And two more months slipped away...

Happy Belated New Year, blog and blog friends! I will spare you the "busy, busy" rigmarole because you've heard it all before. Needless to say, it hardly seems real that the last time I logged on to post anything on the blog was back in October! Life and time have continued to move forward at the speed of light. Over the holidays we (or, more precisely, our builder) finished building the house, we closed (i.e. hemorrhaged money), and then, for extra fun, we moved in...the week before Christmas. Why (you ask incredulously)? Because I'm insane (in the membrane...er, sorry), apparently, and, more accurately, because I already had requested that week off in order to (HA, HA!) relax the week before Christmas. To add to the fun (and this torture was completely self-inflicted, by the way), we just didn't feel *right* about depriving poor little CindyLou and Bean of a Christmas tree and decorations until the week before Christmas (think of the *children!), so we bought a tree for the rental, decorated it and the rental house (including the outside, of course!), undecorated, bought a new tree for the new house, and the decorated the new house once again. I cannot vouch for my mental stability, that bit of madness was unbelievably ill-advised. Regardless, despite several snags, we arrived safely and soundly in the new house before Christmas. Santa even found us and everything! Whew!

So now, I am digging out of boxes, cursing the paper clutter and all of the things that can't be thrown away, but do not yet have a "home." Paper clutter is my true nemesis. We all love the new house. It is so nice to be in a home that is truly "ours" from the very start. Cindy Lou's bedroom is bedecked in lavenders, pinks, and fairies. Bean's is bathed in blues, "Cars" characters, and, let's not forget, monster trucks. We are very happy here, which is good, because (hear this internets) I AM NEVER MOVING AGAIN! (I hope.)

Work is going well, getting back into full swing since the holidays. I find I have so much less to complain about these days. Likely because I am not much on the front lines any more (no more midnight phone calls about cough syrup selection), I am getting more sleep, and more weekends off to play and love on my sweet little family. I still have the occasional fist-clenching moments, like the two sisters, due a week apart. The younger went into labor first, even though the older was *due* first, and the older got so p*ssed off she *refused* to come to the hospital bedside to support her sister. I mean, *dammit* she *always* gets *her* way. (These are grown ass women we are talking about here, you wouldn't believe the adolescent machinations, mostly on the part of the older sister.) Younger sister's baby ended up having an unknown health problem after delivery, which would have made me feel like a criminal that I wasn't there for *my* sister during that time. Older sister's baby was born about a week later and was *perfect,* and I got the vague impression she was feeling quite smug and justified about that. Sad, sad, sad.

There was also the patient whose MIL jumped all over me when, after going to have a "for fun" ultrasound where the US tech said the cord *might* be around or near the baby's neck, I tried to explain that, if indeed the cord was around the neck, there was not a thing in the world I could do about it! I spent 30 minutes with the patient and her MIL, even obtained a (completely normal and beautifully reactive) NST. At the MIL's visit to my partner the next week (for her own medical care) she expressed to them how I just "rushed" them right through the appointment, and how her DIL needed "more TLC" from our practice. GAH! The unmitigated *gall* of that woman! I give up. Haven't seen her or DIL since, and I'm not crying about that one little bit.

So anyway, time marches on...double numbers are luck for me, so I think 2011 is going to be a good one. Maybe, just maybe, I can lose the rest of that weight, organize my life, de-clutter, become a great cook, run a marathon, found a charity organization, and still find the time to be the world's best wife, mother, and doctor. Hmmmmm, probably not! Good to be back, and I hope to write more in the coming year. Hope you are still out there and listening!

Things I Say Every Day (Home Edition)**

1. Good morning, sunshines!

2. I love you.

3. No.

4. What do you say?

5. Hmmmmm?

6. Put your clothes in the hamper.

7. Stop teasing your brother.

8. Stop torturing your sister.

9. Sorry, you cannot have mac and cheese for breakfast.

10. Sooooo, whatcha want to do for dinner tonight?

11. Thank you for (doing laundry, the dishes, going shopping) honey!

12. Are you ready for a bath time? A bath time party? This is old CindyLou (and Bean) ready to get that bath time started....

13. So, tell me about what you learned today...

14. I need some snuggles (or, the abbreviated, "snugs")!

15. I missed you today.

16. Did you set the DVR?

17. No, no, it is (CindyLou's/Bean's) turn to sit in the front of the tub.

18. Pick out the book you want to read tonight.

19. What was your very favorite part of today?

20. Good night, sleep tight, sweet dreams...see you in the morning.

21. Ahhhh, adult time!

22. We need to go to bed earlier.

23. I am going to bed early tomorrow.

24. I love this show!

25. Maybe we can work out....tomorrow.

Cleanin' Out My Closet

With all due respect to Em.in.em (who I strangely love), it is not as interesting as he makes it sound. We are T-minus 3.5 months and counting from the big move from Whooville to NewCity. Mr. Whoo has been a packing machine (watch him get down), and we are getting ready to pack the first of our P.O.D.S. in anticipation of the move. Unfortunately, the closet has been begging and pleading for our mutual attention. We have been fortunate enough to be blessed with a home with a large master closet. Well, I guess I mean blessed and cursed, because every damn thing that does not have a home ends up in our spacious closet. Oh, shit! Company coming? Shove it in the closet. Stacks of paper with no where to put it? The closet sounds like a good idea! No time to deal with it now? Put it in the closet. And so on, and so forth for 3+ years and counting. Except now? We need to show the house, awesome closet and all. Not to mention the fact that we need to pack, and, my lord! Do we really need all of this *stuff*?

So, for the last few days, we have been working on the closet. I have been forced to go through all of my clothing, hanging on hangers in the closet since 1991. I am not kidding. There were clothes in my closet that I wore in high school, and I have the yearbook pictures to prove it. To me, this begs the question...why in the *hell* am I holding on to these clothes? For one, there is no hope in hell of me fitting into my old high school clothes...ever. And, even if I managed to get back down to 110 pounds soaking wet, would I really be wearing a flowered shirt from The Limited? Really? (Does that store even exist anymore?) I took the plunge, made some hard (ahem) choices, and managed to purge more than half of my closet in favor of donations to Good.will. Going through the clothes was kind of therapeutic and fun, in a way. I finally parted with the cute gray skirt I would wear out on chilly nights in college with tights, and the sundry "dressy" skirts I would wear to my sorority chapter meetings. There were a lot of good memories in that closet, and, hopefully, the clothes that I donated will go on to a new owner (someone that can actually fit into them) and be a part of their memories. I feel a bit anthropomorphic, thinking of my clothes this way, but hey, I am the girl who cried about packing away stuffed animals because I thought they would miss me (damn you Veleveteen Rabbit book!)

I am finding that the more of the clutter that we pack away, the clearer my mind becomes. I have loved visiting the past by sorting through old clothes and sundry items stashed in the closet, but I have also felt comfortable leaving them behind and moving on to better things. I feel good about moving forward, and I am happy to be getting closer to a new life...one closet at a time. I hope you all are well...Happy Friday the 13th!

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?

Suspended Animation

That's what the weekends seem like when I am off call. I feel like I rush, rush, rush through the weekdays...labeling bottles, rounding on patients, surgery, office, child pick-up, sundry essential (and I am talking only essential) household chores from dawn until dusk. Then Friday hits, and I experience a euphoria (on the weekends that I am off call) that compares to no drug once the pager gets turned off. And then? I sit....and laze...and eat...and laze some more. Don't I have just as much (if not more) to do on the weekends as I do on the weekdays? You bet I do. For some reason, however, I have no spark or motivation to do *anything* but sit and eat and laze.

Undoubtedly college football plays a role in my sloth on Saturdays. Between Mr. Whoo and myself we have no less than 4 football teams for which we root on a regular basis, so someone we follow is nearly always playing in any given time slot. The football viewing extravaganza starts at 10 am for Gameday and lasts well into the evening should we be interested in a late night game. Of course the child care duties do take precedence over the football viewage. CindyLou gets to go outside with Mr. Whoo and run around, the Bean gets fed and entertained and changed regularly by yours truly, and we get through the day making half-hearted efforts at the laundry, dishes, and cleaning up after ourselves. The bare minimum effort, no more, no less. The result is by Sunday I am feeling so freakishly slovenly and lazy that I begin to hate myself just a teensy bit, but not enough to actually get a lot more accomplished. Add that to the fact that the ladies that clean our house every other week were out last week on vacation so our house hasn't been cleaned in 3 weeks and you can imagine the appalling disarray at the Whoo household.

The bad thing in all of this is that the clutter seeps its way into my psyche, making my head feel cluttered and disheveled as well. So I am faced with the overwhelming desire to power clean the house, and simultaneously crippled with the perfectionist's curse of wanting to do it all at once and to do it flawlessly, at that. It isn't hard to figure out that this is impossible in the best of circumstances, much less in a household with a 3.5 year old and a 4 month old mucking the routine about, so here I sit in suspended animation...knowing what I need to do, but unable to do it the way that I want to do it. Yes, I've heard of Fly.Lad.y and the clean sink rule and the 15 minute rule, which seem great in theory, but my pathological brain can't just stop at 15 minutes. If I can't get it all done, then I don't want to do it at all. Lather, rinse, repeat.

Oh, and the *eating!* OMG, I am a bottomless pit. I know I am breastfeeding, but this is ridiculous. I bet I could have lost so much weight if I took advantage of my milk-making revved-up metabolism. Instead I am plateaued, and still eating bad foods by the boatload. Someone stop me! I am powerless over food. There, I said it...what is the next step?

I am ever so grateful for the 4 days a month that I do get the option to do nothing at all, but I know I need to stop doing nothing and start tackling the to-do list on my days off. It is just such an unappealing prospect. With the holiday season looming ever closer on the horizon (seriously people, Christmas music? the day after Halloween? It is madness, I tell you) I guess I need to just suck it up and get it together. Right after I write this blog, I mean....oh, and after I read everyone Else's blog too....yeah, that's the ticket. ;)

A Baby a Day

...keeps the doctor exhausted! It has been a big week for babies here in Whoo-ville. This is the week after the full moon, and man has it felt like it! Many believe that the day of the full moon is the big day for baby-having, but it has been my reality that the moon driven baby boom tends to fall either the week before or the week after the full moon. I have also noticed that there seem to be more demises and miscarriages during the new moon, whatever that may mean, and miscarriages also tend to come in threes.

My first delivery of the week was a multi-gravid patient with a history of rapid labors. She called me around 10:45 pm with "vaguely uncomfortable" contractions, due to her history, I urged her to head in to the hospital, and I tried to get a little rest in anticipation of a late night trek to the hospital. Triage paged at 12:30 am stating the patient was 3-4 cm with contractions every 6 minutes, she was admitted and wanted to move around so she started walking the halls. At 1:30 am she was 7 cm, and I rose from my cozy bed and cuddly baby, dressed, and was out the door within 5 minutes. On the way into the hospital, labor and delivery paged (around 1:45 am) and reported the patient was 9 cm. I walked into the hospital at 1:50 am, the patient's membranes ruptured as I walked into her room. She gave a low grunt as I quickly gowned and gloved, the nurses barely got the bed broken down, and the beautiful baby girl was delivered in one slow, fluid, controlled push at 2:00 am. No lacerations, no pain meds, just a quick and easy labor. I was back home and in bed by 3 am, but, as is often the case after a delivery, the adrenaline was flowing and I had a very difficult time sleeping. The day in the office passed in a blur, and then it was off to a costume party with the kids in tow.

The following morning, the pager bleated at 5:00 am, yet another early morning labor...just in time for Halloween! This patient, too, was 7 cm upon arrival to the hospital, and dedicated to delivering without pain medication...but she certainly wasn't happy about it! She had an epidural for her prior labor, and she kept remarking that "it never hurt like this last time." (!) She did very well, stayed focused, and delivered a bouncing Halloween boy at 7:30 am. She only had one small first degree laceration that did not require repair. Unfortunately, the plastic drape fell during the delivery spilling all sorts of wonderful goop upon the floor of the labor room. Ick. I then sprinted for surgery and once surgery was over, I dragged myself home...not for a much-needed nap, but for a shower and a trip to the kids' fall festival at the daycare. Then it was time to prep for Halloween tricks and treats. Lots of pictures of the costumed children, and a trek around our very hilly, steep driveway-ed neighborhood. CindyLou got more candy than she could ever hope for, Bean rode agreeably in the stroller, and Mr.Whoo and I exercised more in that one hour than we had for at least 8 weeks prior!

The following day, I had a scheduled induction for a post dates pregnancy. When I checked the patient, there was an odd band of scar tissue around the cervix...likely from a previous cervical surgery. The cervix was very effaced and thin, but it was only a tight 1 cm dilated. I waited for the patient to get her epidural, then gently stretched the scar tissue from 1 to 4 cm. I then headed for the office. At 11:30, L&D paged stating the patient was 7 cm and feeling pressure. I wrapped up my waiting office patients, raced to the hospital, and caught a baby at 12:05 pm. I barely had time to eat lunch before the afternoon patients started at 1pm.

The week ended with a jam-packed Friday morning office schedule, topped up with an afternoon scheduled repeat C-section. Fortunately this went beautifully, and I had time to go back to the office to finish up a bulk of charting and paperwork before starting an unexpected weekend off call. I even got to "sleep in" until 7:30 this morning, when I was awakened by the Bean's overflowing wet diaper...fun! We have plans to take CindyLou and Bean to the "Bee Movie" today and tonight to watch FSU get destroyed by BC (all the while hoping that some miracle will happen to let us actually win the game). Wine may, scratch that, will also be involved. Also, woo hoo, I won in Lara's contest! I never win anything! My luck has got to be looking up! :)

3 Weeks Old and Searching for a Routine

Oh, who am I kidding? We definitely have a routine, it just isn't the most productive routine. My life is incredibly boring right now, a far cry from my usual life, so if you snooze easily you may want to skip this post. My days since all the company left have shaken out something like this:

7am - 8am CindyLou barges into the room, wakes me if I'm sleeping, ignores me if I'm not, and searches immediately for Mr. Whoo. Mr. Whoo and CindyLou get ready for work and school as per as normal routine as they can manage. (Yes, she is still in school, especially this week while I am adjusting to being alone with the Bean), we are trying to keep her life as normal as possible and not to break routine.) It goes without saying that sometime during this period we are nursing, changing diapers, etc.

8am-10am - Variably spent napping, nursing, and lazing about in bed with the Bean. We have mastered side-lying nursing, which I highly recommend for maximum sleep. When I'm not sleeping, I am composing the day's to-do list in my mind. You see, I *have* to be productive if I'm staying home.

10am-1pm - The Bean's usual morning "awake" period. I have managed to shower (once) during this time and at the very least am able to attend to some basic self-care like the brushing of teeth, changing of clothes, using the bathroom, and even, sometimes, eating! I can usually entertain the Bean with the bouncy seat or swing while I attend to basic personal needs, and sometimes I am even able to get some chores done. It is this time of day that I am usually contemplating on writing/typing out a to do list. It is day 4 of this not happening yet. Nursing happens toward the end of this time period to put the Bean into a "milk coma."

1pm- 3pm - The Bean is sleeping. I'm finding it very hard to put him down when he sleeps because he is oh so very snuggly and sweet. I usually will compromise and hold him for a bit before putting him down and working on the day's to-dos and, more likely, surfing the internet.

3pm-5pm - I eat my second lunch because I am hungry *all* of the time. This is probably why my weight loss has plateaued this week. Then there is dinner planning, chores, nursing, and napping (both Bean and myself). Did I mention that I am a rotten housewife?

5pm-8pm - Mr. Whoo and CindyLou come home. We have dinner, a little play time, CindyLou has her bath, if I haven't showered, I get a shower, and CindyLou goes to bed. Mr. Whoo gets some Bean time, and Bean sometimes will have a little fussy period at this time.

8pm- 11pm - It is nurse-a-thon time. The Bean is at the breast every hour, cluster feeding like crazy, drifting into light sleep, awaking and nursing again. Once he is sated, we both tend to pass out on the couch until Mr. Whoo rousts us up to go to bed.

11pm - 2am - My blissful, longest sleep period of the day.

2am - Nursing, diaper changing, dozing, watching Disco.very Health, TLC, Brav.o, and WE. I even saw my own OB on one of the "Special Delivery" shows on Discovery Health. Awesome.

4am- Nursing, diaper changing, dozing, watching only Disco.very Health or one of the news channels because all of the rest of the cable channels turn to infomercials after 3 am.

*Aside* Let me just say that DH and TLC need some more commercial sponsors, or at the very least, they need to run different commercials for the same shows. Some of their commercials are burned into my subconscious - The Last Days of Diana (where they have made some kind of dirge out of "Modern Love." Mightily depressing.) and Diagnosis X (where there is an equally depressing snippet of song playing over and over in my head.) I am also convinced that the lead singer from Cake is the vocalist for the Coc.oa Krispi.es "cereal straws" jingle. That's just *sad* y'all.

Lather, rinse, repeat.

Why yes, I *am* slowly losing my mind, why do you ask? I am having a hard time putting the baby down to sleep 1) because he doesn't sleep very well on his back 2) he sleeps great on his tummy, but I can't sleep worrying about SIDS 3) the kiddo is a very noisy breather, squeaking, squawking, and snoring (I have made the totally non-professional diagnosis of laryngomalacia) making me think that he is awake when he is not, and 4) selfishness, he's only going to be this little and cuddly once. This results in me sitting semi-reclined in bed, propped up on pillows, with Bean sleeping on my chest.

Yes, I *know* this isn't the best arrangement. Actually, I slept with CindyLou this way for the first 6 weeks of her life due to her horrible reflux, but we slept out on the couch, not in the bed. I am attempting to get the Bean to sleep on his back during his daytime naps in preparation of trying to get him down at night. It's sad that I get better sleep with him on me than in his own bed.

I'm trying desperately not to think that my maternity leave is just about half over (sob!) because right now I'm just not ready to go back to that chaos. I am seriously considering cutting my schedule as much as I can and cutting back deliveries for a while until we adjust to the two child family. There is nothing I can do about the call, unfortunately. Also looming on the horizon is the Oral Boards. Argh. I don't even want to think about this. Thank you all for your congratulations and compliments on the Bean. You guys are the best, and I promise that I will get back to more witty, interesting posts as I become more witty and interesting. I am starting to think this is directly proportional to the amount of continuous sleep that I get. Back to the laundry for now....

Still alive, still pregnant, still whiny

Is it really June already? I'm not ready for it to be summer! The last few weeks have been (SSDD, I know) a whirlwind of work, catching babies, visiting family, and minor freak outs about the status of the medical blogging community in general and about my blog in particular. It is difficult for me to even see hits from the same *state* on my stat counter without getting antsy about being "found out." I debated stopping altogether, but I miss blogging and talking to you all out in blogland. I guess that I was never organized enough about blogging to figure out what I wanted this blog to be, a mommy blog? A doctor blog? Educational? Entertainment? To tell the truth, more than anything I approached it like my own personal journal, an outlet for all of the jumbled thoughts in my brain that I need to spill and sort out in black and white. A journal that talks back ! (The coolest part of all.) So, I think that is what it will continue to be, with major alteration of details surrounding the particulars of my job. I think I can live with that. We shall see.

So let's catch up. On a personal note, I am 32 weeks and 2 days. The Bean has hiccups regularly, and I am convinced that he is still in transverse lie. I've been measuring almost 2 weeks ahead for the last few appointments, and I am dying to know how much this kid is going to weigh. (Did I mention that I don't have free access to an ultrasound machine, so I am at the mercy of the insurance/physician order just like every other pregnant woman? Shameful. I'm dying over here.) The "due any day now" comments are coming fast and furious, along with the shock and mock horror when I tell them that I still have at least 8 weeks to go. People can be so jerky to pregnant women, it's unreal. It continues to be a real test to patiently listen and empathize with my whiny pregnant patients, being a whiny pregnant person, myself. More than once, when asked when their maternity leave should start, I've stifled the urge to quip "You can't stop working until *I* stop working." Ha. I would never say this out loud, but it's fun to fantasize about. I had a very busy delivery month in May, and I am looking forward to having only half as many patients due in June. Pregnancy symptoms include lots of contractions (but a negative fetal fibronectin, so all is well), sciatic pain, mild pubic symphysis diastasis discomfort, cankles, borderline elevated BP (130-140s/80s), and killer heartburn. I am happy to report that I am no longer puking, even on a weekly basis.

Remember the less than stellar med student that I posted about a while back as an example of what not to do? Not too long ago, that very same student cornered me in the Doctor's Lounge and proceeded to tell me how "shocked" they were at the grade that I had given them. (For the record, it was in the ballpark of an 85 percent. I felt that I was more than generous for the work the student did!) I got treated to a talk of woe, that they had really, really wanted to do OB/GYN and my grade didn't place them at the top, where they believed they should be. I also heard about how the grade I gave them was the worst grade they had ever received. (Which shocked the hell out of me, leading me to believe that this student must have been allowed to slide by with being "cute" and "sassy" because their clinical knowledge and work ethic was sub par, as far as I could see.) I was as gracious as I could possibly be, and stated that it was possible that I was a stricter grader than the student's prior preceptors, and I encouraged them to pursue recommendations and work hard in their 4th year electives in OB/GYN. Then I politely excused myself before their audacity completely caused me to lose all composure and give them a real piece of my mind. Now I wonder if it would have been better to just lay it all out for them, because, really, I am not doing them any favors, allowing them to think that they were the best student around, and I am just a mean, hard-grading jerk of a preceptor. (No, it isn't me, it's *you.*) I just suck at unexpected confrontation. I need time to formulate coherent arguments, otherwise, I tend to just make off the cuff, not so nice, and certainly not constructive comments. Ah well, just thought it would amuse y'all to hear the update.

I am off this weekend, and Mr. Whoo and I are about to tackle the master closet. A project a long time coming, accelerated by the fact that an entire rack of clothes fell off the wall this past week, requiring immediate attention. Sigh. Home improvement sucks.

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!