So our home teacher came over today and shared a message with us. It was very enlightening, here's the gist of it:
"Life; The residency of eternity."
I'm going to have to get Krista to make me a stitch of that to put on my wall.
Thanks John.
Sunday, February 15, 2009
Saturday, February 14, 2009
Coping with Stress During a Call Month
Oh no not Jake writing another drawn out saga on how he can't handle the rigors of life. Nope not this time, had I written this last night that's what you might have gotten, but today I am post call and when I'm on a medicine month I suffer from bipolar disease. One day life sucks and nothing good can come of anything then the next day everything is peaches and cream. Today is, of course, peaches and cream.
So during some of my downtime (both downtime from work and downtime psychologically) last night I surfed the internet to find studies about resident burnout and depression. There's a little mnemonic that is often used for depression, SIGECAPS.
Sleep Disorder - check
Interest deficit - up for debate
Guilt - check (I feel guilty when I'm not studying during my downtime)
Energy deficit - check (this comes from the sleep disorder)
Concentration deficit - not really
Appetite Disorder - check, check (have I mentioned my 15 pound weight loss in July and again this month, if I can combine that with some exercise I might actually get down to a healthier weight come June)
Psychomotor retardation or agitation - check (very agitated, and I often feel retarded in rounds)
Suicidality - check (just kidding).
So how can I cope with this stress? The internet had answers for me! What did people do before google? One article said the following 5 categories were essential for maintaining wellness.
1. Relationships: this category includes relationships with friends, family, colleagues, and community;
2. Religion/spirituality: this includes involvement in organized religion as well as meditation or prayer;
3. Self-care: make time to take care of you! This category includes hobbies, exercise, good nutrition, avoidance of drugs and alcohol, personal counseling and treatment of depression. Don't forget to have fun!
4. Work: we need to find ways to make our work more meaningful and satisfactory for ourselves. Ideas include suggesting shift schedules that are more circadian friendly, adopting a night float system, debriefing difficult cases with others at work, and planning wellness events with other residents; and
5. Approaches to life: it's important to be generally positive about the journey you are on, maintaining balance, and focusing on your successes.Each of us is different, but here are some quick ideas for enhancing your personal wellness:
Now I know not too many of you who read this blog are residents (excepting Jon of course), but I'm sure all of you probably deal with stress in your lives too. In addition to that you are probably good at a few of the 9 things in the middle of the list. So if you feel so inclined I'm curious to know how you (or those you know) do well at those things, especially during the winter months.
So during some of my downtime (both downtime from work and downtime psychologically) last night I surfed the internet to find studies about resident burnout and depression. There's a little mnemonic that is often used for depression, SIGECAPS.
Sleep Disorder - check
Interest deficit - up for debate
Guilt - check (I feel guilty when I'm not studying during my downtime)
Energy deficit - check (this comes from the sleep disorder)
Concentration deficit - not really
Appetite Disorder - check, check (have I mentioned my 15 pound weight loss in July and again this month, if I can combine that with some exercise I might actually get down to a healthier weight come June)
Psychomotor retardation or agitation - check (very agitated, and I often feel retarded in rounds)
Suicidality - check (just kidding).
So how can I cope with this stress? The internet had answers for me! What did people do before google? One article said the following 5 categories were essential for maintaining wellness.
1. Relationships: this category includes relationships with friends, family, colleagues, and community;
2. Religion/spirituality: this includes involvement in organized religion as well as meditation or prayer;
3. Self-care: make time to take care of you! This category includes hobbies, exercise, good nutrition, avoidance of drugs and alcohol, personal counseling and treatment of depression. Don't forget to have fun!
4. Work: we need to find ways to make our work more meaningful and satisfactory for ourselves. Ideas include suggesting shift schedules that are more circadian friendly, adopting a night float system, debriefing difficult cases with others at work, and planning wellness events with other residents; and
5. Approaches to life: it's important to be generally positive about the journey you are on, maintaining balance, and focusing on your successes.Each of us is different, but here are some quick ideas for enhancing your personal wellness:
- Develop a personal philosophy and prioritize your goals;
- Maintain healthy relationships and set aside time with those people to talk about your feelings;
- Take care of yourself by eating right, exercising, sleeping when you can, and doing the things that make you YOU!
- Find something about each day that brings you joy, including joy at work, such as a positive patient interaction or learning pearl;
- Block off times in your schedule for important things such as family time, exercise, or social events, and make sure you prioritize them;
- Appreciate your accomplishments and growth during this time;
- Learn to say "no" to commitments that are not important to you (although they may be important to someone else), so that you can say "yes" to those that are important to you; and
- Learn where your resources are and don't hesitate to use them.
Now I know not too many of you who read this blog are residents (excepting Jon of course), but I'm sure all of you probably deal with stress in your lives too. In addition to that you are probably good at a few of the 9 things in the middle of the list. So if you feel so inclined I'm curious to know how you (or those you know) do well at those things, especially during the winter months.
Monday, February 9, 2009
Bits and Pieces
Nothing really special brings me to the blog today but I figured it has been a while and I can always ramble.
Thought 1 - I am tired. I notice that at about 1:00 every day I am hit with a grand piano and can't seem to shake off the effects. I remember feeling this way in all my pregnancy's (especially towards the end) but that doesn't mean I like it. Yesterday it was very apparent to me as church finished at 2:30 and Jacob was on-call . Yikes, I must look like a zombie during Sharing Time.
Thought 2 - It might be time to start potty training again. Although technically Jessi still has the occasional accident and has to wear a diaper to bed so maybe I never finished potty training. Anyhow, Kristian came up to me this morning and told me he had to go poo-poo. I thought this meant he had already gone and checked and told him he was fine. He then proceeded to go into my bathroom and attempt to push Spencer off so he could get on. After calming down Spencer, I put him on, just to appease him, and low and behold, he went pee. When he woke up from his nap he told me again he needed to go poo-poo. And once again, he delivered and actually went poo-poo. This is awesome but it also scares me. We started early with Jessi and potty trained for a year and I know I am not up to that again. What to do, what to do??
Thought 3 - Thank heavens for sewing night. I haven't worked on any sewing projects except on sewing night for quite a while. If there were no sewing night my machine would be sitting idly in the corner. It's not that I don't have any projects I could be working on, it is more just trying to get up the energy to start on one. (see thought 1) Also, I have a great time at sewing night. It is such a relief to have a night to just sit and chat with other women without any children interrupting, Ah a slice of heaven.
Thought 4 - Taxes in America are messed up. Due to the fact that we have multiple deductions (3 kids) and only a half years salary this year, and bought a new house this year, we will be getting a sizable tax refund. I don't mean to sound ungrateful, I am way excited to get to have some splurging money, but the amount to me just doesn't seem right. We have a nice home, and a great job, and are getting by in a terrible economy, and yet we don't have to pay any taxes. Ah well, I comfort myself by reminding me that it will probably be the last year we get a return for the rest of our lives, so I should probably live it up.
Thought 5 - Connected to thought 4, what would you do if you had a sizable return to spend? After some thought, it was decided to parse ours about, including a rainy day fund, an investment fund, a home project starter fund, a conclusion to a loan repayment, and finally some splurge money. It's the splurging part I ask about. I keep changing my mind on what I would like to splurge on, (a new sewing machine, home decor, maybe a new bed frame) but one thing is final now (as we bought it on Saturday). A 32" flat screen TV and DVD player for the bedroom. I can't believe it. I don't know how I let up on this, I always said I would never have a TV in the room. Jacob hooked me when he promised it would never be connected to the dish and was strictly for watching movies in the comfort of the bed so we didn't have to keep fighting for laying room on the couch. Jacob was on call last night so I decided to give the TV a dry run and watched pride and prejudice. It was amazing. I never want to go back to watching a movie on our old "blurry" TV on the uncomfortable couch. Ah, my husband is so wise!!
Thought 6 - Teaching children "school stuff "has never been my strong point. I have little creativity and find that when they get frustrated, I get equally frustrated, or more. However, over the last month we have been trying to work with Spencer more on numbers and reading. I am happy to say he can now count to 100 and we are getting through some beginner reading books (with help). It is so interesting to me how I feel like I am banging my head up against a wall for days and then something clicks and wham, he just gets it. It has been very rewarding to see him so excited about his successes and that is the motivation I need to get through the banging my head against the wall days. Although I still wish those were minimized as more often than not, I give up, which only increases those number of days. Ah well, one step at a time.
Thought 7 - A final thought, I am no where near prepared for this baby as I have been for the others, and strangely, that doesn't stress me out to much. Since we don't know the sex I feel there is no sense in pulling out a ton of clothes, so instead I have pulled out none. And since we don't know what room the baby will go in ,the rooms are very gender specific and we (I should say I) want the baby in the matching boy or girl room, We haven't set up the crib. And since none of that is done why would I pull out the montage of baby items in our crawl space or even pack my bag for that matter. I can't believe I am not worried about this but honestly, I am not. Go figure, maybe I have learned a little bit about going with the flow. I truly hope so as I think that will be a big part of having four kids. I can't wait.
Thought 1 - I am tired. I notice that at about 1:00 every day I am hit with a grand piano and can't seem to shake off the effects. I remember feeling this way in all my pregnancy's (especially towards the end) but that doesn't mean I like it. Yesterday it was very apparent to me as church finished at 2:30 and Jacob was on-call . Yikes, I must look like a zombie during Sharing Time.
Thought 2 - It might be time to start potty training again. Although technically Jessi still has the occasional accident and has to wear a diaper to bed so maybe I never finished potty training. Anyhow, Kristian came up to me this morning and told me he had to go poo-poo. I thought this meant he had already gone and checked and told him he was fine. He then proceeded to go into my bathroom and attempt to push Spencer off so he could get on. After calming down Spencer, I put him on, just to appease him, and low and behold, he went pee. When he woke up from his nap he told me again he needed to go poo-poo. And once again, he delivered and actually went poo-poo. This is awesome but it also scares me. We started early with Jessi and potty trained for a year and I know I am not up to that again. What to do, what to do??
Thought 3 - Thank heavens for sewing night. I haven't worked on any sewing projects except on sewing night for quite a while. If there were no sewing night my machine would be sitting idly in the corner. It's not that I don't have any projects I could be working on, it is more just trying to get up the energy to start on one. (see thought 1) Also, I have a great time at sewing night. It is such a relief to have a night to just sit and chat with other women without any children interrupting, Ah a slice of heaven.
Thought 4 - Taxes in America are messed up. Due to the fact that we have multiple deductions (3 kids) and only a half years salary this year, and bought a new house this year, we will be getting a sizable tax refund. I don't mean to sound ungrateful, I am way excited to get to have some splurging money, but the amount to me just doesn't seem right. We have a nice home, and a great job, and are getting by in a terrible economy, and yet we don't have to pay any taxes. Ah well, I comfort myself by reminding me that it will probably be the last year we get a return for the rest of our lives, so I should probably live it up.
Thought 5 - Connected to thought 4, what would you do if you had a sizable return to spend? After some thought, it was decided to parse ours about, including a rainy day fund, an investment fund, a home project starter fund, a conclusion to a loan repayment, and finally some splurge money. It's the splurging part I ask about. I keep changing my mind on what I would like to splurge on, (a new sewing machine, home decor, maybe a new bed frame) but one thing is final now (as we bought it on Saturday). A 32" flat screen TV and DVD player for the bedroom. I can't believe it. I don't know how I let up on this, I always said I would never have a TV in the room. Jacob hooked me when he promised it would never be connected to the dish and was strictly for watching movies in the comfort of the bed so we didn't have to keep fighting for laying room on the couch. Jacob was on call last night so I decided to give the TV a dry run and watched pride and prejudice. It was amazing. I never want to go back to watching a movie on our old "blurry" TV on the uncomfortable couch. Ah, my husband is so wise!!
Thought 6 - Teaching children "school stuff "has never been my strong point. I have little creativity and find that when they get frustrated, I get equally frustrated, or more. However, over the last month we have been trying to work with Spencer more on numbers and reading. I am happy to say he can now count to 100 and we are getting through some beginner reading books (with help). It is so interesting to me how I feel like I am banging my head up against a wall for days and then something clicks and wham, he just gets it. It has been very rewarding to see him so excited about his successes and that is the motivation I need to get through the banging my head against the wall days. Although I still wish those were minimized as more often than not, I give up, which only increases those number of days. Ah well, one step at a time.
Thought 7 - A final thought, I am no where near prepared for this baby as I have been for the others, and strangely, that doesn't stress me out to much. Since we don't know the sex I feel there is no sense in pulling out a ton of clothes, so instead I have pulled out none. And since we don't know what room the baby will go in ,the rooms are very gender specific and we (I should say I) want the baby in the matching boy or girl room, We haven't set up the crib. And since none of that is done why would I pull out the montage of baby items in our crawl space or even pack my bag for that matter. I can't believe I am not worried about this but honestly, I am not. Go figure, maybe I have learned a little bit about going with the flow. I truly hope so as I think that will be a big part of having four kids. I can't wait.
Saturday, February 7, 2009
A haircut to match his attitude.
At one time we hoped that Kristian would turn out to be a gentle giant. To our great dismay that part of his personality hasn't shown itself much as he seems to understand that he is bigger and, as it were, tougher than his sister. When he wants a toy there's not much Jessi can do to keep it from him. With that in mind I decided to give him a haircut so other kids would know what they may be getting into with him. 
It's a little offcenter, but he wasn't one to hold still during the haircut.
It's a little offcenter, but he wasn't one to hold still during the haircut.
Monday, February 2, 2009
Another Call Month
As I start my 8th month of my internship year I am left with the same old feelings of stress and anxiety. I started medicine today and my first call is tomorrow. I tried to enjoy the weekend, but after getting signout on my patients on Friday (2 of whom have been in the hospital for 3 weeks) it just didn't happen. Though I did not have to round on the patients on Saturday or Sunday I still was unable to relax knowing that they were waiting for me.
The first week is always the worst because I find myself scrambling to get up to speed on patients who are already in house and I have to try to find my way through another's train of thought in order to care for these patients. Maybe that's why I don't abhor the first week of OB call nearly as much as medicine (the last week is another story).
Tomorrow will most likely go smoothly. I may have to run a code or two and most likely I'll admit 5-8 patients. The stress comes from the wat ifs. The possibility of having multiple admissions come at 3 AM, 1 or 2 on which may be an ICU admissions. The possibility also exists that the code siren will go off in the middle of one of those admissions and I'll be pulled away to the ICU for 2 hours leaving me scrambling in the wee hours of the morning with multiple unfinished admissions and numerous patients that need to be rounded on before 7. All while being physically exhausted from being up all day responding to various calls from the different floors. Is it likely that this scenario will come to fruition, no, BUT IT COULD and therein lies the stress. I haven't even talked about the ICU admission that I may get at 6 pm teetering on the edge of death all night as I am left to contemplate if we're doing what we should to help him through the night.
I think I have less anxiety than in the past, but it still creeps up on me and I'll most likely get back down to my fighting weight by my birthday (at least I'm post call on that day). At least something good comes of all this (that and it probably makes me a better doctor, but that's still up for debate in my mind).
The first week is always the worst because I find myself scrambling to get up to speed on patients who are already in house and I have to try to find my way through another's train of thought in order to care for these patients. Maybe that's why I don't abhor the first week of OB call nearly as much as medicine (the last week is another story).
Tomorrow will most likely go smoothly. I may have to run a code or two and most likely I'll admit 5-8 patients. The stress comes from the wat ifs. The possibility of having multiple admissions come at 3 AM, 1 or 2 on which may be an ICU admissions. The possibility also exists that the code siren will go off in the middle of one of those admissions and I'll be pulled away to the ICU for 2 hours leaving me scrambling in the wee hours of the morning with multiple unfinished admissions and numerous patients that need to be rounded on before 7. All while being physically exhausted from being up all day responding to various calls from the different floors. Is it likely that this scenario will come to fruition, no, BUT IT COULD and therein lies the stress. I haven't even talked about the ICU admission that I may get at 6 pm teetering on the edge of death all night as I am left to contemplate if we're doing what we should to help him through the night.
I think I have less anxiety than in the past, but it still creeps up on me and I'll most likely get back down to my fighting weight by my birthday (at least I'm post call on that day). At least something good comes of all this (that and it probably makes me a better doctor, but that's still up for debate in my mind).
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