So, here's the link to a story about the octuplets born recently.
There are lots of things I'm finding about this story sad/angry. The worst I think is the last paragraph:
Dr. James Grifo, professor of obstetrics and gynecology at the NYU School of Medicine, added: "I don't think it's our job to tell them how many babies they're allowed to have. I am not a policeman for reproduction in the United States. My role is to educate patients."
WTF? What ever happened to first no harm? There is a lot of harm in having a litter for mom and the babies (and please don't tell me 8 babies aren't a litter). I don't care how large of a family they want, but I think 1-2 at a time, please! That's not policing family size, that's being sensible.
I highly doubt that 8 babies happen naturally. I also think that we, as doctors, should absolutely avoid super-multiples...by monitoring our Clomid patients. By not implanting large numbers of embryos.
Oh, and can you imagine the shitting of the pants of the various neonatologists when they realized they needed one more set-up?
Friday, January 30, 2009
Sunday, January 25, 2009
The Bacteria are Smarter than Us
A young model is dead from a common ailment.
Pseudomonas is a bitch to care for...I remember one case, as a resident, who got a pseudomonas soft tissue infection. Debride until they bleed...we did a lot of derbridement. She got multiple trips to the OR. Note to self : never, never get a vulvar abscess. We ended up chopping off most of her vulva. And the smell!
We are not always miracle workers. Mother Nature is a bitch, and she's smart and wily. We just try to keep up with her. But we're failing. MRSA. VRE. MDRTB.
My hospital now screens every single admission for MRSA. Why? Because if we can show that you had it on admission, it's not a hospital caused event. And we can therefore get PAID for treating it. And there's the public relations factor too...wouldn't look good to get MRSA from the hospital, but if you had it from the community, at least it's not our fault.
Please minimize your use of antibiotics. Support the use of antibiotic free meat/milk. Don't use antibacterial soaps, just scrub your hands the old-fashioned way.
Cuz we're losing the battle.
Pseudomonas is a bitch to care for...I remember one case, as a resident, who got a pseudomonas soft tissue infection. Debride until they bleed...we did a lot of derbridement. She got multiple trips to the OR. Note to self : never, never get a vulvar abscess. We ended up chopping off most of her vulva. And the smell!
We are not always miracle workers. Mother Nature is a bitch, and she's smart and wily. We just try to keep up with her. But we're failing. MRSA. VRE. MDRTB.
My hospital now screens every single admission for MRSA. Why? Because if we can show that you had it on admission, it's not a hospital caused event. And we can therefore get PAID for treating it. And there's the public relations factor too...wouldn't look good to get MRSA from the hospital, but if you had it from the community, at least it's not our fault.
Please minimize your use of antibiotics. Support the use of antibiotic free meat/milk. Don't use antibacterial soaps, just scrub your hands the old-fashioned way.
Cuz we're losing the battle.
Friday, January 23, 2009
2 more weeks
I can make it until then...I hope. My new partner's coming then.
Until then, I've been drowning in work - 8 surgeries, 7 vaginal deliveries and a full office last week. This week will be similar. My numbers for the month are going to be insane!
Yesterday, one of my patients who was scheduled late in the day was complaining about me running 90 minutes late. Yes, it sucks. But do you think I like it any more than you? That's 90 minutes that I'm not home with my kids. 90 more minutes standing with my knee that is screaming despite me taking more motrin than is good for me. 90 minutes of overtime for the nurse who is running me.
And then, of course, she was a "by the way..." as I was walking out the door. And stupid me, I took care of it anyway. Why? Because I looked at my schedule and saw that openings are few and far between.
AURGH!
Until then, I've been drowning in work - 8 surgeries, 7 vaginal deliveries and a full office last week. This week will be similar. My numbers for the month are going to be insane!
Yesterday, one of my patients who was scheduled late in the day was complaining about me running 90 minutes late. Yes, it sucks. But do you think I like it any more than you? That's 90 minutes that I'm not home with my kids. 90 more minutes standing with my knee that is screaming despite me taking more motrin than is good for me. 90 minutes of overtime for the nurse who is running me.
And then, of course, she was a "by the way..." as I was walking out the door. And stupid me, I took care of it anyway. Why? Because I looked at my schedule and saw that openings are few and far between.
AURGH!
Wednesday, January 21, 2009
More music stuff
"You're a gay man in a woman's body"....one of the surgical assists after hearing my iPod's playlist.
Lessee....
Bad 80s pop.
Broadway - both classic and newer.
Simon and Garfunkel.
Weird Al Yankovic.
Some 90s alt rock.
Meatloaf.
And they got to suffer through 3+ hours of it today! I love the shuffle feature! I can hear something from Fiddler on the Roof and then BAM! Green Day next! Followed by mellow Simon and Garfunkel.
I may be late to the mp3 player revolution, but I am loving it now. I have a large portion of my cds now downloaded onto my iPod. I'm trying to figure out how to get my tapes (yes, I still have tapes!) downloaded. There's a lot of bad 80s pop still to be had! Plus some of my Broadway shows are on tape and I don't own the CD, just the tape.
Plus, now that I have that iPod, I have no excuse not to get on the bike and exercise. Ugh, I hate doing that. At least the music makes the time go faster.
Lessee....
Bad 80s pop.
Broadway - both classic and newer.
Simon and Garfunkel.
Weird Al Yankovic.
Some 90s alt rock.
Meatloaf.
And they got to suffer through 3+ hours of it today! I love the shuffle feature! I can hear something from Fiddler on the Roof and then BAM! Green Day next! Followed by mellow Simon and Garfunkel.
I may be late to the mp3 player revolution, but I am loving it now. I have a large portion of my cds now downloaded onto my iPod. I'm trying to figure out how to get my tapes (yes, I still have tapes!) downloaded. There's a lot of bad 80s pop still to be had! Plus some of my Broadway shows are on tape and I don't own the CD, just the tape.
Plus, now that I have that iPod, I have no excuse not to get on the bike and exercise. Ugh, I hate doing that. At least the music makes the time go faster.
Monday, January 12, 2009
Hey, Anesthesia!
I promise that if I'm doing a D&C for an incomplete miscarriage, we do NOT need to get a pregnancy test before we can wheel her back to the OR. Girl Scout's honor, I know she's pregnant with a nonviable embryo.
Really. I can guarantee it will be positive. If you let me scan her in the OR, I can prove it!
So please don't order it. There's a reason I crossed it off my standard pre-op order sheet this time.
Really. I can guarantee it will be positive. If you let me scan her in the OR, I can prove it!
So please don't order it. There's a reason I crossed it off my standard pre-op order sheet this time.
Friday, January 9, 2009
Happy Birthday, Little Man!
Five years ago, I received the wonderful gift of a son. I love you, Mr. Farty Pants.But please, stop growing so fast...
Thursday, January 8, 2009
Follow-up to last post
And days as a doc can run the gamut. Take a day I had recently - awesome OR day! I ended running an hour ahead of schedule by the end of the morning, everything went so smoothly and perfectly.
Then I went to my office - I had patients scheduled from 1-5. My first patient lost her pregnancy. Again. So we cried. We discovered undiagnosed twins on a late care patient - mono-mono (a type of twin that has a high rate of in-utero loss). I'm falling further and further behind schedule because explanations take time!
Then the ultrasonographer came out of her room in tears to show me the films from the next patient - a type of anomaly that will cause the infant to expire shortly after delivery. My heart sank. We go into my office to look at our texts to verify our diagnosis and to get some info so that I can appropriately counsel the patient. Some things are so rare, that I can say "Yeah I've heard of them...but let me look it up to be certain." This was one of them. I then accompany her into the ultrasound room to view live pictures...and my heart is sinking as I see the very rare malformation. Shit. She's not on my schedule but she needs answers, so we talk.
The high risk docs loved the referrals from that day (as a rule, if we find anything funky, we consult MFM for verification). The shit magnet strikes again!
My entire staff left the office that night in tears.
Then I went to my office - I had patients scheduled from 1-5. My first patient lost her pregnancy. Again. So we cried. We discovered undiagnosed twins on a late care patient - mono-mono (a type of twin that has a high rate of in-utero loss). I'm falling further and further behind schedule because explanations take time!
Then the ultrasonographer came out of her room in tears to show me the films from the next patient - a type of anomaly that will cause the infant to expire shortly after delivery. My heart sank. We go into my office to look at our texts to verify our diagnosis and to get some info so that I can appropriately counsel the patient. Some things are so rare, that I can say "Yeah I've heard of them...but let me look it up to be certain." This was one of them. I then accompany her into the ultrasound room to view live pictures...and my heart is sinking as I see the very rare malformation. Shit. She's not on my schedule but she needs answers, so we talk.
The high risk docs loved the referrals from that day (as a rule, if we find anything funky, we consult MFM for verification). The shit magnet strikes again!
My entire staff left the office that night in tears.
Sunday, January 4, 2009
Fun stuff
Like you, there are parts of the job that I hate. There are parts which have a "take it or leave it" feel. There are parts that I love.
The OR is the same way. There are some surgeries that I LOVE to do - myomectomies, laparoscopic hysterectomies - and some that I hate (vaginal hysterectomies, post-partum tubal ligations - both usually involve much swearing out of my mouth).
I still haven't figured out what exactly makes a surgery fun versus routine versus "I hate doing these!". But like porn, I know it when I see it.
The OR is the same way. There are some surgeries that I LOVE to do - myomectomies, laparoscopic hysterectomies - and some that I hate (vaginal hysterectomies, post-partum tubal ligations - both usually involve much swearing out of my mouth).
I still haven't figured out what exactly makes a surgery fun versus routine versus "I hate doing these!". But like porn, I know it when I see it.
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