Wednesday, June 29, 2011

WIAW: A Work Day

If you're here because my lovely sister Shannon's been showing her love on facebook, she's referencing this post where I wrote about being on call (I love you Shannon!) 

Hey friends, it's What I Ate Wednesday!

Breakfast: Something we haven't seen for a little while. I brought back the Strawberry Colada Oats. Seriously my favorite bowl ever. Make it right now. Do not stop. Do not pass Go. I guess you can collect $200 if you want - but you have to split it with me.

Lunch: Since my last WIAW post, I've started clinical rotations, so lunch is eaten while running through the hospital or at a noon meeting. The veganism of the food at meetings is usually a little questionable, but I just do my best. If there's something that's usually made without animal products, I just hope they've done it that way. Today it was rice, beans, salsa and tortillas at the M&M conference - for Morbidity and Mortality - we discuss complications of cases.

Snack: I love my apples.

Dinner: I browned up some Cedar Lake Pecan and Grain cutlets with roast veggies. It looks small but there's 11 g of protein in each of those little guys and they're SO filling. 

Dessert: I might have some yogurt and frozen blueberries a little later. We'll see. It's hot (90+ every day now) and my appetite has been small. 

Workout: 4 mile run in my new shoes. I didn't realize how worn my other ones were, but I was getting bad blisters and these are like walking on pillows. Asics GT series. 

and for a final note...

WIWW: What I Wore Wednesday. 
Mostly I wore scrubs and my ugly comfy zebra shoes - like every day on the surgery rotation, but look at these new ones I bought at DSW this weekend: Grasshopper's Shellie III Fabric Wedge.

Can you see how much pillow is sewn into this shoe? It's like those craaaazy comfortable memory gel Nike flip-flops - but way cuter and could even be worn to work. I'm always on the lookout for something that doesn't make me look 60 and blind to wear on the wards when I'm not in scrubs, so I'm pretty excited about these. 

Happy WIAW. What did you eat? Or wear?

Tuesday, June 28, 2011

Tachy Med Student: First Call by the Hours

When I finish writing this I have to go to take a walk or ride my bike or I am going to fall straight into a deep level of unconsciousness. 

This is my best post-call-I-really-don't-hate-my-pager-face.

"On Call" - It's a phrase I've been both dreading and looking forward to for years. 

On the one hand, it means a pager constantly strapped to your body and the requirement of leaping directly into a state of coherence regardless of how deep into that Natalie Portman dream you were. 

On the other hand, it means a little more responsibility (still heavily supervised) since the care team is smaller, the surreal world of a buzzing hospital in the middle of the night, and it feels like a landmark in my medical education. 

So what does it look like? Obviously there will be a lot of diversity, but let's just look at my very first one. 

Monday, 6:45 am: Arrive at the hospital. Spend some time on the phone with a nice IT guy named Larry who helped me sort out my computer logon (after 5 days...finally). Read/study about recent patients.

7:30 am-12:15 pm: Meet my Attending at his office. Clinic all morning. I did my first digital rectal exam. At least my fingers are small. 

12:15 pm: Buzz in late to Tumor Board. Indian food. Overwhelmed by imaging I don't yet know how to make sense of. 

1:30 pm: Observe a thoracic surgery. Also observe a new PA student scream when forced to touch a piece of tissue, and hide behind the surgeon for fear of being splashed. She's not going into surgery. 

4 pm: Pick up the student pager from the call room, leave my overnight things (backpack, clean scrubs, toothbrush etc.)

5 pm: (When call starts) Page the resident on call. No response.

5:05 pm: Scrubbed into another thoracic surgery. 

6:15 pm: Page the on-call resident again. This time he calls back. I introduce myself, and tell him I'm on call with him that evening. He gets my name wrong, and informs me that nothing is going on, but he'll let me know. I then realized my pager was dead and went on a hunt through surgery and the ICU for a AAA battery. 

6:20 pm: Success. Startling pager beeping may now begin.  

6:25 pm: Cafeteria. Mint tea, honeydew melon and hummus with pretzels for dinner. Two apples for the road. 

7 pm: Page the Physician Assistant (PA) on call, check if he has anything I can do and ask where I can use a computer with internet for research. 

7:10 pm: Hanging out with the PA, learning about the indications for splenectomy. 

9 pm: I've read way too much about indications for splenectomy. Head to the call room to get some sleep. Only get lost once.  

9:10 pm: Notice sutures tied all over various bars in the call room. Realize this is an awesome time to practice.  

9:13 pm: Realize I really don't remember how to tie suture. This is essential to this rotation. I should probably learn again. 

9:14 pm: Decide the call room has a very odd assortment of objects: normal things like a bed, desk, toilet, sink, but also ports for oxygen in the wall, baskets, an empty cardboard box, and plastic drapes in the drawers. I'm fairly certain it used to be a patient room. However it's location - stranded behind the copy room - is a little odd. 

9:16 pm: Climb into the very industrial call room bed. I'm only a little disconcerted by the fact that the sheet is so thin I can see through it. 

9:45 pm: Still lying awake.

10:30 pm: Probably fell asleep.

11:36 pm: Leap out of bed to beeping. Manage to read the pager properly and call back, find out there's a consult in the emergency room (ER). Open the door. Stop. Remember my shoes. Pull myself together. Go see a patient in the emergency room. 

(It is now Tuesday morning)

12 am: Meet the resident and talk through the case. He is an Indian man with a lisp. He wants to be asleep more than I do. He asks if I have questions but his eyes say he hopes I don't. 

12:30 am: Use a computer in the clinic area to work on writing up a History and Physical for the patient. See at least two surgeons who are not on call still working. Rule out surgery as a specialty for my future (again). 

1 am: Still writing and researching patients - get another page for a consult. 

1:15 am: Introduce myself to the patient in the ER. The response, said with some startled fear, "You're not the surgeon are you?!" No. Thank goodness for both of us, I'm not the surgeon. Discuss the case with the resident, get the patient taken care of. 

1:45 am: Find that the door to the hallway outside my call room is locked. Bother a security man who bears a strong resemblance to Igor to unlock it. 

Seriously - uncanny. 

2 am: Crawl into that industrial bed again. No more pager beeping. There was, however, some extensive construction to the wall that formed my room beginning around 5 am. I learned that even while the pager may be quiet, a hospital really isn't. 

5:30 am: Completely awake from all the clamor. Get up, change clothes, do some morning studying. Eat a PBJ sandwich that I packed for breakfast. 

6:30 am: Meet my Attending in the operating room. After some delay, scrub in on another surgery. 

10:15 am: While waiting for the next case to be ready, the Attending and myself go to discuss a couple things with the rotation coordinator. Upon seeing me:
Her: "What are you still doing here?"
Me: "I'm still doing surgery."
Her: "You're supposed to be off at 8 am."
Me: "Well that's all right, the resident knows that and there's no one paging me."
Her: "But you have to leave by 10 am."
Me: "O."
My Attending: "She will miss all the fun."
Her: "Sorry, she has to go."
Me: "Too bad..." 

10:30 am: Peace. OUT. 

And so it was only like 28 hours. And my fragmented sleep probably totaled 4 or 5. It could have been much worse.

Maybe it will be. 

I have to do it again on Thursday. 

Still. The anxiety of new things for me is primarily in the logistics. Questions like:
"How do I use the paging system?" 
"Where's the call room?"
"How much food should I bring?" 
"What if the call room dungeon monster attacks me while I'm sleeping?"

I found that while people may look like Igor, everyone's pretty helpful. And now that is behind me. Call 1/millions - done.

Recipe post soon I promise!

Friday, June 24, 2011

Sitting on a Secret.

A big secret. 

First I had some people to call up and tell, and then I suppose I didn't want to examine it too closely, write it out in too much black and white, because in my head it kind of glows, and I didn't want to dissect away the light. However, I think it will always glow a little.

It involves some beautiful gardens, some surprises, a diamond and me saying, "Yes!"

Yes! On May 31, 2011, after 4.5 awesome years of dating, John asked me to marry him, and we're engaged!

And now, a couple+ weeks later, I'm ready to (try) to share the story, because it was an incredible proposal, I'm ecstatic and also beyond blessed, and I don't want to forget anything about it as time passes. A huge thanks to our friend Eric for the excellent photography.

The Proposal Story

I had just gone through my harrowing Boards experience and driven up to Santa Barbara. I was just enjoying my vacation. May 31 (Tuesday) was John's last day of work, and I spent it as in this post: written when I had no idea what was coming. 

At 4 pm John was supposed to come back to the apartment, but instead his roommate and friend Evan walked into the room, said, "Pack up all your stuff. I'm supposed to take you somewhere and we have to go in 5 minutes."

This was weird, but I went with it. I thought, "Oh, Boyfriend's doing something nice for me because Boards were so stressful."

Evan drove me to a hotel on the ocean, where this was the view from my room:

After checking me into a room under John's name, he also told me I had an appointment at the salon and would need to be in the lobby for dinner a little after 7, then he left. I didn't really know what was going on, but I decided a picture wouldn't be out of order:

Off I went to the salon. There was only one person there and it went like this:
Her: "Can I help you?"
Me: "I think I have an appointment?"
Her: "Are you Kari?"
Me: "Yes."
Her: "Great, pick a color and have a seat. We'll get started."
Me: "Okay...what's my appointment for?"

Because really, picking a color could be anything. Are we dyeing my hair? What's happening?

Her: "Oh, it's a manicure and pedicure."
Me: "Oh! Great."

A couple hours later found me and my awesome nails nervously waiting in my room, dressed for dinner, furiously trying to convince myself that he could NOT be proposing because if I let myself think he was, I would get really really nervous. 

At 7:15, it was time to go down to the lobby, where it was not John waiting for me, but our friend Joe, who forced me to sit in the backseat of his car in order to properly chauffeur me to the next place.

We drove up into the hills, to the San Ysidro Ranch. Joe let me out of the car, walked me through gardens and a gate, and sent me walking on up some more stone steps. I passed Evan, who told me to keep walking up, and as I came up to the top of this staircase, I was no longer trying to convince myself that John wasn't proposing, but I didn't feel nervous anymore, just so happy to see him. We were in this upper garden with trellises and lemon trees, but I barely noticed all of that at first. I was looking at him. Of course he looked handsome. Always really, but I do love him in his suit. 

He had some thoughts for me, about us, what we've been through, where we're going, and then he got down on one knee and asked me to marry him.

And as we already know, I said yes. Eric (who was photographing from the bushes, dressed in all black) says I said yes three times, but I really don't remember. 

I didn't cry, I was far too happy even for happy tears. 

We then went to dinner at the restaurant there at the ranch. He had called and spoken directly to the chef to be sure I would have something good to eat. Just a tiny example of the thoughtful man I'm marrying. Then he had planned a party to celebrate with our friends a bit. A GIANT thanks again to all of our friends who helped plan and orchestrate, and to those who knew but had to keep it a secret - you all did a great job. 

Joe, John, Evan

He told me later that he had called my parents and asked their permission, which was really important to me. 

I could not have conceived of a proposal more suited to us - it was perfect, but more than that, no matter how the proposal had gone, I get to marry John, and that's why this day will always glow a little. 

I'm engaged to someone I love too much for words, who knows me incredibly well - sometimes I'm surprised the way he anticipates what I might think - and who is the kind of best friend I can't wait to walk through the rest of my life with. 

And now I can stop hiding my ring in pictures that show my hands...

Friday Filling My Grocery Cart.

I missed What I Ate Wednesday (WIAW) this week, but I'll throw in a new one... 

FFMGC, Friday Filling My Grocery Cart

Before we get to that, 
Thing 1: I get a weekend! I don't have to go in again until Monday morning, so for the next 2+ days, I'm unscheduled, and suddenly don't know quite what to do. 
Thing 2: I've been planning lots of posts in my brain lately and haven't properly written them. 

Coming up soon:
1. A training plan and new races I'm training for.
2. Thoughts on weight/self-image/where I'm at right now.
3. As always, some tasty meals, and possibly a food challenge.
4. A secret I've been keeping - a big one. 

For now however, I must tell you that this morning for lunch I ended up packing a veggie burger between two pieces of frozen sandwich bread. Procurement of veggies from the cafeteria at the hospital resulted in a decent sandwich, but I realized I'm basically out of food. the grocery stores! Typically my shopping list takes me at least two, sometimes 3+ places. Today was no exception:

From Stater Bros. (Standard Grocery Store):

Soy Milk, Veg Broth, Cooking Spray, Beans, Tomato Paste and Tomatoes, Toothbrush, Herbs and Spices (my most expensive item was Ground Cumin), Onion, Red Peppers, Broccoli, Asparagus, Celery, Bananas, Lemons

From Clark's (Local Natural Food Store):

Organic Fujis, Soy Yogurt, Bulk Bin Granola, Vital Wheat Gluten, Cedar Lake Pecan Patties, Enormous Grapefruit ($0.29!), Frozen Soup Pouches

This is a new-to-me product, I'll let you know how it is. 

22 g of protein!

And, okay, it's only like half the size of my head...still, an enormous grapefruit. 

Total Cost: ~$50.00.

The real question: How long will it last me? A bunch of the items are staples, and some are for a recipe I'm going to make tomorrow and have for leftovers, but I'm hoping the rest easily lasts me a week of snacks and sides to that, considering I get lunch at the hospital for free.

And for dinner tonight, leftover filling from when we made these:

Delicious even without the crust.

When you go grocery shopping, what's always in your cart?

Tuesday, June 21, 2011

Tachy Med Student: What's In a Third Year's Pockets

Today when I took my white coat off to go into the operating room, my Attending physician (the boss) picked it up and said, "Oh my gosh. What is in this?"

Later he told me, "I conducted a randomized survey. Everyone agrees. There's something very wrong with your coat, it's far too heavy."

As I spend more of my life doing interesting things, learning new skills and making more internal observations about the crazies around me, I'm starting a new category of post: Tachy Med Student.

In this, the first installment, lets take a look at my pockets, and what might cause my Attending to survey everyone around me about its weight.

It doesn't really look like that much. 

Left to right:
Top row: Stethoscope, Badge, Pager, Skill Log Books 
Middle row: Phone, Folding Clipboard, Pharmacopia, Notebook, Maxwell's Reference
Bottom row: Keys, Chapsticks, Pens, Penlight, Tide To Go, Surgical Recall, Map of med center

There's a few other papers inside the clipboard, and I forgot to take out the $20 bill, 3 ibuprofen and 2 pieces of gum that I was also carrying around. 

As far as I know, this is a pretty standard collection of items. It is, however, accurate to say that it's quite heavy.

Call it combining my cardio with weight training. 

The way my Attending put it, "On this service, you get free Jenny Craig."

Then again, there seems to be food around every corner, so I don't really know how that's going to work out.

You know what else is on every corner? One of these:

Confession time: I managed to spill coffee on my white coat today, and really that's the reason I took everything out of the pockets ... to wash it. 

And finally, I present you with the ugliest, most comfortable shoes in the world: Danskos.

Anyone in a profession requiring lots of standing has probably heard of these, and I resisted getting some because really? I mean really. 

Just to be clear, the clog is not back no matter how many brilliant healthcare professionals rock these, but I will wear them and the awesome arch support every single day if it means I get to the end of the day and my back and feet don't hurt so much like they do in other shoes. I ordered them last week and wore them for the first time today, and yes, they were awesome. Usually the top is made of leather, but they do have a vegan line. Unfortunately they don't have any plain vegan ones, because apparently we're a bunch of crazy hippies who wouldn't possibly just want our feet to look professional. 

These are reasonably neutral, though my Attending did tell me my feet look like a zebra. 

2 days down.