Saturday, November 2, 2013

A Week in the Life - Day 4

Mark's Version

Friday - 8:05 AM

I wake up late today. After a late night and then a terrible night sleeping, I'm exhausted and sleep right through my alarm. I let the dog out and then call the hospital to let them know I'm running late. My assistant, Pat, tells me that she could use the extra time to get ready and that there is nothing time-sensitive this morning. I rush through my morning routine, but try to be extra quiet since Maxim is in our room again. The rain last night was really loud in his room and he couldn't sleep. That poor kid is having a bad run right now.

8:25 AM

I am on the road. It is warm this morning and very fresh-smelling after the night's rain. Flashing lights from the school bus tell me to stop and I'm reminded why it's bad to get a late start. I get behind a few different school buses today, but still make reasonable time.

8:35 AM

I arrive in the exam room and Pat is waiting with all of my lists, labs, and charts. It looks a bit daunting today and Pat confirms that I should be nervous. Since there are no residential kids to be seen today I can work straight through all of the adult patients. There are a lot of physicals to do, including one that's been put off for 3 days. Staff tells me that this patient is not allowed to refuse her physical today because they need medical clearance to do ECT. Yes, electroconvulsive therapy is alive and well in 2013. R.P. McMurphy would be so thrilled. This patient's physical goes exactly as suspected--she has very little to say and the exam goes nothing like the textbooks tell you they should go.

Another patient comes in, worried about a breast lump she's had for over 8 months. She hasn't really checked it much because touching her own breast makes her feel funny. I ask her a series of questions about it before doing the exam so I can get a better idea of what I'm looking for. I always heard that a good clinician does an exam to confirm his suspicions rather than truly figure out what's going on. If you ask the right questions a reasonable patient should give you just about all the information you need. This woman did not. A quick exam revealed that it is probably a harmless lump, but I encourage her to follow up with her own physician once she is discharged. And FYI, she was not thrilled about me doing a breast exam either.

9:30 AM

Only two people are on my extended acute unit list so it shouldn't take too long. I'm greeted by the charge nurse who wants me to examine an additional patient. This woman has been in the hospital off and on for over a year. She has all kinds of issues, many of them related to poor hygiene and skin issues. Today I get to examine her coccyx to see if she has a bed sore. It turns out she does not, which is excellent for many reasons, one of them being that we are not well equipped to do wound care at our psych hospital.

10:00 AM

The child and adolescent unit is absolutely crazy today. I end up seeing almost twenty kids, many of them needing admission physicals. For some reason everything takes a lot longer today. I'm not sure why because it's not taking me any longer to actually examine them. These days happen sometimes. OK, I did spend a few extra minutes talking to one 5-year-old boy. He had superheroes all over his shirt so we had a great conversation about how powerful the Hulk might be in real life. He did reassure me that the Hulk is not real and that he is just a story. I'm glad he told me that because I was starting to get scared.

11:30 AM

I finish with the last patient and think I'm going home, but then a nurse from the adult unit comes in and hands me an EKG for a patient. I'm not sure why it was ordered, and when I turn around to ask her some questions I realize she is long gone. My assistant and I head back to the adult unit to track down the patient's chart in order to get some background and perspective on the scribbles in front of me. I eventually get the information I need and sign off on the EKG, but not before I have tired completely of the hospital. I remind myself that working 3 hours there this morning is nothing when you consider how light the week has been otherwise.

11:45 AM

I have a normal ride home and by the time I arrive I hear that Diane Rehm is bidding farewell to her long-time producer. She is 62 and is retiring to spend quality time with her first grandchild. I think to myself that she sounds like a really cool grandmother. I also take longer to get home because I'm following a nice new car that should have a bumper sticker that says "My Other Car is a Model T."

I get home and chat with Stacy about my morning and hear about her nightmarish night. We do get to talking a bit about the books we're going to write this month as well as the home projects we'd still like to accomplish in the middle of all of our hectic schedules.

1:00 PM

I have a full slate of patients in the office this afternoon so I settle in and get to work. I have one woman who is back to see me for treatment of her fibromyalgia and vertigo. Three years ago I gave her a series of acupuncture treatments and she hasn't had any problems until recently. She is so pleased that she has sent me a number of her friends over the past couple of years. I also see a patient who has seen me off and on for about a year. She is a dog groomer and deals with chronic back pain. She tells me that her monthly visits keep her going and she hasn't found anything else that helps. It is always great to feel like I'm making a difference.

Throughout the afternoon I step out to talk with Stacy about our book projects. It feels like we're actually coming up with some good ideas that have some potential. It would have been nice to have come up with these ideas a week ago, but we've been quite busy with school, work, and friends. Our life is great to have so many wonderful distractions.

4:10 PM

I'm finished in the office and come out to talk more with Stacy about our books. I also wrap up a birthday gift for my mother that we need to get in the mail today. Dave took our kids to the park this afternoon for a bit so we wait for him to return them before running a few errands together. Stacy and I are both shocked that traffic is so thick in our sleepy little town. Mental note: don't go anywhere in this town on a Friday afternoon between 4 and 6. We take a few back streets to get to the library where we pick up a book on hold for Kate. She has been very excited for this one so we knew we had to get it.

We pull up to the post office and discover that in our town it shuts at 4:30 PM. I thought I'd have until at least 5, but I thought wrong. I'll just have to mail the package tomorrow and hope for the best. We have just a few minutes, but we also need to pick up a gift for a birthday party we're attending tomorrow. We have moderate success at a nearby store, but we still have more shopping to do tonight.

5:05 PM

I take the dog into the house and get the kids so we can go to our homeschool group's trunk-or-treat activity. Earlier, Stacy and the kids sorted out candy to pass out so the bowl is on the table ready for me to grab it. We head over to the parking lot at the playground where we spend most Friday afternoons and there are 10 or 12 families all set up. The kids love showing off their costumes and getting more candy. We are thrilled to have gotten rid of a lot of the candy we had leftover. We are most definitely NOT candy people so it's good to see it go.

5:45 PM

We head back to the house so Max can change into more comfortable clothing and then head over to a local pizza place for dinner with a lot of the homeschoolers who were at the trunk-or-treat. A white sausage pizza, veggie boli, and clams casino later we are quite satisfied. The food there is so great, and it is even better when you can share it with a lot of friends.

7:30 PM

Christie had to work tonight so she had dropped Dave and the boys off at the restaurant. We take them back to our house so we can grab our computers and anything else we need to write a novel. Then we head down to the coffeehouse for our first NaNoWriMo write-in.

8:00 PM

We sit down and start writing. Stacy and I spend the first hour or so finalizing the major details about our characters and plot so we can start writing. We've both tried the "No Plot. No Problem" approach and neither one of us thought it was the best plan for us, so it feels good to get a few more details down. I start typing the story we're writing for the kids, but don't get too far into it before feeling like I want to finish chronicling the day. I'm feeling very distracted and unmotivated on all of the writing projects sitting in front of me. Getting a phone call from the hospital every 98 seconds does not help the process either.

11:00 PM

The coffeehouse closes and we pour into the streets. We're all pretty tired, but we do need to run to Wal-Mart to finish putting together a birthday gift for a party we'll be attending tomorrow. Dave and the boys are getting a ride home from us so they are at our mercy. Dave and the kids stay in the car while Stacy and I run in. It shouldn't take long, and Wal-Mart gives Dave Tourette's.

It only takes a few minutes for us to locate what we need, but then we wait in line for a LONG time, waiting for somebody to demonstrate minimum competency on the register. A manager shows up to do some overriding, whatever that means, and lets an irate woman behind us in line know that for whatever reason she cannot open a new register because then she couldn't override. Wal-Mart is the best. /eyeroll

12:00 AM

We drop off Dave and the boys and then head home. People have bedtime snacks, Stacy and I watch a bit of TV to wind down, and it's off to bed.

Stacy's Version

What a night. With all the trouble I’ve had sleeping the past several nights, Mark offered to do a cranial treatment on me – those almost always help. It’s nice to have a doctor in the house.

It helps and I fall asleep almost immediately and soundly. That is, until 4:50 AM exactly. I know because I wake up somewhat violently with really strong allergies. My throat is ridiculously itchy. I had already dealt with itchy eyes earlier. My nose is a mess. REALLY strong allergies. I scratch my throat (it’s a skill) and try to go back to sleep.

I’m then vaguely aware of a strange light. I open my eyes and see that our storm radio is blinking. I get up to check what it is and cover up the light. I see that it’s a thunderstorm watch. Ugh. I try to go back to sleep but worry about thunderstorms and how our computers are all plugged in (we’re really protective of that kind of thing – surge protectors don’t cut it after our bad experience with a fried motherboard years ago) and how when the kids hear thunder in the night, they wake up and race downstairs to take care of their computers.

After a half hour of allergies mixed with worry about the computers and convincing myself that I should just do it now instead of waiting for the storm to arrive, Mark and I go around turning them off. Back to bed.


Max comes in, as the heavy, heavy rains are too loud for him to sleep. His room is near a balcony and it really IS loud there. He climbs in bed with me. Twice in one week after months of being fine. Wow. We both go back to sleep.

For the record, I don’t do well with interrupted sleep at all. It is really rough on me emotionally as well as physically. I don’t know why I’m having such a rough week, but I am.

7-something AM

The storm radio goes off again – I don't even know what time it is – and I get up to make it stop. It’s loud and it’s waking Max up. It’s now a severe Thunderstorm Warning. Good thing the computers are already unplugged.

I climb back in bed and sometime later (seriously, at this point, I’ve stopped having any idea what time it is and I haven’t the wherewithal to even think to check – this is progress since I usually wake up and immediately start narrating these blog posts in my head), the alarm goes off again. I think this happened three times before I figured out that I was hitting the wrong button. There is one that is more like a snooze button and one that makes it stop. I eventually figure out the difference. I cannot believe the crappy nights I’m having this week.

I go back to sleep yet again. The irony is that the thunderstorms never quite came. Seriously. Annoying irony.

9-something? 10-something?

I didn’t keep good notes today. It’s been too busy. I got up and had breakfast with the kids. I checked email and typed some. I cannot believe today is November 1st and the start of NaNoWriMo. I had so much I was going to get done before now.

Mark and I text each other. He’s having a rough morning. Sometimes he gets easy mornings. Sometimes it’s crazy. Today, it’s crazy.

Both kids are typing furiously. NaNoWriMo has begun! They start sharing word counts, not easy to hear since I haven’t even started yet. Of course I’m happy for them, though. Ah, to be a kid.

11:45 AM

Mark gets home. No one’s hungry for lunch at all. I get ready for the day and Mark and I talk a ton about our books, as well as our days. We make a list of things we really need to make sure we don’t neglect during NaNoWriMo. For example, we really have to pull out winter clothes soon. It’s getting chillier next week.

We are writing two books together this year – one for kids and one for adults. We brainstorm some points for our kids’ book before he goes in the clinic for the afternoon. He has a busy afternoon schedule today.

1:00 PM

Mark starts in the clinic, but comes out a bunch and we figure out a ton about our adult book. In between, I do some blogging and writing and the kids distract me a ton. As does Scout.

2:30 PM

The kids and I aren’t super hungry, but enough to get something to eat. We grab leftovers and eat a little something. I have a mug full of chicken and dumplings. Kate is eating while she watches Mark and I animatedly fleshing out how we’re approaching our book. This isn’t our strongest suit. Once we get writing? That’s when it gets really good.

The kids and I go through all of our Halloween candy and put together a bowl full of candy for tonight’s homeschool group trunk-or-treat.

Mark and I brainstorm a lot for both of our NaNoWriMo books. I feel like time is flying and I’m trying to figure out why.

3:00 PM

I look at the clock and think of how it’s gorgeous out and I want to get to the park with the kids today, if they want to. They do. I have tons hanging over my head, but it’s hard to pass up 70-degree weather in November and I know others in the homeschool group are going, too. I’m debating whether to go, when to go, etc. when Dave texts me and asks if we’re going to the park. I tell him that I think we are but I’m on the fence.

3:05 PM

Dave shows up at the house with his boys and offers to take our kids. I readily take him up on that offer! Perfect! He takes the kids to the park for an hour and 15 minutes and I get to stay home and get stuff done. Wow.

Mark and I do yet more brainstorming. I’m feeling better about having more of a plan with our book. We like writing and doing projects together.

4:20 PM

Dave brings the kids back. That was such a treat – thanks, Dave! We tell them to get their stuff together and Mark and I take Scout and run a few quick errands to the library, post office, and store.

5:00 PM

We get back, trade out the dog for the kids in costume, and go to the park where we meet up with more than a dozen families to trunk-or-treat. It’s fun to see so many friends. We’re having a Newlywed Game Night at our house this month and those who are coming are really excited to do it (so are we)! The kids trunk-or-treat and we get a cute group picture of them all. We have a good group. The overhaul we’ve done recently has been so positive. Several families go out together for pizza.

6:00 PM

Kate goes to the restaurant with her BFF and her BFF’s family. We run back to the house for Max to change his clothes – poor Scout is dealing with a lot of in and out-ness from us tonight. Then we go to the restaurant.

6:15 PM

Dave and the boys arrive. They’re sticking with us for the rest of the night. When Christie works nights, we often do stuff together or give them rides to the homeschool and/or NaNoWriMo stuff we’re doing.

We all eat some very good food. We are foodies, so we enjoy bites of each other’s food as well. Heheheh.

7:45 PM

We stop at our house to get our laptops and then we’re all off to the coffeehouse for our first write-in from 8-11PM. We visit Scout, grab our stuff, and we’re off again.

8:00 PM

We get to the coffeehouse and commandeer several tables. There are 11 of us here tonight. A few people couldn’t make it. Mark and I come up with some good stuff for our books. We love NaNoWriMo time. I talk to Dan, a guy who works there who is always super nice to us and vice versa. We all write for three hours, until the coffeeshop closes.

11:00 PM

We very rarely go to Wal-mart, but there is one more thing we need to get as part of a birthday present for a party we’re going to the next day, so we make a stop there. Dave and all the kids wait in the car while Mark and I go inside. It takes way longer than it should because Walmart sucks – there is one cash register open and about 17 people in line. The line doesn’t move at all for about 10 solid minutes, because there is some problem at the register. A manager walks by to fix it and the lady 3 people behind us in line yells at her for not opening another register. We can’t get out of there soon enough. Walmart is like an emotion sewer – you actually feel worse and stupider every time you’re in one.That should be their new slogan.

12:00 AM

We drop Dave and the boys off at their house.

12:15 AM

We’re home - playing with Scout and talking and getting snacks. Mark and I watch some TV and we go to bed. I sleep well for the first time all week. It’s fabulous.


Boquinha said...

Wow. Remarkably similar, these posts. I like spending so much time with you. :)

Dr. Mark said...

Agreed. We always have such similar posts, but that really is to be expected. We spend a lot of time together. The "emotion sewer" is a good name for that feeling. It's also the feeling of having your soul slowly leeched from your body. Domo arigato, Wal-Mart.

Boquinha said...

OMG! Walmart! Dementors! Maybe THAT is what J.K. Rowling was writing about! It all makes sense . . .

LMW said...

As usual, your account of your time in the hospital is super interesting.

I know that my husband has benefited from acupuncture to help with major discomfort from his Bilateral Ulnar Neuropathy.


How do you "scratch" your throat?

Dang! I'm sorry you've been having such a difficult time with sleep. I have bouts of that. I'm in a good stretch right now, but I know it won't last forever with the way I work. So, I know how it feels. Terrible!

I hate how WalMart under staffs their cash registers. They certainly make enough money to make things more efficient, but they know they can get away with it.

Yay!! I'm so glad you had a good night's sleep!!

BTW, As I read your posts, I take notes for my comments as I go along in order not to forget something that I want to include.:)

Boquinha said...

That's so cool that you take notes! I love that! I think you are super cool. :) I'd really love to meet you someday. Thanks so much for the support.

I think my sleep is getting better and I think that "falling back" is only going to help! Maybe my body was waiting on that since that happens later in the year now than it used to. :P

Scratching my throat . . . I don't even know if I know how to describe it. I do it from the inside - like I can "click" my throat - sort of like a swallow, well, not really (hilarious - I'm sitting here doing it and trying to describe it in writing), but it's more like a mix of "clicking" and "clearing" my throat? I don't think I'm describing this well, but I've been able to do it since childhood - I grew up with WICKED allergies in Massachusetts. The dry air in UT and AZ has always been WONDERFUL for my breathing. PA is nice, because I'm fine 90% of the time and deal with allergies a bit seasonally or when it rains (as opposed to nearly constantly in MA - very humid there).

Jaredski said...

I find Mark's psych hospital stuff interesting. Probably because I don't see patients but it's nice to hear about the clinical side of medicine once in a while.

Reading your posts makes me wish we did stuff with friends more. With family around that's who we tend to hang out with and that has its advantages but I feel motivated to make an effort at more friend time.

Where is all the fighting? Our family can't go an hour without some sort of spat. I guess we all have different challenges.

LMW said...

It would be awesome to meet you someday! We have so much in common it's definitely uncanny.:)

Ha. I can almost imagine what you're trying to describe regarding how you scratch your throat. It's quite humid in Maine too.

Emily Foley said...

Is any woman thrilled with a breast exam? I mean...really.

You should try Walmart in Gallup. I know Walmart in general is a hellhole but the one in Gallup is literally hell on earth. You've never seen anything like it. I have actually had two different friends that both drove through Gallup in the past month and both independently posted on facebook "I've never experienced anything like that" referring to Walmart here.

If it's lunchtime and I'm not hungry, it doesn't matter. You eat at lunchtime. That's all there is too it. Maybe that's the reason my clothes don't fit anymore?

Boquinha said...

Jared! So glad you're reading these, too. We're enjoying reading yours as well!

We spend A LOT of time with friends - we eat out with friends, we play games with friends, we meet up and go to community lectures with friends. And we have friends from all walks of life - we feel very grateful for our friends. We have no extended family here - our friends our like our family in a way.

There is fighting sometimes, but to be honest, not much. It is very rare than any of us are arguing or snapping at each other. There ARE days like that, but they are very much the exception rather than the rule. I hate fighting.

Emily, your Walmart sounds HORRIBLE.

We do that with lunchtime sometimes, too. But I feel lousy afterward.