My last weekend intern call!

It was as bad as I expected...maybe worse. I was up fo 30 hours.

Got to work at 8am. Rounded with my pulmonology attending until noon.

The highlights of my insane night include:

Admitting the mean, drunk homeless guy at 1am who smelled so bad I thought I was going to vomit when I walked in his room. I didn't think it was possible to smell that bad.

Trying to intubate a girl in the ICU with cystic fibrosis and having her jaw clamp so tight when I gave her sedation that I had to paralyze her (by myself) to get the tube in. I was shaking I was so scared. They say you never forget your "first time". Well, I'll never forget the first time to give succinylcholine by myself. One thing that was nice to hear was that the ICU nurse and the respiratory therapist that assisted me said that was one of the calmest intubations they have been in. Little did they know how scared I felt and the ONLY reason I was calm was because they were calm. ICU nurses are truly a gift from God.

Not being able to intubate a guy and having his oxygen sats drop to 20 because he was difficult to ventilate with a bag/mask. I think that's about as scared as I've ever been on call. A stat call to the ER doc saved me (and the patient!).

Getting called at 4am because a new patient with atrial fibrillation suddenly became unresponsive. His oxygen saturations dropped and I had to intubate him without giving any sedation, causing him to have a vagal reaction and drop his heart rate low enough to make us call a code blue. Got him intubated without any problems, and thought maybe he'd had a stroke with the a-fib, but couldn't get him to the CT scanner because his blood pressure was low. I tried to get his blood pressure up as much as I could but nothing worked. 20 minutes on the ventilater he suddenly woke up and started responding to us and answering yes/no questions. He died 2 hours later from what turned out to be a huge clot in his left ventricle.

After all this, I had to round on a bunch of pulmonology patients until noon today.

A hangover feels better than how I feel today.

I'm grateful none of these events happened to me last July when I was a brand spankin' new intern. They would have had to carry me out in a straight jacket.

Ugh! I'm so tired.

I started my month of pulmonology Friday. I have to be at the hospital to round at 7am then be available for consultations in the afternoon. It's not really all that bad, I'm just not quite used to getting up so early. This time next month it will be like sleeping in.

Anyway, I got 3 consultations yesterday afternoon then I was on call last night. I got home today around 1pm and just collapsed into bed but really didn't sleep very long. I've been dragging the rest of today with my "post call headache" I always get when I'm sleep deprived.

Earlier this week my ex boyfriend moved to Dallas. That has been difficult to deal with. We had a fun weekend but he's been busy and distracted with the logistics of moving, so I probably won't hear from him again for awhile. I think he's mad at me, too. I guess I said some things that he took as me trying to make him feel guilty. He got real pissy with me the last time we talked. The thing is, he's always gotten on to me because I don't talk about things that upset me until I get really mad. Now that I am, he thinks I'm trying to make him feel bad. Whatever. Either way, I can't win.

I'm just really, really stressed. I start my official anesthesia residency in 3 weeks. That in itself is enough stress, but I also have to take our in-training exam too. We have to score in the 50th percentile to stay off probation. Plus the break up still feels crappy and to top it off, he's moved away. It all just feels like it's coming together at once. Did I do something wrong?

Vigilance

I'm so disappointed. I heard today one of my favorite upper level residents got caught under the influence of drugs by one of the attendings at work. He is off to physician's rehab and whether or not he comes back is uncertain. Unfortunately, this is pretty common in anesthesia. I'm so tired of hearing how our speciality has the highest drug abuse rate of all specialties. As much as I'm tired of it though, I can't get complacent. It can happen to any of us. All I can say is, I hope it doesn't happen to me. A friend of mine today told me 1 in 8 residents. That seems high. That means somebody in my residency class will have a problem. I can already wager who that will be. "Vigilance" is supposed to be the motto of anesthesia when it comes to patients. I guess that also should be applied to how we conduct ourselves, as well. Never let your guard down.

Just the same, I'm sad he probably isn't coming back. He was really nice.

I'm on call tomorrow. It's my next-to-the-last weekend call of my intern year (Yay!!!). I hope tomorrow gives me some peace. Monday Night was crazy. I had 5 code blues, which is a record for me. It was absolute insanity from about 8pm until 5am. You just never can tell what's going to happen on call. None of the patients died that night, but two of them did the next day. It amazes me how sick people can be yet they continue to hang on. Sometimes modern medicine is not a good thing. A year ago I took an oath to do no harm, yet I'm not allowed to let a terminally ill person (in lots of pain) die unless they or the family have signed a DNR. To me, that is doing harm.

There's a nurse practitioner that works in the NICU where I am this month. She makes it pretty clear to all the residents that she doesn't like us and that she is "the captain of the ship" (even though she's not, the NICU DOCTORS are). Anyway, I've spent the month avoiding her because I find her super annoying. Every Wednesday the NICU staff meets and discusses issues with the babies. She manages to monopolize the topic every week by talking about...what else? Herself!

Today was no different. For one thing, let me point out that she dresses completely inappropriate for an ICU setting. She wears heels everyday with short suits (that her girls practically pop out of). Today she was laughing and talking about all the times she's almost fallen and dropped babies because her heels got caught on something. I just sat there, completely appalled that she thought that was funny. I wanted to blurt out, "maybe this wouldn't happen if you were wearing appropriate shoes for the ICU". I kept quiet. No one else seemed to think any of this was alarming. I bet OSHA would. In fact, I bet OSHA would find my story quite interesting.

I do know this: If I was the mother of a sick newborn in the NICU, I would be absolutely pissed if she almost dropped my baby because of a stupid clothing malfunction. I would make it clear she is not to touch my kid ever again.

Yikes, suddenly I've turned into a lioness protecting her cub.

OK I know I was Debbie Downer in my last blog. It happens. I'm just a bit annoyed by my life. I worked hard to get where I am, and I'm having a lot of doubts and no reward. The next 6 months will make a big impact on my attitude. Another thing is some of the other residents are just outright being stupid and lazy...ie..refusing to see patients in the ER when our attending doc asks them to see them. When our program director finds out, there's going to be Hell to pay, and we're ALL going to pay for it. I'm not looking forward to that, especially since I'm doing what I'm supposed to do. I work with a bunch of spoiled children. I can't wait to see how they'll respond to having to do REAL work come July 1 when the anesthesia part of our training begins.

This morning at church we talked about how God has a plan for everone and you can't rush it. I need to keep that in mind. Just please somebody tell me that I'm not going to end up husbandless and childless.

I cooked 2 big dishes this weekend that I saw on Food Network. Paula Dean's slow cooker macaroni and cheese...(the ultimate comfort food), and The Barefoot Contessa's spaghetti and meatballs. Quite tasty. Her meatballs required veal, which I don't eat, but I managed to replace it with a tasty substitution. Yum. That and 2 glasses of wine and I'm feelin pretty good about now.

Started a new book loaned to me back in February "Everyone Worth Knowing" by the same author who wrote "The Devil Loves Prada". So far, I like it. It's trendy.

I also watched 2 movies this weekend, both featuring one of my favorite actresses, Reese Witherspoon. Sweet Home Alabama and the one where she goes to law school. Did anyone know her dad is a doctor in Tennessee? I did.

nightmare vs. nightmare

I am in a funk.

I woke up this way.

I had this awful nightmare that I residency matched out of state except for my intern year. All of a sudden here it is, 6 weeks until the end of my internship, and I had not started looking for a place to live and I had no money saved up for the move. Even worse, I was having to move to a place where I knew no one. It felt so lonely. I woke up in the middle of the night and stared at the ceiling for the longest time, convincing myself that it was all a dream and that I'm not moving to Kansas City next month. I've been thinking about this dream all day, it bothered me THAT much. It's not that Kansas City is a bad place. It's not. It's how alone I felt.

Eureka, I think I understand it all. I hate my life right now. I'm lonely, I may as well move to Kansas City. I was thinking about the new med school grads and how great they are feeling about now. Last year was so different for me. I was so happy to be graduating and excited about residency and even more excited that I had matched at home where my boyfriend is. Then, a few months ago, everything changed. The boyfriend announced suddenly one night at dinner that he's unhappy and is moving out of state. In the span of 10 minutes, my dreams of spending the rest of my life with him were over. It's not fair, really...he's the one moving but I'm the one feeling lonely. I've reached this uncomfortable fork in the road. Do I live in the past, or do I look toward the future? The Past is so comfortable. I know The Past. The Past was my best friend. The Past knows me and all my quirks. But The Past is moving away. Leaving. The answer doesn't get more clearer than that. I can hear the phrase now.."if he's moving away, then he's just not that into you". If only I could wake up from THIS nightmare!

So today, I stopped at the gas station to get a supply of diet coke for tonight since I'm too lazy to actually go to a grocery store. I was annoyed because the sales lady at Ann Taylor would not grant me the sale price on some clothes I bought Saturday, that naturally, went on sale 2 days later. Actually, they do grant you the "sale" price if something goes on sale within 2 week of it being bought, but the clothes I bought were not actually on sale. The sales lady was more than happy to explain that the 25% off on things in the store was a "promotional rate", not a sale. I got pissed and told her it was the same thing. She again explained to me the difference between a promotion and a sale. I looked at her and said, "it's a sale!" and walked off. You know, when you put down $350 at a store only for the things to be 25% off 2 days later, I think I have a right to be angry. Calling it a promotion is just shady. I'm seriously thinking of calling their corporate office.

OK back to the gas station. I walk in and there's this creepy looking man in line just staring me down. I thought I had a booger on my face or something. I actually checked my blouse too make sure it was still buttoned, 'cause he sure was looking at me weird. So I get in line with my cokes and he comes back to the line to get change for the arcade game (why is a grown man playing a game at a gas station??). Oh no. He starts to talk to me. He then says, "you must be buying those cokes for your daughter or husband". Without even blinking, I replied, "yeeeep!"...grabbed my sodas, and walked out the door. I can only imagine the turn that conversation would have made if I stupidly said, "no, I'm not married, they're just for me."

So let's talk about work for a minute. There are 6 male residents, me, and another female. The other female is doing a month long rotation at another hospital, so I'm stuck babysitting. I call it babysitting because that's what it feels like. When these guys all get together during down time (recess), I try to get away. They exhaust me. I feel like I've been working all day at a daycare when I'm around all of them. I grew up with brothers. It was nothing like this. I really hate it. I'm tired of their disgusting conversations about porn, if they prefer women to wax, shave, or do nothing to their genitals, etc. It's like they don't even know I'm sitting right there....or they don't care. I'm tired of their dumb junior high jokes of smearing a chocolate bar on the toilet so I'll walk in and think it's poo. Every day I put up with this shit. I'm sick of it. My ex boyfriend says they do this because it's their immature way of flirting because they like me and see me as "one of the guys". I really do not think they like me. I don't want to be one of "the guys". I'm not one of "the guys". I'm a lady....in what apparently is still ( I hate saying this) very much a man's world. Last time I checked it was 2007. I have this new respect for older female doctors. I cannot imagine how awful they must have had it.

My favorite beauty stuff

feel free to add to this list!

1. PurMinerals 4 in 1 pressed mineral makeup
2. and their bronzer
2. Dove cream oil body wash
3. Jergen's natural glow daily moisturizer (thanks, Robyn! Now I have a tan!)
4. Opalescence 35% tooth whitening gel
5. Tigi Factor S smoothing lusterizer (for hair)
6. Maybelline Lash Discovery mascara
7. my Braun/Oral B rechargeable toothbrush
8. BreathRx mouthwash
9. Clinique buttershine lipstick in apple brandy
10. Clinique 7 day face scrub
11. Biore pore strips
12. Eucerin extra protective facial moisture lotion
13. Aveeno positively radiant daily facial moisturizer
14. Fresh everytime 5 day antiperspirant (great for us girls who truly sweat. Thanks, Pink!)
15. Aveeno ultra calming foaming facial cleanser
16. Coco Chanel eau de parfum
17 Chi straightening iron

Did you know?

3tablespoons of canned bee maggots has 65 calories?
2 ounces of canned catepillars has 60 calories?
and that 1 ounce of raw silkworms contain a mere 60 calories?

It's all in this new calorie counting book I bought yesterday. I've been reading it all morning along with watching Sunday morning's lineup of infomercials (by the way, I NEED a cordless magic bullet). Yes, I'm bored. I'm at the hospital and on call until 8am tomorrow. It ain't so bad anymore. Due to a very lucky turn of events last week, the residents aren't called by the ER anymore to admit patients. That means all I do is take floor calls and run codes. There are never many floor calls (especially since I don't have to write admission orders anymore) and there will probably only be 2 codes today (based on previous experience). Not sure how long this luck will last, but I am enjoying it. I'm quite sure as soon as our boss finds out we haven't been doing admissions on call, she will find some way to ruin it. But for today, all is well with the world.

Payday!

Don't you just love payday? I went with Robyn to get a much needed mani-pedi. It would have been perfect if I didn't have such a migraine which lasted ALL DAY until about an hour ago. I even had to break out the leftover pain meds from when I had surgery last year. Now that's a headache!

Tonight I stimulated my dopamine receptors by going to Ulta and buying some new makeup. That store is absolutely dangerous. I've never browsed in there before...until tonight. After I left, I realized they didn't charge me for a make-up bag I bought. I debated going back but I had just been to the grocery store and didn't want my frozen food to thaw. I feel bad. It was only $15, but still, I feel dishonest now. Argh!

Now if anyone is wondering, dopamine is your brain's reward center. I was told by a friend that it has been proven that women get high from shopping, thanks to our dopamine receptors being stimulated.

Mini Lion Hell Cat

BEFORE



AFTER


Today Sarah went to the groomer for the first time ever. I've never had a cat's hair cut short before, but my vet recommended it because Sarah is old, has really long hair, doesn't groom herself as well as she used to, and as a result, gets a lot of mats in her hair that are hard to cut out. I really thought she would be mad about the events that transpired today, but much to my surprise, she seems quite happy with her new look. She's been prancing around the house ever since she got home..and purring like crazy!

Eat Crow

I found out today that Sheryl Crow wants us all to use one square of toilet paper to wipe with. Uh...right. Remind me that if I ever meet her, I should never shake her hand.

What is it with Hollywood? Why can't they just stick to what they know?

Leave me and my gun alone, don't tell me to conserve energy while you fly around in your private jet (ahem, John Travolta, Al Gore to name a few), and please, don't dictate to me how much toilet paper to use!

Sad times

My beloved Merrell's got puked on last night by a patient.

Those darn boys!

Last night I was admitting a horribly sick lady who needed an arterial line. I spent at least 30 minutes poking her poor wrist trying to get arterial access. She had virually no pulse which made my job just about impossible. I finally gave up. By noon today, she REALLY need the line put it, so 2 of the other residents went up and did it. They came back down over an hour later and told me that they got it right in on the first try. I believed them. I spent the afternoon feeling bad about my procedure skills and that I let the boys show me up. I found out tonight that wasn't the case at all. Adam couldn't get the line in, and it took Jay (a former phlebotomist) 20 minutes! Those boys! I'm starting to realize I'm not any less competent than they are-they just don't talk about their failures.

Darn you, Clinton!

Last night I was watching a behind the scenes show about Stacy and Clinton's "What Not To Wear". I couldn't believe it when Clinton pulled off a pair of Merrell's EXACTLY like the ones I wear to the hospital everyday and said, "please don't tell anyone you saw me wearing these!".

I love my Merrell's and Clinton dogged them!

A conversation with my friend Robyn yesterday:
Robyn: Hey, what have you been up to?
Me: Just got off work from a 30 hour shift.
Robyn: Oh, is that all?

Hee hee. I thought that was funny.

I had a really busy night. The biggest event was getting called at midnight to see an 82 year old lady the nurse couldn't wake up. I thought she'd been given too much pain medicine, so we tried to give her some meds to reverse the pain meds. That didn't work. I'd been told she threw up several times before I got to her room. While I was in the room, she started having really loud stridor, which had me worried she aspirated vomit since she was unconscious. I went ahead and transferred her to the ICU and then intubated her. I really thought she would be okay once all the meds wore off. I ordered a CT scan of her head, just as a precaution to make sure she didn't have a stroke. The next morning, before the results came back, I went to go see her and look at her chart to see what her doctor had written, since I knew by then he would be there. Her whole family was in there and I saw her husband sitting in a chair next to her, sobbing uncontrollably. I was so touched I was drawn to tears. I didn't realize this at the time, but they must have just been told of her CT results. Unfortunately, she had a severe bleed in her head that caused her brain to herniate badly. That explains why she was unresponsive. The family decided to remove life support, and she died later that day.

I just can't get the image out of my head of her elderly husband crying at her bedside. This sounds horrible, but it made me never want to get married and experience what he is going through. Sooner or later, everything ends. I am in control of nothing.

Fake Bake

Always dreaming to be a sun goddess, I sprayed on some fake tan tonight. If it's how I remember Coppertone's QuickTan worked in the mid 80's, I'm expecting to wake up tomorrow with brown splotches all over me...but hey! It's worth a try! Trying something once every 20 years doesn't hurt. Can I be a sun goddess? Please? I don't even have to be dark brown, just something darker than blinding pale would be just fine.

I was supposed to study tonight, but instead, I smoked cigarettes out on my porch and dreamt of a bigger house filled with Pottery Barn furniture.

I would like to start running again tomorrow. I come up with all kinds of excuses not to. The first week is always the hardest, and I always manage just fine. My latest excuse to not run is that I started some new BCP's last week. Strangely, they have noticeably increased the size of my girls and now they are sore. I don't want to upset them by running.

Good Friday

Today is April 6th. APRIL 6th! And today it snowed. I had to bring in all my potted plants as it's going to get into the 20's at night. I just can't believe it. I'm so glad I didn't go buy a bunch of annuals last weekend like I was planning on doing.


Today I bought a new journal. It's the nicest (and most expensive) one I've ever had. It's #29. I've kept one since I was 10. Whenever I start a new one, I always wonder what the pages are going to say when it is finished. #28 is only a few hundred pages long, yet it took me 7 years to write. My life now, is vastly different from how it was in 2000 when I started it. I've always liked keeping a journal. It's fun to go back and read stuff. I sometimes wonder what the point is though. When I'm dead, my family is going to have a box of homemade books that will just collect dust. They are worth nothing to anybody, except to me. Actually, I'm not sure I want anyone reading my journals. If my parents ever read them, they would be shocked. In junior high and high school, I was profoundly depressed and for awhile, I self medicated with alcohol that I stole from my dad's liquor stash. I would be so embarrassed if they knew what was really going on with me. Looking back though, how could they not have noticed something was wrong? They should have known. Any parent who pays just a little attention to their child would have noticed and intervened. Well, at least I had enough gumption to intervene on myself.


I'm on call tomorrow. Blah! I absolutely hate weekend call. It's the most boring, tense, 24 hours ever. I will spend Sunday attempting to attend church (if I'm not just dead tired) and then going home and going to bed. What a FUN weekend I am in for. At least the weather is going to be crappy, but I will unfortunately miss my neice's 8th birthday. Blah!

Amazing

I just read on CNN that Keith Richards admits to snorting his father's ashes mixed with cocaine. You just can't make that stuff up, folks! I dont even like it when I get water up my nose while swimming, I wonder what it would feel like if a loved one were up there?

Prosopagnosia

Ok so I have this embarrassing problem that I can't seem to fix. I have a really hard time recognizing faces. I've always been this way and as I get older and meet more and more people, the problem is only getting worse. Today I was at Barnes and Noble studying, and the chief resident of our program for next year came over and said hi to me. I had no idea who he was. He didn't even look familiar! He had to tell me who he was, which I think embarrassed him. I tried to make light of it and told him that if he'd been wearing scrubs and a mask, I would have recognized him. God, I'm such a doof...

I really hate this. I don't know if something is not wired right in my brain, or if it's just that I don't really pay attention, but it really bugs me. My ex always thought it was kind of cute and endearing...we'd watch TV and I would get all confused about the plot because I couldn't remember who people were.

Now people I have everyday contact with, I remember just fine, but if I see you somewhere out of character, I'll have no clue who you are. I know this is probably normal for some people, but this goes way beyond normal. I'm to the point where I don't approach someone to say hi because I'm afraid I'll have the wrong person (it happens a lot)! I hide it by being friendly to everyone, just in case I already know them. Time magazine published an article last summer about this and it was like I was reading about myself. I think my case is mild, but some people can't even recognize their own face in a mirror!

One of the other interns, Adam, came up and said hi to me in the doctor's lounge one day. I'd never seen him without his glasses and I had no idea who he was. He looked at me like I'd lost my mind.

In a field where networking is so important, I see all this as a hindrance.

After the storm

We had a huge storm late this afternoon that lasted several hours. I stepped outside and this was waiting for me!!


I Was on call last night. Had one of the best nights yet. Only one admission at 5pm. Slept from 8:30-10pm, then responded to a cardiac arrest which kept me busy (and sweaty) for well over an hour. My pager didn't go off (except for one of my friends paging me at 3am) again until 7am! I got to sleep all night, or at least lay in bed wondering when my pager would go off. It's never really good sleep on call. Plus, the bed is uncomfortable, the blankets are thin and impersonal, and the room is always too hot or too cold.

At 7am I went to go verify a patient death and I saw one of the nursing supervisors. She asked if I was on call tonight. I told her I wasn't. She told me she wishes I was on call every night. I laughed and took that as a compliment. She then told me that everyone in the hospital really likes me and wishes I was on call more. Wow. Now I really took that as a compliment! I wish that would get back to my boss!

Since I got some sleep on call, I actually got to enjoy my day. I came home and walked 3 miles, then I met pastor's bride at the mall for pedicures and lunch. Pretty toes and yummy food, what more could a girl ask for?

Annoyed at Mom part 2

I love my mom. She drives me crazy. I love my mom. I wish she would leave me alone. I love my mom. I can't stand being alone with her. I love my mom.

My mom is a challenge. I know I am a disappointent to her. She can be so mean, and the thing about it is, she doesn't see anything wrong with it. She's critical of everything I do and if I call her on it, she pulls the "poor me" thing and tries to make me feel guilty. A few months ago she told me she wishes my personality were more like hers. Ouch. I'm glad I'm not loud and histrionic. My friends are too ( I think).

I've been avoiding her like the plague lately. I haven't been all that happy and I know talking to her will make me feel worse. Case in point, a few days after my boyfriend and I broke up, she called me and left me a lengthy message on my voice mail stating that I should try and reconcile with him because "he has a lot to offer me". Wow. That really hurt my feelings. A few days later when I tried to talk to her about it, she flew off the handle saying she just can't say anything right to me anymore. Well, I guess not if she's going to go telling her broken hearted daughter to risk rejection and go grovel, as if the break up was my fault. I then get sadly told, "well, I was just hoping you would one day marry", as if I am a spinster beyond my years. Personally, I thought I had a lot to offer him as well, but did she say that? No.

We didn't talk for a week and then she acted like nothing was wrong. Because to her, nothing ever is wrong. She's perfect and we are all her ungrateful children.

Right now we have this annoying little feud over the cause of bladder infections. She doesn't believe me when I say they are from bacterial contamination of the urethra, usually fecal contamination. Tonight she called me and tried to pull an "I told you so" about it. She had visited her urologist and told him her theory of why she keeps getting the infections. It's because she works all day at a computer and she doesn't go to the bathroom enough. He agreed with her, and she couldn't wait to tell me. So I said, well that's true, but bacteria doesn't just spontaneously develop in the bladder without a source. It still comes from the urethra but if you don't urinate enough, it ascends into the bladder and multiplies, making it easier to develop an infection. She STILL didn't believe me, so I asked her why she even asks my advice if she's not going to believe me? We got into an arguement about it and she told me she was never going to bring up the subject with me again. Oh damn, that breaks my heart! This must be my karma. My last 2 boyfriends are doctors and they used to get annoyed when I would argue medical stuff with them. I totally get it now. I don't mind people asking me medical questions, but if you're going to argue with the answer, then don't ask!

Here's the deal. All this stuff seems like no big deal, but I'm already at my 99% patience level with her, so all it takes is a little nudge from her to piss me off. She even laughed one time and told me she likes to say irritating things to me because it's funny to her to get a rise out of me. Is that not the bitchiest thing? I told her that she may think it's funny, but that's the reason why I don't like to spend time with her.

I'm sorry I'm so cranky lately. I'll try to do better.

Deep thoughts....by Me!

So this last 6 weeks have been tough. Really tough. The 3 people I know who actually read this already know each day has been a challenge.... I had this moment of truth tonight: I got through the last 6 weeks without him and it didn't destroy me! All through my 20's I struggled with an eating disorder. Remission...relapse...remission...relapse. My senior year in college I was dangerously thin. Everyone knew I had a problem...except me. I spent so much money on counseling trying to figure out why I am like this. I was SO afraid of what this break up would do to me after going 5 years without a slip-up. Have I lost some weight? Sure, but not in an unhealthy way. I did something different this time: I made sure I ate something everyday, even if I didn't want to.

Break ups have always brought out the worst in me. I learned why in counseling, but before that I always did some very foolish things that just made it worse. Not this time. I vowed to handle things nicely. And why not? I spent 1 1/2 years building a solid friendship with him before we dated for 3 1/2 years. It was a wonderful 5 years. Am I hurt? Yes. Angry? Yes....but it certainly doesn't justify bad mouthing someone you care about all in the name of wounded pride. The only thing I wish I could take back was an angry e-mail about him that I sent in a moment of weakness to a mutual "friend" of ours. She had emailed me telling me she heard the news and was really sorry and would call me soon. I wrote her back telling her vaguely what happened and inserted my own commentary here and there. I never heard from her again. I thought she was my friend and I was looking for sympathy. Now I'm worried she's gossiping to people what little deatil I told her. Funny how I work 60 hours a week but she is the one too busy to check on me. Anyway, I made things as right as I could by telling my ex about it over our "closure over coffee" talk a few weeks ago. He wasn't happy, but I would rather he hear what I said from me. The old me would have bad mouthed him to anyone who would listen, in hopes it would get back to him and hurt him as much as he hurt me. Did he cheat on me? No. Was he a lying drunk? No. Was he physically/emotionally abusive? No. So what gives me the right to say mean things?

Then tonight it hit me. I really like who I have become. I don't need to say unkind words I don't really mean. In fact, not a night goes by (even when I'm on call) that I don't say a prayer for him and hope that he is okay. However things turn out in the end, I know I will be okay. I have a great career ahead of me, I have great friends, neices who think I'm way cool, and maybe, just maybe, if I'm lucky I'll meet a wonderful man who wants to spend the rest of his life with me.

The Evils of Trans Fats

My New Year's resolution this year was to cut out all trans fats. ALL. If it has trans fats, I don't eat it. The former Mr. Big has been telling me for a long time how evil they are, and I know they are...but I didn't truly commit to giving them up for good until this year. That means no crackers, fried donuts, all sorts of things you'd never think of. Today I got to realize the fruits of my sacrifice. I got my fasting cholesterol check back today and I couldn't believe it. My total cholesterol was down over 50 points to a level well within normal range. Even better, my LDL (bad cholesterol) level was also down over 50 points, which is now normal too! I compared them from my labs taken just a year ago and the only difference I can think of is those naughty trans fats, because I didn't take any drugs. Give them up now! It really works!

The only thing that wasn't so great is that I found out I have iron deficiency anemia. I don't know what else to do about that. I take supplements. It's not like I can just quit being female, nor do I want to! Being a girl is fun.

In other news, I now have not one, but two kitties that are officially diagnosed with renal failure. I wasn't surprised. They are 14 years old which is ancient. The attitude I'm taking is they have had a great life. If all the other things out there don't kill a kitty (cars, accidental poisoning, fights) it will eventually die from renal failure. I've never had a cat live this long, so this whole renal failure thing is new to me. They eat special food now and it appears to be helping. They don't act any different, it's like nothing is even wrong.

Work is the same. I'm the resident on call during the day for the hospital this month and it has been quite a challenge. There's a crisis nearly everyday that I have to deal with in a moment's notice. Most of the time, they involve acute respiratory distress and require immediate intubation. I always come out of those situations shaking and really sweaty, relieved no one died. It happened today right after lunch with a lady who I think had a pulmonary embolus. She was just about to crump.

I knew this year would be challenging but when I think about the responsibility we are given as interns, it scares me. I've learned how to handle so many life threatening situations, but I have no idea how to do easy things, like splint a fracture or sew a wound....not that an anesthesiologist would ever do those things but it would be fun to know!

True Confessions

Today I was informally voted "least likely to cheat on a boyfriend/spouse" by the other residents. True, am I a St Bernard..loyal, always. This afternoon I cheated on someone. My hairdresser. I went to a new lady. I woke up Monday Morning and realized I have a terrible affliction called "Mom Hair". Julie, one of the other residents, realized the severity of the situation and quickly made an appointment for me to see her lady today. The first thing I noticed when I went to Julie's place was the average age of the clientelle. Very trendy which made me feel intimidated. I'm not cool. I don't even pretend to be cool. The average age of the salon I go to is probably 50. I liked this place though and the lady who cut my hair, as radical as she looked, did a great job and was really nice. I'm always wary of trendy haircutters because the first thing they want to do is cut ALL your hair off. In this case, she actually wanted to keep it longer than I did, which gave her immediate credibility. My hair is a now slightly longer version of The Rachel. I really like it a lot. My head feels lighter!

Today was Doctor Appreciation Day at the hospital. Free food, massages, etc.I had been on call all night with very little sleep and lots of crazy events that occurred that I'll just save for another day. Anyway, the hospital was offering free lab work to all the doctors so I got the whole shibang...lipid profile, thyroid test, blood count with differential, and a complete metabolic profile. In all it's probably worth around $300. I looked awful. Hadn't brushed my hair and it was all falling out of my ponytail I'd slept in.The lack of sleep definitely showed on my face. The lady was drawing my labs and I was telling her I was one of the residents. She said she'd seen my photo (they have photos of all the residents on every floor) and told me I was one of the prettiest doctors in the hospital! That just made my day! It was even cooler that she felt comfortable telling me that. Now, I'm not bringing this all up to brag. My friends who read this blog know I've been feeling pretty bad about myself lately...it was just nice to hear a compliment from a complete stranger.

"Is everything okay?", my boss asked me today. "Lately, everytime I look at you, you seem a million miles away". That's how my mid-year evaluation began today. How do I even begin to explain where I am? My best friend and lover for 3 1/2 years...the man I wanted to marry suddenly ended things for reasons that still perplex me. No matter where I go or what I do, this sadness never leaves me. Then I come to work, a chance to escape from my personal life and I get griped out along with the other residents on a weekly basis for behavior that I'm not even guilty of. I'm tired of it. Tired of everything.

This week was particularly difficult. It's been a month. Things should be getting better, but I still feel the same empty, lonely feeling. Monday morning didn't help things. I woke up with a horrible headache from grinding my teeth in my sleep...something I do when I'm under a lot of stress. The headache was still lingering when I got called to a code blue up on one of the floors. I got up there quicker than normal because I was right by a waiting elevator when my pager went off. I got up to the room and it was chaos. This 25 year old man was in bed, unresponsive. I could tell by looking at him he was already dead. Nurses were frantically trying to get an IV line in with no success. This guy had just been discharged from the hospital when he suddenly collapsed while getting dressed to go home. "Does he have a pulse?" I asked as I climbed to the head of the bed to get ready to intubate him. He didn't. CPR was started while I quickly intubated him. Something was wrong with the defibrillator and there still wasn't an IV in. One of the other residents jumped in and put an IV in the guy's neck so we could start giving epinephrine. Finally, the defibrillator started working. He was in v-fib. During the next hour, we gave him countless rounds of epinephrine, shocked his heart 10+ times, gave him a bolus of amiodarone then started a drip. A few minutes later the respiratory therapist had to suction his breathing tube because pulmonary edema fluid was coming up the tube. While she was suctioning, bloody fluid shot out of the tube like a geyser, hitting everyone who was standing around. We worked on him for an hour and never got him back. Finally I told everyone to stop. He was dead. Everybody was crying. He had some agonal respirations for about 5 more minutes while the nurses cleaned him up so the family could see him. It wasn't real breathing, just reflex breathing that sometimes happens when a healthy brain is dying. "Make sure he has stopped doing that before the family comes in or it will freak them out", I told everyone. He stopped about 2 mintues later, but the fluid kept coming up from his lungs for a long time. I wrote a death note in the chart and managed to make it to the elevator before I started crying. That was by far, the worst code I've had this year. The medical examiner accepted the case for autopsy, but then called back 20 minutes later saying they were going to rule the death as a pulmonary embolus.

The next day I was working on a discharge summary, depressed about my personal life, and still upset about the 25 year old man that couldn't be saved. Another resident, Adam came in and sat by me while he signed charts. "How much are you smoking now these days?" he asked me. "About half a pack a day", I replied. Adam looked at me and said, "you know you're better than that". Looking back, I think that is the nicest, most caring thing anybody has said to me all week.

What does it take to be a SuperFox?

So while I was out having fun at the mall yesterday, I managed to lose my bank visa card somewhere during or after my buying some new lipstick (because I yearn to be a SuperFox.) I went to the vet later to buy Sadie's kidney failure cat food, and my card was gone. Great. I knew I left it at the Clinique counter because I don't remember the lady giving it back to me. I called today. No card. My bank was closed today so I couldn't cancel it. Tomorrow it will be 48 hours missing and I will finally be able to call my bank. I really hope all my money isn't gone. I'd just gotten my tax refund! I still think the card is hanging out at the lipstick counter, but oh well. I really don't need to lose $4,000 right now. That would really put the icing on what has turned out to be an ugly February Cake.

Tonight I chained smoked 1/2 pack of Camel Lights. Not sure why. I like to sit on my porch when the weather is nice and think. Now I'm just left with hiccups and bad breath. My neighbor, Patti, came over and laughed at my new passtime.

Speaking of neighbors, I feel bad. Remember the ranting note I wrote anonymously to my neighbor about their annoying dog? Well Patty tonight told me that the people took the dog to the pound apparently right before they got my letter. The dog tried to bite the mailman which is a $3000 fine. I feel bad. I didn't want the dog to die. I just wanted him to stay in their backyard and shut up. Poor doggie. He doesn't understand why no one loves him and his owners didn't care enough to show him why other than to take him to the pound. Well, that is now one LESS barking dog in this neighborhood. There are about 4-5 others around me I wouldn't mind finding new homes for, but at least the loudest, most annoying one is gone.

On a positive note, I kicked ass on my case presentation today. I spent a lot of time on it this weekend and I think everyone liked the case, especially the program director....providing further proof to her that I am NOT one of the residents causing problems. I'm also going to point that out to her at my mid year evaluation on Wednesday. SuperFox Resident. That is me.

Pink

I have this friend I'll call Pink. We've known each other since kindergarten. She loved pink panther when she was a kid, so she got nicknamed "Pink". As the story goes, I was in the afternoon kindergarten and she was in the morning. She spotted me one day at school and told her mom all about this girl Katy and her neat red hair. Her mom just had to meet this little girl so she invited me to Pink's birthday party. And the rest is history. Pink and I stayed friends all through school until about high school when we both went through weird stages and weren't friends anymore, which is entirely my fault. Anyway, at our 10 year reunion, one of the main reasons I went was to see Pink. She wasn't there. Then last year, I ran into her mom and got Pink's email address. We've kept in touch even though she lives in D.C. with a way cool job.

So I've not been in a good place the last couple of weeks, and what did Pink do? She moved up her trip home so we could hang out! Nobody has ever done anything like that for me. I'm so glad she came home. She definitely made my weekend much better. Tomorrow we are going to the mall for pedicures and then she's making dinner for me, Pastor's Bride, and her parents.

I'm pretty tired. I had this pediatric life support course yesterday and today. It's a lot of lectures and stuff. Sitting there all day makes me tired, plus, I can't think of a more boring way to spend early morning Saturday than at a training course. I have to say though, that the speakers were really good and I did learn some important stuff. I can't believe I only have 4 months of my intern year left. Scary that I'm going to start putting people to sleep in July.

What I've learned this week

No matter how bad things are, there is always someone having a worse week than you are. Case in point: yesterday I was working in the ED (emergency department, NOT ER, as an ER is an emergency room. I don't work in a room, I work in a department). Anyway, a 5 month old girl came in via ambulance in asystole. She'd been that way for almost an hour. Mom put her down for a nap and she never woke up. I can't imagine having to live through that. I would want to die.

Some other friends of mine ( a couple we were social with at parties) came in with his dad, who has terminal cancer. I didn't even know the chart I grabbed was their father until they walked in the room. We had a little sympathy fest, as they'd heard I was having a bad week. I had no idea they were dealing with caring for a sick family member all this time. How could I not know that? What kind of friend am I?

So today I slept in. Just didn't go to work. I'm taking full advantage of having a flex schedule this month. My neighbor's stupid dog jumped their fence like he does every day and began his incessant barking. Today I became "that neighbor". I've already complained to the city about the loose, barking dog and apparently the warning notices my neighbors get have left no impression. Today I went further. I sent them a very rude, threatening letter telling them if they can't keep their dog in their backyard, I will call animal control until the dog is gone. I will, too. I'm not the only neighbor frustrated with this problem. Others have complained to the city as well. I love animals. I don't want him to go to the pound, but I am really tired of being woken up by him barking outside my window, following me when I go outside, and just the general nuisance.

What else did I learn this week? The ugliest lesson of all: If you've dated him for 3 years and you're not wearing an engagement ring and you don't have a wedding date set, then he's just not that into you.

No more hand washing dishes!

After a month of washing dishes (really not that many because I'm never home to eat), I finally solved the problem with my dishwasher. Actually, it turned out to be the water pressure in my kitchen. $475 later, I have a new kitchen sink faucet, my dishwasher works, my toilet works right, and I got a new bathroom sink faucet. It kinda sounds like I let things go, which I guess I did. The bad news is this fix is probably only temporary. My house is really old and some of the pipes underground need to be replaced because they are partly stenosed. I can guaratee that I will be living in a new house before the need for that arises.

I didn't really need the new bathroom faucet, but the old one was brass and had turned green and it had no drain cover. I couldn't get it to clean up no matter what. It was pretty ugly and it's one of those things that you're so used to seeing that you forget how ugly it is. I was thinking today that the perfect analogy is those poor rejects on American Idol who, for some unknown reason, have friends who don't tell them how bad they sing, then they act all surprised and hurt when they get totally slammed on the show. My faucet was the same way. Completely ugly but nobody would say anything. At any rate, it's now replaced with a shiny new chrome faucet complete with a drain cover.

Boring blog, but really there aren't any neat stories this week so I'm forced to discuss domestic issues.

Is this irony, or what?

Last week when I was on call, I got called emergently to a patient's room who was unresponsive. I got to the room and saw that the patient was my own doctor before he retired 6 years ago. He had been given (way) too much pain medicine and was in pretty bad shape. It took a lot of meds to try and reverse the pain medicine he'd been given. I'm so thankful that everything turned out okay in the end. I went to see him the next day and he was much better. Such a strange thing, being a doctor to your own doctor.

This is the part where I cry

I went to the doctor the other day. You know the one I mean...THE doctor.

What I learned: I have gained 10 lbs since residency started.

My blood pressure which is usually 105 was 130!

Holy cow! Maybe I was just nervous. Maybe when you are going to THE doctor they should wait until the appt is over before they take your blood pressure. Just a thought.

Time to start running again. No excuses. Not even if we get Ice Storm 2007 part II.


Tonight I have to go shopping for a cocktail dress to where to an anesthesia party Saturday Night.

Gee, I wonder what size dress I will end up buying.

Mean Me

I'm starting to be mean. I've noticed when I'm on call, I have a lower threshold of getting mad and speaking my mind than I normally do. I start to say what I'm thinking without keeping my mouth shut. My first victims Sunday morning were some construction workers who came into the call room area at 8:30am and starting doing work. If that wasn't bad enough, they knocked on my door, woke me up, and said they needed in my room and would be there all day working on the cables in the ceiling. I'd had enough. "Look", I said, "I'm here for the next 30 hours and this is the ONLY time I'm going to get any sleep..." I lost that battle. My pager started going off soon after that anyway. I apologized later to those guys. They were just doing their job.

There weren't anymore victims until about 6:30am the next day, when I got paged with the Rapid Assessment Team to go see a patient (who is supposed to be in dire straights for us to get called). I get to the pt's room and there was no nurse to be found to clue me in on why we were called. The patient was just calmly lying there and I asked her if she was okay and she said she was. I went out to the nurses station and asked who the nurse was for that room and why is nobody in there to fill us in on why we were called. She explained she was standing in the hall to direct all the responders what room to go to. Well, that's great and all but she's supposed to be in the patient's room helping us since she's the only one who knows the patient. I was more than a little short with her. I felt bad later and apologized. I was right, it is a rule that when you page the team you must have somebody at all times in the patient's room so we know what's going on, but I thought long and hard later about how I came off. Here I am, this young, snot nosed doctor, getting snippy with a 50-something nurse who probably has more years of nursing on her belt than I have years of breathing. In my exhaustion from being up all night, I forgot to treat her like a person. I hope I don't let that happen again.

So that night, I had 3 rapid assessment team calls, 8 hospital admissions, and a code blue (that I successfully resuscitated only to find out that the pt had a signed DNR in her chart that somehow none of the nurses knew about). I felt really bad about that one. She did die later that night.

No more licensing tests for me...I passed!! Not quite the score I wanted or expected, but I passed and that's really all that counts.

Such a relief....

Ice Storm 2007!!

If you watched the news where I live, you would think it was Armageddon. The drama started last Monday when they predicted an ice storm would hit Friday. Yes, Friday. They talked endlessly about it all week until.....Friday, when it happened. Sleet began to fall and the news soon went on simultaneous coverage for 24 hours. Can you believe it? 24 hours of non-stop Armageddon-Ice-Storm-2007 drama. I loved the storm. I was on call Friday Night and because the roads were so bad, people decided they just weren't sick enough to come to the hospital, which meant an easier night for me. Yes, it's all about me. I was still busy though. Just not AS busy. The storm pretty much lasted all weekend. I woke up Sunday Morning to sleet pelting the windows and roof and.....thunder! It was glorious!! Not so glorious to the 100,000+ folks on the eastern part of my state. They got freezing rain and lost power. That happened to me 5 years ago and it was a complete drag. I'm lucky I live in a big city and was only out of electricity for a day. Those poor people are in smaller towns and it may be weeks.

Now, getting back to "Ice Storm 2007" (insert dramatic music here just like the news did), I went to the store Tuesday Night to buy a few things "just in case". There was a thoughtful sign up at the store warning us all of the impending doom and giving us helpful advice on what staples to buy. Included on that list was of course, cigarettes. I did a double take. Cigarettes? YOU HAVE GOT TO BE KIDDING ME! Yes, by all means, be sure and stock up on cigarettes in case you can't get to your neighborhood 7-11 during the storm. Good grief. That is pathetic. Whoever put that sign up should be ashamed of himself. In fact, I think I will write them and let them know.

Sadie post op

Feeling groggy. She hated the pink bandage where her IV was placed

This week has not been eventful. My board scores were mailed to me yesterday so I'm kinda waiting on pins and needles for them to get to my house.

The guys in my residency program are starting to bug me a little. Just stupid little things that annoy me, like them sleeping in the female call room and using our bathroom and then getting pee on our clean floor. Gross. They also act like they know everything, which is also starting to bug me.

Remember the lady I blogged about who had bad chest pain, was out of breath, and her cardiologist blew me off at first? She suffered an anoxic brain injury from that morning and was never able to come off the ventilater. Her family has been divided as to how her care should be handled. It turned into a Terri Shiavo sort of thing. For all practical purposes, she is in a coma and will never come out of it. I found out today the family finally agreed on removing her from the ventilator and letting her die tonight. It's the right decision in my opinion but I'll just never forget being one of the last people to talk to her and knowing how scared she was. She was in so much pain that she asked if I would rub the back of her neck for her. So I did. I'm convinced she knew she was going to die.

That's really about it. A big ice storm is supposed to hit tomorrow and I'm on call then until Saturday morning. Hopefully I'll be able to drive home okay because I sure don't want to spend my whole weekend at the hospital!

My dishwasher is broken. I have to wash my own dishes. Therefore, I have no time to blog.

Boo bees

I have to go back to work tomorrow. Not only do I have to get up before 11am, I have to get up at 5am!! Thank God for Ambien, otherwise, I'd be getting 4 hours of sleep tonight instead of 7 or 8!

I guess I am ready to go back. My intern year has been pretty fun so far. I'm half way finished now, and with my licensing test over (hopefully I passed), I can just cruise for 6 months until I start doing anesthesia. All of my friends are just now starting to study for it and are getting stressed....not me!

Sadie is feeling much better. She's acting much more like her old self and she's not meowing all the time (in an attempt to tell me her teeth really hurt). I bought her one of those water bowls that recirculate water and then it comes out a little spigot to simulate a real faucet. I'm not sure if she's drinking out of it yet, but she hasn't been spending all her time in my bathroom waiting for me to turn on the sink faucet, so I think she must be (that's how she likes her water). Now she has fresh flowing water even when I'm gone, which, when I'm on call, is about 30 hours. It's important for her to get plenty of water now.

Mr Big and I went to Pottery Barn today. I finally decided what kind of bedroom furniture I'm going to buy. I'm pretty excited. I love their stuff and he bought me a very generous gift certificate to their store for Christmas. I can't wait to get my furniture!

Mr. Big told me a funny joke today: What goes, "BZZZZZZZ....BOO! BZZZZZZZZ ....BOO!" ?
Answer: boobies!

Sad news

Well, so I wasn't totally in the clear about my kitty's health. I took her in to the vet today for her major tooth cleaning. I picked her up tonight. She was still sorta out of it and the vet came out to talk to me, which is probably never a good sign. Anyway, they had to pull 5 teeth because she had developed abscess underneath them, which were probably very painful (insert guilty feelings here). The really bad news is that her labwork shows she has renal failure. I guess I knew deep down that was coming. She has been drinking a lot more water over the last few months, almost competing with me for the sick faucet because that's how she's always liked her water.

Now I have to decide how far I'm willing to go with her illness. I changed her cat foot to a special renal food (no problem there) but the vet was talking to me about giving her subcutaneous fluids every week, hypertension medicine, and supplements. As much as I love my little buddy, she's still a cat. Forcing all that stuff on her, despite the good intention, would drive her insane and she would not tolerate it well at all. She's already hating the antibiotics and pain meds she got sent home with. Lucky for her, that's only for a few days. I was reading online about kitty kidney transplants and I couldn't believe somebody would put their pet though that. It's interesting for research, but kind of crazy. How much does that cost, anyway?

On a good note, Sadie is meowing a lot less tonight. Either she is still sort of drugged or her mouth is feeling a lot better (again, insert guilty feelings here). Imagine, having a mouth full of abscessed teeth and not having it treated right away. I wish I had done something sooner. I just didn't know.

Smelly Cat

I have a Smelly Cat. When I hear Phoebe's song on Friends, I think of Sadie. Her breath is absolutely awful! It has gotten so bad lately that I can smell her breath when I'm just in the same room with her. I've put off taking her to the vet because I haven't had time but I also was afraid of hearing that she had kidney or liver disease. She's almost 14 years old and I've been lucky thus far in having a healthy cat, so I was just waiting for some bad news. I'm off this week and the first thing on my list of things to do (after finally getting over most of my nasty cold) was to take her to the vet. I was relieved to hear that she "only" has bad gingival disease that will require a thorough teeth cleaning under anesthesia. I signed her up for Thursday morning. Funny the things we will do for our pets.

She didn't much care for the visit today for two reasons: 1. the friendly boxer doggie in the waiting room who just wanted to see what was in my pet taxi 2. the rectal thermometer


http://www.youtube.com/watch?v=ETQfuzNGT58&mode=related&search=

Me is sick. It hit me yesterday....sore throat, malaise, achey, tired...blah. It hit Mr. Big today. Tonight both of our pathetic souls camped out on the couch and watched the news, then took a nap. There is one thing nice about being sick: it let's you do things that you normally feel guilty doing, like lazing around the house. Unfortunately for me, I'm on call tomorrow from 8am to 8am, so no rest for the wicked. I'm just praying for a good day. I'm due for a nice, calm call shift.

What I'm listening to: Defying Gravity from Wicked (I have to brag that I went to college with Kristen Chenoweth. She's just as nice as she seems, too!)

Over My Head

When I'm on call, 5am seems to be the bewitching hour of every disaster I encounter. Like that old saying, "the hour is darkest just before dawn". This morning, I'm trying to put out a minor disaster when I got paged by a nurse who works in the physical rehab unit about a patient who'd had heart bypass surgery a week or so ago and is now diaphoretic and out of breath. I tell the nurse to put 100% oxygen on her and I'll be right there. I get down there and the poor lady was absolutely drenched in sweat, complaining of chest pain radiating to her neck, is severely out of breath, and her blood pressure is 70/30. Worried she's got a PE, I order stat labs: a chest xray, cardiac enzymes, blood gas, an ekg, and morphine. I'm seriously contemplating intubating her at this point, but she seemed to be maintaining her oxygenation okay.

While this was going on, I called the on-call pulmonologist and told her what was going on. While we're talking, the lady's blood gas comes back normal and her labs showed she was adequately anticoagulated. The pulmonologist told me she likely was not having a PE but she needs to be transferred to ICU and I need to call her cardiologist (who had already ben called but was slow in calling back). I get word that one of the nurses calls him and he is on his way. We started getting the lady ready to transfer. She was scared and really hurting. By this time I'm thinking she's having an MI. Her cardiologist walks in, looks at her, and I start telling him the labs I drew. He was pretty rude. First of all, he asks the patient if she's been participating in rehab or if she's just been lying in bed. She's so out of breath she can't answer very well. He then starts chewing on me, telling me that you can't have an MI after heart bypass therefore the cardiac enzymes I ordered are pointless. "Did it ever occur to you she might be having a PE?" he asks me accusatory. I told him it did but her blood gas is normal and her INR is 2.8. He's pretty pissed off. I tell him we have an ICU bed for her and he said she didn't need one, just transfer her to intermediate care (sort of in between a regular hospital bed and ICU). He then asked me if I'd bothered to order a chest xray and I told him one was just taken but I hadn't had time to see if was in the computer yet to look at it. He stomps off and I didn't see him again. The nurses helping me were angry that he was so awful to me. We got the lady transferred to the new room, on the cardiac floor. Her new nurses (experienced cardiac nurses) were clearly alarmed at her condition and didn't understand why the cardiologist was so flippant about it. I stay another 10 minutes and then realize there's nothing more I can do, she is the cardiologist's patient now and he needs to write her admission orders. 15 minutes after I left, she went asystolic and quit breathing. Finally, the cardiologist realized how sick she was. I mean, who am I, a mere intern 6 months out of medical school, to tell him when a patient is sick or not? I felt a bit of redemption, but it was at the unfortunate expense of the patient. She's still alive, but now she's on a ventilator and when I left, they were performing a ton of tests to try and figure out what happened to her. As I walked out of the room, he patted my back and said, "good job". I guess he knew he was wrong.

I got back to the call room and realized what a close call that was. This was my first experience with a patient who has heart failure and is decompensating right in front of me. If we delayed her transfer just 10 minutes, she would have either died in her rehab room or worse, died in the elevator on the way to the cardiac floor. Both locations don't offer much hope of survival. It still scares me when I think about it. I don't want to be on call anymore-ever.

Merry Christmas!

Hope everyone had a good one.

My carrot cake turned out...weird. I think I'll probably throw away the recipe. When the main ingredients were pine nuts, carrots, and fennel seeds, I should have figured it would taste odd. Sorry, Giada.

This was an odd Christmas. I didn't have anything to do today. With my family getting together on the 23rd and 24th, it left today with nothing to do. Mom and I were going to go to a movie, but we couldn't agree on one then she decided she didn't want to spend the money. Then we decided she would come over and we would hang out and I would make Turkey Casserole for dinner (yum!). She called me at 2pm and said she just wanted to stay in, partly because her back was sore. Hmmph. I was a little miffed. I wish she had told me sooner. I could have made other plans, namely, driven a couple of hours to have dinner with my college friend and her family. But at 2pm, it was too late. I wish I had a dollar for every time I've had to ignore a sore back and gone about my day. I've had back pain since I was 10 years old. I've learned to ignore it. Today I kept thinking of all my friends and what they were doing. They all have husbands and kids. I'm the only single one and it makes holidays weird because everyone does things with their own family. I sometimes feel like the "ugly spinster". That being said, maybe with each passing year, that's one year closer to having my own family!

Other than today, my Christmas weekend was pretty fun and I got lots of rest. I'm really looking forward to being on call tomorrow night (she says, sarcastically).

mascarpone, anyone?

I'm going to make a carrot cake tomorrow that I saw Giada make on Everyday Italian a few weeks ago. The problem? I can't find any mascarpone cheese. I saw some at SuperTarget last week, but do I dare even think of setting foot in a Target on Christmas Eve so I can buy a small tub of cheese? I don't think so. Instead I bought cream cheese. I hope it works.

Today was better. I went to my dad's tonight and had a nice time. My step sister and her family weren't even there so that totally cured the "do I get them a present" problem. They did buy me something, but I really don't think they'll care I didn't reciprocate. I'm really excited about going to my mom's tomorrow. We always have a good time and I bought everyone cool presents that I think they'll like.

I wish Mr. Big was here for Chistmas. I miss him. : (

What would YOU do?

Christmas is a time of giving, right? Well, I have a question. Where do you draw the line? I have a step family that came along well after I became and adult, meaning, we aren't the "Brady Bunch". To be bluntly honest, I consider my step family to be "my dad's 2nd wife's family". I'm not close to my dad, either. I won't get into the reasons why, but let's just say our relationship is on the brink of disaster. It's also always been pretty clear to me that I'm the least favorite of his children. So here's the problem: I buy a present for my dad's 2nd wife, but am I really obligated to buy presents for her daughter, husband, and three kids (from 3 marriages)? We have a general distaste for each other. I'm sure they think I'm a snob and I personally don't approve of the poor decisions my step sister has made since her mom married my dad. We don't talk to each other and we only see each other once a year. So, why should I buy them all a present? Up until now, I've always sucked it up and gotten them SOMETHING, but this year I just don't have it in me. I can't stand my step family, and in my mind, buying a present that you don't really want to buy is worse than not buying one at all. I see it as dishonest. Christmas should be about giving to people you want to give to, without the pressures of strange blended families. Just because my dad married into their family, does that mean I have to be as well?

Sadly, I'm afraid my predicament is that of the "typical American family". I was 18 when my parents separated. It totally devastated me. Who gets divorced after 36 years?? People always talk about how hard divorce is on children, but it's also hard on adult children. Birthdays, holidays, and special occassions are always awkward in my family. Sometimes we have to have two celebrations because God forbid if my dad has to be in the same room as my mom. Christmas is one of those times. If I'm ever lucky enough to have a husband and kids of my own, I will make Christmas the happiest time of year for them, not the saddest.

All these deep thoughts now require some chocolate....

I turned 36 in October. Here are some photos that I finally download from my camera:





The birthday bowling party. Me with my neices




My 36th birthday and my neice's 10th birthday

Typhoid Me

It seems like everyone I come in contact with these days dies. None of these deaths have anything to do with me, but they are just happening. Remember the guy from 2 weeks ago? Well, there have since been two more. There was a guy I assisted my surgeon on in putting in an AV graft so he could have dialysis. Well, just a few days after he was discharged from the hospital, he had a bad car accident and died a few days later. Question I have is, was he driving? I mean, the guy was paranoid schizophrenic and was not very compliant on his meds. I sure hope he didn't hurt anyone else in the accident.

The other guy I admitted to the hospital on Sunday. He was an older gentleman and came to the ER complaining of an itchy rash that he'd had for 3 weeks (not really an emergency, but whatever). The reason he got put in the hospital is because his blood glucose was 573! He wasn't in any distress and didn't know it was that high. An attending doctor took over his care the morning after I wrote admission orders. Out of the blue yesterday he just went into asystole and died. I feel so bad for his wife. They were so nice when I spoke with them Sunday. This just completely blindsided her. Then today, a horrible thought came to my mind: I bet he has Christmas presents under the tree. It's no wonder the suicide rate is so high around Christmas when things like this happen.

In other news, Mr. Big has gone to the Left Coast to visit his sister. I've spent the evening cleaning my house, catching up with some friends on the phone, and playing my piano. It's weird having free time! : )

I think this has been one of the most difficult weeks I've had. Remember that 2 day test I took last week? Well, I was on call the night I finished it. Fortunately it wasn't a terribly busy night, but still, I was at work and I can never sleep well at work. I thought I was going to get to go home the next morning, but instead I ended up assisting my attending in the OR until 5pm the next day! I was so tired I was near tears. Mr. Big and I went out to dinner that night then I fell asleep on his couch (something I do quite regularly these days). I went home and went to bed at 10pm (wow!) and woke up at 7am dead tired. I drove to work feeling so dejected, depressed, and that I just could not physically do this anymore. I always thought I could do anything no matter what. Well, I learned my limits this week. I should not have tried to fit so many important things into one week. I got to sleep in this morning, but I am still dead tired. I looked in the mirror this morning and my appearance scared me. As luck would have it, I'm on call tomorrow for 24 hours, then I'll have to stay at work through 1pm on Monday, which will put me close to a 30 hour shift. I'm really starting to question if I can do 3 1/2 more years of this.

I crammed almost all my Christmas shopping today online. I really hope everything gets to me on time. How on earth did December get here so fast?

Tomorrow is day 2 of my final licensing exam. Today was hard. 7 hours of questions with 45 minutes of breaktime. Tomorrow is more of the same...AND I'm on call tomorrow night after the exam.

This morning on Good Morning America, Diane Sawyer started off a story about tired docs with, "Doctors can work up to 20 and 24 hours straight. How safe are YOU?" I laughed. Oh Diane, Diane....if only you knew. Doctors are just getting warmed up at 20 hours! People aren't sick 9 to 5.

What I'm reading: Glamour's Big Guide of Do's and Don'ts (I couldn't resist! Pink and Pastor's Bride would be so proud!)

Close call

I knew the anesthesiologists' pre-op evaluations were important, but I got to see just how important they were last week. We had a man come in with multiple health problems who needed to have part of his foot amputated due to a non-healing wound. I went to go see him and do a quick physical exam. While I was there, the anesthesiologist (coincidentally, the same one who slept with my friend then never called her) came in to look at the patient's lab work and talk to him. The man takes coumadin ("blood thinner") and the lab work showed that his blood was way "too thin" for a safe surgery. The anesthesiologist went to talk to my doc (the surgeon) about cancelling the case because he was too high risk for bleeding. My doc was a little irritated about cancelling, but did agree. I was still filling out paperwork on the patient when my doc came to talk to him. He advised him to go to his doctor to get his blood thinner medicine right, then the surgery will be rescheduled for next week. I thought nothing more about the matter, and was honestly relieved that one case was cancelled that day, because as it was, I was already going to be at the hospital until 9pm. A couple of days later, my doc asked me if I remembered the patient who had his surgery cancelled. I told him I did asked why he was asking. He told me that the next day, one of the nurses called him and told him that right after the patient got home from his cancelled surgery, he dropped dead! Wow. I'm assuming it was cardiac related, but it's a weird feeling when someone dies right after you have examined them. One thing I know for certain: my doc escaped a major litigation nightmare by allowing the anesthesiologist to cancel the case. He should buy him a nice present. I have no doubt the patient would have died in the operating room during the administering of the anesthesia, and the family would have blamed it on the docs and probably sued them. It's weird though, I keep thinking of my examination of him and wondering if there was something I missed that would have hinted he was going to die in an hour. There wasn't. I specifically remember asking him if he had any new chest pain or shortness of breath. He said "no"...then he went home and died.

I have officially been grossed out!

Nothing really grosses me out. Blood, poo, puss...you name it, it won't gross me out. Oh wait, there is one thing: wound debridement. Now THAT grosses me out! Just watching it makes me think that it would qualify as some awful torture that the italian mafia would use. I'm on this new rotation, a surgical rotation with a wound care doc. The hospital I am at is the major burn referral center for the state, so we get lots and lots of burns. After a week, I figured out MOST (key word, most) burns are either self-inflicted, stupidity, and/or the result of being under the influence. It's been really busy...because of winter, I'm told. Anyway, last night the last surgery on the schedule was a burn debridement. I'd never seen one of those. Basically, the person is put to sleep and the surgeon slices off long pieces of burned skin with a crude looking tool that looks like a big cheese slicer. You keep slicing until you finally reach deep enough to bleed, which means you are now exposing live tissue (the goal). Anyway, I just couldn't quit cringing watching and listing to this "cheese slicer" cutting off long pieces of dead skin. "You wanna try it?", the surgeon asked me. I learned in medical school that you never say "no" when asked if you want to do a procedure, so I replied with an enthusiastic, "yes!". So there I was, 8 o'clock at night, sawing off long pieces of burned flesh, as if I was carving a Thanksgiving turkey, the whole time thinking to myself, "how on earth did I get here?...."

Role reversal at its finest!

So last night I'm watching football with Mr. Big and another couple. Mr. Big and the other guy were just talking, talking, talking during the game...so much that it became a bit difficult to hear the comentary. Trying my hardest to be polite, I asked Mr. Big if he would turn up the volume. He laughed and asked if they were talking too much.

a case of mistaken identity

Hope everyone had a great Thanksgiving! I had a lot of fun and enjoyed 5 days off. Mr. Big (formerly known as The Boyfriend and Big Guy) and I went to visit his parents about 8 hours away. We were pretty tired from the drive when we got there Wednesday Night. His parents decided to open some wine before we sat down to a late dinner. I went off to the bathroom and when I came out, the wine was being poured. I came up behind Mr. Big and then sidled up to him as he poured my wine. I put my arm around him in a rather close hug. I looked up at him and realize that it was not Mr. Big I had my arms around, it was Mr. Big's dad! I was so embarrassed! I know I turned 30 shades of red as I quickly removed my arms and went over to the real Mr. Big. The thing is, I'm used to Mr. Big pouring the wine, he and his dad are about the same height, and when I came up behind him I wasn't really looking at him...I just assumed it was my boyfriend. Fortunately, nobody made a big issue of it. Mr. Big thinks his dad probably liked it.

I can't believe Thanksgiving is here! It seems like we just had Christmas! Today is my last day at work before having 5 days off. I'm hoping it will be slow so maybe I will get sent home. All I seem to be doing when I'm on call is "coat-tailing", so it's not like I'm actually needed. Yesterday I was doing the pre-op evaluations for people having surgery today. I went to see this one guy who was pretty mangled from a car accident. I noticed he had tattoos all over him and when I leaned over to listen to his heart, I noticed across his neck was tattooed, "Trust No Bitch". I thought that was pretty offensive, but did I say anything? No. God forbid if I upset a patient. This man is very obviously a gang-banger. A danger. A waste of effort, and yet, he will rack up a hospital bill of close to $500,000 and do nothing to repay his debt, let alone the debt he owes to society. He will go back to wherever he lives and continue on his destructive path. I know I sound terribly judgemental and mean, but it's the same people every day, sucking up our nation's healthcare resources.

Access Hollywood report today that FedEx (the loser formerly known as K-fed) had to take a taxi home from the airport. That makes me so happy. Funny how I don't know him and yet I have this extreme disgust for him. I guess it's kind of a relief knowing there are people out that who are way more screwed up than I.

Well, I don't know why I'm so cranky today. Sorry. I hope I snap out of it.

A new obsession

Pottery Barn. I love their furniture. I love their catalogues. The Boyfriend (who now wishes to be called Big Guy on my blog), gets their catalogues in the mail. I always like looking at them, but there's something about being gainfully employed that makes me want their stuff even more. I found about $4,000 of furniture that I MUST have! I swore off cheap furniture...I'm a grown up now and want nice furniture....so I may just save my money and buy one piece at a time. I don't know much about their furniture though. It seems pretty sturdy in their store,but I don't want to buy something of low quality that is overpriced, so I have some research to do.

I guess I'm blogging about furniture because there's nothing else to blog about. Work is okay. I'm back at the universit hospital this month. Twice now, I've been told, "NURSE! Go get me a coke!". Well, there are just a few things wrong with that request:
1. I'M NOT A NURSE! Yes, they even let women into med school now!
2. If I was a nurse, I have more important things to do than to run around getting people sodas
3. If I was a nurse, a simple "please may I have a soda?" would have a profound effect on whether or not you actually got one
4. Don't ever order me around. It's bad enough being an intern. I'm not about to start taking orders from rude patients that aren't even mine.

Only 1 thing

Only 1 good thing came out of this week (and it wasn't the elections): Britney Spears finally filed for divorce. K-fed and his stupid fedora are finally taking a hike. I heard a clip of one of his rap songs this morning and he IS REALLY AWFUL! In addition, every photo I've ever seen of him with that dumb smug grin make me want to slap him and ask him why he is such a big loser.

So today I had to go do pre-op assessments on patients having surgery tomorrow. This one guy I talked to is having part 2 of a surgery. Part 1 was yesterday and consisted of removing a foreign body...a hi-ball glass to be exact....from his rectum, which had been stuck for 2 weeks. Actually, they couldn't get the glass out. They had to open up his belly, open his rectum, and try to push the glass out. It was still stuck so they finally had to break the glass in his rectum to get it out. Incidentally, the guy is also an avid meth user. His wife whispered to me that he didn't yet know that he's had a foreign body removed from his rectum. What?! How does that happen? How can you have a glass stuck up your ass and not know it's there?? Folks, this is your tax money hard at work!

48 hours and counting...

Until the end of the elections! Is anybody else REALLY tired of hearing about it? If I had the money and the time, I would individually mail every election flyer I have received back to the personal home of the candidates. One by one, everyday...they would get their dumb flyers in the mail. I love the idea. I never received my ticket to take my licensing exam in the mail. I am blaming it on the elections. I think I became overzealous in throwing away junk mail and may not have seen the skinny envelope helplessly wedged in between one candidate's pledge for "Faith, Family, and Freedom" and another's pledge for "Conservative Values"....whatever the heck that means. What I find funny is the "Faith, Family, and Freedom" candidate got divorced after she cheated on her husband. How's that for hypocrisy? God I love politicians......

Moving on.....

Where did the weekend go? Do I really have to go back to work tomorrow?

First of all, my weekend began with an unfortunate accident involving me and some Veet. I use the stuff a lot and have never had problems. This time I ended up with alkaline burns all over my legs. Talk about painful....

I dropped off The Boyfriend at the airport today. He's going to a medical conference to get some CME credits in. I have absolutely no reason not to study a lot this week. That is my goal: study a lot.

36?!

I realized when I woke up Saturday morning that I am now closer to 40 than I am 30. I don't feel like it. I feel like I'm 26 still. it's a good thing, I have a few rough months coming up. I decided to take my (final) medical licensing exam next month instead of waiting until the spring. I just want to get it over with. I have another exam in July I need to do well on, so I need to start studying as early as possible.

OK, so what did I do this weekend? I had an awesome birthday weekend with The Boyfriend. It started Thursday Night when my family went out to dinner and then bowling. Bowling is fun, but I think what I love the most is doing something with my family altogether. Friday, The Boyfriend and I went to Dallas and stayed at the Westin at the Galleria and he took me shopping. We had so much fun. It's pretty cool dating a guy who likes to shop. To make it even more fun, I helped him pick out clothes too. I got my first pair of skinny jeans (yes, I know..I swore I would never buy any) and I love them. I must have tried on 20 pairs of jeans and the LAST pair fit perfectly.

OK so we didn't just go shopping. We slept in Saturday morning and watched a football game on TV and ordered room service for breakfast. Went to an awesome seafood restaurant that night, then Sunday visited his brother and sister-in-law pregnant with triplets.

Strange..I never heard from my dad for my birthday. ~sigh~ it isn't the first time. 3 years ago he got all pissed because my birthday was going to be celebrated at my mom's house. Since he has to control everything, he decided over his dead body would he ever set foot in my mom's house, so what did he do? He skipped my birthday. About a week later, I finally got a call from him. I don't know who he's trying to hurt more, me or mom. Grow up, Dad, Mom moved on 15 years ago.

Top 10 80's Flicks

Last night I was on call when The Breakfast Club came on. I couldn't resist it! Does it seem like the movies were better in the 80's? I think so. I mean, can anyone beat the Brat Pack, I ask you?

Here's my top 10, in no particular order:
1. The Breakfast Club
2. St. Elmo's Fire (watched it again a few months ago and it seems to have lost some luster..but still worthy of mention)
3. Pretty In Pink (a Ginger with a pink promdress?? She paved the way for many future prom going Gingers)
4. 16 Candles (Jake Ryan, you're such a babe!)
5. Tootsie
6. All the Indiana Jones movies
7. An Officer and a Gentleman
8. Poltergeist
9. Better Off Dead
10. Some Kind of Wonderfull
11. Say Anything (ooops, that's 11!)

My own Gray's Anatomy

I sort of despise that show for its numerous inaccuracies. However, it seems so convenient on Thursday evenings just to watch it since it's on. That being said, I secretly cringe when people try to associate anything I do in residency with what the pseudo-interns do on Gray's. Like my haircut lady. She wanted to know all about the exciting things I do. Well, for starters, people don't want to hear about the guy with a potassium of 7.5 that you saw in the ICU, they want to hear about two people joined together in a freak accident involving a metal spear. Hmmm. So, I told my hairdresser about having to run codes in the middle of the night and how stressful that can be. "You mean like they do on Gray's Anatomy?" "Uh, no", I replied, "I actually work".

Today I got a glimpse of my own hospital gossip and it felt very much like G.A. One of my old sorority friends had a summer fling with an anesthesiologist at the hospital where I work. As it turns out, I graduated from high school with the anesthesiologist but never knew him. As soon as my friend slept with him, he never called her again. No explanation, no nothing. If you ask me, he's a bit old for that kind of behavior, but whatever. Well anyway, I ran into him today in the physician's cafeteria. I've never met him before but I heard him on the phone saying he was Dr. X and to give such and such medicine to the pt. After he got off the phone, I introduced myself and told him we graduated high school together. He said my name sounded familiar and asked how he knew me. I told him that I'm friends with X who he briefly dated over the summer. Without even blinking, he asked how she was and for me to say hi to her. I so wanted to ask him why he never called her back and how could he treat someone like that, doesn't he want to get married someday? But I didn't. I didn't want to make things worse for my friend. Other than that small glitch in his pesonality, he seemed quite nice. I wish he would just call her and tell her why he was a jerk. It's too late though, I'm sure she's moved on.

Sleeping Beauty

Wow, I think I slept all weekend! I was on call last Wednesday night and got about 3 hours of sleep. I was busy from 6pm until 1am admitting patients from the ER, then during the night I had 3 code blues. Everybody lived. After my shift, I had to stay and round on the PICU patients with my attending, then I had to stay for noon conference. I got home around 2pm, but promised one of the other residents that I would pick her up at 4pm from her Lasik appointment. My point is, I got little sleep. I realized as I was going to bed that night, that I had 3 hours of (poor) sleep in 41 hours. It's no wonder that I woke up Friday morning feeling lousy. I came home and slept for 3 hours that afternoon. Slept 8 hours Friday Night, took a nap on Saturday, then today I slept until 12:30pm! I even got a kiss from The Boyfriend when I woke up.

OK I agree, I'm seriously a big slacker, but now I feel really good!

On a sad note, one of my aunts died this morning. She fell on Friday and I'm assuming she hit her head and got a head bleed, but at any rate, she was in the ICU all weekend not expected to recover. I wasn't surprised she died. I got such a nice card from her at graduation. She patiently taught me how to read the summer between kindergarten and 1st grade. I never forgot that. I really hope I can attend her funeral this week. It would be nice to see all my cousins, too.

Rules for watching sports

This weekend The Boyfriend and I went out of town with some friends for a big football game. We left Thursday and came back on Sunday. It was really nice to have 3 1/2 days off but it sure made coming back to work hard! Friday we went to Humperdink's which (I guess) is the designated hang out for our team's fans. It was pretty much standing room only. We got there at 1pm and stayed until about 6pm, just drinking and hanging out with our friends. Saturday, we went to a watch party at a friend of a friend's house(tickets too expensive and who wants to sit in the endzone?). There were about 8 of us there watching the game. The guy hosting the get together invited his neighbors and their kids over to watch the game. My experience that day made me think about some general rules that should be followed when watching a sporting event on TV with friends:

1. Don't talk incessantly during the game, some of us actually want to watch it and hear the commentary
2. Don't exchange recipes with the person across the room when others are trying to watch the game
3. Don't ask for the results of a replay/review 5 minutes after the fact because you were too busy exchanging recipes to pay attention
4. Get a babysitter
5. Don't block the TV during every critical play by getting up to go into the kitchen for more food
6. When there are only 3 minutes left, and your team is losing by 18 points, don't make the announcement that "all we need is a touchdown, and interception leading to a touchdown, then another touchdown to win the game". You sound like a moron.

OK some of these may sounds harsh, but that girl was driving me absolutely crazy. I found out later she was driving a lot of people crazy, but we were all too nice to tell her to shut up and sit still, so instead, I'm blogging about it here for the world to see.

A 2nd Birthday

I had a patient last week that I was seeing every morning before my attending came in to see him. I'll call him Mike. His heart was failing after having a heart attack. It was so weak, he had to have an intra-aortic balloon pump placed to help blood flow inside his heart better. He was also on two IV drips just to keep his blood pressure on the low side of normal. He was already on the heart transplant list, but his weak condition moved him up to the top of the list. Everyday last week I saw him and he looked weaker each day. Thursday he was pale and depressed-to me, it seemed he was getting worse.

Friday, I came in to see him and the nurse told me that there is a chance he could get the transplant he needed that day. There was a heart available in a city 4 hours away but there were still some tests that needed to be done to see if he was a good match. I went in to see Mike and told him I'd heard the good news that he may have a heart later. His affect was flat and all he said was that he'd "been here before and it didn't work out". With that reply I knew he was losing hope. All I could thing of to say is that we could hope that this time it will happen for him. I patted his arm and left.

All day we waited to see if he would get the heart. The delays were caused by the donor having some health issues that raised some questions as to whether or not the heart should be used. The surgeon came in and told Mike what was going on. Mike called his family and talked to them for a long time, then the surgeon talked to them. Then Mike got back on the phone. When he got off the phone, he yelled, "Doc, my family says go for it!". At around 2pm, there was still one test that needed to be done, but the transplant team decided to go ahead and fly out of town to "harvest" the organ, and if it turned out that they couldn't use it, they would just fly back without it. The brain-dead donor has to be kept alive on a ventilator until the organ is removed. The shelf life of a heart is low: The surgeon has only 4 hours from the time the heart is removed from the donor to the time it goes to the recipient. I found out the hospital has a private plane always on standy-by for instances like these.

All day on Saturday I thought about Mike and hoped he got the heart. I was almost looking forward to being on call Sunday because I wanted to know if he got it. Sunday, I was up in the ICU and asked one of the nurses if he got it. She said he did! He went to surgery around 10pm Friday Night and was in surgery for 6 hours. It was almost midnight put I peeked inside his room to see if he was awake. He was watching TV and when he saw me, he smiled and said, "I got it!". I went in and talked to him for awhile. He was so animated-he had gone from this sad, sick person about to lose hope to a new person who had just been handed another chance. It really made my night better to see him so happy. He looked really good, too. His skin was pink and he seemed to be thinking more clearly.

Mike has a long road ahead of him. He will be on anti-rejection drugs the rest of his life, will probably have several future hospitalizations because just about everyone goes through bouts of acute rejection. He will probably develop diabetes from the long term prednisone use, and the anti-rejection drugs will almost certainly decrease his bone marrow production of red blood cells, white blood cells, and platelets. He is also very weak from being bedridden. That said, I've never talked to a transplant patient who was sorry they did it-it gave them a 2nd birthday.

Last month when I was on cardiology, I found out that transplants are actually decreasing because there aren't as many organ donors as there once were. I found out most donors are young adults who make bad decisions and end up having life-ending accidents. With new safety laws in place like seat belt use, less young people are dying, therefore there are less organs available. I hate it that someone has to die for someone else to live, but what an priceless gift that is!

Zombie girl

I miss my friends. I don't talk to many people outside the hospital anymore. Being busy...well...sucks sometimes. I finished a 29 hour shift this afternoon, went home and took a shower, then went to The Boyfriend's house to sleep for a few hours. Not really quality time but I like knowing he's near.

Last night was pretty uneventful, for the most part. Except for the emergent intubation I couldn't get and had to call and ER doc to come up and rescue me (thank God for the ER docs that are around 24/7). Oh, yeah, and the central line I was trying to put in a guy's neck that I couldn't get. Everytime I hit the vein and started to put the guide wire in, he would turn his head and I would lose access. The third time I hit his carotid and I decided I'd had enough. I called the central line team to come do it. I was really pissed. It's getting late in the year for me to be having trouble with procedures. If this kind of stuff happens next year, I will probably get really chewed out.

Life is looking up though. This was my last weekend to be on call for several weeks. It's about time. It has seemed like lately I'm on call every weekend. I'm really excited about this weekend though. The Boyfriend and some of our friends are going to a certain big city to go to a certain football game. Well, we aren't actually going to the game. We decided if all we can get are nosebleed seats, we'd rather watch the game in our nice hotel room, then party with our friends after the game. It should really be a lot of fun.

So, that's life for me in a nutshell!