Wednesday, December 19, 2007

TV I Love

I don't watch a lot of TV. No time. But I love (in no particular order):

1. Mythbusters. Dude, they blow STUFF UP. How cool is that?

2. Project Runway. I don't care about fashion. I can't sew fabric (but my skin incisions look beautiful - shoulda done plastics!). But I find the process of creativity interesting. Plus, nutty artists = angsty entertainment! And I don't care if Tim Gunn is gay, he's too cool. Carry on!

3. Scrubs. Where else on TV can you find a show that is hysterically funny one moment and the next moment seriously depict religion within America? Few other shows will even say the word abortion, yet the main character and his pregnant girlfriend seriously debated about one. And well, all of us docs have a Dr. Perry Cox in our past. I just started watching the reruns on Comedy Central.

4. I'm almost ashamed to admit it, but I love to watch The People's Court and other shows of that ilk. But the only time I do is during my vacations, since they are on during the daytime. WHEN NORMAL PEOPLE WORK! I can feel my IQ falling when I watch them, almost enough for me to call ITT Technical Institute. ;)

5. Ice Road Truckers. It blows my mind that there are people insane enough to drive a bigrig on a frozen lake! Enjoy your bling and think of these men.
ER's Mom
Runway has a new episode on tonight...

Monday, December 17, 2007

Thinking outside of the, um, box

When I was a senior resident, we had several memorable bad interns. One, in particular, stands out. She was foreign and although she spoke wonderful "Queen's English", she was hopeless at interpreting the slang of the clinic population.

So she goes into a room to take care of a patient. "What is the matter?"

"My box hurts."

"Please explain." (no, I am NOT making up this conversation!)

"My box hurts."

"What is this box that you are speaking of?"

I'm doubled over and crying by now because this is too damn funny. I can't look at the nurse in the room with us (I was in the room to supervise the intern because the attending was tied up and the nurse was in there to help us get stuff out/labeled/etc).

She washed out of the program...communication is important, even if only about boxes. ;)

Sunday, December 16, 2007

Tired

Too many babies, too many catastrophes, too much call. I'm in a 3 person practice - we want about 35 deliveries/month total. So far for December : 20 deliveries for me alone. And the month is only half done.

And I still have to see patients during the day and operate.

My next vacation can't come soon enough. It's hard to be nice when you're tired. Right now, I'm faking being interested in my patients, because I'm too tired to BE interested. I fall asleep eating supper with the family...if I'm there.

So women, take pity on your OB-Gyns...it's a tough life.
ER's Mom

Tuesday, December 4, 2007

Another birth, another death...

My DD loves the Lion King's soundtrack. Listens to it almost daily. What chokes me up is the opening song, Circle of Life (as sung in the movie not Elton John's version).

Every new infant who falls into my hands will eventually die. It is a fact of life. Some are dead when I first touch them, their grieving parents never to hear them cry, but instead are crying themselves. My most recent stillbirth, the mother brought in the child's baby book for me to look through during her postpartum visit. The only people smiling in the pictures are the nurses and me.

Some never even make it to that stage, instead the mother passes what we call POC's, never even acknowledging the fact that this is someone's baby. These parents grieve deeply as well.

There isn't anything taught on handling these situations in med school or residency. So we flop through, trying to say the right things. I cry with them, hug them, pass the Kleenex. They seem to appreciate it, but I'm still not sure it helps.

Then I go home and kiss E&R.
ER's Mom

Saturday, November 10, 2007

Yeah, well, it figures

cash advance

Get a Cash Advance




I guess this means I don't talk down to you. :)

Wednesday, November 7, 2007

I can't make this up...

To set the scene: Young pregnant teen, in room with her mom, me, and my nurse. I want to run a test called FFN, which requires nothing to have been in her vagina for a day.

Me: Have you had intercourse recently?

YPT: What's that?

Mom: What got you here in the first place!

Nurse is cackling away.

YPT: Huh?

Me: Have you had sex lately?

YPT: Oh! No. You used big words!


*sigh*

Sunday, October 21, 2007

OB-Gyn numbers

"Oh, I would never want to do OB." I hear this frequently from my doctor colleagues. Funny, because I can't see myself doing anything else.

But there's trouble in River City. We are being hit left and right...malpractice insurance, hours, inability to recruit young blood to the profession, a noble calling and a genuinely joyful one. OB-Gyn is among the oldest of the medicinal specialties - you can read about early Egyptian ways of birth control!

But we're dying. When I joined this town, just a few years ago, I was the 7th one in town. We're now down to 5 - with the addition of the new doctor last month. The smaller, outlying towns are losing OBs at a rapid rate - the town 30 minutes north of us, lost 1 out of 2. The two towns 20 minutes to the east have lost 2 out of 4. The town 30 minutes south has lost 1 out of 4. The town 40 minutes northwest, 1 out of 2. All of these within the last 3-6 months! And many were for health reasons - the docs were getting old and having some serious issues.

That is the face of rural healthcare. I'm in the largest town...but we still have only about 35K. Most of the other towns are around 15K. Recruiting takes time...very few people want to come to a rural area (I'm an anomaly). I live an hour from the nearest Target/Sam's Club via the interstate. It's almost 2 hours to a decent mall.

I don't have a solution. But we need to acknowledge this.

Friday, October 12, 2007

Random Thoughts

1. Go read Scalpel's analysis of the healthcare crisis. As someone who is living the reality of it, it is a good read. I'm not sure if I agree with his conclusions, but it is a good, thoughtful read.

2. Is it really a vacation if you operate on 2 days and go to a mandatory class on the third?

3. What is a fiscally conservative, social liberal to do in the election? AHHHHHHHHHH!!!!!!!!!!!

4. The bathroom is completely done and it rocks. Purple, green, and gold - Mardi Gras colors (unintentional)

Monday, October 8, 2007

Purple

I am on vacation now. My bathroom is finally painted purple. :) DH said nothing about the color change. It looks good.

What a good guy. :)

I had forgotten how much I hated taping and cutting in. This is why it takes me about 8-9 months between room redecorations...amnesia needs to set in again. I need to forget the pain of taping and the physical soreness of the contortions needed to reach places. Thank god for the massage scheduled tomorrow.

Sunday, October 7, 2007

Frustrations

Docs are full of them. Hell, so are parents. ;) And teachers.

I would be a rich woman if I had a penny for every patient who did the opposite of what was recommended. And you know who are the worst class of patients in this? THOSE IN THE MEDICAL PROFESSION!!!!! Nurses and fellow doctors are the worst!

Diabetics who don't care for themselves. Smokers. People who have TOP (tired of pregnancy) and do literally anything to be unpregnant. Crack inductions of labor (works pretty damn well, as long as you like a lot of blood everywhere), outright lies to try to get the doctor to induce (my personal favorite is "I've been passing out for 10 minutes EVERY DAY!", said in a melodramatic fashion). Drug seekers.

I do not pretend to understand the mindset. I simply can't wrap my mind around it. And the only thing to do is to do what is the best and have them pissed off at you.

Such is life.

Saturday, September 22, 2007

Psych!

I'm in OB-Gyn. I'm here on purpose, seeing as how it was the specialty that I loved in medical school. And ideally, I would be doing only OB-Gyn. Not primary care. Not psych. I'm not trained in it and more importantly, I can't keep up in them...it's hard enough to keep up with the stuff in my OWN specialty.

But anyway, I have figured out that I see about 15% OB, 15% Gyn, 30% primary care stuff, and 40% psych. Because I know this, I went the other night to listen to a talk on depression. It's bad when I know the ICD-9 code (a billing code for insurance companies) for that, but yet not for fibroids (311 BTW is depression).

I had a day a few months ago out of my 4 new paps, 1 was binge drinking, 1 had thought about suicide last year but had never told anyone, 1 is likely anorexic. I'm glad that they felt comfortable enough to talk to me, but I will admit, I am not the best person for this.

And THAT is why women need a family doctor.

Friday, September 14, 2007

Understanding Tests

Docs do a lot of testing. Sometimes, we have a diagnosis in mind and are confirming it. Sometimes, we're just screening.

As an OB, I do a boatload of screening tests. Quad screens, pap tests, mamms, FOBTs, 1 hour GTTs. I also do a fair number of diagnostic labs: CBCs, GC/Chlamydias, biopsies.

I have found that people get confused as to what exactly screening means. Screening tests do NOT give you a diagnosis! Instead, they say, "Hey! You might want to investigate a little further." A positive pap test leads to a colposcopy, possibly with biopsy. A positive FOBT leads to a referral to GI for w/u. Many positive screens turn out to be a big fat nothing.

Diagnostic tests, OTOH, lead me to a diagnosis (duh) and treatment. A positive chlamydia test buys you a dose of zithromax and a repeat test in 2 months (as well as offering further STD testing and reminding you that your SO needs treatment too). I positive endometrial biopsy invokes the cancer talk and treatment.

I could now talk about pre- and post-test probabilities, but most people's eyes would glaze over.

Monday, September 10, 2007

First day of school

There is NO possible way I'm old enough to have a second grader. There's NO way that my little girl is that old.

She was wearing jeans yesterday, and I swear, her legs appeared to go on forever. I'm not ready!!! :)

Thursday, September 6, 2007

Craptastic

The call gods have not been kind to me lately. Between the incredibly stupid other doctors that I have had the displeasure of dealing with (their lack of responsibility and PATIENT CARE!!!!), the stupidity of patients (if you are 29 weeks pregnant and think you have been contracting for 36 hours, why the FUCK DO YOU HAVE TO GO TO LABOR AND DELIVERY AT 4 AM?!?!?!?!?!?), and the just plain bad luck (spontaneous pneumothorax in the middle of my tubal ligation), I have about had it. For the last one, I had one of my General Surgeons buddies come in to place the chest tube; he was laughing at me as I was muttering "And this is going to go in my case file for boards." I was not amused.

I knew that I was leaving a mess for my relief (but at least they were all delivered). I offered to pray to the call gods for my partner when she relieved me. Her reply: "Please don't. You have obviously pissed them off."

My nickname in residency was "Shit Magnet." I wish that I could lose it, since now the nurses on L&D have taken to referring to me by it. Sadly, it seems to be accurate.

I can't even say "At least no one's died" since I had a term still-birth recently.

ER's Mom

Monday, September 3, 2007

OMFG

Appalachian State 34, U-Fucking-M 32.


The Devil is having a snowball fight. Here in Big-10 (the conference that can't count and, apparently, can't play football, since another U-M lost to BGSU), shockwaves are falling.

My FIL is in shock. DH, an OSU fan, is in shock.

wow.

Thursday, August 30, 2007

Vacation

Going on a weekend getaway with DH. Kids are going to the grandparents. Life is grand! :) See you next week!

Sunday, August 26, 2007

Joke

"Knock-knock"

"Who's there?"

"Hippa"

"Hippa who?"

"I can't tell you!!!"
:)

Saturday, August 25, 2007

Rules to live by

1. If you have been given information from your doctor, please oh PLEASE READ IT!!! I'm not killing trees for nothing here.

2. Do NOT have me paged at 3 am for information that is in the papers we give you. See rule number one.

3. Do not have me paged at 3 am for information that we have given you on the DAY YOU HAVE AN 8:00 APPOINTMENT WITH ME!!!!!!!!!!!!!!!!! See rules number one and two.

4. Since we live in a small town with no 24 hour pharmacy, I really don't need to be paged at 4 am about your bladder infection. Really. You won't be able to pick anything up before 9 am, so you might as well let me sleep until a reasonable hour.

5. If you call often enough that I know your home number, you might want to think about calling less often. It's bad when I ask the answering service "Is she at ABC-DEFG?" and the answer is "Yes."

6. Do not page me at midnight to let me know that your period has started. I don't care.

7. If you go to an urgent-care clinic, and the next week when I ask you why, please know the reason.

8. My fingers are likely smaller than a baby. Quit whining about checks.

9. No, pregnancy is NOT a reason to be off-work. I was pregnant when I was a resident, so quite frankly, I'm less than sympathetic.

10. Just because you're tired of being pregnant doesn't mean that I'll induce you when you show up at L&D for the 4th time this week. And why, oh why do you insist on showing up at 1 am?

Sad thing is, there are reasons why these rules exist. :) Heck, number 6 has even happened twice to me. :( Number ten, more times than I can count.

Wednesday, August 22, 2007

Rain, rain

We've gotten a foot of rain in the last couple of days. The entire downtown area is flooded. So far, our sump-pump has held (whew!). The creek near our house has overflowed its banks and the street is blocked off. I took the kids to go and look at it...this creek is normally all of a few inches deep. It's now around 6-7 FEET deep.

I tried to get to the hospital for an elective c-section this morning. Couldn't. Every way that I know was barricaded or otherwise blocked. Normally it takes me 7 minutes to drive the 3 miles. I spent an hour trying every route. I initially tried a route that one of the nurses who lives in my subdivision had said was open when she got on shift at 5 am. By 8 am, it was flooded out and barricaded.

Nursing homes were evacuated - the residents are now in the local hospital. The hospital is under a disaster plan. Staff there is staying (since most can't get home anyway).

I'm thinking flood insurance would be a damn fine idea...

Monday, August 20, 2007

Kids

They're awesome. Forget Folger's, the best way to wake up is to have a 3 year little guy snuggled up against you. My son wakes me up every morning by climbing into bed with me. Not DH, he wants Mom. DD, OTOH, plunks herself between DH and me.

But they grow. And oh, so quickly. I'm looking at a picture on our wall...I'm holding DD who is about 2 months old. And now, she is lean and tall and entering second grade shortly. She has grown another inch...49 inches and 49 pounds at the peds office last week.

And DS is now in pre-school. I can't believe it. Babyhood is in the rear view mirror, never to return.

Egads, I'm getting old. :)
ER's Mom

Friday, August 17, 2007

Getting Started

So, I'm doing this for the first time. I've got a lot percolating through this little head of mine, not the least of which is the glass of wine I'm drinking.

I'm a mom of two, OB-Gyn, and wife; not necessarily in that order. I love Harry Potter, reading, playing my piano, cooking, and causing trouble. I am a liberal lost in middle America, where people still worship GWB. My liberalism, however, smacks up against the realization that many people are happy to take advantage of it. I hope that people reading this will see something of use in my musings. They may even see docs as humans (gasp).

This blog will touch a little upon parenting, upon cool stuff I've seen in my career (all HIPAA ok), upon weird thoughts wandering through my head.
TTFN
Tonks