OK I'll play too!

WHAT IS YOUR NAME:	Stephanie
BOY NAME	Sean
4 LETTER WORD:	sigh
GIRL NAME:	Sasha, Sarah, Shannon
OCCUPATION:	surgeon
A COLOR:	salmon
SOMETHING YOU WEAR:	skirt
BEVERAGE:	soda
FOOD:	skittles!
SOMETHING FOUND IN A BATHROOM:	Shampoo
A PLACE :	Sunset Beach!
REASON FOR BEING LATE:	SNOW!!!!!
SOMETHING YOU SHOUT:	Snap!

OK I'm done!

And the Garden Grows some more...

One nice thing about doing my ER rotation is that I only work 10 hours at a time.....and when you get used to working 30 hours every 4th day, this seems like a bit of a vacation. Another 'nice" (yes in quotes) is that I work crazy hours.....like 5 pm to 3 am or 10 pm to 8a which means that even on my off days I try to stay up overnight. Since there isn't a whole lot to do at 2:00 am, I've gotten a bit of stitching in (though I had a couple of days where I had to just hurry up and sleep).

In other news, I got the scores back from my inservice exam. This is a test we take every year as a resident to measure our preparedness for the boards. You pretty much take this test cold.....no studying so the results are always interesting (and don't count for anything). I was quite please with my results. I was about the 85 percentile compared to other residents across the country taking this test in year 2 of residency, I was only 10 points off the score you need to pass the real boards with 2 years of residency to go and about 98% of residents getting my score pass the peds boards on the first try. All in all I was happy. Shows my attempts to read have paid off.

Nothing else exciting going on here. The weather has been gorgeous and I've spent a lot of time outside cleaning up debris from Hurricane Ike (yes, the Cincinnati area was hit quite hard by the hurricane) and entertaining Sophie. I'm counting down to my vacation in about 2 months. I have big plans for my vacation....I'm going to work...LOL. I'm moonlighting 2 days to make some awesome money so I can do some home improvement projects or maybe just pay for my liscensing exam.

A finish and a new start

A finish and a new start......both in stitching and in life.

I finished Thanksgiving Garden Fairy last week. Beads nearly drove me crazy but I am happy with the final product. It's time for me to leave fairy land for a while and start something new.

I started AAGG after I managed to collect all of the floss for the first couple of pages. I'm stitching it on the recommended fabric, PTP 32 ct Ale. I love the effect and am very happy with it. It's amazing to see how just a few stitches can create something beautiful like the butterflies. I added a small stinger to each of the bees. There stingers did not keep the frogs away. I had to frog out all the bs'ing on the snail and redo it. Oh well minor little problem. I'm hopeful this one is going to keep my interest to completion. I'd love to have it hanging on my walls!

In the rest of my life, I finished my surgery rotation and started my month in the ED. I had a nice weekend off last weekend. I did some stitching and caught up on my sleep. The hardest part of working in the ED (or ER) if that the shifts are all over the place. Most of mine are overnight and try as I might, I cannot seem to get my days and nights switched! It does mean that I've had more stitching time! I am glad to have surgery over and done with. It was not as bad as I expected and I did learn some useful things. I also met an amazing patient who has truly touched my heart. She is a very sick girl and she remains in my thoughts and prayers daily. She really needs a miracle.

I also received a lovely package in the mail from Nancy. She made me a lovely scissor fob and after hearing me whine about beading, she sent me a tacky bob! Can't wait to try it out but well there are no beads in AAGG so it might be awhile!

Not much else to report....enjoying the lovely weather we've been having, taking the dog for a walk and continuing to try to leave my work where it belongs.....but not so good at that.

Over the hump

Tired. That is the only word to describe my current lifestyle. I am surviving my current surgery rotation and though I don't really like it, I don't hate it either. I have completed 4 out of my 8 calls this month. Call is pretty brutal. I've only seen my call room (where the bed is) twice this month and I have only actually uses the bed once and that was for about 10 minutes. The service is busy and the paperwork is endless. The benefit is that I get to leave the morning post call so am usually home by 9 or 10 that morning. And yes, I sleep all day. I get up in the late afternoon, walk around in a fog and am back to sleep in the early evening. That gives you the magnitude of my exhaustion. (I slept for 20 hours pretty much straight over the weekend).

There have been some interesting patients.....the 15 year old that took a pregnancy test that came back positive, dx with an ectopic pregnancy that ended up being a cancer. THat pregnancy test saved her life. There is an epidemic of appendicitis and pyloric stenosis with multiple kids daly it seems. Couple of other interesting things that are too specific for me to talk about.

On the stitching front, I do so intermittently. I'm stil working on my fairy and stitch by stitch I am getting closer to done. It's hard to stitch though with your eyes closed. I've picked up my stitching more than once only to find I could see the holes straight because I was so darn tired.

You can see a picture here:

She is moving somewhat quickly (well in my stitching world anyway). I'm on the last color of purple. Then she needs shoes, some leaves, beads and BS'ing.

What next you ask? I think And A Garden Grows. I need a change of pace...lol.

Another month, another update

August is coming to a close. I have to say I'm not sure where the month went. I also have to say I'm not sure what I did. Oh wait, I know, I went to work, I came home, I slept. This was my second month in hematology/oncology, this time as a senior resident. I still like the field of medicine but well, as a career, I'm not prepared to sacrifice the amount of my life that these docs sacrifice.

It's been a long brutal month with record high census....some days as high as 35 patients. We have a different attending with different expectations every week. We are yelled at, dumped upon and given impossible tasks to complete. In short it's been miserable. On a patient front, it seems there is an epidemic of leukemia. I think we've had about 7 or 8 new diagnoses this month. That's a TON! Sadly, two toddlers that I took care of in February also relapsed this month. Both are on their way to bone marrow transplants. What a horrible journey that is. I pray for both of these beuatiful girls....how I love them both so.

What's up next? Starting Thursday I start surgery. No I am not looking forward to it. No I will not be doing any surgery. Yes I will be doing all of the surgeon's paperwork and dirty work like the slave that I will be. And to add insult to injury, next month is the last month that any resident will be on the surgery service. They have abused us so much that the program director has removed us from the rotation. I am so lucky though that I get to be one of the last 3 people to do the surgery rotation! Is it October yet?

In stitching, I'm not doing much of it. Working slowly on Thanksgiving Fairy. Here's a pic:

It's not a great picture. But took it quickly while I had the camera out downloading resident olympics pictures.

I'm on call today so I should head for bed. Have a great week!

A lot on my mind

Not much of an update this week. I didn't do any stitching at all last week. Looking back I'm not really sure what I did. Oh wait for a couple of days I was reading a book for a book discussion on my current rotation. The book was called "Roadmap to Holland". It is the story and sort of a guide to living the first 18 months with a child with Down's syndrome. Many great resources in the end of the book. The book itself....well, she doesn't talk about the child with Down's as much as she does his twin.

Otherwise, I've been going to work, coming home and fiddling on the computer. I'm not sleeping very well right now, a problem that I unfortunately have on months that I'm not on call (I think I get used to being so sleep deprived that I can sleep anywhere that when I'm not that tired I can't sleep). I'm still enjoying my rotation and will be sad to see it end (doing Behavior and Development). When I started residency, I thought it was likely that I would specialize in this area. I'm pretty convinced at this point that I will. I love the special needs kids.

DId my mommy call yesterday. It was pretty quiet. Only 3 calls. Unfortunately the first of the 3 occurred at 2:15 am Sunday morning. Did I mention my call didn't start until 9:00 am? GRRRRRRRRRRRRRRR. And about mid day I started feeling lousy. Spent quality time admiring my bathroom. Called in sick today since well, it's a good thing there was a bag in my car on the way to work today. Doctors.....not enough sense to stay home when they are sick. I'm feeling much better tonight.

I'm hoping my blahs will go away soon. I'm forcing myself to go out and interact with people even though I feel like climbing into my cave. The next 2 months are going to be hard, I need to find a way to enjoy my time while it lasts.

Enough rambling tonight.

JEOPARDY!

So one of the new responsibilities I have as a senior resident is to take jeopardy call. Essentially I am on call if anyone calls in sick, has a death in the family, gives birth. etc. I could be asked to go anywhere. NICU, PICU, ER, be an intern again. My first jeopardy call was yesterday. I could get called anywhere from 6 am to 6 am. I was like a deer in headlights every time the pager went off. I'd feel this internal groan mixed with trepidation. Thankfully, my pager NEVER WENT OFF and I spent my day on my regular rotation, ent home and went to bed (only slept 2 hours the night before) and continued praying the pager would stay quiet. IT DID!!! My next jeopardy in on Sunday, but Jeopardy 2 this time meaning someone else is called before me. I also have another "new responsibility" on Sunday. MOMMY CALL! My baby has a fever what should I do, my baby has a sunburn what should I do. Hopefully it won't be more exciting than that...lol. I'm actually looking forward to mommy call. But I'll be stuck basically at home attached to my pager all day so that I have access to the computer. Oh whatever will I do with myself?

I did get a bit of stitching on my fairy last week. She doesn't have a body but she has some wings! I think this has been one of the easier fairies. She's a lot of fun though!

A punch in the stomach

My greatest strength and my greatest weakness as a physician is the closeness I feel toward my patients. With that comes both great joy and terrible sorrow. How suffocating the sorrow can feel. How crippling it can be.

As is my habit, I signed on to the hospital electronic medical record tonight to check on some of my old patients that I knew were inpatient. Three of my patients were in ICU this week. One, a child that I saw through a terrible seizure and a stroke has made it out of the ICU and onto the main floor of the hospital and is seemingly doing well. Two, one of my cardiac babies, still on a ventilator and appears to be holding pretty steady.

And three, a beautiful 12 year old girl who I admitted in February with relapsed leukemia, whose only chance for survival was a bone marrow transplant, who has not seen her home since that day in February when I admitted her. Her name is gone. It is no longer on the inpatient census. I cannot breathe, I know what this means. SHe had been doing so well until late last month. She was looking forward to going home with her new fresh healthy bone marrow. She was smiling again. And now she is gone.

It was not unexpected. I knew she was doing very poorly with the most sophisticated ventilator being used in an attempt to help her breathe as they tried to find an explanation for why she was struggling so. I knew 2 weeks ago that she likely wasn't going to make it. Still, the tears are falling now, and I write as a way to release some of that pain. I pray for her and her family with the hope that she is now dancing in heaven with her hair grown back and a big smile on her face.

I close with my heart heavy tonight and an almost frantic feeling that I should do something anything to make sure I make the most out of everything in my life. Will this ever get any easier? Do I want it to?

A rewarding day

I so often write about the emotionally difficult and exhausting things that happen in my daily life, I thought it would be nice to post a more happy event.

My favorite part of residency is my continuity clinic. The patient's I see here are MY patients. I am the Dr. They identify me as their Dr. and though I am supervised, within reason, I treat the patients as I wish.

A couple of months ago I saw a new patient, a 5 year with family concern for autistic like behaviors. This child was completely out of control. He could sit still, he didn't listen, he always played by himself and would have temper tantrums. He did talk but he was very difficult to understand and could not make any s or f sounds. He was tremendously uncooperative with the exam. To complicate things, he also had a hoarse quality to his voice that had persisted for a year. I was very concerned about his development and knew he needed some more evaluation so I made a bunch of referals.....to ENT, speech, hearing eval, behavior and development.

Today I got the results of his hearing evaluation. He has profound hearing loss in both ears. Unusual that this was not caught sooner.....but easy to miss because he was such a difficult child to examine. He is getting fitted for hearing aids and I have high hopes that this will turn this kiddo's life around. Of course I also gave a big sigh of relief because I didn't miss it...and let's face it, he's 5 years old it's been missed multiple times before.

An intern no more

WOW.....it's so hard to believe that it has been a year already, though on the other hand I didn't think this day would ever come. A year ago today, Ientered Children's Hospital in my fresh clean white coat with a bounce in my step and anxiety flowing in my veins. Upon graduation I had in one moment been transformed from "medical student" to "doctor".

The year in review:

July: Outpatient Pediatrics......felt like more of medical school. BOOOOOOOORRRRRING. And I caught the worst virus of my entire life. And personally learned what chills and cold sweats felt like.

August: NICU On call the first day of the rotation. I remember the first phone call from a nurse that required me to make a decision.

Nurse: "Baby Peanut had a 10 mL aspirate".

Me: "Ummmm.....ok, I'll come see the baby" (Internal dialogue, holy crap what's an aspirate?)

Me: {looks at baby, appearing all doctorly} To nurse: "You know I'm an intern"

Nurse: "Yup"

Me: "and you know it's August and let me add I did outpatient last month and learned nothing"

Nurse: "Yup"

Me: "OK, so well, what's an aspirate?"

Nurse explains that an aspirate in undigested formula pulled from the baby's stomach before the next meal is fed to these tiny baby's. Large aspirates can be a sign of serious intestinal infection in a preemie.

Me: "So, what are my choices"

I am presented with three choices and I choose one to which the nurse replies

"Hmmmmmmmmmm"

Me: "I see you don't like that choice, what would you do?"

And thus I made my first decision as a Dr. It' very funny now....not so much at the time.

I became very attached to my preemies...and as a matter of fact I still see 13 of them regularly in my clinic. I lost one baby that month which still brings tears to my eyes but I also witnessed a true miracle. Baby E came into this world weighing 1 lb 12 oz, blue and lifeless. I had to do chest compressions and bag this tiny thing. HIs changes of survival wre less than 20% and his chance of leading a normal life were minicule.

Meet Baby E at 9 months old

Just beautiful.

September: GREEN TEAM This is Adolescent Medicine/Pulmonary/Renal. I hated it, it was miserable. It is over. I have nothing esle to say.

October: Newborn Nursery What a truly happy rotation. I was the little dark thundercloud of doom though. I could bring all the pregnant women in the area into the hospital to give birth on my call nights. I hold the record for the most babies born on a single call day at 17. I also had a 14, 11, and 10. I still see several of these babies in my clinic as well.

November: I bought a house and moved in. Had a rotation of lectures and went on vacation.

December: RED TEAM I was disappointed that I didn't enjoy this more. This rotation was general inpatient pediatrics. Asthma, pneumonia, dehydration. I didn't particular bond with any patients and well I didn't like my senior resident.

January: ER. I had fun, learned alot and was sad to see it end.

February: Heme-Onc The greatest surprise of the year.....this was my favorite rotation. The disease process is interesting though sad. But you get to know your patients well. The relationships I made with these families still continue when I see them in the hospital. I'm returning to heme-onc in August to see if my love of this field is real.

March: Cardiology Not my favorite subject. But I did manage to not let die a 16 year old having a cocaine induced heart attack.....and the page to the cardiology fellw from me was classic "Patient X ont he floor, now complaining of crushing chest pain, ST changes on EKG, need help now" AMazing how fast things happen when something bad is happening. I couldn't find the drugs I needed on the computer eletronic order system so I called the pharmacy and was like I can't find it online but I needed it NOW and presto I had the meds. I recruited a baby to my clinic (see a trend?)

April: 2 weeks of my clinic (bliss) and vacation

May: Neuro.....loved it, bonded with my families. Was sad to see it end.

June: Red team again. Better this time but I don't like the rapid turnover of patient's. I like to get to know my families.

So now that I'm an all experienced 2nd year resident what changes other than I am not called an intern anymore.

Not much. I have fewer call months. (5-6 instead of 9). I'm the senior resident on the wards and have interns that answer to me for 2 months. My other call months are more difficult with sicker kids....surgery, ped ICU, NICU with sicker babies. I have the responsibility of doing more teaching to interns and medical students. And I have to figure out what I want to be when I grow up. I also have to take the boards and get my liscense.

So really, completing intern year though I. AM. SO. EXCITED. is just a hurdle in the process and I have 2 years to go.

Stephanie

In memory of Nicholas

This is what makes my job so hard......but makes me stronger for having known him. This is the first child that I have lost that I had direct long term patient care with. My heart was broken as I followed his condition. Privacy laws prevent me from saying much....but newspaper articles are public record.

Nicholas you were a beautiful child that brought joy to many. May you run free in the heavens and may the memory of your giggle be remembered by all that care for you.

http://news.nky.com/apps/pbcs.dll/article?AID=/AB/20080606/NEWS0104/806060391

Another month, another update

Where the heck did May go? Normally, when I start a new rotation, the first week is nerve wrackng as I adjust and learn the most common problems and how to deal with them. Then the second 2 weeks are pretty smooth and then the last week you count the hours til it's over. Not so this month.....the beginning of the month wasn't really all that nerve wracking and well I thought it was still the beginning of the month! I'm finishing up my neurology rotation which as some of you may remember, is a field I almost went in to. I truly love neurology and I have enjoyed my month despite the fact that it has been the most tragic month of my year.

We've had more than our fair share of brain tumors this month......4 to be exact. One will be fatal, heart breaking for all involved to imagine that this beautiful 11 year old will likely not live to see 13. One was pleasantly benign....and all removed a tremendous relief to their parents. Two the future remains uncertain with one still trying to survive the surgery and the second awaiting multiple pathologists verdict about what the heck he has. Then there was my sweet toddler that come in with eyes that wouldn't stay still new onset of loss of balance. Her symptoms have a name.....opsoclonus myoclonus. And this symptom is associated with neuroblastoma, a terrible childhood cancer about 50% of the time. So I went in search of a tumor, and sadly I found what I was looking for. A tumor in her chest. My fingers are crossed for her.....usually children that present with the eye and balance problems do well. I will keep praying. And finally, my current patient, 3 months old, that came in with new onset seizures....and a CT scan that showed that large parts of his brain did not develop. Or worse, his brain may be degrading. So hard to tell the parents this, a normal baby to them one day....and now a future of total and complete uncertainty.

Truly an emotionally difficult month. I'm learning to leave things at the hospital when I leave though....that helps. And I like the people I'm working with this month. Another plus. My last day of neurology is Thursday. Then I start my final month of my intern year. The year has gone so fast (sure hope June does as well). My finial month is on a General Pediatrics team.....lots of asthma, pneumonia, gastro, etc. Not my favorite but I'll survive.

On the stitching front, I manage to stitch about once a week or so. I've started studyng for boards so I have less free time....and well I like to play in the yard to. Still working on Live Simply, the RAK from Lori. It;s coming along great! You can see it here.

I also did some stash shopping today. Bought the 2 Mirabilia fairies I didn't own and some beads, fabric and floss for some reindeer.

Until next time!

Stolen from Mel's blog

You Are 50% Addicted to the Internet

You're somewhat addicted to the internet - but who isn't? You can keep it under check, and you're by no means a hermit.

Are You Addicted to the Internet?