Warning - gonna talk about the empty net

So if you don't wanna hear about blood, pain or the nature of Aunt Flo - for Pete's sake leave! Or better yet, go see Dave. Besides, he's way funnier than I am. And he may someday rule the world.

****

Okay, so for the brave few that have continued to read - Aunt Flo came to visit yesterday for the first time in three years. Now, I guess she's necessary for the whole 'lets have us some babies' deal, but she's still not a welcome houseguest. I have NOT missed her. I never bled through anything, I never had to go back home after I've already left in order to get my freaking 'supplies' (tampons people, tampons!) and I never had cramps.

Paradise. Freaking paradise.

Now, not so much. And just to make things worse, she's badder and bigger than ever. I am bleeding like a stuck pig. Since you can't trust anything that bleeds for five days and doesn't die, I am definitely NOT trustworthy. At this point, I don't trust myself. I'm going through my supplies so fast I keep on messing up and bleeding on things that shouldn't be bled upon.

People, this ain't normal.

And the cramping. Oh, Lordy. The cramping. I know people with fibroids will laugh at me and pregnant ladies will tell me that I have no idea what pelvic fullness really feels like, let alone pelvic contractions, but damn - for this amount of discomfort I better be birthing a bloody baby!*

So I'm gonna be pissed if we don't conceive relatively fast. Not 'cause I wanna get on with this whole life plan, hey - but 'cause then I can put the IUD back in and Aunt Flo can just fuck right off.

* Sorry for the run on sentence. I couldn't help myself. I'm not sorry for the alliteration. I didn't set out to do that, but I'm pleased with it. So there.

¿Que pasa?

So I'm going to Guatemala in, oh, about ten days. And I don't really know Spanish.

Now, this wouldn't be a problem if I was going down to do a medical Spanish immersion course like other smart people. But remember, hombres, I frequently ride the short bus. I'm going down as part of an international medicine elective. They expect me to already know Spanish.

Doh!

So I've bought Spanish in 10 Minutes a Day and Spanish for Health Care Professionals. The 10 Minutes book is quite cool - it comes with stickies you put around your house on stuff to help you learn vocabulary.

So far I can ask such thrilling questions like - ¿Quien es? (Who is it?) and ¿Cuarto es? (How much is it?) I've also learned that one of my friends from college is named Olivia Curtain, if you translate her last name. Who knew?

Which will really help me deal with that 3 year old well child visit... um, NOT. But at least now I can look stupid in three languages! Awesome.

On a completely different note, I've discovered a new source of fun - The Student Doctor Network! Now, I'm no longer a student doctor, ya'll. I'm an actual doctor. (No really!) (I swear!) But SDN does have forums for those of us in residency. Of course, my home forum - pediatrics - is kinda lame. But the emergency medicine forum is damn funny. The stickied threads definitely take the cake; especially the thread titled Things I Learn from my Patients. However, if you're offended by members of the healthcare workforce blowing off steam and complaining about the stupid stuff patients occasionally (or frequently, depending on the patient) do, or if you are easily offended in general - don't go looking at that thread. If you understand that humor is a coping mechanism, and is actually considered one of the healthier adaptive skills - go for it.

You have been warned.

Six degrees of Kevin Bacon...

Or in my case, four. Ya'll remember, I assume, the craze of yester-year - how everyone in Hollywood could be associated with Kevin Bacon within six degrees of separation - AKA Six Degrees of Kevin Bacon. This means that everyone I know is connected to Kevin Bacon within five degrees. Of course, those of us who know me AND my brother-in-law remain separated by only four degrees.

There have been arguments in the literature that the world is really just 'small world' or a series of small worlds contained in the larger geographic world. Multiple studies have been done, and really, the research isn't all that bulletproof. But six degrees of separation did emerge as the mean value between people within related communities.

But anyway, I have ties to Hollywood! Here it is:

- my brother-in-law went to high school with Jamie Foxx
- Jamie Foxx was in Collateral with Tom Cruise
- Tom Cruise was in A Few Good Men with Kevin Bacon

And just to make your reading pleasure greater, I've hooked each celebrity name up with a different link. That way, you can research all aspects of Baconhood, Foxxhood or Cruisedom!

Will the excitement never end?!?

I wish I was funny... or at least popular

Okay, my life is good. I don't really have any reason to complain... but I'm going to anyway.

I wish I had one of thos blogs that folks actually read. I wish I was funny.

'Cause I'm not - I'm clever, and sometimes whiney (is that spelled with or without the e? I don't know!), but not funny. It doesn't help that I think my life is boring, and I frequently have no clue what to write.

I think this blog might do better if I wrote longer posts... but my ADD won't really let me. I just can't concentrate long enough to create posts longer than about a screen. I know, I know, I don't fit the full DSM-IV criteria for adult ADD, but still.

Really, I have no reason to complain. I started this blog so that I would write - a pastime my profession doesn't encourage. Writing is for wussies - real doctors use abbreviations, super-microsized handwriting and sentences without conjunctions. I once swore I would never write like that... but I do. Routinely. Just for poops and giggles, I'm going to make up a fake history and physical below in docta-speak... so ya'll know how horrible doctor writing acutally is.

CC: fever
HPI: Pt isa 4 yo HA female (not written, but done as the symbol) c PMHx of sepsis presents c 4d cough, fever and sob. Denies nightsweats, chills, n/v/d, decr. po, decr. uop + malaise.
ROS neg x above
FHx = asthma, CAD, HTN, DM
SHx = daycare
PE (vitals listed first... then)
Gen - nontoxic, uncomfortable
HEENT - NCAT, EOMI, PERRLA, TM's clear B, MMM, OP clear, neck supple
Chest - CTA B, RRR no m/r/g
Abdom - +BS, soft, NT/ND, no HSM
Ext - wwp
GU - Tanner I, double down
Labs - none
Radiology - CXR shows RML infiltrate
A/P 4 yo female with pna
- cefurox x 10 days
- f/u with PCP

Yeah - so writing isn't my forte anymore. But damn it, with this blog I will become eloquent once again.

If it kills me!

People are dumb, um-kay...

I don't know why people with chronic, low-acuity problems seem to think that the ER is the best place to get answers. Why do folks think that, at 2pm on a Tuesday (or 3am on a Friday or whatever) doctors will suddenly have the magic bullet pill that will solve the patient's three year history of chronic recurrent abdominal pain most likely caused by an excess of shit and a paucity of fiber?

Why, why, why?!?

But such is life in the ER.

On the other hand, why do otherwise well intentioned but overworked public school officials think that medication all children will solve all discipline problems? And why do these same school principals get upset when, after sending the child to the ER (ya know, where we treat life-threatening emergencies), the ER docs are only able to rule out the stuff that might kill the child quickly (ya know, like emergent medical or pyschiatric problems)? No responsible physicain is going to hand out Ritalin from the ER!!! Just. Not Right.

Yargh. But hey, no one died in the ER today, so it was a good day.

We Won!

Hubby and I decided to go out to a nice neighborhood pub to have a beer. Just to meet some folks who, well, never showed up.

But that's okay.

'Cause we won stuff.

What did we win? A raffle. A raffle we didn't even pay to enter. The folks just down the bar from us knew they were leaving before the raffle draw and gave us their stubbs.

Yeah - and we won.

Again - what did we win? A New Belgium Brewery bike. Yeah - we won a bike. How cool is that?

Oh Lord, it's official

Yet again, money flows like water from my hands. This time, to two super scary institutions - the NBME and the American Board of Pediatrics. Holy shit, it's official. I'm taking the last two major exams required to be a REAL DOCTOR within the next year. Which means, but the end of 2006, I'll be a REAL DOCTOR.

Now, I'm sorta a real doctor now. I make medical decisions, I talk to parents about options, I prescribe drugs, I correct the mistakes and misconceptions of more junior doctors and I intervene without asking for advice... sometimes. But damn, that's still different. Sorta like the difference between living in a dorm in college, then living completely outside of the safety net in a normal apartment. Only way more so.

Like, WAY.

I think the fees really bring the message home. I just dropped $2,000 - that's right, two grand. And it's not like I got an advance on my mucho dinero attending-style job that I landed for next year. Oh no - this is from the same budget that barely covers the mortage and booze for the month.

Awesome.

So today I went to the coffee shop and studied like I haven't studied since 2003 (the year I graduated from medical school, peeps.) This is serious - cause I am NOT taking this shit again. Nope nope nope.

Real life is a bitch, ain't it?

Universal experiences

It doesn't matter what specialty we're in, all residents share a common experience. My favorite is the following, "That's against policy."

What policy? Where is (insert Shatner-esque pause here) this policy? Can I see (pause) this policy. And yeah, I know, even if the RN can't produce the mysterious policy, she won't do what you ask anyway. Just in case the order does violate the policy.

This is why I end up stealing things to better patient care. There is a policy at the community hospital that no bedside testing can happen anywhere (except the ER). I mean, I can't even dip a urine in the freaking NICU or PICU.

Yeah, so, when I'm senior in the NICU I run down to the ER, steal a bottle of urine dipsticks and carry them around. Need to know if that kid with short gut is malabsorbing and that's why he's fussy and distended? Dip the ostomy output! I just saved the patient a full sepsis workup and serial X-rays. Yay me!

All 'cause my residency has taught me to lie, cheat and steal. Awesome.

And while you're at it, check out www.pushfluids.com. They're funny.

Empty Net!

Those of you who know me already know what I'm gonna write about from the title alone. Those who don't, well, if you don't want to hear about the state of my pelvis and hypothalamic-pituitary-ovarian axis, just stop reading now.

I've spent the last third of my life avoiding uterine parasites, i.e. pregnancy. Barriers, hormones and foreign bodies have all played a role... until yesterday. And it feels very bizzarre. I almost feel naked - like I'm not wearing pants or something. (Of note, I had one of those showing-up-for-a-test-naked dreams last night. Related? Nah. Never!)

The OB visit itself was weird. The hubbie and I are sitting there listening to the doc 'prescribe' sex every other day. I don't know what other couples think, but it was kind of a turn off. "Hey honey, we haven't had sex for 36 hours, we MUST have sex in the next twelve hours or I'll miss my next my sperm dose." Blargh. Sperm isn't like an antibiotic, people! The fabulous husband shouldn't be reduced to a sperm donor - he's worth more than that and he's definitely much sexier as a person than as a sperm delivery system.

If we don't have sex every 48 hours, do I have to fill out a missed medication form? Or does he? One of us would if I was a hospitalized patient... I guess I'm glad that I don't bring my work home with me! (Har - bad joke, I know, but hey - I'm a dork.)

Mindsets

So, when you expect to do something easy and brainless... and then the rules change, your day is thrown off.

Of course, I really don't mean to speak in the second person. I mean to speak about me.

I had a day today, when I thought all I had to do was secretarial shyte. And then suddenly, I had to take care of really sick kids. ICU style kids. Blargh. The brain stutters.

But ultimately, the kids and I will be alright. Aww yeah.

All cultured and stuff! (And neon excretions of bizarre origin.)

Well, we had a weekend of culture. The first in a while.

Normally, I'm the kind of gal that likes to go to the mega-plex and watch testosterone-laden men to blow stuff up. Or watch sexy muscular women like Mila Jovovich or Michelle Yoh blow stuff up.

But not this weekend.

We started out by by bowling. I know, I know, not high culture. But hey, cheesy American culture isn't something we indulge in often. Then there was the Basquiat. Yes, I actually went to see art. Real art - the kind actual art critics actually write about. Normally, I avoid this stuff like the plague. 'Cause hey - I'm crass. But this was fun. It helped that copious amounts of booze and music by DJ Grandmaster Flash. It was the biggest party I have ever attended. The entire Houston Museum of Fine Arts was packed with hipsters - and these people were stupid enough to let me in! Hah! We came, we saw and we conquered. Very cool.

Next was Japanese drumming. Not only is that multicultural, which makes it intrinsically cool, but we also knew someone in the group. How cool is that? Taiko is definitely fun to watch. The drumming was awesome and the visuals were very cool. At one point, the drummers held these massive drums between their knees while lying on the floor. They then flexed their abdominal muscles to rear up and beat the drums. So very cool.

A good weekend all-around, topped off by some free booze from my boss and a game of Settlers with good friends. But now on to other topics...

My pee has turned neon yellow. Ya know that ever-so-slightly greenish neon yellow of the mid-1980's? Yeah, that's my pee. Before it was routine yellow of urine. As with any urine, it fluctuated between yellow and dark yellow with my relative state of hydration. Now it is just neon. Why, you ask? As a doctor, am I clueless why this has happened to me?

No, my friends, I am not.

It's my damn vitamins.

I've been a good little breeder and started taking prenatal vitamins well before getting pregnant. I got my vitamins from Central Market, an upscale tree-hugging (but excellent) supermarket nearby. My vitamins include the standard neccesary ingredients for prenatal health... but they also include various foodstuffs like spirulina, wheat grass, barley grass and alfalfa (leaf) juice concentrate.

So yeah, my pee is straight out of a bad 80's movie. But I need the vitamins. What is a girl supposed to do? The answer - suck it up!

Tagged again

Four Jobs You’ve Had In Your Life:

- coffee shop girl
- chemistry lab gofer
- secretarial temp
- doctor

Four Movies You Could Watch Over And Over:

- Serenity
- Kill Bill Vol 1 & 2
- Sin City
- X-men 1 & 2

(Okay, that's six, but sequels and two part movies don't count, damn it!)

Four Places You’ve Lived:

- St. Louis, MO
- Bonstetten, Switzerland (near Zurich)
- Boston, MA
- Houston, TX

Four TV Shows You Love To Watch:

- Firefly
- Dirty Jobs
- Mythbusters
- Good Eats

Four Places You’ve Been On Holiday:

- Steamboat Springs, CO
- New York, NY
- Whistler-Blackcomb, BC
- Rome, Italy

Four Blogs You Visit Daily:

- The Texpatriate
- Go Fug Yourself
- blogography
- Weenie

Four Of Your Favorite Foods:

- wild mushroom rissotto
- filet mignon
- lamb shanks from the Blue Room in Boston
- Ted Drewes frozen custard in St. Louis

Four Places You’d Rather Be:

- Steamboat Springs, CO
- Boston, MA
- my bed
- Kilkenny, Ireland

Four Albums You Can’t Live Without:

- NIN, Broken
- Unwritten Law, Here's to the Mourning
- Liz Phair, Exile in Guyville
- Ray Corvair Trio, Slick 50

Four Vehicles I’ve Owned:

- 1993 Dodge Dakota 4x2 pickup truck - that sucker could fishtail like nothin' else!
- 1986 Toyota Camry
- 1999 GTI VR6
- 2002 Subaru WRX wagon

Now, if I can just get the stinking intern to sign out, I would be able to go home. And nap. Which would be good.

The Goodness of Jhonen Vasquez

Now, I'm not saying Jhonen is going to win any of the same awards as Mother Teresa. But I love the man. He's goth, he's ridiculous, he was successful, and I'm pretty damn sure he's not obese. What more does a girl need?

(Besides 5'5" of computer programmin' lovin' that is.)

Anyway, Jhonen did a cartoon series for Nickelodeon a while back that is just as sick and twisted as his original comic book work. It was called Invader Zim. I've always wondered how the f*ck JV managed to get the child friendly folks over at Nick to agree to this show. It doesn't have the murder that Johnny the Homicidal Maniac posessed, but it wasn't exactly, well, sane.

(On a side note, JTHM is just about the sickest graphic novel I've ever read. The casual and hilarious violence is totally appalling if you stop to think about it. Which is why I don't.)

The whole premise of Invader Zim is based on the idea that every society has a loser - a big pink Twinkie sucking loser. Someone so dumb they can't even be trusted to empty the trash. Now imagine a race of people so eveolved that they have stopped fighting each other and everyone is united under a single goal - the utter domination of the rest of the universe.

Okay - now understand that the protagonist of Invader Zim is the utter idiot of his society. He's considered so dumb that he's sent off to conquer the least significant planet in the galaxy... Earth. Just to get him out of the way, ya know.

Hilarity ensues.

Trust me, watch it at 8:30pm on Nick. It's so worth it!

Stealing again

Stealing a MEME from Karla who stole it too. Aww yeah!

A - Accent: I've actually somewhat of a vocal chameleon; at its roots my accent is midwestern, but there are liberal doses of Boston (Baw-ston) and Houston thrown in. With a little bit of lowland Scots.
B - Breakfast: Not so much. A latte, at most.
C - Chore you hate: Mopping. When employed as a camp counselor, I used to do Whippets to get over the pain of mopping. When I worked at a coffee shop, I would offer to clean the fridge (which was truly truly nasty - ask anyone who've every worked food service, they'll tell you!) to get out of mopping. Now I have a machine that mops. Mildly better.
D - Dad's name: B. Clare. Don't ask me what the B. stands for.
E - Essential everyday item: Coffee. Or maybe toilet paper.
F - Flavor ice cream: Ben & Jerry's cookie dough - yum.
G - Gold or silver? White gold, platinum or silver.
H - Hometown: St. Louis, MO
I - Insomnia: Not often. With my schedule, I pretty much sleep whenever my head hits the pillow.
J - Job title: Pedatric Resident.
K - Kids: Not yet - check back later.
L - Living arrangements: Townhome in one of the funky areas of Houston with my man (yes, I'll go girlfriend!), two cats and 20+ fish. And no, they don't eat each other. Well, the fish eat other fish, but the cats generally leave anything outside of the Felis silvestris catus alone. Unless, of course, they find a cockroach or a lizard. Them's good eats, damn it!
M - Mom's birthplace: Georgia or Michigan - honestly I'm not sure!
N - Number of significant others: I've loved three men - one with unrequited long distance passion, one with late teenage puppy love and one I'm still married to.
O - Overnight hospital stays: None yet. Reference K for future plans.
P - Phobia: Heights. I'm really trying to get over this one, but so far no go. George Bush.
Q - Queer?: No, but it would have been nice in college.
R - Religious affiliation: Atheist. I didn't go running back to 'God' when my dad died, so I figure that the athesim is going to stick.
S - Siblings: None by blood. I've known my best for 'round about 20 years, so we count each other as sisters.
T - Time you wake up: Next month 6am. Argh. But still civilized. Anything before 5:30am isn't civilized.
U - Unnatural haircolors you've worn: Blue, purple, red (think fire-engine), pink, yellow, blue.
V - Vegetable you refuse to eat: Beets. I don't care if they are a natural source of sugar - they're nasty.
W - Worst habit: Forgetting to pay bills. Bad bad doctawife. Bad doctawife.
X - X-rays you've had: Dental (4 views), chest (2 views - showed viral process vs. RADE), right foot (three views with an obvious 5th metatarsal fracture ~ 4cm in length)
Y - Yummy: Coffee, risotto, my bread, beef, martinis, Wendy's crack nuggets, sushi, La Strada
Z - zodiac sign: Sagitarius, or Fire Dragon by the Chinese system. If I had been born in China, they would have left me out to die. Females aren't supposed to have that particular sign - makes 'em too aggressive.

Go figure.

20$ Chucks!

And I don't mean chux, the lovely blue disposable towel of medical fame. I do mean Chucks, as in sneaker goodness. And for once, I really do love eBay.

Now, the coolio pink and black two tone Chucks may look very similar to the ones I have. But lo, beware young Jedi, for they are not. The tounge - it will be pink! And anyway, my current set of Chucks are downright sorry. The rubber piping is peeling from the side and the whoel dang pair is just dirty. DIRTY I tell you!

Now, I could have just bought it now for $23, but I stuck my neck out and put in a bid. I ended up winning the auction for $10 + $10 shipping - viola! $20 Chucks. Magic, I tell ya, magic!

Meat, Martinis and Career Changes

Last Saturday we threw the party I've been talking about for the last several posts.

There was meat. There were martinis. Many, many martinis. I learned many things at the meat and martini party:

- vodka is always more popular than gin
- one juicer just isn't enough
- folks just don't quite know the definition of meat

Per Wikipedia - Meat is animal tissue (mainly muscle) used as food.

I haven't figured out why defining meat was so hard. In our invite, we used the phrase, "red meat and dry martinis". Extrapolating from the phrase, I hoped people would assume that 1) cow based meat would be fine 2) anything else red and meaty would work. For example - venison, duck, horse, etc. Pig, of course, would be acceptable. After all, it is the magical animal of legend!

But damn, hubby and I got loads and loads of questions regarding the nature of meat. Did salami count as meat? How about roast beef? How about pork loin? Would meatballs be acceptable?

I mean please people - YES!

Anyway, on a totally different tangent, I've come to realize that my original career path was total shyte. This is good, 'cause I won't waste three years of my life on training I won't need. This is bad, 'cause I had my little epiphany about nine months too late. So now I have to find something to do for the next year of my life while I apply to the right fellowship program.

Argh.

Holy crap, the house almost feels like its ours!

So we're throwing a party. A really big party.

And I've been working on the house nonstop for what feels like forever, but has actually only been about three weeks.

See, when we closed on the place a year ago, we got going. We busted our ass. The place had no light fixtures, no gas, no electricity, a crappy white tile island in the kitchen and was NEON YELLOW throughout. It was like walking into a dark, ugly jaundice ward. By the time we moved into the place, we had power, gas, a new stove (the old one stank of gas - very bad news), a steel kitchen prep table to replace the island and a coat of paint over about 70% of the walls.

The problem is, we completely stopped working on the place once the furnature was in place. Nothing happened. No painting. No unpacking.

I've lived 12 months without seeing my favorite paperbacks. Now that's lazy.

Oddly enough, the first bought of frantic productivity lasted about three weeks. Interesting...

But now that we're having a party, we've actually gotten a bunch of stuff done. I know I was skeptical earlier... We've exceeded my expectations. I've unpacked my paperbacks. The CD racks are on the wall. 90% painted. All lights above the kitchen working.

Holy shit, I might just faint... but at least now I'll have a nice sissel rug to fall on.

Ingenuity

The US Army - as a unified group - might not be the sharpest tool in the shed.

But the individual soldiers, now they are something else. Check out this article and see what I mean.

I especially like the last paragraph, which I'll just copy below. The Capt. is talking about Iraqi insurgents...

Commanders say insurgents are adept at hiding their work and improving their bombs. And they are quick to learn.

"All the stupid ones are dead," said Capt. Jamey Turner of Baton Rouge, La., a brigade commander in Beiji.

House

So I love this show. House just rocks. Now, there are some things that are really really wrong with the show.

But it does some things just so freaking right.

The things that the show does right include - well - the fact that it will actually consider the process of decision making. Most shows just let the viewer leap to the
correct diagnosis along with the TV doctor. In real life, doctors make a list like anyone else. Then we check our list twice. And try to figure out what fits and what doesn't. Even better, through the course of the show, the patient - and his or her symptoms - evolve. In medicine, there's an idea called 'watchful waiting'. Basically, we shove the patient in the hospital and wait for him to 'declare himself'. That means we wait for the disease to make itself known; we wait for the patient to evolve. This is a good thing 'cause we don't treat the wrong disease, and the patient is in a safe place, a place where the docs can act in an instant - and fix the actual problem.

(By the way, patients hate watchful waiting. They haven't read all of the warning labels on the meds.)

There are bad things about the show. No 'juniors' sit around in a glass office, no simple differentials (the fancy name for those lists) and no narcotic addicted geniouses rule. And for Pete's sake, the differentials don't take as freaking long to develop as the show represents.

So watch House, and think about lists. But not about time.

I am the Mistress of IKEA

So we're having a party. Hopefully, a really big party with lots of red meat and dry martinis.

But there's a catch - we moved into the new place in March 2005. Why is this a problem? Weeeell, we never really finished moving into the new joint.

Oops.

So now that we're throwin' a really large shindig, we gotta get our asses in gear. Hubby has made a Microsoft Project Gantt chart outlining what we hafta do in order to create a actual 'put together' home before the par-tay. Get this - 6.5 hours per person per weekend day + 3 hours per person per weekday.

Hah!

I'm skeptical. Then again, we really want to throw an excellent Meat and Martini party. And today, we did make our goals.

We woke up early, went to the awesome Ace Mart Restaurant Supply Company and IKEA then assembled not one, but two pieces of IKEA furniture. Meanwhile, hubby slapped a second coat of paint on the bedroom doors and started on the other random doors on the first floor.

Now, the division of labor was natural. I rule at IKEA assembly. I've put together so many damn IKEA items it's not even funny. Seriously - our place is 80+% IKEA. And the stuff that isn't IKEA, well, about half of that we wish we hadn't bought. The rest is from Ace Mart.

I never said we were normal, just that I am the MISTRESS OF IKEA!