Friday, January 27, 2006

I ran across this site this week and thought I should pass it on.

BEST ACLS REVIEW...Makes it easy for students and PA's to learn. Breaks it down for excellent review...Even dummi-ifies it properly for those of us that aren't BORN knowing doses and rhythms. (Besides, even those of us post-ACLS need a good review)

ENJOY!
http://www.randylarson.com/acls/

posted by Stacey @ 7:55 PM

Wednesday, January 25, 2006

I keep getting asked in emails what kind of Palm Pilot people should get for school. Easy, the cheapest one with the features you'll actually use. I have a great Palm Pilot but have no clue how to use all the features from it. It's basically a $400 calculator to me. Make sure you get one with a case, that you can us Epocrates on, and pay for the extra film to be able to clean your screen. This will seem important when you're looking up stuff during your messy ER rotation. Mine has a built in keyboard just because I had enough to do without having to learn the "palm alphabet." I also think you can get great used palm pilots. Afterall, they're all going to be outdated a month after you buy them, why not save a few hundred bucks?

Hope this helps. If not, check out some palm review sites.

P.S. Make sure you know if yours plays MP3s. It's quite dissppointing when you've just uploaded 20 MP3s to your palm and their realize it doesn't play them...you're sitting on the subway with your headphones in too embarassed to acknowledge your ignorance, so you just bop your head up and down to silence so NOBODY knows what an idiot you are. Not that it happened to me or anything. :)

posted by Stacey @ 8:50 PM

Who needs Hallmark when you can get one of these to brighten your day!

http://www.msnbc.msn.com/id/10483732/

posted by Stacey @ 6:07 PM

Sometimes life teaches you valuable lessons in a cruel way, so that you remember them. Just yesterday someone asked me about being on call. I said most of what we see in the ER should be there. Then I made some comment about a patient who came to the ER at 9 p.m. for a migraine headache. She had the headache all day but did not go to the clinic. She also had refills at the pharmacy of her migraine and nausea meds, but did not fill those either. I don't mind seeing patients no matter what their complaints were, but I remember saying to the nurse "why didn't she go to the docs clinic rather than spent $2,000 on an ER visit?"

Today I have my answer. I woke up this morning with the worst migraine headache I have ever had. (No professors, it's not a hematoma!!!) It literally felt as if some evil little demon was inside my skull with a pick ax chiseling away at my sanity. I was sick, vomiting, and actually had to call into work. This is not something I like to do, especially when my schedule is packed. (It puts everyone else's day on edge..besides, I'd rather use my PTO for a trip to Vegas or the Bahamas!)

ANYHOW...As I laid in bed with the blinds pulled, lights off, praying for death (my alarm clock went off with my last chance alarm and I swear it was the loudest noise in the universe!), I realized I could go over to the clinic and get some migraine meds since I don't have any. Why would I? It's been over 2 years since I had a migraine headache. I stood up, opened my door and saw light coming in from the window. Judging from the amount of light and the manner in which is fried that back of my skull via eyeballs, I am guessing I was temporarily living on the sun. This excited the pick ax swinging demon in my skull and I slammed the door and crawled back in bed. To make matters worse, my favorite fabric softener smell on my down comforter was actually making me nauseaus. It just couldn't get any better. Until I managed to burn myself on my electric blanket. (Still not quite sure how this happened.)

Back to the point at hand. I knew I could get some meds called in, but I would have to drive 12 blocks to the pharmacy in the BURNING RAYS OF THE SUN! I actually thought, if I wait until 8 or 9 it'll be dark and I could run over to the clinic or ER where...WAIT A MINUTE!!!

It all came clear.

I had become the patient I was questioning. Fate gave me this death worthy headache to teach me a lesson. As Dr. Phil says, People do the best they can with what they have at the time in their situation...(or something like that.) She was coping the best she could. I treated her well and she left as happy as someone can with a migraine headache, but I'll never forget my initial thoughts about this woman that didn't bother to go to the clinic or the pharmacy.

It's now 4:30 pm and I finally left my bed, stopped horking, and was able to get some juice to rehydrate. My head is still killing me, stomach is turning, but at least I was able to shower while the demon got tired of swinging the brain piercing pick ax.

My lesson has been learned. My advice for anyone with migraines??? MOVE TO ALASKA for the dark season, I know I sure woulda loved to be there today!

posted by Stacey @ 3:26 PM

Tuesday, January 24, 2006

Ok, here is an experiment. I have gone vegan. Yes, steak-eater, buffalo burger chower has gone vegan. I figured, WHAT THE HECK...lol..

I went to the PETA website and checked out their milk facts. First of all, I don't really like cow milk any more than soy milk. Second of all, they state that cow milk is intended to make baby cows fat. Does any other species drink from another animal's hootinannies?? NOPE!!!
I also learned that the U.S. allows so much pus in every container of milk. YUCK!!! And finally, remembering in gross anatomy how muscle tissue looked on a dead body...it looks the same on a plate from a cow with sauce on the side. I suddenly can't function thinking about it...so I'm going vegan...It's been 5 days and I've never felt better. I dare any of you to try it...there are tons of great recipes to make it easy. Try hashbrowns in your recipes instead of hamburger and let me know how it goes....you may be shocked...

Also, check you bottles to see if they are tested on animals. If you know that it has burned the eyes of rabbits and people for 5 years..why test it a 6th year?

Ok, now I sound like a freaky activist. I guess I'm an over-rationalist...If someone said they were going to raise children with pain sensation for a brutal butchering, cut them up, and eat them...I would be very upset....now imagine you're a cow...

Now I'm done...back to PA stuff.. :)
Happy Tofu-chowing...LOL...

posted by Stacey @ 9:28 PM

Ok, here is where you get 'the good stuff'...
In PA school they teach you anatomy, physiology, pharmacology, etc....These are not things that are miraculous to learn. Your professors are not magicians...These are ALL things that can be GOOGLE'd and discovered. If you have never gone to PA school or ANY school you can learn anything about any disease. If you can only pay attention in one class, let it be behavioral medicine. This is the class that will differentiate you from everyone else. This is the class that teaches you how to integrate the above classes into a meaningful manner. It saved my butt on many occassions....I hope it does the same for you. Easy Behavioral Medicine lesson: Find out what the patient is truly looking for, integrate it with what you know/do/learn and you have a combo for success... :)

Ok, that said...enjoy ALL your classes.

posted by Stacey @ 6:23 PM

Sunday, January 22, 2006

Another salvaged entry from PA school....not to mention that it'll probably look really bad to the professors at school....OH WAIT!!! I AM NOT IN SCHOOL ANYMORE!!! LOL....

PA school...I was warned....There is an emotional debt to be paid when you join the "BEST OF THE PA'S"...

To be completely honest...I am living wayyy to far away from my family pursuing a dream career. I am so happy to be in the school I am at...but often worry cuz I was accepted at a school much closer to home but chose NYIT. There really was alot of coincidence there. I am sure I mentioned it before..BUT...I'll mention it again...

NYIT was a freak incident. I believe in fate. I lived in ND when I applied through CASPA for PA school. (P.S. When I applied CASPA was new and a MESS!!!)

I did not originally apply to NYIT. I applied to several schools and accidentally applied to NYIT. I had heard of their reputation (one of the few if any schools with a 100% first time board pass rate and NO ACADEMIC PROBATION) and never thought I stood a chance. That and..HELLO!!! I was from ND!!! (insert images of cows and big belt buckles and snow here)....ND is a LONNNGGG way from NY, in more ways than one....Somehow my app went through...I was kinda upset since I had to pay for an application to a school that would NEVER accept me....but I paid cuz I thought "damage is done, it'll look bad to withdraw my app."

Then I started getting mail for someone in NY while living in ND...sign #1. Then a friend won a trip to NY!!! sign #2... Then they called for an interview...(a whole nother drama I'll have to tell you about later...email to remind me)...Obvious sign #3....No other school had called at this point (could be that NYIT called 3 days after receiving my app) so I scrounged up money and went for an interview...I figured I was part of the "gotta at least interview one redneck for equal rights kinda thing.." But was taught by my grandmama that you never turn down an opportunity whether obvious or in disguise...although, I was ready to be the punchline in some NY kinda joke...SO I decided to go...

Anyhoozers....I found out it was cheaper to fly into NYC and stay 3 days than fly in for 1 day..so I did it. (Thank you Dad!!!)

When I got to NYC I spent the first day being amazed at the city and walked across Manhatten. Yes, the WHOLE Manhatten. From Northern Central Park to the Statue of LIberty Park (Battery Park). This seemed like a good idea at the time....except that the next day I was sore as hell as I walked in my big dress shoes to my interview. That day I had to ask the hotel lady how to get to NYIT. She said 'take the X train to the X station and take the X train to the X something or other and then take the X cab to the X something...' I was lost...but I knew I had to be there so I set out on my journey. I managed to make it. The moment I knew NYIT was for me was standing in front of the Central Station Long Island Railroad sign knowing I bought a ticket for the right train. I KNEW in my heart of hearts that this is something I loved. I felt independent, proud, CAPABLE!!! I made it to my interview (another story to remind me of), interviewed, and then went home (home being the overpriced hooker shack I was staying in).

It was several days before I heard that they accepted me (Time goes miserably slow when you're waiting. If you're dying and want to extend your time apply to something important and await the results cuz those 8 days seemed like 8 lifetimes).... They had a timeline for a deposit on my tuition. I had not heard from any other schools so I sold my car and title of my paid for house to pay the tuition..not to mention my father's retirement took a major setback. Part of me was THRILLED that the best school I applied to accepted me...part of me was heartbroken that the 'sub-par' schools didn't even call.....I accepted the spot after much deliberation with Jase....and sold my soul.....

The day after the check cleared all 6 of my other school's called...including the one close to home. (To make a long story short, they couldn't compare with NYIT and didn't even know my name at the interview, compared with NYIT who knew my entire application inside and out. They didn't even have files out and knew the dates of my employment....lol...way to make a girl nervous!) I turned down the other schools (2 of which I interviewed at...the rest I didn't bother paying for interview travel...)....and that is the story of how my life flipped upside down in a wonderfully crazy way..

Back to the main point...

Tonight Jase told me we'd be married if I had chosen the school close to home. That killed me. Not cuz I'm not married. I don't need a piece of paper to tell me I love the boy..but that he encouraged me to come here and that put HIS life on hold. I have lots of friend here, great faculty that I can speak with, and a great house we are renting....but it's not HOME....

This is not a pity party..this is an awakening to people leaving their family for their dream. BUT...IF YOU ARE leaving your family, chasing this dream, following your heart...you'll never be left wondering if it was worth it...if you took the risks provided. Jase and I are fine. He is proud, I am alive, and life is good. I firmly believe that if you KNOW you want to be a PA/MD/RN/PT/Etc...that everything you do to pursue your dream will be well worth it. Life is good....and now I can HONESTLY say that I followed my dream, it is better than I thought....and the rest is details....You have many options, but few real dreams...

Don't jeopordize your loved ones...but don't give up your dreams out of fear that settling will provide a better life. I could be in a sub-par school and married and what-not...but right now, I am happy knowing I picked the best, and taht I have a phenomenal life to tell my grandchildren about...(That and I saved a pic of my toes and their blisters after walking across Manhatten....It's WAY bigger than one would think...)

Keep dreaming, the rest is just details...(I"ll end this with two of my fave quotes...LOL)

"Obstacles are what you see when you take your eyes off your goal...."~Anonymous

"Eagles may soar, but possums don't get sucked into jet engines....." ~Anonymous

posted by Stacey @ 12:30 AM

I have a number of posts from PA school that I now savaged from my old laptop...Here is one of the less optimistic "happy go dumb*** " one of them...


It's 3 a.m. on a Saturday and I'm studying cardiology. Why? Cuz I took on PA school when all my friends back home are taking on tequila shots. Part of me says "study more and you'll pass" and the other part says "screw it..it's late..you'll never learn it by Thursday's test." My classmates seem to have everything together and know their info. They get mad that I learn faster than they do, but they don't realize that I don't retain info like they do. They don't realize that the moment the words EKG are mentioned MY HEART goes into asystole. They don't know that I am terrified of being called on in class cuz I am not up to par....

Most days in PA school I feel like I am a fraud. Everyone in my class seems so smart, so together, so WITH IT! I am not that way. I am what I am. No, not philosophical...just dumb I guess. I see my roommates struggle to memorize info that I can memorize in a few moments....but two days later I'm like blank slate. It's moment's like these I wonder if it's all worthwhile. The other people my age are out having fun and meeting people. Me and my classmates for teh mostpart sleep 5 hours a night, have dreams about test while we do sleep, and have NO social life in the meantime. Is it worth it? I like to think so. Although at 3 a.m. on a Sat I often wonder whether or not I'm delusional. You don't hear of other jobs requiring this. My prev job paid well and didn't require this mental torture. Am I even sane anymore?

I dream of days when I can sleep in til 8 a.m....days where I can see a book and say "tomorrow I'll read the next chapter..." days where it's all worthwhile...but I know deep down it's going to be worth it. I wish I could explain how I know this, but I cannot. I just know in my heart that I am meant for this career and it's meant for me. I know that someday it'll be a distant memory that I can talk about. For now, I want to tell every pre-PA student "RUN AWAY!!!" but know that this is some rite of passage we must go through. If we can think clearly for a test on 2 weeks of 5 hours or less of sleep, than we can take care of patients at 3 a.m. when they need it most.

I know someday I will love my job and my patients. I know that it'll all work out...or fate/God/life would not have led me to this point. I know that without my friends and classmates I would not have made it this far. Someday, this will be a great memory...being up on a Sat wishing I were anywhwere else. But for now...I just wish I was sleeping. And that won't happen as long at Q-T segments haunt my brain.

But the day I save a patient's life, this will be all worth it. And this will be a giggle in the hat.


I agree with the above. 100%!!!!

posted by Stacey @ 12:15 AM

Saturday, January 21, 2006

Movie updates.

Living in a small town leaves plenty of time to get my $'s worth out of Netflix (BTW..NETFLIX IS GREAT!)

Best movies I've seen lately:

I *Heart* Huckabees - Confusingly inspirational
Mail Order Wife - Seems like a real documentary which is disturbing..then you realize it's not. So it either is great or terrible. I'll be nice.
Shaun of the Dead - Maybe the funniest show I've seen in quite some time.
Notebook - Not realistic, but a great sappy movie. Beware, you will hate your husband/sig other for not measuring up to the gorgeous Ryan Gosling.
Crash - Just cool. Makes you really think...
Death to the Supermodels - So bad it was funny.
Wedding Crashers - Don't I know those guys from college???!!!
Super Troopers - Get a box of Kleenexes...You laugh til you cry!!!
Super Size Me - Have not gone to McD's since. I'm not boycotting it, but just seeing him sweat while he chokes down a burger makes me ill. Gag.
High Tension - This movie is messed up when you watch it. Fairly freaky. But it stays with you for awhile and makes you question things for weeks after you watch it.
Sin City - Loved it!!! Watched it several times. Gotta love Bruce Willis. Just gotta.

Worst movies I've seen lately:
Havoc - C'mon. Do you wanna be a chic flik or an intense show. Horrible.
Bewitched - Nice try.
House of Wax - I know, Paris Hilton acting. I deserved what I got.
American Pie Band Camp - S.T.U.P.I.D. Then again, I was not expecting much more than that.
Deuce Bigalow European Gigalo - What a let down. After all his American Pimp'n I was sure his Euro style would be a hit. Very wrong.
Dawn of the Dead (2004) - Except for the cutie pie throwing zombies around, this movie was dead. Get it? Dead. LOL. I crack me up.
Devil's Rejects - Not scary. Dumb. Rob Zombie definately has some issues he should seek some help for. Not scary. Twisted. Gross. Ugh.

I'll keep adding to the list as I go...if nothing else, but to kill time between work posts and to procrastinate doing real work.

posted by Stacey @ 6:39 PM

Work is going well but there are some things that I really am not prepared for. I believe I was educated properly but still got the #*&! scared out of me when a blue tinged little boy walked into the CLINIC with his mother. His O2 sat was 82% and he was wheezing like crazy. Mind you, we are in the clinic when this happened. I immediately was thinking HOLY CRAP HE"S GOING TO SUFFOCATE! I came up with a quick plan then another quick plan...CONSULT THE MORE EXPERIENCED PA and NP. My initial words were "I HAVE NO IDEA WHAT ELSE TO DO FOR THIS BOY!" By the time they ran into the room he was pink again with good sats from the treatment and O2 I started...But it was quite the scare. We had to admit him and do some stuff and shots and abx...but I was NOT prepared to be so emotional over a little smurfy-blue boy. It really frazzled me for the rest of the evening (of course it was the last pt of the day)...I kept thinking I'm going to kill someone if I encounter these things on my own. Part of me said "Hey, you did everything right and he was fine when the others arrived cuz you did the right thing." the other part of me said "HEY STUPID!!! You suck at being a PA."

The day was offset by a patient calling and saying the test I sent them for prob saved their life. They had been going to a different clinic out of town and kept coming in with the same complaint, but was constantly reassured everything was ok. 9 months of wheezing and dyspnea in a non-smoker athlete without history of anything is not OK to me. Apparently her new pulmonologist agrees.

And finally, there was a gentleman who crushed his finger at work on a Friday. There were no plastic surgeons around that day (or ever in Lisbon) and he did not want to drive to Fargo. His finger was a mess and there were complete chunks of flesh missing. It took me several hours in the ER debriding the wound and suturing together the tiny pieces of skin left. He came in adn said his follow up consult with a hand surgeon (he finally decided to go) said it looked amazing and he can't believe his finger was put back together so well. I did nothing spectacular, just tried to jigsaw puzzle it together...but it was another highlight. I only say these things to reassure myself that I am not just a trained monkey on a malpractice mission. LOL...

Anyhow, it goes to show how each day varies. Some days you save a life or a "driving finger", others you $*#! your pants in terror at something ridiculously simple. Gotta love this job. If nothing else, you gotta at least know when you may be in over your head or at least double check if something is as important as BREATHING!!! Sometimes you just gotta say a quiet little prayer or meditation in your brain and hope it all works out. If all else fails, they are opening a Subway here and I think I may be fully qualified to be a sandwich artist.

posted by Stacey @ 6:26 PM

Want to re-evaluate the cost of your burgers and steaks? Watch a few of the animal videos on this site...not out of extreme activism, but to be fully aware of the choices you make. Even kosher meat is not so kosher according to their videos which is disturbing.
http://www.goveg.com/

Ok, enough preaching. Off to nap.

posted by Stacey @ 9:06 AM

Friday, January 13, 2006

I love my job. This is what I tell myself at 3 a.m. after being up since 6 a.m. what is now yesterday.

I love my job. This is what echoes through my head as I am putting on my coat to go home after a swamped ER night and the dispatcher says "Two ambulance headed to your location. ETA 3 minutes!"

I love my job. This is what I remind myself as I cross my fingers and pray that someone's EKG is ok cuz I have no clue what crazy thing I am going to have to do next and am just waiting for someone smarter than me to suddenly figure it out and throw me out on the snowy street without a great job and point and yell profanities my way and.....SIGH...(I usually have some clue, right???) I am told I am harder on myself than anyone else is..but you have to be in this field. When you stop worrying and second guessing, you're missing a key diagnosis/treatment.

I do love my job. Otherwise when my stomach is still thinking of the sandwich I made for lunch that was meant to be eaten 14 hours ago I would go eat the soggy thing instead of grabbing the next chart and bouncing up to take the history.

I love my job, and the people, and the patients. But I truly do hate 3 a.m. tonight, when I finally have time to lay down but can't sleep.

Rural medicine is weird. There are the nurses and you. That is it. The doc is available if needed, but it's YOUR NIGHT on call. If it's quiet, you sleep. If it's swamped, you pick up the pace. If the beds are full, you park people in the hallway or empty patient rooms. If something goes wrong, everyone will blame you. If something goes right, nobody notices (nor are they supposed to..)... I live close to the hospital so I get front row seats when the ambulance drives up. I don't really need a pager as I can see the lights and just start putting on my shoes.

I love my job. I truly do. But at 3 a.m. I stare at the clock and wonder if it's worth it to try to sleep before the 4 a.m. rush hour begins(believe it or not it's very busy here!!! and I'm measuring by city standards!!!)...or if it's slow, is it worth the 3 hours of sleep before I have to be back in the clinic? Somehow I manage to always have a great time and laugh the stresses away while at the hospital...but once I get home I chant "Sleep is overrated you savvy-life-saving-diva-you!" and "You're not an idiot if you at least give the impression you know something."

Oh, and I have learned something valueable. When in doubt, get labs and xrays...while waiting for results...read a reference book! LOL...Ok, this is only true sometimes, but use the time you've got to review. (or point out something you know they DON'T have..."Well, Mr. S doesn't have ST elevation or hyperglycemia") If you're lucky that horrible left sided chest pain will turn out to be someone getting their nipple ring caught in their coat zipper. :)

I love my job...so much that I actually enjoy these chaotics nights...ALOT.
:)

posted by Stacey @ 2:32 AM

Friday, January 06, 2006

Hello again.

Today was a long day. We got swamped with patients and I was still taking appts at 5:15.
To make matters worse I got 3 of my most challenging pts in the office. To me, the challenging ones aren't the ones with multiple health problems, non-compliance, or even rude people. To me, the challenging ones are the ones that insist on telling me the same thing at every visit in their own weird way.

For example, I have the "wannaseeit?" guy. This individual has presented me with a number of medical problems that have either completely resolved or never will. BUT ON EVERY VISIT he tells me about them again and says "Wanna see it?" and before I can say no his clothing is on the floor and he is pointing to every part of his body. "I had a rash on my leg in 1973..WANNA SEE IT?" He is not sleazy or rude but it takes 20 minutes of looking at everything to get out of the room. I can't help but laugh at the end of every visit.

I also had the "lister" patient. This patient makes an appt during my last opening of the day for a sore throat. This patient then presents a list of problems which of course has to include chest pain and dizziness. Nice.

I then had Rico Suave. This patient originally presented in jeans and a t-shirt but now comes in all the time slathered in cologne and dressed to the nines. He usually has a mild complaint and then goes on telling me about his beautiful house, good job, and how much he thinks his medical problems are stress from looking for a good wife or wt loss from not having anyone to enjoy a good meal with. He is very nice but I literally need to pop a Zyrtec when I see his name on the schedule due to the overwhelming amt of manlysmellsauce he wears.

It's not bad, just was a very long day. It makes me appreciate the days where I only see 15 pts or less. I love this job and cannot put into words how happy I am to be here.

IF you don't hear from me again, I was crushed to death in a stack of charts that has overtaken my desk. I died happy and exhausted.

As for tonight, I'm driving 2.5 hours to Bismarck for a little R and R. Maybe a little karaoke? LOL.. Prob not. Enjoy the weekend!

posted by Stacey @ 5:53 PM

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