Every night

That time of month...

Seems like a bad idea

Why? Just why?

Awwwww

I'm not sure if this is manly or not. On the one hand, it is Chewbacca. On the other hand, it's drinking milk and it looks like a baby. On the third hand, it grows up to be an alien that kicks butt with a crossbow.

Oh to be Brittish

Friends

I have a few friends who would do this for me.

Wednesday's Wedded Bliss: Communication

Quick update before we get into the good stuff. I started my cardiology rotation on Monday, and unlike OB, I have to work. A lot. But it's good and I'm happy to be seeing patients again. However, I have less time to create original content. So I'm going to attempt to do all my writing on the weekends and then parse it out during the week. Also, next week, my wife is going to help me out. We have some good stuff planned on what a husband need from his wife, and what a wife needs from her husband. It will be excellent. Don't miss it.

Now for the good stuff. Communication is huge in marriage. When my wife and I are on the same page, when we both are talking and discussing what is going on with us, life is a whole lot smoother. But when we forget to talk things out, or forget to discuss events, things go bad quickly. Tension builds, tempers flare, people die. Well, not the last one, but it gets ugly around here. So we work hard on communication.

My wife doesn't know it yet, but we are going to be starting something new in our marriage. In my readings, I came across a blog that had 5 questions for a husband and wife to ask each other every week. Without telling her, I have been trying to incorporate these questions into our conversations over the past couple of weeks. And it has been good, but now it's time for a full blown experiment. I'll let you know how it goes. For now, here are the questions:

1. How did you feel loved this past week?
2. What does your upcoming week look like?
3. How would you feel most loved & encouraged in the days ahead?
4. How would you best feel pursued in sex / intimacy this week?
5. How can I pray for you this week?

Pillow head

Getting up before 6 every morning for this rotation. My pillow is now my new comb.

Don't forget

Up!

Physiology Friday: How to tell if your are getting a viral infection

It's Physiology Friday again. I had to take a test this morning and it threw the whole day off for blogging. Sorry.

Anyway, on to the physiology. I was talking to a friend the other day and mentioned that I knew I was getting sick because all of a sudden my skin got really dry and flaky. This friend looked at me like I was crazy. Not that I'm not crazy. No. That's a very accurate diagnosis. But that particular statement was actually based on, you guessed it, physiology.

Let's back up a little. First, you need to know something about your body. Your body is made up of cells. Bam! You just survived BIO 101. Some of these cells grow and reproduce quickly and some grow and reproduce slowly. Bam! Bam! BIO 102. This is the easiest class ever. Now if you are keeping up, this next point shouldn't be too much a stretch. The cells that grow and reproduce quickly need more energy. They are like teenage boys, always eating whatever they can get their grubby little hands on. Some of these cells can be found in your hair, in your GI system, in your respiratory system, and in your skin. They all need lots of energy to function properly.

When you get sick with a virus, the virus stages a hostile takeover. It comes inside the cell and says, "Stop what you're doing! You must make 5 gazillion copies of this beautiful me that you see before you." And since the cell is used to blindly following orders, it stops everything and goes into full on production of viruses. This takes a lot of energy. A lot. Of. Energy. Do you see where the problem comes in?

When only one cell is doing this, it's no big deal, your body has extra energy to spare normally. When there are a bunch of cells doing this, your body begins to run out of energy. And so the cells that need a lot of energy to function normally begin to suffer. This explains why your hair feels more brittle when you are sick. This explains why you might even notice your hair falling out more when you are sick. This also explain why your skin is dry and flaky when you are sick. Your body is sending crucial nutrients to cells making viruses and not enough to cells responsible for replenishing your skin. And there you have it, dry skin will often precede a viral infection.

It's physiology baby. I might have a little crazy, but I got me some science too.

*if you are really good at connecting the dots, you will see that this is why pregnant women often have clumps of hair fall out while pregnant and why they complain of dry skin - they have a baby sucking up all their energy.

Titanic

Wow. Two Titanic posts in as many days. I must really love that movie. Nope. Besides the fact THAT YOU KNOW THE ENDING GOING INTO IT, there's also the fact THAT THERE WAS ROOM FOR TWO ON THAT BOARD!!!

This is awesome

Personal space

I have had some situations in the past where this trick would have come in handy. Now I know...

Conflict and compromise in marriage

As I was putting together yesterday's list of reasons to not get married, I really wanted to talk more about compromise. So for today's Wednesday's Wedded Bliss post, we are going to talk about compromise.

As I mentioned before, compromise is a big part of marriage. Taking two people and joining them together is no easy task. It is especially difficult if neither is willing to do any give and take. What my wife and have found to be helpful is a simple way to figure out how important something is to us and then make compromises from there.

While I didn't come up with this compromise system, I am more than happy to take credit for it. Prepare to have your mind blown by how easy it is. First, both you and your spouse need to be able to count to ten. If you can't do that, you need to have ten fingers. If you don't have ten fingers, you may borrow some toes. If you still can't get to ten, find a different system. Next, you need a decision or conflict. There should be no shortage of decisions to make. Finally, you need a smidgen of honesty. Nobody likes a liar. With these pieces in play, you can compromise a little easier.

Let's take this made up conflict of where to hang a painting. I want to hang the painting in the living room because I think it's a neat piece of art and my wife hates the painting and wants to burn it in a fire. So we rationally talk it out. I rate on a scale of 1-10 how important it is to me to have the painting in the living room. A ten would mean that this is the most important thing in my life right now, and a 1 indicates that I'm so apathetic to this matter I'd almost rather watch paint dry while having my nose hairs plucked. In this case it's a four for me. My wife on the other hand says it's a niner. Yes, a niner. This is a big deal to her. This is almost as important as that time I tried to name our son Rufus. Almost.

Now here's where it gets tricky. Not really, I'm just kidding. I already told you this would be super easy. The next step is to just compare the two numbers: 9 is higher than 4. This is obviously very important to her. While to me, I want this to happen, but it's not a nine, not even close. My day won't be ruined if this doesn't happen. So we take the painting, dowse it in gasoline, and set it on fire.

What if we had both said 4? Then you flip a coin or something else easy. Neither one really cares a whole lot about the decision.

What if we had both said 9? Then it gets interesting. When that happens, you break out the dueling canes, first to draw blood gets their way. Seriously. This is the only way to resolve this type of high stakes issue. Make sure to wear goggles so you don't lose an eye.

The nice thing about the rating method is it allows both people to see where the other person is at. Sometimes I would push to get my way, even though it was a 4 for me, because I didn't realize how important the issue was to my wife. But when I know that this is something really important to her then I can better adjust my priorities. It's not a perfect system, but it has helped us out countless times.

Surgery first

Wednesday's Wedded Bliss article is coming soon. I have to go watch a hysterectomy. Updates soon.

There's a flood coming

My mom refuses to get on Facebook too. Hopefully she doesn't miss the boat.

Now in 3D!

Tuesday List: 8 reasons not to get married

While we have only been married for almost 6 years, we think marriage is awesome and we highly recommend it, with just a few caveats. So here they are, 8 reasons to not get married. Oh and kids, this one is a little more PG-13 than usual. Ask your parents if you can keep reading.

1) You aren't in it for life - part of the reason marriage has power is because it's a lifelong commitment. Part of the traditional wedding vows include the phrase "as long as we both shall live." You are telling people publicly that you want to be together forever. If you are only in it for a couple of years or even if you go in thinking, "I'm in as long as it's fun" then don't get married. If you are even thinking "I'm going to work really hard at this and gives it a chance." Marriage isn't for you. Marriage is a lifestyle that you jump into with both feet and submerse yourself in. A marriage built on doubt, with a foundation of fear - fear that at some point you or your spouse is going to mess up so bad that it will all be over, is not a healthy relationship. It must be built on trust - trust that you are both in it for life.

2) You aren't friends - when you are married, you are committing share life with another person. If you two don't get along, getting married is going to trap you in an awful situation. While getting married is awesome, getting married to someone you don't enjoy spending time with is awful. Don't do it.

3) You are already living together - for this group of people, marriage is just a formality. Is the reason you were living together first because you wanted to try the other person out, to make sure you could handle being with them? Now that you know the answer, what does a marriage certificate change? Are you more committed now that you have lived together? Were you seeing if you were "sexually compatible?" Anatomically, if one of you has boy parts and the other has girl parts, you are physically compatible for marriage. But maybe you wanted to make sure the other person had the same sex drive you did. From a physiology standpoint, that's baloney (bologna?) As you go through life, both you and your partner will have different drives in response to so many things; stress, hormones, and life events will all drastically influence that drive. It will not remain a constant thing. If you live together before marriage, just keep doing what you're doing - you don't need marriage.

4) You aren't willing to make compromises. There isn't much to expound upon with this one. If you want to take two people and join them into one, new unit, then there must be some give and take.

5) You aren't willing to grow up - there are two aspects to this one. First, and this is usually an issue for the guys, you aren't willing to leave your mommy and make your wife your number one priority. When you marry, you commit to prioritize your spouse over your parents. Guys, this means that when your mom criticizes your wife, you must stand up for her. When your mom, tells you what to do and it contradicts what you and your wife have already decided on, you must say, "thanks for the input Mom, but we have already made a decision." It's not easy to do, but if you can't do it, then don't get married. The second part of this is that you must accept responsibility. Playing video games every day for 12 hours instead of working is no longer an option. (People who bash on video games are a pet peeve of mine. I am not bashing video games. Anything that reflects a lazy or entitled attitude can be the culprit - from working out 12 hours a day to the neglect of your family, to reading, to playing chess. All these things have their place, but once they become a priority over your spouse, they reflect a lack of maturity). Once you decide to become married, you commit to making your relationship with your spouse a priority. Spending excessive time doing anything else indicates your priorities are focused elsewhere, and you probably aren't ready to be married.

6) You don't share the same religion. This is especially true for Christians. Marrying someone with the intent to convert them is a bad idea and the Bible says don't do it.

7) You think marriage is going to be easy. Marriage is awesome, and it's a lot of fun, but it can be hard work some times. The problems you have before marriage are not automatically cured by a band of gold and some diamonds. You have to be ready to confront some difficult issues and struggle through them. It isn't always that way, but marriage is just like everything else in life - if you want it to be good, it takes work.

8) You or your mate is a zombie - this will not work. Marriage with the undead is just wrong if not downright illegal. Necrophilia (do not google) is just sick.

Comments are appreciated, but if you must use adult language, email my lawyers at mmm.lawteam@gmail.com. Your vitriol is always welcome in their inbox.

Call Jayne Cobb, a Mudder needs help

I remember getting the call from my dad just a few weeks ago, "Your mom has breast cancer." Drawing on my vast knowledge of medicine and doctorly ways, I knew just what to do. I got on Google. Okay, that's not entirely true, I first got out all my medical text books, skimmed half a dozen pages of notes and realized, Google is easier.

The initial diagnosis was DCIS - ductal carcinoma in citu. It's a very treatable cancer in the breast that has a good prognosis. If you have to have a breast cancer, that's the one to have. Or so I thought.

My mom just got done with her first surgery and the new pathology report came back a little differently from the first. According to the biopsy sent for review, my mom actually had Adenoid Cystic Carcinoma. "Eek." I thought when I first heard the new diagnosis. That sounds bad. And it is. Unless it's in the breast. You see, normally it affects the salivary glands and when that happens, it is bad news bears. But when it is found in only the breast, then it has an excellent prognosis. In fact, there is no medical literature that records any deaths from ACC. So we went from DCIS, which is pretty good to have, to ACC which is really good to have.

My mom's doctor is excellent. She is a sturdy, hold nothing back, Scottish woman who eats cancer for breakfast. Actually, that's a little weird. I doubt she actually eats cancer with her eggs and toast. But when I saw her, I was reminded of Mel Gibson with his face painted blue, riding a horse towards the English army and calling over his shoulder in his thick accent, "I'm off to pick a fight." I think she hates cancer as much as she hates the English. So I'm glad she's on our side.

However, we aren't in the clear yet. She still has another surgery and then radiation to follow. Just because there are no recorded deaths, we don't want to mess with cancer.

If you want to follow along with my mom's story, she recently started a blog. She hasn't put a lot up yet, but she plans to chronicle her journey there. I'll continue to post updates on here as events warrant.

Litter

Volleyball

I played volleyball in high school and we had to fight for our right to not wear little shorty shorts. Play basketball instead.

Ginger

One of my best friends has red hair. And I still hang out with him. But seriously, having red hair is not a recognized medical disability and is no reason to make fun of someone. With that being said, here is another ginger post.

I've always wondered about this

Life in L&D

Last week of my OB rotation. I might be going a little crazy with cabin fever. Most of the time I spend the day doing a lot of hoping that something will happen. While the deliveries have been fun and exciting, I really dislike the unpredictability of it all. If everyone would just have scheduled C-sections, the OB life would be great. Of course, there is a higher morbidity and mortality risk with C-sections, so that's probably why that strategy hasn't taken off yet.

I delivered a placenta on Friday. That's kinda like delivering a baby, except nobody minds if you drop it a couple of times.

There will be an update to Friday's Physiology post a little later today as I feel I need to clarify some points and answer some questions.

Keep them mute

This is why animals shouldn't talk. This is also why some people shouldn't talk.

Math

Coincidence?

Why the Unicorn is Extinct

A little OB humor for you today...

Physiology Friday: HCG

So the goal of Physiology Fridays is to explain things we see in our every days lives a little less hocus pocus and a little more sciencey. Today we are gonna talk about HCG injections and their role in weight loss.

For the longest time, I thought injecting yourself with HCG was complete and utter nonsense. While I still feel that way, at least now I can see that there is science behind it. So get prepared, the physiology is gonna come fast and furious today.

First we are going to get crazy and split up HCG into two parts. We will call them alpha-HCG and beta-HCG. Hopefully you are still with me so far.

A lot of people have heard of beta-HCG - the "pregnancy hormone". This is the hormone that we are looking for on a pregnancy test when a woman pees on that little sticks you buy at Walgreens. Fun fact: they all look for the same hormone, so buying the $40 stick doesn't work any better than the one bought at the dollar store. But I digress.

Alpha-HCG is kinda like a jack-of-all-trades. He looks a lot like a number of other hormones the all human bodies produce and can do their jobs too (for those of you keeping track - FSH, LH, and TSH). This is why we don't measure alpha-HCG for pregnancy tests. Dudes would be testing positive for being pregnant. And that's not right. So since alpha-HCG can do the jobs of these other hormones, scientists decided to take advantage of that and put alpha-HCG to work.

One of the hormones alpha-HCG can mimic is TSH (thyroid stimulating hormone). TSH tells your thyroid to secrete more thyroglobulin. Right now, you're probably asking yourself, "Who cares?!!" But let me tell you, thyroglobulin is important. One of the things it does is produce T3 and T4 which raise your BMR (basal metabolic rate). This means that it tells your cells to burn energy faster. A faster energy burn, means you go through more energy in a given time. If you can control the amount of calories you take in, your body will have to search for other places to get energy - and voila! You break down fat.

So that's the theory. Does it work? It seems the answer is a resounding "We don't really know." None of the studies I found were very good. Some didn't take into account long-term effects, and some were just downright wrong. Which leaves us with the question, "Should I use HCG as part of my weight loss program?" If you have a few extra bucks and are willing to live life on the wild side where you inject your body with foreign substances, then that's up to you. Just don't come complaining to me when your pregnancy comes back with a false positive...

*A couple of web sites claim that HCG is responsible for decreasing mom's use of sugar during pregnancy so that there is plenty for the growing baby. They claim that it works the same way in this weight loss program. While this is partially true, HCG may have a small effect on lowering sugar use, this is a very small benefit at best. The hormone they are really talking about (whether they know it or not) is HPL(human placental lactogen). HPL directly antagonizes the effects of insulin so the cells in your body (except for BRICKLE) cannot take in sugar. This leaves more sugar for the growing baby to use. HCG's primary weight loss effect is due to its ability to raise the BMR as a result of its mimicry of TSH.

Do it...

Catholics vs. Presbyterians

Oh Toto

Busy day at the hospital so I'm scraping the bottom of the barrel. Sorry.

Five Manly Movies That Will Make You Cry and Still Make You Feel Manly

Today's intro is short and sweet. Five Manly Movies That Will Make You Cry and Still Make You Feel Manly (okay so the title is long, but that's all the intro you get)

(Spoiler Alert! Do not read below if you don't want to know some surprises in these movies)

Saving Private Ryan

This is an intense movie throughout. But the final scene, where they are standing in the cemetery and the old man pleads to his wife, "Tell me I've led a good life. Tell me I'm a good man." Wow. It puts a lump in my throat just thinking about it.

Tears of the Sun

I make it through 90% of this movie questioning how it could ever make me cry. Explosions, gunfights, chases, more explosions. It's super manly, low on emotion. And then the final chase scene happens. The one guy goes back for the pregnant woman, and shields her with his body. And I lose it. Seriously, I'm a wreck for the rest of the day.

The Green Mile

A gentle giant gets put in the electric chair. He saves a dying woman, and her husband is the one who has to put him to death. "Please boss, don't put that thing over my face, don't put me in the dark. I's afraid of the dark."

Braveheart

Does it get any more manly than this? Bunch of dudes running around with blue paint on their faces, chopping off body parts, throwing off tyranny, and delivering passionate speeches. I can feel the testosterone coursing through me just thinking about it. And then his wifey dies. Not cool.

Lord of the Rings: The Return of the King

What an amazing trilogy. While there were plenty of emotional scenes throughout the 400 hours needed to watch all three movies, the scene in the final movie when the hobbits are told not to now.

John Q

A desperate father, whose insurance won’t cover his son’s heart transplant, takes the hospital’s emergency room hostage until the doctors agree to perform the operation. But a heart donor appears just in time to stop John from committing suicide to save his son. I cried at this one even before I was a father. I'm not sure I could handle watching it now

Some titles that almost made the cut:
Rudy
Up
Toy Story 3
Armageddon
Old Yeller
I Am Legend

This accurately describes my family

Boys

My brother and I had these moments as kids. I fully expect my son to carry on the tradition of the Y chromosome.

Grandma

I feel comfortable with posting this because my mom knows how much I love her. And because I no longer live at home.

Never kiss a ginger

Disclaimer: this may or may not be medically accurate. Wash your hands just in case.

Tuesday

Sorry about the lack of posting yesterday. I actually had to work. It was not cool. But today I'm back at the hospital and our census is exactly one. One post partum. So there is nothing to do. We will return to our regularly scheduled posting today.

Marriage Philosophy

Today I wanted to share our philosophy behind marriage. We have two sayings in our house, the first is "Marriage doesn't have to suck" and the second is, "It's you and me against the world."

We were married young. My wife had just turned 21 and I was much, much older at 22. We were both still in college. When we told our professors, friends, and parents, while most were generally supportive, there were still a number of detractors. The biggest reason for being against it was that we were too young - we hadn't "seen enough of the world yet." A lot of them mentioned that we should wait and "go travel Europe" or that we had "plenty of time to be married and should enjoy the single life."

If you view your spouse as a "ball and chain" or that marriage is a trap that sucks the life out of you, then what they said makes a lot of sense. But marriage doesn't have to suck. When you marry your best friend, and you remain committed to maintaining that friendship, marriage is awesome. I didn't want to go travel Europe by myself, I wanted to get married and bring my best friend along. It all comes down to perspective. Marriage can be a lot of things, but it doesn't have to suck.

The other saying, comes out a lot during our arguments. When you live in close quarters with another person, conflict is bound to arise, never mind the incredibly difficult process of uniting two different personalities. In the heat of things, it's easy to make the other person out to be the bad guy. But when we take a step back and remind each other that we are on the same team, that when everyone else is against us, we have committed to being partners and we are committed to supporting each other no matter what, when we remember that, our fights become resolvable differences, rather than battles to the death.

"You and me against the world" also comes into play when one of us is about to set off on something new. As a single person, you say, "I'm going to tackle this new thing." But as a married couple, we can say, "I'm right here with you, supporting you emotionally, physically, financially, or however else you need it. Even if everything else is going against you, I'm standing with you." You and me against the world reminds us that we are a team in every aspect of life.

Janitor

Busy day today.

My biggest concern

I'm having a daughter in June. I think she is going to be a nun when she grows up.

I get by with a little help from my friends

FYI: I ran out of deodorant today. Don't get too close tomorrow...

Man feeding

I'm pretty sure I'm gonna try this with my daughter when she arrives in June.

Some blood and guts

I was on call at the hospital this weekend, and wouldn't you know it, the babies came like rain in Spain on the plains. Babies to the rights of me, babies to the left of me, babies flying in from everywhere. Actually, there were only three. But it sure seemed like a lot.

I had my actual first ever delivery on Friday night around midnight. Wow. Let's just say it was a good thing I was wearing my special sticky football gloves. That was one slippery little baby. It was pretty awesome to be a part of such a significant event. The little guy and I shared a moment when he first popped out as I cradled him in my hands. "Thanks for letting me be a part of this" I tried to communicate as we stared at each other. I could tell he was just as emotional as he looked at me with wide eyes that seemed to say, "Just don't drop me!"

The other two deliveries were just as exciting. I also learned that I don't really want to do OB for a living.