Legally Blonde the Musical

Went to see Legally Blonde at Lex Opera House tonight and LOVED it. Bruiser was so cute and Emmett was a blonde, more academic hottie version, of Luke Wilson in the movie version. Roy went with me and was a very good sport :-). He even admitted it was "cute" - pretty big compliment from him!!!

Top 10: Things I hate about the ER

10.) There are no windows in the ED - I have no idea what the weather is, if the sun is up or down, if we are having a nuclear meltdown . . . nothing!

9.) Adults smell much worse than kids

8.) Shameless drug seeking - some of these people should be Academy nominated actors and others . . . well . . . bless their hearts

7.) These "hump" shifts: 9-7 is a terrible shift. You shouldn't really eat while you are in the ED and I am a full on member of the geriatric club and prefer to have dinner at 5:30 - not 8:30. Maybe even at 5 since I am skipping lunch.

6.) Parking at UK at 9am - if you live in Lexington you just groaned internally.

5.) I don't like having to tell people they have STD's or discuss their drug issues - this occurs, at worst, 4 times a month in Peds and I am usually not discussing meth or heroin. (A patient told me he started doing heroin before the age of 10! 10! I read "Are you there God, its me Margaret" when I was 10 and still didn't understand the whole process!

4.) I don't get to hang with my friends (at least not very many anyway) - only one peds resident does this rotation a month so I am alone :-(.

3.) I am reminded of how ridiculous people are and how much their ridiculousness is wasting my tax money on an hourly basis.

2.) The ER can be kind of a sad place sometimes . . . I attend deliveries and 9/10 times I see tears, they are tears of happiness.

1.) I have discussed anal warts more in one week than I have in my entire life. Vom-it

So seriously, aside from above, I actually kind of like the ER. Its a nice change of pace, I have met some fun residents (some from family, some from IM, some from ER), and I actually do like taking care of adults (its just been over a year since the last time I saw someone over the age of 25, so I've had to clear the cobwebs). My favorite part of taking care of adults are the "come to Jesus meetings" you can have with adults that you can't have with most kids or their families. You know the "your life can go two directions from this point depending on how much responsibility you take for your health" talks. That's really what I liked the most about adults anyway - you can empower people with knowledge and tools and give them the option. I should be a life coach, haha! I have 10 more shifts and next month I go to Peds HemeOnc (kiddos with cancer) so probably a tearful month. I wish I cold share some ER stories but honestly they are so specific I don't think I could leave out enough details to keep 100% private. Lo siento amigos.

Oh Happy Day

I have been MIA since March 1? Really? Well to recap the first half of this month I took boards on March 5th (Step III - so no more "steps" but I do have my pediatrics boards after I finish residency, which is in 27.2 months if you were curious ;-) and have been in the ER pretty much since then. In the ER the residents work shifts (most of mine are 10 hours) and they usually fall from 9a-7p so the bulk of the day is gone once I get out of there.

But TODAY was my first day off in awhile which was fantastic! However, no sleeping in at the Lowdenback house - the puppies had to be dropped off at 7:30am at the vet for their vaccines, exams, and dental cleanings (don't ask - dog insurance is crazy) and I had a light come on in my car so I had to drop it off and pick up a loaner by 9, a hair appt at 10, and an afternoon of class, meetings, and pick-ups. On the plus, my dogs are healthy and happy (and still mildly sedated); nothing is wrong with my SUV (and I got to drive a fun little hybrid loaner with a mouse instead of a stick shift - a Lexus GX if your shopping - def learning curve), and I like I look like myself again :-). I LOVE days off - even when they are more productive than I intend.

Hope everyone is having a Happy Tuesday!!!

Another month, another service

Thank you, thank you for all your thoughts, prayers, emails, and texts asking about my little patient! That future is still yet to be determined and you will not believe that I got ANOTHER HIE baby over the weekend . . . I'll keep you posted on how they are doing as I continue to check in on them! I asked my attending how many HIE patients they get a year (I cared for 3 this month) and she said usually just 6-9! Can you believe how unlucky a month February was this year?!

Today I started in the ER and I am completely counting down my shifts (18 more). ER and Heme/Onc (kids cancer) are the only two months I don't have to stay overnight on 30 hour shifts (which is awesome!) but because of that I spend more actual days in the hospital. So I work every weekend this month and half of the weekends next month (blah). I've been making my schedule out for next year and one of the upper levels was showing me tricks to get more vacation time :-). This picture is how I feel some days . . . I have 28 more months of residency . . . sheesh . . .

A heartbreaker . . .

If you are one of my many pregnant friends please do not read this post!!

It is sad that I have to provide a disclaimer for this post but I (like many people in the medical field) find myself telling healthcare horror stories and pre-partum anxiety is not something I want to instill in any of my besties. If you do cheat and read please remember that healthy, happy babies are born all day, everyday and they are the norm, not the exception!

We've had several babies this year be admitted on a HIE protocol (hypoxic-ischemic-encephalopathy) and they are just very sad situations. These mom's typically have a completely normal pregnancy and something just flips during their deliveries (the baby gets stuck, heart rate drops . . . each story has a slight variation) and these babies have the dreaded "just don't look good" appearance when they are born. Some immediately have seizures, some have to have chest compressions, some just don't have any respiratory drive . . . again their stories all vary a bit. We admit these babies on a cooling protocol so that we can prevent more of their brain from dying (parts of it will die due to whatever caused their birth depression). So we take this little baby that was happily kicking and hiccuping and keeping mom awake all night jsut 24 hours ago and put them on ventilators and cool their body temperature for 48 hours and just wait to see how much we were able to save of their brain. Sometimes its a lot and these babies go on to live a relatively normal life, unfortunately the ones I've seen so far this year have had variable outcomes. They require a lot of close monitoring in the first few days to keep their blood stable (constantly giving transfusions), monitoring their acid/base balance, measuring if they had a bleed into their head, if their heart is still working properly, etc. It completely rips my heart out to see these nice, normal mom's coming to see their baby who they expected to have home already in their freshly painted room filled with baby toys and shower gifts and asking everyday if we think he/she will survive. :-( Once the baby has been cooled for 48 hours we warm them back up over a 12 hour period to see how they will do. Some do nothing, some have seizures, some wake up. The big benchmark is the MRI of the brain to tell us how much the brain was injured. It's the worst waiting game for a new (already highly hormonal) mother. We have a baby that will be warmed when I am on call next so say some prayers for a good outcome!!!

Stomp!

Part of my Valentines Day gift from Roy included tickets to see Stomp, who had a scheduled stop at the Norton Center on Wednesday. I was post-call (which explains why I am up at 2am posting now) so I definitely felt as though this was the only sort of performance I could stay awake for after a 30 hour shift (loud, high energy). I have to confess I was a little nervous about whether or not I would like Stomp (2 hours of people banging on things sounded like it could go either direction to me) but I have to admit it was INCREDIBLE!! I love live performances of most kinds but it was truly impressive how in sync these performers were - I would be fired on the spot because there is now way I could have kept up!! Also the different sounds they were able to make out of seemingly useless stuff . . . sort of made me want to go home and bang on something :-). They've already left KY but if you get a chance to see it I highly recommend!

On call blues . . .

I am on call tonight - again, and am totally jealous of everyone doing ANYTHING even remotely interesting/fun. The problem with being on call is that I think of things to do (i.e. things I would rather be doing) and think "Oh I'll do that tomorrow!" So my days off turn into these exhausting days of to do marathons just so I feel like I have enough going on in the "real world" to feel human. For example, my last day off I decided I was going to bake for my Junior League secret sister (which subsequently turned into baking for everyone I know), go to spin, shop, read some spanish, have dinner with a friend, run some errands, visit my sister, study for boards, et. al. It's a completely fun disaster :-) Tomorrow I've made plans to go play polo as soon as I get off and then go to game/out with friends (the key post call is to keep moving - sitting should be outlawed). Sunday is last full day off for 2 weeks (3 if you don't call the day I take boards as an off day) - so fun must be had! Plans TBD.

Tonight I have backup (a fellow who completed a pediatric residency and is now in a fellowship to become a neonatologist) which is very comforting!! These little ones like to stop breathing, stop their hearts, stop just about everything that keeps them existing so I am happy there is more than one person keeping them alive! We have a bunch of "sick stable" babies right now (babies who are super sick but for the moment are doing okay). I have mostly babies who were born much too early, a couple who were born with holes in their diaphragm (called a congenital diaphragmatic hernia) so part of their intestines get into the space where their lungs should go so they can't breathe appropriately, a couple where part of their intestines didn't form completely, and one with pulmonary hypertension that has been keeping me in a hypertensive crisis for 3 days. I am giving blood transfusions right now and have a couple follow up labs and HOPING for a pretty quiet night. We will see . . .

I would rather be home with this little guy . . . This is Church and he is the most loving dog I have ever owned, but he completely hates not being able to get on the beds and couches. I caught this photo after I got out of the shower . . . little sneak.

Doesn't that pic just make you want to take a nap?! It does for me!

Hope everyone is having a wonderful Friday!

Inspiration for your day:

What are you reading?

Since I started residency I have read 16 non-medical books on iBooks and Roy must have tired of me burning down the battery in my cell because one of my Christmas gifts was the Nook Color (which I am in LOVE with - I switched some magazine subscriptions to it first and it is perfect!). Last night while I was waiting on some labs to come back I grabbed my Nook and started shopping for some juicy fiction and came across this book by Mary Kay Andrews. Anyone read it? Most of my book recommendations this year have come from Brooke K. (Hedge Fund Wives, Lauren Conrad series), Jay (the Ken Follett books and some financial stuff), and Lauren (Madeleine Wickham and Emily Giffin) but if anyone else has something good to recommend I am open!! So far Savannah Blues is interesting . . . I'll let you know how it turns out!!

Also thanks for the prayers for my call night! My first night alone in the NICU went great (I told my fellow interns the babies must have know they were in survival mode because they all behaved :-). I am on call again on Thursday so it's a GOLDEN WEEKEND!! Yay my favorite! One of my kiddos isn't doing great, he/she was born with part of her skull missing (called aplasia cutis congenita), so now you can pray for him/her :-(.

Just a little mention .. . did you see Dr. McGehee, DVM had her garden featured in Martha Stewart Living this month? She lives in the Lexington area! Nice to have a little local shout out! Hope you are having a Happy Monday!!

Pinterest love

Oh I am in LOVE with Pinterest!!! Recently Ms. Melanie Mauer posted about pinterest.com - a fun new way to keep idea boards online! I think they are PERFECT for people who are big planners - especially for weddings and parties and really just about anything!! Please check the site out, I CAN'T STOP PINNING!!! P.S. I am on call alone in the NICU tomorrow . . . say a little prayer!