Tuesday, March 27, 2007

Two days down, 40 more to go.

Internal Medicine is kicking my butt. I am on day 2 of a 6 week rotation. Long hours. There are 4 medicine teams, and we have a rotating call schedule that goes like this:

Long Call - you admit patients from 4pm to 5am the next morning. Although if the AM and PM teams already took 5 patients, you get to start admitting earlier.
Post Call - everyone that stayed overnight gets to go home by noon.
PM Call - your team admits 3 patients sometime before 4pm.
AM Call - you admit two patients by noon.
Start the four day cycle all over again. On weekends, you only admit patients if your long call day falls on a Saturday or Sunday - if you aren't on call during the weekend, then you just go in and round on your patients with your team and then go home.

But wait, you ask, what about your day off, Shannon? Silly friends and family, there are no days off. Well almost - I have three days off that I can take during the next three weeks. But, as I was told, you really shouldn't take off any day that your team is admitting patients, and you also cannot take a post-call day off. Oh well. I get to take this Sunday off. Woohoo!

These rotations are funny things. In some ways, they are very cool - you get to participate in the care of very complicated and very ill patients. You learn a lot about treatment decisions and get to do some procedures (Raul drew several arterial blood gases while on Medicine.) However, as a third year medical student, you have no control over your schedule or your comings and goings. You get to report to the hospital at a specified time for rounds, and then you round on all your team's patients for several hours, and then you go back and sit in the rounding room and read articles on various internal medicine topics until someone tells you that it is okay for you to go home. Don't really like so much being constantly told what to do. The rotation is still just beginning, and it will likely get a lot better (I hope!). I have just been thinking lately that I really should have gone into social work.

On the brigher side, spring is here!! I also have a ton of seeds I need to plant, so they'll be ready to go in the ground in mid-May. All the bulb plants are starting to come up and the weather has been gorgeous!

I will post soon about that baby blanket--assuming Greta decides not to appropriate it first.

Sunday, March 25, 2007

Home!

We're back! Raul and I both returned home this week to a very lonely cat and a messy house. We took our tests on Friday; I really had a marathon day - two exams and four simulated patient encounters (for those of you who have never had the opportunity evaulate a patient actor, it's really an interesting experience. Some of them are quite dramatic - and even go so far as to put Cambell's chunky soup in their mouth and stage an episode of vomiting right as you walk in the door. As you would imagine, the appropriate and compassionate response to such a situation is not to start laughing - however, some of the encounters really are hilarious.)

Anyways, we're home! It's so nice to be back and to have a free weekend. I was able to catch up with my parents this weekend - I hadn't talked to either of them in several weeks. I met up with some friends. And I finished a baby blanket (post is coming soon!) And apparently, I fell asleep on the couch with the cat yesterday for about 4 hours while Raul did some manual labor. As mentioned in earlier entries, I have been on a bit of yarn buying bender lately. I have stopped for the moment, but I've really amassed quite a stash (see picture below.) I went to the local hardware store (Menards, for all you nostalgic Midwesterners) and bought these big, tupperware totes, so I could store the yarn under the bed. Of course, they were too tall to go under the bed, so Raul had to build these wooden block things that fit around the wheels on the bed frame and elevated the bed. It worked, and now the yarn is happily stashed away! He's quite a guy.

This is an unrelated topic, but I wanted to comment on this experience. When Raul visited and we were flipping through the channels on TV one night, we came across Titanic (the movie with Kate Winslet and Leonardo DiCaprio) on TV. Raul had never seen it before and he wanted to watch it - we tuned in at the point where they'd hit the iceberg and the ship was at the beginning stages of going down. Raul mentioned that big ships like that can take hours to sink, and they really effectively conveyed that in the movie. I saw the movie back in college, and I remember all the girls at my school being in love with Leonardo DiCaprio. I missed that whole infatuation boat, but I didn't remember the movie being so painful to watch - I yelled something like, "sink already!" after watching it for an hour or so. I really have no patience anymore. Med school's ruined me.

Happy weekend to all!

And as promised a picture o' the stash (or at least part of it):

Sunday, March 18, 2007

P.P.S.

I bought more yarn. Oops. I pledge to make no more pledges not to buy yarn. It was kind of an inevitable purchase though - I had bought too few balls of this yarn for this sweater. So, I really had to order 4 more balls. I am not quite sure how this ball of sock yarn ended up in my online shopping cart, but I am quite happy that it did.

Happy weekend to all!

No pictures

Hello,

No pictures in this entry - somehow the camera ended up back at home. It's a long story and involves the snafu that is daylight savings time for me, always. No matter how many times I am reminded, I always managed to be surprised by the change in time the day after daylight savings time (two days after in this case.) This time, I was in Des Moines with Raul, and I was all set to get up at 5am Monday morning, so I could be in Mason City at 8:30am for a scheduled community activity. Somehow, we managed to change the time on all the clocks in his apartment except for the one we used as an alarm clock. Needless to say, we were both an hour late the next morning. Oh well.

Anyways, Raul drove up to spend this weekend in Mason City with me. It was wonderful to see him. Friday night we had a date at a
local steakhouse, and the food was excellent. I am pretty sure they cook all their food in this mixture of butter and olive oil. Instead of dessert, we opted for angioplasty. Just kidding. We were able to walk it off - the weather was warm (40 degrees), so we walked the 4 miles round trip to and from my apartment to the restaurant. I have never been so happy to see signs of spring as I have been since moving to the Midwest. And judging from all the Mason City-ians I saw sporting flip-flops and shorts this weekend, I am not alone in my sentiment. It is always so exciting when winter is coming to an end.

We both have end of rotation tests this Friday, so we spent most of the weekend studying. Med school has really changed my life - if you had told me 5 years ago that there would come a day where I could sit down for 8+ hours and study the entire time (with short breaks to eat and and whatnot), I would not have believed you. Likely, I would have really hoped that you weren't telling me the truth. But that is exacty what we did this weekend - 8 hours on Saturday and 6 hours on Sunday (with more to come tonight) of studying. Some of that discipline is Raul - he's a studying machine. As some of you may know, my grades dramatically improved after we began dating. Truthfully, I miss my old lazy life sometimes. I feel very lucky to be in med school and to have the experiences I do, but sometimes I really miss spending my weekends on the couch talking on the phone or with a book or watching TV. I know, poor me. : )

I hope you all are well!!

PS - I got an email from Canterbury Inn in Atlanta today confirming my reservation
in May. I never booked any such reservation and thought it was a scam. So, I looked into Canterbury Inn, and it is indeed a motel (albeit a very crappy one) in Atlanta. I called to tell them that they'd sent a confirmation email to the wrong address, and the woman on the phone totally read me the address and phone number of the person who booked the room and then asked me for my credit card number. I hung up. Maybe it is a scam afterall...should you receive any confirmation emails from Canterbury Inn, do not give them your credit card information.

Tuesday, March 13, 2007

Nevermind

I started the Bayerische socks, and well...they were hard. Such tiny stitches and so many cables. It was too much. I am going to frog what I'd knitted and make these instead. Although, I have a couple end-of-rotation tests a week from Friday, so knitting may have to take a backseat for the next week or two.

I've really been enjoying the time I have been able to spend with various community organizations these past few weeks. Last Thursday, I made house calls with a hospice nurse. Monday, I spent the day in group therapy at an inpatient substance abuse recovery center - a very interesting experience. The individuals in the group I sat in on were very honest and direct about their past drug use and their intentions re: sobriety. The counsellor asked the group to share stories about positive and negative interactions with providers in various health care settings. It was very interesting to hear their experiences - some of the members had presented to the ER intoxicated and suicidal and were told to go home and return when they were sober. Everyone had different stories, but they all expressed a desire to be treated in a respectful and nonjudgmental way by healthcare providers. It was eye-opening and a little sad. We also watched a film by the Amen group. The video was kind of hokey - this psychiatrist talking about how drug abuse decreases brain activity (as evidenced by SPECT images), but the group loved it. This video basically told them that they all had varying degrees of brain damage, but should they stop using and adopt some healthy lifestyles, they could reverse some of the damage they'd done. They all wanted that imaging done to see how damaged their individual brains were. Interesting.

Today I spent the morning at Opportunity Village. This organization provides services to 500+ clients with mental retardation throughout the state of Iowa, and over 100 individuals with MR actually live on the main campus. They've got some serious efficiency and organization going on over there. Everyone works (if you're physically able) - you build latches, put together the little instruction/screws/bolts packets that come with storm doors, shred and recycle mountains of paper, start seedlings and maintain plant nurseries. It was a little shocking to walk into a big warehouse and see 100+ people with Down Syndrome or other intellectual disabilities sitting down doing assembly line type stuff. Don't get me wrong - this was no sweatshop; the management were liberal with the snack and bathroom breaks. And the clients all seemed pretty happy. I sat in on some music therapy, sensory integration therapy, physical therapy. This place is pretty impressive.

Okay - off to study. You know, I'd started to take for granted how nice it was to live in a house without neighbors above or below. I'm living above an Australian video game junkie, and judging from the volume at which he plays his games (at all hours of the day and night), I am pretty sure he's hearing impaired. I miss home.

Saturday, March 10, 2007

Anemoi Mittens

Finished!





Here are the specs:
Pattern: Anemoi Mittens by Eunny Jang.
Yarn: 'Palette' from Knit Picks in colors blush and bark.
Needles: size 0 circulars for the cuff, and size 2 aluminum circulars for the body of the mitten.
Overall, I really enjoyed knitting these mittens. I like small projects on small needles - you can throw them in your bag for knitting during meetings and downtime, and because they are small, you can finish them in a relatively short amount of time. I will most likely be knitting another pair sometime in the future. The pattern was very well written and easy to follow, and Eunny includes a blank mitten template so that adventurous knitters may create their own colorwork designs. The colorwork was very fun, and the second mitten was much easier than the first. (Actually, I liked it so much that I am making plans for future fair isle projects. Raul's requested a hat - maybe this one will do?) So, overall, I am happy with the way these mittens turned out although I do wish that I had made the thumbs a tad bit larger. I may block and stretch them at some future date, or I may wear them as is. Also, I also was very happy with this yarn - very inexpensive, fun to work with, and it hear that it holds up well with minimal pilling. I will keep you posted! I have quite a bit left - I'm not sure if I have enough to make another complete pair....but I do have a friend with a little daughter that is very partial to pink. H - do you think Maria might like a pint-sized pair?

I finished the mittens last night, and this morning I promptly cast on a new project. The Bayerische socks also by Eunny Jang. It's been quite a while since I've done cables, so this should be an adventure.

Tuesday, March 6, 2007

Public Health Nursing

So, while on my Family Med rotation in January, several of the patients I saw were receiving assistance from Home Health Aides and Public Health Nursing. In these programs, patients would be visited in their homes by aides and/or nurses, and they'd receive help with tasks like filling up their pill boxes for the week, household chores and some personals cares (ie bathing.) I knew they were very helpful programs, but I really did not know any of the specific details of the services provided.

Today, I had the opportunity to follow a public health nurse around on her morning house calls. Let me tell you, these nurses are truly heroes. They brave mean dogs that bite (I saw the photo documentation of the bite marks), squalid living conditions (where every inch of the house is packed with trash and remnants of left-over food all covered in an inch of dust), inclement weather and a variety of other obstacles, just so they can get into your house to change the dressing on your diabetic foot ulcer and manage the 20+ medications you're taking for your congestive heart failure. And they'll even do it while you're hanging out in your underwear in your easy chair. Not sure why you couldn't put on pants, but then again, I'm also not sure why you would choose to never clean your home. And unlike me, these nurses won't judge you. My experience was definitely an eye-opening one. It's easy to imagine that all your patients have safe and clean living conditions when you see them in clinic, and the reality of their situations can really be quite shocking.

It is remarkable how much assistance and freedom these services provide to patients - without help from the public health aides and nurses, many of these individuals would absolutely not be able to live independently. They'd have to be in a nursing home or some sort of assisted care facility, for sure. As stated earlier, these nurses and aides are really providing a tremendous service.

In unrelated news, despite my pledges to the contrary, I purchased more knitting paraphernalia. But this is the last piece for a long time, I promise! I bought this
pattern by Carol Anderson. I am going to knit the baby-sized afghan with worsted weight yarn in a variety of colors that was obtained in my raid of Grandma L's stash a year or so ago. I am working on another baby afghan, and it's really taking forever to complete. Given that these blankets are intended for Raul's and my yet to be conceived, unborn children, I'd say I have plenty of time to finish them.

Sunday, March 4, 2007

Dr. H's slippers and Grandma L's scarf

While waiting for the weather to improve this weekend, I was able to finally finish some knitting projects, and here they are:

Dr. H's slippers (pre-felted with iPod for scale):


Slippers (post-felting, again with iPod for scale):


Details: These are my oft knitted, Fibertrends Felt Clogs. I used Cascade 220, but you could use any worsted weight, wool yarn. The clogs are knit on size 13 circular needles using two strands of yarn held together. Knitting these slippers actually goes very quickly. I've given several pairs as gifts, and I have been told they're comfortable. This pair is almost ready to go - they just have to dry and have some non-skid coating applied to the soles.

My grandma had requested a warm black eyelash scarf, and I am happy with how this turned out. I used Debbie Bliss alpaca silk in black (gifted to me by a very good friend) knit together with Plymouth Yarn Whisper also in black on size 19 needles. I use this pattern often for scarves, and using such large needles, the project always goes very fast. For you scarf knitters out there that would like to try this pattern, email me, and I will send it to you!

Here is Grandma L's scarf (I like this scarf much more than I like the photographs. My photography skills definitely leave something to be desired.)


A close up of the stitch pattern.


Ready to be mailed!

Beware the drift

While watching various weather reports on TV this weekend, I heard many a weatherperson issue warnings re: blowing snow and to beware of the drift. Honestly, I was not sure what 'the drift' was. I initially thought that drift was synonymous with ditch - when you are driving and you slip on ice and run off the road, your car is now in the ditch. Given that the ditch is generally not a good place to be, this seemed reasonable. Driving home from Mason City this weekend, I was enlightened as the the true meaning of the phrase. When you have fresh powder snow covering flat, open fields and 35-40mph winds, the wind picks up the powder and moves it (inches of it) into the road. The roads had recently been plowed, but there were patches covered in an inch or two of snow on stretches of the highway that were surrounded by open fields. The blowing snow also makes it hard to see - especially when a semi-truck passes you at high speeds and kicks up additional snow into the wind. When that happens, you can't see anything at all, and you very nearly have a panic attack.

All ended well...I made it home safely and Raul and I had a good weekend - we ran lots of errands (several large storage containers were purchased to house all the recent acquisitions to my yarn stash.) I think Raul and I have an understanding that I am not to buy anymore yarn for some time. I'm very excited about my new yarn, and I have schemes for several new knitting projects like this and this. I have yet to knit a sweater, so we'll see how it goes.

Here's a picture at the start of my drive home to Iowa City on Saturday. Northern Iowa has gotten so much snow that the snow banks are enormous - here is the one located at the outlet of my Mason City apartment complex:

And for good measure, here is a picture of a very lonely and snuggly Greta. She was happy to see us this weekend, and she sends her love!

Friday, March 2, 2007

Enough already

So, for those of you keeping track of the weather in Iowa, we are currently in the midst of a blizzard as predicted. We received several inches of snow last night - think maybe 8-10"? I'm not sure. When I awoke this morning, all the roads (including the interstate) leading in and out of Mason City were either closed or completely covered in snow with travel not advised and towing services prohibited. Good times. So, I am here for tonight - I think things should be better tomorrow. Raul is also stuck in Des Moines - apparently, yesterday visibility was only about 1/4 mile due to the storm.

I want to go home! I am frustrated and somewhat angry at being stranded in Mason City, and I have decided to blame the captains of industry that pumped pollutants into the environment that are warming the jet stream currents that mixed with this front and prompted it to drop 10 inches of snow and ice on all the roads between me and Iowa City. Despite my Al Gore inspired rant (and he is quite the inspirational figure), apparently storms of this nature are not completely unheard of in these parts. During the many hours I spent listening to NPR this morning, I learned that the word blizzard originated in Iowa (not a surprise) and a similar storm swept through this area back in 1982. All my clinical activities were cancelled today due to inclement weather. I spent my morning knitting, obsessively watching the weather channel, listening to NPR and digging out my car. All and all, it was a grand time. Here are photos:

The car (buried.) I was not excited about the prospect of unearthing the car. I contemplated asking Raul to make a detour through Mason City on his way home to help me clean off the car. I came to my senses and realized I could do it myself.

After 30 minutes of brushing and scraping, here is the finished project. Thankfully, Raul had two mismatched gloves stashed in the car. This work freezes bare hands. And no worries - Raul just reminded me that I need to clean the snow off the taillights.

Here is a completed mitten for the right hand. I wore it on the walk to the hospital this afternoon, and my right hand was quite toasty. Hopefully, I will get to start and finished the mate soon (my left hand was cold.)




 
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