I'll be the first to admit that I straight up dread having to wear professional wear. So you can imagine how thrilled I was while adjusting to my first APPE and having to wear professional clothes 5 days a week rather than the usual 1 day. Like any of you, I would 100% rather be wearing leggings or pajamas at any given time. Seriously during my didactic years I was a happy camper if I could figure out how to work colored jeggings into my lab outfits in a professional way. You know if you've shopped for professional wear that most of the time you give up comfiness for the style. Since my first APPE (and being that midyear is looming around the corner), I've had to shop around quite a bit for new professional clothes. I've been relieved to find that style doesn't have to be a sacrifice! So here I'm sharing a few tricks and tips I've picked up about where to shop for the best professional wear. Hope this helps!

Pants
Alright so pants have always been my worst enemy. Why? I'm 4'11 and in-store petite sizing is near impossible to find, and if it exists it is always sold out. I've also struggled with pants that fit perfect in the waist, and are large and baggy around the calves. However, there are a few styles I've absolutely LOVED and tried on or bought myself because they were so perfect.

1. The pixie mid-rise ankle from Old Navy
$34.99


2. Skinny pants in Marisa fit from Loft
$89.50

No really, you should take a walk. Not only does it promote weight loss and lower your risk for heart disease and diabetes, but it also helps with mood, memory and attention. It took way too long for me to realize how much walking helped mitigate my stress level. Growing up in NJ you don't do a lot of walking to places since everything requires a car, and I was never the "walk without a purpose" type. That began to change when I moved to Philadelphia in my P3 year and one of my friends turned me on to "mindful walking".

Mindful walking is a type of meditation, where your legs are moving but you are reflecting inwardly in a way that the walking becomes autonomous. It allows your mind to move toward the present and focus less on the craziness of every day life. I decided to try it during the year I fell ill in pharmacy school because I was desperate to try anything that might alleviate the anxiety I felt when I left my apartment every day. I was surprised with how much it helped and how easy it was to incorporate into my six minute walk from my apartment door to classroom. This was especially helped by the fact that I used guided mindful walking apps like "Stop, Breathe & Think".

Once APPEs started and I stopped spending my 24/7 studying, I began to adventure around Philadelphia aimlessly with friends. We mostly traveled down to Spruce Street Harbor Park which meant Old City alleyways, hidden monuments and beautiful scenery (ever stumble accidentally across an 18th century garden?). Although it wasn't necessarily "mindful walking" I always felt better after I had walked. In my block 3 my APPE was in a primary care clinic where most of the patients we saw had severely uncontrolled diabetes and hypertension. It wasn't totally uncommon for us to investigate the amount of physical activity our patients were doing daily and recommend changes. My most recommended intervention? The Physical Activity Guideline for Americans suggestion: 150 minutes of moderate-intensity aerobic physical activity (AKA, brisk walking).

Now that I'm finishing out my APPEs in NJ, finding time and places to walk is more difficult. I'm extremely lucky to have friends who are as interested in adventuring as I am. It is because of them that I've ventured to beautiful places like Historic Smithville Park, Mount Minisi, and the Morris Arboretum (where I took the pictures in this post)!

I'm starting to make a list of all the places I want to walk and adventure to in the area so if you have any suggestions comment below or shoot me a message on instagram. I can't stress enough how great of a tool your own body can be in anxiety-relief.

I've always been more of a right-brain type of person. In middle school my siblings opted to do sports, I dropped out and joined a creative writing club instead. I drew, painted, sketched, wrote and crafted my way through elementary, middle and high school thinking I'd perfect my photoshop abilities, pick up skills in coding and become a graphic designer when I grew up. Clearly, that never happened and I ended up on the complete opposite of the job spectrum. But wait. Why do we usually think of science and art as being two totally separate fields?

When I started pharmacy school I lost my drive to create. While I'm sure exams, and extracurriculars contributed, I ultimately blame myself for letting my first love fall by the wayside. I stopped finding time to doodle. I no longer wrote poetry. My paints were touched pretty infrequently. My life became pharmacy, pharmacy, pharmacy. Being focused on school is not something I regret but I do regret thinking that I could never possibly do both; continue to love the arts while also loving pharmacy. I started to realize how much I missed exploring my artistic side during my P2 year. In our College building on campus hangs the beautiful painting "The Gross Clinic" by Thomas Eakins:


After starting school and learning that this painting was of a doctor (Samuel Gross) at Jefferson in our old surgical amphitheater during the 1800s, it quickly became one of my favorite pieces of art on campus. In my P2 year it was temporarily taken down and I found myself hoping every day when I passed through the College building that it'd be put back up. It wasn't long before I realized just how much I was enthralled by that painting, and that my love for it made me nostalgic for the days I spent creating. So slowly, I started again.

I began to use my study breaks creatively rather than using them for social media. It started with just sitting out on my back porch and painting again. By P3 year I was writing again and was even able to submit a poem to our university's literary magazine. In the beginning of my 4th year I picked up brush lettering, a more modern form of calligraphy and used it to help me study.  And of course, I started blogging too! Then during my second APPE, I was introduced to my university's design curriculum included in the medical school's program.

My second block preceptor is co-director of this program and taught me all about using design thinking to solve healthcare problems over our six weeks together. I was floored by this concept and even more in awe of the projects the students in the program were working on. They were all working tirelessly on creative solutions to complicated healthcare problems, from stress ulcers, to hospital noise and wound care. I learned that the design thinking process consists of five principles: empathize, define, ideate, prototype, and test. If you think about it, thats not so different from the pharmacist patient care process: collect, access, plan, implement, and monitor/follow-up.

The idea that we can't be creative in our practice because we're pharmacists is entirely out dated. I believe we get creative every day and it simply goes unacknowledged to ourselves. We get creative with counseling the vast array of patients we care for, we get creative in drug shortages, we get creative in our continued learning, and sometimes in our care plans. Of course there's more! Since rediscovering my creative side and learning about the design thinking, I think about how design impacts us in healthcare every day. I think differently about the problems I encounter. Beforehand I may of thought that a patient who was non-compliant with their inhaler was just being difficult, but now I think of how the design of the inhaler really isn't formulated for compliance. Each inhaler has its own pearls, they aren't standardized, and many are not intuitive. Ease of use plays a big role in compliance. Fellow healthcare students, how often have you had a patient show you how they use their inhaler and its completely right? The number is probably small, but its not their fault! Once you start to see the problems and how they can be helped by better design you see them every where, even with the beloved prescription bottle!

Overall, I think rediscovering my art and being inspired by the work done at our JeffDesign lab has made me a better pharmacist. I think that actively acknowledging your creativity and bringing it into your practice enables you to empathize, and problem-solve in a way that is not accessible otherwise. So before you say "but I'm not creative", I'm going to call BS and insist that you pick up your paint brush anyway, doodle on your papers, start blogging or writing poetry. I think you'll surprise yourself and I think you'll like how it changes you.

Happy pharmacy week everyone! This is a week to acknowledge and appreciate all of the hard work, the love, and the dedication that pharmacists, interns and technicians pour into the profession. I for one have been lucky to study under amazing pharmacists, learn from incredible preceptors, collaborate with hard-working technicians, and grow with my insanely talented classmates. I'm going to start off this week with some insight into what I love about this profession and what I do every day.

1. Pharmacists are the most recognizable and accessible healthcare professionals in the community. We're also one of the most trusted professions. This enables us to tackle health literacy problems within the community head on and to provide education and counseling to our communities. Working in a community pharmacy for the last four years, I've seen my preceptor connect with our community and work to improve their health literacy. He has the uncanny ability to break difficult scientific concepts into a language our patients can understand and learn from. I've always admired this and it has definitely highlighted the impact community/ambulatory care pharmacists have on public health.

2. We improve patient safety and reduce drug errors. This one may seem self-explanatory but I've been consistently impressed by the diligence and attention to detail my preceptors have displayed. Our healthcare system is not perfect, and patient care can be really complicated. Having a pharmacist's eyes on the medications can be critical to providing the safest and most optimal care to our communities. I've been a part of many teams on my rotations who have welcomed the voice of the pharmacist for that exact reason. I've also been that voice a few times myself (team trying to add a beta-blocker to a patient with a heart rate of 32...can anyone say bradycardia!?). If we want the best outcomes for our patients its vital that pharmacists be included on all healthcare teams.

3. Our practice is expanding (exponentially)! Currently there is a push for pharmacists to have provider status. What does this mean? We're looking to be classified under Medicare Part B as providers, a status given to other healthcare professionals such as physicians, PAs, NPs, social workers and midwives. Without this designation we face barriers in compensation, coverage of services, and inclusion in ACA delivery models. Being granted provider status would allow us to help medically underserved communities and fill in the gaps in care.  Even more awesome, some states allow for collaborative agreements between pharmacists and prescribers to provide advanced patient care. It differs per state but this means that in some agreements we can provide intervisit care, titrate medications and order labs under a prescriber.

4. We're team players. I've been lucky enough to be surrounded by other healthcare professionals who love having us around, and I love having them to learn from! I've learned so much from MDs, DOs, NPs, nurses, PAs, social workers, dietitians, other students and MORE. I truly believe we are only as good to our patients as we are to each other. And its only together that we can hope to turn our healthcare system around and work cohesively to bring stellar, efficient care to every one.

This was brief but I hope ya'll got the big picture: we're awesome...and we do more than count by fives (age old assumption...never say this to your friendly neighborhood pharmacist). So this week, take the time to thank your pharmacist, your technicians and your interns (or you know, bring them a donut). We work hard to keep our communities safe, educated and healthy. And to my fellow pharmacy folks, enjoy the week!

P.S I made the above graphic/took this photo at the New Orleans Pharmacy Museum, a must-see for my fellow healthcare peers

My current rotation on GI has led me to observe patients with a range of diagnoses, namely inflammatory bowel conditions like ulcerative colitis and crohn's disease, irritable bowel syndrome, and neuroendocrine tumors. Although these diseases/syndromes are all incredibly different from one another, all who they afflict are subject to extreme GI-related anxiety. This is an anxiety I've known all too well during my entire life. During my first few days at the clinic I was shocked to hear some of the things I dealt with myself growing up and all through pharmacy school repeated from the mouths of the patients we saw. Feelings and thoughts I believed to be exclusive to myself were suddenly the same sentiments shared by other people. After seeing some of these patients and silently reflecting on our shared struggle, I decided to write a little bit about my experience with chronic illness and anxiety while in pharmacy school.

Pharmacy school is an emotional and physical challenge that can take a toll on both your mental and physical health. Therefore it never surprised me to hear about fellow classmates who had to deal with worsening or new onset chronic illness in the midst of their pharmacy school years. I used to feel immense sympathy for those who juggled doctors appointments around exams and struggled with just feeling well enough to show up to class. I felt immense sympathy until I became one of those people who couldn't fit in doctors appointments, who never felt well in class and who was too sick to focus on my education. When that happened, my sympathy turned into empathy.

In my P2 year, I dropped to 86 lbs. I had stopped eating full meals and relied solely on baggies of cheerios and the pre-packaged cheese/cracker boxes at Wawa. I avoided eating in public or with friends as often as I could. I was so nauseous every day that I had to plug my nose while walking by food trucks or be subject to dry heaving in public. I was constantly nervous about where the closest bathroom was, if I'd be able to leave class/rotation, and if i'd make it through the day without throwing up or passing out. This was me at my worst and it was years and years of denial in the making.

It started when I was 6 years old. An unfortunate accident landed me in CHOP's GI department with a colon so dilated it was a miracle I was able to function at all. As a little kid, I didn't have much of an understanding of what was happening but I knew the pain was intolerable and the medications just as bad. For a short period of my life I was able to ignore my illness and avoid preventing the subsequent pain and discomfort with medication. I'd go through pockets of being absolutely fine and it was like I was never sick. I never thought as myself as a person with a medical problem. But then the pain and sickness would come roaring back and I'd wish I was anyone but myself.

Eventually the episodes would present so intensely that I'd fear the next one. I'd stop myself from leaving the house if I felt the slightest belly twinge. I'd map out all the bathrooms, plan extensive escape plans, and make any excuse to drive myself so I wouldn't be stuck. If I knew I was going to be out for a night, I'd make sure I didn't eat just in case my stomach decided to descend into chaos post meal while I was still out. Eating meals out in public were almost always taboo unless it was one of my very few "safe foods" (soup, caprese sandwich, more soup).

It used to be that the anxiety would only linger for a short period of time after an episode finished, maybe a week or two. As I went through my college years, the periods of anxiety became longer and longer until I knew my anxious state better than my calm state. It became suffocating. When pharmacy school came around I was managing my GI-related anxiety and my GI symptoms as if they were this part of me that I had to accept as is. I didn't seek out additional treatments or professional help until my P2 year when after a bad break up, and a bad semester I was left an anxious set of bones. I was inattentive, distracted and in a lot of distress. I didn't even realize what was happening with my weight until I came home for the semester and one of my college friends said, "what is going on with you? You don't look well". A few days after that I got on a scale for the first time in years at a doctors appointment and was stunned to see myself about 15 lbs below my normal weight.

I wish I hadn't waited so long to seek out help. Had I known that making the time to go see a doctor would be the first step in taking control of my condition I would have felt better a lot sooner. I'm extremely lucky that despite my medical troubles I never fell behind in school, and my grades did not suffer. I know there are others who are not so lucky. So my advice is this:

1. Do not wait to seek help. If you're struggling, tell a teacher you trust, a doctor, or a friend. There is no reason to suffer in silence when there are people around you who have access to resources that can help you.
2. Advocate for yourself. That includes in school, in our crazy healthcare system, and in life. 
3. Remember that you don't have to prove anything to anyone. I constantly felt like if I didn't over-explain my situation to people that they would never believe me later when I needed to bail on something due to sickness. It took a while for me to realize that only I knew my condition inside and out and other people really don't have to for it to be real and valid.
4. Seek out accommodations. If your school has a process, use it! Even if you don't enact your accommodation in the entirety of your schooling, at least you have it just in case. It'll do wonders for your anxiety. 
5. People will understand more than you think they will. I've learned so much from sharing my story with classmates. You'll be surprised to learn how many people have experienced similar hardships.