I Matched!!!!!

Woohoo! I was literally jumping up and down, twirling in circles and screaming! I find out Thursday where we are moving.

The most exciting part of all this? I am definitely going to be an OB/GYN!

Update will be on Thursday!

Nervous With a Side of Anxiety

Jake and Manda standing on the top of the bridge. Note that the wood is supposed to hit somewhere around the chest.

Manda totally biffed it by stepping off the trail of hardpacked snow, and stepping on the soft snow: where she sunk.

Lots of elk!

Manda and I standing on Bear Lake.

Jake took a pretty amazing photo!

Manda and I in front of the HUGE icicle!

I'm sitting on the trail railing.

I'm currently sitting on the couch, my stomach just churning in knots. I've been waiting for tomorrow for 9 months, longer really, if you consider how long I've been waiting to be a doctor. Tomorrow morning at 12:00 Eastern time, I will get an email that simply says one of two things. Option 1 "Congratulations, you have matched" or option 2 "I'm sorry, you did not match." On Thursday we find out where we are going. Obviously I have my preferences for where I would like to match, BUT anywhere is better than nowhere. Once I find out I match (I'm being positive here), I will be over the anxiety and just be excited to find out where! I have Benadryl all ready to help me sleep tonight because let's be real, there is NO way I'd be able to without a little help.

This weekend my BFF, Manda, came to Colorado. We had so much fun, and time flew by, which is exactly what I was looking for with so much going on this week. We went up to Bear Lake and Estes Park. Here are some fun pictures.

"Clear!"

Everyone has seen somebody on tv yell "Clear" when a patient is shocked. I had the luxury of doing this yesterday. It was very exciting! A patient with atrial fibrillation had failed medical therapy and needed cardioversion to convert his heart back to sinus rhythm. Dr. T told me that I would get to do the case, as long as I knew the complications and how to treat them. I spent a good amount of time preparing all the possible complications and the treatment because I didn't want to risk not having the answers and therefore not getting the case. The biggest risk is asystole: completely stopping the heart. That's all he wanted to hear. So I was over prepared; but that is always better than being under prepared. So we set the patient up, the anesthesiologist sedated him and I started the defibrillator. On the machine, there is a strip where the heart rhythm is displayed. Dr. T warned me that while doing the shock, I needed to keep my eyes on the strip and not on the patient (who would jump off the table) to make sure that he didn't go into asystole. So, I set the energy to 100 joules, got the patient synced, charged the defibrillator up, and said "clear" and shocked the patient. I made sure to not even glance away from the strip. Luckily, he converted to sinus, and the cardioversion was a success!

Lub Dub

That is the sound the heart makes as it beats. Or at least if there are no mechanical problems. I got to watch open heart surgery this week. I watched them saw open the sternum, spread the chest cavity, and cut into the pericardium, where inside was the beating heart. Lub dub, lub dub. This patient had an aortic aneurysm and needed an aortic valve replacement. His aorta was huge. I was shocked at how big it was. No wonder people die if they got shot in the aorta!!!! Alright, I watched the beating heart for awhile. Then they put him on the heart-lung machine so that blood could completely bypass the system. After that was done, the doctor paralyzed the heart. So at this point, it's flattened out because of no blood, and not beating. Then the aorta was cut out. I was actually very surprised at the length of aorta removed from the body. He then took the new aorta and put in the new valves. And then the most tedious part of the surgery: sewing the new aorta into the system. Both ends had to be attached plus the coronary arteries had to be routed to the new aorta. He was sewing forever. I think there was something around 160 sutures used throughout the case. After all this is done, they SLOWLY fill the heart with blood, 100 cc at a time, making sure that the system reacted appropriately and that there were no leaks. Then they inserted a chest tube, and began to close him up. They "sew" the sternum back together with thick wire, and then close the outer layers. Sounds easy right? Hah, it was 5.5 hours of stressful surgery.

I was amazed throughout the entire surgery. I'm fairly certain the smile did not leave my face for the first two hours. I think one of the weirdest thoughts was that this man's heart was not beating, his lungs were not inflating, yes his brain was intact and blood was circulating through his system.

This was definitely one of the most memorable days of medical school.

My Sister's Trip to New Zealand

I don't know if anyone is interested in reading along about her travels, but she is studying abroad in New Zealand and just arrived this week. Her blog is:
http://mylifeinthelandofkiwis.blogspot.com/

I'm Scared of Dying

This is actually something we hear every single day. New patients will come in because they are afraid of having heart disease, not knowing about it, and dropping over dead. When a patient who has heart disease says that to Dr. T, he has an interesting response. "Well , you might as well get over that right now. You are going to die some day, it will probably be from your heart considering it's the number one killer in America, and as far as I know, we have no say in when that will happen." The patients usually look shocked and then nod their head in agreement. That usually ends the discussion.

Dr. T is so amazing with his patients. He knows how to talk to them, individually, when to take a more holistic discussion (this is Boulder) without compromising care, and being very kind to them.

A funny story: he has a patient who is in her late 90's. I saw that on the schedule and said "Wow, our next patient is 97!" And he said, "Oh it's going to be a lovefest in there! An interesting fact about her, she doesn't dream." My response "wow that is interesting but how on earth did that conversation ever come out."
We walk in the room, he gives her a hug, we sit down and she says, "Dr. have I ever told you that I don't dream." I almost fell off the chair laughing. He looked at me with a look that said "that's how I found out."

I've Been Dreading it For a Year

Cardiology. That's what I'm in right now. When I found out a year ago that cardiology was a required rotation of 4th year, I started dreading it at that very second. I'm now halfway done with the rotation, and surprisingly, I'm enjoying it. Like really enjoying it! My preceptor is AMAZING, and has taught me such interesting and applicable things that I enjoy going in each day. The week is split: 2 days in the hospital, 2 days in the clinic, Thursdays off, and we round every morning at the hospital. It's a great set up! So far, I've been in at least 8 angioplasties (heart catheterization with stent placement). It's very interesting to see the patient's and their family's reactions. For example: this last week a doctor from in the mountains called Dr. T to take a look at an EKG. The patient had some chest pain, had been ignoring it for a couple days, and finally came in. The EKG was abnormal, but nothing too significant. Dr. T wanted a troponin drawn, but because the patient was in the mountains, the blood wouldn't be processed until the next day. So he asked to see the patient the next day. The troponin was drawn and was VERY elevated. The patient and his wife were in complete denial that anything major was wrong. Dr. T had already put him on the schedule for an angioplasty because he knew it was bad. The patient actually sat there and tried to talk himself out of the angioplasty. We get back in the cath lab and he has a 100% occluded right main coronary artery. Not good. So yes, this guy was having a heart attack. The plaque actually was about 7 cm long. It was a tough case. Once, Dr. T saw the big blockage, he sent me out to talk to the wife and let her know that he was having a heart attack and that he'd be in the ICU overnight with a few nights in the hospital. The wife's response "A heart attack???? Really???" I mean, her husband is over 300 lbs and had bad chest pain and the cardiologist was very pushy to get him to the cath lab. What exactly did you think was going on?

So it's been an interesting two weeks.

Eyeballs- Week 1

Well, I was definitely in for more than I bargained for! I've learned plenty this week, saw MANY procedures (who would have thought ophthalmology would be known for procedures), managed to terrify myself, and looked at lots of eyes.

I'll start with the things I've learned:
1. Take care of your eyes- there really is a point of no return. Pay attention to your vision, and if you note changes, call your eye doctor up. There are treatments within a reasonable time frame.
2. Contact lenses are really not that great for your eyes if you don't wear them the recommended way. I'll be honest, I definitely don't wear them the recommended way. You can get a corneal ulcer and then you won't be wearing contacts for months. I have been lectured by more than one of the docs already. For example, wearing them for 24 hrs a day, is bad. I don't do that now, but during residency I was pretty much planning on keeping them in since I'll be awake. Wrong. Apparently, I'll need to update my prescription so my glasses can be updated (they're circa freshman year of college). I'll be making a visit to these guys before I leave for residency.
3. The cosmetic side is very interesting. Botox, Juvaderm, facial laser treatments, and the surgeries. I'm seeing a blepharoplasty (eye lid tuck/brow lift) on Monday.

Ok, onto the things I've seen. If you are squeamish or hate eyeballs, consider yourself warned.
1. On my first day I was floored at the amount of things I saw. For starters, a man came in with a retinal detachment. This is BAD. Think of it as the back wall of your eyeball (on the inside) coming loose off the wall. The symptoms are a black curtain coming over your vision. The treatment is not nice. To start, the eyeball had to be numbed with lidocaine. This meant an injection onto the eyeball. The lidocaine made a bubble on the eye. (My mouth was hanging open). Then he froze the back of the eye with a cryotherapy technique, by basically shoving this thing alongside the eyeball. Then he injected a gas bubble inside the eyeball so that it would push the retina back up against the wall. This means that for 4 days, the patient has to lay in a position forcing the retina back where it should be. For him, it was his left side. Worst case scenario- laying on your face for 4 days. And yes that does happen.
2. Eye surgeries do not mean that the patient will have general anesthesia. For somethings, they just get a valium beforehand. In other cases they get some Versed. This means they can talk to you and move their eyes while operating. Very strange.
3. For wet macular degeneration, the only treatment is an injection into the eyeball. Some patients get these monthly. I was pretty disgusted by the first one, but they are SO common, that I now think it's a normal visit.
4. Lasik is pretty quick. It's not as scary as I thought it would be, but I'm still not interested for myself. I'll continue the road of cornea eating contacts.

The Eyeball

The eyeball is the one thing that I think is pretty disgusting. I hate looking in them, and Lord help me if there is some sort of trauma to the eye or I need to go digging in the eye. Tomorrow I start my rotation in ophthalmology/facial plastics. I am going to have to keep my gag reflex under control and hopefully I don't pass out in the OR, when we operate on them. The worst part about all of this: I have to fake it to my preceptors. They cannot know for half a second that I hate eyes. So you might ask why I'm doing a rotation in eyeballs when I hate them so much. Well, it's 15 min from Jake's place (I guess it's ours now) and I needed a surgical elective. This counted. So I'm doing it.

Welcome 2011

Happy New Year! This is a year I have been looking forward to for a long time. It's quite hard to believe that it's here actually. Here's the list of things I'm looking forward to this year:
1. Graduating medical school and officially becoming a doctor on June 3rd! This is something I've been dreaming about for a very long time. When I think about all the things I have learned since starting medical school, I'm amazed! My family is renting a house in Arizona for the event so we can party it up and celebrate for awhile!
2. Jake getting his PhD! We're not quite sure yet when this exactly will be since his boss decides, but we are sure it will be this year. Then he will find a job and make real money!!!! Jake is also contemplating starting a company based on his research.
3. Moving to an unknown place! As I've previously written about The Match, we won't know where we are going until March 17th.
4. Buying a house! This is very very exciting for both of us. I am looking forward to having our own place where we can do what we want. Plus we desperately need more space. I am constantly on realtors' websites checking out homes for sale.
5. Getting a puppy! Jake promised me that within 30 days of us living together in our new place, I will get a puppy. Our plans are to get a german shepherd pup. I have never had a dog so I'm sure I'll be jumping up and down like a child when I get it.
6. Finally starting my training in being an OB/GYN! If you talk to any 4th year med student, they will tell you how they are so sick of all the extra rotations, when all you want to do is start residency. I am enjoying my time off though.

I can't really complain about 2010. It was a good year. I learned a lot, spent a lot of time with Jake, celebrated Thanksgiving and Christmas with Jake and the rest of my family, and most importantly moved in with Jake. To celebrate NYE, we stayed in, watched movies and made cheese fondue! Today we went and saw Black Swan. My, this was a strange movie, but I'm so glad I saw it.

Anyways, I am looking forward to 2011.