So Long Portland

I've been gone for over 3 weeks now and have so much to blog about.  Like I said in my previous post, I had mixed feelings about leaving Portland.  I was excited to leave the state, have a new adventure, and get out of my living situation.  On the other hand, I was going to miss everything Portland has to offer.  I have really LOVED the last year I spent there, minus the rain of course.  And that was the other thing!  I was going to miss the best part of the year in Portland!  June through November.  Beautiful scenery, fresh air, hills and mountains, picnics in the park, berry picking, hiking, mtn. biking, the coast, downtown and the waterfront, amazing restaurants, fresh seafood, food carts, live music, outdoor festivals and markets, people watching, and the list goes on.  There is so much to do!  And summer and fall are the best time to do it.  I'm going to miss it terribly.  I have missed it.  But most of all, I miss these ladies.......they are my favorite and I cannot wait to see them again in a few weeks!

So the week before I left I had a pretty full schedule checking things off my PDX bucket list.  I put a good dent in it so I feel pretty good about it.  Went to dinner w/ the best of the best and finally had to say goodbye to everyone.  Knowing I would see them all again in 6 weeks made the parting bearable.  But next time, who knows how long it will be.....

Rotation #1 McMinnville, Oregon

My first rotation was in a small rural town about 40 min SW of Portland.  I decided to commute for the 6 weeks to keep my place, as well as my friends and social life.  I worked four days a week w/ 10 hr. shifts.  3 day weekends baby.  Can't exactly remember how I spent them, but it was sure delightful.  The clinic I worked at in McMinnville was the Virginia Garcia Memorial Health Clinic and targeted at the migrant farm workers from Mexico w/out insurance.  It was definitely an underserved population, which my school is big on.  About half of the patients I saw were Spanish-speaking so it was nice to be using my Spanish again!  That was definitely my favorite part about the rotation.

I was a bit frustrated during the first week of my rotation because I was mostly observing my preceptor and not getting to do a whole lot.  My responsibilities progressed, though, through the weeks.  Looking back, I actually had a lot of opportunity for history taking, performing the physical exam, and charting the notes.  I wasn't involved too much on the prescribing process or the process on the next best step, but it was my first rotation.  What do you expect?  I expected more actually.  It turned out fine, though, and I developed some great skills, a safe place to start out my clinical training.  I averaged seeing about 10 patients of my own a day, plus observing another 5-10 of his.  Even though, I didn't appreciate it at the time, I'm actually quite glad I got to observe so much to see how my preceptor approaching things and what to say in certain cases.  I think it was a great learning experience.  Other classmates of mine didn't have that opportunity.  It was also great experience in knowing what to do next when the patient does not have insurance.  We did not have the luxury of ordering any lab test or imaging to help diagnose the problem.

Let me tell you.....when I found out I was going to McMinnville first, I was extremely disappointed.  All I wanted to do was go out of state somewhere.  But, when the time to leave Portland came closer, I found I was actually really sad to leave.  I have loved it here.  More on that next post........

P.S. The reason for the airplane on the roof picture is because McMinnville is known for its famous Air and Space Museum.  This particular plane is actually the start to a few water slides that go down into a waterpark.  I never did make it to the museum, and it was only 2 blocks from where I work!

Beach Weekend, or rather Coast

Funny that the beach in Oregon is referred to as the coast, too cold to call it a beach.  But, what better way to spend Memorial Day Weekend than w/ 10 friends at a beach house on the Oregon coast?  Well, it might have been better had the sun showed its beautiful rays a little more than it did.  High 50 degree weather didn't keep us from the beach, though, and at least it didn't rain.  3 fantastic days were spent playing beach volleyball, jumping in the ocean (can't say swimming at this point, too cold for that), building fires, lounging about, chatting, playing games, laughing our heads off, getting our groove on, and eating beyond our heart's content.  There was SO much food!  Enough to feed us all for a week.  And I just couldn't stop.  Can't wait to get back into a workout routine.  Such a a great, perfect, relaxing weekend w/ the best of friends.  These ladies are my faves!

Can I have some s'more?

That's what you'll be saying after you make this guy! Graham cracker crust, chocolate filling, topped with golden marshmallows. I'm already getting ready to make my second one this week.  The first one was for the missionaries (had them over for dinner).  The second will be for yours truly.  You seriously gotta try this recipe though!  You'll be glad you did!  It's a little rich, but totally delish.

S'mores Pie

Ingredients:

Crust Ingredients:

• 2 cups graham cracker crumbs
• 1/2 cup (1 stick) butter, melted

Filling Ingredients:

• 3/4 cup heavy cream
• 3/4 cup milk
• 1 bag semisweet chocolate chips
• 1/2 tsp. vanilla extract
• Pinch of salt
• 2 eggs, whisked
• 20-30 large marshmallows

Method:

To Make Crust:

Preheat oven to 325 degrees F (160 degrees C).

In a medium mixing bowl, stir together the graham cracker crumbs and melted butter until evenly coated. Press mixture into a greased 9-inch pie plate. Bake for 8-10 minutes.

To Make Pie:

In a medium saucepan, whisk together cream and milk. Warm over medium-low heat. Add in chocolate and stir until chocolate has completely melted and is smooth. Slowly add in vanilla and whisked eggs, and whisk until smooth.  Add pinch of salt.

Pour chocolate filling into baked pie crust. Bake for 15-20 minutes, or until chocolate filling is set and does not jiggle when pie is lightly shaken. Remove from oven.

Using a kitchen shears or a knife, cut marshmallows in half. Place halves in concentric circles over the top of the pie until covered.

Lower oven rack to the middle position, and set oven to the lowest broil setting. Place pie on the rack and lightly toast the marshmallows.  (keep your eye on them and pull out the second you see them beginning to turn slightly golden).

Chill pie in the refrigerator to set for 2-3 hours, or.....just serve warm.

[Recipe from here]

I am living the dream!

Life could not get any better.  Currently listening to 80's music.  Just got back from the Caribbean.  Schooled the boys at basketball last night.  Sun is forecasted for the next week.  Start my first rotation next week at a Spanish-speaking clinic.  Get to enjoy 3 day weekends for the next 6 weeks.  And most importantly, successfully passed my first year of PA school!  Check out these grades.......

Fundamentals of Medicine 1 - 92%
Fundamentals of Medicine 2 - 86%
Infectious Disease - 99%
Evidence Based Medicine - 79% (hey, I didn't have time to even finish the test.  No one did.......)
Behavioral Medicine - 96%
Current Topics - 100%
Hematology/Oncology - 95%
Dermatology/HEENT - 104%
Pulmonology - 98%
Nephrology - 100%
Men's Health - 102%
Cardiology - 95%
Endocrinology - 99%
Gastrointestinal - 101%
Musculoskeletal - 100%
Neurology - 94%
Emergency Medicine - 85% (so I didn't study very much for this one......)
Surgery 97%
Pediatrics - 95%
Women's Health - 90%

Granted, 3-4% points were added to my individual score for doing so well on the group test, but still....I'd say I did pretty well!  And NO group points were added to my final comprehensive exam:
Comprehensive Part 1 - 92%
Comprehensive Part 2 - 95%
Comprehensive Part 3 - 83%
(Comprehensive TOTAL - 90%)

It's amazing I could pull off an A on a test with one year's worth of material and only having 4 days to study for it!  The most exciting part of my education, though, just happened TODAY.  I've been attempting to read these bad boys once a week for the last several months and have really struggled.  There are a million answers to choose from, including ones like "A, C, and F only."  Really?  I hate those options.  Basically, I'll just guess until I get the right one and then try to interpret it.  Reading an EKG is like learning a new language and has been almost impossible so far.  Well, we had a 4 hour EKG review today and I LOVED every minute of it.  I will work in the ER just so I can continue to read them.  Oh wait, I want to work in the ER anyway.  Perfect!

So just a few moments ago, I pulled up Dr. Stanley's free tracing for the week preparing to be frustrated.  But guess what?  Not only did I get the answer right on the first try, I actually felt confident reading it.  I knew exactly what was going on.  It's amazing to see my progress after just one year.  Just think where I'll be after the next year.  So thank you to my amazing family and friends who have supported me through this last year.  Couldn't have done it without you!