Stepping up to the plate

In the last 60 hours since our new block started, I have spent 40 of those in the NICU. I've been to quite a few deliveries. Most of them have ended up very happy. One did not. I'm still mentally grappling with the things I've seen in the last two and a half days, and I doubt certain mental images will ever leave my mind. I keep talking with my co-workers about it because I don't know how else to process everything, and unless you've been right there, understanding the emotions and hearing the guttural cries of someone just given devastating news can be challenging. Even when you know there is nothing else you or anyone else could have done to change the outcome, watching someone suffer such a great loss is heart wrenching. I cried both at work and after work on Monday, and I've actually cried again today. I honestly hope that I never lose that sensitive side, and I doubt I ever will.

I am so thankful to those people that God has called to work in intensive care settings because I am definitely not one of them. I'm a relationship-oriented person which is a huge part of why I love working in a clinic; I get to form relationships with families and partner with them to take care of their children. I have less than 80 days til I start my new job, and I am so excited that words fail me when I try to explain!

I came home after my 29 hour call (yay for friends who let me leave an hour early) and crashed for a glorious 4 hour nap. I'm now waiting for Hubby to get home. He'll give me a big hug, and I know I'll start to feel a little better. Then he'll take me to get food, and since we all know how much I love food (both to make it and to eat it), I know that will help too. He'll make me laugh, and humor (even when it is dark humor at times) is a necessity to make it through the hard times.

A friend of mine told me about a sign posted in the ICU where she did med school that asked the families not to be offended if they saw providers laughing; it doesn't mean we don't care -- it is simply a coping mechanism for us to continue to keep hope and be able to come back to face another day of the battle against death and disease. Sometimes laughing is the only way not to cry, and there is definitely a time and place for both. I've had my tears today; now it's time to let my sweetheart make me smile.

Soon I will be able to go back to bed and sleep (the very opposite of what I did last night on call). I know tomorrow will look brighter, and I am looking forward to another day of helping people even if it's outside my comfort zone. May God give me strength when I am weak and words of peace for others in their troubles.

Sleepwalking

I'm on PICU nights right now. I hate it. I work 7 PM to 9 AM Sunday through Thursday nights for 2 weeks in a row (except that on Sundays I come in at 5 PM). It gives me the required 10 hours off between shifts, but I think it's safe to say that not a one of us thinks 10 hours is enough especially when you work 5 shifts in a row. It's only two weeks, but it's already been a LONG week plus a day. Last night I had parents of a very sick child get angry because of things that happened before I even came to work, and they took it out on all of us. I understand people react differently when they are scared, but to this non-confrontational person, having someone cursing at me and insulting both me and my hospital was very unsettling. To top it off, I'm going 48 hours or so without seeing my husband; this may not sound like a long time given how much time we used to spend apart, but now that I've gotten used to having him around every day, it's awful to go for 2 days without seeing him. :(

Six shifts down ... four to go. Let the countdown commence. I finish Friday around 9 AM, and then I start a 10 day vacation!! My plans include decorating for Christmas, finishing up my shopping (almost done!), and sleeping. Since I'm working Thanksgiving night, I'm making our own Thanksgiving meal on Saturday; the full menu hasn't been planed, but it will definitely include my famous brined and roasted turkey! I seriously cannot wait.

Shoot me now!!

Last night started out on a really good note. Since I was working late again, Hubby grilled fajitas for us and even made a version of Chuy's creamy jalapeno recipe that I'd round on the Internet (very close to the real thing and SO tasty!). I went to bed with a full tummy, very excited about being able to sleep in the next morning; I was so tired that I fell asleep with the dog next to me (Sebastian isn't allowed to stay in our bed overnight). A couple hours later, I woke up with the sensation of having a large knife being stabbed into my right calf. I fell out of bed onto the floor and tried to bear weight on that leg, but the peach-sized knot that had formed in my calf forbid me from moving more than a step at the time. If Hubby had been out of town, I would have been screaming my head off from the pain, but as he was sleeping on the other side of the bed, I did my best to stifle my cries into whimpers and hobble into the bathroom where I could shut the doors and try to deal with this.

Moving into that room turned out to be quite beneficial. As the pain continued to increase, I began to feel worse and worse until all of a sudden, I was losing my dinner in the toilet secondary to the waves of pain washing over my body. I puked uncontrollably for a minute, and when it was all over, I brushed my teeth, drank plenty of water, and hobbled back into bed only to find a small Yorkie there just waiting for his mom to come back. I put the Yorkie to bed and dropped down into my half of the bed. Hubby, still barely awake at this point, made sure I was okay before we both gave into exhaustion and fell back asleep.

I didn't have another experience this bad again, but my calf still has a horrible knot in it. Hubby massaged it for a bit tonight, and I'm resting with a heating pad on my leg. I just hope this all gets taken care of before Saturday. Disneyworld can't wait! :)

Lack of sleep leads to random thoughts

Cardiology has been a pretty good rotation so far. While my call last Friday was way worse than my PICU calls, the day-to-day work has been easier. My interns are awesome, and I have even had great interns working with me when I'm covering other services! I had another long day at work today but at least got to see some REALLY cute kids in my clinic. I've worked 113 hours in the last ten days and will hopefully only work about 23 more over the next two before getting Saturday and Sunday off (isn't that sad that I just used the word "only" when describing that)?

I couldn't stop yawning while I was talking with my mom on my way home. She even asked if I thought I could make it home without falling asleep! I took an accidental nap on the bed with Sebastian sprawled across my shoulder, and when I woke up, I realized just how hungry I was. I grabbed a handful of ranch-flavored Goldfish crackers to tide me over, and I must have wiped my hand on my pants or something because Sebastian is going NUTS. He keeps trying to lick my pant leg and the spot on the bed where I put my hand down. It's hilarious!

I found out as I was walking out to my car today that another patient with whose care I was very involved passed away yesterday. That's three kids in four days. I didn't expect pediatrics to be this hard.

Hubby and I did some serious shopping this weekend. Several months ago, I lost the mixing blade to our breadmaker, so it's been out of use as I was having trouble finding a replacement part. This weekend I found the entire breadmaker on sale for only several dollars more than the blade alone by the time I factored in tax and shipping. Hopefully I will have time to bake bread again this weekend!!

I'm taking a big step by putting my blog address on my Facebook page. This blog has been a haven for my ramblings and is read by a couple close friends but more by people I wish I knew better (and maybe a few random people as well). I don't really know why I'm motivated to do this. It reminds me of something a friend once told me in medical school: "People just want to be known." Maybe that's part of it; I have a huge shy side (the loud side really is just a big act!), and I often feel like I have to put on a certain face depending where I am. I desire authenticity; I just want to be real.

Sweet sleep

Today was my first day off after working twelve straight days. I figured out I worked 140+ hours in those last twelve days, and sleeping in until 7:30 was such a treat this morning. Hubby and I cleaned the house this morning, I had my hair appointment at noon, and tonight I had dinner with one of my best friends from college who is now a vet back in Houston. It was a totally awesome day!! Tomorrow I get to attend church (a much enjoyed rarity!), and later we're having dinner with our pastor's family and a few other families who live near us. This weekend is breathing life into my exhausted soul.

Monday morning I start a new 4 week block; this time around, I'll be the senior on the cardiology service. It will hopefully be a little less intense than the PICU, and I already know most of the members of my new team and am really looking forward to working with them! I'll still work twelve days on/ two off for the 28 days I'm there; I already have a massage scheduled for the day after the block ends.

Right now Hubby and Sebastian are both sleeping away, and I'll soon be joining them. I love knowing that my alarm won't be going off at 5:15 tomorrow and that Hubby and I will get to spend quality time together where I'm not falling asleep in the middle of our conversations. Everyone needs a little break now and then, and I'm no exception.

Rainy day

No profound thoughts on this post ... I'm on the 12th floor again today, and it's raining so hard outside that I can't see anything but gray outside the window. I only slept about 2 hours on call Saturday night/ Sunday morning and then dozed on and off for about 4 more hours Sunday afternoon, so I could really use another good sleep to get caught up.

Hubby and I went to see his mom yesterday. Seeing her was fun, and it was even better to have the time to hang out with Hubby. Even though I slept most of the way there and back, just being together was great. I have really enjoyed having him back in town! I have loved cooking dinner for 2 at night and having someone there to laugh at the little things with me. This is the start of the 3rd week in a row that he's been in town, and I am loving every minute.

Alrighty, time to get back to work ... it never ends here in the PICU!

Wakey wakey ...

I am done with nights for a bit! I have three days off, and then I switch back to PICU days for a month (only two overnight calls for the four weeks). To try to switch my body back to days, I'm going to stay up as much as I can today and sleeeeeep like a baby after a sushi date tonight. Poor Hubby has barely seen me this week; I left for work Sunday around noon, got home the next morning around eight AM when he was already working, and proceeded to sleep until five PM. I'd leave for work around 6:30 and be gone all night til eight the next morning every night through last night, so it almost felt like an out of town week for us. He was so sweet and grilled filet mignon two nights during the week so that I would be well fed for the night (hospital food gets old!), so that made me miss him even more. We decided to go out for a date night to catch up on everything that has happened this week; I can't wait!

Even though we didn't see much of each other this week, I was so thankful Hubby was here this week; I was part of a really sad situation involving a young kiddo earlier this week, and when that got combined with another stressful situation at work, I broke down crying in front of one of my favorite pharmacists. Coming home to a long hug helped my tears to dry and my spirit to heal. I already know that the PICU will have sad stories (as it always does), so I look forward to having his support close at hand.

On another exciting note, Hubby will be out of town for another week and then will be back in our own city for at least TWO MONTHS. There really aren't words to express how overjoyed I was when I heard this project came through. We haven't lived in the same city consistently for that long since we were engaged, so I am THRILLED. This project is such an answer to my prayers. As an added bonus, the project is coming when I should only have to spend four of those nights in the hospital. While they will be difficult intense months for me (PICU and Cardiology senior), having my best friend home at the end of the day will make everything more bearable.

I still got it!

I worked four hours in clinic yesterday, had a two hour break to run home and back to the hospital, and survived a twelve hour overnight shift in the ER as pit boss. When I got home today, Sebastian wanted to play nonstop, so I only managed to get about three and a half total hours of sleep today. I knew I'd be too tired to put on makeup when I woke up this afternoon, so I did my makeup as soon as I got out of the shower this morning. I don't think the makeup really helped because I still looked pretty scary when I woke up.

I had a hair appointment at my usual place in Coppell at 5 PM, so I had about a 30 minute drive to get there. I stopped for a strawberry shake at Sonic just to keep me full until Hubby gets home tonight, and the sugar rush helped to keep me awake. Whitney, my stylist, said I was "in the zone" and more out of it than normal, but I eventually walked out of there with an AWESOME haircut (pictures to come later when I don't look like a zombie). I stopped at Target on the way home to get dishwashing liquid, and as I was bending over to reach the detergent, I heard a voice behind me say, "Hello."

I looked up to see a young Indian man standing there. This part of town where I had stopped has a large population of recent immigrants from India, and I have worked with a few of them in the past, but I didn't recognize this guy at all. Our conversation proceeded like this:

Guy: "Hello, are you in college?"
Me: "Ha ha ha ... no, very far past it, but thank you for the compliment." (I go back to picking out my dishwashing liquid.)
Guy: "Oh, I am in college." Awkward pause.
Me: "Oh really, that's nice ... where?"
Guy: "I'm getting my associate's at *insert local community college here.*"
Me: "That's great! Good for you." (By now, I have my two bottles and am trying to turn around to walk off.)
Guy: "Do you mind if I ask you out sometime?"
Me: "No, I'm sorry; I'm married. Thanks anyways!" (I bolted out of the aisle as fast as I could at this point!)

I felt bad for the poor guy; I guess he didn't see my wedding ring. It was a nice little boost to the ego though; even sleep deprived, I still got it! ;)

Sleeeeeepyyyyyyy ...

I'm so tired; I have worked the last two nights in the ER and have one more to go tonight before i get a little break. A patient's dad asked me last night, "Who did you anger to have to work a Saturday night shift?" I responded, "The better question is, 'Who did I anger to work Friday, Saturday, AND Sunday night shifts?'"

The new goods is that I'm getting much better at LPs; I actually had one of the techs request me to be the one to tap a child last night because he "wants someone who's good at it." It was definitely a boost to my confidence, and hitting the tap on the first try didn't hurt either.

Now it's time for me to go throw on yet another set of scrubs, make a quick dinner for me and Hubby, and then head back out. Unfortunately Hubby will be gone by the time I get home tomorrow, but we'll see each other Thursday. It's just another week in the life of this tired resident!

Did I really just do that?

I'm back in the ER for 2 months straight! That translates to 4 weeks of day shifts and 4 weeks of night shifts. My merciful chiefs have split up the nights so that I work 2 weeks of nights, 4 weeks of days, and then 2 additional weeks of nights. I just finished working four 12 hour night shifts in a row. By the time I count in checkout and the drive to and from work, I'm only home for about 10.5 hours each day. I have been tired but okay, but after work today, I came home and crashed. I've been go-go-go for the last four nights, and I am beyond thankful that I'm not bad for a fifth night in a row!

As a second year, I'm responsible for making sure the traumas and critical patients are covered. I was definitely terrified of this when I started second year, but I've now realized that I have sufficient back-up and have learned enough to feel comfortable working with the sickest patients. Our nurses, techs, and respiratory techs are AWESOME and help me out so much.

I'm working on becoming proficient in my procedures and have gotten to do a few laceration repairs and lumbar punctures (spinal taps) over the last several nights. We are supposed to be signed off on lumbar punctures (or LPs) as interns, so I have been "signed off" for a while and am allowed to perform them without being observed. Unfortunately, I have had a run of HARD taps for the last few months ... so hard that people with more experience me have not been able to get these taps either. I know that should make me feel better, but my self-confidence has been shot. The most frequently tapped patients are little babies less than 2 months old who are undergoing a work-up for sepsis, but we also tap older children as we see fit according to their clinical picture and our index of suspicion. My personal feeling is that the little babies are easier to tap due in large part that it's easier to hold a baby still than a big squirming kid still, but even in babies, performing a tap can still take a while even if you do everything perfectly. A few days ago, I tapped a four year old; while it took some time and a little help from our fellow, I still got it on the first stick! I have been feeling a little better about my ability after that.

Last night a 4 month old needed a tap, so despite my nerves, I set everything up and got the baby into position. I cleansed and prepped him and felt one last time for my landmarks. I slipped the spinal needle in where it was supposed to go ... and beautiful clear fluid immediately came out. The clinical tech who was holding the baby laughed at me when it was all over because of the look of joy and surprise that washed over my face. I was done with the entire procedure in less than two minutes, by far the fastest I have ever done and, according to the tech, the fastest he has ever seen done by a resident. The analysis of the fluid showed that it was a near-perfect tap and actually provided us with essential information in treating this patient. I was grinning ear to ear when I finished. I'm back, baby!!

I was still riding off the high of rebuilt confidence when my shift ended shortly after 7, so I expected to have trouble falling asleep later. Ha ha ... apparently the adrenaline wore off because after I showered and ate my first meal in 14 hours, I was asleep within 30 minutes and slept for seven hours straight. I'm extremely thankful that I have tonight off because tomorrow I will have clinic at 1 PM and will then work my 12 hour ER shift starting at 7 PM, and I still have more sleep on which to catch up. I'm actually looking forward to tomorrow night's shift; I'm back and ready to roll!

Tired (again)

Why do I feel like all my recent posts are about residency? It must be because I've felt consumed by it since mid-January. I can't wait for next block when I will have a few minutes to breathe. I'm taking Step 3 one week into the block (April 14-15), and I am in desperate need of some studying time for this exam. Hopefully I can get myself into gear; it's just about 2 weeks away, and I am SO not ready for it.

I had a truly wonderful call last night. I actually got to lie down for five hours in a row. To me, that's virtually unheard of on a NICU call night. I was a little deeper into sleep than I usually get on call, so when the resus page came across our walkies at 3:45 AM, my fellow second year and I looked pretty funny with our pillow marks fresh against our faces and our eyes blinking against the bright lights of the delivery room. The babies ended up being fine (yes, babies -- we went to 2 deliveries back to back, and 1 was for twins!), so life was good. My attending this month is extremely diligent in getting us out on time, so I was actually able to leave at 29 hours instead of the maximum of 30. It really was a great call!

Now I'm sitting at home after a lovely little nap and a warmed up dinner of leftovers. I'm watching reruns of CSI (which I am just now getting into), and I have a small Yorkie curled up asleep on my tummy. I've been reading blogs and researching sightseeing and restaurants for our trip to NYC (just 3 more weeks!). Hubby's out of town, so I'm planning on turning in early and catching up on my sleep. Tomorrow should be a relatively long day (6 AM to 5 PM), and then I'll be on call again Friday, so I will rest while I can!

Catching up

Today is my 2nd day off this 4 week block -- yay! Unfortunately Hubby had to leave for Philly this morning, but I was so out of it that I barely remember him saying goodbye. I slept for eleven hours straight!! I still can't believe it. At least I feel well rested now; tomorrow night I'll be back for yet another no-sleep call in the NICU, so feeling not tired for now is a great feeling.

My parents came into town on Thursday so that my dad could speak at our church; it was so awesome both seeing them and getting to hear again the message of all Christ has done for us. I think this was my 4th time hearing the talk, so I got teased that pretty soon I'll be able to give it since I've got the medical background as well. If only I didn't have my extreme dislike of speaking in public! To make Easter even better, I was able to finish my work up early that morning and make it to church only 5 minutes late. I had gotten to work at 5:30 so that I might be able to finish early, and praise God, I was able to wrap up quickly and get out! I've had to miss a decent amount of church recently because of work, so being there at all is a blessing, but being there with my church family on Easter Sunday was a special treat.

After sleeping half the day away, I'm working on getting the house cleaned up and back in order. It's not too bad since my parents were just here, but there's always laundry to be done or something to be cleaned. Then I'm running to one of the best and most fun stores in the world, Target, later today to clean up on post-Easter candy, and then I'm going to come home and bake! My mom brought me this AMAZING cookbook, and I'm eager to try out some new recipes. It's going to be a very relaxing day off!!

Chicken soup please

Having all those toddlers coughing in my face has finally caught up to me; I am sick. At this point, I'm just calling it a cold, so I'll be taking it easy tonight and pushing fluids. I have a required workshop tomorrow from 7:30 AM until 7 PM, so I'm praying that getting caught up on sleep tonight will help me feel better and survive tomorrow. I had Friday and Saturday nights off and then worked last night, and last night's shift was so much better than the previous one about which I blogged. I didn't cry, and I even had time to go to the bathroom. :) Since I don't work tonight, I plan on doing nothing productive today and then going to bed early! It will be my reward to myself for a long but successful night in the ER.

Best gift

I have worked 12 hour night shifts in the ER for the last two nights. I don't think I've ever wanted a shift to end as much as last night's. Around 2 AM, I actually broke down crying in front of two of my fellow second years and two sweet nurses because of some horrible experiences from earlier in the evening added to my total inability to sneak away to eat anything substantial for my entire 12 hour shift (I didn't even get a bathroom break til 8 hours in). There was quite a bit of confrontation last night, most of it unnecessary, so being the total peacemaker I am, I was visibly shaken by some of the things that happened. I checked out to one of my sweetest friends this morning, and as I was getting ready to leave, she hugged me and said, "Sarah, you're a great doctor; don't forget that, and don't let anything make you question that. I love you." I got all choked up and teary again, so I left as quickly as I could so that no one would see me cry. This friend had never said that before, so hearing it at one of the moments I needed it most makes me so grateful for such a great friend. Lucky for me, Hubby got home last night, so I was at least able to get a reassuring hug from him this morning to remind me that everything will be okay.

The reasons parents bring their kids to the ER in the middle of the night absolutely astound me. Some of them are totally valid, but there have been several times over the last two nights where I enter a room, talk with the family, and think to myself, "You have waited seven plus hours for this?!?" All you future parents, please call your child's pediatrician before you take your kid to the ER for a cold (or call EMS to bring your child into the ER for a cold). Don't get mad at us when we tell you that she doesn't need antibiotics and that we have no medications to recommend for your baby. No, we are not trying to be mean, and no, we are not trying to make money by telling you not to give your child medicine that the FDA has deemed dangerous for your baby. We are just trying to keep your baby safe; if we wanted to make money, we would have chosen another specialty. Please remember that this is an emergency room. When I don't come by your room for over an hour because your child is on room air, smiling and happy, please know I am not trying to ingnore you; I have probably been in the trauma bay dealing with major badness, and trust me when I say that I would much rather not be back there!

On a different note, Hubby and I agreed ahead of time that we weren't going to make a big deal out of Valentine's Day. To me, it's a big ploy by retailers to get your to spend money. That said, I did use it as an excuse to buy him a Wii game that I had planned to get for Christmas but couldn't find in stock, and he surprised me with delivery of some beautiful pink and white tulips yesterday (my fave!). However, the best gift of all came this afternoon. The construction workers building on the empty lots immediately behind our house have been intermittently playing their music so loud that we can hear it inside the house. We have called to complain at least 3 times in the past two weeks; it's annoying to listen to the thumping bass, but when I only have nine to eleven hours at home between shifts, I need every minute of sleep that I can get. This afternoon, the workers yet again parked their truck immediately behind our fence and proceeded to blast music at the top of their speakers. Unbeknowst to Hubby who was working in the office upstairs, it woke me up, but I was so tired that I couldn't drag myself out of bed. Apparently as soon as it started, he called up someone at the front of the subdivision, but an hour and a half later, they still had not done anything about it. He tried again with the girl at the front of the subdivision, and when she basically twiddled her thumbs, he told her his plans to file a noise complaint with the police. Her response? "Yeah, that's a great idea! It will definitely make them stop." So he did, and the music magically died (I think word got out he called the police because the music stopped 10 minutes later). It truly was one of the greatest Valentine presents ever. Love is trying to ensure your sleep-deprived resident wife can get a good nap uninterrupted by someone else's music!

Decompressing

Hubby had his alarm set for 6 AM this morning, but after 2 nights in a row of dreaming about the PICU, I didn't even need his alarm to tell me it was time to get up. I'm working the night shift in the ER tonight, so I have several hours to spend here at home before going it. The weatherman is predicting a HUGE line of thunderstorms to come in right about the time I start my shift, so I'm looking foward to fun times in the ER tonight. Bad weather always bring in sick patients, so I need to put on my gameface.



This weekend we went to a love and marriage mini-retreat at our church; it was so great to learn and be reminded of the priority of our marriage. We capped the weekend off with the most delectable dinner at Del Frisco's Saturday night; I think I'm still drooling about the experience. I may gave gained five pounds from it, but it was worth it! Sunday afternoon after church, Hubby finished painting the bedroom while I kept falling asleep in the middle of the room. I still can't believe this awesome looking room belongs to us!

My sweetie had to get on a plane this morning again, and when he gets back Thursday night, I will be working all night til 7 AM. I'm not a huge Valentine's day person, but it still makes me a little sad that I won't see him until Friday. When he hugged me goodbye today, I couldn't stop the tears from leaking, and even now I'm having a hard time turning off their slow drip-drip-drip. All the emotions and messed-up sleep habits from the last two weeks are starting to catch up to me, and I just need time to clear my head. Fortunately I am not working Friday or Saturday, so I will have time to be with him for more than just a quick hug before one of us heads to bed or heads out the door.

For now I think I'll spend a little more time watching TV and relaxing this morning before I get up to work on laundry or whip up something yummy in the kitchen. I will work hard tonight, but today is for relaxing and renewing my tired heart.

SIlence

It's 3 AM, and I'm hiding in one of the callrooms in the Pediatric Intensive Care Unit (PICU). Those of you who know me well know that I hate the PICU. The kids are too sick and the stories too sad for me to enjoy it up here. I am beyond thankful for those God has called to minister to these precious ones, but I know my time here is only for a season.

I've got the TV on in the background to break the silence, but even silence would be a relief from the beeping of the monitors I hear every time I walk through the doors of the unit. Alarms are constantly going off, and something is always happening up here. It's never silent, never totally quiet. Some of these kids will walk about on their own with little proof they were ever here. Some will walk out physically broken from the tragedy of a horrible accident or from a crippling disease. Some will never walk out. We all hope and pray that our patients will fall in the first category, but those who don't simply break me. In between the lack of sleep (I've spent 51 of the last 82 hours here and will spend 20 of the next 30 here as well) and the emotions, I'm worn out.

Morning labs will be coming back in less than an hour, and then I'll have more decisions to make. Change the ventilator settings or not ... increase IV fluids or go down ... continue antibiotics or turn them off ... the decisions never end. Fortunately my shift does in about six hours, and I will be off for a refreshing ten hours before arriving again, coffee in hand, ready to face the battles all over again. Six more nights ... eighty-six more hours ... then I will move to a different battlezone.

Again?!?

I am sick yet again. I didn't feel so hot in clinic yesterday, and by the time I got home, it was definitely not good. I threw up around 8 PM and went to bed without dinner. This morning I ate a few crackers for breakfast as rounds were starting, but I didn't have the appetite for anything else. Around 10 AM, my attending told me to call in sick call because he could tell I didn't feel well. I almost started crying right there in the middle of rounds because I was doing everything I could not to call in sick call, but I felt so horrible that I just wanted to go home.

I made myself some soup when I got home, so in the last 30 hours, I have eaten about 6 saltines and a cup of chicken noodle soup. I'm considering some Jello for dinner, but we'll see. At least I have tomorrow off, so I don't have to worry about calling in sick call for a second day.

I'm in the PICU this month. I'm definitely not an intensivist! There are plenty of valuable lessons for me to learn in my 28 days here, but I am so out of my element. I'm seeing such horrible things that I usually want to go home and cry to get it all out. These kids are so sick, and I'm seeing horrific child abuse that turns my stomach. This month is turning me into even more of an advocate for my patients than I was before! I am so tired; I'm waking up at 4:30-5 am every day, and at least two days a week, I work til 8 PM. I'm only on 30-hour call twice this month, but the first time is Saturday. I'm a little nervous about it, but I know that it will be okay.

I think it's time for Jello and a second episode of Law and Order. I don't have any plans for tonight other than to relax and watch TV with Sebastian. Tomorrow Hubby will be home; I'm hoping that I will at least be eating real food by dinner tomorrow.

Happy birthday to me!

I am officially exhausted. Yesterday was my birthday, and what was the best present I got? Ten and a half hours of sleep! I was in bed before ten and didn't get up til after eight (my first day off in twelve days). It was amazing.

In addition to the sleep, I also had some nice and one not-so-nice surprises. I got an awesome haircut on Thursday (nice!), but as I was leaving the salon, I found out that Sebastian has yet another cough and won't get to come home this weekend (not-so-nice). Friday I went to work knowing that I would have to stay later than usual to cover for someone til she got back from clinic to be on call, so I was prepared for a long, busy day.

One of my big pet peeves from work is when people page me with just a call back number. We carry text pagers, so why not make use of the 120 characters you have to give me a heads up on what you want instead of typing in just 4 numbers? Even worse, I got paged about 30 minutes into rounds when I was meeting with the other doctors including my boss to discuss all of our patients; I hate leaving rounds to return pages because I tend to miss out on something important that's being discussed. I called the number back only to rind out that my sweetie had ordered a dozen roses to be delivered to my hospital as a birthday surprise. Doh! What a great surprise! Then the girl I was covering got back to the floor around 4:45 when I hadn't expected her to arrive until 6 or so -- I got to leave earlier than I thought!!

After I got home, I got to open my presents from my parents. They are in Sweden right now, so my mom shipped my presents right before they left so that they would arrive on my birthday -- so thoughtful! I love to open presents ... no idea why it's so exciting, but it's one of my favorite parts of Christmas or birthdays (watching other people open theirs is actually even more exciting!). I ended the day with a delicious dinner of sushi (mmmmm, tuna sashimi and firecracker rolls) followed by me crashing as soon as we got home. My sweet husband just laughed because he knew how tired I was.

Now the hubby is off taking some exam for work, so I slept in and am now spending the morning lounging around and watching the Food Network. I'm unsure when he will be done, so until then, it's lazy Saturday for Sarah. After he gets back, I want to grab some food, run errands, and hopefully go see Shrek the Third either tonight or tomorrow after church. Oh yeah, church! Another exciting part of the weekend, I actually get to attend church twice in one month. That's a rare blessing with my schedule, so I'm really looking forward to being back.

I'm beat

Daylight savings time was not my friend. I'm on call and soooo tired. Why am I not lying down? I'm waiting on labs. Doctors (myself included on occasion) like to order early AM labs. Now I'm waiting on them to come back to decide whether I give a med now or order more labs in 2 hours and recheck levels then. Good times!

On the bright side, our house now has walls. I'll post pictures when I'm more alert. :)

On the down side, my fella's back in New York. The irony of it all -- he's been home for 7 weeks, and I've been on call q4 for the last 8. He left tonight (actually Sunday) for 4 weeks (still home on the weekends), and now I only take call 1 night out of the next 4 weeks. Go figure! I'm now at the point where all I can do is laugh.

WHOO HOO!!! My labs came back, meds given ... it's 1:45, and I get to go rest my eyes til I get paged. YAAAAY!