Week 2 of Whole30 & Psychiatry

Wednesday, August 19, 2015

Well here I am. Halfway through another rotation - wahoo! I keep psyching (haha) myself out, knowing that I have SO many more rotations ahead of me...

So far Psychiatry has been pretty chill. Definitely a "lighter" rotation, although I find myself getting to the hospital earlier and earlier in order to avoid traffic and to read up on/visit my patients.  Like I said last week, the morning is spent rounding with our attending (we're a group of three students...10 total at this location which isn't usual for most of our rotations) and seeing patients in the various Inpatient wards. Then we split off in the afternoon - this week I was at an Outpatient therapy location just down the street from the hospital. I was able to sit in on Group Therapy, spent a day in the Adolescent Day Therapy, and worked with an amazing outpatient physician as well! I started to learn a little bit about all the different types of therapy - CBT, DBT, psychotherapy, etc. and I definitely want to keep learning. We've talked about everything from shame to self-esteem to finding hope and how to deal with anxiety - topics that are just as important for all of us med students.

I'm just really loving Psych! Sure, I love the lifestyle but I mostly love the patient population and the variety of work. When people come to the hospital, they can be wildly psychotic, manic, or majorly depressed - each one so vastly different from the next. Some are withdrawing from various substances or escaping horrible circumstances (abuse, trauma, homelessness). It's amazing to watch these people get better/stabilize right in front of your eyes over the next few days. Humans are remarkably resilient - especially when their basic needs are being met. For many patients, being in a regulated environment like this is desperately needed - away from all the stressors in their life. They are able to get their required medications, participate in group therapy, interact with others, and start to sort through what brought them to the hospital. It's truly amazing to watch and participate in!

I never realized how much of Psychiatry is done through pure observation and history taking. Unlike other specialties, there aren't a whole lot of tests and procedures one can do. You don't check a lab for depression (although you may look for organic causes like hypothyroidism) and you can't just scan someone's head to diagnose schizophrenia or bipolar (although you can rule out secondary causes of psychosis). A lot of the overall impression of what's going on is based on what the patient says and doesn't say, their body language, their movements/facial expressions, previous history, etc. Collateral information from caregivers, family, friends, nursing staff, etc. is all useful in piecing together the puzzle. I find myself reading a lot of old charts - hence why documentation is so important! 

1.5 more weeks to go but I know this won't be my last psych rotation :)


We're steadily moving along in our Whole30 journey this month to the point where I really don't think about it much anymore. Except weekends...weekends are the worst! I just want to go out with friends and not have to worry about things being compliant :/ 2 weeks to go - we can do this!


I'm still getting used to this whole "having a job thing"...as silly as that sounds. Going to class/studying all day is just a whole different world with a ton more flexibility, more breaks, etc. So my energy levels on top of doing Whole30 have been decently low. I'm starting to get back to a good place though with enough sleep!

Monday - Crossfit 5-6p
Tuesday - Crossfit 6-7p
Wednesday - Crossfit 5-6p
Thursday - OFF, 20 minute walk with hubby
Friday - OFF
Saturday - Gym - lifting/running
Sunday - Spinning 10:15-11am

So there's my week of workouts. I was really excited I made it to all three Crossfit classes for the week and even tried a new spinning studio with some friends on Sunday morning. I loved it so much I decided to sign up for a 2 week unlimited offer just to try a few more of the classes. I may try to make Sunday morning spinning a new thing for me just to shake things up a bit!

One thing that is lacking from my routine in running. I just haven't felt like doing it lately and I'm not sure if I want to sign up for any more races or not. With my schedule being somewhat unpredictable, I would feel bad to pay for a race and then not be able to go due to being at the hospital. With Fall approaching though (my favorite season to run in) maybe I will get my desire to run back.

And sometimes you gotta treat yo self...to a new workout bag!

Week 1 of Whole30 and Psychiatry

Tuesday, August 11, 2015

Derp. Hello! Just wanted to pop in really quick to recap the past week. My life basically revolves are a small percentage of things: work, making food, eating food, thinking about food, and cleaning up after my food prep. Welcome to the Whole30. 

Chicken sausage, onions, peppers, and roasted potatoes.

Everything is going just fine this time around. Like last time, weekends are pretty much the worst. It's almost sad that my husband and I don't know what to do with ourselves. We could go see a movie...but then I'll want popcorn. We could go out to dinner...but then we'll want some wine or dessert. We could go out with friends...but then I'll want to eat all the things. Whole30 is a social life killer. 

I did meet up with my friends after work on Friday afternoon. Of course they indulged in a deliciously cold adult beverage while I opted for lemon water. They noshed on chips and guac while I loaded up on a delicious unless burger atop greens with a side of broccoli. It was actually pretty tasty so I can't complain :)

See this? This is the other fun part about Whole30. Dishes. (And this is just ONE DAY's worth). Nick and I feel like our kitchen is constantly in a state of being cleaned. We never can get ahead of it! Prepping 95% of our meals certainly takes time (and seems more costly even though it isn't) but it IS going to pay off! And we keep getting better and better at it!

Now that I'm done being a grouch (yes, I've been pretty moody lately), I have to admit that Whole30 is coming at the perfect time for us! We just could NOT get out of our vacation rut. This month is the perfect time to start over. I'm already feeling lighter and more in control again. Getting plenty of nutritious, healthy foods in my system is helping my acne-prone skin clear up and my belly issues calm down. I'm feeling more energetic but I am having some minor cravings for my favorite foods.

My Psychiatry clerkship is going well this month, too. Our schedule is very manageable compared to Emergency Medicine (no overnights) and we're seeing a wide variety of mental illness and conditions. I'm actually pretty interested in Psych - I will definitely be doing an elective or two during my fourth year! Probably in Child & Adolescent Psych or maybe Outpatient. 

Our schedule changes from week to week but our mornings are always spent on Inpatient Psych with our preceptor. Then after lunch, we spend the afternoon in Groups, the Crisis Center, or two different Outpatient psych centers. I love getting to see the different levels of care and how all the team members interact to care for patients - nurses, therapists, mental health counselors, PA/NPs, & docs. 

For this week, I'm at the Outpatient center spending time with the doctors and sitting in on therapy sessions. My goal for this week is to really master the Mental Status Exam and to work on my question bank/review book daily to help prepare for my COMAT exam at the end of the rotation.

I'm also making my public commitment here to not skip out on my workouts this week. I don't know what has gotten into me but I'm back to my old ways again. I've been getting myself all worked up/anxious about going to Crossfit or running and then I talk myself out of it completely. Not happening this week! 

I'm committing to three Crossfit classes and two additional lifting/running sessions this week. There. Now it has to happen! 

Do you ever talk yourself out of workouts? How do you stay accountable?