The good and bad of 2008 (so far)!

2008 started out wonderfully! I was lucky enough to get New Year's Day off b/c we worked out a "holiday-type" schedule w/ the other admitting medicine team at Mather, and so when work finally ended Monday night, I was freeeeeeeeee until Wednesday.

Shomir's friend Rachel has a house up in Tahoe so we, spontaneously, just went. It took us about an hour and a half to find the place... and rolled in around 11:56 p.m., just in time to get a glass of champagne handed to us to bring in the New Year! It was weird seeing snow up there, just less than 2 hours from (warm) Sacramento, but it was pretty! We joined Arash, his wife, and a friend and checked out a couple of the casinos in town-- no gambling for me, though.

Wednesday afternoon, we tried to go out to Sierra for some skiing, but, due to heavy traffic leaving the Tahoe area, ended up at Heavenly, another resort in town. Now, some of the day had me wondering why it is legal, much less a good idea, to let extremely klutzy/uncoordinated people like me get on two little planks and try to make it down mountains (I will stick to the greens only next time, I think)-- I was kind of paralyzed in fear as I got stuck falling multiple times on a Blue, but I suppose it was good to try. I've been skiing 2 times before, the last time about 4 years ago. I hope to make it up there more times this season to get better and some more confidence with it! I can see how skiing, if you're good, is awesome; the terror, however, is still too much for me.

This would be my level of skiing :)

But even when I was on my butt (Shomir was so patient with me!!), it was lovely because of the awesome views of Lake Tahoe from the hills.. They really took my breath away. What a gorgeous area! Here are some pics from the ski lift.

Well, it was back at work on Wednesday, with clinic in the afternoon. I had my first continuity patient come in for a 1-week OB check and, as she was uncomfortable and was worried about her baby's movement, I sent her over to triage to be checked out with a nonstress test. The admitting resident called me around 7:30 p.m. and said that she appeared to be ruptured and was contracting every 5 minutes! Wow! At the time I got the news, I was at an FP/OB applicant dinner, however, I could not concentrate worth a cent and had to take off for the hospital.

The patient wanted to VBAC (have a vag delivery after a prior C-section, which was in Mexico with an unknown incision), so it was a bit higher risk, but it was cool! I got to AROM her forebag, place an IUPC, and really manage the entire labor! I didn't start her on pitocin for augmentation until she stalled out a bit around 2 a.m. (I really wanted to be there for the delivery so had to be a bit more aggressive than ordinary), but everything went beautifully! I got about 2 hour-long naps in during the night, but I was just so nervous! She started pushing around 4:40 or so a.m., and by 5:11, we had ourselves a gorgeous little baby boy and an easy delivery without lacerations or anything!

Although I was exhausted and had to go straight back to work at the VA for my next day shift, it was really worth it to be there. That continuity is what I love about family medicine-- and the OB part is just plain fun. It was actually strange being back on L and D, as it's been a couple of months, as well as in this different "role" (I've been doing a whole lot of prostate exams on wheezy men this last month!), but it was great to see the nurses and residents again while I was hanging out all night:)

So the bad?

Work this week has been really rough. It's been a lot busier than last week, and the turnaround is getting me exhausted. We are admitting every day and so every morning we come in, there are overnight admits we pick up after having "capped" with other admits the previous day. Our attending is very good, but very aggressive with getting things done and people moving, so our hospital stays tend to be quite brief. I am churning out discharge summaries like there's no tomorrow. Honestly. And then, since we are constantly diuresing our census and have, on average, fewer people than the other team, the overnight admits and more of the transfers tend to come to us, which makes for hectic and quite stressful mornings.

Although I really do like internal medicine and am liking finally feeling comfortable and everything at the VA, all that, combined with extreme sleep deprivation, made me really crabby yesterday. That, and a really difficult patient with some sort of personality disorder that I had to discharge. And constantly being a little short-staffed due to clinic/days off/people showing up late/being sick/etc.

Today, we are having what appears to be a hurricane-equivalent in Sacramento (the mountains are probably getting TONS of snow!). The power went out at the VA, which was running on its emergency generator. I was supposed to give a case presentation over the noon hour today, on which I kind of slaved away last night despite being near comatose with fatigue, but it was so busy today that we didn't get to have lunch/noon conference. The only good? Today was my "half" day which meant that I could get out early, after my work was done (except that we had MORE discharges!! So exhausting!) I went over to the hospital to see my patient, but she had already been discharged!

I was going to go to the gym but it was closed secondary to the storm. Hmmph.

And then my "tire" light came on in my car. When I checked, my left rear tire was hissing and definitely going flat, and I found a piece of wood with a nail in the back groove of my tire space. Excellent way to end the (for normal people-- it's Friday!!!) week. Luckily, 2 blocks from the gas station where I initially stopped to rescue-inflate the tire, was a tire place where they helped me plug it up (I would be near-useless in tire-changing-situations). Also very luckily this was after I'd made it home on my half day and actually had time to take care of this.

I also have that sore throat and fatigue prodrome of a cold coming on. Grr.

At least I only have TWO MORE days of VA medicine to make it through.
Then a month to make it through MICU alive.

Oofda.