2 Years Later...

Residency was a bit rough on the free time. I'm baaaack!

Re-reading what I wrote about 8 years ago- namely running and my love of medicine, still ring true on a daily basis.

I am honored to say I'm now a practicing, Board Certified Pediatrician. I am living the dream. I take urgent calls in the middle of the night to take care of newborn infants in trouble, I hi-five kids who made it through their annual check up, I sit with teens and listen to their struggle with depression, and countless other scenarios. And I love it.

To practice medicine is to be curious all the time, constantly learning and relearning. I love having a new case and diving into the evidence base and primary literature to make sure I'm doing everything I should be for a kid. I love the mysterious unraveling of an accurate diagnosis: what are the symptoms, the physical exam findings, the time line, the age, the labs and imaging showing us? It's so satisfying to yield a diagnosis.

I also really appreciate having more senior, smart, caring colleagues with whom to discuss cases and learn from their decades of experience. Even after 5 years of medical school, 3 years of residency, I am still learning new things every day. It's shocking actually how rapidly medicine evolves and what you still don't know after 8 years of training!

Lastly, I love working with kids and their families. Kids always surprise me with how hilarious, sweet, scared, bored and openly hostile they can be within the same 15 minute appointment. The ultimate compliment is when the parent asks if they can schedule the next visit to see you. It's a heartwarming #Isaidyes moment in medicine.

Every day is surprising, I get a little smarter and wiser, and I bring all that I can to my patients and their families. What a remarkable career I have commenced! My heart is full to the brim with the joy I have being a Pediatrician. #worthit

-Doctor Peds

Running in the Winter is Bliss

There is just something about a cold evening, even better if it's a cold snowy evening that makes me crave a run through Lincoln Park and along Lake Michigan. Weird? Crazy? Lost my mind? Probably all of the above.

Maybe it's the feeling of adventure? Feeling really tough and hardcore? Knowing how happy my husky will be running out in the cold? The joy of the complete silence running through the park, only hearing the snow falling. Or the awesomeness that is having the lakeshore path all to yourself.  When I'm out there I feel so alive, alert, focused, my senses heightened. I'm living life! -2 with windchill won't bring me down!

Probably all of the above. Maybe the secret is coming home, drying off and showering and then snuggling up with a good book in front of the fireplace with Christmas music playing and sipping on hot apple cider tea. The epitome of koselig.

Pretty perfect if you ask me!

When it's less than 20 degrees outside I'm wearing a lot of clothing, in fact i'm toasty!

What to wear:

• 2 pairs of gloves
• 4 top layers (tank, long sleeve, puffer vest, shell)
• 2 bottom layers
• Wool socks
• Waterproof trail shoes (I have yaktrax but never use them. You don't need them for the snow and if it's that icy I don't think it's safe to run)
• Neck gaiter
• Headband
• Musher's wax for your dog's paws 

Just channel the famous Norwegian saying: "There's no such thing as bad weather, only bad clothing".

Baked Margherita Spaghetti Squash

I made this delicious recipe for lunch today using my spaghetti squash and tomatoes from the Farmer's Market. Best spaghetti squash I've ever made! Usually it's a bit too bland for me. I think using the olive oil, salt and pepper prior to roasting the squash made a big difference. The broiler was fun to use and made the cheese look so yummy. Very hot out of the broiler though-beware!

Tastes as good as it looks!

Hooded Merganser

Quite a unique and amazing duck! I saw one yesterday and two today at North Pond, hanging out with the mallards. Easily identifiable to say the least.

Eye catching. Thanks Pinterest. 

Quote of the Day

“You cannot get through a single day without having an impact on the world around you. What you do makes a difference, and you have to decide what kind of difference you want to make.”-Jane Goodall

Conan Birding Central Park

This is hilarious!

Butternut Squash Soup

For a gloomy Sunday, I made butternut squash soup for the first time. Butternut squash, sweet potato, onion, garlic, ginger, tumeric, nutmeg, cayenne pepper and coconut milk. Cooked in the slower cooker for 2 hours and then blended. It tasted delicious with focaccia bread!

Black-throated Blue Warbler

Saw this beautiful creature Wednesday evening at Montrose Point, the Magic Hedge no less!

I am so gorgeous!

American Kestrel

What a gorgeous bird! I sighted and properly identified a female American Kestrel this morning! Several Northern Flickers were pestering it to leave. The American Kestrel is our country's smallest falcon. Being able to identify a new bird is such a cool feeling. It's kind of like making a cool diagnosis in medicine, but even more cool because I haven't received any training in birding, everything I know is self-taught, and no sickness involved!

Alluring American Kestrel -copyright Audubon

5 New Lifers!

Chicago during fall migration is the happiest place on earth! Unless you are the rabbit that I saw a juvenile Cooper's Hawk eating right outside the gates of Lincoln Park Zoo... I added FIVE species to my life list this morning. I know if you are an experienced birder, you are rolling your eyes at me, since most of these birds are pretty common. But to me, this is super cool!

Killer Cooper's Hawk

Dark-eyed Junco in the shrubs on the edge of North Pond.

Dreamy Dark-eyed Junco

About a dozen Northern Flickers, a type of woodpecker that pecks at ants on the ground near North Pond Restaurant. Absolutely beautiful colors and pattern!

Northern Flicker

A teeny tiny Ruby-crowned Kinglet, cousin of the Golden-crowned Kinglet I saw over the weekend.

Ruby-crowned Kinglet

A White-throated Sparrow. So many sparrows today, this little guy as well as more white-crowned sparrows and house sparrows.

White-throated Sparrow

Thanks to pinterest and all the birding websites for these fabulous photos. My blurry pics are not worth posting... Quincy was patient during my two hour birding walk this morning. He even found a nice place to perch.

Quincy the happy Husky. :)

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Golden Crowned Kinglet

Explored Illinois Beach State Park this morning, and saw my very first kinglet - a golden crowned kinglet.  Right next to the sandy beach bluffs, within perfect view. The bold yellow crest on a cute little bird is unforgettable. Apparently this little guy can withstand -40 degree F winters! We will definitely be returning to this State Park, it has a mix of habitats including marsh, dune, swale, oak
woods, beach and Lake Michigan, which make it an ideal birding location. Plus Quincy loved it. :)

Look at that glorious golden crown! Thanks Pinterest

Winter Wren

Like the chickadee, the winter wren is a CUTE bird. I found him on the ground, looking for insects most likely, near the North Pond restaurant yesterday morning.

 Fun fact: "On a per-pound basis, the winter wren generates more song for its weight than any other North American songbird". It is one of the smallest birds around, the size of kinglets (I saw a few of these as well but couldn't ID the exact species). The winter wren differs from the house wren with it's stubbly upright tail. 

The wonderful winter wren!

Red-Breasted Nuthatch

It's a fall-out! Stormy weather in Chicago brought so many great birds to Lincoln Park this week. If only I could identify them all. These fall migrants are tough for a newbie birder like me. The majority of them seem to be colored in variants of brown and yellow, and they are so darn quick it's been tough to definitely identify most of them. The red-breasted nuthatch stuck out though and I was able to make a positive ID. Hip hip hooray!!! :) That rusty-cinnamon belly cinched it for me!

Isn't he handsome? 

Hello Kidney

Just finished my month as senior resident on the Inpatient Kidney Service. Incredibly busy with very sick children all month. Learned a lot, worried a ton. Now have several more grey hairs and probably need a new eyeglass prescription. It's worth it though, I'd do anything for these kids, they are AMAZING. And ridiculously cute.

In case you don't know, the kidneys are really important to every day life.  A litany of potential problems, and possibly all at the same time! Hyperkalemia, Hyponatremia, Hypocalcemia, Anemia, Hypertension, Uremia, Hypertriglyceridemia, Hyperphosphatemia, Proteinuria, Hypoalbuminemia, Thrombosis, Infection, the list goes on...

Any little thing can go wrong when you have kidneys that don't work very well, especially when you are small. Many of our children with severe kidney disease live for years on dialysis until they are big enough for a kidney or until they find a matched kidney donor.

Try to imagine..

• Having a little baby and needing to connect them to peritoneal dialysis every night for 12 hours a night. 
• Trying to give a toddler 10 medicines every single day, and they taste bad.
• Your tween-age sister needing urgent dialysis for kidney failure because of a diarrheal illness a week ago
• Every time your school-aged kiddo has a fever they needed to be hospitalized to rule out a serious bacterial infection

A few acronyms from the month:
STEC, HUS, ESRD, ARPKD, CKD, HD, PD, AKI, ATN, SBP, BUN/CR, UP/C..

Electron Microscopy of Kidney's Glomerulus. Thx WikiCommons!

Kids with chronic kidney problems are at higher risk of infections than us regular folk -whether it be from immunosuppressive medicines to preserve their kidney transplant, extra fluid that can get infected or having a central line/catheter that puts them at risk for infection. Just in case you weren't a germ-a-phobe already, here's a list of the infections I've dealt with recently:

• Adenoviremia
• CMV colitis
• Cryptosporidiosis
• Clostridium difficile colitis
• Enterococcus faecalis bacteremia
• Infectious Mononucleosis
• Streptococcus pneumoniae meningitis
• Ecoli O157H7 

Bottomline: The next time you pee, thank your kidneys. They don't get enough credit for all their hard work!

Love & Birds

In case you missed it, here is a sweet article from the NYTimes from Friday about how a bird feeder in the city impacted one couple: How a Bird Feeder Revived My Marriage

I've been working my 80 hour weeks at the hospital recently. 28 hour call Friday night. Hold your little ones close and give them a kiss. Too many are spending their summer hospitalized. I'm doing my best to get them better and home before the school year starts.

Black Vulture!

What kind of bird did Max see? The best birder I know and amazing friend Wendy in Kansas got to the answer first: a group of black vultures!

Black vulture in flight! Copyright AllAboutBirds.org

Black vultures live year round as north as Pennsylvania and as south as Patagonia. They are frequently in large groups, have a black bald head, and white wing patches that can be tough to see.  They are raptors as you know, and like all vultures are usually scavenging and eating carcasses (someone's gotta do it!).

Chillin. Thanks Wikipedia

Thanks for all the guesses! When I first saw the photo Max sent, my first thought was double-crested cormorant because it's the only bird I've ever seen sitting and drying their wings out, but the neck looked too short to be a cormorant. With more research I found out that anhingas and vultures also do this behavior, so then asked if the birds appeared bald. Max did some sleuthing on his own and on ebirds.org found out that someone else had seen a large group of black vultures in the same area and this confirmed our identification.

Double-crested cormorant. Copyright AllAboutBirds

Size and shape, color pattern, behavior, and habitat were all used to correctly identify this bird! It came down to a bald, black, large bird in a big flock fanning out its wings in Pennsylvania in the summer time. Voila!
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What Kind of Bird is This?

From my friend Max, on a bike trip in Pennsylvania:

"Do you know what kind of bird this is? A whole bunch of them were sitting on the fence and doing this weird thing where they sat with both wings outstretched. There were so many of them, and they were so large and totally unperturbed by humans. I was quite curious."

Hmmm... 

What do you think? 

I'll post our amateur bird detective conclusions tomorrow! 

Birding in Action!

An "action shot" of me birding! This was an early morning along the Ritz Carlton Half Moon Bay oceanfront trail.  A few minutes before this pic this great blue heron ate a mouse. A WHOLE LIVING MOUSE. That was insane. I watched the entire thing through my binoculars and I still get the heebie-jeebies thinking about it.

Copyright Mark Pederson :)

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Fireflies

The brief, sporadic sightings of blinking lights on a warm summer night is something I absolutely love about Chicago. They are my favorite insect by far. I've learned there are over 2000 species of fireflies (who knew?) and they are also called "lightening bugs". Bioluminescence is so cool!

Simply magical! Thanks Google Images.

Black-capped Chickadee

This is a CUTE bird. It's size, shape, color, tweets. I first saw one about a month ago around South Pond. Just a few days ago I saw another 3 around North Pond. I love their song, very recognizable and how I first came across the bird. According to AllAboutBirds.org, one of their calls is a three syllable, "hey, sweetie". The other typical call you can hear is their warning call, "chickadee-dee-dee", The more "dee's" in the call, the more urgent the warning!  I love everything about the black-capped chickadee!

Adorable!!! Courtesy of Flickr