My mid-uni crisis

I spent the night by myself at home looking after the dogs, and it reminded me of being younger in my room when i use to be scared of the dark. So being home alone i did what i use to and turned a cupboard light on for comfort but i realised i didn't need it... i have grown up. I love simply being home and domesticated, doing my washing, lighting the fire, walking the dogs, watering the garden, being able to bake and cook and i realised a large part of what has been getting me down the past few weeks or even steadily building over the past few months... a want for more of a normal life. I am calling it my mid-university and mid-degree crisis. I want to move out of Trinity and look after my own unit/rental/house, i want to have the freedom to cook and clean when i want to, i wish i had more of a set routine like a stable job instead of juggling random clinics, tutorials, lectures and university commitments, i wish i could get this routine to have a better exercise and training program, i wish i was able to have more time with family and friends and not have to worry about whether i have read the latest tutorial information or finished my lecture notes, i wish that guilty feeling would go away and i wish i could have more of a normal relationship to see and spend more time with my boyfriend. Being in the same rotation and group is a blessing for 4 weeks but its so hard to build a relationship over uni studies! 

The question is what can i do? I am growing up, i'm 22 and i am realising where i am is not matching where i feel i should be, it can be scary to think about but its even scarier to think how it has been affecting me. I am still dedicated to medicine, i just want to work better with it, the question is how...

Step 1 - Still my mind.
http://www.youtube.com/watch?v=cvzu3bKgt5Y

Home and my Lemon cake - Sugar free!!

It has been so nice to spend a weekend home so far. I arrived home yesterday afternoon to help Nicole and Dan look after Bella and Lucy while mum and dad are in Europe and found it so therapeutic to do my washing, sweep the floor and water the vegetable garden, sit on the patio in the sun with a nice cup of tea and take the dogs for a walk along the inlet.

Lizard Hunting!!

Loving the attention! 

Lucy ready for walkies :)

It was also nice to have a chat to Nic which we don't get to do too often, she showed me a blog she likes called 'Loving Fit' which is all about exercise health and nutrition and is really good!! I had a lovely sleep in my own bed and woke up to a have a lovely catch up with Lex. I wish we could catch up more often i miss being around her! I loved in 2nd year at Trinity when she was just across the hall and i could always know how she was and have chats everyday and tea breaks, cook or go for walks. We tried walking our dogs together - 2 Bella's, Tilly and Lucy at Hay park. Poor Bella was still scared with other dogs even though she was the bigger one! I was very proud of her when she started walking though even if it took a few stops. Lex and i then went to the Happy Wife for morning tea in the nice warm sun. She has gotten into such a wonderful program called Big sister, Little sister where she meets a younger girl who may have some family or friend issues and becomes their friend or 'Big sister'. She met her little sister the other day and it seems like it will go really well! She would make an amazing big sister and her match is very lucky to now have Lex in her life! I would love to be involved in a program like that one day too but don't think i could fit it in at the moment.

Then i did what i do best at home... I baked!! :) I redid my 'Sugar-free Blueberry' muffins take 3 and added a grated apple this time and they have turned out their best so far! I also added a mix of berries with the blueberries, i really like them. I also experimented with another recipe i found and baked a Sugar-free Lemon cake! It turned out well for an experiment and is tasty, i think it would be yummy with yoghurt on top too! Here's what i did...

Ingredients

• 1 cup self-rising flour
• 1/4 cup Wholemeal self-raising flour
• 1 teaspoon Bicarb soda 
• 2/3 cup organic shredded coconut (or just desiccated coconut would work) 
• 1 Egg 
• 7 Tablespoons water
• 2 Tablespoon vegetable oil (or melted butter)
• 2 1/2 teaspoons of grated lemon rind
• 1 Tablespoon lemon juice
• 2 teaspoons vanilla extract
• *Note: If you do not have self-rising flour, you can substitute 3/4 cup of all-purpose flour and add 1 1/2 teaspoons of baking powder to the dry ingredient mix.

Instructions

Preheat oven to 180 degree Celsius. Line a cake pan or square baking dish with baking paper. 
In medium mixing bowl, combine dry ingredients.
In a mug or liquid measuring cup, combine egg, lemon rind and juice and other liquid ingredients. Beat with a fork until the egg is well mixed.
Pour liquid into dry – mix well with fork. 
Pour batter into prepared pan or baking dish. Bake for 15-20 minutes at 180 degrees. Cake will not turn brown, so do not go by appearance. Cake is done when a toothpick inserted into the middle of the cake comes out clean.
You can also make 6 regular sized muffins or 18 mini-muffins. 
Optional: I sprinkled muesli, pepitas and sunflower kernels on top of mine - yum! If you like it sweeter you can add 1/2 cup of sweetener such as Splenda but i find it tasty just as it is :) I think next time i will add 1/2 a cup of natural Greek yoghurt to make it that little bit more moist! 

Sugar-free lemon cake :)

The end product!

Sugar-free Apple, Banana and Blueberry muffins

Followed by a quinoa salad with sundried tomato, spinach leaves,
home grown beetroot, avocado, pepitas and flaxseed oil for lunch

At the Happy Wife they had lovely savoury muffins which were really good! I want to try cook some savory foods too next time i am home and am thinking of using the same base recipe for the muffins but instead of the fruits add pumpkin, zucchini, carrot, onion etc and mix it up a bit :) My sugar challenge has been going well, i love having a hot drink of cacao at night time which taste like chocolate but in my opinion better! and full of anti-oxidants, iron and magnesium :) I have been having a cranberry biscuit on the odd night which mum made for me as my little 'reward' with my cacao, it has been a little test to see if i can only eat one and i have been doing well!

On a side note i want to remember this to tell my patients in the future when they think they are 'boring patients' in the hospital... "Be boring in hospital, but exciting in life" :)

Geri's week 2

It has been another busy week at Charlie's, Monday we had a memory clinic and sat through a long cognitive examination looking at many aspects of the functioning brain and learning where different areas of cognition can be affected in different pathological processes. You can tell a lot about a patient through asking htem to draw the face of a clock and specific times. Its almost like a scene from Alice in Wonderland as each clock can reflect each individual mind and whether they have the capacity to reason and plan how the clock should be...

I had a trip with an ACAT (Aged care assessment team) on Tuesday afternoon and went with a social worker to visit a lady who had been referred to see if she needed more services. She had been diagnosed with gastric cancer last year and 8 months after her surgery she has a wonderful support network looking after her from her local church but needs to get her independence back while utilising other services to relieve the  pressure of assistance from her friends. She was a lovely lady and you could see her will to want to live more of a 'normal' and independent life. 

Wednesday we followed the DRAC team all over the hospital to assess referred patients as to whether they need transitional care placement or should be in a hospice post hospital discharge. Most patients had poor prognosis and those with a prognosis less than 3 months were usually played in a hospice. TCP allows a few weeks of placement for assessment into relevant care facilities around Perth. I had talked to one lady who had a metastatic cancer in her hip (and a loud systolic murmur i could hear on my stethoscope!!) on Tuesday but we didn't get to see her that day, at least i had a good chat to her :) But  we did get sent ahead to find out information on some more patients before the doctors got there so we could have a go at reporting all the relevant information. Unfortunately my patient in the respiratory ward was severely demented with Alzheimer's dementia and most likely had some delirium due to his inattention, but we didn't get very far with the conversation, it was so sad to see him not know where he was, what day or year it is or what was happening around him. Most of my reported information was from the notes and although only a little test a quiet 'well done' from a lovely Reg was enough to make me feel like i passed the reporting!!

I spent that afternoon having an over 2 hour conversation with a lovely 97 year old lady on our GEM ward. I  was going to put in my first cannula but since she was a little fearful of needles she preferred the intern to do it instead. But she talked to me about her illnesses and mostly about her life in general. She was quite lonely in the hospital and loved the company, and me being too weak to say i needed to go i gave in and enjoyed chatting to her and finally left the hospital at 6pm. From dawn to dusk i don't think i had a ray of sunlight that day... better get out the vitamin D!

Thursday we finally had a ward round with our GEM team and got to know some of our patients our team of doctors were looking after. This was followed by a multi-disciplinary meeting and a case-study lunch meeting... free lunch for hungry medical students is always a win!! Then after a nice tea-break at the new Santis cafe we set off for an afternoon of lectures. 

Friday, today, i spoke to my 97 year old lady who was going to be discharged today but she wasn't ready. Her pain had cleared but she wasn't mentally ready and i reassured her that health is so much more than whether you have pain or not and if she was not comfortable leaving the hospital then she has the right to stay. She is worried about how she will function at her own home where she has been living independently. She has been cleared by the physiotherapists and OTs but in the end it is her confidence which prevents her from having falls and lets her function independently without any mishaps that would lead her into the hospital once more. You really see how age affects you both physically and mentally, it can be such a scary thing and is hard to imagine what it would be like to have to give up your independence and go through your body becoming weaker and slowly dysfunctional with age. It highlights just how important it is to look after your body now while we are young. I would love to reach the high 90's or even make the 100 one day, i want to look after my body the best i can while enjoying all i do. It makes you think what would you do differently today knowing each day is a gift of life and each day gives an opportunity to take to let us live life to the fullest. My time to come old will come i have no doubt, and i can see myself being a grandma who bakes for my grandchildren, still does pilates and goes out in the community still living life in every way that i can. And i want to live it while i am young too, take oportunities, never regret the ones i take no matter how they turn out, always tell those i love i love them and always be true to myself and what i believe in. 

Adventures of my travelling family

2 days apart most of my lucky family bar Nicole (who had a 4 month word holiday last year) and I set off for  trips of a lifetime around Europe!! Sarah headed off with her close friend Georgia for a 4 week trip starting in London staying with Georgia's relative then on a Contiki tour through many different countries. Sarah had been both studying hard with her nursing exams and working hard for funds for weeks beforehand, you can only imagine the excitement they would be feeling!! We saw them off at the airport for their flight to Dubai then London, they made it safely and i have since heard very little from them but know they are having a wonderful time!! I do know they had a tour of one of the Harry Potter sets and had a 'butter beer' at Number 4 Pivot Drive...
         
           

Mum, dad and pop set off 2 days later on Monday the 25th and flew to Dubai and London also. They said the trip went well and they were very tired but excited to arrive. I am so glad pop has gone, he has never been over to Europe before!! They arrived in London in a huge double decker plane, after some rest their first 2 days were action packed!

The first flight to Dubai

Waiting at Dubai airport :) 

So far they have looked around and went to see the Ritz but didn't go in, mum has promised me we will have high tea their together one day :) They went to the London eye, Westminster Abbey, Harrods, Trafalga Square, Buckingham palace and watched the changing of the guards, had a pub meal and mum tried a Blackbird pie!

View from the London Eye

Mums Blackbird Pie!

Some goodies from a local shop

Inside the Ritz, we will get there one day :)

A happy King and Queen

So exciting to see Pop at the Eye!

I would LOVE to be there with them but i know i will get there one day, i look forward to hearing more about their travels, hopefully they wont be too busy to email me their adventures :)

Strokes of Hope

I had a great time at the Melville Aquatic centre this morning with Jason (the coach), Shan, Brianna and a girl i hadn't met before Bec. Melville pool is really nice and i found the oval Len Shearer where they train on Tuesdays and Thursdays. I learnt a few exercises i want to remember to get fitter using the pool, our session today was:
- 300m warm up any stroke
- Running drills in the shallow water (small feet, A skips, B skips, high knees and butt kicks)
- 100m swim any stroke
- 6x 10 second horizontal 'runs' in the water so you are basically making a big splash running keeping your legs and body horizontal holding onto the edge on your back! with 10 sec rest between each (i was surprised how much these hurt :))
- 5x4 squats in the deep end pushing yourself to the bottom, half squat and push off the floor as hard as you can with your arms out and palms up to get more resistance. Do 4 in a row and rest a minute and do 4 rounds in total.
- Swim as far as you can go while holding your breath - we started underwater and freestyled with no breathing until we couldn't anymore. Then turn around immediately and swim back breathing as fast as you can manage so when you touch the wall again you take ONE large breath only and repeat it. Have a break after each 2 swims and do that 4 times... make sure someone is with you doing these as you can easily give in to your breathing reflex and gulp a whole lot of water or even pass out but it is a great way to build up your VO2 max!
- 1km: I did an extra km swimming of freestyle with some fast 50's, it felt so good and i was able to release some frustration at not being able to run :)
- Running drills again but in the shallow warm/walking pool

Another thing i could do in another session is 10x10sec running in shallow water but upright on the spot.

Shan and Jason also gave me some drills to do to strengthen my hips flexors, glutes and calves for hurdling in the future.
1. Snail crawling - only over a meter pull your whole body cm by cm only using your toes to grip the ground, these will increase the strength in your feet
2. On the ground in the position of hurdling i.e. one leg tucked under your butt and the other 'lead' leg out straight as though hurdling - lift the back leg off the ground 10 times (like hip flexor drills) then lift the front lead leg 10 times keeping your knee straight. Repeat on other legs.
3. Calf raises (if foot allows!!) Normal 10x raises on steps, down, mid, up and down to up. Same but pointing toes inwards, same again but pointing toes outwards.

It is so encouraging for me to have these guys understanding how important running and fitness is to me and helping me to improve!! Shan and Brianna are national hurdlers they are passionate about their running and so dedicated. But to have people willing to go out of their way to teach you new drills and exercises to benefit you as an individual is amazing and i value everything they are teaching me even when i am only able to do a few sessions with them. (He didn't even want any payment after all the session saying the pool entry was enough for us!!) It makes me think i would almost love to stay in Perth next year to keep training with them, it has taken years to find a great group to train with, ones with similar interests and determination. I could definitely see myself reaching those goals i have always wanted with them. But we will see what the future holds, i have faith that what ever happens it will be the right path and i will make the most of it.

Maybe one day i will make it to the official squad page :) http://jmeathletics.com/squad/

Hello Geri's :)

I like Geriatrics so far, i like the doctors, my group, talking to seniors, it is like gen med but at a slower pace allowing us to actually absorb what is happening and talk to our doctors. But of course we have a greater emphasis of geriatric issues such as incontinence, falls, osteoporosis, functional ability and independence.

Our first day was a little orientation around the Geriatric unit in C block of Sir Charles Gairdner Hospital, we met our registrar, intern and consultant who are lovely and even on the first day super keen to teach us!! We followed on a rather long ward round and met most of the patients. Our stamina for staying on our legs all morning had worn off since our last rotation so with sore feet and backs at the end of day 1 we need to get that back!! It has been an interesting and rather full first week, we talked to a lovely lady who had rheumatic fever and brady-tachy syndrome and just had a pacemaker put in. Kyle did a good cardio examination on her and we all had a listen to her heart. It was a little difficult to hear and detect with her arrhythmia and our student ears but she had a systolic and an unusual diastolic murmur. We sat in on a multi-disciplinary meeting, this is the first rotation where you can really see how closely the allied health and doctors work together especially the occupational therapist!! It is really good to see and much needed in geriatrics.

There were a few tutorials - how to assess the geriatric patient and a delirium tutorial. Wednesday was a big day on a morning falls clinic and afternoon incontinence clinic. Emma and i sat in with Dr Brendon Foo who i recognised from Gen med and he was a great teacher. He had his arm in a sling and emma and i did all the physical examinations!! we felt like junior doctors :) (which we pretty much are :P) but the 2 patients got a thorough cardio, respiratory, GIT, cranial nerve, upper limb neuro and lower limb neuro examination. It was a great way for us to practice and build up our confidence reporting to the Dr and him checking. Both patients had peripheral neuropathy, one was rather unkept and had a few fungal feet infections and rash over his body which wasn't the nicest in examinations but we are non-judgmental. The incontinence clinic was great to know that there are doctors looking at the intricacies of going to the toilet (if you can make it). You don't realise how much of an impact it could have on your life when your ability to go to the bathroom deteriorates!! I only got to see a quick patient but learnt lots from the doctor afterwards. I realised how many patients need to make lifestyle changes which can fix their incontinence if only they would follow them!

There was a good radiography meeting (with a yummy free lunch with fresh sandwiches!) which may have been a little more helpful if the person in charge wasn't whizzing through each x-ray and CT at lightning speed... if he slowed down i might have known what organ we were looking at :P Friday our PBL was a debate on whether those aged 78 should have their drivers license taken off them due to increased risks on the road with pathology of aging. I was on the for team saying they should, really i believe it is all individual and know my grandpa at 87 still drives fine and takes the caravan up North for holidays which they love and a 98 year old family friend who didn't give in her license until she was 90!! That was self handed in too when she judged she no longer felt competent herself. I don't like debates in general and was happy when it was over no matter how bad i did. Our team won in the end but there was lots of preparation done in our favour.

I am hoping to get some more bedside teaching next week with our team and have a chance to talk to some of our patients after this busy week with clinics and tutorials. I look forward to going on a home visit on Tuesday and another memory clinic and see what the week brings.

The Prophet Lebanese
- Albany Highway

On a different note it was a week of going out over the past few days, Monday night we went to The Prophet Lebanese restaurant along Albany Highway for Rosie's 22nd birthday with a few friends and had a nice time :) Wednesday night Lexi finished her exams (yay!) and we celebrated by heading out to Wagamama's in Subiaco for a lovely meal. I hadn't been there before but heard lots about it and had a lovely teriyaki salmon - yum!! we also tried chicken dumplings :) I'm so happy she can have a break now and hopefully relax after a busy time of uni and studies!! Friday night i also went out for a 2011 RA reunion, we went to TQR just near Trinity which was Vietnamese and had a lovely menu! The company was great and it was so strange but really good to see the old group together again (minus 3) and good to catch up with everyone. I had a nice Vegetarian tofu green curry and hope to go back and try the chicken and vegetable stirfry!! I was feeling a little under the weather and didn't feel like i was the best of company but it was still a nice night. 

TQR Stirling Highway

 

Wagamama Subiaco

I am sitting in my room after finally giving in and turning my heater on in the hope i can feel my toes again (winter is certainly here!) and on my second cup of tea in the past hour... am i turning into a geri?? ;) Tonight Sarah flies off to Europe with a close friend for 4 weeks, i would love to be joining her. Mum, dad and pop fly out on Monday coming too, they are excited and just ready to go now! If we had the mid year break i would be no doubt heading off with them but I'll get to Europe again one day. I would love a break now, i feel like the week off we had wasn't really a week off and although nice to be home not the break i needed. I would of loved to have spent some time with Kyle too! I sometimes even find myself envious of those who live with him, especially last rotation when they would have seen him more than me, but at least we are in the same rotation for 4 weeks :) 7 more weeks until our next week off, i need to pick my energy up so i can enjoy the days more and not be counting down until the next break, there seems to be all these little things building up getting me down lately, but i will find a way to pick up... :)