for no reason...

this morning my day started with the call phone ringing. the strange thing was i had just looked at it a few minutes before wondering, "why has this phone not rung yet? is it even working?" as i started getting out of bed to dress for a morning run, the blasted phone decides to ring. it was a call from the emergency room to inform me that a patient with a gun shot wound was there. i must have gotten there fairly quickly because the e.r. staff were thrilled that i was there right off and they lined up to help with whatever i needed. my patient was a young man not quite out of his teens yet with an accidently self-inflicted gsw. the police were there interrogating him. i was a little incensed with the insistent questioning when we're trying to get the patient settled as he came in admittedly & obviously intoxicated. his labs revealed a bac of approximately 4x legal limit! was i ever annoyed. i was annoyed with my patient for coming in at that hour which resulted in my not running. i was annoyed with the cop's interrogation, as he kept interrupting. i was just plain irritated. as the day progressed, i admitted that the morning e.r. call and admission was a good experience for me. i also did a bit of suturing and salvaging the huge gaping hold the young man left in his foot. later in the day, i walked a brisk 4.5 miles which made up for missing the morning run. after all was said & done, i was embarrassed by my own lack of cool. :-/ 

my family. my love.

"a happy family is but an earlier heaven."
~ george bernard shaw ~

if i had known how complete i would feel to have my family back together, i would like to think that i would have helped fate along. however, i must also appreciate & recognize that all things happen in due course. and at is is often said, things unfold &  happen as they do for a reason. in a few posts dating back to june/july 2010, i may have alluded to going my own way meaning separating from the person to whom i was legally married at the time. thereafter, i was by myself for awhile and quite frankly enjoyed being "single". the more time i spent away from my marriage, it became clear that while i respected the institution of marriage, i did not like the person to whom i was married for many reasons which are better left untold; suffice it to say they were not frivolous nor inconsequential. and... let it be known that wiser & more confident women would never have stayed as long as i did nor endured as much as i did. as way lead to way, i ended up alone & came to love the freedom. and... as way lead to way... i happened upon a road less traveled by... which resulted in a reconciliation with the father of my children. it was not an easy feat, nor has it been smooth cruising but faith has kept us committed to mending & healing our family. giving our love another chance is making all the difference. ♡

wound care conference

half of this past week, i attended a wound care conference focusing on diabetic foot ulcers. the epidemic of type 2 diabetes mellitus in the american indian population and [this is as far as i got when i started this post way back when]. 

what a day...

it started with not being able to sleep around 0300, and then finally nodding back to sleep and having difficulty getting up for my morning run at 0445. instead, i was able to get up for my run at 0500. it was 27º f, is what my phone noted to be the temp at that hour in good old tuba city. the slush from the evening before had frozen down to the sidewalk so it was road running. =P thankfully, no wile e. coyote to creep me out. i trudged along at a cautious pace because i did not want to crack my noggin.

got to the floor to start pre-rounding at 0640, only to find the attending on-call to already be on the floor starting his rounds. so... i joined him and we were almost done with our acu patients when the students and the other attending showed up. while changing the dressings on an ex fix frame, one of the attendings was paged to inform that the first elective surgical patient had already arrived and was ready to be pre-op'ed. while the attending on-call went to pcu to finish rounding, i accompanied him. it was 0730, when he was paged to inform that the patient was already in the o.r. this was a huge surprise. a pleasant surprise. we are usually waiting around for our 0730 start time until 0830. a new world coming. yeah! so... we finished up on pcu and then proceeded to the o.r. i scrubbed in but observed mostly because one of the students was also scrubbed. it is nice to review but also anticipate the next steps so that i can at least assist anticipating the next step in the surgical procedures. they were turning over the room between cases rather quickly so i did not get a chance to have lunch until 1500. then we had a workshop on assembling ilizarov external fixation frames. we were done by 1700. by this time, i trudged home and was changing into regular clothes when a friend called saying she was in town. last minute calls such as this can be a bit annoying. certainly, i am not a neurosurgeon or a cardiothoracic surgeon but... i am still busy. a heads up would be nice. i don't like it when people expect you to just drop everything to visit with them and if you don't they're offended. wtf? anyhow... i made an effort to meet up for a quick chat. fortunately, she was just passing through & needed to get on home to phoenix tonight. then, i went to meet up with my friends with whom i had made plans. we chatted. when i started fading, i drove home. just as i was getting ready for bed, i received a call from my son.

the second i saw his caller id, i knew it it had to be some difficult news because we were not supposed to hear from him until he was done with this pre-deployment training. it was a call to inform me that he is ok but he was involved in a rollover of the combat vehicle he was in which involved the fatality of a member of his crew. while i am tremendously relieved that my son survived the incident with only bumps & bruises, this is the very first time he has had to experience witnessing & experiencing the death of a comrade.

what is a mother to do but pray. offer up smoke. be thankful that my son was spared and pray for healing for the family of the soldier who perished. while anyone can say this happens and is the risk that exists so matter of factly, it is still an outcome no family welcomes. and... we can all get on our political rants on both sides, the bottom line is... if you do not have a loved one serving and only have negativity driveling out of your trap, you best just shut the f--k up! especially around me. i am not a war monger. and, i am not pleased with the manner in which our country entered into this war. but... i love my son and i support him. and, i will pray for him and those serving with him every day. especially when sleep is elusive, as it is now. :-/

hear my prayers

lately, i am having trouble sleeping. each night i wake early and am unable to go back to sleep which was never a problem before. my thoughts immediately go to my son. like this morning, i woke thinking about him. as the wind sloshed raindrops and rattled against the windows, i thought, "please let my yázhí be warm," knowing full well that he is training for deployment. the last two evenings, i spent some time looking at videos on youtube that demonstrate a minute portion of all that which my son will be exposed during deployment. it is more real now then when he called to tell me that he was sworn in and he had signed all his papers. it is more real now then when i stood in the freezing humidity at fort benning to pin my son during the turning blue exercises. i replay the moments when i have been selfish as a mother and try to forgive myself because i want to be strong for him. i relive the moments when i have been the best mommy and hear his laughter and feel his warmth. the reality of my son going to a foreign place where people are diabolically mad, crazed, fanatical & suicidal just wrenches my heart. i pray. i beg. i implore. i plead. i pray some more. i beg some more. i implore more. i plead more. so... when i seem deep in thought, i am.

this all makes everything that i am going through as a resident miniscule. my attending physicians can yell and rip me a new one as much and as often as they so desire. even in front of the entire tuba city community. i do not care. it does not hurt my feelings anymore. i will simply get up earlier. i will rise to the occasion & immerse myself because i believe that if i am good, my prayers will be heard. my pleas will be honored. my son will walk that tádídíínk'eh atiin back to the center of our universe -- our family.

i am sure it sounds silly, insane... you know... whatever! and, i never say that even if i am thinking it until now. all i care about is that my son remains intact spiritually, mentally, emotionally & physically. and... i will cling to whatever i can grasp to hold me steady with hope and faith.

the important things

it's been a rough couple of weeks for my family. my dad ended up in the hospital. after much cajoling by my mom, he finally went in to be seen. he was flown down to phoenix the same day and was scheduled for surgery. my mom & i got down there last thursday. while many were having fun enjoying the mesa powwow, arizona state fair & asu homecoming festivities, our family was huddled with eyes glued to the computer screen tracking our dad's transfers from one part of the surgery center to another. breathing a sigh of relief after we were told a tumor the size of a baseball was excised from his abdomen in the whipple procedure. only to learn that he needed to go back the second day because his blood pressure would not stabilize. and... a third day. and... then had to have the endotracheal tube remain in place until he was determined a low risk for contracting a nosocomial respiratory infection. the fourth day post-op was dad's 65th birthday. we had a prayer done for him. the next day, the et tube was removed and dad got up to walk. a couple of days later, he was transferred from the icu to inpatient status. we remain positive. all the while, being fully aware that dad may still need to go through chemo & radiation therapy. the surgeon intimated that the extent and size of the tumor indicates a prognostication of combo chemo & radiation.

going through this with my family, i had a profound revelation. i will fiercely protect my family. i will pray for my family. i will make the best of everyday that i have with my family. i will make the best of this life that the gods have bestowed upon me to help others. this time we have is more finite than we realize. we all age from the moment we take a breath in this world. we can color our hair, we can dress up pretty, we can get as cosmetic as we want but what matters most is what is inside. relentlessly aspiring to compassion, humility, forgiveness, love, peace. that is what matters most. living the present and accepting the impending with grace. that is important. 

write it down

it  has been awhile since i last wrote. there needs to be more frequent entries to track my progress, document my daily escapades and records my thoughts as i go through this part in my training. so much happens. a fleeting moment of "i got to write this down" or "i got to talk more about this" all passes and goes POOF into thin air.

today we had three surgeries on our schedule. i am very, and i mean VERY fortunate to be the only resident in this program where i am not competing with others to scrub cases. after three surgeries

baby steps

it is amazing to think that last year around this time, i started my core rotation at tcrhcc as a 4th year medical student. everything seemed so foreign. to be honest, i am still in the dark about a lot of things but more and more ever slowly concepts that were taught in classes as classic presentations are illuminating themselves in clinical practice and i am finally beginning to appreciate some of all that book learning that sometimes seemed almost pointless. a couple of days ago, we had four surgeries and my attending allowed me to do a lot of the work. it was a good day to learn and practice. so many lessons. coming to this program, i told my attending that i wanted to learn all the boiled down tried and true surgical approaches and techniques. unlike my cohort, i will have a shorter time to enjoy the practice of podiatric medicine and foot & ankle surgery because i am much older than they are. as such, i am not interested in tweaking my own style later after residency which is a whopping 3 years from now. i just want the most efficient way to medically & surgically treat the gamut of foot pathologies. 

the learning never ends

"there is a reason why you decided to become a surgeon..."

~ dr. jensen, navajo woman general surgeon

it was a rough week in the o.r. especially on thursday. what should have been easy cases were far from simple. all that i thought i learned was nowhere, completely unavailable... my brain was denser than a molasses. and... unfortunately, my confidence was also non-existent. looking back on thursday, after having a meltdown in the dressing room restroom, a venting session, some time for reflecting + finally making peace with my paltry performance... crazy as this may sound... i am actually glad and thankful even that it happened. many thoughts zip + ricochet around in your mind. anger. shame. determination. resolve. and... accepting this is only the beginning, and i have so much to learn. and... tomorrow is another day.

up for a breath

it was an incredibly busy week. many of my cohort will most likely tell me that my week was not as stressful as was theirs, and i would not hesitate to agree. however, i have to say again... it was a busy week!

monday. woke at 3:30 a.m. jumped in the shower. made coffee. packed in last items for tuba city. gave hugs to my family members in their beds (yes... i woke them!) before i was en route. i got to tuba city around 6:30 a.m. and began unpacking a few things. changed. put on my white coat, a longer one for the first time! yeah! and... hit the floor for rounds. "welcome back! where have you been?" abound as i walked through the hospital. it felt good to be back. coffee in hand, clinic started. and... it was a busy day! patients back to back to back to back. i scheduled my first surgery case.

07-30-2011  i wish i had finished this entry when i started it because that first week already seems like a lifetime ago. :/ it serves me right for relying on the [save now] kiosk way too often.

a threesome with don

4.5 miles. ran. struggled through aches & pains. but... did it! yay! then, a quick scrub. and... lunch with my little family. funny tales & lots of laughing. aaaahh... the sound of happiness! so... lunch was a footlong from subway. yeah... a footlong! not a 6" or anything daintier! what of it?! i was famished! since i had a late start with the run, i did not eat anything before the run and did not want to eat anything after to spoil my lunch. anyhow... back to the footlong... i have mine down to a science and if they don't make it right, i don't go back to that location. 9-grain wheat. bacon with pepper jack. toasted. spinach. tomatoes. cucumbers. green peppers. olives. the yellow peppers. a few hard shakes of black pepper and the seasoning mix. washed down with a 12 oz. can of diet cherry coke! yummmm!

after lunch, i packed my overnight bag and hopped in the car. drove out to rock point and picked up my sister for a sisters night out. yes... in the middle of the week! neither of us knew where the brooks/isham performing arts center was in kirtland, nm. on came the navigator on my phone. as it turns out, the brooks/isham performing arts center is located on the kirtland central high school campus. once we knew where we needed to go, we went to get dinner. chinese food at a tiny place up the road. surprisingly, the food was good!

then we went back to the performing arts center and got in the will call line. the opening act was an old guy. i think he was local. he was quite entertaining. :) the announcements followed with a plug for each sponsor. finally... the man himself on stage: don williams. love his deep baritone voice! aaaahhh! he is 72 years old & can still jam, albeit while sitting the entire time in a chair. :) i would definitely pay to listen to him sing in person, again! =) i actually lost count the number of songs he sang. his show ran about 1.5 hours. the auditorium was full to capacity. that is not bad for a week night.

it is safe to say that i am a bigger fan than my sister but it was her idea to take me to this concert. we have a list of performers that we both want to hear in concert and we are going through that list... as we say... "before they die & we lose an opportunity..." or... "get them while they are young, hot & inexpensive..." mr. don williams was on my list for quite some time. and... i am fortunate to have a sister who offers to take me to such a show. ♥

07-30-2011  i started this entry a month ago, and am finally getting it up on the board. =/

determined

i slept in. yes. on occasion, i allow the sun to rise before i do. as i got up for coffee, i noticed that groggy feeling of monday. bleh! it meant the weekend was over and i was a week closer to my vacation coming to end. :(

since i did nothing more than go out on the lake to fish and eat birthday party food yesterday, i felt obliged to run or walk. if i ran, it had to be no less than 5 miles. if i walked, it had to be no less than 10 miles. as time churned pass 10 a.m., i felt it would be best if i ran so i would get done sooner and be out of the heat that much faster. by the time i got out to the trailhead, it was a bit warm but i was not going to make excuses for myself. i told myself, "if you had just got off your hiney, it would have been much cooler when you got out on the trail! no belly aching!"

the first 3 miles, as usual, went fast & painlessly. mile 4 dragged a tad but i still felt strong. mile 5 was testy & seemed to stretch but i was determined to get it done. mile 6 was attempted. i ran 1/2 of it, and trotted & quick walked the rest. so... i am only counting 5 miles.