Saturday, May 12, 2007

Promises, promises

Sorry, I should know better than to make grand promises of fantabulous posts only to disappear into blog oblivion once again! Time is flying past me more and more quickly these days, and many times I am too lazy to do more than lift an arm and swat at it as it zips past. I think that I am a pretty slovenly, lazy person by nature, yet the circumstances of my life rarely allow me to indulge those ingrained tendencies. Thus, I take the opportunity to do absolutely nothing whenever I can, preventing me from being more productive in my rare "off-times."

Last week my parents were in town for CindyLou's 3rd birthday extravaganza, which was great and probably a little over the top for a 3 year old (but not to the level of ponies and bounce houses over the top). We had the party at a local "fun center" that has all kinds of indoor and outdoor games/rides/ mini-golf/arcade etc. because, let's face it, nobody's idea of a good time is cleaning and hosting a whole bunch of 3 year olds and their parents at your own house. (Ok, for some people, maybe it is, but it is certainly not *mine*!) We also discovered the greatest birthday cake idea ever, the cupcake birthday cake. Basically it is a couple dozen assorted cupcakes frosted to appear as one cake. The great part is in the serving...no cutting, equal portion sizes for all, and you can have the flavor that you prefer. I must be quite sheltered because I thought this was awesome. She had a great time, and I can't believe that our baby girl is already 3 years old. I even wrote out the thank you notes and passed them out the following Monday. Go me! Ha. Needless to say, the party and surrounding festivities were enough to put me out of commission for several days, hence, no posts and nothing else got done around here, either.

This morning was one of those rare mornings that CindyLou graciously allowed us to "sleep in" (i.e. she woke up at 8 am and settled for watching Dora the Explorer in our bedroom as we valiantly tried to sleep through Dora's shrill bossiness.) Usually CindyLou is up no later than 6:45 am, and will not settle for less than breakfast shortly thereafter, so when I say that sleeping past 8 am is a treat, I am not kidding! The final straw was a painful song that Dora shrilled through (it was really pitchy, and just ai'ight for me, dawgs) to finally roust us out of bed. Then it was off to the hospital to round for me, out to breakfast and the park on a play date with my nurse for CindyLou, and out to the backyard to assemble the playhouse from hell (CindyLou's birthday present) for Mr. Whoo. I rounded on my patients and OtherDoc's patients, did the 5 circs that he so nicely left for me to do (I hate doing circs) and I am finally back around to visiting good old blog land.

So, as for interesting cases, a few weeks ago a colleague approached me to assist with a likely ovarian cancer case. This physician is rather "old school" and is brave enough to do cancer cases on their own. I, on the other hand, will refer in a heartbeat if I think cancer is in the cards. I'm a big chicken. At any rate, the patient was a young, mid-forties woman, who hadn't been to the gyn since the birth of her last child 19-some years ago. She presented to the emergency room with right lower quadrant pain, thinking she may have appendicitis. Instead she had a firm, fixed 12 cm pelvic mass, and a CA-125 of over 2500. We took her into the operating room, fully expecting an advanced ovarian cancer. Instead we found severe endometriosis. She had a twelve centimeter chocolate cyst that had torsed, causing her acute pain. She also had endometriosis implants throughout her pelvis, bowels, and omentum. We essentially did a debulking of endometriosis along with a hysterectomy. All of the frozen and final pathology came back completely benign. Amazing. Even more amazing to me is that, for as long as it must have taken for the endometriosis to become so severe, the patient stated that she never had a problem with pelvic pain until the day she presented to the emergency room. Women can be incredibly tough. She sailed through post-operatively, and went home within 3 days. It was nice to see that sometimes things that seem to be the worst may not be as bad as they appear. Sometimes it is easy to lose sight of that.

With that thought, I'm off to supervise the great building project and to enjoy some of this spectacular spring weather. Happy weekend, all!

12 comments:

Type (little) a said...

5 circs? I assume you mean circumcisions? Or cerclages?

Anonymous said...

A long time ago, I came across your blog, but I didn't save the address. I have been reading Red Red Whine's blog for a few months now and she cracks me up. Anyhow, I was reading it today catching up on a few posts and she wrote in a recent post that you were her college roomate. Is this true? Anyhow, I just thought I'd drop a note and say, what a coincidence that I have randomly read both of your blogs and you are friends and past roomates. Nancy in Alaska.

guinness girl said...

Awww, happy birthday to CindyLou! And happy mother's day to you, my friend. xoxoxo

Anonymous said...

Ouch! Some of us love your blog but hate hearing about circs! Why do people still want that done to baby boys? How could one half of the human race be born needing surgery? Except, only in America. (outside of religion)

medstudentitis said...

Wow. Endometriosis that bad and no pelvic pain? I'm shocked.

Sounds like a fun birthday party, I too love cupcakes!

medstudentitis said...

Aaaaalso... you've been tagged for a meme! See my blog.

brandoncfi said...

Swiper no swipy

My 2.5 year old daughter loves Dora and I thank Noogin for the extra 1/2 hour of sleep I get when my daughter watches the show

Anonymous said...

My nice OB must almost cringe when I come in. I came armed with questions, and I told her (cannot believe how stupid I am) that I read a lot about trisomy 18 and even what my levels mean...implying obsession on my part. She said she understood why, but that I sounded like I was on the edge a bit ( I think she means the edge of going too far here). I do know based on reading that a trisomy 18 positive screen means a high rate of abnormal pregnancy outcomes, not just possible trisomy 18. I don't see why it's wrong for me to know that. I am not really scared anymore, I feel prepared for a birth (as best I can be) with a baby who might not be healthy, a baby that might make the nurses and my OB uncomfortable. I still know my chances are high for a healthy baby. I don't know it all (wish I could) but I know as much as I can considering the peri leaned on me and kept me from amnio (I don't blame him, I could have pushed...but went with his advice). My last appointment went alright, despite my nervous acknowledgement of my new medical education. I had gained 11 pounds (after loosing 3 last time) and my OB was so nice about it (since at about 24 weeks I've gained a total of 17 lbs). I ate like a nervous wreck this last month, and now I'm slowing that down! When I brought up a sonogram, she was great, saying she had a plan already. I get one last sonogram (if all looks good) at 30 weeks. I will only do amnio if needed based on what is seen on that screen. I think three good sonograms will make my chances great for holding a healthy baby. Of course, I am sure the peri and my OB think I'm going overboard with all this. Still, I am a mother. I have five kids at home to prepare for whatever happens, and my own heart to ready. If I learn, I can deal with reality when it hits. I actually think I will cry harder if the baby is healthy. The nurses are going to think I have ppd!

Dawn (jawndoejah)

Erin said...

You've got a fun blog! I've been reading your past posts and it's interesting to imagine the doc's side of things (I'm due in 3 weeks or so, and I'm seeing my ob a lot). Hope that all goes well with your pregnancy, and since you like owls so much, here is a link to a really neat picture and story about orphaned owls in England. I love owls too, they just have great faces!
http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=452482&in_page_id=1770

Scarlett said...

Hi there,

I'm not sure if you check this anymore but I'm starting my Ob/Gyn rotation next semester and was wondering what the good textbooks to use were? I'm looking for something that is easy to read yet comprehensive? Also, any suggestions on Paeds textbooks?

Cheers!

dr. whoo? said...

type (little) a~ Yes, I meant circumcicions. The peds don't do those here, so we lucky OBs get to do it instead. Not my favorite thing, for certain.

hi Nancy~ Yes, guiness girl is my long lost (well, not really lost, more like haven't seen in person for a few years) college roomate and procrastination soulmate. She is every bit as awesome in person as she is on her blog. It *is* funny that you've randomly read both of us separately. I think that must mean that we would get along wonderfully. :) Thanks for reading.

GG~ awww. Thank you! Mwah. :)

anon~ Oops, sorry for touching upon a sore subject. I promise not to write anymore about circs, 'k?

Medstudentitis~ I was floored, too. Especially when I scope patients with minimal implants who have significant, and at times debilitating, pain.

It was a great party! I promise to do the meme on Sunday...yes I know it is almost a month old. :)

brandoncfi~ Hee. Yes, thanks to Mickey Mouse Clubhouse and Dora, we get a few more snoozes...the intervening dreams can be really trippy, though!

Dawn~ Thanks so much for keeping me updated, I can't imagine how stressful this must be for you. Keep educating yourself, it is so important for good communication with your physicians. Praying for you and your family!

Hi Erin~ Thank you! I am so glad that you enjoy the blog, and I am trying to update more than once a month! Good luck with your pregnancy, and thanks for the owl link. I heart owls. :)

scarlett~ Yes, I'm still here. I had Hacker and Moore for a pretty good comprehensive med student OB/GYN text. Blueprints was good for quick review, and you can't beat Pretest and Appleton and Lange for review questions.

Sorry, but I can't even remember the peds texts I used! Is there such thing as Harriet? I think between the walking pneumonia I contracted during the rotation and the fact that I am ancient, I have blocked it all out. Hope this helps and good luck!

Kirsten said...

Ok, I have a question about endometriosis (I just stumbled on your blog and love it, by the way) ... is it possible to get it from a slightly botched c-section - the doc doesn't rinse the peritoneal cavity with saline, little pieces of endometrium end up hanging out and proliferating, viola, endometriosis? This 3rd year med student (I'm a 1st yr) profferred the above theory but the cause doesn't seem to be 'officially' known. It seems very mysterious to me, but then, I have zero clinical experience.