Click (maybe)

Happy belated Thanksgiving! We ran a 5k trail race that morning and my knees are still a little sore from that.

Work is going a little better. I had a relief shift at a totally different clinic the day after Thanksgiving and there was only 1 neurotic high-maintenance client I had to deal with. ONE. It was amazing! It also helps that it was located in a beautiful coastal town. My usual clinic is chock-full of clients who need constant talking off the metaphorical ledge, which is frankly exhausting.

The weekend went well too. Saturday was kind of slow. Sunday was very busy but I feel as though I handled every case reasonably well. I saw several new things - mastitis (probably secondary to a big mammary mass that I felt), liver damage from a suspected toxin, an eosinophilic granuloma, and more. For some reason I didn't freak out and have my usual "OMGI'veneverseenthisbeforeI'mgonnascrewitup" train of thought. I think a lot of it has to do with having to deal with my own diabetic cat. It's HUGE pressure to diagnose and treat your own pet, and you all know my insecurities about internal medicine. Yet if I can manage him okay then I can probably handle a lot of things.

So at least for now I feel as though I'm settling into a bit of a rhythm - at least with non-surgical cases. I still need to get my surgery mojo back.

Oh, and in other news our practice manager is quitting. I've no idea if someone is lined up to take their place, and if not how that role will be managed. It could be ugly ...

Antsy

I am taking it easy easier today because not only am I on the verge of burning out at work, I went to Crossfit the past 2 days in a row (and yesterday's workout was so challenging that I actually felt sick afterward).
Forcing yourself to do fewer things when you're used to going a hundred miles per hour is a bigger challenge that I expected. I have had to constantly remind myself today to slow down and take breaks, even though there is a lot of housework to do and errands to run. Those things will all get done eventually, they aren't life-threatening emergencies, and I need to REST.
I even managed to go see a movie today. In a theater. Believe me, that's kind of a big deal when you've become so used to work-sleep-work-Crossfit-work-work-work-wedding planning-work.

Tomorrow I don't have much planned either. The shelter is not doing surgeries so I have the morning off. I will be going to Crossfit, and then I have to have my truck looked at by the insurance adjuster for repairs (long story short - I backed into a fence post in my own driveway a few weeks ago because I was exhausted and not concentrating).
Wednesday I'm taking 2 of the cats to work - the one with chronic kidney disease to monitor her PCV after being treated for anemia, and the one with diabetes for monitoring on his first day of insulin treatment. We're closed on Thanksgiving (YAYYYY!!!) and then Friday I'm working at a different hospital to get away from Dr. X provide coverage while their doctor is off. Then it's another action-packed weekend of work.

The 'beetus

One of my cats recently started drinking a TON of water and urinating more than my cat with chronic kidney disease(!) I went back and looked at his pre-op bloodwork from last month (before his dental cleaning) and his blood glucose was 529. Normal is around 100.
At the time I had dismissed it as stress-induced. Cats are especially well-known for their ability to spike a high blood sugar reading when stressed. However, his BG had never been greater than 200 before.
Hmm.
I brought him in to work today for recheck. Urine is pending (I sent it out), but his BG was 496.
Persistent fasting hyperglycemia + persistent fasting glucosuria + clinical signs of diabetes probably = diabetes.

So it appears that between him, my other cat, and several of my patients, I will learn the ins and outs of internal medicine despite my wishes to the contrary.

I'm also thinking of switching back to a 5-day work schedule so that I can (maybe) be a little less tired and only be alone 60% of the time instead of 80-90%. I just have to figure out how to pitch that when Dr. X probably wants to stay on a 4-day work schedule AND the clinic hours are 8am - 7pm.

T minus 2 months

Yesterday marked 2 months until the wedding. Eep! We still have a lot of things to iron out, such as the ceremony, some of the music selections (we have some decisions made but not all), where to have the rehearsal dinner, and more. I know that we will get it done but it sometimes gets a little overwhelming. I have to meter the number of things I discuss with D at a time because his job has been insanely stressful and I don't want to make his brain explode.

I also went to Crossfit yesterday - we did this hero workout. I used an assistance band for the pull-ups and 75 pounds for the lifting (Rx'ed for women was 95, so not too shabby). Afterward, I had a short conversation with the coach:
Coach: "Did you do the whole thing with 75 pounds?"
Me: "Yep."
Coach: "How was it?"
Me: "It was pretty challenging. I can't feel my arms right now."
Coach: "That's what I'm TALKING about!"

So basically we're all just a bunch of masochists.

Speaking of masochism or self-flagellation ... I went in to the shelter this morning to do surgeries again and had my second scrotal bleed from a kitten neuter (the first was the last time I was there 2 weeks ago). I KNOW that my knots are secure and the kittens are fine once pressure is applied to the scrotum but it is still making me paranoid. In addition, apparently a couple of kittens from the same litter that I neutered a few weeks ago developed pretty severe infections afterward.
My confidence is already so shaky from work that I question my ability. I KNOW that I'm using good sterile technique. I make SURE to snug down my figure 8 knots firmly and check for oozing as I release them. Yet I still think I must be screwing up somehow ... (even though I can't think of anything).

This run of post-op complications is NOT HELPING, universe.

Travel and training

Last week I spent 3 days in BigWestCoastCity for a training program designed to orient new veterinarians. The training itself was fine - I learned quite a lot and got to meet a ton of people from all over the country. It was comforting in a way because I met one other person who is struggling with being the only doctor on duty all the time, however the vast majority of people were either never alone or almost never alone. I got to meet up with an old friend who lives in the city, eat excellent food, and even go to one of the local Crossfit boxes!

The very next morning I had to go to work. I was completely exhausted and before I could even get my things settled the practice manager was firing questions and notifications at me.
A. I am not awake before 9am most days anyway and never do well when expected to process a ton of information before that time
B. I need time to settle in before going 100 mph - even if it's 5 minutes to put my bags down!

It was probably pretty obvious how peeved I was because she pulled me aside later and asked me what was wrong and that I had seemed a lot more stressed/angry/upset lately. I laid it all out -
How ridiculously stressful it is for me to be the only doctor at a hospital with complicated cases and techs and front desk staff who want the doctor to make every single little decision for them,
that I was considering asking to transfer to a different hospital,
and that I simply was not ready to essentially be the chief of staff since I STILL NEED TO LEARN HOW TO BE A DOCTOR.
I told her that I was burning out and that the current state is not sustainable for me.

They made an offer to an acquaintance of mine to help in the hospital part time, and that person accepted. The practice manager said she would make sure to schedule that person in on my single doctor days to help me. That's great, but they need to go through their 2-3 months of training first.

So ... while I feel a tiny bit better (I first accidentally typed bitter ... Freudian slip?) that the stress is noticed and that they are trying to do something about it, I am still looking to change jobs after 6-12 months in this one.
I also made a deal with myself to speak up sooner if things bother me as opposed to taking and taking and taking it until I can't take it anymore. That's a tough one for me and always has been.

A whole week off! (Sort of.)

I have an entire week out of the hospital! This week I'm traveling to BigWestCoastCity for a 3-day corporate training event that all the doctors have to go to. I'm looking forward to seeing a classmate again and to meeting up with an old friend for dinner. I might even visit the Crossfit box up there if I have time.

Last week was slower that it has been. I suspect this is the start of the slow season, which is fine with me. Of course we had the requisite tragic grooming accidents and even a mixup where the boarding facility brought us a dog that wasn't sick (whose owner FREAKED OUT at the thought of her dog being sick) then later said to us oopsie - wrong dog. Nice. Apparently they ended up comping the well dog's stay because the owner was really (and understandably) angry.