All By Myself...

HowManyOfMe.com

There is: 1 person with my name in the U.S.A. How many have your name?

How fun is this?

Funny that I'm so unique in the U.S. In Canada, not so much. In fact, there was another girl with the exact same name as me who shared my childhood pediatrician. They always mixed up our files-- she had asthma.

People in Ontario frequently comment on the 'uniqueness' of my maiden name. I tell them that in Quebec, my name is the equivalent of 'Smith'.

And that end's this evening's deep thoughts.

Another Week Down

It's been a long week.

Big dog managed to impale himself on a stick while we were playing fetch in the off-leash park last weekend. One sleepless night and an early morning trip to the vet later he was diagnosed with a wound infection. Since the vet had to sedate him to explore the wound, I actually called in sick to spend the day looking after him. I blame Mr. Couz, who was still visiting his family, for not coming home early to be with our poor injured dog. When I suggested this to him, he called me a crazy dog lady.

The next day the snow started to fall. I got in the car to make the 1 hour commute to my family practice, and made it all of 8 blocks before turning around and coming home. Good call, since by the time the snow stopped falling about 60cm had fallen on my town. More had fallen on the town where I practice. It was not a good day for commuting. I stayed home and studied for my board exams.

The day after that I didn't even make it out of the house. It was a Snow Day-- capital "S", capital "D". People were being told to stay off the streets, and even the malls were closed down. I stayed home another day, leaving the comfort of my couch only to join my husband in shoveling out our front path, our sidewalk and our cars. Considering that I live in a part of Canada where this kind of weather is really not the norm, this was an event. The fact that the snowbanks are as tall as I am brings me back to my childhood faster than a Raffi song.

The next morning I woke up, ready and willing to go to work. Well, maybe not entirely willing... my throat was scratchy, I was coughing, and my head hurt. I am *not* impressed. A month after getting over URTI #1, URTI #2 hits. Ugh. I guess I should be happy it's not a gastro. But how I managed to get sick the one week I wasn't in contact with patients (unless I caught it from a dog) is beyond me. But I couldn't very well take another day off when I had already missed more than half the week, so I dragged my germ-y butt into work and saw a steady stream of patients with the same symptoms as I had. Seriously... if there was a cure for the cold, don't you think I would have used it on myself?

And in spite of the copious amounts of time I've had to sit around with my laptop and a cup of green tea, readers may have noticed a lack of blog postings recently. I've been hit with... The Block. It must be a midwinter blah thing. I can't come up with anything worth talking about, and when I try to force it I manage to create posts that ramble on for pages without actually making a point. So I stopped trying.

So that's it for my random thoughts from this week. At least I made it until the weekend. Hopefully this week will be better-- my last week in my community family practice. Sigh.

All By Myself...

Whoa. Silence.

Mr. Couz has loaded up big dog and velcro dog and headed out to the boonies to spend a few days with his family. Dr. Couz, of course, is stuck working. But now I have four whole days with an empty house and I'm at a bit of a loss as to what to do with it.

But I'd like to state proudly for the record that within 20 minutes of my husband leaving the house, I had managed to blow a fuse in the kitchen for having the audacity to run the kettle and the toaster at the same time. Ah, the glory of living in a 100-year-old house. That's not what I'm proud of, though. I ventured down into the dungeon-like basement, located the fuse box, and solved the problem. Considering that it was something I had never done before and that I am usually irrationally afraid of our basement (don't ask), this was a pretty proud moment. Hey, I appreciate the small victories.

So now I'm headed to the gym to do my long run for the week-- 10k (or a little over 6 miles for you Americans out there). It will be mind-numbingly boring to do it on the treadmill, but there is a lot of very slippery snow on the sidewalks and it would be a really bad time for me to be on crutches. Plus, it's not the same without a furry companion.

Then, the plan is to shower at the gym and head out to pick up a few groceries for the week. Due to my schedule this job is usually done by Mr. Couz, so I'm actually kind of excited about doing it today. There hasn't been enough money lately for fun shopping, so I'll take whatever kind of shopping I can get to get my fix.

Post-groceries I'm headed out to Starbucks to continue my studying (okay-- start my studying) for my CCFP exams. They're fast approaching. And I'm not doing much of anything about it.

My day might be shot to hell, though, as it seems that my LAST prenatal patient (the last patient we have scheduled to deliver while I'm still on service in family medicine) has ruptured her membranes. She's term (39 weeks), GBS negative, and the baby looked fine on the fetal monitor so there's really no cause for concern, but for some reason they admitted her last night anyway. So now I'm waiting to find out my preceptor is going to induce her or what. And if he does, I'll probably have to make the hour trek out to the community where I practice to deliver her. She's a primip, so she might not be pushing until tomorrow morning. I don't understand why they don't just wait at least 24 hours and see if she goes on her own. But either way, I'll be tethered to my cell phone waiting to hear if I'm expected to drive two hours just to catch a baby. I'm not quite as enthusiastic about the deliveries as I was before as I've recently learned that I've exceeded my obstetrical requirements for family medicine threefold easily, and have decided not to include uncomplicated obstetrics as part of my practice in the future. A pretty easy decision to make now that I have a spot waiting for me in the emergency medicine fellowship.

Lots of blogging on the burner, though. I have posts in progress on the subject of the us vs. them mentality that so many practitioners of alternative medicine seem to possess, the answer to a commenter who wondered if I'd come to terms with my childbirth preference or if I was still torn between the extremes of elective c-section and midwife-assisted birth, and some thoughts on the anti-vaccination movement. Now that I've committed to these topics, I hope I'll feel forced to see them through to completion.

And don't forget that Grand Rounds version 3.20 will be hosted by yours truly on February 6th. I can't wait to start reading the submissions. If you have a recent blog entry that you feel might interest readers, send it in. I'm not going to be terribly strict in enforcing the theme this week. The deadline for submission with be 10pm EST on Sunday, February 4th.

On the Road Again

At about this time last year, I took up running. Some of you who have been reading my blog since the start might remember the trials and tribulations of my plantar faciitis at that time. The funny thing is, I hate running. I always have. But at some point in my athletic career, running became the holy grail of athleticism. If you could run, you were fit. If you could run, you were an athlete. It didn't matter how good I was at jiu-jitsu, kickboxing, rowing, softball or any of the other more competitive pursuits I've been involved with in my life, I always looked at runners with envy.

It wasn't that I hadn't tried to run. I had completed the Couch to 5K program no less than three times. After my second year of medical school I completed the Learn To Run program through The Running Room with two of my friends. At the end of the 10 week program I could get through 5k, but still hated every painful minute of it. Regardless of how long I spent on the elliptical trainer at the gym or how much I was able to squat I never got any good at running. I just figured that my body wasn't built for it.

Last spring I decided to give running yet another kick at the can. I wasn't finding the time to make it to the gym regularly, and running had the added bonus of walking the dog at the same time. I'm all about the multitasking.

So I started slow. Big dog loved it. He got so used to our 5:45am wake up times that if I dared hit the snooze button he'd plop his big head up on the bed so that his nose was nearly touching mine. He was not a training partner that would take no for an answer. So I'd get up and run. And walk. And run. And walk some more. And pretty soon, I was doing more running than walking. And pretty soon after that, I was running 30 minutes straight. I still didn't love it, though.

There were obstacles. A heat wave in the summer kept me from running anywhere but the treadmill at the air conditioned gym for three weeks. I never felt acclimatized to the severe humidity, and even my little 30 minute runs became a struggle. In September I ran a 5k race and missed my 30-minute goal by 30 seconds. I got discouraged. But running gave me more energy and I knew if I stopped, I'd lose the gains that I'd worked so hard to achieve. So I kept running.

Soon I began to notice strange urges-- when I was at home in the evening, I'd think about going for a run. If I hadn't run the day before, I'd be thinking about running throughout the day. It's wasn't a guilt... it was a craving. I ran in the rain. I ran in the snow. I ran in the cold. And at some point along the way I realized that I enjoyed running.

I'll never win any races. I'm not breaking any land-speed barriers. But I've recently committed to running a half marathon in May. I'll be happy if I run it in less than 2.5 hours. My closet is filled with running shoes in various states of destruction and I use words like Fartlek and Body Glide without giggling.

I guess I'm a runner.

Mmmm... Books.

I love books. I've always loved books. I admit it. My obsession started early, with Archie comics and Peanuts paperbacks. I was the kid who would be up at night with a flashlight under the covers trying to read one more page before being discovered by my mom. I eagerly anticipated the days my mom would bring us to the library, my sisters and I leaving with armfuls of hardcover books with crinkly covers. There was no feeling like cracking the spine of a brand new book. I've always loved bookstores-- from the tiniest hole-in-the-wall to the enormous Chapters/Indigo/Borders type-places, I can browse for hours.

I don't have much time to read for pleasure anymore, but I still get the same excitement out of books. Even the kind I 'have' to read. This has not always been a good thing. I don't know what on earth possessed me to buy our medical schools recommended pharmacology textbook-- I think I used it once in second year to look up some pharmacodynamics for a PBL session. I also have a nearly untouched Robbins Pathological Basis of Disease... I know that the American medical schools tend to regard this as a bible, but I managed to get through medicine with much more user-friendly texts. Other buys that made more sense at the time were a very good (and very large) textbook on rheumatology (on which my experience beyond the classroom has been non-existant) and a lovely (but somewhat heavy) textbook on infectious disease. That one I should probably crack open again-- I could use a refresher on bugs and drugs. But even now, I find browsing through a medical bookstore one of my favorite ways to spend a free hour.

These days, I'm a lot more careful about buying books. I don't buy books randomly at the start of every new rotation. In fact, since buying a subscription to up-to-date and installing the Lexi series on my PDA, I don't really use textbooks much at all anymore. And the ones I do buy I make sure will be a good investment-- a book that I'm likely to use and refer back to in the future. So most of those are relating to emergency medicine in some way.

Sometimes this works better in theory than in practice. My last major book purchase was one of the bibles of emergency medicine, Tintinalli. (When you're this well known in the world of emergency medicine, you're referred to by name) It was an exciting purchase to make... this text, together with Rosen, form the basis of resident preparation for the emergency medicine board exams. I eagerly dug in-- with each new rotation in my internship year, I'd read the corresponding section of Tintinalli. Great idea, right? Problem was, this textbook is about 5 inches thick. Not terribly portable, particularly for someone who does her best studying over non-fat vanilla lattes at Starbucks. On top of that, the weight of the book causes self-imposed time limits on studying. More than 45 minutes at a time causes painful ridges to form across the tops of my thighs where the book rests when I read. I think that Rosen had the right idea when they split their bible into three volumes.

So it's been a while since I've purchased any new medical books. Which is why I've been anxiously stalking the mailman for my package from Amazon. New medical books... yay!

First I got a family medicine text. It was less than $100 (a bargain for medical textbooks) and it much more complete than the Mosby text I'm using now. I wanted something beyond the review materials being passed around the internet when I'm studying for the CCFP licensing exam which is coming up in a little more than three months. This exam is freaking me out-- coming into family medicine from emerg and therefore knowing nothing about family medicine-oriented subjects like psychiatry, screening for disease and guidelines for management of primary health care issues, I still feel like I'm at a bit of a disadvantage. So over the next few months, I have some catching up to do. A friend brought this text to one of our academic days not too long ago and I really liked it-- complete, readable and relatively cheap. Add that to the shiny cover and pretty pictures and it's pretty much the perfect textbook. I was sold.

As long as I was ordering a book for exam prep, I decided to throw in another text that I've been eyeing for the better part of a year. The ICU book has been recommended by everyone I know who has read it. Seeing as how I'll be spending the month of June in the ICU here, another month of ICU next year during my emerg year, and will be using many of the procedures and protocols described in the emergency room. I had been waiting for the new edition to come out, so it's the perfect opportunity.

And speaking of perfect opportunities, Amazon.ca was offering The ICU Book in combination with another book I had my eye on, the Manual of Emergency Airway Management. This is another topic I'm a little insecure about, in spite of the month of anaesthesia that was intended to teach me these skills. All I've done in an emergency situation is fairly straightforward endotracheal intubation. The fancier stuff I've seen done in controlled situations, but I'd like to have more in my arsenal when some apneic 300lb guy with a Mallampati IV oropharynx rolls in the door. I'm hoping I get a lot more out of my next month of anaesthesia than I did in my first. I am perfectly aware that the techniques that will save my ass in a tight situation aren't the kind that can be taught in books, but I'm hoping it will be a good start.

Mmmm. Books. Love em. I can't wait. Now if only I could find the time to READ them, I'd be laughing.