Advice for newbies

Went to a conference today at my old stomping grounds. My interns are graduating!

I guess that means I'm old.

Here's some advice, hard-earned by me but free for you:

1.Be nice. This directly leads to
2. Your nurse makes or breaks you. I have been fortunate in this respect. Michelle, then Kim, then Jen have rocked.
3. The learning curve the first year of attendingship is steeper than internship.
4. Go to a coding/billing conference.
5. Don't go on a spending spree right away. I know, that first check is burning a hole in your pocket but trust me. Shovel money into savings.
6. Bring in a treat to the L&D nurses the first week you work. Remember, they have your back!
7. Get an MP3 player so YOUR music is playing in the OR. Even if everyone else hates it. ;)
8. Meet and greet the IM, FP, and peds docs.
9. Download some games onto your phone. Useful for whiling away time before a delivery.
10. Take some time off before starting.
11. Do NOT, under any circumstances, be a princess.
12. Yelling frequently means people ignore your yelling. Save it for the important stuff. I want people to KNOW when I'm pissed...and how to fix it.
13. Look at your billings monthly.
14. Be quiet the first few months as you figure out the politics of the hospital.
15. If L&D is swamped and nurses don't get lunch, spring for pizza delivery.
16. Treat your office staff humanely and they will reciprocate.
17. Learn which patients never, never get double-booked.

Did I miss any?

I was wrong

Ureteral cancer.

Now I need to go look stuff up on emedicine/up to date/nih.

OK, OK

So I'm going to ortho later this week. Only because I told my awesome nurse the story about running into him in the elevator. She then called their office and told me either I could choose the time or she would.

Harumph! Outmaneuvered! I admitted defeat and scheduled my own damn appointment, thankyouverymuch.

Not the first time she's made appointments for me...last time she was worried enough to schedule an appointment, I ended up having pneumonia. I'm just not good at figuring out when I need to get things looked at.

Still no word on Mom's biopsy. :(

Waiting

So my mom (finally) got the CT-guided biopsy yesterday of her pelvic mass. I am willing to lay odds on an adenocarcinoma originating from the colon - she had a TAH/BSO back in the early 90s. I however, have not told her that. Yanking away hope seems unnecessarily cruel. She's already gone through a lot in the last 6 weeks. She's pissed that urology isn't too keen on stenting her ureter but is keeping her perc since it's working well.

And now we wait. Because of what I do, I know that pathology usually takes 3-4 business days to process, diagnose, and transcribe. Which means that the wait will probably last until after the weekend for her.

And if I'm right, we - meaning me, my sister, and my mom - will have to figure out what to do. I live a long drive away. I can't manage this via phone. I've been pushing for her to move in (ohdeargodwhatamIthinking!) with me - we have plenty of room.

I worry about my kids - my daughter's kidnergarten year was scarred by our caring for my father in home hospice (stage 4 lung). My son is that age now. DD remembers some. The boy was only 1 at the time, so he doesn't but he certainly would recall anything from now forward. I don't worry about them seeing the completion of the circle of life, but rather the fact that caring for someone very ill involves restricting other activities and paying attention to them.

It's tough - I've read about the "sandwich" generation - caring for kids and parents. I'm in a cage - caring for kids, parent, and patients. I've been ignoring me. I ran into ortho today at the hospital and he asked about my knee. I admitted that it was bad and I need to get into see him for the next step. I'm not sure when I have the time to do that!

To the love of my life

20 years ago, you gave me your class ring.

Twenty. Years. Ago. We were young and stupid, two teenieboppers "in love". But with you, we've weathered a lot and my love has blossomed even more. I can honestly say that I love you more now than I did back then.

I love you with all of my heart. I admire what a kind and great man you are. I'm thankful our children have such a great role model for a father. I love laughing with you.

Here's to a long future together.

Love you, always and forever.

Against the odds

4th, (yes, FOURTH) set of spontaneous triplets diagnosed yesterday since I started practicing here 2 1/2 years ago.

What is in the water!?!?!?!?!?!?!?

Notes about calling your doctor

1. Menstrual cramps ARE NOT, nor ever will be, a medical emergency. Waking me up at 5:30 am (20 minutes after I went to bed from a delivery) is not appreciated in any way, shape, or form.

2. Please listen when I give instructions on what I chart as "labor precautions". Every week from 36 on, I give my little spiel on when to go to L&D. Please listen so you don't wake me up at midnight with a complaint of hourly contractions.

3. On Easter Sunday, don't be surprised when I tell you that the pharmacy is likely to be closed. I'll call in something for your UTI, but it won't help until tomorrow.

4. And don't call me after the pharmacy has already closed for the day...no matter what, it WILL wait until the morning. You're not sick enough to be admitted for the UTI/URI/1 bout of vomiting.

Hope this helps!