Football

Last July I bought tickets to the Chiefs-Denver game for me and my dad for a fathers day/thanks for fixing my car gift. I had no idea at the time that I would be picking one of the best games of the year. We are by trade Chiefs fans and every year I start as a hard core fan and normally mid-season I don't watch as often because I get busy and it isn't as important when you are 0-12. But this year as I watched their season take place I got more and more excited for the upcoming game. Their first loss was to the Broncos in Denver two weeks before our big game which only increased the excitement for our rematch. We got parking in advance, bought custom cut steaks, and put together our drinks the night before in preparation. I also went and bought a new long sleeve thermal and leggings to go under my jersey and jeans to keep warm. When the morning finally came, my dad and I had breakfast with the rest of our family and headed out.
By headed out I mean we headed to Walmart to pick up those last minute things we forgot to get the night before. Like extra gloves, a chiefs hat for my dad, and A1 sauce. (Or and plates because I totally left them on the table when we left.) The ride down we talked about the injuries, how perfect the weather was going to be, and made predictions about the final score. My prediction was 24-21 Chiefs. I unfortunately was wrong, but more on that later.
We waited in a long line of cars to get into the stadium and when we gave our parking stub to the parking people it looked as though we would be parking pretty far away from the actual stadium, which we kind of expected. To our surprise they directed away from everyone else entering the far out parking lot and toward the stadium. Somehow the parking I had gotten us was parking in the lot right in front of the stadium. It was perfect. Everyone was tailgating and there was no way out once you got in there. Most everyone was Chiefs fans though you would see the occasional Broncos fan walk by and get booed by the crowd. The atmosphere was perfect and the sun was shining. We were sure it would be a great day.
Entering the stadium was a whole new experience. We had lower level seats in the end zone and by the time we got into our seats the players were already warming up. It was incredible! The stadium was overwhelming big and the players looked so close. We were high enough up to be able to see the plays develop, but far enough down to see them up close. They couldn't have been better seats.
We got super into the game. The things that happen in the stadium that you don't see on TV are awesome. The crowd is super loud, everyone is very into the game, and their couldn't be more loyal fans. We stood the whole time, screaming until our voice cracked. I remember the 100  yard return getting us the 3rd touchdown of the game. I was screaming and jumping up and down. I think the Broncos fan next to me thought I was a crazy person.
Everything just seemed so perfect. Right up to the point where we started losing. But then we started to make a come back. I remember how disappointed I felt when we didn't get that last touchdown. But overall it was a almost perfect day. Sometimes luck is on your side.

On Family Medicine

Shockingly the end of my time on Family Medicine has quickly arrived. What I was sure would be a relaxing, slow month was nothing of the sort. As I stood in my grandparent's guest room Tuesday night packing up my stuff, we discussed how we couldn't believe it had already come to an end. Somehow I managed to accumulate an excessive amount of stuff in their bedroom. Come to think about it, I didn't clean out the dresser or closet. I also made a trip to walmart right before bed Tuesday when I realized I had left my toothbrush and toothpaste sitting in their bathroom. Spending the month with them was very different from my normal daily life. Coming home to a house with people who are eager to hear about your day and have dinner with you is the complete opposite of me normally coming home to a dark, quiet house. Time just goes by so fast when you are enjoying it.
I had the opportunity to work with two different physicians this month who loved what they did and made Family Medicine look awesome. Actually I enjoyed Sports Medicine so much that if ER doesn't work out for me, I think I will do Sports Medicine instead. I had the opportunity to hear afib and an aortic murmur in the same day and seeing the amount of patients I was able to see allowed me quickly show progress. I really enjoyed the rotation and I enjoyed the opportunity to talk with physicians about their life and career path. It is nice to know I am not the only female doctor-to-be who is interested in working on their career before rushing off to get married and have a family(not that there is anything wrong with getting married and having a family first). And the other doctor has more debt than me! It is easy to forget when you are working with people who evaluate you that they are also human with their own stories.  Life is different away from academic medicine and I greatly enjoyed it.
I could use another month doing the same kind of thing there and I really believe it would be extremely beneficial. However, the next rotation calls and I will be moving on to inpatient internal medicine come Monday. I have already set up my study schedule and have made my goals for my upcoming rotation. I have a feeling it is going to go just as fast as the rest of my rotations this year. Hopefully I finish getting Christmas ready before Dec 25th arrives.

Life in the Fast Lane

I was sure that this month I would have tons of time to get done everything I wanted to get done. But atlas it is the end of November and I hardly got anything done at all. I did see a dentist so I did accomplish one thing on my list. But I really thought I would finish my Christmas decor I'm making, make my sister's Christmas gift, get the house cleaned, catch up with all my old friends at home, see all of my family at home, and get healthy. Unfortunately it didn't really work out the way I planned. I am going to have to put off the gift I am making my sister for next year, I'm going to have to spend tons of time trying to get my house put together to enjoy it a couple of days before Christmas, and I am going to miss out on seeing a lot of people this month. I have successfully tried to get a little healthier. I'm still sore from my work out on Wednesday so I must be doing something right. Life is just always busy when you live it in the fast lane. Now I have an upcoming test and have to start getting busy getting done all the things for this rotation I was supposed to be doing all month. I will say that it has been overall an enjoyable month and I have learned a ton! My first couple of weeks I worked with a physician who does a lot of sports medicine and acute care. This last week I have worked with a physician who takes care of patients that are more chronic and more like the patients I am used to in my normal weekly clinics. I enjoyed the acute care a lot more, but I have still learned a lot of new information taking care of chronic patients in an insured population. The medications, tests, and options available for those with insurance are much different than those without. Since I don't have to deal with the documentation part of the medical world, I am able to see so many more patients and learn so much more by using my time to actually work with patients instead of spending hours working on documentation. After this week I will be switching over to Internal Medicine with my unit and I am looking forward to continuing on. This week with be another busy one with a couple Thanksgivings, the big football game, tests, and decorating. I'll have lots of updates coming the first week of December. Happy Thanksgiving to you and yours!

"Rural" Family Medicine

One of my required rotations is to do a month in "rural" family medicine in Missouri. I am doing my rotation in my hometown which I can't really consider rural with 70,000 people, but none-the-less I am really enjoying it. I have moved in to my grandparent's guest room for the month and have actually been able to be part of my family.  I go watch the little ones dance 2 times a week, go to the gym with my mother, and take care of all of those things I keep putting off like the dentist. Several times a week (when I have the time) I turn my grandparent's living room into my craft room and have watched more night time TV in the last 2 weeks than I have in the last 5 years. (I really kind of like Elementary.) Surprisingly, I feel even busier now that I am home then I did when my hours at the hospital were twice what I am putting in now. I thought I would be swimming in time, but atlas that is never the case.
Not to say that I haven't been spoiled, because I definitely have. The physician I have worked with for the last couple weeks starts at 9 in the morning, takes an hour lunch, and then finishes no later than 5 in the evening. Not to mention his half day on Thursdays.  Even with the shorter days and later mornings, I still have learned a great deal in the last couple weeks. I see more patient and see more of a variety in a day than I would in my normal adult clinic in a month. I have found one of my week spots, orthopedics. He sees so many sports medicine type patients and not only have I learned how to decide on imaging but there is a whole different world of medicines out there for people who have insurance.
Everything about this clinic makes me enjoy it. I have never found family medicine very appealing, but he makes family medicine look very attractive. Let's start with the general atmosphere. His whole staff gets along so well, works together perfectly, and share laughs constantly. Everyone is so laid back and interactive with each other and they were all so welcoming when I joined the team. And when I say team, I mean they are truly an amazing team. Each person has a role in the patient's care and it makes it so efficient. Patients don't wait very long to be seen and then are quickly on their way. There is no waiting around for hours. One of the other things I have really enjoyed is that the doctor treats his nurses and his students like his equals. He talks about his life and listens to our stories. We spent a half hour of our down time this week just talking about the differences in how be got where we are. We talked about how he came to decide on family medicine and his complete honesty was so refreshing. Not to mention it was nice to meet someone who has more debt than I do and is doing just fine. He is a picture of what I hope to accomplish one day. A physician who is able to take care of their patients appropriately, work as a team and have a good relationship with their nurses and techs, and still be able to go home to a family they are dedicated to at night.
So onward with what I have actually seen in the last couple of weeks. I saw the first patient I knew this week. I was completely awkward because it was a first for me. She was so much more relaxed about it than I was. Silly me.  Both me and the doctor I worked with this week had a couple, "I have no idea" moments this week. I had one lady come in with tingling in her hands and feet, but no diabetes and had already been tested for vitamin deficiencies. We are sending her on, but keeping track of her to see what rheum has to say. I realized seeing several patients that I remember a lot from boards that I didn't realized I still remembered. I saw several really adorable little ones. I must say the pen light I bought from the camping section at Walmart is the best investment I have made when it comes to little ones. They will let you do anything while they are shining it on the wall. I met my first autistic child. Broken bones, concussions, broken bones, concussions. Yep I'm an expert. Okay maybe not an expert, but I am much better than I was before. And then I got a lot of experience with changing meds on the chronic conditions that are common. And if you add on acute illnesses, allergies, infections, well checks, depression, ADHD, pain, memory difficulties, and strange bumps you pretty much have my 2 weeks. Did I mention I got to see a lot?
Come Monday I switch to a different physician and have to start getting up at a normal time again. I am hopeful it is as useful as the last couple weeks.

On and just 37 days and a few hours to Christmas. I am very behind!

Regression

While my time in the pediatric clinics has been over for a little over a week now, I still remember my time there fondly. It is funny how certain things make you regress back into childhood. Like water puddles when you are on vacation, tickling, and these special tiles in the pediatric clinic. My first couple of days I didn't even notice that they were "special." I just thought they were strange colored blocks on the floor. Like abstract. But a couple days in some of the other medical students were talking about stepping on them and being afraid they had broken something. These blocks were so cool! (note: I am easily impressed and amused.) Basically it was a block on the floor that when you stepped on it the color displaced. It was like paint in a ziplock bag or something. Once I discovered these gems, I found myself looking around the hallway every time I went to see a patient to see if anyone else was around so I could step on the blocks without being judged. I am sure they are there for the entertainment of the children, but heck there are times when I am still a child at heart.

Christmas! It is another thing that makes me a child at heart and fills me with unexplainable excitement when I allow myself to start decorating. It often takes me weeks to put up all my decorations with my busy schedule, but I start early. Shopping for decoration, putting them up, hot cocoa, Christmas music. You name it, it all fills me with a ridiculous amount of joy. Right now my house is half Christmas, half fall, with a sprinkle of halloween. It is rather beautiful. By the time December 1st comes around though, my house should look something like the North Pole.

I have gone home for the month of November to rotate in "rural" family medicine and come back to my own home on weekends to work giving me a little time to decorate each week. So far my time at home has been busy and enlightening, but more on that later. Work time!

Pediatric Clinics

For the last couple of weeks, I have been working in primary care pediatric clinics and I am loving it! Unfortunately, my time in pediatrics is coming to an end in the near future. I have my SHELF exam on Tuesday and on Friday I switch to my next rotation, rural family medicine. The last couple of weeks has reinforced my love for children, but reminded me that I still have so much to learn. Speaking of which, I should totally be studying, but I have Christmas fever. Anyone who knows me knows how much I absolutely love Christmas! Basically the first weekend in November I consider the beginning of Christmas season. I started shopping weeks ago and hope to be done shopping by the end of November. I don't really like the crowded stores. I prefer being able to enjoy my search for the perfect gifts without having to navigate my way through a bunch of other people. Plus unhappy people ruins my Christmas spirit. So the realization that next weekend will my decoration weekend has me a little side tracked today. I'm thinking a red and white Christmas tree this year and I am trying to figure out the best place for my Christmas village. This time next week I will be rearranging furniture, listening to Christmas music, and sipping on hot chocolate. It would be a total waste of time to try to convince me that it is too early, I totally respect everyone who waits until after Thanksgiving, but in my house it is hard enough to wait until after Halloween.
Speaking of Halloween, I am getting excited for the trick-or-treaters. I plan on decorating my door and have my bowl of candy waiting for the little ones. I just hope I get home in time to give out candy.
So back to pediatric clinics and perhaps a small snap shot of my 2 weeks of nursery. I learned a lot while on nursery and it comprises a good part of our exam, so I am glad I have that opportunity. However, I know that nursery is not in my future.
I have seen some really wonderful parenting in the last month. While in nursery, we were doing the last exam on a baby before the family went home when the dad and big brother came in. The big brother had to be about 2 years old and he was carrying in flowers for his mom. Talk about heart melting! While in pediatric clinic, I did a double well child visit for a 2 month old and her 3 year old sister. Both parents stood by listening, participating, and interacting with their children. The 3 year old continuous was saying either "hi mommy" or "hi daddy" and the parents would say hi back with a chuckle. Never getting frustrated with the constant interruptions which I found adorable. While examining the baby, mom read the 3 year old a book and with each turn of the page she would get excited and start jumping around. You could simply tell that the kids were well loved and thriving. I am a total sucker for cute kids, happy families, and successful parenting. It is a reminder that happiness and good parenting has nothing to do with economic status.

Things I have learned in clinic:
1. 2 year olds love pen lights. I mean seriously they could be entertained for hours. One kid shined it straight in his eye and laughed. All I could think was does that not bother you?
2. Ear exams are tricky. That being said, if you are examining an infant and need them to look the other way simple move your head to that side and they will turn to see what you are looking at.
3. There are way too many people out there co-sleeping with their infants.
4. Giving the "this is puberty" talk is a lot more awkward if you have define words.
5. There is nothing more encouraging than to sit and tell the doctor you are working with all the advice you gave the family and have them sit there and smile and nod their head.
6. There are doctors out there who are like me. Aware of our social issues and want to save the world.
7. It doesn't matter how hard I have to work, how early I have to be there, or how late I have to stay as long as I enjoy what I am doing, I am happy.
8. When I am on my A game, I do super well and parents will tell me everything. When I am not on my A game, apparently I am awkward.
9. I am still able to run down 2 flights of stairs and across a parking lot for a code even in my new dress shoes that have a heel on them. Glad I tested that out.
10. Pediatrics is such a happy place to be. Okay I already knew that.

Even though my pediatric rotation is coming to an end, I still have so much to look forward to and so much I have enjoyed. I learned a ton during this month, worked with some impressive physicians, got a recommendation letter, received tons of advice, and improved my clinic skills greatly. Next month, I get to go home and stay with my grandparents while working in my home town. I'm excited to be able to actually be part of my family for a few weeks. On December 1st, my father and I are going to my first NFL game which just happens to be one of the biggest games of the year. And I'm getting closer and closer to the time where I will get to spend all of my time either in pediatrics or the emergency room. Back to studying!

Time Off

Apple Cider Press

Time off from rotations, studying, and my part time job is almost impossible to find, but I got a couple days off this past weekend to see my family. Every year on the first Saturday in October my grandparents put on a Annual Apple Cider Party. They have been throwing these parties for more than 20 years. My grandpa has an apple cider press that is probably 150 years old that he has attached a motor to and my grandma spends days cooking in preparation. When I was a kid there was no motor on the press and so making apple cider was hard work. You had to cut the apples up and then hand crank the press. The motor really cuts down on the labor, but every once in a while you will get someone who wants to try to hand crank the press and my grandpa will put the handle back on.
There is nothing quite like homemade apple cider. For me, fall officially starts every year on the first Saturday in October.
For the last several years I have only been able to make it to the party for a few hours because of studying or work, but this year I really needed a whole day with my family. No matter how much you love what you are doing everyone needs a break. My 18 month old niece has become a walking, jabbering toddler while I've been studying. She has an very interesting group of known words and runs straight for the stairs even though they aren't her strong suit yet. I helped the kids put apple into the cider press which basically becomes a game of basketball between 5-8 year olds. I get the same questions every year about how much longer I have left and how things are going. This year I was excited to field those questions. I'm loving what I am doing and I only have a year and half left of this part of my journey. I enjoyed a long conversation with my grandpa's best friend who happens to be a dentist about what it is like to have conversations with non-medicine people. Apparently, non-medical people don't like to talk about guts at mealtimes. Who knew? And I was only asked once if I was going to get married any time soon. At sun down the 2013 Apple Cider Party was declared a success.
When the guests started to leave and the press shut down, we moved the get together into the house and continue on with drinks and cards. My whole family plays pitch and it normally gets a little wild in there. Lots of trash talking and telling of embarrassing stories. Laughing and sulking. It never gets old, but even I have joined the "old" crowd and when it hits 11 I'm exhausted.
Come Sunday I was able to sleep in before heading over for a little breakfast and goodbyes. Then off to my mom's for Sunday dinner. It has been weeks since I have been home for dinner and it was nice to have some home cooking. My nephew is also walking, but only a couple steps at a time. It is as if after he takes 2 steps he is surprised and falls down. My parents also adopted a little boy and girl who are 5 and 7 now. They spend from the moment I walk in until the moment I leave attached to my side. Nothing beats the excitement of children. They both are loving school and ready for halloween. We played several boards games and though the little guy normally likes to quit in the middle when he gets bored he made it through several games before dinner time. We found that Janga is right up his alley.
It's always hard to say goodbye when I know it will be another month before I will be home again. With my upcoming Pediatric Shelf exam and lots of hours left to put in it will be impossible for me to sneak home again until November.
Last week and this week I am spending in the Well Baby Nursery. Newborns are a whole different kind of world. Though initially I thought it would be difficult to flip a baby over to do the full exam, I have found it is pretty simple. Newborns are very peaceful. I spend a couple days in the NICU next week and then I am off to primary care pediatric clinic.

A little time by the fire

Lots and lots of cider