public service announcement

Dear world (and you know who you are),
We have started watching How I Met Your Mother. The first episode was good.
Thank you and good night,
Alyson

Glen, 10 days before graduation from Hopkins:

Superfresh on 10th & South just completely renovated, including getting all new signs.
1) that's not how you spell that.
2) these 'marshmellows' take up so much of the aisle that they get their own sign? or were there just that many customers coming in and asking for the 'marshmellows' that you thought a sign would be worthwhile?

OK, I'll head back to working on my overdue paper now.

Tomorrow is Match Day!

I feel a little weird. There's this sensation like it's graduation time, so I should be feeling all the graduation feelings -- excitement, happiness, and bittersweet sentimentalness... that's a word. So I am definitely excited for all of you who are matching, but there's really no happiness -- just the bittersweet knowledge that most of you will be leaving and going three states away or three time zones away. I'm starting to feel like it's going to be very lonely here. I've made some new class-of-2010 friends (and I have a best friend x12 years here of course) but there aren't going to be many more parties like my recent birthday party. It's hard enough managing a group of college friends who are spread out all over the east coast, but now a group of med school friends who are going to be all over the country?? I'm going to miss you guys.

Let's celebrate tomorrow, and party it up for the next few months... while you're all still here.

mildly interesting news

So apparently Jefferson changed their policy or something, and quietly gave me a new email address with my married name. This is good because everyone at Jeff just assumes your email address is the name on your badge @jefferson.edu. People could look me up in the directory under my married name, but I thought that they would get my maiden name email address.

Two things I think are curious about this situation are (1) they didn't tell me they gave me another email address. I just happened to notice that someone I just met emailed me at it. And (2) somehow emails sent to it ended up in my gmail inbox just like all my other mail. I assume that means that the two jefferson email addresses are directed to the same jefferson inbox, which is very nice of them, especially since they decided not to tell me I had the address. If it were going into its own inbox somewhere else, emails would just pile up there indefinitely without me ever knowing to check them!

Overall, it doesn't really matter though. Jefferson cancels our school email addresses six months after we graduate, so I only have ~2 years left with my jeff emails anyway. I don't really want to get too many people using them and then have to switch everyone back over. In the meanwhile though, it will be handy for all of the people who make assumptions from my name tag.

Today I had a patient with paranoid schizophrenia come in because one of his psych meds was messing with his blood sugar and we needed to rule out diabetes. He was a little socially awkward, and obviously anxious, pacing the exam room the whole time I talked to him. He was nice though, even cracking a very quiet joke or two.

He had also had some trouble with low blood pressure, so we decided to take his blood pressure lying down and then standing. We had him lie on his back on the exam table, and he suddenly says, "What's that button?"

He was lying under this special bright light that I've only seen used on a 4-day-old infant, I thought to help keep her warm. It had some tiny knob on it that looked like a button, so the resident explained the light and turned it on for a moment, trying to reassure him.

He then says, "No, that button." We look up, and then on the next ceiling-tile over is a coat button... like, round, with a rim, and 4 holes... stuck to the ceiling. Someone glued a button to the ceiling.

Things like that can make you think you're crazy!



(Or it was hovering. Or it was a bug that could disguise itself as a button. Or an alien that could disguise itself as a button. I don't even have a psychiatric disorder and I came up with those possibilities... or I assume I don't have a psy dx. Yeah, thanks in advance for the comments on that).




Also, my friend from my previous post isn't doing well. The diagnosis right now is transverse myelitis, which indicates it could be at least a few weeks before there is improvement. I pray that she and her family have the strength to carry them through this.

I can't believe it's the last full week of Family Medicine already! The good rotations go so quickly.

On Friday I was interviewing this 80-something year old lady accompanied by her daughter with very vague complaints of feeling unwell and clammy. I was excited to hear my first real crackles in her left lung -- both because I heard them and because it gave me a diagnosis (lobar pneumonia). I presented to my attending, and then she went in and listened too.

While she moving across the lungs towards the spot where I heard the crackles, I was thinking, "I hope she hears crackles too!" I wanted to be right. Then I realized I was hoping that this frail elderly lady actually had pneumonia, and I felt pretty bad. So I started hoping that my attending wouldn't hear crackles... but I couldn't get quite as much enthusiasm behind that.

Being a student unfortunately puts you in that position sometimes. Like on surgery, I occasionally found my self hoping a patient would get sicker so I could see what would be an interesting operation. (I have to say though, I never wished the Psych patients were any sicker than they already were.)

So yeah, the attending heard the crackles too and we gave antibiotics and asked her to get a chest X-Ray. And my wishing one way or the other really didn't affect the outcome.


On the flipside, I just found out that an old friend (my age) is very ill, on a respirator now. And I'm wishing and hoping and praying with all my heart that she gets better, and I have to believe that all of that is doing something, because at the moment, it's all I have to give to her and her family.

I got the best complement while in Walgreens yesterday.

I was waiting in line to fill Glen's allergy script (yay Spring!) behind a 4-year-old and his mom. While the mom was at the counter I chatted with the kid about these handheld back massager gadgets that vibrated and lit up when you pressed a button. The color of the lights matches the color of the gadget! It sounds like there's a fan in there! Why do they light up? Why don't you know why they light up?

They when I came back 15 minutes later to pick up the filled script, the mom and kid were in front me again. The boy says, "Hey! It's the nice person!" :-D

I also got to pick up some regular Claritin for myself (er, discount Wal-itin rather -- the stuff is expensive!) to calm my burning itching mucus membranes, so overall it was a successful trip.

Sorry I keep talking about mucus membranes.

Entering the second quartile...

That was the first birthday in recent memory where no one called me at midnight.

It was also the first birthday in recent memory where I was sound asleep at midnight and very glad that no one called me!

My conclusion is that we are all getting very old.

Seriously though, I had a wonderful birthday and I want to thank everyone who was a part of it, from the Wii bowling tournament to the facebook wall posts. Love you guys!

You don't often hear a patient complain about having a swollen uvula,
but boy was that one swollen uvula!

The email to take a snow day never arrived, so here I am. Let's see if
any patients show up for their appointments.

Is this not a weird poster? Why do you need a naked lady on a diabetes
poster? And why does she have the body of a pin-up from the 1940s and
the face of someone who was around in the 1940s??

Doctor: "Have you been taking your medications every day?"
Man With Alzheimer's: "When I remember."
Doctor: "Do you think sometimes you forget?"
MWA, very matter-of-factly: "It's possible."


I feel much better today, so who knows what that was the past two days. Also, apparently it takes Mono (EBV) 30 - 50 days to incubate, so I'll let you know in a month what happens.

Bleh

I'm getting some kind of sick, a headcold I think. The worst part is that I feel so weak and achy. I'm just praying that I didn't catch Mono from one of the three patients I saw with it last week. Not that I made out with or shared a soda with any of them, but one poorly timed spit particle flying through the air and landing on one of my mucus membranes...
It's weird because I'm not sleepy tired, but my body feels very weak. I'm sure if I lie here long enough illfall asleep though -- that's one of my many talents!

Chief Complaint of the Day: (as written by one of the medical personnel)
Headache, snizzing, and cough.


p.s. why is it so so cold outside??

Also, congratulations to Chuck and Carol! They have a brand new baby girl :-)
They are going to be wonderful parents.

and it's only Thursday...

quote of the week, in reference to my leggings:

"Do those come off?"

--A family med doc at orientation on Monday

I was wearing a dress with leggings underneath and he was looking for a volunteer to demonstrate the leg exam on, and I was the only person in the room not wearing regular pants. While I was explaining that I also had pantyhose on under the legging (he looked confused, I was blushing), Adnaan kindly announced that he had gym shorts on under his exercise pants and he could strip. Thanks again Adnaan! Besides the awkwardness of the conversation, I really didn't want to have to sit on a desk in front of everyone with a dress on, and no leggings. (Why couldn't have have demonstrated the exam over leggings?)

I'm breaking out in hives... must be time to jump into a new rotation! Yay odd reactions to stress!

I didn't accomplish much this weekend except A LOT of cooking. It's one of my favorite ways to spend my time. And with the money that Glen and I would have spent going to out to dinner for Valentine's Day, I was able to whip up an awesome three course meal. We had cheese fondue, crepes with lobster in champagne sauce (my own recipe), and chocolate fondue featuring pretzels, pineapple, banana, maraschino cherries, mini raspberry cheesecakes, and home made caramels. We actually spread the feast out over two nights because we got full in the middle.

I also cooked for some friends who I thought could use a freezer full of food right around now. They got beef and veggie soup, macaroni and cheese, and coq au vin (one of my favorite childhood meals), all en masse. All of those recipes came from our collection of Williams-Sonoma Food Made Fast cookbooks, which we got as weddign gifts and with our wedding money. They make the most amazing food! Although, "fast" is used loosely. I can't imagine the complexity of W-S's standard cookbooks.

So on a different note, I am currently taking suggestions for what I should do with the rest of my life. Preferably medicine.. or business.. -related. Please be nice.

Well, that was fun. There's nothing quite like taking a major exam to the steady sound of a urinal flushing on another floor. That is one busy bathroom.

Now I'm enjoying my inter-block weekend! And it's Valentine's Day, so we'll be cooking some goodies up over here.

I'll try to write more often, or at least post some amusing things..

My thoughts for today

There is a conspiracy to keep me and Glen from getting out of medical school -- every time we try to register for the next step of our licensing exam, our internet goes out for the night. Goodbye, Verizon.

It should not cost $1550 to take *one step* of your licensing exam. Or at least there should be some discount for couples, like buy one test date, get the other half-off.

In the shower just now I had a wonderful realization that with some careful electives selection and thoughtful career choice, I may never have to get up at 4am on a regular basis again!

If it were me scrubbed in at the operating table and my pants fell to my ankles, I would use it as one of the rare valid excuses to scrub out. I would not have the circulating nurse take my pants and then return to the table wearing a paper scrub gown and black knee-high dress socks. But I guess that's just me. Maybe that's why I'm not chairman of the department -- I obviously don't have the required dedication.