The Corridor at Night.

Day 9 – National Blog Posting Month.

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Last night I took my elderly father to his MRI appointment at a downtown hospital.  As the machines in my city run 24 hours a day, 7 days a week it wasn’t surprising to me that his appointment was for 10pm.  Both my parents can drive but neither my brother, nor myself or my husband wanted them driving that late at night, so I decided to take him myself.

Walking through the hospital hallways at night reminded me what I loved most about my medical school and residency training.  The quiet and tranquil feeling of walking down a hospital corridor at night.  No matter what kind of day I had, or night for that matter, being allowed to roam the quiet hallways at night was always comforting for me.  It didn’t matter if I had just lost a patient or was heading to the ER for yet another consult, walking those quiet hallways was like therapy.  I honestly felt right at home.  The lights are dimmed. Patient care areas are quiet except for the occasional sounds of IV machines beeping. Cleaners are buffing the floors. I might see another resident walking in the opposite direction, sometimes a family member from the ER who had gotten lost and asked for directions back to the unit. It was a privilege to be one of the club.

For a few minutes last night, I yearned to be back in that club again.

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A Pain in the Eye

Day 6 – National Blog Posting Month.

All day my eye was bothering me. Between patients I’d go to the bathroom with a saline spray and remove my contact lens to clean it. My eye would feel better after a while but then the irritation would return. It felt like a grain of sand or dust was in my eye. I thought I might be getting a stye. By the end of the day I felt like scratching my eye out.

I had some fluorescein stain at home so I put a few drops in my eye and used the blue light of my ophthalmoscope to look at my eye. Yellow and blue make green. A corneal scratch or abrasion will light up green.

http://www.rcemlearning.co.uk/references/corneal-injuries/

Above photo credit: http://www.rcemlearning.co.uk/references/corneal-injuries/

I was a little surprised to actually see that I indeed had a few scratches on my cornea. Suddenly the pain got worse (psychosomatic?). I called for my two older kids to come to the bathroom so I could show them.

Needless to say they thought it was pretty cool. I had to wear my glasses for the rest of the evening. They have lenses from 2006. They haven’t been updated and my eyes have gotten worse. I really need to get the lenses updated.

Corneal abrasions hurt. Wow. Do they ever hurt. I woke up with a brutal migraine today and I still want to scratch my eye out. It’s going to be a great day.

Three More Hours

I am sitting in a salon chair finally getting my hair done. It desperately needs some help and this was the only time I could fit it in. I 

work this afternoon and then I am off for almost three weeks. 

Three weeks! 

Three more hours of patient visits to go. 

Three more hours of lab reports, consults and prescription renewals. 

Three more hours of dealing with other people’s problems. 

Yesterday I started to worry that I was getting depressed again. I suddenly just felt … I don’t know, I felt off. I felt like I just didn’t care about any of it anymore. I didn’t want to go home and face the chaos of trying to clean and pack and deal with the kids. 

But then I got home and amongst the chaos and dirty faces and piles of laundry to fold, I felt immensely better.  I was happy to be home. I can’t begin to describe how reassuring that was to feel. Despite the state of emergency that my house is currently in, I was happy to be home and in the middle of it. 

I don’t need a break from my family, house or kids. I need a break from work. 

Only three more hours to go. 

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.

A Welcome Reprieve

Family medicine is great. Earlier in the week I was completely slammed, double booked almost every hour. This morning two people no-showed and I have cleared my inbox in record time.  I’ve paid the office bills that piled up on my desk all week, I’ve already had two coffees and am feeling the caffeine buzz.  The phones at the front desk are pretty quiet.

The calm before the storm?

You betcha!

Mornings like this are nice especially when they follow a couple of crazy weeks of non-stop patients. It gives me time to reflect and regroup. It also makes me wish I had my cross-stitching tucked away in my desk. I have several projects on the go and being able to work on something while at the office would be great, especially on days like today when I have done all the work I can do and am just waiting for patients to show up.

I started cross-stitching in medical school.  I was never a crafty person and can’t draw a straight line with a ruler, so this was something I was quite surprised I took to so well.  Counted cross stitching is methodical, it’s relatively easy to learn and hard to mess up.  Having said that, on more than one occasion I have miscounted my stitches and while it can be really frustrating at the time, for the most part it is a relaxing and meditative hobby that I absolutely love.  When I haven’t had an opportunity to stitch I get cranky and irritable.  So at times like this, when the office is unusually quiet, I really wish I had my hobby to go to.

92.5%

I saw twenty-seven patients today. It was busy. There were several add-ons to an already packed schedule. I book 15-minute appointment slots. I have colleagues that book 10-minute appointments but I just don’t see how one can possibly deliver good medicine in such a short period of time. So for me, having an extra patient booked every hour makes for a really busy day.

Of the twenty-seven patients, no word of a lie, twenty-five came in because of cold and cough symptoms and only one patient left with a prescription for antibiotics. One. Did they all need to be seen? Absolutely not. I’ve been coughing for five weeks and haven’t thought to see a doctor. It’s a virus. It will get better on it’s own. If it doesn’t it’ll be pretty obvious and will declare itself with fever, chills, shortness of breath and exhaustion.

I like educating my patients about colds and flu. But damn me if they don’t remember the advice on a year to year basis. It can be really frustrating – for them and for me. They’ve taken time off work to see me, they feel awful and just want to get better. I understand that. But when they see everyone else around them with the same symptoms isn’t it obvious to them that going to see their doctor is kind of useless?

After the day I had, apparently not.

I just hope tomorrow something a little more interesting happens.

No Breaks.

Day 28. National Blog Posting Month

I am actually looking forward to the weekend. It has been a hellish week at work (see my earlier posts).  I’ve been insanely busy with appointments and double bookings and it seems like everyone’s lab tests are abnormal. I was supposed to have a meeting with my colleagues at dinner last night but I felt unwell all day and had to cancel.  I thought the stomach virus was coming back but I think I just needed some sleep. So this colleague and I have not actually spoken about the issue that came up this week and rather than hang around this afternoon to do so, I am going to get the hell out of here while I still can.  I have no one booked this afternoon, so I am finally going to get home before 6pm which is so nice for a change.

I got to work this morning thrilled that no one was booked after 1 pm and dug in to clear my inbox. And that’s when I found out a patient (60 years old) has had a 20+ point drop in their hemoglobin over the past six months. This patient has other serious problems, a degenerative neurological disease, and really doesn’t need me to call and tell him he’s now anemic and we have to find out why.

For those not in the know – a significant drop in hemoglobin, the molecule in the blood that carries oxygen and is a marker of the bleeding status of a patient, in an individual over the age of 50 is a red flag for a gastrointestinal malignancy until proven otherwise.  This patient has not had any overt bleeding events in the past 6 months.  The bowel pattern has changed but was being blamed by the medications used to treat his neurological condition.  This patient has been declining rapidly with respect to his neurological status but now I can’t help but think there was something going on all along this past year that we are only just now seeing.  Could this patient have cancer?  I fear the answer may very well be yes.

And why the hell does this have to happen on a Friday and a month before Christmas?

Really? What the F—!?