Monday, March 5, 2012

Typical Day

It's been a long time since I've described a typical day around here. Mostly because there are no typical days. Even when the days are blurring into one heavy load that sometimes crushes me into exhaustion, I cannot choose one day that accurately portrays my life.

But today was about as routine as they come. So I'll start with today...

4:50 am: Alarm goes off. I push snooze. I always give myself 5 minutes of snooze. It feels like such a luxury.

4:55 am: Alarm goes off again. No more luxury. Time to get out of bed. I've started getting up a few minutes early to do a few exercises and stretches. Because I'm losing a war with my scale. And with my pants. And so ultimately, with myself. I do crunches, push-ups, and stretches. I check to see if I can still reach my toes. Success.

5:00 am: Enough exercise. 5 minutes is enough. Head to the bathroom. I weigh myself. Okay, 5 minutes isn't enough. I wash my face, put in my contacts, brush my teeth, pretend to do my hair and make-up. Even though my eyes is all that people will see of my face most of the day at work.

5:15 am: Get dressed. Put on deodorant.

5:20 am: Downstairs to make coffee while I put on my compression stockings (don't judge, I stand a lot at my job.) I pack a quick lunch. I'm tempted to grab the delicious leftover broccoli-cheese soup, but I remember that vindictive scale upstairs and pack a grapefruit instead. I also put on my boots, because we got a lot of snow yesterday.

5:25 am: Back upstairs. Kiss a sleeping Hubster, Bug, and Monkey good-bye for the day. Monkey wakes up and wants a hug as well. I hug him tight and hush him back to sleep.

5:27 am: Grab my keys, bag, phone, and coat. Back the car down the driveway. And leave. Everyday I hate the leaving part.

5:37 am: Arrive at the commuter parking lot. Check the weather while I wait for the bus. It says it's cold outside. Yep, already knew that.

5:40 am: Get on the bus. Three of my fellow residents are on the same bus. We talk about what cases we are doing that day.

5:50 am: Arrive the hospital. Walk across the frigid parking garage to the side door I always take. Ride the elevator up.

5:55 am: Change into scrubs. Grab my pager, my stethoscope, my scrub hat, my name badge. Fill my pockets with my phone, several pens, and a marker. Drop my bag off in the resident lounge, put my depressing lunch in the fridge, grab my clipboard with my schedule, and head down to the operating rooms.

6:00 am: Grab supplies from the anesthesia work room. An IV set-up, an extra LMA. Stop by the pharmacy window and check of the drugs for my first patient. Head to my OR.

6:05 am: Get my OR ready. I have a mnemonic I follow every day to make sure I don't miss a thing. Everything I need for airway management is prepared. All the drugs I need are drawn up in labeled syringes. I'm incredibly OCD about my labels. Actually, maybe about everything.

6:30 am: Head upstairs for lecture. Today's lecture is a refresher on obstetric anesthesia.

7:15 am: Lecture is over. I meet with the resident who is rotating through anesthesia right now. We head back down to the ORs. I set up a few more things.

7:30 am: I go to see my first patient, a 40 something female, undergoing a procedure for kidney stones. She's unusual, in the fact that she's otherwise healthy. I don't have many patients this healthy. I introduce myself, talk about the plan for anesthesia, the risks of anesthesia. I answer her questions. I start her IV.

8:00 am: Arrive in the OR with the patient. The nurses ask her a few more questions. I help her move over to the OR bed. I put all the monitors on her. The rotating resident helps. My supervising staff arrives. I give her oxygen while he gives her drugs to drift her off to sleep. Once she's asleep, I place an LMA. We work with the surgical team to position her for her procedure.

8:30 am: The procedure has started. I do some charting. I do my little OCD thing and organize everything, throw away all trash, get everything pretty and clean. I talk to the rotating resident about LMAs: how to use them, their benefits, limitations, indications. I do some more charting. I check the weather. It's still cold.

10:30 am: This first procedure is over. My staff comes to the room. We wake the patient up and take her to recovery (or PACU). I give report to the recovery nurse, write a post-op note. I stop by the pharmacy window to drop of the drugs I didn't use and to check out drugs for my next patient.

10:40 am: Stop by the anesthesia work-room again for a spinal kit for the next patient. Head back to my OR to get everything ready for the next case.

10:50 am: Go see the next patient. This patient is over 90 years old and has a two page long problem list. He is at increased risk of adverse outcomes. We discuss spinal anesthesia and how it would be safer for him, given his lung disease. He stopped his blood thinning medication a week ago and the lab I ordered for him shows that his blood clotting time is at a level safe enough to do a spinal. He agrees.

11 am: Arrive in the OR again with this patient. Put on all the monitors, position the patient for the spinal. The spinal goes smoothly. The patient doesn't feel anything during his procedure and we avoided general anesthesia for him. I sent the rotating resident to lunch and then home for the day.

12:15 pm: This procedure went faster than expected. Take the patient to recovery. He is still numb from the waist down and is requiring some medication to keep his blood pressure up. Give report the to the recovery nurse, put in the order for the blood pressure medication, write a post-op note. Stop by pharmacy again.

12:35 pm: See the next patient. He already has an IV. Talk about the plan, the risks. I say the exact same thing every time. I try to be genuine and personable, but it's just the same speech every day. If I say it out of order, I forget things.

12:45 pm: Arrive in the OR with patient number 3. I offered him a spinal, but he didn't want to be awake. My staff and I drift him to sleep, "induction." Another airway is placed. I do some charting. My staff sends me to lunch.

1:15 pm: Grab a cup of ice water. Arrive in the resident lounge for lunch. Most of the residents have already eaten, but there is usually always someone here. We talk about how our days are going. We complain about how tired we are. We complain about the new scrubs. We share stories, trying to make each other laugh. I eat my grapefruit. I look at my cases for the next day. Two oral surgery cases. My favorite kind. Tomorrow is going to be a good day.

1:45 pm: Time to head back to the OR. The case is finishing up.

2:15 pm: Wake this patient up and take him to recovery. Report, note, pharmacy, OR. Rinse and repeat.

2:30 pm: Meet the last patient for the day. Say the same things. Do the same things.

2:45 pm: Arrive with last patient in the OR. Say the same things. Do the same things. Notice how cold it is in the OR. Check the weather. It hasn't changed. Check my e-mail. My schedule for the rest of residency is done. This excites, scares, overwhelms, and depresses me. I don't know why it does any of those things. Keeping one eye on the patient and the monitors, I play a round of Words with Friends. I'm losing. I do some study questions. This OR is freezing.

4:oo pm: This case feels like it's taking forever. Luckily, the patient has been very stable throughout the entire procedure.

4:15 pm: The surgeon announces suddenly that they are done with the case. Page my staff. Wake the patient up. Go to recovery. Report, note, pharmacy.

4:30 pm: Go back to the resident lounge. Do a happy dance as I enter because originally my cases were scheduled to go until 6 pm and we finished early. This never happens. I call the staff I'm working with tomorrow to discuss the two patients we have tomorrow. I'm excited for the cases.

4:50 pm: Go to the locker room, change out of scrubs and into normal clothes.

5:00 pm: Catch the bus back to the commuter lot. It is light outside and this is deliciously refreshing after not arriving home until after 7 for the last 5 work days. I call my mom and my sister, but don't get hold of anyone.

5:10 pm: Arrive in the commuter lot. Plug in my iPod to listen to happy music on the way home. Get stuck in small-town Iowa version of traffic.

5:30 pm: Arrive home. Do another happy dance for being home so early. I hug Monkey, Bug, and Hubster. Hubster is still in his scrubs from dental school; he only got home 10 minutes before I did.

5:45 pm: Make dinner. Tonight is corn and tofu lettuce wraps. I debate on lying to the boys about the tofu. But it's already written on the menu, so they'd know.

6:15 pm: Finally get everyone up to the table for dinner. Monkey has to get down three times: once for a straw, once for a napkin, and once to give me a hug. It's hard to get mad at that. I ask everyone about their day. Sometimes, this is like pulling teeth. But today, they excited about a game they played in P.E.

6:40 pm: The "how many bites" bargaining begins. I usually win by setting the first bid ridiculously high. Tonight is more successful than most. The boys have already eaten most their food. Hubster disappears upstairs to start studying. He has a test tomorrow.

6:45 pm: Encourage the boys to do their chores. Get Bug to practice his violin and do his spelling. We sing silly songs for each of his spelling words.

7:oo pm: Do dishes. Rinse out coffee mug so it's ready for tomorrow morning. Sit on the couch and just feel tired. Get sucked into the internet while the boys chase each other in circles. I read e-mail, Facebook, news, Pinterest, blogs. I shouldn't, but I do.

7:45 pm: The boys' game of tag has turned into a pillow fight. Send the boys to get in their pajamas and brush their teeth. For some reason, this is the longest part of the day. They don't want to get in their pajamas, since it's interrupting their play. But finally, Bug sets the good example and Monkey soon follows. They come downstairs for story time.

8:15 pm: Start reading. I say two stories, but like every other night, it ends up being three. You win some, you lose some. And if this is the one I lose, I'm fine with it. We read Dr. Seuss, a story of a monster, and a story about shadows.

8:40 pm: It's already past bedtime. Monkey is starting to get cranky. He goes upstairs to bother Hubster, who is still studying. I'm starting to feel really tired, but I have to read to Bug. He looks forward to this so much. I read to Bug, with him cuddled next to me, laughing at the funny parts. We are reading a novel about Ancient Egypt. We Google parts of the book we don't know. It's history lesson and reading all in one.

9:05 pm: I give Bug a piggy back ride upstairs to his room. I collect Monkey from next to Hubster and tuck him in bed. As Hubster comes in to their room to join us for bedtime prayer, Monkey starts sharing the fact he can now do subtraction. Which sets Bug off on the probability he is learning in math. We have to shush them for prayer. The last thing I say is, "We are not discussing negative numbers at this time of night."

9:15 pm: Finally, we have prayer. I kiss them both goodnight. Hubster stays and sings to Monkey. This is their thing together.

9:20 pm: Wash my face, take out my contacts, brush my teeth, change into some sweats.

9:25 pm: Sit with my laptop and two anesthesia text books in front of the TV. I blog. I haven't blogged in a while. It feels good. I watch a show from the DVR. I read a section from my anesthesia book. I talked a while ago that I was going to stop all this multi-tasking. It isn't possible. I have to do all these things at once, or I don't get to do them at all.

10:30 pm: Head upstairs. Kiss my sleeping boys good night. Every night, I make sure the last thing I do before getting into bed is kiss them. Even though Bug is so far over against the far side of his top bunk, that his kiss is delivered from my fingertips to his cheek.

10:32 pm: Hubster is still studying. He offers to move his books out of the bedroom and study in the office. But we don't get much time together, so I'm happy to have him nearby, even if the light is on and he's studying instead of snuggling. I should go straight to sleep, but I play a round of Words with Friends. I read part of a chapter in my book.

10:50 pm: Fall asleep. 6 hours before it all starts again.

As far as days go, this was a great day. I was home in time to cook dinner. I had down time. I got to read with my boys. I didn't fall asleep during dinner. My cases at work went very well.

I had planned on writing about last Thursday or Friday. Those were bad days and part of me wants to share my bad days, wear them like military stripes of what I survived. But I don't want to keep reliving the bad days. When I look back and read this again, I'm hoping that I can remember my days being like this perfectly typical day. Story time with my boys. Talking about math at bedtime. Dinner all together. There will be days that will be better and days that will be worse. And hopefully, there will be more of these typical days.


  1. Wow. That made me so tired! I can't imagine the stress load you work under.

  2. This sounds like a wonderful day.

    I'm glad you have good days. They make it easier to get through the bad ones.

  3. This makes me happy and sad. You work so hard. You work harder than me. That's a big deal because I've been really pouty lately about how much I work when I'd rather be home.

    You really are amazing. I don't know how you do it. I don't know why I say that since I find it silly when people say that to me. You just do it because it's what has to be done.

    But darnit, you deserve a nice, long vacation. You rock.

    Also, this stuff about anesthesia is terrifying. Utterly terrifying. I am getting my jaw surgery in April or early May and I am so worried that I will never wake up from the anesthesia. And then my kids...Erg. Don't get me started. I'm having what I believe is called a LaForte proceedure. It's oral surgery. Were you being sarcastic when you said those are your favorite?

    Many days lately, I've just wanted to buy a peice of land in the middl of nowhere and susistance farming and saying screw it all.

    But there are those student loan things to be dealt with.


    You rock.

  4. Your typical good day sounds exhausting to me. It is amazing that you have the energy to do all of that, and to carve some time out for yourself!

  5. As a patient, I am thankful that despite you having to say the same thing over and over and over again, you do it. Glad to hear you had an "easy" day.