Not Feeling It

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!

In a Funk

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.

I am Le Sick and Le Tired

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.

Runner's Log, REI

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.

Palpable LN

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

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!

Back in the Swing of Things

We went back to school to day. And what better way to say "Welcome Back!" then with 3 hours Gynecology lectures? I skipped out on the 8am - hey, I'm sick, remember? I was quite impressed with myself that I made it to the 9:00 on time. I even managed to pack my lunch and get it in the fridge at school before class started.

I'm pretty sure I had "strep throat" this past week. The reason I think that is because I definitely had pharyngitis - a swollen, inflamed pharynx and it was incredibly difficult and painful to swallow. In doctor speak this is dysphagia (difficulty swallowing) and odynophagia (painful swallowing). Sore throats are pretty common, but the painful swallowing is more of a hallmark of strep throat. It's caused by Streptococcus pyogenes and treated with penicillin or a z-pack. In hindsight I should have been treated, but hey - it was the weekend and I didn't have any obligation to study. Spending time in bed wasn't too difficult. Now the pharyngitis is gone, but I have acquired sinusitis - my sinuses are inflamed and producing tons of mucous. Yum... I'm pretty sure this combination is also referred to as "the crud." I have actually heard doctors refer to it as that - they were ER doctors though, so I'll let you draw your own conclusions there.

Kris is working at a different store this week. His higher-ups have decided he is "management material" and are giving him a one week trial run at the Game Stop in Flowood. I really hope he gets it since that means a salary and benefits, plus more control over his work schedule. He found out he can't actually start teaching until August (just a requirement of the teaching classes he's been taking), so he's glad to have the opportunity to do this until then. He still has 30 observation hours to complete in the classroom and then he can start looking for a job. Hopefully he'll find one near us - Northwest Rankin, Madison Central, any of those would be great. We'll see though.

Anyway, I now have 143 days till the dreaded STEP. I am off to study land.