It Makes Me SICK

This Sunday was a particularly good sermon. I'm not sure if it was because I haven't been to church in awhile (it seems I'm always working) or if Betsy just touched me again. Either way, she spoke about how we are all welcome in Christ's family....all comers....rich, poor, liberal, conservative...you get the point. Anyway, it was a great sermon.

Later that same day we had the tv on when the knews about the shooting at a Knoxville, TN church broke. Apparently, this Unitarian church is very open to everyone (including gays and lesbians) and it advertises this point. In fact, there is a new sign outside of their church that states, "Gays Welcome."

In the middle of a children's production a gunman walked into the church and opened fire. According to several church members, "he was yelling hateful things." They refused to elaborate not wanting to give this person's comments anymore attention. The gunman apparently believes in the "old south" and is a fan of confederate flags. So the thought is that this might be a hate crime. Of course, no one really knows what makes someone do something so terrible. Frankly, I don't want to know.

Out of this tragedy, 2 adults have died and several more are injured. No children were hurt. I'm not sure why this particular event has caused so much thought on my part. Probably because we go to a very open church and this could have easily been our Sunday morning. Please pray for this church and their families. Please pray that there will someday be a safe place for everyone.

I won't say any hateful things about the shooter but I am thinking them.

Suprise Date

Friday turned out to be a really nice day. I finished clinic around 1pm and Britney was at the house with the girls so called Mere and asked if she wanted to go to lunch. We decided to try a restaurant that we don't usually go to. We went to Trios and it was GREAT. We shared some wine, an appetizer, a nice meal, and dessert. There were no kids, no rush, and no cell phones (the restaurant in cell phone free). Just us, talking and eating. It was a really nice date. Even better? It was unplanned. That is what life is all about :)

Later we went to see Wall-E....good movie, good message.

Money Can't Buy Happiness

Yes, I know that money doesn't buy happiness....but sometimes it helps! My wife presented me with my graduation present yesterday and I am in love.

My new iphone :) I am not a gadget person and don't usually get excited about these things. When Mere got her iphone last year, I was not impressed. Furthermore, I was NOT going to like that super hyped up phone just b/c apple is good at marketing. But, over the last year I have grown to really like her iphone and somewhere along the line I decided that I wanted one. Now I have it and it totally rocks!!!!!!

Thanks baby....I love you!!!!

Welcome Life in the Big Green House!!!!

Life is funny. It suprises you when you least expect it.....sometimes good, sometimes bad. Luckily, this time good. It all started at the Indigo Girls concert. We were tired after just coming home from vacation. But my good friend had bought the tickets and asked us to go a LONG time before our vacation. So, we went...knowing we would have a great time despite being super tired.

We got there and had a blast. The concert was great and we had a blast with Brooke. The other thing we noticed? There are a lot of lesbians in Little Rock and we know A LOT of them. The only problem? Most of them are single, without kids, and into a much different "scene" than us. Let's face it when you are the only one with kids in a group of people....it is difficult. Fast foward to intermission when we were standing in line waiting for a drink. We were talking about how "out of the community" we felt since having kids. Most of our friends are heterosexual couples with kids. We don't have ANY problem with this and didn't even really think about it until Syd recently started asking about other 2 mom families. Uhmm....we are bad lesbian moms!!! Anyway, we weren't drunk, we weren't going out after the concert, and we were checking our cell phones to make sure our babysitter had not called. We were feeling like we didn't belong in a community that we used to be super involved in/with.

That is when I overhead a conversation behind me. 2 moms talking about their kids. At least I was pretty sure that was what I heard. So I turned around and said, "do you guys have kids?" Their answer, "yes!!!" What happened next? We all started talking about our kids. Similar ages? Check! Living in LR? Check! This was looking good. One of the women, Holcomb, kept saying that she was sure she knew Mere from somewhere. Turns out they had been at a B-day party for a boy in Syd's class (whose mom I work with) and used to live next door to Bridget and Holcomb. Small world!

So, Bridget told me her full name and where she worked (UAMS...same place as me) and I told her I would email her. What do I do next? Email her the next day...can you say stalker? Luckily, she didn't think I was a stalker and got back to me pretty quickly. A few weeks later, a few dinners and phone calls and we are fast friends. The best part? Our kids really get along. Ok, so Layne and Meric (their youngest) are both pretty strong willed but they will be friends, damnit!!!!! Syd and Breck (their oldest) are definately on the same page....she finally has someone to share her love of dinos and dragons with.

It is really great to meet new friends and have everything fall into place. The real point of this post? To welcome Bridget and Holcomb to blogland. When you get a chance, go to their new blog at Life in the Big Green House and welcome them to the family!!!!!

The Week In Review

Last week was a crazy (but fun) week.

Mon: Pool party for one of Syd's friends
Tues: Mere's photography class. A night alone for the girls and me.
Wed: Pampered Chef party at our house
Thurs: Cancelled work out with personal trainer and ordered chinese food (totally worth it!)
Friday: B-day party at ChunkyCheese + hair appointment
Sat: All day pool party (really fun)
Sun: Shrimp boil at H/B's house (yummy)
Mon (today): Pool party for Mere's Daisy troop

Whew! I'm tired just thinking about it. In the midst of this week we have realized how many AWESOME friends we have and how much we love living in Little Rock. I'm thinking we aren't going to be able to leave. I guess that means I will have to look for jobs here in a few years :)

The Stinky Cereal

The last 2 weeks I have spent a lot of time studying for the boards. Obviously, not enough given the fact that I am blogging all the time (i.e. procrastination). Anyway, all this studying equals a lot of snacking. In an effort to improve my snacking habits I have been eating a lot of GOLEAN crunch cereal.

It is sooooo good. Sweet, crunchy, and super yummy. The only problem? Each serving has 8 grams of fiber. One serving equals one cup. I'm not sure how much I eat in one day but I can definately put more than one cup away in no time. It just sort of disappears. Until about 2 hours later when the stomach starts to rumble. This is followed by hours of loud, stinky farts. These are not ones you can quitely release....no you need a bathroom and privacy. Not always easy, especially at work. It is so bad that Syd calls it the stinky cereal because we have ALL fallen victim to its yummy crunch. When Syd has it for breakfast and we have been snacking on it, you DO NOT want to be in our house!!!! I know I don't get enough fiber and I know that this cereal is a good choice but I'm not sure how to get past the GI side effects. Maybe they will go away with time? I hope so because I have had more than one uncomfortable elevator ride this week. The plus side? My gluts are getting strong from all the flexing. Yeah, I know....TMI.

4th of July weekend in the ER

1. Stab wound to the neck
2. 3 heart attacks
3. 1 intraabdominal bleed (read: very unstable patient)
4. 3 MVAs (motor vehicle accidents)
5. Druggies and alcoholics galore
6. BIG stroke that required immediate intubation
7. Tons of stuff in between

The point: it was a crazy weekend with a lot of sick people. But none of them topped mosquito guy. 45 y/o white male with no past medical history who appeared to be mentally normal. He comes to the ER early Sat morning for 2 "bumps" on his head. He noticed them yesterday. Do they itch? A little. Do they hurt? no. What are they you ask? 2 small mosquito bites...no signs or symptoms of infection. Thank GOD I was there to tell him to use calamine lotion and Benadryl!!!!! When he left, I turned to the nurse and said, "I am so blogging about that one."

In other news....it only took me 3 hours to come up with a chemotherapy regimen for a pt w/ recurrent metastatic breast cancer. Just so you know, it probably should have taken 5 minutes or at least I hope that is all it takes in a few years!!!! Slow and steady, slow and steady.

Brown Eyes

Last weekend I had a first in the (small town) ER. I had a child taken away from his mother. I have seen this little boy MANY times for coughs, runny nose, etc. His mom bring him in ALL the time. He is never sick, usually just the latest virus. He is so cute with a blond crew cut and the sweetest brown eyes you have ever seen. He is so quite and such a good little guy. His mom is obvioulsy crazy. This has been apparent since the first time I saw him. All of the nurses know the mom and the child and talk about how she pulls him around in a wagon all over town at crazy hours and in all kinds of weather. She always has a different address, has no job, and I think she has some pysch diagnosis. I have wanted to call DHS before but I haven't because she has never given me a good reason. You have to have a good reason to call them or they just won't investigate. There has never been any evidence of abuse, just really bad parenting.

Anyway, when she brought him in this time she was particulary undone. She was VERY on edge. One of the nurses heard her on the phone talking about how she was going to learn how to cook crystal meth. When I went in the room she told me he was coughing and needed a breathing treatment. I told her I wanted to listen to his lungs and get a chest xray. She refused and said, "just give him a breathing treatment, I know what he needs." Then she jumped up and yelled, "you have no idea what I've been through, I am on the edge, I cannot listen to him cry anymore, I am going to lose it!" To that I said, "I'll be right back." All the while, the little guy is sitting there quite as a mouse.

Long story short, I called DHS and demanded they send someone now. I told them I could not send this child home with his mother without fearing for his safety. After several very loud interactions with the mom and calling the police, DHS finally arrived. They spent about 5 minutes with her and drug tested her (+ for cocaine) before they decided to take him into custody. Apparently, she has had 4 other children taken from her in the past. In my humble opinion she needs to have her uterus ripped out and run over by a MAC truck. But, that's just me.

I talked to the DHS worker and she said that the parental rights would likely be terminated. Then I asked her how I could adopt this child. She said it would take about 2 weeks to fast track me through the foster parent track and then once parental rights were terminated adoption procedures could start. I called Mere and she didn't think it was a crazy idea. We talked about it, I thought about it, and we talked about more.

Then I talked to my mom who has been in the "system" for many years as an attorney for children who are taken away from their parents. She burst our bubble and gave us a total reality check. Were we crazy? He probably has a lot of problems and we were opening a can of worms that we couldn't close. No way, no how, forget it!

So we woke up and realized....not a good idea. But I still can't get his amazing brown eyes out of my head. I hope he finds a good home and has a good life.

The mom? I told the nurses that if she shows up in a year w/ a new baby then they better take me in the back and drug me before letting me near her.

Typical reaction

So today was my first day as a Heme/Onc fellow. It is so much better (and different) than being a resident. Of course, I'm still pretty clueless about chemo reactions, drugs, etc. But that doesn't mean I can't be the fellow on call for the chemo room. Nope, it doesn't matter that it is my first day and I don't know anything. Go ahead, call me when you don't know what else to do because I do (ha, ha, ha).

The first page came around 10am (not bad at all). I had just finished rounding with the inpatient team and was really enjoying NOT being the resident. I even felt sorry for the intern (but only for a second). The nurse on the other line said, "please get down here we are having a reaction." So to the chemo room I went. I walked in and the nurse at the desk motioned me to the back of the room (this was my first time to ever visit the infusion room). The entire time I'm wondering how serious this is...what kind of reaction are we talking about? How am I supposed to know what is going on?

When I get to the patient, nurse Bill is standing over him. He is breathing fast w/ definate wheezing I could hear without a stethoscope. His his heart was beating fast and he was flushed from head to toe. His vital signs were stable and he was not in any acute danger. The following is the conversation I had w/ nurse Bill (thank God for nurse Bill).

Me: "What was he getting?"
Nurse: "He was 30 minutes into his infusion of carboplatim (I had to google how to spell it)"
Me: "Is this his first infusion?"
Nurse: "No this is his 3rd cycle."
Me (to the patient): "Has this ever happened before?"
Patient: "No"
Nurse: "The typical carboplatim reaction usually happens after a few cycles because the toxicity builds up"
Me: blank stare followed with "what's a typical carboplatim reaction?"
Nurse: "Wheezing, flushing, tachycardia"
Me: "What do you normally do for it?"
Nurse: "Steroids and benadryl."
Me: "Sounds good."
Nurse: "Done"
Me: "ok"

Another nurse walks up to me and asked if I can talk to Dr. G on the phone (the attending for this patient). He tells me to stop the chemo, give him benadryl and steroids and send him home once he feels better.

Me to Nurse: "Well, let me know if he gets worse or doesn't get better"
Let me note that the patient was doing MUCH better by this point
Nurse: "Ok doctor, thanks for your help."

Help? Clearly this nurse was smoking crack.

Me: "You realize I am brand new and I don't know ANYTHING. Please feel free to teach me, correct me, and tell me what you think. I promise I won't get offended."
Nurse: "Cool"

All I have to say is thank God I was there. Man, what would nurse Bill have done without me?

What did I do next? Read about carboplatin!