Call #7....in all its 4th of July glory!

I spent the prior week wondering what my night call on July 4th would be? Nice day + beach + lots of drinking + lots of food + lots of people out and about = drunks, fights, MVAs, and sunburns!!

Saturday started off okay. I spent the first part of the day in SICU managing the sick patients plus helping out on some of the floor patients. I flushed an NG tube, helped the nursing staff change bedding on the 450+ pound patient, changed the dressing on a diabetics amputated foot, changed the dressing on a lower limb fasciotomy (for compartment syndrome following AAA surgery), etc. I also had some down time away from patients where I read all about breast pathology and surgical techniques for fixing said pathology.

By late afternoon, the ER started to pick up so I headed down there with my resident. First up, pneumothorax take 2 guy. He was a young 28 year old man who was involved in an altercation on tuesday and was stabbed. He went to another hospital, was treated for the stab wound and a pneumothorax that had developed. On friday, they took out his chest tube and sent him home. On saturday, he was in our ER with difficulty breathing and alot of pain. Turns out the pneumo was not resolved. So, we had to place another chest tube and since this young gentleman had already had one placed a few days back, he was well informed of the intense amount of pain he was about to feel!!

Next up, 87 year old male from nursing home in respiratory arrest. By the time I was assigned this patient, he was already intubated making the interview process a tad bit hard. My only source was a good physical exam and the nursing home notes which were not detailed at all. My senior resident managed to get a hold of the gentleman's nephew who was of even less help than the nursing home. We stabilized him and sent him to SICU.

During this time the red shirt brigade started piling up. You are asking "what the hell is that?" Well, its a wall of stretchers with patients all wearing a red shirt and handcuffed to the bed. These are all drunk patients who are too intoxicated to be released. They put red shirts on them so they are easy to spot in case they escape. Of course, everytime you walk past them they scream (in a slurred, slowed speech) "Doctor, doctor!!!" And once one starts yelling it, they all start yelling.

An older gentleman came in with really bad chest and abdomen pain. On CT exam, he had a aortic dissection that started at the distal end of the arch of the aorta and traveled down to the common iliacs. Unfortunately for him there was no vascular surgeon on call this particular night so he was immediately transferred to Maimo for treatment.

Our last patient was an 80 year old female who was experiencing some abdominal pain. On CT scan she had an internal hernia (a section of small bowel was protruding through another section of small bowel). We had to rush her immediately to surgery for an exploratory laparotomy. Once the doctors reached the small bowel, they realized she had an ischemic bowel and a portion of the small intestines was dead. So, I got to see my first small bowel resection. 2 feet of distal jejunum and proximal ileum was removed. Then the ends were stapled and sutured back together again. Unfortunately for this patient, her outcome was not that good. While closing the incision her blood pressure suddenly dropped to 35/28 and her heart rate shot up to 130 beats/minute. A central line was placed in the patients jugular and we pumped her full of fluids. That coupled with levophed brought her blood pressure back up but she is currently in SICU in very bad shape. The doctor thinks she may have suffered a pulmonary embolus while on the table (she had a history of prior DVTs).

I scrubbed in for the above surgery, and it started at 2:15am. It didn't finish until almost 5am and I slept for about 30 minutes in a chair. I was exhausted when I got home at 9am, so what did I do??? I walked around Union Square with Dy and Amanda!!! Around 2pm, after extreme exhaustion, I took the subway home and at 3pm I crawled into bed and didn't wake until 4am this morning!!!

These call nights are so tiring!! I hope everyone's 4th of July was as exciting as mine!! Take care.

Who knew the rectum was so much fun?

Today I was in clinic all day. And since it is my last week of Surgery II, I decided to try rectal clinic instead of Post Op. I had heard (from other students) that the Rectal surgeon on Coney Island is very good....and very quizzical when it comes to students. He not only pimps....he super pimps. He treats you as a resident in rectal surgery and fires question after question after question at you until your brain starts screaming STOP!!!! But, that is what made this clinic so much fun for me. Because he made me think....hard. And after only 2 hours, I felt like I learned and accomplished so much. So, let me briefly review the wonderful world of the rectum.

The first patient was an older male who was diagnosed with Carcinoid tumor of the colon that was resected. The doctor brought up his most recent labs which showed an elevated 5-HIAA. This is a marker for Serotonin, which is released from this kind of tumor. First question to me, what does this mean for this patient? My response: metastasis to a distant site. Good (first one down), now what sites are commonly involved? My response: liver and lungs. Very good (now I was feeling a bit cocky), now what 2 radiology studies, 5 blood tests, 3 clinical signs and one very important test will you order? OUCH!!! I got about half right, which isn't bad for my first try. By the way, the answers according to this doctor are: Radiology: CT scan, Octreotide Scan; Blood tests: 5-HIAA, Liver function tests, Serotonin, Chromogranin A, CEA; Clinical signs: Flushing, sweating, diarrhea; Important test: Colonoscopy.

The next few patients all had hemorroids, either internal or external. The external ones were easy to find...just spread the buttocks apart and you can easily see them. The internal ones were more tricky. A speculum type of device was placed in the rectum and slowly removed to show the presence of any internal hemorroids. I also got the wonderul opportunity to perform digital rectal exams on all of these patients.

On two of the patients I had the opportunity to perform a sigmoidoscopy. This is a device that allows you to see the mucosa of the rectum. And by blowing up a little balloon on one end, you can advance the device further into the rectum to the sigmoid colon, which is the most distal portion of the colon. Of course, I ran into a bit of a problem on the last patient. I tried to advance the scope and I ran into a big wall of pooh which allowed me absolutely no visibility. I had to retract the scope and the doctor informed the patient that he would need to come back again to have the procedure, but this time taking an enema prior to the appointment.

Overall this was one of the most challenging clinics I had ever attended and for a few moments I thought to myself "Hey, I could totally be a colo-rectal surgeon!!" :)

New things I learned on call.......

I had call last night (5 down, 7 more to go) and I learned some interesting things:

- Never try to interview a patient at 1:30am
- I never want to experience a chest tube placement
- I never want to live in a nursing home
- I am going to write a book entitled "Hernia repair: 101 Ways"

Because our night was very busy, our team did not get around to catching up with consults until almost midnight. At 1 am, my resident sent me to interview a patient on the floor with an abscess on her shoulder. So, I proceeded into the patient's room, turned on the overhead light and had the following conversation:

Me: Ms. BL, I'm sorry to wake you but I'm from surgery. I'm here to ask you about the problem you are having with your shoulder.

Ms. BL: WHAT??? You woke me up to ask me about pain. What the hell is wrong with you!!! I'm not talking to you now....get out of my room.....come back tomorrow morning!

So, I proceeded back down to SICU where I told my resident to please never send me to a patient's room again after midnight unless it was an emergency.

I fully recognize that sleep is very important for any person, especially those recovering from sickness or surgery. However, it is rare in the hospital setting to get any decent sleep at all. Nurses...doctors....therapists.....are constantly coming in and out at all hours of the day. I sometimes wonder if patients would recover faster with more sleep (interesting study idea).

Now on to the chest tube.....OUCH!! It started off okay, with some local anesthetic, 2mg of IV morphine and a small incision, but then the patient was having some pain and the resident was having a hard time getting into the chest wall. So, the senior resident turns to the patient and says "This is going to hurt", then proceeds to jab a blunt instrument extremely forceful into this guys chest and into his pleural cavity. All we heard was a loud "Pshhhhhhh" like if you opened a can of soda, and the patient started screaming in pain (although the word screaming does not do justice in fully describing what came out of this guys mouth)....and the screaming lasted for about 10 minutes after this fairly traumatic event. My first chest tube placement made me quickly realize that I never, ever want to go through that procedure....and, in the unfortunate circumstance that I do, I want to be completely knocked out.

While we were placing the chest tube, the paramedics bring in an 80-something year old female resident of a nursing home with a very visible, pulsatile abdominal mass. My senior resident asks the paramedics if she is responsive. The paramedics reply "The patient has been unresponsive for 2 days." What?? 2 days?? They go on to explain to my senior resident that that is the history the nursing home provided. 2 days?? That seems a little extreme to me. Who in their right mind would allow an elderly patient to be unresponsive for that amount of time. Can you say lawsuit??

Other than that, I also scrubbed in on 3 hernia cases, all involving the right inguinal region, and all of them completely different from each other. By the end of the 3rd surgery I realized several key things: the presentation (extent, location, etc) of the hernia can influence the surgery (where to cut, how long to make the incision, etc); each surgeon has their own way of starting a hernia, repairing a hernia, and closing a hernia (using a multitude of differing instruments, meshing, plugs, sutures, etc). I also quickly realized that I can easily pick out the layers of the hernia until they cut open the hernia sack.....then everything gets boggled up and I have no idea what layer is what (I only hope the surgeon knows ;)

Well, it is officially time for bed. Tomorrow is another OR day. Hopefully, I get the chance to see something new (please not another hernia :). Everyone have a good night.

No sleep = severe crankiness

I have been blessed to recognize, since early on in my life, that sleep is a very big priority for me. I try to get at least 7 hours of good sleep a night. 8 hours is the very best, allowing me to perform at my maximum intellectual level. So what happens when I am on call and the resident sends me to bed at 4:30am and I have to get up at 6am for morning rounds??? Lets just say I am not very pretty (in any sense of that word).

Example: during morning rounds the Chief resident pointed to me and asked me a question. It took me a whole 10 seconds (of complete silence and everyone staring at me) to realize first, that he was pointing to me. I said "are you directing the question to me?" and he said "Yes". And then, after pausing for another 5 seconds, I said "What was the question you asked?" He then gave up and pointed to another student which I was entirely happy about. The funny thing about this whole conversation.....the Chief was also on call with me last night and was fully aware that my sleep was non-existent (as was his), so why he even thought of pointing to me in the first place was something I contemplated for almost 10 minutes after this whole exchange (which of course led me to miss the presentation of the patients in rooms 225A, 225B, 226A, and 226B). So, to start a list of sleep deprived issues...so far I have decrease in responsiveness, confusion, pre-occupation on things that are not relevant at that specific time....oh, and lateness, considering rounds started at 6am, and I arrived at 6:24. Although I could also classify that as an inappropriate behavior and non-caring attitude considering the fact that while I was in the call room staring at my watch thinking to myself that I'm late, I was also saying "I don't really give a shit, I was on call last night!!!" Of course if you truly know me, you realize that none of the above really even come close to describing me, which leads me to the conclusion that without sleep, I am a totally different person. So the moral of my story....sleep is very important for me!!

Last night we had alot of surgeries.....a small bowel obstruction, an abdominal bleed on a patient who had surgery to remove the gall bladder 3 days ago, and an appendectomy. I got to scrub in on the last case which started at 2:15am. The funny part....putting the foley catheter in. I asked the nurse if I could do it...she said yes, but insisted on "watching me". So, I put my sterile gloves on, cleansed the area and proceeded to place the catheter. The nurse then says "Are you sure you aren't in the vagina?" In my mind the answer to that was "If you knew me, you wouldn't have to ask me THAT question!!!" but what came out of my mouth instead was "I am positive I am in the urethra." Sure enough, urine was seen in the catheter tube (damn I know my anatomy :)

I also got to place some stitches in the patient. I used a subcuticular stitch: the stitch is placed just below skin level ( in the dermis) and is continued throughout the lesion. When finished, tension can be placed on the ends to bring the skin edges together. No visible suture marks are seen. I am still working on my surgeon's knot for tying purposes so I didn't have a chance to do that. But I'm confident I will have it down by next call!!

Well, that is it for tonight. I have breast clinic all day tomorrow and then Head and neck on friday. I hope everyone has a great night!

Week 3 done....

Wow, I am really proud of myself. Not because I have successfully completed my third week of surgery. No. More important is that I have kept up blogging with my incredibly crazy and hectic schedule!!

So, as mentioned above, today was the end of week 3 and of Surgery I. On monday, I start Surgery II. I'm looking forward to breast, rectal, and head/neck. Hopefully, I get to see some great surgeries and more importantly, I hope the surgeons are willing to teach us (because I am so willing to learn).

Let me recap this past week. I did make it into the OR on several occasions this week. I saw a carpal tunnel release, multiple phlebectomies (to remove varicose veins), but by far the best procedure is what I saw on Thursday. A debridement and skin graft on a diabetic patient. This patient had a partial foot amputation. They needed to trasplant skin from his thigh to his foot, hoping that the new skin will take and therefore relieve him of a stumpy red foot with no skin. The grafting was interesting. The plastic surgeon informed us that they use a similar device that the cow hide industry uses to shave off the epidermal layer of skin. It looks like a giant metal razor. Then the skin is place on a platform with lots of holes and is pressed in another machine. This makes the skin come out looking almost like an accordian, with the purpose being to allow the skin to stretch more so less skin needs to be harvested. By far the most stomach turning moment was when the surgeons had to debride the patients foot. They needed to rid the foot of any non-viable skin/tissue thereby allowing the new skin to be grafted to healthy, blood rich tissue. Basically, they scraped the foot with tools; and the blood and tissue that flowed off the table and onto the floor made the OR look like a horror film. I swear it looked like a gallon of blood on the floor!! It was both gross and interesting at the same time. If not for the surgical mask covering my face, everyone in the room probably would have seen my mouth wide open and fixed (as if the wide eyes didn't give me away)!! Overall, the surgery was a success and now we get to follow the patient to see if the grafting took and if someday he will be able to walk.

Other than that, I had call on Wednesday night. Only one trauma: an 18 year old patient who was hit by a car crossing the street to school. His head hit the windshield and he had a huge hematoma on the top of his head, but other than that, no injuries - he is very lucky. We kept him overnight to evaluate his mental status. We had lots of consults all night long, and the night was officially annointed Bleed Night. Everyone was bleeding...consults for upper GI bleed....consults for lower GI bleed....even a consult for epistaxis (nose bleed). I have never seen so much blood come out of any oriffice before. The only plus of the whole night was I got to perform my first rectal exam.....and then, about 20 minutes later, I got to do another :)

Overall, call went well although I was exhausted thursday night and basically just came home and slept. I have also found that call night messes royally with my circadian rhythm. I found it incredibly difficult to wake my ass up this morning. But once I was up, I was okay. The best part....lecture was cancelled today so I was out of the hospital by 3:15pm!!! I came home, ran in the park for 45 minutes, ate dinner...and now, I am just relaxing with a Caribe and waiting for the Penguins to hoist the trophy!!!! GO PENS!!!

Everyone have a wonderful night!

2 weeks down.....10 to go!

Tomorrow starts week #3 of surgery, and my last week of Surg I. I should explain a little on how this surgery rotation is set up. In 12 weeks we do the following:
3 weeks of Surgery I: comprised of general, vascular, plastics
3 weeks of Surgery II: comprised of general, rectal, breast, Head and neck
1 week each of: Orthopedics, Anesthesia, Specialty clinic, Urology
2 weeks of Surgical ICU

After this week I move into Surgery II. Of course Surgery I and II have the most time committment since we have to be at the hospital at 6am. To do that I have to get up at 4am so I can make my 5:05am Q train to Coney Island. If we are not on call, we are able to leave after lecture at 5pm, and then I usually get home around 6-6:30pm, where I have dinner, check some email and then get into bed by 8pm to rinse, lather and repeat again!!

Of course, a call day means a 36 hours stay in the hospital. For instance, I have call Wednesday night which means I go in at 6am on Wednesday and I get out of the hospital on Thursday at 5pm!! Very, very long night and day. Its actually not all that bad if you are able to sleep a little, but even then the night of post call, you just crawl into bed at 6pm and go to sleep :)

So how is surgery going so far?? Its okay....I have found that there are good days and bad days and it really all depends on who you are working with that particular day. If you have a great attending/resident, your day is awesome in that you are able to learn so much. If you have an attending/resident that just doesn't seem to care about you/doesn't want to teach you anything, then its a pretty shitty day. I will say this....the residents work hard and are on call every 3rd night. I don't know how they do it and quite honestly, that schedule alone turns me off from being a surgeon. I love medicine and it will be a big part of who I am....but, there is also so much more to me than that and I have so many other things that I love and want to do.

So, for the next 10 weeks I will learn as much as I can about surgery. Because I know that after August 14th, I will probably never be in an operating room again. I hope everyone has a great night. Take care!

LOBECTOMY!!!

This morning I had the excellent opportunity to scrub in with Dr. S and see a right middle/lower lobectomy. This female patient was diagnosed with a carcinoid tumor.

So last night I prepared for this surgery by digging out my old anatomy books and looking up the relevant physical structures. In terms of cutting into the thoracic cavity, I reviewed which structures would be cut (skin layers, subcutaneous fat, muscles, intercostal space). I then reviewed the lung anatomy, artery and vein supply, the trachea, the lymphatics and other structures nearby (heart being the biggest). This morning I arrived early to look into the history of my patient. 57 year old female with 40 year history of smoking tobacco (and some occasional crack). I looked up her chest CT scan and saw where the tumor was localized (right posterior lower/middle lobe). And I was all prepared to answer any question that Dr. S asked me right?

Well, I got the first one; "What muscle is this that I am cutting through?" My answer: Latissimus Dorsi! Correct!!!! And I got the next question right; "What is that muscle's nerve supply? Long Thoracic Nerve! Correct!! But then it was downhill, because the next question was "Do you know the history of the first lobectomy/pneumonectomy?? And I said No. And so began Dr. S's hour long explanation into the history and its importance. I actually enjoyed it tremendously because it gave you an appreciation for how this procedure developed. So now I know that the first pneumonectomy was performed in 1933 by Dr. Graham on a Dentist from Pittsburgh who traveled to Barnes Hospital in St. Louis to have the procedure done. And I should mention that the Dentist was a smoker.....and so was Dr. Graham!!!

By the way, for those who can stomach it....the following University of Michigan video is very similar to the procedure I saw. Enjoy!!!
http://anatomy.med.umich.edu/surgical_videos/pneumonectomy.html

Have a great night!

1st week of surgery done!!!

Well, my first week of surgery at Coney Island Hospital is done. That also included my first call night which was Friday. So far, it is going well. There is alot to know and learn and I am trying to keep up with all of it. We are asked questions constantly and if the answer is not known, then we here the following "Go home and read about it". It seems everything ends with those words. Unfortunately for me, I can read it a hundred times and it doesn't stick, but if I do it then I'm fine. So I try to keep my ears open and volunteer for everything I can just so I can learn better.

Here is a quick re-cap of my week: In SICU (surgery intensive care unit), we saw some patients get better and others that did not. We have 2 patients on the medical floors with diabetes that need amputations. One is scheduled for next week, the other is still waiting on insurance to cover the procedure. I had clinic this week; vascular and ulcer, surgery I, plastics. All went okay. I am still trying to learn the computer system which has been a little frustrating at times but I'm hoping I figure it out by the end of the rotation. I was assigned one patient who came in for small bowel obstruction. She was in SICU. Fortunately, she has not needed surgery. When I left yesterday morning she was feeling much better and they were thinking of discharging her. Also, we were scheduled clinics (suture, respiratory, scrub training) and we had 2 lectures...one on aneurysms and the other on acute appendicitis (which was very beneficial to me considering my first case on call was just that).

Call was okay. The night started off slow and there wasn't much to do. Our resident sent us to the call room around midnight. I slept a little, then I got up at 3:30am just in time for the action. A young 27 year old came to the hospital with pain in his abdomen. After talking with him, and after a CT scan he was told he had appendicitis and his appendix needed to be removed that morning in surgery. Because it was our case, we got to go into surgery and watch. They did the procedure laparascopic. Before the surgery though, we did have one trauma. A 29 year old male who was drinking went swimming with his girlfriend and drowned. Everything was tried to no avail. He died 45 minutes after arriving to the ER.

In terms of procedures, well only one was learning this past week. Before doing the surgery in the ER a foley catheter had to be inserted. I got to do it....actually I volunteered to do it. So now, I can put one in anytime!!!

The only downside to surgery is the tiredness. I was fine pretty much all week. I was going to bed early and eating healthy. Even call was not bad. It has been the 2 days after call that has been kicking my ass. I got home yesterday morning at 10am and slept until 5pm, then had dinner and watched a movie, then slept from 9pm until 7am this morning and for some strange reason.....I'm still tired. And I absolutely hate that feeling. So, that is the only bad part to this rotation. Hopefully I adjust as the weeks move on.

Okay, I have to go and do laundry. I hope everyone has a great day!!! Stay tuned for week #2!

First Day of Year 3

Today starts my first day of Year #3 in medical school. I'm starting with surgery!! One of the hardest and most intense due to the call schedule. I'm actually happy that I am doing it first. I'm hoping that my excitement for starting 3rd year will carry me through this rotation :) Plus, I enjoy surgery, so it should be fun. Here is what my schedule looks like for the next year:

Surgery 5/26/09-8/14/09
Medicine 8/17/09-11/6/09
Pediatrics 11/9/09-12/18/09
Ob/Gyn 1/4/10-2/12/10
Psych 2/15/10-3/26/10
Emergency 3/29/10-5/7/10

I am hoping that my blogging will be slightly better than in Grenada. I know, it really has to do with the blogger (that would be me). I just get so caught up I forget but I will try to blog about interesting things on each service.

And of course, I will also blog about the city!!! Speaking of which, this past weekend, Laura came to visit me and we had a nice little adventure. We went to NY Aquarium, Coney Island for some cheap beer, Little Italy and a Pub on Broadway for some not so cheap beer, shopping all around 34th street, Central Park, Prospect Park (Brooklyn), and we ate at 2 cute little places in Park Slope: Ginza, a Japanese Hibachi restaurant, and Fritters, a burger and fries type of place. Both were very good. And lets not forget Bergen Bagels on Monday morning!!!!

Did I mention that Laura kissed Oz!!!! It was so cute! And smelly (he had wicked Tuna breath that was all over the side of Laura's face :)

Alright, I have to get ready for my big day. Need to iron and look my prettiest. Good luck to me!!

Happy Easter!!

I hope everyone is having a great Easter. In a few short hours I will be munching on Ham, real mashed potatoes, carrots, rolls and later.....cheesecake.....YUMMY!!

Well, I got my test score back. I found out Wednesday March 25th, 3 weeks to the day I took my exam. Before the drumroll begins, let me just say the following: I decided to set a "range" of scores that I would be happy with. My range was 230-240. I knew that if I could land in this range, then no residency that I was interested in would be out of reach. Now to the drumroll: I got a 230!! And I was extremely excited!! Yes it was the minimum of my range, but still within it. Could I have scored higher?? Who really knows. Could I have studied longer and gotten a higher score?? No. As I explained before, I really feel that I studied too much. It does make me wonder would I could have scored had I taken the exam in February when I wanted to. Unfortunately, I will never know, but in the end it doesn't matter. I scored what I wanted and I am very, very happy.

Now that I have my score I am much more relaxed. No crazy dreams about scoring too poorly, or dreams where I did exceptionally well, only to be told I needed to re-take the exam because I performed "too well". It is nice to know that the effort and time you put in was not wasted, and that you achieved something you wanted.

A few of my friends have taken the exam, and some are still waiting to take it. I wish everyone the best of luck with it.

Have a great Easter and I will talk to you all soon! :)

Long time no see.....

Good morning!! I was reading Valuemd.com and quickly realized that I have not posted in a while (who would have guessed?). So I decided an update is in order. When I last left all of you, I was about to take my test February 18th. Well, that didn't work out too well. Some personal issues came up and I didn't feel prepared. So, I rescheduled it for March 4th.

To be honest, I wish I would have taken in on the 18th. I figured the extra 2 1/2 weeks would help. It didn't. I think by then I was just too studied out. I couldn't concentrate on learning anything new. I would do a few blocks of questions and then my brain would go blank. It was hard to focus. So, about a week before my test date I decided to do less. I stopped reading First Aid and all my review books. I instead just tried to do as many Uworld questions as possible. I wasn't at all nervous on the days leading up to the test. In fact, test day I wasn't nervous at all.

The test: Not bad. My first two sections were extremely hard. After them, I took a 10 minute break and told myself not to worry. It's okay. I still have 5 more sections. Then I went back in and to my surprise, blocks 3-6 were so easy. I flew through them with hardly any trouble. My last block was medium in comparison, doable definitely. And then I was done. And driving back home to get drunk :)

So here I sit, 2 weeks and 1 day out of my test. Results are released 3-4 weeks after the test. So, next wednesday I may be a happy....or sad. We just have to wait. And of course, I thought studying for the beast was the hardest part. Everyone have a great day!!!

Can't......study.....any.......more.....

I have been studying for too long. How do I know?? Because I start to focus on something important like enzymes in the body that need thiamine as a co-factor, and next thing I know, I'm on the internet looking up thiamine....where does it come from?? What other creatures in this world need thiamine?? Can my cat have thiamine deficiency?? Wait, I need to go check the cat food to see if it is fortified with thiamine. Do mice have thiamine? And this is just with thiamine!! There are other water soluble vitamins needed by our bodies to function properly. And don't get me started with the fat soluble ones!!

So my test date is February 18th. I can't wait for this day. Studying, for the most part, has gone well. There are things I definitely know, and there are things that I quickly forgot. This week has been focused study on those areas I quickly forget. Unfortunately, I can't tell you much about what I'm studying because I have already forgotten.

Today is very snowy and cold in central NY. It is days like this I wish I was in Grenada. But then I remember that I am going for sushi tonight for dinner (it will cost me less than $12 for 3 rolls instead of 1) and then maybe to a movie.....or to walmart.....or wherever else I want to go, and then I don't miss Grenada so much. Did I mention no "hooting or hollering"!! That is a plus :)

Which has me thinking lately. Maybe I will do my residency in a warmer area of the United States. Any suggestions out there as to where?? I'm thinking arizona....maybe south carolina.

Alright, back to studying. Purine salvage deficiencies here I come!!!

History is made

I'm supposed to be studying for Step 1, but I had to take a much needed break to watch history. Barack Obama becoming the 44th President of our country. I did not vote for him (mostly because my absentee ballot was not mailed on time), but I am very happy that he was elected and I only hope that he can unite people, to inspire everyone in this great country to be the best, and to make change happen. Good luck Mr. President.

I'm home!!

I arrived safely yesterday morning at the train station in Utica, NY. And was I excited, not so much to be in Utica, NY but to be in the states and not in Grenada. The flight went well. A little delayed (45 minutes) at the Grenada airport, but smooth flying to JFK. The plane was only 1/2 full, so I had 3 seats to myself. We landed around 1am and I made it through customs really quick. Then it was off to Jamaica station to get the LIRR to Penn Station. Waiting for the train for 7 minutes outside in the cold at 2am was brutal. I couldn't sleep in Penn Station, so I stayed up all night. Then at 7:15am, I boarded the Maple Leaf to Utica, NY and arrived at noon.

First thing was food....I had a chicken and roasted red pepper panini at the Boulevard Diner. Then I came home to play with my puppy (and got rabies kisses!!). Then I just relaxed and watched movies and tv and went to bed really early.

So today I have alot to do. Unpack my summer clothes and pack them away in bins. Get out the little winter clothes I have. See what I need to buy in the next few days. Oh, and study. Let's not forget about the big test I have coming up!!

I hope everyone has a great day. 4 more days until christmas!!!! :)

The end is near...

Tests are over!! I never have to take another test here in Grenada again, and I can say that with confidence because I already have my scores back. A in pathophysiology, B in pharmacology, and in clinical skills....well, they are still working the final grades out but I can't get less than a B (considering that is what the site shows right now). So, overall this term I did fairly well. Considering I was also studying for Step 1 at the same time as the above classes.

So, the last few days have been crazy and hectic, but REALLY FUN. So lets recap shall we:

Thursday: After pharm, a little celebrating and drinking on campus..

Then to old school for a little more drinking....
Friday night: The best party ever, hosted by Sej!! YES I'm in a DRESS!!

Then, back home to change and off to Dr. Groom's for the end of year party....

Stayed for like 2 minutes (I was really tired and decided to go home and sleep)..

Saturday: Lunch at BB's....one last crab back experience..

Hash with Ishie....my first and last...I had SO MUCH FUN....

Sushi w/friends and saying goodbye....

So, I have 5 more days of sun to enjoy and then I'll be leaving Grenada. In some ways I will miss it here, but in more ways I am so happy to finally get home!! Take care everyone. See you really soon!

Where the hell have I been????

This is something I have heard alot lately. The other is....why have you not posted to your blog since September?? Oh shit....has it been that long?? It has, as I found out about 5 minutes ago. So, there is alot to catch up on and I better type quick considering I have my finals next week and I need to study for those. Here we go:

The first pathophysiology test was horrendous. Averages were really, really low (1/2 the class failed). We had a huge meeting with the directors of the course as well as the other courses, the Dean of Students, the Provost of the school, and so on....after about 2 hours of student complaints we were told the course would be curved.....good thing?? Who knows, all I know is I'm doing just fine and I haven't studied for pathophysiology since this first test and I stopped going to lectures back in September. I have been watching Kaplan videas and doing questions and studying my ass off for Step One. On the second test I did even better. So no worries here.

Speaking of which....Step One. I decided to not take a Kaplan course like many of my fellow students. I couldn't see spending $3,000 on a course for 6 weeks. Not to mention I would have to sit in lecture for 7-8 hours per day for 6 days a week. My attention span would not hold. So, back in July I decided to use this whole semester as my study time. So far its working really well. Once I get back home, I will do some practice tests to judge my weaknesses and strengths and then study my butt off for 6 weeks. I'm hoping to take the test the end of January which is much earlier than most of my friends (who will be taking it in March). I guess I'll have to see how my plan works.

Mit, Marie, Dy, Shelly, and Laura all came to visit me. YAY!!! They all came on November 8th and stayed for a week. I was so excited....its nice when friends or family can come to visit. We had a great time. We went on a hike, and river tubing, and on a sailing trip. And we went to the beach alot!! Here are some pics for you to enjoy:

Did I mention that the boat trip above had all you can drink alcohol. :)

My internet is SO slow right now....so, i'll have to end here for now but I promise I will write again soon....and besides I have to post pics of me in a dress!!! What??? A dress?? You heard it....come back for more real soon!! Have a good night!!!

Beach time!!

So, hell week is over. My last exam was yesterday in pharmacology. It went okay. It is so difficult to study material that has no meaning, at least not now. I'm sure once we get into clinical years, and we see patients with varying degrees of infections, diseases, and such...we will become more familiar as to the standard treatments and drugs of choice. But for now, we must memorize, memorize, and memorize some more and then hope to hell we remember something when trying to answer 3rd and 4th order questions on which drug when given IV causes ototoxicity....or what generation of this family of drugs will treat a Pseudomonas infection...AHHH!!

Also yesterday, our class was graced with our scores from pathophysiology. Lets just say when the class average is 64 (passing grade is 70 don't forget), it says there is definitely something wrong with the class....something we have been bitching and moaning about for 5 weeks. Remember, we are not new here. We are 2nd year medical students and I think by now we have come to know what to expect from our courses. When a class does this poorly it reflects not on us or our learning style, but on the course, professors, and total lack of planning. This is the first year for this supposed revamped and renewed Pathophysiology class...and it totally shows. Not getting handouts or lecture slides in a timely manner (sometimes weeks after the lecture), no clear objectives as to what will be on the test, telling us to post our questions on a class forum and then having no one from the department answer our questions. And then the department posting notes saying please bare with us during this time of adjustment bull****. At least the course director, in an uncharacteristic way, decided to give everyone 20 extra points for the 1st test...so our morale would not be shot for the rest of the course. Why thank you....how generous of you. Now, why don't you FIX THE CLASS!!! Of course, this is a one time shot of extra points and there will be no such curve on the remaining 2 tests. I can't wait to see what those averages look like!!

So last night I watched the debates. McCain really looked good compared to Obama. I'm really sick of questions be asked to Obama and he skirts around them. Just answer the question. What are YOU going to do?? I think the moderator last night asked Obama the same question, re-worded 4x and he still didn't answer it. Right now, I'm leading towards McCain....but, Palin scares me a bit.

Today I am off to the beach to soak up some much needed sun, followed by some lunch sushi. And later tonight I am baking cookies....peanut butter....yummy!! And dinner is meatball subs (something I have been craving for weeks).

Before I go...2 very funny things I have seen this week:

www.nakedclowncalendar.com - this is pretty hysterical if you ask me...i may just get one

http://www.msnbc.msn.com/id/26892950/wid/11915773?GT1=31037 - what is wrong with PETA....this organization is seriously crazy!!

Alright everyone. Have a great weekend and I will update you all soon!! :)

I am at a loss for words, and therefore cannot even come up with a suitable title for this blog.

Tomorrow starts our first found of tests for term 5/6. I have pathophysiology at 1pm. Am I excited? scared? nervous? feeling like I will rock it? NO....none of the above. This is actually the first test in medical school that I have no feelings. And maybe that has alot to do with this department. See, this is an old class with a new look. The school decided to change it up a bit....which is great...change is always good. But in typical SGU fashion, they did it without a plan in place. And because of that, no one knows what to study, where to study from (lecture handouts, books, wikipedia), or really what is going to be on the test. These last 5 weeks have been extraordinary vague and we typically get the following response from the department: "please bare with us and be patient as we are new at this too and we are trying to work out the kinks". Great!! Thanks....and while you are doing that...you are playing with MY FUTURE AS A DOCTOR!! So, needless to say I really don't know what to expect for tomorrow's test. I'm just going to go in and do the best I can and know in the back of my head that I have 2 more tests this semester to make up for this one if I bomb it!! :)

Then wednesday is clinical skills....this class is funny. We have to come in and take a midterm that only counts 8% of our total grade. No, you didn't missread that one.....8%. What a waste of time and not to mention paper. I will definitely not be studying for this one.

No...all my time after pathophysiology.....from monday night until friday at 1pm will be towards pharmacology which happens to be the biggest bear I have encountered in grenada. Now, i hate to memorize with a passion which is why classes like parasitology and microbiology gave me such trouble. This class however, takes the gigantic 5 tier wedding cake. The amount of absolute bull**** and minute details we have to "memorize" and "know" is mind boggling. I thought once we get into the hospital we have PDAs....oh, and those wonderful people that go to school for 5 years straight knowing ONLY medications....hello pharmacists!! So, i will be spending my entire weekend cramming info into my incredibly shrinking cranium only to forget about it next week.

Although I must mention that the season premiere of Grey's is thursday for 2 hours!!! So excited!! I will definitely be taking a much needed break for that.

Alright, well before I go let me fill you in on some of the things that have happened over the last few weeks:
- IGA has no ice cream (bastards)
- IGA has no soy milk (AHHH)
- Union made up of security guards, bus drivers, and other ancillary staff went on strike last week...from my perspective, this was kind of funny (only because I live off campus and have a car)
- My headphones broke (but I learned from term 2 and had a spare pair....i'm too smart!!!)
- I stopped working out for 1 week (tweeked my back)
- OBGYN prof pronounced "centimeters" as "sontimeters" (and she said it ALOT in regards to the dilated cervix and the size of the baby's head....9.5 sontimeters)
- Tom Brady got hurt (BOO FRIGGIN HOO.....little whiner)
- Farewell Yankee stadium (just tonight....how sad)

Alright....i'm off to bed for some sleep before the big day of fun tomorrow. Have a great night.

wow.....

Was July 21st really the last time I posted??? Holy POOH!!! Well, I have alot to say, so lets get started:

Happy Birthday Randi!!! I'm not too happy that you and the fam get to enjoy Coalyard Charlie's without me tonight.....we will definitely have to go when I get home in December.

My dog, in his true golden retriever fashion, chased a skunk, bit into it, and proceeded to get a chunk taken out of his nose. He won of course....skunk down. But, he did not have an up-to-date rabies shot and the skunk tested positive. Now has to be quaranteened until mid February. Poor pup!!

This semester is really crazy and hectic; even worse then last semester. Pharmacology is really kicking my butt since it is all memorizing, and that is my weakest area. Pathophysiology has a new director this term and therefore has no direction. I have no idea even how to prepare for that test. Clinical skills (for the first time) is actually really good. We have hospital visits this term and so far, all of them have been wonderful experiences. And of course, because my parents have not won the lottery yet and I can not take extra time off to study for the all important Step 1 exam, I have to incorporate my studying for that beast of a test throughout this semester. So crazy and hectic is a real understatement!!!

Picture time!!!!

Well, I will stop now so I have more to talk about next time I blog (maybe sometime in October) :) Everyone have a great night!!

Who knew....

On friday I ventured out to Rochester NY to visit Alana. Of course, one mention of Rochester and my step-dad was begging to come along. I, being the nice one I am, said yes...and he took the day off from work to drive out with me. While he was out walking the locks of the old Erie Canal, Alana and I saw the new Batman movie....which should be called "That movie with Heath Ledger". After the movie, Alana, Fur and myself headed over to TGIFs for dinner. It was almost 8pm and Fur and I were planning on leaving when he asked if we could see the old railroad tracks in the city. Always up for an adventure, I said yes. I lived in Rochester for almost 2 years, yet I had never really appreciated the history or architecture within the city itself. It was really beautiful and I am happy I went. Of course I had to listen to Furry's stories (he thinks he is a huge history buff regarding the Erie Canal :) :) Here are some pics:







Aren't I cute??



Furry never smiles...only smirks....

Everyone have a great night!!

:) :)

So, what does one do on a tuesday night in good ole Utica, NY. Why, attend the roller derby event at the Auditorium!!! Mit was gracious enough to call me up and invite me to this most amazing event. I remember seeing roller derby on TV as a kid, but I vaguely remembered...plus, I had never seen it up close and so personal. It was like being in a foreign country. Who knew there were soooo many die hard followers and fans. It took Di a few times to explain to me what the hell was going on....but I finally understood. So, I will try to explain....in my own words....

So you have 2 teams who roll around on this oval track. When I say roll, I mean on roller skates. Remember those?? I remember being around 10 and my mom dropping me off at Midstate to skate on a friday/saturday evening. I also vaguely remember getting my own pair of skates as a present, but whether or not I had a big poofy ball on the skate boot I can't remember (or maybe I blocked it out). Anyway, back to the derby....so you have 2 teams on this oval track. Each team sends out 5 players. There are blockers, and a pacer....and the jammer. The jammer is the person who scores points. Each round lasts about 2 minutes, and the jammers for both teams try to circle the other players scoring points as they pass. Its up to the blockers to prevent the other teams jammer from scoring by knocking her down. They aren't supposed to use their hands but there was plenty of that last night (which apparently the refs were not paying attention to). If a player does do something illegal, they are sent to the penalty box and must sit there until they can rejoin the action. Overall, the game was fairly interesting. No injuries to report, which totally saddened the Doctor in me.....especially when Dy told me about the girl who broke her ankle weeks back, and bones were sticking out....I want to see BONES!!!

After the derby, we stayed to see some of the National Roller Hockey Championships. Very interesting sport as well. Its like field hockey on roller skates. Very fast paced. Honestly, I don't think I could do it....not having spent most of my time on ice hockey skates/roller blades!! :)

My last exciting news is that I ate at Panera Bread last night for dinner. I think I only ate there once before, when I used to work at the Pharmacy and my weekend warrior companions wanted to order out for dinner. I was surprised on how good it was...and how packed it was. I had the grilled chicken asian sesame salad. Very, very good. I was tempted to try a latte, but I really didn't need the caffeine at 6pm....maybe some morning I will try it. I also had a bit of Mit's chocolate chip cookie....and as she said, it was very good!!

Alright, I have some work to do today. Car is getting new tires, I need to go for a run, and do some studying. Everyone have a great day!!

:)

Well, I have officially been home for a week and so far everything is going well. I spent the weekend in Saratoga with the family. I really love that town...very busy...and beautiful....lots of things to do. I just wish it was racing season because I love horse racing. I haven't been in years :(

This week I am slightly busy. Have to take the car in to get its 60,000 mile check-up....also needs 2 new tires and a front end alignment. I have some pharm work to do (need to get a head start so i have more time to study for step 1).

Other than that, I am working out....trying to maintain my new figure, and just enjoying home. 5 more weeks and then its back to the grenada grind. Everyone have a great day!!

Rain, rain, rain

So I leave rainy Grenada to come home to rainy Upstate NY....AHHHH!! Actually, I don't mind because one of my favorite things to do is run in the rain, and this morning it poured!!!

So, my flight home was not very fun. Here is the story: I decided to get to the airport around 2pm, check my bags in, and then hang out at home until my 6:10pm flight. I found out the flight was postponed until 9:30pm. So, I went back home, took a nap, played on the computer and then around 6:30pm, I decided to walk to the airport because a large, dark cloud was rolling in. Then, I waited, and waited, and waited some more until 11:15pm when we finally boarded the flight. Funny short story....I got to my seat to find a Grenadian sitting in my seat. I said "Excuse me sir, you are in my seat" and he responded by saying "It took you long enough to get on the damn flight so you gave your seat up". I looked around....hardly anyone was on the flight yet because they were still back in the terminal (I was one of the first 25 to make it to the plane). Anyway, I decided not to be nice....I told him to get up out of my seat or I would make a huge scene.....he moved.....of course, he grumbled the entire time and was not very pleasant, but I slept most of the way to NYC anyway.

Landing in New York at 5:30am was great!!! Then I made my way to the Jet Blue terminal, checked into my flight, had some coffee and breakfast, and waited for my flight....which was also delayed, but for which I could care less because I was stuck in an American airport with Dunkin!!

Home has been really nice so far. I have gone to all my favorite places....Target, Walmart, Best Buy, Marshall's.....and, I had really good sushi Monday night!! Spicy tuna and an avocado vegee roll....:)

Today I'm heading out with the family to Saratoga for a nice relaxing vacation. I'll be sure to take some pics and post them next week. Everyone have a great day!!!

:)

Well, after waiting the entire week I finally got my path grade. My final for the course: 88.68. I was 0.32 points away from an A :( It was SO close.

So the rest of the week has been hell here...and by hell I mean really boring. I did nothing on tuesday, although I was supposed to be studying for clinical skills. I would start to study and then decide to do something else, like watch a movie, or take a nap. Wednesday's lab practical was funny because I arrived at my designated time slot and was assigned to a room only to find it was the same Doctor I had for my midterm....who happens to be very nice and fair. Then I walked down to the many pieces of paper face down with our practical exams and guess what I picked?? The same patient exam I picked for midterm. So, I told the Doctor I would do it again for her but I would really like to be tested on something else. So, I got to re-pick. So, I had to perform a respiratory exam, plus 2 minors....check for meningeal irritation and palpate the thyroid. My exam went really well, and I got an A. Then, I did nothing for the rest of Wednesday....studied a tad bit on thursday for the written. Took the written test yesterday and then.....

I saw a cricket game!!!!! Kate was nice enough to invite me to my first game and it was awesome....I had a great time. I watched Australia play the West Indies and it was really like watching a professional football team play a prison team. West Indies was okay....but Australia blew them out of the water. The only unfortunate part was I totally forgot sunscreen and I BURNED!!! My face, arms, knees.....so, i'm hurting a little today. I had a great sushi dinner last night and then went out with friends to Prickly Bay to celebrate. Had a few drinks...came home..slept for a few hours....brought Layne to the airport at 3:30am... hung out for a few hours....came home and went to bed.....got up at 9am...ate breakfast and here I am now!!

Today will be a fun and lazy day of packing and relaxing. If the sun comes out I may go down to the beach. Tomorrow I have laundry to do....some more packing....then, my fluffy butt gets on a plane at 5:30pm and I'm off to NYC!!! Can't wait to get home....play with my puppy....have some real sushi....and relax!

It's Over!!!!!

So, Pathology is now a distant memory. I officially finished the 3rd and last test at 12:08pm today. YAY!!!!! Overall, I thought the test was fairly easy and predictable. The questions were not 10th order like in previous tests. Also, the questions seemed to be alot more generalized...no testing of ridiculous details that none of us would remember in 10 minutes. I actually finised with almost 40 minutes left. And, since Pathology is the only class that will not allow you to leave the test early, I spent the rest of the time re-reading and looking over the questions on the one topic I had the least knowledge of....Male pathology!! How appropriate, right?? :)

Anyway, so....now I am just enjoying the moment of not having to study Path. Of course I have a stupid everlasting grin on my face. I think I will watch a movie now.....Baby Mamma is calling my name. And tomorrow morning, I get to spend the whole day cramming for my clinical skills practical. Everyone have a great day!!!

P DAY!!!

Today has arrived. The last Pathology final. :)

AHHHHH!!! Ready......set......

June 19th!!

Today is National Hurricane Awareness Day in Grenada. And I know this because of a neat little feature that is available to us here in Grenada. Something that I never had at home. Text messaging courtesy of your cell phone provider. Anytime there is a contest, or a chance to buy double the minutes for one low price, or a national event (like today) my phone makes its customary "I have a new text message awaiting your viewing" noise....and I look...and there is my message from Digicel updating me on the current news, events, and promotions. Verizon NEVER did that for me. So I guess being here has some nice perks to it.

In other news, I have been busy studying for the final Pathology test which will occur at 9 am sharp this monday. Am I prepared??? Well, I think I am. The better question is, am I prepared to answer insanely long, 10th order questions from professors who find it amusing to test us on disorders and diseases we will probably never see as physicians. Case in point.....we are constantly bombarded about this one disease called Goodpasture's which causes bloody urination and bloody cough/sputum (ask me about the pathogenesis on this one when I'm home because I know it!!). Anyway, today while I was trying to gain better insight into this disease through my search on wikipedia, I found out that Goodpasture's accounts for only 1% of ALL renal diseases. 1%!!! What?? The only doctor that will ever see this on maybe a yearly basis is a nephrologist and I know I won't be going into that field. But, we need to learn about it. Thanks Path for inundating my already swollen brain with useless material.

So, I had the opportunity tonight to try another Grenadian restaurant. We went to The Ocean Grill in St. George's. It was good. I just had a drink and appetizer....coconut shrimp and a pina colada. Yummy!!! Long story on how I ended up going out on a night when I should have been studying, but lets save that and just say that the food was very good and I definitely want to go back for lunch. If not this term, definitely next.

Well, plans for tomorrow are the following: Get up at 5:30am, make coffee and breakfast, drink coffee, wrap up breakfast, go to school, study, study, eat breakfast, study, study until 11am, workout for an hour, come home and eat lunch, shower and small nap, study, study, study, eat dinner, study, study, study, study, bedtime at 10:30pm.

Unless something really good happens this weekend (and you never know), my next post will be monday after the monstrousity. Have a great night. :)

Friday the 13th.....

Am I superstitious??? Absolutely not....because I have no time to be superstitious....I'm working hard studying for pathology. We just finished a week of Bone Path and Neuro Path and I just finished typing up my notes. Next week we get to hear lectures on Forensic Path and Skin Path. The forensics sounds fun and I am actually going to attend those lectures. The Skin packet has lots of pictures, so I may just attend those too (to see them in color).

So not too much to report here. This week has been really hectic. The nice thing is, I will be home really, really, REALLY soon!! I have been on this island for WAY TOO LONG!! And I desperately need a break. I have already been daydreaming about all the things I want to do. Go see a movie. Sushi. Chinese. Outback. Shop at Target. Shop at Walmart. Drive on the right side of the road. Of course, I can't eat too much because I need to maintain my new figure. But I can indulge a little :)

Since I don't have too much to talk about, I have decided to show you a picture of what I have to deal with here in Grenada:

These are the wonderful worms that just seem to appear out of nowhere. One minute they are not there....and the next....a worm. And these are not speed demon worms by any means. They are extremely sloooooow. So how do they suddenly appear in the middle of our dining room floor?? I have actually had the pleasure of finding out where they come from. One day, while sitting in my room....I catch something out of the corner of my eye and hear this very faint "thud" sound. I look over the side of my bed and see a worm (much like the one in the picture) that I know was not there 30 seconds before because I had just come in from getting a glass of water. These worms fall from the sky!!! No really...they do. I think they somehow make it up on to the roof, in through the rafters, crawl their way to a nice open space and drop down on to the floor. Nasty right??? I'm always nervous that one will land on me while I'm sleeping, so I make it a habit to check the ceiling every night before bed. I guess it could be worse....it could be a spider dropping down from the ceiling. I guess in the grand scheme of things I would much rather deal with quarter sized, slower than dirt worms, than quarter sized 8 furry legged spiders. :)

Bummed :(

My penguins lost to the red wings last night. It was inevitable considering Pittsburgh was a young team with little experience.....and Detroit has many experienced veterans and european players. I admit that Detroit really was the better team, but watch out for the Penguins in a couple of years when they are older and wiser!!

So today, karma came and bit me in the ***. Every monday for Path lecture we have a team based learning session where are lab groups assemble, we are given cases that we talk over, and then we spend about 45 minutes presenting them to the rest of the class. A few months back, no one in my group wanted to speak and kept insisting that I do it. I didn't feel like talking that day because I just wasn't in a very good mood. So, as our time approached I discreetly got up to "use the bathroom" and then conveniently returned when our turn was over. I know, that wasn't the nicest thing to do, but...my group was being mean to me that day. Well, today it came back to haunt me. This week, in addition to slides, we had 5 cases to do. Our group assigned the cases to correspond with the slides that we have to present. So on Tuesday, my slide was Adrenal Adenoma, and then I presented Case #2 on Cushing's syndrome. Then today, we learned that those cases were actually scheduled to be completed in lab today. They randomly picked 5 groups to come up to the front and present. And didn't our group get picked for Case #2, and wasn't that the case I presented on Tuesday...YES IT WAS!! So, my group MADE me go up and present the case. The only bad part was, I forgot what I had talked about on Tuesday ( I have been concentrating on studying Renal this week, and not cementing the details for Endocrine). But, I did okay (at least that is what my group mates said....although they are probably lying). There was one question from the professor that I was a little mixed up on, but Layne had gone up with me and she knew the answer. Overall, the moral is....Karma exists!!! So don't mess with it!!

In other news....I'm studying Endocrine tonight. In my attempt to still try for an A in Pathology, I once again have revamped my study style (this is the 3 time this semester for this class). I have decided to skip lectures, and spend that time making my notes and learning the concepts. Then, after reviewing everything, I am going back to listen to all the lectures online. The school records all of the lectures, although you can only hear the audio, no pictures. So far, this way seems to be working well for me. I'm not as confused as to what is going on during the lecture, and I feel I am able to pick up the little details that I usually miss when I'm actually sitting in class. We will see come test time if this method works.

Guess what Satuday is???? BELMONT!!!! Big Brown going for the Triple Crown. I think I will head over to school around 5pm to see history. Although, I shouldn't say that because I may jinx it. But I am rooting for Big Brown to win, and looking at the odds, so is everyone else.

Forgot to mention that Tuesday was Kaushik's b-day. Layne, Allison, and myself made him brownies (he's a choco-holic), went over to his apartment, and hung out for an hour. Of course, Kaushik's roommate Richard made a cake, so not only did I have a brownie, but that as well. Which meant that today, I had to run extra hard and long. 1 hour and 8 minutes. My knees are screaming!! But its okay, because I am deteremined to reach my final destination weight of 128 before I leave this island.

Well, enough about me....how are all of you doing??? I can't wait to be home in 3 1/2 weeks to find out. See you all soon!!! :)

150 - 30 =

20 POUNDS!!!! I have finally reached my goal....almost 4 weeks early! On January 26th I decided that by June 30th I wanted to lose 20 pounds, and I did it. The healthy way of course....eating well, exercising....plenty of water and rest. So, time to celebrate with a nice big ice cream!! No, not really....but I am having some sushi tonight, and that is very similar to ice cream (at least in my mind).

So what is next?? Well, I have decided to try and lose 2 more pounds before I leave the island. And, I have set a new overall weight goal of 125. By August that is where I want to be. Once I'm there, maintaining should be easy. Goodbye to the fluffiness!!!

In other news....I almost cried this week when my Pittsburgh Penguins were down 2-0 in the series with the Detroit Red Wings. But Wednesday put a huge smile on my face as they won game 3. I believe the next game is Saturday....hopefully they can win and even the series up.

I'm finishing up Renal Pathology today so I can work on Male Reproductive Path later. This weekend is study, study, study.... and Monday we start Endocrine Pathology (never ends....I know).

And, I leave you with this little funny moment courtesy of Yoshie, a girl in my Path group (as relayed to me by Layne). Please note that Yoshie is from Japan and english is not her first language....so many times she is looking up words online for their meaning and definition. The sentence in the case was "He has burning micturition." So here is the exchange:
Yoshie: What is micturition.
Layne: Micturition means like he needs to pee.
Yoshie: I looked it up online and it says desire to pee.....so, he has a burning desire to pee??
Layne: Laughing hysterically

Sometimes being lost in translation can be fun!!! Everyone have a great day! :)

Turtle Movie

So I tried forever the other night to get this video up on blogger. I finally converted it to another program and shortened it just a bit, so hopefully it works. Enjoy everyone!!!!

By the way...today is a holiday in Grenada (don't ask me what for). Its a gorgeous day, but unfortunately I will be sitting in the Vet building trying to catch up with Pathology :( I hope everyone has a great day.

AWESOME!!!

Wow....what a fun, fun, fun last couple of days. Lets start with Saturday. When I left you last I believe I was talking about how I was planning on going to the beach on Saturday to soak up some much needed sun. Well, it was cloudy and nasty all day. So, Layne, Alison and myself decided to go for sushi at Carib Sushi in Grand Anse. I ordered a carafe of Saki, edamame, the spicy tuna roll and the Alex roll. Now, please remember I am in Grenada, so this is no where near the variety and great eclectic tastes of the sushi back home. But, it was good. And very, very enjoyable. It was so nice to just hang out and enjoy a good meal. Of course, now I want sushi ALL THE TIME!!! I'll just have to wait for the really good stuff in July.

Monday morning I took my clinical skills written midterm. It was okay....I got an 86, so I still have an A in the class which is fine by me. Now on to part II where we learn examination of the lungs, abdomen, and central nervous system.

I just checked my micro score a few minutes ago and.......I got an A in the class. Which is great except I feel I cheated a little by just memorizing and not really learning the material, but that is okay...it will come back to bite me in the fluffy butt come Step 1 time :)

So, the absolute highlight of the past few days...last night a bunch of us traveled to Levera Beach to see leatherback turtles lay eggs!!! It was so amazing!! I can hardly describe in words but I will try. So, we set off around 7pm and after a quick stop at the store to pick up some beer (courtesy of the drunk boys in the back) we were on our way. The ride was almost an hour through the upper hills of Grenada. Once there, we had some dinner (I ordered the bbq chicken) and when turtles were spotted on the beach we headed over. It was so awesome. The turtles were HUGE!!! More than 5 feet long. I tried to take photos but because you can't use flash photography, only 1 came out okay. But I did get some great video of one turtle covering her eggs.

We were there for about an hour. We watched the female dig her hole, lay her eggs, and then cammoflage the whole area....can't have those predators finding the eggs. The guides and researchers that work/volunteer at this turtle laying preserve were all incredibly nice and helpful in answering questions and allowing us to get up close to the turtles. I was able to touch the turtle too!!! It was very rubbery, but its flipper was soft. I also purchased a royal blue t-shirt with the ocean spirits logo on it. Every little bit helps the turtles!! For more info about the turtles click here. So, overall I would say this was an awesome adventure in Grenada and I'm so happy I did it.

So, today its back to work. Female genital tract Pathology.....Yippy!!! Everyone have a great day!!

The Aftermath

The week is over!!! And I survived. It is so hard to explain how much time, effort, and energy goes into studying. Starting last Thursday with 4 straight days of Pathology and finishing up yesterday morning with a Micro cram session...my brain was screaming. But, its over and I am giving my brain a much needed break.

So, here are my results so far. Pathology went okay although I felt horrible coming out of the test. The questions were horrendously long and I almost didn't have time to finish. I felt so rushed and with many questions I simply picked my answer based on recognition alone, without really thinking the question through because I didn't have the time to think. Not to mention that the night following the Path test I had the worst dreams ever. In one of them I was sitting in front of the Path profs who were screaming at me that I was dumb and they were questioning how I ever got into SGU. Well, I still managed a low B on the test....very low B...but a B nonetheless. I still have an opportunity of attaining my goal of getting an A in this class if i work really hard in the next 6 weeks and rock the final exam. :)

The clinical skills lab exam was a joke.....JOKE!!!! Seriously, I don't know how they can say that their exams are standardized in any way shape or form with not only different patient scenarios but different tutors monitoring the exam. I did absolutely no studying for this exam, I walked in about and hour after my Path extravaganza and literally pulled the exam out of my fluffy ass....and managed a 97. My clinical tutor was really fair and unbelievably nice with her follow up questions. My exam was the following: Your patient has been diagnosed with Buerger's disease. Evaluate arterial sufficiency and report your findings. It was one of the easiest physical exams and I was done in 12 minutes. For my minor examinations I had to evaluate lymph nodes of the head and neck and check the patients sinuses for congestion. In contrast, several people I know had the unfortunate luck to pick the paper that said do a complete eye exam, which is long and tedious, and follow-up questions can be very, very hard depending on what tutor you get. I know some who did not fair as well on their exam. Luck was definitely on my side that afternoon. We have the written exam for clinical skills on monday morning and hopefully I do well.

Bye bye micro.....I officially took my last micro exam yesterday after cramming for 2 1/2 days!! Everything from the virulence factors of Streptococci to which organisms can be used for biological warfare/terrorism. Unfortunately, I barely studied for this class during the last 5 weeks because of lack of time/concentrating on Path. I wish I had the time because it is important and somewhat interesting. Who knew there were so many different E. coli strains hanging out in the large intestine. Or that rat fleas are so important in spreading dangerous organisms. But, cramming is also very helpful and rewarding when you just need to pass a test. I thought the questions were very fair so hopefully I did well. I won't know my final score until wednesday night so I'll update you all then.

Well, I was supposed to go to the beach today and do nothing but lay out and enjoy myself....but its cloudy right now and it looks like its about to pour. So, I may have to change my plans slightly (maybe some sushi and a movie instead). Either way I will just be relaxing today on an island in the carribean. Of course tomorrow is another day and I have to start my slides for Female genital tract/breast/ovary. That is right, Monday starts a whole new day and topic of Pathology. And on tuesday we start Nutrition. The work just never ends, but that is the best part of becoming a doctor!!! Have a great day!!! :)

AHHHHHH!!!

Today has finally come!!! The dreaded second Pathology test. So many students before have screamed how hard this test is compared to the first. I have been studying my fluffy butt off for 4 straight days for this test and I can only hope I have retained something. Nevermind the fact that yesterday my brain was screaming "NO MORE!!!" and wouldn't allow me the courtesy of one last slide review. Nevermind the other fact that not only do I have path from 9-12 today, but I was one of the unlucky few to also have my clinical skills lab midterm scheduled from 1:30-2:00 and because of this I had to TRY to fit in some studying yesterday (my brain was not happy about that either). Nevermind the final fact that because of the Grenada holiday yesterday, Dr. Grooms decided to throw a party which lasted pretty late into the night forcing me to extend my bedtime by a few hours. Besides all of that, I feel I am prepared. I am confident I can go into that test and do well. Stayed tuned for my follow-up where I prove that last sentence correct OR.....well, I am in a positive mode right now, so lets not think about that!! Wish me luck!!!!

Interference by Congenital Disorders of the Newborn

Today is Friday and I just spent the last 45 minutes laying on my bed with my laptop on my incredibly shrinking tummy (weight loss is still going well) watching the new episode of Grey's. Isn't that weird....considering the episode was LAST NIGHT!!! That's right......in my haste to fly through a subject that I have little interest in (see title above), I totally forgot that Grey's started at 9pm. And......I MISSED IT!!!! I can't feel too bad because Layne, my Grey's buddy, also forgot....although she didn't forget to remind me that we both forgot this morning at 7:30am while I was eating breakfast. I was so disappointed and desperate to find the episode that instead of having my usual morning breakfast over ESPN highlights, I preceded to search websites as far away as Japan looking for the episode. I did find it (thank you sidereel.com) and downloaded it....and as mentioned, just finished watching it. It was worth the scramble!!!

So today I spent most of the wonderful Grenadian day heavily involved in pooh.....i mean, in Gastrointestinal Pathology. I covered lots of info....I only hope that I can remember it all. I did break for about an hour to listen to a Micro lecture that I skipped yesterday and I heard an amazing thing. Baby rabbits can become "aerosolized". What??? I had to rewind to listen again because I apparently missed something. So, here is the story:

The prof was taking about the bacteria Francisiella tularensis, which by the way is on the CDC's Category A list for Biological Warfare/ Terrorism Agents. He mentions a colleague in New Jersey who was mowing his lawn one day in the early spring and apparently ran over a rabbit nest full of baby rabbits. Now, some of them made it but a few were "aerosolyzed" (his words not mine). Why is this important??? Because the above virus is found in wild animals like squirrels, deer, beavers, and rabbits. It is usually transmitted by ticks and when that happens you get an ulcer form of the disease with little chance of death. But, this bacteria can also infect humans by inhalation and when that happens, you get a pneumonia form that equates with almost certain death. So, because the mower made aerosolyzed bunnies, this prof had the unfortunate pleasure of breathing in the bunny/bacteria particles. In less than a week, his cough, difficulty breathing, fever, and chills progressed to a sitting on deaths doorstep disease. The doctors had no idea what this man was suffering from. What Doctor would ever think of taking a history and physical for an incredibly sick patient and ask "So, have you mowed over any cute baby bunnies lately???" Of course, once all of the "usual suspects" for pneumonia were ruled out, and more cultures were done the doctors eventually found the bacteria, were able to treat the man and he lived. The morale of the story.....well, from my point of view, even the most obscure, rarely seen/suspected disease in humans can pop up at any time in a patient....from your point of view, don't mow over bunnies!!

Everyone have a great night!!!! :)

Too much to type....

Okay, I have alot on my mind to say before I head off to bed. Hopefully, I can get it all out. Will start with studying.......BLAH!!! Too much studying. By earlier today I couldn't look at another packet, let alone finish GI (which I still need to finish). But, I'm retaining information, and that is all I need to do well on the test which is in 8 DAYS!!!!!

Yesterday I had the opportunity to have a nice break. Daniel had a friend come in to visit from Missouri. She recently graduated from school and is moving to Rhode Island for residency. So, we all (meaning Layne, Alison, Kaushik, Daniel, his friend, Gia, Amy, and Noah) went out to dinner at BB's crabshack in St. George's. I got the BB crab which is a crab and cheese sauce mix inside a crab shell. It was awesome (of course I had it before so I knew what to expect). I also ordered something new.....pumpkin fritters....basically seasoned and deep fried pumpkin........ fantastically AWESOME!! Although, since I have been eating healthy my ass (i mean rectum :) was not particularly happy with me this morning!!

I don't know if I have mentioned but I have been eating extremely well and working out since January. I made a commitment to this...plus I set a personal goal for weight loss on January 26th. I'm not going to say anything yet about how much I have lost. I'm going to wait until I reach my goal weight....so stay tuned for that update!!

So, every sunday morning Layne and I head off to campus to do laundry and workout. We get there about 7am, and are there until 8:30am. Its nice because so few people are using the washers and dryers at that time, so we are able to quickly get our stuff done plus get in a nice workout. I run on campus on these days, so because of this I normally don't eat breakfast until after my workout. Today was particularly hot. There are several steep hills I run up and I almost didn't make one. I started to get very lightheaded (my brain hates lack of food + heat + hills). But, I forced myself to keep going and felt better a few minutes later. I'm just waiting for the day when my brain says "NO MORE" and I face plant on the pavement after passing out....and then my fat fluffy behind rolls back down the hill (look out below!!!!).

Today was the IEA (honor society) mock practical and I signed up to work. Basically we set up cadaver stations for the 1st termers to practice on. It is similar to their practical final except for we ask them to fill in the blank to the questions while on the real test they get multiple choice. Today went well....I was there for about an hour. Anything I can do to help my fellow student doctor :):)

Almost forgot to mention....yesterday was Derby Day!!!!! I had to watch it on ESPN when I came home from dinner. Congrats to Big Brown.....wow that horse is fast. Will he become the 1st triple crown winner in 30 years???? Preakness is coming up in 2 weeks, so we will soon get closer to that answer. In sad news though, farewell wishes go out to 8 Belles. You ran a hell of a race against the boys....and 2nd place is great.....too bad it ended poorly.

Well, I have to start my concept map for tomorrow. What is a concept map you say??? Well....here is one:



Every week for extra credit in Pathology we can pick a topic from the previous week and do a concept map. Last week I did the above on restrictive lung diseases. Tonight, I'm doing the Stomach. Here I come H. Pylori!! Everyone have a great night!!!

May 1st

Today, I had the pleasure of having no classes because its a national holiday in Grenada!! Don't ask me for what, I really have no idea. So, instead of sitting in lecture or lab, I spent all day going over Pulmonary Pathology. Tomorrow, I have decided to skip lecture and spend the morning with my friend Cardio Path. Why am I skipping lecture....because the Prof is just not informative. His lecture slides lack that one thing that we count on from our profs....the knowledge on HOW the disease process is occuring. I am well aware that the gastro-intestinal track is fairly large and complex, and there is a lot of material to cover in a short week. Instead of having 1 or 2 slides per disease with no useful information, how about concentrating on the important diseases and give us details (I want details!!) and then tell us to read on our own for the rest. Well, the objectives pretty much say not everything can be covered....that is fine.....but again, cover the important things well with "need to know to be a successful Dr" information. Maybe its because the prof is visiting from Yale and he is confusing us with his students back in Conn. Maybe he believes we are genetically bred individuals who have mastered the ability to telepathically siphon the years of knowledge and important material gained out of his brain and download it into our own......POOF....I now know Crohn's disease....what's next?

So, tonight was episode #2 of Grey's Anatomy. Once again, it was awesome. I really like the writing on that show.....what I don't like is how they protray the "surgery residents". Come on, like the surgery resident would be telling an HIV patient she is pregnant.....NO!!! That would be an ER resident, or an internal medicine resident, or an Ob/Gyn resident. But, I understand that they need to make some drama somewhere, i just wish it was in the OR.

My week has been fairly uneventful. Study, study, study....that is what I do. Especially since we have a tests starting May 13th. I plan on reviewing for both Pathology and Microbiology (especially since I haven't even looked at this subject for weeks) over the entire weekend. And maybe sneaking in a movie on Saturday night :) Well see how the reviewing goes. Everyone have a good night!!!