Life As Of Late

This year is flying by and I am definitely enjoying being a fourth year! It’s almost surreal that I’m over 75% finished with medical school and I’m starting to see the light at the end of the tunnel. Watching our new MS1 class wander the halls in their tell-tale green Anatomy Lab scrubs makes me a bit nostalgic – it surely doesn’t feel like it’s been over 3 years since I was in their shoes!

So, what’s life been like the past few months? Let’s recap…it’s been a while since I wrote a personal post around here and we all know how I like to share my life with the internetz.

Real Life Stuff

  • We took a couple miniature vacations/weekend trips this summer.
We made a trip to Ikea in Frisco…
and did some swimming in Fort Worth.
13 Weeks Pregnant with the Elves
Then we headed to the water park for some fun in the sun!
And watched the Rangers and fireworks in Arlington.
And took my sister to visit Texas A&M.
  • My belly is growing at astronomical speed! As of today we are 21 weeks into this pregnancy, over half-way done – by Christmas we will be a family of 4 Humans + 3 Dogs.
21 Weeks Pregnant with The Elves

 

  • This past weekend we subtracted a guest room and added a nursery in our house…my Dad helped me paint painted and I posed with a roller brush.
My Dad and I Painting the Nursery

 

Medical School Stuff

  • Passed Step 2 Clinical Skills and Step 2 Clinical Knowledge. What does that mean? Basically, I don’t have to take any more exams as a medical student. NONE! As long as I pass my clerkships this year I will really, truly be an MD in May!
  • Completed 4th year rotations in Geriatrics, Pediatric Genetics, Emergency Medicine and (almost) Endocrinology.
  • Next week I start my Ob/Gyn Sub-Internship rotation. I am SO excited to see what I can learn!
  • Residency applications are nearing completion. I will submit them on September 15. Fingers crossed for some interviews!!

Coming Up

  • Stanford MedX Conference at the end of September!!
  • Hopefully lots of residency interviews…stay tuned for the hilarity that will be maternity suits for interviews.

Stop! Or I’ll…Dump Water On Your Head

A psychiatrist I was working with was recently talking to some families about the importance of following through with so-called “parenting-threats” you make to a child. As I listened in I thought how difficult it must be to consistently do that, especially if following through with the consequence adds an element of stress or difficulty to your situation. A quick interrogation of the Google machine turned up hundreds, if not thousands, of relevant blog posts and articles to confirm my suspicions that this was no easy feat.

Be Careful What You Say

Today I was considering that conversation and came to the conclusion that if anyone in my marriage would eventually have trouble with this, it would be my laid back and quiet husband, not me (because I’m so perfect and all). I’m the type of person who tends to be more over-bearing, outspoken and “in charge” (typically only in my own mind am I honestly in control of anything).

He’s the type of person that doesn’t say a whole lot. But, that means when he does decide to talk – you listen – because it’s either hilarious, important or absolutely ingenius (or occasionally borderline insane).

I remembered an incident from when we first started dating and realized my assessment of which of us was better at following through was apparently starkly inaccurate.

————————————–

  It was Spring of 2007, we’d known each other less than a year and were cooking dinner at his house one evening. I was in an ornery mood and doing something that I’m sure was purposefully annoying and painfully asinine in the name of flirting.

As I tapped and poked him in the ribs over and over, not unlike a four year old I watched in clinic trying to provoke a reaction out of his mother, Donnie said to me,

 

“If you do that again I will pour this entire bottle of water on your head.”

 

I thought,

“There is no way he will do that. We’re in his kitchen and it would make a huge mess and it would probably make me mad. I’m his new girlfriend…nobody wants their new girlfriend mad. He totally wouldn’t do that.

So…I poked him again…right in the ribs. And…

He poured bottled water over my head…right there in the middle of his kitchen.

 

Right there in front of God and everyone (and by everyone I mean Aubrey, his Zambian roommate who ended up as the best man in our wedding) my boyfriend dumped 12 ounces of bottled water onto my freshly-straightened hair and stared at me with an I-warned-you-you-dummy look on his face as spring water some kid in the Andes meticulously bottled by hand (what, you mean your water doesn’t come hand-bottled from the mountains? weak sauce.) dripped down my previously dry t-shirt, rolled down my legs and splatted onto the tile floor of his rent-house.

As I stood, soaking wet, in a puddle in the middle of his kitchen I never thought that incident would come back to me in 6 years as an indicator of how trustworthy he is.

 

And, I can tell you one thing, now when he tells me…

“Stop or I’ll…”

…I stop.

 

Usually.

 

It may seem silly or trivial, but it’s true – when people follow through on their word, even on things that are seemingly pointless (or even mean! like dumping water on your girlfriends freshly straightened hair), it builds trust.

Do you have trouble following through? Do you think this is an important aspect of gaining trust in relationships? Parents, how hard is it to consistently follow through with your kids?

Image: photostock / FreeDigitalPhotos.net

Image: Paul | FreeDigitalPhotos.net

Shift Change on MomMD

Married In Medical School – MomMD Cross Post

In Good Times & In Bad – Married In Medical School

What’s it like to be married in medical school?

My answer is always the same – it’s really fine, but I don’t have anything to compare it to since I was married before I began the process of forgetting basic math, spelling & grammar in order to make room for the Kreb’s Cycle, mechanism of action of Lamivudine and 22q11 deletions. However, I do understand where the question comes from and I remember being a wee little undergrad (see what I did there? now you think I’m old enough and wise enough to talk about the “youngsters”…truth is I still get carded trying to buy sharpies and my advice on marriage and medical school is barely 2 years in the making) and thinking I couldn’t possibly get married until after medical school, because it would just be far too demanding to do at once.

The reality is…it’s really not.

I mean, it is demanding. Medical school is demanding. Marriage is demanding. Buying a house, moving 10 hours away, saying “I Do,” fleeing the country for a romantic (did I say romantic? What I meant was rainy…) honeymoon and starting medical school all in a 21 day span is demanding…but it’s not so demanding that I would change anything about it.

Assuming you have an understanding, relatively laid back and always supportive spouse (and if you don’t, what are you doing marrying them before jumping into this three-ringed spectacle in the first place?), having someone around to help you out during these years is amazing. Not only is it nice to have emotional support and someone to talk with about things other than cardiomyopathy, it’s also been a blessing to have him to help with do the laundry, buy groceries, cook dinner and pick up the house when I’m fully absorbed in studying for shelf exams.

If I were single, I’d have all that to do by myself…plus I’d have to be on the prowl for a marriage candidate who didn’t mind love with a conditional $200k in educational loans. And my dog would likely be dead, because I’d have let his hair get so long I’d have mistaken him for a dirty rug & put him in the washing machine. And I undoubtedly would have slept outside on at least one of the 15 occasions I locked my keys in my car or let the battery die at the library.

All of that to say, it is certainly possible to maintain your marriage while learning to be a physician. Is it hard? Absolutely, but maintaining a marriage is hard no matter what you’re doing with your career. The biggest factors are going to be the personality and “neediness” of your spouse. There are going to be times when you’re busy and unable to take care of your own basic needs…like eating…and showering…and you need someone next to you who doesn’t mind holding their breath so they don’t have to smell you when they go in for a bear hug.

I know preparing to embark on this journey we all heard horror stories of how marriages always fall apart in medical school.

Can anyone offer additional views on if this is inherent in the process of medical training or if it has more to do with the actual marriage and the people in it?

I’d love to hear your stories of marriage in medical school or the medical field in general. I think it’s something a lot of people worry about when choosing this as their career.

Donnie & Danielle

CLICK HERE TO READ AT MOMMD.

Trip To Betty Ford Institute In My Future

    I was three and she was 24 when we left – for years the alcohol and drugs precipitated the fighting, which brought on the feelings of guilt, which inevitably lead to more drinking. It was a vicious cycle that had to be broken and, no matter how much my he begged my mom not to leave with me, she knew we couldn’t stay.
    He’s a good man, my dad – a smart, hard-working, exceptionally talented man with a detrimental disease that makes people look at him differently when they find out. Two months after we left he checked himself into a rehab facility and, when they deemed him healthy enough to leave, he started taking me along to his weekly Alcoholics Anonymous meetings.
    I get my determination and persistence from my dad, an addict who has been clean and sober now for over 20 years.  I have a deep desire to be the doctor who knows addicts are real people who can be helped, a doctor who is compassionate to the struggles of those with substance-abuse issues and understands that addiction is a disease. One thing I don’t want – to be the doctor who passes over these patients as “drunks” or “druggies” who are passed the point of being helped. After all, there’s a good chance my dad wouldn’t have been around to walk me down the aisle two years ago had someone not believed that, when he finally hit rock bottom in 1989, he could still be helped.

I never got around to writing a post for my amazing Dad on Father’s Day, so I’ll talk about him a little here*. He has overcome so much for me and our family – fighting through the tough hand of addiction and trials he was dealt in his early 20’s, he managed to come out on the other side as an inspiring story of success. He truly is one of the most unfaltering and inspiring people I’ve ever known and I’m so lucky to call him “Dad.”


The fight he fought and the journey we travelled together inspired me to apply for an opportunity that promises to be life-changing – a week at the Betty Ford Institute during my Psychiatry rotation. A big-hearted donor, who fought addiction himself, sponsors four of our third-year students to spend time learning about addiction treatment at the world-renowned Betty Ford Institute during their Psychiatry rotations.


Along with @BChanMed and two others from our school I’ll be spending the last week of August submerged in addiction treatment. Although the other patients will know we are at the center for a learning experience and despite the fact that we will have lectures geared at treatment from a physician standpoint, a large part of our week will be active participation in the unique treatment program put forth by the center. We will learn the ins and outs of treatment by participating first hand in small group and counseling activities with other patients who struggle with various addictions.


The Betty Ford Center is the only US addiction rehab facility currently offering a program like this for medical students and I am so honored to be a part of the Summer Institute for Medical Students


First hand participation has been proven time and again to be pivotal in teaching us to be great physicians, but personal experience has taught me that physician-training in the area of addiction treatment is lacking, to say the least. It is not just those of us who choose Psychiatry as our specialty who will interact with people struggling with substance abuse or addiction – these are afflictions felt by patients from pediatrics to geriatrics and everywhere in between. I am so grateful to have this medical education opportunity and I hope that other programs will take note of the Betty Ford Institute’s revolutionary initiative and increase the number of medical students offered this opportunity by following suit to create similar programs. 

I anticipate a life-changing look into how professionals go about treating those who struggle with addiction and also help in teaching their family to be assets of rehabilitation. I am confident that I can take what I learn in my week at the center and translate that into compassion and understanding for the benefit of my future patients and I hope that this experience will enable me to be a better doctor, a better daughter and a better educator.


*My Step-Dad is also a huge influence in my life and if I were writing a post for Father’s Day he would most definitely be included. I’ve written a bit about him & organ donation advocacy here

For My Mothers

A lot of people grow up saying they hope they never turn into their mother…I hope I turn out to be just like mine. Happy Mother’s Day to the most loving, selfless and beautiful person I’ve ever known!! Thanks for teaching me to be forgiving and genuine and for always making sure I knew I could do anything I put my mind to, I’d be lost without you. I love you, Mom!

August 1986
Snuggling. 🙂 See my teensy head poking out over there?
My first Christmas – December 1986
I’m sure that striped hat was cute in the 80’s??
1987
She even loved me when I was toof-less.

Putting a penny from my grandpa in my shoe on my wedding day. 
Easter 2010
Covered in mud after ATV-ing through the Jungle in Cozumel, Mexico.
Caribbean Cruise – Summer 2010
Caribbean Cruise – Summer 2010
Holding Baby Jaden

And no Mother’s Day blog of mine would be complete without mention of another woman who has played a pivotal role in my life, my Step-Mom. Some people get step-monsters when their parents re-marry, I literally got a second mother. Thanks for always being so supportive and understanding. I love you and I’m so happy I got you as my Step-Mom!!

July 18, 2009

The Important Things In Life

Between here and East Texas there are approximately 440 miles of asphalt equaling out to just under 7 hours of 70mph driving*. As a medical student and obsessive worrier it has never been easy for me to make the decision to leave town and now that the monster that is Step 1 has is hanging over my head it has become even more difficult. However, every year we look forward to an Easter road trip to visit my husband’s side of the family and this year was no different. I considered passing up on the opportunity because I had have so much studying to get done, but I weighed my options, threw caution to the wind and made the decision to join my husband and get out of town for a while.


So, Friday morning we packed up the car with snacks, study materials, and animals and headed out to the hill country.

Although I spent a lot of the weekend holed up in Starbucks, squinting at a computer and threatening to use my hot coffee as a weapon against whoever made USMLE World’s Q-Bank so dang hard, it really was a wonderful trip. 

We had breathtakingly gorgeous weather & sweet kids who took advantage of it…

Jaxon, our 4-year old nephew.

Jaelyn, our (almost) 4-year old niece.

There were crazy puppies to play with silly, dancing boys.


We had a fun night out with good drinks and great people…

 took a time-out for some family pictures…



and, most importantly, simply enjoyed getting to spend some time with our family.


*Welcome to Texas, where you can literally drive 15 hours North to South (Perryton to South Point) OR East to West (El Paso to Newton) without ever leaving the state. 

Dialect Debates – You Call That A What?!

Photo Courtesy of Mykl Roventine.
Flickr, Creative Commons.

Leaving Walmart yesterday I decided to write about people who happily peruse a store for 2 hours but, after unpacking their purchases into the back of their Lexus SUV, abruptly become incapable of walking 10 feet to return their grocery basket to the designated area of the parking lot. This sudden onset of disability leaves them with no choice but to roll their basket into the middle of the driving area so the West Texas wind can launch it like a rocket into an unsuspecting vehicle while it’s owner is on aisle 6 weighing the pros and cons white versus wheat. 

When I sat down with my Venti Caramel Frappucino (what? I’m celebrating the fact that the high is 93
°F today. Don’t judge me.to confess my hatred of lazy mega-store shoppers, it suddenly occurred to me that I couldn’t write about baskets being carelessly left around parking lots, because only about three people reading my blog would have any clue what the heck I was talking about. 

I grew up calling those things you roll around at the grocery store full of bread and baked beans, “baskets.” 


Then, I met my husband (well, I mean, obviously he wasn’t my husband when I met him…but I think you probably know what I mean). The first time we went grocery shopping together he said something along the lines of “Do you think we need a buggy?”

Photo Courtesy of Mike Cline.
Flickr, Creative Commons.

Um, excuse me?

A what?


Did you just call that thing over there with four wheels a…buggy?

Uncontrollable laughter ensued.

He then assured me that my terminology was, in fact, flawed, since the “baskets” were the little blue things with handles that you carried around if you were just running in to buy some popcorn and a six pack of Budweiser. 

No, actually those are just called small baskets…or…baskets you carry…or baskets that have handles…or baskets without wheels…or something.

The Battle of Deep East Texas vs. Small Town West Texas Terminology

To prove my word was correct, I decided to conduct some very formal research* comparing words used to describe grocery baskets  buggies  those things with four wheels that you push around when you finally break down and brave the aisles of your local supermarket because, if you have to eat frozen peas or dry pasta or whatever is left in the pantry for one more meal, you just. might. die. 


The consensus? 
We’re both weird. 

Several people answered with “basket,” unfortunately every last one of them were from my hometown. A few people said “buggy,” (ahahahaha….that is such a strange word) but all of those responses except one, which came from Sally in Alaska, were from people in East Texas.


The vast majority of responses? 
Cart. 

Well, okay then.


If you people want to be boring and uninventive, you can call your baskets a “cart.” I obviously take more pride in having a extended vocabulary than you do.
*******************************************************************************************************


What are some regional or cultural sayings you’ve been called out for? 

Here are a couple of mine:


  • I grew up using “fixing to” in the place of “about to.” Ex. “I’m fixing to go study.” I had no idea this wasn’t what everyone said until I was in college.
  • When I was younger my mom would say “oh, you’re trying to get sick.” Not like a literal “you bratty child, stop licking the concrete in attempt to catch something so you can miss school” way, but in more of a “your body doesn’t seem to be doing such a great job fighting this off – looks like you may come down with something” way. When I told my college roommate I “was trying to get sick” she took it very literally…then made fun of me.

Share some of yours with me! I can’t wait to hear them…and tease you. 

*”Quantitative Investigation of Words Used For Rolling Things At Grocery Stores: A Retrospective Analysis.” Jones, et al. Sources – Twitter. Text Messages. Facebook.

Organ Donation – Five Years Ago Today

Become An Organ Donor – Find Your State

It was Spring Break, 2006 – my second Spring Break of college. We laid on the beach in Rocky Point, Mexico all morning and, sometime around noon, made our way back inside for lunch and a quick nap. 

I had strict instructions from my mom not to call or text anyone while I was out of the country and not to answer any calls if someone tried to get ahold of me. So, like a good little college student who is still lucky enough to have a mom who pays their cellphone bill, my phone had been off the entire trip. Before I laid down, for a reason I cannot explain, I decided to turn it back on and keep it by me. 


When it rang I was asleep and I answered it without thinking. 


“Randy got the call. They’ve already done preliminary matching and everything looks good. They are about to take him to surgery.”


For years doctors diagnosed him with everything from depression to COPD. It wasn’t until 2003 that someone finally discovered that the real cause of my Step Dad’s exhaustion, fatigue and cough was an extremely rare form of Primary Pulmonary Hypertension called
Pulmonary Veno-Occlusive Disease. While we were ecstatic to finally have a concrete diagnosis, it was devastating to read things like “no cure” and “survival may be months to a few years in adults.” 

So, standing on the beach in Mexico, trying to hide the fact that I was bawling my eyes out, I tearfully told my Step-Dad to be strong and that I loved him. I hung up the phone and prayed for the donor family, knowing that somewhere not too far from Randy’s pre-op room a family had just had their world rocked by the loss of someone they loved. 

 I would later meet an amazing family and
find out just how massive that loss truly was.


Timeline of Transplant

January 30, 2006: First Call. Match not sufficient – transplant called off.

March 13:
Step-dad takes an Ambien to help him sleep.


March 14, 7:30am:
Step-dad answers the phone, hears “you have lungs waiting on you, be at the hospital in the next hour” and does what any normal person waiting on a life-saving organ transplant would do – HANGS UP THE PHONE AND GOES BACK TO SLEEP. By the Grace of God, my mom was up getting ready for work and was able to ask what the call was about.


March 14:
Match Confirmed. Surgery is a go.
March 14: Step-dad blessed with gift of two new lungs. 

March 15: Very dangerous reperfusion injury discovered. 
April 4: Extubated (off ventilator/life-support) 20 days post-transplant
April 7: Moved to transplant floor after 23 ICU days.
April 11: Liquid diet allowed. First drink in 27 days.
April 14: Some eating allowed. First food in 1 month.
April 20: DISCHARGED! 29 lbs lost since transplant.
May 1: Coughing up blood, short of breath.
May 2: Readmitted. 
May 4: Bronchioplasty.
May 5: Back to the ICU. Mild acute rejection, pneumonia, strictures, low 02 sats.
May 6: Out of ICU. Back to transplant floor. 
May 9: Open lung biopsy. Back to ICU on ventilator.
May 14: Finally off ventilator again. 
May 16: Out of ICU. Back to transplant floor.
May 20: Chest tubes out.
May 21: Pneumonia was from aspiration. Nothing by mouth for 6 more weeks.
May 23: J-Tube Placed
May 26: HOME AGAIN! 49lbs lost since transplant.
June 1: Readmitted, MRSA Pneumonia in right lower lobe.
June 2: Discharged with PICC line.

Sometime in July he got his J-Tube out and was allowed to start eating “real” food again. Note that this was almost 4 months with nothing to eat or drink, there was only about a week long period where he was out of the hospital and able to eat and drink before we discovered he was aspirating. 


There have been ups and downs, including a year of all holidays & birthdays being spent in hospitals and more days being in-patient than not, but he has come so far. The statistics for five year lung transplant survival are mediocre, at best, and he is thriving today.


I wanted to write this blog to express why I am an organ donor and why I think it’s important for everyone to be informed on this issue. 



We were blessed. 

In March of 2007 we had the great honor of meeting the family of our organ donor. He was 20, less than one year older than I was at the time, and his name was Craig. He was taken far too soon from a family who loved him dearly. They made the choice, in their time of horrible tragedy and loss, to see through their pain and help others. Because of Craig and his family – m
y step-dad attended my wedding in 2009, he saw his only biological daughter turn 16 and, God-willing, he will see her graduate high school next May.

Everyone doesn’t get those chances – almost 20 people die every single day waiting on a organ transplants that can’t take place due to the shortage of donations. That person could be your mom, your sister, your husband or, God-forbid, your child. 

You hear it everywhere, “make sure you tell your family,” and I cannot express how true this holds. No mother, in her darkest hour, should have to make the heart-wrenching decision that Craig’s mom so gracefully made. No wife, when she wants nothing more than to turn back the clock just a couple hours, should have to choose to give away a piece of their husband. It’s hard and it’s unnecessary, because we have the choice right now, today, to take that decision into our own hands and spare our loved ones.  

Sign up. Tell your friends and family. Get it on your driver’s license. Carry proof on you at all times. It’s so important…not just because it maintains your final wishes, but because it spares your family that incredibly difficult decision. It’s not just for all those people waiting for organs to save their life, it’s for all the people in your life that you love.

And if you sign up, please tell me – I would love to know. What a tribute it would be to the honor of a precious life lost.  

Become A Donor – Find Your State

There’s a Creepy Naked Guy in Your Brain

One weekend during my Neuro block last semester, while I was busy trying to figure out what the heck a heinously disproportionate and frightening naked guy named Homunculus was doing living in my brain*, my 16 year old sister, Madison, came to visit. When I mentioned that 2013, the year I have to leave school behind and get a big-kid job, seemed like light-years away she kindly reminded me that the world would be coming to abrupt end on December 21, 2012, so I shouldn’t worry about it. I pulled out my collection of notes and books from that 10-week block and decided right then and there that, should the world end in 2012, the Mayans and I would be be sitting down for a serious discussion when I caught up with them in the promised land. Someone better call Peter and Paul to make sure things don’t get outta hand…because I wanted a degree to show for all those brain wrinkles, dangit.**

At the end of that block a package arrived at my doorstep. I figured it was a goody package from my mom  (yes, my mom still sends me candy and cards and decorations and restaurant certificates for almost every, single holiday and it. is. awesome.), but it was actually a gift from my sister.

A giant, 1 pound (ONE POUND!) marshmallow brain…



with a lovely note on the back:
  “Neuro = 
  • 3 months
  • five books
  • helluva lot of studying
  • 10 billion gloves
  • and praying the world doesn’t
    end in 2012 making all of that
    worth nothing.


As far as I’m concerned, the only that could make that gift better is if a life-size marshmallow Homunculus body was stuck to the side of it. She totally gets it.

Yup, I have an awesome family and two phenomenal sisters. My other little sister, Morgan, is 15 and she just got a Twitter. You should go show her some love, I’m sure she would pee her pants if next time she got online she realized she’d gained a bunch of followers. And come on, it’s always hilarious when your younger sibling pees their pants.



*That outta bring some interesting google-search traffic to my blog.
**Medical school brain wrinkles appear at the cost of losing previously learned elementary motor skills and common sense. I mean really, do you think your doctor had that handwriting in junior high? Absolutely not. Somewhere between learning what branchial pouch the parathyroids come from and memorizing what to do should that branchial pouch fail to develop appropriately we just forget how to properly construct letters. And that, my friends, is the real reason we are switching to computerized medical records, because your future doctors no longer know their ABCs.