PCP: Awkwardness

One of the first patients we saw this afternoon was a nineteen-old-girl and her mother for what sounded like a UTI (can't pee). When we first came to the room, the girl was curled in a ball on the bench. When we asked her when her symptoms started she said, "Something happened on Halloween." That was vague, so her mother tried to elaborate. "She was involved in, um, an activity (*sigh* what's so hard about saying the word sex?) with a male friend, and there was, um, some anal..." You get the idea. At this point the girl pipes up and said, "I didn't want him to do it, but he went in real fast, it was only about two seconds, and afterwards my butt hurt and there was some pinkish stuff oozing out." What got me was how the girl sounded totally clueless and matter-of-fact about it, considering this was her first sexual experience. Dr. P asked the mother if she's talked to her daughter about it, and she said, "Yes, and I'm disappointed that her first time turned out like this." This was in contrast to another case I saw yesterday, in which a girl raised by her trying-to-be-cool aunt was being pushed into being a singer, and her aunt said frankly, without worries, "She practices safe sex and only has one partner." Now I've heard of parents being open with their kids about sex, but seriously, how would a parent know whether or not their kid practices safe sex or how many partners s/he has? Sheesh.

We did not get out until 6:15 pm today, and the last patient was a woman who said she was sleeping too much, eating too little (gets full easily, no appetite), had a major case of fatigue, and could barely find strength to lift her purse. Now the wheels start turning, what could she possibly have? I contemplated MS or myasthenia gravis, as well as the obvious: depression (that's probably the most likely diagnosis). Dr. P asked me what tests I'd want to run. First: TSH (see if she's hypothyroid) and also CBC to look for anemia. And of course, a CMP to see electrolyte levels. Those were the big ones =)

Oh yeah, I also learned today that I can't tolerate Allegra-D. It does a good job of preventing congestion for sure, but now my nose is so dry it hurts.