My break-up with coffee

It became my New Year Resolution so to speak. It wasn't planned, it just kind of happened.

Now this was kind of a bid deal because I absolutely LOVE coffee. Latte. Cafe au lait. Regular cup of joe. I don't care just give me anything fresh roasted, organic or simply non-instant and I'm happy. I probably drink 2-3 cups of coffee on any given day and sometimes much more. There is the obligatory morning cup and then another one sometime in the afternoon. There are countless cups to drink while reading the NYT on Sunday mornings or while studying at whatever coffee shop I choose on the weekends. Coffee is my study buddy, my comfort drink, my friend.

But I was over it. And on January first I had my last real cup of coffee. I switched to black teas for a few days so in an attempt to prevent withdrawal headaches. Then I went to decaf teas only. And I survived. Now there were a few afternoons in clinic when I was convinced all I needed was a shot of espresso to make my headache disappear. (And I did get one migraine, but I think it was probably the dehydration, skipping lunch and a busy overbooked clinic that did it, not the lack of caffeine.)

Somehow I made it, including one night on call without a single cup of coffee. And I didn't miss it as much as I thought I would. However the hospital coffee leaves very little to be desired and there are no good/convenient coffee shops between home and work so that probably helped. But in any case, I now know I can live without coffee, and it isn't even that difficult. But I like LOVE coffee...

And so yesterday for the first time in almost two weeks I drove 10 minutes out of my way and ordered a grande nonfat latte. And it was wonderful. Coffee and I are back together, at least for now.

Oh, yeah, I write a blog....

Hi dear readers !I didn't forgot about you, although my lack of posting may make you think otherwise. Insert normal excuses here- busy, nothing interesting, blah, blah, blah. Anyhow, I hope you enjoyed the Holidays, Happy New Year to you!

So, what have I been up to? If you are keeping track at home I'm in my second to final rotation of third year. I just have four weeks of OB/GYN left and then I'm headed back to Cali for IM and then I'm a grown up MS IV! Crazy how time went by so fast.... Of course things are not quite THAT easy because I do have to take those little things called the Step 2 CK and CS, and arrange my schedule for next year, etc, etc. But I'm marching on....

Peds was amazing and everything I could have wanted in a rotation.  Great teaching, interesting cases, cute kids, good diversity and basically confirmation that I was born to be a pediatrician. Every day was fun. I heart babies, teenagers and all those in between. I was even able to spend several days in peds neruo clinic and that was amazing too. So all in all I am happy and ready to get to fourth year already so I can hang out with those kids again! Last night I was on-call on L&D and just down the hall from the nursery so I made a few trips (to check on the deliveries of course) and just because babies are way cuter and more fun than moms' in labor. Or at least I think so.

So OB/GYN. Well I started with clinic so I've gotten to see a little bit of everything and then last night on call I scrubbed for one section and helped with one NVD so all in all I'm getting to see what I'm suppose too. I feel like I'm missing the gene that makes one wax poetic about the miracle of life and witnessing a birth. I suppose I am more upset by how cold the anesthesiologist is to the patient in the C-section, how scared she seems and how horrible it must be to have a baby brought into the world this way. The patient was alone, Spanish speaking and clearly scared. Not a single person in the OR spoke Spanish, or if they did they kept quiet. It broke my heart to see her sitting there, her eyes trying to hold back tears and her entire body shaking (from cold or fear or both). I held her hand before I scrubbed in and a caring nurse or two did the same but during the actual C/S it was only the anesthesiologist behind the curtain with her and he most certainly wasn't comforting her.... but the baby was fine and patient's family appeared shortly thereafter to be with the patient and see the new baby so maybe I'm getting more upset about this than I need to be.

Of course normal vaginal delivery doesn't look like a piece of pie either. Oh my goodness, the crying, the screaming, the mess, the (seemingly) never ending labor. The vaginal delivery I saw was a bit better in that mom got to breastfeed and hold baby within five minute of the actual delivery and the family was in the room, cheering, and celebrating. So maybe magic for them, not so much for me. But babies were born and life begins anew so I'll try to focus on that positive as I sign off today.

Hopefully I'm back to regular scheduled blogging in this new year.

blame it on the kids

HPI: female medical student with sore throat x 3 days, non-productive cough developing over last 24 hours along with hoarse voice and headache, possibly a subjective fever
sick contacts- numerous kids with strep, RSV and all other sorts of viruses seen and examined in the last week courtesy of her time spent in the Peds ER
cough drops and Advil has been mildly effective. no change in appetite. recent difficulty sleeping due to nasal discharge and cough.

PE: pt looks tired and miserable but not that sick. throat is mildly erythematous and adenoids are visible but without purulent discharge. cervical LNs tender.

DDx:
URI/Laryngitits- unspecified viral, top contenders include:

• Rhinoviruses
• Parainfluenza viruses
• Respiratory syncytial virus
• Adenoviruses
• Influenza viruses

Steptococcal Pharyngitis - (pt has had strep throat no less that 50 billion times in her life and blames her sensorineural hearing loss on all the antibiotics she took as a kid trying to get rid of the same. pt can swallow without too much difficulty and lack of real fever, appearance of the throat are less suggestive of this dx)


A/P: Most likely viral so therefore no treatment warranted.

Rx: Take the morning off to stay home, drink tea and study. (Pt would not want to get the healthy kids coming for well-visits sick, after all!)

10 fingers, 10 toes...

I just finished my two weeks of inpatient floor work and next I have a full week of newborn nursery. We had an intro lecture on Thursday and I'm quite excited. How cool is it that I will get to check a newborn and perform physical exams for the very first time for these little ones? Plus they are cute even if there heads are molded into some interesting shapes from the delivery process. And I am sure I'll learn a ton too. Time to brush up on causes of neonatal jaundice.

Peds soldiers on and I'm loving it. Show me the babies!

this is it

peds is here, i'm 1.5 weeks in and have seen plenty of asthma and RSV... plus a few interesting cases, rare and otherwise. the teaching is great. the hours are okay. the patients are wonderful. so really, no complaints except that i feel like i know nothing. there is so much to read and study but every day i'm learning.

i love the population and the diversity. one minute a 7 day old baby and the next a 17 year old teenager. parents of all varieties. play is part of the job. i heart it all!