Thursday, January 7, 2010

A Day in My Life

Through many recent conversations, I came to realize that most people have no idea what goes on in my day to day life. My work friends don’t get my tri life, my tri friends don’t understand my work day, and my parents don’t get any of it! So here is a look at what occurs in a “typical” day. I warn you it’s long, but my days are long!

4:15am- Alarm goes off. Ugh! Not ready to be up yet, but I have a ride to get in before work. Luckily I love riding, so it’s not too hard to get up. Throw on the warmest cycling clothes that I have, eat some cereal , make sure I have all the “equipment” I’ll need for the bikeworkgymrun day, and out the door.

5:15- At Mission Bay. I’m the only car here. Set-up bike and off I go. Not too cold, which is good. Music blaring in my ears to get me fully awake.

5:30-7:30- Soledad hill repeats. I must admit I really like the early am work-out when I feel like I’m the only one awake. Plus seeing sunrise from the top of Soledad never gets old. I am all pumped up to have a good ride this am. Get a flat at the end of my last repeat. Decided it is a small leak and I can make it back without having to change the tire (esp since I did not allot time for a tire change this am!) Just keep inflating with CO2.

7:30-8- Literally speed over to the office. Luckily there is a 24 Hour Fitness in the building, so I make a quick stop to shower and change. No time for drying the hair this am.

8:05- Make it into my office just on time. First patient is already in a room, so I drop my stuff and throw on the white coat. Have to make the mental shift from triathlete to doctor quickly. Ugh!

8:07- First patient of the day. She is a new patient, who is transgender and wants to become a man. Her (his?) friend saw a doctor here and is getting help with that. Can I prescribe testosterone? Thought I was awake, but really not ready for this yet! Definitely not something I learned in medical school. Mind won’t comprehend this one right now. Tell her I have to look into it and will be in touch.

8:20- Next patient is ready. She has missed her Depo Shot this month and is afraid she is pregnant. Luckily the preg test is negative. We discuss contraception.

8:29- Beg someone to make coffee as I go between rooms.

8:30- Patient in for a physical exam. Notice she is only scheduled for 15min visit. Gonna have to kill someone over that later. Luckily she is a very healthy 84 y/o Japanese lady. I try to get her to tell me her secret to being so healthy at her age while getting the exam done.

8:50- A patient who is transferring care to me from another doctor. We do a quick review of her medical problems and medications. She’s fun to chat with but I know I have to keep moving.

9:00- A few minutes to check my e-mail, sign-off labs/x-rays/consult notes, and call back a patient who has left a message. Coffee is ready so I grab a cup. Now I’m hungry. Throw oatmeal in microwave as I head out to see another patient.

9:10- New patient who has made a New Year’s resolution to quit smoking. Yeah! We discuss options and then chat about his recent move to SD from Maine.

9:25- Haven’t done any of my dictations yet, so I power through four. A few bites of oatmeal go in with a few sips of coffee which is now cold

9:35- One of my favorite patients is in for a breast infection. It seems to be healing well. I take the opportunity to discuss her diabetes and blood pressure with her. She seems to be doing well. I notice she has lost 10lbs. Lots of praise for doing that over the holidays!

9:45- My am 15min “break,” which I use to sign off more charts (they seem to be breeding like rabbits while I see patients), do some more dictations, write a letter to another physician about a mutual patient and talk to our lead nurse about some issues. Oh yeah and shovel oatmeal into my mouth.

10:00- A well known patient who has been trying to run, but keeps getting foot and knee pain. We discuss referring her to PT versus Ortho. She wants to go to Ortho despite my urging for the other.

10:10- Sign a few more charts, look through and answer some of my messages (which are now piling up), and call a patient who is insisting on an MRI for her headaches. Not in a mood to fight it, so I agree.

10:20- See a patient who has been trying to get pregnant for a year. She wants fertility testing. I get her set-up for that.

10:30- Next patient needs a PAP smear and some skin lesions frozen off. Freezing things is good fun! Get them both done quick which gives me some extra time for paperwork

10:45- More charts/ dictations/ messages/ phone call. Do you see a pattern? Starving again. Grab a string cheese stick.

11:00- A Medicare eval. Super sweet and relatively healthy lady, so it goes well.

11:20- Need to do my prescription refills. Mostly your standard anti-hypertensive, cholesterol and anti-depressant meds, but there are three requests for anti-herpes meds. Is it going around?

11:30- Last patient of the am. Oh, she is a painful one! Having left arm pain (mostly in her wrist) and is convinced it is a heart attack. I try to get a good history and assure her it is not her heart. We do an EKG. She wants a carotid ultrasound, which I agree to. Wants some other diagnostic studies too, which I somehow talk her out of. I feel bad that I am not that patient with her, but it’s been a long am already and I want to get to the gym for lunch.

11:50- Do more charts/answer messages (luckily my secretary and nurse will call people back for me)/fill prescriptions and dictate. Very motivated to move fast as the gym is calling my name. Feel like a glorified drug dealer!

12:15-1:00- Yeah I have 45min to get in some stretching and core at the gym! The front desk girl at 24 Hour Fitness remarks on my second visit of the day. She’s used to it, and even knows my name. Get my gym work done which helps clear my mind for round two on the work day.

1:10- Back in the office to inhale some lunch while, yes you guessed it, doing more paperwork stuff. Lots of new messages over lunch. Need to call back some people. including one person who doesn’t understand why to antibiotics given to her by the ER are not working for her cold. She seems mad at me about this… Briefly check my e-mail, which is luckily mostly junk.

1:20- A recheck on a well know patient. We chat about her blood pressure which seems to fluctuate a lot and decided to up her meds. She also tells me she heard that running makes womens’ internal organs fall out. This leaves me laughing and pondering.

1:35- Two nurses come in to tell me that one of our medical records staff is feeling dizzy and nauseous. Can I squeeze her in? Of course. See her and make sure she is not pregnant (Negative…Phew!) Can’t put a finger on what is exactly the matter, but send her home for the day.

1:50- Still really hungry. Off to the vending machine for some pretzels. More paperwork.

2:00- Physical exam and PAP smear. The girl has her boyfriend in the room. It doesn’t bother me if it doesn’t bother them, but really…

2:20- Try to catch-up on dictations again. Chat with some staff, one who didn’t think I was in the office for the day since she had not seen me all am.

2:30- Patient comes in with a cough. She is a smoker, so I try to talk to her about quitting. That falls on deaf ears, so I move along. Think she has pneumonia. Send her for a chest x-ray and prescribe antibiotics.

2:45- My pm “break.” But a patient walks in needing an EKG and labs for a diet program. I’m a softee and can’t say no. We discuss the diet program briefly.

3:00- A patient with dizziness. I hate this complaint as it is so vague and often hard to find a cause. I do some testing and have no idea what is causing it. Tell her to rest and drink lots of fluids. She wants a flu shot, which I tell my nurse. Unfortunately she miss understands and checks her for flu. Whoops. We get her the shot and out the door.

3:15- Afternoon is a bit slower than the am, so I catch-up on paperwork and phone calls/messages. Call a patient who wants me to explain what HPV is and all about it. Then another tells me she has been exposed to Natural Gas for the past year and thinks she needs to be tested. No idea what to test for so I’ll have to call her back.

3:30- A patient comes in for a rash. She thinks it is due to an antibiotic she has been on for the past two months. I’m not sure but it seems to be going away now that she is off it. We’ll keep an eye on her. She doesn’t need the antibiotic anyways. Wants a PAP, but I have her re-schedule for that.

3:40- More paperwork/prescriptions/etc.

3:45- An athlete patient comes in with water in her ear from swimming. I don’t see anything, but bust out my mother’s home remedy of alcohol in the ear. She gets relief. We chat a bit about her up-coming marathon.

4:00- Last patient of the day. Very cool old lady for a Medicare eval. She tells me that she’s been a cyclist for the past 40+ years. We chat about bikes and routes. I love that I don’t feel rushed with her.

4:20- Gotta finish up the dictations, phone calls, and paperwork. As I’m working, another doctor comes to inform me that one of her patients is coming to see me tomorrow to follow-up on an HIV test. It’s positive and I’ll have to tell him. Can’t wait for that… NOT!

4:50- Pretty much done. Chat with my nurse about some things that need to get done by the end of the day and some stuff for the next day. She tries to convince me to change my work hours so that she can have different hours. When she implies that my triathlon training is not that important, I get irritated, but keep it to myself.

4:55- Last check on some X-rays and any messages.

5:00-5:20- Ready to go as soon as the clock hits 5! I love days when I get out on time. Make some personal calls on the way home. Good time to catch-up with friends.

5:20-5:30- Go to my parents’ house as I am going to eat dinner with them. Easier to begin my run from their house. Get a little snack and I’m off.

5:30-6:30 Doing another workout in the dark, but I don’t mind. Good way to relieve the stress of the day. Ipod is on and I’m able to zone-out on my day and focus on the run.

6:30- Back at the parents’ house and starving! Help finish up making dinner (I’m always on salad detail), and we sit down. Nice to be sitting finally today. Great conversation. Use their computer to check my e-mail.

7:45- Head home to get ready for another busy day tomorrow. Gotta get the bike out of the car, and remember that the tire is flat and I need to change it. Put together a bag of food for tomorrow as well as unpack all the clothes and equipment from today and pack for another busy one. Try to clean up the house a bit.

8:45- Finally in bed. Got a heat pack on a sore ankle. Reading an OK book. Sound machine on to hopefully help my head stop spinning and help me fall asleep. Out of bed a few times to throw stuff in my gym bag that I forgot to pack earlier.

?9:30- I’m out for the count.


Jennifer Yake Neuschwander said...

Whew! That was a busy day. I was going to go to bed but now my heart rate is elevated and I don't think I can sleep. If one wants to get ahead of you they'll have to get up in early in the morning. We could really use you back at Mercy as an intensivist. You'd spiff things up in a big hurry.

Mike Russell said...

That is a crazy schedule. I thought I was busy but my day looks like a walk in the park compared to your three-ringed circus! It is impressive how you are able to get all of your workouts in with that schedule.

Mary said...

Hi!I loved reading that! I was laughing out loud at some of your patient stories.

Mer! said...

WOW..exhausted reading that..the variety of your patients sounds super interesting--and i'm sure keeps you from getting bored but tiring too!! I was hungry reading it! =0

Loved how the staff thinks your tri life "isn't important"...but i'm sure if you asked her to rearrange American Idol hours that would be a problem =0

JMoTriBella said...

Love this post! I love hearing about your crazy doctor stories...keep them coming! Oh, and I'm using you as motivation to wake up earlier to do my strength workouts. I've been enjoying sleep WAY too much lately.