By nature I am a people-pleaser. I am the kind of person who wants people to like me, and I like people in general. When someone doesn't like me, I feel bad/sad/worried. If I am in a situation in which I want to especially please people, unfortunately, I tend to become tongue-tied and nervous.
This brings me to my mother-in-law. I want my mother-in-law to like me. I really want that. She's never exhibited any behavior that makes me think otherwise, but I am still (after over 9 years of marriage) worried that I might say or do something to make her not like me. So I tend to be overly nervous around my MiL, say stupid things, and occasionally behave like a dolt. Mostly because I want her to like me. Add that to a constitutional inability to ask people for help, and you get sort of a mental quagmire. But I waded through it, called up my MiL (who has never been anything but nice to me, remember), and asked if she would come help us.
She immediately agreed and arrived this past Monday. My MiL is not a traveler. She likes to stay close to home. Her usual visits are about 36 hours, which inevitably make ThePinkThing grumpy (why can't Grammy stay longer?) and sad. But this time my MiL stayed for 3 days. And it was great. Fabulous. Wonderful. She entertained TPT (in actuality, TH and I tend to become invisible when Grammy is around), yakked with me during the day, cleaned stuff up, had lots of chat-time with her son, and was a boon to the household.
I can't thank her enough for taking the time away from work to come and mother/grandmother this household, which was sorely in need of it.
And now, perhaps, I will be less nervous around my MiL, and our relationship will be easier.
Note that my MiL reads this blog -- I am not writing this for her or for daughter-in-law brownie points. I am already her favorite DiL (okay, I am her only DiL, so the competition is not fierce). I am writing this because the visit went so well that I wanted to comment on how I hope it helps me get over my overly-nervous behavior around her (no, my MiL will not eat me) and that things will be better in the future. Which is deserving of a "YAY!"
Showing posts with label Fears. Show all posts
Showing posts with label Fears. Show all posts
04 December 2009
01 December 2009
I am a statistic
It's really difficult to identify how many medical mistakes occur each year, even during hospitalizations. There was a study published in 2000 by the Institute of Medicine that estimated that 98,000 patients die in American hospitals each year due to medical errors. But these numbers are really difficult to substantiate -- and nobody has a clue as to how many survivable medical mistakes occur.
I know that I have made incorrect diagnoses on more than one occasion (hello, that is why we have 2nd opinions...), but I do not believe that any of my errors have directly led to the death of a patient. The closest I came was during residency, when I forgot to order DVT (deep vein thrombosis -- blood clot in the deep veins of the legs) precautions in a new stroke patient. DVT precautions haven't changed in the past 15 years -- compression stockings and/or compression boots (boot thingies that inflate and deflate, squeezing and relaxing the calf and thigh muscles). If for some reason these methods are unacceptable, then the docs use low-dose blood thinners.
Well, I forgot to order the compression boots, and in the middle of the night on this patient's 4th post-stroke day, she suddenly developed shortness of breath and low oxygenation. Not only had she developed a DVT, she had also developed a pulmonary embolus (PE) -- when a piece of the clot in the leg breaks off, moves upstream in the venous system and ends up in the lung(s). Thankfully, the patient survived, although her stroke recovery was not very good (and unrelated to the DVT/PE, most likely). However, I never forgot DVT precautions on any patient thereafter.
This leads to my recent hospital experience.
Post-operatively, I was given SCD's (the compression boots) and compression stockings. However, I literally couldn't stand the damn squeezing of those boots -- inflate, deflate, inflate, deflate. It was making me crazy, to the point where I literally ripped them off my legs. I told the nurse that I refused to wear them, that I couldn't stand it. I have no idea if she passed on this incident to the neurosurgical PA's or not. If she didn't, then she should have ("bad patient in room 3004 is NOT cooperating with the DVT precautions"). If she did report it, nothing was done about it, and something should have been. That leads to the reason why my hospitalization was 14 days instead of 5 or 6.
You see, I developed some mild right leg pain on day 5 or 6, but on day 7, my right leg began to hurt like hell -- worse than my back post-op and worse than the left leg pre-op. It was a different pain, sort of crampy, and drawing up. I told the nurse who passed it on to the neurosurgical PA. The leg wasn't swollen when compared to the other one, but the PA ordered an ultrasound to rule out a blood clot. "Just in case."
Now we all know how hard it is to get any useful information about a test from a technician. Try asking the MRI tech what your MRI showed, and they always say something like "the radiologist has to review it first." I wasn't going to accept any answer like that from the ultrasound technician. So I played the doctor card -- I said that I fully well understood that a physician would provide the final reading of the ultrasound but that I also knew she did this day in and day out. She actually capitulated and told me that yes there was a clot extending from the calf to the lower thigh in the right leg. Fuck, I thought. Fuckfuckfuck. Literally, by the time I got back up to my room, the nurses and the PA already had the final reading which was still "clot."
One treats clots like these with blood thinners, to prevent spread of the clot or pieces breaking off and lodging in less pleasant places. I was started on a drug I'd never heard of (Arixtra), which was supposed to get me fully anti-coagulated within 24 hours. "Fine" I thought. At that point I was placed on bedrest, which was not much more activity than I was actually doing. Except bedrest meant no bathroom privileges, and I had to use the dreaded bedpan. 'Nuff said about that.
Later that evening, around 11 pm, I awoke with left-sided chest pain, shortness of breath, and heart palpitations. I knew exactly what was going on, and for the first time, being a doctor was a major detriment. You see, I realized that a chunk of the clot had broken off, traveled up through the venous system and ended up in my left lung. Nobody could poo-poo me, or say "everything'll be alright", because I knew exactly what a pulmonary embolus was and that I was in danger for my life. They put me on oxygen which thankfully made the oxygen saturation of my blood go from about 84% on room air to 100% on oxygen. Someone finally got an IV in me and they gave me morphine which helped the chest pain. I was transferred to an intermediate care unit, which they do for all patients with pulmonary emboli (the blood clot to the lung). I called TheHusband and tried to minimize the situation. However, he consulted the University of Google ("blood clot, leg, lung") and found out a lot more than I wanted him to. He then spent a sleepless night.
I remained on the Arixtra and Coumadin (warfarin, aka rat poison) was added -- it is the only effective oral blood thinner available on the market. Eventually I had 98-100% oxygen saturation on room air, and the blood was thinning out nicely, so I was finally discharged, about a week after I should have been.
So even though I am a doctor, paranoid to the max about medical stuff, was being taken care of by an experienced medical team and an excellent neurosurgeon, I am also a medical statistic. A medical mistake. And because of my inability to tolerate the compression boots, I almost died, and now I'll be on blood thinners for the next 6 months at least. But I am grateful and thankful and lucky and happy to still be around...
I know that I have made incorrect diagnoses on more than one occasion (hello, that is why we have 2nd opinions...), but I do not believe that any of my errors have directly led to the death of a patient. The closest I came was during residency, when I forgot to order DVT (deep vein thrombosis -- blood clot in the deep veins of the legs) precautions in a new stroke patient. DVT precautions haven't changed in the past 15 years -- compression stockings and/or compression boots (boot thingies that inflate and deflate, squeezing and relaxing the calf and thigh muscles). If for some reason these methods are unacceptable, then the docs use low-dose blood thinners.
Well, I forgot to order the compression boots, and in the middle of the night on this patient's 4th post-stroke day, she suddenly developed shortness of breath and low oxygenation. Not only had she developed a DVT, she had also developed a pulmonary embolus (PE) -- when a piece of the clot in the leg breaks off, moves upstream in the venous system and ends up in the lung(s). Thankfully, the patient survived, although her stroke recovery was not very good (and unrelated to the DVT/PE, most likely). However, I never forgot DVT precautions on any patient thereafter.
This leads to my recent hospital experience.
Post-operatively, I was given SCD's (the compression boots) and compression stockings. However, I literally couldn't stand the damn squeezing of those boots -- inflate, deflate, inflate, deflate. It was making me crazy, to the point where I literally ripped them off my legs. I told the nurse that I refused to wear them, that I couldn't stand it. I have no idea if she passed on this incident to the neurosurgical PA's or not. If she didn't, then she should have ("bad patient in room 3004 is NOT cooperating with the DVT precautions"). If she did report it, nothing was done about it, and something should have been. That leads to the reason why my hospitalization was 14 days instead of 5 or 6.
You see, I developed some mild right leg pain on day 5 or 6, but on day 7, my right leg began to hurt like hell -- worse than my back post-op and worse than the left leg pre-op. It was a different pain, sort of crampy, and drawing up. I told the nurse who passed it on to the neurosurgical PA. The leg wasn't swollen when compared to the other one, but the PA ordered an ultrasound to rule out a blood clot. "Just in case."
Now we all know how hard it is to get any useful information about a test from a technician. Try asking the MRI tech what your MRI showed, and they always say something like "the radiologist has to review it first." I wasn't going to accept any answer like that from the ultrasound technician. So I played the doctor card -- I said that I fully well understood that a physician would provide the final reading of the ultrasound but that I also knew she did this day in and day out. She actually capitulated and told me that yes there was a clot extending from the calf to the lower thigh in the right leg. Fuck, I thought. Fuckfuckfuck. Literally, by the time I got back up to my room, the nurses and the PA already had the final reading which was still "clot."
One treats clots like these with blood thinners, to prevent spread of the clot or pieces breaking off and lodging in less pleasant places. I was started on a drug I'd never heard of (Arixtra), which was supposed to get me fully anti-coagulated within 24 hours. "Fine" I thought. At that point I was placed on bedrest, which was not much more activity than I was actually doing. Except bedrest meant no bathroom privileges, and I had to use the dreaded bedpan. 'Nuff said about that.
Later that evening, around 11 pm, I awoke with left-sided chest pain, shortness of breath, and heart palpitations. I knew exactly what was going on, and for the first time, being a doctor was a major detriment. You see, I realized that a chunk of the clot had broken off, traveled up through the venous system and ended up in my left lung. Nobody could poo-poo me, or say "everything'll be alright", because I knew exactly what a pulmonary embolus was and that I was in danger for my life. They put me on oxygen which thankfully made the oxygen saturation of my blood go from about 84% on room air to 100% on oxygen. Someone finally got an IV in me and they gave me morphine which helped the chest pain. I was transferred to an intermediate care unit, which they do for all patients with pulmonary emboli (the blood clot to the lung). I called TheHusband and tried to minimize the situation. However, he consulted the University of Google ("blood clot, leg, lung") and found out a lot more than I wanted him to. He then spent a sleepless night.
I remained on the Arixtra and Coumadin (warfarin, aka rat poison) was added -- it is the only effective oral blood thinner available on the market. Eventually I had 98-100% oxygen saturation on room air, and the blood was thinning out nicely, so I was finally discharged, about a week after I should have been.
So even though I am a doctor, paranoid to the max about medical stuff, was being taken care of by an experienced medical team and an excellent neurosurgeon, I am also a medical statistic. A medical mistake. And because of my inability to tolerate the compression boots, I almost died, and now I'll be on blood thinners for the next 6 months at least. But I am grateful and thankful and lucky and happy to still be around...
04 November 2009
In the holding pen
Just sitting here in the pre-op waiting room, hooked up to IV's.
Will be taken back for surgery in about 15 minutes, am hoping to wake up about 3 hours later having no memory of the time passing.
To my fellow UCFers, I have declined ALL of your suggested implants as has the staff here at the hospital for some reason.
Will see you all tomorrow, while on drugs
Will be taken back for surgery in about 15 minutes, am hoping to wake up about 3 hours later having no memory of the time passing.
To my fellow UCFers, I have declined ALL of your suggested implants as has the staff here at the hospital for some reason.
Will see you all tomorrow, while on drugs
07 October 2009
Missing child?
I am working from home today, and I got a phone call from ThePinkThing's school about an hour ago.
(ring, ring)
Neurondoc: Hello?
School Secretary: Hello, I am calling from X Elementary School. Is this ThePinkThing's mother?
ND: Yes.
SS: We have her here in the main office. She was supposed to walk home today?
ND: Walk home? No, she doesn't walk home.
SS: Well, we got a phone call from her father earlier today to say that she'd be a "walker" today.
ND: That's not right. She should be at her aftercare program. Are you sure it is ThePinkThing there? (First and last name said slowly and loudly, just in case)
SS: Yes, it is TPT sitting here.
ND: She shouldn't be there. And I guess the buses have left by now.
SS: Yes.
ND: I am a bit confused -- why did you think my daughter would be walking home today? (Mind you, we live almost a mile from the school, and TPT wouldn't be able to find her way home by herself)
SS: I got a call from someone, and I swear he said (insert TPT's first and last names) would be walking home from school.
ND: Okay, I'll be there to get her in a few minutes. What would you have done if I was at work?
SS: We would have taken her to her aftercare program.
(Pick up TPT, who's in the office looking not scared, but a bit bemused. The secretary is trying to figure who was the real kid who was supposed to walk home. As we are getting into my car, my phone rings -- it's TheHusband)
ND: Hello?
TH (in an urgent tone): Where's TPT? Aftercare just called and said she wasn't on the bus.
ND: Ah. She's here in my car. Apparently there was some sort of screw-up at the office and she was told she'd be a "walker" today.
TH: Phew. Okay.
TPT is now at her aftercare program, where her arrival caused a bit of a stir. Several of her friends wanted to know why she was supposed to walk home, why I was bringing her late, where she'd been... I just want to know how pissed the other dad is -- the one who called the office to tell them to have his kid walk home. I bet he'll have a cow on the phone. I certainly would (and sort of did).
This kind of situation highlights all of my worries about having TPT go from one place to another without my (or TH's) direct supervision. And I used the opportunity to reinforce that she shouldn't ever get into a car with a stranger, and who is actually approved to take her home.
(ring, ring)
Neurondoc: Hello?
School Secretary: Hello, I am calling from X Elementary School. Is this ThePinkThing's mother?
ND: Yes.
SS: We have her here in the main office. She was supposed to walk home today?
ND: Walk home? No, she doesn't walk home.
SS: Well, we got a phone call from her father earlier today to say that she'd be a "walker" today.
ND: That's not right. She should be at her aftercare program. Are you sure it is ThePinkThing there? (First and last name said slowly and loudly, just in case)
SS: Yes, it is TPT sitting here.
ND: She shouldn't be there. And I guess the buses have left by now.
SS: Yes.
ND: I am a bit confused -- why did you think my daughter would be walking home today? (Mind you, we live almost a mile from the school, and TPT wouldn't be able to find her way home by herself)
SS: I got a call from someone, and I swear he said (insert TPT's first and last names) would be walking home from school.
ND: Okay, I'll be there to get her in a few minutes. What would you have done if I was at work?
SS: We would have taken her to her aftercare program.
(Pick up TPT, who's in the office looking not scared, but a bit bemused. The secretary is trying to figure who was the real kid who was supposed to walk home. As we are getting into my car, my phone rings -- it's TheHusband)
ND: Hello?
TH (in an urgent tone): Where's TPT? Aftercare just called and said she wasn't on the bus.
ND: Ah. She's here in my car. Apparently there was some sort of screw-up at the office and she was told she'd be a "walker" today.
TH: Phew. Okay.
TPT is now at her aftercare program, where her arrival caused a bit of a stir. Several of her friends wanted to know why she was supposed to walk home, why I was bringing her late, where she'd been... I just want to know how pissed the other dad is -- the one who called the office to tell them to have his kid walk home. I bet he'll have a cow on the phone. I certainly would (and sort of did).
This kind of situation highlights all of my worries about having TPT go from one place to another without my (or TH's) direct supervision. And I used the opportunity to reinforce that she shouldn't ever get into a car with a stranger, and who is actually approved to take her home.
12 August 2009
Scary Times, End Times?
For the past 10 or so years I have been uneasy about the world I live in. Not bothered by a specific action, situation, or person. I just have had fairly constant and general feelings of unease. I can't blame it on ThePinkThing, although I have definitely become much more of a worrywart since she arrived on this planet. An only child provides for much fodder in the worrying business when her (or his) mother is inclined that way. Nothing in particular is bothering me about TheHusband (although I wish he would remember to clean his dirty dishes off the coffee table). It's not my job. I changed that a couple of years ago and really like my current position (I am probably in the minority in that I actually like my job). TheHusband's business seems to be weathering the recession or depression or whatever it is, so far.
I am uneasy about the general climate of my country. I am not overtly patriotic in that do-or-die, One-Nation-under-God kinda way. I love my country, but in an abstract sort of way, like you love a favorite uncle -- you love to spend time with him but you don't think about him constantly or even on a daily basis. Not like you love your parents, siblings, or children (if you are lucky enough to love them). Or your best friend. I am grateful that I was born, raised and live here. I am grateful for the opportunities that I have had and still have.
But I feel like my country is slowly and (not so?) silently becoming something else. Not mine. Not a place in which I am comfortable. A place in which people of substance and regular Joes cannot have a discussion about difficult topics from opposing sides. A place where emotions overwhelm rational thought and reason. A place where a dance teacher who proselytizes to young Jewish girls in her class sees nothing wrong with that and literally can't understand why the parents find it objectionable. A place where my father said to me (shortly after the election) "Now we'll see what Barack Obama does to this country; this man who people like you voted into office." People like me? People like me? What was he thinking I am, a Martian? A bogeyman? A dirty tree-hugging Liberal? This was my father, fergoshsakes, someone whom I love, saying crap like that to me, outlining the unbridgeable divide between someone like him and someone like me. A place where compromise and consensus are evil words, not goals to work toward. A place where it's all about winning and getting your way, even at the expense of other people and other ideas. A place where people use fear tactics to bolster their agendas, to separate their group from the "others", to convince their adherents that what they believe is right/good/better/God's will/whatever. A place where things like McCarthyism, fascism, and a Holocaust could occur and/or flourish.
When did this happen? Why is it happening? Am I being overreactive and paranoid? Perhaps. I don't know. I would like to be wrong. But if this is the case, how can we fight it? How do you make someone (or really boatloads of someones) see that this is where the country is heading. People who think that they are Right. And if they are right, you must be Wrong. How do you have a meaningful conversation with people who are uninterested in reasonable discourse and rational discussion?
I just don't have any answers, although I am still uneasy.
I am uneasy about the general climate of my country. I am not overtly patriotic in that do-or-die, One-Nation-under-God kinda way. I love my country, but in an abstract sort of way, like you love a favorite uncle -- you love to spend time with him but you don't think about him constantly or even on a daily basis. Not like you love your parents, siblings, or children (if you are lucky enough to love them). Or your best friend. I am grateful that I was born, raised and live here. I am grateful for the opportunities that I have had and still have.
But I feel like my country is slowly and (not so?) silently becoming something else. Not mine. Not a place in which I am comfortable. A place in which people of substance and regular Joes cannot have a discussion about difficult topics from opposing sides. A place where emotions overwhelm rational thought and reason. A place where a dance teacher who proselytizes to young Jewish girls in her class sees nothing wrong with that and literally can't understand why the parents find it objectionable. A place where my father said to me (shortly after the election) "Now we'll see what Barack Obama does to this country; this man who people like you voted into office." People like me? People like me? What was he thinking I am, a Martian? A bogeyman? A dirty tree-hugging Liberal? This was my father, fergoshsakes, someone whom I love, saying crap like that to me, outlining the unbridgeable divide between someone like him and someone like me. A place where compromise and consensus are evil words, not goals to work toward. A place where it's all about winning and getting your way, even at the expense of other people and other ideas. A place where people use fear tactics to bolster their agendas, to separate their group from the "others", to convince their adherents that what they believe is right/good/better/God's will/whatever. A place where things like McCarthyism, fascism, and a Holocaust could occur and/or flourish.
When did this happen? Why is it happening? Am I being overreactive and paranoid? Perhaps. I don't know. I would like to be wrong. But if this is the case, how can we fight it? How do you make someone (or really boatloads of someones) see that this is where the country is heading. People who think that they are Right. And if they are right, you must be Wrong. How do you have a meaningful conversation with people who are uninterested in reasonable discourse and rational discussion?
I just don't have any answers, although I am still uneasy.
16 July 2009
Needle #2 (Updated)
By the time you guys and gals read this, I'll be at the NeedleDoc having epidural #2. I'm hoping this one is more effective. If not, I'm dubious about going for the 3rd epidural. It may be on to facet blocks, which are more painful.
I want a bionic spine. Just sayin'
________________
Updated 11:19 am
I'm home now. Holy crap, Batman, that sucker HURT! I don't know if it was because I didn't take any Valium this time (wtf was I thinking), or if it was because he went one level up (since the prior one was unsuccessful). Regardless, it hurt, even though I squeezed TheHusband's hand the whole time. If I get another one, I will be drugged to the gills. And if he suggests facet blocks, Valium and I will definitely be friends. And at least I don't have to walk on the evil treadmill tonight.
I know: whine, whine, whine. It isn't cancer, but I am tired of back pain. I just want to be normal again.
I want a bionic spine. Just sayin'
________________
Updated 11:19 am
I'm home now. Holy crap, Batman, that sucker HURT! I don't know if it was because I didn't take any Valium this time (wtf was I thinking), or if it was because he went one level up (since the prior one was unsuccessful). Regardless, it hurt, even though I squeezed TheHusband's hand the whole time. If I get another one, I will be drugged to the gills. And if he suggests facet blocks, Valium and I will definitely be friends. And at least I don't have to walk on the evil treadmill tonight.
I know: whine, whine, whine. It isn't cancer, but I am tired of back pain. I just want to be normal again.
02 July 2009
Off to visit that doctor I spoke about
Today is the day. Wish me luck. By the time you read this, I will be hopped on drugs and hopefully enjoying my epidural. And specifically not thinking about all of the potential serious adverse events that may occur with an epidural steroid injection.
11 June 2009
Hate is still with us
I am not a student of political science. I don't have a deep understanding of how the American government works ("I'm a doctor, Jim, not a poli sci professor"). I love my country, though, in a non-worshipping, pragmatic kind of way. I am thankful that I have grown up here, that I was given many opportunities to succeed, that I am able to work and raise a family in relative peace. But given my upbringing/background, I have always felt that it could be taken away. You see, I have family members that survived the Holocaust. Not close family members, and I have never heard their stories, but they are there in the background of my life, reminders of how truly evil people can be. And I believe that this sort of evilness can happen anywhere, even here in the US. It is the kind of evilness that begins insidiously, infects a few people, then more and more, until it is epidemic. I also believe that most people can get caught up in that kind of situation. Mob reaction, crowd psychology, call it whatever you want. People can incite each other to perform actions and do things that they may not otherwise have done alone. To me, this sort of behavior manifests by targeting a smaller group, a different group, and making them a scapegoat or a sacrifice. That group is isolated, their difference is magnified, and then once a group is "different" enough, then it is just a small step to violence.
I am sure you know what prompted this post -- the shooting at the Holocaust Museum yesterday. It really bothers me. "Bother" is too weak a word, actually. It makes me afraid. To me, the purpose of the Holocaust Museum is to teach those who have no connection to it and to remind people that this can happen and does happen. And to have such a person perform such an action (for whatever reason might have crossed his mind) at that place upsets me almost beyond words. For you see, I am a member of a religious minority group. I live in a country where 76% of the population identifies themselves as Christian. I have worked with people who literally didn't understand that when the US is referred to as a "Christian Nation", it makes me uncomfortable and uneasy. My daughter has been proselytized while at her after-school program.
Please don't read this post as being anti-Christian. It is not, and I am not. I am not a believer, but I am not the type to judge what other people believe, as long as they don't try to convince me that their beliefs are the "right" beliefs. I am not anti-German, not by a long shot. My best friend is German; I have been there several times and found the people to be just like anywhere else. (And the scenery where my friend lives is much nicer than mine...).
But it can happen here. It can happen anywhere. There are people who hate others because of the god they worship, the color of their skin, their country of origin. It shouldn't happen here. We shouldn't let it.
I am sure you know what prompted this post -- the shooting at the Holocaust Museum yesterday. It really bothers me. "Bother" is too weak a word, actually. It makes me afraid. To me, the purpose of the Holocaust Museum is to teach those who have no connection to it and to remind people that this can happen and does happen. And to have such a person perform such an action (for whatever reason might have crossed his mind) at that place upsets me almost beyond words. For you see, I am a member of a religious minority group. I live in a country where 76% of the population identifies themselves as Christian. I have worked with people who literally didn't understand that when the US is referred to as a "Christian Nation", it makes me uncomfortable and uneasy. My daughter has been proselytized while at her after-school program.
Please don't read this post as being anti-Christian. It is not, and I am not. I am not a believer, but I am not the type to judge what other people believe, as long as they don't try to convince me that their beliefs are the "right" beliefs. I am not anti-German, not by a long shot. My best friend is German; I have been there several times and found the people to be just like anywhere else. (And the scenery where my friend lives is much nicer than mine...).
But it can happen here. It can happen anywhere. There are people who hate others because of the god they worship, the color of their skin, their country of origin. It shouldn't happen here. We shouldn't let it.
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