Monday, July 28, 2014

The Color in My Life.

There is Drama amongst the third years. Third year A did a post discharge follow up on the patient of third year B with a home phone call. Then presented to the resident. Dun DUN DUNNN!

Of course the resident assigned third year A to do it while B wasn't in the room. So it wasn't exactly like A student was swiping the task. But B student was very attached to that patient. And they have to turn in a certain amount of patient follow ups as an assignment. Thus from questionable misunderstandings, grudges are born.

Hahah, so glad that stress isn't my life. I've always been fortunate with getting along with/getting out of the way of classmate drama. Meanwhile, I'm dealing with my own little mystery. It's been over a week since I've heard from the Gift of Life people, and I've tried calling twice, but 4:30 isn't the best of times, I guess. So did one splash exposure ruin my ability to give marrow? Really, we were both tested. Clean. People have worse sexual histories. I guess we'll see. 

But! Set that aside!


This is my attempt of using extreme angles and composition to hide my editing problem

Because clearly, I have one.

Take care, gonna be making color combos for the rest of the night. :D

Sunday, July 27, 2014

Room recovery update. Still Day 1, and it's bad.


My bright idea to kill the mold babies  has left me with an empty bottle of bleach spray, and the closet still isn't done.

Now. The bathroom is looking pretty fine though. But at this point, I'm not sure what the benefit of bleaching down all the walls would be. Coating the whole thing from floor to ceiling in mildew resistant paint though? That sounds very attractive to me right now. Seal those babies in. Will anyone really know the difference?

The air is so thick right now, I could probably plug in the dehumidifier and come up with a mild disinfectant.

I'm whoosy as hell.

It's official. The first thing in my budget is paint. Once I get my loans in. Yes. Fuck, I'm going to Lowe's tonight and getting paint swatches.

New Quest! Lady Cave Project, mission 1: Clearing the Bad Juju.

I can't tell if I'm a little tipsy from so much bleach fumes or if I'm just super pumped about moving into this room. But I am pumped.

What's in here?
It's space!
Which means that it's time for getting this room together. I have 1 week before my roommates move in and the boyfriend moves his storage out, which gives me a little bit of time to move things over. My roommate left a few things behind, the most useful being the dehumidifier. Apparently she can pull a liter an hour in the winter. There's a lot of mold babies on my walls. 

You can't see them in these pictures. But trust me.
This closet is a mold baby nursery. Gingerly collecting humidity from that bathroom.
But it's my own bathroom right? Hell yes it is.

For for the first mission of my quest, I am Clearing the Bad Juju.  Gotta have a clean start. Let's go captain planet style.

Earth: Deep clean the bones of the house. My flooring is wood, so I'm going to mop it. If it was carpet, I'd get a cleaner. The base boards and walls need to be cleaned too. Any holes in walls or cracks need to be patched or caulked. Little fortifications of mildew will be razed without mercy.

Fire: Every light fixture needs to be examined, bulbs replaced. Then the lighting needs of the room must be assessed to see what else must be bought.

Wind: Change the damn air filter, dust the house, and let the fan run on high for a bit. Address whatever smells weren't taken care of with the deep cleaning. Thank god I don't live in a place with a previous smoker. I'd have to seal the residue in with paint.

Water: Leaks. Got to find them. Got to patch them. That wimp of a rental shower head should be replaced with something nice. Toilet needs a bleach biscuit.

Heart: I have to be honest with myself about all the crap I don't need, and get rid of it before moving into the new room. Especially anything with negative sentimental value. Like, I've got a left sock and I know the right is at my ex-boyfriends. I will never get that back. Why the hell is it still here?

This might also be a good time to do any personal rituals to establish the space as yours. I've never done a sage smudge, but if it can cover the smell of the bleach typhoon I'm going to assault the place with, I could be game.

Sitting on my throne. Kingdom in view. 

Friday, July 25, 2014

Top 5 Friday!

Top 5!

1. I have an overwhelming feeling this is going to be a great year. 
2. Holy crap, I need to finish writing that CME. GET TO IT.
3. Still haven't heard from the bone marrow people. Ran into one of my old attendings from heme/onc. He told me that they usually don't get too many options from the bone marrow banks. 
4. Doing nights right now. Feels like a vacation not to pre-round.
5. Roommates are moving out early, the apartment is slowly emptying. 

Bonus 6! I have looked at so many interior design ideas on apartment therapy and pinterest, that I have clearly spoiled myself. I am sick of virtually all interior design trends, even though no one around me keeps homes like these, so for all practical purposes, they would be really unique.

Chevron, white Scandinavian style rooms, the term "pop of color", antlers and faux taxidermy, mason jars, painting antique dressers with pastel colors, wrapping canvas in wall paper, wall hangings and pillows with "words of inspiration"*, you can all go to hell. I am done with all of you, and I've never even seen you in person. Internet, you've ruined me.

Cow or sheep hide rugs, for some reason you can stay. 

And that wraps up the week. 

*It's gotten so bad, that if I see any art with words on it, my insides start to throw a fit. It doesn't matter what it says. Even "Love" scribed innocently on a pillow turns me venomous. Innocent, worthy of praise, love. At this point the only word I can think worthy of art is "Yes". Written in lipstick, smeared on the mirror. That belongs to someone else.

Tuesday, July 22, 2014

Memories of a med student. The worst day of my 3rd year.

I still haven't gotten word when Gift of Life wants me to get further testing, but they did call today to ask questions about some of the answers I put in my follow up. Specifically they wanted to know when I got the splash exposure I mentioned. Everyone was tested when it happened, and we were all clear. But man that was a shitty day.

I was scrubbing in for a hysterectomy. As the student you sit between the woman's legs and hold an instrument that goes through the vagina to guide the uterus into a better view for the OB/GYN, who is going through the abdomen via lap. Beyond the fact that you have to jam that uterus back, and hold still until you're shaking, which means you're going to get yelled at a lot, you'll get yelled at some more when you didn't anticipate the next spot for the uterus to go. Which is fine, I had already been through surgery and had my fair share of enlightenment in my self worth. At least you get to sit down.

As the surgery was wrapping up, the attending whipped out an instrument from the ports, flung some sort of moisture off it, which managed to easily arch over my face mask, past my glasses, and into my eye. I can only imagine this trajectory was possible through the difference in our positions.

I blinked. It was moist. And I froze.

Because I knew I should say something, but I also knew no one gave a damn, and they'd all be pissed off I interrupted the case. But I did. They asked me if I was sure. Yes. Then I got to spend the rest of the case with dirty looks from the frigid ice chief as the med student who couldn't do their damn job right. The one who interrupted the flow.

Pshh. This was the bitch who later wrote in my evaluation that I introduced myself to the patient too much. Yes. I know that doesn't make sense. Like it slowed down care for the patient to know every one on the team. Yeah, stay out of the way scum. You don't belong here.

Now that I had put everyone in a sour mood, I was given permission to break scrub, temporarily flatten myself from existence, and sneak into the hallway to call the hotline. To make the day emotions feel worse, after accusatory statements form the needle stick hot line that I must have not been wearing my mask, they told me that I must find the patient's next of kin to ask for permission to draw blood right away, and then to walk the blood down to the lab myself. Time was of the essence, and they'd had things get lost before. If I did not take care of myself, No One Would. When I returned and told the resident this, with the light of the computer glowing off her face, she glared at me like I was the greatest waste of an idiot she'd ever been forced to endure. "They want you Absolutely not. You'll wait. WE will take care of this"

Meanwhile the nurse had already handed me a red top to keep in my pocket. After turning it over my hands a few more times, I gave it back.

Inside, I was rumbling with fury, ready to explode. But I still pleasantly thanked my resident for 'looking out for me' and offering to cover the patient's end. I held my tongue until it was time to walk to lectures. I just unloaded on one of my classmates. Some how he took the edge off. "Oh yeah, man. That happened to me too. You can't do the talking to the patient yourself because of ethics, man."

His usual roll with the oddities sort of self calmed me down quite a bit. I also had a justification for the resident's behavior as long as I twisted it right, so I could pretend everything was actually going according to protocol. I attempted to ask my department chair what was the best way to go about the situation (framed in a non-accusatory, confused med student who just got conflicting info and wants to do the right thing sort of way), got a vague answer that as a low risk patient I would probably be ok, and was sent out to go on about my day. Sore, but no longer shaking. Which is all I need to function, put on the girl scout smile, and move onto the next task. Later in the day, I got a call, and was told everything was fine.

If this screws up my ability to donate bone marrow, I'll be really upset. But it's highly unlikely considering that the event was well over 4 months ago. I think they just want to be extra careful about making sure they're not sitting in the middle of a window for a blood born disease. One step at a time. Maybe I'll get lucky and they'll ask me to come in for the labs when I have night call so I don't have to interrupt the team.

Monday, July 21, 2014

The next step in bone marrow donation. Contacted my coordinator today.

This morning I was determined to get the ball rolling with the gift of life registry coordinator. So I called her immediately after getting my consults in. Notes can always wait a little. As a bonus, we weren't getting any lectures from the fellow to clog up the 11:00 hour.

My coordinator was kind, and told me the conversation would take about 15 minutes. Slightly different from the 2 minute phone calls I'm used to making now.

Hi I'm so and so on so and so service. I have a consult. Patient's name is Bluh. MRN is ####. Room number is ###. They have a PMHx of bleh and were admitted for blah. Our question is THIS. Ok, thank you. Good bye. 

Fortunately, the bone marrow donation process isn't so rushed. My missing a call back wasn't the end of the world. For the next step of the process, I'd have to fill out a form that helps people decide if I'd be an alright donor. It's the same one you fill out when you join the registry, but obviously needed to be updated since it'd been two years.

Now that I've filled it out, I just have to sit on my bum for a bit and they'll tell me within in the next week or so when they want me to come into a lab for a blood draw. They set up the testing, pay for it, etc. At the same time, hopefully this guy has more than one match on the list. Those people are getting confirmatory testing too.

It'll take 4-6 weeks to process the more in depth HLA typing. Once all of these come back, the hematologist compares donor to donor to see who is best for their patient. If I'm the best match, they'll contact me. If someone else is, they'll let me know too.

At that point, it's a waiting game to see when the hematologist thinks it's best for their patient to receive marrow. Obviously they wouldn't completely obliterate a patient's bone marrow without someone lined up, but an induction process takes time and that can be variable. Patient's need to get a bone marrow biopsy after each attempt to see if their cell count is low enough to replace with a donor's marrow or stem cells. And if that bone marrow isn't running on empty, then the patient has to go through another round.

That's simplified. The point being, a donor needs to wait until they're called, and they might not know when. But they get updates every month so they can plan a little in advance.

But being me, I have to data mine a little more. I mean, really, what's my chance I'll be going through with this?

Monday, July 21, 2014 11:01 PM
  • Registered Donors 235,697
  • Matches 11,195
  • Transplants Facilitated 2,701
  • Patient Searches 67,442
  • Donor Recruitment Drives 5,811
  • Collection Facilities 8
  • Countries Serviced 43

So by signing up, there was a little less than 5% I'd be identified as a potential match. Now that I'm a potential match, there's a 24% chance of a transplant going through. Overall, 1% of donors go from start to finish and 4% of patient searches result in a transplant.

My coordinator gave me a ball park number to be chosen of 30%. So who knows, maybe the current numbers are better than the averages overall. Or maybe it's just close enough, because really, it doesn't change anything other than satisfying my curiosity.

Sunday, July 20, 2014

Things I'll never get used to: Being put on a put on a pedestal by premeds.

I went to the gym tonight to get back in the swing of things. Nothing major, just the good ol' standby of legs and back. I met some undergrads there in the all too familiar scenario of a couple of guys who have a plan and are taking charge of their work out, and a tag along chick who is confused as hell, but doesn't want to step on anyone's toes or ask for too much help, so she takes it extra easy on her body and just sort of plays around with things that aren't going to get her results.

But their cage was right next to mine, and I could see she looked uncomfortable and appologetic that the guys were loading 45s when she needed much less. The guys didn't mind, clearly they were happy to have their friend along for an activity they enjoyed. When she offered to go off and get one of the smaller bars, I had to speak up.

"Hey. You can work into my sets. I'm doing a light load today and not going any higher than this". My bar had 10s.

I knew what was going to happen next. She didn't feel like she belonged in the space. So she tried to isolate herself further by offering to just wait until a new rack opened up. There was some more discomfort with if she could lift the bar or not, because she didn't know how much it weighed.

"Come on. I'll teach you. I can tell you're definitely strong enough to lift 45lbs. You'll be surprised at how powerful you can become"

She agreed and she stated that she was an APK major so she should learn how to do this. Which was cool, and I let her know that I did that in undergrad. Which leads the conversation about what I'm doing now, med school. Sure enough, she was taking MCAT in 3 days. Yeah. That's a lot for the mind and enough pressure to make you carry insecurity into every situation. Could or could not be the case today, but you've got to give people the benefit of the doubt.

So I spent a little longer at the gym, and went through my favorite leg exercises with her. Taught her about strong lifts 5x5 and let her know she could always seek me out if she saw me at the gym. And this woman was so excited her eyes were just completely lit up. She had some friends come by and told them I was her personal trainer. Which made it my turn to get embarrassed and down play myself. Then she follows it up by telling them I had her major, I'm a doctor, and her inspiration for the evening. Woah. That's a lot. Hey, med student, not doctor. Looks like it's time to start my set.

It's eye opening to step outside of the medical hierarchy where you are an annoying time sink, and have pre-meds look at you like you're some sort of goddess. The role model living. 5 or 6 years ago I was in her spot, putting people on pedestals, rubbing my own face in the dirt, and living on such high alert and suffocating self doubt that I couldn't write my personal statement without freezing. When I had to force it done, I got blasted drunk, and went into a hysterical fit of crying and typing at the same time. Oh yeah. I was a mess.

But I'm here now! Clearly life moves on.

And she'll do great. She's pulling 36's on her practice tests and her applications are only waiting on this one score.

It was good to have that perspective of how far I've come. Because I still freeze up and get nervous when I think about this up and coming match process. Same crap, maybe I'm just a little too burnt out now to get as intense about it. Or this is some form of maturity. Who knows.