Doc's Progress Notes
Week of September 25, 2000
Last Updated: 10/1/2000 at 9:58 PM PDT
Another month almost over. Today was spent running around doing errands and last minute things before my mother leaves tomorrow to fly back to Arkansas. She is taking back a starfish from the Oregon coast and toys for my two nephews in Arkansas. We had to find a container to put these things in that could be taken on the plane. We ended up with a plastic tub that is large enough to hold the toys and some clothes. My kids were given money as their gift, they were very happy with the money.
Tonight, Stephen's junior varsity team won their game. The final score was 28-6 over the junior varsity from the team that the varsity beat Friday night. This game was played here in Longview and my mother got to go to it. She could pick out Stephen on the field which was the most important thing for her.
I forgot about a meeting I had scheduled this morning. Actually, I had it entered in Microsoft Outlook at the office but not in my Palm for some reason. I went in to the office, with my mother, at noon today, mainly to show her around. While I was there, I checked my e-mail quickly and found the meeting entry. I called and apologized and the meeting has been rescheduled for Wednesday afternoon. Wednesday is going to be a very busy day for me with appointments all day long, ranging from the dentist to needing to make nursing home rounds.
I have just finished configuring an alternate internet access for those times when I can't connect due to problems with my primary ISP. This access is sponsored by a pharmaceutical company and has drug advertising included but it is free and I will use it only when I cannot access the Web or e-mail through my primary ISP. I have been wanting a backup for a long time.
My mother is back in Arkansas. Her flight left on time this afternoon and she is back at my brother's, in Little Rock, safe and sound. Amazingly, for flying through Dallas-Ft. Worth, her flight got into Little Rock a little early. We enjoyed her visit but now things will get back to their usual routine around here again.
Tonight, I went to an open house at Stacey's school. It was just for her classes and her teachers explained what they were teaching and how they were grading. One of them remarked to me how talented she thought Stacey was and how lucky she felt to have her in her classes. When I told Stacey this later she asked how this particular teacher knew her that well. I know how talented she is and enjoy having other adults confirm it </end proud father rant>.
I am having problems with my new internet access. It installed OK but now I can't log on, giving me an error message that my username and/or password is incorrect. I had previously checked the username and password on their website so I know it is correct. I will keep working with it but right now my internet access is limited because Delanae is busy sending auction items out and has to check shipping charges on the USPS website to know how much to charge each successful bidder. I don't know when I will get to upload this update, it may be tomorrow morning.
Stacey's team lost a volleyball match this afternoon. They lost to the other middle school in Longview who happen to be their chief arch rival. They had beaten them at the jamboree earlier this month but the other team played a lot better this afternoon. I don't know how their coaches have so much patience, I would be screaming at the girls when they don't think.
Tomorrow will be very busy for me. I have four appointments throughout the day and have to squeeze nursing home rounds in somewhere. I also need to start catching up on some paperwork at the office so Thursday is not the longest day in history. Somehow I will get it all in and let you know how it goes.
Short update tonight as Delanae is waiting for the internet connection to finish her shipping auction items. I know, I know, we need shared internet access and that is coming, just not right at this moment. Anyway, I did make the appointments today and did get nursing home rounds finished for this month. One of my appointments was with the dentist for cleaning so I have sore gums tonight but no fillings needed. That is always a success story.
I spent two solid hours going through paperwork this afternoon so I won't start out so behind tomorrow morning. My medical assistant doesn't know about the stack for her yet but will find out in the morning when she walks in the door. I would love to see her face but will have to miss it as I have two patients to see in the hospital in the morning. I also have hospital charts to sign off on although the electronic signatures are up to date. We cannot cosign orders online yet, just dictation. We therefore have to go down to medical records on a regular basis to cosign verbal orders that we might have given while on call. There is no way to get them all signed the next day even if you go looking for all the unsigned ones on each floor. That is why they have to be signed after the patient leaves the hospital and the record gets down to medical records.
Sorry for the short update. I promise more tomorrow night, maybe. I do promise some details about the first day back at work after an extended (for me) vacation.
I survived the first day back in the office. Actually, it wasn't that bad. We were steady busy in the office but the work I did yesterday to go through and do as much of the paperwork on my desk as possible really paid off. I was not inundated by the paperwork today. I just had the usual number of refills and messages, not two weeks worth.
There were two depressing things to come back to. Two of my patients were found with metastatic cancer over the past ten days. I suspected it on both but am unhappy to find that my suspicions were correct. One is in the hospital and should go home tomorrow and one I will see in the office tomorrow to give him the bad news. For both we will be able to offer only palliative treatment to make what time they have left more comfortable. The man in the hospital has metastatic cancer in his brain with the source of the cancer still unknown. We have looked for the source in all the most common organs but so far none has been found. He may end up having a brain biopsy done to find out the organ of origination just so we know what the cancer in his brain would respond best to.
The other man has colon cancer which has already spread to his liver. He has a huge mass in his liver so this is a very aggressive colon cancer. The mass in his colon is not that large meaning that the cancer spread quickly, while it was still relatively small. These are the kind that cause death rather quickly. He will need palliative treatment quickly and may need an operation to remove some colon to prevent him from having a blockage in his colon caused by the cancer. We'll know more about that over the next few weeks.
Stacey's volleyball team won their match today. She told me that she got more serves in than she has in any other match. A lot of their matches are decided by whichever team gets their serves in most consistently since there are not many real "kills". Then, they were taken to the high school to watch the high school girls team play and enjoyed that.
Tomorrow night is homecoming for Stephen's high school. Delanae and I have a dinner meeting to go to before the game and then I need to stay for a continuing medical education lecture immediately afterward. That means that we will both be late for the football game but we should be able to see at least the last half of the game. It may be raining in which case Delanae will not want to go. Stephen has a junior varsity game Monday night but it is 2-3 hours away so we will not go. It does mean he will be back very late Monday night which means one of us will have to be up very late to pick him up. Oh, the joys of parenthood <G>!
Busier day today. Part it was spent arranging things for the two patients with cancer that I told you about yesterday. They both required several phone calls to set up referrals and to get opinions. That meant some time playing telephone tag with other physicians plus paperwork to get the referrals done correctly. Then, two family meetings with the family of the man in the hospital to make sure everyone is up to speed about what is going on. Not that I mind talking to them but it does mean I have to make up that time sometime either by arriving earlier or staying later to finish everything. Tonight, it meant staying later.
I did get to the dinner and lecture tonight. I did not get to the football game. By the time the lecture was over the football game was about over and it was raining and I did not feel like finding a parking place and walking to the stadium in the rain to watch a few minutes of the game. I know, I know, I failed as a parent tonight and as a husband since Delanae did leave the program early and go to the game. I was going to meet her there but, as you can see, I did not.
Tomorrow looks rainy here which means it will probably be a day to catch up on some sleep and watch some college football. We may try to burn another brush pile if it is not raining too hard. The surrounding trees being wet would help contain the fire as long as the pile is not too wet to burn. We will see tomorrow.
It did rain all day yesterday so we made it a lazy day. I watched a lot of college football and read. Delanae and I also put together some shelving for our garage, as a matter of fact, we put together enough to line one wall. We still haven't filled them yet, that will come later.
Since it rained all day yesterday, that made today perfect for burning the largest brush pile. We burned it without catching any surrounding trees or brush on fire because everything was still moist from yesterday. At this time, it has been a nine hour fire so you can imagine how large the brush pile was. Most of it was left over from when they did some logging on our property a year before we bought it. Some of it was brush we added while cleaning up but not much. It could still stand to be burned once more and we plan to do that, maybe next weekend if it stays dry this week.
Last night, we did watch a movie on DVD. It was "Mission Impossible", we are waiting for "Mission Impossible II" to come out on DVD. We still have "Air Force One" and "Tomorrow Is Not Enough" to see, maybe next weekend.
Tomorrow comes early. I have a Leadership Council meeting tomorrow at 7 AM then a full day. Stephen plays in a junior varsity football game tomorrow night about three hours from here. No, we are not going to try and go but we will have to pick him up whenever the bus gets back. I also have call one night this week, so it will be a busy week for us.
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