Tuesday, November 30, 2010

Reality Check

Part of my early job days has included tons and tons of CBT - computer-based training.  It involves going through various modules on the computer ranging from HIPAA regulations to MRI safety (crazy machines, those MRIs).  Well, today, as I'm working my way through the never-ending checklist of modules I come across one titled "Caring for the Dying Child: Grief."  Whoa now, this is a little different than the importance of protecting your password or cleaning up spills on the floor.  So, since its the next on said checklist, I open it  and start working my way through.

About half-way through I get this pit in my stomach.  As I'm reading through the various grieving processes patients, parents and siblings go through when dealing with a life-limiting disease I start to feel uneasy.  Then as I read a statement about how children who are dying come to a point where they accept death, are no longer afraid of it and at times spend their last days comforting their families, I'm on the verge of tears.  In my little "office," I find myself shifting uncomfortably in my chair, adjusting the bottom hem of my shirt, picking at my fingernails.  I am able to make it through that module, take the test and move-on without shedding a tear.

Close call, right?  Oh, but it's not over yet.  The next module?  "Caring for the Dying Child: The Dying Process."  Are you kidding me?!  Okay, I can do this, I can make it through this "silly" little training exercise...its just a bunch of interactive powerpoint slides with words on them.  I get through maybe a quarter of the slides before that pit returns.  I find myself getting the urge to check my e-mail, my phone, my facebook, anything to distract me.  I read through educating parents and siblings on what to expect in the last days, hours and minutes of a child's life.  And I start choking up a little.

WHY??  Why am I getting emotional about this?  It's not like they were showing pictures of dying children or giving specific examples of patients.  As I sat there trying to process my inexplicable discomfort/sadness, a realization came over me.  I just came face-to-face with what my job would entail some days.  This is what I've gotten myself into.  I won't be treating just Alex the asthma patient, little Joey with a broken arm, or Sally's leg laceration.  I will be seeing, treating and admitting kids who are sick, like really really sick.  Like incurable sick.  While I'll come across healthy, happy kids, I'll have contact with kids who have been inside hospitals far too much in their short lives.  Some of my patients won't live to have a first kiss, get their driver's license or attend prom.  It will make my job hard some days, but it will also make it that much more rewarding.  I'll have a chance to make an impact on these kiddos and families who are suffering or scared.  Maybe I'll have the opportunity to make someone's hospital trip/stay a little easier or less frightening, at least for a short time.  And who knows - maybe I'll learn something about myself or life along the way?

Is it going to be easy?  No.  Will it be worth it?  Absolutely, 100%, yes.

Monday, November 29, 2010

Tinkering and Thanksgiving

So I left off my last post with my first day of work going smashingly well.  Well, on the way home I had to run by Best Buy to pick up a part for our brand spanking new washer and dryer set (our early Christmas gift to each other).  To make a long and painful story short, we were missing the part which was needed for the delivery guys to install the dryer (we would like to point a great big finger at the appliance salesperson at BB).  The install guys assured Corey he could hook up the part himself without difficulty, so we set about to do just that.  After some heaving,  ho-ing, climbing between washer/dryer, phone calls to rather rude and unhelpful representatives from BB and tears, my wonderful husband called his wonderful brother-in-law to come save our marriage - okay perhaps a bit dramatic, but it was quite the stressful situation!  He graciously agreed to come over after dinner and help.  I'm pretty sure it was because he overheard me spewing rage in Corey's general direction over the bleepity-bleep-bleepers at BB.  (You didn't read that mom...)

After our knight in shining armor arrived with his lovely wife and daughter in tow, he and Corey got the dryer hooked up to the wall vent.  We kissed his feet and showered him with rose petals as fireworks exploded in the night sky....And then I started load after load of laundry.  I never knew one could love an appliance this much!

Aren't they gorgeous? It was love at first wash...and dry

Super spiffy and just all around amazing!

The next day was Thanksgiving!  My sister, her husband and her 3 girls (+ their beagle) arrived after an all night drive to spend a few days with our two bedroom apartment...  We cooked up a storm in the kitchen with my sister making amazing macaroni and cheese and me successfully making green bean casserole from scratch.  That evening our turkey feast was shared with some of Corey's family.  The next day was super duper busy running around first visiting my grandpa then whipping up dinner to bring to my aunt's house.  We were able to visit with her, her husband and another of my dad's siblings - his older brother.  It was a relatively short visit, but anytime spent with them is good.  Saturday we said our goodbyes to our houseguests and I set about tidying up, doing more laundry (like I said, I'm in love with these puppies) and setting up the Christmas tree and other decorations.

Helping mom in the kitchen!

Big sister with baby sister

I love making messes!!

Happy Thanksgiving from Texas!

Even dogs need a Thanksgiving feast

Look who flew in from MI to eat turkey!
The weekend concluded with visiting more family, shopping with my sister-in-law, and a little stinking opossum lurking outside our door (he's since vanished - not sure if it was by will or force, but as long as he's gone, I don't care how).  I hope everyone else enjoyed time with family and friends over the Thanksgiving holiday!  Now its time to drink hot chocolate, listen to Christmas music, and shop for and wrap presents - I love Christmastime!!

Saturday, November 27, 2010

She works hard for the money

I'm a working girl - finally!  Monday marked my first day of employment as a PA-C ;-)  I sat through 2 days of hospital wide orientation before they let me loose on the patients.  Orientation was okay, but how can you make benefits, HIPAA, information security, and Occupational Health interesting?  I did learn a lot of good information and facts about the hospital though, and it made me respect the organization and really look forward to being a part of the team.  They even included some stories from family members who had been touched by the hospital which was a nice personal addition.  I also met some new employees who applied for jobs there specifically because they had children who had been treated there and were so impressed, they immediately wanted to work there.  I thought that was awesome!

After sitting on my bum for 2 days in a freezing conference room, I was looking forward to being on my feet and running around like a crazy woman seeing patients.  I got myself all spiffed up before the sun came up in new scrubs, my stiff white coat and my bag stuffed with stethoscope, pens, notebook, pocket reference guide, pen light and reflex hammer.  I felt like a little kid on my first day at school!

I was expecting my first day to be mostly shadowing my trainer and perhaps doing a procedure if there was one to be had.  Well, I met my trainer, we looked at the board, picked up a patient and it was decided that I would see the patient with my trainer standing by in the room.  Yikes!  It had been more than 3 months since I interviewed or examined a patient.  I did okay, only forgetting a few questions, but my trainer was there to ask them and I felt pretty good.  Because of patient privacy rules I can't go into specifics about cases, but everything I saw was rather straight-forward and if I wasn't sure on something either my trainer or an attending was more than willing to help out.  Since the day wasn't too busy, there was a lot of downtime and we got to leave a couple hours early.  Not too bad for my first day!  Based on just this first shift, I think I'm really going to like it there.  The best part was seeing the kids and getting a smile out of them - they are just so fun to be around!

I was all ready to come home, finish cleaning up the house in preparation for the arrival of my sister's family, and relax.  Little did I know what was to become of our evening (more on that another time)...

Thursday, November 25, 2010

Giving Thanks!

This year I have so many things to be thankful for - too many to list, in fact.  First and foremost, as it is every year, I'm so grateful for my wonderful family, friends and husband.  They are there through everything and for that I cannot express enough gratitude.  I'm also so thankful for the fact that I'm done with PA school!  The two years as a PA-S were long and hard, but fun and fulfilling.  This year I was able to graduate, earn a master's degree, move back around family and friends and start my dream job - what more could a girl ask for?

I was also blessed to be fortunate enough to take a fantastic 2 week vacation with my husband and explore an entirely new country and culture.  I was lucky enough to have time to spend with family and friends across the country from California to AZ to DC.  And who wouldn't be happy about the fantastic season TCU football has had thus far?!?  There are so many more things, but I don't want to bore everyone ;o)

I hope each and every one of you enjoys your day today whether you are spending it with family or friends!  Take time to reflect on what you have been blessed with this year.

Saturday, November 20, 2010

My Journey

Now you know what a PA is and does, perhaps I'll share my story of why I chose to become one.  Many of you know that I grew up saying I was going to be a doctor, a pediatrician to be more specific.  I loved all this blood and guts and was so fascinated by medicine.  So, what changed my mind? 

Well, in college I was on the pre-med track and majoring in Biology.  I had some slip-ups along the way and my grades were going to have to improve before applying to med school, specifically in Organic Chemistry and one biology course.  I had also met a boy on whom I could blame those slipping grades.  That boy and I started to become more serious and I started to wonder if I was willing to put our relationship through the rigors and stresses of medical school.  I also started to wonder if I personally was willing to spend 4 more years in school, plus at least 3 years in a residency.  

The summer after my sophomore year I had the opportunity to work at a local Emergency Room at the side of a physician, learning what it was really like to see and treat patients.  I cannot exaggerate the importance of this job in regards to my future.  While there, I learned I really did love medicine as much as I had thought, but I still wasn't sure I was willing to put my life on hold for 8 more years. I also had an inside look of the lifestyle of a physician and wasn't sure I was willing to have that same schedule and stress.  Having a family was really important to me and with the boy and I getting more serious it was more important than ever.

I had the opportunity to work with ER physicians, nurses, techs, and secretaries as well as medical and PA students.  I spoke with the PA students about what it was they did, what PA school was like, etc.  It got me thinking about this as a really good idea.  I did my research, talked with that boy and made a decision, I was going to pursue it.   After that decision, my grades improved dramatically, I graduated just 3/100ths of a point off from honors status and got accepted to one of the best rated PA programs in the nation.  

It was the perfect solution for me - I could have my cake and eat it too.  I would be able to practice medicine, treat patients, and have a family without waiting or compromising on anything.  I made a decision and never looked back.  

That boy is now my wonderful husband and is so supportive of me and my career.  After 2 years of the most intense, stressful and jam-packed PA program I could've imagined, I still believe it is the perfect profession for me.  And while I don't like to say never, I don't see me going back to become a physician, the appeal just isn't there.  So when patients, family, or friends ask if I'm going to become a doctor, I politely smile, and tell them no, I'm happy where I am.  

Friday, November 19, 2010 IS a PA anyway?

I used to wonder the exact same thing.  When I first heard about them, I couldn't understand why someone would go get a master's degree just to be someone's assistant.  Well, the assistant part of physician assistant can be pretty misleading.  While we often do assist (as in the OR or in other procedural manners) we more often act as an "extender."  Let me give you some history:

In 1964 Dr. Eugene Stead expressed the idea of training ex-military corpsmen in a 2-year program to help meet increasing patient care demands.  In 1965 he launched the physician assistant education program at Duke University with 4 ex-Navy corpsmen as the first students.  In 1968 the first baccalaureate program for PAs was founded in West Virginia and the American Association of Physician Assistants (AAPA) is founded in North Carolina.  Importantly, in 1970 the AMA (American Medical Association) House of Delegates passes a resolution recognizing PAs.  In 1972, the George Washington University PA program was established and continues to be one of the best in the nation (not that I'm biased or anything).  In 1973 the first national certifying exam is given to over 800 PA program graduates.  

Okay, so there's the early history.  Over the decades the profession has continued to grow expanding to over 70,000 practitioners in 2008.  According to the Bureau of Labor Statistics the number of PA jobs is expected to increase by 39% by the year 2018.  Now every practicing PA must be licensed by their respective states.  In order to get licensed one must have graduated from an accredited program (with the majority now awarding master's degrees) and pass the PANCE (Physician Assistant National Certifying Exam).  When you see a PA, they will have PA-C behind their name meaning they have passed the PANCE and have maintained that certification by taking the re-certification exam every 6 years.

So, I guess I still haven't really explained what a PA actually DOES...well, hmmm.  I found this quote on the Bureau of Labor Statistics that gives a nice concise explanation:

"PAs are formally trained to provide diagnostic, therapeutic, and preventive healthcare services, as delegated by a physician. Working as members of a healthcare team, they take medical histories, examine and treat patients, order and interpret laboratory tests and x rays, and make diagnoses. They also treat minor injuries by suturing, splinting, and casting. PAs record progress notes, instruct and counsel patients, and order or carry out therapy. Physician assistants also may prescribe certain medications."

So, there you are.  Physician assistants see, interview, examine and treat patients in locations from a family practice office to the operating room to prison infirmaries and everywhere in between.  There are even PAs working in morgues as assistants to medical examiners and PAs on the battlefields in Iraq and Afghanistan!  We are detectives, healers and patient educators.  

When you are making your next appointment at your doctor's office (whether its a dermatologist, OB/Gyn, family practice, GI, cardiologist, etc) don't be afraid to take an appointment with the PA!

Oh, and did I mention PAs were #2 on the list of Money Magazine Top 10 Jobs in 2010?

**(Note: History from:; Other stats from:

Monday, November 15, 2010

Food for the Mind

"I have never known any distress that an hour's reading did not relieve."
- Charles de Montesquieu

With all this free time on my hands over the months since graduation, I've been doing a lot of reading for pleasure.  The two years spent in PA school were so crazy and stressful that I may have only completed one or two books that weren't medicine related.  Since graduation I've enjoyed about 9 books (with one being almost 1,000 pages - yikes!).

Since I enjoy reading so much and always want recommendations on good books, I thought I'd share what books I've been reading and what I thought of each.  I've included links to the books on Amazon - my bookseller of choice (that and Half-Price Books).  So without further ado:

First, I started the James Patterson Women's Murder Club series (you know the numbered ones).  I'm currently working my way through the 4th of the series - 4th of July.  I've always loved mysteries and these are easy to get lost in.  I wouldn't say its a great piece of literature, but he weaves interesting story lines with likable characters making for good easy reading.

While in Europe I toted around a giant book -  Pillars of the Earth by Ken Follett.  It was perfect reading for our time there because it follows the story of a building of a church in medieval England.  It gave tons of history into how churches were built and how ideas and techniques changed over time.  It also gives a very good look into the interplay of church and state.  Throughout this all you follow an amazing story of a family who goes through trials and tribulations beyond what you think one could survive.  Its a fantastic story, but definitely requires a time commitment given its almost 1,000 pages long.  (I've bought World Without End, the sequel, and am planning to read that next)

Another series I've been working my way through is Steig Larson's Millenium Series.  So far I've read The Girl With the Dragon Tattoo and The Girl Who Played with Fire.  Great books!!  I had heard a lot about the series and finally got around to buying the first book while waiting for a flight in the airport.  I'm very glad I did!  I cannot recommend these highly enough.  Just waiting for the 3rd to come out on paperback (because I'm neurotic and want all 3 of them to match).

Just a couple weeks ago I finished reading Winter Garden by Kristin Hannah.  I wasn't sure what to expect of this book as I bought it from Half-Price Books without hearing anything about it beforehand.  It was such a captivating and moving story I couldn't put it down.  This is only the 2nd book I've ever read that made me cry (the first being My Sister's Keeper).  I found myself with tears running down my cheeks multiple times while reading.  Good thing I read this one solely at home - not while traveling!

Finally, I just finished reading Little Bee by Chris Cleave.  This was another pickup from Half-Price Books without hearing anything.  Before I started reading it, I heard some good reviews so I was excited to read it.  However, it was my least favorite of my recent reads.  It was an interesting story, but I felt like it was missing something.

I hope you'll find this helpful in picking out your next read.  If you have any suggestions of what I might enjoy, please pass them along!

Saturday, November 13, 2010

Say it ain't so!

It's official - I'm licensed to practice!  Well, its a temporary license, but it means I can finally start work - hooray!  We were hoping it would come through before the end of last week, but the letter didn't arrive until Tuesday of this week.  This means my start date was pushed back to Nov 22nd - the Monday before Thanksgiving.

Since my start date was pushed back, I had another 2 weeks to entertain myself.  Well, what better thing to do than jump on another plane?  I found a cheap ticket via that well-known name-your-own-price website and headed out to DC to visit grad school friends.

A fantastic friend lent me her couch and toted me around from airport to apartment to city and everywhere in between.  Tuesday was spent wandering around Eastern Market, Capitol Hill and the US Botanic Gardens.  We then met up with a large group of grad school buddies for a wonderful happy hour.  We had wine, chatted about jobs and job searches and just caught up with one another.  After which we headed to a friend's apartment "just to see it" and ended up sitting in the kitchen with a glass of wine and chatting away for over 3 hours.  We finally left because it was getting close to the last metro train leaving and didn't want to miss our ride out of the city!
In the Botanic Gardens
made out of all plant products
Wednesday we decided to try out a little hole-in-the-wall place we saw the previous night showcased on Diners, Drive-ins and Dives.  Another friend met us and we set off for La Caraquena featuring Venezuelan and Chilean specialities such as saltenas (huge empanadas filled with stew meat) and arepas.  It was a teeny tiny place that served up delicious food!  We then headed off to Georgetown to spend the afternoon shopping, walking and chatting.  Of course, we made a stop at Baked and Wired for delectable cupcakes (MUCH better than G-town cupcake!).  That evening we met up with another group of grad school friends for dinner.  It was another night of chatting, catching up and having an all around great time.

I didn't realize I'd miss these girls so much!

It was a short but great trip! 

Friday, November 12, 2010

Fall = Horned Frog Football Y'all


One of the perks of going to TCU (besides having a great excuse to wear purple...oh yeah and a great education...and meeting my husband) was getting into home football games for free.  I was lucky to live with some great girls who also enjoyed going to the football games.  And our team made it pretty easy, we've had a winning season every year since my freshman year.  We did have one bad year in that time, but we just won't talk about that. 
We had a tradition of making shirts each year
The last two years were hard for these 2 die-hard Horned Frog fans because we only had the opportunity to go to one football game when the team went out to VA to play UVA.

Dianna came to visit for the UVA game!

This year we were determined to go to every single home game possible.  We missed 2 because of our Europe travels, but Corey made sure to watch them on the internet at 2 in the morning.  College games are a blast, especially when your team wins in the fashion that TCU manages to do every week.  Take for example the stomping against then #5 Utah on the road.  It's also lots of fun because its a great way to spend time with friends before and during the games.  We've decided to start tailgating before home games and after just 2 times this season, we are planning to buy a parking space near the stadium and tailgating regularly next year!

1st tailgate at TCU vs Oregon State @ Cowboy's Stadium

Last year, TCU made it to the Fiesta Bowl but we couldn't afford it and I couldn't get the time off from school.  We were pretty bummed that we had to watch it on TV.  It's already been decided that if the team makes it to a BCS bowl game this year, we will make every attempt to go.  And its looking like we will!

Tomorrow is our last home game of the season, and you better believe we will be in the stands cheering!    

Tuesday, November 2, 2010

The travel bug

Yep, I've come down with an incurable problem.  Its called the travel bug.

Throughout my childhood we took family vacations every year.  They were often trips to WA or AZ to visit extended family.  We also took trips to Mexico, Colorado, northern CA, Texas, New Orleans and Hawaii, to name a few.  I always looked forward to our trips, especially the ones we took in the car.  I vividly remember riding in the car on a trip north through CA at night looking out the window at the stars shining in a pitch black night and thinking I was the luckiest kid in the world.

All those trips instilled in me a desire to continue to explore and experience new parts of the country and the world.  And that desire continues to grow with each new place I visit.  This leads to a small problem in our marriage.  I'm constantly (as in weekly) talking about where I want to go next and begging to book a new trip.  Corey smiles, laughs and rolls his eyes and tells me maybe when I'm actually getting a paycheck.  Seriously, it happens all the time (more often now that I signed up for Jetsetter travel deals website - bad news bears!)

Well, after a near meltdown when my start date got pushed back by 2 weeks, I convinced Corey a weekend away would be a good idea.  We decided on San Antonio because its an easy drive but definitely out of town.  It would only be a short trip because he was working Saturday morning overtime and had to be back at work Monday morning.

We got a great hotel on the Riverwalk for a great deal thanks to a travel website:
Sitting room in our beautiful suite

They had a room service menu for pets!
Saturday evening included Tex-Mex on the Riverwalk followed by watching TCU play at a sports bar.  Sunday morning we walked around the Alamo because you can't go to San Antonio and not go to the Alamo.
Requisite trip to the Alamo Sunday morning

Walking the Riverwalk after breakfast
 After we checked out we headed north to see the Natural Bridge Caverns.  They are full of really cool formations and our tour guide made it interesting.
Natural Bridge

Formations in the Natural Bridge Caverns

Looking scary pale, but having fun in the caverns

Pictures don't do it justice - this place was awesome!

After the caverns, we decided to hit up the San Marcos outlets.  Okay, maybe it was my decision, but who's counting?  This trip to the outlets marks an important milestone - I have now shopped at all the outlet malls on I-35 between Ft Worth & San Antonio!  Amazing, isn't it?  I'm proud ;-)

We had already decided on the way back to hit up one of Corey's favorite barbecue spots, the Saltlick.  It was a very yummy detour!

Despite its limited time frame, we had a great time.  It was great to get out of this apartment, out of town and have a change of scenery.  Come to find out it was Corey's first time to San Antonio!