Week of June 11, 2001
Monday
Tuesday Wednesday
Thursday Friday
Saturday Sunday
Most Recent Update
Today was Monday which means I only have two more days to work this week. Yes, I am going on vacation beginning Friday and will not be going into the office until the following Friday. Of course, that means that today was very busy in preparation for me being gone. This morning was steady but not overwhelming after I had made rounds on my two hospitalized patients.
After my steady morning and a meeting of our hospital Family Practice Department at noon, it was time to begin my afternoon. The afternoon began, innocently enough, with an elderly lady who was coming in to meet me for the first time. It turned out, though, that she has Alzheimer's Disease and is living by herself only because her neighbors do most of her work for her including fixing meals and making sure bills get paid. I find this out fairly quickly but then am left with finding help for her while I am trying to see a bunch of other patients who all have multiple problems. The first lady finally leaves about two and one half hours after her appointment as I think I have things arranged for her for at least a few weeks but she will eventually need to live in some sort of assisted living facility.
The rest of my patients throughout the afternoon all have multiple problems which take a lot longer than the time we have allotted them. This means I am behind all afternoon with people having to wait 30 minutes to an hour and I do not get to dictate any of their charts until everyone has been seen and refills taken care of and phone messages answered. So, I do not get home until after 7:30 tonight. I did get in an hour on the Nordic Track and now am writing this just before going to bed so I can get up and do it again tomorrow. I have a meeting of the hospital medical staff tomorrow night at 6 which means I will not get home until late again tomorrow night. But, I only have two more days to work this week so I can make it.
The current plans are to put the kids on a plane back to Springfield, Missouri to visit their grandparents and other family members next Monday. Delanae and I are then going to leave and drive up to the Olympic Peninsula and see the rain forest and other sites around the peninsula. Before they come back in July we are going to drive to Crater Lake and northern California and see the redwoods. I am looking forward to the time off with Delanae and seeing some of the other sites here in the Northwest and the West Coast.
Another day down and only one to go until vacation. Today was fairly intense with one of my hospital patients causing me no end to grief and phone calls all day long.
My day in the office was fairly uneventful as far as medical problems seen there. Today was the day to talk to patients, or try and talk to them on the phone, about hypothyroidism (low thyroid) and why they were not on enough thyroid replacement. One man had been on thyroid hormone replacement for years but had never had his level checked to be sure he was on enough. Sure enough, he is not and has an elevated cholesterol which can be partially caused by the hypothyroid state. He is also feeling fatigued, now that I mentioned it to him which is one of the symptoms of hypothyroidism. So, now he is on a higher dose which should help bring his cholesterol down and help him to feel less fatigued.
Another patient was on too much thyroid replacement as evidenced by her suppressed blood test. This can cause osteoporosis or loss of calcium from bones which she now has on her bone density study. This will lead to an increased risk of fractures which increase her chances of dying or having chronic, incapacitating back pain. Again, she had not had her thyroid hormone level checked for many years but had been faithfully taking her too high a dose for those years. I currently recommend having a thyroid test checked at least every three years if my patient is on thyroid hormone replacement and every year if the patient is over 65. The body's requirements can change as it ages.
On the home front, we are going to have to get rid of our newest dog. She is a pit bull and is very affectionate around us but is showing a tendency to become very angry and overly aggressive. She and the youngest Australian Shepherd usually play fight all day but this morning she had him down, biting him and would not let him up even with him whimpering which she has been recognizing as his sign to stop because she was hurting him. Delanae had to call her off. Yesterday she tried to jump over the fence to get at a child riding a bicycle and the child was our Stacey. If she had gotten over the fence and gone after Stacey we think she would have recognized her at that time but cannot take the chance that one day she might get out and attack a neighborhood child on a bicycle simple because she doesn't like bicycles for some reason. So, we are going to try and find her a home where there are no other dogs and enough land that she can run and not run into a lot of humans other than the family that has her. If we cannot find such a home then we will have to put her down. Hopefully, we can find a good home for her where she can be trusted.
Today was more like a day off. I did have a 7 AM meeting in Vancouver that I woke up at 5 to get ready for. Then, I came back to the hospital to just go by medical records and make sure my records were up to date, which they were. Then I had planned to go to the nursing home I will become medical director of August 1 to discharge a patient but before I got out of the hospital one of the patients from that nursing home came into the emergency department.
After spending my morning doing the above, I was able to come home and actually take a two hour nap this afternoon. It felt great and is the first time I have been able to do that in a long time. I hope to do more of that during my week off beginning Friday.
UPS had been here while we were gone to church tonight and left a package with my CompactFlash Expansion Pack for my iPaq and the Compaq expandable case. Now I will be learning how to use the Viking 128MB CompactFlash memory card with my iPaq during my vacation as well as seeing the sights on the Olympic Peninsula.
Since my time off starts Friday, that means tomorrow is going to be busy. I have a meeting beginning at 7:30 so will need to see any hospital patients before that. It promises to be a long day as I get all the refills done and messages answered that can't wait until I get back. Wish me luck tomorrow.
I am OFF but I paid for it today. This morning went fairly well, busy but not hectic. I got to the hospital just before 6:30 this morning to be sure I got an early start and got as much done before the start of office hours as I could. I saw my one patient in the hospital and then went to my 7:30 meeting which turned out to be fairly interesting. We brainstormed some ideas to cut down on emergency department utilization by patients without truly emergency problems. It is a very significant problem in our community as it is in all communities these days. Hopefully, some of the ideas we came up with will work here. I will tell you some of them over the next few weeks.
At noon, I had another meeting and was actually completely caught up with my dictation from the morning and all the refills were already done. This afternoon everything exploded, however. I spent all afternoon catching up and my piles of refills and requests also exploded. I finally got finished and got home sometime between 8:30 and 9 tonight but do not have to go back until next week now. I left my desk empty and Outlook sending an out of office reply to all incoming e-mails there. Tomorrow morning I can make sure the kids are up to go to school and then go back to bed if I want to.
Suki may have herself a new home already. Someone called after they saw the free dog ad in the paper today and came over to meet her. He has a male pit bull already and wants to breed him. His pit bull is supposedly a lot bigger than her and she is at his place now to see if they will get along. We will miss her but will feel much better about leaving the other two dogs alone if she is not around. We will also feel better about the safety of the kids in the neighborhood now than if she were to get out of our fenced yard. He will bring her back if she does not get along with his current dog.
No update.
Yesterday was the first day of my vacation so I really took the day off. As you may have noticed, I did not even post to this journal. Stephen had some male friends spend the night outside in tents Thursday night and they all had to catch the bus to school Friday morning for their last half day of school. They stayed up all night and came into the house starting about 5:30 AM to take showers before going to school. This woke me up but it also woke up Stacey who got herself up and got ready for school. After they all left, I was able to go back to sleep and sleep as long as I wanted to. It was wonderful!
The rest of the day was spent putzing around. I did a lot of internet surfing, then read a lot of the afternoon. I did a little bit of work during the afternoon but mostly just rested. Last night Delanae and I watched "Almost Famous" on DVD after watching the Lakers finish off the Sixers in the NBA Finals. All in all, a very relaxing day.
Today was more of the same, without the NBA Finals of course. The kids are getting packed to fly to Springfield, Missouri Monday morning to visit family so the washing machine has been busy now for two days. We got some more of the back yard smoothed out so it can be turned into more of a real yard and cleaned up some more brush. Now, Delanae and the kids are off getting toiletries for their trip.
Suki is doing great at her new home. Delanae called her new owner this morning and he reports that she is getting along really well with their older pit bull male as she did here with our older dog. She just had problems with the younger dog. He has already noticed that about her also but there is no problem there. It looks like she has found a new, permanent home.
Tomorrow is likely to be my last day to post for a few days. Delanae and I will be off driving until Thursday sometime so don't expect a post Monday through Wednesday of next week. My family has already told me that for Father's Day they are taking me to a restaurant here. It should be fun. I'll tell you about it tomorrow.
It has been a nice Father's Day here. After church today, we drove up to the restaurant I mentioned yesterday. Actually, Stephen drove us there which was his first time to drive that far. I rode in the front seat and Delanae was in the back seat. I think she was more on edge than me but, all in all, he did well. He needs to work on speed limit signs, he seems to pick up the slower speed limits rather slowly.
Once we were there, we had a nice meal but the restaurant had just opened today for the summer season and were undersupplied with what they needed so they did not have their full menu available. As well, the service was not too good. The food was OK and the view was great. Unfortunately, Mt. St. Helens was in the clouds the entire time we were there so we caught only glimpses of the sides of the mountain. Every time I am up there, no matter how close we are to the mountain, I get a sense of how powerful the eruption was in May of 1980. I saw some new pictures in the visitors' center there which I had not seen before at the other visitors' centers. These pictures were of the actual eruption and were taken from many miles away and were still awesome. If you are ever out this way you owe yourself a trip to Mt. St. Helens.
The kids are now packed for their trip tomorrow and Delanae is getting some things ready for them to take to their grandparents there. Delanae and I will be taking off after the kids leave tomorrow to drive up to the Olympic Peninsula and the rain forest there. We have never seen it and it is one of the places we have been meaning to go to since we moved here. After that, we will decide which road to take and where to go. I will probably not post anything here for two or three days but will be back here before the end of the week. See you then.
