Monday, May 26, 2014

Treating a Scald Burn OR Why Buying Preserves is Cheaper (and Safer) Than Making Them

Any one who knows me, knows that I like to make homemade preserves. I love the fresh flavor of jams made without preservatives. My favorite, is BLUEBERRY preserves because:

1.) They're BLUEBERRY (DUH!)


 2.) Have you ever priced out blueberry preserves? (You will soon see the irony in this comment).

Now, I am a trained professional and am very serious about Sterile Technique when I make my own jams.

I also prefer, if possible, to make it without pectin.

 Blueberry preserves take little LOT more time to cook without pectin, but they taste AMAZING without pectin.

SO, yesterday I got my 4 pints of blueberries, washed and sorted through them removing the stems and leaves and the yucky couple of blueberries in there.  I mashed them up and had about 5 cups of mashed blueberries.

I added 3 1/2 cups of sugar and 1/4 cup of fresh lemon juice and the rind of a lemon to the mix.

I got a nice, rocking, foaming boil going and the handy dandy candy thermometer said it was around 205 to 210 degrees F.  I cooked the preserves to a nice thick consistency (about 30 minutes) and tested for gelling on frozen plate (I put a drop on the plate, ran my finger through it and the preserves didn't run together through the trough).  I also taste tested them and YUM!

 I washed my hands for the five thousandth time in the process after that, too. (I'm serious about sterile technique).

Meanwhile, I had my jars a-boilin' away in the canner, the lids and rings in another pot, all of my towels out, my jar tongs, my little magnetic rod (to pick my rings and lids out of the boiling water), all ready to go.

I started taking the jars out of the boiling water, one by one, with my special handy-dandy jar tongs and one slipped and poured scalding hot water all over my abdomen, left leg, and the top of my foot.

Now, I was never trained in the art of stripping, but you would never have known that if you had been in the kitchen with me.  I tore off my shirt, and suddenly the foot burn registered, as I tore off my sneakers, socks and pants, and was left standing in the kitchen in my underwear, swearing.

Just so you know, it is not possible to run your abdomen and your foot under cold water for twenty minutes without suffering from hypothermia. 

 I grabbed some ice and made a cold pack with a wet washrag, put it inside my bathrobe and tightened the belt to hold it in, put ice on my foot inside a sock, and went outside to tell my husband that I had scalded myself.

HOWEVER, before I went outside to let my husband know that I was possibly mortally wounded, I poured all of the jam using excellent sterile technique into the sterile jars with a sterile funnel and a sterile ladle, left a 1/4 inch of head room, and wiped off the tops of the jars without touching the preserves or the inside of the jar. I again, with excellent sterile technique, placed the lids and  the rings on the jars, and put them in the boiling water bath with 2 inches of water on top of the jars and processed them for 15 minutes.

Why waste perfectly good blueberry preserves?

Just so you know, the cost of the preserves was about Fifty dollars, after my husband ran to the pharmacy to get me nonstick bandages, wrapping bandages, burn gel, tape, etc.

Below is a link to some AWESOME instructions on how to make your own Blueberry Preserves. 

Even though in my case, they cost about fifty zillion dollars, they are so incredibly worth it. Just stand FAR AWAY FROM THE BOILING WATER WHEN YOU TAKE OUT YOUR JARS.

Sunday, May 18, 2014


First off:  This is informational only. Please, please, PLEASE, use this to talk to YOUR DOCTOR. Don't treat yourself. Don't stop medications unilaterally. Use this to add to your knowledge base as you talk to your Doc.This information is not meant to be medical advice.

Stress incontinence. This is the run, jump, cough, laugh, sneeze  incontinence.

Urge incontinence-is the "got to go right now or I'm going to have an accident" incontinence. Or the "Key in the doorknob" incontinence.

Mixed incontinence-it's a combination of urge and stress incontinence. Your bladder is very full and you've got to go, NOW, and then you cough and then leak.

Overflow incontinence
-"Oh my, my bladder is so full that I had better get to the bathroom right now or.... oh bummer!"---type of incontinence. Often there is frequent or constant dribbling or inability to empty the bladder, and the stream is weak. This can be caused by bladder injury, a blocked urethra, MS, diabetes or prostate gland problems(in men).

Functional incontinence occurs because people are mentally or physically unable to make it to the toilet. Think, nursing home patient with dementia, or immobilization from physical illness.

When you have incontinence, you and your doctor need to look at your diet, overall health, and your medications.  

For example, coffee, tea, soda and alcohol can increase incontinence. (I know, right?! Always the good stuff) They are all mild diuretics and/or stimulants of the bladder.
Drinking large volumes of fluids, quickly, increases the amount of urine in the bladder.

Diuretics, also known as "water pills" can increase your urine output and make it virtually impossible to get to the bathroom in time, especially if you already have difficulty moving quickly.

Muscle relaxants, blood pressure and heart medicines can sometimes affect the muscles, or the amount of urine your body makes. (Don't stop them. Talk to your Doc)

  • Uncontrolled Diabetes increases the amount of urine the kidneys make.
  • Obesity increases the pressure on the pelvic floor and increases leakage. 
  • Constipation increases incontinence by interfering with emptying of the bladder, or by pushing on and irritating the sacral nerves. 
  •  Pregnancy hormones and the stress of vaginal delivery affect supportive tissues and cause the pelvic floor to prolapse. 
  • Hysterectomy can increase the likelihood of incontinence. 
  • Bladder infections can cause incontinence. 
  • Kidney stones, bladder stones and bladder tumors can cause incontinence.
  • Aging can decrease the bladder's storage capacity
  • Menopause decreases estrogen which causes the tissues around the urethra to shrink back/atrophy.
  • Prostatitis -an infection in the prostate in men, sometimes causes incontinence. 
  • Benign prostatic hypertrophy or Prostate cancer, both, can cause the bladder to get blocked off and also the treatment of that can cause leakage. 
  • Neurologic diseases like Stroke, Multiple Sclerosis, Dementia, Parkinson's, Spinal cord tumors, Spinal cord damage, Brain tumors, all can affect bladder function

SO...What the heck do I tell my doctor? Isn't it normal to have urinary leaking? I mean, Look at that list! Seriously? What DOESN'T cause incontinence?

1.) Keep a Urinary and Fluid Intake Diary. Yes, I know that sounds weird and OCD, but believe it or not, I've had people drink 3 gallons of water a day and wonder why they had urinary frequency. 

2.) Bring a list of medications to every single appointment. 

3.) Write down your specific symptoms.

4.) Write down recent life changes, for example, longer commute to work? Increased stress at home? New medications? New herbal supplements or vitamins?

Testing you might have: 
1. Urinalysis and culture to check for abnormal blood cells, infections, etc.

2. Blood tests to check for diabetes, thyroid, etc.

3. Pelvic Ultrasound to check for abnormalities in the pelvic organs.

4. Post Void Residual or Bladder Scan. Here, a gyne or urologist or urogynecologist, has you urinate, then checks how much urine is left in your bladder with a special scan or with a catheter.

5. Urodynamic Scanning-usually done by the urologist or urogynecologist. It measures how much
 pressure is in your bladder at rest and as it fills. This can help with whether the sphincter is healthy
 or the muscles of the bladder are over or under active.

6. Cystoscopy-a fiberoptic scope is inserted through the urethra into the bladder to look around for
  tumors, stones, blockages in the lower urinary tract.

Treatment:  It Depends on the TYPE of incontinence and your other medical conditions.

Timed Voiding-going every 1-2 hours on schedule

Bladder Training-delaying urination by increasing lengths of time after you get the urge to go.

Double voiding -go, then wait and go again, to help you completely empty your bladder.

Fluid/Diet Management-lose weight, limit alcohol, caffeine, soda, acidic foods and fluid volume.

Physical Therapy- Pelvic floor exercises-done by a specially trained physical therapist to teach you the correct muscles to tighten and relax. They also use special biofeedback devices and gentle TENS units (electrical stimulation). You learn how to do the exercises at home and it takes months.

Anticholinergic medications-used for overactive bladder/urge incontinence. Lots of side effects but often very helpful

Topical estrogen-creams, rings, patch-improves the thinning out of the tissues and improves tone. Bonus:  It may Also help with pain with intercourse seen post menopausally. Again, side effects/adverse effects like blood clots. stroke, uterine lining cancer, etc. but very helpful in the right circumstances.

Duloxetine-an antidepressant sometimes used for stress incontinence

Imipramine-an old fashioned tricyclic antidepressant sometimes used for mixed incontinence but again-tons of side effects. Cardiac arrhythmias, dry mouth/eyes, feeling faint/lightheaded,
     constipation.  I have seen it used, mostly by urogynecologists.

Non-Surgical Treatments-
Pessary- is a rubbery knobby ring like device that is placed into the vagina to press on the urethra  to prevent leakage. It has to be cleaned regularly, and often, vaginal estrogen is used with it to  prevent irritation of the vaginal mucous membranes.

Photo credit:

Collagen or other bulking injections-again done by urogynecologist, around the urethra, to bulk up the tissues and keep the urethra closed and leakage reduced. Generally has to be repeated, however.

Nerve stimulators- I've seen one, once. It's like a pacemaker for your bladder. It is attached to the sacral nerves which go to the bladder. It helps prevent overactive bladder.

Surgical Treatments:
 Sling procedure-a bit of synthetic tissue/mesh or your own body's tissue is used to make a sling to pull up the bladder neck and urethra if it's fallen down/prolapsed. This really helps most with
stress incontinence.

There are others, but a urogynecolgist or urologist are the best judges of which of these will work

Skin Care: 
Pads/Diapers/Undergarments-there are all different types out there now. Most important, realize that  menstrual pads are not designed to absorb urine. They may be cheaper, but they are not designed to absorb urine.
 There are smaller volume pads, larger volume pads, night time garments, etc. MOST important is to change them when they get wet to protect your skin. 
Use zinc oxide ointments/creams (Desitin, Boudreaux's Butt Paste, etc) to protect your delicate skin and prevent sores and ulcers from the urine. Keep your skin clean but be very gentle.

Don't get dehydrated to prevent urine leakage. It's tempting to just stop drinking fluids, so you don't leak.

Especially if you are on blood pressure medications, or are older, this is a bad idea and can cause dehydration and kidney failure. Talk to your doctor about how much fluid YOU should be taking in a day, as it's different depending on your medical conditions. 

Saturday, May 10, 2014


(I know this isn't medically oriented, but it sort of is, given Mother's Mental Health is involved.)

On the days leading up to Mother's Day, there is a lot of hype about what Mother needs and wants.

Don't drink the Kool-Aid of commercialism.

Most mothers do not want flowers, stuffed animals, figurines, or any other stuff that dies, wilts, drops leaves or requires dusting, maintenance or paying of the bill in the long run (cell phones).

Jewelry is fabulous if you like it, which I don't. 
I can't wear big flashy rings because I use gloves at work.

Necklaces just whack people in the face when I bend over and listen to their hearts.
 I have a nickel dermatitis so I can't wear most Earrings.
Bracelets are pain in the butt, literally. They get in the way when I write. They make noise. They're hard to wear when you're doing a breast or rectal exam. They get in the way when you're washing your hands. So for me, personally, jewelry is out.

Also, I do not want ice cream, cookies, cake, candy, teddy bears, flowers, or anything else that will make me fat, will die, or will require finding a place for. Or ballons. I saw about 5 mylar ballons floating up in the sky, away into heaven, today.

Perfume. Don't even go there. Doctors can't wear perfume. Why? Because we take care of people who could die from strong odors. Think asthma, emphysema, other terrible lung diseases. People who have allergies. People who would have sneezing fits and then pee in their pants. (See previous post. Yeah I know I still have to finish it.)
 I  have perfume that is from the late 1980s. Seriously. I never wear the stuff. Don't buy me perfume.

Now, I may be a little jaded here. I know, children are a gift from God and I'll miss them when they're gone but right now they're driving me bat shit crazy.

So here's what I want, and I'm going to go out on a limb here and guess that a whole bunch of other moms, want for Mother's Day.
(I even highlighed it so you don't have to take notes)

1.)  Pick up all your crap off the floor. Daily. And flush the toilet and wipe off the poop!

2.)   Change a light bulb now and then. I don't like living in a Bat Cave and I'm the only one that changes the damned lightbulbs

3.) I know this is impossible but I'd really love to have a girl Friday. Somebody to go through the mail, line up all my bills for me to pay, throw away the thousands of pounds of junk mail we get a week. To take my cleaning to the cleaners. To run all of my errands. To drop the kids off here and there.

4.)  Okay I know I'm going out on a REALLY long limb here, but how about a personal chef. Somebody to cook dinner. Every night. Right now we cook on the weekends and if we're lucky sometimes we cook during the week. I would love to have a personal chef make me lots and lots of nutritious meals with lots of vegetables that are complicated and time-consuming and taste just amazingly excellent and are perfectly portioned-a la Oprah.

5.) Massive de-crapification of my house.

There is stuff on every single surface of my house. When my children are done with something, instead of putting it away, they just leave it. I would like to go through the house and pretend that we are moving and get rid of stuff. Worse yet, I inherited some stuff from my parents who were hoarders. It was a lot of stuff that is kind of important and they never did anything with, photos and such. So far I have continued the tradition, leaving it in boxes and not doing anything with it.
Mostly because I know that it is going to require an enormous amount of effort to organize and put things away in a nice way. I don't want to get started if I am only going to leave it half done, which is my usual modus operandi when I start a project.

6.) I would love to have a personal trainer. Someone to kick my butt into action

7.)  While were at it, I'd also like to have a personal shopper. Yeah, it would be nice to get a makeover and the clothes, but really, I want someone else to shop for my kids clothes, and for groceries. 
And Don't talk to me about Peapod. They cost a bazillion dollars for itty bitty portions of stuff.

 In summary, all I really want for Mother's Day is order to be restored in my house, the dog not to smell like a kennel, the furniture fabreezed of dog odor, the crap picked up around my house and straightened, and the light bulbs to be changed. Is that too much to ask for? Happy Mother's Day

Sunday, May 4, 2014

Rights of Passage and Peeing in Your Pants, Part I

Your "First" of stuff is important.

Your first steps.
Eating solid food.
Getting your period.
Your first kiss.
Your first baby.
Peeing in your pants when you run across the street to catch the bus.

Most of these are rights of passage, like winter turning into Spring (finally).

 Peeing in your NOT.
Run, squirt. 
Jump, squirt. 
Cough, squirt. 
Sneeze, squirt. 
Key in the doorknob urgency to go. Stopping every hour on a car trip to go. Carrying extra underwear and pants with you at all times, just "in case."

Women of a certain age know what I'm talking about. It's a shock when it happens to you that first time. When it becomes a more regular event you consider wearing pads and you go to THAT aisle at the grocery store.

I don't know about you, but I was shocked when I perused the aisles and realized how many different products there are now for incontinence of urine. I shouldn't be surprised. We do have a ballooning population of baby boomers.

In the past, women hid in shame and expected it was normal. Doctors didn't ask, and women didn't volunteer the information.

There are many causes of incontinence.
There is something that can be done for most causes of urinary incontinence.
You don't have to be like this Buddha, hiding away.

So why do women develop incontinence and men don't until they have prostate problems? Well it's not all that straightforward but to start with, the urethra, a little tube that leads from your bladder to the outside is very short in women. If you think about it, the urethra in men is very long. It goes from the bladder all the way through the penis to the outside of the body. Lots of room to prevent incontinence. But  men DO develop incontinence.

Wouldn't it be nice, ladies, to just be able to drop trou and pee anywhere, like guys, and dogs?

The muscles in the pelvic floor have to hold up against the gravity and weight of all of the abdominal and pelvic organs pressing down through the hole in the bottom of the pelvic bone. (see below-there is a big hole in the bottom of the pelvis and "stuff" can fall out)

Carrying babies, pushing out babies, getting fat and getting older stretches the muscles out and the organs push down through the hole. Sometimes, they prolapse or evert (the vagina or the rectum can start turning inside out and push out).

Women have three holes, if you will, in the pelvic floor. The Urethra, the vagina, and the rectum. Three places where things can fall down through. Vaginal and bladder prolapse are often associated with incontinence. Prolapse is just a fancy word for things kind of turning inside out and falling out. Also another cause is the ligaments that hold the bladder up tearing or stretching out of place.


I blame my children. It's all their fault.

Next Blog Post, More about Incontinence. Types, Treatment, and (gasp) physical therapy for the pelvic floor.