Good-Bye October, Hello November! In an effort to get back into blogging, how about a weekend recap?

Friday marked my last day of my OB-Gyn rotation which turned out to be bittersweet. Even though I originally considered OB pre-medical school, I've since moved away from the idea. This month really surprised me! (More to come in a future post).

On Friday night, my husband and I decided to go to dinner out and ended up checking out a local brewery. 

We decided to get a couple flights since we had never been there before. My favorite was the chocolate orange stout!

While we indulged in some beverages, we decided to get competitive with a game of Rummy. I haven't played it in FOREVER but I used to play all the time with my dad. Can't beat a relaxing evening like this!

Saturday was obviously Halloween! We had a couple invitations to Halloween parties but ultimately decided to grab dinner and drinks with some other couples. Not being one to skip an opportunity to dress up, I decided to channel Madison Montgomery from American Horror Story: Coven as my costume. I figured it was calm enough for public...maybe even something  I would wear regularly (sans sunglasses at night...).

Our night out ended and we made our way home from some Uno and TV before bed. I think one of the best things about married life is that I feel like I can be my true self. Nick and I are both pretty laid back people and I love that we have fun, laugh, and relax whether we are out in a big group or at home hanging on the couch.

We spent Sunday catching up on laundry, cleaning the apartment, and meal prepping. I also caught up on several weeks worth of Scandal and Grey's Anatomy - all in all, a very productive day! Now it's time for another week and new rotation - Internal Medicine! Stay tuned for more updates :)

Just checking in really quick to say that life is flying by and I'm still working on a getting caught up on blogging.  I thought it may be more helpful to try to write some shorter posts until that time comes...especially now that I'm on a super exciting rotation - OB-Gyn!

OB-Gyn has always been on my radar as far as specialties go (ok...what hasn't?). I really enjoy women's health and wellness topics and I love that the speciality combines all aspects of health care - surgery, procedures, and clinical medicine. There's definitely a lot going on in such a small area of the human body.

Since I'm doing my rotation at a smaller rural hospital AND I'm the only medical student on the service, there are tons of opportunities for me to get hands on! Today was only my second day on labor and delivery and I already got to first assist on a C-section. How cool! I mostly retracted and helped the OB with suturing - even got to hold the uterus. :)

Still have a whole month left to go but I have to admit - I miss the kiddos. I REALLY loved my month on Pediatrics and I hate not being directly involved in the newborn care after delivery. Hmmmm...seems like I'm starting to narrow things down! 

Regardless, this month is going to be great! I just may end up visiting the babies in the nursery a couple times ;)

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 :)

Whole30

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!

Workouts

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!

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?

One rotation down, a whole bunch more to go! Right now I'm wrapping up the end of my very first rotation for third year - Emergency Medicine. Kinda crazy considering most schools don't offer EM until the fourth year. This month was a great way to get exposure to a variety of medical problems - from strokes and MIs to mystery rashes and chronic medical condition exacerbations. The ED is certainly NOT limited to emergency cases! 

Luckily, this rotation hasn't been TOO bad. I worked 13 10 hour shifts and my partner and I were able to create our own schedules as long as we weren't at the ED at the same time. I ended up working a lot of 4p-2a shifts, some 6a-4p, and some 8p-6a. If things happened to get kind of slow or the docs were busy charting, I got to go home a little earlier. Perfect for me because the hospital is about 45 minutes from my house! 

So not a grueling schedule by any means but it was still a hard month, sleep-wise. It's really hard to go from day shift to night shift and back again. I had a LOT of lazy days, especially after overnights, where I would wake up around 10 am and just loaf around all day. I HATE feeling tired and I also hate not having structure.

Even with no other rotations under my belt, I feel like I held my own this month. I was stationed at a community-based ED so it was plenty busy with lots of moderate-acuity patients - TONS of psych/overdoses/withdraws, abscesses/lacerations, abdominal pain, chest pain, etc. It certainly wasn't an academic center in the middle of the city. Usually my day was a mix of seeing patients on my own and following around my doctor. 

Generally, the doc I was assigned to follow around would tell me who they needed me to go see next (so they could go see another patient in the mean time). If possible, I would look at their chart on the computer and look for previous admissions/past medical history. I would introduce myself to the patient/family as a medical student and ask if it was ok to talk with them for a bit before the doctor came to see them. No one ever said "no" and most people were actually very happy to talk with me! The great thing about students is we have plenty of time to chat and are generally a lot less intimidating than the "real" doctors!

Next I would get the history from the patient and/or family. My favorite question to ask is "what made you decide to come to the ER" because it can be very revealing about what could be happening. I'm immediately on my guard if that patient has experienced symptoms abruptly or worse than anything they've had in the past. We do get a lot of patients that shouldn't have come to the ED, for various reasons, but it's important to still make them feel welcome and comfortable. Some people are just scared! 

After taking the history, I do a quick physical exam (I've noticed the ER docs do a VERY focused H&P) and then I explain what I think may be going on and what we will likely do. Then I ask if there is anything I can pass along to the doctors or nurses and explain that the doctor will be in shortly to see them! I then present my findings to my attending and we go see the patient together. Lather, rinse, repeat. Occasionally the PAs grab me for a procedure and let me drain an abscess or close a laceration. 

Gotta practice, right?

Unfortunately, because my computer access is limited, I didn't get a lot of practice writing orders or notes. The docs have scribes so they generally don't write their own notes either. I'm in for a nasty shock when I get to Internal Medicine! 

In between patients, I would look up things I didn't understand or work through this book. My hospital isn't used to having residents or students around so it's been a bit of a learning curve for all of us! Some docs are very comfortable teaching while others just aren't. In those rare cases, I just tried to be as helpful as I could while also following the docs lead (i.e. avoiding interrupting them or asking a million questions that I could easily look up). I filled in gaps by reading Up To Date or another source. I grabbed EKGs and practiced reading them, etc. There are so many way to occupy your time! When possible, I spent a little extra time with my patients and didn't hesitate to grab them a cup of ice water (if allowed!), a blanket, or help a nurse put the patient into a more comfortable position. 

EM has been pretty high on my list of potential specialities for the past couple years so I expected to really enjoy this rotation. And I did enjoy it, just not as much as I would have liked. I'm so glad I had this rotation early, though, so I can start to shift my interests towards Pediatrics and Psych (my secret loves). 

So what did I like? Variety - both in disease presentation and patient population. No two patients look exactly the same, even if it's your fourth "headache" or "flank pain" of the night. It's a tremendous privilege to be there for someone during a vulnerable point in their life. (Almost) no one wants to be in the ER but if you can be a calming force and a good listener, it goes a long way. Also, despite the fast paced/busy nature of the ED, most docs and nurses are pretty laid-back and easy to talk to. Not a lot of ego (that seems to come from the specialists...) and generally willing to help each other out!

As much as I enjoyed this rotation, I don't see EM being my future career. Mostly because I found myself wondering what happened to my patients after they left the ED. I need some follow-up or continuity (although EDs do get their fair share of "frequent flyers"). I'm a patient person and the idea of managing chronic conditions doesn't bother me like I thought it would. There were so many conversations I wanted to have with patients (about nutrition, lifestyle choices, long term treatment alternatives, etc.) that just aren't always possible or appropriate in the ED. So many patients end up coming back again and again - it's heart-breaking. Something about the ED made me feel a little helpless. We could "fix" or help the patient in THAT particular moment but we had little power to do things moving forward. You have to HOPE that your patient has the resources and abilities to get the follow-up they need or to manage their conditions. I'm not completely ruling EM out of the equation since I still have another 4 weeks at a different hospital in December (and possibly January for Pediatric EM).

I'm starting to think Peds, Psych, or Family Med may be more my speed. I know I will still face many of the same challenges in a primary care role (I am dreading the paperwork and insurance red tape) but I know there will be a bigger opportunity to develop long-term relationships. 

In addition to my shift in the ED, I also had the opportunity to do a 10 hour ride along with a local EMS crew. Unfortunately we only got one call the entire day so I was pretty bummed :(. Still, it was pretty neat to see how things work on the other side of emergency care. Our firefighters and EMS crews work SO hard and are amazing at what they do! I had a blast just getting to know them and learning what a typical day is like for them.

Now I just need to take my shelf exam for the end of the rotation and go back to campus for some OMM practice and an ethics session. My next rotation is Psychiatry (starts on Monday) and I CAN'T wait! Psych has always been in the back of my mind but I never really shared my interest with anyone. Mental health is just as important as physical health and I don't feel like it gets the respect or attention it deserves. So excited to see how things work and to start helping people! 

                            

For the last few months, I have let my life be defined by one major thing: boards. All areas of my life has slowly started to crumble...not exactly the "balance" I talk about all the time. The truth is, I have been getting pretty lazy.

My husband has been taking up a lot of slack when it comes to preparing meals & doing housework (all things we used to share equally). My workouts are less consistent.  I can't even remember the last time I went for a run. Crossfit? I went ONCE in the last month. Partly due to vacation and partly due to laziness. My nutrition has gotten progressively more lax as well. Somehow things like potato chips and Taco Bell bean burritos have been making regular appearances. To say it lightly, things are a mess. 

Now starting my first rotation of third year with Emergency Medicine hasn't made it all that much easier. Random hours and long shifts have really been messing with my sleep - and I love my sleep. At this point, I feel tired All. The. Time. Sluggish, unmotivated, and ready to nap at any point. While my weight hasn't actually changed much the past few months (I'm still sitting in the low 190s), I feel bloated and heavy. I feel myself losing muscle tone. And yet, I can't seem to get out of this funk. 

Time to snap out of it. Whole 30 worked really well for me last time. The creators share a philosophy that I truly believe in so when I found out my Crossfit box would be sponsoring a Paleo Challenge at the same time that I wanted to start Whole 30, it was perfect! 

Now here's the fun part. Last Whole 30 (in February), I had a private Facebook group of women who shared the challenging experience together! We swapped recipes, tips, and tricks but most of all, we supported each other 100%. Sure, most people lost a good chunk of excess weight but the most important changes were mental. I feel more in control than I have have around food. Even when I choose to eat "off plan," I do so in smaller quantities (i.e. I don't feel powerless to stop). Overall Whole30 energized me and left me feeling lighter. 

This program isn't purely about weight loss or meant to be "restrictive". You WILL eat - whatever you need to feel satisfied but you also learn to view food as a source of fuel. You will eat more vegetables than you ever thought possible. You will learn how to read food labels and to scutinize the ingredients you put in your body. You will learn that added sugar is hidden in EVERYTHING. Most of all, you will learn that food does not have power over you. YOU decide what goes on your families plate. 

So if this sounds interesting to you, I strongly encourage you to go read "It Starts With Food" and/or the Whole30 website. Then, shoot me an email if you would like to join our secret Facebook group or  have questions!

Past posts:

• My Whole 30 Story Part I
• My Whole 30 Story Part II

Get ready for some delicious recipes and a lot of fun!

I'm backkkkkk! How's that for a long hiatus? Where do I begin? The past month has been absolutely crazy. How about a quick recap?

My husband and I celebrated one year of marriage on June 13! 

One year of marriage went by so quickly! I'm not sure I would have made it through this past year of school without the constant support of my husband - everything from picking up the slack around the house to consoling me during one of my freak-outs. He is ten times more patient, kind, and thoughtful than I'll ever hope to be but somehow he still stick by me. Even more, I'm so proud of all of his accomplishments at work. You'll never meet a more driven or hard working man. Over all, year one of marriage has treated us very well! We're both healthier and certainly "lighter" than a year ago but our relationship as a whole has continued to grow and strength. Definitely our best year yet! 

I took COMLEX on June 16! 

I'm working on a post solely dedicated to boards - my plan and how it worked out (spoiler alert: I passed!). 

My person got married on June 20.

One of my very best med school friends, the Cristina to my Meredith, got married in Louisville after boards! I was honored to be asked to do a reading during her ceremony (which was on a rooftop - beautiful!). We had a great time dancing the night away and celebrating with friends!

We visited family in Cincinnati and then took an anniversary trip to Seattle.

Since we didn't take a honeymoon last year, we decided to take a week long trip to Seattle! Why? Why not. We pretty much ate (& drank) our way across the city of Seattle for 5 days. Everything from oyster po boys to 8 different styles of chowder to fresh prawns. Oh and the coffee! So great. We discovered a new love of ours - ginger beer! Perfect for refreshing cocktails. We went on a brewery tour, watched a Mariners game, saw Kenny Chesney in concert, and more. Just a really great, relaxing trip!

We celebrated July 4th with friends!

Our last celebration before third year began. What's more American than an Indiana cornfield, some drinks, a little corn hole, and a bonfire? We had a great time!

I started my third year of medical school in the Emergency Department!

And then before I knew it, it was time to start my third year. I'm already wrapping up my first Emergency Medicine rotation. Where did July go? 2 more shifts in the ED & an EMS ride-along to go!

So that's an overview of what's been going on and why I've been pretty absent on the blog. So glad that I finally have exciting things to write about again instead of boards studying. Real patients with real problems! So much more to come - stay tuned! 

After many months of long study days, thousands of practice questions, and more sitting than I ever wish to do again in my life, I AM DONE WITH BOARDS. (at least until Step 2).

Some people have been asking HOW I prepared for boards but I'm going to hold off on that until I know how well I did. I would hate to give out poor advice! I will say that my school provided us with a program that we were required to complete. Lots of pros and cons to this that I'll be happy to discuss in the future. I also supplemented with UWorld, USMLERx and COMQUEST question banks and Pathoma. My ultimate point of reference was the med school bible aka First Aid. 

I have NO CLUE how things went yesterday. COMLEX is known for being very vague. There were a ton of questions where I was able to narrow it down to two answers. Praying that I made the right choices! Throughout the test I just felt so strange, not sure how else to describe it. The exam didn't feel like any of the practice I had done.  

Another issue of note. It was originally my plan to take both the MD boards (USMLE) and DO boards (COMLEX) but I eventually settled on just taking COMLEX. I wasn't confident enough that I could hit my USMLE goal and I didn't want to risk performing below average. Better to focus all my energy on doing as well on COMLEX as possible, than risk having two low scores. I hope I won't regret it! Honestly though, after taking one 8 hour exam I'm not sure where I would find the mental strength to take another. 

So...now we wait. I'm trying to resist the temptation to look up the answers to things or dwell on what I could have done better. It's over. Board scores are a pretty important portion of my future residency application and obviously I need to pass them to graduate! At this point there is nothing else I can do so I'm just gonna celebrate and enjoy life!

The next few weeks are going to be so FUN! This weekend one of my very best friends from med school is getting married in Louisville! After that we are going to Cincinnati for a few days before boarding a plane to SEATTLE! Ahhhh I'm so excited! 

We didn't get to go on a honeymoon after the wedding last year so we're taking our belated honeymoon/anniversary trip now. Why Seattle? Why not? We aren't really big beach vacation people so we decided to check out somewhere different. Our goal is to visit all the Major League Baseball parks - two years ago we went to Atlanta and now we'll check another off our list. 

After Seattle, I have hospital orientation and on July 6th I start my third year rotations. Life is flying by and I'm another step closer to becoming a doctor!

Also, don't forget that Weigh In Wednesday has been passed down to Winter @ No Drama Little Mama so go check that out and link up! As for me? I've been maintaining my Whole30 weight loss and slowly chipping away at my goals. The last week has been hit or miss with my workouts but I'm looking forward to the study-free life.

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Hey!  Let's just right in to some news...today will be my last week hosting Weigh In Wednesday.

This link-up has changed a lot in the two years that I've been involved with it! We've had people linking up since day one (way before I started!) and lots of new faces that have become awesome supporters and friends.

My decision to give up hosting duties comes largely from the uncertainties of my future clinical rotation schedule. My participation in the link-up has been spotty at times during my pre-clinical years of med school so I can only imagine what things will be like when I'm taking call overnight and working a crazy schedule. I don't want to continue to put a half effort here when someone with more enthusiasm for the project would do much better than me!

My life has changed a lot since first starting this blog and joining the link-up. When I graduated college, I was the worst shape of my life. Bloated, puffy, sick looking. As I faced adulthood and life after college, I was so insecure and lacking any sort of confidence.  I spent the year after college gaining clinical experience, applying to medical school, and struggling to gain control over my life.

Slowly, through the help of this link-up and the many friends I've made along the way, something finally stuck. After years of yo-yo dieting, self-hatred, disordered eating, and crazy methods, I started to embrace moderation and self-efficacy that comes along with setting realistic goals and chipping away at them.

In the past two years, I've successfully lost nearly 50 pounds (so close!), ran 2 half marathons, and several 5K & 10Ks. I've started lifting weights and discovered Crossfit. I've embraced a "real food" approach to eating - one with healthy fats, complex carbs, protein, and tons of nutrients! (You can read my first WIW here). More than that, I've gotten engaged, married, moved to a new city, completed two years of medical school, and accomplished more than I ever thought possible.

With all these wonderful accomplishments to look back on, I know that I'm not done yet. From a health perspective, weight still needs to be lost. Races still need to be run. Weights still need to be lifted. Yoga poses need to be held (I tried...). I have a career to begin and a family to start (not yet!). I'm not done here but I need a chance to share it with you all on my own terms.

Weight is no longer the singular focus in my life. It actually means very little to me compared to how well I sleep or how high my energy is for the day. Food isn't just comfort or a security blanket for me anymore - it's fuel to power through my workouts and study sessions. Workouts aren't just something I do to lose weight now. I workout to feel ALIVE and strong. More often than not, my workouts are my favorite part of the day! Most days, I wake up ready to tackle the day. I'm starting to feel the confidence that being about to back squat over 200 lbs brings. I feel powerful knowing that two years ago, I never thought I could run a mile, let alone 13! I feel strong knowing that I can make healthier choices but also enjoy life at the same time.

With all that said I will continue to link up with you all, just not as a host. I'm ready to continue my journey on my own and share other aspects of my life besides weight. I will of course update you when I reach the next milestones of my journey. And since we know I'm not the most consistent blogging, please come follow me over on Instagram  (@prettystrongmed) or Twitter since that's where I do most of my updating these days!

Winter will continue to host the link-up from now on so make sure you check her out over at No Drama, Little Mama. I suspect she will be looking for a couple co-hosts to help her so shoot her an email if you are interested!