Thursday, February 24, 2011

first day in ER

Hi Everyone.
Almost 2 weeks down at new job and things are setting down.
I had my first day in the ER yesterday in about 12 years. It went well. I have to admit I have been somewhat indoctrinated into the american way of looking at the Canadian health care system (only very slightly, and even what I had preconceived is wrong)
I had a patient with what appeared to be a strain, I took an xray and it was non conclusive and speaking immediately with the radiologist, he suggested a CT scan (with my preconception of the Canadian system, I said "how long is THAT going to take?), and he said, just fax over a req, and send her over (over to Kamloops). SHe was back to Chase in 2 hours of so.

With one payer, everyone is working on the same page, and for a common goal, and that is the patient care. So it seems to save a lot of money just having everyone working for the same payer, so it cuts out a set of management in every dept.
Also this little "hospital" well its not really a hospital, it has an ER, lab, home care, xray, diabetes teaching, etc etc. No actual beds to spend the night.
The xray and lab are similar to bandon, except they only have techs and no managers, instead there is a manager for the whole building instead of a manager for each dept. (since it is small).

The charting is less onerous since we are only charting for record keeping for the patient, as opposed to the US where your charting is doing to defend your billing to medicare, (or other insurance companies)
What can I say, I just love it.

We DID purchase the acreage we were looking at, and the whole deal is more or less depending on us getting the money from the house in Bandon. SO I have started about 10 large flats with seeds all around the kitchen and bathroom to get all my seeds going, as when the snow is gone, I will have somewhere to put them in the ground.

Everything is going very well, except one ....little thing..
I had Ken remove a lesion that had formed on my vulva over the past few weeks, it is about 3 -4 mm, and very hard and seemed to have been altering the anatomy there.
We have sent it for pathology and are anxiously awaiting the results.
OF COURSE I spent a whole day reading about vulvar cancer and the good thing is that they did not mention any that were from recurring endometrial cancer. So if anything this would be a totally new cancer...which is better than a recurring one.
BUT I will try NOT to get too far ahead of myself and try to be patient waiting for the results.
But I did want to mention for anyone to report any changes spots etc on their vulva (the flappy lips on the outside of the vagina), it is not a really common cancer, but it is not unheard of either.. YOu can get malignant melanonas there as well as basal cell carcinomas, but most are more specific to the vulva.
They often present with itching, or irritation to the area. They can get mistaken for yeast infections. So anyone with chronic problems down there, need to get looked at with regards to the possibility of something else going on. There are many skin conditions that occur in the area including psoriasis.

Not sure if 2 days is too early to be looking for results, but I will head down and search out my results.

It certainly would not be the first time I panicked over nothing, and likely not the last

jankenb @

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