Physician Assistant

Friendship - Just Me - Physician Assistant

Canada Conference Craziness

June 22, 2012 by 0 Comments
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Today I had planned on driving to Dearborn for a “Women’s Health Visit” CME conference.  But when my alarm went off at 6am (and again at 6:10 and again at 6:20) I decided that learning more about pap smears, Gardasil, and osteoporosis was not in the cards for me today. Instead, I asked the babysitter to come an hour later and leisurely roamed around the house before deciding to throw my hair into a greasy ponytail and throw on a fashionable GVSU T-shirt and shorts. When the sitter arrived, I bolted out the door.

A morning to myself.

Can you feel my muscles relax? Can you hear me singing Taylor Swift in the car as I drove away? Can you feel my stress decrease just a little bit?

I decided that rather than catch up on STD prevention and contraception methods, I’d spend my morning doing whatever I want: blogging, reading, working on our digital family photo album. Anything that I could do from the comfort of the Barnes and Noble that I have decided to inhabit this morning.

Last night, as I (finally) published my post on my evening with my fellow PoPoW’s I realized how many unfinished posts I have waiting for me to complete. Therefore, that will be my first task this morning…

A few weeks ago, I packed my rather large suitcase, kissed my girls good-bye and headed to Toronto for a five day weekend with my favorite PA girls for the annual American Academy of Physician Assistants conference.  My excitement was slightly higher than a little kid on Christmas morning… and probably unnecessarily so. But this was my first ever weekend away from my little girls, my husband, and spent with my girlfriends.  I may have even danced a little when waiting for Meg and Sara to pick me up.

As the three of us drove the three hour trip to Lauren’s home in Ontario, there wasn’t a second that wasn’t filled with talking and loud laughter as we quickly tried to catch each other up on our lives since we last saw each other.

When we pulled into the driveway and Lauren ran out to greet us, it was as if the three years since PA school vanished… we were almost all together again.

That night, we celebrated the upcoming arrival of little baby boy Hollis, devoured yummy home-made enchiladas, and ate way too much confetti cake. We shrieked with excitement that we were all together again with no husbands, no babies, and no responsibilities for five whole days.  We all went to bed that night, not needing to set alarm clocks or shush little kids to sleep.

In the morning, I woke feeling completely refreshed and rejuvenated. I flung the blanket off and not-so-quietly walked upstairs, convinced I slept in the latest and the last to wake. Instead, the house was silent except for the ticking on the kitchen clock which read 6:45am.

6:45am? No way. How could I possibly feel this wide-awake this early in the morning? I check the time on my cell phone.

6:45 am

Hmm. Guess not having to wake up in the middle of the night to ease nightmare fears, fix blankets, or pick up dropped stuffed animals makes a difference in the quality of sleep you can get.

An hour later, as my friends began to wake, we huddled under the blankets on Lauren’s bed and discussed everything from baby poop blow-outs, husbands who don’t pick up after themselves, and non-compliant patients.  We had breakfast and took our time getting ready for our drive into the city.  As we loaded our large suitcases into the car like a game of Tetris, the excitement began to build again. Once in the city, we would meet up with Becca and Molly and our girls weekend could really begin.

While the bulk of our trip was spent in lectures from 8am to 5pm learning about diuretics, Ehler’s Danlos Syndrome, and chronic kidney disease, the evenings were ours and they were ah-mazing.

We explored the city of Toronto, ate delicious dinners, sipped over-priced alcoholic drinks, and laughed until we nearly peed our pants at the comedy club.

We sat in our 2 bedroom hotel suite and discussed SIADH and the acute abdomen while Becca pumped and the rest of us gorged on our smorgasbord of snacks. We acted like tourists, looked up at the buildings while we walked throughout the city and stopped to take ridiculous pictures.

We took note of all our Canadian observations that left us confused, frustrated, or completely amused:

Gas station attendants still do exist and when you get out of your car, laugh at the two blue balls spinning around on the gas pump, and have absolutely no idea how to turn it on, the attendant will begrudgingly help the not-from-around-here-are-you girls.

Fountain pop is a rarity and you must go on two mile walks in the early morning hours in search of a restaurant that serves fountain pop. And when discovered, it shoots out of the machine alternating between syrup and carbonated water making you think the machine needs repair, but in fact, that’s just how it’s done in Canada.

Cheque= form of payment
Check= hitting in hockey

Driving is slightly difficult when everything is measured in kilometers and your car only measures in miles.

Mountain Dew does not contain caffeine.  (I know, if blew our minds too)

Recycling containers placed throughout a conference center without trash bins confuses wasteful Americans who are used to throwing away anything without a ten cent deposit. For example, if you were lucky enough to find a fountain pop and now want to dispose of the cup, do you throw it in the paper receptacle, the plastic receptacle, does it really matter? Where the hell is a normal trash can?!

The music selection in public places is simply fabulous. In one afternoon, our ears were graced with the sounds of Gansta’s Paradise, Pump Up the Jam, and numerous Backstreet Boys ballads.

Canadian convenience stores surpass all Walgreens, Rite-Aids, and CVS’ in “the states.” Where else can your forgetful friend purchase a breast pump at 8pm on a Saturday night when she is in desperate need of relief?

Bottled pop is ridiculously expensive. However, when you desperately need caffeine to survive eight hours of lectures, you will agree to pay $3.00 for a 20oz of Pepsi.

Michigan accents are very similar to Minnesotan accents. We speak through our noses and have ‘nasally accents.”  For instance, we say “mam” instead of “mom” and “an” instead of “on.” (Go ahead, say it out loud, it’s true)

There are no pharmaceutical commercials on Canadian television channels.

Hotel pools with a depth of 1.2 (meters) just looks weird.

Toilet paper in public restrooms dispense like napkin dispensers.

Asking to have all your nacho toppings placed in a bowl and your chips kept separate (in order to dip your chips into the nacho goodness) is ‘very strange and must be a USA thing.”

And the number one Canadian observation that completely baffled us American girls…  milk is bought in plastic bags, not plastic jugs and put into pitchers once at home. (weird huh?)

Although I was excited to return home, to sleep in my own bed, and hug my girls and husband, the five days in Toronto with my PA girls went entirely too fast. Thinking back, so did our time spent in PA school.  The days were long, the tests were difficult, and the stress level was indescribable, but those three years were over within the blink of an eye and sometimes (only sometimes) I wish we were back in PA school. Studying at Panera, sipping gallons of caffeine-filled Mountain Dew, and drawing diagrams to better understand neuropathology, the RAAS system, or the coagulation cascade.  Other days I am beyond grateful not to have to sit through another TBB lecture or type up Clin Med objectives.

But no matter what, I will always be grateful for my PA friends that I obtained through the way.

Nothing compares to a friend who can relate to the frustrations with noncompliant patients, discuss pap smears and the whiff test without gagging, and laugh at your medical-related jokes that are often lost on everyone else.

Nothing else compares.

Physician Assistant

Facing Change and Doing Something

June 2, 2012 by 3 Comments

“The best thing you can do is the right thing; the next best thing you can do is the wrong thing; the worst thing you can do is nothing.”  ~Theodore Roosevelt

Well, that might be fine and dandy for Teddy, but sometimes doing something is absolutely petrifying and doing nothing brings a calm and comfort with it that allows us to prepare, analyze, and occasionally reconsider our plans…at least for a little while.

For the past few months, I’ve resisted change. In fact, if I came face to face with Change in a dark alley, I’d probably run away peeing my pants. The idea of change, actively searching for it, when our lives seemd to finally be sturdy and stable, scared the hell out of me.  I realized I was no longer happy in my current job. No, that’s not exactly true. I was happy, but I wasn’t completely satisifed.  I was working two part-time jobs in fields of medicine that I was passionate about, had amazing co-workers and phenomenal benefits. On the surface, I had the dream career. But underneath it all, it was killing me. Each day as I loaded little jammied bodies into the car or kissed sleepy eyes good-bye as I walked out the door, my heart broke knowing that I would only have two hours with them in the evening, which would be spent making dinner, cleaning the house, and a quick cuddle and bedtime story before saying good-night. I had hoped to have a balanced life with equal parts work and family, but for the last few months I realized, I had a little too much Yin and not enough Yang. And Yang, well… let’s face it, that’s what it’s all about. I desperately wanted to swing the work/motherhood pendulum in the other direction, work a little less, stay home a little more, but fear paralyzed me. I was terrified I would make the wrong decision, and rather than focusing on what could happen if I made the right choice, I let the fear of making the wrong choice immobilize me.

I stayed with the familiar and the well-known. I followed the ebb and flow and pretended like it didn’t affect me as greatly as it actually did. I told myself I would let some of the housework fall to the wayside in order to spend more time with my girls, I would prepare meals a week in advance to eliminate time wasted cooking in the evening, and I would repeatedly give myself the “you-are-doing-what-is-best-for-your-family” pep talk. But the truth was, after Marty went back to work, it became harder and harder to convince myself that this situation was working well for our family. I wanted to be home more with my girls, but I also needed to be home more.  Marty’s schedule has gotten more hectic and unpredictable than ever before and as a result, the children/household responsibilities slowly began to pile onto my shoulders… a weight that became difficult to maintain while managing two part-time jobs. Still, the fear of the unknown made me weary.

“What if Marty is laid off again?”
“Am I crazy to walk away from a job with such great benefits?”
“What if I don’t find a job I like as much as this one?”
“Do I really want to start over at a new office with new staff, new patients, new physicians?”

The “what-if’s” plagued me and nearly drove me out of my mind. Naturally, I did what any fear-of-change-girl would do.

Nothing.

At least at first.

I didn’t actively search for new positions and I didn’t tell anyone I was considering leaving.

But fate (or pure dumb luck) stepped in.  Apparently the universe had decided that this girl wouldn’t do anything on her own and needed a little push heave-ho in the right direction. While helping my best friend search for employment opportunities, I stumbled across an advertisement of a family practice office seeking a part-time or full-time physician assistant. I scanned the posting, thought to myself, “Uh huh, suuuure. That sounds too good to be true,” but electronically submitted my resume anyway. To be honest, I didn’t give the job a second thought until two months later when I received a voice mail asking if I would be interested in coming for an interview. I agreed and planned on another interview in which I walked in, they took one look at me and thought, “Is she even old enough to be a PA?”

As I threw my phone into my purse and scrambled to find an unwrinkled copy of my resume, Marty asked “So, are you nervous?”

I think I surprised us both when I said, “nope. Not in the slightest.”  But then again, I had no reason to be nervous. I didn’t need this job, nor had I really planned on looking for a new position, so why be nervous?

That was until I walked into the office and realized I was going to be interviewed by the office manager, the current part-time nurse practitioner, and three physicians.

Hello intimidation. Welcome back nervousness.

I figetted with my skirt, pretended to skim through my portfolio as my ‘interview committee’ organized themselves and made small talk. I smiled my best I’m-totally-comfortable-and-confident-ask-me-anything smile and prepared to be quizzed on pulmonary hypertension, renal tubular acidosis, or pheochromocytoma, diseases that had completely been deleted from my vocabulary since my PA school days.

“Well, I guess I should start off my saying that we are not professional interviewers, as will soon be apparent by our questions and laid-back demeanor.”

I hope no one noticed, but I’m pretty sure I let out a rather loud sigh of relief.

Over the next 90 minutes, we casually discussed patient demographics, my confidence in managing certain diseases, preventative medicine, and their expectations for this position. I was comfortable and actually enjoying the interview, but a small piece of information continued to nag me throughout the process. Actually, two pieces of information.

Lily and Charley.

I wanted to tell them I was a mother. That at the end of the day, my most important job is to be there for my girls. I wanted to tell them that I planned on having more children, that a maternity leave will likely occur in the future. That I am far from a work-aholic and once my work day is done, it’s done and family time takes over.

But I knew better.

As a woman in the work force, announcing you are a mother, is the kiss of death. In fact, you might as well wear a shirt into the interview that declares, “no matter what, this job will always come second in my life” while carrying a sign that says ‘be prepared for my-kid-has-the-stomach-flu-I-won’t-be-in-today phone calls and I-can’t-work-late-my-kid-has-a-soccer-game excuses’.  Like I said, kiss of death.

Legally, they couldn’t directly ask me if I had children, but I also knew that I didn’t want to accept a position if I hid the fact that I had children waiting at home for their mommy.  As I answered their questions and politely made small talk, I debated in my head whether or not to mention my little girls.

As the interview drew to a close I was asked “You mentioned your flexibility regarding the schedule, but are there any prior commitments that may alter this flexibility?”

Here it was, the moment in which all my forced confidence, pleasant smiles, and well executed answers would be erased by my motherhood status.

“Actually, my daughter is starting pre-school in the fall and I need to be the one to drop her off and pick her up. I hope this won’t be a problem.”

Silence.

The three physicians shared glances as I grimaced and prepared for the worst.

“Problem? Not at all. We are all very family oriented. In fact, I have to leave this interview early so I can make it to my daughter’s baseball game tonight, Dr. B already took off a week in September to ease her daughter into kindergarten, and Dr. S is planning on taking a paternity leave this fall when the adoption is finalized. We can easily change your work schedule to fit with your family needs, that will not be a problem.”

I left that interview feeling like I had found my niche. Could it really be that perfect? Could Change really be exciting and not terrifying?

A week later I was offered the position. Once again, I hemmed and hawed as I analyzed (and over-analyzed) every possible scenario based on if I took the job or if I didn’t take it.  I made a pros and cons list, I discussed the possibilities with my friends and my husband until even I was annoyed with myself. Not so secretly, I wished someone could make the decision for me. Give me a crystal ball and guarantee me that my decision was the right one. But the fact was, I knew in my heart that accepting the position was the correct choice, regardless of the fear that accompanied it. I owed it to myself and to my children to at least try.  Anything else that came with it… well, we will just have to figure that out as it comes. We’ve learned that we can overcome the struggles that life throws at us and the fear of facing those struggles isn’t worth holding back and not fighting for what we truly want and deserve.

It may have taken me several weeks to do so, but I finally realized that if nothing changes, everything stays the same. And staying the same, wasn’t acceptable to me or to my family. And so, our family faces another series of life changes that will likely test our patience and our sanity. But at the end of the day, I think we’ve made the right decision and unlike some of the other changes that have turned our lives upside down in the past two years, I am excited to see where this new journey takes us.

Any decisions you have dreaded making?

Physician Assistant - Stories from the Stethoscope

PA Pet Peeves

November 9, 2011 by 1 Comment

I love my career, really I do. But my plan was always to work part-time as a physician assistant, part time as a stay at home mom. After Marty was laid off last June, I’ve significantly increased my hours and juggle two part-time positions. We all complain about our jobs, it’s only natural. If we didn’t complain about the long hours, impossible to please bosses, nosey co-workers, and demanding clients we would surely explode.

However, yesterday was a horrible work day.  And the worst part was, it was for no particular reason.
My schedule was busy, but managable.
My co-workers were happy and helpful.
My patients weren’t exceptionally difficulty or demanding.

However, yesterday was one of those days. Those days when everything irks you. Every. little. thing.

I went home exhausted and frustrated with medicine and health care overall. And so, today I take a break from posting “mommy” stuff and will vent my frustrations. I apologize in advance… I think this job may be making me a tad bit jaded.

And so, without further ado, my list of my PA Pet Peeves (in no particular order):
**Dedicated to my fellow PA friends who undoubtably can relate to these…**

If you’re over-weight, really over weight, taking off your sandles prior to stepping on the scale isn’t going to make a difference. Trust me.

If you come in for treatment for a bug bite, please do not be annoyed when I can not tell you which insect gave you the itchy red bump. I studied medicine, not entomology.

If you are not on birth control, not using condoms, and are sexually active; according to biology you are trying to get pregnant. Please do not be surprised if you do.

Bodily fluid samples, if needed, will be requested. Please do not bring them in otherwise.

Regarding your appointment: if you are late, you’ll need to wait.

Headache, nausea, vomiting, and diarrhea are side effects, not ‘allergic reactions.’ If you experience one of these after taking a medication, you are not allergic to it.

I don’t know everything, I don’t claim to. But I did study medicine and my degree and license prove that. Please do not demand a certain medication or become angry when I suggest (or don’t suggest) a particular medicine.

This is a medical office, not McDonald’s. There isn’t a drive-thru window and you can’t get everything ‘made to order.’  Please do not call and request an antibiotic or a new medication without making an appointment to be seen by a provider.

It is your responsibility to know your insurance coverage. There is absolutely no way I can know what your insurance covers.

If you don’t remember what medication you are taking, telling me it is a “small, round, and white pill” is of absolutely no help. You wouldn’t tell a police officer that your stolen car is “red with four wheels” would you?

Sometimes, I can’t tell you what is wrong or what your diagnosis is unless we run further labs or tests.

Just because Dr. X wrote you prescription for #120 Xanax, doesn’t mean I will.

Pap smears and complete physical exams are not urgent. You do not need to be seen today. Make an appointment.

If you don’t have insurance, I sympathize, really I do. But it is really hard to feel sorry for you when you are holding a coach purse, an Iphone, wearing Jimmy Choo shoes and complain that the $10 antibiotic is too expensive.

Make sure you have your priorities in order when it comes to spending money on your healthcare. Requesting a prescription refill of your erectile dysfunction medication (which you are bound to pay out of pocket for) and then requesting a sample of your asthma medication is frustrating. One is more important then the other, trust me.

Please do not come and ask to be screened for “all cancers.” There are very few tests to screen for cancer and you may not be at risk for any of them.

Please, please, please do not come to the office for a Pap smear when you are on your period. Enough said.

When I suggest you go to the ER, please go. It is my way of saying, “The symptoms you are describing scare the begeezus out of me and I don’t have the resources to treat you here, so GO!”

Antibiotics do not treat colds or the flu. If you have a runny nose for 2 days, you do not need an antibiotic.

When I ask for your sexual/drug/smoking/pyschiatric history, I am not being nosey. I need to know for medical purposes.

I am human, I dont know eveything, I run late, I take a lunch break, and potty breaks to. Please respect that.

Being rude will get you no where. If you are rude to the office staff/medical assistant/nurse, I will know.

Be honest with the medical assistant/nurse when they ask why you are being seen in the office today.  It is their job to prepare me for the exam. If you say you have an ear infection because you are too embarrassed to tell them you really want STD testing, I won’t be prepared.

When you refuse the flu shot, then come into the office a month later complaining of flu -like symptoms, in the back of my mind I will be thinking “I told you so.”

Honesty is the best policy and if you don’t understand something, ask me.  No question or symptom will embarrass me. Trust me, I’ve heard stranger things.  I would rather you ask me a ‘stupid question’ then to become pregnant because you were taking your birth control vaginally or find out you do have discharge while doing a pap smear but were too embarrassed to mention it before.

When I ask how long you have been having a particular symptom, please be specific. Saying you’ve had the symptom for “awhile, “not too long”, or “for a minute” does not help. Hours, days, weeks are appreciated.