Mikala Monroe

Journal #5

2/6/24; 7;45 A.M. - 12:00 P.M.; 12:30 P.M. - 5:00 P.M.

Today I am in the office with Brooke. We've had two patients come in today that were diagnosed

with alopecia areata which is an autoimmune condition causing hair loss. Both patients had been

prescribed medication for it in the past few months and seem to be doing quite well on it. The

woman was a little disappointed because her hair isn’t as thick as it used to be but when dealing

with a condition like this it’s not very likely that it will return to the way it was before. There

was a patient that had some little milia spots on her face that Brooke got to remove so that was

interesting to watch. There was a patient that came in in her 70s and she goes to the tanning bed

a lot during the summer so her reason for coming was so she can get all her precancerous spots

taken care of before she went back. This kind of annoyed us because Brooke told her we don’t

recommend tanning beds and she pretty much said she didn’t care. So it’s interesting seeing

patients care enough to get their skin checked but not enough to stop doing what is possibly

causing the damage. The most interesting thing I got to watch today was a patient getting botox.

She was in her early 70’s and she looked like she was in her 50’s, she looked so young for her

age.

2/7/24; 7:45 A.M. - 12:00 P.M.; 12:30 P.M. - 3:30 P.M.

I’m usually with Christine on Wednesdays but today I was with Brooke again since she wasn’t at

the Warner Robins office. It was pretty busy today but there's mostly just been skin checks.

There was a patient who came in that was diagnosed with eczema and he was having a flare up.

It's easy for me to have sympathy towards patients that struggle with eczema since I had it all

over my legs when I was younger and I remember how much pain it caused me. I also got to see
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a patient get botox and a lip flip which was really cool to watch, she looked like she was in her

late 20’s or early 30’s but she was actually 40 which was so crazy.

2/8/24; 7:45 A.M. - 11:45 A.M.; 1:00 P.M. - 4:15 P.M.

Today I was in Gray with the nurse practitioner Christine and it was pretty slow as usual. I

learned a few new terms today such as stucco keratosis, which are benign growths on the legs

and feet that can itch and a patient came in with this on his ankles. There was also a patient that

came in with a spilus nevus which is essentially a brown or tan birthmark with speckles or dark

spots in them. And those birth marks that are brown or tan are called café au lait spots which

sounds fancy. There was a patient we saw on my 3rd day of internship who had a bad rash on his

back due to some hardware he got put in years ago and he’s not doing any better. He is waiting

to have it taken out but he said he has been waiting for months to get that approved by the VA or

something like that. So right now Christine is just prescribing him medications and topicals to

ease the pain and itch because that's all we can do really. It’s just sad to see patients going

through that much pain and just be overlooked but that will be a part of the job. There was also a

patient who came in and got sclerotherapy and botox and I like watching those procedures.

2/9/24; 7:45 A.M. - 12:00 P.M.; 12:30 P.M. - 3:30 P.M.

Today I am back at the Macon office. They moved me to the front today so I haven’t been able

to go back with a lot of patients, but we were slow anyway so it’s okay. I did learn a new term

today which according to google is a pretty rare occurrence, but we had a patient come in with

one on her leg. It’s called a porokeratosis which are like small round patches on the skin with

thin raised borders. I noticed it when I was first looking at the patient's legs but I wasn't quite

sure what it was. I like looking at spots on the patients a little ahead of Christine because then I

can try to guess what they are before she calls it out to me, but sometimes it is difficult since they
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all don’t look the same. I am still trying to work on how certain conditions and spots look on

different skin colors but I know that will take time for me to learn. Our last patient of the day

was a 7 year old girl and she either had psoriasis or eczema. It looked like eczema but her nails

looked like it could be psoriasis. So because we weren’t sure, Christine had to do a punch biopsy

and applied numbing cream so the lidocaine injection wouldn’t hurt as bad. However it seemed

as though the numbing cream didn’t work at all because as soon as that needle touched her she

started screaming and we all had to hold her down so she could finish the biopsy. It was hard for

me to watch but I had to keep reminding myself that we were doing this to help her, and she will

feel much better in the future.

Day Time In Lunch Time Out Hours Worked

Tuesday, 7:45 A.M. 12:00 P.M.- 5:00 P.M. 8.45

February 6th 12:30 P.M.

Wednesday, 7:45 A.M. 12:00 P.M. - 3:30 P.M. 7.15

February 7th 12:30 P.M.

Thursday, 7:45 A.M. 11:45 A.M. - 4:15 P.M. 7.15

February 8th 1:00 P.M.

Friday, 7:45 A.M. 12:00 P.M. - 3:30 P.M. 7.15

February 9th 12:30 P.M.

Total Weekly 30.30

Hours

Total Hours to 125.30

Date