ob/gyn.

wowsa. ever feel really, really dumb? i mean, really. dumb. i know next to nothing about obstetrics. and gynecology. too bad my preceptor starts every interrogation session with "what do you know about...." NOTHING i want to scream. NOTHING AT ALL. i know i'm disappointing you on at least an hourly basis by not knowing the most common cause of vaginal itching or the epithelial cell type in the endocervix or the incidence of neural tube defects in women who took folate supplements versus those who did not. i'm IGNORANT. and don't offer to let me in on a procedure by asking me the question "any good at phlebotomy?" in front of the patient. i'm going to have to shake my head no. even though the one time that i did it, i hit it on the first stick. but that in no way means i'm GOOD at it. i've done it ONCE. and dimples (my phlebotomy partner, who happened to be H-O-T) had really good veins.

argh. i'm just frustrated with feeling so out of my element. and not really knowing what i should be able to do. i mean, we did inpatient rounds this morning on the post-surgical patients. i coulda done that by myself. written the progress notes, discharge orders, consult orders, etc. all. by. myself. apparently i'm supposed to put myself out there and just start offering to do things.

on a lighter note. i've seen a LOT of vaginas in the past couple days. i'm getting better at measuring fundal heights. i did an ultrasound the other day. not very well, but i had minimal instruction, so i fumbled through on my own. it wasn't a necessary ultrasound - just a mom with her 6 year old daughter who wanted to see the baby. so he let us play together.

i stopped by the hospital to give the nurses my phone number so they could call me when there's a delivery coming. i mean, come on. that's really the only part that seems exciting to me. i'm reading about the stages of labor now so i'll be ready. not really. i'm reading it because just before i left this morning, dr. b asked me what i knew about labor. (see above for answer). so then i was assigned stages of labor and management of complications within each stage. which is an ok thing, because even though i don't have my text in yet (barnes and noble ordered it for me monday night), i DO have lecture notes from last year that enclose those topics in two very succinct power point presentations.

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the only really good thing is the hours. i work very few hours. which is unusual as far as obgyn rotations go. i work mondays 1-6, tuesdays 1-5, every other wednesday 1-3, thursday 1-8 (but he says he never makes the students stay the whole time...), and friday 10-noon. it works out nicely, since there's so much READING for me to do.

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in other news, thanksgiving here was nice. different, but nice. we had to wear dress up clothes and we ate off of china and drank sparkling grape juice out of crystal wine glasses. fancy, no?

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one more thing. i love panera. and i LOVE that they have free wireless internet. i took this picture on my way here this afternoon to show you how much i loved it.
let's be honest. i really took it to show you how hot i look today.

what.

a. long. day. 7 am to 10 pm. and it's not like last month where i just slept over at the hospital and left at noon the next day. i have to be back in at 7 am. and i'll be there until 5. at least in the afternoon tomorrow we have lecture, so it will be less work. but more stress as it turns out, as i haven't looked at the lectures or discussion questions. can you say not good?

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in other news. two days left, and i'll have another month under my belt. insanity, i tell you. BUT... the good news is that i am starting to be able to see that you will be comfortable with things by the time you are in residency and confident in your skillz by the time you are an attending.

i'm amazed at how much fun it is when you actually have kids coming in. you know. sick ones. and there are things to think about. and stuff to read about. and it's kind of like a game. 308 is spiking fevers, give him some tylenol and keep a close eye on him overnight. 305 isn't eating well, start her IV fluids back up. 415 is eating like a champ, stop his IV fluids. 413 has an oozing sore behind her ear, culture the drainage and start IV antibiotics. it's fun, actually.

i'm dreading the end of this month just a little bit. this will end my 3 month stint of seeing only pediatric patients. i will now delve into the world of adult medicine. which will undoubtedly be much more like work and much less like a game. hopefully i can find ways to amuse myself amidst the dreaded mile long lists of medications. i'm going to miss all the cuteness though, that is for shizzle.

nothing really to say.

but i wanted to post anyway.

i'm sad about missing the big family thanksgiving gathering. it's my first major holiday away. i guess i stuck around longer than all ther other kids... who'd been missing holidays for years by the time they were 25. anyway, i'm still sad. especially because so many of the other kids will actually be there this year.

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i have to do a presentation tomorrow morning during rounds about crohn's disease. i'd link for you, but i'm lazy right now. it's an intestinal problem, and you should count your lucky stars if you don't have it. it wouldn't be fun. trust me. anyway... it's only supposed to be 5 minutes long. unfortunately, mine will be longer than that, and people will be annoyed. because there are things to do. sick kids to take care of. LIVES TO SAVE. and all that jazz.

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i move on wednesday. i'm really ready to not be in des moines anymore. it's pretty lonely here.

untitled.

one of my classmates' 5 month old daughter got sick last week. she's now on life support and the doctors say there's nothing they can do. they are probably going to pull support tomorrow. i can't imagine the agony. maybe one day doctors will learn to heal sick people.

"p" fruits make you poop.

something i learned today during didactics. (see: fancy word for lecture). the "p" fruits include prunes, pears, peaches, pineapple, etc. and are good things to give kids who are constipated. we doctor types are good for something, huh?

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my patient this morning did bad things overnight last night. he has a neuromuscular disease (see: bad nerves and bad muscles), and has pneumonia on top of it (and multiple other issues). well, the pneumonia is a problem for him because since he has bad muscles (this includes the muscles you use to breathe with), he has trouble breathing over the pneumonia. and so last night he dropped his oxygen saturation a few times and they had to bag him (see: not breathing good and needing extra help to breathe). at the last hospital i was at, if you were bagging someone on the floor (see: not the PICU), you had to call a code (see: bad). i guess this is not the policy here.

so this morning, he had been flying pretty well for about an hour or so by the time i saw him. and my intern (see: 1st year resident) left me to do an exam on the kid and write a progress note. the respiratory therapist was doing his morning treatments at the time, so i started my note before seeing the kid. i had written no more than the date and time when one of the RTs comes out of the room to summon help as the kid's SATs were dropping again. so i page the intern and walk into the patients room as if i know what i'm doing and will be of a great deal of help to these people.

the next two hours were a flurry of activity. there was me, the intern, a second year resident, a third year resident, both of our attendings, the nurse, the nursing student, the transport nurse, at least 4 respiratory therapists and perhaps 3 RT students. it was a LOT of people. we ended up transfering the kid to the PICU (see: pediatric intensive care unit) and intubating him (see: breathing for him).

it was sad.

because jen is a crabby pants.

no, that's not why. actually because i have a few minutes free right now. that's why i'll post for you. first of all, here are the before and after shots of the haircut. mind you, the after was taken about 30 seconds ago. and it's been a long day.

beforeaftermy newest hobbymy latest discovery. it's addicting.
and the time starts as soon as you get to the page. so HURRY!

and this is really how i spend my days these days. not with this pumpkin. though i'd love to. but with pumpkins just like him. except they have snotty noses and fevers. and they aren't nearly this cute. well, maybe a couple of them are.

they cry when you look at them and scream when you touch them. they may puke on you when you look in their throat and pee on you when you're checking their femoral pulses. but sometimes they pull your hot pink pen light out of your pocket all on their own and their eyes get big and they grin with glee. why would you want to do anything else?

jealous?

today i got my hair cut and taught myself to knit.