I can't say it with strong enough words to convey how I feel - I am surprised, outraged and very saddened by the news that the little medic has been diagnosed with testicular cancer. What a bomb dropped into the middle of his and Miss Bliss's lives. He is getting married shortly after I have, he started his first job at a similar time. I feel like we're in the same stage of life and yet he is facing this gigantic beast. I am so thankful for my health.

paged when not on call

Getting paged when you're not on call sucks. It makes you worry about your patients when you aren't supposed to be the one managing them and it makes you conflicted about whether to manage the problem or not because you're already on the phone. Especially when it's your patient and the on-call doctor doesn't really know them.

So... I dealt with the problem and then shut off my pager. Lesson learned, shut off the pager when you leave work!

I'm not sure how people do this palliative care thing all day every day. I can't give any more of myself or there will be nothing left. I haven't cried yet. I think it's coming.

Happy New Year

Happy New Year

This year has been a pretty big one for me - graduation, starting residency, marriage, a new city and a new hospital. Let's hope 2010 is as fruitful!

sisters in cycling

My town isn't exactly big on women's cycling. Or any sort of winter cycling training. So, I ride my rollers daily in isolation. If I'm lucky, Ben and I train together in the kitchen but he has this crazy endurance-aimed training schedule that involves not being able to do any intervals or talk or do anything fun, so basically we do our own workouts and stare at each other while watching old videos of the tour.

Today I was thinking - wouldn't it be great if a group of like-minded female cyclists could get together over the internet and train together. I envision 4 or 5 female cyclists getting together once every 2 weeks or so and each taking turns instructing a spinning class. I see it being over a skype-type video conference utility where the "instructor" is seen by everyone and what the instructor sees switches between the different people on-line or is a split screen so they can see everyone else at once.

Anyway, this is a pipe dream, but I think it would be good for any of those of us who are lonesome training alone.

How come vacation always sounds so great until you're sitting alone in your living room watching toddlers in tiaras trying to resist eating all the chocolate in the fridge? Good thing I'm going to the movies with a friend to eat nibs while sitting on my ass later this afternoon :)

I'd better turbo tonight or I'm going to turn into a giant lump of chocolate. I'm looking forward to going to the cottage on Thursday and cross country skiing like mad! I wish I had my skis here because we just got fresh snow today. Unfortunately, the thermometer also dropped to -12 last night.. ouch. Ben bought new cross country skis the other day and I'm looking forward to spending some time finally being faster than him for once! I'm sure that will only lastfor a week because Ben never does something without getting really hardcore into being the best at it! Soon he'll be looking at biking as training for cross country skiing not the other way around. Plus, it's a sport that involves tights/spandex/red clothes so it'll be a hit with him.

Now that I'm married, I get really excited about other people's weddings. My friend wrote me a 2-line email asking for a little advice about planning his up coming wedding - whether to do it in Toronto or London (England) where his fiance is from and whether location has any bearing on citizenship application approval. I wrote him back a 4 paragraph message. Why? Because I secretly want to be a wedding planner. I keep asking Ben if he wants to have another wedding just for fun but he has declined. What a party pooper! So, I have to be contented with helping others.

Merry Christmas Everyone!

And to all a good night.

Gearing up for working xmas eve in the cath lab. I worked Monday in my clinic, Tuesday cardiology clinic and then OB on-call, Wednesday post-call and now cath lab. Cath lab doesn't really excite me. Let's hope I get to go home early.

Bike shorts review #1

So, I bought some shorts yesterday because they were cheap and seemed to have a relatively good chamois, and had a nice fit. They were the MEC Rapide cycling short . I'm sure there are fancier shorts out there, but I have to say, after 50 minutes on the rollers, they really stood up to the first test. I haven't washed them yet so can't say how they will fare, but my crotch was suffering a lot less yesterday compared to riding with my old shorts. The only down side is that they are a bit "squeeky" - the fabric kind of rubs against the saddle making vibrations. I'm sure I'll get used to it.

I have a pair of Pearl Izumi Sugar women's shorts and I have to say that they are just too short. They end mid-thigh and bunch up into the crotch while riding so I end up with excess fabric rubbing in my inner thigh. I'm pretty sure they're made for people without inner thigh fat. They do make a selection of longer shorts and I should have gone for one of those.

I'm really tempted to buy a pair of women's bibs. Mostly because of jersey ride-up leading to back exposure while mtbing. Jersey ride-up never bothers me on the road but I think I just move around a lot more on the mountain bike and end up with my jersey around my nipples. Maybe I should just start wearing 1 piece suits!

In other news, I did some standing up on the turbo yesterday and then managed to fall backwards off the rollers because instead of the normal side to side motion you try to stay in the middle of the rollers stationary but some of the momentum gets turned into this forward and back bumping against the front roller and then if you get enough momentum up you fly off the back of the rollers. Oops. The lino in our kitchen now has some of the rubber from the tire on it.

Have I mentioned that I really dislike cardiology? I worked with a really nice guy this afternoon, but the medicine just lacked interest for me. It all seems like a bit of mumbo-jumbo - the up-sloping ST segment means something in one patient but not in another. The q-wave is significant here but not there. Disregard this lead from the ECG - it's meaningless. Bah!

Courtesy of M and 2S, what all female cyclists need to know:
http://www.bmj.com/cgi/content/full/325/7356/138

Ok... so my rollers experience has indicated one thing to me: I need new shorts. Badly. As I don't have the skills to stand up on the rollers yet, my crotch gets REALLY numb. So, cyclists, what brand are your favorite shorts? Keeping in mind that I cannot afford Assos :)

First time on rollers - note the improper "shorts" i.e. my lululemons rolled up over the knee because I couldn't wait to jump on them when I got in the door!

I have now graduated to riding in front of the TV, but still in a doorway.

And... Our christmas tree!

Tap dancing is hard! But, I'm going back next week because it was fun. Everyone else in the class is a teacher and over 40... except me. But, that's ok, they're fun and very friendly and inviting. Now I'm debating whether to ride the rollers before going to bed.

Being a resident is all about trying to wrack your brain for that thing you learned about that disease in medical school and trying to pinpoint the right parts and ask the right questions before leaving and taking a quick peak at "up to date" before reviewing with your consultant/senior. It's all about taking 1 tidbit you remembered and trying to spin it into "knowledge". Then getting put on the spot when your attending asks you questions about all the other parts of that disease/medication/treatment that you forget. Then going home and trying to remember what you didn't know to read about it. Although, after getting through my clinic and paperwork today I got home at 8 and had to eat dinner and am now to fried to learn anything. So I drink a beer and watch a 1/2 hour of tv and go to bed. Isn't life grand?

I'm trying to start a beginner tap dancing class tomorrow. Problem is, I was supposed to go get some tap shoes after work today and ended up leaving after all stores were closed. Hopefully it'll happen tomorrow before the class.

Rollers

So,
I bought rollers today. Rollers with a front fork stand for those lazy days! The best of both worlds between a trainer and rollers. I actually wasn't too bad my first time, it just takes a lot of concentration. I didn't fall off once and I was pretty stoked about that. Ben tried to steal them from me for a while, but I beat him with a rubber chicken and he backed off :)

Tomorrow is a BIG OB day. Lots of preggos, lots of 3rd trimester management. Wish me luck!

Oh, and we put up our Christmas tree today! It's really pretty but I'm SO paranoid it's going to fall over when I'm at work and I"m going to come home to a giant mess!

Another day, another weekend trying to make up for non-weekday riding. It's freezing outside (literally) so I'm riding the trainer while Ben is insane and goes outside. Let's see if I can make it through the whole hour and a half without losing my mind. It's funny how much different the stimulation and torture factors are on the road vs. inside. I have to remind myself not to look at the clock... it just makes things worse!

For everyone who was wondering, these are rollers:



this is a turbo trainer:

The beginning of winter was not a good time for me to start internal medicine. It's my sleepy time, my low mood time, and my most frustrated time of the year. To be frank, adding something depressing to my low mood isn't all that helpful. Coupled with the fact that I start palliative care next after Christmas, doesn't seem very helpful.

In other news, I'm trying to figure out a new exercise regime as the weather becomes more hazardous for cycling outside. The question is: trainer or rollers? Riding Ben's trainer is ok. But, he thinks rollers will help my pedaling technique more. However, I think there's an element of Ben wanting access to rollers in that equation. I am afraid that I'm going to fall off rollers, although tapered rollers are easier to manage. Any advice anyone? I'm looking at you Dr. K.

In other news, I went for a cheer-up visit to the craft store today to buy a wreath for my door - I bought a nice real pine wreath with some berries and pinecones in it and a fancy hanger that goes over the top of the door. I'm really excited to buy our Christmas tree in 2 weeks time (Ben won't let me get it before them because it will die too early).

I love this... I LOVE THIS bracelet.

Do you ever discharge a patient only to lie awake at night and wonder if you could have done better for them in terms of follow-up? I didn't sleep until 1 am last night because I was fretting over a discharge I did yesterday. Now, today, I'm going to fix it because I can't have another sleepless night (I'm too tired already).

Yesterday was a long day and an exhausting day. Went in early to round on my internal patients before family medicine day. Worked until 8:30 in the evening. Came home and crashed. Starting over again today. I have a patient who's going down hill and nobody can figure out why. Her husband is very angry and yells at me over the phone or in person. All I can tell him is that I'm doing the best that I can.

Last night I made the YUMMIEST dinner ever. Amy's Nawlins shrimp (really Webbers cookbook, but Amy made them for me first and I love them), arugula/toasted pumpkin seed/chevre salad and rice. Yum! Ben laughed at me because I was enjoying it so much - but hey, I like food!

what happened to you thatmirrorbelongstofrank?? I just went to see if you've written anything new and it looks like you've gone private? How do I request and invite?

Oh my god, M and 2S hit it right on the head - so many COPD exacerbations and swine flus my first day (Tuesday). We were there from 7 am to 7 pm to get through all the consults in the ER. One very sad case, which lead to a woman with an exacerbation of COPD/heart failure being tubed in the ICU. We started the DNR conversation, but she wasn't ready and now she's vented and I'm not sure anyone will every know her wishes. Hopefully she talked them over with her husband.

In addition, one of our employees of the hospital has been admitted to ICU with swine flu. We're all a little freaked.

I start internal medicine today for two months. I am dreading it. I feel this is really my downfall because I'm not a detail-oriented differential diagnosis junky and that's what internal really is. I feel ill-prepared and nervous and I'm not looking forward to two months of this sinking feeling when the alarm goes off in the morning. And, this rotation starts at 7 am, which when I was in med school was the norm, but here in the community is on the early side since everything else starts at 9. This is going to be a shock for my body-clock!

I think the winter blues are coming upon me. The dark dark evenings and lack of time to do outdoor exercise during the week is sinking in again. Bah humbug.

Got the shot... my arm is killing me! But... no swine flu for me! Hopefully I won't be infected in the next 2 weeks while I"m waiting for it to take effect. Wouldn't that be a crapper!

I went to get my H1N1 shot today and much to my surprise, the clinic had closed its doors to new people at 5 o'clock due to being at capacity. Damn. I'm gonna have to find someone to give me the shot at work or something.

h1n1 myths

Some valuable resources for dispelling h1n1 myths:
http://aap.org/advocacy/releases/swineflu.htm

the webcasts of Dr. Bernstein from Dartmouth are very good:
http://www.aap.org/audio/cisp/bernstein2.mp3

rumors about guillain barre and the vaccine are rampant. This Vancouver Sun article tackles that question head on:
http://www.vancouversun.com/health/Separating+myth+from+fact+debate+about+vaccine/2149677/story.html

a quote from the novartis prescribing highlights:
"The 1976 swine influenza vaccine was associated with an increased frequency of Guillain-Barré syndrome (GBS). Evidence for a causal relation of GBS with subsequent vaccines prepared from other influenza viruses is unclear. If influenza vaccine does pose a risk, it is probably slightly more than 1 additional case/1 million persons vaccinated."

Some people when reading product monographs don't really understand what they're looking at. Listed in the monograph, especially in the CPS, there are study results showing every possible side effect that was seen in vaccine trials, often there are tables showing the number of people in the control group vs. vaccine group who had a certain effect. These effects aren't always statistically significant and often the incidence of the effect is higher in the non-vaccine or non-treatment group. These adverse events often happen in such small numbers in the studies that there isn't enough power to establish a cause and effect relationship. I.e. if there were fewer pulmonary embolisms in the group taking the vaccine that doesn't mean that the vaccine protects you against having a PE.

In addition, every medication has risks associated with it and we have to critically think about the level of risk. If there is a 1 in 100 000 risk of having a certain complication, but in our group the risk of dying from the disease is 1 in 30 000 (not actual statistics from any known disease or treatment) - we have to decide whether we accept the 1 in 100 000 risk in exchange for protection against the 1 in 30 000 risk.

awake

Last night I was awake from 1:45 am until 4 am with no hope of getting back to sleep. Why? Who knows. What did I do with these wee hours? read my book and cursed the fact that I'd be struggling today. And, boy did I struggle. I could hardly keep my yawns in and my head in the game. I slacked. I almost fell asleep in heme rounds and the only thing that kept me awake was free candy.

Please if there is a god, let me sleep well tonight.

Tis the season of darkness when I have to get up in the morning. I'm finding it a hard adjustment. I keep convincing myself I can get up later and later because I still feel so tired. This is just about the time of year I wish again that I had a sunrise alarm clock to turn on a light for me!

I'm slowly getting my exercise mojo back. I bought a new bike this weekend and that definitely helps. 2 x 1 hour rides after work so far this week and I'm hoping to do at least 4 during the week and a longer ride on the weekend. Unfortunately, it might rain tomorrow and I'm not sure about my bravery going out on my new oh so skinny tires in the rain.

I bought a Devinci Silverstone SL4 - I will put up a picture when blogger lets me. It's awesome, but has pointed out to me how out of shape I am!

Ben finally killed the fly.. Hallelujah!

Not much is happening around here, so that's why the posts are scant. I'm behind on writing wedding thank-you cards (about 1/2 way through) and even more behind on studying and those kinds of things, but keeping my head above water in the day-to-day. It's funny though, all of Ben and my friends seem way busier than we are. We try to make plans with people and without making them 4 weeks in advance, nobody is available. Is it that we just don't have very many friends? Probably.

Ben applied for a mortgage today.. and then called me afterward to tell me about it. Somehow I think that's a bit backward ?

There is a fly in my apartment that has been alive for 2 months and mocks me with his alive-ness. I cannot kill him no matter how many times I bludgeon him with a tea towel - not that a tea towel can really bludgeon all that hard.

Today is the first time in a long time that I'm dreading going to work tomorrow. Actually, I am really dreading Wednesday when our university "big brother" comes out to oversee our clinic day. It's a funny thing to be scrutinized and feel that if you let yourself down, you might just let your whole program down.

So far peds has been busy. and independent. and busy. A different kind of busy from obs - more scut on peds and more trying to figure out what the heck I'm supposed to be doing at each moment. I have found a good mentor though and have been following his patients. It makes it harder here because different people cover their own patients instead of the on-call doc. I haven't had much exposure to high-risk deliveries or NICU yet but hopefully I'll get called for something one of these days. I'd like to use my NRP before I lose it.

In other news, my birthday is tomorrow. I got up this morning and someone asked me the date and I realized I had no clue - and had forgotten my birthday was the next day. What am I doing for my birthday? Not much. It's thanksgiving so we're all going to the cottage. I don't feel very birthday-y this year. Maybe it's because I'm tired, maybe it's PMS, who knows.

Back to reality

Well, I've been back since Monday but there's still a big pile of papers on my desk and the apartment's a mess. Ben's coming back from work tonight so I need to clean up and make a nice dinner. Put my wedding dress in the washing machine the other day and it survived and is now going into storage until I have a bad day and need to pop it on. The tiara is probably enough for most disasters.

I was voted chief resident today by my peers - there was another guy who wanted it and so he's vice-chief. Since we're a new program this year, I'm not sure quite what it's going to mean to be chief but so far it's a bit like being a therapist :)

Ben and I doing the Gay Gordons in Scotland

The Scottish bride and groom
running after some guests who drove the wrong way!

I'm not sure who was talking, but they must have been saying something good!

There's no backing up in a wedding dress... you've just got to run around in a circle.

I am getting married. Today. How weird is that?

I am getting married in 2 days and I"m exhausted. Sleeping in tomorrow here I come.

so... the jeweler f-ed up my ring. ugh.

I am getting married in 11 days. I'm surprisingly calm... not quite a basketcase yet. I think that's because I'm at work. This weekend I felt a bit baskety. I've done most things. Still need to print out the place cards and mount them and make the seating chart and card box. Need to buy a guestbook. Need to figure out a way to convince my hairdresser I dont' need THAT much volume on the top. I have my last dress fitting tomorrow and then she's going to steam it and I'm going to pick it up (when I'm going to pick it up is a mystery to me...)

I'm hoping our rings are ready soon...
Even when there's not much to do there's still stuff to be done!

I hate it when you go and review guidelines and figure out you've been missing something in your clinical practice. At least Iwas reassured today by a doc who's been in practice 40 years that he does it too.

Boy.. wasn't that last post a bummer! Things really aren't that bad when it's not 9 o'clock and i'm alone sitting on my couch.

Ben and I are moving him from one apartment to another this weekend. I just got bleach all over my skirt. Note to self for future reference - don't bleach in nice brown jeanskirt that you like.

In other news, next week is my last week of psychiatry. It was more enjoyable than I originally anticipated but I wouldn't go so far as to say I enjoyed it. Maybe tolerated is a good word. Better than hate! Next I'm on elective. My elective is a bit light on scheduling right now but I'm sure I'll be busy just the same. It's 3 weeks until the wedding. Whew. it's getting close.

as the wedding gets closer, living on my own gets more difficult. I'm tired and stressed out. I get home from clinic around 6 or 6:30 and usually have to make some calls about the wedding or go to a meeting or make placecards etc. Then, I call Ben. I'd much rather see him than call him, I can tell you that. I find myself irritable on the phone and just wanting him to be here so he can help. I feel overwhelmed and lonely.

Some days it's really hard to get from my kitchen to work. Especially when work is psych.

well, i'm half way through my psych month and what have i learned? psych is 90% depressing and 10% somewhat uplifting... I haven't seen the 10% yet but I'm holding out. The only call I've done this month is OB call that I snuck in to my schedule. Psych doesn't seem to care whether I do call or not... and I'd rather not. I got enough emerg psych on emerg and I'm sure I will when I'm on my emerg rotation in a few months here.

Wedding plans are going well. Things seem to be coming together. Our catering meeting is tomorrow and I'm going with my Mum because B has to work. I think we're going chicken and salmon, corn on the cob, salads. Why are weddings so expensive? I'm going to my "bachelorette" on Saturday - 3 of us having a nice dinner and sleeping in a hotel. Nothing too fancy or out of control, just the way my type A personality likes it. I had my wedding dress fitting the other day and I felt really pretty in it. Looking forward to the day (30 days until the big 12th of September and counting). I had a lovely wedding shower the other week and now there are Sophie Conran boxes stacked all over our apartment. I'm going to have to start buying a lot of hats or something to store in all these hat shaped boxes!

I've been a delinquent and I'm sorry. I'm 3/4 through my OB rotation and I will be very sad to move on to psychiatry. I love OB. I look forward to doing lots of it in my second year electives. I'm trying to make changes to the rotation to benefit my classmates. I'm kind of sad I was the first one to do the rotation because I think my colleagues are going to get more exposure on the ward and be able to dial their half days back to family practice down a little bit to facilitate being around L and D more.

I'm very tired. I'm waiting for twins to be born tonight and I'll go in if it happens before midnight/if they go vaginally as planned. I'm on call tomorrow night.

I think because Ben isn't living her right now, I get tempted into working way too much. Ben has an interview closer to here on Thursday next week and I will jump for joy if he gets it. I'm tired of living alone. I woke up last night in the middle of the night thinking someone was in my house. It was really creepy. I needed my Ben.

In other news, the tour de france time trial is tonight and I'm hoping Cadel Evans pulls it out of his ass tonight and gives one last showing before slipping away into the depths of the peleton for the rest of the race.

Residency has started and so far I've only been home before 11 pm one day this week. But, it's totally my own fault so don't feel sorry for me. I'm always tempted to stick around for that one more delivery... which last night turned into 5 deliveries. But, I need the experience and as the only resident on the service I get first dibs, which is awesome. I did my first c/s first-assist last night and it was great. The docs are fab. I'm having a good time.

Plus, my family clinic half days are going really well too. I love my preceptor and we're pretty alike. It's most excellent!

Hey all,
If anyone's still reading this blog, I'm on vacation and I'm trying to really vacation, which means trying to de-stress. I've been having a lot of heart palpitations and I'm trying to do everything I can to relax. Funny thing is, I think they're caused by relaxing. I had things to do for the last 2 days and the palpitations went away. Funny that. Maybe going back to work on July 2 will solve them all together.

Anyway, my relaxing hasn't left much to write about. I've been making bread and making a quilt for my new niece and both are going quite well, although the quilting is getting a bit tedious near the end.

I hope everyone's doing well. I'll write more once there's something to say.

Big Week

This week was a really big week for me! I graduated on Wednesday and I have a new niece! My brother had a beautiful baby girl, born at 34 1/2 weeks, weighing in at a slight 4 pounds 14 ounces. She's doing fine and has been moved into the feeder and grower area of the NICU. She's lost all of her tubes and wires and seems to be holding her own. I went to visit yesterday and holding such a small baby is weird! Especially after holding my 9 month old nephew a couple of hours earlier.

Tomorrow is the baby shower we're throwing for my brother and sister-in-law. It was supposed to be before the baby was born but... oops!

Epic 8 hour

Yesterday Ben and I did the Epic 8 hour mountain bike race at Albion hills. My goal was to do 4 laps and I did 4! 4 really good laps without falls and riding everything except 2 steep hills that most others were also walking. Ben did 7 laps for a total of 11. We came right in the middle of the pack of 20, 12th. If I wasn't so slow we could have done better, but just finishing the race was a major accomplishment for me.

The only downer of the day was on my last lap about 300 meters from the finishline. A guy came up to pass me on the left and clipped my handlebar with his and took me out. I landed on him and his bike and had the wind knocked out of me. In his excitement over his fastest lap of the day, he forgot to call out which side he was passing on and as it's a long gravel straight it's hard to tell how far back the crunching gravel sound is, so although I knew he was there, I couldn't tell where. In mountain biking it's the responsibility of the faster passing rider to call out which side they're going to pass on if it's double-track and it's more of a negotiation on single-track where the faster rider tells the slower rider they're there, then the slower rider finds a place to slow up and pull over a little and tells the faster rider which side to pass on. 99% of the people yesterday were excellent passers. About 1% were complete assholes, which amounts to about 3 people who passed without saying anything or at inappropriate times and shoved me off the trail. That's a pretty good record for this race and really does the mountainbiking community here credit.

Anyway, so I have a really bruised up left leg and a somewhat bruised up right leg and I thank god I was wearing pads. I still had fun :)

The day after I book my holter and echo the palpitations stop. Isn't that always the way?

In other news: Ben and I went and rode the Hydrocut mountain bike trails in Waterloo and they were amazing. They're really well set up and maintained and use the small area of woods really wisely. There are some wickid climbs and by the end of our 20k ride I was pooped. Hopefully the course for the 8 hour this weekend won't be as hard as what we did today because then I'll be fu*ked after a couple of laps :)

This week is going to be full of apartment hunting and bridesmaid dress hunting. Still haven't been able to find dresses I like. Might have to *gasp* go into a bridal store (I've been doing my best to avoid them).

Why is starting residency so expensive? 500 dollars to the CPSO, 152 per month to the CMPA, a couple of hundred to register with my new university, having to start paying disability insurance to avoid having a physical if starting insurance after starting work (haven't decided how much insurance to get yet). All this and I have yet to get my first paycheck! Good thing I have some savings. I'm trying to budget out my money for next year and I'll tell you one thing - a resident's salary doesn't go very far.

So, I went to our local conservation area to do some mountain biking today. I was feeling very optimistic after a bad weekend bike in the mud that ended with some bruises and almost tears. I was timid today because I was on my own and not feeling super comfy on the bike as it's still pretty early in the season. I challenged myself to ride a few things that I had chicken out of in the past. One of them involved a steep descent with a sharp right hander and then some boulders. It took me a few attempts to get through the right hander and then I thought I would just sort of step the bike down off one of the boulders because the line was really good after that. Bad idea. I endo'd and then faceplanted into some bushes. I got up and checked my teeth - all still there, but had a wickid bloody nose and did something funky to my neck. I'm alive but shaken. I went on and rode a few easy sections of singletrack because everyone knows you've gotta get back on the bike, but man, it hurt. What a way to ruin a good sunny mountain biking day.

palpitations

I'm using this post today to vent some anxiety. I had a whole day of palpitations last week, chalked them down to studying for the big exam and being nervous. They lasted about 8 hours. On Sunday evening I started having them again. Went to bed hoping they would be gone in the morning. They weren't. Spent 3 hours having them and then started freaking out. Had a bit of chest pain (probably psychosomatic). Went to emerg and felt really stupid, only had one PVC on the EKG. Blood work fine. Doctor recommended a holter if I still had them and they were worrying me but he can't order it. Today I woke up having them again. I'm sure they're PVCs or PACs but they're freaking me out and they're making me afraid to do things like go for my run or go to the gym. I know that they're normal in young people but when they're bad I'm having them every few beats. I am an anxious person by nature and I'm sure that's not helping. Phew. I needed to get that off my chest. I'm a normal healthy person and this is just freaking the shit out of me.

My ego is a bit bruised and I'm nursing it with mountain biking, running and beer. I'll post more when I feel a bit better about myself. I'm enjoying life but dreading the time for results of the LMCC.

Piece of crap stupid exam I hate you.

The big exam is tomorrow and let's just say that I'm freaking out. I don't feel ready, but I also feel like I couldn't study anymore. Studying has taken over my life for the past 2 weeks, like a 12 hour a day job and I'm ready for it to be over. But I'm not ready to take the test. Funny how that works.

Burning heart

Does basil cause heartburn?

Stage II

Now I'm actively in stage II of LMCC prep. I've finished reading the Toronto notes and now I'm on prep questions. I'm currently doing a USMLE step 2 practice question book because it's well presented with answers to all of the questions. I have a couple of other sites and practice questions but the answers aren't as well laid out.

After this: on to more questions and doing the community health and epidemiology pretest to see if I can learn something about studies and 2x2 tables.

I'm having weird fluttery chest feelings. I've been having them for about 2 months but they've really stepped up in the past week. Originally I thought they were esophageal spasms not cardiac and I have no other cardiac symptoms, but, my pulse was a bit irregular today. I have a doctor's appointment next Friday so let's hope I can wait until then.

Blog Spam

What's up with people leaving lame ass comments just so they can advertise their own blog? I'm sure the information in this blog is "well layed out and thoughtful" but I'm pretty sure you also didn't read it Mr. nutrition blog. I'm going on a quest - from now on I'm deleting all such comments.

Idle Threats

so,
Yesterday I got an email from one of the administrative assistants of a department at my medical school saying that if I didn't locate and hand in an evaluation (that I thought was handed in) I wouldn't convocate with my class. I had emailed said admit assistant 3 weeks ago to ask about the form and never heard back, so I thought the doc who had the form had handed it in. Turns out he didn't. He also didn't reply to any of my emails. I spoke with his secretary yesterday and she had no idea where the form was.

After a day of stressing myself to death, the form was in this morning.

Too much stress for LMCC studying time.

The weatherman lied

Well, Saturday morning WAS gorgeous. But, I am still resentful that the weather man lied and Sunday was a bit more dreary than expected. Also, weather.com said maximum 1 mm of rain on Saturday, I laugh to hear it, the torrential downpour definitely yielded >1mm.

In other news, Ben and I didn't go to the race this weekend. Instead, we went biking for 3 hours on Saturday morning/afternoon at Albion Hills then went to my parents house and made surf and turf bbq in the rain. Pickerel mmmm. The biking was good. Made me realize how out of shape I am and how much I need to step it up if we're going to do the Duke's 8 hour later in May. Thankfully, after my exam I have nothing else to do except line up at the passport office to get a new passport.

Gorgeous day

It's a wonderful beautiful sunny day outside and I am studying... bah humbug. I'm going to go sit outside and pretend to read the Toronto notes. Then I'm going for a run, because I need to enjoy this sunshine. Hallelujah, winter's over! We hope.

sad news. today, after 6 years of loyal service, my ipod bit the dust. I loved that thing. Huge, white, high tech that became low tech. No click wheel. Buttons that are not too uber sensitive. Ah, ipod, I hearted you and now you're blank and don't have the necessary files to connect to my computer. Sounds like your wee hard drive is fried.

Should I get another? Or is there some new fancy music device on the horizon.

Got back on the bike today after Sunday's challenging times. Bum was sore, neck was sore, elbow was sore, but otherwise ok. Too windy though!

Well, I finished 60k without training for it. I guess this is the best thing I can say about the ride yesterday. In truth, it was really really hard. The wind was a direct headwind gusting 50km/h which made it brutal. It was cold and the ground was quite wet - making the grass sections sodden and a difficult slog. The singletrack, however, was fun. About 40k into the race I started cramping. First my adductor longus, then my quads to the point where I couldn't flex or extend my legs and I had to semi-crouch and bang my legs for a few minutes with my fists, then my gasterocs. Nobody else knows how cramps feel unless they're also suffering. There was a girl on another girl/boy team who was suffering as much as I was with hideous cramps. We would both ride for 15 or so minutes and then have to get off and stretch and the other one of us would pass on one of our riding stints. We must have switched places with them 20 times. At some points in the race I must have been pinching my median nerve with my handlebars because I started getting shooting pains in my hands and 4th and 5th fingers. That was fun.

All in all I learned a few things for next year... oh and there will be a next year, and I won't suck. I will train. I will eat while on the bike. I will figure out which fancy bike food works best for me because trying to eat granola bars with dry wind blown dust mouth was not working. The only things I could eat yesterday were jellybeans and fruit leather. I drank gatorade but it wasn't enough. Oh, Paris to Ancaster, next year you will rue the day you messed with me.

Yesterday was my last day of medical school. It really hasn't sunk in yet. I have my LMCC part 1 in 2 weeks time and I feel very under studied. Tomorrow we're doing a 60k bike race which we're not very well trained for. Wish us luck!

I hate when you go to bed knowing someone is going to deliver. It seems like such a tease. But.. she's a primip... maybe nothing will come of it.

I really want to spend all morning messing around on the internet instead of studying... hmmm. The LMCC is coming at a really bad time for me in terms of my motivation to get any studying done. I have about 3 weeks left to study for it and I have SO MUCH left to do. Seriously.

Baby Count

I think my baby count is up to 4, 7 if you count C-sections. I wish we had ore. If I was here on weekends I think I could be up to 6 vaginal deliveries. I think I'm improving with my dexterity with each one to be able to do more myself with the coordination of cord gases and baby care and placenta management :) When it's just the Mom things don't seem very complicated, but when you're looking after the baby too, there's an added layer of complexity. My vaginal laceration sewing is getting better too. Of course, nobody wants anyone to have a tear (I managed one tear-less delivery) but the jigsaw puzzle of tissue is starting to make more sense now. It's funny how when you look at enough of them they actually start looking like something...

Fight

Argh. I got into a fight with my mom. I hate fighting. You know when you want someone's opinion, but you want them to like what you like? We were doing really well over email with suggestions and corrections. Over the phone, not so well.

Today Ben and I went for a 45 km training ride. As Ben says, we were riding temp piano. It took us about 2 and a half hours. Hopefully when we're riding tempo forte it will be a lot quicker. We're ramping up to ride Paris to Ancaster in two weeks time. We're doing the 60k, which is longer than either of us have raced before without it being a relay. Ben is nervous. Maybe ignorance is bliss, but I'm pretty stoked.

The haircut went ok, but she chopped a little more than I'd like. Plus, she spent the whole time insulting my previous hairdresser. Not the way to have me come back again. It's not my hairdresser's fault that I'm growing out my pixie cut into wedding hair. Jeeze.

I'm going into my last 2 weeks at this family doctor's office. It's been a really good learning experience. I'm going to have to get off my ass and finish the course work for this block - some logs about patients, a community description and readings for a MCQ online quiz. I found out the other day that I passed the surgery exam, which is awesome. No more worries about that. Now I just have to get one of the supervisors to hand in an evaluation that he has lost somewhere and I'll be able to graduate. Maybe. :)

2 weeks and counting until the end of med school!

I'm getting my haircut today. I'm not confident that the lady is going to understand "just a trim" because they never do, do they? I have another 6 months to grow out my hair for the wedding and I don't want any setbacks! Not that the hair is all that important. It's more the tiara that's the important part :)

Sorry for not updating. Things are good. I've delivered 2 babies this week so far and it's only Wednesday. We had a section last night too and it went very smoothly. I'm getting ready to order my wedding invitations and my sister is going to help me make my second invitations for Scotland. I hope they don't look daft. I hope I don't have to pay huge duty on the invitations coming from the states. Why can't I get cute bicycle and bird invitations in Canada?

Work OUT

My sister has started a new workout routine. As I am trying to get in shape for the mountain biking season, I joined in. Yesterday we did the video the "30 day shred" level 2. Then I died a small death and then today we went jogging! My favorite! Erm, now I can't sit down, or get up, I can only stand. My only solice is that my sister hurts like I do. And that I can justify having some ice cream.

I delivered a baby today! Our second delivery of the week (our first was vaccuum so I didn't do it). I love delivering babies. It always makes me emotional.

Hopefully more will happen this week and then we'll have a nice weekend. I'm catching up with an old friend on Friday for coffee and I'm looking forward to that. Plus, he's a massage therapist, maybe he'll give me a discount :)

I got my new car this weekend! It's a manual so I've been spending the weekend reaquainting myself with driving manual. It really adds some excitement to the driving experience. Now I'm back to work but there's nothing happening this morning. I'm hoping that there weren't too many people who delivered over the weekend. I have 4 more weeks here and I'm really hoping for a babyfest. My cold is getting better, which can only signify good things to come :)

Dr. K's advice was excellent. I called my dad mid-meltdown and he called his insurance agent and saved the day. Things should be all set for picking up the car on Saturday. I'm stoked.

I have a really sore throat. I'm peeved - I feel like I've been sick all winter and now it's spring and I"m sick again. My nephew has the "coughs" and I wonder if this is the prelude.

Tired of being a student

I'm so tired of being a student. I can't buy my own car without a cosign, I can't get insurance without being on my parents policy, I can't do freaking anything. I'm emotional today and I had to sign up for my LMCC which hasn't improved my mood. No babies are born yet. Ben isn't very sympathetic which is making me feel more pathetic. Who cries over insurance? I guess I do.

I am SOOO old. I bought a car this weekend. A Mazda 3 in (hopefully if it's still available) electric blue mica. It looks like this:
if not the electric blue, I'll get the dark grey or silver. Whichever they can find in a 5 speed manual for me. I signed a 5 year car loan, which doesn't mean much because it's only 1.9 percent and I'll be earning more in 2 years anyway so I can buy out the loan. I also bought some awesome mountain bike shoes today, 50% off at the bike show. 'Sidi's which are the best brand ever made basically.

I couldn't afford them at full price but at half price they're cheaper than any other 3 strap ratchet shoe on the market. Score. Good think I'm a woman with size 41.5 feet. I got the last pair.

The weekend has been too short. I'm ready for a good night's sleep tonight. Barring any babies of course.

Staying with my big sis

I'm finishing up med school by doing my family medicine rotation. I'm doing it in Guelph with a doctor who does afternoon clinic 4 days a week + OB. I think he delivers half the children in this city. Unfortunately, we only had one delivery this week since I've been here and he didn't call me for it because he didn't want to waste my whole day on an induction - I assured him yesterday that I want to see EVERY SINGLE BABY born in the next 6 weeks.

One of the best things about this rotation is staying with my sister in Guelph. She has two kids and is on mat leave so she's home for at least part of the day when I'm home. It's fun to hang out! My nephews are so darn cute. the littlest one just started to sit up and he's so cute. He has the best social smile ever. Plus, my sister makes me dinner. That's a great novelty. I feel bad, but I love it too. Next week I'll make the dinner.

Match day

So, although I had a good match day, some of my friends did not. I won't go into any deatils but I had a couple of friends who were bitterly disappointed by their results. I'm sure, in time, they will come to peace with it, or not, and move on. One friend considered her results such a failure that she was considering a career change. I think match day is a bad day to make that choice. We all thought it was over when we got into medical school and were told we would be doctors some day - what a load of bull. If only we had known what was coming. In good news, there were some very happy surprises and some expected good results among my friends as well. This helped to take the edge off the tearful phonecalls and consoling words that just couldn't say enough. I wish I was at my university on Monday to sit and be with the people I care about, instead I was at the other end of the phone trying to convey a hug through words.

In other news, I want to get on with my internal match to one of the two sites within my program. I haven't been contacted by my matched site yet and I'm wondering when that's going to happen! I hope soon.

I'm super stoked. I matched to my first choice! I'm nto sure if I should reveal what that is here because I'd like to keep this blog going. Maybe I'll start residentitis. Thanks for all your support!

Tomorrow is match day. Duh duh duhhhhhhh. I'll let you all know how it goes - if I can ever remember my password for logging onto CaRMS.

Tomorrow is my LAST NBME exam! Hoorah. I just have to pass it. Tomorrow is also my last block exam of all of medical school. hoorah! Monday is match day. LMCC is a month and a bit away. Graduation is May 27. Things are moving very very quickly.

I have had really bad pimping days lately. Days in which I cannot answer a single question. Plastic surgery just doesn't seem to be my bag, but not only that, many of these things are simple family medicine things. For example: I cannot tell you whether a lesion is suspicious for basal cell, squamous cell or melanoma. I cannot tell you what the cardiac dose or anaphylaxis dose of epinephrine are (granted for the cardiac thing I haven't taken ACLS yet). I constantly forget the word tenosinovitis. I don't feel the bump that you're trying to tell me is there on the fractured but non-displaced zygomatic arch. These are only a few of the things I don't know. Life just sometimes seems to be going forward without me acquiring any more knowledge. That sucks.

2 days until stupid exams.

Good things: I was on call last night and never got called. There were muffins left this morning in the call kitchen. I am going home at 8 this morning because there are no ORs. The weekend is here.

Bad Things: I haven't studied enough for my surgery, anesthesia and ER exams. I can't remember the things I need to remember for technical skills OSCE. I am burned out.

Sorry for taking a little hiatus from the blogging. I started plastics this week and it's not too busy but long hours and early mornings (groan) and I'm studying for 2 exams and an OSCE that I have next week. The grandrounds went well and really stimulated some discussion but I"m putting working on the associated paper on hold until I get my life back. Match day is March 9 and I'm pretty nervous. The next two years will be decided for me in one minute. Eek.

I feel very fatigued today. This will be my third 4 to midnight shift this week plus 1 day shift on Monday (I didn't get a stat holiday, boo!). I have a really hard time winding down when I get home from an emerg shift. You use your adrenaline to keep you going in the evening and through those last cases on the table at the end of the night so when you get home you're pretty wired. I try to have some herbal tea, watch some tv or read a book then get to bed. This morning I had to be at the hospital for grandrounds at 8:30 and it was a tough sell. At least I stayed awake through the whole thing! I'm giving a grandrounds presentation at another hospital tomorrow, wish me luck!

Back to work

I can't say that i'm exactly sad to be going back to work in the ER on Monday. I can't exactly say I'm happy to be leaving Ben either. It's a giant catch 22. I have 3 more weeks of rotations at my med school's home hospital left. Then I have 6 weeks of family medicine in the city where my sister lives. I'm going to be their 6 week houseguest, I don't think her husband is very excited about it but I totally am. I have lots of fun every time I stay with Erin and her fam. We have good sister bonding moments. Unfortunately, this time there is also some manditory studying for the LMCC that's going to have to happen. I've been slacking lately because I really needed a bit of a break. Back to the grindstone!

On another note: I have a new obsession with eating cottage cheese and broccoli with pepper on them. Don't ask me why I think it's soooo good. Mmmm.

This week has been a flurry of activity so far for Ben and I. We did two things this week and are going to do a third tomorrow that we always talk about doing but never do. Monday we went to lane swim at our local pool. Tuesday we went skating at the local skating rink - which would have been more fun if there were less children (is there such a thing as adult skate?) and tomorrow we're taking a spinning class at our local bike shop. I spin already but at my gym that Ben isn't a member of, so I'm excited to take him to his first class. It could go well or horribly wrong, since Ben doesn't really like people telling him to push himself harder and make himself hurt. I'll have to pass on the secret of putting your hand on the spin resistance wheel but not turning it up when you're just too maxxed out to go any further. I feel that it's up to you to take control of your workout and often I push too hard at the beginning and have nothing left - it's all I can do to keep up the resistance I have, that being said, I still put my hand on the wheel to fake it. It must be my fear of disappointing the instructor!

It's been fun to do so many things together but expensive! The gym is essentially free for me because I pay one lump sum at the beginning of the year and then forget about it until the next September. We get a corporate rate at Goo*Lif* through my med school which is very reasonable. Hopefully there will be some deal through residency next year too. I'm too cheap to pay the full thing. I really like group exercise classes so it works really well for me. If we were going to swim a lot, I'd probably get a membership to the pool because shelling out 6 bucks each time feels steep. Skating was cheaper but still 3 bucks each or something. I wish you could just get a rec membership for the city that let you into everything. Hey, maybe you can and I just don't know about it. Since I don't actually live here, it wouldn't be worth it for me this year, but next year when Ben and I are in the same place we should look into things like this. It's nice to do things together.

Sleeping sickness

Every few months I get a few days to a week where I have a really hard time not sleeping every hour that I'm not at work. I get these feelings of overwhelming fatigue and the minute I sit down to study or do anything where I don't have to talk to people, I fall asleep. Fast asleep. This past week that's been happening to me. I got up at 9 this morning and was napping by 11:30 and could easily fall asleep again now. What the heck is wrong with me! I guess maybe I should have had caf instead of decaf this morning.

Edit: the antenna on my car also got crunched in the carwash that Ben forced me to go into today. Boo that.

CaRMS rank order submission starts today, eek! I've got my first two choices set but after that the waters are a bit muddied. I can't decide what to do with third spot. I have two contenders - one is the known and one is the unknown.

Just for fun Ben and I have been looking at the MLS listings for the places we're putting 1 and 2 and trying to see if we could afford to buy a house - a fixer upper perhaps. Things look good in one place and a bit expensive in the other. We'll see what happens!

Sometimes I look at my Clustrmap and get really intrigued by who is reading my blog. Especially the person who is reading it from Manitoba somewhere in the region of Wapusk national park or perhaps Thompson. I am not spying on you whoever that is and have no idea hwo you are - I just find it fascinating that someone from there is reading this blog. Likewise that there are people from all over Europe, Africa, India, Australia and Southern and Central America who have at least taken a gander.

This morning they turned the water off in my apartment. I showered beforehand but now I have to go to the bathroom... I'm torn about what to do!

Save the dates

I finally finished the 'save the date' cards for our Scottish wedding. Since this version I did change around a few of the birds on the tree so they looked more random but this is the gist. I originally wanted to use a photo of us, but it was getting really hard to get good contrast with the text so I went for this instead. I'm thinking of using the two birds at the top of the wedding invitation and on the reply cards.