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!

Baby Blankets

Last night we had dinner with my aunt and uncle and sweet Lilly in Gtown (shout out for the "thrice" baked potatoes!) and got to talking about baby blankets. Lilly's baby blanket is a hand crocheted blanket that my aunt used because Lilly would pull the blankets over head and she figured she probably wouldn't suffocate if it had holes in it :-). My blanket was made by a friend of my moms and it never left my side for at least 10 years. My husband teases that it has been replaced by a hideous old sleeping bag that I wrap up in when I am home :-). I was thinking of this conversation this morning when I pulled Churchill's blanket out of the dryer:

Church is the puppy and I have no idea why but he will pull up certain parts of the blanket and suck on it . . . very strange. It's a good thing he's not like humans who get attached to one specific blanket because about every 6 months or so we have to reinvest in new "blankies" for him. Hope everyone is having a happy Saturday!!

A Night in the NICU

Oh the NICU . . . we have such a love/hate relationship :-). I love the NICU because it is a place where miracles can happen (because lets be honest, there is nothing miraculous about curing an ear infection) and because you will see diseases there that you just will not see anywhere else. The hate comes from the AWFUL social situations - drug abusing moms, crackhead dads, abusive families etc. where sadly, social services often deems the families suitable to care for these fragile little people.

Well last night was my first 30 hour shift this month and I want to share the good, the bad, and the ugly from my first night back in the NICU. I'll keep the information trim so I don't violate patient confidentiality :-).

The good:

- one of my babies was born with a serious heart problem called a "hypoplastic heart" where part of the heart is underdeveloped and doesn't pump blood well. These babies have to have at least three surgeries to fix the problem and the likelihood that they will live through just the first phase is ~30% depending on the severity and other anomalies!! I've had several babies in the past with this problem and sadly most of my last have either passed away or had an injury to their brain. Well my latest kiddo with this condition is doing GREAT and is going home this weekend to grow and play and get ready for the next phase of his/her treatments. :-) Discharges are happy days.

The less than good:

- We recently had a new baby who was born with both male and female private parts (called ambiguous genitalia) which is really tough for the families first - luckily we looked at the babies chromosomes before he/she was born and found out the babies sex (it helps the families identify with their "little girl" vs. "little boy"). This kiddo will be worked up for things that cause this condition and that will help determine how this baby will do. If its just an anatomy issue then supposedly its a fairly easy fix (at least according to the surgeons).

The ugly:

- we had a baby whose mom tried to self abort at home but the baby lived and now has a lot of issues :-( I won't go into the how's and why's but it is just one of the MANY sad stories.

One of my most memorable babies was a full term baby who was born to lovely parents who tried for several years to get pregnant and had a completely normal pregnancy. However she had a rough delivery and the baby essentially suffocated at birth (called birth asphyxia). He/she was put on a ventilator just so mom could get up to say goodbye :-(. I think about this baby every time I walk in the nursery where the baby was.

I'll leave you a recent quote as told to a resident:

Resident: "Tell me about the dad, what do we know about his family?"

Mom of patient: "Oh it was just one of those meet and greets."

So much of medicine just can't be made up. . .

Family Traditions LLC and Teodora

I love, love, LOVE to cook so this entry pains me a bit but I really have to share a little gem I've found recently. I know many of you have crazy schedules and do not always want to eat out or on the run!! Well we are the same in this house - Roy and I have many nights (like tonight) that we do not get home until 8:30pm (or after) and unfortunately those nights are becoming more frequent due to his recent promotion and my call increasing. However, a little local company by the name of Family Traditions (www.familytraditionsky.com) has made it possible for us to have "home cooking" even with our crazy schedules!

This company posts a menu on their website monthly and you can place orders (usually place on Monday to pick up by Friday) that are preassembled so all you have to do is defrost and pop in the oven! For instance, today was a hectic day and when Roy arrived at home at 7:45 pm he preheated the oven and popped in a Chicken Pot Pie from FT and dinner was ready by the time I was home at 8:30pm (not to mention how proud my husband was that he "cooked"). The owner also has many Weight Watcher options to choose from!! My MIL bought us our first order last week which were all Weight Watcher items or "lightened up" selections off the regular menu. We are so thrilled that there is an option between cooking and eating out and intend to use her services more on my busier months.

Also, she can deliver but we picked our order up and discovered she shares her space with a Romanian bakery called Teodora and let me say . . . YUMMY!! We were headed to a dinner on Friday night and purchased several Romanian desserts called Carpati (carmel and chocolate dessert that looks like a thin bread slice with dark chocolate dipped on the side) and Amandina's (we tried the lemon and chocolate) to take as dessert! I included a pic of the Carpati because they were so good!

Although I still am a firm believer in planning ahead and preparing healthy meals, we are so excited that we have a healthier option as a backup! Hope you find yourself at their store and finding a way to have more meals at home.

Redecorating, again

Whenever I have too much time off I always end up redecorating something (Roy says its too expensive for me to be off work :-) - so right now we are planning to finish a storage room in our basement and I want it to be a "project room"/extra office space and I think I've finally convinced Roy how great of an idea it is!! I want it to resemble his pic with the tall project table and the credenza of deep drawers to store stuff from all of my various hobbies but with the entry cabinet in the next picture and with a wrapping station that holds paper, ribbons, adornments, etc. It'll be a highly functional "multi purpose room". Here are few photos I am using as inspiration (change everything to white with green accents in your mind - I like things to look clean and crisp). Also a corner desk for Roy since our nice office furniture is constantly covered in work "stuff".

This project may be a late summer/early fall because last time I was off I picked out curtains and new bedding designed by Hubbuchs (Carolyn T. is wonderful) and we are getting some new furniture and plants for our courtyard as soon as the sun peeks through the clouds! Looking forward to sharing as soon as everything is done!

Looks so picturesque - think how productive I can be in that room! Sorry I've had this photo awhile and do not remember where it was from!

Little charging station for our plethora of electronics (from Ballard Designs)

Wire In/Out Baskets so little papers have no place to hide (Ballard again)

Love this desk set from Pottery Barn but its not solid wood and I do not prefer the spaces between the credenza bases (although that would give me a great place to store all of our x-rays of Olivers hips and of the things he's swallowed :-)

I think these entryway cabinets are genius. I think the ones I am going to get have shelves above the hooks so it can hold baskets of winter wear and extra bags in the bottom (gym bag, barn bag, etc). From Ballard Designs

Def need a big bulletin board above the credenza for organization and planning and to get all of our invites off the fridge! (Also from Ballard)

A GC win

We went last night to watch GC play St. Catherine's at home and are happy to report two Tiger victories!! This pic isn't the greatest but my phone couldn't quite keep up with the speed of play :-). You can see my two favorite players in this pic - the guy at the free throw line has so much personality and always seems to hit 3's when it counts and number 11 resting on the bench plays with so much speed it looks like he's on fire. Also next to 11 is my father in law - he's helping out with GC Men's Bball this year and is loving every minute of it!

Melanie Mauer Photo Session

As I was replacing some photos around our house with our latest, I realized I forgot to add a photo from our session last summer with the uber talented Melanie Mauer!! We wanted some professional family pics in between wedding and babies (and no - there are no babies in immediate plans) and could think of no one other than Ms. Melanie to take these images. You'll see why - she's completely amazing and has an incredible talent. You would have no idea our dogs were about to overheat (well maybe Oliver's big floppy tongue is a bit telling) and that we were sweating! We love her and will cherish these photos forever!!

"My wife rode Tubby Smiths horse"

Roy and I have been together for a total of NINE years (dating for 7, married for 2) and he had yet to see me ride a horse! We couldn't believe that he had never watched me ride because as my dad has said horseback riding is something I have an "uncompromising passion" for. I rode all. the. time. in elementary through high school and rode only occasionally in college because I tore my ACL my soph year and had little time to ride after. So now that I've been riding more regularly he's missed it because I'll go on days I get off early (yes, even residents occasionally get off early) or days when he is going to a game or something else "manly". Anyway, as part of our staycation mission he promised he would come to the barn with me!

So, when we arrive at the barn my trainer pulled out a horse and started telling me about all of his accomplishments and telling me about his bad habits and as she and I are talking Roy leans over and reads his name plate: "Heirithmatic Owners: Orlando and Donna Smith". Of course his mind is clicking and he interrupts and asks the trainer, "Does Tubby Smith own this horse?" She smiled and said that they do but since they've moved to Minn. he can be used for teaching. . . .

So our ride was great and I wish I had a picture to post (mostly for Roy since he probably only looked at the horse the entire time), but because my husband is worse than a politician with his phone (ALWAYS texting, replying to emails, checking voicemails, checking out the stock market etc. etc. etc.) when I want his attention I always ask that he leaves his phone in the car. Since we were without iphone assistance I attached a photo of the horse being ridden by someone else that I found with help from google.

Anyway, as we were pulling out of the barn Roy called his dad to tell him we are coming to his game tonight and he blurts out, "Hey! My wife rode Tubby Smith's horse!" I couldn't help but laugh . . . typical man - completely uninterested in the whole riding part but all over the former UK bball coach! His dad did not let us down with his response either: "Really! He'll be so happy! I'll call and tell him right now!" :-) Glad something made them proud today!

PS his barn name is "Ken" because when he was a baby he would always stand so pretty - like a little Barbie doll. I agree - he's a total ham.

Job well done hubby!

In more ways than one!! For starters, Roy rec'd another promotion (this is just 8 months after his last!) and I have honestly never seen a man more dedicated to his work than he is. Every time we have a pause in the day I ask him what he is thinking about and he simply gives a sheepish grin and says, "work". He loves his job and feels so lucky to work at our alma mater where so many wonderful memories live (#1 - where we met and fell in love :-). He also recently received a job offer from another school in KY right after I had an offer from Paducah (the two cities are 7.5 hours apart!) so obviously his hard work is being recognized.

Secondly, Roy bought me these towels (so those of you who know me well know that I love our house and love making it more perfect for us) at LV Harkness on Monday as a "staycation" gift. When you unfold them they are full of pictures of things we love around Lexington including Keeneland, Rupp arena, the arboretum, etc - and they are absolutely beautiful! Roy had too much going on at work and not enough days off for us to take a big trip so I've been doing fun things around town and he's joined me for some of them so it at least feels like a vacation. He also traded me a new Kate for a half day him going to work when he could have been home - this is a reward system I could get used to!

Thirdly, this guy has been kicking my butt in spin this week! We went Monday and today and both days he comes home with pep in his step and I can barely walk!

Just had to take a moment to brag and show you these too cute towels!

R squared

So I just did a quick little google of "r squared" to see if my blog comes up and instead I found many definitions of the statistical meaning of r squared. I thought this was too cute to not mention. "An r squared of 1 indicates a perfect fit". Well if thats any indication consider our R x R to = 1. :-)

Much too long . . .

Happy New Year everyone!! Our household is thrilled to welcome 2011 (mostly because that means we are that much closer to 2013 when I complete residency)! We also have some THRILLING news to report - two of my besties, Margaret and Cindy, are getting married!! Margaret is getting married this October and Cindy will have a NYE wedding - congrats to both these terrific ladies!

My grandmother always says "every ol' crow thinks hers are the blackest" - translate: everyone thinks what they have is the best, and this is how I feel about my friends! I feel so lucky to know so many great people and honored that they consider me a friend.

This photo is of Margaret, Mandy, and I at one of my favorite 2010 weddings :-).

2011 will be an awesome year for this little pocket of the world and we hope its wonderful where you are as well!