Start of rotation 2 and quotes from prison

I realize that I haven't been keeping up with the blog, but I hope to change that with this next rotation. My primary care rotation ended successfully and I was fairly tired by the end. I was working 55 hours in 4.5 days...seriously fun but exhausting!

I have now moved on to prison. Federal prison to be precise. I have completed 3 days and I think I have gotten over my initial claustrophobia from being locked in the medical area. There are a series of very large double locked doors that you have to go through to enter and exit the prison. It is a strange feeling to be standing there waiting for a guard at central command to open the door. More on all of this later, but here are some quotes for your enjoyment:

preceptor asks a patient "why are you taking acyclovir?"

patient "herpes.....man! don't make me say that in front of the lady" (the lady being me)

patient "when I got inside (read: incarcerated) they told me I only had one testicle, but before that I had 2.....I don't know what happened to the other one"

Bangtail Divide a LITTLE too early in the season...

Monday I rode my bike up Stone Creek (well, actually, I pushed it most of the way past all the crazy switchbacks....) and along the Bangtail Divide trail toward Olsen Creek. Most of the way it was awesome, gorgeous, perfect riding weather...

But then I hit snow.
The trail disappeared and left me post-holing up to my thighs, flinging and dragging my bike over and through snowdrifts. Long story short, I backtracked and made it home safer and wiser (hopefully)

Day 1 of first rotation

Yesterday was my first day of my primary care rotation. This is a 6 week rotation at a local family practice office with 1 Doc and 3 PA's (all are alumni from my program). I will be shadowing the first 3 days and then I get to start seeing patients on my own this friday. So, I observed 23 patients and was in clinic for 13 hours! Awesome. I saw a wide variety of conditions ranging from high cholesterol to ingrown toenail removal and everything in between. I got home at 8pm, heated up some food, entered my patients into Typhon (school system that logs our patient encounters), reviewed some pharmacology that I could not remember when I was pimped in clinic, then to bed. It is 6:15 a.m. and i'm getting my lunch and snacks together for today.

Woot!

Egads!

Since returning from spring break we had a week of obstetrics and now I'm in the second week of pediatrics. Yes, peds. Or perhaps "aw gahd peds!" would be more fitting. It is a metric sh** ton of information and at this point in the didactic year I think my brain is on strike. Chili doesn't seem to like it either. I get home, make some food, take her for a walk, and then study. Last night it was the chi who was on strike....

"It's not you, it's me....really"

Baking: Week 1

I started baking bread at the co-op in Bozeman this week. My shift started at 3:30 in the a.m. and I got to weigh and mix, shape, score, and bake hundreds of breads, including:

baguettes, challah, ciabatta (loaves and rolls), foccacia (salt & herb, red pepper parmesan, caramelized onion, mushroom, pepperoni, and blue cheese walnut) and a different flavor levain every day, sourdough, burger buns, sausage buns... a lot of bread!

There's a lot to learn, and next week I'm training on the second bread shift so I get to sleep in! It doesn't start til 4:15 a.m.

Clinical Rotations 1 and 2

Today we got official notices of our sites for rotations 1 and 2!

Rotation 1: 6 weeks of primary care in The Boro (Jesse's new name for Hillsboro)

Rotation 2: 6 weeks of community medicine at the Federal prison in Sheridan. That is, if I pass the background investigation.....

The good news is that Won and Jesse will be nearby for both rotations so much fun will be had by all.

We are Aunties

Over spring break we got to visit my brother Josh and his wife Autumn and their new (week old!) baby boy, Mason. He was born March 13, 2011.

Little Mason Robert Gullickson

Josh, my brother, holding Mason

It's pretty neat how his tiny little fingernails are so perfect. He has really long fingers and feet.

Spring Break 2011 = New Car!!

Chi Bath!

Baths are so trying.

Glove and Gown

I am in the middle of the Women's Health module. However, this past Thursday evening we headed over to Tuality Hospital which is on campus for an OR experience. We got to scrub in, glove and gown, and check out a general surgery and laproscopic OR set-up.

Me in the middle, feeling groovy

In the laproscopic OR, the nurses had set up a simulation for us using the camera with one hand and a grippy graspy thing in the other hand to try and retrieve a toy. In my case it was a rubber spider. I hate spiders. I was saying "I hate spiders" over and over the whole time. But it was still good fun.

French sourdough whole-wheat loaves

Last weekend I got to play with my sourdough and the bread book Andrea got me for Christmas. These are boules of "pain Poilâne"

I just scored.

Snow!

We awoke to a beautiful snow day. It is so peaceful! Check out this video.

http://www.whitevinyldesign.com/solarbeat/

Vertical Mattress

As we started the surgery module this week, we are continuing to learn fun techniques that are practiced on a fresh round of pig's feet. Yesterday I solidified my vertical mattress suture and learned the running subcutaneous sutures. The vertical mattress is useful when you need to apply a fair amount of pressure to close a wound but do not want to invert the wound edges (this leads to a nasty scar). Subcutaneous sutures are sewn with an absorbable suture material and do not need to be taken out. When you get a nice run of those you really see how small of a scar the pig will have. Happy pig.

vertical mattress

We also got to numb a wound with lidocaine -- that was super fun! You insert a syringe into the subcutaneous tissue and numb as you go. It's difficult not to say this out loud: num, num, num, num, num, num, num.

http://www.youtube.com/watch?v=gFf90Yl91-4 Click on this video link to hear the rhythm and melody. Warning: this will stay in your head for quite some time.

Yesterday my pig's foot also had a punch biopsy done, wound closure with a staple, and I froze off something that I pretended was a wart.

GBHs and Odd Weather

The Great Blue Heron is considered the Portland city bird. They nest all around this area, and this is the time of year when they are choosing where to nest and raise their young. They've been staking out the conifers near the Hillsboro Public Library over the past couple of weeks, and last week I found these 2 sentinels peering down on the foot traffic. Look closely and you'll see a nest!

Nest top/center

This morning it was snowing (see the video) and this afternoon, tiny hail and rivers in the parking area.

Prison and Pig's Feet!

There were 2 exciting developments at school today.

#1) I found out that I am going to prison and

#2) I got to try suturing for the first time on pig's feet!

Prison. I knew that a rotation at a prison was possible so I gamely put in for the experience. You have to understand that at this point we don't even know where our 1st rotation in May will be, so finding out that I will do a rotation at the Federal Prison in Sheridan Oregon was huge. I have to fill out something like 19 bazillion forms and attend an orientation etc. so this is why I found out in advance. Gotta love the feds! I don't know when I'll be going, but at least I know that I'm going.

Suturing. Since this is the emergency medicine/surgery extravaganza month, we get to learn to suture. The last few days I've been learning to do the different knots and today was the first day of actual suturing. On pig's feet. Weird at first, but makes a lot of sense. The pig flesh is very similar to people flesh....I know, it's creepy. But hey, at least we are practicing on someone other than our classmates or patients.

Knots!

I started the Emergency Medicine module today with Surgery following in 2 weeks. This week we start to work on knots and suturing. Unfortunately, my handy trucker's hitch, good for so many things in the backcountry, will not be used. How about the ever trustworthy (read: trust your life to when hanging off the side of a mountain) clove hitch? Nope. Figure eight? Don't be silly. But after today I can slowly tie both the one handed and two handed square knots...

No I'm not trying to channel Obi-Wan, I just have a cold.

More to come in the days ahead.

Hillsboro Library Saturday Morning Chi Walk

Andrea's brain was fried from 2 weeks of neurology, so we needed some peaceful outdoor time.

Drippiness was no deterrent, and we were rewarded with some unusual sights.

Duck butts!

Red-breasted Sapsucker

As we were walking, this sapsucker flew low over our heads and then landed on a tree a little way off. Andrea stalked it, sneaking up behind a nearby tree trunk to snap this photo.

Recently excavated sapsucker wells on a tree trunk

Fabulous wood duck

American wigeon (not a socialist commie wigeon)

Is it a goose??? No, a Great Blue Heron! In a tree.

This regal bird was posed for us just below its nest (can you see it?) It really is quite an amazing sight to see such a big bird way up in a tree, perched daintily on its stilt-like legs. The one below was atop (very tippy top) a 200 ft tall fir tree!

WTF.

Back to the bike commute

With the rain temporarily letting up and darkness waiting until 4:48 p.m. to take hold....it's time to bring the bike out for my school commute. We just wrapped up 3 weeks of musculoskeletal fun and I'm thinking this pose must be seared into my unconscious because of all the time spent staring at muscleman. See photo below.

Boo-yah! Who's ready for Neurology?

Beer for strength

Northern end of Jackson Bottom Wetlands Bird Survey

This morning the sun came out, for the first time in... well, we quit counting the days. We were very excited and went outside. I did a bird survey for the northern end of the wetlands while Andrea played with the camera.

Mourning Dove

Steller's Jays

American Robin

Ortho. Behind the scenes.

Today, Andrea got to practice casting (and uncasting, I hope).

I emailed this photo to Kadie mid-afternoon so that she could see what I was up to....The last time I had my left arm in a cast was when I was 11. I had ridden my bike off a jump and did not make the landing. As an 11 year old I thought being in a cast was pretty cool.

My first cast!

These legs belong to my classmate Trish. The closest leg is my first attempt at a short leg cast, or any cast for that matter. This pic was taken halfway through the process. I still needed to add another layer of the fiberglass casting material. After I finished I got to cut off my first cast. The saw is a bit intimidating, but we both made it through ok. Just think, the next time I get to do this it will be on a real patient. heh.

Winter Break 2010 Bozeman

It is hard to believe the entire 3 weeks of winter break went by so fast, but I guess that's what happens when you're having fun. We enjoyed the sunshine and glittering snow, the friends and food, the skiing, and the drinks. Andrea's summary of the break: "Eat. Sleep. Ski. Drink."

"Bunny Pose!" The Chi is such a good sport.

Nordic skiing with my little Swede

For Christmas, Andrea got me a book I'd been drooling over, "The Bread Baker's Apprentice". I dove in and baked up a storm in Kaaren's kitchen. The Kitchen-aid mixer was fun to play with and I had time to try a couple of different shaping techniques.

This challah tasted as good as it looks

Even the squirrels are in better shape in Bozeman!

The last few days of our Bozeman break the temperature didn't get above 0 degrees, so we made the most of it, staying all cozy and warm reading and resting up from all our adventures.

Oregon had some very cold weather, too!