merry christmas

What a strange holiday season for me this year. It's the first one being totally away from any family, which is pretty depressing, because that is what the holidays are supposed to be about. I have been working so much up to Christmas that I didn't really notice until the 24th that it is very lonely spending the holidays alone. I actually asked one of my colleagues if he wanted me to work for him on Christmas. Normally I would never do that but when you are totally by yourself, you are not missing anything by being at work. He declined, so here I am talking to my dog on Christmas morning. Thankfully a friend invited me over for Christmas dinner, so I won't spend the whole day alone but it will be with someone else's family. I guess I should be thankful for her though, because she is the only person who offered to have me over.

Enough of moping! I'm getting a new tri-bike soon! 2008 cervelo p2c dura-ace! I decided to name her Brit, after Chrissie Wellington (she's British and won Kona on this very same bike) and of course my favorite pop tart, Miss Spears ;) The bike should be here any day now, it had to come from the cervelo warehouse in canada, so had to go thru customs and everything. It was the only 48cm frame left in North America. And it's all mine. Look out people, I'm going to kick more butts in 09 than I did in 08. For real.

ahh... ortho

Back on ortho this month. Even though there are things I dislike (long hours, millions of patients on the service, inefficient hospital, eternal fear of doing something wrong), I love it. Today I got to scrub in to surgery for the first time since August and got to do about 60% or more of an ankle fracture. Woo hoo! Very cool, I love the power tools. I felt a little disorganized today especially since I had 11 new patients today to learn. It'll be better tomorrow.

step 3: check!

I took the USMLE Step 3 exam yesterday and today. It was mildly painful, and I sincerely hope I passed so I don't have to endure it again, or pay for it again. I don't even know exactly what it means if I pass it. Am I a licensed physician? Eligible to get a license? All I know is I have to take it, and I have officially checked that off the list. I hope someone will tell me WTF it means.

I also did Ironstar... and it was a bittersweet experience. Set a swim PR, got a flat on the bike, cramped up HORRIBLY the entire run, then got blisters on both feet at mile 3, then got 3rd in my AG. An experience to say the least. I would consider doing the race again, it was nice other than my little mishaps that made me question my sanity.

I signed up for a Turkey Trot on Thanksgiving. I should probably run at some point before this race.

My month on Anesthesia is winding down, and my experience has been I feel half like a med student and half like a nurse. I'm not switching no matter how much the Anesthesia residents tell me I should. I am anxious to get back to Ortho in December. I will have a fellow intern with me so I think the experience will be better this time, and I know I will continue to learn more and more! I hope I didn't forget everything I learned in August, but I think I may have.

I am going to buy a tri-bike. I will probably get a cervelo P2C or a Felt B12. I don't know if I will get it before the new year or not, but it will be very excititng when it finally happens. I need to test ride though. I need to dedicate my road bike to roadbike racing and the tri bike to Tri's and time trialing. You really can't have the best of both worlds in terms of position on a road bike with aerobars. I feel I have proven I am invested in both sports and I have the potential to do well (mostly limited by available training time) so I deserve to have the proper bike for each.

Ok that's it.

winding down

OK, I did it, I registered! I have mixed feelings about it, of course, but oh well. This is the last tri for 2008. Then comes "winter" which as I see it in Houston will mean that I won't always be wearing my sleeveless jersey. There are a lot of running races in the winter here as in Indiana so I will definitely partake in those, as well as keeping up with the bike stuff so I can race my bike next year!
I have my eye on a Turkey Trot (5 miles) on Thanksgiving day. Which gets me thinking... what else will I be doing on Thanksgiving day? No family here. I suppose I will invite myself to someone else's house for turkey. We'll worry about that later.

what to do...

Should I register for Ironstar or not? Should I punish myself for 6+ hours or not? I can't decide! I told myself I would decide by today... based on how today's bike ride went. Well, I rode 62 miles in 2:58 with the Pearland Race Team for an average of almost 21mph. However, this is DRAFTING pretty much the entire time except for the last 12 miles where I said F-them and rode on my own cuz I was exhausted and the Cardiovascular system wasn't having it anymore. I don't know... I looked at my training logs from July 2006, right before my last 1/2 Ironman, and it looks like I am training harder right now than I did then, but I am also about 8 pounds heavier than I was then. And no, it is not all muscle. Trust me! So that will increase the pain factor on race day. I will decide by the end of the day. I'm leaning toward doing it.... however it will cost 175 bucks. Hmmm.

Rheumatology Rules

But only for a month. I work 3 hours a day, 4 days a week. Not too shabby, really. But it just doesn't have the same satisfaction as surgery does. You don't fix people, you just keep them from getting worse as fast as they would otherwise. While many of the patients I have seen this month have been ecstatic with their RA treatments, I find myself frustrated with the inability to fix them. Oh well. I'll just enjoy the sleep, exercise, and sunshine I've been getting while it lasts, and quit complaining. On that note, I am contemplating doing a half-Ironman on November 9. That is just a few weeks away and I am still "deciding." That's funny to me because in the past a half-Ironman would require months of planning and training and stressing and doubting... but since Ironman, it's just another race. :)

human zombie

My first day feeling like a person in the last 3 weeks. I did something other than sleep or work. I went shopping, went on a bike ride, and cleaned the house a little. I have certainly questioned how much I want to continue giving up the last few years of my youth in order to be an orthopedic surgeon. Your job is supposed to enable you to do the things you like, not prevent you from doing them. That's what mine does right now. Hmm.

I asked for this?

So I am now 2 weeks into my orthopaedics rotation at Ben Taub general hospital. It is a pretty intense rotation as an intern. I have a lot of responsibility and autonomy, yet someone more senior is always available for help. The hours leave something to be desired...Q2 call is a little rough. I am daydreaming about those programs that have night float...
I have already learned a ton, though, and you can't learn how to do stuff from a book, you have to learn by doing it! I have reduced many fractures in the emergency room, and re-located a dislocated shoulder. It's really fun because the patients think you are awesome when you put their bones back together! It's also stressful because ortho is a very busy service and I have to ask the chiefs about almost everything so I waste a lot of time that way. I'm sure I will get more efficient with experience so I am just trying to absorb as much as I can right now. It's rough, but I can't imagine doing anything else. I made the right choice!

It's also my birthday, 28 freaking years old, so Happy Birthday to me.

Status Post 1 Month

I survived the first month of internship. Only 11 more to go!
The last day of plastic surgery I got to do an extensor tendon repair all by myself! My chief was kind enough to even list me as the primary surgeon. It was exciting to me, even though years from now it will all be routine.

Today was my first day of ortho! It was really chill, because it was only a half-day and was just clinic. And we got free lunch. Apparently we get free lunch every day, which rocks. I also have the entire weekend off. I guess it will be a little crazier more toward the end of the month for me. I need to get some friends, because what am I supposed to do all weekend! Also, I have no money, which puts a damper on the fun this weekend.

I'm going to take Parker to Memorial Park tonight for a walk. He has been halfway good lately!

i kick butt

I woke up super early for a Sunday and did my lovely rounds at the VA, then skated out just in time so break the speed limit so I could make it to the start of the PCC group ride. We did 57.5 miles in 2:50, averaging like 20.1. The race team guys were impressed that I could hang with them and even was in the front a bit, and they think I should join their racing team. They have a very small women's team, aka 2 riders. Maybe they're just desperate but I'd like to think they have faith I would do them proud. After all, they have sponsors and everything, so you can't suck too bad since you get free gear to show up and race. The only issue would be time commitment, since I am kind of owned by Baylor right now. But if it can be done, I will squeeze it in to my schedule, because that's how I roll.

Back in the swing

Yay, I joined a gym today! I decided it was necessary since I am going to be in the hospital during the coolest daylight hours (morning). I kept meaning to go running this week but I am either too hungry right after work or it is too hot or it's dark. So I ran 40 minutes on the dreadmill today, and although slightly boring, it felt good. The cardio equipment at my gym overlooks a 50-m pool! So tomorrow I may go swimming. That's awesome because in Indy, there were 2 separate facilities for the pool and the gym, and that meant 2 membership fees. Now I have it all in one. And they have nice private showers so I can go early in the a.m. when it's dark and then shower before work. I think I have gained a few pounds since Ironman so this was a key move for me! Now I don't have any excuses though.... :)

Damned if you do, damned if you don't

Multiple times this week our team (plastic surgery) experienced this conundrum. We have one elderly patient that just had surgery a week ago, and he has an artificial valve in his heart so he takes coumadin (a blood thinner) on a regular basis. This predisposes him to bleeding problems. After the surgery he developed a hematoma in his wound and had to go back to the OR to evacuate it. Every time we try to get him back to his usual dose of coumadin, he bleeds from somewhere. But he has to have it or he could get a clot in his heart valve and have a stroke and die. What is usually a routine postoperative course has gotten this man 5 blood transfusions and an extra week and a half in the hospital (so far).

That's just one example but if you think about it this type of problem is frequently encountered in medicine. Drugs have side effects. Surgeries have complications. Patients are not textbooks. For every action there is a reaction, and it is not always beneficial. These situations make me realize that there really is an art to medicine. There's no algorithm for what to do NOW with our bleeding patient beyond vague recommendations, yet we have to deal with it. We are still dealing with it.

I feel like a lot of choices in life are between the lesser of two evils. Either the patient will bleed or clot. Which do we choose?

I want to ride my bicycle...

Against my better judgment, I rode with the Pearland Cycling club today. The reason this is questionable is that I am still not 100% after Ironman CDA and I haven't ridden at all since then. They usually break up into groups, and I usually average over 20mph. For 40-50 miles. Including stops. Normally this is a great training pace and I love it. But I kind of pictured my first ride back just being more like an easy spin, not rocking the recovery boat so much. There are slower riders that I could have hung with, but alas, I just couldn't help myself, and I sped on.

Surprise! I did awesome! We rode 54 miles, and for about the last 6 or so I did feel like I might pass away (note the euphemism) but otherwise I was strong and even pulled for a little while at 22mph. I also met more people which is always good. We ended up averaging 20.5 and I was pretty pleased with that considering it was hotter than Hades!

However now my legs feel tired, so I think tomorrow will be a yoga day.

one more thing to do

Why, oh why, did I start a blog? I'm not a talented writer. And it's just one more thing to do. As if there's not enough already! Well, I guess it might help me blow off steam and since I am about to embark on a stressful stage of my life (AKA Residency) I figured why not. Plus, I doubt anyone will read it so if I ramble needlessly I don't have to apologize to anyone!

I've always had intentions of keeping a journal but it usually lasts a max of 2 days so hopefully that won't happen here. Only time will tell.

The title of my blog stems from something that I need to work on, and that is I need to stay off the sidelines of my life. I need to live it. Every moment. Not later, or someday, but now. I wasted a lot of time in the past (with Brandon, if we have to spell it out) and I missed out on way too much of life in general. I didn't experience things or spend time with people because of my suffering for his mistakes. I want more than anything to put that behind me. I think I have, but I still need daily reminders to get out there and live. Nobody else is going to do it for me!

So staying off the sidelines is goal number one. Goal number two is to love myself. Wow, doesn't that sound vain! I just mean I want to accept myself for who I am. For some unknown reason I seem to never be satisfied with myself or my accomplishments. I ran a marathon. Not hard enough. I did an Ironman. Not fast enough. I graduated from medical school. If I don't enter the most competitive specialty people will look down on me. These are the thoughts that go through my head! Why can't I just accept less than absolutely perfect? How am I supposed to enjoy life if nothing I or anyone else does is ever good enough? I mean what's next? Everest? Then what! And I am obviously not going to climb Everest, because it would be too cold. So when will I finally be happy and proud of myself? I don't know but I am trying. I am trying to find joy in things that are not measurable. Hanging out with friends, playing with my dog, and reading fun books, for example. Not in my 5K time. I am more than that and I just need to get used to that idea so I fully embrace it!