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Thursday, April 27, 2006

Whoopsie...

Hey! Did my first foreign object retrieval yesterday, on someone in for their first exam ever, no less. Me: "um, did you guys have a condom break recently?" Her: "yeah, actually, on Monday..." Me: "well, here it is...."

Good opportunity for me to do a little education about Plan B. Everyone: If a condom breaks, you COULD GET PREGNANT! It's not over-the-counter yet thanks to politics trumping science in the FDA, but you can take Plan B up to 5 days after an incident like this and reduce your risk of getting pregnant by 75-80%. Ask your doctor or friendly nurse practitioner about it. Get some. Keep it in your sock drawer so you don't have to panic if a condom breaks.

And if you're 16 and had a condom break, you might want to panic just enough to mention it to the person doing your exam wondering what on earth that thing might be...

Tuesday, April 25, 2006

TV free zone day 2

Much like day one. I guess this is a bigger deal if TV is a big deal to you. Though it is nice to not have the constant background noise and ads ads ads. So on to a different topic.

Things I have learned that I would be just as happy not knowing:
Fake boobs really do feel fake.
Those spray-on tanning places leave tan lines in some really odd places.
The latest fashions in piercing, tattoos, and hair-removal patterns
Not to mention the latest fashion in ring tones. Folks, do you really want to take a call from the exam table? Turn the blasted things off!

Monday, April 24, 2006

life without TV, day one

Ok, so I got up at 5:15 this morning to go for a run, and yanked the plug on the TV first thing, so that any kids wandering downstairs before I got back wouldn't be able to just reflexively turn it on. Unfortunately, that's how many of our days start: "turn it off -- you know there's no TV before school..."

Then, since it was cold and rainy, I decided to go to the Y and hit the treadmill. I hadn't thought about how to avoid the giant bank of TV's the treadmills are oriented to. I picked the back row, took off my glasses, cranked up the tunes and focussed on the middle distance. Oops, picked a treadmill on the left, vaguely in front of the TV that's constantly tuned to ESPN. Must avoid baseball news....

Later, I went to work. We have a TV in our waiting room that is constantly on, tuned to terrible daytime dregs of humanity shows. No problem avoiding that.

Came home to dinner, and afterwards sat on the floor playing with S. (when he wasn't agitating to play computer), read a few books, still wound up getting the kids to bed a little late (thought I'd feel like we were gaining at least a little free time -- I should have picked up a half hour when I normally would have been watching "Good Eats").

No Sox game today, so no inner conflict there. Unfortunately, they're playing the Indians this week, and we'd actually be able to watch the game on cable here...

So, day 1, quieter house, otherwise not much difference. Easy for me to say, since I'm out of the house much of the time anyway. The real adjustment is in being at home with the kids and trying to get things done while still keeping them entertained.

Friday, April 21, 2006

'Nuff said...

Instant karma's gonna get ya...

Friday, April 14, 2006

Media blackout

April 24 is the beginning of TV turnoff week, and I'm getting ready. I've decided to lay off MLB.tv for the week, but I will probably still have the little Gameday play-by-play up during Sox games. I don't watch anything on a regular enough basis that I'll feel like I'm missing something if the TV is off. The kids will be back at school that week, which makes things a little less stressful than if we were banning TV this week (on vacation week).

We will have to unplug it... I'm sure we'll get a lot of resistance.....

Thursday, April 13, 2006

Pseudacris crucifer

Some new rap artist we haven't heard of yet? No, just spring peepers. They're singing all day here. they don't even wait for dusk. Other signs that spring is here, besides the tulips planted by the previous tenants? Ungodly amounts of roadkill. Squirrel, skunk, raccoon, fox, deer, things I don't even recognize....

Spent the day today calling people to find out if they'd gotten the follow-up care I'd asked them to do. Funny mole checked out? No -- no insurance. Mammogram to take a closer look at that breast lump? No, couldn't get a ride. Other phone calls to people who have moved, cell phones that were not in service, nothing finished. A foot-high stack of charts in my bin still needing something. My office looked like the medical records room exploded for most of the day.

I never did mention what had happened to the woman with the adnexal mass I sent to the ED. Turns out it was indeed a rather large ovarian cyst. They wrote her a prescription for some stronger pain meds to get her through the weekend, and she folllowed up with us the next week. It ruptured and resolved on its own.

Hey, Liz, if you're reading, e-mail me! I can't find your e-mail address! I have some med questions for you...

Friday, April 07, 2006

Must read...

Oh, yeah baby, right here ...

Tuesday, April 04, 2006

multitasking like mad...

I'm finishing up the taxes, e-filing, and watching the Sox on the computer. I finally bit the bullet and signed up for MLBtv, since we can't see any games out here given our standard cable set-up. So recipe for depression -- taxes and death by Texas Rangers all at once. Yesterday we won our first opening day game in five years, and today... not so much. Ah, well. At least I'm pretty happy about how Coco Crisp is doing thus far...

One of the girls at work knew someone who was trying to find a home for two parakeets. They came with their cage and all, nothing to buy... So now we have a couple of birds. The kids are loving it. Now we've had just about everything but a dog... that will have to wait until we get a house. Gotta have someone to run with!

Saturday, April 01, 2006

regina papilloma

Things seem to come in streaks at work. At the beginning of the month, I was crowned the wart queen, because I was seeing so many cases of genital warts. I became quite adept at burning them off with a toothpick or the wooden end of a sterile swab soaked in TCA. I had a regular lineup of repeat customers coming back for weekly treatments. One of the nurses told me one morning "we had a patient come in last night with warts -- and I thought of you." How sweet. I wondered how I could abdicate my reign and pass the crown on to someone else.

Then, suddenly, the warts dried up, so to speak. It was herpes week. People kept coming in with the chief complaint "I have bumps down there" but they needed acyclovir, not TCA. We sent viral cultures to the lab and wrote lots of scripts, and told people to pour warm water over their bottoms when they peed, so it wouldn't sting so much.

I guess we shouldn't have been talking about stinging while peeing, because this past week was UTI week. I'm starting to hate Bactrim because it doesn't ever seem to work. It's the first thing we prescribe (as long as you're not allergic to sulfa drugs) while we send a urine sample for culture and sensitivity. Two days later, I call you to see how you're feeling (I never seem to have my C&S back by the time I'm supposed to check back with you) and you're still miserable. So I call in a script and send you to the drugstore for macrobid.

I'll have to keep your chart in my bin for at least a week while I wait for labs, call you, and call you again to see if the second antibiotic worked. I'm going to call you rather than wait for you to call me if things get worse. Because you probably won't call me and I'll worry that you're in the hospital with pyelonephritis. Probably because the first girl I saw with a UTI said in an offhand fashion "oh, last July I was in the ICU with a kidney infection. And I've been having back pain..." Her C&S came back resistant to about 2/3 of the antibiotics we could have given her. And I chased her for a week trying to make sure she got the right meds and didn't end up back in the hospital. She wouldn't call to check in, she wouldn't come back for follow-up, she gave me a few more grey hairs.

It was a lovely warm sunny week and I didn't get to enjoy it because I work inside, in rooms with the blinds drawn. Twenty minutes before I got off work on Friday, a cold front came through and it started raining. Grey and 40s today. People were out burning brush all week. Plumes of smoke and campfire scent dotted my drive to and from work