Monday, August 31, 2009

Flu is here to stay.

I suppose you'd have to be living in a hole for the last 4 or 5 months not to have heard about this year's flu strain. I refuse to call it "swine flu" because that sounds more sinister, confuses people, and makes them worry they can get it from eating pork.

I saw at least 6 people in clinic today who most likely have it. In kids, it seems to mostly be causing bad colds with high fevers. Adults tend to have more GI upset, vomiting and diarrhea.

My advice: if you are otherwise healthy, don't come to the doctor, and definitely, DEFINITELY don't come to the ER. This includes children. Yes, you will feel horrible. Yes, you should stay home from school or work until you've had no fever for 24 hours. Most people get over it in 3-4 days. The medicine doesn't really help that much, (you feel better maybe 8 hours sooner) and costs like $100. Motrin is great for fever and headaches. If you have chronic health problems, like diabetes or lung disease, then you should come in, just because these are the people more likely to get worse complications.

My other advice: GET YOUR FLU SHOT! Regular flu shots should be ready soon; go ahead and get them. The H1N1 vaccine likely won't be ready until October (probably too late to do me any good) but you can get that one then.

My other, other advice: WASH YOUR HANDS! especially when you are around anyone who is sick.

Wednesday, August 26, 2009

Good summer eating.

Our tomatoes are just now (finally!) starting to come in - we got a late start this year, but the last few days we've been picking a few here and there. I cannot wait to do more cooking with our fresh tomatoes. I thought I'd post two links for my favorite summer recipes - perfect for fresh, delicious tomatoes.

We've been making grill pizza a lot these days - we had not made any for a while, and I've certainly felt like we needed to catch up. My favorite is still topped with olive oil, rosemary, caramelized onions, sliced tomatoes, and cheese.

And finally yesterday we made our first batch of bruschetta for the summer. It is easy to forget how delicious this simple recipe is - we have some leftover today and I'm excited about including it in our dinner tonight.

Any other favorite summer recipes out there?

Tuesday, August 25, 2009

Health Care Reform.

With all this talk out there about health care reform, I thought I'd add a few comments.

Let me start by saying that I do think some things need to change - insurance companies seem to have some of the most reprehensible policies and try to avoid paying for everything they can. Every day, I have some kind of paperwork to fill out trying to get people the medicine they need. I hate it that insurance is so expensive - and I would love a way for more people to get it.

That said, there are numerous problems with the President's plan:
1. Forcing people to buy insurance doesn't really seem like a viable solution.
2. Having a huge government option will likely drive other companies out of business, decreasing competition and taking away people's choices.
3. Taxing what employers pay for insurance is not a good idea - this will hurt businesses, especially small businesses.


Finally, what I see as the biggest problem:
Obama has spoken repeatedly about decreasing wasteful spending. I definitely agree that there is a lot of waste in our healthcare spending. The biggest reason for it, though, is not because doctors are trying to make more money or are deliberately defrauding the goverment. The reason doctors order more tests than needed is because they are worried about getting sued. Patients who come to the ER are going to get just about every possible blood test, radiology test, ultrasound, etc, just to make sure the ER doctor cannot be sued. Similar things happen in our primary care clinics. In this current climate of everyone being willing and able to sue physicians over anything, with no limits on damages, doctors are afraid if they do not order the most comprehensive test, it will come back to get them later.

Certainly, when physicians make egregious and purposeful errors, they should be punished, and the patients they harm should be taken care of. But there is a difference between taking care of a patient and levying a 30 million dollar "pain and suffering" remuneration against the doctor.

If you really want to save money in health care, make some reasonable tort reform. No health care reform can really be meaningful without it. Of course, I'm not holding my breath for that one, seeing as the biggest donors to both parties are trial lawyers, and most of the senate and house at one point actually were trial lawyers. But "real change" - if that is what the president wants - needs to include this, too.

Saturday, August 22, 2009

My kind of saturday.

1. A lovely delicious breakfast - stuffed french toast and sausage - eaten at about 9:30am.

2. Eating that breakfast with some of our closest friends here in Greenwood.

3. A post-breakfast nap.

4. Leftover grill pizza for lunch.

5. Chilling on the couch for most of the afternoon.

6. Baking a chocolate cake for church tomorrow. (And sampling a little icing - just to make sure it was good.)

7. Watching the BBC version of Pride and Prejudice for the first time.

8. A nice pre-dinner bike ride.

9. Grill pizza for dinner. (Yes, we ate it for both lunch and dinner. That is just how good it is.)

10. Enjoying the smell of freshly baking pesto rolls my husband is making for church tomorrow.

11. Relaxing at home all evening.

Friday, August 21, 2009

TV

I have never been excited about having the Lifetime Network as part of our cable package until I realized that Project Runway now comes on that channel.

Now all I'll be watching is the Food Network and Lifetime. I'm such a old woman.

Tuesday, August 18, 2009

Should I mow the lawn this summer?

Its something of a cruel trick of nature here in the south, that the months which require the most lawn mowing are also the months in which lawn mowing is least desirable. These days the heat index is just shy of Hades, and the humidity is barely short of actually raining, so putting on long pants and closed toed shoes to mow the lawn is not so appealing. So while my heart tells me to grab a cool beverage and stay in the nice A/C, my head tells me to be more logical about this, and to think things through. So I began to think...

1. Naturally, my thoughts go first to our national economic situation. Buying gas for the mower might be a good stimulant for the country and keep somebody in a job. Mow: 1 Not Mow: 0

2. However, gas is also a non-sustainable fuel, and running my mower causes unpleasant emissions which contribute to global warming. Is it really worth killing the polar bears just to have an aesthetically pleasing lawn? Mow:1 Not Mow:1

3. By now, many bugs, crickets, and other small animals have taken up residence in my lawn. Would it be right to heartlessly mow down their habitat? What would PETA think? Mow: 1 Not Mow: 2

4. Of course the real question here is, is it Biblical? In 1 Corinthians 3 Paul mentions that one man plants and another waters. But notice how he fails to mention the presence of a third man who mows. Perhaps what I really ought to be doing is either planting more grass, or watering the grass I currently have, and trusting that if God is giving growth, then he must intend for me to have long grass. I should not try to out do God by artificially controlling the length of my grass. Mow: 1 Not Mow: 10 (bible reasons count extra)

Question answered. Sorry neighbors.

Monday, August 17, 2009

Observed.

The campground we went to this weekend was filled with mostly campers and RVs, and almost everyone brought their boat and/or their jet ski.

It also seemed like everyone had a golf cart - mostly these just seemed to be used to cruise around the campground after dark while shirtless. (At least the men were all shirtless. And tattooed.)

Apparently, golf carts must be the new thing to have and soup up, because I saw THREE golf carts with ground effects - i.e. - blue lights underneath, TWO that were painted with flames down the side, and one what I'll call a "monster" golf cart with huge wheels probably 3 feet tall.

We just had to resort to what is called "walking" to get around the campground. We are so behind the times.

Friday, August 14, 2009

Turning the tables

We're going camping this weekend with another couple. "Car camping" as we like to call it.

Jeff left yesterday with Jason to set up the tent and make sure we get a pretty good place. So for the first time in a long time (definitely the first time since we moved to our current house) I was home alone last night.

I realize Jeff deals with this all the time when I'm on call, but it was a first for me. I didn't really like it. Our house was too quiet. That is not to say that Jeff makes a lot of noise - those of you who know him know that he makes few noises. But I didn't like the weird noises, or even just coming home to a house that is empty.

Lucy didn't like it either.

Thursday, August 13, 2009

Bad bloggers

We have been bad bloggers. I have been harassing Jeff to post something, but thus far it's no go. Instead of his funny, witty posts, you will now get some random 2 am thoughts:

It's now 2 am and there seems to be little chance I'll ever leave the ER tonight.

I'm learning it is not always easy to be on call with new interns. It would be so much quicker and easier if I just did it myself. That, though, would defeat the purpose. Which is what I have to keep telling myself over and over, especially at 2 in the morning, when all I can think about is how I'd really, really like to go lay down. I've never been a patient person, but 2am might be my least patient time of day.

I love the new Gatorade G2. It's not oversweet, but refreshing, especially when it's....you guessed it... 2 in the morning!

I need to take out my contacts.

We had a fairly sick patient earlier. I realize just how much I've learned in that I knew more or less just what to do for him, and could calmly do it. He's now doing much better. Residency is a great place - even though it might not be my favorite at 2 am.

I discharged 2 ER consults straight from the ER to home. Most of you don't know what that means or care. But to us, it's always like a personal victory - making sure people who don't need to stay in the hospital don't get admitted in the first place. Woohoo.

Friday, August 07, 2009

Collector

I am, I have recently decided, a collector of experiences. I do not collect knick-knacks or china, but I want to experience things, which I line up in the proverbial shadowbox in my head. Eating insects? hmm - we'll put that one on the shelf next to swimming in the amazon and making myself a dress. During the first year of med school, I went swimming in the ocean every month of the year, just so I could say I had.

I think maybe that is at least part of the pain of infertility. Not knowing if I'll ever experience pregnancy. Or giving birth. Or feeling the flutters inside you that are another human being, moving around. I hear my patients talk about it, my friends describe but, but I want to actually live through it. It's like I have this checklist in my mind that I am slowly making progress on - going to med school - check, completing a triathlon - check, getting a successful intubation - check, and then I come to "have a baby" and it feels like I can't move past it.

Instead, I add a few unexpected things to my list:
hysterosalpingogram
fertility medication
appointments with specialists
miscarriage

And yet, I know deep down that these things, though unwanted, are still useful and even beneficial me. I strongly believe they have made me a better doctor. Even today I was able to give a lecture about infertility, its treatments, work-up, and causes to all the other doctors at my program, giving them just a glimpse of what this is like from a patient's perspective. And I know that all these things have instilled in me more prayer, more faith, and more love for a God who is enough and has sustained me through all of it.

I am reminded of this bible verse: Romans 8:32
"He who did not spare his own Son but gave him up for us all, how will he not also with him graciously give us all things?"

I am suddenly not so sure why I worry so much about my checklist. I've already been given God's own son - and even have a promise to be given "all things." I know that this doesn't necessarily include pregnancy, but it is good to be reminded constantly of the gracious God we serve. And that whatever he brings my way will be wonderful. Even if I don't realize it at first.

Thursday, August 06, 2009

Creation - 2 parts

1. Jeff and I walk almost every day, usually 1 lap around the neighborhood, mostly for the benefit of our dog. In the summer, though, I especially enjoy them. Around dusk in the summer, we gets lots of bats flying in our neighborhood. I am not sure why I enjoy watching them so much. Bats are, after all, disease-infested and slightly cringe-inducing, because they seem like, and basically are, a flying rodent.

Nonetheless, I always smile as I watch them swoop and dart back and forth over our heads.

2. It's been super hot and humid lately, which is not nice. The humidity, though, seems to induce these late-afternoon/evening thunderstorms, which I also find to be wonderful. We were walking the other night and I loved getting to watch the long arms of lightning shoot back and forth across big clouds. I sometimes call this type of lightning "heat lightning" but I've also called it "sheet lightning." I realized that I had at some point likely misheard what it was really called. What do you call it?

Wednesday, August 05, 2009

Hitting the gym.

Some things in medicine require more muscle than others.

For example, being an orthopedic surgeon. Lifting large limbs, breaking and resetting bones, using drills/saws/chisels - all use lots of muscle.

I'm learning that intubating people also requires a lot of muscle. You'd be surprised at just how difficult it is to lift up the jaw and hold it up while trying to put a tube in it. Plus you have to be very careful not to break any teeth. No one wants their teeth broken. Not to mention that holding a mask on a person's face with one hand and breathing for them with your other hand requires both coordination and strength.

I write all that mostly because I've noticed my bicep/tricep strength leaves something to be desired. I guess it's time to do some sort of weight-lifting.

Monday, August 03, 2009

New rotation.

Well, I would have posted some new photos, but the camera battery is dead.

Today I started an anesthesia elective. Mostly, I wanted to do this rotation so I could get better at intubations and maybe get a few central lines, with the hopes that I'd get enough to get privileges before starting medicine in 2 months. I thoroughly enjoyed day one - 2 intubations and 1 central line. I'm already feeling better about my intubations - I've never felt very confident in doing them, but today was good practice and I got some great tips from the CRNA.

Hopefully the trend will continue.

Sunday, August 02, 2009

Home.

We're home again from our travels - seeing all of our nephews and our niece within the span of 1 week was wonderful.

Our tomatoes are oh-so-close to being ripe. We got a late start this year, but finally, finally, we have some delicious looking green ones slowly ripening. I can't wait to eat the first one.

We will have some photos to post soon. I promise.