Welcome to another installment of National Blog Posting Month (NaBloPoMo), where bloggers post daily for the entire month. It’s a big commitment but one I have succeeded at in the past and I hope to be able to keep it up again this year. I can promise my readers there will be talk of running, life as a mother, being a doctor and running a practice and being a daughter to elderly parents. So, probably nothing terrible new. Ha!
It’s the day after Halloween and it’s not even 10am and I think my kids have asked for candy about a hundred times. Right now I’d rather stick a fork in my eye than hear them ask for candy one more time.
The clocks turned back an hour last night. Daylight savings time. I can vaguely remember it the thought of an extra hour of sleep was heaven. Not so much anymore. In fact, it’s a horrible joke played on many parents. An extra hour of sleep? What a joke. The toddler was up just before 5 am. And when I say up, I mean awake and ready to meet the world. There was no way he was falling back asleep. Then the older two, I could hear talking around 5:45 am. My older son came into my room and gave me a kiss – the distinct smell of chocolate on his breath. It would appear they sneaked some candy in their room before going to bed last night. Well played, kids. Well played.
The FB running group I am a part of held a virtual race this weekend to end the month of November. It’s been a pretty crappy month of running for me. One of the worst this year. I’ve been feeling like a sloth all month and with how busy it’s been at work and the multiple illnesses I’ve been plagued with, it’s really no wonder I haven’t been able to run.
But all that changed today. On this final day of November I made a deal with myself that I would get out there today and just do it. And I did. I managed a pretty decent 5 km run to share with my running group. It was a solo run, all my runs are, and it felt great. I suppose actually that this was my first race though the entire time I was running I kept telling myself it wasn’t. Yet by the time I was about 500 meters from the finish (aka home) I found a burst of energy and ran home as if I were crossing a finish line.
Ah, that felt good.
And with that, another NaBloPoMo Is done. Thank you all for all the comments and encouragement. It’s been fun.
Yesterday afternoon husband showed the new Star Wars teaser trailer to the kids. Star Wars (the original trilogy from the 70’s and early 80’s) was hugely influential to my husband. I mean, he can recite the films line by line entirely from memory. The epitome of geek, right? The kids have already seen Star Wars: A New Hope more times than I can count. Daughter has seen The Empire Strikes Back only once and she just turned six.
In our household Episodes 1-3 do not exist. Husband was so disappointed in that trilogy that he desperately tries to erase it from his memory and if has anything to say about it the kids will never know those movies. I have to agree with him – those films are pretty awful. So when we heard earlier this year that Disney (of all companies!!!) bought the rights to the Star Wars franchise and were planning a series of movies, husband and I were skeptical. Then when it was announced that J.J. Abrams (Felicity, Alias, Lost, Fringe) would be directing the first film of the new trilogy – well, husband was just beside himself and not in a good way. J.J. “Lens Flare” Abrams? Now in his (J.J, not the husband’s) defense, the reboot of Star Trek was pretty darn good. Maybe J.J. would pay homage to the original trilogy with his film? One dares to hope, right?
I haven’t been following the news of Episode 7 as closely as husband so I wasn’t aware that the teaser trailer was being released. When I got home from work yesterday afternoon, husband and son were screening the trailer for the … wait for it … 5th time!! Was it that good? Husband wouldn’t say until I watched it.
And watch it I did. And I loved it! I actually got a few goosebumps. The images reminded me a lot of Episode 4 and that has me encouraged that J.J Abrams is respecting the original trilogy and what it meant to the fans. Watching the kids react to the trailer was so amazing. Daughter will be 7 and son will be 4.5 when it is released in theaters next December. What a perfect age to bear witness to a brand Star Wars Trilogy.
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?
I found this drawing the other night while the kids were going to bed. Daughter made it. She said she and her friends play a spy game at recess and she drew the map. She sounded out all the words herself. Both husband and I were giddy with excitement when we looked at it and told daughter that we wanted to keep it and frame it. Daughter would have none of that, “But I need it for recess!!!” She promised us she’d take care of it and when she was done with it we would get to frame it. I really really hope she takes care of it. Of all her drawings to date, this one is so much a keeper that I will be forever sad if it gets destroyed.
Daughter’s Map of Evil. Graveyard, Evil Castle, Evil Gate, Ghost Town, Sauron, Zombie. “X” marks the treasure.
My professional trust has been shaken. There was an incident at my office last week. A patient was given a test result over the phone by one of our front desk staff without consulting with the physician (wasn’t me) first. This patient was told his results were all normal but in fact one critical result was not yet reported and he wasn’t told that. So he was under the assumption that all if his tests were back and reported as normal. You can imagine his surprise when he was called back a few days later and told that the one test he wanted a result on was in fact was never done by the lab and he needed to repeat it.
The physician, my colleague, was quite upset by the encounter and rightly so. This physician confronted out staff and explained in no uncertain terms that any test result given to a patient must first be authorized by the attending physician. Obviously the assumption is that our staff are not trained in interpreting results nor would they know if all tests that were done were in fact reported back.
Yet on that same day, this colleague was covering lab results for another colleague (not me) and instead of reviewing the labs as requested, the physician delegated the task to the front desk staff. “Please look at Dr.X’s labs and tell me if there’s anything abnormal I need to look at.”
On the one hand, the front staff is not competent to give test results to patients without express consent from the attending physician while on the other, the same staff member is competent enough to review test results for the physician?
I have reviewed this physician’s labs on countless occasions when they’ve been away on vacation. I have stayed late doing so as I have an equally busy practice. I am flabbergasted that this physician would actually delegate this task to our staff when they told our colleague they would review the labs. I don’t even know how to address this with the physician, I am so disappointed and upset.
A person’s memory is everything, really. Memory is identity. It’s you.
-STEPHEN KING, Duma Key
Another doctor’s appointment with my dad. I got up at the crack of dawn just as the baby was waking up for his bottle. My dad’s appointment was at a downtown hospital early this morning so I had to hustle to get there on time. They had already started with the nurse when I arrived. She was just starting to get his history as I sat down on the exam room table. Looking around it was your typical hospital office/exam room. I noted the clock on the wall and stared at it for a second, realizing it wasn’t working; I checked my phone to confirm the time. Dad was busy talking away with the nurse. My eyes kept returning to the clock; probably five minutes elapsed before I realized why I was drawn to the clock.
By this point the nurse was starting the memory testing with my dad so while I was trying to pay close attention to how he was doing and mentally trying to remember how to score the test as he did it, several minutes elapsed and I noticed something else about this clock.
It was very surreal. I wish I could describe the thought processes my brain went through when it was trying to reconcile what I was seeing with what I know about how a clock should look and act. When it all came together I almost laughed out loud but I restrained myself as at this point in the interview, my dad was asked to draw a face of a clock and put the hands of the clock on to show a specific time – 10 minutes after 11.
The clock drawing test is a brief but highly informative tool that physicians and psychologists use to test an individual’s executive functioning. It is a very easy test to administer and is part of the screening tests used to diagnose, or exclude, a diagnosis of dementia. My heart skipped a beat when I watched my father do it. He drew the circle, placed the numbers and the hands of the clock correctly, without missing a beat. I’m pretty sure I breathed a sigh of relief when he was done. In fact, most of his cognitive testing was normal, particularly in executive functioning, language and calculation skills. Where he failed was in memory and recall – pretty much exactly what we’ve noticed over the past year or so.
We were reassured in one respect that his issues right now are mild and that 90% of individuals with amnestic mild cognitive impairment remain stable over time. Yet now as I am reading up on mild cognitive impairment, it is widely considered to be a precursor to Alzheimer’s dementia. I think it might be time to stop reading. He’s going to be seen again next summer and I suppose we will just have to take the “wait and see” approach. Right now there’s nothing we can do and for a doctor who is also a daughter, that’s probably the hardest thing in the world to be told.
The image on the left is the acute fracture through the distal radius. Image on the right, healing callous formation is visible as the fracture line starts to shrink.
Daughter’s cast came off yesterday. I couldn’t make it to the fracture clinic appointment because of work (cue the mommy guilt) but husband took a lot of pictures. Her bone is healing, there’s good callous formation, so off came the cast and no more follow-up is needed. Her little forearm has atrophied as she hasn’t used those muscles in a month and she has some bruising on the underside of the forearm where the fracture was. She insisted the discoloration was from her putting a chopstick in there to scratch an itch but really, it’s from the fracture.
I reminded her a lot today before school that she has to be careful with her arm especially in gym class. She seems to get it but the mommy in me still worries. Shouldn’t they have casted her again? Isn’t it too early for an almost-6 year old with a freshly healing bone to be running around with no cast?
I woke up today to cold feet. They were mine and they were cold. Our furnace is ancient and doesn’t warm the top floor of our house very well. It really should be replaced but until it actually stops working, I’m not getting a new one. So yeah it was cold this morning. Like, -17°C cold.
Everyone on my FB feed had something to say about the cold and none of it very good.
Come on, people! Are we gonna start the bitching and complaining already? Three months ago, people were bitching about the heat wave. We live in Canada. We have seasons. The temperature changes. Deal with it.
I want to turn off my FB feed completely. I am just so done with the constant complaining. And the irony is not lost on me that I’m doing the same thing here. Complaining about the complainers.
So it’s cold. Suck it up, buttercup. It’s November. In Canada. It’s cold.