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Thursday, December 30, 2010

and then there were three


So long to another rotation. Done and over with. See ya!

Today was my last day at the VA~! and that makes me oh-so-happy. It was a great month. I ended it on a positive note by saving a man's life. Well, I didn't save his life...I just didn't ignore him, and he got the care he needed. It had a happy ending. :) 

He also told me that "if Pharmacy school doesn't work out for you, then you should be a super-model". LOL, I told him, "No sir, I doubt it, plus I am way to old for that"...then he said "Nah, 40s the new 20" Um......HELLO, I am NOT 40!!!.....  Talk about a back-handed compliment. Haha!

The VA was my sixth rotation out of nine! And now there are only three left. WOW~ !

On another exciting note....I have started applying of jobs.  I was contacted by a past preceptor...she told me that the Children's Hospital, where I was on rotation in October, will be hiring 6 new graduates to start next summer! That would be perfect timing for me. I applied for the job the next day.

My preceptor from this month told that there are two job openings that I should consider applying for...they are both located about 30 minutes from our house in really RURAL settings. One is a small office that is essentially made up of one doctor, 2 nurses, and one pharmacist.  Evidently the fact that is a small office out in the country with a small staff is a turn-off for some people. The other is a work-from-home opportunity. I applied for both. :) I would LOVE LOVE LOVE to have either of these jobs.

So, I have some prospects.....in the meantime, I am praying that the right opportunity will come along for me and our family...*fingers crossed*

Next Monday I head back to the Children's Hospital for another month. It feels a little less daunting because I was there in October and have already met some people. But first, a three day holiday weekend ahead.

I can't believe it is almost 2011~ FINALLY! It's gonna be a good one.

“The future belongs to those who believe in the beauty of their dreams.” Eleanor Roosevelt

Wednesday, December 29, 2010

winter wonderland


Here are some more pics of our first snowstorm in OH! Karsen knows the rules~ We can't play in the snow until we pose for a pic or two.


This was our first snowstorm here, so the kids were really excited.


Dylan (left) was eagar to run off and play with his friends in our neighborhood. Evidently, it isn't cool to play with Mom and Dad in the snow. Not so fast, Dylan. Of course I had to get a pic first. His face makes me laugh. His eyes are basically saying, "mom, you're embarassing me!!!" LOL I hear that all the time these days!


Even Chris had fun "working" and clearing the driveway. Can't you see the excitement on his face? LOL, well nevermind... (Yes, I have a corny sense of humor.)


Then they got busy working on a snowman....


TA-DA!!! Meet "Joey", our first OH snowman!
I am sure there will be many more to come.


Look who else was out enjoying the winter wonderland. SANTA!
He was strolling through the neighborhood (behind a fire truck) giving out candy canes.


It was so beautiful that I did not want the snow plows to come clear the roads.

We can't wait until the next big snow!



Friday, December 24, 2010

Merry Christmas 2010


Merry Christmas from Dylan, who has chocolate on his mouth and is telling me to hurry up and take his picture so he can finish the cookie he has in his hand. Dylan basically eats like it is the holidays 12 months out of the year, so he is especially enjoying the fact that something is constantly going on in the kitchen, and we are letting him eat 24/7. Tis the season!


Merry Christmas from Karsen, who wants me to point out that her pajamas are new and were the first present we let her open tonight. She took a break from her I-Touch App that is literally counting down the seconds till Christmas to let me take this picture. Christmas is T-minus 0 days, 2 hours, 13 minutes and 11 seconds away, people! Can you stand the excitement?!  We get updated about every 3 minutes! Ha!


Merry Christmas from our family to your's!


Sunday, December 19, 2010

weekend snapshots


Beautiful Christmas lights.....



a surprise visit from our favorite family in NC.....



Best friends playing the snow in camouflage hunting gear. NC meets OH. Can you believe Christmas is in 6 days?!
 

Monday, December 13, 2010

first big snow ...


for us
together in OHIO.


Saturday, December 11, 2010

Friday, December 10, 2010

courage

(google)
I knew the Veterans Affairs Clinic would be an interesting month for me...So far...

on Day 1: A patient barked at me in the hallway for no apparent reason.

Day 2: A patient came in and after I talked to him for 20 minutes I realized he was wearing a sweatshirt with a big deer head on it that said WELL HUNG TAXIDERMY.

Day 3: My clinical pharmacist preceptor is about 5 months preggo, and our patient noticed and said, "I didn't know you were expecting?! I thought your butt was just getting big!"

Day 4: Diabetes Clinic: A man came in with uncontrollable blood sugars due to non-compliance (eating poorly and not taking his oral meds and insulin) and after I told him all the body systems his diabetes could negatively effect: his eyes, kidneys, nerves at his extremities, and that it could even cause erectile dysfuntion....He screams, "Now, you got my attention!"

I have spent time in various clinics: Coumadin management, Heart Disease Risk Reduction, Diabetes Care, MTM, and Lipids.  I feel passionate about this patient population because my Daddy and father-in-law are both Veterans....and there is so much NEED. They need our care; it is the least we can. In 10 days I have heard as many stories that would just break your heart and make you cry. They are in pain, emotionally and physically...but their resilience is awe-inspiring.

It is a bittersweet mix of feeling a great deal of satisfaction when you feel like perhaps something you tell the patient may ultimately help them take better care of themselves....versus feeling so sad for the patient that tells you he has PTSD and stays "hunkered down" under his comforter each day until the sun goes down. At the end of each day, he tells himself, "I will try again tomorrow."

Then you have the moments where they crack you up, make you laugh, or shock you! Thankfully, (due to my crazy family and interesting upbringing) I am not easily shocked. I feel at home and quite comfortable there.  What does that say about me?

Regardless, I thought I would be learning a great deal from my preceptor this month, but I am learning much more from the patients.
“Keep your fears to yourself, but share your courage with others.” - Robert Lewis Stevenson


Wednesday, December 8, 2010

Thursday, December 2, 2010

Being 9 rocks!

Since Karsen turned 9 a couple weeks ago she has.....

 a new-found confidence

  and has been a little more sassy

and is just as silly as ever.


 Actually, she has always been sweet, confident, sassy and silly.  
 We can't believe our baby is 9. She is growing up so fast, but she will always be our baby.
And according to her, "Being 9 rocks!"


Wednesday, December 1, 2010

Rotation #6: VA Ambulatory Care


It's December 1st! Today I start my 6th rotation at the Veteran's Affairs Ambulatory Care Clinic. It will be a major change from the kiddos at the Children's Hospital last month. I hadn't thought about it, but when  I went to give fingerprints at the VA (they have extensive security checks before the rotation starts) I checked in at the front. A few minutes later, a woman came up to me and said "Hi, Heather, you can come with me"...I guess she could see the surprise on my face. I was wondering how she "knew me". I had some government conspiracy theory going in my head....lol when she leaned in and said, "Well, you are the only woman here, so I figured it was you". Ha! Duh!

I looked around and just saw dozens of men, and then there was me. I had not thought about that aspect of the rotation.

Well, I am going to read up on anti-coagulation for the coumadin clinic and diabetes management for the out-patient counseling I will be doing. It will be a refresher for me, but it is amazing how stale your brain can get when you have a month off.

I want to make a good impression because they have a job posted at the VA that I would LOVE to have. Wish me luck!

Tuesday, November 30, 2010

thanksgiving 2010



Hope you all had a Happy Thanksgiving. We had a whirlwind of a trip home to NC. I mentioned that I would be offline for the week, since we would be in BFE. I assure you that I was indeed in BFE. We were down a long dirt road, where there is no internet access there, and cell-phone service is iffy at best. I love it!!  It is the perfect place to get away from it all and enjoy time and good food with family and friends.

Chris shot guns with his Daddy and made some memories with his brothers. They had a good time with a variety of guns that all make alot of noise and scare me to death. I cooked the entire Thanksgiving spread with with his Mom, and Karsen learned how to make home-made buttermilk biscuits. YUM!

Everyone was BLOWN AWAY by how tall Dylan was. A few months ago he was almost as tall as both of his grandmothers, this time he was much taller than them. Everyone wanted to know, "What am I feeding him?"

We enjoyed sitting by a fire roasting hotdogs and marshmallows and making s'mores with all the cousins in SC. That visit was long overdue.

In all, we made four stops along the way through our NC and SC trip, slept in 3 different beds, ate turkey with all the fixings two days in a row, saw one of our favorite families, all before we got back on the road for the 10 hour drive back on Saturday. Sigh, are you tired yet? Well, it gets  more interesting.

What's grosser than gross? Dealing with a stomach virus on a road trip. Yep, Dylan woke up sick on Saturday morning and he vomitted all the way home. Poor thing. Poor me. Poor anyone who was sitting in the same car as he was. It was rough. I think it was quite fitting that our appetites were absolultely killed after several days of eating everything in sight. Nothing like having a little balance in your life. Ha!

We made it home safe and sound to a very cold Columbus. It was 25 degrees outside and 45 degrees in our house. Whoops! I thought it was a good idea to turn off the heat. Maybe not. We ended up spending the first night back home in front of the fireplace all snuggled together because it took about 18 hours for the house to get warm. What a memorable night. Fortunately, we were all so exhuasted that we slept great as Chris kept the fire going all night for us. <3

And suddenly it is almost December...they are calling for snow tomorrow. A fitting start to our first December here in Columbus. I start another rotation tomorrow. My birthday will be a week later, and I look forward to my sister's long visit later this month. And then there's Christmas! I will check in when I can in December~the most wonderful time of the year.

P.S. Where did this year go?!

Tuesday, November 23, 2010

Going to Carolina

Can't you see the sunshine, can't you just feel the moon shining!?
Sorry, I have been known to bust out in song when I get really excited~Ha!
We are OFF to NC for Thanksgiving to spend the holiday with family and friends! I am really ready to see everyone. This is probably the longest that Chris' parents have gone without seeing Dylan and Karsen.


Karsen with Nama and cousins, Leigha & Jake
June 2010
They think we are arriving late tomorrow, but we are REALLY getting there today. Sneaky snakes, huh?

Happy Thanksgiving, everyone!

 I am taking a much-needed sabbatical from the internet. Partially, because we will be in BFE
(without internet service). ;)
See you next week!

Friday, November 19, 2010

Letters of Intent: Dear New OBGYN (the rated R version where I died on the table)

Disclaimer: You should only read this post if you are a female over 18 years old, as there are several references of a sensitive nature that may make one uncomfortable/won't understand unless you have had a pelvic exam. Even if you are a female over 18 you may still be uncomfortable, so proceed with caution.


Dear Mr. Dr. New OBGYN,
Oh, if you only knew the anxiety I had about seeing you for the first time. It is never ever never fun to bare all to a complete stranger. I mean, I am a nice, proper southern bell, and well I DON'T know you.


(Google)
I really appreciate your discretion to come in, meet me, sit down, and talk to me a while first. You wanted to hear all about my past medical history, specifically about my hellish pregnancies, aka hyperemesis gravidarum, that I experienced when I was pregnant with Dylan and Karsen.  I wanted to make sure you knew that battling hyperemesis is serious work; that it was more than just morning sickness. Were you the man for the job? Thank you for patiently listening to me talk. Thank you for the (discouraging) encouragement you gave me when I asked you how aggressive and proactive you would be with dealing with HG. Your response was:
"I am aggressive as the individual needs me to be. You would definitely need to start off on a PPI/H2 blocker along with scheduled anti-emetics like Zofran as opposed to using them as needed. The management of nausea and vomitting in pregnancy is much like treating chronic pain, it is best to stay ahead of it before it gets really bad as opposed to waiting until you are already very sick and then trying to chase it to find relief. If you know you have a wild, mean dog that you are about to deal with, instead of chasing him around, how about we just close the gate before he gets out of the yard?"
WOW. Thank you Mr. Dr. New OBGYN. I love your candid response, and the fact that you threw in a metaphor about chasing a wild dog really spoke to my southern roots. You were basically speaking my love language. Thank you. Now, I will show you my goods. Ha!~ Seriously, I did NOT think or say that!
He went on to say:
"It sounds like you have walked through hell twice. If you decide to go through another pregnancy, you will likely walk through hell again. So, if you and your husband decide you want to take that journey through hell again, I will gladly walk through hell with you all."
(google)

Ummmm, thank you? It was quite unsettling to hear him say HELL 4 times in 3 sentences regarding a future pregnancy that I may or may not have. I could not decide if I was encouraged or discouraged. Alot to think about....

On to the pelvic exam....(I know this is what you want to hear all about anyway). Ha! Well I won't go into details (you're welcome), but I do want to share one (or three) things with you. I have a running list of Things Your OBGYN Should Not Say to You During a Pelvic Exam. Seriously, it is of future best-seller quality...a possible book maybe...Oprah would love it....publish date TBA. Consider the following copyrighted, people! ;)

(google)
The first thing an OBGYN should not say to you when you are 18 years old...and having your 1st visit there with your Mom's doctor....once you awkwardly slide down the table with your knees rigidly apart, your OBGYN should never start the exam and then casually say, "Oh, you look just like your mother." Seriously, there is not enough counseling in the world to heal that wound.

(Google)
The second thing a new OBGYN should not say to you once you assume the position and the exam has begun is, "You must work out". Um, what are you looking at Mr. Dr. Man? My legs?, my bum?, my who-who or WHAT? OMG, I slowly died on the table. Seriously, you should have asked me how many times a week I exercise [to assess my heart-health] when I was fully clothed and we were talking before the pelvic exam started!! Then I could tell he got nervous because he realized the inappropriate timing of his comment. He starts rambling, "I mean you just appear thin and toned" I just laid there and nervously said:
"Ummmm, I am a "social exerciser"...you know like a social drinker, I usually exercise when I am with someone else who is exercising"
And then we both got very uncomfortable (or maybe it was just me)....I heard crickets in the background. LOL. Thoughts to myself as he palpated my ovaries "Seriously, Social exerciser? what the flip is that, Heather? stop-talking-NOW."  What felt like 140 minutes later, he finished and as I was scooting back up the table, holding the sheet across myself, trying to maintain a smiggin' of dignity, he goes on to say the third thing an OBGYN should never say during a pelvic exam. "Everything looked great!". 

I cringe and try to smile as I die a little more and say thanks and see you in a year.....or sooner if I decide to venture to Hades Mr. Dr. OBGYN! Gotta run now, but it was so nice to meet you.

Signed,
Deciduous and mortified Heather

Thursday, November 18, 2010

good morning, charlie!


Last month's rotation was not without a little bit of fun! For Halloween the Pharmacy team dressed up as Charlie's Angels. One of the other PharmD students from Ohio State (Megan, on far left) had very convincing Farrah Fawcett hair going on! The Angel in the middle was our boss, Dr Novak, maybe the smartest Clinical Pharmacist EVER. Then there's me! I'm on the right, smiling because it was the last day of the rotation! Right after this, I happily turned in my pager.

Wednesday, November 17, 2010

i have learned a thing or two~ pediatric pulmonology



Image at: columbusparent.com

I finished my 5th rotation a couple of weeks ago, and it was by far the most challenging rotation of my P4 year. Here's a snapshot of my time at the Children's Hospital.
From day 1, I quickly learned that I would be expected to follow ~15 patients with the pulmonology team each day. It was my responsibility to go to rounds and be ready to answer any question the attending doctor, attending fellow, residents or medical students had about the patients. 

 Image at: theage.com.au

Which antibiotics is little Bobby on? Are they appropriate for what we are treating? Can he be on P.O. or does he still need IV? Does he need a PPI? What is the dose of Zosyn for a 14 month old, 15 kg baby? What is the motility dose of Augmentin? Does little Haylie need one or two flu shots this year? Is her pain medication adequate? How much PRN did she use yesterday? Should we increase it? To what? Does she have Miralax on board to prevent the opioid induced constipation? What are her allergies? Did CJ have a bowel movement yesterday? Was it large? Do we need to HOLD his Vancomycin due to the most recent levels? How are his kidneys? What are his Ins/Outs? Let's have a look at the Chest XRAY....

 Image at: healthguide.howstuffworks.com
And the list goes on and on.

It was so intimidating initially to be the go-to person for the team of DOCTORS?! I wanted to say, "HEY, y'all ummmm, ehhhh, I am just a pharmacy student. To-be-sure, you aren't depending on me for all this?" But, they were! I was surprised at how heavily the medical team relied on the Clinical Pharmacist and her two students for the entire month. It took me about two weeks to even trust my own recommendations (without looking them up twice and verifying first before saying a word), but after that- I hit my stride. What a wonderfully, satisfying feeling. To truly realize that, "WOW, I have learned a thing or two the last 3 years". :)

It was a change for me to work with kids and babies.....my heart could barely stand the fact that all these beautiful children were there because they were very sick. We had two patients in particular; two sisters, ages 3 and 5, with beautiful hair... so blond that it looked white....they were both admitted with cystic fibrosis exacerbations. They ran around their hospital unit in the sweetest yellow PJs with their hair flying. I watched them laugh and play and prayed that a cure would be found for cystic fibrosis in their lifetime, please......

My next to last day there was the most challenging.

A week before we had a little 17 month old baby admitted with altered level of conciousness; I looked at his medical record and read the saddest birth story ever. He was born to a 15 year old mom that had premature rupture of membranes. Her water was leaking for 8 days before she told anyone about it and went into active labor. At delivery, the baby was born in respiratory distress and having seizures. His prognosis was not good.

17 months later...he was admitted to the pulmonology unit to see what was going on. His electrolytes were a mess, and he had signs of infection. He was given a certain medication that could potentially worsen this. The medical team asked me what to monitor, what to expect with that drug, how long will the drug be in his body.....etc....I sat there scared for the little guy because clinically he was failing. Please, don't let him suffer.

He fought for a week as many medical technological advances helped him hang, but finally his body couldn't fight anymore. His family had to make the tough decision to let him go...he was technically brain dead.  Several head CT scans showed cystic brain (essentially just fluid) where normal brain matter should have been. An abdominal scan showed massive infection despite being on 3 different IV antibiotics. Nothing else could be done. His sweet soul went to rest the next to last day of my rotation.

It was a very trying month on many levels. Physically, I did not get much sleep. It was all one big blur quite like the newborn days from way back when.  I had to be there before 6:45am to have time to work up all my patients before medical rounds at 9am. I also had homework/projects/research to do at night when I got home. I logged >250 hours for the month. Do the math. That is just pure insanity! Academically, I had to function all on cylinders. They expected my very best, and that is what I strived for each day. At home, everyone suffered. Laundry wasn't done. Housework fell behind. We ate too much take-out. Chris tried to take up the slack. I am not sure who was more relieved at the end of the month, them or me! No sacrifice, no gain, right?!

This month, I am OFF. YAY! Next month, I look forward to the being at the VA Ambulatory Care Clinic. It will very different from last month, 95% of the patients will be (cranky, old)  men! I am looking forward to the challenges it will bring as well and praying that it will afford more work/home/life balance. One month closer.

And the countdown to graduation continues....

Satisfaction does not come with achievement, but with effort. Full effort is full victory.
Mahatma Gandhi  

Sunday, November 14, 2010

Saturday, November 13, 2010

hocking hills

Our destination today:

Ash Cave, Hocking Hills OH
Image at: escapingtoparadise.com

Will be back with my own pics later! :)

Friday, November 12, 2010

a day in the life, my internal dialogue

Today was a teacher's workday. Rewind to any other day of the school year...our normal routine is that it usually takes an atomic bomb landing to wake Dylan up. And then he still hardly wakes up! Not this morning, not on the one morning where we can sleep in....nope. He was up bright and early at 7am. Of course he was.

We had coffee and eggs and toasts and talked about how to spend our day out of school.

I decided I was sick of looking at the dust in the corners. Well, actually I accidentally used the bathroom downstairs in the basement: READ: Dylan's territory. OMG, after that I decided I needed to CLEAN. So we spent the morning (we meaning I) cleaning, vacuuming, dusting.....I felt much better after it was done.

Then we made our way to Target with the windows down, it was such a beautiful day. Karsen and I wanted a bagel from Brueggar's. Dylan decides he does not eat bagels. Ok.....

Off to Target we go to get snow boots. Yes, I just typed that sentence. Dylan is now in size 8 MENS!  We found a pair that we both liked, and I realized that this was no small victory! One less thing on my to-do list.

The new Diary of a Wimpy Kid book came out this past Tuesday, and Dylan's goal was to get it today with his birthday money he had saved from last month. Target was SOLD OUT. Meijer was SOLD OUT. Start the pouty attitude. Like it was my fault or something. Yes, life is unfair!  Finally, we go to Barnes N Noble....they had it! Mission accomplished. Return the sheepish, sweet look on his face. My heart melts when he says "Thanks Mom". He counted down to the days until this book was being released.



Fast forward one hour, we are back home. I love walking into a clean house :) Dylan is downstairs reading.  I bet he will have the entire book read in the next 20 minutes.  Countdown starts. Karsen is in the living room flipping and jumping to Miley Cyrus songs on Napster. Actually, I am the DJ; as I am blogging, I am finding her fast or slow songs depending on her mood...well actually depending on which "routine" she is working on. She is wearing her new leotard that we got her for her birthday. She loves gymnastics as much as I did when I was her age. <3

I have mentally planned what we will be having for supper. Wondering if we will watch a movie and snuggle on the couch tonight.....Chris Brown, "Forever" is playing now...Karsen thinks this song would be good for a floor routine. Yep, I agree baby! Chris will be home soon, going to start dinner. I love Friday nights.

indian summer

Olentangy River, OH, Fall 2010
picasaweb.google.com
*Indian Summer -a meteorological phenomenon that occurs in autumn, in the Northern Hemisphere. It is characterized by a period of sunny, warm weather, after the leaves have turned following an onset of frost, but before the first snowfall.(according to Wikipedia)*


I am so thankful for Mother Nature's sweet grace. She is easing me quite nicely into winter with the most beautiful indian summer weather. Everyone has told me that this Fall in OH has been exceptionally warm and sunny. I believe it is because I have prayed without cease for a not-so-cold slap-you-in-the-face kind of winter weather. I wanted a true Fall, and a nice gradual transition into the first real winter of my young life and that is what we have been having. :)

Actually, this week we have gone from freezing in the morning to highs of 60s-70s. Today we actually got HOT while we were out running errands. I sure did not complain at all. I know by the looks of all the sleds, boots, scarves, and etc...that I see everywhere that winter is so on her way! And we better get ready!

We live about 1/2 mile away from the Olentangy River. It is a beautiful area with running and biking trails that span about 20 miles from downtown Columbus all the way north into the countryside. I have been told that the river will look like this by mid-January.

Olentangy River, mid-winter 2009
krygier.owu.edu/

Oh my sweet word!! Indian summer, stay around as long as you want! I will surely miss you when you leave.

Since the weather will be so lovely, (for one more weekend according to the mean weather man on the news) we are heading to the Hocking Hills of southern Ohio to go hiking tomorrow! We are going to enjoy this weather while we can.

Tuesday, November 9, 2010

9

Happy 9th birthday, Karsen~! We love you!

Friday, November 5, 2010

because he knows i'm deciduous

One weekend recently, Chris surprised me with a fire pit. Evidently, eveyone in OHIO has a firepit. (Um, I know why~because it is already freezing here at night!) He and the kids spent the afternoon putting it together.


Even Miley came over to help.


 It is the little things like this that the kids really missed while we lived apart for a year. Time with their Daddy. There were just some things that I couldn't do to make up for his absence. Like....build things. Totally Daddy's territory.


The mandatory "smile at Mommy" pic of the afternoon.


The finished product. Smiles all around. I think the kids were already planning on roasting marshmallows in the next 15 minutes.


 Basically, Chris knew that this was the only way to get me outside when the weather starts getting cold. Ha!


And, it worked. Man-made fire. Hot!


We have enjoyed it several times already.  
Dylan was reading "Scary Stories" to Karsen and Ky (until they genuinely got scared and I had to make him stop).


Now, maybe I will live through the winter.

Deciduous Heather