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Posts Tagged ‘medicine’

My Nashville family has returned home from New Zealand and Australia. They Ubered straight from the airport to their home, just a few hours after we’d tucked the Grands into bed. Bob and I were happy no bones had been broken during our tenure. Well, just my left thumb, when a basketball landed straight on it in the Sound Waves pool. This was ostensibly the highlight of their week with us, the biggest water park in the world!! (maybe) at the Grand Ole Opry; but for me it was always those tender bedtime talks.

I found out that the L’il Pumpkin loves school. He really loves learning, and can now count by tens! He also plays alphabet Go Fish with aplomb, proving he’s ready to read. And the Love Bug is so sweet she offered to finish singing my Yiddish lullabies because my Fall cold was having its most severe effect on my throat. In fact, my croaking voice wasn’t relaxing at all, it only made them giggle.

Pop Bob had fun fixing little things around their house. Like any good pilot, he had his checklist of things to do – new batteries for the dogs’ invisible fence collars, fix master bathroom door, replace the silverware holder in the dishwasher. I texted my daughter in the middle of their trip, asking her if they might mind all this fixing-up? Great Grandma Ada had once warned me about stepping on the toes of in-laws.

The Bride replied, “You are welcome to fix as much as you’d like!”

After all, they are a busy professional couple. The Groom was accepting an award for his Vanderbilt research in Melbourne, at the World Congress of Intensive Care in collaboration with Australia New Zealand Intensive Care Society (ANZICS). As much as we’d like to think the world is flat and connected by technology, there is still something to be said for actually meeting up, face to face, with others around the globe doing research in your field.

Still, we could Facetime with them after meeting a koala! And I could pull out my smart phone at Sound Waves and slo-mo video the Love Bug under a waterfall!

I was reminiscing with Bob about his primitive use of early video cameras, the kind you hoisted on your shoulder in the 80s. Just then the Rocker texted us – did we happen to have that stop-action film he made in our NJ garage with his Star Wars action figures? He was just about the Bug’s age when he and a friend would spend hours recording Luke Skywalker’s adventures in minute detail. If the weather wasn’t conducive for a trip to the beach, creativity ensued on that cement floor.

The L’il Pumpkin and Pop Bob assembled an incredible Star Wars battle station in Legos while I drove the Love Bug to basketball practice one night last week. And just like that, this morning, my son and his new company Totem has released another amazing Star Wars trailer, “Star Wars: The Rise of Skywalker.”

All those years ago, in our garage with his imagination, and later with his bandmates. Music was always playing in his mind and through his fingers. I am trying to convince the Bride that we should all be Star Wars characters for Halloween because,  “The Story Lives Forever.” Here are our little Jedi Knights at the museum.

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Last night, amid a flurry of texts and Tweets, Bob and I were glued to the Democratic Debate. The Bride had asked us if we wanted to join their “watch party,” but I was determined to stay home and take notes. I knew adding two delightful children to that mix would completely throw me off my game. I was disappointed to see social media quickly turn snarky on Uncle Joe for his “record player” comment, and am still wondering what Bernie said to him as Castro pounded Biden again and again about “opting-in.”

While Castro was questioning his elder statesman’s memory, Bob was reminding me about the concept of “opting-out.” In case you forgot, behavioral economist Richard Thaler wrote a book about this very idea, about how to get people to do what’s right and is in their best interest! His groundbreaking book “Nudge” describes the ideas for which he won the Nobel Prize. Though not an entirely new concept, using psychology to mold public policy and marketing is new.

Prof Thaler’s central insight is that we are not the rational beings beloved of more traditional economic theory.

Given two options, we are likely to pick the wrong one even if that means making ourselves less well off.

Lack of thinking time, habit and poor decision making mean that even when presented with a factual analysis (for example on healthy eating) we are still likely to pick burger and chips.  https://www.economist.com/free-exchange/2017/10/09/the-nobel-in-economics-rewards-a-pioneer-of-nudges

Why? Because it’s our habit, it’s easy, and it tastes good. Climate change and our clogged arteries just don’t factor into a good burger! When Corey was asked if he would have all Americans adopt his Vegan diet, he said “NO” in two languages!

But if we apply Nudge theory to health care the answer is simple. Forget private vs medicare for all vs Amy Klobuchar who READ the bill; according to Thaler and Bob we enroll everybody in ONE healthcare plan! Give it a name and give people the option of “opting-out”…. and because it’s such a pain in the neck for most of us to change, the majority will stay on that plan.

My psychologist brother Dr Jim has said time and again, “There’s always that 10%!” Sure maybe 10-20% may opt-out for something better like a boutique, fancy schmantzy doctor plan, mostly people who are up around the 1-5% stratosphere. Some may just want none of this healthcare nonsense, they want to live like a hermit and prepare for the end of days. Doomsday preppers aside, this is what universal healthcare looks like in most of the G7-or even 8 countries.

My Friday morning quarterback, Dr Bob, has just told me that last night was “…Pure Posturing.” Granted his experience as an ER doctor and Director of his group, who also opened an Urgent Care and ran his own billing company for years gives him a unique “from the trenches” perspective, but when he talks the business of medicine I mostly listen! Because it’s still a “For Profit” business model – private insurers make 20% on every dollar paid for healthcare in this country, while Medicare makes 1%!!!! PLUS:

Bob insists that we are already paying for 80% of our healthcare in one form or another!

We already pay it in premiums (630Billion), out-of-pocket expenses (365B), and in state and Federal taxes (1.695Trillion) for Medicare, Medicaid, and the Military.

It’s only that 20% that businesses and unions pay that needs to be addressed, and think about it –  one political party wants to phase that into Medicare over 4 years, buy-in or buy-out or maybe even call it something else…. and the other party just wants to return to the past and forget about affordable healthcare. Think about what you would want.

Now who is the nudnik or the PAB in the room? Hint – he wasn’t on that stage last night.

This is us voting for the guy who didn’t win Nashville’s mayoral contest last night. Let’s nudge ourselves into picking a winner this time Dems!

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My heart goes out to Sen John McCain, 80, who was recently diagnosed with an extremely aggressive brain cancer. His glioblastoma was found “incidentally” in medical parlance, in that doctors were removing a blood clot that was associated with this condition when they found the culprit. It’s the same kind of tumor that killed Sen Ted Kennedy and Joe Biden’s son, Beau.

It’s the same cancer that killed my Father.

My Father was a pharmacist in Scranton, PA. He had survived the Great Depression and was raising five children with the Flapper. At first, it was only headaches, but later he lost the use of his left arm. My sister Kay had to help him actually grind medication in a mortar at the back of the drug store while her younger brothers read comic books up front. Psychology was a relatively new field at the time; a psychiatrist told my parents that they should have another child because my Father had “lost the will to live.”

I am that sixth child and I wouldn’t be here if it weren’t for his glioblastoma. The Flapper always joked that I was the only child she had planned! My Father’s friend, an ophthalmologist, noticed his bulging retina and sent him back to the university hospital where they operated on his brain right before Christmas 1948. I was three months old. He died in April the next year, he was only 47. Our Year of Living Dangerously was just beginning.

Although I may not have agreed with Sen McCain’s policies over the years, I have always considered him a true patriot. And unlike many politicians, he didn’t couch his words in innuendo. He played it straight and tried to be fair and work across the aisle. His daughter, Meghan, Tweeted:

“It won’t surprise you to learn that in all this, the one of us who is most confident and calm is my father. He is the toughest person I know. The cruelest enemy could not break him. The aggressions of political life could not bend him. So he is meeting this challenge as he has every other. Cancer may afflict him in many ways: But it will not make him surrender. Nothing ever has.”

But this type of cancer is a very cruel enemy indeed. Survival rates are devastating – only 14 months average with 5-10% alive five years after the diagnosis. Will he choose to fight with chemotherapy and radiation, or will he choose to battle Mr T on the Senate floor? Looking at his recent statements to Sen Lindsay Graham, I think he may do both!

Something happens to us when we are reminded of our mortality, when time begins to shrink. Bob said after his cervical surgery, he had less patience with hospital shenanigans and employee’s misbehavior. Before surgery he may have forgiven a surgeon’s harassment in the OR, for example. After surgery, not so much.

McCain is a war hero, and he is already criticizing Mr T’s strategy, or lack thereof, in Syria and Afghanistan. But if you recall, that other Lion of the Senate, Ted Kennedy, was instrumental in getting President Obama’s ACA passed while he was battling this same cancer. If John McCain were to bring both parties together to salvage healthcare in this country, his legacy would be outstanding. I wish him well on this battlefield.

And check out the Google Doodle today. It’s celebrating the 106th birthday of Marshall McLuhan, who coined the phrase, “The medium is the message.” He predicted the internet but I wonder what he would think of Twitter. It was a key factor in Mr T’s election, and has taken the place of greeting cards as our politicians send heartwarming thoughts to McCain in 140 “characters.”

I don’t know which brother’s arm is sticking out behind the Flapper, but this is one of the few pictures I have of my Father.    IMG_0991

 

 

 

 

 

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“What should I write this morning?” I asked Bob. He mumbled something over coffee that sounded like, “I dunno thatsatourriff.” This is what happens when you talk with your mouth full, cause I’m pretty sure he actually said, “I don’t know that’s your gift.” Or gig, or whatever. So I said,

“I know, facelifts!”

Well, actually I don’t know much about facelifts except, that every celebrity of a certain age is starting to look the same. And when you go too far under the knife, or too often, you could start to look like a lion. Beware, that image you see in the mirror may no longer be you!

But I DO recognize that schoolyard bully who might tell a young girl her lips are too big, or her hair is dirty, or (pick a body part and insert a slur). Mr T has got a huuuge problem with smart women, like Mika Brzezinski, and fast, tiny fingers that tap out his stream of putrid consciousness almost every morning. This is horrifying to the civilized world but somehow continues to delight his followers. Leaders don’t do this, they don’t intimidate, harass and belittle others into compliance. They certainly don’t talk about women bleeding…

When I opened Twitter this morning, one of my favorite authors, Joyce Carol Oates, popped up with this:

“Face-lift? Who needs a face-lift? All of US badly in need of soul-lift.” 

Here are a few things we can do for our souls, instead of trying to dissect the Presidential Twitter feed – which is simply vindictive nonsense.

  1.  Do something good for our planet. Plant a tree, pick up garbage on your street, bring tote bags to the grocery store if you’re not already. Donate to an environmental agency like The Sierra Club, or pick a non-profit: http://www.motherjones.com/environment/2006/03/guide-environmental-non-profits/  We only have THREE years to get right with the world, so what are you waiting for? http://www.huffingtonpost.com.au/2017/06/29/we-have-3-years-to-act-on-climate-change-before-its-too-late-s_a_23007680/
  2. Become someone your grandchildren will admire. Pick a cause (and not cyber-bullying, FLOTUS has that covered y’all) and throw your body and soul into it. Is gun violence driving you mad? Guns kill nearly 1,300 children each year in our country. Join “Moms Demand Action for Gun Sense in America” and help them #disarmhate https://momsdemandaction.org. If you think women’s rights are human rights, see what your local Planned Parenthood is up to, that is if they are still open?
  3. Go Deep. Turn off all those devices and listen to the world. First of all, your inner peace is depending on you. Meditate, even if it’s just for ten minutes while you’re watering the garden. Did you know walking the dog could be a meditation? You don’t have to sit in a lotus position and chant things. Great Grandma Ada said she would have to get up and dust if she ever tried meditating. But once we make peace with ourselves, we have a ripple effect on the rest of our lives. Acceptance is a form of grace, and it doesn’t just happen on Sunday morning.

Wasn’t it Lady Gaga or the Dalai Lama who wrote about self-acceptance? Everybody has a body part they don’t like, and we women are notorious for being critical. Her nose is too long, her hands betray her age, if only I could just lose that last ten pounds…The Flapper didn’t like her freckled, ski jump nose. She told me she would rub lemon juice on her nose to try and bleach out the freckles. For me, I was a tomboy just as flat-chested as the Flapper, and there were some boys who liked to remind me of this fact.

Lucky for me, I never succumbed to the ridicule by placing sacks of saline in my chest.

Stay Woke people. Get out there and enjoy this glorious weather and remember you don’t need to eat and breathe politics. When I was young, we had one half hour at night to watch Walter Cronkite and complain about the news…as a family, around one TV set. Daddy Jim read the newspaper, you remember those, in peace and quiet. It wasn’t all consuming all the time. Mr T’s Tweets are bad for our collective health. Here’s the latest Dalai Lama’s Tweet:

“We experience happiness on a sensory level that is relatively short-lived. But lasting happiness is related to our state of mind.” 

Enjoying a frozen hot chocolate with cupcake bear can also be soul-lifting.

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Today is just another day. The hazy hot and humid days of mid-summer are upon us. While I had to live without AC for a week, I thought about my childhood. I know, make fun of me now; but my purpose here isn’t to tell you how much harder it was for us. It is simply an observation. We went to the movies because at least they had AC, and we slowed down. We opened windows and used fans. The ice cream truck would come every day and we couldn’t wait to hear its music on the street. My Foster Daddy Jim would come home from Picatinny Arsenal and scoop me up to Brown’s Pond for a dip in the cold water.

Nobody complained about the heat, because what could you do? We were in it together.

Today isn’t just another day in Nashville. It’s The Groom’s birthday, and lately he’s been very busy. He started a new job, a first position as an attending at Vandy. As Bob knows only too well, the buck will stop at his desk. No matter what goes right or wrong, he will have to answer for it. He is an excellent teacher, herding new and seasoned residents around those sacred halls, taking night call in the MICU for weeks at a time. He credits his team when they win a battle. And he is the one who will talk to a family member when sepsis or cancer wins the almighty struggle. Not everyone is suited for such sacrifice, but he is supremely good at what he does.

He is 6’6″ tall. His voice, his mere presence is enough. The Groom can command a room, but chooses to listen to every opinion before embarking on a treatment plan.

The Bride and Groom just moved into their new house. He’s been hanging curtains and moving furniture around. He rushed home when a smoke alarm went off and his Bride fell off a chair trying to fix it. It made me think of that day when they were living in Cville, and one of their friends thought a smoke alarm was going off. It turned out to be a new medical student’s beeper in the pocket of his white coat! They had left the hospital for some time in class, and the white coats were abandoned in a hall closet; the battery singing its last tune.

And today is just another day. The Groom will return home and scoop up their two babies, placing them in a red wagon, and walk to the park. He will play with them, and talk to them about all the bits of nature around them. He will invent new games, he will stare up at the clouds with them and imagine animal shapes. And he will most likely bring the dog along for some exercise. He doesn’t complain about his fatherly duties, because this generation of men know they are in it together with their wives. And he knows instinctively if it’s a day to bring home dinner, to hunt and gather, or to go out for a meal.

But today isn’t just another day. My daughter will cook his favorite food and bake a three-layer birthday cake, letting the Love Bug help peel carrots and lick the frosting bowl. With all the stress of the past few weeks, I hope he gets to kick off his shoes and dance a little bit tonight – pick up his guitar and unwind, put the Baby on the keyboard and give the Bug a harmonica.

Because today we are all thankful you were born. Much love on your birthday, and thank you for being an outstanding husband and father, for joining our “outlier” family of giraffe lovers.We couldn’t have asked for a better son-in-law! Remember today to slow down just a little, this time with young children will fly by, in Joni’s immortal words:

We’re captive on the carousel of time
We can’t return we can only look behind
From where we came
And go round and round and round
In the circle game      10320486_10203678944316165_691215505164009992_n

 

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“What’s that term honey, the one you use when somebody tries to sue a doctor for no good reason and it gets thrown out of court?”

I was reading a local news article about a woman in the next county who was suing her ObGyn doctor for “coercing and threatening” her if she didn’t deliver her baby by Csection. The Mother had diabetes, and for one reason or another her doctor actually had her sign the consent form five years ago, and now she’s crying foul. Bad doctor, oh and BTW good baby and mommy were just fine after the surgery, so I wasn’t quite sure what this was all about, besides the 2 Million dollars.

“Frivolous, are you talking about a frivolous law suit?” Bob said. Indeed I was.

I usually never jump into the fray of a public forum, since I neither have the time or the energy to fight with true believers. But I was home sick, teetering on the edge of adding a snarky comment to the long list of online comments either praising said doctor or lambasting our entire health system by internet thugs who use pseudonyms for names so they can’t be traced. The lurid underbelly of social media, trolls living under an online bridge of anonymity. I wrote, I deleted,, I worried. Finally, I said:

“We live in litigious times. Certainly we deliver more babies by Csection than any other country in the world, but at the end of the day I believe most docs are recommending what is best for their patient.”

I only hooked one smirky, smiley comment.

“So American women just generally need Csections more than the rest of the population?”

I smiled. Should I tell her about Brazil? But before I had time to pick up the bait, the news posted that the jury had decided in the doctors favor, Not Guilty, after 20 minutes of deliberation. My faith in our justice system was temporarily restored as I put fingers to keyboard:

No we need to train American Doctors differently, transfer well patients to nurse midwives, and institute a board of docs and citizens to review lawsuits and throw out frivolous ones like they do in MA

Ps, my daughter was breech and a section was MY decision – as much as I wanted a natural birth, I didn’t want to risk the health of my baby

This lawsuit disturbed me because it assumed the woman could be coerced, was not in her right mind because she was in labor or something and all of MY feminist peeps, the type of women who believe we have the right to make our our own decisions about our own bodies were lining up behind her defense. Like HE MADE HER DO IT…She was of sound mind and maybe her body was trying to expel an alien at the time, still she could have put on the brakes and said, “NO, WAIT, I want another opinion.”

Childbirth is messy, it is a risk/benefit analysis. Some women go through days of labor only to have an emergency section to save their child, or even their own life. This was the Bride’s biggest nightmare last year, she was determined to have her baby boy VBAC, and she knew everything that could go wrong. My husband has seen women come into his hospital’s ER with a dead baby from a homebirth with a midwife who didn’t transfer them fast enough.

When you hire a dola, a midwife, or a doctor to assist you in delivering your child, you are entering into a sacred trust. When we won the right to vote in the early 20th Century, when science gave us birth control in the later part of that century, we women willingly gave up our status as arm candy and fertility goddess. We got tired standing up there on that pedestal for so long, all those corsets binding us into place. And now we have a woman in a pantsuit running for President. We should never be willing to be coerced or threatened by a man, boyfriend, husband, doctor, or lawyer ever again.

And the mom/plaintiff reduced her amount from 2M to $200,000 yesterday afternoon before having her case dismissed. Ask me again why our health system is so crazy. http://www.nbc29.com/story/30455784/update-augusta-co-jury-rules-in-favor-of-doctor-in-c-section-case

Here is our friendly little ghost, delivered by section three years ago because she was breech, just like her Mama!

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Over the weekend we had a friend come for dinner. While sitting on the deck at twilight, sipping VA wine and gazing out at the mountains, she noted the lack of bugs. Which of course led to my narrative on life at the Jersey Shore, how Monmouth County was the epicenter of tick/thug life, and eventually my experience as a West Nile survivor.

It was the summer we were packing up the Rocker for college. We lived in a tony swamp, on an estuary of a river. I’d have to swat mosquitoes off my hands in the middle of the day while hanging laundry outside on my clothesline. Let it be said, I love hanging towels, sheets and everything else in the sun and wind for that smell. It’s become a meditation of sorts.

For a full week I suffered with a blinding headache and a fever. But I carried on, never seeing a doctor because why bother, I lived with one.

Not until my eyes had turned as bright red as stop lights, and I could no longer read. That’s when I went to the first eye doctor. The one who told me to go home and wash my hands, I had conjunctivitis…

Then Bob took me to the “good” eye doctor, my savior, the one who realized right away what was going on. I remember distinctly his feeling of – what? Pity, sympathy – no doctor has ever looked at me like that before or since – and I was off to Bob’s old ER on the river for tests. Dropping steroid drops in my eyes every hour, swallowing steroid pills while packing up my son for his next great adventure. And eventually, I was an empty-nester who had lost my right-mid and lower-quadrant visual field; the peripheral vision of both eyes. My daughter’s favorite medical term, I think just because she liked the sound of it on her tongue, became my final diagnosis; Homonymous Hemianopsia. Say that five times fast!    

When i think about it, that’s most likely the reason I fell to the right in the bounce house. It’s the reason I jump when someone approaches me from the right. Most likely I abhor crowds because of my brain injury and it’s why I turn my head to the right so much while driving. All because of a little bug.

Which is why this recent headline caught my eye, “Orange horse is first West Nile equine victim of the year.” 

Orange is not the color of the mare, it’s a county one field away as the mosquito flies. “In 2014, there were seven cases of West Nile virus in humans in Virginia and three equine cases, according to the Virginia Department of Health. The human cases occurred in August and September and the equine cases occurred in September and October.” http://m.dailyprogress.com/news/local/orange-horse-is-first-west-nile-equine-victim-of-the/article

So even though we live in the mountains now, in a relative bug-free zone, I guess these are the months to spray bug repellant and light citronella candles. Makes me long for the Berkshires.  IMG_3030

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