Monday, October 12, 2009

Where have I been?

First, we've made the difficult decision to close our business. It sucks, but it needs to happen. We're actually at peace with it, even thought we'll continue to be fairly bad off, financially speaking, for a while.

Peanut is due to arrive via scheduled repeat section a week from Thursday (I have a heart condition and everyone agrees that this is the best course. No flames, please. I'm okay with it, and I don't need to be pitied, thanks.) I spent last Thursday night in the hospital, as I thought she was on her way. I was 37w3d, and I expected them to say, "OK, call the OR," but nope. My doctors are AWESOME. They said, "not before 39 weeks, you don't." They figured out that I was dehydrated, gave me 3L via IV and made me drink another two and gave me a wee bit of terbutaline. It did the trick, and I went home the next morning. What with the details of closing the business this week, she needs to stay in til, at least, Saturday. (What's the best way to make God laugh?!)

I'll be returning to the OR in the new year. Shit, I got rid of most of my hats. Time to look for pretty fabric and sew this winter, cause you know, it's all about how I look. That and some snazzy clogs.

Thursday, September 10, 2009

Completely unrelated

A Public Service Announcement:

Call your bank and ask them if your checking account has a "feature" that enables your atm/debit card to never be declined. Ever. They do you a "favor" by putting through every single attempt. They are GIVERS! Well, givers who charge $36 per use. So, while on our little vacation, every time we used our card, including for a $2 parking meter, it charged us an extra $36, plus a $6/day fee for every day we continued to be overdrawn. That'll teach us to be smug about scoring street parking on Newbury Street at lunch time.

I went to make a deposit today. It wasn't enough to cover the hundreds (pushing four figures, honestly) in fees that they charged without a single "hey,dipshit...your account is overdrawn!" Funny, the nice man who bid me farewell by name, as our business account is there, never mentioned that I just put a little bit of money in a much bigger hole. So, I went to the grocery store to buy food and grab some extra cash. It all went through without a hitch. It wasn't until I got home and opened the first of what will be MANY letters advising us of our initial transgression on the 4th. So, there's another $36 for them.

Yes, it's our job to track our check register, but how about the smallest inkling that we are digging a big hole? They let this go on for over six days. Smells like loan sharking to me.

So, do check on that fine print, won't you?

Edit: Nothing new, apparently. This very issue was covered in the NYT yesterday

Monday, August 24, 2009

Let's not have Labor Day be LABOR Day...part II

My first daughter was due in October. I am pregnant again, and again, October is the due date.

For some reason, when I'm pregnant, my in-laws decide that we MUST have a family reunion on Labor Day weekend. The notion that we might not be able to attend such a thing is always met with, "but WHY NOT?!"

So, in two weeks, we pack up the minivan and head up to Boston for a week. Last time, just as the BBQ was about to get underway, I started having super regular contractions that were not relieved by drinking two litres of water or lying on my left side. After they went on for two hours, and I was getting increasingly uncomfortable, we went to the hospital. I told them that we were visiting from a stereotypically southern state, and I guess that, combined with "why are you traveling at 35 weeks?" resulted in them assuming I was simple minded. They spoke slowly and told me that if I was actually in labor, they weren't going to stop it. Now, I worked in Boston for a year, and I'm well aware that all things medical were invented there. (Heck, the ORs rename half of the equipment.) So, in their minds they were doing me a favor by allowing my baby to be born where I could receive such superior medical care.

Luckily, like a lot of women, the minute my butt hit the bed in L&D, I started feeling better. The contractions that had been startlingly uncomfortable in admissions down in the ER just...went away. We went back to the bbq, where I continued to lounge on my left side, then we flew home, and the Peanut arrived promptly on her due date in my impoverished, uncultured, southern state.

So, let's hope that this time, I won't be visiting any hospitals. Can you sense my excitement that this time we're driving?! On my best day, I hate long car rides. This time, I'll be eleventy months pregnant. Oh, I-95 in Connecticut. I have not missed you. But, Emma's Pizza in Cambridge? We have a date.

Saturday, August 22, 2009

Why I Always Fill Out Implant Reports Fastidiously

They might be the key to proving someone's identity

Common criminals know that bodies can be identified via fingerprints and dental records, so this sick individual removed all of that evidence. But, you weren't THAT smart, Joe Sociopath, now were you?

Almost everything that is designed to stay inside of you is tracked. Most of those items have serial numbers. This isn't the first time that breast implants have proven useful post mortem.

Tuesday, August 18, 2009

30 weeks

Baby...punching cervix. OW.

Monday, August 17, 2009

Asking a nurse for a physician referral

Himself has a small sebaceous cyst on his back, and he is FINALLY willing to let someone do something about it. He made an appointment with a dermatologist who a friend visited and liked. Said doc took a suspicious lesion off her torso, and I actually know their PA. The PA does a nice closure, as opposed to the GIANT 2-0 Ethilon another derm used to close a sample they took off of the top of my breast once. I went straight to work and asked a CRNFA to redo it with some 5-0. The girls do occasionally see the light of day!

Anyway, despite said doctor's website claiming otherwise, they just called and canceled his appointment, stating, "We don't do sebaceous cysts." Apparently, they are going to only do cosmetic dermatology, I guess, as they are all about Botox and resurfacing. It's a tiny thing, and we have awesome insurance, but cash is king.

He just IM'd me:

Himself: They recommended three general surgeons: Drs. X, Y and Z. Know any of them?
Me: DR. X ONLY!!!!!
Me: Holy $hit
Himself: Heh. ok.
Me: never breathe those other names around me in reference to caring for live human beings
Himself: That's why I ask you first. :)
Me: *hyperventilating*

I'm a little biased. Dr. X is one of my all time favorite surgeons. Ever. He is the rare combination of incredibly talented and NICE. You don't always get personality with general surgeons. Most of them would prefer that there be a conveyor belt that brings in the patient, lets them do the surgery, and moves them on without ever having to, you know, TALK to the patient or anyone else. Dr. X is near my husband's office. He works about 50 miles away from our home. However, if anyone in my family ever needs to r/o appendicitis or needs any other general surgery care of any kind, transfer us to one of the two facilities where he works. He's a righteous dude, and I'm fairly certain his hands were blessed by the diety of your choosing.

The other two are the sort, that when it's midnight, and I've been called in to do some case (which was rarely ever an emergent case,) and the patient would turn to me and say, "He's a good surgeon, right?" Well, this is the part where M'Lynn lies by omission. It makes me feel like dirt, but grabbing them and saying, "RUN WHILE YOU CAN" is frowned upon by my superiors. I say something like, "Oh, I've worked with him a lot." "Good old Dr. Z? He's taken out a lot of (healthy) appendices in his day!"

Dr. Z once brought in a woman with a cholecystitis. She wasn't septic. There was no rupture. She was actually, other than being in some pain, in decent shape. He decided that her gallbladder needed to come out at 10pm on a random weeknight. Add to this that she was only visiting our area, had a plane ticket to return to her home the next day, and her husband was back at the hotel with their 8 month old twins. Even his PA (who had far more experience than said surgeon, and honestly, was going to be the one actually DOING the surgery for him) that the smart thing to do was medicate her for pain, let her get on her plane the next day, and get back home, where they had help to care for the kids. But, no. The wallet biopsy was positive, so we took out a fairly cranky, but by no means emergent, gallbladder.

Sunday, August 16, 2009

An oldie, but goodie

I found this when going back through Livejournal, looking for my birth story. "Annoyed doctors and nurses." That would be putting it mildly.

Clowns + ketamine=NOT a good time.

can't sleep...clowns will eat me

Bad Docs

Just like in every walk of life, there are good and bad to be seen in various professions. I can tell you, I've worked with some damn fine physicians whom I'd trust (and have) with the lives of me and mine. I've also worked with some docs who I would not trust with the care of a pet rock.

I'll be telling some bad doc stories. Probably, a lot of them. They are more interesting than, "You should see the way he handles a difficult intubation! [but when I was single and considered dating in the workplace (for about the first six months, then, just, NO!) grace under pressure made hot a lot hotter.] That is not to say, all doctors are quacks, charlatans, misogynists and out to do the most expensive procedure so that they can make their tee time.

I'll start with one of the first I encountered. He was memorable. A young lady came in for a laparoscopic tubal ligation. He had ordered NO LABS. Anesthesia said, "WTF," and ordered a CBC and chem 7. That painfully thin young woman was dangerously hypokalemic. Most likely from an eating disorder. Anesthesia then said, "Oh, HELL NO," and canceled the procedure. The doc shows up, and I tell him that anesthesia canceled the case and why. He was PISSED. Demanded to know who ordered labs on his patient?! I told him, "The doctor who was responsible for putting her to sleep." He continued to rampage, saying, "I didn't order labs. I don't order labs when I know I won't like the answer."

It's rare when you get someone to admit that they are an uncaring hack.

Saturday, August 15, 2009

Big nifty words

I've always been fascinated with words. Specifically, the way that some of them sound. In nursing school, it was pheochromocytoma.

Pinky's OB fistula post made me remember that one night in the OR, I learned a new word. Colovesicular-cutaneous. It was describing a fistula. This is pretty damn high on the list of things that I don't ever want happening to me, or you, or anyone else. It went from the colon, through the bladder and out the skin on the abdomen. We had to attempt to repair it every three weeks for a while. It kept recurring.

If you've ever gone into the belly surgically, three weeks after just having been there is a hot mess of forming scar tissue. We had also been closing her up with Marlex mesh each time so it took a good 45 minutes just to get into the abdomen each time.

This fistula wasn't a result of an obstetrical incident, but it could have been. I'm thankful that we have options here that they don't in Africa.

My Freudian Slip is showing...

I'm not currently practicing, which means, some of you will tell me, that I'm not allowed to have an opinion on anything medical. But guess what? This is my blog! It's not a democracy! I'm President for Life of this dictatorship/blog, and I get to post whatever I want! Woohoo!

I currently own a small business. I am doing a promotion for some of our guests. A "Grab Bowl." The sign I made says, "Grab Bowel." over!

Thursday, August 13, 2009

Pinky made me do it...

I mostly signed up for a Blogger account so that I could have a Blogger ID for commenting.

I was an OR nurse for 11 years. I'm not sure of what I'm going to talk about here. I'm not currently practicing, so any stories I tell are hella old and won't be identifiable aka HIPAA compliant, beeyotches!

I'm eleventy months pregnant, it's hot and I'm cranky. Crotchety is a good word to describe me.

My husband says this describes me as of late.