Sunday, August 31, 2008
Thank you Gustav!
So due to the hurricane, the Typhon offices in New Orleans are closed and hence, TYPHON is down. Oh sad, tear, cry, sob. I wish Gustav could linger for the next 12months! Oh darn, guess I won't be entering things into TYPHON in the next few days. Oh darn.
Hurricane approaching = dumb people.
I never thought I would have to send the clinical team a warning that I might have to miss a couple days of clinic due to a hurricane. Well it won't be a direct hit where I am, but apparently we will most likely get some very nasty rain, wind and flooding. They have closed the schools down in the past for this terrible weather. My family stockpiled food, canned goods, bottled water, batteries and anything else they thought was necessary in case we are house bound for a few days. I really can't see how this will be all that bad where I am and maybe since I have forewarned the clinical team back in OR and my mom and of course my hubby that I may be out of touch for a bit, nothing will happen and Tuesday, bright and early I will be headed to prison as usual. (In the picture - I work in Humble and live south of I-90 by Baytown)
Did I mention we also filled all the cars with gas? Apparently the first things to disappear with a storm like this are bottled water, gas and ATM access. I think the news left out the part how people's common sense disappears too. Here is my gas station story (watered down version).
Went up the street to fill the miata up, I use my debit card, pick up the nozzle, press the grade of fuel I desire and before I even get the nozzle into the car, the numbers start going up. Puzzled, I hang up the nozzle and press the help button as my receipt prints. "Um, no gas came out and yet the numbers went up" I tell the voice on the other end. "Try another pump" I'm told. "Yeah, but I was charged for gas I didn't receive." I reply. "Not my problem, try another pump." Like hell I'm going to try another pump I thought, so I drove down the road a bit turned around with no gas station in sight and stopped again at the same station. This time, no gas, no charge. I asked what the trick was to using the pump because no gas was coming out (Until moving to the NW I had pumped my own gas for nearly 10 years and am quite familiar with how to operate a gas pump). "Must be operator error" echos the voice. After peeling out of the gas station, I drive 15min in the opposite direction to another gas station. Upon approach I could see it was really busy, must be all the Louisiana residents coming off I-10 to fill up. I pull behind a lady in her truck. It is sweltering hot, the AC isn't blowing cool air when I am just sitting in park. Long story short, turns out the lady in front of me decides to wash her Ford F350 with a squeegee, I am blocked in at every possible angle by a truck, a trailer or a truck with a trailer, thanks to the hurricane zoo at the gas station. I'm stuck. I'm getting impatient - I've been here 20mins. I'm really hot, sweat is pooling on the leather seats and the lady, squeegee in hand, waves at me. You've got to be kidding me. Get me out of TX now before I go postal (oh no, that wasn't in TX, they have psycho cheer moms down here) So get me out of here before I go "cheer mom."
After a few more incidents I finally got my gas. I was gone so long that my family called me to make sure I was ok, still alive and not lost. That was very thoughtful of them.
Bring your glory Gustav!
Went up the street to fill the miata up, I use my debit card, pick up the nozzle, press the grade of fuel I desire and before I even get the nozzle into the car, the numbers start going up. Puzzled, I hang up the nozzle and press the help button as my receipt prints. "Um, no gas came out and yet the numbers went up" I tell the voice on the other end. "Try another pump" I'm told. "Yeah, but I was charged for gas I didn't receive." I reply. "Not my problem, try another pump." Like hell I'm going to try another pump I thought, so I drove down the road a bit turned around with no gas station in sight and stopped again at the same station. This time, no gas, no charge. I asked what the trick was to using the pump because no gas was coming out (Until moving to the NW I had pumped my own gas for nearly 10 years and am quite familiar with how to operate a gas pump). "Must be operator error" echos the voice. After peeling out of the gas station, I drive 15min in the opposite direction to another gas station. Upon approach I could see it was really busy, must be all the Louisiana residents coming off I-10 to fill up. I pull behind a lady in her truck. It is sweltering hot, the AC isn't blowing cool air when I am just sitting in park. Long story short, turns out the lady in front of me decides to wash her Ford F350 with a squeegee, I am blocked in at every possible angle by a truck, a trailer or a truck with a trailer, thanks to the hurricane zoo at the gas station. I'm stuck. I'm getting impatient - I've been here 20mins. I'm really hot, sweat is pooling on the leather seats and the lady, squeegee in hand, waves at me. You've got to be kidding me. Get me out of TX now before I go postal (oh no, that wasn't in TX, they have psycho cheer moms down here) So get me out of here before I go "cheer mom."
After a few more incidents I finally got my gas. I was gone so long that my family called me to make sure I was ok, still alive and not lost. That was very thoughtful of them.
Bring your glory Gustav!
Saturday, August 30, 2008
Sacrifice
6 weeks is a long time to be away from Shawn. He's working extra hard while I am in school to provide for us and make sure everything is ok and save so we can by a house in the near future and maybe a car. He also has to take care of the dogs, which has proven to be more of handful than once anticipate (well at least one of them). He typically works 12 hour shifts as a medic but lately has been trying to pick up extra time here and there, sometimes extending his days to 16 or 17 hours not including the extra 45minutes in the morning before work to get the dogs walked and fed and the hour or so at night to clean Wrigley (who has apparently not myelinated the neurons leading to her butt to hold her poop even on a normal 12hr day) and then he plays with them extensively, eats, showers and maybe he can squeeze in a little down time before going to bed and doing it again the next day. I owe him big. I don't know how I am going to repay him, but I will -one day and it will be big. I couldn't ask for a more loving, supporting husband. PA school is a much bigger sacrifice than I thought it would be. I'm glad I didn't have this reality before I started, I'm not sure if I would have gone back to school. I miss my family in the NW and I am praying that this year goes quickly.
AMR is deploying EMS help down here and in Louisiana in anticipation of a category 3 hurricane hitting, but Shawn isn't on the list to go, plus those darn puppies would have to go somewhere for 2 weeks.
AMR is deploying EMS help down here and in Louisiana in anticipation of a category 3 hurricane hitting, but Shawn isn't on the list to go, plus those darn puppies would have to go somewhere for 2 weeks.
Preparing for Gustav
Fridays are always hit or miss I have determined in my short two week stint. Although we were caught up with our double intake on Thursday (thanks to the LBJ holiday) all of the sick call supposedly was moved to Friday. My goal was to not crash the computer when doing intake physicals. I managed to make it through the first physical ok, nothing too exciting, just trying to get the flow of things, I like it when they are young and healthy, not too much to take care of, less computing if you will. I wish I could quietly go from person to person and ask how many medical problems they have and pick out the good apples, unfortunately I don't have that luxury in the free world or in here. Too bad when I was given step by step instructions on how to input patients would have included tricky ones or involved ones but no it didn't, those two days they were all simple. My next guy (my final guy I should say) 50 with a history of mental illness, Hepatitis C, TB+ status post prophylaxis with TB meds, seizure disorder and hypertension. Holy cow. Where to start? As I went through his problem list to ensure everything was accurate he said "I don't think I got that Hepatitis C, I took 3 shots for that" This is a common misconception here, the 3 shots are to provide immunity for Hep B, not C. So I explained this. Next I told him when the labs were drawn to confirm Hep C to which he replied "Oh, well now I remember I just had a touch of the Hep C but I'm better now." This is also a misconception here. Everyone seems to think that you can have a touch of Hep C, a touch of HIV like you might have a touch of a cold. It would be the same as saying I'm just a touch pregnant. (which I'm not at all for the record) Back to remembering what to do for this patient -I remembered to order the PSA, offer a rectal and get the inevitable refusal signed, order intake labs, change his complexity satus from a 1 to a 3. Then I knew I had to schedule a chronic care clinic visit within 30 days, but wasn't sure how, order repeat labs every month for his liver problem, again not sure how and so on and so forth. So while I waited for someone to show me these things I wasted 45min, and probably the opportunity to see at least one more. On the plus note I finished it just in time to be asked by the doc to take off a toe nail. Whoohoo!
His toenail wasn't as rotted as the last, and removal isn't exactly the treatment for this guy, but there just aren't any other options here in the captive world. The doc had me do a new technique to deaden the toe and asked me to put in a ridiculous amount of lidocaine into his toe to deaden it. The patient was a total baby and I was so nervous as she hovered overhead I made a couple stupid mistakes when injecting, like going through the toe completely on one side. Despite my mistakes and for being told "you're being way too gentle" I manage to get the entire nail off in one piece - a small victory in my book. I was feeling good but it was about 20min later, out of the blue when I started getting reprimanded about my poor technique for anesthetizing the toe and for not just grabbing on and going for it (being gentle) and how I caused a couple extra drops of blood from being too gentle. I thanked her for her (less than tactful but insightful) comments and quickly tried to find another room to observe from, but neither PA was in their office, so back to sitting with the Doc. We had a couple sick calls, and a couple chronic care visits which turned out to be very complex with a new diagnoses of Hep C. (again, the patient said he had shots for it and stated matter of factly "so now I have just a touch of Hep C" sigh).
After clinic was done we were instructed to prepare for the pending hurricane (Gustav) which may make landfall near or far from us Mon or Tues. We are about 100miles from the Gulf (where I'm staying is a tad bit closer). But I guess if we are north of where it makes landfall there is a large chance for tornadic activity and of course wind and rain, lots and lots of rain. We covered all of the computers with plastic bags, and put X's made of tape across all the windows (which are double plated anyway) and unplugged all electronics and wrapped the cords in plastic bags too. All important papers had to be accounted for and anything you value should go home. I was surprised at all the hype, I guess I thought we were far enough away to not have to worry about anything, but I suppose it's better to be safe than sorry. I'm actually a little worried about the house I live in, or at least the area around us flooding if we do get heavy rain. With just a normal storm we flood and we have what I call Lake Corman right in front of our house. Should be interesting - as everything seems to be around here.
His toenail wasn't as rotted as the last, and removal isn't exactly the treatment for this guy, but there just aren't any other options here in the captive world. The doc had me do a new technique to deaden the toe and asked me to put in a ridiculous amount of lidocaine into his toe to deaden it. The patient was a total baby and I was so nervous as she hovered overhead I made a couple stupid mistakes when injecting, like going through the toe completely on one side. Despite my mistakes and for being told "you're being way too gentle" I manage to get the entire nail off in one piece - a small victory in my book. I was feeling good but it was about 20min later, out of the blue when I started getting reprimanded about my poor technique for anesthetizing the toe and for not just grabbing on and going for it (being gentle) and how I caused a couple extra drops of blood from being too gentle. I thanked her for her (less than tactful but insightful) comments and quickly tried to find another room to observe from, but neither PA was in their office, so back to sitting with the Doc. We had a couple sick calls, and a couple chronic care visits which turned out to be very complex with a new diagnoses of Hep C. (again, the patient said he had shots for it and stated matter of factly "so now I have just a touch of Hep C" sigh).
After clinic was done we were instructed to prepare for the pending hurricane (Gustav) which may make landfall near or far from us Mon or Tues. We are about 100miles from the Gulf (where I'm staying is a tad bit closer). But I guess if we are north of where it makes landfall there is a large chance for tornadic activity and of course wind and rain, lots and lots of rain. We covered all of the computers with plastic bags, and put X's made of tape across all the windows (which are double plated anyway) and unplugged all electronics and wrapped the cords in plastic bags too. All important papers had to be accounted for and anything you value should go home. I was surprised at all the hype, I guess I thought we were far enough away to not have to worry about anything, but I suppose it's better to be safe than sorry. I'm actually a little worried about the house I live in, or at least the area around us flooding if we do get heavy rain. With just a normal storm we flood and we have what I call Lake Corman right in front of our house. Should be interesting - as everything seems to be around here.
Thursday, August 28, 2008
crash and burn
Today I learned the computer system. Sounds simple enough but the EMR (electronic medical records) at the prison is semi-confusing. To get to point A you must first go to point A1, A2 and then A3 and finally arrive at point A. The computer system is linked to the main computer hub in Galveston at UTMB and incidentally the computer has been known to suck a chart note or set of orders or in my case my intake physical and order sheet from the computer and launch it somewhere into cyberspace never to return. The computer system is also known to crash, a lot which basically requires that all notes be printed, copied multiple times, signed by 6-8 different people, and hand scanned into the computer and filed online. Today I learned the computer system - I also crashed the computer system, single-handedly. The IT people told me not to worry, it happens almost always when a new person logs in and tries to sign their note. Unfortunately due to this malfunction, I only got to do one intake physical today. On the other hand I got to enter the patient in twice since my first note is lost somewhere over the hard drive.Too bad I forgot to re-enter a few key things onto my note. I was feeling a little bit scattered brain when trying to fix my note with the IT guy sighing into the phone while he waited for me to try again. My first intake, minus the computer meltdown, went great. I remembered to ask the few key questions, remembered to have him stand on the X in the middle of the floor and for my own sake remembered to have him turn his head when he coughed during the hernia check. I was actually relieved that he deferred the rectal. I even remembered to give the don't use too much soap lecture that I am all too familiar with now that I have watched 2 weeks of intakes.
Despite waiting for IT to figure out what to do with me, the time I spent waiting was not all lost. The inmates sit in chairs lining the walls of the hallway waiting. There is a big sign that says "NO TALKIN" (the "G" is really missing from the paper) but it is rarely enforced. Today two young guys were waiting in the hall, chatting it up. One was a 23 yr old who just lost his nursing license for whatever it is he did and is now worried about the 3 mouths and wife he left behind in the free world. Next to him was the younger guy who was in for stealing a $13 pizza from a delivery person (I make it appoint not to know what they're in for, it was mentioned in the conversation and hence I repeat it). The first guy was telling the younger that he needed to do something with himself, get his GED, make something of the 10months he would be spending behind bars. The young kid laughed (which did earn as sssshhhhh from the unit secretary) but the older and obviously wiser 1st-timer continued urging the young guy to fill himself with knowledge and gave him word after word of encouragement to rise above this one mistake and not make it a habit. He pointed out the tattoos and said "I have tattoos too, but where have they gotten you? Here, behind bars, but education, that will take you farther." This continued on for quite sometime as the older 20-something told of his story and how he would vow to help anyone else like him out there in the free world that was like him - young, educated and headed down the wrong path. Overhearing this conversation was interesting. Most of the guys I have seen have one of three attitudes. 1. I'm here because this is how the world works, I can't change it, 2. Oh poor me, I'm in jail and now my life is ruined or 3. What's 2-15more years here? So to hear just one youngster really get it, to know that he has the power to make better choices and to use the time wisely was really refreshing. It's hard not to have this counselor mentality when a young guy comes in for the first time, there are so many things that cross your mind that seem like a natural thing to say in a situation like that, but it's really not our place. I have heard my preceptors remind the younger ones and first timers it's not too late, but I'm not ready to make that leap yet even though I believe there's hope for some of them.
Other interesting items from today: pt with large cysts on his head - almost looked like horns, could be HIV related but I doubt it. The biopsy I did last week - Basal Cell Carcinoma. Oh hooray! So tomorrow I will spend 30minutes educating the patient on what that is and what can be done. I had my first polydactyly patient (I will double check the spelling of that and correct nomenclature - it's where multiple fingers are fused together making a pincher-like claw for each hand). Also had my first possible dwarf (with a wicked heart murmur) - not sure why this is interesting, but it was, probably because he came in after our 6'11 pt.
Enough jailhouse news. It's super humid here in TX and the miata heats up like an oven during the day - I think it's from the burnt orange leather seats. Even worse than the humidty though are the mosquitos. Oh how I dont miss those little buggers. I have giant reminders that they are out there lurking, just waiting for me. They are particularly heavy in the morning and night - as soon as the door opens you are swarmed, I even manage to get 4 or 5 in the car with me, which explains the 2 or 3 new bites I get each day on my way to work.
Shawn has picked up some extra shifts to fill his time while I'm away. It worries me he works so hard, but I think it's just awesome to know he is busting his tail so we can travel and get a house when I graduate. I feel like such a deadbeat wife.
Oh and awkward moment for the evening, watching the first part of the movie "knocked up" with your cousin and her mom...
Despite waiting for IT to figure out what to do with me, the time I spent waiting was not all lost. The inmates sit in chairs lining the walls of the hallway waiting. There is a big sign that says "NO TALKIN" (the "G" is really missing from the paper) but it is rarely enforced. Today two young guys were waiting in the hall, chatting it up. One was a 23 yr old who just lost his nursing license for whatever it is he did and is now worried about the 3 mouths and wife he left behind in the free world. Next to him was the younger guy who was in for stealing a $13 pizza from a delivery person (I make it appoint not to know what they're in for, it was mentioned in the conversation and hence I repeat it). The first guy was telling the younger that he needed to do something with himself, get his GED, make something of the 10months he would be spending behind bars. The young kid laughed (which did earn as sssshhhhh from the unit secretary) but the older and obviously wiser 1st-timer continued urging the young guy to fill himself with knowledge and gave him word after word of encouragement to rise above this one mistake and not make it a habit. He pointed out the tattoos and said "I have tattoos too, but where have they gotten you? Here, behind bars, but education, that will take you farther." This continued on for quite sometime as the older 20-something told of his story and how he would vow to help anyone else like him out there in the free world that was like him - young, educated and headed down the wrong path. Overhearing this conversation was interesting. Most of the guys I have seen have one of three attitudes. 1. I'm here because this is how the world works, I can't change it, 2. Oh poor me, I'm in jail and now my life is ruined or 3. What's 2-15more years here? So to hear just one youngster really get it, to know that he has the power to make better choices and to use the time wisely was really refreshing. It's hard not to have this counselor mentality when a young guy comes in for the first time, there are so many things that cross your mind that seem like a natural thing to say in a situation like that, but it's really not our place. I have heard my preceptors remind the younger ones and first timers it's not too late, but I'm not ready to make that leap yet even though I believe there's hope for some of them.
Other interesting items from today: pt with large cysts on his head - almost looked like horns, could be HIV related but I doubt it. The biopsy I did last week - Basal Cell Carcinoma. Oh hooray! So tomorrow I will spend 30minutes educating the patient on what that is and what can be done. I had my first polydactyly patient (I will double check the spelling of that and correct nomenclature - it's where multiple fingers are fused together making a pincher-like claw for each hand). Also had my first possible dwarf (with a wicked heart murmur) - not sure why this is interesting, but it was, probably because he came in after our 6'11 pt.
Enough jailhouse news. It's super humid here in TX and the miata heats up like an oven during the day - I think it's from the burnt orange leather seats. Even worse than the humidty though are the mosquitos. Oh how I dont miss those little buggers. I have giant reminders that they are out there lurking, just waiting for me. They are particularly heavy in the morning and night - as soon as the door opens you are swarmed, I even manage to get 4 or 5 in the car with me, which explains the 2 or 3 new bites I get each day on my way to work.
Shawn has picked up some extra shifts to fill his time while I'm away. It worries me he works so hard, but I think it's just awesome to know he is busting his tail so we can travel and get a house when I graduate. I feel like such a deadbeat wife.
Oh and awkward moment for the evening, watching the first part of the movie "knocked up" with your cousin and her mom...
Wednesday, August 27, 2008
Happy Birthday LBJ!
I am celebrating LBJ's birthday today in holiday form meaning no work. Don't ask me why the prison system uses this as a holiday, but they do so I am relishing in the fact that instead of making my usual 45min-hour drive I slept in and will start working on in-puting my patients into Typhon and working on my next oral presentation (which may be entitled; Really cool opportunistic infections HIV pts get). What a birthday party huh?
Yesterday my presentation went ok, I think the preceptors words were, "interesting, not what I expected but interesting." Hmmm. Well given the fact that I almost never spoke for more than 3 or 4 minutes at a time before being interrupted by my audience or people barging into the lunch room I guess interesting is better than anything else. I know my presentation did earn me two presentations per week for the rest of my rotation. Whoo.
Patients have been dull lately. The usual scamming to get a low bunk or get new restrictions. We also haven't had that many patients outside of intakes which have also been straight forward. Due to the lack in patients we've been getting done early around 2 or 3pm. I still haven't figured out the EMR though, it's tough. But tomorrow I will be trialed by fire in learning as I will be seeing some of the intakes myself, in my own office. We have double intake tomorrow since we are celebrating LBJ's birthday today. And my preceptor won't be in on Thur or Fri as she is helping conduct a research experiment on the vomit comet for NASA.
I'm off to do more celebrating!
Yesterday my presentation went ok, I think the preceptors words were, "interesting, not what I expected but interesting." Hmmm. Well given the fact that I almost never spoke for more than 3 or 4 minutes at a time before being interrupted by my audience or people barging into the lunch room I guess interesting is better than anything else. I know my presentation did earn me two presentations per week for the rest of my rotation. Whoo.
Patients have been dull lately. The usual scamming to get a low bunk or get new restrictions. We also haven't had that many patients outside of intakes which have also been straight forward. Due to the lack in patients we've been getting done early around 2 or 3pm. I still haven't figured out the EMR though, it's tough. But tomorrow I will be trialed by fire in learning as I will be seeing some of the intakes myself, in my own office. We have double intake tomorrow since we are celebrating LBJ's birthday today. And my preceptor won't be in on Thur or Fri as she is helping conduct a research experiment on the vomit comet for NASA.
I'm off to do more celebrating!
Sunday, August 24, 2008
I'ze gotsta J-up
That's TX prison slang for, I need to get a job. The first time I heard this phrase was Friday, and I thought the man was speaking a foreign language. The phrase all ran together, thank goodness I recognized the term J-up from my pre-rotation prison slang reading packet. The patient who said this was a relatively large white possibly hispanic male who put in a sick call (office visit here in jail) because of a hernia. He has been working in the kitchen for the last year or so and has found that when"lifting cans of slop I feel my insides come through my belly button" oh and his lower back hurt. Medical personnel can't change someone's job, but can place restrictions if legitimate. For example, those with HIV, Hep C and TB can't work in medical, those with documented seizure disorders have high bunk restrictions, etc. Further on in the interview, "I can'ts be liftin no more cans of slop, I'ze be gettin written up for not going to work cuz my back hurts and for not doin my job, I'ze gotsta J-up with the yard crew, they sez I can do that" TRANSLATION: I've had disciplinary action taken on me for not going to work due to my back pain and for not lifting the vats of food, I need to get a job with the grounds crew mowing grass or trimming"
Not all of the inmates have such an interesting dialect, but many of them do. Some even sound like this in the hallway when waiting and then are incredibly proper with impecable grammar during the actual office visit.
Friday was pretty bland. I did 1 urethral swab for an STI. The guy was such a baby. Shawn told me to not be so callous about the whole thing and I wasn't trying to be, I'm sure it's uncomfortable, but really, it can't hurt if I'm not touching you and the whole thing only takes 2seconds or less. In retrospect I should have said to the patient 2 seconds of swabbing or lifetime of impotence - your choice. This same guy was shocked to learn that HIV is spread the same way as chlamydia and that HIV can in fact be spread through unprotected heterosexual sex. I was shocked to find that a 20-osmething didn't know this, and still wasn't convinced after the doc told him so. Anyway, it's funny how some of the inmates look at me like I haven't seen certain parts before - the PA tells them "don't worry she still has her brick." For some reason the saying in our facility is: if we see something we've never seen before we get to throw a birck at it - and we still all have our bricks. Don't ask me why this saying works but it does.
We also had some strange labs come through, an almost 50 y/o who dropped their Hgb 3 points in 3 weeks (he's at 9), the kidney is shutting down (Creatinine 1.9)and a few other things are way off. WE do have our share of lab errors, and the guy didn't look ill when he came in, no complaints either. We're working him up to find the cause of the anemia, hence the presentation I should be working on, but I really just don't want to read anything else about anemia. Could be colon cancer, some type of deficiency, maybe undiagnosed Liver disease, HIV, something. We'll see.
Only 12 more months and I too will have to J-up.
Not all of the inmates have such an interesting dialect, but many of them do. Some even sound like this in the hallway when waiting and then are incredibly proper with impecable grammar during the actual office visit.
Friday was pretty bland. I did 1 urethral swab for an STI. The guy was such a baby. Shawn told me to not be so callous about the whole thing and I wasn't trying to be, I'm sure it's uncomfortable, but really, it can't hurt if I'm not touching you and the whole thing only takes 2seconds or less. In retrospect I should have said to the patient 2 seconds of swabbing or lifetime of impotence - your choice. This same guy was shocked to learn that HIV is spread the same way as chlamydia and that HIV can in fact be spread through unprotected heterosexual sex. I was shocked to find that a 20-osmething didn't know this, and still wasn't convinced after the doc told him so. Anyway, it's funny how some of the inmates look at me like I haven't seen certain parts before - the PA tells them "don't worry she still has her brick." For some reason the saying in our facility is: if we see something we've never seen before we get to throw a birck at it - and we still all have our bricks. Don't ask me why this saying works but it does.
We also had some strange labs come through, an almost 50 y/o who dropped their Hgb 3 points in 3 weeks (he's at 9), the kidney is shutting down (Creatinine 1.9)and a few other things are way off. WE do have our share of lab errors, and the guy didn't look ill when he came in, no complaints either. We're working him up to find the cause of the anemia, hence the presentation I should be working on, but I really just don't want to read anything else about anemia. Could be colon cancer, some type of deficiency, maybe undiagnosed Liver disease, HIV, something. We'll see.
Only 12 more months and I too will have to J-up.
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