Wednesday, December 31, 2014

Flu is awful.

There I was in New Hampshire, visiting my family and having a great time with my husband, our adorable daughters, and my loving in-laws. Then we got home. Then I sneezed. Ok, big deal, one sneeze. Then a headache. Hmmm. Probably just caffeine withdrawal, right? 

Then at work, Monday morning, I start to feel dizzy. Am I pregnant? Umm, no. I start to cough. My throat is on fire. My face fills up with snotty fluid. What the hell? How could all this happen so fast? And to me? My temperature was 101 F. For 3 days. I thought by now my immune system would have been exposed to all the pathogens ever produced— I have 2 daughters in daycare and I work in primary care and urgent care medicine. People sneeze on me all the time. And I got my flu shot. 

Ugh. Now, my head feels like it’s being squeezed and every single muscle and joint in my body is 100 years old. No offense to my 100-year-old patients. Flu has made me painfully aware of every muscle it takes to get up out of bed and sit in a chair. It has made me cherish Nyquil and Tylenol and piles and piles of blankets which I then throw off myself in the middle of the night. Flu seems to be teaching me about the body telling me to slow down and rest. Having the flu and having 2 healthy toddlers who scream and cry and jump around me while I’m trying to get up slowly from the floor teaches me that I can interact with my children when I am calm, and when they are not. When I move slower, they seem to move slower, too. My younger daughter asked me the other day, “Are you OK, Mommy?” And I said yes, as she jumped on my abdomen and used it as a trampoline. 

This is not to say that I don’t recommend the flu shot. I absolutely recommend it; even though I got the flu anyway. I haven’t had the flu since middle school, and I attribute that streak of luck to the flu shot and frequent hand washing. 

I think the best way to recover from the flu is to get back into moving around as much as your body will let you, as soon as it will let you, and drink lots of fluids. Yes, this will involve more trips to the bathroom; but that activity helps unwind the tight muscles that have been tensed up from all the fevers and coughing and bed rest. My daughters both had the flu before I did and it was remarkable how quickly they recovered. They are such busy little bees. They have the right idea to be active, as long as they don’t jump on me so much.

As for my husband? Not sick. Yet. 

Friday, July 25, 2014

"I didn't know I was pregnant..."

The longest I've seen a patient go denying her pregnancy is 23 weeks and 6 days. I'm sure there have women who have denied it much longer [see "I didn't know I was pregnant"on TLC] but it's not quite the same as seeing it happening. She was 19 and looked like she was 12. She came in for abdominal pain. "Something doesn't feel right down there," she said. I admit, I should have been listening more closely and I should have asked her more questions. I scanned her empty chart and checked her vital signs, no allergies, no medications. No recent labs. "Ok, well let's take a look," I said. I took my first full look at her, probably for the first time since she came into the office. She was wearing a brown corduroy jacket and tight jeans. Her abdomen was clearly gravid. I looked at her chart again, as if that would tell me any answers. No, Chloe, still blank.

Yup, she was pregnant. She later told me she had not had her period for 5 months. She wanted something to be done, but she didn't know what.

I talked to her about options. I laid them out for her and what she could expect, but honestly, I don't think I could prepare her enough. I don't think anyone is really prepared for their first child, much less someone who is a child herself. 

I got her an appointment with an OB/GYN, but she later ended up not showing for that appointment, and I never heard from her again.

What a Fever Feels Like

I have two bright, beautiful, darling daughters who are in school and who bring home every possible illness about every two weeks to share with my husband and me. There are periods of about five to six weeks where J and I are feeling fantastic and not sick at all, but then there are times like right now, where I am stuck at home, in bed, shivering and sweating, and markedly aware of every muscle and joint in my body because they all ache.

Meanwhile, my girls are happily playing at school today. They have a few snots, but that doesn't stop them, and they don't have fevers, lucky them.

Update: I don't have a fever anymore. My husband has taken the girls outside. I love him so much. 

Thursday, July 24, 2014

A lot happens in 2 years…

When I look at childhood friends’ Facebook pages, friends I have not spoken to or really seen face-to-face in over 30 years, I am surprised to see how they have grown and changed. I don’t know why I am startled by the outlines of their evolved faces, their bodies taller and their children’s pictures peppering their time lines. This is especially true when I look at ex-boyfriend’s pages, and I admit, I do this, though not often. I suppose I am surprised because I value my memory over reality. How dare things change when I look away for 30 years!

But my life has not changed with as much depth and breadth as it has in the last 2 years. I had another beautiful baby girl, Sweet D, now 1 and ½ years old, and moved from Boston to a sleepy suburb just outside it. We bought a house and we have a second car, despite our diehard love of public transportation. Our oldest daughter Poco was very sick for a time, but now she is better, happy, and growing. Lastly, I changed jobs, which was probably the hardest change for me. I loved the last practice I was a part of, but the commute into the city via car and train and trudging uphill was too much.

Now, I’m a primary care doctor in Quincy, MA at a practice smaller than my last and a short drive from my house. My children go to school literally next door to my office. My patients are older than those at my last practice, but I still have some younger patients. Everyone here has been calm, attentive, and most of all, kind. The atmosphere is different. I see many older patients, something I love to do. My mother is a Geriatric Psychiatrist and she tells me she doesn’t want to retire, because she loves taking care of her patients. I can understand how she feels. It is quite rewarding.

Saturday, October 20, 2012

Debt Free: It Can Be Done

President Barack Obama was on Late Night with Jimmy Fallon back in April 2012. I watched him slow jam the news with Fallon and talk about student loans during his interview. On the show, the President says he and the First Lady paid off their student loans eight years ago. Only eight years ago? I said to myself. I couldn't believe it. It was refreshing to watch our President speak so openly about his debt. It encouraged me to know he paid it off only recently, and that he was unashamed in talking about it.

I graduated from medical school in 2004 with over $100,000 worth of debt. A physician colleague of mine had almost half a million in debt she combined with her husband, also a doctor. My own debt included mostly student loans, but also included a car loan, and many credit cards. When I met my husband, he was taken aback by my debt, but he wasn't especially surprised. It is expensive to go to school, even a public medical school as I did, in America.

My husband and I paid off our student loans and various debt one year after we married, six years after I graduated from medical school. I could not have done it without him. I met him during the last year of my medical residency. He was really the inspiration for our becoming debt-free. One of the first things he told me while we were dating was that he would be happy never to use a credit card again. That really lit a fire in me and made me love him more than I already did. We were on the same page, but he was more forthright about his goals. He was the most likely of the two of us to make it happen.

After 4 years of internship and residency, my salary as a real doctor shot up and it was tempting not to spend all that new money I was bringing in. There were many times I threw little tantrums unbecoming for a woman my age over things I wanted to buy, but had to wait on and save up for. I wanted them now. I deserved them, god dammit, after all the training I went through. It isn't fair, I'd say to my beleaguered husband. All my doctor friends drive nice cars and live in homes with yards and more than one bathroom. Why do we still live in a one bedroom apartment and take the subway? I would come down eventually from my angry tirade. It usually happened once a month but less frequently as I noticed our debt shrinking.

We started our debt-free saga by putting together our debts in a chart, listing them from smallest amount owed to largest. This made me feel guilty since most of the debt was mine, but we were stronger together than separately attacking our individual debts on our own. We planned to pay the smallest debts first. I tried paying off debt in order of interest rate, but the psychological benefit of paying off a smaller debt first, even if it was only $50, was encouraging. After a debt was paid, we would cross it off the list. We would pay off all minimum payments due for all debt each month, and set aside as much as we could from our take home income to pay off the smallest debt first. After the first debt was paid off, the money we would have taken to pay off that minimum payment due would snowball into the next debt owed on the list.

We told everyone we knew what we were doing. This put some people off. Not everyone likes to talk about money. Our families were supportive. My family reacted first by saying, "Why would you want to pay off your debt? Don't you want a house?" But I felt strongly about what we were doing. We listened to money-minded podcasts warning us most of our support network would find it strange we were living on less than half of what we took home and putting it toward our debt every month. Though he is not religious, my husband listened religiously to The Dave Ramsey Show, and I listened to The Suze Orman Show for motivation and inspiration. I also read a book by Kimberly Palmer (who writes for U.S. News and World Report about money and finance) which was helpful because the author and I are around the same age.

My husband put together a poster on which he drew a rocket made of squares. Each square represented $100 worth of debt paid. We would fill in a square with a colored marker for each debt paid. I saw that rocket poster every day. It was taped to the door of our coat closet, so it was impossible to ignore.

Once we got to the top of our rocket ship, I colored in the last square as my husband took a picture. It was truly a wonderful feeling. An enormous weight lifted off, and a hard lesson was burned into my consciousness. I don't use credit cards now and probably never will again. We still take the subway and live in a one bedroom apartment, but we're happier and debt-free for it.

Monday, May 07, 2012

Sick Day

My daughter spent the weekend in mountainous, majestic New Hampshire with her ebullient Gram and Grampa. She came back happy, well-fed, and vocal. She showed me a couple of new tricks. She loves to stand, though she can't stand up alone yet, and she likes to get up on all fours. She lifts her belly off the ground, rocking back and forth. It's only a matter of time before she starts crawling full-force. She turns 9 months old next week.

Unfortunately, once she got back, she was sneezing and coughing up a storm. A few hours later, so was I. Ugh. Poco started daycare at 12 weeks old, and since then, she and I, and occasionally my husband, will get beat down by a cold or stomach bug or random fever or all three every 2-6 weeks.I hardly ever call in sick, though I tell my patients with similar symptoms to do as I say, not as I do. I don't know why I don't call in sick more often. It's not as though my work doesn't understand the weakening effects of illness. Perhaps it's a pride thing. Perhaps I feel bad cancelling a day of patients who have been waiting to see me.

I have a couple of doctor friends who are the same way, in that we could be dying or feel like we are, and we will still show up to work. I know it's idiotic. Why would I show up and spread my germs around, not only to patients, but to my colleagues? Sometimes, we just have to work. I have many patients who don't call in sick, either. If they get a cold, this is usually what they have: a runny nose, facial congestion, ear popping, post nasal drip causing a cough, especially at night, and general fatigue. The fatigue is likely due to the fact that when you sleep with a stuffy nose, you're just not getting as much oxygen and you don't sleep as deeply. This is how I feel right now.

What do I do for my common cold? It's come down to a science, since I've had it so many times in the last 6 months. I drink lots of water. I love hot herbal caffeine-free tea with honey and lemon, if my throat can stand it. Then I sleep as much as I can. If' I'm at work, I have a water bottle on my desk. I wear a mask and wash my hands frequently. I usually will take a combination of an anti-histamine and decongestant to help me breath easier. This can be Claritin-D, Zyrtec-D, or Allegra-D. I take generics, but I list the brand names here because that's how they are most commonly known.

At the end of the work day, I'm usually beat. I skip the gym. I do not go the gym if I'm sick. I don't get anything out of it, and I feel absolutely crappy if I do go. I get to bed early. That's key. I'm not getting quality sleep, so I need as much of it as I can get. A lot of times, the post nasal drip will make me cough like crazy if I lie down flat, so I raise my head with 2-3 pillows. I will also take a Benadryl to help with nasal stuffiness and post nasal drip. If I have a fever, I don't go to work. That's a new rule for me. My mind gets fuzzy if I'm febrile, and I don't trust myself to make medical decisions when I'm mildly delirious.

My daughter is in the middle of her mid-morning nap, and so far, I don't hear much coughing from her. As for me, I'm waiting for Fexofenadine-D [Allegra-D] to kick in as I boil more water for tea. Perhaps this will only be a 24 hour bug.

Monday, April 30, 2012

Poco's First Yard Sale

Until this past weekend, I only went to other people’s yard sales to browse, bargain, and occasionally buy. My neighborhood moms group held its annual spring yard sale and I gladly signed up to sell various items collecting dust in my home. I also thought the sale would be a great way to meet other moms and interact with the people in my neighborhood. There’s something about having a baby that makes me want to settle in one place. I’ve lived in a lot of beautiful cities conducive for settling,but I didn’t seem to fit in or they didn’t fit me. 

I brought Poco with me to the yard sale. She tends to be observant and quiet in noisy public spaces where there are a lot of new faces for her to smile at. For the first 30 minutes, I set up “shop” and put prices on items, cleaned an old vase, and made my allotted yard sale table look as pleasing as I could with index cards, sharpie markers, tape, and strategically placed items. For example, I put the baby stuff together in one corner so that perhaps people would buy more than one baby item at a time. While I was doing this, I didn’t even notice Poco was there. She was quiet but alert in her stroller. A couple of buyers asked me jokingly—I think—“How much for the baby?” Our assigned table sat at the entrance of the church basement where the yard sale was taking place, so everyone saw us as they entered and exited. 

My first buyer was a pleasant and very pregnant young womanwho said she needed an infant carrier. She told me her story about finding the right carrier and how many carriers she already owned. We talked babycarriers like old pros, but I wondered if she was trying toengage me to lower the price on the carrier or if shejust wanted talk. I felt guilty for thinking the latter, especially when she boughtthe carrier in the end and didn’t negotiate.

The baby items sold quickly, leaving the more grown-up items on the table. My shoes, skirts, scarves, gloves, and a random towel rack from IKEA were keeping each other company at the end. An older mother and her adult son bought my jewelry box, vase, and a 12 piece set of china in one swoop. No boxes or bags needed. They hauled those items out like it was moving day. It was interesting the way her son bought the items. He saw his mother eye-ing the vase, and without asking me or looking at me, he said, “Hey, Ma, I just bought you that vase.” I wasn’t offended; it was sort of funny. He later paid for it.

Another lady looked at an unopened cat litter box wicker cover (retail: I have no idea) with a price tag clearly marked “$20” and then asked me how much I really wanted for it. I really wanted $20, but I also really really wanted it out of my basement, so I said $15. She hesitated. I mentioned that I never used it and that the box top was still glued together. She bought the cover in the end, which was unexpected. I underestimated people’s love for their pets. I was even able to sell my cat’s old hair brushes to a nice lady after we talked about our cats.

Cat lady: “See, my cat has very long hair. Will this work?”

Me: “I’m almost certain it will. It’s called the Furminator.It uses static cling, I think, to get the loose hair out.”

Cat lady: “Why are you selling it, then?”

Me: “Well, my cat died. She was very old.”

(Four strangers looking at my table stop, look up at me, and gasp. For real.)
Nice stranger who loves cats: “Oh, I’m so sorry. That is so hard, losing a pet.”

Me: “Yeah, it was really hard. Much harder than I thought it would be, you know? I got really attached to her.”

Nice stranger #2 who loves cats: “How old was she?”

Me: “She was 14 and a half. It was time.”

(The group seemed to sigh collectively.)
Cat lady: “So, how much for the 2 brushes?”

Me: “5 dollars.”

Cat lady: “I’ll take them.”

I was never a fan of bargaining until I decided to buy a car about 6 years ago. My sister and I read an online “How-To” book on negotiating for your first car. Our mother loves negotiating when she shops for a car, and we didn’t know how she did it with such confidence. I used to be so uncomfortable when having to confront a salesperson and calmly ask them if they wanted to sell me something for less than it was marked. My face would flush and my heart would beat rapidly. But it made me upset to read a study that showed minorities and women tend to pay the most for cars, whereas white males pay the least. This is not because minorities and women don’t like to bargain. Car dealers simply tend to quote them the higher mark-up price. This is from a study written by Ian Ayres and Peter Siegelman, “Race and Gender Discrimination in Bargaining for a New Car,” published in The American Economic Review in June1995.  

I used to hate bargaining, but I wanted a car for a fair and decent price, which I did end up getting. At the yard sale, I felt completely comfortable negotiating a fair price with interested buyers. And it didn’t hurt that I was wearing my cute, smiling daughter while meeting new people in our neighborhood. I felt at home.

Monday, April 23, 2012

Rainy Day Weekend

While Saturday's weather was gleefully sunny, Sunday was a turnaround. Rain and wind sang my family and me to sleep and we woke to clouds and horizontal rain pecking at our windows. My 8-month-old daughter didn't seem fazed. Waking at her usual time of 6AM, weekend or not, she talked loudly and pleasantly to herself, pushing her pacifiers through her crib bars onto the hardwood floor, waking my husband and me. We call her Lil Poco because she is small for her age, but lately, she's been catching up.

We were planning to take Poco to the Esplanade, but the weather was crappy. There were definitely household items we "needed" from the local IKEA, but planning a trip to IKEA always accompanies in me a sense of shame, excess, and consumerist waste, so I saved that for the next day, which I happened to have off. Instead, we visited the Museum of Fine Arts in Boston. It was our daughter's first visit to a museum of any kind.

You may be thinking, What is she doing bringing baby to a museum? That's what I thought, when I was young and childless and encountered screaming children with their tired parents in otherwise tranquil art museums and galleries. I took a chance. Fortunately, we brought a reverent version of Poco who seemed fascinated by color and lights and people. This isn't how she is every day, but at the MFA, she was relatively peaceful. She didn't throw up on anything that I was aware of. I don't know if she liked the art, but my husband and I did.

We headed straight for the new wing which presented mostly American art in a stunningly beautiful way. I loved showing my daughter portraits of Paul Revere and George Washington. There were a lot of works by John Singleton Copley. Then we walked over to the Contemporary Art section. I especially liked explaining to Poco the story of Lilith as we showed her a sculpture depicting Adam's first wife. She did not seem to feel one way or another about Lilith, but she liked touching a long glittery curtain of gold beads that may or may not have been an exhibit unto itself. I love watching her face as she ponders a thing completely new to her. Watching her watching something else transforms me.

I expected the MFA to be crowded due to the rain, but it wasn't. It may have been a combination of the high price of admission and the fact that it was Sunday, it was raining, and most people would stay in. I know I would, but I guess I've changed.