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Posts Tagged ‘medicine’

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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When you see an obese child, what do you think? Do you immediately blame the parents, and/or poverty? There is no fresh produce to be found in their neighborhood, or maybe you think the parents are just lazy…What if we make school lunches more nutritious. Let’s get Jamie Oliver into every school cafeteria and teach those lunch ladies how to steam vegetables! Get a communal garden going outside the gym!

I find it fascinating that the GOP is all about getting government out of our way for free enterprise. They start yelling “fascist” whenever Mrs Obama wants to see kids get off the couch and move, or a school system tries to change what a school lunch may look like – don’t tell us parents what to do with our kids! Get government out of our lunch boxes!! We know what’s best for them, and if a parent wants to leave a gun lying around well…and then I picture a two year old yelling I WANT TO!!

Bob tells me he rarely mentions weight to one of his patients, after all he is not a family practitioner. But when he sees a severely obese child, he may say something to the parent in the ER. Because this is such a serious health risk, he risks that patient’s dismal satisfaction score. Not all doctors have the courage to tell a parent they are endangering their child’s health. Luckily, the rate of childhood obesity in this country is finally leveling off:

After a steady rise for many years, the number of calories American children take in each day is going down. Childhood obesity rates, though still too high, have now leveled off, and are starting to go down in some populations. The 5 billion school lunches served each year are more nutritious than they were a decade ago. Children are eating less processed food and drinking less sugar-sweetened beverages and full-fat milk.  http://www.cnn.com/2015/06/30/opinions/clinton-brown-healthy-kids/index.html

So yes, we can put juice in vending machines and model a healthier diet for our youngest children: by including them in food prep and offering fresh, real food; by sitting down to dinner as a family (an almost insurmountable task these days); by going to farmer’s markets or even helping them plant their own little tomato plant in a pot. I’ve mentioned my neighbor Kath the food blogger before. I love the way she has introduced real food to her toddler, he http://www.katheats.com/ways-motherhood-has-changed-me

Still, I think about how my Foster Mother Nell really didn’t cook, she would jokingly say she could open a can. Women in the 50s were sold that bill of goods – TV dinners on a tray, canned vegetables with marshmallows. Life was supposed to be “easy” for the 50s housefrau. They grew up watching their mothers actually grind meat on the dining room table, and wash clothes by churning them through a semi-automated washing machine, or maybe they were hauling clothes down to the creek? Why shouldn’t they get to vacuum in high heels!

And all I ever ate for lunch in high school was tuna sandwiches and potato chips, followed by a cheeseburger at White’s Drug Store immediately after school, with fries dipped in gravy… SO, canned food, semi-fast food, and I was never fat, in fact I made spaghetti for myself at night cause I thought I was too skinny! Those were the days, before babies, before menopause packed on the pounds.

We can all teach ourselves to prepare a healthier diet, we don’t need an RD to work up a meal plan. If there are no markets with fresh veggies in our neighborhood, we could plant some in pots. What we cannot and should not do for our kids is model complacency. What my generation had was the ability to walk to school, to go out on our bikes after school and not come home till twilight. We had the freedom to move, which this next generation may lack.

Kudos to the city planners and engineers who are redesigning parks and playgrounds all over the country. And bravo to the police who are walking beats and making neighborhoods safer and crime-free – not by stopping and frisking but by stopping and talking.

And maybe we could have a course at the police academy on nutrition?

Basil is ready for Pesto

Basil is ready for Pesto

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Summer’s here and it’s time for singing in a horse barn! And dancing in the street too, but I just had to drop a quick note about the Groom. Some doctors play golf in their free time, some fly planes or collect trains. And then there is that rare one, that cerebral brainiac that can also play a guitar like nobody’s business, and write his own lyrics too, and sing…oh, and did I mention he can sing! It’s our Groom. J&M  0975

He’s been in a band since high school, and indeed created a band during his residency at Vanderbilt. With a few other talented, young doctors they were known as The Bourbon Family, and they played roots Americana music all over the state. They’ve played at weddings, bars, and private parties. They even produced a record! https://itunes.apple.com/us/artist/the-bourbon-family/id445461482 And more importantly, almost every night, he would play and sing to his new baby girl.

Then the doctor/musicians finished their residencies and went off to pursue fellowships all over the country. The band broke up and you might have thought the music died. Except the Groom didn’t move, he was still playing his guitar and singing to his family in the Music City where he continued to be a Chief Resident and continue his education in Public Health. Until one night at a Full Moon Pickin Party in Nashville, this happened – here is his Facebook post:

So, at last week’s Full Moon Picking Party, a bunch of recording engineers from Dark Horse Institute (of Faith Hill, Tim McGraw…Megadeath) set up a makeshift recording studio in one of the horse stalls. They grabbed people walking by and recorded videos of them playing. Whoever’s YouTube video gets the most ‘Likes’ wins $15,000 worth for free recording time at Dark Horse…which for me would mean an official reunion for The Bourbon Family.
I don’t think I have ever asked Facebook for anything before (partly because I lost my password for about a year and had to reset it for this post)…but this would be pretty cool. Please consider using the mouse on your personal computer to place a ‘Like’ on the YouTube video attached by hyperlink.

And here is the YouTube link! Please consider “Liking” this post on your computer, the link won’t work on your cell phone

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…or determination?

Yesterday, I got up early and drove North to attend the public opening of a community hospital’s new ED. Yes folks, it’s a “department” not a “room,” one of the many changes I’ve witnessed tagging along with Bob over the years. “I can’t run a room,” was his constant semantic complaint. But it seems he can run a department.

When we first settled in the Blue Ridge, I thought it would be like old times. Bob would do some shift work at the local hospital, and we’d slide into a comfortable retirement; plenty of time together to visit grandbabies and pursue some new hobbies, maybe  keep a few alpacas? Or donkeys, or chickens? Then one year in, the Emergency Department Director just up and quits, asking Bob if he’d like the honor!

And just when I thought his directing days were over, he not only took over the reins, he became Chief of Staff and sat on the Board for many years. We had plans to go to Australia for a sabbatical that were put on hold, but we did manage to build our little house with a view. And one day he presented a plan to that Board for a new Emergency Department – they were bursting at the seams and the population was growing. He wanted a state-of-the-art facility and he managed to persuade the leaders and shakers with his constant optimism and tenacity.

Yesterday, the ribbon was cut joining the new building with the renovated old department, virtually tripling the space of the old ED. Twelve million dollars and five years later, the CEO introduced Bob and kindly said this project was his baby, and without his “persistence” we wouldn’t be here. Everyone nodded their heads, because everyone who works with my husband knows he can be pretty determined to achieve excellence in emergency medicine. He wrote the book on managing an ED and he served as President of ACEP in MA when we were young and just starting out in the Berkshires.

Unlike lots of physicians his age, he never gave up on medicine and he taught our daughter to love the profession too. To never forget the sacred trust a patient shares with them.

I was pretty proud of Bob yesterday, but we couldn’t celebrate yet. He had a lunch meeting with a colleague and then he was scheduled to work the 8 hour evening shift. Kudos to Bob, his assistant director Harvey, who followed him here from the Berkshires, and all the nurses and administrators who helped to make this remarkable transformation possible.

Maybe someday he’ll slow down, just a little? 19114_10152801541071943_7135939311025461658_n

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Although we may not be caught up with all the news that’s fit to print while four generations cavort in the Florida sunshine, we did manage to see the latest Downton. Some of us watched the Masterpiece special on TV, and some caught PBS online the next day. And just to be safe, Grandma Ada had her son at home in the ice and snow taping last Sunday’s program. Naturally we were all speculating on the birth control device Lady Mary sent poor Anna Bates,her Lady’s maid, out to fetch from the pharmacy. Remember we are now into the 1920s, and Flapper fashion and suffrage is de rigeur!

Still, the same week a period drama wrestles with pre-marital sex, in fact seems to condone Lady Mary’s bohemian idea that 1) women should take charge of their bodies and not leave this messy business to the man, and B) she get to know this guy Tony “in every way” before marriage without having to deal with an unwanted “epilogue,” Pope Francis chimes in with this: “Some think, excuse me if I use the word, that in order to be good Catholics, we have to be like rabbits – but no,” he said, adding the Church promoted “responsible parenthood”. http://www.reuters.com/article/2015/01/19/us-pope-airplane-idUSKBN0KS1WY20150119

The doctors in the room all speculated Lady Mary was using a diaphragm and whipped out their devices to google this idea! Indeed, cervical caps were used in the 20s and 30s but were very scarce in this country. And just in case you haven’t heard of our modern-day saint Margaret Sanger, she thought ; “…the best method of birth control was a doctor fitted device, either the cervical cap or a diaphragm. Sanger opened North America’s first birth control clinic in New York City in 1916. Sanger and her sister, Ethel Higgins Byrne, did the work themselves, assisted by a receptionist. Sanger claimed to have fitted 488 women with diaphragms in the 10 days before the police shut the down the clinic. Sanger claimed she could not find a doctor willing to work at the clinic.” http://www.case.edu/affil/skuyhistcontraception/online-2012/Cervical-Caps-Diaphragms.html

Enter the Dutch physician, Dr Rebecca Gomperts. She is truly an inspirational woman who travels the globe to educate, enlighten and skirt the regulations and restrictions on a woman’s right to choose her method of birth control. She started Women on Waves where she would induce medical abortions with the morning after pill, mifepristone and/or misoprostol in international waters. In countries where politics restrict access to reproductive health care she is viewed as a villain, for most women she is their savior. In 2006 she started Women on Web https://www.womenonweb.org in order to enlarge her vision and reach more poor and marginalized women.

Using Mifepristone and Misoprostol is no more complicated than using other medications. You will get clear instructions about how to use the drugs, what to expect, and when to go to a doctor. If you have questions about any step of the process, you can contact a helpline. A medical abortion does not need to take place in a hospital or first aid clinic.

http://www.salon.com/2015/01/06/the_political_landscape_is_not_ready_meet_the_woman_leading_a_d_i_y_abortion_revolution/

Of course today, in this country, we can purchase Plan B over the counter. Whether we call it responsible or planned parenthood, it’s good to know the Pope gets it, even if he has to backtrack to keep the Cardinals happy. And as for Lady Mary, she is more a vixen than a rabbit, don’t you agree?

Rebecca Gomperts, one foxy lady

Rebecca Gomperts, one foxy lady

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