Long Time No See

My last post was a couple of months ago, but it seems longer. I keep thinking I need to do a catch-up post but there's not much sense in recounting everything. I'm not sure this is supposed to be a "diary" anyway. Main event after my last post was health issues for my 79 year old dad. His jumper cables gave him a shock, which is his way of saying that his AICD (defibrillator) fired. Long story. Short version is that he's home now after a week in hospital and step-down. Both parents are elderly now. (Gosh, I almost feel guilty using that word on them but it's true). When people ask, how are your parents? My answer is: They're still waking up every morning!

Boring post, but this will give me a jumpstart into getting back into the blog.

H1N1, flu, cold viruses, & my advice

Dear friends,

The H1N1 flu is here, as well as run-of-the-mill cold and flu viruses. Please accept my unsolicited advice:

Wash your hands with appropriate frequency. Use soap and water. Get hands wet, add soap, work the suds for a full 20 seconds (outside of the water stream), then rinse. You'd be surprised how many people put a little water on their fingertips and call that washing -- or start rinsing the soap off as soon as they touch it.

Use sanitizing hand gel, especially after touching people or using public equipment of any kind (public computers, phones, etc). Work the gel into your hands (back and front & between fingers) until the gel disappears. It doesn't work if you rinse or wipe off the gel right away because you think it's slimy. It's supposed to be that way.

Spray or wipe phones, keyboards, computer mice, and your TV remote controls with something like Lysol or those sanitizing wipes. If someone is sick at home, go through the house once per day and wipe/spray things like the refrigerator door handle, light switches, doorknobs, cabinet handles, and other things that everyone touches. This will decrease the spread of cold & flu viruses within the household. For businesses, also pay attention to things like copy machines, fax machines, and printers. No need to get paranoid, but do this when someone is sick or in public/work environments.

It is not necessary to buy soap & sanitizers labeled "antibacterial." Cold and flu viruses are viruses, not bacteria. All soaps are sanitizing, anyway. The word "antibacterial" usually indicates that the product contains Triclosan, which is harmful to the bio-environment. Use it if you already have it, but you don't have to seek out those labels.

If your doctor has recommended that you get the flu shot, please take that advice. This is a decision between you and your doctor based on your personal risk factors. If you have been advised to get either the regular flu shot or the H1N1 shot, please do so.

Thanks for putting up with my advice!

Good luck and stay healthy!

"The Good Dr. Laura"

Feel free to forward.

The Dog Whisperer

What I've learned from Cesar Millan:
1. Exercise, discipline, and affection, in that order.
2. You must be the alpha dog, the leader of the pack. If you give up leadership, it's very difficult to get it back.
3. Maintain a calm and assertive demeanor at all times.
4. Correction must be done immediately -- instantaneously, in fact. Cesar uses a curt noise of some kind and a deeper/serious vocal tone. Once you've made your correction, give immediate reward with affection and a gentle tone of voice.

The Physics of Vampire Sex

(dare I post this?) A new blog's first entry was sent to me by a friend via Twitter. Here is my comment/response:

http://physicsofvampiresex.blogspot.com/2009/08/to-start-this-blog-off-on-right-foot.html

love the vampires, hate the maenad

True Blood:
I can't wait for that maenad bitch to get devoured or whatever so I can have my normal vampires back.
I had to turn on all the lights in the living room tonight during the show cuz I was askared.
Eric and Bill are hot in different ways. Eric is &#%$in' hot to look at but I'd rather have Bill feed from my vasculature.
Queen Sophie looks the part but her voice is too anachronistic. She has that gravelly deep vocal thing that is just too late 20th century San Fernando Valley. Nobody thousands of years old would talk like that. Too bad. She could have passed for a Botticelli model, or a model for one of those Greek statues. It all stops working when she opens her mouth. Then I remember I'm watching a TV show.
Poor Lafayette. If it weren't fer bad luck he'd have no luck at all.
WTF is that egg?

I actually did give blood at a Red Cross event last week. It was the first time I wasn't disqualified. No recent travel. My life is boring. Almost got dinged on old Ghana stuff or that trip to Nigeria a few years ago, but they gave me a pass. Anyway, I did fine that day -- no fainting or diaphoresis or anything -- but I was flippin' WEAK AND TIRED for 3 or 4 days. By my calculations, I probably gave away about 13% of my blood volume. Dude, Sookie must be tired all the time! How can she run around and fight bad guys like that if she's chronically anemic?

Class of 2012

So far, so good, with the new class of 2nd year students. We've had orientation all week. The clinics, docs, and staff are much more welcoming to this class than the inaugural class last year. Last year everything was new and the clinics were under stress from several other major, simultaneous changes at the health center, so there were reasons for their apprehension. Now, after a year of this program, the culture of the health center is starting to include the medical students as part of the family. I think we still have a long way to go, but we're moving in the right direction.

Senator Edward Kennedy

I just found out, through Twitter, of course, that Senator Ted Kennedy has passed away. I had the opportunity to meet him in 2004 when he was stumping for John Kerry. It was early in the primary season, so it was a fairly small crowd and I was able to be just a couple of metres away from him. He was amazing. First of all, really handsome! More handsome than I expected given his age and more handsome than he looked on TV. His body looked just really worn and tired. I guess he had terrible back problems. But his spirit and mind were vibrant! He had quite a powerful voice to carry his eloquence. I got to shake his hand. It was a humbling experience to be in the presence of greatness.


Now our task is to carry on his legacy by passing a good health care reform bill, one with at least a few teeth! He lived his life doing great work, but also the often tedious work in Congress to get lines in bills and getting bills passed that serve the American people, ALL of the American people. At the VERY LEAST, we need to make illegal any discrimination by health insurance providers against people with pre-existing conditions. End of life counseling is a compassionate way to touch the lives of our patients and we should not shy away from it because stupid people have made ridiculous and outrageous misinterpretations of this. There should be the availability of a publicly funded segment of health insurance if not delivery. We already have this in the forms of Medicare, Medicaid, KidsCare, and the V.A. These kinds of options should be available to every American who chooses to utilize them. Health insurance should never have been linked to employment, certainly not as the primary method of coverage for the country. Most importantly, for-profit health insurance companies and health care institutions should absolutely not exist. Why? Because in a for-profit system, illness will always pay better than wellness.

Healthcare reform was the Senator's last crusade. Let us carry on that mission and help him achieve one of his last goals.

Minnie Ripperton

@yayayarndiva said she was listening to "Loving You" by Minnie Ripperton. I tweeted a short version of a story about that song and she wanted to learn more, so here's a longer version.

I was in Chile in a town in the mountains in what I thought was supposed to be their summer, or at least their spring. It was too fkncold for me and I got sick and I needed a break to a warmer climate, so I took a 25 hour bus ride from Santiago de Chile to Arica, the northernmost town in the country (and on the beach and, therefore, warmer). Somewhere in the middle of that amazing journey through, among other things, the most desolate landscape I've ever seen (the Atacama desert), we stopped at a little cafe/diner. There was nothing else around, at least in my memory, but this little restaurant. We had a half hour to eat and use the facilities. It was close to the time to get back on the bus, I was sitting on a bench outside the restaurant. A beautiful little girl was sitting next to me. Minnie Ripperton was singing "Loving You" on the radio. It was a peaceful and lovely few minutes.

So, Mimi, that song reminds me of that day.

Week 2 in Review

Busy week!

Baseball: Trent started off his major league career with a bang, to say the least. I heard it was the best debut since 1954, but I heard that from his mom, and I don't know the original source, but he still had an incredible debut. At one point his batting average was .500, but he's cooled off to a human, but respectable .314. That's where he usually lives, anyway.

His mother flew in from Sydney and it was a delight to meet her. We hugged as if we had known each other for years. Seriously, I've been in tears for a week. Mom & Sis are in Philadelphia, where the Dbacks are playing now. What a great way to spend a holiday!

Work: Crunch time. Stress. Too much to do. No time to do it. Gotta see patients tomorrow, when I have too many other things to do to prepare for the new medical students next week. And I need to get to work now to give a presentation, so I'd better get going. Just wanted to give a catch up for all five of my loyal followers. =]

There IS crying in baseball!

I'm so proud of Trent. I've been crying off & on since the home run tonight - his 3rd in 5 days! He's worked so hard. Spent so many years in the minor leagues. Stuck in AAA for 3 seasons watching other guys pass him by. He was not a power guy last season. He's naturally a good top of the order guy, a table setter. Overall, he did better there than when they had him hitting at the bottom of the order, which was most of the time. He's always been fast. Used to be a bit impatient at the plate. It was sometimes a struggle for him to lay off. I haven't had a chance to actually see him this season because he's been in another city, but watching him on the Dbacks I can really see how much he has matured as a hitter, even since one year ago. So many nights last season he'd come home after a game, tired, frustrated. We'd talk about hitting. When to swing, whether to swing, whether or not to think about it. He had some really unhappy, frustrated times. He also had a lot of great games, offensively and defensively. We all thought he was ready at the beginning of this season, but the extra time and experience seem to have paid off.

Minor leagues suck. It's just hard. Medical school and residency suck too, but at least you know for sure you'll be a doctor, and you keep going in one direction. In baseball, you never know what will happen, you go up, you go down, you ... just never know.

Here's the link to his first post-game interview. There's my boy - great smile, familiar voice and accent. Sounds normal to me, of course, because I've had Aussies in my house for 3 seasons.

His mom (his real mom) will be flying in from Sydney this week. I can't wait to meet her. (I'm crying again!)

Pain in the B...elly

Urgent care doc friend says that he saw a patient over the weekend with a 3 month history of abdominal pain. He asked, after three months, what made you decide to seek care today? (in the E.R.) She answered, "Well, we were in the neighborhood."

Nurse Jackie

DirecTV's synopsis of an episode:
"Jackie admits a dying patient she previously treated; O'Hara tells her sister Jackie's secrets; an organ donation form is forged. Comedy."

Oeltjen

My Aussie kid, Trent Oeltjen, has had quite a first 2 days in the major leagues. In his first game, he got a hit in his first ML at bat. Went 2 for 6 and the other hit was his first ML home run! He stole TWO bases. His first ever fielding opportunity in the majors led to an out at 2nd base. Wow! Not many guys have a first game like that one. See boxscore, one to keep!

In his second game, he was already 0 for 3 when he was called out at first, but it was a bad call. Replay shows he made it. His manager got in the umpires face. They were screaming at each other and you could see the bad words on the TV closeups. Manager A.J. Hinch got tossed. Cool! Trent got a hit on his next at bat.

I know I'm not his real mom, but I feel like a proud mama!

Goin' to the Show!

One of my baseball players is going to the Majors!

I suppose I should explain. I live within walking distance from the Colorado Rockies Spring Training site. I've been hosting minor league players at Spring Training for several seasons - all Aussies. They call me their American Mum. Another Aussie who's with the Arizona Diamondbacks (they train in town but at another site) joined our little family in 2008. Trent Oeltjen has been in AAA for 3 seasons. It's been tough to watch a number of his AAA buddies go up for their taste of coffee without him. But last night he finally got the call!

He's goin' to the Show!

The Diamondbacks are in Pittsburgh today, Washington DC for the weekend, and home on Monday. You'd better believe I'll be there! I'll take my 10 year old nephew and Harry Potter (the new 15 year old). I'm sure Trent's girlfriend will come in from San Diego for the game. Can't wait to cheer him on!

The Brain of an 18 Year Old

Yesterday I was getting ready for a party - actually a fundraiser that I was hosting, but at someone else's house. I made the mistake of FIRST getting ready, THEN loading up the car. Lemme tell ya, not a great idea. So, I'm wearing the 4-1/2 inch shoes - wedge, not skinny heels, but still. I loaded up my arms with platters that I was going to take over for our "wine & cheese potluck," so we would have a place to place the cheese & crackers. I tripped stepping out of my house, fell forward, platters shattered in my arms, and I realized that my head had just smacked right into the concrete in my carport. F***. If my head is split open, how am I going to take care of this party? I wobbled to the bathroom - no lacerations - a miracle. Not on my face and not on my arms from the broken ceramic. Somehow I managed to sweep up and get to the event. In flats.

If I say so myself, I was fabulous. Friendly, normal, interactive. But I had a headache and felt a little off balance. At the end of the event, when most people had left, I had a crying spell over some confusion about the dishwasher. I finally had to come clean. I'd had a closed head injury. (Emotional lability can be one symptom of a concussion.)

My friends were great- shocked at me but helpful. Luckily, many people I know are doctors. Friend wrote me an order for a non-con head CT. Got a ride home. Another friend stayed the night and checked up on me intermittently. Dude, that is a good friend, to set an alarm for 2 am to check to see if I was still alive.

Yeah, yeah, I know, I chose not to go to the E.R. But only because I knew what would happen. They would ask me some questions to check my mental status. I pulled off hostessing that party, I would say my mental status was adequate. They would ask me if I was vomiting -- I wasn't. They would see if I was dizzy -- I felt a tiny bit off balance, but no true vertigo. They would ask about the headache. It was about a 3/10. Not "worst headache of my life" territory. And they would order a scan.

So this morning I called my boss, got a sick day. Called the Radiology place, got an appointment. Called my office, got the scan ordered in our EMR. Called my old referrals clerk, got the prior auth. All before 9 a.m.

To shorten this long story, I got that head CT and the radiologist was nice enough to call me back to look at the scan with him. No subdural hematoma. He said I had nice sulci - a beautiful brain. Said I had the brain of an 18 year old. From a radiologist, that's a compliment.

I went home, had lunch, and slept all day. Broken platter parts still in the carport. I'll clean that up tomorrow. Head still hurts, but not too bad. Not feeling as woozy. But I have unattractive abrasions on my forehead and nose.

All in all, I think I got lucky.

Turtles On The Runway

Hello everyone! So, I've been commenting on other people's blogs, but finally decided to start my own. I'm watching David Letterman right now while I'm trying to think of a name for this blog. He was talking about a 90 minute plane delay at JFK airport today due to turtles on the runway. Sounded cool. So there it is.

I suppose I'll write about medicine, teaching medical students, baseball, and movies. I follow some nurses and docs, both on Blogspot and on Twitter. I also follow a number of Peace Corps blogs because I used to be a PCV (Peace Corps Volunteer) in Ghana. (That's a country in West Africa where Barack Obama went to visit recently. That is NOT the country in South America where Jim Jones killed all those people with Kool-Aid.)

I'm looking forward to comments. I'm new at this. Can't possibly be as cool or funny as Dr. Grumpy, but we'll see where it goes.