Monday, February 28, 2011
Happy anniversary
In March last year I went to Samoa for 8 weeks to do my Introduction to Medicine module. I went so fast, I couldn't believe it. It's so beautiful there, I could easily go back, and I hope to do so. I estimate I have another 2.5 years of preclinical and just under 4 years in total left. Wow. To think I've already done a year, or 20%...
Here's an excerpt from my first entry into my journal I wrote while in Samoa (please understand I was at this point culture-shocked, jet lagged, home-sick, over-whelmed, and in an extremely hot and humid environment);
22nd March 2010 - Day 2
Dear Diary,
I'm finding it increasingly frustrating to try and study by any other means than via self-study of my Biochem text I brought with me. I'm starting to believe I was learning more studying on my own at work, where I at least had reliable access to the internet and adequate lighting....
..... I am rather disappointed I came all this way only to be studying less effectively and more remotely.
Trying to keep a positive attitude. Now determined to study the text on my own....
.....I am enjoying the different experience in a friendly country and looking forward to returning home to my house and pets.
CJ
Ha! I forgot how frustrated I was with the lack of aircon, good lighting, and very unreliable internet! By the end of the 8 weeks I had totally adjusted to:
a) Getting up early to study in the (only) cool part of the day (and by the end of the 8 weeks had acclimatised so much I wished I was in the non-aircon rooms with the ceiling fan only)
b) Rearranged my room to try and squeeze the lamp onto my desk
c) Gave up on using the internet as my source of information and replaced it with these things called "textbooks" in the uni library
d) Found an internet cafe in town with a way better connection and speed than at the hotel or uni, and much cheaper. Used it only for FB, emailing, and internet banking anyway!
I had also learnt to pre-study the day's material before I went to class, which I still try and do now and is such a life-saver.
Can't wait to look back at this time now and laugh... so far away.....
Working and running and studying....
Part of my 4.5km loop
My whole life atm can be summed up into periods of working, running, studying, sleeping, eating, and MoHing. That's about it. Sometimes there's housework, and sometimes there's tv (I'm missing the Oscars right now), and even occasionally there's a shower or bath followed by rapid grooming, but that's about it. So, yeh, I really enjoy my runs in the lovely fresh air and quiet country roads of my town.
Today is overcast and misty, but not too cold, and the air is still. The rain makes the dust settle and the smell of grass, gum, and pine is lovely. My dog got away from me again today when he saw the alpacas - they freak him out. He didn't discover the electric fence between them as yet, and I hope he never does. My mistake was that I was walking that section of the road and he is easily distracted when walking as compared with running. I couldn't run very far at all today, I think due to working overnight and the >500km of driving the ambulance cramped up my legs a bit. I've decided to try and rest my legs well before the next run because these poor performances are discouraging me.
Yesterday I finished the quiz and submitted it, 40 of the 50 pages of the case study, and 10 of the 17 tasks. I will need today to finish them all and therefore will be a day behind my revision schedule already :(
Sunday, February 27, 2011
Study and more study
Yep, I'm still studying. Well, I had a day off yesterday, which I hadn't planned to, but things happen....
According to my schedule I must finish by the end of today:
- 50 page case study (ARDS)
- 10 question quiz and submit
- 17 questions tasks and prepare for lecture
I'm also at work, did I mention that?
Work's clinical guidelines are changing again, and at first I was concerned about re-learning new guidelines, but when I read through the summary I was happy because they are changing to be more in-line with "the rest of the world" medicine and allow for more clinical reason. For eg Stemetil can now be used in severe vertigo, and not just motion sickness, air medevac and/or an alternative for Maxolon. Vertigo is probably the most common indication for Stemetil we encounter in reality. And if anyone has ever had really bad vertigo, then you'd understand why I really want to be able to give it to certain patients. There are a number others which make clinical sense, which in the past I'd have to consult for. This is good news for everybody.
I didn't go for a run yesterday either. I can't remember how many times I've gone this week. I think twice, but maybe only once....? I went on that hot day before I started call, on Thursday, and I must've gone either Monday or Tuesday, surely... It feels weird to have gone 3 days since running. I must try and go tonight when I start call. The treadmill is sitting there but is not attractive...
Edit: thanks to my former posts I realise I did 4.5km 5 days ago and 2.5km in high temperatures 3 days ago. Time is jumbled.
Friday, February 25, 2011
Study... more....
Doing some study this morning at work. Feeling not too far behind, which is a nice change. We didn't get any call-outs last night so I got almost 8 hours sleep in-a-row! Unfortunately for me, this week's case is very difficult. It's about ARDS (Adult Respiratory Distress Syndrome) and there's lots of lab values to interpret, plus I have no experience in an ICU, therefore no experience with ventilators and ICU drugs etc. I'm way out of my comfort zone.
Then I flicked ahead through the case to the unit material and the first line was: "The heart and lungs are vital organs situated in the thorax protected by the rib cage". !!!! It's the end of the respiratory module, I think I know where the lungs are..... Funny. I find most of the provided unit readings are 90% super-basic with the odd fact dispersed throughout,so it's a matter of skimming before heading to the textbooks for further reading. That is, of course, when I'm not frantically trying to finish the tasks before next week's lecture.
This is the last case study for the term. I'm scared I have to study and cram so much before the exam. I sent in my quiz without trying or looking up answers, I just thought it was overdue so who cares and I still got 9/10. Maybe I feel like I'm doing bad because it's so difficult, but really we're being prepared really well by our lecturer with all these compulsory tasks. Unfortunately, I wont know until after the exam, which will be too late, so I wont be taking any chances with my exam prep, which commences in 3 days....
My run yesterday was reduced to the 2.5km, which I think my dog was so grateful for because he was running way behind me on the last part of the loop. It was just too hot. And near the end I looked down at my watch and got so excited because it read: 15:35, and my goal is 2.5km in 15 minutes, then I realsied that that was the time of day, not minutes:seconds as I had forgot to start my stop watch :/
Edit: ARDS is now known as Acute Respiratory Distress Syndrome.
Thursday, February 24, 2011
New book
Finally got the latest version of Kumar and Clark's Clinical Medicine. Ordered it from abebooks.com. Check it out...
I love this book. I'm so happy. It's way more exciting to me then buying a new dress. I think I'm definitely in the right profession, if I had any doubt...
Off to squeeze in a run before work (in 30oC heat).
Wednesday, February 23, 2011
Today
My question was: "Classify lung cancer, including prevalence of different types and 'typical' patients at risk". One thing is for sure, if I still smoked now, I would certainly quit after this week. Last term doing cardiovascular I was reading about dilated cardiomyopathy caused from excessive alcohol intake, and I am now really scared to drink more than 3 drinks a week, although the grueling study schedule plus the marathon training I've been doing doesn't allow for much more than that anyway.
This afternoon I finally sent my missing tasks to my lecturer. I think the student-teacher relationship is like any good relationship - it's all about communication. I let him know as far in advance as possible what was going on and if I could have the chance to make up for lost grades. Even, embarrassingly, I had to admit to missing last week's lecture due to sleeping through my alarm. That does not look good, but it was the truth :/
Now, I am going to squeeze 30 minutes of gardening in as my friend gave me some plants not in pots about 3(!) days ago, and if I don't get them into the ground, they are sure to die on my nature strip, and when he walks his dog past my place I'm sure he will be annoyed.
Tonight, I am catching up with a friend for a few hours to nurture both our sanities from our hectic lives. I do feel guilty leaving the books, but it is the one night off I have this week and I need it.
Tuesday, February 22, 2011
Same ol'...
Went for a 4.5km run for the first time with the dog today. He ran like a champ and kept me going on the back stretch. I'm running really, REALLY slow so I'll have to work on speed some time before the proper 5km event next month otherwise I'll be finishing behind the people doing the 10km event....
I have yet again somehow managed to muck up my school timetable and am yet again in panic mode.. Seriously, wont this term just end already?
MoH duties continue and don't seem to be slowing down any time soon.
I did an practice test with USMLE World Q Bank tonight - just the respiratory ones, and I got 55%. I know that sounds horrible, but at 75% I would be extremely happy and believe I can achieve that before my exam as it is slightly easier, but has more curve-balls, than the USMLE prep exams seem to. By curve-balls I mean that, for example, last term it was cardiovascular, and then up popped questions on epidemiology/statistics eg what the difference between cohort and control studies - wtf?
Met my mentor at the hospital down in the ED for the first time today. It was excellent and what I really needed to focus on why I'm sacrificing so much time, money, and grey-hairs to my studies right now. Although I felt like a total waste-of-space, it was a nice start. Plus (almost) everyone in the ED already knows me from ambulance work and are really friendly. couldn't ask for anything more, really.
Complaining
Watch your words, for they become actions.
Watch your actions, for they become habits.
Watch your habits, for they become character.
Watch your character, for it becomes your destiny." - Unknown
Sorry, but I don't know said the above quote as I stole it from my friend's FB status update.
Sunday, February 20, 2011
hmmph
I'm suffering from insomnia at the moment, despite being the healthiest I've been in ages. I eat really good, no soda, max one coffee every few days, alcohol only once a week, and good exercise and sleep (when I get it). My body clock is set to be awake at night instead of the day, but I guess that's not overly surprising considering I do most of my call-outs at night.
I have two things due for med school today and I haven't done them yet. I think I can certainly send in one thing today I have finished but just need rewording, and the other thing is the quiz which I have sent in a day late every week for the whole term, so why change that now in the second-last week!
I did some light weights yesterday, which have already noticeably tightened up my arms, but boy does it ever ramp up my appetite! Analysing the way my body works, I think I might do weights only once or twice a week, and keep the running to three times a week.
I'm finding that at work my med studies are coming into play all the time. I don't think I've annoyed my co-workers much yet by bringing up ideas that fall outside the normal paramedic practice. Certainly, I'm not treating my patients any differently, but it is interesting to be able to start to interpret labs, go through a differential diagnosis including diseases which are no life-threatening/of concern to ambulance, look at ECGs more deeply, and to understand more about what investigation will likely be done at the hospital.
Saturday, February 19, 2011
Awful
Just has a terrible run. Fatigued from work, I decided not to take the dog and try for my PB... I also have a sore shoulder from him pulling on the leash. I ran into head-winds on the uphill part and it killed my ears. My legs felt as though they had no muscles in them and that my shoes had concrete in them.
So I decided I'd at least power-walk portions that I couldn't run... Then I got to the turnoff and decided if my intensity was low, I'd have to up the duration. In the end I walked/ran my new 4.5 km loop. At least I got a good sweat up and have experienced something like what it might feel like somewhere along a marathon.
Note to self - run every second day and have a coffee before if fatigued from call-outs.
Friday, February 18, 2011
Dog
So I wanted to try doing my 2.5 without my dog to see what my serious time would be before I go up to 4.5km. But when I put on my runners he got so excited I couldn't disappoint him. Might have to come up with a plan...
Quote of the day
Thursday, February 17, 2011
Learning technique
So, anyway, I get a daily "med term" on my iGoogle homepage. A lot of the ones I don't know are the names of medical conditions, often genetic ones, and usually rare. I've started seeing the term, trying to think of a person with that name, surname, or something similar. Anyway, it's a little bit wicked but the med term I had today I immediately thought of an old uni lecturer with the same name, and when I saw the condition caused mental retardation and a disfigured face, I had to laugh. Won't forget that one in a hurry :)
Running
I had a good run yesterday before my mentor session. I beat my time on the 2.5 km loop. I think I might do it without my dog tomorrow (or maybe even today) to see what kind of time I can get if I dont have to stop at every tree or lamp post! I'm aiming for 15mins before I start doing the 4.5km loop next week. I want to get close to doing 5km in 30mins before the x-country event in late March.
I'm going to download some more iTunes today. Need to start making a run playlist...
Today I'll be finishing last week's tasks and also finish reading this week's case and then: guess what? I'm finally up-to-date! Wow!
Wednesday, February 16, 2011
10/10
Six hours later.....I just did my pimping session, which went for 6 hours, with one 5 min break, which I was unprepared for! I thought it was on Friday. Ooops. Luckily my question was on PE which I luckily know something about through paramedic practice. Then straight after that I did my presentation (picture shows notes/new scrap paper). It went ok. Sooo glad that's out of the way. I'm just getting used to the pimp sessions now and the term is nearly over. Oh well, I think there will be more of it to come in my medical career....
Life update;
Res exam - starting to think maybe I know more than I think and I was just comparing myself to last term, expecting to be more advanced. I hope res is not considered an "easy" module, or I'm screwed.
Med - looking forward to the next term off to revise everything so far and get myself back to the level I want to be at.
Masters - still think I'll try and do it on my break. I still want it and I don't want to have to wait until I'm 55 to be able to do the sort of work I want to do overseas. Need to double-up and make up for lost time. Got my welcome email a few days ago. Need to quickly have a look at that and get some folders ready to hit the ground running after the exam.
Marathon - stupidly put my run off to the afternoon yesterday and it never happened. Going to have a nap now (only had 4 hours sleep) and have a run before I go an meet my mentor tonight. Have to do it today. Plan this week is to maintain my 2.5km with 3 runs and beat my time on Sunday if I'm not on a call-out with work, or Monday morning. 4.5km starts next week.
Travel - Still only have my September trip planned and to look forward to. Maybe some hiking during March break for a few days only. As for next year, I'm considering doing a cruise with my friends that goes to Christmas Island and Indonesia! Looks great.
Love life - Not going to mention it on this blog. Sorry. Private.
Social life - Maintaining it. Just. Thankfully I have a few friends that don't take it personally when I ignore them for periods of time. Have a girls dinner tonight. Trying to socialise once a week.
MoH (Maid of Honour) - I'm also getting used to the organza, satin, and sequins and have another wedding dress try-on with my sister next week. This time one store is a place where I would even consider myself if I was shopping for big white dresses. The dresses there are vintage-inspired and made of gorgeous silks and Chantilly lace.
Work - Going good. Can't believe how many res patients I'm having this term. If I do repro next term I will be sure to deliver a baby.....
Tuesday, February 15, 2011
Today
I can't adequately explain how long 8 weeks can feel to me right now. Normally with working weird shifts at work time flies, but when I'm studying med, the time lasts forever. It's probably to do with the large amount of information I'm absorbing in a small amount of time. And as Albert Einstein theorised (and then it was later proved) time is relative to the observer (thankyou, Dr Hawking). In my meagre mind I think this is partially why time seems to speed up as you get old. One year when you're 10 is 10% of your whole life, but when you're 100 it's only 1%. Yep... I'm good at maths too....
Then I drove about 30km in a round-trip to the bank as the Post Office wasn't able to deposit cash for me. Then I got back into the study for a short time and got recalled into work for 4 hours. Then I came back, made some dinner, and here we are now. Deciding whether to go for a run or finish my friggin presentation to send off ready to get up at stupid o'clock again to present it.
Ugh.
However, I told my co-worker today that I want to stop complaining so much, or rather I want to stop thinking everything annoys me all the time. He said "You never act annoyed" just after I told him how so-and-so really annoys me when they do such-and-such. Maybe it's because I don't have an overtly emotional response to my annoyance, but I would like to retrain my mind to stop perceiving everything as irritating or frustrating and think of it as "just is". I'm good at the big obstacles, I'm just not so good at the small annoynces. Yet.
Monday, February 14, 2011
Kindle
Anyway I have to get up now and lock myself in my study for the day to;
-finish my presentation slides to send to my lecturer
-complete my weekly quiz and email it
-make inroads on two sets of weekly tasks, one from last week and mostly from this week
............
I've just been to the cafe to get my large frappe and I'm ready to rock.
I had about 12 hours sleep last night which is usualy on my first day off for the week to repay my sleep debt from being on-call. So I'm feeling good. Then I went into my kitchen and found the below picture which looks like a snail has been walking along my ceiling last night! How did a snail get in my house, and where is it? I do leave my backdoor open a lot for fresh air and for the pets to not annoy me to come in and go out all day, and it has been raining a lot ths Summer. It made me smile.
Sunday, February 13, 2011
Balance
Just had an awesome, encouraging run after work. Now I have the night off and need to study but really feel like watching tv. Don't worry, I will be doing the former...
Ah, the technology...
I'm posting from my new phone! Wow. I'm so technological.
I also mapped my running route on MapMyRun and now know my distance of my next two preferred routes! Google maps does the same thing. I also got myself a Polar watch today so I have no excuses!
Med studies - I'm finishing off my presentation on lung transplant and really wishing I had a more current edition of my Harrison's.
Saturday, February 12, 2011
Getting my act together
Right now I'm reading about lung surfactant and finding it way cool. I also need to attribute some of my turn-around to another fellow classmate that emailed me. Even though she is in the US and not my study partner, she offered help and gave morale support and that really goes a long way to build the confidence to stop that little voice in my head that likes to tell me I'm going to fail. When meditation failed me, an unexpected friendship and small show of compassion went a long way.
I still haven't decided about the MIH (Masters of International Health), as I mentioned in my last post, because I so want to take my medical studies into that field eventually. Afterall, it is international health that pushed me into med in the first place. Census date is still some time off so I don't have to make any decisions now. I might even just cut back to one subject per semester, but again I'll wait and see how I feel after I finish this med term. It's funny after studying med I think MIH subjects will be so much easier. I'm also hoping that as time goes by I will be able to keep a more even keel in med studies because I know that when I start my clinical placements that there will be little room for "off days".
Good news - I finally got my new phone after my last one was destroyed on a job in the floods. I feel like I've rejoined the 21st century!
Friday, February 11, 2011
Still overwhelmed
I had a phone call with a fellow classmate which was the equivalent of "pull you head in" and "this is medicine". Tough love. Love her for it.
I'm sticking to my plan I did yesterday. So far. And I've just typed out all the learning objectives for each week which was good to just remember all the topics I have already covered and that I have learned something. In the revision week (week 8) I'll use them to revise thoroughly.
In other news, I'm considering dropping my Masters studies. I think I need the term off to revise what I've so far studied in medicine to do well in the USMLEs. This is difficult to swallow, and I haven't decided 100% as yet. Even though it's not as difficult as med, I think I need a break so I don't lose motivation in my next module.
Thursday, February 10, 2011
Organisation
I think I should be able to make up for lost time if I really put my head down now.
My mentor told me about how she had trouble staying focused for a term when she was back in med school. I really love it when people I look up to are generous enough to share their pitfalls with their juniors. I really respect that, and I find it is those I respect the most who are the most willing to admit these things. Perhaps it's to do with feeling comfortable enough with their abilities to admit their failures.
Anyway, I hope I can not make this a habit and get myself together to finish this term with a respectable grade and be a model student next term.
In marathon news, I only ran for 1km (!) on the treadmill today at work. I hate treadys. I went and saw my friend and co-worker at lunch and she said we should do the Emergency Service Games 5km cross-country next month. Don't tell everyone, but last year there were so few competitors that almost every age class was guarenteed a place in the medals... sshhhhhh... And it would be a good medium-term goal for marathon prep. So, i have to build on 1km to 5km before some time in next month.
While considering all of the above, I will also keep mindful of the below quote which the Dalai Lama's Facebook page sent me today;
The more you think about your own self, the more self-centred you are, the more trouble even small problems can create in your mind. The stronger your sense of ‘I’, the narrower the scope of your thinking becomes; then even small obstacles become unbearable. On the other hand, if you concern yourself mainly with others, the broader your thinking becomes, and life’s inevitable difficulties disturb you less.- Dalai Lama
Wednesday, February 9, 2011
Motivation
Studying for an exam isn't as motivating for me as studying for a future patient that may need my help and has no-one else to help them. Volunteering in the clinic I had only a local Khmer ex-Army doctor to help me. It was frustrating to not have more ability and be limitied by only my paramedic experience (which doesn't really help much in the area I was volunteering in). Now, in the final few weeks of the term, I hope to take this attitude with me to the books and try and resurrect this resipratory module.
Tuesday, February 8, 2011
Welcome to hell
In other news, I go back to work in less than an hour. It's always so hard to get back into the rhythm of feeling like a robot with a an old battery which wont hold charge.
And in the best part of my day today, I went for my first marathon training run this morning and it went encouragingly well. My dog loved it.
Monday, February 7, 2011
New shoes
So how did Day 1 of my marathon preparation go? Fail. No run. I was still hungover from my sister's engagement party last night. But I did buy some new runners. This is not looking good.
Another life saved
But tonight I just got a message from some surgeon somewhere in a big hospital in the big city. It came via the patient themselves, who was told to pass on this very message, and then through another paramedic, who the patient initially thought was me (they were very sick the last time we met), that I "saved their life". Nice one. I didn't do much, and I wasn't working solo so I can't take all the credit, and I would like to think the average ambo would make the same decision in the same circumstances, but it is still very nice to hear. It's nice to know that sometimes the decisions we make all day every day sometimes add up to something good.
:)
An engagement
Sunday, February 6, 2011
Home again
The flight was good - it's not very long- but I did have some dramas going through security as I bought 3 pairs of big metal hoop earrings and they kept trying to tell me I had a big pair of scissors in my handbag. Ugh. At least it was my handbag and not my carry-on which would have taken a lot longer to convince them. They seemed pretty sure that I had scissors.
I got home to find my garage had been flooded in the big storm, which was the tail-end of Cyclone Yasi. It's amazing to think a cyclone can affect the weather more than 2000km away. It had already drained out and there wasn't much it damaged, but I need to closer inspect my golf bag. Some of my garden got washed away too, but I'm glad it didn't come up just another few centimetres otherwise it would have been in my front door! My house it located higher than the town, which is 1000m above sea level, so I am assuming that the water was from the downpour itself, and not being washed down from anywhere else.
So,I do think this is due to climate change, but I didn't think we'd see weather as extreme as this for a few more decades. Goes to show, that in a battle between humans and Mother Earth, we're going to lose.
Friday, February 4, 2011
Rabbit
So, I'm putting it out there. I want to run a marathon this year.
I'm not a runner. My body is in no way built to run a marathon. Didn't Oprah run a marathon once? And I've been worried about my diet and risk of diabetes and when I did the hike yesterday I realised that if I don't get fit now, I'll never be fit.
I used to be in the Army. I was my fittest then. And still then I didn't feel fit. I used to like running about 4 or 5 km cross-country, but not 42km flat.
My friend took 6 months to prepare, but she was already pretty fit before she started. My rough plan is to work towards the Melbourne Marathon in October.
Ok so I am really scared thinking about it. It will be a lot of work, and right now my calves are killing just sitting here. But because it seems just so impossible right now is exactly the reason why I want to do it. I am also aware that I have just had 2 weeks off work and my body is in a routine which I don't normally have the luxury of. Sometimes work is so crazy that I eat, work, and sleep only. No tv, no housework. Just come home, go to bed, and go back to work again. I do, however, have a deadly-treadly at work.
I'm frightened. I have overcome pain and boredom before, but not at the same time of extensive periods. Do people listen to their iPod during marathons?
Thursday, February 3, 2011
Hiking and stuff
So, I got to tick another one off on my list of "things to do" which is to hike through Freycinet NP to Wineglass Bay. There are no roads there, and apart from boat, you must walk over a small mountain range on a very well-made, yet slightly challenging path. It takes about 2.5hrs return, but the mandatory rest on the beautiful beach adds a bit more time to the journey.
I had picked up some supplies at the Red Bridge Cafe in Campbell Town the day before and have been inspired to buy a dehydrator, ever though I hear they are not cheap. I had vegetable chips (dehydrated slices of sweet potato, taro, swede, carrot, and green beans with sea salt), then some dried fruit and apricot delights. They were so nice on the trail and down on the beach. I filled my water bottle up with the tap from the tank water at the car park, but I don't feel sick yet. I would recommend doing that back at the National Park info centre.
Tuesday, February 1, 2011
Gaiters
Have a whole day of study in front of me today, which is a continuation of last night, preparing for my weekly grilling in my online lecture tomorrow morning at stupid-o'clock. It's all about immunocompromisation and pneumonia these two weeks in a double case-study. I also just found out I can watch the recorded lectures, not just listen to the podcasts. Glad I found that out now and not at the end of the year.
So I've realised that as a paramedic I found cardiovascular easy and respiratory difficult. I can't see any other systems getting any easier for me. And, yes, yet again, it is just one reason why I'm really enjoying my studies.