whole wheat kraft dinner sucks.

So, my current rotation is total balls! Not because the actual rotation is bad, but because the scheduling is a nightmare. I took 2 weeks of vacation during this 6 week rotation (which we are entitled to) and that caused a scheduling problem that was sorted out... or so I thought. Over 4 weeks I need to do 9 shifts and I show up for my shift tonight and find out the person who was supposed to teach me traded the shift to a person who doesn't teach. So, I had the ward clerk bring up the schedule for the week and not only was this shift traded but 2 other shifts have been traded... which leaves me 3 shifts short for the rotation... out of 9. Two thirds of my shifts are gone. I'm not sure what I'm going to do.

Does anyone know any physicians who were trained in Canada or the US and moved to the UK recently to practice?

I know it's a silly thing to say, but I'm nervous about my holiday. Husband and I are going to Italy and we're landing in Rome and driving 6 hours south to see/stay with my father in law and his partner. I've been getting maps and directions and phrase books and trying to figure out where we're going and how best to do it. It doesn't help that the directions I got from my father in law say that he lives on an "unknown road" and the last few directions on the google map have no street names. I know that people went on vacation and made it without GPS units and fancy gadgets for decades and I'm sure it will all be fine, but I'm a worry wart and this apprehension is make me hard to live with. I think my husband wants to kill me.

First year almost over

So, first year of residency is almost over. Someone the other day asked me what I was going to do in July... he thought I was done my two years already. That made me wonder - what am I going to do next July? Things are up in the air with the husband's job and whether he will be able to move to the town where I'm doing my residency. Right now we live about 1.5 hours apart and only see each other on weekends. It's a good thing, because my one bedroom apartment is waaay too small for both of us. We are constantly tripping over each other on weekends and now that we have 5 bikes between us, storage is becoming increasingly difficult. So, if he's making the move here, I think I'll have to make the move into a bigger place... I think a 2 bedroom is ideal for us. A bedroom and a bike room! We also still need to be on a ground floor because taking the bikes up and down stairs is very inconvenient!

Anyway, I know that I want to do OB as a part of my family practice and I know that I want to be in an office with a more experienced doc or a group of more experienced docs to bounce things off of. I have lots of patients in my resident practice who will want to follow me and some I would rather didn't!

I signed up for the LMCCII the other day - SO EXPENSIVE. I never knew it would cost me 1850 dollars. Good thing I got in on time because the late fees are ridiculous as well. If anyone has any tips - I have no idea what to expect.

I'm on holiday. I hate holiday when there's no actual holiday. I'm at home. With a cold.

I was planning on training a lot this week. This cold is really slowing me down. I tried to compete in a race this weekend and had to pull out because I felt like ass. This racing thing isn't going as planned right now. I'm hoping to see some improvement over the next couple of weeks after this pesky cold is gone. It's funny - it feels like everyone else is getting faster and I'm getting slower. How frustrating!

I'd better start reading my big stack of journals so I feel productive. And stop eating chips. Yikes.

What a shit ride!

It was raining, I had the wrong tires on and it was muddy muddy muddy. I slip slided my way around 3 laps of misery. I HATE biking in the rain. I HATE biking in the mud. I HATE when my husband tells me how I should enjoy my back wheel skidding out because it's FUN and why else would I mountain bike. I was just looking for some G-D Sympathy! OK?!?!

And they're back

The palpitations are back. I think it's a mixture of stress, exercising and caffeine consumption. I'm going to go tea free for a while. I always know this is related to stress because not only do I get PVCs but I also get horrible GERD at the same time, making me think I'm having chest pains. The summer ramp up in my training schedule probably doesn't help.

I had an awesome mountain bike ride yesterday with a bunch of guys and girls from our club. The rain fell but we weren't deterred... well, atleast the 5 of us that kept going weren't deterred. We did about 25 km of mountain biking in 2 and 1/2 hours with lots of stops to keep the group together. All in all I think my skills are improving with only one fall on a slippery wooden bridge. I did that Wednesday night race series ride last week and will be heading out there again this week and I'm stoked! There are only 4 of us in the sport women cat but there's one girl who does the o-cup cross country series as well so I think she's really going to motivate me to be more competitive.

And she died...

My first family practice patient to die passed away yesterday. She has been in palliative care for quite some time and I really met her at the end of her life. I wish I could have cured her. I wish I could have made dying even easier, I wish I could have predicted the day she would die so her family could have had more peace. I wish I had the perfect words to say to the husband she leaves behind.

New Things

I'm debating going to a weekly race series in town here. I would be going alone because husband isn't here during the week and I basically wouldn't know anybody. But, it would be an opportunity to meet people and mountain bike during the week instead of only rode riding. Bad news - I wouldn't get any more work done than I am now (um.. zero).

The first race is tomorrow. What to do!?!

ENT

I'm starting ENT on Thursday. Something I admit I know very little about. Anyone got a good ENT resource for primary care?

Ocup 1

The bike computer is found! It was in a box of granola bars we'd taken to the last race. Hoorah!


This weekend was the first o-cup race in Mansfield Ontario. It also marked my first sport category mountain bike race, which would have been much better if a girl hadn't fallen on me right at the start causing me a penalty of about 30 seconds to a minute as she couldn't get up. Anyway, I did ok (6 of 9) for my first one and learned some valuable lessons - I should eat before I start. I should try to drink something at some point on the course (point to be determined for next race). I should hold back a little on the first lap for the second. I should shoot the guy who adjusted my gears after replacing my drive train last week because I dropped my chain several times.

In other news, I spent a lot of the weekend worrying about a patient of mine who has just gone into hospital. She had bad back pain and he has cancer and then later she started having abdo pain and throwing up and I convinced her to go to the ER. When she came to our office with back pain I checked her for compression fractures and there were none and his symptoms seemed mechanical, but our usual pain meds weren't helping. I was lying in bed last night thinking, maybe she has kidney stones. I hope they do a CT on her. I'm not sure why I didn't think stones in the first place - I can't remember the exact character of the pain off the top of my head but she had been seen by two of my colleagues the week earlier and diagnosed with mechanical back pain and the pain started around the time that she was doing some heavy lifting to take care of a sick child. I wonder about diagnosis momentum. This is one of the biggest errors I've noticed in my practice so far. I need to go back to first principles when someone comes to me and they're not getting better. A valuable lesson.

I spent the weekend feeling so good and now I feel so bad. The husband is away in Mexico on a work thing and he's going to be there all week. No phone calls because of the expense and his work won't cover it. Just emails. No snuggles. I miss him.

I lost my bike computer and it sucks. I got all ready to go out on a bike ride today and then couldn't find it and realized how messy our house is. I'm not sure I could find anything in here. So... took off the bike clothes and started cleaning. Still haven't found the computer.

I really need some vacation. I feel really burned out. I have a week off in May and then 2 weeks in June. I'm ready for them now.

Medstudentitis Triumphs over Paris to Ancaster knocking 1 hour and 30 minutes off her time from last year!

big day

Big day tomorrow. Big race - Paris to Ancaster. I did it last year and suffered really badly. This year I'm gonna kick it's ass.

Yesterday I attended a memorial service for everyone who has died in our palliative care and cancer care units over the past year.

One of the staff physicians gave a speech and talked about how patients ask her how she goes to work every day and deals with death and dying over and over. She said something that resonates greatly with me - the greatest burden we carry is yesterday. Very apt for a time in my life when I have many regrets on a daily basis and fears about performing badly and disappointing my patients.

We all carry a bit of the sorrows of the past with us and the memorial service is an opportunity for us also to cleanse our souls clean and move on. It reminds us that people's lives go on after their loved one dies and they leave our doors and ours will too.

One missed diagnosis and BAM, one of my good friends and colleagues is partially blind in one eye.

4 weeks of intermittent one sided headaches that aren't relieved by the usual migraine medication. History of cluster headaches but never with this odd "Vaseline vision" in one eye.

Saw them in the cafeteria - mid fixed and dilated pupil. Took them to emerg to be seen. Expedited their entry but couldn't stay with them because I had clinic. Found out later they'd discharged with meds and a diagnosis of cluster headache.

The doc didn't look at the eye - dismissed it.

2 days later a 6 am. phonecall - "I think I've got acute angle closure glaucoma" - a sleepy drive to emerg. Thank god for a smart medical professional self-diagnosing on google.

We are all relieved when we miss and it makes no difference - but how do we deal with the one we missed that resulted in a bad outcome? I am as guilty as they are - I saw the pupil in the cafeteria and I tested the reactivity and misdiagnosed it myself - all those ophtho lectures in med school didn't sink in. I will never miss a case of this. I will never miss a case of the thing I missed a month ago - but what about all those other things I've never seen?

I'm struggling with the responsibility that comes with my profession.

Today was a horrible day. I made a mistake. I made a big mistake. The mistake was caught right before it was too late. I apologized and they accepted. I still feel like crap.

Easter is a dangerous time. I can fit a lot of mini eggs in my mouth at once.

I was angry because I got my schedule for June (emerg) and I had been scheduled for several shifts during my vacation... which was booked several months ago. Along with the schedule came a note asking if I could change my vacation to suit the emerg department. The Husband and I have spent quite a bit of money on plane tickets, rental car, bike boxes, etc. for this trip and some of those things are non-refundable. The good thing is that my program director is supporting me in still taking the portion of my planned vacation that I'm spending away (I took 2 weeks but I'm only away for a week of it). The bad thing is that without the emerg shifts during that week, I might not have enough shifts to complete my rotation. Fortunately, my program director is going to help me navigate this tricky situation.

So, more to come on this at a later date.