Rotation #2 San Diego, California

The hardest part about working at an Internal Medicine clinic is not managing patients with 10+ chronic illnesses, keeping tabs on lab work, or even adjusting medication doses (I recently made 5 different medication changes all at once for a patient), but rather saying goodbye to patients you've developed a relationship with.  I saw the cutest and sweetest 90 year old lady for the second time the other day who asked for my card so she could talk to me if she had questions.  When I told her this was my last week, she was extremely disappointed.  I wished her the best.  Then there was a jokester I saw who really appreciated the joke I cracked about the Dermatologist checking his prostate.  He just lined it up so nicely for me, I just had to.  Loved the hearty laugh I got out of him.  Going into school I thought I wanted to do ER after graduating, but you just don't establish that relationship w/ your patients since you never see them again.  Primary Care just might start being more attractive to me....  It's also surprising how many patients have remembered my name after hearing it just once.

Apart from the enjoyment I've experienced from meeting so many different people (accents from around the world), I've also had the opportunity to develop my skills.  I got thrown in on day one to see the patient by myself w/ free reign on deciding which labs to order, if any imaging is indicated, which mediation to prescribe if needed, etc.  I've really appreciated this, especially since in my last rotation I slowly advanced week by week.  I had my end of rotation evaluation w/ my preceptor and the first thing he said was, "You really scared me that first week."  Ha, only because I didn't know what to do w/ so much free reign for each of my patients.  He proceeded to say I've really progressed and will make a great PA.

I've actually really enjoyed Internal Medicine.  I might consider it as a future career option.  It's much more challenging and there are no crying kids or teenagers.  I decided I like to keep my relationship w/ the young ones outside of the medical world (yes, I miss my high school kids TERRIBLY).

Like I said, this rotation has been very challenging and extremely good for me.  I discovered a patient w/ debilitating dizziness who actually needed a pacemaker placed.  Then today a patient coded (became unresponsive) while my preceptor was placing an IV due to his extremely low blood pressure.  I only wish I could have done more, but the code team (comprised of 10+ members - ridiculous) showed up w/in 30 seconds.  He turned out to be fine.  This is the only picture I have of Scripps Clinic located in the Anderson Outpatient Pavilion.  Yes, there is valet parking.  Yes, only in La Jolla.....  Let's just say, my clinic (attached to the hospital) was less than 1 mile from the beach w/ a golf course separating the two.

Now that's I've addressed my learning experience, time for the good fun!  I ended up living w/ a friend of a friend and her roommate.  SO MUCH FUN!  They are the funniest and I had such a great time w/ them.  Not to mention the the 8 other girls I became good friends with.  True, there are no guys in San Diego, but who needs guys when we have so much fun on our own?  I wish you could understand even just a part of how much fun and amazing these girls are.  I wish I had a picture w/ everyone.  They all threw me a going away party last week - we tie dyed t-shirts, ate pazookies (per my request), and they gave me a framed word collage of all the best inside jokes over the last 6 weeks.  I'm going to miss them for sure.

Here's what I've been up to in the last 6 weeks.....

I've been to the beach on average 2-3 times each week and visited 7 different beaches - hard to pick my favorite....Take a look.....

La Jolla Shores - Went here several times during the week when I got off work early, only about 7 minutes drive.

La Jolla Cove - only made it once, but one of the more picturesque beaches

Pacific Beach - my "go to" beach for Saturdays, not too far and not too busy

Mission Beach - Mid Singles Activity on the beach one Saturday afternoon.  This only reaffirmed the fact that one day I want to own my own beach house.

Moonlight Beach - played some beach volleyball w/ some friends then a bonfire and pizza for FHE.

Torrey Pines State Beach - not my favorite beach, but it made for a great lunch break.

Coronado Island - This is probably my favorite beach of San Diego.  Such wide open white sand w/ the picturesque Hotel del Coronado in the background.  Good thing I made it here the day before I left!

Beginning the first weekend I was in San Diego, for 6 consecutive days there was always something going on.  I decided there was going to be minimal studying while I was here.  The last few weeks while here have included birthday parties, BBQ's, beach parties, volleyball, exploring downtown, going to the movies, baseball games, free concerts in the park, the county fair, 4th of July fun, eating at In-N-Out Burger, Disneyland (see previous post), exploring - you name it.  Basically, I had the time of my life.  I may seriously consider moving back after graduation.  Here's some pics to represent my time well spent in SD.  Enjoy!

My 2 main goals while in SD:
1) learn to surf.  Status: never happened.  It's gonna have to wait.....
2) eat at In-N-Out once every week while here.  Status: accomplished!

The Happiest Place on Earth

So the week of July 4th I found out I was going to have Friday off in addition to Wednesday.  So I called Amy, who currently resides in UT and was already planning to come visit at some point, to ask if there was any way she could come that weekend instead so we could go to Disneyland for two days instead of just one.  Well.....she made it happen!  Good thing she likes D-land so much.  We had a blast.  We partied at Disneyland all day Friday and all day Saturday.  We're talking 7:30 am to 11:00 pm - no breaks, on Saturday that is.    We're hard core when it comes to all things Disney.  With the opening of Cars Land, lines in Disneyland were almost non-existent.  Perfect timing on our part; longest line we stood in was only 30 minutes.  I mean who can turn down a second ride on Indiana Jones or Splash Mountain when the workers ask if you just want to stay on the ride for a second go around? And how about those soup bowls, churros, chocolate covered bananas, and dole whips?  Delish!  The above photo is my favorite.  This storm trooper wouldn't take a picture w/ me, but instead ordered me to follow him.  Amy got a sweet picture of the whole thing.  I already want to go back!

Sunday we finished our fabulous weekend off at the beach, La Jolla Shores.

Road Trip!

My Mom flew out to Portland to spend the worst 20 hrs. of her life in the passenger seat driving down to San Diego w/ me, occasionally seeing a new perspective in the driver's seat.  She is a gem and I am so grateful she offered to drive down w/ me.  We pit stopped it for the night in Sac Town (aka Sacramento) and I spent the evening w/ a friend who drove out from San Francisco so we could catch up.  Best part of the whole drive down (not that I didn't love seeing my friend or spending time w/ my mom, but.....come on!) = lunch at In N Out Burger!!  My goal for the next 6 weeks in San Diego: eat at In N Out once per week.  I mean, lying on the beach while the sun burns off all the extra calories will take care of it, right??

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!