Doc's Progress Notes
Week of October 9, 2000
Last Updated: 10/15/2000 at 8:54 PM PDT
I'm feeling better! I guess you could tell that since I am writing an update today. Last night I was too exhausted after a full day's work and then going and watching Stephen play in a junior varsity football game. All I did was come home, eat, watch the last of the Monday Football Game between Minnesota and Tampa Bay, then go to bed where I read for awhile before falling asleep. Today, I feel almost completely human again and am thinking about returning to running tomorrow. First, I want to sleep in a little in the morning and get some energy back.
I had mentioned last week that I thought I had found my third case of cancer. As it turns out, I was right. My 42 year old patient does indeed have a lung cancer and I had to talk to his wife about it yesterday since he was at work. Understandably, they had been hoping it was something else. The CT scan confirmed that it was a cancer and could already have spread to the lymph nodes in the middle of his chest which is called the mediastinum. That means he has a more ominous prognosis if it is true. Still, we are planning on sending him to a surgeon who can hopefully operate on him and remove the cancer and it will not have spread enough to give him very little hope for cure. We will only know for sure once all the workup and surgery are completed.
One of the other two patients with cancer is being discussed at our local cancer conference this Friday. This conference will be broadcast by video teleconferencing to an affiliated hospital in Ketchikan, Alaska. I will be there to present the patient, then the members of the cancer team will discuss the best way to treat his cancer.
I currently have three patients in the hospital. Two are currently undergoing drug withdrawal, one involuntarily and the other one is being treated for depression by a local psychiatrist. The one being involuntarily treated for drug addiction will be able to leave tomorrow afternoon and probably will, returning to metamphetamine and her boyfriend who gives it to her. I had hope that she would see that he is just using her but she refuses to see the obvious; he has other girlfriends besides her and she knows it but refuses to believe that he will not change. A friend of hers had tried to get her out of this situation but she has now gone back to it and resumed using the meth. Hospital rounds, at the present time, are not any fun for me.
A team for our corporate headquarters was in our office building today testing the computers installed in the exam rooms to be sure their network connections were functional and they were printing to the appropriate printer. This is being done in anticipation of us going live using electronic medical records Nov. 1. I am being trained this Saturday so I can help my fellow physicians learn how to use the software package between now and then and after we go "live" on Nov 1. I will need to be available in the building on that date although it is a Wednesday and technically I am off that day. That is also the day after I am on call the night before so I will be tired but this is an important date that I have been waiting for for almost three years now. I would not miss it for the world.
Yes, I am on call Halloween night. I won't miss much as my two kids are probably too old to trick-or-treat, although Stacey may go around to a few houses. Stephen is definitely too old and we would not allow him to be out on a night full of mischief like Halloween anyway. We do not trust him enough yet to allow him that kind of freedom.
I think I am caught up now. Updates should be more regular from now on but there will be occasional days I do not post an update. Bye for now.
Not much happened today. I tried to sleep in a little today but had to get up and take Stephen to school at 6:40. I then came back and took a nap before going to the hospital and seeing my patients. I did send the patient home who was being held involuntarily. She says she is not going to go back to using meth but we will see. She will be doing urine drug tests if she continues to see me. She probably has a mental disorder and says she will see the psychiatrist to saw her in the hospital but we will see if she keeps that promise. If I sound pessismistic, well it is because I have heard all this before. I will believe her when I see her following through with her promises.
My other patient should be going to the nursing home for about a month either tomorrow or Friday. She will need IV antibiotics for that time and neither she nor her husband can care for both of them at the present time. She is agreeable to doing this. I volunteered today to see two patients of my partner who is off tomorrow but now tonight find out I have had two more patients of mine admitted to the hospital after I left today. I will be very busy tomorrow making hospital rounds. Couple that with Stephen having a game tomorrow night, at home luckily, and it makes for a very long day tomorrow. Stephen and Stacey are both out of school Friday for some statewide teacher inservice so I won't have to take Stephen to school that morning. Also, they are both going to church retreats, separately, Friday afternoon and will not be back until Sunday evening. That means Delanae and I will have almost three days with no children and on a weekend no less when I am not on call. We must find something to do with ourselves.
One of my errands today was taking our Jeep and getting the oil changed. I had tried to get it changed last week at the dealer but they said they could not get the oil plug out and wanted to replace the oil pan at a cost of nearly $400. I said I would take it back to Jiffy Lube who had been doing the oil changes and give them a chance at it or have them pay for the new oil pan. Well, Jiffy Lube got the oil plug out with only a little problem, changed the oil and filter and refused to let me pay them saying customer satisfaction was the most important thing to them. They felt like I had been through enough already with the dealer telling me that Jiffy Lube had put the wrong size oil drain plug in some time. Tomorrow I will call the dealer and ask them if they were lying to me or just did not try hard enough. Jiffy Lube has made themselves a lifelong customer now for the price of an oil change.
One update every four days. That is quite an enviable record for what is supposed to be a daily journal, isn't it? Too many things happening and too little time in each day. I had not even gotten to my e-mail here at home until earlier today. My apologies to anyone who sent me a message, I will answer them.
Thursday night was the varsity football game which Stephen did not get to play in but his team won. He and I did not get home until after ten, by which time it was time to go to bed so I could get up and go to work at my regular time on Friday morning. Thursday and Friday had been very busy in the hospital. Thursday, I saw six patients total in the hospital and had a full day in the clinic. Friday, I had a couple of patients to discharge from the hospital which took awhile. Also, Friday at noon, I had to present a patient at Cancer Conference. This unfortunate patient is the one with the cancer in the colon and liver. He is only 47 and has no hope for cure, we can only make the time he has left a little more comfortable. The problem is that the cancer in his liver is much too large to remove and will not be cured by chemotherapy. If the cancer was much smaller and could be removed, he would have about a 25% chance of cure.
After getting home Friday night at my usual 7-7:30 PM, Delanae and I watched a movie and ate pizza. Both kids were gone to church retreats and this was our date. We enjoyed it and enjoyed each other's company. I did not want to spoil the mood so did not even come downstairs to check the computer.
Saturday morning, I went to the training session for our new electronic medical record software. By the time I got home, I was feeling bad again, like last weekend. I spent the rest of the day curled up on the couch watching college football and the league championship series games. Then, Saturday night, Delanae and I watched "Armageddon" on DVD. Again, I did not touch the computer Saturday and it felt good. My vacation from this journal is now over but the upcoming week looks very busy again.
The kids are back from their retreats. Stephen is sleeping since he got very little sleep this weekend. Stacey ate about four times what she normally eats for dinner saying it was real food and tasted good because it was real food. She evidently did not like the food that was served at the retreat. Stephen went to a different place and said his food was good. They both enjoyed their weekends away as did Delanae and I.
Right now, I know of two patients I need to see in the morning as well as a Leadership Council meeting at 7 AM. Tomorrow night is worship team practice for Delanae and I. Right now, I need to end this and go get things ready for an early start in the morning. Bye for now.
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