Tuesday, July 31, 2012

Tasty Tuesday: Grilled Zucchini Orzo

One food that I obsess over each summer is zucchini. I love it. I can't get enough of it, even when the garden is overflowing with zucchini and it's coming out of our ears, I can't wait to eat more of it. It genuinely is one of my favorite foods; as a child, I loved loved loved fried zucchini (oh of course I still do!), but now that I have grown up (a little), I have branched out and found that I love zucchini in all of its ways: masked in casseroles, hidden in desserts, showcased as a steamed side, with a bit of pasta, with a bit of quinoa, with a few mushrooms, with a little salt, breaded and baked and dipped in tomato sauce...well, you get the idea.

This summer, I have been doing my best to eat as clean as possible (while allowing room for cheats of ice cream and other goodies - what's life if you can't enjoy food, am I right?!). Going along with clean eating, I have discovered a new recipe for zucchini that I am currently maybe a bit too excited about. I have, in fact, made this dish three times in the past week (I can't help myself, really).

So, without further adieu, I give you: Grilled Zucchini Orzo

Grill 3 cubed zucchini and 2 diced onions in a small amount of olive oil until nice. Boil up some orzo (I make the entire box, but that might be a bit much for you!) and cook as directed. Chop up about a half a cup of fresh basil, 2 cups of arugula, and a red pepper if that's your style (not for me - no thanks). Drain the orzo, add it to the grilled veggies, toss in the basil/arugula/pepper, add in a bit of salt and pepper and your desired amount of balsamic vinegar before plating. Top the pasta dish with sprinkles of Mediterranean mix Feta Cheese and enjoy. You can thank me later.

It's so quick and easy, yet so flavorful and delicious, it's no wonder why I've had the urge to cook it so often while I'm in full-on study mode! 

Hope you enjoy!!!! :)

Sunday, July 22, 2012

Boards, Boards, Boards, Boards, Boards.

My schedule has been crazy, studying for the boards. I've learned from what worked for step1 (and more importantly what didn't), so I am already seeing improvements in my performance. I still have 12 days to study (I'm taking the exam Friday, August 3), but I'm feeling fairly confident at this point. I have a lot of things I need to look over a few more times, but I'm not too terribly overwhelmed right now. I mean, I have been preparing for this exam for the past year, I've done well on the shelf exams, so I should do well given the 4 weeks I've given myself to solely prepare for the exam.

My daily schedule looks something like this:
7-830: Run/Shower
8:30-12:30: Watch Doctors-in-Training lectures
12:30-2:30: Attend Pathology Cases
2:30-4:30: Do 44 questions in UWorld
4:30-7: Finish Lectures/Review DIT
7-10: Do 44 Questions in UWorld
...and of course a few breaks to sneak in dinner/a cup of tea/walks outside with Marley/tidy the house. I might enjoy my breaks a little too much - it is just so hard to sit still for 14 hours a day!

I'm so ready to be back on the wards, and to have all of my major exams of my medical school career done and over with!

Next up after boards: A week's vacation with my family (which I have missed every year for the past 4 years!), followed by 2 weeks of Inpatient Hematology/Oncology (I absolutely cannot wait for this), which will lead me into September and 4 weeks of an Acting Internship in Internal Medicine - - - I can't wait!!!!!!!!!!! :)

Tuesday, July 10, 2012

The Two-Horned Uterus

I am currently in full-on Step2CK/Boards study mode. I'm averaging 10 hours a day at the moment, trying to increase it to 11, and I take the exam in less than 4 weeks. I'm surprised at how different studying is this year as compared to last year's studies for Step1. I was in England, and I was absolutely spoiled; the only thing I had to do was study. No bills to pay, no laundry to do, no food to make, no dishes to clean, not one single obligation outside of studying (Mike's parents are absolutely amazing and I cannot thank them enough for their support!). I'm also taking my science-based clerkship right now (pathology), which takes up a little bit of my time. This year is so much more difficult. Mike is busy studying in between loads of coaching sessions and summer camps...which means the housework is falling on me, miss needs-to-study-all-day-every-day. And it's pretty hard to balance, actually, as one may notice by how absolutely messy the apartment is!

Anyway, enough complaining! I do love what I do, and I wouldn't trade it for the world. I'm performing better on my exams than I had for Step1, which is a really promising sign. I have a goal score for my Step2 and I am absolutely going to achieve it (even if it means everything else in my life is put on hold for the next month!).

As I have been studying, I am constantly reminded of interesting patients I have seen in the past year. It's funny, the whole first year of clinical work everything seems amazing and everything seems rare because everything is brand new to you. It's not until I've reached the end of my third year that I realized just how amazing some of the patient's stories actually are! So, as they come up, I would like to share them with you. I have nothing else to blog about anyway, unless you want to hear about how I sit at my desk for days at a time, taking breaks only to go to case studies, eat, shower, walk the dog, and run! (didn't think so....)

Story #1:

While I was on the OB service, I was able to scrub in on every delivery that occurred during my shifts. My very first experience with a C-section was something I'll never forget. Gowned up (with high boots and all), I watched as the OB and her senior resident cut open a gorgeous woman's abdomen and pull out a beautiful baby. After the baby, the resident laid a strangely heart-shaped organ onto the mom's abdomen - the woman's uterus - so that he could suture the uterus closed. That's when the resident decided to pimp me -
Resident: "what's significant about this patient?"
Me: (Hm....quite an open-ended question, but) "her uterus appears to be misshapen."
Resident: "Yeah, it's called a bicornate uterus, meaning two horns. It's an anomaly which occurs in about 1 in 1500 women. This is the first time I've ever seen one before. Aren't you lucky to have scrubbed in today?...Since she has this malformation, what other things should we be concerned about in this patient?..."
Me: (oh my god I have no idea, but that was one of the most disgusting procedures I have ever seen in my life; I feel a bit light-headed...) "... ... ..."
Resident: "Which organs are related to the same embryological origin as the uterus? It's the kidneys. The malformation is due to the failed fusion of the Mullerian ducts. We need to make sure there are no anomalies in this patient's kidneys, as about 1/3 of patient's with a bicornate uterus also have renal abnormalities."

That was pretty cool. Thinking back on the patient, she was an older woman and this was her first delivery. I thought it kind of strange that she was so old (only like 35), old for a first time mom. But looking back, this makes sense. Women with a bicornate uterus have difficult conceiving, as the egg finds it difficult to implant. Moreover, second-trimester miscarriages occur due to defective implantation of the placenta. Other complications of pregnant women with a bicornate uterus include: fetal anomalies, prolonged labor, malpresentation of the fetus (such as breech and transverse lie), and increased bleeding.

Bicornate Uterus literally means "two-horned uterus". Animals which carry multiple offspring during pregnancy often have this type of uterus (such as dogs), but its occurrence in humans is 1:1000-2000 women. It consists of a double uterine cavity with one cervix and one vagina.

For more information regarding embryogenesis of the uterus and kidneys, click here. That stuff is more Step1 material than Step2 so (thank God) I don't have to memorize that junk again! ;)

Monday, July 2, 2012

Final Thoughts: Family Medicine

My eighth (and FINAL) clerkship of third year (Family Medicine) has come to an end...

  • 5 weeks, 21 days, 161 hours of work in areas ranging from Family Practice clinic to Inpatient Family Medicine in the hospital.
  • Working at the clinic and hospital, I worked 16 days for 141hours (average of 8.8hours/day; about 35.3 hours/week)
  • I was in lecture for 5 days, totaling 19.5hours (average of about 4 hours per lecture day).
  • I enjoyed 12 days off in the last 33 (that's ~2.5 days/week).
  • I completed 0 nights on call.
  • I studied family medicine outside of work a total of 50 hours.
  • My total work in Family Medicine over the past 5 weeks is: 211 hours in 5weeks (42.2 hrs/week...about 6 hrs/day).

What I LOVED about Family Medicine:

  • The lifestyle is amazing. The days when you work are long (9-12 hours), but the days off are pretty much full days off. 
  • You get to see different things with each patient, and each day is different. You never know what's going to happen in the office, so it can be somewhat exciting.
  • It's the first line of diagnoses for most diseases. Think about it...who diagnosed your asthma? or broncitis? or sinus infection? or your ankle sprain? And they do most of their diagnosing based upon a thorough history and physical alone, and order labs/tests as necessary based upon their clinical inclinations. That is pretty fun.
  • I actually enjoyed seeing kids! I couldn't do it all day, but interspersed between adult visits was actually kind of enjoyable. I know, I'm just as shocked as you are. I like the kids! 
  • You have a long-term relationship with your patients.
  • Patients trust you, and rely on you for your second opinions for more specialized conditions. And they are always asking for advice from their family doctors. Strangely, although some medical professionals seem to lack large amounts of respect for family doctors, the patients seem to respect their family doctor most.
  • If anything gets too complicated --> refer to specialist.
  • There are procedures that you can do! ...even if it is just removing a wart, it's still a procedure!! 
  • I delivered a few babies, without going through OB-Gyn residency. That's pretty awesome. And both the mom and the new baby will be members of the family doctor's practice for many years to come. I love that.
  • I love working in a clinic. We also got to do some rounding on the patients who were in the hospital, which I also enjoy doing. 
  • It's just a little bit of everything. And if there's something you don't like to do, you don't have to do it - just refer to a colleague. The freedom is unbelievable.
  • I really love preventative medicine. I enjoy having conversations with patients regarding their nutrition, exercise, lifestyle, habits. I also like to talk to them about what they can expect in regards to their health. I also like the idea of stopping a disease before a patient even notices its presence (like with hypertension or hyperlipidemia or diabetes).

What I DIDN'T love about Family Medicine:

  • Some days get super long.
  • Some patients come in with the strangest complaints...like weird complaints. Like "my belly button itches, what's my diagnosis?" kind of complaints. I know it's probably just anxiety, but it still feels strange to hear such bizarre reasons for coming in to the doctor.
  • Each visit is so short. 10-15minute visits just aren't enough for some of the more complicated patients or diagnoses. 
  • I would like to know more about the specific diseases. I think deep down inside, I'm meant to specialize. I just want to know everything about something rather than something about everything.
  • Often times, other doctors don't give family physicians the respect they deserve. 
  • Patients will do as they wish...all of our best interventions are useless if the patient decides not to comply with our recommendations. This is such a huge source of frustration for me, but can sometimes be avoided with proper patient education - which requires more time spent with the patient in each visit, which is simply not very feasible.
  • The compensation is nothing to write home about...not that money matters, but it is certainly a factor in the decision making process.

Since I didn't actually get the chance to work in the Ambulatory Clinic with an Internist, I'm not sure if this is kind of how their days are arranged (minus the kids). If so, even life as a General Internist wouldn't be a bad choice for me...but at this point in time I really would love to specialize (likely in Medical Oncology).