was 325 mg of regular aspirin, because, he said, he heard it was good for you. Further questioning revealed chronic headaches and regular use of ibuprofen, Aleve and aspirin powders.
We discussed all of this, and the plan was to reduce the aspirin to 81mg of enteric coated, and avoid the NSAIDs. Use Tylenol instead, and to follow up on the headaches with his primary care provider.
When the patient left, he thanked me. I guess I didn’t look so uninformed anymore.
It feels good…