Wednesday, December 17, 2008

Ta Da!

Sometimes you meet a person and you know that your life is forever changed.

Such was the case one year ago when Leonard and I sat next to a gentleman during a flight from Salt Lake City to Portland. Tall, gangly, and in his early 40s, he was one of the friendliest people I had ever met. While discussing the things typically said when new acquaintances are acquired, he responded to my question of "What do you do for a living?" with a long pause. "I work for Boy Scouts of America, a good job. But in my spare time I work as a magician." His eyes twinkled when he spoke that word. He told us of his dream to one day quit his job and work as a magician full-time.

Leonard and I exchanged excited glances. This would not be a boring flight.

I was about to ask another question, when suddenly he flicked his wrist, and a business card came tumbling out of his sleeve. He mumbled an apology, picked it up, and handed it to me. I realized he had intended to produce it out of thin air.

For the rest of the flight he entertained us with interesting discussion about getting into the magic industry, as well as a few magic tricks performed with child-like enthusiasm. My favorite was when he turned a $1 bill into a $5 bill, exclaiming with a sly grin "be sure not to tell the IRS!"

When we finally said our goodbyes, Leonard and I were both sad to see him go. He walked away with a little hop in his step, a man passionate about his use of spare time. Leonard and I thought that was it for our encounter with the magician. However, although magicians are known for making things disappear, this one had a knack for reappearing in our lives.



Last Saturday Leonard and I awoke to my cell phone alarm at 4:30 a.m. and prepared ourselves for our 7:00 a.m. flight from Boise to Salt Lake City. It was going to be a quick weekend trip to be with the George's, as work constraints made it impossible to spend Christmas there this year. While waiting in line to board our flight, Leonard pulled on my arm excitedly. "It's him, it's him!!!" he exclaimed. I looked and saw our magician. He was dressed in a three piece suit, the hem of his pants barely below his skinny ankles, a bright vest covered in overlapping orange and red bunnies under his jacket. He sat with perfect posture, a content grin on his face. He was flanked on either side by teenage boys dressed in dark sweatshirts with uncombed hair and sour expressions, both engrossed in their respective handheld video game devices.

When I addressed him by his stage name, his already large smile increased in breadth, and he glanced quickly to either side to see if his sons had heard. They had, but they barely acknowledged our conversation. He was off to California to perform a magic show for his father's birthday. I was so happy that he was still doing magic, and impressed by his show attire. I excused myself when our boarding number was called.

Leonard and I found our way to our seats and got settled. I nuzzled against his arm while he opened the SkyMiles magazine. We looked at each other with soft, deep expressions for a brief second, the kind of look you give when you know that all is right in the world.

It was going to be a magical weekend.

Monday, November 24, 2008

Four Weeks of Leonard PA-C

It's time I wrote about how Leonard is doing at the clinic.

We work just down the hall from each other. It's nice because I can pull him into a room to consult about an abscess, and he can call my extension and double check the facts of when a blood test needs to be drawn after starting a new medication.

It's nice having someone around who I'm not ashamed to look stupid in front of. Leonard is as important a resource as my palm pilot or my stack of medical books.

Our first two weeks were crazy and frantic, but after a month we're getting more into the swing of things. Here are some highlights of Leonard's first month:

Leonard's stats:
# of patients seen per day: up to 16! Our patient load recently increased.
% of patients that only speak Spanish: 65-70%
Clinics Leonard works at: Nampa Clinic (with me) 3-4 days/week, Caldwell clinic 1-2 days/week
# of patients seen with real insurance (not including Medicaid or Medicare): ~7 total

Funniest presenting symptoms:

-abdominal pain starting in the belly button and spreading outward but only when the patient eats eggs x 3 years
-Bell's palsy (a transient paralysis of one side of the face) in a 17 year old female, which the mom was convinced was because she always held her cell phone on the affected side of her face.

Coolest procedure so far: Toenail removal (Leonard is really good at these)

Most frustrating experience: Trying to convince a gentleman that he needs to go on insulin for his very uncontrolled diabetes. Leonard has seen the man about three times now, and has spent a long time trying to educate the him about his disease and the possible complications, but the man won't budge. Leonard came up with a compromise: The patient is doing a two week trial of aloe vera juice which he is convinced will help. If it doesn't he agrees he'll start the insulin. Leonard can't help but wonder if the next time he'll be seen will be in the hospital after he's admitted for complications from his diabetes.

Proudest moment: Diagnosing a pyogenic granuloma (a benign but weird-looking growth, see below) on a patient's leg just from looking at it. The pathology report just came back, and sure enough, Leonard was right. Thank goodness for dermatology rotations during PA school.


Toughest transition - introducing himself multiple times as "Hi I'm Kyle a PA student...um, used to be a PA student, now I'm a PA, um...what brings you in today?"

Leonard has realized that some patients are not very self aware:
He had a pt come in and while going over her current medications she stated:
"Yes, I'm taking some natural supplements. The three "G's":
Ginseng, Green Tea, and, well there's a third one that they use for memory but I can't remember what it's called." (Leonard and I assume she meant Ginko Biloba). She had no idea how ironic that sounded.


Saturday, November 15, 2008

Leonard the Bully

One of the first things I learned about Leonard when we were dating is that he was a relentless teaser to his siblings. He would relate the stories with strong regret - picking on a pint-sized Louis until he cried, a young Adam calling his mom on vacation because Leonard just wouldn't leave him alone.

"I knew I should stop bugging them...but I couldn't," he once confessed.

I learned very quickly that this wasn't just an older sibling phase.

Leonardism:
It's a lazy Saturday morning - Leonard is eating cereal, my head in his lap. I slowly stretch my arms above my head. Sensing my vulnerability, Leonard swiftly sets his cereal down, and grabs both of my wrists with one hand. With the other he taps his finger on my forehead in quick, successive beats.
"Name 10 fruits," he says.
"I can't Ky, don't!" I protest.
"Name 10 fruits!!!"
"O.k., o.k., um, Strawberry, Plum, Banana, ow!, um, Peach, Apple, Pear..." I trail off, my concentration completely altered by the distracting tapping.
"Four more!!" He says encouragingly.
"Um, um, Raspberry, um, Cantaloupe, Mango, Papaya!"

The tapping stops immediately, and relief washes over me.
"Good job!" he says, and I realize he still has my wrists.

"Now name 10 cereals!"
The tapping quickly picks up again.
"No, no, I can't!"
"Just do it!!!!"
"O.k., O.k."
The subject matter gets more and more difficult. When he wants me to name 10 shampoos I completely refuse.
"O.k., then, name 10 liver diseases and I'll let you go."
No problem, I think.
I fail to realize how difficult it is to access the medical part of my brain with the tapping.
"I can't! I can't concentrate!"
"You can do it Megs, I know you can!"
"O.k., o.k., um, Hepatits A, Hepatitis B, Hepatitis C," (I completely forget about the uncommon Hepatitis D and E), "um, ow!, liver cirrhosis, liver cancer, um,"
Dang it, knowledge! Where are you?
Leonard cuts in, "Intrahepatic cholestasis of pregnancy."
Show off, I think. He has the luxury of uninterrupted concentration.
"Budd Chiari" I respond defensively. "Non-Alcoholic Fatty Liver Disease, um, Hemochromatosis, um, um.." Just one more "Gilbert's Disease!" I shout triumphantly.

The tapping stops, but Leonard doesn't let go of my wrists.
"Now, name 10 Himalayan Prime Ministers" he grins.
I scowl at him and he lets me go. I sit up, rubbing my forehead.

At least I didn't get a noogie or a wedgie this time.

Monday, November 10, 2008

Doris Day Monday

Sometimes our days are meant to be themed.

I wasn't thinking about this concept this morning when I walked into the Boise Antique Mall. I had the day off. My mom met me there and together we walked through row upon row of antique and vintage items. The amount of stuff was overwhelming - old kitchen tools, a black mourning dress from the 1920s, oddly shaped glass figurines, vintage costume jewelry, worn Christmas ornaments, etc. I loved perusing and marveling at a time when women were glamorous and homemaking was an art form that women around the world worked on perfecting daily.

Around noon I received a phone call from Leonard. He'd had a rough morning - he was working in a satellite clinic with limited resources and a few tough cases this morning had put him be
hind. Though he's rarely not in a good mood, I could tell he was still frustrated when I received this text message at 12:42 pm:

I am at the post office and apparently they thought it was a good idea to hire the slowest human being alive.

And then at 12:46 pm:

Seriously this man looks and moves exactly like a sloth
. It's probably the government's way of saving on wages. Minimum wage only applies to humans, not sloths.

I texted Leonard back, telling him it would get better and promised him a delicious dinner when he got home. Mom and I went out to lunch and then to a wallpaper store. Afterward I hurried home and put away my new vintage items:Some magazines from the 40s and 50s - for future sewing inspiration

A pair of big clip-on earrings

This head band/hair accessory thingy

I'll figure out an occasion to wear it.


My favorite find - a wall hanging for the guest bathroom

The clock was ticking. I put on my apron, hummed a cheerful tune, and prepared dinner as efficiently as I could. The menu was going to be a hit: Butternut Squash Soup, Cornbread, and Fruit Salad. I just wanted Leonard to be able to come home, enjoy a hearty meal, forget about his day, and relax. All was going well until:

The bottom of the blender wasn't screwed on correctly as I was smoothing out the second half of the soup, so the entire contents gushed out making a huge mess. The humming stopped. Large beads of sweat appeared on my delicate forehead. One shirt change, three washcloths and numerous paper towels later the mess was cleaned up. Luckily I had enough soup from the first batch.

When Leonard came home I greeted him with a smile and a kiss, wearing my new earrings.


And this is what he saw:


Take that, Doris Day.

Friday, November 07, 2008

My First Two Weeks

Here are some highlights from my first two weeks seeing patients on my own:

My Stats:
# Patients seen daily: 10-13 (this will increase over time)
% Spanish speaking only patients: ~40%
% of patients that are homeless : ~15-20%
% of patients without any insurance: ~80%

First prescription ever given under my own name: Vicodin (hopefully this isn't a trend!)

Weirdest Moment: Getting hit on by a 400lb. toothless man with uncontrolled diabetes.

Most Frustrating Moment: Getting yelled at by the husband of one of my patients. She was new to the clinic and was requesting extreme amounts of pain medication for her chronic back pain. I had run a Board of Pharmacy report which showed that she had been to multiple providers over the course of a few months and had received hundreds of opioids and strong anxiety medication. I wasn't going to give her the medication she was requesting, so she ended up sobbing and he was yelling. At one point I literally had both hands out in front of me, palms facing forward saying things like "we're going to try out some of these other medications first," and "I really think physical therapy would help you" but to no avail. They walked away upset and she didn't show up to her next appointment.

Saddest Moment: Seeing an 8 month old baby for her well baby check, and learning that her 14 year old mom had been feeding her cow's milk as she couldn't afford formula. The baby ended up having iron deficiency anemia. This is a pretty big deal in babies this young, as they can end up with impaired mental development even if the iron deficiency is corrected.

Proudest Moment: Diagnosing a very grumpy 54 year old man with vertigo after he'd been previously diagnosed with a viral stomach infection twice. I gave him some Meclizine, called him the next day, and he was feeling better and sounding much less grumpy.

Coming Soon: Leonard's First Two Weeks

Friday, October 31, 2008

Overexposed

This is what Leonard and I would look like if we were vampires:


Just wanted to make sure you saw something as scary as a Leonardcula today.
Happy Halloween!

Thursday, October 30, 2008

Apple Sunday

On Sunday Tiffany and I canned up a storm.

This time it was 50 lbs of apples. It was tempting to get even more than that. The branches of the trees were sagging with the weight of apples and I knew that what we didn't pick would go to waste.

It was a lot of work and the yield was huge. We ended up with 20 quarts and 9 pints of beautiful cinammony apple pie filling.


That's enough for about 49 apple pies.

Too bad neither of us even likes apple pie.

Wednesday, October 29, 2008

It's About Time

New Hair:

Sunday, October 26, 2008

When Life Gives You Lemons...

I'm not a big fan of portrait studios with their fake backgrounds and posed shots. So when the clinic Leonard and I work for gave us vouchers to a local portrait studio for a headshot to be displayed in the clinic lobby, I wasn't very stoked. I begrudgingly got ready, and Leonard and I rushed to have our pictures taken. These are the pictures the clinic will receive:
Meh.

But here's the best part. The actual portrait packages were for multiple poses, meaning we got to choose what to do with the rest.
The photographer girl wasn't too impressed with our idea of what looked good, but I think you'll agree these next photos are the bomb.

Here's Leonard's idea of "Artsy Halloween:"Pretty cool, right? Then I discovered the prop wall full of creative accessories, stuffed animals, etc.

Here's Fairyland Leonard:


This photo really got me excited, and the creativity just kept coming. I noticed a picture on the wall of a newborn baby whose floppy neck was held upright by a small stuffed teddy bear. I looked at the prop wall, and sure enough, there was a humongous stuffed bear, waiting for Leonard to create his own infantile shot.

It took begging. A lot of begging. And promises of delicious future dinners. And promises that I wouldn't ask him to do anything embarrassing for a long time (although, the word "long" is pretty subjective, isn't it?)


Here is the result:



Once Leonard decided to just go for it, he really got into character. We have an 8x10 of this next one, and they even added a unique border:
This is my favorite one by far. I was crying as he made this pose, I don't think I've laughed this hard since I was a pre-teen:
We even have wallet-size for those of you with brag books:

I have an 11x13 print of this interesting collage photo:

By the time we were through, the photographer chick was happy to see us go. What was going to be a horrible experience turned out to be a blast, with tons of photos as evidence. I owe you Leonard, I owe you big time.

Wednesday, October 22, 2008

Bountiful Harvest

Last weekend we went to a friend's orchard near my parent's home. No one is using any of the apples grown there, so we pretty much have an orchard full or apples all to ourselves.
The sun was setting when we got there. I love Nyssa at dusk.

Leonard and I were lucky to have my kid sister Molly along:Molly (aka Molescule) is a gifted journalist.


She's also my only non-blue-eyed sibling, leading to plenty of adoption stories while growing up.


Molly does a heck of an impersonation of that Newton guy coming up with the Law of Gravity:

After only an hour or so, we ended up with about 90 lbs of apples that my sister in-law Tiffany and I turned into 17 quarts of scrumptious applesauce:

Leonardism:

Tuesday, October 14, 2008

Leonard's Mistress

I've always felt secure in my relationship with Leonard. He's never been the type to follow the silhouette of a beautiful woman with his eyes as she walks by our table at a restaurant (thank goodness). During any given day of rest as I am busying myself with any myriad of tasks, I can usually turn and find Leonard at my heels, simply desiring to be near. The fact that we've gone to school together and now work together is a pretty good indicator that he enjoys spending time with me. Recently, though, this confidence was shaken.

Leonardism:
It was one of the hottest days of the year in Portland this summer. Leonard and I were cuddled up next to our portable air conditioner, trying to cool down. The rest of our apartment outside of this 15 foot radius was stifling and muggy. I turned and looked at Leonard, noting the content look on his face. "What are you
thinking about?" I asked, and then immediately chided myself for the cliche question. "Oh nothing," Leonard replied, placing one arm around me and the other around the air conditioner. "Just layin' here with my girls."

After that conversation we always referred to the air conditioner in the female gender. "Honey, it's warm in here, will yo
u bring her into the living room?" "Sure thing, sweetheart, she'll be there in a moment."

One day I was fixing my hair, frustrated that the air conditioner was constantly blowing at my face. I sighed, annoyed, and turned it off. This caught Leonard's immediate attention. Looking at me fiercly, hands clenched into fists, he hissed under his breath, "You take your filthy hands off of her!" I faked fear, turned the A.C. back on, and giggled, impressed by my husband's exce
ptional acting abilities. The emotion, delivery, it was all so...real.I was excited the day of our move. I had gone through every item we owned, judiciously throwing away some articles while giving some to Goodwill, keeping only what we truly needed. That bulky air conditioner unit was going to be a problem. "I think we should put her on Craigslist," I told Leonard. "Our next place will probably have central air." Leonard's face fell. In barely a whisper he spoke, "But what if we need her?" His beautiful green-blue eyes were distressed, the corners of his mouth downturned. I was taken aback. It reminded me of a child forced to give up his beloved dog. No, it was more than that. The look on his face, the sorrow, exactly what was he conveying? Realization hit me hard: true love, driven asunder.

Friday, October 10, 2008

Just how old is Leonard, anyway?


Leonard is 70 years old:
He chews Doublemint gum

His favorite candy bar is the Salted Nut Roll
He uses Old Spice
He whittles
He eats high fiber cereal

He has a side part


Leonard is 10 years old:

He plays video games
He sleeps on his tummy
He eats peanut butter from the jar
He's shy around strangers
He watches zombie movies
He has a side part

Tuesday, October 07, 2008

No trapper keepers or pencil boxes this time

In the spirit of being forced to take pictures in my first day of school outfit year after year, I made Leonard take a picture with me before our first day of work.

Note the mirror that broke during our move.

For the next two weeks we will be enduring endless orientations on electronic medical records, HIPPA/OSHA, etc. We'll also be spending time with another provider to figure out the flow of the clinic. Then it's time for our own patients. I'm still trying to not hyperventilate when I think about that.

Sunday, October 05, 2008

The Georges: Unplugged

Leonard and I have decided to go without television for awhile. I've noticed time goes by more slowly and that I'm getting more done.

Entertainment can be a dilemma, though.


We've learned to compensate.

camera + colorful dot painting as background + funny fac
es = Minutes (3 at least) of enjoyment
Tomorrow is our first day of work in the real world. We'll see how it goes.

Friday, October 03, 2008

Grape Juice Reality Check

I overheard the wrinkled elderly woman in front of me in the grocery store explaining to her friend her plans of canning grape juice that day. I leaned over to see mason jars and 5 lb. of sugar in her cart.

I waited for a pause, and barged my way into her conversation. I'm making grape juice today as well! It's my first time canning. I smiled smugly, and felt warm fuzzies at the thought of talking homemaking with this probably well seasoned home canner.

That is so nice, dear. I was beaming at this point - proud to be part of the club of self-reliant women. She continued with her conversation, explaining her simple way of making grape juice in only one step - juicing the grapes in a special double boiler and placing the juice in hot jars leading to an immediate seal.
My zeal was replaced by suspicion. Only one step? There's sure to be plenty of silt! I thought. And no processing time to ensure sterility? Tsk tsk.
When I told her I was doing it the old fashioned way, she was surprised. That's going to take quite a bit of time, she said, years of canning wisdom rampant in her eyes.
I didn't mind, I'd done the research. My recipe had been known to win first prize ribbons at fairs across the nation.
For two days I washed, mashed, and cooked grapes. I strained pulp through cheesecloth and again through coffee filters. I processed at the exact temperature for the appropriate amount of time.
In the end I had 12 perfectly sealed jars of beautiful concentrated grape juice (with a little too much headspace). The juice was clear and flavorful - and not one grain of silt!

But I'll never get those hours of my life back.

Thursday, October 02, 2008

Leonard of the Caribbean

Here are some photos of our recent cruise in the Caribbean:

the Georges on the ship


green - it was everywhere


there was a lot of snorkeling



even with turtles!




there was also plenty of relaxing


Mmmm...St. John was my favorite island



my beautiful mother in-law



soaked after a walk in the rain forest



Ronnie Sue - this poor man took a lot of teasing



Mandy, Irene, and Zach



one of the top 10 most beautiful beaches in the world


one of the top 10 most snuggliest hugs in the world