devine1

When I started anesthesia school I had a 4 yr old and twin one year olds. I've been working part-time for the past two years in addition to school and managed to have mostly A's. I've got good family support, including a very understanding and supportive wife. If you want to do it, just set your mind to it; it is not impossible. I graduate in November and don't regret my decision at all.

Thanks mcbeah for the references!

Thanks for the replies! The use of physostigmine isn't my choice of routine neuromuscular blockade reversal and I've never chosen to give it over others. The CRNA that shared this technique with me certainly has her reasoning for using it, but it is my intention to find out why it may or may not work. Obviously I don't just reach in the drug tray and give drugs without knowing all appropriate indications; but, if there are "tricks" that people have passed down over the years, I don't mind investigating one's reasoning before accepting it.

During my pediatric rotation I worked with a CRNA that routinely uses a combination of neostigmine and physostigmine for older children & adolescents. She calculates her normal neostigmine reversal dose but only gives 2/3 of it and the other 1/3 as physostigmine. For example, a 40kg pt may require 2.4mg of neostigmine but she only gives 1.6mg while giving the other 0.8mg as physostigmine. She states that these patients wake up "smoother" than those receiving just neostigmine but has no solid reasoning for doing so. Apparently she learned this from her preceptor many years ago. I understand that physostigmine has a tertiary amino group that passes the blood brain barrier but this patient population doesn't necessarily receive any anticholinergic that passes the barrier (e.g. Atropine). Does anybody have any insight on this? Thanks.

My thanks to Tommy and TraumaNurse for your advice. I know it will be a huge sacrifice in the "short-term" but not without any "long-term" benefits for myself and my family!

I was very relieved today when I answered the door for the mailman delivering a certified letter from UAB, knowing that my rejection letter last year wasn't certified. Now that I've been accepted, reality is sinking in and I'm getting very nervous, as is my wife. My main concern is finances. How do most students afford to live while in school? We have three children under the age of 4 and one of our most reasonable options is to move in with the In-Laws. How does one go about getting student loans, grants, stipends, etc.? Any advice would be greatly appreciated!