Friday, March 26, 2010

2 months left!!!

i can now say 2 months left in rotation time for M3 year! woo!

i finished up my fam med in my hometown...now just have 2 weeks left, and 1 of those weeks is at the hospital i used to work in the cath lab at. i'm just glad to not have to be driving so much anymore, and i have today mostly off because my preceptor took today off in his clinic. but he's still doing botox at 10 so i'll meet him up to do that. luckily the place is right down the road from me, so not to much driving needed.

i'm tired of being asked my opinion on health care. i really don't care at this point...all i'm focused on is 1) graduating and 2) getting into a residency without having to scramble. honestly. but if you really want to know, 1) yes, i agree that something needed to be done, 2) i would have rather seen reform happen slowly and gradually, and 3) had much more information given out during the debate/decision process. i understand what some of the "big things" are in the bill, but as far as truly understanding all the little things, eh, not so much. big fan of the "no pre-existing conditions can deny you insurance" or something like that. you never know what will happen to you as you age, so that's a comfort to know that you can get something to help your costs. but i'll just leave these thoughts as is...i'm just tired of being asked about it.

a doctor the other day was telling me i needed to drop out of med school because "YOU HAVE NO FUTURE IN MEDICINE"...i almost told him to eff himself and stay the eff out of my business, but i didn't. that's the thing, at my hometown experience, all the doctors i saw (except for 2!!!) were old white men, half of whom were fat...overweight fat, not obese i guess. the other 2 were a black man and a black lady. oh yeah, and 1 white lady. well, all the white men would get together in the mornings and talk shit about whatever in the world was ailing them...well, i don't think they were hurting too much in their fancy shoes and i saw what fancy cars they were driving up in. while watching fo.x news (which i can't stand and am permanently scarred for life for having to listen to it). well, after they'd leave, i'd go and change the channel to cn.n or something...ha! (i don't really care which news i had it on, just not fo.x!) one morning it was on ms.nbc, so i guess that was a pleasant surprise. but anywho, no offense against white men (my father is white! my boyfriend is white! i'm half white! hahaha...), but i guess i'm just tired of hearing rich old white men who haven't had to undergo any sort of prejudice or hardships bitching about how their worlds are going to end because obama is the president and now health care is CHANGING. ummm, as far as i know i woke up this morning and the world was still spinning, so that's that. and you are still going to make your money so you can fly your private plane to the beach every weekend. blah.

sorry about the rant...it just tumbled out of my fingers!

so for today i have some botox to go witness, some gymming, some studying, some school errands, and some hanging out with H to do! it's nice to be back in town again.

Wednesday, March 17, 2010

a tiny ray of sunshine

today i got to fish out some damn ear wax out of a person's ear. the first hands on thing i've done in a few weeks. and i got excited. the excitement only lasted about 30 seconds.

what is wrong with me?

in other news, my Tdap vaccine booster i received yesterday is currently doing a number on me...i feel like i have the flu, my arm hurts (which was expected), but my whole body? and i keep feeling lightheaded and i can feel my heart pulsing throughout my body...like if i sit really still i feel like my body is swaying with every heartbeat. or pulsing, rather. and i can see my arms MOVING without me moving them!

also, i want an effing fancy coffee drink and there is ONLY ONE COFFEE PLACE IN THIS TOWN that closes around 5...so i think i might take a shower and make my brother drive me there shortly.

i guess i'm being a whiny baby. why couldn't we have gotten a whole week off for spring break? that makes me sad. only 2 days, boo.

in other news, i've found some programs that i am going to apply for away rotations at...hopefully i'll get 1 so i can satisfy my urge of exploring new land.

Thursday, March 11, 2010

crossing my fingers

here's to hoping that i don't get the puking and shitting virus that's been spreading around my family med clinic the past few weeks...because i sure felt like doo doo today. after lunch i went out to my car, put the windows down, and straight up napped for 30 minutes. i'm such a loser.

so life is easy, been studying for step, and doing lots of driving back and forth. my preceptor also runs a botox clinic in my university med center town, and boy does he get excited about some botox! personally, the only cosmetic procedure i think i would be interested in is the laser hair removal, but it is interesting to watch the botox being done. i think botox is ok when it's done to "slow down" aging just a bit...the person still looks like a NORMAL person that can show emotions, they just aren't as wrinkly. however, the people who flip out because their forehead can still move and it's "not supposed to"? wtf. it just weirds me out. he also does smartlipo and juvederm fillers, so i'm hoping to get to see some of that while i'm there.

so here's my take on the kind of patients that i've been seeing:
  • problem lists consist of at least 95% of the following: diabetes, hypertension, GERD, hypothyroidism, CAD, PVD, atrial fib, COPD
  • at least 1/2 are obese
  • they all say "i hate taking medicines" and their medicine list is like freaking 30 pills long, and they want more
  • if they smoke, they don't smoke "too much". i mean, i only smoke like 1/4 of my cigarette at a time! i don't even smoke a whole pack!
  • everyone has sinusitis, so everyone gets antibiotics and flonase spray
here's some of the questions that i ask almost everyone:
  • what kind of numbers are you getting with your blood pressure?
  • what are your sugar numbers?
  • are you still taking all your medicines?
here's a fun conversation:

- so are you checking your sugars at home? your last A1c was 8.7...
- i am doing a great job...i check it about once a week! but i can always tell when my sugar is too high or too low!
- how do you know when it's too low?
- i get shaky and feel like i'm going to faint!
- and when it's high?
- oh, i just know when it's high.
- what happens?
- i just get a feeling.
- what is that?
- (silence).
- you can't normally tell when your sugars are too high, that's why you need to check them everyday to make sure that your medicine is working.
- well, the nurses just checked it and it was 160! that's the lowest it's been!
- 160 is not good...it should be closer to 100.
- but 160 is the lowest it's been in a long time! i'm doing great, see?! i don't need no insulin!
- (smacks forehead).

or how about this:

- your blood pressure today is 160/100...are you taking all of your blood pressure medicines? (proceed to read off medicines.)
- i mean, i take them when i feel like it, but i didn't take them this morning, and oh, hey doc, my back hurts can i have some lortab?

oooh, what about this one?

- so i've been having these weird sensations in my arms and legs...it's not muscle tingling, it's sort of like a twitch but i've never seen them twitch. it's like a pull. yeah, a pull! but it twitches and it wakes me up from sleep and then i rub them and then it tingles...etc...etc...
- ummm...have you started exercising lately? any differences in sensation? you sure you've never seen twitching? changed your medicines lately? etc...etc...
- nothing's changed...no...it's got to be my heart! it has to be circulation, and then when i think really hard my heart is pounding and then i get shaky and then my head starts to hurt and then my neck has this bulge but it's been there forever and oh yeah i stopped my synthroid but that was back in 2009. could it be nerves? i think i have carpal tunnel and i've also been having diarrhea and i don't understand why dr. ___ took me off that medicine and changed it and i don't trust generics so don't give me one of those.
- ummm, why don't i get dr. ___ in here and see what we can do?

yeah, so i can't wait to just be a surgeon, or whatever i become...

Tuesday, March 02, 2010

family medicine

omg. private practice is the awesomest!

round in the hospital for an hour or so. clinic starts at 9. lunch is from 12-2. clinic ends no later than 5. oh yeah, and lunch is provided most days of the week. clinic is less than 5 minutes from my parents' house.

ARE YOU KIDDING ME?!

and the patients are CLEAN! BATHED! well, i would say the majority are, at least. ha. some of them try to lose weight! they take their medicines!

granted, i don't think i will be swayed to family med regardless because i'm too much into the procedures and whatnot, but maybe i'll be a private practice surgeon...oooh...

this month is going to be nice. plenty of time to study, access to a 24/7 gym, and a laid back daily schedule.

i've scheduled my step 2 cs finally...july 26. i was peeved that all the weekends were taken, but i guess a monday won't hurt me too badly in the long run.

still trying to decide on my M4 schedule, but i think i'll have it turned in by the end of this week. i hope so at least!

ok, now it's time for bed...gotta get the beauty sleep!