family practice issues and general life events

Vaccinated and Proud

Friday, I was vaccinated with the second dose of the COVID vaccine. So thrilled that it was time. I did have some side effects and it laid me into bed for about 12 hours. Not so bad as the symptoms of the flu, but enough that I was happy that I did not have to work yesterday. Those symptoms, however mean that my immune system is working. It means that I now have a 95% chance of not contracting COVID.

What did not happen, I did not grow a tail, nor turn into a crocodile. I am a bit disappointed about that, but it did not happen. I also did not get 5G signal in my arm. There is now tracking signal being released. The needle is not big enough for a tracking chip. Not even the size that you chip your dog with. And those chips, no one can track your movements. And seriously, I am certain Bill Gates would be completely bored should he decide that he did want to track me, I am certain he would stop within 24 hours. My life is simply not that interesting. And I would bet the same for about 99% of you out there. Additionally, if they did want to track you, why would they go to the trouble of microchipping you? Most of us carry around our own GPS tracker devices that we happily pay for. The majority of the US market being manufactured under the names of Samsung or Apple.

Now concerns about the vaccine, itself. The majority of the development occurred after the SARS threat. They didn’t throw away that data, and so the ability to make the vaccine was there. Testing took less time than normal due to the high prevalence of the virus in the community. The rest of the vaccines were developed on viruses with a much lower prevalence in the community, which is why they took years. The prevalence in the community meant they could gather data at a much quicker rate.

As for it altering the DNA. Not possible. mRNA does not do that. Simple genetics. It doesn’t do anything but trigger a warning to mount an immune response. We have to use something that will allow for the virus mutations not to make the vaccine moot. If we used the old technology one mutation and the new vaccine would be worthless. This is why we don’t have a vaccine for the common cold. Coronaviruses frequently mutate, something we have known for years.

And so if we will vaccinate, we will be able to start to resume somewhat normal life again. It won’t be back to before, but maybe that is ok. But I want to be able to travel again. I want to not need to volunteer for shifts on the weekend to give bamivalamib. I want to not have to see patients suffer any longer. I want to not live in a state where the rate of infection is 1 per 1,000 people. Even though the state has a mortality rate of 1.1%, that is still allowing for 10 of those people to die. Not sure why Americans seem to be ok with that, maybe they are just bad at math. Maybe they just lack compassion, but I cannot watch this continue. My colleagues and I are tired of watching people die. Watch people suffer. Explain why they are not admitted to the hospital when previous years with the same symptoms would have guaranteed admission. And then, for those who do survive what to tell them about their long term effects. Their long term heart and lung damage. Because sometimes merely surviving the disease is not as easy as one things. And so I am vaccinated, and hopefully soon the rest of the population will be able to get vaccinated.


It’s an eerie feeling at work, really. I imagine it is a similar feeling that people had before they shipped out to war, or when NASA locks up its flight crew the couple weeks before a mission.

We still see people. The few that want to come into the clinic. Or via skype or zoom. A lot of phone calls. I threw away my mask today. It had been worn 5 times. I get a new paper bag and mask with the next PUI.

But reality is that it is mostly waiting. I have never seen the parking lot so bare outside of a weekend. I took a picture earlier, not sure what happened. But really we are mostly killing time until it is time to be called in as replacement

Second string

So, I don’t know what to do. I haven’t visited this site in a while. And I am not going to start writing about a medical topic. Not directly at least. But I am needing to write.

Here we are in the middle early stages of a pandemic, and I am still working. I have asked several times to be made nonessential, but it isn’t going to happen. We have cancelled most appointments, doing most by telemedicine or phone.

Basically we are now spending our days not doing anything. Or maybe I am, but not nearly what pace I am used to doing. But mostly feel like I am doing nothing. Sure, I have seen a few that might have the virus. None of mine have tested positive, but I wasn’t able to test them all either. The reality is, we are being kept safe for when the bottom falls out of the bottom. Then they have their second string, sitting and waiting, and free to be brought in. And that might be what is the most frightening. While others will be recovering or the virus is continuing to mutate, that is when I will be exposed. And I am high risk

Apparently that is all I am going to say about that. I can’t find peace in my normal peace finding things. I can’t find peace in exercise. I can only go 2 miles. I can’t read. There is no peace in doing that. And so I am here, doing what I am told

Nothing more, nothing less

Or subtitled, It is this type of behavior which caused my husband to put me on a budget, and not allow me to spend any more money

So back in May, I signed up for a few races during the summer. One I signed up for, let me purchase their summer racing series all together and save. The other, I might have actually signed up for its first race back in March, but it was Spring time. And it was the first of 3 different races at Midnight in Tulsa, Oklahoma. The other previously mentioned was 8 pm in Joplin, Missouri. These 2 towns are roughly 2 hours apart, and I live almost exactly in the middle. So it is an hour drive no big deal. The problem is that when I signed up for the 3 races, I paid absolutely no attention to the dates of run #2 and run #3. The Joplin run, I signed up for 3 10Ks. The initial race in Tulsa at midnight, I signed up for 20 miles. They were not on the same date. They were about 2 weeks apart. Fine and good.

Race 2 for both series were a week apart, I think. I did a half marathon in Tulsa on July 10 (I think. The date might be a little off). And that was at midnight. The next week, I did the second 10K in Joplin, at 8 pm. No biggie. So I go on with my life. Not even thinking about how race #3 for both series are on the same date. Well sort of. Joplin race is at 8 pm on August 11, and essentially the Midnight run is at midnight on the 12th. So about a week ago, I start realizing my problem. They are 4 hours apart. And my 10Ks were coming in between an hour ten minutes, and an hour and 20 minutes. If I have a bad race, easily makes it 90 minutes. So if I run in Joplin from 8 to 9:30 pm, it puts me getting to Tulsa at 11:30 pm, which is ok, but I like to have time to walk around the course. And neither race had early tag pick up. Well, I don’t think that the Joplin race did, I know that the Tulsa race did not.

So Monday or Tuesday, I received the race reminder emails. So I emailed the people in charge of the Joplin race and ask to change from the 10K to the 5K. Probably better anyway, since I have 2 races so close together. They do so graciously. Actually, I think I sent the email, Wednesday or Thursday. My mind is still a little muddled from the lack of sleep.

So Friday, after I get home from work, picking up an extra shift at another clinic, I tell my husband what I did. His response, “You aren’t going to do both of them, are you?”

My response, “But they are both a series and I did the first 2 in each series and I really want the special prize for doing all 3.”

He sighs, shakes his head, and says, “If you’re sure, whatever.”

So Friday about 6 pm, I leave my house and head to Joplin. I have my new trail running shoes on, as it is a trail run. And I am ready to go. (The shoes are a part of the spending issue, so …). But I get to Joplin in plenty of time to fill my car up with gas, and get to the course, park and big up my gear. I also walk down about 1/2 to 3/4 of a mile on the course. It is a down and back, so maybe a mile.

Anyway, once I get back, it is time for the 1 mile fun run for the kids. I watch and cheer, and then, there is the National Anthem, and the 10K starts. We start the 5K, at 8:15, right on time. I am feeling good.

My headlamp is not quite right on my head, so almost immediately, I take it off of my head, and the glow sticks that I have in a necklace around my neck is annoying my neck, so I take it off, also. I get the headlamp readjusted, and placed back on my head, and change the necklace back into 3 pieces and circle them around my tank top and bra. I guess despite how sticky and humid it is, I will be keeping the shirt on, and not running in my sports bra alone.

I get down to the turn around, grab 2 cups of water and head back. I turn on my headlamp at that time. It is starting to get dark. I check the time on my watch, and realize that I am doing well. Possibly a personal best well. (And I mean from when I started running as an adult after having babies, not from when I ran cross country in high school).

I pass the 3 mile sign, and start hearing the crowd, and when I see the crowd, I have a little left in for a final kick. At that point, I see my time. My watch says the course is a bit short, but as they follow the national guidelines, maybe my watch is a little off from the tree cover. I don’t however, remember what my PR is, so i am not sure that I made a new one.

I text my husband, that I am done, and the time, and he tells me that it is my new PR, and by quite a bit, based on what I have written down on my medal board at home. About 2 minutes faster. Yay me.

I go to the beer area, for my obligatory post run beer. Seriously, it is the only time that beer even tastes good to me. I drink about half, keeping in mind, that I have a 2 hour drive, and other than the Stinger waffle that I had prior to the race, the only thing I had to eat today was lunch, about 8 hours prior.

I toss the other half away, and take my pic with the medal for completing all 3 races. (They didn’t give out medals for the individual races, other than an award for each division and the fun run)

I, then, stop by the ice cream/popsicle stand for my free treat and get one and head to the car.

It was delicious, but 88 degree temps caused it to start melting fairly quickly, and I am trying to eat it while walking quickly to the car. I finish it shortly after getting there, pull up Turkey mountain, Tulsa on my GPS, and head on my way. Though the GPS choice for Turkey Mountain, while correct was not the correct parking lot, and I have to pull out my phone, to navigate to the correct place in the dark. The roads are not well lit at 10:30 pm.

I arrive safely, and get out of the car, and head to check in. They give me my special coasters for completing all 3 races at check in. I guess if I can finish 20 miles and a half marathon, they weren’t too worried that I wasn’t going to finish the 5K.

While waiting around, I start talking to some of the others there. And the bike for 2, Fireball provided is there. I take a “shot” otherwise known as a small cup of Fireball before the race. And then it is time to start. The first part of the race is downhill, and it is also an out and back. And I remember thinking running down that hill, this is that horrible half mile hill, that was not the worst hill in the 20 mile run, but the second. And it is going to be at the end of this race. Ugh. But no use crying. I run across the bridge next to 71st St. Follow those in front of me, under the bridge, and the leaders are starting to come towards me. I grab 2 cups of drink, I think they were both Gatorade, but one might have been water, and head back. It was 12:15 am, and i barely slept once I got home.

Ran back over the bridge, and race walked back up that nasty half mile hill. Several (probably 4 people) passed me on that hill. I managed to stay with the last one, and as it became less steep, I started jogging again. It was already past my finish time from earlier in the night, so I knew no PR was coming, but it wasn’t a terrible time for me.

I got to the computer to get the official time, and the computer kept saying that I failed to finish. So the race people could see by their screen that I had an official time. So he got another person, who refreshed the computer, and I appeared. They also gave me a banana. And one of the volunteers poured me some fireball, as my hand was shaking so bad. I was drinking my water that they had handed me at the finish line, but I was tired and a little shaky.

I grabbed a can of “Good ass beer” (seriously the name of the beer) and sat on a rock

And the bike with the Fireball came by, and gave me another shot. Which I drank with my “new friends” none of which I remember their names. I ate my banana and a slice of watermelon. Drank my water and about half of this beer and cheered for the final finishers and listened and cheered for those who won. Then I was ready to go home. As I am walking to my car, I talk to another nice lady (name also not remembered) and we talked about our racing. I may see her at the Route 66 run, both the 5K and the half marathon in November .

And so I stopped by the QuickTrip before getting on the highway to head home and bought 2 starbucks double shots, vanilla. 2 because they were on sale 2 for $5. I didn’t think that I was actually going to drink both on the way home but I did. I made it home at 2:45 am. Decided not to attempt the garage, as tired as I was, and walked through the back gate to get to the hot tub, for a nice soak, before going inside.

And that is how I ended up running 2 5Ks in about 4 hours, in 2 different states/cities 120ish miles apart.

So this is my splits by my watch on the first run in Joplin

My Strava data

My splits from my Garmin in Tulsa

My Strava data

Joplin swag

Tulsa swag

And everything all together

Holding my breath

2 years ago today, was one of the most difficult days of my life.  I was sitting, alone in the waiting room at the Baylor Heart Hospital in Plano, waiting.  My kids were with my parents, and my husband was back in the surgical suites having his AV node ablated.  His pacemaker had been placed 19 days earlier.  And I sat there and pretended to read, paced, got coffee, nursed a pounding headache from a child screaming in the waiting room, which staff did tell the family to contain, as she was so loud, they could hear her in the surgical suites.  Funny what you can remember, on those days. But I was there in that waiting room for hours that seemed to stretch into days, wondering how our life would be in the future.
 We knew at that moment we would be moving, had pretty much chosen Vinita of the sites, but the future was still uncertain.  I sat there waiting for what I knew best case scenario would be, surgery went well, we will see in 3 months.  Worst case, it didn’t work, he will have to be on the heart transplant list immediately, or worse.  And I thought about all that.  How my life was going to change.  What was I going to tell the boys, who were already very much aware that daddy had almost died.  And so I sat there, and I paced, and then I pretended to read and then I got up to get coffee.  I was alone, and I was terrified.  My knowledge frightened me.  It was already the worst summer of my life, from the heart attack, the trying to work for both of us, being both mom and dad, the dog dying of cancer, and then having to spend our anniversary in this same hospital for a week, ending with the pacemaker being placed.  Some good had happened, we had a new job lined up, and I could support us all with that job, should things not get better.  But could I get from here to there?
Questions flooded my mind during those hours as I sat watching the clock.  I headed down, and bought lunch in the crowded cafeteria.  Pretending that I was ok.  Pretending that I was not about to crack.  Pretending to be strong.  It was my shield.  It was the only thing that kept me moving forward.  And I had made it pretty strong during the 47 days since the heart attack. For 47 days, I had put on that armor, sleeping little, worrying a lot.  Sure it cracked a few times, when I went ballistic on the patient demanding pain medication, that had previously been fired by my clinic, but was a patient of the person whose space we shared while he was on FMLA. But I had to work, I had no choice.  IF I didn’t see patients we would not get paid, and I had bills and kids to support, but that patient, and that pain script, it was too much.  I should not have even been working that week.  Jeff was still in the hospital from the MI, and his EF was so low, but I was not given a choice.  And so I constructed this façade.  
It almost crumbled all the way, when the dog stopped eating, and got significantly worse.  And I had to call the vet to put her down.  Only to get someone covering who was terribly unsympathetic.  They told me that I would need an appointment and well there did not seem to be any openings to do that this next week.  I hung up the phone in tears at that point, and hubby had to contact the wife of our vet, who got him in touch with us, when he got back and town.  And he came in for us.  It was then that I finally had to reach out to someone, in another state, because my life was taking too much of a turn towards a bad country song.
It wasn’t all bad, or we tried to make the summer slightly better, for the oldest child’s 13 birthday.  Previous plans were cancelled, so we spent a weekend at Great Wolf Lodge in Plano.  It was something, and a brief light before things would darken again.  And maybe the false hope I had at that moment, was good, and something that I would not have had if we had decent internet service at home, and the life vest that Jeff wore had been uploading all along.  But it was a brief moment of hope, where I allowed myself to take a breath, because after that weekend Jeff returned to work, and somewhere with internet service, and his vest uploaded, and things were not better, and his heart had been going into shockable rhythms that he did not feel, and was merely annoyed at the beeping on the vest that he shut off.
And thus resulted in an emergency drive to Baylor in the pouring rain, trying to choke back the tears in my eyes.  Kids loaded into the backseat, and fearing the worst.  That stay was a week, waiting for the coumadin to wear off, the amiodarone to have a chance to work, and a pacemaker to be placed.  It is also the week that I learned, people don’t mean it when they say, “If there is anything that I can do for you…” because I did ask that week, for someone to watch my boys the day of the pacemaker placement.  And they were all busy.  Sheesh, I have never written all this down, and now two years later, the tears are flowing, probably more than they did then, when I had to be strong, and yet I was not quite there for the boys.  I tried, but they ended up leaning on each other more than me.  But the pacemaker/defibrillator placement was a success.  Went in for a recheck, and they scheduled the ablation, which led to two years ago.
Finally, they called me, and took me to the room that would be Jeff’s for the night.  Everything had gone well, and he would be kept overnight and sent home in the morning.  And so the waiting began.  But they were hopeful. There was a chance, and a good one that he would not need a heart transplant.  I sat with him that night for a while, and went to a local hotel that night.  And went back the next morning.  We had hope for the future, and while the next 3 months were anything but easy, sometimes I would think that it would be ok. And some days I would accuse him of trying to give up, and if that was the goal, I wouldn’t blame him, but could he please wait until we get moved into a new house, the new town, the new job and the new life.  And he would respond that he would.
And in October, we had good news, not as good as hoped, but the heart did seem to respond, and for now, no transplant would be necessary.  He would live, and we could stop holding our breath.  And so we moved forward.
And here we are 2 years later.  He is with the boys out on a boy scout rafting trip. We have taken more trips as a family, and we have spent more time together as a family, much to the chagrin of my two teenagers (well the one is almost a teenager).  And I am here alone in my thoughts and remember what happened that day, 2 years ago.

I stopped blogging a while back, not because I had nothing to say, but because I was in the middle of something, that I couldn’t say. Feelings and thoughts that might have gotten me fired, or even worse committed. Well probably not committed, but maybe on some days

I have since left that job, 9 months ago. And then moved across the state to start a new job 6 weeks later. And while I cannot still bring myself to discuss the horrors in a written state of my previous employer, I can say that they were the reason for most of my problems.

So now I am free of that, I move forward with a new job and a new outlook on life, and I might just be able to start blogging again

And so what happens now

So for the first time since medical school, I am unemployed.  Well temporarily, I am between jobs for the next 6 weeks.  It is a bit odd.  And so far, I have been to a cardiologist with my husband and today, I was back at my old clinic, briefly, but even still.

I took 2 walks today. I hate to clean and since we have a moving company moving us to our next house, I don’t really care to pack, when I am paying someone to pack for me.

And yet, I don’t miss it yet.  So wednesday last week was my last day, so I haven’t been out of work even a week yet. I just don’t know what to do with myself.

After almost 3 years of being told that I wasn’t seeing enough patients to be worth equipment that was standard of care.  I wasn’t seeing enough patients to warrant a scribe even temporily following surgery on my right elbow.  Did I mention that I was right handed, and less than 6 months later, others seeing fewer patients were given scribes. 

And it was during that three years, I realized that corporate medicine is detrimental to patient care and physicians both.  Corporate did not realize that while I didn’t do the expensive procedures that were great for their bottom line, I was the one referring them.  The response of “You’re just family medicine,” became so frequent and demeaning, I started to accept that I was less than I really am.  The administrators who make larger salaries, for what, I don’t know.  When you try to tell those in charge how things have to be done, and when you are ignored only for them to realize later that they should have done it your way. 

It is difficult to complain as I realize that others have it worse, and even though I was severely underpaid, others had it worse than I did.  And so now I am venting.  I don’t know what all I should say, and so I can’t say more at this time.  Maybe later.

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It’s easier as a doctor to ignore your own symptoms then to look for a reason why.  That’s why I spent a year having terrible pain in my hand before seeking help.  Then spent another year treating it medically with a neurologist before getting a second opinion from another surgeon who has scheduled surgery to relieve the pain.
It’s why I took 8 months to get the 6 month follow up on a mammogram.  And when the hubby asked how it was, I told him the lesion was smaller than before.  His response was “they were watching something?  You didn’t tell me that.”  I just didn’t think that a probably benign lesion was worth thinking about in my days.
It’s why I worked until I almost collapses a month ago with pneumonia before getting an x-ray and being forced to take a week off.
Though yesterday wasn’t necessarily denying my symptoms, it was just thinking it was asthma until the chest tightened further.  And the hubby got scared.  After last month’s bought with pneumonia, I didn’t fight the trip to the ER.  Though I would say the pain scale on my chest seemed odd, since the hand pain stays at a higher level than the pressure ever got in my chest.  But they let me go home. 
However, my husband is making me rest today.  I don’t think that he trusts me to not go full force.  I have no doubt that rest is needed.  A good night sleep is a rare thing for me.  I really wish nursing homes had patients who are fall risks to sleep on mattresses on the floor.  Apparently Medicare states that they have a right to fall, not to get injured but a right to fall.  So anyway, until I heal, I guess I am stuck resting. 

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