Baby Burns Photo Shoot

Hello, family! We finally have something interesting to post! We had an ultrasound on Monday July 21st and we got to see our baby! He/she is still very tiny--only about 2 inches long and his little foot is 0.81 cm. But everything is there and where it is supposed to be! We even got to see the heart beating. He was just bouncing around all over the place. Mike liked that part the best. I'll be 13 weeks on Monday. I'm feeling better now and I have much more energy. Now maybe I can actually get something accomplished!

In other news, Mike is finishing up his last weekend of summer classes today and tomorrow. Now he only has 6 hours left. Woo hoo! We decided that he will take one class at UCCS and one class online. This way he only has to go to school one night a week instead of three this fall. Of course he'll still have the work for two classes but it will allow him more time to work on the actual homework part. I think he is ready to be finished. My schools starts on Aug. 20 which means I'll start working here at home the next couple of weeks and then start working in my room around Aug. 11th. I'm ready. It's nice to go back knowing how the school works.

That's all for now. Love you all!

Kim's New Job

Hi Everyone! I accepted a new job yesterday in Gastroenterology (Mike will be happy). It's in Belleville, IL, which is about a 25-30 minute drive and I'll be working 9-5 Mon-Fri with an occasional Sat morning about once per month. I spent Tuesday afternoon following the PA to be sure I wanted the job. She is having a baby October 1st and will be leaving in one month. She'll come back next year two days per week. They want me to continue full-time when she comes back. I'll be seeing more patients than I did in Tulsa. With a specialty, though, it doesn't take as long. In Internal Medicine I always had patients that would say "just one more thing" and show me a callous on their foot or a strange mole on their back. No more! Now I just say, "tell your primary care physician" if it isn't related to GI (gastroenterology). I know that sounds kinda mean, but when you have a long list of patients that start backing up in the waiting room, you have to stick to what is pertinent.
The physician spends every day in the hospital doing colonoscopies and EGD's (where they go into the stomach), so I'll be on my own in the office. That's a little scary, to say the least. The nurses seem to be really helpful, though, and there are a lot of them (I think 4?). In Tulsa, I did a lot of the nurses job like calling in prescriptions, putting a patient in a room, and calling patients back on the phone. I didn't mind it because I didn't have as many patients, but now I'll definately appreciate the help.
So, I start Monday learning from the PA for about 2 weeks and the doctor about 1 week. Pray for me if you think of it! Love you all!!

VBS Week

Last week was VBS at our church. It's our third year to put on a VBS since having our new property and our curriculum uses a different time in Jesus' life each year. We've done Bethlehem, Galilee by the Sea, and now Jerusalem, Jesus' last days. The whole property is transformed with marketplace tents outside, palms and hay strewn everywhere. Everyone is wearing tunics and headscarves and the kids are divided into the 12 tribes of Jacob (actually 20 tribes with several duplicate names). Jack looks forward to it all year. It's very scripture-based and the kids learn a lot. My job this year was in the kitchen. I baked 18 loaves of whole wheat bread (not a big deal with my mixer) that the kids have every day during their lesson and passed out popsicles after their playtime. Almost everyone, including women with kids not even old enough to participate, comes to help out. Dads take off of work to be rabbis or Roman soldiers. Next year Todd plans to take a few days off work and come help out, too. It's so fun to see everyone together every day for a whole week. That being said, I'm glad it's over! It wore me out.

First Two Days

So the first two days of residency have come and gone. I started off not knowing how to use the computer system and where or who to ask for the countless questions I had. By now I'm becoming more and more familiar with how things work, and what exactly is expected of me.

My first rotation is Hematology (blood) and Oncology (cancer). It's a pretty cool rotation and all the PGY-1's (post grad year one, or interns) have to rotate through. Even though there are a lot of sick patients, the nurses are awesome and REALLY helpful and friendly.

I was assigned 4 patients my first day. The first was a 65 year old guy with Hemophilia A. His condition was relatively mild until 2 years ago when he developed antibodies during surgery, now he bleeds with even minor trauma, and requires a $5,000 injection so he will stop bleeding. He went home today (day 2) but will continue his regimen to try and make his disease less severe.
The second is a lady with metastatic breast cancer. She already had a double mastectomy, and had a port catheter placed under her skin so that chemotherapy could be delivered easier over a long period of time. Unfortunately, the port cath became infected with MRSA (methacillin resistant staph auraus - meaning the usual antibiotics are INeffective = BAD). We removed the cath and she is doing much better, unfortunately this doesn't do anything for the cancer. She will probably go home tomorrow.
The third is a guy who was admitted for open heart surgery, a CABG (coronary artery bypass grafting). He also has sickle cell anemia and when he was admitted he started having a sickle cell crisis, which is where you blood cell can't fit through the capillaries and you have lots of severe pain all over your body. By the time I saw him his pain was much better. He went in for surgery this morning and had one-vessel disease. He was transferred off my service and into the ICU.
The fourth is a guy with Hepatitis C who subsequently developed cirrhosis and Hepatocellular carcinoma (liver cancer). He was admitted for a special procedure where they go though your femoral artery (similar to a heart catheterization) and inject chemotherapy agents directly into his liver, followed by a special gel that clots off the artery leading into the liver -effectively removing the blood supply to the tumor. He is doing well after his procedure.

So my day basically consists of: waking up as early as possible, arriving to the hospital and checking new labs, overnight test results, vital signs, nursing reports (all pre-rounding) in order to get ready to round with the attending. Being one of the hospital newbies, I have LOTS of questions of how to do stuff, where stuff is, and also questions about the management of patients (you know, why I'm there in the first place!) There is no senior internal medicine resident, instead we have a Heme/Onc fellow. Our first 1.5 days there was a great fellow named Seth who was nice and knowledgeable - a seasoned doctor. Today we were introduced to the new fellow who will be with us for the rest of the month. She is new to SLU too, so it's kinda like the blind leading the blind, except she had 3 years of experience on the rest of us. (My second day was her first day of her 3-year fellowship in Heme/Onc, so she'll improve - she also went to East Tennessee, in Jackson City, or something). After rounds we grab a bite (after this week it will be during noon conference) and try to catch up on all the work we need to do: discharge summaries, endless orders, checking on patients, and tons of paperwork. While it's intimidating, it fun too.

Tomorrow is my night on call, which means when my fellow interns are going home at 5:00, I'll be roaming the hospital waiting for nurses to call with any questions they have, or orders I need to write. And if a patient needs to be seen, I'm the one who has to see them. I'll stay at the hospital until we finish rounding the next day (July 4th) at noon, after which I can go home and get some sleep. Fortunately I'm off Saturday, so I think Kim and I will get a chance to hang out with my buddy, Lee and his wife Danielle, who are coming to St. Louis for the downtown arch fireworks and to see one of his other friends and his wife. So after all the work, I think I'll still try to have some fun - I usually do ;)


Someone else needs to post, by the way. It doesn't have to be anything amazing.