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.
Saturday, July 16, 2011
Monday, July 11, 2011
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!
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.
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.
Friday, July 8, 2011
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!!!
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!!!
Thursday, July 7, 2011
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 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.
Wednesday, July 6, 2011
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.
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.
Tuesday, July 5, 2011
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
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
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