Friday, March 30, 2012
So how has it been? I'm writing now during "quiet time" on the floor where I take care of most of the neurosurgery patients. I love quiet time. They turn the lights off and it is a nice, somehow soothing (considering the beeping alarms behind me) hour or so to promote quiet time for patients so they can get some rest (which is surprisingly very difficult in the hospital). It helps to take my stress level down somehow just having the lights dim.
Anyway, this has been a taxing month. I feel tired. My skin is not as clear. I have been bad about exercising. Worse about cleaning my house. Abe and I haven't seen much of each other unless you count him watching me sleep. And haven't done much of anything beyond work the past 30 days. Luckily I was able to rid myself of my bushy neurosurgery eyebrows with a quick wax!
I appreciate more my chosen specialty. The hours (although I'll probably forget and still complain), my ability to get more sleep, and the patients who usually stay alive, and the procedures. It is so sad to see patients and their families struggling to live or to gain the life they once had back. I've seen us say goodbye to patients when they don't recover. And I've seen miracles. One man's family was talking about withdrawing life support. The day they were supposed to make the decision he opened his eyes, he started following commands. I had said a prayer for him when I realized he may not have much time the day before. I think prayer works, maybe it did for him. I'm sure others were praying as well.
This month has made me a little afraid of the horrible things that can happen to you or your family members at any time. But it also has made me remember to take time to appreciate our lives and those around us more each day.
And in just 2 days, I will be on vacation! I'm hoping to catch up on all the sleep I've missed this month.
Saturday, March 24, 2012
In a lot of ways I'd say I am not the traditional wife (or maybe the traditional Mormon wife). I am almost 30 and have no children. I work outside of our home and have plans to do so even after I have children (although hopefully not full time). I didn't always plan for things to be this way. When I started dental school I thought it would be a great way to find a husband. I figured the earlier I found him, the better the investment. But making it more than halfway before securing that certificate of marriage, I figured I might as well just stick with it. I do think Abe was worth the $100K investment up to that point but it seemed to make sense to continue on.
If you stopped reading there, hopefully you realized I was joking. I used to tell people that when they asked why I was going to dental school. If you find someone within the first year you are only out about $50K. Well worth it if you marry a dentist yourself.
Anyway, back to the wife thing. I am surprised being the working and non-traditional childless wife that I am how much my identity hinges on my (traditional) duties as a wife. I am so lucky to have a husband who shoulders probably well over his share of home duties (laundry, dishes, cooking, making lunches, etc). But I do feel it is MY responsibility in the end to account for what we are putting into our bodies and the status of our home. Which I am sad to say is usually a status not worth updating facebook or tweeting about.
My goal has been to clean up after ourselves more (I'm an adult but still can't seem to figure this one out!) and to keep our place clean enough to not be embarassed to have last minute guests. I was on a roll and then started Neurosurgery. Talk about disruption!
Anyway, I have toyed with the idea for quite some time about paying someone to come help me for a few hours a week getting things put back in order. I find I spend most of my free time on weekends (if I get free time) either sleeping or cleaning. I could use the help. I'd probably feel happier.
But it comes down to the wife thing...maybe it is that phrase "Cleanliness is close to Godliness," (who said that, anyway?) but I feel it is my personal moral responsibility to have a clean home (I also feel the same way about running, silly, probably, but I feel like I should be disciplined enough to like running and the fact the thought of running a marathon makes me want to barf makes me feel somehow of lesser character. I digress...). I feel a bit like a cheater if I need help. I feel like it is a lesson in discipline that I need to master. But I also feel that it would probably be money well worth it to feel a little cleaner and less stressed at home.
I bet you are thinking, "Go for it!" or "There is a time and season for everything," "don't be so hard on yourself,"etc etc. I know because I tell myself the same thing. But sometimes I find my mind wrestling my heart and often my heart wins, however illogical. But maybe I do need your "You go girls" (one of the main purposes of blogging, right?) to go for it.
How much does a "maid" cost anyway? I'd prefer to call her (or him!) my helper or "personal assistant." (And now I'm wondering, what do you call a male maid? A bit of a oxymoron. Housekeeper I guess...)
Anyone want to be my new personal assistant?
Wednesday, March 21, 2012
Here is what my typical day has been like:
3:45 (am). Alarm. I try to squeeze in a few minutes extra of sleep as much as possible.
3:55 really get out of bed. Forget about make up or earrings or even more than a messy ponytail.
4:15 arrive on the ward and review the stats for my patients each day
5:00 review new inpatients and xrays from the day before with the NSG team
5:45 round on all of the patient.
7:00- write orders, notes, discharge patients. Intermittently see clinic patients for history and physical exams. Go to the OR if I have time
4:30ish round on patients, give update to on-call resident
sometime after 5 go home! Make dinner. Shower. Veg on couch. And go to bed way too late.
Restart about 5-6 short hours later.
Last week I was able to participate in my first two OR procedures. I was able to do a "burr hole" which is a procedure where you use a large drill to make a hole in the skull, often to drain out a blood clot that is putting pressure on the brain. Cool!
It has also been sad. It is very different from my usual day to see such sick patients. It isn't uncommon for people to die or to not be able to talk, swallow, eat, move, etc. I am really glad that I don't have to see that on a day to day basis. I also find myself getting pretty attached. I really root for the patients and their families who often stand by morning (early morning!) and night for a small sign from the patient (like opening their eyes, wiggling their toes, etc) or good word from the surgeons. It breaks my heart to see the look of disappointment on their faces when we have no good news for them that day.
On a positive note, we booked a vacation for Abe's graduation celebration to Curacao!
I'm excited to celebrate this great accomplishment after 8 years with a trip to the Caribbean!
Has anyone ever been? Any recommendations?
Wednesday, March 14, 2012
I just got a twitter account. Follow me if you are way hipper than me and are already there. Or join and start following me. I'd like to follow you back.
Check the link in the side bar.
Oh, and if you have any info on why I should be on twitter (still wondering) let me know!
Monday, March 12, 2012
Today 4th year medical students around the country found out IF they matched for residency or not.
Thankfully, Abe matched. After submitting a "suicide" rank list (only one program), we know exactly what the envelope will say come Friday when everyone finds out WHERE they matched.
I'm so grateful that things worked out for us. Pretty good when we both only ranked Iowa.
Oh, and did I say what residency he finally chose?
Otolaryngology. Also known as ENT (ears, nose, throat surgery).
We will both be considered "head and neck surgeons." We will even have some potential rotations together next year (oral surgery, SICU, and ENT). And I will look forward to manipulating him into taking care of my facial trauma patients in the middle of the night (just kidding, maybe).
It is weird when you finally reach those milestones that seemed so far off. We've been waiting for this closure for almost 8 years (well, 8 for Abe, almost 7 for me).
Saturday, March 10, 2012
Then I grew up. And got my own house. And like most daughters who seem to realize they are a lot like their moms, I find myself doing the same thing. I’ve been dreaming up home remodel ideas since before we moved in. Right now I am pining (or should I saw “pinning” away on pinterest) to remodel our basement. Right now it looks like this:
Ok not really, but hopefully you get the idea that this is a picture of a dungeon and that is my best description of our dark, cold, and often wet basement. (Oh, and FYI, be a little careful when searching online for images of “dungeons!”)
As of now I avoid going down to the basement. It has cold floors that as I said are often flooded, lots of spider webs and steep stairs. I don’t know how much it would cost to update things but I am mainly hoping for a finished off area we can enjoy, even if it is mainly for laundry or storage. We have limited closet space so some extra storage would be great and I’d like a nice place to be able to sit if there were a tornado warning -- or even if there isn’t a tornado warning, where we can sit without worry of drowning, freezing, being bit by spiders, or some radon related ailment in the future.
This is maybe my favorite picture. I could definitely see this working in our basement!
I also like the idea of a versatile work space with lots of cupboards and storage.
I am hoping to meet with a contractor this week to find out if this is even a possibility. Until then I’ll try not to obsess over it too much. Anyone have any ideas? Also, I am thinking of trying to use recycled cabinets if anyone has any leads.
I wont go in my ideas for the attic…that’s just going to have to wait. Probably forever.
Does anyone else do this, besides you mom? Plan your imaginary home?
Monday, March 5, 2012
People keep asking me how my Neurosurgery rotation is going. Well, for one, at just after 9 pm it is way past my bed time. My mornings start nice and early. Even living within just a few minutes of the hospital I find myself waking up in the 3 am-4 am block. Even when I am well rested, it just feels strange. I am starting work "in the middle of the night" to be there in time to pre-round on my patients about 4 am. We round as a team at 5am. We eat breakfast and then I take care of patients "on the floor." Luckily so far this part has been manageable. We have a small amount of patients (about 30 compared to the usual 60) and a large team this month.We focus a lot on "the neuro exam," which includes the ability to move body parts, respond to commands, feel sensation, and answer basic questions appropriately (some of the math questions are hard for me that early, "What is 100 - 7?"). We are responsible for surgery work ups during the day. We round at least one day per weekend. The earliest I can leave is 5pm.
I've had very little exposure in the past to neurosurgery in the past. During my anesthesia rotation I saw many different surgeries but only a few neurosurgery cases.
The only memorable neurosurgery moment I've had was with a well known surgeon at our hospital. I was rushed in to take over an emergency brain surgery within the first few days of my rotation on anesthesia.
During the procedure I heard the surgeon yelling, "Valsalva. Valsalva!" It took me a few seconds to realize he was speaking to me.
"Oh, are you speaking to me sir?"
"Valsalva!" As if saying it more loudly and more often would help me register the meaning.
I was puzzled. I know what a valsalva is (essentially the "bearing down" action like when you cough), but had no idea how to perform it on someone else. He continued to yell this impatiently.
"I'm sorry sir, but I don't know how to do that."
He was angry about this. He was muttering to the resident working with him. "Can you believe she doesn't know how to valsalva? Who doesn't know how to do that? etc etc." I waited for him to assist me by giving me some instruction (I wish I would have asked, "Do YOU know how to valsalva?) but finally he yelled at me to bring in my staff.
I frantically called the staff doctor who talked me through the procedure (basically a long breath hold). At the end of the case he told her, "She didn't even know how to do the valsalva! Can you believe it? How could this be?" He was obviously trying to get me in trouble.
She was wonderful and told him to back off, that it was my first week, and did he know everything his first week?
"Yes, in fact I was born a neurosurgeon and have been doing these procedures since I was 2!"
When we round I laugh about this story knowing this doctor has no idea who I am or how scared he made me early on.
Today was my first real exposure to a real neurosurgery case, a cranioplasty. Essentially they replaced the missing portion of a woman's skull that had to be removed due to a trauma. It was very cool to see them reshape her sunk-in skull with a metal piece that simulated the missing skull (ala the bionic woman or the tin woodsman). But, unlike our procedures that are quite safe, even this cosmetic surgery caries a large risk. These doctors carry a lot of responsibility with them every day!
I hope to see some more procedures and my first live brain in the near future.
Saturday, March 3, 2012
I think I’ve been a little cranky lately.We have been quite busy at the clinic the last few weeks (or months—I mean this year!). This past month I extracted 550 teeth (I usually do about 300 per month plus other procedures). I was up a lot in the middle of the night on call so maybe that is partially why. I’ve talked in the past about the borderline rude comments patients make about dentists (usually based out of fear). Normally I just smile and brush it off but this past week it seemed like everyone had something to say.
Patient #1: “You know, I’ve only had one dentist ever give me shots without hurting me.”
Me: “Oh, I’m guessing you don’t mean me?” (Come on, it’s a shot! And it’s given so I don’t have to hurt you on the next step. Believe me, you want the shot.)
Patient #1: “Oh no! Definitely not!” He laughs.
Me: “Well, I guess we are just a bunch of meanies here!” In a friendly tone.
Patient #1: “No, just you!” Pointing to my assistant,”She hasn’t hurt me yet.”
Me: I just didn’t feel like putting up with it. He was acting like I was purposefully hurting him when he had come to me for relief of his pain and we had nicely worked him into our schedule. He was extra work (and paperwork) for me on a busy day that I had been up since 3 am (which unfortunately is my life this month! ha ha). “It’s probably not a good idea to insult the person who has all of the sharp tools before she starts working on you.” In as friendly a tone as I could muster. Maybe not the best thing to say but I was so frustrated.
And on to patient#2, another add-on patient. She was very anxious. She was crying and wimpering when I walked into the room (before I ever “came at her with my sharp tools.”). I asked her what was wrong, if she was in pain or scared. She said both. She gave me a big spiel about how she hates dentists more than anything/anyone else in the world, how the whole experience is the worst, was I going to shove a needle up in her tooth (because that is the worst)?, etc. I’m used to this sort of thing but this is was what made me angry:
Patient #2: “I think you are all a bunch of sadists.”
Me: (Thank you! You saying that gives me so much extra pleasure, to know that you really are suffering!) “I’m sorry you feel that way. We are just trying to help you and I think the real sadistic thing to do would be to send you away without helping you feel better.” (Considering how much pain you were having before I even came in here.)
She of course cried throughout the whole thing, but we luckily were able to easily remove the tooth. I hope she feels better.
These experiences are so interesting. My few days of Neurosurgery have reminded me of a new perspective. We are lucky in oral surgery that our patients rarely have serious problems or complications. A hole in the sinus (that heals spontaneously), a broken tooth, a little numbness pales in comparison to the complications that can (and very often do) occur in these brain surgery patients who often can’t talk, move, or be themselves anymore (if they live). Yet, people don’t come in and tell us that Neurosurgeons are the worst and scariest people on Earth. These people have a lot more opportunity to inflict suffering, but they are admired and appreciated. I find it ironic.
The life of a dentist! To be feared and hated (and I think as an oral surgeon, we are THE most feared and hated). I guess I am lucky. Most sadists have to lure their patients in. They either have to find masochists who will enjoy the torture or kidnap or trick people into it. But, I am lucky. People willingly come to me for their torture. And in fact, they pay money. Or their insurance pays. And I have multiple rooms and devices dedicated solely to inflicting pain and misery. I have assistants who help me maximize the torture and fulfill my every bidding to ensure the maximum amount of fear and discomfort. Sometimes I even drug my patients so I can do my best torturing without having to worry about their cooperation!
(In case you aren’t familiar with oral surgery, here are some of my torture devices. Frightening, I know!)
--I hope you can tell I’m only joking. Or am I? (evil laugh)