You're Fired

I had no idea I would have so many people irritated with me when I went into medicine.  I thought I was going to be helping people and they would be happy for the help.  Most people are happy, but there are always those select few who cause trouble.  For whatever reason it seems like this week has been one incident after another where people are mad or upset.

First off I had the typical person get mad at me because I didn't want to give her antibiotics.  Three days of cold symptoms with no exam findings suggestive of an acute bacterial infection does not qualify someone for antibiotics in my book.  Despite explaining my reasoning she was still visibly upset.  Often it is hard to rationalize with someone who is irrational.

I sent out two letters this week terminating my physician-patient relationship due to frequent no-show appointments.  I have never in my life missed an appointment without calling to cancel.  Not once.  One of these patients managed to miss three appointments in two days.  It's not that difficult to pick up the phone and call.  I can understand things happening and not being able to call once, but not 4 times.

Then the icing on the cake happened today.  I had a patient no-show an appointment yesterday (a separate patient from the two discussed above).  Apparently she called the office 90 minutes after her appointment time to reschedule and was told that her earlier appointment would be marked as a no-show.  This made her mad, though I'm not sure why.  You can't just call at any time after your appointment and reschedule.  It doesn't work that way.  You have to call before the appointment.  At any rate, I saw her the next day and she wanted to spend the entire appointment complaining about the no show.  First she said her transportation didn't work out.  Then she said she over slept (the appointment was in the middle of the afternoon and she's an adult, mind you).  At this point I interrupted and said she could have called regarding the transportation and oversleeping is not an acceptable excuse for missing an appointment.  It is unbelievable to me that someone can do something wrong and still want to turn the tables and make it seem like we're the bad people.  Then again, I've found that most adults are not very responsible people.  My 13 year old sister is more responsible than the average adult.

This has been my week and it has been a joy.  Hopefully Friday goes smoothly and I can enjoy a non-stressful weekend.

A Friendly Reminder That This Is Allergy Season

Being in primary care is somewhat frustrating during this time of year because we get bombarded with people who have three days of symptoms likely caused by allergies (congestion, runny nose, sore throat, cough) and no real signs of an acute sinus infection (focal pain in one sinus, gum pain, fevers).  It's possible that some people have viral sinus infections but still, after just a few days of symptoms and no strong signs of an acute bacterial infection, antibiotics are not warranted.  It's amazing to me how easily people forget what these symptoms are like despite having similar symptoms year after year during the spring.  There has been a noticeable increase in the number of visits to the office with this type of stuff and I don't think it's because there is a raging bacteria out there infecting everyone's sinuses.  I explain this to people and most are accepting of it but some leave upset, usually spouting off something about needing to get better now so they can return to work.  This comment ranks up there with some of my other favorites, such as "I don't get fevers when I'm sick" or "My temperature usually runs low so 98.8 degrees is high for me" or "I had a fever but I didn't check my temperature."  I've sent the Man upstairs a message about treatments to resolve symptoms immediately.  Thus far I haven't had a response.

Terrible Announcing

This is a great time of the year for sports.  Baseball and racing seasons are beginning after long off seasons, and NBA and hockey playoffs are underway.  Admittedly I am much less interested in the basketball playoffs this year as the Pacers are sitting at home, but I am still tuning in a bit in-between Cards games and hockey.  Every sport has its share of bad announcers, but basketball (both college and pro) has by far the most.  There are far too many former players announcing games these days that quite frankly just are not any good.  This is unfortunate because it makes the games almost unwatchable.  Reggie Miller is a prime example.  Reggie, who as a Pacers fan, I loved as a player, is not a very good announcer.  This all came to the surface this afternoon when I was discussing with a co-worker how much better hockey announcers are compared to basketball announcers.  Then I came across this post on Durden, with the following video.



Imagine having to listen to this and similar commentary for an entire game.  I think I would rather watch April baseball.

Update On Spring 2015 Outdoor Projects

With the spring season here our annual spring outdoor projects have begun.  It's hard to believe this will be the third summer we've been in our house.  The first spring we were busy moving in and getting settled, and last spring we were busy with two infants.  Obviously we're still busy with the kids but this year is setting up to be the most productive season yet.  As the kids get a bit older it becomes a little easier (with planned coordination), especially if we can get help from my parents.

Thus far, I was able to get our outdoor lights working with help from a friend, so that project is finished unless I decide to add more lights in the future.  This is something I might do once we work on our landscaping situation some more.  We started this project last year by bringing in new mulch and removing a large tree that had died and a large bush that we thought was too large for the area.  This year, Sarah and Auntie have been working hard coordinating a plan to advance our front landscaping.  After much discussion I think they've been able to come up with a plan that hopefully we can put into effect in the upcoming weeks.  Additionally, we were able to get some outdoor furniture for our sunroom as well this year.

Lastly, I placed crab grass killer and early grass feed on the yard a few weeks ago.  I've noticed some dandelions appear over the past week so I am planning on spraying a broad leaf herbicide on the yard in the near future.  However, due to work requirements, kid requirements, and frequent rain that interferes with the few available times I have to mow the lawn, we've decided to have a service mow it for me during the spring and early summer seasons.  I'll likely take over after that.  Part of me feels defeated as the yard is supposed to be my domain, but the reality is that there is only so much time in the week to divide all responsibilities.  I will say, the yard looks much, much nicer this year compared to last spring.  Much fuller, greener, and less weeds.

My goal is to have these projects finished before Memorial day weekend when I have the race crew over.  Historically over the past two years we were mostly able to finish our spring projects by then.  I've already begun thinking of projects for upcoming years, including updating our backyard landscaping and enlarging our patio in the backyard.  There is always something that could be done.  I try not to let things drive me crazy and take the projects one season at a time.

Firefox, You're On Probation

I first discovered Firefox over ten years ago while doing my computer science training in Linux systems and I've been using it ever since.  I found it to be fast and innovative and have even donated to the Mozilla foundation in the form of buying a T-shirt.

Just like many other large companies, the company I work for uses a shockingly old version of Internet Explorer as the default browser.  So old, in fact, that some versions they use don't even have tabbed browsing, a feature that has been available for at least 10 years.  Internet Explorer is admittedly better than it used to be, but using an old version in today's internet environment is brutal.  I have 3-4 computers that I use frequently at work and have downloaded Firefox on all of them to use as the primary browser.  Then a couple of weeks ago an annoying thing happened.  Every search on a secure site (including Google, UpToDate, and many others) started giving me security certificate warnings.  I could bypass the warning but that requires a handful of clicks, which becomes quite bothersome after awhile.  I assumed this had to do with network settings at work because I've never had this issue at home.  I refuse to use an old version of IE, so I downloaded Chrome as a substitute.  This is the first time I've ever used Chrome, and it is freaky fast, to borrow Jimmy John's line.  It is noticeably quicker than Firefox.  An adequate substitute, to say the least.

I've been using Mac OS full time since October and have been using Firefox since day one without any trouble.  Then a couple of weeks ago my browser started to get quite sluggish.  Some sights would scroll slowly, some sights would never stop loading, some sites would respond to keyboard input slowly, and others would cause temporary lock-ups.  I restarted the browser which seemed to fix things, but only temporarily.  I ran a diagnostic check which came back OK.  I'm not sure what happened (OS change? Flash update? etc.) but the bottom line is that browsing has become somewhat frustrating.  Then I did what would have been unthinkable for me in the past - I downloaded Chrome for my Mac.  I haven't switched, but it is ready to go if I decide to switch.  I'm really hoping something happens to fix the problem - an update or something.  But if things don't correct, I might be forced to jump ship.

EDIT: Interestingly, as I was putting the finishing touches on this post I found this story which may be related to my issues at work.