Last Week



Doc's Progress Notes

Week of October 16, 2000

Last Updated: 10/19/2000 at 9:27 PM PDT

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Monday October 16, 2000

Two days in a row, not bad. Two days in a row with an update, I'm on a roll. Now to keep it up. I warn you though, I am on call this weekend so there may not be much later this week.

Today began with the Leadership Council meeting. We had to select a new member to replace one of the current members who is ending their two terms in office and can not be re-elected for a period of time. There were three excellent candidates so we compromised and have invited one to become an ad hoc member until there is another open position and he or she can be elected to that position. Another position won't open up for another two years and we did not want to lose leadership talent by making them wait for two years.

I saw two patients in the hospital and sent one of them home. I also sent one patient home from the nursing home at noon today. One of my patients died at the hospice care center last night. He was terminal due to his emphysema and was prepared to die, he just did not want to have any pain or difficulty breathing. I believe that was accomplished for him. As things stand now, I only have one patient still in the hospital but that may change overnight.

I don't recall volunteering but I was told I volunteered to help do the call schedule for the Christmas and New Year's weeks for the Family Practice physicians in our group. That means trying to coordinate about twelve people's work schedules over two weeks. It is going to be a big headache I can already tell. I just know I am going to be off over Christmas but will have to work some over New Year's. Tomorrow I begin soliciting ideas from specific physicians about when they are willing to work.

Tonight we are waiting for Stephen to get home from his junior varsity football game. It was in Vancouver, WA and he should be back within the next thirty minutes or so. Delanae and I both went to worship team practice tonight at the church since I could not get out of the office in time to go to Vancouver and get there in time for the football game. This should be the only one we miss for the rest of the season. Oh, I will miss the varsity game Friday night since I am on call. I should not miss any junior varsity games however. Stacey's last volleyball game is Wednesday afternoon and I will get to see it. After that, she is threatening to play basketball so we will see when those games are if she makes the team. I have no idea how many girls they allow on the team.

That's all for tonight, see you tomorrow night.

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Tuesday October 17, 2000

Last night's junior varsity game did not go so well. Stephen says they lost 57-0 because they only had 14 players total to play since so many had played on the varsity team last Friday night and would be over the total number of quarters they could play in a week if they had played. He ended up playing a position he had never played before, in a game, when one player got hurt. For Stephen that is very difficult as he has very little patience with change that is unexpected and even if he has lots of warning. He has always wanted to do things the way he first did them, including not moving to a new position if he has played a different position all year long. Me, I would have looked at it as an adventure. He did get to play the entire game which tired him out and hopefully will be valuable for him in the future.

Most of today was spent seeing office patients. I only have one in the hospital at the present time and she should go home tomorrow or Thursday at the latest. She is recovering from pancreatitis caused by a gallstone passing into the duct to the pancreas, blocking it and causing the pancreas to try and digest itself. The pancreas makes digestive enzymes, as well as insulin, and if its duct gets blocked those enzymes are loosed on the tissue that made them. She is much improved since the duct is no longer blocked but will need to have her gallbladder removed and the duct studied at the time of surgery to be sure there are no gallstones left behind. She will probably have the surgery in another week or two so she can have a little time to get stronger. She is 69 so pancreatitis weakens her more than if she were twenty years younger.

I now have two of six days taken care of for the New Years holiday week. I have two volunteers for call, I only need four more; one of those will be me and I am trying to get out of getting stuck with either New Year's Eve or Day. I am making out the schedule but want to give everyone a fair shot which means I will probably get stuck with one of those days. Actually, I do have one volunteer for either day, whichever needs to be covered so that reduces my chance of having to do one.

My partner who had been out for six weeks for back surgery, returned to work half-time today. It was good to have him back but we told him to take it real easy and not reinjure himself while he is getting well. He is one of the six who will be in the call schedule for the New Years holiday week so he needs to stay healthy.

Tomorrow is Stacey's last volleyball match for this school year. She is feeling a little under the weather tonight, hopefully she will feel like playing tomorrow. I will be able to go to the game tomorrow which is a rarity for me. They are playing a team at another school here in Longview that has beaten them before. They now say it is because the gym was so small and the volleyball court was too short. We will see if her team is able to beat them in the same gym they lost it last time.

Also tomorrow I have to go to a meeting about preparedness for the "go-live" on November 1 of our electronic prescription writing module in the electronic medical record system. I have been ready for three years, I think most of my partners are also ready although there will be the usual grumbling about having to learn a new way to do things. The benefits of using this module will far outweigh the time it will take them to learn how to use it. I am ready to use it today but it won't be turned on until October 31. We will see if I can use it on that day rather than wait for the official first day, November 1.

See you tomorrow.

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Wednesday October 18, 2000

Today was a good day, all in all. I got to sleep two hours later than normal since the kids both had late arrival at school today. The school district starts classes three hours late one Wednesday morning a month to allow for teachers' meetings. I am glad they picked my day off. I am a little more caught up on my sleep now before I go into the weekend on call.

Once I left home this morning, a little after nine, I did not get back until after 5 PM. First, I sent my one patient home from the hospital. She is the lady with the pancreatitis and she is now scheduled for gallbladder removal Monday, November 6. Her ultrasound of the gallbladder also showed some "sludge" which means she could pass some more small stones which could block the tube to the pancreas once again. Hopefully, she will not do that before her scheduled surgery. She needs a little time to get a little stronger.

After going by medical records to check and see if I had any charts to sign, I did not, I then checked my office e-mail and did a little paperwork at the office. Following that, it was time for a haircut, then lunch, then pick up Stephen for an appointment. Later in the afternoon, Stacey had her final volleyball match which her team pulled out by winning the last two games after losing the first one. She was pretty pumped! Basketball starts for her (and us) now next week. After the game, run, fix dinner, go to church, pay bills, and now update this journal. All in all, a full day and a good day. Interspersed in the day were some periods of reading. I am currently reading Tom Clancy's new book "The Bear and The Dragon". I find his books hard to put down once I start. I am enjoying this one as I have all his others.

That was my day. It is now time to get ready for tomorrow. See you later.

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Thursday October 19, 2000

Short update, long day. This morning began with a couple of no shows. I did get caught up on my paperwork during this time but quickly got behind again as the day went by. I almost have the call schedule done for the New Year's holiday week, now I just have to run it by all involved. The ones I have talked to have had no problems with it.

I went to a meeting at noon today where we rehashed some issues we had worked out two or three months ago, or so I thought. We reworked them out and now will put them in effect Nov 1. November is going to be a big month for us as far as embracing new ideas, processes, and uses of the computers at work.

Later in the day I got put in my place by the state. I was informed, by a pharmacist, that my prescription for an antipsychotic medication would not be paid for my Medicaid since I was not qualified to write it, according to Medicaid. Since I am not a psychiatrist, Medicaid feels that I do not know enough to write such a prescription. Once again, big brother government know better than I what is good for everyone, especially me. I told the pharmacist to do what his conscience told him to do. I chose to not get mad, I will simply get even the next time I am asked by Medicaid to do something that takes my time and I am not compensated for it. I will explain to them that they have already told me I am not smart enough to know how to prescribe medication so I am not smart enough to answer their questions.

Tomorrow starts three days of call. Updates, if I do any, will likely be short. Have a great three days and I will resurface next week.

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Friday October 20, 2000

No update.

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Saturday October 21, 2000

No update.

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Sunday October 22, 2000

No update.

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