So, Kris is 36 weeks now. At her last OB checkup, she's already 2 cm dilated, ang 50% effaced. Uh oh. Getting close.

And so, I was naturally anxious when I saw M's name on my patient list today. She was my 10:30AM appointment, follow up of her prolactinoma.

When she walked into clinic, the first thing I said was, "I hope you're not going to bring me trouble..."

It was two years ago when I saw her for an 8:00AM appointment, when I got the call from my wife: I'm in labor, get your butt here.

And so, seeing her again today with us being so close to our due date, made me ansy. I carried my cellphone in my breast pocket, in case my wife called me again.

But no, thankfully, I did not get any urgent phonecalls. And as I sent M away and showed her the door, we both breathed a sigh of relief. She giggled as she wished me luck.

Another 4 weeks? I'll be surprised if we can last 2.

Fraud

One of the things all docs dislike is the paperwork. It's a necessary evil; prescriptions, letters of medical necessity.

Of late though I think we're all seeing increasing cases of Medicare fraud. Or so I think. If they qualify, Medicare pays for their diabetic supplies. The glucometer, ever-so-expensive strips, lancets and all. Up to 3 tests a day for insulin users, more if necessary. And often, these things are obtained not directly from the pharmacy, but from 3rd party suppliers that are out-of-state.

Curiously enough in the last 6 months our clinic has seen more and more prescriptions from these companies, stating that our patient has requested to get supplies from them. Even more suspicious is getting 3-6 requests from different companies for our signature, for the SAME supplies, on the SAME patient. And some didn't even make sense- devices like back supports, heating pads. Things that have little to do with their diabetes.

And so sometime ago, on a hunch I began to call some patients up, asking if they really are wanting XXX supplies from YYY company. And invariably the answer is "No, I've never even heard of them", or "No I didn't ask for it, but they've been calling and bugging me".

Perchance these are honest clerical errors. But the pessimistic me thinks this is merely greedy companies trying to drain Medicare funds even more, probably contributing in a big way to medical expense here.

It's a matter I've reported to the administrators, but these faxes keep coming, and it's maddening. Human greed.

But, if nothing else, there is a silver lining to this. On a bad day when I feel that I need to vent, I've been known to call these suppliers, speak to the 'person in charge' and give them a piece of my mind. I've caught a few of them blatantly lying, like "We called Mr. X on this day" then in fact the patient denied vehemently talking to anyone. And sometimes threats of reporting them to the Medical Board quickly gets them to apologize and blame it on some misunderstanding. Ah, perks of the job.

But yes, be on the lookout- not all requests for medical supplies are real- beware!

Busy Weekend

Feeling productive! The in-laws came over for the weekend to hang out and help us get the rooms ready for the addition to the family. For one, we moved the office out from one of the bedrooms to the main floor. And we finally got Alli some big-girl furniture since we were going to need the crib for the baby.

And so, it was a nice family event. Even Allison helped clean up her room before we moved the furniture in!

We got some white furniture for her, to match the white trim and shelves already in her room. We got the Hailey Collection trundle bed from Costco- we were impressed by the simple yet cute design, and the quality of the bed. And, it was much cheaper than the furniture stores. But these things came in 4 back-breaking boxes. It look us two trips in my wife's SUV to bring everything back.

Assembly took about 2 hours, though at least the instructions were intelligible. And thank goodness for power tools!

 After a busy morning, her room was ready. Right now, she is still sleeping soundly in her bed (and hasn't yet rolled off onto the carpet!).

And, her sister-to-be has her room set up too. This time, we're using the room next to ours to set up base for the baby. And with the office downstairs, we have another spare room upstairs for guests.

Only 5 weeks to go before our due date!

Worlds Apart

I'm oncall again this week. And as usual, we always have patients in the ICU, typically the post-cardiac surgery ones, but sometimes the occasional DKA.

Walking from the Main Wing to the East Wing of the hospital, I have to walk past the cheerful Starbucks store on the left, after which comes the waiting area for families. This is a modern area with numerous sofas, a couple of family-conference rooms, and is flanked by the neuro/medical ICU and the surgical ICU.

While I find the modern design inspiring, often, like today, walking past this area always tugs at my heartstrings, and reminds me to not complain about work and to be grateful. For, I often walk past hordes of families sitting, many sleeping, in the waiting area. Today, quite a few people were teary-eyed. Many looked exhausted. A woman was wailing while a man was consoling her.

It was pretty clear what was going on. Some critically ill patients. Perhaps some who were on the verge of passing. When there was little hope we doctors could provide anyway.

It tugs on the heartstrings, and even makes me feel a bit guilty, that I'm strolling from one unit to another carrying a mug of coffee, but just a mere few feet away, some families were receiving devastating news. Worlds apart.
And so I remind myself, even on a busy call week when I'm prone to complaining, that I have much to be thankful for.

Backyard Project

Finally, it's finished!

This year, one of our home projects was to expand on our backyard patio. We had some stone pavers put in along with a firepit and seating area for campfires and S'mores. Over the years we've had at least a dozen campfires each summer.

And this year, we decided to add to it by building to the other side, and to add a stone wall and a hammock for privacy. After a week of hard work (no, we had the landscapers do it!) it was finally done.

And, I'm particularly proud of the fact that I was able to install landscape lights on my own. No, not the solar ones, but the wired low-voltage ones. I've always wanted to light this area up, but was too stingy to have someone do it. And thankfully, Youtube has plenty of DIY videos to tell you how to do it. And it helps knowing that your neighbor is an ER doc so that if I was stupid enough to electrocute myself, he'd probably know how to revive me.

But no, I came out OK with all my fingers intact. Bring on summer!

Heatwave

Phew! It's official- it's hotter here than in Malaysia!

Stay cool, everyone. And don't be stupid and leaving your pets/kids in your car!