The MCAT Experience

So if you want to know what it feels like to have your brain contents scooped out and then slicked out with a spatula, take the MCAT. I highly recommend it! It is an interesting experience. Oh and practice tests don't count you have to take the real thing and muster up the energy to care how it goes even if you are doing it just to experience this feeling.

I took a total of 7-8 practice tests before the real one. But I am not a stressed test taker and in fact, I can find myself enjoying a good standardized test (yes there IS something wrong with me as if you needed more proof). It doesn't mean I do well all the time, it just means they don't mess with my head too much. So the practice tests were sort of a 5 hour cake walk. I was just bummed that I had to sit for 5 hours but once I got into them they were kind of interesting. Although they were hard I just did my best and let it go.

Somehow my brain yesterday KNEW it was a real test versus a practice test and I exhausted every last neuron on that thing. Five hours of 100% neuron flushing is quite the experience. Ten minute breaks between sections flew like 2 minutes while I shoveled sandwiches, avocado, chips and vitamins into my mouth. Then I watered it all down with 10 oz of water (yes, I figured out how much water I could drink without having to pee during each section). I visited the echoing bathroom. Then ran up and down the hall to get my blood going, that was so stagnant it was threatening to coagulate in my veins. Every time, no matter what, my computer scolded me in no uncertain text for taking more than my allotted 10 minutes.

Oh, you haven't taken the MCAT? Well here's what you can expect.

In the physical sciences which is Physics and General Chemistry there are 52 questions 13 discrete and 39 based on 5-7 paragraph fragments of scientific articles and you have 70 minutes to finish these. This works out to 16 minutes/passage and you better understand all that scientific garble since they will ask you about the minutia of it and 13 minutes for the discrete questions. Oh and you don't get a calculator so you better figure out how to do square roots in your noggin or if you're me, on your fingers and toes and be snappy about it.

Then you move on to sixty minutes of verbal where they go out of their way to find articles with the greatest mismash of big words all shoved into a 7 sentence paragraphs. But they cut off the beginning and end so its like reading 7 paragraphs out of the middle of an article and then answering questions, like infer what the author meant by this whole article half of which you didn't read. Or if the author makes this assumption about the economy and we make this other assumption about it how could it be applied to horses and cows (You think I'm joking? I had one like that yesterday really!) Not all of them are that bad but there are always some.

Next, are two essays on a surprise topic of their choice. Questions like, "In times of war, maintaining public support is often the most difficult battle," (this is one of the real questions taken off the MCAT test website... they give out examples). Now write for 30 minutes on when this is true, when this is not true and bring it together. This was my hour break. I love writing and can write LOTS about nothing. Can you tell?

Then it is the biological sciences section. I struggled the most with this section on practice tests and I don't know why. Biology and Organic Chem are my two favorite subjects and that is what it covers. It is similar to the physical sciences 70 minutes 52 questions 13 discrete and 7 passages with various numbers of questions attached. The passages tended to be more interesting to me and perhaps that is why I struggled... I actually read them, for fun. Things like x genetic disorder affected family g and h but their phenotype was different and here are the physiological affects this disorder has. Now answer obscure questions about them. Or this enzyme is cleaved through hydrolysis and then NaCl is added and it turns orange then we... ok I'll spare you... this would be organic. Please in less than a minute tell me what the intermediate molecule is. Why did it make this intermediate molecule etc etc... With a little more time these could be fun but I was constantly running behind. :D My triage efforts sort of died somewhere early on and got worse as the day worn on. hmmm I didn't even think of that. It doesn't bode well for my score. Oh well...

Anyway, we went out to eat after wards to celebrate it being done and because we were over an hour away from home and were hungry. I often just checked out in the middle of conversation staring through some customer with my mouth hanging slightly ajar. No, I am not exaggerating. Charles would have to almost shake me to bring me back from whatever empty corner of my brain I had gotten lost in. The waiter asked simple questions like, "do you want water." And I replied brightly, "no, I'm cold." It made sense to me... Fortunately a little food helped and I was able to drive home but once I sat down on the couch there was no standing up again. :D

I have highlighted the hard parts of the test for your reading enjoyment. It isn't too bad, time is the thing that makes it hard. I have taken the GRE and SAT and ACT and PSAT but this one is king of all. With that being said, a little practice and of course taking the prerequisite classes most people could do it. Just takes a little work.

Enjoy your day. I am!

So Good

Its amazing what a little sleep; sympathetic friends; some time alone with my Friend, my thoughts and taking a day off will do for perspective. Not to say I won't feel crazy again but life is too short to be all pent up all the time. :) I probably should write about more than my considerable frustration on here though. I was the person who disliked blogs that were filled with mostly angst. Like venom spread to infect the world that read it.

Charles packed more of the apartment yesterday and then he went out to look at apartments in Raleigh. We now have 4 possibilities but we cannot know which ones are real possibilities until we know what we will be getting for financial aid.

No one at Financial Aid seems to believe we lived on the amount of money that we did and we that we aren't amazingly unhappy or starving or being secretly supported by a anonymous and glamorous donor of the college underground. So we have had to send in all sorts of supporting paperwork to support our claim of being excessively poor. :D I'd like to see anyone try to put two people through college on 4 hours of work a week at $10/hr and living off what's left of one person's student loan after paying books and courses and not be pretty poor! :) hehehe!

We're doing what we have to, to follow the path we have chosen or feel is what is right and to explore the recesses of our dreams. And as depressed and frustrated as I have been the last week I'd rather deal with that then sit huddled in a corner afraid to explore and try new things out of fear.

I know and knew that perhaps I didn't come here to become a Dr, I didn't even want to be a Dr in the beginning that maybe I'm here to find another path... perhaps a Chemist or a Nurse Practitioner or who knows? I know that I will be happier not forcing things my way. It is my lack of knowledge of how to really let things go and be what they will be that causes me this frustration. I wish I could meet one person who has this totally figured out. That could tell me how they REALLY give up stuff the first time and forever and don't find themselves desperately clawing to get it back when it seems to slip further and further away. And unlike some, I learn by falling down, hitting the bottom hard, realizing I don't have ultimate control and letting go. Sometimes, in the case of this week a couple times in a week. :D

I have said this before but I share these times to unmask the struggles of a Christian. I struggle. In the end I choose to trust God but it is a fight and I passionately fight, cry and finally let go. But the good news is that I have seen the days that it takes me to release the pain and struggle to Him shorten.

Back when we first moved to CO and Dad, Charles, Todd and I started a construction company things were very, very tough. We were often being underbid by people who had no insurance and did poor quality of work. They were getting the jobs not us. I believe I spent a week or more upset and fuming at God about it. (Yes, the question is why blame God? I know the arguements but it happens to the best of us.) Unlike that time, this week it was a day of struggle I guess all hope is not lost. I'm learning unfortunately this one takes some doing to learn and I probably will never have it all figured out.

Last summer about this time I realized that life is the most profound teacher a person can have. I can either learn or flight the same battles over and over. I believe God helps me to come out a better person on the other side and gives me perspective other's believe it is something else. But my point is that I think we all struggle with the same things in the end letting it go and trusting that we will be made more compassionate and more beautiful in the end.

I would like to acknowledge the people that shared their sympathy already on my last blog and that I KNOW are struggling with things more difficult than my own. Your empathy and patience with my ramblings put me to shame thank you for caring.

So I'm off to enjoy the day. To breath in green woods, to feel the grit shift as I walk down a path, to laugh with Charles, to revel free of the burden that pressed my heart and to rest knowing that the future is not my responsibility.

The Strangulation of a Dream

I just found out my eligibility for financial aid for next year is most likely compromised by my incomplete courses because of surgery. Mostly likely it just means more paperwork to do to get them all happy I am not just playing hooky which is weird cause teachers don't give those out without a valid reason.

I am completely overwhelmed right now with all there is to do. Last night I sat up doing some angry ranting in my journal and crying. I've tried so hard to do well and be careful and when it all comes down to mattering I am kicked in the back by life. Recognize that feeling? ;-)

Yep I'm trying to remain positive. I make it through one day feeling pretty good and get blasted the next with more stuff to do... papers to fill out, deadlines to meet and the looming MCAT with a score that is dropping. Last night I told God I wish He would come down here so I could grab His collar and yell at Him. :D I spend a lot of time praying and meditating to find perspective. At some point I feel like its just over for me and I should stop caring... its just too much. But then I get mad and start fighting. Of course I realize how foolish I am being, I am not starving and my opportunities are by no means going to end if I don't get into medical school. I guess its hard to feel that a dream slowly being strangled to death by things outside my control.

Perhaps you have heard that women in labor go through what they call a transition phase. Its a time when they are just sure they cannot make it and cannot do it. Well, I think with this particular problem that is where I am. God has always come through for me in the past and I know it will work out... He's proven it over and over. But it doesn't stop me from being overwhelmed in this phase and at this time. Perhaps someday my halo will gleam as it sits at a rakish angle above my head and I will calmly look the prospective death of my dreams in the face and not be hurt or afraid but I'm not there yet. My halo sags unbecomingly about my ankles and its tarnished with the sweat of work and the mud of life.

Perforated Uterus - not a play on words

Hopefully no one is offended by this information but I sincerely believe that we can all learn from each others experiences and this has been mine for the last several weeks. If you are a man, perhaps your wife/girlfriend will benefit from your knowledge and if you are a woman perhaps this can help you be informed when making your own decisions. This was originally posted on a blog for potential IUD users so it isn't a story.



When this has been posted you will know where I have been the last few weeks. :)

I will try to make this as easy skim for information as possible. This is here for educational purposes and for those who have perforations and come looking for information. I had difficulty finding much useful perforation information when I was looking.

IUD of Choice: Mirena

Insertion:
Where: Planned Parenthood in NC
Cost: Free - because I agreed to allow a medical student to try first under supervision (I would want someone to do this for me when I am in that situation)
Pain During Insertion: Highly painful, nearly passed out, couldn't unclench hands or legs for several minutes, nauseated, never felt pain like that before in my life pain
Pain After Insertion: After 20 minutes left and drove to school used 800mg Ibuprofen that day and the next
No sonogram used for insertion

Other than that it my uterus would "bite" me if I stood wrong or walked wrong or sat wrong. Just a short painful cramp. Had cramping of my lower colon come to find out it was sitting against my lower bowel. Also had alternating diarrhea and slight constipation. This may be different for women who's IUD is sitting in a different place in their abdomen.

How I realized it was out of place:
Checked a week or so later and could not find the strings. Felt all around my cervix, no strings coming out or around it. Spent two days in and out of the University Women's Health Clinic, Planned Parenthood and Dr's office, lots of waiting.

Day's leading up to surgery:
1. Women's Health couldn't find strings either, didn't have sonogram so sent me back to Planned Parenthood
2. Planned Parenthood checked with sonogram couldn't find it in my uterus (used Plan B since it had been 80 hours since sex)
3. Women's Health for an x-ray to find the missing IUD - found near my hip
4. Dr's to talk about surgery and get questions answered
5. Hospital to get blood test to make sure I wasn't pregnant

Had two Ob/Gyn Dr's say that it wasn't an emergency to have it in my abdomen and since it was the Mirena it was roundy and unlikely to puncture anything else but also said there is little information out there on this happening as it doesn't happen that often. They did not give any special instructions on what to do not to do while waiting for surgery. I chose to move carefully as I didn't want it moving around my abdomen any more but that was MY choice. Dr who did insertion was very kind and apologized profusely also after much uncertainty the hospital the Dr was employed under agreed to pay for my surgery and care in connection with the IUD incident.

If I had been pregnant the Dr who inserted the IUD said they would wait until a later trimester to remove the IUD since they didn't want me under general anesthetic while in early pregnancy OR I could have a therapeutic abortion. I have been on birth control for 17 years so it was unlikely I was pregnant but just in case. Conversely surgeon stated that if I were pregnant they would still want to get it out right away and allow me to continue my pregnancy if I so chose. SO not sure which of those would have happened.

Dr said that complications for later pregnancies is highly unlikely. There should be no problem with implantation as they worry about that only with multiple D and C's and large amounts of scar tissue. Also I should not have to have a C-section but should be able to deliver vaginally but they would look at uterus while they were in surgery. I continued to have cramping in my bowel, alternating diarrhea and slight constipation. Again my days were spent waiting, waiting to hear when surgery was, waiting to hear who would pay for the surgery etc etc. It is very busy business to be sick actually and I got very little done but running to the hospital for tests and trying to figure out the details.

Pain: cramping in uterus, light bleeding, light overall abdominal pain all these were from Plan B I assume. Still have colon/rectal cramps and diarrhea/constipation

Surgery - Laparoscopy:
I was called the day before surgery and told not to eat after midnight and to drink only apple juice/water up to 3 hours before surgery. Dr suggested I could eat 8 hours before surgery since I struggle with low blood sugar levels. So I ate breakfast 7.5 hours before surgery and drank water up to three hours before surgery.

Had told me I would be kept in the hospital a day after surgery but then they decided to do it outpatient. I was glad about this, I would rather be home then laying in a hospital bed. But we packed over night items just in case. Here is what we took to surgery with us and it was helpful.

1. Contact Case/Solution
2. List of questions and things to tell each the anesthisiologist, dr and nurses
3. Loose clothing for after surgery, nothing tight around tummy and able to be sagged really low below lowest incision, also a loose t-shirt and heavy sweatshirt (it was almost summer but this was a real fortunate choice! I needed it)
4. Friend to drive
5. Lots of people who care about you

Anesthesiologist (things you may not think to ask your anesthesiologist):
- I have veneers on my front teeth do not allow a student to intubate me or use a LMA (rubber hose for airways much gentler) (answer: must intubate because organs are pushed against diaphragm and it is difficult for patient to breath)
- I don't drink or take medication very often so child Benedryl is affective (ie I am what they call a "cheap date" little to nothing and I'm out)
- Can I be put under before they start the IV? (answer: no :) )

Surgeon (things you may want to ask your own surgeon):
- Length of surgery (answer: 10 minutes - reality for me was around 1 hr 30 min)
- Risks of surgery (answer: damage to internal organs, infection, death lots of lovely things)
- Post Op expect what (answer: should be able to do sit ups in 2 days if all goes as planned - didn't happen)
- Visualize Uterus for damage? (answer: yes)
- Visualize path IUD took through intestines? (answer: can't tell but will check as much as possible for any damage)
- How many holes (answer: one through my belly button and hopefully just one by my hip)
- Can I walk up the two flights of stairs to my apartment after surgery

Arrived for my surgery 1 hr before the surgery. My sweet husband and a dear friend accompanied me.
1. Peed into a cup
2. Changed into a long cloth tie back gown, funny mesh disposable undies and thick socks with tread
3. Taken to Pre-Op chair which in the facility was a two person room with curtains between.
4. Nurse asked lots of questions and took vitals, started IV
5. Brought in my husband and friend
6. Anesthesiologist stopped by to answer questions, Surgeon stopped by, my Dr stopped by, Nurse who attended in the OR stopped by, whole parades of people came through a few forgot to tell me who they were so I had to ask...don't be afraid to ask. It's your body. Also keep your contacts in until the parade is over. I took mine out and my only recollection of my surgeon is this fuzzy blob person. :) It made me feel more out of control.
7. I become nervous and scared by this time. They took my BGL it was 71 which is fairly low or quite low depending on what scale you use.
8. They pushed 2-3 drugs into my IV - I don't know right now what they were but I would like to find out...probably Versaid and Valium...but I could be wrong.
9. Announced it was time and trundled me off
10. Everyone was in the room, OR table was shaped something like a cross (sorry not a positive connotation but the easiest way to explain). It allowed them to strap my arms up and away from my body and allowed them to get in as close to my body as possible. Very cool actually. It tips up so that my feet were above my head and my organs would fall up onto my diaphram so they would have as much room to work as possible. This is why intubation was necessary.
11. I laid on the table they began to strap me on and *ding* that's the last thing I remember

Post-Op:
Operation was 1.5 hrs much longer than anticipated. They have told me it is because I am thin and healthy and it made it more tricky to get into my abdomen...less room I guess to work in there. They had to pump me up with CO2 twice. The CO2 allows them to expand the abdomen and have more room to do the laparoscopy.

Woke up with my husband and friend there. I shivered and shook uncontrollably. This was supposedly part of coming off the general. I was very cold although they said my temp was normal. They had me drink soda - ginger ale but I can't recall it tasting like anything. I recall most of my first conversations but I was VERY sleepy. At some point they dressed me in my pajama's and sent me home with three warm blankets and my husband blasting the heat in the car. I slept most of the way home. I almost slept all the way up the stairs. It made me nauseated and I nearly threw up when I got into the apartment - but I didn't and fell asleep in bed.

Slept most of the next few days. Took Darvocet N 100 (much gentler than Percocet or Hydrocodone) and Ibuprofen 800mg every 4 hours and staggered so when I was coming down from one I had full dose of the other. The general anesthetic knocked me out pretty hard.

Tried to stop all pain meds 3 days after wards and could not. Pain was tolerable to me but was still bad enough to make me nauseated (means I didn't feel it as bad as it was in my body I guess from what they say).

Pain etc:
Lots of back aching, abdominal aching, shoulders aching.
Taut abdomen. They did not get enough of the CO2 out and it presses against the internal organs and causes referred pain. Still have it after 5 days. My abdomen is like a barrel and I generally have a flat stomach (yeh my fat goes to my hips :) )
Constipation from the anesthetic and Darvocet
- used prunes/prune juice
- lots of water
- fruit
- more water

Use a pillow to put back pressure on your incisions when coughing or moving your bowels. It is much more comfortable and provides support.

Only get stool softeners with Darvocet if recommended by Dr!!! This is different then Percocet or others I believe.

Slept on a pillow ramp partially sitting up and have had to get up every night and pee at least once.

Should have taken a walk around the apartment complex sooner then I did (day 3) it would have helped the CO2 dispurse more quickly and after pushing myself to walk I have gotten better feeling exponentially.

End of Day 4 - Pain med 2 Ibuprofen 400mg, still ache in my back and abdomen. Sleep only on my back still. Incisions still somewhat painful but stopped leaking around Day 3 or 4.

From what I read it could take 2+ weeks to get all this CO2 out of my abdomen and I believe much if not most of my pain is from this with less coming from the weird feeling of my intestines being a little "loose" and stirred around and some from the incisions themselves.

Found during surgery:
Could not find exit hole from uterus
Uterus points off to right and down so they would not recommend another IUD being placed without sonogram to watch that it is going on the correct place.

RECOMMENDATIONS:
- CHECK YOUR OWN IUD I know some Dr's recommend against it, I do not, my Dr does not. It's YOUR body and you should know what's going on not just have to "trust" the Dr (and yes I plan to be one in the near future). Learn how to check for your cervix if you don't know. Don't be afraid to ask for it to be checked by the Dr if you can't find it and then if they find it, have them show you how. They were amazed I caught it so early and it made surgery much easier because it hadn't adhered to the colon which makes it more tricky to remove.

- Have the first one placed with a sonogram. There are those few women who's uterus is pointing in strange directions and they are more at risk for perforation. I didn't know until it was too late. In my life I'm all about minimizing risk when possible and this is an easy way to minimize risk.

- My Dr agrees with this one and it was her idea: Only have an experienced provider place the IUD if you are NP. They can tell because of experience whether its puncturing the side or not.

Otherwise enjoy your new IUD!!! I will not be getting one any time soon, I have too much to do to risk anything else. I have an MCAT to take in a few weeks and all my classes are sitting at incomplete.