Clean bill of health . . .relatively

So, I went to the doctor. Not my favorite thing. I am not sure why exactly. It doesn't make me nervous . . . I understand what they are saying to me . . . I always take a book so I don't mind the wait. . . and although I don't love needles, I don't have a phobia against them. I don't love the poking and proding, but understand the necessity. (Although that whole pap smear thing - there has to be a better way.) I think the biggest issue is that I read to much into every question that I am asked. I mean if they ask me my favorite color, in my head I am trying to decide what the right answer is so they don't decide I have cancer. A little psychotic I understand, but that's me.

I was told that I was in very good shape for my age and profession. Yea that's what I said - for my age and profession. What does that mean? Would I be an unhealthy accountant? Do they grade the age thing on a curve? They didn't teach me that in medical school. What are they thinking - wow she would be a crazy unhealthy 28 year old, but since she is 35 this is the best we can hope for? I use the expression he/she looks great for their age all the time, but I am talking about 70 and 80 year olds! I am choosing to put a positive spin on it and to move on - suprising for me I know, but learning you just have to let some things go.

We did discuss my recent dizzy spells. I am told that they are most likely related to benign paroxysmal positional vertigo. Big fancy term - the only things that I could recall about it were that it involved these really cool little tiny rocks that live deep in your inner ear and it was almost always the cause of dizziness in little old ladies. Turns out I was right on both counts.

The simplest explanation is that there are these cool little rocks in your inner ear that tell your brain the position of your body. As you move, they roll against each other sending new signals about their new position. Outside of the cardio-pulmonary system - coolest part of your body. As one ages, or also happens following head trauma, viral infection and for some unknown reason increased incidence in Urban dwellers, for lack of a better description dust or debris makes it into the area of the little rocks. They can no longer send as clear of a signal, therefore one gets dizzy when changing positions.

Good news is that it is almost always self limiting. Housekeeping eventually comes along and cleans out the dust. There are some exercises that I can try at home to help speed along the process. Of course, they offered to have me see an Otorhinolaryngologist (ENT doc). This is the funny thing about going to the doctor when you are a doctor. Doctors seeing doctors are always afraid they are going to miss something or you will second guess them. Therefore, we are very quick to refer you to a specialist or for a second opinion. Crazy logic, but true anyway. I politely declined and went along my way. Only hurdle left is a fasting lipid panel. I should do it soon since I am currently still off meat and chances are good it may actually be a decent number.

At least I am off the hook for another year.

Slight miscalculation

Okay - I don't love to admit when I am wrong, but like to think that I am a big enough person to admit it on the rare occasions that it actually happens: :) Boy was I wrong. I mean couldn't have been further from correct. I missed it by a mile - as the saying goes. The colossal mistake that I made - thinking that I could survive a Philly winter.

I know you are already laughing. Half of you are saying I told you so - and the other half sneering that it is still October. My concern is the latter. It is only October!!! Today in Philly, it is a balmy 36 degrees, windy with precipitation. The precipitation I might point out has been snow for a good portion of the day. I'm sorry, but where I come from we call this a bad January day. If this is only October weather here - I am seriously afraid to stay and find out what January is like.

I am not completely naive. I expected that it would get cold. I even expected snow. I didn't expect the wind that makes the cold so much less tolerable, and I figured it would at least be December before the snow arrived. I don't have clothes for this weather. I am not sure they make enough clothes for me to handle this weather. The only bright spot I can see is that you have to wear so many clothes in the winter here, that no one could notice an extra few pounds. A bonus yes, but not quite worth the cost. Call me weak, call me spoiled, just call me a taxi to the airport.

Fanatic indeed

Okay - I have lived in a World Series town before. . . I was in Atlanta during the 90's. It was a lot of fun. I saw some great baseball and a lot of good clean fun had by fans. I never felt in danger or that the fun would get out of hand. Of course, maybe part of that was they kept losing the World Series, but I digress.

As most of you probably know, Philadelphia is in the World Series. Even though I do not tend to follow sports, I can't help but also know this fact. You can not sneeze in this town without hitting someone or something with a Phillies logo on it. The whole town is seeing red - literally. I honestly think the election could be tomorrow - Mickey Mouse could win and it would compete for headlines in this town.

They have a chance to win the series tonight, and honestly I am a little worried. The fans here do not strike me as the well behaved good clean fun kind of fans. I am afraid something will burn or a car will turn over. Crowds took over the streets when they clenched the NLCS. I am not sure they can handle more. I am hoping to leave the hospital at a decent hour, put my car in the garage and settle into my apartment tonight. Hopefully, all will be well, but I currently couldn't outrun a two year old much less a crazy fan. Therefore, I will watch from my lofty apartment window.

aches and pains

Okay - I know that very recently I argued that one should only be as old as they feel. I take it back. At least this weekend. I feel VERY old. It started toward the end of last week. I developed back pain. I think it was a combination of a weird case that required me to stand strangely for four hours and the increased amount of studying that I have been doing recently.

When I study, I have poor posture. I hunch over the desk. If I am studying regularly, I either strengthen my back muscles or I learn to study with better posture. When I am only studying sporadically - as I am right now - I just end up in pain. I develop mid Thoracic pain just to the right of my spine. Interestingly, this is the same place that I carry stress. I am sure that is probably not a coincidence, but strangely related. I also developed lower back pain from standing in a weird OR position.

In the past, I could shrug it off. It hurt a little, but was easily ignored. This weekend, I struggled getting out of bed. Not because I wanted to sleep or stay in bed like normal, but because physically it hurt to get out of bed. I had sharp pains down my arm and right hip pain. I am old. I am at least up with a lot of Advil, but no longer want to feel my age.

Much to be Thankful for

I know that Halloween hasn't yet arrived, but I find that my thoughts have already turned to Thanksgiving. I loved Thanksgiving when I was growing up. We always ate a late "dinner" ( in the South that is what we call the mid-day meal) at my grandmother's house. My grandmother died on the Tuesday before Thanksgiving my fourth year of medical school. I will be honest - I haven't really enjoyed it much sense.

I have tried. I have planned elaborate dinners that I forced all of my family to attend. I forced friends from work to come to my house for Thanksgiving dinner - all trying to recapture my love for the holiday. I don't hate the holiday - I just don't get that bubble of excitement or anticipation that I used to get.

That finally changed this year. I was looking at my schedule yesterday - trying to make some plans about my Nashville trip when I noticed that I am not on first or second call from the Wednesday before Thanksgiving till Sunday. My first thought was actually oh no - now what am I going to do with all of that time. I decided to check out the price of tickets to fly home on a whim.

Bless our failing economies heart - tickets from Philly to Greenville-Spartanburg weren't only available, but actually had an affordable price. I try to call my mom to sell the idea of flying me home - she was in a meeting. So, I made the phone call that I should have made first. I called my dad. Now we all know that I am a daddy's girl, but even I usually have to hint gently at what I want. I started the conversation by saying - I was looking at my schedule and noticed that I am actually off over Thanksgiving. I didn't have to get any further. My dad says - find a ticket home - we'll pay for it. I love my dad.

So, that was a very long-winded way of telling you guys my news. I not only get to fly to Nashville to see my friends there in December - I also get to fly home for Thanksgiving. Very excited - I think I may need a warm weather break by then.

Wish List

I am not sure why exactly, but lately I have developed a sort of wanderlust. I have been dreaming of traveling to lands far away. Maybe it is the idea that the end of my training really is at hand. Maybe it is that I will finally be able to afford to indulge in a great vacation. Maybe it is just that I haven't had any real vacation in 2 1/2 years. Regardless of the reason, I have been mulling over places to go in my head.

The list is long, and would cost me way more than a Thoracic Surgeon's salary. [Too bad I haven't made much progress on that marrying wealthy and chucking the whole career thing plan.] However, I decided I would narrow it down to 10 and make them places that I truly plan to see and spend some time before I die. [Don't worry I am not sick - although I do have a doctor's appointment next week. I have been having strange dizzy spells. My diagnosis is some inner ear thing, but since I almost fell in the operating room the other day I am being pushed to have it checked.]

The making of this list was quite fun. I would highly encourage you all to do the same. It can't be generic - no I want to go to Greece. Really pick a place that you want to see and imagine what types of things you would do there. I have had so much fun with this that I might make a places to go closer to home list next. I will share my list with you below - if anyone is interested in traveling to these places let me know. I am always looking for travel companions.

Places to See Before I Get Too Old:

(1) - Hiking in Bernese Oberland (Swiss Alps)
(2) - Biking Iverness - Base of the Scottish Highlands
(3) - Art tour - Florence, Italy
(4) - Explore the "Peace lines" in Belfast, Ireland
(5) - Outdoor markets of Tangier, Morocco
(6) - Fishing in Nova Scotia, Canada
(7) - "Roughing" it Australian Outback
(8) - Cruise the Northeastern Aegean Islands, Greek Isles
(9) - Discovering Ruins Athens, Greece
(10) - Shopping Rome, Italy

Now I just need a vacation slush fun.

No more Oprah for me

I like to watch Oprah. Not the Phil Donahue-like ones (showing my age there), but about half of her shows I find entertaining. Oprah comes on at 4 pm here in Philly. No, I am not usually home at that time, but I TiVo them. As an aside - TiVo is the greatest thing EVER. Not only do I get to watch shows that I would otherwise never get to see, but it is much easier than setting a VCR and I can fast forward through all the commercials.

Saturday morning is my catch up on Oprah time. If I am not working, I get up - walk down the street for coffee and a bagel or scone and curl up on my couch to watch a little Oprah. This past Saturday I had to round in the morning, but I curled up on my couch around noon. A lot of recent shows have been about the economy and how to be more frugal. I know she is incredibly smart, but Suzy Orman bugs be for some reason. Again I digress.

There was an episode on last week, I am not sure which day, with Lucy Liu. The episode was about the raising of farm animals. Now, most of you know that I grew up on a pseudo farm. We had the occasional cow, pig, chicken, duck, or goat. I by no means romanticize farming, but I do have a certain world view about it. Most of you also know that I refuse to eat veal. It all started MANY years ago when I read that veal calves are raised in a small box so that they reach a certain size. The idea bothered me. The Oprah show was about some new proposition that is on the California ballot this year talking about increasing the mandatory size of cages for chickens, hogs and calves.

Lucy went to a compare and contrast farm with each animal. There was a free range cow farm vs a "factory farm", etc. etc. I had difficulty watching the pictures of 700 pregnant sows in small cages that didn't even permit them to lie down. I am not sure why I can't stand to see animal suffering - especially since I see human suffering every day, but it has always bothered me. I refuse to watch Animal Planet because it always makes me cry. I finished the episode, and moved on to Live Friday on Oprah. Where strangely Halle Berry spent a huge amount of time talking about orgasms. I tried not to give much thought to the "farm" episode.

Saturday night I decided that I would walk downtown for dinner. I headed off down the street and could find nothing I wanted. The hamburger place made me recall the cows in boxes, the bar-b-cue place (yes they have them here, but they are bad) flashed me to the sows, etc etc. I finally settled on a vegetarian salad. No big deal, but now it is Tuesday and I still can't bring myself to eat meat. Luckily for me I have bought cage free eggs for a couple years - mostly because they have extra Omega-3 fat which Gail and Martindale drilled into me was good.

I don't think I want to be a vegetarian, and I don't think I could be vegan. I truly love a good juicy cheeseburger. I would just like to enjoy it again. I already had to worry whether or not the cow had received antibiotics, steroids or growth hormones. Now I also have to worry whether or not he got to walk around or was forced to stand it one place inside a box for his entire life. I am not sure I like being an educated consumer. Naive consumerism was much less stressful. I think I need to swear off Oprah for awhile.

I HATE computers

Computers make my life more difficult. I seem to spend more time trying to figure out why the computer program didn't do what it was supposed to do, than it would have taken to do a lot of the tasks by hand. I know McCain says that putting medical records on the computer will save money, maybe - but it just makes me pull my hair out. And don't even get me started on "computerized order entry systems". My handwriting is quite neat thank you - so get off my back and give me an order form.

My current issues with computers probably stems from my home computer being on the fritz. On Friday night, I downloaded the new "adobe flash player" that my computer recommended that I download, and now it doesn't recognize half of it's own old programs. Nor does it recognize the fact that it has internal speakers. I always like to listen to Itunes when I play on the computer, and currently it is incredibly silent. I spent most of the weekend trying to fix it. By that I mean that I would try something for about five minutes - get incredibly frustrated - and move on to something else. Currently my home computer and I are taking a break from each other. I feel we both need some space to figure out if our relationship is really worth saving.

It is FREEZING up here by the way. I pulled out the Southern card last night and turned my heat on low. I know Kris has claim to the "windy city", but the breeze here is fairly biting. I am starting to have a bad feeling about this winter thing.

What Oprah knows for sure

Post call so I am stealing from Oprah. In this month's mag, she summarizes her top 20 "things I know for sure." Pretty good words to live by.

1. What you put out comes back all the time, no matter what.
2. You define your own life. Don't let other people write your script.
3. Whatever someone did to you in the past has no power over the present. Only you give it power.
4. When people show you how they are, believe them the first time.
5. Worrying is wasted time. Use the same energy for doing something about whatever worries you.
6. What you believe has more power than what you dream or wish or hope for. You become what you believe.
7. If the only prayer you ever say is thank you, that will be enough.
8. The happiness you feel is in direct proportion to the love you give.
9. Failure is a signpost to turn you in another direction.
10. If you make a choice that goes against what everyone else thinks, the world will not fall apart.
11. Trust your instincts. Intuition doesn't lie.
12. Love yourself and then learn to extend that love to others in every encounter.
13. Let passion drive your profession.
14. Find a way to get paid for doing what you love. Then every paycheck will be a bonus.
15. Love doesn't hurt. It feels really good.
16. Every day brings a chance to start over.
17. Being a mother is the hardest job on earth. Women everywhere must declare it so.
18. Doubt means don't. Don't move. Don't answer. Don't rush forward.
19. When you don't know what to do, get still. The answer will come.
20. "Trouble don't last always." This, too, shall pass.

Are you REALLY only as old as you feel?

Okay - although I complain a lot about my age, in actual fact - most days I feel like I am still pretty young. I don't think of myself as "middle age". I know that I have been out of college for a while and that I was 14 when my mom was my age, but all that aside - i still feels young and relevant. [I mean let's be honest - I have been flirting with twenty year old lately.] Oh, how much a single day can change your perspective.

The day started innocently enough. I was doing an anterior mediastinal mass resection, and as the case was going really well and I was sans staff - we were all laughing and telling stories. I was telling some tale about when I was in medical school. At some point in the story, I mentioned that the parents of the two year old who could not afford $3.00 for antibiotics had no difficulty buying him a pair of Air Jordan's. This is where my story takes a frightful turn.

My medical student innocently asks "what are Air Jordan's." I pause for a minute and look around. I have an anesthesia resident, medical student, two scrub techs, one circulating nurse and two nurses observing in the room - a full house. All who look barely old enough to drive. I then ask the unthinkable question - "Who in this room was born after 1980?"

EVERYONE IN THE ROOM RAISED THEIR HAND!!!!!! I almost walked out right then and there. When did this happen? When did I become one of them? I, like Peter Pan, didn't want to grow up. I guess it had to happen some time - and for me today seemed to be the day. Well, I am going to rub on some BenGay and sit and yell at the television during the debate. Does this mean I have to start identifying with McCain?

Screeching halt

Surgery is a funny thing. It is a profession of unbelievable highs and unfathomable lows, but it also is incredibly cyclical. For anyone that spends anytime around surgery or surgeons, they know exactly what I mean. Instead of having a constantly busy but steady stream of work, surgery tends more toward the all or nothing variety. I am either working my now sizable backside off or sitting on it twiddling my thumbs. There really is no in between.

Even more ironic is how shocked all surgeons are by this incredibly predictable occurrence. We complain when we have too much to do, but are even more vocal when things slow down. We start pacing the floors worrying that we have nothing to do, and let me tell you surgeons with time on their hands can be dangerous.

I say all of that to offer the following complaint. I have worked ridiculous hours for the past week and lived on very little sleep and today --- I did absolutely nothing. I went to work, but our one and only case was cancelled. I sat around all day reading and playing on the Internet. Unfortunately tomorrow looks about the same. We have only two cases, and one of them is looking kind of iffy. I don't mean to complain about a much needed rest, but is there no in between? Why can't the fates combine to produce a steady stream instead of flooding or drought conditions? Oh well - there are many things that I don't understand about the fates.

Still alive

Despite what my mom and Kris currently believe - I am still alive. Let me explain. Whenever I get busy and don't stay appropriately in contact I can always count on both of them leaving me - "just want to make sure you are a live messages". They have an uncanny ability to usually call within a couple of hours of each other and both evoke the same guilt. I feel incredibly chagrined and make the appropriate time to "call home." Unfortunately for me, not only have I been busy and sick, but my cell phone is currently on the fritz.

In all honesty, I sometimes get so wrapped up in the speed and craziness of my life at a particular moment in time that I forget that I haven't spoken to any of my friends or family in a few days. I actually count on the above mentioned phone calls to remind me that I haven't spoken to anyone outside of the hospital for a week or more. It is perhaps not the best system, but it has worked for several years now. At least it did until my phone decided to stop telling me I had messages or missed calls.

My first clue - Kris called Saturday evening and gently hinted that I should have called Matt back to congratulate him on his goal. (Scored his first soccer goal on Saturday - WAY TO GO MATT). When I protested that I did not get the message, I find out it was not the first. With a sinking feeling in my gut I proceed to call my mother. Turns out I missed a lot of calls there - and the fact that my mom threw her back out and required a trip to the ER. She will probably eventually forgive me, but I'm guessing no time soon.

I took my phone to the local Sprint store this afternoon, and they think they have the problem solved. The phone problem that is - I still have some ticked off friends and family. Therefore, I am offering a HUGE I'm sorry. Last week was crazy, and I was somewhat felled by the "common" cold, but neither is an excuse for being completely out of touch. I will try much harder in the future to do better. (I will even send you some dates Jessica so that we can plan my trip to DC.) I continue to be thankful for all of your great patience and understanding. I will get better some day - PROMISE.

Whew!

I am still at work. A place that I have spent an overwhelming majority of the last 160 hours. I don't think I worked this hard as an intern. I know I wasn't responsible for such sick patients. It didn't help that I was the only Thoracic resident in town this weekend and four of our patients got sick enough to need an ICU, reoperation or both. Thought things would slow down today, but so far I am wrong. We still have one more case to go.

It does not help that I am also getting sick. I woke up this morning with a sore throat and a fever. Not the end of the world - right?. Well, I was rubbing my neck this am before my first case and found a lymph node. Everyone in the world - medical or not - would say : sore throat, swollen gland - most likely connected. Not me. I have decided that I must have lymphoma. (Yes, Bassam and Jill, not exactly what we learned in medical school, but I think I may need a biopsy.) Oh well, I will continue to obsessively rub my neck to monitor it's size.

I am quite jealous of those of you back in Nashville. You have a Debate buzz going on tonight. Hoping I get home in time to watch it. I completely slept thru the Vice Presidential debate. I had been up the entire night before playing like a doctor on ER and didn't get home in time for an adequate nap. It doesn't sound like I missed much more than a few winks. The SNL - Tina Fey debate was HILARIOUS.

Rain Rain Go Away

So everything comes at a price. The cost for my gorgeous weekend a couple weeks ago - rain. It started raining here last Friday and continued to rain until Monday morning. Now I have really enjoyed the convenience of living in a pedestrian city, but it is A LOT less fun in the pouring down rain. Rumor has that it briefly stopped raining during the day on Monday, but I worked all day so I missed it. Rain started back Monday night and most of the day Tuesday. I had Tuesday off (2 of my 3 staff were observing the Holiday so we had no cases). I had the great joy of running errands in the rain. Another rumor circulated today that the sun actually came out and it was gorgeous. I am on call and haven't left the hospital. Tomorrow - my post call day - it is supposed to start raining again. Oh well - that's life.

Because it just randomly crossed my mind - I need a favor. I am sad to report that I no longer am a frequent visitor to Macy's. My move to Philly has turned me into a Fiscal conservative (personally - not politically and hopefully only for 9 more months). Therefore, I try to avoid temptation. However, I need new moisturizer. I refuse to pay $60 dollars for my Estee Lauder moisturizer unless I get a free gift out of it. {Yes dad - I know that is a ridiculous amount to pay for lotion, but think of the money I am saving by putting off my first face lift.} So, I need someone who still gets to walk thru Macy's and look at the pretty things to tell me when Estee Lauder is having their gift time. Thanks.