Day 13 of #NaNoWriMo

Another productive day today. A few more chapters have been completed and I'm close to midday on the week I'm writing about. 'Diary of a Female GP' is progressing steadily, another 6478 words of the book written (and edited) today. The grand total at the moment stands at 72488 words. Will I reach 90000? It is possible. We'll just have to wait and see.

So far, I have not written anything for my sixth book today yet. I will possibly get on with that after I return from picking up my son from school. If there is enough time left, that is. Otherwise, it will need to wait until tomorrow.

So, here is today's graph and an excerpt of the book can be found below as always. Hope you are still enjoying this.

Only one more patient remains. That is, of the list of patients who were booked into existing appointments. The rest of today’s list consists of ring backs and emergency patients. 
Sixty-three-year-old Jeffrey walks in and glances around him hesitantly. 
“Come in and have a seat,” I force a welcoming smile on my face. 
A red flush colours his cheeks, “You’re a female.”
I can’t deny that, “That is right. Did you want to see a male doctor instead?”
“Well, I’m here now, anyway.”
Jeffrey tells me about his embarrassing problem, “My foreskin is that tight if I go for a wee, everything squirts everywhere. It’s time I saw someone about it. Sometimes the foreskin even swells up like a balloon before I can finally urinate.”
After an examination confirms an excessively tight foreskin or phimosis as it is known in the medical world, we agree I will refer Jeffrey to the urology department for assessment and treatment. At Jeffrey’s age, this is not a pleasant operation. I suspect it is not at any age, but at least young children will have no memory of it. Forewarned about this, Jeffrey leaves my room, a form to book a choose and book appointment in his hand. 
While I write the referral letter, another message from Ruth to check a patient with her pops up on my screen.

Joni

A belated update for yesterday's #nanowrimo2018 progress

Apologies for a late update. Yesterday was a busy day, the usual household chores and grocery shopping coming first. Then I wrote another chapter of  'Growing Love', which also included a bit of research for a holiday scene. Although I had visited the area a lot in the past, I needed to double-check a few details and make sure nothing had changed. This took most of my morning and writing the #NaNoWriMo project took a bit of a step back.

Yesterday afternoon I did write another chapter of the book, 2511 words, bringing the total up to 66010 as per yesterday. The update on the progress of 'Diary of a Female GP' had to wait. No time was left over to do this last night as I needed to visit a friend in hospital.

So, here is the belated update:

Or if you prefer to see the daily progress broken down per day (bearing in mind I have not done any writing yet today as it is only eight in the morning and therefore today's count is still at 0), you can have a look below:
(I love yWriter 6 so far, a free programme with a lot of helpful things to create your writing projects)

And for the daily excerpt, here you are. I hope you enjoy it.

Ben, the forty-six-year-old man with lower backache is the first extra patient of the afternoon. Ben phoned for a sick note this morning, which he did not require and called back later in the morning as his back pain was such he wanted to be seen because of it. Or so he told the receptionist.
“Doc, I know you said I don’t need a sick note, but my gaffer..., well...,” Ben fidgets with a leaflet he picked up in reception, “The thing is..., he won’t let me take time off unless I get a note from you. Honestly, I really need that sick note.”
So, how about that backache worsening? “Can I just make sure? You are here for a sick note and not because the pain is worse? Is that correct?”
Ben nods, “Yes, it was the only way the receptionist would let me speak to you again.”
“Well, here is the situation. Legally, your employer is not allowed to ask for a doctor’s note until you have been off sick for at least one week. Employers are legally bound to accept an employee’s self-certificate for a duration of up to one week. Obviously, you should only use that option if you are unable to work. If your employer for some unknown reason insists on a doctor’s note, there is only one option for that. I can give you a private sick note, but such a note carries a charge. A charge I believe the employer should pay, but they will often leave it to the patient to pay for it instead.” 
Ben nods.
“Knowing what I have told you, do you want me to give you a private sick note? A note you legally do not require?”
“Well, if you put it like that. I will try my employer again and get back to you if he insists on a note from you.”
“And how about your back? Is it worse, the same? Can I examine your back while you are here, so we have that to back up any notes you may require later?”
“No, really, there is no need. It is improving already. No need to bother with that. Cheerio.”
Ben leaves and I wonder why people will sometimes make up things to see us.

Joni

Time for another daily update, day 11 of #nanowrimo2018

So here we are again on day 11 of #NaNoWriMo. Time for another update on my progress and this will as always include a little excerpt from my work in progress.

Today I have reached 63499 words, and I was tempted to add another one, part of my OCD really. I like to have nice round numbers. The added number of words today was 3445, so adding another one would have messed with the nice round number there anyway.

Now it will be time to get back to writing my sixth book again soon, not much has happened with that over the last few days, only about 300 words and that is nothing really.

So here is the excerpt (also on the picture above), I hope you'll like it.

Five-year-old Bradley is my next patient. Today he has come with his dad. Bradley spends half the week with his mum and the other half with his dad. Tonight he will return to his mum for a few days and then return to dad again on Sunday. Although his parents are no longer together, they sorted the childcare out well between them and work together as a team where Bradley is concerned.
The reason they are here is due to a deterioration in Bradley’s asthma. Over the course of today, his breathing has worsened, he is more wheezy and, although his inhalers help, he needs to use them on an hourly basis.
When I examine Bradley’s chest, there are a few crackles on the right and he is very wheezy. The skin on his chest gets drawn in between his ribs a little and this is again a sign he is struggling a little. I try to test his peak flow (a breathing test), aware Bradley is likely too young to be able to perform this, and it is lower than expected for his age and height. The technique shown during this test was however poor and the result is therefore not accurate. When I test his oxygen levels, they are 99% and his pulse is a little fast at 96 per minute. 
At the moment I wonder if we should have Bradley admitted. When I suggest this to dad, he is adamant Bradley has been far worse than this and usually recovers quickly with antibiotics and steroids. Bradley’s breathing appears to have settled a little and I agree to give Bradley antibiotics and steroids and let him go home, provided his parents will seek medical attention immediately if he does not improve or worsens overnight.
Before he leaves, I also book an appointment for the next morning to review Bradley again, “Although I officially have no appointments available tomorrow, I still want to see him again. Does ten to ten suit?”
“That sounds fine doctor. His mum can take him, she is off on Friday. Are you sure it’s not too much bother?”
No, Bradley needs to be reviewed tomorrow and if creating an extra appointment before tomorrow’s surgery is what is needed, I will do that. They leave, promising to re-arrange the appointment if it is not suitable after all.

Joni

60000 words behind me on day 10 of #nanowrimo2018

Another day of writing, another update. Today I have added 3473 words, the total over ten days now at 60052 words. Gradually edging towards the end of the book after another two chapters have been completed. Yes, I'm quite pleased with my progress so far. Not bad for a first-timer at #NaNoWriMo.

My next job today will be to do a little bit of editing, perhaps another chapter of this book and then continue to write some further on 'Growing Love'. For the last few chapters I was in need of some research. The information is still somewhere lurking in that head of mine, but I can do with a slight reminder. Suffice it to say that details about a holiday location need to be double-checked with the knowledge hidden in my brain.

There won't be a lot of time left to do this today, I have promised to cook Chinese for the family today. That always takes about an hour and a half to prepare.

But, for now, here is the update on the progress and another excerpt of the work in progress can be found underneath. Yes, 'Diary of a Female GP' is progressing nicely.

I love Baby Clinic, or well baby clinic as it is officially called. During Baby Clinic we see babies for their eight-week check or their heart checks at the age of one. The little cuddles and playing with the little ones always make me feel happier and also make me feel broody. Yes, I know, I already have four children.
The first one on the screen is eight-week-old Joshua, who has come with his parents. His beaming mum and dad walk in the room with Joshua in his carseat.
"Congratulations. How is everything going? Do you enjoy being parents?"
Their smiles become even wider and their eyes shine as Joshua's parents confirm they love being parents.
So far, no problems have been found. Joshua feeds well, he is breast-fed, and he smiles and follows movements.
Now it is time for Joshua's check. Mum carries him to the couch, closely followed by dad, and undresses Joshua, leaving his nappy on at my request. In the meantime I wash my hands and grab a stethoscope and ophthalmoscope (a tool to look into eyes with). For the checks, I start at the top and work my way down the body. His soft spot feels normal, his eyes are open and he follows where mum goes. When I look in Joshua's eyes, the light reflex is normal. Joshua's mouth seems normal, his neck and shoulders too. He has two arms with hands and the expected number of fingers. The heart sounds normal and the lungs too. Joshua's tummy shows no abnormalities and there is no evidence of a hernia. Both hips are stable. When I check his private area, all is in order there as well and his testicles have descended ( a real feat considering my hands are usually freezing cold). Joshua's legs, feet and toes are fine and all reflexes are normal. Now I turn Joshua over and a check of his back is also unremarkable. He does have a 'storkbite' though, a little birthmark at the nape of his neck. 
The last thing I check is mostly for the benefit of the parents. When babies are this young, they often still have an old 'walking-reflex'. I lift Joshua up and let the top of one of his feet touch the couch. Yes, as expected Joshua lifts the foot and places it on the couch, the next foot follows and he takes a few steps. His parents absolutely beam at their brilliant son.
Now that Joshua has passed his first check with us with flying colours, mum dresses him again while I enter all the details of the examination on the records.

Joni

It's #NaNoWriMo day 9!

I have put 'Diary of a Female GP' to the side for today. Even though I have not written a lot of words today, I'm still on track to complete the first draft of this book by the end of the month, I believe. 

Twenty-five of an estimated forty-three chapters have been written so far and today's total is 56579. A total of 4009 words have been added to the project today.

After my update yesterday, I finally gave in to the urge to edit some of this book. By now, the first five chapters have been edited for an initial time. Once the first draft is complete, I will read through and edit the book again. Only after that, I would estimate the book ready for the beta-readers. So, if there is anyone out there who would like to help me out and read the book before anyone else does and give me their opinion, please let me know.

The next job on my list is to have some relaxation time now and update myself on e-mails and social media and the like. After that I'll get back to writing 'Growing Love'. That has been rather static over the last few days. The need to complete that book is growing steadily. In the near future, my husband may need me to help him out at his business. If that will happen, the time left for writing will be greatly reduced. The sooner I get the book finished, the better it is.

Now for the daily excerpt, here you go, I hope you enjoy it. But as always, please remember this is still a work in progress.

When I return to my room afterwards, a ringback marked 'urgent' is waiting for me. Before doing anything else, I open the notes to check the details. "Paramedic with patient. Requesting urgent visit. Please ring asap," it reads.

The daughter of eighty-seven year old George has phoned an ambulance as he was struggling to breathe and she suspected he needed to be admitted. George suffers from severe COPD (chronic bronchitis) and is bringing up thick green phlegm. Even simple activities like putting his clothes on, have George gasping for air. After the paramedic has given me this background information, he then continues to tell me about his oxygen levels, which are only eighty-two at the moment.

Why are they even asking for a visit? George needs to be in the hospital, not to wait for me to do a visit and lunchtime and then be admitted to hospital.

"George does not want to be admitted, doctor, and we can't transport him against his wishes. We would therefore ask you to come out now to see George as an emergency."

Sorry? Come again. They want me to leave a busy surgery with patients waiting to be seen? Only so they are covered if they leave as George does not want to be admitted? "Sorry, I'm afraid I'm a little overstretched at the moment and will not be able to see George until later today. But really, he needs to be in hospital with the symptoms and signs you just mentioned."

The paramedic asks if I can speak to George in that case.

"How are you feeling George?"

"Like a wrung out towel to be honest. But I don't want to go to hospital and be told I'm a time waster." George needs to take a breath every other word, he is really struggling.

"George, it does not sound like you are a timewaster. You sound like you need to be in hospital and I would strongly advise you to go with the ambulance who has come for you."

George sounds dejected, "Okay, if you really think it is needed I'll go." He still needs to stop every other word to catch his breath.

Pleased to have succeeded to convince George to do what is best for him, I continue to the next thing on the list.

Joni

#NaNoWriMo Day 8.

And here we are again. Another update on the process and another day spent writing a little. 7467 words more to be exact. And this means:

I've crossed the 50000 words threshold today. Yippee, no more stress, no more pressure. Only the pressure I put on myself, which obviously continues. 'Diary of a Female GP' is well underway and half-way to completion of the first draft, I estimate.

So, now my target has changed. 50000 is no longer the target I work towards, after all I have already gone over at 52553 today, but I aim to complete this novel this month. So, all the words this novel will have eventually I want to be written. I also want to have a first edit of the book done, so I can look at re-edit and second draft by the end of this month or December at the latest.

And then? Then I will need to find some beta-readers for advice and then re-edit, final draft and publish. Perhaps this can be done by the end of January.

Of course, 'Growing Love' is still waiting to be completed as well. I'm working the last few chapters of the book and hope to be done with the first draft by the middle of November.

Now, for those of you who are waiting for another peek, here is another little excerpt from 'Diary of a Female GP', the work in progress for #nanowrimo2018.

Claire agreed and left and after signing a few new electronic prescriptions and grabbing the box of prescriptions I already signed, I got up to leave my room.
At that moment there was another knock on the door and Carly walked in, "Can I have a word?"
What now?
"I'm so sorry, Dr J, but I have just had a call from Dr K. Dr K won't be in this morning due to illness. We have a problem. All Dr K's appointments for this morning are already fully booked, what should we do?"
That indeed is a problem, the nightmare already starts before the first patient even enters my room. 
"It can't be helped, we'll have to do what we can and cope. If you girls try and rearrange the appointments you can, I'll see the ones who can't be rearranged or turn up before you have had a chance to reschedule them. We'll just have to fit them in where we can. We've done it before and have managed. We'll do it again. I'm sure we can cope if we just work together like the great team we are."
Yes, I hope we will. Personally, I am not so sure, but I have to keep the morale up. A lot of the practice lays on the receptionists' shoulders. Without them doctors would be nothing and could do nothing. In reality it is not so much the doctors who keep the practice running as it is the receptionists. Well, we really need the entire team. Together we can be strong and deal with the pressure put on us, unless that pressure becomes too much. Will it be too much today? Time will tell.
"But I'm so sorry for you, Dr J, it seems like you always end up with these situations."
I'm sure that's not entirely true, it must happen to my colleagues on occasion as well. Although I don't call in sick very often. In general, I will even get to the surgery if I have to hold myself up on the walls to make sure I don't fall down. I hate letting anyone down and will drag myself in to work even if I don't feel well. On occasion I have had patients tell me, "You don't looke well, doctor. You should see a doctor." Which, of course, I do every day. Either at work or at home.
I hand Carly the prescriptions and make my way upstairs to get ready for the nightmare that will be today.

Joni

Day 7 of #nanowrimo2018

Time for another update.

Today I have taken it easy, it's my birthday after all. Still, I have written 4183 words on the project, bringing the total so far up to 45086 words. Not bad over seven days I think. I have so far not written anything on my sixth book yet, but I have also published another book review on a book I've read.
Other than that, I have also baked a cake, it's my birthday after all.

I hope everyone else taking part is doing well too.

And here is another little excerpt from the work in progress,

Now I continue with the electronic prescriptions, signing them and signing a few of the prescriptions in the box I brought down with me as well. Once the electronic prescriptions have been dealt with, I move to deal with the tasks, but notice there is another patient awaiting to be dealt with on my screen. In the bottom of the screen on the clinical system, several coloured squares show, which contain numbers. Some are for the results, showing how many results there are in total, how many there are for me and how many there are with no clinician assigned. 

Next to that it shows the letters in much the same way, total number of letters with next to it number assigned to me. 

The next line of coloured squares shows all my appointments for the current session, the number of patients seen, the number of patients awaited, the number of patients who have arrived and the number of patients waiting for me. 

The following squares show the total number of electronic prescriptions, and the number assigned to me.

The last group of squares relates to the number of tasks, total number, tasks assigned to the group I belong to and tasks assigned to me.

In the square of patients awaited, there now shows a number one. Another patient has been added to my list. As I don't want any patients to slip through the net through either my own or someone else's mistake, I return to the appointment screen and find another ringback waiting on my screen. Why did no one alert me? Or is this again a ringback added in error?

When I open the patient's notes and check details of the ringback, it only states "Personal problem. Patient wants to speak to you."

Oh, yes, it is Eleanor, a forty-nine year old lady who only wants to see and speak to me. For some unknown reason, she only trusts me. We have patients like that and I suspect there are patients like that in every GP practice. Usually she wants to talk about her panic attacks and I take a deep breath and phone Eleanor.

"Oh, thank you for phoning back doctor. I would like to make an appointment to see you please."

Huh? Why did she not ask the receptionist for an appointment?

"Is there any reason why you wanted to speak to me today other than to book an appointment?"

"No there isn't. Do you have any appointments next week perhaps?"

"Eleanor, there is no need for you to speak to me to book an appointment. Perhaps you can phone our receptionists to book an appointment?"

She agrees and we finish the call. My mind boggles at why she would want to speak to me to book an appointment. Five wasted minutes in which more of the paperwork could have been completed.

Joni

Book Review: Ghostly Writes Anthology 2017

Book Review

 

Basic Details:

Book Title: Ghostly Writes Anthology 2017

Subtitle:

Author: Multiple authors

Genre: Horror/supernatural

Part of a series? Yes

Order in series:

Best read after earlier books in series? No

Available: https://www.goodreads.com/book/show/36506400-ghostly-writes-anthology-2017

Overall score:

I scored this book 4/5

⭐️ ⭐️ ⭐️ ⭐️

Short Summary of the book:

This book is a collation of several ghostly writes. Ideal for anyone who likes these types of stories.

What I liked about the book:

I particularly liked that there were stories from multiple authors in the book. Something to like for everyone.

What I didn’t like about the book:

I wasn’t impressed by the odd writing style of individual authors, but in general it was a good read.

My favourite bits in the book:

I loved some of the stories, but not all. That is why this is a nice collection. Something to appeal whereas other stories may not be for you.

My least favourite bits in the book:

This book is not the usual genre I go for. I enjoyed some stories, others not so much.

Any further books in the series? Any more planned by this author?

I understand these anthologies are published on an annual basis.

What books could this be compared to and why?

This book reminded me of The Shining, although different at the same time.

Recommendation:

In summary, I would recommend this book for the following readers:

Children	No
Young Adult	Maybe
Adult	Yes

If you like Horror and supernatural stories this book is the book for you.

I look forward to reading more books by these authors.

Book Description by Author:

ENTER IF YOU DARE. A new Ghostly Writes Anthology for 2017, gives you sixteen authors from around the world with ghostly stories and poems for you to read. Each short story will take you to a new place, be it the future, present or past.

Plaisted Publishing House is happy to present this book to you - our readers. Please note that all stories are written in the English of the country the Author resides in.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Slight addition to the original review at the request of one of the readers of the review.

Which stories did I like, which one did not do it for me and why?

·       The Crow Watches - A great poem.

·       Soul Man, Part Two – I really enjoyed this story as well, a bit of a hero ghost in this story.

·       Lily – A great ghost story, which could really give you the willies.

·       Rimor’s Riddle – Although the story is interesting, the delivery was lacking a little.

·       The Old Oak Tree – A great story, well told. A malignant ghost takes control of humans to exact his revenge for his own murder.

·       Boneyard – Another great story, which I really enjoyed. Crime doesn’t pay.

·       The Piano – Loved this story as well, although it had an unexpected twist. I had expected it to turn out the other way it did.

·       A Sanctum for Charlie – Another fabulous story, which had a bit of a historic twist to it and time travel.

·       Together Forever – I really enjoyed this story as well, a bit of a hero ghost in this story.

·       A Grave Business – Interesting twist on the undertaker business with a mixture of ghosts and technology.

·       They Came for Him – Another great story. Don’t play around with an Ouija board.

·       The Big Escape – I liked this story of a girl in an orphanage finding her gift still links her to remaining family.

·       Primrose Point – An interesting story with a love story underneath. Although the possibly happy ending does not lay within this story, you could envisage one when the story would develop further.

·       Blood Bond – This was an interesting story about a girl raised by her dad after her mum’s death. Dad believes there is a supernatural world about and Ciara comes face to face with what dad always looked for.

·       Wicked Moon – A poem, that did not quite work for me.

#NaNoWriMo Day 6, still going well.

I'm still going full steam ahead for #NaNoWriMo2018.
Today I spent most of the morning writing on my project and I'm now gearing up to continue writing my sixth book 'Growing Love' again. There is still a bit left of the book and I would like to finish the first draft of this book soon as well. Although I'm getting close to the end of the book, I'm still not quite there yet.

So, how did I get on with 'Diary of a Female GP' today? I have now passed the 40000 word mark and have reached 40969 words, today 6772 words were added to the project.

I hope you are enjoying my daily updates so far, with the little excerpts from the book as well.

Here is another taster:

And then it is time for my fifth patient already. The amount of time I was ahead, has now been reduced and shattered and instead I'm running five minutes behind. Oh, well, you can't have it all I guess.
Thirty-seven year old Jenny comes complaining of abdominal discomfort and bloating. She has gradually increased in weight over the last few months and denies any possibility of pregnancy, "I'm just getting fat, should stop eating rubbish."
When I ask her when her last period was Jenny informs me she has no idea, she has always been irregular and doesn't keep track. "They come when they come and that's just how it is."
After asking her to lay on the couch so I can examine her, I have a good feel of her stomach. It is quite large and, if I am to believe Jenny this is due to obesity. However, I'm fairly certain I can feel a baby inside. Even if it is not moving at the moment, I'm fairly sure I can feel the head, the body and the limbs. No chance of pregnancy? I'm definitely not convinced. 
"Jenny, I believe you may be pregnant after all. Would you like me to check if I can find a heartbeat?"
Jenny's eyes shoot wide-open as does her mouth. Speech appears impossible, but she nods.
I walk to the cupboard and collect the doppler. Hopefully the battery is still working. After putting a bit of jelly on the probe, I place it where I expect the baby's heart to be, and..., indeed, there it is. A fast heartbeat can be heard.
"That is my heartbeat, though, isn't it doctor?"
Not a lot of patients have a resting pulse of around one hundred and twenty a minute. I move the probe to where it picks up her heartbeat, "This is your heartbeat. Nice and slow." I move the probe to the baby's heartbeat again, "And this is the other heartbeat. Hear, it's faster."
"But..., but...," Jenny can't get her words out easily, "I can't be pregnant. This can't be true."
Well, I'm afraid it's too late now. When I examined Jenny it felt like the womb reached to around thirty-six weeks already, there is no going back now.
After informing her of the approximate pregnancy duration and advising her she will probably need to prepare herself real soon, I arrange for an emergency referral to the midwife. If my estimation is correct, she only has about four weeks left. Not a lot of time to get used to the idea of becoming a mother and preparing for it. Not quite the surprise you would expect on your visit to your GP.

Joni

#NaNoWriMo Day five.

 
Okay, so today is not something to write home about. Too many other things have interfered with the thing I needed to do, write.
Instead, I have spent time doing the housework (also necessary), the shopping (the family needs to eat after all), booking a short trip in December (not urgent, but would help) and sorting a few other things out.
But, I have still managed to write to, albeit short, chapters of the project.

Current word count: 34197
Today added: 1898 (yes I know, I should do better)

This is, however, a convenient place to stop. The end of a chapter, while I already know the next chapter is going to be a long one.

Ready for another short excerpt? Here we go (it's not much, but something is better than nothing, right?)

Again, I walk back to my room after and start preparations for the day. A few more of the letters waiting are dealt with, and I notice the complaint I received yesterday. I will need to make some time to answer that one as well today. Officially we may have two weeks to answer a complaint, but I always feel the sooner it is dealt with, the better. I absolutely hate receiving complaints. As a perfectionist, I always aim to do the best I can for all my patients. A complaint to me means that I have failed in doing that and that hurts, a lot. It makes me wonder if I will ever be good enough, or whether I never was good enough in the first place. Still, I must be to have gotten this far.
After putting the complaint to the back of my mind for the moment, I return my attention to all other jobs still waiting for me. The letters. Electronic prescriptions that have been put in my inbox since this morning, tasks that have been sent already. At least I'm not on call today and that is something to be thankful for. 

Joni.