Rolling, rolling, rollling

Yesterday was my brother's birthday. They were supposed to go to the lake so we didn't plan anything. For whatever reason they didn't go, so I had everyone over to my house at the last minute for hot dogs and then we went bowling. I haven't bowled in 3 years. The Boyfriend, who wasn't too excited about the opportunity to roll a heavy ball on the floor to knock down pins, informed me he hadn't bowled since 1971. Ouch. So my nieces, ages 9 and 7, like to bowl with the bumper guards up so they don't gutter every ball. A crisis ensued when the bumper guards weren't in place right away. They had to bowl a couple of turns guttering the ball, each time sulking with their arms crossed across telling my brother, "I want the bumpers". Then The Boyfriend took his turn. He guttered both balls. My 9 year old niece, still trying to make a case for getting the bumper guards, went up to him and said, "You need the bumpers!". He took the news well. Imagine, a grown adult, bowling with bumper guards. The thought just made me laugh!

I've never broken 100. My 3rd game last night I bowled a 130 and beat everyone! Maybe it was all the beer I drank, or maybe it was I decided to try a new strategy: keep my eyes on the pins instead of the floor. It seemed to work really well. I can't wait to go bowling again. The Boyfriend got his groove on too and managed to beat my nieces.

Back to work tomorrow. It is my last day of being on the hospitalist team. I can't contain my smiles enough. The hours were long and I got so sick of doing nothing but writing history and physicals all day. I'll still have to do it on call, but in much smaller doses.

I heard a good joke on The Tonight Show: What is the largest export of Cuba?

Answer: Cubans. I guess you could expand that to include Mexico. If I was the leader of either country, I think I would be really embarrassed that so many people want to leave. Perhaps they should do something about that....

Has it been over a week? All my friends are WAY ahead of me on blogging, so, even though I need to go to bed because I will be up for 24+ hours tomorrow (stay off the road around 8am Thursday) I will blog.

The Boyfriend and I went to Dallas last weekend and stayed at the Westin at the Galleria. His brother and sister-in-law are about to move to Dallas so we met them there and got to see the new house they are building. I'd never met them before so that was fun too. The wife is 14 weeks pregnant with triplets so things are getting exciting for them. Now that I've seen this humongous house they are building, I want to buy a bigger house. There was a gang shooting at the 7-11 two blocks from my house recently and it has me wanting to move about 10 miles North. I love my little house though. I planted trees, crepe myrtles, refinished the wood floors, had porcelain tile put in the kitchen, painted...and now I want to move. All that work I put in is being ruined by a bunch of stupid gang bangers who have no respect for human life.

So, getting back to Dallas. I managed to spend $377 on 2 pairs of jeans and a t-shirt. it's my best work yet. Perhaps if I didn't spend so much on clothes I could afford a larger house payment!!

Now for my rant. What is it with voters?? I'm not even talking about people not in my party. I'm talking about people WITHIN my party. Today we had a primary election for governer, Lt governer, and a bunch of other stuff. Somehow I managed to vote for the candidates who lost. I'm convinced that most voters don't care about the issues and they vote by name recognition. I'm ready to get rid of career politicians and elect some new blood, but no, we have to keep voting for the same old boring people because most people who vote are not very smart. I've decided that voting should only be a priviledge to those who pay taxes. Why should somebody on welfare be allowed to vote on what to do with MY tax money?? Seems a bit like theft to me....

Well now I'm sure I've managed to piss people off with my opinions. Just so you know, I make no apologies. I worked as a social worker for 6 years and saw how great entitlement programs work. Just so you know.

I put in 75 hours last week..close to the 80 work week restriction, but I can't complain. I have friends who put in WAY more than 80 hours a week, despite the law...

I was on call all day Saturday until 8am Sunday morning, which pretty much ruined my weekend. I was trashed all day yesteray but it was my only day off all week. The Boyfriend and I went to see The Devil Loves Prada. He came along to earn what he calls "chick flick points". It was a great movie and he actually like it too...that is, the first 2/3 of it. The last 1/3 got a bit touchy-feely and I was just happy he didn't throw up in the theater. We were going to make a non-cash bet over whether or not it would be #1 in the box office for the weekend. I was willing to make the bet, but apparently the stakes were too high for him, so we didn't make the bet. He shoulda, because he woulda won the bet.

Tonight we're going out to dinner and then I'm going to walk. Granted, it's 104 degrees outside right now, so if it doesn't cool off before 8pm, the walk may not happen. I'm not on call again until Thursday night. Friday I will get to leave after noon conference since I'll be post-call, then The Boyfriend and I are taking his M6 to Dallas for a fun weekend. I'll get to meet his brother and sister-in law who is pregnant with triplets. They live in LA but are moving to Dallas soon.

"That's all." -Miranda

The Residency Diet Plan

I've been on a diet since January. I want to lose 15 pounds. I started counting Weight Watchers points and had pretty good luck, but I hit a plateau after I lost 7 pounds. I've been walking 3 miles 5 times a week for almost 1 1/2 years. During my vacation I added The Firm twice a week thinking that I needed to supplement my exercise with weights. Still, my weight didn't budge. Then I started residency. I thought I was going to gain the 7 pounds back because I don't get to walk my 3 miles as often. Granted, I am on my feet ALL DAY at the hospital but it's not really aerobic. I've also noticed I've had a ravenous appetite and have been eating like a big pig lately. Well, I guess all that doesn't matter because I weighed today and Eureka!! I lost 2 pounds in 1 1/2 weeks! The elusive 2 pounds I have been struggling with for 2 months have finally come off! Could residency be the secret potion for weight loss?

I was on call last night. I was busy until 4am admitting patients. Everytime I would get finished with one, the ER would page me with another one. It was crazy. These people were really sick, too. One lady close to my age gorked her liver with chronic alcoholism and was as yellow as an Oompa Loompa. Another elderly gentleman was so demented that he cursed me when I tried to examine him. It was endearing. I felt bad for him. Confused and angry, he didn't know where he was, and he didn't know who the family members were that had come to see him. So when he cursed at me, I just smiled. Another lady has meningitis. One guy had a liver trasplant a few months ago and was complaining of a big belly. I can't remember what was wrong with one admission, and then there's my last one. Some goon who overdosed on Soma and was a real pain in the ass. By then it was 4am and I was losing my patience with him. I enjoyed listening to him holler while the nurse put in his foley catheter. I felt like the evil witch doctor for that.

Fussbudget Love

I had a fun weekend, except for the first part. I had to take what was supposed to be the 8 hour board certification exam for anesthesiology. Since I only knew about 1/8 of the answers, it only took me 4 hours to complete. For now, the test is only used to gauge my progress through the next four years, so this year's score really doesn't matter. However, when I'm taking the exam to become board certified in 4 years, the score really matters a lot.

After the test was over, The Boyfriend and I drove my car to Wichita, KS to pick up a new car he ordered...a BMW M6! We stayed the night at the Hotel at Olde Town and enjoyed a mediocre dinner of sushi at a nearby restaurant. The waitress kept bringing us other people's food, and she tried to give our appetizer to somebody else. There was also some sort of festival in Olde Town so the streets were noisy and crowded with people. The Boyfriend said the street noise lasted until 3am. I wouldn't know. I crashed early at midnight and didn't hear a thing. That's been happening a lot these days. I can't get my book read because everytime I settle down to read at night, I end up getting sleepy and going to sleep.

So, back to the weekend. This morning we went to the dealership and picked up his car. Like. Wow. It was in the center of their showroom and the guy said it had received quite a lot of attention since they put it out. It's the first time The Boyfriend and I have ever seen an M6 (they are really, really hard to get) and I just fell in love.

After that, we went to our favorite restaurant in Wichita- Yai-Yai's. I've been looking forward to eating there for about 2 weeks. We got there we noticed there's some sort of Sunday brunch buffet going on. I asked Teeny Bopper Hostess if we could have a menu. She tells me, "they don't like to do that during brunch". Hmm. Well, that's nice and all, but I didn't really ask if "they" liked to do anything. I mean, I don't really like doing rectal exams, but I've had to do them a time or two. So I asked her again, "So can we order lunch from the menu?" Teeny Bopper Hostess says I can but they aren't really ready to cook anything. Whatever. I am truly annoyed. So we ate the brunch buffet. Sadly, it was not the same. We were both a little more than slightly disappointed. Teeny Bopper Hostess really pissed me off with her attitude. The Boyfriend thought that part was pretty funny. Apparently being a fuss-budget is one of my good qualities!

So me, The Boyfriend, and the new M6 are safely back home tonight. I have to say, the M6 got a lot of stares from people today. I got to drive it a bit tonight. I'm not sure what was more amazing, the drive itself or the fact that The Boyfriend let me drive it! If that ain't love, then what is?

My first code

Ask any resident where the worst place in a hospital to have a code is, and they'll tell you in radiology on the CT scanner. Guess where my first code was? Radiology at the CT scanner. When my pager went off, Hell, I didn't even know where radiology was! So I get there, along with my 7 other colleague-residents who came along, and there are no less than 25 people there watching the show. The lady had sort of been brought back by the time I got there, so she was quickly transported back up to ICU (without getting the CT). No sooner do we get to her room and she codes again. Fortunately for me, ICU nurses can run codes without me but I have to be there anyway so I ordered some lab work. I tried to run through my head what could be wrong, but she was so sick, it could have been anything and there comes a point where a loved one needs to decide enough is enough. Her doctor came in and then went out to talk to the family. They decided not to have her resuscitated anymore, so the nurses cleaned the patient up and the family came in to spend the last few hours with her. She died about 3 hours later.

Tomorrow I am not a house officer. I don't have to admit patients or respond to codes. I can relax. I'm glad my first week is almost over.

My first night on call...

wasn't so bad other than the face it was a holiday and I wanted to watch fireworks and eat junk food rather than hang out in a lonely hospital for 24 hours with no one to talk to.

My day started at 8am on the 4th. I did a history and physical on a new patient in the morning and was finished by noon. I sat around on edge all day just waiting for my pager to go off. Finally, at 5pm, I started to get paranoid that maybe the hospital operator had the wrong pager number down for me so I called her to make sure. Everything was fine. I tried to take a nap, but it's hard to sleep when you know you could get paged with a crisis at any moment. At 10pm I finally got paged to go see a new patient. That took a couple of hours. Then I got paged to see a guy whose family was anxious about him. I basically just took a look at him and reassured the family that he is stable.

I finally fell asleep and woke up at 2:30 this morning to my pager going off. It was an ICU nurse who needed me to come up and check a breathing tube of a patient. I didn't really understand what she was saying on the phone. So I get up there, and there's a bit of excitement because this patient was restless all night and had managed to dislodge his breathing tube and wasn't getting any oxygen from the ventilator. One of the nurses was manually "bagging" him so he could get air. I started putting gloves on and went to the head of the bed to get ready to replace his breathing tube. He was really squirming and fighting me (I don't blame him). A nurse asked me if I wanted to paralyze him. I really don't have much experience with that yet and told her I didn't want to do that because if I can't get the breathing tube in, I'll have to bag him for 15 minutes while the drugs wear off, so, I ordered etomidate to sedate him to go along with the versed they had already tried. It worked great and I was sort of able to get the tube back in. I couldn't really tell if it was in the right place, but I could hear breath sounds over both lungs and the ventilator indicated that he was getting oxygen again. I ordered a chest xray to confirm placement of the tube and then waited around for the radiologist to call me with the results. As it turned out, the tube was a little high and I briefly considered retrying and then I stopped: why fix something that isn't broken? He's oxygenating fine now, and he quit fighting the tube because we sedated him, so I decided to leave it where it was. I was so relieved that ended fine without any catastrophe. I was also glad I didn't have to call one of the ER docs to come help me with him. I managed it by myself with the help of some awesome nurses.

So by then it was 3:30am. I went back to my room, finally fell asleep and got paged at 6am. That call was just settled on the phone, but I was so excited to know my shift was almost over that I couldn't get back to sleep. I went home at 8:30am and slept for 2 hours before I had to be back at the hospital for noon teaching conference. By then I felt like a train wreck but the conferences are mandatory-even if we have been up all night. I came home at 2pm and slept another 1 1/2 hours and then got up. I felt a lot better after my 3 mile walk. I haven't walked since Sunday and I really missed it so I was glad to get to do that today. Hung out with my boyfriend tonight and now I'm going to bed early.

In all it wasn't a bad night. I'm starting to feel better about all this. What I'm really glad about is that I stayed calm during that whole ICU incident. I didn't even have to think about staying calm, I just was calm on my own.

I'm starting to think things won't be so bad after all. It's not like I'm the first person to ever be an intern. Everyone else gets through it, so will I. I talked to some of the other guys I'm with and they admitted to kinda feeling freaked out last week like I was.

Our program director took Julie and me around the hospital so we could get a taste for how each floor is organized. We met some of the nurses and they all seemed really nice. They were also pretty excited to have 2 female residents this year, since it's been 3 years since they have had any. That really made me feel good.

I met one of the docs I'll be rotating with. I asked him what time and where he would like to meet Monday morning. He actually asked me if 7:30am was too early for me. Too early? Hell no! Not when most interns have to be at the hospital at 6am! I think I'm gonna like him....