Archive for March 2010

Monthly Archive

Which Is It?

Running to PottyI spent the weekend lying around feeling like death on a cracker. And most of my mental thought other than, “Please, please go away, bug” was consumed by the question, “Which is it?”

Food poisoning and a bad weekend for me
or
Gastroenteritis and a bad week for me, my O, my F, the husband, and my friend visiting from San Francisco

Let me explain. Food poisoning is not likely to be contagious, gastroenteritis (or stomach flu) is. This phenomenon of stressing on my exact diagnosis has occurred only since having kids. See, I had the “stomach flu” all weekend. I visited the porcelain bowl more than 30 times on Saturday. I felt like utter crum-dog. You’ll have to endure no more details than that, but lemme tell you, it was awful.

As a mom now, what worries me the most when this happens is ensuring the kids don’t get it. Because then it would be a total nut-house-disaster-ness-gross-vomitorium-diarrhea-pit. You know what I mean. Nausea and “not being able to control my secretions” is something okay for me, but nothing I want my kids to endure. Let alone have to clean up after. Read full post »

Vitamin D: Vitamin Of The Year Part 2

Vitamin D SunsetVitamin D is clearly important. And like I said earlier this week, it is getting all sorts of attention. Two studies from this week have captured my attention.
I don’t think this vitamin D thing is a fad. The new (2008) recommendations for 400 International Units (IU) of daily Vitamin D in infants and children represent evolution in our understanding how we can protect and prevent illness in infants and children. It’s not that Vitamin D is more important than other vitamins, it’s just that Vitamin D is more likely to be absent in children than the others. New data this week suggests that delivering mothers (the ones with the big belly about to birth) who live in the city (are out in the great outdoors less) are more Vita D deficient that we thought. Another study finds that supplementing all infants, no matter what they eat, is essential in providing them the vitamin D they need. Vitamin D is synthesized in your body when you get some good sun (above) or from fortified foods in your diet including milk, cereal, formula or eggs and fatty fish. During the winter, getting those rays of sun is more difficult. And it’s more difficult all year long in infants who we say shouldn’t be in the sun whatsoever. So we have to ingest it. Take a look at this data and rationale for all of the D-detail.

Watch the video at the bottom of this post, too… Read full post »

Vitamin D: Seattle Vitamin Part 1

Offer Vitamin DF calls it our, “Seattle Vitamin.” In the upper left hand corner of the US (read: Seattle) we’re a little lacking in sunshine. It’s a product of not only our rainy weather, but our latitude on the globe. New data finds that taking supplemental vitamin D may be more important for we mamas, we city dwellers, and we little ones (infants) than we thought. Especially up here where the sunshine comes around about every fifth day.

Vitamins are so well engineered these days (gummy what?) my boys think they are a marvelous daily treat. So do I.

A study yesterday in Pediatrics finds that urban Boston moms (think Northern climate) who spent at least ½ of their pregnancy living in the city, were at far greater risk for having vitamin D deficiency than we thought. So were their babies! In this group of urban moms, up to 58% of newborns and 36% of the moms at the time of delivery were vitamin D deficient. Holy deluge of D deficiency! Say it with me…

A second study published yesterday found that we are doing a poor job getting babies the vitamin D they need. Less than 1/10 of all breast fed babies and less than 1/3 of formula fed babies are getting the vitamin D pediatricians recommend. Something has to change. Read full post »

Seeker.

Chemo SeekerSeeking perspective and cure. If it’s true that life is all about your perspective, I know this Friday sunshine will help.

This past week has been a total mind melting experience. Cloudy and cold, too. With my mom’s chemotherapy and subsequent complications, my perspective of medicine has changed again. Forever. Being the patient, or in this case the patient’s daughter and advocate, reminds me how hard it is to sit on the other side of the white coat. Power differentials, hierarchy, miscommunication, communication, laboratories, computers, research, trainees, and simple distance sit between the provider and the patient. They take up all sorts of space.

Invisible yet room-filing.

Above is a photo of my mom directing her chemotherapy. She felt that if she gave the chemo direction (via her powerful words and a Sharpie), the chemo’s accuracy would improve. Got to give her credit. Speaking up (even to your chemotherapy) is always essential in medicine. Read full post »

Tweet This, Cut That: Live Twitter Feed From The OR

Twurgery?

On the right side of my screen I’m watching a live Twitter feed from Swedish Hospital in Seattle.

Tweeting commenced soon after 8am this morning and was performed by 4 observers in an operating room in Seattle. Those 4 observers were in the presence of a surgical team who was performing a tumor resection on the kidney of a 69 year-old patient from California. The man had consented to the scenario, surgery, observers, twittering and all. While the surgeon did his job, his maneuvers, goals, and timed procedures were detailed on Twitter in a live feed.

It’s 10am on Wednesday as I write. I’m watching the twitter feed populate into my screen.

I must say it gives me an eerie feeling.

During medical school I assisted (translation: watched in awe and was likely told to be quiet) on a nephrectomy (removal of one entire kidney) for the same reason—a kidney mass. I remember well what the surgery looked like. This is the first time I know what it tweets like. Read full post »

Nut Free TV? Food Allergies In Children

I was interviewed this week on TV about food allergies. I’ve pushed all my inner-Cindy Brady moments aside. Watch the video below…

When F was about 13 months old his face turned bright red after he ate breakfast one morning. I eliminated all the foods he had eaten that morning– milk, oatmeal, banana and berries. He’d had all those foods many times but I was concerned he’d developed an allergy. Gradually, I introduced them back, one food at a time. Mild reactions returned (his face looked like a work of art, his ears turned red), but inconsistently, so I was confused. After strict re-introductions, I finally figured out cinnamon was causing his facial flushing. Turns out, regular oatmeal did nothing, but eating apple and cinnamon oatmeal he got all red goofy faced. To this day, F doesn’t complain when eating cinnamon, I just know he has ingested it when his face is covered in artful red spottiness.
We were lucky; F’s reaction was mild and limited to cinnamon. It’ still unclear to me if it is a true allergy. I consider him sensitive to it so I avoid serving him cinnamon whenever I can.
But I had a dagger of fear in my heart while trying to determine what was causing his facial rash for a few weeks. Like most parents who have children with allergies, I found the not knowing what was going to happen absolutely unnerving.

Allergies can be scary. Read full post »

Doctor, Daughter, Mother, and Wife: Four Corners

MamaDoc and MamaMy mom starts chemotherapy tomorrow. It feels like my two feet are reaching to stand in four separate corners. Doctor, Daughter, Mom and Wife. Four corners. Except nothing about the sky looks like Utah right now.

I’m caught in the middle of a generational sandwich. I’ve started to understand that taking care of those older than me and those younger than me (while, at the same time, attempting to tend to myself) may define adulthood. This week I awoke to the sobering reality that I’m a real grown-up. Good morning, Sunday, meet me, Grown-Up number 221005. It seems I’ve finally earned the title.

Titles tend to follow set milestones in life. You finish your twelfth year and you’re a teenager. Eighteen and you’re a voter. Finish college, you’re an adult. Finish Med school and they call you Doctor. Yet often, these titles are granted asynchronously from earnest accomplishment or achievement.

Take the example of being called, “Doctor.” Read full post »

This Crockpot Is Gonna Save Me

Crockery PotGame changer in our house. Splurged on a fancy crockpot last week. Big news, I know. Should have sent out a flyer.
My beloved crockpot. Regal, able, and ready like any good army, boy scout, or Labrador Retriever.

This.crockpot.is.gonna.save.me.
Last week broke me a bit. We’ve not been sleeping again. Previous memo to the boys was received and then promptly forgotten. And I’ve been sick. After busy days seeing patients, I didn’t leave my office for more than 2 hours after I was done with appointments. Twice. Didn’t even make it home in time to kiss O before he was off to bed on my “early” day. Heartbreak city.

This.crockpot.is.gonna.save.me.

Buying it was one of those, “Ah-ha, this is how I am going to balance my life” moments. Do you buy those things? They can be anything from an orange pair of socks to a closet organizer to a jumbo bottle of Advil to a new can opener. They feel like triumphs in life when you find them. In my attempt to eat right, lower my cholesterol, and live a long time, I rationalized the purchase of the large pot now inhabiting my kitchen. Healthy food made easy. I remain hopeful this crockpot is worthy of its post. Read full post »