picture perfect

You're in for a photo treat today! I got Chris to upload TONS of photos for me, and I'm so excited that I'm going to share them all at once! Yay!

First, these are some gorgeous roses we got at Meijer a couple weeks ago. They were too pretty not to share!

Next is a set of photos of some cupcakes I made for my friend Sabrina's bridal shower. Sabrina was my roommate for...maybe four years? I can't remember exactly but it was a really long time! She's a super awesome friend and I'm so happy for her and John. John is definitely a lucky guy!
The cupcakes are a mixture of red velvet (of course with cream cheese frosting...yum!) and a special "princess funfetti" mix with only pink and purple sprinkles! :) I also made a couple "UK" cupcakes since Sabrina and John are super UK fans. I wish that I had gotten a close-up of the engagement ring cupcakes because I added "luster dust" on them - making them shiny and sparkly!
Me, in my cute little apron that Chris got me a couple Christmases ago!
I love how well the monograms turned out - it was so easy with my little food writing markers!
Mmm....velvety!

These pictures are WAY overdue - they were for my Grandpa's 90th birthday party. When I think of Grandpa, I think of bourbon, so this cake was perfect for him. I placed the bottle on top of a delicious chocolate chip cake, and we had both his families get together to celebrate 90 awesome years.
Oh and the brown "bourbon" color? Those are peanut butter candy melts. The only thing yummier than a rice crispy treat is a rice crispy treat covered in peanut butter candy!


Hooray for cake! :) Now the only photos I'm missing are those of my dad's chocolate-raspberry layer cake that I made for his birthday. He's got those pictures (not Chris this time!) so I've got to get those from him.

Now that school's out I'm working on a pretty sweet project that I will give you details on soon. A sweet project that actually does not include cleaning my house, painting my fingernails, or the rainy yucky weather. It does involve cake, though, and a bunch of other things. That's just a hint. I hope you are excited. :)

the family doc

My mom has had a chronic cough of and on for years. She typically seems to get a cold sometime throughout the winter and, although she gets over the acute illness, a dry cough lingers for months afterwards. She obviously hates it and my dad has made it clear that it drives him crazy.

Unfortunately, tax season always seems to ramp up right as the cough starts. My mom is a CPA and gets extremely busy this time of year. Things also always seem to fall apart in one way or another during this time every year. One year, my brother had appendicitis. Another year my grandma got sick. This year my grandpa Joe had a bad fall that led to his passing away in March. These months are always so busy for my mom and she doesn't have much time to get seen by a doctor.

But she went to the doctor anyway! She was so sick of coughing that she went to a few appointments. She was prescribed a couple different rounds of antibiotics, steroids, allergy medicine, and even an inhaler! Nothing seemed to help...

One day a couple weeks ago my mom asked me what specialist she should go to for her cough once April 15 passed by. She told me she was planning to make an appointment with an ENT, a pulmonologist, and an allergist. Holy cow - that seemed excessive but apparently she wanted to get to the root of the problem. This cough was driving her nuts! I felt sort of guilty that, here I was, almost an MD and I hadn't even thought about how much it was affecting her.

She had already been prescribed good antibiotics and due to the length of the problem it seemed unlikely she had an ongoing infection (unless it's fungal or something really weird, which is unlikely). My first guess after a URI was allergies/asthma. She does seem to have reactive airways that are worst in the wintertime. She has never been diagnosed with asthma but it runs in the family so it could be a cause. However, the steroids should have helped with that and the inhaler would have made a dramatic difference.

What else could cause a chronic, dry cough? The only thing I could think of was GERD. My mom has no history of heartburn, doesn't ever notice a sour taste in her mouth, and is completely healthy other than this cough. When I suggested this diagnosis to her, she was skeptical. I actually did an UptoDate search and found out that up to 30% of people with chronic cough because of GERD actually have no other symptoms!

Either way, she had no other options until she could get in to see a specialist, so that night my dad sent us off to the store to get some prilosec. I was really hoping that it would work, not only for my mom's cough to get better, but just to prove that my medical education was worth it - I actually learned something!

After about a week and a half of taking the prilosec, my mom told me that she was not coughing nearly as much - almost not at all! It's been well over two weeks now and she seems about back to normal.

I'm so glad my mom feels better. I'm also glad that I apparently learned something these past four years! Hooray for being a doctor!

M.D.

Well, it's all done. Four years of medical school are now behind me...it's kind of hard to recap it all!

Four years ago things were surprisingly different. I spent the summer working in a pharmacy in Colorado and raising chocolate lab puppies. I came back to KY just in time to drive down to Florida to watch my little brother's baseball tournament. I had a nice tan and crazy blonde hair (not just regular blonde hair, mind you).

I still have vivid memories of orientation week - everyone introducing themselves on the first day, lining up for hours for our IDs, for our TB tests, and filling out paperwork. I think we were all really, really excited. We had no clue what we were in for!

Then, anatomy started. It was awful. It was intimidating and stressful, and I think the worst part was we didn't know each other well enough to talk about what we were going through. Then biochem started, which was almost as overwhelming as anatomy. Blech. This became the beginning of Chris and my friendship, though, so things weren't all bad. :) I think Chris was one of the biggest reasons I passed that class! Springtime rolled around, and with it came neuroscience and physiology - and a nice breath of fresh air! We started spending afternoons playing frisbee and evenings watching House.

Second year came and went sort of as a blur - IID, path and pharm...then the boards. I just remember hours and hours sitting in those chairs at the library being MISERABLE but knowing that soon it would be over and we could move on with our lives. Step 1 came and went and I wasn't too happy with how I did. But I passed, and life went on. (I still made it into my top residency choice so apparently it didn't make too big a difference.) Second year I was overinvolved as well, taking way too many leadership positions at once made me a little crazy but I think better at time management in the end.

Then - Third year! Clinicals! Everything was new, frightening and exciting at the same time. Once I got the hang of them, I really liked almost every rotation - it was nice to know that after all this time putting in hours studying I actually liked what I was going to do with my life. I had made the right decision going to med school after all!

Fourth year was just plain awesome. Except for the stress involving the match, every rotation was what I wanted to do and when I wanted to do it. I even got a month off and married my best friend! I have become much more confident in what I know and, on occasion, I really feel like a doctor. How cool is that!? (I need to write the really awesome story of how I cured my own mom - I'll do that soon!)

Exciting times to come, too! May 15 is graduation (I'll admit - I've already paraded around the house in my cap and gown), June 1 is our closing date for the house, and July 1 starts residency! I'm excited (and very nervous) to start...it definitely will be another adventure.

School's out - forever!

TOMORROW is my LAST DAY OF SCHOOL.

EVER.

After TWENTY YEARS of school.

Holy cow.

Next time I see a patient, I'll be "Doctor ______"
(Dang, now I have to decide Twist/Simmons)

There are tons of thoughts and memories I want to share. I want to celebrate, I will miss a lot of my friends...I think a long post commemorating the past four years is in order, but may take a bit of thinking on my part so I probably should wait until I don't have to give a presentation at 8am to actually start writing. We'll see about that tomorrow then.


A side note: "Happy Birthday Dad!"


And finally, my funny patient of the day:

Chief complaint: "absurdly sweaty armpits, hands and feet."

And nerdy factoid of the day: Hyperhidrosis (or excessive sweating) is often treated with topical aluminum chloride (such as Drysol or Xerac), but can actually be treated with botox injections or even surgery to cut the symptathetic nerves going to your skin so you can't sweat. You can also take anticholinergics but they typically dry out your mouth, eyes, etc. in addition to your "absurd" amount of sweating. I learned all this during my dermatology rotation. I admit, I am a huge nerd and I really, really like derm. But it's OK, because I AM ALMOST A DOCTOR!

literally?

Straight out of the chart:

ALLERGIES: Allergy season is kicking my butt =)

Ah, and part 3

Student health is way more entertaining than I thought.

This is, word for word, what a patient put on his check-in sheet for what ended up being an acute case of epididymitis (read: infection of the testicle):

Location: inside inside.
Describe your pain: at first it was slightly throbbing but it just hurts inside it so bad worsening
How severe is it on a scale of 1-10: 8, for real it's my freaking nut, it hurts

I quite literally "LOL'd" when I read that in the chart. Oops. He frequently referred to "his freaking nut" throughout the history/exam. He also wore his sunglasses the entire time, told me his life sexual history (without me asking anything about it), and told me how violated he felt after we were done.

Sent him to the ER for a rule out torsion (which would mean emergency surgery and probably losing the "nut") but thankfully it was only a case of epididymitis.

I love student health, part 2

So this kid comes in for an STD check. (A frequent occurrence only weeks after spring break...) Anyway, part of the check involves a urine sample. He gets the schpeil about peeing in the cup then putting it in the little metal box in the wall. The box opens on the other side, which is the lab where they can run the tests.

Kid goes in the bathroom, kid comes out.

A few minutes later the doc comes over and asks the nurse "where's the urine sample? did you already send it off?" Nurse replies "what urine sample? I haven't done any urine in a couple hours"

Look in the box, no urine. Look all over the lab, no urine. Look in the bathroom, no urine. Look in the OTHER lab on the other side of the office, no urine. Nobody has seen this pee!

They go back and ask the kid, "did you pee?" and kid answers in the affirmative - he put it in the metal box on the wall.

Where did this kid's pee go?

Doc walks back into the bathroom and starts looking around. Next to the toilet is another type of metal box ON the wall. His pee is in the dirty tampon box!

Eeewww!

Healthful Foods

For some reason, I've been on a real "healthy foods" kick. I think it comes with the change in weather and my desire to eat more fruits and veggies (rather than scarf down the heavy meat 'n' potatoes of the winter months). I've actually tried a few things that were surprisingly delicious!

1) Baked Kale Chips
This sounds disgusting, doesn't it? For some reason, I always thought kale must be like arugula or other spicy greens. I could also never seem to find it in the grocery store when I was looking for it. Apparently I can't read because Chris found it first try... Anyway... Basically all you have to do for kale chips is pull off the stems, rub them with some olive oil and sprinkle with salt. You bake them in the oven and they are ADDICTIVELY CRUNCHY! Little curly little crisps, that somehow remind me of roasted pumpkin seeds. I made a half batch yesterday and used the rest in soup (see below), but I'm already craving more. Weird, huh? I need to experiment with this method using spinach, too!
Fun Fact: Kale is not only delicious but also high in calcium, vitamin A, C, and K!

2) Kale and White Bean Soup
Since I had kale to spare, I threw it into soup. Would it make a slippery, slimy mess? No! It was delicious! I also threw some leftover pork tenderloin in the soup to make it extra yummy. It was an unbelievably good lunch, and left me really full without hardly any fat!

3) Finally, one-ingredient banana ice cream
Yes! I've been wanting to make this for quite some time but somehow never got around to it. We had some bananas that were turning brown so I peeled them, froze them, then blended them in my fancy Cuisinart food processor. You have to be patient, but after a couple minutes of blending they turn into a light, fluffy, not-too-banana-y frozen custard! So good! I need to try this with a touch of peanut butter or honey...although it's pretty darn good plain or with a squirt of Chocolate Magic Shell on top.

I love student health

Actual exchange with a patient today:

Me: So what can we do for you today?

Student: I think a bug crawled up my nose.

Me: Why do you think that?

Student: Because I fell asleep outside yesterday and I noticed something moving around in there.

Me: Have you done anything to try to get it out?

Student: I ate spicy food, sniffed febreze, and used tweezers. None of it helped, but I think the febreze made it angry.


Despite our best efforts, we were unable to retrieve (or find evidence of) any pests up this poor girl's nose. Personally, I think our recommendations were just as amusing: black pepper (for sneezing) and a Neti Pot to flush the little bugger out!

(Disgusting) Update! - The patient emailed my doc last night...apparently she used the Neti Pot and out came......


are you ready for this?


A WORM!

Eeeeeeeeeeeeeewwwwwwwwwwwwwww! A little white worm. Now she's afraid it laid eggs in there.

homeowners!

Holy cow, we got the house! They didn't accept our first offer but they countered and we countered their counter...and you know how it goes...but it ended up and they accepted!

Of course, everything is pending inspection and the bank and all those other hoops to jump through, but, we are under contract (yes! $8000 tax credit!) and all looks to be going in the right direction.

It was quite funny because Chris and I had still really been debating house vs townhouse and we actually didn't think they would accept our second offer. We had convinced ourselves that we didn't want the house anymore, and we wanted to get the townhouse...then we got the call...UH OH! I'm glad we hadn't completely made up our minds! But, we're super excited and happy and maybe for once in my life I'll feel like a grown up ;)

Now we need to start getting stuff to fill the house up...I've never shopped at IKEA but I have heard pretty awesome things. May need to make a trip up there soon. It's going to be a lot of fun to set up our new home!

We still have quite a bit of time left, though, as we don't close until June 1. That way we don't have to double up on as many rent payments WITH a mortgage...but June 1 seems so far off- I can't wait!

Happy Easter!

Well, we put an offer on a house! For those of you keeping track, it was "option A" ... it's really exciting but still doesn't seem real. We're going to hear back from them by noon on Monday-I don't expect for them to just say "OK" to everything we wanted but you never know! We went back to look at it last week (with my super picky Dad) and the house just seemed right. The bathroom isn't that small, after all. The kitchen is beautiful...and there's a huge backyard (which I suppose is both good and bad!) We crunched the numbers and we can afford this house AND we can afford to put some furniture in it!

I've started my LAST rotation of medical school - which is also surreal. I'm working at the University Health Services Clinic. Basically it's all college students, and mostly acute problems. It's sort of slow, but I get decent practice using an EMR, good opportunities to learn about acute problems (like food poisoning, sinusitis, etc), and since it's two weeks after spring break, I'm becoming and STD expert!!

Friday night was my last performance in the Humanities Festival - a talent show for med students/faculty. I did not get the opportunity to play flute this year but I danced with the "Rhythm and Bones Dance Troupe" which was a lot of fun. We practiced SO MUCH this past week so I'll be glad to have my evenings back, but it ended up all coming together and being a lot of fun. There were supposedly videos made, so I will post up links when I get the chance.

As far as Easter goes, it doesn't feel like it's quite here yet! The beginning of Lent was very stressful with my Grandpa getting so sick and passing away, then with my long hours on surgery, I just don't think I had time to process it. Also, we practiced dancing so much this week I've missed a lot of the Holy Week services. We went to the Vigil Mass last night because a family friend was confirmed. It was a LONG service but, as always, it was nice. It's Chris' one year Catholic birthday, too!

Unfortunately, I forgot to take photos of the cake before it got devoured at our Easter gathering...it was very yummy though, so I'll give you the recipe just to tempt you! :) The recipe comes directly from here, and there is a delicious and tempting picture for you to drool over for a couple months before you finally break down and make it. Or does that only happen to me?

CHOCOLATE BOURBON CAKE

1 cup (2 sticks) unsalted butter, softened, more for greasing pan
2 cups all-purpose flour, more for dusting pan
5 ounces high quality, unsweetened dark chocolate
1/4 cup instant espresso (can use instant coffee)
2 tablespoons unsweetened cocoa powder
1 cup bourbon whiskey (can use 1/2 cup), more for sprinkling
1/2 teaspoon kosher salt
2 cups granulated sugar
3 large eggs
1 tablespoon vanilla extract
1 teaspoon baking soda
1/4 cup confectioners’ sugar (powdered sugar), for sprinkling


1 Preheat oven to 325°F. Grease and flour a large bundt pan (10 cup capacity), or two 8- or 9-inch loaf pans. Melt chocolate in a microwave oven or in a double boiler over simmering water. Let cool.

2 Put instant espresso and cocoa powder in a 2-cup (or larger) glass measuring cup. Add enough boiling water to come up to the 1 cup measuring line. Mix until powders dissolve. Stir in whiskey and salt; let cool.

3 Beat softened butter until fluffy (2-3 minutes on high). Add sugar and beat until well combined. Add the eggs one at a time, beating well between each addition. Beat in the vanilla extract, baking soda and melted chocolate, scraping down sides of bowl with a rubber spatula.

4 With the mixer on the lowest speed, beat in a third of the whiskey espresso cocoa mixture. When liquid is absorbed, beat in 1 cup flour. Repeat additions, ending with whiskey mixture. Scrape batter into prepared pan and smooth top. Bake until a cake tester inserted into center of cake comes out clean, about 1 hour 10 minutes for Bundt pan (loaf pans will take less time, start checking them after 55 minutes).

5 Transfer cake to a rack. Unmold after 15 minutes and sprinkle warm cake with more whiskey. Let cool. Sprinkle powdered sugar through a mesh sieve over the cake before serving.