Monday, December 17, 2012

it's cold outside

i'm currently on my 2 week "vacation" known as anesthesia...very minimal requirements.  five intubations.  i've done 4.  i think i'll make the mark...

last night on call i got really nauseated/sick/wanting to pass out...my chief made me go to bed "just for an hour" after force feeding me juice and crackers, that was around 11pm and i woke up at 5am.  no pages!  no traumas!  but i still felt like crap and came home and slept for 3 more hours.  now i've been coffee'd and will be heading out shortly to rummage up some food.  and finish presents buying.  there's been some bugs going through my resident group and i think i had a touch of it last night.  probably was just hypoglycemic/GI distress/dehydrated, but it was funny how my chief was like ANY FOCAL TENDERNESS?  YOU THINK YOU HAVE AN APPY?  I CAN OPERATE ON YOU.  (fwiw, i would have let him and the attending on call operate on me, so it's fine.  i have my standards.)  and no, not pregnant.  (why is that ALWAYS the first thing people ask a female surgery resident who is ill?  alas.)  currently with a bit of a headache but at least i feel like i don't have to blow chunks from both ends anymore.

i'll be working over christmas, should be fun.  still debating going home for new year's, but with a 16 hour drive it's a little daunting.  plus there's absite and i've been cramming/studying for that too.  we'll see.

i enjoyed my trauma rotation.  i wish we operated more, but i enjoy the "thinking" on the critical care side of things.  also i've gotten pretty awesome at putting in chest tubes on AWAKE people.  wahoo!  also also i can do central lines by myself (before i would do it totally alone with an upper level lurking somewhere "just in case", but now i can just do them totally alone).

in house news we got a new chair for the living room.  the other room that we painted, well, the closet is only partially finished and we need to pick out carpet.  H has been making incredible headway on updating the electric outlets and killing evil vines in the backyard.  i have been...well...not doing much.  alas.

so just to throw it out there, these are the specialties i'm considering in no particular order: trauma/cc, plastics, vascular, and MIS.  i just wanted to document it somewhere to see how it changes as the years go on.  and yes, i'm very much aware at how NOT ALIKE they are all to each other.  i guess i'm complicated.

alright, i'm going to attempt to do normal people things now.  just have to finish up my christmas care package to my family at home, tomorrow i'll ship it out.  and eat lunch.  hope all y'all out in internet world are doing great.  happy holidays.

Sunday, November 11, 2012

step 3? check!

i got my score report back this week.  PASS for step 3!  so excited!

so i felt that i should have passed, but i know i didn't study for it like i wanted, but whatever.  i took the test, left feeling really crummy.  alas.  but i got my score report back and i had a respectable score!  so pumped!  a nice confidence boost going into my ABSITE studies...i know i need it.  glad those things are done with.  granted, i still have those yearly ABSITEs and boards and whatever, but at least i'm done with the steps.

i was on vacation this last week, and i wish i had a few more days.  it felt so nice to get house work done.  we painted a room, ripped out old carpet, updated kitchen cabinet pulls, swapped out washers, put in an updated kitchen room light...those were the main things.  still tons of work to do, but man it felt good to get some stuff done.  the house is really coming along.

tomorrow i start my trauma rotation.  blah!  so now i need to brush up on all the patients.  thank goodness for electronic medical records!

Tuesday, October 30, 2012

waiting

so i took step 3 two weeks ago.  people say it takes a while to get your scores back.  i'm so nervous...i feel like i should have passed, but never say never, right?  at least work has been so busy that i haven't had too much time to sit around and be anxious for it.  also, got ABSITE coming up in january anyway, so i've been picking up the study pace.  got to be better than last year, that's for sure...

i'm on call tomorrow, second year in a row for halloween call.  boo!  and then i am on call again friday and then i'm OFF FOR A WHOLE WEEK.  oh yes.  i was supposed to NOT be on call friday, but then people quit programs and then the rest of the class has to pick up the slack.  (that's a long story, but unfortunately not mine to tell.)  it is what it is.  i don't mind call, i just don't like last minute changes when it comes to call i suppose.  at least my last call wasn't so bad...i got about 3 hours of sleep so i was downright HYPER when i got home yesterday!  i folded a ton of clothes and finally put things into my dresser cabinets.  (oh yeah, and we moved into this house in june!)

trauma starts in 1.5 weeks.  all my calls next block are trauma/icu calls.  i've only done 2 of them so far, and things have been ok.  you essentially just stay awake all night hyperventilating that nothing bad happens, vs. ED consult call, where you just sit around and wait for people to come in.  and when the weather is crappy outside, not too many people come in!

alright, i'm going to read about the pancreas and whipples...WAHOO.  seriously.  things are going well overall, just sleep deprived, but what else is new for surgery residents?

OH, and i made a kick ass turnip soup the other day.  take THAT!

Friday, September 07, 2012

chest tubes!

i remember as a med student wanting so badly to be the one to put in the chest tube, and now i can freaking drop them in easily.  well, at least on sedated patients!  on ventilators!  hahaha...well i did do one on an awake patient which didn't turn out too well, but i blame that partly on him and on myself.  but last night i did a chest tube on a sedated vented patient and it just went in like butter.  get the post procedure chest xray, and BAM!  beautiful tube!  no more pneumothorax!  and the tube just gently curves up just so nicely and then when the trauma attending says "nice tube" it's hard to not feel a little happy on the inside.  i finally got it in my head how "hard" i have to push to poke into the chest cavity with the kelly.  you got to be just aggressive enough, but not too aggressive at the same time.  so now i just got to do some on awake patients...

i got both my fem sticks last night...i was pretty stoked about that too.  it's the best feeling...palpate the femoral...go a little medial (but for me, i've learned that i tend to want to go too medial so stay a little more lateral than i think, and go at a steeper angle than i want)...put the needle in (big stick!)...hit the vein...aspirate and BAM!  dark blood!  yell out LAB!!!  they grab the tube from you and it's like YES i didn't screw it up that time!

this morning i presented at M&M (morbidity and mortality) conference.  my first presentation as a 2nd year. i think it went decently, i handled the questions pretty well.  granted, it could have been better, but 1) my case was kind of blah and 2) post call!  but i got the basic messages across and held my attending's point of view up.  all i can ask for.

then after i left for the morning my 3rd year friend (who was also on call) and i got some post call drinks and chatted about things like normal people do.  hahaha, i guess if normal people went out at 10:15 AM, but i guess we're really not that normal anyway.  we did some fun girl talk, some good pep talk, some shop talk (i.e. OMG THAT SPLEEN, etc), then got into some very intellectually stimulating conversation about how we like to tie knots depending on the suture or what we're trying to tie, etc.  surgeon nerd girls.  i love it.

so now i'm post bowel movement, post shower, and now lying in bed about to blissfully pass out.  you know you're a resident when all you want is enough time to properly go to the bathroom, a nice shower, and NO PAGERS!!!  and i have tomorrow off!!!  SO EXCITED!!!

so all i gotta say is 2nd year is nice so far.  and my tomatoes that i grew FROM SEED have finally started to ripen and they taste damn good.  and to all my blogger peeps, my perpetual apologies for my infrequent posting.  i should blog more...i love my field...everyone should do surgery!

and with that i'm going to peace out and sleep.  have a great day.

Thursday, August 02, 2012

technology

so i'm trying out reading textbooks on the kindle.  my program gives a nice sized educational allowance, so i thought i'd start trying to kindle read in addition to regular books.  my program gets books online too, but i hate reading stuff on the computer after a while.  my eyeballs hurt.  plus when going on trips the standard books are freaking heavy!

today i practiced tying 6-0 surgipro...now i understand why my attending said to practice tying knots with your eyes closed!  you can't feel the suture!  i also want to buy a large needle driver so i can practice my palming.  have i mentioned that i like vascular?  (probably not, since i hardly ever update anymore!)

H and i have joined a CSA and omg i love getting the weekly veggie boxes!  today we are going to grill chicken, eggplant, squash, and i'm going to roast some purple potatoes.  yums!

so yes, life is going well.  i'm trying to read a hell of a lot more...trying to be a lot better on the ABSITE this next go around and be the badass resident i know i can!

Sunday, July 01, 2012

2nd year

so i've been a 2nd year for a week now.  i've been q2 call since 1 week ago.  i'm on call again tomorrow.  then i miraculously have fourth of july off.  then call again thursday.  then the calls lighten up.  also, i'm being pulled from my vascular rotation to do trauma while the new 2nd year prelim gets ATLS certified.  that person will be doing my vascular work instead.  oh the joys of residency.

i've enjoyed 2nd year!  i've done tons of cool cases, and since i'm at the hospital all the freaking time, i guess that's a nice reward.  and attendings have been letting me do more in the OR.  fun!

my new interns are a nice group...hopefully it will be a good year with all of them.

chao!

Tuesday, May 15, 2012

6 more weeks!

roughly 6 more weeks of intern year!  i can't believe time has gone this fast.

i start trauma in 12 days.  aak!

today i was post call and have been blissfully sleeping the afternoon away.  i need to do some reading though.

also, H and i are getting a house!  i'm quite excited...it's less than 5 minutes from the hospital and i can't wait!  i have tomato and hot pepper and bell pepper seedlings that i'm hoping to put in the ground once we move...

so that's it for my monthly post...hahaha...

Sunday, April 08, 2012

le sigh

hey everyone.  i feel like i've been a bad blogger lately, i don't ever post anymore.  it's not that i'm having a lack of things to post, i just feel like i don't have the time.  i'd rather be sleeping or eating or attempting to read, ha.

life is good.  i'm logging tons of cases and learning a lot.  a lot of attendings have commented on my surgical skills and that makes me feel good.  i didn't do as well as i would have liked on ABSITE, so alas.  i've revamped my study techniques and  i'll just do better next year.  no harm done yet.

i was irritated earlier today because my attending took forever to come round at the hospital, but oh well.  he thought i was on call today, but that was 100% wrong.  so i caught up on all my pending paperwork, organized the list, and did a little bit of online shopping!  hee hee...so i guess i got screwed from a time perspective, but hopefully the dresses and the swimsuit i ordered fit me well!  the three hour work morning i envisioned ended up being a 6 hour morning, so irritating.  and then H made me lunch, i was able to finally take a shower (i have a habit of just going to work "as is" on the weekends, and then adding to that the fact i wear my scrubs 2-3 days in a row, i guess i'm a bit disgusting, but not as disgusting as a boy), and now i've caught up on my internet fun and have decided to blog!

the other day i was assisting on a perirectal abscess case, and we had finished doing the fistulotomy, and the patient then took that moment to have a bowel movement to end all bowel movements...of course we're all up in the butthole region, and then this geyser of poo comes exploding out.  my attending got the brunt of it on his chest and arms, so he descrubbed and rescrubbed in.  i, however, am significantly shorter, and somehow the poo went lateral and pegged me square in the face (and chest and arms).  luckily i was wearing a face shield but i had to spend the rest of the case staring at the shit stuck on my face shield hoping and praying it wasn't going to slide down and drip onto exposed skin and/or scrubs.  ha.  luckily, it stayed put, i had no actual skin/hair/clothes contact with the poo.  word got around so fast in the OR that i got sprayed...but the funniest part was the attending is a very professional sort of guy, someone that you can't just bust into laughing around, so i was trying to hold it together so hard.  i think i ended up muttering "so that was dramatic", but omg on the inside i wanted to break it down and hoot and holler!  and thank goodness for face shields.

so far i've logged 206 cases.  i'm such a case whore...i want to have the MOST!  wahoo!  i even enjoy being a glorified med student...you learn so much about technique watching other people operate.

ok i think i'm going to nap now.  i needs it!

Tuesday, February 07, 2012

don't hate me!

ok, an update.  i find that it's getting harder to find time to blog, but i digress...

ABSITE was alright, i hope i got above 30th percentile...that's what my program uses as their cutoff for remediation, basically a "pass/fail" measure.  we'll see...scores should be back by the end of the month.  the past 2 weekends have thus been quite celebratory in nature, and i'm doing a self imposed liver detox now to make up for all my bad behavior, ha!

my hospital has this wellness campaign right now and we all got fitbits!  they're fancy pedometers, and they have that wii technology in them so they can tell if you're walking, running, jumping, going up stairs, etc.  i'm interested to see how much i can walk around.  tonight i'm on ED call, so we'll see!  the website lets you add your food eaten and all so you can do calorie counts, but i predict i'll be too lazy to input that stuff.  i'm more interested in the mileage, etc.

so as to my goal of reading all of greenfield's...1 chapter down!  hahaha!

i presented my first M&M last week.  gallstone pancreatitis...patient had a lap chole but then ended up with a retained stone about 3 months postop.  i was so nervous before the talk!  we had just switched to a different presentation style, 5 slides, 1 article.  i said my piece, presented my article, and then BAM, all the various attendings in the hall started talking about their views and experiences and blah blah blah...basically, my presentation and article had inspired a lot of talk and that is viewed as EXCELLENT JOB.  even some of my fellow residents chimed in!  yes!  also, i'm so happy that there was a podium i could hide behind...my hands were shaking really bad.  but now that i'm done with my first one, and know the routine, the next ones shouldn't be bad at all.  and then some of my upper levels told me i did a good job afterwards...now THAT makes me happy.  and then throughout the day some attendings STILL kept telling me their tidbits.  it was like i had entered into some "secret club" or something.  like i was telling H, that day was a great "professional" day for me...and we celebrated by eating some fabulous italian food.  yums.

so now my total cases is about 150.  i almost have a 100 majors woo woo!

ok, i will try to update more often.  i really do appreciate ya'll that stop by and check on the ol' blog.  it's hard to believe sometimes that i've had this thing since 2006!

Friday, January 27, 2012

absite

absite.  tomorrow.  aaak!

Wednesday, January 04, 2012

happy new year

holiday schedule almost kicked my butt...but all in all not so bad.  i finally have my central line numbers!  and the other day on call i got fem sticks on an essentially dead person...no pulse for my landmark and the code team was doing CPR, so i was proud of myself for finding blood on my first stick.  so it was nice when i had to do one on a living patient in the trauma bay that i also got that one on my first stick as well.

everybody's been talking about resolutions.  i'll throw some of mine out there...

  • exercise at least once a week (which is going to be hard, believe you me)
  • cook more
  • read the entirety of greenfield's this year (might as well set lofty goals...haha)
so there you go.  reflecting on the last year, it's kind of amazing to see where i am now.  i can't believe intern year is half over, and i guess i'm not as bad as i think i am.  i hope by now the other residents feel that they can trust me, at least with the little things.  i've become more confident in my "this shit is bad" sense, ha.  i do need to work on my confidence level and speak more authoritatively.  i do need to become more efficient...i know i have, but it's still a long road.  i refuse to compromise thoroughness, and i won't apologize for that.

right now H and i are looking at possibly buying a house vs. renting...it's weird thinking about "grown up" things.  a part of me is afraid to do anything until i get my ABSITE score back...and oh yeah that test is jan 28.  puke.  (after i finish this blog entry i'll be doing a practice test to scare myself.)

i'm happy where i am.  sure, it sucks to not see friends and family, or to not see H in 36+ hours at a time, but i do enjoy my job.  it sucks also when you have edema around your ankles after a long day, and i should probably invest in some support hose while i'm thinking about it.  and my back hurts a lot, but the free massages through my insurance help out!  it super sucks when a chief calls you out on a mistake or your omission of important facts, but you just have to realize they want you to become a "bad ass" to quote the words of one of my chiefs.  (Frylime, i don't want you to become a good surgeon, i want you to be a bad ass!)  ok then!  i'm trying!  really hard!

so excuse me for a bit while i go cram some ABSITE.  i'll try to update more and be better about commenting.