Monday, October 22, 2007

Eight More Random Things About Me

This is long overdue, sorry Mark ! I think I did this one a while back, too. I'm out of the office this morning (1st true sick day that I've taken in about 8 years) with a high temp and pukiness from the mastitis (woo!) so this will be a good way to distract me from how crappy I feel.

1. When I first started medical school, I thought I wanted to be a dermatologist. Good hours, good pay, good lifestyle, etc. I had it all figured out...until I worked my first derm clinic. Granted, I did my medical training in a huge city with a lot of indigent care and really sick people, but the things I saw in that clinic grossed me out beyond measure. I came home itchy every single day, and before the rotation was finished, I picked up a nice case of ringworm to boot. Thus ended my grand career in dermatology. I think it worked out pretty well, but oh how I pine for 9-5 office hours.

2. I am powerless over potato chips. There, I said it. I can resist sweets, cake, cookies, and even ice cream, but I cannot resist any kind of chip. If I walk past a bag or a bowl, I must indulge. My favorites are sour cream and cheddar, with Doritos running a close second. Love. Sigh. And I wonder why the weight isn't coming off?

3. I love to sing, but I am not very good at it. Mr. Whoo and I sing to the kids all the time and make up goofy songs to current radio hits to make them laugh. When CindyLou was a baby, we sang "Let's Get it Started" and "Crazy In Love" (the uh-oh-uh-oh-uh-oh part, especially) with altered lyrics to her. We also sing a bath version of "Oh My Darling, Clementine" with body parts (such as "wash your bottom, wash your bottom, wash your bo-ttom, CindyLou.) With Bean, so far the favorite is "Ridin' Dirty" (but we sing "gotta catch him wet and dirty...") Dorks, I know!

4. I am the proud owner of a karaoke machine, and Mr. Whoo and have been known to take it with us when we travel and subject our friends to our caterwauling. Our friends usually join right in! My favorite karaoke machine memory is once, after I had gone to sleep, I woke up to hear the guys singing the theme song to "Growing Pains" on the karaoke machine. Priceless.

5. On a somewhat related note, I am the master of remembering lyrics. Seriously, I am the *true* reigning "Singing Bee" champion. Unfortunately, my expertise is somewhat limited to the songs of the 80s and 90s. I can get some popular 70s songs, but when it comes to disco, I am totally clueless. It amazes me that I can remember all of these lyrics, but can't easily cram new medical knowledge into my overstuffed brain. I do occasionally memorize facts to a tune. That seems to stay with me.

6. I am a binge shopper. I would say that 90% of the time, I'm not a big shopper. I dislike going to the mall. I do not get a rush out of buying new clothes. In fact, I could really do without clothes shopping altogether. (This is probably partially due to the gargantuan proportions of my posterior.) However, when I do shop (especially for things for the house), it is like I cannot stop. I blow a ton of money, suffer a shopping hangover, and don't shop again for months. Does anyone else do this?

7. Sometimes I feel like I have just a small tinge of psychic ability. Nothing that I can control consciously, but sometimes I just know things are going to happen. I also have dreams that come true on occasion. I wish I could tap into it more, but for now I guess it is like a step above intuition.

8. I can't even do a sick day right. I'm into my sick day one hour already, with a temp of 102 and a round of GI distress early this morning, and I find myself planning all the chores that I can get done today. It is pathological. My body wants to lie on the couch and watch "The Price is Right," but my mind is thinking about laundry. I just feel guilty about being sick. How sad is that?

I don't tag anyone since this me me is 3 months overdue, but I hope that this peek into my warped psyche was entertaining. Now for TPIR...or maybe some laundry.....

Sunday, October 21, 2007

Caution! Full Force Whining Ahead

This weekend has been less than ideal. I'm on call (which always puts a damper on the weekend), I'm nursing a second bout of mastitis due, I think, to Bean weaning some night feedings, even when I'm not getting called every couple of hours, I'm not sleeping well. My best sleep seems to be right around 6 am, which is unfortunate because that is when CindyLou has decided to wake up for the last 3 mornings and demand to be fed. The house is a wreck, I don't feel like cleaning, something in the fridge smells bad, I don't want to search it out, the bottles need labeling for the week, and I don't want to do it. I feel fat, but all I want to do is eat bad food like pizza, pasta, and Chinese. I need to organize baby photo albums, not just for Bean, but for CindyLou, too. I need to go shopping, but I don't want to leave the house. Florida State lost (again) to a team they should have beaten. I got a new consult this morning on a patient with an adnexal mass that looks like cancer. Oh, and Mr. Whoo is sleeping in today. (Now, this is partially my fault, since I told him to go ahead and keep sleeping when I took the kids downstairs at 6:30 this morning, but he is taking full advantage, let me tell you!) Bitch, bitch, nauseam.

I feel really short tempered and snappish, but I think it all stems from being bone tired. Yesterday I had to transfer a patient with PROM to the tertiary care center, and I got treated like some kind of second class resident by the accepting physician. Usually I can let these things roll off my back, but they really ticked me off. I got the business about whether or not I had personally examined the patient (I had), whether or not the appropriate antibiotics had been started (they had), and whether or not the patient was in active labor (she wasn't). I realize that I am a community physician, but I'm not stupid. I trained in a residency that was 90% management of high risk patients. I know that tertiary care centers get a lot of "dumps" on the weekends, but I have never shipped a patient that didn't warrant transfer. I don't know why I let that physician get to me that way, but I'm still silently fuming about it.

I also heard about a terrible call that the L&D nurses and pediatrician had to attend. Apparently a woman was being attended in a home birth by a lay doula, (no midwife, no back up physician, just a doula with no medical training) the baby was footling breech and had a cord prolapse...instead of immediately going to the hospital, she continued to labor the mother at home. The baby was dead when it was delivered. A beautiful, perfect term baby that didn't have to die. When the medical team arrived the doula was chanting and lighting incense around the house and the mother was hemorrhaging in the tub. It just makes me physically ill to think of it. Don't get me wrong, I respect the art of midwifery, and I think that having a doula can greatly enhance a mother's birth experience. In this case, the doula overstepped her bounds of expertise with deadly consequences. I wonder if she will be subject to the kind of lawsuits that obstetricians face daily. Sometimes, even in normal births, things go terribly wrong, and ignorance of when to forgo the desired birth "experience" and get to the hospital to save a baby or a mother is catastrophic. So sad for that family.

I'm dreading heading back into the hospital. The only patients in house are OtherDoc's patients, and it is always difficult to manage his patients because our styles are so very different. I tend to be overly cautious, and I write a lot in my progress notes. He tends to be a bit more relaxed, and often will not write notes at all. It can be really frustrating. Oh well, at least I have next weekend for which to look forward. Two whole blissful days off, just 5 short days away. I think I can hold out until then. Hope your collective weekends are going far better than mine! :)

Saturday, October 13, 2007

Whoop, dere it is

Do you ever get inappropriate song lyrics stuck in your head on constant repeat? (Whoop! Shakalaka-shaklaka-shakalaka, whoop!) Just me? Damn. The inspiration for my chosen song of the weekend is not so funny, unfortunately. It seems that Bean may be in the early stages of whooping cough or pertussis. A child in the daycare was just diagnosed this week, and yesterday he started with the characteristic cough. Since he is such a little man, and has not completed his vaccinations yet, he is now on antibiotics to (hopefully) keep him from developing the paroxysmal coughing spells that are pathognomonic for the illness. Poor guy. He actually otherwise seems very happy. He is eating and sleeping well, so that is all that I can ask in this situation. Hopefully we have caught the illness in the mild stage in time for him not to develop the severe symptoms. Fingers are crossed.

Did I mention that I am playing single parent this weekend? Well, I am, and boy, is it rough. Mr. Whoo is off in the woods with his (boy)friends, acting like 13 year olds (video games, junk food, staying up late, oh and also with beer, lots of beer). They do this trip once a year, and I think it is great for their friendship, but man, it is difficult at home. When CindyLou was a baby, she decided to get her very first stomach bug when Mr. Whoo was off on his "guy" weekend. Bean just had to do her one better, I guess. You may remember at the onset of this blog that the wives started their own little get-away weekend. We didn't do it this year (logistics were tricky with pregnancies and whatnot), but are in the early stages of planning next year's trip. (A whole lot less video games, same amount of alcohol, and more spa time.) CindyLou and the Bean have actually been angelic, though, so I have been really lucky. She is off on a playdate right now, and he is sleeping somewhat peacefully in his swing. Hence, blog time! Woot!

I am taking a little longer to adjust back into a full work schedule than I anticipated. I am booked for new patients out into April, with women approaching me personally in the hospital and elsewhere (!) requesting to be seen sooner. I also am trying to decrease my patient load for less deliveries per month in hopes of eking out some sort of better lifestyle. I am going into the 3rd year of a 4 year contract, and I have a lot to consider. Now, with two children, I am finding that lifestyle is becoming increasingly important. I came in to this opportunity with the attitude that I could do anything for 4 years (just like residency). When I come out of this contract $200,000 of my student loans will have been repaid. (You read that figure correctly.) This is huuugge. I will not be "debt free" but the amount left over to pay after that is entirely manageable. I love the location and the patients. I do not love the call all. I am still only getting 4 days off per month (every other weekend). I am on call 24/7 all week long and 2 weekends a month. This is too much. I was led to believe that call would be 1 in 3 when I arrived here. This never materialized, and I am somewhat bitter. My employer is looking to expand, and I am hopeful that adding one or two more OB physicians is in their sights in the coming years. If I could have a true 1 in 3 (or 4) call with 1 in 3 (or 4 )weekends, I think I could be a very happy camper. If this does not happen, I'm afraid I may have to start the process to look elsewhere. Bleah. I hate moving. I am trying to be patient.

I am glad to be back with my patients. It is awesome to get back into the OR, and catch some babies. One of my favorite patients is due this month, and I can't wait to deliver her second baby (I delivered her first about a year and a half ago). That is the part that I love about OB, the continuity of care and the relationship with the patient. It is such a privilege to be a part of such an intimate occasion as childbirth. I wish sometimes that I didn't love my job as much as I do. I wish it would be an easier decision to scrap years of training and debt and say "I'm staying with my babies." I just can't. I love my children immeasurably, but I know that the work that I am doing is more than a job, it is a calling; just as much as motherhood is a calling, and so I do my best to serve both of my passions in an equitable way. It isn't easy, and I will state now that I am choosing not to engage the work vs. stay home debate mongers here. A few of the comments I have received and chosen not to publish are hurtful, not only to me, but to women in general, and I will not allow this misogynistic rhetoric on my blog. If you are looking for a fight, please look elsewhere. We women are doing the best we can, and we don't need members of our own sex seeking to tear us down for the choices we make in life. With that, it is time to nurse the little man. Happy weekend, one and all...thank you for reading my stream of consciousness. :)

Friday, October 05, 2007

Been Away

....haven't seen you in a while. Thanks for continuing to check in on me. I really have missed blogging and checking in with all of you. It is like a missing part of who I am, but who has the time? If I thought life was crazy before, it was nothing compared to working full time with a toddler and a newborn. As much as I hate to do it, I am being forced to become more organized, lest I pay the very hefty price when I neglect organization. I now try to shower, prep bottles for daycare, and, if I'm really good, lay out clothes for myself and the kids in the evening. If these three things are done consistently, mornings tend to be hectic, but smooth. If not? Unmitigated chaos.

Our daycare likes to complicate matters more by these ridiculous restrictions on the bottles that we bring in for Bean. For example, all bottles must be labeled with the baby's name (naturally), ounces in the bottle (mmm, okay, but can't you see the marker yourself?), and, here's the kicker, the date can only be the day prior or the date that the bottle is being used (seriously?? Don't they know that breast milk keeps longer than 24 hours in the fridge??) In addition, all bottles must have nipples on them, as they cannot rinse and re-use a once used nipple (ridiculous). This is a pain in the ass because half of the bottles we have are breast milk storage bottles, so nipples must be washed twice as frequently during the week. I have offered to provide a "doctor's note" that it is perfectly acceptable to re-use nipples and to use breast milk that is older than 24 hours, but no one seems to take that offer seriously.

So, every night we have to re-date bottles (because let's be serious, I'm not washing perfectly good breast milk down the drain, the stuff is liquid gold), wash and re-place nipples, and keep track of how many bottles are needed for the next day. It seems a small feat, but add that to feeding, entertaining, and bathing a toddler, feeding, bathing, and entertaining the newborn, and feeding (and in my case, bathing) ourselves, and things get a little more hairy. Then there are mornings like yesterday morning when we all woke up late, and Bean decided to give himself (and his mother) a different kind of shower. Now when changing a boy's diaper, unexpected sprinkles are not uncommon, but this one occurred in between the removal of the requisite "shield wipe" and the fastening of the diaper. The result was pee on his head and chest, my hair, my clothes, and all over the bed (he even peed over the chux that he was being changed on!) This earned him a quick wash down from head to toe with my closest available "washcloth" (a clean sock) and baby shampoo, and it earned me a whole new shower. Which,in turn, made me unable to go in for rounds and just barely on time for the office. Ah yes, life is different indeed.

On the work front, I am working with my staff to whittle my schedule back to a reasonable pace. For now I am restricting OB patients to 15 total deliveries per month, with the availability to go to 20 per month if my schedule allows. I have blocked time to pump throughout the day. I also have stopped having routine scheduled patients after 4 pm, leaving the hour between 4pm and 5pm for work-in patients and emergency room follow-ups. If there are no work-ins, then I have that time to do the office charts for the day, sign off on labs, and dictate. So far it is working well. Time will tell if I can keep that pace and still be profitable for the hospital. The call schedule is still less than desirable, only 4 days off per month is not going to hack it in the long term. I am holding out hope that the hospital will hire one (or two) more physician(s) sooner than later. If no help comes for the call schedule, no matter how much we like everything else, here, we will likely go looking for a better quality of life. My patients are happy that I am back, and that makes coming back a whole lot easier. I did miss the patients and the relationship I have with them. I love what I do, I just need to find a way to make my job fit more into my life rather than working my whole life around my job.

Eh, this entry is boring, but it is what is on my mind. I am glad to have this time to write, and will make an effort to make more frequent forays into blogland. As for topics, if you have any requests I'll be happy to try to work them in between the whiny me, me, me posts! :) Happy (OMG it is freaking) October!