Saturday, December 22, 2007

Merry Christmas


I have survived the return to med school following Thanksgiving break, and although the stretch of tests were not fun, I manage to scrape decent marks. The tests were all pretty fair and straightforward, so I can't really complain about them. The quirky schedule, having our last test on Monday, yet having class through Thursday, was not conducive to my, nor most of my classmates' learning. All of our motivation left after the Pharm test Monday and for all intents and purposes, break started then. Even the professors partially checked out by then too! Oh, well, I'll have plenty of study time over the break after Christmas. Since last post, I have also had a few OSCE's (simulated patient experiences). My last interactive session (in teams of three) was Thursday afternoon. We had a sore throat module, which through differential diagnosis we determined to be strep, a bacterial vaginosis case, which was altogether confusing and weird, especially since our facilitator/patient was a male. It was quite the surprise to me as I was gaining a history to say the least! But we had a pelvic model to run the pelvic exam, but it was still weird! Then my third case was a low back pain, which as osteopathic medical students, we destroyed. There are actually a lot of differentials with low back pain. We have to rule out cancer, kidneys, visceral problems that would refer pain to the low back, or vertebral injuries such as compression fractures, spondylolysis (Scotty dog fractures), spinal stenosis, osteoporosis and so forth. Then of course there's back pain that is musculoskeletal in nature. Now most physicians would just diagnose this as nonspecific low back pain or mechanical back pain, but using my osteopathic training and anatomical knowledge, we can find the muscles or muscle groups that are affected. For example, if the patient says that they feel better bending forward or lying in the fetal position, it is likely the pain is stemming from a psoas/hip flexor problem that is pulling the upper torso forward. If however, they are backbending to find relief, the spasm/injury is from the erector spinae/paravertebral muscle group. And, in addition to prescribing muscle relaxants or pain killers, we can treat the patient right there with soft tissue work, then follow up with manipulation of the vertebrae if there are somatic dysfunctions that are facilitating the pain. We can also refer to physical therapy the strengthen the core abdominals to relieve the load on the low back! So there's a lot to think about with each patient you see in coming up with a differential diagnosis. It takes a lot of time to get this down, which is why we spend our entire 3rd and 4th years in clinical rotations with patient interaction to practice this over and over again! Speaking of, we also have to plan our 3rd year rotations, so I've been trying to get information about it. We have a number of core rotations we have to do such as family medicine, internal medicine, pediatrics, OB/GYN, general surgery, rural medicine, etc. Midwestern has a lottery set up where we look at student reviews and can pick the top three places where we want to rotate, and the computer will sort it all out. The tricky part comes when you are trying to schedule military rotations or an away rural rotation. For instance, I am trying to set up my rural rotation in Cedar City, Utah, where I did my undergrad, but I have to set it up myself, find which month I want to go, and make sure the computer blocks that time out so I don't get scheduled for another rotation at the time. And the same is with my military rotations. I can do an early experience Army rotation, which is tailored for young students who haven't had a lot of experience to do at the beginning of the 3rd year, to get used to military hospitals and their system. I'm looking to do mine in August at Ft. Carson, which is near Colorado Springs! It should be a lot of fun. And Meghan and the kids can come for a good portion of it, as Meghan's mom's best friend lives right by there and they can stay with her. So I am very excited to start my clinical experience, albeit a little nervous.

More importantly, Christmas is looming so near! As Braylei is 2 now, and knows what's going on, we really want to emphasize the spiritual aspect of Christmas and why we celebrate it. So one family home evening, we each wrote down what we wanted to give to Jesus this year. Braylei decided that she wanted to give Jesus a birthday cake and work on sharing with others! It was so cute. She drew Jesus a picture, then we put all the little papers in a small box and put it under the tree. On Christmas morning, we will open that little box first and read them all in order to keep an emphasis on the Savior. We have also been reading Christmas related scriptures each night and sing Christmas songs. Braylei has learned Jingle Bells pretty well, too. This past week for family home evening Braylei made a little gingerbread house with graham crackers and icing. I think she ate more of the candy decorations than actually got on there, but she had a lot of fun, and there was a lot of mess to clean up, too! Another thing we did this week was take names off of the giving tree at Walmart and Braylei helped pick out toys for underprivileged children that otherwise wouldn't have anything for Christmas. As Braylei gets older (and Tayscen too), we will give them more responsibility and ownership into an act of Christmas service.

On Saturday, my mom, sister Suzi, along with her husband John and daughter Elizabeth, came out to the house to spend some time with us! It was good to see them. Braylei had a really good time playing with Elizabeth. She loves the Little Tykes drawing table that her grandparents got for her, too! Then today, for Christmas Eve, Meghan's parents, along with her little bro Jon cam out to the house to see us! We had a white elephant gift exchange and reenacted the nativity. Tonight we went to see the downtown Glendale lights, which were really nice. We came home and Braylei put out cookies and milk for Santa and a special magic key for Santa to be able to get into our house since we don't have a chimney! I'm sure excited for Christmas tomorrow and I'll post again soon with pictures and video of our Christmas!

Sunday, December 9, 2007

Going, Going, Back, Back, To Med School, Med School


Oh, how sweet my short-lived break was. But alas, I have been back in school for two weeks, and I feel as though I won't get back in the swing of school until we get another break for Christmas in a week and a half! It's not easy to jump right in and study like that after enjoying a nice break. And I even studied a little bit during the break for my board exam coming in June! It's nuts!

But classes are good, nevertheless. Everything seems to continue to grow more and more clinical. We are in the midst of scheduling our clinical rotations for next year, which is insanely confusing, as they only talked to us for about 10 minutes regarding the process, thus making our lives even more frustrating and stressful than they already are thanks to Pathology, Pharmacology, and Microbiology! We have 3 tests over the next week. Tomorrow we have a Pathology test on the GI system. I love that my professor prefaced this with being a super short test, covering only 14 hours of lecture. However, the amount of material this test covers is extensive, and our objectives packets are longer than in the past, irrespective of how much she covered in lecture time! Oh, well, I guess we'll have to see how this one turns out. Then we'll turn around and have a Micro test on Friday and a Pharm test on the following Monday. Hopefully I'll do better on that one than I did on my final!

After the Pharm test on the 17th, we still have classes through the 20th, but no tests until after the new year. So a bunch of us are going to go see the new movie "I Am Legend" with Will Smith Monday afternoon at the IMAX by our school! Then on our last day, Thursday the 20th, I have my last interactive OSCE (simulated clinical experiences). Those have been very helpful for me with my clinical skills! We are paired up in 3's and we see a simulated patient who has a group of symptoms. We share responsibilities in that one student performs a detailed history and asks the questions, then another student performs a focused physical exam according to the information gathered in the history, and then from that the third student gives a patient presentation with an assessment, differential diagnosis, and plan of action. since we have 3 of these, we rotate responsibilties each time. After break, we will have 2 individual OSCE's where we are by ourselves and do the whole exam before receiving feedback from a physician facilatator. Yikes! It should actually be really fun. I'm looking forward to it! The clinical aspect of medicine is what really excites me. My Osteopathic Medicine class has also been more clinically focused. We went through a low back pain module and walked through different clincial scenarios and how we can treat those problems. That's what I love about osteopathic medicine. When someone comes in with neuromusculoskeletal pain, we can actually treat the pain and the underlying problem and not just mask it with medications. But we can always augment our treatments with pain relievers or muscle relaxants! It's awesome!

But, going back to the break, it went way too fast! We had a really nice Thanksgiving, though. In the morning, I went and played in our ward's turkey bowl, which didn't have a good turnout at first, but people slowly showed up, including the Elder's, and we had a fun game! Later in the day I took Braylei swimming, as the pool is heated (and we live in Arizona and it hasn't been that cold, anyways). Then we had our families over to our house for dinner. It was really nice not having to take the kids out and about, especially with both families close by. It's so hard to take them out all day and into the evening when they go to bed. It throws everyone's schedule off and then it's harder to get back into. Then of course came Black Friday. This has been a longstanding tradition with Meghan's family. Thanksgiving evening we go through all the ads, decide what everyone wants to try to get, and then we split up to the various stores. I went to Best Buy to try to get a computer for Meghan's parents. I got there around 2:30 am, thinking that would be enough time to get a good spot. Oh, how I was wrong! When I arrived, an incredible line was already formed past the outside of the store plus 2 adjacent stores! Apparently, people had been waiting in line since about 7pm the previous night! How insane is that!? At least they handed out tickets for the various door buster items around 3:30am so by 4am I knew for sure that I was out of luck so I could go home. Meanwhile, Meghan and her dad were out at Toys R Us really early too, and had slightly better luck than I did, but not much!

And finally, we enjoyed the opportunity before I headed back to school to put up the Christmas tree and holiday decorations! Braylei was a big help and had a lot of fun. I invite all to see some of the video clips that are on the YouTube bar at the top right of the blog! Or you can see all the videos post on YouTube at http://youtube.com/thejschro. We have tons of decorations for the inside of our house, most of them Meghan has made herself! But we are lacking in the outside ornations. I think we will wait until after Christmas and buy stuff while it's 90% off and save it for next year!

The kids are doing well. Braylei continues to grow and astonish us all with her development. Last week, Meghan had some of her file folder matching games she had made for when she taught preschool, which are 3-5 year old level, and let Braylei play with them and Braylei did them all! I can tell she has so much of Meghan in her! Meghan is the master of memory games and stuff like that and Braylei is definitely following in pursuit. Tayscen continues to be just a happy-go-lucky kid. He loves his jumperoo so much! And he just got in his first tooth! We saw the ridges of it yesterday!

On a sadder note, my uncle, Ron Hottman, passed away recently from small cell carcinoma of the lungs. He was able to spend his last days at home. Our thoughts and prayers are with my aunt Janet (my dad's sister) during this very difficult time. Also, Meghan's uncle, Jay, recently suffered an abdominal aortic aneurysm. Luckily, doctor were able to find it before it ruptured. He has since, however, had many complications from the various procedures and treatments and our prayers are with him as well, hoping that he will recover soon!

Tuesday, November 20, 2007

Update: Zoo Pictures

I just added a bunch of pictures to the post "Whew! I'm out of my hole now!" There are also some pics of when Braylei fell asleep reading a book in her bed, Tayscen eating rice cereal for the first time, Tayscen in his Jumperoo, Braylei loving the ducks at the Wildlife World Zoo and many more!

Tuesday, November 13, 2007

Whew! I'm out of my hole now!


I am now 2/3 of the way through my didactic studies of medical school! I finished the horrible, horrible finals week on Friday and now I get to enjoy 2 weeks off! The rest of the quarter went relatively well. I survived a group of Monday/Friday/Monday tests including the terrible trio of Path, Micro, and Pharm! It will only get worse next quarter, though, as nearly the whole quarter is Monday/Friday/Monday exams.

For Halloween, Midwestern put on a really cool "Safe Halloween" for the kids. All the departments had things set up for the trick-or-treaters to visit. This was Braylei's first time trick-or-treating. It was a different concept for her, and she was a little scared at first, but once she realized that she would be getting candy by saying "trick-or-treat," she seemed to be much happier. Of course, she wanted to be "Dr. Braylei" as she was dressed up in little scrubs. Tayscen was also dressed up in little scrubs, but he of course was a little more chill in the stroller.

Finals week went pretty well for the most part. Because I needed to pull later hours, Meghan brought Braylei and Tayscen to school to have lunch together every day. It was a lot of fun to see them during the day. Braylei loves coming to my school. I think she feels like such a big kid! Ever since Halloween, when she saw a girl dressed up as the little mermaid, as soon as she gets to my school, she'll say "I want to see mermaid!" It's hilarious! On the Saturday before finals began, we went to Chuck E. Cheese's for dinner. We had Meghan's niece, Aliya, with us too. Braylei had a real good time being able to play some of the games and ride the little rides! She is really getting to be a grown up little girl.

The previous week held my Osteopathic Medicine written and practical final, which being my favorite class, went really well. We also had our Clinical Correlates final, which was nice to get out of the way to free up more time for study during finals. That test was tough, but I ended up doing well. Ironically, I had the most time to study for my Pharmacology final, which was on Monday, but that test did not go well at all. I totally tanked it. I don't know why. It was weird. I had been through the material quite a bit, and felt pretty decent about it. But about a hour and a half before the test, something happened to me and it seemed like I lost everything. I wasn't able to go through the drugs in my head like I had been, and it felt like I knew nothing! It was crazy! I tried to regain it, but it was definitely a struggle. The class average was only a 71% on it too, so in addition to my brain spasm, it was a ridiculously difficult exam. Then we had two finals on Tuesday: Clinical Medicine and Topics in Medicine. The clinical medicine final was tough to me, but again I did relatively well, but the Topics final was by far the most ludicrous test I had ever taken! With these tests, they are written by physicians rather than PhD’s, so sometimes the questions don't make sense or there are multiple answers that are correct, or none that are correct. It can be a real crapshoot sometimes. For a relatively minor class, a lot of people struggled on that final. I surprised myself and did better than I thought. But then we had to turn around and take the Microbiology final 20 hours later. Now I had been through the material already but with virtually 2 weeks of finals, it was like a week ago, and new material was presented in the meantime. So we have to assimilate all this information so fast! Again, for the short amount of time we had to prepare, I was pleased with my results. Luckily, we didn't have a final Thursday since we took our clinical correlates final the previous Friday, giving us more time to study for my arch nemesis, Pathology. Path is actually a really good class, and the information is so vital to being a physician, but so much info is crammed into the course, and the professors don't have time to go over all the testable material in class. I took a big hit on the first test, which wasn't too horrible due to the fact that for one, I had no idea what to expect, and also that it was Braylei's birthday, and my Saturday studying was greatly truncated. I don't what the scrud happened on the 2nd test, but I ate it on that one, too! That was another beastly test, with a really low class average. Then I scored a nice A on the third test, which brought tremendous relief to me in securing that I would have to get like a 40% on the final not to pass the class! So things were up in the air about this final. But I ended up getting a 98%! That was the highest grade I've ever received on a major exam in medical school. I had gotten high grades like that in human behavior and clinical medicine last year, but this has been my hardest class and I nailed it! I was very pleased with myself. I've said this before, but sometimes it's hard not to compare myself with my other classmates who don't have a family with kids and a spouse, who doesn't study on Sundays, and has life responsibilities. All those things draw time from studying, and I do the best I can with the time I have. But I am not going to sacrifice not seeing my family and spending time with my kids for a higher GPA or class rank. It just isn't worth it. So it's nice to see that like during finals week, when I did put in that extra time, I can do really well too.

Meghan is my hero. She took up even more of the superfluous slack I usually leave her over the last few weeks. Since I stayed late during finals week, she not only got the kids dinner, but bathed them got them both ready for bed, fed Tayscen, put Braylei down and red her stories and sang songs all by herself. Granted, she usually does most of that, but most of the time I was home for dinner, would give the kids baths, and would have one of the kids while she had the other. But she does this all day, every day. It's really disappointing to me that society places such a negative connotation on the stay-at-home mom. I know it's hard for Meghan because she worked so hard for her education and is insanely intelligent. I always tell people that she would do much better in medical school than I would! I don't know, do people think homemakers just stays at home and watch TV while the kids run around? Meghan is constantly working with Braylei and Tayscen on developmental skills. It's because of Meghan that Braylei has a flippin enormous vocabulary and that she speaks in full sentances as a two year old when normally at 2 kids are just beginning to put two words together and have a 20 word vocabulary. Braylei also loves to color and gets to do that everyday. She works with Tayscen and gets down on the floor to do exercises with him and continuously interacts with him, which does wonders for a child's development. Plus, they go to the library every week for story time, and Braylei picks out new books and learning videos to check out, and they have a rotating playgroup with a couple other kids in her church nursery class. Seriously, they have such busy schedules and they are immersed in stimulating activities all day long. I am so grateful for Meghan's sacrifice to stay at home with the kids.

But she does get me for the next 2 weeks. Honestly, though, it's more as if she has 3 kids to deal with now rather than another parent to help out. She always tells me that she's so much more efficient when I'm at school! On Friday afternoon after my test, we went to go see the Bee Movie. Braylei had been wanting to see that for a long time. It was a really good little movie, too! Then on Saturday we went to the Wildlife World Zoo that's only about 15-20 minutes from our house. I remember going there in middle school. It was so much fun! It was nice because it was much less crowded than the Phoenix Zoo, the exhibits were more accessible for Braylei to see the animals, and there was less space in between the exhibits and every in between the big exhibits were smaller ones with different birds or monkeys. We had a really good time there. I'll get pictures up soon.

And now for these 2 weeks, we have lot to get done around the house and various tasks to accomplish. I'm doing half days of studying as I need to begin preparing for my dreaded board exams coming up at the end of May/early June. But I'll be home by 1pm every day so I can spend more time with Megs and the kids and get stuff done around the house. It should definitely be a lot less stressful, for sure!

Sunday, October 7, 2007

Family Pictures!


Boy, sometimes it feels as though I'll never be done with school! There are so many demands on a daily basis, there's never enough time to study, and no matter what you do you know that you're not spending enough time at home. I always try to do the best I can, but it really does weigh me down. I just have to keep telling myself that this is the last year of straight classroom work and then I'll be in the clinical world, where although demands there will only increase, at least I'll be in an environment that I can thrive! We are past the midway point of the quarter and we are learning tons! The topics are very pertinent for a physician, but there is just so much to learn! It's really like being told to drink from a fire hose! You can't possible get everything the first time around, but we tend to see things over and over, as the subjects will overlap quite a bit.

More and more families are moving into our new housing development. It's nice to have neighbors that are in similar situations as us. Last night we had a little block party. I was late because I was at the priesthood session broadcast, as it is conference weekend for the Church of Jesus Chris of Latter-Day Saints. But Braylei had a blast playing with all the kids and being able to stay up past her bedtime! We were able to meet more of our neighbors, too. I look forward to developing good friendships here. We are also meeting more people in our new ward. It will be nice to finally be in a non-transient ward, where families stay for long periods of time! Braylei is finally warming up a little to junior nursery. Meghan set up a play date with the nursery teacher and her littler boy in hopes that Braylei would feel a little more comfortable with the teacher. It seems to have helped, as I have actually been able to go to my meetings the past couple weeks. Meghan is already immersed in the ward as the primary pianist, and that leaves me with a great opportunity to spend some good time with Tayscen. He is growing so fast and is developing a cool little personality!

What I wanted to do today was post all of our new family pics, as we cannot possibly send them all out to everyone. But these are all hi-res, so if anyone would have the desire, you can download them and print them off!

Sunday, September 23, 2007

Whirlwind


Well, it seems that once again I have neglected the 'ol blog! Life is just so crazy and its hard to believe that the last entry was back in July while I was still in San Antonio! Well, to recap, we moved into our new house about a week after I returned home from the Army's Officer Basic Course. It has been so nice to be home with Meghan, Braylei and Tayscen! The day before moving, Braylei had tubes put in her ears to help reduce the quantity of ear infections she has, and I was impressed about how tough she was about it! She was real groggy after coming out of the light anesthesia, but after I got her some apple juice and cheez-its, she was in good spirits!

The actual moving process was a lot smoother than I expected. We had a loading crew out at Meghan's parents house and a bunch of med school buds made up the unloading crew at the new house. We have since unpacked, and made the new house a home. Braylei loves it! Since Tayscen needs the crib, we got Braylei a "big kid bed" that will last her a long time! Since being here, she has slept really well at night, too! Tayscen is doing really well, too! He's such a happy, laid back little kid with a big coolness factor goin' on! When we first moved in, he was still getting up a couple times a night to eat, but is now sleeping 10-12 hours straight typically! He has grown a ton, too! He loves being on his tummy, too! He would probably play (and sleep) all day on his stomach if we would let him! As a result, his back muscles are really developed and he is trying to roll over and scoot now!

A few weeks ago we were able to bless Tayscen at church. It was an amazing experience! While we were standing in the circle, he was smiling, cooing, and looking at me with his big, blue eyes! We also had a bunch of family out for the event, and that was really nice to have everyone out here on this side of the valley rather than us traveling all the way out east. Since everyone did come all the way out for Tayscen's blessing, we decided to have Braylei's birthday out at Meghan's sister Kim's house. It was pretty low key, Braylei wanted to have a "Cars" party, and picked out sunglasses for party favors! Braylei loved it because she got to go swimming with everyone! She loved going down the waterslide! She has gotten so grown up, too! Her speech and comprehension is scary sometimes! She just picks up words and really understands them, too! She uses multi-word sentences all the time and has no problem vocalizing any concern she has. Last week when I was giving her a bath, she was tossing around her floaty turtle and said, "Daddy, I want to catch it to you!" Then she tossed it to me so that I could catch it! It was so stinkin' cute! She also is very skilled with the crayon! She holds crayons and markers properly already and is displaying pretty good control and loves to use tons of colors.

Meghan is doing great. After delivering Tayscen, she was up and about right away! She is simply amazing! She takes care of the house, the kids, me, and makes excellent dinners while still finding time to work out! I am so, so very lucky to have her in my life! She spends all day with the kids, playing with them on the floor, interacting, and when the other is down for a nap, spends one on one time with them, helping with developmental skills. She does exercises with Tayscen everyday to help him as he gets ready to roll over. Braylei is so advanced because of the amount of time Meghan spends with her everyday.

Meanwhile, my second year of medical school at Midwestern University-Arizona College of Osteopathic Medicine is well under way! It's hard to believe that we are almost halfway through with the fall quarter already! This year is absolutely nuts! The classes are way more rigorous, expectations are higher, there are way more small assignments, and much less time. We have the triple threat of Pathology, Pharmacology and Microbiology this year, and if that's not enough, we have tons of clinically oriented classes and the best of all, our Osteopathic Medicine class. I am still trying to get find a solid rhythm for studying and spending time with family. I am getting up at 3:30am everyday, going to school, working out, studying before and after classes, and I try to be home by 6pm every night to have dinner with the fam, and getting the kids ready for bed. I am trying to go to bed between 9 and 9:30pm, which is needless to say, much earlier than my classmates. But it has been a good schedule for me, as I at least get a couple hours of family time in a night and then in the morning, everyone is sleeping, so it's not cutting out of their time. Oh, and me being me and wanting to get involved, I'm the President of the Sports Medicine club, Vice-President of AMOPS (Association of Military Osteopathic Physicians & Surgeons), Vice-President of the Latter-Day Saint Student Association (LDSSA), and also the class liaison for the UAAO (Undergraduate American Association of Osteopathy.) We do a lot of lunchtime speakers and evening workshops to facilitate of medical school learning, so it's pretty beneficial on the whole. Plus, it helps me to get to know the 1st year students and students from the other programs. Hopefully I'll get fully into it soon! We have a huge Pharmacology test tomorrow morning, so I'm keeping my fingers crossed that I'll do well!











P.S: Here's some funny video clips!