Bridgeport Public Library

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

Disconnected

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

ILLIN', pt 2

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

The Mystery of Rotation 8

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

Settling back in

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

A lesson in compassion

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.

So How Was It For You?

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