Attitude Adjustment

So I need to find my happy place and quickly.

To say that things have been a mite difficult at work lately is an understatement of gargantuan proportions.  I won't bore you with the details mostly because the idea of seeing all the reasons work is currently not a good place for me is likely to end with me in tears.  I will say that I am near a breaking point that I have never approached previously.

My career trajectory has not always been a bouquet of roses, but I have always been able to accept the good and make peace with the bad.  I have previously had what I am now seeing as an enviable ability to not see things or at least separate myself and more importantly my happiness from things I could not change.  Perhaps that is the problem.  Perhaps, quite mistakenly, I have convinced myself that I could change some things about my situation and am frustrated with the reality of that not happening.

I guess that leaves me at a place where I have some difficult decisions to make.  Can I unsee what I have now seen?  Can I separate my happiness from my professional self?  Doesn't my professional self make up a huge part of my personal happiness?

I don't know the answer to any of the above questions, but realize the importance of finding them.  I refuse to remain the unhappy dejected person that I have morphed into currently.  

Moody and I know it

I have always admitted to a little Seasonal Affective Disorder, but it is either much worse this winter, or something else is clearly getting me down.  I also do not seem to be the only one.  Why is everyone in such a bad mood at the moment?

All of my tried and true fixes are also not working at the moment.  Had a girl's day last weekend which included  shopping, nails, nice meal, a great movie and a beautiful pair of Valentino stud flats, but happiness was still fleeting.

Maybe all the negativity in the US at the moment is getting to me more than I realized.  Maybe I finally reached my limit of tolerance for my grumpy, never happy, drama-filled work partner.  Maybe I hate change and the fact that I only recognize 3 people in my office (all providers or mgmt) is more than my routine loving heart can handle.

All I know if something has to change and soon.  If this goes much longer, I will have no friends left and Coco is already threatening to go live with grandma and grandpa.

Baby it's cold out there, and in here come to think of it.

I love my puppy, and her needs get top billing at our house.  I hate cold.  Turns out, those two statements are currently in conflict with each other.

Don't worry, she still walks every morning. . . wearing an adorable sweater and overcoat.  I go out for our morning walk looking like a Sherpa ready to ascent Everest (minus the oxygen tank).  The only thing keeping me going at the moment is those mid-60's forecast for this week.

I accept, albeit reluctantly, that cold days in January are necessary if one lives in Nashville and has to go outside.  What I find difficult to accept are the cold days in January found inside my office.  I currently find it necessary to wear a heavier winter coat inside my office than I wear getting from my house to said office.  (Shout out for garage to garage living.)

My office at present . . .

Please ignore the probably illegal space heater on the floor, and if you hear reports of the hospital being aflame - just remember:  I was with you the whole time.

Approach to 2017

I always start the New Year with such great plans.  Like most people, I always resolve to eat healthier, work out more and "be kind" to myself.  I always start out strong, but then at some point, I will slip up on something.  One little slip is all that it takes my brain to then give up on everything.  If I can't be perfectly good, my brain decides it will go for perfectly bad.

To be honest, it's not really working for me.

This year, I'm not making 20 changes that all had to start on 1/1 and require utmost devotion.  This year I am making one change.  Once that one change becomes a habit, then I may add something new.   My goal is to put minimal expectations on the one change.  It obviously had a start date, but no obvious must be completed by date.  (Quite honestly, I am too old to keep beating myself up over things - I bruise so easily these days.)

My one thing you ask?  It's may surprise you, but I'm simply trying to take back my weeknights.

I often work long days that can be a combination of physically, mentally and emotionally draining. This left me some days coming home, and sitting on the couch to "catch my breath" (read vegging out) for the hour or so before it was time for bed.  Some days morphed into most days which is unacceptable.  (It also leaves me with ridiculously long weekend chore lists.  I can not recommend attempting to accomplish all of life's errands, and rest/recover for the next week in a 48 hours time frame, especially when half of them still involve going to work for call.)

Therefore, I am working to accomplish at least one task each night when I get home.  This week, I am working to re-paper and re-organize my kitchen cabinets and pantry.  I am happy to report, working on it a little each night I am almost finished, and it won't have to make it to the weekend chore list. Coco is happy to report that I finally got rid of all the treats she does not like, but that I kept trying to convince her that she might.

Here's hoping for a full 2017 for us all.

The Laundry Conundrum

I hesitate to complain about laundry.  Every time I do, my mom or a friend will quickly point out to me that I only have to do laundry for myself and not the "___" other people living in the house.  While I accept the premise of the argument, I counter that doing laundry for one has it's own challenges.  Especially one the one is me.  

For starters, I wait until almost everything that I own is in need of laundry before I put the first load of clothes into the washer.  This is a bad habit developed in college when one had to trek three floors over and down for the laundry room.  (This is also the reason that I happen to own a month's worth of underwear.)

Laundry not being my favorite past time, I then vow to accomplish the entire backlog all in one day.  Not the most exciting way to spend a Saturday I must point out.  It also inevitably leads to a late night of ironing because I also refuse to put clothes back into my closet unless ready to wear.  (Starting to see my problem?)

Last  and certainly not least, I have a strange need to have completely empty laundry baskets.  I have been known to pull off the clothes I am wearing and put on my bath robe so that for a moment in time, everything I own is clean.  For unclear (but clearly in need of therapy) reasons this makes me extremely happy.

Bet you can't guess what I did this weekend?

One of THOSE days

Ever had a day start and within a very short time realize that is was not going to be your best?  Today is that for me.  It started with a 6:45 meeting.  Why anyone wants to meet that early is beyond me.  It is also one of those meetings where one actually has to be awake and interactive.  Hence my first stop of the day.

Suspected it was going to be as bad as it is turning out to be so went straight for Venti with an extra shot.  Another meeting followed and now clinic.

In the meantime, my partner wants to rework the next three months call schedule which we both approved just last week.  A call schedule already made difficult by holidays and four weeks of personal time off (for him) to accommodate his girlfriend's work schedule.  Are you kidding me????? I have a "mood" calendar on my desk.  Today's forecast . .

Faux Christmas?

To me part of what makes Christmas so special is that it engages all of the senses.

        -   The sight of lights twinkling.  (Warm white of course.)

        -    The sounds of Christmas Carols.  (Hark the Herald Angels on repeat.)

        -     The taste of Williams and Sonoma Peppermint bark.  (What do they put in there that makes it soooo good?)

        -     The feel of glitter - everywhere  . . . (what?  there is more glitter on my face, but I wiped it away already, now it's on my shirt - oh wait I don't necessarily love that one as much.)

       -    The smell of a freshly cut Christmas.  (For me that is a beautiful Douglas Fir.)

Growing up we always had an artificial tree - my mom hated vacuuming needles.  So I determined at a very young age, that I would always have a real tree when I grew up, and the biggest tree I could find.  (Fit being a factor you will see has unfortunately never been high on my priority list.)  I have kept this promise to young me every year except for the time I spent in Miami.  I gave myself a pass there because South Florida is not really conducive to Douglas Firs or any evergreen.  The only trees that do well there give rise to coconuts not cones.

My first Christmas in my new house I skipped a tree.  (If it had not been for Christmas Elf Kris, I would have also skipped any decorations that year.)  I had only been in my house for a month and still had more boxes than furniture.  Therefore, last year I was excited to go on a tree search.  The Friday after Thanksgiving, I forced my family to Home Depot where we proceed to purchase the largest tree we could find.  I have 20 foot ceilings in my living room - I felt there was nothing to hold me back.  It took four of us to bring the tree into the house,  an 8 ft ladder for me to decorate it, and I never was able to reach the pinnacle for a topper.  I had to completely rearrange my living room to accommodate the tree's breadth, and Coco (to my great dismay) enjoyed nothing more than playing on the tree skirt watching needles rain down on top of her.

All of this I could handle because I had a huge gorgeous tree with the most amazing smell.  But then Christmas was over, and the tree needed to go.  Now it was just me and dad and a HUGE dead Douglas Fir.  The tree eventually made it to the curb for pick up, but it was neither easy nor pretty.  I decided then and there that I needed to switch to artificial.  I told my dad who laughed and said he would believe it when he saw it.  Where dad, here it is. . .

It even comes with a remote control which allows me to not only turn off and on the lights, but to pick white, colored or both.  I purposely picked a slender version so that I would not have to rearrange my furniture completely, and capped myself at 11 feet so that I could decorate it without having to rent a crane.  The only thing missing is the smell.  And I must say that I do miss the smell.


I have a lovely "Christmas Tree" Aspen Bay candle which does smell nice, but it is just not quite the same.  So the question I have is does a faux tree mean that there will be faux gifts underneath it?

Elusiveness of Time and Perspective

Have you ever noticed how often you hear people talking about time?  Time is now Public Enemy No.1.  We are always trying to acquire more of it, outsmart it or out run it.  Our lives revolve around a clock.  If you took my Outlook calendar away, I am not certain that I could continue to exist.  It is the only reason that my smart phone always wins in our perpetual love/hate relationship.

It is unfortunately common knowledge that if you put something on my Outlook calendar, I will show up at the designated place fairly close to the designated time - no questions asked.  (Which has me on quite a large number of committees, boards and at way more conferences that I knew could exist in addition to an ever increasing operative load.)  While at the designated place, I will be keeping a close eye on the clock to make sure that I make it to the next entry appropriately.  This has become the framework of my days. . .  A series of Outlook calendar entries.

This is not unique to doctors, although we seem to have a unique perspective on it - more on that later. All of my friends seem to be racing to see who can cram the most into 24 hours.  From stay at home moms, attorneys, executives at companies big and small, we are all scheduling our lives away. We are now so needy for schedules that we plan every minute of our vacations and even our "down time".  When we find ourselves with that rare blank spot in our day or an unexpected cancellation it creates in itself a small crisis as to how best to fill the time, because we certainly can not let it "go to waste."

Recently I was a participant in three separate conversations with colleagues of mine.  All were complaining regarding significant others or friends or non-MD colleagues in their lives who "didn't really know what busy or tired was".  It is a commonly held belief among doctors (and perhaps surgeons worst of all) that no one else on the planet has as much on their plate or as stressful of a job as we do.  (Yes most of us would compare and declare ourselves the schedule victor even up against POTUS - especially since most of us have never had time for Tweeting in our lives.  I'm looking at you President-elect Trump.)  However, I found myself playing devil's advocate in all of these "our time is more precious" conversations.  My position was that it all comes down to perspective and life experience.  It is impossible to judge how "busy" a friend or colleague is in his/her daily life, because I have no frame of reference.  Their perception of their day may have them feeling way more stressed about their ability to fit it all in than my stress level at a full, but planned day of two esophageal resections, three meetings and an evening women's work event.  Perception is reality and who am I to define someone else's reality.

Besides, I want off the time is of the essence train.  While it is not realistic for me to live without a calendar (see above note about cessation of existence).  I can let go of having to have an accounting of every minute of every day.  It's winter so there will be no smelling of the roses, but perhaps I will be able to start observing the "little things" again.  Starting to realize as I get older that perhaps it is the little things that I want to define my life, not a time schedule.  

Absence Makes the Heart Grow Fonder?

Since my last post was over 18 months ago, one would think that I would have much to tell.  Sadly, one would be mistaken.  Unless tales of work, more work and time spent comatose on a couch excites you, I do not have much to show for my long absence.

However, this brings me to the motivation of my post.  Perhaps if I have to semi-regularly detail the happenings of my life, it will embarrass / encourage me into getting details of a life.  I can not promise the details of this post to rival an episode of Sex and the City, but perhaps it can get me to put off catching the next episode of Game of Thrones and go out some where to do something.

Of course that being said, the following sums up my weekend. . .

It is my shadow you see taking the picture of my lonely car.  This was the doctor's parking garage this weekend.  Although usually quiet, I don't ever recall it being this lonely.    

My 42nd Year

I turned 42 years old yesterday, and not to brag, I did it with the dignity befitting someone of my advanced years.  I rounded, had clinic, participated in a multi-disciplinary tumor board meeting, chatted with several family members and friends, had a delicious dinner that I prepared myself, and played with Coco.  It may not sound like anyone else's idea of a great birthday, but was exactly what I needed this year.   

It is no secret that I did not gracefully embrace 40 (or 41 for that matter).  To be entirely truthful, I went a little nutty.  I had started to worry that my funk was never going to pass - two years is a long time even for me.  However, as this birthday approached, I noticed that it was not nagging at me as had it's two predecessors.  I found myself dwelling on the positive aspects of being my age as opposed to the negative ones that had consumed me for the last few years.

Having reached the grand age of 42, I am happy to report that I am doing well.  I am healthy - something one does not take for granted in my line of work.  I have a wonderful family and great friends.  I have a job that I enjoy and allows me to feel as if I make a difference.  I earn enough money to keep a roof over my head and beautiful shoes on my feet.  Feeling sorry for myself as I have for the last two years now seems a waste of time and disrespectful to those who have real problems to face.     

Perhaps the 40's and I have finally come to terms.

What is going on here?

It's snowing - AGAIN!

My car is no longer speaking to me.

Peek-A-Boo

Nashville appears to be playing peek-a-boo with Sunshine.

Saturday was GORGEOUS. The sun was shining, the sky was blue, the temperature was in the mid-60's, and the convertible top was down. All was well in the world.

Fast forward to Monday. The sun has made no appearance all day, the sky is gray, the temperature is in the low 40's, and the convertible top is firmly back in the up position. All is not well in the world.

So it is technically still Winter, and the Northeast is frigid and covered in snow. I don't care. I want my Sunshine back.

Winter Time Blues

Leaving Miami might not have been my brightest move ever.

Yes it is wonderful being close to my family. It is great being able to see my best friends and the kids on a random Tuesday. I even recognize - despite the current state of unsettledness - how great it is to be able to afford a house and shoes.

However, I am not a fan of winter. It's not the cold. (I have an enormous amount of coats, gloves and scarves - especially considering I have spent all but 12 months of my life living below the Mason-Dixon.) It's the lack of sunshine and daylight. Nashville is at the Eastern edge of Central time. This means that it starts getting dark here around 4:45 in the afternoon. Therefore, unless I leave work in the middle of the afternoon, by the time I get home, it feels like bed time - even though the clock may only say 6:30. This leads to an entire week going by with my accomplishing NOTHING outside of work. Throw in back to back weekends of crazy call, and I am down for the count.

Okay, enough whining. I will figure this out. Perhaps I can start getting up at 4:30 and get things accomplished then - the sun comes up by 5 here so it is at least light. Or perhaps I will just keep thinking of solutions.

Home Sweet Home

Yesterday was punch list day for my new house. For those of you, like me, who have no idea what that means, allow me to explain. During a punch list, one walks through one's soon to be purchased home with a roll of blue painter's tape. One then marks every imperfection that one sees regardless of how small, and the builder then fixes it. Basically, an OCD girls dream. Although at one point I was fairly certain they were going to take my tape away due to overuse - it actually went pretty well. There are only two "real" issues with the house both of which seem like easy fixes - if one is a plumber and an electrician.

All of that being said, it means that move in day is rapidly approaching. This weekend as a matter of fact. Although the spector of closing on Friday still has me somewhat petrified, I am starting to get really excited about moving into this house. Let's just hope the excitement wins out over the commitment issues. Hopefully pictures soon to follow.

Thank You Mother Nature

Started this week, like many weeks, determined to get back into a health work out pattern. Mother Nature must know how desperate things are getting because she threw me a bone - temperature in Nashville on this end of July day - perfect 82 degrees.

Warp Speed Ahead

When I decided to embark on building a house, everyone kept warning me about what a drawn out process building can be. They encouraged me not to be upset with delays, and that I could take it to the bank that I would miss my closing deadline. These predictions were always told with a horror story from someone's own personal experience.

Therefore, in my head, I was moving into this new house of mine next year. Imagine my surprise and immediate heart palpitations when my builder informed me the other day that we are about one month ahead of schedule! They painted my entire house this week - inside and out!! We started talking about the trim guy!!!

I thought it was common knowledge that I have commitment issues - you can't move things up like this on me. I thought the building process was stressful - the actual idea of committing to a morgage - now that's real stress.

Construction Crazy

Allow me to go on record as saying that I love my General Contractor. He is fabulously attentive and responsive. He has a certain attention to detail that can only truly be appreciated by a fellow member of the OCD club (and we all know my dues are well paid up there). My "allowances" are top notch which has done wonders for keeping me on budget, and he has been receptive and encouraging to any suggestions or changes that I have brought up. He believes in "building homes not houses", and really wants my personality to be reflected in our finished product.

All of that being said, please remind me to never build again. Building, even with a wonderful contractor, budget and good weather is STRESSFUL, and don't let anyone try to convince you otherwise. I have found myself obsessing over ridiculous details that I would never have noticed in a home that I was thinking about purchasing. However, when building, these details become things for which I lose sleep (a high cost for someone who spent 10 years as a surgical resident).

Have you ever walked into a tile store and looked around? It's not as simple as knowing your color scheme which I naively thought. One has to decide natural stone vs ceramic or porcelain. Shape and size factor in to the overall look. What pattern or style should the tile be laid? Are you kidding me????? Quick - can you tell me what color the grout is in your bathroom? I can't, but I have now spent entire hours of my life (which I can not get back) discussing "different, but complementary" grout colors on the floor vs the shower tile.

I am still having nightmares about chrome, brushed nickel vs oil rubbed bronze finishes - three concepts that until recently did not have meaning in my vocabulary. Entire websites are devoted to which is best and if they can be mixed. Please explain to me why one really needs an entire room of faucet fixtures from which to choose? My neck still hurts from the hours spent looking up for the "perfect" light fixtures.

Please don't remind me of the entire afternoon of my life spent at the cabinet makers. Did you know that you have to actually go to a granite yard to pick your slab? Even within the same color, the slabs differ so you have to pick which pattern most appeals to you. The same goes for marble, and I now know more about the care of quartz than any girl ought to know.

All of that being said, I am assured the "tough" decisions are almost finished. I only have to pick the stain for the wood floors and the wall colors. However, I am now being told I have to meet the electrician for a walk through regarding switches and outlets. I also have to meet the sound guy - seriously I have a sound guy??

Hopefully this house is going to turn out beautifully because I am fairly certain that I am going to end up to traumatized to ever want to move again.

Perspective

So my weekend hasn't exactly gone as planned. I spent 14 hours at the hospital yesterday, and am still here today waiting on a family to arrive so that we can withdraw care of their loved one. I would normally whine about how many hours that I have spent in the hospital the last two days, and how many sick patients that I have treated in the last two days, but I am waiting on a family to withdraw care of their loved one, so no whining for me.

Motivation

Is it possible that one is born with a limited amount of motivation, and once it's gone it's gone? Up until several months ago, I would have described myself as a highly motivated person. I currently resemble that person not at all. I currently resemble a couch potato - something that I have never been despite my love of french fries. Did I use up my supply? Is there a store where one can purchase extra? I have been searching high and low for my motivation. I seem to locate it for a few hours, but then it escapes again. I don't recall it being this slippery previously. Perhaps I need to forget about my motivation, and count on my need for order. If I start organizing my life in a more positive way, perhaps I will stumble across my motivation somewhere along the way. Let this be a lesson to all out there - motivation seems to have a limited supply.

Body Run Amok

My body has run amok. I'm not talking about a few unwanted hairs or some emotional lability - I'm talking full on anti-survival of the fittest. When pressed, I must admit it has been going on for a while, but recent events have made me acutely conscious of how far from "normal" I currently reside.

To start near the beginning, it is no secret to my closet, that I have struggled with my weight. Despite losing a large amount of weight during residency, and keeping it off for over 7 years, the last two years I have fought the scale. I'm talking a full on knock-down drag-out fight. I ran like a maniac, worked out with a personal trainer, swam, walked, spun, pilated, yogaed and tried every "lose weight quick diet" on the planet. All of the "tricks" that worked in the past quit working, and despite how hard I exercised, the scale did not budge. So I did the only sensible thing and quit working out. It worked - not in a good way, but the scale did move.

At my last physical, not only was my weight up, so was my cholesterol, triglycerides and blood pressure.

I blamed my job, my stress level and my crazy "life".

I changed my job, my stress level and my crazy "life" - but the scale still didn't move.

A few months ago, a friend of mine had approached me about the Biggest Loser Ranch. She asked me if I would be willing to "keep her company". The first couple of days on the ranch, I truly felt ill. I was tired, grumpy, sleepy, and had a headache. I blamed the lack of caffeine - those Mormons and their clean living. I blamed the altitude. I was so focused on blaming, that I almost missed the fact that by the end of the week, despite a VERY active schedule, I felt fantastic, and I was sleeping like a baby.

I wasn't so focused on blame that I didn't pick up on the fact that within a week of coming home, I felt tired again. Could it really be the caffeine? With not a little misgiving, I gave it up. Still had no energy. Whew - that wasn't it. Started looking around, and began reading a lot about the evils of sugar. Hmmm - could that be it? I did a sugar detox for 10 days, and had to admit I did feel better. However, avoiding sugar is hard! Especially when convenience is important to you. I decided that if I tried for "sugar lite" it would be better than nothing - right?

And then my "skinny" aunt had a heart attack, and I ended up back in a doctor's examining room.

She's fine. Thankfully. However, she ended up with a stent in her main coronary artery. The lesion which is known in my world as the "widow maker", because people who possess it often die from it before they get to the hospital.

While home visiting her and my mom for Mother's day, I was stung on my foot by a honey bee. (I know exactly what stung me because I killed it shortly after the event.) Having grown up in the country with a distaste for shoes (for the record, this time I was wearing) and a love of the outdoors, this was not my first enocunter with a stinging insect. I can't say that prior stings are fond memories, but they never slowed me down for long. By Sunday, my entire foot was swollen, and by Monday morning, my leg was swollen to mid-calf, and now my foot was a redish-purple color. Clearly something was awry.

One of the advantages of being in healthcare is knowing how to work the system. I was in a PCP's office at 9 am to have things checked out. A dose pack of steroids later, my foot although still purple at the site, has returned to a normal size.

It is the steroid dose pack that has me concerned. Our bodies are amazingly complex, but for almost every reaction there is a counter reaction designed to start shortly after the first reaction to stop the first reaction from going too far. Our body spends most of it's time and energy balancing the yin and yang. It is insulin vs glucagon. It is bleeding vs clotting. It is an ingenious system really.

Clearly my bodies pro-inflammatory and anti-inflammatory pathways are no longer in balance. My body needed the ultimate anti-inflammatory medication to halt its reaction. It was not capable of keeping it's response under control. I am by no means anti-Western medicine or pharmaceuticals. I think medications are good, necessary and have saved or prolonged millions of lives. However, I don't want them to do things that my body should be able to accomplish on its own. Why is my body so revved up from an inflammatory standpoint that it can't stop itself? Is sugar the cause as so many books, reports and documentaries are currently suggesting?

I'm not sure, but it is time to find out. It's no longer about fitting into my "skinny" clothes. It's about avoiding the doctor's office.