Only One Month????

This is the beginning of the 5th week of school, meaning I have completed 4. This strikes me with a serious sense of incredulity, because, seriously?!?!?!? Only 4 weeks? Not 4 months? By far the longest 4 weeks of my life. Don't get me wrong, they were very good weeks. I have really enjoyed school (even though it is definitely NOT the easiest), but so much has been packed into these 4 weeks that I can hardly believe it. Who knew 4 weeks ago that I would be able to do a Head, Neck, Lymph, Lung, Heart, and Skin physical exam? Who knew I would already have held not just the lungs, but the heart in my hands? Who knew I would have learned so much about the Upper Extremities (although definitely not enough, as evidenced by my grade on the exam)? Who knew? Not me, that's for sure. I knew I would be learning a lot, but had no idea how much.

That being said, I still really need prayers. Fitting everything in is a big struggle, especially since we are moving. Learning anatomy isn't easy for me and I struggled a bit at the beginning of the class. I want to do well, not for the grade, but so I know the material. I wouldn't want to go to a PA that didn't know what lung fields to listen to or where those lung fields are located, so why would I be one?

One big struggle is also not being able to do the fun summer things I love to do. Summer in Colorado is my FAVORITE. I haven't even gone camping yet this summer and it's almost July! I know that I'm giving it up for a worthy cause, it's just a little difficult. So please pray that I have the right mindset and don't get whiny. :)

Good Grief, Charlie Brown.

The dreaded anatomy exam is over. Now, I would like to share with you one cool thing that I can do (this is really more for me, so that I knew that I can do it). I can follow a drop of blood from the Left ventricle of the heart to the right index finger and back to the Right Atrium:

LV to aortic arch to right brachiocephalic artery to the right subclavian artery to the right axillary artery to the right brachial artery to the ulnar artery to the superficial palmar arch to the common digital arteries to the radialis indicis artery to the common digital vein to the superficial palmar vein to the ulnar vein to the brachial vein to the right axillary vein to the right subclavian vein to the right brachiocephalic vein to the superior vena cava to the right atrium.

Unfortunately, this was only one question on my anatomy exam. The rest? Multiple, multiple choice. What is that, you may ask? That would be a multiple choice question with possible multiple right answers. For instance, :

A:

B:

C:

D:

E:

F: A and B

G: B and C

H: C and E, so on and so on.

These are also known as the most heinous questions ON EARTH. I'm pretty sure they originated at the same time as the Fall of Man. Not only did sin enter earth, but so did the multiple, multiple choice question.

It's behind me now, though. It was pretty odd to study for HOURS and HOURS for 1 exam that wasn't even a cumulative final! However, I do know considerably more now than I used to 16 week days ago when I started anatomy. I do catch myself speaking anatomy when I have to give directions: "So you go posterior to Santa Fe and then anteriorly to Wadsworth....If you hit a tubercle, you've gone too far."

On another front, Steve and I are moving out of our current place soon. As in, next week. We found a townhome near my school that we loved and it was too good a deal not to jump on it. It's bigger than the place we are in now, has more storage, will let us have a dog (at no charge!), and AND AND has a washer and dryer! Now, you with washers and dryers just hanging out in your home may have forgotten the luxury that is to be had with such a wonder appliance. Steve and I have shared washers and dryers since we moved out of home to go to college, 6 years ago. These past couple years, we have shared these appliances with those who wash their baby diapers in them. This means our clothes smell like urine. Seriously, baby pee. It makes one feel awkward when their choice of clothing smell is a)formaldehyde and cadaver or b)baby pee. That being said, I'm all for saving the environment and cutting back on the cost by using cloth diapers. I just don't enjoy the sharing the washer machine with those that do. :) Anyway, we are moving soon and are very excited to be on to the next place. We do get to paint (and be reimbursed for the paint!) and will hopefully be starting on that this week.

Have a good one!

Here It Comes

This is my third week of class. Just last week, I thought I had been in school a month already. I think that I've learned a month of material though, so it's fair. Starting tomorrow is the first test of a gauntlet that's been thrown down. I have 2 tests tomorrow, one "quiz" that's really a test on Friday, and 2 more tests on Monday. I still have all the normal preparation to do as well on top of that. So forgive the brevity of this post and forgive that I definitely won't be posting for the next coupla days.

Enjoy the weekend and sunshine for me!

No, That's Not My Sternocleidomastoid Muscle....

Today in Physical Diagnosis, we were conducting Head, Neck and Lympathics exams on each other.  As part of all that feeling around, the thyroid gland was also palpated (fancy word for felt).  In class, our instructor mentioned that a normal size thyroid gland wouldn't normally be felt.  Assuming (always a bad decision!) that I was in possession of a "normal" thyroid glad, I also then assumed that what I was feeling on either sides of my trachea was a muscle.  Although it was in a rather inconvenient and unusual position, I just figured that it was all the pumping iron that I do.  In my neck.  *Just kidding!*  Anyways, so I get to the actual exam room with my partner and he's just palpating everything, feeling my face bones, my skull, my occipital lymphatic nodes, my post cervical nodes, my precervical nodes...then he stops and says, "I think I feel your thyroid gland."  Despite the fact that the man was a medic and has performed an emergency tracheotomy in the field, I said, "Naaahhh."

Man, was I wrong!  Our faculty advisor happened to enter the room at just that second, so Greg asked her what he was feeling.  She confirmed that he was in fact feeling my thyroid gland.  Say what????  Then she said, "And it's rather large."  Well, I figured that since she was a PA and all, she definitely knew what was going on.  I did get a second opinion (which is extremely easy to do when PAs and MDs compose more than 30% of the population in a given room) and was again confirmed that my thyroid gland is indeed enlarged.  Great thing the school has insurance I have to have...too bad nobody on faculty will just order me a lab test!  :)

I always heard that when you enter a medical training program, you always begin to self-diagnose.  I just didn't know that I would be diagnosed by a classmate! 

***Factoid of the Day****

Did you know that normal, anatomically speaking, is a structure that occurs in a certain position in only 33% of people? 

Support Means I Stay Out of the Kitchen

Since starting PA school, Steve and mine's roles have completely switched. I haven't cooked a single meal (unless you count heating an Amy's up in the microwave) in 2 weeks. I haven't cleaned, done laundry (other than my lab scrubs, because that's just mean to make someone else touch those), grocery shopped, or done the bills either. Never fear that we are living in starving unpaid squalor, though. Steve has jumped right in and done all those things; further more, he's done them well! It's been amazing to come home at night to a meal waiting for me and not have to worry about getting any of those other housekeeping items done and to just be able to focus on studying or balancing (see post below for an explanation of balancing).

That being said, it was a little difficult giving over the reins. Not in every area, however. Really, the only area was the kitchen. Since I've cooked for the past 4 years and was taught how to cook with basic skills from the time I was young, I have very specific ways I do things. When you boil water, you don't use non-stick. You place the pot on the largest burner and turn that puppy up to high. To me, this is obviously the most efficient way to boil water. Not if you are Steve. Steve does it almost the exact opposite. He uses the non-stick pot on the smallest burner with the heat at medium. Now, both of these ways will boil water. One will just take a lot longer. However, I've learned that I just can't be in the kitchen when Steve cooks. If I am, then my bossy side shows itself in a rude way. We have made a pact that I won't be allowed in the kitchen when Steve cooks. We made the mistake the other day of allowing me to stay in the kitchen to chat with Steve about our days when he was making dinner. I got shooed out pretty quick. :)

That being said, it's been really great to have Steve be so supportive and I'm glad he's my husband.

Balancing Act

Second week down and eight to go until the end of the summer semester.  If I consider all the information that I have to learn by the end of the summer, my head might explode.  I guess that's why it's always recommended to take things one step at a time.  I do like to know where I'm headed, however.  By the end of the summer, I will (roughly) know every nerve, artery, vein, and lympathic vessel in the body.  I will know all the muscles, their actions, their attachments, and what they look like.  I will have a decent set of physical diagnosis skills down (hopefully) and have practiced multiple times on Steve.  Poor guy's ears and eyes are already taking a (gentle) beating.  :)  I will have a rudimentary understanding of differential diagnosis and developed a broader understanding of underserved populations.

However, as important as the information and skills are, learning how to balance is just as important.  So today, I balanced.  Steve and I went for a decent hike up in Estes Park, doing two separate hikes with a total of about 8 miles.  We went up Deer Ridge Mountain, which provides an amazing view of the park and Estes Park at the top.  We then went through Beaver Meadows, enjoying the beautiful lush green that's everywhere right now.  Then we drove back through Boulder, stopping for a post-hike meal of french fries (that's right) at Spud Brothers, aka the best french fries in the whoooole world.  Well, just maybe the best.  :)  Now we are back and I smell like bug spray and sweat, but have to get through some more anatomy before tomorrow.  I'm determined to have a good attitude about it, though.  It's all learning more of God's great creation, right?

Extraordinary People

This is only my second week of school, but I'm already so amazed with my fellow CHAPA classmates.  The first day of orientation, we had to tell about ourselves and the stories were pretty amazing - but aren't they always with those things?  People seem to always tell the best things about themselves and then that's the end of the story.  These people, however, just keep getting better and better.  The faculty apparently takes into serious consideration the people they let into the class, ensuring they get a good class fit.  This means that from the interview, they assess if they think the candidate is a good fit for the program and a good fit with the other candidates that are likely to get into the program.  I've heard second year students say that each class has its own vibe and that ours is already apparent "cuteness".  Well, if "cuteness" means awesomeness, then they're right!

Let me tell about just a few of my classmates.  We have a retired Green Beret, an active duty Air Force Reservist, several people with children, an ex-carpenter/snowboarding bum, a 23 year old guy who already has another Masters degree, and someone who did relief work in Burma.  My program tries really hard to choose diversity.  Even though (as Steve laughed) most of my classmates are Caucasian (ok, more than most: 39 of 40), there is such a wide variety of folks that are going to become PAs.  The program seems to shy away from the typical 22 year old who just graduated from their undergrad and chooses more experience and unique-ness.  Pretty awesome, if you ask me.

Today was pretty awesome, because my lab group didn't have to go in to finish yesterday's dissection!  Actually finishing the dissection and finishing it a little early was amaaaazing.  However, tomorrow we are going to pull a 7-8 hour shift in the lab so we hopefully don't have to go in on Friday.  Then we can have all Friday to study Anatomy and let it soak it.  Too bad I can't just rub my pencil over the book and absorb all the knowledge that way, huh Dad? :)

I'll be puffing a little air into your ear canal now...

Today was Physical Diagnosis and we were able to practice on each other in the CAPE.  My physical diagnosis partner for the next couple semesters is an older guy (not old, but in his late 40s, early 50s) who actually worked as an Army medic in Special Forces for years.  He's got some great techniques and is already teaching me a lot...and he's my partner!  Today we practiced doing Ear, Nose, and Throat exams.  I would be doing fine with Greg as my patient and then a faculty member would walk in to observe and I would forget everything!  I guess that's good to have that little bit of anxiety to make me work harder to really cement how to do these exams.  Anyways, Greg was examining my tympanic membrane and forgot to tell me he was going to blow a little bit of air to assess if the TM had any holes in it.  Woah!  Made me jump big for sure.  It is really neat when you get to see the TM move against the pressure, though.  It looks like a blister being flexed or a piece of cellophane being crinkled.

In Physical Diagnosis lecture, we were lucky to have a PA who practices in dermatology give the lecture.  She has so much experience already and is only 7 years out of school.  She primarily lectured on pathology and how to assess what is called skin lesions (which encompasses moles, freckles, scars, etc).  She also told us about her most memorable patient ever.  I won't write about this story, for fear that anyone who reads this will quit reading it!  However, if you really want to know, ask me next time we talk.  It's....odd enough that she said when she examined this patient, she turned white and had to leave the room.  She also stated that EVERYONE needs to be wearing sunscreen, especially here in Colorado.  She said that she sees this one patient every 3 months and every time has to remove more of his nose because he is a fair skinned farmer and keeps developing melanomas, basal carcinomas, and squamous carcinomas.  She highly recommended doing a derm rotation when we get the option, saying that even if we don't want to do derm, it would still be beneficial.  

Is clear a color?

Taking a break from writing about anatomy...and thinking about it....today was Physical Diagnosis.  This is definitely going to be one of my favorite classes.  Anatomy is so stressful and yesterday I spent a lot of time getting ready for it and wasn't able to get to my reading for PD until late.  When I finally got to it, I felt a weight lift off of me.  Not because it was easy, but because it was something I really wanted to read about!  Reading my PD textbook was like a treat after sludging through that big anatomy book.  Today our class was so informative and practical.  We learned how to view the tympanic membrane using our handy dandy otoscope and to describe it.  Luckily, none of the TMs I looked at were anything but clear and translucent (meaning no irritation and of good quality).  We were told to describe the color of it and then our lecturer busted out with that clear was a color.  Ummmmmm, isn't that the complete absence of color?  Oh no, it's for real, folks.  Let me look in your ear and I will be happy to inform you if it has a color!  :)  This class was really great, however.  To get my mind off anatomy (specifically that I don't know how to study for it and nobody else seems to know either) and to be able to begin to develop those skills for examining a patient was needed.  It's only day 4 of anatomy!  I swear it's been weeks.

This is what my typical day looks like:

5:45 Wake up and get ready for the day (can be reviewing notes, too)

7:00 Leave for school (if I didn't leave now, it would take an hour.  Odd traffic window)

7:30 Get to school and run any oncampus errands.  Otherwise, make it to anatomy lecture room and study

8-10 Anatomy

10-12 This varies on Monday through Thursday.  Only one of those days is that time slot not filled with something.

12-1 This is supposed to be lunch.  I scarf some awesome leftovers (that Steve made) down before studying, running errands, getting ready for lab (changing into scrubs)

1-4 or 5 Lab or Practicum

5-7 Study because traffic is too bad to leave

7pm Eat dinner????  Maybe if there's time.

7:30-? Study Study Study

Got to run!

It Looks Like Somebody Stuck Something Sharp There

Today I spent another 2 hours in the anatomy lab.  It looks like that's what my life is going to be consumed by for the next few months.  We didn't get done all of our assignment done yesterday and had to suit up for another go-round today.  Now, remember that we are all first year students and for every single person (there are 4 in mine) in our group, this is our first cadaver dissection.  Some of us have been in anat classes before where the instructors dissect the body and students just view it.  We now all very much appreciate that technique, because you can actually clearly see all the structures all cleaned and ready for you.  We do all the cutting and cleaning ourselves.  So when you don't know exactly WHAT the heck you are cutting (i.e., is that muscle or embalming fluid colored fat?), it's time consuming.  This week we are dissecting the back muscles.  We have to look for the nerves that innervate those specific muscles.  When you are slicing into something that you don't know exactly what it is, it's very easy to cut through those.  VERY easy.  Luckily, there are two sides to every body.  :)  Unless you are Moe, our cadaver.  Then he only has one trapezius muscle.  Which means that if we accidently slice it in half, like we did, then you are just out of luck.  Like our professor sayed, looks like somebody stuck something sharp there.  Oops!  Anyways, this was a very good learning experience.  It is a great experience, although kind of smelly.  I got home today and was greeted by a sweet husband and went on a sweet bikeride to Starbucks for an unsweetened free iced coffee.

Today I also had Psychosocial Aspects of Healthcare.  This is also a course that develops my clinical skills, but in the bedside manner way.  We are learning to approach patients using the Biopsychosocial model, meaning that a patient is more than just a biological issue that needs to be solved.  They are a whole person with a multitude of issues that affects how they respond to treatment and comply with it.  This is taught by a social worker, who is really qualified in teaching us how to correctly assess any psychological issues that will need to be referred.  This class is continued all the way into my second year.  I really appreciate this, because I want to be the type of PA that patients feel like actually look at them as a person and listen to them, not just walk into the room to look at a section of a body that is malfunctioning and write a script for it.

One thing that I really appreciate about my program and my school is the emphasis they place on working as a team.  Their philosophy is that we will be part of the healthcare team when we graduate and it's best if we begin building those skills now.  I will be taught by physical therapists, MDs, PAs, DOs, and socials workers.  I will be in classes with nurses, med students, dental students, and physical therapy students.  The school emphasizes this so much the buildings don't even have signs on them designating one as the School of Medicine or another as the Graduate School.  This is such a well-rounded education and I'm so pumped to be in this program!

I stink. Literally.

I'm at school, "watching" a lab orientation video that was assigned. However, I've already had my first lab but still have to watch it. Today was my first anatomy lab. That means cadaver dissection. The school really maintains a very respectful attitude towards its donors (who donated their bodies to be studied, i.e. cadaver). One thing about this lab: it SMELLS. Not like bodily fluids or anything, but like chemicals. Way overwhelming chemicals. It stings your eyes and your nose and you can't touch either of those because your gloved hands are slimy. Anyway, I won't get too in detail about this, for those with sensitive stomachs. It's an awesome way to learn and I'm really lucky to be able to do this. It's really cementing where muscles attach, what they look like, and where they are.

That was most of my day, was anatomy lecture and lab. I smell horrible (just like those chemicals) but am waiting for rushhour to be over and this video to be done. :)

Oh dear.

My first day is over and it went pretty well.  I am completely overwhelmed, but expect to experience that for the next 3 years.  Today I had Anatomy lecture (which I have every day except for Friday), a talk from a CHAPA alumni who practices in the UK, and Physical Diagnosis Lecture/Practicum.

When 2nd year students say to you, "Don't worry about Anatomy.  Everyone fails the first test", it doesn't inspire the most confidence in the course.  Then you start the course and totally understand what they mean.  The professor expects you to come prepared to class, at least having looked over the relevant diagrams and vocabulary.  Not so bad, right?  Except for the little fact that she doesn't tell you WHERE to find said relevant diagrams and vocab.  Also, if you find any old tests of hers, you have to take them to her immediately.  Otherwise, you will be in violation of the Honor Code.  So this class is Grade A INTIMIDATING.  On a positive note, I like all the my lab partners and think that we'll do well together.  This is essential because we will be spending 8 or more hours together per week and have to depend on each other to get good lab grades.  However, I think I could have gotten placed in a group with anyone in my class of 2012 and been satisfied.  Yes, they are all that fantastic and nice!

I'm pretty sure that Physical Diagnosis is going to be a favorite class.  This is because A)we get to be around live people rather than a cadaver and B)it's awesomeness!!  :)  Really, it's just starting to develop the skills I will need as a practitioner.  Today was very very basic, such as learning how to take vital signs.  Since I volunteered in a clinic and have my dad as my dad, I knew how to do all of those.  It made me very confident to take someone's blood pressure and correctly identify the Kortikoff sound (which identifys the systolic reading) first off.  Also, I got to use my new equipment, which is always way fun.  My blood pressure pump (technical name, haha) is pretty cool and fancy.  Also, I will be practicing taking blood pressures like crazy now...I have plans on practicing on everyone I know.  No, really.  :)

The talk from the PA practicing in the UK was extremely informative.  There are only about 30 PAs in the UK and they are not licensed because there is no governing body yet.  The UK is just now learning about PAs and are not quite sure what to do with them.  More on that later!

Time to hit the books.  Tomorrow is my first cadaver lab...

Orientation's Over...Now What?

Since I'm starting on a new phase in life, which will most likely entail little time for long visits home and long chats, I decided to start this blog to just keep anyone who wants to read it up to date.  While I realize that a blog doesn't substitute a good visit or a chat on the phone, this will let you know what little things I encounter on a daily basis that I might forget to mention.  Also, it lets you know where I've disappeared to (thus the title).

Orientation was Thursday and Friday.  It was pretty informative, but a little boring at times (as with all types of orientation).  There were quite a few surprising portions, such as the little factoid that when a fire alarm goes off on the campus, you don't have to leave the building.  Apparently people set off the alarms pretty frequently with burnt popcorn.  There are coffee makers in student spaces, which are alllllll over campus.  Oddly enough, even though the campus can provide the coffee makers and filters, they are for some reason prevented by state law from providing the coffee.  For a coffee snob like myself, that's not such a bad thing.  I'll just bring little baggies of ground coffee if it comes to it!

With orientation over, they told us that we would have the weekend off.  Our last weekend to do as we wish without any studying/tests/assignments/service projects/etc hanging over our heads.  I sure wish they had told our professors that!  We've already gotten 2 emails from our Monday profs, saying that we COULD read these suggested readings, if we were so inclined.  To a group of self-proclaimed overachievers that we PA students are, as if we ever had a choice to read those!  Of course we're going to have them read and memorized by Monday.  Gah!  :)  However, I was determined to not let that ruin my weekend.  Steve and I went hiking, went to a movie, hung out with friends, worked out, and went to church.  It's now 10:10 and I have to get up in less than 7 hours, but I still have reading to do.  (One professor didn't email us our "optional" reading until 5pm tonight and I didn't find out about it until 7:30.)

Thanks for reading!