thankful, reconnaissant, agradecido, a be plenty thankful soteh...

Apologies for not writing in awhile...life has found me rather busy.  Really, by the time I get home, get a work out in of some kind, eat dinner, I can barely raise my arms for the remote control, let alone type out a post.

Today I find myself up in Olympia to spend time with the family.  My SIL and I got up to participate in the "Oly Trot"... a 4 mile turkey trot this chilly morning at 8am.  It was great to get up and get going... however there were about 700 runners attempting to run around Capitol Lake which has a path for about 3 people wide, which made for some annoyingly slow moments.  Not that I am a fast runner by any stretch of the imagination, but when you're stuck behind a family of 5 with a stroller... it's annoying.  When we finished the run, they had run out of cups for water (which were small Dixie cups)... which almost sent me over the edge...  Really? Is this your first day? Effing amateur hour!  I mean, don't ask me to pay $35 bucks and not have any water!!! I'm just saying. Oh yeah, it's Thanksgiving and this post is about being thankful.

The past year has been pretty tough, and now that I'm am starting to see the sun peep out behind the dark clouds, I am reminded of what I am thankful for:

1. My wonderful friends who inspire me on a daily basis.  I have been fortunate enough to have collected an incredible gaggle of great friends through my travels and life experiences. My only complaint is that they are scattered all over the country and beyond... would love it if they all lived in my neighborhood.
My dear friend Kate is in India right now particpating in a medical rickshaw race from Mumbai to Dehli.  Not only am I super proud of her, but I'm extremely jealous... as I feel she and I would have made a fabulous team... I should be there! Please check out this link and if you feel like you have a coin to spare, consider donating money to this worthy cause.  http://www.crowdrise.com/rallyforhealth and http://www.facebook.com/RallyForHealth

2. My family and my family's health. My family experienced a bit of a medical turbulence earlier this year and fortunately, the outcome seems to be ok... I am very thankful for that.  One of the greatest lessons I have learned by being in health care is that life is precious and the fact that I and most of my friends and family have adequate access to health care should not be taken lightly.  I think of this on a daily basis as a primary care provider... my decision making is often dictated by not what test to order but what test will the insurance pay for if any...

3. Being the Eff done with school! I am pretty GD thankful for that.

4. I basically hit the lottery with my new job... and I feel thankful that I even have a job considering the economic climate and this job is pretty money.  I don't have the pressure to see 5 million patients in a day... which as a new grad is pretty incredible.  I am able to take my time, which comes as a blessing considering I am practically looking things up with every visit trying to figure out what the heck to do.  I am  hopeful that this parts gets a little easier as time goes on... there is just SO much to know.

5. I feel very lucky to have access to amazing, healthy, local food.  I've attached pictures of the PSU Saturday Farmer's market... I went two weekends ago and it was incredible.

Only in Portlandia!

Celery on Roids

Ok, now I need to get fired up to enjoy yet another Thanksgiving dinner with my family as the only single member of the clan.  Cheers! Happy Thanksgiving! Bon Appetit! Chop Fine!

whoa...we...whoa

I've mentioned in previous posts is that recently I finished a doctorate program while working part time and thought that short of having a newborn...it seemed unfathomable I could be as tired as I feel after my first full week as a primary care provider.  I get off of work and feel as though my head might explode, starting this new career has been way more mentally draining than I had ever expected.

Because I have a completely open schedule, when patients call the clinic wanting to be seen that day, they see moi.  What I feel most comfortable doing are well women exams....history taking, physical including a pap and then a discussion on birth control options.  I would have been over the moon if I had several of these said appointments on my schedule to begin my first week.  Start with what you know right, then work up to the hard stuff? Wrong-o.  No, I get to start with the acute illness patients...I walk into a patient's room to find a man who got jammed in the abdomen by his boat's anchor or the blind, bilateral below the knee amputee (bbka), type 1 diabetic has severe bone pain under his dentures....WTF?  As I am taking their history, I'm multi-tasking with listening to what they're saying whilst shitting my pants a little trying to figure out what the hell I'm going to do for this patient.  Luckily there are 5 other providers in my practice and one day, I asked each one of them 5 separate questions about 5 separate patients.  Thought I would share the love a bit (read: I don't want them to all think I'm a complete idiot). Honestly, is there ever going to be a day where I know what the f%&k I'm doing?

The crazy part of it all is...I write prescriptions...and sign them...and the patient goes to a pharmacy and fills them.  This is an odd sensation.  I mean the last three years of my life have been spent sitting in a provider room, shoved in a corner, attempting to be completely out of the way....sucking down an iced quad americano trying to appear cool, calm, collected and awake.  If I was lucky I would get to interview my patients alone and return to my preceptor with a case presentation and a plan of some sort, which would be commonly be responded by: "well...that's a good point but, we are actually going to do this (insert their plan)...nice try".  I spent hours writing the perfect SOAP note which no one read except a clinical instructor who got her jollies off by making me cry.  Basically my point is this, I've spent three years without responsibility of making critical clinical decisions without someone looking over my shoulder.  Now, I have my name on stationary, business cards and prescription pads.  How did I get here?

Don't get me wrong...I've never felt more certain that I've taken the right path for myself, it's a solid fit.  ER nursing had me pretty burned out, I enjoy the ability to build relationships with patients and my A#1 goal is to keep my patients out of the ER for an unnecessary ailment.  However, it is tough.  One night after work I found myself swimming laps thinking with each stroke resonating over if I had put a patient on the right medication that day...ugh.

I have a fun weekend planned...hitting the famous PSU farmers market and a run in the park with Amiee...and my sister is coming down Saturday night.  Hoping to catch up on some Z's too.  Until then...one day at a time.

Only in Portlandia

As mentioned, my sister-in-law came down from Olympia this weekend for a visit and also helped me through the final push of unpacking. Our recurrent quote as Liz and I drove and ate around Portland was "Only in Portlandia!"  I am starting to settle into Portland but I gotta tell you; Portlandians are so nice, and it's requiring a bit of an adjustment.  Examples to follow.

I have heard and am experiencing first hand the food/restaurant utopia of Portland.  Friday night Liz and I headed to Montage a place that has come highly recommended by my Macaroni and Cheese expert SEF and some others.  The place was packed....we enjoyed some great cocktails in the lounge before getting our table which was a place on a long...community-style setting where you are eating elbow to elbow with a complete stranger.  Then, after stuffing my face with mac and cheese...this willowy gal with dread locks (my guess is her former life was a dancer at a Dead show) swept in to take my leftovers and returned with a aluminum-foiled scorpion (Liz got a crab). Only in Portlandia!   We then headed back towards my house and I found a great bar called Circa 33, where they had an exceptional bourbon list and fantastic garlic fries!

Saturday night after a long day of unpacking, an IKEA stop (aka a trip to Hell), a 3 mile run and a Zuzana workout....Liz and I headed to PokPok.  A once food cart turned into restaurant...tent style. Only in Portlandia!  The thing about Portland is, I feel like there is some sort of code that I haven't learned yet, it takes me back to a mindset similar to how I constantly felt in junior high/high school where you never want to be perceived as not knowing what to do.  Our initial encounter with PokPok brought up that anxiety...it could have also been the Hangries I was experiencing at the time BUT it goes like this: you go in an check in with the hostess at PokPok...then you cross the street over to the Whiskey Soda Lounge where you give your server your piece of paper.  Now you are free to order drinks and appetizers...when your table is ready at PokPok...they "communicate" with the WSL people and you walk back across the street to eat.  Thankfully some kind Portlandians directed us...which relieved a small portion of my social anxiety, Only in Portlandia!  Then we sat down to eat... we soon discovered that PokPok is not your run-of-the-mill Thai place (read: no phad thai, drunken noodles, etc...), finding ourselves looking around at our neighbor's food (again, close quarters)... when a very friendly young lady asks "have you ever eaten here?"..."no" we replied, "but hear it's amazing".  She then proceeded to get the entire table involved in giving us suggestions of what to order.  After Liz and I looked at each other saying silently, "why is she talking to us? is this for real?! are people really that nice here?" Only in Portlandia!   Now I was feeling confident and ordered for Liz and I, they have some of the best chicken wings I've ever put in my mouth and an incredible curry soup.  When our neighbors got up to leave, we felt obligated to 'gain closure' and eagerly, waved goodbye to our young friends...so much to learn, and such a far cry from Seattle.

All in all it was a great weekend.  I will admit to a few moments of being extremely overwhelmed and wanting to lie down on the floor when Liz was gently forcing me to unpack the rest of my boxes and to get organized.  This is not one of my strengths and I am well aware of this...although I am fine helping others organize their stuff, but that's pretty common right?  A lot of dialogue from the weekend went like this:
Liz: "Wha, What is this?"
Me: "What? Oh...that's one my box of letters that I've received over the years"
Liz: "Do you go back and read them"
Me: "No, but that's not the point, I heart letters and cannot throw them out"
Liz: "K, there is just a lot of stuff here, are you sure you want to keep them? Seriously?"
Me: sweaty palmed and tachycardiac, "YES, they are important to me! ga gow!!!"
Liz: shaking her head..."ooookaaay".
I heart your face LP!!!

Entering my first full week of seeing patients...as many of my friends say, "try not to shit yourself Haws!"...one day at a time.

and....SCENE

As promised I mentioned that I would let you know about my first day seeing patients.  Well... the morning started off with a bang when I didn't wake up to my alarm...0836 I shot out of bed to make myself presentable for a possible patient at 0900!!!!  Thank the universe I live a whopping 5 blocks from work...and my first patient was scheduled at 1000.  Little did my first patient know that I was busily watching modules on patient charting in the new electronic medical record system up until the minute I entered the room!  I know my school friends are smiling right now saying...typical Haws, waiting until the last minute.  As SEF and I like to coin ourselves as pressure prompted versus procrastinators...not much has changed.

The day progressed with similar anxieties, my next patient had a plethora of problems and I won't violate HIPPA here but lets just say I was walking at a fast pace up and down the halls...back and forth from our lab asking what culture vial I collect for what and resorting to my wonderful Medical Assistant (also brand new to the clinic) who gave me that look of...wouldn't this have been nice if we had been given a little training?!  What should have been a solid 30 minute appointment turned into 90 minutes...but I believe (and hope) my patient left feeling like I had been somewhat thorough.

I saw a grand total of 4 patients today, but I have to keep in mind...it was four more than I had yesterday and I dream to look back to this first day (which in reality will be the first few months) and smile.  Holding up to a solid standard...I do believe that I DID NOT kill anyone today!  Hooray!  Just keepin' it real.

I managed to muster the energy to drag my fat ass to the gym to do yet another Zuzana workout at the gym after getting home...even though my new couch and a plethora of "On Demand" episodes were calling my name.

I'm entering Friday trying to constantly recall the message my best girlfriends constantly advise me: "be kind to yourself!"  There was a point this summer, honed up in the windowless office, sitting next to my chair of my committee...(who continues to get so caught up in the minutia, it's a effing wonder the crazy bitch gets herself dressed in the morning) hemming and hawing over a semi-colon in the final report of my capstone thinking..."I'll never get out of this academic hell..."  And here I am a short 3 months later finding myself feeling slightly elated and uneasy about the fact that I don't have hours of homework waiting for me when I return home.  I no longer have to mentally prepare myself to gear up for a weekend of 3, brutal 12 hour shifts in the ED after 5 solid days of class, clinical and papers just to make ends meet.  I am still in disbelief that I've finally reached this point.

I'm looking forward to a weekend with one of my favorite people on this earth...my sister-in-law (who is more a sister/best friend than anything) is coming down to visit Portland and me.  I'm hoping to have her help me unpack some more boxes and organize the house a bit more...I've found myself a bit stuck with the nesting portion of this move...I've lost my mojo and hoping Liz will help me get out of the vortex.  The other goal is to hopefully walk around Portland (unless it's unrelentingly raining) and find some new treasures I will tell you about.

Until next time, I'll leave you with a very wise mantra from Tony Horton himself - "Just do your best and forget the rest"....that's really all we can do isn't it?

Fog and Sunshine

Today I was lucky enough to have the day off granted by my new boss...Mrs. C, a quirky, lady in her 70's who is the administrator at my new clinic.  Everyone calls her by her former name, even the MD who has been at the clinic for 25 years.  Anyway, tomorrow is my first day to see patients...so I was given the day to get some errands and regrouping accomplished.

I met my friend Amiee for a run at Forest Park....we traversed over the tricky terrain on a new trail (to me) called Maclay Park.  It was beautiful sight as we wandered up the switch backs....me huffing and puffing at a barely running (more of a fast walk) pace and Amiee constantly looking back to make sure I wasn't cyanotic...the Maclay Park trail is adorned with ferns, moss and patches of sun.  We then filled our empty bellies at a local eatery, the Cricket Cafe on Belmont for a hearty breakfast...served by a very odd, overly tall, aloof server...but I enjoyed every sip of the stumptown coffee as he absentmindedly refilled my cup.

Somehow I was talked into motivating to go to the gym to get our Zuzana on.  If you haven't checked out the BodyRockers blog....Zuzana is this crazy buff Czech woman who has a workout blog....she kicks your ass.  Needless to say my legs are now overridden with lactic acid!  and P.S., mountain climbers = not such a great idea after eating the Ranchero Hash...just sayin'.

While we were driving over the downtown bridge to Forest Park this morning, the sky was amazing...fog and sun, the picture of the building I've included looked like the building was on fire when in fact it was the sunbeams reflecting off of the building.  We also stopped at a lookout after the run where we saw a spectacular view including Mt. St Helens, Mt. Adams and what I think was perhaps Mt. Rainer (second picture)....it was incredible.

After the gym I came home to find a lovely card from my dear friend Lisa in Vashon....made my heart smile to read her beautiful handwriting and informing me of her latest goings ons.  Amiee and I set off for a chai at our favorite tea shop and I indulged myself with some new paper for bookmaking at Paper Source.  Keeping to a new pact with SEF,  I signed up to be on the list for a letterpress workshop, a craft that never ceases to amaze me.  

As mentioned, tomorrow is my first day as an official provider.  Since I was not at the clinic today, I have no idea if anyone is on my schedule, all I know to do is to show of for a possible first patient at 9am!  It all seems so surreal and am excited (and scared)... I will let you know how the day goes...feeling like I'll be living by the mantra...fake it till you make it...whoa we whoa.

Enjoy the crisp autumn air.  Sitting now with a glass of a great new Riesling Kungfu Girl.

Je commence plus à Portland

Ok, so don't get too impressed with the title, my french is shotty at best. I recently spent four days in Vancouver, B.C. with one of my dearest old friends. I recently completed my doctorate and after 3 and a half long, grueling, emotionally-tough years I treated myself to an "international" trip... not to offend the Canadians, but I was hoping for the southern hemisphere for my travels, however Sallie Mae and Direct Loans sort of have me by the nuts. Anyway, the point of this is that my dear friend SEF, is an avid blog reader and after hours over bourbon and Prosecco...I am inspired to start a blog. On Vas Vois!

As I mentioned, I am on the other side of a very difficult doctoral program and have landed in Portland, Oregon. Not a far move as it was only 156 miles south on I-5 from Seattle, Washington. I am starting over...leaving a broken heart and spirit and a sleep deprived self in Seattle to start afresh in Portland. I have a new career...I'm an adult and women's health nurse practitioner and have landed in a great family medicine clinic to establish myself. I would be lying if I said I wasn't scared out of my mind...I'm a former Emergency Room RN and this is a lot of responsibility to become a primary care provider. But...I've spent many long hours preparing for this day and it is time.

I plan on blogging about new finds in Portland, trials and tribulations of my new job and my journey to returning to my former in-shape self. Maybe no one will read it...but my plans are to find myself here and discover the treasures of Portland everyone is talking about. I am starting to work out with Zuzana on Bodyrockers inspired by my extremely fit, good friend...her blog is attached to this so feel free to join me!

Cheers!

Put a bird on it!