Monday, August 31, 2009

Pharm rep today

So I tend not to like drug reps. Avoid them like the plague.

Get called back to the drug room today (need to witness you signature -- BULLSHIT!). Some rep I don't know is rattling about the newest variation on birth control pills. I don't give a shit. 90% of what I prescribe is Sprintec cuz that's the cheapo pill on Evil Empire's $10/month list. I'm not even sure what Sprintec is generic for... Off topic, another 5% is Apri (generic for Desogen) and the rest is Micronor or Alesse.

So anyways, she prattles on about some note she left on my desk last week. What note...playing dumb will get me far here. So she asks about setting up a dinner meeting with me to discuss Paragard IUDs...I shut that down quickly by saying that I don't take away free time from my family for anything like that.

And yes, that note had been seen last week. And appropriately filed...in the trash can.

Sunday, August 30, 2009

"That must be a great place to work!"

When I tell people what I do for a living, that's what they say.

"It must be such a happy place!"
"You are so lucky!"

The nurses and I were talking about this yesterday. L&D is the happiest place in the hospital...until it's not.

Do we talk about the term stillbirths? Or the nightmarish scenarios of losing a mom? Tell them about coding a newborn? I used to have nightmares about some of the deformities I had seen...I don't anymore. Delivered one recently that had multiple anomalies...my resident had to leave the room, it upset her so much. My practice has lost 6 babies so far this year, either as stillbirths or shortly after delivery. Do we talk about the crackheads on their umpteenth baby who refuse to get sterilized?

We don't. We just nod and say "Yes, it's great."

Until it's not.

Saturday, August 29, 2009

Smile!

My new range has been delivered and installed.

5 burners, baby!

The blueberry pie that caused the previous oven's downfall has been baked and is cooling as I type.

Whipping cream is in the fridge, ready to be whipped.

All is right with my kitchen...

Chocolate chip cookies are on the agenda for tomorrow.

Friday, August 28, 2009

Always be prepared

Operating is easy...if you are well prepared in advance. The MOST important part of the surgery involves not the OR but the stuff that happens in my office.

The history taking. Physical exam. Labs and imaging. Discussing options including nonsurgical management. Surgery is more than "Me operate and fix problem." Despite what the internists think, we do sometimes need to use our brain. Sometimes I have to talk someone OUT of having surgery if I think I can't help.

Take today - I knew that it would be a difficult case and booked the OR accordingly. Asked for the most experienced assist. Contemplated where to enter the abdomen. Put my bovie far away from my hands. Had in the room (but unopened) possible needed instruments and other things. One of the general surgeons was laughing at me - he knew of the patient and thought I was a might touched to consider operating on her.

Good prep work creates good luck, and the case went smoothly. Hopefully, she'll feel better.

Friday, August 21, 2009

Girlfriends

Are a beautiful necessity of life. I'm lucky to have collected quite a few. But up until the last few months, they have not lived here...I have friends from college, med school, working all around the country. But I've been too busy to find someone local. I know that my friends are willing to stop on a dime to help me. But they were all several hundreds of miles away.

Until my buddy/coworker/patient stepped in and made me her project. I think she was afraid I'd skip town due to lack of roots. But I'm now in a community of women who are an amazing bunch. We're all in different stages of life, but somehow we click. And I needed that.

Knitting the strands of life ever closer...

Yet another PSA

This one is on tampon use.

Remove the old one before inserting the new one.

And please remove the last one when your cycle ends.

Thank-you.

Thursday, August 20, 2009

End of an era

So R went to his first day of school yesterday. I'm officially out of the baby/toddler stage. Even pre-school is a memory.

The problem with being an OB is we get to see all of these darling little babies at appointments. My husband hates it, because I'll get whiny when I see all of these cuties flirting with me.

But I'm in my late 30s...time to kill those thoughts.

Wednesday, August 19, 2009

Good for a laugh

So in one of my deliveries from last night, the patient was a little (OK, a lot) out of control. A screamer with a potty mouth and pleasant personality to boot.

So she's pushing...and screaming...and screaming...and screaming.

Last night was the tour for the expectant mothers. They walked through during all of this. Evidently all of their eyes bulged out in fear.

The unit clerk told them : Don't worry. It's usually not like this.

I doubled over laughing when I heard that.

WOOT!

All delivered. All vaginal.

Crap, only a couple of hours before my OR starts.

Thank goodness I got about a 2 hour nap between the last 2.

Tuesday, August 18, 2009

It will be a crappy night

Got several laboring, all with either protracted or arrested dilation. Pit has been liberally ordered.

Knife is going to be sharpened...

Monday, August 17, 2009

For Dr. Grumpy

IF (and that's a big IF) you go school shopping, go at 9 am on Saturday to your favorite store.

Crazy people are still in bed then. Your cart is safe.

Cashiers are perfectly happy to accept Visa to pay for hundreds of dollars worth of crayons and glue.

FYI, 5 year old DS came downstairs this morning, wearing his brand-new Bakugan backpack...excited for school. Except it doesn't start until Wednesday. He was bummed when I told him that.

Sunday, August 16, 2009

My appliances hate me

In the last year, I have had to repair/replace the: washer/dryer, water heater, furnace, dishwasher, and sump pump.

Now add oven.

AURGH!

I'm hoping I can freeze this uncooked blueberry pie I fixed today.

More on small town living

So the big county fair is this weekend. We went last night for the big fireworks display. Ran into one of my dearest friends while wandering the concourse. She had already staked out an awesome spot and invited my gang to sit with her and her extended family. We accepted.

Ate good bad food - DD and I had ribs from someone who had a ton of trophies from various competitions. They were good. Kids (mine and hers) rode the rides on the midway. Why does lemonade from a carnival taste better than what I make?

My friend and I wandered away from the group after we had settled back to our seats - a terrible mothering tragedy, the balloons sailed away after multiple kids let go. So we were on a mission to get more balloons. Every minute, I ran into someone I knew - patients, my hairdresser, nurses, office folks at the clinic. I'm admiring babies ad nauseum. And that's just how a small town is. You are never alone.

Oh, and I never saw the fireworks. I got called to L&D 5 minutes before they started. :( Someone arrived complete and ready to push. Second year in a row that has happened to me!

Saturday, August 15, 2009

The joys of small-town living

Our "newspaper" has a great daily column of all of the police-calls/fire-calls/divorces/marriage licenses/court sentencing. I read it daily for the entertainment value - whoever writes it deserves to be making millions. The turn of phrase he employs is hysterical. I also check to see how many people I know. The most ever in a day was 4 people - one in the marriage license section and the rest were in the court sentencing section.

Today's lead-off bit : Police assisting in corralling donkeys along a nearby rural road.

Take that New York Times!

Finally agreed

To get the stupid knee surgery. I don't want to have it done. Truth is, I'm chicken. Yes, I am aware of the irony. I don't like the idea of the loss of control. Docs are control-freaks.

But the steroid shot worked for all of a week before I started hobbling again. I'm at the point where I can barely stand for anything. If I limp, my knee feels better but my hip starts hurting. If I walk without a limp, the pain is so intense I'd volunteer for an AKA. Laparoscopies are killing me with all of the foot controls for the instruments.

Ortho was just laughing at me. In the "I TOLD you this is where you would end up" sort of way. It's not easy, trying to schedule stuff when you are a doctor. I had looked at my OR schedule a few days ago and knew that I had surgeries booked out until October...so I scheduled for late October. Now the secretaries have the fun task of rescheduling that week of office. I hate doing that to them. I'm only taking a week...ortho thinks I'm insane. But coverage is an issue. I hate to dump on others.

Thursday, August 13, 2009

Thoughts on being a doctor

So Duncan recently commented along the lines "But you're a doctor."

Yes. I am. And a damn good one.

But I am so many other things than just a doctor. I'm a wife, mother, daughter, sister, friend, dog-lover, pianist, cross-stitcher, trivial pursuit player, avid reader, gardener. I love to cook and make (without help) huge holiday meals for 15+ people. I am a lousy hausfrau, but hubby overlooks that.

I don't look the part of a doctor. I don't own a white coat. I drive a beat-up sedan that has seen better days. I round in jeans and t-shirts. Most of my co-workers have never seen me wear a dress. My purse cost $10 at the mall. I finally bought a new winter coat last year - after my old one bit the dust (I had that one for 18 years). I drink cheap wine and expensive beer.

I cuss like a sailor. But not in front of my kids or my mother-in-law. I give hugs after every delivery and many office visits. I ask my waitress how she's doing (since she is my patient)...and ask about her kids by name.

And I am just as much of a doctor as the stuffy old guys in a white coat.

I am secure enough now in myself to be true to my authentic self. I won't conform to what you think I should be. And I hope to pass that onto my kids.

Old dog, new tricks...

So the funeral is later today. I'm getting ready to leave to drive to it in a few minutes.

I rounded, wearing what I'm going to wear to the funeral. Navy dress, heels (ugh), full make-up, and jewelry.

L&D nurses didn't recognize me.

I think I wear scrubs too often.

Wednesday, August 12, 2009

FYI

As much as I bitch and moan about the great unwashed folks, you REALLY do NOT need to put glitter on your hooha before your annual pap smear.

It sparkled when I turned on my lamp, like a disco ball.

I drew blood from my tongue to keep from laughing. I swear, I should win an Oscar for the acting I do at work, keeping a straight face.

Monday, August 10, 2009

You gotta laugh

I've been too damn depressing that last few days. So in order to change things up, here's a new high (?low?) in patient complaints.

I work in a free clinic. We have an STD clinic twice a month, where folks can get checked out. Men and women.

Chief complaint a few weeks back:



Wait for it......



This is going to be good....



It still makes me snicker...



"There are dots on my ding-dong."

Sunday, August 9, 2009

4 years

Since my father slipped away. He lived 9 months after his diagnosis with stage 4 small cell of the lung. DONT'T SMOKE!!!!!

Egads, I'm getting morbid lately. Life is seeming to be so grossly unfair! The sad thing is, as much as work is sucking and blowing lately, it's at least a relief from the disaster known as my family.

Mom got readmitted Friday night. I had driven home to Michigan. Arrived late Friday afternoon to her house. By 10 pm, we were in the ER. She then got transferred to Mecca. I drove the 3+ hours to get there and spent the rest of my weekend there.

Emily's family lives in Meccatown, so we were together. No one was particularly happy. I imposed upon them (I'm SO SORRY!) so I could sleep last night in a bed and shower this morning. Funeral arrangements are still pending...my cousin is trying to decide between lots of options. I don't know how she does it - just the grace and composure. I would have totally have lost it by now if I was her. I need to aim to be like her. I am in awe.

Please, kiss your kids.

Friday, August 7, 2009

Sad news

We're awaiting funeral arrangements for my cousin's 14 year old daughter.

I just delivered a 14 year old a few days ago. Life seems grossly unfair right now. During the delivery, I was having thoughts of Emily and how different life is for these 2 girls the same age.

Thursday, August 6, 2009

Reproduction don't need no BRAINS!

So we got this patient who is expecting. Big surprise, I'm an OB. But she's not, shall we say, the sharpest knife in the drawer. She's playing 2-card pick-up.

She also has hygiene issues. Or did...until my NP told her that she needed to shower every day (why this needs to come out of our mouths at all is another thing) to keep the baby clean.

And by golly, she's been doing it! To keep the baby clean! Now, she's not due for a few more months, but that's one less "Shower upon admission" order I need to write.

And I sadly, write a fair number of those.

Wednesday, August 5, 2009

Blah

I'm just feeling blah. BLAH.
blah, blah, blah.

I'm sick of whiny patients. I'm sick of other docs being idiots. I'm sick of my cell phone ringing at all hours. I'm sick of limping because of my stupid knee.

Blah.

I feel like Eeyore.