Eyes, Brains, Fertilization

I was right, our brain wasn't well fixed. My classmate that's had the most autopsy experience did a really good job of getting it out though. It involved four sets of hands and a bucket to catch the runoff, but it came out in one piece. We put it in fixative for a few days, but when we checked it today it was still mush. I didn't have high hopes, but we figured it couldn't hurt to try to fix it and it did firm up the parts that were less liquified. Oh well, there were a lot of really nicely fixed brains around so we were able to see all the nerves in person and I don't feel like I missed out on much.

Today we did eyes. One was left in place but the skull was dissected above it so we could see the superior muscles and the other one was taken anteriorly, which exposed all of the inferior muscles. The ear was optional but we didn't get to it today. I've done ear enucleation specimens in the gross room before but only from animals, so I do want to be able to see a human one to be able to compare them. I might be able to get to it on Friday, we're scheduled to do the neck but I can be in the skull while other people are working elsewhere.

Colorful, fuzzy brain worms.

One of our classmates took our bone box replica skull and marked the various foramens and canals with labeled pipe cleaners. I have to share a picture of it because it is fantastic.

Meanwhile, I'm up for notesgroup notes tomorrow for a lecture on fertilization. Luckily we are done with classes at noon tomorrow, so I am going to throw something together for the family to eat for dinner tomorrow and plan to stay until 8ish. It will give me a chance to do my notesgroup notes as well as go back over the lectures from Monday and Tuesday. Friday goes until 5, with both a microanatomy and a gross anatomy lab so I know I won't be in the mood to stay late then. I am planning to spend the weekend studying in the library or the PA room though since there are only two weekends left before final exams.

And then there were three...

A year ago, if you'd searched the internet for a pathologists' assistant student blog you wouldn't have found any results.You would have been a few weeks too early to find Forrest's first post as he was preparing to start at WVU's program in January. But now we are up to three, representing three of the nine NAACLS accredited Pathologists' Assistant programs.

If you're reading this you've obviously found my blog, but you might also be interested in reading the other two:

Forrest is a WVU student, and his blog is The Making of a Pathologists' Assistant.

Paul is a future Drexel student, due to start in May (I believe), and his blog is No Job Too Gross.

Must NOT make zombie jokes!

While January is our big neuroanatomy month, tomorrow the skull cap is going to come off. It will be a first for a lot of students; although, at least one of the med students did neurology research so it'll be no big thing for him.

To be honest, I'm not expecting particularly well preserved cranial contents because of the cause of death. Hopefully it won't be all liquified since it will make studying it easier, but if it is that's why it is nice to have friends on other tables.

When my sister was doing gross anatomy there was one guy in her class who every time an instructor said brains would do a zombie impersonation under his breath. It was sort of funny for the first few times, but he kept it up the whole class.

Tomorrow also starts the penultimate week of actual classes for the fall. After that we have a week with three exams (Monday, Wednesday, poorly time Canucks hockey game that I'm still excited about, Friday) and then we're half way done with our didactic year, hooray!

We've had a lot of countdowns. First it was Molecules and Cells when we hit the first test and we were a third of the way through, then it was two thirds of the way, and the we were done with Molecules and Cells (and we were happy!). Then Normal Body started and it was all about making it through October (did you notice the huge drop in blog entries in October? ha, it was sad), then we were focused on the second gross anatomy exam, and now it is two weeks of new material and studying up for our cumulative (yuck!) physiology and microanatomy exam. Chopping it up into smaller sections makes it easier to deal with since it is quite a lot to deal with, which is possibly why the cumulative final seems particularly unappealing but we'll make it through.

Edit: Can I mention that the temperature is in the seventies still? It is so strange for it to be the end of November and I'm still walking around in short sleeves! Atlanta is supposed to get a dusting of snow this week while we might drop down into the fifties.

Hobbies and Life Balance

This is outside the library on campus

Bring a grad student is a lot of work, a lot more than just having a job since you don't generally take your work home with you (especially in grossing!) but with school there is always more work to do, something else to review, make note cards for, etc. Studying is important, studying becomes a lot bigger part of your life than it has even been before. Studying can even be very interesting and the information can have correlations to things you will see in the gross room (I especially enjoyed the endoscopy lecture we had), but studying is very rarely fun. And studying all the time leads to burn out.

Going into grad school I acknowledged that I would be giving up a lot of my free time and set aside quite a few of my regular hobbies, passed on my responsibilities in organizations to others, and promised myself that it wouldn't be forever. I even left my sewing machine at home when I moved to North Carolina since I knew I wouldn't have the time for it.

I've given myself permission to keep up with a few things. I read at least one book for fun a month (thanks to the kindle app on my phone I can sneak a few minutes' worth of reading on the bus or while eating) and I have one or two TV shows I keep up with (thanks to Hulu, which currently has a Hulu prime trial membership that is a month or so for folks with a .edu email address, just FYI). I'm also averaging about one outing to the movies a month and play Words with Friends (user name is Thatgirlwiththescalpel, btw if you're interested!). I blog, which you've probably noticed, and that makes it okay that I have stopped my other writing for a year or two.

My food looked a lot like this, it was so good!

I like to go out to eat a couple times a month (today was Vietnamese food, which included a Vietnamese classmate who clued us in on all the different food types. The company was good and the food was absolutely delicious.) and try new things. Durham/Chapel Hill was voted America's Foodiest Small Town by Bonappetite magazine, which means it could take years and years to explore the various fantastic local food options. And I like to host dinners once a month or so (or as my budget and schedule allows it) for the company and the joy of sharing my food/culture with others.

Nice study view, right?

I also like to take time when possible to enjoy the views on campus. I know, I know! I've mentioned how gorgeous Duke is on a regular basis, but it really does make you feel better to walk out into those surroundings, take a deep breath of clear fall air and just soak in the scenery. Even if it is just going outside for an hour during lunch to soak up some sun and fresh air, or throwing open the windows in the PA student room. The view from the computer lab/printing room upstairs is quite nice as well, it looks like something from a Jane Austen novel (see picture).

Those are the things that keep me feeling like a balanced human being and not an academic automaton. I don't have any complaints, I'm busy but I'm happy and it has been a great experience so far. Of course, I'm eagerly anticipating our rotations but until then at least the studying part isn't driving me crazy :-D

Thanksgiving and things that are not a radius

Cutest invitations ever :-D

Our class had its own Thanksgiving dinner last week and I just had to share the invitations made by the classmate who hosted! They're super cute :-) Dinner was awesome too. It was a blasty-blast, because everything with my classmates is a blasty blast (ah, that would be funnier if you were one of my classmates).

I was talking to one of our professors about something else and he told me that the instructors thought our class was one of the best in years in terms of working well together and integrating with the med students. Aw, that's nice to hear. Of course, hearing how we were the smartest people ever would have been super as well, but I'll take what I can get. There are worse things for people to be saying about us than that we're friendly and get along well.

Actually, it is really helpful having classmates you like. My husband was in town this weekend so I sequestered myself on campus to study for Monday's gross anatomy test while he took care of the kids (they went to the Museum of Life and Science on Saturday, the kids love it). Between Saturday and Sunday I spent 26 hours in the PA room. On Saturday I was in there with one classmate and on Sunday I was there with two different ones. Even though everyone was focused on studying their own stuff, it was still good to have company (especially since it gets a little eerie being in a building mostly by yourself), so when you have a question there is someone there to ask.

Someone even labeled our bones so you know which one isn't the radius!

Of course sometimes it can backfire. When we got our bone box (a suitcase full of model bones that we can take home and study at our leisure) one of our classmates pulled out the fibula and said, "Is this the radius?" and it has been a running gag ever since. Oh ha ha, the fibula is not the radius and we all know that only a mutant with freakishly long arms could ever have a fibula sized radius. Then on our practical we had a fibula and when I saw it I chuckled to myself about how it definitely wasn't the radius. It wasn't until I was at the next station that I realized that I had scribbled down radius as my answer because my subconscious has a sick sense of humor. That would have been horrifically embarrassing to get wrong! I don't think I ever would have lived it down.

I'm glad that test is over though. I am pretty sure I spent more time studying last week than not studying. Which makes this week, where we've been off since Monday, even more appreciated. I'm still studying this week because it isn't too much longer before we have our cumulative (that is a dirty word!) physiology exam, but no where near as intensely.

Oh, and because it is almost Thanksgiving I will take a moment to be grateful. I am incredibly thankful for my father for picking up and moving here so I could go to school and still have my kids with me. And to my mom for her support, prayers, and caring. I'm grateful for my husband who lets me neglect him when he comes to visit on a test weekends, and who I love like a crazy person. I'm grateful for getting to spend more time with my children, even though they are huge study distractions they bring so much affection and cuddling to my life. I am so grateful that I got into Duke and that I have the classmates I have, I can't imagine going through this without them. Also, I am extremely thankful for anti-anxiety drugs so I can take tests without throwing up. I'm thankful that everyone I love is healthy, and that I have so many people to love. I am sure there are a lot of things that I am forgetting, but that's a good list for now. :-D

Not not appendicitis...

Since Saturday my oldest child has had intermittent abdominal pain either low along the mid line or in the lower right quadrant. He was fine Sunday evening and most of Monday, and started up again with pain/nausea/unwillingness to eat this morning. But the intensity waxes and wanes, he said his pain level (based on the frowny face chart) is usually around a 2 but has gone up to 6/7 more than once for extended periods of time.

Now I know the technical term for things, fancy yes?

He has pain at McBurney's point when palpated but pain is diffusely present throughout the lower right quadrant pretty much all the time. Doing a heel strike made it hurt but that is a new development tonight. Laying on his left side made it hurt more. Flexing his hip caused marked increased pain. He doesn't have rebound pain.

We started out at urgent care because I was hoping it was a stomach bug or something similar, but they told us to go to the ER because it had a lot of the hallmarks of appendicitis. The ER had mixed results but we didn't do anything quantifiably diagnostic (blood work, ultrasound, etc), so I was given the option of admitting him for observation or taking him home for observation. Since his symptoms were fairly mild I took him home with instructions to come back if it got worse... It hasn't gotten markedly worse but it isn't better.

So I don't know what to do. I mean we could go back to the ER but I don't know that it would do us any good since he's not much more likely to get a firm diagnosis of anything today than he was Saturday. Basically I'm just waiting around for this to either go away (fingers crossed on this option!!!) or turn into miserable acute appendicitis.

Meanwhile the doctor at the ER scared him a bit by introducing the idea of a ruptured appendix. Luckily, I could assure him that I'd seen a couple hundred appendixes a year for several years and while many of them were big and angry, very few were actually ruptured (I think he took what the doctor said to mean that his appendix would literally burst like a balloon).

I wish I had a slightly more advanced way to diagnosis this than "let's wait and see what happens" but unless it is already fairly inflamed an ultrasound might not pick it up and I'm not doing to give him the massive dose of radiation that would go along with a CT scan (which was an option presented to me by the ER doc, but presented in such a way that it was obvious he was just mentioning to have it down that he did mention the option, even though we both seemed to be in agreement that it was not going to be a viable option).

So that is where we stand. My son has pain that is not diagnosable as appendicitis, but at the same time appendicitis hasn't been ruled out.

UPDATE: The pediatrician thinks he has some bowel inflammation, so he has a prescription he will drink for a few days and hopefully things will calm down and all will be well.  

Absolutely gorgeous!

I forgot to mention this earlier, but the weather here is gorgeous. It is amazingly nice for November, highs in the 70's, sunny, breezy, short sleeve weather.

I like to go outside during lunch to get some sunshine and fresh air. Today I sat down on a bench with my online anatomy flashcards and all of a sudden a small horde of med students descended on the benches all around me. Less quite, more social, and it was nice to sit beneath trees with friendly people, a blanket of soft yellow leaves all around us.

Before too long my classmates came down from our student room bringing their lunches along with them, drawn by the fantastic fall weather. They actually managed to snag a table (the courtyard was packed today, for obvious reasons!) since they have amazing timing, which made eating a lot easier than the whole balancing my laptop and lunch on my knees maneuver I was attempting on the bench. I gave up on studying at that point and stuck my laptop back in my bag. Although, I do love that one of my classmates brought a femur down with her to study while eating lunch. :-)

Tomorrow's high is 77 degrees. Even typing that makes me happy inside. Weather like this just makes me happy :-D

The things I choose to do.

I can neglect a lot of the other chores (*cough* laundry *cough*)  but every night I cook a homemade meal from scratch. If I'm staying late on campus to study then I make something my dad can pop in the oven to heat up (pot roast works well for this).  I just feel like eating a real meal as a family around the table is important, even though it takes up an hour or two a night. The kids like to help me cook and I hope it helps them develop good eating habits for life.

Of course on pretest weekends, especially when my husband is in town, I neglect everyone and a lot of scavenging occurs (and leftovers finally get consumed). The kids get to do things like eat hotdogs or get pizza delivery. They would love for me to have more tests, perhaps even daily tests. Tests mean a serious decline in the number of vegetables served and a huge upswing in sodium intake.

But this is why you don't let 5 and 7 year olds make their own menus since they'd end up as hypertensive diabetics with scurvy. I have decided not to feel guilty about these interludes. It is one year of their life where they get to eat more processed food than they would normally, and even that is only a couple weekends a month. I figure if that's the worst that happens to them because I'm in school then we're doing okay. If it ever gets to the point where figuring out what to have for dinner means consulting a stack of take out menus, I'll send them to live with my mom (who has been wanting that to happen since they were born anyway since my mom loves her grandsons like crazy). I don't see that happening though! :-D

The Absolute Best Pathologists' Assistant Program!

Is any one PA program better than any other? Well yes and no... They are all going to qualify you to sit for the certification exam and they're all held to the same standards by NAACLS. So in that sense they are all good programs and will allow you to be a pathologists' assistant (which, conceivably, is your goal, right?). 

Each school has its advantages and disadvantages. The cost of tuition is not insignificant regardless of where you go, but if you're lucky you will be a resident in one of the states where being a resident can save you tens of thousands of dollars. However, tuition isn't the only cost since a big part of your loans will be allotted for living costs. The city you live in will make a big difference. The Durham area, for instance, is really quite affordable so for $600 you can get a two bedroom apartment and have a roommate.

Location matters, not just for cost of living, but for lifestyle reasons since Philadelphia is a very different city from Durham which is very different from Detroit, etc. Weather might also matter for some people, so if you don't like snow I would advise against going to school in Connecticut for instance. Plus, if you're close to your family and they live in Indiana then you probably wouldn't want to go to school here in North Carolina but would be thrilled with getting accepted into IUPUI.

There are differences in the programs to consider as well. How big do you want your class to be? Class sizes range from four to thirty three. How the classes are taught varies as well, we take all of ours with the Duke medical students which concentrates their didactic curriculum into a single year. In other schools you might have some classes with nursing students, some with dental students, some with physicians' assistants, while in the programs with larger enrollment numbers you might have PA only classes.

Rotations vary as well. We stay fairly localized for ours, while other programs send their students to other states, and even other regions of the country. That was actually a huge factor for me since I was bringing my kids along, I wanted them to be able to stay in the same school/state/environment for the two years I would be in graduate school and not have to worry about being sent to Texas or UCLA (of course if you're from a western state and would like to be closer to home, then one of those programs would be great!).

There are a lot of other factors. Each program is different and you can't look at one or the other and say in every instance, for ever case, there is one superior one. Apply to every program you think you could live with going to, because ultimate the best program--the absolute best one--is the one that accepts you as a student.

Oh, that's bad...

I get home tonight to find my school laptop, which had been placed closed on a desk, open on the floor next to my couch. The couch my 7 year old is sleeping on, the couch on which my 7 year old had an couch wetting accident, which dripped off the couch into my laptop. :-( So I took out the battery, unplugged it, wiped it down and stuck it in some rice to soak up any moisture (we're going to call it moisture and not think about what specific kind of moisture it is!) for the rest of the night.

Hopefully it turns on in the morning because I have studying to do :-(

Edit: It seems to be working, except for the "C" key which I have to press really hard to make work. It is enough that I will be able to study today and tomorrow I will stop in to see those nice guys in the laptop support office (my fourth visit, and third time having it sent off for physical repair, but the other two weren't really my fault).

I have the most awesome classmates ever!

Dinner was a blast! And I think everything was actually cooked and set out to serve within 20 minutes of when everyone was told to arrive.

One of my classmates showed up an hour early and helped out, which was amazing. It makes it so much easier when there is another set of hands! As other people arrived everyone pitched in and there were more people in my kitchen than I ever thought could fit in there! One of my favorite med students took over the cheese slicing while someone else was arranging it on the platters, one of my classmates is actually getting really good at making pancit, and other people were organizing dishes and setting out dishes. It is a great sense of community. People brought homemade bread and dip and delicious desserts--everything from colorful Vietnamese mixed fruits and jellies to puppy chow (which I've never had before, I love the cultural exchange lol).

Seriously though, if you ever have people over my classmates are the best! They bring stuff, they're great to play games with, are adventurous about foreign foods, and clean up after we're done. Maybe next time I'll finally remember to take pictures, but we're always so busy with the eating and socializing that we're slack about that. Good times though. :-D

Edit: I forgot to add that we had a small fire! It was so weird to look over and see flames. Luckily it was just some stuff that had fallen below the burner that caught on fire so it wasn't any actual food that was ruined. Very exciting. 

State of the student...

I wrote about test anxiety/panic attacks back in September and then made the post private because I felt vulnerable having documentation of that experience out there while the situation was still fresh and I couldn't get an appointment with a counselor for a couple weeks.

In more recent news I've been prescribed a very useful anti-anxiety medication. It is immensely helpful. On Monday we had a Gross Anatomy test and there was a section on autonomics, which was both a weak area for me and a surprisingly long section of the test. It would have been a huge trigger for me if I hadn't gotten help, instead of moving on and doing the questions I felt better about I would have just stayed on that one section getting more anxious, changing my answers and constantly second guessing myself. Instead I went ahead to the other questions and then went back to that section and tried my best. Since the practical was immediately after the written, I'm particularly glad that I didn't get too stressed out over the written part.

We have a multi-week gap before our next test and I am seriously looking forward to a weekend where it won't be 100% about studying. I'm still going to study some but it'll just be a few hours each day to go back over the material from this week.

Hopefully mine turns out something like this!

And since we don't have an upcoming test, I thought I'd invite everyone over for dinner and boardgames. Hooray! I invited the second years as well, and a handful of medical students and the evolutionary anthropology graduates students that two of the PA students were paired with for gross anatomy. They very nice and since they're just with us for this class they don't know any of the med students. Plus it is kind of weird for them to be thrown together with a bunch of strangers who all know each other. So we've tried to be friendly since we're friendly kind of folks :-) I don't have that many chairs but I think we'll all at least fit in the apartment.

The menu is mostly Filipino (I'm going to try to make Sinigang Na Baboy for the first time!) with some American food thrown in because one of my classmates has mentioned a couple times that she wants a corned beef brisket. One of our classmates is going to make a Vietnamese dessert that I'm excited about because it is pretty similar to Filipino dish called Halo halo that I don't make a lot because it requires a lot of ingredients. Someone is baking bread and someone's wife is making a pumpkin roll (yum!). Oh, and I will have a scaled down cheese plate because it just isn't the same without cheese (and cold weather just always makes me want a nice capricho de cabra).

It should be fun, maybe a bit loud but luckily I'm on the outside corner of my apartment building and my bedroom separates my living room from the neighbor most likely to be disturbed by noise. I'm not sure what games people are bringing but we should have several options and enough people that we can be doing different things.