Updates and Realizations...AKA: Random Blog Day

I had a huge test today. It sucked. It was hard and it was overwhelming and I wanted to cry and go to bed afterwards. It certainly didn't help that after trauma conference we sat around as a class and "shared" our clinical experience thus far. I have felt frustrated about my personal clinical experience but hearing my classmates talk about the exciting experiences they are having made me so sad and frustrated. I wanted so badly to be at my hospital because I felt a connection there. I wanted to believe that because I think so highly of the hospital and because I feel like a vested member of the team there they would value me and want to teach me. I never would have guessed that I would be ignored, shut out, and generally dismissed the way I have been in the last two weeks. It has been so awkward and generally humbling (not in the productive way but in the demoralizing way) that I don't ever want to go back. That's NOT because I don't like intubating because I do. I really do. I think it is interesting and exciting and would have loved to do more. I am bitter about it yes. It is only exacerbated by the fact that my program director actually wants me to buy them a 'Thank you gift' for accommodating me. I would like to buy them a "screw you" gift instead but I do understand the need to make nice for future classes should they find themselves looking at my hospital as an option for clinicals...NOT something I would recommend BTW! OK, enough about that...long story short....I am miserable right now...with school that is. It feels like last term was challenging but this term feels nearly impossible! It feels disorganized from the scheduling of assignments to the grading on up...nightmare!

Random musing number two is on the fitness front. I have been resisting the urge to put my wedding dress on every other day to see if my hard work has been paying off. In fact, I had resisted the urge since the day after Christmas...resisted that is until Monday. I broke the box out of it's deep dark plastic wrapped hiding place and slid the delicious fabric over my head. My heart was pounding as I put my arms down and reached for the sipper. Last time I tried the dress on it had been tight through the chest and back, and it had clung to some of the wrong places over my hips and belly. Monday night I zipped it up and turned to face the mirror and was shocked to see the change. I am only 9.5lbs down since starting all of this in the middle of December but there is no disputing the change in my body. My arms are beginning to take a more proper shape and the "bubble wrap" under my boobs and on my back has begun to fade. My belly is even taking on a more toned shape...no more food baby, baby! Even the Hubbs has pointed it out. I know it is hard to notice things like subtle weight loss and body shape changes when you see someone everyday but we were at the gym the other night and he got on the treadmill next to me and said "honey your butt looks smaller. You ARE losing weight!" He is not the smoothest operator out there but I could tell he meant it because it was all awkward and surprised. As nice as it is to hear that stuff from him, I am not doing it to "get" him or to make him think I am sexy...God help him, he already thinks that! I am doing all of this so that I feel sexy to me and feel healthy, so I can feel good about growing a baby in this body or raising a baby in a healthy lifestyle. I am doing this for the wedding dress too. So far I am down a pant size and making huge strides in the dress department. I'll keep you posted.



Random musing number three...Things that have changed since getting married. #1: We "fist bump" ring hand to ring hand. Vomit! I know, but the Hubbs thinks it's like "the Obamas honey...it's cool". I humor him. It makes me happy to see him all silly over our rings. It makes me happy to see him happy...more vomit, I know. Thing #2: We graduated from therapy the other day. It was never hard to go or to work on things in between meetings. I really think Tim (our guy) just helped us trust in the strength of our relationship even in the face of our struggle this fall. I think I more than Hubbs needed an outside, unbiased, uninvested voice of professional reason to help me clear away the mental clutter so I could see how good I have it. How good we both have it. He was so sweet as he told us he thought we were on the right track. "You can always call me or email me to make an appointment but I don't think we need to set anything up at this point. You two seem very happy and grounded right now. I see good things to come". It was so nice. I feel that way too but I think I am biased and I am always afraid I am deluding myself...What makes me even more nervous is that I don't even care if I am deluding myself. I am so happy with Hubbs and so happy to be married that it doesn't matter what anyone thinks. Thing #3: Is in the same vein as thing 2. I realize that sometimes I am high speed and he is not and vice versa. Today was a perfect example. After my test I was despondent. I was hungry and exhausted and pissed off. I mostly wanted to eat melted cheese and go to sleep. Hubbs was on full boogie talking about the EMS research he thinks he would like to conduct but knows politics will never allow. He was going a thousand miles an hour explaining all of this and I was for all intents and purposes Homer Simpson...all drooly and "Ghaargh". I have almost no idea what he said. It is not that I lack interest or that I routinely do not pay attention. What I am reflecting on is that this never seems to be a problem for us. We take turns being worthless and vegged out. The important thing is that even when exhausted or despondent or maxed out we go to one another. Just spending time be it sleeping, running errands or walking the dogs, is quality time together. It is what recharges us. Being together is always better than being apart. I spend plenty of time on my own, 4 nights a week in fact. I like my alone nights but I love snuggling in between a dog and my husband. Even if he or I am yammering away while the other one actively passes out. It's just better together. I know this is all a leeetle on the random side but it has been a long day. I am mostly ready to head to bed and am now just waiting for the Hubbs to get home so I don't pass out before he gets home.

Fitness day 46
Down total of 9.5lbs! Woot!
Get-ups x 7min
Water aerobics

Things That Make Me Homacidal...re: jack asses in the OR

I am back in the OR today for another run at some intubations. I woke up at 0550 in order to get myself together and be on time 0700. I arrived at 5min to 7 to find the place a tomb. No one was there. I found the charge nurse making coffee in the break room and she informed me that Thursdays always start at 0800. "I always ask if they are going to tell the students and they always say it would be too confusing". Too COMFUSING?! WTF?! We are learning how when and why to paralyze people, how when and why to shock people with electricity and how when and why to do nothing more than provide 02 for people. Coming in at 0800 on Thursday is beyond our simple medic brains? Jeeezus! Anyway, after getting over that I went to the atrium where there was a beautiful sunrise happening just outside the window. I had some coffee and did some homework. It was a pretty nice start to my day after all.

I made my way back down to the dungeon and looking at the schedule saw it was going to be a mostly LMA day. LMAs are an airway device that sits above the glottic opening and occludes (mostly) the esophagus allowing ventilation of the trachea and thus, lungs during surgery. They are mostly NOT used in EMS as they are not a definitive airway and they do not block the esophageal opening enough to prevent aspiration (at least not to the standard of most medical directors). They are however, quite popular for healthy pts having routine and short surgeries with the opportunity to fast beforehand to avoid vomiting and aspiration...and all the associated baddness. So, LMAs mean very few intubations.

On top of this there is a Life Flight RN in the OR today trying to get some tubes himself. There was a similar situation on Monday and Bernie and I worked it out. This guy today was a different story. A jack-ass, big, dumb, tube stealing, jerky themed story. I went to my first case and asked if Dr Scott, the doc I worked with last time who had been so wonderful to me, would allow me to shadow him and maybe assist. This is how I approach these guys. They don't want a tube whore they want a student. He told me he was going to LMA her and there wasn't really anything for me to do. I stood outside, waiting for my coffee to kick in and hoping something else might roll by. I heard the overhead pager "Lifting help to OR 6..." That was something I could help with. I walked back into the room and said "I can help lift". Dr Scott looked at me and said "You just earned yourself a tube." We moved the pt, I applied 02, then he put her under and I started preoxygenating her.
C-E seal and jaw lift as shown in this pic I pirated from the intertubes...I had her at 100% and had the doc happy with my technique. He told me to intubate and I took a look and thought I saw the cords and promptly tubed her stomach. Bummer. I was sure I was gone but nope. He told me to pull it out and get back in with the blade and show him my landmarks. This time I placed it and saw mist in the tube, equal bilateral chest rise and fall as well as a proper end tidal C02. I was in. He taught me how to tape and then we positioned her for her procedure. I was so high! I LOVE Dr Scott and I don't care who knows. He is my hero. My airway guru. Unfortunately, the next 2 cases he had in the day were going to be LMAs for sure as they were young healthy peeps with minor surgeries. Bummer!

I went on to find my other buddy Dr Pan. He had been quick to recognize me the other day and let me take a crack at the tube in the young woman with success. He was quiet but very nice and very helpful. I had seen him earlier but had not had the chance to ask about his cases. I was standing talking to the LF RN who had already been kicked out twice after missing 2 trys this morning, and I said "Oooh, I need to ask Dr Pan if I can get in on his late morning surgery, he's great." The charge RN came up to tell me something about tomorrow and the instant Dr Pan hung up the phone the LF RN went over and asked him if he could tube the late morning pt! What the FUCK!!!!!????? Pardon my french but the F word doesn't even begin to do justice to the horror of this dude's actions. What the hell kind of person does something like that?! What a shit head! Dr Pan of course, said yes. The LF RN smiled at me and I said "Nice, thanks" and walked away. There was nothing else to do. That was the last shot of the day. Fuck him! This means I got ONE tube today. I know that's better than none but c'mon! ONE after that bastard misses 2! and then steals mine?! I am pissed. He knew I am a student. I am not getting paid to be there I am paying to be there. He is on the clock! He only needed 2 tubes to be up to date. He will have had 4 tries if he can even make the next one. What a jack ass. I felt like saying a whole lot of "I hope you...." but wishing ill on other prehospital providers is bad mojo as far as I am concerned. When people are taking care of other people's lives you don't wish them ill. Especially since the Hubbs wants to fly some day. I just think it's poor form. So, I wish that someday really soon, he does something heroic. Something truly newsworthy...something that gets him on TV....maybe national news....and then I hope the butt of his flight suit rips....wide open.

Fitness day 42
I am down a true pant size! Woot Woot.
Water aerobics today again...
Also probably some weights. Feeling good. Love being at my own hospital so I can plan a work out before heading home. Makes things MUCH easier!