Goodbye Kentucky..... Or not?

Who knew a month could fly by so quickly? I sure didn't. It feel like I had just gotten to Kentucky when I was packing up my car to drive home. First and foremost, when you have a head cold, driving 11 hours is probably not the best idea.... however, when you have a head cold, you just you want to sleep in your own bed. Let me rewind a little bit.... 

We finished up our last week of work. It was interesting to see patients that I had seen the first week that I was there who came back and remembered me. I think that is one of my favorite parts of medicine. Seeing patients on a constant basis and seeing how their lives change and evolve and realizing that you can be a huge part of that. You can touch so many lives just by being someone to listen and give support. You learn to follow their stories and eventually become friends with some. It's a remarkable thing. Now I better move on before I run the risk of sounding sappy..... 

Dr. Zook, Susan, and Sam were getting ready to leave for Gulf Shores, Alabama for vacation so I would be staying in their house alone for the night. The original plan was to meet Susan and Sam back at the house and then they would leave from there. However.... things aren't always the way you plan them. Susan ended up getting out of class early so she packed her truck and drove to meet us at work. Saying goodbye to Dr. Zook and her family is always hard for me... They truly have become like my second family and support system. I'm not gonna lie when I tell you that I shed a tear or two on the way home... which makes this next part even more ridiculous. 

They were taking Dr. Zook's Ford Edge to Alabama so I was blessed with the responsibility of driving Susan's truck home. Let me tell you this is a big ass truck. Not that I know much about trucks, but it was so big that you had to step on the side of it just to get into it! Did I mention I was wearing a Polka-dotted skirt with a pink top on this particular day? Obviously it looked like I was supposed to be driving this truck..... Also, did I mention that it was storming? 

After receiving several stares from men driving much smaller trucks then mine on my drive home, I came home to an empty house with no electricity. Luckily the electric came back on fairly quickly and I was able to watch some television. All of sudden I heard someone open the door and began to panic. I quickly got up and tried to be quiet and walked to the kitchen. It was Charlotte, Dr. Zook's house keeper/house sitter. She came to check on the dogs. She's very sweet. I was feeling rather sick so I decided to go to bed. The downside of being a doctor is that when you first start, you are exposed to so many illnesses that you haven't had so you're sick all the time. Luckily this was the first time I had gotten sick since being in Kentucky. 

I woke up the next morning and was scheduled to go to a Yoga healing class that emphasized relaxation before heading home. I got in my car and drove to a gas station to purchase a bottle of water. When I came back out and got in my car, the engine light was on and it was almost as if I had exchanged my cherry red for escape named Lucy for an El Camino on hydraulics. It was bouncing up and down so much I could have fit right in driving through Baltimore City. I knew there was an Advanced Auto Parts right around the corner so I braved the drive there. 

When I got there, I walked into the store crying and asked for help. Watching three socially awkward mechanics trying to soothe a 21 year old girl who is balling her eyes out must have been pretty amusing for those around us but at the time I was a wreck. Turns out that three of my engine coils were pretty much dead which meant that my car wasn't drivable. I texted Dr. Zook to tell her what happened and before I knew it, my Kentucky family sprung into action. 

Susan got on the phone with me and tried to make me laugh at the situation even though I was still in moderate hysterics. Dr. Zook then came on and said, "Everything will be okay, Grasshopper." The next thing I know Dr. Zook's Dad, Frank, was coming to my rescue. We drove over to a garage and told them the story. I called triple A and had them tow my car. After coming back four hours later and paying 700 dollars, I had my car back but it was too dark to begin the drive home. Charlotte and I watched Sex and the City 2, which I find funny because she watched it the night before and insisted we watch it again. 

The next morning I got up and began the trek home. Although my initial plan was to stop in Morgantown and spend the night with friends, I just wanted to get all the way home. I wanted my own bed and to see my dog. Was that so much to ask? 

The drive was beautiful and when I made it home I was finally able to breathe. The last few days it has been difficult not getting up and going to work. I find myself searching medical terms online and wanting to increase my knowledge. The search for medical schools is on and I am happy with my current decision. I have a long road ahead of me but with the encouragement of both my families and my friends to support me, I know I can do it. 

Until Next Time,

~Wacko Jacko~ 

Ps. Another blog may be coming soon entitled something else. If you all want to keep reading about my life, let me know and I'll continue writing. I mainly do it for myself but if you enjoy it I'd be more then happy to share it with all of you! 

The beginning of the end...

Sam Time

Dear World,

Today I went to karate and swimming. I went to camp and took apart a VCR. It was cool.

*End of Sam Time*

The past few days have been an absolute whirlwind. I mean this in the "wow that went really fast and was really awesome" way not the "filled with death and destruction of people's livelihood" way. I got to see patients again on Friday which was really a nice change of pace from the primarily research based week that I had. We saw one patient that was particularly interesting on Friday.

Patient 90 is a female in her mid thirties or potentially early forties. She came in with severe pain in both feet with predominant sores. This has taught me that I never want to be a dermatologist because quite frankly.... it was nasty. Not just nasty but, as Ru Paul would say, there was some leprosy realness and I needed to just sashay away. (Shout out to any fans of dragrace!) The welts that she had all over both of her feet were blister-like and filled with yellow-green pus that would occasionally ooze (need I mention why I don't want to be a dermatologist? I went through puberty once, I don't need to see it again on my patient's feet). It was one of those things, kind of like a car accident, where you look at it and you know it's bad.... but you can't look away... The foot was tender to the touch as well as when any type of weight was placed on it. Although Dr. Zook now has a pretty decent idea of what it is after some lab tests, she's still trying to figure it out and find the best possible treatment. Needless to say, there will be more to come on patient 90. Friday went by fairly quickly because we had quite a few patients.

Like I may have mentioned before, this is my third time coming down to work with Dr. Zook. In all this time, Dr. Zook and Susan have never met or spoken to my parents. Finally, my parents wanted to see who these wonderful people were that I talk about all the time. They decided to come down this weekend and the visit couldn't have come at a better time. I have a very close relationship with my parents. They have come to every event that I have ever been a part of since I was born. I love and respect them both so much I don't know what I'd do without them (Love you Mom and Dad). Although some of you may think that this is cheesy and think it is unheard of that I have this great relationship with them, it's very true. With all this being said, I was starting to get very homesick last week. I decided to stay at the hotel with my parents and we had an absolutely fabulous weekend.

Friday night we mainly just hung out at the hotel and caught up with each other. They gave me the latest scoop on Harold (my four legged white fuzzy ball of love) and how his knew habit is to shove the covers on the couch into the couch in order to conceal his bones. We've had him for a little over four years and he still thinks he's not going to get fed.... I suppose that's what living on the streets does to a dog. I'm going to create an MTV reality series surrounding him called "Harold's Thug Life". It will be glorious... premiere to come soon.

On Saturday we woke up early and went to Maker's Mark Distillery. Maker's Mark is my absolute favorite bourbon. The only issue with this is that Maker's Mark is in the middle of Kentucky countryside nowhere. As many of you can probably imagine if you know me, my family is quite dysfunctional. I mean this in the most affectionate way possible. So what happens when you put three dysfunctional family members in a small SUV with an outdated GPS that does not have ANY of the current maps in its system? Chaos. Sheer chaos.

We finally got to Maker's Mark and had a really wonderful time. I got to taste the mash bill as it was fermenting and got to hand dip my own bottle of Maker's 46 in their signature red wax. After that, instead of heading back the way we came, my father wanted to go towards the highway in order to "save time". Little did he know that this would actually add another half an hour onto our trip. We eventually ended up driving through Lexington. We attempted to get onto an express way entitled "Circle 4". My father did not understand at the time that this was, indeed, a circle. It was a concept that we were still trying to figure out through the rest of the weekend (love you, Dad!).

Later that night, we meet up with Dr. Zook and Susan for dinner at the Boone Tavern. I was a little nervous at first seeing as it was the first time my Kentucky family was meeting my Baltimore family. We had an absolutely lovely dinner and ended up sitting and talking for three hours. I couldn't have been happier with the way that it went. The next day we hung out around Lexington and went to Wild Turkey Distillery.

Saying goodbye to my parents was difficult but I know that I'm going to see them on Saturday. I cannot believe how fast that this month as flown by and I have learned so much. More to come this week on my final meeting with patients!

Until Next Time,
~Wacko Jacko~

Shit got real.

Sam Time


Dear World,

The last few days I went down to pop pops. Yesterday, I heard Amanda sing on the piano at Berea Hospital. Today I learned the breath stroke which is the frog stroke. He also says never talk to strangers if you don't seem her or know him. Especially if they look like Mrs. Shirley.

*End of Sam Time*

The last few days have been a little bit of a whirlwind. Dr. Zook and family have been very sick so I've been having days to work on my final research project. I've found a great place in town called Berea Coffee and Tea and they by far have the BEST chai tea lattes I have ever had. I have also learned that I could never be a plumber for several reasons. The first being that I cannot deal with the smell of sewage. You see, Tuesday we had a rough day. I had woken up and taken a bath and when I got out of the bathtub, I had heard Bobby (the painter who has been working at the house) calling for help. Dr. Zook in her sick and sleepy drunk state meandered down the steps reluctantly getting out of bed. By the time I got ready and headed down the damage had already been done. As I descended the stairs, I looked into the garage to see that there was about two inches of water spread evenly across the floor. Later, we came to find out that the source of this leak was the drain at the bottom of the garage. Turns out this was not just water...... The drain at the bottom of the garage was linked to the sewage lines. Apparently there was a major blockage in the sewage line which caused the sewage to back up into the garage. I guess you can say that the kids were ready to get out of the pool..... There was a pipe in the front yard that was also a drain. Sewage was everywhere. There was an overwhelming smell of poo throughout the entire house. We eventually got it taken care of but.... all in all it was a pretty shitty day... heh... heh.... l

For my final project, I've been working on informational brochures for Bluegrass PCP. This requirers a decent amount of research but at the same time, I get to express my creativity which I'm really enjoying. So far, I have made brochures on COPD (a very common respiratory disease here), General Health (basic guidelines on how to be healthier), Hepatitis C (A disease that is also common among Suboxone patients due to the sharing of needles), and Suboxone. I also plan on making an informational brochure on child check points (when they should have their vaccines, etc.) When I get home (because it would be difficult to do while I am here), I am planning on making some models of the human body made of plastic tubing so that kids can follow marbles through the heart, GI track, and different parts of the brain. I though this would be a good way for the kids to learn and still have fun.

Although this week has been primarily research based for me, I also had the rare opportunity to go to Berea Hospital, as Sam mentioned. Originally when I was to come down to Kentucky, I was supposed to be working part time with Dr. Zook and part time with Debra Hille at the hospital. Debra Hille is a contractor at the hospital who is brought in to do art with patients. This is not to be confused with art therapy. Kentucky has strict laws about the licensure of art therapist and even though doing art with patients is therapeutic, it is not considered "art therapy". Art therapy is when art is used in order to attain a certain result or get them to think a certain way. This is different then doing art with patients because the main goal of doing art with patients is just to have the patient express his or herself.

Finally, this past Wednesday, I got to put a face behind the e-mails. Even though the internship fell through, I was still able to play in their summer concert series. I met them at the hospital at 11:15AM and was able to get set up. They provided a piano for me and I was placed in a corner. It wasn't so much a concert as it was me playing for people coming in and out for their lunch hour. Not what I was expecting but lower pressure and I was fine with it. I ended up playing for about an hour and a half and afterwards, Debra took me on a tour of the hospital. We look at the different artwork on the walls and talked about how patients interact with her. She even showed me an exhibit of patient artwork. After that we framed some photographs and made plans to meet next week. She's absolutely wonderful and I'm more then excited to see her again.

Last night, Susan, Dr. Zook, and I were all up late working on the sink. When I say this, I actually mean I was handing things to Susan, Dr. Zook was trying not to die but still being a trooper for moral support, and Susan was cursing at the sink.... a...lot... At 11:30PM I made a taco bell run for everyone to refuel. AFter going through the taco bell drive through and ordering a chalupa meal, two beef tacos, chicken taco al fresca, an order of nachos and cheese and a diet pepsi. I had to go to McDonald's to get a large coke for Susan and obviously an order of fries. After pulling up to the window to get my food, I was judged harshly for the full taco bell bag sitting next to me. I hung my head and shame as I told the boy working the window to "Not judge me" and I drove away.

I cannot believe that I'm a week away from going home.... this month flew by so fast and I am so thankful to have had the experiences that I have had. Let's hope this next week slows down a little bit!

Until Next Time,
~Wacko Jacko~

Difficulties

Sam was at his Dad's this past weekend so unfortunately there will be no "Sam Time".

Things here have been difficult. It seems like anything and everything that could possibly go wrong, has gone wrong. On Thursday of last week, the house got hit by lightening in one of our freakishly loud and bright thunderstorms. Because of this, the outlet to the wall that the cable box plugs into has been completely fried as well as the router, cable modem, and tower for the desktop. We have been out of cable and internet here at the house for the past several days so I've been raiding Dr. Z's movie collection. Spending my Sunday morning eating left over mushroom fried rice and watching the little mermaid was pretty much the best thing that could have happened in my book.  

With all the rain, it's been difficult to work on the house and we're trying the best we can. The rain isn't the only problem... Dr. Z and Susan have both been very sick. So I've been trying to help out as much as I can. I've been trying my best to get both of them to rest but they are definitely people that push themselves to their limits. Dr. Z finally caved and went to the doctor today so I have had the day off which has been pretty nice. We got the ethernet up and running so at least I can do a little bit of work from home but hopefully we'll have her back up on her feet in no time.

I'm supposed to play a concert at St. Joseph Berea hospital this coming Wednesday. Dealing with them has been a challenge because I was initially supposed to intern with them part time while working with Dr. Zook this summer and things just didn't turn out the way they were supposed to. The last I was informed they were working on getting a piano in for me to play on but I'm still not sure if that has happened yet.... More updates to come on the concert front!

Until Next Time,

~Wacko Jacko~

The 4th

Sam Time

Dear World, 

Today we're going to my Dad's house and we're going to party. 

*End of Sam Time* 

So this year was interesting because it was the first year that I've been away from home on the 4th of July. My family doesn't really do anything huge every year but it was weird not to be with them this past year. Even though I became really homesick towards the end of the evening (I miss you Mom, Dad, and Anthony, but especially Harold), the fun that I had compensated for my emotions. Susan and I got up early and worked on the deck. We made pretty good progress and I am getting much better with power tools. After that, we hung around the house for part of the day and then went to Cameron's (Sam's dad's) house for a cookout. He had a pool and we spent some time hanging out and relaxing then had some delicious food. We then planned to come home and watch a movie since we thought that there was a ban on fireworks due to the drought. Turns out, people in the town of Berea don't really care whether or not they start fires. Dr. Zook, Susan, Dr. Zook's parents, their neighbor, and I all sat on the part of the deck that was complete and we had the best view of the fireworks. From there, we could see fireworks across several of the counties. At some points it was overwhelming because we wouldn't know where to look. It almost felt like watching a fireworks display at Disney world. 

Needless to say, it had felt like a Saturday so getting up for work on Thursday was not my cup of tea. Since Sam stayed at Cameron's, there was no six year old bouncing off the walls to wake us up. We typically leave the house at quarter of seven but next thing I hear is a cry of minor panic from Dr. Zook from the upstairs screaming, "WE OVER SLEPT!" I looked down at my cell phone and saw that it was 7:52AM and quickly got myself together. Having planned to shower in the morning, I felt like I was running my fingers through bacon fat trying to put my hair up. We quickly got into the car and headed off to work. 

During the day I felt like most of what we saw were Suboxone patients. Although I understand that you need to see Suboxone patients every week, I'm starting to get bored with them. They either do what they're supposed to or you find benzos or other drugs in their urine. It's difficult. Although they are boring, you get a patient or two that has an interesting story for the week. Some of the patients that come in I can hardly believe their stories. For example, one woman who we saw today stated that she had to go have her children tested for methadone exposure because their father was running a methe lab out of their nursery and there were chemicals everywhere. Some of the stories I hear are completely unbelievable and I don't know whether to feel sad or sorry for them or just be angry that people have such a total disregard for other human life. I suppose that's the power of addiction though. 

We saw a lot of older or geriatric patients yesterday as well. Although I don't particularly like working in geriatrics, we have one older lady that I really enjoyed seeing. Patient 58 is a female patient who is 82 years old and weighs 90.8 pounds (She was very proud of that extra .8 because she's been trying to gain weight). Over the course of her life she has broken both hips, a wrist, and an arm. She had been doing particularly well and hasn't fallen down in quite some time. The thing I liked the most was she was still able to walk on her own, however slow, and was still very sharp. She was able to banter with her daughter and is incredibly sassy. Seeing this brought me extreme joy. You see, I have a grandmother in a nursing home back in Baltimore who is 96 years old (soon to be 97 this October). She has severe dementia and her short term memory is almost completely shot. Although sometimes it's rather funny to see what she's going to come up with, I laugh just so that I don't cry. Seeing Patient 58 reminded me that it doesn't have to be like that and that is not everyone's fate. As long as your keep your mind and body active you will lead a fairly healthy life. The saying "use it or lose it" really does apply here. 

On the complete opposite side of the spectrum, some geriatric patients are incredibly complicated and confusing. Patient 60 was a 92 year old female who was quite whiney to be completely honest. She is one of ten brothers and sisters and is obese. She is confined to a wheel chair and has severe edema in both her right and left legs. She was seeing a "wound specialist" for a gash in her left leg. She complained of pain in her right hip and part of her back. She stated that she had a CT scan and MRI. She noticed that her appetite was starting to fade and she is unable to sleep on her left side. She is seen by home health care who comes and checks on her as well as takes her blood for testing. She claimed to not have any cartilage in her knees and a pinched nerve in her spine. This patient made it difficult for Dr. Zook or I to get a word in edge wise and just continued to talk and talk and talk. She also did not care to listen to what Dr. Zook had to say about her care because she seems to believe that she knows better. We get a lot of patients that enjoy telling Dr. Zook how to do her job and I'd imagine that this is a problem no matter what practice you are involved in. I don't understand why people go to doctors if they're always going to completely disregard everything that the doctor says. It's very frustrating and confusing at the same time.

Until Next Time,

~Wacko Jacko~ 

Back to work!

Sam Time


Dear World,

Today I ate chocolate ice cream with Pop pop and went swimming in the pool.

*End of Sam Time*

Sam time is getting pretty original! Now we're getting a little more information then just going swimming, he's really keeping us on the edge of our seats! I've found that I keep getting more and more behind on my blogging. Like any habit I suppose, if you skip it one day it makes you more prone to skip it the next day but I'm trying to get better. To make up for lost time, I'm going to combine the last two days of work into one post.

I'm starting to really get used to seeing Suboxone or Subutex patients. I can almost completely recite the questionnaire that we have to ask each patient at our visits. I have mixed feelings about suboxone and I suppose it depends on the way that the patient handles the medicine. Some people feel that Suboxone is just substituting one drug for another, however I would beg to differ. When I first came to the clinic, I felt as though this were true but seeing how much the Suboxone patients improve their life because of it, it is almost impossible to say that it is substitution. Yes, you are taking a medication but it is so much different then being dependent on opiates. The goal of Suboxone is not to be on it for the rest of your life, but to make things a little bit easier while you are trying to get clean. Although this is the purpose, I feel as though some patients that we see have a skewed vision of what Suboxone is for. They become incredibly worried when Dr. Zook begins to taper down their dosage and immediately ask for "nerve pills". Of course Dr. Zook doesn't prescribe these because the last thing that a recovering addict needs is a medication from the benzodiazepine family.

Speaking of benzos, the practice here is getting a lot of people that want referrals to a new psychiatrist. On Monday, a Dr. Melbourne Williams (A psychiatrist) in Danville, KY had his medical license suspended. Officials are currently investigating allegations that more then 12 of his patients died of drug overdoses in the past year. The Board of Medical Licensure issued an emergency order of suspension that prohibits him from practicing any type of medicine. This is a huge deal. Typically, when a doctor is being investigated, they are on a probation period versus a full suspension. To put it bluntly, this guy is in the shitter. According to Kevin Johnson, the Clay County Sherif, Williams over prescribed Xanax and other prescriptions regardless of their diagnosis. The state medical board reported that Williams prescribed more then 1.3 million Xanax tablets on 12,622 separate prescriptions between April of 2011 and March of 2012. Some patients came to Danville from as far as Georgia just to get their "fix" from Williams. I have included the Hyperlink here if you would like to read more.

This whole situation is terrifying. It's a shame to think that a doctor would put money before the safety and care of his patients. If you get to that point, you pretty much become a respectable drug lord if there even is such a thing. Unfortunately enough, this happens more often then you would think. Things like this really irritate me. This just goes to show you that (unless you're an apparent drug addict or you really trust your doctor) you should always get a second opinion because you never know who is going to have another agenda.

Monday morning I was a little bit concerned when I came into the office. With our first couple patients, it was shaping up to be a day much like last thursday. I don't have a problem with patients and wanting to hear their concerns but sometimes, they just can be so whiney and you start to wonder whether they need a primary care physician or a psychologist. Sometimes I wonder whether or not some of Dr. Zook's patients think she's a counsellor. I can understand that because she's great to talk to but still, that isn't her job. To give you an example of this, there are two Suboxone patients that were dating. They had come in the previous week with the female patient's daughter who is 7. She had swallowed a penny. The male patient was our first of the day on Monday and looked clearly distressed. He told us his side of the story about how he and his girlfriend had broken up and she was no longer allowed to live in this house with his son. Because of his current stress, he stated that he wish he could use but luckily his urine screen (which every Suboxone patient must go through at every visit) was clean. Later that day, his girlfriend came in the office as well. Her side of the story was a bit more dramatic and put him in a much more negative light. She talked with us for a good forty-five minutes. This is not uncommon with her patients that are in relationships. One patient will come in and talk about the other and it is interesting to really get a good sense of their relationship just from talking to them. I think that almost all people should go see a psychologist or have someone that can be a sounding board. It is so important to get emotions off your chest rather then keeping them in because once they build up, you might explode.

I'm still finding that the patients that are the most interesting to me are the one's that have neurological symptoms. We had one particular patient, Patient 38, who came in with severe migraine accompanied by dizzy spells. She mentioned that changing positions particular triggers these episodes as well as any type of activity. She has high blood pressure which could be a potential cause of dizziness as well as excess of cerebrospinal fluid. She also had mentioned that she had been diagnosed previously with pseudotumor cerebri. Psuedotumor cerebri occurs when the pressure inside the skull (also known as intracranial pressure) increases for no obvious reason. Symptoms can mimic those of a brain tumor even when no tumor is present. It can occur in both children and adults but most common in obese women of childbearing age (this fits the description of the patient in question). If this patient had no underlying intracranial pressure (which she did due to the excess CSF) this can also be called idiopathic intracranial hypertension. This can cause swelling of the optic nerve and result in vision loss. Medications can often reduce the pressure but sometimes surgery is also necessary.

Over the last few days, I have also learned that I do not want to be a doctor that deals primarily with geriatric patients. A few are okay but we had one day this week when it seemed like we had one after another after another. It is almost like working with children again because they don't understand you and have trouble answering your questions or even paying attention. For example, Patient 41 is an older woman. She had an acid reflux problem and Dr. Zook asked her the question, "How often do you get your acid reflux per week?" As an answer to this question she continued to speak about how badly her reflux was bothering her. She then would go on to state that she had it all the time, but then say she didn't have it often, but then say she would have to take medication every night for it, but continue to say she only got it three or less times per week. About 30 minutes into the visit, Dr. Zook and I were both incredibly confused and didn't know which way was up. She also appeared (as most older patients do) to be quite the hypochondriac. She started mentioning how she had pain in her legs and her first reaction was to assume that she had fibromyalgia. Excuse me? Come again?

This is common in a lot of patients here in Kentucky. When they start experiencing something, they immediately jump to the worst case scenario. I suppose this could be to the large amount of "nerves" which is Kentuckian for anxiety or depression. I'm starting to wonder if this is a problem everywhere or just here. My guess would be that it is everywhere. It is almost like people want something to be wrong with them which I have a difficulty understanding.

Until Next Time,
~Wacko Jacko~

Indiana

Sam Time

Dear World,
This weekend I played with Addy, Brooke, and Delaney.

*End of Sam Time*

Everyday when I come home from work, Sam immediately asks me if we're going to blog. He always says, "I have the first line! Dear World..." It is possibly one of the cutest things that I have ever experienced. This past weekend Dr. Zook, Sam, Susan, and I went to Indiana to visit their friends Julie and Steph. Julie and Steph have three kids; Addy, Brooke, and Delaney. Addy is the oldest and Brooke and Delaney are twins. Sam and these three girls play so nicely together. There were also three more kids at the house this particular weekend, Kaleb, Nathan, and Anna. The ages ranged from 6-9. I was really surprised at how well they all got along considering that most of the time with children this age, there is bound to be a fight.

Dr. Zook and I left work a half day early on Friday so that we could get home and load up the car. We left Berea around 2:30PM. We were going to Remington, Indiana which is about five hours from Dr. Zook's home. As soon as Sam found out that we were going to see Addy, Brooke, and Delaney, he got incredibly excited and continued to ask how far away we were about once every fifteen minutes. At this point in time, I'd like to apologize to my parents for every time that I had done this when I was a child.

About 45 minutes away from Remington, IN is Lafayette, IN which is Susan's hometown. There, we stopped for dinner and met her friend Andy (who had been helping us work on the house the previous weekend) and his wife for dinner. The food was delicious however, about halfway through Sam started to get a little bit grumpy because we hadn't left yet. The waterworks began and we waited it out. After dinner we hit the road again.

Before we got to Julie and Steph's house, I saw one of the most interesting things that I have ever seen. The area in Indiana where we were going is in the windiest county in the United States. Because of this, they have windmills set up in order to generate wind power. There were hundreds of windmills that stretched out for miles. At night, every other windmill has a flashing red light on it so for miles it was all you could see. My childhood instincts kicked in and I felt like a sniper in a game of good ol' N64 Goldeneye.

I had noticed that as we were driving I kept hearing tapping on the exterior of the car and just assumed that it was pebbles or what not flying up from the road. It was then that I noticed that Susan's windshield wipers were on. Incase you didn't know, Indiana is possibly one of the flattest states that I have ever been to and therefore is a great place to grow crops, particularly corn. As we were driving through cornfields, bugs were hitting the windshield and splattering. This explained both the windshield wipers and the noise. After I look up through the front of the car, I managed to control myself before I vomited up my dinner. I am terrified of bugs (which is an irrational fear I know considering I am a couple hundred times their size) so this was difficult for me to witness.

Soon we arrived at Julie and Steph's. Sam was so excited he could hardly restrain himself. He jumped out of the car and said hi to his friends. After I was introduced, we went inside and I began to take everything in. Sometimes I forget what it is like to be a little kid and live in that sort of environment again. Being the youngest in my family, it is easy to forget. Julie and Steph live on a farm so they have a lot of animals. They have four dogs and, I believe, around fifteen cats! I love animals so I was in heaven.

The next morning, I was informed that Addy loved to play the piano. Being a pianist myself, this excited me. Dr. Zook and Susan had me play for everyone and Addy told me that she wish she could play like me when she got older. I was very impressed with her considering she had only been playing for six months and was already capable of playing with two hands and reading music at a decent rate. She was struggling with two songs so I decided to help her. This brought back memories of when I initially thought that I wanted to be a music teacher. Seeing her eyes light up when she realized that she could play something correctly was such a good feeling and I was so fortunate to be able to help her. After we had gone through the two songs, Addy asked me where I lived. When I responded that I was from Baltimore, MD, she grew quiet and looked rather said. I asked what was wrong to which she responded that she was upset that I lived so far away because she wanted me to be her piano teacher. This was probably one of the nicest things anyone had ever said to me.

We spent the rest of the weekend hanging out, watching TV, and playing with the kids. It was so relaxing and calming just to take some time to do nothing for a while. One of the things that definitely threw me though, was the fact that Julie and Steph live on the boarder between the eastern and central time zone. I could look at my phone at one of their house and it would say that it was 8:00PM and then I could walk to the other side of their house and it would say that it was 9:00PM. This was particularly confusing int he mornings when I was in a half drunken state trying to wake myself up. I set my alarm for 8:30AM. When I initially woke up without my alarm, my clock said 8:27AM so I figured I had about three more minutes to sleep. After falling asleep and waking up what felt like some time later, my clock read that it was 8:02AM. I felt like Marty McFly in back to the future or perhaps that I just walked into a Stephen King novel.

Julie and Steph are possibly two of the nicest people I have ever met and I was so fortunate to get to have them in my life for the weekend. There are some people you meet who are just good people and these two were definitely part of that category and so were their children. I hope that our paths cross again sometime in the future because two people like that are not ones that you're going to want to let go of.

Until next time,
~Wacko Jacko~

Who will be the next America's Next Top Model?

Sorry for the delay in posts. It has been a few crazy days and I haven't had access to internet. There should be two posts going up today, this being the first.

As you should know, from now on there will be a "Sam Time" section within my blog. He has really taken to blogging with me and, since he cannot blog with me about the medical work that I do, we decided to create his own section. This section will be word for word what Sam says.

Sam Time
Dear World, 


Today I went and swam with Poppop. 

*End of Sam Time*

The end of last week was definitely interesting. We saw a wide range of patients and ailments. One of the things that I found I enjoyed more then I thought was dealing with little babies, most of which were around a year old. Going into medicine there were a couple things that I knew. I didn't want to be an OBYGN or a pediatrician. After the last few days, I've decided that if I could be a pediatrician who only worked with patients between the ages of 1 month to 3 years. I would do it in a heart beat. Most of them do not speak and they just sit there and act cute. Even when they cry and carry on, I don't seem to mind. One thing I cannot stand, which comes with this territory, is the parents. Many of them worry too much and freak out over little things. Perhaps I don't understand that because I am not yet a parent (thank God) but it just seems to get under my skin. It's also incredibly easy to tell the difference between first-time and second-time parents. The first-time parents freak out, they are so nervous that something horrible is going to happen to their child when they bump into anything or breathe.  Second-time parents on the other hand, pretty much only bring their child in if they're afraid the child might actually die. It's a stark contrast.

One particular patient that really hit home for me was Patient 21. Patient 21 is a thirteen year old female that weighs 249 pounds. From what her mother tells us, she is on a mainly carbohydrate diet and drinks a lot of "pop" or if you're from the East coast, soda. Her mother expressed to Dr. Zook and myself that she was very concerned about her daughter's weight and that she knows her daughter needs to do something. The mother did this in a way that was relatively demeaning and embarrassing for the daughter. At this point, the daughter then asked for the mother to leave the room. Dr. Zook and I tried to explain to the patient that we know it's hard but there has to be something different that she's doing. She gained 12 pound in the three months since her last visit. We suspected emotional eating to be the culprit. Patient 21 shut down. Dr. Zook asked the patient how she felt about herself and in her body. The patient responded that she hated herself. Being a girl who has struggled with her body image and weight her entire life, this was really hard to watch. These are the types of young ladies I feel the need to help. I can completely empathize with despising how you feel in your own skin. I've personally come a long way and even I have slip ups from time to time. It was clear that this girl was horribly depressed and miserable. The first piece of advice that we gave her was to start thinking of things that she liked about herself. Dr. Zook and I told her things that we, as outsiders, thought were wonderful about her. The girl showed no desire to open up. I have thought about her everyday since and am really concerned for her because I know how difficult that can be.

Patient 27 was definitely one of my more interesting patients. She is a 28 year old female that suffers from severe panic attacks and chronic pancreatitis. Pancreatitis is the inflammation of the pancreas. The pancreas produces enzymes that help digestion and hormones that help regulate the way the body processes glucose. Symptoms include upper abdominal pain, indigestion, sudden weight loss, and oily smelly stools (steatorrhea). It is typically treated by fasting, pain medications, and intravenous fluids. This patient had been put on a high pain regiment and claimed that she was put on Suboxone in order to get off of the opiate drugs. This was a little fishy considering people only go on Suboxone if they are addicts, and this particular woman seemed as if she was high. She also asked for "nerve pills" which in Kentuckian speak means Xanax or Klonopin. If this wasn't crazy enough, the following scenario happened. I had to go to the bathroom so Dr. Zook headed into the patient's room before I done. After I was done, I knocked on the door and entered the room. As soon as I entered, this patient's eyes grew really wide and she said, "I know you!". I looked at her and replied, "I'm pretty sure that you don't considering I'm not from around here." She looked perplexed and responded with, "No! I definitely know you from somewhere." I responded that I thought she had me confused with another person. Then her eyes widened again and she looked shocked. She said, "You're the girl who won that last America's Next Top Model!" I had to press my tongue to the top of my mouth to contain my laughter. I am 5'9" and weigh close to 200 pounds...... she had to be on something in order to think that I was the previous winner of America's Next Top Model. She was so adamant about this, she grabbed me by the arm and pulled me out into the waiting room to show her mom. She asked her mom who I looked like and her mom said she didn't know. The girl proceeded to state that I looked like the girl from America's Next Top Model and her mom said "Yea.... right..." Then mouthed the words "I'm sorry". As the girl walked out the door, she screamed "YOU'RE BEAUTIFUL!" Although it was one of the crazier things that has happened to me at the clinic, it was certainly the most flattering.

Until Next TIme,
~Wacko Jacko~