Friday, June 26, 2009

Busy, busy week ...

... and I'm not talking about the demise of Farrah, Ed and Jack-o; or the 3 ring reality show circus of 'Jon and Kate'. Life has been busy this week for us "real folks".

1) "crazies" - a non-flattering term that I use for all my mental health patients who got kicked out of their psychiatrists' or psychologists' offices only to land on my doorstep. Primary Care has been become the dumping ground for bipolars, schizophrenics, demented seniors, sociopaths, drug-seekers and borderline personalities. People that have fallen through (or in most cases, shoved through) the cracks by society and mental health specialists. Some well-meaning, low-paid and under-appreciated county worker rallies to get them medical insurance through MedicAid or Medicare and then sets them loose. They ricochet through ER's and 72 hour holds in the psych ward until some social worker gives them a piece of paper that says "Follow up with a primary care provider for refills on your medications". I have no problem treating their medical issues but I am NOT a psychiatrist or psychologist - If I wanted to be one, I could have gone into a Psych residency and ended up making more money with better hours. But I didn't, and I'd rather pluck out my eyelashes and eyebrows and eat them than deal with their psych issues.

Sorry, got caught up in a rant there for a moment. Anyway, this week sucked because all my worst head-cases came in to see me in a matter of a few days.

Some even came in twice.

2) the kid is all right - Peter had a cold (parents, you know what I'm talking about); and is officially doing fine; in fact, better than fine! That's all I'll say about that.

3) hypochondria solved - the problem with being a diagnostician and a closet realist is that you are going to be slightly hypochondriacal. The worse situation for a hypochondriac is when you're right - you are sick or have a disease.

I'm going to be a little vague here on purpose, but I was having a little problem, so of course I thought the worst, so I had a test and let's just say I got my "B-9" card punched. Whew.

4) the in laws are coming - Actually, they're here. Laura's parents are renting an apartment in St. Paul for a few months. They're escaping the oppressive heat of southwest Florida but are mainly here to see, spoil and spend time with the sole heir to the Mill's dynasty.

There's a saying about guests and fish after 3 days, but I'm glad they're here. My father-in-law helped me shovel about a ton of sand for Peter's new sandbox:



They also can watch Peter for a few hours and Laura can get some stuff done (like golf lessons, yay!) and de-stress a little. For everyone knows, if momma ain't happy, then nobody ain't happy.

I wanna keep momma happy.


5) my new toy - Well I finally go my new iPhone and it's pretty cool. One of the neat things I've done is downloaded an app that serves as my stroke coach and GPS on the water when I row. Here's my row in a double with Bruce this morning all mapped out:


View Larger Map

You should be able to zoom in and out. The breaks in the blue lines show when we stopped for water breaks, etc (it was pretty humid and hot even at 6:45 am). We only rowed about 5 miles because I had to go to a 8am meeting.

This really isn't a bad thing, but it's been keeping me busy. And I have to go to bed early in order to get up at 5:55am to row.



So, life goes on ... for most of us (sorry, Farrah and Jack-o). I just have to keep on reminding myself to stop and smell the roses. Some of them are pretty damn sweet ...

Monday, June 22, 2009

Hmmmm ...

... why is summer so busy?

I think it has to do with the 15 hours of sunlight up here in the northern climes.

Tuesday, June 16, 2009

"What's in a name? A rose is a ..."

"... is a rose is a rose."

True. A rose flower would still smell as sweet but I doubt it'd be as popular with gardeners and florists is it was called "sweaty butt muncher".

So I'm looking for a fitting name for my boat.

It nameless now, but it's generally considered bad luck not to re-christen a boat when it becomes yours. I don't think there's an accepted time-frame, but I'm arbitrarily calling it a year.

The relationship of man (or woman) with a boat is symbiotic. There's a lot of give and take. Well, mostly 'give'. I bought the damn thing. I transported it across the country. I pay to have it stored at my club's boat house.

And I just bought it this snazzy cover so it won't get all dinged up and covered with dead insects when I precariously strap it to the top of my car:



As far as the 'take', well, as I use it more ... I'm becoming pretty fond of quietly gliding across a nice lake at 6:40 in the morning with no one else around.

(Especially when I run into a dock! Like I did this morning; don't worry - no damage to me or the nameless boat.)

So, I'm taking this naming/re-christening kind of seriously. I've always wanted to try to be appropriate and right on the mark with this kind of thing. Hell, they were almost wheeling us out of the maternity ward before Laura and I settled on "Peter". We were seriously thinking that "baby boy Cytrynowicz" sounded OK, but we were worried we were limiting his future career choices.

We took a long time to name our cars, but "Bob" the CRV and "Miles" the Mazda are so ingrained into our vernacular to the point that we forget when we talk about them to non-family members.

I could go with something profound or moving, but that's not my style. I could just call it "Owen" as that's the name of the manufacturer, but I'm having trouble committing to that - it's kind of lazy.

I'm also contemplating "Minnesota Fugue" - ripping off the name of this blog - but that's too wordy. Maybe just "Fugue".

I don't want some corny, pun-ny phrase like "Myassis Dragon". Or something stoic like "Endeavor" or "Fortitude". However, "Sanity" is looking kind of good now.

A friend of mine has suggested the "Flying Wasp" and I'm considering it as an homage to my youth and one of the funniest movies ever made.

I also don't want to get too personal, but the "Bowlegged Sculler" keeps on percolating to the top of the list. I broke my right ankle in college and as a result my right knee wants to flail out on the recovery when I get tired. It's a definite technique "no-no" but maybe my boat name will let others know that, yes, I do know how to scull, I'm just not that good at it sometimes, so shut your pie hole.

Any name suggestions? The boat is red (my boat club already has a "Red Beaver"). It's old (made in 1988). And, it's helping me keep fit and healthy, physically and mentally.

I'll consider all - just as long as it doesn't contain any of the these words in any order: sweaty, butt, muncher.

Tuesday, June 9, 2009

"Hi, I'm a PC ... but I'd like to be a Mac" ...

Apple had their annual WWDC meeting yesterday.

I think it was held in a secret lair on Steve Job's island in the South Pacific that is uncharted and home of an immense energy source that can make time travel possible. Wait ... sorry, that's LOST.

Anyway, they announced the new iPhone yesterday - the 3GS. And it's cheaper than the previous model for the same amount of memory with new bells and whistles.

I have to admit it - I have Mac-envy. Especially every time my PC crashes at work. I was an early Mac follower - in fact, this is what I used in the 'computer labs' (remember them?) in college:



I love my first generation iPhone and I'd buy a mac computer if they weren't so expensive and/or my work would reimburse me. As of now, we're a PC-compatible company - so I'm stuck being a wannabe.

But, I'm going to pre-order the new 3GS phone. It's been a few years since I had a technology fix and I'm jonesing a little bit.

Plus, I need the 3G network so I can use my phone as a GPS on land and when I row - check out this app that I'm thinking of buying. It's a little spendy (as they say here in MN) but it's cheap compared to the real stroke coaches.

Hmm ... maybe I should learn how to row better before I worry about how fast and how far I'm going ...

Monday, June 1, 2009

"Ok, you're ugly too..."

... As a primary care doc, I see a myriad of ailments and complaints from a variety of people who are all shapes and sizes from all walks of life.

But there are a few common threads, observations, demands that pop up enough from my patients that merit some translation through my "Doc, what I'm really saying" translator (coming sooon as an app for your iPhone :)).

What they say: "I'm having trouble losing weight and I'm tired all the time, I'd like to have my thyroid checked out."
What it means: It usually comes from the 30 to 50 year old female wearing too much eyeliner and clothes that are 2 sizes too small - screaming kids are optional. They have a knock-off handbag that is filled with mentos and a 2 liter bottle of Mountain Dew. What she means is "I haven't exercised in years; I still eat like I did when I was a teenager; I like to drink and smoke .. alot. I'm starting to get fat and lonely and I want an easy solution that doesn't require any real work." Trust me, it's not your thyroid. Put down the twinkie and go for a walk.

What they say: "Your nurse said my temperature is 98 degrees; that's a fever to me because my temperature is usually 95 degrees."
What they mean: This usually comes from the mid 30's to mid 60's professional or soccer mom who looks pissed that they have to take a break from their busy day to see the doctor. They're not really that sick, but it usually means "This virus is annoying and disrupting my already too-hectic life. Write a prescription for an antibiotic, you little twit, so that mentally I'll feel better through the placebo effect. And no, I don't give a crap about causing community-resistance to common bacteria, I've got shit to do." Relax, take a day off of work, put your cell phone in a drawer, sit on the couch and eat chicken noodle soup and watch cartoons - the world and it's problems will still be there tomorrow. Yes, I will also validate your assertion, that because your "temperature is normally 95 degrees", you are unique and special.

What they say: "Tylenol and Ibuprofen don't seem to work for me."
What they mean:
The patient will have some sort of pain complaint - twisted ankle, migraine headache and the classic, non-specific lower back pain. He or she is wincing and groaning and being incredibly histrionic - Emergency Room patient identification bracelet optional. Ocasionally will have rotten teeth and may actually be actively 'tweaking'. Their body language is screaming, "Give me oxycodone, hydrocodone, hydromorphone, morphine, tramadol, valium, horse tranquilizers, those frogs that you lick from the amazon-freekin-rainforest - anything that will get me high as a kite so I can get away from my miserable life for 10 minutes." I used to be sympathetic. Now, It just makes me sad.

What they say: "What? Hop along marietta beaver?"
What they mean: This is an elderly couple, usually in their 80's to 90's. She is deaf but refuses to wear hearing aids. He is pleasant but has dementia and always wears a baseball cap too high on his forehead. They are usually being seen for vague symptoms like fatigue, lightheadedness, insomnia and achey joints. This is usually the response to when I ask "How long have you had a fever?" What they really are saying is "We're old and tired and in pain. We want someone to listen to us and take us seriously. We know we're coasting into the 'beyond' but we want to enjoy the trip and remember the ride. Thanks for listening." Besides tweeking (not 'tweaking') their medications a little bit, that's all I usually do and it's that all they usually want.


Avoid saying any of the above and your doc may take you seriously the next time you're seen. Oh, never ask me for a 2nd opinion as you'll get the response (I can't help it) that's in the title ...