Borderline

An early Madonna song, a personality disorder, and the term that best describes my blood pressure and cholesterol. Borderline hypertension. Borderline hypercholesterolemia. The borderline between just being fat and being fat with long term health consequences. Physician heal thyself! I went for a routine follow up with my internal med doc early this week to discuss my allergies, which are terrible since I have moved to this new town. I wound up with a diagnosis of borderline hypertension and borderline hypercholesterolemia. Since that day I have been scared into submission. I'm eating salads (without cheese or french fries on them, thank you) for lunch. No carbs after 3 pm (high triglycerides!) No food at all after 7 pm. Exercise? 2 times this week for 30 minutes, shooting for 5. Omega-3 fatty acids. Eating veggies. Check, check and check. I'm in my early 30s! I'm far too young for high blood pressure and cholesterol. I'd like to be around to see my little one grow up. I now have more motivation than the reflection in the mirror. Unfortunately I'm holding water like a sponge thanks to my hormonal status, so the scale is not my friend this week. I know that I'm doing better, and that is enough for now.

This week has been very busy, but thankfully not terribly exciting. I (just barely) made it to the delivery of one of my patients on Sunday evening. She had been into triage earlier in the day, contracting, but only dilated to 3. She went home and came back dilated to 6 at 11 pm. The nurse called me at 11:15 pm. I got to the hospital at 11:32 pm, and the baby delivered at 11:34 pm! I'll say it again. You have got to love a spontaneous, natural labor! I also delivered 2 breech babies by C-section and a uterus by vaginal hysterectomy yesterday. My hyst patient has an allergy to the type of suture most commonly used in the procedure, Vicryl. No problem, says naive little me, we'll use Monocryl (different type but comparable suture). Unfortunately, no one clued our OR in, because they didn't have the kind of suture that I wanted on the kind of needle that I needed. A compromise was made, and though it did prolong her surgery, I got that uterus and one ovary out from below. I counted that and pulling out a 10 lb breech baby as my workout for yesterday.

I got a *stat* consult from one of the family docs on a patient whom (they were convinced) was bleeding to death. I called the nurses to gather the equipment to facilitate an exam and possible emergent surgery, I rushed through the rest of my office and sprinted to the hospital to find a very stable, not sick, perimenopausal patient. She was indeed bleeding, equivalent to a regular menstrual period. Her vitals were stable. Her blood levels? Normal. Me? Feeling foolish for getting all in an uproar over this "stat" consult. The punchline is that when I called the admitting doc (whom I like very much) and told him my impression and plan for treatment he seemed surprised (and pleased) that I would call him to tell him my thoughts. Isn't this what a *consult* is supposed to be? You ask my (expedited) opinion and I relay it to you immediately? Community medicine confuses me. Good night.