Missed a work meeting I was supposed to be at this morning.
Purely forgot. I have no other excuse.
Did my apologies to the appropriate parties involved, and found out that in fact, the meeting didn't really concern me much anyhow.
Still, not my best work.
A couple of weeks ago I was lucky enough to have a 3-day weekend, and I was able to make it up to Seattle to spend a few days with my friends and family.
It seems to have made all the difference.
I came home feeling so much less anxiety about work and being in Bend...I just felt re-charged and better. My last two weeks of work went really well. I'm starting to find my footing, and the fact that the patient load has slowed down significantly since the second wave of H1N1 seemed to drop off, has made my life a lot easier. I know it will get busy again before my first Winter is through, but I'm feeling more confident and having more successes, which is helping so much. I also have gotten to know the people I'm working with a bit better, and this has also been a good thing. The physicians are really willing to help me when I get in a bind, or just need a second set of eyes to confirm my diagnosis. The nurses are very patient with me, and they work hard to make my life easier. Even the scheduling staff is always quick with a smile and does their best to make sure my day goes smoothly.
As a benefit to working a real job, I was able to fly my mom to Bend to spend Thanksgiving with me. (CJ had the whole week off work, so he went home for the holidays). It was great! I picked her up on Wednesday and we spent the whole weekend eating, going for walks, watching crime shows on TV and just hanging around. I have a little bit of the holiday blues this morning as life returned to normal too quickly, but I'm looking forward to going home for Christmas in just one short month.
CJ came home a day early to spend a little time with my mom and I, and we all went out and picked a beautiful Christmas tree! This is the 5th Christmas CJ and I have spent together, but the first tree we've gotten!! I'm so excited - it looks so festive! It also helps to make Bend feel a little bit more like home. It has surprised me how long it is taking me to feel comfortable here...
Anyway, that is essentially all that is going on with me. I'm always keeping up with the rest of you, and hope you are doing well.
With love,
Jen
Well, I've officially been seeing patients by myself for almost 3 weeks, 2 of those weeks have been at full-speed (the first week I got double the time for each appointment).
I won't lie or sugarcoat it. It's been hard. Many a morning I've woken up so nervous about going to work that I can't eat breakfast. I often go home just to think about a case or two that I feel like I didn't quite get right. I've cried. Multiple times.
But breakthroughs are starting to happen. Last night I was working the 2-8pm shift when we had a walk-in leg laceration. Turns out, it was a 15 year old who had been cutting down trees with his dad, and the chainsaw accidentally met his left thigh. It was a beauty....macerated edges, 7cm x 1.5cm x 1cm deep. Luckily I had a couple of openings in my schedule before my dinner break, so I got in there, cleaned him up really good, trimmed the edges and did a double layer closure that John Van Horn would have been proud of (thank you Legacy trauma!). It made me feel so proud because in a position where I am constantly faced with my weaknesses (ie: pediatric medicine), I finally got to shine a little. And, it didn't go unnoticed. None of the other mid-levels in the practice like to do suturing in the office, so the nurses and other providers were excited to see me getting right in there!
It also helped to remind me that at one time, that lac would have scared the bejesus out of me, just like pediatric medicine does at the moment. It reassured me that I can learn pediatrics, just as I learned to sew, and one day, I'll be damn good at it. For now, I must admit, it is still a struggle. It is a good struggle though...I need to struggle sometimes. It reminds me that asking for help is a strength, not a weakness. And I do love the learning that comes along with this position. In the last month, I've learned so much about normal child development, pediatric nutrition, H1N1 (of course), pediatric reflux, croup, etc. If nothing else, this job will make having my own children SO much easier!
So, I am adjusting. I'm surviving. I'm keeping my head above water, and though I might not be the provider I want to be yet, I am sticking with it, and I'm on my way.
And yes, I'm doing self-affirmations. They work.
Jen
It's 11:15am on Monday and I'm at home watching "Who Wants to be a Millionaire?" CJ is here too, we are both sick.
I came down with the flu (presumably H1N1, which I was, ironically, vaccinated against) and subsequently developed a secondary sinus infection which I finally got antibiotics for today. I gave CJ the flu as well. He went in to work today and they sent him home, telling him to Lysol everything he touched on the way out.
I'm lucky that I am so new at work, because even though I was scheduled to see patients at a regular pace today (I saw patients last week, but at a very slow pace), I only had one appointment scheduled (usually my day fills up with same-day appointments). Work was really cool about it, and they actually have me blocked out for tomorrow unless I let them know that I'll be coming back in. I think I'll probably be fine by tomorrow because I usually respond really quickly to antibiotics.
Work in general is great, but super overwhelming. Jumping into pediatrics during the height of a flu pandemic that is targeting children, as well as the beginning of the croup and RSV season, is insane. I am dealing with really sick kids and questioning every single decision I make. And I know I've made mistakes, so I am just trying to ask for as much help as I can....a second set of ears to listen to a 9 year-old's lungs (yep, bilateral basilar rales), a second set of eyes on a strange looking scab-rash-thing on a 5 year-old (Non-textbook impetigo) or an opinion on prescriptions (too many instances to list).
It's been really humbling...which I think it is supposed to be. I do admit, however, that I spend more than a little time at home thinking about patients I've seen each day, wondering how they are doing, and if I did the right thing. That part of the job sucks.
I know it will get better, but I also know it will be a slow road with lots of peaks and valleys.
Missing my Hillsboro peeps.
Jen
So my last post was during a very frustrating game of phone ping-pong with the Oregon Medical Board and the United States Postal Service. End result was that my "missing" registration form that I mailed in was finally found...and thank goodness, because I was about to drive up to Portland and look for the damn piece of mail myself!
On a happier note, I really like my job so far. I finally saw some patients "on my own" today (rotation style: I went in first followed by the regular PA). She said she agreed with all my findings and diagnoses, and seemed impressed that I could actually see most TM's clearly despite squirmy kiddos with lots of ear wax. I didn't realize how much I missed seeing patients!! I had a blast talking to the parents and making funny faces at the kids. I still have a lot of medicine to learn, and some forgotten medicine to remember, but the love is still there, and that is the most important thing.
On a less happy note, I get heartburn now....way too often. Thinking of starting myself on a daily OTC H2 blocker or PPI. What a bother.
Random.
Jen
Holy moly the Oregon Medical Board needs some serious re-vamping. A million days later, I should be getting my official license number today. Now, it isn't that the delay is completely the board's fault (my fantastic supervising MD failed his questionnaire the first time) but come on...I overnight mailed my registration paperwork and apparently the lady on the phone says it STILL takes two days AFTER they receive it to process it. TWO DAYS. It cannot possibly take two days to open an envelope, take my money and check me off a list. (edit: the lady at the board just called me back...they haven't even received my registration form yet...wtf?!?! Damn post office).
Anyway, licensing is such a big deal because my credentialing paperwork cannot be turned in until I officially have a license number. Apparently credentialing (getting my name in to the insurance companies so they will cover the services I provide) takes FOREVER, meaning that it will be FOREVER before I can see patients on my own (which we are still hoping will happen Oct 5th, but it is now looking doubtful).
For the last four days (and today) I've been shadowing with a bunch of different providers throughout the practice. Monday was all day with my supervising MD at the Redmond office, which is really nice, the Tuesday was at the West Bend clinic with one MD in the morning and another in the afternoon. Wednesday and yesterday was at the East Bend office with a similar schedule (two docs each day) and today I am finally with a PA for my whole shift (and it is an evening shift to boot!).
Mostly everything has been going very smoothly. The licensing crap is the most frustrating, followed by some IT issues (I have an email address...but can't get to it?). The medicine is good...I'm less afraid that I will kill a child at this point, but still very wary. The day tends to be split 50/50 with well child checks and sick visits. Yesterday I saw so many 6 month old well visits that I was able to memorize one of the doc's "spiels." I've also memorized the recommendations for seasonal and H1N1 influenza. Every single parents asks about the swine flu at every visit. Seriously. 100%.
Anyway, time to get in the shower and get to work....and track down my registration form.
Jen
A lot has happened in the past two weeks, but I'll briefly recap the important stuff:
I took the boards (passed)
I got a job at a peds clinic in Bend
I moved to Bend
Funny how life always seems to work out...I was terrified of not getting a job, and now I've gotten one that I really think I'm going to LOVE! My first day will be Sept 21...I'll shadow MD's for a week, then mid-levels for a week, then the 3rd week I see patients on a 1/2 schedule (each appt twice as long) and then the 4th week, it's sink or swim! Learning all I need to know to be a good pediatric practitioner wont be easy, but I'm totally up for the challenge!
Living in Bend is awesome. We have a great house we are renting that is close enough to the Old Mill District and downtown that we can ride our bikes to almost anything! CJ and I have both been on vacation the whole last week so we spent it exploring and hiking and riding bikes, and it's been great! I do dread the thought of the freezing cold winters, but I'm sure I'll get used to it.
So, for now, I'm on vacation before starting work...spending some time in Seattle with family and friends, and remembering why I love this city so much. Back to Bend next week....
Jen
My schedule for the next few days:
Tomorrow (my 26th birthday): Study. McKenzie's at 11am until 5 or 6, then sushi with CJ at Todai, where you eat for free on your birthday. Brilliant.
Monday: Study in the AM, leave at 1pm to drive to Bend for a 5pm interview at a small internal medicine clinic. Drive back to Portland right afterward.
Tuesday: Get up, drive to my dad's in Seattle. Study.
Wednesday: Study.
Thursday: PANCE. Have one drink. Drive back down to Portland.
Friday: Drive to Bend to shadow for a few hours at the peds clinic. Drive back that day.
Saturday: CJ and I are throwing ourselves a going away party (yes, you're invited).
Sunday: Sleep, be hungover, eat, relax.
Next week....???? I HAVE TO get to Seattle for some actual FUN time with my family and friends. I am starving for some Sea-town love.
Yes, I'm nervous. Yes, I wish I had more time to study. No, I won't postpone the test. Why? Because I can do this. I know I can. I am going to channel the little engine that could and just push through.
Nothing else.
Jen
I have really enjoyed the last few chapters of my life:
College chapter: I probably had more fun at college than you're supposed to. I got to live with my best friend, learn about stuff I was actually interested in, try all sorts of new things, and of course, party, party, party. 
I was adventurous and carefree, and it was wonderful. Of course there were some growing pains, heartbreaks and other life lessons, but they paled in comparison to the fun I had. Truly, the best years of my life.
Post-College chapter: I left my carefree world, and entered the real world....harshly. I got a crappy job with crappy pay, and lived in some VERY crappy apartments, but I was also starting my life with CJ, and that softened my world. 
I learned that landlords can be terrible people, rent is not always based on the actual value of the property, and that life is very, very expensive. Especially when you live in Seattle. I also learned, however, that CJ and I made a great team, and that I had some wonderful friends who were always quick to invite me to sushi or happy hour, just so we could gossip and forget our woes for an hour or two.
PA School chapter: It was what I'd been waiting for, finally, I'd been accepted. I was ready to learn my craft. I was so hungry for knowledge, and PA school did not disappoint. There were dead bodies to poke at, midnight study sessions and days I was so mentally exhausted that I had to take a nap on the exam table in the breakout rooms, (so what if I missed another boring Schnabel lecture?!?) The greatest part was the camaraderie...we were all in this boat together, and we were determined to get through it together.
We were competitive, but mostly with ourselves, not each other. Study guides were emailed to everyone, spontaneous tutoring sessions arose out of nowhere and when it came time to leave on rotations, we supported each other in every way possible.
Which brings me to part 2 of PA school: I was so scared. SOOOO scared. The nauseous on a daily basis, grinding my teeth at night, kind of scared. I faced challenge after challenge, and spent so many weeks away from anyone I knew. There were some miserable days, crocodile tears and wistful phone calls home, but there were also victories and crazy fun times that were unexpected, and those are what I really remember. I have to thank Curtis for his "call a PA student day" phone calls...I remember feeling so alone in Havre, Montana, getting one of those phone calls, and feeling so much closer to home. 
And every PPS, it was like nothing had changed, except I couldn't believe how smart all of my classmates had gotten, and I hoped I was keeping up. Suddenly, I realize that our next August trip to the Forest Grove campus will be our last...and this time we are getting our real white coats. Even as I type it, I don't believe it.
The NEXT chapter.
I don't know what else to call it...the Bend chapter? The career chapter? The getting-married chapter? All I know is, I have a wedding date set for 11 months from now, two interviews for physician assistant jobs, and tonight, CJ and I are leaving to Bend to find our next home. It's overwhelming. It's fantastic. I had visualized myself going to PA school since I was 17...but I had never quite gotten around to picturing what would happen after. Now, the future is opening up to me, and things are uncertain, and new, and it is again an adventure. It could all go horribly wrong, but it never has before, so I have to imagine that it is all going to be perfectly right. I've worked hard to get here. I've finished my schooling completely. I'm primed to reap the fruits of my labor. Of course I'd feel better if I had a job offer nailed down, but compared to how I felt last week, I'm just thrilled an employer called me back, nonetheless to have two interviews.
I think of how far I've come, and the only thing I can really think of is how many people helped me get here. My family, foremost. CJ. My best friends in Seattle, and my new best friends here in Oregon. My professors, preceptors, their nurses and support staff, and a few other random people who have helped me along the way, like the nice guy who towed me out of a snow bank when I spun my car going over Blewitt pass at night, the cop in Montana who didn't give me a ticket for speeding because she liked PAs so much, (even the cop in South Dakota who gave me a ticket anyway, but was nice about it). Then there are the people I've lived with: Michelle in Oakridge, Oregon, who not only let me rent a room from her, but gossiped and drank vodka tonics with me nightly, and invited me to Bunko with her friends.
Sarah, the MD student who ended up stuck in Havre, Montana with me, and let me drag her around town for some company.
Amanda and Sabrina, who not only let me share their house for 4 months in Coeur d'Alene, Idaho, but taught me to drive in the snow, let me join their social circle, and became two of the best friends I've ever known.
Melody in Brewster, Washington, who let me rent a room from her without knowing who the hell I was, and made me a cup of tea the first night I got there because she knew I'd had a rough drive.
The Gerberdings in South Dakota who were more hospitable than any family ever has been, gave me my first taste of pheasant and venison, and let me tag along to the kids' recitals and practices as if I were another member of the family. And finally, Tonya, Janell Gerberding's zestful medical assistant, who took it upon herself to make sure I had a good time in South Dakota, and succeeded!
I have been blessed. Perhaps this next chapter should be about giving some of that goodness back to the world.
Bring it on.
What did you do on your Summer Vacation? - By Jen.
After the first week of school picking out my clinical research topic, I spent July 4th weekend with CJ in Olympia. We had fun hanging out with the other agency interns from Statefarm, especially when we all went go-kart racing and CJ and I took 1st and 2nd place.
We spent the holiday up at the Tacoma Freedom Fair eating way too much food, watching a cool airshow and seeing fireworks. The best part was a stealth bomber hovering over the water and doing quarter turns. Amazing!
After that I spent a week up in Seattle to visit friends and family, but mostly to see my sister who was moving to New York at the end of that week. I did some fun stuff, but the whole week was overshadowed by having to work on the first draft of my paper, which was due only 9 days after I'd actually picked a topic. I did get to go to my first Mariner's game of the season though, which is always a delight (even though they lost).
Finally, I returned home and spent the next two weeks with CJ cleaning and packing up stuff in the house to get it ready to sell. Holy moly, was our house dirty. You never take the time to look at how much dirt is on doors and walls and skirting boards, but once you start washing the suckers, it's disgusting. We also did a lot of yard work. Ivy is the devil .
My mom came into town to visit us and she and I took a roadtrip to Bend to explore my soon-to-be home. It was a great trip even though it was super, super hot. We drove around to see the sights, walked through Drake park, ate at McMinamens, and drove around to look at some rental properties (very affortable!) Just before we left, CJ's mom called and said that she was also in Bend, so we got together for lunch and the two moms finally met! (mine is the one on the right, in the green).
Soon after, my mom left for Seattle and CJ and I headed on a 4 day trip out to the Tri Cities for BOAT RACES! (their version of SeaFair...hydroplane races, food, fun, alcohol and thousands of half-naked people. Brilliant!).
We also drove over to Pendleton that weekend to work an MMA fight, which is always SO much fun. I did pre-fight physicals and was an inspector, and CJ judged. There were a few last minute drop-outs, so we got CJ's friend Yoni to be a judge and Yoni's awesome girlfriend, Siouxie, was the timekeeper!!!
Finally, when we got home last Monday, I realized that I'm a failure and am still unemployed, so I started making cold calls to the clinics in Central Oregon. Its been very frustrating, because most of the time I get voicemails, and they are rarely returned. Still, there has been some positive news. A doctor at the large pediatrics group in Bend got my CV and emailed me. He said they are looking for a midlevel provider and would I please call him next week when he is back in the office? YES, I WILL. Also, I saw a craigslist ad for a "FP/Internist," which I assume meant physician, but I left a voicemail anyway stating that if they would consider a PA, I'd love to send my CV. Well, they called back and asked me to fax it in! That was yesterday, and no word yet, but I'm keeping hopeful. It sounds like a small clinic with offices in Madras and Redmond, and I would love internal med, so I'm crossing my fingers.
This weekend should be pretty relaxing - just hanging with CJ tonight, BBQ'ing with Cindy and Zack tomorrow and I think we have something on Sunday too, but I can't remember. Next week my dad is coming into town, and hopefully I'll be going to Bend for some interviews!!! If everyone would please send some good "employed" energy my way, I'd be forever grateful.
Thinking of you all, graduating in T minus 15 days!!!!
Jen
Well, tonight is my last shift as a PA student. I'm here in the resident lounge, waiting for traumas to make my night go by. I've finished my paper, my 2 drug summaries and am almost done Typhoning. Tomorrow I walk out the doors and into the great unknown.
So how do I feel about it?
Relieved, unsure, scared, ecstatic, exhausted, fired-up, etc. The same feelings the rest of you have, I'm sure.
I've learned a lot at Legacy - the hours are tough, but I've gotten to do so many procedures, become really familiar with hospitalist medicine and even got some more surgery practice that I actually enjoyed! I'm thankful this was my last rotation.
CJ is pretty thankful this is my last night. Apparently I've been quite grumpy. My plans for the summer are as follows (so far):
This weekend: Sun Valley, ID
Next week: Hillsboro, paper crap
July 4-10: Seattle
July 11-23: Paper
July 24-26: Tri-Cities for Boat Races and an MMA fight
July 27-Aug 7: Paper
Oh, and somewhere in there a great job is going to land on my plate magically.
I hope you're all as twitterpated as I am.
Jen
So after trying to rally the 09-ers with Curtis to go to the PA picnic today, I slept through it.
I set my alarm, and from what I can tell, my alarm went off....I just didn't wake up.
I also didn't wake up for the alarm I set to by UFC Portland tickets, and now the cheapest seats available are $200.
Madness.
I'm very disappointed on both accounts.
The guy on the news from Salem who blew up his hand...
I (HIPPA)'d his (HIPPA) and helped (hippa) his (HIPPA). His (HIPPA) is MESSSSSED up!
...that's all I'm gonna say.
That's it...after tonight's shift is over (4.5 more hours), I will only have 7 more shifts left of my whole clinical year. Legacy has been a difficult rotation to end on, because working 72 hour weeks with a nasty case of senioritis is difficult to do. I can only imagine how worthless my clinical project is going to end up being.
I've got some anxiety brewing at the moment about a lot of different things: finding a job, moving to Bend, wondering how CJ's job is going to play out, etc. I always assumed when I graduated that there would be an abundance of jobs to choose from. I hadn't anticipated moving to central Oregon, where I've barely driven through, nevermind made business connections. It's ruffling my feathers a bit, and I'm trying to brush it off, but it is difficult.
One thing I am really looking forward to is the last weekend in June. I will finish my last shift at 6am on that Friday morning and will be on a plane by 1:30pm with CJ heading to Sun Valley, Idaho for Kate's (my stepsis) wedding weekend. Not only will I be heading to a sunny spot with my man, but my dad and sister will be there as well, in addition to other good family and friends, with whom I cannot wait to celebrate and relax. I need some good "life is more than work and money" vibes, and I think this vacation will be just what I need. I'm bummed I'll have to head back so soon in order to complete clinical project week, but the sooner I get that whole mess over with the better.
So, that's me. Sitting around in the Legacy resident lounge, waiting for a trauma or 6am, whichever comes first, running on fumes at this point.
Jen
PS - also excited to see some of you at the PA picnic this weekend?!?!
Finally on the night shift at Legacy...3 weeks away from being done with rotations FOREVER!
Started the night shift last night (Saturday) which was super rough...I hadn't managed to sleep in as late as I wanted to, so I had already been awake for 9 hours before I started my 12 hour shift. We had 11 traumas last night, which means that aside from a 45 minute lull where I ate a sandwich at 9:30pm, I was running around in the ED all night. There wasn't anything too exciting, the usual drunk suspects, including an 18 year old kid, who while celebrating his high school graduation with his friends, accidently got stabbed. I guess that's why mom says "don't play with knives." I sewed up a couple of facial lacs on a drunk guy who kept telling me (in Spanish) that my eyes were beautiful (and then would laugh hysterically for no reason), and I got to do the whole trauma evaluation (head to toe) on the kid who got stabbed, because it wasn't really a trauma (so the attending left almost immediately), and the PA was busy closing up his wound. Overall, a good night. By the time 6am rolled around I felt as though I was actually being more helfpul than not, which was nice.
I went home today and closed all the doors, shut the curtains and slept for 8.5 hours straight. Got up, quickly walked/ran the dog, showered, and back to work I went. Tonight I'm on with a different PA, who I'd initially thought was a bit cold, but as I've gotten to know her better, I've really enjoyed working with her. She's been a good teacher tonight and friendly, so despite no traumas (yet), I've quite enjoyed myself. We did get to go in on one surgery (she assisted, I observed), which was an emergency repair of a ruptured AAA. About 40 minutes into the surgery the time of death was called. The guy had lost so much blood, and the PA told me the rupture in his aorta was huge. His BP got down to 17/13, he was in v-tach and not responding to transfusions, epi or atropine. I'd like to say I was deeply saddened and really affected, but I wouldn't be cut out for this job if I was. I do hope he had the opportunity to say goodbye to his loved ones prior to the surgery.
So, for now I'm signing off and going to try and catch some shut eye...should probably be working on my assignment....
PS....this paper writing thing sounds awful, not looking forward to rotation 10!
My Legacy trauma experience so far:
1) I actually quite enjoy this rotation most times...it was a bit of a steep learning curve coming off a buttload of family practice that seem cushy in contrast, but now that I'm more in the groove, there is a lot to soak in and learn.
2) My dream of looking cute in scrubs was shattered by the horror of how I look when I am forced to get up at 4:30 in the morning. And I have to wear my glasses all the time, and they make me look like I'm 12.
3) Green food cards. Brilliant. Just fantastic. Free food is underrated.
4) Sleep is precious, I go to bed early (when I can block out the fact that it is still sunny outside).
-Jen
I should probably make some mention of how we've all come so far and its been a year since we started our rotations.
Let me tell you, I'm just not feeling that poetic.
I want to be done. Truth is though, I'm not ready to be done, which makes the wanting to be done that much worse.
Next up is Legacy Trauma (I think I can, I think I can). I'm either going to love it or hate it, this I know. I've been working on a major attitude readjustment and am now leaning much more towards thinking I'll love it. Why?
I look cute in scrubs. And Sugar-Free Red Bull is cheap at Winco.
BRING IT ON, BITCHES!
Jen
..because I'm pretty sure that he is the one who made me sit down like, 15 years ago, and watch "Encounters of the 3rd Kind," which is what made my visit to Devil's Tower last weekend even slightly meaningful.
Love you dad.
Jen
I've had a rough last couple of weeks.
There's been the senioritis (when will I ever NOT be presenting every patient?).
And then there's been the crisis of confidence (OMG - what am I going to do when I can't present every patient? How on Earth will I ever pass boards?)
And of course, the homesickness. I miss everything that is familiar: my dog, my couch, the meals CJ makes, my gym...
And then there is the homesickness I have for Seattle (my parents, my sister, my crazy friends whom I love dearly, driving over the floating bridge on a sunny day).
And finally, there is the stress of graduating (getting my licensing crap together, finding a job, writing a cover letter, wondering if I'll have to work at Starbucks to supplement myself while I FIND a job).
And let's not talk about money. Seriously. Denial is my coping tool there.
But...as much as I want to VENT, I know I can't COMPLAIN, because every single one of my classmates is going through the same thing at the moment. So, I'm sending out a big hug to all of you. This too shall pass....eventually. Until it does...I recommend drinking (aids in the denial).
On the plus side, I love family practice. It's totally my niche. Also, I still love my preceptor, her family and the rest of the people I've met here in SD. I would adopt my preceptor's 9 year-old daughter if I could, and the MA in the office has set up a whole girls night out this weekend as a going away party. Plus I get to tool around with Andrea on the weekends, so all in all, its been a good experience here.
Next up is Legacy, which I've been dreading, but Kitty has been enjoying herself apparently, and my dad got me all excited by reminding me how much I liked ER - so I'm more open to it now. I just wish that rotation came with an automatic prescription for Provigil. Oh, and an email back from the preceptor would eventually be nice.
Jen
Friday: After work, went to gym, came home and watched "True Lies" on TV with the family (ate popcorn too). Went to bed at 10pm.
Saturday: Spent some time at the library, then met up with Andrea for lunch and the Adam's Museum in Deadwood (super coolest museum ever, had a great time). Then we walked the town and spent some time chatting - she's an incredibly wise woman and I'm happy to get to spend time with her. Later that evening I went out in Deadwood to the bars with Tonya, Janell's MA, and some of her friends. Had much too much to drink, which was my intent - spent the night on her couch, but had to get up early as they were going to church.
Sunday: Drove home from Tonya's, showered, then went back to bed for 3 hours. Was up for an hour watching "Fiercest Warrior" with the family, then developed a massive headache and had to take some Motrin and sleep it off. Finally got up at 4pm, spent some time baking for tonight's dinner (boxed stuff that I couldn't mess up) then read outside in the sunshine.
Pictures to come.
Missing everyone.
So, forever on this blog I have disallowed comments, because I had this idealistic view that I was writing this blog for myself, and I didn't want anyone's comments to cause me to edit my ramblings.
But, as it turns out, my blog is pretty damn vanilla, and hardly full of radical ideas.
Comment away, (or not).
Jen
I just spent some time going over my oldest posts in this blog, from the beginning of my first rotation through the halfway point of my second one...and wow. First of all, my posts were way more interesting back then. Second of all, I realized that I've lot a little bit of the excitement. Of course this is expected, but it is a little sad too. I want to rekindle my rotations spark!
It certainly was interesting to read about how miserable I was on my first "far away" rotation in the dismal little town of Havre, Montana. My coping skills were non-existent! I am proud of how much more emotionally self-sufficient I've become over the last year. That being said, however, I think I've also become more boring. I'll have to work on that.
Today was a great day with Andrea going around to Mount Rushmore, Crazy Horse and a fantastic little winery in the middle of nowhere. I forgot my camera, (and it barely works anyway), so I'll write more about it when I have some pics to post (Andrea said she'd email some of hers to me).
For now, I'm off to the community center to get a workout in.
Love,
Jen
1 week down that is...and it was a pretty good one! The workload was pretty light because my preceptor had two half-days this week (one because her hubby was getting knee surgery, the other because they were skipping town to visit relatives for Easter). Thusly, I have the house to myself this weekend, which is nice I guess. It means I can spend my time hogging the only computer in the house (no wireless internet) to update my sadly un-updated blog.
This is my elective rotation, but due to my dermatology preceptor being axed from having students (...), and my lack of pediatrics/women's health in my previous 18 weeks of family medicine, I'm back in good ol' primary care! This one is actually way more fantastic though. Even with a slow week we've already diagnosed Cushings, dealt with an acute flare of familial pancreatitis, and I personally did 2 paps, 10 or so pediatric visits and 2 suture jobs. Plus there was an interesting case today of a 19 year old female with an intermittently rapid heart rate. Normal exam in the office today, but I'm interested to see what the holter monitor will say! I would really enjoy this type of job.
Living with my preceptor and her family is also going well. The kids are amazingly well-behaved and fun, and I've been thoroughly absorbed into the family unit. We all sit down to the table every night for dinner, and I got a 30 minute lesson in hunting rifles/shotgun and different bullets used for different sized game (I am in South Dakota....) I really kind of hope to have the life my preceptor has (minus the hunting) when I'm her age. A good career, good kids and a happy family - what more could you want?
Tomorrow Andrea (yes, PA student Andrea....we are working in the same clinic!) and I are going to go down and visit Mt. Rushmore and the Crazy Horse monument. I'm super excited to get out and explore a little bit. I'm hoping the weather holds - there is still snow on the ground here and mumblings of more powder this weekend....
I miss my man, of course, but we've been pretty positive about the separation between us. This is my 6th rotation away, and the 2nd that requires us to go a full six weeks without seeing each other (some were close enough to do a long drive for a quick weekend). We are old pros at this!
Much love to all my homies out there across the U.S...I hope you're doing as well as can be.
Jen
I'm here....and "here," is Sturgis, SD - home of the biggest Harley Davidson rally each Summer, and also my new home for 6 weeks.
My rotation is family practice with a PA named Janell. I am also living with Janell and her wonderful family. They consist of Janell, her husband John, her two kids Seth (12) and Holly (9), 2 dogs and 3 cats. They have me in a very nice room in the basement and they feed me dinner while charging me next to nothing. I have only been here 24 hours and I already feel pretty comfortable, so I'm hoping by the end of the week some of this home sickness will wear off.
The drive out here was pretty uneventful. I got a bit of a late start on Saturday, not leaving the Portland area until 1:30pm, so I didn't get into Missoula until 11pm (I lost an hour due to time zones). I was back on the road by 9:15 the next morning and made it here around 7pm. I was knackered, and slept like a rock last night.
Today was day #1. I rode with Janell into work and we actually had a pretty light day with only 11 patients. This is a good thing, because it gave me time to get a little more settled in and acclimated, without feeling rushed or like I was slowing my preceptor down. This is the first time she has ever had a student, but she is pretty laid back and I think she will get the hang of being a preceptor pretty quickly. Already today she let me take the reins on a few appointments, and had me do some quick and dirty (ok, ok, they were sterile) suture jobs. I think I passed the first day.
We went home and we all had a nice, sit-down dinner of chicken, stuffing, potatoes and salad. It was sooo nice after eating on the road for the last two days! There is even a community center that I got to check out today and will probably join to go work out in, and hopefully that will give me a little extra sanity.
Anyway, I'm going to turn on the TV and see if the game is on...GO MICHIGAN!
Jen
Very strange last week or so...worked a 72 hour shift last weekend (seriously, you sleep/shower in the on call room and the kitchen feeds you) and immediately left afterward to drive home to see CJ.
We spent a couple of days at home, then went to Cannon Beach (and got engaged!) over the weekend. It was sunny, there was good food and GREAT wine.
Everything was going swimmingly.....
Then:
Last night on my way back to Brewster I spun out into a snow bank going over Blewitt Pass. A passerby with a truck and a tow rope was nice enough to get me out, but it scared the bazookas out of me.
This morning I locked my keys in my car while stopped at a gas station on the way to work ($70 later the tow truck man let me in)
Then just a few hours ago I lost the key to the on-call room that I'm supposed to be sleeping in tonight. Not a huge deal, except that it is the ONLY key for the on call room that ALL the ER providers use during their long shifts. I already spoke to someone about getting a replacement key in the works, but I feel pretty dumb, and will have to explain myself to my preceptor, which is embarrassing. I have no idea where the frickin' key went...it was in my pocket, and then it wasn't.
Oh...and somehow my name tag fell off in the parking lot and it was run over by a car. Is this shit symbolic? WTF?
I accept my karmic lessons humbly, but wish they would end now.
Sweet, sweet internet.
Thank you Bridgeport Public Library.
I'm not using my time well. I am in fact watching TV online...because I miss my sweet, sweet terrible reality shows. If anyone has a minute to spare, I strongly recommend checking out "Tool Academy" on VH1...just make sure you watch the first episode first. It's fantastic.
I've had the last few days off, but there isn't much to do in Okanogan County in the middle of the week. On Wednesday I went down to Wenatchee to run some errands and just generally get out of town. I ate an Applebees by myself (my favorite "I'm on my own in the middle of nowhere" eating spot). I sat at the bar and, oddly enough, found myself talking with a representative from Roche whose job it is to go around and sell Accucheck meters. He heard me explain to the bartender that I was up here for a PA school rotation, and off we went discussing the finer points of the appropriate A1c cutoff. Is there nothing sacred about a dinner out anymore!?!?
Yesterday was a bit more productive. I did plenty of cleaning and ironing and all that domestic stuff. I even managed to make it to the gym and the grocery store. I ended the night watching Crash with a bottle of wine as my company. A pretty great day if you ask me, and I spent the whole time here!!!
Today - I got up a little late (see aforementioned bottle of wine), to find that my incredibly domestic roommate had made blueberry muffins...from scratch (this, in addition to the sourdough sun-dried tomato bread she made from scratch a few days ago). Delicious! Anyway, we spent some time chatting this morning and eventually I got myself showered and dressed and made my way down to the library...where I am now.
I will work the next 4 days, 8am-8pm (at least), then on Wednesday morning I'm heading home to Oregon!!! CJ has rented us a small cottage (dog friendly) in Cannon Beach so we can have a romantic weekend away - I'm super excited!
Ok so this is boring enough --- there really isn't much going on in my life so there isn't much to write about.
Jen
I've been in Brewster, WA for one week doing ER. Here is a summary:
Sunday night - got in late. My roomie is one of the RT's at the hospital. She lives in a modest 3br 1 ba house and letting me stay with her for a very reasonable rate. But there is no bed, so Cindy was kind enough to lend me her air mattress. I'm getting used to it. There is also no TV or internet. That, I cannot get used to.
The roommate is shy but nice. She has a sweet old dog named patches (a dalmation) and a parakeet named Fred, who is allowed to fly freely around the house. He is a social animal and likes to fly directly at your face and land on your head. It was cute at first....
Day 1: Er from 8am - 8pm with Jose, my main preceptor. He is a little intense and gave me a one-hour long "expectations" lecture, but I think I made an ok impression and we got through the day quite well. The ER can be quite slow seeing as it is a very rural place, so there wasn't too much excitement.
Day 2: Went in at 8am, trained with Chris - a Pacific PA grad. He was doing outpatient internal med AND the ER...(it's that slow). Did mostly outpatient stuff during the day, then the ER picked up around 7pm. The night doc came in at 8pm and immediately started pimping me on renal artery stenosis and the renin-angiotensin system....I was 12 hours into the shift and failed my pimping miserably, but he was forgiving. I decided to stay just a few extra hours....which turned into all night...so I worked my first 24. I did manage to get an hour of sleep in the chapel (thank God ;) )
Day 3: slept.
Day 4: Went to Omak to get a pillow and some more groceries. There is a Walmart there...ah, civilization!!
Day 5: Was hooked up with surgery for a day. From 6am - 8:30pm (save for a 20 minute lunch) I was in on ortho surgeries (1 surgeon, two rooms going...done with one surgery and would walk right into the next). It was pretty bad ass for the first few hours, but then my feet and back started hurting and I remembered why I don't like surgery. I did, however, get some seriously fantastic suturing hints and practice, and got to help prepare an ACL graft from a cadaver. Very very cool. Still don't like surgery.
Day 6: drove to Seattle, saw my mom and best friend
Day 7: today - seeing my dad, have to leave any minute to go back, and I'm so homesick. It sucks to be so disconnected (no internet) from everyone, but I will just have to keep busy working.
I miss you all and can't wait to reconnect at PPS II. So happy that I already did my journal club thing and presentation though - I fully intend on zoning out the whole time.
Jen
My last post got all messed up because I cannot multi-task.
Long story short, I got the stomach flu this week. It seriously sucked and today is the first day that I haven't been nauseous since like, Sunday. Ironically enough, today was also "a drug rep brings lunch" day, and it was Olive Garden instead of Qdoba (again). YUM!
I'm getting very excited for my next rotation, which is ER in Brewster, WA. I've talked on the phone to the PA who organizes it all (I mostly train with someone else, but he oversees it all). Anyway, he called himself a "lame ass" and said "dude" like 12 times, so I'm pretty sure he's the greatest thing ever. I'm supposed to start on Monday, but he said to just drop by the ER whenever I get into town on Sunday and say "hey man, where are my scrubs?" I am so ready to learn all the procedures that I've had very little practice with. Plus, I'll be living with one of the respiratory therapists who works at the hospital, and she is only charging $200 for the whole six weeks! I talked to her on the phone (brief and awkward), and she was like "yeah, whatever, just come in whenever you get here, the back door is always open, etc." Definitely a small town attitude, I think I'll love it.
But, moving to a new place means leaving an old one, and I'll be saying goodbye to Coeur d'Alene, my home since November. I'll miss a lot...but at the same time, don't think I'd really prefer to stay. I've enjoyed my time, but it has run its course, and it feels right to be leaving. Strangely enough, it appears as though my mentee may spend her family practice rotations at the same clinic! I think the slower pace will suit a starting-out clinical year student more than it suited me as a "mid-way through" student.
Almost time to start packing again....(but not until I finish that paper I've procrastinate on....again).
Jen
Well, ladies and gentlemen...the mystery of my rotation 8 has been solved.
Initially, it was to be dermatology with in McMinnville...but alas, I will now be doing family practice (for the 3rd time) in...Rapid City, South Dakota! Now, I completely expected to be sent somewhere random, so I am really just happy that it is a drive-able distance (18 hours). Secondly, I am happy that it is family practice. Not that I don't hate the monotony of viral URI's and back pain like the rest of you, but this practice apparently has a lot of peds, which I REALLY need. I am still afraid of the little aliens and their strange childhood diseases. Plus, if I can't get a derm rotation, family practice is as close as I can get to it.
Life otherwise is so-so. The clinical year is starting to feel like one long business trip and I'm ready to come home. I've been living away from Portland since the first week of November, and won't return until mid-May (except for one week at the end of March for PPS week). Not only that, but by mid-May CJ will have likely MOVED as he is applying for a job in Bend that we are optimistic about. Yay for the job, boo for never seeing the love of my life.
It is a little weird only having 3 weeks left in Coeur d'Alene...I've been here so long that I actually feel like I put some roots down. I've met great people...people who blindly welcomed me into their social circles and let me call them friends. This has been one of the most hospitable places I've been, which I didn't necessarily expect given CDA's reputation. It's also been the largest city I traveled to (even though it isn't nearly as big as I thought it would be), which was an interesting change. I find myself strangely excited to be heading to Brewster, a tiny town in the orchards of north-central Washington. I think I'm really a rural girl at heart.
So, that's really it. The travels continue.
Oh, and I can't remember if I wrote about the woman on whom my preceptor let me order a brain MRI...but my hunch was wrong and it came back normal. Glad she doesn't have a tumor....sad I have yet to develop that clinical intuition.
Jen
Well, I survived my sinusitis/bronchitis....a special shout-out to my preceptor for taking one look at me and writing a prescription for antibiotics. Pretty awesome.
I forgot to mention an interesting patient we had last week: mid-thirties female presenting with one YEAR of vague symptoms including forgetfulness, fatigue, headaches, lightheadedness, clumsiness and myalgias. My clinical red flags went up and my preceptor, though he was sure it was nothing, allowed me to explore my intuition. He let me order a brain MRI to look for space-occupying lesions, plaques, or anything else that would spell serious trouble. Got the results back today: Normal. So much for clinical intuition....but at least she doesn't have brain cancer.
Today was a fantastically busy day...and it was all weird stuff. There was the woman with all the signs of pregnancy without actually being pregnant, the guy with two different rashes at the same time, and a patient whose chronic pain is almost certainly a psychiatric, rather than physical issue. I swear, all day, if it wasn't this, it was that. It was kind of fantastic, but a little bit of a rough way to start out the week - I'm exhausted!
This last weekend I was able to go home to Seattle to have the Christmas that I missed (due to weather) with my mom and sister. It was lovely! We exchanged gifts in a skeezy diner called Cyclops and drank overly-peppered bloody marys. Then I met up with CJ (who was kind enough to drive up to see me), and we spent Saturday night at a dive bar celebrating one of my best friend's 26th birthdays. What a fantastic weekend! I got to see my whole family, my boyfriend, almost all of my best friends, and CJ and I even went and had dinner at the old sushi place we used to frequent when we lived in Ballard (complete with fried green tea ice cream for dessert!).
It is always so hard to say goodbye, especially to CJ, and yesterday I was definitely feeling a bit bummed. I really didn't think it was going to be harder as time went on to be away from my loved ones so much, but I'm really struggling right now. I know that once I finish up these next 4 weeks, I have another 6 weeks away. Then I'll be home for PPS II, but rotation 8 is still as yet unassigned, which probably means I'll be sent to Timbuktu. I sometimes wonder if this year will ever end!!!
It will end, right?
Jen
I'm blogging at 5am on a school night (morning?).
Why?
Because I've been tossing and turning all night and I couldn't stand it anymore. I am sick....sicker than I've been in years, and I'm miserable. I have a sinus infection AND the MOTHER of all URI's (upper respiratory infection).
Started on Sunday night with a sore throat....never a good sign. Woke up on Monday feeling pretty awful, but assumed this was because I'd missed out on some sleep (and engaged in some drinking) due to a free comedy show on Sunday evening. Still, it was just the sore throat, and by the end of the day it was gone, so I was just dandy.
Then I woke up yesterday. I didn't even have to open my eyes to know something was wrong -- I felt like I'd been hit by a truck. My face and head hurt, I couldn't breathe out of my right nostril, my throat was sore again and now there was a cough...the barking seal type of cough. So, at 1pm when I was to report to work (Tuesday is our half day), I came in jeans, announced that I was "calling" in sick and asked for some samples of Allegra-D.
I spent the day at home, drank plenty of fluids and took my medicine. Surely I'd feel better if I did all the right things, right? Wrong.
Around 4pm yesterday I started feeling really horrible again, and by 9pm I barely had a voice left (although at least now I know it is viral, as I've learned that bacterial infections won't cause laryngitis). I went to bed last night at 11pm....but probably didn't fall asleep until 1pm, and definitely never slept for longer than an hour at a time until I got up 15 minutes ago to make more tea.
There is NO WAY I'm working today either.
I've completely lost my voice, and now when I cough it is extremely painful (throat, not chest). I've got some big old lymph nodes in my neck and despite the Allegra D, my head still feels like it is going to explode.
So....to all the patients I brushed off for having "just" a sinusitis or URI - I'm sorry. I feel your pain.
And that....is compassion.
PS- I fully intend on gaining hold of some Tussionex and passing out into drugged-up oblivion for the rest of the day.
Christmas break is over and I'm back in Coeur d'Alene....meaning, yes, I got out in the first place. We ended up having somewhere between 28-32 inches (I never measured) and the day after I posted all the last pictures my two roomies and I played in the snow all day! The next day I was determined to get home because it was my only break in the weather. I learned how to put on chains (I had to use them to get to the freeway) and off I went! I had to drive from CDA to Seattle and then to Portland (pesky I-84 was a mess) but it was worth it to come home and get snowed in with my baby!
On Christmas day we managed to drive to Tri-Cities...it was slow going, but we got there just in time for the prime rib dinner and white russians!!! CJ and I had a great weekend there and I got to spend some time with his best friends, which I was so happy to do.
The rest of the holiday was very laid back, with CJ and I spending as much time together as possible. We watched movies, baked cookies (and ate them all), drank, ate, drank, ate...etc.
Now...I'm back again. Today it took all of a half hour to get back into the routine of things, and then I was off to the races. A bit of a slow day, but here are the highlights:
-Not a single sinus infection or bronchitis...whoopee!!
-Funny rash on 11 year old kid....a recurrance of chicken pox, or viral exanthem?
-18 female snowboarder who fell hard on her back, exquisitely tender to palpation over the L flank region......urine dipstick shows...TADA! Microscopic hematuria! Diagnosis: Renal contusion.
-Pared down and froze plantar wart on a 16 year old boy...for the second time. This thing is my nemesis...it will not die.
-Finally finished my Rapid Interpretation of EKG's book....I am now a genius.
I wanted to share just a few of the pictures from our fantastic winter break:
Mary sitting in the "Christmas Corner," (we had no tree, so we designated a corner):
CJ and the dog playing in the snow:
This gem is from Halloween (CJ as David Hasselhoff in Knight Rider....me as Sarah Palin)
Much love to the PA homies...all this traversing around is starting to take a toll, eh?
Jen
