26 December 2009

A stop in Savannah (with bonus)

I enjoy meeting internet friends in Real Life. After all, I met my best friend and my husband online. So far I haven't met an axe murderer, although my parents were half-convinced TheHusband was one before they met him ("he has tattoos!").

This year, I had a Christmas Eve present awaiting me in Savannah -- a meet-up with an internet friend, a fellow member of the sooper seekrit organization, the UCF. This friend prefers to remain anonymous, so I won't spill any info. I will, however, provide the picutre we took of TheHusband, MWT, me, and ThePinkThing.

It was fun, funny, yummy, and I'm sorry that MWT won't be in Savannah on the day we pass back through.

Now it's off to our real vacation. See you in a bit...

20 December 2009


Snoverload: an overload of snow.

Granted for the DC metro area, 7 inches of snow is a snoverload, but this is really insane. We totally got walloped with snow. TheHusband measured in two places in our yard and we got 29 inches of snow. Yes, yes, that includes drifting, but still, it is a ridiculously large amount of snow. The official amount is about 16 inches at National Airport, but that really doesn't reflect real life here in the DC Metro area. I am hoping that we are plowed out by Wednesday. Schools have been closed for tomorrow, and I expect that they will be closed again on Tuesday. I think Wednesday is a half day, so they punt that day, too. ThePinkThing thinks the snow is great (she and TheHusband had a snowball fight and tromped up and down the street this morning). I wish I was up to playing outside in the snow, but since I am still using the cane (and walker for longer walks), that is not in the cards. Boo. She is ecstatic at the thought of a snow day tomorrow. "I like learning, Mommy, but sometimes it's fun to not have school", she just told me. Maybe my place of employment will be closed tomorrow, since I'd like a snow day, too.

TheHusband has cleared the walkway completely, cleared his car off, and made a teeny little path along the edge of the driveway next to both cars. Since we live on a one-block long street with no streets behind us, I don't expect a plow to come through until tomorrow. He decided to bag any further shoveling until tomorrow for that reason.

As I said: snoverload.
Updated 8:28 pm

Hot damn. My office is closed tomorrow, so I get a snow day too. Yay, me!

19 December 2009

Let It Snow

Ah to be 6 again, during a big snow storm. It is much simpler and more fun.

I am worrying about being unable to help TheHusband clean off the cars (much less even touch the shovel), how he's going to shovel the 18+ inches of snow without having his back go out, and if I'll actually be able to get out of the house on Tuesday for my appointment. ThePinkThing was only thinking about fun. FUN! Snow! Eat snow, swim in snow, make snow angels (including one in the middle of our street), roll down the lawn in the snow, throw snow at Daddy, etc.

I think she has the right way of it... Perhaps I'll go out and eat some snow. :-)

Eating snow

A hand towel as makeshift ear-muffs

Butt-high snow by 5 pm


This is as far as I got

Our lonely street

Below knee-high at around noon

Well above the knees at 5 pm

Afterwards -- footie PJ's

14 December 2009

Nothing much to say

Really nothing much to say lately. Recovery is going along, not as fast as I would like, but not any slower than the neurosurgeon is expecting. I just want it to be over and done with. I am not good at this patience gig. But thankfully I am no worse, and there have been no further sequelae from the blood clots.

04 December 2009

Fun with phone menus

Call 1-800-295-0051. When you are asked if you want to continue in English or Spanish, don't choose either one, wait about 10 seconds, listen to the options and press 4. Then press 7 in the next set of options. If your phone has a mute button use it, because any noise (including laughter) resets it.

I literally howled with laughter.

No mother-in-law blues for me

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!"

02 December 2009

Happy neurosurgeon is a happy patient

Saw the neurosurgeon on Monday. He is pleased with my recovery so far. I am recovering as quickly as he was expecting me to (barring the bonus DVT and PE). The level of back pain is exactly as he expected. He wants me to see the rehab doc and start planning outpatient rehab.

There is only one thing about my recovery that I don't agree with and really can't stand. He expects me to be off work until January. Ummm, no -- can't do that. I'll go totally nuts. But he understands my need to get back to work, being a doctor himself. So I will try to work from home for a couple of hours a day beginning next Monday (12/7). I suspect that my supervisor and coworkers will be happy. I won't reappear at the office until after the new year, but I need to get back to work. Need to. I am looking forward to getting back into the swing of things...

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...