A Little Worried.

Day 12 – National Blog Posting Month.

Being a doctor who is also a daughter has its privileges. I can navigate the system on behalf of my parents. I can advocate on their behalf and ask for tests and referrals. I can attend appointments and understand what is being discussed.  I can find out results before they do.

It is fraught with disadvantage as well. With their permission, I am privy to tests results before they are. I understand what their diagnoses mean and if I don’t, I know trusted resources to educate myself.  I understand in general terms what “illness trajectory” means. Specifically, I have seen what illness trajectories look like.  I also know what the end may look like.

I am the one my family looks to for advice and comfort.  I have to be strong and composed. I can’t let them see that I’m worried.

Vague.

Day 5 – National Blog Posting Month.

3D-man-stabbed-on-the-chest-with-a-knifeIt’s been on and off for a few weeks now, this sharp, stabbing pain in my left chest.  I know what it is and why it is and as much as I try to control it, I just can’t.  It’s work related and I can’t talk about it.

Wow, I think I just “vagueblogged”.  And yes, I just made that up.

I hate when people “vaguebook” – you know, someone posts a very vague message on Facebook which then prompts friends and followers to ask, “Are you okay?” or “Thinking of you!”  “Hope you are okay.” Suddenly whatever they are actually posting about really isn’t as important as how many friends actually noticed and are asking about it. That is what is really wanted by the original message.  Someone is feeling upset and alone and vulnerable – reaching out to social media is the way they can feel important again.

Which reminds me of a comedian my husband introduced me to recently.  He’s so funny and so NOT politically correct, it was actually quite refreshing to watch.  His name is Anthony Jeselnik.  One particular “bit” really struck home with me.

So today, I ask my blogging friends and readers not to forget about me.

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Facing the Void

My brother and I had a long talk the other day about our parents.  He has positioned himself to be their power of attorney for finances and I am their power of attorney for personal care.  In the past year, it has become evident that we may need to start exercising our roles.   I can’t tell you how sad that makes me.

Growing up, my father was larger than life. He was a tall, formidable man with a deep voice but he was for all intents and purposes, a gentle giant.

Over the past year or so he’s become impatient, occasionally verbally aggressive toward my mom and is forgetting things.  He was diagnosed with mild cognitive impairment last fall but his condition seems to have deteriorated in the last 3 months.  He has a much shorter fuse now and asks my mom to repeat things several times a day.  He denies feeling depressed but we all think he is. Thankfully his family doctor suggested a trial of a low dose antidepressant and he actually agreed.  

He will be having an brain scan soon. I fear it will be normal.  Why? Because the thought of watching him continue down the road of dementia is heartbreaking. It would frankly be much easier if he was diagnosed with a brain tumor. I don’t think I could bear the day he forgets his grandchildren and then me. I don’t think I can watch him become aggressive and angry and frightened at his memory loss.  I see it already happening with my maternal grandmother. 

And there’s the kicker: dementia on both sides of my family? What does that mean for my brother and me? Are we destined for the same end?

We talked about all of it. Dad won’t want to go into a nursing home when the time comes. Will I have to have him declared  incompetent and take over as POA?  If dad moves into a nursing home, mom won’t be able to stay in the condo; will she live with me or my brother or alone in an apartment?  How long are we going to have to watch him deteriorate? He would never want to live like that. I certainly wouldn’t. 

I fear the road ahead. 

Burnt.

Further to my post yesterday, I haven’t had any extended time off from my practice since July, 2014. When my receptionist pointed that out to me, I was kind of surprised. I’ve taken a few long weekends here and there but yeah, I haven’t really had a break from my job in well over a year.

It’s no wonder I’m a little cranky.

My older colleagues regularly take a month off every summer and at least a week or two in the winter. They can afford to do so as their children are now all grown up and out of the house. I am not in that position yet. I still have a mortgage and other debt to pay off and I wonder sometimes if I ever will?

I love my job but it’s hard to listen to other people’s problems day in and day out. Most of the time I can help solve the problem; here’s an antibiotic for tonsillitis; here’s a pill for your awful irregular periods, or here’s a great physiotherapist for your chronic ankle sprain.  If that was the extent of the problems I would be fine without a regular holiday.  But it’s not like that in family medicine.  In family medicine I see the wife who found out her husband is having an affair; I see the schizoaffective patient off their meds; I see the teenager with anger management issues displaying cluster B traits (borderline personality disorder) who bounces from one psych unit t to the next;  I see the elderly woman with memory problems who doesn’t remember she has memory problems.

I am privy to the knowledge that a wife plans to leave her husband, who is also my patient and is about to be blindsided. I am privy to the knowledge of a history of horrific childhood abuse and the subsequent psychological damage that does to a person. I am privy to the knowledge that a 40-something year old man really wants to be a woman.

It is a privilege to be these people’s family physician, it really is.

But even the doctor needs a break.

Near the End.

She stepped over the threshold of their home, a visitor.  Through the doorway the hospital bed was visible and the hiss of the oxygen tank audible. She heard the patient’s voice speaking in his native tongue, French. His son whispered in her ear that he was talking to family abroad. She stepped into the room and put her bag and coat on a nearby chair.  He waved to her, finished his call and gestured for her to come closer.  She took his hand in both of hers and squeezed.  He thanked her for coming.

The hour passed quickly. She learned that his wife, having been always very demure and quiet in the office, was quite the spitfire at home.  His wife chastised him for wanting an ounce of red wine when he was barely eating any food. Though he was hungry at times, he could only eat a few mouthfuls before the nausea set in, this despite being on the appropriate medication to aid in controlling his nausea.  She explained that slowly his need for food would diminish and that would be okay.  So long as he could enjoy sipping on water, juice, or wine, that would likely be enough.  She learned that he enjoyed doing puzzles.

At one moment, he looked her in the eye and asked if she could help him go.  Tears welled up in his eyes.  Then in the next breath he said he wasn’t ready.  She reassured him that these emotions were normal.  There would come a time when he would become less aware of what was happening and so she reminded him to say the things that needed to be said now while he still had the chance.

She forgot about the tea that had been offered and accepted.  He told her to drink it before it got cold.  He asked for water, then said he was tired and wanted to rest.

She said goodbye and squeezed his hand again.  She said she’d like to visit again soon. He said he’d like that.

On Strength.

I know it’s been a while that I’ve written when I can’t remember what my last post was about. There’s been a lot going on, all of it good for the most part.

Daughter got her cast off and is on the mend. Most days I think she forgets about the elbow injury but she has been careful not to test it on the monkey bars (thanks in large part to the Orthopedic surgeon who told her not to go near them for a few weeks).

I’ve been a slammed at work… again.  My colleague had a family emergency quite suddenly and we’ve had to juggle her practice.  Thankfully there was a replacement doctor coming in for some vacation time so that has eased the burden this week.  I often feel I am asked to cover for my colleagues more than they cover for me and it’s been like that for years.  I work more than they do so it makes sense, I guess.  Still, it’s annoying and not likely to change unless I also reduce my hours, which isn’t going to happen anytime soon.  I nod politely and tell them I’ll do what I can but inside I can’t help but feel resentful. I know this is something that can’t continue because it will eat away at me. I just want things to be equal and I fear it’s never going to be.

Running is going well. I signed up for a 15k race and it’s coming up this weekend.  Of course I am nervous about it; I worry I’ll fall flat on my face and not finish even though I ran 18k two weeks ago, my furthest run to date.  The last 2k were very hard and I walked a lot so I know I was pushing myself but I felt I needed to in order to feel more confident about the upcoming race. I’ve been tapering since then and haven’t run more than 5-7 km and taking more rest days.  I ran 87.5 km during the month of May. My total for the year so far is 381 km.  I am not sure I’ll reach my goal of running 1000 km in 2015 but I do know that I will run a half marathon.

I also started strength training at home on the suggestion of my chiropractor and Pilates coach.  I’ve been doing upper and lower body free weights and have noticed a significant difference in my stamina already after just a month.  During my last run a few days ago, I was able to run up a very large hill without any walking.  That’s not something I could have done a month ago.  What an exhilarating feeling!  I have to say it’s also pretty cool seeing the changes in my muscles.  I already had pretty strong arms thanks to carrying toddlers around for the past 6 years almost non-stop.  My main weakness has been in my glutes so I learned how to do dead lifts and started incorporating those a couple of times a week into my routine.  Core strength is incredibly important as well and planking has helped.  My FB running group has a daily elbow plank challenge going on this month and my time has already increased by almost 25 seconds in just a week.  I’ve also been biking to and from work at least once a week as well.  I have a mountain bike, it’s pretty heavy and not terribly efficient so it’s a good workout, especially when I’m riding along the trail and have to climb the hills.

Fortis ego sum.

I am strong.