Cherish your Blues

With time and age the part of our eyes that filter light become stained with the pollutants of this world. Your filter becomes yellower the older you get. And because of this, as you age, you cannot see blues as vividly.



It is said that when this began happening to Pablo Picasso, he became obsessed with the color blue and with trying to re-create the vivid blues that he saw with his young eyes...but would never again see with his old ones.

The sunset over the Pacific was beautiful tonight. The vivid blue of the sky behind the pink clouds and the increasingly pink then dark water with surfers silhouetted against the light.

Cherish your blues.

Line-dried

There's something kind of fun about line drying my clothes. I like arranging the colors and seeing them dance in the breeze. I like the clothespins that are used for more than elementary school art projects. I like being outside. I like the sun...and I think my clothes like it, too.

No Fro Yo!

I was post call today. And unlike the previous two unusually glorious call nights I was up most of the night. At one point I was all in sterile attire (which consists of a funny puffy hat, mask with face sheild, and a sterile gown and gloves). It was almost 11pm and I was trying to get an umbilical artery catheter into a 3.5 kg 34 wk baby who was recently intubated and starting to crump a bit.

I tried, the other resident tried, then the attending tried. I f he couldn't do it then I felt a little better that I'd been unable too. We ended up getting a radial line and calling it good, but not after about 45 minutes of trying...and dying of heat stroke.

The nursery is warm to begin with. Then you're near the radiant warmer which is keeping the poor sick little one warm. Then you're in these plastic completely non-breathable clothes. Then you're anxious and nervous.

I could feel the sweat dripping down my chest. All I could think about was the frozen yogurt machine in the cafeteria that opened for the midnight snack. That and a cold shower. Or even snow.

Even Dr. E was soaked when we finally took the gown off. His entire scrub top was drenched. I guess I wasn't the only one.

I made sure all was temporarily well before I went down stairs to get everyone some of the fro yo. I am stragetizing on how to stack it as high as possible on my way down.

But I get in front of the machine and am examining the flavors trying to decide on the pure chocolate or the combo swirl. And I hear a voice, "It's broken." This can't be happening, "What?" "It's broken." Noooooooo! The hope of the cool treat was all that had gotten me through the last hour and now it was broken. I must have looked like I was about to cry. "I'm really sorry. I called the engineer. He'll be here in a little while." It will be too late. I won't have time later. And if I do I should really sleep while I can.

I survived. Maybe it was the hope of the fro yo rather than the actual stuff that got me through. I tend to look very much forward to things...but then I inevitably tend to be sometimes dissappointed. I'll survive the next time, too.

"The Cat in The Hat Comes Back"

A big long pink cat ring!
It looked like pink ink!
And I said,
"Will this ever come off? I don't think!"

"Have no fear of that ring,"
Laughed the Cat in the Hat.
"Why, I can take cat rings
Off tubs. Just like that!"

Do you know how he did it?
WITH MOTHER'S WHITE DRESS!
Now the tub was all clean,
But her dress was a mess!

Then Sally looked in.
Sally saw the dress, too!
And Sally and I
Did not know what to do.
We should work in the snow.
But that dress! What a spot!
"It may never come off!"
Sally said. "It may not!"

But the cat laughed, "Ho! Ho!"
I can make the spot go.
The way I take spots off a dress
Is just so!"

"See here!" laughed the cat.
"It is not hard at all.
The thing that takes spots
Off a dress is a wall!
Then we saw the cat wipe
The spot off the dress.
Now the dress was all clean.
But the wall! What a mess!


I knew when my roommate made the tub pink the other day that it triggered something in my childhood memories. Something much more pleasant than the clogged pink puddle of hair dye in our tub that would soon become a pink ring.

We had been having bathtub draining issues for weeks. I wanted to call the maintenance company but she has the contraband cat in the apartment so doesn't like to call them. "It happened every couple months with my previous roommate, too," she said, "We just bought some of the drain clearing liquid stuff and it would go away." I am irritated that I have to deal with this since it is part of the reason that I enjoy renting--having someone else come fix all this stuff.

But after one particularly awful morning shower with water up to my ankles and my shaving cream sloshing around in little islands on top of the water, I'd had enough.

This was especially bothersome because I usually take great pleasure in my showers. It is one of the few truely peaceful times of my day. With warm water running over me and that feeling of clean and fresh. And sometimes I even like to sing in the shower. I like the steam; I like the smells; I like the clean; I like the white quiet noises drowning everything else out.

I do not like the water up to my ankles with floating shaving cream islands. "I do not like it, Sam I Am!" I'd had enough.

That day I stopped on my way home to get some liquid plumber. When I got home, I found that P. had already purchased some other sort of drain unclogger too. I was not about to deal with it further than that so I just left the bottle in the bathroom. Not angrily, just didn't want to mess with the mess.

And the mess became, worse, just like in "The Cat and the Hat Comes Back," Oh what a mess!

P. has red dyed hair and she choose that night, with the tub clogged, to redo the dye. This is normally a very messy process for her and the dye ends up making the bathroom look like a murder scene (because it gets everywhere and she doesn't wipe it up), but this time was the worse.

I guess she rinses the dye out into the tub--the now clogged tub--the now moved beyond slow draining to completely clogged tub. Clogged tub full of blood looking pink hair dye stuff just sitting there.

I'm annoyed but don't say much. She pours first her bottle of stuff in the tub (three times already the amount that is supposed to work). Nothing.

Then she pour half of the bottle I bought. Nothing.

Then the other half. Nothing.

I go to bed that night and there is still a five inch puddle of "blood" in the tub. I am imagining cold red water in the morning and pink feet up to my ankles. I'll have to wear shoes that don't show any of my feet. No, I decide I will go shower at the gym. That is a pain, but so are cold red feet. Ugh.

But, I wake up in the morning and the puddle is gone. Left in it's wake is a ring...you guessed it...a pink ring.

"A big long pink cat ring!
It looked like pink ink!
And I said,
"Will this ever come off? I don't think!"

Breast is Best

Not what you think. Just a plug for breastfeeding. After seeing mothers struggle with it for the last two months, I know it isn't easy...but it's worth it. Here are just a few (of the ever growing) reasons why:

"Epidemiologic research shows that human milk and breastfeeding of infants provide advantages with regard to general health, growth, and development, while significantly decreasing risk for a large number of acute and chronic diseases. Research in the United States, Canada, Europe, and other developed countries, among predominantly middle-class populations, provides strong evidence that human milk feeding decreases the incidence and/or severity of diarrhea, lower respiratory infection,otitis media, bacteremia, bacterial meningitis, botulism, urinary tract infection, and necrotizing enterocolitis. There are a number of studies that show a possible protective effect of human milk feeding against sudden infant death syndrome, insulin-dependent diabetes mellitus, Crohn's disease, ulcerative colitis, lymphoma, allergic diseases, and other chronic digestive diseases. Breastfeeding has also been related to possible enhancement of cognitive development."

www.wellstart.org with a link to the American Acadamy of Pediatrics policy statement on breastfeeding.

Some tricks for successful breastfeeding.

1. Football hold-hold the baby with his body under your armpit and let the nipple fall into his mouth.

2. Unwrap him-if he is too warm and cozy he will fall asleep

3. Hold the top of his neck- instead of the back of his head. Holding the back of the head creates a reflex to pull back away from the breast. Position his head by holding the sides of his skull bones just below the ears.

4. Wait until his mouth is wide open - then latch him right on. His mouth should cover the areola, not just the nipple. This could take up to 20 tries. Be patient.

5. Get help early - there are probably lactation specialists who you can access through your pediatrician. The ones I've met have been wonderful...and make a huge difference.

5.5. No pacifier for the first week until breastfeeding is established. Helps minimize "nipple confusion."

6. Only breast milk for the first six months of life.

Hot Cheetos are Evil

When not in the Newborn Nursery these past couple weeks, I have been in the pediatric clinic. I tend to like the adolescents here. They are such complex almost adults sort of kids invincible people trying to figure out themselves and the world.

Problem is about half of them are overweight, obese actually, with BMIs at the 99%. They mostly seem to know what is good for them. They just don't do it. It's no mystery (to them or me or their parents) why they are overweight, but they live in denial about it a majority of the time. It's just easier that way.

On Friday, I walked into the room of particularly round eleven year old and her round mother. This is a bright, beautiful young Hispanic woman who aspires to be a pediatrician, does very well in school, attends a private school. She was in for an emergency department follow up after an asthma exacerbation. I dealt with that, found that she had pretty bad allergic rhinitis also, and then tackled the weight/diet/exercise issue.

I should have known something was up with her body image when the first thing her mom said when I walked in was, "See, like her," and pointed to me, "You need to drink more milk and be tall and slim." Firstly, I am 5'8" and she is 4'11" and her mom is 5'4", her chances of milk making her taller are slim. I jokingly told her she might have better luck with one of those medieval stretching machine things. But her chances of being slimmer are achievable--and important for her future health. And milk might actually help with that...2% milk in moderation.

It is better, by far, than the multiple sodas that she drinks every day. "See, you have to drink juice!" Her mom interjects again. "How about water?" I say, "Drink water. Juice has a lot of sugar it it. Even if you get the no sugar added juice, the fruits themselves have a lot of natural sugars and when they are in juice form you lose all the benefits of the fiber. A small glass of orange juice is worth the calories of at least four oranges minus the fiber. Drink water."

And then the clincher, and something I didn't even know existed until I started this residency, "Do you like hot cheetos?" Apparently they are some sort of super spicy form of the original Chester cheetah finger turning orange snack. One of the pediatric endocrinologists here says they are the worst thing ever. The snack companies have finally come up with the perfect combination of fat and taste. They are the most fat and calorie dense snack on the market. And they are empty empty calories. No redeeming feature. They really are evil.

Before I was at the clinic where I am now, the attendings conducted a little experiment with the residents there at the time. They bought and left a bag of the hot cheetos in the work room. And they were gone within hours...or maybe even one hour. Experiment confirmed. They are addictive. Fortunately they stopped the experiment there or else the residents may have been rapidly "super sized" themselves.

So, back to my patient, I ask the dreaded question, "Do you like hot cheetos?" "No" she says while her mom gives her a look like the answer is really yes. "I don't like them that much!" She shoots her mom a look, "I like doritoes." Super. Just super. They're evil, too.

Okay, so I launch into healthy diet education mode: fruits, veggies, non-fried meats, pay attention to iron intake and make sure you get enough calcium in things like low fat milk, yogurt, cottage cheese. Eat salads and get the dressing on the side, dip the fork into the dressing and then get the lettuce and stuff on the fork instead of pouring it on the salad itself. Etc. etc. She is going to meet with our dietician also.

Then there's the exercise tack. "What do you like to do for fun?" "Watch TV...I have PE at school." Again a standard answer. "Yeah...but school doesn't count. It is too variable. You stand around for most of the activity." Some schools, though probably not hers, don't even have enough equipment for all the kids to participate at the same time and they get no more than 5-10 minutes of exercise in a 45 minute PE period. "Plus that doesn't develop good habits for you to take responsibility for your own fitness." "But I am at school 11 hours a day," she says. And her mom adds that their neighborhood isn't safe for walking. So we strategize, "Do you pick her up from school?" "Yes." "Well, how about stopping on the way home and going for a half hour walk in the park together. It will be good for both of you; and you'll get a chance to visit too." They can do this, they agree. And this gets the girl thinking, too. "I like to dance. I can do to dance classes; they make me sweat." "Perfect," I agree.

The hard part is actually doing it for herself. I hope she does. She'll be headed toward early onset type 2 diabetes and high blood pressure (like her mom already has) if she doesn't. It's hard. "Start with simple changes," I tell her.

Drink water.
Exercise.
Avoid hot cheetos!




Case in point:

Don't Miss: Flamin' Hot Cheetos


All over America, school kids can be seen stumbling around, their eyes watery, their mouths ringed with the atomic red powder from Flamin' Hot Cheetos.



May 9, 2006 · I know, I know... you thought Flamin' Hot Cheetos was best known for Californication.

Nope, it's NPR's Luke Burbank's entry into the fast/bad food phenomenon that's hitting the schools. Luke sends this most serious warning exclusively to Mixed Signals readers:


"If you've got kids between age 5 and 15, you're probably already aware of a pernicious red menace that's sweeping the nation these days -- Flamin' Hot Cheetos. That's right, the snacks, introduced in 1991 by Frito-Lay (which also makes Original Cheetos, the nation's best selling extruded cheese-flavored snack), have exploded in popularity over the last few years. All over America, school kids can be seen stumbling around in Cheeto-induced dazes. Their eyes watery, their mouths ringed with the atomic red powder that gives the Cheetos their zest."

Luke beat the House Committee on Un-American Activities to the punch. He visited an elementary school in Pasadena, Calif., where the principal has banned Hot Cheetos -- though the students sneak them in anyway. Check out his report on NPR tonight.

One serious thought: If Flamin' Hot Cheetos were outlawed, then only outlaws will have Flamin' Hot Cheetos.

-- Ken Rudin

6:42 p.m. EDT | 5-9-2006 | permalink

Comments (This post is no longer accepting comments.)
I am a first time writter, and an adult who likes Flamin Hot Cheetos. My problem is with the principle trying to dictate the eating habits of the kids. Personally, I say that she should worry about her cafeteria, teaching the students, and stop trying to make everybody live life the way she wants.


Sent by Kevin Callaway | 5-10-2006
Your story on Flamin' Hot Cheetos came to my car radio at the end of a VERY long work day. The children's humor and laughter brought a much needed smile and uncontrollable laugh to my day. I've never had that flavor of cheetos, but I will no doubt think of your report when I do eventually buy myself a bag. Thank you so much.


Sent by Craig Samson | 5-10-2006
I suspected spicy foods aroused a state similar to being intoxicated when I was 13 years old and ate hot chicken wings, after which my head buzzed as though I were drunk. I proceeded to inhale the steaming hot sauce through my nostrils to enhance the sensation. I discovered years later that my sense of smell had greatly decreased. Anyway, thanks for this informative piece, which validates my long-standing claim to my friends that chicken wings can get ya high!


Sent by Mario Commeret-Medina | 5-10-2006
Good thing the kids haven't discovered Wasabi Peas yet. Dried green peas coated in bright-green wasabi--which are in many supermarkets health-food section--are the current addictive snack for grown-ups at the college where I teach. Top that, kiddies.


Sent by Rachael Williams | 5-10-2006
I work in the medical field and I've seen an increase the number of people developing diabetes at a younger age. This is another example of how we as a society fail our children for providing them with food that has no nutritional value but putting them at higher risk obesity and other medical conditions that could easily be preventable with proper nutritional and exercise.


Sent by Vincent Dang | 5-10-2006
Deja vu... isn't this a repeat? Cute... both times.


Sent by Julie Latimer | 5-10-2006
I've never gotten high from Flaming Hot Cheetos or any spicy food. Now I feel like I've been missing out.


Sent by J. Mann | 5-10-2006
I "outlawed" Flaming Hot Cheetos for my son two years ago when he was in fourth grade. He's very hyper and impulsive, and certain foods exacerbate his inability to focus or maintain control. Although I normally provide only healthy items in his lunch, I had bought a multi pack of Hot Cheetos from Cosco for his lunches as a reward for having behaved well at school the previous week. The plan totally backfired on me. The link between his behavior and Hot Cheetos was so obvious I threw away the rest of the box after just a week.


Sent by Kristin Majda | 5-10-2006
I'm a high school health teacher and I think Kevin's comment is awful! If kids don't learn to eat nutritionally at home, then our only hope is that they'll learn it at school. Does Kevin really believe that the majority of parents out there are doing a good job of educating their children about nutrition? Many people are extremely ignorant about nutritional issues like this and the principal at this school and others, as well as NPR, should be commended for trying to do something about that. Lower income families are particularly in need of help since healthy food tends to cost more and junk food is easily accessible and provides instant, inexpensive gratification. Good habits start during childhood and teachers, principals, and the community have a responsibility to step in and help parents guide our children towards developing them.



Hi, my name is Tage and I am addicted to Flaming Hot Cheetos. I can scarecely let a day go by without a dollars worth of my favorite munchie. Although I'm not sure about the induced "high" of the snack their popularity is unquestionable. I'm a junior at a public high school and our cafeteria contains two areas which are stocked with two six foot tall shelving units, both of which overflow with Flaming Hot Cheetos. I'm not sure how the snacks would be more of a mess for janitors than any other snack, however they probably do provide more mess than any other chip in the cafeteria merely because of their relative abundance. I believe their popularity lies mostly in the fact of their uniqueness every other chip on the market has 10 other chips that, althrough perhaps not packaged, manufactured, or dispersed the same, taste nearly the same. Spicey cheetos are the only mass produced snack that are actually too spicey for many to handle. The flavor is nearly unpalatable for some, but of those who consider it agreeable, many find Flaming Hot Cheetos to provide a rare snacking euphoria.

Inappropriate Comments

One of my patient's grandmothers...two days in a row mind you...made the following comments:

1) "How long have you been a pediatrician?" I go through the whole "I'm a resident" song and dance. And she follows this up with, "Because you look about fourteen." Uh...okay...

2) She's been staring at me the whole time I'm in the room examining her new grandson and she suddenly burst out, "Dr. Quinn!" "Huh?" "I have been trying to figure it out. That's who you look like. You know, Dr. Quinn, Medicine Woman." I'm pretty miffed my this one. Especially since my right eye was mysteriously swollen (no longer mysterious--was a dust mite allergy) at the time and I was pretty sensitive to my loss of facial symetry. So, without really thinking as much as I should have, and remembering Jane Seymour has something funny with HER eyes, I say "My eye isn't always swollen like this. I am not a domestic violence case, you know." Now it's her turn to be miffed and she's sort of taken aback, "No, I mean...she's really pretty. And you look like her. It's a compliment." Maybe but I think I look nothing like Jane Seymour. I took one of those facial feature look-alike celebrity things on line and came up with Gwenyth Paltrow...don't look like her either, but I like that one better.

Next few days of the patient's stay. No grandmother. Hope I didn't scare her off...sort of.

Pretend the labels aren't there and see if you can figure out which one is me. I know it's tough. Since we look so much alike and all.





Oh, and then the following day in clinic, another patient made the following comment (this, mind you after we'd been through many of the intimate details of her life), "Can I ask you a personal question?" I am wary from my experience with the grandmother, but I sort of glance up in assent. "Why do women doctors never wear face make up?" What?!? "Not that you need it. Because you don't." She back-pedals like she's being chased by a rabid skunk, "It's just that I have noticed that no women doctors wear foundation. Not that they have to. I've just noticed." I sort of laugh it off and try not to let my disbelief reach my facial expression. "I guess we just don't have time to put it on...nor really want to." And back to business. Serioulsy, in what universe is it okay to ask a stranger these things. Frontal lobe disorders much? Cripes!

All that glitters...

I am now working at a super fancy hospital in town. They have fresh flower arrangements everywhere. They have a grand piano in the lobby and a person actually playing it ("I could have danced all night" at last check). The nurses get free massages in the hospital. They anticipate nearly everything that I want and do it before I've even written it down. The nursery is decorated with a carousel horse theme, including stained glass windows and gold painted running horse silhouettes on the walls.

This is in sharp contrast to the drab floors and walls at the University hospital where I was last month. And things occasionally fall through the cracks there. And if you want something done soon, you're best off doing it yourself. And, the real tragedy, no free massages. Poppy-cosh!

But, in my opinion, the medical care at the latter is superior to the former. They focus more on the welfare of the patient. We do family centered rounds--where we actually talk to the nervous new parents. Whereas where I am now, the nurses (promptly) wheel the babies into the nursery so we can gather vitals and examine them there without the parents "slowing us down." Well, that takes all the fun out of it if you ask me. It is faster, but at what cost?

They don't routinely check bilirubins. They don't do as much to promote and support breast-feeding. They do circumcisions while the little boys are still trying to figure out how to eat. They keep the babies away from the family sometimes. I don't know what kind of educations happens between the parents and nurses or the parents and the attendings because I'm never present. The babies are just in their bassinet, alone in the nursery. Until I come along to pester them with the exam.

This morning, I had eight of them to see in a couple hours. Lots of bilirubins to check (because I thought they should all get one so I'd ordered them) and notes to write. I was on call the night before and didn't get called for a single delivery. If all call nights were like that (eight straight hours of sleep) this whole intern gig wouldn't be nearly so bad.

Anyway, when I was in the nursery surrounded by my eight patients plus three of those seen by another service, three or four of them started crying at the same time. I was going from crib to crib swaddling them or picking them up and patting them on the tooshie. But as soon as one would calm down, another would start. Surrounded by multiple screaming hungry infants. It made my ears ring.

The point is that while the fancy hospital does perhaps have better amenities, it does not have the same quality of care that you get at the academic hospital. Despite the golden horses, all the glitters is not gold.

Travel Sized

P. and I have had bathtub draining issues lately. Three bottle of Draino, Liquid Plumber, and some generic Alberston's brand later, we once again have a functioning bathtub plumbing system. Until more of my hair clogs it up again I guess.

So the combination of wandering around stores looking for drain unclogging stuff and my recent attempt to fly to Miami led me to wonder about all those little travel-sized shampoos and conditioners they have in stores. Are they now outdated? Are the obsolete? You can't take liquids on plans. And if you're going in a car, you might as well just take a big bottle. I suppose they could be used for the luggage you check through. Just seems like they're old news now.

They're still cute, though. Like baby shoes. Even though most babies are born already to big to wear the tiniest (and cutest) of them.

Dream Foal

I dreamt last night that Mokka, my horse, was alive again. And that she had a baby, but it was three months early. And it wasn't eating well so we had to start an iv.

My rotations even infiltrated my dreamscape!

My Dad got beat up by our llama

You may think this title is hyperbole just to attract your attention, but I assure you, it is not.



We really do have a llama. His name is Maximus Desimus Meridius, Defender of Man and Beast. He is the protector of my brother's goat herd. Turns out llamas are very protective of their herd when they are raised with them from the time they are young, which is what we did with Max. And as a bonus, and unlike guard dogs, they eat the same things as the goats so you don't have to make extra trips with special food for them.

My brother got him after we'd had some trouble with someone cutting our fence in the middle of the night and some of the goats went missing. His ex-fiance's uncle had caught three wild pigs on his property so my brother traded the three little pigs to the local animal dealer for the llama.

And so we acquired Max.



He is a funny thing. He has no sense of personal space. He will come right up into your face and make wierd snorting noise and like to smell your breath. He is very curious and sweet and soft. He is very agile and runs like a deer. When my horse was alive, he used to like to race us up and down the fence line.

He's quite the novelty on our street. There have been several subdivisions going up around our property so the newbies loves the goats and chickens and horses, and espcially Max. Whenever they have visitors from out of town, he is a great stop on their walking tour of the neighborhood.



And my dad has always been Max's favorite. He will come right up to Dad and sniff him and Dad pets him and spoils him...and "calls him George." (just kidding on that last part--some sort of temporary flash back to some cartoon take off on that "Of Mice and Men") Whenever we need to catch Max to do anything with him, Dad is always the one who can do it. Usually the only one who can do it.

These past couple weeks, our fences have been down and Maxe and the goats have been getting out on what sounds like a regular basis.

Yesterday Max got out and was frolicking all over the neighborhood having a grand ol' time, according to my Dad. Alas, however, all good things must come to and end and he had to be caught. We live uncomfortable close to the freeway, which is always a worry when any of the animals get out.

So, Dad was the logical one to try to catch him. After spending some time chasing him around, he finally got him cornered in some sort of alley area and somehow got a rope around him. But the rope slipped too low and was around his belly and seemed to be hurting him because he went pretty crazy.

Dad said he was butting him with his neck and chest butting him. And that he's very strong. Plus he was making these loud awful prehistoric noises and biting him (even broke the skin in a couple places and gave him a few huge black bruises). And he was spitting green goop all over him.

The neighbors watched in somewhat terrified awe and were too afraid to offer to help. Once the spetacle was over, one of them would bring over stuff he found on the internet about how to cook a llama.

Dad finally got the rope off of him and Max was mad and scared and pouted the rest of the day. I think he's still afraid and traumatized today. And Dad has huge bruises to show for it. Poor Dad. Poor Max. Hopefully they will make up.

Hair Whorls

When a baby's brain is developing there is a period of time when there is no bone in between the brain and the skin. During that phase of growth is also when the hair roots begin to form on the scalp--I think around 16 weeks gestational age.

So, it is believed that hair whorls (or cowlicks) are a reflection of some of the brain growth in utero. That they are from the brain expanding backwards and the hair follicles being stretched over that area.

Only 3-4% of the populations has two hair whorls and if you have more than that or if they are further away from your posterior fontanelle, then it may be a marker for developmental abnormalities.

Who knew? I thought they were just a pain for combing your hair in the morning.

Dream Interpretations?

This past week or two I have been having the strangest batch of dreams. And I have found that I'm not the only one. Maybe it's the full moon.

1. Was in the field being attacked by and evil black and white llama when our llama (yes, we really do have a llama) came over to rescue me but he was too little because the mean llama had been eating all of the his food. We had to escape and hide in the house while the mean llama ran around the field with all the horses (including my horse who died). Max (our real llama) and I were hiding in the house and he was tiny and had to eat all the house plants he could find to get bigger.

2. Again in our field, but this time there was an elephant with sort of people shaped feed that our cats liked to sleep on. The elephant was nice to the cats but eventually had to move so he kicked them off one by one and they landed in the fence. I thought they were dead but they got up and started moving. They followed the elephant all over the field. They loved him.

3. I was sleeping in a backyard pool but woke up at 4 am and couldn't sleep anymore and was going to take some pictures when a burgler started to hop over the fence and I said, "Hey, go away." He apologized and did, but came back soon after with a friend. I tried to scare them away by shooting pictures of them with the flash. It didn't work at all.

4. Mike kept trying to break up with me and I told him he was loosing me and he said the he didn't care.

5. C. started seeing some other girl besides his fiance and I grabbed him by his hair and made himi stop it. His fiance said that here mom would never trust anyone else because they'd really liked C. And that she was sad because she really thought this was going somewhere since he'd given her some sort of gift in a uterus-shaped box.

6. Mike went out drinking after we'd already talked and said goodnight and he said he was going to bed.

7. I was at some conference and my youngest brother B. was there but he was about eleven years younger than he is in real life now. Some of the senior peds residents started reading some sort or wierd poem/story thing and I interrupted to asked them what the point of the story was. They kept telling me to just be quiet and maybe I would get it. I insisted that I wanted to know what we were supposed to get out of it and they refused to say. I stomped out and grabbed my bags from the hotel room where B. was and stormed away from the conference.

photo editing

Does anyone have a favorite photo editor you can recommend?

Polyamorous

I had never heard this word until yesterday when my fellow intern in the nursery called to let me know about our schedule for the holiday today. "Polyamorous?" I guess the word sort of explains itself if you break it down: "multiple love." I haven't googled (honestly sort of afraid of what I might find) it but that's my take on the verbage. Besides, the behavior of the "polyamorous" woman in the nursery explains it much more than I ever wanted it explained.

I guess the story that this is a 40 something first time mother from Germany. She has a husband...and a boyfriend. Both of whom are present at the delivery of the child. Some rumor was started that it is the boyfriend's child, but I don't think anyone is really sure. The are all very open about their threesome and commited to the child (poor very confused baby).

Pitocin is used a lot in labor and delivery for "failure to progress," but this woman did not want to have medication, despite prolonged second phase of labor. So, one of the alternatives to augment delivery is (and this makes me cringe again just thinking about writing it): nipple stimulation.

But that's not the worst of it. She decides this will be better for the delivery and proceeds to instruct the men (waiting meekly for her directives) to stimulate her nipples. Right there in the middle of the delivery room, surrounded by everyone. And tactile stimulations would have been more than sufficient, but somehow they decide that oral stimulation will be more effective. And they do that. One man per breast. I wasn't there. For which I am very very glad.

Why do people do these things? Once again, I don't understand. And why is reality so so much stranger than fiction. Really, you can't make these things up.

Happy Labor Day.

Monkey Balls

Now that I have a little more free time I get to take advantage of some of the free personal training sessions that came with my gym membership. My second of five sessions was on Wednesday last week. And I was sore for a good...well, actually I'm still sore.

There are so many different people that go to gyms. But once they get there, they all seem to sort of morph into a similar mold, myself included. I retreat into "headphone world" where we just life the same iron and coexist.

I do really like my trainer, though. He showed me some good stuff this time. It was way better than last time when all we talked about was that I should eat more yogurt or protein or whatever. I was really tired then and I knew my diet was bad and I told him I knew it. I just didn't have the energy to get more variety in it at that moment. It's better now.

So, if you read this far, you might still be looking for an explaination of the title of this post. It is coming, don't worry. It's one of the ab workout moves that I learned, otherwise known as "transfer," but with an alternative name like "monkey balls" who would want to call it transfer. It's like calling Superman, Clark.

My mom was asking about my work out with the trainer (and I wanted to write down the details before they slip my mind and go the way of all good intentions). I told my trainer I wanted a "butt, arms, shoulders" work out. And this is what I got:

Warm up/Stretching:

1. Lunges. alternating leg forward then other leg back, then switch legs. This builds your muscles and provides active stretch.

2. Stability Ball walks: this is probably a lot easier for guys, but with my upper body strength, it was sort of hard. Legs on the ball at the knee (or lower for more challenge) and then walk back and forth and do push-ups on alternating sides.

3. Squats: figure out where you legs should be by jumping up as high as you can and where your feet land your legs should be. Knees go out over feet and can go to greater than 90 degrees when you squat down. It is helpful to do this in front of a pillar or something else to hold onto if you need stability as you go down.

4. Resistance band pulls: I don't know if that's the real name or if there is a real name but you get the point. Hands on the handles and pull them toward your body without breaking your wrist (ie keep it in line with the pull of the band) and try to touch your shoulder blades in back. Keep your elbows in.

Circuit Training

1. Leg press: Big machine that you do sort of sideways squats in. My clavicles are so bony that is hurts a little to have that much pressure on them. Not to mention that my legs were vibrating by the last circuit. "Just one more!" Keith says. "All the way down." Ouch.

2. Overhead shoulder lifts: Down to 90 degrees, up fast over your head with two free weights of challenging weight, then slowly down. One count up and four counts down.

3. Row machine motion: Careful not to strain your back getting in to the machine. Same sort of motion as with the resistance band but this time with weight. Keep your elbows in and focus on using your back.

4. Smith machine: big thing with barbell sliding up and down it. Sit on a stability ball and push the bar up over your head.

Abs

1. Tough ups: weight in your hands, crunch position, lift weight straight up toward the ceiling imagining there is someone's hand there to touch it too just at the edge of your reach.

2. Catch and Toss: You need a partner or a wall for this one with the stability ball. Catch it on the way down and throw it back on the way up on the sit up.

3. Leg lifts: lying flat lift legs up and down. Touch floor on the down and then go off to either side for more challenge/different muscles.

4. Hip lifts: Lying on back lift legs to 90 degrees then lift feet up toward the ceiling.

5. Monkey Balls (the moment you've all be waiting for): stability ball between your feet as you are lying flat on your back. Lift your body up into a V and transfer the ball from between your feet to your hands. Down and then back up and transfer it back. This one killed me.