Sunday, March 28, 2010

Thanks

I’ve been contemplating this post for awhile. I have decided to stop blogging. I started this blog three years ago and it has been a place for me to put my thoughts on paper. It’s given me a chance to meet new people and learn new skills. I’ve learned a lot from my readers.




Things have changed in the last three years. I’ve become much busier. I need to streamline my life and really decide what is most important. To be honest, I tell myself I am going to just write a quick blog post. But then I end up spending hours on the Internet writing and then reading all my favorite bloggers or exploring new ones. That isn’t a bad thing really. But when it interferes with my ability to get enough sleep, or keeps me from spending time with my family and friends it is a problem. “Virtual” relationships, be it on Blogger or Facebook, should never replace the real face to face relationships of my family or my friends.  HIPAA restrictions have gotten much stricter at work. Blogging is not worth losing my job.



So as much as I have enjoyed these three years blogging, I am going to stop. I will probably leave the blog up for awhile. But eventually I plan on taking it down. Maybe I will compile it into a book to tuck away on my shelves and remind myself of these past three years.



Thank you to my readers. Thanks for your comments that have taught me. Thanks for your support. Thank you for the adventure. Oh. I almost forgot. Yes, the wedding went very well. All my children are officially married. I am officially an empty nester. Maybe that is why I feel a need to change my life right now.

Wednesday, January 6, 2010

Thoughts

I am still here, just haven't blogged in a long time.  I've been busy, but that's not the only reason.  Just trying to decide if blogging is still something I want to do.  I have lots of good things that keep me busy...too busy.  I already cut out a lot of things and am now left with deciding on what "good" things to drop in order to maintain my sanity.  HIPPA regulations at work are getting more strict.  I think blogging about births is always interesting.  Somehow blogging about endless pap smears, cranky patients and discharge isn't as interesting.  I feel some responsibility to you, my readers, but for now....I think I am taking a writing hiatus.  Maybe I will be back in March after I get my last child's wedding done!

Sunday, December 6, 2009

December beginnings




It is December!  We put up our Christmas tree yesterday.  One of my friends from work was moving to Florida and so she gave me her prelit Christmas tree.  It is tall and very pretty.  Plenty of room for all those family ornaments I’ve collected over the years.  I always shed a few tears when I put on the little house that was on my mother’s tree when she was a child.  I get wistful when I put up the ornaments from my childhood, and I treasure those hand made ornaments my children created many years ago.  At the center of my tree are the picture ornaments of my grandchildren.  I used to think, “Someday I am going to have a tree with color coordinated and matching ornaments.”  Now I have come to realize that I cherish my tree where no two ornaments are exactly the same.  

Sunday, November 29, 2009

Thanksgiving Safari

I did a non-traditional Thanksgiving this year.  I went on a African safari....

If you are really quiet you can sneek up on the animals

I hung out with the elephants


watched the rhinos sunning under the trees



and pet a zebra.



Well, not really.  My brother-in-law is making wooden puzzle animals for the grandchildren. I thought they were just too cute and had to get some pictures of them.

Hubby and I went camping with my sister and brother-in-law here...


  My second son came up as well for a short visit.  I loved my relaxing weekend.  It was just what I needed!

Wednesday, November 18, 2009

Up late Update


Not much to post. I've been too busy. 27 patients tomorrow, two procedures, two new OB's. I'm getting tired of running at full speed. I've taken to listening to music on my Blackberry when I drive to and from work. It helps me stay calm. I am back eating healthy again (and have the three pound weight loss to prove it). Can't find time to exercise but I am trying to be content with just getting back on track with my food. Trying to get my eight hours of sleep every night. I can tell the stress is getting to me because I am having a hard time sleeping. I am having vivid dreams and nightmares. And my neck and shoulders hurt all night. Usually a good sign that I am way too stressed.




I did have a wonderful weekend relaxing at Catalina Island with my brother and his wife. Spent Sunday in the mountains with friends. My soul needed that. I'm trying to realize that I have to change my expectations. My schedule isn't going to get better, patients will always come in with lots of problems on their annual exams. I need to stop getting frustrated about both of those. It's just the way work is right now. I'm trying to find the little joys in my day.



For instance: today my student saw all the patients for the morning. She is doing fantastic. I am having to give less and less direction. Today she inserted her first IUD and was so proud of herself. My postpartum mom was beaming and showing off her adorable baby girl. It was so great to share in her joy. I had a patient who is ready to address her weight issues and signed up for a weight management program. I had a great new OB couple who are from Russia and one from Mexico. I love having the telephone translation line. We got our next shipment of H1N1 vaccines so we can finish vaccinating our moms. We laughed so hard at lunch I had tears in my eyes (gallows humor, but a great stress reliever none the less).



This picture is of a flower that was growing by the side walk in Catalina. It reminds me to grow where I am planted.  For now anyway, that's what I am trying to do.

Thursday, November 12, 2009

hormone evaluations

 
I tap in my password and hit the return key.  The computer adds my electronic signature to the chart and I click onto the next patient on my schedule.  Reason for visit: hormone consult.  I sigh and begin to frame what I plan on saying to the patient about hormone testing, therapy, risks and benefits.  I walk to my exam room and lift the papers out of the chart rack by the door.  I turn them over and look at the name.  I raise my hand to knock on the door and I see her age.  12 years old.
 
"I want her hormones checked.  She has had two periods and they were more than a month apart.  She is angry one minute and crying the next.  She doesn't like boys but all her friends do and that makes her cry because all they want to talk about is boys.  Her boobs have just exploded!  She fights with me all the time and I am just tired of her. She needs to get her act together.  She needs her hormones fixed because there is just something wrong with her. And she needs on birth control.  I hate her....but it's OK honey, I really do still love you." 
 
I stare at the mom in disbelief.  I look at the girls eyes as they start to fill up with tears and then I see her turn angrily at her mother.  "Well that's OK cuz I hate you anyway." 
 
I spend the next twenty minutes explaining normal puberty, middle school angst, variable maturation rates of teenagers and try to explain why a hormone evaluation isn't needed.  I also try to explain as gently as I can why birth control is a bad idea for a 12 year old who doesn't like boys yet and who is still developing. After they leave my office I don't know whether to laugh or cry.  I spend five minutes tapping out a note about our visit.  I tap in my password and hit the return key.  Then I click onto the next patient on my schedule.
 

Sunday, November 8, 2009

3 greatest challenges

I think one of my greatest challenges is to try to educate and motivate my patients.  Just like medicine can't heal the body, we can only support it while it heals itself.  I can't help a patient heal unless they are willing and motivated to do their part.  The best medications don't work if the patient doesn't take them.  The greatest therapies or surgeries won't work if the patient doesn't want to do them.  Educating a patient on their diagnosis doesn't work if the patient refuses to admit they have a problem. I struggle the most with three issues:  Denial, non compliance (yes I hate that word but can't think of a better one) and lack of personal responsibility. I feel helpless at times to assist a patient in getting healthier, stronger, happier. 

Denial:    The diabetic who refuses to check her blood sugar, who says"But I am really healthy other than my diabetes" and then comes to see me because she is peeing all the time.  She is sure it must be a bladder infection, or a problem with her bladder.  It can't be that her blood sugar is elevated and that makes her kidney's overproduce urine in an attempt to lower her blood sugar. Her normal urine culture and large amounts of sugar in her urine don't convince her.  The normal bladder exam doesn't convince her.   She wants me to fix her problem.  And gets upset when I say the way to fix it is to get her blood sugar under control. The teenager who doesn't want to believe she has placed herself at risk for an STD and doesn't want tested or to use condoms.  And then cries six months later when I say she has Chlamydia or even worse, an STD I have no cure for.
 
Non Compliance:   There is the woman who comes in pregnant and insists she was using birth control but then admits she decided she didn't like having to take a pill every day so she just took them when she had sex and can't figure out why she is pregnant.  "The medicine you gave me just didn't work." is a common complaint...but they didn't take the medicine like they were instructed. You can't take a 10 day antibiotic for one day and expect it to cure your severe bladder infection. If you want to get better, you should probably come to your appointments.  If you aren't getting better, you should probably come to your appointments so we can try a different treatment. 
 
Lack of personal responsibility: The problems they are having are not their fault.  They tell me it is my fault.  Or it is their parents or spouses fault.  I see a huge lack of willingness to accept personal responsibility for their own health.  I see many patients who want an instant fix for their problems.  They don't want to hear that it will take effort.  They want instant cures, something that doesn't inconvenience them, isn't uncomfortable and that requires no effort on their part.  If they didn't take the medicine, it isn't their fault.  If they didn't go get a test done, it was because it wasn't convenient enough.  Or the patient who "has to be seen right away" but can't make any of the appointment times we offer.  Then tell us we are refusing them access to care. 
 
What do I see in patients who do get better?  Honesty, personal responsibility, and persistence. But that is a blog for another time...