Yay holiday tomorrow!

Happy Canada Day!

So many babies born last night! What happened 9 months ago? Every room in the inn was full last night and a few babies were born in assessment rooms instead of birthing rooms. Everybody did just fine. We were called for a prem, a few meconiums and a few sections. Everyone cried on the perineum or after being ripped from the nice warm womb :)

It was a pretty satisfying and exhausting night and I was on with my favorite resident!

Visual diagnoses

I like a good visual diagnosis. I've had a couple in the minor emergency clinic over the last few days:

1) Fifth disease (parvovirus) - macular to lacy rash starting on the face (slapped cheek rash) and the moving to the trunk and extremities, especially extensor surfaces.


2) Coxsackie virus (hand foot and mouth disease):
Child presented with high fever (40 degrees celcius) and no other symptoms. Resp virus going around at daycare. Throat looked like this:
but my patient had more vesicles present all over both tonsils and the uvula. Coxsackie virus is classic for this. Can also cause blistering lesions around the lips, inside the gums, inside the cheeks. In the classic cases there is a blistering rash on the hands and feet, but not always present.

3) Add in a good subconjunctival hemorrhage today with a small abraison on the conjunctiva showing up with fluorescein dye and it was a pretty good day.

I'm on call tomorrow for the NICU - not looking forward to it. It's hard when you haven't done any time in NICU and you have to go and round on all of the patients! Argh!

I'm in a funk. Liana made me come out and say it, solidarity in numbers. I've been having a lot of trouble making my brain work lately and today in clinic I felt like a giant retard. I couldn't think of blood tests I wanted to order, I couldn't find the words to express myself, I didn't know any of the answers for the questions I was answered. In short, I was a failure.

Let's hope tomorrow is better.

Ok,
I have a new thing I don't like about medicine: dictating!
I wish I could just sit down and type notes on patients and give them to a secretary to mail away instead of having to dictate them. I hate dictating. I forget what I said, I miss things, and you can't really practically go through and listen to a whole dictation for completeness. I have dictated about12 cases since starting ambulatory peds on Monday and I have no idea how I'm doing. 9 of them were today. I managed to do them all in about an hour, which I'm pretty proud of because I'm usually a very slow dictator. Unlike Hitler. (ok... bad pun)

I also hate coming home from a long day just to start studying. Argh. And, our oral exam that was supposed to be on July 8th has now been moved to July 4th, which means I have one less weekend to study for it, and, I'm on call this weekend. Argh!

PICU

So,
I just finished a 3 week stint in the Pediatric ICU. It was one of the most emotionally taxing and stressful 3 weeks of my life. I had my first pediatric patient die, my first patient funeral, my first death summary. I've had adult patients die before, but it just wasn't the same. At all. I'm moving on to ambulatory peds and I'm excited about it.

I'm on call tonight and hoping for good call karma. Last call I had on peds ward was a steady all-night affair. Apparently Mondays tend to be bad because everyone has been resisting coming in over the weekend. Hopefully that applies to the day moreso than the evening. I'm glad I've chosen a specialty that doesn't involve a lot of call and can be scaled back to no call when I'm old and grey.

In other news, Ben is leaving me for 3 weeks to go home and visit his family. I'm joining him for a week 3 weeks from now and I"m pretty excited about it. We have a packed itinerary already that involves climbing a monroe, going to sheep dog trials, high tea, and many other things I forget.

I think we're caught up now!

Why is life so hard sometimes?

So, the things I need in a family medicine residency program are as follows:
1) be able to live with Ben
2) community and rural experience
3) time spent in centers that do not have specialty residents
4) time off to go to my own wedding
5) mountain biking
6) snowboarding

Things Ben needs in a residency program:
1) being able to live with me
2) being able to get a job as a foreign-trained engineer
3) mountain biking
4) snowboarding

Now we have to decide where we want to go.... We talked tonight about taking these two years and using them as an opportunity to take an adventure and go somewhere interesting before settling down for life and families and stuff. Even if we're not sure about babies and stuff yet. I came to realize that I'm ok with that. If he wants to go somewhere fun for 2 years, I'm fine with that. It's two years, I have lived in a foreign country for a year and I'm sure I could do more if I'm with Ben. Now we just have to decide where... before CaRMS

The ring!

Wedding and pediatrics

So, we booked our wedding venue today! We went with the smaller venue that Ben and I really liked. It was funny, we found out that one of the weekends we were considering was booked and we both got sad... I guess that was our litmus test. So, we will be getting married on September 12th, 2009. My bridesmaids/men will be my sister, brother and cousin and Ben will have his two sisters and his best man. He hasn't asked him yet, so I'm not going to mention it here just in case I let the cat out of the bag. Anyhoo, I'm excited to get this part of the planning done and upwards and onwards to trying on wedding dresses!

Pediatrics so far has been good. I was on call for the NICU last night and did a few well-baby exams and other than that there wasn't much to do. Didn't get called for any deliveries and had bad dreams all night about my pager malfunctioning... Haven't heard that I missed anything so I guess it was working. PICU is interesting. We have one patient who is critically ill and one patient who lives in the hospital full time and has for the past 3 years since his birth. The critically ill patient has been a huge learning experience about brain injury. This review supplement to pediatric critical care has really helped me understand what is going on.

The case is taking a big emotional toll on me. I feel very attached to this patient and the patient's family who are just the nicest people. I'm crossing my fingers and toes for this kid.

Wedding plans

Ben and I went to look at wedding venues yesterday. We found somewhere we like, but it has a 70 person limit. This means that our guest list is going to be limited to people we really want to be there. Which introduces a conundrum: how to invite someone without a date. There are people I would like to invite to our wedding who do not have a steady partner, thus, I would want to invite them without a date so they will be there, without a stranger. How do I do that?