Renu's Week

Monday, August 02, 2010

Report of 2 Aug '10

Hello from Indiana -

Trust all are well. A new month is on us. And soon, a new year will be.

Several people asked very kindly why I got teary last week. Here's the story: I spend a fair amount of time explaining the ills of controlled substances to folks. If they persist in wanting them, it makes for a very frustrating encounter, with acrimony, which I detest. So, if I want to avoid this, I have to prostitute some of my beliefs which I do not do - and the impasse persists.

Busy schedules last week, but those are nice. I had a patient with a prominent lymph node in her armpit, and a family history of breast cancer. I sent her to a surgeon, and he removed the node and sent it for a biopsy (normal, thank goodness); follow-up with him was postponed as he had a death in the family. In the meantime, her armpit became swollen, and she could push it and squirt fluid out through a gap in the incision. She actually demonstrated this in the office. I was somewhat concerned about infection, or blockage of the lymphatic ducts, which drain fluid that collects the waste products from cells; I started an antibiotic and suggested she apply heat to the area. She returned this week, completely healed; there is a small lump at the incision, but she is otherwise free of the squirtings and swelling. At one time, general surgery was a consideration for my career choice - for joys such as this healing - but I headed elsewhere. This patient has also beaten a cocaine addiction and is back in school, and I commend her for both choices every time I see her. She is a lovely person, determined to succeed, and I wish her the best.

As I documented a physical exam last week, I noticed the left halves of the letters start to blur. I took off my glasses and shook my head, and the letters - on my note and on the posters on the wall - were still blurry. I checked to see if I'd just left a brightly-lit room for one less bright, and I hadn't; my left field of vision then looked like clear jello with multicolored wavy lines. This was a wee bit freaky - was I having a stroke? - and I asked my remarkable colleague, Nurse Practitioner Karen to examine me. Nurse Practitioner Beth would have done as stellar a job, but she had just left. Karen found nothing wrong in the neuro and eye exam, but thought the suddenness of the symptoms merited an ER evaluation. The ER doc was perfectly willing to see me, but he only had an ophthalmoscope to look in my eyes, which Karen had already done. So Karen sent me to the optometrist (I am really grateful to Karen for following through), who ably ran a battery of tests, and diagnosed me with ophthalmic migraine. Huh? The visuals were my aura - which indicate that a headache is about to hit - and then the headache hit. The optom and her husband suffer from the same condition (!) and she quickly produced a migraine pill and a Sprite to keep down the puke. I got home a tad exhausted, and paused to mull over the effects of aging, and illness, and illnesses that hit when one is not aged. The first thought through my head as I sat in the chair with the optom ruling out a retinal detachment - S.c.o.t.t. I didn't want to go through it alone, but all was okay.

Some fine times last week - I got together with Sid, his family, and 2 visiting lady missionaries to discuss Mormonism, faith and such. It was a nice discussion. I had not realised that was the purpose of the evening - thinking it was just a get-together to meet the missionaries, see Sid's family, eat some dessert - and so, got mildly disconcerted when the organised education started. It was actually great, though: I enjoy hearing about various faiths. I got to ask a lot of questions and we will meet again. One of my best colleagues from a previous job is Wiccan, and I have asked her a lot of questions also. I spent the weekend at the farm with some of my favorite people - Scott's mom, sister, aunt, uncle and nephew. We went out to eat, hung out, talked and laughed. My sister-in-law, Diane, and I visited her grandparents at the nursing home, and that was nice. I wish more people would visit their older relatives: it so recharges the latter.

Salsa continues well, with our instructor Dean's assistant, Audrey, having to lead like a male. She does very well, it can't be easy learning to lead. That class is fun, and I like it. Boot camp is fabulous and we do much running and twisting and crunching - it is a charge.

Inception, shminception. The best movie I've seen so far this year - "Winter's Bone." This year's "The Hurt Locker" for its realism. It was excellent, and the young woman who played the lead did magnificently. The supporting entourage also served to make the whole package fabulous, and I enjoyed the flick immensely.

I got to talk to my Dad, Scott and Navin, and that was nice. Naren has wanted to come home from the dorm for a couple of days when I return, and I was quite honored by that request.

Unw -



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