Thursday, July 31, 2008

Ewww. and then Aahhh.

Tuesday morning, just before we left for vacation, a friend was at our house to study with Jeff and noticed a whole bunch of maggots on the floor by our back door. (Maybe my new contacts aren't as great as I thought since somehow I hadn't noticed them.) I can barely even type that without it sending a chill down my spine. I am not easily grossed out, but the little, squirmy, white, wormy-looking things crawling all over my floor will do it. The only reason I really think they were maggots is because after Jeff sucked all the ones he could find up in our vacuum (and then quickly emptied it out), the next day there were several flies in our kitchen. Apparently he had missed a few.

I still have no idea how they got there. But ew. Ew. ew. ew. It was hard to leave on vacation thinking about whether or not we got them all. I do not want to come home to any sort of infestation.

On a more pleasant note, today in Cleveland I went to the most awesome store ever. It's a Joanne's, and maybe they are all like this, but this was not your average fabric store. They had a huge and great selection of fabric. But. Then they also had a complete selection of almost every kind of craft supply imagined. Like a Michael's and Hancock all rolled into one. After going this morning, I thought of a few more things I needed for a little project related to the wedding, so I went back. Both times I was there I had almost no time, so I basically found myself wandering around taking it all in. Until I remembered that I had no time, and frantically found the things I needed.

I may go one more time before I go home.

Wednesday, July 30, 2008

YMCA

I'm a big fan of the YMCA. Ever since the West County Y in St. Louis offered $4/mth memberships to poor seminary students, I've been hooked. Later I joined the Y in Colorado, and now Aubrey and I have joined the Y here in Greenwood.

I've begun to notice something. I call it the universal law of YMCA locker rooms. It's pretty much the same all around the country as far as I can tell. The older, and more out of shape you get, the more likely you are to wander around the locker room naked. It must be required in the fine print of the contract, because it happens everywhere. They get out of the shower and slowly fold their towel so they can sit on it. Then they carefully and deliberately put on each of their socks. Then its time to apply deoderant, and walk over to the mirrors to comb their hair. Perhaps make a phone call. Socialize a bit. Anything to avoid getting dressed. This happens everywhere.

The other day I went to rinse the chlorine out of my hair after swimming. And one of these old men had taken the plastic chair that is normally outside the shower area, and had brought it into the shower area, and was just as relaxed as can be, enjoying a shower in a chair. I thought this was funny. Not least because he was using the shower right NEXT to the shower that has the built in bench, which was presumably built in for people just like him. Mental note: I must never ever ever ever set my towel on that chair again.

Monday, July 28, 2008

Nothing to post.

My brain has been running in low gear for the last little while. So although I wish I had a clever post, I don't.

I went shopping on saturday, and tried on way too many clothes at Target. Trying on clothes sometimes depresses me. I did get a few cute things, though I'm still somewhat undecided about what to wear to the rehearsal on Saturday, which was the main reason I went shopping in the first place.

My brother is getting married in less than a week! I still remember him as he came at me and successfully stabbed me in the forehead with a fork when he was maybe 2, and I was, I guess, 7. You'd think a seven-year-old could fend off a toddler. But apparently I couldn't. And now he's marrying a wonderful, Godly woman. Because he's turned into a pretty great guy, even with that somewhat dubious beginning. I'm excited about getting to be there as they begin their new life together.

Jeff and I finally had our first boating expedition of the summer. The water was super choppy, so I only skied for about 5 minutes, but it was great. Almost as much fun as actually skiing myself was watching two family friends (ages 13 and 10) get pulled on the tube. Kids and tubes are a great combination.

I decided to turn over a new leaf and start packing my lunch. I'm tired of eating somewhat unhealthy lunches just because it's someone else's job to order our lunches for us, and there aren't always healthy options. Instead of grumpily eating whatever it is they order, I (finally) figured out I should just take responsibility and make my own lunch. I got a little box (I do love Target) to put it in.

Jeff and I both get very, very excited whenever we get to stay in hotels. And we leave Wednesday to stay FIVE whole nights in one. Woohoo!

So that's all I've got. Maybe my healthy lunch will kick my brain into high gear and I'll have something more interesting later. But don't hold your breath.

Saturday, July 26, 2008

Back up

I'm on back up call again tonight. Unlike last time, I have two interns on with me - so my pager has been fairly quiet due to the absence of floor call. (Yay!) Twice now, the interns have called me with questions about patients who are or who could be very sick, and they want to know what to do.

I do not like this. My blood pressure starts to rise and my heart starts to beat faster when I realize that I'm the one here who is supposed to know the most. Although I have help that is only a phone call away, MY help is a whole. phone call. away.

Thankfully, thus far we are managing fairly well on our own, and I've been able to calmly (on the outside) assess patients and mostly know what to do.

I do wonder, though, if this nervous feeling I get when making important patient care decisions ever goes away?

Thursday, July 24, 2008

Vision

I got my eyes checked on Tuesday. It had been a while. I went because I knew I needed new glasses (my current pair I've had for 6 years) to wear some when I'm on call. My eyes always protest a little around 3 or 4 in the morning from being subjected to 18-20 hours of straight contact wearing in a fairly dry-aired building.

I actually told the nice nurse who was checking my vision that I knew I needed a new glasses prescription, but that "I feel like I'm seeing very well in my contacts. I don't think I need a new contact prescription."

Hah. Less than 30 seconds later as she was testing each of my eyes individually I quickly realized that the vision in my left eye was bad. Really bad. My right eye was ok, but I still was struggling way more than expected. She quickly made some adjustments and aha! Those tiny letters became crisp. I left my appointment with a new prescription and a brand new pair of contacts. The minute I put them on, I looked around and suddenly realized that I had, indeed, been living in a blurry world for quite some time.

I was thinking, then, about how much sin is just like this. We think we recognize the big sins in our lives - the blatant selfishness and pride, the anger and hate that makes us snap at our husbands or doubt God's goodness to us at all times. But suddenly, when we are truly reminded of who God is and what he has done for us, the hardness in our hearts can quickly soften and the scales can fall off as we realize that much more than those "big sins" we were avoiding, all this time we have been blinded to the small ways that our fallen-ness has crept into every single aspect of the way we live and think.

I praise God that he does continue to spit in our eyes even though we'd rather just stumble in our blindness, and offer us that living water when we want nothing more than to die of thirst in a desert.

And I pray that he continues to give my heart the vision check it needs.

Wednesday, July 23, 2008

Photos




As I said earlier, we had a great time with Dave, Hannah, and the kids. There is something just wonderful about hearing your two-year-old nephew call you "Auby" and "Bwo" (for "Bro") and talk about the dog "Lu-key." I just melted. Ashlyn gets prettier every time we see her, and Jack is really just all boy now - he seemed so much more grown up.

I also enjoyed sleeping in this weekend, not working at all, and eating some delicious bruschetta (which Jack loved - this is one kid with sophisticated taste), grilled pizza, and baked oatmeal.

It was sad when they left on Monday, but it left us trying to figure out when we'll get to see them again - Christmas, maybe? We hope so.

Tuesday, July 22, 2008

Garden Ridiculosity

Throughout the spring and early summer I kept telling myself that I was not going to judge the success of our garden until we were actually eating (or not) the vegetables of our labors.

Well. I now declare: The garden is a success.

The other day Aubrey and I were estimating that we have probably picked about 150-200 tomatoes so far. And I just came in from the garden, where a quick, cursory count shows about 250 tomatoes currently in the process of ripening, and more flowers blooming with the promise of even more. Thankfully, many of these are the small cherry tomatoes, which are easily used in bulk, but still...

Note to self, next year plant fewer tomatoes, and more other things.

In other garden news (non-tomato division) there are now the beginnings of the highly anticipated cantaloupes. I am extremely excited about these. There are three started so far, and the vines are getting bigger every day.

















And here I am with one of our first bell peppers. Its small, but smells sweet and pepper-like.

Helpful.

Two very useful signs posted next to the (very public) hot tub at our YMCA:

Shallow water. No diving allowed.

Swimwear required at all times.

I'm beginning to think someone doubts our intelligence.

Quick Note.

Just a short note to say that we had a great weekend with Dave, Hannah, Jack, and Ashlyn. We've got some great pictures to post later. I also made some tasty jam last night - I'll have to share the recipe soon. For now, though, it's back to the grindstone.

Thursday, July 17, 2008

I still love my job.

It's been a crazy, busy week.

I was at the hospital until 12:40 on Monday night, waiting for one of my own OB patients to deliver. Sadly, she ended up going to C-section, but she did have a beautiful, healthy baby boy. Of course, I was exhausted the next day, but since I wasn't actually post call, I couldn't leave early and then Tuesday night I did some sewing before bed, which always makes it hard for me to sleep. (Yes, that's right, sewing late at night makes it tough for me to fall asleep. I'm not sure what that's about - it's not like I'm inhaling caffeine while doing it.) Yesterday, another of my OB patients delivered right in the middle of lunch, meaning I was 1.5 hours late to clinic (where thankfully there were almost no patients) and I had to eat quickly once I got there, making my day more stressful than usual. We had prayer meeting at church last night, but I just couldn't go. Jeff sweetly understood that I needed a few hours to stay at home, mop, do laundry and enjoy being by myself. Today our pediatric rounds lasted. forever. Then I got a call that Jeff was waiting for me over here. I came to see him and was happily surprised that he had brought me a huge bouquet of pink and purple gladiolas for our anniversary. Now I have these lovely flowers that have definitely brightened both my desk and my day. Thanks, honey!

I have realized this week how much I love being a second year and having my own patients. I had already decided that there is almost nothing as much fun as being in on deliveries, but being with my own patients when they deliver is an even bigger joy. I love meeting those cute and sweet babies I spent so much time looking at before they were born, and am so happy to have played a (small) part in their getting here.

It is truly an honor to have someone choose you to take part and be with them during such a special time in their lives, and I feel blessed to be in a place and have a job that allows me to do it.

But now I need some rest. Please.

Wednesday, July 16, 2008

Better walking.

I love my dog.

I love to walk her. I love running with her. She's a great dog. But she has had this little problem. She gets super excited on walks and runs. Especially when she sees, say, a cat. Or, even better, a squirrel. This puts her into even more excitement and she will think that she needs to either chase the villain away (how dare he eat nuts in that grass!) or maybe just go say hello and try to make a new friend (her "friends" might just scratch her nose trying to get away). She does this in spite of the arm which is attached to the leash, trying to hold her back. That arm does not like being jerked around. When we'd try to hold her back, she'd choke and gag because apparently she loved squirrels more than oxygen.

We recently found a great solution to this problem:
Looks simple, right? It almost looks too simple to work. Jeff didn't even believe it could work and so we tried on the kind that goes around the nose and pulls the nose down. It took her about 3 minutes to paw that thing off her face. She didn't pull with it, mostly because she was so distressed by it being on her face she wasn't walking, just frantically trying to get it off.

But the easy walk harness she doesn't even notice; she just walks very nicely (true to its name), without pulling. The first time we used it, we had a little pulling episode, and the vectors involved (ah, physics) somehow just flipped her over on her side. I'm not even sure how that happened, but all I know is that she has quickly learned that she cannot go chasing every bunny, squirrel, cat, or other dog she sees.

And that works for me (and my arm).

Sunday, July 13, 2008

Money.

I moonlighted last night. (Moonlit?) Basically I had to carry my pager, answer some nurses questions, and go in to the hospital a few times to admit people. The beep of the pager, though, is especially horrible when you think of your own, home bed as being safe from its sound. It is a lot easier to be happy about doing an admission when you realize you are getting paid about $80 extra for going in. Which I definitely had to remind myself when I got called in at 3am for two admissions.

I could (somewhat) happily come home at 5am when I realized that the $200 I made between the hours of 3am and 5am definitely made this my most productive early morning ever.

Saturday, July 12, 2008

Come back interns...

I took medicine back up call on Thursday night. Sadly, though, all the interns were gone to Columbia, SC to take the ALSO course (stands for advanced life support in obstetrics) so that when deliveries don't go as planned, you'll know what to do.

So it was sort of the opposite of backup call. (Front down call?) Even with just one backup call under my belt, I quickly realized that floor call (when nurses call you with questions) might be the most annoying part of being on call. My pager just kept going off, with nurses needing extra pain medicine for their patients, sleep aids, something for constipation, or to inform me that someone was leaving against medical advice. (All valid and necessary reasons to call, but they really start to add up.)

At least I got to use the nice bed in the upper level call room.

Thursday, July 10, 2008

More OB excitement.

Lately I feel like all I've had were exciting deliveries. Today continued this tradition - but was more fun than usual since today I delivered the first baby of my very own patient, someone I've followed and cared for throughout her entire pregnancy. My other deliveries up to this point were other people's patients - which are still great, but there is something wonderful about delivering the baby of a patient you have come to know.

This lady is very sweet, from Mexico, and is 41. It's also her first baby. She was actually told in the past that she couldn't get pregnant, and so was very ecstatic about this baby. Her husband has been at most of her appointments and excitedly watched during all the ultrasounds I did. Unfortunately, this has been a somewhat difficult pregnancy for her, complicated by diabetes and high blood pressure. We actually induced her yesterday because she had preeclampsia. This morning, at 11:30, she was 2cm dilated. I figured she'd be delivering sometime tonight. Around 12:45 though, (just over an hour later), I got the call that she was complete and ready to push. I got upstairs, gowned, gloved, and goggled up. I told the nurses to page the attending to come for the delivery. She started pushing and after several pushes, the baby's heart rate dropped to around 90.

And there it stayed. I kept watching as the seconds ticked by, waiting for it to rise. It didn't. The attending still wasn't there. Several of our new interns were there, which was great, but they have even less experience than I do. After 2-3 minutes, I told them to get the vacuum and another minute or so passed before it got to me. Very slowly the heart rate rose, but as soon as she pushed, it dropped again, staying in the 80s and 90s. I kept hoping our attending would come and help me since I've never actually used a vacuum myself. I've watched it done, but haven't actually put it on myself. I even got them to page the OB-Gyn who was on the floor just in case.

Finally, I realized that I couldn't wait and that baby needed to come out now. I quickly applied it and with her next push, pulled the baby out. As soon as the baby delivered the OB walked in, heard the lovely sound of a new born crying, smiled, and walked right back out. It took me a minute to figure out how to get the vacuum off the baby's head. Our attending walked while they were cleaning the baby up.

I breathed a sigh of relief, thinking that the exciting part of the delivery was over. Oh no. I was waiting for the placenta to deliver and gave a gentle tug (like I always do) on the umbilical cord. It ripped off, leaving the placenta still inside. This is not supposed to happen. Nor is it good. I had to stick my hand...er...my entire arm up to my ELBOW... inside the lady's uterus to manually pull the placenta out. I could feel the uterus clamping down on my wrist. I could also feel drips of sweat tracking down my leg as I tried to stay calm and prayed for God to help me take care of this lady.

I've decided there is no feeling quite like having your entire arm deep inside someone else. Placentas, I've also discovered, are quite slippery. I couldn't quite get a hold of it, so my attending finally had to get it out. The baby, I'm happy to report, is a beautiful baby girl who is doing fantastic. She also has these beautiful eyelashes and lots of dark hair. Mom and Dad are very excited to have such a lovely new member in their family.

I figured that was my one exciting delivery for a while, but just now I was watching a colleague do another delivery and I was there to help with the baby. There was a shoulder dystocia (baby got stuck after the head came out) and also very thick meconium (the baby's poop) present in the fluid around the baby. So it took a very long minute or two to get the baby out, and then the baby had to be intubated to suck all the nasty goo out of his throat and mouth so it wouldn't get in his lungs. After that and a few breaths with a bag and mask, he pinked up and started squawling and is doing great.

I've had enough excitement for 1 night.

Wednesday, July 09, 2008

Bruschetta Recipe

I thought I'd post my recipe on here, since Hannah asked and maybe others out there want to know.

This recipe is sort of a compilation of several different that I've looked at. And keep in mind that I sort of cook by gut instinct - completely imprecisely, rarely measuring things.
6-7 tomatoes (obviously, you can use less, but with our bounty of tomatoes I wanted to make a big batch.For my batch, I used a bunch of the little ones and maybe 3-4 big ones.)
1 onion
2-3 tsp fresh minced garlic (I like garlic.)
1/2 c. (or so) fresh basil, chopped or torn into small pieces
1/4 c. parmesan cheese (I used a combo of pecorino and parmesan.)
1/4 c. olive oil
2-3 T. balsamic vinegar (I'm guessing here. I just poured some in.)
salt and pepper to taste

Serve with toasted french bread.

And it makes a great dinner. Even for two nights in a row.

Getting ready for guests and inexpensive frames work for me.

I have two little tips here today that are working for me.

1. We are getting very excited to have some family visiting next weekend, including our very cute nephew and niece. I'm always having to do lots of cleaning before people come, since I get somewhat overwhelmed with my job, and the idea of keeping my house always ready for guests is a bit beyond me at the moment. But, I've discovered that one easy thing to do to take a little stress off is to wash the guest sheets, towels, and washcloths as soon as your guests leave, then immediately remake the bed and hang the towels in the bathroom, so that you don't have to stress about doing that little job at the last minute. When your guests leave, you are already ready for the next ones to come - or at least the room and bathroom are ready.

2. I recently had to order a bunch of pictures frames for a little renovation project we were doing at work. I found this great website with tons of different frame sizes, including very large ones. I ordered a bunch of 16X20 frames (this style) and they only cost about $13.00 each, including the mat. I looked all over the internet and couldn't beat that price. These are probably not made from the finest of wood, but they really look nice, and come in a variety of colors and styles, some even cheaper than the ones I got. They arrived in a timely manner without problem. Next time I need a bunch of frames for my house, this is definitely where I'm getting them from.

Monday, July 07, 2008

Yum.

There is possibly nothing quite so delicious (and this coming from a chocolate lover) as bruschetta made from tomatoes out of your very own garden. Eaten with bakery-fresh bread for dinner.

Yep. That's all we ate for dinner last night. And I'm rooting for a repeat tonight. With maybe some of fresh homemade pesto thrown in. Because you know how I feel about pesto.

Sunday, July 06, 2008

A Snarkful

















Our garden is getting into full swing now, especially our little tomato plants. Last week we had been picking about 15 of the little tomatoes per day. Then we were gone this weekend, and this afternoon after church we picked 52 tomatoes. The big ones, obviously, are doing quite as well, but they are coming along at their own pace. We also brought in a pile of basil leaves and two of the little peppers. The peppers aren't ready yet, but these two had some blossom end rot going on, so we have to remove them anyway. Tonight Aubrey is making a big batch of bruschetta for dinner, and a big batch of pesto using the leftover basil plus a bunch of basil from her mom's garden.

Thursday, July 03, 2008

Back Up

I'm on my first night of back up call. Two interns are taking call and I'm the one they call with questions and problems. So far, it seems to be going well - nothing too complicated has gone on yet.

It feels very odd being the "wise" experienced one, but it is kind of fun getting some teaching in.

It also feels wierd going into the upper level call room - it has a bigger bed. And a couch. Which hopefully I'll enjoy later. But since I'm now headed back down to ER, it will have to wait.

Wednesday, July 02, 2008

Update..

The sweet little baby boy went home yesterday.

Although I wasn't there, a nice foster family, who really wants to adopt him, came to pick him up from the hospital.

They brought a sweet outfit for him to wear. They were excited to be told that they could be given the certificate that we give out to all the parents that has the baby's footprints on it.

They had a young daughter also with them who apparently was very excited to be bringing home a baby brother. So thanks for the prayers - it certainly sounds like this little guy got a great family. Now I just pray that everything works out well for this family to be able to adopt him.

Easy Meal with Tzatziki dressing

I'm a huge fan of easy meals with few ingredients. Mostly it's because my great and tough job keeps me rather busy, so I love to find recipes that are delicious but not complicated.

I have already blogged here some great, five-ingredient-or-less, recipes like appetizers, pasta, other tasty dinners, and low-fat cookies.

Last night for dinner, Jeff and I ate what we call our Greek Feast. Basically, this consists of chicken grilled with greek seasoning on it, pitas, cucumbers, tomatoes, feta cheese, onion, and lettuce. To top it off, we put Tzatziki - the greek yogurt dressing that really makes this meal over the top. I always loved tzatziki at restaurants, but figured it would be too tough to make. It just sounded so exotic. Thankfully, I realized that although it requires a little forethought, it is made with very few ingredients, but is fairly low-fat, and makes a great dressing. So here is my recipe:

32 oz. plain, fat free yogurt.
1/4 c. olive oil.
1/4 c. lemon juice (or vinegar if you don't have it)
3-4 cloves garlic
2-3 cucumbers, seeded, and shredded in a food processor
2-3 tsp. dill (we used fresh dill from our garden)
salt and pepper to taste
(I know that is 6 ingredients, but still it's not very many. And two of them are spices.)

Strain the liquid out of the yogurt using cheesecloth.
Strain as much water as possible from the cucumber using cheesecloth.
Combine all ingredients in a blender and mix thoroughly. Serve on top of pitas or as a separate veggie dip.

For other good, easy recipes go visit Shannon.

Tuesday, July 01, 2008

And it all starts again....

So yesterday, I went to bed an intern, and woke up a second year!!

I don't really feel any different. Last night, several of us got together for a celebratory dinner and prayer time - we ate shrimp and grits and ice cream cake and laughed and shared about our year. God really has blessed us with amazing friends and co-workers. I'm very excited about what this next year has to offer.

I've enjoyed my first day as an upper level - this morning I went to genetics clinic, which was fun. I've always had an interest in genetics - I remember writing a paper back in the seventh grade (during a detention, I'm afraid to admit) on some different recessive genetic diseases like cystic fibrosis, hemophilia, and sickle cell anemia. I was amazed how the little lower case letters separated themselves out only to combine in just the right way to get these diseases. One little protein error and the whole system falls apart. (Yes, I really did choose to write a paper during detention on genetic diseases. See - I've been this way for a long time.)

Fast forward 10 years to medical school where I learned about even more interesting problems that can arise. Now it's not just about where the lower case letters go, but what happens when genes get moved around or deleted. We also learn that if the bad gene comes from mom you can get one disease, but if it comes from dad, a completely different syndrome develops. I was continually amazed at the incredible inner workings of our bodies and how we have such a complicated design.

Today, I sat in a room with a young woman who has one of these diseases and was amazed to learn not just about the pieces of her genes that were missing or duplicated, but about how she loves to put together puzzles. And shop. And that she just graduated from high school. And the loving way her older sister takes care of her.

It was a great morning.