Starting tonight, I'm back to nights for the next four weeks. Sunday through Thursday nights, you can find me at the hospital from 7 PM til about 7:30 or 8 the next AM. Good times! I'll have Friday and Saturday night off, and for the last two of the four Sundays, I will be at the hospital at 1 PM instead of 7 PM.
The good news? I'm not the intern anymore. The bad news? I'm not the intern anymore. I won't be the all the dumb calls, but I will be the one getting all the serious calls. Scary but exciting!
Sunday, August 26, 2007
Friday, August 24, 2007
Update on my little girl
A few weeks ago, I wrote about a patient of mine who is a mystery to me as well as multiple other doctors. Unfortunately, I'm thinking I may be getting closer to the answer, and I don't like what we're seeing. We thought we had found a possible diagnosis, but we didn't think she fit it too well since she was missing one big characteristic. My heart sank when I walked into her room in clinic this week, and I immediately observed her performing this missing piece. There is a gene test that can be performed to assist in confirming this diagnosis, but it is extremely expensive and not performed at our hospital, so we would have to draw her blood and then send it to another lab in another city. We couldn't order the test in good faith knowing that her parents would get the bill when they couldn't even afford a month of one of her medicines that is likely 10% of the cost of this one test, so until we can work out the financial aspects, we will just continue to treat her symptoms. The results of the test will not change how we manage her care, but I know these parents well, and I know in my heart that if I can provide them an answer to why this is happening to their precious baby girl, I need to do that. Right now they still blame her seizure medicines for all the changes that they have seen in her, but I have a dark suspicion that it is something far more than the medicine itself. If it is within my power to do so, I want to be able to give them something more than "I don't know" when they ask what her life holds. If my hunch is correct, there will still be so many times I will say "I don't know," but at least I will be able to provide them with examples of what has happened to other children in the past.
That said, I firmly believe that God works miracles. I have seen more than one child come back from something horrible in ways that no one expected. My own little sister should have died fourteen years ago when she developed a horrible pneumonia and an empyema that was missed for over a week while she was hospitalized. She spent a total of two weeks in the hospital including several days in the pediatric ICU, and the doctors there told my parents to prepare to lose their little girl. Instead, God performed a miracle, and my sister is now a healthy 22 year old college student! I can only pray that He will work a similar miracle in my patient's life. If He chooses not to do so, I know that He has a perfect plan, and I pray that He will provide comfort both to her family as they care for her and for me as I feel helpless to make it all better.
That said, I firmly believe that God works miracles. I have seen more than one child come back from something horrible in ways that no one expected. My own little sister should have died fourteen years ago when she developed a horrible pneumonia and an empyema that was missed for over a week while she was hospitalized. She spent a total of two weeks in the hospital including several days in the pediatric ICU, and the doctors there told my parents to prepare to lose their little girl. Instead, God performed a miracle, and my sister is now a healthy 22 year old college student! I can only pray that He will work a similar miracle in my patient's life. If He chooses not to do so, I know that He has a perfect plan, and I pray that He will provide comfort both to her family as they care for her and for me as I feel helpless to make it all better.
Ouch!
About seven weeks ago, I was in an accident where I was hit on the driver's side (my fault). Ever since then, my back has been hurting. It has actually been getting a little worse over the last two weeks. Hubby knows it's actually bothering me when I'm talking about going to see "a grown-up doctor" as I call them. In the meantime, I've been taking some advice from my dad (a grown-up doc) and trying several suggestions to alleviate the pain. One of them is so use capsaicin on my back, so last night we stopped at CVS to pick up a bottle. Dad had suggested I use the liquid because it is less messier than ointment and would be easier to apply when I'm at the hospital for the next few weeks (my month of night float starts Sunday -- whoo hoo!).
As we were getting ready for bed, I made sure I put my eye cream on before the capsaicin so that I wouldn't burn myself. Unfortunately I didn't realize how often I really touch my eyes because I inadvertently rubbed my upper eyelids 20 minutes later. Despite having washed my hands, I still had some residual on them. Ouch! It was quite warm!
As we were getting ready for bed, I made sure I put my eye cream on before the capsaicin so that I wouldn't burn myself. Unfortunately I didn't realize how often I really touch my eyes because I inadvertently rubbed my upper eyelids 20 minutes later. Despite having washed my hands, I still had some residual on them. Ouch! It was quite warm!
Monday, August 20, 2007
Puppy drama!
Oh my goodness, what a day! The day started off shortly after 5:45 with my hubby rolling out of bed. I lazily dragged myself out of bed a few minutes later and started getting ready. At 6:30, Hubby was loading up the car with his suitcases when I noticed that Sebastian had something in his mouth. I was able to see that it was one of my soft foam ear plugs ... right before he swallowed it. I immediately went into panic mode and let Hubby know what had happened. Of course this event didn't change the fact that his plane was leaving in an hour and a half, so he was forced to leave while I stayed with the puppy. Sebastian was acting pretty normally, but since he weighs less than 3 pounds, I wasn't sure if he could handle the ear plug in his gut.
I called his vet as soon as the office opened at 7. The girl answering the phone said that she thought he would be okay but to call back in an hour to talk to someone else. I called at 8, and the nurse I spoke with asked me to go ahead and bring him in. We arrived at the office at 9 and were seen around 9:45. The vet (not our normal vet but still great -- I love this office) told me that if Sebastian had been a Labrador, she wouldn't be worried about the ear plug, but since he was so little, she thought it would be best to induce vomiting in the hope of retrieving the ear plug. She anticipated that the process could take two to three hours, so I left him at the office and ran some errands. When I showed back up around 11:45, she told me that he hadn't thrown up the ear plug yet but that she wanted to give him another round of vomiting before giving up. She let me come behind the desk to the room where the pets were being treated, and my heart melted.
Sebastian was in a row of cages that looked like horizontal lockers with grates instead of doors at the front. He had a towel he was resting on, and I could see little puddles of white phlegm that he'd been throwing up. His little beard was all wet, and his little ears were pulled back. When he saw me, he slowly tiptoed over to the front of the cage and licked my fingers as I stuck them through the grate. The vet let me open his cage, and he slid into my arms. He quickly found his favorite spot, nestled up on my chest with his head tucked over my shoulder next to my neck; then he turned and started to lick my cheeks. He was so docile, and I could tell he felt horrible. As I talked to him, he cuddled into me as deeply as he could as if to say, "Mom, please make all this stop." The vet told me to take all the time I wanted with him, but I couldn't stay much longer because I started crying right there in the vet's office. I felt so silly; Sebastian is only a dog after all, so why was I crying?
I left and called Hubby immediately upon getting into the car. I broke into tears again as I related to him everything that had happened since we talked last. I also told him that I felt responsible since it was my ear plug that Sebastian had eaten. He reassured me that he didn't blame me for any of this and that I hadn't forced the ear plug down Sebastian's throat (I'm guessing it had fallen off the nightstand in the middle of the night, but I don't know for sure). I felt a little better after talking with him, but I still didn't feel great about leaving Sebastian behind without a good solution. At home, I scoured the entire ground floor, hoping against hope that I had just missed the ear plug and that he hadn't really swallowed it, but no such luck belonged to me!
I still hadn't heard from the vet, so I left to pick my puppy up around 2 PM. When I got there, she saw me coming in and brought him out to me. He still hadn't thrown up the ear plug, so she discussed the options with me, and together we decided that I would take him home to watch and see how he did. Armed with the number of an emergency vet nearby, I returned home with my sleepy Yorkie baby.
We got home, and I could tell he immediately felt better knowing that he was back in his own domain. I got him to eat about twelve bites of his puppy kibble (how do I know twelve? I counted!), and we went upstairs to watch TV. About five to ten minutes later, all of a sudden, I saw him start to make gagging motions. I swooped him up with my right hand, and with my best mommy-to-be-one-day motion, I used my left hand to catch his throw up. To my (great) surprise, along with his kibbles was an intact ear plug!
I am so thankful that this has all turned out okay. I was very nervous about leaving him alone even for a few hours for me to go to work tomorrow (luckily for me I am on a rotation where I could take today off as I wasn't essential to the team today), but now I feel much easier about going to work. He is curled up next to me on one of his favorite towels right now, and he looks comfortable for the first time since early this morning. I couldn't imagine a better ending to this day!
I called his vet as soon as the office opened at 7. The girl answering the phone said that she thought he would be okay but to call back in an hour to talk to someone else. I called at 8, and the nurse I spoke with asked me to go ahead and bring him in. We arrived at the office at 9 and were seen around 9:45. The vet (not our normal vet but still great -- I love this office) told me that if Sebastian had been a Labrador, she wouldn't be worried about the ear plug, but since he was so little, she thought it would be best to induce vomiting in the hope of retrieving the ear plug. She anticipated that the process could take two to three hours, so I left him at the office and ran some errands. When I showed back up around 11:45, she told me that he hadn't thrown up the ear plug yet but that she wanted to give him another round of vomiting before giving up. She let me come behind the desk to the room where the pets were being treated, and my heart melted.
Sebastian was in a row of cages that looked like horizontal lockers with grates instead of doors at the front. He had a towel he was resting on, and I could see little puddles of white phlegm that he'd been throwing up. His little beard was all wet, and his little ears were pulled back. When he saw me, he slowly tiptoed over to the front of the cage and licked my fingers as I stuck them through the grate. The vet let me open his cage, and he slid into my arms. He quickly found his favorite spot, nestled up on my chest with his head tucked over my shoulder next to my neck; then he turned and started to lick my cheeks. He was so docile, and I could tell he felt horrible. As I talked to him, he cuddled into me as deeply as he could as if to say, "Mom, please make all this stop." The vet told me to take all the time I wanted with him, but I couldn't stay much longer because I started crying right there in the vet's office. I felt so silly; Sebastian is only a dog after all, so why was I crying?
I left and called Hubby immediately upon getting into the car. I broke into tears again as I related to him everything that had happened since we talked last. I also told him that I felt responsible since it was my ear plug that Sebastian had eaten. He reassured me that he didn't blame me for any of this and that I hadn't forced the ear plug down Sebastian's throat (I'm guessing it had fallen off the nightstand in the middle of the night, but I don't know for sure). I felt a little better after talking with him, but I still didn't feel great about leaving Sebastian behind without a good solution. At home, I scoured the entire ground floor, hoping against hope that I had just missed the ear plug and that he hadn't really swallowed it, but no such luck belonged to me!
I still hadn't heard from the vet, so I left to pick my puppy up around 2 PM. When I got there, she saw me coming in and brought him out to me. He still hadn't thrown up the ear plug, so she discussed the options with me, and together we decided that I would take him home to watch and see how he did. Armed with the number of an emergency vet nearby, I returned home with my sleepy Yorkie baby.
We got home, and I could tell he immediately felt better knowing that he was back in his own domain. I got him to eat about twelve bites of his puppy kibble (how do I know twelve? I counted!), and we went upstairs to watch TV. About five to ten minutes later, all of a sudden, I saw him start to make gagging motions. I swooped him up with my right hand, and with my best mommy-to-be-one-day motion, I used my left hand to catch his throw up. To my (great) surprise, along with his kibbles was an intact ear plug!
I am so thankful that this has all turned out okay. I was very nervous about leaving him alone even for a few hours for me to go to work tomorrow (luckily for me I am on a rotation where I could take today off as I wasn't essential to the team today), but now I feel much easier about going to work. He is curled up next to me on one of his favorite towels right now, and he looks comfortable for the first time since early this morning. I couldn't imagine a better ending to this day!
Monday, August 06, 2007
Goodbye
We buried my grandmother today. Today was horribly difficult and draining, but it was healing as well. I felt God removing my anger and was able to realize that despite her flaws, my grandmother still really loved me. I'm looking forward to seeing her in Heaven; until then, I want to make sure that my sweet grandfather is surrounded by love even if we're not physically there to show him how much he means to us.
My dad preached the funeral today. I forget how beautifully he speaks sometimes, and his words today moved me to tears. Throughout his speech, he spelled out the plan of salvation and the story of Christ's sacrifice and love for us. He quoted I Thes 4:13-18 -- "But we do not want you to be uninformed, brethren, about those who are asleep, so that you will not grieve as do the rest who have no hope. For if we believe that Jesus died and rose again, even so God will bring with Him those who have fallen asleep in Jesus. For this we say to you by the word of the Lord, that we who are alive and remain until the coming of the Lord, will not precede those who have fallen asleep. For the Lord Himself will descend from heaven with a shout, with the voice of the archangel and with the trumpet of God, and the dead in Christ will rise first. Then we who are alive and remain will be caught up together with them in the clouds to meet the Lord in the air, and so we shall always be with the Lord. Therefore comfort one another with these words." And he did.
My dad preached the funeral today. I forget how beautifully he speaks sometimes, and his words today moved me to tears. Throughout his speech, he spelled out the plan of salvation and the story of Christ's sacrifice and love for us. He quoted I Thes 4:13-18 -- "But we do not want you to be uninformed, brethren, about those who are asleep, so that you will not grieve as do the rest who have no hope. For if we believe that Jesus died and rose again, even so God will bring with Him those who have fallen asleep in Jesus. For this we say to you by the word of the Lord, that we who are alive and remain until the coming of the Lord, will not precede those who have fallen asleep. For the Lord Himself will descend from heaven with a shout, with the voice of the archangel and with the trumpet of God, and the dead in Christ will rise first. Then we who are alive and remain will be caught up together with them in the clouds to meet the Lord in the air, and so we shall always be with the Lord. Therefore comfort one another with these words." And he did.
Thursday, August 02, 2007
I have no idea
I have a patient right now that is such a mystery to me. No one has figured out what's wrong with her yet, but I'm determined to try. I met her for the first time in April, and I saw her yesterday in clinic for the first time in two months. Seeing how much she has changed for the worse in two months blew me away. I am still bothered by the tears her mom cried when I told her I believed that her daughter needed to come back into the hospital again so that we could provide her with a higher level of care than she could get at home. I've been so frustrated by my inability to figure out what she has despite several hours pouring over the literature and resources available to me. I may not find the answer immediately, but I'm not going to give up. She is my patient, and I'm going to be her advocate.
Last night my hubby and I prayed for her and for her family. I don't know how God will answer our prayer, but I know that He is faithful.
Last night my hubby and I prayed for her and for her family. I don't know how God will answer our prayer, but I know that He is faithful.
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