evals and f$&@ RSV!!!

so i believe i have caught a delightful case of RSV...it is the season, after all. first it started off as the "feeling of impending doom", and then a slight sore throat, then after all sorts of halloween party exposures over the weekend, the doo-doo hit the fan and BAM i was sick. i was on call sunday and you know you're sick when every time you sit down you fall asleep if not otherwise occupied with important M3-like duties. today is better...i have more energy, but the sickness has evolved into the more classic upper respiratory gunky sinus one nostril is plugged at any given time phase. i am also sneezing. and coughing. i live for those brief moments where BOTH nares are PATENT! yes. also, it sucks to have to climb up and down stairs...the children's hospital elevators are the major suck so it's quicker to just climb 4-5 flights of stairs than wait. so i've been getting my gym on at school. this is also my last week of wards, and i'm kind of excited. because that means moving on to clinic. which means no more wards. which means no CALL. which means i am happy.

peds so far has been a double edged sword in a way...i enjoy being with the kids, i really do. i like the babies, even if they make me sick. however, it really saddens me to see the abused kids, and the ex-preemies who are now trach'ed and feeding tubed and whatnot living out some sort of strange existence. i know, these kids are someone's child and they are loved and have their purpose in this world, but at the same time, on some level it just seems almost wrong. i don't want to start an ideological/philosophical war, because i have never had children or suffered through horrible chronic diseases, etc, but it just seems wrong to try and "beat nature" or surpass "God's will" and prolong life when it seems that the most humane thing would just be to let nature take its course. i have had a couple of ex-preemie kids (like extreme preemie...like 23 weekers) who have such severe neurological devastation (so they are functional vegetables), they have a tracheostomy (so they breathe through a tube, most of the time there is oxygen being pumped into the tube as well), they have feeding tubes (so they are fed through a tube that goes into their stomach or intestines)...it just really makes me sad. these folks are in and out of hospitals for seizures, pneumonias, you name it. i have no idea what that family has gone through, or the decisions they have had to make, but i can't help and think that for me and my future family, i don't know if i'd want to "do everything possible to make life happen" if i happened to deliver a child at extreme prematurity. call me selfish, but i just don't see how that is humane to that child to keep them living when there is really nothing to live for. maybe they do have hopes and dreams, but it's hard to imagine that they do when they can't even interact with the world around them.

just some thoughts i've been having on that topic.

it's kind of hard to not wrestle with those tough topics when you see the patients every day. are we really doing good? for example...kid has some crazy something going on. they can't feed by mouth for whatever reason. ok, well, they need to eat. how will they eat? let's stick in a feeding tube. that tube goes in through the abdominal wall into the stomach. uh oh...now the hole in which the tube is inserted is leaking. oh, it's leaking stomach acid. now there's a ginormous hole in the abdominal wall and all the skin around it is disintegrating because of the acid. how do we fix it? also, how does the kid get nutrition? we got to stick more holes in the body to get to a vein to give some IV fluid nutrition, but that doesn't help out too much in the long run. then all those veins get clogged, and now you have clots that are threatening to go into the heart and lungs and cause some major damage. and you still have the ginormous acid hole in the abdomen...

another example...a kid who is deaf and blind and has a whole host of other neurological problems. why is the kid that way? mom had some sort of infection while she was pregnant, and the infection crossed over the placenta into the baby and now the kid is just a living vegetable. i guess the kid only knows if people are there because of touch. what kind of existence is that? no speaking capacity, can't even move, or see or hear...it's just tough to wrestle in my mind sometimes...

ok, let's move on to something else.

i just checked out my last set of evals from ob/gyn, and i got the nicest, most uplifting evaluations from that rotation. things that said "would make a great house officer" (a.k.a. kickass resident). "above average student". "worked well with others". "hard worker". i guess it's just wonderful and incredibly validating to do your best and for your work to be acknowledged by others in a positive way. when i read some of those comments, it really gave me a good self-esteem boost, because i sure feel like i'm dragging now, and surgery is yet to be done! and i know i'm not the smartest person...i certainly get a lot of questions wrong, which sucks, and i don't know what's supposed to happen next 99% of the time, but at least i'm learning from my mistakes and people recognize that i'm a good worker. that makes me feel good about myself, and sometimes that is hard to come by when everyday in medical school is just another reminder of what you're doing wrong and of how much you just don't know and need to learn. i know, what a fatalistic way to approach life, but that's kind of how it is nowadays.

ok, i think having RSV is making me a bit too philosophical. and it's time to make dinner, which will be pancakes, eggs, and sausage because dammit, breakfast for dinner is awesome!

h1n1!!!

i got my h1n1 vaccine today, and my arm isn't hurting at all! when i got my seasonal flu shot earlier this year, my arm hurt like hell. this time, no pain. though i do feel tired, but that could also be due to lack of sleep and 2 glasses of wine...

go get your H1N1 vaccine if you can!

tonight was the ob/gyn interest group "mixer"...it was really nice to see all the residents again! it just made me feel all excited again about ob...hopefully this christmas break i'll get a chance to go and play on L&D some.

today was a bit hectic as far as patients were concerned...had to pick up 3 without even having seen them while they were being admitted, and then told i had to pick up another. that's ok, more work is alright by me, but it was just a tiny bit hectic. i was glad to go home for sure. tomorrow should be better since we won't be post call, and i get to wear my cat ears for halloween fun! woo!

ok, early bedtime for me tonight. bye!

a milestone

i can now say without a doubt that i have finally watched FOREST GUMP the movie!

and it was a darn good one too! why did i wait all these years? haha...

i am now in my 3rd week of wards...it's going alright. i'll be glad when wards is over...i'm on call tomorrow. i plan on waking up a bit early to make some banana muffins for the team. or moreso for me, ha.

there's an ob/gyn party on thursday that i'm going to. i'm going to do my best to not force myself down one specialty path, but to compare and contrast several. when i applied to college i only applied to one place, and sometimes i wonder what life would have been like if i had applied to several places. so for my future career, i'm thinking of different things. i may end up with peds anyway...the kids are fun! i just kind of am just "blah" about wards. maybe it will be better next year when i do it as a sub-intern...that way i have more duties and more work which makes time pass by so much faster than just sitting on your butt for hours...alas. another story for another day.

i gots to sleep. chao!

update needed, i suppose

so i've been on peds for a week. i've had some good moments and some blah moments. is it everything i've hoped for and then some? eh. i've still got 5 weeks left to go. i do enjoy being with the kids, but it seems like all my patients have been BABIES, like 2 wk old babies. while i do enjoy a good baby, well, they aren't too exciting. i've certainly had some interesting diagnosis, like pyloric stenosis, labial abscess, suspected child abuse resulting in significant brain damage, rsv (like a really bad flu), and UTI in tiny babies. i haven't gotten sick yet, but i'm pretty sure that this week i might get a virus because one of my patients wasn't on contact isolation, but then all of a sudden was (the rsv baby), and of course i was all up in his business and so it's just a matter of time. as far as hours, it's not so bad.

it's just hard to think about IS THIS GOING TO BE THE THING I DO FOREVER AND EVER? i just get anxious i guess. i really liked ob/gyn, but all i can think about now is the female domination (leads to cattiness, i guess, and i'm not so much of a girly girl), the really long hours, the high insurance, etc, etc. and now i'm like, peds? it's only been a week, and it's alright, but i can't judge the entirety of peds just on one week of being on the wards. i still have my clinic week to do. and i like the kids, i really do. i guess i just hate wards? or rounding? blah! haha...i'm just so anxious about it all. just don't want to make a mistake or something. WITH MY LIFE. aak. the pressure, alas.

yesterday H and i had a really nice bike ride at a local park. my butt is still sore, but it was super fun to ride through the mud and the trees and whatnot. i really need to invest in a helmet...almost had a few close calls with some puddles. tonight i'm going to make a curried pumpkin soup. i'm super excited. i've really been into winter squashes lately for some reason...i guess it's because roasting is fun and especially ROASTED PUMPKIN SEEDS! those are the bomb.com. for serious.

i guess it's time to go to the store to get ingredients for dinner, and then i needs to study. got a small group tomorrow i gotta prepare for, and to write my H&P. boo that. and then i think i have a test on friday? better check up on that!

taste test

so today during our peds orientation we got to taste some of the medicines that are prescribed to the kiddos while they are sick with various diseases. some of the medicines were tasty enough, evoking banana, bubble gum, and cherry. however, some of them i wanted to just hurl afterwards...ferrous sulfate anyone? or clinda? prednisolone? YUCK. disgusting, but very important exercise to understand how hard it is to get kids to take their medicines.

today was light...just got oriented and assigned a patient to see in the morning, so the real stuff starts tomorrow. and i'm on call tomorrow. fun times!

now i need to get ready to go to an alumni event at a local swanky restaurant. don't tell anyone, but i'm just going for the free food, but i guess it would be nice to mingle with fellow engineers, even though i'm not an engineer anymore. who cares. free food is always good enough to get me somewhere.

golden weekend

this weekend is the glorious weekend-in-between-rotations...that means no responsibilities, no studying, no NOTHING! oh how it makes me happy. friday i went out for sushi with some friends, yesterday i slept in till like 10:00 am, laid around and watched tv, ate some dinner and gymmed, played in target, and today i slept in AGAIN till 10...so far i've just straightened up my apartment a bit, washed dishes. and now i'm just laying around. ha. i've also been brainstorming a halloween costume idea...my school puts on a huge party and i really want to "go all out" as they say.

the last week on gyn onc wasn't so bad. i had the privilege of taking care of a 14 year old girl for a few days post-op from an ovarian mass removal. unfortunately she is going to have to have some chemo, but her prognosis is actually very good. i just really enjoy working for the teens, i really do. it's kind of fun to be like, ok, have you tooted today? pooped? THESE ARE IMPORTANT QUESTIONS!!! THE ONLY TIME IN YOUR LIFE THAT EVERYONE WANTS TO KNOW ABOUT YOUR POOP! and i say it dramatically, ha, and everyone laughs. and when she finally pooped i did a mini-happy dance and all was well. i found out later that the family told the resident that they really liked me, and that made my day. i wonder if i'll see her in the cancer clinic in the peds hospital...

the last surgery was so crazy. a lady came in looking like she was full term pregnant, but turns out she was only 14 weeks or so. she shouldn't have really been showing anything at that point. took her back for surgery assuming we would take out her ovarian mass that the radiologist said was on the ct scan. turns out, ovaries were fine. she just really had a liver mass! liver what? check the scan, and then, plain as day, a huge liver mass was very apparent. lesson learned? check the scan YOURSELF before doing the surgery! don't just rely on the report! so we had to get the transplant folks in to remove the liver mass which turned out to be benign. us M3s got to run up and down the various ORs in the different hospitals transporting the various equipment...we got a lot of interested looks and i was like YES WE ARE IMPORTANT AND OUT OF THE WAY. hopefully the lady will be just fine and the baby too.

so with this, i'm going to try and not opine too much on how i loved the ob/gyns. i will say that i've gotten some great feedback so far on my evaluations and that is very encouraging to me. i'll definitely have to make some time to come back and hang out on the L&D suite. but now i got to look forward to peds! woo! i already got some stickers so can bribe the little ones...monster stickers. i mean, how cool is that! i just hope i don't get chronically sick. i got enough health issues going on, i don't need anymore.

so the rest of today, i plan on going grocery shopping. i was thinking about making some bread, but also thinking of baking a veggie torte or something with some puff pastry if i can find it at the store. and i'll probably watch a lot of tv, just because i can. i already did laundry, and finally hung all my skirts that i haven't had hangers for. i could try and mend the sole of one of my shoes. i should also try and sort through my clothes, but eh, i'm too lazy. i'll save that for later.

interesting week

last week i was on benign gynecology. spent a few days in clinic, few days in surgery. got to assist in 2 abdominal hysterectomies. also, my car wouldn't start one morning...turns out a cell in my battery had died. luckily a classmate on his way in to the hospital just happened to be driving by my street when i called, so no harm there. got that fixed easily. H went off to boston for a week and some change, so i'm taking the opportunity to just clean up my apartment (kitchen specifically) and STUDY for my ob/gyn board on friday. then i'll start peds...and my mind is just so conflicted. i know that i'm going to miss all the surgery...there's nothing like seeing inside the human body. it's such a privilege and a crazy thing and such responsibility all at the same time. there's all kinds of crazy sounds...the bovie as it burns and cauterizes blood vessels and cuts through tissue, the suction of the vacuum sucker, snips of the scissors, the music (sometimes) in the background. i really enjoy the process of it all...the scrubbing, the gowning, the way everyone interacts in the OR to take care of the patient. all defined roles. i just think it's pretty cool.

you know what's crazy? there was a PIG meeting last week and *gasp* i didn't go to it! i forgot all about it, and was stuck in surgery anyway, and the kicker? i didn't care that i missed it. i wonder what that is saying about my love for peds...is it dwindling? is the ob/gyn love greater? i also happened to look up pediatric/adolescent fellowships for ob/gyn...they're not completely "official", but some programs offer 2-3 years of extra training in various areas. maybe i can pair my 2 interests together after all...but we'll see. i'm so glad peds is next in my rotation schedule. i'll really be able to compare/contrast the 2, because i really feel that's what it's going to come down to in the end.

this morning i finally got a haircut. i sheepishly told my hair stylist that when i was bored at school i would play with my split ends, so it's been time for a long time to get a cut. he just gave me one of those "alas" looks, and laughed. i love my hair guy...i don't know what i'm going to do once it's time to move on to a new locale. bring him with me? so now my hair is just a touch shorter, but still long and luscious...ha! i also went down to the ann taylor loft and they were having a sale...i got a gray skirt and a khaki skirt (and i've been needing a good khaki skirt to round out my colors of skirts!) and some brown capri pants. i probably shouldn't have spent money, but everything was on super sale, so i didn't spend too much. plus i got basics that i've been wanting, and the only thing left on my list of "i want" are some black pumps that are FUN but also comfy, but i'm not too much in a hurry about that. one thing i want to get into this fall/winter is wearing tights under skirts...i hate wearing pants, but it's a necessary evil. i want to be stylish like my friend Seriously Silly...she always wears fun tights with skirts and dresses in a way that i want to.

for this afternoon, i figure i'll go to the mega-beauty store and look at the hairbrushes...i've been wanting a new one for a while. maybe i'll pop into the shoe store next door, but i'll end up at the bookstore so i can get a fancy coffee drink, read some magazines, and study my blueprints questions. the weather is just so nice, i love fall! then i'll go grocery shopping for just a few things and come on home. it's a "me day" today, and i'm thankful for it. next week i start gyn oncology, which i hear is a toughie, so taking some time off for myself before a hard week + hard exam is always welcome.

la la la

sorry folks, i've been a bit lazy. that's what REI does to a student...not so many patients, not so many surgeries...more time to just catch the ol' breath.

so far so good, we had adolescent gyn clinic on tuesday. that was really cool to get to see some of the kids and teens. what was sad was seeing little girls with genital warts. "her cousin got the same warts from taking a bath and sharing the wash towel with her daddy!" newsflash: you do not get warts from sharing baths. you do not get warts from using the same wash towel. shady. this patient though probably got it from her mom via the birth canal during her vaginal delivery. sadness.

today we saw a lady in clinic and her BP just happened to be over 200 systolic. yeah. that's bad. hypertensive urgency. no symptoms, thankfully. so we told her to go to the ER immediately after her appointment was over. she appropriately started to freak out a little, but we assured her that this was just urgent, she's not having symptoms, but she needs to get it fixed. i spent some extra time with her just telling her that she is allowed to have a visitor and that it would be fun to talk about the strange folks bumming around the ER, which made her laugh a little. and then i told her that she had a great personality and attitude and that she was going to be able to conquer her high blood pressure and control her weight. she was already aware of her problems, which is the first step. i really do hope she does well, and i actually feel like she is going to do well.

so yeah, at this point, i really feel like i may end up doing ob/gyn as a career. i know, completely different than peds, but i have REALLY enjoyed myself. i really like hearing about all the different women issues, and i like the idea of being able to be there for fellow women and help them out through their hard times. also, i can still see the peds patients because they got their own issues going on, and you don't have to do a fellowship to be a pediatric gynecologist. it's just a niche field. well, peds is the next rotation, so i feel like by christmas i may have my career choice already settled. i don't see myself doing surgery, family med, or psych. and none of the other fancy specialties (rads, derm, etc) appeal to me. so now it's between peds and ob/gyn. how about that.

it's funny how people change. i may even change my mind again. HA.

end of shift

no more night shift for me...finished with a nice shift. last night i assisted in a c-section, watched an epidural, put in a foley cath, and checked a cervix. plus the writing of a ton of notes. and then rounded on patients in the morning. i got the lovely task of taking of bandages...ripping tape off of people's skin at 5 am is probably not the best idea of the day. i definitely had some angry people at me, and i tried my best to just be gentle and to take breaks and let the patient tell me when they're ready to keep going. alas. i was going to take some staples out of a lady but she was wigging out on me so bad that i didn't even want to go there. the resident said i did the right thing, evidently that person had some documented "issues" so i'm glad i didn't go ahead and attempt the staples.

the saddest part about L&D is seeing the very young girls having babies. well, not all the young girls make me sad. just one in particular...this girl was 14, got pregnant at 13, and had suffered all kinds of abuses which are currently manifesting as a bazillion different psych disorders. (and if i had to go through what she did, i would have some major issues too. all of us.) the worst part about her situation was that her home life was just atrocious. the mom of the girl was all kinds of weird and an enabler of some of the abuse, and it just made me so sad to think that this girl and now this girl's baby probably will have zero chance in the world. ok, maybe not zero, but definitely a very slim chance of getting out of all the craziness and getting a decent shot. just sad. when i checked up on her this morning i made sure to tell her that she did a wonderful job during her delivery and that she should be proud of her beautiful baby, because who knows if the mom said anything. i instructed her to make sure that if she was ever hurting, to ask for pain medicine because the nurses don't just automatically give you some, you have to ask. when she said that she was going to try and breastfeed and use bottles for backup, i said that was a terrific plan and that i was glad that she was going to try breastfeeding, since it is best for baby. and then i left the room and she actually waved goodbye to me (she hadn't been doing that at all before). such a sad situation...wish i could have done more, but i did what i could.

so now i am regulating my body back to normal sleeping...today when i got home i slept until 2 or so and then woke up. hopefully i will go to sleep at a normal time tonight and be adjusted back without any problems.

next 3 weeks are going to be just gyn. i start off on REI, which is reproductive endocrinology and infertility. i think that is just going to be super fun. i know i'll miss the babies, but it's good to learn about everything, and since they force us to i don't really have a choice...ha. i hope i enjoy gyn though overall...i hear a lot of people love the ob part and then hate the gyn. i'm going to have to really jump in and try to experience all i can because if ob/gyn is what i want to do as a career, i got 3 more weeks to really "see it all" in a way. but then again, if i really hate it, well, alas. then peds is the next rotation. it's going to be so hard to decide, or maybe it will be super easy. i really do feel that if i did go into ob/gyn, then i would probably focus my practice on the adolescents. for some reason most of the patients i followed on L&D were the 14-20 range, and i really liked interacting with them. and i have thought about going into adolescent medicine before, so maybe that would be a possibility for me.

ha, and watch in 6 months or so that everything that i've ever thought about "what am i going to do with my life" just go out the window. i can always go to culinary school, right?

night shift

is not so bad. i feel like i've adjusted pretty well without too much trouble. the only problem is night shift is WHERE ARE ALL THE PREGNANT LADIES!? ha, for the last 2 nights there just have been not many pregnant womens! where they at? hopefully tonight will be bumping...i haven't had any opportunities to scrub in on a c-section or really assist with a delivery...and i'm getting antsy!

also, last night i was following a spanish speaking patient, her english was so limited that i had to break out my broken spanish to talk with her. i kept screwing up of course, and didn't know all the words, but managed to get through what needed to be asked. her family was really appreciative i think because i tried. and the husband knew more english and helped to translate once he got the gist of what i was asking. and we can get into all the arguments of "the foreigners in the US should learn english"...i 100% agree with that assessment. if you are here, learn some english! at least try! my family moved over here from korea and learned some english real fast...i go to visit foreign countries and i practice my phrases because i don't expect them to cater to me. but alas...it is the here and now, no use making people feel bad when they need help, and i'm so glad that i was able to build rapport with that patient. it just strengthened my desire to become working-fluent in spanish anyways. and she had a super cute baby! ha, and during the delivery she kept yelling DIOS MIO!!! love it! no translation needed there...

last night i got to check a cervix and i finally could appreciate the dilation and effacement...and i was accurate with my check! 6 centimeters! and felt baby head! very cool indeed. and i took out some staples from a c-section wound. taking out staples is fun!

so now i'm eating some granola and about to start reviewing a case to go over tonight. hopefully the ladies be all trying to deliver or something...i'm going to be really sad when L&D is over!