Day #8 – Bullet your day.

1. Alarm rings at 6:30. Snooze and fall back to sleep. Repeat every 5 minutes for 20 minutes, until alarm turns off.
2. Second alarm rings at 7:10. Snooze and fall back to sleep. Repeat every 5 minutes for 20 minutes, until alarm turns off.
3. Third alarm rings at 7:50. I should be at work by 8, but it’s been slow, but in order to be there by 8:30-9, I should get up.
4. 7:50-8:20 Shower. Dress. Brush teeth
5. 8:25 Remember that I really, really need to get my licensure paperwork figured out and need to print out a form again to mail to my med school.
6. 8:38 Finally leave house
7. 8:40 The radio is playing the last 3 notes of Marc Cohen’s “Walking in Mephis” one of my absolute favorite songs. I’m disappointed that I missed it.
8. 8:45 Stop to buy gas.
9. 8:49 Turn the car on to listen to the last stanza of Marc Cohen’s “Walking in Mephis” on another radio station. I missed it twice in 10 minutes??? Not a good sign.
10. Traffic is good to work.
11. 9:00 Pager goes off as I pull into the parking lot. My nurse is asking me to call back ASAP.
12. 9:13 Return call. An insurance company suddenly has refused to cover a med that my patient has been on for 3 years. I tell her I’ll write a letter to the insurance company later that afternoon.
13. 9:20. Fellow arrives. We have 2 new consults to see. One actually has lung issues! Yay!
14. 9:40 After checking email, decide to get breakfast before seeing the new patients.
15. 9:48 It’s French Toast Day! The lunches at the VA are bland and repetitive, but I do love their breakfast.
16. 10:10 Finished breakfast. Have read and reviewed the medical chart on the two new patients.
17. 10:15 Stop by to see new patient #1. On the phone. Patient also has no idea what’s going on. Listen to his heart and move on.
18. 10:30 Visit the neuro clinic. My junior residents from September are both on the neuro consult team. We talk about sleep apnea and going out for sushi next Monday. Katie’s there as well. Only 4 weeks to go until she has her baby! She’s not going to be around next week to go to Harry Potter with me. Drat. Kris overhears and invites me to HP tomorrow night. Hmm, maybe it will fit into the schedule.
19. 10:50 Say goodbye and go visit patient #2 who’s doing much better than I was lead to believe. Won’t have many recommendations after all. I do make patient cry.
20. 11:10 Discuss patient with Fellow. Write notes.
21. 11:55 Notes are finished. Fellow agrees with plan.
22. 12:00 As I’m leaving for clinic remember the license forms that I still haven’t filled out.
23. 12:20 Post office is open! Mail important letter. Cave and buy Simpsons stamps (super cute!).
24. 1:05 Grab lunch: hummus and pretzel chips, yogurt with berries and granola and milk.
25. 1:10 Clinic conference. Learned something new: check TSH whenever somebody has high cholesterol. I’ve been doing this for how long now?
26. 1:40 First patient is here. Leg pain. Story changes every time I talk to patient. Decide on physical therapy, a new cane, and scheduled naproxen.
27. 2:15 Next patient (I’m only five minutes late!!) describes palpitations. Listen to heart. Tachycardic. And irregular. Order EKG and go over all of the test results from last time. EKG done. A fib with RVR (fast, heart rate: can fatigue the heart). Crap. Discuss it with the attending and then arrange to admit the patient. I’ve never done this before (I’ve had great luck!). Call the admitting coordinator. Argue back and forth as to whether patient should go to the ER. Get admission paperwork done.
28. 3:30 (50 minutes late) See new patients. Multiple problems, long standing. Workup has been massive with no satisfactory answers. Spend an hour with patient, who leaves happy even though I don’t do anything new.
29. 4:40 (60 minutes late). Next patient. Follow up diabetes. Patient has had no more “passing out and getting into car accidents due to low blood sugar which I don’t tell my PCP about” episodes since last being seen. Blood sugars are up again – I’m relieved. Visit is short.
30. 4:45. Page from nurse. Patient from this morning demanding to know why letter hasn’t been done.
31. 5:00 (50 minutes late). Last patient. None of pain medications are working. Wants to try something new (which is same meds that I switched patient from the last visit). Discover how to find out if somebody has a criminal record for drugs (patient didn’t). Give patient new-old meds.
32. 5:30 Finish documentation about why Patient #2 needed to be admitted to the hospital so the new team can adjust meds, etc.
33. 5:35 Remember letter that I need to write. Call pharmacy instead to brainstorm ways to get around ridiculous insurance rules. We come up with new drug combination that may be acceptable.
34. 6:10 Call patient back. Patient is not so happy with new ideas and wants me to call in new prescription. Manage to convince patient to try my idea.
35. 6:30 Decide to call it a day. I’ll finish the 4 new clinic notes + 14 that I didn’t finish last week (and the week before) later.
36. 7:00 Get lost driving in the 3rd Ward district. Finally find the restaurant.
37. 7:05 I love free food. I love my neurology coworkers. I talk about why I love Milwaukee and hopefully don’t scare off all of the potential Med-Neuro candidates.
38. 8:50. Pumpkin chiffon torte!! I’m in love!!
39. 9:05 Dinner comes to an end
40. 9:15 Get lost again. Why can’t these streets be numbered?!
41. 9:40 Arrive home and heat up rice bag and read reviews of the Harry Potter movie. Catch up on emails, Facebook, my blogs.
42. 11:05. Start “bulleting my day.”
43. 11:49. Complete list. Decide it’s time to go to bed. And there is the end.