Best Thing

Sometimes the best thing that happens in your day is that your scary psychotic patient doesn't show up.

Bad Mouthing

Why is it that different medical specialties AND doctors within the same medical specialty love to badmouth each other? He is a bad doctor because he didn't do this, she's a bad doctor because she didn't do that, surgery hates medicine, medicine hates surgery, everyone hates family medicine, psychiatrists are crazy. I have been guilty of this myself. But, you know what? We all do our best. We all have 24 hours in a day and spend at least 10 of them working, usually more. We worry about our patients when we go to bed at night, we try to do our best by them because we are responsible for them. Orthopedic surgeons ask you for help because they are busy worrying about the broken hip in the ER that they have to get to the OR and feel unsure about that insulin order, family medicine asks for your help with the Guillaine Barre syndrome because they feel uncomfortable sitting on them until a hospital with a neurologist deems the patient bad enough to take them, the internist, they didn't know the patient's fracture needed reducing when the ER doc had casted it. We all work together, we all need each other, let's pull together and stop bad mouthing each other.

note to self

stop reading ratemds.com

I'm back!

Back from Italy, ate too many carbs, drank too much wine, had an amazing time. Feeling a bit jetlagged :) zzzz. Went in to the office today on my usual day off to work through all the messages. Found out that the person's license I took away before I left (she screamed at me for 5 minutes over the phone) came in and had a MOCA score of 1/30... for those non-medical types, that's really not good. I was dreading seeing this patient and am really glad she was seen when I was away by our superstar N.P.

 One of our partners quit today so we'll be looking for fresh blood. Can't say I didn't see it coming.

All of my OB patients who acted up the week before I left started behaving themselves as soon as I was out of the country! score!

All in all, this 2 weeks off was a success. I'm still looking forward to going to the St. Paul's family med conference in Vancouver next month - another week off!

dreading the backlash

This week I took an extra day off in order to spend a long weekend biking in Allegheny park in NY/PA. I took ONE DAY and came home to 40 messages in my EMR inbox and a backlog of crap to deal with. My stress level shot up to 13/10. Maybe even 20/10. I felt like I never left. I hope my 2 week vacation doesn't end up this way.

vacation rocks but getting ready for vacation sucks

I hate getting ready for vacation because it means:
1) doing more call in preparation for vacation so you can get the time off
2) making extensive handover notes on all OB patients just in case they crash and burn while I'm away
3) stressing about packing
4) worrying about crashing in a ball of fire and dying on the flight over
5) worrying that I'm going to forget something when packing

If your stomach has become noisier in the last 2 months and you are worried, fear not, I will do nothing about it when you come to see me. Staying home would probably be a better thing to do.

my body is rebelling

Over the past week my GI system has started seriously rebelling - painful gas one day, GERD, diarrhea. Each on their very own day and not at all related to what I have eaten (I think). I don't feel particularly stressed but I have started forgetting things and putting the milk in the cupboard, so maybe I'm just ignoring my stress better...

I do not have to work for 4 whole days. Amazeballs!

the slooooow crack

Our manager we hired has officially turned down the job after an informal acceptance. I almost cried. I have never really been speechless before... I was speechless. I went to bat for this woman and basically convinced quite a few of my colleagues to go for her and she let me down. I probably feel more gutted than I should, but I was really looking forward to finishing up with my "extra duties". I'm sick of this.

Thankfully, I haven't been sued yet.

I brought a proposal today to our physicians at our board of directors. The proposed plan would have simplified patient's lives and improved patient care and leveraged our already available services from allied health professionals. Why was it rejected? Money. Even though the numbers show that the majority of physicians would not lose any money. Normally I wouldn't take something like this so personally but today I was totally pissed off. Well, live and learn, try to do something good and you get shot down. Maybe I should just stop trying.

Manager Hired!

We finally hired a new manager. Hopefully this one will stick. She seems to have all of the great relevant skills and is very nice. Now to vomit all the things I have learned out of my brain and into hers! I am very excited to get these extra tasks off my plate.

I have been waking up in the middle of the night a lot lately, anxieties, fears, almost like going back to my first month in practice when I worried about everything and anything. I feel like I'm back in that headspace, like someone is suddenly going to figure out that I'm an imposter and I'm not worthy. Someone is going to find me out and sue me and my life will never be the same. I don't know if anyone else feels this way, but I do.

In other news, we are building a deck. Ben and I aren't very good at cooperating on things like this but thankfully there haven't been too many disagreements - just a few bickering sessions! The deck beams and joists are almost done, we're just waiting for some cement to dry and then we can start putting on the deck boards! I'm stoked to hang out and have a drink on the deck when we're done.

change... again

Our office seems to be in a constant state of flux. Managers retiring, new manager starting, managers sucking, managers leaving, interviewing new managers etc. etc. etc. In the absence of a manager the MDs have had to pick up the slack and act as an office manager. I must often have a look of panic on my face because my colleagues have told me I need some time off. I dream about full sharps boxes and paper shredding boxes and needing to discipline employees. I just was not trained for this and never wanted to do anything like this. Management is just not something I get any pleasure from. I also don't like change. Too much going on all at once.

Plus, I have a patient who came in to get copies of his xrays of an injury to "take to a lawyer" and now I wake up in a cold sweat afraid that I'm getting sued. I'm just waiting to be served papers. Ugh. I know I didn't do anything wrong, but that doesn't mean you don't get sued in this business...

Wendy Davis

I hope that you all, like me, are standing in support of Wendy Davis. She is standing for 12 hours in the Texas State Senate to filibuster the anti-abortion bill. You can watch her live here:
http://www.youtube.com/watch?feature=player_embedded&v=2Q8Hr0O20LY

good karma

I must have done something right because the day after my wonderful natural childbirth experience, I had another great delivery! Someone's smiling on me.

fibromyalgia

How many times in a day can you argue with patients about not increasing narcotics for a syndrome that narcotics are not indicated for and haven't actually helped this patient very much given that their pain scores haven't changed with the last increase? I think pain management in general but specifically fibromyalgia management is one of the most frustrating parts of my day. I feel like neither of us leave satisfied from that encounter ever.

Ouch and Yay

Not every birth is beautiful. Most are, but some are hair raising and anxiety provoking and it takes a while to see the beauty. Then, there are some births that are just amazing right from the start. Today I saw one of those. Natural, 2 cm to fully dilated in 45 minutes, 3 pushes, healthy baby. Extraordinarily, it was a 39 year old mother who had been told that she had a very high chance of her baby having Down's Syndrome or another genetic anomaly and who had spent the last 2 weeks coming into my office telling me that she had a bad feeling about this pregnancy and that the baby wanted to come out. It all turned out wonderfully in the end. Phew.

Now on to the ouch. After my race I discovered that the little finger and half of the ring finger of my right hand are numb. It's called a handlebar palsy and is quite common for cyclists. Unfortunately, it hasn't improved much over the past week and it's very uncomfortable to do thinks like wash my hair because something about the texture of hair on my numb fingers is very painful. I really hope this gets better soon because I feel I can't ride my bike until it has resolved to avoid further injury. It's a bummer. I really don't enjoy running this much!

The Real Test

This weekend I went to Lake Placid/Wilmington NY and participated in the Wilmington 100 mountain bike race. It was the most amazing race experience I've ever had. It wasn't because of the race itself, it was because of the people. I think I almost cried 3 or 4 times due to the inspirational speeches that were made at the pre-race meeting. I had the amazing privilege to ride and chat with Rebecca Rusch ( my new girl crush - she's kicking ass and taking names in her 40s setting endurance records and she is SO genuine and nice it's unbelievable) at the pre-ride.

The founder of Leadville, Kennith Chlouber and his wife were there and he gave a similar speech with her to this: http://www.youtube.com/watch?v=I9N_YT-kIaI . I remembered it during the entire race and it pushed me to go further than I thought I could, faster than I thought I could, and push through the killer leg cramps that were so bad I could hardly get back on my bike after pushing it up a loose climb, but I did. I was better than I thought was. I did more than I thought I could. The high of finishing 1 minute under my 6 hour and 30 minute goal was great. I only hope to get faster next year (and maybe train a bit more for endurance - I think 2 endurance rides probably weren't enough). 

The other inspiring thing was the number of amputees there were who raced hard and fast. It was awesome and amazing.

110 km and 7,641 feet of climbing. I wasn't first. I wasn't last but I did it. 

is it working?

Who knows if this physio stuff is working. 4 weeks until my 100km off road/on road race and 4 hour ride today. verdict was: my back hurt. Is it any better? Probably not. Am I going to do 4h of singletrack on race day? no. I think there's probably 2 km of singletrack in the whole race. I need to start just road biking on my mtb.

Most annoying

I tried not to tell the physiotherapist that I was a doctor because often that colours your interactions with other healthcare professionals and not always in a positive way. Unfortunately, I had to put my occupation on the survey. This lead to the very annoying question of "what do you think is going on"? if I knew what was wrong, I would have fixed it myself! Of course, when I told him, he agreed. Hrm.

Doctors are the worst patients

Why is it that I can't seem to take my own advice? I've been suffering through horrible back pain every time I ride my bike for about a year now. I remember that last year's 8 hour race turned into a 4 hour because my back hurt so much. Fast forward, this year's 8 hour is in a week, today's 3 hour ride had to be cut short at 2 hours because of... wait for it... cripple back pain! I really should have gone to a physiotherapist (which is what I would have told my patients) a year ago. Why didn't I go? I'm cheap. I have no coverage and physio is expensive. Yes, I can afford it but would prefer if the pain just went away on its own, but it hasn't, so tomorrow I'm calling for a physiotherapy assessment. A year of pain is enough I think! Hopefully I can get one organized pretty quickly and have it during my day off so I don't have to take any time away from work and cause patient and receptionist anger.