OB/Gyn

These past 4 weeks I've rotating in OB/Gyn at Trinitas Hospital at Elizabeth, NJ. It's been exhausting. This is probably the 2nd most exhausting rotation I've done this year. The hours were very long. It starts at 7am and can go until 8-9pm the latest. Thankfully, there was no call. We had to do 1 week of clinic, 1 week of gyn surgery and 2 weeks of L&D.

For my 1 week of clinic, I realized clinic work really doesn't work. I get exhausted even with clinic being only 6 hours or so. I get bored and feel like I can't really do anything. It could be the patient population that I get to see, but I feel like I was seeing the same thing over and over again. There isn't really much variations.

The week of gyn surgery was fun. I really enjoyed it. It was definitely exhausting, assisting with any where from 3 to 15 cases a day depending on the day. But it was fun. It kept me going nonstop. I didn't realize I was tired until the end of the day. I definitely like being in the OR more that the office.

L&D was very different. I couldn't really describe it except that it's a mix of office and OR. The office aspect is that we would have to keep track of pregnant ladies and the contractions, determining when they are ready to deliver and taking care of all the prep for the delivery. The delivery is very much like to OR, catching the baby as it comes out and taking care of the lacerations and the baby in the sterile field. The true OR experience in L&D is the c-section.

For me, I personally caught 2 babies on my own, with the midwife helping me. The babies were slippery and I couldn't really find the grip to not drop the babies. I feel like I'm on the verge of dropping babies constantly. The whole process of labor and delivery really turns me off. The girls on the rotation couldn't really decide if vaginal delivery was better or c-section. Both are very crude and cruel. For C-section, some surgeon would take the uterus out and plop it on the stomach to stitch it up then shove it back in. Most of us decide that between the two choices, c-section is probably a bit better. Who knows, medicine is really making us think differently.

During the week of gyn surgery, the most memorable is literally first assisting a vaginal prolapse, which is the bladder drop into the vaginal area and out to where you can see and feel it. This one I was in was fairly big and it took like 20 clamps to hold it and for the surgeon to repair it. It took about 40 mins to repair and this was done by a surgeon who is very fast. It was great watching a prolapse turning it into normal.

I would definitely say this is the 2nd craziest rotation. The first was my surgery rotation, filled with work and politics, very draining.

Anesthesiology

I just finished my 2 week rotation in anesthesiology. It's been fun. I definitely enjoyed my 2 weeks there. The people there were fun and I had a lot of fun with them. I just felt that the people there are happy and very satisfied with their career choice.

Even though there is a bit of physiology, I'm sure I can get it eventually, but everything is very much to my liking. It has calculations and pharm. It's more of having answers right there and then. It is not like in medicine where there is not an end to treatment. So far I haven't seen much of where there isn't an end to the treatment plan. There's always a definite end, very much like surgery. The hands on portion is very much delicate as well. Like spinal or epidural, it's a fine touch and can easily cause big problems. Even intubation is delicate as well. There's an art to it, deciding how to intubate and the actual intubation itself.

I feel more solid in choosing this specialty. Now the problem is figuring out how to get to it.

I picked out my USMLE Step 2 date: July 11

My Birthday

This year's birthday was very low key. I just made myself the pseudo annual birthday meal myself. In my family, my mom would always make fish, crabs/lobster, veggies, birthday noodles and buy the Asian/French yummy cake for everyone's birthday. So for myself, I made noodles and pan fried a orange roughy fillet and bought myself a slice of chocolate cake from the market. It's my ghetto version of birthday meal for myself.

I went out to dinner with a couple of med school friend to CPK. I haven't been to CPK since I was in LA. It was still good. Going there reminded me of home, more of So-Cal. I totally wouldn't mind going back but I don't if I was willing to stay. I feel more comfortable being out here, the east coast. It's more of my pace and fits my more impatient personality more. Who knows, it might change in the next day or so.

Regardless, thank you for all the well wishes.

Cookie Dough Truffles

adapted from Taste of Home

½ cup butter, softened
¾ cup packed brown sugar
2 1/4 cups all-purpose flour
1 can (14 ounces) sweetened condensed milk
1 teaspoon vanilla extract
½ cup miniature semisweet chocolate chips
½ cup chopped walnuts (optional, I did not add them)
1 ½ pounds semisweet chocolate candy coating, chopped

In a mixing bowl, cream the butter and brown sugar until light and fluffy. Add the flour, sweetened condensed milk and vanilla; mix well. Stir in the chocolate chips and walnuts, if using. Shape into 1-inch balls; place on waxed paper-lined baking sheets. Loosely cover and freeze for 1-2 hours or until firm. (The dough softens quickly at room temperature so it works best if they are frozen, not just chilled in the refrigerator.)

In a microwave safe bowl, melt candy coating, stirring often until smooth. Dip balls in coating; place on waxed paper-lined baking sheets. Refrigerate until firm, about 15 minutes. If desired, melt remaining candy coating and drizzle over candies. Store in refrigerator. Yield: 5 ½ dozen.

WW Daily Target Points

To figure out how many points you are allowed each day answer these questions and add your score:

1. Gender:
Female- score 2
Male- score 8
A nursing mom- score 12

2. How old are you?
17-26- score 4
27-37- score 3
38-47- score 2
48-58- score 1
over 58- score 0

3. What do you weigh?
Enter the first two digits of your weight in pounds.
(for example, if you weight 199, you will add 19 to your score)

4. How tall are you?
Under 5’1- score 0
5’1-5’10- score 1
Over 5’10- score 2

5. How do you spend most of your day?
Sitting down? score 0
Occasionally sitting? score 2
Walking most of the time? score 4
Doing physically hard work most of the time? score 6

Now add them all together and that’s your daily total.

You are allowed an additional 35 points per week, if you wish to use them. You must use all your points each day in order to lose weight.

Whole Foods - New Eye

Today, I went to Staples to get some stuff printed and bound and saw that Whole Foods is next door. Being that it's lunch time and I couldn't try the Thai restaurant that I wanted to so I decided to venture in and see what I could get for lunch. All through undergrad, I never liked Whole Foods at all because of being too organic and too expensive and totally not my taste. But this time around, I find Whole Foods very intriguing and totally fun. It's just too bad that I don't have the time today to wander around.

They have this whole area just for salad bar but their salad bar is very different. They've got the real salad bar, hot foods like Indian curry, popular Thai dishes, traditional American comfort food and desserts. All this and they have a dine in area that look very much like the ski resort's cafeteria by the windows in Tahoe area in Cali. Not only this, the shopping there is awesome. A ton of stuff that I missed from Cali and I was able to find them. It was great for the 20min that I could squeezed in to wander.

This new perspective on Whole Foods must be because I am older and have changed my taste a bit. Before you would never find me willingly to step foot into a place like this. I am so glad that I did today and found a great place very close to my apt. It seems like a great place to study for my upcoming boards as well. :)

Salty Soy Milk Soup (xian dou jiang)

The other nite my brother called and asked about how to make salty soy milk soup. I was surprised because it's not his thing. It's more of my type of Taiwanese food. I really do miss it especially when eaten with the fried doughnut/sticks. I can't wait to go home and go to the really good northern Chinese restaurant with all the good breakfast.

Ingredients:

• plain soy milk (not sugared). Use the real kind that comes from a soy milk shop, not the super filtered kind made by Silk
• rice vinegar
• pickled mustard greens (available at Chinese or Japanese supermarket)
• sesame oil
• chili oil
• soy sauce
• something salty (e.g. Chinese bbq sauce, dried shrimp, or fried shallots)
• salt & white pepper

Place all ingredients except for soy milk into a bowl that is the single-serving sized; the quantities should be determined by the individual's taste. Lightly mix.

Warm enough soy milk for 1 serving in a pot on the stove until just boiling. Carefully spoon the soy milk into the bowl. If desired, top the soup with a few sliced of Chinese donut. Serve immediately.

The 11 Most Expensive Catastrophes in History

This was in my email inbox after I got back from hospital today and thought it was great, especially the last one. Wonder how our world has become like this.

# 11. Titanic - $150 Million
The sinking of the Titanic is possibly the most famous accident in the world. But it barely makes our list of top 10 most expensive. On April 15, 1912, the Titanic sank on its maiden voyage and was considered to be the most luxurious ocean liner ever built. Over 1,500 people lost their lives when the ship ran into an iceberg and sunk in frigid waters. The ship cost $7 million to build ($150 million in today's money)

# 10. Tanker Truck vs Bridge - $358 Million
On August 26, 2004, a car collided with a tanker truck containing 32,000 liters of fuel on the Wiehltal Bridge in Germany . The tanker crashed through the guardrail and fell 90 feet off the A4 Autobahn resulting in a huge explosion and fire which destroyed the load-bearing ability of the bridge. Temporary repairs cost $40 million and the cost to replace the bridge is estimated at $318 Million.

# 9. MetroLink Crash - $500 Million
On September 12, 2008, in what was one of the worst train crashes in California history, 25 people were killed when a Metrolink commuter train crashed head-on into a Union Pacific freight train in Los Angeles . It is thought that the Metrolink train may have run through a red signal while the conductor was busy text messaging.. Wrongful death lawsuits are expected to cause $500 million in losses for Metrolink.

# 8. B-2 Bomber Crash - $1.4 Billion
Here we have our first billion dollar accident (and we ' re only #7 on the list). This B-2 stealth bomber crashed shortly after taking off from an air base in Guam on February 23, 2008. Investigators blamed distorted data in the flight control computers caused by moisture in the system. This resulted in the aircraft making a sudden nose-up move which made the B-2 stall and crash. This was 1 of only 21 ever built and was the most expensive aviation accident in history. Both pilots were able to eject to safety.

# 7. Exxon Valdez - $2.5 Billion
The Exxon Valdez oil spill was not a large one in relation to the world ' s biggest oil spills, but it was a costly one due to the remote location of Prince William Sound (accessible only by helicopter and boat). On March 24, 1989, 10.8 million gallons of oil was spilled when the ship ' s master, Joseph Hazelwood, left the controls and the ship crashed into a Reef. The cleanup cost Exxon $2.5 billion.

# 6. Piper Alpha Oil Rig - $3.4 Billion
The world ' s worst off-shore oil disaster. At one time, it was the world ' s single largest oil producer, spewing out 317,000 barrels of oil per day. On July 6, 1988, as part of routine maintenance, technicians removed and checked safety valves which were essential in preventing dangerous build-up of liquid gas. There were 100 identical safety valves which were checked. Unfortunately, the technicians made a mistake and forgot to replace one of them. At 10 PM that same night, a technician pressed a start button for the liquid gas pumps and the world ' s most expensive oil rig accident was set in motion. Within 2 hours, the 300 foot platform was engulfed in flames. It eventually collapsed, killing 167 workers and resulting in $3.4 Billion in damages.

# 5. Challenger Explosion - $5.5 Billion
The Space Shuttle Challenger was destroyed 73 seconds after takeoff due on January 28, 1986 due to a faulty O-ring. It failed to seal one of the joints, allowing pressurized gas to reach the outside. This in turn caused the external tank to dump its payload of liquid hydrogen causing a massive explosion. The cost of replacing the Space Shuttle was $2 billion in 1986 ($4.5 billion in today ' s dollars). The cost of investigation, problem correction, and replacement of lost equipment cost $450 million from 1986-1987 ($1 Billion in today ' s dollars).

# 4. Prestige Oil Spill - $12 Billion
On November 13, 2002, the Prestige oil tanker was carrying 77,000 tons of heavy fuel oil when one of its twelve tanks burst during a storm off Galicia , Spain . Fearing that the ship would sink, the captain called for help from Spanish rescue workers, expecting them to take the ship into harbour. However, pressure from local authorities forced the captain to steer the ship away from the coast. The captain tried to get help from the French and Portuguese authorities, but they too ordered the ship away from their shores. The storm eventually took its toll on the ship resulting in the tanker splitting in half and releasing 20 million gallons oil into the sea. According to a report by the Pontevedra Economist Board, the total cleanup cost $12 billion.

# 3. Space Shuttle Columbia - $13 Billion
The Space Shuttle Columbia was the first space worthy shuttle in NASA ' s orbital fleet. It was destroyed during re-entry over Texas on February 1, 2003 after a hole was punctured in one of the wings during launch 16 days earlier. The original cost of the shuttle was $2 Billion in 1978. That comes out to $6.3 Billion in today ' s dollars. $500 million was spent on the investigation, making it the costliest aircraft accident investigation in history. The search and recovery of debris cost $300 million. In the end, the total cost of the accident (not including replacement of the shuttle) came out to $13 Billion according to the American Institute of Aeronautics and Astronautics..

# 2. Chernobyl - $200 Billion
On April 26, 1986, the world witnessed the costliest accident in history. The Chernobyl disaster has been called the biggest socio-economic catastrophe in peacetime history. 50% of the area of Ukraine is in some way contaminated. Over 200,000 people had to be evacuated and resettled while 1.7 million people were directly affected by the disaster. The death toll attributed to Chernobyl , including people who died from cancer years later, is estimated at 125,000. The total costs including cleanup, resettlement, and compensation to victims has been estimated to be roughly $200 Billion. The cost of a new steel shelter for the Chernobyl nuclear plant will cost $2 billion alone. The accident was officially attributed to power plant operators who violated plant procedures and were ignorant of the safety requirements needed.

# 1. 2008 Presidential Election- $800 Billion in the first two months alone.......

Duk Bok Ki

I was watching some Korean shows and keep seeing the DukBokki. I remembered eating them and loving it when I was visitin Korea. So I got the urge to look up the recipe. It doesn't seem hard and the ingredients seem easy to find, especially now that I know where a Korean marked is in my area. Yummy. Can't wait to try it.

Ingredients:
4 servings Korean Rice Cake (tteok)
2 tablespoons Sugar*
2tablespoons Branston Soya Beans In Mediterranean Sauce
2 tablespoons Fermented Red Pepper Paste(gochujang)
1 teaspoons Garlic
1 servings Carrots

Instructions:

Put the rice cake in cold water for about 15 minutes to soften.

Put 1 cup cold water in large pot. Add sugar, soy bean sauce, red hot chili paste and garlic. Bring to a boil and boil for about 5 minutes.

Put the rice cake in the pot and continue to boil for 10 minutes.

Add chopped scallions and continue to boil for 2-3 minutes.

Calories 311 Calories from Fat 17
Total Fat 2.33g Saturated Fat 0g Monounsaturated Fat 1g Polyunsaturated Fat 0.03g Sodium 319.44mg Potassium 105.34mg
Total Carbohydrate 65.68g Dietary Fiber 2.02g Sugars 8.01g
Protein 15.25g

Life, Death and Age

This past week has started out shocking but not quite depressing but by today, it is outright depressing. Earlier, I got a notice saying the sister of one of the girls that I knew at UCLA has been diagnosed with a really rare stage 4 cancer, either paraganglioma or carcinoid. She is only 21, I think. I have met her a couple of times where her sister brought her out to church a few times. She is not a believer and I really wonder what her thinking is with this facing her. Her sister, B, has been diagnosed with thyroid cancer a few years back and has recurred again over the las year. Their mother was also diagnosed with breast cancer. B is a believer and I have heard from her when I was at UCLA how she went through it with God at her side leading her. That really got me thinking how in the world would I deal with something like this if I didn't have God on my side. It would be hard because I wouldn't know that there is something better waiting for me and know the hope that God has given me.

Then 3 days ago, I got one of the massive email from GOC group asking for prayers for Grace and Andrew. I knew that Andrew's tongue cancer came back a few months ago and things were actually looking okay, so I was totally not expecting this email from them. I then come to find out that there isn't really much hope on the cure unless it's a miracle. But miraculous healing does happen thought. Then I finally got an email last night saying that he passed. This really shock my system for a bit. I actually met the couple a few times during my freshmen year and then hearing this really jarred me. I was thinking wow, someone so young and someone that I actually know has gone through this and is really gone. Not only did he and his family fought the cancer aggressively, I was thinking what are his kids going to do. They are 3 1/2 and 2 1/2 yr old. They have blog of their journey. It's definitely worth the reading to see how God was glorified in their lives.

This all brought me to think that life and death really don't care about age. If it is set to happen then it will, no matter how much is fought. Life has to be taken care of, living to the fullest and having no regrets. Death will come and the preparation for it is not to prepare how to die but to prepare to die without regrets, without feeling that you haven't done a certain thing yet. Whatever that is done on earth will stay and nothing can be taken with death. So everyone's death does have an impact on somebody whether it's a good one or not. Why not make our own impact a good one so that even our deaths will help someone? I truly see that God has it designed that even our deaths are to glorify His work and to let others see what an awesome God he is.