Emma found the chocolate frogs!!!!

How many times in my life am I going to say, "If I was a stay at home mom, this wouldn't have happened!"? 

I had a rough day today.  I have managed, though, to stay on the diet, and that is AMAZING! 

A very old patient of mine passed away today.  She was 104.  I know that she's cheated death for quite some time, but a patient's passing is always hard on me.  Her daughter called me this morning to ask me to come by and see her because she hadn't slept well the night before, but she passed before I had a chance to even call her back.  That bothers me, too. 

My nurse, who is like a member of my family, also had some medical issues today, and this was pretty worrisome. 

I also made a patient cry today.  I don't mind when patients cry because of events in their lives, but it makes me sad when I make them cry.  I guess sometimes it's what has to be done.  Case in point - this woman is very sweet, but she is extremely obese.  She also smokes 3 packs of cigarettes a day.  She came in today having gained 15 lbs since her last visit in October.  She admits that she has been eating a lot of junk and smoking more.  She also states that her sleep apnea has gotten worse and she's having trouble with waking up confused and uncertain gasping for breath.  She also is having increased pain in her extremeties and trouble breathing with exertion.  After listing her littany of complaints, she looks at me and says, "Why?"  I was quiet for a few seconds, and then I asked her, "Why do you think?"  She stated that she thinks it's because she's getting old and maybe she needs a different medication for her breathing.  You could have heard a pin drop.  Finally, I said, "Have you ever considered going to wal mart and getting a 15 lb bag of cat food and putting it on your chest before you go to bed at night? "  She admitted that breathing might be more difficult if she did that.  She also admitted that getting around might be harder as well.  Then I mentioned that she is actually about 150 lbs over weight.  What does she think would happen if she took 150lb bag of food and put in on her chest?  It would probably make her feel pretty bad. 

THEN we talked about her smoking.  This was the 2nd time in 2 days that our government's logic just made me speechless.  This patient had bought a battery operated nicotine delivery device, but was afraid to use it because of the warnings that the government has insisted be placed on it.  "DO NOT USE IF you have depression, heart disease, lung disease, or thyroid disease."  OKAY.  Nicotine can aggravate all of these conditions.  This is a fact.  But, she is smoking 3 packs a day!!!!  Does she not think that the cigarettes could exacerbate all of these conditions???  I was just speechless.  Finally, I said, "Would you think twice if the same warning was on your cigarettes?"  She said no, she'd still smoke them.  AARGH! 
I had a similar conversation with a patient yesterday who has end stage lung disease and has a pacemaker/defibrillator placed because of end stage heart disease.  Now, honestly, the horse is already out of the barn here, but she WANTS to quit smoking.  She was told by two doctors that she couldn't use a nicoderm patch becuase of the FDA warnings about heart disease and the patch.  Seriously.  So, they'd rather that she smoke 3 packs a day because if she does have an event, it's her fault, not theirs.  She will get less than 50 percent of the nicotine that she's smoking now plus no chemicals or tar if she switches to the patch, but she's not allowed to because of fear of medical malpractice.....this is a whole other day's topic.....
So, I had her sign an informed consent and wrote her the patches in the hopes that it might add a couple more months to her life - which is exactly what she wants. 

Back to the first lady. 

I finally told her that all the medications in the world are not going to make a damn bit of difference for her if she didn't start taking care of herself.  I told her that she's going to die in 2 years if she doesn't make some changes.  She needs to stop eating whatever she wants and she needs to quit smoking.  She needs to do something besides sit on the couch and watch TV all day (she admitted that was what she was doing).   I, as her physician, could not do it for her.  I also talked to her about self love and self respect.  She needs to make her boyfriend stop bringing crap into the house that she can't eat.  If he won't, then either he doesn't realize the gravity of the situation, and I'd be happy to talk to him, or he doesn't give a crap, and I'd get rid of him. 

This is when she started bawling.  Ugh.  I hate to do that to people, but sometimes, you just gotta.

So, the day progressed... I had a heated discussion about school lunches (HOT topic for me), and got done a little late.  That was not good because I had to pick Emma up at play practice at 5:30, bake a cake for her birthday party tomorrow, have Lee at a Cub Scout ceremony at 6 (I'm the den leader), get the dessert for the Cub Scout dinner, then come home and make chocolate frogs for Emma's Harry Potter party tomorrow.

Phil had started on the cakes when I finally got home at a little before 6.  When we got home from the ceremony, Phil went to start on the cake decorating, and both pieces of the cake fell apart into a million pieces becuase we took them out too soon because we were rushing to Cub Scouts.  We tried to fix it with frosting and coconut, but it completely collapsed.  THEN, I went to make the chocolate frogs, and I couldn't find the molds.  I tore my kitchen apart (leaving me a huge mess to clean up), but couldn't find them.  An hour later, Phil went to Wal Mart to see if he could get a cake and molds.  They had neither.  As I was on the verge of a nervous breakdown, Emma came up and gave me a hug and told me, "I love you.  I know how hard you tried to make a special birthday."  OK - I seriously lost it. 

A couple of minutes later, Emma says, "What's that?"  Under a stack of cake pans, a little plastic edge was sticking out.  SHE FOUND THE CHOCOLATE FROGS!!!!  I was totally amazed!  So, the frogs are made and eerily decorated.  We're calling Kroger in the morning for the cake.  I have to work until the guests are supposed to arrive tomorrow, so hopefully, we've got it under control. 

All's well that ends well.

And, yes, I did have a glass or two of wine....

Dr. Mindy