Thoughts after work

Dave performed once again last night at the Coffee Gallery in Altadena. Fortunately, even though I couldn't make it... AGAIN... our good friends Sherman Lee and Ben Wideman made it out and both even posted a blog on the night that kept me up to speed.

Thanks to Sherman, when I got back from work, I watched a couple videos of Dave doing what he loves. I loved watching him in his element, probably just as much as he loves watching me gab about how much I enjoy my job and school. Both of us are at a peak in our lives that may define our careers for many more years. It has been a challenging time that has brought many thoughts about our values to the forefront. Where has our time gone to be with friends and family?

I can't help but think of the many elderly patients I see in the hospital admitted because they have been living independently for years and suddenly one day collapsed at home, only to be found days later by their busy family members. When I asked my patient where her son was, she replied, "He's too busy to care for me. He's a corporate attorney." I think to myself, I truly hope my parents or grandparents don't end up in that predicament and vow that it won't. Yet, here we are living just hours from my mother-in-law and grandparents and only seeing them, if we're lucky, once a month - let alone my parents who we see in short spurts during the year.

Globalization has definitely made the world smaller... but are our families getting the brunt of it? We're still trying to find the right balance and somehow I think it will be a lifelong struggle.

Out with a bang

Ants have been following me around today. At Fuller Copy Services, an ant crawled up my arm. I quickly caught it with my bare fingers, rolled it up and tossed it on the ground. At Target, I found another one crawling on the counter in front of me. Where are they coming from??

Well, the little critter that I caught earlier must have released some sort of venom or toxin when it died, because it left my left thumb itching all day. Who would've thought such a little bug could cause so much of a nuisance after it died.

When I die, I wonder if I'll go out with such influence. Nuisance or not, that little creature kept this big creature thinking about it all day long.

Juxtaposition of life

Stumbled upon this photo from a trip to the Huntington Library during March of 2010. So ironic is the dependence we have on family during the beginning and end stages of our lives.

Divine tutorials

Maybe I'm meant to do this whole nurse practitioner thing. It seems to be total providence that I'm exposed to learning opportunities every which way without even trying... I'll explain.

Last night, at the end of my shift, one of my co-workers got a bunch of orders from a doctor to give calcium, D50, and insulin to a hyperkalemic patient (someone with high potassium in their blood). I looked at my co-worker, confused. I had never heard of giving insulin to decrease potassium. I look this up on my iPod touch and am reminded that patients with hyperkalemia have peaked T waves on their EKG. I come home and before bed, I watch an episode of Grey's Anatomy and whaddya know! The emergent patient who codes in the OR with a junctional rhythm has peaked T waves. New medical resident speaks up to mention he thinks the patient's hyperkalemic and they give... calcium gluconate, D50 and insulin.

So maybe that might have been a freak coincidence.

Last Monday, I had a clinical rotation with a doctor that had been unable to come up with a diagnosis on a woman with a skin rash from her hands to a clearly demarcated line on her forearm. She also had a rash from her face to her neck, also with a clearly demarcated line, like a sunburn. This was the second time he had seen her, after trying to treat her with an antihistamine (Benadryl). The rash had not gone away and he was considering steroids this time. Stumped, he asked me what I thought. I asked her about sun exposure and chemical exposure, cleaning products. Asked about new lotions, perfumes. She was unemployed. Nothing significant.

Today, on the New England Journal of Medicine's main page (which is set up as my home page on firefox), I see that the image challenge of the day is exactly what I saw that day. It's a niacin deficiency. This deficiency is called pellagra and shows up like a sunburn.

This stuff excites me. And amidst work and my limited time to study, I truly feel like God is helping me out... giving me some tutorials here and there.

Coffee Gallery

On Friday night, Dave performed a couple songs at an open mic at the Coffee Gallery here in Altadena. He sang "Everyone Can Smile" and "Home". I'm sad I had to miss it.

Internal Medicine

This semester, I'm starting what I consider to be the meat of my coursework as a family nurse practitioner. I'm on the prowl, however, for a good internist to precept with. I already have a placement at a Spanish speaking clinic... except... I don't speak Spanish. I think the patients will figure me out pretty quick. Buenos dias! Habla espanol un poquito. Tiene dolor... no? Que... es... uh...

Thoughts on the road

A couple weeks after Dave and I first met, we had the opportunity to spend a couple hours talking in the car as we drove to my college campus to post fliers. We totally hit it off. There wasn't a moment of awkwardness. Even the silence was comfortable. Maybe that's why we love road trips so much and can talk for hours on end. Especially now that we're married, road trips give us time to rethink our lifestyle. We're much more open to suggestions when we're on the road.

One breakthrough I had this last trip to Monterey Bay is that Dave is a carefree person that takes life by the horns. If it weren't for him, I probably would never have backpacked around Europe. If he chooses to do something, he will do it with extreme joy. I, on the other hand, will do something I don't really feel like doing and complain about it, or do something I really enjoy doing and feel guilty about it. I think a lot of people are like that these days. And it doesn't make life particularly fun, does it?

This world could use a lot more people like my husband.