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Thursday, August 19, 2010
Sometimes you wanna go...
So, with Surgery, comes the glamour of high-speed, critical patients, life or death decisions and exacting procedures that make you sweat just THINKING about what you're suppose to do to this person, let alone what it feels like when the scapel is in hand and you're about to cut skin! And then there's the long hours... and by LONG I mean, LONGGGGGGGGGGGG...
My day starts rounding on my in-patients at 5am. Throw in some dressing changes, a few unstable patients about to crump, and various people switching from one ward to the next and suddenly you're 50minutes into your 'lunch break' - which I have just deemed, "hour that normally people who have lives get to sit down and eat something, which I think is normally done around Noon???"...
Then, when you think you're exhausted and you've MORE than completed HealthParnters 10,000 recommended steps ten-times over... it's THEN time for you to do the FUN part - SURGERICAL CASES! Which IS fun, except that to have that fun it requires another 6+ hrs of standing... when all you want to do is lie down. Since starting in surgery - and I realize this is only day FOUR for me... but there is a funny paradox, in that STANDING is actually WAY more tiring then MOVING. In terms of fighting sleepiness, I'd so much rather see 40 bed patients running around to 8 different sections of the hospital, then STAND... in ONE spot for Four hours... it's grueling. It wears me out...
Which brings me to the point of this post. When the days get long and hard, and your separated from your Fiance, friends and family... you need an escape. Which I have found in my new favorite hang out - which is a) conveniently located on my bike ride home b) an obvious choice for it to win my patronage, because it is FRENCH themed! Yep... just like the bistros of Paris I miss so dearly!
They have Belgian beers you can only find on the old continent, make a MEAN true french style latte, and best of all -and I know Steph would appreciate this most if she could come out and visit me ;) - they have REAL French pastieres and chocolates and most importantly MACARONS! ;)
Plus they are open to Midnight and show free movies on Mondays, plus ample outdoor seating to enjoy the perfect Northwest summer nights. I've been hanging out there a lot after work to long in my patients, skype Ryan, etc... I look forward to it so much!
So here's a view of my post-work de-stressing session at "Pix"... ;) can't wait til tomorrow at 9pm for another round. Bisous!!!! - Mego
My day starts rounding on my in-patients at 5am. Throw in some dressing changes, a few unstable patients about to crump, and various people switching from one ward to the next and suddenly you're 50minutes into your 'lunch break' - which I have just deemed, "hour that normally people who have lives get to sit down and eat something, which I think is normally done around Noon???"...
Then, when you think you're exhausted and you've MORE than completed HealthParnters 10,000 recommended steps ten-times over... it's THEN time for you to do the FUN part - SURGERICAL CASES! Which IS fun, except that to have that fun it requires another 6+ hrs of standing... when all you want to do is lie down. Since starting in surgery - and I realize this is only day FOUR for me... but there is a funny paradox, in that STANDING is actually WAY more tiring then MOVING. In terms of fighting sleepiness, I'd so much rather see 40 bed patients running around to 8 different sections of the hospital, then STAND... in ONE spot for Four hours... it's grueling. It wears me out...
Which brings me to the point of this post. When the days get long and hard, and your separated from your Fiance, friends and family... you need an escape. Which I have found in my new favorite hang out - which is a) conveniently located on my bike ride home b) an obvious choice for it to win my patronage, because it is FRENCH themed! Yep... just like the bistros of Paris I miss so dearly!
They have Belgian beers you can only find on the old continent, make a MEAN true french style latte, and best of all -and I know Steph would appreciate this most if she could come out and visit me ;) - they have REAL French pastieres and chocolates and most importantly MACARONS! ;)
Plus they are open to Midnight and show free movies on Mondays, plus ample outdoor seating to enjoy the perfect Northwest summer nights. I've been hanging out there a lot after work to long in my patients, skype Ryan, etc... I look forward to it so much!
So here's a view of my post-work de-stressing session at "Pix"... ;) can't wait til tomorrow at 9pm for another round. Bisous!!!! - Mego
Monday, August 16, 2010
Surgery 101
So, today was my first day on my Burn Surgery rotation! And... it. was. awesome!!!!!!!!!
So most rotation schedules entail doing Clinic on 2-3 days, In-patient hosiptal visits on another couple 1/2 days a week and Surgeries the other 2-3 days... Well in my first day, I did ALL THREE!
I should up ready to roll at 7am... my preceptor had already been at the hospital since 5am. The only other resident in the service with me is a Surgical Resident (aka he's really far along in his studies, already has the title of Doctor, and is just doing an extra 5 yrs of SURGERY specific residency... so to say he is a 'resident WITH me' is a VERY relative term). The other 'resident' Dr Bonson has only been on board since last Friday so he and I were at least both lost as we checked in at the front desk and they immediately had us start rounding on Patients. We have 16 beds in the Burn Unit and another 10 beds designated as Burn ICU.
My preceptor is AWESOME. His name is Dr. Eshraghi. And he pocesses that rare quality in a Surgeon of being both WICKED smart AND entirely normal and personalable! He didn't pimp me too hard. Just taught me. And I just in general tried to keep up. I have shin splints for running around in my completely worn-to-the-bone zebra ballet flats (thanks Tom and Caitlin - Christmas 2008... LOL, yeah I need new shoes...)
In the morning, after rounding on our in-patients on the unit, we moved over to the clinic and saw pre/ post-op patients. Coming off of my Family Med rotation in Elmendorf, and the great face-time I got with patients, today- witnessing even someone as brilliant and wonderful as Dr. Eshraghi stumble over and foil-up patient encounters- I felt kinda proud to be a PA... like, in the back of my head, I was thinking : "Wow, I would have explained that proceedure and explained our treatment approach rationale SOOOOOO much better, faster and more appropriate to the patient's view point than you just did..." Even when your humbled and in the presence of greatness like a Burn Surgeon, there's definitely things a PA would do better. That kinda made me feel good ;)
The highlight of the day, was definitely the afternoon where I ASSISTED on my first ever surgery!!!!! It was over 3 hours long! Our patient was a 50 yo Female with complications of an abdominal wound. She had ovarian cancer and as part of her removal of the tumors, she had a colostomy bag. The incision from that and her tumor removal became infected and she developed fistuals and a large, gaping wound over a good 12 x 12 section of her abdomen. We used a new device in surgery today that I had never seen before, called a Versajet. Essentially it's a high powered water pic. And instead of 'cutting' the patient, the high-pressure water jet removes the tissue!!!! AMAZING!!!! I told Ryan about this and he said they used it when he was deployed in Afganistan too. It was a new toy to me though and I was super excited to see it in action.
While, I didn't get to play with the water thingymabob... I DID get to do a SKIN GRAFT! Yep, that's right, I scrapped off a piece of someone's leg, ran it through what looks like an industrial pasta roller and then glued it on to the patient's wound. Can you say AWESOME! Total highlight of my career thus far! And this is only day ONE! ;)
Who knows what tomorrow holds, but I can bet it will be just as crazy, scary, fun as this one... STAY TUNED! :) xoxox Mego
So most rotation schedules entail doing Clinic on 2-3 days, In-patient hosiptal visits on another couple 1/2 days a week and Surgeries the other 2-3 days... Well in my first day, I did ALL THREE!
I should up ready to roll at 7am... my preceptor had already been at the hospital since 5am. The only other resident in the service with me is a Surgical Resident (aka he's really far along in his studies, already has the title of Doctor, and is just doing an extra 5 yrs of SURGERY specific residency... so to say he is a 'resident WITH me' is a VERY relative term). The other 'resident' Dr Bonson has only been on board since last Friday so he and I were at least both lost as we checked in at the front desk and they immediately had us start rounding on Patients. We have 16 beds in the Burn Unit and another 10 beds designated as Burn ICU.
My preceptor is AWESOME. His name is Dr. Eshraghi. And he pocesses that rare quality in a Surgeon of being both WICKED smart AND entirely normal and personalable! He didn't pimp me too hard. Just taught me. And I just in general tried to keep up. I have shin splints for running around in my completely worn-to-the-bone zebra ballet flats (thanks Tom and Caitlin - Christmas 2008... LOL, yeah I need new shoes...)
In the morning, after rounding on our in-patients on the unit, we moved over to the clinic and saw pre/ post-op patients. Coming off of my Family Med rotation in Elmendorf, and the great face-time I got with patients, today- witnessing even someone as brilliant and wonderful as Dr. Eshraghi stumble over and foil-up patient encounters- I felt kinda proud to be a PA... like, in the back of my head, I was thinking : "Wow, I would have explained that proceedure and explained our treatment approach rationale SOOOOOO much better, faster and more appropriate to the patient's view point than you just did..." Even when your humbled and in the presence of greatness like a Burn Surgeon, there's definitely things a PA would do better. That kinda made me feel good ;)
The highlight of the day, was definitely the afternoon where I ASSISTED on my first ever surgery!!!!! It was over 3 hours long! Our patient was a 50 yo Female with complications of an abdominal wound. She had ovarian cancer and as part of her removal of the tumors, she had a colostomy bag. The incision from that and her tumor removal became infected and she developed fistuals and a large, gaping wound over a good 12 x 12 section of her abdomen. We used a new device in surgery today that I had never seen before, called a Versajet. Essentially it's a high powered water pic. And instead of 'cutting' the patient, the high-pressure water jet removes the tissue!!!! AMAZING!!!! I told Ryan about this and he said they used it when he was deployed in Afganistan too. It was a new toy to me though and I was super excited to see it in action.
While, I didn't get to play with the water thingymabob... I DID get to do a SKIN GRAFT! Yep, that's right, I scrapped off a piece of someone's leg, ran it through what looks like an industrial pasta roller and then glued it on to the patient's wound. Can you say AWESOME! Total highlight of my career thus far! And this is only day ONE! ;)
Who knows what tomorrow holds, but I can bet it will be just as crazy, scary, fun as this one... STAY TUNED! :) xoxox Mego
Saturday, July 24, 2010
Sorry it has been FOREVERRRRRR since I've blogged!It's been a wild, crazy, fun month to say the least! My days in the Clinic have been full to say the least. Which I TOTALLY don't mind. But it would certainly be made more tolerable if I had cell/internet service in the hospital. I could fit in so much more if I could jump in to check an email, text a friend back home, look something up online, (and ok, ok... I'll say it - update my facebook! hehe) in my spare in-between minutes. Instead I now have to save all of these activites for the end of the day - at which point I'm busy logging in patients, working out, or just out enjoying Alaska. So thus my internet usage has gone to the way-side.I only have two more weeks left at Elmendorf here, and it's hard to believe. I've really lucked out with having this rotation first. While it certainly has been challenging, I know if PALES in comparison to the cut-throat, uber-competitive rotations that my other classmates have already been on. I'm very thankful to have started out with a rotation that has let me ease-in to this whole clinical medicine thing.My preceptors here have been phenomenol. Sadly, my two favorite ones, will both be leaving this site. One will deploy to Iraq for 7 months starting in September (Maj. Spencer). And the other will retire next July (Maj. Kubly). I'd say 25+ years with the Air Force is a good run and he deserves it. But it bums me out that the rest of my classmates won't get to work with these two amazing people.I worked with Major Kubly this past week and on my last day with him he hooked me up with a giant grocery bag of Alaskan salmon and reindeer saussage and elk links. All caught/ killed by him of course ;) Ryan and I grilled up the salmon last night and it really DOES taste better than the store bought stuff. I'm so lucky to have such amazing and generous teachers. And even luckier to have someone to help me eat it all! :)My next rotation is Surgery in Portland. Two weeks out, and I still haven't sewn up my housing or living arrangements... I should probably get on that... And with my next rotation I'm sure I'll be bored out of my mind without Ryan and all these outside adventures and exploring to go on. So I anticipate a full return to blogging at that time.Stay tuned! And as my final days in Alaska (for THIS round anyway) tick by, I'll try to post more pics and snippets.Miss and love you all! xo Mego
Tuesday, June 15, 2010
Character Studies and Rants...
So... there seems to be two main populations I deal with... and of course, they are the extremes. Either I have the patients that come in asking for 5 months of disability for a HANGNAIL, or I get the person with a CLEARLY fractured ankle coming in 10 days POST fall just- and only because the swelling was so bad they could no longer force it into their boot for work... uggggg
I feel like I should host a mix-er where both the hypochondriacs and the non-reactors could get together and teach the other group their ways... Again, the Eileen McKenna school of medicine that I grew up in ("if it's not arterial bleeding, and you still wanna go to gymnastics practice, then quit whining") has made me sympathetize more with the tough guys than the frequent flyers... but still, even with my bias I recognize the unhealthy aspects of both groups' approach to care.
In honor of that, here are some GEMS I've encounted thus far...
Patient #1 : Chief Complaint (reported to me via my tech) "Patient would like an MRI so she can be diagnosed as dyslexic".... Now, I can get her an MRI to diagnose her as CRAZY TOWN but, ain't no brainscan for dyslexia. And after 45 minutes of one of the most disjointed, anxiety-ridden conversations I've ever born witness too... I finally had a plan for her: Referral to mental health and a manic depressive disorder! Yikes
Patient #2: 40 year old male with "penile discharge"... now don't worry, this isn't going where you probably think it's going... his "discharge" was PEE... and upon digital rectal exam, he had an enlarged prostate... so after palpating the poor man's prostate, I told him "Now, you need to go over to lab and get the very first catch of urine in the cup becau-..." He states starring at me in HORROR as I am taking off my ky-jellied gloves and throwing them in the trash (which I thought was a perfectly RATIONAL thing to do with them...) but he interrupts my instructions and starts yelling "whoa whoa whoa!!!!! What are you doing?! Why are you throwing that away?!?! Aren't you tossing the sample?!?!"... I'm thinking, "did ya really think I went in there and scraped a lil' of your prostate under my finger nail for cytology to take a look at..." But instead... I had to calmly and with a straight face say "no, sir. I was just explaining to you that now that we've stimulated the prostate what we need is a URINE sample..."
Patient #3: 25 year old female coming in for "Back Surgery..."
Turns out, she wanted relief of work orders (what we call 'quarters' for Active duty Airmen) because she was having a MOLEEEEE removed from her back, or as she liked to referred to it, her BACK SURGERY... uggggg... Shaving something the size of a pencil eraser off your back and putting a bandaid over it, HARDLY qualifies as an invasive procedure mandating disability leave! uggggg This patient was such a joy, that the tech's started referring to her as "Eoyore"... because the second you went into the room there was an instant black rain cloud over your head. We were all quoting "thanks.for.noticing.me." and siging "I'm just a little black rain cloud... hovering over the trees..." the rest of the day. So ironically, this bitter patient, actually made our day BRIGHTER ;)
Hope you all enjoyed the stories... just a tip of the iceberg... trust me... hehe
Miss and love you all! xoxo
I feel like I should host a mix-er where both the hypochondriacs and the non-reactors could get together and teach the other group their ways... Again, the Eileen McKenna school of medicine that I grew up in ("if it's not arterial bleeding, and you still wanna go to gymnastics practice, then quit whining") has made me sympathetize more with the tough guys than the frequent flyers... but still, even with my bias I recognize the unhealthy aspects of both groups' approach to care.
In honor of that, here are some GEMS I've encounted thus far...
Patient #1 : Chief Complaint (reported to me via my tech) "Patient would like an MRI so she can be diagnosed as dyslexic".... Now, I can get her an MRI to diagnose her as CRAZY TOWN but, ain't no brainscan for dyslexia. And after 45 minutes of one of the most disjointed, anxiety-ridden conversations I've ever born witness too... I finally had a plan for her: Referral to mental health and a manic depressive disorder! Yikes
Patient #2: 40 year old male with "penile discharge"... now don't worry, this isn't going where you probably think it's going... his "discharge" was PEE... and upon digital rectal exam, he had an enlarged prostate... so after palpating the poor man's prostate, I told him "Now, you need to go over to lab and get the very first catch of urine in the cup becau-..." He states starring at me in HORROR as I am taking off my ky-jellied gloves and throwing them in the trash (which I thought was a perfectly RATIONAL thing to do with them...) but he interrupts my instructions and starts yelling "whoa whoa whoa!!!!! What are you doing?! Why are you throwing that away?!?! Aren't you tossing the sample?!?!"... I'm thinking, "did ya really think I went in there and scraped a lil' of your prostate under my finger nail for cytology to take a look at..." But instead... I had to calmly and with a straight face say "no, sir. I was just explaining to you that now that we've stimulated the prostate what we need is a URINE sample..."
Patient #3: 25 year old female coming in for "Back Surgery..."
Turns out, she wanted relief of work orders (what we call 'quarters' for Active duty Airmen) because she was having a MOLEEEEE removed from her back, or as she liked to referred to it, her BACK SURGERY... uggggg... Shaving something the size of a pencil eraser off your back and putting a bandaid over it, HARDLY qualifies as an invasive procedure mandating disability leave! uggggg This patient was such a joy, that the tech's started referring to her as "Eoyore"... because the second you went into the room there was an instant black rain cloud over your head. We were all quoting "thanks.for.noticing.me." and siging "I'm just a little black rain cloud... hovering over the trees..." the rest of the day. So ironically, this bitter patient, actually made our day BRIGHTER ;)
Hope you all enjoyed the stories... just a tip of the iceberg... trust me... hehe
Miss and love you all! xoxo
Friday, June 11, 2010
Alaskan Extra Curriculars...
It's a been a great but LONG 11hr+ days week! But on the plus side, that means I have today OFF! It's been so nice to spend a lazy morning in bed chatting with my grrlz back home, takin' my time witha proper breakfast (my favorite meal of the day) and working on my 2nd pot of coffee :)
So to celebrate my vacation day, I thought I'd kick off my weekend of excessive blogging with some shots of the amazing things I've been able to experience here in Alaska!
Last weekend Ryan took me skydiving for the first time and LOVEEEEDDDDD it! We went with 6 friends from work and we all did tandum jumps with people that are actually trained and know what they're doing - so we didn't have to do any of the ground-school classes stuff... just showed up, got our PowerRanger suits and JUMPED! It was AWESOMEEEE! My tandum leader was (read: is) an Army Special Forces Ranger- he's done something like 7000+ jumps! CRAZY TOWN! Needless to say, I made a special request for as many flips as possible leaving the airplane. They took us up in a Sesna with all the seats removed, save for the pilot's. We were crammed in there like sardines. Because the plane was so small, there's only room for two jumpers, the two trainer/tandum professionals, a videographer (if you choose to buy a dvd of your possible last act on earth - which of course I DID, and YES, it's supposed to be in the mail on Monday so I'll be sure to post it as soon as I get it), and the pilot.
They take you around for a 20 minute tour of the Valley, and then... as you watch the altimeter on your wrist climb to 10,000 feet... you JUMP!!!! I wasn't nervous or scared at all! I was just psyched! The best part is when you step out onto the beam outside the airplane door looking down at 10,000 feet, wind whipping by you... and then the release!!!!!!!!!!!!!! AWESOMEEEEEE... you're technically supposed to pull your chute at 5,500 ft... but because my guys was a) pyschotic and b) knew I was too... he didn't pull until 4,800!!!! Ride of my life. Even though Ryan and his guy jumped first, we were the first to land! hehe The photos you see here include the whole group of us pre-jump (and no, my friend Teresa did not put her little girl Bella in the babybjorn for the jump); Ryan and me making a fashion statement in our suits and nerdy hat/ goggles; and me practicing the landing technique in the trapeeze :)
The weekend before last, 5 of us went camping 3 and half hours north of Anchorage at Lake Louise. It was truly BREATH TAKINGLY beautiful up there... Ryan took a TON more pics than this but here's a few to get you started for now. I don't know if you can see how COMPLETELY coated in mud Amber and I are in this pic... but believe me - the jump into the very COLD lake post ride was DEFINITELY worth the pain!
Lastly there's a shot of Ryan and me and trudging through the woods with his 12-gage shotgun on my back... Grandpa Dar would be so proud. And yes, I fired a gun... and yes I hit my very first clay! It's in my blood I guess... or maybe the fact that Ryan's an official Marksman rubbed off on me, whatever it is... just don't tell anyone or I may lose my npr membership.
Well, off to run some errands and take care of some business on my day off here. I miss and love you all BEAUCOUP!!!!!
xoxo Mego
Thursday, June 10, 2010
When in Rome.... er, Alaska...
Sorry I've been slacking on my posts, everyone! My dumb roommates neglected to pay the internet bill (ahhhhh, I KNEW there was a reason I swore I was done having roommates...) uggg. Anywho, that's not my only excuse for my M.I.A.ness... I've also been out enjoying the wonderful things Alaska has to offer in the summer.
Since I got here 3 weeks ago, I have camped, hiked, climbed, skydove, 4-wheeled, and most shockingly perhaps, shot GUNS! hahaha Before you think I've completely turned my back on my bleeding heart liberal ways... just know that the targets were all pointed in the direction of Sara Palin's home in Wasilla (true story!). ;)
Well, I will be posting more tonight, but I just wanted to let you all know I have not COMPLETELY fallin' off the face of the Earth. More to come SOON! You are all missed and LOVED! xoxo
Since I got here 3 weeks ago, I have camped, hiked, climbed, skydove, 4-wheeled, and most shockingly perhaps, shot GUNS! hahaha Before you think I've completely turned my back on my bleeding heart liberal ways... just know that the targets were all pointed in the direction of Sara Palin's home in Wasilla (true story!). ;)
Well, I will be posting more tonight, but I just wanted to let you all know I have not COMPLETELY fallin' off the face of the Earth. More to come SOON! You are all missed and LOVED! xoxo
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