My head is spinning....
Feb. 19th, 2009 09:37 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
osodecanelaTo everyone who has commented on the "Associations Meme", thank you!
It has been and continues to be something I have thoroughly enjoyed responding to, and in turn, have loved giving others a chance to ponder. Please know I'm very clear that I have several more to respond to, which will happen over the next couple of days. The last 24 hours however have been shall we say, 'a bit busy'.
Please allow me to digress. Today has been an exercise in 'Alpha and Omega'.
I headed for home last evening right after finishing Associations: Part Deux .
On my way home, a call came in from a lovely young woman, a week overdue for her first delivery; she thought she might be in labor. Given that it was already 10 PM, I decided the better part of valor would be to send her down to the hospital for labor check, confident that she would probably be very early along and that the best course of action would likely be to give her some sleeping meds. From her description it sounded like her contractions were strong enough to keep her from sleeping, though not strong enough to do anything to change her cervix. A sleepless night would do her no good, particularly if she went into serious labor the following morning, already exhauseted.
Well, it was one of those nights at labor and delivery. Any woman coming in, needed to show up with her own manger, because honey, there was no room at the inn! There were women laboring in every room, and L&D had to take over several nearby rooms on the postpartum ward, to deal with the overflow of women in labor. My patient wound up pacing the floor for an hour, just waiting for an open bed, so she could be examined. By 12:45, it was clear that a) her contractions were not changing her cervix, and b)chemical help was needed is she was to get to sleep. I ordered some Ambien for her and let them send her home, hopefully to sleep in her own bed in a quiet environment.
Two half hours later she called, both groggy and in tears. The Ambien was knocking her out, but every five minutes on the dot, she was awakened for by a contraction. Time for a visit with Mme. Morphine. I sent her back to L&D, had her re-examined and onto a monitor, and by 5 she was in the arms of Morpheus, thanks to a moderate dose of an opiate.
Unfortunately, I was not so lucky. My sleep was at best, fitful.
When my patient awoke from her chemically induced slumber, not only well rested, but dilated to 7 cm. I headed to the hospital, to assist in the joyful delivery of a healthy, bouncing baby boy. T'was a beautiful delivery, the child's father and maternal grandmother assisting in support for this first-time mom. The mom's folks were first-time grandparents; both grandma and grandpa burst into tears, when holding the little man for the first time. Got to tell you, seeing that got me misty. It always does. What greater pleasure than the joyful welcome of a new life?
I made it to my office just in time to start seeing patients at 2; frankly, once there I needed rollerskates. People just weren't scheduled appropriately. Twice, I had newly diagnosed diabetics, who'd been scheduled for 15 minute appointments. There's so much bloody stuff to go over with a new diabetic that 15 minutes just doesn't work. To have that not once, but twice this afternoon? Sheer madness! Two other patients were dealing with psychiatric issues and trust me, those aren't 15 minute appointments either. At least thank God, everyone in today was either an English or Spanish speaker; if I'd had to deal with a translator today, I simply would've lost it.
So, I finally got to my 6:15 patient at 7:30, only to find the man is there for a vasectomy. Not to discuss having a vasectomy, but to get it done
Give me a bloody break! A vasectomy? Scheduled on a Thursday night? After I've been on call a whole night and had a delivery!?!?
No time like the present, I guess. So I start my day with childbirth, and end it with permanent birth control; as I said, 'Alpha and Omega'.
The women in my office are odd at times. When it comes to dealing with anything that's sexually related to a female patient, no problem. They can be in the room, they can hear things discussed, and nothing seems to be disturbing for them. A male patient? That's a whole other story!
There were a couple of times I needed an extra pair of hands, while I was doing that office surgery tonight. I didn't want to violate my sterile field, so I needed someone to hold the anesthetic bottle so I could draw up the lidocaine I needed; then later, someone was needed to hold open the cup of preservative, so I could drop in the vas I'd removed. No big deal, right? None of my staff people however, wanted to be in the room.
"The guy is my age, and I don't want to see his testicles. It will make him uncomfortable."
It will make who uncomfortable? The man is sedated! (Jeez.)
Finally, when all was done, I went out to the man's wife, who was nursing their 2 month old, to get the Jockey shorts I'd insisted he wear home. My staffers still there looked at me confused; why had I insisted on Jockeys and why didn't he have them in the room already. Wasn't he wearing underwear when he got to the office?
Yup, he had been. Boxers.
One of them asked what the deal was, but before I could say anything, she quickly changed her mind, held up her hand and said, "Wait, I don't wanna know."
Boxers just don't cut it, when those puppies need to be supported. I had just cut into his cremasteric muscles to get at his vas. Afterwards, if he's left 'dangling', he's going to hurt all the more. But then not having a pair of her own, how was she supposed to know that?
So, all is well, and all that's left for my day is to e-mail the transcription to the transcriptionist and then drive home for a much deserved rest. Tomorrow is another day.
With luck, tomorrow I'll have a chance to post "Associations: Part Trois".
It has been and continues to be something I have thoroughly enjoyed responding to, and in turn, have loved giving others a chance to ponder. Please know I'm very clear that I have several more to respond to, which will happen over the next couple of days. The last 24 hours however have been shall we say, 'a bit busy'.
Please allow me to digress. Today has been an exercise in 'Alpha and Omega'.
I headed for home last evening right after finishing Associations: Part Deux .
On my way home, a call came in from a lovely young woman, a week overdue for her first delivery; she thought she might be in labor. Given that it was already 10 PM, I decided the better part of valor would be to send her down to the hospital for labor check, confident that she would probably be very early along and that the best course of action would likely be to give her some sleeping meds. From her description it sounded like her contractions were strong enough to keep her from sleeping, though not strong enough to do anything to change her cervix. A sleepless night would do her no good, particularly if she went into serious labor the following morning, already exhauseted.
Well, it was one of those nights at labor and delivery. Any woman coming in, needed to show up with her own manger, because honey, there was no room at the inn! There were women laboring in every room, and L&D had to take over several nearby rooms on the postpartum ward, to deal with the overflow of women in labor. My patient wound up pacing the floor for an hour, just waiting for an open bed, so she could be examined. By 12:45, it was clear that a) her contractions were not changing her cervix, and b)chemical help was needed is she was to get to sleep. I ordered some Ambien for her and let them send her home, hopefully to sleep in her own bed in a quiet environment.
Two half hours later she called, both groggy and in tears. The Ambien was knocking her out, but every five minutes on the dot, she was awakened for by a contraction. Time for a visit with Mme. Morphine. I sent her back to L&D, had her re-examined and onto a monitor, and by 5 she was in the arms of Morpheus, thanks to a moderate dose of an opiate.
Unfortunately, I was not so lucky. My sleep was at best, fitful.
When my patient awoke from her chemically induced slumber, not only well rested, but dilated to 7 cm. I headed to the hospital, to assist in the joyful delivery of a healthy, bouncing baby boy. T'was a beautiful delivery, the child's father and maternal grandmother assisting in support for this first-time mom. The mom's folks were first-time grandparents; both grandma and grandpa burst into tears, when holding the little man for the first time. Got to tell you, seeing that got me misty. It always does. What greater pleasure than the joyful welcome of a new life?
I made it to my office just in time to start seeing patients at 2; frankly, once there I needed rollerskates. People just weren't scheduled appropriately. Twice, I had newly diagnosed diabetics, who'd been scheduled for 15 minute appointments. There's so much bloody stuff to go over with a new diabetic that 15 minutes just doesn't work. To have that not once, but twice this afternoon? Sheer madness! Two other patients were dealing with psychiatric issues and trust me, those aren't 15 minute appointments either. At least thank God, everyone in today was either an English or Spanish speaker; if I'd had to deal with a translator today, I simply would've lost it.
So, I finally got to my 6:15 patient at 7:30, only to find the man is there for a vasectomy. Not to discuss having a vasectomy, but to get it done
Give me a bloody break! A vasectomy? Scheduled on a Thursday night? After I've been on call a whole night and had a delivery!?!?
No time like the present, I guess. So I start my day with childbirth, and end it with permanent birth control; as I said, 'Alpha and Omega'.
The women in my office are odd at times. When it comes to dealing with anything that's sexually related to a female patient, no problem. They can be in the room, they can hear things discussed, and nothing seems to be disturbing for them. A male patient? That's a whole other story!
There were a couple of times I needed an extra pair of hands, while I was doing that office surgery tonight. I didn't want to violate my sterile field, so I needed someone to hold the anesthetic bottle so I could draw up the lidocaine I needed; then later, someone was needed to hold open the cup of preservative, so I could drop in the vas I'd removed. No big deal, right? None of my staff people however, wanted to be in the room.
"The guy is my age, and I don't want to see his testicles. It will make him uncomfortable."
It will make who uncomfortable? The man is sedated! (Jeez.)
Finally, when all was done, I went out to the man's wife, who was nursing their 2 month old, to get the Jockey shorts I'd insisted he wear home. My staffers still there looked at me confused; why had I insisted on Jockeys and why didn't he have them in the room already. Wasn't he wearing underwear when he got to the office?
Yup, he had been. Boxers.
One of them asked what the deal was, but before I could say anything, she quickly changed her mind, held up her hand and said, "Wait, I don't wanna know."
Boxers just don't cut it, when those puppies need to be supported. I had just cut into his cremasteric muscles to get at his vas. Afterwards, if he's left 'dangling', he's going to hurt all the more. But then not having a pair of her own, how was she supposed to know that?
So, all is well, and all that's left for my day is to e-mail the transcription to the transcriptionist and then drive home for a much deserved rest. Tomorrow is another day.
With luck, tomorrow I'll have a chance to post "Associations: Part Trois".
