Thursday, July 9, 2009

Grumpy Summer Vacation, Day 2

Breakfast at Residence Inn. I love the smell of Diet Coke and artificially processed waffle-flavored batter in the morning.

Today we went to Legoland. It should be noted here that today’s post is not as funny as you might expect. At some point at Legoland your kids wander into an area where they can sit and play with Legos and Duplos (which they want to do for hours), and you suddenly realize you just took out a 2nd mortgage to pay for them to play with Legos and Duplos at Legoland, which they can do at your house FOR FREE. And that ain’t funny.

Driving there we discovered my son Craig is under the impression that any car with an “Obama” bumper sticker is actually the one that the President is riding in at that moment. Since a lot of cars still have them on, Craig is now wondering why the C-in-C is following us all over California. [Please note- this paragraph was written to show childhood silliness, and is not meant to express either a red or blue viewpoint. I do not want this blog to be a political war zone, and political comments from either side will not be published.]

I left Legoland’s address in our room, but our Garmin GPS gadget has an entry for “Legoland”. I punched that in (hoping that it wouldn’t take us to Legoland Denmark). For mysterious reasons it took us to the delivery entrance. So here we are, in a mini-van, in a line of delivery trucks and other Garmin using mini-vans, trying to find our way to the regular parking lot. While the kids went nuts because they could see Legoland over the fence, and couldn’t figure out why we weren’t getting out of the car and going in. By the time we got in to the park my parents had fallen asleep on a bench at the entrance while waiting for us.

I was in line for the Dragon rollercoaster when my cell phone rings. It’s Mary back at my office. Dr. Unka, a cardiologist in my town, is looking for me. So I called him back.

Dr. Grumpy: “Hi Unka, this is Ibee Grumpy.”

Dr. Unka: “Ibee, one of my patients had a stroke this morning. He’s over at the hospital, and I need you to consult on him.”

Dr. Grumpy: “Thanks, Unka, but I’m at Legoland”.

Dr. Unka: “Is that at the mall?”

Dr. Grumpy: “No, it’s in San Diego.”

Dr. Unka: “So when will you get here to see him?”

Dr. Grumpy: “I’m on vacation.”

Dr. Unka: “Well, he’s had a stroke. Couldn’t you just fly home for a few hours to take care of this?”

Dr. Grumpy: “Unka, I’m not going to take a day off my trip to see a consult. Why don’t you call the neurologist on call?”

Dr. Unka: “I don’t trust him.”

Dr. Grumpy: “I’m flattered, Unka, but I can’t come back for 1 patient.”

Dr. Unka: “Okay, I’ll keep him at the hospital until you get back.”


I love Legoland. It gives a parent hope. Some days you think your kid will never grow up to find a job he’s capable of, and here there’s a park built entirely out of Legos, some of it quite remarkable, and you realize that maybe this is something your child can do. I know mine can spend all day building stuff with Legos, then losing them in the sofa cushions. So why can't they do this for a living?

(click to enlarge)




Mrs. Grumpy brought the kids a snack consisting of crackers and 2 flavors of instant spray-on cheese. They ate the crackers and had a fight with the spray-on cheese (like it was silly string) while standing in line for “Captain Cranky’s Challenge”, showering other riders with artificial dairy products. I dragged them out of line to keep other happy families from killing them, and put them on a water ride to hose down.

While dragging them off for something more substantial, I was in line behind 2 obese women who were talking about the food at Legoland, and how much they liked that it was healthy. In particular the fact that they had apple fries at one place (deep fried apple slices, served with a side of heavy cream), and they thought that was a form of health food. If you consider that healthy, I can see why you are the size of a bus.

If your kids like Splash Mountain, DO NOT take them on the log ride at Legoland. It has to be the wimpiest log ride, ever. It is never a good sign when the log ride can only have 3 logs going at a time.

They have a ride called Bionicle Blasters. This is a tamer version of the Disney teacups. But my kids, always interested in any ride that might make me nauseas and vomit in public, got me on board. It was a windy afternoon, and the ride wasn't too bad until a large hairy animal suddenly flew into our car. My horror was replaced by shock when I looked up and realized that it was the hairpiece belonging to a sheepish appearing bald man in the car next to ours.

I took the kids on the Legoland mini-golf course. Never a good idea with Marie (for those of you who aren’t aware of her golfing skills, read the last 2 paragraphs of this post). On the 5th hole she teed off like she was trying to hit the ball to Catalina, narrowly missing a pregnant lady and knocking a chunk off the claw of a Lego statue of a grizzly bear. I put the chunk back in place and returned to the game. And carefully helped Marie swing on future holes.

After our exciting day at Legoland, my Dad wanted to take the family to a nearby Italian restaurant. It was in a strip mall, and had a sign in the window that said "We Make Our Own Sausage". This is not normally a big deal, but the next business over in the strip mall was an animal hospital. I suggested going to Costco for pizza, but got voted down. But I still didn’t try the sausage.

After dinner we went back to Legoland, only to find it had closed for the night. That’s early for an amusement park. I can only assume that it was past bedtime for the guys who build the big Lego stuff.

Our attempts to read and relax back at the hotel were shattered (along with a glass candy jar) when a swordfight broke out in our room.





And that’s the way it is.

Wednesday, July 8, 2009

Grumpy Summer Vacation, Day 1

We met my parents in San Diego this year. They’re staying at a Residence Inn, but Mrs. Grumpy had made reservations for us at a different place miles away. The clerk she booked it with told her it was in a "safe, family, neighborhood".

When we got here after a long 2-day drive it was nice to learn that local families felt safe in a hotel that was bordered on one side by Les Titties Gentleman's Club and on the other by the Vick Hubcap Emporium and Doberman Stables. It was also reassuring, when we pulled through the barbed wire automatic gate, that the hotel was patrolled by an armed ex-convict walking a Rottweiler around the parking lot, and there was a line of couples at the check-in desk who looked like they were only planning on using the room for 30 minutes at most. The clerk reminded me of Pee-Wee Herman's character in "Cheech and Chong's Next Movie".

Mrs. Grumpy, concerned our children might be allergic to Rottweiler teeth, immediately called my parents and begged them to find us a room at their hotel, explaining that I wasn't comfortable with the pleasant looking place she'd picked out (LIAR!). Fortunately, there was plenty of space there.

We went over to that hotel. My mother was waiting for us by the curb, and had thoughtfully brought a large metal luggage cart out for us. We loaded it up with all the junk a family of 5 travels with: clothes, extra clothes, clothes I've never seen before in my life but magically appeared in our trunk during the drive, hangers, Nintendo DS, DS games, DVD movies to make them watch (at gunpoint if needed), a portable DVD player, Lunchables, Uncrustables, Inedibles, magazines, books, coloring books, puzzle books, stuffed animals, medicines, suntan lotion (3 strengths), 2 cell phones (with both car and wall chargers), bags of toiletries, snacks, 12-packs of Diet Coke, coupon books, hats, sunglasses, pool toys, sand toys, hotel room toys, crayons, pencils, paper, juice boxes, a roll of film (WTF? we only have digital cameras!), my faithful laptop, AA batteries, AAA batteries, batteries of a type not seen since Edison made them, books, cameras, glue, tape, and other assorted items Mrs. Grumpy felt was essential. By the time we were finished the luggage cart was sagging in the middle and looked like it was on the verge of collapse. And so while Mrs. Grumpy led the kids off I went to pull the cart up to the room.

After dragging it around the parking lot looking for a ramp a few times, I asked my mom how she'd gotten it off the sidewalk. She said she hadn't seen a ramp, and had just pulled it down. This was easy when the cart was empty. But it wasn't now. And I'd be damned if I'd unload it, push it up on the sidewalk, and reload it. So off I went on a 12 mile hike pushing the Grumpy Expedition 2009 luggage down onto a local street, around a restaurant in front of the hotel, and finally up a ramp in the handicapped space on the far side of the building. And of course the place's only elevator was located on the other side of the hotel, back near our parking space. By the time I found our room I was half expecting to see my picture on a milk carton (“last seen pushing a luggage cart with possibly stolen goods”).

I staggered into the room, covered in sweat and desperately needing to pee. The clan looked at me with their best "where the hell did you go with the luggage" glares. It was hot in the room, and Mrs. Grumpy was over in the corner fighting with the air conditioning unit. It only had a power button, but nothing to control temperature, and was blowing warm air. So while I gratefully stumbled into the bathroom, she called maintenance.

They sent up a guy who showed us the temperature control, which was in a large wall-mounted box, marked "TEMPERATURE CONTROL" positioned in plain site that we’d somehow missed, or thought was a piece of abstract art, or something. We were idiots. He didn't tell us that. But you could tell he wanted to. I know the look. I give it to my stupider patients all the time. I'm sure tonight I'll be posted on his blog "Grumpy Maintenance Guy".

After such an exciting day we took the kids out for a deluxe dinner at McD’s. We pulled into the drive-thru. It was awesome. We heard this:

Mrs Grumpy: "We'd like 3 chicken chunk happy meals".

Male voice on speaker: "Okay, that's 3 chicken happy meals and what did you...” (cell phone ring noise) “Hello? Hey bitch! I'm at work! Don’t call me here! You think I got nothing better to do than listen to you yap!” (coworker's voice in background) “Hey! Keep your ugly nose out of my business and go flip some burgers or something! Sorry ma'am, what did you want to drink with those happy meals?"

Good night, Colonel Kurtz, wherever you are.

Tuesday, July 7, 2009

Heart of Darkness

There are some journeys in life that we try not to discuss.

They can be so dark, so disturbing, so frightening, that even the bravest of adults don’t want to talk about them. When forced to do so we use hushed voices, as if silence will protect us, to no avail. Only once, in 1983, has a movie adequately portrayed the horror of one such journey.

And we face the most dreaded journey of all at this time. And it’s the Grumpy family’s turn to address it.

The time has come to confront our worst fears and begin.

It’s Summer vacation.


Tough Choices

For those of you who don't know, an EMG/NCS is an unpleasant neurological test we do. It's to determine nerve and muscle function, and involves running electrical shocks through limbs, then sticking needles into various muscle groups. It's not horrible, but not fun, either. But it gives us a lot of useful information.

Anyway, a guy called in today to schedule one. His internist had ordered it.

My secretary explained the procedure to him, needles, shocks, blood, gore, etc. He didn't really care, but had very specific dates and times he could come for the study.

As the conversation went on it turned out that the dates and times he wanted the study done coincided with when his Mother-in-law would be at his house, and he felt the EMG/NCS was preferable to seeing her.

Another Fine Patient Quote

"I've had a rash for 15 years. It's everywhere. I mean, nobody can see it, because it's invisible. Sometimes I can see it, but doctors can't. But it's still a really bad rash. Like poison ivy, if that were invisible."

Today's Brainteaser

Today's guessing game was supplied by Mr. Mystery Patient, who called at 11:25 last night:

"Hello, mumble gargle patient of Dr. Grumpy's cough sneeze in my briefcase snap crackle pop pain medicine garble static mumble so I'll just call back in the morning."

Monday, July 6, 2009

More Allergy Fun

Today's patient quote:

"I once had a rash from Sulfa, so now I have to avoid all other Aspirin products."

Sunday, July 5, 2009

Clarifying My Position

In the heat of being pissed over the FDA panels recommendations on Acetaminophen, I didn't really clarify my position, and so got all kinds of comments and email from both sides of the aisle.

To summarize my worthless viewpoints:

1. I stand by my point about regulating cars, pools, alcohol, and tobacco. The bottom line is that no amount of guidance, laws, and regulations will EVER protect people from their own stupidity and misuse (intentional or unintentional) of ANYTHING! People such as The Angry Pharmacist's "Cracky McCrackhead Addict" will continue to do whatever the hell they want.

2. I have no problem with regulating Acetaminophen (or APAP for short) to smaller doses and/or cutting out the combo meds. I'm not sure the APAP component really does much compared to the narc, and it falsely gives the impression these drugs are less addictive.

I understand the risks of hepatic toxicity (and, from a more practical viewpoint, rebound headaches), and have counseled patients about this for years. APAP is in a HUGE number of both OTC and prescription drugs, where it's existence isn't well listed. Many of these are "me too" crap, where the public buys them without reading the ingredients, and ends up unintentionally taking too much APAP. Getting half of this junk off the shelves would be nice.

3. Pain is a serious issue. Especially for people who are suffering from terminal illness. None of us want to die in misery. In a perfect world we wouldn't need pain medications. But we don't live in one.

And that's all, folks!

I'm Going to Throttle My Children

Our house was originally built in 1993. For no apparent reason the kitchen had a ledge put about 12 feet up on the walls. Since no one can see or reach up there, I assume it hasn't been dusted since it was first installed.

After getting back from the Independence Day Carnival at damn near midnight, and our kids waking us up at 5:30 this morning beating each other up over whether to watch Nick or Cartoon Network, Mrs. Grumpy and I really needed a nap.

When I woke after a very deep 2 hours, I discovered it had snowed dust bunnies in our kitchen. All over the floor, counters, sink, stove.

Apparently, while we were dozing, the Junior Legion of Home Terrorists began launching balloon rockets in the kitchen.

One of them didn't come down. So they assumed it was on one of these ledges. They got a ladder and climbed up, and with a broom swept 16 years of dust bunnies, spider webs, dead bugs, dog hair (how the hell does dog hair get up there, anyway?), and heaven knows what else, all over the kitchen.

The missing rocket, for the record, was lying in the hallway the whole time.

Stupid People At Large

Yesterday we went to an outdoor Independence Day carnival. At some point I wandered over to the snack bar and heard this great conversation:

Woman in line: "Do you have bottled water?"

Clerk: "Yes, we do."

Woman in line "What kind is it?"

Clerk: "Uh, the wet kind."

Friday, July 3, 2009

More Phone Calls

My office is closed today for the holiday, so my message says "Hi, my office is closed today for the Independence Day Holiday."

It's amazing how many people who call in feel this is something they need to leave a pointless message about (without a name or phone number, of course). So far today I've gotten:

"Oh, I forgot it was a holiday this weekend."

"I guess you're closed today."

"My regular doctor is closed, too".

"It's hot today"

"What time today will you be opening?"

"Since you're closed I'll call back next week."

"Are you completely closed? Or are you seeing patients today?"

Say That Again?

Working my way through some data research surveys about up-and-coming products. What do you guys think of this quote from one:

"Product M is not statistically non-inferior to Oxycodone in both relief and non-relief of pain".

Thursday, July 2, 2009

An AWESOME Drug Rep

Oh, this was just a TERRIFIC way to end the work day. I couldn't have asked for something better.

Mrs. Grumpy had a meeting tonight, so I had to feed the kids. Fortunately for me, a Big Pharma, Inc. drug rep brought lunch today to the office, and there were a lot of leftovers.

So as I was leaving this afternoon I grabbed a big bag out of the cabinet (with the Big Pharma, Inc. logo on it), tossed the leftovers into it, and headed out.

As I was passing a cardiologist's office on my way to the elevator, a pretty female rep I'd never seen before, wearing a Big Pharma, Inc. name tag, came out of his office. We made eye contact, and I nodded, smiled, and continued on my way.

Only to be stopped after another few steps by her saying loudly, "Oh MY GOD! What are you doing?"

I turned around to find Ms. Prettyrep looking at me, horrified, with her jaw agape. "Excuse me?" I said.

Ms. Prettyrep: "Are you taking food from a doctor's office?"

Dr. Grumpy: "Um, yeah, is that okay?"

Ms. Prettyrep: "NO! It's rude! It's unacceptable and inappropriate! And look at the way you're dressed!" (I tend to be on the casual side) "No name tag!. What are the corporate people teaching you new reps, anyway?"

Before I could answer she went on: "I'm sorry. I suppose this isn't your fault. The training people must be slacking off." She offered me her hand. "You must be new. I'm Stacey, from our cardiology marketing division here".

I shook her hand. "I'm Dr. Grumpy, from the neurology division down the hall."

Stacey from the cardiology marketing division looked even more horrified now then she had a minute ago. After a few stuttering attempts at saying something she answered her cell phone (which hadn't rung), mumbled "nice to meet you" and ran into the stairwell.

Tips for Patients

When asked "What brings you to see me?" the following answers are NOT acceptable, helpful, or desired:

1: "A car" (or bike, bus, or other method of transportation).

2: "My PCP said I should see you."

3: "My daughter drove me."

4. "The hospital sent me."

5. "My medical problems"

6. "The guy at the grocery store told me I should see a neurologist"

7. "Your name is on the referral".

8. "What kind of doctor are you?"

9: "I need a refill on the white pills with numbers on them"

10. "You were on my insurance plan."
 
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