Oh yeah...

I forgot to mention...



I love my little guy!!!!!

CMB part II - The long-delayed sequel!

Remember how about 3 weeks ago I finished my blog with "more story soon"? I had stupidly believed that infants sleep 16 hours a day like the books all say. The problem is my silly baby can't read yet (I'll fix that soon enough). He is a very good night sleeper, but during the day he just wants to be held while we are walking. Not a fan of tummy time, movie time, or mommy blogging time. I can occasionally get an hour-long nap out of him, during which time I wash bottles, do laundry, take a shower, and in general try to do all the things I thought I would have so much time for until I have to feed him again.
By the way, I now know why all the books and classes and everything are so encouraging to breast feeding: because otherwise all women would give up in about two days. I'll leave out the graphic details, but I will state that the only time I had to take narcotic medications, after a C-SECTION(!), was because I had back and chest wall spasms from the pain of nursing (I wussed out and took a total of four pills. I really wanted bragging rights). CMB also had a lot of trouble getting the hang of it at first. We got to make a fun four trips to the pediatrician his first two weeks because he was having so much trouble gaining his weight back. We eventually came up with a pretty good system of nursing, pumping, and some formula to fatten him up (gingerbread house not included). Well, it worked. Little buddy chubbed up like a tourist on an all-you-can eat cruise. In the span of about two days he went from looking a little Gollum-ish to being almost too big for his newborn clothes and diapers.
A few other goings-on:
Darren's birthday was last week, and the two of us polished off an entire 16" cookie cake in 4 days. Nice.

My mom stayed with us the first two weeks. We had a lot of fun taking walks with the baby and watching too much tv.

I had to take my annual in-training exam last week. It was really odd going back to work for a day in the middle of my leave, but it went well. I don't really care about the results since I have to take my residency boards (aka final exam) in July. I'll study like crazy for that one.

Mastitis sucks (see paragraph 2)

Time for pics!

The bouncer that doesn't put him to sleep!

My favorite pajamas

When he was still really really small.

CMB part I

After weeks of planning and preparation, our new baby took us completely by surprise. We had been told about 3 million times that first babies are usually late and the due date was more of a suggestion than anything. So, I had left a good chunk of cleaning and organizing of the nursery for another day. I figured with a due date of November 12th, I had plenty of time for those last minute details.
On Saturday the 24th (37 weeks, 2 days), I got an email from one of my fellow residents whose wife was due 11 days after me. She had gone into labor at 36 weeks and the baby was born without any problems. He sent me a message asking how I was doing, and my reply was "start the pitocin any time please". Ha ha, funny Jen.
As Darren and I were just lying down to go to bed that night, my water broke. Having not wet my pants in about 25 or so years, this came as a very odd experience. I think I told Darren in the least panicky voice I could that it was time to go have a baby. Another part of me is so accustomed to staying cool under pressure from years of trauma work that I calmly walked into HUP's ER with my soaking wet sweats on and told them I was in labor. By the way, no one mentioned that when your water breaks, it's not a one time deal. It's a little more every few minutes. Awkward.


We got to the L&D floor around midnight. I was 4cm dilated and everything was moving right along. Another bonus with having your water break on its own is that they give you a 24 hour window; no prolonged labor allowed. I was having contractions every 3 or 4 minutes with very little discomfort, and we got an epidural placed around 2am (wait, what's with the "we" voice here? I didn't see any catheters in Darren's back).

Darren and I played cards and watched movies and just waited for nature to run its course. And, we waited. And waited some more. Through the 15 hours between arriving and 3 pm, I was stuck at 5-6 cm dilated. More pitocin? didn't work. Tincture of time? No go. My favorite idea? Go down on the epidural to see if I needed to be in more pain for things to work. Stupid idea, and again, no progression. This kiddo was stuck. (you are allowed to not progress before 4 cm, but it's not a good idea between 5-7). Around 3pm, we decided that that it was too dangerous to allow things to not continue, and we elected to go ahead with c-section. Two quick reasons I was not totally happy with this: one, I wanted to go au naturale, and two, it was right in the middle of the Steelers-Vikings game.
I got wisked off to the OR, where I was given a bolus through the epidural for pain control. Having never had a single narcotic in my system and not having slept in 2 days, I was completely knocked out. I couldn't stay awake the majority of the time we were in the OR. I remember the baby being born and seeing him the first time, but I was so zonked I couldn't really enjoy it.

I remember crying when I first saw my perfect baby boy but it was a really muted experience. When the drapes were taken off in the OR, I was moved to the stretcher back to my room. I was so numb I couldn't move my right arm to hold the baby, so he just went along for the ride on top of me.


The rest of the night was spent trying to feed him and just get used to the idea that this was my son. My parents and mother in law took turns holding him and taking tons of pictures. I passed out for good around 11. More story to follow!

Calvin Michael
3:32pm October 25
7lb, 3oz

36 weeks

Ooh boy, here I was coasting along with the pregnancy, patting myself on the back for the awesome job I was doing, and then I hit 33 weeks. At 32 weeks, 6 days, I was hitting the gym, operating like a champ, and avoiding any semblance of whining. At 33 weeks, 0 days, my abdomen pushed its way up into my thorax and my little dream pregnancy became that third trimester nightmare of diminished lung capacity, fatigue, and inability to sleep more than 2 straight hours. Not every day is bad, but I definitely am no longer comfortable on a regular basis. I've also gotten a few of the "hey, are you having twins?" comments. Geez, I'm not that big yet.
While mommy may be cranky, baby is doing great. He's got his head down crushing my bladder and his little butt is nice and cozy with my rib cage. My weight gain is appropriate, blood pressure in the normal range, and his heartbeat is jumping along at about 120.
We've got some stuff packed for the hospital, but I'm still stalling packing some things while I'm still using them. Our labor room bag includes such essentials as extra contacts, toothpaste, a deck of cards, and Finding Nemo (it's like watching an aquarium with witty dialogue). My project is coming along nicely, although a lot more work than I estimated.
Here's the only pic of Darren and I taken in the last 4 months. We just never seem to get our picture taken together.

How is this fair?

From a recent catalog in the mail:
Male version:

Female version:

You can't teach taste

Eagles eagles eagles eagles eagles eagles. Seriously, when you live in Philly, all talk is about the Eagles, 24-7, 365 days a year. I even went to the World Series parade last year, and people were pretending that it was the Eagles' Super Bowl Parade. The sports section today has a three (3) page article about Michael Vick's creditors today, with this interesting photo thrown in:

Really Michael Vick? You were one of the highest paid players in the NFL and lived in a 20,000 square foot mansion with an above ground pool? Really? And, is that a propane tank?
I have no problem with these things per se, but when you are trying to sell your mansion, these will not aid your re-sale value.

Who knew?

A few weeks ago, the hospital cafeteria rolled out their new menu. Most of it is standard cafeteria fare: salisbury steak, spaghetti and meatballs, etc, but they added some new veggies. The best tasting ones so far were the German potatoes. I devoured those things. I even remember telling Darren the potatoes were especially good that day. I just couldn't put my finger on what tasted so different. A few days ago, they served them again, and again, I dug right in. About halfway through, I realized what tasted so good: HAM! Holy crap, I've been a strict vegetarian for 13 years and the best tasting thing was ham? Dang, no more German potatoes for me.

Arts and Crafts

You'd think with as much going on as there is, I would be blogging more about my recent adventures. Sadly, no. While waiting for the new baby has been interesting, it would be really boring to be constantly writing, "well, I gained another 4 pounds this week, and I lost the ability to see the drawstrings on my pants!" My sister suggested that I blog about what we've been doing to get ready for baby, so I guess I'll do a little of that.
Darren and I have actually not purchased one single item for the kiddo. We were given the crib and changing table by a friend, and most of the rest of stuff came from family and friends at my baby shower a few weeks ago. Since we figure we'll be buying a ton later on, we decided that we would each first make something for the baby. Darren had actually planned a long time ago what he was going to do if we found out we were having a boy. He planned and plotted and finally went out and spent a decent amount on supplies. He spent several hours working on it at the dining room table. Trust me, the final result is awesome. Did I not mention what "it" is? Too bad, you'll have to wait.
As for me, I was going to fall back on my old stand-by of making a cross-stitch sampler. I made one for Laura's baby and I was just going to use the same pattern. Then my mom mentioned she was making one and I lost all momentum for that. I think I'm going to end up making a Christmas stocking, but I haven't ruled anything out. Any suggestions? Can I make anything neat out of unused orthopaedic implants?
The nurserice/officery seems to be coming along. We're planning on leaving the desk in the room (mostly because we have no where else to put it), but the bookshelf and cds have already been moved. My in-laws are coming in tomorrow to move the bed and file cabinets and start setting up the baby furniture. The room is already yellow, so we'll just leave that as-is.
Other than that, things are pretty much normal. Work is work, but not too stressful for me right now. My doctors appointments have gone on without any problems and the baby is healthy. I do hate the heat, though. I thought it was one of those wimpy mom-to-be things that they were always hot, but trust me, I am always hot. I also laugh at the wimpy mom exercises in my books. For example: sit in a chair and lift one leg up into the air and then lower it back down. Repeat 5 or 6 times. If you get tired, take a break in the middle (slightly exaggerated, but only slightly). Seriously? Is there a version where I can strap 60 pounds on my ankles to make it interesting?
Alright, enough rambling. I think I'm going to turn the air conditioner down a few more degrees and take a nap.

Life after cable

When Darren and I first got married, we didn't get cable for nearly two years. I was finishing med school, he was finishing his Master's, and we didn't have a ton of money (which hasn't changed). So instead of mind-numbing cable shows, we played cards, played all the Simpsons games on PS2 (Road Rage is fantastic, btw), and watched our favorite shows on DVD. Our parents also loved it because we would come visit whenever we wanted to watch a sporting event on ESPN.
With the coming of the new baby, we have once again decided to cut some costs and eliminate junk such as cable. With Comcast now getting close to $90 a month for basic service, we decided to get rid of it completely. We also switched to DSL to save a few bucks. We bought a TiVo and an HD antenna to continue to be able to record our favorite shows (Lost, 30 Rock, um, and well, Pushing Daisies got cancelled, um, maybe something good will start this fall). We're still working out the kinks with the antenna (we share two walls with neighbors), but I'm hoping we'll have all the broadcast channels soon. We're also getting NetFlix so we can rent the 10 movies I don't have on DVD.
I spent the weekend reading and playing Wii, and I started to remember the good old days before I wasted time with things like Jon and Kate plus 8. Darren is working on a project for the baby, and I'll start my own soon. Here's to well-spent free time!

Nesting

In an attempt to prepare the house for the arrival of el bebe, we have finally cleaned our basement. Max was a notoriously destructive doggy, and our basement paid the price. Most of the junk was just shredded cardboard, but there were also some broken fluorescent bulbs and eaten electronics. No problem.
The disturbing thing was that we found a dead bird. An actual, skeletonized, decayed bird, in the basement! Clearly, we need to clean more often (and seal any cracks).

Baby Boy!

Despite every gut feeling I had and everyone's guess, we are having a boy. Darren claims to be genetically YY, so this was an eventuality anyway. We are registering for baby stuff later today, and I have no idea what kind of stuff a baby needs. Darren spent an obscene amount of time researching strollers, finding this perfect model that weighs 17 pounds and folds down to the size of a ham sandwich. I started re-reading Harry Potter (and if you've ever accidentally picked one up, you always end up reading the whole tome).
My last OB visit went well; I managed to only gain 3 pounds this time for a total of 15 (actually closer to 18). I've had to quit riding my bike because 1) bending over for that long results in fists of fury from below and 2) my hands go completely numb from carpal and cubital tunnel compression. Swimming is still fine, but I feel like a breaching whale doing backstroke or trying a flipturn (still faster than douchebag frat boy next to me).
Here's some pics!

legs

arm

As of today, 22 weeks, 2 days

Philly Hexathlon 2009

I wanted to try and do one triathlon while pregnant, and so I did. While I wasn't going for time or speed, I did want to at least go out and do a pretty good job. I think I saw one or two other women who appeared to be in about the same state as I was. Darren even made me an iron-on shirt that had my theme of Hexathlon (triathlon for two) on it. Because of the extra weight gain, I bumped myself into the Athena class (that's 150lbs plus, no age groups) to try and make myself slow down (I hate losing to people in my own class). It was a gorgeous day, clear with a water temp of 74 and air temp just under 80. Darren and T came to watch, along with Anne Marie's dad. By the way, her dad said he would make fun of her if she lost to a pregnant chick. Commence with the taunting (I beat her by about a minute)!

Swim: 0.9K, 16:06
Two seconds faster than this race last year! Started out pretty well, swallowed a half-gallon of Schuylkill about 200 yards in and had to stop for a few seconds. I recovered fine and finished the swim in a respectful time. You will not see pics of this because I am too chubby.

T1: 3:18
Took my sweet time, got some water, threw on a shirt, and started the bike.

Bike: 57:41, 15.5 mph
Again, although it hurts my ever-competitive soul, I took my time and tried to just keep a nice effort up. I skipped wearing my bike gloves in order to save time, and instead my carpal tunnel got so compressed in my left hand that I couldn't shift about 15 miles in. My thumb and index finger were completely numb.

T2: 2:25
More water, more gatorade, slipped the running shoes on.

Run: 32:40, 10:30 min/mile
Because of the lecture I got at my 16 week OB appointment, I was wearing my heart rate monitor for the run and bike. During the bike, I kept my heart rate around 170 and tried really hard to keep it under that. However, during the run, I went off the charts. I kept having to stop and walk because I was getting up in the upper 180's, even though I didn't feel all that tired. Ugh. But I know I have better things to worry about.

Total: 1:52:12, six minutes faster than last year (with a broken leg)! I came in 5th in the Athena division, which is fine with me.


Although I didn't break any PRs or win my division, I'm completely happy that I was able to finish in a respectable time (and 20 weeks pregnant). I'm hoping to sign up for the Olympic distance next year, but we'll see what happens after the baby is born. No more tri's this year!

Baby Updates

Everything is going great so far with the baby. I followed in my mom and sister's footsteps and had zero morning sickness or other first trimester problems. I did have some shortness of breath, but that resolved several weeks ago. At the present, my friend Anne Marie and I are training sorta hard for the Philly Triathlon this weekend. I say sorta hard because obviously I can't go bonkers and train 3 hours all out in the heat in my condition. We usually ride for about an hour or so and then maybe do a quick half-hour run. Which brings me to my first story of the blog.
At my last OB visit, my weight was up 10lbs from my visit 5 weeks earlier. Oops. Besides the fact that I ate a gigantic lunch that day and was eating starburst and coke in the exam room, I had also just gotten back from my sister's wedding. Presto Fatso! No problem, I told the nurse practitioner, I'm training for a triathlon and the weight will hold steady there. You would have thought I had told her I was taking up competitive smoking and drinking. I explained to her that I was taking it more easily than usual, but she didn't seem reassured. She then told me I shouldn't get my heart rate above 140 while pregnant. I didn't ask where the random number came from, I just told her I would try.
Being a good patient, I went out and bought a heart rate monitor. Now, I have used a lot of cardio equipment that records heart rate, and I am a friggin' hummingbird when exercising. While biking and running, I can get into the 170's with just minor effort (this is in addition to my non-pregnant resting heart rate of 55-60). So I took my little heart rate monitor out for a quick run. As soon as I got going, BAM!, 163 bpm. Okay, I'll jog slower. Only down to 158. Huh. So I started walking. Within 10 seconds of walking, I was down in the low 120's. I bounced around for about 20 minutes of walking and running with the same results: no form of exercise that I do keeps me in the 140s (maybe swimming). Which made me think, if I can do moderate exercise with a pulse in the 150-160s and still be able to carry on a conversation, I can't possibly be shunting blood from the uterus (otherwise, the lungs would be compromised too). So, screw the arbitrary 140 limit, I'm doing what I know I can handle without too much effort. Besides, everything I've ever read on pregnancy and exercise mentions that it's good for the baby as long as you don't overdo it and try to run a marathon or something.
In other news, my big ultrasound is scheduled for next Tuesday (6/30). That's when we find out baby's sex and, more importantly, if everything is going ok (I had no genetic testing or triple screens performed). Just scheduling the ultrasound reminded me how much HMOs suck and I won't go into details here (shocking as that is).
Currently: 19 weeks, 3 days (6/21/09) and with no more nights spent in the hospital for call!

Good Dog

I love dogs. My favorite books and movies as a kid were about dogs and their undying devotion to their owners (Where the Red Fern Grows was my favorite book for years). So when Darren and I got married 7 years ago, our first gift to ourselves was a rescue dog named Max. We had gone to the Humane Society in Louisville in search of a great big dog to bring home, but after looking around, we were struck by this cute little beige dog that would just watch people go by, with none of the anxious yipping and barking of the others. He just watched and wagged his curled tail. During his, uh, audition for us, he immediately went outside to the lawn and rolled over. He did this for about a full minute before he decided it was time to pay attention to us. We took him home and kept the name of Max.


Max had been given up by his previous owners at the age of five due to his massive anxiety issues. He was the most awesome chill dog when people were around, but would go absolutely bonkers when he was scared and people weren't around. We went through several kennels, couches, and rooms of carpet over the past seven years. He also went to the doggy shrink and was placed on sedatives, but we hated the side effects and gave those up.

About six months ago, I noticed that Max was having trouble getting up the stairs. He kept getting weaker and weaker until he could barely stand for any length of time. He had also gotten extremely thin, dropping from his adult weight of 42 lbs to 28 yesterday. As with humans, their are very few options available for the treatment of spine disorders. So with heavy hearts, we said goodbye to Max, two days shy of our 7th wedding anniversary. I'll miss our walks, his openness to wear any stupid thing I would put him in, and his big brown eyes and curly tail. Goodbye buddy.


Also see Darren's blog.

I get so emotional, baby

I am normally a very emotional person. Usually, this means when I have a gripe, I let you know. However, I also cry extremely easily at sentimental situations. This has been amplified by the massive amounts of cry-ogenone (not a real hormone) circulating though my system with the baby. The most recent episode occurred today while watching the movie Up. Please remember that I am a huge fan of Pixar movies, and I have an attachment to pretty much all of them. If you have not yet seen Up, please see it now or as soon as the warden allows.
Now Up tells the story of Carl Fredrickson and his adventure with a young neighbor, Russell, and a house attached to a thousand helium balloons. But, the movie starts with the story of Carl as a young boy and how he met his wife. The next ten minutes is almost a perfect silent film of how two people in love will spend their lives and adventures together, although they may not be as exotic as the ones in their dreams. I cried for the whole sequence. I'm crying while typing this. Most of the theater was at least sniffling.

I also started crying a few days ago when I was listening to a review of the movie on NPR. The reviewer also discussed other poignant scenes in Disney movies, and I instantly thought of the scene in Dumbo where the young elephant is separated from his mother (if you forgot, she was placed in the elephant looney bin for protecting Dumbo from hecklers). The song "Baby Mine" is playing during the sequence, and it is about as heart-wrenching a scene as exists in film. The other scene I thought of was the second-to-last scene of Pinnochio, just after he has saved Gepetto and his friends from Monstro the whale. Jiminy Cricket is calling for Pinnochio, and stops short when he finds him washed up, presumably dead, on the beach. He had sacrificied himself to save the others. There I go, crying again.
It's a shame that the Disney company in general seems to have abandoned good story-telling just so little sister Pixar can continue to pound them (Bolt was really good though).
As for me, I will continue to get emotional any time I think about my life with my husband and our new baby. I can't help it; how many people get to live a life this perfect?

About a baby...

Least shocking statement of the year: We're having a baby (really, once it's on facebook, it's over).
It took almost an act of God (aka: vacation) to free up enough time to write this blog. It's been really hard the past several months to keep my blabbering mouth shut about this whole baby thing. Every blog I've typed over that time period has had to have a "I'm pr, pr, pr, pr" deleted from it as I had to control blurting it out. As you may or may not know, Darren and I are extremely A-type people. Everything must be absolutely perfect at all times, period (with the exception of our house; it's a disaster). So when we found out, we had to wait until the 12 week appointment before we would tell ANYONE*. I'm still getting used to whole concept that there is a little lemon-sized infant inside me, depending on me for its every need.
So, as I begin this next chapter in my life, this blog will now be devoted mostly to the new baby (quite a bit less about triathlons, although I'm still going to try one this summer).

How it all started:
A few days before I figured out what was going on, I noticed that I could not catch my breath. I would be walking down the halls or climbing stairs and get winded very quickly. Normally, I am like a 6 year-old, walking as fast as I can and sprinting up stairs. This was very odd for me. I also was running one day and was completely wiped out after 2 miles. 2! A few days after that, my stomach felt like I had been sucker-punched the day before and not remembered. It was like 80-minute abs! So I quickly figured something was up. Darren and I had not been trying very long, so when I finally did take a test, it was a complete surprise. Yay!!!!
Since those first uncomfortable weeks, my stomach pain has relapsed and I have some breath control back. I still can't run for more than about 30 minutes, but it's a huge improvement. I also totally avoided any morning sickness, which is great, but I over-compensated the whole eating more thing. When I go to the pool now, I look like the chubby chick instead of the pregnant chick. My belly is still pretty small but the rest of me grew plenty. I need a shirt or billboard or something that explains my condition "Pregnant, not fat!".

At this point, I am 14 weeks, 4 days. Can't wait for the 20 week ultrasound. Will it be grandson #2/6 or granddaughter #1 on both sides?


*The exception to this is the residents that I am rotating with. Orthopaedics requires a ton of exposure to radiation and toxic airborne chemicals, so I had to let them know why I was skipping certain cases.

RIP Robley Rex

As a med student rotating through the CCU (cardiac intensive care unit) at the VA hospital in, oh say, 2002, I remember always seeing this little old guy pushing his walker through the halls. He was always friendly, always smiling, and always trying to cheer up the very sick vets in the unit. I also remember that he had this handmade pin he wore that was shaped like a hand making the "hang loose" sign.
This man's name was Robley Rex, and as I came to find out, he was Kentucky's only surviving World War I (that's a one there, folks) veteran. He was 101 years old and cheering up WWII and Vietnam era vets up to half his own age. Mr. Rex died this week, just 4 days shy of his 108th birthday. He was a true inspiration to living your life with purpose and grace. He will be missed.

Just checking in

Sorry I haven't written in a while. I've been working my tail off the past several weeks and I have the bags under my eyes to prove it. Here's what I've accomplished lately:
1. I've operated on over 200 people so far this year, which averages out to around 15 surgeries or so a week. I am rapidly approaching complete and total residency burnout, and I am currently counting down the number of in-house calls I have left (9). After those, I never have to sleep in a hospital again.
2. Max is really sick. I'm pretty sure he has either a tumor on his spinal cord or bad lumbar stenosis, but either way my poor puppy is struggling badly with stairs and walking. He doesn't seem to be in any pain, and he will still play some, but he doesn't have his old doggy happiness.
3. Trying to get into the pool more. I always dread the lead-up to getting in the water, but once I'm in, I'm happy as a clam for the next hour of so. I still like beating people younger than me (Yay!)
4. Sad about Harry Kalas.
5. Happy as heck for Isaac and Sarah! Also all of my other friends who are expecting (Jackie, Leah, Melissa, Mary, Catherine, Autumn, April).
6. Welcome my new nephew Zak to the world! (son of Eric and Sylvia, 4/16/09, 7lb9oz)

A Comedy of Errors

One of the greatest things about Philadelphia is that is really close to much better cities. The crown jewel of these is, of course, New York, especially during conference tournament time. For the past three years, I took a week off during the Big East tourney in order to travel up to Madison Square Garden. Usually, Darren and I stay at Casey's place in SoHo. This year, however, I took my vacation in February to go to Jamaica, so I was only able to travel on the weekend. Luckily, Louisville managed to get into the finals on Saturday night. Since Casey is in China, he kindly mailed us his house keys so we could still crash at his place (and watch his cat). Darren found some tickets on Craigslist Saturday morning, and the day was set! That's about the last thing that went right....

Problem 1: I blame Tim Burton. If Big Fish wasn't such a darn entertaining movie, I would have put more thought into the packing process. As it was, Darren and I got stuck watching it until 11:30 or so when our bus to NY was supposed to leave at 12:30. After the scramble to get out the door, we started our trek to 30th street station to catch the bus. About 2 blocks from our house, Darren remembered that we forgot to put Max up. So he ran back to do that while I kept walking. When we reached the bus stop at 12:15, our ticket was nowhere to be found. We still haven't found it. Perhaps Darren dropped it while trying to catch up? The bus pulled away while we stood there frantically searching our bags.

Problem 2: Well, the bus problem was easily solved as we were already at the train station and the R7 Septa line goes to Trenton, where we can switch over to New Jersey transit trains. We were out $24 bucks, but at least we would still get to NY in plenty of time for the 9pm game. We waited in yet another line for Septa tickets and caught the train with a few minutes to spare. (side note: Septa machines spit out $1 coins for change, but yet don't accept the same coins. Go figure). As our train pulled up to Trenton Transit center at 1:48, Darren leaned over and asked, "did you grab Casey's keys?". Uh, no. I felt like the fat kid in Stand by Me that only remembered to bring a comb (I brought two of those). After a quick discussion before the 1:59 NY bound train left, we agreed that Darren would return to Philly for the keys, and I would continue on to Penn Station in order to meet with the lady we were buying tickets from. Darren would drive up in our car.

Problem 3: I've had my phone for a couple years now, and as it has aged, the battery has lost the ability to hold charge. When we left the house, I had 3 bars. By the time I reached Penn Station at 3:15, I was down to 1. I called Darren on his train and asked him to grab my charger. The problem arose when I had to meet the ticket person. As my phone kept blinking stupidly at me that my battery was dead (side note, if you are dying, stop doing the equivalent of jumping jacks. save your damned energy), I was able to get the tickets at 4:55. With my phone now completely dead, I waited outside Casey's apartment hoping that Darren wouldn't break down on the way there (my car is ancient).


After all that happened, we were finally together by 6pm in order to enjoy the day that we wanted to. The NY alumni associated hosted their annual pre-game party at Stouts Bar on West 33rd, and we got to talk to Denny Crum and Darrell Griffith while listening to the pep band. Much more fun than missing buses and forgetting keys. The game itself was awesome, and congratulations to UofL for not only winning the Big East (twice), but doing it with a crowd that was 70% Syracuse fans. Darren and I went down to the lower levels for the trophy presentation and cutting of the nets, and it made the whole day of adventure well worth it.


Last story: we went to a diner accross the street from MSG after the game for some (veggie) burgers and fries (I also wanted a milkshake but their machine was broken. Bastards!). We talked to our waiter who had worked Thursday night during the 6 OT SU-UConn game. He said the manager had let all the waiters but one leave at midnight or so. Then they got swamped with post-game fans at 1:30 when the game let out. I guess they should have turned on the radio or something.

Catching up on things

1. I would like to start an awareness campaign for the entertainment industry. Please know that for a very long time now, doctors are not filthy rich. They do well as a group, but very very few are millionaires. I bring this up because on Law and Order the other night, the DA was arguing that a pediatrician shouldn't be allowed to post bail because he was worth 9 million dollars. Uh, no. The average pediatrician makes $90,000 a year. That's it. 20 years of school and three or more years of residency. Wow.
To be fair, surgeons make more, but most of that is because we do procedures, which are compensated by insurance companies at higher rates than office visits. Even that has decreased significantly in that past 20 years, as a joint replacement surgeon makes about half of what they did then.
I almost still wonder why college kids go to med school. Again I think it's the media portrayal. Here's the reality: go to med school, bust your ass for 3-7 years of residency making $12 an hour, graduate, and then pay half your income in malpractice insurance. Have fun kids!
(disclaimer: I don't care how much I make, I like my job just because it's fun)

2. Late in high school and early college, Street Fighter II was a great way to spend an evening. The new SF IV makes me laugh because it looks exactly the same. Same jerky graphics and all.


3. MarioKart for Wii is fun.

4. I'm ready for spring. The Chuddley Cannondale is ready to go (once she gets new tires and a tune up).

5. We're considering getting a new car, but we're concerned that the car we want is made in Mexico by non-union labor. Seems kinda silly trying to stimulate the economy by buying an American car when the workers aren't American.

Jamaica recap

To be honest, there's not really a lot to say that wasn't said in Darren's blog. We had a great time, enjoyed the weather, and ate more then is ever recommended (I had a bowl of ice cream at every meal). We got back a week ago, and the Philly weather has welcomed us home to light snow, cloudy skies, and below average temps. I actually got out on my bike this week, but that was only because I had to take the car to get new brakes and it was the only way home. It was nice to get out on the old girl again...
Here are some pics, enjoy!

Hasta luego!

For the first time in seven years, Darren and I are off for a one week vacation. No cell phones, no internet, no work, all the sleep I want. We're headed to Runaway Bay, Jamaica, for one whole week of nothingness. My perfect day would look something like this:
9am: wake up, breakfast
10am: morning nap
11am: sit by pool or on beach for 2-3 hours (yeah, it's the worst time of day for skin cancer, but I am young and invincible)
3pm: lunch, afternoon nap
4pm: go for hike, scuba dive, snorkel, or nap
8pm: eat
10pm: sleep

That's 11 hours of sleep a day!

Moving Buddy

Darren decided to make a cake today, and he thought he would use the white cake box we've had for a while. By "for a while", I mean about 5 or 6 years. It expired in February of 2004, nearly 5 years ago. We estimate that we bought this box sometime in 2003, meaning that this box has lived in four different houses in three states. We can't even cut out the box top for education; that expired in 2005.
We apparently need to make more cakes.

Blink

I've been reading Malcolm Gladwell's books since Darren received them for Christmas, and I'm not quite sure what to take from them yet. Blink discusses how humans have developed the ability to make very good decisions at a glance, but how these decisions can be horribly wrong if we don't have the correct background of information. A great story that leads off the book is about a good number of art historians who knew that a piece was a forgery, but couldn't quite put their finger on why. The other book of his that I read was The Tipping Point, which discussed how some events, such as disease epidemics and fashion trends, begin because of a few specially connected people. I am currently in the middle of his latest book, Outliers. I mention these because Blink has really gotten me thinking, and I wonder if I can apply any of the lessons of the book to my daily interactions with patients. While running today, I realized I already have on several occasions.
As an intern in orthopaedics, most of my struggles came while trying to build up my background of information. Orthopaedists read their own x-rays (while ignoring radiologists), but this is a skill that took me several months of practice to pick up. The advantage we have over radiologists (and why we ignore them) is because we have physical exam findings to correlate with the radiographs. For instance, I often pick up subtle findings on xray that radiologists don't simply because I know that the patient hurts at a certain location. By the same token, I have had to see patients with no injury because a radiologist thought they saw something that simply wasn't there.
Another example of knowing something without knowing why happened to me a few months ago at work. My intern called me about 2am about an inebriated young woman who had been struck by a car and was complaining of severe leg pain. Xrays were negative for fracture and the patient constantly screamed how she was going to sue the driver. She was also screaming in pain at the most minor of movements to her leg (these are all strong predictors for not really having an injury). When I examined her, her leg muscles were all soft (this essentially rules out compartment syndrome), there were no gross deformities, and her nerve function seemed to be intact. She was also not cooperating with any exam, so I couldn't do as much as I would have liked. It was also 2am, and I was cranky having to deal with a histrionic, drunk, annoying patient. But something was wrong, and I could not figure out what. I remember calling my attending and telling her that my spidey sense was tingling (really, I used those words). As the patient's pain continued unabated the next day, we did an MRI just to prove that she was crazy. And of course, she wasn't. She had an Achilles tendon rupture, which I completely missed due to such a limited exam (and xrays can't pick that up). Now in truth, Achilles ruptures generally don't hurt that much (it's like a really, really bad sprain), but at least something in me knew her exam didn't make sense. She had surgery to repair it a few days later.
So have my skills increased over the past four years? Undoubtedly. Do I still make mistakes? All the time, but now I have the background of experience and education to make a whole lot less.

New babies everywhere!

In my residency program, we usually divide the last several days of December into two 6 day blocks: those encompassing Christmas and the ones for New Year's. Half of the residents work one, while the other half work the other (there are many fewer elective surgeries to staff). I traditionally try to work the New Year's half, because I couldn't care less about that holiday (I went to bed at 10 this year, but I was also sick). I also really wanted to be home when my sister delivered her baby. Alas, I was destined to work the Christmas half. It turned out to be a blessing in disguise, however, since Laura's baby came late. Darren and I packed up the car and left town Friday afternoon (after I had a very difficult pelvis fracture to fix). We stopped just outside of PA that night, and then raced home Saturday morning when my mom called to say she had been admitted. Unfortunately, we missed Isaiah's birth by about 1 hour. We went straight to Baptist East to meet our little nephew!

Isaiah James, 9lb, 3oz, 21.5 in, December 27, 2008

My roommate from college, JP, was also expecting the birth of his daughter Emerson around the same time, and wouldn't you know it, she was born 7 hours after Isaiah! It was a wonderful day for everyone.



Other highlights:
We had dinner with Darren's high school friends Keith and Amanda (the couple we double-wedding'ed with) and their 6mo old Macy. So cute!


Got to know Julia's fiance Gram a little better. I have a sneaking suspicion we may end up getting along really well because he is a funny son of a gun (although, he does make a lot of bizarre comments about cannibalizing my sister).

Happy Holidays from the Bergants, Breys, Cornwells, and Gibsons (and Max's butt)!