J Schro, the student D.O.

Year 4! Block 1: Rheumatology/Neurology

2009-10-11T17:24:00.002-07:00

To start off my 4th year, I had my medicine sub-specialty block, so I chose to do two two-week rotations in Rheumatology and Neurology. Both I felt to be very important aspects of family medicine and sports medicine.

My preceptor for Rheumatology was Dr. Gary Silverman, DO. He ran a pretty chill, low-key office in Scottsdale that made for a pretty good learning environment. I became very familiar w/ arthiritis, many auto-immune diseases such as lupus, and fibromyalgia. Most of the patients were long-term established patients who had diagnoses in place, so I was able to see how treatments were tweaked over time, and used this as an opportunity to learn more about musculoskeletal pharmacology. I had learned about a newer drug class called TNF-alpha inhibitors, and had become very popular over the last decade. It was interesting that Dr. Silverman remained very skeptical about them. He related that traditional DMARDS (disease modifying anti-rheumatic drugs are like a watering hose on the disease, and TNF-a are like fire hydrants; very effective, but very broad, leaving risk of serious side effects. And even though I will rarely use those drugs in my own practice, there were tons of other musculoskeletal joint meds that I learned a lot about. He was also very active in the medical community, and introduced me to an online medical community known as Sermo, who was recently in the news as they opposed Howard Dean and the proposed new health care legislation. Overall, this was a good rotation, and I am glad that I did it. But in 2 weeks I saw about everything I was going to, and wouldn't have gotten too much more out of an addition 2 weeks.

I moved on to Neurology next with Dr. Mark Winograd, who ran an office next to Banner Thunderbird. It was nice that it was so much closer to my house. This was a very different environment. Dr. Winograd was a lot more intense, as he reminded me a lot of Regis Philbin, as he would raise his voice at unexpected times, and often wouldn't make complete sense. He would also tell me the same thing over and over. He was a very good neurologist, though, and good to his patients. I learned a great deal about EMG's, and I appreciated that I had a lot of one on one face time with the patients. He had me see all new patients first,to evaluate them and present my assessment to him before he would come in. I saw some good things, like fibro, seizures, lots of dizziness, movement disorders, and a lot of chronic pain. I learned that neurology is the specialty that gets the patients that no one else knows what's wrong with them. As such, I became very familiar with the diagnosis of myofascial pain syndrome! This again was very good for hitting upon different areas of pharmacology, and found applications to primary care and sports medicine. And Dr. Winograd was good at trying to make connections to sports med, and related first line management at a primary care setting. It was a good rotation, but again, 2 weeks was perfect.

Meanwhile, on the homefront, Meghan was at the end of her 2nd trimester and feeling all the discomfort of pregnancy. She had a really bad bout of sciatic pain from the uterine growth causing secondary impingement on the nerve. I was able to provide temporary and partial relief with osteopathic treatments, but it was not long lasting at first. Finally, either treatments helped or her pain tolerance improved greatly, and she was able to do better with her normal activities. Braylei and Tayscen were both still in swimming classes, and I made it as often as I could, but I was at the will of my preceptors and the work schedules!

For updated pictures of the family and our adventures, check out my facebook page For all our photo albums!

Year 3 in review

2009-09-27T18:46:00.003-07:00

Well I didn't do too well on keeping up with the blog. Needless to say, my 3rd year of medical school went by like a blur! Much faster than 2nd year at least! After surgery, I had a great family medicine rotation with Dr. Jack Hawks, who was an AZCOM grad himself. He ran a great office, and I was able to learn much about patient management with him. The downside was the same drawback from all civilian family medicine- there wasn't that much diversity. There was not much peds at all, no OB and very little GYN. There was some sports med, but it was small. Mostly it was adult ambulatory medicine. Lots of HTN, DM, and cholesterol, with flu/colds mixed in. I did learn a great deal about pharmacology, and different management strategies for common cases. There was also drug rep lunches every day, which is a huge perk for civilian medicine! Dr. Hawks was a great doc, and I did like his style of practice. He was very laid back and easily identified with the patient.

In February, I was on OBGYN at Maricopa Medical Center. I am so glad that I did my OB training here, as it was very hands on and lots of opportunities. A huge majority of the patients were from Mexico, and most did not have great OB prenatal care. I was able to do 2 weeks of the "mole shift," or night float. My day started at 6pm and I was on all night and got off at 8am. Then I got to make the 40 minute drive home, and sleep for about 5 hours before going back in. Over those 2 weeks I slept in our closet because it was dark and quiet, especially when Meghan ran her preschool twice a week. But the service was good, and like I said, I was afforded great hands-on training. I got along well with the chief resident and most of the residents. However, I noticed that the morale wasn't all that great there. Maybe it was just the residency, or maybe it's OBGYN in general, but there was a little backbiting too. I also spent a week in clinic, doing mostly prenatal care, with some colposcopy mixed in. And I spent a week on GYN surgery, where I was seeing a lot of hysterectomy and D&C cases. I loved what I did there, and I gained a great appreciation and fondness of the field, particularly the obstetric side. There's something magical about the birthing process, and I was able to share in the joy of the family, and create more enthusiasm in them by sharing my own experiences as a parent! However, I don't think that I could exclusively do OBGYN. It's easy to burn out on, with all the call and long hours. Plus, I do enjoy diversity in my day-to-day schedule.

March was a fun month, as I did my outpatient pediatrics rotation in the greatest place on the planet, Cedar City, Utah! I figured Utah would be a great place to do peds, as there are so many kids per capita! I was at Color Country Pediatrics w/ Dr. Burrows. I was amazed at how much I saw there, for a smaller community. I also came while it was still flu/strep/croup season, so I became quite familiar with a upper respiratory infections. I also saw some more rare conditions, such as histiocytosis, fragile X syndrome, and a cephalohematoma. Megs and the kids came up for 2 weeks. We crammed into the small 1 bedroom apartment that was given to us by the rural health education center who coordinated the rotation. The funniest part about the apartment was that the hallway from the living room to the bedroom doubled as the kitchen. On one side was the sink and dishwasher and on the other was the fridge and microwave. Classic. But it was fun for the kids because it snowed quite a few times while we were there. So they had fun playing in the snow quite a bit. They also really like discovery park!We also got to see some old friends. We really missed seeing Cordelle and Wendy, and Emily and Chris. It was awesome to see Scott Bauman and the women's gymnastics team, too! It was a great month. Especially because during this time, Meghan found out that she was pregnant once more with child number 3! We were so excited!

Then we returned back to AZ for April and I had my ward based Pediatrics rotation at Phoenix Children's Hospital. Let me just saw that that is one of the coolest hospitals ever! All the staff seem to be much happier there than in other hosiptals! The walls are all colorful, there are massive toy trains that go around open gardens. Best of all, the food was awesome, and as a student, I got a card with $1000 limit for the month!! But inpatient peds was a very different experience than outpatient peds. These kids were really sick, very seriously so in some instances. I saw everything from a little one year old with E. coli meningitis, to a 16 year old elite soccer player with extrapulmonary coccidiomycosis. There were obscure things like rat bite fever, to complications of more common cases like mastoiditits. Plus, I got to really work well with the residents, which I really enjoyed. I learned a great deal over this month and it made a huge impression on me. Peds is one of my favorite disciplines of medicine, and I frequently tell people that if I wasn't in the military and I wasn't exposed to the vast diversity that military family medicine had to offer, I would likely go into civilian pediatrics. I was very rewarding, but at times, very sad.

Then I moved on to my final rotation of the year- Internal Medicine at the VA hospital. Despite mixed reviews from some of my classmates, I had a great experience. It was challenging for me, but I got a lot out of it. It was a stark contrast to PCH, as all the walls were white, the hospital was bland, and the staff was not nearly as enthusiastic! That being said, the residents were very helpful, and I was able to see a good bit of pathology. I did see a lot of COPD, along with diverticulitis/osis. Of course, there were trips to the ER for chest pain cases, and many more people had complications regarding their coronary artery disease. I did see a cool Ace inhibitor induced angioedema. My favorite patient was a 61 yo male presenting with cocaine intoxication. After a huge drug binge, he realized her needed help (probably ran out and had no more money), so drove down to check himself into the hospital. He managed to make it to the hospital, but her ended up crashing his car into the flagpole outside the ER! We took care of him, got him cleaned up and after a few days, he was doing well. He said he wanted to check into a program and return to family up north to get away from influences and start fresh. He came back in the next day with repeat overdose. Found out he sold everything he had to get that extra fix. How sad it was.

After the rotation, we had a week of classes, simulated patient cases, and a comprehensive exam. Then I flew out to Philly to take my level 2 performance exam, which tests clinical skills. Each examinee has 12 simulate encounters. We had 12 minutes in with the patient then had 9 minutes to write a soap note. They were very anal in the testing center, and I was rebuked multiple times for showing too much enthusiasm or smiling, or some other means that could be construed as communicating. It went pretty well, though, and it was fun because there were 5 other students from my school that took the test at the same time.

Then it was back to AZ, where I had a few weeks to study for my level 2 written board exams. I studied quite a bit and felt pretty comfortable with what was going on. I walked out of the exam feeling relatively well. However, when I got my results, it was not what I had hoped. In fact, it was lower than my level 1 score. Sure, I passed, but it was not what would be considered a strong score. I was pretty down for a couple days. But Meghan really came through and picked me up. She is always such a great support for me, and she lit a fire inside of me, and convinced me that I will go out into my audition rotations and show them the kind of doctor that I will be, and that I will not let a number define who I become. I'm so lucky to have her in my life.

Also during this time, we had the kids in swimming lessons, so I enjoyed taking them to swimming nearly every day while I was off. Braylei was also involved in many things such as her city gymnastics class and dance class. Meghan also finished her preschool classes in May, and she decided not to teach again for the fall, as she is due at the end of October. And so we got Braylei in another in home preschool. Meghan will still be teaching piano, however. And little Tayscen is just a hoot! He is so full of energy and he can entertain himself for hours if he needed too! I love that little guy!

Rotation Block 5: General Surgery

2009-03-11T08:08:00.000-07:00

During late November through Mid December, I had my general surgery rotation at Banner Del Webb Hospital with Dr. Marco Canulla and Dr. Kathleen Koerner. The best thing about this rotation—it was right by my house!!! The past few months I had been traveling to Scottsdale and Wickenburg every day! The hospital was less than 10 minutes from my house!

This was a pretty sweet rotation. I realized that I really liked surgery and enjoyed the OR more than I expected. What I did not like as much is the sometimes crazy hours they worked and the ridiculous turn-around time from one case to the next. There were a few days were we got there at 5:30 or 6 am and were there until 10 or 11pm! It was nuts! I am very happy that I decided to do a preceptor/department based surgery rotation as opposed to a ward based rotation. Ward based rotations (at teaching facilities with residencies) are important for students looking into surgery residencies. It is great exposure, you typically see some pretty cool cases, and any ward based rotation is good to get more comfortable with the residency environment. The downside, though, is that it is with residents who are training and therefore get to do most of the work, leaving the student to watch or do very minimal participation in the case. On my rotation, I was able to scrub in to most of the cases, and many times was the 1st assist on the case! I had a ton of opportunities to run the laparoscope, make incisions, use the electrocauterizer, use laparoscopic tools, and do closures! And as I am a hands-on learner, this was very helpful to me!

Another student, Stephenie Sterrenberg, was on the rotation with me, and we usually both scrubbed in on the surgeries or took turns. We also rounded on all the surgical patients each morning and wrote notes, so we still got a lot of hospital experience. And the learning was good too. Dr. Canulla is a laid back, hip-hop lovin’, get-er-done kinda guy who would perform 25 minute lap cholecystectomies. He seemed absolutely fearless! There wasn’t a case he would turn down, and he did general and vascular surgery. So in addition to the GI surgeries, I was able to assist on a lot of AV fistula grafts and revisions, which got extremely bloody sometimes! He took a genuine interest in our learning, quizzing us on things like fluid maintenance in addition to surgical knowledge. He was always looking for ways to improve the rotation as well from our perspectives. He was a great model of a preceptor. Dr. Koerner was an AZCOM grad and was fresh out of her surgical residency. It was awesome to get her perspective on things, and she was really patient and easy going in the OR. She remembers what it was like to be a student, so she made sure that we had a lot of opportunities for hands-on involvement. I was also able glean some osteopathic surgical philosophies from her. Nothing crazy or anything, but just thoughtful methods that perhaps took an extra few minutes, but showed that they improved healing time and patient comfort, as well as enhanced post-surgical performance. This mostly involved different types of irrigation, different methods of closures and so forth. True, being fresh out of residency translated to some longer cases, but she always seemed happy that we were there! It was a really strong rotation, but I was very grateful that we had a 2 week winter break afterwards! And then there was the shelf exam. That did not go as well for me. True, I passed, but it just took me longer to get through the questions. And as we only have 2 hours 10 minutes for 100 questions that are all clinical vignettes. Needless to say, I had to bubble the last 15 questions in with “C.” So thankfully I still passed!

Rotation Block 4: Psychiatry

2009-03-10T21:33:00.000-07:00

In Block 4, I had my psychiatry rotation, which was with Dr. Karp, DO, at Rosewood Ranch in Wickenburg, AZ. Rosewood Ranch is an inpatient based center for eating disorders. They see patients from across the nation for anorexia nervosa, bulimia nervosa, binge eating disorder, and mixed disorders. They also have both male and female patients. The structure of the program was very interesting to me. The rehab features both a very custom nutrition program along with group and individual cognitive based therapies. The idea is that when someone is so nutritionally imbalanced, they are cognitively affected as well. There is also three levels to the rehab. The first is the inpatient facility, after which they can transition to a residential setting, where they converted a motel to apartments for the residents. There, they have more freedoms and choices, but still have the program structure and support they need. A typical treatment period is variable from patient to patient, but was usually 30 days inpatient, with an additional 30 days in the residential. Many also choose to do an outpatient program, where the patients work or go to school, then have evening classes and programs as they continue to transition back into life. Another neat aspect they have is called Family Week, where the patient’s family comes to Wickenburg and has day classes with the patients. With eating disorders, it doesn’t just affect the patient, but the entire family. They learn in detail the psychological and medical aspects of eating disorders, and have a lot of family based healing therapy. Many times, the eating disorder will tear the family to shreds.

I learned so much on this rotation! This was recommended to me by an upper classman as a great way to immerse yourself in patient interaction and delving deep into the patients’ psyche. The first few days I mainly sat in on the group therapy sessions so I could gain a good grasp of the concept of the program. Then I sat in on new patient interviews and the daily and weekly interviews with Dr. Carp. The next week I spent going back and forth between the inpatient and residential facilities. The third week I spent at family week, where I was able to witness both the damage that an eating disorder can cause, as well as the healing that can take place with therapy, commitment, and work. The final week I spent conducting the new patient evaluations, along with daily and weekly interviews. I even was able to dictate my initial evals! It was a really great experience for me, and I grew a lot as both a person and future physician.

The whole time I tried to put myself in another’s shoes. Whether it be the patient, thinking about how easy a mental disorder can take control of my life, and the tailspin of detriment that can result, or the perspective of a brother, father, or significant other, who is watching this happen to my loved one. There were many times at Family Week that I cried as I witnessed the hurt and anguish that has come from this underestimated disease.

On the positive side, I bonded with many of the patients, trying to connect with them and showing them that I really cared. It was really rewarding to me to see the progression of some of these patients, and it is awesome that I am still in contact with many of them today.

While this may not have been the most academically challenging rotation, and true, I didn’t see a ton of pathology like I may have in an acute psych ward. But I gained so much more than that. I got so deep into the minds of those around me, and this was emotionally challenging for me. I feel that it prepared me to be able to handle other mental disorders as well, as I worked in acute, and chronic settings, and also worked with the family aspect. This helped me to see how I can apply this to the Army physician setting in working with PTSD or other acute stress disorders. One thing is for certain—I will always be grateful for the lessons I learned from Dr. Karp, but even more importantly, the wonderful, courageous patients at Rosewood Ranch!

Oh, this rotation was actually my first NBME Shelf exam, which are nationally standardized tests for all the core medical rotations. You basically get 2 hours and 10 minutes to answer 100 clinical vignette based questions. It really is not enough time to get through everything, especially as I am a slower test taker. I felt the Psych exam was fairly straightforward, but it asked a lot of questions about the type of therapy that would be best in different cases that I wasn’t prepared for, especially since it is so subjective and different psychiatrists use different methods. I also did get to the last 8 or so questions, so I had to bubble in “C” for the last handful. Luckily, I still did okay despite that fact!

Absent

2009-03-10T21:30:00.002-07:00

I have been way too negligent of my blog over the past few months. I am trying to get them up now. Things have been insanely busy and I haven't had the necessary time to dedicate to updating the blog. I will post my medical school rotation reviews first, then I'll go back and write about my family happenings, including Thanksgiving, Christmas, New Years, and Valentine's Day. So hang in there, if anyone still checks in!

Halloween!

2008-11-16T15:53:00.007-07:00

Oh boy! Halloween flew by fast! But it was fun-filled for the kids! We started things off the weekend before when Old Navy had a big Halloween special. Any kid who dressed up get a coupon for a free screen print t-shirt. Plus, there were tons of discounts throughout the store that day! Braylei had her beautiful Cinderella outfit that Meghan's mom made, and Tayscen was supposed to be a lion, but didn't wan any part of the headpiece. So we knew we'd have to make some adjustments for Halloween. Luckily, Old Navy had all their costumes on sale for $5 during those few hours, and there was a pretty cool Ninja outfit that would be good for him and for general dress-up play around the house!

On Halloween, I dressed as festive as I could to work. I had recently begun my Psychiatry rotation which is at Rosewood Ranch Center for Eating Disorders in Wickenburg. It's all inpatient, but it's pretty laid back. I wore my bright orange dress shirt with black pants. I also had on my black skeleton shirt I bought at Old Navy for $1 underneath my dress shirt, but it was buttoned down enough to see the ribs pretty good! I found this somewhat humerus, so I posted on Facebook whether or not it was bad to dress up like a skeleton to an eating disorder facility! It went over great, though! Some of the patients went all out for their costumes, based of course on what they had. The girls mainly dressed as crazy psychos, or Hollywood divas at an addiction center. Cool stuff like that!

I got to leave a little early so that I could get back for the kids. Each year, Midwestern puts on a Safe Halloween Carnival event. The kids trick or treated at all the department offices throughout the school, and then there were cool games and activities in the Cafeteria, like fishing, cake walks, cookie decorating, and ring toss stuff. Then outside there was a bouncy castle and a couple of other games. Then we headed back home where we had a potluck with our neighbors. We got to hang out outside and let the kids run around. Then all the kids went together around trick or treating in the subdivision. Braylei loved it, but Tayscen just wanted to run around.

A cool new tradition we implemented for the family is the Great Pumpkin! Since the kids don't need all that candy for Halloween, we thought it would be a good idea to trade it out for something cool. We did it with Braylei this year. She got to pick out 5 pieces of candy she wanted to keep, which she could have periodically, and the rest she left out for the Great Pumpkin. In return, the Great Pumpkin leaves a toy or other surprise. This year, the Great Pumpkin left a Cinderella Barbie with a horse, along with a Halloween Strawberry Shortcake DVD!

Braylei's preschool class (she's a year younger, why she's so short); Braylei getting a pumpkin at the farm; Braylei decorating her pumpkin

Braylei as Cinderella; Tayscen's intimidating Ninja custome with his Chuck Taylor's; bro and sis

At Midwestern: Bray eating the cookie she decorated; Taysce in stealth mode; fishing with the kids; Me and Tayscen

Braylei on the Bouncy Castle

The kids from the hood; trick-or-treating; Braylei hitting the Halloween pinata!

Taysce getting the pinata; children looting the streets (is Taysce doing the chicken dance?)

OMM Research

2008-11-16T15:36:00.002-07:00

I always caveat my passion for OMT by stating that it is a great tool and provide a great use, but that it's not like it will cure cancer or anything. True, it is awesome for musculoskeletal pain, headaches, migraines, pregnancy uncomfortabilities, and even some GI or autonomic problems. Well, I recently had the opportunity to perhaps build on that foundation when I teamed up with Midwestern's OMM department for their Parkinson's research study. I was asked to be one of the clinicians for the study, where I would either perform an experimental treatment or a sham patient, assigned randomly to study participants over a 6 week period. The aim of this study was to see if the use of OMT, specifically Muscle Energy/PNF, could reduce physical symptoms felt from Parkinson's Disease. Muscle Energy uses proprioceptive neuromuscular facilitation that targets the golgi tendon organs and muscle spindles and manipulates their normal responses in order to increase flexibility, decrease pain, and increase overall functionality to a given muscle group.

This turned out to be a very cool study indeed! It was awesome interacting with these Parkinson's patients! It was randomly assigned whether of not the would receive real or sham treatments, but those who were sham patients would be given 6 real treatments upon completion of the trial. It was still hard performing the sham treatment to the same person week after week, especially when the would come in and tell me that they felt like they were improving. What can I say? I'm just a darn good sham clinician! The post-trial assessments were just done on Friday, so I am excited to see how the results are! Hopefully good enough to be published, as that does look very good for residency!

Rotation Block 4: Sports Medicine/Orthopedic Surgery

2008-11-16T14:38:00.002-07:00

This last rotation was spent with Dr. Gary Waslewski, MD at the Arizona Sports Medicine Center. Dr. Waslewski serves as the orthopedic surgeon for the Phoenix Coyotes and also works with the Chicago Cubs and San Francisco Giants, whose rehab programs are stationed in Arizona. He also is the team physician for Chaparral High School, which was a nemesis of my high school, Tempe High. Having a true interest in sports medicine, I wanted to see both aspects of the field- the primary care side and the orthopedic surgery side. Although I had strong leanings already for the primary care route, I wanted to see firsthand what life as an ortho doc would be like. To start with, Dr. Waslewski is easily the nicest and must humble surgeon I've ever met. His patients love him because he is actually willing to listen to them. After examining a patient, he'll usually say something like, "Hmm. So what are we going to do about this?", before going into a number of different options for the patient to decide upon. This was very gratifying to the patients, as they were able to weigh the pros and cons of each option. Then, another cool aspect was that they didn't feel like they had to decide right then, as he would tell them that he would write up the note, and then when his medical assistant goes through them the following day or two, see would call the patients to schedule either a surgical procedure or conservative followup. He also reassured the patients by offering a number of conservative approaches, instead of pushing them into surgery right away. Of interest, he was very interested in Osteopathic Medicine as a valuable alternative approach. During my first week working with him, we saw a mid 30s lady with chronic Right hip pain. Imaging showed some arthritic changes, but not really enough to mandate surgical intervention. Injections had proved unsuccessful. Out of the blue, he said, "How's you hip and pelvis OMT skills?" I said they were pretty good, and began a quick eval. Her seated flexion test was prominently positive on the right side, revealing a locked out SI joint on the right side. I made sure to show Dr. Waz the huge difference there as she bent forward for the test. I also quickly evaluated her innominates by rocking her ilia anterior to posterior, which showed major restriction on the right side, as it was stuck anteriorly. At this point, I had Dr. Waz come over and rock her ilia and put my hands over his to ensure that he could appreciate the difference. So I did a few techniques to balance things out, explaining to the patient, Dr. Waz, and his medical assistant, all of whom seemed mesmerized, what my treatments were accomplishing. When the patient got up from the table, she stated she hardly felt any pain! It was such a thrill! Sharing my enthusiasm for osteopathic medicine to the medical community is almost the same rush as sharing my testimony of the gospel of Jesus Christ (although of course not as eternally fulfilling)! I got major props from Dr. Waz and his assistant, which opened up a lot of opportunities for me to incorporate OMT into this allopathic rotation!

I also had the chance to follow and work with some of the other docs in the practice, which is always nice to see how each physician conducts his/her practice differently. One doctor, Erik Dean, is a primary care physician who specializes in sports medicine. I was able to spend a week with him, which was completely awesome! I really enjoyed the diagnostician role of the primary care sports doc, which was more acutely injured patients. To me, it is more exciting seeing a presentation and trying to figure out the injury based on history, mechanism of injury, and clinical exam, than to have all the imaging and saying what it is and decide the plan of care. I also was able to do a lot more procedures with Dr. Dean, as the primary care schedule is more spread out than the clinic time for a surgeon. Overall, it was a great rotation!

Braylei's 3rd Birthday!

2008-10-19T14:20:00.003-07:00

I am quite belated in my posting of this, but on September 16, Braylei turned 3! It's crazy how fast the time goes! We had her birthday at the Peoria Splashpark! We didn't think that it would be very crowded, but it was packed! Luckily, we found a ramada to set up! The kid's played in the water for awhile, and then came back over to have some cake and hit the pinata! For cake, we actually had cupcakes, but they were iced over and was the Little Mermaid! Braylei loved it! We also had a Little Mermaid pinata. Braylei had a blast and she had a lot of her friends come! I mainly wanted to post all the pictures from the festivities!

Rotation Block 3: FM/OMM

2008-10-12T14:49:00.003-07:00

This last rotation was spent with Dr. Markham McHenry, who is dual board certified in Family Medicine and Neuromusculoskeletal Medicine. He owns his own private practice in Scottsdale and is also part of the OMM department faculty at Midwestern. This was really a spectacular rotation. It was really neat to see how a private practice is run, and I learned about what all goes into it. My biggest reason for seeking out Dr. McHenry for this rotation was to learn how to integrate true OMT into a Family Medicine setting. I was relatively comfortable with providing a designated OMT visit, if given 1/2 hour- 1 hour, as they are scheduled at our University clinic, but he does it in 20 minutes, comparable the military visit timeframe. The first time I saw a treatment, he blew me away! He truly incorporates the philosophy that the body is a continuous unit and that a problem at one end of the body can have big impacts on other areas of the body! He also integrated a lot of teachings of Dr. Philip Greenman, a master of exercise prescription. This mainly focuses on muscle imbalances, firing patterns, and retraining techniques. He was very good at not only treating a patient's dysfunctions, but also giving them exercises or stretches to help retrain the body to prevent recurrences. In addition to the musculoskeletal cases, he saw a wide range of family medicine visits. I really enjoyed the balance there. I was given pretty loose reigns while there. I would see many of the patients first, get the H&P, come up with an assessment and plan, and then present it to Dr. McHenry. He would then go back in with me and finish the visit. With the OMT visits, I would start the treatments, and then Dr. McHenry would come in at some point and finish up. It was really encourage that most of the time, he would tell me that I had corrected nearly everything, and that he just needed to spend a couple minutes with the patient so they felt that he was spending the time with him. I was pleased that numerous patients complimented my skills and commented kindly to Dr. McHenry regarding my treatments. One long-time patient told him that I was easily the best student that had treated him! I also gave many flu shots and saw a couple joint injections. I came out of this rotation a lot more equipped in not only my OMT skills, but my entire medical knowledge was bolstered this month!

Rotation Block 2: Army Family Medicine

2008-09-14T14:21:00.006-07:00

Throughout August, I was on active duty with the Army, stationed at Fort Carson, near Colorado Springs, while I completed a 4 week medical rotation in Family Medicine. It absolutely rocked! Going into my third year, I was already heavily leaning toward family medicine, but this was nearly the clincher this month after having any doubts about what family medicine would be like in the Army laid to rest. From day 1 I felt welcome and a part of the Army healthcare team, and by the end, I knew this was where I am supposed to be! I totally love the broad scope of practice covered in family medicine within the Army. They really give you reign to become credentialed in whatever you want, whether it be more OB- even cesarean section deliveries, more GI procedures like colonoscopies, flex sigs, even appendectomies! You name it, you can do it! The way they accomplish this is via a number of unopposed family medicine residencies within the Army. An unopposed residency is a residency program located at an Army community hospital (MEDDAC) that only has FM residents in addition to the clinical staff. Therefore, the FM residents do much more inpatient service, work more closely alongside the surgery, OB, and peds staff, and getting far more procedural training than a residency that has to compete with IM, OB, surgery, and peds.

The other aspect I was curious about was in regards to how much I would be able to incorporate my osteopathic medicine training. I knew that some residency programs have already started up osteopathic specialty clinics that the D.O. residents get to do about once a week, but I want to integrate OMT into my everyday practice as well. Well I was fortunate enough to have a D.O. preceptor, CPT Joshua Will. He is awesome! He served as a great mentor, as he is much younger than my wise and well experienced cardiology preceptor, Dr. Cucher is. It was really nice to have a preceptor that I could relate with on many levels. He also used a lot of OMT in his practice, and recounted many stories about how sought after OMT is in the Army, especially overseas on deployment. Soldiers will seek you out if they know you are a D.O. and utilize osteopathic manual therapy.

I was assigned to one of the four family medicine clinics on Ft. Carson. It was really cool to see how integrated the healthcare team is in the Army. Everything is on one system (AHLTA), and put through a prescription at the end of the visit, or order labs, and your patient can just walk right down the hall and do them. You can also see whether or not they get the script or orders filled right away, lab results come back super fast, as do imaging reports, too!

I was able to get a lot of practical experience while up there. I saw a ton of patients, a lot of school physicals, and some cool procedures, including two vasectomies and a cesarean section! To be able to assist on these was totally awesome! I learned so much and was given so much guidance from all the physicians there! It probably will be my best rotation of the year, and moreover, it will totally prepare me for my audition rotations coming up next year!

I was also lucky enough to have my family come up to see me for a week and a half! It was fun for the kids to get away, even if the normally 12 hour trip took Meghan 18 hours due to the increased amounts of stops for the kids! We had a great time, tough! Unfortunately, there was a lot of rain storms that hindered our plans to see some things. We wanted to take the kids to see Santa's Workshop at the North Pole (conveniently located on the north side of Colorado Springs), but they were closed the days we were to go due to the weather. We did, however, go to the Cheyenne Mountain Zoo, despite the rainy weather! It was the coolest zoo! It is built on the mountain, offering some amazing exhibit enclosures and really unique terrain! We were able to feed giraffes, Braylei touched a snake, we were up close to wild deer (part of the mountain, not the zoo), and saw everything from Hippos to Grizzly Bears! We had a really great time! During the week, the kids also got to ride horses at some family friends. One weekend, I was showing them around the post and we were playing at one of the big playgrounds. Then all of the sudden these sirens started going off! We thought it was an air raid at first. But it was a sever lightening warning issued. We thought we would have a few minutes, as the dark clouds seemed a little ways off, and let the kids keep playing. Then out of nowhere it started pouring! We hurried and got the kids under cover under some playground equipment, but we were still getting wet as the rain started coming down sideways and then leaking from above! We decided that we would be there awhile if we tried to wait it out so we made a break for it. Most unfortunately, we were a good 400 yards from the car, so we were all soaked, and got all muddy from sprinting through the park. It made for a great memory though! Another cool thing we did was go a dinosaur museum in Canon City! There were cool exhibits, including the most complete Stegosaurus fossil in the world, fossils the kids could touch and sit on, and a really cool children's discovery area, where they could find pretned fossils, play with dinosaur toys, compare dinosaur fossils to other bones, and color. I probably had as much fun as the kids did!!

And lastly, after getting back home, Braylei got her hair cut short, which is what she wanted. It looks so cute and she looks so grown up, with the exception that she is so small!

Schroeder Family Update

2008-08-24T11:47:00.006-07:00

I haven't been doing a very good job of keeping everyone updated with our summer adventures, so I'll try to do a quick summary.

Tayscen had his first birthday in June, and we had a fun little party for him with family and some of our neighbors! We went swimming in the community pool, and had a dinner/cake back at the house! We had a lot of fun! Meghan made organic low-fat chocolate cupcake and we iced the tops to make them look like baseballs! Believe it or not, those cupcakes were awesome!

On another day following my board exams, we took the kids, plus our nephew, Kameron, niece, Kelsey, and little brother, Jon to BounceU, a huge bouncing facility filled with inflatable equipment from giant slides, obstacle courses, castles and other fun things! It was a blast! And a good workout! It definitely made my foot sore, as I was still rehabbing from my surgery at the time, but it was worth it!

Throughout the summer, both Braylei and Tayscen were in swim lessons run by the city of Surprise. We took them 4 days a week in 30 minute classes until the beginning of August. Braylei was in the preschool class, and she learned so much! It was really nice to see her grow more and more comfortable with the water. Most of it was water exploration, playing games in the zero depth area, being able to reach for things underwater, and work on basic swim stroke elements. Tayscen was in the parent-tot class. Meghan took him most of the time, at least through June, as I still had my stitches in my foot and couldn't get them wet. But I did take him alot in July, although it showed the he preferred his mommy over me.

We won 4 free ticket to the City of Surprise 4th of July Bash. There were tons of things to do there. There were bouncy castles, baseball pitch/football toss, and for the kids, Home Depot had a design a tile where she used an assortment of markers on the tile. She really like it! She also got her face painted. The downside of the night was that it got really stormy and windy. There was a big dust storm and the fireworks show was delayed for like 2 1/2 hours! But the kids really wanted to see the fireworks, so they got to stay up really late and they ended up having the fireworks after all!

We also ventured a couple times to the Peoria Splashpark. It is a really cool place for the kids to have fun! We went with some neighbors and had a blast! Tayscen was having fun walking around and Braylei was splashing through all the sprinklers and fountains!

Rotation Block 1: Cardiology

2008-07-20T13:09:00.004-07:00

Life is good now. Boards are finally over, though I am still awaiting results, and I have no more didactic training for medical school! I just finished my second week of my first third year medical rotation, and it is awesome! This first rotation is cardiology, and I have great preceptor, Dr. Fred Cucher at Phoenix Heart. It's been really challenging jumping right into a sub-specialty like cardiology because I have no other clinical background yet. So basically I've felt like an idiot that doesn't know anything. It's frustrating that I spent the past two years reading and learning about all aspects of medicine, and often, the patient presentations are not classic like in the textbook. But on the bright side, I have learned a ton! First, I have become extremely proficient at the basics, like blood pressure and heart sounds. I also have heard many abnormalities, which makes the process much easier to know what's normal and what isn't. Also, I have seen the pharmacological side of cardiology, and I am picking up patterns of what to do in different situations. It is a relief to see just how subjective medicine is. Everyone has their own way of approaching a given scenario, there's not typically a stringent black and white answer like we were trained with countless multiple choice tests.

Another thing about a cardiology specialty I learned is that the elderly population loves me! True, some thought and asked if I was indeed as young as I looked. But overall, they trust you and have been very nice to me during my time at Phoenix Heart! Although I don't have too many inklings to specialize in cardiology at this time, it has been a very good experience for me to gain so many skills that I can apply to every facet of medicine.

The biggest thing I gleaned from Dr. Cucher was just how special the humanistic component of medicine truly is. In many cases, he has long term doctor-patient relationships and has known his patients for a long time. I see how big of a role that plays in the medical care they receive. They trust him and respect everything he has to say. The reason that he has such good relationships with his patients is that he really cares for them. He takes the extra time to talk to them and listen to them. He asks them about how aspects of their loves are going and takes a vested interest in them as a person, not just a patient. I liked how he did all the blood pressure measurements himself, something I have never seen a doctor do. On my last day of the rotation, he wrote on his prescription pad to me "primum non nocere," and gave it to me. He told me to never forget it, and to always remember the patient first. I later translated the phrase as, "First, do no harm." I am truly grateful for the opportunity I have had to learn from Dr. Cucher.

Board Time

2008-06-01T10:22:00.013-07:00

Wow. It's been forever since updating my blog. Things have been so crazy over the past couple months with the end of the school year, preparing for boards, and of course, dealing with my foot surgery. Needless to say, the past couple months have been a huge flurry! First, there was Easter. It was fun to watch Braylei go on her first easter egg hunts (she ended up going on 3!) One of them was at my school, and another was out at the Surprise Stadium (there were tons of eggs, literally!) Tayscen was very content just being able to be outside so much over the Easter weekend! It was tough, though, as I still had a test that Monday morning! But it was worth it, and I had a blast!

Oh, I guess my little basketball injury was more serious than I thought. I ended up with 4 fractures (1st and 2nd cuneiform, 3rd and 4th metatarsals, along with the lisfranc ligaments)! I had surgery, getting a screw through my cuneiforms. I was casted for 6 weeks, then I was in a boot for a couple weeks before starting physical therapy. I got pretty good on my crutches, and provided a good workout going across campus. The hard part was not being able to do the little things, like going up the stairs with kids in tow, not being able to sneak up on people, and stuff like that. This injury has truly affected our whole family. This has been a huge burden on Meghan, as she has had to pick up even more of the already endless slack that I create. But she has taken it in stride, and hasn't even complained. She just makes fun of me! I've been able to adapt, though, as I still attended the American Academy of Osteopathy convocation held in Dallas back in March, and I attended the Association of Military Osteopathic Physcians and Surgeons national conference in New Jersey at the beginning of May! I also volunteered to help with the medical tent at Ironman Arizona! I volunteered last year too, and had a great time. I didn't get to do a ton of hands on stuff because of my foot, but I ran a pretty smooth medical info tent! I also volunteered for a program called TOPS, where we gave hundreds of high school sports physicals in Phoenix, which is always great clinical exam practice!

Finals were rough as usual, but I got through it, and it was a good feeling to be pretty much done with my classroom education forever! The next two years are all clinical rotations. The only thing left standing in the way is my step 1 board exam, which I take on June 12. I've been studying pretty hard for it, but it's such a ridiculously hard test that I'll never be prepared enough for it! I just want to do the best I can. Once that's over, I will feel a huge burden lifted off of me! I look forward to starting my rotations, even if it will be very hard and strenuous. At least I'll be interacting with people rather than staring at books all day!

been doing well in PT and I have regained a lot of my strength. The removal didn't go as smooth as planned. I was scheduled to have it removed right in the clinic, but apparently, I had some bone growth over the screw and they doctor. Yesterday, I finally had my screw removed from my foot. I've couldn't visualize it, and had no imaging in the office, so they ad to sew me up and take me to a surgery center, where the had more equipment for my doctor to see where the screw was under the bone and scrape away enough to unscrew it from my foot. I'd have to say that it was much more painful than I expected, partially due to the complications that occurred. But it should be on the mend now.

So now that the craziness is mostly behind me, I should be updating more often! That's what I always say though!

Oh, where to start??

2008-03-09T15:28:00.008-07:00

Well I would have to say that this past quarter caused me the most pain--both mentally and physically! I struggled though most of the quarter, and I don't exactly know why. Things were okay after the Thanksgiving break, but we were only back for a couple weeks before Christmas break. Having that much time off really can affect a study groove. It was tough coming back. Granted, Winter quarter of the 2nd year is notoriously the toughest in medical school, but this was no joke! But I made it through okay and now I get a week off to rejuvenate before going into the final quarter of didactics. Our course load will ease up over the next quarter so that we can turn our focus to board exam prep. I have my test scheduled for June 12th. After that, I have a week of clinical prep classes, and then I start my first rotation at the beginning of July.

made me a little flower heart bouquet out of straws, paper, and a cardboard dowel for a vase. On the vase says "I love Daddy because..." then each heart-flower has a little way she loves me. Of course Meghan helped her, but Braylei came up with them all on her own! I didn't really get to celebrate my 25th birthday too much, which was on the 21st of February because I was in the midst of finals! But ITo backtrack a bit, I wanted to note that for Valentine's Day, Braylei did get a great birthday present. I mentioned in my last post, that my old brick iPod kicked the bucket, but I now have a sweet new replacement... a 32GB iPod touch! It is incredible! Once all the 3rd party applications come out in June, it will be not only an awesome iPod, but a totally rad PDA as well! I'm so stoked about it!

My Spring break of course just flew on by! I had to finish putting in my requests for my clinical rotations. AZCOM has a lottery system where we select our top 3 choices for each of our core rotations, and then the computer figures out where we will go and when. We should find out the results in a week or so. We also did some final touches on our side yard, including some rock, putting in a bench, and cleaning our grill. I also got a chance to visit with a mentor of mine, Dr. Mitch Kasovac, who is now the director of Family Medicine at AT Still University in Mesa. He showed me the new medical program out there and the innovative curriculum that they have. While out in the east valley, I was also able to swing by my old work at Mezona Orthopaedics. They have a brand new facility where the docs and the physical therapy are together, which makes it really nice for the patients. Then I was able to stop by and see my dad for a few minutes before heading to my old high school, Tempe High, where I helped out an old friend, Eric Greenhalgh, who is now one of the softball coaches there. I went out do do some strength and conditioning drills for the team, which centered around core stability. Most of all, I really enjoyed spending more time at home with Meghan and the kids! During this time, Braylei got her first haircut! It was just a trim, but we took her to Cool Cuts for Kids, where she got to sit in a car and watch the movie Cars while she got her hair cut!

We also made a return trip to McCormick Ranch's Railroad Park in Scottsdale. We had some leftover tickets to use from Christmas break, and they were having Kid Appreciation Day, which was way cool! They had carnival booths, face painting, jumpy castle things, and some craft centers. Braylei got to make her own choo-choo whistle, and colored some blocks which will be put into a big mosaic at the Children's Art Museum. Braylei of course loved riding the carousel!

The kids are doing great. Tayscen continues to grow by the day. He is becoming a connoisseur of fine foods, developing his favorite baby foods, as Meghan makes all sorts of fun combinations for him to eat. He is rolling around all over just has a permanent smile on his face! My favorite thing that he does, is that every night when we put him down for bed, he will always end up in the top left corner of the bed, regardless of where we lay him down! It's hilarious! Braylei is of course my little princess. She is so smart. I've noticed her speech continues to improve even more that sometimes I forget that she's still just two! She can look at almost any word and spell it now, and I have the feeling that pretty soon she'll be helping me with my board review studies!

Oh, and then Wednesday night, when I was playing basketball at the church, I ended up injuring my foot pretty bad! Early in the game, one of the guys on the other team had a fastbreak, but I caught up to him and got an amazing blocked shot, but I must have got too much hang time, because I had a bad landing on my left foot. At first I thought it was just a little sprain, so I just loosened it up a bit, changed up my running pattern so I wasn't running on the ball of my foot as much, and it seemed fine. But the pan kept worsening throughout the game, and by the time I got home, it was hard to move and was pretty swollen. The pain was exponentially worse the next day. I couldn't put any weight on it, and I couldn't get into the doctor until Friday, forcing me to hobble around everywhere. I still thought it would resolve in a few days, but I was starting to get worried. It hurt a lot worse than any sprain I've ever had. So Friday morning I went into the Podiatry clinic at my school, and it didn't take me too long to figure out something was up> Whenever a doctor asks for more X-rays numerous times and then returns to have more physicians and podiatrists exam your foot, chances are good that you have something wrong. Turns out that I most likely have a Lisfranc dislocation, which is a rupture of the ligament between my 1st and 2nd metatarsal in my midfoot, and there was a separation between the medial and 2nd cuneiform, which are other small bones in my foot. Chances are excellent that surgery will be required, but the decision will be made tomorrow when the results of the MRI come back. If I do, the return to activity timetable is 6 months to a year, with me being completely non-weightbearing for 6 weeks. In the meantime, I've been crutching around with this giant immobilizer boot feeling completely useless. I've also realized how rough it is to live in a 2-story house! But I will be sure to update everyone when I find out more info!

That that didn't stop the fact that on the 8th, Meghan and I celebrated our 5 year anniversary! It's crazy to think we've been married 5 years already! And then add in the fact that we've known each other for almost 11 years now and it's like we're an old married couple! We obviously couldn't do a lot given that we have two small kids, one of whom is still nursing, I'm in school, and I have a gimpy foot! We did go to dinner and a movie, and it was nice to get away for just a few hours, if nothing else!

January Recap

2008-02-03T13:30:00.000-07:00

What the scrud? It's February already? Where has the time gone? Oh, yeah, I just got through "Black January" at school, which is probably the worst stretch of my medical school career. It is called this because of the ridiculous slew of tests, quizzes, and other requirements that preclude you from seeing the light of day! It has been very draining on me physically and mentally. But I only have 1 more test before finals! It really has been a pretty solid butt-kicking for me this quarter. Yeah, it's busy, but it seems more like I've been in a funk since returning from Christmas break and I haven't been able to get into my groove. But I've squeaked by okay. It's also been busy trying to figure out what I am going to do for my 3rd year clinical rotations. We have to try to schedule where you want your cores, what elective you want to take, not to mention trying to set up military rotations. I'm also applying for a predoctoral fellowship program in osteopathic medicine. In this program, I would be helping teach the 1st and 2nd year OMM labs at school, as well as spend every other month working in the school's osteopathic specialty clinic, where I would be seeing my own patients! It's a totally awesome experience, and would be a huge asset to my clinician skills! But, as a tradeoff, my clincal rotation period that normally lasts 2 years (the 3rd and 4th years of med school,) would be extended an extra year so that I would be able to alternate working in the clinic as well as completing all my normal rotations. I would be receiving excellent training, but even if I am selected, I am not sure if I will be able to do it due to my obligations with the Army. They are paying for 4 years of medical school and want me in one of their residency programs as soon as I graduate. I am trying to convince them that by giving me an extra year, I will be able to be an even better Army doc. My request is currently going up the chain of command, which is no speedy process, unfortunately. I guess I'll just have to wait and see what happens.

One of our school requirements is to do a rural rotation, and I have decided to return to Cedar City, one of my favorite places on earth, and the home of my undergrad, Southern Utah University! I love that place and it will be fun for us to go up there for a month and see everyone again! I tentatively have it set up for March 2009 (a peak time to see some gymnastics meets), but that might change depending on the outcome of the fellowship position.

I have also completed my solo OSCE's (orientation to student clinical experience), which was very nerve wreaking. It was like being in a real doctor setting and we had to apply all the information we've gathered over the last year and a half to patient scenarios. We are in a real exam room and are monitored and evaluated by a facilitator behind a 1 way window. There is a simulated patient in the room and we complete an exam based on our findings, then write up a SOAP note, which documents our findings, our diagnosis, and our treatment goals. It was a really good experience for me to see where my strengths an weaknesses lie, and try to improve upon them.

On the home front, Tayscen is now 7 months old! Isn't that crazy? He has truly discovered the joy of food and eats a ton! Meghan has been making his babyfood, but he is eating a lot more than we expected him to! He just loves to eat! He also loves the biter biscuits and Zwiback toast! Braylei never liked the babyfood that much! He is also finally rolling over a lot more now and is growing more aware of his surroundings by the day! Braylei has loved being potty-trained and is doing so well with it! She has a little sticker chart where she gets a sticker and a little treat each time she goes. She is also making leaps and bounds with her alphabet. She knows all her letters and what sounds they make, and can spell her own name! Meghan has been working with her every day, as she focuses on a letter each week and does numerous activities that go with that letter. At the end of the week, Braylei has a little letter book that she made and she even traced the letter B by herself! That was crazy to me!

On a more sober note, Gordon B. Hinckley, prophet and president of the Church of Jesus Christ of Latter-Day Saints, passed away on January 27 at the age of 97. To his last days, he was filled with joviality, kindness, wit and compassion. Through his leadership, the LDS church has grown so much. President Hinckley was the prophet since well before I joined the LDS church in 2002. Even before I joined the church, I had the utmost respect for him. A kinder, more genuine individual I have never known. He was truly a disciple of Christ and a champion of humanity. Regardless of religious affiliation, no one can say a negative thing about Gordon B. Hinckley. He was loved by all, making himself open to the media, and was awarded the Presidential Medal of Freedom from President George W. Bush, which is the highest award given to a civilian. I know that I am a much better person because of his leadership, counsel and wisdom, and I know that he was a true prophet of God.

On a lesser note, I suffered another loss this month. My 4th generation 60GB iPod Photo, which I have had since 2005, went caput for good after a multiple month battle with freezing. "Old Bricky" was a hard drive based iPod, and was subjected to a lot of jostling, as it was a daily running companion to me. I was deeply saddened by this loss, and neither my workouts or daily commutes have been the same since.

Also this month, one of our good friends, Jill Stevens, competed for Miss America 2008! Jill, who was Miss Utah, was one of Meghan's roommates our freshman year, and was a Presidential Ambassador with me at SUU! Jill is also a medic in the Utah Army National Guard, and had completed a tour of duty to Afghanistan. It was so fun to watch her in both the pagent and on the TLC reality show leading up to the contest. It is always nice to see someone of such genuine character stand so firmly in her morals. She was even voted as America's Choice finalist! Of course we thought she should have won, but she represented not only the state of Utah, but the United States Army as well! Great job, Jill!

Another Break Ending Too Soon!

2008-01-02T21:17:00.000-07:00

My Christmas break was far too short. I resume classes tomorrow, with an with a gauntlet of tests ahead of me. I have a big quiz in my clinical correlates class over an entire board review book that we were supposed to read over the break (yeah, right), then a Micro test on Monday, our clinical correlates midterm that Friday, followed by a Path test 3 days later! But, that's my life in med school! Thankfully I only have a little ways to go before my clinicals are through!

This break has been very good for our family. Christmas was so much fun! Braylei was so excited and had so much fun! She wanted to stop and and play with each present and thus she was opening presents forever! Tayscen was just chillin out being the happy little kid he always is. He got a cool little musical book that he likes to play with and has been good for tummy time with him. Braylei has been having a hard time deciding what she wants to play with and runs around from one thing to the next, whether it be playing with her Cinderella doll, pushing her shopping cart or vacuum, playing with her kitchen, coloring or riding her bike. She has had an awesome time.

We also used this break to do our planning for our "side yard." Since we live in an urban housing development, we don't have a back yard and our front yard is maintained for us, so we have a little 10 x 40 side yard which is in between our house and our neighbor, with our neighbor's house acting as the far fence, while their yard is on the opposite side, and so forth. Plus, with all the houses being two story, it doesn't get much sunlight, which adds to the difficulty in planning out our space. We want a fun area where the kids can play, but since our yard gets about an hour of sunlight a day (high noon), grass won't be able to grow. And even if it did, it wouldn't be worth it to install a sprinkler system or get a lawnmower for such a small area. So, we are going to use synthetic grass. At first, I thought this would be like astroturf, but most of the good stuff looks really good and is real soft and durable. There's no watering and no maintenance either! Some of the lower end stuff, though, did look like a flattened Christmas tree! We also are going to have a small area where we will put in mulch and a bench. And we just had some concrete put in for a barbeque area and a little pad by the gate. I'll be very excited to use it!

On the 29th, we took the kids to Railroad Park in Scottsdale! It was a really neat place! Braylei rode the carousel 3 times! I had Tayscen in the Baby Bjorn the whole time and he was as happy as could be! He was just kickin his legs and waving his arms! Of course, there were two train rides that we went on and a huge park! Braylei had a lot of fun going down all the different slides! It was a lot of fun for the kids!

Yesterday was another big day, as Braylei made the leap to "big girl panties!" We had been warming her up to the idea of using the potty to go to the bathroom for awhile now and she had picked out little mermaid, Elmo, and Dora underwear. She loved the potty videos we got from the library (they are weird, let me tell you, but she was mesmerized by them)! But yesterday, she told Meghan that she wanted to wear her mermaid panties and so we went for it. We spent most of the day in the bathroom, but it really paid off! She only had two big accidents, and they were the first two. It didn't take her long to realize the feeling and be able to tell us when she had to go. The following times she just wet her underwear a little bit before pinching it off and holding it. Then she went really well before her nap and stayed dry in her pullups through her whole nap, and went again after she woke up! It's really neat to see how quickly kids catch on and how they can regulate their systems and gain control. She had another good day today and has continued to improve, so we had a potty party at Chuck E Cheese, which was where she wanted to go. The key was to get her excited about it and have her take ownership in it. It started with her picking out her "big girl panties" and have her want to wear them over diapers. Then the potty videos helped a bit warm her up to the idea. Then each time she went on the potty, she would get a little treat that she got to pick out that was special and only used for that purpose. She also got to put a sticker on her potty chart, and when that fills up, she will get a toy (she wants a baby doll). Then we told her that if she went on the potty all day and would tell us when she had to go, she would get a potty party where she wanted to go. It's been a lot of fun!

Tomorrow, Tayscen is getting his 6 month pictures taken! His hair has gotten pretty long already, so today, we trimmed his little hair for the first time. It is way hard cutting a baby's hair! They don't exactly sit straight, you know! But we got it trimmed so we can spike his hair for his pics. He looks so much older, too!

The hard thing about going back to school is with the kids, I love spending time with them and this break especially, I felt like I really bonded with Taysce. I was barely around for his birth, as that was right in the middle of basic training over the summer. Then I missed that whole 1st month of his life. When I got back, we moved into our new house and had to get situated there and everything, and then I started school again. He goes to bed around the time I get home from school and so I really only get to spend time with him on Sundays. But with him older now and interacting more, it was really fun to spend so much time with him. He's still a mama's boy by far, but I feel like he really knows me now. Hopefully I won't ever lose hold of that!

I also posted some more YouTube clips that you can access via the VideoBar to the right or by visiting my YouTube channel http://www.youtube.com/thejschro

From our family to yours, we hope you all had a Merry Christmas, Happy Holidays, and a very Happy New Year! We always love to hear from you by leaving comments, too!

Merry Christmas

2007-12-22T07:18:00.000-07:00

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!

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

2007-12-09T06:02:00.000-07:00

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!

Update: Zoo Pictures

2007-11-20T22:01:00.000-07:00

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!

Whew! I'm out of my hole now!

2007-11-13T21:35:00.000-07:00

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!

Family Pictures!

2007-10-07T07:20:00.000-07:00

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!

Whirlwind

2007-09-23T05:49:00.000-07:00

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!

Update: OBC pictures

2007-08-19T09:18:00.000-07:00

I have added some of the pictures from my Army Basic Officer's Course. Please disregard the lack of picture quality. I opted to take a disposable camera rather than our $500 camera. One of the guys in my squad broke his $400 camera while low crawling out in the field. I'll try to get better copies of some pictures from others who had better cameras!

Update

2007-07-17T15:04:00.000-07:00

I have now added pics from the 4th of July with Russ Wilde! They are under "Another Wilde Week!" Enjoy!

Almost Done!!!!

2007-07-16T17:13:00.000-07:00

Oh, Boy! It feels so incredible to be done with all of our field training for the Army Officer Basic Leadership Course! It felt just as good to take a shower when we returned to post Friday evening! Although baby wipes and liberal amounts of medicated Gold Bond (the menthol is a real treat!) do wonders, nothing can beat a real shower! What a week it was, though! This whole week focused on AMEDD operations, or medical related simulations. We were given a full OPORD (operations order), which describes in detail the simulated situation and mission. It was pretty funny that we were sent in to protect the newly liberated Southern Republic of Texas (SRT) from the communist People's Republic of Austin (PRA). We also had to be aware of SRT insurgents who called themselves the Texas Unification Front (TUF). We were charged with the challenge to provide medical support to the US troops sent to protect the SRT from the PLA and TUF. On one day, my group was in charge of setting up a battalion aid station, which is a level 1 station. This is typically acts as a casualty collection point for injured soldiers. Casualties are brought in and are triaged, treated, and, with minor bumps and bruises, are usually returned to battle, or in more serious cases, are taken to a level 2 hospital. I was in charge of triage, where I had to evaluate and rank the severity of the casualties coming in, which determined who was treated first. Another day included setting up an AXP (Ambulance Exchange Point). This is an intermediary point between level 1 and level 2 stations in order to cut down traveling distances for the vehicles. An ambulance from the battalion aid station would bring the casualties to the AXP where they would be taken off, quickly triaged and then placed on the ambulance belonging to the level 2 hospital where it would return. The key with the AXP and level 1 is that these are unestablished areas that need to be secured and cleared before they could be set up. The last task dealt with setting up a level 2 hospital, which is set up within the FOB (forward operating base). This was split into two parts. The first was concerned with running a level 2 hospital, which received and treated casualties from both the level 1 via the AXP, as well as the FOB, which was concurrently under attack. I was part of the quick response force (QRT) aid and litter team. the 4 of us were the first responders to immediate casualties on the FOB. It was pretty intense to go into hot areas to retrieve the injured soldiers and take them to treatment. It was hard work, too! I got pretty tired after carrying a few 200 lb soldiers a few hundred yards! The second part focused on FOB operations. My duty was as the lead radio transmission officer, where I relayed all incoming radio messages from all posts on the FOB to the company commander. It's really hard to try to relay a message as three more are coming in! The whole day was crazy as we were dealing with insurgent fire, mortar attacks, angry civilians, and injured soldiers, but it was a great learning experience!

Overall, I thought this week was very beneficial. We had some breakdown in leadership that caused a lot of moaning and groaning, as they decided to enforce rules that were never mentioned before. And then on the last night, they went crazy on us as we were cleaning our M-16 rifles! They were given to us in pretty poor condition, but they acted like they were brand new and expected us to return them as such! We cleaned them for hours on end and were up past 1am! Then we had to get up at 4:30am to do a 3 mile road march. Little did we know that we would end up doing over 5 miles due to the cadre's miscalculation. It was a good march, though. I was given the charge of keeping everyone in the back of our platoon together. This was very rewarding indeed, as I was able to motivate my platoon, keeping morale up. This was especially important toward the end, as we began to realize that our march was going to cover much more than 3 miles. Some of the platoon was pretty frustrated, and the lack of sleep did not alleviate the matter in the least! But in the end, we stayed together and it we made it through our last week of field training!

This weekend was pretty relaxing for me. I had pretty good food, especially as opposed to MREs! The best part about it was that I had an opportunity to attend a session at the San Antonio Temple for the Church of Jesus Christ of Latter-Day Saints. The little Ft. Sam Houston branch made a little temple trip. It was so wonderful to escape the world, escape the vulgarities of the Army for a few hours and find true peace in the temple. It was revitalizing and refreshing. On Sunday, the investigator family returned to church, this time bringing 2 more members of the family in tow! They are wonderful people and it is a shame that I will never know what paths their lives will take, but I hope that they were able to feel the sincerity of my heart as I testified to them of how I found my place in this world.

This week should prove to be relatively uneventful. We have a lot of lectures, but not much else until our final exam and graduation on Friday! I can't wait to get back to my beautiful family in Arizona! I began to cry as I talked to Braylei on the phone Saturday night, as she kept asking me to color with her. She wanted to see me through the webcam, which is unfortunately blocked from streaming while I am on post. She says, "Daddy! Cue-per!" Meghan said that she also has taken up the pastime of tickling! She will run up to people and just start tickling, saying "Tickle, tickle, tickle!" Tayscen is still eating well, and beginning to go longer than 2 hours between feeding at night, allowing Meghan to get a little more sleep! I miss them all so much! I can't wait until 9:21 Saturday morning when my plane arrives and I am reunited with them once more!

Another Wilde Week!

2007-07-08T18:12:00.000-07:00

Only 2 weeks of officer training left to go! I am so excited to go back home to Meghan, Braylei and Tayscen! I miss them so much! Braylei is going through a growth spurt and is getting more and more clever by the day! She loves to carry a little step stool all over the place and is now using it to turn lights on and off as well as open doors. Her new movie phase is the CG animated Madagascar, asking for "Video! Lions!" Meanwhile, Tayscen is up to 9 pounds, is eager to hold his head up on his own, and definitely enjoys eating! Meghan is doing excellent, and her incision from the c-section has healed and looks darn near close to her pre-pregnancy self, save her uterus is still a little enlarged. She has adjusted to taking care of two kids amazingly well. I don't know how she does it! She is incredible! I can't wait to see them again.

Meghan has also been working hard, with the help of her family, in painting our new house so it will be ready to move into when I return! Everything looks so great! They painted the living room, loft, and the kids' bedrooms! The living room is a khaki color called prince I believe, while the loft, which will be the kids' play area primarily, is kind of a khaki green. Braylei has a sherbet green half wall with yellow and pink stripes, and Tayscen's room features a rich chocolate brown. We haven't decided what we will do with our room. We also ordered chocolate brown leather living room furniture and bookcases for our room and the loft. We are looking at TVs but haven't decided on that quite yet either. I am so excited for our house! I get to install ceiling fans and a garage door opener when I get back! Yea!

Meanwhile, this past week was pretty exciting. We spent Monday and Tuesday out in the field, working on FOB (forward operating base) operations, and convoy operations. A convoy is a group of vehicles with the mission to get from one point to another. In the field, or in theater (an area of war) anything coming into or going out of the FOB is conducted by convoy. It isn't safe or prudent to have single vehicles coming to and fro. Plus in today's warzone, Iraqi insurgents using roadside bombs disguised as everyday items. So there are many battle drills that we must know so that if something were to happen. I was selected to be one of the Truck Commanders (TC), which was a crazy, but cool experience. I did, however, inadvertently cause the death of two Iraqi citizens at a wedding party due to a gun firing wedding ritual that was unknown to me. I mistook it as enemy contact, and by the time I saw otherwise and gave the command for my truck not to fire, the truck behind me saw my signal and opened fire before I could stop them. That's exactly why we practice these drills before we're actually in that situation for real. During the convoy, the rain started coming down very hard on us again, which in many respects made it seem really cool because we were dismounted at the down and we were simulating a medical evacuation. It was pretty intense. On the Wednesday, the 4th, we were back in San Antonio and we had the day off. I was able to get in contact with my old college roommate, Russ Wilde, who recently took a job as a news reporter for a station in nearby Austin. He and his wife met me in town and we were able to have lunch and see the new Transformers movie,which is brilliant, by the way! We then hit up downtown San Antonio where we saw the Tower of the Americas, the River Walk, and the Alamo. It was really good to see them. The rest of the week was just classroom work, which was pretty dull. Nothing major went down this weekend. I did have a really awesome missionary experience at church today with a wonderful young medic, her 4 year old son, along with her mother and grandmother. I was able to share my conversion story with them, and help answer some of the more obscure questions that I remember asking when I was in their shoes! It is always important to me to express how thankful I am for my upbringing and hold in esteem the catholic church and all others that I investigated years ago. There is light and truth in everything, and we must all see it. As a member of the Church of Jesus Christ of Latter-Day Saints, I believe that the fullness of the gospel's light and truth has been restored to this earth. But never let go of all the good within you and around you. I would just invite anyone to look and see if we can help them find a supplement to the wondrous light they already have in their lives, not to reconstruct it, but rather enrich it. People will say what they will about my religion, but the only thing that matters is what our hearts tell us. I intend to follow my heart through the promptings of the Holy Ghost, who so beautiful guides me through this life!

Welcome Tayscen Daniel Schroeder!

2007-06-30T13:49:00.000-07:00

At 0933 Wednesday, June 20th, we welcomed Tayscen Daniel Schroeder into the world! He was 8 lbs, 2 oz and was 20 1/2" long. Meghan delivered Tayscen via a scheduled c-section. Due to the vast complications with Braylei's delivery, this was deemed a high-risk pregnancy. However, we were very blessed that there were no complications this time around! Meghan was never on bedrest this entire pregnancy (unlike last time), and she even drove out to our new house to sign the closing papers and everything the day before the delivery! Tayscen was born full term, had no respiratory difficulties, and no jaundice. Meghan healed very fast, much unlike last time, when she lost so much blood and was very weak for weeks. Meghan was up and moving around the same day, and the next day she was moving around with ease! Again, it was a true blessing to us, especially since I have been away with my military training.

Another surprising, yet truly wonderful blessing was that I was granted permission to fly home for the delivery. I left at 0600 Texas time, arrived at 0621 Phoenix time, and immediately headed to the hospital where Tayscen was born at 0933! It was very exciting indeed! I was able to be with them the whole day and through the first night. I had to leave again early the following afternoon so that I could return to my training, and although the time with them was short, it was so worth it! It made the biggest difference in the world and I will always be thankful to the company commander and the cadre (staff) for the opportunity to be present at my son's birth!

As of yesterday, Tayscen was now up to 8 lbs, 12 oz and is doing exquisitely! Braylei, meanwhile is adjusting very well to being a big sister. She loves to help hold him and get the diapers and wipes when he needs to be changed. We had been reading her a book titled "I'm a big sister now!" for the past month or so to help her get excited for her new little brother. Hopefully she will stay that enthusiastic about it!

Officer Basic Leadership Course

2007-06-30T12:02:00.000-07:00

I am now in San Antonio, Texas (Boo, I know!) for my Army Officer Basic Leadership Course (OBLC) at Fort Sam Houston. I arrived on the 10th of June and I will get back on the 21st of July. As of today, I have three weeks left! I have learned a great deal thus far. It's crazy being thrown into the Army life of an officer, having all the enlisted soldiers saluting you all the time, and trying to recognize all the customs and courtesies in the military. The first couple weeks consisted of a great deal of in-processing and paperwork, and with 300 medical, dental, vet and PA officers, that translates into a lot of sitting around. We haven't done near as much Physical Training (PT) as I thought, but I have been running daily with Ken, a former Army Ranger who is also going to be a 2nd year at AZCOM. That has been good for me. As far as our PT test, I did better than most with the 2 mile, 2 minute push-up and 2 minute sit-up tests, especially considering the amount of time (or lack thereof) I had from the end of school to my report date. I wanted to spend as much time as I could with Meghan and Braylei before I left so my workout time was reduced to before either woke up each morning!

We do a lot of classroom didactic study, as that has taken up most of our time thus far. However, we just spent a week and a half out in the field. There is a large military reservation on the other side of San Antonio that simulates what is like to be in a FOB (forward operating base). We had no showers (yuck!) or plumbing (go port-a-potties!), but there was water so we could shave, brush our teeth and wash our faces. We also had air conditioned tents, so that was nice. There were probably 30 of us per tent, so it was pretty large. The cots weren't horribly uncomfortable, and we were very blessed with cloudy/rainy weather the whole time so it wasn't too hot. While there, we did a lot of training, much of which was very new to me. We shot with a M-16 rifle, an M-9 handgun, conducted day and night land navigation, mounted (vehicle) land navigation, and urban tactical training (clearing houses and buildings). I did really well, getting perfect marks in all my land navigation training, and qualifying as a marksman with both the M-9 and M-16! I told Meghan that I'm becoming a real man out here! We had to return to Ft. Sam a day early due to heavy rainfall and flooding, but we are going back for two more days Monday, then we will have another full week after that which will all be medical related. We will be in charge of setting up a combat support hospital, transferring combat casualties (injured soldiers) to level 1 (battalion aid station) to higher levels. It has been a very good experience for me, but I will be happy to return back home! I will add pictures once I get back and develop the pics from my disposable camera.

Our First House!

2007-06-30T10:19:00.000-07:00

We are very excited about our new home! We had been searching for quite some time for a home closer to my school in Glendale. It was becoming just too much to be driving 2 hours round trip every day. I was still doing fine in my studies, but it was taking away from family time too much. We weren't sure if we wanted to rent or buy, but we felt that it would be a good investment to buy. But it sure wasn't an easy process! For one, the market by my school is an expensive one. The houses we looked at were not in very good condition, or were very small. It's amazing how different a house can look in person from the pictures posted on the MLS! We were just about to give up when we stopped by a brand new housing development. We were told that we wouldn't be able to get in until November, but then we found out they had a spec home that would be done at the end of June. It was perfect. A brand new home that was bigger and cheaper than the others we had seen. Plus we were able to pick the upgrades, the carpet, tile, and everything else. The mortgage process was not fun as the in-house group did a very poor job. Needless to say we will be refinancing in a few months. However, that being said, it is now ours, and we will be moving in as soon as I get home from my military training! Braylei is excited as every time she goes out there she runs around and goes in her room, saying "my room!" It's super cute! Plus my commute time is greatly diminished, as it is less than 15 minutes from my school! So I can get to school earlier to work out and study, and I can get home earlier to spend with my family!

What the Scrud!?

2007-06-30T09:49:00.000-07:00

Whoa! It's been forever and a day since I posted! Life has been unreal! So much has happened! So to start off, I'll cover Spring Quarter. This was by far my best quarter of the year! I did much better than the previous two, and I seemed to have more time for things. My study habits were a lot more focused, and I felt like I was spending more time with Meghan and Braylei! I was also diligent in keeping the Sabbath day holy and not studying on Sunday. This is a really hard thing to do sometimes, especially since we always had Monday morning tests. Plus, this quarter was tougher because we had more classes, and thus more tests. So we often had Monday/Friday/Monday test schedules, so I didn't get to really hit the studying for the Monday exam until after the test on Friday! It was really crazy! But everything worked out well in the end!

I also had a great experience with my preceptorship, Dr. Carfagno. He is a physician who is dual certified in Sports Medicine and Internal Medicine. I was able to see many different cases, conduct history and examinations on patients, and even sports physicals! I learned a great deal, and also gained many volunteer opportunities, like the Valley of the Sun half Marathon, and the Ironman competition in Tempe! I look forward to continuing learning under Dr. Carfagno's guidance.

Another really cool service opportunity came with the TOPS program, which stands for team of physicians and students. We conducted 1000s of sports physicals for an entire high school district in Phoenix. I myself performed over 20, which helped me greatly work on my techniques. It was a really cool experience!

I will definitely enjoy my time off from school, as we don't start up again until the end of August! But it has been a busy Summer, with moving, having officer basic training in Texas, the birth of our son, and so much more! But I will get to all of those soon!

Onward To Spring Quarter!

2007-03-04T21:36:00.000-07:00

Whoa! I guess I haven't posted in awhile! I've been in a super flurry of events as of late! Let me give a brief rundown of all that's been going on! First, finals week was like none other! It was absolutely insane! Through the first week, I ended up doing really well on my OMM exams, getting solid A's on both the written and practical portions. However, my intro to clinical medicine final didn't go as smoothly. Typically, Dr. Schwartz asks pretty surface (albeit sometimes obscure) questions, but apparently he was really mad that hardly anyone went to his lectures on the morning before one of our killer Anatomy/Histology/Embryology block tests, so he had a ton of questions on that information. Fair, I suppose, but pretty stupid. It's a good thing I had a hefty cushion in that class. Then, as for the real finals week...it went okay. I didn't sleep a lot, but I manages fairly well. I received my best test score in Physiology of the whole quarter on the final. Then the Anatomy/Histology/Embryology block came pretty hard. I received my best grade of the previous two quarters in Histo and Embryo, but at the cost of Anatomy, which was a sub-par score for my anatomy standards. But it didn't bring my average down too much. Next was Human Behavior, which was a typical crapshoot human behavior test. Psychiatrists, go figure. The last final was Biochemistry, my arch nemesis. However, this exam's material was very interesting to me, as it dealt mostly with human nutrition, and of special interest, nutrition during pregnancy, and infant nutrition. I did pretty well, earning my best score from the past two quarters in that class! It was a good thing that was the last final, because we were all looking pretty ragged by the end! The best part was that we had a week off!

My "Spring Break" flew by so fast! I was able to enjoy most of it by just being with Meghan and Braylei, my two favorite people in the world! Bryalei just cracks me up! She is so clever and smart. She has also fallen in love with the movie Cars. I probably watched it 20 times over this past week! She mainly likes the racing scenes, but loses interest during the middle. It's hilarious because she'll point to the TV and say "Ideo" and "Carsh!" She is getting even better at her animal sounds, recognizing both when she sees a picture and by name. We've also been including her in helping out. She'll go put things away, or hand something to Meghan or myself. It's really unbelievable how fast she is growing. She also will point to Meghan's tiny little stomach when we ask her where the baby is, or where her brother is.

Alas, the week has come and gone. And now Spring quarter is upon me. I am excited to be done with Anatomy, histology, embryology, and biochemistry. Now we start neuroscience immunology and our early clinical experience preceptorships! I guess I'll find more details out tomorrow at orientation! 11 more weeks until summer vacation!

Treading Water!!

2007-02-04T14:04:00.000-07:00

Wow! This has been one long week! Probably because I haven't slept very much, but I am nearing the end of this treacherous testing stretch! Biochem went okay on Monday, the OMM quiz wasn't too bad, the Anatomy and Histology tests were pretty tough, but hopefully I did well enough to get by. My Physiology group presentation Friday went well, although the other groups took too long and, as we were the last group to present, did not have a great deal of time. Unfortunately, the Physiology test did not get moved like I was hoping. The class liaisons presented a good case to the Physiology department chair, and they had it arranged to switch the Wednesday biochemistry workshop to Monday so that the phys test could be Monday at 8am. However, AZCOM has this really lame "unwritten" rule that states that for a change like that to take place, the class has to unanimously vote in favor of this change. And there were two people (out of 150) who did not want the test to be changed! Apparently, they wanted to just get it over with so they could have a week off. But there is no reasoning with them, as these are confidential votes, and they are most likely those students where everything comes pretty easy to them and aren't concerned with those of us who need a little more time because we actually have lives outside of school. Oh well. After tomorrow, we have our OMM written final next Monday, the practical final Wednesday, and our Intro to Clinical Med final Thursday. Then we hit finals week! Yea!
Braylei meanwhile is feeling much better and has returned to her usual hilarious self. I wish that I got to see her more. And those days when I do its only for a half hour or so before she goes to bed. I hope that she understands. Meghan is doing well, and is the most incredible person I know. She is so supportive of me and does so much. I admire her so much for her selflessness in putting aside her own wants and needs to take care of our family. She is a true inspiration and I am eternally grateful for her!
I hope everyone is doing fabulous and I wish an awesome week ahead upon all!

Pouring it on

2007-01-28T11:26:00.000-07:00

Sorry it's been awhile since I posted, but school has been absolutely nuts! I got through midterms okay, albeit a very crazy time! The day after MLK brought a 6:30 am Gross Anatomy test on the Lower Extremity, then Wednesday was a Osteopathic Manipulative Medicine quiz, Thursday was my midterm in Intro to Clinical Medicine, Friday brought a midterm in Human Behavior, then we got to rebound with a Physiology test on Monday morning on Cardiac Physiology. Now I am facing perhaps an even bigger challenge with a Biochemistry test Monday morning, then an OMM quiz Wednesday, Head/Neck exams in both Anatomy and Histology on Thursday, then Physiology the following Monday! It's really hard to balance studying time when there are so many tests back to back! I guess that med school for you!

Meanwhile, Braylei has gotten pretty sick, currently battling both an ear infection and pneumonia. We have had some long nights, and for Meghan, some very long days. Braylei's vocabulary is soaring! She is learning new words every day, her cognitive skills are really developing, as she is getting so good at basic problem solving, and she is all over the place.

Meghan's been very busy as the Young Women's President in our ward. They just had their New Beginnings, for which she invested a lot of time. She also just had her second OB checkup and we are happy to say that we are having a boy!!!! I'm so excited! Plus, the ultrasound revealed a high placenta, so as of now there is no placenta previa as was with Braylei, and there are no other current signs of a high risk pregnancy! So we are praying that her conditions will stay this positive!

Hopefully I will get through this set of tests, especially Biochem tomorrow!

The Wonderful World of Coagulation!

2007-01-07T12:33:00.000-07:00

Every time I have a break from school, it is so hard to get back into the swing of things. This time, though, I do not have a choice, as our first Biochemistry exam is tomorrow! It is really unbelievable how much information they cram into such a small amount of time! A test over lectures 1-10 and workshops 1-3 doesn't sound like a ton, but the breadth of the material is really incredible. Especially deep are the first 3 lectures on the inflammatory response to injury and the coagulation/healing process. At first I thought, "oh, no big deal." I remembered covering that in my undergraduate athletic training classes. I can still vividly recall my professor Ben Davidson spitting out terms like prostaglandins and neutrophils, but it came across like a magical process! We have learned every step of the way, a the systematic process by which blood clots are formed and resolved. The same thing with my athletic training pharmacology class. In undergrad, it was just knowing names and what they did. I knew COX-2 inhibitors like aspirin, ibuprofen, vioxx and celebrex, but now I know what they do and how they do it! The more I learn, the more I see the interrelation of all things, and although very complicated, the up and down regulations of these processes really testify to me that we are divine creations. It really is amazing!

I have put in a tons of time in my studies, but there is still more that I would like to cover before the 8am test! Then I can look forward to a patient simulated male invasive (rectal) exam! Doesn't that sound spectacular? I hope Midwestern is paying these people well! That means yet another late night here, but at least that gives me plenty of time to study for my 3 exams next week!

Sundays are really nice for me. Establishing that I will keep the Sabbath day holy and not study was at first a trial, but now it is a huge blessing. Sure, I get up super early on Mondays to prepare for my tests, but I love spending time with my family and being able to take care of church responsibilities. I stayed home from church today since Braylei was not feeling too well and Meghan was teaching a lesson in Young Women's. I will take every opportunity to spend time with Braylei since I hardly get to see her during the week. She is really getting so clever and smart. Her beautiful personality is coming out and she reminds me more of Meghan every day! My family truly lights up my life and I wouldn't trade anything for that.

Merry Christmas/Happy New Year

2006-12-31T14:41:00.000-07:00

Merry belated Christmas to all! We had a wonderful Christmas, and it was so fun to watch Braylei open presents and enjoy the day! It was busy, though, as we went to have brunch at Meghan's parents, came home for Bray's nap, then had my parents over in the evening. Then we packed up and headed up to the White Mountains with our friends, the Sessions, to hang out at Chris's family's cabin. It was nice to just chill for a couple days. Braylei got to play in the snow for the first time and had a lot of fun! I actually rode a snowmobile for the first time and almost killed myself! Chris and his brother Mike told me to go off a jump, but I didn't realize how big it was until I was 2 feet away and going full speed. I got some sweet air, but nearly fell off. Luckily I landed it okay, but it scared the crud out of me! On the way home, we got caught in a snow storm that kept getting worse as we went. We hit a patch of ice and nearly slid off the rode, but through the grace of God, I was able to turn with the slide, and we spun a full circle but stayed on the rode and continued on. We were quite shaken up, though, and the storm continued, so we stayed the night in Payson.

I am excited to bring in 2007. 2006 was a great year, as the Lord blessed us so greatly. I am so grateful for my last minute acceptance into medical school, and the time I was able to spend prior to that adjusting to parenthood. I was able to spend a lot of time bonding with Braylei, and watch her grow and develop. I am so thankful for my beautiful wife Meghan and the patience she has with me. We are also very excited to announce that we are expecting our second child! Meghan is currently 15 weeks along and she is due on June 23rd! It has been a wonderful year, indeed, but I look forward for 2007 to be even better!

That said, my Christmas break will soon be over, as I resume school on the 2nd. The last few days before break was just as crazy as I expected, but it was loaded with great learning experiences and it is over with. I have really enjoyed how AZCOM gives us so much patient simulation exposure, so that we are a little more familiar with clinical exams when we start our preceptorships in the Spring. The rest of the quarter should prove to be very crazy, as there are many instances with 2 tests a week. So it will be challenging to balance my studies and stay up with everything. I do, however, look forward to the challenge!

Well I hope everyone had a Merry Christmas and I wish everyone a happy and safe New Year!

On the Brink of Insanity!

2006-12-17T15:23:00.000-07:00

I apologize in advance for the conciseness of this entry, but these next three days are unbelievable! I have already described my schedule in the last entry, but experiencing it has been something different altogether! I have been studying like crazy, and hopefully my efforts will be enough to receive good marks on my exams and that the information I have been studying will be applied to permanent memory. I must never lose focus that these classes aren't just for a degree, but for being able to provide quality, competent care to others. I absolutely love medical school, despite its immense difficulty, but I do look forward to Wednesday after my Physiology exam!

The Importance of Elvis' Pelvis

2006-12-10T14:20:00.000-07:00

Another week has come and gone. A week and a half is what separates me from Christmas break. However, in that period of time I will face an onslaught of tasks! In Anatomy and Histology, we are fully immersed in the Pelvis and Perineum unit, which has been an excellent learning experience, as my athletic training background didn't hit a whole lot on urogenital systems, reproductive organs, and everyone's favorite, the rectum! We have both tests next Monday, the 18th at 6:30am!!!! It's unbelievable how early that is, but that afternoon, I two patient simulation clinical exams as well. I have a heart and lungs exam in the afternoon, then from 6:30-9pm I will conduct a female pelvic exam. Now this is a great opportunity to have real clinical experience so early on, but it is amazing to me that they can get people to sign up to be patients for this. I personally have never undergone a female pelvic exam (seeing that I'm a dude), but having 5 extremely nervous 1st year med students examining a very sensitive area is not exactly comparative to the excitement of standing in line for a PS3! So next Monday needless to say will be long and tiring, as I have no breaks throughout the morning, day or night! And I can't relax after that because we have our first and biggest Physiology test on Wednesday morning, which is worth 25% of our quarter grade! This week will be crazy because of all the preparation needed for the heinousness of what I have just described. I also have an Head, Eyes, Ears, Nose, Neck and Throat (HEENNT) exam to conduct tomorrow, a quiz for osteopathic manual medicine (OMM) Wednesday, and a case presentation for our Physiology workshop on Friday.

As I mentioned earlier, studying a topic day and night really sets the subject in your subconscious. Mix that with a lack of sleep and trying to maintain sanity and you will find yourself in my position. I swear, I had a dream about a mutant uterus that was chasing me, not unlike those scenes from war of the worlds, only the ovaries were firing flesh-eating oocytes at me! I may be going crazy, but the female reproductive system is a "hostile environment," biologically at least. Also, after seeing so many illustrations of the uterus, a particular coronal section (cut in half view) looks scarily like the logo for the Chicago Bulls! Hmm. The more I say, the more I think I'm going mad!!

On a less traumatic note, we started manipulation techniques in OMM on Wednesday. I was pleased to find a good deal of success even on my first tries! Now that we have done so much diagnosis and theory, it makes sense of what we are trying to do, as well as the detriment that can be caused by those "who know not what they do." I look forward to practicing these techniques a lot, and will be a great tool for me as a physician.

On the home front, Meghan and Braylei give me the strength to keep going day in and day out. They light up my life and I am so thankful for them and their beautiful spirits. Braylei just cracks me up! She is such a funny little girl! She has been talking non-stop and is everywhere. She always has a smile on her face and is very affectionate. Meghan, meanwhile, is one whom I am in absolute awe. She amazes me. She is such an incredible mother and wife. In addition, she is making a fabulous Young Women's President in our church ward. She has been so understanding of the demands of my education and is very supportive. In what time we do have with each other I absolutely cherish. We occasionally get to watch a Phoenix Suns game or maybe a movie, but her support means everything to me.

Well, hopefully I will survive this week and I will post again then!

Back to School!/White Coat Ceremony

2006-12-03T22:05:00.000-07:00

Well, my break came and went, so now I am back in school and have completed my first week of my 2nd quarter! It was challenging going from going on walks, trips to the park and zoo, along with watching Playhouse Disney to getting up at 4am, sitting in class for hours on end, smelling like formaldehyde, not seeing much of Meghan or Braylei, and pulling 18-20 hour days! It's been hard really focusing and getting down into the study groove. I am sure it'll come back, though. My transition wasn't made any easier as my car broke down on the freeway Monday night and had to get it towed. I found myself attempting to study Physiology on the side of the road! And it was a chilly night, too (well, for Phoenix)! So I've been driving Meghan's car to school and we are looking to buy a new car (well, new to us, at least!) Also, I started reading (and by reading I mean listening to the audiobook on my iPod during my commute) the book, Eragon, in anticipation for the movie coming out soon, and have quickly gotten hooked to it! I don't know if I'd go as far as saying it's as good as Harry Potter, but I am really enjoying it!

On Friday, AZCOM held its White Coat Ceremony, where 1st year medical students were presented with our professional white coats as a rite of passage into our clinical training! It was a very cool little ceremony. Many of my classmates were excited to finally meet Braylei, whom I talk about all the time! This ceremony was not only symbolic, as we begin patient simulated exams in the next coming weeks, including male and female pelvic exams and head, ears, eyes, nose, neck and throat (HEENNT) exams. We are also getting more into our osteopathic training, as we have been learning alot of soft tissue treatment techniques, and next week we will introduce joint manipulations! I'm very excited about it! Well, I better check out as Meghan has fallen asleep on the couch and I need to make my lunch for tomorrow!

Back at the Park!

2006-11-25T00:07:00.000-07:00

Today we met at the park with my parents, along with my sister Suzi, her husband John, and their daughter Elizabeth (who live in California)! We had a good visit! Braylei has been really starting to walk more and more over the past few days! For the past few months, she would take a couple steps here or there, but she preferred crawling. The past couple days has been a different story! She has been walking across the living room, back and forth between Meghan and I, and she'll just stand up on her own and walk somewhere! It's really fun to watch! But it was good to visit with my parents and Suzi & John. Elizabeth has grown a lot since I last saw her. Braylei was perfectly content playing in the sand most of the time, and enjoyed grabbing a handful of sand and dumping into her Grandpa Schroeder's hands!

Trip to the Zoo!

2006-11-24T23:29:00.000-07:00

On Wednesday, we took Braylei to the Zoo! She, as usual, loved it, and we tried to see some different exhibits this time around. She absolutely loved the tortoises! She also really liked seeing the babbons, especially as we were there at feeding time! We also saw the largest rodent in the world, the capybara! The Phoenix Zoo is a great place with not only great exhibits, but it is very interactive, great for kids, and features great themed areas like the jungle! On the trip home, both Meghan and Braylei were out! While my girls were napping, I was able to visit my former co-workers at Mezona Orthopaedic Physical & Hand Therapy. It was great to get to see everyone again. I learned so much while working there and a wonderful work to be in. I miss them all a lot.

If anyone is interested in learning more about the largest living rodent, the capybara, please visit the Smithsonian National Zoological Park at this link!

Feeding the Ducks!

2006-11-23T23:00:00.000-07:00

On Tuesday afternoon we took Braylei to Freestone park to feed the ducks! It was so much fun! There were many different varieties of waterfowl, and there were a lot of duck around us! Braylei enjoyed watching Meghan and I throw the bread to the ducks, but she wasn't quite so charitable with the bread we gave her to throw, she would eat every piece we gave to her! We also were able to play on the playground for a little while, which she loved tremendously!

2LT Schroeder!

2006-11-22T22:19:00.000-07:00

On Monday, I was officially commissioned (sworn in) into the United States Army as a 2nd Lieutenant! I was selected as a Health Professions Scholar, and this program will pay for my entire medical education along with all associated costs! I will be inactive throughout med school, residency and fellowship. Upon completion of my medical training, I will enter into active duty for four years as a military physician. I then will have the option of doing a military career, or enter civilian service. I am really excited about the opportunities that the Army will provide and for the opportunity I have to serve my country. I will have my officer basic course (basic training) in June in San Antonio!

The Coolest Med School Waitlist Story EVER!!!!

2006-11-21T08:59:00.000-07:00

So Medical School wasn't exactly the easiest process I've ever gone through. My first year applying resulted in two interviews and one waitlist spot at LECOM, D.O. school in Pennsylvania. I was hoping to get accepted, but it wasn't meant to be. In the grand scheme of things, I am incredibly grateful that I didn't get in, as my wife gave birth to our first child, Braylei. I'm so happy that I didn't have the stresses of med school, and that I could focus on being a father and trying to adjust to a new lifestyle. I worked at a physical therapy clinic during that time, and learned a great deal. I reapplied for med school, which result in three interviews and three waiting lists. TUCOM, a school in San Francisco, Midwestern University-CCOM in Chicago, and LECOM in Pennsylvania. I felt pretty good about being accepted off of one of the waiting lists, but that faded as the summer wore on. As it became pretty evident that I wasn't going to get in for a second time, I began looking at other options to advance myself to put me in a better position to get into medical school. I ended up accepted the Assistant Athletic Trainer position at Southern Utah University, and we were in fact all set to move! We had the U-Haul loaded and we were actually on the road to Cedar City when I get the call. I received a call from the Director of Admissions from Midwestern University-AZCOM (the Arizona campus)! He said that they weren't comfortable with the individuals on their waiting list, so they borrowed the list from their sister campus in Chicago (where I interviewed at), and saw that I was in Arizona! He offered a spot in the upcoming class and orientation began four days later!! We pulled off in Prescott to talk about it, and then turned around and headed back! The funny thing was that I had my primary applications in for the following year, but I was having a really hard time writing the secondaries! It turned out to be a great blessing! I ended up getting into my first choice school without even interviewing there! And what an awesome school! They have a 100% board pass rate over the past 3 years! Being a med student and a father has been a huge adjustment, but I wouldn't trade my family for anything! But that just goes to show that we all just need to keep working hard and always be prepared for the next great opportunity that the Lord provides!

Why a blog?

2006-11-13T14:49:00.000-07:00

I have wanted to start a blog for quite some time, but made countless excuses to myself that have kept it from fruition. My inspiration is derived from my beautiful wife, who started a blog as an easy and convenient method of journal writing, and also as a way to keep everyone up to date of what's happening in our lives. So there you have it.
I have just completed my first semester at Midwestern University Arizona College of Osteopathic Medicine (AZCOM)! Medical school has been a huge adjustment for me, especially in trying to balance a wife and daughter! But it has been such an amazing blessing for me, and I am incredibly grateful that I have been afforded this wonderful opportunity.
I hope that I can stay active in keeping this blog. I have made a goal to write an entry at least once a week, so we'll see how that goes!