Welcome to the blog!

We are two people, one dog and three legs...well technically ten. But this is our story about going through life with some obstacles we have to maneuver and how we go about doing just that! And by the way, our life is fewer obstacles and more awesomeness. Stay tuned for more awesomeness...

Tuesday, November 10, 2015

Dear Everyone in Pain

Dear Everyone in pain,
I am not the gait keeper of your opiate pain medication, and I am not the drug dealer either.  Chances are, if you are under 40, and you haven't been in some kind of serious accident or have an active major illness (cancer comes to mind), then the pain you are in really shouldn't require opiate analgesics (aka, Norco, Vicodin, Oxycontin, Percocets).  Chances are also, if you have a nickname for your medications like "my vic's" (pronounced Vikes) then you are not in so much pain that you would need an opiate analgesic.  Or your pain comes from someplace higher that needs other interventions that opiate analgesics cannot achieve.
The drug addiction epidemic in this country is vast and expanding.  Many news outlets have been blaming physicians for this problem.  It is true that we, as doctors, have the ability to put people on these medications, and if they have a tendency toward addiction, it may turn into one once they are given the opportunity.
It is amazing how many people come into my door at the office already saying that their home medications include Norco 5/325 three times daily for pain (or higher doses), and when I ask them why they are on these medications it seems an injury happened five maybe ten years ago, and technically speaking should be well healed by now.  But that patient assures me that they cannot function without those medications and that I would be a cruel hearted you-know-what if I were to take them off of that medication.  Part of the problem is that patient's lie.  I do it too sometimes, to my doctor.  We have this crazy tendency to want to please others so we leave out important details, like "oh yeah, I am a recovering alcoholic or BTW I often smoke crack but only like twice a week and its been like a whole week since the last time I did."  I as the physician don't get that information from the patient, I had to find out because when you come in my door asking for those medications I make it a point to always check your urine to see if you a)have been taking the medications b)are taking other things you didn't say you are and c)that you are not doing other illicit drugs.
This comes on the heels of the ACA which now links hospital reimbursements to patient satisfaction.  Believe me, I want my patient's to be satisfied with their care, but on the same note, often times patients do not know what they need and will fight you tooth and nail, or go somewhere where they will give them what they WANT, not what they NEED.  So am I going to be considered a bad doctor because I don't give my patients what they want all the time?  Maybe.
It is this "Have it your way" mentality that is crushing medical practitioners.  Everyone comes in having either already diagnosed themselves, or having been to the ER where they don't treat chronic pain, they just want those people to GOMER and so they give them their Vic's or their Norcos.  Then I am the one trying to clean up this mess.  Often times I will lose patients because I do not give them what they want.  There are plenty of doctors down the street who will give you whatever medicine you ask them, but I'm not that doctor.  I will work with you, try to treat your pain and find out the cause as best I know how.  But I will not be your drug dealer.  I will not be complacent in this epidemic.  I will not.  

Monday, July 13, 2015

Nine months, in or out

So, on the first of July JD turned 9 months old.  It has been a whirlwind, an exhausting, scary, exciting, amazing and awe-inspiring whirlwind.  I cannot believe that soon he will be older on the outside than when I was carrying him on the inside.  I have not had time to blog, nor do many of the things that I love to do.  And I don't blame him because really all I want to do when I go home is hang out with him, until he is cranky and doesn't believe me that sleep is what he wants...then I could hand him off and go write a blog or two.  But man, what an awesome adventure it has been so far.  He seems to be an introvert, as we described one day at a restaurant he literally was facing outward looking and smiling at other people.  He loves activity and people watching and now he is crawling!  He is so opinionated and so I guess he takes after me in that way.


So far the things that make him laugh the most:
He thought that me copying him while he banged on his high chair was a killer.  Literally he couldn't catch his breath and gave himself the hiccups. 
Oh and when I showed him how to blow up a pound it, that was pretty frickin' hilarious. 
He is starting to be ticklish, especially under his armpits, so that is cool.
Oh and did I mention how much he loves his grandma?  Sometimes he prefers her over me, which started with Moose (Moose prefers her over me hands down) so I was prepared to no longer be the favorite. 
He currently has been jabbering away, he likes to hear himself talk.  Grandma always puts words to his jabbering and sometimes I think, yeah...maybe that is what he said. 
And did I mention he is a big kid?  He is in 12-18 months now, and can fit in some 24s.  So that happened.  Our nine month check up Dr. Hasaba said "OH he is now in the 75% for weight, for a 1 year old..."

Anyways, this past week Carl has been in Orlando for a church conference and I have been working long hours in the hospital.  Thank God for my mom because I would NEVER be able to do this on my own.  He is a great kid but he is not the best sleeper even still, we will see if that ever changes or he grows up to be like his dad who still has trouble sleeping.  Someday we will look back and remind him of the sleepless nights that he gave us...and we will hopefully be frustrated as to how hard it is to get him out of bed...instead of now where we are frustrated at him for waking up at 5:45am on my day off when the past three days I have had to wake him up at 6 to take him to daycare before work.  Alas, parenting is filled with twists and turns that no one can even describe or prepare you for.  As I am learning, day by day.  But man is he cute.  We sure do love him a lot.  #blessed.