The Best Meal Ever

With me being on break, I don't have any medical stories for you, so I'm going to post about the amazing dinner I made tonight. Since seeing Julie and Julia, I've been wanting to try some of Julia Child's recipe. In the movie, Julie makes this yummy creamy mushroom chicken thing. Well, I found the recipe and made it tonight. It was A.M.A.Z.I.N.G. I'm not kidding; hands down one of the best meals I have ever cooked. I don't have any pictures, but let me tell you that I licked my plate when we were done. Please, go out and get the ingredients to make this meal. Make sure you plan it for a night where you have some time....it takes awhile, but definitely well worth it. One bite in, Jake says "Umm you are making this again right?"

Supremes de Volaille aux Champignons

(Chicken Breasts with Mushroom and Cream)

Source: Mastering the Art of French Cooking, Vol. I by Julia Child, Louisette Bertholle and Simone Beck (Knopf, 1961)

Ingredients:

4 supremes (boneless, skinless chicken breasts)

1/2 teaspoon lemon juice

1/4 teaspoon salt

Big pinch white pepper (I left this out, we hate pepper.)

5 tablespoons butter

1 tablespoon minced shallot or green onion (I used shallot)

1/4 pound diced or sliced fresh mushrooms

1/8 teaspoon salt

For the sauce:

1/4 cup white or brown stock or canned beef bouillon (I used chicken stock)

1/4 cup port, Madeira or dry white vermouth (I used Madeira)

1 cup whipping cream

Salt and pepper

2 tablespoons freshly minced parsley

Directions:
Preheat oven to 400 degrees.

Rub the chicken breasts with drops of lemon juice and sprinkle lightly with salt and pepper. Heat the butter in a heavy, oven-proof casserole, about 10 inches in diameter until it is foaming. Stir in the minced shallots or green onion and saute a moment without browning. Then stir in the mushrooms and saute lightly for a minute or two without browning. Sprinkle with salt. (With being at Jake's, my kitchen supplies are limited. I used his large metal deep skillet and put that in the oven. Just make you remember that the handle will be hot (unlike me) because you will burn yourself.)

Quickly roll the chicken in the butter mixture and lay a piece of buttered wax paper over them, cover casserole and place in hot oven. After 6 minutes, press top of chicken with your finger. If still soft, return to oven for a moment or two. When the meat is springy to the touch it is done. (Please Note: Although Julia suggests to check the chicken after only 6 minutes, I (as well as other people on the internet!) feel that this amount of time is inadequate to thoroughly cook the chicken. I cooked it for closer to 30-40 minutes. I think my final time was 42 minutes, but some of my chicken pieces were really thick. I think at 30 min, I pulled them out and cut into them to check and there was still a little pink).

Remove the chicken to a warm platter (leave mushrooms in the pot) and cover while making the sauce (2 to 3 minutes).

To make sauce, pour the stock and wine in the casserole with the cooking butter and mushrooms. Boil down quickly over high heat until liquid is syrupy. Stir in the cream and boil down again over high heat until cream has thickened slightly. Off heat, taste for seasoning, and add drops of lemon juice to taste. Pour the sauce over the chicken, sprinkle with parsley and serve immediately.

Serves 4.

What's Coming in the Next Year?

For those of you not familiar with the whole med school path, my next year will be insane. In July, I officially have to decide what I want to be when I grow up, and start applying to residency programs. Between now and then, I have to figure out which programs I want to apply to, sign up for audition rotations (I'm currently waiting to hear back from one), and take my Step 2 PE boards. This means on June 3rd, I will be in Philadelphia seeing 10 fake patients, examining them and then writing up a note. I'm not too worried about this test, but it was $1100 so I will be taking it seriously. Alright, so these audition rotations- basically it's my time to kiss ass and be a rockstar med student so that the programs realize how amazing I am and they want me to be a part of their program. I'm hoping to do 4 audition rotations...one at the end of 3rd year and three of them in the beginning of my 4th year. Ok, after I apply to all these rotations, I can be invited for an interview. So I will spend my fall flying around the country doing interviews. I'm hoping to stay in Ohio, so that wouldn't be too bad because I could drive to all the places. Just for example, I know a girl who is one year ahead of me and is going into OB/GYN...she has gone to 20 interviews this fall.....think of all those plane tickets and hotel rooms. $$$$$$$$$$$

I'm in a DO school. There is a DO match and an MD match. I can do either just one or both...I'm still deciding what to do. Anyways, if I do the DO match, next January I will rank all the programs I'm interested in. At the same time, all the programs rank the students. This company, figures out all the rankings and then does the Match. I will get a little note in February saying where I will be doing my residency (hopefully). If I don't match, then I would do something awful called the Scramble. I'm not even going to explain what it is because it's pretty much my biggest fear.

So yeah, 2010 should be super busy and expensive.

Oh yeah, we're hoping to go to Korea in June. Jake will hopefully be presenting at a conference in Seoul which means his trip would be paid for, meaning all we have to do is swing my way. We won't know until February or March though.

Merry Christmas to You!

Today was the first Christmas I've ever spent with just Jake. We didn't go see anyone else...just us. I think other people should do this every once in awhile. Maybe I just appreciate it more because Jake and I are long distance, but today was a really great day. We started the day opening presents, although there should have been nothing underneath our Christmas tree. Lesson learned...don't trust anyone except my sister. Anyways, then Jake made me breakfast. Then we played Mario, snacked a bunch, went and saw Alvin and the Chipmunks the Squeakquel, called a bunch of family, made a nice ham dinner, and lounged around reading and watching tv. That was one hell of a run on sentence huh?

What did you do today?

Ronald McDonald House

The famous Ronald McDonald at the entrance.

The entrance.
One of the guest rooms.

A local bakery donated cupcakes for dessert.

The lobby.

A local Hallmark puts up the Christmas village each year.

The dinner counter.

The amazing kitchen!

The dining area.

One of the women I went to Brazil with asked me to come with her yesterday to cook dinner for the families staying at the Ronald McDonald house. I jumped at the chance. The Cincinnati location is just amazing. I was just shocked and how big and fantastic this place is. There are 78 rooms, with huge kitchen facilities, laundry, a library, computers, and play areas for the children. The rooms are like hotel rooms with two tempurpedic beds. There are 25 transplant rooms which are a little more like apartments due to the fact that the children have to stay at a minimum of 100 days after their transplant surgery. They have a white board in the front listing where each family is from. There were people currently there from Russia, Romania, Puerto Rico and many states across the country.

The volunteering that occurs at this location is just heartwarming. There are only 6 employees with approximately 400 volunteers who run the place. Breakfast, lunch, and dinner are made by volunteers every single day! In fact, at the current time, new people can't even sign up because all the slots are full.

The group that I went with has been going for over 6 months so they really know their way around this kitchen (actually 6 kitchens in one large kitchen). Last night was casserole night, so everyone brought the ingredients for their meal and assembled and baked them at the house. Once dinner was ready, it all went out on a big warmed counter, and an announcement is made overhead that dinner is being served. Everyone comes in and gets in line to eat. I have to say that the atmosphere was happier than I expected, although most people really just kept to themselves. I am sure that this is a tough time of year for these people and it's hard to keep upbeat. One woman made up a plate and put it away for her husband who was at the hospital. They were doing shifts and she wasn't sure when he would get the chance to eat. In the past, the group has done soup night, baked potato bar, english muffin sandwiches and others.

We were all wondering what the House would be doing for Christmas. It's actually pretty amazing. In the basement, there's a room filled with toys that have been donated. Each parent can go down and pick out what they want to give their children. They can choose to have them wrapped (they are so busy some just don't have the time) or can do it themselves. On Christmas Eve, Santa will come visit the children. He will call up each family and visit with them and then give them their bag of wrapped presents.

I'm really happy that I found a way to give back this season. The group goes monthly and I am invited to come along as my schedule allows. I urge you all to check your local Ronald McDonald House (or other charity) and check to see if they need help. It really is an amazing program.

So The Nose Is Pretty Amazing....

Yes I'm aware I haven't written in awhile, but to be honest, ENT is pretty boring and no good stories until Monday...so I've spared you from reading about my non exciting days.

Ok first i just want to say that the nose is not given enough credit. I just thought it housed boogers and did things like let you breathe. Well, it's huge....I guess I mean deep. Look at the pen on your desk, and now imagine a doctor sticking the entire thing up your nose. It would fit, I promise, but you would not like it very much. I was in on a sinus surgery yesterday and just sat there amazed! With the camera up the nose, I could see a lot more. The maxillary sinuses (ones behind your cheeks) drain into your nose via a hole....well that's exactly what it is, a hole. And in this sinus surgery, they take a balloon and use a catheter to get it up there, blow up the balloon, and BAM the hole is bigger, and your sinuses can drain better. It was so cool.

Story #1- 14 year old girl gets sent straight down from family doc because her newly pierced ear cartilage is mega infected...like so swollen you can't even see the earring because it's in between the front and back of her ear. The plan is to numb her ear with some lidocaine (this is done with an injection) and then make a tiny slit with a scalpel and pull out the earring. As soon as she hears injection...she freaks out...like screaming, telling him he's not touching her, telling her mom forget it, basically carrying on worse than any 5 year old I've ever seen. Dr. M gets mad because she's wasting his time....we keep going in the room and leaving...etc. We finally get to the point where he's about to inject the lidocaine and she flips her shit. And then manages to push out the earring through a non existent hole in her ear. Basically when confronted with a needle, she was willing to do anything. I can tell you that it must have hurt like a beeotch to push that out considering when he touched her ear she started crying. Can I tell you what would have happened to me if I had acted like that at the doctor's office? Something not good.

Story #2- 8 year old girl comes in because she failed her hearing test at school and needs to be checked out. She is all dressed up in a skirt and tights and basically cute as a button. Getting a good history, Dr. M asks her if she plays any sports and can she keep up with friends while running. She says she doesn't do any sports. Her older brother (maybe 11) says, "Well hunting is a sport...she hunts." Dr. M- " Oh really? Wow! Did you get anything?" Brother- "She got a doe and a 6 point buck." Her mom- "She did it with a crossbow." Little girl shrugs her shoulders like this isn't a big deal. Like holy cow! That's just awesome.

A Bit of a Mess

The last few days have been crazy. That buttcheek spreading really threw my back and I ended up getting sent home on Thursday. I was hunched over to the side like an 80 yr old lady. It was a crazy day: one of my facilitators ended up taking me to her chiropractor (she got treated too), I was put on supplements, spent 2 hours at her house laying down, got put on a bunch of prescription medications, and have spent a lot of time on my couch. Today I had acupuncture done. My back is getting better, it's not good, but definitely better.

My next rotation was supposed to be urology....due to some affiliation difficulties that was canceled and I will be starting ENT (ear, nose, and throat) on Tuesday. I'll only be there for two weeks because of the holidays, but I'm actually pretty happy about it. This hospital is closer than where the urologist was, so my drive will be shorter. So you can all look forward to stories about boogers, ear wax, and thyroids. LOL. Seriously people, I wish you could see the size of the ear wax balls that get pulled out of ears. I know I just grossed out most of you, but it's actually pretty crazy.

Thanksgiving

Laura reading on the couch.

The take a picture of myself photo.

Jake is cutting the turkey.

Our pies.

Yummy homemade crescent rolls.

Sweet potatoes!

I have to say that Thanksgiving was a total blast. My sister and Jake joined me on Tuesday. We spent Wednesday seeing New Moon and starting to prep some of the food for Thursday. Wednesday cooking included the pumpkin pies, the dough for the crescent rolls, taco dip, and a pumpkin dip. Thursday morning I got up early to drive into town to buy a paper since Black Friday shopping is one of my favorite activities. We made the turkey, crescent rolls, sweet potatoes, mashed potatoes, corn, gravy, stuffing and a caramel apple dessert. We had two mishaps- Mishap 1- I forgot to buy the cheesecloth which we use for the stuffing inside the turkey so Jake made a quick store run. Mishap 2- Laura forgot to add the butter to the caramel apple dessert- it ended up being just fine. So next year when I make this, I'll be halving the butter in the recipe.

Friday- We were in line at Sears at 3 am. Crazy? Yes yes we are. Jake bought me a treadmill though so I'm really happy. The gym here is too far away. I leave in the dark and get home in the dark and there are no street lights in my neighborhood. Plus he was nice enough to rewire the cable and move my tv in the office so I can watch tv while working out. Then after Sears we went to Dicks, Macy's, Target, and then JoAnn Fabric. Then they dropped me off at the hospital where I had to do a hernia repair and a wound debridement. They picked me up and we headed to the mall. Needless to say I was super tired and took a nap when we got home.

Saturday- Laura and I played Super Mario Bros on the Wii all day long. It was addicting and fun and reminds me of the one we played when we were little but this has better features!

Sunday- Laura left :( Jake went out with a friend to put up deerstands and four wheeling while I studied.

I Hurt My Back Spreading Buttcheeks Yesterday

Yes, this is a true story. Most people know that I have a bad back, but it's been pretty dang good lately. Yesterday is was kind of sore but still ok. In the wound clinic, this woman had a sore in between her cheeks, so I had to hold it open. This wouldn't be too bad but I was in a very awkward position. She was laying down, I was sitting behind her legs and had to twist to hold her cheeks open because the dr was directly behind the sore. Now I can barely walk. Amazing. And yes I know this story sounds hilarious. I thought my sister was going to pee her pants when I told her what I had to do. It's funny because I don't even think twice about this stuff, but to nonmedical people it sounds crazy.

Another funny penis story. This poor elderly gentleman came in with his wife because he was having prolonged rash in his groin. His wife did all the talking since she's taking care of him. Well apparently this man is incontinent and refuses to have a Foley cath kept in, so his underwear are constantly wet, keeping it a perfect place for a rash. Well his wife tried using a condom catheter (I had to look this up). She said it was difficult to use on him because "His penis is just so flacid and the directions say to slide it (catheter) down his penis but it just gets sucked up there so all you see is his head and testicles." Okaaaaaaay. Super weird moment and this honestly took a lot of self control to not smile. Then she says "Dr, what size is his penis so I know what size to buy?" I felt awful for this man. It's one thing to have the male doctor here the story, but the young female med student, that kind of stinks.

Thanksgiving- I'm going to write a post about this later.

I Got What I Deserved

Being the first student at a hospital is bound to come with some hiccups. Like every other day someone changes their mind about what I can do in the OR. Well, on Friday, after observing 10 or so lap chole's (galldbladder removal via laparoscopy) I asked if I could scrub in to hold the camera. Dr. H said yes, asked the charge nurse and she said no. So the surgery starts, I'm sitting on the stool all pouty, and Dr. H finds that his gallbladder is actually gangrenous (very bad!) and he can't distinguish the anatomy because it's so inflamed. This means that a conventional cholecystectomy has to be done (with a big incision). The charge nurse tells another nurse to call the HEAD NURSE to see if I can scrub in because well there isn't enough people and Dr. H needs another person's help. The head nurse says "uh yeah, she's scrubbed in all week" so I go scrub in. Well let me tell you, I had to hold retractors (which is normally med student duty) and I had to hold them for a long time and hard. My hand became stiff, my back hurt for hours, and yeah I got what I asked for that's for sure. This poor man ended up having gallstones the size of olives with a pitt. Mmmm hope you weren't eating olives for lunch today.
In the office Friday afternoon I got to help with two I&D's on patients. Then the office manager asked if I would take off all her skin tags. I'm thinking "You do know that there is a surgeon in this exact room that could probably do a better job than myself." She wanted me to do it. Thank goodness I've already learned how to do this because I might have turned the job down otherwise. Halfway through, Dr. H comes in to check to make sure I'm not screwing up. I'm thinking "Umm now's a fine time to come check. I'm almost done."

I know I need to find pictures because people like reading posts with pictures more than just text but it's kind of hard since I can't really take pictures of patients. That was a Brazil privelege only.

Disgusting Things That Somehow Don't Bother Me

Medical school has definitely introduced me to some disgusting things. Somehow they don't really bother me.
Incident #1: ok this isn't really as disgusting as it is messy. A c-section is very very messy. Once you cut into the uterus, all the amniotic fluid and blood comes bursting out. Yesterday morning I scrubbed on two c-sections and at the first one, I just got sprayed from neck to toes....so happy that we're gowned up so well. We actually where booties that go up to our knees....making them more like leggings.

Disgusting incident #2: Being in my surgery rotation, I have to go wherever my preceptor goes. Tuesday afternoons, this includes the Wound Care Center. People come here with the most disgusting wounds I have ever seen. Some of them are small and getting better, but some of them are huge, gaping holes. There are some that are the size of a softball and are 3-4 inches deep. My job today was to debride them. This includes me taking a currette and scraping the wound. This one guy today had four huge ones. Two patients today had really smelly ones. I am perfecting breathing out of my mouth.

I have to say though, that if wound clinics didn't exist, these poor people would have no one who could help them. Their care is weekly, and they don't go away on their own; they just get worse. So Dr. H is a huge help to these people who are otherwise ignored from all their other doctors.

My First Week of Surgery

Things haven't quite gone how I expected, but hopefully this next week the kinks will all get ironed out. I'm working with a really nice general surgeon named Dr. H. He is NOT the typical arrogant asshole who I imagined I'd be working with. He's hilarious, kind, and teaches me lots each day. The great part about this rotation is that I get to wear hospital scrubs everyday. This means way less laundry and way less thinking about my clothes. Oh yeah, and I get Wednesday afternoons off so he can go golf. Works for me.

Most of the surgeries this week have been cholecystectomies (gallbladder removal). I'm really interested in them mostly because I had my own out when I was 17. The coolest part about this surgery is that it is laparoscopic and it is JUST. SO. COOL to see the inside of the body that way. But because it's laparoscopic I don't really get to help. So that's a bummer. On Tuesday afternoons, we go to the wound clinic. Let me tell you, nothing can prepare you for these wounds. They are big gaping holes in flesh. Then you take a currette and debride the inside of the wounds. I was told this week, that is all me. Sweet. Actually, it will be good to do that by myself.

There was a little snafu this week regarding a surgery center that Dr. H goes to on Friday mornings and Monday mornings. I wasn't able to go with him so instead I went to a different hospital to go work with Dr. P (the dr who took me to Brazil) and was able to scrub in on all of her surgeries. We repaired a rectocele, did a laparascopic assisted vaginal hysterectomy, and a vaginal hysterectomy. Oh yeah, I also got to catch a baby! I love it. It seriously is a very fun thing. It was a girl and she was perfect. The mom had some issues with her placenta though and we had to take her to the OR to get it all out. Unfortunately, it came out in about 30 pieces and she lost a lot of blood. It was very messy. I didn't get home until 2 am and then I had to walk the dog that I am currently dogsitting. It was a long day.

Tomorrow, I'm scrubbing in again with Dr. P on some c-sections! Then I'll be heading back to the other hospital to see patients with Dr. H in the office.

My Grandpa

This is not medically related, but today is Veteran's Day and I thought I would quick post about him. He served in the Korean War when he was a youngin :) Today at the place where he lives, the group hosted a veteran's party where they decorated, served food, posted pictures, and honored the men who had served. Each guy spoke and told his story. One of the local news teams found about this luncheon and came and "caught the story." They interviewed my grandpa and apparently they fielded phone calls all day since everyone they know in town saw it. So here's the video. He's famous :)

http://www.wsaw.com/home/headlines/69796597.html#

Thanks for serving Grandpa!

Last Week of Peds :(

Yup that's a sad face. I hate leaving Jake. Bah. Anyways, this rotation has gone really well. I have to admit it was a pretty easy rotation. I mean, yeah I have to work hard and all, but my hours were amazing, and seeing only 20ish patients a day is pretty sweet.

I have some good stories from today.

Story 1- I'm in the room doing well child checks on siblings: 6 year old boy and 3 year old girl. I ask the 6 year old what he likes to do for fun. His response: "I like to throw fake spiders at my sister and make her scream." How fun! Seriously, it's pretty close to impossible to not laugh at these hilarious things. At the age of 3, kids should be able to answer questions like who's a boy or girl, hot and cold stuff, etc. When I asked if she was a boy or girl, she looked at me like it was the stupidest question in the whole and in a very exasperated tone: "Giiiiirrrrl." Like duh Jenny. When I asked if her brother was nice to her "Nope."

Story 2- Twin 4 year old boys. I asked them to each draw a picture: Twin 1 of his mom and twin 2 of his dad. At that age, it's really crazy, but they usually will not add the body. It's usually a head with a face, two very long legs OR arms (not both) and feet (or hands). So twin 1 draws his beautiful picture of his mom. Twin 2 draws his dad and then says "Oh wait, I didn't draw his penis." Somehow, I held it together and said "Well that's ok." He drew it anyways...right between his legs. Again, how do you not laugh?

Story 3- I'm doing a physical on a 12 year old boy. He's relatively overweight. We get through the history, and I tell him to take off his shirt so I can examine him. He starts sobbing. His mom tells me that he's very self conscious. Wanting to avoid all conflict and 12 year old sobbing episodes, I tell him to forget it, I'll just work around his shirt. Mom, however, disagrees with me and yells at him, saying that everyone goes to the doctor and has to take their shirts off. He ended up doing it, but was not a happy camper. I was just so surprised at his sudden outburst of tears. I'm used to the 2 year olds crying, not 12.

Story 4- We went to the hospital to go check on a newborn. I've seen this baby for a few days now so we "know" the family. When we walk in the hospital room, mom has her shirt around her neck, a breastpump connected to one boob and the other just hanging out. Now, being in medical school, I've seen a lot of boobs, but that was a first for me. It's just like one of those moments where you're thinking "WHOA!" but you can't show any surprise on your face. I see and hear the oddest things every day, and somehow just keep a neutral look on my face (at least I hope I do).

SNOW!!!!

We are in the midst of a winter storm warning. The pictures are current, but it is still snowing and is going to continue through tomorrow night. We're looking at upwards of a foot. Jake was nice enough last night and let me park in the garage so I wouldn't have to scrape this morning! Love him!

So today I had two families that just totally made my dad.

Family 1- 12 month old check up. Grandma, mom and dad were along in the room. When we were all done, the grandma took my hand and told me that I would make a wonderful pediatrician. I said thank you and then the mom said that she agreed and that they really liked me. I love hearing stuff like that. The patients are the ones you want to like you.

Family 2- 9 month old little girl in for her check up. Mom, Dad, and 3 yr old brother in the room. The 3 year old climbs up into the chair and whispers something in Dad's ear. Dad says "What did you just say?" 3 year old- "She's cute!" Mom- "Great my 3 year old is hitting on your medical student." 3 year old- "Can she check me out too?" Watch out Jake! A 3 year old is moving in! LOL.

What's a Normal Family?

The thing with peds, is that you establish a relationship with the child and the parents...so basically the whole family. Dr. S has been telling me lately that there is no such thing as a "normal" family. Everybody has shit that happens...bad grades, divorce, kid acting out, drugs, anxiety, depression...you get the drift. He told me that he used to be a lot more judgmental before he had kids. Because, things happen. You can't control every single thing about your children. And when these things happen, they happen to your entire household. Everyone experiences it...all from different viewpoints, but they all get to deal with it. Today we had two cases that I tried to wrap my head around. 1. a teenager who has been getting into drugs, truancy, failing...except an A in a science class. He's depressed...and Dr. S and the mom were talking today about sending him away to some military sort of school. My opinion? He's bored. His one A proves that he's interested in something...I think he probably thinks the rest of school is boring and a waste of time so he finds other things to do. Are they wrong? Of course. Why do I think this? One, Jake got D's in a bunch of his high school classes (including chemistry) because he was bored and didn't want to do the work. He's getting his PhD in chemistry now...I think he's bright enough. Anyways, back to this kid...yeah he's probably depressed, but I don't know if anyone has actually sat down and asked him some simple questions. Ok enough about him.
Patient 2 was a pre-adolescent who was having some behavior issues. I'm not sure what I'm getting to. But I don't judge these families. I do however judge the parents who don't immunize their children against anything. Why wouldn't you want to protect your children? The diseases that they protect against are ones that can kill you.

Ok this post was all kinds of random and if you can follow I congratulate you.

The Patients that Make it All Worth it.

There are just some patients that make it all worthwhile. The ones that make your day better, make you smile and laugh, and the ones that you want to take home. I had the most adorable 3 year old little girl who came in for her well child visit. As I've said before, 3 year old kids are my favorite. Well, Dr. S and I walked in the room, she stops talking, looks at me, points and says "Umm I like you." So Dr. S told her that was fine and he left the room. She promptly climbed into my lap, told me all about colors and that she is a girl, her daddy is a boy, what she is planning on being for Halloween (a magenta butterfly), how my necklace looks like an "O," and on and on and on. She was pretty advanced too. She was able to draw a circle and a cross (the cross can usually be done by 4 year olds) and she could hop on one foot (also 4 year old thing).

During the course of the exam for the kiddos, I try to find out who their favorite character is. Well, her's is Ariel, so when I looked in her ears, I told her Ariel was in there. For the first time in a year, this backfired on me. She wanted to look and wave at her. We had to tell her I was pretending like she pretend plays. Anyways, this little girl was just so fricken cute. She seriously made my day.

I hope when I look back on this in a few years I remember her.

What kind of things make your day better?

Christmas is Canceled

Well the present giving that is. Unfortunately, my next set of boards is going to cost a lot of money. The boards themselves cost $1700. I have to go to Philadelphia to take part of them. So I'm thinking at least $2000 for the entire ordeal. Jake and I decided with this extra expense we were just going to not do gifts with anyone this year. It really is ok considering neither one of us want or need anything. My parents are okay with it because they are coming out for New Year's to Colorado...so they look at the trip as their present. It will probably just be a little weird on Christmas morning to have zero presents under the tree. Normally, I spend Black Friday shopping for all my family members, but I'll probably still go out just because it's so much fun to me!

I'm not sure what we will spend Christmas day doing, but we'll figure out something.

Becoming a doctor is an expensive ordeal. There are so many costs other than tuition that no one tells you about. Boards are ridiculous. After all the core rotations we have to take shelf exams. In order to study for these shelf exams you have to buy all these books. Audition rotations are rotations that you do at residency locations that you might be interested in. Unfortunately, you usually have to pay for housing for a month in a new location. Money, money, money. Someday, this will pay off, but it sure seems a long long long ways away. So maybe Christmas will be canceled next year too.

Are you making any cutbacks for the holidays this year?

Pediatrics and the Swine Flu

I now have one week of pediatrics under my belt, and I have to say my life is pretty dang sweet right now. We start at 9 am and are done sometime between 5-5:30. Oh yeah, and depending on how the morning goes...I get between an hour and 1.5 hours for lunch. And because the clinic is so close to home, I get to spend my lunch at home. It's great. Jake's actually been lucky enough to have a wife who can cook for him at night. I believe I have cooked almost every night, which is amazing! What else...I get my own tablet/pc to use. It's so much better than flipping through paper charts.

So what do I do in pediatrics? See a bunch of healthy kids for their well child exams and a bunch of sick kids. My favorite well child exams are the babies and the 3 year old kids. I love the babies because they are fun to play with, although as soon as I pull out the otoscope (look in ears) they begin to wail. The 3 year old kids just crack me up. They are into everything, bounce around the room and manage to tell you everything all at once. I'm just glad I get to leave them to their parents.

This clinic in particular has a wealthier and more diverse group of patients than I am accustomed to. For example, in the last week I have had patients from Russia, England, and Israel. I also have had two sets of lesbian moms (one set adopted the child and the other set used a sperm donor, used one mom's eggs and the other mom's uterus. Did you get that?). I'm also pretty happy with the acceptance that I have received from the parents. Typically, the wealthier the family, the less likely they are to allow you to touch their child. Now I know this isn't a black/white situation, but it tends to follow this path. However, I have had zero problems with parents, in fact, these parents are even more interested in me and my education process.

Alright, what everyone is waiting for...the swine flu. To be honest, I'm pretty sick of hearing people FREAK THE HECK OUT over it. And I also believe, that many people do not have all the facts. When people say the doctor says they have the swine flu, it is a most likely situation. For example, in the state of Colorado, there is only one lab in the entire state that is testing for the swine flu. The only places that are taking swabs from patients and sending it to this state lab are hospitals. You have to be an admitted inpatient to receive this test. So why are the doctors saying that you have the swine flu? Because that is what is currently circulating. If you have the correct symptoms (by the way, you need a fever for this diagnosis) then you are being diagnosed with the flu, probably the swine flu. Again, for everyone freaking out, I have been exposed to about 10-15 patients a day with this. I have yet to get it (hopefully I didn't just jinx myself). Wash your hands....a lot. Wipe down the grocery cart at the store. Get the flu and swine flu shot. For those of you with little babies at home, the CDC is advising you to get the shot not the nasal mist. I really encourage everyone to read the CDC's website for information. And before anyone gets huffy puffy at me about this, I am aware that people with low immune systems are more likely to have complications.

Oh yeah one more thing...the recommendations on when to go back to work/school are 24 hours without a fever without Ibuprofen/tylenol.

Ok, I think that's it.

I'm pretty lucky!

I thought I'd put up a picture of me and Jake to celebrate my good news! This was from our anniversary celebration!

I don't think I've mentioned it on here, but I am going back to Colorado this weekend to complete my 4 week pediatric rotation! I'm so happy that the school was willing to let me do this again. The best part is that the clinic I'm rotating at is 5 minutes from Jake's and it's across the street from the hospital, so my travel time will be awesome! The thing that will be the strangest for me is that this office is not accepting new medicaid patients. All of the offices I have worked for are CHC's which means they are federally funded and accept ALL patients. I'm interested to see the differences in the office.
I need to keep making a good impression. I got this rotation because the last doctor I worked with in CO literally picked up the phone, called this pediatrician on his cell phone and asked if he would be willing to take her medical student. She told him that I was really good, and voila, he said yes. Seriously, the way to go far in medical school is to know people and make good impressions. That's how I got to Brazil, and that's how I got this next rotation. So yeah, I'm pretty lucky.

Surprisingly, I Like It and Some Humor

I have surprised myself. I really enjoy my inpatient part of my rotation. The geriatric patients are so sweet and I love seeing them getting better! Most of the time, these patients get admitted because they are having "behaviors." These behaviors include things like: trying to choke a family member, grabbing a loaded gun and going through the window chasing a UPS man who is coming to kill your wife (who died a year ago), punching staff members at nursing homes, becoming extremely argumentative, hoarding things at home, accusing family and neighbors of stealing, and inappropriate sexual comments. Why do they act like this? Well, they usually have dementia, however most of them are being medicated and while they get worse, their family doctors just keep increasing the dose of their medications. Adverse effects of over medicating are irritation, agitation, and violent behavior. Simply tapering their medicine makes them so much kinder and sweet. I really really like seeing them get better. It is rewarding.

What's the hardest part of the geriatric patients? Since most of them have dementia, their short term memory is just shot. They tell you the same three things ten times in fifteen minutes. That's really sad, and frustrating when you're trying to get specific information from them. It's really hard to look at them and think that could me or Jake in 60 years. Scary.

Ok, this rotation has definitely left me with some laughs. This is more just for my own sake so that I don't forget them.

"Well, Christ, he had four testicles. And it was the Holy Grail."
"Vampires, dead people's ashes, the spirits in the cemetery, they all talk to me."
"The sky lab has created a pill that makes you fifty years younger."
"Hey, you got whiskey in there?"- to me as I walk in with my coffee cup.
"Jesus tells me to behave."
"You better keep your pants on."- to Dr. S as we walk out of the room
"Are you going to go put some clothes on?"- to me as I left the unit
"You're such a beautiful girl." - a few of the ladies told me this everyday. It made me feel really good.
"What are you, his sister? You look identical."
"I kept taking my cane and poking him in the foot. He was sleeping and not listening to me and well I get paid to talk."
Dr. S- "what year is it?" patient- "1970."
"Leave me alone. I'm sick of this crap. I exercise every day and I DON'T WANT TO DO IT."- this was after speaking to the sweet patient that she was in the morning. 1 hour later...totally different attitude.

The Saddest Day of Medical School

If you are hormonal or don't want to read about a baby dying....this probably isn't the post for you.

Sunday morning I went to the hospital to round in the nursery with Dr. G because she asked me to. Yes, I'm currently in my psych rotation, but did it anyways because I like her and was anxious to show her how much I have learned since the last time I rounded with her. Well, I walked into the labor and delivery floor and the nurses told me there was an emergency and I better get back in the room with Dr. G. I hurried back to the room where she came running out with a 26 week gestation baby. We all run to the nursery where they quickly put me to work. My job was to pull air out of the baby's stomach through an NG tube. Because of the ventilations being administered, the baby's stomach was getting full of air. I was thankful for a job, because I was able to keep my mind on doing the job right instead of sitting there watching all of this happen. There were 5 of us working on the baby, plus the people in the room grabbing equipment for Dr. G as she needed it. The baby's heart rate was only in the 20's when it should have been over 120. Finally, after an hour, Dr. G said she thought we needed to stop. Nothing was happening, the baby wasn't getting better, and if he did survive he would have been in pretty poor shape. So she asked each one of us if we were okay with stopping. Every single person in that room had tears in their eyes while we had the internal fight of stopping to save a baby's life. So as we pulled everything out, they cleaned the baby up, wrapped him up and took him to his mother so she could hold him. The mother was crying when she gave him the baby. Then she asked her "So what now?" And Dr. G told her "You're going to hold your baby and he's going to die." That was pretty hard to hear. I had to walk away because I started to cry. It was an awful feeling.

So you might be wondering why this baby died. The mother was a drug user throughout her pregnancy. She admitted to taking heroin, ibuprofen, Klonopin, and flexeril during her pregnancy. Oh yeah, and the baby's urine had 3 units of alcohol in it. And what was the mother doing an hour after the baby died? Oh she was outside smoking.

It's a good thing I had five healthy babies to examine after that. They made it much better.

So yeah, worst day of medical school. I know that event will stay with me the rest of my life. It was my first baby death and unfortunately probably not my last.

The Crazies Week 1 in Psych

Well, I'm in psych now. I'm back in Ohio and I'm stuck in this psych business for 4 weeks. Jake left this morning. Needless to say, I've been in better moods before. I spend my mornings at an inpatient geriatric psych ward and my afternoons in an outpatient setting with a different doctor. As of now, I really like the morning stuff. As of now, I hate the afternoon.

Inpatient: I have a schizophrenic patient who just makes my day. She's pretty old and looks really good for her age, but she has no clue what she is saying. I just laugh and laugh. Today she told me to go put some clothes on when I left. Yesterday, she told me that I look exactly like my preceptor so we must be siblings. (He's middle aged, Middle Eastern, and looks nothing like me.) Jesus also tells her every single day "To behave." She is constantly talking about inappropriate sexual things to the other patients and nurses, but she never speaks like that to me or Dr. S. She did hug and try to kiss him yesterday. It's very very humorous. And for everyone who is chastising me for laughing at a patient....too bad, it's funny. And she sits there and laughs right with us...she doesn't have a clue what she's laughing at, but it's ok. The doc I'm working with is fantastic. He sat down with me to make out a schedule for how we're going to go over all the material. I really am happy with him.

Outpatient: I hate it. I'm not too pleased with my experience thus far. I don't want to get into it too much on here, but I disagree with a lot that the doctor does. I dread going there and my afternoon drags on. Again, I hate it.

My Fave Thing to do in the Office

I really do think this is my favorite thing. I just love finding the baby's heartbeat for the first time in new parents. They are always so excited and happy. It just makes my day! It usually takes me a few minutes in early pregnancies so I always warn them that it will take me awhile and not to freak out or think something bad has happened. Those 12 week fetuses are like little fishies swimming around so sometimes it can be really hard. By the end of the three minutes it takes me to find it, my heart is usually pounding just in case something really is wrong, but alas, I find the heart rate.

Fun Procedures and One Bad Story

I'll start with my good story. On Wednesday there was a guy coming in for skin tag removal. I asked Dr. M if I could help and she of course said yes. So he comes in, and there are 25 skin tags to remove in his armpit and side area. We walk out of the room to go draw up the anesthetic and she asks if I want to go get started while she sees another patient. My first reaction "You want me to poke a needle into this man a million times while you're in another room? Hell no." So I went in the room to start cleaning the site up..and then waited, and waited for Dr. M to come in. Well, she took too long, so I decided this couldn't be THAT hard. Besides I've anesthetized plenty of times before...like 5 or 6 times. So I started numbing the guy up...and I did a good job. She came in the room and was like "oh you did get started?" So she took one skin tag off to show me how to do it. It's pretty easy. In fact, this is something you could do at home. You take a pick ups (medical version of tweezers)..pick up the skin tag, and take a scissors and cut it off at the base. The ones I numbed up didn't really hurt, but some of the smaller ones which couldn't be numbed he flinched at. I have to say that it's really hard to continue doing a procedure that I know is hurting the guy. So after they were all cut off, I applied silver nitrate to stop any bleeding..and he was ready to go on his way...25 skin tags less.

Delivering a placenta. Have you done this before? I delivered my first one by myself on Tuesday night. I've participated in a lot of deliveries but never have I delivered a placenta. So in case any of you want to know how to do it: you grasp the umbilical cord and gently use traction and pull. All of a sudden the placenta will plop out. Then you have to check the placenta to make sure it is all there and intact. It was awesome! I was a bloody mess.

Ok my bad story- we had a fetal demise at 37 weeks. It was awful. Especially because she was one of our patients who I had been seeing pretty regularly. The screaming and crying from the mother was enough to rip my heart out. I felt so bad for Dr. M as this had been her patient for those 37 weeks. I'd only known her for 3 weeks.

So this upcoming week is my last week in Colorado. I'm really sad about it. Oh well, what can I do?

Happy Birthday to Me

Ok I realize this is like 4 posts in one night but I have a lot to catch up on!

So my birthday was August 11, but I was in Brazil so Jake and I celebrated on Saturday. He gave me my present right away in the morning and I must say I am a lucky lucky woman. He got me the new hot pink leather Tribeca Coach purse. I was squealing and bouncing like a 5 year old! I also got a bouquet of blue irises :) We spent the day in Rocky Mountain Park! We love being up there and it's so refreshing that we might go back up this next weekend! For dinner we headed to Carelli's which was yummers!

My new purse:

http://www.coach.com/online/handbags/-handbags_feature_tribeca-10551-10051-5000000000000045551-en?t1Id=62&t2Id=5000000000000045551&tier=2

My first week in Family Practice in CO!

So my facilitators are awesome and got me a rotation in CO so I can live with my husband (you know like a real married couple). It's really great. The doctors I am working with are really motivated to teach and are doing a great job. On my first day, I was suturing up a neck! I have also put in a cortisone injection to the knee which was kind of freaky, but so much fun! My SOAP notes are getting better and clearer as the time goes on. Yesterday I was on call with Dr. M and had a good time at the hospital. We had a delivery, rounded on 5 babies, went and had lunch, then saw a 17 year old that had been admitted.

Today, my favorite patient was a 4 month old who was so happy and busy smiling and laughing at me. It might have been because I had a huge shiny necklace on, but I like to think she was enjoying me! I find that the hardest patients to work on are those who just cry and cry in the office. I'm not talking about children either. Adults who are so depressed that they can't even carry on a conversation without crying. I was told by my facilitators that I need to identify who those patients are and make sure they don't suck all my energy out because it can make you down in the dumps. It's very difficult to get through those conversations. Anyways, there's not many like that and most people are in pretty good spirits.

I've gotten asked so many times how old I am. Apparently, I look very young and they are always shocked I'm so far along in my education. What they don't know is that I will be like in my early 30's before I'm all done!

Ok, done for today.

Boards!

So I passed! My heart was pounding and my respirations increased greatly, but I finally got the nerve to click submit. And there it was "passed."

Thank you to everyone for all the good thoughts and prayers. I know they all helped!

Brazil Trip

My birthday where I have a pan of maracuja mousse.

Me in my rede!

C-Section baby!

Our boat!

Me with a scalpel, making my incision for a tubal!


So I've been a super slacker and never updated my blog since getting back from Brazil. Let me just start off by saying it was amazing. We flew in, took a bus to our dock, and spent a lot of time loading all of our luggage on the boat. Our boat was pretty cool and most of us slept on the top deck in our redes (pronounced hedgies...aka hammocks). We started out on the Rio Negro river and made our way to the Amazon river. We traveled all night and made it to the village of Sao Sebastiao in the morning. This is one of the larger villages in the Amazon and the mission I went with is very involved in that community. That afternoon we just sorted medicicines and got the boat ready for patients the next day. We also got a tour of the village.

So the next day we got up and traveled to a very tiny village where patients boarded the boat in families and went through all the stations. We even had our own dentist on the boat! That evening, the boat dropped the surgical team (5 of us) in Uracura where we stayed for almost a week in a hotel. There was myself, Dr. P, two nurses and our translater. The surgery days consisted of tubal ligations, A&P repairs (which is basically making them tighter), and hysterectomies. Many of these women have had 7+ children and their uteruses (uteri?) and bladders start to prolapse out. I also got to take part in a C-section. During the tubal ligations, I assisted on the first one, and then spent the rest of them acting as the surgeon! It was very exciting to do a tubal ligation almost entirely by myself! My first time with the scalpel was daunting though. It took a little while, but I gathered up the courage to do it and now I'm addicted. Don't worry, I won't become a cutter :) I have to say that these Brazilian women are just warriors. All they get are spinals for anesthesia and not once did I hear a peep out of them complaining. I hate how people in the US think pain is such an awful thing.

Moving on. So the food...which is obviously a very important part of my life. We had these awesome cooks on the boat. But I wasn't on the boat so much so we had to eat out a lot. We ate at the same restaurant for lunch every day and they told us what the menu options were each day. The food was ok, but in Brazil there are rice and pasta at every single lunch and dinner. And so within a few days I was a smidge sick of it...but you just suck it up and eat when you can eat. My favorite thing I ate in Brazil was maracuja mousse. This is basically passion fruit mousse. OMG it was the yummiest dessert I have ever had. Even better than creme brulee. They made this for me on my bday :) Also, I found the best soda: Bare. It's like a combination of root beer, creme soda and Coke all in one. It's made from a fruit of the Amazon. On my last day, I finally got my hands on a Caipirinhia - a yummy Brazilian drink. I was able to buy some Cachaca at the grocery store (a Brazilian rum) for a whole $2.50. It is currently in the fridge waiting to be put to use.

The heat: I have never sweated so much in my entire life. It was only in the mid 90's every day, but holy shit was it humid. Like my legs and stomach were even sweating! I didn't even know my stomach could sweat. I would get out of the shower and be sweating. I would be sleeping and sweating. I enjoyed walking more than standing still so at least I couldn't feel myself sweating and the air would be moving across my body! I can't even describe how hot it was, so I'll stop trying.

Overall, amazing trip! It was kind of hard because the group who went was all from the same church and knew each other very well so I was the outsider. Oh yeah, and it was a mission trip so there was a lot of praying and "Praise God." If you know me, I'm not into that so much, so I spent all of my down time reading. I think I got through 7 books in that time. I learned so much and moved very quickly on the learning curve. I would love to go back and do more surgeries.

Bon Voyage!

I'm off to Brazil! I actually won't be there until tomorrow but my journey begins today. I'm heading over to Dr. P's at 4, and we have flights to Charlotte and then Miami tonight. We'll "sleep" in the airport and catch our early morning flight to Manaus tomorrow. Needless to say I'm pretty damn excited and just hope this whole trip runs smoothly. I'm pretty much packed and just have some last minute stuff to put. Jake has me so prepared for this trip it's pretty unbelievable. I have my own first aid kit complete with a snake bite kit. After reading on mission's website the other night that all the heavy rains are driving the anacondas into the villages, I dug my handy little kit out to make sure I knew exactly how to devenomize myself. I still can't believe I'm about to see things IRL like anacondas. I'm really going to have to internalize some freaking out with all the snakes and bugs.

I'll be there for both our 1st year anniversary (Aug 9) and my 25th bday (Aug 11). That's pretty bittersweet, but I'll survive. I'm hoping I can at least talk to Jake on both days. We bought an international plan for my phone so hopefully it works. If not, I have some phone cards for back up.

Alright, I need to get some last minute things done today so as I think they say in Portuguese "Adeus!"

ER Week 2

Ok, this will be a short post, but today was pretty awesome. I got to suture up a laceration on a finger and do a digital block (numbing the finger) all by myself!!!! My ER doc was right next to me talking me through the entire thing, but in the end, I put in everything alone! Woohoo. Halfway through a surgeon walked in and was breathing down my neck the entire time watching. Scared the crap out of me, but he was very kind and encouraging.

We had a man come in with a GI bleed today. I had done the physical exam, went back and presented to my dr and he asked if I did a rectal exam. Umm nope, I had not. Figured I'd save that for the good ole ER doc. As my friend Lara would say "Oh contraire mon frere." In his exact words, "You're all over that girlfriend." So I headed back, with gloves, lube, and a hemocult test (testing for blood in stool) in tow, plus a nurse to help me. We get him rolled over, and there is massive blood everywhere. So lucky me, I got out of the rectal exam, but the smell of a GI bleed was quite possibly the most awful smell of my life. Like I gagged.

More to come tomorrow.

Emergency Medicine

I'm currently rotating in the ER. I have to say I love it. I started last Monday and within two hours of being there I sutured up an arm. It was very exciting, as I'm used to working on raw chicken! I'm now working 12 hour shifts: 7-7. I'm currently working the day shift, but will probably pick up an overnight at the end of the week. The patients that come in the middle of the night are different than the kind during the day.

So basically my day goes like this: patient is triaged by a nurse, I go see the patient, come out and tell the doctor what I want to order/prescribe, he orders what I say, goes and sees the patient to tell them what we're doing, and figure out what's going on with them.

Some of my highlights besides the suturing are learning to read EKGs far better than I have been able to the last two years, a man who came in to deliver his overdue baby, my first acute abdomen, and the thankfulness of the families of the really sick people.

My two saddest moments: 1) An elderly woman who kept falling and breaking open her leg. We had to tell her she needed to go to a nursing home for rehab to get her strength up and she was just crying and telling us that going to a nursing home was her greatest fear. It just about broke my heart. 2) A baby who was seizing for over an hour. The mom was just sobbing. It was awful.

Oh yeah, I got ACLS certified this week too. This means I can now run a code. Yup that's right RUN A CODE. Like be the person in charge. Pretty scary if you ask me. My ER knows that I'm certified now. I'm slightly frightened this means in the next week I could be running a code so that I can do a real one...not one on dummies.

Can I Get Some Help?

Ok boards are tomorrow. I have to be there at 7:30. Jake and I are heading down to CO Springs in a few hours to check in to the hotel, eat dinner, relax, etc. I'm doing a light study today, but don't want to overwhelm myself in the last 20 hours or so.

So what I'm asking is that if you can send me good vibes, think about me for a second tomorrow, pray, or whatever you feel comfortable doing. Please. I can only do my best, but I would love any extra help I can get. I would really appreciate it.

Thanks, and I'll see you all on the other side.

Terror Has Set In

Ok, my boards are in less than a week. LESS THAN A WEEK! OMG. The last two nights I've had dreams about boards...not good ones either. I'm cramming in as much as I can this last few days but part of me is freaking out that I can't possibly know enough and I think I'm going to fail. My blood pressure is going up as I type this so I need to switch topics.

My parents and sister are coming on Friday and are staying for a week. It should be lots of fun, but the first few days I can't spend too much time with them as I need to study my brains out. Somehow I went back to that subject. Anyways, some of the plans for the week include: Pike's Peak, Colorado Springs Zoo, Garden of the Gods, Estes Park, introducing them to some good ethnic food (let's be real, WI is known for cheese, not Indian and Thai), and lots of lounging by the pool. Jake's apartment complex has a hotel room that they rent out to families so they'll even be in the complex with us!

Ok I need to get studying.

Jake's Birthday

Frosting, frosting everywhere.
The final product....a little ugly and a little manly. Jake loved it.

A picture before we left for dinner.

Jake blowing out his candles. I did not put 28 on there.


He's opening his gift. I was sneaky and packed it in a laundry rack. Hehehe


Jakester turned 28 on Thursday. I've been pretty busy and am getting to this late, but I have pictures. I spent Wednesday making his birthday cake: Devils Food with chocolate frosting in masculine colors. Thursday, we celebrated by going to Water World, a pretty fun waterpark about 35 minutes away. It definitely wasn't as nice as Noah's Ark, but we still enjoyed ourselves. Some of the highlights of the day: realizing we're not spring chickens anymore, world's biggest wedgie, going down a slide so fast keeping our eyes open was impossible, losing all modesty as you fly out of those fast slides, and enjoying the day with my perfect husband.

After coming home and showering, Jake opened his gift, with my parents on Skype to watch. We (my parents, my sister, my grandparents, and I) chipped in for a flight on a World War II bomber. Jake is very very excited about it. He goes for his 30 min flight on July 11th. http://www.warbirdsunlimited.org/about.htm

After presents, we went to dinner at Brasserie 1010 http://www.brasserietenten.com (one of our favorite restaurants). The food was delicious and we both stuffed ourselves beyond uncomfortable. After dinner, our friends came over to eat cake and hang out. We had a lot of fun and kicked them out at 11:40. A day in the sun wore us both out.

Sun over the Mountains

I looked out the patio and saw this amazing sunset/storm cloud over the mountains. Beautiful!

Greekfest and Dinner Tonight

I forgot to take a picture of the yummy honey teriyaki chicken, so here's Jake with the empty wok.
Here's my pasta mess :(
Me eating my gyro!


Yesterday, I dragged Jake to Greekfest in Denver. Oh man, it was awesome! The music and dancing and food was just fantastic. I ate way way way too much, but oh man was it good. I had saganaki, tyropita, a gyro, and loukoumades.

So tonight, I made dinner. Jake was supposed to but something broke in the lab and he kind of got stuck. I made honey teriyaki chicken and a lemon linguine pasta dish. Both recipes came from a low fat cookbook that we picked up at B&N. I made dinner while Jake was tutoring and I made a huge mess. Like I dropped the rest of the pasta on the floor. I left it for Jake to clean up. Oops.

An actual married couple living together

These are some pictures of Jake building his new work bench. He decided this last weekend that he needed one because he was using the kitchen table, but now that I'm here, all of my study materials have kind of taken over. So he drew up a plan, went and bought the materials and started building it. Plus it gives him something to do while I'm studying.

So living together....it's been so wonderful!!! I think the weirdest part is not constantly thinking that one of us is leaving in a few days. Normally we are attached at the hip, but this weekend he actually has plans with some friends while I stay home and study. On visiting weekends, he would usually cancel to hang out with me, but I encouraged him to hang out with the buddies so I don't get distracted by him. What else is weird? Cooking for two people! We are both so used to having leftovers that last a long time but now we eat the food up pretty quickly. It's nice sharing the cooking and cleaning duties with him too.

So I guess I'll end this with a poll: what's your favorite meal for two?

When Did the Library Rule Change?

Seriously, am I the only person who thinks being in a library means being quiet? Am I the only one left who whispers if I'm forced to talk? On Monday, I studied at Jake's campus library. This is a huge library on a huge campus. I assumed that studying there would be a good quiet place. Boy was I wrong. People answering their phones, people talking in normal voices, slamming doors, etc. I didn't go back. Today I'm in the Longmont public library. Yesterday wasn't too bad, but there is currently a mother with her two children sitting at a table reading with her children; in a normal voice. Really???? There are about 7 adults who are quietly doing their work and she comes in with her noisy, bratty boys. She's not even attempting to be quiet. I'm a heartbeat away from walking over and telling her this is a library, not a classroom. People are studying...for MEDICAL BOARDS!!!!! I could care less about hearing her child learning to read. Shut up please.

Brazil Visa

Well today I am sending off for my visa to enter the country.
Application- check
Passport photo- check (I wasn't allowed to smile!)
$140 postal money order- I will buy this at the post office
Passport- check
Copy of my itinerary - check
International immunization card - check
2 postal express envelopes- I will buy this at the post office

In 15 days, I should have my visa!

Yesterday I went and met up with Dr. P to get the itinerary. Man do we have some long traveling days. We will be departing Cincinnati on Aug 3rd at 8 pm and we arrive in Manaus at 1:30 pm the next day. Then we take a 12 hour boat ride. On the way home, 12 hour boat ride back, 4:30 pm flight out of Manaus, and we don't get back to Cincinnati until 4 pm the next day. I am going to be one tired girl.

10 months!

We have been married 10 months today! Gosh time is flying by. Pretty soon a year will be past, and then we'll begin year 2. I have to say I have had an amazing first year of marriage so far (don't screw it up now Jake, lol). I'm getting pretty antsy. In three days I'll be out in CO with him. Thank goodness. It's strange getting everything wrapped up here though. It's definitely not the same as when I just leave for a long weekend. For example, I'm eating like crap because I'm trying to clean out the fridge and cupboards. Blech, I can't wait to get back on a healthy regimen when I'm out in CO. I will not even tell you what has gone into my mouth today. Bad Jenny.

IVs and Foley Catheters

Me doing an IV on the fake adult arm.


Starting a female catheter.

Starting a male catheter. I'm totally bummed that he cut my head out of this photo. Oh well.


Yesterday was a pretty good day. We practiced IVs and Foleys on fake arms, penises, and girly goods. The fake arm was not very realistic because we got to keep lifting the arm and turning it the way we wanted. Yeah I don't think my patients would be too pleased if I turned them 360 degrees. But we had fake blood that came out when we got into the vein. We practiced on an adult and then a pediatric arm. I did get the chance to practice on Kasia. It took a little while, but I did get one in her hand. I know that I'm a super hard poke because my veins are really small and deep. She tried in two different places and couldn't get me.

So the foleys we obviously didn't practice on each other because, well that would be very very weird. So we had models to practice on...not as fun and exciting as I had hoped, but oh well.

Last night, we had a BBQ at our professor's house for an end of the year celebration. It was so much fun. There was plenty of good food and lots of laughing. It's weird because it will be a long time before everyone is together like that again. And then at the end of the summer the new students will be joining us and the whole dynamic will be different. Oh well.

I'm Going to Brazil!!!

Typhoid, yellow fever, and malaria Oh My! I don't think I've blogged about going to Brazil. Well I'm going August 3-14th for an international medicine rotation with an organization that goes into the Amazon www.cbm.org.br/amazonboatministry.html . One of the doctors I work with asked me to go with her (at her cost). I pretty much fell over myself saying yes. Turns out, we are doing a surgery mission. I went over to her house on Sunday to discuss some details since I'm leaving for Colorado a week from Friday and won't be back until two weeks before we leave. So the itinerary is: fly to Miami where we will meet up with the rest of the group (there are 18 of us I think), fly to Manaus, get on the boat and take a 12 hour ride to either Sao Sebastiao or Urucura. Once we are there, Dr. P, myself, a nurse, and a translator will get off the boat and stay at the preacher's house (Wesley). For 3-4 days we will be doing surgeries from sun up to sun down, go home to eat and rest and go to sleep to do it all again. We will then get on the boat and head to the other village and the four of us will disembark but this time stay at a hotel. For 3-4 more days we will do surgeries, then head back to Manaus on the boat.

I am obviously very excited about this trip. It's an opportunity of a lifetime and I'm hoping to be a rockstar at these surgeries by the end of the trip! I still can't believe she asked me to go with her. I promise that I will use this opportunity to learn everything I can!!! And let's be real, there will be three of us in that OR with the patient, in the middle of the jungle...In the US there is usually 6-7. I am hoping to do a lot more.

So back to my first sentence: I've been getting immunized and I'm all done with my shots. On Friday I received the hepatitis A and yesterday was yellow fever and typhoid. I will start my antimalarial medicine on the first day of the trip. My left arm is killing me. That typhoid shot just sucked big time. Oh well sore arm vs typhoid...I'll take the sore arm.

I'm going to be there for my 25th birthday. It will be strange considering I won't be surrounded with any loved ones. Unfortunately, I will also be gone for Jake's and my first anniversary. I am aware that I suck and will be making this up forever.

It will be weird to be without my computer for two weeks considering it's pretty much attached to my hip, but I'll be paper journaling (back to ancient times) and taking tons of photos so you'll all be bombarded with reading and photo looking when I get back.

The Life of an OB on Call

What a day I had yesterday! I have been following a pregnant patient (who we will refer to as "C" ) her entire pregnancy. She was due May 25th and I have anxiously been waiting for THAT call. Yesterday morning at 6:45 I got it. Labor and Delivery called to say she was 4 cm, 100% effaced, membranes were still intact, and had an epidural. Man did I fly out of bed. I was so excited! I drove the 20 minutes to the hospital to find out that floor is busy! There were 4 babies in the nursery (two being discharged soon) and 2 moms in labor. Dr. V found me, updated me on C, and we went and saw her. I got the summary from C, examined her, and began the waiting game. I spent a lot of my day glued to the monitor at the desk which shows a graph of the fetal heart rate, mom's heart rate, and contractions.

Another patient (who I will call A) got an epidural and went to sleep for awhile. Before the epidural, we checked her and she was about 4-5 cm. She slept for awhile, so again back to the monitors I went. Around 15:00 we went to check A out, and she was complete so we told her it was time to push. I was on "hold a leg and foot, push it back and tell the patient to push duty." I realized how awkward it is to tell a woman who is in a very bad mood and in a lot of pain to "push push push push push. Push like you have to poop. C'mon PUSHHHHHHH." Anyways, at 16:21, baby girl A was born :)

So, we clean up, get ourselves together, go check C who is sllloowwwly progressing, and see that she's about 9.5 cm at around 17:30-18:00. Dr. V told her she would come back in about 20 min to see if she was complete. So we're at the desk, discussing the rest of the day when we hear from one of the nurses "Dr. V would you like to join me for a delivery?" While A was delivering, another patient (B) had come in about 3 cm, wanting an epidural. Well, she went to 10 cm in less than 20 min and it was time to push. Again, I was on hold a leg and yell push duty. Baby boy B was born after about 5 pushes.

We literally changed gloves, and walked over to C who was ready to push. This time I went to "hold a leg and yell push, hold the fetal monitor, and help stretch around the baby's head duty." After about 15-20 min, Dr. V decided to let her rest because the baby was not tolerating pushing. The heart rate was bouncing between too low during contractions or too high between. In addition, we were pretty sure her pelvic bones were too narrow and his head wasn't going to make it. So the OR team was paged, we got everything ready to go and Dr. V and I rolled C down to OR where we got her prepped and ready to go. Once she was set, we scrubbed in and began surgery. Baby Boy C was born at 20:25. I'll admit, I got pretty scared as he didn't cry for about 3-4 minutes. There were a lot of people in the corner working on him, and they finally got him to. Phew. So baby C and dad left, C was knocked out and we finished up surgery. Dr. V allowed me to suture up the fascia, only two days after practicing on a chicken! I was scared, but I did fine.

Alright, surgery is over, we walk C to recovery, Dr. V goes to dictate and I go to find the baby and his family. I found the baby in the nursery with the nurse but no family. Where are they you ask? Oh in the basement. Why? Because there's a tornado warning. Yup Baby C was born in the midst of a tornado warning. No one even told us in the OR! LOL. So I found the family, told them C was great, baby C's weight and length and there were hugs all around. I waited until C came out of recovery to see the two of them together. One of the nurses snapped a picture of C, her husband and baby C with me. They will be emailing it to me later.

So, I got home at 22:50. It was a very long day with little food. My feet hurt like never before; I was exhausted. BUT it was the BEST day of medical school yet! 3 babies! Woohoo.