A Perfect Nap

This afternoon's nap may have quite possibly been the best I've had in a long time.  After lunch I curled up on the couch with my heated slippers and a book and started reading.  It didn't take long before my eyes were feeling heavy, so I put the book to the side, grabbed a couple blankets, and bundled up for a little nap.  Next thing I knew I was waking up from a very deep sleep, feeling like I had been sleeping for hours.  A quick look at the clock revealed I had been sleeping for more than 2 hours!  It was FANTASTIC!  

Aside from my long nap, the rest of my day was pretty good too.  I hit the gym right away this morning for an hour of strength training.  After a hearty oatmeal breakfast, I braved the wind and cold and hit the farmer's market.  Today's produce included carrots (larger than I've ever seen), greens (mustard, kale, and tender), broccoli, vidalia onion, sweet potatoes, tangerines, honeycrisp apples, and a bosc pear.

I used the broccoli and carrots to make this Detox Salad.  The only changes I made were to leave out the sunflower seeds (didn't have any), and use balsamic rather than the apple cider vinegar.  This would be a perfect salad to serve during the summer when you want a fresh and crunch salad.  Definitely a winner!

Along with the detox salad I had a cup of eggplant soup and a juicy pear.  Apparently it was the perfect fuel for a 2+ hour nap!

I had planned to go for a long run today, but as I laid on the couch listening to the wind howl, I quickly decided to save that for another day.  Instead, I dragged myself off the couch and nailed a 3000m swim.  Then I continued the relaxing theme of the day and enjoyed a bubble bath.

Dinner tonight included more farmer's market veggies.  I picked up fresh spinach florentine ravioli a few weeks ago at Earth Fare (one of their free items with purchase that I LOVE).  I stuck it in the freezer, but pulled it out tonight for an Italian meal.  I sauteed vidalia onion, garlic, and a mix of tender and mustard greens in a little olive oil.  Then I added a jar of tomato basil pasta sauce and let it simmer for 15 minutes.  After a quick 5 minute boil, the ravioli were ready to be served.  Fresh parmesan reggiano finished off the plate.

I'd say it was a pretty successful Saturday.  Workouts + Hibernation + Tasty Meals.  Time for a movie.

Vampire Diaries

February marks my last month on orthopaedics as an intern.  In an attempt to become more comfortable taking call, I had planned to spend this entire week on night-float with one of the 3rd year residents.  There is a single junior level ortho resident in the hospital each night to handle all of the orthopaedic consults and in-house patients.  You essentially work Sunday - Thursday nights from 5pm - 7:30am the next morning.  Unfortunately, my night-float schedule didn't exactly go as planned this week.  I worked Sunday and Monday nights, then had to work Wednesday during the day, then switched back to nights again on Thursday.  The end result was a very sleep-deprived Crystal with a completely altered circadian rhythm.  I've slept for a grand total of 26 hours (in increments of anywhere from 2 -7 hours) since Sunday morning.  Can you guess what I'll be doing this weekend?

In the midst of a crazy week, pictures like this kept me smiling.
Wish you were here to snuggle up and sleep with me this weekend, Bailey!

Aside from the crazy schedule and work politics, I learned a TON this week.  It's definitely intimidating knowing that come July 1st, that solo in-house resident will be me.  However, after this week, I can honestly say that I feel much more comfortable managing ortho patients and the whole system of patient care from ER to OR.

It's crazy how out of sync my appetite became this week without a normal schedule.  I essentially ended up eating whenever I got hungry, whether that was at 5am or 11pm.  I probably ended up eating less though because I never really felt hungry like I normally do before each standard meal time.  Here's what kept me energized:

Hummus toast and lots of fresh veggies

3am:  Crashing hard, more consults to see, and a freezer full of ice cream.
I don't remember the last time I had an ice cream sandwich.  Yum!

Seared tofu, roasted parsnips and carrots, orange

Mixed veggie salad, coconut chicken, and pizza toast

Seared tofu with mango BBQ sauce, butternut squash puree, and  chopped veggie salad

The most exciting food photos this week are of Veganomicon's Caramel-Apple Spice Cupcakes.  The resident I was working with on nights had a birthday this week, so it was the perfect excuse for me to bake.  If you don't own a copy of Veganomicon, then this recipe alone is reason enough to make the purchase.  OMG - these are AMAZING!!  They are incredibly moist and topped with a decadently rich caramel icing.  You'd never guess they are vegan!

The finished product, complete with hand piped frosting.

Workouts have been decent this week, considering the odd work hours and fatigue.
Monday: 5.5 mi endurance run
Tuesday: swim speed work, 1hr bike
Wednesday: 1hr strength training (kick-butt athletic conditioning class at the Y)
Thursday:  swim pull intervals, 5 mile run
Friday: 1hr 15min bike, yoga
That puts me at just over 6 hours of training so far for the week.  Plans for the weekend include strength, a long run, speed work in the pool, and a 2hr bike trainer session.

Time for some lazy couch time and movie watching.  Something tells me it won't take long before I'm staring at the back of my eyelids.

In Memory

Judy Maiuri

1949 - 2012

My Great Aunt passed away earlier this week at the young age of 62 after a long battle with metastatic breast cancer.  She was truly a remarkable woman who lived life with great passion and devotion.  She treated me as if I was one of her own grandchildren and has always been an enthusiastic supporter of my endeavors and accomplishments.  Below are just a few pictures of us together.  Rest in peace, Aunt Judy.  You are much loved!

Me with Aunt Judy and Uncle John at my graduation ceremony from Agnes Scott College in 2006

Husband and Wife.  What a great pair!

Celebrating graduation from medical school.
Augusta, GA 2011

Grandma, Aunt Judy, me, and Mom
Christmas 2010

Falafel and Cookies

You know it's a great day when one of the options for lunch in the cafeteria is a falafel and hummus salad.  I nearly squealed with joy!!  It was certainly not the amazingness that is the Taim falafel pita, but it was pretty darn great for a hospital cafeteria.

Please excuse the rather ugly picture.  I was so hungry that I began to dig in to lunch before I stopped to take a picture.
Spring mix, tomato, cucumber, carrots, sprouts, bell pepper, cabbage, baked falafel, and roasted garlic hummus

Tonight after I finished dinner I had a hankering for a freshly baked treat  I happen to see a picture of  a lemon layer cake while browsing Pinterest and suddenly HAD to have a slice.  Unfortunately, cooking a lemon layer cake at 8pm wasn't exactly feasible.  I did, however, recall that half of a lemon was sitting in the refrigerator waiting to be used.  So with inspiration and ingredients, I quickly through together a little baking experiment.

Tart Luscious Lemon Cookies

Ingredients:
3 tbsp Earth Balance
Lemon Juice and Zest from 1/2 of a fresh lemon
1/4 Cup Sugar
1 tsp vanilla extract
3/4 cup unbleached all-purpose flour
1 tsp baking powder

Directions:  Preheat oven to 350 degrees.  Combine earth balance, lemon juice and zest, sugar, and vanilla extract.  Beat with a mixer until smooth (30 seconds).  Gradually mix in flour and baking powder.  Mix until just combined.  Roll spoonfuls of dough into one inch balls. Place on a greased cookie sheet.  Use the back of a spoon (or your fingers) to slightly flatten the cookies.  Bake for 8 minutes.  Cool on a baking sheet for 2 minutes before removing them.  Enjoy immediately!

If you're looking for a tart lemon cookie, this is definitely your recipe.  It literally took 15 minutes from the time I started gathering ingredients to the time I was enjoying bite after bite of lemony goodness. Enjoy!

Hour by Hour

Anyone curious about all of the fun and excitement that is squeezed into my average day on the ortho trauma service?  Here's what today looked like:

4:10am - alarm goes off.  lots of negative thoughts race through my head that essentially revolve around the fact that I don't want to get out of my nice warm bed at such an early hour.  i know I have just 20 minutes until I have to be pulling out of the garage though, so I'm up and moving right away.

4:25am - throw a piece of bread in the toaster and slather on some almond butter and cherry preserves.

4:30am - in the car headed to work.  enjoy my PB&J toast along the way.

4:40am - pull into parking deck at work.

4:45am - review the ortho admissions from overnight and update our list of trauma patients.  print patient notes and review any important events from overnight.

5:15am - hit the floors and start rounding on my patients.  you can imagine how thrilled patients are to be awoken at this hour for me to poke and prod at their injured extremities.

6:00am - finish rounding (rare morning with only 4 patients to see). finish reading articles on pediatric non-traumatic cervical disorders.

6:15am - caribou coffee time!

6:30am - trauma checkout and peds ortho conference

8:00am - no nurse practitioners to cover the floor and consults, so I assume control of "the bomb" (the name we have ever so thoughtfully assigned to the pager that receives all ortho floor questions and consults for the entire hospital).

8:02am - consult #1.

8:05am - quick breakfast of overnight protein oats and strawberries while reviewing the xrays of consult #1.

8:10am - consult #2.

The morning continues with a total of 4 consults.

11:45am - sit down at a computer to update our patient list.  just 5 seconds after sitting down the pager is going off.  it's Major (i.e. the highest acuity trauma section of the ED).  you can only guess that it's never good to be paged by them.  consult #5 comes my way.

12:30pm - quick slice of whole wheat veggie pizza, steamed veggies, and apple while reviewing morning xrays with my upper level residents

12:45pm - yet another consult from major.

1:30pm - pediatric ED.  Consult #6.  put a long arm cast on a wiggly 2 year old.  not an easy task.

2:00pm - if the same nurse from the floor pages me another time (I've already received 10+ pages from her today), I'm going to get angry

2:30pm - issues with patient on the floor.  time to be the tough guy and refuse to continue to increase pain meds.

3:00pm - major calling again with consult #7.  another broken bone, another cast.

3:20pm - back to the floor to fill out paperwork for a patient going to a nursing home.

3:30pm - consult #8.

4:30pm - finally caught up on consults/floor problems.  head to the surgeon's lounge to do some massive list updating and review xrays from consults.  hungry again - banana, granola bar, water.

5:00pm - our night float resident arrives and we review pending films and chat for a bit.

5:10pm - time to escape!  quickly change into running clothes.

5:20pm - throw bag in my car and head out for a run from the hospital.  try to forget about work and clear my head with a 5.5 mile run.  BEAUTIFUL weather makes that pretty easy to do!

6:08pm - in the car and headed home.  hit charlotte "rush-hour" traffic (nothing compared to atlanta, but frustrating nonetheless)

6:32pm - arrive home.  14 hours after I left.  shower.

7:00pm - dinner time - reheated spaghetti squash, black beans, and avocado salsa. watch national news.

7:30pm - catch up on the 50 million emails I received over the course of the day that I was too busy to deal with earlier.

8:33pm - typing this blog post.  not really sure why I'm wasting time doing this when I should be curled up in bed.

8:34pm - pushing publish. plan to grab something sweat to eat then headed to bed.  need my beauty sleep to do it all again tomorrow.

And that is the glorious life as an orthopaedic surgery intern.

Squashed

How is it already Sunday night?  Does anyone else find that Saturday and Sunday are much shorter days than are Monday - Friday?  Somehow those weekend 48 hours pass so much faster than those during the week.

Today started as I rolled over and saw 8:35am on my alarm clock.  Seriously, 8:30am?  That means I slept for 10 fabulous hours.  I was cozy in flannel pajamas and buried under four layers of sheets/blankets.  That must be the secret to a really great night's sleep.  Well, and maybe the sleep deprivation plays a role as well.  I moved from my bed to my comfy leather chair and bundled myself in a blanket with a mug of tea.  Somehow, the next thing I know it's 11am and I haven't done anything productive.  It felt so great just to be lazy!

Once I got moving, I put some energy into my workouts - 45 minute recovery bike and 2500m in the pool with descending intervals.  Man am I sore after strength training yesterday!  150 push-ups is no joke!

Tonight's dinner inspiration was from Veganomicon - SPAGHETTI SQUASH MEXICANA WITH TROPICAL AVOCADO SALSA FRESCA.  The dish came together pretty quickly and was a great mix of flavors.  Unfortunately, I forgot that I needed a ripe avocado and had only unripe ones on hand.  So, it was avocado-less.  I had a hefty pile of roasted kale on the side.

And to finish off the evening I enjoyed an hours worth of girl-talk with a good friend while we indulged bowls of Yoforia frozen yogurt.  Despite the arctic cold weather, it was a fun treat.  My only disappointment was the lack of hot fudge that my froyo was desperately needing.

And with that, the weekend comes to a close.  Time to set the alarm for 4:00am.  Oh, how I love being a resident.

Not Enough Time in the Day

The start of another month and my disappearance from the blog could only mean one thing - it's another month on ortho trauma.  Very early morning rounds combined with OR cases running into the evening leaves me with very little time to accomplish much of anything other than a short workout and sleep.  My perfect night's sleep would be somewhere between 8-9 hours.  On busy months like these, I'm lucky to get 6 hours each night.  While I feel fine when I'm busy, the fatigue hits hard the second I slow down.

Meals haven't been all that exciting recently.  Lunches at work are eaten in a hurry between OR cases.  Depending on the OR schedule, there's not time for a traditional lunch, and instead I snack between cases.  When I do get a chance to go to the cafeteria, I most often opt for a giant salad with lots of great toppings.  Sometimes, however, I'm desperate for a warm meal after freezing in the OR all morning.  

Curried green beans, corn, tomato bisque, and foccacia.

Chickpeas and Eggplant, Cinnamon Carrots

Sunday I made a pot of pasta in preparation for the week.  It was a saute of shitake mushrooms, garlic, spinach, and diced tomatoes mixed with whole grain spaghetti and topped with fresh parmesean cheese.  It was quite delicious and I really enjoyed it the first two nights.  However, by the time I was finishing the last of the leftovers on Thursday night, I had my fill of pasta.  Cooking during the week is nearly impossible though, so microwavable leftovers is the only feasible option.

Today has been all about sleeping in, exercise (strength training, run, yoga), running errands, and relaxing.  I love days like today!  Now I'm curled up on the couch with a warm blanket watching TV while I type this post.

Breakfast was a classic - PANCAKES!  Today's stack was topped with chia charger almond butter, cinnamon brulee bananas, chia seeds, and maple syrup.  Served alongside was some plain greek yogurt with chopped strawberries.  Perfect breakfast to fuel my morning workouts and shopping.

The farmer's market was packed as usual, despite the bitter cold temperatures.  For just $8, I picked up everything in the picture.  2 bunches of kale, 3 tangerines, 2 bosc pears, tomato, green bell pepper, vidalia onion, beets, spaghetti squash, and pea pods.

Mid-morning I hit the YMCA for athletic conditioning.  While it's not quite the same as The Sport Factory's strength class, it's a very challenging strength workout that pushes me much harder than I ordinarily would push myself.  Case in point - I did 150 pushups this morning.  It's quite possible that my shoulders might not function tomorrow.  I followed that with a quick, yet productive treadmill speed workout that left me a sweaty mess.

Dinner tonight was eco-friendly fresh salmon, pearl whole wheat couscous, and roasted asparagus.  The salmon was marinated in a combination of balsamic and orange juice, and is topped with a reduction of the same sauce after it roasted in the oven.  The pearl couscous was sauteed with onion, garlic, and spinach, and then cooked in white wine + water, and seasoned with paprika and curry.  The asparagus was simply roasted with EVOO and lemon juice.  

I have so much fun in the kitchen when I actually have the time to prepare excellent meals.  Unfortunately, that just doesn't happen as much as I'd like.  Tomorrow I'm ready for another day of good eats.  Spaghetti squash is on the agenda for dinner, and I might just have to do a little baking too.  

Until then, it's time to get some sleep.  My heated blanket is already turned on, which means my bed is calling.  Good night!

Step 3, Done?

I'd like to be kicked back relaxing and relishing the fact that I am officially done with USMLE and their ridiculously stressful tests.  I did, in fact, finish day 2 of the exam today.  480 multiple choice questions and 9 clinical case scenarios completed over the course of 2 days.  Sounds like fun, right.  Well I guess I was having so much fun today that I clicked on a wrong button approximately halfway through a question block and ended the block.  The downside of computer based testing versus old-school scantron is that you can't go back and fill in questions you didn't answer.  And thus the reason I'm feeling less than confident - 20 questions that went completely unanswered.  Big mistake!

I'm just hoping that I had enough correct answers to buffer those 20 unanswered questions.  Now rather than blocking the test out of my brain and feeling confident I did plenty well enough to pass, I'm stressed out knowing that I have a 3-4 week wait until I learn the fate of my STUPID mistake.  Hopefully I won't be reliving the joys of test-taking yet again a couple months from now.

Fortunately the weather was beautiful outside this afternoon and I soaked up some 72 degree sunshine and caught up on the many magazines that were accumulating on my living room table.  Evidently the groundhog thinks we're going to have 6 more weeks of winter.  Hmm, I think he's either very confused or there's some dramatic weather changes headed our way.

Workouts today featured 2000 meters in the pool at 5am and then a 90 minute bike tonight.  I'm trying to stay focused with workouts this month despite being back on ortho and having very minimal free time.  We'll see how that goes.  At the very least, my goal is to get good QUALITY training sessions even if duration and frequency has to suffer.

Dinner tonight was a big salad.  I mixed a can of Trader Joe's tuna with half of an avocado and a couple tablespoons of dijon mustard to create a tuna salad.  It was the topper for my base of spinach, edamame, bell pepper,  broccoli, tomato, cucumber, sweet potato, parmesean cheese, and a drizzle of balsamic vinegar.

I'm off to read an article about Sarmiento braces in the treatment of diaphyseal humerus fractures.  Sounds riviting, right?