The Wienerschnitzel Nationals are coming to Tucson - March 3rd. Not sure if I can make it, but I'm sure Buster would be able to win.
Tuesday, February 22, 2011
Monday, February 21, 2011
Back to work
I've been back for two weeks now from vacation. That first week back seems so very tough. By the end of last week, I was zonked- I felt so completely drained. Saturday night I went to bed at 9pm and slept in until 7:30am. Heck, I was happy that was 10 hrs of sleep.
Right now I'm on inpatient medicine - which means that I work in my base hospital and take care of adults who are in the hospital for various problems - ranging from shock to heart attacks, from pneumonia to osteomyelitis (bone infections), from diverticulitis to altered mental status, from deep venous thromboembolism to urinary tract infections and everything in between. It is interesting to say the least. It is one of our harder rotations, but also one that I learn A LOT nearly everyday.
I was going to take the time in this post to share with a quick view of what an average day is like, because if you've ever been a patient or a visitor of a patient in a hospital - you are probably wondering where is the doctor?
I wake up between 4:45-5:00 am, let the dogs outside before Penny decides to pee in the house. Feed the dogs bfast. Shower (or not if I did the night before), throw on some scrubs, grab a quick bfast then head out the door by 5:30-5:40. Sign out (which is where the night doctor tells us if any significant events happened overnight with our patients. Then 6:15-6:30ish we look at any new labs online, vital signs, etc and go see the patients. We meet at around 8:00-8:30 and round with the attending. (This schedule is what happens in a teaching hospital where there are residents - in other settings some of these steps are removed and many physicians still run clinics during the days while they check in on their patients either in the mornings or evenings). Rounding consists of us presenting the patient's to our boss. Going over the new problems, what we are doing to fix the problem, physical exam, etc. This is where a lot of our teaching happens. After rounds, the we go back to put orders - such as changes in medication, diet, new tests needed, etc.
In the afternoon we work on getting discharge paperwork finished. There is A LOT of paper work that has to be filled out to get patient's discharged from the hospital. In addition, we often have to act like detectives trying to track down old medical records or call pharmacy's to find out the dose of patient's medication, because.... well - they often don't know what their medications are or if they know the meds, they don't know the doses, etc. We also call consults if we need a specialist opinion, follow up tests, and admit new patients that come in from the emergency department or the clinic. Which surprisingly can keep us busy all afternoon. In addition - nurses are calling asking questions. Each time the phone rings - I think to myself silently, please let me able to answer this question. My knowledge is growing, but I still have a LOOOONNNNGGGG way to go.
This keeps us busy all afternoon until evening signout at 5pm, where we tell the night team what to watch out for, who to follow up with, etc. That takes us until 5:30-6pm and thus there is your 12 hour day x 6 days a week. Whew - let me tell you it wears on you and man am I tired by the end of the week.
Tomorrow I promise a fun blog post that will be sure to make you smile :)
I wake up between 4:45-5:00 am, let the dogs outside before Penny decides to pee in the house. Feed the dogs bfast. Shower (or not if I did the night before), throw on some scrubs, grab a quick bfast then head out the door by 5:30-5:40. Sign out (which is where the night doctor tells us if any significant events happened overnight with our patients. Then 6:15-6:30ish we look at any new labs online, vital signs, etc and go see the patients. We meet at around 8:00-8:30 and round with the attending. (This schedule is what happens in a teaching hospital where there are residents - in other settings some of these steps are removed and many physicians still run clinics during the days while they check in on their patients either in the mornings or evenings). Rounding consists of us presenting the patient's to our boss. Going over the new problems, what we are doing to fix the problem, physical exam, etc. This is where a lot of our teaching happens. After rounds, the we go back to put orders - such as changes in medication, diet, new tests needed, etc.
In the afternoon we work on getting discharge paperwork finished. There is A LOT of paper work that has to be filled out to get patient's discharged from the hospital. In addition, we often have to act like detectives trying to track down old medical records or call pharmacy's to find out the dose of patient's medication, because.... well - they often don't know what their medications are or if they know the meds, they don't know the doses, etc. We also call consults if we need a specialist opinion, follow up tests, and admit new patients that come in from the emergency department or the clinic. Which surprisingly can keep us busy all afternoon. In addition - nurses are calling asking questions. Each time the phone rings - I think to myself silently, please let me able to answer this question. My knowledge is growing, but I still have a LOOOONNNNGGGG way to go.
This keeps us busy all afternoon until evening signout at 5pm, where we tell the night team what to watch out for, who to follow up with, etc. That takes us until 5:30-6pm and thus there is your 12 hour day x 6 days a week. Whew - let me tell you it wears on you and man am I tired by the end of the week.
Tomorrow I promise a fun blog post that will be sure to make you smile :)
Friday, February 4, 2011
Vacation Recap
My vacation is slowly coming to an end. Ok, not slowly - but rather quickly. That's how it always seems while on vacation.
After my medical lesson for this vacation - I got to slip away for a little while.
Lake Tahoe was the destination. Cold crisp air and beautiful views!
This was Sief's first visit to Tahoe as well as his first time hitting the slopes. As the smart girlfriend, I stuck him in ski school for the day. He received professional level instruction as well as patience. :)
After my medical lesson for this vacation - I got to slip away for a little while.
Lake Tahoe was the destination. Cold crisp air and beautiful views!
This was Sief's first visit to Tahoe as well as his first time hitting the slopes. As the smart girlfriend, I stuck him in ski school for the day. He received professional level instruction as well as patience. :)
Sief getting his rental boots fitted. Cousin Nate behind him.
Ready to hit the slopes!
Love the view from the top of the hill. Beautiful Lake Tahoe. A site that never gets old. Not much snow though.
Ski school. Can you tell which one is Sief?
They no longer have the rope tows I was used to as a kid in ski school. Instead now, they have moving rubber mats that they can stand on.
The next day we decided not to go skiing again. The hills were icy the day before and we felt it was better not to push Sief's new skills too far too fast. Falling on ice is not fun. Instead we went on a mini hike down the street from my aunt and uncle's house to Zephyr Cove.
The drive home. It snowed the night before we were supposed to leave. Ugh...we missed a great day of skiing. I tell myself that it was snowing and windy on the mountain and that I would have been freezing.
Got in a lot of reading time on the drive back, as well as on the drive to and from San Francisco. There's nothing like a good book - the kind where you get lost for hours on end. Eagerly reading, not wanting to wait to find out what happens next.
Next stop on the vacation trail was San Francisco. A quick overnight trip, mainly for the opportunity to eat good dim sum.
Penny got to go with us. Lucky girl. There wasn't any way she was going to miss out on an opportunity to be pampered in the big city! Pictured above, is Penny at the little doggie station in the lobby of our hotel. There was water, little doggie treats, and milk bones. Penny doesn't like milk bones. She was polite at only took a treat if I gave it to her.
Penny was not a huge fan of the city. Too many loud noises. On our first walk, every 3-5 seconds she would turn around to make sure I was still there. And a man with a shark puppet on his hand asked if he could eat her! No wonder she was scared.
Dad and Mom at union square - snack time! The closest patch of grass for Penny to do her business.
Now we can't miss wine hour in the hotel. This was before a most delicious dinner with my Uncle Russ and Aunt Sharon at a French-Japanese fusion restaurant in Japan town.
Penny got a fancy dinner too! Dinner in bed :)
And...vacation not's over until I meet the newest member of the family. Little Ruby Jo.
Edwina got a new puppy. Ruby with her red dress on!
Isn't she adorable?!
Penny trying to play with her new found friend. poke, poke - let's play Ruby.
There were more babies to meet!
Baby Trent's cutesy little feet. Trent is Sara McGrew (formerly known as Sara Hall's) little one.
Trent 4 weeks and Carter Couto at 7 months. So cute with their matching outfits.
Sooooo cute.
Do you think Penny was jealous?
I fly out tomorrow and am back to work on Monday. Unless of course you count packing, driving (well riding) to Sacramento, and navigating the airport with 2 dogs in dog carriers, sitting in the plane listening to Buster cry the entire way back to Tucson (hopefully not) as still part of my vacation.
Monday, January 24, 2011
A Vacation in Eyes of a Patient
I have officially started my 2 week vacation. YaY! 2 weeks of freedom, sleeping in, 2 weeks away from the hospital and patients....or not ;)
Life is a constant journey and learning does not stop when vacation starts. Since the start of my vacation, I have spent some time each day in a hospital. I am not held down by the weight of my white coat, nor do I know the halls like the back of my hand. My stethoscope does not hang across my neck and the patient's in the rooms are not my responsibility, well all but one. Grandma Ann is mine. My job is to sit, keep her company, and try to get her to eat. No orders to write, no heart to listen to - my time is spent nearly on the opposite end of where I spend my working days. Not quite a patient, but a family member - watching and waiting.
I've learned a lot in the past 3 days. Observation is an extremely valuable tool. I notice details that as a physician writing orders and stopping in to see the patient once maybe twice in a day that I otherwise miss. I hope that as a family physician, I do better at looking at the entire patient and addressing all of their needs compared to a specialist. That is what my training is supposed to do. I'm learning so much right now. I watch and see more of what the nurses do - how much time it takes to check on each of their patients, to change IV meds, etc. I listen as my grandma's roommate calls for someone to help her to the bathroom, not once, but twice in a 20 minute period and does not get help until her visitor finally steps out into the hall to get someone.
It's weird to be in a hospital and have no power. To anyone passing by, I'm sure I look like my grandmother's 15 year old grand daughter sitting on the bed next to her. Or maybe college aged. I ask a lot of questions and maybe seem to know more than an average teenager. They probably believe I hope to be pre-med or maybe they just see me as one of those annoying family members who asks too much. I try to sit back and let things happen, but it's hard to see her in pain and not be able to go write an order for more pain medication.
After spending this time with my grandma, I know the next time I walk into my own hospital - white coat and stethoscope on my outlook will be slightly different. I will be reminded to look at the bigger picture - to try and take the time to care for the entire patient, to better explain the treatment and what is happening. How long will my new found knowledge last? a few days? a week? a month? Hopefully it will be incorporated into my daily routine and will not be something that falls to the wayside as my work increases and the time I have to do it in decreases.
Here's to a vacation full of learning. My education continues tomorrow...
Life is a constant journey and learning does not stop when vacation starts. Since the start of my vacation, I have spent some time each day in a hospital. I am not held down by the weight of my white coat, nor do I know the halls like the back of my hand. My stethoscope does not hang across my neck and the patient's in the rooms are not my responsibility, well all but one. Grandma Ann is mine. My job is to sit, keep her company, and try to get her to eat. No orders to write, no heart to listen to - my time is spent nearly on the opposite end of where I spend my working days. Not quite a patient, but a family member - watching and waiting.
I've learned a lot in the past 3 days. Observation is an extremely valuable tool. I notice details that as a physician writing orders and stopping in to see the patient once maybe twice in a day that I otherwise miss. I hope that as a family physician, I do better at looking at the entire patient and addressing all of their needs compared to a specialist. That is what my training is supposed to do. I'm learning so much right now. I watch and see more of what the nurses do - how much time it takes to check on each of their patients, to change IV meds, etc. I listen as my grandma's roommate calls for someone to help her to the bathroom, not once, but twice in a 20 minute period and does not get help until her visitor finally steps out into the hall to get someone.
It's weird to be in a hospital and have no power. To anyone passing by, I'm sure I look like my grandmother's 15 year old grand daughter sitting on the bed next to her. Or maybe college aged. I ask a lot of questions and maybe seem to know more than an average teenager. They probably believe I hope to be pre-med or maybe they just see me as one of those annoying family members who asks too much. I try to sit back and let things happen, but it's hard to see her in pain and not be able to go write an order for more pain medication.
After spending this time with my grandma, I know the next time I walk into my own hospital - white coat and stethoscope on my outlook will be slightly different. I will be reminded to look at the bigger picture - to try and take the time to care for the entire patient, to better explain the treatment and what is happening. How long will my new found knowledge last? a few days? a week? a month? Hopefully it will be incorporated into my daily routine and will not be something that falls to the wayside as my work increases and the time I have to do it in decreases.
Here's to a vacation full of learning. My education continues tomorrow...
Saturday, January 15, 2011
A doggone good day!
Great weekend so far.
Friday night, Sarah and I made grown up mac and cheese and had another friend over. We just lounged around, drank some wine, watched some tv, and laughed A LOT. It always feels so good to have a nice good long laugh and to just be silly.
Buster included - he has a new game - it's called, "put my chin on your mouth while lying down." For whatever reason when you lie on the ground, Buster runs up and puts his chin on your mouth and if you move he moves his head to keep his chin on your mouth. It's ridiculous! I'll have to get a video soon and post it.
Today, we went out for dim sum. It was mediocre at best, but I didn't expect much seeing as we are in Tucson. The dim sum will do in a pinch, but doesn't hold a candle to San Francisco. Even the dim sum in the San Fran airport was better. But the dim sum in the airport was 3x's as expensive.
Next up on the list was taking Buster and Penny to Reid park.
At Reid park, Buster proceeded to chase the ducks and geese, until.....one of the geese turned and started trotting toward him. You can bet he turned and bolted.
Next up at Reid park was the dog park. This is the nicest dog park, I've ever been to. There was a section for big dogs and another section for little dogs. Penny and Buster had a blast running around the dog park. Well not exactly. I think Penny was freaked out half the time, but she did a pretty good job. She followed me most of the time, but she did make a few friends. Buster on the other hand ran wild. At one time he was being chased by 4 dogs, leading the pack. I thought it was all fun for Booster, until Sarah informed me he was being violated and.... sure enough as soon as he stopped this little Chihuahua like dog started to lick Buster's wee wee. Then Buster would run and then Oscar, the Chihuahua would start humping him. Poor Buster. Oscar was another little boy dog, wearing a red collar with a red flower on it. He was infatuated with Buster. Sarah had to pick Buster up to keep Oscar away and Oscar would just follow Sarah around, jumping up and down trying to get to Buster. Oscar's mom finally got him, but eventually he found Buster again.
Here's a picture of Aunt Sarah saving Buster from Oscar.
Friday night, Sarah and I made grown up mac and cheese and had another friend over. We just lounged around, drank some wine, watched some tv, and laughed A LOT. It always feels so good to have a nice good long laugh and to just be silly.
Buster included - he has a new game - it's called, "put my chin on your mouth while lying down." For whatever reason when you lie on the ground, Buster runs up and puts his chin on your mouth and if you move he moves his head to keep his chin on your mouth. It's ridiculous! I'll have to get a video soon and post it.
Today, we went out for dim sum. It was mediocre at best, but I didn't expect much seeing as we are in Tucson. The dim sum will do in a pinch, but doesn't hold a candle to San Francisco. Even the dim sum in the San Fran airport was better. But the dim sum in the airport was 3x's as expensive.
Next up on the list was taking Buster and Penny to Reid park.
At Reid park, Buster proceeded to chase the ducks and geese, until.....one of the geese turned and started trotting toward him. You can bet he turned and bolted.
Next up at Reid park was the dog park. This is the nicest dog park, I've ever been to. There was a section for big dogs and another section for little dogs. Penny and Buster had a blast running around the dog park. Well not exactly. I think Penny was freaked out half the time, but she did a pretty good job. She followed me most of the time, but she did make a few friends. Buster on the other hand ran wild. At one time he was being chased by 4 dogs, leading the pack. I thought it was all fun for Booster, until Sarah informed me he was being violated and.... sure enough as soon as he stopped this little Chihuahua like dog started to lick Buster's wee wee. Then Buster would run and then Oscar, the Chihuahua would start humping him. Poor Buster. Oscar was another little boy dog, wearing a red collar with a red flower on it. He was infatuated with Buster. Sarah had to pick Buster up to keep Oscar away and Oscar would just follow Sarah around, jumping up and down trying to get to Buster. Oscar's mom finally got him, but eventually he found Buster again.
Here's a picture of Aunt Sarah saving Buster from Oscar.
After the park, we got frozen yogurt with another friend and her kids, then off to dinner.
Here are the babies snuggle buggin' after their long fun filled day!
Hope you are all enjoying your weekend. I will be in the hospital tomorrow, working all day long!
Thursday, January 13, 2011
Resident nightlife
Or should I say lack there of.
Average evening - lucky enough to get off a little early and had time to the take the dogs for a walk. Ate some dinner, watched a little TV and now up writing clinic notes, eating hot chocolate, with a doggie in my lap.
Hey - it could be worse :)
Average evening - lucky enough to get off a little early and had time to the take the dogs for a walk. Ate some dinner, watched a little TV and now up writing clinic notes, eating hot chocolate, with a doggie in my lap.
Hey - it could be worse :)
Friday, January 7, 2011
Part 3 to present
Most recent hike. "Hiking through residency" hike #2 - apparently these are quarterly hikes! I need to go much more often. There are sooooooo many places to go, just not enough time.
Hiking pals - Penny and Buster.
Honeybee Canyon - it's a flat hike that is supposed to be good for taking children and doggies (or at least little doggies like mine)
Hiking pals - Penny and Buster.
Honeybee Canyon - it's a flat hike that is supposed to be good for taking children and doggies (or at least little doggies like mine)
If you look closely you can see snow on the mountains!
Maybe you can see it now?! It does snow here and get cold, brrrr...
Nice wide trail, helps to keep the doggies out of the cacti.
90% of the walk I had one hand out in front holding Buster back and the other hand behind me dragging Penny along. Walking 2 dogs is harder than it looks!
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Now I know it's sunny in those pictures and I will admit that it was warmer that day than I expected. Wearing my ski socks and a sweatshirt made me a bit over dressed and a little sweaty by the end of the hike.
But I swear it does get cold here. About a week ago, I woke up to get ready for work - walked in and went to the bathroom, I flushed the toilet and as I was standing at the sink, thought to myself that sounds funny.... Hmm... I turned on the faucet and had my answer. A trickle of water came through the tap. Uh oh. That's when I realized that our pipes had froze! Didn't expect that in Arizona now did you? Well neither did we. I was on call the whole day, but Sief wrapped our pipes and thankfully we got home all had been fixed. He also left a faucet downstairs dripping to release pressure in the pipes ( i know not eco-friendly, but better than busted pipes). Apparently relieving pressure is what prevents the pipes from bursting.
Golden weekend this weekend - both Saturday & Sunday off! Yippee! What shall I do???
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