Pink Eye, How I Hate Thee

Ah yes. After working a month in the Peds ER, I have contracted that oh-so-frightening infection known as pink eye. (Technically, viral follicular conjunctivitis - but pink eye covers it pretty well.) Bright red eye, itching, burning, tearing, swollen eyelid, eye crusted shut when I wake up in the morning, sore throat from all that drainage running down my throat, the works. And it's apparently highly contagious, which is why I haven't been allowed to work...

For the record, I have NOT wanted to be stuck at home with this infection - I have tried to work but continue to be told not to be around patients, other residents, etc., by DOCTORS... I was sent home from my ER shift on Wednesday morning with my bright red draining eye, then went Thursday evening for my overnight ER shift and was sent straight to the Eye Foundation Hospital's ER for an evaluation. That doc grounded me from work until it got better or until seeing my opthalmologist. No improvement over the weekend so I saw my doc today, who says come back Wednesday and no work before then! So I can't be back at work until Thursday at the earliest. SO frustrating. I will have missed 7 days of work just because of an eye virus! :(

Christmas Lights? It's November 10!

While driving home from dinner last night, Matt and I passed a house in our neighborhood with Christmas lights up, and lighted reindeer with Santa's sleigh in the front yard. Now, really, people... don't make me go into my rant about starting the Christmas season before Thanksgiving...

Early Mornings

3:30am, and I'm wide awake! (Trust me, this NEVER happens... I'm such a sleeper!) My sleeping schedule has been a bit messed up after switching off of the night shift - yesterday I woke up at 5am, also wide awake. I didn't go to bed until 11pm, though, so you'd think I'd be tired....

Anyway. My usual routine is that I am a very sound sleeper and have a hard time waking up to any kind of alarm (unless I'm on call at the hospital, when any little thing wakes me up), and usually am very groggy for awhile - at least until I get a shower - before being anywhere near glad that I'm awake. (I don't think I'm a mean or grouchy person in the mornings, though Matt might say otherwise, having a more honest perspective on the situation - I'm just quiet and don't like to be bothered, and am easily bothered first thing in the morning!) So my early morning awakenings recently have been quite a change. It's been nice, actually - I like having time in the mornings to relax, drink a cup of coffee (or hot chocolate in tonight's case), have my quiet time, get some things done around the house, and not be rushed to get out the door. That's my dream of the kind of person I would like to be - it's just not who I usually am right now - so, while strange, I'm actually enjoying this off-schedule-ness!

Good Morning from the ER

1:12 AM. Just over halfway through my ER shift tonight! I'm working a series of 7pm-7am shifts (fondly called "overnights"), beginning last night and going through Monday night. Certainly not my favorite thing I've done in residency so far, but at least I'm 1.5 shifts down, 4.5 shifts to go....

The Children's Hospital ER is an interesting place, to say the least. We have such a range of patients who come in - for example: between last night and tonight, I have:

• sewn up 2 facial cuts (one hit chin on bathtub; one hit forehead on coffee table)
• seen a few patients with wheezing (they all went home)
• admitted a 6 year old girl to the psychiatry ward (she was threatening to kill her mother and sister, bad situation)
• admitted an 18month old who swallowed a coin and is going to the OR tomorrow morning to have it removed
• seen a few patients with colds (seriously.... there are WAY too many people who come to the ER with snotty noses and cough...)
• seen a few patients with abdominal pain, diarrhea, etc.
• seen a 7 week old with a VP shunt (a tube placed in the brain by a neurosurgeon to drain excess cerebrospinal fluid)

Trying to think... not much else that's been exciting.... Right now I'm just killing time until the next patient comes in, who knows what that will be.... or when, for that matter!

Why I'm Learning to Love Medical Conferences

I'm at the North American Cystic Fibrosis conference this week, in Anaheim, California! Finally, all the work I did in medical school on my CF project (a questionnaire that I gave to adolescent & young adult CF patients, focused on what they know about the genetics of CF & various related issues) has paid off.... with more work, of course (I submitted an abstract for this conference last spring, got accepted, & then had to prepare both a poster and a presentation of my research). But, I'm learning to love medical conferences:

1. Location, location, location! Southern California weather (70's and sunny!), beautiful hotel, and..... Disneyland right down the street (walking distance!)
2. Time with my wonderful husband, who came out to be with me and attend my presentation as well as enjoy the location (see #1)
3. A great conference tote bag (free)
4. Free delicious dinners out, courtesy of your friendly neighborhood drug reps
5. Free stuff - again, thanks to drug reps & other conference sponsors - lots of pens, highlighters, hand sanitizer gel, breath mints, a rubber duckie, a personlized cell phone charger (okay, I haven't stood in the long line for this one yet, but I will), popcorn, Dippin' Dots, Starbucks coffee, sodas, and (which I just found in the free WiFi lounge) a soft-serve ice cream cone machine
6. Oh yeah, and I might actually learn something...

Anyway, today was the last day & was the Big Day of my presentation. I think it went pretty well! I presented to a "workshop" (series of short research presentations) with topics specifically related to genetics. I had 10 minutes to present, followed by 5 minutes of "discussion" (which ranges from research critiques to questions to personal anecdotes). I stayed within my time limit, and only had a few times where I "ummm...."-ed or hesitated, and I got more comfortable after getting my nerves out in the first 2 slides or so. And from the discussion afterwards, I think my presentation was very well received... and I'm SO glad it's over (and fairly proud of my efforts, I must say...)!!

September Update

Only 3 days left in the NICU, and I haven't posted since - well - before I started Heme/Onc, so it's been awhile! I'll start with a general update and then try to post more often. :)

Heme/Onc (i.e. hematology, which deals with blood disorders, and oncology which is cancers of course) month was my first "real" month as an intern. I had done so well with my clinic month in July that intern year didn't seem very hard - or real - yet; but once I started heme/onc in August, which was my first inpatient month, the fact that I'm an intern hit home fast. I cried after work almost every day for the first two weeks... and not so much from the emotional piece of dealing with kids with cancer - more just because I was working such long hours (over 95 hours my first or second week, but don't tell anyone...), and felt so tired and stressed and overwhelmed! I almost constantly felt like I didn't know enough about what was going on, yet there were people looking to me to know & to make good decisions about the patients, and that was a very bad feeling. Fortunately I learned as the month went on and I actually ended feeling fairly good about it, and even enjoying it. Oncology was certainly fascinating, though I wasn't as excited about the hematology part.

From there I moved on the NICU (neonatal intensive care unit) at UAB, which is notoriously one of the hardest months of intern year, and it has certainly lived up to that reputation. I am responsible for up to 10 babies every day, with problems ranging from extreme prematurity and its associated issues (babies born as early as 23 weeks into what should be a 40 week pregnancy - sometimes as small as 1 pound in weight at birth!), to babies that are just little & need help keeping warm, to babies that are full term at birth but have birth defects or just difficulty transitioning to life out on their own. It's long hours - I'm on call every 4th night, which means a 30 hour shift with no sleep. Thank goodness for the legal 30 hour limit, though, so that I can leave around noon on my post-call day and go home and sleep!! I am really ready for this month to be over!

In other news - I got to be a model for our friend David last week - he was doing a photography project for a class. Look at his blog (see the link at right) for one of the pictures! I'm trying out for America's Next Top Model next fall. (Ha, ha.)

Thoughts on Laziness

I love being lazy.... in the moment, that is. It was so nice to spend the whole day yesterday in my pyjamas, never leaving the house, sitting on the couch playing board games and watching baseball and brainless movies (Jackie Chan and Owen Wilson being very silly) and working on a crochet project. But I always pay for my laziness later. I wish I'd gotten up at some point and gone to the gym and/or the grocery store, or done laundry, or cleaned, or studied, or done any one of those things that I had meant to spend all weekend doing!

So I loved being lazy yesterday, but today I hate that I was lazy yesterday. I think it's mostly because I still have to do all the cleaning/laundry/studying/errands/etc., as unfortunately the laundry didn't do itself, surprise surprise, nor did any of those other things get done without my putting the energy into the doing of them. But, I think that a large part of me wants to be a go-go-go kind of person, always on top of things, always with lots of energy to get everything done & learned on time, and so I hate it when the real me comes through and turns out to be just a lazy slug!

By the Numbers: Oregon

19: hours spent in airports or planes while travelling to & from Portland, Oregon last weekend.

50: pound limit on each piece of luggage, which I overshot both going & coming home... oops.

3: full days on the west coast.

4: rowers in a boat that beat an eight!

7,000: feet elevation of Timberline Lodge, on Mt. Hood, otherwise known as Brian & Ginny's wedding location.

16: approximate number of times my ears popped (between flights & travelling up & down the mountain...).

130: wedding favors (packages of s'more supplies) made by the bridesmaids the night before the wedding. (We had waaaaaaay too much fun with this, by the way.)

1: husband I missed very much while I was gone!

Vacation!

I have worked exactly 12 days. (Not including orientation.)

And now I'm on vacation.

Woo-hoo!

(I can't get used to this!)

A Day in the Life - July Edition

I know at least a few of you are wondering what it is I do all day, so here is the first of a monthly series on that subject - it will change monthly as I move through different rotations. Enjoy!

6:00am. Alarm goes off - hit snooze.
6:09. Dang that alarm clock -there it goes again. Snooze.
6:30-6:40-ish. Finally get up after hitting snooze (and thus aggravating my sweet husband) a few more times. Stumble toward shower.
7:00-ish. Running late for quiet time (my goal is 30 minutes every morning), but sit down for a few minutes for QT & prayer, accompained by breakfast (usually cereal).
7:15. Final touches before heading out the door.
7:25. Leave house; drive to Children's. If really running late - eat breakfast in car.
7:45-8:15. Morning report.
8:15-noon. Attend one of the clinics - mostly different types of pediatric surgery (general, ENT, Orthopedics, Urology, Neurosurgery, etc.). Sometimes I just shadow the attending surgeon; sometimes I see a patient on my own, then present the patient to the attending and accompany him/her while s/he sees the patient and makes all the decisions.
Noon. Noon conference - a lecture (usually) on some pediatric topic, aimed at educating the residents and medical students. They feed us lunch, too, which is great.
1:00-4:30/5:00-ish. Afternoon clinic - something different from the morning clinic, but my role is similar.
5:00ish. Drive home.
Evening. Various activities - e.g. attending Matt's softball game; going to Bible study; running errands; fixing dinner. (It's nice to actually have time & energy to do these things in the evenings.... though I need to start incorporating a bit more exercise into these possibilites, especially given the lunches they feed us at Children's!)
9:00. Start thinking about going to bed soon. Keep watching the Braves with Matt.
9:30. I really should go to bed.
10:00. Drag self off sofa and to bed. Read for a few minutes - then sleep...

Firsts

First week of intern year.

First time being addressed as a doctor by a nurse who actually thought I knew what I was doing.

First time being addressed as a medical student - despite actually being a doctor - by a parent who recognized that I didn't know what I was doing.

First hug from a patient - in orthopedics clinic, a 4 year old girl who loved the stickers I pulled out of my pocket.

First hug from a parent, too - while checking on her daughter, a 4 year old oncology patient whose pain I helped control.

First call to a code as a doctor - and I was the first one there! - fortunately, it wasn't really a code after all.

First time to take call as a doctor.

First notes and orders written without someone approving them before they were officially put in place.

First call from pharmacy (of many to come, I am sure!) about a medication order I had written incorrectly.

First intern class event missed because I was at the hospital, on call.

Bugs Bunny Band-Aids and Other Orientation Tidbits

Bugs Bunny band-aids just make life better. All of the new Peds residents had to get their blood drawn this afternoon "to get titers checked" - I'm still not sure exactly what they were checking for, but oh well - and at a children's hospital, the band-aids are fun. (One of my fellow interns even got stickers! He deserved it though..... he had to get stuck twice.)

We started orientation & various types of training last Wednesday (CPR training, pediatric advanced life support training, neonatal resuscitation training, computer training, suturing and splinting and Dermabond training, HIPAA training, paperwork, paperwork, and more paperwork, etc.........), and I think we're all a bit worn out at this point! Thankfully, tomorrow morning we finish the last of the computer training, and then I actually ended up with the weekend off. Returning to a schedule (after being on vacation for so long) has been difficult! I'm glad I start with one of the easier rotations; I think it will help to adjust gradually to a more grueling schedule, rather than getting hit with it all at once.

Speaking of schedule - we did get our schedules for the year; I start with Community Pediatrics (a clinic month - mostly in a general peds clinic somewhere around the city, specific location to be determined, and also some subspecialty clinics at the hospital). I'll do a month of Hematology & Oncology in August, and then a month in the neonatal ICU (when I'll be on call every 4th night) in September. I also got the time off that I had asked for to attend weddings (Ginny's in July, and Eli and Lee's in December), so that was terrific news!!


I promised triathlon pictures, so here they are:

on the bike.....
still happy

crossing the finish line!

life is better with Powerade and water

I did it!

Triathlon....... I Did It!

Hooray... my first triathlon in 4 years is done! My overwhelming thought is - I'm glad I did it, and had fun; but I'm not planning on doing another one anytime soon!

I've been sort-of training for it over the past few months, but I knew that I wasn't doing as much as I should have. I only rode my bike about once a week, and really should have gone at least 2 or 3 times a week; I ran more regularly than that, but still not enough; and I only swam once (though I wasn't at all worried about the swimming part!). So I knew going into Saturday's race that it wasn't going to be comfortable, but I knew I could do it - my goal was just to finish and not worry about racing hard. That turned out to be a good thing.........

This particular triathlon was a 400 yard swim, 13 mile bike, and 3 mile run. The swim went great......... no surprise that was my strongest leg, despite really not training for it at all! (I don't know the breakdown of the other legs, but on the swim leg I placed 72nd overall out of over 400 racers!) It was fun passing a lot of people, too, but that didn't last long.... I started getting passed as I was running out of the water up to the transition area, and that uphill run after the swim was much harder than I had though it would be! I had a hard time getting my shoes clipped into my bike to start off the ride, but after I got that figured out, the bike went fairly well. Of course I got passed a lot, but I passed a few people too, especially going downhill! The 3 mile run was quite a challenge though. I can run that distance just fine ordinarily, but doing it after the swim & bike was a different story. My legs felt like rubber coming out of the transition, but I was determined to keep running & not walk - until I got a terrible stitch in my side that just would not go away. At that point I was really glad I could remind myself that I was doing this to finish, not to win or anything, so I was totally okay with walking when I needed to, simply to keep moving forward! So I did it - in less than two hours, which was one of my goals - it wasn't comfortable, but crossing that finish line was a great feeling!

Matt came with me and was so helpful and encouraging. He was a great cheerleader! I saw him several times over the course of the race - at the beginning & end of the bike, and also at the beginning & end of the run, and of course at the finish. (He took pictures, which I'll add later if anything came out.) I am so thankful to have such a loving husband!!

Next time, I'm going to look for a team that needs a good swimmer, and let some other people train for & do the bike & run!!

Graduation Pictures!

There's really no way a few pictures can do the West Point Graduation weekend justice, but here are a few of my favorites:

Friday's graduation parade

Matt and me, Eli and Lee headed to the formal banquet

Saturday - Marching up to graduate

And of course, what would graduation be without a hat toss?

Esther loved meeting Uncle Eli, but especially those bright buttons

First time in a second lieutenant's uniform - Mark, Dad, and Josh pinning on Eli's bars

Gen. Patton and Other Things West Point

Eli graduated from West Point on Saturday (and we're all so very proud, despite the fact that the Go Army, Beat Navy thing everywhere - even on the water bottles - got a bit old!), and so the whole family was together for the first time since - well - a long time ago. Eli (and his fiancee, Lee) got to meet Josh & Amanda's baby, Esther - and Josh & Amanda got to meet Lee - and everyone got along great (which is good news, since we're giving neither Esther nor Lee back). Eli turned over his fancy digital Nikon to me for the weekend photography project, which I loved, and hopefully I'll get some of those pictures to post soon.

One of the most memorable images of the weekend for me was at the graduation banquet on Friday evening. Eli took Lee, Matt, and me as his guests. General Casey - current Chief of Staff, Army, and recently commander of the multi-national force in Iraq - was the speaker. Afterwards, another general (whose name I have forgotten, and I am thoroughly embarrassed about that, as this is probably the only time in my life that I can say I shook hands with a general!) was meeting cadets in the crowd, and watching my little brother interact with this far superior Army officer was really remarkable. He stood up a little straighter and stiffer - very politely and properly introduced us as his guests - and, when asked by the general what he would be doing after graduation, said something like "Sir, I am one of the few cadets with the privilege of being chosen to attend graduate school in Cambridge......." etc. Of course I had heard much from Eli over the past few years about Army protocol and how things were done at West Point, but this was the first time I had witnessed him in that role, up close and personal.

Another interesting note - on how things that are reported in the news are often not completely accurate: Vice President Cheney delivered the graduation address, and "He received standing ovations before and after he spoke to a crowd of about 20,000," the AP reporter wrote - having failed to mention that the crowd was specifically instructed to stand when the VP approached the podium to speak, as well as when he finished.........

The Patton thing - his statue is currently displaced from its proper location at West Point as their library building project is underway (apparently he stands with binoculars looking at the library - to which he never went, as he graduated last in his class). So his name came up several times over the course of the weekend, and his movie is on TV this evening, and since I have never seen it, I'm currently learning a bit more about military history. Apparently, learning about history is good for me. (Who knew?)

Oh, and thanks to everyone who e-mailed & posted after my first entry........ I'm even more excited about this blog thing now!!!

It's Official.....

Medical school graduation has come and gone, yesterday in fact, so today is my first full day of doctorhood. I'm spending it relaxing at home - still in my PJ's at 11am - despite the charge we received at the graduation ceremony to fix all the problems of the world (and especially of the medical system) over the next three weeks. I guess I'm not exactly jumping at the opportunity.

I have, however, been thinking about starting a blog for awhile. I have about a month off before beginning residency, but once that starts I won't have a lot of time for keeping up with everyone; this seemed like a fun way to update y'all on what I'm doing & how I'm doing & why you aren't seeing me or hearing from me! So please read it - leave a comment every once in awhile so I know you're checking it - it will help motivate me to keep this relatively up to date........