Rotation #7 Ashland, OR

I just finished my 6 week rotation doing General Surgery in Ashland, southern Oregon just 10-15 miles from the border to California.  Ashland is about 10-15 south of Medford, located in the Rogue Valley which you can see pictured above.  Ashland is set in a beautiful area and population is about 20,000.  I loved being in a small town again.  On one side of the freeway was rolling hills of farm country and on the other, mountains covered in pine trees.  There was a good mix of sun, snow, and rain to keep me enjoying the weather.  Ashland is known for its Shakespeare Festival and has a cute downtown area with shops and delicious restaurants lining main street.

I ended up living with the best friends of one of my friend's parents, if you follow that.  They are in their 60's and also members of the church.  They had a nice house on the edge of town with the basement all to myself.  They would cook dinner and I would do the dishes.  I was really a nice setup, not to mention we got along fabulously.

Apart from San Diego, Ashland has been my favorite place to be thus far.  I went on quite a few hikes while I was in the area too.

As for my rotation, I worked with a fabulous surgeon.  Surgeons in general have a bad rap as being jerks, but I learned wonderful things from my preceptor.  He had great relationships with his patients and really had no concept of time (he was pretty much late for everything).  We would spend as much time as need be with each patient and he would even stay after work for upwards of an hour to teach me something.  I learned a great deal from him and definitely feel I will be a better clinician because of him.

Going in to school, surgery was my second interest after emergency medicine.  I sound realized, however, that I don't think I'm cut out for it.  To begin with, I didn't realize how many clinic hours it was.  I only did 5 surgeries in the first 3 weeks I was there (I definitely made up for it in the next 3 weeks though).  I dislike being on my feet all day every day.  And can I say swollen ankles?  Who knew standing would make your feet swell so much?  Also, surgery days were brutal.  You have to squeeze in bathroom breaks and a snack here and there.  It's one surgery right after another.  5 in one day?  Forget food altogether!

Unfortunately I had to bow out on a few surgeries due to getting light-headed.  They say it happens to every one, but those lights get so darn hot!  I also blame my mask - hard to get used to breathing through that sucker for 2 hours straight.  Fortunately that only happened a few times, but too many for my liking!  Embarrassing to say the least, although the whole surgical team was really great about it and told me not to worry.  Funny because it wasn't the blood that got to me, like some people.  It was those dang lights!

I got to do and see a ton!  I first assisted in all the surgeries I did with my preceptor which includes things like making the initial incision, retracting the incision, holding structures out of the way, assisting his suturing, suctioning, and suturing/stapling the wound back up.  I loved it!  If it weren't for the brutal schedule, I could do surgery all day every day.  Some of the surgeries I was in on included hernia repair, gallbladder removal, colectomy, anal fistula, rectopexy, appendectomy, toxic megacolon, intussusception, c-section, skin graft, rotator cuff repair, knee scope, and a few others.  Good stuff!  We ended up working in 3 different locations: the clinic, surgery center, and local hospital.  I had a great time with surgery, but I can honestly say I'm glad it's over.  That schedule is too brutal for me.

Hiking is the new Mtn. Biking

I don't know why, but this winter has seemed so loooong.  It's nice to finally experience sunny warm(ish) spring weather.  Unfortunately I didn't think the weather would be nice enough yet, so I elected not to bring my mtn. bike with here to Ashland.  I've since regretted that decision, however I have gone a few hikes instead.  I forgot how much I enjoy hiking.  Ever since getting my mtn. bike back in the year 2009 +/- 1, hikes have ceased to exist in my world.  Although not as thrilling as going downhill at high speeds on a bike, while at the same time avoiding rocks at all costs, hiking still has its perks - a great workout and time to appreciate the scenery.  I've tried to get out as much as I can while its been sunny and warm to try to get my personality back.  Yes, the doom and gloom of Tacoma took it out of me.

Upper Table Rock Trail - basically you hike to the top of some cliffs, yielding excellent views.

Lithia Park - found out a classmate was close by so we hiked this one together, not as many views, but fun to be surrounded by trees.

Lower Table Rock Trail - just like Upper Table Rock, but with even more breathtaking views.

I'm going to have to figure out a balance between hiking and mtn. biking, but hard to do with only one day off each week.  Another hike tomorrow or study for my upcoming 300 question 5 hour test??

I am a HOMELESS person

It's true.  I don't deny it.  At least I haven't stooped so low as to live out of my car....yet.  I THRIVE on change and love exploring new places and meeting new people, so this moving around every 6 weeks for rotations really had its advantages.  However, it's starting to wear on me.  All of my stuff is in storage and I have no place to call home.  Want to send me mail?  Good luck, my parents don't even know where to send it!  My church records are still in my ward in Portland and I haven't had a calling since last June.  I've stayed in so many different places since last summer and some how it's all worked out.  Take Kearny, AZ for example, where I stayed with a sweet 85 year old lady and her 3 cats during the week, and a friend's house in Phoenix on the weekends.  Or when I was writing my paper and I was in Portland for 2 weeks, then my sister's for a week, then my sister's friend's place for another 2 weeks.  Or right now, where I'm staying with my study abroad friend's (who I haven't seen in about 6-7 years) parents' best friends in Ashland, Oregon.  BUT this weekend I'm staying with her parents because the best friends are out of town.  Yeah, try and figure that one out.  What an adventure!  Yet, I'm so ready to just settle in somewhere... It will be interesting to see where I end up after graduation...

Rotation #6 Tacoma, WA

Hmmm, where to even start....

I absolutely loved this rotation, although it didn't turn out the way I expected it.  This was my Emergency Medicine rotation that I have been waiting all year for.  Going into school I had a real interest for working in the ER upon graduation.  Well, let's just say I won't have the experience I need to do that.  

I was assigned to work at Madigan Army Medical Center located on the Joint Base Lewis McChord (army & air force) just south of Tacoma, WA.  The Emergency Department there (like many others) is splint into two: the main ER (the emergent side) and the Fast Track (the non-emergent side).  Because there are so many residents (medical students) working in the ER, I was only able to work in the main ER once a week, for a total of 4 times (sick one week, adjusting one week).  The PA's mostly man the Fast Track, thus that is where I ended up spending the majority of my time.  Don't get me wrong, I still loved it, just didn't get the ER experience I needed to get a job in Emergency Medicine upon graduation.  Despite all the viral upper respiratory infections (the common cold) and back pains, I enjoyed suturing lacerations, draining abscesses, cutting out toenails, and putting in IV's.  I was able to do quite a few procedures and loved the hands on experience.  Another reason I feel cheated is because the "Fast Track" was changed to the "Urgent Care Clinic" halfway through.  Urgent Care is not the Emergency Room!

I never got the chance to admit anyone to the hospital, but came close with a pericardial effusion in a 14 year old girl after crashing on her dirt bike.  But because it had happened 2 days previous and was not likely to convert to tamponade, we could manage her outpatient.  I got experience working up a myocardial infarction (heart attack), stroke, and appendicitis....although none of the patients actually had those things (thank goodness).  But at least I was able learn what questions to ask, what tests to perform, and what tests to order.  So it was still a valuable experience.  Not to mention, I worked with a PA in the main ER who pimped the heck out of me.  In PA school, "pimping" means getting asked question after question which you most likely do not know the answer to.  It's a great way to feel like an idiot, but is big motivation to study more.  So I learned a ton from him.

The other PA's on the Urgent Care side were amazing PA's.  They really knew what they were doing and I learned a great deal of valuable pearls from them.  So yes, I am disappointed with my ER experience, but on the flip side my education was invaluable and I now feel like a more knowledgeable and confident provider.  My favorite part was that I got to wear scrubs all day every day :)

Housing turned out to be a nightmare.  I surprisingly have had no problems until now.  My 2 options were 1) stay with some classmates (boys & girls) in another PA student's house or 2) stay with an older lady close to the waterfront.  Obviously option 2 wasn't ideal so I went with the older lady.  Turns out I only lasted 3 days there due to the cold temp of the house, not being able to fully stand up in the bathroom (my living quarters were on the third floor loft), and flies buzzing around everywhere.  Not to mention, she was a little eccentric and controlling. She spent 2 hours talking non-stop about the house and my expectations when I first got there.  She went so far as to explain how to work the microwave and light switches (?!).  I'm in PA school for heaven's sake!  She was a nice lady, but 6 weeks was way to long to spend with her... So I ended up going with option 1 which I should have done in the first place.  Us girls had our little own corner of the house and it turned out great. 

Apart from the housing mishap, Tacoma was a little lonely with no friends or family around... just these chickens to keep me company on my days off :)  I actually only had 4 days off the whole 6 weeks with 2 weekends I spent with D.  I'm not a big fan of Tacoma itself, but maybe that's because my uncle in Seattle doesn't like it (not enough theater or fine dining for his taste).  Never got a chance to go check out the waterfront either.... At least there was plenty of fog to keep me happy!  I love driving in it!

Birthday Weekend in Utah

I am now 29... yikes!  My last year in my twenties!  They have been some good years too, and this one will be no exception.  I have some exciting things to look forward to - Honduras, Hawaii, graduation, and getting a new job.  Excited for what the future holds.  This last weekend I flew to UT to spend time with family, friends, and last but not least, D.  I was really upset with myself for sitting on the wrong side of the plane on the way there.  I was hoping to get a glimpse of Mt. Rainier and thought for sure I would have to be on the right side of the plane.  Was sure surprised when I saw it out of my window on the left!

I had a fabulous birthday on Friday w/ my first go-kart racing experience, what a great surprise!  Lots of crazy turns at high speeds just so D wouldn't try passing me.  He knew I loved the Autopia at Disneyland, but this... this was 100x more fun! Celebrated on Saturday with family eating my favorite J'Dawg.  And sushi that night?!  Things get better all the time.  And to top them off, cake batter waffles on day three?!  Multiple days of celebrating is a birthday MUST.