Bizarreness

I woke up early this morning, thinking it was going to be a good day. I spent some time in prayer, praying that the Lord would conform my will to His and that He would protect me from all of the onslaughts of the devil. Basically I just prayed for more of Him and more of His presence, and His forgiveness for my sins. It was sooo good. But, because it was so early, and I didn't need to be up for another hour to get to my 8am class, I decided to sleep a little longer.
Suddenly, my eyes flew open and I looked at the clock. "Oh crap!" I shouted, and bolted out of bed. It was ten to 8, and my teacher is a stickler for being on time. I threw on some clothes, grabbed a piece of gum (cause I didn't have time to brush my teeth; ewwww, I know) and tore out of the door. I ran into my friend who had been waiting for me to come get her, and then gave up on me. So, we pretty much sprinted to class. Hot and sweaty, we waited for the world's slowest elevators to take us to the 17th floor, where class is. Wouldn't you know it, it stopped at nearly every floor. With each delay, I was getting more and more anxious. It was a long week, and I was so tired from everything going on, and now I was going to be late to a class that I should not be late to! Plus, I hadn't had my coffee, so I was barely coherent, still had pillow creases on my face from sleeping, and hadn't eaten so I was lightheaded.
The elevator doors opened, and we ran out, dashed around the corner and down the hall to class. The clock on the wall said 2 minutes to 8, but our teacher had already started...
It was then break time, but only a short one. But I needed caffeination and food-ation if I was going to make it through. So my friend and I went down to the coffee cart outside and got egg sandwiches and coffee. But the coffee I ordered went to someone else, and I ended up with her large coffee. And it took forever to make my sandwich. I was going to be late again. My friend kindly waited for me, even though I didn't want to make him late. So, we get back upstairs, late, and sit down and start to eat our sandwiches. At one point, I dropped some egg on the floor and leaned over to pick it up. My leg jostled my desk, and tipped over my large cup of coffee onto my notes, across my desk, and onto my leg where it proceeded to soak my sweats. My friend Kevin sprang into action and got me some paper towels, and Craig sopped up what he could and threw the mess away, all while my teacher is lecturing. This is in a small classroom, with maybe 40 students, so we weren't being unobtrusive. It was a mess.
So, I'm sure my teacher thinks that I am someone who doesn't respect timeliness, and then makes messes and disruptions in class. And it is only the second day of this rotation. Oy vey! Okay, off to take a quiz now. Hopefully I won't impale myself with my pencil, but with the way things have started, it doesn't seem too far outside of the realm of possibility.

A Poetic Pathophysiologic Ode to Hearts

This is what my life has become. I am now writing poetry about what I am learning in school. Some tidbits:


(Disclaimer: the poems that follow might sound bitter, but they are written with no one in mind; just silliness during Patho class!
(These are dedicated to all my fine friends in the healthcare field who are learning all this business with me...I love you guys! Couldn't do it without you!))


Why do you hurt me?
You know my cardiac cells can't replicate...
your hurtful words, your hateful actions,
your neglect lead to ischemic scar tissue.
My heart, which once beat for you
now beats arrythmically
interrupted by the scar tissue of your hate.
My heart, once strong, once healthy
is now on the fast track to sudden cardiac death.
Rapid decompensation, as a result of the diuresis of my tears,
drives my heart to necrosis.
If only cardiac cells replicated
but they don't.
And you're the jerkface who killed them.
~S.Weinkauf, aka, "the Love Doctor"

Heart Haiku

Right heart fail
Congestion of peripheral tissues kills my heart stone dead
I am scarred

Arteries are red,
Venules are blue,
Fibrosis leads to heart failiure,
and so do you!
Happy Valentine's Day!
~A. Manko

My cardiac output is declining
As the multiple hormonal compensatory response of your silence deactivates
my renin-angiotensin system.
My atrial naturetic peptide
is no longer enough to increase my sodium reabsorption
I am edematous with pent up emotion.
The vasoconstriction of my arteries
makes me white, like a ghost
This is how I looked as you walked away.
the net effect of your neurohormonal response
potentiates the degree of my heart failure.
Your love, once verdant, increased my preload;
Your words, now bitter, decrease my afterload.
The vicious cycle of this pain shuts down my sympathetic stimulation, decreasing my heart rate and contractility for you...
~ The Love Doctor

Alterations in the Frank-Starling Mechanism with CHF: by S. Weinkauf

My left ventricular end diastolic pressure decreases as my cardiac output increases.
If my heart were healthy, my x and y axis would be proportional;
because of what you've done, even if more blood enters my heart,
my contractility and output are static.
Does Frank-Starling mean nothing to you?
You change the laws of nature;
structural heart disease without symptoms of heart failure means zilch, right?
Like poison, you change my heart's afterload
and left ventricular end diastolic volume by decreasing my blood volume by inducing my tears, you nerd!
I wish you'd give me back the wasted beats,
the healthy filling capacity.
The days when Frank and Starling ruled my heart's ejection fraction.
But quoth the cardiothoracic surgeon, "Nevermore."

Last Week's Miracle

Last week was really hard, school-wise, and incredibly exhausting. Case in point, I slept in til 2pm today, and 12pm yesterday. That isn't usual for me, as I am a morning person. But I saw the most amazing thing last week which was a ray of light to me and a reminder of why I'm doing this.
I have been in my OB-Gyn rotation these past few weeks. I am working at a hospital in an area of town that is predominantly Spanish-speaking, and of Dominican heritage. I love these people, and am loving this population more and more each day. And I have been blessed to witness two additions to their community this past week.
I came into the Labor and Delivery portion of the hospital on Wednesday morning, not really sure what to expect, but excited for anything. Because I used to work in the NICU, I had always seen the babies after they were out, but had never seen the process leading up to that. Well, I was paired with a nurse who was caring for a first-time mom who had come into the hospital the previous afternoon, and had been in labor for over 12hrs. She wasn't dilating, and they thought they'd have to do a C-section. But then she started to progress, and they decided to try a vaginal birth. I got to see it all, from when she was dilated to 8 cm to when the baby came out. After she was fully dilated to 10cm, they had her start pushing with the contractions, and it was so amazing to see that little head suddenly appear with a push, and then go back in. With each successive push, it came further out, until mom was ready to give birth. About an hour into pushing, the baby's head crowned, and the OB was called in to deliver. They had the mom sit up, broke apart the bed, and had the mom give a few more pushes. By this time, she was completely exhausted, and almost couldn't do it. Her mother and husband were in the room with her, encouraging her on, and as she looked into her husband's eyes, I think she found the strength she needed to keep going. 'Empuje! Empuje! Empuje!' 'Push! Push! Push!' The mom cried out in pain as the head came, and then the rest of the body slipped effortlessly through. I started crying; I couldn't help it. Even now, thinking about it, I get choked up. The mom was crying, and the dad was beaming. It was a beautiful, healthy baby girl.
Life is truly a miracle, in every form. From the miracle of physical birth to the amazing grace-filled miracle of spiritual birth, it made my heart sing praises to the Lord for this new little person that He had brought into the world. The joy on the faces of her parents; her grandmother beaming with pride as her little girl brought another little girl into this world. The lusty, beautiful sound of a healthy pair of lungs protesting about being out of the warm, cozy environment of the womb into the harsh reality of the world. There is nothing more beautiful to me than the sound of a heartily crying baby. You know that they are healthy then. They can breathe. They can live. Working in the NICU gave me a greater appreciation for that; our kids were so often so premature or so sick that they couldn't or wouldn't do more than make little baby whimpers, or grunts. A healthy set of lungs is such a blessing!
I also saw a C-section; equally amazing, equally tear-enducing. The mother, with tears streaming down her face, whispers "Hola, bonita.." as the baby is placed by her face. Her abdomen is open and exposed, and I'm sure she and her husband feel nothing but the joy of their new little daughter. "Felicidades!" we all say to them. I'm sure the L&D nurses, who have seen a million births, think that this never gets old. All of the promise and potential in this new little person. All of the joy and love and life before it. Its precious innocence, the beautiful gift of its uniqueness will be given first to its family, and then to the world.
Childbirth is such a miracle, and after I saw these this week, I felt a deep and gripping appreciation for my mom in a way I never had before. To think of everything she went through to give me life, and to think of the awful ways I have sometimes treated her. My heart overflowed with deep deep love for her and her and my dad's sacrifices for me for all of my life, and I consider myself so truly blessed to be their daughter.
What a hard, hard week, but what a sweet, sweet miracle. Praise the Lord!