GOOD FOOD, GREAT COMPANY

Wow, it's hard to believe that it is already that time of year again. This year has just flown by! And what a crazy year it has been! I am looking forward to sharing the holidays with family this year, and hoping the holidays will be a little easier on us all. Last year about this time is when my Mom's mom (Grandma Hill) passed away from progressing breast cancer. We will always remember her this time of year especially. It's comforting to know she is always with us still, but I'm looking forward to sharing the great memories of her this year instead of the pain we were all going through this time last year.

Thanksgiving was a little more traditional this year than it was last. Last year, I was WAY bogged down with school, so Ryan and I boycotted cooking and went to dinner hosted Moody Gardens. I know...thanksgiving just the two of us and no cooking. See, a bit untraditional! This year, my parents came down with Aimee since I was working again, and we all cooked a nice, big meal here at our house with our roommates. It was perfect! We had awesome food (mainly cooked by Heather...before she broke the disposal. But it's ok, Dad fixed it), the best company anyone could ask for, and the Packers played the Lions that day and won! It was really nice to have a more traditional Thanksgiving with people we love so much. We even squeaked in a little Hibachi on Wednesday :) We all spent Friday recovering and ate leftovers for about a week.

So ER is finally finished. Nights were as difficult as I expected, especially with the rest of our goings-on with Cheeto. This has been the first rotation where I was really looking forward to the end, which I hate to say because every rotation is supposed to have it's good and not-so-good sides, but this one was rough. Note to self: ER full time is not a good option for Lauren.

On a happier note, I am absolutely LOVING orthopedic oncology and surgery. This rotation has been my favorite so far. There is some continuity of care, which we all know I like, but the patients aren't generally needy. They may require more attention because of the unique circumstances at hand, but their attitudes are just so different than in any other field. I get some clinic time, lots of surgery time, and even a little admin time built in. Every patient I see has a unique condition requiring precise, personalized care. All in all, it's a little primary care (continuity of care), a little general surgery (getting to close wounds, excising masses for biopsy), a little oncology, and a little carpentry (essentially building new bones and joints for patients when theirs fail). It's a bit of a boy's sport, as orthopedics generally is, but I've never had a problem with that environment. I actually tend to work better because there are fewer girls, which means it's usually less dramatic and involved. We work hard and work efficiently...no fluff. But they also don't have a problem having a little fun every now and again. This is definitely a field I'll be strongly considering when I graduate.

Also, I was discussing this with one of the working PAs there-she was reminding me that finding a good doctor to work with is a lot like dating. You have to get along-on good days and on bad days. You have to be able to communicate well. You have to work well as a team and be able to back each other up. You just have to mesh well. A bad boss, or one you just don't see eye-to-eye with, can ruin your morale, even if you are doing work you love. Something to consider as I get closer to graduation and start interviewing for jobs. Yup, that's just around the corner, too! :)

HIS TIMING, NOT OURS

This post will probably be different than posts you’re used to on here. It will be long, and you’ll have to excuse me as I cry my eyes out while I write. This is a story about timing, timing I don’t understand right now…and about an adorable little orange puffball of a kitten that blessed our family for 11 days.

Looking back, it all started a little over a month ago one morning at church. Ryan and I listened to a sermon about others’ needs, generosity, and the ability to give. It definitely hit our hearts, and we agreed that we needed to make sure we were keeping our eyes open for when others are in need where we can help. We also needed to make sure we reserved some of our selves (our time, our money, our abilities) for when someone else needed us. Little did we know that God would be calling on us to help someone very soon. I went to work later that week, and was struck to find a little grey kitten at my car when I went out to grab my surgery goggles and scrub cap. She was wet and hungry. I called Ryan and asked if he would mind if I brought her home after my surgery that afternoon, and we agreed that her need was one we could help with. I had to go into surgery, and when I came back out to look for her, she was no longer there. My hope is that someone else took her home and cared for her. I went along my way knowing that although I couldn’t give her the care she needed, our hearts were in the right place for wanting to.

About two weeks later, my mom called me with terrible news. As I mentioned in a previous post, my cat back home was viciously attacked and killed by some stray dogs. Our hearts were so heavy knowing what a tragedy it was, and that my mom had to handle the situation while I was away and my dad was out of town for work. After a 12-hour shift in the ER and that news, I was absolutely drained; I can’t even imagine how my mom must have felt. She is so strong, but this situation was more than anyone should ever have to endure.

That evening, Ryan was leaving for work and found a little orange kitten looking for a warm, safe place to sleep out under his truck. He knew the kitten was too young to be away from mom, nonetheless with a wet, cold night ahead. Much like I did before, he called and gave me a heads up on the situation. We agreed that he should bring the kitten home, because we honestly didn’t think he would survive the night outside alone. He brought home this tiny (3/4 of a pound), screaming, hungry, and scared puffball of a kitten. We had to start nursing him with milk because he was just so small. We went to the vet the next morning for a once-over and got the okay from the vet. He may be small, but he was healthy. On hearing the good news, we settled on the name Cheeto. He spent the next week growing…growing in size, growing in ability, and growing in confidence. He could now run with some sort of coordination (i.e. without falling over), he started eating softened kitten food, and he was learning how to play and have fun. The dogs responded quite well to him. Maverick took ownership of him and was always looking out for him. Goosey tolerated him. Even Tigger was interested in him and would check up on him periodically. It was now a morning routine to enter the bathroom and he would run up to you with his little tail sticking straight up as he cried for us to pick him up, pet him for a minute, then feed him. He was definitely growing. His feet turned into little clubs, his legs sprouted, and he was even getting a full belly. We were so happy to have this new, unexpected addition to our family. We were filled with joy just watching him and loving him.

One Saturday morning, I took him out of the bathroom to let him come out and play. He would jump around the bed attacking the covers, chase the dogs, and try to copy the things Tigger did. After a tiring morning of playing, he curled up next to me on the bed and took a nap. I just enjoyed laying in bed on a lazy day, feeling the warm sun, and listening to him pur. He woke back up around lunch and wanted on the ground to play with the dogs. He was using Goosey as a jungle gym…just climbing all over her. She was so patient and understanding, and just let him for a while. They must have been 5 feet from me at the foot of the bed, she was still lying down and I could see him playing by her when I heard her make a strange noise. I looked down, and saw him walking away from her. Then, he stopped and let out a gut-wrenching meow/crying noise and sat down. I went to pick him up to see what was going on, and noticed his eyes couldn’t focus. He couldn’t walk, he couldn’t see, and his little legs just started flailing. I ran out to the living room and cried to my roommate for help. We put Cheeto on the ground, and his condition was obviously worsening, so I wrapped him up in a towel and was headed straight to the vet. He was acting so bizaar, this was absolutely not the kitten I knew. At the traffic light just before the vet, he stopped flailing about, and came to peace. He passed away in my arms at that moment. Ryan was at work and had to meet me at the vet so we could say our good-byes. We were taken completely by surprise, and beyond heartbroken. This is one of the most tragic situations I have ever known. I’m in the medical field and deal with medical emergencies routinely, I have experienced the death of a person before, but this melted me down to a crying mess of nonsense. I asked the vet what could have happened, and the short answer is that we don’t know. He said it could have been a seizure, a stroke, a bleed in his brain, he could have hit his little head on something, or one of about a million other possibilities. He had no signs of trauma and passed within about 30 minutes of showing any signs that something was wrong.

It was so hard to leave the vet without our sweet little kitten. We instead had this sadness, this emptiness. When we came home, the other animals knew that something had gone terribly wrong; they were very solemn and kept trying to go into the bathroom to look for him. The look they gave us as we picked up his things was absolutely heart-wrenching and Goosey kept sitting with her back to us. I was back working the ER that evening doing my best not to melt back down to a crying mess of nonsense while Ryan was at home attempting to work on things through the night to keep his mind away from the situation at hand. The next few days were unspeakably difficult and I can’t say that either of us handled the situation particularly well, but I guess that’s to be expected. I want to make sure to thank Ryan for being my rock and stronghold during this. He has been comforting and supportive, and I am so thankful for him. We both still feel an emptiness, but each day is slightly more bearable, and I know our God will see us through this and give us the comfort and peace we so desperately need right now. We have to understand that this was not our timing but His, and maybe the reasoning just isn’t for us to know right now. We also have to be confident that we followed God’s will in fulfilling Cheeto’s need at that time. If it weren’t for us, he probably would have died alone, cold, and hungry that night at the golf course at the ripe age of 4 weeks old. Because of us, he had a warm home full of love for 11 days, but to him, he had a warm home full of love for his entire life. We are so blessed to have had him, if even for such a short time. Though it hurts right now, I pray that we won’t harden our hearts to love in fear of hurting so badly again. I’m thankful for our loving family and that we were able to serve God’s will, and I pray for strength, for comfort, and for peace during this time of grieving and sorrow.

Thank you for listening to the story of our little CheetoPuff. I admit that writing this was probably more therapeutic for me than it was for you. He will be so missed. Please remember to keep your hearts open for when someone needs you to be a blessing to them. We will always remember the love we experienced and blessing to us in fulfilling his need.

UPS AND DOWNS

My mom called me on Tuesday and had to give me some terrible news. I was already tired from a long day at work and knew I had 3 more shifts before my week was over, so I probably took it worse that I would have normally. She had to tell me that my cat back home, Scooter, had been viciously attacked and killed by a few stray dogs that morning. They had also killed other cats in the neighborhood and threatened to attack some of the people. I was, and still am, extremely upset about the situation, so please keep our family in your thoughts and prayers. We found out today that the dogs were captured and taken to the local pound, which helped provide some closure; I just hope they won't be allowed access to hurt any people or any other animals.

As if my day hadn't already been physically, mentally, and emotionally draining, Ryan called on his way home from work to let me know that he was bringing home a kitten. Apparently he went out to his truck and found this little guy trying to find a safe, warm spot to sleep, then he followed Ryan around crying to him. He said he wouldn't normally bring home random cats, but this one was really little and we would be getting a cold front that night-he didn't think he'd survive outside alone without any other kittens or a mama cat. So...we got another kitten. And little he is...the vet estimated 4 weeks old and he weighed in at a whopping 3/4 of a pound. He was a bit scraggly looking at first, but he has cleaned up nicely and started putting on a little weight. He's really coming into his own now! He is playing, getting along with the pups and Tigger, and he has this eating thing down. Mav just loves him, Goosey hates him, and Tigger will finally go within a 5 foot radius of him. Everyone, meet Cheeto!

He looks innocent...but he can be a little firecracker!

Goosey is still mad that we have a new kitten. This is one of her ways of expressing how mad she is.

He's already a Packer's fan!

Apparently, he is Mav's kitty. They get along surprisingly well.

My first picture!

LIFE IN THE ER

First, an addendum to my post about General Surgery...to everyone, I know your mother probably taught you to wash behind your ears, but apparently some mothers have been failing to teach their children to wash their belly buttons. The deal is, when you go into surgery, especially anything to do with the abdominal or pelvic areas, the team will clean the area, and it often includes cleaning the belly button. Now, I saw some terrifying things come out of some of my patients' belly buttons. So almost as a PSA, please clean out your freaking belly button when you bathe!

So now ER business...I'm not sure this is quite my cup of tea. I have enjoyed some aspects-mainly the fast pace makes the time go by fast and working 12-hour shifts means I have to work less shifts. Plus, I really have gotten to see and do a lot. However, 12 hour days are really quite long. I'm not sure I'm cut out for that. I work with new staff each day, so each day is essentially Day 1 of a rotation, which wrecks my nerves and I always feel out of place and awkward. I also feel that once I get to know a preceptor, they help me with my weaknesses. In this scenario, I don't quite get that opportunity, so I feel like I've grown in a few small areas, but no significant areas like I did in some of my other rotations. Also being in a very urban ER is much different than my small-town ER where I got my first ER experience. I preferred the small-town vibe :) Now, don't get me wrong, the staff I've worked with here has been quite helpful and generally friendly, but I like to develop relationships and work with people on a more personal and less formal level. Regarding big lessons to pass on to yall...I'm still working on thinking about that one. The cool stories I can't really share for privacy reasons and the rest you'd probably find boring. But I'll keep thinking about it... I've actually finished my days in the ER and am now switching to nights for a few shifts. For those of you who know how much I love my sleep, pray for me and this transition!

FALL FESTIVITIES

I have about 3 days off before my next rotation starts, so we decided to take the pups out for a little fall fun. We went costume shopping and visited the pumpkin patch. :)

We dressed Mav up in the "Land Shark" costume...we thought it was pretty fitting for him! lol But even though we had the largest size (an XXL), it was still too small :(

LIFE IS LIKE A GAME OF DODGEBALL

Well, I survived general surgery! Yay! And I didn't pass out! I ended up enjoying it much more than I expected. What did I enjoy most? Probably the atmosphere. It was a light, relaxed atmosphere, but it was still efficient and productive. My preceptor was also pretty awesome, so I'm sure that had an impact. So what did I learn? First, life is apparently like a game of dodgeball. You'll always have people on your side and always have people not on your side. You may have strengths, but you'll also always have weaknesses. You'll play the game better if you learn to work as a team. You won't get very far by sitting in the corner alone doing nothing or just being scared to play. And lastly, it CAN BE FUN! Granted, I also learned a lot about the surgeries we were doing and patient care...but you'll probably find the dodgeball thing more interesting :) So all in all, I had a great rotation, I really learned a lot, and surgery is still in the running for career possibilities. I also learned/realized how important it is to have a boss that I really get along with if I do choose a career in surgery because of how closely we will be required to work. So ER is up next...yet another foreign environment and new experiences!

PRIMARY CARE

Well, I can hardly believe it, but I've finished my Primary Care rotations! Wow! One block of rotations down, three left. I enjoyed primary care because of the variety of cases, the (sometimes varying...) continuity of care, and because you can really get to be a part of some of the families. I appreciated being the provider that helped people be proactive in their own care, the provider that helped patients cope with what will be life-long illnesses, the provider that patients could confide and trust in. Primary care really re-instated that "patient-driven" kind of practice in me and I learned very quickly that relating to and communicating with the patients is where good care starts. My last rotation wrapped up really well! It was another great rotation where I learned more and more each day, got new opportunities, and enjoyed the preceptor and office staff. I'd have to say, I had some really great rotations for primary care! The final exam was...umm...challenging. Not challenging in the sense that it was biased or unfair, but it was extraordinarily comprehensive, which I didn't quite expect. And sometimes I'd have an internal conflict of what the textbook says to do and what experience/actual situations would guide me more towards. It was also challenging because I haven't taken an exam in about 3+ months! I think my brain almost forgot how to take these PA-school exams! I did just fine on the exam, but it helped point out some weaknesses I may have developed while away on clinicals instead of in a classroom. C'est la vie...live and learn! So here are some highlights of what I learned in Primary Care:

1. For my first job, I want to work for someone who wants to teach and encourage me to grow.

2. My idea of an "emergency" and someone else's can be quite different. I learned how to gently, but effectively, express this and how to tell someone that (only in an appropriate situation...) their complaint would probably be better managed in an office rather than my ER.

3. Pain is entirely subjective. Relief of pain is also subjective :) This can be influenced. Some people think they will experience an entire lifetime without ever having pain-I think this is naive and dangerous.

4. Learn to communicate with your patients. They have to TRUST you to take your advice; they can't trust you if there is a communication deficit. This will involve actively listening to the patient.

5. It's all about confidence. Not being arrogant or cocky, but confident. A smile doesn't hurt, either.

6. The nurse or MA in the office is my best friend. Special thanks to the nurses and MAs on my rotations who helped show me the ropes, saved me when I needed help, and taught me so much!

7. I can do a whole lot more than I ever gave myself credit for.

I'm not sure if Primary Care is my calling in healthcare, but it's definitely still in the running. So what now? Four weeks of general surgery, four weeks in an ER, and four weeks in surgical oncology. We are about to find out if I have a future in surgery or not. While, from the little experience I have, I've enjoyed surgery, I'm a little worried about my pesky "passing out" issue. I haven't had a big episode in a little over a year, so I'm afraid I'm about due and the OR just might be the trigger that's been missing. I had an "almost" episode a few weeks ago while in surgery...I guess we'll find out soon enough! Regardless, I'm looking forward to new adventures and new experiences. And when this block is finished, it will be Christmas-time! YAY!