It May Be Frozen Over, But It Isn't Hell (It Just Feels That Way Sometimes)

One little cold snap, and you maggots all take cover? OK, maybe a few of you are on a treadmill in a warm gym somewhere, but I know there are a lot of you sitting in front of the computer eating cookies and whining about the cold.

Get your mewling asses out there. If little old ladies could wait for hours in the cold for the inauguration, you can bundle up and run for 30 freaking minutes.

After all, these days they can bring you back to life even after you freeze to death.

Just remember: synthetics, layering, a 20 dollar bill for emergencies, and maybe a toe tag (I bought one after nearly perishing under the wheels of a cell phone infested pickup truck).

Let’s hear some inspiring stories of your cold-weather running. If there’s a really good one, I’ll ship out another shirt – long sleeve this time.

Wimpy Changing of Subject!

How about some more “kids say the darndest things,” since it won me an award last time?

HB, bringing me the doll he calls his “little sister”: Criss-cross applesauce, sit down on the floor and close your eyes!

[I obediently sit cross-legged on the floor. HB lifts my shirt and tucks the doll under it.]

HB: OK, now, you’re going to feel something a little weird, but don’t worry, it’s just your va gina stretching as the baby is born! [Pulls the doll back out.]

Me: [muffled horrified laughter] Is everything okay?

HB: Oh sure. Your va gina is already going back to normal—look down! Now say, “What’s this white stuff in my breasts?”

Me: … what’s this … white stuff ... in my breasts?

HB: Did you forget? It’s milk! For the baby! Feed her!

I swear I haven’t been drilling him with inappropriately detailed info on where babies come from. Don’t all the books say to just answer the questions asked? Well, he asked how babies get out, and then he kept probing and probing and probing … and clearly remembered it all. At least he didn’t seem freaked out by it. He knows more about the process than some pregnant people.

Changing the subject yet again: I got this for my husband (the Pro version), and I’m astonished to report that it works—I no longer have the distasteful task of nagging him out of bed.

(I did respond more on the last post, if you want to look in the comments.)

The Problem with Lists (Updated)

A while back, I made mention of doctors’ dread of lists. Now, I love a good list. I make them all the time. For example, here is a list I made for one weekend day last month. (And I wonder why I feel pressed for time. The ones on the side, by the way, were the “possible if I magically morph into a superhero,” so I don’t feel too bad about all the blank boxes. I’m not sure why “side tables” merited an exclamation point, unless it was because I was unlikely to attend to them, as evidenced by the glaringly unchecked box next to that item. And yes, Aaron did come.)

I don’t mind most patient lists either. A list like this one is quite helpful.

But. A list like this one will give any clinician an overwhelming sense of being sucked into a vortex of negative energy. I have removed anything that might identify this patient in any way, but I will tell you that this patient is in their 20’s and is remarkably healthy, despite having had these symptoms for years.

Healthy, but not well. When you see a list like this, you know that you are about to embark upon one of the least satisfying clinical relationships in the world. Because this is a person who, for some reason, must be a Patient. This is a person who has no interest in being well, because they feel so rewarded by being sick. Why? I have no idea. Personally, I find being a Patient absolutely horrifying; I will deny that I need help until I am lying on the floor, and even then I’ll refuse to go to the ER.

Wanting to be a Patient has no relationship to how sick you are. I have one patient with a terrible neuromuscular condition who comes to my office on a ventilator, in a motorized wheelchair that he steers with the one finger he can still move a tiny bit. When I ask him how he’s doing, he has to wait for a puff from the vent to answer, “Great!” (I doubt my aversion to being a Patient would take me quite that far, but I like to think it would.)

It’s very hard not to take these list-writers by the shoulders, shake them, and shout “Get a life!” Maybe I should, because what I do—nod sympathetically, gently suggest exercise and possibly antidepressants, and try my best to avoid the unnecessary testing that will involve random false positive results that will then engender more testing—doesn’t seem to help much.

It seems a miserable kind of life, but then again, how would I know? Perhaps this feels like fun for them. Perhaps what they need is a Patient Theme Park: giant stuffed medical personnel walking around and giving injections, an MRI Tunnel (with Realistic Banging Noises!), a 24-Hour Urine Collection Log Slide, lots and lots of blood draw concession stands, a place to pose for overpriced photos of yourself that make it look like you’re intubated, and people hawking baseball caps emblazoned with Another Sufferer of A Really Rare Disease Whose Doctor Totally Dropped the Ball* and t-shirts that read I MAY LOOK FINE, BUT I KNOW MY BODY.

*Not that this does not ever happen, OF COURSE. I have dropped a few balls myself. However, most bad things will “declare themselves,” as we say; they get worse and become diagnosable. Not-bad things usually go away, and the less you test for, the better off you will be. As I teach my residents, “follow” is not a dirty word.

UPDATE: To all who are saddened/angered by this, let me say a few more things:

• There are many, many crappy doctors, I know. Believe me, I know. I do not excuse any of them. They’ve messed me up too.
• Most of us have had frightening, unexplainable symptoms at some time or another. That doesn’t make us Patients.
• Yes, most people just want someone to listen carefully and, if appropriate, reassure. I love listening to people, watching them, finding out what it is that frightens them about their symptoms. I’m not talking about those people here. I’m not talking about you here.
• There are a few diseases that have multiple seemingly unrelated symptoms that can be overlooked. I test for these where appropriate. That patient who wrote the list? Had had multiple tests already.
• These folks can get sick too, and that’s frightening, because they do fall victim to the crying-wolf problem. It’s part of what makes them so tough as patients.
• There are also, I am quite sure, many diseases that we cannot yet diagnose no matter how many tests we do. We doctors must remain humble about this.
• And know this: if you’re suffering, I wish I could help you.

And In the Summer, He Wears Toenail Polish

Thanks for your wise counsel and perspectives. I’m feeling much better now (at least, as long as I don’t think too hard about another Tom Cruise in the making). I was also heartened by the result of the recent (and I am sure scientifically very accurate) Glamour poll of men: when offered the choice of being 6'2" with a 3-inch pen is or 5'2" with a 7-inch pen is, 68% chose the latter. I will not discuss my son’s package even on an anonymous blog, but I do not expect the former to be his fate.

I think my freakout was a combination of contemplating kindergarten starting next year and having a visit from Nana, who truly, truly believes that HB would be taller if we fed him more. But when I think about HB’s personality, he could not be more temperamentally impermeable to the taunts of others. For instance, these were his favorite holiday gift:



Yes, those are tights, and he has coveted them for a long time. He’s been making do with tight-ish long johns (always paired with colorful shorts), but has been begging for the real article. I had told him, “I will probably have to buy girls’ tights,” and he said, “Girls’ tights are fine!” Then a pause. “But not pink.” Another pause. “Hearts are okay though.”

This past Monday he wore them to preschool for the first time, and that night I asked him if people had liked them. “Oh yes,” he said. “Jacqueline and Emily said, ‘What are those?’ And I said, ‘tights,’ and they laughed together and said that only girls could wear tights.” Yet he said this in a quite gleeful way. “Did you tell them that wasn’t true?” I asked. “No,” he said as he wandered away. “A teacher did, though.” Then Tuesday he wore the second pair to school. Wednesday, he was upset that I hadn’t done the laundry yet so he could wear them again. Clearly, this is a kid to whom the only opinion of importance is his own. He reminds me a little of those tiny dogs who don’t know how small they are and run up and challenge gigantic Cujos—successfully.

(He says he likes the tights partly because they’re like his father’s cycling tights, but partly because they’re … “tight.” He has not worn regular pants since last year.)

(He does run around shooting things All. The. Time. with anything that could remotely be interpreted as a weapon, so I doubt the tights are an expression of gender confusion. Actually I know they’re not, because this kid is never confused about anything. If he wanted to be a girl, he’d be a girl, and nothing anyone could say would stop him.) (Not that I would try to stop him, FYI.)

(Click here for a picture of the toes.)

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 findasmokinhotguy.com 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?

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.

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?

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].

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.

Yup.

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.

Yup.

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.

and

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.

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.

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.

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.)

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?)

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.)

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
insomnia
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.