Gestational update

I'm currently 32 weeks pregnant. It has been a smooth pregnancy so far. No GDM, no pre-ecplampsia, just the usual back aches, round ligament pains, annoying Braxton Hicks and the frequent elbowing and kicking from the growing peanut. By the way peanut is a SHE :)

Yesterday my hubby and I went for our last ultrasound. I did not expect to hear the words 4.7 lbs from the tech! I thought she'd be small or at least average in size but 4.7 lbs at 32 weeks seems like a giant to me. People kept saying how small I was and that I should eat some more. Oh well... Last week when I weighed myself at my prenatal visit I have gained 23 lbs. Looks like I'm on the right track in terms of gaining. Of course some of the weight went to my thighs and hips- totally unavoidable! But I'm happy I'm not gaining weight uncontrollably.

Tomorrow will be my first baby shower. It's being hosted by the medical director of the surgical center I used to work at. I can't wait to see old friends again! Some of the gifts have already arrived. When I came home today there 3 big boxes waiting by the front door. Can't wait for hubby to come home tonight so we can open the boxes together ;)

I have been so blessed with this pregnancy. I have not been plagued by fatigue despite my 5-6 calls/month. It has been very tolerable so far. Co-residents are amazed by how much stamina I have! I am too :-O

Thank you Lord for all your blessings :)

Taken at 22 weeks



ICU Rotation

I just got done with my ICU rotation. Despite being on call every 3 days I thoroughly enjoyed it. Did I learn a lot? Maybe...But learning is really hard to gauge. What I really learned most is to make sure that critical patients have some sort of advance directives. Otherwise the Ethics Team will hound you till you get one. I had some patients who did not have a family at all to help them make any sort of decision and are now unable to decide for themselves. So we go about in applying for a gurdianship with the state which can take 1 month or so for processing. In the meantime, these patients are under the wise and discreet care of their residents and attendings.

Some families do not know how to let go of their obviously dying relative. Seriosuly, I had patients who were in and out of the unit, with a trach and PEG in place, lying like a rotting vegetable, clearly suffering, yet families do not want to pull the plug. "This is America! Do what we pay you to do!" I think that's what these people are thinking. Oblivious of the fact that medicine can just do so much and sometimes you just gotta let nature take its course.

I know it's hard. But personally, it's harder to see your loved-ones suffering...What do you think?

My Routine

o, it's been 4 months since I started internship. So far it has been great. With my pregnancy I do consider myself very lucky as I do not have the complaints of most pregnant women. My stamina is the same, my appetite is the same (although my sweet tooth is bacn and I do crave a cookie after dinner), and my personality is as preppy as ever :) Although I do have the occasional back pain- esp when I sit for more than 30 minutes.

Calls have been tolerable. We do calls 5-6 times in a month. That's pretty good compared to other programs.

This month I am rotating in one of the floors. The schedule is pretty much routine in a daily basis:
7:00-8:00AM: Morning Report
8:00-9:00: Occasional lectures
8:00-11:00: If no lecture then patient care
11:00-12:00PM- Teaching rounds
12:00-1:00: Noon Conference (while eating lunch)
1:00-4:00:Patient care

Yup. We are done at 4PM if not on call. If we are oncall then we stay until 12N the next day. It's pretty laid back compared to what I was used to during med school. Not that I'm complaining ;) We do get to eat breakfast after morning report and it is a good way of bonding with co-residents. I love my batch. I think we all get along pretty well. I don't see anybody giving potential problems....Hope I'm right :)

It's kicking! :)

I just turned 18 weeks yesterday but starting 17 weeks I started feeling tiny pokes on my lower abdomen. I was like, "Wow! I'm disgustingly very gassy today!" Then I realized that it could be the baby letting me know it's growing ;) Now, I constantly feel its movements all throughout the day- when it's awake of course. When I'm on call it likes to keep me company :) How sweet of my little baby.

In 2 weeks I'll be finding out the sex! Can't wait :)

I miss bedside care :(

During my training back home I spent way too much time with patients that it made me sick. We were the ones doing EVERYTHING from drawing blood to taking specimens to the labs or taking patients to radiology. Now that I am in a new world where technology is so much more advanced and staffing is so much more adequate I spend more time on the computer writing progress notes, checking lab results and typing orders. I've only been here 3 weeks and I can truly see the huge difference in clinical exposure. I have to admit I do learn more now that there are teaching rounds with attending physicians than back home since back there work was more physical. But I do want to interact more with my patients and just learn about them in general. I love connecting with patients. 2 have already pledged to be my patients when I graduate. I guess technology does make one lazy. Gone are the days where diagoses are solely done clinically. Also with the rise of lawsuits doctors are now more cautious in their patient care that they tend to practice defensive medicine. "We need to order such and such just to be sure we rule out everything." I don't blame them. I would do the same thing.

On call

My first call experience was not bad at all. I only had 2 admissions. But was I able to sleep? Not really. I don't sleep well in a new environment. Plus I kept checking my pager making sure I didn't miss a page. Yup! Paranoid me as usual.

The call rooms

It was my first time to enter the call suite. It was so eeriely quiet. I guess everybody is busy on the floors. Each on call intern and resident has his/her own room with an adjoining bathroom. Pretty convenient but would I really get a chance to take a shower after my shift? I HOPE SO!

My first week

I haven't really been excited about the start of my residency until about 3 days before my orientation. I guess it really hasn't sunk in yet and now it's just a few days away and my adrenaline then started to flow.

I got my stuff ready for my new job. Well, there's nothing really a whole lot to prepare. I got my stet, good quality pens, 2 comfortable pairs of shoes, 2 pairs of maternity pants (which I wouldn't probably start wearing until I'm mid 2nd tri), a small notebook to jot down some important info, a binder for my patient list, etc. My lab coats and pager will be provided for. Ok...I'm, ready! :)

First day of orienation was our ACLS class. I have already been certified but I decided to take the class again since I didn't really learn a whole lot from my recertification class last year. It was fun and I got to meet most of my co-interns (3 of them got delayed due to visa issues). Next day was our pre-employment screening, distribution of benefits packages and computer training. Benefits are great! Residents are 100% covered and if I choose to give birth at the hospital my bills will be fully covered- except for the professional fee which I will need to pay 20% of. Not bad! Then at the end of the orientation we got our lab coats, pagers, badges and locker keys. Yeah!

First day of official training went by really fast. My first rotation was in CCU (Coronary Care Unit). I had a resident with me at all times.  Going through the Electronic Medical Records (EMR) was a breeze but getting to know all our patients took a bit more time due to their conditions but on the 3rd day I got the hang of it and started doing my own rounds ahead of the resident ;)

I'm actually glad I got the tough rotation first. In that way when I rotate in the wards it would be a piece of cake :)....Hopefully....