Bleah

2002-09-03 - 8:45 p.m.

Last night it took me a very long time to fall asleep. This morning I woke up dead tired with a stomach ache and thought I was febrile until about 45 minutes later when my mom said, "Whew, sure is hot in this house this morning." My dream disappeared before I could get a grasp on it, so no dream for tonight.

Today I went to North East. The usual security guard was on vacation so there was some lazy security guard there taking his place who wouldn't even get off her ass to let me in. So I had to go around and get the girls up front to buzz me in. Eliza, my student, was there so she did the refills while I saw patients. Unfortunately, none of my patients showed up until the very last time slot which happened to be double-booked. Of course both of those patients showed up and Eliza was nowhere to be found to take one of them. So one had to wait. The first guy I saw had no chart. I had no clue why I was seeing him other than his med profile. He didn't seem to know either. His blood sugar was in the 300's when I tested it and he is taking (according to the computer) metformin 500mg qd. Minimum effective dose is 1000mg/day. The patient said he has a "kidney problem" but who knows what that means. Metformin should not be given to male patients with a SCr>1.4. But I had no idea what his creatinine was because I had no labs and no chart! I even went and looked on the ancient lab computer, but it had never heard of him. Anyway, I decided to increase his dose to 500mg bid because there is absolutley no benefit in taking 500mg qd. I told him about s/sx of lactic acidosis and gave him 0 refills on his metformin so he would have to get labs done before he could get more. The second guy I saw is a big teddy bear. I saw him a few weeks ago and he's actually doing much better! His BP was at goal and his HbA1c was around 6.5! Yahoo! His lipids were slightly elevated, but still on their way down. That made me feel really good.

So I finished up late and ate lunch in the car as I sped over to Capital for my afternoon clinic. Only one patient came in and I let Eliza see her. So I did Capital's refills and then headed over to our residency meeting. I hate the way I feel so left out of the loop. Everyone else is working at the hospital and they see each other and talk about things, while I'm off driving around the clinics. We did this exercise today where we had to evaluate how well the P&T committee is complying with certain guidelines. I have never been to a meeting and am almost completely unfamiliar with their work. The only thing I really know is their protocols for formulary therapeutic interchange. I was able to contribute very little to the discussion. We also did a lot of other pointless stuff. I forgot to ask Slick if she would switch a weekend with me...I should go send her an e-mail right now...

Stretch called tonight. He actually hasn't called for nearly a week. I was thinking of calling him tonight but spent all day being in such a crabby mood I decided it would be better to wait. When he called I was in the bathroom so he talked to my dad. I asked my dad to tell him I would call him back, but instead they talked. My dad mentioned the 5k I'm running in a couple of weeks and Stretch just thinks that's wonderful. Finally Eucalia has taken an interest in running! So he has invited himself down to come run it with me. I told him I was coerced, the whole thing is against my better judgement. He doesn't care much. I told him my best 5k time so far is 36:16. After a lengthy shocked pause he said, "That's...well...that's...that's a lot better than a lot of people..." And not only that but the baseball players decided not to strike so we're on for the Giants game. So he's coming Friday, running with me and going to the game Saturday, and then leaving Sunday. I have two spare tickets to the game. I'm trying to decide if I should find someone to give them to or just hang on to them. Whoever I give them to will be sitting right next to us and will probably drive there with us too. If I'm going to talk to him, it would be much easier without other people around. I don't know what to do about him. He even already asked my parents' permission to marry me. But my parents know I'm significantly less enthusiastic about it than he is. Aunt V asked me once if we were going to get married. I said, "He wants to. I haven't decided yet." I guess that about sums it up. I'm just not ready to tell him so. Actually, I did sort of tell him that I'm undecided on the marriage matter. I asked him not to ask me to marry him, that's a start, right? Although I gave some other excuse. I told him that if he was really considering doing a residency too then he would be away from me for another year and there's no need to rush things. But now I'm beyond just not rushing things. I think maybe I want it to be over. He asked me today, "Did you miss me, even a little bit?" I said in a joking tone of voice, "Yeah, I missed you a little bit." I'm such a dork. What should I say? "No, actually Stretch, I really didn't. Maybe we should just call the whole thing off." He asked me in that whining, pleading tone. He knows something is up. He has to. I think I am not very reassuring, but at the same time, I am not overly discouraging either. But the thought of actually breaking up with him is...horrible. After it is done, other than questions of whether or not I did the right thing and a bit of self-loathing for causing him pain, I think I will feel better. Maybe he will feel better too...after all, it will end any doubt he's having right now. And its more fair to him because then he can start looking for other girls. It's not as though he will have trouble finding someone else, he is a cutie-pie after all. Want to hear my silly/mean thought for the day? I was thinking that since right now he hates everything that reminds him of his ex-girlfriend (I really hate hearing about her, I was tolerant at first, but I think it wouldn't be too much to ask to refrain from bemoaning your ex in front of your current, don't you?), I should take an interest in things that he loves that I can't stand. For example, I think I should become a diehard Republican, Dallas Cowboys fan , and Huey Lewis and the News fan, then break up with him so that he will hate all these things and actually become a better person because of our breakup :-P I'm kidding about that, of course.