End of the sleep age...

My anesthesia rotation is officially over. It was amazing! Procedures, little supervision as to what you were doing when you weren't in the operating room, everyone easy-going and just wanting to make sure you had a good time and got to do and see things! I am told that this is definitely not the norm. Now, to start working Working People hours! Working People! That's like...8 or 9 hours a DAY!! IN THE SAME PLACE! Ok, I have definitely been spoiled. I have yet to work an 8 hour day and am nervous about starting this crazy transition to the...dare I say...real world! gasp!

I have avoid said "real world" as long as possible. I have been told that LSU is more like Imagination land rather than the real world because they get money from the government and operate completely differently than private hospital. But all this aside, it will be a welcome change from spending 8 hours a day in two different places but always behind a book.

I am excited to start my Family Medicine rotation next. Of the 10 work days I spend on this rotation, 4 of them will be in Zachary, Louisiana seeing how family medicine works in a small, privately own clinic...a far cry from LSU's free care clinic. The patient population varies but so do the types of problems. This is why they are implementing these changes. (We are the first class to do this and are therefore glorified guinea pigs...well, not even glorified, just guinea pigs).

So I'll keep you updated on how things go. But I am definitely optimistic.

Also, should get my scores back next wednesday...at least that's what I'm hoping.

Birthday Weekend!!

Birthday weekend was AMAZING!! Well, it seems I've been celebrating a lot longer than that. Last weekend was amazing too!! Went out on the boat with a very happy puppy! (forgot how much fun that is). Got to visit a beautiful baby boy all day then came back to the Craig's for a surprise visit from Mom, Daddy and Rebekah! We had stuffed Papa Murphy's pizza and delicious cupcakes. Mom gave me her golf clubs so that Roger and I can play together! Great weekend. Then came my first week during 3rd year. The week ended, then came...the birthday!

It started off with a big huge from Molly...well a very needy puppy decided I looked like a legitmate body pillow and piled on. This all after I got to sleep as late as I wanted! Then we got up and went to IHOP for breakfast. I got to bring my new wallet/purse Bethany gave me for my birthday (It's amazing, holds everything including my phone and my keys and fits in my white coat pockets! and it's really really cute!) As you will notice in the picture below, someone at IHOP was a little hungrier than someone else! :)

Next is was home for some relaxation time, then up to the church to finish an announcement video. I worked on learning how to make a collage of pictures (as seen below). Then we came back home and went bike riding. It was a lot of fun. If you stay under the trees, the breeze and the shade made it a really enjoyable ride, even at 3 or 4 in the afternoon. But I'm still majorly out of shape so back at the house, I collapsed on the floor. Then Daddy called and sang me my birthday song....

But wait, toward the end there were...2 birthday songs! They were at the door! It was amazing to see mom and dad for my birthday. They, of course, came bearing gifts...OF CHOCOLATE CAKE!! We relaxed then went off to the boardwalk for crawfish ravioli, spinach and artichoke dip, and Caesar salad. Yummm! We were so full by the end of the night we didn't even have time for birthday cake. To solve this problem, the next day we ate chocolate cake for supper!!

The morning brought a great visit and some more great food at Strawns. Mom and daddy dropped me off at church then headed home. Roger and I went to church, then came back to the house and slept until 3! too much fun for one weekend. The rest of the day was nice and relaxing. It has been suggested on facebook that I turn my birthday into birthday week... I am not sure I can take much more! surprise visits, cupcakes, boating, intubating, starting IVs, relaxing in the evening and not studying, IHOP and bike rides and more surprise visits and copelands and strawns! ohh my! So much fun and so much love from so many amazing people! I am so very blessed to have so many amazing people in my life who love me some complete. I can never truly express my gratitude!

Just another day...of awesomeness!

Today was my first monday of third year. But today felt like every other day on anesthesia rotation since the hospital only casually acknowledges weekends. Today, however, we were suppose to page Dr. Chandler, a woman with lofty ambitions about what the new anesthesia rotation will be like. She was on vacation all of last week and this week she is on call for two of our 5 days with her. She has still yet to make out our test for Friday, which is great.  We are hoping that she uses the one from last year. 

As far as getting to do stuff today, I go to intubate two people today, each with a nasal intubation. They were having surgery on their mouths which required them to be left accessible to the surgeons. So the tube when in their nose and down in between their vocal cords.  The first patient I got with no problems. He was young and really healthy.  He was having his jaw broken and reset.

The second intubation I wasn't able to get. The CRNA I was following likes to use a straight Miller blade rather the a curved Mack which I have learned on. Although the concept is the same, there are small difference between the two.  The Miller relies on the aligning of the planes in the mouth by positioning in order to see the cords. It also requires less strength as the alignment of angles is doing all the work for you. This technique takes more time to learn.  The Mack is great at pushing fatty tissue out of the way and holding large tongues to the side as you look for the airway. It's curved and more easily allows you to follow the pathway to the back of the throat if you haven't gotten the angle perfectly.

Both blades work the same way and it's really a matter of preference. There are many ways to establish and airway for a patient, it's all a matter of what you have to work with, both in your patient, your equipment and your own knowledge.

End of the week, start of Birthday Weekend!!!

My first friday of third year. I am kind of a dork and wish this week was a full week, but I am looking forward to sleeping in tomorrow. Today, I got two more intubations and I am learning to better manage my time as a third year. I found a woman in the holding room and stood by her bed until the CRNA came by and asked if she was a good candidate for me to intubate. She said to talk about it later and I thought I was in trouble. The woman couldn't have been nicer but didn't look like the typical LSU patient.

Her mother was there and they both took an extreme interest in who was going to be in the room with her, writing down every name. I didn't think anything about it. They say that is more common with parents of children having an operation and I took it that this woman was just watching out for her 30 year old daughter going into surgery. She also mentioned that ENT (ear nose and throat) would be doing the surgery and I still failed to get it. I thought they were going to remove nasal polyps or something of the sort.

It wasn't until we got into the room and the patient was put to sleep that the CRNA told me that all of these small deviations from the norm that I had observed are because this was a "plastics" patient. I was blown away because just a few minutes earlier I was thinking that I had never seen a patient look so good going into surgery. This woman was gorgeous! I still don't understand why she was having the surgery, but that's not something I'll ever know.

I asked another CRNA why a rich woman was having a nose job done at a state/charity hospital and she said that the plastics doctors specializing in ENT have privileges are multiple hospitals and probably could get in here the fastest. She also said that LSU has some of the best plastics physicians around. Who would have know?

After this, we got to go downstairs and play with the very smart dummy that has pulses, heart sounds andt talks to you. They call it the simulation lab and you get to run through a case and see if you know what you are doing...basically does your patient live or die. Ours lived for today but next week their will be complications that he wants us to be prepared for, so next week I'm not sure iSTAN is going to make it. But we're hoping for the best. Either way, it'll be really cool. Great end to a great week. Now for my birthday weekend!!!

Intubation

I'm so excited about what I'm doing and seeing I wish everyone could experience the excitement and thrill of being able to be a part of saving a life or making someone's life better.

First off, a little bit about intubations. They are only done when necessary to do major surgery. This is to put you into a deeper sleep than what you would experience at the dentist office, although some of the same medications are used. The reason a patient is intubated is that the procedures that are done couldn't be done when the patient is awake because they would be far too painful. The procedure goes something like this.

The patient is brought into a waiting area, where their family waits with them and the doctors come by to see them and check everything over one more time before they go to the room. The trained nurses put in ususally 1 IV in which to put the medications/fluid/etc into the patient. They usually receive medication for nausea/anxiety at this time if they want it. Then pain medication is given. They are then taken to the operating room with the nurses and CRNAs. The room is preped and the patient is made as comfortable as possible, usually with warming blankets, etc. Everything is set up and the patient is moved to the operating table. After they get comfortable and properly positioned on the table, they are given some pain medicine and ususally a muscle relaxant. They then go to sleep by breathing in oxygen. After they are properly sedated a tube is inserted into their mouth (intubation) in order to breath for them during the procedure. This is to enable the patient to be put into a deeper sleep so they won't feel any of the pain during the surgery. After this, sometimes an additional IV is placed in the other arm. This is the one that is available to be tried by students because the patient is alseep and muliple sticks will not annoy the patient. A trained professional is watching over your shoulder at all times and helping to prevent you from doing anything that would harm the patient. This second IV is usually only used in emergency cases but is good to have for precaution sake.

After the patient is intubated, they are constantly monitored by the CRNAs watching the blood pressure, pulse, temperature, air saturation, amount of air in, the pressure of that air, the amount of gas and the physical actions (if any) of the patient. The body has a lot of reflexes and if the patient moves during surgery, it is always reflex actions. These are not conscious movements because the patient is not conscious.

The pain medicine that is used works on the pain receptors in your brain so that they are no longer firing (same as Tylenol). They also have an amnesia affect very similar to what you would think of with alcohol. Time passes, but you don't really remember what's going on. The drunk affects or amnesia effects of these medicines is an added benefit and not the main cause for the use of the drugs. The recommended dose of the drug is the amount of drug needed to remove pain in 50% of people. Some people's pain receptors are more resistant to these medications than others. But the amnesia effects (just like in alcohol) are always affective at the recommended dose in everyone. the benefit to the amnesia (and it's only a benefit and not the main reason for the use of the drug) is that if the person doesn't respond to the recommended dose and feels any discomfort, the amnesia is in effect, so the CRNA can focus on fixing the dose rather than on the fact that the patient is experiencing pain. These nurses and doctors are very attentive and right down vital signs including blood pressure, pulse, temperature and how much air and what pressure the air is at every 5 minutes. Each of these inducators helps the nurses/doctors to know the state of the patient, whether they are resting comfortably or not. They are constantly adjusting the gases in order to keep these number in tight ranges and therefore the patient stays as comfortable as possible.

Intubations and gases which happen to produce amnesia but also anesthesia (or no pain) are life saving. The reason I was unable to intubate my patient today was because she had an ectopic pregnancy or a baby growing somewhere other than her uterus. God made us very well and has a special place for women to grow babies. Babies grown outside of the uterus cannot survive for lack of room and access to nutrients. What the baby can do is grown big and into things, rupture and lead to the death of the mother because of massive blood loss. That's what this woman had. She was bleeding on the inside and feeling excruciating pain. You couldn't touch her belly without her crying. The pain medicines and intubation allowed the surgeons to go in laproscopically and remove the ectopic pregnancy, remove the blood and stop the bleeding.

Intubation saved this woman's life and many others each and every day. The nurses/doctors are not naive. They are aware that nothing in medicine is benign or not able to hurt you. As some physicians like to say: every drug (or thing you put in your body) is a toxin, in the wrong doses can be lethal. Just think of the woman who drank too much water. Even water can be toxic. Therefore, the decision to do a procedure under anesthesia is not taken lightly. There are risks involved and they are most definitely considered. As many physicians have said: medicine is all about risk/benefit. Everything has potential to hurt you and lots of things have the potential to help. It's about the risks verses the benefits that have to be considered for every patient, every time.

First Real day of school

Ok, so today is the first real day of school or the day where we went into the hospital and got to see cases. The first case I saw was of an 80 year old woman with a colon that was being removed laproscopically. I got to watch this intubation. Next, I got to see a little girl intubated, which is a little different. She was there to evaluate a mass which turned out to be benign and was completely removed. She's recovering nicely. The third case I got to see was AMAZING! The head and neck surgeons (went through dental school, last two years of medical school, then through oral surgery residency and are now on their fellowship for head and neck cancers...they must really like school) were removing a mass located in a very dangerous position on her neck. The nurse anesthetist had drug to push her blood pressure up or down ready at the push of a button. Lots of excitement over this case, and the four 4th year medical students who were standing around couldn't see much of anything. Since I was rotating with anesthesia, I was able to get a look in to see what everyone was doing! Soo exciting!!

After this came my excitement!! Some of the Certified RN Anesthetists (CRNAs) asked if I had gotten to intubate yet, and I said no. They found me two cases. The first I tried to intubate but couldn't see completely and wasn't 100% confident of what I was doing, so I removed what I had done and let the CRNA do it. He later said that he thought that I had it the first time and know that I knew how to do it, he would expect me to get it the next time. Right after that, I found another case and asked if I could do the intubation and tat CRNA was amazing! Very encouraging and honest about the whole thing. First try and I DID IT! I was so proud. They checked my work, listened to the lungs and the stomach and everything was good! Couldn't be more proud of my work today.

I did try an IV on a guy after he was asleep and couldn't get it. The CRNA even had trouble and we decided that it wasn't us, it was the man's hairy hands! Everyone there was very friendly and some of them are excellent teachers. I went to lunch, came back and found that there was nothing to do. The CRNAs told me that I had stayed waaay longer than medical students usually do and said to go home. So I obeyed. (I'm such a good student like that).

I realize that I am naive and innocently hoping for the best out of this year. I know from what I've seen so far that there will be plenty of misunderstandings and lack of guidance to get us where we need to go. But overall, I am so very thankful to be starting out where I am. I start on an easy rotation with laid back people working along side 4th years who know the ropes. I am pumped about what new adventures lie ahead. I'm also hoping to gain inspritation from these posts in a couple of months when I'm exhausted and frustrated. God is so good.

First Day of School!

Well, just got done with my first day at school...i actually got home before 10:00am but whose counting! I am starting on Anesthesia rotation and everything is different this year than last year, therefore: MASS CHAOS! The resident told me to show up at 6:45 and go to the operating room. The nurses there said, "you're not suppose to be here, go to the second floor and talk to anesthesia, not the surgery people." I go to the second floor and was told, "If you're here to do IVs and intubations then you need to come back at 8:45 because those procedures don't start til 9. Go get some coffee." In the cafeteria I met a friendly 4th year who helped to straighten everything out. He told me I was suppose to go to the 4th floor (no the 2nd or the 3rd) and ask for Trish and she would get me set up! So I finally found the place I was suppose to do, met up with the Chief Resident who's first words were "Oh, there you are."

As I waited, the two other members of my group showed up and they are actually 4th years and have already done this rotation and are just using this as a time to study. This is excellent because they know how it use to be (a breeze) and they are trying to help the program coordinator to change things back to the easy way (and the way that seems to work better). Besides, the director of the rotation and the others who want to make it harder are all off on vacation this week. So today, I watched a video on how to intubate and then fourth years showed me on the dummy. We practiced til about 915 and then she told us to go home and come back tomorrow. Maybe someone will be around in order to teach us. Until then, it looks like I get to learn from the 4th years, who know all the tricks.

Overall, a great day. So now I get to use the rest of the day getting the house in order and going grocery shopping. It was amazing to see everyone, but I am so happy to be home again. Tonight, I will try cooking in the crock pot...I'll let you know how it goes. Summer has been amazing so far, and by summer I mean this past week! I hope yours is going well. I love you all.

AC

Darn med school strikes again.

Med school has ruined my ability to combine my love of medicine and mystery. While watching a medical mystery show, the woman coyly suggest to check chromosome 4 for a CAG repeat. THANKS A LOT. I had to learn that one.

So when she smuggly discloses at the end of the show that the murdered husband's odd behavior was due to Huntington's disease, I am far from impressed. I diagnosed that 30 minutes ago!! And those tests take waaay longer than that!  Not to mention the totally geeky fact that this fictional character had a daughter who would now have a 50/50 chance of getting this same disease and suffering a slow, painful death at the ripe old age of 45. Yea, lady. You're a real hero!

I realize that my geekiness is reaching new heights and I must learn to adapt. So I've considered my options.

1: not watch medical dramas
2: get over the fact that they obviously didn't finish reading the Wikipedia article on their disease.
3: perfect my angry letter writing skills.

Last test!!!!

Ok, So tomorrow is my last test. This is a great thing and a not so great thing at the same time because there is so much that I want to do before then. So I've got my work cut out for me and I definitely need your prayers.

Week 1 lectures
Week 2 lectures
Week 3 lectures -done

2009 test
2010 test

such a short list yet so exhausting just to look at!!

Thursday

yesterday was a test question day. I typically get tired when taking tests. in the second hour, my brain gets tired and I start marking answers based on gut feeling and words that I recognize. The problem is that I must look at every question critically because they are trying to trick you by placing words in there that I recognize. My gut, I'm learning, is simply an organ for processing food and should not be relied upon to determine a correct answer...after all, that gut feeling was probably just breakfast.

Today, I have a lot to do but I'm running low on focus and energy. Today is our last day of lecture for our last test of our second year or medical school. How crazy is that??! I feel like this fact should give me energy but to be honest, I am very very tired. I would just go to sleep but I haven't found how to cover the guilt of not studying! (free gift from medical school)! haha

Lectures:
Clinical aspects of lactaion
puberty and pubertal disorders
breast cancer surgery
medical complications in pregnancy
prostatic and testicular cancer
materanl physiology
fetal physiology
menopause

First Aid review book
Pathology Test Questions

Tuesday

Roger is heading out today to go to a conference in the Baton Rouge. He's really excited about getting to spend some time with the church staff. I still am not sure what the conference is about but I just know everyone's excited to spend time together. Warren Jackson (the music minister) cooked for us again last week and sent me home with a lot of food so I'll be set for the week. I just need to remember to fix it and eat it! I do the typical: get busy, get really really really hungry and then eat the first thing I can find and call it a day).

Pray for the guys that they have a great, safe trip.

peri-natal infection I -done
peri-natal infections II -done
lactation physiology -done
clinical lactation
First Aid book
review kaplan pathology -done

Monday

Sunday was an amazing day off. I meant to read in two of my review books, but that didn't really happen and I just enjoyed the day off. It was amazing. Saturday night was also great!! Watched Knight and Day, Roger and I both loved it! Great dry humor. Absolutely wonderful. We ate sushi and drank Dr. Pepper. I had ice cream with turtle shell. Roger had strawberry cheese cake with ice cream on the side! It was absolutely wonderful. Today, we just had pathology labs where we review things we've already been taught. then we had a lecture from a lawyer telling us what to do when we get sued. He explained the entire process to us and what we should and shouldn't do. It was very interesting. Did you know that Louisiana has a cap on what you can get from your doctor?! it's 100,000. Which is great if you're a doctor and have insurance. Not everyone gets the cap, only if you do certain things and keep up certain paperwork, etc. etc. I don't really understand it all.

But my list for today is to read First Aid, and Goljans. And do some old Test questions.

Saturday

Review Week 2 lectures with Katherine

BOH
prenatal care
gonadal disorders
STDs
breast path
breast cancer -done
contraception- done
ped. urology -done
pharmacology: labor/teratorgens -done
pregnangcy/fetal testing -done
OB ultrasound -done
Impotence-done
GYN oncology-done
vaginitis done

Old Questions -06 test done
Goljans
First Aid

Friday, April 1st

pharmacology of labor and teratogens -done
pregnancy/fetal testing -done
OB ultrasound -done
Impotence -done
GYN oncology -done
vaginitis -done


Yesterday was wonderful, relaxing and refreshing. I slept great, got to talk to Bethany and Dad. Got my hair cut and colored. Had a wonderful dinner with my hubby. Overall, it was wonderful.....it just wasn't productive. I didn't get done anything for school, I didn't even get around to making a to-do list! That's how great it was!

New day, new list, new accomplishments!

Wednesday

Breast Cancer Endocrine Prescription -done
Contraception/Family Planning -done
Pediatric Urology done

Read First AID
Work on Patient presentation write up
Old Test Questions
read Goljans -read 8 pages

Had a really good day today. Mostly because we learned clinical skills- the pelvic exam. Our school as really good models to practice on which is a good thing because some people were all thumbs! it was amusing to say the least. They said I did surprisingly well for my first time. I was pretty proud. But I did pay attention and go towards the end. You get all the benefit of the correction of the others that way but you also have a higher expectation because they expect you to pay attention and learn from the mistakes of others.

Tomorrow will be a busy day, we get to learn the prostate exam, again on a life like model. They do make us talk to the models like there were really there so that we won't be as creepy when we see real patients. And everyone today kept getting hit (literally) for saying "s" words. Some of those are spread and stick. biiiiggg no-nos. Haha. It's amazing how far we'll have come at the end of this. Who knew you would have to hit the first 5 students in a row for using S words?? Too funny. Great day.

Tuesday

BPH -done
Prenatal Care -done
Gonadal Disorders -done
STDs -done
Breast Path -done

Present Ward H&P patient at 1:00 -done
Observe pelvic and breast exam 2:00 -done
Review today's lectures with Katherine -done
Read 30 pages of First Aid book (pg. 1-30)

Full day today. But should be fun!

Monday!

BPH/orchalgia -tomorrow

5th Ward History and Physical - done
present patient -moved to tomorrow
complete write up -moved to tomorrow

supper with the Jackson's! -done and delicious!! lot so left overs!


AMAZING PATIENT!!! For my 5th H&P, i got to see a patient with Hereditary Angioedema. We're actually doing research right now to create cases in order to test doctors, fellows, residents and medical students. The current cases are about angioedema, a life threatening condition which periodically causes your throat to swell up. She presents to the ER very frequently and therefore LSU knows her and knows what to do. If she goes to the other area hospitals she either gets too much or not enough treatment b/c they aren't use to dealing with this condition on a regular basis. It was such an amazing experience just to get to talk to her and spend some with her as she waited to be discharged. Her baby sister is currently at another area hospital delivering her first baby. Everyone is so excited and she was anxious to be discharged so that she could go and see the baby. She's amazing and I had the greatest time! God is sooo good.

Sunday

DeSha's histology review session- Quiz tomorrow 8am -done
Review for 5th Ward History and Physical - going to wing it

Study with Katherine: review week 1 lectures -utter fail
Make notes for week 2 - there's still hope

-- bad headache earlier, now utterly exhausted...must...finish...lectures....
-- first comes headache, then comes nausea, then comes a 3 hours unauthorized nap! not a very productive day

Saturday

review with Katherine first 3 days of lecture - done
need to review anatomy, histology, and lymphatics tomorrow

female reproductive pathology I-III -done
lecture 1 - done
lecture 2 -done
lecture 3 -done
reproductive pharm -done
Male pathology -done
histology I -done
histology II -done!!!
Male Anatomy -done

Review lymphatics again. - probably not today

Friday, 25th

make notes from book for female anatomy (done)

notes for lectures:
Female Reproductive Physiology I-II (done)
Histology of Male Genital Tract (done)
Male Reproductive Physiology - done
Incontinence - done
Mammary Gland/Lymphatics -done
Male Anatomy
Female anatomy (done)
Female Pathology

i need your help

Well, it's official, no more studying in public. Also, no more tid-bits for everyone since everything thinks you're pretty perverted if you give the latest tid-bit on the human reproductive system. no matter if it's male or female.

but there is something I would like to ask of everyone. This is the last test of our school year. It's getting harder and harder to stay motivated. In an effort to learn self-motivation. I plan to make a check list every morning related to school and post it here. What I am asking of those who love me is accountability via email or text. Please help me out on this. whether you want to email everyday or whether you would just do it as you think about it, i would really appreciate it. I am a people-pleaser and nothing is more motivating to me than the approval of those I love. I value each and every one of you so much that I would rather bust my butt than to let you down.... as you can tell this isn't exactly the definition of self motivating but that's why I need work on it! Thank you in advance for your support. This will only be until the 11th of April, 17 days from today.

Decisions, Decisions

OK, it's been a while and I have some things I would like to blog about. But right now, I have one thing front and center on my brain. That would be Boards! I feel like I need to hurry up and schedule my date on when to take them because spots in Shreveport are filling up. It would be nice to take them in Bossier rather than having to drive to Alexandria, Tyler, Beaumont, Lafayette, or Baton Rouge. (yup, Lake Charles doesn't have a Prometric center...)

I am looking at the week of June 21-25. Only the 23, 24, and 25 are available in Shreveport. The course I am taking in Dallas ends on the 17th. I am really praying hard to know how much time I need to leave myself or not leave myself in order to the best that I am able to do. I would appreciate you prayers on this one. I've talked to others but it's pretty much an individualize things (or so they tell me). Everyone is different, some need more time, some need to have less time.

I appreciate your prayers for me whenever I start that long haul beginning in May. It'll be the hardest test I've ever taken and require more studying and I've ever had to do in my life. they highly recommend 12 hours a day, 6 days a week. You get a break and only have to study 8 hours on the 7th day. Ain't that nice? yea.. i'm terrified!

Good morning! 2 Days left to study for the next gastrointestinal test! Things are a little bit stressful this time around. This course has been a little more disorganized than those in the past and there seems to be more material thrown in at the last minute. I would appreciate any prayers I can scrounge up.

Studying the GI tract has been a lot of fun. I really enjoy the topic but don't think I would enjoy the actual practice of being a gastroenterologist. But then I have a lot more time before I figure that one out. Also coming up, the registrar is working on the schedule for 3rd year. Once they publish it, I believe we have about 2 weeks to trade with everyone to get the rotation that we would like. They've changed the rotations this year to split up our vacation and give us more choices, which I believe will make switching schedules all the more difficult. I am not sure when I am hoping to use my vacation. It's crazy that all these things matter, but there are strategies for how you do your rotations during 3rd year. For instance, they recommend that you take the courses that you are most interested in early that way you know if you really like them. That way when you make your schedule for 4th year, you won't have to rework it because you found out you actually hate the field that you thought you would be doing for the rest of your life. (True story).

Then there is the lovely step 1 always looming over our heads. It seems the faculty love to remind of us of this "next hurdle" as if we could forget that this one test dictates 1 whether we can be a doctor and continue our educations and 2 what types of specialities are still available to us.

So, I am kind of feeling some of the pressure lately. The seconds keep ticking by, the days pass much more quickly than I would like. I won't say that there are not enough hours in the day because I don't need an hour. I just need a couple of minutes to rest. If medical school has taught me anything, it's how to value time.

How To Date/Be married to a Med Student

I found this helpful article when a fellow classmate posted it on facebook. Among the favorites of the class are numbers 3, 8, 10, and 11. Enjoy!

: How to Date a Med Student

1. Don't expect to see them. Ever.

2. Accept the fact they will have many affairs. With their books.

3. Learn to hide your “ew, gross” reactions when they tell you all the stuff you never wanted to know about your bodily functions.

4. Support them when they come home after each test, upset because they failed—and gently remind them after they get their well above passing grade how unnecessary the “I’m going to fail out of medical school and never become an MD” dramatics are.

5. Each week they will have a new illness. Some will be extremely rare, others will be more mundane. Doesn’t matter. They will be certain they have it (no second opinions necessary.) Med school can, and will, turn even the sanest into a hypochondriac. Date them for long enough, and you’ll become one too.

6. There will be weeks you'll forget you even have a boyfriend—friends will ask how he is and you'll say, “What? Who? Oh....right. He's well...I think.”

7. They'll make you hyper-aware that germs are everywhere and on everything. Even though you used to walk into your home with your shoes on, and sit on your bed in the same clothes you just wore while riding the subway, or sat on a public bench in, you'll become far too disgusted to ever do it again. Believe me, it's going to get bad...you'll watch yourself transform into the anal retentive person you swore you'd never become. And when you witness others perform these same acts that, before you began dating your med student, you spent your entire life doing too, you'll wince and wonder, “Ew! How can they do that? Don't they know how many germs and bacteria they're spreading??!”

8. Romantic date = Chinese take-out in front of the TV on their 10 minute study break.

9. A vacation together consists of a trip down the street to Walgreens for new highlighters and printer paper.

10. Their study habits will make you feel like a complete slacker. For them, hitting the books 8-to-10 hours a day is not uncommon, nor difficult. You'll wonder how you ever managed to pass school on your meager one hour of studying per night.

11. They're expected to know everything. Everything! The name of the 8 billion-lettered, German sounding cell that lives in the depths of your inner ear, the technical term for the “no one's ever heard of this disease” disease that exists only on one foot of the Southern tip of the African continent. But ask them if your knee is swollen, or what you should do to tame your mucous-filled cough, or why the heck your head feels like someone's been drilling through it for oil for two weeks straight, and they won't have a clue.

12. “My brain's filled with so much information, I can't be expected to remember THAT!" will be the standard excuse for forgetting anniversaries, birthdays, and, if you get this far, probably the birth of your first-born.

13. You'll need friends with unending patience who pretend never to get sick of listening to your endless venting and complaints. Or, you'll need to pay a therapist who will pretend never to get sick of listening to your endless venting and complaints.

But take this all with a grain of salt. It's not like I'm speaking from experience or anything...

Rearranging the Mantle

Ok guys, I need a little bit of advice on how to rearrange the mantle. Got a great new decorative piece and can't find any other useful place to put it. So I thought I would try it on the mantle. But I've always had trouble with the asymmetrical thing... what do you think?

Here is my starting point, just for some reference...

option 1

Ok, so first we have the simple unbalanced, lazy version.

Option 2

Next we have the slightly more attentive, unbalanced version.

Option 3

This one is the flabbergasted one.

I tried positioning the piece on the right side of the mantle.

I think this arrangement is perplexing to some...

Option 4

This is a more active version, kinda for the indecisive at heart.

I don't know how I feel about it...

Option 5

I call this one the moody modernist.

That style has never really been my thing, but I thought I might give it a shot.

I think it's a little too moody for my tastes.

Got any useful suggestions?? Can't wait to hear them!

all roads lead to ...

Ok, I've been slacking on the blog but have been doggie-paddling in school with a group of olympic swimmers. So here is my interesting tidbit of the day then it's back to the books. Test is tomorrow at 100pm. (say a extra prayer for me, please: retention, confidence, peace, clarity of thought and ability to understand the questions-what they are asking)

You've heard the expression all roads lead to Rome. Well, it seems that the same thing can be said of the gut. Atherosclerosis affects most other vessels of the body. Even in the anatomy lab, the arteries that have been affected by atherosclerosis are hard and break when handled. This, however, never happens to the vessels of the gut.

The reason why the heart, aorta, brain, etc are so prone to this build up of plaque is because there is usually one vessel to supply one area. In order to get blood to that area of the body, the body has no choice but to travel that road. Plaque, therefore, is deposited only in that one vessel each time the blood passes that way.

The gut however, has an extensive collateral system. As you would guess, there are many many roads to get almost anywhere in the gut that you want to go. This goes for arteries and veins. The gut even has two venous systems to get blood back to the heart. Most travels through the portal system through the liver then to the heart. But, in case there's a problem with that system, the body also has areas that connect to systemic veins (or the veins that bring blood from everywhere else in the body back to the heart). This way, there is always a way to get the blood back to the heart, even in less than ideal situations.

I found this fact very interesting. The body will often demonstrate what is most important by it's blood supply. And as you can clearly hear, the body is telling you that the gut is very very important. However, if you ever have to run from a bear the blood going to the gut is sacrificed and re-routed to the muscles...but that's for another time.

Superbowl Weekend

This weekend was great! We got to spend some time with some great friends. This weekend, Roger and I got to help some friends get their house ready for their home visit. They are adopting and their home-visit is on the 11th. So Roger headed up the remodel crew while I got to help rearrange their back room. They have a 17 year old living with them until he finishes high school. So Warren and Lisa decided to convert the office into his own bedroom. They wanted to him to feel at home in their house. so we converted it all on his birthday while he was away at a surprise birthday party. I felt like we were on a design show where you completely rearrange a room in a day. It was wonderful and Warren cooked for us two nights in a row AND gave us the left overs. We are so very blessed. It was a great time with life-giving friends.

Then for the superbowl, we were able to go to a friends house to watch the game. We had a great visit and talked long after the game ended. Had a little trouble getting up this morning but it was so worth it.

It's amazing how God has blessed us recently with such amazing friends. Although I do not consider Shreveport home and don't think that I ever will, having such great friends here has made the experience of living away from our friends at home such better. I am excited about the new friendships that are developing and look forward to growing those friendships. At school, the relationships are not the same and it's easy to get into a negative attitude. Several people would describe themselves, joking or seriously, as miserable. I don't want to be that way. I want to be happy about where I am at. I am in medical school. I worked really hard to get here and I'll have to work really hard to stay. This is what I want to do . Whether I make money at this later or not (Thank you, Obama), this is the career path I want to take. I believe that this is exactly where God has placed me and I plan to enjoy the journey.

I love you all and really miss y'all. Getting a little homesick lately and look forward to seeing each of you soon. Until then, it's back to the book and dinner with some great friends.

Snow Day!

Being in medical school has a lot of benefits but getting school cancelled is not one of them. Yesterday, we even had mandatory lectures so everyone had to brave the weather to listen to a physician tell us about how to give an abdominal exam (she didn't want to be there either so it was quite amusing). Then we were able to come home and play in the snow again!

We had a lot of fun playing in the snow. Molly wanted to play nonstop. When we woke up, Molly was panting. I think we solved that problem! Thankful, there were no golfers on the golf course. Molly got to go play out there twice in one day and both times were during the daylight!

Apparently, Feiona didn't like snowballs being thrown at the steps she was hiding under! Excuse me! How were we suppose to know?

Feiona was not a happy camper but we think that's just because she just realized she's not a dog like Molly. Those are sad days when she remembers she's a cat. She's all pissy and doesn't want to see anyone. It's really sad. Then she forgets again and continues to act like a dog and the world is a better place.

We had a great time. After this, Roger went to help some friends paint and mend holes in their sheetrock. They are trying to adopt and have a home-visit come up soon. I stayed home and relaxed (instead of studying) in front of the fire place. It was wonderful.

Our friends are amazing cooks, so Roger came and picked me up and we had the most amazing brisket, mash potatoes, baked beans, green beans and chocolate/cherry cake you could ever imagine. AND they gave us all the leftovers!! I need to contract Roger out more often. They also introduced us to the concept of beer mugs in the freezer, used for drinking milk-they even gave us an extra set of beer mugs that they had! It was truly a great day. But that being said, I'm done with the snow until next year. Anyone want to come take it for us??

More than you wanted to know..

Ok. So I think this is interesting but I am not sure who else will. Fiber.. and how it works.

Fiber is not able to be completely broken down by the gut and therefore adds mass to all the other things that are being processed. The amount of water in your gut is determined by the amount of stuff you have in there. More stuff means more water. So you can see how adding fiber to your diet creates more mass and therefore the body adds more water so you get less constipation. You also wouldn't get diarrhea because the fiber is there to provide substance. I know, kind of gross. But what's worse is that you can have fermentable fiber.... think about that one for a second. ferment...makes gas. Yea, it ferments and then you release the by-products of digestion...carbon dioxide and methane gas... which I hear they are now trying to use as a fuel source. So, the moral of the story is: with you and your fermentable fiber, you could power the world!

It's up!! It's up!!

The church's new website has been silently launched. I have to keep my mouth shut for now until the church announces it. So my mouth is shut while I excitedly type this message to y'all!! :)

I love my husband so much and he is so amazingly talented!! check out the website and let us know if you find any glitches, spelling errors, etc.

www.churchatredriver.com

Where do you feel pain..

OK, I think this is pretty interesting and maybe you will too. Today we learned again about visceral and somatic pain. The way I tell the difference between these is somatic pain is specific pain. It is easy to localize and these receptors are found in places that have a lot of nerve receptors (because they are use to being touched). So you finger would have somatic or specific pain receptors. Visceral pain is vague pain. These receptors are located in areas that normally don't need to tell you what's going on except when something is wrong. So visceral or vague pain receptors generally only transmit pain (aren't they sweet).

Now, to go one step further...stay with me here. Here's where it gets good. Somatic (specific) sensation is pretty important because it usually tells us a lot more than just pain. It is our general sense of touch. So somatic (specific) receptors can have their own relay station in the brain, or it can share a relay station with the visceral (vague) receptors. But the visceral (vague) receptors always have to share because they aren't nearly important enough to have their own relay station like the specifics.

Because of the sharing of relay stations, this is where we get referred pain. When you have a tooth ache, your body is telling you that the area below your teeth is having a problem. This area generally doesn't tell you anything and so when it does speak up, it's always to tell you that there is a problem. Because this part of the body is usually silent and is going to a shared relay station the brain sometimes will say that the specific fibers in the relay station are the ones that are firing, like the ear, which seems to share a spot with the teeth. This is how tooth pain can feel like ear pain. Also interesting is that somatic (specific) pain trumps visceral (vague) pain every time. Vague pain can be mistaken for somatic but somatic is way too important to be mistaken for vague pain. Pretty cool, huh?

Back to the grind stone

Well, I had an amazing weekend. It don't think it could have gone better if I had planned out every aspect of it. Our visit to Lake Charles was short, but packed with meaningful visits. I am so glad we were able to see everyone that we did. Still wish we had been able to stay for Sunday. But Sunday church in Shreveport was incredible! The sound was truly great. I could even tell a difference and that truly is saying something. God has given me a heart for the girl who sang on Sunday (she also cuts my hair). While she was last cutting my hair she was telling me all the ways God is moving in her life and it is truly incredible! He is doing amazing things in and through her. I can honestly say that one day, I'll be able to proudly tell you that the lead singer of the wildly famous band "They say" did my hair! Such an incredible humble woman of God.

Well, after this weekend, it's really been hard getting back into the swing of things. Ever sense Thursday, I've not had to do anything school related. So now, transitioning back into hard work and loads of concentration is a little bit more difficult than I had imagined. The good thing is, I now go back to school very refreshed and ready to face the next course.

We are now starting GI, then we'll do endocrine. Easter break for 5 days comes next then it'll be time to study for boards!! So much in such a short period of time. That just means I get a short amount of time to make it all count. I am excited about the place God has placed me and the things he is doing in my life, Roger's live and those around us in Shreveport. It is a unique opportunity and I want to spend every day being thankful for where I am and the amazing people God has placed in my life.

Well, now back to studying. I am not very good at keeping this thing updated but I will try harder. I thought about added my tid-bit of the day on here. hmmm, we'll see how that goes.

New Master Bath!!!

Check it out!! We (meaning my husband) has just finished the master bath! Roger asked for help moving in and I was very eager to help. I immeditately went around the house to decide which flower arrangement should go in there. It as a surprisingly difficult decision because I didn't know if I needed to rearrange and create a new arrangement or go with the existing. I mean we are going for the spa/luxury thing and flowers make a HUGE difference... yea, he was talking about the toohtbrushes and tooth paste. Things like that... oh well. :)

View from the bedroom. Vanity and mirror from Craigslist for $200.

Jewelry box customize by my father and designed by my momma, his first work of carpentry. Little did he know that a kitchen would follow as a direct result of this customization....well, not directly.

Same bathtub. Need to make some window treatments, but that'll come.

The only storage in there for the time being. Roger is making me some shelves in the closet. He just painted the closet door. It looks a million times better!!

Just in case you were doubting that I married the most talented (and cutiest) man ever... Now you know. I know it's not a competition, but I will. I'm just sayin'

I'll think about it tomorrow..

Well...Now that that whole starting back to school thing is out of the way..

I am not sure what possessed me to think about Gone with the wind on my first day back to school, but that's what I was thinking about. And I can honestly say, I know what Scarlet O'hara felt like when she said her infamous line, because I was saying it all day.

There is something refreshing to say, "I"ll think about it tomorrow." There are so many things that need to be done and thought about and scheduled. But as for me, I am learning to live one day at a time and that day does NOT and will no longer include a week, month or year. The sermon our pastor gave on Sunday was genius!! My favorite quote, which I believe I mentioned earlier, is If you are going to do something great, you're not going to do it all at one time, but you can do a little something every day....or something like that. It sounded better when he said it. So I am focusing on doing my little something, enjoying it and then moving on. As for the rest of the world....

I'll think about it tomorrow. Right now, I'm busy living.

tomorrow...

Tomorrow, tomorrow, tomorrow. There are so many things that I would like to say but it looks like they must wait until tomorrow. For now, there is today. And that will have to be enough.

If you are going to accomplish something great, you can't do it all in one day. But you can do something..everyday.

Don't over-exaggerate yesterday or the power of tomorrow. Instead look at the present.

Jeremiah 6:16 " This is what the Lord says: 'Stand at the crossroads and look; ask for the ancient paths, ask where the good way is and walk in it, and you will find rest for your souls."

Success if found in your daily agenda. Do something every day but don't do it all day everyday.

These are little tid-bits from the sermon yesterday. The sermon series is FIVE and today- Part 1: the rule of five. Pastor Troy challenged everyone to pick 5 things that they could do every day (Proverbs 17:24 An intelligent person aims at wise action but a fool starts off in many directions."

Then we are to prioritize those 5 things. If something is a priority in your life it will reflect in your time, thought and effort. (Psalm 90:12)

Next we are to enjoy our five. Find ways to do the 5 things in ways you want to do them. He said that if you don't like reading the bible it isn't because you dont' like God, its because you haven't found the reading plan that is right for you. Do a google search. Find what is going to work for you so that you enjoy it. In all honest, I will not do 5 good things that I hate doing. I will quit after a while. He also talked about working out and how he hated to run and play basketball, so he does the weight machines because that is something he enjoys. (Hebrews 12:1-2)

Next is to fight for your five. When things get tough and you want to quit even those things that used to be enjoyable, fight through. You can't be a disciple without discipline. In order for us to do what God has called us to do, we must move to a higher spiritual level. This is way we achieve righteousness or right relationship. (Hebrews 12:11)

Last is to evaluate the five. Check with outs who know you and will be honest with you. How are you doing doing those 5 things and are they workings? Do you need to change your five things. A true goal will very rarely be met by someone who puts a plan in action and then never stops to check whether that plan will actually work.

His closing thoughts:

Don't turn over a new leaf, turn over a new LIFE. (John 10:10, Romans 8:13NIV, Romans 8:13Message)

And do it Now (1 Peter 1:3-4Message Because Jesus was raised form the dead, we ahve been given a brand-new life and have everything to live for, including a future in heaven - and the future starts now!)

To listen to the sermon, there is a link to the churches website on the left. It should be posted by Tuesday, Jan 4th.

the new year

The New Year brings new things at the Craig household. The most exciting of which is the new bathroom!! Tomorrow it should be 100% complete!! We are both so excited. We should begin to move all of our stuff in and be using it Tuesday morning! Roger has done an absolutely amazing job. He has worked hard every day, even though we've both been struggling with allergies for the past couple of weeks.

Christmas was amazing. It was really good to see everyone, although it was very very short. We are getting better at making our trips very efficient and our visits full of quality but we are still working on that. It's taking a while to get it right.

As far as Christmas goes, we are so incredibly blessed beyond words. It was so great just to visit with everyone and everyone did amazing on gifts. Roger has effectively replaced his gray hat for his green one (the ultimate compliment to Bethany). I absolutely love my dishes and was really sad to have to put up my new willow tree addition to my nativity. But my other willow tree angel is sitting on my desk. It means so much, there aren't words to say. I am also thrilled about my new colorful dishes that I bought to go with my fiestaware. They look amazing and I have my mom to thank for running to the store to buy them before they were all sold out! She is amazing! Couldn't ask for better.

We even got to see Grandma yesterday which was great. We didn't get to visit as much as I would have like, but I do have pretty high standards for what I call "enough time to visit." I really enjoyed talking with her. Last time we visited her, I realized that my perseption of her was entirely wrong. She is very frank and honest and upfront about what is going one. She is realistic and approaches life with such honesty. I am not sure how I would have described her before, but as of late, I have come to truly appreciate the woman that she is. I hate that it has taken me this long to see and appreciate, but such is life. I just hope that I am able to get to know her better in the time we have.

As for New Year, Roger was thrilled that we spent it with a licensed pyrotechnic. He has a shed full of fireworks and remarkably wasn't working his usual side job. So the guys had a great time blowing up all manner of things and custom creations. Yes, there was a fire extinguisher and yes it was used. Too much fun! We had a really good visit while we were there and even made some new friends. it was a good time.

Now for the new semester, school starts on Tuesday! We'll see what it has in store for me as Roger see's what the house has in store for him.