Friday, April 18, 2014

Have you Dyed Your Easter Feet Yet?

Feet.



Feet are like poop. 


Some people are completely disgusted by feet (and poop), and others are fascinated by them. There seems to be no in-between.

Why am I writing about feet, you ask?

First, I've already written about poop. (Still one of my favorite columns, if I do say so myself).

Second, a fellow Wood Badge participant (Boy Scouts) was lamenting not having worn arch supports or of taking good care of her feet during her mis-spent youth (not really mis-spent. I just like how literary that sounded. Actually, she's an upright citizen and a great person)



Third, I recently purchased sneakers for my kids and it was almost impossible to find shoes to fit either kid properly, and it WAS impossible to find shoes for myself.


Whether you call them Tennis shoes, Tennies, Runners, Running shoes, Sneakers, Athletic shoes, gym shoes, it depends upon what part of the country you're from.  No matter what you call them, they need to be supportive and prevent injury from the ways we torture our feet.



I USED to have AAA feet-super narrow, size 10 feet. 
Then, I had kids.
Now I have high arches, bunions, and wide toe box type of feet.

My daughter has Peruvian feet. Wide, flat, but in a larger size than most woman of Peruvian descent. Women's sneakers do not fit her.

My son has In-toeing, narrower feet and wears out the inside of the heels of his shoes as a result. 

We all need good shoes.

I need men's sneakers because they are wider in the toe box to contain the destruction wrought by carrying two children and the subsequent weight gain.

I never wore heels. Not because I'm tall, (I am, but that is not why). I never wore them because they HURT. 

Heels are a form of torture brought about by a male centric society that values people of height, and women in heels. Both. 

(I'd better stop now or I'll go on and on in some long-winded rant about how society needs to be changed one heel at a time, in order to equalize the world for women all over. )


So, here's the thing. I spend more money on my kid's foot gear than I do on clothes. Or food. Or hair styling products.

 I shop at Tar-jay or goodwill for bargains on clothes that they will outgrow in 3 months. 

It may be a throwback to my grandmother's depression era rant about how her feet were ruined by having to wear hand-me-down shoes, but mostly I think it's because I look at the ravages of time on feet ALL DAY LONG.  I would rather spend money to prevent curled up hammertoes and bunioned feet than to have my kids in stylish but useless foot gear.

I do NOT get grossed out by anything anymore. 

People apologize ALL THE TIME for not having gotten a pedicure before their appointment.

GUESS WHAT? I DON'T CARE!! In fact, I'd rather you didn't. I need to look at the nails, the cuticles, the nailbeds, the fungus between your toes, your calluses and bunions. It's what I do. 

BUT--I beg of you, please buy good fitting foot gear for yourself and your kids. I WILL look at that. I might even comment--For example:

 "Those shoes are shot. You need wider shoes with better arch supports, less flexibility and better cushioning. And if you wear them every day, you need to replace them every six months." 

I know of what I ask.

It is nigh to impossible these days to find sneakers that actually are supportive. I was at an unnamed athletic shoe store and it's sister store in a nearby mall recently. Most of the sneakers had no cushioning in them. They had a few that were supportive with excellent insoles and arches. It was maddening trying to find a pair that were in my or my kids sizes.

After I shelled out a small fortune to get my two kids some decent sneakers, they both commented on how much better the ones I chose felt than the ones they had chosen.

They were, however, lacking that "cool" factor. They weren't fluorescent orange and green, with undulating springing soles that had built in music systems and disco balls. 

But their feet won't be gross in forty years. I hope. 

Okay, go get a piece of brown paper, like a paper bag, and put it on the floor. Wet the bottoms of your feet, and stand on the paper. What do you see?  Do you see a practically full footprint with minimal or no curve where the arch should be? Then you have flat feet, and possibly pronation-or in-rolling  of your ankle joint. THAT causes all kinds of problems, like ankle pain, plantar fasciitis, knee, hip and low back pain. When your ankles roll in or pronate because of flat feet, it causes malalignment of your whole leg, hip and back, wear and tear of the joints and arthritis. Ugh.

Do you have a narrow imprint of the outside of your foot and nothing on the inside of the arch? You have HIGH arches.

Walking shoes are stiffer, running shoes are more flexible, but dress shoes also need to be stiff. Pick up your shoe and hold the heel and the toe box and twist them in opposite directions. Do they twist easily? Then they are flexible. Not great for American feet. Is it challenging to twist them? They are better.

There should be a thumb's width of room between the end of your shoe and your great toe. The shoes should not pinch anywhere, and the heel should not slip off. The old rule of breaking in shoes is defunct. They should fit right out of the box.

Go get fitted in a store where a knowledgeable shoe salesperson works. Remember that the shoe size may not be the same between brands, or even shoes of the same brand. Make sure they're comfortable and they fit properly, no matter the number on the box.

Here is my contribution to EASTER FEET!
Feet:  Dipped in water and food coloring for that special FESTIVE EASTER feet Look.
Decorated by:  Daughter and her Bestie, and Moi.
I especially would like you to take notice of the Easter Walrus. Daughter says that the Easter Bunny is retiring and The Easter Walrus is taking over.

And here is my Long Suffering Esther in her Easter Ears.




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!

http://poniesandmartinis.wordpress.com/

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.

http://doctordivagetshealthy.blogspot.com/2011/10/poop-report.html


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 and...it'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!!
Instead of GIVING UP SOMETHING, WE ARE DOING SOMETHING POSITIVE!!

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.

Seriously.

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!!)




WORKOUT SCHEDULE FOR MY FAMILY

MONDAY, WEDNESDAY AND FRIDAY:

1.)   WEIGHT TRAINING:
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


7 DAYS A WEEK:  DO A FIVE MINUTE WARM UP ON BIKE, TREADMILL OR RUNNING IN PLACE.
           

1.)  FLEXIBILITY AND STRETCHING:  after warm up
                        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"

2.)  PUSHUPS:
                        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.
3.  CRUNCHES:
                        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
           
4.)AEROBIC EXERCISE: 
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.