ER is over

Today was the last day of my ER rotation. That’s 5 of the 13 rotations for this year done. Yeah!! The ER was nice – I worked 21 eight hour shifts and had 7 days off. The shifts ranged from 7am-3pm, 9am-5pm, 2pm-10pm, 5pm-1am, and 11pm-7am. I saw quite an array of people with lots of differing personalities and problems, ranging from no reason for being in the ER to every reason for being there and very sick. Here are examples of some of the more interesting things I saw:

An older man who had a tumor growing on his head for a year before seeing a doctor finally because it was giving him headaches and leaking lots of junk on his shirts. It was about 5 inches wide and 1-2 inches deep and was eating into his bone. We took a biopsy and he ended up having a really bad squamous cell skin cancer. He will need a lot of work with plastic surgery to try and fix it.

A teenage girl who came in 1 week after being diagnosed with strep throat with no other medical problems. She was put on an antibiotic and had a rash appear on her stomach and the front of her legs, and we thought it was just a reaction to the antibiotic. We got some basic labs that came back showing signs of cancer. Further testing showed she had a new leukemia (blood cancer).

A lady had back surgery about 10 days before and had gone to a rehab center. She was not having very many bowel movements and started having a lot of pain and bloating in her abdomen. She ended up having a hole in her large intestine from all the pressure that had built up and was quite sick from it. The CT scan of her belly showed lots of air in her abdomen (a really bad sign) and she was rushed to the OR, where a large part of her bowel was taken out and she was in the ICU on a ventilator for almost a week afterwards recovering.

A man who was wheeled in by EMS with really bad chest pain. We were sitting in the other room and heard, “I need a doctor and nurse in the room now!!” so I rushed in after the attending doctor to watch. The patient had stopped breathing and had an abnormal heart rhythm. The doc ran in and gave a large thump with his fist to the man’s chest while the machine was getting ready to shock him. I think he ended up being shocked 3-4 times before he came around and said “Ouch!” with the last one. He was rushed up to cardiology to get a rapid procedure to look at the blood vessels to his heart, and they found a giant clot blocking the main vessel in his heart. He is so lucky because if he had been at home when he lost consciousness, he wouldn’t have had the machine there to shock him, and so he probably would be dead.

A lady who got something in her eye from raking leaves. We placed a fluorescent dye on her eye and then used a machine called a slit lamp to look at her cornea to see if there were any abrasions (cuts), which would fluoresce a light green color, and I got to see it.

I got to suture (sew) up a few people’s lacerations – one on an eyebrow and one on a head – all by myself, which was so much fun.

I would go see the patient, then talk with the doctor over me, and we would talk about the possible things going on and decide what labs or other tests to order. It was a nice month because the ER is run by the attending doctors, and we are there more to learn than to run it. So we could go a little slower and take time to learn about our patients. I also enjoyed the people I worked with.

There were some frustrating things that would keep me from choosing ER as a career: 1) I saw firsthand the problems that our current healthcare system has with respect to the ER – so many people who use it as their primary care office because they don’t have insurance so they don’t go to a regular doctor, which drives the premiums and taxes up for everyone else; 2) I got annoyed by people who use the ER like McDonalds: they think they can come in, pick and choose (sometimes demand) what tests they want ordered or what pain medicines they want, and then get mad when things are not done as fast as they like because they need to be somewhere else; 3) I don’t like the lack of continuity of care while working in the ER – you see patients, figure out what is going on with them, and then send them out, and it is hard to know what happens to them. I guess if anything this year continues to make me more and more excited for the upcoming training when I will get to learn dermatology, which I am liking more and more the more I see of it.

In other news, Kolby has now done 2 weeks of piano and loves it. He can already play a song that is recognizable (“Merrily we roll along”). The boys had doctor’s appointments this week for well-child checks and they all seem to be doing well. We went on Thursday to JC Penney to get a family picture that we will send out for Christmas. The lady who did our session was the same one who had taken the pictures of the boys in their Halloween costumes a few weeks ago, which turned out so cute, and she was so good again this time – we want her to do it for us every time we go. I can’t wait to get the pictures back – they turned out so nice. Thursday night was Daddy-Eli night and we went to see Wall-E together. Eli was so excited to get a little bag of popcorn and watch the movie on the big screen. We took the van in for a $20 oil change on Friday that ended up costing about $400 – the area where you put the key in locked up and so we had to have a locksmith go to the car place and replace that; the battery was dying and needed to be replaced; and we got the oil change. At lease that van works so well for us most of the time. Yesterday Kolby had a practice for his primary program that he participated in at church today. We had dinner tonight at the Eccles, a family in our ward. The kids had so much fun playing together and we had fun just talking. It has been a pleasant evening and a nice week.

Count Down to Match Day!

So, this week started out pretty busy (and kind of stressful), and ended up really nice. As I mentioned in my earlier post this week, we had to deal with all the financing for getting the new van and we are still trying to tie up things with the insurance company, but we are glad to be in a new van that works well (what a relief to have a car that doesn’t die when we stop at a red light and doesn’t need to be jumped if we leave the doors open (and the lights stay on) long enough to take the groceries into the house). After we got everything worked out with the van, got the house all cleaned up, and got past a few different days of a few of our kids being sick, it turned out to be a pretty good week.

The Egberts came over for dinner last Sunday night, which was fun to get to know them a little better. And I also had fun because we decided to get out the nice tablecloth and the china for dinner (we haven’t used the china for a while, but because Camden is in a high chair and Kolby and Eli are old enough now, and the Egberts’ kids are old enough too, so there weren’t any small babies to pull the dishes on the floor and break them). On Thanksgiving we set the table with the china and nice tablecloth too, and when the boys saw me get them out, they insisted that I get out the fancy candlestick I used at Thanksgiving too, so that was pretty cute. And our kids played great with the Londyn and Dyllin Egbert when they came over too. I think Kolby has a little crush on their daughter, Londyn. Londyn goes to Kolby’s gym class at the YMCA on Wednesdays, and this week I went to pick Kolby and Eli up from class and Kolby ran up to me and the first thing he said was, “Mommy, Londyn’s here!”

On Monday the boys missed preschool because Kolby woke up early in the morning throwing up (some kid at church the day before must have had a little bug or something). I wanted to stay inside that day, especially with Kolby having been sick in the night, but we had a WIC appointment that afternoon (the WIC office is only open two days a month, plus Kolby was acting totally fine during the day). So we went, and it’s probably a good thing that we got that done. And then we went over to the car place and emptied all of our possessions out of our old van. And then Michael was on call that night, but call hasn’t been bad this month at all so far. He is on call overnight, but this is one of the rare months in medical school that he is on home call, so they just call him in if they need him (which is what I assumed that ‘on call’ meant when we came into medical school, not the usual staying at the hospital overnight). Anyways, he hasn’t been called in yet, which has been really nice for us.

On Tuesday Michael got a little time off work in the day between surgeries and we went and signed the loan papers at the bank and then that night when he got home we went and picked up the van. It was great, except the radio needed to be fixed so we took it home without a radio while the dealer ordered a new one. Then that night Kolby and I had our night out, and we decided to go to the mall. I let Kolby pick what he wanted for dinner, and he got a burrito and a treat from Taco Bell (and I got to have Chinese food, which sounds much better to me than Taco Bell anytime). Then we went over to Barnes and Noble and Kolby played with the Thomas the Train set they have there in the bookstore for kids to play with. Then he picked out a few books and we sat together in one of the big comfy chairs and read them. Although it sure makes me smile when I see my little boys all getting along and playing well together or when I see one of the older ones being sweet to the baby, I have to agree with what my mom told me once: that she enjoys her each of her children individually more than all of them together. I think doing these little one-on-one nights with the kids once a week has been a really good idea so far, because we can do such simple activities with them and they still think it is the greatest thing ever to have alone time with Mommy or Daddy.

On Wednesday morning the boys had preschool and then they had swimming lessons that evening. Near the end of each session, the swim teachers hand out notes to the parents saying if the kids should take the same class again or move up a level in the next session. Kolby’s teacher said he is ready to move up, and Eli had a substitute teacher this week so we didn’t get a note for him yet. I had actually already signed the boys up to be in the same swim classes next session because it is so convenient for us to go and have them in their lessons in the same pool at the same time. The problem is that their lessons are from 6:30 to 7:00 now, and I was looking at the program for the spring session, and the class that the teacher recommended for Kolby is only during the middle of the day or right during our dinnertime. We’ll have to see what Eli’s teacher recommends and then decide if we want to change their classes for next session or not.

On Thursday I finished catching up on the housework that had gotten backed up with this busy week, even scrubbing the kitchen floor and getting everything looking nice again. Then we went over to Karissa’s house for Marcela’s baby shower. She is having a little boy, which will be so much fun. That night we had the Kearls over for games, which is always fun (although it might be nice someday to be able to afford a babysitter so that we could do things without our kids sometimes, but I do think that it’s pretty impressive that we can usually get all four of our kids and both of the Kearl’s kids down to sleep at the same time so that we can play games).

On Friday morning the boys missed preschool again because when I got Camden up in the morning I found that he had thrown up. After he got a good bath and some clean clothes he seemed just fine and didn’t act sick at all. That afternoon I made several cakes and decorated them for the young women’s fundraiser at church (and the next day I was able to ‘fix’ the frosting on two of them so they turned out better than the pictures I had posted earlier). Michael was on home call again on Friday, but didn’t have to go in, so that was nice.

Yesterday we got a lot of little things done in the morning that needed to be done. Michael went to the dealership and got the new radio put in the van, I went grocery shopping, Michael got all the laundry done, we cleaned the kitchen and picked up around the house, and I ‘fixed’ those cakes. On the way to the grocery store, I stopped at Kohls and they happened to be having a sale. I found some cute jewelry (thank you, Grandma Faun – this is what I ended up using the Christmas money for that you gave me and I had been saving up until I found something I really liked) and a shirt on sale, and I got Michael a few shirts on clearance too – I love the Tony Hawk brand of guy’s clothes at Kohls for Michael (especially when we can find them for a few dollars on the clearance rack). That night we went over to the church for our ward’s annual Chili Cook-off and the dessert auction fundraiser. It was fun to see friends at the party, and we were glad for the young women that the fundraiser seemed successful. (My cakes, by the way, did sell, even if they didn’t bring in the most money, but at least they didn’t have to return them to us because no one would bid on them). :) And after Michael came home and helped me get all the kids in bed, he was invited to go and play video games with a few guys from church. He said he wasn’t any good at the game they played, but it was nice to hang out with a few people that he hasn’t had a chance to hang out with in a while.

And today has gone pretty well so far. Michael had one of his home teaching appointments this morning and the boys are all ready to go to church. They have watched the Testaments church movie twice this morning (once in English and a second time in Spanish) while we finished getting everything ready to go. And Michael got the dinner started for tonight while I made bread. We are having corned beef for dinner (it’s my favorite way to have meat prepared).

I made my big batch of bread, and once again it didn’t rise as much as it should have. The bread tastes really good, but it only rises about as high as the edge of the bread pan and won’t go any higher than that. Last time I wrote about having trouble getting the bread to rise, several people gave me suggestions (thank you!), but many of them didn’t apply. I am using a Bosch to mix the bread, so it’s not a problem with the kneading process, and my mom just bought the yeast a few months ago, so the yeast is not too old, and she got me her favorite kind of yeast that she said doesn’t depend on the temperature of the water, so that shouldn’t be an issue either. I have tried letting the bread rise on top of the stove, on the countertop, and inside the oven at it’s lowest setting, and none has worked just right. So, I told Michael this morning that I am hoping the problem is just that our little oven cooks too hot or not hot enough, and maybe when we move we will have an oven that works better and that will resolve this issue. I would appreciate any other suggestions you have for me to try, though.

After church we are staying for choir practice because Michael is going to sing in the Easter program. Then we are having the Maases over for dinner. Marcela’s mom has come to stay with them for the next four months, and she mostly speaks Spanish, so I thought it would be nice for Michael to speak Spanish with her and make her feel welcome. Plus we haven’t been able to get together with the Maases lately, so it will be nice to talk to them again.

This week should be pretty exciting. Tomorrow morning at 11:00 Michael will get an e-mail telling him if he matched or not. Then on Thursday we will all go over to the school in the morning and sit at tables in the alumni center and wait while each student is called to the front of the room one at a time to receive an envelope telling them where they are going for residency. That is at 11 am also, and then there will be a lunch afterwards. And the Hedgecocks are being nice enough to watch our boys for us so that we can go out and celebrate by having a nice dinner out. Michael has been pretty anxious for the match the last week or so. I think he will feel a lot better after tomorrow when he knows that he did match, and is just waiting to find out where (hopefully). I have just been more impatient than nervous lately, since I am such a planner and I want to start researching for houses, school districts, moving plans, and everything else for the place where we will end up. We will be sure to let everyone know how it turns out.

Oh, and I almost forgot the biggest thing of all: Camden gets to start his first day of his nursery class at church today! He has been looking forward to this for weeks – going to the door of the nursery and watching the kids play with toys and sing songs, and then crying when he didn’t get to go in too. He will be in the same class with Eli, so that will be fun for them. I know he will just love it!

Long Lost California Photos

So, I've been having a bit of a rough week. Since we got back to Milwaukee almost two months ago I have been doing such a good job of always doing the dishes immediately after they are used and keeping up on cleaning the house a little bit here and there all the time so there is never a big mess that will take hours to clean -- and it feels really nice to have it clean all the time. This week we got extra busy, even though I was thinking that things couldn't get much more busy with Michael being gone early every morning and me taking the kids back and forth to school all the time, keeping up with the housework, and running all the errands. But our van got totaled and we were looking for a new one. We found one we really liked that was in our price range, but the bank that the car dealer tried to get us financing with turned us down for the loan of a few thousand dollars that we needed after we used the pay-out from the totaled van. Because Michael doesn't have a job and we therefore have no income (and no, they don't count the student loan money that we live off of as income), we are considered "high risk" and they wouldn't give us a loan. I was concerned that we were not going to be able to get a loan anywhere, and that the van that we liked would get sold to someone else while we were trying to figure out the financing, and then we would be stuck without anything because the other guy's insurance company would only pay for a rental car for 4 days after our van was totaled. Anyways, we ended up going to our bank and they didn't give us any problems (although they did give us a nice high interest rate -- but we aren't too concerned about that since it is a small loan and we should have it paid off before too long). Anyways, we got our "new" (2001) minivan, and we love it! But I was rather stressed out this week with the whole process of trying to get it paid for and all the other little things that had to be taken care of (and several that still do) with the van being totaled, getting a loan, and getting the new van. So, all the normal everyday things got put on hold and I was yelling at the kids a lot more than I know I should have been the last few days. Today has been better. One of the things that got put on hold was the cleaning, so in a matter of one or two days the entire house looked like a hurricane had gone through. We suddenly had four-day old dishes sitting in the sink, the kids had gotten food all over the floor that hadn't been swept in days, there were little piles of "stuff" all over all the furniture and countertops, there were loads of unfolded laundry, and toys, clothes, blankets, and other assorted things were spread all over the floors. So, besides being stressed about the car stuff I had also lost that good feeling from having the house nice and clean. It took two days to do all the dishes, scrub the kitchen floor, pick up all the stuff around, and get it looking nice again. And then, when I had a minute to "relax," I started thinking of all the unfinished things that I would like to catch up on. (Yeah, sounds really relaxing, huh?) One of those things is getting caught up on posting all the photos and videos from our trips and from after that on the blog. I keep thinking I will just not worry about the photos from January, since that was so long ago, but then I look at them and think, how could I not include the pictures of Kolby's first time skiing and all the other fun stuff we did? So, I am still going to try to catch up. I think I'll just make a few big slideshows of all the photos, though, instead of taking the time to upload each one separately, then hopefully I can get caught up quicker. (By the way, I am feeling a little better these last couple of days. Not so stressed, even though I still feel like there are still a ton of things that we need to get done. But I feel a little less like I am drowning now, and even though it’s probably only about 30 degrees outside I have bright sunshine streaming in through my window at the moment, so maybe this depressing winter will actually come to an end sometime in the next few months. At least we have another good day to look forward to – Match Day is only 6 days away. Next Thursday we find out where we are going for residency. And then that night we are going to go out to dinner to celebrate (hopefully it will be a celebration). [Anyone up for babysitting four adorable little boys that night for us?] :)

These are the photos of our trip to my parent's cabin in Mammoth Lakes, California in January (Mammoth is six hours north of San Diego, near Yosemite). We always have so much fun in Mammoth. Camden was being especially cute the first night up there when the cabin was not yet heated up and I wrapped him in a big down blanket on the bed -- he was all smiles. My brothers, Matthew and Aaron, had a lot of fun playing with the boys. And the one picture of the three older boys shows how deep the snow was on their back deck -- just about as deep as Camden was tall. I love the photo of Camden folding his arms for prayers -- I had to take a picture of this before he starts growing up and is big enough to reach his arms all the way across his little belly; I just love that he rests his little arms across the top of his chest when we tell him to fold his arms for prayers! And then there are the pictures of Kolby skiing, of course. That was so fun! And Kolby was lucky to have my dad as his ski instructor. And then the last photo is of Eli in his uncle Aaron's old "moose hat." Pretty cute!