WhiteCoat

Dear Diary

The holidays have been eventful so far.

In the “I wish I had my camera ready” department: Driving down the main drag in town where all the stores are located. A man in Clifford the Big Red Dog outfit is walking up and down the street with a sign saying that puppies in the pet store on the corner are $100 off up until Christmas. At the stop light someone sticks his head out the passenger window and starts yelling at Clifford. Clifford keeps walking. Rolled down the window to hear what the guy in the car was saying and heard him yell “don’t buy there – they sell puppies from puppy mills!” Clifford drops the sign, spins around, and gives the motorist two front middle toes.

Went to a holiday party and was discussing the economy with a friend. Said that he was having problems with home life. His parents moved out of their house and are living with him in their spare bedroom. His adult son and his son’s fiancĂ©e are living in his basement. Another adult son dropped out of school and is living in his attic with a girlfriend. His quote was “I don’t have a home any more … I have a commune.”

One of our family members went to the big goldfish bowl in the sky on Christmas Day. The kids won a bunch of goldfish at an amusement park 5 years ago and the goldfish have been part of our family ever since. Flash started swimming upside down a few days before he died. The causes of upside down swimming are apparently related to a swimbladder problem in fish. We treated him with antibiotics for possible infection and gave him peas to combat possible “bloat” since peas are a laxative for fish. Despite antibiotics and peas, Flash died. He had a good life, though.

There are sooooo many people showing up in the emergency department over the holidays. Our hospital is packed. Of 26 beds in the emergency department, 19 were being used to board inpatients at one point during my last shift. Makes seeing patients a little more difficult when there’s nowhere to put them. Everyone in the waiting room is wearing masks because most patients are suffering from influenza-like illness. My informal survey of patients is that <10% of patients I treat for influenza symptoms have been immunized for influenza. Both the immunized patients on my last shift were elderly and had mild symptoms compared with their non-immunized counterparts.

Mrs. WhiteCoat and I went to bed about 12:30 AM Christmas eve. We had to make sure that the fireplace was open so Santa wouldn’t have any trouble getting inside. Bad idea.
WhiteCoat children set their alarms for 5AM and were running around and arguing 15 minutes thereafter. Dogs started barking and clawing at the bedroom door and I had to make various non-Christmaslike threats to make everyone go back to bed. By 7AM, everyone was wide awake, so we all went down to open presents.
After we were done, our youngest daughter thanked us for her presents, but then became quiet.
“Why are you sad?” I asked.
“I didn’t have any money to get you and mom anything.”Note
“Honey, all of you are our presents. Every day you make our world so happy that we don’t need anything else but to see your smiles.”
That seemed to cheer her up a little.
As I was using my advanced engineering skills to remove dolls from boxes and to help junior assemble a Lego project, youngest daughter disappeared for a while. We assumed that she was playing with her toys, but then she reappeared about 30 minutes later with some haphazardly-folded used wrapping paper taped onto itself.
“I was just kidding. I really do have a present for you.”
I carefully opened it up. Inside was a piece of paper – quite a neat Christmas message from a six-year-old.

We didn’t go anywhere for the holidays but instead used Skype calls to visit with many family members for Christmas. It was good to see parents and siblings even though we couldn’t be with them. We flipped through photo albums and laughed just as if we were sitting next to each other on the couch.
One of our several holiday traditions is to go out to movies on Christmas night. I didn’t think there would be that many people out and about and there weren’t … that is until we hit the movie theater parking lot. Couldn’t find a damn parking spot for 15 minutes. Fortunately, the movie previews last 20 minutes. We saw Parental Guidance which was amusing and was a good family movie. Billy Crystal is a riot.

Had my own problems a couple of days ago. Was running on the treadmill after dinner the past few nights and started having episodes of chest pain about 5 minutes into the workout. The first night, I chalked it up to dinner. The second night, the pain got bad enough that I had to stop running. I felt like I was having a skip in my heartbeat, so I listened to myself with a stethoscope. I had a murmur. I never had a murmur before. What gives? Then I got to thinking. I’m not getting younger. Being 37 with 6% body fat doesn’t mean that I still can’t have heart disease. How many of those people that I see come in by ambulance in full arrest thought it was just a stomach problem, too? I resisted the urge to go to the ED, but called a cardiologist friend. He would try to get me in for a stress test the following day. I didn’t sleep well that night.
I woke up the next morning and got a call from the outpatient testing department. They had a cancellation and I needed to be there in 30 minutes. Done.
The tech shaved little patches on my chest and attached the electrodes. I sat there watching my heart rate go up and down on the monitor. After about 10 minutes, my friend got there and I got on the treadmill.
“You’re up to date on your ACLS certificate, right?”
“No,” he smirked, then he pointed at the tech “but he is … right?”
The long and short of it is that I was able to go just under 16 minutes on the treadmill without any chest pain. Got to my maximal predicted heart rate with no changes. Normal stress test.
“What about the murmur,” I panted, “listen to my heart. There’s a murmur there.”
“You’re right, there is a soft murmur there. Good ears …”
S0 he took me over to the echo lab and did a quick echo on me.
“Mild mitral regurgitation. Nothing to worry about.”

When I told this story to one of my co-workers, he joked that “you went through all that testing for nothing.”
I look at it more as making sure that I’m around to get more great Christmas presents next year.

Now it’s time to go running – before dinner from now on.

4 Responses to “Dear Diary”

  1. tracy says:

    Wow, scary, Dr. Whitecoat, i’m really glad you are alright.

    What a sweet note from your daughter. i’m glad you are enjoying the holidays.

    i love it when you talk about your family or “Dear Diary”.

    Thank you for a wonderful blog!

    You’re only 37 ?? Just a kid!

  2. Tarl says:

    I’ve been watching this year’s flu season develop, a nasty one:

    http://www.google.org/flutrends/us/#US

    It’s not perfect, it’s based on google search usage heuristic, but it’s close enough that the CDC uses it for crude real-time monitoring.

  3. SeaSpray says:

    I’m so GLAD you are alright WC. What an awful thing to be concerned about at Christmas. But, what was the chest pain all about then? heartburn?

    What a precious gift from your daughter. Kids are so darn sweet and cute. And they are the BEST presents. :) It sounds like you had a fun Christmas day – the way it should be. I want to see that movie – thought it looked funny in promos.

    I didn’t realize goldfish lived that long and flash obviously had a good life. This will seem dumb on my part …but I decided to get a goldfish when we first got our house. Enjoyed watching the fish swim and the tank I fixed up. But then became dismayed when I realized goldfish poop. I don’t know why that was a surprise to me considering they eat. So, their image was forever tarnished. It ruined the whole ambiance of the fishbowl. But ..I tolerated it. Just never got another. :)

    I agree with Tracy – love the Dear Diary posts and pictures.

    Belated Merry Christmas and wishing the WhiteCoats a Blessed New Year. :)

  4. girlvet says:

    Yeah, our hospital is packed too. It sucks. Boarding ICU patients is the worst.

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