Merry Belated Christmas Wishes!

So, I've been sucked into the vortex of residency. But that doesn't mean I'm done with this blog. Life has been busy, but it has also been very good. I worked both the 24th and 25th but it was okay, because someone has to work and because I volunteered my co-interns got the days off to enjoy the holiday. And I enjoyed being at work, I did. Lots of Christmas cheer, Santa sightings and tons of holiday spirit in spite if it all. Being a kid in the hospital is never fun but especially not at Christmas and so yesterday we tried to make the most if it. Silly hats that sing and lighted scarves were just part of the fun.

In other news, I cannot believe that intern year is half over! Hooray! (Gulp.) Wow, how time flies...
I'm actually enjoying nephrology. And next month I'm back on inpatient wards but at our community/county hospital so that will be good. And then I get to take Step 3 in February. And then vacation!!! So very exciting.  So that's what's up with me.

I've decked out our pedi lounge for the holidays and that makes me happy. Belated Merry Christmas wishes to you. And a very happy new New Year too!

P.S. Anyone wear a tacky Christmas sweater on the 24th? I did and it was awesome, not quite as bright as the one pictures above, which I am ordering it now for next year, yay!

Christmas countdown, life and reflections of an intern year almost half over!

Hi all,

I am still here. Sorry if you have been looking for me and I've been MIA. You know, this thing called residency is happening. Doesn't leave too much time for other stuff.

Although my parents did visit Houston for 10 days in October, poor Dr Boyfriend had to do most of the entertaining as I was pulled to MDA (oncology) at the last minute. MDA is suppose to be our hardest month and it was not fun but I survived so I do have that going for me.

Also, Christmas is in 6 days and I am unbelievably excited this year. I have decorated the resident lounge and bought mini stockings for each of us to hang. It makes me very happy. Also (a word I'm using way too much this blog post, sorry about that) I have decided it is okay to wear corny holiday themed antlers and headbands and scarves and hats and all things tacky since I am a pediatrican after all. And I want others to as well so I have declared December 24th, the official wear your tacky Christmas sweater (to work) day! You can participate too, I'd love pictures if you do. If you have to work the holiday you may as well have fun while doing it, that it my motto anyhow.


I'm up early this morning. Presents are wrapped. Cookies are baked. I do have some clinic notes to complete though..... but blogging is more fun.

Oh and random links, just because:

1. interesting, my future research is going to do with this i think:
EverythingHealth: The Microbiome

2. fun gift ideas for the last minute hard to shop for person on your list: http://gifts.rescue.org

3. just because: http://www.pinterest.com/pin/72057662761780782/

Merry Christmas!!!!

P.S. Don't forget- tacky sweater on 12/24. And the best way to spread Christmas cheer? Singing loud for all to hear!

C is for...

team C!

I'm back on wards and starting on nights. I figure I kind of know what I'm doing this time around and instead of endure it, I'm embracing.

team C as in Cat!

I found our mascot.  And have plenty of Candy including Candy Corn. It may also be reason to Celebrate the month of Colorful Costumes and pumpkins with Candles!! And yes, I might be Crazy,

C is for Crazy, lets go Team C!

I need costume ideas... C is for Countdown and just 30 days until Colorful Crazy Costume Day!

What are you going to be dear reader?

mimosa, samosa... life after wards

Wards is over, I made it! There were many times in the past month that I doubted my desire to do this. To be a doctor. To complete residency. Multiple days/nights when I just did not want to go to work.... But yesterday at 10am when I walked out of the hospital I felt accomplished. And my spirits climbed as I brunched and shared multiple pitchers of mimosas and good company.

My collapse into bed followed by wonderful sleep before meeting my awesome wards team for outdoor theatre fun in the form of Bollywood dance made yesterday the perfect ending. I had a good day, a good month. I am now that much more confident that I can do this job. And more importantly that I still want to.

Nights were difficult for me. I feel into a semi depression and despite the actual free time I only slept and worked. It is only now as the nights and memories of them recede that I feel myself again. The reading, the to do list, that didn't happen... but it is okay, because I survived and came out the other side and I'm still here. And now I have energy and optimism once again.

A sampling of what I saw last night, I just LOVE Indian culture/dance/food!

Night after day after night...

Residency day 57.

Well actually night 2, as I am officially on nights. We have kind of an odd system when on wards where you work every other night for two weeks. Saturday was my first "night" and it was rough because I haven't had to stay awake for 30 hours straight in a very long time. I was falling asleep while writing up my H&Ps and that was an awful feeling. I will be prepared tonight with gum, candy and an extra cup of coffee for 3am. The every other night off is kind of odd. 16 hours on. 30 hours off. In theory that sounds nice but it hard to get on a schedule. I had planned to simply sleep all day and then use my off night to read, do things around the house, etc but I guess that residency caught up with me because I simply slept for 18 out of the last 24 hours. Ooops. Now I have all day "off" before I got to work tonight and it is not the weekend and so Dr Boyfriend is at work and I have the house to myself. So what to do...  Finally, I can read! I am so behind in everything, it will be nice to read about medicine and not medicine. I need to go join the Houston Public Library. And grocery shop and bake and lounge and do laundry. And exercise. And finish my graduation thank you notes. Yes, residency  has kept me busy. My to do list is long. So I'm thankful for the time right now to catch up.

Otherwise I really don't have much to say. Inpatient wards is busy, good, horrible, awful, scary and/or fun depending upon the moment in time. I hated my first week and rather enjoyed my second week. I like the patient care aspect of it and struggled with the documentation aspect. There is never time to write good thorough notes and yet I know that notes are super important and without good documentation it is difficult to practice good medicine. And yet I struggled with this daily.  I can only hope I get more efficient as time goes on. I am trying to dictate but that has pitfalls too. Being an intern is about doing paperwork, calling the consults, updating the lists and admitting/discharging patients. I ended up staying  late to talk to parents, answer questions, etc because there really just isn't time during the day for that aspect and it is the education part of doctoring that I so love.

Time to work on my to do list, and maybe walk my dog. Happy Monday to you!

Residency, day 48... feels like 539

I am now about to start my eighth week of residency, crazy huh?

I finally get today off after 12 days on and it is a glorious feeling to have an entire day to myself without  a pager or need to set foot in the hospital! (Minus those delinquent discharge summaries to finish.) Thursday was maybe the second hardest day of residency.... more lows, more tears, a migraine, a screaming child, not enough hours in the day to take care of everyone and myself. But then it was Friday and I had one of the best days of residency. I utilized my medical students and I took the time to pre-round with them. We were efficient on rounds and I made it to noon conference with a hot lunch in hand. I made decisions by myself. I admitted two patients, discharged three, supervised my med student talking out his first PICC line and almost made it out in time with only an hour worth of notes to finish when I got home. I survived my first week and half of inpatient wards and I see the light... five more days on and then I switch to nights for the rest of the month. So all in all, I'm okay.

More than okay. I'm surviving despite what I felt like was going to be the worst month of my life. Some days have been quite craptacular. I feel like a glorified secretary. I haven't been reading like I know I should. My sick patients scare me. I think the medical students know more than I do. I feel slow and have yet to finish my progress notes before rounds or even before lunch time.  I am not good at multi-tasking. I am an intern. But I notice that I'm faster than I was a week ago and more confident each day than the day before. I am figuring out the little things and those make a big difference.

Residency is hard. I'm awake at 5am on my single day off in two weeks. I could complain about many things. But I also realize that I'm lucky. I'm doing what I have always wanted to do and the little things add up. The educating patients and supervising med students and being responsible for my own time.

I'm happy. Exhausted. But happy. Enjoy your Saturday, I know I will enjoy mine!

Golden Weekends

In residency having two days off in a row is kind of a big deal. So much so that it has its own name. golden weekend.



And since residency has started this is my first golden weekend. Although working 12 days straight kind of sucks I think I'd rather do that once if it means I get a golden weekend in return. There is something magical and restorative about having two days off in a row. Yesterday I cleaned, exercised, hung out with hubby and my Sancho, slept in, met co-residents for a drink, furniture shopped and watched a movie. It was a pretty great day off and now I still have today to read, study, BBQ w/friends, swim, grocery shop and finish laundry. By Monday I'll be ready to work which is good because I start inpatient floor this week. just three more days of ID left. I think I'm ready, ID was a great intro but it will be nice to be the primary provider and not simply a consultant...

I've survived my first month of residency, I adore my co-residents and I don't imagine I'll ever grow tired of newborn babies or toddling kiddos or sultry teenagers, peds is awesome and I'm reflecting on just how blessed I am this early golden weekend Sunday.

Happy weekend to you!

Play by play (aka a day in the life...)

6:05 awake, blogging, reading, working on ppt presentation for Monday. Plan for day: ID round and home by noon to enjoy my Saturday.

7:15 phone call from chief resident informing me I'm on back up jeopardy call and that I'm needed in the floor to fill in for sick intern. Team is admitting and has 6 old pts for whom I need to see/write notes.
8:30 walking into hospital, contacting ID attending to inform her of my extra duties, only mildly freaking out. (Times I've worked on Floor team= 0.!!!!)
9:00 pre-round w/ med student, see pts, start notes
10:00 round with ID attending
10:30 round with Team, love my med students!
12:30 get sign out from ID attending
          Get sign out from well nursery, inherit pager and 8 babies
2:00 notes, team stuff
2:30 admit new pt in respiratory distress
4:00 notes, coffee, chit chat with the other weekend warriors
6:00 sign out
7:30 complete ID note
8:00 finish admit H&P
9:00 home, dinner, final episode of Orange is the New Black
10:30 finish ppt for Mon
12:00 edit notes in bed, pre-round on ID census in prep for Sun rounds
12:30 sleep

Highs and lows

Low- sobbing in the middle of the PICU in front of my team while trying to present my patient.

It was the perfect combination of fatigue, high stress, crappy situation, oncoming migraine and frustration. The perfect storm that cultivated in me, in tears...or as Grady Doctor would say, the ugly cry. Nothing discrete or pretty, just raw emotion and sobs. 

Yes, definitely my low. 

High- interacting/talking with a patient and parent several hours later. I had already seen the patient by myself and with my team earlier in the day but he had been sleeping the first time and his mom was on the phone and so I hadn't really finished a full exam yet. My follow up note was complete and  doing an entire PE would not change anything, plus we were not primary so had no pressing reason to go see him again and yet I told myself I needed to. And I'm so glad I did. It was mid-afternoon and the hospital was quiet in the way that no one was really rounding anymore. My patient wouldn't talk but that didn't mean he wasn't communicating. I did my exam and bantered with his mom and nurse. He smiled and pantomimed responses and I updated them on our latest findings. 10 minutes later as I walked out if the room I couldn't believe that I has almost talked myself out of seeing him. 

Residency is all they promised and more. Emotions run high. Child abuse sucks. Life is not fair. 

But then something good happens. A moment. A high. And you can go on again. And that's all I know on this early Saturday morning, one month into residency as I get ready for the start of another day and another week. 

Internship, day 9

So.
It happened.

Intern year started and I survived my first week. I won't lie. It was rough. I felt like a glorified medical student at my best and a worthless imposter in a long white coat at my worst but I made it through. I finally figured out how to get from the elevator to the lounge to the PICU to the bathroom to conference without getting (too) lost. I started to create my own templates and navigate myself around several different EMRs. Now that I'm one plus week in I'm starting to actually feel semi-confident. Or at least no longer super stressed that I'm the worst resident in the world. It is a gradual process.

Of course that being said, I only have one more day of work and then I'm on vacation to The Best Place on Earth. I figured it was a long shot to ask for vacation two weeks after starting but someone has to take vacay in July so why not me? I'm glad I'm going. MS Teen Adventure Camp is the reason I decided to go into Child Neuro so to NOT go to camp would be like a fish that decided to go without water for a minute. I might survive but it would not be pretty.

Residency is scary and I'm not even on the wards yet. I'm on ID this month so it is just consults with tons of fellow and attending support. But still, I'm Dr. Neuro Chick-Kid Doc when I walk into the room. And it is absolutely amazing. I love my patients and parents, I love my job and I especially love the fact that I get to do this for the rest of my life. Today was orientation to continuity clinic and I already have patients scheduled to see ME. I browsed their charts and I just can't wait to see my 5 year old and my brand new newborn baby and the reluctant teenager and whoever else may walk in the door. I just can't wait!

Internship day 10... bring it!

a very special mermaid

Once upon a time a little girl was born to excited and newly expectant parents. They named her Sophie and for three months she was a perfectly normal baby. But then one day she had a seizure and another and another. Fast forward many years and hundreds of seizures despite numerous medications, diets, etc. Eventually Sophie was diagnosed with intractable epilepsy and she continues to have uncontrolled seizures to this day...

Love is central to this story and her parents loved her as parents do. Along came two brothers and they shared a life with Sophie and loved her as well. Sophie has grown up to become a beautiful young lady. I "met" Sophie and her family via Elizabeths' blog- a moon, worn as if it had been a shell and am not exaggerating when I say she has shaped who I want to be, as a clinician, as a doctor, as a person.

I have followed along over the past several years and I have learned so much about epilepsy and family and love from Elizabeth and her blog community. As a medical student I once left a comment and she turned it into a post where I received numerous pieces of advice and encouragement. I had long ago decided to enter the field of Child Neurology but if I needed another reason than Sophie is it.

I am posting this here because I think this is the best possible cause and because I consider Sophie and Elizabeth my blog family. Donate if you have something to spare or simply read the comments, look at the pictures and feel the love.

To read about a tradition of love-
http://elizabethaquino.blogspot.com/2013/06/the-long-distance-casserole-brigade.html

To donate, comment or see pics-
http://www.youcaring.com/other/a-bicycle-built-for-two-elizabeth-aquino-and-sophie-/60783

Miss Rock and Mister Cactus

Sancho greets Miss Rock

My California morning walks are coming to an end. In less than two weeks I'll leave for Texas but in the meantime I'm trying to soak up the humidity free sun and enjoy my final time here...

Mr. Cactus (rocking his new frames)

I hope you have a good day and Mr. Cactus hopes so too!

5 year goals

• become Neuro Chick-Kid Doc (complete Child Neurology residency)
• have fun
• become a mom
• embrace Texas
• take care of lots of kiddos
• master neuroanatomy
• bike more
• bake often
• start a book club for pediatricians
• love my job
• be the best wife I can be
• enjoy life
• be me!