i pity the fool
i thought about starting this post with a fake ultrasound and pregnancy announcement, or by proclaiming that inspired by michelle i am quitting peds for anesthesia to make some (fine, a lot) more money, but i know you wouldn't believe me and i bet everyone else is going to do that today anyway. so let's just acknowledge that it's april 1st, consider yourself fooled, and you can feel okay to believe everything in this post. it's not all that exciting, anyway.
yesterday afternoon, i felt like a doctor again. along with a social worker, i visited the homes of two of durham's most severe asthmatics, both to check on the patients themselves and to assess home environments for breathing-friendliness. the social worker and i went around the houses looking for asthma triggers (mattresses sans dust covers, old air conditioner filters, roaches -- fortunately, none of those were sighted). we had patients demonstrate their use of inhaler with spacer, and went through meds to refill any that had lapsed. it was fun and pretty eye-opening, and i think it was cool for the kids to see a doctor in their own environments (the two-year-old we visited kept trying to get me to play with her barbies).
according to this npr piece, apparently house calls are making a comeback (or at least they were in 2005). while it sounds nice, i see many practical problems with this. for one, if you are sick enough to need a house call, then you probably need more equipment than is mentioned in the article. i'm not exactly about to go door-to-door with a JET ventilator and ECMO setup. second, i can see 8 patients in an half day (and a more seasoned private pediatrician more than double that), but our two home visits took up a full afternoon. time (yes, even my time) is money, ya know?
i could see how this kind of setup would be ideal for home hospice care, but door-to-door well child checks are likely not coming any time soon. which is probably good because most people wouldn't want someone coming up their driveway and vaccinating their kid with a briefcase full of needles. it just doesn't sit well.
today i have more healthy lifestyles clinic, and then my own clinic. and tonight, it's out with 4 generations of pediatric endocrine fellows (all women!) -- i'm the baby, obviously, since i don't start for 15 months! we're trying out tonali, a mexican place in durham i've been drooling over for quite some time. a margarita is sounding really good right now . . .
workout: 5 miles outside in chapel hill, 8:42/mi pace. whew! this felt 8,000 times easier than my hot miami run. it's amazing the effect that temperature has on my cardiovascular system. i greatly enjoyed this run, and my hip felt decent (not perfect, but decent).
i was supposed to shred, but it got late and i didn't want to sweat and get my heart rate all fired up before bed, so i did 30 minutes of lunar flow yoga instead. it went by so quickly and was a great stretching routine, not to mention super-relaxing. i will definitely do this one again!
doin' time: i strayed from martha and just freestyled my own salad for the evening. josh did not make it home for dinner, and i wanted to go recipeless for a change. i combined baby romaine with tomato, avocado, blue cheese, and a soft-boiled egg, and then topped with some homemade vinaigrette (olive oil, white wine vinegar, mustard, honey, salt & pepper). it was a satisfying meal served with some stacy's pita chips.
reading: 2 articles on community pediatrics and the medical home, and then a short piece on TRALI, which stands for transfusion-related acute lung injury.
flossing: yes! 2 in a row.