Time Flies...

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.

Shifting Gears

*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!!!

Runner's Log

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

Runner's Log

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.

Runner's Log

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?

Runner's Log + Peds Day 1

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

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

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

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...

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.

Runner's Log

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 :)

Lame

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.

Runner's Log

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

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.

Runner's Log

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

Runner's Log

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?

Runner's Log

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

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!

Running Log

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

Runner's Log

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