Friday, October 31, 2008

Happy Halloween Part 2

I found something else that might scare you. This one makes my stomach churn. I can look at blood and see water gush out of a woman's uterus/vagina (bed I surprised you there! - I saw some births over the past few days, which I will write about soon). In the mean time below is a picture of something that if I stare at it long enough makes my tummy feel funny. And yet I keep looking because I have a certain fascination with it.
My Aunt Edwina sent this to me in an email today. She works at a wildlife refuge outside of Willows.
This was outside our back door at work this morning. Someone saw this outside their backdoor at work on the wall.

Here's here e-mail:
It is about 2 inches from front legs to the back legs. It is covered with babies. Rachel (co-worker) saw on the morning news if you were to see a spider on Halloween it meant that your deceased loved ones are watching over you. Happy Halloween. Ed

I guess all the babies are there to make sure everyone at work is being watched over today!

I highly suggest clicking on the picture - this way it will make it larger so you can get the full effect and really appreciate the 100s of babies on the spider's back! ewww...





Thursday, October 30, 2008

Happy Halloween!

Creepy, crawly, it's that spooky time of year!

Below are some pictures of various decorations that are scattered about my house.

Here's a link to a scary story to spook your imagination.
The Tell-Tale Heart by Edgar Allan Poe.
Tell me that a dismembered heart doesn't scare you!







Wednesday, October 29, 2008

Happy Birthday G-ma!




Here's a little Happy Birthday post for my Grandma Ann!
I Love You!





And a couple of fall pictures from this year that I promised.
Lots to tell - I've been busy these past few days, but it's nearing my bedtime so I will have to post about the excitement later in the week!

Monday, October 27, 2008

Giving Back



I don't know why, but recently I have been thinking about Trinity a lot. Partially I guess in reference to my last post. The subject of college came up again in a conversation this past weekend, which of course always takes me back. I wouldn't give up those 4 years for anything. Trinity prepared me well for medical school and life. The dorm experience and being part of the Trinity bubble for 4 years was a wonderful experience. I enjoyed watching the campus change over my 4 years there & I look forward to the day that I get to travel back to SA town to eat at those familar resturants and wander around a campus that is sure to have changed since I left.

Last night my phone rang with a 210-999-xxxx number, which signifies an on-campus number. I didn't answer because I was busy and later put together that it's Phone-a-thon season. Soon students will be calling to ask for donations for scholarships. Well tonight they tricked me. Anonymous came up on my phone tonight & the curiosity got to me - I answered it. A little while later I had donated $20.06 to Trinity in recognition of my graduation year. And you know what - it made me feel good. To give back if even just a little to a place that has given me so much.

Thank you TU and thanks to all of the amazing people I met there who shaped my experience and me.

Thursday, October 23, 2008

Round 3


Deja vu - that's the feeling I have about this year. It's taken me 3 times, but I now recognize the pattern. Here I am in my 3rd year on the brink of rest of my life. I've stood here 2 other times - as a junior in highschool and in college. Again I am realizing that after this year I have one year left, before I move onto the rest of my life. In high school that meant applying for college, anxiously awaiting with my fingers crossed for acceptance letters.



Flash forward 4 years - there I was as a junior at Trinity, compulsively checking my email for med school interview opportunities and daily checking my mailbox hoping for the infamous thick envelope deciding where I would spend my next 4 yrs.



Flash forward 4 years again realizing that hopefully I have 1 year left on the east coast before I once again move onto the rest of my life. Yes - I've changed, I've grown, and I've learned. The funny thing is that the emotions are still the same. Excited yet scared. Wanting to explore my surroundings that much more, because I only have 1 year left. Knowing that I will be leaving my friends here for another one of life's great adventures. We will always be connected by medical school. As I am connected to my childhood friends from Willows and my Trinity friends.
I look ahead at the year and now realize these feelilngs I've felt before. It's odd. In less than a year I will repeat what I did 4 years ago - apply for residency and then compulsively check my email for the opportunity to interview. Then cross my fingers and hope I match on that infamous day in March.



In a way after next year I will repeat this cycle one more time. Residency for 3-5 years or more depending on the specialty I choose. Then interviewing for a job.
Cyclic just like the seasons...

Wednesday, October 22, 2008

an escape

Quick post tonight, because I just got done working a 16 hr shift. The last few hours I've just been studying, but we were pretty this afternoon/early evening visiting kids in the ED and deciding who to admit and who to send home. It was a good, but tiring day. So now it's shower time and then bedtime - repeat tomorrow (only 11 hr day!)

Today I thought I would share with you one of my daily pleasures - reading my mom's cousin Corey's blog. (not that I don't enjoy reading Ashley, Nava's, and now Sammy's blog) Corey is pretty faithful about posting everyday and takes beautiful photos. Her latest entries have been of pictures from the Musee d'Orsay in Paris (where I visited 7 years ago!). Her blog is often times my little break from reality - transporting me to France, to antique markets, and famous museums even if only for a few minutes.
Here's a link: http://willows95988.typepad.com/

Tuesday, October 21, 2008

It's Here, It's Here!!!!




Fall has finally arrived. The cool crisp air that hits your face and fills your lungs making you feel completely alive.

The leaves are starting to turn, the breeze is picking up.



Warm sweatshirts, hot cocoa, and the outdoors calling my name.

This weekend there will be a picnic - outside amongst the leaves!

Ahh... the changing of the seasons to remind one of the cyclic nature of the year and our lives. A reminder to enjoy each moment, for fall will be fleeting and soon winter will set in with snowflakes and the holidays!

So get out there and enjoy the weather. Go for a walk, take a deep breath and breathe in the beauty of fall.

P.S. These pictures are from prior years! I haven't had time to take pictures this year, but will this weekend. Pics from this year to follow. and don't think I've forgotten I owe you all pics of my dorm here in York. I will eventually get to them I promise! :)

Sunday, October 19, 2008

A small town called home

I've been a bad blogger. That tends to happen around the weekends for me.
Below is a link to an article my dad sent me in an e-mail.
I want to forewarn you that it is a rather lengthy and sad article that still manages to capture the essence and heart of my hometown.

http://sports.espn.go.com/espn/eticket/story?page=willows&lpos=spotlight&lid=tab8pos1

Wednesday, October 15, 2008

a day as an outpatient peds doc

I spent my day yesterday from 9-5 in an outpatient clinic. I'm actually in outpatient clinic all week - 2 full days and 3 1/2 days. I still see newborns and inpatient's in the mornings. I enjoyed my day today and think that I'm meant for something outpatient. I know, I know - I'm supposed to keep an open mind and I am trying my best, but I feel good at the end of a day in an outpatient clinic, be it family or peds (my only 2 experiences yet). The rest of the year is yet to come and we shall see how it all pans out. Next week I'm on inpatient all week - so I will let you know how that goes.

But my day yesterday:

Your typical well child checks - 4 mo, 12 mo, 18 mo, etc. Those are just run of the mill - answer any questions parents might have. Make sure the kids are hitting all of their milestones - can they sit up, are they walking, talking, eating solid foods.
One specific cute 18mo old knew a little bit of sign language and made the best faces when I pushed on his belly and touched him with my cold hands. Another parent was worried about bubbles in their baby's poop. Dr. H calls them poop watchers, which most parents are. You only have to worry about it if it's red, watery, or black. Those are Dr. H's rules to poop. Personally, I think the baby is just making fart bubbles in her diaper.

Then we had a kid come in for a refill on his ADHD meds. Seemed like your normal quick visit for some amphetamines to help control the child. Some parental counseling about not letting this kid have a tv in his room, since mom is concerned because the child has a hard time falling asleep at night. Interesting part about this child is...as he is checking out he decides to turn around and vomit all over the floor. He seemed fine when I saw him. I asked...do I have to write that in his chart? Dr. H says pretend you didn't see it. Most likely viral illness. He'll be back in a few days if he's not feeling better.

Then a few 10 year olds came in for nausea, vomiting, and sore throat. Apparently in children usually 10 and under this is how Strep throat can present - with the nausea and vomiting. I saw one of the kids and Dr. C saw the other one. This boy had the best posterior palate petechiae I have ever seen! picture perfect - see below red dots on posterior palate!
this pic was taken from www.strepthroatinformation.com

So we did a throat swab. Rapid strep test came back negative. We thought this was rather unlikely seeing as his history and exam made it seem extremely likely. Dr. C did the next throat swab and definitely got a good sample - gagging and tears coming out of his eyes. We really wanted to treat him if this test was positive to quicken the course of the illness. Her swab came back negative too! The swabs are also sent out for culture which is more sensitive at picking it up. If it's positive then we'll treat. Otherwise for now it's most likely viral.

Followup Emergency Department visit for a child with a history of asthma and cough/cold. Kid also had epistaxis (bloody nose) 2x's yesterday am. This child's lungs sounded fine, he looked well - happy 15mo old interactive, alert, etc. Dr. H has seen this patient before and most likely a case of overly worried mom. So we talked to her some - the kid just has a cold.

That's all I remember for now. This is getting to be pretty long. So there you go - a typical day. May sound boring to you, but I enjoyed myself (minus the 4mo well child check where the baby didn't stop crying for the entire visit!).
Ok off to eat lunch and then back to clinic this afternoon!

Monday, October 13, 2008

Disneyland




My mom, Aunt Ed, and a friend of theirs are on their way to Disneyland! I wish I were going! They are going to see it decorated for Halloween and enjoy all the wonderful rides, etc.
As a kid, I have about a million memories of Disneyland - I went a number of times due to my A. Ed living near L.A. and my Dad going to some grocery conventions in the area. I remember playing with the little sample boxes he would get at the conventions.

And no matter how old I get - it is ingrained in me how "we do Disneyland." It's reflexive for me to approach any trip to Disneyland in this fashion. Someday I hope to take my kids and pass on this crazy neurotic tradition to them.

We have our system (really my mom & aunt's system) of how to make sure we get the most out of Disneyland. First, you must understand we are ride people. That's ultimately why we are there. You have to arrive as soon as the park opens - which means be at the gates when the park opens ready to go. Hit the big rides first - the ones with the longest lines (space mountain, Indiana Jones, etc). Then from there you can space out the other rides depending on where you are in the park and where your fast passes take you. In the afternoon when it gets hot, we take a trip back to the hotel for naptime (more so when I was young and needed the nap). After missing the heat of the day it's back to the park to ride more rides. The first day on any trip to Disneyland I was allowed to watch the Light Parade - now they have some other parade. The next day (we were usually there for more than one day) - there is no watching the parade - it is prime time to ride the rides while everyone else is watching the parade. And that's how we do Disneyland!



I'll never forget one trip when I was younger, my mom and I rode Splash Mountain late at night. As soon as we got off the ride soaking wet, we were freezing cold - we ran to the nearest souvineur shop and bought sweatshirts to keep us warm! It may not seem that exciting, but when you're a little kid running through Disneyland at night with your mom in search of a brand new sweatshirt is pretty exhilirating!


My one and only tea cup riding partner!

Ah...Disneyland the happiest place on earth ;)

Friday, October 10, 2008

moo mama moo

This article was posted on a cupboard in the newborn nursery. I thought it was interesting and wanted to share it with you!

http://www.time.com/time/health/article/0,8599,1844721,00.html

Breast milk ice cream? It's cruel to milk cows, but not people? Not to mention all the other issues associated with such an absurd idea.

Wednesday, October 8, 2008

When normal becomes abnormal

I've noticed over the past few months in both my family practice rotations and this pediatrics rotations that I am excited and surprised when I walk into a patient's room to see both a mom and a dad sitting there with their child. This is a rarity. It's a rarity to find a married couple excited and curious to learn about their new little one. You would be surprised the family dynamics that can be observed in a 15 minute visit. My insides smile when I see parents who you can tell care about each other and show love and concern for their little one.
It is far too often that I see teenage and single mothers with these babies that yes they love, but just want them to be better so they will stop fussing. I am not saying that a teenager or a single mother cannot be a good parent, I'm just commenting on what I have been observing far too often. It is amazing the developmental differences between these types of kids - the ones who are nurtured and truly cared for compared to those who are left in front of video games or the tv all day.
It's a tough job for both the physician who has a limited amount of time with their patients - often referring to social services when needed. I have lots to learn about social services and what they can do for my patients. Don't worry I have the perfect resource - social worker in training - Ashley Melson.

One more example of when normal becomes abnormal. Melanie was in outpatient clinic the other day and this mother came in worried that her children were not gaining enough weight. She said she felt they were too thin and wanted to know if it was a problem. The doctor said nope - the children are fine and are at a very good weight for their age and height. The reason that your kids look so thin is because many of the other kids are overweight!

Monday, October 6, 2008

Cherry triangles, gnocchi, and jelly




So I was thinking about what to write today. I realized that even though I brought my camera with me to York that I forgot the cord to my computer. So you have to wait 1 more week to be able to see pictures of my lovely dorm room. This will give you the full effect when I have had more time to settle in (aka spread all of my crap everywhere in a chaotic mess).

In thinking of this I remembered what I get to look forward to this weekend. My Grandma sent me pomegrantes! Yes! I love pomegrantes - just eating them plain or adding them to a salad. The worst part is peeling them and trying not to stain whatever clothing I have on. Grandma's pomegrante jelly is the best. Lucky for me that stays good all year long!



Looking through some pics I found a few of Gma teaching the kids and grandkids some things. The types of dishes where recipies are a suggestion rather than a rule. The cooking is based more off of a feel and experience that exact measurements. The fine art of baking that cannot really be taught, but only learned through obesrvation and practice.



Throughout the post are pics of the fam learning to make yummy cherry triangles and gnocchi. I don't have any pics of us learning to make fillozes (portuguese donuts). Those are my absolute favorite.



Sunday, October 5, 2008

texting

Many of you probably heard about or read about the train wreck caused by a person text message. Well - according to a magazine I get from AMSA (american medical student assoc) text messaging while walking has led to enough emergency room visits (stepping off curbs, falling down, walking into poles, etc) that the American College of Emergency Physicians has issued an alert about how dangerous it is.
There have even been injuries reported while bicycling, riding a horse adn cooking noodles. 2 texters lost their lives after being hit by cars while texting.

It seems like common sense, but I know there are a lot of us out there who text when we should be paying attention to other things. Just something to keep in mind.

Saturday, October 4, 2008

little surprises

So much for writing everyday. I missed yesterday already. Can I say that the weekends don't count? haha It feels so good to be home for the weekend. I got to have a nice hot shower in my own bathroom and sleep in my own bed nice and big and cozy warm.

You know the feeling of when you pull on a pair of jeans and stick your hand in the pocket to find $5 dollars. I love that feeling. Well, today I used a purse I haven't used in a while and it's sort of the same way - filled with surprises you wouldn't expect. I found a hair tie, floss, a halls cough drop, and some old stuff from when I was on vacation in China a few summers ago with my parents.

I found a quote I wrote down on a card while we were out somewhere sight seeing. It must have been a translation - but here it is:

"Life isn't about waiting for the storm to pass, it's about learning to dance in the rain."

Thursday, October 2, 2008

takes me back to the old days

I'm trying to write something everyday. My first night of call and nothing eventful happened. from 5-10 pm I just hung out and did some studying and then watched 1 hr of the debate.
Took a shower and now it's 10:45 and time for bed. Up to the newborn nursery at 6 am hoping there will be a baby there waiting for me.

Being back in this dorm, eating dinner with my buddies takes me back to the old days.

Another quote from starbucks:

"The way we get to live forever is through memories stored in the hearts and souls of those lives we touch. that's our soul print. It's our comfort, our emotional nourishment at the end of the day and the end of life. How wonderful that they are called up at will and savored randomly. It seems to me we should spend our lives in a conscious state of creating these meaningful moments that live on. memories matter."
- leeza gibbons

Wednesday, October 1, 2008

the start of real 3rd year

Yesterday we had orientation at the hospital here in York - where I will be for the next 6 weeks. I am finally on an inpatient service, which means I am working in the hospital. Working in the hospital requires more work and less sleep than my past 3 months of 3rd year. This is what I mean to the real start of 3rd year. Now comes those times when I will have call (even though call for us is only from 5-10pm, not overnight). I will have "my own patients." Not really mine, but I will follow them and be responsible for seeing them each morning before rounds.
Here's what a typical day will be like for me in the next 6 weeks.
Wake up early - go to the newborn nursery and do exams on the new babies before the residents arrive at 6:45-7:00ish. Then head over to the inpatient floor and visit all of my patient's, do an exam and get any updates or changes since the last time I saw them before 8am. At 8 we have a lecture and 9am we have rounds. Rounds consist of going around and discussing the different patients the team is seeing. (the team consists of attendings, residents, and students) After discussing the patients, their progress, treatments, etc - we will go see the patients and re-check how they are doing.
Next may be another lecture or a simulation lab or just time to read until lunch. My afternoons here change daily just depending. Some afternoons we have off and others are spent in an outpatient clinic, etc. Today I'm heading to an ENT doc's office for the afternoon.

Oh and it may sound busy, but... today we only had 1 newborn on our service and 1 inpatient. We still have to be up early to make sure no new babies were delivered overnight and be done seeing our patients by 8. I have this feeling it's going to be slow or super busy. We shall see!

I'll keep you posted! :)