Just The Facts

22 patients today (and that's an abbreviated schedule less one hour than usual for an OB meeting this morning). The roster:

2 yr old girl with history of neuroblastoma, in remission, here for ER follow up of vomiting
71 yr old woman with vertigo, generalized weakness, terribly uncontrolled diabetes, multiple falls at home, failure to thrive, needs higher level of care
15 mo old girl for well child
24 yr old woman for initial OB visit
71 yr old woman with dry cough for a few months
37 yr old woman for annual gyn appointment, turns out she had a work up for amenorrhea 1 year ago that showed premature ovarian failure which no one explained to her, still wondering why she hasn't had a period in over a year, hoping to become pregnant
66 yr old male, new patient, with 5 major complaints: blood coming out of his eye, shoulder pain, uncontrolled diabetes, urinary and fecal incontinence (and blood in stool), and chronic cough
17 yr old girl with cough
84 yr old woman with uncontrolled blood pressure (actually her real chief complaint was that her husband was driving her crazy and stressing her out. it took a few layers of interpretation to figure out the medical significance of that, which is that she thinks it is making her bp too high)
31 yr old woman for annual gyn exam with pelvic pain, history of fibroids s/p hysteroscopy and some sort of fibroid removal, attempting to conceive now for 2.5 years without success.

(And that's just 10 am - 1 pm. Normally we see patients 9 am to 1 pm)

Lunch (aka frantic charting, cleaning out of the inbox, digging through piles of reports, letters, refill requests, then 10 min of shoving down pb and j + apple)

64 yr old woman with abnormal pap last year, colpo, now here for 6 month pap smear
47 yr old woman for annual gyn exam with fatigue, weight gain, palpitations
37 yr old woman for ER follow up of 9 week miscarriage in the process of passing
1 yr old girl with cough
13 yr old girl with cough
1 yr old girl with persistent high fevers, seen last week, unresolved. I requested a cath urine specimen, discovered that no one here does that, found 1 lone cath kit, grabbed a nurse to help restrain, and did it myself (negative for infection).
19 yr old girl with impressive rash on face
10 yr old boy for ADHD follow up (my first ADHD patient to make me believe the meds are worthwhile)
75 yr old new patient, recent immigrant from Nigeria (speaks Igbo) with diabetes, hypertension, glaucoma (maybe. at least she came bearing a bottle of eye drops usually given for glaucoma), hasn't had any preventive care (never had a pap? ever?)
9 yr old boy with a cough (popular these days, as you can see)
10 yr old boy with asthma
74 yr old woman from Thailand, speaks Mien, COPD with frequent exacerbations and on methadone maintenance for opium addiction (that's the real deal opium. not opiates). Her request today was that she be able to get more than a day's worth of methadone (she's been going to the methadone maintenance clinic in Seattle for 15 years!) at a time because her COPD makes it hard for her to travel there every day. I think she actually might be an excellent suboxone candidate. We'll see if our favorite addiction medicine specialists agree with me.

Frantic charting, cleaning out of the inbox, digging through piles of paper on my desk.

Time to go home now.