You say you want a resolution...ye-ah, you know...

I've never really been the kind of person to make New Year's resolutions. I don't know, I guess there just aren't a lot of things in my life that I really want to change. Not that I'm perfect, of course, just that the things I'd like to be different aren't really that easy to make a resolution about. Plus, it always seems like a silly construct: what's so special about Jan 1 that makes it the day to start making changes?

But last year, I sort of accidentally made a couple New Year's resolutions. I never really thought about it as "These are my resolutions," but near the beginning of last year I decided to try to make some changes. Namely, excerise more and eat more fruits and veggies.

I'm not exactly sure what prompted that, actually. A combination of factors, it seems. First semester of Med School was behind me, so I felt like I had a handle on the coming semester and could manage to make some changes. Plus, the curriculum is full of reminders about how important diet and exercise is to health, and I began to feel that, if I was going to counsel patients on losing weight, I'd better be able to do some of those things myself. And, annoyingly, my BMI was just in the "Overweight" range, which was frustrating. I never considered myself overweight, and still think that BMI is not an exact science and I might have been one of the people it didn't quite apply to. But I also didn't want to be one of the people who just makes excuses, so I wanted to try to get that BMI down into the normal range.

I don't actually remeber making a plan, but I ended up with what turned out to be a pretty good one. Rather than try to super-diet and drop the weight (which was really only about 5 lbs) really quick, I figured it would be better if I started slow. You know, so I'd have some chance of making it stick.

So I decided to try to go to the Nat and swim one day every week for the whole semester. And when it got tough to wake up at 6:30 am in the dark of winter and drag myself across campus, I told myself it was okay to do an easy workout, because it wasn't about the intensity, it was about just doing any exercise.

And it worked! Every week last semester, I went to swim (except for maybe once when I was sick--sleep was more important). I kind of fell apart over the summer, but last semester, I kicked it up to two days a week. (Though now I'm just working out in my apartment's weight room, not the Nat, because it takes less time out of my much fuller schedule--but it's not about the activity, it's just about doing something.) And, with one week under my belt this semester, I am aiming for three times a week. (And I think I can do it!)

Plus, I also got myself up to 5 fruits and vegetables every day. This took a little more planning, but I've managed to work in more plants to my diet--carrots for snaking, broccoli with my pasta, etc.

With all this, my BMI is now safely in the "Normal Weight" range, which I am proud of. I'm going to keep at it, though, because even if I don't need to lose more weight, exercise is good!

Lifestyle change like this is interesting to me. If I had thought about exercising 3 days a week at the beginning of med school, I would have thought it was impossible. But even with my much busier current schedule, I'm pretty sure I can do it. I think the key is baby steps, really. It sounds kind of cheesy, I guess, but it works.

I'm starting to see that this idea is catching on, too. I've heard some ads for the smallstep.gov website that's supposed to help give people ideas about little changes they can make (though I'm not sure how useful it actually is--a lot of their suggestions aren't really that small). Plus more and more of my classes and clinical preceptors are mentioning this idea when talking about counseling patients. I hope it keeps spreading, and not just with medical types. It seems like most people who need to make lifestyle changes don't even realize some of the easy things they could be doing differently. If we could get everyone to take just a couple of those small steps, I think health would improve in general.

It was only a matter of time....

I think I just became a coffee-drinker.

For the first 23 years of my life, I never drank coffee, minus the occasional sip at a wedding or other occasion (followed by dislike of the taste and continued non-consumption). But this year, as med school continues unrelentingly, I began to think it was time I learned to like coffee. So far, I've been able to maintain my 8 hours of sleep nearly every night, but there are still days that I feel sleepy and in need of caffiene. Plus, I know my future holds many a night of on-call or other long shifts, so I doubted I'd be able to handle that lifestyle with caffiene from tea or Coke alone, as I had done so far.

So a couple of months ago, I bought a cup of coffee at the coffee cart at school, on a day when I was literally falling asleep in lecture. And I choked down about one-third of it (black, because I don't want the hassle or calories of cream and sugar). ANd, again, about a month or so after that, I bought another cup on an afternoon when I was tired and having trouble focusing. Both times, the coffee had the desired effect, and kept me up, but I really didn't like it.

But today...I got another cup, and I actually enjoyed the taste. I mean, it's not my favorite thing in the world (that would be chocolate), but I've finished almost the whole cup, and I really don't mind it at all.

Check. One more milestone on the road to becoming a doctor achieved.

Pop quiz!

My throat was numb for the better part of this afternoon because:
A. I drank too much ice water
B. It was sprayed with lidocaine
C. Of a weird side effect of my allergy nasal spray
D. Strange things like that just happen sometimes

If you guessed B, you win the prize! Now, you may ask, why did I have lidocaine in my throat? For the laryngoscopy, of course! That probably doesn't clarify much, so here's the story:

For my Doctoring class, we were learning about how to do an ENT exam, so we were assigned to a couple hours with ENT residents to learn about their exams. And instead of using standardized patients (ie actors), they had us do it with student volunteers. So for the laryngoscope exam, I volunteered to be the patient. No one else really wanted to, and our class gunner was trying to volunteer a different girl, so I said I'd do it so she didn't have to. I really didn't mind, actually, it was pretty cool to see my own throat up close, and it really didn't hurt or anything (thanks to the lidocaine, of course). And now I know what it feels like, in case I ever get the chance to do it on a patient!

Which one am I?

I think this is fitting, since for some reason I've been thinking more lately about what specialty I want to pursue once medical school is finally over (if that ever happens...) Which category am I in?



From Movin' Meat

What have I gotten myself into?

I die a little bit inside every time I see doctor bloggers complain that the 80 hour per week limit for residents is not enough time for them to learn everything.

Is is just me, or does 80 hours a week seem like too many hours already? I mean, I can see that 40 hours is really not a lot, so I'm okay with more than that. Plus, I understand that in residency, they push to get more experience in in a shorter time. And I know there is a LOT to learn, so it takes time to learn it all.

But hearing about what's coming at a time when I feel like I am already spending every waking minute studying or thinking about how I should be studying, makes me feel like the next 6 years of my life are going to be more of the same.

I guess it's good that I'm teaching myself to like coffee now, because it looks like I'm going to need it...

First post! (for me)

This is my first post here, so I figure I should probably introduce myself. I'm Abby's sister, Dr. Liz ... except, I'm a Doctor of Pharmacy, versus being a medical doctor. I work in the retail setting (at a store I'm going to be referring to as Rx's R Us ... and, of course, all patient names and identifying information will be changed for patient privacy reasons), and I graduated from college a few years ago. I've been working in pharmacy, though, for a half-dozen years or so by now, though, so I definitely have plenty of stories to share. I generally won't bore you with old stories, but if something interesting happens at work, I'll definitely pass it along.

And, it just so happens that I have a story about a "special" patient of mine to pass along.

Last night, a patient calls in a refill for her Diazepam 10mg. Directions: 1 tablet three times daily. She received 90 pills 10 days ago. I flag it as being too soon to fill, and call the patient to tell them that I will not have it ready for them that evening. The doctor's office is closed, so I can't check about getting an early refill.

But, wait, it gets better.

The patient proceeds to tell me that she talked to the nurse, and the nurse said that she was going to call in a new script with the right directions. And what directions were these, you might ask? 30mg of Diazepam three times daily. Because the patient was in so much pain, that's how the doctor told her to take it. (my mental response: riiiiiiiiiiiiiight)

I tell the patient that I don't have any way to get ahold of the doctor, but they're willing to try if they'd like to do so. I say that I cannot fill the prescription until I hear back from the doctor giving me new directions and/or an authorization to fill the medication early.

This morning, I call over to the doctor's office - they do a lot of orthopedic stuff and deal with a lot of patients in pain, but I'm pretty sure that the nurse will not be confirming the patient's story.

RPh: Patient Susie Smith --

Nurse: *audible sigh*

RPh: I take it you talked to her this morning?

Nurse: Last night, actually. She called to have the doctor call in a new presciption for her Valium (brand name for Diazepam), saying that she's had to take more of the medication because of her pain. I told her last night that the doctor was already gone when she called in, so it would have to wait until today. He won't be in until after lunch since he's in surgery this morning.

The nurse said she'd call back once she talked to the doctor about the patient, but I didn't hear anything back before I left work this afternoon.

And, to top things off, the patient finally realized that I wasn't going to fill her RX without doctor authorization (which didn't appear to be forthcoming), so she had the prescription filled at a different pharmacy. I told the other RPh about the too soon issue, but it's their problem now ...

One of these things is not like the other...

Many time since I've started medical school, I've gotten the feeling that I don't quite fit in. I don't mean that in a whiny, "nobody likes me" way, just that in the course of typical medical school activities, I sometimes realize a new way that I am different than the my classmates. There are lots of these examples, but this post is about one that happened today, in one of the million small group sessions we have for our Respiratory course.

I forget why, but for some reason the conversation landed on "back-up plans", what we would do if medical school didn't work out. I don't think any of us are actually expecting to need these, but it's kind of nice to fantasize about an alternate life when the pressure of medical school gets too high. But after today, I'm starting to think that I need to get a new back up plan...

The other people in my group had back up plans like "wedding planner" or "librarian". Guess what mine is: Pharmacist. No, seriously, it is, and I tell people that all the time. Way less time in school than medical school, but killer compensation when you are done. (Not that I'm in it for the money, but still.)

What does it say about me that my back up is so similar to my current plan? Obviously, the fact that I have a sister who's a pharmacist has something to do with it, I think, but I can't even think of a non-medical fallback career I'd be interested in. I think I need to work on that...maybe alpaca farmer? (Come to think of it, I do think that would be a pretty sweet gig. They're so cute!)