Anesthetic Medic

Wow

2011-05-19T21:27:00.000-07:00

So, it's been a long time since I've blogged in any way, shape, or form. Today is a huge day. I finished medical school today! Graduation is actually next Friday, but all requirements are finished as of this afternoon at about 2:15. I am now certified to save someone by shocking them. It's a big responsibility, and a huge burden at the same time. I'm excited to take on that mantle, but so scared to screw it up. I know that as I transition to an intern, resident, and ultimately an attending, that I will probably lose my perspective on what it is that truly drew me to my field, and medicine in general. To this end, I think tonight is the apropos time to write about what, at this moment in time, draws me to my profession.

As an OB/Gyn, I will be a surgeon. I love the OR. I love the dance that is scrubbing and gowning up. I love the routine of a specific cycle of washing one's hands, the feeling that you'll never be so clean in your life. The feeling of being gowned by such seasoned staff who know how to touch anything and keep it sterile. The twirling of your body as the gown is tied in place, like a ballerina in pirouette. The learned ability to maintain sterility while being allowed the privelege of reaching inside someone. The trust required to allow you to heal someone from the inside out. The ability to find the best path to follow surgically, and knowledge that after closing, and withdrawal of anesthesia, the patient will feel better than before.

I also love being an OB. To bring life into the world. To face so many complications and stare back at them, ready to take them on. To protect the most vulnerable form of life in our world, while protecting those that would bring them into it. To care for mothers who are scared, unsure, excited, nervous, etc, about bringing a new child into the world is a privelege and excitement beyond mention. To help those who are not ready; and to comfort those who are in the throws of loss is a task that very few take, and fewer attain proficiency in.

I will learn courge, in the face of fear and possibly of certain death. I will learn true empathy in measures unknown to me as a medical student. I will learn to bring someone back from the brink of death and manage their new, complicated life. I will learn to be a friend and advisor who does not, can not, flinch from difficult decisions.

I will also learn to seek help. Help from friends and family when things go poorly. Help from mentors and superiors when I don't know what to do. Help from the depths of myself when I am not sure where my conscience wants me to go. No man is an island, and neither is this woman.

I will also learn to go home. To go home and greet my family as if no baby has died today; as if no mother had complications. I will learn to love every moment of my happy life for what it is; a gift that as easily as not could be blinked out of existance.

I am not a particularly faithful person. But I know that in this life we are guided. I know, that despite the choices presented, I was not randomly assigned this path in life. I believe it is my purpose to do this good; to help those whom I am trained to help, and to ask little in return.

I remember when I was in college and dating someone who was clearly not my match (as J obviously is!). I told him that merely graduating and making money was not enough, that I wanted to make a contribution. He asked, "a contribution to what..."

I want to do something greater than myself; to help so many that I might not otherwise ever know. I want my contribution to be to those who need me. A person who needs an empathetic ear; a teenager so afraid of her parents she feels she has nowhere else to go; a family that desperately wants to expand and share their love.

My life can only get better in this practice of medicine. It's been such a long road, with so much more to come, but I know that in the end what I do will make a difference to so many people; starting with me.

And we're....moving!

2011-04-02T13:42:00.001-07:00

That was a bit of a shock to us! We didn't really even consider the possibility. But, in the realm of, when one door closes, another opens...we're headed to the Mayo Clinic. This is definitely a good thing! I will no doubt get exceptional training there and in the end, I will be able to do anything I want. The only down side is having to move. We've really grown to love Colorado, and I never relish the thought of moving. Blech. We're trying to get all of our things out of the house now, and we plan to rent it out for the time being since the market is so-so at best.

It's been a whirlwind for sure, but now we have a few months to gather our wits about us before the really hard stuff begins. There are days when my panic of moving definitely gives way to the panic of actually being responsible for patients. Scary stuff. The first time I tell the scrub tech "knife to me" is going to make my mouth dry and my heart pound, but I'm starting to feel like it's time to move toward that. And in some ways, even look forward to it!

Wow

2011-03-16T19:06:00.001-07:00

Well, tomorrow is the big day! I felt like I would be freaking out a lot more than I am. I guess it can be chalked up to feeling like I've already wasted too much good anxiety on this! I'm hoping for the best, but preparing for the worst, which has substantially improved since Monday. On Monday I found out that I would be matching into OB/Gyn. This means that I will, come hell or high water, be beginning an OB/Gyn residency come late June. Now just to find out where!

I can't help but feel like Match Day is in a lot of ways a bigger deal than Graduation. After match day all the pieces come together. I know that my class is all bracing themselves right now. Tomorrow is a huge day, and I know that it's totally possible it might be an awful one. I'm cautiously optimistic, secure in the knowledge that in 4 years I WILL be able to practice Ob on my own.

I'm sure I'll be posting on facebook at about 11:01. Stay tuned!

Awake again

2011-03-06T21:49:00.000-08:00

Well, once again the house is completely quiet and here I am awake. I'm watching the world's trashiest tv (You're Cut Off on VH1), and staring at the computer wondering why on earth I can't sleep. Of course, I know why, but thinking about that will only make the insomnia worse!

I really do wish I didn't have class in the morning, if so, I would be able to just take a benadryl and get some zzz's. However, I do not want to have the "hangover effect" in the morning, so I'll just make due with whatever sleep I'm able to grab on my own.

The peanut is doing great these days. Getting to look more and more like a "kid" and not a "baby" every day. She is the ultimate distraction and makes every day a little brighter!

Here's hoping you all are getting the zz's you need, and that you have sweet dreams when you do!

The strangest way to get a job...

2011-03-02T21:41:00.000-08:00

So it's clearly been a really long time since posting here. If you haven't gotten an invite to my family blog and want one, send me your email address and I'll hook ya up. But, back to medicine in this forum...

So, residency. It's the looming black cloud that follows four intense years of medical school. It's also a job. A paying job. For that, I couldn't be more excited. It's a lot of hours. Only recently have the "rules" (aka guidelines) changed to mandate the maximum 80 hour work week. This is as an average of 4 weeks. It's acceptable and expected that on occasion you'll go over that 80, but basically you shouldn't make a habit of it. I have chosen to pursue a residency in Ob/Gyn, which is typically one of the more hours-intensive residencies, up there with general surgery. Call for OB tends to be physically demanding. You don't frequently get to sit in front of the computer and write notes and answer pages, you have to be on your feet, often in the OR, often doing procedures. All this being said, there is absolutely no field I could envision myself doing except this, and there is no such thing as an easy residency, so taking these four years (in the case of OB) and making the absolute most out of them is just what needs to be done. I would never choose a field based on perceived difficulty of residency, it isn't worth it in the long run.

Now, how does one get this dream job, you might ask? Well, this is the strange thing. After working your butt off for 3 and a half years of medical school, you begin to apply to residency programs. Generally speaking, you apply to one field. However, some folks do apply to several fields if they can't decide, or one field is very competitive and they want to cover their bases. The application is done online and is submitted to however many programs you'd like to apply to.

The programs then start to respond and ask you to come out for interviews. Now, this is not like getting a job out of, say, law school. There is no schmoozing, there is no wining and dining (generally). There is you paying out of pocket for the interview times that are available by the time you rsvp for an interview spot. There is you paying for a hotel and a rental car and making arrangements for your travels. For most average fields, folks do about 10 interviews give or take. This number can change greatly if you are 1)applying in an incredibly competitive field like dermatology or 2)applying as a "couple" where both members of the couple are applying into a field in medicine and need to live in the same area. Both of these things make it more difficult to match, so you need to apply to more programs.

So, you go to interviews. Meanwhile, you still have to make sure you are completing any course work you need to finish. At the interviews you generally have a dinner the evening before the interview day where you meet some of the residents, the other applicants who will also be interviewing, and sometimes faculty. This dinner is always about balance. Balance between asking too many questions and not enough. Balance between looking "fun" and having a drink with the residents and looking stupid and having too many. Balance between getting there too early and being the only applicant and getting there late and looking like a slacker, and by the same token leaving to early and looking to eager to get out and leaving late and being that awkward hanger-on that just can't get the hint. The next day is an interview day which usually includes a tour of the facility and 3-5 interviews with faculty and residents. Then you'll usually book it to the airport to get out of there.

After each interview you try to make notes about the place, the people, the program, etc. Some people go to such lengths as to make complicated spreadsheets with numerical values assigned to each category and a tally of total points. I just wrote about the general feel of a place, could I see myself working with these folks in close quarters for long hours for 4 years?

After all your interviews are done the end game comes into sight. Ultimately how this whole deal is decided is remarkably similar to Greek rush in college. Applicants make a rank order list, where they rank each program they interviewed at (or if you're really nuts you list programs you didn't interview at...they will not rank you). The programs will also make a list of the applicants they interviewed in the order that they would like to accept them. This is all due in late February. For us, Feb 23 at 9pm EST sharp! From this date until "Match day" some sort of black box computer program sorts through all this, matches up who wants to be where, and presto-chango, you will become a resident! Signing up for the match is a legally binding congtract, so you better not list somewhere that you really don't want to go. You need to be willing to move wherever you list on that rank order list.

Sometime between your interviews and the due date for the rank list, it is generally accepted that students should send "love notes" to the programs they are most interested in and thank you's to all their interviewers. Some programs will send love notes back and there is a strange kind of courtship that goes on, all the while walking a thin line that the National Residency Match Program deems within the rules. You are never allowed to outright ask a program where you will fall on their list, just as they are not allowed to solicit this information from you. Both parties are allowed to voluntarily offer this information, but even that can be deceiving. For example, a program might tell an applicant "you have been ranked to match at this program." Well, that sounds great! Maybe they should be first on my list so I can for sure match there. Not so fast! Think how different it would sound if they wrote to a different student "we have ranked you in our top five, and you will match here if you rank us number 1." Apparently two different students from last year's class got these two messages. Knowing these are both possible, it makes it awfully hard to interpret what they tell you. And to make it worse, so many of the programs will give you absolutely no guidance at all, in part to not influence your decision, and partly to abide by the rules of the match.

Applicants are informed of whether or not they matched (but not where) on March 14th. If you did not match, you will then join the "scramble." That is, you will be left to scramble into one of the positions that did not get filled. This may or may not be in your field of choice! Match day is when you actually find out where you matched if you were able to match without scrambling.

Match day this year is March 17th. I'm hoping it's lucky since it's St. Paddy's day. The process on that day is neuroses inducing as well! It's not mandatory to go to match day, but it's a big deal and most of the class does attend. Family is invited as well. We are having it at Invesco Field this year at an indoor conference room. A nice lunch is going to be served, etc. The weird part is the ceremony. The program starts at 10am (and the bar opens as well) with some speeches by professors we've chosen and a toast from the dean. Then, and this is the crazy part, at 1pm EDT EXACTLY, you are allowed to open the envelope that contains the location of your residency assignment. Again, you don't have to open it there, you can bring it home or whatever, but most people choose to open their envelope with their class. This makes the atmosphere at the luncheon totally bizarre. There are people screaming with joy, there are people crying with joy, there are people screaming in agony and crying in desparation. It is the strangest, and most electrifying, environment I've ever seen (I had the honor of going to last year's match and helping to plan this year's). Last year they had all the envelopes on a table and everyone ran up like a herd stampeding. This year we will have them in a goodie bag at the tables (covered in very noisy cellophane so no one thinks about opening it early...). We are doing this 1)so no one gets trampled and 2)because programs often text message their new incoming interns at the 1pm EDT marker, and a lot of folks thought it was kind of anticlimactic to find out in a text while you were waiting to get your envelope.

With only 2 weeks to go until the big day, I am starting to feel the effects of the stress. Let me just say that a few weeks ago, I would not have been awake after 11 when the baby is still waking up repeatedly throughout the night. When I do sleep, I have nightmares about ending up somewhere I truly didn't want to be. I worry about having to move my husband and my daughter, I worry I won't be happy. It's a huge weight on my mind. To make matters worse, we have a mandatory two week class through next Thursday that puts us all captive in a room, our anxiety feeding off each other. It's just insane. We've had beautiful weather lately, and hopefully it holds out, maybe I can burn off some steam since we just inherited a running stroller from some family friends.

No matter what happens, on March 17th, green beer will be had. Probably in fairly large quantity. The in-laws are taking la nina so we can have a night out and if you're in town and want to join, shoot me a line so I can tell you where we'll be. I'll either be celebrating or crying into said green beer, but you are welcome either way!

Isn't She Lovely!

2010-08-23T13:35:00.000-07:00

Well, two days after my last post I was in the hospital being induced! We went in on the evening of J's birthday to get things going. I didn't have enough amniotic fluid anymore and my blood pressure was starting to creep up so we scheduled the induction at 38 weeks. The next morning contractions were really intense but the little one's heart rate was not tolerating the stress. She was having what's called late decelerations. In most cases this is due to "uteroplacental insufficiency". It's a dangerous situation if it is allowed to continue, and if the baby doesn't come out it can cause a serious loss of oxygen. So 18 hours after we checked into the hospital we made the decision to get her out via c-section. The little one was born on July 29th at 2:45pm.

Here's the very tired momma after the c-section when I finally got to hold my baby. Somehow the epidural traveled up to my arm and face so for a while I was numb really high and couldn't hold her.

Day before we went home from the hospital in mom's favorite piggy pjs.

On the way home!

She's now three weeks old! Being a mom changed everything, from the very first minute. It scares me all the time, but I've never smiled so much. I have four more months home with her and I plan to enjoy them as much as possible. It's hard work, keeping a baby alive, more than I ever could have expected. The days fly by so fast I can't even believe it. I'm sure the challenges will just keep coming, but I'm already starting to know her better. One of these days I'll possibly even feel comfortable taking her out of the house on my own! I'm getting there, slowly.

I will be starting to keep a password protected blog to post all the updates about the baby. If you would like to be added, just send me your email address, either as a comment or on facebook or to my email address. I just wanted to let everyone know that mom and baby are doing great. And dad couldn't be more proud (or more helpful, he's the best!)

What I'll miss...

2010-07-26T15:00:00.000-07:00

About being pregnant? This is a question I read online all the time, and I always laugh. Miss about being pregnant....hahahahahahaha! But there are a couple of things I might miss. I'll miss her moving and grooving in there, when she's not bruising my ribs. And I'll miss blaming all my food desires on her ("the baby wanted the ice cream. I had to have it")

But seriously. Am I done yet?

I see the finish line....

2010-07-21T08:50:00.000-07:00

Inching so much closer! As of now the kiddo is full term. She can come at any time and be ok. I prefer sooner, so we'll see. She's already over 6 and a half pounds. Which is plenty if you ask me. So hopefully soon. We got her room ready and I even took some pictures!

That's pretty much my favorite seat in the house. Gotta love the glider. The dresser was a partially finished mess we got for $5 but was made of good wood so J refinished it to match the crib. I think it looks great! What you can't see is how completely packed with clothes it is! She has more clothing than I do!

Here's her cute crib and bedding. I suppose once she's in it, and leaking all over it, it won't look as cute, but I like it lots right now!

We also got the bathroom fixed up. Not that she'll be using it anytime soon, but we seem to like the monkey theme so we're going with it.

Yes, I know she won't have teeth to brush for some time, but come on, how can you not get the see-no-evil-hear-no-evil-speak-no-evil monkey toothbrush holder?

And, last but not least, J's very favorite outfit for her. Even though it probably won't fit her until long after the regular season!

Speaking of finish lines, J crossed his first half marathon finish line at the end of June! He ran the Slacker half marathon in Georgetown. He even kept his time under 2 hours! Not too bad for not training!

Well, I think that's enough for today. I have today and tomorrow off from the clinic, so I'm just trying to keep myself busy until either the baby comes or it's Friday. I hope everyone is having a great week!

I'm still here!

2010-07-09T13:10:00.000-07:00

And still pregnant. And still studying. But the good news is the end is in sight on all counts. I'm taking my boards on Sunday, and after that I will post pictures of the baby's room and our little herb plants we're growing this year. J has had the whole week off, which has been awesome, and we've cleared a lot of clutter so that it actually looks like a 3rd person might fit into this house in the near future. My practice scores are creeping closer to where I won't be calling J in tears when I get the scores back. I'm spending this month doing some elective work with my OB, so I'm sure I will be constantly thinking about the day that I go in to the office and don't come home without a baby in tow. But, that will come after boards on Sunday.

Boards, boards, bored

2010-06-28T07:46:00.000-07:00

I have officially moved my test back to July 11th, and it's truly as late as I feel I can take it without going into labor during one of the blocks. Though it might make for a great story, probably won't make for a great score... I took a practice test on the weekend and I'm still not quite where I want to be for this test. The problem is, I have other rather pressing things on my mind that make studying more than a little difficult. Why would I want to stare at practice questions when I could be refinishing the baby dresser, buying those last minute things that I haven't gotten around to yet, putting shelves into the closet, packing the hospital bag, reading the mounds of books I've accumulated on labor and infant care, making frozen dinners that can be easily reheated after we have her, etc.

I would be less freaked out if I felt like this kid was going to term. But somehow I just know that is not the case. I've been having some seriously painful contractions, disturbingly often recently, and not only does it make it hard to concentrate (or sleep or anything productive..) but it makes me worry about getting this test done before we have a kiddo. Yikes.

Not to mention that she's definitely "dropped" and now I truly understand the uncomfortable pregnant woman. Blah. I'm just a little stress ball right now, and hopefully I'll get it together this week so I can relax a little. Anyone have any tips?

PS. The application for residency opens this week. Not that it's stressful or anything....

33 weeks

2010-06-18T10:19:00.000-07:00

I don't talk about my pregnancy too terribly often on public forums. It's just kind of a private thing, and frankly, not my favorite experience ever. But I thought I would update folks about the little peanut. She's doing great! Had an appointment this morning and she's wiggling around as usual. As of right now she's about 4.2 pounds (seems shockingly big to me!). My doc thinks she'll probably get to about 7-7.5 pounds by the time we have her. He also thinks we won't make it all the way to the due date, but of course doesn't have a crystal ball and can't really predict when she'll make the grand entrance! I'm ready to start a pool soon, so let me know if your interested! J thinks she'll come on July 26th since that's the date I was assigned to for my meeting with the dean to go over my dean's letter for residency. I think my doc thought there was some dramatic irony in that, would be about par for the course in the past 7 months! I'm just hoping for the end of July so I have all of August to spend at home with her. But, she'll come when she wants to. One can dream though!

As for me, I'm getting to the point where I can't really sleep. I fall asleep no problem but I'm uncomfortable and wake up often. She's super low now and it makes my hips pull apart which is not super comfy. I feel bad for J since I wake him up as well. But I have lots of time to rest today. So it's good. I'm really more rested than I have been in the past year, and a lot less stressed out. Overall, things are good. Now I just need someone to walk one of the pups so I can just handle one of them. It's so beautiful outside and I want to enjoy it. I feel really lucky that as of now, I really feel happy in the heat. Everyone has been telling me how miserable summer will be, but I've always been the type of person who is more comfortable in the heat than in the cold, so I'm just happy I can wear nice loose clothes and enjoy the Colorado sunshine. So far so good!

Happy

2010-06-09T06:30:00.000-07:00

Things that make me happy this June:

-I actually took a bubble bath in the middle of the day yesterday, just because I could!
-It poured down rain yesterday with the sun shining. Summer is wonderful!
-Studying for this set of boards is infinitely better than the last time around, and I feel good about learning a lot in the past year
-My dogs are great company! They love me even when I waddle.
-I am already finding time to meet up with old friends. So great! One of these days I will get my big belly to Golden and revisit my favorite places. Then it will really be a perfect June!
-The house is starting to look like a 3rd person is at least on the way. Scary, but exciting!
-I baked cookies on Monday, and they didn't turn out like big puffy pillows for a change!
-I have made and eaten my weight in pasta salad in the past week. I do not feel bad about this. It is delicious.
-It's farmers market season, and the big guy is great company. He's such a ham when we go to all the stalls, everyone has to pet him. He's great, and never pulls me around. I don't think I could so much stop him anymore so at least he's good on the leash!

June makes me happy. It's gonna be a great month!

Heart failure....and summer!

2010-06-07T05:18:00.000-07:00

I think I promised a while back to have some less depressing stories from my 3rd year of medical school. I've been saving this one. Now, don't judge. Although I find this absolutely hilarious on some level, it's still sad that there are people who really let things get this bad.

Last week of my medicine rotation we get a consult on a patient who is in kidney failure (yes, I know the title is heart failure). She has no history of previous kidney failure. She has pitting edema in both her legs. Pitting edema is just what it sounds like, you push your fingers into her legs and the imprint of your fingers stays there like a pit. Hers was particularly bad. I was sent in to get her history. You know it's bad when...

"Well, I last went to the doctor about 3 months ago and I was so surprised because I had lost about 20 pounds, and all I had been eating was cheesy puffs. So I figured, if I could lose 20 pounds eating cheesy puffs, it must be because of the cheesy puffs. So that's all I've eaten for the past 3 months."

Me: "When you say that's all you've eaten, do you mean that's mostly what you've eaten?"

"Nope. I am on the cheesy puffs diet. Sometimes I have water, because they make me thirsty."

Far as we can tell, she was on such a low protein, high salt diet that several things happened. The decrease in protein in her circulation allowed her blood vessels to get really leaky and her blood volume got squished out into her interstitium (area in tissues that is not in blood vessels). This made her functionally dehydrated, even though she was full of fluid weight that was making her all puffy (the pitting edema). Her heart was trying hard to keep up with the decreased fluid by pumping faster than it was used to. Over time, this put her into heart failure causing fluid to back up further and contribute even more to her edema. This also made less blood available to the kidneys, which are very sensitive to changes in blood flow. The kidneys were also seeing all this extra salt that made them think the body was very dehydrated, holding on to as much fluid as possible and making her more fluid overloaded, which also ended up in her interstitium. Also over time, this led to renal failure, which was then picked up on routine labs and ended her up in the hospital.

Lesson: though cheetos are delicious and a fun bright orange snack, they are in no way enough to maintain a human being for any sustained length of time. Sorry Cartman.

The good thing, for this woman it's a reversible condition treated readily by protein replacement and fluids. And likely lots and lots of nutrition counseling.

More good news: she'll likely lose even more weight after all the fluid is diuresed from her legs.

The best news: this was actually the day before I was done at this particular hospital, so I didn't have to be responsible for the care of this misguided patient.

Ah memories.

I'm happy to say that my subinternship ended well and that I had a wonderful time. I learned so much and I feel like there's no doubt in my mind that this is what I want to do and that I found "my calling." I find that folks in medicine are always on about where their passion lies and what they are called to do. Considering all the training that goes into medicine, it doesn't completely surprise me that people want to end up doing something that really speaks to them and will make all that work worth it. I'm glad that I've decided to bite the bullet and do that. When I started med school I was pretty focused on "lifestyle" specialties which could afford me a lot of free time and good pay. But, ultimately what I do for a living will have to make me happy while I do it, since so much of my time will be spent working, regardless of the field I enter.

And for now, I'm even happier to say that summer is here and I'm home to enjoy it! Today starts the first time off I've had in some time and I am looking forward to it. So are my feet. They get tired standing for 14 hours at a time. I am taking my Step 2 board exams this month, so it's not a complete vacation, but I think it will probably seem like it! And the way fresh air feels in the morning in the summer is something I'm excited to experience again! I love summer!!!! Shoot me an email or text or let me know when you all have some free time! I'm looking forward to catching up again!

Time Flies

2010-05-28T19:14:00.000-07:00

I'm still crazy about my subinternship. It really does make the time fly when you're having a great time. I love what I'm doing at work every day. I might not alwaays love getting up at 4:30, don't always love the beautiful way my ankles swell when I am on my feet for 14 hours, and don't live for the bad outcomes that seem inevitable on this service, but I know now more than ever that I want to do this. And that counts for a lot!

So what have I been up to? I've gotten to do a lot! A couple of weeks ago I got to do an amniocentesis, the procedure where a needle is inserted into a pregnant woman's uterus and amniotic fluid is removed for evaluation. An amnio! Me! I was excited. I've been in surgery, and happily have retained my knot tying skills. I've seen lots of forceps deliveries, and now have a new greatest fear for my own delivery.

And now I feel like I'm on cruise control. I had the whole weekend off, which after the 24 hour call last weekend was greatly appreciated! And since tomorrow is technically a holiday, there are no scheduled procedures or anything of that sort. My resident is having me come in at 7am instead of the usual 5 and told me that if there's nothing interesting for me to see I can go home. This is my last week on this service, and though I'll miss it, particularly the patients I've been taking care of for the last month, I'm also happy to have some rest.

We get to see the kiddo this Friday and we're looking forward to it. If my growing gut is any indication, she's definitely a lot bigger. J has the week off to get the house ready for her, and I'm pumped to be able to set things up in her room instead of continuing to make many, many piles. One of these days I'll post an ultrasound picture of the little bug.

But it'll be sweeter to have a picture once she's here!

Fourth Year Rocks!

2010-05-15T07:11:00.001-07:00

I have to start out by saying sorry, sorry, sorry to everyone who has been trying to get ahold of me, or expecting a call or email that just isn't getting to them. I am exhaused. Currently I'm taking my sub-internship, which is a fourth year medical school elective that focuses on students learning to act as an intern and be more autonomous with their patients in their chosen field. It also kind of acts as an audition at the residency program where you are doing the rotation. I am doing mine in Maternal Fetal Medicine (high risk obstetrics) at a major referral center. I have never been this busy at work in my life. And I love it!

The hours are crazy. I get in at about 5am and leave after 7 most days. This isn't the most I've ever worked since I don't have every fourth day (or q4 in medspeak) call on this rotation, but being over 6 months preggo and on my feet for every one of those hours gets exhausting to say the least. I originally specifically chose this rotation because weekends are free. I need this time to recover right now. And it's a luxury I won't have as an intern. I was worried when I registered that I would have nothing but bad outcomes for my patients and that I would feel sad and overwhelmed for the whole month. This has, thankfully, not been the case.

My patients are almost exclusively women who are pregnant but not yet at term (defined as 37 weeks pregnant), so their babies are premies. They usually have either an obstetric or medical condition that causes them to have a difficult pregnancy or to have the expectation of a difficult labor (or no labor at all). This week I scrubbed on a c-section for a 28 week baby(due dates are at 40 weeks of pregnancy). I have never seen a kiddo that tiny. At this center we have an amazing NICU (neonatal intensive care unit) and this little one has been very well taken care of and is doing quite well. I know they won't all go well over the next weeks, but I love that I can really get to know these women and give them some sort of comfort when they are so uncomfortable most of the time.

And I'm learning SOOO much! It's been a year since I got to spend any time on labor and delivery. It is a place I really like to be. I think the medical issues are challenging and there's surgical issues too. It's definitely the field for me, and even though I'm tired and my feet hurt, I am happy.

I also really love this residency program. I love the residents, and yes, they are exhausted. But I've never really seen residents who aren't tired. Residency is hard. Every one of them. But I think these residents are so well trained. They really know what they're doing and they come out exceptionally well trained. My favorite part is the awesome OB training they get. I think other programs get great surgical experience, maybe better than here, but OB is such a big part of practice and the OBs from here really know what they're doing. I would feel confident after finishing a residency here that I would not panic regardless of what walks through the door. It makes me excited!

I'm not gonna lie, though. Sitting here in my chair with my feet up on a Saturday morning feels pretty great, and after June 4th, when I can do this all the time, I will be a happy camper!!!

Patient story of the week:

A woman was being induced (unsuccessfully) for labor. Her cervix was not dilating much and we were inserting what's called a Foley bulb. It's when you take a Foley catheter (the kind that goes in your bladder), thread it into the cervix, and blow up the baloon. This acts like the baby's head and makes the cervix start to dilate. We were explaining the procedure to the patient and her mother. Her mother had this horrified look on her face and said "they're gonna pop you like a champagne bottle!"

Third Year Memories

2010-05-06T19:53:00.000-07:00

Now that 3rd year is over, I'm starting to prepare my personal statement for residency and filling out questionnaires for the dean's office to make sure my dean's letter is the best it could be. It makes me remember a lot of the memorable patients and situations that I've been presented with in the past year. All of these things have shaped who I've become and what kind of doctor I will be. I feel humbled to have been a part of their lives.

The most vivid memory I have of my entire clinical experience to this point was from my OB rotation on labor and delivery. I did my rotation at the University Hospital, which does a lot of high risk OB care. I think I wrote about my experience with the fetal hydrops baby at the time, and it's an experience I've thought about often throughout the year. As the year went on I felt I needed to write the experience down. It was just published in the arts in medicine journal for my school. I'm copying it here. It's a sad story, but it was a life changing experience for me. I promise to write happier stories in the days to come!

Can We Name Her

The induction of labor had carried on for 48 hours when I sat at board rounds. My intern was nowhere in sight, and someone let me know that the lengthy labor was at an end and Mrs. T was ready to push. I remember running down the hall, feeling strongly this was where I was supposed to be. My first vaginal delivery.

But it wasn’t to be a normal delivery. Mrs. T had come in two days ago to triage at 32 weeks. Her ultrasound showed a baby with severe hydrops, edema so bad that waiting much longer to deliver would only make the delivery more difficult. The baby had little chance of survival regardless of how long the pregnancy was allowed to continue. The parents, who spoke only Vietnamese, spoke with the fellow for hours before the understanding started to show. Their child would not live; mom’s health was at risk if delivery was postponed. They would induce. And so for two days they would walk the halls, without pain relief, to deliver their first child, a daughter.

When I reached their room my intern calmly asked if I really wanted to be there. I agreed that I did. I had been taking care of this family since they came in, and I wouldn’t feel right if I left them now. I gowned and gloved, and for some time only myself and the intern were there. Slowly, as rounds were finished and the baby was imminent, the room filled to capacity. Every OB resident, attending, student, pediatric fellow, attending, resident, student found their way into the room. Fetal hydrops is not common; quite a learning experience.

The delivery was nothing like what I had expected. When she was born there was no crying; not from the baby. She was hurried to the pediatricians. I saw her only briefly, but for weeks to come I saw her again and I again whenever I closed my eyes. My first baby. The saddest thing I’d ever seen.

I couldn’t keep the tears out of my eyes as the pediatricians intubated and compressed; trying desperately to keep fluid out of her lungs. They tried to make a miracle.

Twenty minutes later, though, it was clear that there wouldn’t be a miracle today. She hadn’t made it. She was swaddled and wrapped as any other infant headed for the nursery. She was brought to mom and dad, who waited to hold her just once.

Quietly, everyone wept. The pediatricians quietly left the room, holding each other for support. I stayed with my intern as the placenta delivered and the lacerations were repaired. We stayed as the family cried together, trying to stay quiet and small, to give them their moment together, as alone as they could have it.

Out of their quiet moment, as the instruments were being put away and the drapes taken down, came a question. The English was broken, but the question was clear – “Can we name her?”

“Of course,” my intern said, “I think that you should.”

I felt like a voyeur watching this tender moment. My mask still covered my face and it was as if I was watching from behind a two way mirror. Such a small comfort, but one the family needed so desperately. I couldn’t imagine a time when a physician could have made more of a difference than she did for that family. In such a terrible moment, so much compassion.

In the week to come, so many happy deliveries came through that floor. And every happy delivery confirmed just how great this career could be. But I’ll never forget that day when I learned what it was to be truly needed. From surviving the lowest low I could imagine, I found new meaning in my future work, and I’ll be forever grateful for the lesson.

I never found out her name. But, somehow, knowing she has one makes me feel better. I know this moment changed me forever. At that moment I knew what I would do with my life.

Rant

2010-04-23T20:32:00.000-07:00

So, I avoid politics on this blog. I find it's a topic that is unpleasant whenever discussed unless you are certain that the other person shares your exact view. And hence, I'm not going to rant to anyone about health care reform or anything else along those lines.

However.

Some things are too ridiculous to watch them roll past without comment. In my post third year reading (for fun!) I came across the story of Sue Lowden, the woman running for Senate from Nevada. Ms. Lowden has an interesting idea of how to move forward health care reform in this country. The barter system.

She states, in nearly so many words, that doctors should, in fact, be paid by barter, specifically citing the fact that in the past docs have accepted chickens and paint jobs for their houses as reimbursement.

I wish I were kidding.

My questions are these, Ms. Lowden:

1)Should I pay my tuition this semester with eggs? I am actually fairly skilled at making paper airplanes, I could potentially pay for tuition with those instead...

2)When I have my future practice and I need to order new equipment or lab supplies, do you think I'll be able to, in turn, pay for things with the barter system as well? Or will I actually have to make money by taking on a second job at the grocery store (likely the only thing I could be qualified to do outside of medicine) so that I can cover the costs of my patients' care?

3)Will the electric company, landlord, heat, internet, etc also work on the barter system, or shall I rely on my husband to pay for that for the rest of my life?

4)Do you really think that doctor reimbursement is what drives the cost of healthcare up? Do you think so many docs are jumping ship to take on jobs in the corporate sector because they are just rolling in dough? Do you think that bartering, to some extent, does not already go on for the good of the patient?

Ms. Lowden believes that doctors are an altruistic bunch and I agree. However, they are human and they are citizens of this country too. They are people with families of their own and they undergo a difficult training which leaves them sidled with debt. How can we possibly in all seriousness afford to take care of ourselves and our families. Why should the (way over 40) hours we work a week be worth nothing because what we do helps people? I fully intend to provide pro bono care as a regular part of my career and I truly believe that everyone deserves health care. I don't aspire to be a rich woman from practicing medicine. I also don't pretend to know the answer to how to fix health care. I just know that this ain't it.

And just like that...

2010-04-23T06:08:00.000-07:00

It's over. I take an exam this morning and this year that I have been counting down since before it began comes to an end.

I learned more than I could have imagined, truly. When you study for boards you think you have learned a lot, but it pales in comparison. I've seen wonderful stories and terrible stories, met wonderful people and horrible people. It's a lot when I think about it and I plan to write about some of the stories when this test is over.

For now though, it should be a fun day! A short exam, then a short presentation. I'm meeting a friend from high school for some coffee and we get to go to the doc to see the baby. Should be a great day!

Snow Day!!!!

2010-03-23T11:17:00.001-07:00

Hurrah! Snow day! We got a bunch of snow in one of those CO freak spring storms and classes were cancelled this am. Me and the dogs are enjoying some quality R&R, which is extra nice since I haven't been able to sleep properly for about the last week. In fact, I've been so miserably tired I've started writing a blog post about 3 times entitled "Not glowing" referring to the difficulties of being preggo.

But, everytime I've started it, I've deleted it. Even though there are days (many) when I totally want to fast forward to August, I don't want anyone to believe for a minute that I'm not thrilled about this baby. Baby yes. Being pregnant...less so. It makes it even less tolerable when you're so excited to meet this little person who's coming to change your life forever! She's kicking the crap out of me even as I write this. Letting me know she's on the way and to get ready!

Days like today make me think about it even more since, seriously have you seen what's on TV during the day? Wow. And really, who studies on a snow day?! I can't wait till I have a little 1 1/2 year old to run around in the snow with on a day like today!

The big bright side right now...half done!!! Wahoo! On Friday we go for our anatomy scan, which means a lot less when you've had as many ultrasounds as we have! Since the big 16 week ultrasound where we learned she is in fact a she, my doc's checked two more times and there's no doubt in my mind, it's definitely a girl! Also on Friday I'm doing my oral glucose tolerance test. Basically I drink a high sugar syrupy drink and one hour later they check my blood sugar to make sure I am able to use it appropriately. Women become more insulin resistant during pregnancy so that a larger amount of glucose stays in the blood to be taken up by the baby. This becomes a problem when blood sugar gets too high and can lead to birth defects if it is uncontrolled early in pregnancy (we're past that point) and very large babies in women with poor control. Then after birth, the baby does not get as much sugar as it is used to, but it's pancreas is still kicking out a ton of insulin, so these big huge babies get hypoglycemic after birth and can have seizures from that. I have a strong family history of diabetes and so we are doing this test a little early. I'm hopeful that it will be ok, but this has been my biggest anxiety about pregnancy for years. Those women who have gestational diabetes are 66% more likely to develop type II diabetes later in life, so it's a big deal. Hopefully it will go alright; should find out by Monday or Tuesday next week. I'll feel better when that's done with!

I hope everyone enjoys their day, even if you're all not lucky enough to have a snow day!!

Light Reading

2010-03-12T05:50:00.000-08:00

I don't think any one will really appreciate how pumped I am to have stumbled over a copy of The San Francisco Ferry Plaza Farmers' Market Cookbook! I love that farmers' market so much that it inevitably leaves me disappointed when I visit any market around here even in the bounty of summer. Maybe J, but maybe not, could understand how much I think about thsi place. I get cravings to go there. Many cravings. And not just because I'm pregnant. At least once a week I think about being there on a Saturday morning, seeing all the delicious produce and looking at the beautiful city, bay, bridges. I probably tell J about these once a month or less, so really I control myself better than I get any credit for. Anyway, I'm pumped to read the recipes and look at the great pix. It's like an early birthday present! (I love my birthday, and my birthday is tomorrow...woohooo!)

On a sadder note, I actually heard someone running for office on the platform that as a state legislator she "defunded Planned Parenthood." Whaaaaaa? Regardless of your feelings on abortion, I think we can all agree that birth control, affordable birth control, is one of the most important services health care can provide. In this country 50% of pregnancies are unplanned. The emotional, physical, and financial toll this takes is enormous, not just for the individuals involved but for society at large. I feel very passionate about pregnancy prevention, it is a major part of my desire to be an OB/Gyn. I'm not asking everyone to feel like I do, but seriously, I was taken aback by that commercial.

One more reason to read my awesome cookbook and turn off the boob tube!

Hard

2010-03-09T16:02:00.000-08:00

Today I spent the day in a hospice setting. It was a difficult day. I really only saw one patient throughout the course of my day, she is dying from cervical cancer (don't get me started on getting paps in a timely fashion, that's for another post). Advanced cancer is painful, and this woman is in pain. Her family does not want her to receive pain meds because they've "seen other hospice patients and they are all out of it." They want her to only receive pain medications when she asks for them, or in med lingo, prn.

Here's the difficulty with end of life pain meds. Pain is difficult to control, particularly in patients who have a lot of it for a long time. And once the patient is feeling the pain and asking for meds, it is harder to keep it at bay than it is if we "stay ahead of the pain". By staying ahead of the pain this does not mean snowing people so they are completely incoherent. It means giving a monitored dose of long acting pain medication in a scheduled fashion so that people are less likely to need the short acting, heavy hitting "breakthrough" meds. In addition to the benefit of less pain, the patients are often less agitated and better able to handle their surroundings and are less likely to become delirious secondary to pain and anxiety.

It's also important for patients and families to understand that addiction to pain medications in this setting is almost never an issue. Addiction implies an illness defined by the patient actively seeking out a drug. Pain medications for chronic pain almost never fit this category. Dependence on the pain meds often does happen. The patient will grow to require higher doses, but often this stems from advancing disease processes rather than the patient getting used to a certain dose of meds. The patients may withdraw if they are removed from the pain meds, and this is also not a sign of addiction. In fact, withdrawal can occur even from antidepressants, a class of drugs which is not addictive in nature.

It's important to me that patients become informed about what palliative care and hospice really mean. It is not simply a place to die. In fact, hospice is not a place at all, but a philosophy of care. Hospice often happens at home. Currently the average patient is in hospice care for a median of 15 days. 15 days until they pass away. This is most often because both physicians and patients are not informed about when a patient may receive hospice and what kinds of services they may be eligible for when they do. If you feel a loved one may need Hospice care, or would like to find out more about what Hospice entails, please visit www.hospicenet.org.

The people who work with Hospice are about as caring and giving as it gets. I truly believe if more people understood hospice and what they do, more people would take advantage of this amazing benefit at the end of life. Check them out.

And as one last note from my soapbox - talk with your loved ones about your wishes long before you reach an end of life situation. It can make all the difference in the world.

I learned sumthin...

2010-03-04T05:30:00.000-08:00

Everyone all year has told me how much they learned on the internal medicine rotation (re: rotation I just finished with). I didn't really believe them as I went through the rotation and pretty much just struggled to hang on for the ride. But now as I go through my family medicine rotation, I know that it's true. I know what meds to give people with specific conditions. I know when a symptom is very serious and can't be ignored, and when "it's just a virus." And I'm finally starting to understand treatment of diabetes. Starting. Diabetics who can alter their insulin levels to their carb intake are still much more proficient than I am. I'm starting to feel like a doctor. Or at least like I could someday be a doctor. Which trust me, at the beginning of third year, was not the case. And more importantly, I like it and know it was the right decision. Every now and again when the hours are long I haven't been able to shake the feeling that maybe I should have just finished the PhD and moved on. It would be done by now, there would be no residency to follow. But there would be no catching babies. No teasing out a history of potential endometrial cancer that may have gone overlooked. No pulling off ascites fluid to make someone's quality of life better in their end stage liver disease. It would be a different life. In some ways better (more time with the coming kiddo) and in some ways so much worse. I know residency will seem impossibly hard at times, but in the long run, I don't want to do anything else.

It does make it easier to feel this way when you get off work at 3 every day.....

Drumroll please....

2010-03-01T05:47:00.000-08:00

For those who knew, this is not what we were expecting going into the ultrasound on Friday! He was pretty sure it was a boy! He sounded so sure we had even picked up some cute baby sheets that were on a crazy sale. Luckily, returnable. Those who know me well, know that I'm not a huge fan of the little girls covered in head to toe pink. Never has been my thing. I'm a little nervous.

When we went in, my sister came with us, but waited in the waiting room so me and J could find out the sex alone, then J went to get her. As soon as he left the room I said "oh god, here comes the pink nightmare." Please keep this in mind when looking at those "oh so cute" pink lacy...things. I do, however, love purple. And really, yellow is not as gender neutral as people think it is...how often do you see boys wearing yellow...

It will be great to have a girl. Almost all my girlfriends have girls, and it makes me excited for them to someday meet. Knowing what wonderful women are in my life, I know their daughters will have such great role models, and become such wonderful women in their own right. I just hope I don't screw mine up so she can fit in with all those beautiful ladies!

I am not, however, excited about how tight my pants are getting. It's a weird feeling to feel like you'll fit into your clothes one day, then the next there's no way that button is getting to that hole, no matter how hard you try. Tough stuff for any woman, any person really. But I'm trying to stay positive and today I finally feel like I am well enough and have enough time to get back to the gym. I got the red light on running/jogging and that makes me sad, so I guess I will become one of those power walker types. The big guy should appreciate that. Not that any of this will help the expanding waistline (clearly) but I'll be better ready for delivery (too scary to think about really right now) and hopefully I can stave off the dreaded ankle swelling. Blah.

Well, I do plan to keep updating this site on the baby, but I won't forget about medicine stuff too. I will be starting family medicine today, and I'm really looking forward to it. I'm even more excited for it since I got an email from my attending saying she works from 7:30am to 3pm. Nice!

Tests and tea.

2010-02-24T08:28:00.001-08:00

For the first time in what seems like months I feel well rested and really excited. I was granted the last day of clinicals off to study for my exam, and my dog actually let me sleep until almost 9! I do plan on studying a lot today but I also plan to stop my whole foods for some delicious grub for dinner to celebrate the end of a very tough clerkship. And no one's more surprised than me that I liked it. My patients were very interesting and I couldn't have gotten luckier for my team. My residents and interns were super helpful and let me have just the right amount of autonomy. My attending was a really great teacher both on rounds and in these didactic lectures he prepared for us. When I saw the last group of students leave the U at the midpoint of this block, I was sure I would hate it. They looked exhausted and so UNHAPPY! But, though I am exhausted (or was last night), I am not unhappy with my experience. And the best news of all, one of my patients is getting written up for a journal and I'm going to be published! If I got nothing else out of this rotation, which I did, that would be worth enough.

Even better is knowing what the weekend brings. Yes, I have a crazy hard test on Friday morning, and a less hard but still irritating test on Thursday morning, but then the fun begins! My sister is coming in while I'm taking said crazy hard test and will be at my house when I'm done! That's the day we'll find out the sex of the baby, so that's pretty exciting too! We're doing 5280 week for dinner and I'm super excited about it. Then Saturday we're going to the Celestial Seasonings Tea Factory for their tour. I haven't been there since I've been a little kid and it just seems like a good thing to do when you're pregnant and can't go to the beer tours :-(. It feels good to have lots to look forward to and some time to rest before it all goes down.

But a question, anything up in Boulder that we absolutely shouldn't miss while we're up there? I really would love to go to Redstone meadery, but I don't really think my sister would like it, and as previously mentioned, alcohol and pregnancy etc. But any place to eat or see on a February day you can think of? Comments appreciated.

Getting there

2010-02-15T04:54:00.000-08:00

Well, I'm over half done with my time at the U. I am exhausted. This week I have Friday off since I am on call next weekend. Two more call days. I don't sleep so well at night these days, and I pay for it during the afternoon when the work slows down but I'm still stuck in the hospital. Since today is pre-call I am hoping we'll get out a little early, but we picked up a ton of patients on Friday call and haven't discharged very many. Which means we'll probably be pretty busy trying to get that accomplished today before we are on call again tomorrow. It makes me feel a bit less optimistic about the finish line when I'm so tired and I'm starting to get sick (I am never sick, is it kosher to blame the unborn?).

But there really is a bright side. I have 9 work days left of internal medicine. And on the really bright side, I do not hate it as much as I thought I would. I've been lucky to have a good team that is interested in making sure I learn lots and make me feel like I'm helpful,and when there's nothing to do, they make sure I get out of there. And at the end of the tunnel my little sister is coming out for a visit! And at that point I will have only one more rotation in my third year. Today or tomorrow I should get my fourth year schedule, and I'm really, really hoping to get the sub-internship (aka acting like an intern, not getting paid) I hoped for in May. It'll give me some peace of mind to know I'll get through the 4th year requirements and that I'll graduate on time even with the baby.

If I can just make it through 9 more days of squeezing like a sardine into my normal clothes I will be a happy camper. Four of those days are call or post-call, so those are scrubs days. And I have to thank my dear friend D who hooked me up with some more options for when my normal clothes are no longer an option. You are the best!

Hopefully I'll write about some of my weird stories in the days to come. But if not, I'll catch you all on the other side of medicine.

Kind of a Big Deal!

2010-01-31T19:19:00.000-08:00

So, I've been about bursting with the news, and now it's official. Rocky and the little guy are going to have a baby to protect, starting in August. By ultrasound our due date is August 5th. My sis's bday and our anniversary. By dates, I am due on August 12th, so you know, somewhere in between would be a-ok.

It's a pretty great story, how we found out. We knew having a baby 4th year would be pretty perfect for us. Lenient schedule, lots of flexibility. So it was in the works. As lots of you know, though, I have endometriosis. Not a huge deal, but can get a bit painful when I'm off birth control for long lengths of time. It was reaching that time. So my preceptor, who I'm thrilled to say is now my OB, was planning a surgery in the beginning of Dec to clean me up. An added bonus of the surgery is the increase in fertility following so it would be perfect. J and I showed up that morning all set to go, got the IV going, left some pee in a cup, and we were wheeling back to the OR. The anesthesiologist gave me some Versed, wicked stuff that cuts the anxiety, and I was pretty out of it. I scooted over to the OR bed and that's when things started to get a bit hazy. I remember Dr. B saying we couldn't do the surgery because I was pregnant. And I remember bawling my head off when the pre-op nurse handed me the positive tests in a ziplock baggie for me to keep. I remember crying and asking if I would remember this (because Versed has amnestic properties-can't shut off the med student in me), and I remember coming out of my haze and seeing the pictures J took on his phone of me clutching positive pee tests to my chest and crying like a little girl. It was a pretty great day.

I'm really excited, but I know I'll be even more excited when I'm done with internal medicine and have more time to think about getting the house ready. But being in medicine when you're pregnant has it's benefits! It is really great to have immediate access to ultrasound whenever I want. And Dr. B is always excited to see the baby. I've had 6 ultrasounds already, and he's pretty sure of the sex...but I won't post that 'till he will commit to it for sure!

Anyway, we're excited. Very excited. And even more excited to be out of the first trimester. Zofran was my best friend. I am starting to feel like a new person, but really tired. Could be partly due to internal medicine. So in four weeks, bliss.

Skool is hrd

2010-01-19T15:02:00.000-08:00

So, let me start out by saying that internal medicine is not for me. I had guessed this before I even started by 3rd year. I didn't really have a reason for it at that point though. I knew I didn't like to round for hours on end, and that was as far as I ever got. Well, I've learned a lot about myself, internal medicine, aging, all sorts of stuff really, in the last 2 and a half weeks.

I ended up getting extremely lucky (again!) with my assignment for a rotation. I am spending this first 4 weeks at St. Joe's. I'm in love with the place. Internal medicine here would be wonderful, if you're into that kind of thing. They work on a night float system which means no overnight call unless your on Friday or Saturday. This makes for happy residents from what I can tell. Call on the week days involves admitting until 7, then finishing up what you've started, and leaving by 9. The day usually starts around 7 am. These are great hours for internal medicine. Truly. During the day the teaching is exceptional. Every day there is morning report where different teams on the wards and the unit present interesting cases and we all sit around and generate a differential diagnosis a la "House". It's a great way to learn. Then at noon there is a conference every day where an attending presents an important topic to help with patient care. Oh, and they provide lunch at that conference every day (M-F). Then there is a teaching attending assigned to each ward team who meets with the team for at least 3 hours a week. For us, we present a patient and go through the House-esque routine again. Then we see the patient and all assign each other a topic to look up to help us better understand the case. It's great experience. Once a week we do the same with the head of the department. It's busy, very little down time, and I am pressed to get my progress notes done in a timely fashion, but so worth it.

So, no, it's not the rounding or hours that deters me from internal medicine. It's just the type of patients internal medicine sees. They are so complicated!!! Me, I like to look at a single problem at a time: i.e. baby's coming, I better catch it! Somewhere along those lines. Internal medicine is complex, with each patient having 10 medical issues that are all intertwined and all of which need addressing. These docs are the thinkers. They have to look at it all. It's easy to miss stuff. I told my resident today I don't think I'm smart enough to do what she does. And that's not necessarily what I think, but it's close. I am just at my best when I can know a whole lot about a smaller area. It gives me confidence that I won't miss something huge because I'm so bogged down with the details. I give those docs credit. They are amazing. And I am lucky to have a great team that really is invested in my learning. My resident even told me she thinks it's her job to make sure when I go to the U next month that I look like a rock star. I'm learning so much, but it's taxing and I'm tired - even with this great schedule. The patients can be very sad, lots of end of life issues.

But there's a lot of hope in this field too, so I see why people like it. I actually had a patient who was 98, and when I walked into the room for the first time and saw him lying there, I turned around and walked out because I was sure that was a 60 year old! Nope, 98. "I climbed a lot of mountains in my day." That's his secret. Guess J was right about that afterall.

I only have a week and a half left at St. Joe's. Then I'm back to academic medicine. I'm pretty sure that type of medicine, any field - not just internal - is not for me. I like private practice. I like how nice people are, and I like how they still respect you as a person while acknowledging the fact that there so much more to learn. My experience at the U has been one of a very strict heirarchy. A place where you never forget your "station." It's only 4 weeks. It's only 4 weeks. It's only 4 weeks...

Holiday break!

2009-12-20T15:12:00.001-08:00

The holidays are finally here! Last night we had an early Christmas dinner with J's family and tomorrow we leave for the great White North. I'm so looking forward to seeing my family! There are just some parts of holidays from home that really resonate with you and make them sseem more like holidays. That and we'll most definitely have a white Christmas! Hopefully I'll be more motivated to blog when we get back. Have a great holiday!!

2/3

2009-12-10T05:57:00.000-08:00

Well, tomorrow this time I will be done with surgery, for now. Feeling under the weather has made me do the one thing I vowed would not happen during third year....I missed work. And I mean a fair amount of work. Enough work to be forced to make it up after 3rd year is over. Blah. Of course this happens when I have just made a sparkly schedule for 4th year (at least an outline in my head) that would maximize my chances for a Denver residency. But oh, well. All is not lost I that front I think. I'll just need to come up with a slightly different timing.

If I don't include the time I need to make up for surgery, I have 16 short weeks separating me from the end of my clinical 3rd year experience. I know it seems silly that I would be counting that down. This is what I want to do, no? Well, yes and no. Ever since I let myself come to the concusion, the very real conclusion, that the only area of medicine that will really make me happy is OB/Gyn, I find it much harder to get excited about the upcoming internal medicine rotation. Family practice should be better, I might actually get to deliver a baby and do women's health-y things during that block. Fourth year is going to be much more exciting as I will be doing the things that I want to do for a living. Now I'm pretty much 2/3 of the way through my 3rd year and really looking forward to the future.

And all along the way I still have my preceptor visits. Today is an exam day and I'm still going in to see him. I just learn so much from even watching him interact with his patients. Not to mention it's a once a week dose of what I want to do.

I'm also super pumped to head up North to see the fam for Christmas. I am excited for the change of scenery, even if the change is to a flat, white expanse that's so cold the exhaust from the relatively few cars hangs in the air like a San Fransisco fog. But more importantly my fam is part of that change of scenery and I'm excited to see them. Lots of relaxing, baking and Wii playing.

Of course, I still have a week of class on "Death and Grief." So cheery for the holidays. Great timing school of medicine - well done.

2009-11-29T19:59:00.000-08:00

I'm starting to get the blah-blah-blahs. It seems to happen in every block, that point where you are over the initial excitement/nervousness, and just ready for it to be done. I've enjoyed my time in surgery, but I'm starting to question whether I'm learning anything useful at this point. You have to wonder whether it's important for me to hold a camera to see yet another gallbladder taken out, or a retractor to see another lumpectomy when these are things I'll likely never see again, and have seen many times thus far. I just need to heed the advice one of the OB residents had for me on my rotation - enjoy all these things you'll do this year as much as you can secure in the knowlege that if you hate it; you'll never have to do it again. I only have 9 more days I need to go into the hospital for this block, and that's pretty great too. I'm looking forward to heading up to the Great White North for a week to see my family. I love Christmas and I'm looking forward to celebrating.

I am getting pretty antsy to just GO somewhere I have to say. Christmas trip notwithstanding I think it might be time to plan a mini vacation...

Thankful

2009-11-18T14:42:00.000-08:00

So, taking a cue from a friend on facebook, I thought I'd write about what I'm thankful for. First, I'm thankful for my family and friends. I could not make it through this year, or this path in life, without them and their unending support. Being able to have someone come to pick up the dogs when we need, someone to help me by cooking some dinner when I can't get home in time, people to just vent at when work is tough; these are things that are priceless and that I couldn't live without. I am so lucky.

I'm thankful that I have all my faculties and that, even though med school is hard, it is not as hard for me as it is for some. I am thankful that I don't have to study as much as some people which gives me more time with those I care about.

I'm thankful I have found such fantastic mentors all along the way that will hopefully continue to be fantastic mentors and collegues throughout my career.

I'm thankful that I can be a part of patient care. I'm thankful that even though I can't, right now, take out someone's cancer, that I have the ability to offer empathy and compassion when the others around me don't have time to do so.

I'm thankful that I didn't find out today I have pancreatic cancer, unlike my patient. I'm thankful I could be there for them when all the pieces fell apart, and I'm thankful they have a great family to be there for them as they get put back together.

A Few Things

2009-11-12T15:51:00.000-08:00

Surgery has been a positive experience (so far) in so many ways:

1) I know what I want to be when I grow up! (No, for real this time!) Barring some life-altering event in the next year, I will be applying for a residency in Ob/Gyn. I've learned from my rotation that I love the OR. It's my favorite place in the hospital; well, favorite next to labor and delivery. I also have learned that I really don't mind heading to the hospital at 4am on a Sunday when it's to do something I enjoy. Knowing that makes the idea of a tough residency (as if any are easy) much more palatable. I've learned that I am tougher than I thought I was and that I can take what's given and smile knowing that in the end, I win! I get to do what I have wanted to do for so long.

2) I gots myself tough. Getting told you're dumb all day everyday will make it run right off ya.

3) I've learned how to be a more effective team member and, someday, a better senior resident, etc. How did I learn this? By watching what my chief does and knowing that I can do so much better. I've had some great teachers, and the people coming behind me deserve the same.

4) One handed knot tying is sexy.

5) Having a beer after 3 nights of call is the best beer you'll ever have!

Keepin on.

2009-11-07T13:07:00.000-08:00

Wow.

That was a long night.

24 hour shifts are for the birds.

Trauma surgery is for a tougher person than I.

And getting hit by a car looks like almost the worst experience a person could have.

I'll write more later when I have more wits about me.

Terrified.

2009-11-05T18:56:00.000-08:00

Tomorrow night I will take a night of trauma call at the infamously busy Denver Health Medical Center. I'm freaked out. More than that, really. But this too will pass.....

Why did I want to do that?

2009-11-03T19:01:00.000-08:00

So I am on my anesthesia week, and clearly when I decided a long time ago I wanted to be an anesthesiologist, I was not thinking. I don't like it. It's not a bad week, the days are short, the people are (mostly) nice, but...the patients are asleep. Universally (almost!). I also have started to believe the addage of anesthesia - 90% boredom, 10% panic. They are amazing critical care docs. They can stick a breathing tube in faster than anyone in the hospital. They can get access to pretty much any vein, or artery, for a line when it's needed. If you are really sick, you want an anesthesiologist around, even if you never have to actually know they are there. But do I want to be one? No. I got to intubate today, and I really didn't like it. Something about shoving a giant tube down someone's throat just rubs me the wrong way. It's good, I suppose, to knock a few choices off the list, and start to narrow down what it is I want to do, but something about watching my attending get to work at 7 and leave at 1:30 in the afternoon makes me wish I could find a redeeming quality. I just don't think I can.

On Surgery

2009-10-25T12:53:00.000-07:00

For everyone who I have been neglecting...I'm so sorry. Surgery lives up to its rough hours even when you're at the "good" place. I'm on call this weekend, so yesterday I was there from 4am to 4pm. Today I was in at 4, but I was able to leave after rounding was over at 10. That was a nice surprise. There is a case going later today, but we'll see if I get called in since it's just a laparoscopy and probably quicker for the surgeon to not wait for me to come in. Plus he asked me if I was getting enough rest today, so maybe I looked like hell and he wants me to sleep. Either way, I'm feeling lots better after my little nap. Refreshed, at least a little, and almost ready for the week ahead. And there's no excuse for complaining since after today, I only have 2 weekend calls left, and I don't mean the whole weekend, 2 weekend days.

On the whole, once I'm out of bed I am really digging surgery. I think the OR is a really fun place, after you're comfortable with how to stay sterile or stay out of the way of the sterile people. Even though I can do less during them, I love the laparoscopic procedures. I think it's amazing the stuff you can do through such a tiny incision. And I'm hoping that with the exception of C-sections, most of the procedures I'll do in the future will be laparoscopic too. If the rest of this rotation goes well, I think I will be able to safely say I can handle Ob/Gyn. It might not always be pretty, and the hours, especially during residency, can be really long, but if I love it and love the OR it's the right place for me to be.

Study break

2009-10-12T11:14:00.000-07:00

So, the good news is I only have 3 more shifts in the ED. This is great because, as it turns out, I don't really like emergency medicine. I like continuity of care. ED is the opposite of that. The other good news is, working in the ED gives the greatest stories ever. My new personal favorite: A teenager came in to the ED stating "there's a piece of chicken stuck in my throat!" This kiddo had no respiratory distress so for a while we all stood around looking at him like "so, should we do the heimleck?" We figured we shouldn't, though, because he clearly could breath so it wasn't stuck in his trachea or airway. There was almost certainly something stuck in his esophagus though, since he couldn't even swallow his spit and everything we tried to put down his throat promptly came back out. We told him he should vomit. He said he knew that. We said, put your finger down your throat and make it happen. He said - "don't you have something a bit more medically advanced than that!?" We grabbed a tongue depressor. He actually managed to throw up gastric contents, but not dislodge the piece of chicken! After that he continued to vom Dr. Pepper, but no chicken. We were starting to think maybe his hot chicken sammie burned his esophagus and it was actually so inflamed it was closing. The Dr. Pepper coming out was so dark we couldn't tell if it was bloody or not, so the doc asked him to throw up in the emesis basin rather than the trash can just in case we needed to test it. At that he promptly barfed up the piece of chicken and asked "so can I finish my chicken sandwich now?"

We have a large, tough, written exam on Friday, so that's a bummer. But as always, I love test days. It's great to have a weekend where nothing is due, there's nothing to study, and you can really, truly relax. That'll be me come Friday afternoon. Then I start surgery.

I'm actually pretty excited about surgery. Do I want to be a general surgeon? NO. But do I think my future career will entail some surgical procedures? Yes. So, it'll be a great learning experience. And let's not forget, it's at Rose!

On the down side, since I've been working nights, I've had hardly any time to do all the fun fall stuff I love. There have been no recent visits to the Farmer's market, no pumpin patch, no homemade apple cider. Three more shifts. I really hate nights. And rest assured, there will at least be apple cider this weekend!

From the Wards

2009-10-04T12:18:00.000-07:00

So, I've seen the good, and some of the bad. Here's a couple of the not so great things I've seen in the last few months:

-A patient was denied pain medicine after hitting a wall (quite literally), the provider claiming a possible drug interaction. After the patient was in their room, the provider makes the comment that the pain in their hand was just cause and effect, and the provider likes cause and effect.

-A mother abandoned her baby in the nursery after delivery. Yes, there are many silver linings here, but the gut reaction is disgust.

-A group of providers laughing at a patient with dementia secondary to a progressive, and inoperable, brain tumor. Worst of all, the patient knew they weren't making any sense, and was incredibly frustrated by the situation.

-A nurse rolling their eyes and making fun of the provider every time the provider turned their back.

Man. Medicine can be a catty, crappy world sometimes. But then there are the good times, like my preceptor talking to a little girl, the daughter of a patient, who he delivered and being so excited telling her how he was the first person in the world to see her. His excitement made me realize that there is a reason to do this. And it's a pretty great reason.

I had my own beer festival....

2009-09-27T08:49:00.000-07:00

And didn't take any pictures! Last night we had some friends from college over to have our own version of the Great American Beer Festival. We've been to the GABF 3 times in the past, and for those who aren't familiar, it's a giant ruckus with breweries from all over the country pouring one oz. samples of their products. The Denver Convention Center gets so packed with people, they line up 12 across and the line goes all the way around the Convention Center for 2 days of beer drinking debauchery. It's a good time, but it's getting to be too big, too loud, and too crowded for our aging tastes. What can I say, we're getting old. So instead, this year we decided to have our own version. I went to a liquor store near us that lets you buy individual beers and mix and match your own six packs, so I found 24 different beers we'd never tried, or had tried and liked, and asked everyone to grab a six pack or a bomber of something they liked or wanted to try. Our friends S&B just got back from the real thing Oktoberfest in Germany so they brought their faves from there. Let's just say that this morning we have a LOT of leftover beer, so we'll obviously have to have some more fun next weekend.

For food we went German style and grilled up some brats in the afternoon, then let them cook in beer and sauerkraut for 6 hours. They were delicious (but my stomach is none too sure about them this morning). We also had some homemade beer cheese soup, that would have been helped greatly by some croutons, but hey, lesson learned. I did buy a bunch of those super pretzels, but we didn't make a single one and now the freezer is packed to capacity plus some. The food was really tasty though!

Overall, I think the party was a great idea, and next year, look for an evite early. I think this could catch on!

Well, crap.

2009-09-24T19:57:00.000-07:00

This week I have spent every morning at the University Hospital Level I nursery. This is the happy nursery. The nursery where the healthy babies go. It is awesome! A very happy place in medicine, that's for sure. The thing about it, though, is that it has reignited my interest in ob/gyn. I just love that stuff. And I wish I didn't love that stuff. I want to have a life. I'm afraid of that residency. But, when it comes down to it, maybe I'm just afraid of residency. There is no easy residency. I just have to face that fact. I guess I'm right back to where I started.

So at least I get one more day with the cute babies, and one more day at the private practice peds office! All good things. I'm looking forward to a nice weekend, and hopefully getting organized again. Ever since this clerkship started I've just been kind of flying by the seat of my pants. Hope everyone is doing well, and hopefully I'll have some fun pictures to post after the weekend!

Rocky's Day Out

2009-09-19T12:14:00.000-07:00

Today I took Rocky to the farmer's market with me. He was great! I love having (at least) one good dog that I can bring in public without worrying he might eat a kid or pull me into a vendor's tent.

I have to say I'm enjoying the fall. It's the best time of year for farmer's market produce, the weather is nice and cool but still warm enough to enjoy it, and for me it just seems to be the most optimistic time of year. This is only fueled by the best news I've gotten all year - I am going to do my surgery rotation at Rose Medical Center.

Why is this great news? Because at Rose your life doesn't suck. That's why. Students work one weekend a month instead of every weekend. Students get meal tickets! Students get free parking! Students (so far) don't get yelled at! I've been so dreading this rotation (which starts in the middle of October), and now I don't feel nearly as scared. So far third year has shaped up to be better than expected. I hope I don't jinx myself for saying that!

For now, I am just enjoying my time in private practice pediatrics. Everyone has been so nice, and I enjoy working with kids and families. Right now, life is good!

Fall

2009-09-14T07:01:00.000-07:00

I have actually read books - fiction! This is an exciting perk of 3rd year I never anticipated. We had a really great relaxing weekend. Saturday, after my donut-eating, movie watching rest time we headed up to Superior CO for the Mile High Chili festival. It was great! For 5 bucks each we got all the chili we could shove in our bellies and 2 free beers. Plus there was a great live band too. It rained a ton for a long time, and it was really cold, but overall it was a great day!

I also read the Time Traveler's Wife. I cried like a baby. I don't think I will watch the movie.

It is really starting to feel like fall, which always seems like the time for starting new things. I know I feel this way because I've been in school for-well- ever. But I think I'd like to try a new hobby. Any ideas?

Lazy mornings

2009-09-12T09:33:00.001-07:00

Pediatrics is a fantastic rotation! Don't get me wrong, it is definitely not for me. My stomach turns a little everytime I have to give a little baby shots and hear the inevitable screams that follow. But the kids are almost always great patients. They are unassuming, trusting, and honest. That's the best part. It's fun to work there, and the hours are great. That's about all I can ask for!

Plus it lets me spend my weekends here on the couch with J, eating some Winchell's donuts, drinking coffee and otherwise being lazy and happy.

And we're one third through it!

2009-08-14T14:37:00.000-07:00

I am so excited that neurology is over! Tonight J and I and a bunch of med school peeps are headed downtown to Great Divide Brewing Co. for their release party for two new beers. It should be a lot of fun. I'll take pictures and for once maybe I'll post them!

To leave everyone on a fun note, since I promise I didn't actually hate neurology, I have a great patient story, two actually.

#1: I walked into the patient's room (one who was admitted for altered mental status and what was starting to look like a possible dementia) and asked how the patient was doing that morning. Patient says: "I'm great doc. Ask away, I'm ready to think!"

#2: A patient came in after losing consciousness. He was in a coma. This was the third time he'd been in this year. He continually was stopping his insulin and skipping dialysis, having a seizure, going to the hospital, getting righted and heading home. Not the fun part. The good part is what his daughters did the last time he came in. He had a small stroke and couldn't really remember anything afterward. So what did his daughers do? He asked for a cigarette and they told him he quit smoking 3 years ago. He couldn't remember so he just believed them. And quit smoking cold turkey.

Have a great weekend!

Neuro...so/so

2009-08-12T05:12:00.000-07:00

Well, the final verdict is, I didn't completely hate it, but I sure don't like it. I'm pretty sure I'm going to walk in this morning and my patient will have died. This is not a rarity in neuro unfortunately. Brain tumors are not good news.

But, I don't have to love everything. And in fact, I'm relieved that I don't! Looking at how I feel about neuro (and if I'm honest, inpatient medicine in general) it makes me feel certain that by the end of the year I'll know for sure what I want to do. More and more often I think that something is OB/Gyn. The lifestyle scares the crap out of me. But not all residency programs are as scary as the one I did my rotation at. I think a small community program might just be ok. I still have a lot of thinking about it to do. And I still love psych. Also, I have two weeks of Physical Medicine and Rehabilitation coming up, and that sounds pretty fun too! I can't rule that one out either.

I was able to be the first assist on an oophorectemy (I helped my preceptor remove an ovary) and I haven't felt that excited about a piece of medicine for months. I think it might be a sign. I know I can choose anything I want, especially because I have such a supportive hubs. And residency won't last forever, so it's silly for me to choose something that has an "easier" residency but that I like less. Lots to think about I guess.

But, next week is vacay! I will write more later, but for now, it's back to the wards. TWO MORE DAYS!!!!!!

3 days down 17 to go...

2009-07-23T05:06:00.000-07:00

So, I thought for sure I'd love neurology. After all, I've pretty much loved everything else, and I did a master's in neurobiology. But no. I have never been so bored in my life. I got there at 7 yesterday and didn't get done rounding until 1pm. Gross. Psych is looking better and better everyday. I can deal with a little cognitive dissonance for a career that I like to do.

Not that I wouldn't like OB/Gyn, I definitely love that field. But the lifestyle is hell and frankly, I find myself liking my life so much better, regardless of what I do during the day, if I have a lot of free time for my real life. When I think about it, forensic psych might actually be perfect for me. I had a lot of angst out of college about whether to try to apply to law school or med school. I decided med school because I like science more than liberal arts in general (but not always). This might be the best compromise.

At least neuro is not the longest rotation, and not the longest hours. But it's not a lot better than OB/Gyn was, and the time isn't filled with babies. No call. No weekends. I should not complain about that one.

But the best thing is: there's a wedding this weekend! Hooray! A couple of our college friends are finally tying the knot. It's going to be great to see everyone and reminisce a bit. Plus it'll be nice to catch up on everyone's lives. Everyone has accomplished so much! I'm very excited. Just need to get through, really one more day. Tomorrow we are in the epilepsy clinic, which should at least be really busy, and I am pushing to have my preceptor on Friday afternoon, which is always the best part of my week!

Wow. That was a boring post. But I felt like I had to write since it had been a while. I'll write again later about my evil OB attending and what he wrote on my eval. Jerk face.

Cognitive Dissonance

2009-07-14T06:48:00.000-07:00

So, I'm conflicted these days. I really love psychiatry. I never thought that was possible. I often think it would be the perfect compromise between trying to have a great personal life and a rewarding professional life. It seems to be for my attending. It would be a bit hard for me because I don't know as much about matching into psychiatry as I have learned about OB/Gyn or anesthesia. But, not so hard that I couldn't do it. The main thing stopping me from doing more research is my own stupid ego.

Think about it this way. If you were going to be a physician, would you want to be able to offer medical advice to your friends and family? Or do you want to send them off to a "medical doctor." After all, what is 4 years of medical school worth if not to end up a medical doctor? There's some excitement and privelege in being allowed to see someone from the inside in surgery, or help deliver their new baby. I know that the absence of those things does not make psych any less noble a profession, but it's just not what one, at least this one, pictures when they go into medicine. "Is there a doctor on the plane," "Well sort of, I"m a psychiatrist." Does that count?

Alas, I have a whole year to figure it out. But this is my last week to really see psych and all it offers. I was always raised to believe that women can do everything that men can do, that I am capable of anything, and somewhere along the way, I determined that that should be the hardest thing possible. Maybe that's just not the lesson I should have taken from it. Maybe it's fine to want to be there when my future kids have band concerts (blah) or swim meets, or (please) track meets. And maybe, just maybe, there's an area of medicine where that's possible.

What do you think? Does being a "head shrinker" make one less of a doctor?

My Psychation!

2009-07-02T06:14:00.000-07:00

It's been a fabulous 2 weeks! I have to say that maybe I was premature declaring I would be an OB/Gyn. I am having an excellent time in psychiatry. I actually look forward to going in every day. The patients are incredibly interesting and my attending is a great mentor and lets me ask the patients anything I want (with some direction for those patients that have a violent history!). The lifestyle is really great and I think that's something that has to be considered. Let's just say it's on the list!

And even better, during psych I've actually had time to do things! Last Saturday J and I hiked our first 14er together. He's done some before but I never had. We climbed Mt. Bierstadt. It was definitely harder than I expected! But the view from the top was pretty great:

We brought the dogs with and they had a blast. The big guy kept laying on the snow on his back and squirming around until he slid down upside down and backward. As soon as he got to the bottom of the snow field he would run back up to the top and do the same thing again. All the people watching thought he was pretty hilarious.

Mugs had way more energy than the rest of us and on the way down he would run in circles around us on the snow. Then he slept for three days. So did the rest of us. I actually started to feel a bit under the weather after the trip, so I felt a little down for a few days, but I'm getting better in time for my long weekend! It's hard to believe that in 3rd year so far I've had 2 three day weekends. I really thought that by this time I would feel like I've been hit by a truck. I've been lucky so far. It also makes me think about what I really want in a career. I am happiest when I work normal hours and have free time. I love medicine, but I'll never be so gung ho that it will be my whole life. Maybe that makes me less of a physician, but I think it makes me human. I do have my preceptor today, and I think it's good that I will get the opportunity to compare how I feel about OB to whatever I am doing at the moment. Should be interesting.

The fourth of July should be a good time. J and I are going to run a 4M race in the morning and then head out to a BBQ with his fam. That night we're going to a soccer game and fireworks show. Friday should be great too! We're planning on going for a hike in the morning and stopping by Oscar Blues in Lyons. We are huge fans of Dale's Pale Ale and have been looking forward to going to Lyons to check it out for quite some time. Who knew that it would be 3rd year when I had time to do it!?

Things to Learn in Psych

2009-06-24T06:20:00.000-07:00

Number 1: Never place anything heavy or throwable within reach of patients.
Number 2: If you forget rule number 1, be quick to duck.
Number 3: No neckties for men, no dangly earrings for the ladies.
Number 4: Just expect to be surprised, and work on your poker face.
Number 5: Did you know Mensa is a "support group for gifted and talented people" like my patients?!

Overall, it's pretty fun thus far. Something new everyday. And something fun at home everyday since I have all this free time! The dogs are mucho grateful. And I am grateful for the peace and quiet. J has been working like crazy on finishing the garage, and he's getting pretty close. I'm pumped to park inside again. I have been spoiled. Plus it'll be nice to get the contents of the garage back in the garage and not in the house. But he's been really quick on this one and I appreciate it!

For those of you without a huge commute, remember it's bike to work day! Not very feasible for me, but hopfully I'll be able to make it up later on when I am closer to home!

Well, time to get going. Gotta walk the dogs and take a peak at the materials for our "student study session" this afternoon. Did I mention that's done at 3!?

End of the (Very) Beginning

2009-06-23T06:16:00.001-07:00

So, I have one block of 3rd year behind me. One sixth of the way to being a 4th year medical student. Baby steps, people, baby steps. In the end, I found a new love in my life. I hope that the OB-Gyn world will work out for me. But I do have 5/6 left to change my mind. If anything keeps me from doing this, it will be the lifestyle. It's a tough balancing act, deciding on having a fam, being the best doctor I can be, and really enjoying what I do. I have great support, so I know it's very possible. But to me, the whole thing is like breaking in a new pair of shoes that you absolutely loved and HAD to have. It costs a lot and you know it's going to hurt while your getting them just right. I guess I will keep shopping over the next 10 months and hopefully find just the right pair. I know myself though, and more often than not, when I really love something I tend to know it right away.

Yesterday I started my psychiatry rotation, and can I just say - I couldn't be more thankful that it's only 4 weeks. I am working with a "dangerous population." And I'm not super thrilled about it. But, my preceptor has promised me every Friday afternoon off, no weekends, and getting out by 4pm every day. There is a reason why I picked it for summer. I am quite sure, though, that I'll have a lot of stories. I also don't have to be there until 9am. So, I'm off to take the dogs for a walk. We finally have some nice weather!

June!

2009-06-02T08:13:00.000-07:00

But it doesn't feel like it. Today is about 50 degrees and not all that nice. Actually, crappy. Rainy, windy, cold. Add the fact that the pup is ridiculously enthralled by the umbrella and hence won't actually go to the bathroom while I have it open, and it's been on the miserable side this morning. But I have no where to be until 3 this afternoon, so I'm cozy in the house. I feel like I have so much to do, all my thoughts about it could come rushing out of my ears at any moment. I've always been less than productive when I start freaking out about how much has to be done. So I'm trying to break it into managable bits and work from there. We'll see if I still feel sane by the end of the weekend.

My weeks in emergency medicine have gone exactly as I expected. The shifts are quick and kind of fun, but leave me knowing that both emergency and pediatrics are not for me. I get really sad to see kids so sick. It is handy to learn about peds since it will make me feel more well equipped to take care of my own kids one day without being that parent that runs to the ED everytime the kid has a fever.

I better get to working on some of this mountain of work. I feel like I'm pretty much swimming in it at the moment. So much busy work, it makes the 14 hour shifts of L&D seem easy.

Feels like summer

2009-05-28T09:59:00.001-07:00

I can't help but feel like I'm on summer vacation while I am on this emergency medicine block. Yesterday I had a ride-along with the Fire Department EMS division. It was a pretty low key day, and they were pretty hilarious. I also think they would have let me do pretty much anything I wanted on calls, so it was good experience. I was glad I got to ride with the fire fighters, especially when I ran into a classmate on the ambulance. She wasn't really able to do anything.

Today I don't go in until 3pm. I stay until 11. This is awesome. Although I won't see J today, I'll still get to sleep at night when it's dark and J should at least have part of tomorrow off so I'll see him before I go in tomorrow again at 3. Plus it's a beautiful day outside and I get to take a nice run/walk with the doggies. I have stuff I should be doing for school, but I am really enjoying this "free time." Working 8 hours after my 14 hour days last week feels like a vacation in and of itself. Plus there is a lot less stress on this block since it is 100% pass-fail. No way to honor, you just show up and learn all you can. I don't have any interest in doing ED work as a career, but it'll be nice to get familiar with it a little for future ED consults, etc. The best part about the pass/fail thing is that a 70% on the test next friday shows up the same as a 100%. It just makes things seem less stressful, which is always appreciated.

I think it always helps to have something to look forward to as well! The awesome thing is that the day after our exam for emargency there is a beer tasting event at Great Divide Brewing Co. For 20 bucks (part of which goes to charity) you can try all the beer you want and they are even having food! Pretty good deal for a 5 hour event. Plus it's Saturday afternoon, leaving the evening time to get some good sleep and still be refreshed to start GYN clinic on Monday morning. So, I'm adding a countdown to the top of the blog. I do love a countdown!

Up Side

2009-05-23T09:28:00.001-07:00

*not the real baby, that would be wrong on so many levels...
**I only tell this story because I know you'll all hear it from her, I won't say names in the interest of patient confidentiality, but among friends, I know she'll be telling the story too!

So, the week of nights turned out to be much better than my week of days. In the last two nights on service I delivered 3 babies! But by far the best story happened on the last night, Thursday! I guess technically it was very early on Friday morning. It was shaping up to be a slow night, steady in triage, but no one, not in the whole hospital, was in labor. So, myself and the residents were going to head down to the caf for a snack. As we were walking out toward the elevator, I saw a familiar face in a whole lot of pain. One of the ladies from my sorority in college was coming in to triage in labor! The residents assured me we still had time, the nurses would check her in and get her set up. I ate "lunch" and my intern checked to make sure she was ok with me being present during delivery. She was fine with it and being transferred to the low risk floor. I got her stuff together and was headed up to get her history for the admission paperwork. When I walked in the room, I knew there was going to be no history taking. She was complete and ready to go. I ran out, called my intern, and went back into the room. I realized there was no time for waiting for the docs and grabbed a gown and gloves. My intern made it up to stand behind me for support, but the little one was not waiting any longer for the grand entrance. I was able to deliver my sorority sister on my own. It was so exciting! All the docs thought it was a hilarious story, and my attending let me sign the fake birth certificate that goes in the baby book. I felt so lucky, priveleged really, to be part of it. I think my interest in ob/gyn is secure.

Tough Stuff

2009-05-15T18:43:00.001-07:00

If I still have an interest in OB/GYN by the end of this rotation, it must be meant to be. Today was probably the toughest day of my (very short) medical career. It was my very first vaginal delivery. Yes, after an entire week on a very busy labor deck, I had yet to see a vaginal delivery that did not involve forceps. Lots of cesarean sections, not a lot of your normal births. So you would think this would be a big exciting moment. But, on said first delivery, the baby died. After just spending my last week on oncology, I thought this week would be so much more up beat and exciting. However, there have been 3, countem, 3 dead babies this week. And a multitude of other bad situations. This was such an anomolous week, the head of the OBGyn department footed the bill for a nice lunch for all the residents and students on service, about 8 of us, and talked to us for about an hour about all the great things that so often happen in this field and why he feels it is the best field there is. It was really nice of him to do that, and much appreciated by everyone, but certainly by me. I have always known that regardless of what field in medicine you go into there are horrible low points. But keep in mind, this is my very first clinical rotation of medical school, and it's been full of badness. My first ultrasound I looked at was a confirmed miscarraige. The first big surgery I was scrubbed for took 9 hours and involved a much more advanced cancer than the patient was aware of, causing her to wake up from anesthesia with no spleen and a colostomy bag. It has not been an easy rotation. To say the least. If it weren't for J I would be a puddle of sadness on the floor by now. It does put your problems in perspective. At least there's that.

I am on OB nights next week, and I"m cautiously optimistic. I can't let myself believe anymore that it will be nothing but exciting and fun. I don't think any part of medicine is that. Sometime this week the rose colored glasses fell off and I stepped on 'em. But I keep going in, because I've tried other things, and nothing else makes me want to come back for more. For now, I"ll enjoy my awesomely understanding husband and my tired and affectionate pups and just enjoy the fact that I am home for the weekend. Sunday night is the farthest thing from my mind.

Cinco de Mayo!

2009-05-05T17:06:00.000-07:00

And I'm home at 5:30! OB/Gyn is pretty great as services go. I don't have OB until next week, and I know that will be more labor intensive, pun intended. But overall, I have learned a lot and I"m seeing interesting patients. The great news is that boards went really well. I set a goal for myself and I got just over it! So that's fantastic. I have noticed that since I have been getting less sleep my eye is bugging me quite a bit more. I'll have to keep the other eye peeled to see if it's something that needs attention. It probably just needs some time to adjust. Good thing for the weekends. J calls me a sleep camel, because I'm storing up sleep for the rest of the week! It seems to be working! Haven't had the urge for a nap all week!

Just Awesome....

2009-04-28T19:19:00.000-07:00

Did I mention I don't have to go in tomorrow until 8:30? I think I am going to love clinic.

Here we go!

2009-04-28T15:58:00.001-07:00

Well, so much to catch up on!

First of all, I regained my sense of taste just in time to enjoy my trip to San Fran! We had such a great time! As soon as we dropped off our bags we walked straight to the Ferry Building for the farmer's market. It was a gorgeous sunny day and we ate some delicious eats while looking out over the bay. While doing some research online I found out about this little Mexican food cart that is at the market on Saturdays and J was naturally super excited. He got a plate of chilaquilles, I got my salumi cone. My vice is mystery meat after all... It was super funny though because as we walked through the ferry building a girl came up and started to offer us a sample of some organic produce, but then saw my cone and asked "did you get meat in a cup?" I said yes, and she said "oh." and just stopped offering anything to us. Oops. We spent the rest of that day doing all the touristy stuff along the wharf, heading over to Ghirardelli square, then bussing it back to our hotel. We made a trip to Trader Joe's to get stocked up on some snacks and wine and then walked to dinner at Tommy's Joynt, which we saw on Diners, Driveins and Dives. The next day we spent mostly in Golden Gate park. I'm super jealous that such a huge, gorgeous, GREEN park is in the middle of a great city. I wish we had it here! I also got to meet up with a friend of mine from high school at San Francisco brewing company. I haven't seen her since I was a freshman in college. I was pretty pumped. We had a great time and then had some dinner at yet another diner we saw on triple D.

Monday in San Fran was the highlight of the trip. In case you couldn't tell, we are beer people. I set up a tour of Anchor brewing a long time ago and I'm so excited we went! It was a great tour, with great beer (in unlimited quantity...) and we even met some fellow Coloradoites who we talked with for quite a while. It was a really good time! We walked up to Coit tower and had a nice dinner overlooking the bay. For some reason I'm having problems uploading pics right now, so I'll skip through some of the details and save em for picture captions. The next two days we spent in Napa, and that was a lot of fun too. I was really sad to leave, as usual, but happy to get home at the same time. At one point on the way to a bus stop, I walked us right through the heart of the Tenderloin in SF. Not a great place for tourists to walk. I'm just glad it was daylight and we weren't too far off the beaten path. Makes the suburbs of D-town look a little brighter.

Right away when we got back my mom and sis came to town! Also super exciting! We had a great time, except for the giant snow storm we had!! I can't believe that they came to Denver from Fargo and we had such a snow storm. But I was able to bring my sis (who is recently turned 21) to Coors brewery, and that was awesome! We also had some great meals and went out for a "Ladies' night" on Saturday with some family friends. It was a great trip!

All of last week was spent in orientation sessions getting us all ready for third year. I think it was pretty helpful for the most part. Only time will tell. Yesterday and today we have had 2 days of 10 hours of lecture straight (no breaks, no not lunch either). I'm starting my OB/GYN clerkship and this is all material we should know before we all go to different sites. I am so looking forward to this rotation! I am really lucky because I am able to spend the rest of this week in the Reproductive Endocrinology and Infertility clinic. I think this is something I might really consider for my career, and I am the only student in this session that is able to spend any time in this clinic. I feel really lucky. The best thing about this clerkship? No weekends! That's right! I will have every weekend free!!! That means I'll have two blocks in a row with weekends off! I might not forget what my husband looks like afterall!

I know I have lots of phone calls to catch up on and emails and everything else. Lots of people to meet up with in the near future! I promise I will get on it starting this weekend!

Apparently tomorrow is "score day" for boards. I sure hope that's true. I am really looking forward to getting that behind me. Then I can really move on to third year!

Recovery

2009-04-08T07:01:00.001-07:00

Yikes. So, I have a way overactive immune system. So much so that even when J got really sick at Christmas, even though I was immunosuppressed with high dose steroids, I never got as much as the sniffles. However, apparently the long term stress of preparing for and taking the boards is a much more effective immune suppressant than prednisone. I am SICK!!!! So sick. J had it last week and is just feeling better. I can't really get solid foods past my gigantically swollen throat. It is no fun. I figure, I have 3 days to get better before my awesome trip. I've been planning this trip for months and months, so I will do absolutely everything I can to make sure this thing gets better quickly. We're already planning to bring all those symptomatic meds just in case we're both not up to par. But I'm willing to try any home remedies that might have some validity. If you have any ideas, let me know! And I promise I'll be resting with loads of fluids. So outside of those, please send ideas!!!!

DONE!!!

2009-04-06T15:04:00.000-07:00

Well, it is over. I can hardly believe it, and it took me a while to decompress, but it's done. Overall I think it went well. The first and last blocks were the worst and I can't help but perseverate on the ONE question that I am absolutely positive I missed. But, it's rapidly leaving my thoughts. I have this to think about right now instead...

What can I say, my J knows how to take care of me. Off to have beer and pizza, then more beer!

Whatever

2009-04-04T15:10:00.000-07:00

I'm tired. I'm grumpy. I think "maculopapular rash" is a term designated for "anything on the skin we couldn't come up with an eponym for." As of 2pm tomorrow, I give up. But tonight at 7:30 it's time for a Blue Moon and a movie.

Adding insult to injury

2009-04-02T20:21:00.000-07:00

Tomorrow night is not only E-days, my favorite Mines festival, but The Flobots are performing. So sad. Alas, micro calls. But at least we should get a chance to see the Lewises! See you tomorrow Sonny and Becky!!

One more week

2009-03-30T13:19:00.000-07:00

I have the attention span of a two year old. I am dragging this week. I give my classmates and all who have gone through this before me a lot of credit. I can only handle this for so long. This last week is going to be a tough one for me. I can study hard for a lot of the day, but I'm starting to need longer and longer breaks. But, it's coming fast, and I"ll get there. One more week. One more week. One more week.

My typical situation

2009-03-25T10:32:00.000-07:00

I feel like all I talk about is "I need to study for boards!" And it occurred to me this morning that most people won't have the pleasure of ever finding out what that is like. Hence I present "a day in the life of a medical student who is studying for step I: written in my 10 minute lunch break."

For these 3 study weeks, my typical day starts with Mugs crying in his kennel so he can go out. I know J just let him out about an hour ago, but I'm a sucker, and he's really, really annoying, so I get up. I brush my teeth, get dressed (sort of, I put on a sweatshirt and socks and remain in my jammie pants...for how long, who knows?) and let the monster out of his cage. The three of us go downstairs and I take the little one out on his leash and let Rocky have at it. Inevitably, they leave a present on the lawn and I take care of it.

I go inside, go to grab a cup of coffee. J left me a quarter cup...sigh. So I put my pan on the stove for my morning egg, let it heat up and start a new pot of joe. I eat my egg and fake breakfast sausage in about 5 minutes while I check my email and the weather on my AWESOME new toy...my iPod touch. Once said breafast is down the hatch it's time to hit the books. I read the review book, take notes in First Aid, then make flashcards of all I've done. This goes on for about 4-5 hours; usually from 7-12ish. At about 11:30 I could eat the aforementioned review book, so I throw some sort of garbage in the microwave and chow down while I continue to write flashcards. I usually take about 10 minutes to read blogs about now. I go on with this for about another hour.

Around 1 I take off to my "safe haven" which has now become the gym. I am a lazy person in my nature, so you know it's bad when the thought of a sweaty workout gets me all excited. Being as it's my only real break of substance throughout the day, I'll take what I can get. I usually take my time in the gym, shower there so I don't have an annoying puppy licking my legs as I get out of the shower, and head out. Break time's over. By about 2:30 or 3 I'm back at it. If I am very likely to kill the dogs on that particular day, I go to the library and set up shop there; if they aren't on my last nerve, I go home and study there. Usually I head home. The kids in the library are equally annoying after 3 so it's kind of a wash anyway. Around 6 J comes home; I tease him about leaving such a huge cup of coffee for me we whip up some dinner; I chow down and leave him with the dishes. I head upstairs for about another 3 hours of Kaplan Q bank filled fun. Then straight to bed to start it all again.

All told, this is not very fun. This is why I am taking the exam as early as I feel I can get away with. It makes me glad I am not a lawyer studying for the bar, since I hear it's just as bad if not worse.

Rest assured though, I'll be looking back fondly on this time when I need to be at the hospital by 6 (or earlier) for rounds in a few months. Grass is always greener..

Back to work!

Update

2009-03-24T07:45:00.000-07:00

In an odd twist of events I've decided to take the Step 1 exam a few days early, on April 6th. I figure, it's my dad's bday, so it's probably lucky, and my scores are going well on practice exams, and I really don't want to forget any more of the little details I've crammed into my head in the last week, and will cram in there in the next two weeks. So, I need to update my countdown. This also gives me a little more free time before third year so I'm looking forward to meeting up with friends and forgetting all about that test.

Git 'er done

2009-03-14T22:17:00.000-07:00

I really never thought I would study so many hours in a row the day after my finals. I am beat. I have to say though, I had a great birthday yesterday, and I really loved getting together with those who could make it. Knowing that everyday from here on in is going to be this long is a bit of a downer, but the material is interesting and I'm ready to get this thing done!

Happy Birthday to Me!

2009-03-13T13:17:00.000-07:00

I love my birthday! I always have, I always will! Today I love it even more because today is the last day of my pre-clinical curriculum in medical school. From here on out, I'm actually going to be reminded of why I did this in the first place. Don't get me wrong, it's a little scary. I've never really been anything but a student, and so this is going to be an adjustment. But I'm so excited for it. I know I have to get through boards first, but it's just another necessary bump in the road. And honestly, I've been looking forward to this time of boards prep. It's not hard to study when that's all you have to do.

It's shaping up to be a great day. This morning was hilarious. During our microbiology course we've learned about fungus (and a lot of much more disgusting stuff, but, another time). The professor who talked about this would constantly say "when you see that under the scope It's Miller Time, that's your diagnosis." He must have said "It's Miller Time" 30 times per lecture. So, during the exam, when someone got up and wrote "Miller Time" on the board with an arrow pointing out the door, I chuckled a little and finished my test, thinking nothing of it. I couldn't help but giggle when I turned in my test and left the room to find a sign on the wall that said - "Now it's really Miller Time" with an arrow pointing down - to a big ice bath full of Miller Lite. I took some pictures, I'll post them later. For now though, I'm off to call my friend from college to catch up, pop the cork on some bubbly, and just enjoy one more day before the road to Boards really begins. Feels good.

Indisposed

2009-03-11T07:23:00.001-07:00

Sorry for the hiatus. Let me just say I am trapped behind a pile of books and can't get out. If I never hear the name "Bronfenbrenner" again it'll be too soon. And parasitic worms are the single most disgusting thing I've learned about medicine thus far. I'm out.

Random

2009-03-03T15:49:00.000-08:00

Everyone has a bucket list somewhere in the back of their mind. You know, that list of things you absolutely must do before you kick the bucket. Well, mine came to the forefront today when we did our geriatric interviews. I felt honored to meet the wonderful woman (89!) that I met today. She still had every one of her faculties, and was quick-witted to boot. We practiced doing screens that we should do on our geriatric patients, including a depression screen. When my classmate sitting next to me asked this lovely lady if in the past month she's felt depressed or hopeless, her response was "I feel every morning that this is going to be the best day of my life!" And my classmates' response was "That is sooooo lucky." We all cracked up because I don't think she meant to say that last bit out loud, but it was hilarious. I think that attitude of seeing everyday as (at least potentially) being the best day so far is one that I want to adopt so badly. I think that with my eye problems, I've been trying to take on a new attitude. That the things that happen to us, are just that, things that happen. They aren't retribution for some sort of past life, they aren't perpetual bad luck. They are just things that happen. And I think that looking at them that way makes me realize that it's not about the things that happen, but how you deal with them that counts. And I know that I can deal.

So, that bucket list. I think I have less of a true "bucket list" and more of a "third year list." Gotta start somewhere. More than things I need to do, there are people I need to see before I get swept up into what will surely be just the beginning of a very fulfilling, but very busy clinical career. You know who you are. And if you don't, just call me! Chances are excellent you are one of them!

One thing that I never pass up the chance to do is visit Golden. My alma mater is here, but much more importantly, it is just a place I love to be. I'm sitting here, in Golden, writing this in a coffee shop just off campus, and it makes me so happy. Even better, it's 70 degrees outside and I took a nice leisurely (read: slow) run along Clear Creek this afternoon after meeting with our geriatric patient. Life is good. I actually did come to Golden for a reason, though. Tonight I'm giving advice (who me?!) to the newly formed Mines pre-med society. When I went there, there was no such thing, and I'm glad they have one now. I always get excited to see Mines students applying for med school, and even more excited when they get in. Afterwards, I am meeting with some friends from college and that just makes me all warm and fuzzy.

It's always a little bittersweet to go to Golden when so many of my friends are all over the country. Some of my best memories are of walking to the restaurant/bar at the end of the street with my friend D for happy hour. Toward the end of school we did that...a LOT! But it was always so much fun, and a great way to fill up a lazy afternoon. I thought about going there today to kill the time before the pre-med meeting, but it just wouldn't be the same on my own. Oh nostalgia.

Well, this is a pretty random post, but I wanted to wish everyone well, and here's to the hope that everyone can wake up in the morning and think "this is going to be the best day of my life!" It's at least worth shooting for.

Funny stuff from lecture

2009-03-03T09:06:00.000-08:00

So med school isn't all work, work, work. The lecture today was actually pretty entertaining. He opened with this joke:

"A priest is talking to a rabbi. The priest says, 'Rabbi, have you ever eaten pork?' and the rabbi blushes a bit and says 'Yes, Priest, occasionally I have partaken of pork.' Then the Rabbi says 'Priest, have you ever had sex?' and the priest says, 'yes, before I was a priest.' The rabbi says 'better than pork isn't it...'"

Then he tells us about a worm (a parasite of the human GI tract) that can easily be treated with drug therapy. There is actually a group that is against the use of drugs to cure this bug because it may lead to the eradication of the worm and its subsequent extinction. Unbelievable.

Keeping the Faith

2009-02-28T12:25:00.001-08:00

So, yesterday was my final follow up with NeuroDoc. I feel terrible for the patients that came after me, because NeuroDoc really, really, really likes to give me advice about med school, careers in medicine, handling a marriage while being in medicine. I really appreciate all the advice he can give me, but when I walked out of there, I'd been in my appointment for over an hour, and there were people waiting when he got to me in the first place. I really do learn a lot from him though. One thing he has me working on is changing my dominant eye from my right to my left. He's pretty convinced, and I am too, that my eyes will stay the way they are for, if not forever, a very long time. That is to say, by the time I'm a third year medical student using ophthalmoscopes (to look in eyes) and otoscopes (noses and ears), my right eye will still be sub par, and the blind spot might keep me from seeing all there is to see. So I need to be able to look with my left. To me, this is like trying to write with my left hand. Not easy. So in order to do this, he recommends that I use a patch on my right eye for about a half hour or 20 minutes a day while I watch tv. This way my brain will start to pick up on the fact that it's my left eye it needs to get the most info from, rather that my right eye like it's used to. I also need to practice, practice, practice. It's not just the lack of vision that makes this little maneuver difficult. When you get used to holding an instrument in a certain way it's really hard to switch your technique. But, I'm lucky to have J, Mugs, and the big guy to practice on. I'm confident that by the time my neuro block rolls around in June I'll be much better at it.

After my NeuroDoc appointment, I had to get the registration renewed on my car. And by had to, I mean that I was on the last day of my grace period and really had no choice. Being the last day of the month it was incredibly busy. I waited in line, pretty happily since it was a nice day, and a Friday to boot, and everyone else seemed pretty cheery. But the very second I got to the head of the line, was called over, and sat in the chair, the computer system went down and no one was going anywhere until it came back up. I have to say I was impressed with the patience of these people. At first, there were of course those jerks who walked out and slammed the door. The woman I was sitting across from was dismayed about that, as anyone who is in the door by closing time is going to be helped, regardless of how many hours of overtime they had to put in. But then, everyone got really happy. Everyone knew they had to be there, and the employees had to be there, and that everyone was doing the best they could. The security guards came by with little lollipops for the kiddies in line, and everyone was just pretty collegial about the whole ordeal. And the computers stayed down for 45 minutes. It gave me back a little of the faith in humanity that shopping at Walmart on a Sunday often takes away. Overall, I left there pretty happy, amazing for a trip to motor vehicle hell.

The weekend thus far has not been productive. I studied a bit this morning, but then gave up when the dogs would not stop playing around and making a TON of noise. So I went to the gym for an hour and then got the grocery shopping done. By the time that I was home, J was almost home (work on a Saturday, yuk, it's like looking into my future). Did I get lots done since he was home to watch the dogs? Nope, did all the ironing. Eh. I figure, it's probably my last weekend to get to all the stuff that really needs to get done around the house, to plan for VACATION (!) and for my MOM and SISTER'S TRIP! After this weekend, not much other than boards is going to occupy my time. Yes, I feel that I can get a decent score if I took it right now, but there's nothing wrong with working a little harder. After all, on Friday I found out that the average board score of the interviewed applicant for an anesthesia position in residency (not from CO), is 255. That's 35 points over the national average, and hence 35 points over my practice score. I'm not saying it's completely impossible. But damn near. Good thing I'm expanding my career differential to include ob.

Overall, though, things are good in LG land. School as I know it is over in 2, count'em 2 weeks, and I'm so ready to keep moving forward!

Also, I made the coolest find for our San Francisco trip! Pretty much the first thing I want to do when we get to the city is drop our bags off at the hotel and go to the Ferry Building to the Farmer's Market. It is a year round farmer's market that is just awesome. Well, it's always been awesome for me. Last time we went J picked up EHEC O157:H7, a form of E. coli that causes really bad enterocolitis. He was lucky in that he didn't have any kidney issues with it, but he was so miserable. So, I figure - number 1, I'm really lucky because more often than not my overactive immune system is an annoyance to me, but it might protect me from all these crazy pathoogens, and number 2, maybe J developed some immunity from the toxins that make this E. coli strain so dangerous. In any case, we will be sure to make a trip into the actual Ferry Building for - wait for it - Salumi Cones! Oh. My. God. It's like a Sno-cone full of my favorite salami goodness!

I am so excited I can hardly stand it sometimes. Wow I love that city!

It's all gravy...

2009-02-26T06:29:00.000-08:00

So last night J and I found ourselves in great company of my friends LG and DG. We were all out at Red Square Euro Bistro to participate in Denver Restaurant Week. For those not from the area, restaurant week is the week (or this year...2) when some of the most upscale, fancy-pants restaurants in the metro area create a prix fixe menu for two people for only $52.80. It's wonderful. The Red Square's schtick is an infused vodka bar. It took the four of us a while to decide on one to try, but we settle on a carafe (yes, a carafe) of the fig infused vodka. It was truly the baby bear of vodka. Not too sweet, not too strong. Just right. In fact, I felt a little like I was sipping on the liquid verson of a fig newton. First course was great. I decided to be adventurous and try the house pate with red onion jam. I'm really sad I didn't take a picture of it. It was delicious. I should not be surprised I like this paste of liver as I am a big fan of mystery meats of the world. The red onion jam was really tasty and was the perfect complement to the extreme creaminess of the pate. Overall I was really pleased, and I even got everyone at the table to try it. Everyone agreed it wasn't so scary after all. For mains I got the pan seared salmon with a saffron risotto and J ordered the pepper encrusted NY strip. J's steak was huge. And very tasty. I also loved the salmon. It was perfectly cooked, not over done, and the risotto was tasty, though I had a hard time picking out the flavor of saffron, so I was a little disappointed with that. J's steak came with a mixture of cannelini beans, green beans, and tomato which was a great complement to the pepperiness of the steak. The dessert course was really good too. I had a shortcake with fresh fruit and a cream cheese-honey drizzle. It was a perfect light way to end the meal. J had a much more decadent chocolate dessert that was very good, but a bit on the sweet side to me. All in all, though, I loved this place. The ambiance was beautiful and I could just see us sitting out on the porch in the summer sipping on some more delicious infused vodkas and people watching at Writer's Square. Good times. I did manage to take a few pictures:

The entire bottom panel was all vodkas. Wow.

Liquid fig newtons...

It's a good thing that dinner took us 3 hours because soon that, turned into this:

My salmon was so pretty

And J's steak was huge!

My dessert was also pretty and tasty. I walked away feeling more full than I have in recent memory!

Overall, we had a great time and a great meal!

We took the light rail home and J's dad picked us up at the station to bring us back home to see the monsters. I had taken them on a walk earlier so they would hopefully sleep while we were away. They seemed pretty awake to me!

It has been so warm here that we even got to sleep with the window open! It was so nice to get some fresh air in this house!

I also got the results of my practice USMLE last night. The score was exactly what I could hope at this point. Although I would be slightly disappointed if that was the score I pulled in April, it would be totally acceptable and I am quite certain I'd get the residency I'd want with it. So pretty much, from here on out, it's all gravy.

I love Food

2009-02-24T20:29:00.000-08:00

So, I think it's only fitting during Denver Restaurant Week that I should wax philosophical about my love of all things gastronomical. I love food. And I don't mean in that sad Kashi-esque commercial way (we eat only the most natural ingredients...). No, I've tried my "all natural" "vegetarian" lifestyle, and I say bunk. I LOVE food. I love looking at a recipe for something that (when I'm really honest) I've never even heard of, and deciding, what the hell? And in it goes. More often than not, it's awesome. I love butter. And when I really want a fry up, I love butter WITH olive oil...less smoke that way. Even better, I love my fried fish, chicken, even veg, with a deliciously bitter beer that is dark enough to be opaque and awesome enough to get a double take. I love food. I love beer. I love wine. I love the whole dining experience. I may never be as thin as a supermodel. In fact, I would rather train for a marathon for the rest of my life than give up the foods that I love. I love preparing food and drink and ambiance for friends, family, and anyone else who wants to stumble along. I love reading about food, learning about food, watching other people make food. I love food.

I know that so many people who venture into medicine feel that medicine is the one true love in their lives. I respect that. But I must say that, other than J, food is it for me. I'm not yet sure how to meld my love of food with my love of medicine, and if I can do it to make a buck, be sure that I will. But if not, you can be equally sure that on every day off; every day post-call, I will not be sleeping away on the couch. No sir. I will be raking over the latest cook book I've gotten from the library. I'll be checking out foodgawker.com and tastespotting.com (thanks B.H!) and finding new ways to make these mine. Someday when we have kids, I hope I can pass this one love on and that no matter what we all have going on in our lives, food (and great drink to accompany!) will bring us all together. I just love food.

Tomorrow night we are heading out with my friend LG from med school to sample the wares of Red Door Euro Bistro in Larimer Square. Stay tuned for our delicious adventure. Next week we'll also be headed out with friends to Chef Kevin Taylor's at the Opera House. So much delicious food, so little time. Especially with studying for boards. But as I'm totally tired of blogging, thinking, dreading, obsessing about this, it'll be all about the food for quite some time. And the drink. Did I mention Red Door has a vodka bar full of delicious infused vodka? I will take as many pictures as I can remember. J and I are getting a ride to the light rail, and there are no required classes on Thursday morning, so it should be a great time had by all. As it's also the Top Chef finale, it should be an adventure of epicurious proportions. Have sweet, sour, or savory dreams. I know I will.

And.....breathe

2009-02-23T08:53:00.000-08:00

So, it's been a really long 2 weeks. Four exams, 12 days. It seems like such a trivial thing to be concerned about, I know other people have real problems, but such is the stress of my life. On the one hand it's such a relief to have those over. On the other hand, the exam on Friday, well...that exam!

So Friday was an exam where a standardized patient is assessing our ability to perform a physical exam and take a medical history. That part was not so bad. We knew exactly what exam we'd be performing and pretty much if you aren't completely mute you'll be alright with the history. Then we had to write a SOAP (subjective, objective, assessment, plan) note. This is where the trouble started. I think mine was way too narrative and I really ran short on time toward the end. After the SOAP note we had to give an oral presentation of the patient to a fake attending, also a standardized patient. I felt like my presentation was a bit on the rushed/disorganized side. We won't get our results from that one for about a week I think. Worst case scenario I have to re-write my SOAP note, which might actually be a good thing since we'll have to do these third year, and I feel utterly unprepared. If all goes well then a week from Friday I'll have a review of the assessment with a real doctor to just go over what I did well/need to improve upon.

The exam this morning didn't feel as great as I'd hope. Big surprise. The last 4 exams I've taken have felt like I've done poorly, but they've all turned out alright. Hopefully this one will too. I should find out in a few hours.

Also this week I should get the results of my practice boards exam. I am anxious to find out how I did so I can tailor my studies to do as well as I feel I need to. But I'd rather not find out today. I just feel too stressed out to deal with it today. I think it's just the let down of the exams being over but not having many scores.

I know these are trivial things, but in med school it seems like they take over your whole life. I think I will take the dogs for a nice, long walk and clean the house a bit to destress.

On the plus side, though, it's Denver Restaurant week! Wednesday we're heading to Red Door Euro Bistro with a friend from med school. I'm pretty pumped about it! I will take pictures, so at least there will be a fun post to read rather than all this gloom and doom. I'm sure once I'm organized and get my score things will be on the up and up.

Foodie Stuff

2009-02-18T17:40:00.000-08:00

Well, in honor of Top Chef night, I like to make something a little more labor intensive than our usual fare. Tonight was my attempt at persuading J to like fish. It's funny because he knows he wants to like fish because it's so good for you, but he is convinced it keeps him less full than other food and he just has some sort of aversion to it. So tonight's offering was tilapia. It's a pretty mild fish and doesn't leave the house smelling fishy, so I think it was a winner. The recipe is my own design, so hopefully you'll like it.

First, I made the red pepper sauce. I sliced up about 3 bell peppers, today it happened to be 2 reds and 1 orange, and sauteed them in a little bit of olive oil until they were soft. After they softened up a bit (lot) I took them off the heat, out of the pan and let them cool a while. When they were cool I added them and one seeded chipotle chili in adobo sauce with a bit of olive oil and salt and pepper to taste. I pureed this and let it be until the other components were done.

After I had the sauce done (and J was on his way home), I drizzled a bit of olive oil, kosher salt and ground pepper over the brussel sprouts and threw 'em in a 400 degree oven for about a half hour, till they looked overcooked but were actually carmelized and delicious!

Next came the cauliflower puree. I took one head of cauliflower and cut it up into pieces, then boiled it in milk with salt and pepper and a little bit of garlic powder. It really only took a few minutes for the cauliflower to be fork tender, and then I took the cauliflower out with a slotted spoon and pureed this in the food processor, adding some of the milk it was cooked in to make sure it was smooth.

The fish was the last to go since tilapia cooks pretty quickly. I sauteed it in a little olive oil dressed only with salt and pepper. I sauteed on each side probably for about 4-5 minutes tops. The fish had a nice crust to it, but was flaky when we took a fork to it.

To plate it all up, I laid out a bed of the cauliflower puree, laid the fish on top and dressed it with the red pepper sauce. The brussel sprouts were on the side. It was really tasty, and even J liked it! We had about 10 times as much red pepper sauce as we needed, so this weekend we are going to use it as a spicy pasta sauce with rotini and grilled chicken.

On Valentines Day I tried out my baking skills on an incredibly rich devils food cake. The cake and frosting were so rich I decided to add strawberries for some contrast and it was a good addition. I think it turned out very pretty too!

Oh yeah, and it fed J and I twice, and his entire family. I think I maybe should stick with cupcakes.

Happy Top Chef night!

Holy Crap!

2009-02-18T14:13:00.000-08:00

Wow, so seven weeks eh? Where does the time go? This week is completely ridiculous for me, I had an exam yesterday, another on Friday, and then one on Monday. So, I'm keeping busy. I left the exam yesterday 100% certain I'd done poorly, only to find out that I am a much better guesser (yet again) than I give myself credit for. Luckily, though, when I got home from the exam I was still feeling like a failure, so instead of taking it easy I got all caught up from last week and got organized for this next round of exams. So, for the first time ever, I was not completely worthless after an exam. This is good because I don't really have time for that just yet. That'll come in 7 weeks! Anyone from around D-town who has ideas about what I should do on a Wednesday night after the most grueling exam of my life....please leave a comment! And if you want to accompany me to said locale, even better! The exam starts at 8 and overall we have 8 hours to complete it, including break time. I would like to tell you that I am a very thorough test taker who always takes all the time allotted to make sure I didn't make stupid mistakes, but this is simply not the case. I am an incredibly fast test taker. I am the speed racer of test takers. For better or worse, the longer I stick around in an exam, the more right answers I change to wrong ones. So, I will likely be done a bit early, but not too early. I'm already starting to formulate a plan in my head of how this test taking should go. We have a total of one hour of break time and 7-one-hour sessions of test time. I've never been one to enjoy lunch breaks. During the MCAT it only served to make me anxious for the upcoming sections. I think my strategy will be to take a break, probably about 15 minutes, after ever 2 sections, with a longer break after the 6th section to collect my wits before the final leg. We'll see how it goes.

I've been doing a lot of thinking about OB/GYN yet again. I spent a long time at my preceptor's office today talking about the field, what I think about it, would I want to do it, etc. I'd probably have to change the name of the blog to obstetric medic, but let's not put the cart before the horse. OB is my first clerkship of 3rd year. It's a bummer in some ways, but I actually requested it. I figured I actually know a tiny amount about that field and so I won't look like a complete moron, and at the time I requested it, I didn't have any desire to do it. I don't really think that's true anymore, but it is one of the more dreaded clerkships so it will be good to get it over with I guess. Ultimately when I decided while I was talking with Dr. B was that I will just have to try it out during 3rd year and decide for myself.

Well, I'm off to do some practice questions. I can't completely neglect the boards studying with all these other exams on the horizon. Plus, it's the one thing I can do while I watch Top Chef.

Med Updates and Other Tasty Treats

2009-02-11T06:43:00.000-08:00

So, went to Doc Neuro yesterday to get the scoop on my latest MRI. This MRI didn't take nearly as long; the last one was 2 hours and I couldn't move my head, all the while wearing this:

This time I just had to wear the little face cage of mri gear, so that wasn't so bad. The only bummer is that, since I needed contrast, a doc had to be on the premesis, and she was called away on an emergency right before they gave it to me; so I got an extra 20 minutes of hanging out, again not moving my head. But at least he pulled me out of the machine.

Since I'm a medical student, and have spent a fair amount of time thus far looking at MRI's, I was pretty excited to have a CD of the images to look at on my own. I wanted to see if I could pick out any problems. Imagine my surprise when I saw something that looks like this (not my mri, found on google images):

Now, mine looks more like a well circumscribed circle, but you get the drift. No one likes to see a big lump on one side of their brain. So obviously for two days I was freaking out and googling everything I could think of that might be back there. When we went to Doc Neuro yesterday and he said everything looked great I was totally confused; how does a giant brain tumor look great?! Well, turns out it's something called an arachnoid cyst, and was found only because I had an mri. It won't ever cause any problems, just an "anomaly of development." I always new my head developed abnormally.

Anyway, the rest of the news at the doc was similarly good. It seems that the hand issues my be an adverse reaction to the drug I was prescribed for my optic neuritis. Hopefully within a few days of not taking it, the hands will get much better. The only unfortunate thing is that it appears I may not get my complete vision back in my right eye. I may be stuck with a blue hole in my vision for good. It's a rare but unfortunate complication of optic neuritis. But, other than that, all should be good!

Last weekend we had J's parents over for dinner, so I decided to make some dessert. I made these tasty red velvet cupcakes with cream cheese frosting. They are so delicious!

A Few Pics

2009-02-10T19:15:00.000-08:00

So I did take a few pics of the dogs in the last few months, just not many! Some of my favorites are from New Years, when I tried to give both dogs a celebratory beer. Rocky is pretty used to this tradition. In fact, I give him beer whenever I can find a reason! So he pretty much attacked the bowl and drank it as fast as he could. But when I set the bowl of beer down for Mugs, he freaked out and backed away. He was really scared of the beer! Rocky took it upon himself to rid Mugs of the threat though!

As you can see, I tried to give the Mugs a taste for it, but no dice. He has been giving my beers a sniff a lot, so there is hope. Afterall, we can't have a non-beer lover in this household. Just wouldn't fit in.

Hope all is well!

Wishing for warm climates

2009-02-10T07:14:00.000-08:00

I can't believe that little test is less than two months away! You know what that means...two months from tomorrow I'll be on a plane headed to San Francisco! Wahoo! This morning, to make myself happy, I'm watching all the pictures we took the last time we went. I love to look at these pictures because both J and I looked SO happy. It was probably the best trip we've ever taken together. So, to get excited, motivated and happy I'm watching the pictures and listening to some of my favorite music. And drinking lots of coffee. Over the weekend I spent a lot of time listening to pathology lectures for board review and watching these pictures yet again. I've been so distracted with my health lately that I feel like it's been really helpful to watch this and get my mind focused back on why I'm doing this.

On this trip, rather than take a bus tour up to wine country we are renting a car and spending a night up there. I found a really good "winter" deal at a hotel/brewery and I'm really looking forward to heading up. I think on the way up we'll stop in Sonoma, then hit up the northern wineries via the VINE shuttle system, then the next day on our way down we'll go through Napa. If anyone has been and has some favorite spots, send'em my way!

One of my classmates is every bit as countdown-happy as I am and sent out this link, http://www.timeanddate.com/counters/customcounter.html?month=3&day=13&year=2009&hour=11&min=00&sec=00&p0=75. It counts down the time to the end of our last final. Which happens to be my birthday! Wahoo! It's coming fast, I can hardly wait!

Looking foward to it!

2009-02-05T11:06:00.000-08:00

So, as everyone knows I am so pumped to get to San Francisco after boards. One of the days we are there we are planning to visit the anchor steam brewing company. It's a small, fun microbrew, just like we like'em. The big deal is that their tour is A)free!, and B)so busy you have to make reservations....a month in advance. So today I called 'em up and made reservations for Monday, April 13th! I am so pumped. Our trip is shaping up and it's fun to have a reward for this goal that is so huge!

Also a bonus, today I was able to get out and take a walk with the boys. I've been fairly immobile and tired lately, so getting out of the house and soaking up some Colorado sun was fantastic. It did wonders for my mood and it's gotten me ready to spend the afternoon studying for boards. I know I can do this. I've been pretty distracted, but anything I put my mind to I know I can get there. Just need to get my will power behind it as much as my good intentions!

You know it's bad

2009-02-04T16:39:00.000-08:00

When you turn on House Hunters and you've seen the episode before....wow.

9.1

2009-02-03T06:52:00.000-08:00

Wow, has it been almost a week already? Well, another test is over and I have to say I feel like a crazy good guesser! The test went much better than I initially thought after leaving school and the rest of the day was nice and relaxing. Who schedules an 8am exam after the Superbowl anyway?!

The exam next week is not a real exam for credit. Actually it's a practice USMLE that the school makes us all take. It's supposed to be pretty predictive of your ultimate score, but I can't help but think our scores should actually increase seeing as we still have a lot of time to study. Though that time is slipping away a lot faster than expected!!!

On the home front, lots of exciting stuff. The first is the worst, though. It seems that whatever immune process took it upon itself to attack my eye, has elected to do so to the muscles of my arms/hands as well. So, needless to say, I'm back in the care of my trusted neuro guy and I'll keep you all updated. When I know, you'll know, as they say. It's been a bit more than an annoyance but less than an emergency so while it's stressing me out, I don't want it to stress anyone else out. Rest assured that I am really doing fine, albeit annoyed, and hey, it's the perfect reason to get out of microbiology lab. What could be better!? The thought of all my classmates elbow deep in MRSA while I sit in front of the fireplace reading notes and watching lecture does tend to make me forget any discomfort I might be having.

Less exciting...dentist appointment. Ugh. Yes, I know I've fallen off the floss wagon. I swear I will get back on it...just don't make me bleed!

I'm also super pumped up for Denver Restaurant week! It's Feb 21-27th (or 28th, I forget) and J and I are going with a friend of mine from med school to this cute Euro-bistro in Larimer Square. Double super bonus...they have a crazy cool vodka bar that has tons of different types of infused vodkas. Since my buddy is rustling up a date, the vodka should rid us of that awkward "getting to know you" period! We'll probably just go once, but it's definitely something to look forward to. For those who aren't familiar, Denver Restaurant Week is when a bunch of (usually) expensive restaurants put together special menus, usually 3 courses, for two people for $52.80. I'm really looking forward to it! Extra super bonus..no exam that week!

Valentine's is also coming. Not overly exciting, but who DOESN"T want a heart shaped pizza from Papa Murphy's?

Probably the most exciting thing for me right now, though, is the fact that January is over. I think I may have mentioned how much I hate winter, and even though that little rodent sees his shadow every damn year I can't help but feel relieved when bitterly boring January reaches its end. It feels like spring must be coming soon, even if it really isn't.

Well, I think that's about it for now. Still no pix of the Mugs, I know. I'll get the camera out one of these days so you can all see his cuteness. Hope all is well!

10!

2009-01-28T07:05:00.000-08:00

Wow, 10 weeks from this very moment I'll be sitting down at a computer getting ready for the big event. It seems like time is going extra fast this semester. We had an exam on Monday, so last weekend was totally devoted to that and since then I've not gotten much accomplished. But it's back to it today, for oh so many reasons. First of all, we have yet another exam on Monday. In fact, I worked it out that we have an exam every week until the end of February. Yikes. When we have 2 blocks at a time it seems we all end up playing catch up constantly just to stay on top of things. This block is just a worse version of that since we are all also studying for boards.

I want to add a huge CONGRATULATIONS to the Maiden Metallurgist on her wedding. If you don't already read her blog, or her husband's (!), Berg with Fries, you definitely should. I'm really happy for you Drea!

The bad news in the midst of all the good is that the optic neuritis came back. Everything was back to normal, but as of last Friday, it's back with a vengence. I can't see the color red from that eye and it hurts to move it. I just can hardly believe how often you really move your eyes. But, I will go see my neuro guy next week and if last time was any indication, it won't last forever. Until then, I will be listening to my friendly online pathologist, Goljan, to guide me through the boards.

Well, I better get to school. And by "get to school" I mean fire up the course cast and watch class from the comfort of my couch. The dogs are even bigger fans of this "class recording" system than I am. I promise to get some cute pictures of Mugs and Rock up later this week. Mugs really is at a great size. When J took him running last weekend he was stopped by all sorts of people and one lady in particular was very disappointed that he was going to get bigger than he is. I am too. He is the perfect dog size right now, no offense to the big guy.

Record breaker

2009-01-21T12:08:00.000-08:00

What an awesome day! It's 70 degrees, sunny, and still. It's probably the nicest day I could imagine in Colorado in January. I got up early, went to see Dr. B, my preceptor and got out of there pretty early since he had a slow morning. J and I got a gift card to Whole Foods for Christmas and there was still some money on it, so I headed over after preceptor and picked up some fun stuff for dinner. Once I realized how gorgeous it was outside I knew I had to bring the doggies for a long run. We pretty much got lost in the neighborhood across the street, but it was so nice to get out in the sun and forget all about studying for a while. I don't know why I'm acting like I have nothing to do, but even though I do have lots to do I can't pass up this kind of day in January, particularly when it's going to snow all weekend. Yes, I have an exam on Monday, but I feel like I've kept up with the material and even survived giving my first prostate exam. If that's possibly a reason to celebrate, I'll take it.

There is another plus side to getting all three of us out in the sun...I don't think the dogs are going to make a peep all afternoon. Awesome.

Another thing to celebrate - my mom and sister got plane tickets to come out after my trip to San Francisco in April! Hooray! It's the first time my sister has been out here since she's been 21. This is extra exciting because Colorado is the Napa valley of beer after all. And she's never even been able to partake of my favorite place - Coors lab! Super exciting. Just have to get through that itsy bitsy little test first. With motivation like this I can definitely do it!

History in the Making

2009-01-20T07:47:00.000-08:00

Well, for all my good (?) intentions of keeping buried in books today and not watching the inauguration, there's no way I can let that happen. This is history. I can't actually be in Washington DC today, but I can watch it on television. I've watched every bit of the election season, and remember several points knowing that this was history that I would someday tell my kids about, and I suppose I shouldn't let the culmination of that go without me watching.

Besides, infectious disease is so ewie.

11 and change

2009-01-19T07:29:00.000-08:00

So last week went entirely too quickly. It was a really busy week. Last Monday we had our 2nd year "retreat." It was held on campus, was mandatory, and probably could have been accomplished in 2 hours rather than 6. Once again they got us all nervous about 3rd year, all the forms that need signing the badging and blood work that needs doing. Vaccinations, etc. etc. All the while all any of us can think about is that teensy little exam that stands in the way of us actually becoming 3rd year students. The timing of the whole event seemed pretty bad and overall, all I got out of it was a sense of urgency and a pretty awesome brownie.

That aside, I did manage to get a little excited for third year. It will be so nice to learn by doing again. On the job training has always worked better for me than reading things ad nauseum. I really am looking forward to working with patients. That was the whole point of leaving the PhD program in the first place. I requested to take my OB/GYN clerkship first since that it what I am by far most familiar with, and yet don't really have a desire to go into. A good learning environment, I hope.

Speaking of gyn, last week was my group's turn to "learn" how to do pelvic and prostate exams. The sessions were really well run and I feel like I'm that much more prepared for 3rd year having that out of the way. It helped that I've done loads of pelvic exams already. But I never really understood what "turn your head and cough" meant until last Tuesday.

J has also been training for a marathon. I think this is making all 4 of us more active and that's a good thing. It would be an easy thing to forget about when all I can think about is study, study, study. Last week though, he was taking both dogs with him on a run and R mashed into his leg. His knee is really messed up. We tried to do 5 miles on Saturday but at the 4 mile mark, after he stopped to wait for me, his knee was so tight that we had to walk the rest of the way. I hope there's nothing any more wrong than a little inflammation that will clear on its own.

It's a long weekend for us as we get Martin Luther King Jr. day off. So instead of writing this from class today I am at home. I keep wavering between studying for class or studying for boards. There's these audio lectures that I listen to that would really be best done today since I have no distractions. I'll probably do a bit of both. We do have a micro exam next Monday after all.

Not that anyone is counting, but we only have 37 actual days of class left. Wow.

I hate to waste these next two days slaving over books since it's such a historic time, and it makes me feel inspired. But, I guess that's what the DVR will have to be for. Of course, with all the stuff I want to record and save for after boards, I will be taking a year off instead of starting 3rd year, just to catch up on my shows! Happy Martin Luther King Jr day and Inauguration Day all!!

12.5

2009-01-10T07:33:00.001-08:00

That's how many weeks are left to boards. Yesterday we had our first afternoon review, where our favorite faculty comes to give us review lectures on their respective areas of expertise. To some of us it was scary and made them nervous, but to me, it helped me get into the mood to study. I think that Friday evenings after these reviews will be my time to relax and hang out with J and the dogs. The rest of the week will be busy as will the weekends, but Fridays, they will be for getting ready for the next round.

Other than studying, not a whole lot is new. The eyes are the same, and thankfully I am lucky because everyone has been very helpful in allowing me to continue on with studying while I can't see or drive. They are recording our lectures in class now so I am able to watch class from home within 10 minutes of lecture being over. That is a huge deal for me and it's been very helpful to feel like I'm missing nothing at all, but also not bothering people to drive me around. I hope this goes away soon so things can go back to being completely normal for me (and everyone else) again.

The dogs will certainly be happy when I feel comfortable running again. Mugs has a serious case of cabin fever!

Looking forward

2009-01-07T20:28:00.000-08:00

So, after a whole day of this type of studying I feel a little exhausted and a lot like I need some motivation. This'll work.

And we're off

2009-01-07T07:30:00.000-08:00

So, it begins. What begins you might ask? The last semester of real classroom med school. And the biggest study semester of my life. I've spent the last half hour determining my study schedule for the next two weeks. I hate to go much farther out than that because I want to be able to be fluid and change it. But I wanted to apologize in advance for anything I might miss. There may be events that I would normally be at and enjoy myself at, but this semester things are going to be different. This eye situation isn't helping. It takes me much longer to get through things that are heavy on the sight as they fatigue my eyes a lot. I need to take a lot of breaks. Luckily I still have some lectures to listen to so that is helpful. It's gonna take a lot of discipline, and I'm sorry if it takes (even) longer to get back to you when you call, but know I'm thinking of everyone when I've got my nose stuck in a book. It'll be done before I know it.

It's not to say I don't hope to keep up with the blog, but you know, I wouldn't expect a post a day or anything like that.

One day at a time...

2008, etc. etc.

2009-01-04T07:25:00.001-08:00

So, not that it's the worst year I can recollect, but I'm glad that 2008 is over. Let's review. Some things made me sad. My grandpa died. My sight took it's own private vacation from whence it has yet to return. I had a personal disappointment last spring that was more difficult to recover from than I cared to admit. I didn't go on any vacations.

But a lot of things made me happy. I started blogging, and hence have wasted countless, ridiculous but completely fun hours writing and reading other people's musings. I finished my first year of med school. I TAed in the anatomy lab. I got an offer to write a texbook chapter. I reconnected with some old friends and made some new ones. I got to see my friend through a pregnancy and even got to meet her lovely daughter! I finally figured out how to make decent meatballs. We got the Mugs, though at first, standing outside in my jammies at two in the morning while he peed made me wonder for a while if that was truly a good thing. I've decided it is. So much more happened this year that has decidedly made me smile. Overall, I can't complain too much.

2009 is off to a good start. Since it started, I've planned a vacation, visited the breweries in Fort Collins, and met up with a friend from high school I haven't seen for 9 years. It has been pretty cool. The trip up to Fort Collins was my Christmas present from J. A bunch of us drove up there together and started out with lunch at Panino's. It's a tiny little family joint that is right across a parking lot from my old office at CSU. I love thir food, it's great. Then we headed over to New Belgium. Here I met up with a friend from high school. Crazy to see her since it's been so long. It was nice to catch up and hear what other people from our class are up to. Not to mention, I'm a huge New Belgium beer fan so that was great too. After New Belgium we headed over to Odell. Odell is much smaller, but I think I might like it even better than New Belgium. After Odell we made our last stop at the Fort Collins brewery where they actually had a beer they called the Baconator. Yes, it tasted like liquid bacon. Disconcerting and disgusting. Blech. After we left the Fort behind we came back down to A-town and had a couple of friends over. We all fell asleep watching a movie. We must be getting older because a few years ago we wouldn't have been asleep until the wee hours of the morning.

I am so excited about the vacation we're taking. I needed something to look forward to after boards. I've always been one to bribe myself into doing what I need to get done. I have about 13 and a half weeks to boards (yikes!) and I need to be on top of it. We talked and talked about what we wanted to do and where we wanted to go. But after spending one afternoon last week looking at photos from our last trip to San Francisco, there was only one place I wanted to go. I adore San Francisco. If I could pick up and move to anywhere in the country, and be miraculously able to afford it, it would be San Francisco. I love the chill in the air all the time that makes it feel like fall constantly. I love looking at the ocean and the bay. I love that you can walk two blocks and be in a completely different feeling neighborhood, complete with its own weather. I love sour dough bread, I love clam chowder, I love wine. I love wine. I love wine. I love the hills, I love how green it always is, I love palm trees. I love wine. I love wine country. If I could do any thing in the world it would be to make wine. Unfortunately, that's not really in the cards, so I have to settle for visiting. But I will register religiously for the HGTV dream house in Sonoma. Don't I wish. But it should serve to motivate me for the big exam and get me rested for 3rd year. I can hardly wait.

Updates, etc.

2008-12-28T08:12:00.000-08:00

Hey all, thought I'd write to say thank you all very much for the nice messages, and update the eye situation. The good news is that there were no other spots on the MRI, so I am in the super low risk category for MS. Wahoo! The bad news is the optic neuritis has spread to my other eye. It started when I was just leaving Boston, and for that I'm thankful! I got to see my friend D and her awesome baby girl and for that I am thrilled. I will be posting pictures, etc (but not of the baby, you gotta get those from her!) of the trip later. The pain (I think) is about over. From everything I've read, and those who know me know that's probably been a lot, when the vision starts to go, the pain usually stops. So that's the bummer of the deal. I am significantly more blind than I was a week ago. I've been trying to explain to J what it's like, and the best I can come up with is that I have these spots in both eyes (one per eye) that looks like the imprint you get when you look directly at the sun. Not that anyone's ever done anything like that. When I look at something straight on, it's really not that bad, just feels like I forgot my glasses. But peripherally I don't really see much. So, still not driving. But outside of that inconvenience, it hasn't been so bad since I've been on vacation and all. I've been listening to lectures for board review and that doesn't really require eyeballs, so - so far so good. I have noticed an increase in the times I've knicked my hands in the kitchen, so maybe I can get out of cooking dinner too....Actually that would make me sad so I'll just have to be more careful.

Besides, I made so much food for Christmas we won't actually have to cook for like a week! I took some pictures of the food too, because I'm a nerd like that, but again, I'll post more later. For now I'm feeling lazy, and since it's vacation and I can actually afford to feel like that, I am going to milk it for all it's worth. I hope everyone had a great holiday, or are enjoying thir holiday right now for all my Jewish friends out there. As always, I'd love to see anyone who has some extra time like I do, and as long as I can find a ride, will travel!

Optic Neuritis

2008-12-16T10:18:00.000-08:00

Well, the fun never stops. The past few weeks I've been a hard one to get ahold of, so I thought I'd fill people in on what's been up. Last week I woke up and couldn't really see out of one eye. Bummer. So I got my butt to the doc. They tell us in school that nothing sends a patient in faster than visual changes and they are right. You don't realize how much you truly use your eyes until they aren't so much doing their job. I was amazed at how quickly I got shuttled off to the specialist, and to be honest it freaked me out just a bit. But ultimately they got me figured out and I have something called optic neuritis. Basically my immune system got all pissy at my optic nerve and decided to tear the myelin covering off of it. The good news: 92% of people who get this recover full vision and the pain that is associated with eye movements almost uniformly goes away. The bad news, I can't drive and since it's a problem with the nerve and not the lens, my glasses don't do a thing. So, although it's creating some unique problems with my studying abilities, it could be worse and I don't want anyone to worry.

If you're like me, you're probably already opening google to see what exactly this is all about, so I'm saving you the effort. Before anyone freaks out, there is a risk of multiple sclerosis but it is SMALL and since I really have no other symptoms I think that is not a problem. I had an MRI last week and we're having a follow up appointment today, so it should get figured out soon enough. This is all very treatable, manageable stuff so I appreciate all the thoughts, prayers, juju, whatevs, but everything is fine. I will say, however, that the countdown to boards is looking a little more daunting when I can only see it out of one eye.

But, the good times keep rolling. This weekend I'm off to Boston for my first time ever to see my friend D and her adorable daughter. I'm super excited, even if I have to have one of those golf cart-driver thingies get me to my airport gate. In a strange coincidence my preceptor and favorite doc in the world is actually flying to Boston on the same flight, so I'll have someone else who is afraid to fly to have a cocktail with. Bonus. Plus he should be able to point me in the right direction, at least to my seat.

So, I'll keep you posted and I hope all is well with everyone. Rest assured I am still super excited to see everyone who is coming to town and you can bet this is not going to slow me down too terribly much. I am a Christmas junkie and I would enjoy it with no eyes, hope you all are feeling the same!

Palm trees and cookies

2008-12-04T07:40:00.000-08:00

We stink at taking pictures. I think the only pictures we snapped over the weekend was a few at the airport bar before we got on the plane (I have a slight fear of flying) and one of J, my grandma and I. I'm a little sad that we don't take more pictures more often. I really need to work on that.

I caught some sort of stomach flu in the days since I've been back. It hasn't been the most fun thing ever. I'm catching up on some rest though, and that's been good. Today while I'm working on some school stuff I'm being serenaded by Mugsy's loud snoring! That little puppy is more like an old man. Better than his barking though.

Although I'm not making it into school today, I am slowly starting to feel better. The soup I had for breakfast is staying put, so I think maybe tonight we'll be able to put up the Christmas tree. And the Chanukkah candles. We're funny like that. I love this time of year. We always end up seeing friends we haven't seen in a long time, and even though its hard to believe sometimes, people are just nicer this time of year (unless they are shopping at Walmart in NY). It's always nice when people pleasantly surprise you, and I think that happens during this season more than others.

I'm doing my best to get in the spirit today rather than get bummed out by the weather. The temps are in the low twenties/teens which totally grosses me out, especially when I have to take the little goob out about 10 times a day. So, I picked a good movie that definitely does not gross me out to watch and decided to make some cookies. But, I'm not jumping into Christmas with both feet, the movie is set in southern California (Tortilla Soup) and I'm just making oatmeal raisin cookies. I'm not going to the store in this ridiculous weather to get the stuff for mexican wedding cookies no matter how much I want them, and while some people have dreams of white Christmases, I think I'd take palm trees from time to time. So maybe it's just what I need.

100!!!!!

2008-11-25T19:26:00.000-08:00

Well, Happy Early Thanksgiving!!! And happy 100th blog post to me! For a while there I didn't think I'd ever keep it up this long, but I'm glad I have.

Well, I don't have any cool pix today, but we are heading out to the great white north on Thursday and we'll be sure to bring the camera with us. Hopefully we'll have some pictures of our adventures.

I am also super excited that in a few weeks I'm heading east to see my friend D and her adorable little daughter! It's going to be great. I"ve never seen Boston and I have never seen her daughter (in person of course) and so I can hardly wait! Most of all I'm just excited to see D. She's the one friend I've met throughout the years that is always just a phone call away and always, always keeps in touch. She's so much better at that than me! (Thanks for always calling D!)

Tomorrow morning, though, I have my last excursion into biochemistry (until the weeks before the boards) so good riddance to that. I am pretty worried about that test, there's waaaaaaaaaay too many lysosomal storage diseases. I have a chart that's 9 pages. Ouch. The really great part of this test, though, is that there's loads of stuff about obesity. We had 4 lectures yesterday and 3 today on obesity. Yes, this is a big problem that needs our attention. Does it need my attention the week of Thanksgiving? I think not.

Well, I better get back to it. Less than 12 hours from now and I will be in the thick of it, better shove as much into my little head that I can!

(I already have a bucket of fun getting ready for me in the freezer for after the exam. I am always prepared.)

Things

2008-11-22T11:55:00.000-08:00

So I've had some time to think lately and that's gotten me nowhere with school, but it's let me put some things in perspective.

First, I've decided that people hold onto their angst with every bit the tenacity they hold on to their dreams and hopes. Even though things might not be as bad as they make them out to be, very few people want to be told otherwise. They'd rather have the angst to keep them company than to give it up and look at the flip side of the coin all by their lonesome. I find a lot of my classmates in this position right now. We are an angry group. Overall, at the end of the day we are all angry because we have to work hard to end up as doctors, really not such a bad thing. But don't tell anyone that...

I've also been spending more time working on my project with my old boss JW. We do a lot of waxing philosophical about what it takes to really reach students these days. Why can't students see how intrinsically cool this stuff is and let that be their motivation to soak it all up? We go around and around about it, and what I've decided is that the longer you're a student, the more bitter you get about being taught. Likewise, the longer you're a teacher, the more cynical you get about the mental capacity of those you are teaching. I feel kind of lucky that I get to see these things from opposing perspectives. Now if I can just temper my bitterness with cynicism...wait, that might not be the greatest combination... But in all seriousness, I think if I can remember how great it was to see students who were truly interested in the material for the sake of just being interested, it might help take the edge off that stuff that just doesn't seem too "clinically relevant."

Speaking of working with my old boss, I have some exciting news! He's asked me to not only edit the figures in his electronic text book, but write a chapter. That's right friends, LG is gonna get published. I'm super excited. Did I mention its the reproduction chapter? Yep, Birds and the Bees by LG. Cool. I'm excited to do it because I think the hormones involved are really quite cool and I took a fair amount of graduate course work on the subject, so it's definitely something to look forward to!

And in news of looking forward, I completed my registration for the Untied States Medical Liscensure Exam (aka Step 1 of the boards). Yikes. The countdown begins. April 8th. Lots of beer that night. You're all invited. Yes, it's a Wednesday, yes, you still need to come. But in the event you can't make it, I think we'll be trying to get some sort of party together that following weekend so long as we're not out of town on vacay. Something to keep in mind.

Last night we got to see some friends from the college days when one of my college friends was celebrating the receipt of her MBA! Congratulations KV! It was good to see everyone again, I'm glad we made it. And in honor of KV and her husband C:

SuperMugs says hi.

Slacker...

2008-11-17T13:31:00.001-08:00

Well, I've been slacking. There's no doubt about it. Although I have had 2 exams since I last checked in, so I've been at least a bit productive. We also had Halloween. J and I just stayed in, but it was a nice night and to get in the spirit I dressed up the dogs! - Before you ask, no I didn't go out and buy them costumes, I'm not that kind of girl -

Unfortunately, them being boy dogs and all, everytime they have to go out the costumes have to come off. Oh well.

Mugs and I have been bonding lots lately. He's a cuddler. Still drives me completely insane when I want to study in the afternoon, but he's pretty cute. He likes to crawl up into my lap and make himself comfortable.

Last week we had a little excitement as J got his windshield smashed by some sort of unidentified flying object on his way to work. We ended up both staying home last Thursday after it happened, he was fine and the rest of the car was fine, but we had a good day anyway.

The next morning I had an exam which was good, then we got to spend a whole weekend hanging out together without any (well much) studying from me. This week is really busy with school stuff, and it will undoubtedly fly right by, then next week we're off to the Great White North for Thanksgiving. To all those already up there, wanna get sick? It's 70 degrees and sunny today....

Personal day

2008-10-27T09:35:00.000-07:00

So, sadly I overslept so much today that I actually had already missed the first hour and a half of lecture by the time I rolled out of bed. I blame benadryl. I had an allergy attack last night and had to take some, but I guess I need to start actually measuring the dose of the kiddie benadryl, because this whole gulp and hope it's right approach didn't work out so well. Alas, it's nice to take a personal day! The dogs are sound asleep, I'm working on some school stuff and catching up on some blog reading. Also, I have the TV on. Not great for productivity, but I saw the most entertaining thing. There was a commercial for 7news where all they did was show a video of people riding up the ski slopes on the lift and in the bottom corner they had a countdown; 30 second break from political ads. I thought that was pretty clever. Not to mention appreciated. Seriously, my ballot is already in the mail. I'm over it.

Throughout the last week J and I have been catching up on our netflix movies, which we had been very behind on lately. The reason for that is the fact that we had Atonement. I was underwhelmed. I knew it would be a sad movie, but there are lots of sad movies that are so good you can't help but like them. This one was not in that category. We powered through it, but I don't think either of us were blown away. The great one, though, was Run, Fatboy, Run. I love Simon Pegg. He's fantastic, and really funny. This was not a letdown at all. In fact, we don't buy a lot of movies, but this one might just have that much potential. And if you're looking for even more Simon Pegg goodness, check out Hot Fuzz. Also fantastic. Of course, I'm in love with all things British, so I may be biased.

I'm completely in denial that it's already almost November. I love the fall, and I despise, loathe, abhor, the winter. The good news, we're flying back to the great white north to see the fam for Thanksgiving, the bad news, it's still winter. Gross. Oh well. The Thanksgiving trip will be great. I'm excited to see everyone and get out of town for a little while. It's always good to shake things up. I love it here, but I've been itching to go out of town for a while now. Luckily, I also have a trip planned in December to visit a good friend from college, so I have some fun sprinkled in among the drudgery of med school, and yeah, right now that's pretty much what it is.

Well, I better get some work done, but hopefully I'll be updating more often these days. I really need to take some more pictures of the little guy before he's no longer little!

Thinking Positive

2008-10-21T11:43:00.000-07:00

So, yesterday I had a bit of a funk going on about med school and how it has taken over my life. In a way, it has. I can't relax without thinking about studying, I can't look at people without thinking about what they might have wrong with them, and I can't help but think, with almost everything I do...how will this help me get a better residency. All ridiculous for the most part. So, I took the little monster dog for a 4 mile run to think things through. I think I will never need antidepressants so long as my knees hold out for running. And I also think that not working out is tantamount to going off my meds.

The run worked, I calmed down and actually got some studying done. Furthermore, I got an email from my old mentor at CSU today. Last week, as I neared the very end of my fraying rope, I contemplated the idea of taking a year off after boards to do research. I am actually not all that into research. I did, afterall, quit a PhD program because it isn't what I can imagine myself doing in the long run. So, although I'm not overly excited about research, I thought by taking a year off to work for my mentor up at the Fort would do me good, recharge the batts and of course...look good for residency. In his email today he said he'd love to have me in the lab, but that it's just not a really productive lab these days. He does a lot of teaching, and that takes most of his time. I kind of expected as much, but I had hoped. But, rather than leave me hanging, he offered me work on a project editing the impending publication of an e-book of his physiology lessons. It's something I could work on from home, and I'm pretty sure I could wrap up this whole mentored scholarly activity quite nicely in this project. Which means I could get it done before 4th year, which means that 20 weeks of vacation time is looking like a real possibility. All good things...very good things. And best of all, it's an MSA to do with teaching. Since I really am holding out hope that a large amount of my career can be wrapped up with teaching, this is a step in the right direction. Did I mention I'd get paid...

Overall, I think I need to remember a couple of things...noncompliance is bad, and just like I don't want my patients off their meds, I don't want me off running. Also, thinking positively really can help. It's better than feeling so stressed that I can't even concentrate, which is where I was last week. And last, but not least, always keep in touch with those people who have meant a lot to you. Keeping in touch with my mentor not only always makes my day, but often times, good things will follow.

I'm back

2008-10-16T14:34:00.000-07:00

Well, we're in a new block, and I'm sad to report I completely neglected to take any pictures last weekend. But, Beer Fest was the greatest! We had such a great time, and it was exactly what I needed after that brutal neuro final on Friday (good thing for that cushion...). We tried some good beers, and some really bad beers, but my favorite discovery of the day was that there is a microbrewery less than 2 miles from my house. Awesome. Even better, they did not have the bad beer. So, I'm definitely looking forward to paying a visit. Check out the website at www.drydockbrewing.com. Turns out next weekend is their 3rd anniversary party. Sounds like a good time to me!

So this week has mostly been about getting into the swing of a new block. Harder than it should be I think. I just want to have a good time this year while I can, since we had a class meeting about 3rd year that convinced me life as I know it is about to end. It's hard to make yourself work so hard in the face of all that. But, I'm going to have to get it done somehow. That and studying for the boards. Yuk.

It was a great day today though. Lecture was so-so at best, but I finally got some stuff off in the mail (which I've been meaning to do for way too long!) so I feel like I at least accomplished a little bit. And then I got to talk to my friend DO for a long time, for the first time in a long time. So, I have to say that, you know other than waiting for the Comcast guy for what is now 4(!) hours, it's been a good day. Now if only our house phone was working...

One more day

2008-10-09T07:43:00.001-07:00

Well, I am sad to see it go, but neuro will be over tomorrow. It's a lot of work, this class, but it's been by far the best run block of med school and I've learned more in this block than any of the others. This is a big deal to me because I've already taken 2 years of this stuff, but I still learned more than I have in any other block. So, it's not been easy, but it's really been worth it.

Tomorrow morning is our final exam, and I pretty much have to fail it to miss the mark I'm shooting for. I won't let that happen, but it takes a lot of pressure off for today to allow for some daydreams about....

Beer Fest!

That's right, the Great American Beer Festival is tomorrow (well it starts tonight, but it's tomorrow for me!). I am so excited. Tomorrow after the exam, as I had planned, I will be making pretzel necklaces and watching Beer Fest the movie! I also have plans to go for a (long) run...we'll say that tomorrow I'm doing a bit of carbo loading.... And I plan on stopping for a (hopefully) celebratory lunch at the brand new Sunshine Market that's opening up by us. I'm really excited for that place. So, it should be a busy day. After the necklaces are made and I"m all set to go, I'm meeting J and his sister at their parents' house and we're leaving from there. I think we're all going to stay downtown with J's sister's boyfriend. It'll be nice to not have to pay for the light rail or have to worry about who will pick us up. We're going to meet some of my college friends and med school friends at the fest, and I'm so excited to see everyone out in celebratory mode! It should be awesome.

Well, just to make sure I don't fail this exam, I suppose I should get to it. The school has kindly given us this one day off for preparing for the final, so big of them. So I better take advantage of it. Can't guarantee another post for a little while, big weekend plans you know!

Hurray!

2008-09-29T20:01:00.000-07:00

For...

Exams that go well...

4 year old birthday parties....

Macaroni and cheese....

That color that white wine turns in the dusky sun in the fall....

Puppies that are afraid of the shower and hair dryer....

Hair cuts....

Running into a random acquaintance from high school 9 years and 1,000 miles away....

Running into old friends again....

Meeting new people and watching people come together to change their lives....

Running tights....

All the things you can learn about yourself from your patients....

Today!