Week of June 25, 2001
Monday
Tuesday Wednesday
Thursday Friday
Saturday Sunday
Most Recent Update
I had even less time the last three days than I thought I would. So, no updates after Thursday. Friday, I went back to work as the inpatient physician and had multiple admissions throughout the day. I did not get home until after 8 so I spent time with my lovely wife rather than update this journal.
Saturday was more of the same at the hospital. There were really sick patients and some not as sick but they all took time. I was then on call Saturday night and had four admissions after midnight which meant I did not get a lot of sleep that night. One of my internal medicine department partners helped with one of the admissions since she was already at the hospital seeing an admission of her own.
Sunday I had to round on all those patients and discharged several but the the total number of patients on the service Sunday night was more than the number that had been on it when I took over Friday morning. Normally, I will have the number reduced by Sunday night but not this stretch. Sunday night I had to call my partners to update them on their patients for this morning. I did not get home until 8 last night so, again, this journal did not get updated. Having said all that, let me get back to our vacation.
Tuesday night was spent on the beach on Vancouver Island. We had gone to the waterfront in Victoria and walked around for a couple of hours then drove back to the campground on the beach after stopping for some supplies at a couple of grocery stores. Upon arriving at the campsite, Delanae went to take her shower so she would not have to the next morning. While waiting for her to finish I introduced myself to the couple in the next space. They turned out to be from Germany and had flown to Vancouver and rented an RV for 11 days to drive around western Canada. They were also driving and just stopping when and where they decided to. They have two teenagers as well so we swapped stories about them. Interestingly, in Germany you cannot get a driver's license until age 18 and then only after completing a certain number of hours of driving school. Their auto insurance had also increased markedly when their oldest teenager got his driver's license.
We got into our sleeping bags fairly early Tuesday night to get up early Wednesday morning so we could head down to the waterfront to get in line for the ferry ride back to Port Angeles. We awoke to a beautiful sunrise over the water. The sky was incredibly pink just before the sun rose over the Cascades which our tent door was facing.
We packed everything into the Jeep and headed down to the waterfront where we were one of the first ten vehicles in line for the return trip. We then walked around the waterfront until it was time to board the ferry for the ride back. Interestingly, the ride back was cooler and the ocean was rougher than it had been the previous day. After getting off the ferry, we proceeded to the western side of the Olympic Peninsula and our destination for the day, the rain forest.
We finally arrived at the rain forest in the middle of the afternoon. It is called the HOH rain forest and the HOH river runs along it. I thought the name of the river was very interesting since it is a rain forest but could never find out who named the river. We hiked two of the three trails through the rain forest while we were there Wednesday afternoon. The third trail was 17 miles long and led to the glacier meadows on the mountain so we skipped it. We left around 6 and decided we had enough time to drive back to our house that night. We made it home by 11 and unpacked the Jeep then hit the bed as we were both very tired after a very long but enjoyable day.
Today at work was another catch up day. I had paperwork to finish from my vacation last week than I had been unable to get to over the weekend. I had a full schedule of patients and a noon meeting. Tomorrow looks very busy again. Hopefully, I will find time to update this journal.
Another busy day today. My hospital patients are improving. One, who came in with diarrhea for two weeks, is going to turn out to have Crohn's Disease which is an inflammatory bowel disease. These past two weeks is the first time this patient has had any symptoms at all. It was just diarrhea and abdominal cramps that would not go away. All the stool cultures were negative for any infection so today colonoscopy showed what we thought we would find; namely, areas of inflammation in the walls of the rectum. Biopsies were taken and the final diagnosis will be made by the pathologist who interprets the tissue samples under the microscope. The gastroenterologist felt that it clinically looks like Crohn's Disease and our treatment is directed toward that. The patient was already on steroids and an appropriate antibiotic and the amount of diarrhea had improved already but abdominal cramping has continued with any oral intake. The patient should improve even more rapidly now.
My office schedule was overbooked, as usual. Nothing particularly exciting or memorable. I did make it to our noon continuing medical education lecture where the topic was the use of Viagra in men with cardiovascular disease. The bottom line message is that Viagra is safe in men with cardiovascular disease as long as they are not on a nitrate of any kind and their heart can tolerate the exertion of sexual intercourse. There have been deaths reported in patients who got Viagra from a website on the Internet and were on nitrates or were not able to tolerate the extra exertion of intercourse. If they had discussed their use of Viagra with their personal physician rather than just buy it sight unseen from a website they might still be alive today. Anyway, it made for an interesting presentation with NO Viagra jokes; well, maybe one.
Tomorrow I have an early committee meeting. Then, I need to make rounds and go to the nursing home to discuss my contract to become their medical director in August. Hopefully, I can find time tomorrow afternoon to mow the lawn if it is not too wet as it has been raining here today and is supposed to continue at least part of the day tomorrow. This weekend is supposed to be sunny so we can get some more work done outside.
Very wet here today. We had rain hard enough to remind me of the severe thunderstorms we had in Arkansas. There was some minor street flooding but it is all supposed to clear out tonight and be beautiful for the weekend. Needless to say, I did not get to mow the lawn today but did get a run in between showers. The lawn will have to wait until this weekend.
I have the contract from the nursing home now. This is the one to become the medical director and I see no problems with it. I will sign it and get it back to them tomorrow probably. I would then start August 1. I should not have to spend any more time there than I am now.
My hospital patients are leaving the hospital. There were only two left when I finished making rounds this morning. Both should be able to go home for the weekend; that is if the one with Crohn's will be able to eat and drink more without having abdominal cramping. That is a problem with acute Crohn's; the cramping with anything they eat or drink until the acute inflammation calms down.
Tomorrow promises to be a long day. I have a circumcision to start my day in the office and am on call tomorrow night to end my day (and night). I am completely off this weekend and am looking forward to it as I have not completely gotten rested up from last weekend yet.
I only have one patient still left in the hospital. One went home, unexpectedly, today as his pneumonia was much better than I expected it to be today. He is very happy that I felt he could be discharged this morning. I am on call tonight so things could change rapidly before 7 AM tomorrow.
Right now, tomorrow doesn't look too bad in the office. Kathy and I were looking at the schedule before she went home this afternoon and wondering about the openings. I am sure they will be filled first thing in the morning but it was interesting to see so many openings. No other day is like that and I will not plan to tomorrow being a little slower. Today certainly wasn't.
Tomorrow night Delanae and I will be going to another interview dinner for an applicant to join our group. We should have a good time as we will be eating with several members of the group who are friends of ours also. It should be a lively time tomorrow night so I may not have an update tomorrow night. Come back and see.
No update.
Good day yesterday in the office. All those openings I spoke about Thursday night were filled up yesterday so I saw my usual number but got through reasonably on time. When I left I only had one patient remaining in the hospital but that may change before Monday morning. Speaking of which, I need to do the reflection for our Leadership Council meeting Monday morning so I need to find something tomorrow.
My call night, Thursday, was not too bad. I did not get any admissions and only one or two phone call between midnight and 5:30 AM. That is a good night, believe me. I had one other admission before I left the hospital to go home and try and get some sleep. That admission was fairly uncomplicated. All in all, a good night on call.
Today was spent straightening up the garage. Delanae and I put up shelves in our detached garage and started the process of cleaning out the stuff we don't want or need anymore. That took us all afternoon. I did get the yard mowed before we worked on the garage and, with our landscaping, our yard is getting larger. Well, the amount to be mowed is getting larger. The new fence means it takes longer too as now we have to open the gates and take the lawn mower through them to get all the yard mowed. Tomorrow we have something to put together for Stacey so it will be ready for her when she gets back from her visit with her grandparents in the Midwest. Both kids will be back July 14 so we have to get it put together either this weekend or next weekend. Delanae and I are taking off on a camping trip again next Sunday so we must get it done tomorrow.
We did not get a lot accomplished today but then Sunday is supposed to be a day of rest. We only had one service at church today and no adult bible fellowship classes so we did not have to be there until 10 which meant we slept in longer than normal for a Sunday morning. After church we went out and ate chinese food for lunch then begin putting Stacey's surprise together(it will also be used by Stephen). This is a more complex job than it looked like in the beginning so it will take several days of working on it to get finished putting it together. We will have it put together before they come home however.
We both had to be at the church early tonight; Delanae was doing a solo and I was asked to do the sound. She did her usual magnificent job and got many, many compliments afterward. This was her first solo at this church so she was nervous but next time she won't be as nervous. She did not make any mistakes and she sounded so good that even I got a couple of compliments about how good I made her sound. The truth is that it wasn't me, she was born that way.
Then, after worship our present pastor discussed why he is leaving to go to another church. He feels that God is calling him to move on to another church to help build it. There are no problems here and he does not want to leave but feels God is telling him that it is time to move on and he is being obedient. He will take our worship leader with him but the rest of the church staff will be staying. So now our church has to find a new pastor and worship leader which should be an interesting process to observe.
We got home late tonight due to all the above happening. I am now finished preparing for tomorrow which will start very early. I still have one patient in the hospital and have a Leadership Council meeting at 7 tomorrow morning. I am doing the reflection for the meeting tomorrow and have chosen to read some of Proverbs from the Message. Wish me luck.
