Last Week



Doc's Progress Notes

Week of June 26, 2000

Last Updated: 7/1/2000 at 10:13 PM PDT

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Monday June 26, 2000

As predicted yesterday, this was a very long day. I did finish rounds before 7 AM this morning then went to the office to see patients all day. I finally got out of the office about 7 PM tonight. I then ran in the 85 degree(F) heat before coming home where I have been working on budget matters here. That pretty much sums up my day and I don't really feel up to writing any more here tonight. Tomorrow night should be different although it is supposed to be up near 95 degrees(F) tomorrow. I will try and write more tomorrow night.

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Tuesday June 27, 2000

Another hot day here in western Washington. It was supposed to be around 95 degrees(F) today but I have not heard what the high was yet. When I was coming home tonight around 8:30 it was still 90 outside. Of course, this is dry heat compared to what I am used to growing up in Arkansas. When they say it is muggy here the natives really don't know what muggy is. This hot spell is supposed to break Thursday with temperatures back in the high 60's to low 70's for the weekend with a chance of rain again. We are already getting some high clouds where the skies have been clear the last two nights. It will probably be cloudy and cool for the Fourth of July.

I don't know when this will get posted as I am having trouble connecting through my ISP. This has been happening at night the last three nights. The modems will get connected then the connection will be dropped. It does not happen early in the morning so I don't think there is anything wrong with my computer or modem, just the modems at the ISP. I really am writing this Tuesday night no matter when it gets posted.

Today was busy as usual. Not busy in the number of patients seen but busy with all the paperwork generated when two or three clinicians are gone for a week. I also have now three patients in the hospital who I need to see tomorrow even though it is my day off officially. I also need to make nursing home rounds and have a meeting at noon tomorrow. Sounds like a pretty full morning to me and I have a couple of errands to run tomorrow afternoon. It should still be hot tomorrow so I will get up and run in the morning. Probably no time for biking tomorrow.

The kids have been calling every night. They must be getting bored at their grandparents now. They went to visit my mother today and enjoyed themselves. She is coming out here to visit us in late September. It will be her first visit here in a year. We are looking forward to it.

Connectivity is back so I will end this post now. See you tomorrow.

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Wednesday June 28, 2000

It was hot yesterday. The official high temperature here in Longview yesterday was 99 degrees(F) which set a record for the date and broke the old record by something like 13 degrees. Today the cooling trend has already started with the high being in the high 80's and it is already below 70 degrees outside now before 10 PM. We will have much more typical weather for here for the weekend.

I ended up spending most of the day either at the hospital or making nursing home rounds. Tomorrow looks very busy again with five patients to see in the hospital before my office hours begin. Friday I am inpatient physician again and that will run through Sunday. I will be on call Saturday night so I will end up covering the hospital for 36 hours in a row. That is like being a resident again. I only have to do it about once every three months or so due to the size of our group. Luckily, the Fourth of July falls on Tuesday this year and I am not on call so Delanae and I can go to the big fireworks show in Vancouver, Washington. Hopefully, it will be warm but not too hot during the day and not too cool at night. Last year was our first time to go and we really enjoyed it. More details as the day gets closer.

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Thursday June 29, 2000

Today's weather was more typical for this area at this time of the year. The high was in the mid to upper 70's and very comfortable, at least at 7 PM tonight when I finally got out to run. Tomorrow I will be running in the morning when it should be in the low to mid 50's which is again typical. Forecast so far for the Fourth of July weekend is highs in the low 70's and no rain until perhaps July 4th itself. That would not surprise me as that is the day we have something planned.

I only saw four patients in the hospital this morning, rather than five as expected. One had already gone home yesterday afternoon without me knowing about it. I sent one patient to a nursing home today which takes a lot of time as they have to have pages of orders filled out plus a discharge summary dictated right then. I did manage to get to the office on time and started the day off with a work-in patient with shoulder pain which she was afraid was coming from her heart. It was not, it was shoulder pain due to some inflammation of her rotator cuff probably from doing work with her left arm that she was not accustomed to doing. Pain due to inflammation of the rotator cuff is a very common presenting shoulder problem, one that many patients think is bursitis. It is not, technically it would be a tendonitis I suppose but is treated identically to a bursitis. The difference? A bursa is a fluid filled sac over a bony prominence to prevent that prominence from rubbing on the soft tissue structures that cross it. When it gets inflammed, it begins to hurt and can swell. In the shoulder, that will cause pain to palpation directly over the outside of the shoulder or upper arm. Rotator cuff tendonitis, on the other hand, does not cause pain to palpation there but rather pain when one tries to lift their arm overhead or reach behind themselves to, for instance, fasten their bra or scratch their back.

Tomorrow I go back to being the inpatient physician again. Tonight, the inpatient list does not look too long but that could change tomorrow. It should not with this weekend being a holiday weekend but you never know. The hospital is taking advantage of the smaller inpatient census at the present time to close a floor and replace the carpet. They plan to do this one floor at a time. Eventually, the plans are to remodel each patient floor but that may take a couple of years.

Tomorrow night Delanae and I are going to a concert featuring all Eric Clapton songs. The group playing is made up of several individuals from the community and is very good. I heard a little of their program two or three months ago when they performed at one of the high schools here. The program is the result of one boy's idea for a senior project to benefit the children's hospital in Portland. He recruited the band members and they gave a benefit concert for that hospital and raised several thousand dollars. Now they are doing it again for a local charity. We are looking forward to going and hearing the entire program. Because of that, tomorrow's post may be very short or nonexistent. See you later.

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Friday June 30, 2000

No update as I warned you.

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Saturday July 1, 2000

Just a short post tonight. Very busy yesterday with admits to the hospital. Got out in time to eat a sandwich with Delanae, then go to the concert. It was very good and the crowd did not want the band to stop playing. They had to come back and repeat one of the songs because they had played all they knew.

So far, I am not enjoying the holiday weekend. Call has been very busy, especially with telephone calls. I helped with two c-sections back-to-back this afternoon along with admitting and discharging patients all day. Now I am answering phone calls tonight. Three people have already tried to get me to refill their controlled substances on a Saturday night by calling just after the clinic closes and before the pharmacy closes. They know I would be unable to check their clinic chart and see if they were abusers or not. I refused them all citing our policy of not refilling controlled substances during hours when the office isn't open. We do make exceptions for cancer patients of course.

Hope your holiday weekend is better than mine. Just drive carefully if you are traveling on the highway and get to your destination alive.

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Sunday July 2, 2000

No update.

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