tag:blogger.com,1999:blog-57890294106475716872024-03-04T20:41:26.465-08:00That Girl with the ScalpelA recently graduated Pathologists' Assistant Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.comBlogger243125tag:blogger.com,1999:blog-5789029410647571687.post-65311813637148983592020-08-01T11:42:00.001-07:002020-08-01T11:42:15.078-07:00Oh wow, so... heyI forgot about you. I'm sorry. Life has been busy. Kids are teenagers, my dad (who moved with me to grad school and helped me with the kids during those years) passed away in 2018, and I'm still with the same hospital system. Had a couple pathologists retire and brought on some new ones.<br />
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We went live with Beaker, which is the EPIC lab module. It was a nightmare, but after two years we are more or less used to it. Beaker is an interesting LIS, in that while it is an EPIC product, it was put together in large part by the individual hospital's IT department. So if your build team is bad, you get a sub-par product. The EPIC employees we worked with weren't great. On the 60 day follow up visit, one of the EPIC guys actually fell asleep while on the panel addressing all of the problems that the laboratory had as a whole. Although, in their defense, most of the lab's stuff was functional. Pathology and microbiology were the glaring exceptions. For our go-live we were assigned an EPIC employee for the week, except he wasn't actually someone that used Beaker, didn't understand the lab, and he didn't pack his phone charge (it was a USB-C right when they came out so no one had one to lend him) so he couldn't even text or call his coworkers that might actually be able to help. His name was Lionel and after the second day, we never saw him again. It was an epic mess, forgive the pun. The most interesting part is since we switched, new pathologists and staff who have come in have asked us why our Beaker doesn't do X or Y. Our in-house Beaker staff and even our EPIC aftercare point person tell us that Beaker doesn't do those things. Until our new-hires point out that it did at their last hospital. It is very strange that EPIC didn't bother to copy the positives from Cerner Millennium or literally any other system that works well.<br />
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We are in the process of getting VoiceBrook now. It is a good company, and if I have to go back to voice recognition it is the best option. It sounds like in the four years since I last used them, they have implemented a lot of neural network-y smart technology stuff so I am excited to work with that.<br />
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Let's see... what else? In 2018, our autopsy business exploded, so by the end of the year I was actually much more comfortable with them than ever before. It turns out just doing a whole bunch of them was all it took. I stepped down from management in 2018 as well. I was working most weekends on top of 8-5:30 most days, to try to get the administrative stuff in on top of the grossing. With my dad being ill and my kids growing up so fast, I decided that I was going to prioritize my family. It was absolutely the right choice as it was evolving from a gross room supervisor position into an AP manager position with no bench time. I declined to apply for the manager position and instead asked to move to a staff PA position (one opened up six months later). I am not a fan of administrative work and meetings. They are endless and at the end of they day, when you're mentally drained and worn out from hearing people talk, you can't actually point to anything concrete that you've done. I like the simplicity of grossing and the neat little rows of blocks at the end of the day. Also, I clock out when it is time to go home and I leave work at work. Plus, I lobbied to be paid hourly, because if I'm going to be there over 40 hours I'm going to get overtime. One of the tricky things was being salaried the trade off is supposed to be that for the hours or days you work over, you should be able to duck out early on the slow days. Except... there were never those slow days. If there had been slow days, I wouldn't have been working Saturdays. Overtime is the absolute best.<br />
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I still love the work though. I like the busyness of the gross room and the rhythm of grossing. I like training the AP assistants on new things and watching people develop professionally. Our AP manager is settled into our organization and is doing great with all the administrative things that drive me mad. So many fights I didn't want to fight, like overhauling the entire billing process.<br />
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There is a pathologists' assistants subreddit, if you're someone looking at going to PA school. We're still not great at PR, but there is a little more out there if you're looking. New programs are popping up as well. I can't speak to their quality or admissions process.Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com1tag:blogger.com,1999:blog-5789029410647571687.post-61780359840328691242017-08-02T19:14:00.001-07:002017-08-02T19:14:26.596-07:00Still going!Oh my... hello! I'm woefully behind on blogging, aren't I? Terrible really...I suppose I could mention, in my defense, that I've been rather busy working, occasionally sewing, occasionally painting, sometimes writing, often cooking, constantly doing laundry, and partnering and parenting with my husband. All of the things that entail modern life.<br />
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Is there a great excuse in there? No... but it is the one you're getting.<br />
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Professional update: Four years past graduation and I've been certified long enough to have gone through recertification. I have a ridiculously high level of job satisfaction. I love grossing! And, not to toot my own horn (as I'm sure some horribly complex specimen will come along soon to keep me humble) but I like to think I'm good at it. My pathologists are happy anyway.<br />
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I am on my second job as a PA! I was at my first one for two and half years but the commute was killing me and I never liked SC. My parents had settled there and my husband's job was there so we had ties that bound us. My parents moved to be closer to my sister (9 hours away instead of 2), my dad (who you may remember from when he lived with me during grad school to help take care of the kids) had a hemorrhagic stroke resulting in paralysis, and I thought I'd try being a traveling PA so I could have more time off to help my mom out.<br />
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<span style="color: black; font-family: Times New Roman; font-size: small;">I failed as a traveling PA... but in the best way possible? I only traveled to one place. I really liked it and they liked me... enough to create a PA supervisory position to entice me to stay. I'm four hours away from my parents, which is close enough to go up once (sometimes twice) a month to give my mom a weekend off. My husband resigned from his job of ten years and the whole family moved up last summer. I love our new state. I'm happy to be out of the heat of the south! Of course, I still go back to Durham now and then! Up until I moved, it was every month or so now it is every three months or so. The town has changed a lot and new things are happening all the time. I should go back to visit Duke some time but it is someone else's time there now and there are fewer familiar faces. </span><br />
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<span style="color: black; font-family: Times New Roman; font-size: small;">Now I'm in charge of two other PAs, one OJT PA and one from the Canadian program. We have four lab assistants and eight pathologists. I think we'll break 28,000 specimens this year. Autopsies vary but we do a few a year. Never been my strong point... I think it wasn't to my benefit that most of mine during grad school were with residents instead of the autopsy PAs. I'm not as confident at as I am with surgical pathology and we eviscerate differently than we did at Duke but it also happens with a lot less staff. It isn't bad though. </span><br />
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<span style="color: black; font-family: Times New Roman; font-size: small;">That's it for now! I'm really glad I became a PA and while school was grueling, it is now over and done and I couldn't be more pleased with my profession. </span><br />
<b></b><i></i><u></u><sub></sub><sup></sup><strike></strike><br />Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com2tag:blogger.com,1999:blog-5789029410647571687.post-13798965971759556632014-11-30T16:54:00.003-08:002014-11-30T16:54:35.178-08:008830...what?The other PA where I work has been promoted to interim lab director in a week or so, which I hope will be a good experience for her! As a result I'm now verifying the charges for the cases we do. I haven't dealt with that much since leaving school but it is a good skill to have. It goes a lot faster now that I've refamiliarized myself with things and I don't have to think about the specimen types we see all the time. <br />
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I have other things I need to blog about but because of those other things, I haven't had too much spare time! Maybe in a few days. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com2tag:blogger.com,1999:blog-5789029410647571687.post-36775617559124984122014-11-09T08:34:00.002-08:002014-11-09T08:34:21.835-08:00Revisiting DukeSo last month one of my favorite bands was playing on a Monday night in Chapel Hill and I spent the preceding weekend in Durham revisiting old haunts. Since I was there on a weekday, I thought I'd take the opportunity to go back to campus and the hospital (the VA was closed since it was Columbus day). There was a bakery in the little town that I lived in that makes these amazing yeast donuts and I would bring them in sometimes, so I had called ahead and ordered five dozen to commit myself to going to visit (so easy to have the intentions but elect to sleep in more otherwise). <br />
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I got to see the renovated autopsy suites (SO BRIGHT!) and they've added lifts to help move the bodies, it is a nice improvement! Plus it was good to say hi to the autopsy folks and I popped into say a quick hello to Pam, the course director, and drop off donuts with her for the PA students. <br />
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Getting donuts to surge path was an ordeal... they moved to a new lab and it is further back from public areas. I didn't have an ID badge anymore or the number for the lab, but I ran into some residents I knew (they weren't going to surge path unfortunately) that gave me the direct number which helped immensely. I was able to call and someone came out so I was finally able to make the donut delivery!<br />
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It should be noted, that it makes me intensely uncomfortable to be somewhere like that without context. So I didn't stick around. It is nice to see people and catch up, but I'm also aware of the fact they're working and I don't want to overstay my welcome. Plus I had one more donut delivery to make! A small thank you for the friend that gives me a place to stay, who works downtown close to everything. <br />
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The concert was amazing and I had a great time in Durham, as always, and I felt slightly less bad about always going back to the area but never visiting! Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com1tag:blogger.com,1999:blog-5789029410647571687.post-20385969242967193212014-10-02T06:49:00.001-07:002014-10-02T06:49:18.327-07:00A week with VoicebrookFirst off, I'm so pleased at how much I remember about navigating the software. Go me! It has made the transition smoother than it could have been otherwise. That and my keyboard is a lot more accessible than it was last time I started using voice transcription software. Right now I'm doing things around 80% with voice controls and 20% with mouse clicks and typing. <br />
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Second, it makes everything take longer. A big contributor to that is how long each window takes to open, and that we're opening more windows than before. It is 5-10 seconds here and there, but it adds up. Then there's the proofreading and the editing, but I'm sure that will improve as I use it more and the software gets better trained. At least I hope so. I'm used to being able to cut while dictating instead of having to stop every time I say something to watch the words going into transcription to make sure they are the right words in the right place. <br />
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The net time turn around time is lower because it doesn't have to get dictated, go into the queue for the transcriptionists, and then transcribed. But it used to be handled by me and the transcriptionists, instead of just me... Meanwhile, the transcriptionists, who are still doing a bit of transcription (we'll just say that the doctors are easing into using Voicebrook, rather than going cold turkey), are picking up other administrative duties in addition to the ones they were already doing. What will happen long term remains to be seen. <br />
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Overall the software works well, the accuracy is 95%+ and that's good. But oh, that few percent that it isn't getting can be so frustrating!! Cholelith vs choleliths and having to correct things like 3 vessels to three vessels. I remind myself that it comes with training and it isn't nearly as bad as it was the last time I went through this 4 years ago. <br />
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I have added to the stock of templates with some personalized ones. Also, I've prefilled some bits with things that are the case much more often than not, like the aforementioned three vessels. It saves time to default to that and change it when it isn't right than to dictate something over and over. I'm working on maintaining a good attitude about it, mostly because I don't have a choice in the matter so might as well suck it up and forge on with what I have to work with. Hopefully speed will pick up. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com0tag:blogger.com,1999:blog-5789029410647571687.post-80730178530600506532014-09-21T15:14:00.000-07:002014-10-02T05:44:48.150-07:00Neglect, but interesting things upcomingMy laptop is not currently working, so I've been doing most of my internet accessing on my phone. It isn't the best way to blog, which is one reason why there haven't been any updates lately. Also... I don't have any study obligations this year, so I've gone INSANE with Halloween! I started sewing in August. I love it!<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTkzX6r8AVau0TgpQoehnUOxcWambEIxwvcDUbbkEuDy7otmIk-OJ1FOG0ucKgMZsz0JWgV2nNiNfvrCZsCivF80fBrSj5hlE1WKt6XhmcBecJtF6JEOWC2OycQITc-KFQGA5DdjLJcp4b/s1600/untitled.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTkzX6r8AVau0TgpQoehnUOxcWambEIxwvcDUbbkEuDy7otmIk-OJ1FOG0ucKgMZsz0JWgV2nNiNfvrCZsCivF80fBrSj5hlE1WKt6XhmcBecJtF6JEOWC2OycQITc-KFQGA5DdjLJcp4b/s1600/untitled.png" /></a></div>
Next week we're transitioning from live transcriptionists to <a href="http://voicebrook.com/" target="_blank">Voicebrook</a>, so that'll be something worth talking about. I have experienced training my Dragon (medical) and it'll be interesting to compare the medical version to the pathology specific one. Voicebrook is specifically tailored to pathology, but Dragon had a solid pathology vocabulary built into it as part of the larger medical lexicon. Personally, I'm more concerned about how it will interact with our version of Cerner since there are different active windows that I'll have to navigate either using the mouse or with voice commands. I know the software folks say that voice navigation will be easy and intuitive but we'll see. <br />
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Attitudes at work are not entirely enthusiastic about the switch, but the powers that be want it, so we're going with it. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com0tag:blogger.com,1999:blog-5789029410647571687.post-28100150635426803772014-08-18T07:34:00.004-07:002014-08-18T07:43:26.671-07:00"On the job training with lectures"A pathologist on reddit (yeah, I know, it is reddit... you can't take it too seriously) just described the Pathologist Assistant education as "on the job training with lectures". <br />
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Well... isn't all medical training that? Clinical rotations are OJT in a much more standardized form where you try to ensure that every student passing through has roughly the same guidelines and instruction. And sure, I guess if you wanted to be dismissive you could describe a grueling year of medical education as "lectures". <br />
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I suppose, if you wanted to paint with such broad strokes medical school, residency, and fellowships are also OJT with lectures. Nursing is OJT with lectures. Physicians assistants get OJT and lectures. I would hope that in regular life the pathologist who posted is not quite so dismissive of other's education. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com1tag:blogger.com,1999:blog-5789029410647571687.post-27293653939286955902014-06-25T18:57:00.001-07:002014-06-25T18:57:21.733-07:00Assistant obtained and conversations relevant to my interestsThe new assistant started on Monday. He's learning all the ropes and seems keen. I'm fairly low maintenance so, I'm fine waiting until he's finished learning all the non-gyn processing and administrative tasks before making him learn any random preferences of mine (how the rack is oriented in the formalin tub matters!!!).<br />
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In other news, my husband and I were out watching soccer at a local wine bar and the lady next to me was discussing a friend of hers with diabetes. She checks up on him every other day and runs errands for him. Apparently he had developed a festering foot wound and for months the odor was nauseating. When she found out it had maggots she manufactured an issue with his prescription refills (working with the pharmacy and doctor's office) that forced him to go to the doctor's office for a follow up visit. Now, <a href="http://en.wikipedia.org/wiki/Maggot_therapy" target="_blank">maggot therapy is a thing</a> but that is under controlled circumstances and not wild maggots that have just shown up after being attracted to the necrosis. So the woman says how the man's doctor referred him to a wound care specialist and things are being treated currently.<br />
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It was a great conversation to be around and I joined in, because how often do I get to discuss maggots and necrotic toes in public serendipitously?Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com1tag:blogger.com,1999:blog-5789029410647571687.post-72637315247210189892014-06-06T06:08:00.002-07:002014-06-06T06:08:56.698-07:00Having an assistant is great!I really miss having one! All the little things that used to just get done aren't magically getting done! So the histotechs are doing some of them, I'm doing some of them, and the pathology manager is doing some of them. It'll be so nice when someone is hired again and trained.<br />
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I'm taking the gross photos myself, which I'm able to do and it isn't an onerous task. It is just an end of day thing that stands between me and going home. Whereas when there is an assistant it would all just happen while I was still grossing and it would have a picture before I even got it to describe. It was nice. The interviews continue on, but I think the last one will be next week sometime. I'll be out of town!Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com3tag:blogger.com,1999:blog-5789029410647571687.post-1103944604564495572014-05-07T16:41:00.001-07:002014-05-07T16:41:26.353-07:00Things in my life and goodbyes!The most important thing that's happened in my life lately is that my husband became an American citizen yesterday! His allowed to maintain his original citizenship so I'm glad that he didn't have to give anything up for this to happen, which is what my mother had to do when she went through the process almost thirty years ago. It means I don't get to make anymore jokes about deporting him when he irks me (usually with bad jokes of his own!), but now he can vote and really belong to the country he's made his home for the past twelve years.<br />
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Then today he had sinus surgery, which was less exciting and momentous but important all the same. His specimen went to the pathology group where I used to work and my old coworkers promised to keep an eye for it. It is one of those totally benign things where you're just sending it for insurance purposes though, so no need to prioritize it. He'll be hanging out on the couch for a week or so recuperating, with plentiful popsicles and DVDs to keep him company.<br />
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<tr><td class="tr-caption" style="text-align: center;">Grumpy cat says, Good Luck, you'll need it. </td></tr>
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Now for work news... oh, sadness and happiness! My lab assistant is leaving on Friday to enjoy a few <span id="goog_1333486319"></span>months break before she starts medical school in August since her husband has already moved up to start his job near where she'll be going to school. She's been a great assistant and I know she'll do well at <a href="http://www.pcom.edu/General_Information/georgia/georgia.html" target="_blank">PCOM</a>! I'll miss her, since we've worked very closely together and she's the only one in the lab with me for several hours in the day, but she's leaving for a good reason and I wish her so well. To that end, the head of our department and I wanted to give her a little sendoff, and since she loves grumpy cat I made her this one! It is her sense of humor and hopefully she likes it. <br />
<span id="goog_1333486318"></span>Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com1tag:blogger.com,1999:blog-5789029410647571687.post-32711370689005320822014-05-01T06:38:00.003-07:002014-08-18T07:36:45.200-07:00Tan that is just...tanA while back I was triaging a kidney and one of the pathologists wandered by and asked if it had a <br />
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<tr><td class="tr-caption" style="text-align: center;">So tan!</td></tr>
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mass. I said that it did and he asked me what it looked like. I told him that it was tan. He asked if it was yellow tan, maybe hemorrhagic? And I told him no, it was tan... Solid tan. Uniform and...tan, just tan and didn't look like an RCC at all. <br />
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Then the kidney gets grossed and the slides go out. The pathologist is on vacation, the one filling in for him gets the case and pops his head into the gross room to ask me what color the tumor was (while holding a copy of the gross description??). I told him it was tan and expressed surprise because I thought I had dictated that (I'm terrified that the dictation system, which is occasionally glitchy, will not pick up some really pertinent information). He looked at the paper in his hand, underlined something, and said "oh yes, tan" but... then he stood there. I went ahead and told him that it wasn't tan yellow, it wasn't hemorrhagic, it wasn't cystic, and it wasn't mahogany. It was tan. He said thank you and left.<br />
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About half an hour later the other pathologist comes in and says he wants to ask me about the kidney tumor.... Oh goodness. He asked me what color the tumor was, if maybe it was more tan red or mahogany. I told him, sorry no. It was just tan and I said there wasn't a central white scar in it either, since I knew that was going to be a relevant follow up question. Then he said thanks, said he thought it was an oncocytoma anyway, and left.<br />
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It was funny. I know that things tend to be pink-tan, white-tan, yellow-tan, brown-tan, etc, etc, but this one was genuinely just tan, like a paint chip of uniform color. Patients don't read the text books so things often don't present as expected and you can't take it personally if the pathologists question and dig to see if they can't get the gross description to match up to expectations just a little bit better. But all you can do is describe what is in front of you and trust that the microscopic matches up better. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com0tag:blogger.com,1999:blog-5789029410647571687.post-23986495570967010882014-04-05T09:00:00.003-07:002014-04-05T09:00:43.650-07:00Break a leg and then identify all the pieces!The title is from a good luck message a friend sent in the wee hours of the morning, wishing me well on my certification exam.<br />
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That I took this morning.<br />
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That I passed!!!<br />
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Months of worry, months of study, and I passed.<br />
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I will have free time again. I don't have to feel vaguely guilty that there's some studying I need to be doing.<br />
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I passed the certification exam of a terminal degree, that might officially be the last major test I'll have to take in my entire life. <br />
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This is not a well written blog entry, I understand, but... it gets the point across! I'm done! I passed!<br />
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Hooray!Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com5tag:blogger.com,1999:blog-5789029410647571687.post-81312509009497737412014-03-31T17:01:00.001-07:002014-03-31T17:01:58.584-07:00Looking for things that aren't there.One of the pathologists came into the gross room at the end of the day to look at a multi part case <br />
from early last week. It is always worrying when they say something like, "well, what do you think it was?"<br />
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<tr><td class="tr-caption" style="text-align: center;">There was nothing like this...</td></tr>
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Eek! It didn't look like anything particular... but at least I threw out an option that was plausible based on what I saw grossly. It wasn't right, but I'd argue that it made sense given what the surgeon thought was the primary and better than not having any answer at all. <br />
<br />
Meanwhile we went back to the bucket to look at one of the parts, where he was interested in one particular area...already knowing before he saw it that the primary tumor should be there... Except it wasn't.... at all. There was a nearby tumor but nothing where we were looking.<br />
<br />
Which is infinitely comforting. The idea of missing a tumor is terrifying--especially when it is a specific and semi diagnostic sort of one.<br />
<br />
On a related note, I get paranoid when large swaths of bowel are removed for "neoplasm" and all that is in there is a lipoma or a little polyp. I always have to worry that there's something more sinister that I'm just not seeing. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com0tag:blogger.com,1999:blog-5789029410647571687.post-23768445273241482372014-03-30T07:22:00.002-07:002014-03-30T07:22:40.990-07:00That might be the saturation point...I think I might have hit the point in studying where I feel comfortable, where all of the words are starting to look more and more familiar. I woke up this morning to consider what I felt like I needed to study and...there just wasn't anything pressing. I'll keep reviewing here and there, but there isn't the feeling of compulsion to keep reading/making notes/reviewing. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com0tag:blogger.com,1999:blog-5789029410647571687.post-87201908369927898682014-03-20T20:11:00.004-07:002014-03-20T20:11:48.699-07:00And what did we learn, boys and girls?We learned that if we blog about getting legs and how gross they can be, you tempt the universe to send you more legs. What the heck? Between end of last week and the start of this week I had more legs than all of last month. <br />
<br />
But! We've had students coming in from a local career center touring the various things we do in the laboratory and since they've been coming in I haven't had any legs! The only plus side to them is that they make a very interesting visual aid (and potentially fun Halloween decorations if you were so inclined and wanted to scar some children for life....) for when you have people coming in to see what you do. People know what a normal leg looks like, but very few people without a medical background know what a gallbladder looks like. I do like showing them gallbladders though, because there is the potential for stones. <br />
<br />
A lot of the students are interested in nursing and labor/delivery or pediatrics. So at least I can bring out a placenta and show them the membranes and where the baby would go, etc. It helps to have something relevant to their interests. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com1tag:blogger.com,1999:blog-5789029410647571687.post-19426459437574452342014-03-16T19:19:00.001-07:002014-08-18T07:47:33.709-07:00She's got legs...Oh legs. I don't know anyone that likes legs. On my best day, with a not particularly bad leg, I don't mind them. On the wrong day, I dread seeing one come in the door.<br />
<br />
Why? Well, they are unwieldy and just won't stay where they're put. Sometimes all the vascular margins aren't clipped so if you grab it blood shoots out the resection margin because of the pressure you've applied. And they're fresh. They're fresh and bloody. They are the single largest exposure I have to unfixed, biohazard-y tissue (which I'm not particularly concerned about, but at the same time puddles of blood aren't exactly my favorite).<br />
<br />
And the smells. Oh the smells! Gangrene is a popular reason to have your leg amputated, plus non-healing wounds, ischemia. These are not nice legs, these are legs that have allowed toes to rot off and nails to get hoof-like. Legs with popliteal arteries that are thrombosed and wide enough to stick three fingers in. Sloughing skin and muscle turned gray, green, and purple with rot.<br />
<br />
The legs get wrapped up, in layers and layers. The more layers, the worse it smells generally, more layers to try to contain the stench. The last layer is the worst, it is a sort of adhesive plastic that sticks to the skin. Sometimes it comes off easily, and sometimes removing it brings part of the foot with it. <br />
<br />
At the end, it all gets re-wrapped, put back into a biohazard bag, thrown into a rigid biohazard box, and then put into the morgue fridge. The temperature keeps it from rotting too much more, but you still hope that you never have to go back to it. Time is not kind to detached legs. <br />
<br />Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com2tag:blogger.com,1999:blog-5789029410647571687.post-46223453177142299482014-02-20T18:14:00.001-08:002014-02-20T18:14:35.334-08:00Trying doesn't quite count...Life gets in the way of things... like studying and signing up for the certification exam. So I'm finally getting to the point where I feel that I've studied enough that I can set up a date to take the exam (maybe that or I'm getting to the point where I'm tired of studying and figure I might as well get it over with). I started off by filling out a printed version of the application so I could just send a check (can I mention that writing the ASCP a $500+ check hurts?) but there was a number I'd have to email my course director to get and didn't want to be a bother. So I figured I'd just do the online application and skip that bit, except four minutes after I started filling out the online application the website went down for maintenance. Rats, foiled again!<br />
<br />
So I'm going to stay up and try again in a few hours. I don't get any bonus points for just trying to sign up, I have to actually do it and having now finally gotten around to doing it (and having located my sealed transcripts) I'd really like to be done with it.<br />
<br />
I have to do the online application and then mail in my sealed transcripts, and then I wait to hear back from them with my three month window for when I can actually take the exam. So even this doesn't mean that I'll know my date immediately....<br />
<br />
But, still... it is a step in the right direction. I'm tired of having it hanging over my head. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com0tag:blogger.com,1999:blog-5789029410647571687.post-13202275013962627342014-01-26T10:54:00.001-08:002014-01-26T10:54:53.250-08:00Strangely busy!I've been awful about updating, I know. Apologizes.<br />
<br />
This past week has been busy, more colons, more breasts and lumps, random kidney, and more hysterectomies! I am starting to wonder if anyone over the age of 45 has their uterus anymore. I was chatting with one of my classmates the other day and we were in agreement about that! It seems that hysterectomies abound everywhere. Some days I'm baffled that as many of my autopsy cases has a uterus as did.<br />
<br />
In the same conversation with the same classmate we both discussed how we should really sign up for the certification exam... And we should. I should. I just haven't. I feel like if I just keep studying eventually I'll feel like I'm ready, but I know it isn't true. I should just sign up and get it over with.<br />
<br />
Meanwhile, I've been going to the library in the morning to study before work. It is easier when I'm not at home... when I'm here I just keep seeing things that I need to be doing so I study for a bit then load the dishes, study for a bit, start prepping dinner, etc. Life would be much easier if magic elves would just take care of all of that stuff while I'm sleeping, but sadly, childhood fairy tales lied to me and that sort of thing just doesn't happen. So... I just try to do it at night after I get home from work, provided I don't get home after 7:30. I hate late nights, sincerely. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com2tag:blogger.com,1999:blog-5789029410647571687.post-9161613194660269752013-12-31T19:52:00.000-08:002013-12-31T19:52:21.713-08:00The year that was, and the year that will be. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuSKvMN8FDudzGZ9HxmkgKrvuZDNbVzGYpdJcX4sKAvIvUsQ7rCmKvgdSOJoT691zRp7J37hkC2yTpWtR7lRLZBi6VGKaVz5jpSNtLuMLJnPvZtoNz0OWkcdglWFm5kwVj6y0Ll5BCPSGs/s1600/2013.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuSKvMN8FDudzGZ9HxmkgKrvuZDNbVzGYpdJcX4sKAvIvUsQ7rCmKvgdSOJoT691zRp7J37hkC2yTpWtR7lRLZBi6VGKaVz5jpSNtLuMLJnPvZtoNz0OWkcdglWFm5kwVj6y0Ll5BCPSGs/s320/2013.jpg" width="320" /></a>2013 was chock full of exciting and wondrous things, and a few things I'd rather never have happen again. I will forget to mention great swathes of things that mattered, I'm sure, but that is par for the course. The things that seemed so horrible at the time (I'm looking at you laptop crash!) have faded from the forefront of memory, as most unpleasant things tend to do. <br />
<br />
It was an accident prone sort of year, between ending up on crutches and having my car totaled (and still feeling the ill effects of that, to be honest) I spent more time in doctor's offices than any other time in my life (excluding the years I actually worked in a doctor's office). But I'm still grateful that nothing worse came of it, and the kids were not with me when the accident happened. <br />
<br />
<br />
Educationally, I received a master's degree and finished the PA program. It isn't a small thing for anyone, but considering my past it meant more than I had imagined. I still felt a bit silly in the black robe, but participating in the ceremony is something I'm glad I did for my family. The certification exam is still hanging over my head, but that is something that belongs to 2014.<br />
<br />
Employment-wise, it was an interesting year. My husband's promotion determined where I'd be searching for a job, but it is something that he earned and something he worked very hard for. It did mean that I've become a labor department statistic (ie: the under employed), but considering the job market in my state (largely non-existent) I'm fortunate to have found something that allows me to actually live at home and work as a PA. And I couldn't have imagined a nicer place to start out working though, honestly. My boss is really great! The pathologists are nice too, but not as fun to hang out with!<br />
<br />
Moving back to where I lived before would have been easier if we'd stayed in the same house, but... for the children's sake we uprooted ourselves and found a homey house in the best school district we could find. We're firmly ensconced on the other side of town from where we were before, which meant condensing the old house, the NC apartment, and whatever we inherited from my parents into the new house. So much moving! On the upside, we now have two extremely well seasoned cast iron pans (and so many magic bullet cups). Ah, but I loved house hunting. I always do. For the potential of the places, and the dreams of lives that may be lived there. I even tagged along when my best friends in Durham were looking for houses, I couldn't help myself.<br />
<br />
July was miserable for all the goodbyes. School ended and most of us scattered, leaving behind the teachers, PAs, residents, pathologists, techs and everyone else that had been so important during our time there. And then I had to say goodbye to Durham itself, and all the places I'd come to know and like. It was a sad month, my best friend (since 1996!) moved far, far away and then I had to leave my other best friend there in NC while I moved far away. In a lifetime of moving and meeting strangers, there are three who have become my closest and best friends. One had to move away, one I had to leave behind, and the third I finally got to live with again after being apart for two years. The latter helped offset the former two. Getting to be all together as a family, and living with my dog again is good. <br />
<br />
Things that I've never experienced before happened... for instance I was mentioned in the dedication of a book (I'm actually in a book circa 2000, but as one of dozens of people)! And we had a housewarming party, where forty people crammed into my kitchen while ignoring the entire rest of the ground floor. Oh! And I've started baking, which seems a small thing but it is something I've always been intimidated by but after the previously blogged about pie making weekend (inspired by a conversation at work one day), I've gotten more adventurous!<br />
<br />
And as this has gotten quite long, I'll wrap it up. 2014 will be here soon! Let's hope it is a good one. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com1tag:blogger.com,1999:blog-5789029410647571687.post-57691363059865856422013-12-29T14:27:00.001-08:002013-12-29T14:27:56.202-08:00And I've studied sporadically at best...I need to dig out my sealed transcripts so I can sign up for the certification exam. Having a date will help with motivation, I think. November was good for studying, December has been very Christmasy with some interspersed studying.<br />
<br />
On the upside, Christmas is now over and we had a lovely time. My family all came to visit for a few days and it was really nice, probably the least stressful Christmas we've ever had. We tried to model things on my husband's Swedish Christmas traditions and it went over well. <br />
<br />
I worked Christmas Eve and the day after, which is about what you expect in the medical field. Things slow down but it doesn't stop because people like to get things done while their deductibles are already met. At least I didn't have to work Christmas Day, which my sister's had to do several times in the past. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com0tag:blogger.com,1999:blog-5789029410647571687.post-12577806194677878082013-12-13T06:14:00.003-08:002013-12-13T06:14:52.494-08:00December has been busy...I don't know if traveling over Thanksgiving just put us behind, but December has felt like a month of catch up. My husband is working some evenings and some weekends, so I'm trying to pick up the household slack while studying and getting ready for Christmas and working. Somedays I just want to hang out in a blanket fort, reading something fictional and fun.<br />
<br />
But work is still going well. Lots of babies being born apparently, but relatively slow on colons. Things come in waves with no rhyme or reason.<br />
<br />
My student AAPA membership expires at the end of the month, so I should probably look into renewing that. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com0tag:blogger.com,1999:blog-5789029410647571687.post-15791215295022326282013-12-01T18:38:00.001-08:002013-12-01T18:38:42.970-08:00Scrubs...My husband took advantage of some black Friday-esque sales at Brooks Brothers while we were driving back from our holiday trip to DC (since we don't have a store locally, it made sense to stop when we saw one). And it made me really grateful that I wear scrubs to work. I put a lot less thought into what I'm wearing on a given day to the hospital...light blue scrubs every day. They are hospital issue, which makes sense for the type of job I have. In a position where you could be soiled with chemicals and/or bodily fluids, it is comforting to know that non-contaminated clothing is as close as the break room.<br />
<br />
Plus as a new grad, it was nice not to have to buy a new work wardrobe... Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com0tag:blogger.com,1999:blog-5789029410647571687.post-3815134151151495822013-11-26T06:39:00.001-08:002013-11-26T06:39:59.407-08:00Schedule...I haven't signed up to take the exam, but I have a mental deadline for myself. I want to be done with my first pass through Robbins by the end of the month. In December, I'll actually see about registering to take the test for sometime in January. And I'll have the month of December to go back through Robbins and make outlines (I do love outlines) for major diseases/topics, etc.<br />
<br />
In the meantime, we're going on a road trip to DC for Thanksgiving with the kids because it makes much more sense to do this now that we live three hours further away from DC instead of when we were in Durham. We meant to but never had the time! It will be good, a family trip before my parents move away, lots of pictures and memories of being together.<br />
<br />
Today is my last work day for the week, which makes it a ridiculously short one. At least the rest of the week is relatively quiet so I don't have to feel bad about leaving a lot of work for my boss to do. That is the thing about working in medicine...you can't just leave the work to pile up while you're not there, someone has to do it. It isn't a good profession for people who like to call in for sick days because there always has to be someone there covering for you.<br />
<br />
But, days off are nice sometimes and is travel, even if it is just around where you live. It is nice to have a break in routine and play tourist somewhere... even if I will be studying in the backseat while someone else drives us there.Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com1tag:blogger.com,1999:blog-5789029410647571687.post-66572066001578133422013-11-17T08:49:00.001-08:002013-11-17T08:50:25.073-08:00Typhoon Haiyan (Not related to pathology)You can't work in medicine without knowing some Filipinos. We come over as doctors, as lab workers, and nurses. We are ubiquitous throughout American hospitals, and almost all of us still have family members back home.<br />
<br />
I appreciate that my hospital system sent out emails expressing their support of Filipino employees and that coworkers asked after my family members. It took several days for my aunts and cousins to be able to contact relatives in the Philippines but outside of the effected area. Thankfully everyone is fine, and other than some roof damage, my mother's childhood home survived the storm. Also, my grandparents' house has a well of sorts so they have water, which is a big concern for survivors. <br />
<br />
A lot of people have not been so lucky and it is heart breaking to hear the news reports of mass <br />
graves of bodies to be identified later...to hear the worries of people still waiting to hear from family...and of survivors left wondering, "Now what?"<br />
<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsbHGYhKOEu7Ni5vID1lgGpl8vqkZ0fT-vHOFnc8KOMQ0xiKBa2boOT4YNmPmKM3hUA5ig7NPZXav4_8f02-fMOJDwRIQLQKmJQ27kz-5d2IeA1ylpb4ZIg9-qM-WvPAAKk_YKtzIiZPEj/s1600/bahay-kubo.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsbHGYhKOEu7Ni5vID1lgGpl8vqkZ0fT-vHOFnc8KOMQ0xiKBa2boOT4YNmPmKM3hUA5ig7NPZXav4_8f02-fMOJDwRIQLQKmJQ27kz-5d2IeA1ylpb4ZIg9-qM-WvPAAKk_YKtzIiZPEj/s320/bahay-kubo.jpg" width="320" /></a>More than anything this past week I've thought about the story of the three little pigs... The Philippines has a type of housing called nipa huts (or bahay kubo), which is made of bamboo, grasses, and/or woven mats and is built on stilts. These are not homes designed to withstand 150 mph winds.The people who have been displaced are not necessarily people who have a lot of resources to replace the things that have been destroyed. I don't know what will happen in the recovery process, but I am heartened by the attitudes of the people there. They are hopeful, they are hard working, and they are resilient.<br />
<br />
If you can<a href="http://worldnews.nbcnews.com/_news/2013/11/09/21386694-how-to-help-organizations-offering-relief-to-typhoon-haiyan-survivors" target="_blank"> help </a>in anyway, please do. Because of how long it takes to ship goods internationally and the difficulties with transporting things between islands (especially where the roads have been damaged), money really is the easiest and most effective way to help. Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com1tag:blogger.com,1999:blog-5789029410647571687.post-5158057416302001052013-11-14T19:53:00.001-08:002013-11-14T19:53:40.888-08:00Flashback to rotationsNothing specific, but an interaction with a random person in a store today reminded me of the weirdest experience with one of the residents. <br />
<br />
Me on dictation: "The specimen (an aggregate of normally soft tissue) is diffusely indurated; however, no masses are grossly noted."<br />
<br />
Two days later, the resident to my staff PA (that I'm standing next to), "Was there a mass in that specimen."<br />
<br />
Staff PA, "No, I don't think so, but you can double check with [me]"<br />
<br />
Me, "There wasn't a distinct mass, it was an aggregate and it was all relatively firm."<br />
<br />
Resident, "But a mass would upstage the diagnosis, so I need to know if there was a measurable mass."<br />
<br />
Me, "There was not a mass."<br />
<br />
Resident, "Nevermind, I'll just pull the bucket and look at it myself."<br />
<br />
Me, "..."<br />
<br />
Sometimes some people just really need to see something with their own eyes to confirm or disprove a mental picture they've developed.... that mass was her Schrödinger's cat of tumors, neither there or not there until she directly observed it.<br />
<br />
Plus, I'm pretty sure she always disliked me and when you don't like someone it taints all of your interactions with them. Luckily, I really only had to work with her on autopsy so it didn't impact the year too much (except... you know, on autopsy). <br />
<br /><br />Thatgirlhttp://www.blogger.com/profile/13664379534257317554noreply@blogger.com0