Spring Awakening

It's early Saturday morning, and I'm sitting in my little loft, waiting for the sun to come streaming in through my windows and for my new little birdie friends to come visit me on my windowsill.  I almost feel like Cinderella... now if only I could get them to do my laundry... haha.  It promises to be another beautiful day here in Baltimore, and I am grateful for the change in season.  I used to think that summer was my favorite time of year, but after this winter and the recent shift in weather, I realize how much I LOVE spring.  Not just because it allows me to walk to school in the morning without the need for 5 layers of clothing, but rather for what it symbolizes: REBIRTH.  I've enjoyed walking through the city streets, admiring the budding and blossoming flowers, rejuvenated after a long winter hibernation.  Despite the 80+ inches of snow we had this winter, these marvelous works of nature are able to "come back to life" and share their beauty for us all to appreciate.  I know I personally appreciate the return of the sun, and the warmth that it brings with it, but I feel like I've reawakened - to life, to possibilities, to the wonder of this Earth, and to our individual significance as a member of humanity and one of God's children.  Easter is next weekend, and when you are able to look past the chocolate bunnies and see what the day really represents, it is humbling.  The most important and significant "rebirth" -- the true symbol of this time of year.  I feel so blessed... for many more things than I have time to share here.  But I am grateful for the knowledge that I have, the opportunities and experiences I have been given, and for the people that give my life meaning.

SO.  One thing that I struggle with is being present, in the moment, and recognizing and appreciating that which is right in front of me.  My mind likes to race forward, planning and preparing for the coming weeks and months, and before I know it, another day has passed me by.  Here I am, end of March... I only have one more full month in Baltimore, and then I'm OUT!  April will definitely be a busy one, so I know that it will be over in the blink of an eye... I have much to look forward to, but I'll get there soon enough.  So let me focus on what has happened the past couple weeks since I last posted...

I had the opportunity to return to the OR for another surgery... it was an incredible experience.  Watching the surgeons repair a thoracoabdominal aortic aneurysm was... awesome.  Not sure how else to describe it!  And let me just mention that the guy they were operating on was 6'5" and 450 pounds.  No joke.  Unfortunately, the surgery lasted much longer than I could stay for (I had tutoring with Ivan) but I do hope that he is doing well and making a full recovery to return home to his family and then to work as a middle school principal.  I will say... that is one thing I appreciate about bedside nursing -- the opportunity to develop a connection with the person behind the diagnosis.  It's not enough for me to understand the diagnosis and treatment plan; I need to know what events brought them to the hospital, and other factors that may be helpful pieces of information to improve the course of their care. 

After my second day in the OR, I was able to escape Charm City to enjoy a few days of my Spring Break in the Big Apple.  And I couldn't have asked for better weather!  The first day of spring in the city was well over 70 degrees, and I was thrilled.  New York can be one of the most miserable places to be when it's cold and windy... I was ecstatic when I was able to walk down Fifth Avenue with my sunglasses on :]  haha.  It's the little things that really do it for me!  The other highlights of my weekend included spending a sunny afternoon at the park relaxing on blankets with some new friends, , exploring the hidden beauty of Battery Park along the banks of the Hudson River, wandering through the halls of the impressive New York Public Library, and spending quality time with one of my favorites as we did yoga underneath a willow tree in Central Park.  Not a typical weekend in the city, by any means, but one of the most enjoyable and memorable ones to date. 

 

 

 

But of course, good times must always come to an end... and usually much quicker than you hope.  So Sunday night I returned to Baltimore, just in time to get a few hours of sleep before a painfully long and busy week of school.  Projects... assignments... exams... everything is piling on as we near the end of this semester -- only 3 more weeks to go!  At least I'm having an enjoyable time in clinical -- much less intense and stressful than Adult Med-Surg.  Thursday of this week, we spent the day at a catholic elementary school with the school nurse, and did some health education with a class of second graders.  Topic of discussion:  HEALTHY SNACKING!  Not just healthy eating... but what to reach for (or ask for) when they are hungry between meals.  I hope our activities at least got them to recognize that fruits and vegetables are better than chips and candy.  Gahhh -- don't even get me started on the obesity crisis that we are currently experiencing in the US!  That is definitely one of my interests when it comes to health promotion and education... here's a video that can better illustrate the nature of this problem that we must acknowledge and deal with:



 ... and here are some facts that I'll add on to that message:

• In 1990, ten states had a prevalence of obesity less than 10%, and no states had a prevalence greater than 15%.  By 1999, NO state had prevalence less than 10%, eighteen had prevalence between 20-24%, and no state had prevalence greater than 25%.  In 2008, only ONE state (Colorado) had a prevalence of obesity less than 20%.  Thirty-two states had a prevalence greater than 25%, and six of those states had a prevalence greater than 30%.  
• This is the first generation where the child's life expectancy is SHORTER than their parents.
• In 2000, obesity-related health care costs totaled an estimated $117 billion.

SO.  Take from that what you will... but this is more serious than people want to admit...!!  And after that educational moment on Thursday, I spent my day at clinical with a patient who is obese... spends 6-8 hours every day watching television, and refuses to participate in sports because she doesn't enjoy it.  It's a cycle -- kids aren't active, they get teased because they're overweight and unable to participate, and then they hide at home to escape the hurt and embarrassment they face at school.  It's terrible.  I tried to talk with the girl (13 years old) about her habits, but she wasn't really willing to listen.  I know it's tough for her... she comes from a broken home in East Baltimore, where it probably isn't very safe to be outside, with a mom who probably can't afford to buy healthier food (which is another community issue altogether), but hopefully she can find something to motivate her to be more actively involved in life.

Speaking of being active and eating healthy... I'm keeping up with my yoga practice, and I feel amazing.  I treated myself to some shopping in NYC at my favorite yoga store:  Lululemon Athletica.  I'm hoping to get a part-time job at one of the stores in Denver/SLC this summer.... keeping my fingers crossed!  I've also stuck with my "no sweets, no soda" pledge for the past 34 days -- SOOOO pleased with myself!  And what's even better, because I haven't had much sugar for the past month, it really doesn't sound appealing... maybe I should just keep this trend going... except for the dark chocolate of course (antioxidants, it's a healthy choice!) :]  Well, I have to get ready for my Saturday morning yoga session... Namaste!

springing ahead...

It's a GORGEOUS spring day here in Baltimore... I took a walk this afternoon through the city, appreciating the warm sunshine as I wandered along the banks of the harbor.  I love this time of year!!  As much as I enjoy winter, the shorter days and decreased sun exposure really affect my mood... I can already feel the shift, and look forward to sunny days that lie ahead!  And if that weren't enough, there are many other things that have brightened my outlook on life, and I'm excited to share that with you :]

To start, I had the great opportunity to observe 2 surgeries yesterday in the cardiac/vascular OR, a result of meeting Dr. Julie Freischlag a couple weeks ago.  It was an awesome experience.  First, I watched her resect the first rib of a woman suffering from thoracic outlet syndrome -- pinching of the nerve/artery/vein that run through that narrow region of the shoulder.  It was a relatively short procedure, and one that Dr. Freischlag is well-known for.  After that procedure, she whisked me off to observe a surgery that had already begun -- CABGx2 (coronary artery bypass graft) with an aortic valve replacement.  WOW.  I walked into an open-heart surgery!  I stood at the head of the patient for 3 hours, transfixed on the scene playing out in front of me... I could see the heart of this man, and watched the surgeons as they meticulously grafted on an artery cut from his leg onto the outside of his heart.  For those who are not famliar, CABG procedures are required for patients who have diminished blood flow to the heart itself, because without that blood support, the heart cannot function to pump blood to the rest of the body.  Usually the coronary arteries are occluded by fat deposits, result of long-standing diet and exercise habits.  (Prevention, people!)  The aortic valve, also a vital part of the heart, functions to keep blood from flowing back into the heart as it is pumped out of the left ventricle.  If not working efficiently, blood can flow back into the heart, decreasing the amount of oxygenated blood that is delivered to the various tissues of the body.  Replacement valves are synthetic -- created in a lab -- that are designed for maximal efficiency in patients that have weaker hearts.  Medicine never ceases to amaze me... even though I've learned about these types of procedures in class, it's something completely different to see it in person.  Anatomy and physiology is somewhat completely predictable, and although there is still much to be learned, it's fascinating to really understand and appreciate all that we DO know.  One of the aspects of Adult Med-Surg that I appreciated most was connecting all the patient data to understand the much larger picture... one that includes not only physiological factors, but also emotional, psychological, environmental, and social factors.  For example, my one patient who was suffering from congestive heart failure and renal failure -- she came into the hospital for fluid overload due to the complications of those two chronic diseases, but with further investigation, I learned that her meals included easy-to-make foods such as canned soup, which are known to be high in sodium... which would further exacerbate her fluid retention.  Interesting what health care providers can learn when they take the time to talk with their patients and learn more about their lives outside the hospital...... which can help us better care for them while they are inside the hospital.

In my last post, I mentioned my upcoming trip to St. Croix... I met with my group and instructor last week to learn more about what we should expect from our clinical experience on the small island in the USVI chain.  Our responsibility focus will be on health screening and health promotion.  The big diseases we will be faced with include diabetes, obesity, CHF, and... HIV.  We have a lot to prepare before we head down there, and I'm excited to research ways to better educate people on the prevention and management of these health complications that plague our modern society.

I'm nearly half-way done with my pediatrics rotation (really??) and this past week, I was fortunate enough to have a charming 13-year-old boy recovering from a sickle cell crisis as my patient.  For a kid who is familiar with the inside walls of hospitals, he was handling his most recent hospitalization with a great sense of positivity.  Maybe it was because he was missing school.... haha.  But he was a great patient.  In order to better manage his pain, we played Clue, wii, and Operation.... all completely nursing-related interventions, of course.  :]  It was a great day, laughing as we chatted and played games.  We even worked on some of his math homework!  He was not excited about that, but I made a deal that we would play Mario Kart after he finished a page of problems.  Kids truly do amaze me... his resilience and optimism was inspiring, and I was grateful for that short amount of time that I was able to spend with him.  He has such lofty ambitions for his future (he wants to be an engineer) and I hope that he finds motivation and support to pursue his dreams!  It reminds me of my younger years... wanting nothing more than to be a doctor.  I've definitely grown since then, and I'm grateful that I've found my calling as a Nurse Midwife. 

It's now Spring Break, and I'm enjoying the time I have to take care of my looong "To Do" list that has been haunting me for the past few weeks!  But of course, I'm taking advantage of this free time to escape to my favorite city -- NYC, of course!  I'll be heading up there this Thursday and staying until Sunday to do some therapeutic shopping :]  Then it's back to the grind... next week is going to be quite busy with school assignments and projects and what not, so I'm trying to stay mentally engaged with that reality.  Having days in the OR is actually helping... I'm returning tomorrow for a very serious and extensive thoracic surgery -- repairing an aortic aneurysm, and also placing femoral shunts.  I'll have more details next week... but I'm looking at multiple hours in the OR tomorrow!  What an opportunity and experience.... I'm quite excited, to say the least!

I'm looking out the window of my room, and it's still bright and sunny outside.. at 5:30pm!  I love DST.  Looking forward to the blooming cherry blossoms this spring.... only a few more days of "winter" -- I survived. haha. Until next time, take care all!

... could spring finally be here??

It's a beautiful Sunday afternoon here in Bal'mer... I just arrived home after a trip down to DC for church with a friend.  It was a much-needed break from the city -- sad to say that I was excited to be in a car driving on a freeway!  That says a lot about my life lately... Aside from my recent trip to New York with Greg, I haven't left the city of Baltimore for 2 months now.  I've forgotten what the world is like outside of my little bubble of Fells Point... thankfully the weather is finally starting to shift -- the sun is shining brilliantly on the harbor water today, with a bright blue sky overhead... could Spring finally be here??  I'm crossing my fingers, but definitely not holding my breath... Baltimore has found a way to disappoint me on more than one occasion in the past.  But I do have one thing to look forward to, that will happen whether Mother Nature wants it to or not -- DAYLIGHT SAVINGS TIME!  My favorite time of year... I don't care that I lose an hour of sleep, all that matters is that the sun will set after 7pm... I am so excited to walk home with some natural sun lighting up the sky! 

Well.  Because I have loads of studying and work to catch up on this evening, I'll try to keep this (somewhat) brief.  I've finished my second week in pediatrics, and it has been an interesting transition from Adult Health.  I've been assigned to work on the general med-surg floor for adolescents, and at Hopkins, "general" doesn't really encompass the breadth of medical cases that we see on our floor.  While I was working on the adult med-surg unit, we saw many local patients with common chronic diseases that they had been managing for many years -- namely COPD (chronic obstructive pulmonary disease), CHF (congestive heart failure), CKD (chronic kidney disease), DM (diabetes mellitus) and so on.  With the adolescent population, we are seeing families from all over the country, here at Hopkins as a "last resort" -- the hospitals back home are at a loss trying to diagnose and treat their ailments, so Hopkins is their only hope.  It can be a depressing situation, in that sense, because many patients do not know what is causing their problems, or if they do, it might not be something that can be treated at any regular hospital.  My first patient was from New Mexico, here to treat symptoms and complications from a rare genetic disorder that was only recently discovered (by her physician at Hopkins, no less) only 5 years ago.  She had spinal fusion surgery to correct her severe scoliosis, and had growing rods inserted to stabilize her back.  Her parents were present, and I cared for her over the course of my 12-hour shift.  We were happy to see her walking a bit by the time I was leaving, and she was such a trooper.  Thankfully her parents were very supportive and willing to assist with her rehabilitation, encouraging her to push through and do the activities that she did not want to do.  I think that's one of the most crucial factors in the health care of a child, whether the parents are willing to accept the diagnosis and comply with the course of treatment that their child needs, especially if it means pushing and challenging the child to do what he/she does not want to do.  As a nurse, my responsibility is to care for the child, but I am also "treating" the parents, by educating them and including them in the care of their child in preparation for discharge back home.  It's a delicate balance, and it will be interesting to see where the next 5 weeks take me....

And now for some exciting news:  This past Wednesday, I was fortunate enough to attend a lunch presentation by the Chief of Surgery for Johns Hopkins Hospital, Dr. Julie Freischlag.  Yes, a female Chief of Surgery.  It's an unfortunate rarity in this country, but she is managing the department quite successfully and spoke to us about taking on challenges when others say it isn't possible to succeed.  She was a fantastic speaker, and made some really interesting points that I greatly appreciated.  I was surprised to learn that she had completed her residency at UCLA, and that she had returned as the Director of Vascular Surgery at UCLA Medical Center for a few years before she moved to Baltimore.  I approached her after the presentation and thanked her for words of encouragement and inspiration, and to make a complicated story short, I asked her if it would be possible to observe one of her surgeries... and she was more than happy to arrange it!  So, next Monday over Spring Break, I will be in the OR... I'll be excited to report back details of my experience.

So, yes, Spring Break is next week... with the amount of school work I have looming on the horizon (between exams, assignments, projects, and presentations) I'm somewhat relieved that I won't be traveling anywhere.  It will give me some time to (hopefully) relax and check a few things off of my "To Do List."  I'm trying to plan a trip up to the Big Apple, at least for a few days... I don't mind the idea of traveling alone, and besides, I have friends to visit there and work that I can get done while I'm in the city.  And I will definitely appreciate the change of scenery!

With that, I'm going to leave you all... look forward to exciting updates on my next blog entry!!

*New York, New York*

 

[Dinner at The View Lounge]

  

 [Rockefeller Center]

  

 [Times Square]

  

 [Grand Central Station & The Chrysler Building]

 

[Grand Central]

  

[Lex-53rd Subway Station]

 

[Central Park]

 

 

 

 

[NYSE]

[The Met]

 

[Brooklyn Bridge]

 

...parting shot of Manhattan...

just another 33 days...

It's another blustery winter day in Baltimore... I just arrived home after spending a few hours in the computer lab at school, and was not prepared for the weather that I would encounter when I stepped out of the building!  When I left my house earlier this morning, it was pleasant - I opted for a long-sleeved shirt and a puffy North Face vest, which suited me just fine on my walk to school.  Complete with knitted gloves and scarf, of course.  But the weather, as I have come to learn, is NEVER predictable... even from one hour to the next.  So... I walked out to a blast of cold wind, foreshadowing the approaching storm this evening... MORE SNOW.  I cannot believe it.  Unfortunately, the weathermen are not very accurate out here - one is predicting a light dusting, while another is predicting a possible foot.  Who are we to believe?  At this point, I don't really care.  As long as it doesn't cancel school -- one week off due to snow is enough for me!  It's been 2 weeks since the mighty blizzards of 2010 (the biggest snowfall in Baltimore history, I would have you know) and the snow is FINALLY melting away.  Snow bank piles still litter the road, a small reminder of what surely feels like a dream... I wonder if the city government will actually put some money towards purchasing a few snow plows to have in case of future emergencies... not likely. haha.  They'll continue to rely on the fact that Baltimore usually only gets about 20 inches of snowfall a year... and that this winter with 80+ inches was merely a one-time issue.  Why is it that I'm lucky enough to live here during this record-breaking year...? I will say, Baltimore was actually a lovely little city with the white crystals covering the darkened streets for a couple weeks...

My last update was the morning after the first blizzard -- not two days later, we were hit with another storm, that dropped another 20 inches of snow on our already-crippled city.  It was too much; 40+ inches in one week is absolutely unheard of in these parts.  We heard some locals talking about the "Storm of '96" that brought about 25 inches of snow -- the fact that they actually remember a storm from 13 years ago that brought a mere 2 feet indicates how rare it is for blizzards to hit this region of the country.  So to get 2 blizzards, and in one WEEK, Baltimore was completely shut down.  We were in a "Level 3 State of Emergency" which asks that all civilians remain off the roads and in their houses... it was a tad bit ridiculous, if you ask me.  But they were able to bring in some snowplows to help clear some of the main roads to bring some traffic back into the city.  Unfortunately (yes, UNfortunately), Johns Hopkins University decided it would be best to close school for the entire week, and as fantastic as it was for the first couple days, I hit a wall on Wednesday and was struggling to keep sane.  Cabin fever hit hard.  Amy, Britte and I decided to venture out into the middle of the blizzard, just to get some fresh air, and here are some photos from our adventure:

 

 

Our excursion into the frigid weather definitely helped relieve some of the pent up energy that we had from being cooped up inside for a solid 5 days.  And to add to our stress, we found out that the hours we missed in clinical would have to be made up the following week -- 16 HOURS.  And we already had 2 exams and a project that needed to be completed... apparently they assume that we don't have lives outside of school.  Granted, I know that it was necessary to do some supplemental/replacement work for the hours missed, but I think that they could have been a little more lenient or offered alternatives.  But that was not the case.  Needless to say, my life outside school was non-existent last week.  But I survived!  And at the end of the week, I had completed my clinical rotation in Adult Health!!  I don't quite remember those 32 hours I spent on the unit over the course of the final 3 days of last week, my memory seems to be quite the blur... but as I look back over the past 7 weeks spent on that unit, I recognize how much I have learned and grown with the experiences that I have had, and I am that much more confident with my knowledge and abilities as I move on to my next rotation:  PEDIATRICS!  My first day of clinical is tomorrow, only once per week due to our 12-hour shifts.  I have been assigned to work on the adolescent unit at Hopkins, not my first choice, but the more I think about it, the more I am excited to work with this specific population.  Thankfully I have some experience working with teenagers, so hopefully the transition will be a bit smoother... but I will keep you updated with my thoughts and perspectives after I spend my first shift on the unit.

 

[Halsted 8 Adult Health Clinical Group]

After the next 7 weeks working in pediatrics, we will begin our Public Health rotation.  Each year, Hopkins takes 3 different clinical groups to 3 different sites (Haiti, St. Vincent, and St. Croix) for a clinical experience abroad.  It's a highly selective program - only 8 students are chosen for each group, and a large majority of our class applies.  With recent events in Haiti, that site was unfortunately removed from the list (although I think it could have been an amazing experience to travel there and help) so that left 2 sites, with 16 open spots.  I applied, not really confident in my chances to be chosen (we have many returned Peace Corps volunteers in our program who had also applied) and to my great surprise, I received an email this past weekend informing me that I had been selected to travel to St. Croix!  We have yet to have our informational meeting, so I will fill you in with further details after that date, but I am THRILLED (to say the least) to have this opportunity.  I have a general idea of what our responsibilities will be while we are down there - mostly related to health screening, health education, and health promotion.  It is going to be an amazing opportunity, and a great insight into the world of global health (something I intend to contribute to once I am a midwife).  So I will be traveling to the small Caribbean island at the end of May for about 10 days with a small clinical group and our instructor -- thankfully I know a few of the girls who are going, and I'm excited that we will be able to share this experience together!  Not to mention that I'll be able to escape Baltimore and relax on the gorgeous white sand beaches... something to look forward to...

 

 [St. Croix]

Only a couple more months... haha.  Until then, however, I have much to focus on, so I can't get ahead of myself!  Thankfully, I was able to escape "Charm City" this past weekend -- Greg came to visit!!  It was a somewhat last-minute trip, his last guaranteed "free" weekend before he starts his job in California.  He arrived out here last Thursday, wish it could have been a bit of a smoother trip... but he made it nonetheless.  Friday we enjoyed our time in Baltimore before taking the bus up to New York City on Saturday!  It was a whirlwind adventure, but we thoroughly enjoyed our time spent together.  I was just so grateful to have my little brother out to visit, and so excited to share one of my favorite cities with him!  We were able to see all the highlights of the city, including Downtown (Wall Street, Ground Zero, SoHo), Midtown (Times Square, Rockefeller Center, Fifth Ave) and Uptown (Central Park, The Met, the LDS Manhattan Temple) and everything in between.  I'll post a few of my favorite pictures in a separate entry.  We walked EVERYWHERE, thankful that the weather was cooperative for the few days we were there!  We were able to enjoy a delicious dinner atop the Marriott Hotel in Times Square -- it's a revolving restaurant, that affords incredible views of the city.  We spent over 2 hours there, admiring the spectacle that is New York City, and appreciating the time we had to spend together.  As excited as I am to be moving back to Utah this summer, I will surely miss having him around... it won't be the same in the SLC without him!  But I wish him all the best as he ventures off to begin the next phase of his life in California!!

And if you're wondering why the title of this blog says "just another 33 days" ... well, I'll fill you in on my current goal.  I challenged myself to 30-straight days of hot yoga, and was able to fulfill that goal (amidst the blizzard, which did force me to rearrange some of my schedule) and loved the rewarding sense of accomplishment.  So, I have set a new goal/challenge: 40 DAYS WITH NO SWEETS.  This includes chocolate and baked goods.  Amy (my roommate) and Britte (a friend) both gave up sugar for Lent, and I decided that I wanted to test myself, to see if I could meet the challenge -- it's actually been quite empowering, to say NO to sweets when offered.  Even in this first week, it has really helped me see how easily I can give into temptation just to please that other person and not turn them down.  Quite a lesson, I must say.  I will keep you all informed as to my progress... this could get ugly in a few weeks as my level of chocolate reserve runs low... but hey, at least I'll be appropriately prepared to lay out on a beach in May!  Even if my skin is ivory white... haha.  Anyways, I have to get going... yoga in an hour, then its back to the books!  Big day tomorrow... I'll be sure to fill you all in on the world of adolescent med-surg nursing soon!

*post-blizzard images*

  

[my street!]

 

[no joke... 30 inches...]

 

[Thames Street Park]

 

[snow up to the benches!]

  

 [is that a car under there....?]

 

[SO grateful that I don't own a car out here...!]

"SNOWMAGEDDON"

It's early Sunday morning, and the sun is poking it's head through my window.  The snow rests peacefully outside, no indication of the havoc it wreaked just a mere 24 hours ago.  "BLIZZARD OF THE CENTURY" and "SNOWPOCALYPSE" were some of the catch-phrases tossed around yesterday... and for Baltimore, I don't think that the monikers are far off.  In relation to those who have lived in snowy climates, however, it's somewhat amusing to hear these descriptions of this "monster" snowstorm... aside from the winds, and the thunder and lightning (yes, THUNDER AND LIGHTNING in a blizzard... never knew that was possible) it really wasn't that bad.  haha.  But...  Baltimore is not equipped to deal with snow (I believe I have mentioned this before) so to have 30 inches drop in one storm, over the course of ONE day... it's not hard to imagine what this city is trying to manage right now.  But here I sit, in the comfort of my warm home (THANKFULLY we still have power) sitting in front of my computer - where I was the majority of yesterday, watching the storm rage on outside.  I'm in the middle of finishing my second Adult Health care plan.... just a mere 20-page assignment that details the nursing diagnoses and interventions for my patient that I was responsible for this past week.  I believe I'm at 14 pages as of right now... and I still have a long ways to go.  But I thought that I would take a break and spill my thoughts out and onto the "pages" of this blog.  It's been a long 2 weeks since I last had time to write, and there is much to mention... so without further adieu...

There are a few things that I must have in my life in order to keep me sane throughout the rigorous schedule that I currently endure... 1) yoga, 2) dark chocolate, 3) music (thank you Pandora), and 4) volunteer tutoring. 

1. I am at 26 days of my 30-day yoga challenge... and I feel amazing.  I love hot yoga... 90 minutes to allow my mind to clear and focus on being in the moment - that is quite a challenge for me.  My mind likes to race ahead to organize and plan my agenda of things I need to accomplish, so to sit and BREATHE and recognize what my body needs right NOW is quite empowering, to say the least.  It requires a lot of control, and it has helped me recognize what is truly important, which benefits me in so many other aspects of my life. 
2. umm... does this need any explanation?  The darker, the better. I always have to keep some on hand... Dove Promises are my vice.  Especially frozen.  And hey, it contains antioxidants (a "super food" if you will) so they are healthy!  In moderation, of course.. haha.  And what does "moderation" really mean to a chocaholic...?
3. For those who are not familiar, Pandora.com is one of the greatest websites that has been developed.  It's a "personal" internet radio, and it is ALWAYS playing on my computer.  Depending on what I'm doing, I'll play different "stations" that help me stay focused on the task at hand.  Currently, I am listening to "Spa Radio" -- music that you would hear if you were enjoying a massage (which does sound quite appealing, now that I mention it...).  Basically, you type in a type of music or a specific artist, and the site "creates" a station that plays music similar to your interest.  I love it because it plays music from a wide variety of artists, music that I have never heard before...  It's part of the "Music Genome Project" -- the creators of this website match similar music styles based on the underlying tone of the music.  It's quite fascinating, and I am SO grateful for it.  I think I have about 6 stations that I listen to regularly... from Carrie Underwood to Piano Instrumental to House.... I really do love music, and quite the variety as well.
4. I realized this week that I haven't really talked much about the volunteer tutoring that I do weekly.  I started last October, at a local elementary school called "Wolfe Street Academy."  It's a few blocks from my house, and I tutor a third-grade student named Ivan for one hour each week.  Doesn't seem like much, but I love the opportunity I have to spend time with him and help him with his homework.  I may have clinical on Thursday and Friday where I am constantly caring for my patients, but doing this type of service has its own rewards.  It took a while for him to warm up to me, but now we have a great time focusing on his reading comprehension and fractions.   This past week, he seemed more excited than normal -- he pulled his backpack up on the desk, and reached inside to pull out a chocolate rose and a small Valentine's Day stuffed animal.  He proudly explained that he had taken his $2 to the Family Dollar store near his house and picked these two things out for me, all on his own!  Then, with a big smile on his face, he stated how much fun he has in tutoring.  Tender moments like those... really keep me focused on the big picture, and how serving others is really the most important and rewarding part of life.  

 Speaking of service... this past week in clinical was a new experience for me.  We were assigned only one patient, as we had to collect data for our care plans, so I had ample time to focus on the elderly woman I was asked to care for.  Her sons brought her in to the ED (emergency department) due to her complaint of worsening chest/epigastric pain, fearing that she could be having some sort of cardiac event.  Upon further review of lab work, it was revealed that she had severe hypercalcemia -- elevated blood calcium levels, which is critical and requires emergent treatment.  In examining her other lab work, the doctors discovered that she was in acute renal failure, and with no past medical history that would explain the etiology of these medical issues, she was admitted to the hospital.  Upon further diagnostic studies, the underlying cause was discovered: she was suffering from the end-stages of Multpile Myeloma, a relatively rare, and terminal, form of cancer.  I found out the diagnosis before she did, and was present in the room when the physician came to inform her.  After he left, I sat with her for a while, and listened to her as she reminisced over her marriage and raising her 3 children, all the while emphasizing how grateful she was to have "lived a good life."  I asked her if there was anything that I could do, and she requested to "take a walk" -- that seemed like the least I could do.  I helped her clean up and then we went for a stroll, with me pushing her in a wheelchair around the halls of the floor.  There wasn't much to see, so I asked the nurse if I could take her downstairs, to which she smiled and said to the two of us: "Don't get into trouble!"  The first floor was quite the scene - an array of doctors, patients, and families rushing this way and that, and I pushed her down the hall to the older section of the hospital.  Knowing that she was Baptist, I asked her if she would like to see the statue of Jesus that is housed in the dome of the original Hopkins Hospital, and she nodded her head.  I wheeled her into the rotunda, where the 10-foot marble statue of Jesus is found (for those who are LDS, it is the same statue that is found in our temple visitor centers).  She sat in awe, and I read to her the inscription on its base: "Come unto me, all ye that are heavy laden, and I will give you rest."  We sat in the silence of this revered space of the hospital, and after some time, she asked to touch his toe (a gesture we had seen many do as they walked by) and I pushed her close.  It was a very special moment - to see her hand, with the IV line in place, reach out and grasp his toe as she bowed her head... all I could think about was how she was soon going to be in His presence.  We then made our way back into the bustling halls, surrounded by the steady stream of hospital patrons.  She had mentioned earlier how much she loved flowers, so I asked her if she wanted to stop at the flower shop to look at some flowers.  Her eyes lit up, and we made our way to the little store nestled in between the cafeteria and the admission lounge.  We sat in that shop for a good 20-30 minutes, as I pulled out each type of flower from its refrigerated vase in order for her to hold it and take in its fresh, crisp scent and its bold, colorful beauty.  I'm not exaggerating -- every type of flower they had, I pulled out.  From carnations to lilies, roses to tulips... I was actually quite impressed with the selection.  The lady in the shop was very sweet, and pointed out some of the more unique flowers and told us what they were called.  Forgive me, I cannot remember any of them! haha.  After some time, I took her back upstairs, in time for lunch and some afternoon consult appointments.  Shortly thereafter, her children arrived, and I left them to share some time together.  Friday I was able to work with her again, and her first request was to go down to the flower shop again.  I happily obliged, and after getting her ready, we made our escape off the unit and downstairs.  The same lady was in the shop, and she pulled me aside and told me that my patient could have any one flower that she particularly liked.  After going through all of the flowers, again, she held onto this one particular rose, with a deep pink hue... that was it.  I pointed to the store employee, and she smiled and told my patient that she would put the rose in a vase for her to take upstairs to her room.  What a sweet gesture -- she put the single rose in a small vase with some greenery, and handed it back to my patient.  I can't adequately describe how happy my patient was, clutching the vase in her hands as we wheeled back to the elevators.  She was so happy with her flower... gave new meaning to the phrase: "Stop and smell the roses."  After returning to the unit, I helped her find the perfect spot for her new prized possession, just in time for another guest -- her grandson -- to come in and visit with her.  I ducked out, leaving them to share some time together.... again grateful for these opportunities I have had to touch the lives of others, all the while recognizing and appreciating how much these experiences are impacting my life as well.

Unfortunately, the snowstorm we have just survived has left the city quite paralyzed... no snow plows make the streets quite dangerous to drive on, unless you have a 4-wheel-drive vehicle.  Therefore, our bishop has decided to cancel church today.  Guess that means I'll be stuck inside, yet again... I'll probably be taking a walk through the snow later, just to get some fresh air.  The sun is shining bright, looks like it's going to be a beautiful Sabbath day.... Enjoy the coming week everyone, I'll be back soon enough!