A DAY IN THE LIFE
Babies to Boomers
by ADAM NEFF , MD
Opening my EPIC Haiku application at 7 a . m . before heading into the office , I scroll through the scheduled patients and see a list of all ages from newborns to geriatrics , some days with ages 0 through 105 . I look through the list of problems and mentally prepare myself for the variety that tends to come with each day , attempting to think of a pre-plan to lead the discussion in each room . Some days are standard , we have our routine follow-up for diabetes , hypertension , thyroid disease , depression / anxiety . I might have the expected onslaught of sports physicals and Medicare Wellness exams . Some days are fraught with overwhelming emotions , folks with worsening depression , unexpected loss of family or friends or new uncertain symptoms and diagnoses . Yet others come in with small and / or large achievements , significant improvement in medical conditions , overall well-being or the welcoming of a newborn baby .
As an internist and pediatrician , I often must alter my disposition and responsiveness as I move from room to room , meeting the variety of ages and different families just where they are on this day . As a primary care physician , I must also do what I preach . I wake up early for a 6 a . m . spin class or a workout at my local YMCA , quick rinse , then to the office . I start the day with one of my well known 75-year-old patients who is in for his diabetic monitoring ; we talk about his blood glucose control , whether his medications are effective or not and the utility to each of them . I might ask him about his significant other or grandchildren , his upcoming holiday plans and wrap up with some blood work . Next , a pregnant woman who is 30 weeks along , new to me , is in to establish care and do a pre-natal visit before the delivery of her first-born baby . I ask her about how the pregnancy is going , what complications , if any , she has had , and overall , how the pregnancy has been for her . We discuss plans for baby , chosen name , tentative delivery date and routine newborn care and expectations . Next up , a 13-year-old with worsening anxiety who has been having more frequent episodes of somatic symptoms since returning to school , we talk about school and home stressors , how we can learn to navigate these and move forward with a close follow up strategy .
Lunch hits , I wrap up the notes from the morning , answer patient messages , peruse and interpret diagnostic workup . If I ’ m on call for the newborn nursery , I will drive just about 10 minutes North on I-71 to LaGrange . I will quickly review each baby ’ s records , mom ’ s prenatal history and move from room to room congratulating the parents and welcoming the newborn baby into the world .
Before I know it , lunch is finished , and it is time for the afternoon visits . The afternoon starts with a young man who hasn ’ t seen a doctor for years , since his pediatrician last at 18 years old . We talk about routine preventive care including recommended STI screening , discuss drinking and tobacco use , about his work and day-to-day stressors . A middle-aged woman who has been dealing with menopause needs options for her leg swelling , hot flashes and further steps in managing her symptoms . At the end of the day , if I ’ m lucky , I ’ ll end with a 9-month well-child check with the cutest baby . I ’ ll counsel the parents on expected developmental milestones , complete a 9-month ASQ questionnaire and do a full exam ( aka , have some baby time ). We will talk about upcoming vaccines and precautions to have in the house as she starts to get more mobile .
Lastly , as I wrap up with patients , I ’ ll finish up my notes , return MyChart messages that accumulated throughout the day , return phone calls and cut up a little with the office staff before leaving clinic for the day . Then on to relax , make my favorite sheet pan sausage and veggies for a grain bowl and take some time to read a non-medical related book . I ’ ll listen to my newest music addiction of the week - all to do it again the next morning : babies to boomers to the ( sometimes ) babbling oldsters .
Dr . Neff is a primary care internist and pediatrician with Baptist Health .
October 2023 13