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!