This is what I do all day.

This may or may not interest you. Most of you know I type dictated medical reports day after day in hopes of becoming good enough at it to earn some money from home. It's not easy. In fact, it's pretty difficult a lot of the time to understand what the doctor is saying. Some of them are brainless and dictate with food in their mouthes, or let the phone ring right in the recorder without bothering to stop talking. I can only guess at what they are saying when they do this. Some of them talk at the speed of an auctioneer, and others like to cut off the ends of their words. Anyway, I copied and pasted one of the reports I did so you can all see the stuff I do. This was actually a fairly easy one. I'm sure you've never seen a medical report, so maybe this is interesting. Or maybe not. It's a slow blog day. The blanks are names or dates and are left confidentiality purposes.



Rheumatology progress note.

LIST OF PROBLEMS:
1. Rheumatoid arthritis.
2. Emphysema.

MEDICATIONS: Methotrexate 10 mg per week on Monday, prednisone 5 mg daily, Nasacort, Zantac 150 mg b.i.d., Tylenol p.r.n., Paxil 20 mg per day.

LABORABORY DATA:___: Creatinine 1.4, albumin 4.2, AST 25, ALT 15, CBC unremarkable, sedimentation rates 51.

Chest x-ray shows moderate diffuse emphysema. Today’s patient has no complaints in regard to his arthritis. When he saw me 6 weeks ago he had a flare of his RA. His methotrexate was increased from 7.5 to 10 mg per week. His prednisone was increased from 3 mg to 10 mg per day for 5 days. The patient today states that his RA is doing well. He has no complaints of swelling. He denies any shortness of breath, chest pain, fevers, or chills while on methotrexate.

Starting yesterday he has developed a dry cough along with myalgias and congestion-type symptoms of his head and nose. He took his methotrexate Monday. He denies any nausea, vomiting, or diarrhea.

PHYSICAL EXAMINATION: There are no oral ulcers. The lungs are clear with no wheezing or crackles. Heart: Regular rate and rhythm. There is essentially no synovitis on examination today. There are no vasculitic lesions or rashes.

IMPRESSION:
1. Rheumatoid arthritis. He is stable on his current medications.
2. Because methotrexate can induce a cough and even a pneumonitis, I told him not to take methotrexate next week. It told him I will give him Sudafed for his postnasal drip and congestion symptoms. I told him if his symptoms should worsen or if he gets short of breath, cough worsens, or should he develops a fever, see his closest physician as soon as possible.
3. I will obtain a CBC panel and a liver panel today to monitor methotrexate toxicity.
4. Because of his chronic obstructive pulmonary disease by history, I will obtain baseline pulmonary function tests as well. He will follow up in two weeks for reevaluation.

Vent

How is it that eating healthier = higher grocery bill? I can't win.

Jade's gift to me.

She LOVED this part! (It IS the best!)

The color she picked is called "baby pink".

My turn!

She is the best. She wanted me to have an authentic pedi, so she insisted on rubbing my feet.

All done! She really wanted to paint my toes too, but the carpet was too light and the paint too red, so I did it myself. Not nearly as good as the professionals, oh well.

When Jade heard all about Jared's tea party, her little heart was broken. She didn't have anything to give me or sing to me, and it just devastated her - so of course that devastated me! I promised her we'd get pedicures on Mother's Day together, and that can be her gift to me (she doesn't know any better, really). I decided to fore go the trip to the salon and save the $40. I have a foot soaker here, and I thought it would be fun to do it at home instead. We took a little trip to Walmart and we each picked out a polish. She was so excited she dragged the foot bath out of my closet and found a sponge under the sink and cleaned all the dust out for us. She's such a sweetheart! We had such a great time with out pedicures. What a great Mother's Day I had!

P.S. Happy Mother's Day to my grandmothers! I'm sorry I didn't call, time snuck up on me and it's already after 9pm! Calls tomorrow.

Catching up.

Jade and Luke are good friends. Luke is Jared's den leader's boy, and he's the same age as Jade. She wouldn't DARE touch those worms, but she sure loved watching Luke play with them.

Jade likes to get in on the action too.

I couldn't get too many shots of Jared. He and Doug moved all over the lake trying to get a bite. The sun was just about to go down, and once it did, more fish were caught.

There were a few things that happened over the course of the weeks my computer was down. One of them was Jared's cub scout pack Fishing Derby a few weeks ago. As many of you know, our park has a catch and release lake, and that's where we all congregated. Doug has invested in this "Banjo Minnow" bait he saw in an infomercial, so we tried it out that day. Well, THEY tried it out. I don't fish. It's kind of boring to me, unless you go at the right time when the sun is down and the breeze picks up. Then it's really relaxing. Still, I'm good with a drink and a book. Anyway, this pack activity was to prepare the boys for the camping trip we went on last weekend. I'm hoping one of the moms will post pics and I can get those from her to show you all. Doug and Jared didn't catch anything (so much for the Banjo Minnow crap), but other kids did. They used bait like hot dogs and white bread. Figures. Still, it was good times!

Mother's Day Tea.

Jared is bringing me tea.

Jared handed me a rose after he sang to me.

Here is the plate Jared fixed for me.

He's in the very back in the blue shirt, singing directly to me!

I just came back from the neatest little tea party Jared's class put on for us. We all got invitations about two weeks ago, to attend Mother's Day tea time in Jared's classroom at 10:30. My friend Jaime down the street did me a favor by watching Jade so I could have Jared all to myself. When I walked in his class, he was so excited to see me! He grabbed me by the hand and said "THERE you are, FINALLY!" and pulled me to his desk. I sat down with the other mothers where a personalized place mat and bookmark adorned each place setting. Jared drew a picture of me on my placemat with red flowers in my hair. When all the mothers were seated, the kids took their places at the front of the class and sang to us. One of the songs was titled "You are my mother"and was sung to the tune of "You are my sunshine".

You are my mother, my important mother.

You make me happy when I feel blue. But, remember, if I disobey you,

Just please don't take my scooter away!

You are my mother, my important mother,

You make me happy when I feel blue.

I think you're special, and I love you!

So, I have this flower for you!

You are my mother, my important mother.

You make me happy when I feel blue.

I think you're pretty,

and I have some muffins for you.

You are my mother, my important mother.

You make me happy when I feel blue.

I want to tell you how much I love you,

So please enjoy your Day!

Happy Mother's Day!

At one point during the song, I moved to get a better picture. Jared lost sight of me for a second, and I could see his eyes searching for me. I waved to him, and once he spotted me he never took his eyes off me. He was singing those words directly to me, and I'm a little embarrassed to say I got a little teary-eyed.

After the song, we were all served muffins, strawberries, iced tea, lemonade, cheese, and crackers. It was so yummy! I could tell Jared was really hungry so I shared my plate with him. He leaned in close to me and I put my arm around him, and we ate together. After everything was over, Jared really didn't want me to leave until he saw it was almost lunchtime! So, I did finally leave. It really was the sweetest thing ever. I'll never forget our tea time together!