CARDIOLOGY. DONE.

I'll admit that I was super anxious headed into this rotation. Probably more anxious than any rotation except ER, that one was kinda scary too. But I can barely believe that it's actually my last week here! And I must say that I have quite enjoyed it. They have given me some great independence, which I enjoy, but this has also tested my knowledge and skills. I've had the joy of meeting lots of wonderful practitioners from various fields, and learning from them as well as my preceptors. My preceptors have all been fantastic to work with. They are kind, patient, and always available when I have a question or concern. The patients have been dynamic and each one presents to me a different set of circumstances to consider. I may not have learned as much about cardiology in particular as I might have if I had stayed in clinic all the time, but this rotation has taught me more about medicine in general, cardiology included, addressing a variety of disease processes, and has tested me as an independent provider. It has really been a great rotation and one that I am thankful I got placed on.

DUCKS!!!

Anyone that knows me well, knows that I just love ducks. They're so cute! When Ryan and I were first dating, he actually bought me 2 ducklings which we raised in my parents' back yard...probably not the best decision either of us have ever made, but we just loved them nonetheless. We have a siberian husky dog named Goose, so we actually had Duck, Duck, Goose :) Yup, I'm a total nerd and found that amusing for the entire time we had the ducks. Anyways, in our neighborhood now, there are a few ponds with lots of ducks! It's one of my favorite sites when I go jogging. I don't know, they just make me smile. I am bias towards two of them. They are always together, and they are about the most unique ducks I've ever seen. I call them Puff Duck and Dalmatian Duck. The white one has a little afro! Come on, tell me that doesn't make you smile!

With spring coming, there are also baby ducks at the pond! Oh, they're just adorable with their little yellow fuzz. One momma duck has about 7 babies with her right now.

Ok, that meets my cute duck quota for a little while...back to school stuff...

HAPPY BIRTHDAY!

Happy birthday, Ryan! Ryan turned 29 on January 19. We celebrated on his birthday with dinner at Saltgrass, then the next night we went out with friends for Hibachi and drinks. We even had our first Sake bombs! We had a fantastic time, and thanks to Heather, Jason, Lindsay, and Lonnie for coming out with us. I wanted to get a picture of all of us out, partially to prove that yes, we PA students DO manage to get out every now and again to go have fun. But, we got distracted and never got a pic. :( I managed to get a picture of the food though! lol

This was Ryan's present from me. I felt like being mischievous, so I wrapped it in consecutive boxes with different kinds of wrapping paper. On the last layer, you can see princess, dancing birthday monkeys, and Christmas paper :). It was a very small box, about 2 X 4 X 4 inches, and the largest box here was for a rolling garage toolbox...many boxes in between! Oh, it was fun.

MATTERS OF THE HEART

Well, it's back to the grind now. No more vacay :( But that's okay, I had a fantastic month off and am very grateful to be rested and ready to go. First up for this year is cardiology. I was stressing about this rotation for a few reasons. First, the heart is one of my weaker subjects. There is so much to remember, and it all gets inter-twined. I'm hard of hearing, so hearing murmurs can be very difficult. Second, there are so many contributing factors that make this less of a action/reaction, direct effect, instant gratification specialty. I like to see a problem and fix it, which is harder in cardiology than it is in other specialties. Third, my next rotation will be vascular in nature, so this whole heart thing is going to be a big deal then, too, so I'd better be paying attention! And lastly, I've been on vacation for a month. Going from doing whatever I dang well please all day every day straight to keeping someone else's schedule and explaining my every move is not an easy transition.

With all that said, I have honestly really enjoyed my rotation so far. I wanted independence, and I got a big dose of it! I'm rounding on my own at the hospitals, so I see lots of patients with a variety of ailments. The best part is that while I'm mainly concerned about cardiology-related issues, I'm treating a whole patient and have to consider the whole picture, so it really keeps me interested. I can look up stuff I have questions on, and I can always call my preceptor with more questions or concerns.

This has been a whole new experience in another aspect-most of my patients are in ICU or long term care facilities. That means that their situations are very fragile and can literally change by the day. This is the first time I've ever had to convey that to a family. I don't think I've ever chosen my words so carefully. I also have to watch for the subtlest signs or changes in lab values each day. It has made me realize, again, how important it is for EVERY person to discuss with their loved ones what their wishes are if they become incapacitated. Please keep in mind that from my view, incapacitated doesn't always mean dying...it has a variety of implications, including severe dementia, dehabilitating infection, changes in psyche, and otherwise. And it's not always a permanent situation. It's important to discuss resuscitation, intubation, "life support," restraints, medications, etc...don't leave some subjects unbreached because it makes for an uncomfortable discussion. It breaks my heart to see families in distress over what their loved one would want in a time that already brings about such emotion. It breaks my heart even more to see families go into denial regarding very real situations, and watch them simply leave family members behind at the hospital. Would you want your family to leave you in a hospital bed for an undetermined amount of time and come visit once a month for 15 minutes because it makes THEM uncomfortable to think about it? It's never an easy conversation, but being in the heat of the moment won't make the decisions any easier or any more clear. I'm sorry to bum yall out on a beautiful Sunday morning, but this really weighs heavily on my heart today, and I saw it way too often in just one week. On a happier note, I also saw true love this week. I saw spouses come sit bedside all day, every day. They knew what their loved one wanted, and did everything possible to uphold that. They would read, make sure favorite TV shows were playing, talk, and even hold hands. And sometimes, I saw the patient respond to such love with a squeeze of the hand, a head nod, or even as subtle as blinking-once for no, twice for yes.

Realizing how fragile life as you know it can be, I think I learned from my patients that it's probably better if we all take it just one day at time, and never pass up an opportunity to show love or have meaningful conversation with our loved ones. Thank you, week one of an intimidating rotation, for teaching me such a valuable lesson.

CHRISTMAS 2011 PICS

My baking madness! Yes, I made this all in one day from scratch. We have: 2 batches of chex mix, a Texas cake, 2 dozen chocolate chip cookies, a dozen cinnamon rolls, 2 dozen sugar cookies (frosted and decorated), and about 4 dozen cake pops. Best news-I didn't hurt myself or catch anything on fire! Yay for no trips to the ER this year.

Ry, Me, Sue, and Tom at Gaylord ICE. The nativity scene was beyond gorgeous this year!
Aimee feeding the birds at the zoo. She asked for 2 hours while we looked at all the other animals on the way back to the aviary to feed the birds. This was the highlight of her day!
Aimee playing with the beautiful white tiger. She doesn't realize that he probably thinks she looks like lunch. Thank goodness for her naivity and all that plexiglass between them.
We got Aimee a Barbie makeup set for one of her Christmas gifts. She was so excited, she didn't even know what to do when she opened it. What you don't see is that shortly after this picture, nearly every bottle and brush was opened and being applied. Dad groaned when he saw this :/
Me and Aimee at Christmas Eve dinner
Mi Familia! I love this picture! On the back, we have my sister Brittany, my brother Jason and his wife Jennifer, my mom and dad, Ry and me; down front is my brother Anson and his wife Sonya with their two girls, Grandpa, and Aimee. This just reminds me how blessed we are :).
MERRY CHRISTMAS AND HAPPY NEW YEAR!

AS PROMISED...SF PICS!

In no particular order...

You better believe we made it out to Golden Gate Park and got our pic with the bridge!

Boudin's-the fresh sourdough bread place. Ridiculously delicious.

Me with surfer Santa. I wanted to get a pic of me, Ry, and Santa and do a mele kalikimaka card for Christmas...but that didn't quite happen.
Boudin's bread. They make these fun shapes! Christmas tree, teddy bear, alligator, another bear, another alligator, and a lobster. Now how fun is that!
Ryan on the cable car.
My first time to see the ocean! Apparently the Gulf of Mexico doesn't count as an "ocean."
Big shark swimming over us in one of the walkway tubes at the aquarium.
This fish really didn't like me. He kept trying to eat my hand. And I enjoyed taunting him.
We were on Alcatraz looking back at the city.
Most heavenly dessert ever-the Mint Bliss by Ghirardelli.
Ryan really liked riding the cable cars. :) I love to see that boy smile.
Me on a cable car. I even managed to not hurt myself or fall off :)
Thank you, Macy's, for some serious Christmas spirit! This display was gorgeous.
I want this at my house now. A Christmas tree between two palm trees...all with like a billion lights. :)
The trees during the day. Still fun, but the lights at night just make it better.
We found Chinatown! We got lost in Chinatown :/
Oh yes, we definitely went down Lombard "curvy" street.

Oh, home sweet home...

The painted ladies from Alamo park. Quintessential SF!
And yes, I most certainly drug Ryan along to find the real Full House house. The door has been changed out, but it's the house!
The sea lions were hilarious to watch!
View of the city on the way out to Alcatraz.
View of Alcatraz on the way out.
Fisherman's wharf is where we stayed-it's close to Pier 39 where we spent most of our time (and money...).
The end! We had such a great time!