Wow, I just went fifteen days without even thinking about blogging! Maybe that is because I have delivered 12 babies in the last 2 weeks, including my second set of twins for the month. I am very happy to have attended 2 twin births this month, both vaginal deliveries, one without an epidural (go mom, woo!). February has been filled with post-dates patients and big babies (though none coming close to my recent 11 pounder!) It has also been filled with more C-sections than I would like to have, but I guess my good run of vaginal deliveries had to end somewhere.
The word is out that I am leaving the hospital. The feedback that I have gotten overall has been really positive. By that I mean, people seem sad to be seeing me go, but they aren't being jerky about it. Most people are very understanding of my family and call situation, as well as the reason why I am leaving. It's nice to know that I will be missed by the staff and the patients, for I will surely miss (most of) them. We have been showing the house sporadically. Let me tell you, getting the house "show ready" with two messy kids and (let's face it) two fairly messy adults is a serious challenge. After every showing I get this huge surge of hope that we will finally sell the house. And then? Nothing. I know it is a bum market right now, but the thought of carrying this house payment with us after we leave is daunting. So much hinges on whether or not we sell the house. Will we buy or rent in NewCity? Are we looking for temporary or more permanent? CindyLou will be starting Kindergarten (!!!) in the fall, so we are trying to find the area in which we want to settle in the "right" school district. So much uncertainty is fairly uncomfortable.
The licensing process is dragging on and on, but I think I have it all pulled together. Now I just have to get it all submitted. I don't know how anyone could fake being a physician and get a medical license. I can barely get all the bases covered, and I am totally legit! I just can't believe how much I am being nickeled and dimed to death on all of the various and sundry fees. I've decided that New State will be our final destination for the duration of my medical practice. I cannot fathom going through the licensure process yet again.
Mr. Whoo, CindyLou, and the Bean are all doing great. The Bean is 18 months old. (Can you believe it?) He is such a little sweetheart. His language has really taken off since he got his tubes put in last summer. He loves books, and will sit in your lap, snuggle, and read books for hours! He idolizes his big sister, and while he cannot say her name yet, he calls her "sissy" in the most adorable way. CindyLou is a stellar big sister, and, at times, is very much a little mommy to the Bean. She is so smart and curious. She drives crazy with her constant jabber sometimes, but I suppose this comes naturally. Both Mr. Whoo and I often got the admonishment of "Talks too much!" on our progress reports and report cards! Mr. Whoo continues to be the best husband on earth. I don't know where our family would be without him. I feel so lucky to have such a wonderful partner.
As for me? I'm getting through one day at a time. I am still 2 steps forward and 2 steps back (Paula Abdul reference completely unintended, sorry!) with respect to weight loss. I still find myself turning to food for comfort at the end of a long, hard day. I keep seeing everyone with whom I went to high school and college (via facebook, mostly) all looking so fit and well rested, I veritably seethe with envy at times. I look ten years older than I actually am, not to mention 50 lbs heavier than I should be. I know better times are on the horizon; I just need to quit making excuses. Any way, I just wanted to check in and let you know that I am still alive and kicking! Now I just have to figure out 2 snazzy posts for MIM before next Friday. Hmmm....
Saturday, February 21, 2009
Thursday, February 05, 2009
Is Mercury in Retrograde or Something?
Hello all, what a crappy week it has been. Is anyone else having "issues" this week? My week actually started out on a pretty good note. One of my patients, pregnant with twins, began to develop preeclampsia. We made the decision to augment labor (she was already contracting and 3 cm), and late in the evening I got to do my first vaginal twin delivery since residency. I was nervous because I am used to doing twin deliveries in the OR as a "double set up," just in case there is a need to emergently deliver the second twin by C-section. In Whoo Hospital, there are no ORs on the L&D floor, so the deliveries are done in the room, and, should an emergency arise, you have to go down several stories to the OR. In a situation where minutes and seconds are precious, this is a daunting thing, especially as the night wore on and I realized that she would deliver in the dead middle of the night (aka skeleton crew time). Luckily, it was the smoothest twin delivery I'd had or seen in a long time. The first baby had no complications on delivery, the second baby stayed vertex, we broke the second bag of water, and baby number two was born about 5 contractions and 2 pushes later. Both babies and mom did wonderfully well. It was truly an amazing experience, and I was happy to be a part of that.
After that, though, it all went downhill fast. Of course, due to the middle of the night delivery, I got very little sleep. Therefore I overslept, and was later than I wanted to be getting to the hospital. Waiting for me there was a consult for the ever dreaded "pelvic pain." Before I get roasted about pelvic pain, let me emphasize that yes, it exists. Yes, there are gynecologic causes. Yes, it is not always supratentorial (all in the patient's head). But this patient definitely had supratentorial pelvic pain. She was already on a cocktail of narcotics and benzodiazepenes, and she spoke of severe excruciating pain in the calmest of voices, her pulse at 60, blood pressure at 90/60. Her exam was completely normal, as were her labs and imaging studies. She blithely asked me to "go ahead and do a hysterectomy while she was "here" (IE admitted to the hospital for pneumonia)." I blithely declined, set a follow up appointment in the office, offered medical suppression for her cycles (got denied), and asked her to sign a medical record release to obtain information from her prior ("out of state") physician.
Already in a *fantastic* mood by this point, I proceeded to the office. Where my right hand woman, SuperNurse, had slipped on the ice in the parking lot and (unknown at the time)broken her leg. For a while she tried to walk on it, but we all finally convinced her to go get xrays. So then, I was stuck with NotSoSuper medical assistant, who may well be the laziest person on the face of the earth. Any one who has worked in an office knows that the nurse who assists you can make or break the flow of your day. This day was definitely broken. The afternoon dragged on with the most draining kinds of patients around including such hits as "every organ system bothers me, can't you just wave a wand and fix it?" and, after a "routine" annual, a 20 minute nervous breakdown over the (unfounded) perception that her female anatomy was somehow horribly disfigured, and she wanted vaginal reconstructive surgery, not one but two Op.rah inspired "natural hormones" consults, and, last, but certainly not least, a patient with known cancer, sent to me by her radiation oncologist for a "skin tag" removal, that I am almost 100% certain is a vulvar carcinoma. Good times, good times.
Then, after a long, hard day already at 5pm, I log on to the internet to learn that one of my friends that I knew from middle school, high school, and college had taken their own life, and leaves behind a small child. I was shocked, then dismayed, and am still very sad over the whole thing. Just terrible news. Mr. Whoo had his community service club meeting, so I kid wrangled alone for bedtime and bath time. Exhausting. To top all of the rest of the day off, after being unnecessarily snarky when I had meant to be funny, I had a misunderstanding with one of my friends, feelings were hurt (I believe on both sides), and now I am getting the technologic freeze out which isn't very pleasant, either.
I am still struggling with the license application for obtaining my medical license in New State. So far I am out almost $1000 in various fees and I haven't even submitted the application proper (which will be $5000 +). We haven't sold our house yet, we haven't begun packing, I'm still over weight and not losing, despite my best efforts, and for extra fun, I have decided to cut all alcohol consumption for the month of February. Oh yes, and I am on call this week and all weekend long. So yeah, my week has pretty much sucked! How about you all? Am I the only one?
After that, though, it all went downhill fast. Of course, due to the middle of the night delivery, I got very little sleep. Therefore I overslept, and was later than I wanted to be getting to the hospital. Waiting for me there was a consult for the ever dreaded "pelvic pain." Before I get roasted about pelvic pain, let me emphasize that yes, it exists. Yes, there are gynecologic causes. Yes, it is not always supratentorial (all in the patient's head). But this patient definitely had supratentorial pelvic pain. She was already on a cocktail of narcotics and benzodiazepenes, and she spoke of severe excruciating pain in the calmest of voices, her pulse at 60, blood pressure at 90/60. Her exam was completely normal, as were her labs and imaging studies. She blithely asked me to "go ahead and do a hysterectomy while she was "here" (IE admitted to the hospital for pneumonia)." I blithely declined, set a follow up appointment in the office, offered medical suppression for her cycles (got denied), and asked her to sign a medical record release to obtain information from her prior ("out of state") physician.
Already in a *fantastic* mood by this point, I proceeded to the office. Where my right hand woman, SuperNurse, had slipped on the ice in the parking lot and (unknown at the time)broken her leg. For a while she tried to walk on it, but we all finally convinced her to go get xrays. So then, I was stuck with NotSoSuper medical assistant, who may well be the laziest person on the face of the earth. Any one who has worked in an office knows that the nurse who assists you can make or break the flow of your day. This day was definitely broken. The afternoon dragged on with the most draining kinds of patients around including such hits as "every organ system bothers me, can't you just wave a wand and fix it?" and, after a "routine" annual, a 20 minute nervous breakdown over the (unfounded) perception that her female anatomy was somehow horribly disfigured, and she wanted vaginal reconstructive surgery, not one but two Op.rah inspired "natural hormones" consults, and, last, but certainly not least, a patient with known cancer, sent to me by her radiation oncologist for a "skin tag" removal, that I am almost 100% certain is a vulvar carcinoma. Good times, good times.
Then, after a long, hard day already at 5pm, I log on to the internet to learn that one of my friends that I knew from middle school, high school, and college had taken their own life, and leaves behind a small child. I was shocked, then dismayed, and am still very sad over the whole thing. Just terrible news. Mr. Whoo had his community service club meeting, so I kid wrangled alone for bedtime and bath time. Exhausting. To top all of the rest of the day off, after being unnecessarily snarky when I had meant to be funny, I had a misunderstanding with one of my friends, feelings were hurt (I believe on both sides), and now I am getting the technologic freeze out which isn't very pleasant, either.
I am still struggling with the license application for obtaining my medical license in New State. So far I am out almost $1000 in various fees and I haven't even submitted the application proper (which will be $5000 +). We haven't sold our house yet, we haven't begun packing, I'm still over weight and not losing, despite my best efforts, and for extra fun, I have decided to cut all alcohol consumption for the month of February. Oh yes, and I am on call this week and all weekend long. So yeah, my week has pretty much sucked! How about you all? Am I the only one?
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