I’m writing this as I sit in a taxi on my way to a conference. My driver is a woman. This is a first for me! I can honestly say I have never had a female cab driver before. My initial instinct after telling her my destination is to take out my phone and snap a photo of her. Why? To post on Instagram of course.
I stopped myself.
“You aren’t on Instagram anymore.”
“Who are you posting that for?”
“Why does anyone care!?”
I admit I got caught up in the desire to photograph my life for others to see, that is, to photograph those things that I wanted people to see. Again I have to ask myself why? What does it prove? Why does anyone care that I’m awake this early on a Saturday attending a conference about the Eye? The better question is why I feel the need to tell people about it?
It’s been two whole days since I took myself off a couple social media sites and I am doing surprisingly well. It certainly doesn’t hurt that work has been insanely busy and there have been lots of letters to write and forms to fill out for patients.
I also volunteered earlier in the fall to be a file reviewer for a medical school admissions program and had forgotten all about it until an email arrived this week advising me that the files will be sent to me in the next few days. I am very excited to have been given this privilege of helping review files of prospective medical school candidates. It really does put a lot of things in perspective for me.
I am also attending an all day course this weekend, so will be busy learning all the things I need to be taught again. This break from social media is good for me and so far hasn’t been nearly as hard as I expected it to be.
Perhaps the withdrawal hasn’t quite kicked in yet.
I’ve spent the last 9 hours at a very intensive course on the essential approaches to palliative care. It’s been a really long day with a lot of information. I’m glad I attended but after last week’s conference, I am all learned out.
I have to make my daughter’s birthday cake tonight and I really need a run but I have a headache and I just want to curl up on the couch and take a nap.
But I sat on my ass all day at this conference, drank too much coffee and ate too much food so I need to run. This month has been awful for running due to one illness after another and with the colder weather it takes a little but more motivation to get going. I know I have to though. I finally reached my goal of being able to fit into my most favorite pair of jeans and I have been feeling really good about that. After three kids I am damn proud of how I look and feel and to maintain that I have to keep up the running. So no more excuses!!
Back to life, back to reality. There really is a song for every occasion, isn’t there?
I’m at the airport. Just went through security where I had to take off everything but the shirt off my back. Seriously – boots, coat, scarf, belt. I joked with the security officer – “Pants and sweater too?” He didn’t look too pleased. The gentleman before me was transporting a small cooler that had a large sticker on it, “DO NOT X-RAY”. OOOH! Is there an organ in there? I was so tempted to ask.
So, I’ve been in “doctor mode” for the past few days, talking with my friends about patient encounters, tossing stories back and forth about the difficult patients. I haven’t had to put on the “mommy” hat or the “wife” hat and if I’m honest with myself I have to admit that the break has been nice. Husband is exhausted – I can hear it in his texts. The “mommy” hat will go on the second I open that car door and here, “Mommy!!! Hi Mommy!!!” I can’t wait to see the kids. While I didn’t really miss them per se, I did miss seeing their little faces. I feel refreshed despite still coughing up a lung (stupid bronchitis!) every now and then. I’m ready to put on the other hats. I’m just going to enjoy this last few hours of quiet contemplation.
Conference centers are like mazes only with poorly designed signage. Seriously this place is so confusing and watching a group of doctors all thinking they know where they are going only to find find out they were supposed to turn left at the fork then right at the double doors then right again is kind of funny.
The morning sessions were pretty good. I got a refresher on the difference between episcleritis and scleritis and learned its never a good idea to prescribe steroid drops for the eye. I also learned that the adolescent brain is very vulnerable to substance use and their neurobiology doesn’t full mature until well into the mid-20s.
I had a very educational 3 hour workshop/course this afternoon. I learned some key tools that I think will go a long way in helping me with some of the more challenging patients I encounter.
Overall it was a great day aside from the ongoing gastro and bronchitis I am still plagued by.
Now to pretend to care about dinner. Honestly, this lack of appetite is getting old.
Later today I am leaving the city for a big conference. Getting on a jet plane, folks. Don’t know when I’ll be back again.
I feel a bit weird leaving my husband and kids. I know they’ll be fine but it’s a lot of work, three kids and a household. Two days ago I told husband I felt guilty for leaving him with the kids. He said not too, that I deserved a break. I couldn’t help but think, “I need a break?! I get to go to work everyday! He needs the break!” I love him for saying it though. I know if he were in my shoes, he’d be excited to go away for a few days. I’m sure I will be excited once I’m at the airport but right now I worry about how the grade one parent-teacher interview will go on Thursday and I worry that the baby still isn’t quite over his stomach flu because nor am I.
Last night husband made sure he knew where my life insurance policies were. You know, just in case. Oh God, that reminds me that I still haven’t done my will.
I really do need this conference though. Since having the baby I haven’t really done much in the way of organized course work/self-learning. I’ve done some online reading around patient issues but not much else. I really need some time to focus on medicine and what’s new. I am meeting my friends from residency and we’ll be doing some guided self-learning workshops in between the conference sessions. We’ve booked some restaurants and I pray my stomach is better. My appetite is returning, very slowly, so I know I shouldn’t overdo it in the eating (or drinking) department. Le sigh.
I plan on bringing my winter running clothes as the temperatures are about to drop and I’m headed a bit northeast of my current location. I haven’t run in almost a week because of this stomach virus, so I really really hope I can get a 3-5 km run done. I really miss it.
I have a morning clinic to work and a few errands to run before the car picks me up for the airport. I’m sure the excitement will set it in at some point but for now I just wish this stupid stomach virus would end.
It’s Saturday morning in Montreal. I decided I needed to sleep in, so I skipped a few morning sessions. Yesterday was jammed pack full of learning. Here are a few clinical pearls.
1) Skin-to-skin in first 6 hours of life is good. (well, duh!) — actually, I totally get it. When my son was born, the nurses told me that even though I was having surgery, that they would put him on my chest as soon after birth as possible. It was news to me as 2.5 years earlier, in the same hospital and the same case-room, my daughter was wrapped up and given to my husband to hold. I have to say that the bonding I had with my son during the time he was on my skin in the case-room was the best hour of my life. I will remember to tell my expectant mothers to ask for skin-t0-skin when they deliver their children.
2) Soap is bad for your skin – skins’ pH is 5.5, soap is pH 9. Soap breaks down the barrier and lets in nasty stuff. — I am not sure I’m comfortable advising my patients to stop using soap. I’ll be responsible for countless stinky people roaming the big city. So what’s the alternative? Well, I also learned that Aveeno body wash is pH 6. That’s great, right? It is gentle on the skin and protects the barrier. What’s the down side? It’s $10 for a small bottle!
3) I am ordering too many ferritins. Must stop. Bad, doctor. Costing our health care system untold $$$. Initial work up for anemia is a CBC. Plain and simple. If Hb and MCV are normal, it means ferritin and B12 are as well. Right. No more ferritins. (We’ll see how long that lasts!)
4) Conferences are exhausting.
Home tomorrow! Thank goodness for the clocks changing tonight. I’m going to need that extra hour of sleep before I go home to my two children. Oy.
I’m exhausted. Mostly because I was out last night with my friends at DNA here in Montreal. We did the tasting menu, with alcohol. A lot of alcohol. I’m still a little bit hungover. Did I mention there was a lot of alcohol?
I just finished a 4 hour session on Men’s Health. It was great, but it was very biased toward prescribing testosterone. So much so, that one of the doctors in the group suggested to the facilitator that he disclose his conflicts of interest at the beginning next time. Ouch. It’s not like he was promoting one brand of testosterone over another. There’s one or two kinds of injectibles, one kind of oral and two kinds of topicals. There ain’t a lot to choose from! And the main topic was symptomatic hypogonadism. How else is one to treat it? Seemed like a no-brainer to me. I was always afraid of testosterone replacement therapy because of hearing all about how it caused prostate cancer, or rather, increased a man’s risk of prostate cancer, when in fact, that is just a myth. I learned today that testosterone will increase a man’s small, shriveled up prostate to the size it would have been had he had normal testosterone in the first place. If there was a teeny nidus of cancer in that shriveled up prostate, then testosterone treatment would, in fact, unmask it, hence bringing it to attention earlier. Good, right?
Bottom line is that I am now a little bit more comfortable in how I’ll approach the next middle-aged guy who comes into my office complaining of decreased mood, exercise tolerance, low libido, sexual dysfunction, etc. And I will likely consider Testim, since that’s what’s in the sample cupboard, thanks to the drug rep who came by last month with lunch. 😉
And the best part was getting a preview copy of the PAACT guidelines of Men’s Health Topics for the Family Doctor. Boo ya! I love getting free stuff at these things.