Yoga continues to provide me with moments of bodily and emotional discovery. Last night I went to sleep just listening to the Ocean Waves Dark Screen YouTube Video, and it did help deepen my sleep. But the previous night I also did 10 minutes of Yoga by Adrienne and also the Ocean Waves Dark Screen YouTube Video – and I slept much more deeply. Good sleep is very important to have a clear spirit and mind.
Something Adrienne at Yoga by Adrienne said really struck me during one of the meditation YouTube videos. It was a series of simple stretches and meditation exercises toward the end of the day, and she said something along the lines of “embrace the close. The close of the day. And with the close, tomorrow you can accept the morning and a new beginning.” Maybe I made that up, but I could swear she was saying that directly to me. For no particular reason my thoughts started turning toward shifts in my professional life and other big life decisions. My thoughts turned to the two little toddler patients that had cancer that are intertwined in what had been a period of deep personal saddness for me, and whose story I have alluded to others several times and has been each time painful. And I realized that on multiple different fronts, I was ready to emotionally embrace the close.
I’m really proud of myself. I think it’s a function of having very encouraging parents who always taught me to be proud of myself when I deserved the praise. But I’m really proud of myself. I spent my time last evening being certified by the California Department of Public Health as a California Vaccines for Children Provider (VFC). It’s simply a series of 5 modules one has to go through, and are very specific for vaccine storage, distribution and how to account for these vaccines. Because it tests on a specific set of tasks that is required to order, distribute, store and ensure the safety of vaccines – you really can’t guess. I had done a similar training at the CDC website when I thought about leaving my current job during the height of my physician burnout and opening my own office. Good thing I started walking along the beach, and stopped feeling so bad. But this training was specific to california. For each module I was able to answer most of the questions as the material was similar to the federal one, but it was not exactly the same. Therefore missing one question, I had to go through the entirety of all four modules and test out. I passed them all.
I proud of myself just like I’m proud of myself when I pick up a bag of litter. I have 2 more bags to reach my 20 bag a month goal I set for myself. It’s raining today and I have to orient a young pediatrician regarding the minutiae of quality metrics and then also have patients. But definitely this weekend I eyed a new spot I want to hike at, and maybe will pick up a bag of trash there.
Well. That is it. Nothing earth-shattering (which is good!) this morning. I spent last night on my OFF time training to be a California Department of Public Health as a California Vaccines for Children Provider (VFC). I’m one of two pediatricians in my organization, and it helps save our organization millions of dollars. Certainly that 4 hours is worth it. I also updated my resume on doximity! LOL.
Thank you to everyone for the virtual and real sympathy yesterday after my adventures with Moderna #2. Now almost 48 hours post vaccination, I am better after 3 doses of tylenol 1000 mg. My body feels like it ran a marathon, just exhausted but refreshed after actually sleeping and Mr. Plastic Picker brought home Rubio’s fish tacos and the fish taco was very healing. Someone in high school once told me fish was brain food, and since then I always think that when I eat fish – even if it’s from a fast-casual place.
The sympathic messages were very appreciated and healing. Please text me if you need similar sympathy, as I’m happy to text back some encouraging messages now that I’m done with Moderna #2 post-vaccine experience. Many of my real MD friends are about to embark on their experiences. This is a common shared experience for us, which is relatively uncommon in general but so much more frequent since the COVID-19 pandemic started.
I have been thinking about frugality and the importance of being truly fiscally responsible. Yesterday as I was trying to make it through the day, I was alternatively moaning in bed without anyone to attend to me (Mr. Plastic Picker was at work, my usually attentive tween daughter was at blended school, my teen son doesn’t hear anything and he’s a teenage boy and I’m his middle aged mother, and my in-laws are hard of hearing) except our crazy poodle-mix puppy. I did rest in bed, which was good to catch a few extra hours of sleep. I did take some tylenol 1000 mg doses, because after the first time it brought relief – I said why not??!! and took two more doses as I’m confidant that my body is teeming with spike protein antibodies. Just half kidding. I did take a total of 3 doses in the 48 hours. But in between my delirious social media posts about generating your will as I was thinking about my own eventual demise, texting my friend Usa who is the troop cookie mom this year for more cookies, and passing out again on the bed – I did do several things that I know were very healing and they were very cheap. The most relaxing things yesterday that helped me feel fundamentally better were sitting outside in the sunshine for a bit, and watching the birds at our two bird feeders. I looked at my small little container garden to see where the onions, sweet pea plant and succulents were at in their journeys. And then twice yesterday I did a few yoga stretches, once in the afternoon on the artifical grass in the warm sun and last night before going to bed. I turned on ocean waves as well before I went to bed and I had a good nights sleep. And now I feel better.
I am grateful to have received Moderna #2 yesterday. After Moderna #1 I had slight headache, fatigue and body aches. I was still able to go to work, and usually being ill (as long as I am not infectious) it is better to go to work because it distracts me. But last night Moderna #2 was a whole other experience. It just goes to show you can’t predict how one will react. I thought I would be fine. I received my vaccine at about 9am, and was doing fine most of the morning. I called into a middle managment meeting and conducting my irreverent Assistant Boss commentary from the parking structure – 4th floor. I was double masked and feeling good that Moderna #2 was done and I actually made it on time to the appointment. But by the evening I was getting irritable and more body aches. My temperature began to climb up, initially just low grade. I finished making a vegan dinner for the children (Beyond Beef and vegetables on corn torillas). The children immediately made it a vegetarian meal, because they added a little bit of cheese – but much less than they would have before.
I then headed up to bed and had to lay on my left side, because I receieved the intramuscular deltoid injection in my right arm. I decided on my right arm, because the first one I got on my left arm. The arm soreness for me was more than I ever imagined so I thought it was better to alternate. Then I settled in to bed, and it was one of the worse nights of my life (in terms of me just feeling ill). I had fever up to 103, headaches, chills, and arm pain. I just felt horrible. The entire time I was thinking , great the spike mRNA vaccine is working. I am still grateful for the vaccine but last night was not fun. I didn’t take tylenol the first moderna #1 because I wanted it to work. For moderna #2 I had resolved to try to do it without tyelnol, but by 2am – I was feeling so horrible I had Mr. Plastic Picker bring me 1000 mg tylenol and I took it with some water. The height of the fever had already passed but I honestly did not think I would make it through the night.
This morning I called in sick. I will still attend some meetings virtually regarding some middle management meetings and state programs that are important. I feel weak but still able to type and drink coffee. Wow. What a night. I was not sure if I should let everyone know the truth about last night. But I think it’s important to be honest. I’m 100% sure that receiving moderna #2 was the right decision. The pandemic has claimed over 400,000 American lives. I worry about my parents-in-law who still have to receive #2 to get full protection, and my own parents are due tomorrow for #1. It’s worth it to go through one bad night, to protect myself and my community and the ones I love. But wow, it was not easy. I will marvel at the miracle of the research that went into the Moderna vaccine later. But this morning, I’m just going to dwell on how residually crappy I feel. Even my coffee taste a bit off? I think maybe I had covid at some point and did not know it? I mean I’ve been working for 9 months in clinic. We haven’t done routine testing. I bet you I had asymptomatic or very mild COVID when Dr. Dear Friend had it. I tested negative but the test is not perfect. That would explain why I felt so bad with moderna #2.
Anyway, even with the tylenol 1000 mg – I know there are a lot of antibodies circulating in my blood stream right now. Something happened last night and something is still happening in my body. And that is the truth of Dr. Plastic Picker’s experience with Moderna #2 and using a rare sick day.
I was completely overwhelmed last night. There is a bit of political tussel at work about committee responsibilities. It’s easy being Assistant Boss because that’s the title I have, and I’ve reached a point in my career where I realize the titles are not that important. The important part is that I have specific responsibities in areas of our organization that actually mean money. I have to make sure we meet certain metrics, state required projects need to be completed, clinical quality measures reached. And if we don’t meet these metrics or get these state required quality projects completed, it means millions of dollars in fines. We are also a bonus driven organization, so when the physician group meets certain metrics than there are certain calculations to our compensation that happens. Sometimes I look out at departmental meetings and a fellow physician will be spouting nonsense about appointment times slots and 15 minute this and 30 minute that or why they aren’t included in certain meetings, and I’ll go into a trance and stand there and nod but I retreat into my own inner universe. I’ll think to myself “penny wise, pound foolish” and think about my networth or about the plastic pollution crisis or about my EMR inbox and the patient results I need to respond to. So much of the world is penny wise and pound foolish. I need to retreat into my inner universe at a lot of meetings, so I can just stand there, keep my mouth shut and move our department painfully forward.
It’s 542am and the wind is howling. It’s raining in Southern California, and it’s much needed but unusual for us. Having lived through multiple droughts in our sunny state, I’m always grateful for whatever rain we can get. I spent last night updating our finances and refining our goals. I thought I had neglected things of late, but everything was fine. We are in tip-top shape financially and have some medium sized investments that we will make soon. It’s funny how the hard-work and foundation we laid out fifteen years ago are paying generous dividends. Personal finance is easy now. I had mentioned on the KevinMD podcast that it helps to be financially independent, and I wanted to check if that was true for our numbers. And it actually is. I could stop working now completely, and we would be fine without my income. But that has never been the point of financial independence, it was more freedom from someone else or some other entity being able to control me.
GATHER was featured in the New York Times and a critically acclaimed film on Indigenous Food Systems and Indigenous Food Rights. It explores the connections between restoring ecosystems and food systems. (Peds Chief) , (CATCH Peds Obesity Clinic) and I are proud to invite limited interested members of our medical group to a free virtual film screening of Gather, and panel discussion with Chef Nephi Craig (Western Apache Nation and professional chef) and our own Dr. Dana Patton (Pediatric GI) and Dr. William Pfeiffer. Target audience is primarily the AAP-CA, Kaiser SD Peds Department, and San Diego Area Pediatricians, but we will have room for some interested in our medical group outside of pediatrics. This is funded by a generous grant from AAP-CA3 San Diego. You will be emailed a link to view the movie for free, and panel discussion for CME will be on March 5, 6pm. Please comment below or email Mr. Hakim Tokhi to RSVP AAPCHILDRENSARTCOUNCIL@GMAIL.COM
I made this wine-cork upcycled ocean plastic figure yesterday. I was in an intense storm of professional angst, and he came together from the bits and pieces I had saved from the last solo beach clean up. I remember where I found the figure, who I now know is Evil Kenevil, in the sand embankment where the Surf Rake deposits it’s load. I found the blue plastic sand toy handle nearby, broken as many cheap plastic beach toys are. People are often surprised that there are plastic hangers in the beach. I’ve found many like the one above. Just the top parts. I don’t know how and I don’t now where from. I just find them and keep the interesting plastic bits. It all came together to make a sailboat, and a plastic figure (now I know from Toy Story 4) that was trying to ride off into an unknown future.
I just wrote this great post that I won’t publish. I needed to work through some emotions and a work situation. I feel a lot better now, but I don’t want to create more waves than I need to – so I’ll keep it to myself. Writing is ever therapeutic for me. I’ll instead try to be productive and get stuff done for the environment today.
Movie Screening “Gather.” Wrote to Director Sanjay again to try to nail down a date and time for a film screening. I’m wondering if professional creative types and their email response times. Maybe he has a lot on his plate. Maybe he’s working an another fantastic movie. This is my first time interacting with a director!
CleanMed 2021 Abstract Submitted: Possible Conference May 2021
Climate Activism from A Middle-Managers Perspective: How Do I Engage The Department?