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:: Wednesday, December 27, 2006 ::
The Christmas break comes and goes far too quickly for a student. On the one hand, a fanatic concentration on final exams helps distract from the Christmas commercialism. You don't see it if you never make it to the malls and shopping centers. All you do see are the Christmas lights on the houses as you drive through on your way home through suburbia. On the other hand, when the break does finally start, it flies. Fortunately, my wife handles most of the gift shopping, because back in my bachelor days, I would have been panicking to get it all done. Online shopping is also helpful to avoid seeing all the overt commercialism. A majority of our dollars were spent online this year. The UPS guy practically knew us by name and house... well, not really.
For pharmacists, there are several dreaded workdays throughout the year, and most tend to occur during the holidays. First, the expectation for any day after a closed holiday is a crazy-mad rush. People still take medicine and get sick when the pharmacy is closed, so increased volume up to and including twice of normal is not unheard of. I worked the day after Christmas this year, and fortunately, it wasn't so bad.
The other dreaded time is New Year's. Many employers and insurers renew insurance plans effective January 1. Wow, this is difficult for the pharmacy. Insurance rejects on a prescription, so the pharmacy "cashes out" the prescription until the patient returns for pick-up. We ask for a new insurance card, input the information, re-process the transaction, and the pharmacist rechecks the prescription, almost doubling the workload for a prescription. At 6-8 minutes to process each prescription, from drop-off to finalizing the cash register transaction, this adds up for a couple hundred scripts a day. This is when long lines form at all the counters, and productivity behind the counter seems to grind to a halt. Medicare Part D was especially fun last year. I didn't have to work during the first week of 2006 when the billing fiasco was at its worst. I go back to school January 3, so fortunately, I'll get to dodge the bullet on most of the new year insurance changes.
A memorable event of this Christmas season was the Christmas Eve get-together at my mother-in-law's (MIL) house. The MIL and her siblings take turns hosting the Christmas Eve family party each year, and this year was the MIL's turn. One of her sisters has not spoken to her daughter for over 10 years, disowning her after some fallout over the daughter's choice of boyfriend, whom she eventually married and had 3 children with. The entire situation was sad, but perhaps saddest of all was the father, who didn't really object, and was too passive to speak up. He used to sneak in visits with his daughter, which became impractical when she moved further away. He had never seen his grandchildren.
The MIL invited her estranged neice to the party, who actually came, and with her kids, no less, arriving at the same time as one of my sister-in-laws and her family. The estranged mother didn't even recognize her estranged daughter after 13 years, and thought she was a friend of my sister-in-law. Well, when recognition occurred, there was an uneasy silence, but eventually they spoke and appeared to make some sort of peace. By the end, the estranged mom was holding her grandbaby, and the reunited family posed for family photos.
As for me, I always wonder what comes next. What happened on Christmas morning, and the day after, and the day after that? Did someone call the other person? Will they get together away from the prying eyes and ears of extended family to make their lasting peace over multiple glasses of spiked eggnog? The daughter is ready, no question -- it's the mom who has fueled this thing for 13 years. I guess we'll see.
The other memorable event of the season so far was rather less pleasant. My brother outted me on my agnosticism in front of my mother's new husband and one of his daughters and her fiancee. Except as he framed the statement, he presented me as an atheist instead of an agnostic. When I opened a present to reveal a David Sedaris book, he announced, "No, it's not one of your atheist books." I guess you could say there was a tense and hushed moment in the wake of that statement, broken only by the gasp of my new step-sister across the room, who up until that point, knew nothing more about me than my name. I guess it's a good thing I'm not gay, because since atheists are the most distrusted minority in America, telling the family there was a gay man in their midst would have been the only way he could have topped himself. So we'll see how that goes, as well.:: Bryan Travis :: 12/27/2006 @ 10:41 :: [link] ::
:: Friday, December 01, 2006 ::
I'm killing a few minutes until the follow-up appointment for my irregular heartbeat. I haven't had a cup of coffee since the first appointment on November 17 revealed an "unspecified ventricular conduction abnormality" on ECG. I also had some bloodwork that day, four days after the first incident, which revealed hypokalemia and hypocalcemia. Yeah, potassium and calcium are kind of important for cardiac function. Since seeing the labs, my assumption has been all that coffee managed to diurese me into electrolyte depletion, but that's the doctor's call. So, I've been consuming food and drink rich in potassium and magnesium salts to get that potassium back up. But whatever the cause of the cardiac craziness, things are now feeling normal.
I've been recording my blood pressure and heart rate since the first appointment. For a few days after coming off caffeine, my heart rate went into truly bradycardic territory, going as low as 47 beats per minute, usually hovering in the low 50s, before normalizing in the 70s over a few more days. That's crazy. In a heart with complete AV block, with no electrical communication between atria and ventricles, the ventricles begin to beat independently at about 50 beats per minute, which I find intriguing, given all the craziness I felt in my chest. Not sure if that was a result of electrolytes, or high parasympathetic activity trying to compensate for all that caffeine-induced sympathetic stimulation that was suddenly no longer there. Again, a call for the physician, although not as if it matters now, just a curiosity.:: Bryan Travis :: 12/01/2006 @ 10:32 :: [link] ::