top three [01.31.2016]

one of my favorite purses doesn't get the love it deserves

medicine

• The "breath of death" is a late sign of liver disease and a clinical sign of hepatic encephalopathy. I personally have not smelled this, but apparently it has a "sweet, fecal" smell. Hmm. 
• Pre-eclampsia is a complication of pregnancy that is defined by high blood pressure and a large amount of protein in the urine. Experts believe that vessels in the placenta are the reason for these changes, but exact mechanisms are unknown. Interestingly, one of the risk factors for pre-eclampsia are if the baby's father's mother had pre-eclampsia in her pregnancies. 
• The advancement of pharmaceuticals over the last few decades has been amazing, but as it turns out, the number one thing you can do to lower your blood pressure if you are overweight is to lose weight. The boring, and hardest, answer to what you can do for your heart. Here are 21 other, probably more interesting, facts about the heart. 

on the internet

• Weight gain is something that happens to most women, but few openly discuss it. I know that personally as someone who has PCOS and has a really hard time losing weight, it isn't something I like to discuss either, so that makes me even more proud of Alissa for opening up about her struggles. In addition, and the best part of the post, is that she discusses ways to still work on your style and love clothing with those extra pounds. 
• How cute is Merritt's all neutral look? Makes me want a pair of gold sneakers real bad. 
• Morgan and I worked together the summer between first and second year, and she is seriously one of the best people I've ever met. Reading her latest experience in the ICU made me cry and want to hug her - she's going to make the best doctor. 
• Bonus: Alyssa's post about Switzerland officially moves it to the top of my MUST GO NOW travel list. 

spotted

• Do you really love Valentine's Day, or have a fun Galentine's Day party to go to? Please wear this heart covered dress - it's so freaking cute!
• RED TRANSPORT TOTE. omg. 
• OTK boots are all the rage this winter, but I can't bring myself to spend $700 on a pair. These look alikes are on sale now, are maybe even cuter than the original, and are under $100!

ask me anything

• I am a 2nd year pharmacy student and your posts are my favorite study breaks. Do you interact with pharmacists much? If so, what are your interactions like? 
• I'm doing most of my third year rotations at a smaller community hospital, so unfortunately I personally don't get a lot of interaction with the pharmacists. We do have pharmacy students round with us occasionally though! I know that at larger hospitals that many times they have pharmacists on rounds with them, which I think would be such a great experience since you guys know so much more about dosing and drug interactions. We do occasionally have to call our pharmacist though for questions, especially for our patients who are on many different medications, and they have always been so helpful and knowledgable! 
• My husband are loving the show Code Black, and while watching it last night I wondered what people in that field thought of the show. So, my question is, If you watch any shows that take place in hospitals, what is your favorite? And which show do you feel is the most realistic? 
• I'm actually a pretty big fan of medical shows - I have watched Grey's Anatomy from the beginning, I've watched almost all of House, I've seen some of Code Black, and I recently started watching Nurse Jackie. I've really only been in the clinical setting for seven months now, and only in my limited role as a medical student, so I can't really say how realistic the life of a surgeon is portrayed on Grey's or what an emergency medicine residency is like, but I can tell you that much of what goes on in the hospital is fairly mundane - a lot more charting and a lot less on call room romance ;) That's not to say that some of the situations haven't happened, but showing residents putting in orders is a lot less thrilling to watch on TV than a patient with a bomb in them, so I guess it's a tiny bit realistic, but not in the moment to moment, hour to hour life that is portrayed on television. 
• I start PA school in May and have been so inspired by your style to build up my own wardrobe for school. I was wondering if you have any suggestions for a handbag I could use for school, preferably under $60 since I'm on a budget. Thanks so much! :)
• Yay - congrats on getting accepted, that is so exciting! There are definitely a ton of bags at the price range, it all just depends on what you are looking for. This Phase 3 tote is the most classic black tote you're going to get (bonus is that it's currently on sale for under $40!). Sole Society has a really cute structured option that is just a few dollars over your limit. I found myself using a leather tote during the week while at school, and then using a bookbag on the weekends since I always took that much more with me to the library. I'd recommend this minimalist version from Everlane - large enough to fit allllll those textbooks, but sleek enough to look like you aren't on your way to kindergarten (and again just a few dollars over the limit!) 

on franish

• on the blog: this month's budget (+ all of the ladies linking up!) 
• on the instagram: sometimes you just gotta put your new eyeshadow palette next to your $5 tulips...#doitforthegram
• on the twitter: sometimes I feel bloggers forget their audience...

notable sales

• Gap: 35% off
• These simple cut blouses are always my favorite - they go with everything! If this particular style works on, you it comes in a bunch of cute patterns so you can grab a couple - my favorite is the cherry print!
• I don't own many shorter skirts, but I'd reconsider for this cute sailor inspired navy version! It would look so darn cute with a striped tee or v-neck, with a jean jacket. 
• And speaking of jean jacket...it doesn't get more classic than this version, does it? 
• J.Crew: 40-50% off sale items
• You guys have no idea how much I want their toggle coat. The red version is just perfect. 
• How freaking pretty is this striped dress? I can't decide if I love the blue stripes or the mauve striped version more. 
• I have, and love, this pair of pajama pants - they run true to size (see them on me here)
• Loft: 40% off new arrivals (+ 60% off sale items)
• I immediately ordered this black sheath dress when I saw it - it's PERFECT. 
• Kinda majorly in love with their olive trench too (did you see in the inside?!)
• I'm determined to make this lace swing top work on me - I just think it's the cutest lace top that can be worn so many different ways. 

personal

• I know it's called "the common cold" but damn does it knock you down! I had to take my first sick day this week since starting rotations just because I felt so awful. I slept all day, coughed all night, and am just now starting to feel better. 
• 14 months ago I started with my invisalign braces, and this week I finally finished the "fixing my teeth" process by getting my front tooth redone (it was no longer the right shape and color). Let me know if you'd be interested in a full post dedicated to the process - I'm more than willing to share my experiences but don't know if anyone is actually interested in teeth ;)
• It's my last week on the general internal medicine team, and I'm actually pretty sad to see it end - I have learned so much in this time! Next is GI, which was one of my favorite subjects during second year. The doctor I work with seems really great, so I'm excited to learn from her! 

january budget

Nordstrom cashmere poncho: originally $200, on sale for $100

Ann Taylor scarf: originally $70, on sale for $35

January total: $135

Quarterly budget: $35 in November + $202 in December + $135 in January = $125 to carry over

I have found the trick to not buying a lot of clothes - find a job where you have to wear a uniform! I'm only have joking...but this whole scrubs thing really has cut down a ton on buying clothes.

Over the last few years, I really have worked on "quality over quantity" when it comes to my clothing budget. When I first started my budget, I really tried to stretch it as much as I could - I was buying like 15 things every month! Guess how many of those things I still own/wear? Very few. While the items I bought this month are pricey, I bought only two things I really like, and still came in way under budget. The poncho/turtleneck sweater is so darn soft, and while it may not be considered the most versatile of all garments, I love it so much. The "blanket" scarf (I would say it's more oversized scarf than blanket scarf) is so darn soft - I wear it every single day and just can't get enough (more about it next week!). 

If you follow along on instagram, you will also see that I bought myself a pair of pearl earrings this month. Back when I was working, I used to take a percentage of my tax refund to buy myself that wasn't included in my monthly budgets - that's how I bought my Hunter boots and my DvF wrap dress. Since I'm now considered "self-employed" for the earnings I make from blogging, I pay into my taxes rather than get something back. I do put about 95% of what I make from blogging into savings/taxes, but my mom recently convinced me that I should reward myself a little bit (although she was hinting more at the Chanel bag I've been saving up for for three+ years). I went with a bit more of a conservative route, and bought myself a pair of pearl earrings from Tiffany's. I'm obsessed with them, and I know they will be something I will wear for the rest of my life. 

This upcoming month, I'd really like to find a pair of distressed black jeans. Something like this affordable pair from Volcom would be preferred! I'd also really like to try on this cute peplum top from Anthropologie - it's a bit outside of my normal style, but I think it could be really flattering on. Lastly, it's time to get a second pair of my black ankle work pants - I just wear mine all the time, and a second pair would be really handy to have around (especially when I'm on away rotations next fall, and won't always be able to do laundry whenever I want).

beauty tuesday: oribe grandiose hair pumping mousse review

I know I've lamented about the fact that my hair does not hold a curl nor keep its volume very well in the past. A couple of days after posting my most recent hair curling routine, I saw a post on Glamour's facebook with a clickbait title of "You'll never believe the one thing you need to make your curls last!". I'm always one to fall for clickbait, but I really was expecting something outrageous like "use snail mucus " or "wrap your hair in maple leaves and dry with a heating lamp". Nope, turns out the thing you won't believe will make your curls last is...mousse. 

While the article was clickbaity, it did bring up some good points about straight haired girls using mousse to make curls last, and their recommendation with the Oribe Grandiose Hair Pumping Mousse. As a lover of their texturizing spray, and also as someone who had a little bit of an Amazon giftcard left, I figured why not? 

what it promises: 

Each luxe pouf gives hair an exaggerated sense of body and structure, without the slightest hint of crunch. All-day memory leave styles supremely soft yet set, for hair that's thicker, fuller, larger than life. 

how I use it:

After I've air dried by hair 50% of the way, I use my Kiehl's smoothing cream all over, and then my Aveda tonic at my roots (review here). Then I'll put the smallest "pouf" I can get out of the bottle, flip my hair over, start at the ends of my hair, and then work it up towards my roots. Then I dry as I normally do. 

what I like:

They're not lying when they say it isn't going to cause any crunch. I've tried some cheap mousses in the past that did leave my hair crunchy, and that doesn't happen with the Oribe Mousse. That's not to say that you won't feel it in your hair, because you will, but it's definitely not the crunch I remember from high school.

And my curls really did last longer, which is the whole reason I even started using it in the first place! It's not perfect, and they did loosen up quite a bit, but I noticed a visible difference in how long the curls lasted throughout the day. My hair just overall looked thicker and bouncier than it normally does. 

Lastly, while I enjoyed the smell of the Oribe texturizing spray, it could be overpowering at times. The mousse barely has a smell at all, which is great. 

what I don't like:

What I liked about the Aveda volumizing tonic is that it does give you volume without make you feel like you have product in your hair. I can't say the same for the Oribe mousse - it does make your hair feel just a bit stickier than it does on its own. That means you feel you have to wash it sooner because it feels greasier. I also think it makes my hair the next day look a bit flatter. That's definitely the trade-off between having naturally smooth hair, and having hair that holds a curl. 

Also, lets be honest, $38 for a bottle of mousse is a bit (!!!) outrageous. 

would I buy this again? 

I don't think so - it's just too expensive for something I could maybe get at a lower price point. I love the results on the first day I use it though, and I do really enjoy that it makes my curls last longer, so I intend to use it on days I need them to not disappear in ten minutes, but I don't think I'll be buying a second bottle. I will look for a slightly more reasonably priced mousse though, so if you have any recommendations, I'd love to hear them!

ps. that's the Target organizer I was talking about a few weeks ago! Isn't it cute?!

i get it from my mama

I loved this outfit, partially because my new poncho is so darn comfortable, but mostly because it reminded me of something my mom would 100% wear (I'm sure she's actually worn this exact outfit and I'm just copying her). When someone asks me who my style inspiration is, my answer is always the same - my mom! She has such a knack for putting cute outfits together, pairing unexpected pieces with one another, and just always looks so nice. While I've somehow turned into the "go-to fashion girl" in my family because of my blog, she's really the person who knows what she's doing.

I'm just faking it for the internet ;)

Poncho: Nordstrom [exact]

Tee: Banana Republic [similar on sale]

Pants: Express [exact]

Boots: Vince Camuto [exact]

Purse: Coach [mine is vintage from Etsy - it is called the Willis bag]

Watch: c/o Daniel Wellington [exact for 50% off!]

Bracelet: gift from my friend Lizzi [very similar]

My poncho has been popping back in and out of inventory, so below are three options at three different price points. Which one is your favorite (and also...who is your style inspiration?)

save | spend | splurge

top three [01.24.2016]

favorite :)

medicine

• They always teach us that a good history and physical exam can basically tell you everything you need to know about your patient. There are so many physical manifestations of internal diseases - Janeway lesions are an example of that. They are little lesions on the palms or soles that are indicative of bacterial endocarditis (although they are apparently extremely rare manifestations - none of my attendings have actually ever seen them). 
• If you are diabetic, but don't know it (or are non-complaint with your medications), you can go into DKA (diabetic ketoacidosis). One of the hallmarks of this is often a "fruity breathe" due to the ketones the body is producing. Until Janeway lesions, this is a very common finding in DKA patients, and something I smelled this week for the first time. 
• Another physical manifestation is the Trousseau sign of latent tetany, which is a sign of hypocalcemia. Another name that has been used is "main d'accoucheur", which translates to hand of the obstetrician because it apparently looks like the hand position of someone delivering a baby. Here's a quick 20 second video showing what it looks like. 

on the internet

• I love the way all of colors came together in Hallie's outfit - plus you guys know I always approve of the #hussyankles in the winter!
• How freaking chic is Tam in a recent work outfit of hers? It almost makes me want to wear heels to work. Almost ;)
• Merrick shares her tips for cleaning converse (one of my closet staples!). Definitely throwing mine in the wash the next time I wash towels. 

spotted

• Has anyone tried these Henley blouses from NYDJ? They look really cute and come in a bunch of different colors and patterns (my favorite is berry pacifica!). A bit pricey for what they are...but cute!
• With the current discount, this new open front cardigan is under $30 (and definitely looks like it costs more!). Old Navy is consistently killing it lately. 
• How fun are these rose gold loafers from Sole Society?! Since I only wear flats to work, I'm always look for shoes that are fun but also comfortable. 

ask me anything

• What are your tips for keeping your energy levels up (food, vitamins, exercise, dance parties, etc.) 
• Dance parties are definitely at the top of the list, as lame as it sounds. But my roommate and I truly had dance parties at least several times a week throughout the first two years of school. Hans was often involved (he loved it, promise). Now I would definitely say that listening to louder music in the morning wakens me up, as well as an iced coffee a few times a week ;) But I do think that eating a healthy diet (most of the time) and having a regular sleep cycle does help a lot with energy levels as well. I wish there was an easier/less lame answer though!
• How did you get through the tough times during 1st and 2nd year when everyone is studying nonstop and it's gross/dark outside all the time? I feel guilty for taking breaks, but have totally lost myself here in exhaustion and feeling stupid. How did you juggle life with boards + school + bf and not go crazy?
• I'll be honest, the first two years of medical school kind of suck. They are a wonderful time because you are finally doing the thing you've always wanted to do, every day you get to learn something new, and it's really an opportunity that not many get. But, it's also a time where you are constantly stressed, you don't get nights and weekends anymore, and you always feel behind and that you don't know enough. You just have to find ways to get through it. Really enjoy the nights after exams - get pizza with friends, go watch a movie, get a good nights sleep. Find ways to spend time with friends that pulls double duty - my bff and I used to go to the gym three times a week just so we could talk while on the ellipticals. If you're at the library with your friends and truly doing work (instead of messing around), taking a break every three hours and go on a quick walk - it really is a great mini break to get some fresh air, bitch about studying, and then feel better when you sit back down. Make studying as comfortable and relaxing as you can - at home I always studied with a heating blanket on my lap (bonus is that I always had a cat or dog at my feet), and at the library I always made sure to have an iced coffee and my favorite headphones on (I love the epic station on pandora!). And just remember to breath once in a while, so if you just can't take another minute of reading Robbins, go watch an episode of your favorite show because bad studying is pointless. 
• How long did it take you to make a profit from your blog?
• If you use an affiliate company like ShopStyle, you can make money pretty much right away (although it may take quite a bit to get to the $100 payout). I've been blogging for almost four years, but I would say that I didn't get regularly monthly payouts for a year, and didn't make my current level of income until about 2.5 years into it. 

on franish

• on the blog: my experiences with using a tretinoin cream
• on the instagram: sometimes it is just necessary to curl your hair, even if you don't have to (my shoes are old and from Target, but this pair is almost the exact same!)
• on the twitter: seriously, we see you buying followers!

notable sales

• Anthropologie: 40% off sale items!
• Trina Turk's tote is now 1/3 of the original price! I love both the main pattern, and the pattern on the included pouch. 
• How freaking cute is this polka dot shirt dress? Love. If my size wasn't sold out, I would definitely order it. 
• Pick up a couple of these satin-trimmed tees as they now under $20 (go for the blush or the blue!!)
• Banana Republic: extra 50% off sale items
• I saw this cardigan in stores yesterday, and it is so soft. If I could wear whatever I wanted every day, I would just wear that. 
• I'm definitely ordering this tie blouse though - blush or white? I can't decide, I love both!
• Their scalloped blouses are fun...plus it comes in several colors!
• J.Crew
• I love their striped tippi sweater (it also comes in red). 
• Their pencil skirts don't always go on sale, so now would be a good time to pick one (or a couple) up!
• Pop-pom hats are the only good thing about snowstorms, amiright? 

personal

• CR and I took a little day trip down to Pittsburgh yesterday - we initially went because we had to get paperwork done for school, but then did a bit of shopping and then got the best sushi. And then spend the whole night watching The Office (because we are only 11 years behind). 
• We're looking to do a few DIYs around the house in the next few months, including finding/making new legs for our couch, and legs for our TV stand (our first almost Ikea hack). Any tips for newbies?  
• Hansi is 6.5 years old now, and so even though he acts like a puppy, his body says otherwise. He's been having some back problems again, and it just breaks my heart to see him in pain :(

my closet staples

It's been a good three years since I started working on building a cohesive wardrobe, and while I don't think there is ever a final perfect closet, I am very happy with where I'm at currently. The following are the items that I grab for the most, the items you may see on here the most (although many are worn in real life more than you see on here), and items that I have found to be the most versatile.

While I don't think I would ever do a capsule collection (it just doesn't make a lot of sense for my current life), these are the 32 items I would pick if someone made me choose! I was going to tell you guys about them all individually but I found myself writing "this is my favorite XX" or "I wear this all the time!" so...I stopped that. So...these are my favorites and I wear them all the time. Any questions? Ask away in the comments!

tops

Boden breton top [seen here] 

Everlane cashmere sweater [seen here] 

J.Crew Factory blouse [seen here]

J.Crew chambray [seen here]

Everlane tees [seen here]

BB Dakota cardigan [seen here]

bottoms

J.Crew Factory skirt [seen here]

Paige black jeans [seen here]

Madewell skinny jeans [seen here]

Express ponte pants [seen here]

The Limited Ankle Pants [seen here]

toppers

H&M blazer [seen here]

Paige jean jacket [seen here]

Olive jacket (I actually have 2 different ones)

shoes

Hunter boots [seen here]

Cognac Vince Camuto boots [seen here]

Black Vince Camuto boots [seen here]

Madewell leopard flats [seen here]

Ferragamo red flats [seen here]

J.Crew Factory wedges [seen here - I also have them in black]
Tory Burch flats [seen here]

Converse [seen here]

Jack Rogers sandals [seen here]

accessories
Nordstrom tan scarf [seen here]
Daniel Wellington watch [50% off! seen here]
J.Crew Factory necklace [seen here]
Coach purse [seen here]
Ann Taylor scarf
Michael Kors watch [seen here]

Madewell tote [seen here]

lounging favorites
LL bean sweater [seen here]
Zella leggings 
J.Crew Factory socks

wishlist items
red crossbody, like the chloe marcie bag
distressed black jeans, like these from paige
classic pearl earrings

beauty tuesday: my experiences with retin-a micro gel

This past August, I had my first appointment with a dermatologist to start my tattoo removal process (I have a small star on my wrist from a poor decision ten years ago). Because I was already there, I asked my doctor about what can be done about larger pores. I have pretty large pores on my nose that have always bothered me, but I haven't found anything that actually reduces them in size, so I wanted an expert's opinion. Unfortunately, she said that pore size is genetic and not much can be done to change that, but she has seen some success with a tretinoin cream, and since I had a bit of acne on my chin, it may be successful for me for both of my concerns.

Tretinoin causes skin cells to divide and die more rapidly, which increases epidermal turnover, while also stimulating collagen and elastin. The end results is that the new cells should replace the cells of acne, wrinkled, and hyper-pigmented skin (this article describes it in more detail if you are interested).  My skin concerns are really the hyper-pigmentation from acne scars, occasional pimples, and now that I'm in my late twenties, starting to be more proactive against wrinkles, so this seemed like a great option for me. Cost all depends on your insurance, but with my insurance and a coupon card from my doctor, it ended up not costing me anything out of pocket.

I was prescribed the 0.08% Retin-A Micro, and have been using it for four months now. Because I have fairly sensitive skin, I continue to use it the same I did when I started. Every other night, I wash my face, then wait a minute or so to make sure my face is truly dry. Then I use about a chickpea size of the gel, and rub a small amount on each section of my face. I then follow up with generous amount of Vanicream, a horribly-named but efficient moisturizer recommended by my dermatologist.

For the first week or so, I didn't really notice any difference in my skin. Then all of a sudden, my skin started to peel like crazy. Ugh, it was so so bad for quite a few weeks. There was just nothing I could do to get my skin from peeling - I tried gentle exfoliation, extra moisturizing, different moisturizers, less of the gel, more of the gel, layered under and over moisturizer. I probably was in that state for a good month.

I would say that for the last month or so, so about three months after I started using the Retin-A micro gel, my skin is finally getting over the peeling and dryness side effects. Things that have worked well for me are: gentle exfoliation with a konjac sponge every time I shower, using the First Aid Beauty Hydrating Gel every morning (review here), using the Vanicream at night, and using the Origins Drink Up Mask on nights when I don't use the gel.

So the results have been pretty good and worth it, in my opinion. I think the biggest thing I've noticed is that my hyper-pigmentation has drastically decreased. I used the picture below in my review of Paula's Choice BHA toner, but you can see how the acne scars really have almost disappeared from where I was a year ago. I think the BHA toner helps me a lot more with my acne than the Retin-A micro, just because I forgot to use the toner for like two weeks a few weeks ago, and my skin really blew up. But my scarring is decreased, my acne is reduced (from a combined effort, it seems), and I would say my skin overall is more even. I don't know if it has really had an effect on "wrinkles" because although I have some fine lines around my eyes, I don't really have that many wrinkles yet. And while the original reason for starting the cream was for enlarged pores, I haven't really noticed a change in them - they are still as present as they were before :/

Retin-A micro is a prescription medication, and with all medications that are certain side effects. Of particular importance if you are female is that this is a Category C drug that has shown to have adverse effects on fetuses, so if you are or planning on being pregnant in the near future, this prescription drug isn't recommended. It's not to the level of Accutane (a Category X drug) so you don't have to prove that you aren't pregnant/be on several modes of birth control, but definitely worthy of noting. I am actively trying not to get pregnant at this moment of time, so this didn't change anything for me, but will be something to consider in the future.

So that has been my experience with starting and continuing to use Retin-A micro. I am very happy with my results, especially now that I have figured out how to control the flaking, so I intend to use it for the long-term. Several of you have asked about my experiences using a tretinoin cream, so I hope that answers some of your questions! Have any of you had success with a prescription tretinoin cream?

Disclaimer: I am not yet a doctor, nor would I ever give medical advice on the internet. I'm just a girl sharing my experiences with a prescription medication - this is not medical advice. Please talk to your own doctor if you are interested in starting this medication!