It's a good thing to just review the day. Yesterday: F. came in. She is on dialysis from renal failure, had a stroke and has a fairly severe and painful nerve injury from her fistula surgery (the site where they do the dialysis). She just go over a terrible infection. P is a new patient. She is fainting, but no one really knows why. She has had every test in the world. She's very anxious, and can't be left alone. T came. Another new patient. She has developed very severe every day disabling migraines. It's getting to the point where she can't work. P - another new patient. She fell and fractured her head from tripping on a hurricane panel floor brace. She is very much off balance and can barely walk. She has diabetes. I ordered some tests. I think she has a spinal cord problem. L: He's amazing. It's a pleasure to see him. He's had Parkinson's for about five years and looks totally normal. His golf score hasn't changed a bit. This is very rare. D- has Alzheimer's. His wife is starting to get burned out, which most of them do. He is depressed. I added some anti-depressants. I changed his Exelon to the new patch, because he has chronic diarrhea (likely from the medicine). E: Neuropathy. He's doing well. F: She is just fantastic. I see her only once a year now. She's been a patient about six or seven years. She had severe neuropathy pain, but it is totally controlled now. She has a great outlook and is happy. Her happiness helps control her disease. S: He is in severe constant pain. He's had a neck fusion at every level with rods. He has a severe daily headache that's uncontrollable. I changed his medicines. He gets Botox in three weeks. It gives him no headaches for about a month then wears off. M: a new patient. She has severe migraines. She was nearly crying so I think she's depressed, even though she takes Paxil. She is young, and has urinary incontinence. J: She just had back surgery. I'm not sure if it helped. She's in severe pain, which she's had for a couple of years. She is allergic to just about everything. D: He has seizures, but they are well controlled. They think he has "memory loss". I just tested him, and the thinking is still good. D: She had severe neuropathy "CIDP". I have treated her with immune suppression for two years. She is great right now, and I think she's in remission. I'm planning to see her one more time, then she'll be done with me. It's going to be sad to see her go, but it's always nice to "cure" someone. L: He got chemotherapy that caused extremely severe nerve damage. He can barely walk and is in severe constant pain. I increased his Oxycontin, and changed his Keppra. I've been seeing him for a few months. He's definitely better, but still very far from "good". Three patients didn't come - either they cancelled or just didn't show. My technician decided she wasn't coming in because she didn't have money for gas. That's odd, because she just bought a new couch. I'm not sure that's a good reason to not come to work.
That was yesterday. Yesterday was a good day. You battle against disease. It's all about gaining a few inches here and there on the front. If there are one or two "good" patients that's what makes the day feel like there's success. With the others, there's just hope, sweat, creativity, hanging in there, and inches.
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3 comments:
It must be such a challenge to allow yourself to have suffering when you are reminded daily for several hours that you should be grateful for the good in your life. I wonder how healthy tool that is to avoid all suffering. Although it is a good mantra,there are times that people need permission to suffer. If you decide to always use this tool and never allow yourself an opportunity to suffer, you will suffer more. If I have sadness and then feel I have no right to complain because of all the suffering in the world, I then feel a since of failure when that does not work. Good doctors are nice see becasue it is a safe place where no one is going to say, "well, it could be worse and you should be grateful." Everyone needs a doctor just so they can get a prescription that states they have permission to suffer about their situation. To bad doctors cannot self-prescribe.
Everyone has suffering. It is in our nature to suffer. I suppose that if we feel guilty for suffering then we get to suffer more: we suffer and we suffer for suffering. So I understand when you say that we should allow our suffering. Then we suffer and that's all. I can't give myself a prescription to suffer because we aren't supposed to give ourselves prescriptions. My wife gives me suffering permission and validation. Almost all of my colleagues suffer (I think far too much at times) and they not only give me permission to suffer, but they want me to suffer. We are all in a "suffering club" where we can understand each other and validate each other. I'm not the best club member, because I don't always suffer enough alongside them. Perhaps you are giving me suffering permission, but you didn't write a prescription for it.
You already have a prescription from the best place you can get one. Actually, it is better than getting one from a doctor. Many spouses would not write that prescription. I would have to say that you are the luckiest of all. Maybe that is why you do not meet up to the standards of this club you speak of. I assume she does not self-medicate either.
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