Light At The End Of The Tunnel

   Before you start your third year of medical school, people try to tell you how hard its gonna be.  And you think you know what they're talking about, but you can't possibly know until you go through it for yourself.  Before this year started, I thought I understood what being a doctor would be like - but I had no idea.  Its just something you can't describe until you experience it.

   This last rotation has been quite hard for me.  I have been on pediatrics, something that I am not at all interested in.  And we've been going straight for six months without any breaks, and often not even having entire weekends.  I never thought I would feel this burned out, but here I am.  These last two months have been a pretty low point in my life, and its gotten to the point where I don't like who I've become.  I'm bitter, irritable, unmotivated, withdrawn from family and friends, and don't even enjoy fun things I used to.  I can't even pinpoint anything in particular that's made me feel this way.  Its just all of it.  I need a break... really bad.

   The one thing that makes me feel slightly better is that:
A) I'm not alone - everyone, even the most bubbly, giddy people in my class are feeling like I am right now.
B) There is something I love in medicine - OBGyn.  I loved my time on that rotation and am really looking forward to being an OBgyn resident.
C) After my shelf tomorrow morning, I have three wonderful weeks off.  THREE WEEKS.  I have only had four days off in the past month!
D) BF takes care of me, though he has to take care of himself too
E) Puppy is coming home in like two weeks and I CAN'T WAIT

   For the longest time I was trying to ignore how down I've been, in fact that's a big reason I haven't blogged in a while, because I knew it would just be bitter rants about my days.  But I finally realized that I don't have to live like this, so I tried to make an appointment with our school psychologist, however she was booked solid this week (I'm guessing everyone else is having crises around this time too?).  I'll get in there soon enough haha.  But yeah, I'm not afraid to admit that sometimes we all need a bit of help.  And I hate how people are so hush-hush-taboo about mental health and seeing therapists.  It's completely normal, and quite helpful - if you buy into it.  Anyway, just wanted to share some of the things that I've been struggling with lately.  And if you are a pre-med, med student, or resident out there who is struggling a bit, you aren't alone.  Sometimes, we all just need a bit of a boost.

 

Something's Gotta Give

   I've always been a stress eater.  In fact I'm the type of person who eats for comfort after a long day, even if the day was good.  It just makes me feel good.  And I can't control myself.  It's my drug, I'll admit it.  So every now and then I need to go to rehab, aka go on a diet.

   Depending on how long you've been reading my blog, you may or may not know that back in 2010, I lost 30 pounds through diet and exercise.  I was taking a class on nutrition at UCLA, and learned a lot about healthy eating, as well as the fact that I was borderline obese based on my body fat measurement.  That was a wake-up call.  Using all the tips I learned from my nutrition class (taught by the amazing Dr. Heber who wrote What Color Is Your Diet), and with some moral support from my friend J who also went on a diet with me, I was quite successful in getting down to weight which put me in a healthy BMI.

   I kept that weight off for two solid years... until boards.  Boards rolled around and I crept up 8 pounds-ish.  Normally, I fluctuate a good 5 pounds or so at any given time, but this weight was staying on.  And then my surgery rotation hit - another 8 ish pounds on top of that.  And since then, I've been about 15 pounds heavier, and holding this weight.

   I refuse to get back into an unhealthy weight.  So that's why I have to do something about it before it gets out of control.  I think the major wake-up call for me was trying to put on some jeans a few weeks ago, and none of them fit.  NOT EVEN MY FAT JEANS.  When you wear scrubs all the time, it's easy to ignore the weight gain.

   Since my jean-nightmare-wake-up-call, I've been trying to "diet" again, but I put that in quotes because I have been extremely undisciplined.  I last like one day and then eat horribly again the next.  It's very hard battling between my logical reasoning of needing to eat healthy and my emotional longing for a good box of mac n cheese, especially when my brain is fried after a long day.  It's too easy to make bad decisions.

   So today, I went jogging with my friend E, who has recently decided she would like to get down to her own healthy weight.  She was telling me about her recent discovery of keeping a food diary to keep herself accountable for what she eats.  I used one in the past when I lost all my weight, and it was extremely helpful and motivating.  I think I've been resisting it lately because I thought I could lose the weight without it, but obviously I can't control myself.  So I've decided I'm going back to food journaling.  It becomes tedious sometimes, but it's often a necessary self-check, and makes you reflect in the moment, "Do I really need to eat that entire box of mac and cheese, when that's the calories allotted for my whole day?!'  Also, it's nice to have someone else who is going through the same thing I am, so we can motivate each other.

   Hopefully this works... because I'm getting really frustrated.

I Wonder What An IUD Looks Like On MRI

   One of the surprise perks of being a leader for my school's chapter of MSFC was getting a free one-year membership to the Association of Reproductive Health Professionals.  And what's so great about being a member of ARHP is that you get to read the medical journal Contraception online FO FREE!  Let me just get one thing straight really quickly - I hate reading medical journals.  They are super dry, overly-detailed, and they just pile up and take up space in my room (*cough* JAMA *cough*).  But I love reading Contraception.  Maybe this is a hint that I am meant to go into OB/Gyn, the fact that I actually enjoy reading about it over and over.
   Anyway, I just got a letter asking if I want to renew my membership.  It costs $50 for students, but if I pay that, I think I actually get a PRINT copy of the journal... Tempting.  Very tempting.  I'm honestly considering renewing for $50.  Especially considering I will be saving a lot of money pretty soon... (more to come on that)
 

Hey, look - it's MY brain! (Also, notice how lumpy my skull is...)

    I saw this article, about the MRI safety of intrauterine devices.  Just a few weeks ago, I got an MRI as a control subject for some psychiatry study on campus.  I didn't get paid or anything, but I got to look at my brain FO FREE, so I said, "hey why not?!"  (Btw are you beginning to see a theme here about me loving things 'FO FREE'?)  So yeah, I got a kick out of it because it was completely relevant to me and my beloved Mirena, but just one week too late!


   I probably will end up coughing up 50 bucks... if only to amuse myself like this again.

I Run To Get a Dose of my Own Medicine

13.1 miles.  If you would have told me that I was going to run that far a few months ago, I would have told you that you are crazy.  Somehow, one of my amazing classmates wrangled about 45 of us MS2s (medical school second years) into running the Nike Women's Half Marathon in San Francisco.  Before training, I could only run for 25-30 minutes or about 2.5 miles if I worked REALLY hard.  Now I have run for three hours at once and for 13.1 miles.  The biggest hurdle for me was the pacing.  I realized that I just have to run pretty slow (so basically a jog) in order to be able to go long distances and times.  If I run too fast, then my asthma acts up and I just can't breathe, so I might be slow, but hey, jogging 13.1 miles is still pretty good, right?  My official time for the half marathon was 2 hours and 46 minutes, which I was happy with.  My goal was to get under 3 hours.

The Nike Women's Marathon was one of the coolest events I have ever participated in.  There were 20,000 runners and many spectators, mostly women, which was super empowering.  The crowds were so encouraging, and some of their signs were HILARIOUS.  Some of my favorite signs said:

"Run like there is a shoe sale ahead"

"Toenails are for sissies"

"Your feet hurt because you are kicking so much ass"

Among the spectators were families, friends, cheerleaders, bands, coaches, and even a gospel choir... and you know how much I love gospel choirs!  They gave me goosebumps, they were so beautiful!

I was lucky to have been able to run the whole way with friends, which made it so much more enjoyable than if I had to do it myself.  One of the most amazing parts of the race was when I rounded the corner and saw the finish line.  I literally felt a surge of adrenaline through my body, I got all tingly.  Suddenly, I just could not help but to all-out-sprint towards the finish.  I surprised myself how fast I ran those last hundred feet or so - I almost thought I was gonna puke, but luckily I did not. Haha.

The firemen in tuxedos and the Tiffany's necklaces were just as exciting as I anticipated.  Overall, it was an amazing experience, from training to the finish line, and I really hope I can do it again someday.

By the way, we all thought it was quite poetic that in the week before and after the NWM, which benefits leukemia and lymphoma research, we happen to be learning about leukemia and lymphoma in Hematology.  

**Side Note** The title of this post relates to one of my biggest inspirations to exercise and stay fit: that we, as physicians should practice what we preach.  How can we tell our patients to eat healthy and exercise as part of a healthy lifestyle if we, ourselves do not lead by example?  That is why I run to get a dose of my own medicine - a healthy lifestyle is more powerful than any pill. 

Where Do We Step In?

When my mom told me on the phone that my grandma was having trouble remembering the last 24 hours, that she didn't know how she got to where she was, that she may have had a stroke, I felt nothing. I knew she was talking about my Nan, but it felt like she was talking about some stranger. Even when my cousin called me, and was absolutely hysterical about the whole thing, I still felt numb and disturbingly calm. Then, all at once the grief swept over me and overtook me. I couldn't breathe and felt myself gasping for air between sobs and tears.

Luckily Nan ended up being okay - no permanent damage. But when I called her the day after to see if she was okay, my grief turned into anger as soon as she started explaining that she had just "overdone it" and was "just dehydrated", even though the doctors told her she had experienced a mini-stroke. I just about lost it when I told her she needed to lower her cholesterol and she stubbornly responded "oh, I don't subscribe to that school of thought".

So what do you do when someone is so out of touch with reality? Is it my job as her granddaughter to somehow convince my western-medicine hating grandma that she has to change her life? Is it even possible? Sadly, I don't think I'll ever get through to her.

So the next question is do I continue to worry that she will have another (more devastating) stroke in the future? I think for my own sanity I can't. Ultimately it's her choice if she chooses to believe in aliens, psychics, teleporting and "natural" medicine. (and when I say "natural" medicine in the sense that my grandma believes in it, I mean basically anything that she reads in quack magazines that goes against main-stream western medicine). I have come to the realization that - for my own sanity - I simply must separate myself from all of it and accept the consequences of her lifestyle choices.

If anything, it's good practice for difficult patients later on, because I don't think it gets much more difficult than good ol' Nanny.


- Posted using BlogPress from my iPhone

Hello 2011, I've been expecting you!

New Year's Eve was absolutely amazing this year.  You know how sometimes you just have one of those nights with old friends where the conversation is great and you just stay up for hours spilling all of your secrets with each other?  Well, that's what my NYE was.  We were up till 5 am!  To me, that was so much better than any "night on the town".  It was amazing to just be able to reconnect with my friends and talk about stuff we had never even mentioned before.  What a great way to bring in the new year!

Anyway, I've been doing some thinking, and I have been having a really hard time coming up with New Years Resolutions...  So here is my make-shift list for now:

1) Do some serious soul-searching/spiritual discovery.  I feel like my spiritual self has kinda just been in "limbo" for a while, which is okay because I wasn't in any rush to figure things out, but I feel ready now.

2) Yes, this is about as cliche as it gets, but we are going to Vegas for spring break, and since I will be seen in a bikini, I am going on a Las Vegas diet/fitness plan.  I have put on a bit of weight since I started med school (mostly just because I have been lazy and not motivated to eat healthy) but I'm getting back on my healthy kick.  Sometimes you just need a little push!

3) Put more effort into establishing and maintaining friendships.  I know I have some pretty amazing people in my life, so I am going to make more of an effort to keep them around.  More specifically, I plan on actually having skype dates with long distance friends (instead of just saying I will), maybe sending a snail mail letter here and there, the occasional fb message or wallpost, phonecall, etc.  And with the ones that are close by, making more of an effort to spend time together.

4) Take pictures whenever possible.  Maybe learn a thing or two about photography so I actually know what I'm doing.  And on that note, get back in touch with my artistic side.  I used to love to sew, paint, ets and I just don't know what happened to that part of me.  I am gonna search for it!

5) Improve my cooking skills and cook some delicious stuff!

Well, I'm sure there are more things I need to work on, so this is a work in progress.

Obesity Doesn't Just Affect the Obese

http://www.nytimes.com/2010/06/06/health/06obese.html?hp

This article (thank you to Neha for posting this on her facebook) is very scary.  It is really frightening to me how little people are starting to care about their health.  Now, not only are people giving themselves completely preventable diseases like diabetes and heart disease, they are putting their children at great risk.  Something needs to be done, but unfortunately people need to care enough to do something for themselves.  How can we get through to people to make them want to change their lifestyles?  For now, it looks like this is what I am going to be dealing with in a few years...

It's so simple, yet so hard...

    So today I went to donate blood on a study break, and when they were taking my stats, I realized what an impact my weight loss and healthy lifestyle change has actually had on my health.  I lowered my resting heart rate to 60, which is very good!  I am not sure exactly what my heart rate was before, but I know for sure it wasn't as low as 60 beats per minute.  Also, and probably more exciting, I lowered my blood pressure to 110/70.  I used to be anywhere around 120/80 (which is about "normal", although they are changing the definition of "normal" to more around 110/70).  Having a blood pressure this low is exciting because it means that I am further away from being hypertensive, which is very unhealthy.  It is amazing to see what an impact healthy eating and exercise has made on my health and general well-being. 
    On another note, I have hit a slight slump in my weight loss, in that I have been strictly following my plan, but haven't lost any weight in the past week.  This is okay though, because after all, it is finals.  And staying at the same weight instead of gaining several pounds from stress and overeating is fine by me.  Also, I've noticed I'm a lot stressed this finals season, but that could be due to my senioritis.  Unfortunately I will probably gain some weight in Cabo from drinking and eating out, but I'll continue my healthy eating once I get back, so it should be okay.
     Speaking of Cabo, I am really excited! I keep imagining myself in the warm sun on the beach, and I can't wait!  Today, some reporters from NBC News knocked on my sorority's door asking if anyone who was going to Mexico for Spring Break would say a few words for their story.  Now first of all, I was in my typical finals get-up, which meant g-phi shirt with obnoxious yellow sweatpants and no make-up.  And the guy was like, "You look fine!"... YEAH RIGHT!  I am not about to go on the news to look like an absolute scrub.  Second of all, the story they were doing was about the danger in Mexico right now.  So obviously, I would look like some idiot sorority girl who is too ignorant to know what is going on down there because all I care about is getting drunk.  Let me just go on the news and make a complete fool of myself... NOT!  I mean, I know Mexico is dangerous right now, and believe me, I AM a little nervous, but we are going to Cabo, which is super white-washed.  And the story they wanted to relate me to was about some couple who got killed in a Mexican town called Ciudad Juarez, which is no where near Cabo.  Anyway, the guy was really pushy and I didn't appreciate it.