A Good Week! Yay!

I've seen the best
I've seen the worst
I wouldn't change what I've been through
I've touched the sky
I've hit the wall
But I did what I had to

On my way here
Where I am now
I've learned to fly, I have to want to leave the ground
I've fallen hard
But I've been loved
And in the end it all works out
My faith has conquered fear
On my way here
Clay Aiken, On My Way Here

Part of the lyrics from the first single on his new album that was released Tuesday (May 6th) - I love it. It makes me cry, and it's almost like he's been living my life for the past few years (although I realize he didn't write the song.) Anyway, the whole album is good - his best yet by far, in my opinion. Of course, I will always love that voice, and the production quality and the songs seem better this time around.

So! I finished my first week back at school and I have lots to say, but I just wanted to let y'all know that I have had a GREAT week, and I am loving life right now, and I'm all-over-the-place thankful to my Lord, from whom all good things come. He is so good to me. I'll write more later about what I've been up to this week, for those of you who are interested! But for now, I'm a sleepy girl and I need a nap. :-)

Before I went back to school, I got my hair cut and my hair guy (Ron Wilson from Ron Wilson Hair Gallery, he is fantastic) talked me into highlights:

I decided after awhile that they were too red and were making me look a little washed out (and I'm translucent anyway) so I bought some Perfect 10 at Walmart and darkened the red a little. The red still shows through, but not so much, which is exactly what I wanted. I was scared as I was washing out my Walmart dye, though, because the suds? Were purple. Lavender, actually. So I was terrifed that I'd end up like one of those little ladies with violet hair. To ease your troubled mind - I didn't.

More later.

A quick update

I haven't written for awhile - I had the pain clinic decrease my fentanyl patch from 50 mcg/hr to 37.5 mcg/hr (which is a 25 patch & a 12.5 patch) beginning 4 days ago, and I've been in quite a bit of pain, despite my breakthrough meds. I'm also decreasing my Paxil from 40 mg to zero (I'm down to 10 mg), overlapping it with Prozac so that the short half-life of Paxil doesn't cause SSRI discontinuation syndrome as I cut it down (the whole discontinuation thing TOTALLY sucks - tingly extremities, "electric shocks" through my head, extreme irritability, total insomnia, and crying for no reason.) If you're taking Paxil and want to taper off of it, talk to your doctor about adding 20 mg or so of Prozac during the taper, for a Prozac a day keeps the SSRI discontinuation syndrome away. At least it has for me - I've been decreasing by 10 mg every 2 or 3 weeks, and haven't had problems so far. Except for my anxiety going through the roof.

I start back to school in a week, and I'm so nervous about it. I could really use your prayers, please - because I'm still sick, and I'm so anxious, and sad, and lonely. It gets increasingly harder to put on a face in public, you know? So I haven't written here, because I'm afraid I would end up saying what I actually think. I'm just not one of those people who is all, "I'm fine on my own!" because I'm not. I need Christ. I need Scott. I need my family, and I need friends. I need people to hug me occasionally; to send a quick message to let me know they're thinking of me. I need to be told that things are going to be okay. I don't care if that makes me seem weak, because I AM weak. I'm not sure how else to cry for help - help. Help. Help.

Kim is ...

... already tired of that "I drink your milkshake up" line. Already! That didn't take long.

Statuses? Statusi?

I'm rather addicted to Facebook, and it has this nifty little status feature that you can use to let your "friends" who also use the application what you're doing and/or feeling RIGHT THAT SECOND. In the event that they care. Which in my case, they probably don't. So I thought that from time to time, I'd bring my status over to people who MIGHT care - you, my blog readers.

Here's what the status looks like on Facebook, in case you don't know what I'm talking about:

The text says "Kim is crying. And stupid. Stupid for bringing things up that bother her rather than just keeping them in to avoid needless conflict, because she hates conflict."

And I DO hate conflict. So why can't I keep my stupid mouth shut? Grrrrr.

Scott's birthday

Scott turned 29 today, and I wanted to drive the 30 minutes to his house from mine to go to church with him, and then hang around and watch a movie or something. (And likely eat cake and possibly pizza, knowing his mom!) Scott, church, a movie, pizza, and cake = an evening of my favorite things.

Instead, I felt too weak and fatigued to even take a shower. My doctor ordered some bloodwork which I had done yesterday - he ordered a CBC w/diff (meaning they separate out all of the types of white blood cells and give a percentage of how many are there) and a monospot. I'm thinking it may be mono, because I had it about 10 years ago and I remember how tired and generally crappy I felt. I would sleep about 12 hours each night, and then come home from class and take a 3-4 hour nap, and still feel exhausted. That went on for a good while, too. And I've read that mono is worse in someone who is past their mid-to-late teens. Great.

I am just so sad that I didn't even get to see Scott on his birthday because of this stupid mysterious illness that I have, that I wish someone would diagnose so that people would stop getting irritated at me for feeling bad all the time. I know my family and friends are starting to think that I'm just lazy, or depressed, or something. I really miss Scott, though - it's hard for me to see him these days, because during the week, he's working and understandably doesn't want to spend the hour on the road (round-trip) that it takes to come to my house, plus the couple of hours it takes to watch a movie or whatever. And I simply don't feel like driving to his house, or anywhere else.

I'm sitting here crying as I type this because I'm so mad at myself for feeling so hideous that it's keeping Scott and me apart. But I just don't see any solution. I'm open to suggestions.

Geeeeeeeeez! I've been gone for awhile.

I have no excuse - just holidays, my birthday, and sickness. Did you know I've been sick on about 26 of the last 29 birthdays? It's kind of my trademark. You should see some of the pictures that I have from my birthdays when I was a wee tot - standing in front of a flickering Snoopy cake, looking unsure whether to blow on it or barf on it. Actually, in this day and age, you COULD see that picture. I'm at the apartment, though, and the picture's at home - I'll scan and add it later. I was so darn cute when I was a kid, I'd hate to deprive you of my cherubian face and my dark curls. (I'm not being vain - because while I was a cute kid, I'm not so cute anymore. So.)

What have I been doing, you ask? Let's see. I ushered in Christmas Eve. Then I ushered it out and ushered in Christmas. Then I ushered it out and ushered in my birthday (my 29th birthday - this is the one that I just keep celebrating the anniversary of, right?) and my pancreas reared it's ugly head even higher than normal. And then I got some sort of virus that came complete with lots of barfage, weird leg pain and twitching. That stayed around until New Year's Eve. Scott was very sweet through that whole viral crap - he came up to see me almost every day and was all attentive and stuff. Awww.

Then I started back to school on January 7th - I'm on my Family Practice rotation. So far, I really like it. It's soooooooo much better than my foray into Internal Medicine (I blame a lot of that debacle, though, on the fact that I was so sick and everyone was all, "How dare you be human!!!") This time, a whole different me showed up to the first day of the rotation. I am a lot more interested, responsible, and attentive when I don't feel like someone is stabbing me in the gut.

And I've watched Reign Over Me, Juno, and Enchanted. I'd recommend them all - especially Juno. I adore Michael Cera (is he too young to join my Geek Love Fake Boyfriend Brigade? I'll have to check.) And Ellen Page makes a great debut. It's funny, heartwarming, and just very darn good.

Oh, and I saw a toenail fungus yesterday. I itched the whole rest of the day. I know that Trichophyton (Trichophytons?) don't have legs and couldn't have jumped on me, but still. The mind is a powerful thing. Also, did you know that adults most commonly get toenail infestations by dermatophytes, which invade normal keratin? And that older adults (i.e., geriatric adults) most commonly get toenails infected with mold, which invade irregular keratin? I didn't either.

Busy, sick, busy, sick, sick, sick.

The title basically sums up my past 7 or 8 weeks - my "personal leave" from this rotation. I had so much I wanted to get accomplished, and have done none of it because I've felt so flippin' awful. If I do feel like writing soon (hopefully I will - and prayers that I'll feel better are always appreciated), here's what you'll see:

• What the Internal Medicine rotation was like for me
• The evaluation with an attending physician who completely crushed my spirit and still has me wondering if I should be in medical school in the first place
• My Christmas photo shoot Gabe (and now Reed)
• Gabe's little brother Reed's entry into the world
• Christmas
• Some health & beauty products that I luuuurrrrve lately
• Your Fentanyl Patch and You
• A few good movies
• The recipe for some yummy fruit salad that I've been making lately (only 2 Weight Watchers points per cup!)
• My hope that I will soon wake up, discover that the past 2 1/2 years were only a terrible nightmare, and find that I am just preparing to start medical school, without pancreatitis or debilitating anxiety and depression - and that I'll be able to perform the way I could if I weren't shackled with this hateful pain and anxiety. Actually, that wouldn't be a whole post - it's just a thought.

I'll try to feel like writing. :-)

The Lord answers prayers, part deux

I have had many, many, many (many times infinity) talks with God about Scott's and my future, given that Scott's degree is a doctoral degree in chemistry, and this area isn't exactly booming with opportunities for someone trained as such. When he was away at Virginia Tech working on his graduate degree, and I was here missing him like crazy, I remember him telling me that the chances of him finding permanent employment here at home were like, 2%. (He's speaks in percentages. It's part of the nerdiness that is so "him" that I love so much.) I don't remember if he said "2%", exactly, but it was something that translated into "very, very, very unlikely."

Now, if y'all can't tell, I am a total homebody. I'm from a big family (Mom had 9 brothers and sisters and Dad had 7, and I have 40 first cousins and uncountable second cousins.) Although I'm an only child, I grew up around my extended family and I love them all dearly - and besides, this area is home to me and always will be. I should mention that Scott's family are all here as well. So I've been torn, because Scott is without question the one that God put on this earth for me, and yet he pursued this degree which would almost certainly take him away from here. It has been a huge source of stress for me because I can't imagine a life without Scott in it, forever; nor can I imagine a life lived somewhere else.

You know what, guys? And to segue into this next part, I'm going to have to quote a guy in my class here, after he got his score on Step 1 (hi, Billy!), "Jesus must like me a WHOLE LOT."

I'm not sure how much I can say as far as details go, but God has worked this out in such a wonderful way. And Scott was so perfectly sweet in telling me about it. I never prayed for specific things - I always just told the Lord that He knew my heart, and He knew my future, and I just prayed for His will as far as Scott and employment was concerned. God is so good. SO good. I can't imagine not knowing Christ as Savior, and not being able to claim these verses that I quoted the last time I had a huge prayer burden lifted:

For I know the thoughts that I think toward you, saith the LORD, thoughts of peace, and not of evil, to give you an expected end (Jeremiah 29:11).

And we know that all things work together for good to them that love God, to them who are the called according to his purpose (Romans 8:28).

Ye have not chosen me, but I have chosen you, and ordained you, that ye should go and bring forth fruit, and that your fruit should remain: that whatsoever ye shall ask of the Father in my name, he may give it you (John 15:16).

I think my life may actually work out almost exactly the way I've imagined it (or at least the way I've imagined it for 10 years, since Scott showed up and quickly became a positively permanent fixture in my future. Alliteration? It's a good thing.) And for the first time in a long, long, LONG time, I actually feel happy right now. Happy. Huh.

This was in the summer of 2003 - see? I'm actually not so scary on the eyeballs when I don't weigh 4 1/2 tons. I'm on my way back down, though - I'm back at Weight Watchers, eating healthy stuff, and I'm exercising again. That's one thing I'm working on while I'm taking this rotation off. I used to run between 3 and 5 miles every day, and I felt so sane and actually had some self-esteem. I need to get back there - somehow I have let myself get WAY out of control. Oh, and it looks like Scott has a rather large hole in his head. He actually doesn't - his head is 100% intact. Dont' be alarmed.

My right foot has been completely asleep for about an hour.

I just felt like sharing.

Doctors who are nice. I like that.

I was reading through the comments on Kevin, M.D. for the post in which he mentioned my unfortunate incident with an evil hair-removal laser that burned and scarred me and a dermatologist who must have been absent on the day they taught ethics, and I read this comment that I wanted to bring over here for posterity. I would LOVE to know which physician that knows me took the time to post this in my defense - it makes me feel all warm and fuzzy.

I know this woman. I am a doctor. I can't believe that after seeing the pictures, untouched, of an 18 year old woman with facial disfigurement, that anyone has the right to critique the patient! Yes, all procedures have risks - this case of substandard care was artificially absolved as follow-up care for a major burn with keloid scarring was remediated. However, the patient did trust that the ethically correct move was being made in this regard and the physician mocked her by dropping all guilt as soon as "time for a lawsuit is up!" This is an outrage and a sadness to a profession. Knowing the patient's character and decency, I assure you that the blog is meant as a warning, not as a critique among all physicians. It is also meant as a testament to the standard of care of which SHE chooses to practice after medical school.

SarahK is making me think of bloggable things

Like this post, which reminds me of that time that Scott was at my apartment and in the bathroom (actually, I think he might have been in the shower) and I only have one bathroom, and I had to pee in a jar. Have I just shared too much?*

And on this, the most gigantonormous post I've ever seen, she says that FrankJ thinks that Lipitor sounds like an alien name - I told her that she should see the cancer chemotherapy drugs or immunopharmacology. When I was trying to study those, I felt like I was reading notes in Martian. Gemtuzamab? Mylotarg? "I am Gemtuzamab, from the planet Mylotarg!" Here's what I know about those drugs - doxyrubicin and daunorubicin cause cardiotoxicity (I know that because "rubor" means red, and hearts are red. Reddish.) I know that bleomycin causes pulmonary fibrosis because "bleo" sounds like "blow". And I know that vincristine and vinblastine are vinca alkaloids and that they inhibit microtubules and work during mitosis. (I know that one just because I randomly memorized it.) And that's pretty much all I know about that.

From that same post, someone is telling FrankJ that he looks 17 (heh) and won't tell poor SarahK that she looks young (I tell her that she looks like Kate Hudson - I hope that helps.) We went to lunch at Subway once last semester, and I had a photo album with pictures from our first year of medical school in the backseat of my car. Todd and Michael were sitting in the back (with Christy in the front) and Todd was flipping through the album. He goes, "Wow, everybody looks so much OLDER since we started school!" Christy and I get identical looks of horror.

Us: Todd!
Todd: What? I mean, ALL of us look older.
Me: Nope, that's not better. Not better at all.
Todd: I mean, I'm sorry. We ALL look older - but you guys, you look, uh ...
Me: Todd, never tell a woman she looks older.

To his credit, he did apologize approximately 1,037 times in the next 24 hours. And then there was that guy in Walmart that time, when I was trying to buy an R-rated DVD and got carded (heh). My license still said "under 21" even though I wasn't, and of course the weight was laughably wrong. So I said, "Oh, I'm not under 21 anymore - and that weight isn't right anymore either, ha ha!" Clueless cashier boy goes, "*I* didn't say that." Boo.

I wish I got thousands of hits like Rachel Lucas. Or even an almost-thousand like SarahK. But I just don't have enough time to blog regularly enough. Ugh.

I have had a horrible week, pancreas-wise. More on that later.

American Idol - meh. More on that later too.

* I sterilized the jar afterwards, obviously.

Pay no attention to the T-shirt - it's at least 13 years old

Thanks to Ron at Ron & Associates, I now have a spiffy new haircut. I felt like my hair didn't really look like anything, and since Ron does such a great job on Christy's hair, I made an appointment. I ended up with pretty much exactly what I wanted. I don't normally just sit around and take pictures of myself, but I wanted the new hair pictures for posterity.

You are everything to someone

Dad sent this to me, and since several of them apply to my life at the moment, I thought I'd post it. You know, because I liked it. I usually find these kinds of things cheesy, but I liked most of this one. It helps a person with no self-esteem (like me) to think these kinds of things sometimes - whether they're true or not!

Sometimes I used my blog as a personal diary, a place to rant, someplace to keep links to websites I want to remember later, or a sort of filing cabinet for things like this that I want to be able to find at a future time. Oh, and to connect with all of you fine folk, of course. Speaking of you fine folk - you should comment more. Let me know you're reading, say hi - something. It would make me happy. :-)

• Someone is very proud of you
• Someone is thinking of you
• Someone cares about you
• Someone misses you
• Someone wants to talk to you
• Someone wants to be where you are
• Someone hopes you aren't in trouble
• Someone is thankful for the support you have provided
• Someone wants to hold your hand
• Someone hopes everything turns out all right
• Someone wants you to be happy
• Someone wants you to find them
• Someone is celebrating your successes
• Someone wants to give you a gift
• Someone thinks you ARE a gift
• Someone hopes you are not too cold, or too hot
• Someone wants to hug you
• Someone loves you
• Someone admires your strength
• Someone is thinking of you and smiling
• Someone wants to be your shoulder to cry on
• Someone wants to go out with you and just have fun
• Someone thinks the world of you
• Someone wants to protect you
• Someone would do anything for you
• Someone wants to be forgiven
• Someone is grateful for your forgiveness
• Someone wants to laugh with you about old times
• Someone remembers you and wishes you were there
• Someone needs to know that your love is unconditional
• Someone values your advice
• Someone wants to tell you how much they care
• Someone wants to stay up late watching old movies with you
• Someone wants to share their dreams with you
• Someone wants to hold you in their arms
• Someone wants YOU to hold them in YOUR arms
• Someone treasures your spirit
• Someone wishes they could stop time because of you
• Someone can't wait to see you
• Someone wishes that things didn't have to change
• Someone loves you for who you are
• Someone loves the way you make them feel
• Someone wants to be with you
• Someone has a song that reminds them of you
• Someone wants you to know they are there for you
• Someone is glad that you're their friend
• Someone wants to be your friend
• Someone stayed up all night thinking about you
• Someone is alive because of you
• Someone is wishing that you would notice them
• Someone wants to get to know you better
• Someone believes that you are their soul mate
• Someone wants to be near you
• Someone misses your guidance and advice
• Someone values your guidance and advice
• Someone has faith in you
• Someone trusts you
• Someone needs your support
• Someone needs you to have faith in them
• Someone needs you to let them be your friend
• Someone will cry when they read this

Oh, and I got a new haircut. I'll put some pictures up later.

30 Unknown Facts/Secrets About Meeeeee

Occasionally I get an interesting quiz posted as a bulletin on MySpace, and I usually bring it over here because I find bulletins on MySpace annoying in general. Especially the ones that are like those stupid chain emails - *shudder*. Check things out at Snopes before you pass them along, people!

1. What ended your last relationship?
   Hmmm. It was almost 10 years ago and couldn't really be classified as a "relationship", especially compared to what I have with Scott. To make a long story short, I was at my high school's first football game the weekend after I started college, and I was sort of going out with the assistant coach. I say "sort of" because after he did what he did, he used, "We're not dating!" as an excuse. Anyway, I told him that I wanted to talk to him after the game, and he told me that he was going to the locker room for a few minutes and would be right back - he asked me to wait. So I did. And waited. And waited. I would still be waiting - he didn't come back.
2. When was the last time you shaved your legs?
   Heh. When you're in medical school, and when you run out of hot water in the shower after about eight minutes - probably about a week. Sometimes it gets so bad that when I finally do decide to defuzz, my tub looks like I've just shaved Oliver.
3. What were you doing this morning at 8AM?
   It's not 8AM yet. But I'll probably be in the shower - I have an MRI this morning on zee eeeeeevil pancreas.
4. First thought after waking up this morning?
   Why am I awake at 4:43AM?
5. Are you any good at math?
   Eh. Probably better than most of the general population, given the whole science degree thing - but compared to Scott and his crazy-intelligent mathematical mind, I can't add 2+2.
6. Your prom night?
   Junior high proms don't really count, and my junior prom? Ah. I had my first real documented panic attack the day of, and ended up not going. Sorry Jared. My senior year I was afraid of Panic Attack: The Sequel (that's how panic attacks work, see - they make you afraid of the next one), and I just went to after-prom. That way, it would be cheaper if I panicked and backed out again.
7. Do you have any famous ancestors?
   Unfortunately not. Yet! (I'm still waiting for my screenwriting cousin Dale to be famous.) Unless you consider a bunch of people with a weird form of hereditary pancreatitis to be famous. My family *was* in the journal Pediatrics way back when - documenting our screwy trypsinogen gene.
8. Have you ever taken out any loans to pay for school?
   Not until medical school - and I only take out the $8000 or $8500/year that is subsidized (or maybe unsubsidized - it's the one that doesn't accrue interest until I'm finished. I always mix them up.) God bless my parents and their hard work and sacrifice! One day, I will pay them back.
9. Do you know the words to the song on your MySpace profile?
   I know the words to an embarrassing lot of songs. I wish pharmacology was set to music.
10. Last thing received in the mail?
    Some crap from USMLERx - sorry USMLERx, but I'm already signed up for Kaplan's Q-bank for Step One. If it makes you feel any better, though, I'm totally not using it yet.
11. What would you rather be doing right now?
    Sleeping.
12. Do you ever leave messages on people's answering machine?
    Always - and they're usually long and rambly.
13. Who did you lose your CONCERT virginity to?
    What???? I haven't ... oh, CONCERT. Well, that one I can answer - it's somewhat embarrassing, but I was only like, eight. I went with Mom & Dad to see Conway Twitty and Randy Travis - LIVE! A double headliner. I still like a lot of their music - classic country is awesome and It's Only Make Believe is one of my favorite songs.
14. Do you draw your name in the sand when you go to the beach?
    It's been so long since I've been to the beach that I don't even remember. Now, I'd probably draw something dorky like a DNA molecule or a brainstem.
15. What's the most painful dental procedure you've had?
    My permanent "eye teeth" were chilling up in my gums, growing sideways. So when I got braces, I had surgery to put a bracket on each of them (the surgeon cut my palate and flipped it back to get to the wayward teeth - ouch) and attached this little plastic thing to each bracket, which my orthodontist would yank on and then tighten every time I had my braces adjusted. Yeeeeouch.
16. What is out of your back door?
    "Doo, doo, doo ... lookin' out my back door ..." Ahem. At home, there's a patio, a backyard, a "well house", and a garage. At the apartment, there's a hallway and stairs.
17. Do you have any plans for tonight?
    Probably studying and watching American Idol. Bleh, studying. Yay, American Idol! My life is sad, y'all.
18. Do you like the ocean?
    *sigh* Yes. I need a vacation.
19. Have you ever received one of those big tins of 3 different popcorn?
    That's a random question. No - no I haven't. I am a popcorn fan, though I could never eat that much by myself.
20. Have you ever been to a planetarium?
    Not since about the 5th grade.
21. What was your first alcoholic beverage?
    One drink of champagne at a cousin's wedding - and it was hideous. No alcohol for me since. Not only am I not interested in it, it would probably cause my pancreas to completely explode.
22. Something you are excited about?
    Finally being a doctoooooooor.
23. What is your favorite flavor of Jello?
    Strawberry. In all my days of pancreatitis, I've had lots and lots of Jello.
24. Favorite TV shows?
    Didn't I already answer this somewhere? All right, I'll do it again, because I love TV. 24; American Idol (shut up); America's Next Top Model (see previous comment re: shutting up); Arrested Development (RIP - Fox.Ruins.Everything.); Best Week Ever; Chappelle's Show; Coupling; Da Ali G Show; ER; Family Guy; Friends; House MD, House MD, and House MD (my TV boyfriend); Law & Order & L&O SVU (not Criminal Intent - I can't stand Vincent D'Onofrino); Monk; My Name Is Earl; The O.C. (again, Fox.Ruins.Everything.); The Office (US); Scrubs; Seinfeld; The Simpsons; South Park; and every stupid countdown on E! and VH1. Note that Grey's Anatomy is not on that list - I just can't get into it. It's just so ridiculously inferior to House and Scrubs.
25. Describe your keys:
    What? They're - uh - keys. Let me try again - they're usually locked in my car. Or my apartment. Or somewhere else that they shouldn't be.
26. Where do you keep your change?
    All over the place. Is anyone actually so organized that they have one place for their change? Wow. I'm in awe.
27. When was the last time you spoke in front of a large group of people?
    I did a presentation for behavioral medicine about a year ago with Todd & Michael - I think that's about it. Unless you count testifying and/or talking in church, which I do often.
28. What kind of winter coat do you have?
    Too many. A white puffy one from Lands End, an off-white one with a fuzzy collar, a black peacoat, a red trench coat, a blue trench coat - aaaaand I'm too embarrassed to list any more. Coats and shoes are my weaknesses. And beauty products - I have a love/hate relationship with Sephora.
29. What were you doing ten years ago?
    In my senior year of high school, probably pining over the guy in #1 and freaking out about going to college. I wish I could tell my 18-year-old self that I was going to be just fine.
30. Do you sleep with the door to your room open or closed?
    Open.

I'm shrinking! Shreeeeeenking! (I hope.)

I'm a Lifetime member at Weight Watchers - I lost about 40 pounds back in 1999, was running 3-5 miles a day, and my anxiety and depression were at an all-time low. I kept my new routine up for a couple of years, and then ended up in a downward spiral (long story, maybe I'll tell it sometime) and gained all I had lost plus more, and stopped exercising. And then I started medical school, and gained about 20 more pounds. Ugh.

But, I'm tired of being fat, ugly and repulsive. I'm tired of being Scott's fat girlfriend. I'm tired of being everybody's "fat friend". I'm tired of my rock-bottom self-esteem. I renewed my YMCA membership on Monday (and actually worked out on Monday, Tuesday and today) and re-joined Weight Watchers on Tuesday. This huge person I'm walking around in is not me, and I'm quite tired of her - her thunder thighs, sausage arms, lack of energy, and giant rear end. Keep me honest, y'all. I have exactly 50 pounds to lose to get back to my Weight Watchers goal weight. I'll keep you updated (because I know you care.) :-)

Waaaaaaaah!

I didn't go to class this morning (four reasons - main reason, I overslept; also, I was at the hospital kind of late last night because my cousin-who-is-as-close-as-a-brother's wife was in labor (Eeeee! Welcome Samuel Lucas [insert last name here]!); I am so freaking tired and I probably would have slept through class anyway; and Mom was sick last night and I didn't want her to be awake and sick by herself, because I don't like to be left alone when I'm sick. So.)

I didn't go twice last week either, because of that evil GI virus I had and my eeeeeeevil pancreas. And we've only been in class for like, 9 days. I'm feeling guilty and panicky. The panicky part is a given, because I'm on the edge of an anxious breakdown anyway.

I'm not particularly worried about getting behind, because Christy and I have been studying a bit, in the afternoons/evenings, but I'm wondering - what kind of doctor am I even going to be, when my stupid pancreatitis or my anxiety attacks me at every turn; and also, when I want to be there for my family when something is going on, med school be darned? I'm afraid I'm not disciplined enough or something. *sigh*

Also, a couple of friends wanted to take Christy and me out to lunch this afternoon for our birthdays (both are in December, during our Christmas break) and I wasn't there for that, so they'll have to go without me or reschedule. I hope nobody is mad. I hate it when I make people mad. I need a hug.

At least I finally remembered to pay my class dues and avoided our class treasurer's bone-breaking thugs.

Random 10 - Happy Birthday to ME.

So, my birthday was the 26th (even though I'm writing it on the 29th - I've been busy getting old and what-not.) Anyway, I thought we'd do a little Random 10 Lyrics for my birthday - all from my birth year, 1978. And instead of 10, it's 14 - which is half of my age (I was going to do 28, but that's too darn many. Of anything, mostly.) Leave answers in the comments - the one with the most correct gets an iTunes song, courtesy of the birthday girl old lady. And ... go!

1. Every day, love me your own special way. Melt all my heart away With a smile. Take time to tell me you really care, and we'll share tomorrow together.
2. Love him till your arms break, then he lets you down. It ain't right, with love to share, when you find he doesn't care for you. It ain't wise to need someone as much as I depended on you.
3. The sun ain't nearly on the rise, and we still got the moon and stars above. Underneath the velvet skies, love is all that matters - won't you stay with me? And don't you ever leave.
4. Feeling down & dirty, feeling kinda mean - I've been from one to another extreme. This time I had a good time, ain't got time to wait. I wanna stick around till I can't see straight.
5. Don't know why I'm surviving every lonely day, when there's got to be no chance for me - my life would end. And it doesn't matter how I cry - my tears of love are a waste of time. If I turn away, am I strong enough to see it through? Go crazy is what I will do.
6. If you need me, let me know, gonna be around. If you've got no place to go, if you're feeling down - if you're all alone when the pretty birds have flown - honey I'm still free.
7. I finally see the dawn arrivin'. I see beyond the road I'm drivin'. Far away, and left behind.
8. I gotta know right now! Do you love me? Will you love me forever? Do you need me? Will you never leave me? Will you make me so happy for the rest of my life? Will you take me away and will you make me your wife? I gotta know right now! Before we go any further - do you love me, and will you love me forever?
9. All you gotta do is smile that smile, and there go all my defenses. Just leave it up to you, and in a little while, you're messin' up my mind and fillin' up my senses.
10. We take the pressure and we throw away, conventionality belongs to yesterday. There is a chance that we can make it so far - we start believing now that we can be who we are.
11. I don't mind you comin' here and wastin all my time, time - 'cause when youre standin' oh so near, I kinda lose my mind, yeah. It's not the perfume that you wear, it's not the ribbons in your hair. I don't mind you comin' here and wastin' all my time.
12. Well now, I get low and I get high - and if I cant get either, I really try. Got the wings of heaven on my shoes - I'm a dancin' man and I just can't lose.
13. I've paid my dues, time after time. I've done my sentence but committed no crime. And bad mistakes - I've made a few - I've had my share of sand kicked in my face, but I've come through.
14. My love for you is immeasurable; my respect for you immense. You're ageless, timeless, lace and fineness; you're beauty and elegance. You're a rhapsody, a comedy, you're a symphony and a play. You're every love song ever written. But honey what do you see in me?

Also, if anyone happens to see another common theme in these songs - well, don't mention it. Heh.

Fa la la la la ...

Because I know it's the burning question on everyone's mind, my favorite Christmas song is O Holy Night - I think the lyrics are so beautiful. Coming in at a close second is Carol of the Bells, because the music and the harmonies are gorgeous. Guess what is third?

Well, it's the quasi-Christmas song, Last Christmas by Wham!, obviously.

I have a question, though. Last Christmas was in a movie, and neither Scott nor I can remember which one. The Internet doesn't know, either, although it does puzzle at Last Christmas' curious popularity. So I need your help, y'all. What's the movie? It will drive me even crazier than I already am until I figure it out. Any help will be appreciated.

The one where I'm Debbie Downer. Sorry.

You know, I actually had a post knocking around in my head today, and I thought, "Tonight there will be a new post on the blog! A good one too!" These kinds of things are exciting to me, because my life is sad.

However, I ended up having a rather crappy evening (nothing I want to talk about here or anything - I mention it only because I want to remember what date it was) and then when I got home and looked at all the shopping bags and merriment and such littering my floor, I realized that ... I don't have a job. And I can't afford to give people Christmas presents like I usually do, and like I love to do, because I don't have a job. So I've spent the last couple of hours crying, and putting together bags of stuff to return tomorrow, which isn't nearly as much fun as buying gifts for people. Bleh. I can't wait until 2 1/2 years go by and I'm employed again. I've almost decided to take out more loans than I usually do the next time I have to fill out a renewal FAFSA, because I hate mooching off of my parents. I know my dad doesn't mind, but I still hate it.

Sorry for the downer post. And if you're still shopping, by any chance, you could use my Amazon link to help me pay for my server. It really does help, when people use it. And whoever bought the diamond watch, I love you to bits. That is all.

Oh, and this? Re: Justin Timberlake and the *bleep* in a box? Is hilarious. Not that one of those is on my list or anything. I just want some DiorShow mascara and DVDs. That video almost, almost - made me feel better after an evening of tears and feeling crappy about myself.

Six Weird Things About Me

Because I was tagged by Kelli:

Here are the rules - Each player of this game starts with the "6 Weird Things about You." People who get tagged need to write a blog entry of their own 6 weird things as well as state this rule clearly. In the end, you need to choose 6 people to be tagged and list their names. Don't forget to leave a comment that says 'you are tagged' in their comments and tell them to read your blog!

Okay, so I found this difficult. And I'm not sure why, because I know I'm plenty weird.

1. Quite often, I get Merle Haggard's "Workin' Man Blues" stuck in my head for long periods at a time, and for no reason whatsoever.
2. Not so much lately, because it's so depressing, but I used to wake up every morning (or afternoon, whatever) and lift up the bottom of my shirt and look at my stomach in the mirror. This was kind of a semi-conscious thing, before I was really awake - I guess I was just making sure it was still there, or that some evil gnome hadn't stuffed something gross in my bellybutton while I slept. Or whatever.
3. After I take a shower, if I realize that I've forgotten to wash my ears, I almost have to take another complete shower. If my ears feel yucky, that's just not acceptable.
4. I am insane about alphabetizing stuff. CDs, books, DVDs, whatever. When we get something in some notes that is a list, like a list of hormones or amino acids or something, I have to alphabetize it before I can even think about learning it.
5. I can't sleep unless the TV is on. That may or may not be weird, but I'm running out of steam here.
6. I can't come up with a 6th thing. Those of you who know me, help me out. Just don't get too carried away - don't make me cry or anything. I asked Scott for input, but he refused to answer. Heh. Told you he's smart!

I'm tagging Jill, Allison, SarahK, Punchberry, O Meaty One, and my favorite monkey.

The one where I post lots of non-airbrushed pictures

Since I was accused by commenters at Kevin MD and now at the RateMDs forums of being deceitful by using my "excessively airbrushed senior picture as a "before" picture in my "victim of malpractice" story, I thought I'd post some pre-burn snapshots. You know, so you can see what a freakazoid I REALLY am, and that I look absolutely nothing like the senior picture I posted earlier. Except not. The debated senior picture is included at the end, so you can compare. Here's what you're supposed to notice in the "before" pictures - that both sides of my upper lip used to be EVEN.

Oh, and the fact that I have pancreatitis has absolutely nothing to do with the fact that I was horribly burned and scarred. Yes, that was really suggested. Idiots.

Finally, I have a brilliant cousin who is an attorney specializing in healthcare (his firm represents doctors in cases like these, not patients) and he told me that this is 100% malpractice and that I would have won a suit hands down. Anyway, behold the pictures:

Summer 1997 ; Fall 1995

Spring 1997 ; Summer 1997

Spring 1997 ; Winter 1996

Both Spring 1997

Spring 1997

August 1997

Told you that the senior picture really looked like me. And the reason I'm not wearing makeup in the pictures featuring the burn is that I was told not to - for risk of infection. I did have a big gaping wound, you know. The reason that you don't see any "before" pictures without makeup is that I typically am not photographed makeup-less (is any girl? Really?)

The kind of doctor I'm NOT going to be

For the 2nd installment of our medical ethics course, we had to write a critique of a peer-reviewed article that addressed one of the topics on our schedule for the semester. The paper I critiqued was on medical errors, and it focused on whether or not doctors would even tell the patients about particular hypothetical errors, or how much detail they would provide, etc., and a bunch of other boring stuff that y'all don't care about. In this paper on medical errors, I had to include the following personal story (altered slightly from the way it appeared in my paper to make it more blog-friendly.) This is the story of a doctor who "oopsed" with me, and then proceeded to make a major goof four years later. She is now the kind of doctor I do not want to become. Enjoy. Or not.

Being on the wrong end of a medical error myself, I cannot discuss this topic without a personal bias from a patient’s point of view. When I was a freshman in college, I had laser hair removal done on my upper lip by my dermatologist, and the laser severely burnt my skin (see the next two images, taken the day of the procedure.)

November 4, 1997

My doctor was very apologetic and it was obvious that she felt terrible about what had happened. She called me at home multiple times to check on me, and scheduled an appointment with a local plastic surgeon (with the understanding that she would cover any costs incurred until I was nearly back to normal.) I am not a litigious person by any stretch of the imagination, but my dermatologist's apologetic attitude and the steps she took to correct the mistake at her own expense basically took any thought of a lawsuit off of the table. "Everyone makes mistakes," I thought (although I wished it hadn't been on MY face!) and my doctor seemed genuinely sorry. So my family and I decided that taking responsibility for my medical care related to the burn would be enough. We didn't even disclose her name to anyone that asked (and there were many inquiries about my face – one of my professors even asked if I was in an abusive relationship!)

The wound healed as a keloid scar, and my dermatologist paid for cortisone injections, which were administered by a local plastic surgeon, and then for removal of the keloid (the first image is the icky-looking keloid, the second is after it was removed. I know, I know - the removal left me looking like Elvis. Well, Elvis with an unfortunate flesh-wound.)

February 1998 (left) and April 1998 (right)

Incidentally, we thought that a collagen injection may improve the asymmetry of my lip. So we gave it a whirl - and I ended up looking like Elvis had run into a wall. Not good.

The final surgery that I had was performed by a doctor in Pittsburgh. And here's where my ex-dermatologist messed up. My main problem, four years after I was burned, was the asymmetry of my upper lip (the fibrous scar tissue had caused the left side of my upper lip to be pulled higher than the other side - i.e., Elvis.) My dermatologist recommended a plastic surgeon in Pittsburgh (Dr. Brodland, who was excellent) and set up the appointment for me. I traveled there for a consultation, and asked him for a copy of his treatment plan so that my dermatologist could be aware of the procedure that I would undergo and the costs involved (below are before and after pictures of Dr. Brodland's scar-rearrangement surgery - called a V-to-Y procedure, which would "push" the scar (and my lip) down.)

November 2001

Imagine my surprise when the response to my letter came from her attorney, refusing to cover the costs of the surgery ($1400.00, which my middle class family ended up paying out of pocket.) Conveniently for her, she had taken advantage of my kindness and my naiveté for just long enough – the four-year statute of limitations had just passed, and there was absolutely nothing I could do legally.

The letter from the attorney also said that she hoped that I would continue to visit her office for my dermatologic needs. Needless to say, I found another doctor.

I included my story because most articles and sources (at least those in scholarly publications) concern themselves with protecting the physician from litigation, and avoiding apologetic terms, and disclosure of the error. As I perused these articles, I found myself thinking, "What about the patient?" I can tell you that as long as my dermatologist was apologetic and was trying to fix her mistake, I did not consider a lawsuit and I continued to visit her office for dermatologic appointments unrelated to the scar. Patients are reasonably intelligent people, and I believe that they deserve to know about procedures that they have incurred or illnesses that resulted due to circumstances beyond their control. I believe that a certain amount of lawsuits are necessary – if a patient must pay for extra surgeries, more medicine, more office visits, etc. that are the result of a medical error, then they deserve reimbursement. Healthcare is expensive anyway, and patients should not be expected to pay in order to preserve their doctor’s pride or reputation.

There are many discussions involving legal action, shame, status, and other issues related to medical error disclosure, but there is one thing that is all but absent in these discussions – the right thing to do. I cannot make sense of the fact that doctors do not have to take responsibility when they make mistakes, while most other professions are expected to do so. Not taking responsibility, not telling the patient the truth – is equivalent to lying, as far as I am concerned. Right up until the day I received the letter from my dermatologist’s lawyer, I admired her. She was a female doctor, a profession that I aspired to myself, she had a family as well as a successful private practice, and although she had made a mistake with my care, she was taking responsibility and trying to restore my face to normal. The lawyer’s letter changed all of that. Now, she is the kind of doctor that I hope that I will not be – the kind that looks after their own interests before the interest of their patients. And worst of all, the kind that is an effective actress as well as a physician. She put on a completely convincing performance – I truly believed that she was sorry and that she would see the mistake through until my face looked the way it did before I walked into her office on the day she burnt me with the laser. In reality, she was sorry – but she was sorry for herself, not sorry for what had happened to me. Not sorry that my face will never look the same again and that it is her fault. Not sorry that I had to treat the scar night after night after night, had to endure painful injections and more than one surgery, and have to use special makeup every day to try to cover it. Not sorry that complete strangers notice and ask me what happened. I used to protect her, back when I thought she was protecting me. Now I tell them – and I tell them her name, too. (If you're in this area, just so you know, it's not Dr. Vaughan or Dr. Marshall.)

I am sure that I will make mistakes as a physician. Maybe I have stars in my eyes, but I hope that I will never react to a mistake in the way that she did – sugar and spice and promises to help, but only until the statute of limitations expires – and then my patient receives a letter from my malpractice attorney. I definitely believe that physicians should take steps to prevent lawsuit abuse, but I believe that these steps include placing certain individuals in the legislature, and taking the utmost care where a patient’s health is concerned – and that the steps do not include deceiving a patient or telling them a half-truth about the extra care that they ended up requiring as a result of a medical error. Patients should not all be treated as ignorant, litigious monsters.

I have totally avoided all references to Dr. Evil and the "laser". Until now. I just couldn't help myself. And also, here's one of my senior pictures (from high school) so that you can see my face before it was messed up:

August 1996

Dang, that's depressing. I used to be not-so-hideous to look at. *sigh* I really am going to work on this fat thing. I hate being fat.

Addendum (12/1/06, 6:15PM) - based on the comments left at Kevin MD, I feel that I should address a couple of things, since I wasn't expecting to be critiqued by a bunch of health professionals. First of all, I'm not a physician - I'm a medical student (2nd year). And I WASN'T a medical student at the time of the procedure, or I would have researched the risks myself. (Had I been a medical student in November of 1997 and STILL only in my 2nd year in of medical school in December of 2006 - wow. Talk about extending the torture!) I was 18 years old, barely an undergraduate in my first semester of college, and I stupidly trusted my doctor, who told me that my skin may be a little pink after the procedure, but it should fade by that evening. Of course the fine print said "scarring, death, etc." as it always does. So of course I was aware of the "risks". But every release form warns of the worst, doesn't it?

As for using my high school photo as a comparison - I just happened to have that on my computer, which is why I used it. I will replace it as soon as I get back home to my scanner. It was taken one year before my surgery, and you can't see the upper lip hair because it was taken at the end of August and I had a tan. The use of the photo was not meant to be "manipulative". It wasn't excessively airbrushed either - that's what I looked like.

And I didn't fail to disclose the use of photosensitizing agents, tanning, or medical conditions; nor did I fail to disclose a propensity to develop keloids. I had no idea I had such a propensity - things that I've read since say that keloid scarring is most often seen in people of African descent.

What upsets me is not that I was burnt (which probably was faulty laser settings, due to the fact that the procedure hurt BADLY. And I have hereditary pancreatitis, so I know pain. This laser HURT. I almost asked her not to do the other side!) I was upset that my doctor seems to have taken advantage of my naivete. When I got the letter from her lawyer, I cried. I felt so, so stupid for believing her, for feeling that she had my best interests at heart. That hurt worse than the burn, truthfully - leaving a different kind of scar, you know?

It's upsetting to see people blame ME for this incident - it really is.

Edit (12/9/06) - More before pictures (non-airbrushed) are posted here.