Psychiatry Resident

I love it. I could easily be a psychiatrist. It's just very interesting to me.

I will continue my GP training pathway though because I do want a life outside of work and GP provides the best work-life balance. I will do extra training in psychiatry though.

For the past two weeks I've recommenced my TAM (Tracy Anderson Method) workouts. This time I'm streaming! I absolutely love it. Tracy has really grown i the past few years since I've not done her method and I'm very happy with what she's up to. There is a lot more focus on paraspinal strength and functional strength and mobility. Also on the mind-body connectedness regarding not just movement but strength and health.

Already I feel brilliant. What i really wanted was the energy and strenghth to play with my kids more, both at home and at the playground. So often I get there and just want to sit down and have a coffee. Yesterday I finally got that motivation and energy back and went on the pay ground equipment and they climbed all over me and I felt good within my body.

MY aim is to do it daily, allowing a day or two missed a week if necessary (but hopefully not).

Another random update

I'm on annual leave at the moment, so I'm enjoying not stressing about anything.

I just got back from a most excellent road trip in Tasmania where I got to enjoy the magnificent natural beauty down there.

For the rest of my time off work I'm generally focusing on my fitness. I've had enough time to not have any excuses not to workout daily, and now I'm building a bit of a morning routine which I hope to carry with me into the craziness that is my work roster. My goal is to have the diet and fitness sorted before returning to med school so I don't have to worry about falling back into bad habits like caffeeine abuse and junk food use.

I've been still eating a mostly fruitarian diet for nearly one year now. I find the more fruit I eat, the better I feel, however cooked starchy carbs call me most afternoons/evenings. I seem to have finally broken the bread addiction, which in my opinion was the hardest to break.

My current day's food look a bit like this:
A large bowl of watermelon
About 10 mandarins and a few bananas
A few handfuls of raisins during the day as needed
Steamed potato or sweet potato or pumpkin with a handful of baby spinach
Then I make some sort of semi-raw dinner (last night was a sort of shepherds pie with raw grated zucchini/carrot/tomato layers and a layer of mashed steamed sweet potato)
And of course more water during the day
I also tend to have a few pieces of dark chocolate, maybe every second day. That's another difficult one to break.

I stopped drinking juices and now only drink water. I make the occasional watermelon smoothie or banana n'ice cream but I'm trying to eat fruit in the whole state.

My workout consists of about an hour (sometimes longer) of the Tracy Anderson Method, 6 days a week. I first do 30 mins of dance cardio, which is high-intensity, high-impact, and then 30-45 minutes of the muscular structure work which changes every 10 days. The Metamorphosis series has only 30 mins of musc, but I have an Mat DVD of heres which goes for 45-60 minutes and I really love it as it has standing legs (instead of on the ground) and more arms and abs, so I rotate that one back in every few days.

The main thing is, I'm sweating. I'm improving my cardio and I am really toning up nicely. I am not losing any weight though, which is really frustrating, but I keep reminding myself that this is a long-term process and not a quick-fix like under-carbing. I feel pretty good about how I look, it's just that it's annoying that half of my clothes don't fit. When I get up in the morning and look in the mirror, I'm like "Man, I'm looking good" but then I try on some of my clothes and they don't fit and I get upset. Such is life.

I am also doing taekwondo. It's on 3-4 times a week and the classes are really long at 2.5-3 hours. I'm going for my 7th kup grading next week so I'm trying to make the classes but on my annual leave I'm desperately trying to catch up with people and that gets in the way of evening training. There's also a Monday night social netball comp I'm now involved in. It's just held in my little town here, so I can even attempt to play when I'm on-call. Another girl in the team is from work so she's got it all down pat. It's good to have something to do in town.

So, I return back to week next week and I'm performing higher duties for the month, which means I wont be able to study as much, which means I'll have only 2 months of proper study before returning to med school. And...the anxiety flutters back through again.

My darling bf is currently doing assignments and studying for exams for his psych degree. He's so stressed and everything else in his life has been put on hold and he's procrastinating, and it's interesting to watch someone do that to themselves from an outside perspective. I really don't want to do that to myself when I go back to study. I did well at banning myself from stressing in the Chinese med course, but then again I was only doing 3 subjects (75% study load) and it was pretty easy compared to med school and it was only the first semester. But... saying to myself "I'm not allowed to stress" and "I'm prohibited from stressing" etc really worked well and I'll try to do this when back at med school.

Also, I've just completed the recruitment for St John Ambulance (volunteer first aid/med team service) so I will be volunteering with them as a paramedic and medical student in their medical team. They do events like the Iron Man and music festivals. I worked along them as a paramedic a few times (paid with my job) and saw other med students get some much practical experience and develop into really good emergency physicians that I want in on that action!

I've also got to tee up another observation placement at the GPs. I might ask him (the GP I shadow) if I can go in tomorrow seeing as some of my plans have opened up some space. He's only available for me to shadow Tue, Wed, and Thu. It's a really large multi-clinic so it's such a great experience for me there. I feel the volunteering stuff will give me more confidence that I can actual do this doctoring stuff. Being lost in textbooks isn't very encouraging right now.

Oh, I've also been listening to Jodie Whitely on YouTube who does hypnosis/guided meditation and I find listening to her at night sends me into a nice, deep sleep. I don't have that many sleeping problems, but with shift work and the chronic anxiety I had a while ago I found the hypnosis to be a really great tool. I can recommend it.

Tonight, I'm off to a Tibetan Buddhist centre to have a vegan meal and have a lesson on....can't remember. I think it's the Four Noble Truths or something like that. I listen to lessons occasionally on YouTube. I like the Dalai Lama, but the lessons can be long. I don't have much patience for long lectures which is why distance education works well for me.

That's my wrap up. I will try and post more again when I go back to med school. For now, it's all Kaplan and Dr Najeeb revision stuff.

If it ain't rainin'...

...it ain't trainin'.


Sorry about the sideways picture again, but this was my run this morning in the cold and rain up Windy Hill and towards a rainbow!

Code Red and ravenous

I'm at Code Red. I feel anxious and stressed. I worked until 3:30am this morning and just couldn't attend my lecture. I was also under-prepared and so friggin tired from the weekend. I feel like I've lost the plot and I don't know where to start.

It is really not helping that I've been on a diet. Cutting out refined sugars is NOT helping! I know it will be better for me in the long-run but I wish I had waited until after the end of this term. Now I've done really well to get my BMI from 24 to 23 I don't want to undo all this hard work.

I'm quite ravenous after my morning run, lack of sleep, and lack of food (I had watermelon for breakfast). Completely cranky. I should really end this rant here.
------------
Off to go figure out my damage-control plan for this term...


EDIT: Sorry for this terrible post. I had some more breakfast and feel much better. I shouldn't be allowed in public so hungry.

Reality: I only missed one lecture. It's best not to miss any, but it's no the end of the world. I normally miss 2-3 every term and I have decided previously that this is acceptable collateral damage to continue working full-time. Also, I normally have lulls in each term, that was mine. Now to stop complaining and start taking action.

Furniture mahjong

Just moved and thoroughly cleaned a whole bedroom on my own. No need to workout today.

Running with the dog

I took the dog for a run today during my 10-hour fatigue-break. I normally sleep the whole 10 hours but today is my last day at work for the week so I got up earlier in the hope of sleeping tonight at a reasonable time.

The weather isn't the best today but I thought to myself that that is the reason I have all the cold and wet-weather gear. We managed to stay dry on the 2.5km run but my ears are still frozen.

So today I wont have much time to study at work as it is such a short day for me now but that is ok because I actually got ahead yesterday. I discovered that I need to take more regular breaks now that I'm actively in calorie deficit but I was still able to get a lot done.

iPad and no service

I've been trying to blog this weekend but my iPad Blogger app wont work and I'm not get enough signal strength on my mobile anyway.

So, my boss quit and now he's been packing up everything this weekend. It's so sad. He has been going though his stuff and found a lot of old paperwork he doesn't know why he ever kept in the first place. It has made me think I really need to go through my draws in my study at home and the top shelf of my locker at work. I generally take pride in having a clear in-try and in-box.

Being a vegan is going really good for me! My diet and workouts have been going really well too. I just had to motivate myself a LOT and during the day if I think of inspirational things I write them in a memo to myself in my phone.

Study - I have done a bit this weekend but not as much as I should have done to catch up (for various reasons - work, personal life commitments). It's ok. I'm not panicking just yet.

New Years Fitness Resolution

After working until 5.30am I got up "early" and did a workout. It is now only 3pm on 1/1/12 but I've already refused donuts, bbq shapes, chocolate and coke.

I got my Nintendo Wii in 2008. Today is my 1333rd day since I started using my Wii Fit!

Back to reality

I'm well-and-truely back to reality - I'm back home, back at work, and back into studying!

Today is the last day of 2011 so I'm having my last McDonald's breakfast hehehehe.

On today's agenda - at work, so normal work duties which are minimal, but I would like to clear out my locker ready for the new year. We have new Clinical Prctice Guidelines and I was waiting for my new copy to turn up but it might be weeks so I will look at the electronic version instead.  There's my Masters readings and I can even do the first two assignments for one subject if I wish, presuming they haven't changed (much) since my first attempt.  Then there's the molecular biology I threatened to learn about of before next term (which starts on the 9th of January) and my academic advisor keeps asking me about but that is going down like drinking nails. I hope to find some good YouTube videos on that subject because my textbook is about the most boring thing I've ever read in my life.

That's about it.  Oh yeh and making my home gym more gym-like and less laundry-like and getting good, healthy food ready for my New Year's resolution.

Survival stroke

Survival stroke was a swimming style we got taught in school as kids - ie how to not drown.  That is what I feel like I'm doing this week in med school.

We were busy at work, and because I feel like I totally stuffed up last week and I have a few extra pressures coming up this week, I sit down, look at what I have to do, have a mini-meltdown, and the completely freeze-up.....

Ah, that reminds me of a story.....

I have been mentally collecting stories of the best (ie worst) excuses for calling an ambulance and getting despatched to.  Out in my rural area, these types of incidents are few and far between.  The best one I have personally got despatched to was a cut finger while cooking.  A few nights ago I topped my previous personal best of "hungry" and "scared of thunder" when I heard a city crew got despatched to a "brain freeze" - yep, the kind you get after drinking a slurpee too quickly.  Seriously.  How does that even make its way past the call-taker to the despatcher.  I'd love to know what the paramedics had to say to the caller.

But I digress....

I'm in brain-freeze myself, but the other kind.  The kind that makes you go completely mentally blank.  If I was trying to write a novel it might be called writers block perhaps?  Or is it pure procrastination?  Overwhelment (yet again)?

I'm in damage control. Again.

In good news, my fitness regime has been going surprisingly well!  I hope I can keep it up.  I've decided to workout every day on my days off, and to not worry on my days I'm working.  That's still 7 days a fortnight which is pretty good and includes cardio and muscle workouts - TAM of course.  I caught a quick glimpse of some surprising muscle definition this morning and I am again a converted follower of Ms Anderson.

My diet has been going well.  My sugar cravings have diminished quite a lot which is good.  My brain is getting used to functioning on slow-release carbs and fruit instead of lollies and Coke.  This has to be a good thing.  I'm still into my tofu and veges.  I craved a cheeseburger last night, got one, ate about two bites and  seriously couldn't stomach it.  My dog was happy about that.  I'm not sure what has happened to me - this doesn't usually happen.  I can still usually have my cheat food day, but this week I struggled to eat a Cheery Ripe.  I had to eat half, take a break, and eat the other half later on.  Well, I think I know what's happened - I started drinking this meal replacement called Rapid Loss.  I got sucked into the infomercials and I'm kind of glad I did.  It's working well for me.

So this morning I had a meeting online with my academic advisor and we started going through molecular biology and the basics of pathology, you know, just to add more study on top of my endocrine case studies, the intergrated learning series, etc.  Ugh.  So I looked at the MIT free online courses (Open Courseware) and I've ordered the molecular biol text to do their course.  WTF?  When will  Ido this?  Ugh. 

Overwhelment.

Damage control.

Survival stroke.

Sugar

Trying to keep up my schedule, utilise maximal brain power, and keep my good humour are all very difficult to do on a calorie-restricted diet.  But seeing as my weight ballooned to an all new high last week, and new research is strongly suggesting what most intuitively know that it is much  better to never gain the weight in the first place, I decided I needed to take action asap.

I'm happy to report I'm back down under the previous personal record of top weight to my "comfortable" weight, but I'm going to try and get down a bit more towards my "happy" weight.

Studying is much easier for me under the fuel of lollies, but as I've said time and time before, my medical studies are not going to come at the cost of everything else which is important in my life.

Speaking of studies - we've been really busy at work.  This is good in one respect because the call-outs over night are earning me enough money so as I don't need to do any over time atm, which is doubley as good because I have stuff to do on my days off  including study and more study.

Today I was sleeping util noon (we were working until past 2am) and I started studying the adrenal glands in Robbins for an hour before having to work again.  It's now nearly 5pm.

So, again, I must go back to it.  I'm hoping to get an hour and a half done before going on-call and then I'm hoping to do a TAM workout as I just got my latest Metamorphosis dvds in the mail this morning.

Links and yikes

Yesterday I got to almost finish my case study - that wont take long this morning to complete.  I also got to read a little in the Anatomy and Physiology book which we have here at work in our mini-library which the staff have just formed over time with book donations. They are all very old and probably a little out-dated, but never-the-less.  The readings this case aren't too massive so I'm staying optimistic that i might get them done this week.

I also did another section for my PT course and have seen I really need to do more on that to get it done in the allocated 12 months, seeing as I'm half-way through! Yikes!

I've added a few links to interesting articles.  I will try and do this regularly.  The first one is about a fellow OUM student. 

Student on a mission
Intern squeeze could hurt reputation
Rural doctors say scholarships are key

Off to go read/learn.

At work

Seven working days left until holidays!  Yay!  And that includes a training day, so only 6 left on the road (with six nights of call, unfortunately).

I just looked at my ambulance station's stats this morning, and our workload has more than doubled since changing onto this new despatching system.  This could be a very good thing if we want to get funding for a proper night-shift here and stop doing call... Ah... a girl can only dream....  The good thing with more call-outs though is more money.  It seems to be getting a bit easier to meet my tuition fees right now.  Feeling fairly good.

Masters - Essay one of two has been commenced.  I'm giving myself until the end of Tuesday to complete it.  It's about the epidemiology and burden of STIs and HIV in India and the second part requires me to decide on priorities for programs in the prevention of STIs and HIV.  It feels strange to write an essay again seeing as I don't do them in med school right now, but I'll just work through it systematically as usual.  Start with the heading and subheadings, collect data and references, and mould it into a coherent piece of writing.

Easy?

Fitness update - it has totally been sacrificed for everything else in my life.  I had a great conversation with a guy at work that is the perfect picture of good health and fitness and I watched him throughout a working day and he had already gotten up really early for a run so was planning to do not a lot after work, then spent the rest of the day preparing and cooking meals every few hours, shopping for more fresh groceries etc.

My other friend at work that works out every day puts all her energy into getting a workout done that everything else gets done second.  She eats fairly "normally" though but is not a high performing athlete like the guy from the first story.

So, what I'm trying to say is I haven't found that perfect balance for me yet but I'm still searching and I wont give up because right now I feel soft and sluggish.  Yuk.

So unfit

After just 2 days of manual labour around the house I am so sore, so tired, and feel like the most unfit slug/blob in the whole world. So horrible enough to friggin do something about it.

In bed now resting my aching body.

Must find trackies in the morning. Actually looking forward to it. I have all day spare at home while my fence gets finished.

Goodnight.

PT couse and internal chatter

Well I finally submitted section 1 of the first assignment for my personal trainer course.  I'm not sure how long it took - probably longer than it feels - but I'm happy that the ball is rolling along in the right direction albeit slowly.  Not bad me thinks for the hours I'm working and, oh yeh, that medical degree I'm doing too.

So in my med degree the modules are fairly independent from one-another, that is, there is no sort of pre-requisite in the pre-clinical module from one module to another (except the first one in biochemistry) and the learning is sort of more horizontal than vertical.  This is all fine, except I'm in my second year and I feel as clueless as I did last year.  I'm just starting to realise it's because I'm not necessarily building on past terms, one on top of the other, it's more of a building side-by-side, and accumulation of breadth at constant incredibly scary depth. I've been doing practice USMLE World question and I'm, like, "I don't know anything!"  but it's really I don't know anything about the musculoskeletal system (yet).

Well with section one of the PT course submitted at least I can relax and I wont feel bad if I completely leave the next section until this med term is over - in 4 weeks!  Eek!

Don't tell anyone, but we didn't do a single job today at work (I was on over-time, "the perfect crime" as my work colleague put it)!  Not one!  And after a great amount of sleep-bank deposits yesterday I studied from 7am to 6.30pm tonight!  I'm so proud of myself.  Then I just did about 30 mins on that PT assignment to get it submitted.  Feeling like I accomplished something today.

Well, only two months until I go on my trip now.  I changed shifts today with someone who went to Nepal two years ago so I got chatting to him and a good lead on a good tour guide in Kathmandu (for the first week where I still have nothing planned and plan to keep it unplanned until I get there as the rest of my itinerary is already mapped out).  Then I got on eBay and had an interesting discussion with myself on whether North Face clothing was worth the money and whether I would be a victim of marketing/consumerism/capitalism if I bought a North Face down jacket.   The internal jury is still out on that one.  Standby....

Practicing Buddhism seems to have increased how much I notice my internal chatter, so don't be alarmed if you're not used to listening to the internal chatter.  The say the difference between a mad person and a sane one is mad people talk out-loud.  I'm also still deciding whether talking to my pets is crazy or not.  At least I'm not talking to the wall...

Epic fail

So I just did my weekly mini-quiz and totally stuffed the whole thing up.  I'm so unimpressed with myself.  Feeling really down now.  But there is nothing I can do now, I just have to keep moving forward.  The only thing that is reassuring is that I was doing bad in the other modules in the beginning but pulled it all together by the end.

My next case study is "Fractured humerous".  It's the 4th out of 7 for the term.  Our learning issues surrounding this case are;

• Anatomy of the upper limb (skeletal, muscular, vascular, innervation) - here comes the brachial plexus
• Mechanisms of pain (physiology, biochemistry, pharmacology)
• Pathophysiology of hand weakness
• Consequences of vitamin D deficiency
• Pathology of fractures
• Clinical features and management of fractures.

So, yes, starting afresh tomorrow.  Too bad I have a mini-quiz for last week's case still to come. 

Oh well.  Hopefully I'll feel better tomorrow.

I think I'll try and finish a section of the PT assignment and sent it off to feel like I've achieved something.

Harrison's and the curse

I'm back at work now on my normal rostered shifts.

I spent my whole day yesterday grocery shopping, cooking a roast, making stock from chicken bones, baking protein muffins, and making a beef and brown pasta dish... And after all of that I think I've only got enough food for about 3 days!  I did a good workout though, so I'm happy about that.  It's much easier on a day off, but I'll try and find some time today again.

Right now, I'm obsessed with Harrison's Principles of Internal Medicine.  I got a cheap old edition a while ago because I heard it was a great reference text to have.  You can get the 14th edition (~1995) for about $1!  Slowly, slowly I've been replacing my old editions with newer ones and donating the old ones to work's library - I've pretty much double-it now. 

The books I donate I put a Medieval "curse" on the front of them that I first saw at the hospital library in Warragul - a little country town, where I did my emergency department and anesthetics clinical placements for ambulance.  The curse goes:

For him that Stealeth a Book from this Library,
Let it change into a Serpent in his hand & rend him.
Let him be struck with Palsy, & all his Members blasted.
Let him languish in Pain crying aloud for Mercy,
Let there be no Surcease to his Agony till he sink to Dissolution.
Let Bookworms gnaw his Entrails in token of the Worm that dieth not,
When at last he goeth to his final Punishment,
Let the flames of hell consume him for ever & aye.
I think it works better than the electronic devices!  I'm scared!

Ok, so I'm going to read the chapter on joint pain in Harrison's now as I am still not motivated to look at bone anatomy.

Things I'm learning

This week's case study is osteoarthritis, and there are some new medical terms I am coming across;

• osteophytes
• subchondral sclerosis
• subchondral cysts
• Herberden's nodes
• Bouchard's nodes

When there's not much going on in the case study, I guess you hang on to whatever you get!

I'm still too bored to read all about bone anatomy, so I'm currently looking at the musculoskeletal section of First Aid for the USMLE Step 1.  I wont get my 30-day subscription to USMLE World Q-bank until Week 5 or it will run out before the end-of-term exam.

Even my presentation this term on Paget's disease is not overly exciting.  Sheesh.

I know somewhere in this module the infamous brachial plexus is going to turn up, so I might as well start looking at that too.

I'm pretty happy with  my current understanding of NSAIDs/paracetamol and the DMARDs.  I suppose I could look at bisphosphonates and perhaps a little more biochem in the areas of gout and inflammation.  Yuk.

I also have a gaping hole in my knowledge of genetics, but my genetics book looks so scary.  My lecturer (Dr Laura Gunder) has authored a textbook Essentials of Medical Genetics for Healthcare Professionals and I'd love to get that one.  I might check the hospital library for it this week.  All other textbook purchases will have to wait a few more weeks at least.  I also really, really want Murtagh's General Practice as I love the way his companion handbook is set out.  That one I know they have in the hospital library, but I want my own to draw in!

And reading Metamorphosis-time.blogspot.com by Bethany, I am so jealous of her results!  Dang.  My friend at work is also looking awesome.  We started trying to get in shape together a few months ago and she kept going and I fell off!  I need to get back on the wagon.  My excuse is she is one of those people that only needs about 6 hours sleep a night.  But excuses don't get me anywhere!  So I just made a fortnightly(!) grocery list for tomorrow, this time trying to keep to bill down as well as being extremely healthy, so I went through my cupboards and have found plenty of ingredients I don't need to buy like brown rice, brown pasta, tea bags (not my fancy organic oolong, but oh well), and chicken stock power (not my fancy organic, non-MSG stock, but oh well!).  I tend to do better if I commit 100%, so let's try again!  At least I can still see most of the great definition from TAM (like I have mentioned before, I'm a 50/50 mesomorph-endomorph).

Anyway, just realised the time and I have to go get ready for my 14-hour night shift :(

Busy

It's started again - I'm flat-out with work and study.  It feels much busier at work now that I've goone back to study.  It has been a busy day but I've been studying on all my downtime so it feels even more draining.

It's 9pm and I just got home from work and ate Indian takeaway for dinner.  I am in fear of letting my fitness totally get out of control.  I am really glad I'm doing the PT course to centre my goals and bump up the important of fitness in my life.  I type this now while drinking a glass of coke...

I bought another Doctors in Training Solid Pharmacology lecture today.  I find them excellent, but mostly because they are convenient to by at just $12 each, they reference my Lippincott's text, and they perfectly supplement my course which is really self-directed reading heavy with a bit of audio/PowerPoint covering the case studies.  It's good to have pure pharm video lectures that go over key points.  I bought the anti-inflammatory ones - there's two: one mainly on NSAIDs and paracetamol, and the other on DMARDs which I wanted to watch before tomorrow but I'm running out of hours in the day now.  Sheesh.

Ok, just realised tomorrow is Thursday and I'm starting to panic about these new end-of-week mini-exams they introduced this term.  Crap.

New gym

I've finally converted the spare room into my gym/workout space.