out the winder

A Happy Reunion

2011-11-22T15:38:00.000-08:00

(To the tune of Amazing Grace.....)

Oh coffee mug
I love you so
At work, you comfort me
I lost you in the ICU
Today, reunited with glee!

Ah....so much to be thankful for!

A Brief Glimpse into the Weirdness that is my Brain

2011-11-21T13:15:00.000-08:00

I was on long call at the VA last night. Luckily it was a pretty slow night with only four admissions. So there was no wailing and gnashing of teeth....the way I prefer it. And for me, there is nothing quite like post-call sleep. Crawling into bed, utterly exhausted, with a belly full of eggs and bacon is one of the best feelings ever. And knowing that the crazy that lives at the hospital is now someone else's problem....well that's good stuff!

So I crawled into bed at about 10:00am and, per usual, slept like a baby. With a few interruptions from Charlie. Per usual. Luckily he usually responds to me yelling, "SHUT UP CHARLIE! GAH!" My post-call sleep was going well until the dreaming started. In my dream Danny gave me a kiss on the neck....which turned into a huge hickey....because my INR was high. Then my dad yelled at me because it looked "tacky" and "unprofessional."

Awkward....

Veteran's Day at the VA

2011-11-11T19:56:00.000-08:00

This morning I went to see an elderly patient with severe dementia. He was in a pleasant mood during my exam and on my way out the door I wished him a happy Veteran's Day. His face instantly changed and he began to weep quietly. I could only make out a few of his words...
Laying there....

Dead...

Birds pecking at their eyes....

And then he broke down. Inconsolable. There are some memories that even Alzheimer's can't erase.

To those who have served our country so bravely.....

Thank you.

Sometimes it's hard to keep my pants up....

2011-10-30T11:07:00.000-07:00

The Quadruple Grenade Sign....the poorest of prognostic indicators.

You say it's your birthday.....

2011-10-19T16:20:00.000-07:00

Ah, October 18th.....a blessed day!

It's really kind of sad when facebook has to remind you that it's your birthday. Oh well, so be it.

I woke up yesterday at 4:30am to the sound of my dear husband doing P90X. He is a freak of nature. I'm still trying to figure out what mutant gene he acquired that causes him to wake up at 3:50am to work out and that entices him to eat vegetables on a daily basis. I have the opposite of that gene. Or I'm just lazy and prefer buttered noodles, take your pick.

Anywhoozles....I stumbled down the stairs and hurdled the baby gate, as I do every morning. Yesterday I cleared it without incident....not always the case. I glanced in the mirror and noticed a few pimples on my nose....probably from my increased Nestle Quik consumption. I may be 31, but at least I have the complexion of a 13 year old! Ah...thank you, T-Zone, for making me feel young. ( I can hear all of you gasping....you thought I was 24, didn't you!?!?!)

Work was uneventful. I would like to give a shout out to the patient, who prior to receiving a rectal exam from yours truly, stated, "Gosh, I wish you were some old, ugly lady....that would make this easier." You made my day, sir. You made my day. Oh, and you were hemoccult negative....so that's good.

My lovely attending, knowing that it was my birthday, decided that I should take off early in the afternoon, and so I did. Thank you Dr. L for being so thoughtful. And as for you, Dr. P.....YOU forgot my birthday....even though I'm sure facebook reminded you. But I'm over it. No, really.....it's cool. I'm fine. Clearly.

I got home and called Danny. He was at the store picking something up. I imagined that he was buying me flowers for my birthday.....and the following is what I was planning on blogging after I received said flowers:

"My sweet husband....even though I've told him dozens of times not to buy me flowers. He knew deep down that I really did want flowers."

He came home with a card and a bag full of Aspen Mulling Spice, a CD and Nutty Bars....no flowers. And to that I say:

"My sweet husband....he knows that flowers only wither away, but this girl LOVES HER SOME NUTTY BARS!!!"

Later in the evening, Danny and I attended a free dinner at Ruth's Chris. This doctor gig if finally paying off....'bout dang time! Unfortunately, my steak came out well done. In the ultimate show of selflessness and devotion, Danny gave me half of his steak, which was cooked medium to my preference. I drank 1.5 glasses of wine, and per usual, declared myself drunk after the first glass. Wine at Ruth's Chris is very potent. I'm not sure what the speaker was talking about, but he was very energetic....and blurry.

So that about sums up my birthday. It was a good one.

In crummy news, my Grandma B. fell and broke her hip last night. She's currently at SMMC where they're getting her fixed up. If you could send some prayers her way, well, that would be nice.

An Ode to Rachel....on the Eve of her Wedding

2011-10-07T21:45:00.000-07:00

All the wine at the rehearsal dinner tonight sent me into an emotional tailspin...several unfortunate people sitting in close proximity can vouch for this. I will now type and cry, type and cry. It's therapeutic.

Rachel is the one I met in the 1st grade. She had just moved from the "dot" and I was her mother's worst Johnson County nightmare.

Rachel was my three-legged-race partner during field day. We won second place. I have not seen her move faster than a walk since that day.

Rachel is the one who cried with me before I told my mom about the stupid thing I did in 8th grade.

Rachel is the one who used to love wearing "country apple" body lotion from Bath and Body Works. That is, until her mother told us we were too old to go around smelling like fruit.

Rachel is the one I spent countless hours with at 3&2, watching baseball games on warm summer nights.

Rachel is the one who spent hours with me at Abercrombie & Fitch, even though the plaid carpet made her dizzy.

Rachel was my very first roommate. She is the one who tolerated one year of me eating powdered coffee creamer out of the can, leaving my cheese wrappers lying around our room, and setting my alarm clock for ungodly hours.

Rachel is my Endless Love duet partner....even though she always makes me sing the boy part.

Rachel is the one who looked me in the eyes and said, "I've always thought you should be a doctor." And when she said it, I had the confidence to do it.

Rachel is the one who thinks that God sent a hail storm just for her, so she could collect the insurance money and buy herself a Louis Vuitton bag.

Rachel is the one I think of when I hear Aerosmith or Tom Petty on the radio.

Rachel is the one who fell in love with a boy named Travis. And when I saw the way he looked at her tonight as they were practicing their vows, my heart was happy....because I know he is the one.

Congratulations, my dear friend!

I'll see you in the morning, after I buy myself some waterproof mascara.

First Impressions

2011-09-27T07:15:00.000-07:00

I'm fairly certain that when people meet me for the first time, they think, "Now there's a girl who is clearly more concerned with skin cancer than she is with vitamin D deficiency."

This has been on my mind for a while....just needed to share.

Numbers

2011-07-22T08:05:00.000-07:00

Yesterday....

4:50 - the time I rolled out of bed. Moaning and cursing.

9 - the number of consecutive days I'd worked.

14 - the number of hours I worked in one day.

1 -The number of cinnamon rolls I ate.

4 - The number of cups of coffee I drank. The minimum required dose to maintain consciousness.

3 - The number of pagers I carried.

0 - The opportunities I had to go to the restroom.

5 - The number of times I've heard Dr. S's sepsis lecture.

2 - The number of admissions I did after 1600.

7 - The number of times my stupid ID badge fell off my coat.

52 - The number of seconds it took me to pull out a pericardial drain. My fellow told me if I went too fast I might tear the heart.

8:15 - The time I left work.

1 - The number of drinks consumed before I declared myself officially intoxicated.

2 - The seconds it took me to fall asleep after crawling into bed.

Happy day off to me!!! It's about freaking time!

Assumptions....

2011-07-16T22:02:00.000-07:00

Several years ago, I promised my BFF Rachel that I would buy her a fancy pair of designer shoes for her wedding. At that time, she was single and I made this promise based on two assumptions. Either 1. Rachel would never get married, or 2. I would be extremely wealthy by the time she finally did meet that special someone.

Well, turns out that Rachel met, fell in love with, and is now engaged to a wonderful guy. I've learned to look past the fact that he went to MU, and focus on the things that we have in common; a mutual admiration of station wagons (be it Volvo or Subaru), and old plaid-lined Lands End jackets. We have a strong foundation. And of course, we both love and adore Rachel.

So....Yay! Happy! Fun! Rachel and Travis are getting married!

And I am left scratching my head as to how assumption number 2 hasn't quite panned out. Yeah, yeah...I'm a doctor....but I'm so far in debt from my medical school loans that the only thing I can afford to be is a doctor. And the last time I calculated my hourly wage, it was approximately $4.00.

None the less, a promise is a promise.

So Rachel and I did lots of internet searching for fancy bridal shoes. We looked online at Bergdorf, Nordstrom, Neiman Marcus and Saks 5th Avenue. We both fell in love with a pair of Manolos, only to be crushed when we found out that the $158.00 price was the price for the knock-offs and the real Manolos were closer to $600.00. Gah....I still weep.

Then Rachel finally narrowed down her favorites to a group of about 4 and let me make the final decision, which was a bit nerve-racking. The choice of wedding shoes is not to be taken lightly!

So I picked out a pretty little pair of Vera Wang slippers and my promise from years ago was kept.

And if I start looking thinner over the next few months, its likely that I can't afford food.

Cheers to Rachel and Travis....and Vera!

Oh....and if you happen to be attending the blessed event, please take a moment to admire the shoes. I would appreciate it. Thank you.

Bacon

2011-07-07T10:41:00.000-07:00

Dear Cardiology Patient,

Although I have no evidence that you have coronary artery disease and your work up for chest pain has been completely negative, I cannot, in good faith, let you have a regular diet while you are on the cardiology service. While you are in the hospital, you will comply with the low sodium, low fat, low cholesterol diet. My apologies.

Now excuse me, I have to get down to the cafeteria before all of the bacon is gone.

Your friendly cardiology resident,

CBart, MD

oops....

2011-06-16T19:46:00.001-07:00

Today I accidentally texted my pulmonary fellow, thinking I was texting Danny. I asked her to call the exterminator. Then I told her I loved her.

Disturbing

2011-05-11T20:24:00.000-07:00

Yesterday one of my co-interns was wearing a fabulous pair of Frye boots. I lusted over them. I resolved to buy myself a pair someday. Then I resolved never to spend more than $300.00 on a pair of shoes. Now I am in a state of perpetual turmoil.

Then I went home and dreamt that I had my own pair of Frye boots. It began as a very happy dream. All of my friends and co-workers were very excited for me and my new boots. Then I looked down and discovered that my legs were covered in hair....thick, curly man-leg hair! It was awful! How could I not have noticed this when I decided to wear a mini-skirt with my Frye boots?

The dream went on and ultimately I had to shave the legs of one of my (male) staff doctors before I could shave my own legs and remedy the situation.

I have no idea what this all means....

Still distraught,
CBart

Anatomy of Night Float

2011-05-07T00:00:00.000-07:00

I am on my third night float rotation this year and I am starting to notice some patterns....

The phases of night float...by Christi Bartlett

1. The Mauling Phase
- This phase begins as I walk through the door of the Med 3 room. The respective members of the Med 3, Hematology and Oncology teams wait, perched, ready to pounce on me, much like fresh meat. Then the mauling begins as upwards of 50 patients are handed off to me at a dizzying rate. I am left bruised and beaten. I also get to hear about the stuid thing I did the night before and how the staff couldn't believe that I gave a patient 60mEq of K instead of 40......ahem.

2. The Nursing Shift Change Phase
- This typically happens during or shortly after the Mauling Phase. Night nurses start their shift and notice loose ends from earlier in the day that I HAVE TO ATTEND TO RIGHT NOW! There is usually a patient with a blood sugar of 425 during this time, as well as a patient with a blood pressure of 200/98. Inevitably, there is also a patient who has no admission orders.

3. The "I'm Starving" Phase
- This phase is usually starts around 2300, and involves a trip to the all night cafe downstairs. I typically look at the same 3 meal options (frozen pizza, fettuccine and macaroni and cheese) and contemplate their nutrition facts before ultimately opting, again, for the fettuccine. Then I have to talk myself out of chocolate milk...never easy.

4. The "I Need More Coffee" Phase
- This is more of a chronic issue, rather than an acute phase, but not until the "I'm Starving" Phase is over, do I typically act on the "I Need More Coffee" Phase. During this phase I take the steps up to the 6th floor....to burn off my fettuccine....and I sneak into the nutrition room and snatch some coffee, 2 creamers and 3 sugar packets. Heaven knows how long that coffee has been sitting there.

5. The "Code Blue and/or Rapid Response" Phase
- Just as it seems things have settled down, we hear the infamous beep of the code pager. Expletives are muttered under the breath of the night team. We grab our coats, stethoscopes and walk swiftly to the coding patient. Usually anesthesia and the ICU team have already arrived, so we (the interns) stand against the wall and try to look like we are contributing...the whole time thanking the good lord that someone else got their first to run the darn thing.

6. The "Let's Try to Learn Something" Phase
- This phase involves choosing a previously recorded lecture from a list of podcasts and trying to stay awake long enough to try to sort out ILD, UIP, NSIP, ARDS, AIP, DAH and COP. This lecture was discontinued early as we decided that our brains were too sleepy/overwhelmed/mushy to retain any of the information.
*These lectures are often chosen based on the attractiveness of the attending....*

7. The Sleep Phase
- Hahahahahahahahahahahahahaha...........

- And when I do get to lay down, I typically have some obnoxious VeggieTales song stuck in my head.
- And if I don't have a VeggieTales song stuck in my head and I do manage to nod off, my pager goes off 5 seconds later. Then I lay back down, manage to fall asleep....pager goes off....repeat cycle x 50 bazillion.

8. The Check Out Phase
- No doubt the best part of the shift. This is where you inform the primary teams of the events of the night and hand off every bit of responsibility to them. Then you hand off the code pager...such a fantastic feeling.

9. The Breakfast Phase
- Usually accompanied by my fantastic co-intern....the other CB. Bacon is always consumed during this phase. This is where I drink more coffee....usually to cover up my horrible morning breath.

10. The Erroneous Post-Check Out Page
- This is when a nurse calls you about an issue after you've already checked out to the primary team. It begins with a bit of annoyance because, "why are they calling night float at 7:30????" but ends with pleasure as you return the page and ask the nurse, very nicely, to CALL THE PRIMARY TEAM! FOR THE LOVE OF PETE!

11. The Car Ride Home
- This is the part of the day that I don't really remember, but somehow I make it to my house every morning....with just enough energy to climb the stairs and curl up in bed.

Then Charlie starts whining.

Then I yell "SHUT UP CHARLIE! FOR THE LOVE OF PETE!"

Ode to Color Pink (Crayon)

2011-05-05T20:18:00.000-07:00

Weezy's favorite color
You were Charlie's favorite too
Now you're in the backyark
In a lump of poo

Lent - not to be confused with the stuff in my bellybutton

2011-03-07T22:28:00.000-08:00

Ah, the Lenten season is upon us. I typically don't give anything up during lent because 1) I'm a horrible person and Jesus will likely scold me someday. Then he'll give me a hug and tell me, "It's cool." And 2) I really don't have many vices....that I am consciously aware of anyway....that would be good candidates to be given up. Danny has decided that he is going to give up coffee for lent. This worries me. The boy drinks two pots every day. Minus whatever I manage to steal from him when he isn't looking. I am anticipating a painful period of withdrawal....headaches....rigors....seizures. Well, probably not seizures, but it's not going to be pretty. To make things worse, he is the sole producer of the coffee that I drink and he has informed me that he will no longer be making my coffee either. I'm not sure why I have to suffer during his time of sacrifice. It's cruel....and it isn't very Christian if you ask me! So I will be visiting QT on a more regular basis for the next several weeks.

As for me....I couldn't sleep last night, so I got up and watched TV. The only thing that was on was Two and a Half Men. I felt a little dirty after watching it, so I opened up the Bible and read for a bit, cleansing myself of Charlie Sheen. I sat reading for about thirty minutes, chewing fervently on my fingernails when it hit me. Nail biting....it's what I need to give up.

Hi, my name is Christi, and I bite my nails. And the skin around them. I have been a life long nail-biter, much to the dismay of my mother and grandmother who have staged many an intervention on my behalf, and have made countless attempts at bribery. There was a time that I managed to stop biting my nails, shortly after Louisa was born. I wasn't even trying to stop. Babies are just that time consuming. I didn't even have time to nibble. I managed to maintain this life-style for several months. During that time, I was able to enjoy activities I had never tried before....painting my nails, opening soda cans, picking my nose with more efficiency and tenacity than I've ever known before! That all ended in July, 2010. My first month of internship. The combination of a certain Hematology attending and the overwhelming, un-subsiding anxiety that comes with being responsible for human lives was just too much for my little nails to survive. It started with one nail here, half a nail there....then it became an all out massacre.

There was blood.

Since that time, my fingernails have been nothing but nubbins. And my nose-picking has suffered for it.

So there....I just spent thirty minutes of my life re-hashing the tumultuous tale of my fingernail woes...which will end on Wednesday. Say a little prayer for me.

I'm not exactly sure what to do on Fat Tuesday.....

A Lament

2011-03-03T20:49:00.000-08:00

I've been a little bit gripey the past few days. I will blame this on my wonkey sleep schedule and call it "lamenting" rather than "griping." Capiche?

My first lament involves Panera. It has nothing to do with the taste of the food or the quality of the service, but rather the fact that they have plastered the nutritional information of their food all over the menu. Gone are the days where I could assume that because I was eating a turkey sandwich and small bowl of mac n cheese, that I was making a wise dietary decision. I can no longer claim ignorance. Now I know that a bowl of mac n cheese (oh Wisconsin cheddar....you will be the death of me) and a turkey sandwich have 1460 calories and 82 grams of fat. Gah, I say! The only thing that could possibly be worse than knowing the nutrition information of my food is seeing a picture of the cow Ruth Chris butchered to make my filet mignon. Devastating.

Lament #2. So, I just got a cute new pair of glasses. They make me look smarter and more sophisticated. I started at a 0 on the smart and sophisticated scale, so this is quite a little victory. I have been wearing them for the past several days, and during that time, when I would look in the mirror, I looked a bit thinner. Not that I had any reason to be losing weight (see above lament), but I was excited none the less. Fantastic! So today I decided to wear my contacts. I took a bath, looked in the mirror....and did not look thinner! Blast! My glasses were deceiving me. My soul weeps.

I could go on, but I'm going to chose to be a positive person now. Cup is half full.....of cold coffee....

Over and out.

Nights at the VA, Part Deux

2011-02-28T21:59:00.000-08:00

"Ahh! Salam and good evening to you worthy friend. Please, please come closer...."

Quick! Name that movie!

I am once again blogging from my sad little night call room at the VA. With my sad little bowl of Chef Boyardee. I had a week of vacation 2 weeks ago which was glorious, now I'm back at it....saving lives and taking names. Well, I'm not really saving lives. As of yet anyhow. Mostly just following up potassium levels and writing for sliding scale insulin. It's a glamorous life. And I'm not taking names either....they're actually just given to me. On a piece of paper. Next to one of the names on that piece of paper are the words, "Pt's BP dropping, may crash tonight." Ah, lovely.

My biggest struggle so far tonight has been my ravenous appetite. This is a bit of a problem because, well, I'm at the VA and, low and behold, they don't have a Waffle House on the premises. What they do have is a little room with a refrigerator and random snack food. I've visited this room twice already. The first time I took some cereal and the second time I opted for the aforementioned Chef Boyardee. You can imagine the vast array of culinary temptations if the best I could do was Boyardee. I won't bore you with the details. I will tell you that the light in the little room with the refrigerator in it has been burned out since Friday. And it's dark. And scary. I have to prop a basket up in the doorway so the door won't close all the way. If I could remember anything about physics, I could do a better propping job to keep the door open a little wider....but that was too many years ago and my brain has grown old and weary.

So anyhow. Now I'm eating my twicely aforementioned Boyardee waiting for some labs to come back so I can try to go to sleep. The good thing about working nights at the VA is that I typically get a few hours of sleep. The bad thing about working nights at the VA is that I have to leave my sweet husband and cute little P. Nutty girl at home.

In closing.....
- Vacation = glorious
- I'm hungry
- Following up on and replacing potassium = glamorous
- I miss my peanut
- Goodnight

While driving home

2011-02-11T18:54:00.000-08:00

As I was driving home today....in my super-rad station wagon....I became keenly aware of that pesky roll of fat that has persistently protruded over the top of my pants for the past 17 months. And I thought back to the days, many moons ago, when I worked at Jerry's Bait Shop and would tie my Budweiser t-shirts up in a knot to show off my belly. (What? Stop looking at me that way.) I never ONCE had to suck in my belly. Even when I was sitting down. No fat rolls. No blubber. I took those days for granted.

As I drove, I sat up as straight as I could, arched my back a little bit and sucked, and sucked and sucked some more. But the roll would not go away. It actually shifted to my back a little bit.

Then I went to my mom's house and ate a cookie.

The End

tap tap...this thing on?

2011-01-29T19:11:00.000-08:00

So....I used to have this thing called a blog. And I would update it on a semi-regular basis. Then I started this thing called residency. And my blogging took a backseat. As did my housework. And my personal hygiene. And my knowledge of celebrity gossip. Can someone please tell me what Lindsay Lohan is up to these days? Rehab? Jail? My world is spinning out of control.

I'm finishing up a pretty rough three month stretch. I started out on night float at the VA. Not a bad gig. My job there is essentially to make sure that nobody dies over night and admit any new patients who show up in the ED. And I actually got a little bit of sleep each night. Pretty sweet when you can sleep at work.

After night float, I went to the ICU. I believe I blogged about this previously, so I won't bore you with too many details. Lots of ventilators, vasopressors....that sort of stuff.

Then I went to cardiology. This is one of the more dreaded rotations. We cover both floor status patients and really sick cardiac ICU patients....who have come in with a major MI....and coded several times....and are clinging to life by a thread. You know....that sort of stuff. I managed to survive that rotation relatively unscathed. As did most of my patients.

Now I'm on a general medicine rotation in the hospital. My team (an attending, one senior resident, two interns and a menagerie of medical students, pharmacists and pharmacy students) round on about 16 inpatients daily. We have a constant influx of admissions and discharges (Can you have an influx of discharges? Does that make sense? Is that an oxymoron? Am I a moron? Don't answer that.). It's super busy, but I enjoy it.

On a sad note....one of my very favorite patients passed away this week. He fought a long hard fight against a nasty disease. I will miss you, my friend.

On a happy note....in exactly two weeks, I will be on vacation! Yippee! Perhaps I will catch up on my personal hygiene.

Happy weekend everyone!

CBart, MD

PS - let it be known that I spelled "menagerie" correctly on the first try. Spell check did not have to correct me. It's the little things.

Overheard in the ICU Today

2010-11-24T19:47:00.000-08:00

Resident 1: Did that patient die?

Resident 2: Yeah, celestial discharge.

Resident 3: D/C to JC.

Resident 1: Hey, did you call Urology to see the patient?

Resident 2: The rod squad?

Resident 3: The stream team?

Resident 1: Did you check that guy's penis?

Resident 2: That's what she said......

Fellow: How'd the tap go?

Resident: Good....I tapped him twice. Er....(giggle giggle).

Apparently the ICU team has regressed to 12 year old boy humor.

Happy Thanksgiving!

Hello Friends!

2010-11-22T18:39:00.000-08:00

Hey there! So, I've noticed that I have a few followers of this here little blog. While I know most of you...some of you are peeps that I haven't actually met. And that leaves me wondering....Who are you?!?! I'm excited that you think my blog is worth coming back to (you must have a lot of time on your hands) and I'd like to know more about you. So if you have the time, leave a comment and introduce yourself. This will kind of be like a bridal shower where you go around the room introducing yourselves one by one. And if I already know you, feel free to leave a comment as well. And if you just stumbled on my blog because you googled "pigs feet" and this is were you ended up, you can also leave a message!

Word to your mother.....

I See You - Life in the ICU

2010-11-19T20:12:00.000-08:00

I think I finally have my sleep cycles straightened out. It was a bit difficult going from working nights to working days, perhaps what jet lag feels like. Anyhow, it's nice to be able to sleep at home, in my bed, with my super-cute and cuddly husband. And it's also nice to be able to put my little Peanutty girl to bed with a big smooch and hug each night.

I'm just a few days into my ICU rotation and it has been a whirlwind so far! On my first day, I got to place an art line, watch a chest tube insertion and see an autopsy.

I'd never seen an actual autopsy before and it was an experience I felt like I needed to have as a doctor. We spent a lot of time with cadavers in med school, but they are so altered by the preservation process that they hardly seem like real people. The autopsy was just crazy because the body was so freshly deceased. The pathologist had already started the procedure when my senior resident and I showed up. We walked into a big room, and there in the center, on a metal slab, was the patient. Chest and abdomen were opened up and all of the organs had been removed. It looked like something out of a horror movie. The pathologist slowly and methodically sliced into all of the organs to take samples for analysis. He looked more like a butcher than a doctor. It's amazing the things people can get used to after doing them on a daily basis for several years.

Pathologist: Hey, have you seen the pancreas?

Assistant: Well, I'm sure it's around here somewhere (rumaging through the abdominal contents which have been placed in a large bucket).

Very surreal.

I almost got to start a central line today but my senior resident beat me to it. I'm going to have to start being a little more aggressive. Instead I got to take another stab (quite literally) at an art line. This one I missed....dogonnit! Intern fail. Then the med student came in and got it. I haven't seen my ego since...last I heard she was in Bermuda.

Okay...I'm having a really hard time keeping my eyes open. I'm going to go to bed now. Then I'm going to get up at 4:30 and go back to work. Where I live.

Hello....I suck at blogging.

2010-11-15T21:21:00.000-08:00

My apologies for being a blogging failure. And I don't have a great excuse for being MIA....my schedule has been relatively tolerable for the past month or so. Right now I'm on nights at the VA, so I'm actually blogging in the middle of taking random calls from nurses.

Some of my favorite pages so far:
- Um, hi....Dr. Bartlett? Yeah, so this patient is complaining that his butt feels paralyzed....

- Hello Dr. Bartlett. This patient has a blood sugar of 350 and he is on a regular diet. AND I found candy wrappers in his room. He needs a diabetic diet and a diabetes educator to visit him. (Now this would be a perfectly fine page, except that it occurred at 2:00am. I'm sorry, but we don't have diabetes educators on call for STAT consults in the middle of the night.)

- Hi there, I'm calling about Mr. X....on the red team.
    (Dragging myself out of bed, finding my glasses) Well, I don't have that person on my check out list. Are you sure he's a red patient?
    Yes...Mr. X....on the red team.
     I didn't get check out on him....is he a new admit?
    No....he's been here a while.
    (I look in the computer and find that Mr. X is on the green team)
    Well, it looks like he is on the green team.....
    Oh....oh my goodness. So sorry....
    Humph!

- Hi Dr. Bartlett. Ms. R is having 9/10 pain!!!
Where is her pain?
EVERYWHERE!!!
(I walk up 6 flights of stairs to evaluate the patient....who states upon my arrival that "well, I'm really not doing too bad." With a smile on her face...at 1:00am)

After this experience, I'm convinced that patients lay around all day thinking of ridiculous reasons to wake me up in the middle of the night. So far, they are winning. And the nurses seem to be in on it.

Okay....patient with pressure dropping....I'm off. And no mom, they don't need a chest tube :)

Then Sings My Soul (alternate title: The day I cried like a baby infront of complete strangers)

2010-10-27T20:00:00.000-07:00

I apologize for my extended blogging absence. I temporarily lost my blogging mo-jo.  Because I was working 80 hour weeks. So I guess I temporarily lost everything but the basic functions needed to sustain life....heart beat, aerobic metabolism....you get the picture.

I did another stint in Palliative Care last month and I loved it! I'm fairly certain that I'll do a fellowship in PC after I finish my Internal Medicine residency. If you're not familiar with PC, it's functions are broad. Palliative Care docs help manage symptoms, help patients and families navigate our complex medical system, support patients and families during difficult illnesses and help in end of life care. That barely scratches the surface of what Palliative Care involves, but I'll leave it at that for now.

So during my Palliative Care rotation, I got to spend a few days at the Hospice House. This is a really beautiful facility that houses patients who are often in their final days. One afternoon at the HH, my attending suggested that I shadow the music therapist. I'd never seen the music therapist in action, so I agreed.

We walked into the room of a patient whom I had never met. I introduced myself to her family and took a seat at a small table. The music therapist took out her guitar and asked the patient's son what kind of music his mother liked. It didn't take him long to report that her favorite music had always been hymns. If there is one thing in this world that is guaranteed to make me cry....hymns.

The music therapist then started strumming her guitar slowly. The first sounds of an old familiar song.....How Great Thou Art.

Hello there, my name is Dr. Bartlett, and I have a tendency to cry.....easily.

It was surreal as she sang:
When Christ shall come
With shouts of acclamation
And take me home, what joy shall fill my heart......
Then I shall bow
In humble adoration
And there proclaim
"My God! How great Thou art!"

She finished How Great Thou Art and went right into His Eyes are on the Sparrow.

Breathe.....just breathe........weenie.

Then In the Garden, one of my dad's favorite songs.

Are you kidding me, lady?

All the while, the patient is lying in her bed, eyes closed. Peace and serenity evident in her wrinkled face. Her son recalled her involvement in the church throughout the years....up until she became too sick to attend.

And then.....you can probably guess for yourselves. The final nail in my coffin.

Amazing Grace

I tried to focus on something....anything other than the fact that I was in a room with a dying woman and her family, listening to Amazing Grace.

I generally find catheter bags helpful in these situations. (Hum....wonder how many cc's in the last 24 hours. Looks kind of dark. He he....that's pee pee!) But this patient didn't have a catheter. Blast!
I managed to hold it together until the last verse. The last verse is often left out, especially in all of the new-fangled versions of the song (don't get me started). But the last verse is my favorite:

When we've been here ten thousand years
Bright shining as the sun
We've no less days to sing God's praise
Then when we've first begun

Stick a fork in me.

So there I sat. Trying to be all professional and doctor-y, but reduced to a puffy-eyed, snot-dripping, tear-streaming, blubbering mess. Seriously. I was crying so hard I could barely speak. In a room full of strangers.

I was sure that the patient's son thought I was nuts, but when the music ended, he put his arm around me and said, "That lump in your throat is what will make you a great doctor. Don't lose the lump."

The music therapist and I stepped out of the room and I tried to make a joke about regaining my composure, but I still couldn't even speak.  I spent the rest of the day with red, puffy eyes and splotchy skin. The curse of a fair complexion....and a tender heart.

T waves

2010-09-25T18:57:00.000-07:00

Last month I had a patient with a potassium level of 5.5 when I checked his labs in the morning. 5.5 is slightly elevated. Slightly elevated potassium scares interns (me). Slightly elevated potassium can turn into really elevated potassium which can turn into an arrhythmia which can turn into death. Death is bad - I catch on quickly. So I did what any good intern would do....rechecked the potassium level and got an EKG. Sure enough, potassium was still high on the recheck, and the EKG.....well....I'm only on chapter 3 of Dubin's Rapid Interpretation of EKGs, but it looked to me like the T waves might be peaked. They were certainly tall. But I wasn't sure. This is the part where the intern (me) freaks out a little bit. Peaked T waves can be the first sign that the elevated potassium is affecting the patient's heart. It was certainly affecting the intern's (my) heart....as it began beating more rapidly.

Are these T waves peaked? Well heck....they look a little peaked....maybe they're just tall....tall but not peaked.....or maybe they're just peaked and the patient is going to die in 5 seconds because you don't know the difference between peaked and tall. Maybe you should just call your senior....or maybe you should sit down with your head between your legs. Or maybe you should go get a doughnut.

Just then, a senior resident, who I'd never spoken to before in my life, started walking down the corridor toward me. I lurched out from behind the patient's chart, clutching the EKG in my hands, knuckles white, thrusted it out in front of me and said, "ARE THESE T WAVES PEAKED!?!?!?!" My heart was beating 500 times a minute....I was about to call a Rapid Response on myself. He looked at me like I was crazed....which was an accurate evaluation, but he took a quick glance at the EKG and said, "No....just a little tall. Give him some calcium gluconate, D50 and insulin, and a little kayexalate."

Yeah....that's what I thought......

So now I'm much more comfortable managing hyperkalemia.

Next time....managing an upper GI bleed.

briefly....

2010-09-22T20:05:00.000-07:00

I got to sleep in until 6:40 this morning. There was a bright yellow ball in the sky when I drove to work. This frightened me initially. Then I recognized it as the sun.

The End

No, but I play one on TV

2010-08-28T20:17:00.000-07:00

Most days I feel like a complete and utter impostor. I walk around the hospital with my long white coat, examining patients and writing orders and wondering who in the world thought it was a sound idea to slap an MD behind my name and let me be responsible for sick people. Nurses address me as "Dr. Bartlett" and ask me questions about patient care. They call and tell me that my patient just had a run of sinus tachycardia in the 170s. Then they ask me what I want to do about it. My response usually starts with an "Uh......well......uh......" Then the pharmacist pages me wondering why on God's green earth my patient with c. diff is on both vancomycin AND imodium. "Well.....er.....uh....." I've heard on several different occasions that you just have to act the part. So far, I think I'm a pretty crummy actor.

And speaking of pharmacists...they must think that doctors are the biggest idiots in the world. We have a pharmacist that rounds with us daily, and bless her heart, she's as sweet as can be, but the look on her face would suggest that she wonders, frequently, who in the world thought it was a sound idea to slap an MD behind my name and let me be responsible for sick people. She paged me yesterday and had to explain that the dose I'd written for on a particular medication didn't exist. Intern fail.

Thursday was a bad day. I felt particularly incompetent on Thursday. I spent most of the afternoon on Thursday cornering my co-interns in the halls and asking them if they felt incompetent every second of every day, like I did. The response was an overwhelming YES. So that made me feel better. Then I called my smartest doctor friend Bethany and she reported that she also felt incompetent on a daily basis. Again, I was reassured. I believe, however, if you got a CT of my head, you would see a striking amount of atrophy. Or nothing at all. Just a big, empty skull. Abrainia.

Today was a better day. My incompetency meter was probably a 4/10 today, as opposed to a 9/10 like on Thursday. And I got home at about 4. And I have tomorrow off. That means I can go to church and ask God to make me a little less incompetent.

So, in summary:
- I am incompetent
- Pharmacists believe most doctors to be stupid
- Pharmacists are correct in their assessment
- I have the day off tomorrow

Differential Diagnosis Part 2

2010-07-29T19:25:00.000-07:00

During my Hematology rotation, I became convinced that I had leukemia, or some other horrible cancer that had metastasized to my bones. My symptoms were: weight loss, night sweats and leg pain. I had several conversations with my senior resident trying to convince him that I needed a bone marrow biopsy. He thought I was crazy.

After analyzing the situation further, it was determined that my symptoms were residency induced. The leg pain was secondary to being on my feet all day, and being dumb enough to wear heels. The night sweats were caused by my crazy stress and anxiety. They got better when Danny started turning the fan on at night. And the weight loss....well, I guess that's expected when you have no time to eat.

So....I feel better now. And I have all day tomorrow to try to re-gain the weight I've lost. And my senior resident was right.

Day Off!

2010-07-24T09:08:00.000-07:00

Happy Saturday to you! This is my fourth day off for the month and I'm enjoying the heck out of it! I went to bed last night at 9:30 and woke up this morning at 9. During that time I dreamed that I had another baby....who I delivered all by myself. And then somehow I ended up in a canoe. And then a strip club. Freud would love me. Last week I had a dream that I could palpate my own pancreas.

Enough about my freaky-weird dreams. Things at the hospital have been good. I kinda-sorta feel like I'm getting the hang of things. For one, I've learned that when I go to the bathroom, I should leave my pager elsewhere. I've also learned not to pimp the med students. They seem to know more than me. But my coat is longer, so neener neener neener.

Oh, and my journalism degree is finally benefiting me. I've received several complements from my fellow and my attending on how nicely written my consult notes are. This really says nothing about how knowledgeable I am about Factor IX deficiency or thrombophilia, but how well I can feverishly scribble down what my attending rattles off and translate that into a note. It's been suggested that I write better than I speak. I'm not sure what to make of that. Maybe I'll stop speaking.

And of utmost importance.....I finally got PAID! They don't pay the residents very much. One of these days I'll calculate the hourly rate. I anticipate it will be in the neighborhood of $3.00ish/hour. But regardless of how measly my salary is, and how utterly and hopelessly and hilariously in debt I am, when your family income doubles all of a sudden, you can't help but feel like you're RICH! I've warned Danny that I might go a little "willy nilly" and take myself on a shopping spree (don't tell Dave Ramsey!). I told Louisa that we can start shopping at Gap Kids and Janie and Jack. She didn't seem to care. At the time of this conversation, she was wearing a yellow and white polka-dot halter top and pink and white stripped terry-cloth shorts....happy as a clam. Okay, so I won't go too willy nilly with my newly found riches, but at least I can buy myself some new underwear so I won't have to do laundry so often.

Alright, I'm going to get back to my day off. Have a lovely weekend!

-Dr. B

Hellooooooooooo

2010-07-20T19:58:00.000-07:00

Is anybody out there? Anybody?

Just wanted to let you all know that I'm still here.....still alive.....haven't been eaten by the boogie man.

Residency is going pretty well so far. Everyone has pretty low expectations of the interns which is fantastic. I'm on the Hematology service, so I see lots of patients with leukemia and lymphoma. Cancer sucks. That's what I've learned so far.

My attending is an old salty fellow who is quite legendary at the hospital. He commands the attention of everyone in the room and he makes my blood pressure, as well as my anxiety level skyrocket when he shoots me his infamous, squinty-eyed glare. My co-intern and I, as well as the two med students on the service, have taken several a tongue-lashings from him. But as much as he tears us down, he tries to build us back up as well. His tirades usually go something like this:

One breath: Why didn't you check Mrs. So-and-so's fibrinogen? That is completely irresponsible! Is this your patient? Are YOU managing this patient? Why don't YOU know the side effects of all of the medications she is on?

The next breath: I remember what it was like to be an intern. It's hard. You don't know whether you're coming or going. You guys are doing just fine.

The third breath: Did the patient have pulsus paridoxus? What? You don't know? You didn't check? This patient might have tamponade and you didn't CHECK FOR PULSUS PARIDOXUS!?!?!?

Next breath: You guys are doing a fine job. I think we have a really strong team of residents and students.

I must say, although I might be developing an ulcer, I really like this attending. When he's not making us want to pee our pants, he's so darned funny that I forget how scared I am.

So that's what's been going on with me. I've been averaging just under 80 hours a week, but when I'm at the hospital, the time seems to fly. I hardly have time to eat and go to the bathroom. This might be the best diet plan ever. And when I finally had time to eat today, I really had no appetite. Hard to snarf down a quick meal when you can't get the sight and smell of your patient's diarrhea out of your head. (Thank you, Mr. Patient, for saving that just for me.)

Colorado.....where the wind comes sweep....er....nevermind

2010-06-27T19:09:00.000-07:00

Okay, so I was going to write a series of entries, one for each day we spent in Colorado, but, you see, my time is running short. So here's the quick and dirty.

Danny and Christi; Adventures in Colorado.

Day 1:

Drive to Denver. I have a bit of a cold, so I buy some Vick's Vapor rub at a gas station and slather it on my neck and chest.

We spend the night in Denver (which is a rockin' town - if you didn't already know). I become paranoid when I read a notice next to our hotel door that says: For your safety, please bolt and latch your door. And then I was tempted to sleep with a knife under my pillow. But that seemed kind of dangerous.

Day 2:

Wake up with rash all over my neck and chest. Strong work, Dr. Bartlett. Got a little carried away with the Vicks. Glad I didn't put it on my face. Continue driving to Redstone. Stop for lunch in Carbondale. Eat the most delicious burger ever. Go to the pharmacy and pick up some steroid cream....because steroids fix everything. Except TB. And they can make your testicles small, but that's not really a concern of mine.

Check into The Avalanche Ranch. Sit on porch, take in view of mountains, drink hard cider.

Day 3:

Wake up to a mild, yet strange odor. Reconcile that it is merely my feet. Forget about said odor.
Go for a hike on a desolate, isolated, abandoned, unpopulated trail. Become paranoid that we will be eaten by a bear. Especially after seeing this:

Clearly the paw print of a very large, mean, people-eating bear.

And then this.....

Most likely left over from a bear attack. Probably human, but I have no way to confirm this.

Do you see the crazed "I'm-convinced-a-bear-is-going-to-eat-me" look in my eyes?

Look closely, it's there!

Luckily my psychosis didn't keep me from enjoying the scenery.

Because I like to plan ahead, I made Danny rehearse what we would do in the case of a bear encounter. It went something like this:

Me: What if we see a bear?

Danny: I don't know (clearly not concerned).

Me: No, really!

Danny: I don't know.

Me: Well, I've heard that if you stand really still, they can't see you.

Danny: I'm pretty sure that's the T-Rex in Jurassic Park. Doesn't work on bears.

Me: Blast!

~ THE END ~

So, I guess we really didn't have a plan.

Returned to cabin. Again noted smell. Continued to assume it was my feet, socks, shoes or some combination of the three.

Day 4:

Drove to Aspen. Very upscale and kind of snobby. A bit like the plaza, but in the mountains.

Danny buys Northface jacket. I get nothing but annoyed and resentful.

Spend more time in Carbondale. Attend local rodeo. Resolve to move to a ranch and spend my time wearing Wranglers and barrel racing. Will make a cowboy out of Danny.

See? He clearly loves this.

Imagine Weezy having field parties on our land. Imagine the debauchery this entails. Resolve to stay in the suburbs and send her to the strictest of private Christian schools.

Day 5:

Smell is worse. Danny believes that while my feet are generally rancid, this smell is a bit more carcass-y. We alert ranch staff and they relocate us to a new cabin.

Go horseback riding with Cowboy Randy and his staff of ranch hands through the mountains.

Danny does an exceptional job for a beginner. I nearly drop my mom's camera and fall off my horse as we go galloping through a field. Poor job for a ~~seasoned equestrian~~ city girl who used to have horses.

Luckily I didn't drop the camera and managed to get some cool pics.

Of course I asked Cowboy Randy about the bears. He assured me that in the 5 years he'd owned Avalanche Outfitters, he'd only been charged by a bear 4 times. And really, it's the mountain lions that are dangerous.

Thanks for putting my mind at ease, Cowboy Randy! Now, do you have any xanax?

At least the cowboys had their pistols and hunting knives handy.

Finished horseback ride and hopped off my horse like I was John Wayne. Landed on noodle legs and prayed to God that I wouldn't fall over. Clutched horse's neck until I could use my legs again. Couldn't sit comfortably on my tush for the next several days.

Day 6:

Missed our girl way too much. Got up early and headed out of Dodge....or toward Dodge? Heck, where is Dodge?

Made good time. Made fun of Danny and his issues with Cruise Control. If I get a chance, I'll address this annoying quirk of his in a new post. But.........

If you don't hear from me in the next 3 years, it's because I'm starting residency this week. If I have any extra time in my schedule it will be used for sleeping, eating and bathing. Hopefully I can maintain the blog on a somewhat regular basis (because I'm sure I'll have lots to blog about and I know that you depend on me), but I'm not promising nuttin'.

And here are some more pics from our trip.....

On our way through Kansas, saw hundreds of these weirdo things. I'm sure they're good for energy and what-not, but they're kind of creepy.

Cookies waiting for us in our cabin when we checked in.

I could be really obvious and tell you that this is the kitchen, but I won't.

I spent a good amount of time in that tub.

Danny prefers a shower to a bath. He claims that a bath is nothing more than sitting in your own dirt. I don't know who asked him to open his pie hole and spout out his opinion.

My dream house will have a clawfoot tub.

Our first cabin. The carcass-y one.

Danny in the Morning with Coffee - by ~~Ansel Adams~~ Christi Bartlett

My little hummingbird friend.

Dandelion path

Does anybody know what these are?

Does anybody know where I left my keys?

Obligatory blurry water shot, thankyouverymuch.

No bears here....

I like to eat a balanced diet - here I'm drinking my fruit group.

My fruit group makes me act silly.

Danny laughs at me when I'm silly.

I laugh at Danny when he wears tennis shoes to ride a horse. Even though my boots were totally Steve Madden. Not exactly intended for s#%t kicking.

It just does not get much better than this.

Avalanche Ranch Path

Look at me, I'm artsy. Or a tool....take your pick.

If I could drive any vehicle in the world, it would be this truck. We parked next to this bad boy in Paxico, KS. Did I just say "bad boy" on my blog? How embarrassing for me.

Love

More Paxico

And some bathtubs...

And now......

AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA.....................

..........The sound of me falling off the face of the earth.

Further into Domesticity

2010-06-19T13:36:00.000-07:00

Today I did something that I have never done before. I. Made. Pie.

We had lunch with some friends this afternoon and I had offered to bring dessert. I was going to make old faithful - chocolate chip cookies, then I considered strawberry shortcake (thanks for the suggestion Humble Hostess!). And then, for reasons yet to be understood, I decided to make mulberry pie.

What is a mulberry, you ask?

Why, I have no idea, I say.

Alls I know is that we have two giant mulberry trees in our yard that leave a purple mess on our driveway every spring. And the birds love the berries....I've seen the purple poop! Ha Ha....purple poop! [Insert favorite K-State joke here.]

So I decided to use the resources in our front yard and make a pie. I put Danny in charge of the picking. He put me in charge of everything else. Including the homemade crust. How we all lived and thrived without Google for so many years is a mystery I ponder daily.

The following is a how to regarding mulberry pie.....

1. Move into a house surrounded by mulberry trees.

2. Find yourself a husband to go out and pick them. Ideally, he will be tall with a large wing span. He should also have broad shoulders and a kind heart. And a nice tush.

3. Have a baby that can watch out the window as her daddy picks berries.

Then when she sees him.....

4. I'm sorry, what was I talking about....?

5. Rinse the mulberries in cool water. I'm just guessing on this one. Not part of the actual recipe, but it just sounded like a good idea.

6. Google "how to make pie crust." Then fill said pie crust with berries smooshed together with flour and sugar.

7. If you're feeling especially daring, you can also google "how to make lattice pie crust." Find instructions with pictures.

8. Have a big fat Obsessive Compulsive Personality Disorder moment and make sure your slices of dough are EXACTLY THE SAME WIDTH!!!

9. Take some xanax.

10. Feel really good about yourself when you figure out how to lattice. Say something like, "What's up now!?!?" or "Who's your daddy?!?!"

11. Have a melt down when you realize that you messed up one of the strands of lattice work.

12. Feel better after your husband suggests that you repeat the same mistake on all of your pies as your special "signature." Kind of like a serial killer.

13. Bake.

14. While the pie is in the oven, take pictures of your baby's chubby thighs. Wish that your chubby thighs were as cute as hers.

15. Remove from oven. Take lots of pictures of your pie. In the event that you never make pie again, you'll have proof that once upon a time....you made pie.

16. Do like they do in the old folks home and wipe your drool.

17. Repeat step 16.

18. Slice. Plop some vanilla ice cream down next to your pie.

19. Eat

Girls Weekend, WOO HOO! (alternate title: 7 old hags get out of town for the weekend)

2010-06-13T20:47:00.000-07:00

I really want to blog about our trip to Colorado, but I haven't had time to edit my pictures yet, so you'll just have to wait. One of the reasons I haven't had time to edit pictures is because I had the pleasure of spending a few days at the lake with six of my bestest girl friends! So you get to hear about that.

Ready?

Here goes.

Myself, the Socialite, the Supermodel, the Artist/Preacher's Wife, the CRNA, the Coach/Preacher's Wife and the Shopper headed out last Thursday for a weekend of fun and sun to celebrate the year of our 30th birthdays. And to escape all responsibility. And husbands. And children.

We stayed for FREE in a beautiful condo overlooking the lake. There are perks to being friends with a preacher's wife! After we rolled into town, we made a quick trip to Wal Mart where we bought the necessities....wine and bacon. And a few other things, I think. But none as necessary as wine and bacon.

We got settled into the condo late in the evening and kicked back with some fantastic drinks that the Socialite whipped up. They weren't as strong as they could have been because the Shopper didn't like vodka. Blah blah blah...

We slept in a bit on Friday morning, because that's what you do when you don't have a husband and a baby making demands of you. The sky looked stormy, so we decided to go shopping, because that's what you do when you don't have a husband and baby making demands of you.

First stop: the outlet mall. Ahhhh, outlet stores as far as the eye could see. I splurged a bit and bought some new shirts for myself. Danny bought a new Northface jacket in Aspen, so I reckoned that I was entitled to a little money spending of my own. That and I needed more responsible looking clothes to make my patients believe that I am a competent doctor. Right? Right! Nothing says "trust me, I'm a doctor" like a T-shirt that says "Trust me, I'm a doctor." Oh, and a closet full of cardigans. And glasses. I will be wearing my glasses each and every day, starting July first.

So we shopped forever at the outlet mall until one of the preacher's wives became a shoplifter. Then we decided it was time to hit the road. Before lightning struck her down. Our next stop was MEGA MARSHALLS. I could have wandered around that place for all of eternity. Maybe that's what heaven is like....my heaven anyhow. Danny would argue that it is the other place. Anyhow, other than the fact that the store closes at night, I couldn't come up with any good reason to ever leave. They have clothes, furniture, bedding, towels, food.....and cute little office organizers so when Danny forwards my mail to MEGA MARSHALLS, I will have somewhere to keep it. Neatly. Finally the Socialite decided that she'd had enough of MEGA MARSHALLS and demanded that we leave. The Socialite sorta runs the show. I generally do what she says. That's why we've been best friends for so long. Mutual respect.

That night we got dressed up, the Supermodel teased our hair, we put on too much eyeliner and went out for mexican food. We laughed because we couldn't figure out who we were dressing up for, but we went ahead and did it.

On the way back to the condo we stopped to take ridiculous pictures in front of a miniature golf course with a huge pirate sign. They didn't turn out very well, but here's one of them. In the name of modesty and decency and potential legal action, I will refrain from posting a picture of one of the preacher's wives mooning the camera. I won't say which one it was, but it was the same one who shoplifted earlier in the day.

This is me and the CRNA. Respectable health care professionals.

Then we went back to the condo for some wine and girl talk. Which turned into cookie-eating and inappropriate picture-drawing. Again, mostly from the Preacher's Wife.

The next morning we got up and ate some more bacon. The following conversation took place during the cleaning up of said bacon:

Shopper: What should I do with this bacon grease?

CRNA: My mom always put it in a can.

Shopper: Lets turn the water on really hot and put it down the drain.

Socialite: My mom always put it in a can.

CRNA: Just make sure the water is REALLY hot.

Shopper: You don't think it will catch on fire, do you?

Socialite: No.

CRNA: Well, if you throw a match on it.

- THE END -

After the bacon grease was disposed of, we went to the pool to get some sun. I got fried after about 45 minutes and caught endless slack because I didn't put any sun screen on. Apparently when you become a doctor, people expect you to start eating vegetables and wearing SPF 50.

So that was our weekend in a nutshell. Oh, heck. I left out the part about the Supermodel and the Goober-burger. Probably for the best.

Here are a few pictures:

On the road again....(they made me sit in the back).

Preacher's Wife #1, Socialite, Shopper, CRNA, Supermodel, Me and Preacher's Wife #2 at lunch.

Me with Supermodel and Socialite. (Re: hat - my ode to Matthew McConaughey)

Ready for our night on the town. First time my hair had seen a curling iron in years!

Supermodel and Shopper - work it....OWN IT!

Shopper's not-so-graceful enterance into the car. Preacher's Wife wondering how she ever ended up friends with hooligans like Shopper. Contemplating existence. And another glass of wine.

Lake of the Ozarks Barbie

This was the cute little place we had lunch. The picture was super-cute, except for my heinous appearance. That's why I'm all scribbled out.

Helpin' a brother out

2010-06-09T21:06:00.000-07:00

A few days ago, my friend Kelly (who volunteers at a dog shelter) sent me a message about a new dog who had been dropped off at the facility. His owners were moving and their new place would not allow pets. So they took him to the shelter. But the shelter just happened to be a "kill shelter." Meaning that the dogs who are there too long are put to sleep to make room for more dogs.

Because I am a lover of all things furry and slobbery, I immediately posted a link to "Midnight's" profile on my facebook page. Several people commented, but my sweet friend Molly, who lives in Omaha, was genuinely interested. After much texting and calling among Molly, Kelly and myself, Molly decided that she would be Midnight's new mommy.

So today, Danny and I drove over to Half Way Home Pet Adoptions to pick up Midnight, the beautiful little black Cocker Spaniel, who was to be renamed "Kansas." We brought him back to our house for a few hours and he got to spend some good, quality time with our pups while Molly was driving in from Nebraska. When Molly and her boyfriend got to our house, I had a hard time letting him go. That sweet face just melts me. As they were driving off, I yelled to Molly, "If you decide you don't want him, I'll take him!" Somehow, I don't think that's going to be an issue.

Hello there. I don't know who you people are, but I have a feeling things are looking up!

The Three Amigos

I'm so glad that Kansas has found a forever home and that he did not have to die. But it makes me sad to think about all of the helpless pups at shelters across the country who will eventually be put down because nobody comes to take them home. If you are thinking about getting a dog, please consider rescuing a dog from one of these facilities. Charlie, Mabel and Kansas would appreciate it.

Now off to the shower....I smell like the pound!

Charlie's Corner

2010-06-06T12:52:00.000-07:00

Charlie here.

Mom and Dad just got back home. They went to a place called Cowowado for a week. That's why Mom hasn't been on this bwogging thing. Anyhow. Just wanted to let you know that as soon as she gets her pictures downwoaded, she will tell you all about it.

As for me and Mabel, welp, we had a pwetty good week. Mom's BFF, who just so happens to be the object of my affection (Oh Wachel...how I wove thee!), stayed with us and made sure we didn't get into any twouble. The week would have been better if it hadn't been for that pesky Twavis. He's twying to move in on my Wachel. And I tink she woves him more than Charlie. My heart has been smooshed into a billion tiny pieces. Just so you know.

It must be the persistent dwooling that has turned her away.

I weep.

I bewieve I have spent enough time on this computer, spewing my emotions for today. I have a bone out on the deck cawing my name.

Wove,
Charlie

I Heart You

2010-05-27T20:50:00.000-07:00

Okay, so an update on my heart. Started drinking coffee again and finally my PVCs came back. Recorded a few good ones on my monitor. Stopped drinking coffee. Still having PVCs. But now they have a hard time getting up in the morning and have less energy during the day. Oh wait, that's me.

I think in an earlier post I mentioned something about wearing the monitor for "a few days." Well, make that 30 days. Seems a little excessive to me, but what do I know? I'm just a doctor. A doctor withdrawing from caffeine. A doctor withdrawing caffeine who just had to type C-A-F-F-E.... in the little google toolbar because she couldn't remember how to spell it. Lord help me. Isn't there some sort of caffeine substitute? Other than meth?

Anyway...so I get to wear my monitor for another two weeks. And I'm starting to feel a little self conscious when I go out in public and have an EKG sticker stuck to my chest with a conspicuous wire attached to a black box on my belt. I look like either I'm dying or I'm a suicide bomber....or a dying suicide bomber. Is that redundant?

Okay, it's late and my brain stopped functioning sometime in March.

Word to your mother.

Turn on Your Heart Light

2010-05-17T21:40:00.000-07:00

Last week I got my heart monitor in the mail. I wasn't expecting it since I hadn't even seen a cardiologist yet, but you know....they're probably all too busy golfing. So they sent the monitor in their stead. Clearly nobody thinks I'm going to drop over dead from my PVCs, so....that's reassuring.

This little monitor that I have is supposed to monitor events. Would you believe that since I've stopped drinking coffee that my events have stopped? Yeah, I've been wearing this silly thing all day, every day actually HOPING for some PVCs so I'll have something to record to show the cardiologists so the following scenario doesn't take place:

Cardiologist: Well Ms. Bartlett....

Me: (coughs "Dr. Bartlett" under breath)

Cardiologist: You've been wearing the monitor for 30 days and we haven't recorded any abnormalities.

Me: But....but....I promise. I get these weird spells where my heart goes "lub-dub.....lub-dub.....lub-dub-lub-dub...................*come on little SA node!...........lub-DUUUUB.

Cardiologist: Oh, of course. I believe you. I'm just going to have our front desk make an appointment for you to follow up with one of the nice people in our psychiatry department.

~The End~

So now I've started drinking coffee again to try to make my heart misbehave. So far no luck. I knew this was going to happen. Stupid heart!

But....if it turns out that caffeine is the culprit...well, that just means that the universe is a cold, cruel place for Christi to live. Starting my intern year without the performance enhancing effects of coffee is like dropping me off in the middle of Lake Michigan in a wee little boat with no paddle. And then putting sharks in Lake Michigan. Would sharks even survive in Lake Michigan? I'm not a marine biologist. Scratch the sharks. Lets go with the traditional evil sea creature ~ sea bass with lasers. The ill-tempered variety. That's what intern year will be like for me. Sympathy please!

I don't know where I'm going with this. Big surprise. I'm just frustrated that there is no rhyme or reason to my crazy heart beats and I can't even catch them on the monitor. They're like big-foot.

Stay tuned for my adventures in the psych ward.

Oh, and just for fun, here's a picture of me rocking my EKG sticker. Don't even ask what I was thinking.

Well, what I was thinking was, "Oh heck, Carrody has a camera, quick, do the mad model look, no...don't do that, you'll look like a tool....blast....too late!"

Gradumication

2010-05-16T20:49:00.000-07:00

About seven and a half years ago, I was sitting at a desk, working as a receptionist for EVCO Wholesale Food Co. in Emporia, KS. One day, between taking telephone orders for chicken gizzards and being heckled by Sarge, the crusty old warehouse manager, I had an epiphany. (Do I use too many commas? If this bothers you I'm sorry.) Where was I? Oh yes, the epiphany. I was going to be a doctor.

And that night I had a very interesting conversation with Danny. Well, it wasn't so much a conversation as it was me talking about my change in career plans and Danny sitting there with his mouth agape wondering what had happened to the person he had just married.

I had started out at KU as a pre-med major (mostly because it sounded good when people asked me what I was majoring in), but after taking chemistry and biology I thought, "Golly-gee-wizards! This is hard!" and opted for a journalism degree. I was going to be an uber-successful, uber-blond, Manolo Blahnik-wearing pharmaceutical sales representative. But lo....that had too many syllables and I wound up as a receptionist at a food wholesaler making minimum wage and wearing knock-off Manolo Blahnik Tims (you know, the one's J Lo used to wear). Fate is cruel.

Follow this link for a picture of me on their website. Yep....quit working there in 2003. They just can't let me go. Or they haven't updated their website in seven years. Either is plausible.

http://www.evcofoods.com/customer_services.htm

You're welcome to leave me a comment telling me how I haven't changed a bit since then. Or, if you have an aversion to lying, don't write anything.

Be that way.

Where am I going with this? I've forgotten myself.

My name is Christi, it's 2010, Barack Obama is the president....

Oh yes. Graduation.

Last night, seven and a half years after my epiphany, I walked across the stage at the Lied Center in Lawrence as Dr. Christi Leigh Bartlett. I was hooded, handed my diploma and recited the oath of Hippocrates....all while wearing some stinking cute red shoes. Still not Manolos. That dream has died. And go figure, the "hood" isn't even a hood, which I found somewhat disappointing. But I still consider myself "hood"...you know...I went to Shawnee Mission North.

So that's what's been going on with me. As Oprah would say, it was a "full circle moment." Then she would give me a big hug and invite me to her mansion in Montecito. Nate Berkus would be there and he would give me decorating tips while lounging by the pool and sipping mojitos. Charlie and Mabel would be invited too and would spend the day frolicking with Oprah's cocker spaniels.

Oh please! Tell me you don't have an Oprah fantasy!

Talk to you all later.

Sincerely,

Christi Bartlett, M.D.

A Mother's Day Apology

2010-05-07T17:57:00.000-07:00

I have a confession to make. I have been judgemental, critical, mean and downright snarky to my mother. It started several years ago and involved her affinity for granny panties. I took every opportunity to make fun of her and her ugly, beige, "but-I-can-tuck-my-turtleneck-into-them" undies. I thought I was superior because I wore cute little Victoria's Secret underwear. Who cared if you could see my butt cheeks when I bent over?

All of this changed nine months ago when we brought Louisa home from the hospital. As you may recall, I left the hospital fatter than when I was admitted. The universe is cruel. And the underwear that fit me while nine months pregnant were now too tight. So I sent my mother out to buy me the "biggest, ugliest underwear you can find." Because, clearly, she knew where to find them. She didn't fail me.

Initially I thought, "okay...I'll just wear these until I can fit back into my cute underwear."

After a couple of weeks, I lost my water weight and could legitimately fit back into my old, cute undies. But I didn't want to! I tried to wear them, but they just weren't the same. The hot air balloon-sized Hanes in my underwear drawer were far too enticing. So soft! So comfortable! So difficult to tell the front from the back! They go so far down that you never have to pick a wedgie. And they rise so far up your back that you don't have to worry about your tush hanging out. In fact, I've noticed when I wear them that my shirt can creep up over my waist line, but those underwear go so far up my belly that it just looks like a tank top under my shirt. No joke!

So, I have seen the light and have become an ugly underwear wearer like my mother. And I sincerely regret all the trouble that I have given her over the past 29 years.

I'm so sorry, Mom. I'm sorry for laughing at you in dressing rooms. I'm sorry snickering when I would walk past your laundry basket. I'm sorry for trying to use your underwear as a Barbie parachute. Thank you for being patient with me when I didn't understand. Thank you for never giving up on me.

I love you! Happy Mother's Day!

(You can send words of support/sympathy/your-wife-is-nuts to Danny @ dvb16@yahoo.com)

P QRS T

2010-05-03T20:06:00.000-07:00

For the last 3 years or so, I've had some irregular heart beats. It's really no big deal, I'll notice one or two episodes every day, and they don't cause any symptoms. But for the last 2 weeks they have been getting pretty out of hand. My heart is usually pretty chill....tickin' along at about 62 beats per minute. But recently, it has been downright misbehaving! At one point, I was having these little premature ventricular contractions (PVCs) every 5 beats. Even though it's probably completely benign, it's a little unnerving when you can actually feel your heart going into a weird rhythm. So last week I made an appointment with my doctor. Wouldn't you know it....pesky little PVCs pretty much stopped as soon as I got off the phone with the receptionist. I went ahead and kept my appointment though and I saw my doctor today.

Nurse: So, what brings you in today?

Me: I've been having some irregular heart beats.

Nurse: (eyes almost pop out of her head) Oh. My. Are they associated with any anxiety?

Me: Well, you see, I'm going to be a doctor here pretty soon, and people's lives are going to be in my hands, and I'll be responsible for not letting them die and/or killing them, and then there's Weezy, who I'm afraid I'll never see after I start residency because I'll be working all the time, and then when I'm done with residency, she'll be 4 and she won't remember me and she'll have lots of bitterness because "you weren't there when I needed you!" and then she'll be in therapy when she's 30..... No.

Nurse: Okay then. I'm just going to take your blood pressure. Oh, 122/72. That's very good! Very good.

Me: (Please don't ask me what kind of work I do.)

- Doctor comes in....blah blah blah...EKG...blah blah blah...blood work. Wham, bam, thank you ma'am! -

(Doctor leaves, nurse comes back in)

Nurse: Okay then. The doctor wants you to get an EKG. Have you ever had an EKG before?

Me: No, but I was on the monitor when I had my c-section.

Nurse: Well, see here....I'm just going to put these little sticky pads on your chest. You don't have to do anything. Just lay back and relax. It's really pretty quick and easy.

Me: (Please don't ask me where I work.)

So I got my EKG. Of course it was normal. And my heart rate was 62. Because that's how it ~~rolls~~ beats.

Then I went down the hall to the lab. The phlebotomist (person who draws blood) had the personality of a clam, and apparently the dexterity/coordination/depth perception of my one-eyed dog Charlie. I have pretty good veins, so it's usually no big deal when I have blood drawn. Not the case today. No siree Bob-O! After she missed my vein on the first try, instead of drawing the needle out and staying superficial (because that cotton-picking blue thing RIGHT under my skin, is, in fact, my vein) she gouged the needle in even further. I don't know if she was trying to hit artery or bone or what, but I gave her a look of disapproval, threatened to pass out, and suggested she try the other arm. A-hem!

And now I look like a heroine addict.

So that was my day at the doctor's office. I think my doc was going to wait and see what my blood work looks like before she sends me off for an event monitor (basically a portable EKG machine that I have hooked up for a day or so.)

The funny thing is that the treatment for PVCs is usually a beta blocker. Beta blockers slow your heart down. If my heart slows down much more from its lazy 62....well....that probably wouldn't be a good thing. I might just have to deal with my ventricles acting up every once in a while.

And just for your edumacation....

This is a normal EKG:

And this is what a PVC looks like on an EKG

That's all I know. Seriously. And I had to google that.

Voyage into domesticity

2010-05-01T19:42:00.000-07:00

Danny had been pestering me all week about making cookies, so I finally broke down and did it. I thought it would be a good mother-daughter bonding activity. So while Danny was outside mowing the ~~grass~~ weeds, the girls got to work in the kitchen. First things first - the immobilization of Louisa. This turned out to be easier than I had expected. Apparently she doesn't mind sitting in her little highchair. As long as I keep giving her cereal. And attention. And cookie dough.

That kid's not going anywhere.

(Ah, look. You've now seen my entire kitchen. Danny thinks it's the right size, as it is just big enough for one woman. Feel free to smack him the next time you see him. But don't tell him why. That would be funny.)

After I got her tied down I started on my cookies. I talked Weezy through the process. We discussed mommy's journey to find the perfect margarine, the margarine to flour ratio and the importance of using Nestle chocolate chips. I made her promise me that she would never ever ever use the cheap chocolate chips from Aldi.

So help me, amen.

I don't want my girl to suffer through same mistakes that her mother has made. She seemed only mildly interested. Apparently she didn't understand the importance of the information that I was bestowing on her. She was too busy fumbling around with the little nugget of dough that I'd given her, trying to get it from her sticky little fingers into her mouth.

Then Charlie decided to get in on the action.

When we finished up with the cookies, we went outside to watch Danny finish up mowing. Weezy sat on my lap and clapped for him every time he went by. She didn't clap for me when I was stirring up the dough....by hand....without a blender....

meh....

daddy's girl.

Dunzo

2010-04-30T20:14:00.000-07:00

Last Friday was my last day of medical school EVER. Sadly, there was no party, no fanfare, just one last test to close out my anesthesia rotation. And it was harder than I had expected. Thank you, anesthesia department, for making sure that I felt stupid up to the last second of medical school. Mission accomplished.

So now I'm done with school and I don't start residency until July 1st. Ah vacation, glorious vacation....er....

What? Weezy wants to get up at 6:30?

Weezy needs to be entertained every second of the day?

Weezy needs her laundry done?

Weezy needs a bath?

Weezy needs me to follow her around to make sure she doesn't choke on something/smack her head on something/knock something over/lick the floor/abuse the dogs?

Weezy doesn't understand that mommy is on vacation!

So this past week has been a crash course in stay-at-home-mommying. I'm convinced that I stink at it. Weezy's convinced that I stink at it and has asked, on several occasions, when I get to go back to work so Oma can come over. We are learning together.....this will be a process.

Thankfully, GG came over on Wednesday and played with the Weez so I could try to get a few things done around the house.

GG has a way of getting Weezy to fall asleep. Nicely done GG, nicely done. While this was going on, I was dusting in our sunroom. I was all proud of myself too and then Danny came home and didn't even notice. My feelings were crushed. I'm still recovering.

Then Bethany and Natalie came over for a visit. And Bethany brought Chipotle! She is my favorite person.

And that baby of hers is one cute little punkin. Look at that face!

While Bethany and I were eating, we did what any good parents would do. Tied our children down and plopped them in front of the TV. Ah silence :) They were watching educational, life enriching television....of course!

Natalie was born in December and Bethany is already skinny again. Skinnier than she was before Natalie. It's a good thing she brought me food, otherwise I wouldn't speak to her.

On Thursday we had coffee with our friends Nici and Maggie. Well, Nici and I had coffee. Weezy and Maggie practiced interacting with each other. Maggie was very eager to play, but Weez was in a bit of a stand-offish mood. Aloof, really. And a bit whiney. Not sure what that was about, but she warmed up eventually. Nici gave me some pointers on stay-at-home-mommery. She seems to have it mastered. Her house (at least what I saw of it) was spotless, her hair was curled (at 8:30 in the morning), and there were fresh muffins and fresh coffee in the kitchen. Freaking birds were chirping outside of her window. Oh, and I'm pretty sure she makes her own baby food too. If she didn't give me lemon-poppy seed muffins, I wouldn't have spoken to her either.

After our playdate, The Weez and I were on our own. She was tuckered out from being snotty, so she took a 2.5 hour nap when we got home. During that time, I contemplated my existence, cleaned the kitchen, dusted the blinds, came to the conclusion that I need a cleaning lady, remembered that we can't afford a cleaning lady and then wept violently. Then I watched Days of Our Lives.

Tomorrow, Weezy and Mommy make cookies......

A Recent Conversation

2010-04-25T17:57:00.000-07:00

(Between me and James B. Nutter Guy (JBNG))

Me: Hello Mr. JBNG! We're thinking about buying a new house. How much can we get approved for?

JBNG: Well, lets see here. How much money do you make?

Me: Well....my husband is a teacher and I am getting ready to graduate from medical school, so our income will increase a bit starting in July.

JBNG: Oh, well, that's great! So where are you going to be working?

Me: The Med Center

JBNG: A doctor, huh? That's great! I'm sure we can get you set up with a great loan. How much are you going to be making?

Me: I'll be making about (insert measly resident salary here).

JBNG: Oh.....

Me: Uh.....?

JBNG: I thought you said you were going to be a doctor.

THE END

Anesthesia

2010-04-09T21:02:00.000-07:00

If I had been around the anesthesia department earlier in medical school, I might have considered it as a career choice. But, alas, my soul belongs to the Internal Medicine department. And that's okay, I still love IM.

In the past week, I've been hanging out in the OR with the anesthesia folks. I show up at around 6:00 in the morning, help hang fluids, draw up drugs and do whatever else they tell me to do. "Hey med student, go get me a 20-something-or-other-anesthesia-foreign-language-talk." Yessiree! And then I spend 15 minutes hunting around the supply room, for what, I have no idea....but it had the number 20 in it.

You get to see some pretty cool stuff in the OR. We all do surgery rotations during our third year, but it's a lot of the same stuff over and over. I saw lots of gall bladders, prostates and livers last year. Got a little boring after a while (with the exception of the day that the attending stepped out of the room on a retroperitoneal lymph node dissection and I got to be first assist with the resident and he let me use the Bovie right up between the renal artery and the aorta....sweet!). But in just one week of anesthesia, I've seen a brain surgery, a gunshot wound trauma, a spine surgery and a bypass surgery. Here's a brief run down:

1. The brain - pretty cool. And, well....it does take a neurosurgeon. While I was in the room, the resident and I were just chillin', making sure the vitals were looking good, when all of a sudden I hear sounds reminiscent of the Texas Chainsaw Massacre. Oh yeah, that's the saw cutting into the skull. No biggie. Then the surgeon hands chunk of said skull to the scrub nurse, and there's the brain. Hello brain! At this point I stopped paying attention to what the anesthesiologist was doing....because there was a BRAIN - sticking out of a patient's head - and the flow of isoflurane just didn't seem very interesting anymore - because there was a BRAIN - did I mention that already?

2. GSW (16 in the clip and one in the hole....I love Nate Dogg & Warren G) - So, some poor kid got shot in the gut. Lost a lot of blood. About 20 people packed into an OR with blood all over the place trying to keep him alive. As far as I know, they did. Didn't stay for the whole case, because I went to.....

3. Cabbage - actually CABG (coronary artery bypass graft) - it's not every day you see someone's chest cracked open (more Texas Chainsaw Massacre noises) and their beating heart right in front of you. Well, unless you're a cardiothroacic surgeon....or Indiana Jones. Anyhow, so there beats the heart. Then they hook it up to the "pump," which shunts blood away from the heart and lungs and reoxygenates it and sends it back into the body, and then they STOP THE HEART. Like, for real. One minute it's ticking away and the next, it stops. Flat line on the monitor and everything. BEEEEEEEEEEP. Then the surgeon goes to work fixing up the coronary arteries. The surgeons usually have their iPODs playing during surgery, and this particular surgeon had one of the most appropriate surgery songs I've ever heard in the OR - I Will Try To Fix You - by Coldplay. Cute. I think this surgeon really likes music because as he was mucking around with the heart, he was giving a dissertation, comparing and contrasting Miley Cyrus and Taylor Swift. He went on and on about how Taylor Swift is a better musician, but is still just a tall, skinny, awkward teenage girl without a lot of stage presence. While Miley Cyrus, who doesn't necessarily have all of the musical talent in the world, is a fantastic entertainer. This was all done with a completely straight face....like he was lecturing on some cutting-edge cardiothoracic surgery breakthrough....except he was talking about Miley Cyrus and Taylor Swift. I love surgeons.

On a super-exciting note, I got my first intubation today! Right through the cords on the first try. Made me feel better after the two failed attempts earlier in the week.

Have a lovely weekend!

Last Palliative Care Blog....I Promise.

2010-04-05T20:01:00.000-07:00

Now that I'm done with Palliative Care and have moved on to Anesthesia, I thought I'd do a little wrap up of my month on PC.

Here are a few things I learned......

1. The Train. People die in hospitals every day. Some days, however, it seems that one person after another dies....every room you walk into, the patient has either just expired, or is taking his/her final breaths. On these days, it is common to hear talk around the PC service that "The Train" came today, or "The Train is here." In my head, the train is much like the Polar Express, except that it takes you to Heaven....hopefully :)

2. "I see dead people." One strange phenomenon that happens as death draws near, is that patients will tell you that they were visited by family members. That's great....everyone should have family come by to say their goodbyes. Except that the family members that these patients report seeing are usually people that have already died. It's crazy how many times this happens. And it seems to me that it only happens when people are very close to death. It might be easy to chalk this up to delirium, but it just happens so consistently that there has to be something to it.

3. Miracles. Most people who are dying pray for miracles. Family members hold out hope and say that they are praying and that God can work miracles. While this is all well and good, (and you can bet your false teeth that I'd be the first to hit my knees if myself of anyone I love was dying) sometimes I wonder if we have a teeny-tiny-in-a-very-small-box-idea of what miracles actually are. I believe whole-heartedly that God can do anything He wants, be it cure cancer, reverse congestive heart failure, bring people back from death. Most of us would say that these things are miracles. And I would agree. The longer I spend around death and dying, however, I've come to believe that death is just the beginning of the true miracle. It's a miracle that I can't comprehend and don't understand, but a miracle that I know is greater than anything we could fathom in this life. The miracle was set in place a couple of thousand years ago when Jesus hung on a cross and died for all of us. And yesterday we celebrated the miracle of the resurrection and the forgiveness of sins and the eternal life that is offered to all of us. That miracle blows curing cancer and healing brain death out of the water (although I would take either of those if offered.) I'm not trying to make light of death, because it sucks. It's horrible, it hurts, it leaves a hole in our hearts. But I just have a feeling that when we die, there is something so spectacular waiting for us that, well....there really are no words. Just the voices of hundreds of thousands of angels.

"Where O death is now thy sting?"

I hope you hear the angels someday.....but not too soon :)

Palliation

2010-03-16T16:51:00.000-07:00

Three patients died today. One of them was my most favoritest patient ever. I fought tears most of the day. Sometimes to keep myself from crying, I do this weird thing where I suck my tongue into the back of my throat. Occasionally it causes me to make a grunting noise. I grunted today.

So after palliating all day, I am in need of some palliation myself. So far, that has consisted of angel hair pasta with lots of salt and butter. And now I'm moving on to the hot chocolate phase of my treatment plan. I doubled the dosage and put 2 hot chocolate packets into one mug....one packet wasn't going to cut it. If I'm still symptomatic after the hot chocolate, there's a half full bottle of vodka in the kitchen. Not that I'm going to drink myself into oblivion, but I might just drink myself into oblivion. Just kidding. Sort of.

Palliative Care

2010-03-06T19:57:00.000-08:00

This past week I started my new rotation, Palliative Care. Oh lordy....when people hear "palliative care" in the hospital, they immediately think they're going to die. And while this is true on occasion, palliative care docs do whole lot more than give morphine and hand out Kleenex.

Palliative care is a phenomenal service. This team is consulted for a variety of situations; to help patients figure out what their goals of care are, to help primary medical teams determine if a patient has the capacity to make decisions regarding their medical care, to help with symptom management, and to assist with the dying process - whether that be helping a family cope or keeping a patient comfortable - often both.

That being said, it is a very emotionally demanding job. In the past week, I've stood with a family, gathered around their loved one, with tears in their eyes, holding onto frail hands, saying their last "I love you's." I've heard husbands say, "I just don't want to see her suffer anymore." I've counseled scared siblings asking if their brother was going to be in pain when he passed. I've had to hold back tears watching a father gaze across the room at his young son, now nearly brain dead after a severe trauma. I've stroked a cold, thin hand and said, "It's okay....just rest." I've stood by the bed of a patient and wondered if she knew she was dying alone. I've wondered what it would be like for Danny if he had to bring our sweet baby girl home from the hospital without me.

It's been a hard week. But it's been a good week. I think this is something I could see myself doing.

*again, situations have been altered to adhere to HIPAA*

Tales From a Small Town ER, Part II

2010-02-24T19:57:00.000-08:00

Did my second 12 hour shift in the ER on Tuesday. Unfortunately this time there was no helicopter. And still no George Clooney. There was, however, a thumb with a big, fat, gaping hole in it from a misdirected steak knife. Oops. Hopefully a certain someone learned a lesson and won't try stabbing at grapes with sharp objects anymore. Hopefully. But judging by the other scars on this patient's hands....well.....he'll be back.

That was really the only exciting thing that we saw all day. Then there were the people who, for whatever reason, think that the ER is their own personal pregnancy testing facility. Really? Have you heard of EPT? They have them at Walmart. I know you're familiar with that place.

And you, ma'am? You're here because you had a "funny feeling" in your wrist? I'm sorry, you must have the EMERGENCY room confused with the I'M SMOKING CRACK room. I haven't even started residency yet and I'm already jaded. I don't know about you guys, but I wouldn't even entertain the thought of going to the emergency room unless I was convinced that I was dying.

Speaking of being convinced that you're dying....I think this is a common theme among medical students/residents/doctors. Recently I noticed a big bruise on my arm, one on my leg and one on my tush. I didn't know where the arm and the leg one came from. The tush one came from an unfortunate fall down the stairs at my preceptor's house. Glad nobody saw that one. Not pretty....nor is the bruise. Right now it's turquoise, purple and brown. Kind of looks like a Monet. Anyhow....the other bruises. I had no idea how I'd gotten them, so of course I start to suspect that I have leukemia. Random bruises, fatigue - I fit the description perfectly. So I resolved to pay better attention to the things that I bump into. By golly if I don't run into a bunch of stuff during the day. Yesterday I ran into a door in the hospital, bumped my knee on the bedpost in my room and ended the day by attempting to run and jump into the gigantic bed I sleep in here in Iola. Well, I misjudged my distance a bit and didn't quite make it onto the mattress, but instead hit the side of the bed and sort of slid down to the floor. Glad nobody saw that one. So, apparently I'm kind of clumsy. Since I can now account for all of my bruises, I've ruled leukemia out of my differential. But now the question lurks: Why am I so clumsy? Surely there is something amiss in my brain! I probably need an MRI.

Well, I'm going to head to bed. Tomorrow is my last day in Iola. We have another section in the morning, then I'm headed home to the big city and my big chubby baby.

*as usual, patient information has been altered to protect the innocent*

Last Week

2010-02-22T17:48:00.000-08:00

Today I drove down to Iola for the last time. On the way I stopped at D'Bronx and got a J Bomb for my preceptor, then I was drawn by a supernatural, magnetic force to the corner of 119th and Roe where I found myself in the parking lot of Dean and Deluca. Oh boy oh boy oh boy! I was like a kid in a candy store, or an adult woman in a gourmet foodery surrounded by cases of desserts....same phenomenon. I bought some brownie pops (chunks of brownie covered in chocolate - in an assortment of flavors - original, caramel, peanut butter, mint and raspberry), and then some chocolate kahlua something or others....all's I know is that they were balls of ooey gooey chocolatey deliciousness topped with more chocolate and then topped with white and dark chocolate shavings. Does life get any better? Me thinks not.

When I got to the doctor's office, there was some sort of drama unfolding and hormonal typhoons were running rampant. Luckily the chocolate that I brought seemed to squelch the adversity, restore peace and bring about contentment. Birds chirped, woodland creatures scampered about and a lovely rainbow shown over the office. You're welcome.

So this is my last week here. Tomorrow we have a c-section scheduled in the morning and then a 12 hour ER shift. Wednesday will be another day in the clinic and Thursday morning we have another c-section. Then I'll head back to KC and pick up my peanut from her grandma and grandpa's house and smooch her like crazy. I'll have the weekend off and then I start a Palliative Care rotation on Monday at KU.

In Weezy news, she had her 6 month check up last Thursday. I can't remember her height and weight, but she is in the 70th and 97th percentiles respectively. Oh, and her little noggin is in the 97th percentile as well. She has a huge cranium...like sputnik! Here's a picture from her 6 month photo shoot - complements of Oma....

I could gobble those little cheeks up!

While I'm in Iola I get frequent updates from Louisa's Oma and GG regarding Louisa's daily activities. Today she ate lots of baby food, continued her frustrating quest to figure out how to crawl, took a nap on Oma's lap, then became indignant when Oma took a nap and in doing so, ignored her. The nerve! She also waved at Oma, GG and her daddy. Speaking of her daddy....he's pretty cute.

See? Told ya :)

In other news, Darius Rucker is trying to kill me. Have you heard It Won't Be Like This For Long? He is an evil, evil man. Martina McBride tried to kill me a few weeks ago when I heard In my Daughter's Eyes while driving to Iola. As of yet, Miley Cyrus has never tried to kill me, so It's a Party in the I-O-L-A!

Tales from a small town Emergency Room

2010-02-15T17:31:00.000-08:00

Over the weekend I got to tag along with my preceptor during an ER shift. Turns out, my assumption that the only time the fire truck and ambulance are called out in a small town is when a cat gets stuck in a tree, was wrong. The shift started out quiet enough, a few random old people who weren't feeling so hot - filled them with IV fluids, marveled at their miraculous recovery and sent them on their way. A quasi-trauma involving an old guy, a restaurant, a window and a motor vehicle. Oh, and a backboard covered in potato chips. That was about as exciting as it had been all day. Later in the shift we found ourselves sitting around, a bit bored, when my preceptor declared me a "white cloud" in the ER. (A white cloud is someone who seems to keep patients away, while a dark cloud is someone who seems to attract them and in doing so, conjure up lots of work - it's all very voodoo.) Something else that is a bit voodoo is prematurely declaring someone a white cloud or uttering the words, "Gosh, it's slow." As soon as those words come out, it's bound to hit the fan. And sure enough, as soon as my preceptor labeled me as such, patients started coming out of the woodwork. The first was an older guy who was working on his roof and slipped and fell. He beat himself up pretty good and ended up being pretty critical. The next patient was a younger guy who was playing footsie with his girlfriend in the ER bay while he was waiting for us to come see him. As far as I'm concerned, if you're well enough to play footsie, you have no business in the ER. In addition to these patients, we had a smattering of coughing kids, twisted knees and facial lacerations. Luckily I didn't get drafted to lay on anybody while they were getting their faces stitched up. Instead, I helped the life flight crew load up our roof guy and get him flown to the big city for more specialized care. And by "helped" I mean tagged along and tried to stay out of their way.

Yeah, so the helicopter was pretty freaking cool. They landed on a street behind the hospital, almost in somebody's back yard. The person who lived there was out with his dog, who for a second looked like he was going to attack the helicopter....until he realized that it was much bigger than him and made of metal. Smart dog....wise decision to run the other way. Anyhow, after we they got the patient loaded up, the EMTs and myself walked about 40 yards away to watch the helicopter take off. I had a pair of scrubs and a sweatshirt on and it was really cotton-pickin' cold. If you've ever worn a pair of scrubs, you know that the only purpose they serve is to make you not naked. They offer no warmth....none. So as soon as those helicopter propellers (is that what they call them?) started spinning, I thought I was going to die a cold and painful death. And as soon as the helicopter started lifting off, I had flashbacks of when the jerk doctor on ER got crushed by the falling helicopter. And I again thought I might die a cold and painful death. Then I hallucinated that George Clooney brought me a cup of coffee from the cafe across the street. But alas, there was no George Clooney and the cafe across the street was just a Casey's General Store. Then the helicopter got higher and higher and eventually flew over the hospital into the black night sky and all we could hear were its engines. Then quiet.

About that time, our shift was finishing up and another doctor was coming on (still not George Clooney). Turns out that small towns have more than just cats stuck in trees. Who knew?

*Ages, genders and/or diagnoses have been changed to keep me out of trouble with HIPAA*

Adventures in Iola Part II

2010-02-08T19:16:00.000-08:00

A beautiful snowy day in Iola! Actually not so beautiful, a little more on the stark and desolate side. When does this thing called summer happen again? Anyway... We had a full day of clinic today. My preceptor sees lots of peds patients, so I got to drool all over several babies. I wish I was drooling on my own kid, or that she was drooling on me, but I'll get to see her soon enough. I also got to remove another mole today as well as an ingrown toenail. Pretty sweet. And because it was so snowy, I wore my super-cute pink polka-dot boots to clinic instead of my super-ugly-yet-comfortable doctor shoes. They were surprisingly comfortable. I might have to wear them on a more regular basis.

Clinic finished up around 5:00 and I headed to Sonic for a burger. I usually don't let myself eat greasy burgers with greasy bacon and mayonaise, but I'm 100 miles away from my sweet peanut and I decided that a little comfort food was in order. So what does one do after dinner on a Monday night in Iola? Why, go to Walmart of course! I'm a little embarassed to say that it wasn't my first trip to the Iola branch. Tonight I bought some Reese's Puffs cereal and some Ghirardelli dark chocolate. 60% Cacao - that's what it says. Since when are we keeping track of the percentages? And what do they mean, anyway? There was one that was 90%, and I must admit, I was a little intimidated. If anyone is a little more savvy as to what this phenomenon is all about, please enlighten me. Thank you.

So now I'm back at the house. I'm convinced that my preceptor is trying to turn me into a drinker. She's always offering me hard cider or wine.... and I'm always accepting. Now that I'm a little tipsy I'm going to take a nice little bath in the nice big tub. I've got to be good and clean for our 12 hour ER shift tomorrow.

More to come.....

Adventures in Iola

2010-02-07T19:07:00.000-08:00

Before we can graduate from medical school and be real doctors, we are required to spend a month in rural Kansas working with a small town doc. My first year of medical school, I was paired with a third year family medicine resident as my preceptor. She was just about the coolest girl ever and luckily, she's now a small town doc and I get to hang out with her during February to fulfil my rural requirement. That's the good part, the bad part is that I have to leave my sweet little peanut and my super handsome husband at home for several days and nights.

Last week was my first week in Iola. I drove the 100 miles down 169 in the dark on Monday night and pulled up to the 1890's Victorian that my preceptor and her family live in at 9:00. Their home used to be a bed and breakfast so I kind of feel like I'm on vacation when I'm in my room. Sometimes I say, "I'm going to retire to my quarters." Because that just fits the feel of the house. Actually I don't say that, but I think it to myself. Then I giggle a little bit because I'm such a tool.

Anyhow, my room is large and has tall ceilings and lots of tall windows. I sleep in a big 4 poster bed (requiring a stool or a running leap to get into it) with a heated blanket. By the windows is a jacuzzi tub with lots of bath products for my sampling. If you've ever lived with me (Rachel and Danny) you'll know that I rarely take showers, but usually opt for a nice hot bath. Standing requires too much energy. Why would you stand to do anything when you could lie down? If I could lie down and drive I would do it. Lie down and cook? That would be just dandy! The only exercise I do is sit-ups....you guessed it, because you can lie down! Anyways...Danny thinks that baths are inadequate for proper cleansing as you just "lie in your own filth." But I disagree. Unless you've been out rolling in the mud, a bath is a perfect way to bathe.

So, back to my room. It's just all around wonderful. The bed is ubber-comfortable. There are lovely original antique touches here and there - the ornate old doorknobs, the embellished white radiator in the corner, the bowed stained glass windows in the bathroom. OMG, I forgot my camera! I must take pictures before this month is over! Here's a picture of the house that I found on the internet:

Pretty sweet huh?

Last week was fun, as they let me jump right in and get my hands dirty, literally with a c-section on my first day and a mole removal my second day. One of the doctors handed me a scalpel and let me go to town on the mole. The patient was remarkably calm. So was I until I looked away for a second to find my sutures, looked back and saw blood oozing down the patient's arm all over the sweater that was lying at his side. Oops. Luckily hydrogen peroxide takes blood out nicely.

I'm having a good time down here, but man is it hard to leave my sweet Weezy girl at home! I left early today to miss the snow storm that was forecasted. The only thing worse than a two lane highway at night is a two lane highway at night in the snow. So I'm here, safe and sound, but missing my little peanut.

More to come....

2010-02-05T14:31:00.000-08:00

Today I dropped the peanut off at her Grandma & Grandpa Bartlett's house and went out for a little retail therapy. For me it's not so much about buying stuff, but just wandering through rack after rack of clothing. It's mind numbing and wonderful. I ended up buying a couple of outfits for Louisa because she WON'T STOP GROWING. What is it with babies?

When I got home I thought, "by golly, I'm going to shovel!" And not because I'm the perfect, dutiful wife, who wanted to save her husband a little work and save his ~~little~~ huge feet from getting cold on the walk in. Nope, I shoveled because I had a pair of cute little pink polka-dot boots that needed a reason to be worn.

Here we are before we got started shoveling....

Now, so you can experience the cuteness.....

And finally - we looked out over our handy work and said, "It is good! And we are adorable!"

As cute as these are, with their precious little side buckles, I think they were designed for rain, not snow. My feet are freezing! But totally worth it...and Danny's going to be so pleased and think that I did all this for him.

My Three Stools - (not poop)

2010-02-04T19:25:00.000-08:00

It seems like lately I've required the use of stools much more than any normal person should. Sure I use one to get to the top shelf in the kitchen when Danny isn't around, but usually that's the only time I need one. Sometimes I even use one when Danny is around just because he won't get up and help me. He sees me standing in the kitchen jumping up and down with my arms flailing toward the open cupboard, laughs and says, "use your stool!" And I say, "What? Do you think I married you for your looks? Get your tall hiney in here and help me!" Okay, enough about our kitchen stool drama.

So, here are the other stools that have come into my life recently:

Stool #1: I'm doing a rural rotation in Iola, KS and am staying with my preceptor. She and her family live in a huge Victorian home that used to be a bed and breakfast, and I am staying in a guest room with a ginormous bed. When they showed me the room, they pointed out that the bed was likely too tall for me to climb up in all by myself and pointed at the stool in the corner. Actually, I can get into bed all by myself, but it requires me backing across the room and getting a running start. Okay, so that's stool #1.

Stool #2: My first day in Iola, I got to help with a c-section. The nurses saw me standing at the OR table, on my tip-toes trying to catch the action. They were nice enough to bring me a stool so I could see what was going on...and break the amniotic sack....and hold retractors....and cut sutures...and irrigate. Because that's what med students are good for dadgumit!

Stool #3: Last month I did a rotation in the ICU. My last week, I was on nights (6pm - 6am). My very last night, we were getting ready to intubate a patient when the patient coded unexpectedly. We went through all of our options trying to bring the patient back....epi, cardioversion, and of course chest compressions. Chest compressions can be pretty exhausting, so the people who are standing around jump in so one person doesn't have to do compressions for the entire code....which can be over an hour. When I jumped in, one of the nurses told me to keep my arms straight. Well, because of certain laws of physics and geometry and the fact that I'm a munchkin, I told him that I couldn't keep them straight. Enter Stool #3. Unfortunately our efforts were futile and the patient, who had been talking to us earlier in the evening, died right there in front of me. And I had "Stayin' Alive" stuck in my head for the next few days. (If you do chest compressions to that beat, you'll stay at 100 compressions per minute - fun fact for the day)

So those are my 3 stools. Stool #2 will be in my life for the next few weeks as I continue my rotation in Iola. I'm sure I will see Stool #1 again as well. Stool #3 can take a flying leap. I'm tired of patients dying.

Panties in a bunch....kind of

2010-01-12T18:25:00.000-08:00

Today during rounds, I was presenting one of my more complicated patients. Well, they're all complicated. Especially when you've been up since 4:00am, your baby didn't feel like going to sleep the night before and your brain needs an oil change. Did that make any sense? See what I mean? Even this blog is complicated.

I digress. So, I was presenting my patient, and all of a sudden, when I was going through the pertinent lab values from today, my resident and my attending just started laughing. They acted like they were trying not to, but they both were finding something really entertaining. I shot a quick glance to my right and then my left, but there was nothing I saw that was funny. "Oh crap," I thought. I could feel my face getting red and warm. "They're laughing at me." I'm turning into the med student that rattles off random lab values, comments on the color of the patient's gown, reports the music that was playing in their room, says "um" every other word..... But I hadn't. Did I have a booger? Were my boobs leaking? Ugh! Why are they laughing at me?

I'm usually not a very sensitive person, but I was a little upset during the remainder of our time rounding. My paranoia festered so much into the afternoon that I finally broke down and asked my resident what they were laughing at. I played it all cool though, like I really didn't care.

Apparently while I was in the middle of my accurate, concise and well thought out presentation, one of the ICU nurses went to change out some bags on the ventilator in my patient's room. When she bent down, her pants were sitting really low and her shirt came up a little bit and... heavens to Betsy! Her thong was showing! Actually the resident said...."and we saw her THONG!" I don't know what part of my naive little brain thought that an ICU doctor might be a sliver more mature than the average joe, but alas! I was wrong.

You wish you were as cool as me

2010-01-11T16:51:00.000-08:00

So, I'm getting the hang of this whole doctor gig. I've got a spring in my step...my step which is accompanied by my friggin' awesome doctor shoes. My swagger makes my cute little pink stethoscope swing. I'm so important that I don't even have time to brush my hair in the morning. I was walking my awesome self out of the hospital tonight when.....when..... oh dear....my friggin' awesome doctor shoes hit some black sidewalk ice. And in a moment of complete and utter humiliation my swagger became a splat.

And I was kidding about having the hang of things.....don't get sick when I'm on the job :)

Oh, and I'm SO not important. I don't brush my hair in the morning because I'm lazy....when most of your patients are unconscious it's hard to find the motivation.

More than you ever wanted to know....seriously

2010-01-08T21:19:00.000-08:00

If you're squeamish, uncomfortable with bodily functions, or want to preserve your image of me as a proper lady, then seriously, don't read this.

Today I had a procedure. It starts with a colon and ends with an oscopy. Ooh, my sphincter just got all out of sorts just typing that sentence. I'll spare you the details of the symptoms leading up to this, but the -oscopy (my tush and I don't like the word in it's entirety, so we'll just whack the first half of it off) was essentially to make sure that I didn't have anything bad lurking in my bowels.

If you're under 50, then hopefully you have no idea what all goes into this process. And if you're over 50, hopefully you're intimately familiar with it. Anyhow....to get a good look at....er....what is needed to be seen, your bowels have to be empty. Accomplishing this feat requires a full day of consuming only clear liquids followed by a cocktail of gatorade and some lovely medications designed to make you go go go! Are you grossed out yet? Because if you are, you can totally stop reading this. I won't be offended.

I left the hospital early yesterday, telling my staff that I had "a procedure." He said something like, "Oh, okay, none of my beeswax...." I think the whole breastfeeding thing freaked him out enough and he didn't want to hear any more about my bodily functions. After I left the hospital, I went to my parent's house for my "prep." My dad, being a seasoned veteran of the -oscopy, was my self-appointed bartender for the evening. He whipped up my cocktail (sans any booze - dagummit!) and kept me on schedule. And he poked a bit of fun at me as well, because really, you kind of have to have a sense of humor when you're running to the bathroom every 5 minutes (think Dumb and Dumber).

So keep in mind I can only have clear liquids....gatorade, water, tea, broth. None of which even come close to filling you up, and by 5:00 I was freaking starving. This was right about the time my dad whipped out the STEAKS he had bought and started marinating them. Um....are you kidding me? What had I done to deserve this kind of torture? Oh, okay....I'll just sip on my sad little bowl of broth while you guys feast on steak and potatoes. I didn't expect my family to participate in my fast, but for the love of Pete! Have some respect!  And some cereal for dinner. Apparently the steak was delicious, and my mom's was cooked "ah, just right!" And I'm sure Danny's was absolutely delectable, and I think that my dad's probably melted in his mouth....whatever. There will be reckoning for this....

The rest of the evening went well and I spent the night at my parent's house because the doctor's office is right down the street from them. At about 2 in the morning I woke up shivering. I had a long sleeved shirt and sweatpants on and was curled up in about 4 blankets but I couldn't stop shaking.  About that time I started feeling really crappy and decided that I must have the flu or something.  Then the nausea hit and I spent the next few minutes in the bathroom. Ah, that toilet is so over me! Then I did the only thing an intelligent, almost 30 year old woman would do under those circumstances....I went and got my mommy! Because really, when I'm not feeling well, she's the only one qualified to take care of me.

I started feeling better (I think I had a little dehydration/non ion gap metabolic acidosis - for you nerds out there), and I was able to get back to sleep fairly quickly...with my mommy next to me, of course.  Then morning came and Danny drove me down to the doctor's office. When I checked in, the receptionist thought I was scheduled for an upper GI (sticking a scope down your throat to look at your esophagus, stomach, duodenum....), when I told her it was the other end, she looked at me like, "Oh....well....that's bizarre....what the heck is wrong with you?" That was comforting. At least let me think that 29 year olds get -oscopys all the time and it's really no big deal.

When they took me back they asked me a whole lot of questions, made me get undressed and then asked me if I could be pregnant. My 99.9% certainty that I wasn't didn't fly with them and they made me take a pregnancy test. When it came back negative, the nurses all congratulated me. Danny seemed a little disappointed.

Then they started my IV and rolled me back into the procedure room where I met the lovely Dr. S. Then the nurse anesthetist started the propofol and I was out in like 2 seconds. When I came to, Danny was walking toward me in the recovery bay. The first thing I said to him in my clouded mental state was, "They gave me propofol....that's what killed Michael Jackson."

A few minutes later, I was pretty lucid and Danny showed me some paperwork that they had given him (he was my official "responsible adult" who was there to take care of me - which makes me giggle). The paper had a box checked next to the word "biopsy." Along with the -oscopy word, biopsy is right up there with my least favorite words. When I hear biopsy, I immediately think cancer. Just like when I hear the word delicious, I immediately think of Matthew McConaughey - you get the idea. So this freaked me out a little. I was sure that they'd found some huge necrotic cancerous mass and that I should just start preparing for the worst. But a few minutes later, Dr. S. came by and said that the only thing he saw was a small polyp and that he really wasn't concerned. Ah....pheewwww. It will be sent for pathology and if it's pre-cancerous, all that means is that I'll have to have -oscopies every 5 years, but if it's nothing, then I'll get my next one when I'm 50, like normal people.  Then the receptionist won't give me such a funny look.

So....that was my adventure today. I'm sure you could have done without hearing about it. Sorry.

Life Update

2010-01-06T19:00:00.000-08:00

Well, Monday saw the return of The Red Suit when I had my second and final residency interview.

This time I was at UMKC. They seem to have a good program with the residents alternating between Truman Medical Center and St. Luke's on the Plaza. They shuttled us back and forth between the two in a Navigator limo. Pretty pimp....a bunch of med school geeks rolling in a tricked out tool-mobile. Unfortunately, the running board was pretty high off the ground and the combination of huge high heels, a somewhat tight skirt and a couple of inches of slushy ice on the ground did not make for a very lady-like entry and exit. Oh well, at least I didn't face plant in the snow. What I found really impressive about the program, however, was the air hockey table in the resident lounge. Hummm, going to have to bring that up with the program director at KU.

What else......oh, I started my Pulmonary/Critical Care elective on Tuesday. Should be a pretty interesting 4 weeks. I get to wear scrubs every day, which is awesome! Yesterday, I got to hold up a patient's arm while the fellow put in a chest tube. Pretty sweet, I hope I never need one! Lots of needles, skin slicing, tissue tearing and finally, chest wall puncturing. Oh, and then shoving a tube up behind the lung. Fun times.

*FYI - a fellow is someone doing specialty training after completing their residency training - this wasn't just "some fellow" who put in a chest tube. I know you were wondering....Danny.*

I love the first day of a new rotation when I have to tell the powers that be (usually a male resident or a male attending) that I'm breastfeeding and have to go pump. The reactions have been pretty standard. Er....um....(choke, choke)....breast....um...(blushing, twitching nervously)....you just do what you gotta do. During my interview Monday, one of the male interviewees asked me what was in my bag. "Oh, just my breast pump." Gasp, twitch, fidget....

I got fancy new doctor shoes from my parents for Christmas, so I have been feeling more "doctorly" than ever. They are pretty hideous looking clogs, but they are super comfortable and they are somewhat of a status symbol. They say hey...I'm ~~such a tool~~ so totally awesome, I can wear ugly shoes! You SOOO wish you were me! (Unless you have any fashion sense or self respect, of course.)

It's getting late and I need to ponder the many causes of pulmonary effusions (and pump my boobs - are you twitching?), but I will leave you with a few observations from today:

- Pretty much everyone in the world is taller than me.

- A surprising number of people are missing most, if not all of their teeth.

- People who eat smart and work out still get cancer. Boo, as if I needed any more convincing to eat oreo balls and lay around on the couch.

Survey

2010-01-02T15:50:00.000-08:00

So....apparently there are a handful of people (besides my mom) who check in on this little blog of mine, either on facebook or at www.outthewinder.blogspot.com.

For those of you who consider yourselves regulars around here, here's my question: If I were to move my blog to the blogspot only, would you continue to follow? I'm thinking of allowing adds on my blog to see if I could actually make some moola. If I could make an extra $3.74 every month, that would be one more Caribou Coffee small-nonfat-white-chocolate-mocha-with-light-whip that I could buy and not feel guilty for paying nearly 4 dollars for a cup of coffee because I WORKED HARD FOR THAT MONEY!!!

Okay, just wondering. Oh, and if there is something in particular that you like reading about on my blog (Charlie, my dirty house, my limited knowledge of medicine) then let me know. I could use a little positive reinforcement/ego stroking. It's an only child thing.

Muchas Gracias!

The Conundrum

2009-12-30T15:23:00.000-08:00

(You will learn in this blog that Charlie can speak. His voice sounds much like Anthony Hopkins character in Legends of the Fall after he has a stroke. Much like the scene where he says, "Screw em!" repeatedly. This knowledge will enhance your experience while reading this post.)

For whatever reason, Charlie - sweet Charlie, insists on chewing his nylabones on top of our metal heat vents. That is when he's not gallivanting through the house with them in his mouth, dropping them with a big bang-clank everywhere he goes.

The following is what can happen with such risky behavior. Let this be a warning to nylabone-loving dogs everywhere:

Oh, my....however did this happen???

A close-up of the casualty. And no, that's not a combination of dust and dog hair in my vent. How dare you even think it.

Desperate and running out of options, Charlie calls Mabel in for help. After this picture was taken, Mabel shook her head and walked away.

"Whud aw we gonna dooooo mom?" (Charlie can't pronounce "T's" or "R's" very well)

In a stunning show of intelligence, Charlie opts for the larger nylabone model, but is quickly drawn back to the small one in it's precarious position.

"I'm towwy (sorry) widdle (little) nywabone!" (Okay, Charlie has trouble with most letters of the alphabet.)

Inconsolable....

*Danny and I both tried to wrench the nylabone out of the vent with no success. As of now, it remains in peril.*

Paid in full

2009-12-28T21:51:00.000-08:00

There's a joke amongst medical students that we're all so far in debt with student loans that the only thing we can afford to be is doctors. Sadly true, unless one were to run off to LA and become the "triple threat" like J. Lo. I don't foresee this happening anytime in my future because I'm really only a single threat. I can't sing or act, but I'd like to think that I can dance. But my sad, flabby little postpartum belly is something that should not be wiggled about. At least for now. How did I go from talking about student loans to my midsection? Redirecting.....

Anyhow, although we've been blessed by wonderful families who give us everything and anything they can to make our lives easier, it's rough sometimes to get by on a teacher's salary, especially now with Miss Louisa. We just bit the bullet and got a new-to-us '01 Camry (with a little help from my grandma....okay, a lot of help. Thanks GG!) The civic was starting to feel a little small and rickety and it is quickly approaching 200,000 miles. It was decided by all that Louisa needed a safer car. Forget about Louisa's parents. We are chopped liver. It's all about the baby.

We found a great car with pretty low mileage, but it had a little damage to the left rear panel that needed to be fixed before it started to rust. The guy we bought the car from had an estimate from a body shop for about $700.00.

After we bought the car, we took it to a collision center which is owned by some dear friends. We frequented their business all too often when we owned "Black Betsy," an '05 Corolla that was cursed by the devil and destined for mutilation. We sold her after her 5th wreck in 2 years, none of which were our fault.

My parents were going to pay to have a keyless entry device installed in our new car for a Christmas present, so the car spent a few days getting un-dented, re-painted and keyless-entry-ed. Danny and I went to pick up the car last week, fully prepared to pay for all of the services....it was a good investment, after all. We picked up the keys as the owner walked by.

Us: Car looks great! How much do we owe you?

Him: Um....well....nothin'. Been paid in full.

Danny: (bends over to pick jaw up off of the ground. He's tall....it hit pretty hard.)

Me: (thinking to myself "don't cry, don't cry, don't cry!")

Us: (after Danny's mandible had been reattached to the rest of his face) No, really...we need to pay you.

Him: Nope. Merry Christmas.

Wow! They always give us a deal and do fantastic work for us, but this was completely unexpected. And it wasn't done for any recognition or praise, just a great guy helping out some crazy kids who are trying to make ends meet. After several hugs and handshakes, we left the shop and headed home. Danny took the Camry and I climbed back into the civic to run some errands. Well, to go to Target. It beckons me.

While I was driving to Target, his words kept replaying in my head....paid in full. (don't cry!) He didn't have to do that! (okay you big baby, no tears!) I was still dumbfounded, humbled and elated all at the same time. And I couldn't help but think about someone else who paid our debt in full. Someone who, a few thousand years ago was born into this weary world to bring hope, healing, restoration. Who taught us how to live, how to love and how to give. He was ultimately crucified, but rose again and offers forgiveness and life eternal to those who love Him....for free. He takes our dented up hearts, makes them whole again and says, "Paid in full."

So during this Christmas season, I am thankful for our wonderful families who give so much of their time and resources, I am thankful for a warm home, plenty of food to eat, a new-to-us car and the generous man who fixed it up and in doing so (whether he realized it or not), gave us a little glimpse of the love that our Heavenly Father has for us.

I hope you all had a blessed Christmas this year!

I will now step down off of my little pulpit and retire for the evening :)

Another Friday at the Bartlett's

2009-12-18T20:54:00.000-08:00

On a normal Friday night, we would go out and party hard into the wee hours of the morning. Actually that's a lie. We did that in college. Okay, that's a lie too. We're lame and have always been lame. I'm planning on a hard core midlife crisis someday.

Tonight was a nice Friday evening. It started out by getting our church on - Danny likes to watch the live web casts from a church in St. Joseph. So we did church on the couch with coffee and a jabbering/sleeping/eating baby. Then I snuck off to take a bath while Louisa was watching her "Your Baby Can Read" DVD. If they made a "Your Baby Can MCAT" we would probably own it. Yeah, she's 4 months old....what of it?

My bath was fantastic. I really needed it, and not just because I needed the relaxation of a hot bubble bath with a glass of wine (thanks Chris & LeAnn!), but I actually hadn't bathed in a while and was really starting to smell like rotting cheese. How is it that a baby can drink milk and then spit up cottage cheese? I'll never know. Anyway, my bath was so great, with my favorite candles and new bath gel.....and after my first glass of wine I barely noticed the hairball laying on the side of the tub. And the mold growing around the caulking.

I got out of my bath and Louisa started fussing a little bit in the other room. Oops! I guess mommy can't help you. Would hate to damage your cute little liver. Daddy!!! So I went upstairs to change and Charlie followed me. I got my jammies on and then hopped in bed with one of my favorite guys....the smelly/hairy one (Charlie ~ I realize that wasn't so obvious). We snuggled for a bit and he rubbed his slimy little snout all over the pillows. (My mom is cringing right now.) He got his belly scratched, his chin rubbed and lots of smooches. If everyone in the world had a one-eyed pirate dog, the world would be a better place! I might need a second bath now though.

We came down stairs and Danny was putting Weezy to sleep. She has recently learned to roll from her back to her front and likes to practice doing so at every opportunity. The only problem is that she can't roll to her back from her front and she really despises tummy time. So we'll roll her back over and pretty much immediately she'll roll back onto her tummy.....and resume the face-planted screaming. This is a prime example that just because you CAN do something doesn't mean that you SHOULD.

Speaking of examples.....last weekend I was cleaning the house (and I use the word "cleaning" very loosely) and spent a great deal of time painstakingly cleaning the salt and pepper shakers. As I was doing so, I realized that I was really missing the forest for the trees. But boy did those salt and pepper shakers look GOOD!

Okay, my Friday night is coming to an end. Danny just kissed me and went to bed. I should probably head that way myself.

I hope you all have a wonderful weekend! If you get the chance, take a nice, hot bubble bath and smooch a shaggy dog!

PRMCE

2009-12-11T08:50:00.000-08:00

In the grand tradition of entrance exams (MCAT, LSAT, GRE), I propose that the Price is Right institute a minimum competency exam, the PRMCE. This test would be administered to any potential audience members before being allowed to enter the studio. Questions would be similar to those listed below:

1) Put the following numbers in order of smallest to largest:
1 100 10 10,000 1,000

2) If Carlos spins the wheel and gets an 85, and on your first spin you get a 45.....
a) should you spin again?
b) what do you need to spin to tie Carlos?
c) what do you need to beat Carlos?
d) If you spin higher than a ____ you will have gone over.

3) Which of the following options is the correct way to say the following number: 11,267
a) One hundred eleven thousand two hundred and sixty-seven
b) One thousand two hundred and sixty-seven
c) Eleven thousand two hundred and sixty-seven
d) Eleven
c) Eleven point two, six, seven

4) Fifteen thousand nine hundred and ninety nine corresponds with which of the following numbers?
a) 14, 999
b) 115,999
c) 1,599
d) 15,999

5) If someone bids $500.00 on an item and you think that the item is less than $500.00, it is a good idea to bid $499.00.

True/False

6) Have you shopped at a grocery store in the past year?

7) Have you seen a Ford Focus commercial in the past year?

8) If the wheel has to go around one entire time, how many times does the wheel have to go around?
a) 1/2
b) 3/4
c) 15/16
d) 1

I know I'm a bit of a hard a$$, but I think that a perfect score should be required for entrance to the Price is Right.

If anyone knows Drew Carey, would you be kind enough to pass this on to him?

Left Out

2009-12-09T08:54:00.000-08:00

I don't know how she did it, but Mabel Jane figured out that I blogged about Charlie and didn't mention her. Oops! Feelings have been hurt. Big sad Basset eyes are in full effect.

Here are a few pics of my little Mabel Jane to make her feel better....

Crazy Lady!

Starved for affection, Mabel attempts to sabotage my study time.

Mabel would like you to think that she's classy and only plays with the highest quality toys.

This picture proves otherwise.

Hitting the bottle on New Years. You should have seen her doing keg stands! Talent.

The next day....

A favorite past time. I was afraid she might take flight with those ears!

Please rub my belly.....please please please. Please somebody....just love me!

Clearly she is very neglected. Hardly gets any attention.

Poor thing.

CHARLIE!!!

2009-12-08T19:37:00.000-08:00

If I were a betting woman, I would put money on Louisa's first word being Charlie. Not because he's cute and cuddly and is quickly becoming Louisa's buddy, but because we say his name 50 bajillion times a day.

Most of the time, his name is used in phrases like:

Charlie, get DOWN!

Charlie, stop that!

Charlie, drop the pacifier!

Charlie, stop chewing that!

Charlie, what are you doing!?!?

Charlie, NO!

Come here Charlie....NOW!

For the love of Pete, Charlie!!!

Charlie, don't lick the baby's face!

Charlie.....Charlie.....CHARLIE!!!!

Despite his orneriness, we sure do love that little feller! The following is a list of the things that he has eaten/destroyed in the past few months:

numerous pacifiers

numerous nursing pads

one nursing bra (sorry Julie)

2 pairs of my underwear

one pair of baby socks

the tassles off of two of Louisa's stocking caps (hand made by GiGi) (What kind of tassles did you think I was talking about?)

3 hair bows

too many pieces of paper to count

Louisa's commemorative birth certificate from the hospital (just one corner)

one sleeper

2 burp cloths

one shoe

one rattle

one stuffed rabbit

one bib

And, my personal favorite, Louisa's immunization record. He was kind enough to throw that one back up :)

I'm sure I'm leaving several items out, but I think you get the picture. Regardless, he's our sweet little one-eyed pirate boy/wiggle butt and we wouldn't trade him for the world.

So don't be surprised when Louisa's first word isn't Mama or Dada, but CHARLIE!!!!

Red Suit

2009-12-01T20:07:00.000-08:00

I tend to gravitate toward the color red for important life events. I wore a sequined red gown for Danny and my first prom, a red suit for my med school interview, the same red suit for my Pop's funeral, and yesterday I bought a new red suit for my residency interviews - Red Suit 2.0, if you will. I would have worn red suit 1.0, but for some reason (read: recent birth of child, can't stop eating corn bread cake slathered in honey butter) the skirt is a little snug. I did try on a black and white skirt/jacket combo for my interviews, but the combination of shoulder pads and a shiny pleather belt didn't really scream "PROFESSIONAL!"

So, about the interviews. If you've spent much time in an academic medical center during the fall/winter months, you've probably seen herds of people, all dressed in black, walking purposefully through the hospital. You probably wondered where the funeral was, but these people were actually 4th year medical students interviewing for residency positions. I guess you could call intern year the funeral???? These people can be distinguished from similarly fashioned pharmaceutical reps, because on average, the drug reps are way more blond, thin and big boosmed. Oh, and they have the little rolley suitcase things full of pens and other fun toys that they use to entice unsuspecting doctors to prescribe their drugs. Anyhow, my interview at KU is Friday. From what I understand, it should be pretty laid back, and unlike med school interviews, this time, the program is trying to impress the interviewee, instead of the other way around. So, I expect all to go well, barring any unforeseen, spontaneous leakage of milk from the breasts.....canNOT forget the boob pads!

Okay, so that's all I've got for now. Going to try to be better about blogging over the next few weeks. But before I go, a random thought: Pizza seems much less fattening when it is cold because the grease has solidified....and thus....seems much less greasy.

Nostalgia

2009-10-22T08:05:00.000-07:00

Last weekend Danny and I attended my 10 year high school reunion. The combination of the football game, the drum line and chatting with old friends got me feeling a little nostalgic. And now, a look back at some highlights from my senior year.

Cheering for the SMN Indians (mostly the quarterback :)

Homecoming assembly

I think this was the homecoming dance....

Very lady-like. That Amy is such a bad influence :)

Best party of the year! The Time Warp Dance!

Cheering for the basketball team (Amy, Amanda, Nancy, Lisa and me)

It has recently come to my attention that the cheerleaders no longer do the Funky Chicken. What a shame!

Spring Court assembly with Erica

With Dave - so coordinated!

Enough of the cheerleading - playing ball with Mer and Christy

Prom '99

Danny doing my dad's hair....must have turned out okay.

Graduation (obviously)

Post graduation party - good friends

SMN class of 1999

10 years and one Louisa later............

Still in love with my Danny. So glad we never listened to the people who told us that we were too young, or that we'd never last. HA!!! What's up now!?!?

An ill-conceived idea

2009-10-11T20:41:00.000-07:00

Okay....my 10 year high school reunion is coming up. In FIVE days! I'm super excited, but a little disappointed that I won't exactly be looking like a super-model when I see all of my old friends. What is it about reunions that bring out the vanity in people? Oh well.

So, in a last ditch effort to lose the last 15lbs of baby weight, and be as super-modelish as I possibly can be, (Okay, so petite super-modelish. Is there even such a thing? Petite/plus size? I digress) I decided to go jogging today. Sounds totally benign, right? Little jog around the neighborhood....

Mistake #1: Mabel sees me putting on my tennis shoes. She KNOWS what that means and proceeds to work herself up into a full fledged TIZZY. She started barking and whimpering and was threatening to wake up a sleeping Weezy, so I put her in her kennel (Mabel, not Weezy). Then Charlie was standing there looking at me with his one, sad little eye, just beckoning me to take him with me. Here is my dilemma - take Charlie, who is standing by the door looking all together pathetic, or take Mabel, who is the instigator of all buffoonery around our house. The one who could use a good walk to get rid of some of her energy.

Mistake #2: I walked past Mabel's kennel to get Charlie's leash. Ooooh, she was none too pleased. Now I'm feeling super-guilty so I let Mabel out. This was the point of no return, their excitement at the prospect of taking a walk had reached fever pitch.

Mistake #3: At this point I should have just given the dogs treats to appease them, but instead I put their leashes on them and headed out the door. But not before asking Danny to say a little prayer that all 3 of us would make it home in one piece.

The dogs were horrendous on our walk! It's my own fault for not walking them regularly, yes Caesar Milan....exercise, discipline and then affection....I know, I know. I tried all of the dog-whispering tricks that I could think of, but ultimately, my dogs know that I am a piss-poor pack leader and they walked all over me. And by walking all over me, I mean pulling me down the street, this way and that, Mabel going one way and Charlie going the other. One would stop to chew on an acorn while the other took off after a squirrel. I felt like Mel Gibson at the end of Braveheart when they tied him up by his arms and legs and stretched him in different directions. I'm really surprised that they didn't strangle themselves, the way they were pulling on the leashes. All I heared the entire way was HEEEH HEEEEH HUUUUUH HUUUUH (choking....) HEEEEH HEEEEEH (slobber flying, more choking...).

I finally made it home, with both dogs in tow. I guess the walk was a success in the sense that I didn't lose either of the dogs and I managed to keep my shoulders from dislocating. I dropped them off with their father, and feeling like I really accomplished nothing, I headed back out for a little jog.....REUNION PEOPLE!!! I made it further than I thought I would and probably burned all of 20 calories before I got home, popped a nitro, took an aspirin and put my O2 mask on.

Maybe I'll try again tomorrow, sans the dogs.

I was not in a car wreck....

2009-10-10T16:17:00.000-07:00

When I was in 8th grade, I fractured the bone right above my left eye. It swelled shut, turned purple and looked all together gruesome. People would stop and ask me what happened. I told a few people that I'd been in a fight and that they should see the other girl. What really happened was a collision on the basketball court, but that's just not very exciting. He He He...I remember going to the mall with Rachel and chasing her around acting like Sloth from The Goonies. That's kind of what I looked like. And she's still my friend....

So now I wish I had some awesome story to explain why I've been wearing a neck brace for the past few days. Like I survived some horrific car crash or got a little whiplash while bungee jumping or some such thing. But no. Nope, I seem to have incurred a Louisa-related injury. Apparently my cervical spine doesn't appreciate being bent forward looking at the little peanut all the time. On Wednesday my upper back was a little sore and by Thursday afternoon I could barely move. It's a good thing my dad is a chiropractor. And it's a good thing he makes house calls, well, for me anyhow. And that's probably only because he knew he'd get to see Louisa. Yes, I use her to manipulate my parents. I have no shame.

After a little traction (during which I thought my dad might pull my head off), an ice pack and the neck brace, I'm feeling much better. I think I'm ready to take the brace off. There goes the sympathy from strangers. Oh well. It made my face look fat.

The breast pump

2009-09-23T21:03:00.000-07:00

My breast pump speaks to me. At first I thought it was the percocet, but I haven't taken any for at least 3 weeks and the breast pump continues to speak to me. Usually it offers words of encouragement while I'm pumping (which is appreciated), sometimes it just mumbles, and other times it speaks french.

More inappropriate comments from randoms

2009-09-19T19:59:00.000-07:00

5 days after Louisa was born, we went to the pediatrician for a check up. Danny was carrying Louisa in her car seat and I waddled in after them. Keep in mind I'm still HUGE (as discussed earlier....and my butt is still itching). Oh yes, and Louisa is small, as most newborn babies are. There was a woman sitting next to us in the waiting room with a child who looked to be about 8 months old. As we walked past her, she looked at me and said, "Oh, you're going to have two close together!"

Me: "Eh?"

Lady: "Two babies...that one is pretty young."

Me: "She's 5 days old."

(silence - my eyes glow yellow - flames shoot from my nostrils)

I realize that people are inherently dumb, but this was the last place I expected to encounter such brazen and unabashed stupidity. This lady had a baby too! She was still a little chubby, so I'm guessing she looked a bit pregnant after her baby was born as well. Maybe she honest-to-goodness thought that there was still a baby in my belly that was just incubating a bit longer. I don't know. As Ron White says, "You can't fix stupid."

....continued

2009-09-18T20:28:00.000-07:00

Where was I? Fentanyl, c-section, Louisa screams.... ah yes. So Louisa Grace Bartlett was born on August 17th at 7:50 pm and weighed 7lbs 7oz and was 18.5 in long. I don't remember a whole lot about what happened after I heard Louisa scream for the first time. I think I let myself relax after that. The thing I do remember is the horrible pain I was feeling in.... my shoulder???? Yes, after 20 hours of labor and finally a c-section, the only pain I'm feeling is in my shoulder. Dang phrenic nerve! Okay, I probably shouldn't slander the phrenic nerve since it's pretty important for, oh, breathing, and thus, life, but seriously....PAIN! I asked the nurse anesthetist for something to ease the pain, after all, this was the guy administering the fentanyl. And what did he give me? A hot pack. Thanks dude.

At this point, Dr. S is working on my uterus and tells Danny that he should get a picture. Awesome!!! No, seriously, I think it's AWESOME that I have a picture of my uterus and even more awesome that Danny was cool with taking a picture of his wife's innards. Then Dr. S closes me up using some new staple gun that they had in the OR. I probably would have done a running subcuticular, but that would have taken forever (especially if it was me doing it - picture a little old man, hunched over, painstakingly painting a model car under a magnifying glass - this is me suturing - but my incisions are pretty, by golly!).

The next thing I remember is being in the little recovery room, shaking because of the drugs. Then they brought Louisa in to me and I think I cried a little. Then my dad gets all teary as he takes out a little blue box from Tiffany's and hands it to.....my mom???? For real? Where's my box from Tiffany's? I did all the work and gave him his first grandchild! Cotton-pickin'! It's cool though, I'm over it. And my mom got a lovely "Grandma" charm for her charm bracelet. After that lots of family and friends came in to see us and hold Louisa. Louisa was bright eyed and was checking everybody out.

Then they wheeled me to my room, which was a double room, so Danny got his own bed to sleep in. The next few days were kind of a blur. Lots of family and friends visiting. I got to order my breakfast, lunch and dinner from a handy-dandy menu on the TV. Emily brought me an orange cream slush! I was a bad patient and didn't really get out of bed except to go to the bathroom. The nurse made fun of me because I put my TED hose on backwards. I developed the itchiest, most awful rash EVER on my tush. This may have been the most horrifying part of the whole experience. And not only did my tush have a rash on it, but my tush was HUGE, so there was lots of tush to itch. And the rest of me was huge too. Thank you IV fluids. I thought surely I'd loose a couple of pounds, you know, having a baby and all, but I was fatter leaving the hospital than when I came in. Feet and ankles were unrecognizable. Demoralizing!

Then we came home. Loading Louisa up in the car and driving on THE STREET with OTHER CARS was FRIGHTENING! But we made it home in one piece and settled in quite nicely. The dogs were very excited to finally meet their little sister. I was able to wean myself from the percocet pretty quickly, mostly because I wanted to have extra to sell on the street (call me if your interested - I may have some xanax too - I kid, I kid).

As soon as Louisa was born, Danny turned into Super-Dad. He's been changing diapers, doing house work, charting Louisa's feedings, poopy diapers and wet diapers, assembling breast pumps and loving on his girls....ah, we are blessed! He also really enjoys brushing Louisa's hair, which is the most adorable thing ever.

Welp, I think that covers most of the highlights from the birthing extravaganza. I have a few stories about my nurses, but I'll save those for later. And I have another "inappropriate comment" story, but I'll get to that later as well.

2009-09-05T16:48:00.000-07:00

Ah, it has been too long. There are a ton of things that I have been meaning to do for the past 3 weeks (including writing thank you notes - so if you gave us something and have not been properly thanked....I'm working on it). It's amazing how the maintenance of a newborn can take up nearly every minute of the day (and night). I decided that it is high time I updated the old blog though.

So....in recent weeks, I had a baby.

We checked into SMMC on a Sunday night and shortly after they placed the cervidil. Okay - cervidil worked a little too well and I started having contractions. They told me I might have some cramping, but Lord Almighty!!! Then Louisa had a prolonged heart rate deceleration and all of a sudden 4 nurses came busting in our room, made me get on my hands and knees (to relieve any pressure that might be on the cord) and shot me up with some terbutaline. I didn't even have time to freak out about the needle. This is when I lost all inhibition and stopped stessing about Danny seeing me in less than glamourous positions.

After that, they removed the cervidil and Louisa's HR came back up and looked good. Then they started me on low dose Pit to finish dilating my cervix. Things quieted down quickly, but I had a feeling that Louisa would not be coming out the old fashioned way. The rest of the night was uneventful and in the morning they turned up the Pit and I started having contractions again. Lord Almighty!!! Call anesthesia STAT!!! [Side note: what I thought was pain from Louisa stretching out during the last 2 months of my pregnancy turned out to be Braxton Hicks contractions - glad I didn't know I was having contractions during my 9 hour board exam.]

I requested some Stadol before I asked for the epidural. This was a good idea and I would highly recommend it if you're as freaked out as I am around needles. What? Doctors have to use needles? Ahem.... So the Stadol put me into a quasi-drunken state and I was able to be a big girl and get my epidural. Hardly felt it. When the catheter was placed, it somehow ended up toward the left of my spinal cord, so I had to lay on my right side to make sure that my right pelvis/leg got the drugs. Regardless of this small snafu, I am completely in love with fentanyl and the doctors/nurses who give it...legally, of course.

Where was I....stadol....fentanyl....oh yes. So I got the epidural and things progressed nicely. I was completely effaced and I dilated to 9.5 really quickly with just a lip of cervix remaining. Danny, my parents, Grandma French Fry, Carmen, Rachel and Julie were all in the room and we started making bets about what time Louisa would be born, length, weight, etc. Most of the guesses called for her to be born between 3:30 and 4:45. Har har har.

We kicked everyone out of the room and I started pushing around 3:00. After about 30 minutes of pushing we hadn't made any progress and Louisa's head was in an unfavorable position. I pushed for a while longer to no avail. I always envisioned myself pushing 2-3 times and popping out a baby. I also always thought about how much it would suck to be in labor and pushing all day, only to end up having a c-section. Har har har. Okay, so after a while it was determined that I needed a break (Danny said I turned purple every time I pushed). They had me lay on my left side to try to get her head to turn. Okay, too much fentanyl on the left, NOT ENOUGH ON THE RIGHT!!! 30 minute break - Danny feeding me ice chips - me day dreaming about an orange cream slush from Sonic. Dr. S rechecks Louisa's head position. No big change. Dr. S reaches in and manages to turn her head to a more favorable position. Sweet! Resume the pushing! After pushing for another hour or so Louisa started having late decels (this is a bad sign for baby). And she still wasn't moving any closer to the outside world. I was so relieved when Dr. S said I would need a c-section. They wheeled me into the OR and gave me more fentanyl! Delicious! They took Danny somewhere and got him all dressed up in a white spacesuit. He looked pretty hot in it, but this was neither the time nor place for romance.

Dr. S scrubs in, we make small talk, then she says, "can you feel this?" Although I couldn't feel it, I knew what she was doing and it made me squirm....well, not really since I couldn't move my body, but if my motor neurons weren't comatose, I would have squirmed! What she was doing, I'd seen far too many times before (and squirmed every time)! She had a pair of sharp clampy tweezery things and was pinching and jerking around the skin on my abdomen. (Squirming)

To be continued (Louisa awakens).......

Nevermind....Danny's on top of it!

So, surgery ensues, then I hear a pinch of panic in Dr. S's voice. I think Louisa was further into the birth canal than she had expected and she had to work to get her out. Dr. S gets her out rather quickly....no crying. Nurses take Louisa....no crying. Dr. S orders nurses to get oxygen on Louisa right away....no crying. Mom is starting to panic. Finally CRYING!

To be continued....for real this time....baby girl needs her mommy!

Louisa

2009-08-19T13:19:00.000-07:00

FB is blocked at the hospital, so I'll just put some pictures here for now. Several (thousand) to follow at a later time :)

Leaving the house....just the 2 of us

I finally get to stop pushing. The OR was the best part!

Oh look, it's my uterus. How'd that picture get on here?!?!

Sweet Louisa Grace!

Family picture. Danny looks pretty hot!

The Boulder....

2009-08-16T12:12:00.001-07:00

Danny was carrying some laundry downstairs for me and I was following close behind him, he suddenly turned, looked at me, and the look in his eyes reminded me of this....

http://indianajones.lego.com/en-US/movies/RealMovie_Boulder.aspx

More inappropriateness from random strangers

2009-08-15T17:55:00.001-07:00

Today I decided that the nursery was not quite decorated enough. I wanted to go down to the Rivermarket Antique Mall, but decided to go to Mission Road Antique mall instead. We need a few more things on the walls, but we really need to wait until we get our rocker back from the upholstery place (ah, that's a whole different soap opera - sans Luis Lopez Fitzgerald) so we can see what looks best where. So I was wandering around the Antique Mall and found a couple of fun things. I didn't buy anything, but I got some ideas. I found a super-old copy of Jo's Boys by Louisa May Alcott. It was a really pretty book, so I might have to go back and get it. More so for decoration than anything. The previous owner had written in the front cover in the 1960's, but I think the book itself was from the 20's.

So, back to my original story, which I never really started....ahem....

I was wandering through the mall and there was a guy sitting in a chair looking at some antique stuff....I think....I mean, we were in an antique mall, after all.

Guy looks up as I walk by, eyes almost pop out of his head as he sees my belly....

Guy: Twins?

Me: Nope, just one.

Guy: OUCH!!!

Me: (chokes on spit)

Seriously? "OUCH?" At best this was a lame attempt at empathy, at worst a sinister way of messing with my fragile mind, causing me to dwell, for the rest of the day, on the "OUCH" that is the inevitable end to the last 9 months, making me rethink my choice to procreate in the first place. Evil man.

In a redeeming turn for mankind, I ran into some super-sweet ladies at the victorian shop next to Mission Road Antique Mall. At first, I was annoyed with them because they were clearly staring at my belly, but then they started asking (appropriate) questions about the baby and were sincerely thrilled for me. The lady working at the store even got a little teary-eyed. Okay, kind of weird, but still sweet.

And I'm not actually rethinking the choice to procreate, I'm just really going to need some combination of an opioid and local anesthesia. And I won't grope the anesthesiologist.....Rachel!

The goings on of....me

2009-08-12T16:09:00.000-07:00

Since my life is so gosh-darned exciting, I thought I'd update on what's been going on around here the past few days.

Last Friday: Took step 2 CK (9 hour computer test) aka "boards." It went about as well as you could expect a 9 hour test to go. The chair was comfortable, which was pretty much all I cared about. Louisa kicked the crap out of me for the majority of the test. I choose to think she was just being sweet and trying to keep me awake rather than trying to pester, distract and injure me. I should have my results in 6 weeks.

Monday: OB visit. Still at 1cm, but "a little softer." My cervix is lame....kick it into gear!!!

Tuesday: Went to Don Chilito's with Rachel, Julie, Carmen and Eva. Had a regular combination burrito, red sauce, no lettuce. Based on the Don Chilito's Economic Outlook Forecast things are looking up. They are no longer charging for individual honey packets. The recession, however, isn't totally over, and it won't be until they put the honey back out for the patrons to use up willey-nilley, next to the sopapillas instead under the watchful eye of the cashier.

After dinner, the girls came over and helped me get the nursery situated. They made good suggestions, moved some furniture, reassured me that I would, in fact, be okay. They told me what to pack to go to the hospital. Apparently cute socks are important to have in case my feet are cold while I'm pushing (or to spare Dr. S from my uber-stinky feet). And I need to have cute pj's for after Louisa is born as well as cute outfits for Louisa to have her picture taken in. Child birth is as much about looking good as it is about bringing a new life into the world :)

Eva, who is 19 months old, entertained (actually, terrorized) Charlie for a while. I was super proud of my little one-eyed pirate boy. He let her grab at him, try to ride him and steal his nylabone right out of his mouth! He's going to be a good brudder! Mabel, on the other hand, was completely belligerent and was banished to the backyard. I really can't blame her for acting out. She knows things are changing around here.

Today: I had a super-important meeting with a super-important person (SIP) set up for 11:00. I showed up in SIP's secretary's office (who had scheduled this appointment yesterday), and she informed me that SIP had been out all week sick. She made NO attempt to contact me this morning to let me know that SIP would not be available. Then she asked me if I wanted to reschedule for Friday. When I pointed to my belly and informed her that Friday would be a little too close to D-Day, she looked surprised. Um....hello lady, even skinny 17 year old check out girl at HyVee could see how close I am to popping out a kid! Ugh. It was a completely frustrating experience. Mostly because I had to find a parking spot at SIP's place of work, which was a 10 minute waddle to the door. Then I had another 10 minute waddle once I was inside. AND she scheduled the COTTON-PICKING appointment YESTERDAY AFTERNOON!!!

I'm over it!

So then Danny and I took both cars, both bases and the car seat to our friendly Roeland Park Police station to have our bases installed. Turns out that we are missing a very important piece of hardware for the seat that attaches to the seat belts and helps to lock them into place. There was some seat belt feature that came about in 1999, which made the hardware unnecessary, but since we drive pre-Britney Spears Era vehicles, we need the goods. Put that on the list of things to do tomorrow.

Currently: Cleaning ladies have taken over my house. They have been here since 1:00 and it's like 6:39 now. My house is not much bigger than a doll house, so I don't know what it says about my house keeping abilities (or lack thereof) that they have been cleaning my house for almost 6 hours. My mom said it took 4 hours to clean her house, which is probably 3 times as big as mine. Also, what are you supposed to do when there are people in your house cleaning? It's just kind of awkward. I feel like I should be entertaining them somehow... or apologizing to them. "Um....so sorry about that dust there on the mirror! Oh, and that unidentified goo on the floor in the kitchen. Oh, yeah, we kill spiders and leave them on the walls....don't people do that with deer and fish? What, you didn't think it would take 6 hours to clean my teeny, tiny house.....so sorry!"

UPDATE: Cleaning ladies just left. They didn't look thrilled with me. Infact, they looked a little disappointed. They said that they tried their best to clean my house, but I really should consider having them back every 2 weeks. I realize that this would be in their best interest to make money, but I'm pretty sure they were concerned for the welfare of my unborn child and dead serious that I really do NEED THEM! They were muttering something in a different language as they walked out the door. I can only imagine. Hmmmm. Mom?

Okay. My dogs have been cooped up in their kennels all day - being perfect angels, I might add, so I'm going to go entertain them. Outside. So we don't make a mess of my spotless house.

Thank you, skinny 17 year old check out girl at HyVee

2009-08-06T17:33:00.000-07:00

Well, we've already established that I'm super-duper pregnant. No more need to point that out, right? Wrong, apparently. Last week I was at the HyVee in Shawnee (so not as cool as the HyVee in Mission - I think there might be a little Indian vs Cougar involved in that opinion - I digress), and this super skinny, 17yr old-looking check out girl was all "ooh, when are you due?" and I was all "2 more weeks." And she was all " 'Cause you look like you're about to pop!!!"

What do you say to that?
a) Thank you
b) I know
c) ***cries a little***
d) Climb fat, pregnant arse over the register reaching for skinny girls neck yelling profanities while my poor, helpless husband tries to restrain me

I'll let you decide.

Today, so far....

2009-08-03T12:04:00.000-07:00

I have 4 days before taking Step 2 CK on Friday. So this means that I have to study, study, study until then! I got up early (well, a little early) and studied for a few hours before my 37 week OB visit. After my appointment, at which my blood pressure was 102/65 (this will be relevant later), I went to Sonic and got an Orange Cream Slush. Then I went to my daddy's office and got my back cracked....ah, wonderful. Then I came home and fixed myself some angel hair pasta and added extra salt.....because I was almost HYPOTENSIVE earlier. Okay, I probably built up the blood pressure thing a little too much earlier, but I just felt compelled to justify my massive salt consumption....ahem. Then I tried to figure out how to return something to overstock.com. The website was not cooperating, so I had to initiate an online chat, during which "Brynn" and I had a small debate over the color implied by the name "linen." I, being of the school of thought that "linen" is a creamy off-white color, "Brynn" thinking that it was a light brown. Regardless, the curtains that came in the mail were gold, and I didn't want no stinking gold curtains. So off they go, back to the land of overstock.com.....to be overstocked once more.

Okay, that's it. Now I really have to study.

Love

2009-08-03T11:57:00.000-07:00

Boy do I love these furry little kids.....

Of Bathrooms and Bladders

2009-07-13T16:57:00.001-07:00

Either Panera needs a sharps container or people need to stop shooting up in their bathroom. This is what I saw all three times I visited the potty today....in a 2 hour span of time.

Dear Louisa,

Thank you for trying to rupture my bladder on several occasions today. I admire your strength and determination, but please......stop.

Love,

Yo Mama

Adventures at childbirth class

2009-07-12T17:06:00.001-07:00

Okay well, not really adventures, but a little bit of inappropriateness.

Danny and I had our 7.5 hour childbirth class marathon today. Overall, it was really good. I was familiar with 90% of the stuff we talked about, but there are some things you don't learn about in medical school. KU's L&D is pretty old school.....very old school....so we never get to see patients use the bathtubs or the labor balls. There is no room for either at KU. There is barely room for mom, dad and a doctor at KU. Also, most of the patients at KU deliver without much in the way of pain intervention, so I didn't see many patients deliver the way that I want to deliver. Drugs please :)

During the class we learned about different postures and positions to try with our "support person" to relieve the pain of contractions. At the end of class, we had to try out four different positions for one minute each. This is where it gets fun. Danny and I started out in a position where my back was to his chest. I leaned back into him and he was supposed to massage my belly. We made the mistake of facing the rest of the class so Danny couldn't help but see all of our fellow students in funny poses as well. Lights are dim, relaxing music is playing.....my darling husband can't stop giggling. Things were going well at first, and then I feel Danny's whole body start shaking. Then I hear this muffled snorting noise coming from his head. He couldn't stop. For most of this exercise, instead of relaxing and actually practicing these techniques, I myself was trying not to laugh. At one point I had tears running down my face because, 3 minutes after the initial giggling episode, Danny was still shaking and making grunty/snorty/giggly noises and I could barely keep myself from busting out laughing as well.

Hopefully we can take things a little more seriously when I'm actually in labor.

Another fun Danny story from today: we're watching the birth video and the husband is being all supportive of his wife who has chosen to have no pain meds. Under his breath I hear Danny say, "suck it up...." Ah, August 17th could be a long day.

Nursery (with pictures)

2009-07-11T16:54:00.000-07:00

Louisa's nursery has finally started to take shape. For the longest time, all we had was the crib, which was jammed into our former office along with an oversized desk, several book cases and an assortment of other random crap.

(yuck....look at all that clutter)

We sold the desk and chair on craigslist (so handy) and moved everything else out. I want to have a garage sale later this summer to get rid of all of the displaced things that are now taking up our entire basement, but we'll cross that road when we get there. If anyone would like to come over and give me cash, I will let you take things from my basement.....pretty much anything you want.

So, without further ado, pictures of the nursery:

1) Super girly curtains

2) Crib and Quilt

3) Mabel Jane modeling Louisa's chenille carpet

4) Aunt Becca's chair - we're in the process of having this reupholstered. Know anyone who reupholsters furniture?

5) This really doesn't have anything to do with the nursery, but it's pretty cute.

Tomorrow we have our all day birthing class marathon. Danny is less than thrilled. I wonder if they'll make us watch the birth video that we all had to watch in middle school...... Why am I all of a sudden hungry for cherry cobbler?

Changes

2009-07-05T20:10:00.001-07:00

So....things are a-changin' around here. First of all, tomorrow will be the first day of my fourth year of medical school. Freaking CRAZY! It seems like just a few days ago I was starting my first year, scared to death, in over my head, contemplating the hours I would spend crying in the bathroom. And now I'm almost done with medical school. And no crying in the bathroom to speak of. I took the clinical skills portion of Step 2 in Houston last week and I'm pretty sure I passed....based solely on the fact that I speak English....I kid you not. Step 2 Clinical Knowledge (CK) will be August 7th, assuming that Louisa decides to hang out into her 38th week. My worst fear right now is not sitting through an 8 hour test with a near-term infant in my belly, but going into labor in the middle of it. That would be badness. I might have to have some alcohol on hand, for the tocolytic effects. Clearly.
Other things are a-changing as well. Our once cluttered office is now transforming into a nursery. I found myself washing onsies last night and organizing some things in Louisa's crib. Mabel, Charlie and Mickey all decided to pitch in and help. Charlie tried to make off with a stuffed rabbit at one point, but I reminded him that it was Louisa's and he dropped it. I may have smacked him on the butt too. Danny has shown moments of handy-man-brilliance over the past few weeks. He patched some cracks in our walls and did a fantastic job of painting. His next job is to fix up an old dresser at my grandma's house. More brilliance to come, I'm sure.

Well, it's way late (10:30 - I usually go to bed at 9:00 - because I'm street like that), so I'm going to sign off. Maybe I'll post some nursery pictures soon....if I feel like it.

I can't wait to....

2009-07-05T20:03:00.001-07:00

Things I can't wait to do again:
1) Roll over without it being a 5 minute ordeal requiring the use of a crane
2) Go 2 hours without a trip to the bathroom
3) Use my abdominal muscles (not for working out per se, but just for general purposes, like sitting up)
4) Sleep through the night without hip pain, leg pain, belly pain, back pain, GERD, urinary FREQUENCY!!!
5) Sit in my reclining deck chair without cutting off blood flow from my IVC, and feeling like I'm going to pass out
6) Walk for 5 minutes without my round ligaments yelling at me
7) Drink a glass of wine

Bloopers

2009-05-03T19:44:00.000-07:00

I keep forgetting that I'm pregnant, so it's a shock every time I walk past a mirror or a window. Since it was so nice today, Danny and I decided to go knock around the tennis ball for a while. Everything was going well until he hit the ball a little too far to my right. I ran as fast as my little pregnant body would carry me, took a swing at the ball (which I missed), but then couldn't stop the momentum that had accumulated from the extra 25 lbs of weight distribution that is concentrated in my belly region. I was like a run away freight train, overloaded with coal, headed for a down hill track. Luckily I was able to keep myself upright long enough to coast to a stop before slamming into the fence or face-planting on the court. Danny made me calm down after that and he decided that we wouldn't keep score.....just for fun. Just playing for fun.

As if that wasn't enough, I pulled a totally bone-head stunt tonight while we were making our bed. Danny was airing out our down comforter and I kept messing with it so he couldn't get it straight. He kept at it, so finally I decided it would be funny if I just belly flopped right in the middle of it. I went air born, thought "uh-oh", then came crashing down on my belly. Well, I kind of tucked a little bit so I wasn't flat on my belly, but still. I'm a bad parent. I apologized. She's going to kick me tonight, I know it!

Cry Baby

2009-04-08T15:32:00.001-07:00

Is it ridiculous that I get a little misty-eyed when I hear the song Centerfield?

Yep...thought so.

You are a tool - second installment

2009-04-06T19:03:00.000-07:00

Tyler Hansbrough.

http://www.youtube.com/watch?v=NUzxBa_yuCs

You are a tool - first installment

2009-04-03T13:01:00.000-07:00

For a while now, I've been trying to come up with a good working definition of the word "tool". It's one of those things.....you know a tool when you see one, but I just can't define the word. So I've decided to document the tools I encounter in my life and try to come up with some sort of a pattern that I can work into a definition.

Here goes.....

Hey guy with no shirt on who I saw crossing Linwood at Prospect....I realize that the sun is out, but it's still only 50 degrees. I don't care how big your muscles are. You are a tool.

I dream of Don Chilito's

2009-03-20T10:41:00.001-07:00

Do you ever kinda-sorta wake up in the middle of the night, knowing you're dreaming, but understanding that you are talking in your sleep? This happens to me every once in a while, but I usually forget what I've said. Well, the other night, I woke up about 3:00am and said, "Regular combination burrito, red sauce, no lettuce." I looked around, realized I was in my dark bedroom, shrugged and went back to sleep. Danny was able to verify this episode the following day.

In other, semi-Don Chilito's, related news: my mom bought me some body cream a few weeks ago. It's by Burt's Bees and it's called Honey Shea Butter. Well, it smells just like honey, and when I use it, I smell like a big sopapilla who has been rolling around in a vat of honey. This, of course smells....well....delicious, but I'm not sure it's appropriate to smell like a honey-drenched sopapilla. I remember my friend Rachel's mom commenting that we were too old to smell like fruit (Country Apple, anyone?), does this apply to pastries as well? Any thoughts?

The best thing I've heard lately....

2009-03-18T17:43:00.000-07:00

"He's really cute, but he's so schizophrenic!"
- anonymous attending

This stinks

2009-03-12T19:52:00.000-07:00

After much denial and misguided rationalization, I have finally come to terms with the fact that I am allergic to my very favorite candle - the Applewood scented Woodwick. In the beginning it was easy to contribute my sneezing and watery eyes to "just something in the air" or "maybe I'm getting a little cold". But it has become quite obvious that the culprit of my symptoms is, in fact, my dear friend the Woodwick.

Because I have 1 and 3/4 of these large (and somewhat pricey) candles left, I will continue to burn them until my symptoms become unbearable or I go into anaphylactic shock....whichever comes first.

Does anyone have an extra epi-pen?

resurfacing

2009-02-28T11:17:00.000-08:00

Ah, it's been a while. For the past 2 months I've been a slave to surgery. First Urology and then Transplant. My shelf was Friday and now I'm on spring break (wait...is it snowing?). Urology was a lot of fun and I got to participate in a lot of cool cases. I got to use a scalpel to open someone up. They let me cauterize between the aorta and the renal artery (I think the resident was more nervous than I was), and I got to do pretty much an entire cystoscopy and hydrodistention by myself. As far as I know, all of these patients are still alive and well :) Oh, and I learned how to do a pretty wicked awesome running subcuticular suture.

Transplant wasn't as much fun, but the hours were a little better. I worked between 12-15 hour days on urology, and then 10-12 hour days on transplant. Unfortunately I didn't get to see an actual transplant while I was on transplant, just a lot of cholecystectomies and liver resections. I did get to take care of some pretty interesting/sick patients though. It's pretty cool to see someone on the brink of death who gets a whole new life after receiving a new organ. By the way, if you're not an organ donor, you should do it....and make sure your family knows!

So yeah, that's what I've been up to for the past 2 months. What else is new? Um....oh yeah....having a baby. But don't expect me to be all ooey gooey annoying about it, because that's just annoying. And to be quite honest, I don't really have time to think about it and get all sentimental and introspective. And I won't be posting any belly pictures on facebook, so you can just forget about that.

More updates to come over the next week. My next adventure is trying to figure out what I want to do with my life. Apparently it gets a little more complicated than just being "a doctor."

2008-11-18T17:58:00.000-08:00

I delivered my third placenta today.

Immediately following, I resumed eating my cherry cobbler.

Resemblance?

Peds Wrap Up

2008-11-07T16:48:00.000-08:00

Today was my last day on pediatrics. I'm kind of glad it's over, but it wasn't as bad as I had imagined.

I actually had a few cool/new experiences on peds:
1. Call - essentially means spending the night in the hospital in case anything exciting happens over night. The two times I took call....nothing exciting happened, so I slept from midnight to 5am, and went to rounds greasy and with bad breath. It's never a good thing when you drink coffee to try to hide your morning breath. Next time I'll bring a toothbrush.

2. Drawing blood - I didn't do this to a patient, but one of the interns decided that I should learn how to do this.....on HIM. Crazy person. (For a little background, I hate needles. I passed out in the parking garage at KU after getting my immunizations before starting med school.) It turned out to be okay though and I think I did a fairly decent job. I got the vein on the first try and Dr. Crazy Man said that it didn't hurt.

3. Scalpel Please - we had a patient with a deep abscess that we decided should be drained and cultured. You couldn't really see it just by looking, but you could definitely feel it. The attending and the resident decided that I should be the one to weild the scalpel. This made me a wee bit nervous. Expecially after they both pointed out that the abscess was near the spinal cord, you know, so as to remind me that one slip of the hand could cause some serious neurological problems. I managed though. We got enough goo to get a good culture and I'm pretty sure the kid walked out okay.

So, those were my cool peds experiences. I also got to spend some time in peds cardiology which was way cool. If I had to pick a specialty right now, it would be at the top of my list. I might have to do adult cardiology though because I don't know if I could make it through 3 years of general peds residency.

I'm starting on OB/GYN next week. I think it will be exciting delivering babies and all, but I've heard that the schedule is pretty demanding. If I'm reading the schedule right, I'll be on the night shift for the first week - which means I'll get to the floor at 6:30pm and stay until 8:00 the next morning. I might not see Danny for a while :(

In other news....the elections happened. Not the outcome I had hoped for, but I'm trying to remain optimistic. Obama won a few brownie points with me today when he said that they wanted to adopt a shelter dog for their new pet. For a moment I imagined a one eyed, shaggy dog like Charlie running rampant through the White House....it made me smile.

Differential Update

2008-10-11T21:13:00.001-07:00

I had previously diagnosed myself with prinzmetal angina - I have now changed the diagnosis to precordial catch syndrome. This means that I'm not going to die of an MI any time soon.

My spot that looked like a basal cell has spontaneously regressed. I would have preferred the spot that looks like squamous cell to have regressed, but I'll take what I can get.

I briefly diagnosed myself with meningitis, then I drank some coffee and my symptoms went away. I am DEPENDENT!!!!

Enough of the politics....back to the medicine

2008-10-06T17:41:00.001-07:00

I've been on peds now for the past week. Like with any new experience, the first few days were scary and I was unsure of what in the bejibbers I was supposed to be doing. This is my first inpatient experience and it is so much different than the outpatient experiences I've had so far. The scariest part is the presenting to attendings. I've done tons of presenting by now, but not in front of the team. So now, instead of just the attending listening to me blubber my way through a patient history, we've got several residents, social workers, pharmacists, nurses and other students as an audience for my stupidness.

The first day was by far the worst, but it always is. I'd never really been through an inpatient presentation before and was unsure of what all to include about this uber-complicated case. The attending was really nice though and managed to guide me through it, sparing my fragile confidence for the time being. So at this point I'm relieved because my big speaking gig in front of the team is over, now we get to go in and see the patient....cake. We're getting ready to go in the patient's room, but before we can go in, we have to do the little alcohol foam hand stuff on the wall. If you've seen the new Batman movie, you know what I'm talking about - hilarious. Anyway, so I go to get my hand foam, but the dispenser is different than the one I always used in my previous clinic. So instead of squirting foam into my hand, I managed to manipulate the dispenser in such a way that caused an explosion of foam to shoot out the side and hit the attending in the head. Nice work Christi. Fortunately....again....she was super nice and acted like she hadn't noticed. I'm sure the rest of the team was snickering....heck, I would laugh too if I saw someone do that. In fact, I would probably be rolling on the floor.

I managed to live through the first day, and things have been looking up ever since. I've managed to put together decent presentations for rounds and have been able to answer the questions that the attendings have "pimped" me on. In fact, I had the answer to a completely random question that one of the attendings was wondering out loud about....the incidence of sarcoidosis. I had just looked it up a few minutes before rounds and was able to give him the answer like it was no big thing. I love it when that happens! Woot woot! (Is it still cool to say that?)

In the past week, I've been on overnight call twice. This is a crazy thing, but I'd better get used to it now, because when I'm a resident it will be all to common an occurrence. When you're on overnight call, you get to the hospital at 6:00am and stay until 10:00-11:00 the following morning. That's 28 hours, and I've done 2 of these shifts in the past week in addition to my regularly scheduled 8 hour days. I'm a machine! Call isn't quite as interesting as it sounds, but it allows me the opportunity to use super-cool doctory phrases like: "I'm post call" or "I just pulled a 30." Okay, I totally made that last one up, but doesn't it sound good? If you overheard me say that (while wearing scrubs, a stethoscope and looking all together disheveled) you would probably think that I was way cool - which is my ultimate goal in life :) The only thing bad about call is the following morning when you're greasy and haven't brushed your teeth in forever. Next time I'll bring a tooth brush and those cute little face blotting papers. Although someone told me today that I looked good for being post call. I don't know if this was a complement, or if I just always look like I've been run over by a bus.

Anyhow....that's what's been going on with me for the past week. Peace out!

The View

2008-10-06T09:34:00.000-07:00

UGHHHH! Why do I watch this show!?!? They should really call it "We Hate Conservatives" or "Lets Not Let Elizabeth Get a Word In Because We Don't Agree With Her." Seriously! Today they were being all condescending (shocking) and asked Elizabeth why she was resorting to "smearing" Barack Obama. And by "smearing" they were referring to the fact that Elizabeth has concerns because Obama has ties to William Ayers. Okay. I think that it is a legitimate concern when someone running for president of the cotton pickin' United States has ties with/common interests as/runs in the same circles as a KNOWN TERRORIST. An unabashed terrorist with no remorse. How is this "smearing?" Isn't smearing when you bring up something rather inconsequential or from like 40 years ago and try to make a big thing about it? Whoopi tried to make the argument that Obama and Ayers were acquaintances in 2002....like it was ancient history and terrorism is some sort of self-limiting condition that you grow out of. Then Whoopi, Sherri and Barbara lit into Elizabeth like she was some sort of idiot to even CARE that Obama has these ties. Why do I watch this show? Cotton Pickin'! Oh....and I'd like to know what kind of credentials Whoopi has that she thinks herself the grand master of politics....besides being the center square on Hollywood Squares.

Photo rundown

2008-09-27T20:00:00.000-07:00

I had the last week off, which was fantabulous.

Here is a picture from our lazy Friday morning (Danny took the day off so we could hang out).

We went to St. Joe on Friday afternoon to see some sights and hear Jason Upton at Word of Life Church. Here's a random picture from a creepy museum.

And a random picture from a creepy antique store.

We didn't make it to the Jesse James museum because they had already switched to "winter hours," closing early. Um, yeah....winter hours? 85 degrees people....85 degrees. We did make it to the Pony Express Museum. Did you know that the Pony Express only operated for 19 months before the company went bankrupt? Oh snap! My blog just got all edumacational!

Oh, and we interrupted these guys when we sat down at a picnic table to enjoy some ice cream. Danny made me take the picture.

I was also able to spend some time with my besties and their adorable children.

(This is Rachel and Carmen's daughter Eva)

(Julie's Daughter, Alexis)

(Ellie and Alexis)

(Eva at Louisburg Cider Mill)

(Ellie at the Cider Mill - she usually doesn't like to smile for me, so this was a treat!)

Differential

2008-09-27T17:59:00.000-07:00

So....here's a list of some things that are plaguing me:

Pink, shiny papule right below my left clavicle....probably a basal cell.
Rough, scaly skin just distal to afore mentioned papule....potentially actinic keratosis, or squamous cell.
When I lay down to sleep at night, I can feel my abdominal aorta pulsating strongly - probably an AAA.
Random chest pain - most likely prinzmetal angina.
Occasional pain in the region of my right scapula....gall bladder must be acting up.
My left leg has been aching lately. Feels like bone pain. I don't think I'm growing anymore, so that leaves me with bone cancer.
I clear my throat a lot, as do my mom and grandma. I think we've all got silent GERD. Probably erosive esophagitis too.
I'm pretty sure my panic disorder is resolving - I can drive on the highway again, thank you very much - but I think I may have developed a little OCD. I check to make sure that things are unplugged or off SEVERAL times before I leave the house because I don't want my house to burn down, incinerating my animals. Completely rational, right? Thought so.
I could probably make a case for IBS, IBD, Crohn's or UC, but I'll leave those details to your imagination.

That's if for now. I would hate me if I were my patient.