Lessons learned

I taught my first class today. To students. Real live students.

As a perpetual student and a person generally not afraid to speak in public I thought it would be no big deal. However, when you speak to students as a teacher, you notice things that may have never crossed your mind before.

• No one cares.
• It gets freaky quiet when you have 40 blank faces staring at you.
• No one cares.
• You can hear the whispering from the back of the classroom even though the students think they are uber sneaky.
  
• No one cares.
• The jokes you tell aren't as funny in real life as they were when you were practicing in front of the mirror.
• No one cares.
• The right speaking speed becomes hyperspeed.
• No. One. Cares.
  

Teaching is tough. The clock becomes your nemesis as you are fully aware that each 'tick tock' brings the class closer to its end and the students get anxious to leave . Cell phones are an evil invention - brick breaker and texting are way more important than your lecture on skin care.

Someone did ask me a question. "Excuse me, Dr. Moody....." If I were sitting down I would have fallen out of my chair. The whole 'Dr.' thing is still new and somewhat uncomfortable - Just last year I was in their shoes.

In the end, I survived and no one threw tomatoes at me or booed. Success!

Fancy coats

"Wow, look at all of those people in their fancy white coats."

That's what I used to think when I saw the pharmacists and doctors around the hospital.

Then I became one of those people.

At first I felt like a stud. In putting on my white coat, there was an added pep to my step and the world was mine for the taking. I carried papers that looked important and a brand spankin' new green gel pen.

As time passed, my white coat fantasy world started crumbling. It was only a matter of time. I'm the girl who can't walk and chew gum at the same time and now I was supposed to maintain this level of super confidence at all times. Something bad/embarrassing was bound to happen.

Yesterday I strolled into work saying hello to the Saturday morning crew while wearing the magical coat that was supposed to protect me from being a moron. It wasn't until after I had been at work for 20 minutes that I realized my fly was open. Wide open. It wasn't remotely conceivable that you could ignore it if you were paying the least bit of attention. *Sigh*

It's hard to convince a patient that you are truly capable of being in charge of their medication when you can't remember to zip up your pants.

Maybe Operation Stretchy Pants isn't such a bad idea after all. At least I wouldn't have to worry about zippers...

Please tell me it's not a train

I'm a great believer that there is always a light at the end of the tunnel. Right now, it's just really far off in the distance.

I've got research proposal deadlines looming, patients to see, a boyfriend to make happy, meetings to attend, drug information questions/consults to investigate and answer, and last but not least I've got to find some time in there somewhere to breathe. It's been stressful to say the least.

I keep having to remind myself that I signed up for this. I signed my name to a contract that locked me into a year of getting paid less (a lot less) to do more. Most of the time I love it, but there comes that moment where you hit the wall. This is my moment.

With all of this whining, comes excuses. Operation Tiny Pants has come to a screeching halt. I've adjusted my eating habits trying to gain control of my portions, but the only exercise I get right now is running up and down the hospital corridors. I keep telling myself, "Next week it will be better." Next week needs to turn into NOW.

Tomorrow I'll wake up early and put on my game face while continuing to search for that light. My only hope is that the light at the end of that tunnel isn't a train.

Compliance

I am currently on rotation at a clinic for people on blood thinners (aka, warfarin clinic). My days are spent poking patient's fingers, running the blood through a machine, and hoping that the result (their INR) is within the desirable range.

When they are perfectly in range, the patient gets a high five and an appointment to come back and see me in 30 days. When they aren't, it could mean trouble. A INR that is too high means the patient's blood is thinner than we would like and puts them at a higher risk for a bleed. Conversely, a low INR can put the patient at risk for a blood clot. In clinic, we prefer a happy medium.

For some people, you can find an obvious reason for the discrepancy.

• Consuming alcoholic beverages
  
• Forgetting to take doses during the week
  
• Eating too many or too few vitamin K rich foods (spinach, brocolli, or greens for example)
• A new prescription added to the regimen
  

For other folks, it is more difficult to figure out what on earth is going on.

A patient came into clinic with an INR that was far higher than the previous results. I drilled the patient with questions:

Me: "Have you been drinking?"

Patient: "No. "

Me: "Have you taken your medications every day this week?"

Patient: "Yes."

Me: "Have you put on a clown suit and juggled kittens recently?"

Patient: "Not this week."

Me: "Have you done anything differently? Come on... ANYTHING?"

I actually ran out of questions to ask.

Then I had a light bulb moment. Maybe the patient wasn't doing anything wrong, perhaps he was actually doing everything right. I started a new line of questioning.

Me: "Do you usually take your medication everyday?"

Patient: "No, not usually. I made a special effort this week."

AH HA! The fact that the patient was now taking the medication as directed instead of at his own discretion made all the difference in the world. It's not often that you find compliance to be the problem.

I'm not a mind reader, people. Meet me half way. I'd even accept a quarter of the way. Anything.

At least it keeps me on my toes.

Cravings

I see and hear the most random, funny things at work. It's the little things that make the day enjoyable. Things like this make me smile:

Male Patient:
"I've been craving ice cream. Lots of ice cream. Quarts at a time. Is that bad?"

Nurse:
"Maybe you're pregnant."

Male Patient:
"Well, I haven't seen the doctor in a month, so anything is possible..."

Sea of red

No, not this sea of red (though I will be seeing that in about a month).















I'm talking about the wave of red stupidity that flowed out of my purse today.

When I left clinic today I was in a hurry. Something dripped on my pants after I stepped outside. Like an idiot I looked up to the clear blue, cloudless sky wondering where it was coming from. I spun around in a circle looking for the drippy culprit. Then I figured it out. Possibly the dumbest thing I have done in a while. I forgot to put the lid on my gatorade before I put it in my purse. Sweet.

Red gatorade poured through the bottom of my purse onto my tan pants. My first instinct was to hold it away from me and watch the liquid trickle out. Then I thought, "There is stuff in my purse I should probably save." I must have looked asinine laying a drippy red wallet and a semi-soaked calendar out on the sidewalk. Then I remembered my phone. Oh crap, my phone!! You know, the electronic device that doesn't like to be submerged? Yeah, that thing. In my urgency to pull it out of the wet mess, it flew out of my hand and hit the cement. Somehow the thing still worked, but it was sticky and it didn't open so well. Oops.

Way to go, me.