missed the boat.

I missed the boat on beach weather!! Yesterday was beautiful, sunny, light warm breeze and PERFECT for the beach. However, today was our beach day and this is what we have to work with:

photoShould’ve gone to the beach yesterday. I guess this means I HAVE to clean, study and prep for the week ahead.

Today includes 1 exciting thing though…

Grocery shopping, meal planning, cleaning, laundry, studying, organizing, maybe some thrift shopping for a piece of furniture we’ve been needing, fusion barre at a new fitness place in town…::cough cough::  A FITNESS CLASS!! I haven’t been to one since cross fit…and that made me hurt so bad. I hear barre is hard, so I’m expecting the worst, but I’m super excited to be in a group class again!!

Also, yesterday was my man and my 7 year anniversary (for dating…when do you stop counting dating and just celebrate wedding?? Our 4 year wedding anniversary is in 2 weeks…is it time??) I still count both b.c I feel like we’ve been through so much. We dated across countries for 3 years!! Part of that time I was abroad in England (he’s English) and there were SEVERAL trips to see each other, but we mastered long-distance and I’m proud of it. The marriage has been easy compared to it, we live together and that makes planning life a LOT easier!

To celebrate, I’ve planned a surprise for my love. In 2 weekends we’re heading away for a romantic night in an airstream trailer (the old silver ones) that someone rents out on their malibu property, overlooking the ocean. I’m so excited to be secluded, in a beautiful place, with beautiful things to do around us — we can go to the beach, roam through the meadow, enjoy wine out side of our trailer watching the sunset…. ahhhhh

I hope he likes it!! {{He doesn’t read my blog, so no worry about him seeing it here}}

Off to officially start my day with coffee 🙂

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Sunny California

Today has been one of those CA days that makes you just smile from ear to ear. I was able to sleep in, get up with my pooch, and enjoy my cup of coffee out on the porch in the glorious 70 degree weather with the beautiful sun beaming down on my skin. 

ImageThe pooch was around to enjoy the action and soak up the rays as wellImage

ImageHe has to stay on the yard leash while we’re in front b.c there isn’t a gate and if this pooch sees a cat take a stroll by, he’ll be on his merry way…chasing the cat….like he needs dinner. No bueno. 

After coffee, we had a run and walk around the neighborhood, ran for 30 minutes and walked briskly for 35, ended up in the back yard doing some box jumps onto and off of the porch. The dog thought that was fun…and then went crazy. Not really crazy, but the kind that is fun to watch and reminds you that pooches need to play games and have play dates too. It’s time for one for sure! 

Got home, had a massive lunch, headed over to a house in our friends neighborhood that’s for rent (we’re looking to move soon)…the house was crappy, got home and juiced some veggies 🙂 and got into a stupid fight with the man about moving (lame) and then got past that (yay) and am now packing for my mom’s house. 

I’ve got a lovely night with my mom and sister and our two pooches planned. Excited to get some family time in. 

 

And excited for the 3 day weekend. And the sun. And life. x 

 

 

 

Beer. Pooch. Weekend.

This week has been busy! Finished today, pooped and ready for a very restful weekend. I promptly took myself home, walked the pooch, ate more valentines day chocolates:

photo-6and have been relaxing and planning my weekend/upcoming weeks since.

Saying goodbye to everyone at the hospital and clinic was hard today. I have realllllly enjoyed all of the folks that have helped make this rotation so great, the nurses, medical assistants, techs etc… and especially the clinic staff! Most of all, I’ll miss rotating with my dear friend!!

photo-7Saying goodbye to colonoscopies and the lab wasn’t as hard, haha, but actually I’m really going to miss the procedures and the clinic work, it was an awesome rotation and I’ll be going back at some point for sure.

Valentines day was pretty uneventful, I stopped by TJ’s on the way home from work for beer, chocolates and a special can of wet dog food (you can’t forget your furry loves on vday!!) and when I got home, my sweet husband had flowers

photo-9chocolates (pictured above…and almost gone : / , dinner, and more beer 🙂 We ate and then he went off to do some work and I did a fun workout with the pooch. I took him around the colleges and did some intensity training (is that what you call it?!). We ran up and down stairs, did squats, threw balls and raced to see who would catch it, all in all…exhausting at 9pm! I got home and slunk into bed and fell promptly asleep. Husband has been working on a script for the past month and is nearing a deadline, so he was up late.

Tonight has been filled with this

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Planning life in my Georgia O’Keeffe planner…my FAV artist AND trying on my 5 pairs of warby parkers. This site is great! They send you 5 for trying on at home and they send them for free with all of the shipping labels and box for the return as well. I think I’ve settled on my favorites, but currently wearing a close second to see if they usurp the first place ranking. #2’s are red. hm…

photo-8Excited about this weekend. Will visit with mom and help her add rock to her yard, woot! Hopefully see sister for a brief visit, and most importantly spend some time gearing up for my next rotation!! Excited!! Also, will try a new fitness class, Fusion Barre, due to my groupon I purchased at 6am in bed when I was waking up and checking my email. Maybe I’ll make all of my decisions in the morning haze. Less time to ‘think about it’ and more time to DO! haha.

 

 

 

 

it’s all good.

Woke up to a WEIRD dream and then husband brought me my HUGE cup of coffee with ‘its all good’ printed on the side. Indeed it is all good when I’m in bed with my pooch, coffee, sun streaming in from outside and my laptop perfectly positioned for my research on postcholecystectomy syndrome. Ahhhh

Yesterday we were slammed! It was 2 students (before it was 4) and the doc…we saw 33 patients in 4 hours (it was 4 because the doc had an emergency meeting at the hospital, so he was an hour late). Last night was a night to relax.

Today I’m thankful for the birds currently chirping outside as my bedroom door is open to the backyard, its a beautiful day here and I’m truly thankful for my life in California. I’m also thankful for the food we’re able to buy. We’ve been stocking up on healthy and nourishing food and I’m so appreciative that we’re always able to buy what we need. Finally, I’m thankful for my workout buddy: pooch. He has been my buddy the past week and I love him so x

Weekending.

It has been a great weekend!

I’ve been holding true to my desire to spend lots of time with the dog, instead of yoga I’ve gone hiking and running [both with the pooch which makes them SO much more enjoyable :-)] and I’ve just finished weeding and raking the back yard!

Heading to the horse trails to hike, my favorite co pilot

My favorite co-pilot and I off to the horse trails for a hike

 

playing ball with pops

Playing at the park with pops x

I also put together a big ol’ salad for the week, am currently roasting veggies [potato, sweet potato, chives, shallots and onions + olive oil/pepper/cayenne pepper/salt/rubbed sage]…and later will put something together for the morning. I LOVE having time to prepare meals, just simply one of my favorite things.

It was also a great weekend b.c I got some great friend time in. We were at a friends house on Friday, her husband made crab and we brought dessert — it was awesome!!!! I don’t know what he did, but it was loooovely and we enjoyed a very long dinner with giggles and full bellies. Today I hiked with my friend and her two pooches, both adorable and about 1/5 the size of Rooney, but the love each other all the same 🙂

what i get to wake up to x

This upcoming week is my last week of GI. As mentioned before, I’ll be deciding if I should ask for a letter of recommendation. I’ll also be putting together my ‘thank you’s’ and my baked goods that I bring to say goodbye. I wish this rotation was 2 months long, then it would be perfect! That being said…I’m excited to move onto my next rotation in OMM.

P.S. this morning it was 39 degrees…in Southern California…again, toooooo cold!!

OH and I finally got new shoes for work {i ended up cutting off the tassels, I thought they were silly…}

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Versed

You know you’re on too many medications when…you’re given 8 versed (sedative) via central line, on 15mg of dilaudid (mega pain meds), benadryl and fentanyl…and…you’re STILL wide awake.

One of our patients yesterday. I don’t blame him entirely, he’s young, has had several back surgeries, has some psych issues and I truly think the medical system mis understands him and has created some of his issues for him. On the other hand, he’s an adult and is responsible for his life. Yesterday was a rough day with him.

We tried to do an EGD (esophagogastrodudonoscopy) i.e.: scope down the mouth so see inside of his stomach, he has some symptoms that need explaining and he agreed to the scope etc… after we scoped him, he kinda went into another place, yelling, ripping things off of him, wanting to leave. I was so taken aback, but also concerned and upset. I felt like he was being very unfair, I felt like he needed a lot of help, and I felt like it was an experience that he had had before. I debriefed the experience a little with my friend on rotation with me and moved on. Sometimes its very surreal to be in medicine and have experiences that you just have to ‘move on’ from, esp for someone like me. I’m a talker, a feeler, a sympathizer 🙂 that’s what the husband is for, he always lets me vent!

Next week is my last week. I’m so sad about it, I wish this rotation was 2 months long. I’m vacilating back and forth between asking him for a letter of recommendation OR waiting until I can get another rotation with him and asking him after that etc… It’s so hard b.c they know we need letters and they know we don’t have a lot of time on rotations, but I still always feel like it’s premature to ask for one.  I should take a hint from the pre-med student that was shadowing me the other day, she walked right up to the doc and said {{note: this was her second afternoon with him and she wasn’t shadowing him, but rather me…so they don’t REALLY know each other}} “dr. ____, my uncle said you would be able to write me  a letter of recommendation for medical school” dr ___ : “yep”

haha…knowing people always gets you places!

Anywho…Off to the hospital and then back to school today during afternoon clinic, I have some stuff to take care of.

Excited for the weekend!! I plan on doing lots of yoga, dog walks and studying!!

Colonoscopy Dreams

Hello!

It has been a few weeks b.c I’ve been busy getting schooled on my GI rotation. Currently I’m on an internal medicine rotation with a GI doctor that also does some PCP care. So that means in the morning I’m in the hospital doing {read: holding the scope and pushing it when I see lumen and holding heads of sedated patients undergoing EGD’s…not really DOING them…but close for me :-)} doing colonoscopies and EGD’s and ERCPs etc…

After the procedures are done for the morning, we eat lunch in the cafeteria (free…yes, this is something that students are very easily swayed by, FREE FOOD). After lunch it’s off to the clinic just a few minutes away and we’re pretty busy every day with GI patients and PCP patients alike.

Let’s go back to the first week. When I started this rotation, I had 3 under my belt: surgery in June, Family Medicine inpatient in July and Family medicine outpatient just prior in January. That means that I had a solid 4.5 months in between with NO rotations, NO medicine (other than the medicine I can include in my teaching of OMM). To add to it, this was my FIRST internal medicine rotation…um…that means this rotation covers pretty much every body system [with an emphasis on GI, obviously, but b.c he does primary too…that means everything] that means anemias….to fibromyalgia….to colon cancer…. to asthma….to dermatology. The translation: I am WAY BEHIND!!

I knew that doing the fellowship would cause me to be a little behind when I started back on rotations. But because this was my first year of rotations and I literally had 3 rotations under my belt…it has been a little extreme with the learning curve. What I didn’t realize coming into this rotation…this doc has a reputation. He is well-known for not sugar coating anything and pushing his students to be great. That is AMAZING and I love it so far, BUT, that means that most of the day I’m fearful of what he’ll ask me and what I won’t know. The first week was by far the worst.

I cried 3 times that week in my car. I’d leave the office, start the car, and let the tears come. It was a combination of fear, feeling stupid, and disappointment in myself. I know I shouldn’t be too hard on myself and I definitely recognize this as a learning experience that I’m really lucky to have. However, that being said, this is not my ideal learning situation. When he pressures me for an answer on something that I know…even though I know it/have JUST looked it up/literally written a paper on it…I can’t answer his question b.c I freeze inside.

Fortunately, I think he likes me. The atmosphere has improved and I feel like he sees my effort and can see me working hard to learn. It helps that at least 5 of my patients have commented to him how much they like me and want me as their doctors [it’s always the older folks! I just have a deep love for the grandparents, maybe geriatrics is my future?!]

So here we are, week 3, and I’m loving GI. I don’t LOVE the smell of poop during messy colonoscopies, I don’t LOVE the farting during procedures with watery diarrhea, and I don’t particularly LOVE that EGD’s are really uncomfortable for a lot of people. What I do love, though, is teaching/learning/and counseling on GI stuff! I have IBS and have that in common with so many patients. I love that I can understand them and can relate and really sympathize with what they’re going through. I am also starting to love the technical part of the job with procedures. I REALLLLLLLY want to get my hands on a colonoscopy and do it solo.

Basically there’s a scope and then there’s a ‘wheel’ that we drive it with, meaning there’s a handheld device that we hold with the hand not pushing the scope in. This device can turn the scope [which has a bent end], can suction, take pics, and send water out over the surface of the colon. I’m still a little confused on the hand-scope-colon coordination and obviously don’t think I’ll really ‘get’ that until I do one myself…b.c sometimes he’s in the sigmoid colon and I think he’s already in the transverse…but the reality is that some people have really TWISTY colons 🙂 and it just takes a long time to navigate through.

The other day we did several in the morning [including two possible cases of c.difficile, and they were very graphic compared to the ones that are simply for screening] and that evening, I’m sure as an aftermath of seeing so many colonoscopies, I had a dream I was having one! And get this…………it was AMAZING, ha! In my dream I was SO happy and so well-rested from the sedation, lol. I woke up confused, but happy that my vision of my colonoscopy experience is going to be so good 🙂

Tomorrow will be another long morning, I’m excited to see what we’ll get to do! {I just want to say, I’m so thankful for this rotation. My last one was a break compared to this and gave me no opportunity to see patients, this one is a HUGE learning experience and I’m seeing tons of patients each day, it’s awesome}

On a side note…my dog child had his anal gland surgery 2 weeks ago. He’s now completely healed and happy as could be. Thank goodness! For a few days he was totally out of it!

one week countdown

The weekend went my so quickly, working on saturday helped to move it along, but man, where did it go?!

I had a great day at the clinic Saturday morning. I just keep thinking how grateful I am for the patients. They open up to me, help me learn, and are understanding enough to answer my questions as I perfect the history and physical portion of being a doctor.

Saturday the pooch was at ‘daycare’ ‘pooch camp’ whatever you wanna call it…the folks there on the weekend were so impressed with his jumping ability 🙂 thank god he hasn’t figured out that he can jump OVER things, yet. That evening we met up with some friends in LA for a birthday dinner that was amazing. We had delicious soups, salads, appetizers and the creamiest polenta EVER.

Yesterday was pretty low-key. A nice walk w the pooch in the AM, a visit with my mom in the afternoon and PM, Golden Globe watching and dinner with my lovely man. I did almost keep a stray dog though…

I can’t just watch them on the side of the road and LEAVE them!! I had to stop to pick up the hairiest, scrawniest, cutest little pooch. Ended up being very old, but had a harness on so I figured it must be someones. After nearly an hour of having her, feeding her, holding her, we went back to where we found her (i had already scanned her at the local vet hospital and no luck on finding a chip.) She ended up belonging to the first door we knocked on! Her name was coconut 🙂

I’m hoping today I get more responsibility in clinic. I think my preceptor has forgotten a little what it is like ot be a 3rd year student. H & P’s is alllllll we do and we’re pretty good at it! I know her patients come to see her (and some wait 1+ hrs to see her!) so I understand if she doesn’t want me seeing them instead of her, but at the same time, she opens her office up o students. Here’s hoping!

hmm…are you sure?

Being one-on-one with my preceptor is awesome in so many ways. I get to have her undivided attention when she’s teaching, I get to interact with every single patient, and I can ask her a multitude of questions without judgement from another student 🙂 and without them taking my time!

The down side, however, is that I have to hold my tongue a bit. The unfortunate truth is that I can’t just tell her everything I think about a patient, my personal experience, or that something we’ve said might be wrong etc…not that I can do that with any preceptor, but there is a level of conversation when you have several people as opposed to you and your preceptor.

For instance, I’ve had digestive issues my entire life (IBS, woot!) and what finally helped me get control of my symptoms: dietician! When I took the time after undergrad to really focus my time and energy on my diet I quickly figured out how to alter my pain, discomfort and the overall hassle of IBS. Of course as soon as medical school started and my stress level went up…well…not as well controlled, but you get the point.

So yesterday there was a patient that presented with pain from IBS and diarrhea that was causing him to stay home and wear diapers when he had to leave the house. Of course, this is awful and he needed help. I was pretty shocked when there was absolutely not talk of diet. I’m not all roses about our medical system and I know that medical schools on average don’t train doctors in diet. I also know that insurances (like medi-medi or low-income insurances) often times won’t cover a dietician visit for anything other than Diabetes management (and often times that is 1 visit). I also know that it takes time to evaluate your diet — and this patient in particular was extremely overwhelmed with their life and taking care of their partner who had several medical problems.

When I asked my preceptor if she had already been given counseling on how a dietician could help…she basically asserted that she wasn’t sure a dietician could help an IBS patient. Hm…are you sure? I just feel like I’m doing a diservice to the patient when I don’t offer every possible solution. I know that a lot of people won’t take it, I know that a lot of people want to walk away from a visit with a medication to feel like they’ve been helped. And I know that it’s our responsibility to help them how we can — for low income patients that might be managing IBS w meds that are only 4 dollars at some stores VS a dietician visit that may cost hundreds in the long run. I just don’t know how to become comfortable in all of this.

This has been my challenge since rotations have started. I’ve printed out pamphlets, phone numbers, addresses, and many resources for patients that the hospital or physician doesn’t have the time to provide. I’ve wondered what else we could do without thinking…will the patient appreciate this or listen to this? I know some of my efforts have been a waste of time, but I also know that it is sometimes the only extra help they get. That sometimes patients may feel desperate and will make any effort possible when the conventional methods have fallen short.

This is why I’ve been suggesting peanut oil when appropriate. What?! Well…peanut oil is a natural topical anti-inflammatant. For those patients that have unrelenting pain in their joints and the meds, steroid injections and PT aren’t helping…sometimes I simply suggest it. Who knows, it might help. **side note, this is a suggestion that one of my amazing mentors and faculty members on campus has made me aware of.

On another note, old patients are the best. I think geriatrics is a top runner for my specialty. Yesterday I was treating an older patient for neck pain. I was stood up, treating the neck and upper back. I spent about 10-15 minutes with her and when I was done I asked her if she felt better…she said, ‘why didn’t you do more?’ lol

Today is a half day, excited and thankful for the opportunity to learn from patients and my awesome preceptor.

Bang.

I got bangs! I’ve never had them…::cough:: never gotten them DONE. Oh, I’ve ‘had’ bangs, those really strange short ones that extend too far around your head because I cut them myself. Now though, I have real, professional bangs. It’s weird, some people don’t recognize me at all and other don’t notice the bangs.

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Side note, it’s 28 right now in CA at 7:30 am…TOO COLD.

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This past weekend was another wonderful one. My sister came out (has since began law school again, boo) we had a lovely hike w the pooch

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worked on invitations to our celebration in October, a little early on those but we have family and friends that need to save way ahead of time, so off they go in the mail!

photo-4 copythis is my new best friend and I use it daily, the cuties are so happy before the needles 😦

photo-5 copyAnd last night I got to cuddle this:

photo-6 copyWe had a really interesting patient the other day that I’ll write about soon!