What the Hey?

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

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?

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

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

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

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!

Last Day in the OR

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

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...

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?"

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

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!!!

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

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

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

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,

I want my life back.

Signed,
Your pal - Chazing Zebras

Ahem, Make that 13.3

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)

*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

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.