The adult medicine service at the hospital is our most challening rotation. The hours are long, the patients are really sick, and the cases are usually pretty complicated. But I guess that's what makes it fun - I get to use my brain to figure things out, and my best people skills. I didn't always think it was fun, but this year as my confidence has grown, so has my enjoyment of medicine. Of course, I won't be sorry for the month to be over. On to new things! The rest of the year should be a piece of cake since this is my last medicine month this year. I've gotten all the hard rotations out of the way.
I got to go home for a weekend too -that was fantastic! It was so great to just hang out with friends and family and to visit my church back home. I'll be home for Christmas too, but only for 4 days. Can't wait to see everyone again!
Friday, November 25, 2011
Tuesday, October 25, 2011
Aaahh. Family!
The highlight of this month was seeing my niece and nephews, especially my newest nephew. There's nothing like family to remind you what's important and eternal in life. I am blessed to have two sisters who share my faith in Jesus and want to raise their children to know God and follow him. My niece is especially sweet and has such a tender heart to please the Lord and love her brothers.
I enjoyed spoiling her by taking her for ice cream (it took her over half an hour to finish a cone!!) and buying her Halloween costume. Doesn't she make the cutest witch you've ever seen?
She got to meet Christopher Columbus at a special event, but she was a little shy. Apparently a man dressed in strange 15th century garb was a bit scary for her. So I took her for ice cream and we watched the people walking by. She's really into "I Spy" right now. I got to play for hours while she licked her cotton candy cone.
Here's the two older ones giving me a concert. The middle nephew is all boy. He doesn't sit still - likes to be on the move, making noise, running, jumping, going up and down stairs . . . and up and down . . . and up and down...
And here's the newest guy. You have to admit he's adorable! I couldn't put him down!
I don't know when I'll get a chance to visit again. Thankfully, I will see them all at Christmas. It will be rushed and crazy, and I'll be competing for their attention with Grandma and Grandpa. But I'll settle for whatever I can get. They grow up so fast!
I enjoyed spoiling her by taking her for ice cream (it took her over half an hour to finish a cone!!) and buying her Halloween costume. Doesn't she make the cutest witch you've ever seen?
She got to meet Christopher Columbus at a special event, but she was a little shy. Apparently a man dressed in strange 15th century garb was a bit scary for her. So I took her for ice cream and we watched the people walking by. She's really into "I Spy" right now. I got to play for hours while she licked her cotton candy cone.
Here's the two older ones giving me a concert. The middle nephew is all boy. He doesn't sit still - likes to be on the move, making noise, running, jumping, going up and down stairs . . . and up and down . . . and up and down...
And here's the newest guy. You have to admit he's adorable! I couldn't put him down!
I don't know when I'll get a chance to visit again. Thankfully, I will see them all at Christmas. It will be rushed and crazy, and I'll be competing for their attention with Grandma and Grandpa. But I'll settle for whatever I can get. They grow up so fast!
Thursday, October 20, 2011
Colorado Trip 2011
Every year, my residency program takes a trip to Colorado with the first and second-year residents. I posted photos about the trip last year. This year I was on the organizing committee, so it was a different experience. But it was lots of fun. Despite the fact that we call the trip "Bike Trip", I did not actually take a bike ride. I did get a massage (very nice) and take a hike to a lake and waterfall. The weather was fabulous and the aspens were just beginning to change color.
Here are some photos.
Thursday, September 29, 2011
Toenail Removal
Yep, you read that right. That's what I've been doing this past 2 weeks - removing toenails. Sounds pretty gruesome, I know, and actually it is pretty gruesome to watch. Doing it is not too bad though. And it has to be done. Ever had an ingrown nail? They hurt; they get infected; they make life miserable. It's really pretty easy to fix. And I have now learned how to do it!
Podiatry is a pretty important thing for a family doc to know. Foot problems are so common! All diabetic patients reach a point when they need regular foot exams to trim nails and callouses and check for neuropathy. Athletes and regular people who work out have heel pain, pain in the ball of the foot, capsulitis. The foot is an amazing appendage - it bears all of our weight, allows us to walk, run, jump and gives stability and balance. So you can imagine how much of a beating the foot takes and how prone to injury it is! I've learned to recognize and treat plantar fasciitis, bunions, joint capsulitis, warts, ulcers, corns and callouses, fungal infections, arthritis, and lots of other conditions. I can inject steroids and anesthetics in the right spot to provide relief, take off all or part of a toenail without pain, and suggest exercises and inserts to relieve pressure on different parts of the foot. It has been a very practical two weeks.
September also included a trip to Colorado for our annual first and second year resident team building activity. Once again, the scenery and weather were spectacular. The aspens were just beginning to turn colors to yellow and orange. The air was fresh and cool. I enjoyed walking around Dillon Lake (reservoir actually) and up to Continental Falls. As one of the trip organizers, I had a bit more responsibility for all of the logistics. But even with that, I had time to enjoy the time away.
Well, all for now. My eyes are starting to close of their own accord. Miss you all!
Podiatry is a pretty important thing for a family doc to know. Foot problems are so common! All diabetic patients reach a point when they need regular foot exams to trim nails and callouses and check for neuropathy. Athletes and regular people who work out have heel pain, pain in the ball of the foot, capsulitis. The foot is an amazing appendage - it bears all of our weight, allows us to walk, run, jump and gives stability and balance. So you can imagine how much of a beating the foot takes and how prone to injury it is! I've learned to recognize and treat plantar fasciitis, bunions, joint capsulitis, warts, ulcers, corns and callouses, fungal infections, arthritis, and lots of other conditions. I can inject steroids and anesthetics in the right spot to provide relief, take off all or part of a toenail without pain, and suggest exercises and inserts to relieve pressure on different parts of the foot. It has been a very practical two weeks.
September also included a trip to Colorado for our annual first and second year resident team building activity. Once again, the scenery and weather were spectacular. The aspens were just beginning to turn colors to yellow and orange. The air was fresh and cool. I enjoyed walking around Dillon Lake (reservoir actually) and up to Continental Falls. As one of the trip organizers, I had a bit more responsibility for all of the logistics. But even with that, I had time to enjoy the time away.
Well, all for now. My eyes are starting to close of their own accord. Miss you all!
Friday, August 12, 2011
Family Meeting
This past week I had the opportunity to conduct a family meeting regarding a patient whose prognosis was extremely poor. The patient was a 71 year old woman with advanced breast cancer who was in hospice at home doing fairly well. She comes from a large and very close family. One night she woke up, felt dizzy, vomited and passed out. When EMS arrived, she was in asystole - her heart had stopped beating. No one knows for how long. They shocked her, did chest compressions, put a tube down her throat and started mechanical ventilation. Generally speaking, the recovery rate from "coding" someone (doing all those things I just mentioned) is pretty poor. Technically the patient was dead, and the EMS team brought her back. Unfortunately, her brain suffered extensive damage during the time her heart wasn't beating. By the time she arrived at the hospital, it was evident that she was severely compromised. At first the family wanted to do everything possible for her in the hopes that she would recover.
The purpose of the family meeting was to help the family understand the patient's condition and make decisions about how aggressively to treat her. It was a pretty emotional meeting. There were about 10 family members present, mostly the patient's children. Most of them understood that the patient was not going to get better. They knew she did not want to be kept alive on a ventilator and they did not want her to suffer unnecessarily. After many tears, honest answers and prayers (on my part), the family decided they would take the patient off the ventilator. We stopped all of the medications and IV fluids and wrote orders to keep the patient comfortable (medications for pain and anxiety). The family all gathered at the patient's bedside and later, when they were ready, they had the patient extubated (pulled out the tube that was helping her breathe). She passed shortly after that. It was one of the hardest things I've ever done, but also beautiful in a way - helping a patient die with dignity surrounded by their loved ones and helping the family through a very difficult time.
The purpose of the family meeting was to help the family understand the patient's condition and make decisions about how aggressively to treat her. It was a pretty emotional meeting. There were about 10 family members present, mostly the patient's children. Most of them understood that the patient was not going to get better. They knew she did not want to be kept alive on a ventilator and they did not want her to suffer unnecessarily. After many tears, honest answers and prayers (on my part), the family decided they would take the patient off the ventilator. We stopped all of the medications and IV fluids and wrote orders to keep the patient comfortable (medications for pain and anxiety). The family all gathered at the patient's bedside and later, when they were ready, they had the patient extubated (pulled out the tube that was helping her breathe). She passed shortly after that. It was one of the hardest things I've ever done, but also beautiful in a way - helping a patient die with dignity surrounded by their loved ones and helping the family through a very difficult time.
Wednesday, August 3, 2011
New House
Here are some pics of my new house. I moved at the end of June and have gradually been settling in with my new roommate Alexis. I don't have any pictures of her yet but I'll try to update soon.
It's a townhouse/duplex - pretty cute and comfy. Trying to fit two people's stuff in is a challenge, but we're managing to downsize bit by bit and get organized.
Started a new year and had a great first month as a second year resident on adult medicine. I'm on pediatrics now, so totally the other end of the spectrum. Life is still ridiculously busy, but I guess that's just the way it's going to be for another two years.
Tuesday, July 19, 2011
Notes from an Upper Level Resident!
Well, I survived my intern year - the first year of residency! It's July, and a fresh new crop of interns has arrived. That means I am officially promoted to PGY-2 or second year resident. I don't really feel any different, but I can definitely see how far I've come in the last year. My first rotation this year is adult medicine - the hardest and most challenging rotation we have. I started off on a week of "night float."
(Digression - due to changes in the duty hour requirements, first-year residents are only allowed to work 14 hours in a row, instead of 30 like we did last year. So we had to change our call system. Now, rather than take 6 30-call shifts spread across the month, we do a week of night float. We are on call for 5 days in a row, taking new admissions overnight. In the morning we get to go home instead of staying 6 more hours to round on patients. It's actually pretty nice once you get used to doing the night shift.)
I was on night float with one of the new interns. My role as supervisor was to supervise (duh), or rather provide support for the intern as she worked up all the admissions. Of course, I was very helpful and even did a few admissions when we got backed up. But she was really smart (smarter than I was when I started), so she didn't need that much help. I still stayed up all night and saw all of the patients with her, but it was a much different role than last year. I found myself giving advice on how to write orders, what to tell attendings, what to consider in terms of diagnosis and treatment. Wow - I must have learned a lot last year! In fact, I can tell I'm much more efficient and confident with my own patients this year. What a journey! I still have so much more to learn, but it's fun to see how far I've come.
In between first and second years, I managed to move to a new apartment/townhouse. I have a new roommate - a Baylor med school alum who graduated from my residency program last year and spent a year doing an international fellowship in Zimbabwe. I also took my last set of board exams - Step 3 - a two-day test that will allow me to get my license (if I pass). Once I get my license, I can "moonlight" at immediate care centers and rural hospitals for more experience. I also want to volunteer at a free clinic in my free time.
Maybe second year will mean more time for keeping up my blog. I hope so! Meanwhile, I'm enjoying staying inside the hospital during this 110-degree heat.
Stay in touch!
(Digression - due to changes in the duty hour requirements, first-year residents are only allowed to work 14 hours in a row, instead of 30 like we did last year. So we had to change our call system. Now, rather than take 6 30-call shifts spread across the month, we do a week of night float. We are on call for 5 days in a row, taking new admissions overnight. In the morning we get to go home instead of staying 6 more hours to round on patients. It's actually pretty nice once you get used to doing the night shift.)
I was on night float with one of the new interns. My role as supervisor was to supervise (duh), or rather provide support for the intern as she worked up all the admissions. Of course, I was very helpful and even did a few admissions when we got backed up. But she was really smart (smarter than I was when I started), so she didn't need that much help. I still stayed up all night and saw all of the patients with her, but it was a much different role than last year. I found myself giving advice on how to write orders, what to tell attendings, what to consider in terms of diagnosis and treatment. Wow - I must have learned a lot last year! In fact, I can tell I'm much more efficient and confident with my own patients this year. What a journey! I still have so much more to learn, but it's fun to see how far I've come.
In between first and second years, I managed to move to a new apartment/townhouse. I have a new roommate - a Baylor med school alum who graduated from my residency program last year and spent a year doing an international fellowship in Zimbabwe. I also took my last set of board exams - Step 3 - a two-day test that will allow me to get my license (if I pass). Once I get my license, I can "moonlight" at immediate care centers and rural hospitals for more experience. I also want to volunteer at a free clinic in my free time.
Maybe second year will mean more time for keeping up my blog. I hope so! Meanwhile, I'm enjoying staying inside the hospital during this 110-degree heat.
Stay in touch!
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