Wednesday, December 31, 2008

Sure, Frodo's Cute, but Aragorn Gets All the Action

While I’m on the topic of body image: there is a type of prejudice of which I have become acutely aware since the birth of my son.

Why is still okay to make fun of short people?

Why is it a compliment to remark upon how tall a child is, but a slur to point out that a child is short?

Why is everyone so happy when babies are big?

Why is automatically better for a man to be tall?

How is height any different from any other immutable physical characteristic?

The first time I watched Shrek, long before HB was born, I didn’t find it odd that one of the running jokes is about how short the prince is while the movie is (ostensibly) about how it’s okay to look different from society’s expectations of beauty. Now it grates on my nerves, and I wonder if I should even let HB watch it.

HB is normal—he’s “on the curve”—but he’s waaaayyyy down there, usually in the single digits percentage-wise. He’s the size of the average child a full year younger, and there are kids in his class who are taller than he is who are two years younger. In some ways this is an advantage for him now; people routinely think that he’s outrageously advanced for his age. (My husband used to correct people who said things like “He talks so well!” by saying “No, he’s really small for his age,” until I pointed out that he was implying that HB was short and stupid.)

It won’t be an advantage forever. He’s currently on track to be about 5'5" or 5'6" when he’s an adult – maybe 5'7" if he jumps the curve at the end the way a lot of boys on my side of the family do. This means that he will be routinely eliminated during searches (or whatever it is they have in 2025). He will probably be accused at some point of having a Napoleon Complex or “short man syndrome.” He might have trouble being elected president.

Let me make clear that I realize this is not a terrible problem to have. I am tremendously grateful that my son is healthy and normal. I don’t actually want to be the mother of a president. But it does worry me, and I really don’t know how to help him negotiate his way as he gets older. With one exception, all of his close male relatives—father, uncles, grandfathers—are 5'10" to 6'3", so not a lot of role modeling there.

There is a fair amount of advice out there on how to help your daughter gain a healthy body self-image, but very little for boys.

Those of you with experience with the short guy thing: any advice?

Tuesday, December 23, 2008

Wire Monkey

My friend J and I were talking about body image recently, and she said, “I’m very comfortable with my body—I don’t mind being naked in front of people—but I don’t really like it.”

“What’s wrong with your body??!” I asked. J is beautiful and tall and solid and stacked. She’s a Brick. House.

“Well, there are parts of it that are just ugly,” she said.

“Like what?”

“Like—like my back fat.”

“What’s wrong with back fat?”

“Back fat is objectively unattractive.” Which has to be one of the most ridiculous things she’s ever said.

“Not liking back fat is the epitome of subjective,” I said. “Take my brother. You’re too skinny for his taste.”

Then I confessed one of my body issues to her: when I see well-upholstered mothers cuddling their children, I feel sad that HB will never have that kind of comfort. All he gets are clavicles and acromion processes.

J eyed me for a moment, then said, “You know, you’re right. You’re like the wire monkey.”

And damn it if that image doesn’t keep cropping up in my head every time I hug my child now.

So go enjoy your holiday feasts. Do it for the children.

Monday, November 10, 2008

Genius My Ass

A little over a year ago, I went from never listening to music while running to almost always doing so. (Thanks again, E! Did you know my ipod survived even an epic soaking in a thunderstorm?) (Also, the pants fit, and belated thanks for those ...)

My problem: I don't have enough songs. Turns out, my favorite music is not my favorite running music. For running, I need:
  • A driving beat
  • Lyrics -- I can't run to the podrunner music, for instance -- but the lyrics must be interesting or funny, unless the beat is REALLY good
  • A certain je ne sais quoi -- and therein lies the problem
So it was with great excitement that I tried out the Itunes Genius feature. Finally! A way to locate songs that are like the songs I like but that I never heard of!

Some middle of the night insomniac hours later, I have come up with exactly one new song.

So I need suggestions from the real geniuses out there: you guys. Here's a snapshot of a few of my current running favorites:

Help me out here, people. What am I missing?

Tuesday, September 30, 2008

Brazilian Boy

Not depressed anymore, just unbelievably overbooked. Doesn’t feel as bad when I’m not depressed, at least.

I try to refrain from posts on “kids say the darndest things,” but I’m too busy to think of something better, and I have to get at least one post in for September.

The other evening I was in a restaurant bathroom with HellBoy. He is looking at me in his usual serious way.

HB: You know, not all grown women have furry va ginas.
Me: Um, they don’t?
HB: No. They have – well, you know how little girls’ va ginas look?
Me: Yes?
HB: They look like that, only much bigger.
Me: Have you – seen one like that?
HB: Ms. L at school. Her skirt came up on the playground.
Me: Uh, and she didn’t have underwear on?
HB: She did, but it kind of came up too … it’s complicated. But I saw hers. And it was like a little girl’s. But it was GINORMOUS [holding hands far apart from each other].

Saturday, August 30, 2008

What I Really Think

A couple of weeks ago during office hours, I saw a particular name on a chart, and my heart sank. This is a patient who sucks up an inordinate amount of my time every time she comes in, and to no discernible benefit to anyone. She has severe hypertension, for which she is on medication, and she obsesses about it. She takes her pressure three times a day, documents it each time, and brings the list in to convince me that she doesn’t really need blood pressure medication. Thing is, her numbers don’t even look very good. She doesn’t want to stop her medicine – I’ve told her that she is of course the boss of herself and doesn’t have to take my advice – no, she wants me to tell her to stop.

I sighed heavily to myself, then went into the room. And as I was sitting down to talk to her, she handed this article to me. Uh-oh, I thought, here we go.

My patient had circled one of the statements from the article:
I know that Reader’s Digest recommends bringing in a complete list of all your symptoms, but every time you do, it only reinforces my desire to quit this profession.
And I’m thinking, How am I going to get out of this one? Because I absolutely do feel that way. Then my patient says, “I read that, and I thought, That’s me! I bet that’s what DoctorMama thinks! So you know what? I didn’t bring any notes with me! And I stopped taking my blood pressure all the time – and you know what? I feel so much less stressed!”

And we had a really pleasant visit; she even hugged me on the way out.

Naturally I was curious to read the rest of the article, but I found that while I did agree with some of it, most of it didn’t resonate with me at all.

Here’s some of the things I have to admit I do agree with:
The most unsettling thing for a physician is when the patient doesn’t trust you or believe you.
“Unsettling” is the right word for this (though not necessarily “the most”). It doesn’t make me mad, it doesn’t make me insecure – I just don’t know where to go once I realize that a patient thinks that I’m full of it. Usually I just back off and say, “I can only tell you what I recommend; what you decide is up to you.”
It saddens me that my lifelong enjoyment and enthusiasm for medicine has all but died. I have watched reimbursement shrink, while overhead has more than doubled. I’ve been forced to take on more patients. I work 12- to 14-hour days and come in on weekends. It’s still the most amazing job in the world, but I am exhausted all the time.
At least a third of what doctors decide is fairly arbitrary.
Absolutely. But I usually let patients know this right up front.
Most of us haven’t been to see our own physicians in five years.
Quite true, but not just because we don’t practice what we preach. People mostly shouldn’t go to doctors as often as they do. I never lecture a patient who is essentially healthy about not coming in more often. Every visit is an opportunity for iatrogenesis, really. And most screening is overrated. Doctors screen folks a lot more often than the data say they should, partly to avoid having to argue about it and partly to avoid being sued for it.
In many ways, doctors are held to an unrealistic standard. We are never, ever allowed to make a mistake. I don’t know anybody who can live that way.
Sometimes it’s easier for a doctor to write a prescription for a medicine than to explain why the patient doesn’t need it.
Kind of true, but not stated correctly. What it should say is, Sometimes it’s easier for a doctor to write a prescription for a medicine that won’t work than to explain why it won’t.

Some of the statements seemed neither here nor there to me – such as:
Those so-called free medication samples of the newest and most expensive drugs may not be the best or safest.
Well, duh – I hope that most doctors are telling their patients this!
In many hospitals, the length of the white coat is related to the length of training. Medical students wear the shortest coats.
This is not a secret, is it? Medical students identify themselves as such, in my experience.

But most of the stuff in the article I could not relate to at all. For instance:
Not a day goes by when I don’t think about the potential for being sued. It makes me give patients a lot of unnecessary tests that are potentially harmful, just so I don’t miss an injury or problem that comes back to haunt me in the form of a lawsuit.
I would say the potential for being sued crosses my mind maybe twice a month, max. I long ago realized that the thing you get sued for is never the thing that you would have avoided had you been thinking about being sued.
It’s pretty common for doctors to talk about their patients and make judgments, particularly about their appearance.
No, not particularly about their appearance – about their personalities, yes.
In most branches of medicine, we deal more commonly with old people. So we become much more enthusiastic when a young person comes along. We have more in common with and are more attracted to him or her. Doctors have a limited amount of time, so the younger and more attractive you are, the more likely you are to get more of our time.
I feel almost the exact opposite. I am much more impatient with and bored by people who seem a lot like me. I love the crazy old coots – I could talk to them all day. (And “attracted to”? Um, eww.)
Doctors are only interested in whether they are inconvenienced—most don’t care if you have to wait for them.
What an awful view of the rest of the world this person must have. This is far, far from the truth in my experience.
When a doctor tells you to lose 15 to 20 pounds, what he really means is you need to lose 50.
Huh? Why would you do this? I don’t tend to talk in absolute numbers anyway, because a healthy weight for one person is different from that for another of the same height, but if a patient asks me how much they should lose to improve their health, I’ll give them an honest estimation.
Ninety-four percent of doctors take gifts from drug companies, even though research has shown that these gifts bias our clinical decision making.
Doctors often make patients wait while they listen to sales pitches from drug reps.
Long ago I took the No Free Lunch Pledge, and I’ve stuck to it. I don’t take stuff, and I don’t talk to drug reps. I made this decision when I realized that everyone thinks they’re the one who isn’t influenced by such things, and yet studies show everyone is. Why should I think I’m special?

Overall I think the article probably caused more harm than good. But maybe it will inspire a few more doctors to take the pledge. And I’m sure glad my patient read it.

P.S. Now that you know what I really think, you can go here for a (flattering) idea of what I’m really like.

Sunday, August 17, 2008

Maggot FAQs (& a Few InFAQs)

Department of Motivation/Inspiration

Q: Will I get better/faster? WHEN? I know you know the answer, don’t pretend you don’t!!! How not to get discouraged?
(Slowpoke) and How do you push past the three mile slump? (mrsssg)

A: One run out of the week (only one!), push yourself, either faster or farther—but NOT both, never both. You might try one run a week with someone else who’s a little bit faster than you are. You’ll feel like you’re dying, and it’ll be embarrassing, but the next run you do on your own will seem easier. You might “bonk” or “hit the wall,” and you must not feel defeated by this. A bad run is better than no run, and some days just don’t work out.

As for WHEN … if you are running slowly enough, you will be vastly better within six months. If you keep running too fast and doing each run like a wind sprint, you might never get better.

As for not getting discouraged, just keep reading the success stories here! (This just in: a picture of Victoria in the maggot shirt she won for most inspiring story. Doesn’t she look fantastic?)

Q: Any tips for treadmill running to make it, well, not suck? (Julie)

A: Aside from varying the speed/incline and watching TV, the one interesting tip I’ve heard is to try running some intervals BACKWARDS. I’ve never tried the latter, so do it at your own risk (and maybe take some video footage, please?). (Julie’s a little busy at the moment and probably not reading this, but perhaps in a couple months she’ll be back.)

Department of Pain

Q: Any thoughts on plantar fasciitis/heel spurs? (erika)

A: First, know that the heel spur is not the problem, but rather a symptom of the plantar fasciitis—it’s a little bit of extra bone that grows due to chronic inflammation. Special stretches and exercises help a lot, as does running later in the day rather than in the morning.

Q: I have an annoying little pain in the muscles next to my right shin bone. Any good stretches for this muscle? Can it do a lot of damage if I run through it? (mrsssg)

A: These are shin splints, and can be a lot more than an annoying little pain. The advice I got somewhere long ago when I started was that I should expect to get them at some point and to run through them. I did, and I did, and it worked out—BUT everything I read about them suggests not just running through them. Running on a softer surface, maybe better shoes, avoiding hills, and not increasing the amount you’re running all seem like good advice. (Since the standard advice for all pains in runners is “stop running,” and it’s patently ridiculous most of the time—and starting to be disproven—I’m automatically suspicious whenever I hear it.) (Thanks for the link, anonymous!)

Department of Gear

Q: Do you have any favorite online stores for running basics? (Slowpoke)

A: Some places I’ve ordered from more than once and liked every time are the REI Outlet, Campmor, and Running Warehouse; I’ve heard good things about Title Nine but haven’t tried them myself.

Q: What’s your opinion on spendy inserts? good, not necessary, imperative, couldn’t hurt? (blue)

A: Depends. I never used them until this year, when my shoes felt a little too uncushioned. First I tried cheap ones—not good. Then I tried spendy ones, and they do feel good. But good running shoes shouldn’t require extra inserts if your feet are pretty average-shaped (mine aren’t). I’ve heard warnings not to use inserts as a way to try to extend the life of your shoes, and that makes sense to me.

Department of Scatology

Q: I can make it 1 mile before I have to desperately find a bathroom to defile. I’m unsure how to add much distance through potentially bathroom-free territory and there have been times that I’ve had to cut off a run to walk, clenched and desperate, to somewhere that I’ll have trouble showing my face again. (Muddy)

A: I think long ago Denise had this question, and I was flummoxed. I still am, but I think this is what I’d do: run my first mile in a little loop back to my house, then continue my run from there. Also, try stripping all milk products from your diet, as lactose intolerance can present this way. Finally, relax about the showing your face thing. Everybody shits, and everybody’s shit stinks. Look at it this way: you’re making people feel less embarrassed about themselves!

Q: I find that I can’t poop unless I run, and I find that it takes longer and longer for running to work its magic. This is how I become literally addicted to running. And like a drug, it takes more and more to get the job done. I ran 4 miles last night and my intestines just laughed. (also Muddy)

A: Muddy, you do have some issues, don’t you? It sounds like you’re an IBS sufferer, and that’s a pretty tricky problem overall. The general advice I give my patients is to quit eating any simple carbohydrates (they plug you up), quit dairy as above, and find a daily dose of good old-fashioned Milk of Magnesia that works for you.

Q: When I run I get really itchy in areas it isn’t polite to scratch publicly. I’m assuming this is because of sweat, but whatever the reason I end up with a red butt from my attempts to ease the itchiness. Any ideas? (mdt)

A: Well, I just go ahead and scratch, but I know I’m less than couth sometimes, and I could see how this might get annoying if the itch kept up. Are you wearing underwear when you run? If so, take them off (but put your shorts back on, please). Next, try some toe-vagina-butt cream—maybe you’re a little yeasty. Third, try some powder—I love Lush’s Silky Underwear.

Q: My mother-in-law insists that running is bad for the PC muscle. Is there any validity to this claim? Please put this nagging fear to rest! (Allison)

A: No. No validity. You must already know that your mother-in-law is nuts anyway, right?

Q: Is it true that women who have had children have to pee more often, or does it just seem that way? I ran a half marathon and I swear I must have stopped at 6-8 port-a-potties. Also, I just got back from a week of camping and it seemed like no matter how many times I tried to empty the bladder before getting in the tent, I always had a 2 a.m. nature call. It was worse right after I had my daughter, when I finished a 5K by truly wetting my pants. What can be done, if anything?

A: Like this question, the answer is a three-parter.
  1. As women get older, they can have more trouble holding in their urine. This is only slightly more common with women who have borne children than those who have not (except for the unfortunate few with really nasty tears). But this is a basic muscle-strength issue, and no matter how old you are, you can get your muscles really strong if you work at it. Here’s a tip: Kegel while you run. Not the whole time (now that would be a challenge!) but every now and then.
  2. Having to get up to pee in the middle of the night is not a muscle problem, it’s a drinking too much problem. Just as with little kids who wet their beds, restricting liquid past a certain time can magically fix the problem. (A lot of people just naturally wake up in the night and then assume they have to pee, too.)
  3. Having to pee a lot while you’re running can be due to #1 or #2. Are you peeing a huge amount when you go? If so, you’re overhydrating—try drinking fluids until an hour before you run, then stop completely, then pee just before you go. Are you peeing a tiny amount? Then you may need more Kegeling.
Department of Postpartum Affairs

Q: Any post c-section running advice? (Jacq)

A: Just don’t be afraid. You won’t split open like an overripe watermelon, I promise. Follow the Slow Down rule, and you’ll be fine.

Q: Advice on a good running bra for a nursing mom? My chest is currently enormous so good support is a must but little one is still nursing enough that easy access is essential. (amy)

A: Anything with a front closure (zip or hook)—I’ll put another plug in for the Last Resort bra, because women with racks seem to adore it, and I adore the name.

Q: I’m afraid I have some kind of prolapse—I feel like something’s coming out “down there” when I run. (Rebecca)

A: This is a peculiar thing that happens postpartum, and it’s most likely due to the vaginal dryness when you’re in the non-ovulatory state. You can actually feel the rubbing together of the walls when you run, and it’s freaky. But it’s not prolapse, and it’s not dangerous.

Department of Weather

Q: Any advice on running in the heat? (Other than, “Wait until 7:30 when it’s only 85 degrees, dumbass.”) (anon)

A: Shaded paths (with company if it’s a sketchy area). Also, slow acclimation. Some of the best distance runners in the world come from the hottest parts of Africa, you know.

Tuesday, August 05, 2008

At Least I Floss Daily

My blogger meet-up the other week was terrific, which was no surprise to me, since every blogger I’ve ever liked on screen and had the chance to meet I’ve also liked in person. The only thing that has ever startled me is that many of them are much taller than I thought, since that’s one thing you can’t tell from pictures. For some reason I expect everyone to be kind of shrimpy like me.

For those of you who have had the opportunity to link up with a favorite blogger, have they been the same in person as they appeared to you on screen? (I don’t think you can count brief meetings at events like BlogHer, but I wouldn’t know for sure since I’ve never been.)

I will be testing my 100% record soon, because through happy chance, I have a quick trip that will take me near the lair of E of Oral Hygiene Queen, whom I have been wanting to meet for years. My only worry is that she will find my dentition lacking, and I think it’s too late to get my teeth capped. She can probably spot caps a mile away anyway.

Saturday, August 02, 2008

Feets, Don't Fail Me Now

I recently received this query from a friend:
My feet are trashed—ingrown toenails, blisters, corns, bunions. I fear they will end my running career. Any advice?
This made me realize: I forgot to tell you folks about feet! This is a gross oversight on my part.

This is what I told her:
Yes, running can trash the feet if you’re not careful. I can pretty much guarantee that your shoes suck and are too small, and you need new ones NOW. Your shoes should not be rubbing on your toenails or your corns.

Then, you have to become annoyingly fastidious about foot grooming. Meaning, getting a callous cutter (the scary ones with the razor blade insert) and using it aggressively a couple of times a week, and using corn remover pads for incipient corns. Then, get toe-vagina-butt cream (aka vaginal yeast cream, the cheapest way to get antifungal stuff over the counter, excellent for diaper rash too) and rub your feet with it daily to decrease fungus growth.

Finally, get these socks; they have 2 layers, which cuts way down on the blistering.
Less than 48 hours later came her reply:
I just got new shoes a half size bigger and about twice as expensive
and am IN HEAVEN.
So Maggots, watch out for your feets, please.

(There are new links to t-shirts on the sidebar, fyi.)

Thursday, July 31, 2008

T-Shirtte Shoppe

Is this about what you had in mind? Microfiber, in girlie or unisex style:

First one goes to Victoria. Victoria, if you'd like to claim your prize, send me an email w/ a place to mail it and your preferences re: style and size (doctormamamd is the name and gmail is the place, and don't forget the "md," someone else stole plain "doctormama"). (Will that circuitous address decrease the spamming, you think?)

Friday, July 25, 2008

My Hair Doesn't Work, and T-shirts

Upswing underway, I’m fairly sure. I am looking forward to things here and there—for example, I am really pleased that I get to meet up with a fellow blogger tomorrow. (Caution: if you let your location slip and it’s anywhere near me, I may hunt you down. I have made several of my best friends this way. I’d link to them, but then my own location would be obvious.)

Mignon noted the diversity evident at HB’s preschool. That this does make a difference was illustrated yesterday evening: I was sitting on the front stoop with him and he started trying to put cornrows in my hair. “This won’t hurt, but it will pull a little bit,” he said. “You twist it and twist it, and then—Mama, your hair doesn’t work!”

I am addicted to your running success stories. I really have to make up some shirts to send to folks with the best stories. If I do, what should they say? “At least I’m running”? “Another Maggot”?

And if you’re looking for something funnier and spicier than what I’m up to (not a very high bar, I admit), check out Feral. (Warning: if you’re at work and your internet access blocks “inappropriate” content, her page may not open.)

Saturday, July 12, 2008

It’s Not You, It’s Me

You’d think I’d recognize the signs earlier by now:
Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

depressed mood most of the day, nearly every day
markedly diminished interest or pleasure in all, or almost all, activities
significant weight loss when not dieting
psychomotor agitation or retardation
fatigue or loss of energy
feelings of worthlessness or excessive or inappropriate guilt
diminished ability to think or concentrate
recurrent thoughts of death
It’s always such a weird relief to realize what’s going on—like when you’re driving around lost and suddenly spot a landmark you recognize: I’ve been here before, and I know the way back. I have increased the dose of one of my medications on my own but have an appointment with my psychiatrist soon.

Probably the worst part of it is what a fraud I feel like when I’m counseling students and residents.

TH has not hung up his shorts (nor stopped shaving his legs), but no races in the near future and no discussion of two-wheeled conveyances. My father-in-law has donated a TiVo, so the Tour can be watched without me having to keep HB quiet.

I am running, and that feels good.

There are still things that make me feel happy. Things like this comment from Victoria:
Please count me as one of your success stories. In January, I was completely sedentary, obese, & suffering from pretty serious arthritis pain in my hips, as well as meralgia paresthetica & near-crippling referred pain from a bulging disc in my back. The orthos told me there was nothing to be done about the hips until I got old enough for a replacement (I’m only 42). I had a couple of steroid shots in my back for the disc pain, but they did nothing. The spine ortho was talking about surgery. My PCP told me that weight loss would help—but how can you lose weight if you’re in too much pain to exercise?

Then, I slowly decided to start trusting your advice that it’s ok to run even if you’re in pain. This is contrary to what the orthos were telling me, but then, they really weren’t helping me, and I knew something had to change. … I knew I had to lose weight to stop that pain.

So, I trusted you. I started running, very, very slowly (so slowly that my dog was walking on the uphill sections of our runs!), only half an hour at a time, only every other day. Running itself isn’t burning many calories, but there’s something about being active that makes every other challenge in life seem more manageable. It made me feel optimistic, and powerful.

I made a strenuous effort to lose weight. Since the beginning of the year, I’ve lost 35 pounds. I’m now “mildly overweight” instead of “obese.” Everyone keeps commenting on how different I look. But the most significant change—the one that nobody can see—is that I have NO PAIN. My hips feel tender when I run, but the rest of the time? No meralgia at all. No referred pain from my disc at all. And no arthritis pain at all (except a little bit during & after runs).

This is incredible. I would say I have a 95% reduction in my pain. Back in December and January, when the pain was at its worst, nobody was giving me any hope that I could recover from my pain. … I was panicking—I felt like a decrepit old lady with no hope. I was in so much pain that I couldn’t work. I was taking Vicodin every day, and feeling stoned all the time, and still in too much pain to think about anything else. Sometimes, I couldn’t even carry on a simple conversation with my husband about what to have for dinner because all I could really focus on was how much pain I was having … Now I am pain-free and I feel like I’m in charge of my life and my health.

I am convinced that there’s something about exercise itself (not just the weight loss) that helps my body manage pain.

Anyway, what is so incredibly helpful about your website is not only that you tell us not to be afraid of pain and not to give in to it, but also that you set really strict limits on how much we can do. In the past, I’ve always, always overdone it, gotten injured, and become discouraged. Now, doing only half an hour every other day, I have had no injuries. And I also have no excuse not to exercise. If I feel like having a glass of wine in front of the t.v. instead of going for a run, I tell myself, “Oh, come on, it’s only half an hour.” And I go.

I think of you every time I go for a run. I think you would be so happy to see what a difference your advice has made in my life.
And things like this picture of HB, HAPPY at daycare, sent unsolicited by one of his great teachers:

Note the evidence that he now chooses his clothes himself: (green) socks with sandals.

Tuesday, June 24, 2008

Mamas, Don’t Let Your Babies Grow Up to Be Cyclists

So I get this email last week:
Subject: racing sat and sunday combined race
Date: June 17, 2008 1:12:38 PM

There is a mid day fri short part (home in time to pick up HB no problem). Sat 9am start to 2 hour race (so leave here @ 7ish, then back by @ 1-2). Sunday early start and 1 hour race...home by 10am. Would figure out some reasonable time to catch up on sleep.
I was not too upset about this email, because I have been trying to have a Good Attitude. I have also been practicing saying No at work (which is pretty hard, as it turns out; one thing I had to say no to three times. Someone also went out early on maternity leave, and the system has been stressed yet more. But if I never waste ANY time—no blogging, no lunch break, no chitchat—I can make it happen).

No problem! I say. I have been trying to arrange a date night for some time, but I will simply work around these parameters. I find an early movie and line up the babysitter for Saturday night.

Friday night I confess I do occasionally glance resentfully at our new kitchen cupboards, which despite my discomfort that they even exist in all their bourgeois glory, are really cool. The resentment arises from the fact that I am not allowed to restock them because I developed a rotator cuff injury from emptying the old cupboards in record time at 10pm on a Sunday night after HB’s birthday party because TH forgot that the workers were coming the next day. TH has promised to restock them, but hasn’t found the time. Which is cool, I’m in shape, nothing wrong with my legs, I can run up and down the basement stairs: need salt …. down … up … need a spatula … down … up … need a measuring cup … down … up …. etc. No problem!

Anyway, Friday night cannot involve cupboard restocking, because before each and every bike race there are hours of arcane preparation involving not just a bewildering array of greasy bike parts but much consulting of the computer, rearranging of the car interior, phone calls, etc.

Saturday morning I have a really lovely time with HB. We eat breakfast on the patio, then I pay some bills while he plays relatively quietly and only shoots a plane at my head once, then we go downtown to put the change in the coin counter at the bank as per his request, then we wander around and have lunch. At noon my cell rings: it’s TH. Maybe home in 2 hours? As long as I get my run in and we get to our movie, I say.

HB and I head home. Phone rings at 2:00. TH: Maybe home in half an hour? Oh, and I forgot to mention, I invited Jack and his mother over for a playdate this afternoon. They’ll be there any minute.

Fine! No problem! As long as I get my run in and we get to the movie in time!

Jack and his mother arrive. I don’t know her, but she seems very nice. I neatly avoid having to say her name, since I can’t remember it, if I ever heard it at all. (I am THAT mother at daycare, the one who doesn’t know anyone’s name.) HB and Jack play in the wading pool. I find out that Jack is on “the Spectrum,” which is why he always has a tutor with him at daycare. I tell his mother that I just thought it was because he could already read so well that they gave him a reading tutor. I don’t think before I say this, and I hope afterward that it makes her feel good. I tell her that I worry about HB being a bully. She tells me that she gets daily reports on how Jack interacts with all the kids, and HB is NOT one of the bullies. This makes me feel good. Everything is good! No problem!

TH finally arrives at about 2:45, and I run upstairs to change into my running things, leaving the play date to him. I go for a glorious run. When I get home, the play date is still in full swing. I remind TH that we have to leave by 5:00, and our guests take their leave. I take a shower. I ask TH if he has fed the neighbor’s cat yet, which he volunteered to do over the weekend. He has not.

We make it to the movie in time! My dinner is a cheese stick and a beer, but that’s OK! As long as beer is involved, it counts as dinner to me. No problem!

I have chosen Iron Man, because it seems like a no-lose proposition. I am willing to watch Robert Downey Jr. do just about anything—he is, after all, on my List—and I figure TH will be happy with the gadgetry and the explosions. We haven’t been to a movie in a YEAR. We used to see a couple of movies a week.

I enjoy myself immensely. I could have done without RDJ’s overly precise facial hair, but compared to TH’s shaven legs (and the unavoidable resultant “hair shorts” effect), well …

As we exit the theater, I smile and point out a little girl who is yawning and stretching in her father’s arms. “Wouldn’t it be cool to have a kid who would sleep through a movie?” I say.

“It’s PG-13 FOR A REASON,” TH hisses. He then launches into a rant about how they should ban torture scenes in movies, and a laundry list of other complaints about the movie.

Now, we have a problem.

“I’ve been looking forward to this all week,” I say. “And you’re ruining it for me.” (I feel like such a trite asshole for even saying this. Then I feel mad that I’ve been turned into a trite asshole.)

He did apologize, and he didn’t go to the last part of the race on Sunday (though partly because it would mean waking up at 4 am and because he’d been “shelled” on the Saturday portion, I believe), and he did restock the cupboards.

But I’m still feeling bereft.

He used to make me laugh. He used to watch my back. He used to talk about subjects other than how to avoid razor burn behind his knees.

Do I have to change his nickname?

Sunday, May 25, 2008

Maggot Q & A

Q: What about knee pain? My knees have dull, generalized pain ... my knees swell … Any opinions on the running is bad for your knees if you have bad knees theory?

A: Running really isn’t bad for your knees. It can make them hurt, sure, but it doesn’t cause destruction. Football players, who run explosively while carrying 300 pounds, destroy their knees. Runners don’t.

The most common cause of knee pain in runners—especially women runners—is something called “patellofemoral syndrome,” “chondromalacia,” “runner’s knee,” and some other terms I forget. There’s a reasonable description of it here. It’s not dangerous, but it is annoying and painful. The best treatment seems to be strengthening your quadriceps; those little knee sleeves with cutouts for the kneecaps might help.

ITB syndrome give you pain along the outside of your knee; stretching that band helps that one.
After 2-3 months of retraining, most of these problems are solved.

My basic rule: If running is clearly making a problem significantly WORSE, you might not want to do it. Otherwise, go ahead.

Q. I have LESS pain now than before I started exercising regularly. WTF???????

A: You know that line in Apocalypse Now, “I'm here a week ... waiting for a mission ... getting softer … every minute I stay in this room, I get weaker…”? Every day you spend babying yourself is a day you get weaker. No matter what might be wrong with you, you’re not going to get stronger sitting on your ass. Not that I want any Maggots going on homicidal missions into the jungle, but if you get off your ass, you will feel better.

Q: Side cramps. Any tips to help avoid this? Sometimes it gets so bad that I can't finish the run and even sometimes run for a few days after that.

A: This problem plagued me for years. A “stitch” doesn’t even begin to describe how painful this can be. I figured out that I could usually avoid it by—yes—starting slowly, but it wasn’t until I finally learned what it was that I could really fix it. For most people, this is, basically, a cramp in your diaphragm (no, not the birth control device, the thin flat muscle under your lungs that helps you breathe and gives you hiccups). It comes about when your breathing and your stride don’t mesh well, and can be prevented/treated by focusing on your breathing. For me, it works to breathe in step with my feet. Doesn’t seem to matter which foot, but choose one and breathe in or out every time that foot strikes. If you’re already cramping up, slow waaay down while you do this. And if you give yourself a good 5 or 10 minutes of starting slowly, it seems to help a lot. I still have trouble every now and then if I forget to start slowly—happened yesterday, in fact.

Q: Any comments on treadmill vs. road running?

A: I say, however you can do it, do it. There’s running and there’s not running. Running = good. That said, I imagine that if you run exclusively on a treadmill, there are a lot of muscles that are used in traversing uneven ground that are left underdeveloped. I find it fun to get on a fancy treadmill every now and then just to see the numbers.

Q: How do you deal w/ the guilt? (I'm running, therefore I'm not at the work or with the kids.)

A: Do you feel guilty about brushing your teeth? About going to the doctor? About eating dinner? About taking a dump? About washing your clothes? You get the idea. I have felt this twinge, but then I realize that this makes me SO MUCH BETTER of a mother/person that I should feel guilty if I don’t do it. I tell my son that it’s something I have to do to be healthy and feel good.

Q: Any advice for running with a group?

A: I have run solo for much of my running life, but I think groups can be great if you stick to a few rules: 1) No discussion about when/where/if. It happens every week at exactly the same place and the same time. Maybe no one else shows, but so what? If you spend a lot of time figuring out schedules etc., it breaks down quickly. 2) Resist competition. If you want to run next to someone, figure out who is naturally faster and then spend the next five minutes with the faster person running far BEHIND the slower person, until the pace is established.

Q: Am I just buying the hype from the shoe companies or is there a real benefit to replacing my shoes?

A: If your feet/ankles start to hurt, you probably need new shoes. I used to resist this, but after years and years, I’ve found that if I get good shoes from a real running store (i.e. NOT the sneaker store at the mall), my feet feel a lot better. If new shoes don’t feel good, take them back and get different ones. A real running store will exchange them even after you’ve run in them. As for replacing after a certain number of miles—I don’t know, probably not a bad idea. I just replace mine yearly.

Q: I noticed that no one ever talks about fat people running.

A: That’s because my advice is the same for the very small and the very large: Go SLOW. Focus on time, not distance. Get good shoes and a good bra. You will, sadly, have to spend more on your bra and maybe your shoes than a small person does, and it is likely that you will be slower for longer. But there is no reason you can’t do it, and boy do I give you credit: if you strapped 130 pounds on me and told me to hit the trail, I would have a VERY hard time, if I could do it at all. You’re working harder than anyone else, and you should feel proportionately prouder. I also direct you to the most excellent Jul.

Q: Do you have any advice for running in the morning?

A: Ugh. I am an awful morning runner myself, for two reasons: 1) I am soooo much more stiff in the morning that I have to be really careful or I end up hurting something and 2) I’m not really in need of stress relief until the end of the day, so the reward of running is much less. So I’m probably not the best person to ask about this. But that hasn’t ever stopped me from dispensing advice: I don’t do it without some cereal and coffee first.

Sunday, April 13, 2008

Maggot Tricks

Now that spring is here, the running paths are getting pretty crowded. I don’t mind; I love seeing you maggots finally getting out there. You’re looking good, you really are. A couple of you still need a little more support up top, and a few of you are still trying to go too fast, but I’m proud of you all.

Some of you may be wondering, after you’ve gotten comfortable with slow and steady, what’s next? Well, here are a few tricks to try:
  • Focus on form. Put your shoulders back, tuck your butt under, and pull your gut in. This will feel better, look better, and build up those core muscles in the proper position.

  • Relax. As you run, think about letting your hands relax, then your feet. Hard to describe, but you’ll see what I mean if you try it.

  • Add time. At the end of your run, if you’ve still got jump, do an extra little loop around the block, the park, the penitentiary, whatever.

  • Add speed. I know, this violates my second rule of running, but if you’ve mastered the slow, you’re allowed to try a little bit of the fast—but only at the end of your run, in a tiny little burst.

  • Listen. This sounds a little groovy, but a neat thing to do every now and then is to try to focus on each and every sound you come across as you run. (Yes, this necessitates shutting off the ipod, but it’s good for you once in awhile.)

  • Smile. Smile in encouragement at all the other maggots you see, and smile at the non-maggots, so as to prevent them from saying to each other, “Did you see the rictus of pain across that runner’s face? That’s why I never run.”
Any questions (that haven’t already been answered)?

Sunday, March 23, 2008

Full(er) Disclosure

Re: my backside. Yes, I have an awesome ass, and yes, sometimes this knowledge sustains me in times of trouble. Thank you for the nice feedback; it did cheer me up. I wish I could promise that you too will get one from running, but mine is a genetic gift; I perhaps will maintain it longer by running, but I had it before ever I stuffed my feet into clompy Nikes.

But I also have a great stomach, which is something running can foster:

BUT. As anyone can plainly see, I lack a rack. In that picture up there? I’m wearing a padded bikini top. This state of affairs is more than fine with me – I love not needing a bra – but it does lower my overall hotness quotient. When I’m out running in warm weather, I don’t get hoots and hollers until after I’ve gone past someone and they’ve gotten a look at my hinder.

(You’d never know that belly once housed a fetus, would you? I was an absolute freak when I was pregnant, keeping a death watch out for stretch marks—mainly because my mother has truly horrifying ones. When I went into labor and realized I’d escaped without getting any, I kept babbling to everyone involved in the admission process that night, “I didn’t get stretch marks!” They all smiled politely while secretly adding me to the list of Most Self-Centered Laboring Women Ever.)*

Re: BadCat. Not to worry, he’s been the recipient of all that modern veterinary medicine has to offer, and then some. I would love to have him on antidepressants, but even the vet has acknowledged that he cannot be pilled. Even if one is so foolish as to pay $64 for specially compounded liver-flavor liquid medicine to squirt down his throat, he forces himself to vomit it back up. I did not know that there was such a thing as a bulimic cat, did you? He is unmoved by Feliway. Our lovely vet has agreed to supply us an injectable anti-inflammatory medicine. It is not approved for more than one-time use, but injections are the only way to go, and when he’s feeling stiff and arthritic, he’s worse than usual. We have our house arranged something like a ship, fully swabbable.

He’s actually a very loving, curious cat who has never injured anyone who was not trying to pill him. I got him from the shelter when he was seven years old and near-unadoptable due to his slow-to-warm personality and his obesity—he was so fat he had to lie down to eat. (We trimmed him down by seven pounds.) He’s behaving himself this week … and HellBoy has finally learned that if he throws a tantrum, BadCat may pee on something beloved, e.g. HB’s fireman costume, his spelling computer, his guitar case … not a bad tantrum deterrent.

Re: HB. It finally occurred to me in a rare moment of clarity that the thing I need to work on with him is his anger. He is who he is, every strange inch of him, and I love him, but the ability to control his anger is something he must develop in order to become a successful person and a positive force in the universe. I know he can do it—I’ve watched him turn his mood around on a dime—so rather than stress about his personality, I’ve been focusing on pointing out and then not tolerating the ugly outbursts. For instance, “I know you’re mad at me for not letting you take a shower with me, but if you stand here in the bathroom yelling and screaming instead of going to your room to do it, we’re not going to Target.” And so far, IT’S WORKING, PEOPLE!

Re: the snake. Yes, it is a reticulated python, and no, I didn’t pull it from the ocean. The story is much less interesting than that: the poor creature was being pimped by the beach photographers who take pictures of drunk tourists with monkeys, toucans, and snakes and charge mucho dollares for the resulting prints. My stepdad snuck this shot in with his own camera, but I did the honorable thing and ponied up the money anyway. The python seemed pretty happy; he had a huge rat-shaped lump in his midsection.

Re: the bicycles. No, it’s not a phase—more like an old flame. TrophyHusband was on a cycling team in college, but turned to running in medical school as it’s much less of a time and money suck. Then I came along. But over the past couple years he’s been plagued with a strange toe injury (in my opinion brought on by running too fast when he wasn’t running with me), and couldn’t run, so his thoughts started to stray to his old love. He was already using a bike for commuting (and for taking HB to daycare), but then he started going on some group rides, then he bought a better bike, then a real racing bike, then he joined a team, and before I could say “Tour de this, buddy,” I started getting emails like this one:
From: TrophyHusband
Date: Wed, Sep 5, 2007 at 3:22 PM
quick-ish ride tonight ...

... with my guy friends....80-90 minutes, meeting 6:15 if I can (hopefully) make it (so shorter than usual thurs ride).
And I was like, when did 90 minutes become “quick”? Who are these “guy friends”? Where’s my TrophyHusband? Waaaah.

I’m happy for him, really I am. And I know I have no real right to complain. But damn, he loves those bikes. Sometimes I feel like this woman.

Re: the job. Oy vey. The less said the better right now.

One sort-of nice thing coming up next weekend: I get to go stay in a hotel room for TWO nights all by myself. (I have to give a presentation that I’ve not yet prepared, but I’ll figure that out somehow.)

*Note: NOTHING prevents stretch marks. There is NO magic cream or potion. Strangely, they seem to occur more in women who have their first pregnancy at a younger age – I guess infertility can pay off in unexpected ways. (That photo was at 30 weeks; it got even weirder looking from there.)

Tuesday, March 11, 2008

Bikini 'n' Snake

Now that I’ve drawn you in with that title, I will take advantage of your attention to complain:

I once read somewhere that a lot of working women say that a good thing about working is that even if things aren’t going great at work, there’s always home to escape to, and vice versa. But what about when nothing seems to being going right anywhere?

I used to love my job. Adore it. But for the past year or so, I often hate it. I really don’t know what to do about this. Today I had my first (near) panic attack in years. I just got back from vacation to get some very bad news at work. Then today I was busy busy busy and got to the cafeteria just before it closed, only to discover that they were out of grilled cheese sandwiches, OH MY GOD, NO GRILLED CHEESE, and there was nothing else I wanted to eat … and suddenly I felt like I just couldn’t take it. And I don’t even particularly like grilled cheese sandwiches.

Then there’s home. Something I haven’t blogged about at all because I really hate to whine about him is TrophyHusband’s relatively recent obsession with cycling. LATELY ALL HE THINKS ABOUT IS HIS FUCKING BIKE(S), there, I’ve said it.

Then there’s HellBoy being hellish. While he was out sick, his usual bud Justin started playing with Jack instead, and now they won’t play with HB, which makes HB come home in a fouler mood than usual, which, trust me, is saying a lot. He is so ill-tempered, this kid.

Then there’s BadCat, who has escalated from peeing on things that are not his litterbox whenever he’s mad to defecating on things that are also not in the litterbox category. He is also half blind now and looks like he’s giving you the evil eye all the time:

So it feels like everything kind of sucks. Many nights I fantasize about checking into a hotel all alone.

Do you still want to see me in a bikini holding a snake? Here you go:

Proof of the mysterious unpredictability of phobias. I know, I’m wearing the same dumb shirt and hat as in last year’s picture. Same bikini too. At least HB got upgraded to a Superman suit. And even if everything is falling down around my ears, baby’s got back.

Wednesday, February 20, 2008

Me and My Big Head

Being a physician is for the most part a humbling experience. You think you’ve figured out the key to helping a patient control her hypertension, and the next week she gets admitted to the hospital with a pressure of 230/110. You don’t even think of asking the sweet grandmother about substance use, and she has a stroke from smoking crack. You reassure a chronically complaining patient that her shortness of breath is nothing to worry about, then find out that her oxygen level is low enough to qualify her for home oxygen. I shouldn’t be using the second person; I did all of these things.

But every now and then, you—I—hit one out of the park and feel like a freakin’ genius.

The other day, another attending was supervising the medical residents in the outpatient office when she pulled me away from my own charts.

“You like Derm stuff,” she said. “Maybe you can figure this out.” It was a very young woman who had what the attending and the residents thought looked like bad psoriasis—but it had happened very quickly and in some unusual areas, including in the places where she’d irritated her legs by shaving them dry.

I swept into the room, which was now filled with several residents, a student, and the poor girl, who was sitting on the table clad only in a gown. A red, angry-looking, scaly rash was spread over her elbows, her wrists, her abdomen, her knees, and down her shins. In many places, the rash was in the form of small round patches.

“Mm-hmm.” I said. “Tell me: did you recently have strep throat?”

“Last month!” she said, her eyes widening. The residents literally gasped. “It was culture-proven,” one of the residents said.

“Yep, that’s it,” I said.

What?” they all asked.

Guttate psoriasis,” I tossed off casually. “Happens after a strep infection. What’s on the legs is the Koebner phenomenon.”

Now they think I’m The One.

I won’t tell them just yet about the guy I said could go home who went to the ER instead and ended up in the ICU, intubated, in a hypothyroid coma.

Thursday, February 14, 2008


Your words are way more interesting than mine. To amuse myself while propping up a febrile three-year-old (who, having finally exhausted the orifices from which noxious liquids can be discharged, is all better), I categorized your words into several groups (and arranged them in alphabetical order – no, my word isn’t “compulsive,” why do you ask?):

Tough Stuff
I was interested to see that this is the largest group. If you find your word in the list below, you don’t break under pressure. What doesn’t kill you makes you stronger, etc., etc. I aspire to be here myself, but I’m really not:
If you find your word in this category, your theme song is “What a Wonderful World,” especially as sung by Israel Kamakawiwo’ole. We need more of the likes of you:
Is your word here? You’re not in a good place. No silver linings for you; life is one big ugly cloud. Your glass is half-empty – or maybe even bone-dry:
If your word is here, you have trouble deciding, though you may be charming while you ponder:
This is the category for those who don’t want to follow stupid rules. You make your own rules, and if you want to have three words instead of one, you damn well will:
Bad Attitude
DILLIGAF (“Does it look like I give a fuck?”)
Friendly Cranky-Pants
Shoot here
Yeah, yeah, whatever
Not too many people fall into this category, more’s the pity for the rest of us:
No pretentions here; you are what you are:
The realists:
It is the last group into which I fall, because my word is:


Boring, right? But accurate. This essential aspect of my nature explains many of my choices and actions in life. It’s why I was much better suited to being a doctor than a writer. It’s why I can’t stand spending money on fancy cars or cosmetics or wedding dresses. It’s the backbone of most of my advice to others (“What is it you hope to achieve in this conversation with your ex?” “In deciding what you want to do with the rest of your life, think about what will make you happy to be doing every day”). It allows me to remain Zen-like in the face of “difficult” patients (getting upset will only hurt me, after all).

Being incorrigibly practical has its downside. For instance, it makes it hard to dream big. I hate the interview question “Where do you see yourself in ten years?” because I have a hard time imagining my perfect future. This seems sad. I do save like crazy for retirement, but only because I am following the rules, not because I have any specific plan for what I’ll be doing with the money. Being practical made infertility treatment uniquely awful, because I had a very hard time wrapping my mind around doing it when each procedure was more likely to fail than not. And occasionally my aesthetic sensibilities are pitted against my pragmatism. I learned the hard way that I can’t live in an ugly place no matter how much money I’m saving, but I am feeling very conflicted over our current plans to replace our hideous but relatively new kitchen cabinets with ones that yes, will function better, but mainly will look nicer.

Have I miscategorized? Anyone want to change their word?

Sunday, January 27, 2008

What's Your Word?

I may have spoken a little too early about having extra time. My Big Talk (which went well!), then a Saturday “retreat” for work (silly me, I didn’t realize that “retreat” meant “long-ass meeting” – though I guess I should be grateful that there were no falling-backward trust exercises), and some bumps in the road with the new colleague (e.g., a patient declaring “I never want to see that doctor again in my life”), and the month has veritably flown.

But! It could have been worse. I have had some great runs, I have not been ill, and today – today I tackled our “to be filed” pile of papers. I was a little shocked to realize that I hadn’t filed anything for about fifteen months, but never mind that now – I am now up to date. It’s frightening, how happy I feel about this. I keep stopping at the door of our office/guest room and peering into the formerly overflowing, now empty baskets just to bask in the overwhelming sense of order and accomplishment.

Anyway, what I really wanted to post about was this: a couple of months ago one of my residents and I saw a patient who had a tattoo over his heart that read (in the usual Gothic lettering so popular with tourist-trap tattoo shops):


Talk about truth in advertising. Naturally we got to talking about what one word we’d choose if we had to get a tattoo to describe ourselves. One resident thought his would be something along the lines of “Calm.” Another resident’s should be “Ebullient,” we all agreed. An attending who was passing by said hers should be “Skeptical,” but we argued with her on that; she’s actually kind of gullible.

So if you had to have one descriptor tattooed on you, what would it be? It has to be true most of the time, and something that those who know you well would agree is apt.

I’ll tell you mine after you all tell me yours.