family practice issues and general life events

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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.

New outlook, no more burnout

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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Ignoring ones own symptoms

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. 

Daily Fitbit stats

My fitbit #Fitstats for 10/24/2014: 3,729 steps and 1.7 miles traveled.

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