Busy Bee.

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.

The Grim Reaper

December is not a good month to be a family doctor, or any doctor for that matter. I have lost count the number of bad diagnoses I have had to give before Christmas.  What an incredibly shitty way to end a year.

“I’m so sorry to have to tell you this, but that lump in your groin is lymphoma.” 

“The biopsy has confirmed it’s malignant melanoma.

“Unfortunately, your baby stopped growing around 9 weeks of pregnancy.” 

“The lump in your breast is suspicious for cancer.” 

January is sometimes even worse. Who wants to start a new year with bad news?  

Every year I feel like I’m back here lamenting the fact that it’s supposed to be a magical time of year, these “holidays”, and I’m forced to give more people more bad news.  Can’t I just have one year where everyone is healthy? Is that really too much to ask for?

Seventh Kid

This past week my older son has been unwell with a fever but no other symptoms.  Maybe he had a mild cough but otherwise seemed okay.  A few nights found him coming into our room and the heat raging of him indicated to me he’d had a fever.  The inevitable phone call from the school telling us that he was sick came and he ended up staying home just one day and actually seemed pretty good that day except for not having much of an appetite.

So imagine my surprise when I go to pick him up from school the other day and his teacher (who knows that I am a physician) tells me that six children are away with strep throat.  Six!  I thank her for the information and immediately turn to my son, take out my phone, turn the flashlight on and look in his throat.

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The white spots on his tonsils are pus, or exudate. Probably from a strep infection.  He hadn’t had much of a fever in 24 hours so I decided to wait to get him tested.  This morning he woke up with no fever, but complained of his tummy hurting every time he tried to eat something.  Husband and I wondered if it was his throat that was actually causing him pain.  Kids are kind of dumb when it comes to being able to tell you where it hurts, I find.

Anyway, husband worried that our son had already had the infection for a few days and would be more susceptible to complications (post-streptococcus auto-immune diseases) so I took him to my office in the hopes of getting a rapid strep culture done.

Now, it’s hard enough to take a throat swab for a 4.5 year-old patient in the office, imagine trying to do it on your own son? I had to bribe him with a cookie his grandmother made.  When he saw the how long the “Q-tip” swab was he panicked and covered his mouth.  I told him it would be really fast and that we had to do it or he wouldn’t get the cookie.  “Oh fine,” he said.  So he opened his mouth and I was able to get a really, really, really quick swab of that tonsil.  After lots of crying and “Ow! Mommy, that hurt!” there was no way he was going to comply again.  Looking at the swab, I could see I had gotten a bit of that junk off, so I proceeded with the test.

The rapid strep kit really helpful in the office.  Normally a throat swab takes 48 hours to get results.  With these rapid kits I can have an answer in 5 minutes. I also really like doing them because it’s like a little science experiment I can do right in the office!  It definitely makes a typical day more interesting.

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Very much like a pregnancy test, one line is negative for strep and two lines is positive.

My son’s test had a very faint second line.  Given the history of six other children in his class with strep infections, his on and off again fever, lethargy and lack of appetite, not to mention the tonsils looking the way they did, I elected to treat him.  Yes, I should have taken him to his own pediatrician but I didn’t.  After a couple of doses of Amoxicillin, he is already looking better.

Sometimes it’s really convenient being a doctor mom.

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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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.

Geeking Out.

What do you do when it’s a reallllly slow day at the office?  All my paper work is done, referrals are faxed, labs are reviewed, and patients are seen on time.

Watch the new Star Wars trailer, of course!!!!

I just totally geeked out in my office.  My staff are probably thinking they should haul out the Form 1.

#letstalk

I deal with mental illness on a daily basis in my family practice. Having been treated myself for depression and post-partum depression I am well aware of the stigma that still exists. Mental illness is real.

I am not okay.
My life is good.
I have no reason to be depressed.
I feel so alone.
No one understands me.
The voices are so loud.
I think I need help.

Today, let’s talk about mental illness. It’s closer than you think.