Doc's Progress Notes
Week of March 27, 2000
Last Updated: 4/2/2000 at 10:36 PM PDT
Yes, I am still alive! I just have not written anything for two days. Why, you may (or may not)ask. Let me tell you my tale of woe; if I sound like a whiner, please excuse me, I do not mean to.
Monday, the carpet was finished here in the house so after a day at work that began about 6:30 AM when I left the house and ended about 7:30 PM or so when I got home, we put up some wallpaper in Stephen's room, then reassembled Stephen's bed. You can read some of the details on Delanae's page here and please do because there is an apology there directed to me. After doing that, we moved some furniture and by that time it was close to midnight, so I went straight to bed.
Yesterday, Tuesday, began the same way but I did not get home until close to 10 PM. After moving a little more furniture, I was too tired to write anything so did not. Now, I am doing this while waiting for a telephone company technician to get here to fix a two line telephone jack downstairs in my office. This jack was installed by the telephone company sometime after we moved in but has stopped working sometime during the last two months while I have been out of that office. I checked it Monday night before reassembling my office in that room and it was completely dead. We had some static on one of our lines in December or January and the phone company came out to fix that and I am wondering if they disconnected that jack at the junction box for some reason. Anyway, we need that jack back working so I have internet access without having to run a telephone wire fifty feet or so down a hall.
In other(unrelated) news, I have had one patient in the hospital since yesterday morning. This is an unfortunate 40 year old man who has now had two strokes but has been lucky enough to have very little residual weakness. He came it Monday night having the second stroke but has made a tremendous amount of recovery already. He is talking normally and has only a little left arm weakness which should resolve completely with physical therapy. He has been on an oral blood thinner, Coumadin(Warfarin), since his first stroke about a year ago. Unfortunately, he had an auto accident on March 21 near Barstow, California and was taken off the Coumadin there because his blood was a little too thin. He did not follow up with me as directed and his blood got too thick and he has had his second stroke now. This has been his pattern, not following up when he is supposed to. If he had done as he was told, perhaps he would not have had the second stroke. He will now be unable to drive for at least a year, probably, and will never be able to go back to being an interstate truck driver which is what he was doing at the time of the stroke. Before someone asks me the logical question, he has one totally blocked internal carotid artery and we are investigating to see how much blockage is present on the other side. He may be a candidate for carotid artery surgery if he has a greater than 70% blockage on the opposite side from the completely blocked carotid artery.
After seeing him this morning and helping Delanae pick out new linoleum for our bathroom, I made nursing home rounds. When I am not rushed for time, like today, it is always fun to sit down and talk to the nurses at the nursing home about each patient and what progress they are making or not making. One of the patients is going home Tuesday, less than a month after admission from the hospital following a stroke. That is always a cause for celebration by the nurses. We also talked about the gradual degeneration of a couple of patients with Alzheimer's Disease. They no longer know the month or year this is and don't know their own family. There is nothing more we can do except to keep them comfortable, they have not improved on the present medications we have for Alzheimer's Disease.
Before I close, let me welcome the newest Daynoter, who is known as Warlock. We have known his alter ego for sometime and were just waiting for him to get his own daily journal online. I've enjoyed his e-mails and know you will also enjoy his journal entries as much as I do.
Now, I have some other things to do while I wait for the telephone repairman(technician) so I will close for now and I do plan to be back tomorrow.
No telephone technician yet. That's right, no one showed yesterday and no one called to explain why. When I called this morning, the customer service rep said he did not know why no one showed but said we were scheduled to have someone here at 10 AM this morning. I proceeded to tell him that no one would be here because the technician was scheduled for yesterday afternoon, not this morning. Finally, we got another appointment for Saturday morning, want to take a bet whether one will show up? By the way, when Delanae got home today there was a note on the front door that a technician was here at 9 AM and where were we? US West has such great customer service!
The stroke patient continues to improve. His speech is back to normal but he still has some left hand weakness which should resolve completely with therapy. He is still in the hospital because his blood is not thin enough on Coumadin to take off the IV Heparin yet. Once it is, he will be discharged, hopefully tomorrow. He is getting a little tired of the hospital already.
I had a fairly strange visit with a patient in the office today. She had come in for a scheduled physical and said she wanted to talk about allergies. When she got to the office, she smelled of alcohol but denied daily use of it or problems with it. She also proceeded to tell me about the abuse she had suffered first last summer then around Thanksgiving at the hands of the man she was with. When I tried to pin her down on the exact times she became very evasive. She also told me she lived alone now and the man who had abused her was in jail.
During the exam, I found some bruises on her arms which were obviously very fresh. She told me one was from the Thanksgiving episode and the other one was from when someone helped her up after she fell recently. The latter bruise looked like someone had grabbed her arm and squeezed very hard and the former bruise was obviously not more than a week old at the most. I then asked her to get dressed while I stepped out of the room for a moment. When I went back she had left and the front desk girls said she had left hurriedly with a man and a small girl. I am concerned that she is still being beaten and came in to get help but chickened out at the last minute and fled with the guy who is beating her. She is 41 years of age and probably using alcohol to dull the pain both physical and emotional.
We got an offer on our house in Arkansas today. Unfortunately, it was a lot lower than what we are willing to sell the house for. We countered back with a more reasonable price and we should hear back tomorrow whether it will be accepted or not. I don't have much hope that it will be but stranger things have happened. The couple renting it now want to stay in it for three months longer than their lease runs since their house won't be ready until sometime in July. If this offer is rejected, then we will probably be able to continue renting it to them. Hopefully, this offer means the market is picking up again back there.
The weather was beautiful here today, or so I hear. It was sunny and in the 60's. Now the forecast is for this weather to hold through Saturday so we may be able to till the spot for the garden after all. I found out that one of my neighbors has a tiller which we can borrow. Now if the ground is dry enough by Saturday we will try to use it. It should be a busy weekend with furniture to move, wallpaper to put up, and outside work to be done. Stephen will be disappointed to find out that he will be staying home this weekend to WORK around the house.
Now I don't know how much work will be done around here this weekend. I had a long, hard day today complete with a headache which I have very seldom. I thought it was just because of the stress of the day but when I got home I was achey all over and running some fever. Looks like I have picked up a virus from someone at the office. I am planning on feeling much better tomorrow but am turning in early tonight.
Delanae and I watched a good movie tonight. It is "Message in a Bottle". If you are in the mood to just kick back and watch a movie with the one you love, this would be a good one. One warning, have kleenex handy.
Sorry for the short post. I must get up in the morning to be ready for the telephone technician in case he shows. Notice I don't have much confidence that he will. Oh, we still haven't heard back about our counter offer which probably means it has been rejected. Maybe more on this tomorrow.
The telephone technician showed but I ended up repairing a lot of the problem. We found that the telephone line in my old office had been cut, probably when the old carpet was being taken up. It would short out causing static on the line so when they came in January they simply disconnected the two lines to that jack at the outside junction box. When he reconnected the lines today, there was no dial tone until we found the cut area. He then spliced the line back together and left. Later, I was moving this computer back down to the office and found that only one line to that jack worked. Yes, he had spliced back only one line. I then took matters into my own hands and went to Radio Shack where I found some telephone wire splice connectors and carefully matched up the wire colors and voila, I have two lines again to that jack. Now, if I could only fix Delanae's computer.
Most of the day today was spent moving a piece of the computer then lying down regaining some energy then repeating the process. Now, my computer is set up again in my original office in this house. I am still running fever and to make matters worse, my back is really giving me problems today. I told Delanae that I looked like my father used to look when his back would hurt him. As I remember, he was about my age when he began having problems. I guess I am doomed to suffer problems with my back also although I stay in shape partly to prevent back problems.
I did have to check on an injured person today. I was in the midst of lying down, watching the Final Four when Delanae screamed for me to come. I ran out and found that a tree had fallen on the son of one of our neighbors. He and his father were cutting down an old tree and it had fallen the wrong way, striking the boy and knocking him to the pavement. Delanae called 911 while I went to check him. He was not knocked out but probably had a dislocated hip and multiple bruises and abrasions on his face and arms. As always, I was impressed with the job that the paramedics did evaluating him, packaging him, and loading him into the ambulance. Luckily, he had good pulses downstream from the hip so he should have no circulatory damage and at his age he should have a good recovery. Tomorrow, I should find out more about his condition.
I must get to bed now. Hope you remember that we lose an hour of sleep tonight so set your clocks up one hour. Otherwise, you will arrive at church an hour late. Hopefully, I will feel like going but I may not be able to sit much with my back bothering me.
We did make it to church this morning. A lot of people were dragging in a little late with looks of fatigue. I sat a lot through the worship service which isn't like me but I was too fatigued from this virus I have. I am improving as I managed to move the rest of the stuff out of the room I was using upstairs as my office into my new (really, original) office. All that is except some books which are in a cabinet built into the wall of the room. I will move those when these bookshelves down here are empty again which will happen when Delanae moves her books to her new office. So far my back is holding up pretty well although I feel twinges in it from time to time.
The boy from across the street is doing well. According to his father, he had a broken femur (thigh bone) and had a metal rod put in this morning. I'm guessing the fracture was probably at the surgical neck of the femur given the angle that his leg was laying yesterday. I will find out for sure tomorrow since I will go by and visit him in the hospital. He should be able to go home Tuesday or Wednesday.
Tomorrow, I begin a four day stretch again as inpatient physician. I will be only responsible for hospital patients Mon-Thurs of this week from 7 AM to 6 PM daily. As of earlier tonight, there were only four patients on the service but I expect there to be more by morning. I have a 7 AM meeting of the Leadership Council followed by the monthly group meeting at 7:30 so I will not be seeing patients until after 9 AM in the morning unless it is an emergency situation. The reason for the special Leadership Council meeting is to decide whether to make an offer to join the group to an oncologist who has been doing a locum tenens with us. I don't know how the vote will go.
All the clocks in the house are reset now so I can go to be when I close here. I will be cheering for Florida in the NCAA championship game tomorrow night since they are an SEC school which is the conference that Arkansas is in. While we're on the subject, don't forget that it was Arkansas not Florida that won the SEC tournament. Until tomorrow......
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