Sunday, March 30, 2014

On Emotional Abuse

My Mother passed away last week.

It had been a long time coming.  She had Lung cancer and NonHodgkin's Lymphoma, and COPD and...

I got to fly in and say goodbye to her. 
I also said goodbye to any hopes of a nurturing, normal family. 

I have operated under the delusion that people want to change. Some don't. My parents don't. Didn't. 

I realized this when my father started a fight with me as I was trying to say good-bye to my mother on the last day I would ever see her alive. 

He will never change. He will be judgmental and mean and abusive until the day he dies and I'm done.

An emotionally abusive family situation is not made of one or two instances of being mean, or over reacting. It is NOT being a tough disciplinarian. What it IS, is a pattern, over time, of demeaning behavior, name calling, put downs, humiliation and teasing. It is failing to respect another’s opinions as valid, refusing to stop the behavior when asked. It is telling the person being abused that they are too sensitive, or “can’t take a joke.” 

It is refusing to apologize for mistakes. It is holding grudges for some thing contrived in their minds. It is never forgiving a mistake and constantly pointing out another’s shortcomings. It is not caring how the person being abused feels, or discounting their emotions completely. It is constantly putting others down to build themselves up. 

So although I am grateful to all of the people who have expressed their condolances, I would like to take this opportunity to use my experience to prevent others from being stuck in an emotionally abusive situation. 

If you are an adult child of emotionally abusive parents please read this:

and this:

Tuesday, March 18, 2014

Liebster Award Winner!!! Woohoo!

Last week, I was awarded the Liebster Award by the amazing and fantastic blogger of Ponies and Martinis!

So! What the heck is the Liebster Award?

Liebster Awards are given by other bloggers to bloggers with fewer than 3000 subscribers.  

Since I have 25, I count.  I have been so excited to see my numbers of post readings going up since winning the award that I can't wait to pass this on to other bloggers!
Ponies and Martinis  started her blog earlier this year and I realized I had stumbled upon a person with a warped sense of humor and a soul similar to mine.  I enjoyed reading her blog and met other bloggers through her on facebook and twitter. (@ponymartini). (I'm @doctordivablog )

So, part of the award is that I have to give you 11 random facts about myself, then answer questions posted for me to answer!
Here goes:
1. I am a TRUE redhead. (yup. red all over.)

2. I wanted to be a vet when I was a kid after my dog had a small bowel obstruction.  I became a people doctor instead.

3. I thought I would never get married or have kids, that I would summer in the South of Spain when  I got older, and I would have lots of cats. (I still fantasize about that sometimes, except the cats part. I hate changing cat litter)

4.  I actually like camping. But I want an RV. Enough sleeping on the or near the ground.
5.  If I had known how much I would like Calc II, I would've taken Calc III and P Chem and had a chemistry minor.

6.  I binge read. I love horror, mystery, fantasy, sci fi, and romance.

7.  I quilt--SEE???

 8.  I am an athletic spaz.  I Never could play sports. I was ALWAYS the last one to be picked in gym for anything. Even the basketball coach, after he saw me run, decided not to ask me to be on the basketball team in high school

9.  My nickname in grammar school came from crying on my Iowa tests and getting them all "mushy" and that name haunted me all through high school (not in a good way, either).  At our first high school reunion, someone said, "Hey Mushy! How the heck are you?" and I said, "That's DR. Mushy to you!" and we all got a good laugh out of it.

10. I don't know how it happened, but I married the (mostly) most amazing guy on the planet. (Oh, c'mon! We all have flaws. Except me. I'm perfect) <--------(insert sarcasm font here)

 11. I secretly always wanted to act. But, doctoring is a form of acting, in a way. You can never show your true feelings, you have to figure out who your patient needs you to be in the moment. You have to leave all your baggage outside the exam room and BE a doctor, even if you feel like crying because you had an argument with your family members, or the World Trade Towers just came down (true story).

Now to answer the questions posed to me by Ponies and Martinis blogger:

1. What do you want to be when you grow up?
     I ALWAYS wanted to be a doctor, but NOW I want to be a writer, quilter, camper, world traveler kind of gal. While doctoring. I love doctoring. 

2.  What is your favorite ice cream flavor and why?
     Ben & Jerry's NY fudge chunk brownie OR Cherry Garcia.  It's a draw. Frankly, anything with chocolate ice cream as a base with hunks o' chocolate in any form is a go. 

3. If you could change one moment in history, what would it be?
    I would change the moment in the future where time travel becomes a reality. I  would destroy the  machinery because we all know they're going to foul us all up with their evil future plans. Or it's going to require so much energy that the galaxy will disappear into a giant nuclear explosion. 

4  Pick the ultimate superpower.
     I've been thinking about this a whole lot lately because I believe that women should be gifted 
     with a superpower to go along with hot flashes.  In fact, I'm writing a novel  right now about this.  I think I would go with telepathy. Healing would be cool, but then, I'd have NO life at all because  I'd be expected to heal the world. Telepathy would have drawbacks of actually KNOWING 
    what people think all of the time.  So maybe, telekinesis.  Yup. That's it. I could do the laundry and
    clean the house while sitting on my butt.

5. Cats or dogs?  
     Is this really a choice? I had two cats, Jumpy died at 16 and Fuzzbutt died at 22. (Yeah, I know, the vet loved the name too.)
     Now I have a dog and she's like having another kid. So I'm beginning to think, hamster. 

6.  How did you pick your blog's name?
    Funny you should ask. My partner and I went into private practice and named the practice with 
     our names. It was BORING. BUT we decided to have a website and needed a URL. It was either going to be DoctorChicks or DoctorDivas.  We thought DoctorDivas was cooler. You see, Neither of us are divas, as our patients well know, and that's the fun of it.  When I decided to write a blog, it was natural to call it Doctordiva, and I was trying to get my own health in shape at the beginning, hence, doctordivagetshealthy.  NOW I use it to entertain and teach. My patients LOVE it and miss the name of our old website since we're now employed by a large University group. 

7.  What is your favorite post that you've written? 
     Oh, clearly,   The Poop Report.   Hands down.

8.  If you could travel anywhere in the world, where would you go?
     Tough one. Probably somewhere not very similar to America or Europe.  Maybe Vietnam, or Thailand, or China or Nepal or Mongolia. Or Madagascar.  I want to see stuff I don't see every day and try new foods and have cool adventures.

9.  You can only eat one thing for the rest of your life. What is it? 
     Okay, this is tricky since I'm a doc and am SUPPOSED to answer this one way. but really, there is only one answer.  Chocolate.

10  Describe yourself using only one word.  
     Labile. (I'm a Gemini--need I say more?)

11. Any regrets? 
     I wish I'd stayed in better physical shape and I wish that I had more patience with my kids.

Now for my Nominees for the Liebster Award:

1.)  Outmanned Mommy
I especially love her blog on how "spring break-ers" are like toddlers. I snorted my coffee through my nose reading that one.

2.)The Foodie Physician-Sonali
This is a rockin' doc who can really cook. My husband and I have taken on, as our own, several of her recipes (the ricotta blueberry lemon pancakes, the black bean and quinoa burgers to name a couple) as keepers.

3.)Christella Morris  Okay, I don't know how many followers she has, but I don't care because she is awesome!!  She makes wonderful blog posts about the normal everyday insanity of a working mom.

4.) Pesky Pippi  She is a Mom with enormous energy and a fabulous sense of the absurd. She posts great pics of her yellow lab and her sneakers as the family goes out on exercise excursions into the lovely area of the world she lives in, and posts cheesy smiles and great art work.  I smile at all of her facebook posts too.

5.)  Meghan Ciana Doidge--She is an amazing author of romance and paranormal and fantasy.  I just LOVE her stuff.  She wrote a great post apocalyptic book called After the Virus.  I couldn't put it down. I heartily recommend her as an author and a blogger. She has great interviews with other authors and reviews of books of other authors as well.

I have a colleague who has a fabulous blog about surviving cancer. He is an oncologist and an amazing writer. He has two blogs. I need to check with him re: which one is the most active one. I'll update once I reach him.

Okay, Now my questions for the winners to answer!

1.  Vacation:  with a friend or spouse or with entire family? Warm or Cold spot? Explain.
2.  How did you stumble into (if you did stumble into it) blogging?
3.  Hobbies? Avocations?
4.  Do you think a manicure/pedicure is a luxury/necessity or a waste of money? Explain.
5.  Skirts or pants?
6.  Do you thinking eating alone in a fancy restaurant is weird? or brave?
7.  The world is ending tomorrow. What will you do as your last acts on earth?
8.  Is a car a status symbol or solely a means of transportation? Why?
9.  Okay, I'm repeating this one from above, but I think it's important: What is your favorite post from your own blog?
10.  Pizza and beer or Filet Mignon and wine?
11.  Are you who you thought you would be when you were a kid, dreaming about your future?

Okay, that's it.  WHEW!  Long post.
Thanks again to Ponies and Martinis.  Sorry it took so long, but the doctoring gig took all of my attention the last several weeks.

Thursday, March 13, 2014

Disappearing Food Staples and My "In-speriment"

In my house, there are certain foods that disappear.
 I mean it. 

They literally disappear. Like a super power built into the food.

Take, for example, strawberry preserves.  I buy a big jar every week, along with a vat of peanut butter.  GONE.  I just want a little jam on my bread.  Nope. Sorry. GONE. 

Parmesan Cheese.  Does this happen to anyone else?  You have a HUGE bottle of the crappy Parm that comes out like powder, you go to get it out for a recipe's gone.  No one knows what happened to it.  NO one claims to have used the last of it.

Oh.  Then there are foods that MOVE.  All by themselves.  (No, they're not infected with bugs).
The craisins and the pretzel chips somehow end up in the living room--or the leftovers end up in the basement refrigerator, never to be seen again, until they're black and overgrown with mold.

Oh!!! Milk.  That's another one.  I could buy 4 gallons of milk a week and it will be gone in 4 days.

I suspect it's the teenagers in the house.  They're like vermin. They eat EVERYTHING.

For Lent, we are running an "Insperiment."

An "In-speriment" is an "Experiment" run In your HOME.  Never to be published in scientific journals, or to win awards.

The DoctorDiva's In-speriment

See how much fruit (fresh, dried) nuts, and veggies my kids will make disappear, by NOT buying any crap. 

"Crap" is defined as:  cookies, candy, chips, crackers, ice cream, cake, sugary cereals.  (granola bars are crap but they're not on the list.  I have my reasons. You can and should exclude them if you are able).

I will not be drawing up any tables or charts to show fruit/veggie consumption. I simply am making this an observational study (I know, I know, the worst type of study besides retrospective).

BUT if it works, if my evil plan works!  Well, then.  Muhaaahhaaaawwwwww!!!

I'm hoping to see the disappearance of pounds and pounds of fruit because THERE'S NOTHING ELSE TO EAT.

Wish me luck. 

Sunday, March 9, 2014

Eye of The Tiger, Baby!

 The DoctorDiva's Family is starting a personal workout plan.

I looked at the Boy Scout's Personal Fitness Merit Badge and talked to a colleague who is a rehab doctor and we are going to work out for Lent!!

FIRST, We figured out our BMI's and took our measurements for waist, biceps, thighs and hips.
We measured how many sit ups we could do in one minute, how many push ups in one minute and we didn't have a pull up bar or we would have done pull ups in one minute.  We measured how far we could walk/run in 9 minutes or how long it took us to go one mile as fast as we could.

I used Fat Calipers to figure out our body fat percentage. (ugh....)

THEN, I bought resistance tubing and resistance bands, and now the rest will take place over the next 12 weeks.  I posted sheets for each member of the family in the bathroom so we are logging what we've done every day.

My goal is to lose an inch in my waist, and to be able to do a push up like a boy, on the floor.
Also, to hopefully tone up and get more aerobically fit.

I am not focusing on weight here.  I am focusing on HEALTH and starting something that my family can continue to do forever.  The equipment doesn't cost much.  You can download
"Map My Walk" for your smart phone (free) to measure your speed and timing outside if you don't have a treadmill.

Now  remember, this is for MY family.  Talk to YOUR doctor before starting any exercise regime.  Your doctor will examine you, and decide if you can exercise and how much you can do.


Talking to your doctor first, is the most important step, before starting an exercise program, and the Boy Scout Personal Fitness book reiterates that. (SO DO I!!)



a.     Use resistance bands to do rowing, biceps, triceps and deltoid and lower extremity work-abductor and adductor mm’s of legs.  Watch video that came with bands. Start with light resistance bands and work up.
b.     Use resistance tubing to do biceps, triceps, deltoid work.  Do 3 sets of 10 reps each. Start with light resistance tubings and work up to heavy over time


                        a.  stretch upper body-biceps, triceps, deltoids and pecs
                        b.)  stretch lower body:  quads, hamstrings, calves, abductor and adductor           
                                    muscles of legs.  Stretch the front of lower legs by doing the Child's Pose"

                        a.  start with countertop push ups-do 3 sets of 10 a day(if you can)
                        b.  move to couch height push ups when able/stronger
                        c.  finally do push ups on the floor once strong enough.
                        a.) start with 2 sets of 10.  Remember:  crunches, not sit ups
                        b.  move up to 3 sets of 10 after 1-2 weeks
                        c.)  increase to 4 sets of 10 after 3-4 weeks
                        d.  increase to 5 sets of 10 after 5-6 weeks
c.     20 minutes of                                    
                                               i.     treadmill flat at 4.0 or faster or aerodyne bike for 20 mins or outside running/walking  for 20 minutes if weather conditions ok
                                             ii.     treadmill sideways at slower speed, alternate legs -3-5 minutes
                                            iii.     treadmill backwards slowly for 2-5 minutes
                                            iv.     with each week, add incline to treadmill           
                                             v.     jump-rope is also good aerobic exercise

Tuesday, March 4, 2014

"Doctor-ese", OR What the HELL Are You Talking About?


Doctors have their own secret language.  

In the comments in my last post, a great friend of mine pointed out how doctors talk WAY over patient's heads.  Often. 

Part is that is that sometimes it isn't  easy to describe stuff in English.
Part of it is that we forget to use English.
Part of it is laziness.

 It's easier to use specific words and we figure if we use the word in context, the patients will learn the correct terminology.

 This is true.  Sometimes.

  Patients or caregivers for patients with chronic medical problems end up with honorary degrees in medical terminology at the end. 

I try to use a word and then define it.  I hope that patients "get it."  And I tell them to stop me if I'm saying something they don't understand. 

As a physician, it is such a relief when we have a nurse or doctor as a patient because we can use medical terminology.  It's very difficult to constantly translate in your head from "medical-ese" or "doctor-ese" into plain English.

 When you can just say: "Your Ejection Fraction is 30% which means you really need to restrict your sodium content in your diet to 1200 mg a day and exercise aerobically daily,"

 Instead of: "Your heart is really weak and only pumping 1/3 of the blood that goes into it-- out.  That means you have to stop eating salt and salty foods so you don't hold on to a lot of water in your body. You need to start reading labels.  You need to know that salt is sodium on labels and you need to count how much sodium is in everything you eat and only have 1200 -1500 mg a day.  Also you need to exercise hard enough for 20-30 minutes every day that you can't hold a conversation.  Walking fast, swimming, biking so that you are short of breath...." and on and on.  You see what I mean. 

(By the way, the above is an example, not advice.  I individualize my instructions to people based on their ENTIRE medical history.  The above only is an example, not recommendations to every person with a low Ejection Fraction)

We also are being pushed to see more patients daily and a lot of this requires time we don't always have.  We don't have RN's in the office anymore because they're too expensive.  So we pawn off the instruction to a dietician.  That requires the patient  go to see the dietician, or the diabetic educator.  Often, they don't go or CAN'T go because of work restrictions.  Then they get worse. Then they miss work anyway. It's frustrating. 

I would love to have a pocket translator for medical language.  I could say, "Your edema is much worse and you're getting a diabetic ulcer on your right great toe." 

The pocket  translator could then say, "Your legs are swelling up too much and you have a potentially serious problem with an open sore on your big toe.  That's bad because it can cause your toe to get infected, and that's how amputations start in diabetics. You need to follow your diet , look at your feet, keep them clean and dry and keep the swelling down by elevating them whenever you can. Also, wear shoes or foot-gear all the time, even in the house."

Since Doctors don't have  pocket translators, remember that your doctor is human and sometimes forgets to translate.

 Don't be shy about stopping them and saying, 
"What the HELL are you talking about?"
or maybe,
"Could you please translate that into plain English?"

Your doctor will thank you for reminding them because honestly, we WANT you to understand, we WANT you to get better, and we WANT to succeed as physicians by having our patients succeed.