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the waiting game May 12, 2011

Filed under: Uncategorized — cempanger @ 2:03 pm

My life seems like it is on hold for this next month.  Since I don’t start my training for Target until June 6, I still have a few weeks to “kill.”  Luckily on Saturday Jeff and I are going to Hilton Head Island, SC with Jeff’s mom and dad.  We will spend the whole week out there relaxing on the beach and playing in the ocean.  I love to travel and vacation and have been looking forward to this getaway for quite some time!  I know I should be studying for my boards, but I just don’t have the motivation to do so right now.  I know when the time gets closer I will start to cram, but for now I will continue to procrastinate.

Today Maggie and Aaron are coming over to play some Settlers of Catan (super fun board game) so that should be fun.  Then tomorrow I have my INR blood draw in the morning and Alyssa and Grant are coming to spend the night here for a wedding on Saturday.  Then we are driving down Saturday morning to Winona to watch my little sister Kristina graduate, and then it is straight back to mpls/st. paul to catch our flight to Hilton Head!  It’s gonna be a busy few days but it’s hard to complain about busy when I have been so bored lately 🙂

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Introducing… Dr. Carlene Empanger May 10, 2011

Filed under: Uncategorized — cempanger @ 4:52 pm

Finally!  After 20 years of school, I have finished my formal education and my new title is Carlene Empanger, PharmD!  While it felt like forever, the four years really flew by fast.  This last year of rotations especially…it is hard to believe that I have worked the last year for free at 9 different sites.

Now I have another 4 weeks off before starting my job.  I am not sure that I have officially blogged about where I will be working, so for those of you who do not know… I start June 6th as a float pharmacist for Target in the southwest suburbs.  To be exact, I am in District 101 which includes 10 stores: St. Louis Park, Knollwood, Richfield, Minnetonka, Eden Prairie, Chaska, Chanhassen, Shakopee, Waconia, and Savage.  I am very happy with my district!  Although it will be quite a commute from St. Paul, I really like the SW suburbs and would love to buy a house in that area within a few years.  I will be floating for anywhere from 1-6 months and hopefully by then a full time position at a single store will open up and I will have a permanent store.  My float schedule will be 42 hours per week, working every 3rd weekend.  The shifts will be a variety of hours, ranging from 8-4 to 12-9.  This might make summer plans difficult to make, but hopefully it will only be this unpredictable for this summer.

I have been feeling very anxious lately and actually had 2 panic attacks last week.  I think all of the stress associated with the PE along with graduating, paying back loans and becoming a healthcare professional has taken it’s toll on me.  I know that exercise is an excellent way to cope with stress, so my new goal is to go on a walk every day.  This will help me deal with the anxiety/stress and also help me get stronger and hopefully within a month or two back to exercising like I was before the PE.

 

Feelin’ a little under the weather April 29, 2011

Filed under: Uncategorized — cempanger @ 3:55 pm

On Monday I started to develop an upper respiratory tract infection, and finally went in to see a doctor on Thursday.  Typically I would just tough it out since I thought it was viral, but the triage nurse wanted me to come in since it was affecting my lungs.  Turns out I was right, its just viral and I was doing everything I should minus a humidifier.  So I just have to deal with a runny nose, sore throat and nasty cough until my body decides to beat it.  Sometimes I get a little nervous because I think that the pain in my lungs is related to the PE, but I am sure its just the cold and my constant coughing.

My INR was 2.84 today which was great, and I don’t have to go in for another blood draw until next Friday!  They are (hopefully) finally figuring out my dose.  When I blow my nose, I have a little bit of blood coming out which is slightly scary, but hopefully its just a combination of my blood being thin and my mucous membranes being irritated.  The major risk of the warfarin therapy that I am on is bleeding, so I constantly need to be checking for blood in my sputum and poop to make sure I have no internal bleeding.

A bit of better news- I am graduating in 8 days!  Everything is done for graduation- all my grades are submitted, my paperwork has been dropped off at the board of pharmacy and I have picked up my cap and gown.  It seems so surreal I can’t even describe.  I have felt like I am living in a dream since the PE, and now with graduation on the horizon it seems even more like a dream.  For the last 4 years of my life I have always been certain of my immediate future- but now there are so many unknowns.  While a new path is intimidating, I also need to realize how exciting it is.  I have over a month off until I start my job on June 6th, and I am going on vacation in 2 weeks with Jeff’s family.  I really hope to cherish this time I have to relax and prepare to start the rest of my life.

 

April 26, 2011

Filed under: Uncategorized — cempanger @ 2:23 pm

Not much new with me- I had a great weekend of celebrating my birthday and Easter!  Wow – 27 – sounds super old!  I can’t help but think about my future with all that has been happening.  I am 27, finally graduating with my doctorate, and feel like I should be “growing up.”  I am still renting, not married (or engaged) and only have a few thousand saved for retirement.  While I am thankful that I will have a job after graduation, and money to help pay off my loans and save for my future, I really need to start planning for “adulthood.”  I hope to meet with my financial advisor in the next few months to get my finances sorted out (now that I will actually have a paycheck) and start to plan for the rest of my life!  But what about my personal life?  What about marriage?  Children?  I certainly thought by now I would be married and planning for my first child but life doesn’t always go as planned.

In regards to my PE, my INR is finally therapeutic so I am able to stop the shots.  Hopefully all of the bruises on my tummy will disappear before my trip to Hilton Head in May!  I am going into rotation today, and plan to for the next three days.  I probably won’t stay there the entire night, but I will just see how I feel and play it by ear.

 

Keeping Busy April 23, 2011

Filed under: Uncategorized — cempanger @ 3:55 pm

I had started to feel much stronger over the last few days.  Last night Jeff and I went to the Water Street Inn in Stillwater with Jenean, Michael, Zan and Steve.  We had been planning the event for months so I was glad I was able to go.  We had a four course dinner, and each had our own suite that we stayed in.  This morning we met for a huge breakfast and then headed off to Target field.

I let myself had a glass of champagne and wine last night- even though it might goof up my INR a bit.  I am still on lovenox until monday, as friday’s INR was 1.96.   It was nice to relax and enjoy time with people I really care about.  I also appreciate the fact that they were up for just staying at the hotel and playing card games.  It made it easier for me to just relax.

Then today we went to the Twins game (they won!) and I was able to walk for about 10 minutes.  While I felt a little tired, I was surprised I could walk so far.  We had excellent seats on the 3rd base line and the game was a ton of fun.  I know Jeff, Michael and Jenean appreciate me being the DD.

It is nice to feel normal, both physically and socially.  I have been so bored just sitting around the house so any opportunity to get outta here I’ll take.  I plan on going into 3 more days of my rotation this week, even though my preceptor told me that I don’t have to come in anymore and my evaluation has been completed.  I really like the ED and would love to spend 3 more days in such a unique environment and with such a great preceptor.  In fact, my preceptor came over on Friday to my apartment and we spent about 3-4 hours going over materials and just talking about life.  I can not even describe how appreciative I am of her support and understanding.  Hands down the best preceptor I had during all of my 8 blocks.  She understands that rotations are not just about learning tons and tons of material.  She is more interested in helping to shape you as a future practitioner and for me has helped to teach me the importance of work/life balance.  I can’t say it enough- I am so so so blessed to have her as my preceptor during this time in my life.

The only bad part about feeling normal, is I sometimes forget the new limitations I have.  For example last night, I ordered a side salad with my dinner.  About three bites in, I realized I can’t eat the whole thing because I can’t have that much vitamin K.  Even though it was delicious, I took a few more bites and then had to stop.  I didn’t even think about the long walk to Target Field today- even though it went just fine, I forgot that I might not be able to walk that far until I had already walked 5 minutes.  It’s going to be hard to adjust to, and I really hope these changes will only be for 6 months.

My last random thought pertains to insurance.  I can’t help but imagine how my recent health events are going to impact the types of insurance I can get in the future.  I have the opportunity to lock into a long term disability policy with no physical examination/personal history within the next week or so.  I am trying to gather more information and determine how difficult it will be for me in the future to get good insurance for reasonable premiums.  Also I don’t have life insurance right now, how hard is that going to be?   It seems funny because I am otherwise very healthy, just this stupid blood clot has to be on my medical history to screw things up.

 

Good News April 21, 2011

Filed under: Uncategorized — cempanger @ 4:41 pm

I’d say today was a day of good news- overall.  I met with a hematologist who was very knowledgable, personal, and understanding.  He explained that my use of estrogen, a long car trip and possible genetic clotting disorder all added up to push my over my clotting threshold.  They drew blood for the various clotting disorders, and hopefully I will know the results in a few weeks.  He also gave me a prescription for medical grade compression stockings (to prevent future clots) and I will follow up with him in 6 months.  As far as exercise goes, I am allowed to return to any exercise that I can tolerate!!!!  I am soooo happy about this.  While I still get winded pretty easily, I am anxious to start moving more and getting physically stronger.  He explained that with clots in your lungs, your blood pressure in your lungs is so high that the clots don’t usually last more than a few weeks.

I also decided to change my INR clinic.  I have been getting my draws at Boynton and now I will be getting them at Fairview.  They are right down the street from each other, but I feel more comfortable being followed by a pharmacist (naturally).  So I was able to meet Rich and his team (including one of my classmates who is there on rotation with him) and I feel very comfortable with this new set up!  Today my INR lept to 1.89, so he backed down on my dose to 5mg — Which is exactly what I would have done!

Also I am cleared to travel, and he told me that if I have a long trip I am worried about after I am done with anticoagulation, I can take a shot of lovenox to cover my for 12 hours.  I love this idea.

Finally we discussed future pregnancies.  I will be on lovenox throughout my pregnancy and will have a scheduled delivery where I will stop my lovenox 24 hours before the delivery.

All-in-all it was a good day.  I still get teary at times when I think about the drastic changes that have happened in the last week, but I am thankful that the picture is becoming clearer and a plan is in place.

 

Divine Intervention? April 20, 2011

Filed under: Uncategorized — cempanger @ 4:02 pm

As I reflect on the activities of  my pharmacy rotations, I can’t help but think that my rotation schedule was not randomly selected by chance.  Let me briefly explain:

May-August:  I am at the hospital where I ended up getting my treatment for my PE.  I actually GAVE  a 45 minute presentation on pulmonary embolism and presented a case study of a young woman who came to the emergency room with pulmonary embolism which they attributed to her birth control.

January- February: I am at a clinic in North Minneapolis learning all about warfarin and INR management.  Little did I know that I would soon be a warfarin patient.

February- March: I am at a retail pharmacy studying woman’s health where I learned all about various types of birth control and risks associated with them (clots, etc).  Also I studied alternative forms of contraception for women who have had blood clots

March-April : I am at the emergency department at Unity hospital where I was able to understand how the ED works from the provider side.  Also, I am working with an EXTREMELY understanding preceptor who has had medical issues themselves.  My preceptor completely understands my personality and what I am going through right now.  My preceptor has also given me advice on how to cope with such a large change in my life.

I know that sometimes looking back on life event’s it is easy to draw a line to connect the dots.  But I really think that my experiences and the knowledge I have gained this last year have prepared me for what I went through on Friday and what I will be going through the rest of my life.  I don’t think that the last 3 rotations that focused on the emergency room/critical situations, women’s health and warfarin/INR were selected merely by chance.  Someone is looking out for me.

In other news, my INR was 1.41 today.  I am sick of these daily blood draws.  They increased my warfarin to 10mg, and of course I am going back in tomorrow for another blood draw.  Also, I meet with the hematologist tomorrow at 2:15 and my OBGYN on Friday morning.  My chest pain is slowly beginning to dissipate but I tire from walking more than a few minutes and find it harder to breathe- so I sit down and rest.  Taking deep breaths is less painful, but still uncomfortable.  I know the recovery phase is long, so I just have to be patient.  I’ve been on my computer a lot, playing games on my ipod and watching random TV shows.  It’s nice to relax, but hard to stop myself from thinking of all the things that I could be or should be doing.  But I will try my best to take the advice of my preceptor and just take this time to relax, recover and reflect on everything that has been happening to me and for how thankful I am to still be here in one piece.