1st Week in OB/GYN

Well, almost done with my first week in OB/GYN.  The first day we were on gynecological duty, so we were seeing patients in the hospital for ovarian cysts, pyelonephritis, etc.  However, we did assist on two C-sections and I got to observe a vaginal delivery.  It feels very odd to see a family react to a "birth" in scrubs while surgery is still technically taking place (suturing everything up, still have half the environment sterile).  The vaginal delivery setting makes a lot more sense - the delivery I saw only took about 40 minutes too so that was a pretty quick delivery.  Watching the men is the funniest part because they look terrified and helpless at the same time - after all, it's not like they can relate in any way and they can't really participate in the actual process - she's doing it all herself.  Of the two delivery methods, I'd definitely rather do the vaginal one personally (with epidural of course) - it just looks a lot more impressive.  

The next time I was in the hospital we were rounding on patients and doing a lot of gynecological surgeries so several hysterectomies and salpingo-oophorectomies (tube/ovary removal).  Not the prettiest of surgeries...especially when they do a hysterectomy through the vagina.  Before heading into this rotation, I had no idea that OB/GYN doctors do so much surgery.  Anyway, tonight we are on-call from 7:30pm to 7:30am, so I best be getting off to that - should be interesting.  I like night time, and I'm packing an energy drink - I hear there will be many deliveries.  I will post about it next time I have a spare moment!

In other news though, I got my loan disbursement, so money is not a problem for a little while.  I emailed my school contact about year 4 rotations and I am still studying for the boards - Feb 4.  

Long Day of Surgery

Well, another surgery day is at an end. I was first-assist for a cholecystectomy and a thoracotomy plus decortication. The cholecystectomy was fine, went about as expected - and I sutured up two of the short incisions and they looked quite nice. The thoracotomy is where it starts getting interesting - it was on this 22 year old obese autistic individual, very obese. We had to go through 4 or 5 inches of fat to get to his ribcage where we had previously inserted a chest tube to drain pleural effusion. The guy had a really bad pneumonia infection and it had caused empyema, so we needed to go in, break a rib, spread his rib cage a bit, and detach as much of the pus-covered fibrinous exudate as we could - it was really remarkable how much there was. Imagine peeling really glued on labels off a glass beer bottle, except instead of glass it's lung tissue and the label is dense clotted blood, pus, exudate, and fibrin material. It took a total of 2 hours to do the surgery.

After that I observed a cholecystectomy, but this was kind of an odd case because the woman had a standalone piece of liver, about 2 inches by 1 inch by 0.5 inches, living by itself on her gallbladder. It was really weird, it had it's own blood supply and everything. At any rate, same procedure took place - removed the gallbladder along with that tiny chunk of free-living liver, and stitched the woman up. She took a half hour to come out of anesthesia and even then she was too weak to do much so they decided to intubate and let her sleep and recover overnight.

In other news, my car needed to be repaired, battery/alternator trouble and the cost is gonna be about $2,000 - really painful to think about. At least I have loan money for this sort of thing - unfortunately they still haven't disbursed the majority of my loan money because there is some problem with my stafford loans over at the main university headquarters on the east coast and they are waiting to hear back from them. If I don't hear anything tomorrow, I'll bug them again.

Also, I contacted an infectious disease specialist who works with AIDS patients and he told me to email him so we could set up the rotation - I haven't heard back yet, but hopefully tonight or tomorrow he will respond and I'll know if/when my infectious disease rotation will be. I'd really like to do that, we shall see.

A Productive Day

Well, one of my tasks was very simple, the other much more frustrating. The matter of getting my immunization records was a hassle because I am no longer a member of the HMO which holds all the records of my immunizations, and because I was a member of two different regions, Northern and Southern California. I was on the phone for forever, getting shuffled around until I finally ended up at member services and I was told I could send the form to them and they would give it to my old doctor. I heard this from Northern California. So I tried to do it down here, assuming it would be the same, and I was told it would not be possible to have a doctor sign it because I am no longer a member. I am now stuck sending official immunization reports from the office of medical records, and hoping Touro accepts them and is able to put two and two together. On the plus side, I was driving to so many different Kaiser locations that I came across one that was having a blood drive, so I stopped to donate and get an ice cream coupon! Blood for ice cream, a very sweet deal. I also got some art supplies, so I can work on creative endeavors in my spare time. I also made my appointment to see a D.O. for a physical (Osteopath pride!) - July 23rd, and she's a graduate of Touro University (California)!

The second task, which involved calling Wells Fargo and sorting out my student loan situation, was much more pleasant. I got my loan application numbers, got my Master Promissory Notices, and took out that second loan for $13,500 which will be at 7.5% interest, lower than the "recommended" Federal PLUS loan for graduate and professional students, which has a fixed interest rate of 8.5%. The title of that loan is MedCAP (Medical College Access Program, an alternative loan for health professionals). I knew my history and good credit with Wells Fargo would pay off. It's a shame I didn't qualify for a Perkins loan (issued by the school, $2,000 maximum per year, fixed 5%) but maybe if I file early enough next year I will get it and/or a grant.

Baby steps

I must admit, I am a bit of a procrastinator. Not just with studying, but with everything, including financial aid and certification deadlines. Each time that I nearly do not make a deadline is a lesson, and usually I learn. I think I am slowest with snail mail correspondences. I finally mailed the financial aid award letter back to Touro, indicating that I accepted the $8,500 federal subsidized and $32,000 federal unsubsidized Stafford loans. Based on my calculations and some estimates from Touro, I will need about $13,500 more from a private loan to cover personal expenses, equipment and texts, plane flights for Kit, car maintenance and gas, health insurance, etc. It may be more than I need, but I'd rather have extra than not enough. I need to call Wells Fargo tomorrow and see how to go about dealing with them, since I don't know what information they want from me and I don't think I am supposed to fill out an entirely new loan application (at least not for the Stafford stuff) - just sign the Master Promissory Notice. I also need to call a doctor within my PPO to get a physical for school. Joy.

Now, I need to decide how to best spend my time, as I am starting to feel a bit listless with so little to do. I could work on my book list, keep collecting insects, computer games, cook new things...I have writer's block so that is frustrating. In two weeks I will be going to Monterey with the family for a week, then I will be going back for the 4th of July, and then at the end of July I move back home. I kind of wish I weren't going back for the 4th, since it's a whole week that I could be spending with Kit AND working, and I'll be living with the family for the next four years... The 4th wasn't my idea. At least I'll have summers - it'd be nice to leave home next summer and spend the months with Kit. Such a long road...but it'll be worth it (my new mantra).

Student Aid! Hooray!

Well, perhaps I am celebrating my soon-to-be indebtedness too soon, but I have nearly finished the financial aid packet for Touro University, minus one question, and I have submitted my FAFSA and the online quiz for first-time borrowers. It is nice to know the different options I have. I hope to do all my loans through Wells Fargo, including the Stafford Loans, Grad PLUS possibly, and maybe an independent loan. I have been with Wells Fargo for a while and should have a good credit history with them, so I may be able to get less than 8.5%. It's also reassuring to know I can request forebearance on the loan during my residency years, and so get reduced payments while I have a resident's salary.

For those who are curious, here is how medical students generally fund their education:
For Touro, here are all the fees per school year:
Tuition/Fees: $39,036
Room and Board, Supplies, Health Insurance, Transportation: $30,055

Loans:
Federal Subsidized Stafford Loan - $8,500 (max) - pay interest after school
Federal Unsubsidized Stafford Loan - $32,000 (max) - can defer payments
Federal Grad PLUS or Private Loan - however much I need, so $28,555

I am going to live at home for the first year, so I can take away about 15k from the private loan. I'm curious how the school will interpet it - I filed my FAFSA and my taxes as independent, yet I plan to live at home. I don't know whether that waives just the room and board costs, or more. Regardless, I will be relieved when all the loans are figured out.