Chasing Zebras

Oh Hello!

2012-02-04T20:23:00.004-06:00

I must get more clever wih these titles but just wanted to check in and let everyone know I'm surviving! I just finished my fourth consecutive month of my alarm going off at 3:00 AM and carrying the call pager during the day and I am so excited. On call tonight, get off tomorrow morning and will get to spend time with my family watching the Super Bowl.

Monday starts my second rotation on Labor and Delivery. I am excited and a little scared all at once. It feels like so long ago since I've been there! It was just August but feels like 2 years ago. Here's the rotations conquered so far:

OB Receiving - days
Labor and Delivery - days
OBI - 3:00 AM rounding, scheduled c-sections
HO I - 3:00 AM rounding, carrying call pager
HO I - again
OB I - again

Next up is L and D, then Gyn (the sweetest rotation), then Clinic/Ultrasound, then OB Receiving days again and intern year is finished! It gets better every day. Most of the attendings trust you to do the things they know you're competent at. We did lose an intern at the end of August and it really increased the workload. He quit without much warning and threw our schedules into a tizzy - specifically the call schedule. Most of us get one weekend off a month. And it is a glorious weekend.

But enough about work. Otherwise things are fabulous. Kris and I bought new cars back in November and are in love with them. The animals are as good as ever, and we are still hanging in our little yellow house by the reservoir. Counting the days until intern year is over but happy to be where I am.

Oh Hi

2011-08-06T10:54:00.003-05:00

Oh hello... Did you think I'd forgotten about my little blog?

I haven't. Things have just been as crazy as I'd predicted they would be. I just finished my month of OB Receiving (aka pregnant lady ER) and I am so glad it's over. To give you an idea of how busy it was - I ate food 2x last month while at work and subsequently lost 8lbs in 31 days. I don't recommend this diet but at least I can fit into my clothes a little better on the 1 day off a week that I get to wear them!

Speaking of that one day off... Today is that day. You think I would be overjoyed, excited, thrilled but instead I am anxious and a little sad. Because I know it all starts over tomorrow and the clock is ticking. K is at work so I'm all alone. I have a million articles and book chapters I need to read, anatomy I need to review, etc... And of course a dirty house and fridge that need to be cleaned. I'm having a hard time shaking the "day off blues." So far I've found that certain bible verses as well as getting outside in the sunshine help so that's what I plan to do today. Clean a little, cook a little, go out for a walk or to work in the yard, and do a bit of reading. I've never been so inspired to read medical literature in my life. Mostly because the fear from being called out by an attending either in front of 30 people (this happened to me this week) or being kicked out of the OR or compromising patient care. Now journal articles about which antibiotic prophylaxis is best prior to surgery are absolutely thrilling to me. Because it helps me understand why we do what we do and alleviate any fear of not knowing about it when asked.

Earlier this week at board sign outs (where the night team tells you whats going on with each laboring patient on the board) there was an HIV+ patient. The attending then turns to me and asks when we usually induce these patients, what maneuvers we avoid, what dosage of medicine and for how long they need it prior to delivery, the vertical transmission rates, etc... I did not know. It was painful for everyone. I was encouraged to read the article. Which of course I went home and did as I was falling asleep. The next day I got asked what the transmission rates are without treatment and BAM! I spit it right back out at her. 25% thankyouverymuch :) So that was a good day.

But the thing is there's always another complicated patient, another article to read, another muscle to know the exact innervation and blood supply to, and that is why I have the day off jitters. Instead of enjoying today I'm worried about what I will be asked tomorrow.

Now that that pitiful rant is over, here's highlights from last month:
1. Seeing several women come in between 30-35 weeks desperately hoping to be in labor. I gave them each a serious talk on how their baby could be impaired if it was born this early. I don't think most of them cared.

2. Checking a cervix on an above-mentioned patient (around 34 weeks pregnant) and noticing something pink and rubbery and prophylactic in my hand when I withdrew it. Of note, the attending was in the room with me which made it even more hilarious and awkward.

3. Getting to show several women in their first trimesters who were worried they were miscarrying their cute little healthy babies with heartbeats right where they should be.

4. Getting frustrated with patients who keep going back to abusive households.

5. Having a baby born in OB Receiving my 2nd week. (I had checked her an hour before and told the nurses to get her up to Labor and Delivery, just so you know...)

6. Having a G11P10 (gravida 11 para 10 - she's on her 11th pregnancy with 10 living children) labor silently and almost have a baby in OB Receiving

7. Doing several circumcisions on cute little baby boys. I really enjoy these!

Highlights from this Week:

1. Delivering several babies!!! (4 or 5?)

2. Scrubbing c-sections and getting to sew fascia and skin :)

3. Scrubbing into 1 placental abruption section and 1 uterine rupture section. The rates of uterine rupture are less than 1% and I got to see it in my first week on Labor and Delivery

I suppose I'm off to clean, read, get outside, and try to cheer up. Hope the rest of you are having a marvelous Saturday!

This Time Next Week...

2011-05-25T14:36:00.002-05:00

I will be a doctor and I will be in Mexico. And hopefully I will be very relaxed and happy! That's all :)

Oh Dear

2011-05-14T12:16:00.003-05:00

It's starting to hit me that I will in fact be a real life doctor person very, very soon. Technically I will be a doctor May 27th once I am handed my diploma but I will not see any patients until July. So in my mind it doesn't really "count" until then.

I am on plastic surgery this month and just happened to be in the Women's and Infants' hospital yesterday for some oncoplastic breast reconstruction cases. Of course I ran into several of my soon to be fellow Ob/Gyn residents and attendings. PS - this is much more fun now that I know they like me - they really, really like me! *spoken in the voice of Sally Field winning the Oscar.* As I've said before - when you're working with these people and trying to make a good impression it's difficult to enjoy your time with them. At least that's the case for me anyway. I was always trying to appear eager but not annoying, helpful but not overbearing, funny but not inappropriate, etc... It's a tight-rope act and you never quite know what small move can make you lose your balance - and influence people's opinions about you.

Anyway, it was all happy times and "hey, what are you doing here?" type conversation and then one of the residents asked if I had my schedule yet. They were in the lounge.

THE SCHEDULE FOR THE NEXT YEAR OF MY LIFE WAS IN THE LOUNGE!!!!!!!!! 10 FEET AWAY!!!!

So of course I run in and pick one up. Here is what our intern year will consist of:

2 months of Gynecology (clinic, hysterectomies, post-menopausal bleeding, fibroids, etc...)

2 months of Labor and Delivery (12ish hour shifts of delivering babies :))

2 months of Clinic (clinic M-F, different every day)

2 months of "Dober" (this means Days OB Receiving aka the "pregnant lady ER", also is shiftwork)

1 month of OB I (scheduled c-sections, high risk clinic, rounding on PPROMers and postpartums)

1 month of HO I (house officer I - you carry a pager that beeps ALL THE TIME. You also do circumcisions, round on postpartums, etc...)

1 month of ADU (this means antenatal diagnostic unit. It's where they do the high tech fancy ultrasounds and amniocentesis)

1 month of ER (this is the regular adult ER. All OB residents love this rotation because you get 2 weeks off this month.)

Now that you know what those months are like, I will tell you that I was most terrified of starting out on Days OB Receiving. It's a busy, busy place. Essentially any pregnant lady that comes into the hospital starts out there. Also, not pregnant ladies, but ladies that think they might be pregnant. And gyn patients. Pretty much any Ob/Gyn patient starts there. Then I have to see them and decide if they go up to the Labor and Delivery Suite to deliver, go back home, get set up in clinic, get worked up for an operation, etc... It gets very busy and it gets backed up. And people can see how many patients you have even in the lounge 2 floors up. It's on a computer monitor. And they say things like - "Wow, OB receiving is really filling up." Oh dear. So without further ado, here's my own personal schedule:

July - Days OB Receiving (cue the screaming lambs)
August - Labor and Delivery Days
September - OB I
October - Gyn A
November - Clinic
December - HO I
January - ER
February - Labor and Delivery Nights
March - Gyn A
April - ADU
May - Days OB Receiving
June - Clinic

So I thought that was bad. Then I looked down at my dear fellow intern who I'm closest to in our class and she starts out on Labor and Delivery!!! In the past they didn't let interns run the L&D unit until we'd been doctors for a full 6 months. They're throwing us into the fire this year though.

And because I got so scared once I saw this schedule I did something I thought I wouldn't do. I started studying last night. For intern year. Just the things I knew I would use - like the first line of treatment for UTIs in pregnancy, and exactly what tests to order when you suspect Gonorrhea or Chlamydia. And steps to ruling out preterm labor.

Overall I'm pretty thrilled with my schedule. The "easier" (ha ha) months are interspersed pretty well with the more challenging ones. Now I am just anxious to see the call schedule. And wondering if the hours will change for any of these blocks...

Easter and Whatnot

2011-04-22T19:52:00.011-05:00

Hey peoples - just got back from a 4 mile run with my fabulous Cousin A (we walked and talked more than we ran though). We also went straight from the trail to a Mexican restaurant where margaritas were imbibed so you know - keep that in mind while you read this post.

I am about to get started on a little cooking for the Easter weekend. Am planning on making some cheddar biscuits that I've made a few times before and some chocolate chip cookie dough truffles that I've never made before but are sweet and therefore can't be screwed up too badly - by me anyway - sugar loves me. The biscuits have chunks of cheddar cheese in them and use heavy cream instead of butter or Crisco aka lard, so what's not to love? So much easier to stir and they come out all light and fluffy once they're baked. Here's the recipe for truffles and a link to the blog:

our little beehive: Chocolate Chip Cookie Dough Truffles: "When I worked in my company's main office I used to bring baked goods to work all the time. When I announced that I was moving and (very tha..."

And here's a link to the recipe for the biscuits:
http://www.cooklikeachampionblog.com/2011/01/cheddar-cheese-biscuits.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+cooklikeachampion+%28Cook+Like+a+Champion%29&utm_content=Google+Reader
(copy and paste that one - not sure why it's not working)

And here's a few pictures from Easters past:

That's from Easter 2006 and is me, my sister, mom and grandmother. We inadvertently color-coordinated pretty well.

And those are the Easter eggs we made and subsequently hid.

One of my favorite pictures of me and my sister and mama. We are such "in the moment" type people that we usually forget to take pictures so I am glad for the few we have together.

One of the whole family.

And me and my sister aka "Seeser!" with our Peter's pottery bunnies. Also - holy shiny T-zone. I swear I own powder and will not let this happen again.

That's all. Happy Easter everybody!

Lazy Days

2011-04-19T22:07:00.005-05:00

You think with all this time I've had off I would be posting every single day, but I've found much more fun ways to fill my time.

For those who read and don't know already, Match Day was great! I got my first choice (although I wasn't tacky enough to say that while up at the microphone). It was such a great day. I couldn't be happier with our intern class. There will be 6 of us - 5 girls and 1 guy. 4 of us trained here during med school and are staying for residency. 1 girl is from Arkansas and another from Florida. Arkansas girl and her husband are really nice. They stayed at our house one weekend while they apartment-hunted. I haven't met Florida girl yet, but I hear she's expecting a big surprise. Due the first week of July. Oy. Wondering how much that's going to suck not only for her, but those of us who will have to be there to pick up the slack.

I was on a high for about a week after Match Day. Later that week was the annual Hal & Mal's St. Patrick's Day Parade and I had nothing else in particular to do so I went to the parade for the first time ever. Here's a picture for proof: (Yes, I'm wearing a red shirt - but my shorts were GREEN! And this is the only sleeveless shirt I own since I'm now in the 25-34 age group and I didn't want tan lines. Phew. Is that enough explanation of a very straight forward picture for you? Now enjoy the picture:)

The parade was pretty much what I thought it would be, but I'm not sure if I'll be going back any time soon. Crowds aren't really my thing... It was nice to hang out and enjoy some nice weather with friends though. Felt like I was on the "med school street" seeing as how I kept seeing residents and med students all along our sidewalk. Too funny.

Speaking of school, I'm in the process of applying for my medical license. I've already sent in all the paperwork once, along with a check for $50 (natch), but have received a request for even more documents. Yay. At least this marriage license is getting to see the light of day for once. Ha ha. I went to UMC a few weeks ago and signed my contract, got drug tested, poked, prodded, and had an incredibly unfortunate i.d. picture taken. Maybe I'll get lucky and they'll redo it during Orientation. One can only hope.

Our Ob/Gyn Interest Group has a lunch meeting tomorrow for the M1s and M2s about how to do well on the rotation and I'm going and might have to speak. I'll also get a chance to see my program director for the first time since matching. Wonder if I'll still be nervous around her? Before Match Day I was always careful to mind my Ps and Qs around all the staff, but now they're stuck with me :)

Anyway, this is probably the most boring blog post ever, but just felt like I needed to update. I start my Plastic Surgery rotation in 2 weeks so I should have some good stories for y'all then :)

Good Food, Good Meat, Good Lord Let's Eat

2011-03-10T17:27:00.006-06:00

The title of this post was my daddy's trademark "blessing" before family meals when he was asked to pray. Short and sweet!
Since I've had this month and basically last month off I've had a good amount of time to cook. I sort of found, sort of created a crockpot stew recipe that I've already made twice since February and I can happily report that it tasted just as good the 2nd time around. Don't tell my mother-in-law but my husband said it was just as good as hers. That means a lot coming from him. Without further ado, here 'tis:

BEST STEW EVER

1 small package stew meat
1/3 cup flour
1 small can V8
1 can English peas
1 can corn
2 potatoes
1 small onion
Tony's, salt, pepper

Put crock pot on low. Grab a pan and put it over med-high heat on the stove. Dump a little flour, salt and pepper in a bowl and toss the stew meat in it to coat. Melt a little butter or fat of your choice in the pan. My mother would say to use Smart Balance or whatever because it's GOOD for you. Not good within reason for a fat, but actually the butter is GOOD for you. I prefer Brummel & Brown's butter-like product but that's because it says it has yogurt in it and yogurt is GOOD for you. Anyway, then saute your meat until it's all brown and mostly done, or all the way done, whichever you prefer. While the meat is browning chop your onions. I chop them real big because Kris doesn't like them and that way I can easily fish them out of his bowl. Throw them on the bottom of the crockpot. Then chop your potatoes and throw them on top. Now dump the corn and English peas on top, juice and all. Sprinkle all those veggies with a little bit of Tony's. Then throw the cooked meat on top, then the V8 on top of that. Leave it on low for 6 hours. It's so, so good. If you don't keep V8 in stock pretty sure you could use a can of tomato sauce and a little water. It's not an exact science.

This makes a dense, hearty stew. If you like yours more soup-y I suggest you put some broth or something in it but I can't guarantee it'll taste as good.

Just a Few Things

2011-03-02T13:49:00.002-06:00

1. I had a very scary dream last night. It was Match Day. I was somehow in my old college dorm, but it was in Pennsylvania. I saw several members of my class walking around in the snow saying how relieved they were that they had matched in Pennsylvania where they wanted to. Cue some confusion since I didn't even interview there and a mad search for where they keep the envelopes containing where we did match. I found my envelope, ripped it open, and it said.... The absolute last place that I ranked on my list. Oh dear...

2. Serena Williams had a pulmonary embolism. This does not make much sense to me medically. That's all.

3. Goals for today include recycling some super old electronics I cleaned out from my Mom's house, wrapping wedding presents for a dear friend of mine, cleaning out my car, and mounds of laundry. It's nice to be a stay-at-home-mom with no kids sometimes :)

Time Flies...

2011-02-28T00:54:00.004-06:00

I was just shocked and amazed to realize I haven't posted in 2 months. Since Christmas Eve y'all. That's a long time. Here's what's been going on:

January - finished up interviews with different residency programs. Ended up doing 12 total. Probably should have just gone on 9 or 10 but hindsight is 20/20. Also did Ob/Gyn clinics this month. Got to spend a little more time with the residents and faculty and learn about digiChart - the new digital charting system they're using.

This month (February) I am technically taking review of pharmacology. Here is why the 4th year of medical school is wonderful: On Feb 1 the teacher sent me an e-mail basically saying he didn't want to see my face this month. Just wants a submission by Feb 28th of the drugs I'll be using most during residency, dosages, mechanisms of action, etc... Since Ob/Gyns don't use too terribly many drugs this shouldn't be too difficult. Of course I haven't started on this yet. Planning on hunkering down at Cups and banging it out over the next day.

Other fun things I've done this month: gotten fitted for my real life official white coat, turned in my words of wisdom and picture for the yearbook, attended a fun engagement party for my best med school friend, attended financial aid counseling - okay, not so fun. Found out how much $$$ I owe for all these loans. (Hint: <$100,000 but >$50,000) On the upside, found out you can defer loans until after residency. We might be doing that. Not sure yet.

I've also started running again after a 2-3 month hiatus from about October-December. This is partly due to the fact that I missed it and partly because interview season was not kind to my mid-section. Must've been all that pasta and king cake they fed us.

So for now life consists of finishing up various projects around the house that I haven't had time to tend to over the last 3.5 years and waiting for Match Day. Match Day is March 17th and the day that me and all of my fellow classmates find out where we'll be for residency during the next 3+ years. But truly March 14th is the day that really matters. This is the day that you find out whether or not you "matched" at all. If you didn't then you can either "scramble" to find a job for the next year or just decide to try again the next year. Needless to say we're all hoping to match and not scramble.

Oops He Did it Again

2010-12-24T12:28:00.007-06:00

The husband, K, is a notoriously amazing gift-giver. He has already given me an early Christmas present before my last few long interview trips. And what was it you ask? Well just a Chi travel set complete with straightening shampoo, conditioner, styling creme and silky stuff along with a mini CHI hair straightener and mini hair dryer. It came in this nifty little bag that has a ton of compartments and rolls up all nice and compact. It even has a little hook to hang from towel racks. I got so much use out of that little sucker over the last few weeks and know that I'll use the heck out of it during residency. I'll be able to get some sleep on call not worrying about what my hair looks like the next day. Ha. Honestly I see myself throwing it in my bag to have on call and being very, very lucky if I get to use it.

Anywho, all of this to say that by the melieu of small packages that have been arriving on our doorstep I can already tell that he has WAY outdone me once again this year. We always set a budget and I'm pretty sure he exceeds it by 2-3x every single time. And I stick to it! Now who gets the crappy end of that deal might I ask?

Oh yeah, Merry Christmas Eve! Let's not forget the real reason for the season - to outdo your significant other in gift giving therefore making them feel incredibly guilty for not blowing the budget on your happiness.

As for the rest of life, things have been going great the last week since I'll be getting a few weeks of rest before my next set of interviews. I've finished 9. 9! and have 3 more. There's pretty much nothing they can throw at me now to make me nervous during these interviews. Sometimes I get angry when they don't ask really random or behavioral questions. Where's the challenge? I've got my life story condensed to a 1 minute shpiel from birth to present day.

Here are the highlights so far from interview season:
1. Showing up to the wrong hospital 10 minutes before my interview (but you already heard about this in an earlier post)

2. All the interviewees crowding into a shuttle to go to an interview and having the driver ask us "So where y'all work at?" There was a collective "SERIOUSLY!!!???" Only 1 girl knew the actual address we were going to. The rest of us had heard "We'll shuttle you to the interview" and mentally checked out.

3. Getting a flat tire and then sideswiped (notice a theme? People love to hit me. I must be super attractive in a magnet sort of way.)on the way to an interview at a place I probably won't even bother ranking.

4. Getting ready for an interview and on the verge of running late when the electricity goes out WHILE I'M IN THE MIDDLE OF BLOWDRYING MY HAIR.

5. Getting caught in a snowstorm crazy blizzard, having panic attacks in the car while watching huge trucks swerve and wreck all around me and trying to remember to breathe. Making it to the interview to find that only ONE other applicant toughed it out. And her ass was from Washington. She had what she called "snow gear" whatever that is. Then seeing all my hardcore girl surgery buddies at the same snowy institution that had closed for the day! PS - only the FEMALE applicants toughed it out for these interviews. Not a man in sight. How typical.

6. Seeing said Washington applicant at my next interview and watching her anguished face as she actively passed a kidney stone during the pre-interview Powerpoint, ran down to the ER to get checked out, and then back up to complete her interview. She is TOUGH. These are the women I'm up against. What the hell?

7. Listening to nearly all the Sweet Potato Queen's books and making it my life's goal to have as much fun as Jill Connor Browne. I laughed out loud all by myself a few times in the car. Passed those hours so well. I also recommend any of Greg Iles' books on tape/CD.

8. Following my mapquest directions to a hotel only to end up 20 miles away at someone's house in a nice subdivision by the same name as the street the hotel was on. Hmmm. Yeah, I might be your doctor one day. Be afraid. And Merry Christmas. I'm thanking the sweet baby Jesus that I've survived this year so far.

Breathing a Sigh of Relief

2010-12-04T13:41:00.003-06:00

***Warning - incredibly boring post ahead***

Made it through November and House Medicine. There were some days that were touch and go though. Had an average patient load of 16 throughout the month, only finished rounding before 11:30 1x the entire month. That doesn't mean we finished work at 11:30 for the non-medical people. The real work begins after you finish rounding. And of course you can't get anything done from 12:00-1:00 because everyone you really need to talk to (ahem, specialists...)is at lunch. Several of our patients were of the chronic "fill in the blank" pain variety which really try my patience. Kept reminding me of Law #8 of Samuel Shem's The House of God. Also, #5 was a recurring theme. Here are the laws, in case you aren't familiar:

Laws of the House of God
1.GOMERS DON’T DIE.
2.GOMERS GO TO GROUND.
3.AT A CARDIAC ARREST, THE FIRST PROCEDURE IS TO TAKE YOUR OWN PULSE.
4.THE PATIENT IS THE ONE WITH THE DISEASE.
5.PLACEMENT COMES FIRST.
6.THERE IS NO BODY CAVITY THAT CANNOT BE REACHED WITH A #14G NEEDLE AND A GOOD STRONG ARM.
7.AGE + BUN = LASIX DOSE.
8.THEY CAN ALWAYS HURT YOU MORE.
9.THE ONLY GOOD ADMISSION IS A DEAD ADMISSION.
10.IF YOU DON’T TAKE A TEMPERATURE, YOU CAN’T FIND A FEVER.
11.SHOW ME A BMS (Best Medical Student, a student at the Best Medical School) WHO ONLY TRIPLES MY WORK AND I WILL KISS HIS FEET.
12.IF THE RADIOLOGY RESIDENT AND THE MEDICAL STUDENT BOTH SEE A LESION ON THE CHEST X-RAY, THERE CAN BE NO LESION THERE.
13.THE DELIVERY OF GOOD MEDICAL CARE IS TO DO AS MUCH NOTHING AS POSSIBLE.

My residents and attendings were really nice thank goodness. That helped move the month along some.

Other fun things that happened in November - a few residency interviews, including the one at UMC. It went well, as far as I could tell. I left there in a great mood and feeling pretty relieved so I think that's a good sign. Have 5 more scheduled for December and 4 in January. I finally got them all scheduled how I want them and am quite relieved to have a few days to relax in between each of them.

I finally got my car back. It looks better than it has for the last several years thanks to the new paint on parts of it and fancy clean and wax job. At one point during the month we had 4 cars in our driveway everyday. It's a long story, but basically Kris's car quit. He bought a new one before sending the old one away to get fixed up. Then we had the milieu of rotating cars for me to drive while mine was being repaired.

Also in November - we now have 2 nieces! Kris's youngest brother and wife had their first baby. She's quite the cutie. I wish I could say this was taking the pressure off us to have one for a while, but lately it's turned into "Now it's y'all's turn!!!" and "You're the last ones without a baby!!!!" Oy vey...

Now it's December though. The 1st was such a great day. We had been on call Nov 29th and didn't leave the hospital until 2:30 pm Nov 30th with no lunch break. This was pretty much par for the course our entire month on call and post-call days, so I can't say I'm surprised. Just exhausted. The one good thing about that many patients is it teaches you to be efficient. By the last morning I saw 6 patients in a little over an hour, a personal best for me. Anywho, December 1st is my sister's birthday so after sleeping in until 10:30 or so I ventured out with her and my mother on a little shopping trip. Or vicarious shopping trip? I managed to keep my purchases down to $30, which included her birthday present. I'm incredibly broke right now, so every dollar counts. These hotels and interviews don't pay for themselves!

As for the December 2nd, Kris had the day off so we ventured around town together running errands. It was nice. We haven't seen each other that much for the past few months so even getting to hang out doing mundane things like getting a new car tag was a treat. Seems every time I was getting off work the last 2 months he was heading in. We grabbed a bite at 5 Guys over at Renaissance, always delicious. Then we came home and played the Kinect for the XBOX. Not gonna lie - I broke a sweat. It's really fun though. It's like any other game except your body is the controller. If your character needs to jump, you have to jump. Pretty cool.

Yesterday was my grandmother's 82nd birthday so I spent the morning baking her a diabetic-friendly egg pie. Sounds gross, but was pretty tasty. Drove down to Durant to visit with her a bit and then came home for my sister's "Totally 80s 30th Birthday Party." It was so fun. Everyone's outfits were great. She even had slap bracelets :)

And that has been my November and December. Heading out to South Carolina tomorrow morning for an interview and have a few books on tape/CD to listen to on the way. While Kris and I were running errands we finally went and got library cards and learned all about the local library. I was pretty impressed. They now have books on mp3 online that you can download to your iPod/iPad. Also have a wall of books that people have read 1x and donated that they sell for $3. Great Christmas gifts if you're as broke as most of us are right now. Happy December and Happy Interviewing to my fellow classmates!

Also - congrats to my bestie Julz who has just completed Law School at Ole Miss in just 2.5 years. Good job Julz!!!

Oh House Medicine...

2010-10-31T16:55:00.004-05:00

I've been a bad blogger. I'm aware. A lot of stuff's happened. And I'm gonna put it in list format in an attempt to keep it organized.

1. September ended. Mom is making a fabulous recovery from her knee replacement.

2. October started - along with Labor and Delivery. I caught tons of babies, didn't drop any, and got to sew up some subQ fat and skin. I had an amazing month. I even made friends with some of the nurses!

3. Also in October - I learned how to make scrub hats. This might be part of the reason the nurses want to be friendsies. Ha ha.

4. The first Friday in October I got sideswiped by an 18-wheeler while heading home from the hospital. It was incredibly scary. I need to take pictures, but pretty much there's a long green stripe down the L side of my car along with parts of it all dented in and missing and whatnot. The scariest part is the chewed up metal on my hubcap (not the cute, decorative rim, but the actual metal part underneath that that holds the tire). Very scary. Best part - the driver just kept on truckin' so to speak so I get to pay $200 for the repair. Awesome.

5. I had my first interview this past Friday at Ochsner in New Orleans. It was quite the experience. I was on nights the last 2 weeks, so I didn't get home until 2:30am the night before I had to leave. We got into town just in time to get checked in and head to the party. The interviewees seem pretty cool. I even met one girl who is doing an away at UMC right now and she's super nice. As for the next morning, it was a cluster! I left the hotel at 6:15, assuming I'd have plenty of time to make it to my interview 6 miles away by 7:30. I made it, but just barely. The New Orleans downtown area is a little difficult to navigate. It doesn't help that there are 2 Ochsner hospitals on the same highway, 3 miles apart. And both have pianos in their atrium. We were told to meet by the piano in the atrium. You can see where this is going. Long story short - here's what I've learned from my first interview:

1. Wear a watch. Some hospitals don't have clocks abundant as ours do.

2. Take a purse with a pen and some paper. I asked all the girls the night before if they were bringing their purses. They said NO. They all showed up with their purses (those b*tches...). By the end of the day my lips were chapped, I had no pen to take notes with, and felt pretty yucky.

3. Do a night before trial run. Drive to the hospital. Find where you're meeting.

4. Find out about discounts. After trying to make reservations at the hotel on campus and getting no response, I made reservations elsewhere. Morning of I got a confirmation email from the original hotel. It was too late to cancel hotel #2 at this point. While eating breakfast at the interview the unhelpful secretary announces - "Be sure not to let the hotel here charge you for your stay! Show them my email. That should be enough." And boom. I'm out $130 and pissed. Did she mention anything about that hotel in any of her million emails? No. Of course not. Did she mention it would be free. Well no. That would be logical. So pimp those secretaries about free hotel rooms if they're not upfront about them.

5. Don't overdress for the party the night before. I wore jeans, a cute tunic top, and cowboy boots and was on par with the residents. If you show up in a little black dress, heels, and pearls, you will feel really awkward.

6. On a similar note - Ann Taylor Loft is having an amazing sale right now. If you need cute shirts for under your suit - go get some. I got one for $14 last night.

That's all of my interview advice. I'm glad the first one is over with. I have my UMC interview this coming Friday and am pumped. However, I start medicine tomorrow morning. Already have 3 patients assigned to me and notes expected for in the morning before rounds at 7. We have orientation at 8. Oh how backwards...

My New Best Friend

2010-09-28T15:12:00.003-05:00

My new best friend is this yummy FAGE yogurt with strawberry. This stuff is AWESOME!!! I'm not getting paid to sponsor them, but I wish I was :) It's especially good with graham crackers. Anywho, back to all the important real life stuff...

Mom's surgery was a success! The first few days were pretty rocky. She got behind the ball on the pain thanks to hospital staff that put the pain pump out of reach. Awesome. After that you can bet I was on that pain pump like white on rice. I pushed it every 10 minutes, even if she was sleeping, because I'm an awesome daughter and all. 2.5 weeks later and she's back at home after a 2 week hiatus at premier physical rehab location Casa de Bennett. It's really exclusive. You pretty much have to be my mom to get in.

I've been on Peds Clinics all month. Lots of achy ears, sore throats, rashes, etc... I haven't really seen anything interesting this month unfortunately. The schedule is ridiculously wonderful. I had time to finally go to the dentist today for the first time in probably 1.5-2 years. Not sure exactly, but it's been a while. I got lucky and had a new patient discount and was really pleased with the staff and service. It's Dr. Burns on Northpark Drive in case anyone needs a new dentist. Got x-rays and a cleaning for $110 today. Woo hoo!

I start Labor and Delivery on Friday. Woot!!! Maybe I'll finally get to deliver that 1st baby. Yeah, I know. I haven't delivered a baby yet. I'm an M4 doing OB. I get it. That's bad. That's really bad. L&D was just slower when we were on it and at the time I wasn't really digging the whole delivering of the babies and whatnot. It was really scary to me. I changed my tune about halfway through that rotation and by then it was too late. Alas, hoping to deliver my 1st one Friday.

On a related note, I got my first rejection letter today. I was relieved. Is that sad? That's bad, probably, but I'm already worried about scheduling. I'm beginning to think I applied to too many schools. Oh well. I guess better too many than too few.

On a slightly related note, I'm now officially poor. I was wondering how this came about since I was more budget conscious than usual at the beginning of this semester and then I figured it out:

New air conditioner in July $1100
Step 2 CK in June $500 or $550? can't remember
Step 2 CS in July $1100!!!
ERAS (residency application) in September $600 - yes, I applied A LOT of places

So that about explains why I'm coming up 2 months short as far as budgeting. The upside - we're probably gonna get one hell of a tax refund next year since all that school stuff can be written off :)

The weather is absolutely gorgeous, so I'm about to thread some shish-ka-bobs and make the hubby fire up the grill in a bit. Hope everyone's having a great week!

Total Knee

2010-09-09T11:01:00.002-05:00

My mom's going in for a total knee replacement this afternoon. Please send up some prayers for a safe and complication-free surgery and speedy rehabilitation. Thanks y'all!

Shifting Gears

2010-09-01T21:23:00.004-05:00

*This update is dedicated to my Cousin A, who likes to send me friendly reminders that she hasn't seen a post in a while. Ahem...*

It's September 1st. New month, new rotation. I'm doing Pediatric Clinics this month, aka "Peds ambulatory" aka "if you're an M4 you leave at noon everyday, no questions asked." That's good and all, but it was really hard for me to hang out in clinic and only see 2 patients in 3 hours today. Normally by noon I've seen about 15 inpatients on OB. It's incredibly hard for me to stand still anyway, but after running nonstop for 12-15 hrs a day, nearly every day last month it was next to impossible to just hang out.

I'm a little sad my High Risk OB rotation is over. Even though the hours were killer it was so nice to be busy and feel like I was actively learning things I would use in the future. Plus I got to do a few procedures - speculum exams, wet preps, looking at said wet preps under the microscope, Implanon insertions, ultrasounds, cervix checks (I'm getting better; correct about 50% of the time now), etc... Got to scrub into about 20 C-sections and 5 D&Cs. Wish I'd gotten to sew, but my dear intern only got to sew 3 times, so it's not like she was being greedy. (frylime - I'm jealous!!!) I've already decided I'll probably sew every one of my future patients after c-sections anyway, so there's plenty ahead of me.

Ran about 2.5 miles tonight. I know I haven't been posting my running in the last few months, but I've been keeping up with it. Ran about 2 miles in June while studying for STEP - embarrassing!. Then about 30 in July while taking that easy computer course. Ran around 6 last month. Anywho, off to watch Top Chef and clean house before I go to bed and get to sleep until 6:30 tomorrow. Score!!!

Quote of the Day

2010-08-13T20:27:00.002-05:00

Pt: "I've been feeling drained lately."

Me: after a few other questions: "Are you constipated?"

Pt: "Oh yes!"

Me: "When was your last bowel movement?"

Pt: "Well the 1st one I had today was at about 7 and then I had another an hour ago."

*bangs head against wall*

Quote of the Day

2010-08-12T18:17:00.003-05:00

Because I don't want to violate HIPAA at all I'm just gonna tell you we had a very, very young patient come into OB Receiving today after getting a positive pregnancy test at the pediatrician's office yesterday. She's not even in high school yet :(

Me: "When was your last menstrual period?"

Very Young Girl: *says nothing* Mother tries to persuade her to answer me. They end up telling me it was about 5 weeks ago.

The kicker - we do a sono and she's almost 6 months pregnant.

It was a really sad situation.

P.S. - I've finally adjusted to the hours, gotten in a groove, feel more useful than a burden to the residents, and am 100% sure I've made the right decision about what career to pursue. Thank God! - literally, thank God! I'm having a blast. Even though the days are long, they somehow fly by. It's incredible.

How Do They Do It?

2010-08-03T21:11:00.002-05:00

I was at the hospital for 13 hours today.
My residents were probably there 14 hours.
I saw my resident eat 1/2 cup of cereal and a Coke today - that's all.
I am literally sore all over and not quite sure how they keep up the momentum!

Today was a bit more fun than yesterday though. We had clinic all day yesterday (not my favorite). Today was a bit more scattered. We started the morning out seeing postpartum patients, then ended up in the OR for a delivery and D&C after a very scary miscarriage, then ended up helping out in OB Receiving for the afternoon.

I think tomorrow will be more fun though :)

Quote of the Day

2010-08-02T20:09:00.002-05:00

Today was interesting. Especially the part where I found out that my team rounds at 4:00AM.

Anywho... Best quote of the day from high risk OB clinic:

Intern: I'm just going to insert the speculum now. (inserts it)

Preggo: (sharply inhales) Woo!!! I hope it doesn't hurt this bad when the baby comes!

At this point the intern, nurse, and I just look at each other and laugh.

So Excited

2010-08-01T16:36:00.004-05:00

I start High Risk Obstetrics tomorrow and I've gotta admit - I'm pretty pumped. I didn't think I would be excited to start a rotation but I really am now. What the heck? I guess I picked the right profession after all. Speaking of which, so have 11 other people in my class. That makes 12 of us. There's 6 spots at UMC. Oy. Let's hope everyone else wants to travel, because I really want to stay here!

We had a little orientation Friday which lasted about 45 minutes, much better than the orientations we had last year. They managed to drag them out into all day affairs. The funny part was when the secretary looks at me and tells me that the course coordinator really didn't want her to give me a syllabus, but she felt that would be cruel, so she did. (Thank God!) Whenever I see this doctor I'm not supposed to mention to him that I have a syllabus. Everyone else has one. They're all doing the routine courses though - Labor and Delivery, Clinic, Operative Gyn. I think the director was afraid the syllabus might constrain me to situations that aren't conducive to learning, such as sitting around the hospital waiting for women to labor. I get that.

Is it terrible to say that I'm glad I don't have a partner on this rotation? It was nice during 3rd year to have partners to split up the work, but I'm afraid that during 4th year when you're trying to do a good job, work hard, and impress the residents and attendings things could get a bit competitive and ugly...

From the looks of this syllabus-that-doesn't-actually-exist it appears that I'll be in clinic out at the fancy new building a few miles from campus on Mondays and Fridays, then assisting with c-sections and hospital work Tuesdays-Thursdays. As far as tomorrow goes I'm just supposed to show up at clinic at 8:00, but I have a feeling the rest of the month will consist of much, much earlier mornings.

I'm pretty pleased with the schedule though. Mostly Monday-Friday with the exception of working 2 Saturdays for 12 hours each. These are my call days. One will be from 7A-7P and the other from 7P-7AM. I have 7 days off in August, today being one of them.

I'm using today to write that dreaded essay for my computer course. I know, I know - I should have done this already, but I just got carried away enjoying this month "off." My goal is to get this stinking essay done before Mad Men comes on tonight.

Other updates in the academic world:
-Got my Step 2 CK score back. It went up!!! Although I can't really say that's a surprise. I studied a lot harder for this Step and worked hard to figure out what methods worked for me and which ones didn't. Now that it's time to stop studying hard core I've finally figured out what works. Typical...

-Got a first draft of my personal statement written. Still gotta do that C.V. Meet with the dean Wednesday.

-Switched my schedule around, putting in more slacker courses where possible :)
Here 'tis:

July: Computers in Med
August: High Risk OB
September: Peds Clinics
October: Labor & Delivery
November: House Medicine
December: OFF
January: OB/GYN Clinics
February: Review of Pharmacology (slacker course)
March: Review of Anatomy (slacker course)
April: OFF
May: Plastic Surgery (this will only be for ~2 weeks since we graduate during the 3rd one :) )

I think I'm finally happy with that schedule. It's slightly front-loaded with alternating heavy and light schedules. I think that'll work well for me.

Anywho, back to this stinking essay. Hope everyone who started their August rotation today has been having a good one so far.

*** As I was reading this post I realized I can drop another one of the electives I have scheduled. Score! Now which one gets the axe - review of pharm or review of anatomy? Hmmm... Decisions, decisions. Wish I could drop Computers in Medicine!

Turning Into My Mother

2010-07-27T19:37:00.001-05:00

I just heard a phone ring on tv and wondered if Kris had somehow installed a house phone while I was away shopping today...

What's Been Going On

2010-07-25T13:05:00.003-05:00

Here's a LONG overview of what's been going on lately. It's mostly for myself, so I can remember what the heck I've been doing the last 2 months. When I'm not at the hospital all the days just run together.

I finished up my M3 year sometime in June. It was painful and tiring most of the time, but I learned a lot and had some fun thrown in there too.

My best friend got married in the middle of June. Here's proof:

I spent most of the month of June prepping for Step 2 CK (clinical knowledge. They ask us pertinent questions about patient care - diagnosis, treatment, what test to order next, etc... It was an all day test which I took on June 28th. June 28th also happened to be my 25th birthday. I came home to find this:

I wish I'd thought to take pictures but I was a little brain dead due to the 9 hour long test and surprise waiting for me when I got home. There was quite a spread. Most of my immediate family was there plus a few friends from school. It was a great way to spend a birthday. Kris worked really hard on this one.

About a week after that Kris and I journeyed to Houston, TX so I could take the 2nd part of Step 2. It's called Step 2 CS (clinical skills) and judges how we work in a clinic situation. There's actors who act like patients. We have 15 minutes with them to talk, get the history, do a physical exam and a little counseling. Then we write a note in standard format summing up the visit, what tests we want to order, and our top 5 diagnoses. The test is very expensive $1100 and is only given in 5 major cities in the USA. I'm really hoping I passed for all of these reasons.

Unfortunately the test isn't given in a nice area of Houston. Fortunately our hotel was very nice. Kris and I spent 3 nights there. The first night we just settled in and I studied a bit for my test the next day.

Day 2 = Test day. It was long and short at the same time, nerve wracking at first, then just monotonous. Spent the night unwinding with room service, beer, and hot tubbing it.

Day 3 = the Aquarium, the Galleria, and the Improv. The Aquarium was surprisingly small and for some unexplained reason featured a white tiger. It was huge. I managed to piss it off by pretending to pet it through 6" glass and it lunged and tried to attack Kris. We scared several children.

The Galleria is huge! We spent a lot of time looking, but I didn't even buy anything! Pathetic I know.

As for the Improv - I highly recommend it if you like comedy. It was open mic night when we went so the tickets were FREE. Even when they have well known headliners the tickets are $22 which is a great deal for several hours of guaranteed entertainment. Even though it was open mic night I only had to break out my pity laugh for 2 of the comics. Fortunately they were on stage 2-3 minutes each so the misery doesn't last long.

Day 4 = Time to leave. Before we left we toured the National Museum of Funeral History. Sounds weird, but it was one of my favorite things we did. Tickets were cheap. It was a large open space, and most of the time we were the only 2 people there. They had tons of gorgeous old hearses, the Pope mobile, funeral programs, and lots of interesting coffins.

As for the rest of July I've been taking a course called Computers in Medicine. This consists of searching for journal articles pertinent to your future profession on a topic of your choice, creating a Powerpoint, and writing a 3 page paper. Sounds simple enough, but as the teacher is out of town until August 2nd, I have no idea if the assignments I've turned in so far are up to snuff. Just going to keep turning things in. Hopefully when he gets back he'll be so overwhelmed with his inbox he'll just give me a pass. I HATE writing papers. That's one of the reasons I chose medicine as a career.

I still haven't written my C.V. (resume) or Personal Statement. I meet with the dean on August 4th to review these things. I'm planning on tackling one or the other tonight.

Our air hasn't been working for the last 2.5 weeks. After 4 maintenance calls, 3 box fans, 2 personal fans, and many sleepless nights our home insurance company has agreed we need a new unit and some new ductwork. It should be here by the end of the week. It's about time. Our unit was 25 years old.

Also - K and I went to St. Louis last week, but I'll post about that later. This post is already entirely too long!

Hope everyone else's July has been going great - and that you all have working air conditioners. It's HOT out there.

Delinquent

2010-07-20T17:38:00.005-05:00

I know I've been a bad blogger lately. I'm about to rush off to a book club meeting, but I just had to post this picture. Because I LOVE it:

Promise I'll post more later. I stole this picture from myfavoriteandmybest.com. I tried to hyperlink that but I'm either too dumb to do it correctly or blogger malfunctioned.
You should check her out. As long as you're not afraid of profanity and pretty design pictures.

I Conquered World!

2010-06-24T11:19:00.003-05:00

Okay, so I didn't conquer THE world per se, but I did finish USMLE World question bank. It's ~2300 questions long, and pure misery. I finished it late last night. I know, I know, I said I was going to finish it before the wedding last weekend, but there were just things that needed to be done before the festivities began. Then I needed a day or 2 to recover it seems like.

I take the big test Monday. So what will I do until then? Well I've just used my most OCPD characteristics and made a list of the subjects I did the worst on in World. I'm going to start my review by reading those sections in a review book, then reworking the questions I missed for that subject. Maybe that will help me learn just a few things in the next 3-4 days. Wanna know what I suck at? Here 'tis:

WORST SUBJECTS:
1. Poisonings - don't come to me if you overdosed. I will likely kill you in the process of trying to save you. Sorry.

2. Infectious Disease - don't come to me if you're um, well... sick? But really, if you do come to me and you've got pneumonia I'll likely just look up the most appropriate antibiotic at the time. Or ask my attending. Then I'll write the order for it. Then I will have learned it. I can't learn all this crap by skimming it on a page, but I digress...

3. Genitourinary - but Allison, I thought you wanted to be an Ob/Gyn? Don't worry guys. That section is separate. This section is a little more Urology-ish.

4. Endocrinology - I just don't think organ systems should exist that have little pieces in the brain, above the kidneys, and in the throat.

5. Gastroenterology - I'm kind of surprised about this one. It's one of my favorite subjects (it's just a long tube y'all). I think I've gotten better at it as my studying has progressed and I get really relieved once I realize it's a GI question being asked.

Okay, so now y'all know what I suck at. Do you wanna hear what I'm good at? Well I don't care if you do or not. This is my blog and I'll do what I want :)

BEST SUBJECTS:

1. Psychiatry - I'm betting this is everyone's best subject.

2. Dermatology - I'm as surprised as you are.

3. Preventive Medicine - I'd rather prevent you from getting sick than have to pick the appropriate antibiotic once you've gone off and gotten sick.

4. OB/GYN!!! - See, I told you not to worry.

5. Biostats - This makes me laugh. Because we took this class 2nd year. And my grades speak quite the contrary to this being on the list of things I'm good at. I think I still remembered some of this because I had to study so hard for that last test. You know, to pass the class.

So that's that. I guess I'm about to study some poisonings and infectious disease. I've already made a list of things I want/have to do once this test is over and I can't wait to tackle some of it.

Things I'm Loving Right Now

2010-06-15T23:47:00.004-05:00

Since I've mostly been staying at home and studying the last few weeks in preparation for STEP 2, I've been taking mental notes of all the little things I'm loving in and around the house right now.

1. Saving money. How, you ask? I've been cooking a lot more. It's a much needed distraction and it's easy on the wallet. We get our next loan disbursement on July 6th but knowing our institution, it will most likely be a week late. I ran out of money sometime around the end of May. Thanks to my lovely husband and a credit card with a high limit I'll be fine, but it's still nice to feel like I'm saving some pennies by cooking more.

2. ULTA Smoothies. Most of you know I indulge in a daily bubble bath. That can get a little expensive if you're not careful. I had been buying the cheap-o Wal-Mart bubble bath but due to it's dilute nature it ran out rather quickly. The scent selection is also a little limited. Enter a coupon at ULTA and their smoothies being on a buy 2, get 2 free sale. I think I ended up paying about $20 for 4 bottles of the stuff. It's really a good deal because they are uber-concentrated. 2-3 pumps and the bath is full of bubbles. I currently have Pineapple Passion, Creamy Cocolada (coconut), Key Lime, and Candied Caramel Pecan. Pineapple Passion is by far my favorite. It's fun to mix them up though. 1 pump of pineapple, 1 pump of coconut. You get the drill.

3. My new treadmill! Most of you know the saga of my last treadmill. It was a craigslist find. I paid $225 for it. That's approximately $100 for each week that it worked. Sadness. After scouring the internet/Academy sports/Sears for the best deals I came across the one I wanted. It was $377 at Wal-Mart - an amazing deal for a brand new treadmill. Enter the problem. We don't own a truck. Solution - Wal-Mart will ship stuff to your house for $0.97. Yep - 97 cents. Bonus - it arrived 2 days early. I have enjoyed studying on it because Lord knows you get sick of sitting on your butt all day long and studying. Kris and I were able to assemble it in about 2 hours. It was relatively easy, but definitely a 2 person project. I've been very pleased with it so far.

4. Splenda with fiber. Because Splenda is good. And Splenda with fiber is better. Because I do not eat a bowl of shredded wheat with strawberries on top of it every morning, or barley with lentils for lunch. Sometimes I just drink coffee til noon - or until 2:30 if I wake up at noon.

5. The fact that my best friend's wedding is in just 4 days. It's going to be so much fun! Just gotta work on my speech for the toast the night before. I'm not so good with words... or public speaking... or public speaking with words...

6. Wingback headboards. I'm thinking about trying to make one of these once Step is over (June 28th for me). I've read a lot of how-to guides online and I think I can make it happen. Besides, one time I took an aptitude test in junior high and it told me I should either be a carpenter, race car driver, or doctor. I feel like I'm the last 2 on most days, so why not try to embrace the 1st one more?

As for the step studying, it's coming along slowly but surely. I feel a lot more prepared than I was for Step I, but that's not very hard to do considering I only completed half of the USMLE World question bank. True story. Right now I have about 500 questions left. I'm planning on being finished by Friday afternoon so I can party it up at the aforementioned wedding all weekend and then review the next week. I do confess that I wish I was a faster studier and could just cram all this info in in a 2 weeks or so, but I know now that's not how I learn. I need lots of time to digest the information, then review it again. I am getting very, very tired of studying though. Less than 2 weeks as of today :)

I Have Decided

2010-06-09T19:37:00.002-05:00

I have decided that from now on all major STEP exams should be held the first week in February. We could all start studying in January, when it's brutally cold and uninviting outside. We would all be so full of pep too, since it's just after New Year's and all. The resolution would be to do well on the Step. Christmas would be over. There would be no major holidays to look forward to/procrastinate about. It's cruel and unusual to make us trudge to the hospital in the snow and rain and freezing temps of January and then have us stuck in the library/coffeehouse/house/classroom wing during the BEAUTIFUL summer.

I'm feeling a little sorry for myself (and the rest of us M3/M4s) today.

I had to turn down a boat ride and dinner on the Reservoir with my bestie today (for the 2nd time this summer) and it almost made me cry.

I hate the STEP.

That's all.

Two Years Ago Today...

2010-06-07T16:17:00.004-05:00

We got married!

Not Feeling It

2010-06-06T17:03:00.003-05:00

This marks day #3 of not feeling so hot. It all started Friday morning. I felt a tiny bit sick to my stomach, but blamed it on too much greasy Waffle House with Kris the night before. (Always a good idea the night before a big standardized test, amiright?)

Things got worse as the day went on. My sweet mama tried to take me out shopping and I could only make it through 1 store. Thankfully it was Pier 1 and I was able to sit down in chairs throughout :)

Went home, got in bed and hibernated most of the night. Kris got home with some Pepto Bismol which worked the absolute opposite of how it was supposed to. Funny, I didn't know Pepto was just Syrup of Ipecac...

Saturday I managed to feel pretty okay in the morning, made it to a good friend's wedding. It was a gorgeous morning wedding with a reception following at the Old Capitol Inn. There was a jazz band called Dr. Jazz - made up entirely of older doctors who play weddings for fun. They were great! I was wondering how many of them had families though. I don't imagine they're ever at home if they're off playing gigs on Saturdays.

Today I woke up thinking I could finally get to studying hard core, but I was wrong. I'm jut still not feeling it. I slept until 11:00 and then fell back asleep at 2:00 and just woke up. I've got absolutely NO appetite so I'm trying to force the gatorade and fluids down. I'm pretty sure it's just a viral gastroenteritis, but if that pain starts heading down to my right lower quadrant.... I'm gonna be pissed! (That means appendicitis, hospitalization, and likely surgery for the non-medical people. Aka - lots of lost study time)

Hope everyone else is getting some work done and not being sick!

"Lett-ush"

2010-06-03T17:17:00.001-05:00

I just ate a BLT.

And I grew the L part in my backyard.

Because I wanna be Martha.

But just a little bit sassier :)

Have you Heard This?

2010-05-26T14:59:00.002-05:00

Because I really don't appreciate Lady Gaga's music very much, but I LOVED this song that the geniuses behind Glee deconstructed. Here 'tis:

Also a good Lady Gaga redo by Pomplamoose:

Back to stupid board studying. Should've been an interior designer. For realz.

I have 6 episodes of lost to watch before tonight's finale

2010-05-23T12:06:00.001-05:00

Can I do it?

Well - I'm no quitter...

Runner's Log

2010-05-20T19:34:00.001-05:00

Since I didn't feel like studying or watching tv - I went for a run. Then I had to give Penelope a thorough scrubbing to get all the mud out of her fur. Now she smells like strawberries though. Win win :)

4.15 miles; ~42 minutes

In a Funk

2010-05-20T15:56:00.004-05:00

I'm feeling in a funk today. I don't feel like studying. I don't feel like watching tv. I can't fall asleep. I'm in limbo. I'm not sure if it's from the 2 Benadryl I took last night and the lingering congestion and postnasal drip I've got going on or what. I just feel completely foggy-headed and can't quite get situated. I tried to study earlier today to no avail. 2 diet cokes, 2 cups of coffee - no effect yet. I read 3 words and get distracted. Getting distracted is not too unusual for me, but my goodness - drifting off in the middle of a sentence... That's just bad. It almost feels like I've forgotten how to study thanks to all this scutwork I've been busy with all year.

Good thing that test tomorrow is only 10% of our final grade.

White Cloud?

2010-05-19T14:32:00.004-05:00

All year I've been stating I'm a black cloud. This means I have bad luck. If something can go wrong, it will. It's been proven time and time again throughout the year. But I'm beginning to think being in a sister group full of white clouds has rubbed off.

My partner and I were supposed to be on call yesterday. We came in scrubs, with books and computers and lean cuisines, prepared to be at the hospital all night. We saw our patients in the morning before class (well, my partner did... I was lucky and didn't have a patient. This is the 2nd time this has happened to me the ENTIRE year.) I skipped class because I slept in and got there at about 8:10. Didn't want to walk in late. We rounded at 9:30 as usual. After rounds our chief/attending looked at all of us and told us what a good job we'd done, how he'd taught us all he could, and that he didn't need to see us back. Oh lucky day! Our intern made us sweat it out though. She looked at my partner and I several times and told us to "run it by our upper level." Great. We knew we'd be stuck there all night.

Somehow, by the grace of God, she decided to be cool for once in her life and let us get the heck out of there! We still had to meet with our preceptor at 1:30 and didn't end up leaving until 3:00, but what a wonderful day. We didn't have to come back for call. We have no more clinical duties this year! We have a test Friday, 2 boards next week, 2 boards the week after, Step 2 CK, Step 2 CS, and we're officially 4th years. For now this means:

No more 5:00 am awakenings.

No more waking up sleeping babies.

No more Saturdays spent at the hospital.

No more call nights.

No more mile long treks from the stadium parking lot in the blazing heat.

No more busy work. (Hallelujah!!!)

No more patient logs to keep track of.

No more tests.

Best of all - no more putting on that filthy "white" coat. (I used to love putting it on. Before I had stuff in all the pockets that causes it to weigh 50 lbs. and terrible neck and shoulder pain.)

Some of these will return for parts of 4th year, such as the 5:00 am awakenings during certain rotations and the mile long treks from the stadium, and call nights and Saturdays spent at the hospital. And of course this summer isn't going to be super fun since it will be spent studying for boards, STEP exams, etc... but it's such a relief to have this year over with. It was a lot of fun, but mostly it was a whole lot of work and sleep deprivation. All that said, I've got to get back to finishing up some busy work for the Peds department... At least I'm in my pajamas at home though :)

Runner's Log

2010-05-17T19:22:00.002-05:00

5.03 miles, 50"45'

Took Penelope and ran down by the reservoir again today. It's just so pretty at sunset! She did pretty well considering she just had surgery (of the fixin' variety) less than 3 weeks ago. I did pretty well considering walking 1/2 a mile 2 days ago had me exhausted. I think I'm beating this little sinus infection I've got going on.

Countdown:
Calls left: 1
Days on the Ward left: 3
Peds Test: 1
Clinical Skill Exam: nada; completed that one today. It wasn't quite as painful as I thought it would be, but probably because I'd taken a Benadryl and Aleve and just didn't quite care.

I am Le Sick and Le Tired

2010-05-16T21:07:00.002-05:00

And I'm pretty sure those darn rugrats are to blame. Nearly every single one of their parents that I've talked to have said - "Oh yes, this is little Johnny's 1st week at daycare. He's had a runny nose and sore throat for 3 days!!!" Awesome. Pure awesome.. With that, I leave you: "The End of the World"

P.S. - last full week of M3 year!!! I only have to do scutwork for 3 days this week, have my last call of M3 year, and my clinical skills exam (with fake patient actors) tomorrow. What a week. Can't wait for it to be over.

Rounds - the Highlights

2010-05-12T16:38:00.003-05:00

I'm currently on Peds Wards. We got a new team this week which means new residents, new attending. Same old M3s :) Anywho, it's always interesting to see what the team's dynamic will be. The first day people are usually polite and try to feel each other out. As an M3 you try to determine what style of patient presentation your attending likes, whether you will be pimped to no end, etc... Our current team makes rounding a little less painful than usual. I still dread it, but there are some funny bits tucked in here and there that make it a little less painful. Sometimes these funny bits are provided by the patients, and are sheer luck. And with that, I leave you this week's highlights:

#1 Whenever our rather large team (at least 12 M3s, residents, an M4, and chief) approaches another team in the hall while rounding, an all out snapping battle a la West Side Story breaks out. (See video below if you're my sister and didn't get that reference.)
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#2 During day #1 of rounds we managed to discuss Kurt Cobain, Miley Cyrus, and Courtney Love while standing outside a patient's door.

#3 While in a patient's room, discussing the child's treatment plan with the parents and grandmother, grandmother's cellphone goes off. That's not abnormal. The ringtone was. Then she says: "Grandma got a GOOD text!" It was just a bit unexpected from a little old white lady. Here it is:

#4 Today on rounds I managed to completely piss off a patient without speaking any words, in approximately 1 second, with one motion. No, I didn't flip her off. It was a young-ish mother who rolled over on her baby 2 nights ago and nearly killed it. After receiving a lengthy lecture on putting your kid in their crib, on their back, EVERY TIME they, or you are falling asleep, the student checking on her this morning found her and the baby snuggled up together again in bed. Long story short, we all come in as a team and our chief/attending begins explaining to her how she had a close call and the importance of placing the baby in the crib to sleep. The mom just stares at the tv the whole time, trying to drown out his words, not caring to hear a bit of how she can keep from KILLING her kid. So I walked over, reached up, and flipped off the tv. I got the biggest "go to hell" look ever. It was SO worth it. I just smiled back and then turned my attention to our chief, showing her how she should be behaving.

#5 Today my resident was eager to finish rounds and start working on discharging all of our patients going home. We got to one pt with a really straightforward issue and she gave me 30 seconds to present it. I finished in 27 seconds. Wish they could all be like that!

Runner's Log

2010-05-03T19:51:00.004-05:00

Just completed a wonderful run over by the Reservoir. Nearly the whole run had a gorgeous view of the water. Started over on Breakers Lane, then wound around a few curves and went out to the little lookout point that jets off into the middle of the water. Very fun. Penelope enjoyed it too, but got VERY tired.

4.05 miles, 40'25", 9:58 per mile (wahoo! that's a personal best!)

The funny part - saw my next door neighbor (the man who complained about the dog) walking as I was running back to my car. Then as I'm pulling into my driveway, he pulls into his at the exact same moment. Weirdness. I immediately shut the garage door and scurried into the house to avoid conversating with him. Just not on my list of things to do today.

As for my March running total, it came out to 29.5 miles or some nonsense like that. Typical that the goal was 30.0 and I'd come out to 29.5. This seems like the perfect occasion to "curve" that score to an even 30. Don't you think?

Peds Wards and Wedding Season

2010-05-02T18:39:00.002-05:00

My partner and I just wrapped up our 1st week of Peds Wards yesterday. For those who wonder what the heck "Peds Wards" means, it means we take care of kids that have been admitted to stay in the hospital overnight. It could be due to an infection, asthma exacerbation, or any problem which necessitates multiple tests and consults. It can be one night or multiple nights. We check on them every morning, bright and early, see how things have been going, and then make appropriate changes to their therapy or send them home. There's no clinic (hallelujah!) and most of our residents are pretty nice.

You know wedding season is getting started when you go to 2 showers in 1 weekend. Friday night I got to go to my cousin Carrie's shower. It was a small family get together with BBQ, flip flops, kids playing in the pool, and banana pudding (recipe to follow). It was nice to sit back and visit with family.

Saturday began bright and early with call. My partner and I were at the hospital at 6:30 and left the hospital at about 7:00 that night. It ended with our resident saying - "Oh yeah, I probably should have let y'all go about 2 hours ago. Go home." I hear that one a lot unfortunately. I'm really going to try to remember not to torture my M3s when I'm a resident. Not that staying there that long was torture - I got a good bit of studying done, much more than I would have at home. That's the optimistic view I guess. Came home, ate, popped 2 Benadryl, and hit the hay for a solid 12 hours. It was bliss. I really needed to catch up on some sleep. Wards is nice, but it starts early. I'd only been clocking 4-6 hrs every night for the last week. Weekends are essential for catch up!

As for today, I woke up around 10:30, cleaned a little, sipped on some coffee and caught up on tv shows and then headed to a shower at 2:00. It's for a girl who is marrying one of K's cousins and she is great! I'm super excited to have someone else my age to goof off with at family Thanksgivings, Christmases, and Easters. Plus, they're just a really fun couple. I see a lot of dinners eaten together in the future.

Since then I've been at home, listening to the rain, cutting coupons, and catching up on the 6th season of Lost. Such a productive day, ha ha. Really need to go run, but might have to take a raincheck. It's kind of nasty out there.

With that, I leave you a no-fail recipe for banana pudding. I make this often and always get compliments on it:

BANANA PUDDING

2 bananas
1 box Nilla wafers
1 large box vanilla pudding mix
2.5 cups cold milk
1 tub frozen Cool Whip
1 can sweetened condensed milk
1/4 tsp almond extract
1/2 tsp vanilla extract

Combine 2.5 cups cold milk with pudding mix. Beat for a minute or so. Let sit about 2 minutes. Add Cool Whip and sweetened condensed milk and almond and vanilla extracts. Mix it all up. Alternate layers of Nilla wafers, pudding, and bananas. Top with wafers.

P.S - Sometimes I make it with NO bananas and extra Nilla wafers. Scandalous, I know!

Considering...

2010-04-22T01:09:00.005-05:00

buying an iPod Touch. Not an iPad. No, I like to stay 2-3 years behind current technology, thankyouverymuch.

As for school, things are kind of blah right now. I am currently on Peds Ambulatory which means Heme/Onc clinic in the morning (that's kids with sickle cell anemia or lymphomas, leukemias, etc... for those who don't know) and then general Peds clinic in the afternoon.

I haven't enjoyed this week as much as my counterparts but that's all my bad. I just don't enjoy clinic, period. I'm sure it would be different if these were my patients that I'd seen before and built a relationship with but they're not. Plus, heme/onc is kind of depressing to me personally. The kids don't seem depressed at all for the most part. Even though they have fragmented lives, they are really resilient and have surprised me at how well-developed they are socially. I'm glad someone out there can do it, like my friend twotinyletters over @ http://twotinyletters.blogspot.com but it certainly isn't for me.

As far as general Peds clinic there's a lot of well-child checkups which are incredibly easy but these appointments drive me nuts. I feel like they're a waste of time. I know they're not, but I just feel worthless having made a parent take off work, come to the hospital, wait for an hour or longer, just so we can say - "Yep, baby looks great." There are certain things that need to be done, such as shots given, etc... but I guess it's more of a surgical mindset I have. I want a problem and a solution. I just want to get in there and fix something. I had the same issues in family medicine clinic. Drove me nuts every time I saw a chief complaint of "3 month f/u." These go something like this:

Me: "Hey Mr. Smith, how have you been the last 3 months?"
Mr. Smith: "Great, I have no complaints."
Me: "Good. See you in 3 months"

Now this is not how it actually happened. First of all these visits end up dragging on forever because they have to tell you about you know - their low back pain or that funny looking bump on their left toe that their cousin's aunt says is a spider bite because she knew a guy her 4th cousin twice removed works with that has the same thing on his exact same toe. I know this guy went to the lab for a routine blood draw. I know it's important to check his HbA1c. I know you want to see him when he's well so you can know when he's really sick. But still, these visits bother me. That's a big hangup of mine. Don't know where my malfunction is. Maybe I've got some kind of chromosomal translocation that predisposes me to clinic hatred? That's my excuse for now.

As far as studying, things have been incredibly lackluster in that department as well. The weather has been so beautiful and I've had a lot of projects going on around the house. All I want to do is PLAY, PLAY, PLAY!!!! I find myself reading things and not remembering them an hour later.

Figured out my learning type, finally, but not exactly what to do with it. I'm a mostly kinesthetic or tactile learner with some visual components. What's that mean? I learn by doing - or drawing a picture of something, etc... That means all those lectures I sat through, there's a reason I didn't get much out of them. All those books I try to read, worthless unless I find a way to incorporate the knowledge other than reading it. All the things I've gotten to do on wards - I'll never forget. Some of the suggestions for kinesthetic learners online are pretty comical though. Pretty sure I'd be "that girl" if I partook in a lot of these. They include:

* Take your notes and repeat them to yourself while walking. If you’re in a rush, walking faster or bouncing while you walk can sometimes help, though this method’s effectiveness might vary with subject. When space is limited (or you’re in a hallway awaiting a test), a few-step pace back and forth can suffice instead of a wide circling you might prefer when you have room.

*As crazy as this might sound, some people have their best results from this one: studying while yo-yoing. The motion and sound (the yo-yo has a type of buzzing sound while twirling on the string) make this method especially useful to audio-kinesthetic learners. If you try this one, you’ll probably find yourself walking while studying, as well.

Tips above are from http://www.dirjournal.com/guides/study-tips-for-kinesthetic-learners/

With that, I leave you to go pace around my house while yo-yoing and talking to myself.

Runner's Log + Peds Day 1

2010-04-12T18:39:00.003-05:00

I'm a little delinquent on updating my running log. Ran 4 miles today, 2 miles Saturday in Kosy, and 4ish miles on Thursday. Finally getting into the swing of things. I think it's the gorgeous weather we've been having lately. Took Penelope with me today and ended up running into my cousin A going the opposite direction on the trail. She was very proud of my "technical gear" running shirts I believe she called them...

Today was Day #1 of peds. Everyone seems to really enjoy this rotation, so let's hope it can overcome a serious case of Spring Fever/I'm sick of living at the hospital/M3-itis. I'm not even at the hospital that much anymore and I still can't get away from that place fast enough. Everyone else seems to be feeling the same way fortunately... or is it unfortunately?

6 more weeks.

Bring it.

Runner's Log

2010-04-05T20:10:00.003-05:00

2.25 miles; 20 minutes - around da neighborhood

My fellow partners and I started on Gyn Onc today. However... the only gyn onc attending is out of town all week and we have 1 patient who is just hanging out and waiting to be discharged. All this adds up to a pretty slim workday. I won't post the hours I actually worked today for fear that a few of my classmates might actually assassinate me.

Anyways, all that free time lead to lots of time to exercise my credit card at Wal-Mart and Academy Sports. I finally got some proper running shorts (Cousin A, are you proud?) I have been wearing old Soffe cotton shorts from high school and sometimes even tennis skirts to run in for the last few years. Terrible, I know. Also got some moisture-wicking shirts. T-shirts are probably the worst thing you can wear to run in (besides maybe a sweater?) because they trap all that hot air and moisture and just don't let go but I wear those a lot too. Maybe all this new gear will improve my running times. Ha ha. Also got a new Nike + system since my last one bit the dust and got lost.

I'm going to have to pack my lunch for the next 2 months to justify all the money I spent to run today :)

Running Log

2010-04-03T14:34:00.000-05:00

4.0 miles; ~1 hr. Beautiful day!!!

Trying to do at least 30 miles this month. Gotta break down the big goal into smaller goals.

Big Decisions

2010-04-03T09:44:00.004-05:00

Well folks, a decision has been made. I am going to do Ob/Gyn. I know this might be a shock for a few of my classmates who read.

I went into OB/GYN thinking I would love it immediately. Then I was overwhelmed by their language made entirely of abbreviations. Ex: "Mrs. S is a 37 yo AAF G5P4 here to r/o PROM, h/o PreE, DM; GBS+" It goes on and on. There are tons of abbreviations. I also was intimidated by the deliveries and afraid of screwing something up. I got nervous that I couldn't feel the dilation of the cervix, etc... I started thinking about malpractice insurance and focusing on all the bad in order to talk myself out of it as a career option.

Now the last 2 weeks I've gotten a bit more comfortable, learned the lingo (mostly), and finally learned how to correctly do a bimanual pelvic exam (your fingers go BEHIND the cervix and push up), and seen some incredible surgeries.

During one of the surgeries this past week I just so wanted to be the one digging in and doing the work. It was a fibroid removal aka "myomectomy" and it was amazing. Plus, they use a ROBOT to do surgery - a robot!!!

The other pros on my pro/con list I made:
*no incredibly detailed H&Ps to be taken; just a general PMH, PSH, and then detailed OB/GYN history which consists of a few precise questions. When I was considering Internal Medicine the though of having to do thousands and thousands of detailed H&Ps over the years made me want to jump off a cliff. Those patients' medication lists alone are enough to turn me away. (For those of you not in the medical profession, H&P is the entire medical history and physical exam performed on people when they're admitted to the hospital. It takes me anywhere from 30 minutes to 1.5 hours depending on how sick the patient is and gets really old asking people the same questions over and over again.)

*surgeries! I've started really enjoying the OR (as long as I remember to eat before I go in so I don't get all hypoglycemic and cranky) Plus, most of these surgeries are SHORT (aka less than 3 hrs) and there are just fewer surgeries to perfect compared to general surgery. But still, you get to be a surgeon - you're just a surgeon with dangly earrings (amiright Ewok???) Ha ha. Threw that in just for you. I've found that when I don't know our schedule for the next day I find myself really hoping it's a surgery day and not clinic. There are only 2 specialties where that's an option. Ob/Gyn and General Surgery. So that really narrows it down.

There's more pros than this, I just can't think of them right now. There's also some cons of course but a lot of those are true for all specialties. The main difference is malpractice insurance. I'm pretty sure the amount that Ob/Gyns make is more than enough to cover that and live comfortably though, so I'm not worried about it. I'm often quite surprised to see how much people in my class freak out over their future income and paying back loans. I mean honestly - I've never seen a POOR doctor who doesn't have enough to support their family. And since I'm not the type that's going to buy a new BMW every year I really don't stress about it. We could be in a lot worse shape people!

Anyway, now that I've gotten that out I feel better. Think I'm about to drink some coffee, go for a run in the sunshine, and then get ready for a Crawfish Wedding Party for a very special friend of mine. Have a great Easter weekend everyone!

P.S. - My running total for March was 15 miles. Geez. I think that puts me at around 45ish miles run for the year. I'm going to have to pick it up this month if I want to hit 300 by 2011...

Obsession

2010-03-25T22:30:00.002-05:00

You see this room? More specifically the paint color? How the white trim POPS off it? How everything looks so crisp and perfect? I'm BEYOND obsessed. I've been looking no less than 1 hour for the perfect color of grey with just enough brown or is it more brown with just enough grey? I can't tell. Anyway, I've been looking for that color to paint our bedroom. If anyone has any clues, I'll gladly pay you in cookies.

Runner's Log, REI

2010-03-24T19:50:00.003-05:00

Went for a run Monday - 4.0 miles on the Natchez trail again, this time in 50ish minutes instead of an hour - woohoo! I stopped less this time too. Just for the water break at the 2 mile mark and Penelope's inevitable potty breaks.

Then went for a run today - ~2 miles. Can't be sure of how far I went but it was around 30 minutes so I think that's a conservative estimate. I've got to get a new Nike+ set so I can be accurate! The weather has just been so gorgeous lately I'm really hoping to catch up to my 300 miles in 2010 goal. It's not completely hopeless yet :)

As for school, my 2 partners and I started Reproductive GYN this week. It's actually been pretty great. Monday was a piece of cake. I scrubbed for a TVH (transvaginal hysterectomy - a surgery where they remove the uterus through the vagina, meaning no giant incision or scar). It was pretty cool except for the 1.5ish hours I spent retracting straight UP. I don't mind retracting the abdomen. I pretty much stick a retractor in there, steady my feet, and lean back with most of my body weight. It's kind of like water skiing. Retracting the vah-jay-jay on the other hand... It's not quite as forgiving. Not to mention I was pulling straight up. That's always harder. When the case was over I was dripping with sweat. The oh-so-intelligent attending looked at my scrubs and said, "what is that on your scrubs?" It's sweat you dingbat!!! That's what I wanted to yell, but of course I didn't. I swear they forget what it was like to be the lowly 3rd year med student...

We went home after that surgery because our resident said "she'd call us." We'd heard a rumor that she doesn't care too much where the students are. At 1:00 that afternoon we had a Clinical Skills Exam. These are the tests with actors who pretend to be patients. The whole encounter is set up like a clinic. There's a chart on the door, the whole works. We have 12 minutes with the patient and then a few minutes to write a note. Then we get a grade on the whole encounter, what we remembered to ask, what we remembered to put in the note, etc... 12 minutes with a patient just isn't very much time. These 2 cases weren't bad at all. The 1st one was discussing the results of a mammogram and the possibility of breast cancer with a patient, the other was spousal abuse. It's kind of tough because you have to notice subtle clues like "bruises" painted on with eyeshadow and decreased eye contact. After all that was over I took Penelope for that 4.0 mile run I talked about earlier. Then K and I went and ate at Little Tokyo. I got veggie hibachi and a veggie sushi roll. Safe choices right? Apparently not...

Yesterday was not so pleasant. I didn't even make it to the hospital. Woke up about 4:30 am incredibly nauseous. I usually have a stomach of steel. I can eat anything, drink anything and I never get bothered. I proceeded to vomit 3-4x. Yuck. Not fun. I was supposed to be the student in clinic that day but fortunately one of my nice partners, R, volunteered to take my spot so I could stay home and recuperate.

Today I scrubbed into a tubal ligation and watched 4 or 5 others. They all kind of ran together. Really quick procedures. Then it was time for lunch. Then a meeting with one of the attendings at 3:00 to discuss various sundry chromosomal and hormonal problems that we'll probably never see. It was interesting though. Came home around 5, dug up a bush, ran 2 miles and now I'm typing this. What a long and incredibly boring post. I can't believe you're still reading this. The end.

Runner's Log

2010-03-21T16:43:00.003-05:00

I've been slacking when it comes to updating my running on here, but oh well. I've been keeping up with it in my planner.

Went for a run yesterday on the Ridgeland Multipurpose Trail near my house. It's a 2 mile run to the craft center, then 2 miles back to the car. The goal was to change it up from my usual intervals of run/walk/run/walk, so I just ran incredibly, almost painfully, slow at the beginning and managed to make it the whole 1st 2 miles without stopping! Hooray! Then Penelope and I stopped for a water break at the craft center on the Natchez Trace and started the run back. I had to stop one time because Penelope got all tangled in a thorny branch and then during her flipping out session she swung it over to me so we were both tangled. Every time I tried to move another thorn would get caught in my legs. Ouch!!! Managed to get untangled and then stopped and walked 2 more times for about 1 minute each. Here's the breakdown:

4.0 miles run, 55 minutes, 1 thorny branch entanglement

Also, if you like running with a dog that happens to pull you, you might want to buy this thing:

It looks a little scary, but it's wonderful! The mouth part stays nice and loose as long as the dog is relaxed. It even allows them to drink water. The second they lunge forward (after a bird, fellow dog, whatever) it cinches a little tighter around their snout so they can't bite. It also keeps them from pulling you off over into the bushes or putting strain on your arms while running. It's fabulous. It doesn't hurt Penelope at all and she's gotten so much better about running beside me and not trying to drag me! Makes running much easier. I got mine for about $15 at Petsmart. It's black and blends with her fur so it doesn't look like I have a crazy muzzled dog :)

L&D Nights, Spring "Break", Etc...

2010-03-18T19:41:00.004-05:00

So, right now I'm on L&D nights. Me and my 2 partners in crime were here at the hospital 13 hrs last night and this morning and did approximately 45 minutes of actual work. Pretty much we waited on ladies to deliver, went in, watched the babies being caught, and then got the glorious task of delivering the placenta. But other than that we checked on them every 2 hrs and wrote a note in the chart. Then at 6:00AM we ran around like chickens with our heads cut off trying to see 5 patients in 45 minutes, write scrips, and fill out notes for said patients. It was a little comical. Mostly because we spent 12 hours pretty much sitting around and then were expected to jump! Right now! Faster!!! Higher!!!

So that's pretty much it for L&D nights. It's boring. I feel like all I do is sit around and get hungry, go eat breakfast food at 2:00AM, and watch the clock.

The upside is that we only have to do this for 2-3 nights because we had a Spring "Break" earlier this week on Monday and Tuesday. Kris and I took advantage of this break and went home and then to Louisiana.

I also found out over the weekend that my youngest sister-in-law is pregnant! Hooray! We're all pretty excited about it. They're going to make a pretty cute baby, plus - let's be honest... It takes the heat off of me for at least another year or two. Right? Right? Please say yes.

Anywho, we spent Sunday celebrating "Easter" since Kris's dad will be offshore when the actual holiday rolls around. I woke up early and had coffee and cinnamon rolls with the in-laws, milled around and helped my MIL cook, then got ready and visited and ate for hours. We had an Easter egg hunt for my niece Caden and the weather was just perfect. It was a great day. Then Kris and I left for The Myrtles Plantation in St. Francisville, LA.

It's a bed and breakfast with a restaurant on site, a little pond, a courtyard, and it just so happens to be one of the most haunted places in America. That's what everyone says anyway. We didn't see any ghosts, but didn't sleep very well either. I think that had more to do with cheap mattresses than any ghostly presence. Here's the story though for those who are interested: Chloe the house slave liked to eavesdrop. Her master got mad and cut her ear off and demoted her to field slave. She had a plan to make the children sick so that he would need her and hire her back as house slave so she baked them a cake which she had flavored with oleander. The children and their mother ate the cake and all 3 died. Chloe was then hung from one of the huge oaks in front of the house and thrown in the Mississippi River.

We stayed in 2 different rooms on our 2 different nights because that's all they had left. We stayed in the main house the first night in a big bedroom upstairs. Hardwood floors, 4 poster bed, high ceilings, the whole kit and caboodle. We found out on the tour the next day that we had stayed in the original children's room. How creepy is that? The next night we stayed in a room that was built right off the Carriage House restaurant. It's not original, but did have a huge clawfoot tub that I enjoyed soaking in. None of the rooms have TVs or radios so it was really quiet and peaceful. Most of the other guests were friendly and let us tour their rooms.

One of the best parts was every morning there was homemade breakfast in the house that was the original main house from the 1700s. Grits, biscuits, sausage gravy, blueberry scones, fresh fruit, eggs, hot coffee, and orange juice. Yum, yum, yum.

On day 2 we toured Afton Villa Gardens.

That's just a picture from the drive in. It was gorgeous. It's a garden centered around this old plantation that burned down in the 1960s I think. They have boxwood hedge mazes and a pond, lots of huge oaks and camelia bushes. We spent about 2 hours touring the grounds for just $5 and we only ran into about 5 other people total. I highly recommend it. (I don't know those people in the picture below... but that's just a little taste of what the place looks like.)

On our drive back Tuesday we passed through Natchez and made a stop to eat at The Castle at Dunleith plantation. We didn't tour any plantations there, but I'm glad we got to eat some good Southern cooking before we got home. It was really, really good.

That's about it! What a long post. I might be driven to post again before the night's over if things don't get any more interesting.

Slacker

2010-03-10T16:03:00.003-06:00

Just realized I haven't posted in about a month. What a slacker. I've got a lot to write about, but might just have to wait until Saturday to do it. Need to do some case studies for a preceptor meeting tomorrow and then prepare for our OB test on Friday. I'll just leave you with this jewel:

A 49yo female and 37yo female, mother and daughter show up to OB receiving both stating that they're pregnant. Took Urine Preg Tests at home that were negative but they can both "feel the babies moving." Note that the mother here had that daughter when she was 12. When my classmate was explaining to her about pregnancy tests and hormones, she thanked my classmate and stated: "Noone's ever explained any of this to me before. When I got pregnant with my daughter here, I thought the stork was going to drop her off. I didn't realize I had to deliver her." Not lying. Dead serious. Whoa.

Lame

2010-02-13T14:34:00.002-06:00

Sometimes I do silly things - like pay $15 to run a 5K and then sleep through it. Ha. At least I intentionally slept through it. I've had trouble going to bed before midnight for the last 2 weeks and then I get up most days around 4:30 or so. Weekends are prime catch-up time! Waking up at noon, making cinammon rolls and drinking coffee while catching up on some tv was well worth $15. Besides, I'm going to run now, then gonna head out and pick up some groceries and Valentine's Day surprises for the hubs.

As for yesterday, my sis and her husband didn't have any electricity so they came and stayed with us. We had dinner at McB's where they tried to convince me that the rodeo isn't just for er, country people. They did make it sound pretty fun. Might have to try to go this year. Then Kris and I went to see The Wolf Man. It was okay, not my favorite, but I guess worth the price of admission... The fight scenes were just a little comical. Tried really hard not to laugh and piss everyone in the theater off.

All in all it's been a fun little weekend so far. It's nice to have 2 entire days off in a row for once and I'm determined to enjoy every little bit of it - even if it means sleeping through 5Ks and not taking baths until 3:00 in the afternoon :) Hope everyone else's weekends are going splendidly.

That Time I Almost Crapped My Pants

2010-02-10T21:52:00.006-06:00

So today was a wonderful day. I knew it would be. Our patient list had been whittled down since being on call a few days ago which means less patients and shorter rounds, less to do, etc... I knew there was no way they could find enough scut to keep us occupied until 2:00 or 3:00. One of the interns tried, but no one took him up on his offer to go to his afternoon clinic with him.

I can only imagine. He would have had us see all the patients, come up with assessments and plans and present to him just like he was an attending. That way he wouldn't have to think or work. He automatically turns into the authoritative one as soon as our upper level resident steps out of the room. This is the same intern who showed up this morning at the same time as our upper level resident without having seen any of his patients. It's a little ridiculous.

Anywho, we finished rounding pretty early this morning and said intern told us to go read about CHF. Instead we went and ate and lounged, checked our test grades, e-mail, and so on like good students. Ha ha. This was probably around 10 or 10:30. He said to check in around 12:30. I snuck off and went to lunch at Basil's with my mom and sis and subsequently saw no less than 3 classmates and 3 4th year med students all there. Guess that Fondren corner building would be a really safe place to fall out, huh?

I arrived around 12:40 or so to see my classmates headed for the Exit with bookbags in tow. Yes! Our M4 had dismissed us and told us to say the other intern did it. I went home and got all cozied up in bed, was almost asleep and then I heard my phone ringing.

It was my UPPER LEVEL RESIDENT! I literally jumped out of bed and started pacing, considered not even answering it for a split second.

Upper Level: "Hey Allison."

Me, very nervous: "Uh, hi upper level resident"

Upper level: "Umm, WHERE are you guys?"

Me: "Uh, erm, uh, we were told to go home?..." (yes, with that slight upward lilt at the end)

Upper level:"Oh good, I just wanted to make sure you guys had left. I'm about to leave myself. Didn't want y'all stranded at the hospital."

And then I had to take several deep breaths to calm down. Got back in bed and took a 2.5 hour nap. I think I could have slept 8 hrs but Kris woke me up. I had to be all responsible and take our taxes to be done, like a grownup, gah. K went to the doc to get a brand new slightly suspicious looking mole on his face checked out. My advice before he went: Let's watch it for a week for changes in size, color, shape before cutting it off. Doc's advice: Let's watch it for a week. Guess I am learning something?

We had dinner at Pigskin's tonight. We'd never been. K got the smoked chicken sandwich and I got the BBQ. It was delish! It didn't hurt that the waiter brought us 3 pieces of FREE cake. Lemon, chocolate, and pound cake. We ate it ALL but to be fair they were about 1/2 inch thick little slivers. Ah, who am I kidding. I can't say no to cake!

On call tomorrow; let's hope we cap EARLY and don't get snowed into the VA!

Runner's Log

2010-02-08T22:14:00.002-06:00

Went running with my cousin A today. We did 4 miles. It felt so much easier than if I'd tried to go it alone. That makes my monthly total for February 5.5 miles so far with 277.06 miles left to go this year.

Eventful or Uneventful? You Make the Call

2010-02-07T21:47:00.003-06:00

I was on call today. Yes, Super Bowl Sunday. I wasn't that upset about it since I usually just enjoy the food/festivities more than the actual game. Here's the thing though...

We got there at 8am and I just got home. We stayed 13.5 hours and each saw 1 patient. That's it. My 2 partners had already gotten their patients and finished working them up hours before my veteran came in. Then I go see him, take a full history and do a full physical, and my resident tells me not to even finish my note - just sign it over to him and he'd do it. I guess it was nice of him, but I really wish he would have just assigned that patient to me in the morning rather than make me wait and wait and wait and then not even finish the note on him. I REALLY wish he would have sent my poor partners home. They finished their work and had to sit for hours while the game was on and family and friends were partying it up. I felt terrible for them! All waiting for a patient for me to come in. Oh well. Tomorrow we'll get to go home by 3:30 or so, so that will be nice. Granted, we'll get there at 5:30 or 6, but no complaints here!

Anyway, congrats to the Saints!!! I enjoyed watching the 1st 2 quarters and the last 3 minutes of your Superbowl. I enjoyed hearing squeals and shrieks of joy during the 3rd and 4th quarters echoing down the halls of the VA while I was asking my veteran about his bowel habits.

Oh yeah, and I ran 1.5 miles on Friday. Subtract that from whatever :) My treadmill is officially broken and I could just about cry :(

About to take a bath, get in bed, and do it all over again in 8 hours. Oy. This rotation would be so much more bearable if we got more than 4 days off this month.

What a Morning

2010-02-03T19:47:00.002-06:00

I woke up at 6:56 this morning. I was supposed to be at the hospital at 7:00 (a late day since we're on call) We usually get there around 5:30. Anyway, this is the 1st time I've overslept this year and it was so not fun. I'm sure I won't have that problem again all year!

As if that wasn't bad enough I got rear-ended on the way to the hospital!!! No real damage, so no big deal. We just swapped a little paint and it came off easily with my fingernail so I didn't even worry with calling the po-po. Once again, this car has NOT been good luck for me!

Runner's Log

2010-02-03T19:46:00.002-06:00

Did 1.8 miles last night before my treadmill decided to quit on me. So sad! 282.56 miles left to go this year :)

Things Overheard in the Lounge

2010-02-02T16:04:00.003-06:00

Sometimes things can get monotonous on medicine - like writing orders for Joe Veteran's cough syrup and finger sticks, updating the list, etc... and music provides some relief.

Chief Res: "I'm about to put on some music. What do you guys like?"

M3s, M4s: "Oh, we listen to anything"

Czechoslovakian intern: "You got any Russian nasty rap?"

Runner's Log

2010-02-01T20:48:00.002-06:00

2.3 miles; 26 minutes; 250 calories burned; 284.36 to go

I tallied up my miles from January and was a little disappointed with myself - came in at 13.34! I've got a long way to go before I hit 300. I'm going to try to be a bit more disciplined in February. Plus, it just feels good :)

How are everyone else's resolutions for 2010 coming along?

I've Just Got One Thing to Say:

2010-02-01T10:09:00.002-06:00

Thank God Neuro is OVER!!!!!!!!!!!!!!!!!!!!

and because I can never say just 1 thing: I'm happy to be starting VA House Medicine for the next month.

Runner's Log

2010-01-28T21:39:00.004-06:00

1.5 miles; 286.66 to go

Quotable Quote of the Day - from the VA

Joe Veteran, obese, in wheelchair: That's gonna make you fat, you know...

Me: It's a DIET Coke. Zero calories.

Joe Veteran: Say, when are you girls going to graduate to be nurses?

(We all have on white coats that say School of Medicine)

Me: NEVER.
Austin: We'll be doctors in a year.

Female in elevator: Well, my husband is having surgery today and his surgeon is a LADY! and BLACK!!! (said in such an incredulous way) He's just so impressed with her! It's amazing how things are now!

*slap myself on the forehead*

-10 points for feminism and the civil rights movement

Neuro Exam

2010-01-26T21:21:00.003-06:00

At our institution we spend 2 weeks on Neurology. During this 2 weeks they have a pretty stringent list of things to be done in addition to things we already have to do for Internal Medicine at the same time. One of those requirements is a witnessed neurological exam to be graded by your attending or 4th year neuro resident.

My group has known that we were having ours today for a week, but it's still nerve wracking. We were expecting to do the exam on a patient or on each other but our attending had a different idea.

He took us into an examination room and had us do an entire simulated patient encounter with him, as well as the full neuro exam - on him. They say you should be able to do one in 5 minutes, but I think it took all 3 of us at least 15 minutes a piece. It was a bit scary but I really enjoyed 2 parts of it:

1 - asking him to smile because I had not yet witnessed it. Just as I expected, he wasn't very good at it...

2- the Babinski reflex :) Let me explain. To see if a patient has a Babinski reflex you have to apply a painful stimulus to the bottom of the foot and see if the big toe goes up or down. Upgoing toe is Babinski + and abnormal. Downgoing toe is normal. So to elicit this reflex you have to take an object (the pointier, the better) and starting at the heel drag it very deeply and painfully up to the pinky toe and then around to the big toe. My other 2 classmates were pretty gentle with him, but I really let him have it. He had downgoing toe before I even got to halfway down his foot.

3 more days of Neuro - on call tomorrow, so they'll be a long 3 days...

RUNNING LOG
I've run 5.58 miles since last time I posted. Only 288.16 miles to go this year. I'd better get on it!

Oh, Dell

2010-01-25T21:49:00.002-06:00

I'm not sure if many other med schools do this, but as a way to make things as *easy* and *stress-free* for us as possible (and possibly make a ton of profit)they peer-pressured us into buying these crappy Dell computers before our 1st year started. They only charged us $2500 though! what a steal! Ha.

They never point blank stated that we had to buy them, but made it sound tempting with promises of free tech support and whatnot. Well - it's a good thing, because I've needed every bit of it. My hard drive crashed during October 2008, after using the computer 1 year, and had to be replaced. Fast forward to 2010 and 2 weeks ago my computer got a terrible virus. I took it in last week. Here's the discussion that went down with our school's tech support today.

Me: "Hey, how's my computer doing? I haven't seen it in a week. Any progress?"

IT: "Yeah, you see what it's doing here... It's been stuck on that same screen since Friday. I think we're going to have to replace your hard drive. I'm going to have to call in a specialist from Dell."

Me: "Awesome. Well, I have a question for you... I have to put this program of practice questions on my computer that costs around $300 and my computer needs to be functional for at least 4 months so I don't lose it. Do you think I should put it on there once you get it fixed?"

IT Lady: "Hmmm... This isn't something you could backup on a disc is it?"

Me: "No, it's highly copyrighted. You can't copy/paste any of it."

IT Lady: "Yeah, you're better off putting that on your husband's computer. You only need this computer to last until next year though, right?"

Me: "Ugh, yeah, I guess?..."

IT Lady: "Good, good. You know, these laptops have actually held up pretty well!"

Oh mercy, y'all. This does not look reassuring. What if I went to do surgery on someone and said - Hey, you only need this colon to work for the next 4 months, right? Methinks I'd be getting sued for sure.

Neuro Call

2010-01-24T19:00:00.004-06:00

I was on Neuro call today. It consisted of arriving at 7am, seeing a pt we'd never seen before, then rounding with the head of the department. My partner, A, presented to him, but luckily he ran into another attending who my pt belonged to and I didn't have to present anything. Score! Thank you Jesus!!! Honestly, I'm grateful. I'm not just using the Lord's name in vane. Anywho, around 1:30 or 2 we got a consult from the ER:

"22 yo female c no past medical problems here for R sided weakness"

Sounded simple enough, especially since there aren't very many 22 yo females who actually have strokes. None of the tests had actually come back by the time we left around 3:15 this afternoon, so I don't know what was wrong with her..

other than the fact that she was 28 WEEKS PREGNANT!!!

Our residents spent a lot of time with her doing a very detailed neuro exam, asking about any meds she took, etc. and she neglected to leave that little detail out. Because she was already an obese woman it made it hard to tell on observation. Here's my favorite parts of the interview process:

Resident: "Have you had any surgeries in the past?"
Patient: "Just 3 c-sections, had my last baby in 2008"
R: How many pregnancies have you had?
P: "4; 1 miscarriage"
R: "Are you on any form of birth control?"
P: *bewildered look on face* "No."
R:(Moving along with the social history) What do you do? Do you work?
P:bewildered look again* "No."
R: Why not?
P: *in disbelief he's asking* I don't know.
R: How do you afford things?
P: I got people to help me out. My dad helps me. (And me, and you, and Uncle Sam)

And now for my favorite part:
R: "When did you realize you were pregnant?"
P: "Oh, about a month ago."

Seriously?!? She almost made it on that TLC Show - "I Didn't Know I Was Pregnant."

Also, just as an aside - when I have my M.D. in 1.4 years and am taking social histories (are you married? where do you work? kids? tobacco/alcohol use?) from my patients I plan on doing the same line of questioning. People who are able to work but just sit at home and con the welfare system should be guilt-tripped. My family/little old ladies from church/peers would have guilt tripped the hell out of me if I hadn't applied myself and gone to college, etc... so why don't these people deserve the same thing? I just want to fulfill my social duty as a friend:)

Ah, Vets...

2010-01-20T22:45:00.002-06:00

Favorite quote at the VA today - happened as a caretaker sat a vet down for lunch and basically screamed - "Stay there!":

"One is the loneliest number. Now I know how Jesus felt up on the cross."

What Had Happened Was...

2010-01-20T21:40:00.003-06:00

All the comments after my last post made me laugh so hard. Here's what happened:

At 4:00 today we had finished up in clinic and were prepared to head home, just waiting for the magic words from our residents. My partner, A, was on call tonight and supposed to be over at the main hospital within the next 5 minutes or so. WRE (Worst Resident Ever) decided that was a good time for us to give our presentations on ours topics we looked up yesterday. I gave him the most simplistic explanations ever pretty much from wikipedia, of what he told me to look up (which he DIDN'T EVEN REMEMBER!!!) Since he didn't remember, I felt it wasn't necessary to include the parts that were ridiculous - like the the dysautonomia and "pearl" from Sapira.

K - I just might have to say something about the hair. That would be the funniest thing ever. Also, Chaka Khan is AWESOME. We definitely try to stick with him whenever possible. When I asked him a question about all that crap I had to look up up he said "Here's the deal. You can either spend all your time trying to look up this super specific stuff over the next 2 weeks or you can just spend the 2 weeks trying to learn about Neuro in general and perfecting your Neuro exam." Made so much sense. Just gonna try to survive!

And I Thought Endocrine Was Bad...

2010-01-19T21:43:00.004-06:00

Oy. Neurology is going to be the bane of my existence for the next 10 days of my life. I can already tell. Here's some of my favorite quotes from today from the worst resident I have ever come into contact with in my life:

To dear old veteran who is in excruciating pain and trying to give a good history of why he is hurting: "NICE STORY; NOT RELATED to what we're dealing with." He said this very, very loudly and then just bustled out of the room. I dearly hope he goes into private practice and STARVES - because no one will come to him voluntarily, EVER.

To me:
"Hey you, tonight I want you to look up myelopathy, spondylolisthesis, dysautonomia, and compression fractures as it all relates to that patient and give us a presentation tomorrow. I also want you to throw in one pearl from Sapira's book - you know, the one no one bought." (Yeah, I don't have that book. It's from 2nd year and I didn't even buy it then.)

It's gonna be a long 10 days.

Things That Happened This Week

2010-01-16T15:17:00.002-06:00

It's been quite a week.

***Warning*** ***Rant ahead***

Had a slow leak in my tire since I went sliding on the ice and I went to get it fixed earlier this week. I really needed an oil change, new brakes, and maybe a new tire but decided just to just go to Wal-Mart and let them deal with the oil and tire. I was pleasantly surprised when the guy working there told me I had a nail in my tire and that he was able to patch it. No new tire. Money saved. Woohoo!

Then I got home from the hospital the next day, walked by my tire and saw that it was once again low and now missing the hubcap. Alas...

The water pipes in Jackson needed to undergo extensive repairs leaving several people without water. Fortunately I don't live there and had plenty of water - so much in fact, that I was able to wake up sitting in 3 inches of it on Thursday morning.

It's a long story, but it all starts with me losing my phone on Wednesday. Turns out it was at the VA. Hooray! Found! (See, I'm trying to be positive about all the crappy things that have happened!)

I usually use my phone as my alarm clock with my other huge, incredibly loud alarm clock as a backup. It's a delicate system that sometimes breaks down, but it's worked most every day this year to get me to the hospital on time (praise Jesus!). I really had a hard time getting to classes on time the last 2 years, but haven't has as much trouble getting to "work" on time this year. Anyway, back to the story. My phone alarm snoozes for 5 minutes and that's normally the perfect amount of time to run my bathwater. On a normal morning I get up, cut the water on, and get back in bed for 4.5 minutes of glorious sleep. On this morning, without my phone and without wanting to wake Kris up again with the loudest alarm clock in the world snoozing every 5 minutes I just went into the bathroom, cut the water on and took a seat on the floor. I laid my head in my hands on the edge of the tub and left one hand dangling in the tub so I'd feel the water and wake up. Well, you guessed it.

I woke up sitting in 3 inches of water. I also used up all the hot water. So I tried to be a kind, considerate wife and clean the floors and boil some hot water so at least Kris could take a hot bath. When I asked him if he wanted to take a bath he was so confused and then he got all mad and started yelling something about me "needing to get 8 hours of sleep." You can imagine where this went. I would LOVE to get 8 hours of sleep every night, but sometimes it's just not an option and you deal with it.

Anyway, long story short, it's been a rough week. While some people didn't have to go in to school this week because of the water outage we were rounding. We stayed until 6pm Friday and at one point I got pimped by the head of the department and I didn't even realize he was asking me a question. He said something about the side effects of phenytoin and then looked at me and started saying "1,2,3,4..." It was pretty funny because none of us knew that he was asking a question. He then asked my partner a more straight forward question about diabetes. What on earth?

Things could be worse, and I didn't mean to throw a pity party all over this post. At least I have a warm house to come home to unlike those poor people in Haiti. I'm really not even upset about the week. I just think it's weird when everything happens at once. At the end of the day I know all this work and humiliation in front of attendings will probably be worth it. Right? Right?

Running Log

2010-01-13T22:46:00.002-06:00

Ran 3.55 miles yesterday. Still 290+ miles to go this year. Hmmm...

You People

2010-01-11T19:53:00.003-06:00

Just another lovely day in the world of Endocrine.

80 yr old attending: "Hey, you people(me and my partner), who on earth is responsible for teaching you at the bedside?"

Us: *deer in headlight stares directed at him, thinking to ourselves - "YOU!!!!"*

Easy, Healthy Banana Bread

2010-01-07T18:17:00.002-06:00

Hey y'all. Just made this banana bread recipe and it turned out pretty decent so I thought I'd share:

Ingredients

* 1/3 c. natural applesauce
* 3/4 c. brown sugar
* 3 egg whites
* 2-3 bananas
* 1/3 c. water
* 1 2/3 c. wheat flour (I used whole wheat pancake mix - cause I didn't want a huge bag of wheat flour that I wouldn't have time to use before it went rancid...)
* 1 tsp baking soda
* 1/4 tsp baking powder
*OPTIONAL - chocolate chips, walnuts, dried cranberries, etc... I added chocolate chips and it was pretty dang delicious. Other than that I don't think this bread has much fat/cholesterol in it at all.

Directions

1. Preheat oven to 350 degrees.
2. Mix applesauce and sugar.
3. Stir in eggs then bananas then water.
4. Stir in dry ingredients.
5. Pour mixture into a loaf pan and bake ~35 minutes or until knife comes out clean.

This bread was a tasty end to a not so awesome day on Endocrine. I just don't really "jive" with the people who have chosen to do endocrine as their careers. It's not that I don't like them or respect them. We don't fight or disagree or anything. They're just kind of... different. They definitely don't have the same sense of humor as me and my partner. I'm not sure if I've ever seen one of them laugh - ever. They do stare a lot though. Here's a few reasons Endocrine is just not jiving with me:

1. We round at 2:30 in the afternoon, mostly because our attending is semi-retired.
2. They're big THINKERS; not so much DOERS. They're very nice, but I'm more of a doer for sure.
3. Today we met to round/have a case study with our attending at 2:30. He gave us the case, we all pondered it. At one point my partner and I were discussing what hormones were secreted from the anterior pituitary vs the posterior pituitary. It was all pertinent to the question he had just asked us. At that point he says, "Girls, pay attention now..." as if we're his 5 year old great-grand children or something. (He graduated from med school 50 yrs ago, literally. He told us so.) I really had to bite my tongue.
4. After berating us for discussing the pituitary gland, he then asked me a question and when I had to think about it for a second he said, "Come on Ashley, give us an answer." Is my name Ashley? No. thankyouverymuch.
5. About 30 minutes into our case study some nice gentleman came into our room and stated that all the students were to be dismissed because of the bad weather and that only the department heads had gotten the e-mail. Our attending stated that he saw that, but didn't think it mattered. He then proceeded to keep us for the next 45 minutes before letting us go to "do whatever it is we do all day." Yeah, he said it.

Can you tell someone's made my sh*tlist???

Runner's Log

2010-01-05T18:58:00.001-06:00

2.71 miles today; just 297.29 more to go this year!

2010

2010-01-02T15:08:00.003-06:00

I've read a lot of posts about new year's resolutions, summaries of the last decade, and what's to come in the next decade. I probably should have been thinking about these things more but I've figured out that I'm more of an "in the moment" type person. You know how some people live in the past? I'm definitely more involved in what's happening right now. I think my friends will agree with this.

My one good friend J can tell you exactly what she was wearing and everything she did last Tuesday and how she felt about it all. I usually cannot even tell you what I did 2 days ago. I used to be able to do that. Maybe the mind is slipping? Maybe I should start quantifying things like that? Who knows. It's probably not ever going to happen though. My other good friend A will ask me about plans for the weekend or plans for next year, etc... and my answer is almost always "Oh, I hadn't really thought about it yet." So, with all that said, here's some resolutions for 2010:

In 2010 I would like to:
*run/walk at least 300 miles (treadmill or outside). I think this is a very realistic goal. Keeping it all recorded, on the other hand...

*quit being so self-centered. Maybe it's part of living in the moment, but I often forget things people tell me, not about themselves but mostly in reference to time. I forget that a friend will be coming into town or that my husband has to work all weekend.

*get this house organized so there's a place for everything and everything in its place. I'm getting closer every day, but there's always more to be done. I joke with K that as soon as I have everything just like I want it, it will be time to move.

*watch less tv. A friend of ours in class, S, who just had a baby has one night per week with no tv with his family. He was my partner for part of the psych rotation and he claimed after trying it out the first night that he felt like he's been cheating himself for years. That kind of stuck with me. Think of all the things you could do if not glued to the tv. Granted, I usually am folding clothes or doing sit-ups or painting my nails while watching tv but you get the point.

*Eat more steak. Probably sounds like a weird resolution, but it's one of the few meats I know how to cook decently that doesn't ever really disappoint. It's lean, it's fast, and it feels like an indulgence for much, much cheaper than even a meal at McDonald's.

*Cook more - kind of goes along with be more organized. Ideally I'd like to cook 2 days a week (Sunday and Wednesday) and eat leftovers all week. It would be such a timesaver. Also, related - I'd like to pack my lunch more often. That would save tons of moolah.

I could keep writing forever, but I need to get off my sniffly little butt and get some things done around this place before the hustle and bustle starts back on Monday. K and I both have moderate cases of acute sinusitis right now which has resulted in lots of lounging, reading, and movie watching together over the last few days. I guess if you're going to get sick, it's nice to have someone there with you. While other people were toasting champagne and kissing at midnight on New Year's we were popping Aleve-D out of the foil backing and washing it down with water. Such a glamorous life...

OCD

2009-12-30T20:33:00.004-06:00

You know you're OCD when your favorite part of New Year's is not the celebration, but rather the anticipation of scribbling lots of engagements and to dos in a brand new blank planner.

Holiday Highlights

2009-12-24T14:50:00.003-06:00

We've already celebrated 3 out of 4 times for the season. Here are some of my favorite moments:

*My mother cluing me in on Lady Gaga after I claimed I didn't get her.

*Kris's father lecturing me and my sis-in-law on the merits of pearl earrings and how you can wear them with jeans or "dressy clothes."

*Getting not one, but two digital picture frames at two separate dirty Christmases.

*The Speedy One and I trying to survive lots of socialite ladies and oohs and ahhs at the Christmas shower I hosted for my bestie J. (It was a success I think!)

I'm sure there's many more that I'm forgetting, but these were all I could think of right now. I'm about to head out into the rain and crowds to pick up a few last minute goodies. Merry Christmas everyone!

Lucky?

2009-12-15T18:48:00.003-06:00

Anybody who knows me and my medicine partner, A, knows that we like to gripe. It's mostly out of habit and we're never 100% serious. I feel like on most other rotations we've had it a little harder than some others or either we feel compelled to do more and not be lazy (I'm not talking about anyone who reads this blog, obvs; those girls WORK). So we do our stuff, but we gripe about it the whole time - and afterwards :)

Why am I saying all this? Because I feel like we've gotten pretty lucky on Medicine so far and I just wanted to put it out there. Don't want to ALWAYS be a griper for no reason at all. Here's where we've lucked out that I want to acknowledge:

1. We've only had to take 2 nights of call (since our very 1st day on medicine was our team's post call day), even though we did work our little tails off during them. Other classmates have had 3 or 4 and some of them will be post-call during our midterm on Friday [sorry Ewok :(]

2. Our residents and attending are very nice, maybe a little organizationally challenged at times, but very very nice. I'll take a good attitude over OCD organizational skills any day of the week.

3. We both only see 2 pts daily and that's all our residents/attendings want.

4. We've gotten 30 minutes to 1 hr for lunch every day. Have never gotten a chance to eat dinner while on call, but this is supposed to be a positive post so pretend you didn't hear that.

I'm sure I'm forgetting something, but oh well. I should be studying anyway. Hope everyone's had a good week so far. 3 more days of waking up early for those of us on Medicine!!!

Ice Ice Baby

2009-12-07T19:00:00.000-06:00

Remember how it snowed this weekend? I don't think I'll ever forget it - not because of how pretty it was though. There was lots of ice all over I-55. Fast forward to 5:30 am on Saturday morning and guess who had a run in with the ice on the way to the hospital? You guessed it - yours truly. Here's what happened:

Driving along, not too fast, when I notice 2 sets of blue lights in the left 2 lanes of the highway. What does everyone do when they see blue lights? They SLAM on their brakes. I did not, because I knew there was ice on the road. The people in front of me decided it was a great idea though. So in order not to hit them, I had to slam on my brakes too. Then my brakes completely locked up and my car slid a little to the left - directly towards the cop car. I thought I was going to take it out. Then my instincts made me jerk the wheel to the right, so I went veering across 3 lanes of traffic towards the right. Then I jerked left again. Then right. The last time I veered right I must have really done it good because my car decided to do no less than 3 complete 360 degree circles across 3 lanes of traffic. I was screaming at the top of my lungs. It was NOT FUN.

Then, miraculously, my car stopped. I ended up with my rear left tire slammed against the concrete side wall and facing oncoming traffic. From the sound of it, I thought my whole back end was totaled. I actually braced myself right before I hit the wall and thought I'd be headed to the hospital in an ambulance. Then I realized the police men 3 lanes over from me WEREN'T coming to help me. What was the deal??? I clearly just had a massive wreck!!! So after calling my friend and partner for Internal Medicine, A, and letting her know what had gone down I went outside to survey the damage.

It was insane. The only thing that was messed up was my hubcab. It was wedged in between my tire and the concrete wall. No scratches - no dents. Craziness. So what did I do? I threw that hubcab in the back seat and made it to the hospital only 15 minutes later than I intended to get there. I was pretty shaken up and I'm still convinced that the police actually CAUSED more wrecks than they prevented that morning. But overall I'm thankful. It was very scary, but at least I made it. I guess God wanted me to live that day!

Since med school started this car has not been the luckiest for me. I've gotten 2 speeding tickets (M1 year), sideswiped by a lady and her son during our 1st test week of M2 year, and now sent on the icecapades M3 year. I think I better get rid of the thing before next year. Not sure if I can survive the next one!

Quotable Quotes

2009-12-07T18:53:00.002-06:00

Just got off the phone with my dear grandmother who turned 81 a few days ago. I was calling to wish her a belated happy birthday and we got to discussing my cousin A who recently ran her first marathon. Here's how it went:

Mam-Maw: You know C (another cousin of mine) ran that same race A ran in?
Me: Yeah, and M and D ran the 1/2 marathon. (M and D are C's parents.)
Mam-Maw: We've got some nuts in this family!!!
Me: Yeah, I know :)
Mam-Maw: I'd be bitching and complaining the whole time if I had to run that!
(This is the first time I've heard my grandmother say the "b-word" and I almost can't contain my laughter. Who am I kidding - I never contain my laughter.)
Me: Yeah, I imagine so.
Mam-Maw: I think A was sore for a whole day afterwards. I would have been sore for a whole year!

Gotta love it. I'm very proud of all of my running cousins. Not sure if I ever want to do a marathon. We've been studying a bit of nephrology on Medicine and knowing that bits of muscle that have broken down get all clogged in your kidneys is really not making me want to do it.

Catch Up Post

2009-12-03T21:46:00.003-06:00

Runner's Log: ran/walked ~15 miles in the last week in 2.5 hours. No clue of calories.

Now for the revelation:

I DON'T hate Medicine so far. What's wrong with me? Everything I've ever said or thought goes against this. Maybe it's because our team is really nice. We just have an intern, upper level resident, and then the attending. I was expecting really "anal" people but they're nice. They give us actual responsibilities which I enjoy because I don't feel my day has been wasted and it makes the time go by faster. Then, after we do our work - they are APPRECIATIVE. It's the first time this has happened this year I think. At least I know it's the first time residents have ever vocalized gratitude so often.

What I like about medicine:
1. It's organized. Patient presents with problem. You acknowledge problem, determine BEST treatment plan based on evidence, and then treat them. They get better (usually).
2. Our residents and attendings have been nice so far.

What I don't like:
1. Early hours - alarm goes off at 4:30 most days and I still haven't gotten in the habit of going to bed before 10:00.
2. I hated rounding multiple times a day at first, but since then we've mostly just run the list a once or twice daily and then had attending rounds once daily. It's not bad if your team is efficient and it keeps everyone up to date.
3. Lack of procedures. I like working with my hands.
4. Lack of time off. We are supposed to get 1 day a week off "on average" which means you can potentially work 26 days in a row, then have 4 off at once. Shoot me.

Another exciting tidbit - on our very first day of rounds at 6:30 we were walking by a room just as the nurse happened to shout "CODE!!!" Turns out our team was the code team that month. It was a little chaotic, but long story short both me and my partner got to do chest compressions multiple times and our patient survived. Pretty exciting stuff.

What the Hey?

2009-11-27T13:55:00.000-06:00

How in the heck did I make it back home with NO leftovers at all? Oh well - maybe my pants will fit a little looser next week...

Runner's Log

2009-11-22T13:22:00.003-06:00

45 minutes; 3.87 miles; 380 calories burned

It wasn't very pretty out today - hello clouds :( but at least it wasn't raining. I knew I was giving Penelope a bath today so instead of steering her around every mud puddle and gutter filled with stagnant rainwater I just went ahead and let her jump in every single one of them. How liberating! She was so tired for her bath that she didn't protest at all. Just sat there with her head resting on the side of the tub and let me bathe her. Guess how many towels it takes to dry a 9 month old cocker spaniel?

5! She completely soaked through 5 towels. Methinks it's time for a haircut.

Today Kris and I plan on getting the house all gussied up for Christmas. I'm hosting a Christmas shower for my dearest friend Julz in less than a month so decorating should be a lot of fun this year. As for the rest of the day - I really need to start preparing for ACLS (advanced cardiac life support). This is also known as "running a code" or what to do when someone's dying. We're being trained and tested this Tuesday and Wednesday and I haven't even begun studying. Yikes. Psych really has made me lazy.

You Know What's Not Cool?

2009-11-21T14:16:00.001-06:00

When you've gotten all decked out in running gear, got the iPod at the ready, leash on the dog and step outside to see

RAIN. Boo rain. Go away.

Things I'm Loving Right Now

2009-11-18T16:32:00.002-06:00

1. Berry Berry Good - it's my latest obsession. I've spent $8 on frozen yogurt there in the last week. Today I tried the peanut butter, mint, strawberry & cheesecake (swirled), and plain tart with some strawberries and pineapple on top. (All the flavors were separated by a little bit of room in my cup - I'm not a complete neanderthal) They give you a cup, you run around filling it up, then they charge by the ounce. I want to say it's actual frozen yogurt and not sugary/ice cream stuff but I'm not 100% on that.

2. The fact that psych is almost over. Today my attending (who is triple boarded) asked me why a diabetic patient of his shouldn't have concentrated sweets. Really dude? Really? I was so in shock that I couldn't even blurt out an answer and then he said - "Yeah, I don't know either..." Whoa - talk about making your profession look bad.

3. All the fun flavors at Cups right now. I got the butterscotch blitzen au lait a day or 2 ago and it was fan-freaking-tastic.

4. My schedule/partners/group for Medicine. We start Internal Medicine next week and I couldn't be more excited about my schedule and being (hopefully?) super productive all day. I'm sick of being useless on psych. I'm not loving the q5 call that goes along with medicine :(

5. Recycling old electronics - sounds weird I know. I've just been in a super organizational mood for the last few weeks and it feels good to get rid of some junk. So far I've dropped off 2 huge old computer monitors (from my Mom's house), a printer, and Kris's old laptop at Best Buy. At one store they charged me $10 per item but then gave me a $10 Best Buy gift card in return for each item. At the 2nd Best Buy I went to on a different day they just took the stuff.

6. The fact that my kitchen cabinets are now officially organized. If you've been to my house it's no secret how tiny my kitchen it. I have 2 cabinets for ALL of our food, not including the one above the stove where I keep spices. Up until 2 days ago I just had everything shoved in there all haphazardly and 50% of the time when you opened cabinets something fell out or you couldn't get it shut again. No more my friends. Pictures are to follow because I know you're all just dying to see inside my kitchen cabinets - ha ha.

7. Finally having just the right amount of comfy shoes for trekking around the hospital all day. Here's what I needed to make it work and not feel limited in style options:

a pair of Dansko-ish type clogs to wear with scrubs
2 pairs of boots - 1 black, 1 brown
2 pairs heels - 1 black, 1 brown
flats - lots of 'em. I guess you only need 2 pairs, but I've got quite a few more than that.

Anyway, off to our Psych exit interview. Not real sure what it will entail, but hopefully it won't take too long!

Runner's Log + Psych VA

2009-11-02T17:43:00.003-06:00

25 minutes - probably ~2 miles

The old iPod decided to die 5 minutes into this run and therefore I have no idea of the actual distance run or calories burned. Penelope had fun though. I've been pretty steadily running between 1-3 times a week for the last few months, but I'm beginning to get BORED... I definitely need to switch it up and go somewhere besides my tiny neighborhood.

As for school, I am now in my 4th week of psychiatry. Although they all boast that they are some of the most handsomely compensated doctors I am still not interested. I might have been at first, but that all changed the day a 67 year old lady punched her nurse in the face and then told me I was going to die.

She was "the Chosen One" and we were all despicable and all going to die. No she did not want her Ativan shot and no, she was NOT going to give us a urine sample. Long story short, the police got involved, she got her shot, took a nice long nap, and then got transferred upstairs.

Most of the patients I've seen on psych are either homeless, drug abusers, child molestors, criminals, or sometimes all of the above. They're usually looking for either:

a) a warm place to stay
b) a meal (I was going to say a good meal, but it is hospital food after all)
c) somewhere to hide from the police/gang members/family for a few days
d) more drugs

I don't have that much empathy. I wish I did. I think I used to - but it's all gone now. Now, for happier news:

I spent the last 3 weeks at the ER doing psych. Now I'm in the holiest of holy lands - VA Psych. I was home by 1:00 this afternoon AFTER going shopping at Target on the way there. I was at the VA a total of 2.5 hours. It was a productive 2.5 hours though. I met my attending and his physician's assistant. We ran the list. We rounded on the patients. The PA taught me how to and let me write orders on the patients and told me a few of the more interesting cases from years past. Then I went and hunted down a lady to give me access to the VA computers and that was it! Settling in for a night filled with reading (for fun) and Castle. Woohoo!

Palpable LN

2009-10-13T22:18:00.002-05:00

Oy - came down with a rough case of acute rhinosinusitis yesterday which is being controlled pretty well with Aleve-D, my Neti pot, and lots of hot tea and cold water. I'm not sure of the percentage, but I'm inclined to say >90% of rhinosinusitis cases are viral in origin which is why there's no point in going to the doctor for these things (unless you want a shot of decadron) and there's especially no point in asking for antibiotics. Anyway, all that was to say that I've been regularly checking my supraclavicular and cervical (neck) regions for palpable lymph nodes and wouldn't you know it - this afternoon I found 2! I've been skeptical of my LN palpation skills ever since I read Mom's Marijuana by Shapiro. After his diagnosis with lymphoma and subsequent stays in hospitals he commented on how most physicians never palpated with enough pressure to pick up his nodes, but he always knew where they were.

Fell in love with psychiatry today when the resident realized I was sick and immediately sent me home and told me to come back in a day or 2 when I felt better. Hooray for thoughtful residents. I could get used to this...

Slacker

2009-10-12T20:41:00.003-05:00

Whoa - didn't realize it until today but it's nearly been 2 months since I posted. My sister called me out. Told me that I was still stuck in surgery in blogland. I decided that must be remedied immediately!!! So here's a quick rundown of what's been going on lately.

Finished surgery, took the test, class average was a 67 - most definitely the lowest our class average has ever been on any test. Very surprising to me.

Started and finished my family medicine rotation. We do 2 weeks at a big hospital with the family medicine residents and attendings. Then we go off to a "rural" location. Most everyone picks their hometown since they have a free place to stay. I did this and the funniest part to me was that 1/2 way through my 4 weeks, one of my relatives (not telling which one, wouldn't want to have a HIPPA violation!) ended up becoming an inpatient. Not just any inpatient, but a patient on my attending's service. That means I had to go see them every morning and afternoon, get the pertinent info, write the note, etc... It was pretty funny. Here's the breakdown of hours for each part for those of you who want to know what you have to look forward to :)

Big Teaching Hospital: arrive around 6 or 6:30. See 2 patients (no matter how many are on the service, which is AWESOME). Write notes. Go to morning conference at 8. Usually a specialist of some sort would come in and teach for 15 minutes. Then we'd head down to the doctor's lounge and run the list/dry round over delicious breakfast. FREE delicious breakfast. They really know how to treat students and docs over there! Then we'd go on work rounds. Then we'd have class. Then free lunch. Then class. Then home by 3ish. It was pretty relaxed.

"Rural" Medicine: Get to hospital between 6 and 7 depending on how many inpatients we had. My preceptor and I would split up the patients or "divide and conquer" as he liked to say. I'd usually see 2 or 3, write their notes, then he'd look it over and tell me what orders to write. Then he'd sign them. I really enjoyed getting to know the entire staff at the hospital there. It's so different from being at a big teaching hospital where noone really knows each other. Anyway, then we'd go to clinic and see about 15-25 patients from 8:00-4:30 or 5:00. Then it was time to head back to the hospital for afternoon rounds. I usually got home around 6. All in all not a bad experience, but I'm not sure it's for me. Think I would approach burnout very quickly. Not so much from the hours worked, but from the patient population. That's a long story for another day though. Let's just say I'll be okay if I never have to hear about low back pain EVER, EVER again... My preceptor was incredibly nice, liked to quiz, liked to teach, and trusted my work which was exciting and scary all at once. I did most of the admitting H&Ps on new patients coming in and a few of his discharge summaries. He'd usually sign orders before I wrote them after going through a care plan with me. Very strange to write orders and have nurses ask you, seriously, what tests you wanted done, IV fluids, etc...

Now for a fun update - this past weekend the stars and planets must have aligned just right because for once:
1) I had no responsibilities, technically (I guess I could have been studying for well, anything)
2) My husband was able to take off Friday, Saturday, AND Sunday
3) His grandparents just so happened to have rented out a 3 bedroom suite overlooking the Gulf Coast.

Fun times ensued. K's grandparents, 2 brothers and their wives, aunt and uncle all ended up staying for the weekend. There was a huge car show so the girls pretended to be interested for a few hours on Saturday morning. Then we split from the guys and headed to the mall for a good long while. After that we all met back up and headed to the beach to play for a while. There were hardly any waves and the tide was so far out you could walk on all the little sandbars close to the shore. K and I were kind of amazed we were still finding debris from Hurricane Katrina so long after it happened. He found a cool little piece of a 2x4 that was smoothed and rounded like sea glass. Sad :( Anyway, after our romp on the beach the 3 brothers and their wives went to a restaurant overlooking the ocean that we just knew would be awesome, but alas (frylime, that one's for you) that was not the case. However, the margaritas I made back at the condo later were quite tasty. The next morning we had to get up and leave, but we stopped at the outlet mall on the way home and shopped our little hearts out.

This post is getting terribly long, and I've got a killer case of acute sinusitis that reared it's ugly head today. (Thank you to Caden, my 2 year old niece who thought it was funny to wipe her boogers all over me this weekend) Those of you who know me well know how much that almost killed me...

Psych started today and I'm really happy with my partners and rotations. Wahoo!

Last Day in the OR

2009-08-25T14:14:00.003-05:00

Surgery is almost over!!! The only thing left is the test tomorrow, at 9am. We had today off to study. I woke up at a glorious 10:30, when the sun was already out, and I got literally 2x as much sleep as I normally do in a night. Let's talk about my last day in the OR, shall we?

Here's the good part - I spent all day with the pediatric surgeon who is in charge of the surgery program from our standpoint. He makes the test at the end, is in charge of call, etc... In other words, he knows what's up. He cares about the students. I scrubbed into all 3 of his surgeries Monday. The first was a simple little esophageal dilation. No biggie. They consecutively stick these flexible tubes down little babies esophaguses? esophagi? in increasing diameter in order to dilate their precious little throats so food will go down and stay down. It's pretty fast, relatively painless, good times. The next one was an umbilical hernia repair. Super fast surgery. He let the intern do most of it.

The next surgery of the day was THE BIG ONE. Although it was about the same length of time as most of the cardiothoracic surgeries I scrubbed in on, it was the most physically exhausting. Partly because I hadn't scrubbed on a long one in a while. Partly because all I'd eaten that day was 2 brownies. Thirdly because I was actively doing something the entire surgery. We did a laparoscopic colectomy with ileostomy and ileostomy pull-down. This means the attending and chief resident took out this little girl's colon, connected her ileum to her anus, and also connected part of her ileum to an ostomy - or bag on the outside of her stomach. She had ulcerative colitis that left her colon an ulcerated, bloody mess. Taking it out decreases her chances of colorectal cancer.

Doing a surgery laparoscopically cuts down on healing time and huge scars, but it takes FOREVER. You're working through very tiny holes, which means the tools you put in are very tiny, which means you have to take tiny little bites at the tissue. So essentially they managed to get 95% of her colon taken down this way. It took about 6 hours. Then, for the last little bit, when her colon goes down into her pelvis, they couldn't take it down. Her pelvis was just too narrow. So at this point, at 5:30pm, we have to switch to OPEN. If we had started open, this surgery would've taken maybe 3-4 hours.

On the upside - I learned how to run the camera for the laparoscopic surgery. On the downside, we were in the OR forever. Dr. S did give me a 3 minute water break at one point which was nice since I had the unfortunate issue of food poisoning the night before. Don't want to get graphic here, but going to the bathroom 5x in 3 hours and losing 2 lbs worth of fluid just doesn't make a happy camper! Was definitely feeling a little woozy.

Okay, so we switched to open, made the ostomy, connected the ileum to the anus. I retract like a rockstar, get super sore, get to put in a couple of stitches, and then leave the hospital at 7:30pm. I got home at 8:00. I'm EXHAUSTED. I have less than 48 hours until the surgery test. I could study for an hour before passing out, or I could eat and go to bed. Guess which one I picked?

It was a rough day, but I think it was a good way to end surgery. The case was exhausting for everyone. The attending and I were the only 2 who were there for the whole thing except for our 3 minute water breaks. There's something about tough days in the OR like these that really suck, but it's such a rush when it's over that it's worth it. You really get to know the people you're working with because you're stuck in an area of 3-4 square feet and they can see your work ethic firsthand. They know if you follow instructions, if you listen, if you retract hard enough, how you treat the people around you, if you have a sense of humor, what kind of music you like, etc... I don't think I necessarily want to do surgery because I don't think I could sustain this kind of work ethic for the rest of my life, but I do think I'll miss it sometimes when I'm on services like internal medicine where we hardly touch the patients. Time will tell.

Good luck on the test everyone! I've had little time to study and now I'm wasting it writing this post, so I'm sure I won't do too well. Let's just hope I don't have to repeat this mess all over again :)

Putting My Running Shoes On

2009-08-16T13:42:00.003-05:00

I'm not actually going running. Lord knows I haven't done that in 2 weeks. I'm getting ready for peds surgery. I was really excited about it until I found out the other 2 medical students who were supposed to be on the service with me switched off because... get this - "they wouldn't have enough time to study." If you're not ready for a rant, please stop reading.

Here's the thing. On most services, every patient has to be seen in the morning by an M3 BEFORE the intern/resident sees them. You generally meet the afternoon before or the morning of and divide the list of patients to be seen. Since I've just come off an incredibly busy service where I was seeing 6 pts every morning before 6:40am, I really feel I deserve a break. I've had NO time to study - at all. Some nights I go home and don't even eat dinner. I just sleep. And now I'm going onto one of the busiest services with absolutely no help. It would have been fine with the 3 of us to see patients I'm sure. Now it's going to be hell. I'm really not sure how I'm going to survive. This, my friends, is why I'm counting down the days to family medicine. I've already been given the first day off by my preceptor because he'll be post-call and not seeing patients that morning. Gotta love it :)

I think I've decided I'd like to do some sort of primary care when I "grow up." I like the idea of knowing the patients you're going to see and work with instead of hurriedly brushing up on their history in the 5 minutes before you go do a consult on them. So most likely it'll be family med, peds, or ob/gyn. Can't wait to do ob/gyn because I think c-sections would be really fun. I enjoy short surgeries, love opening the abdomen, love closing at the end, but just don't really care too much about the colon or liver. I also enjoy patients who are healthy enough to have walked into clinic to see you that day. ICU patients really intimidate me.

Anyway, on to happier thoughts. I managed to somehow get this weekend off. When I told my 2nd year resident I was leaving Friday afternoon at about 3:00 (the M4 was on call and covering us the rest of the day since she had to be there anyway) he just could not understand why I'd want to go home. He questioned me for 5 minutes. It was comical. Then he got really upset when he realized there wouldn't be another M3 coming onto the service. Ha ha. Goodbye cardiothoracic surgery!!!

Went home Friday night for a birthday diner celebration with my in-laws. Spend Saturday morning moving my grandmother's furniture into her new place of residence. Then spent Saturday night at an engagement party for a friend of mine. Today I plan on doing a little cleaning, a little exercising, a little studying, and definitely dinner out with the hubs and watching Mad Men at 9:00! Hooray for fun weekends :)

What a Week...

2009-08-06T09:36:00.003-05:00

Here's how my week on cardiothoracic surgery has played out so far:

Mon - arrived at 4:45am. Saw 2 pts, wrote notes, rounded with team at 6:45. Scrubbed into a CABG x 4 (quadruple coronary artery bypass graft) at 7:30. The chief resident becomes ill and has to scrub out. Haven't seen her since Monday. That leaves the 2nd year resident, the 4th year med stud, and me. Snuck away at 3:00p and went home. (The chief states that she would like the 4th year and I to alternate scrubbing on cases)

Tues - arrived at 4:45am. Saw 4 pts, wrote notes, rounded at 6:45. Hung around and waited on CABG X2 to start. A heart transplant bumped it. Heart transplant finishes at 2:00. I was told not to scrub in, but to observe. The 2nd year resident informs us that he would like one of us to scrub, and the other to observe every case. Nice... Left hospital at 8:45pm.

Wed - arrived at 4:45am. Saw 4 pts, wrote notes, rounded at 6:45. Hurriedly changed clothes and went to M&M conference at 7. Go observe a mitral valve replacement from 9-2:30. I didn't get to go to the book club discussion :( because at 3:00 the resident informs me that even though I don't go on call until 7:00pm, I'm "stuck there." Yet he provides no instructions as to what he wants me to do. So I went and got "stuck" in the on-call room and attempted to rest up before call. 7p - call starts. Nothing happens. I study. Nothing happens. I sleep from 11p-1:30am, and THEN the page comes in. *18 y/o fell off his horse. Why was he riding his horse at night? (*info has been changed because I'm afraid of the HIPAA monster.)At 2:15 or so, my fellow M3 on call and I decide to fulfill some of our technical skills we have to do before we graduate. These include things like inserting Foley catheters, starting IVs, venipuncture, arterial puncture, insertion of NG tubes, etc... I'd already done tons of Foleys, but really needed to stick some people. They had the perfect patient for us. He needed arterial blood gases drawn, was comatose and heavily sedated. Awesome. I really didn't want to stick someone's artery that was aware that it was my 1st time and awake. I watched my M3 counterpart stick the artery with incredible ease. Then my turn came. I had to stick twice, along with some rearranging of the needle once inside the skin. Not very encouraging. Then it came time of the venipuncture. Here's how it went down on the very quiet SICU.

Female nurse #1: Well, we don't have any pts that need venipuncture, but *John here has great veins.

Female nurse #2: Oh yeah, they're like ropes. I'll go get some needles. (M3 counterpart and I laugh, thinking they're obviously joking)

Female nurse #1 then reappears, with John in tow. "Here he is!"

Me: You're not serious, are you? Really?

Nurses: Oh yeah, it's fine. He lets people practice on him all the time.

Then my partner and I proceeded to stick this guy 4 or 5 times while sitting at the nurses station with a group of nurses around us in order to each get in an IV and venipuncture. The entire time he was giving us instruction. It was bizarre. Can you imagine telling someone where to stick you? To push DEEPER into your flesh with a needle? He ended up leaving one of the IVs in because he was dehydrated and planned on taking in some fluids.

Then it was 4:00am before we knew it. 2 more trauma pages came in. Old lady with dementia who fell and then young guy who got in a fight. Typical stuff. Overall it was most definitely the lightest call night I've had so far and actually pretty enjoyable.

Then 5:15am rolls around. Time to see my now 5 patients and get notes written on them before 6:45. We go round and the M4 states that she's forgotten to see one of the pts. I have to be in class at 7:00 and she tells me to go do it. NICE... Whatever though. Went and checked on him. Went to class. Decided to stay lost for a while and take a breakfast break. We had another CABG today, but I peeked in and saw 2 attendings, a resident, and an M4 scrubbed in. I refuse to observe another one, especially post-call. I'm about to make like a banana and split! 6 more days of Cardiothoracic surgery!!!

"What are you on?"

2009-08-04T08:24:00.002-05:00

It's the first question all of us M3s ask each other when we pass in the hall or meet in the "student surgery lounge" - aka McDonald's in the hospital. It just strikes me as funny because I'm sure passersby are wondering if we're all asking each other what illicit drugs we're partaking of.

Speaking of illicit drugs... I've joined the M3/M4 book club and our book of the month is Mom's Marijuana. It's written by a psychologist, Dan Shapiro, who was diagnosed with non-Hodgkin's lymphoma in his late teens or early 20s. His mother is your typical anti-drug mom, but when she finds out that marijuana will help with the side effects of chemo, she begins growing it in her garden of sunflowers for her son. The book is really great so far. I'm also anti-drug of course, but I think it's really interesting. The best part is that Dan Shapiro is actually coming to discuss it with us tomorrow at 3:00. I hope I'll be able to get out of whatever surgery or clinic they'll have me crammed in.

Quick Tips for the VA Rotation

2009-07-19T17:56:00.003-05:00

Disclaimer: You might not want to read this post if you're not a med student at my school. The information will be boring and useless. However, if you are, you might find it of a little value. I'm post-call though, so be warned.

How the VA Works:
*Disregard most of this for tomorrow. They're just going to spend the whole day giving you the tour and getting you set up on the VA computers.

*M/W/F are surgery days. T/Th are clinic and education round days.

*If you don't have VA scrubs, show up the 1st day in blue scrubs, go down to the basement to the OR control desk, and ask for VA scrubs. They will give you a pair. You will not have access to a machine, so you will have to wash them yourself.

*When you arrive on a normal morning, you will go to the residents' cubby hole in either 2045 or 2035 (sorry, can't remember!) and pull up the list. You will then put your initials by the pts you would like to see.

*Print several copies of the list and leave them laying by the computer you were just working at. Be warned, the list will print at the nurses station, about 30 ft away. Just go grab them and put them by the computer in the residents cubby hole or be sure you have 2 copies with you - one for yourself and one for the chief when it comes time to "dry round."

*Go see your pts (usually 2, sometimes 3.) Check the white board on the floor before you barge into the room. They switch rooms a lot without letting you know.

*Once you've seen both of your 2 pts and asked about pain/f/c/n/v/BM/flatus/diet/ambulation/check drains, tubes, and restraints, find a computer. There's 3 in the room where you'll sit around and do the dry round in the morning. There's more at the nurses station or on the 4th floor.

*At the computer, find your pt. Sign in under the resident's name that is seeing the pt (because we're not allowed to have our names on charts at the VA). Don't worry. The resident has to review the chart and sign it before an attending sees it.

*Everything you need, such as vitals and labs will be posted on the computer. Vitals will already be filled in on the note when you go to write it. Then just do the whole SOAP note thing. It's got a template there for you. You CAN look back at older notes while in the middle of writing yours and it won't close yours out. So if you get confused, just look back at an older one.

*Be prepared to do a quick run-through of your pt at dry rounds, but the residents will most likely do it. We did it 2-3 times in our 2 weeks there, towards the end when they figured we were competent.

*For T/Th education rounds, you need to know your patient's medical history pretty well. You don't have to KNOW it, but you do have to have it available on a sheet in front of you. Especially know their vitals and presentation on admission, as well as their normal and current weight and bathroom habits (diarrhea today, but have they had it for 30 years? Is that normal for them? For a lot it is...) Know family/social history as well. You can find A LOT of this by digging around in their chart on the computer. Also, have a differential, but don't mention it in your presentation. You'll probably get asked about it. Know how you would rule out those possible diagnoses - what tests/procedures you would use. This sounds overwhelming, but the attendings are usually nice about it all. If they're quizzing you, it's so they can teach you something you don't know.

That's about all my info. If y'all have questions, post them in the comments and I'll try to answer them. Good luck and have fun!!!

P.S. - Dr. Wofford might be the cutest little old retired cardiothoracic surgeon I've ever seen. He's going to give y'all lessons 2x a week. He repeats himself a lot, but he's really funny and you'll probably learn something.

It's a PASS!!!

2009-07-15T14:28:00.003-05:00

Never in my life have I been so happy to have passed a test!!!

Sorry the posting has been pitiful lately. Surgery is working me to the bone. That being said, today was an incredibly rare exception to the rule and we were finished with surgery by 10:00 this morning. Checked our STEP scores (in the surgery lounge, where I screamed "PASS!!!" and slammed my fist on the table. Then my good friend A came running up and we sort of did a jump/chest bump/hug in mid-air. I thought I got a pneumothorax from one of her pens jabbing me in the chest. The surgery residents thought we were crazy.) Then after the crazy rush of it all we had to give presentations and then we went with our team (residents + us M3 students) to Mugshots to have some burgers. All in all it's been a pretty good day so far.

Decided I should treat myself to a little reward, so I stopped at my favorite boutique - Target, and got a nifty bag that I can put my laptop, pens, wallet, books, and a change of clothes in. Essential for the surgery rotation. I've needed it the last 6 weeks!

To make the day even better, I got home and Netflix had brought me Bride Wars. Cha ching! About to sit back in the recliner with the fan on, a blanket, a pup, maybe a cold beverage, and a movie. Does it get much better?

Hope everyone else's day has been wonderful and if it hasn't, I'll be sending up some special prayers for you :)

Hoping, Wishing, Thinking, and Praying

2009-06-26T21:43:00.001-05:00

that call this weekend won't be as draining as it was the 1st time I was on call. Either way, it's on the weekend so I get to go home by 7am on Sunday. Wahoo!

Finally

2009-06-24T20:31:00.004-05:00

I finally ENJOYED one of the surgeries I scrubbed in on! Wahoo!!! Apparently I really like vascular surgery. Never EVER would have guessed that in a million years. I just really liked watching them tease out the arteries and veins and SO wanted to get my hands in there and do it myself. It's so much different in a living pt than in a cadaver. Finding arteries and veins was not my idea of a good time during Gross lab.

Today we made an AV fistula in the arm for a patient's hemodialysis access. The surgeon also moved the vein more superficial than it was originally to allow for easier access for the nurses who will be sticking the pt when it's time for dialysis.

The best part of the case: You get to SIT DOWN during vascular cases. Score. Also, the attending and resident were really nice and I only got asked one question, which of course I didn't know the answer to. Once again, nice attending, so it wasn't completely mortifying - just a "teaching experience" as they call them.

Exciting part: I got to suture the underlying tissue together and then staple the incision. It was my 2nd time suturing, and a different technique than the one I did the 1st time, so I was glad to learn how to do it. Surgeons make it look easy, but there's very subtle differences in how they hold the tools, tie the knots, etc... which can make us look very clumsy comparatively. Anyway, it's now time to get in the bed. Gotta be up at 3:00 :)
7 more days at the VA - wahoo!

Cool Side Note

2009-06-23T22:54:00.002-05:00

Today I got to see an A/V fistula created by one of the vascular surgeons at UMC for dialysis access. The cool part:
*I felt a "thrill" over it - a buzzing sensation
*I heard a bruit! Finally! I've been wanting to hear a bruit for the last year or so. It's just a little "whoosh" type sound you can hear with the bell of your stethoscope (the smaller side). You hear it in the carotid arteries when there's blockage and also in AV fistulas.

I'm more excited about these things that I saw in clinic rather than in surgery. All the surgeons HATE clinic, but I really prefer it to most of the other things we do. Perhaps it's a sign.

Dear Surgery,

2009-06-23T22:37:00.001-05:00

I want my life back.

Signed,
Your pal - Chazing Zebras

Ahem, Make that 13.3

2009-06-15T20:46:00.001-05:00

So, a few of us thought that half marathon seemed a little long in the last 3 miles. We were CORRECT! Turns out one of the miles was actually 1.2 miles. So that leads us to a grand total of 13.3. That almost makes up for my time discrepancy. (I wanted to finish in 2:30:00 and finished in 2:38:03ish).

I would post about my day today, but after driving home, eating dinner, and checking my e-mail and checking on my pts, it's time for me to get in bed. Gotta be up at 3:30:) I think today I decided surgery is NOT for me! Maybe I'll change my mind, but I doubt it.

Goals for Today (in no logical order)

2009-06-14T12:56:00.003-05:00

*cook dinner
*get a new phone (because AT&T doesn't pick up in the hospital)
*recover from the half (knees ok now, hips might fall off - could barely walk yesterday!)
*clean house
*do stupid EBM assignment for school
*throw together 5 minute presentation on diverticulitis for tomorrow
*figure out financial aid's hangup
*pack lunch for tomorrow
*pay bills

Not sure if it's the week of surgery or the half marathon, but I've been walking around in a daze trying to figure out what I should do at any given moment and therefore getting nothing done. Hope everyone else's weekend was fabulous!

13.1

2009-06-13T14:13:00.002-05:00

Ran and finished my first half marathon this morning. I'm gonna be honest - I'm glad it's over! I don't think my body can withstand 80 hour weeks at the hospital and running this much. The only reason I spent ~80 hours at the hospital this week is because I was on call though, so that should ease up hopefully.

As for the half, I ended up seeing a lot of people I knew. That was fun. People I went to high school with, college, then some dental school kids as well. My cousin A and I ran it together. It got kind of warm towards the end and was in full sun for about the last 2-3 miles. My body did not like that! I was getting cold chills and just praying I didn't keel over right there on the pavement. I really got an adrenaline rush at the 13.0 mile marker and was so relieved to cross that big finish line. It took me 2:38:03. I was 636/1055, so pretty much right in the middle. That's fine with me!

Now it's time to rest, hydrate, eat, rest, hydrate eat. I haven't left the bed yet the few hours I've been home this week and I don't plan to until Monday. I'll post about a typical day on Acute Care Surgery later.

Preparedness FAIL

2009-06-08T21:32:00.003-05:00

So after I leave my house at 7:00am tomorrow (Tuesday) morning, I might not be home until 5:00pm Wednesday night. Why, you ask? Because I'm ON CALL! Now, I did see something that said if you're on call during the week, you're supposed to leave around 1:00pm the next afternoon. However, we have an entire day full of surgery lectures and I'm not really sure what the protocol is. Also, I'm not really sure what I need to take with me tomorrow morning. We're supposed to be in professional dress for the lectures, but definitely in scrubs overnight for call. Guess sometime between the two I'll do a switcheroo. Feel like I'm packing for a slumber party.

Runner's, er... Walker's Log

2009-06-08T21:31:00.001-05:00

Taking it easy. Kris and I walked 40 minutes. No clue how far or how many calories burned, but it was very relaxing :)

Headed to the BEACH Y'all

2009-06-02T00:04:00.004-05:00

I'm leaving for the gorgeous blue waters and sandy white beaches of Florida tomorrow morning bright and early. It's me and three of my fellow back-row-sitters. It should be a blast.

Today I made my mama's oatmeal pumpkin muffins and my very own chocolate chip cookies for snacks/breakfast options on the trip. I'm excited because Future Pathologist is going to be making yummy dinners at the condo at night and I'm pretty sure Future Pediatrician has got some things up her sleeves as well. I'll just play seux chef since I really only know how to bake.

Here's what I'm reading:

I was going to be reading House of God, but it didn't arrive in time: