Thursday, February 15, 2018

Falling Apart

Do you ever feel like you have one foot in the grave?

I swear I've been eating so healthy for three weeks and I don't feel like there is any difference. My conclusion is that there is no way to lose weight after the age of forty. I guess I'll keep shaving off the calories and try to exercise more. Helps when you are not on call, which I am half of this month. I do think my body composition is changing some, and I feel good eating mostly fruits and veggies and nuts.

Last week half of my mouth went numb and I couldn't chew without extreme pain in my jaw. I self diagnosed TMJ syndrome, which my mom has, with consequent nerve damage that will hopefully get better. Web MD suggested not clenching teeth ever and stop chewing gum, which I did, but the numbness remained. I thought I was hiding it pretty well, although it still feels very weird to talk, but during a board meeting yesterday afternoon Dr. Music loudly declared, "What's wrong with your FACE? Did you go to the dentist?" and I turned to chief, who I had consulted last week but he said whatever I was feeling my face looked perfectly normal, and said, "See? I told you something was wrong. The chewing pain is gone but the nerve damage is still here. I can't feel half of my mouth." Then everyone spent the next 15 minutes dissecting my face. Their conclusion: my left eyebrow was lower than my right when resting, and maybe I had Bell's Palsy. This morning I was stopped in the hall and by Dr. Music and Chief and they thought my eye socket was now droopy. I laughed out loud. "I think it's a little better today."

But I'm faking it. It's scary. Paralyzed face can mean stroke and we all know my blood pressure is wonky. I called my bff doc who I remembered had Bell's Palsy once and she made me answer a few questions looking in the mirror about facial symmetry and concluded, "Well, it could be TMJ with nerve damage like you said. Or it could be Bell's Palsy. Either way, it started last week. So using steroids and antivirals is not helpful after 72 hours, according to the literature, if it is BP. I wouldn't do anything unless it gets worse. I don't think it's a stroke, but you can check your blood pressure a little more regularly if you want to. You should experience full recovery in the next few weeks or months."

If I smile my face looks normal. So I'm smiling a lot more than usual. I just beamed at everyone in the radiology suite for like 5 minutes while reading a smear on a lung mass. It's funny how people open up to you and talk more if you smile. Except if I overdo it I might start making everyone feel uncomfortable. There's a fine line between happy welcoming smile and psycho smile. Alcohol helps too. I wonder if that's a good enough excuse to drink at work. Probably not.

Friday, January 26, 2018

Just Because

I've been getting a lot of sleep lately. I don't know if it's this new diet or what. Really, it's happened all winter. I'll plan to watch an hour show at 8:30 and be headed to bed by nine. Penny Dreadful, which should have lasted a few days, has dragged on for much longer. 10-11 hours a night. It's like I'm hibernating or something. The one time I had to stay up until 11:00 to pick up C and some of her friends at a party I thought I was going to die. No waking early, no worrying at 3am, just zonked out. Monday I slept through my alarm and missed an early needle. Maybe if I lose a few pounds I'll get my edge back. Maybe not. Maybe my body is catching up on years of sleep deprivation. That might take a while.

I've changed my primary news source to The Guardian this year. It's very progressive. They just feel more objective and comprehensive. Plus the website to The Atlantic got all wonky at work and I can't read it anymore. I'm still paying for it and can get on my phone, but I never read it on my phone. Isn't it weird how there are things you do on your phone but not on your laptop or desktop, and vice versa? I once opened Facebook on my laptop last fall and was completely overwhelmed with the format. I only do that on my phone.

I'm so excited!!!!!!!!! Do more exclamation points convey just how much? All winter I've been studying Paganism through Celtic Myths and Legends (Ellis) and other sources online and studying the science of trees in The Hidden Life of Trees (Wohlleben). Trees communicate, parent, and befriend. I've even imagined, especially during tree position in yoga when I'm trying not to fall over, that in a former life I might have been a tree (it's harder to fall over if you have roots). And now I'm headed to hike ancient forests in Whistler, BC. There is a molecular pathology conference called CAMP that I've been eyeing for years. Since molecular advances are the hot button topic at Tumor Board it makes sense to brush up. At least they were last fall, dunno about now, the hibernation thing has kept me away for a few months. It can't hurt.

They even have snowshoe guides that will teach you all about the ancient forests and medicines and herbs and belief systems at the time, while you are hiking through beautiful ancient forests. And Margaret Cho is performing Wednesday night! Not in the ancient forests. I need to try to figure out how to get tickets. The hotel looks like a dream fairy tale hotel, not a real hotel. Or maybe a little bit like the one in The Shining. You could come at it from either angle.

Did you know that just like a solar and lunar sign, we all have Celtic tree and animal signs too?  Mine are  hazel and a salmon. Salmon! According to Druid tradition, it is the Oldest Animal. And the hazel tree has significance in being at the heart of the Otherworld. Fascinating stuff.

Happy Friday!!!

Friday, January 19, 2018

DeWorm the World

Fizzy from A Cartoon Guide to Being a Doctor reminded me yesterday that I was already published in something that is not a major medical journal (the benchwork is fun but the formatted writing is a pain in the ass) - she published me! Under my blog name, years ago. She has made an impressive few grand off of the book and she donates it all to a charity called Deworm the World - it helps pay for medications to treat parasitic infections in children in developing countries. I ordered it yesterday, first accidentally the kindle version (which was available yesterday) and then the paperback version. I believe I let her use some of my old old tales from this blog, but I can't remember, so I'm super excited to find out and help Deworm the World. If you want to contribute to this awesome charity you can at the link above or by buying Fizzy's book, in which I contributed here.

I talked to my friend at Cleveland Clinic. Apparently Springer is a great place to get a publication going but they give the author and the editors no control over the book cover or pricing. If only I had googled it I would have raised a red flag. Oh well. Live and learn. And I am getting a free copy, I found out, after I ordered it.

Wednesday, January 17, 2018

Mixed Feelings

So I have mixed feelings over the launching of our blog book, link here

First of all, the cover is not us, the Mothers in Medicine blog, at all. But I learned sometimes you have no control of cover, as in this case. It appears they are marketing it as a textbook, by the outrageous price that has made it inaccessible to family, friends, and book clubs. Are they marketing it to medical schools? If so, the idea of making a med student have to pay $40-$50 dollars to read it makes me sick to my stomach. Again, I just learned pricing the book is sometimes out of control of the author and editor.

So if you have a bunch of money to spare, go get our book at that link up there. If you don't, you are welcome to borrow mine, as soon as I order it myself. Doesn't a contributor even get a free book before publication? How cruel is this world? Or you can just follow the blog. Honestly most of what I have written was cobbled from past blogs - it took less than an hour to put together the day of the deadline because I am the queen of procrastination. But I'm still going to get it anyway because it's my online family and I want to read all the others.


And by the way, if there are any profits to be made here, not a dime will come to any of us, including our amazing editor.

Doctors Make the Worst Patients (Part 2)

Read it, over at MiM

Friday, December 22, 2017

The Most Wonderful Time of the Year

Whoever coined that term was not a healthcare professional in the 21st century.

I was on call last week, and I am on call next week starting Christmas Day, and it has been extremely busy. I had more brain frozens last week than I'd had in the last six months, the culmination of which was 9:30 PM stressor on Friday night in between carpooling children to and from where they wanted to go. I had to cut the frozen myself, which is not so easy when you are out of the habit - we are spoiled with our P.A.s I learned after the surgery it was not a resection but a thing new to our institution which I later learned in PMG pathology is a thing some places - a fine needle aspirate of a brain tumor. Which explained why the surgeon wanted me to freeze something that looked like a sneeze on a piece of shiny surgical paper. Not a sick, colored sneeze, just a few clear droplets and some blood. Luckily I had the forethought to do a squash prep first - where I touched the tissue with a slide and smeared it with another - because the frozen yielded nothing but the squash prep was a field of diagnostic information - necrosis, hypercellular pleomorphic cells, giant blood vessels that resembled octopus tentacles - the triad of Glioblastoma Multiforme. I called it suspicious, expected much more tissue, got another sneeze, and a local expert confirmed my diagnosis a few days later. He told me the FNA is much better for the patient, and text updated me throughout his own progression of stains and levels with what I provided him. I alerted the other members of my group of the new procedure - the gross room told me another neurosurgeon did one a couple of weeks ago. If that was the only case I had last week we would be living in an episode of House. But with thirty - sixty cases a day I can't worry over one too much, luckily. Just triage, do my best with what I've got, send the stuff I'm uncomfortable with to the experts, and move on.

One thing good about being on call over the holidays is you don't have any obligations to anyone. I kind of like that. "Nope, sorry, I'm on call." But the way the holiday fell this year Christmas and New Year's Eve are crammed into one week and that doesn't usually happen. I heard from a nurse in bronch lab that Benton schools are out not this week, but the next two weeks, and I think that's a lot smarter than Little Rock, we get an extra week to stress and present shop and make Christmas a little more crazy (or just go to work) then rush back to school after New Year's Day.

Everyone in PMG pathology is lamenting end of the year insurance deductibles. It really does cause a crunch in November and December, but the worst is the last two weeks of the year. I was talking to my friend who is an opthalmologist on Monday and she said she has people coming in on December 15 expecting to get their cataracts done before New Year's Day and when they learn she's booked she has to talk them off of a ledge. Someone in PMG pathology smartly suggested that we switch the cutoff to people's birthday so the work is more spread out. Seems like getting something that monumentally entrenched to change won't come easily.

I can't believe I finally have a lull in my day. Partly because I finished a book I got last week, one that I've been sneaking into whatever gap I can find. I learned new words, elision and benthic. Ha! Look at that spell check doesn't even know benthic. Now I can get back to my other two books I'm juggling, but first I've got to address Christmas cards, a yearly chore but worth it for every one I receive.

I'm starting to think that you get the most out of life by just relaxing into what is, and not worrying too much about what isn't. It certainly yields happiness, I've found.

Wednesday, December 6, 2017