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#69622 - 08/06/08 03:29 AM Re: married momof3 resident2008
TexasRose Offline
Super Elite Member

Registered: 06/30/02
Posts: 1431
Loc: Texas
It's been an interesting week on the new ward. We cover 2 floors with Neuro and Surg patients as well as general peds. We only see the surgery patients if general peds is consulted. The work load is about the same in terms of number of patients for the team. What's vastly different is the nature of the illnesses we're covering. On the neuro floor there are a few rooms reserved during the weekdays for video EEG monitoring for patients with seizures or suspected seizures. Then there are a number of different neuro cases such as seizure disorders, stroke, altered mental status, global developmental delays, etc.

More than one person has remarked on my improved mood and acting more like myself this week. I think it has a lot to do with surviving my first month and also with finishing heme/onc. It was a mentally tough time for me. I'm much happier being on a floor where I can actually "cure" some of my patients. wink I've had a recent influx of patients with neck abscesses (lymphadenitis) which responds very well to some good ole antibiotics after some good ole I&D (incision and drainage.) I don't do the I&D's in this case, we leave that to ENT. I do get to prescribe the antibiotics however! :goodvibes:
_________________________
"All you have to decide is what to do with the time that is given to you."

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#69623 - 08/20/08 12:14 AM Re: married momof3 resident2008
TexasRose Offline
Super Elite Member

Registered: 06/30/02
Posts: 1431
Loc: Texas
Is it really possible that I haven't written in 2 weeks already? Where'd the time go???

Being on call does make the time pass quickly because you always feel like you're trying to catch up. Catch up on sleep, catch up on work, catch up on family life, catch up on laundry... All because of those 30 hr shifts that leave you exhausted and useless the afternoon you get home. So that's 2 out of every 4-5 days where things don't get done in the usual way.

It is getting easier, however. I'm not nearly as exhausted and mentally slow as I was the first month I was on call. I even managed some intelligent conversation after my nap yesterday.

...
But here's the thing on my mind right now. The death of our great leader, Dr Ralph Feigin. http://www.texaschildrens.org/DrFeigin/default.aspx

The sense of loss and mourning at the hospital is profound. He touched so many lives in so many ways. For me personally, this hospital and Dr Feigin were the reasons I wanted to go to my medical school. I knew where I wanted to do my residency even before I applied to med school. After meeting Dr Feigin and participating in his famous "Feigin Rounds" as a 2nd year med student, I knew I wanted to be trained as a pediatrician under him and his program. It is a source of great sadness for me that I will not be able to claim myself as one of his trainees. And apart from that personal/professional loss, there is the tremendous loss to the medical community and to the children who benefitted from both his remarkable intellect and compassion.

For me, and many of us, the best way to honor his memory is to try and emulate his compassion and his passion for knowledge.
...

Other things on my mind include the kids going back to school next week and my husband's interest in a job change. The job change is something that I've been expecting for a while and think will be very good for him. Fortunately it's not the out of town position that I was alluding to last month. *whew*

As for the back to school stuff. Well, my son who never wanted to do his homework and turn things in on time last year has now been moved down to regular classes. At the middle school level, you're either in all advanced or all regular classes. You have to keep an 85 in all classes to stay in advanced. Not really appropriate, in my opinion (and I do have a teaching certificate to back that up). Plenty of kids have strengths and weaknesses and to demote a kid for having issues only in Math is maddening to me. Of course, I'm also not the kind of mom to force my kid. I didn't punish him for his poor grades in math and I didn't force him into tutoring. I figured now is as good a time as any to learn the lesson that you have to take responsibility for your own work. Still, as a mom, it's awfully hard to watch him take this consequence. Of course he was devastated when he found out they really did put him in regular classes this year. frown You can imagine how tough that is on a kid whose friends are in Adv and whose twin brother is an A+ getting kind of kid. :ouch:

So my son's plan is to make very high grades those first few weeks and see if they will bump him back up to Adv. We'll see what happens. I'm crossing my fingers like crazy and praying this all works out for him while trying to look like mom is totally calm and at ease with whatever happens. Of course it's crossed my mind that if he stays in Reg this year he might have an easier year and build up some of his confidence, etc. He can take separate Adv reading and science classes in Jr High next year if math is still troubling him.

Well, that's a lot more than I thought I would write. I've been so down since the loss of Dr Feigin last week. On top of that, I think I was sick because I had headaches and fatigue that just wouldn't get better for about 5 days. It was a huge relief to wake up this morning, feel rested and actually feel like running again.
_________________________
"All you have to decide is what to do with the time that is given to you."

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#69624 - 08/26/08 12:55 AM Re: married momof3 resident2008
TexasRose Offline
Super Elite Member

Registered: 06/30/02
Posts: 1431
Loc: Texas
So much to say and write about that I'm not even sure where to start and have started and deleted several times already in the last week. Maybe I'll break it down into spheres of my life and see if that doesn't make it more manageable.

Pediatrics:
Had a crazy call night last weekend where I admitted 11 patients and wound up sending one to the PICU. Heard my name "Is that TR?" coming down the hallway the other day. It was a patient of mine from my Sub-I over a year ago. laugh Actually, it was his mom. She remembered my name and asked me how school was going. You can imagine the smile on my face when I told her I had graduated and was now one of the doctors! Her son looks so much better than he did when he was last admitted. He had been so ill and I was sure that he wouldn't be around by the time I finished med school. Turns out they were able to discover the source of his feeding intolerance and he's gained something like 30kgs!

He's one of several severely handicapped patients I've taken care of now. They are really difficult patients to have, and yet I feel very compelled to do my absolute best for them. I suppose that's because very few others want to take care of these patients and it's obvious how much frustration and disappointment these parents have dealt with over the years with doctors nurses and techs wanting to avoid them where ever possible. I feel like doing something right for a kid who can't speak for him or herself is one of the best things I can do in medicine. Guess that's why I love Neo as well.

I'm trying to remember what my other big plus was the other day. Another positive patient encounter. Wish I had written it down at the time. There are definitely days when it is good to be able to review these little pearls of positivity.

Oh, I remember one! It was really simple. I took care of a former 28weeker last weekend (for transient synovitis) who is so smart and bright and obviously a happy ending for a NICU patient. It was nice to see that not every very preterm child winds up somehow devastated. (there are days in a hospital like this where you think severe disease is commonplace and childhood cancer and devastating organ disease lie around every corner.)

Family life:
Kids went back to school today. My daughter started her first day of High School. She was quite nervous, but seems to have done marvelously. :goodvibes: She's thrilled to find several friends in her classes and is excited about all the goings-on. The boys just walked in the door and seem very happy, except for the part where they have to go to school! wink

Husband:
Looking at changing jobs. Don't know why that's stressing me except that he's stressing and so I'm stressed... It's not a bad thing, it's a good thing to have this opportunity. It just means a little upheaval in our routine.

Me:
Gaining weight. Not eating right. Barely running at all. *sigh* Not sleeping enough either. Need to do something about this ASAP. Don't know what resources I have to apply to this issue. This is always the thing that has to "give" in my life when something's gotta give. P=MD is good enough for med school, but not acceptable as a resident. Not sure how I'm going to handle this yet. Balance is harder and harder to come by.

But overall, life is good. smile
_________________________
"All you have to decide is what to do with the time that is given to you."

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#69625 - 09/02/08 07:31 PM Re: married momof3 resident2008
TexasRose Offline
Super Elite Member

Registered: 06/30/02
Posts: 1431
Loc: Texas
Today is my last day on the regular ward for a month. I've survived 2 months of call now. laugh Starting tomorrow I will be in the well-baby nursery learning the newborn exam and filling out scads of paperwork. TBH, I think this rotation is more about the slave labor for the paperwork on this very busy delivery service than it is about learning the newborn exam. You don't need 4 weeks and 10 patients a day to learn that! wink Still, I'm excited to be seeing babies on a daily basis. I'll still be working 6 days a week, but no overnight call and only 2 late shifts in the ER for the month. That'll come out to only about 50hrs/week! (woohoo? :goodvibes:

Guess I don't have all that much more to add today. I'm sitting at home right now because I got called for jury duty today. I drove straight from the hospital after a 24 hour call shift (which I had to end early, it's normally 30hrs and peers had to cover for me) an hour away to the county courthouse. I sat there for an hour and then was told to come back at 1:30pm. I drove a half hour home in hopes of catching a nap but can't sleep because of the caffeine required to drive all that way postcall this morning. *sigh* So I guess there will be no postcall nap today and I'll just have to hope that no lawyer wants a sleep-deprived doctor on their jury! wink

Oh yes, and I engaged my dietician friend for a couple of sessions again. It's just one of those things I can't seem to manage on my own when so much of my life is more immediately demanding. So my solution is to ask for help!
_________________________
"All you have to decide is what to do with the time that is given to you."

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#69626 - 09/11/08 12:34 AM Re: married momof3 resident2008
TexasRose Offline
Super Elite Member

Registered: 06/30/02
Posts: 1431
Loc: Texas
I love, love, love the newborn nursery! blush

One of the boys has started tennis lessons with a college student who lives in our neighborhood. He seems to really be enjoying it and I know he's happy to be doing something that his siblings are not doing.

School year has started off pretty well for the kids. Somehow it's been much less stressful than in previous years. I don't really know why. Maybe because the kids are so much more settled now. I'm sure it helps that this is their 5th year in the district.

If I have any interesting stories from the storm, I'll be sure to share!
_________________________
"All you have to decide is what to do with the time that is given to you."

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#69627 - 09/22/08 04:28 AM Re: married momof3 resident2008
TexasRose Offline
Super Elite Member

Registered: 06/30/02
Posts: 1431
Loc: Texas
A quick post to say that my family and I are fine. I did spend 48 hrs in the hospital with the hurricane Ike. My hubby and kids road out the storm at home with a week's supply of canned and dry goods and all the doors and windows covered with plywood. Minimal damage to our home. Our city was hit pretty hard though and there are still lots of folks without power here in the big city and surrounding areas. My kids haven't been in school since the Friday before the storm. 1/3 of the campuses in the district are without power, so home they'll stay for a few more days. My week of vacation (1 of 2 this year) happened to fall shortly after the storm, so I've been home with the kids. We got our power back on the 3rd day. I lost a lot of money in lost groceries (no power, no refridgerator), but I cannot complain. Many people lost far more than we did.
I'm burnt-out on my job and program right now. But, I have 2 more days off and some time to recover. I think it hasn't helped having the death of our leader and the hurricane occuring in the first couple of months in residency. Things seem pretty bleak in the program right now, but I have hope that things will turn around.
I'll write more tomorrow. I've been without internet access at home until today, so lots of catching up to do!
_________________________
"All you have to decide is what to do with the time that is given to you."

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#69628 - 09/23/08 05:27 PM Re: married momof3 resident2008
TexasRose Offline
Super Elite Member

Registered: 06/30/02
Posts: 1431
Loc: Texas
Don't laugh at me, but I think I made a very important connection today.

I've been pretty unhappy with my program lately. I struggled with my frustration at being put on the ride-out team (again) and spending 48 hrs in the hospital with limited contact with my family and the outside world. I never got a full day off that weekend. Our relief team came in at 7am on Sunday morning so we could go home, but we had to return on Monday morning. I also just found out that I am on call on Thanksgiving day and that I don't even have a day off that holiday weekend until Sunday. frown

Add to that a recent phone call with my very good friend and fellow resident. Her apartment got water damage from the hurricane. The carpets had to be replaced and she had to move all her furniture into her garage while waiting for the repair and replacement work to be done. She took a day off when she was sick and had to pull all the carpets out shortly after the storm. Then she told me she might take a day off again in order to move all her furniture back into her apartment. I found myself getting angry.

Wait, angry? At my friend? For taking a day off? During my run this morning I had to ask myself why I was angry. I had also noticed I was ticked off at my husband for saying he had to leave work early today to coach our son's soccer team. Why was I mad?

Then it hits me. I'm angry because I have needs that aren't being met while my husband and friend have needs that are being met. Why are they getting what they want and need while I'm not??? Duh! It's because I don't ask for anything!!! :crossfingers: That my kids are back to school tomorrow. At this rate they're going to have to add 1-2 weeks onto the end of the school year!
_________________________
"All you have to decide is what to do with the time that is given to you."

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#69629 - 09/27/08 10:59 AM Re: married momof3 resident2008
TexasRose Offline
Super Elite Member

Registered: 06/30/02
Posts: 1431
Loc: Texas
I'm not 100% sure what I'm going to write today. Usually I sit down to write when I know what I want to say.

Things have continued to be rocky. I took a personal day on Wednesday when my kids were still not back in school. I was concerned about having my boys home without adult backup after the bus incident. (If I didn't already mention it, it involves a nutty neighbor dad who threatened my son.) I went to work Thursday and things were a little crazy. We had a mock code in the nursery which went well enough. Problem was, I felt completely unprepared for it and took a total backseat.

Then Thursday night I got some kind of food poisoning. I was in and out of the bathroom from midnight until shortly before my alarm went off. I felt horrible, but went to work anyway because, well because I'm supposed to go to work! I was still sick, however, making frequent trips to the BR and thinking about how pissed I'd be if I was a mom and a sick doctor was seeing my baby. On the surface, it totally made sense for me to be at home. But, there were a lot of patients and my co-interns would have to cover for me (again!) and I was supposed to have a late shift in the EC as well. :guilty: You can imagine the guilt I was feeling. I finally had to give in, though, when I broke out into a cold sweat right before going in to see the first patient. I thought it was just food poisoning, but I couldn't take the chance that it was contagious. Plus, I didn't relish the thought of puking in the patient's BR!

So I came home. Someone had to take my EC shift yesterday, I'm sure. I feel bad about that. Even though I know that's what back-up call is for, I feel guilty. But I know I'll be that person next year taking back-up call and maybe this'll make me more understanding of other people's illnesses! (I'm so rarely sick that I have a hard time understanding other people calling in sick to work. It's a fault of mine.) After taking a personal day this week and then having a sick day, I'm worried my fellow interns and upper levels must think I'm a slacker. I guess I'll just have to get over that.

Here's the thing I'm conflicted about. I find myself backing away from running codes, letting other people take procedures and generally not looking for opportunities to "get in there." Is that a personality thing or am I just scared? If I'm scared, why? When I was on my surgery rotations, I wanted to do procedures. I drilled in people's femurs on Ortho and thought it was great! I intubated and started lines on anesthesia and enjoyed that pretty well. I decided I didn't want it for a career, but I thought that meant I was a procedure kinda person.

So why am I suddenly squirrelly? And who can I talk to about this? I really feel like I need some guidance at this point about both my lack of confidence and my conflicted feelings about the demands of the job. I find myself resenting the hours I'm working already. I didn't expect this. I also find myself contemplating a LOA because I suddenly can't remember why I'm doing this. Whereas last month I told anyone who asked that I wanted to do Neo, now I'm wondering if I want to do any fellowship at all. The thought of extending this workload into 6 years is just...horrible!

Sure, rationally I know that intern year and first year of fellowship are the hardest and that the other years are more reasonable, but right now my more primitive response is "let me out!!!"

I suppose that's natural. At least, for some. I don't know. What's wrong with me? Dammit.

Usually writing helps me solve things. Today I've just worked myself into a tizzy. :boggled: I'm tempted to delete this all, but it's a much more accurate portrayal of my life as a resident than if I only posted the more upbeat stuff.

Hopefully I'll be back later with some resolution. Anyone who's been through this and has some thoughts or advice is welcome to PM me. smile
_________________________
"All you have to decide is what to do with the time that is given to you."

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#69630 - 09/27/08 11:15 AM Re: married momof3 resident2008
TexasRose Offline
Super Elite Member

Registered: 06/30/02
Posts: 1431
Loc: Texas
You know what? A couple of minutes after I posted this I realized something. Nothing is going to make me love the schedule. :p Really, liking the job and being happy being in medicine does not have to equal wanting to work six days a week for 50 weeks of the year. Nobody wants to do that! I'd be a little crazy to not wish I had more time off. :rolleyes:

What I need to do is go back to work tomorrow and jump right into things. I need to volunteer to do procedures and take lead in mock codes and do the things that will increase my confidence. Then I can have my confidence back!

And no, I don't want to stay home. My kids are gone all day anyway. I wouldn't have anything to do but turn into a desperate housewife! :laughing:

I love medicine and I love working with kids. I just need to focus on the things I like about it and deal with the downsides. Just like every other job on the planet.

You know what's funny, between the last post and this one, my pager went off. It's my day off and I could have ignored it. Instead, I found I wanted to answer it and be connected to what is going on at the hospital. So I suppose that right there answered my dilemma. wink
_________________________
"All you have to decide is what to do with the time that is given to you."

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#69631 - 09/27/08 04:15 PM Re: married momof3 resident2008
TexasRose Offline
Super Elite Member

Registered: 06/30/02
Posts: 1431
Loc: Texas
Don't laugh at me, this is how I work through things...

I heard this song the other day on House (I watch this show for the characters, the medicine is highly inaccurate). It's by Dave Matthews, one of my fav artists. The lyrics suddenly meant something to me today.

"You Might Die Trying"

To change the world,
Start with one step.
However small,
The first step is hardest of all.

Once you get your gate,
You will walk in tall.
You said you never did,
Cause you might die trying,
Cause you might die trying.
Cause you---

If you close your eyes,
Cause the house is on fire.
And think you couldn't move,
Until the fire dies.
The things you never did,
Oh, cause you might die trying,
Cause you might die trying.
You'd be as good as dead,
Cause you might die trying,
Cause you might die trying.

If you give, you, you begin to live.
If you give, you begin to live.
You begin, you get the world.
If you give, you begin to give
You get the world, you get the world.
If you give, you begin to live.

Cool song and I like the meaning. It goes very well in step with what I've been thinking since my pager went off this morning. I just need to jump back in there and start living again, as it were. wink
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"All you have to decide is what to do with the time that is given to you."

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