Sunday, December 30, 2007

What a year for a new year

I always feel contemplative around this time of year. In my more obsessive days, I would have written out resolutions, committed (or re-committed) to my diet plan du jour, planned out my exercise schedule, and berated myself for not weighing what I thought I should (even if it was unhealthy).
This year I am trying to avoid the obsession with remaking myself. I am trying to organize myself for work, which I am realizing I need desperately. I have had quite enough of trying to keep it all in my head, and then failing miserably. So, I am making up a study schedule (to try to avoid cramming), and making up a patient database, so I can keep track of who I've seen, what they've got, how it's been treated and what I need to do for them. These are lofty goals, and while they may come across as a bit obsessive, I've driven myself crazy over the past 6 months without such a plan, so we'll give it a go.
As far as my body goes, it's more of a struggle. I know I've gained weight over the past year, and I know it's been part of my recovery. I also know I've started to shed some of the (really excessive) weight I put on during the move/house buying/new job starting phase. Which is good, but I'm still not entirely resistant to the barrage of ads for diet and fitness plans that are out at this time of year. I'm hoping that instead of trying to overhaul myself, I can stay focused on who I am, with or without whatever weight issues I've got going on, continue listening to my own inner voice, including my own hunger and tastes, and recognize that there are things I can do to make myself feel better that are productive - such as going to the gym and to yoga.
So in a way, I am trying to change things. But I feel like I'm trying to change them by getting back to myself, or even getting to know myself, as opposed to trying to become something that I'm not, and setting myself up for failure.
In addition, I think this "listening to myself" mantra will lead me back into therapy. Not that I need anything intensive - I think I've been dealing with my eating disorder remarkably well lately - but I did like having a third party to help sort out my feelings and experiences. I've got a referral, and plan on making an appointment soon.
Finally, I feel like I am taking a huge, cleansing breath. The end of this year has thrown so many things my way that I haven't been quite sure how to deal with - not the least of which include feeling overwhelmed at work, and losing my Grandma right before the holidays. So I'm taking a few days just to breathe. To be good to myself, hang out with my husband, get my thoughts together, and breathe.

Friday, December 7, 2007

You turn your back

Somehow it's been nine months since I wrote a post here. In that time, I've moved cities, gotten a different job, bought a house, bought furniture for said house, had a tree fall on my car, bought a new (old) car, spent hours and hours studying, and ended up in the middle of grad shcool classes again. I finished the alst of my semester fianals today, which is something I didn't think I'd say again. Granted, I'm not taking radiobiology or physics for credit, but I can't shake the over-achiever mentality that I must do my best (rather than just pass, which would certainly be acceptable, given that it's a pass/fail class.

I'm not sure what I want to say here, what I want this space to be. For now I'm just going to try to keep track of what's going on in my life right now.

At this moment, it's insomnia, House, and my new laptop.

Tuesday, March 20, 2007

Grand Rounds is up!

Please check out the wonderful job that Sam at Blog, MD did with Grand Rounds. Thanks for including my submission!

Wednesday, March 14, 2007

TB with a side of pi

First off, happy pi day. (My geek is showing).

Next, I did something in clinic today I did not expect I would have to do...treat a 25 year old for TB. Granted it was latent TB, but it scares me because she's a recently graduated nurse, and had negative PPDs. However, her quantiferon gold test was positive, and a nodule showed up on xray. And while she's been asymptomatic, and working (!!!) per the employee health recommendations, I have now sentenced her to 4 months of fairly hardcore antibiotics. It makes me wonder what I have been exposed to.....

Thirdly, I am having so much fun buying things for my Yarn Pron Swap pal! I need to be careful to stop buying things for myself too.... :) Etsy has so many good things, how's a girl to decide?
My Cozy lace shawl is driving me nuts. I've frogged a row about 5 times, and I cannot figure out why it looks like it's in pattern at the beginning, and then towards the end, the pattern is off, and I have an extra stitch. WTF??? I think it's back to the soothing ribbing on my sock for awhile.

Tuesday, March 13, 2007

Toys in the Attic

I had an incredible breakthrough in one of my own biases today, and it made me feel really good about some of the personal work I've been doing this year.

A little background....

I've had an eating disorder for the past ten years or so, and recently reached the decision that I could not live that life anymore. I have been in treatment for about 8 months. Part of that treatment was the determination that I have had a low-level depression for the past few years, through which I have been functional, but not optimal (a dysthymia, if you will). I was advised that an antidepressant could be very helpful to me.

While my logical, medical brain told me that this made sense, my gut put on the brakes. I came to recognize that when I see patients who are taking psych medications/have psychiatric history, I tend to conceptualize them differently in my own mind. At least in the inpatient setting where I spend most of my time lately, it often means that those patients are more difficult to treat. They often have accompanying social issues (I swear I have learned as much social work in my intern year as I have medicine). They may be less likely to take their meds, and keep their follow-up appointments. And now, I was going to be ONE OF THEM.

To clarify, my greatest fear was that, in reviewing my "med list" someone would see that I take an antidepressant medication, and would form the same opinion about ME. That's when my bias stood up and slapped me in the face.

I have tried to keep this in mind as I have carried on through the wards the past few months, and have been able to see things through different eyes to a certain degree. Another facet of this which emerged is that I was often reluctant to talk about psychiatric disorders frankly with if they didn't know they had it, or something? I think it's mostly because it's not a field that I see frequently/am comfortable treating.

In any case, I am on an outpatient month now, and while in my preceptor's clinic this afternoon, had the opportunity to meet a 70-something lady with bipolar disorder. It wasn't something I could pussyfoot around - the reason she came in to the internal medicine clinic was to talk about her current manic episode. Ok.

The patient was there with her daughter, and both spoke frankly about it as soon as I walked in:

Dr. Raygungirl: "Tell me what brings you in today."

Patient: "Well, I'm having a manic episode. I'm not sleeping, I'm spending more money, and I have 15 projects going on at home right now. And I want to remodel my kitchen." (She meant remodel it herself, not hire someone, FYI.)

And so it went. I found I was incredibly comfortable talking to the patient about her symptoms, explaining why she was experiencing what she was, and even guiding her and her daughter in the best way to navigate the god-awful insurance coverage for mental health. I called it a disease, and the patient stopped, faced me directly, and said, "I never thought of it that way!" So I went on to explain that it was a disease, no different from diabetes or hypertension except that it was happening in her brain. And then she shared with me that forty years ago, after she had her "nervous breakdown," she and her husband moved their family to a different town because they were so embarrassed about her "problem." It felt really good to reassure her, and in doing so, reassure myself. Mental health diseases are diseases, and they can be treated and managed in a similar manner to blood pressure, as long as we are not too hung up on stereotypes or limited experience (me).

I was frank, upfront, and I was helpful. I feel today that I've been more helpful to that one patient than I've been to all the patients I did blood pressure checks and well-woman exams on all month so far. And she, in turn, has helped me. I know that mental health issues are still stigmatized in our culture, but now, I'm not going to be part of the stereotyping and stigmatization. Next time I see a chart with psych meds or diagnoses, I won't jump to my previous conclusions. And maybe, next time someone sees my chart, they'll show me the same respect.

Tuesday, March 6, 2007

Yarn Pron Survey

Late with this, but just got back from Vegas (see upcoming post)....

1. What kind of fibers do you prefer? Anything natural, although I do love merino lots

2. What kind of weight do you prefer (sock, worsted, bulky)? sock through worsted

3. Do you spin? Nope

4. Do you crochet? Nope

5. Are there any books, patterns, magazines would you like to own that you don't? Oh, lets see: SNB nation, anything Interweave, Wicked and Rusted Root from Zephyrstyle, Fitted Knits

6. Are you participating in any themed a-longs like the Project Spectrum? Nope.

7. Do you have a wishlist on or (provide a link) Mostly doctor-related books, so not really relevant.

8. Any Etsy stores that you would love to get something from? Hmm, Ruby 297, Yarn Botanika,
and not necessarily etsy, but I love Lisa Souza, and would love to try socks that rock, yarn pirate, tofutsies or yarntini.

9. What other crafty things are you involved in (quilting, drawing, painting)? Beading/Jewelry making.

10. What is your favorite sort of scent? My absolute favorite scent if my eucalyptus spearmint BnBW line of stuff, but I'm also a big fan of Ralph Lauren Style.

11. Do you have a sweet tooth and what kind of sweets do you like best? Yes, and dark chocolate is my by-far fav.

12. What kind of music do you like? Everything except country, really. Seriously. (tm) My favorites are Jack Johnson, DMB, Sarah McLachlan, Fiona Apple, etc but I have everything from Grateful Dead to NIN and in between on my iPod.

13. What do you like to knit? And for whom? Everything. And for anyone, mostly. I usually only gift to those who are close ot me and I know will appreciate it, because I knit pretty slowly. FOr that same reason, I will not sell anything I knit, because it takes me so long, the prices would have to be ridiculous.

14. What sort of things do you like to collect? Not a collector type, really. Books, I guess, as my shelves seem to get more packed by the month.

15. Do you want needles? And what kind do you prefer? I can always use needles. I love my KnitPicks options set, but would like some of the smaller circs. I also only have one pair of DPNs, US1s, as I've just started sock knitting. I like metal as I can be hard on needles, but am intrigued by the Lantern Moon needles.

Thursday, February 15, 2007

Knitting with the Plague

I've been hit by the plague, othgerwise known as a fabulous little respiratory virus that is not influenza, and therefore not covered by the little shot I got a few months back. It has me down and out for 5 days. I don't think I've been this sick as an adult. Every time I'm feeling better, it starts up again with the fevers and chills, and aches and sore throat. Ugh. This is getting complicated at work, as Healthcare Conglomorate terms any sick time greater than three days a "leave of absence."

Are you kidding me? I took one day as a vacation day, two as sick days, and now I need a NOTE FROM MY DOCTOR to go back to work. Oy vay. It makes me want to just hang a shingle out front of my house when I have my own practice, and keep the linear accelerator in the basement. Or at least remember not to get to close with Healthcare Conglomorate. Too much paperwork.

At least I've finished my Big Bad Baby blanket and a calorimetry to compliment my sister's scarf in time for their various events. Pics to follow.

Monday, February 5, 2007

The Exotic Perfumed Engine Weasel

Sometime last week, I started noticing a faint perfumey smell in my car. Originally I thought it belonged to the baby sweater I had bought my friend and kept in my car for a day, and had a nice little smell to it. But the sweater was gifted last Wednesday, and the smell persisted. It got stronger, and somewhat perfumey, and I thought maybe it was on my scarf. Then, as the temperatures PLUNGED into the depth of frozen hell this week, the heat in my car started to be on more frequently and in greater intensity, I noticed the smell increasing proportionately.

Yesterday, it got to the point that it smelled like a little old lady had crawled up inside my heater and died. It sounds awful, but I Kid. You. Not. It reeked like my grandma's perfume. So as I was driving to our friends' Superbowl party, I asked N if he smelled anything. He did, and I proceeded to see if he knew what it was. I shared my observation about the heat, and we further deduced that it only happened when heat was blowing through the lower vents. I asked if an animal could have gotten up inside there, and N claimed that it would smell much more rank than it did. He then added (totally deadpan)...."Unless it's an exotic perfumed engine weasel."

Hilarity ensued, we arrived at the party, and the car was so damn cold by the time we got back in it, that the weasel was forgotten.

Today driving around, I had no choice but to blast the heat or lose my toes and was nearly asphyxiated by grandma-smell by the time I got to work. By this point, the matter was concerning me ever more greatly, and I called my dad. I described the smell, and he asked whether it was sweet....and then proceeded to freak me out by suggesting that I could potentially have antifreeze fumes leaking into my car.

When N got home today, I sent him outside to the car to smell my coolant to see if it was similar in scent, and approximately ten minutes later he returned, with his hands behind his back and a very smug look on his face. "I present the exotic perfumed engine weasel." He holds out a dryer sheet, which he had found clinging to the under-part of my driver's side dashboard.

It had escaped the apartment on my shoe, and lived on the floor of my car for one very odiferous week. *slaps herself on the forehead*

N offered to nickname me the perfumed engine weasel, but I suggested that it sounds a bit kinky without the backstory.

Saturday, February 3, 2007

Ice Princess

Good mother, it's freezing here. My page tells me it feels like -18 degrees F. I am shivering away in my computer room right now, drooling over lovely wool yarns that I ought not buy, but I want to. I want a stash. N would argue that I already DO have a stash, but it only takes up one little square area in a bookshelf. So not a stash.

If I had a stash, I think I would snuggle up under all the balls of lovely warm wooly yarn goodness tonight, and not come out. That's just how damn cold it is. It is certainly too cold to go traipsing out to see my friend's band tonight, what with the dearth of downtown parking, and the smoky bar, and the cold, cold me. Sorry guys, I'll catch ya next time.

We do have to go out to the Superbowl party tomorrow, not because I'm terribly enamored of the Superbowl, but party because our friends throw this party every year, and next year we'll be in Ohio, and therefore not able to attend, but mostly because I am making an AWESOME black bean dip. It's called a black bean dip, but really it's mounds of melted cheesy goodness with some jalapenos and black beans thrown in for good measure. It's from our favorite hole-in-the-wall restaurant. I shall post it later, after I dig it out. Yum.

I was on call last night, for the first time in the last month that I will ever do general medicine wards. It struck me how much more comfortable I feel doing this now than at the beginning of the year. I think I've learned more in the six months of my intern year than in my last two years of med school, at least as far as amount learned per period of time goes. I can figure out what's wrong with a patient, I uaually have a reasonable idea of how to fix it, and if I don't I know who to call to get a specialty opinion. This does not mean that I have learned all that there is to learn about the art of internal medicine, of course not. But I've become a much better diagnostician and know how to handle patients in the inpatient setting. I suppose that's what this transitional year was all about. Ok, great, so can I be done now? I'm totally ready to move on to RadOnc and start treating cancers, my true interest and career. I'm over pneumonias and diabetes, I tell you.

Monday, January 29, 2007

You know you're obsessed with knitting when....

The scene: Friday evening, computer room

Husband: playing WOW on his computer

Me: Kissing him goodbye on my way to the gym..spies that he is killing Ice Yaks
(no, I don't make this stuff up)

Me: Save me some Yak fur.

Husband: uh-huh (not looking up from the yak-slaughter).

Me: I wonder what I could knit out of yak fur?

Husband: Weren't you going to the gym?

Friday, January 26, 2007

FO, #1

The Crossover Scarf, for my sister's birthday.

I think it looks better in person than in the looks kind of messy when laid out, but it's nice and lacy-looking in person.

I lied, this will be my first gifted knit object, as my friend's baby is due after my sister's birthday, and I really wanted to try this technique before I go back to stockinette in a baby blanket.

Thursday, January 25, 2007

I got the Ick

Oh, I'm sick. As a dog. It came on like someone flipped a switch the other night, right after we had chinese food. My throat got very sore, and my glands felt huge, and at first I thought I was having an allergic reaction to chinese. But then, the fever started and the body aches. I've been in bed for most of the last two days, alternately knitting, groaning, sleeping, and watching TV. Ugh. I really really want to get better to go to Yoga Day USA on Saturday - a whole day of free yoga classes! - with my mom, but we shall see. Right now I'm trying to beg her to bring me soup and medicine, and some TLC. I'm sure she will after work, because she's such a good mom. Don't know what I'm going to do when I'm sick in Cincinnati. I mean my husband takes good care of me, but it's not the same as my mommy.

Monday, January 22, 2007

Gifts for Yourself

I posted a ton of new stuff in my shop last night, including Mary's debut handbag listing, which is garnering lots of attention so far! Take a look!

I'm also having a Valentine's Sale - But one get item, get 25% off an item of equal or lesser value.

Saturday, January 20, 2007

What I'm cooking...

Made these recipes last night...I tried to replicate the whipped sweet potatoes from the Weber Grill restaurant, which I love, and these came pretty close. My only issue was with trying to peel the potatoes after they were cooked...too soft to do with my veg peeler, I ended up peeling off the skin by hand, and these suckers were HOT! Next time I'll try peeling before microwaving. As for the chicken, I added about 1/4 c barbecue sauce instead of 2 teaspoons. Who on earth could make barbecue chicken with two teaspoons of barbecue sauce? Much more flavorful my way.

Overall a good, yummy dinner that was quicker than I thought it'd be.


Vanilla Sweet Potatoes
2 pounds sweet potatoes
3/4 cup 1% low-fat milk
1/4 cup packed brown sugar
2 tablespoons vanilla extract
2 tablespoons butter or stick margarine, softened

Pierce potatoes with a fork, and arrange in a circle on paper towels in microwave oven. Microwave at HIGH 10 minutes or until tender, rearranging potatoes after 5 minutes. Wrap in a towel; let stand 5 minutes. Peel and mash potatoes. Combine with milk and remaining ingredients.
Place in a 1-quart casserole; cover and microwave on MEDIUM for 7 minutes or until thoroughly heated. Yield: 6 servings (serving size: 2/3 cup)

Chicken with Barbecue-Bourbon Sauce

4 (6-ounce) skinless, boneless chicken breast halves
1/4 teaspoon salt
1/4 teaspoon freshly ground black pepper
1 tablespoon canola oil
1 tablespoon butter
1/3 cup minced shallots
1/4 cup bourbon
3/4 cup fat-free, less-sodium chicken broth
2 teaspoons tomato-based barbecue sauce

Place each chicken breast half between 2 sheets of heavy-duty plastic wrap; pound to 1/2-inch thickness using a meat mallet or rolling pin. Sprinkle chicken evenly with salt and pepper.
Heat oil and butter in a large nonstick skillet over medium heat. Add chicken; cook 6 minutes on each side or until done. Remove chicken from pan; keep warm.
Add shallots to pan; cook 1 minute, stirring constantly. Add bourbon to pan; bring to a boil, scraping pan to loosen browned pits. Cook until bourbon mixture is reduced to 2 tablespoons (about 5 minutes). Add broth and barbecue sauce; cook until broth mixture is reduced to 1/2 cup (about 3 minutes). Serve sauce over chicken. Yield: 4 servings (serving size: 1 chicken breast half and 2 tablespoons sauce)

Thursday, January 18, 2007

Big Bad Baby Blanket

I'm very of my friends from work is pregnant with her second baby, and she's due in about 6 weeks. Which is of course very exciting. BUT. I am excited because I decided to knit her a baby blanket from the Stitch 'n Bitch book. It will be my first knit gift to anyone, but it's a relatively simple pattern, and I've got all that on-call time next month to knit (when I'm not admitting and taking care of my patients, that is. Right.) I think she would appreciate it, too, as she's very into stuff that's not mass-produced chain-store. Her daughter right now is always dressed inthe cutest little-girl funky stuff, so I know I can get away with making it in a cool variegated blue-green yarn, rather than pastels. I'm getting yarn today!

Wednesday, January 17, 2007

Crazies in the ER

Usually I joke about how unrealistic the ER-type TV shows are...ERs are never that busy, that crazy, and very rarely have gun-toting nut-jobs. I know. I've been in quite a few ERs at all hours of the day, and it never happens.

I may have to eat my words today.

I worked an 11-11 shift, and my god, I am spent. I had two people in florid congestive heart failure, one guy with an infected leg...all the way up his leg, and a lady who was eating dinner in a restaurant, and collapsed, with a huge bleed in the left hemisphere of her brain. Those were just the interesting patients. Then I went to reach for a chart, glanced at the name, and recoiled in horror, as if it were a snake.

It was a patient who is what we call a "frequent flier." All the other ERs in the city know not to admit this guy, except ours. We have a few docs who have the CYA-complex, and he keeps getting admitted. I know this because he was admitted to my team back in August, and we could. not. discharge the man. He knows how to manipulate the system, he knows how to fake symptoms, he steals from other patients, he pleasures himself in his hospital room in front of nurses.....he's a disaster. Luckily, as the resident, I have the ability to cherry-pick the "learning cases," and did not go see him.

So when I heard the deafening crash from one of the other hallways, imagine my surprise to find out it wasn't him. No, this time the suicide-attempt patient, who was guarded by at least two cops, broke out of his room, knocked over all the storage carts in the hall, and invaded the room of another patient, threatening her. Then, the cops tackled him, cuffed his wrists and ankles, and the attending snuck up from behind with a shot of Haldol.

So, to all the Doc-dramas out there that I take such great pleasure in shouting at while my husband rolls his eyes at me, today I eat my words. Today. I can't promise that when Grey's Anatomy comes on tomorrow I won't shout "that's not how you do it!" at the screen, but for tonight, you were right.