Medstudentitis

2012-01-11T03:56:00.001-08:00

I had one of those cold sweat mornings where you wake up worried about a patient and wondering if they're ok. On the intellectual side, I'm 90% sure of my diagnosis and that I did the right thing, on the emotional side, I am worried. Sometimes being a doctor sucks.

2012-01-09T15:54:00.000-08:00

I know I should say that my first day was great and that it was so much fun and I loved it, but it was completely and utterly exhausting, mind numbing and scary. I only had to see 15 patients because they're going easy on me for the first little while, and at times I was twiddling my thumbs, but at times I had real head scratchers. And, at times, I was just at a loss. Apparently I'm bad at chronic msk pain. I already knew I was bad at that, but I feel like I'm failing at it. I guess there's some reading to do.

2012-01-08T16:57:00.001-08:00

tomorrow I become an attending physician. eek. Wish me luck.

2012-01-05T14:56:00.000-08:00

Ok, I found curtains that I like but Ben doesn't like them. How long will I leave them up pinned to the door frame before he groooows to like them?

In other news, I love these:

2012-01-04T07:44:00.001-08:00

Both sets of curtains have been rejected. Back to the drawing board. Just as a note - those are website pictures, our walls are actually a taupe/mushroom colour!

2012-01-03T12:43:00.001-08:00

Who knew that buying a house didn't end with buying a house... it involves toothbrush holders and toilet brushes and laundry hampers and blinds and curtains and mini garbage bins for the loo and kitchen islands and dining tables and .... lots of stuff. Stuff that involves going to 20 different shops because you can't find the right one!!!!! Our apartment seemed full. Our house seems empty and somewhat pathetic :)

Right now I'm trying to decide on curtains that both Ben and I will like. He's not available to go to the shop so I keep bringing them home and hanging them up for him to veto... we're on curtains number 4 and 5, let's keep our fingers crossed! What I have realized is that I'm going to have to sew blackout material on the back of these fashion curtains because they're much more sheer then they look in the shop! Even the ones that are lined! (oh, and while I"m on that, why line a dark brown curtain in white fabric, it totally discolours the curtain when the light shines through it, making it look purple). I think they'll look better at night. Now hanging:

opinions?!?

2012-01-01T05:59:00.000-08:00

Happy New Year everyone! As usual, I didn't actually see the new year come in as I was in bed at 10 o'clock. However, I did drink to the Scottish new year (7pm EST) and we had our new year's Haggis, Neeps and Tatties.

I have one more week off before starting REAL work. I'm scared and unsure of how things will go. I hope well. There are a few key study points for this week to get me ready... most namely the new Ontario immunization schedule, which came out while I was doing my fellowship and is a bit of a pain to remember the ins and outs of. Need to read up on rotateq. Also need to complete getting my OB privileges at the hospital. Today, though, is new year's day and a day of rest! May the new year bring you happiness, health, and reduced work hours :)

House

2011-12-28T15:14:00.000-08:00

So, some photos of our house...

The outside, we're the right half of the semi.

The open concept kitchen/living room/dining room
we're going to put an island with an eating bar area in to add counter space and fill in the tiled area.
The view from the kitchen.

The master bedroom with view into ensuite and hallway
Giant Bathtub!

A friend kindly gave us a gift certificate to a home store so we can buy a few things to make it feel like we've decorated. We only have our couch and bed that we're determined to keep, everything else can go, so we're looking for decorating ideas!!!

2011-12-22T06:53:00.001-08:00

Vacation day 4... realized how bad I am at vacation when I'm the only one on vacation. Stress, stress, stress!

Marriage

2011-12-20T13:54:00.000-08:00

So, buying a house will tell you all sorts of things about your husband that you never knew. For example, that he dislikes light coloured countertops and doesn't like a stone backsplash. Also, that he likes carpet in bedrooms and hates top loading washing machines. That he loves Dyson hoovers and hates California shutters (which I love). That we will have lots of compromises ahead!

2011-12-19T18:57:00.000-08:00

Our mortgage finally went through to the lawyer. looks like we're going to own a house on Friday after all. I still can't sleep.

2011-12-16T19:33:00.000-08:00

Sometimes when you can't cry about real life you can really have a good bawl fest during a sad TV show.

2011-12-15T18:53:00.000-08:00

Tomorrow is my final day as a resident. ever. The big wide world is looming in the distance and I'm pretty scared. All month I've been thinking that I feel ready to be done, but this past day I've been worried. What if I forgot how to do family medicine in the last 6 months of being an OB/Gyn fellow? I'm going to miss the life of always having an attending around that I can call.

In other news of becoming a grown-up, Ben and I bought a house. So, I officially have no money and won't get any money until the ministry of health pays me sometime in Feb. So, I need to be smart with what remains of my savings. Thank goodness Ben has a steady paying job!

2011-12-06T17:50:00.001-08:00

I feel burned out. I need vacation. I have lost some of my mojo and get up every morning after 8 hours of sleep feeling more tired than when I went to bed.

2011-12-06T03:18:00.000-08:00

Today is the anniversary of the Montreal Massacre. Let us never forget these women and that they were killed simply for being female.

Geneviève Bergeron, aged 21;
Hélène Colgan, 23;
Nathalie Croteau, 23;
Barbara Daigneault, 22;
Anne-Marie Edward, 21;
Maud Haviernick, 29;
Barbara Maria Klucznik, 31;
Maryse Leclair, 23;
Annie St.-Arneault, 23;
Michèle Richard, 21;
Maryse Laganière, 25;
Anne-Marie Lemay, 22;
Sonia Pelletier, 28; and
Annie Turcotte, aged 21.

2011-12-03T05:26:00.000-08:00

I survived my first sick baby. Survived but did not excel. It definitely revealed a few things to me that family medicine residency didn't prepare me for - putting lines in babies, reading newborn xrays, intubating babies, taking blood from babies. I praise the neonatal team for their mad skills and being so open to teach and having a skills day in the spring that they encouraged me to attend. I'll be there with bells on.

One of the most obvious things to me about almost not being a resident anymore is that the learning isn't going to stop and the learning curve is going to be very steep depending on where I end up. Biggest lesson learned: ask for help, don't be afraid to call the consultant back several times, stabilize stabilize stabilize and ship.

2011-11-22T18:15:00.000-08:00

Finally finished all the paperwork. Just remembered I'm not immune to mumps... I guess I need a booster. I've already been boosted - maybe I just have cell-mediated immunity. How many times will I have to get this immunization?

In other news... there is no other news. These forms have dominated my life for the past few days. I've been procrastinating and now they're finally done! done! done!

2011-11-21T19:22:00.001-08:00

AHHHHHHHHHHHHHHHHHHHHHHHHHHHH. could these forms be any longer?!

2011-11-20T19:31:00.000-08:00

Went to look at rental houses today near the new job starting in January. In a total turnaround, we ended up leaving thinking we're going to buy a house and if things don't work out, turn it into a rental property. Hmmm.. how life changes quickly! Did a quick mortgage calculation this evening and we figured out that we would be approved for a ridiculous sum - a sum we could never afford without giving the majority of our monthly income to our home (i.e. no eating). I had a fun fantasy 15 minutes looking at houses that cost that much and then came back down to earth to look at some practical options. Looks like we might be home owners soon! Scary thought!

2011-11-17T18:51:00.001-08:00

Wading through paperwork for my new job. Keep picking it up and then putting it down after writing one or two things... really need to finish it tomorrow to get it in. I wish life didn't come with so much paperwork.

There isn't often time when I don't get along with people on the team, but I had an incident with a nurse the other day that really didn't go well. At least it wasn't only me she was horrific to. The other resident I was with was in agreement that she should be in another line of work. In good news, I felt confident in a neonatal resus situation today for the first time ever... and then the baby didn't need anything, figures!

Went climbing today for the first time in over a year. Man, my hands are sore and my forearms are burning. I think I'm going to have to go more often - there were some moves I've definitely done before and have lost. I guess it's like medicine - if you don't use it, you lose it.

2011-11-14T18:52:00.001-08:00

I finally got my billing number! Yay! Now I just have to figure out what I need to do for electronic transfer and I'll officially be able to work!

In the finishing months of my fellowship I'm starting to get a bit bored with asking for other people's approval to do things I know how to do. I guess this is a good way to end a fellowship - feeling ready to be in the big bad world as opposed to being scared out of my mind. I'm sure I'll still have a few nail biting moments, but I feel pretty confident that I'm going to be able to deal.

In other news, I'm helping one of my mentors write a book full of his obstetrical knowledge that he's going to use to give to his patients as a teaching tool. Dr M's version of "what to expect when you're expecting". His hope is that he will write this edition and then I will write the next one. I may, however, need to remove his controversial chapter on midwives!

In other news, I've been trying to get to the gym because otherwise I"ll be a depressed mess, but lately I've been getting home from the gym at 10 and have been unable to sleep so get into a cycle of being tired in the a.m. then working late and then going to the gym and then being tired again... argh.

2011-10-27T18:47:00.000-07:00

Today I thought about my first (but not the last) patient to die. I was on my peds rotation of clerkship and was on peds ICU... a very small service. One patient. I spent every hour of every day watching the ICP monitor on that patient, hoping that they would make it. I came in one morning after a night off call and the I asked the nurse how the patient is. The nurse said "they're a donor" and I lost it. I think I cried all day. I felt so close to that family and so bad for their loss... I went to the funeral and felt so bad that they appreciated me being there so much. I will never forget that patient.

2011-10-27T17:19:00.000-07:00

I've been studying and practicing for years and I'm sooo ready to have a house and decorate it! I've used apartments to experiment with colours and figure out what I like and now I know... just to find a house to put my stamp on! (Let's hope it's got room for 8 bikes)

Epworth Sleepiness Scale

2011-10-25T18:31:00.000-07:00

After reading Table for One I decided to score myself on the Epworth Sleepiness Scale I scored 10 - seek advice from a sleep specialist without delay... The thing is - I've always been proud of my ability to sleep at a moment's notice. I often fall asleep in a boring meeting but never in an interesting one - I just find it to be a filtering mechanism. I've never fallen asleep with a patient but have fallen asleep waiting for a patient to arrive... I like to think of it as an economical use of my time!

real job

2011-10-13T11:30:00.000-07:00

I just took my first real job. Now I'm peeing my pants. It's only for 6 months, 4 days a week. With obstetrics - about 3 to 4 deliveries per month. We'll see how it goes!

promise of things to come

2011-10-11T17:17:00.000-07:00

So, with the prospect of a long term locum on the horizon, of course Ben and I go crazy looking for houses again. We are so desperate to have a real house with real places to put all our stuff that every time we think we're going to move somewhere we go crazy moving into MLS houses in our minds. We have only ever looked at 1 house and I have to say, it looked a lot better in the pictures on-line.

Week 2 of my rotation is going a bit better than week 1 because there aren't 3 learners trying to work with 1 consultant this week. Two seems to work much better when there are two consult rooms and one consultant. I'm trying to push myself this rotation to do more teaching of the medical student. I just hope I don't teach her anything wrong! The consultant I'm working with doesn't really ask a lot of questions so I find myself "pimping" the medical student. Not in a mean way, but I'm used to being taught using the Socratic method and I found it quite effective... I'm trying to embody Socrates.

new rotation

2011-10-10T17:45:00.001-07:00

Just started a new rotation in a small town just outside of the bigish city where I now life. Things I have learned so far:
1) crystal meth is much more prevalent in small town Ontario than I thought
2) I need to re-certify my NRP (neonatal resuscitation). If you don't use it, you definitely lose it. Most of the places where I've trained there are NICU nurses that come to resus. situations and do all the work. Hence, I have lost all skills. These are skills I really think I need to have given that I will probably work somewhere where if they have peds, peds will be on home call. Need to learn how to depend on self.
3) I love delivering babies. I did 2 deliveries this week that were uncomplicated, which my last 10 or so haven't been, this was a real blessing and reminded me how much I love birth and being part of someone's birth experience.
4) Getting a good real job might be harder than I thought. The first place I went and met with didn't seem like a great fit and they already have someone starting and someone filling their locum. I have another interview on Thursday which seems promising. I felt out the HR person in the town where I'm now placed and they have no more waiting list so aren't looking for any doctors at this time. It seems like some places are desperate and others are over-supplied. I think it often has to do with whether the city/town has a residency program and is supportive of new grads - those positions seem like they're in high demand. Plus, if you're a resident coming from there, you're a known quantity and are more likely to be hired. I guess we'll see how things go on Thursday
5) after 2 days of being 30, it doesn't seem so bad. We'll see how being a grown up goes.

2011-10-05T17:53:00.001-07:00

I can't think of many people who have changed the world we live in so drastically as Steve Jobs did. Whether you love his products or hate them, he started in a garage selling the first personal computers and revolutionized the way we live. I raise my glass to you Steve, you were taken from the world too soon.

wishing and hoping...

2011-10-03T16:20:00.000-07:00

If I ever win the lottery I'm buying all my clothes from Orla Kiely

I would buy these (all of them):

accomplishment

2011-09-25T04:25:00.000-07:00

I am turning 30 in a couple of weeks. Yesterday I did an 8-hour solo mountain bike race to prove to myself that I was young and fit. Yesterday someone died at that mountain bike race. My friend did CPR and was wishing I rode by. Unfortunately, I was someone else out on the course and couldn't help her. He did not survive. Life went on as usual. Nobody stopped (except a couple of the guys who helped with the CPR efforts), the race went on, no announcement was made until the awards ceremony. There was no moment of silence, no cancellation of the race. It felt pretty wrong to be honest. Because I was in the midst of a grueling solo effort, quite honestly it didn't compute at the time. My husband was supporting me at the race and wasn't racing himself and he had a really hard time coming to terms with everything just going on as usual without any acknowledgment that a man's life had just ended in his 50s out on the trail. Nobody knows for sure what happened. They told us all that he had an MI, but it's impossible to know. He died out there in the woods, while we all pursued small plaques.

Stop all the clocks, cut off the telephone,
Prevent the dog from barking with a juicy bone,
Silence the pianos and with muffled drum
Bring out the coffin, let the mourners come.

Let aeroplanes circle moaning overhead
Scribbling on the sky the message He Is Dead,
Put crepe bows round the white necks of the public doves,
Let the traffic policemen wear black cotton gloves.

jobs

2011-09-21T12:03:00.000-07:00

I'm starting to look for jobs. The problem is that I'm not sure what I want in a job. I have a couple of requirements:
1) must have OB
2) must not have ER
3) opportunity to do palliative care, preferably inpatient

I would also like:
1) in house peds and OB support
2) other family docs doing OB to share call

is that reasonable?

The weight of the pad

2011-09-05T13:22:00.000-07:00

Sometimes your prescription pad feels very very heavy. You don't realize until you're not a resident anymore how many people will casually ask you for scrips who aren't your patients. Nurses at the hospital, family members, neighbors, people ask on behalf of other people. Often it feels like it's something trivial and there's no harm but there's always a voice in the back of my mind telling me that I don't have a chart on this person and I don't have any documentation of what they told me and that I could get in big trouble... Of course I take these things on a case by case basis - is it an emergency? Is it a day or location when they have no access to care otherwise? Do I trust this person to take my advice?

An example - I got a text from a friend while I was at the cottage and she had an infected cat bite. I couldn't see the bite so I sent her to the ER for assessment but she was really pissed that I wouldn't just call in an Rx for antibiotics.

Sometimes people take advantage of you because you're new and young and want to make a good impression i.e. nurses at the hospital. It's a hard line to walk and the pen sometimes feels very heavy.

dear back

2011-08-31T18:48:00.000-07:00

Dear Back,
Please stop hurting. This 30 minutes of biking then back pain thing is getting old and it's only been a week.

NSAIDS - I love you. kisses.

future plans

2011-08-29T18:35:00.000-07:00

It's very hard to plan your future when your spouse keeps applying for jobs in different cities. Maybe I'm destined to locum. I hope I can find a family/OB locum if I need to locum because it would be a shame to lose my skills.

The OB quotient of my fellowship hasn't picked up at all over the last few weeks. My only 2 deliveries were actually with the OB on call because I stayed in the hospital on Friday instead of going to the office. The family medicine part has been good, but I feel a bit like been there done that and having someone still supervise me although I'm fully licensed is a bit annoying. We have a few people due over the next couple of weeks so hopefully things will pick up!

Some people have anxiety when they're over worked, but honestly I'm made anxious by under-working. I've tried to use my time wisely but often end up sleeping too much and learning too little. I'm planning a few conferences over the next month to try and up the learning factor.

over training or under stretching

2011-08-24T19:26:00.000-07:00

I am suffering from either biceps femoris tendonitis or IT band syndrome. I have odd bruising and pain at my fibular head and aching on the lateral knee precipitated it seems by road riding more than mtbing but lately all riding brings it on. I realized today with my foam roller that my IT band is very tender along its length but my hammies are also tight. Looks like I need to do some major stretching and foam rollering. Good thing I have a supply of topical NSAIDs and ice packs.

Jack Layton

2011-08-22T06:05:00.000-07:00

Dear Jack,
I was so sad to hear of your passing today. You were a fighter both personally and politically and have inspired a whole new generation to embrace the socialist agenda. Your accomplishments are many, most notably turning the Canadian conservative political scene on its head during the last election. I sincerely hope that you death does not derail the plans you have for Canada, as I think your vision is of a better country for us all.

I hope you did not suffer and that you went gently into the night. I offer my condolences to your family and hope that they had time to tell you how much they loved you. Canada is far worse off without you.

anxiety

2011-08-15T07:27:00.001-07:00

I was a very socially awkward child and if there's something that makes you have, it's social anxiety has an adult. Not so much being anxious about social situations in general, but being anxious about people liking you. It makes you work probably harder than you should to make and maintain friendships and it makes you worry that people don't like you. It makes you lie awake in bed at night analyzing social situations from the day before and wondering if you did/said something wrong. I wonder if this ever goes away.

breast feeding

2011-08-10T14:37:00.000-07:00

Today I convinced a woman to give breast feeding another try when she didn't get adequate support in hospital. I am so glad I took that breast feeding elective!

podium!

2011-08-08T19:53:00.001-07:00

Well, I guess all that extra mountain biking paid off because I came third in my race this weekend! First ever podium since being in the beginner category!

zzzzzzzzzzzz

2011-08-02T07:43:00.001-07:00

My new preceptor just told me to view my next two month rotation as a summer vacation... not exactly what I'm looking for. This is my "family medicine OB" experience. Unfortunately, he only has 4 people due this month. He does 10 deliveries per month on average but it seems this month is slow. We'll see how this goes. I guess I have lots of time to read and mountain bike!

The Grand Tour

2011-07-24T09:15:00.000-07:00

The Tour De France is over and FINALLY Cadel Evans has won. I have bet on him many times in the past and this year I've finally been rewarded. This year is supposedly the cleanest year in tour history. Read about it here. I almost cried watching him standing on the podium listening to the Australian national anthem. I think it was a good thing that he didn't win yellow until the last day as that jersey seemed to weight him down in the past rather than give him wings. I'm so happy for him.

Yesterday I did a tag-team 8 hour mountain bike race in temperatures over 30 degrees and humidity over 40%. Many people were pulled from the race with heat stroke. After 5 laps each, my partner and I had to bow out - her with stomach issues and me with leg cramps. It was still a fun day of riding my bike!

2011-07-22T11:46:00.001-07:00

Wow. Yesterday was the day of trends. Started the day with 4 c-sections. 2 planned and 2 people coming in with rupture of membranes before booked repeat sections. Then there were a couple of vaginal deliveries and then it started... the big babies came. In total I did 14 deliveries yesterday and 2 were over 10 pounds, another 3 over 9 and an 8'15. Shoulders were tight on one, everything was tight on the other 10 pounder. One woman was told she was having a small baby and her previous baby was only 7'5. This was a bit of a shock and she did not have an epidural... What a tough lady! She was a champ.

It was an exhausting day but I really felt like I enhanced some people's birthing experience and all but 1 baby was healthy (there was one expected fetal demise with genetic defects). And there were beautiful twins that didn't have to go to nicu. all in all a good day on L and D but I'm exhausted.

Cooking day

2011-07-17T18:11:00.000-07:00

So, today I decided to make the ultimate veggie burger from Fresh Restaurant in Toronto. Recipe found here.

This is one of those recipes that I hate because you need to go to the store and buy a bunch of stuff you may never use again in another recipe. And then you have to go to another store because your grocery store doesn't stock millet. Thankfully my grocery store (Fresh co. formerly known as Price Chopper) has a very large ethnic section so did have tamarind paste.

If I was making it again I would:
1) put the tamarind in when I whiz the carrots, tofu etc. in the food processor
2) make it as a loaf - it tastes and has the texture of an awesome meatloaf more than a burger
3) add an egg white. I'm not a vegan and I think it would bind it a lot better
4) adjust the quantities - I doubled the recipe and ended up with 16 burgers

What I did:
cooked 3 today for dinner and lunch tomorrow and froze the rest on baking sheets in the freezer. I then cooked one from frozen for Ben's lunch tomorrow and it stayed together better when cooking from frozen.

2011-07-15T07:49:00.000-07:00

You know, all day I made difficult decisions, deal with many personalities, bring life into the world but then I come home to my most difficult conundrum: what to make for dinner. Because I'm a pesco-vegetarian the options although numerous are often a bit higher maintenance. I make a lot of fish, but this drives the husband crazy because although he enjoys fish, he hates the smell it makes in the apartment (even with the extractor fan on). I often get all excited about making recipes and then realize that most of the ingredients are not in my cupboards and in order to make said recipe for two, I'm left with huge left over packages of many random ingredients.

So, I'm still left with the question, what to make for dinner...

directionless

2011-07-14T08:33:00.001-07:00

Is anyone else in the world utterly clueless when it comes to a sense of direction? I have managed to get lost twice in the last week, once mountain biking and once driving. Well, I guess 3 times because I got lost on my way to mountain biking too.

I just have no sense of which was is north/south/east/west and my best way of finding where i'm going is to go the wrong way and then try to find my way out of it. I can read a map, but starting off always needs a sense of which direction the map directions correspond to.

Was I born without some internal compass?

2011-07-11T14:08:00.000-07:00

Every time I unpack a box I look around and think "how can we have more stuff than this" and yet, there are more boxes. I ahve thrown out more stuff in the last week than I knew I had. I have learned how many random sports we've tried and then abandoned but kept the equipment - baseball, volleyball, climbing, badminton (just the husband), golf... not to mention the sports we still do. We have 6 bikes (soon to be seven), two snowboards, full camping gear, yoga mats, myofascial release logs and two sets of cross country skis. We have a first world problem: too much stuff. I hereby declare a moratorium on gift giving that makes more stuff. We have more pillows than two people can ever consume in a lifetime and have been pawning them off on people to take to their cottages. Not to mention the doubles of items from our separate apartments - irons, microwaves, dining tables. I'm going insane.

an addition for Dr. J: this is a myofascial release "roller" which I think looks like a log especially because mine has a kind of bark pattern on it

2011-06-24T12:38:00.001-07:00

ok. the college is really pissing me off now! They still haven't sent the names of the new certificants to the CPSO and there are only 3 business days left until I need to register with McMaster for my new fellowship. No CPSO license = no fellowship!

Dear College of Family Physicians

2011-06-22T06:31:00.000-07:00

I am waiting for my results of the exam to be sent to the College of physicians and surgeons so I can get my independent practice license before July 1, when I'm supposed to start my fellowship. Seeing as the results have been out for almost 2 weeks now, do you think you could please send said results to the college so we all can move on with our lives? Yet again, an example of how much of a waste of my money that very expensive exam fee was that's supposed to cover administration. Website errors, wrong dates, over filled exams, and now poor communication with other licensing bodies. I'm pretty disappointed with my college.

2011-06-16T03:47:00.000-07:00

I need to re-certify my ACLS, do PALS and re-cert NRP... this is all very costly and time consuming. My fellowship doesn't specify that I need any of these but I feel like I need them for my own education as I keep hearing that certain ACLS protocols have changed this year. Does anyone know if there's a central registry of ACLS courses?

aaaand

2011-06-10T18:58:00.001-07:00

I passed. Phew.

2011-06-04T10:11:00.000-07:00

So, residency is winding down. Two years has gone by SO FAST. I'm actually getting glad that I'm doing a fellowship. A month or two ago I would have said that the fellowship was a bit of a waste of time and I felt ready to go into practice. Now, I'm glad I'm doing it because I feel unprepared to do all the business side stuff of starting a practice AND if I failed the exam then I'll have time to study and take it again in the fall. The exam still looms over my like a dark cloud and there is still another week and a half until the results come out. Someone told me they'd be out on the 15th - not sure if that was just a rumor. Was talking over the SOOs with a colleague yesterday and feel even worse about them now than right after the exam. I wish I could stop thinking about it but it seems every day someone asks me if I got my results yet. Sad me :(

I need to start thinking about how to pack up and move all my stuff! 2 apartments worth of stuff, 1 apartment, interesting conundrum. Good thing Ben is really low on furniture and his place is a 2 bedroom. I'm tired of moving but we'll probably end up moving out of the waterloo place sooner rather than later because it's ugly and sucky. Maybe we can finally have a place with a dishwasher that isn't named Kate!

2011-05-28T20:13:00.001-07:00

I have a knee effusion. It only feels better when I ride my bike without falling off. Can I have a doctor's note to say that I need to not fall off?

2011-05-27T18:19:00.001-07:00

I have sciatica. It's only better when I ride my bike. Maybe I'll be able to get a doctor's note to skip work and bike every day...

2011-05-25T19:37:00.000-07:00

This is REALLY important to watch if you're in healthcare.

2011-05-23T17:41:00.001-07:00

The trip was wonderful and I never wanted to come home. Nothing like no TV and no internet to make a couple focus on each other!

2011-05-20T07:02:00.000-07:00

I'm taking the husband away this weekend for his birthday. We're going to a surprise place and I"m excited because I think he'll really like it. I hope. Things have been tough with our living apart these past two years and I'm really looking forward to being together, finally, come July.

Saturday is going to be an epic road ride - a metric century (100 km). Hopefully the weather holds up!

2011-05-17T16:19:00.001-07:00

I hate it when you call a consultant because you don't know what something is and you're afraid of a dangerous diagnosis and then they make you feel like an idiot for not knowing what it is... kind of defeats the point of them being a SPECIALIST and me being a GENERALIST, dontchya think?

2011-05-15T13:40:00.000-07:00

So,
First mountain bike race of the season today. Had an alright day, fast on the double track, sucked on the muddy singletrack. I just need some help with my mud riding, it's all about being dynamic on the bike, which I find super hard when I'm tired. I need to go out on miserable days and ride in the mud more even though I hate it. I almost beat the girl that I really dislike but she got me just over the line by 2 seconds. She really irks me because she gets up behind people in singletrack and yells at them that they need to go faster instead of just passing or whatever. it's super annoying. She needs to just ride her own race.

2011-05-09T05:10:00.001-07:00

As the days go on I'm becoming more and more convinced that I've failed the SOO portion of the exam. I keep thinking of the things I missed and the problems I should have looked for and it's really interfering with my sleeping etc. Why can't they just come out with the results sooner? This 6 week thing is pure torture.

The Exam

2011-05-01T13:37:00.000-07:00

So, my morning starts with leaving 2 hours to get there. It takes an hour, but I like to be prepared. On the radio on the way to the exam they say there are some road closures because of the Sporting Life 10k run... I get downtown and avoid those streets. As I'm trying to get to the exam, I am confronted with the North/South street I am taking being closed, so I ask the police officer for an alternate. He tells me to go to Bay street. I get to by street and the crossing is closed, so then I am told by the cop to go to Bathurst. I get to Bathurst and it is closed to get North. I break down and start crying and ask Cop #3 who tells me to go down this road to the next lights and go North. 5 minutes later I'm seeing the SAME COP again because he gave me the wrong directions. He gives me another set of directions. This time I call my parents bawling because I'm not sure this road will be open. My Dad gives me directions on how to get to my destination. I have 5 minutes to get there. I get to my destination and there is no parking because THERE IS A POLICE PARADE circling the venue. I dump my car near a fire hydrant and pray I'm far enough away. I get to the venue with 2 minutes to spare. I'm sitting there and some of us are asked to stay behind. They confess that they overbooked the exam by 6 people and can only accommodate 5 so they're looking for a volunteer to do their exam at 1 pm instead. After a few minutes I volunteer because let's face it, I'm a mess and have a puffy red face. Waited for 3 hours, did exam. First station, someone I know is the freaking examiner so they have to scramble to get someone else to do it. Slightly shaken, I continue. Exam is ok, but not stellar. One station I fucked up royally. Hopefully the rest is good.

2011-04-30T14:41:00.001-07:00

I am now in the post exam period of every second thought being "why did I put THAT".

Exam number 2 tomorrow. Hopefully once it's over I can just relax and not think about these things anymore.

2011-04-28T18:38:00.000-07:00

The exam is tomorrow morning and I am shitting my pants and can't sleep. My friend who wrote it today said it wasn't bad... we'll see. I just tried to cram some nephro... so not happening.

2011-04-25T20:52:00.001-07:00

Hello objective 66... I vaguely remember you... ish.

I'm starting to feel burned out. Only 4 days to go until the first exam and 6 days until I'm freeeeeeeeeeee. I plan on riding my bike every day, every darn day!

2011-04-21T10:49:00.001-07:00

545 pages later, I finish objective 99... now to go back and actually learn stuff.

2011-04-17T19:39:00.000-07:00

A wonderful young man that I went to high school with has died from melanoma. Of all the people from high school that I remember fondly, he perhaps sticks out the most. He was a non-judgmental, gentle soul who brought a smile to many faces in his too short life. He will be missed. RIP Doug Wright.

Stop all the clocks, cut off the telephone,
Prevent the dog from barking with a juicy bone,
Silence the pianos and with muffled drum
Bring out the coffin, let the mourners come.

Let aeroplanes circle moaning overhead
Scribbling on the sky the message He is Dead.
Put crepe bows round the white necks of the public doves,
Let the traffic policemen wear black cotton gloves.

He was my North, my South, my East and West,
My working week and my Sunday rest,
My noon, my midnight, my talk, my song;
I thought that love would last forever: I was wrong.

The stars are not wanted now; put out every one,
Pack up the moon and dismantle the sun,
Pour away the ocean and sweep up the wood;
For nothing now can ever come to any good.

W.H. Auden

although Doug wasn't my working week or Sunday rest, I think this is a beautiful poem for a beautiful person.

2011-04-17T00:18:00.000-07:00

I'm really bad at turning down people who I think are seeking narcotics. Tonight I said no and then she acted/was all offended that I suggested she had been to the ER for narcotics several times and she freaked out and then my attending gave in on my behalf... I'm bad at being firm.

2011-04-14T19:58:00.000-07:00

84. f.u. STD guidelines and the fact that all of skin is one objective. seriously - all of dermatology in one objective??

2011-04-11T18:12:00.000-07:00

lucky objective number 79 - only 20 more to go! Then to go back and read it all again because I'm sure I didn't absorb much the first time.

2011-04-03T18:21:00.000-07:00

I'm on objective number 57. I'm starting to feel like I'm not even paying attention anymore. It's like I'm robot studying... not sure it's actually going to help me in the end. Good thing I can take it again in the fall without consequences as I'm doing my fellowship. Not sure I could think of doing anything differently to study though. argh.

2011-03-28T16:20:00.000-07:00

I'm on objective number 38 of 99. My exam is in a month. I feel burned out already. At least in med school your only job was to learn. Now, my job is to work, remember what to do practically AND remember what the book says to do. Not always the same thing. Does someone want to take the exam for me?

2011-03-09T04:43:00.001-08:00

This exam is going to be the death of me... so much material and so easy to flip through it all convincing myself that I know it already..

Teaching Practice

2011-01-16T15:10:00.000-08:00

So far my teaching practice placement in Collingwood has been awesome; this is in no small part because my Aunt and Uncle have rolled out the red carpet of hospitality. If I keep drinking wine at this rate, I'll never get any studying done. On Friday my supervisor was gone so after rounds I snuck out snowboarding. Hopefully this week I'll get out night boarding one of the days. The hospital is small but offers lots of opportunity for family doctors to work in the full scope of their practice. The family docs basically look after all the in-patients both medical and ortho and ICU! I'm scared S***less for the first time I have an ICU patient to look after, but my supervisor strikes a really good balance between pushing for independence and having good backup, which is great.

I am also spending my weekends trying to get in some good xc-ski training and bike training and quality time with Ben. This hasn't left a lot of time for cracking the books but I've vowed to start this week now that I have my feet under me. I'm sad that this weekend has gone by so fast.

I passed!

2011-01-05T08:17:00.000-08:00

Whew. I passed the LMCC II! One more step (the CFPC exam) and I'll officially be a family doctor! I've been passively studying (reading journals, doing self learning modules) for a month now but need to ramp things up and start more active studying to prepare for this exam. The hardest thing is that I'm going to be away doing 2 months of rural practice during a large amount of the study period. Thankfully, there are some other family med residents who are also going to be there and hopefully we can form a study group. And helpful hints/study materials from those of you out there who have passed it?

2010-12-18T17:19:00.000-08:00

I'm feeling marginally better, although I now just can't stop coughing and coughing and coughing. But, unfortunately, today the husband started coughing. Uh oh. No good for plane journey on Wednesday. Cross your fingers for me that he's a quick healer.

so sick

2010-12-15T04:14:00.000-08:00

I've never been this sick in my life. I was on call last Thursday and got what I thought was a migraine. Early Friday a.m. I was woken up to do 2 deliveries and 1 had a pph, that got rid of the tail end of the headache that lingered on. I went back to bed and woke up for rounds at 6:30 - bam. worst headache I've ever had + body aches. That progressed to body aches + headache + cough and 6 days later bam! now I have diarrhea. If the big guy upstairs thought this was a way to re-fill my empathy bank, I'm not laughing.

2010-11-27T17:04:00.000-08:00

Going out to do a very challenging mountain bike trail with a group of people who are WAY better than you are on a day when you're getting your period = bad idea. 2 hours in, I was feeling great, I had accomplished more than I could ever imagine, then I went over the bars twice in about 5 minutes. 4 of those minutes were spent lying on the ground trying not to cry (as tears involuntarily streamed down my face) after crash #1. Thankfully, crash #2 wasn't half as bad. Now I'm having trouble bending my left leg because I'm pretty sure I have a big hematoma in my rectus femoris sheath. Oh well. Tomorrow will reveal the severity of the bruising. Thankful I didn't do anything worse.

2010-11-18T13:00:00.001-08:00

It really bothers me when people say it's their "right" to have a child. I believe that it is a privilege to have a child, not a right that I should guarantee every woman who lives in my country. I know that not being able to have children is heart breaking and difficult for many people, but just because something is sad, doesn't mean it's your right not to experience it. There is no right to happiness.

Now, that doesn't mean that I don't support fertility treatments or funding of fertility treatments through the public system. I think that is a separate issue. Would providing single embryo transfer reduce health care costs for multiple premature babies enough to cover IVF? That's where the question lies for me.

The Canadian study Too early, too small released by the Canadian Institute for Health Information concludes that the average lifetime cost for each and every multiple birth baby is $616,800, mostly due to premature birth. 56% of twins and 98% of triplets are born premature.

With Quebec's new publicly funded IVF single-embryo-transfer system, I guess we'll see how things pan out over the next few years.

2010-11-18T05:11:00.000-08:00

This week two astounding things happened:
1) a person actually came to me and ASKED to quit smoking
2) a person in my practice came to me having LOST a large amount of weight.

Day after day after day I feel like I harp on people about the importance of weight loss, exercise, a healthy diet and smoking cessation. I try different techniques for different people. I place them on the spectrum of change and use different techniques to try and move them from one stage to another. Most of the time, I know it's going in one ear and out the other. They've heard it before, they'll hear it again. How nice to have two individuals in one week seemingly follow or want to follow my advice. hurrah.

2010-11-17T04:56:00.000-08:00

Today is SOO prep day. For anyone who doesn't know - SOO stands for structured office orals and they are an integral part of the Canadian College of Family Physicians exam. We have some medical students visiting our family practice unit this month so we're using them as standardized patients to practice our SOO skills. I'm not sure how this is going to go! SOOs are complex and you really need to figure out a pattern of how to approach them because the patient always has a primary problem and then a secondary problem you need to tease out of them during the interview. This second problem can be totally unrelated or be related to the presenting problem (when it's unrelated it can be difficult to pry it out of them and at times I've resorted to "is there anything else you would like to talk about today"). I worry about running out of time at the stations. We'll see how things go today!

2010-11-14T17:59:00.001-08:00

Why is November such a hard month? Daylight savings should have made my mood better, but coming home now with it being darker and darker I'm finding it difficult to get my shit together. I've been managing to follow my turboing and biking regime to try and stay sane, but I just can't find the motivation to read and learn. The journals and piling up and I feel like I'm getting dumber. I'd better snap out of this soon because I need to start studying for the CCFP. Guidelines Guidelines Guidelines!

2010-11-11T04:40:00.000-08:00

In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie,
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.

let's all insult family doctors

2010-11-07T05:39:00.000-08:00

I'm working with a specialist right now who is VERY good at what he does, but constantly insults family doctors. Most of his stories revolve around how a family doctor sent him a ridiculous consult or screwed up or gave the wrong med or was manning the ER when someone died. Does he not realize that I'm a family medicine resident? Or does he not care? Or does he not see how insulting his stories are.

2010-10-31T17:57:00.000-07:00

I had a very nice day with my Mom today. Is it the sign of a youngest child that I still go home to hang out with my parents when my husband is away?

2010-10-26T15:35:00.001-07:00

Today I had a non-alcoholic beer. I think this is a sign of progress in my recovery from the LMCC-II. Now I have until December 16th to try and forget about it before results come out.

2010-10-25T05:22:00.001-07:00

That was the worst exam I've ever done. Seriously. There are 2 stations I absolutely bombed.

2010-10-17T08:59:00.001-07:00

I'm SO OVER EXAMS. Damn you LMCC II.

2010-10-12T19:44:00.000-07:00

When I see children dying and I read about children dying and the PAIN that their parents go through, I can't help but ask - how can people do it? Is it insanity that people want to bring a life into this world when there's a chance that life will be cut too short and cause them immeasurable pain? Or is it the promise that most people make it to adulthood alive that drives the need to reproduce? Or the opportunity to bring a new and wondrous life into the world?

I struggle with the fact that right now I have no desire to have a baby. I'm too worried. I am content to bring them into the world and hand them off to those more prepared.

2010-10-10T05:56:00.001-07:00

And then she was 29.

Kitty

2010-10-04T18:24:00.000-07:00

So,
Kitty is still alive but now unable to walk, use the litter box without help, or manipulate his position very well. He often looks like me in an undergrad lecture, nodding off to sleep with his head on his chest only to jerk awake realizing that he can't sleep and hold his head up at the same time. The prednisone is at least increasing his appetite, although he's just skin and bones. Poor thing's owners can't get home soon enough - they'll need to put him down soon and I just can't bring myself to do it without them seeing him. Friday seems like such a long time away.

2010-09-28T16:29:00.000-07:00

What kind of karma do I have? I am cat sitting one of my attending's cats while he is on vacation for 3 weeks and 1 week in one of the cats contracts a deadly neurological disease... I guess I should have helped that old lady across the street last week.

When I said I had an interest in palliative care, this isn't what I had in mind.

R3

2010-09-21T19:38:00.000-07:00

I'm struggling with whether to pursue R3 training in obstetrics and women's health. On one hand, it would be great to match to a program in the same city where Ben is living/working so we could be together and I could get to know the city/hospitals etc. On the other hand, I could probably just go get a job there post-graduation. My hesitancy with the "just get a job" route is that I don't feel prepared - but does anyone? I still have >6 months of residency left and I don't feel prepared to even make the decision but applications are due Oct 15 so I'd better get my ass in gear if I want to apply. Plus, applying would mean revealing to my program director and colleagues that I'm not planning on staying in the city I'm training in (which I would love to do if Ben could only get a job) - which will make a lot of people unhappy. But seriously, Ben and I cannot live apart for any longer!

2010-09-15T19:00:00.000-07:00

To dance or not to dance? I am going away for 2 months during this year's dance season and I think I'll have to pay for those classes whether I take them or not. Is it worth the money for the months I can take class to just suck up the 60 bucks, or should I not start off the season at all since I'll miss a significant portion? What to do!

In other news, I came second in my weekly mountain bike series!! I had so much fun and met so many awesome people. I'm totally motivated to do it again next year along with my goal of doing a solo 8-hour race and maybe a 24 hour race. I need something to motivate me to keep up the winter training!

2010-09-02T19:10:00.000-07:00

The contrast between my studying and my urgent care clinic tonight is very obvious. The text talks about all these classic clusters of symptoms. My patients come in with weird shit that I have no idea what it is. It's unfortunate that studying doesn't teach clinical judgment.

LMCC Study day 2

2010-09-01T18:51:00.000-07:00

lipid guideline
diabetes guideline
reading about januvia and Victoza
ovarian cancer
asthma guidelines (to be continued)

LMCC II study day 1

2010-08-31T17:34:00.000-07:00

A study of randomness:
1) cardiovascular events TOP guideline
2) Cognitive impairment TOPS guideline
3) Urinary tract infection in nursing homes TOPS guideline
4) progesterone for luteal phase support - Cochrane review + other resources
5) Gout
6) Polycythemia vera
7) Canadian guidelines on Sexually Transmitted Infections (to be continued tomorrow)

I should really start doing something systematic, but these were clinical questions from my day/past week I needed to look up anyway. The Alberta TOP guidelines are really useful! They can be found at: http://www.topalbertadoctors.org/informed_practice/about_informed_practice.html

2010-08-27T19:38:00.000-07:00

It never ends to amaze me how much people appreciate a simple gesture like a phone call from their GP when something tragic happens in their life. I have had two pregnant patients who got devastating news within the last month - each took it differently, each was heartbroken in their own way. All I could offer was words and a shoulder to cry on - it was almost as if they had expected less.

random crying

2010-08-16T20:02:00.001-07:00

I missed my exit on the highway today because I started crying because there were bagpipes on the radio and they reminded me of my wedding day. I'm not sure how I feel about that.

The joys of trying things you're not good at

2010-08-15T17:57:00.000-07:00

I never participated in a lot of sports in high school. I was a figure skater and a bit of a dancer, but never found the pleasure from competition and sport that some of my peers did. I think it was because I just wasn't very good at it. I was really good at school and got a lot of pleasure from reaping the rewards of being smart and it motivated me to try harder - which I can thank for getting into med school and getting my commonwealth scholarship to do my Master's degree. In sports I was so behind everyone else I felt like there wasn't a small gap to close that I could strive for, I felt like I needed binoculars to see the rest of the field.

Fast forward to now. I have started doing some mountain bike races and I still need binoculars to see the rest of the field most of the time, but you know, it has started to feel good just to get out there and participate. I know that sound corny, but participation and trying something new and exhilarating has become more important than proving I'm the best or not trying because I can't be the best. I'm married to the man of my dreams, I have the job of my dreams (or I'm on my way anyway) and this added new challenge seems more like the icing on the cake than something I need to hang my self-esteem on. It feels pretty good to have fun just going out and trying, no matter the consequences.

2010-07-25T05:06:00.000-07:00

It's nice to be a PGY-2 going back and doing things you've already done for a second time - makes you feel like you actually know something about something! Sometimes. Other times it's extremely challenging because you are viewed by most attendings to be able to do everything yourself and asking PGY-1 type questions is frowned upon. Freedom always comes with a price!

I had my first palliative patient this week who actually expired during the consultation. While I was trying to clean his face with warm towels so the stains of death didn't disturb his family, I noticed that I no longer have overwhelming feelings of sadness when people die. I'm not sure that's a good thing. This month on palliative I have yet to cry and considering I treated someone the other day who's younger than I am and who is dying of metastatic cancer - I'm starting to wonder what's wrong with me. Is my skin growing in too thick after many years of being tender-hearted? Has my disillusionment with residency extended to not emotionally engaging with my patients? Or is it a compensation for one of my colleagues that cries over every patient. Who knows.

Back to OB next! I've delivered 2 of my own babies so far and have another due this week so I'm pretty stoked!

Dear Squirrel

2010-07-12T18:47:00.000-07:00

Dear Squirrel,
I know you have baby/adolescent squirrels that are running around with you chucking chestnuts out of the tree on me, my car, my path, but WHY DID YOU HAVE TO EAT MY PEA PLANTS??? That's where I draw the line!!!!!