Monday, August 10, 2015

1st Trimester Bump Updates

I'm a little delayed with posting this 1st trimester update but I'll utilize the excuse of being a busy, pregnant, and tired pharmacy resident. I am currently 16+ weeks pregnant but I shall give you a recap along with some bump pictures of the 1st trimester. Although not very eventful per se, I still want to remember how I went through my very first pregnancy with my first-born and how I handled life (read: pharmacy residency) at the same time.

I started documenting my pregnancy at week 8, and I hope to continue doing so until the very end (that is, sometime in late January).


Week 8

  • Baby is the size of a RASPBERRY
  • Mama is busy with: 
    • Figuring out which insurance plan to choose from my her employer to make sure she doesn't pay a million bucks out of pocket for your prenatal care, labor, and delivery - although you are so worth a million bucks. But mama doesn't have that much. So we'll  stick with paying higher insurance premiums to get a plan with a not-through-the-roof deductible. (Although both the premiums and the deductible are still high considering mommy's puny little resident salary).
    • Studying for the Illinois MPJE and Indiana MPJE (Pharmacy law exams)
    • Taking the MPJE exams and freaking out that she failed. FYI: She didn't. She was far from failing even though it really didn't feel that way as she was leaving the exam. 
    • Seeing you for the first time on our first ultrasound. Staring at the ultrasound screen in disbelief that this little teeny tiny miracle is growing inside of her. Watching daddy smile. Feeling daddy squeeze her foot from excitement as we both stared at the screen in awe. 
    • Hearing your loud and fast heartbeat for the first time and not being able to resist the huge grin that spread across mommy's face and the joy that sprang up in her heart. Seeing daddy's smile and awe, too. 
    • Seeing daddy take the printed ultrasound pictures after we walked out of the US room, and put them against his chest while closing his eyes, as if he was hugging you. (Mommy will have that image of daddy pressing the US prints against his chest forever imprinted in her mind).
    • Going on a mini weekend getaway to the Smokey Mountains in Tennessee with Daddy and with daddy's best friend and his wife (who is mommy's very good friend). 
    • Having a huge appetite on our vacation and everyone enjoying mommy's pregnancy cravings and hunger pangs and attempting to feed her all the time
    • Taking pictures of daddy and friends tasting free moonshine, wine, and whiskey while mommy could only stand there and imagine how good it tastes and figuring out how many more months until Valentine's day, which is the date mommy will try the mudslide moonshine daddy bought for her at David Crockett's distillery

Week 9

  • Baby is the size of a GRAPE
  • Mama is busy with: 
    • 1st week of residency (orientation week)
    • Being excited and scared at the same time about what this year will bring as we were presented with all of the different projects  and tasks we will be responsible for as residents
    • Figuring out how and when to tell the RPD (Residency Program Director) that mama is expecting you in a few months
    • Praying, praying, praying about mama's pregnancy, residency, your coming into the world, your health, daddy's job, daddy's health, daddy's new role (praying to St. Joseph to be His Patron and Model of a good and chaste husband and gentle and caring father).
    • Mama went to adoration and spent an hour with Jesus asking him to care for our family. Jesus listened. Jesus is always a good listener.

Week 10

  • Baby is the size of a PRUNE
  • Mama is busy with: 
    • 1st week of Internal Medicine I rotation. 
    • Drafting IRB (Institutional Review Board) approval form for mommy's proposed research project
    • Learning the Clinical Pharmacy Policies and Procedures of my hospital (Ex: vancomycin dosing and monitoring, warfarin dosing and monitoring, Total Parenteral Nutrition, etc)
    • Studying for the NAPLEX (North American Pharmacist Licensure Exam)

Week 11 

  • Baby is the size of a LIME
  • Mama is busy with:
    • Taking the NAPLEX at Grand Rapids, MI (And using that as an excuse to spend the night on my parents' farm in Michigan)
    • 2nd prenatal appointment (heard your sweet heartbeat again!)
    • Working her first weekend as a clinical staff pharmacist 
    • Starting data collection sheet for her research project, which is going to be focused on Antimicrobial Stewardship, aka analyzing the utilization of certain antibiotics at the hospital and suggesting ways to improve their utilization (to decrease bacterial resistance and healthcare costs)

Week 12 

  • Baby is the size of a PLUM
  • Mama is busy with:
    • Finding out she passed all 3 of her board exams and is now officially a registered/licensed pharmacist
    • Preparing a presentation / mini lecture on stroke, focusing on the treatment guidelines, CMS core measures, and discharge counseling 
    • Hospital orientation where we found out all about the Franciscan Mission and Values of Saint Margaret's (I described this as well as why I love my residency program here)
    • First time experiencing morning sickness at work (before it always happened at home) and barely making it to the pharmacy bathroom to puke out her breakfast, hoping nobody can hear her since she has not spread the news yet
    • Taking EKG classes
    • Telling the RPD (Residency Program Director) the big secret and having a discussion in her office about how we will proceed and how this will affect my residency (The RPD was very understanding and supportive, as she herself is a mom of 3 and she herself went through residency - although not while pregnant).

Favorite thing(s) about pregnancy as of this trimester? 
**Husband COOKING for me and FEEDING me and getting so much joy out of it** BEST.THING.EVER!!!

Least favorite thing(s) about pregnancy so far? 
Morning sickness, No caffeine, No Ethanol ( I do have an occasional small cup of coffee on bad mornings and an occasional small sip of my husband's beer on a hot day).

Funny thing that happened this trimester? Having lower back / side pain on a particular day and self-diagnosing it as pyelonephritis, being scared that it's "flank pain" - a characteristic symptom of pyelonephritis (kidney infection). Because self-diagnoses are oh so accurate, lol. It was just lower back pain guys but I worried for a while.

And that is all. Leave some love in the comments :-)

Yours in Christ,

Tuesday, July 28, 2015

The Start of my Pharmacy Residency and Post-Match Reflections

Can you tell I started residency last month??? You probably can because I totally abandoned you guys meanwhile. The first month wasn't all that bad and it flew by like crazy...but the real ride is about to begin.....
So let me update you on some stuff.....

First of all: 

"So how does it feel to be a licensed pharmacist?" - my friend asks me today.

My exact response: "It feels a little intimidating to tell you the truth. Now I have all of these responsibilities on my shoulders - it is kind of scary to think that people's well-being is in my hands...that my decisions will be affecting the health outcomes of ill patients in the hospital."

Just showing off my new resident white coat
It definitely is scary to sign your name at the bottom of a "progress note" in which you explain how you will dose a patient's antibiotic or why you will be switching a particular medication to a different one. That note is a permanent record in the patient's chart. That decision has a permanent impact on your patient's health. And your name stays with it forever. Your decisions cannot be reversed. So God forbid you make a decision that is less than optimal to the patient's health and well-being. This is one of the reasons why choosing to do residency and have a truly clinical role was such a huge discernment process for me - and this is why I always have and always will study hard and pray hard.  Because I want to make sure I deliver the best care possible and make the best possible decisions based on the most recent medical research / evidence and based on sound clinical judgement coming from my experience...and wisdom coming from the Holy Spirit. Most importantly, I pray at the beginning of every workday and I place everything in the hands of the Lord, because at the end of the day, it is He who is working through me to heal and to save lives. 

Despite being humbled by being given such a critically important and impactful role within healthcare, I am certainly ready to accept this God-given role and do my absolute best to provide optimal healthcare to the people God puts on my path. I promise I will do my best...because this is not just my career, this is not just my money-maker - this is my VOCATION, this is my MISSION. God created me to do this for a reason and thus I will do my best to be the best clinical pharmacist I possibly can. 

But.....enough of my shpeal...let's get back to the original point of this blog post: 
My residency program.

Back in the day....after I announced that I matched to a residency program, I promised a bit more info. Since I told you guys all about the application and interview process as well as familiarized you with all of the hospitals at which I interviewed, I figured you might be interested to hear where I ended up matching...or rather...where God, the true matchmaker, placed me. I have been promising to deliver this blog post since the spring, but as you know...I was just a tad bit busy finishing up rotations, graduating pharmacy school, studying for board exams, getting licensed, and preparing for residency.

March 2015

To start off, here is a picture of my post- residency match Mexican food outing with my husband.
I am now jealous of the above pictured girl and her mango margarita. This was probably the last margarita I have had and will have in 2015. Pregnant woman problems blessings. :-)

Anyways.... On the infamous "Match Day," I raised my head from my pillow in the morning and grabbed my phone to check my e-mail for match results. I saw 2 emails: one from the National Match Service (NMS) and one from the Residency Program Director (RPD) of Franciscan Alliance with the subject: "Congratulations." So I did not even have to open the official National Match e-mail to know where I matched, because the RPD sent all 4 of us an e-mail just a few minutes after the results came out. 

And so at first I was like:

And I let myself be happy for a few moments....maybe even a few days. I spread the news among family, e-mailed the professors and preceptors that wrote me letters of recommendation to thank them, and I went out with my husband to celebrate the newly determined course of my future.

But it wasn't too long until negative thoughts, doubts, and fear started creeping in and stealing my joy. As always. The devil won't let you be happy for too long, because your happiness really irritates him.

So after thinking too much like a human and for too long...I was like:


Despite my long discernment process, I once again started having doubts about residency. And not only residency in general, but at this time, I had doubts specifically about the program I matched to. Instead of being happy that I even matched to a program (less than 1/2 of the people that apply actually get a residency) and instead of trusting God with where He placed me, the never-ending train of "Why's" and "How's" began haunting me. 

The one thought that I specifically remember haunting me was 
"Why did I not get into my #1 ranked choice but rather my #2?" 

Right before the Residency Match Day, I had a pretty good feeling about both programs. In fact, I ranked all 6 programs where I interviewed but was really only hoping to get into #1 or #2....the other 4 were just backups. But after I matched to #2...of course the devil (and my human nature) made me want MORE. My mind was convinced that my top program was the best match for me...and had the best options...but let me just tell you (now that I am 4 weeks into residency), that I was wrong (haha, did you see that coming??? God once again showed me that HE IS RIGHT and I AM WRONG. Just always works out that way. He's too smart!). But since between March and May I did not know that, I kept being hesitant about residency and really not knowing whether it was a good decision to commit to. But after the initial flood of "why's," I really just took the backseat and let God be the driver. I kept working and finishing my rotations and I knew that what was coming at the end of June was good...because everything that God gives us is GOOD for us in one way or another. It might not be EASY, but it is always GOOD. 

So I placed my trust in God and stopped worrying about what is coming and where I am going. And then of course from mid-May through the start of residency, my heart and mind were elsewhere...I was distracted with something way bigger, way more important.... NO, not just graduating with my PharmD. I was busy thinking about the baby God had placed in my womb. Of course, when you read my initial baby announcement post, you will see (or have already seen) that I also had lots of questions and doubts regarding how I will survive residency and give birth to our first child in the middle of it, and then have to finish 6 more months of it and be away from my newborn for such long days/hours. I still think about that a lot but I try not to worry about the future because by now I figure God knows what He's doing with my life. Even though some things seem impossible and very difficult and scary right now as I look into the near future, as always, I choose to place it all in His Hands and trust, trust, trust and pray, pray, pray. I asked for one or the other (baby or residency), but God chose to give me both (because He always gives abundantly to those who place their trust in Him) - which just means that obviously God knows that I can handle both. 

Buy anyways, going back to discussing the program where I matched for a year of residency. I have only been there for a month and the "real fun" hasn't really started yet because we're still kind of shadowing and working under direct supervision of our preceptors for this first rotation....but to be completely honest...I love everything about Franciscan St. Margaret Hospital. In fact, the whole entire Franciscan Alliance Health System (comprising of several hospitals throughout Indiana) is just a wonderful company to work for. I mean, the whole culture of the Fransciscan system is just so different from all of the previous hospitals I have experienced through rotations. It is as Catholic as they come! Not just Catholic in name. Catholic in EVERYTHING they do and everything they stand for. 

For example, this is a portion of their employment application. Came across when I was filling out my paperwork and I thought it was awesome that all of the employees and potential employees have to read and live by these Franciscan standards.

The first time I went to the South campus (St. Margaret has two campuses that we residents alternate between), I was very impressed. 


Do you know what literally went through my head when I first arrived at this campus and walked from the parking lot into the hospital? ....I looked around and I thought: "A crucifix (not just a cross, a real and life-sized crucifix with Christ's body hanging on it) is standing by the road right by the main entrance into the hospital, a life-sized Statue of Saint Francis of Assissi prominently displayed right in the center of the parking lot entrance, and a Vatican flag waving in the background. I feel like I am home." I felt at peace, assured that this WAS the EXACT place that GOD brought me to for residency, and I felt so proud to be Catholic at that moment. ...And proud to be a resident for the Franciscan Health System. I JUST KNEW I WAS IN THE EXACT PLACE GOD PREPARED FOR ME FROM THE VERY BEGINNING. (Of course, all of the anxiety that came with residency discerning, applying, interviewing, matching was just useless worrying. This was God's Will for me this whole time and He brought me to it, as He always does. But at least I learned a whole lot through this experience and it brought me closer to God.)

Then we had our residency program orientation, followed by 2 days of hospital orientation. I felt very peaceful, assured, and happy at both. There was no doubt in my mind I belonged at this hospital, at this residency program, at this specific time. All my thoughts, doubts, and fears were cleared...especially after we watched a video about how this Franciscan hospital system was first founded, what its mission and values are, and just how very different it is from your general (especially secular) hospital. The mission of the hospital, which is prominently displayed all over the hospital and all over paperwork is:

"Continuing Christ's Ministry in Our Franciscan Tradition."

So now that God called me here, this is MY MISSION as well. 

And into the 3rd week, when I started getting overwhelmed with some of the projects being assigned to us...and then also thinking about how I will handle everything with this pregnancy and having a baby in a few months and then coming back to finish another 6 months...I saw this phrase on a piece of paper pinned to the Nurses' Station on the 6th floor [which is the IMCU - or Intermediate Care Unit]:

And I immediately thanked God because I literally saw this message right when I began getting discouraged. Perfect words and perfect timing. And again, I was assured that if God brought me to it, He will bring me through it. God obviously wants me here, and He also wants me to have a baby while here...He will not forsake me. My journey over the next 12-14 months (until I finish residency) may be HARD AS HELL, but I will get through it with God and I will come out on the other side VICTORIOUS!

For now, I know that I am in the right place and I cannot imagine being elsewhere. I cannot wait to meet my munchkin in January and I cannot wait to finish my residency program in July/ August 2016 so I can spend more time with my munchkin after the craziness of residency is done. 

I came across this on pinterest a few months back, and I decided that this will be my little motto for this residency / pregnancy / baby year....I think I will print this quote, frame it, and put it on my resident's desk...just specifically for those difficult times of discouragement and exhaustion. 

You can't go wrong with God.


(P.S. I missed you all and I will be back shortly to post my 1st trimester updates with weekly pictures. I am almost done with that post! So come back ya'll!)

Agnes  :-)

Wednesday, June 17, 2015

Our official fun pregnancy announcements!

I am waaaaaay to excited not to share!!! We had our first ultrasound today!!! We saw our little miracle and had our little moments of happiness as we saw and heard the 8 week 3 day old baby's heart beat. Precious!!!

And in case you've been wondering about me....
I'm doing fine! Just feeling nauseous a lot these days (mostly mornings, hence its called "morning sickness" but today I've been feeling kinda crappy all day).

I found a wonderful OB office.
Had my first prenatal appointment last week and my first ultrasound today.

Going on a little getaway to Tennessee this weekend and starting residency on Monday.

That's all the updates of my life lately in a nutshell. I will get more specific in my next post. Life's been busy, ya know!

Enjoy my fun pregnancy announcements!

I am also planning on documenting my pregnancy every week or two, depending on how crazy busy residency will make me. So keep on coming back and checking up on me :-)

So's the first official picture...
(not much of a belly yet...I mean there is...but that's just my base cushion I've been carrying around lately, haha).

Friday, May 29, 2015

7QT #52 All kinds of amazing news

Another post in the 7 Quick Takes Series.

I have a lot of news to share with you this Quick Takes. Of course, if you're a regular reader of my blog, I have already shared some of these news in their own stand-alone posts, but for those of you visiting here from the Quick Takes are some updates about my life. And this will be a good general re-cap of how I FINISHED pharmacy school and where things stand as of right now.

#1 Finished my last APPE

That's right! I am no longer a student! Here is one of my very last selfies as a pharmacy student. I really enjoyed my 6th and final pharmacy rotation, which was at a small, faith-filled Catholic Hospital in the suburbs of Chicago. I met some amazing people there that I will probably keep in touch with long term, because we just enjoyed each other's company and presence and faith so much. I even got offered a job (within like 2 weeks of starting there!) but they knew I was doing a residency so they told me to contact them next year, a couple months before I finish residency and that I "have a spot guaranteed!" Ahhh...and my preceptor just loved me and treated me like I was her daughter. But more about this final rotation shall be described in its own post - coming soon.

#2 Found out I'm double blessed

To those of you who missed the big news, the Monday right before graduation I found out I am carrying a little miracle inside of me and that God blessed me DOUBLE! Even though the journey ahead is scary because the next 12 months of residency will be LONG and INTENSE and I get no breaks but a mere 10 personal days off....I am definitely seeing God's hand in all of this. A while back I had a long struggle about whether I should pursue residency or just take a retail job and start a family (because I wanted to be a mom so badly)....and I wasn't even sure I was going to match to a residency program since it is so darn competitive. I ended up applying, scoring interviews in 6 out of the 7 programs I applied to, and matching to my #2 ranked choice. I then finished my last rotation (as described above), and the weekend right after I finished, I just kind of did a "let's just pee on a stick for fun" kind of pregnancy test, not really seriously suspecting pregnancy since my period really was only 1 day late (which has happened before), and found out I had the lovely mother hormone in my pee pee (hCG).

So yeah, basically...after asking all these questions for all this time...and after praying...and discerning...and praying....and discerning some more...guess what the Almighty has done for me? He didn't want me to have to live with just one choice and not the other. He wanted me to HAVE IT ALL. HE GAVE ME A RESIDENCY AND A BABY - BOTH AT THE SAME TIME. I learned my lesson. With God, there is no limits!!!!!!!!! Do not ever put a limit on GOD! Ask Him for big things because He is just waiting for you to ask...and He'll give, give, long as it's in His Will. 

Read more in my original baby announcement post.

                                             And this cheesy one is what I sent to daddy's phone :-)

My favorite thing about pregnancy so far is eating without feeling guilty, hehe ;-)
And the fact that my body is awesome and is not protesting to the little being inside of me with nausea or other symptoms. I am completely symptom free and if not for the lack of my period and positive pregnancy test, I wouldn't even know I am pregnant. I'm still kind of nervous about telling my residency director. And I'm just nervous in general about giving birth in the middle of residency and not having a maternity leave. That's probably what scares me the most. It scares the crap out of me to even imagine leaving my few-day or few-week old, first-born baby and going right back to the stress of residency. I know I won't be able to focus because I'll be thinking about my little teeny tiny innocent sweetheart the whole time. But I pray about it..and I'm sure it will work out. Hopefully my husband will finally leave his current job and become self-employed, which will make him way more flexible and able to dedicate time to his family. This is what we need right now. FOR THIS I PRAY. AMEN! 

Keep those prayers and advice coming. I appreciate the outpouring of love, prayers, and advice I have received so far...I am taking your advice seriously and purchasing the books you recommended and reading the websites you passed along. Keep them coming...because I still don't know what I'm doing. :-D

#3 Had a little makeover for graduation

My co-worker (pharmacy technician) Sahira came over and did my nails before graduation. She painted on a dancing capsule and we called it "the happy pill." Perfect for the occasion :-)

I also chopped off my hair!!!!!! Woo!! It's so much easier now. Here is a BEFORE and AFTER photo. My last day of last rotation vs. right after I came from the hair salon. What a difference, huh? I think the last time my hair was this short was right after my First Holy Communion, when I decided to chop it off after growing it for so long.


#4 Started some serious studying for board exams

In just a few short weeks, I have to take 3 different board exams. One is the NAPLEX, which is a 4h 15min exam that tests all of your pharmacy knowledge. And then I have to take the MPJE for two states, since my residency is in Indiana and I live in Illinois. I have to take the Illinois Pharmacy Law Exam and the Indiana one as well. 

My RxPrep book is 900+ pages and the IL-Law and IN-Law study guides are ~300 pages each. So yes, perseverance in my studies is needed! And prayers!

#5 Got awarded Summa Cum Laude Honors at the Pharmacy School Commencement Banquet

#6 Graduated Pharmacy School and got my Doctor of Pharmacy Degree!!!!


#WheresWaldo Agnes
Don't even try to find me in here...because I'm towards the back and you can only see 1/2 of my face

Go to my original graduation post for a lot more graduation and grad banquet pictures!


...and will you look at these other cool things I got? Those are some of the same things I talked about here.

And now...that all the celebrations are behind me....

24 more days until residency starts.
240 days until baby gets here. 

I have always told you that 2015 was going to be a great year, full of hope and good things. And it is ;-)

Peace and God Bless,