R3

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!

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!

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

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

LMCC II study day 1

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

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

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

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.

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

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!!!!!

I hate when a delivery goes well, but not perfect, and I come home and obsess about it. Is this going to be the story of my career?

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.