Estoy relajando antes de las festividades.

"It's Christmas Eve Eve!" ~Eloise (from Eloise at Christmastime)

Last night, I drove into White Plains after getting off work to drop some keys off for a co-worker. On the phone, her voice was so choked with guilt it sounded as if she was about to cry. Her family is visiting for the holiday, and knowing that, her co-workers have gifted her with a three day weekend. She had not asked for it, and knowing how much others will have to work to cover for her, she was having a hard time accepting the gift.

I very quickly put an end to her qualms about accepting the three day Christmas weekend. We are, after all, surgery residents and pulling together and covering for each other is what we do. She will have ample opportunity to pay it forward and pay it back. A part of me was saddened to see that residency creates in us an almost inability to accept more than a "golden weekend" (saturday and sunday) once a every couple of months, if we're lucky. But an even greater part of me was really happy to see how our small family of surgery residents takes care of each other.

I, myself, was able to spend Christmas Eve Eve at home as well. I was able to wake up and read/study for 5 straight hours before even getting out of bed!  I've had a Pandora Christmas station playing all day long, and even after putting down my books, was able to maintain the productivity. Cleaned the nooks and crannies!

I found the tin of Jacques Torres Wicked Hot Chocolate mix that my sister had bought long ago during her visit. Perhaps I could go buy some milk and make the Christmas Eve Eve extra special! Opened it. It still looked good. So then decided to shake it in an effort to mix up the separated layers. Two seconds later I had a cloud of chocolate dust settling all over my apartment. Christmas Eve Eve extra extra special!  On a brighter note, it made my apartment, previously smelling like bleach, smelling like chocolate instead. So after cleaning again, I went and got the milk anyways. There was about 1/2 cup of mix left, and figured I'd better use it quick before it had a chance to fly away from me as well. Christmas Eve Eve extra extra extra special! ;)

On a follow-up note from work,
1) The kid with the machete to his wrist injury showed up back in the ED again. So we booked him again. Super excited, as we had a second chance to do his repair surgery. We waited for the day with anticipation. We even called his mom the day before to make sure she was going to make him come. (It was his mom that got him to show up back in the ED again). Aaaaaaand (drum roll....) He didn't show up.
Well, to be completely honest, he showed up 5hours late. My Attending confronted him. He's going to give him a third chance. This kid is lucky. Many Attendings would have signed off on him after the first time. The kid is also a dingbat. Even with repair and months of hand therapy, at this point, full return of function to his hand is highly unlikely.
2) I got to operate on the twins again! Only this time from a plastic surgery perspective. Talk about continuity of care! :) They are growing so big!! It's so fun to watch them grow and develop. They don't go anywhere without their fuzzy pink blanket. I say, it must be a magical blanket. One of the twins can be crying, give her the blanket, and she's instantly calmed down and quiet. It's pretty cute. They're moving up the separation to next month. I'm going to have to find a way to get in that OR, you know, for continuity of care! ;)

Much Love.

Estoy disfrutando aprender cosas nuevas.

Did you know that there are eight layers to the eyelid? I learned that this past week. I learned it in preparation for a surgery in which I dissected through one layer at a time to arrive at a dermoid cyst at the corner of a boy's eye. I'm sure I completed the surgery much slower than necessary, but doing delicate surgery with your Attending watching your every more saying, "Don't mess it up! Don't mess it up!  Don't pop the cyst!" (Of course, not in such politically correct terms ;) Well, I imagine that would slow anyone down.
I've never really liked working so close to the eye before, always felt like a wrong twitch the patient made, or I made and we'd somehow end up with a needle in the eyeball. But I learned that it doesn't have to be like that. If you understand the tissue you are working with, and respect the tissue you are working with, then it will return the favor to you.

I had a really good case lined up for this past Thursday. I had just gotten into bed Wednesday night when the long range plastics pager went off. I groaned to see that it was the ED. I was soooo tired, had close to zero desire to go in to work. But I knew there was no way around it. A kid had cut through all of the extensor tendons of his hand with a machete. Perhaps not an emergency, but at the same time unable to be ignored, and so I got dressed and went in. Cleaned the kid up and put him in a splint which kept his hand in extension and then scheduled him for the following day for tendon repair. Having crossed all the T's and dotted all the I's I headed home again and finally got some sleep excited for a nice case the following day. Unfortunately we start our day to discover our patient had walked out at 2am!!! Nooooooo! We tried calling the patient and his parents but without luck. He has every right to walk out against medical advice, but I just want to know why?! A couple theory's could be that he was coming due for his next fix, or perhaps he already knew another surgeon he preferred. But for whatever reason, I do hope that he gets some sort of help... before he permanently looses function of his hand.

Much Love.

Estoy extrañando a mis sobrinos.

We made it happen! I turned in all my favors and secured a three day weekend without call! I bought a ticket and spent every single second with my family in Illinois celebrating Christmas and the fact that we were all together! The weather in Chicago delayed my flight home bringing me into NYC after the trains had already stopped. But, it is NYC afterall and an uber is never no more than 5 minutes away, so I got home eventually leaving just enough time for a quick nap before prepping for my 07:30 presentation this morning. I was so tired that I think I left out about half of what I had wanted to say, but then again I don't really remember. All I know is that it was so totally worth it!

Every single picture makes me gush about my nephews and I want to show you and have you agree with me that I have the cutest nephews ever. But I know there is a line, even if I can't see it, a line exists between acceptable and excessive amount of bragging about my nephews. Therefore, I will reign it in, and apologize if unsuccessful in my attempt.

 Peter Bear and Little Lincoln

Miles Austin keeping tabs on everyone!

Cute little sparkly red nose reindeer face painting at the neighborhood Christmas party!

 Little Lincoln makes an absolutely adorable elf with his spectacles falling down his nose!

Fireman Peter out to rescue the good guys!

 

 

Police officer Lincoln out to catch the bad guys!

Who ever said a police officer can't have swag?

Amazing how little boys automatically know how to be a super hero!

 It's a bird...  It's a plane...

...It's a little boy all ready for his Sunday School Christmas program!

(Heart squeeze)

 Merry Christmas 2016

Much Love.

Estoy practicando cirugía plástica.

Plastic and Reconstructive Surgery.
I wasn't but one hour into my first day of the rotation December 1st, and had come to the conclusion that I can not be a Plastic Surgeon.
Not that I had ever really seriously considered it, but at the same time could not deny that I liked the reconstructive stuff, the creativity required to make something look pretty again.
But alas, without going into detail, I shall not be a Plastic surgeon.
That being said... this month is proving to be absolutely amazing! I am loving the surgeries. Seeing the surgeries. Discussing the surgeries. Doing the surgeries. All of the above.

At Westchester, Plastics alternates taking hand consults with orthopedics. And then it alternates taking facial trauma consults with ENT surgery and OMFS (oxillo maxillofacial surgery). This past weekend it so happened that Plastics was taking both Hand and Face call simultaneously. And it so happened that I was first call for Plastics Friday, Saturday and Sunday.

Now, my basic understanding of both hand and face consists of simple anatomy and physiology that I learned back in med school. Which translates into... I know nothing. I am doing my best to learn fast. The weekend was intense. Two of the three nights I didn't get home until 3am. and even home I'm still on call. No chance of a nights rest because the pager goes off multiple times. Gave me a little bit of appreciation for being a resident, and that when I go home, I can be all there.

I am having so much fun though. I got to reduce my first broken nose. A guy got his finger caught in a wood chopper, and I got to piece it back together. A man had the palm of his hand completely in full-thickness avulsion, and I got to put it back on. A girl's face was attacked by a pit bull, and I got to make it looking like a face once again. And then a whole slew of smaller things in between.

Thankfully, they don't leave me on Plastics first call by myself. I have a fellow back up if I need it. Most of the time I could just text my plan for their approval or their advice.

There's so many things I want to see yet before the month is past. Certain special plastics closure would be so helpful to have in my bag of tricks, and then of course things like reducing broken noses or dislocated fingers as well!  We'll see how it goes!

Much Love.

Estoy agradecida.

I was blessed to be able to be with friends and family for Thanksgiving this year. It was the type of thanksgiving where everyone was invited and then brought their turkeys along with. It makes for a home brimming with life... and turkey. But no one minded, and we just got to eat that much more turkey!

 Ezra Elizabeth turned One on Thanksgiving Day. She is full of kisses, tasty "mmmm's" and smiles. She loves doggies and kitties, but only at safe distances. There's no one she is not willing to love... eyebrows and all! :) Made Thanksgiving that much sweeter to get to love on this little sweet pea a little.

Pie for Thanksgiving.

I got to be with the Viens for Thanksgiving this year. I was looking forward to it. Since Bekah moved out over a year ago I have not stayed there as much as I did when first moving out East. It kind of gave me a feeling of "Home for the Holidays" to get to return after many months. It was also really fun to leave work Wednesday night and tell everyone "Happy Thanksgiving" as I skipped out the door. When you have no change in your work schedule it seems an almost futile sentiment, but with plans for the holiday you can really sense and share the excitement.

So for the next three years at least, I'm sure to be working on Thanksgiving. That being said, I did my best to eat enough turkey this year to last.
Blessings everyone,
Much Love.

Estoy siendo refinada con fuego.

Wood firing of the Kiln at Muddy Brook Potters! November 19, 2016.
Daniel 3: 9-29 

  They spake and said to the king Nebuchadnezzar, O king, live for ever.
¹⁰ Thou, O king, hast made a decree, that every man that shall hear the sound of the cornet, flute, harp, sackbut, psaltery, and dulcimer, and all kinds of musick, shall fall down and worship the golden image:
¹¹ And whoso falleth not down and worshippeth, that he should be cast into the midst of a burning fiery furnace.

 ¹² There are certain Jews whom thou hast set over the affairs of the province of Babylon, Shadrach, Meshach, and Abednego; these men, O king, have not regarded thee: they serve not thy gods, nor worship the golden image which thou hast set up.

 ¹³ Then Nebuchadnezzar in his rage and fury commanded to bring Shadrach, Meshach, and Abednego. Then they brought these men before the king.
¹⁴ Nebuchadnezzar spake and said unto them, Is it true, O Shadrach, Meshach, and Abednego, do not ye serve my gods, nor worship the golden image which I have set up?
¹⁵ Now if ye be ready that at what time ye hear the sound of the cornet, flute, harp, sackbut, psaltery, and dulcimer, and all kinds of musick, ye fall down and worship the image which I have made; well: but if ye worship not, ye shall be cast the same hour into the midst of a burning fiery furnace; and who is that God that shall deliver you out of my hands?

¹⁶ Shadrach, Meshach, and Abednego, answered and said to the king, O Nebuchadnezzar, we are not careful to answer thee in this matter.
¹⁷ If it be so, our God whom we serve is able to deliver us from the burning fiery furnace, and he will deliver us out of thine hand, O king.
¹⁸ But if not, be it known unto thee, O king, that we will not serve thy gods, nor worship the golden image which thou hast set up.

¹⁹ Then was Nebuchadnezzar full of fury, and the form of his visage was changed against Shadrach, Meshach, and Abednego: therefore he spake, and commanded that they should heat the furnace one seven times more than it was wont to be heated.
²⁰ And he commanded the most mighty men that were in his army to bind Shadrach, Meshach, and Abednego, and to cast them into the burning fiery furnace.
²¹ Then these men were bound in their coats, their hosen, and their hats, and their other garments, and were cast into the midst of the burning fiery furnace.

 ²² Therefore because the king's commandment was urgent, and the furnace exceeding hot, the flames of the fire slew those men that took up Shadrach, Meshach, and Abednego.

 ²³ And these three men, Shadrach, Meshach, and Abednego, fell down bound into the midst of the burning fiery furnace.

 ²⁴ Then Nebuchadnezzar the king was astonished, and rose up in haste, and spake, and said unto his counsellors, Did not we cast three men bound into the midst of the fire? They answered and said unto the king, True, O king.

 ²⁵ He answered and said, Lo, I see four men loose, walking in the midst of the fire, and they have no hurt; and the form of the fourth is like the Son of God.

²⁶ Then Nebuchadnezzar came near to the mouth of the burning fiery furnace, and spake, and said, Shadrach, Meshach, and Abednego, ye servants of the most high God, come forth, and come hither. Then Shadrach, Meshach, and Abednego, came forth of the midst of the fire.
²⁷ And the princes, governors, and captains, and the king's counsellors, being gathered together, saw these men, upon whose bodies the fire had no power, nor was an hair of their head singed, neither were their coats changed, nor the smell of fire had passed on them.

²⁸ Then Nebuchadnezzar spake, and said, Blessed be the God of Shadrach, Meshach, and Abednego, who hath sent his angel, and delivered his servants that trusted in him, and have changed the king's word, and yielded their bodies, that they might not serve nor worship any god, except their own God.
²⁹ Therefore I make a decree, That every people, nation, and language, which speak any thing amiss against the God of Shadrach, Meshach, and Abednego, shall be cut in pieces, and their houses shall be made a dunghill: because there is no other God that can deliver after this sort.

Much Love.

Estoy separando emociones.

After weeks of agonizing waiting...

I turned the corner with my Attending, our patient's father sees us from the door way and joyfully greats us with, "She's pooping!" We don't say anything at first, almost too scared to believe it to be true! But he keeps repeating it, louder each time, completely oblivious to the other inhabitants of the unit. Mom joins in, laughing more than actually saying anything. She keeps going back and forth between the bathroom door and the room door to make sure we keep coming. Our patient, inside the bathroom, exclaiming to her mom to close the door, she's not done yet!  And little brother, not sure what's going on, but aware enough to realize whatever it is, is very. Very. Exciting! We get to the door and Dad hugs me... he squeezes me so hard. His little girl is pooping! And I couldn't help it. My eyes got wet all on their own. Welled right up! My patient pooped and I cried.

A few days later, she got to go home, and that night I had a nightmare. I dreamt that she came back to the hospital. I dreamt that she was admitted under General Pediatrics and a large collection in her abdomen was drained by Interventional Radiology. The worst part of my nightmare, was that we hadn't known she was there. Not until the next day at work, a pediatric resident, stops me in the hallway to ask about her history. My eyes still get big and my heart rate goes up just thinking about it. First: our patient having to come back. And Second: her not coming back to us.

You wake up from a nightmare like that and immediately start praying, "Please, let that just be a nightmare." "Please, let her be okay."

Much Love.