Friday, December 7, 2018

Interesting Vignettes from the past week...

I've kind of fallen off the radar, during this busy season I've had so much to focus on...  Here are some interesting tidbits from the past week...

My mom and dad went to help out at my son's school.  Apparently everyone at school told them that they know me/who our family is.  One of the priests said, "Oh, I'm going to their house for dinner next week," which is true.  Our pastor said, "Oh, Meg, yeah she's here all the time helping at school and the church, I also think she's a vet on the side."  Kind of interesting that my profession is second place to the fact that I help a lot at church and school.

My husband and I talking about a particular workplace where I seem to be more in demand, "Well, after the magna carta of regulations was written up about expectations, I can see how some people could be personally offended."  My husband raises his eyebrow, "Yes," I look at him, knowing what he is thinking, "I get easily offended about personal stuff, but I'll have you know, professionally, I'm very even-keeled."  I had shared an example of this with him earlier in the week, so I think he believed me, but might wonder if he wants more of a professional relationship with me...

Later on, after I was annoyed with something, "Meg, I wish I could get inside that head of yours, sometimes I just can't understand you."  I looked at him and appreciated his compassion, "You know you don't want to get inside my head, you'd have a horrendous headache, there's way too much going on in there."  "True," he responded and left it at that.  I'm not sure if that's what they refer to when they say you should always be a little mysterious with your spouse.

Around the dinner table conversation:
Apparently the awards in our family for the following are:
"Daddy's the grumpiest and sings the worst."  My son is the funniest, I sing the best and am the best snuggler.  My husband then asked, "who yells the most,"   Daddy, my son said.  As a positive control to make sure these awards my son was giving out were fair- "Who's the crankiest in the morning?"  Mommy, my son replied.  "Mommy also snores the most," to which I replied, "have you ever wondered how I know when you are truly asleep at night?" No, my son said, "because of your snore,” I replied.  He couldn't believe me and I don't quite have the heart to record him.

Saturday, November 10, 2018


I think I finally have synchronized my computer and my phone so that everything is getting the same e-mail.  For a couple of months now, I'm not sure how it happened, they got out of sync.  Since it involves setting new passwords, and that is difficult to do when not at home, it's kind of fallen to the bottom of my to-do list.  My to-do list has kind of not been my top priority lately.  Between fighting off colds, travel and just trying to keep up with things (I've had some schedule changes, changed work opportunities, stuff come up at my kid's school and unexpected things like needing 4 new tires), I haven't gotten around to this task.  Slowly, my unread e-mails have been approaching 60,000 on my computer and 5,000 on my phone.  I've gotten off most e-mail lists but there's still school stuff that I get, things from friends and family, things I need to read/do for work and just lots of stuff I eventually need to get to.  It doesn't help that I somehow got elected to leadership of multiple volunteer opportunities (not by choice) and I have to try to keep those things going too.

I don't like deleting e-mails I haven't read and I like trying to catch up on stuff from friends and family, but it can just get overwhelming.  Hopefully I'm on track to being able to process through stuff.  I think the clutter on my computer is worse than the clutter in my house and it all just makes my brain cluttered and difficult to function.

It probably doesn't help that I pretty much don't have much time to devote to technology.  Both my husband and I are trying to stay off our phones more.  There was a time this summer where my son was so excited about getting his new school clothes and my husband missed it (although he got strongly chided by me) and I've had those same moments where he has to tell me to put it down and live life and make memories.

I think we all feel pressure to stay up on stuff.  Whether it's news, work or social media, others have expectations that we will read and respond to their e-mails and texts.  I do have to work and I do have to supervise my kid and so that means I can't instantly respond and/or be on my phone at all times.  Quite frankly, after my kid is in bed, I just want to calm down and relax and I know screen time isn't healthy for sleep.  I also don't want to wake up early just to go through e-mail.  There is definitely overwhelm when there's so much stuff going on.  The one time I got on Facebook this month, a friend had posted some politically divisive stuff and I was almost worried for the friendship.  I stopped and called my friend.  I called three different times (I was a little worried I was being ghosted) and then we had an actual conversation and all was well.  Social media and technology I fear is not healthy for our relationships.  We keep upping our need for instant gratification.  I'm finding it more and more stressful to try to reply, respond and "like" things and still live my life.  I think as Advent comes, I may just put my phone (and my hubby's, if he is willing) in a box when we are at home.  I will probably have to learn my home phone number and give it to family and friends in case there's an emergency, but I think a little bit of fasting from technology might be good at bringing a little sense of peace and time for quiet in preparation for this Christmas season.

My son's principal today was actually discussing when good things become bad.  I believe this was because a recent round of parent-teacher conferences revealed a bad relationship with video games, but I digress.  She asked the students who had phones.  It seemed like the kids above 4th grade had phones.  She then asked the kids if anyone in their homes was a little too attached to their phones and spent a little too much time on their phones.  There were quite a number of hands raised.  I had difficulty seeing if my kid raised his hand, but I do know that my kid has asked both my husband and me to put down the phone before.  Oftentimes, it was when we were working and actually had to be on it, but how many times does he not say it when we are checking scores, e-mails or other things that can be done when we aren't taking away from family time?  I think that is a question we all have to ask.  I do know, the next time the principal asks that question, I don't want my son's hand to be raised.

Friday, November 2, 2018

Book Review: Cloud of Witnesses: A Child's First Book Of Saints

I had the pleasure to receive "Cloud of Witnesses: A Child's First Book of Saints" as a surprise in the mail.  It was perfect timing, as my son is just beginning to learn about the Saints in his kindergarten class.

It is a board book.  So it's very durable, but I was pleasantly surprised to find the material to be richer than what I would expect from a typical board book.  I guess I shouldn't be surprised, since the Saints do demonstrate the richness of the Church!

My mom commented that some of the quotes from the Saints are pretty advanced.  Some are more simple prayers and acclamations from the Saints and some have more material in them.  "Pray, hope, and don't worry" by Saint Pio is fairly understandable, but I don't know if it's even possible to bring a quote by St. Augustine to a 3 year old's level.  I think this is actually a good feature of the book because all age levels can enjoy the book (and the younger sibling can't easily destroy it).  I also think that many children's books underestimate the intellectual capacity of kids.  My 5 year old enjoys listening to some books that are at the middle school and high school level and as far as I know, he's not a child prodigy.  
Cloud of Witnesses: A Child's First Book of Saints is a great way to introduce young kids to Saints and to have as a spiritual resource for them even as they grow older.  My son, the five year old has requested me to read it over and over. It is mom and 5 year old- approved!

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Thursday, October 25, 2018

Catholic School

My husband and I are very grateful that our son is able to go to Catholic School.  It's a small school, where there is only one class for each grade and everybody kind of knows everybody.  So far, there have only been benefits to that.  I'm sure at some point in the next couple of years we might see a disadvantage to the "small town" effect, but overall I feel that most parents and staff are so busy that no one is really a busybody.  At least so far I haven't seen gossiping and I think the no-gossip culture is because there's a no-gossip principal.

There are tons of reasons I love my son's school, but one of them I witnessed the other day in two
kids at lunch who were having a disagreement.  One of them came to me to tattle on the other.  The two girls were telling each other they weren't friends anymore.  It was a classic she-said, she-said.  I had flashbacks to mean girls in my youth.  As the conversation became whining nonsense, I said, "Wait!".  They stopped talking.  I said, "How about you pray a Hail Mary for her to have more patience," and turning to the other girl, "you pray for her to have more patience."  I went on to the next distraction in the lunchroom and turned back watching the girls finish their prayers with the Sign of the Cross.  I also witnessed them back to playing with each other on the playground.  I was shocked on a couple of different levels.  They actually listened to me and they actually did what I asked and it seemed to work!  I thought to myself, "wow!  that's a tool in the toolbox I wouldn't have been able to use in public school for sure!"

My husband and I also really like how every day starts with prayer in the Church.  The whole school gathers together and says morning prayers and prays for everybody.  They also have a time of quiet before their busy day starts.  The principal also engages them in a lesson and they might practice singing.  We think it's a great way for them to start the day.

There is one downside to this way of starting school though...Everybody in the whole school is together so if you are tardy.... Well...  I call it the "Walk of Shame".  Fortunately my kid doesn't seem too ashamed, but it's certainly embarrassing for me when it is obvious that I brought my kid to school late.  The Kindergarten sits in the very front, so everybody, from all the kids and staff and teachers to the principal can see who came in late.

The other day, my son was having a meltdown during this time and several people, even days later said, "We saw him crying the other day, he was so sad."  The science teacher and both of his teachers came out to the back of the church to try to make him feel better.  My kid wasn't embarrassed by his meltdown, but I was.  Oh.. the shame.  Thankfully, one of the other parents related a story to me that made me feel I was not alone.

The next day (I'm not sure if there's a connection) the principal came up to me and said, "We are so glad you are here, your family has been a wonderful addition."  My husband asked me why she would say that.  I told him, "Maybe because I spend half my life around the school volunteering and stuff?  I don't know, but it was nice she said that."  Maybe the next time my son has to do "The Walk of Shame"  I won't be so ashamed, maybe I will remember that all of us parents are just trying to get to school and work on time and some days... Well, some days are just some days.

Friday, October 19, 2018

Sensitivity and Specificity

This is a topic that I think doctors- both of the human and animal professions do not explain very well.  Another thing we don't explain very well is about testing, and the consequences of testing.

A highly sensitive test means it will "catch" all of the positives for a disease and a few (or even quite a few) false positives.  A highly specific test means if it says it's positive, it's positive, but it might come out as negative when it's really positive (or a false negative, if that's not confusing).

If you come up positive on a sensitive test, you might find yourself quite scared for a bit and then find out your diagnosis was incorrect.  You might even get put on medication that isn't necessary or even worse, could hurt you.  That's why most of the time if we perform a sensitive test, we try to follow it up with a specific test for confirmation.

There has been talk about breast cancer screening, prostate screening and colonoscopy screening and that some organizations are actually advocating reducing screening and increasing the time between screenings.  While it's easy to think this is due to a embattled health care system and cost issues, there are actually some legitimate reasons to think that maybe we screen too much.

First of all, is the issue is that not all screening tests are without risk.  I actually knew someone who went in for a colonoscopy screening, and due to a medical error walked out with a colostomy bag for the rest of their life.  That's obviously a extreme circumstance, and I still plan to get colonoscopies as I get older, especially if I ever develop clinical symptoms.  I don't mean to talk anyone out of screenings.  They can save people.  I'm just trying to discuss that everything should have a cost-risk analysis that should be discussed with your doctor.

Breast cancer screenings have radiation.  They are highly recommended for people with a family history of breast cancer.  They also can expose people to extra radiation, which can cause cancer. It seems kind of like a catch-22.  In looking for cancer, you can increase your risk of cancer.  Again, this is an individual's responsibility to talk with their doctor.  In my case, I had a aunt who died of breast cancer.  I spoke with my doctor about mammograms and she went over the thinking that yes, we still do them, but not as early on in a woman's life and not as frequently unless there is a clearer genetic risk.

Sometimes the treatment for things is worse than the disease. I sometimes find myself looking at blood work on a pet and feeling stuck between a rock and a hard spot.  I'm a doctor.  I'm supposed to treat disease, but in a pet that is feeling great and the only problem is their lab work isn't normal, I have to have a careful conversation with the owner.  A disease, such as Cushing's Disease, or hyperadrenocorticism can cause problems like increased thirst and urination, obesity and higher risk of infection.  It can be worthwhile to treat if the pet is experiencing medical problems from it.  However, if the pet is just a little overweight and otherwise happy, I'm less inclined to put them on medication that is actually meant to kill their adrenal glands and may send them into a life-threatening crisis.

There are many diseases where the treatment and side-effects can be worse than the disease.

I recently had personal experience with a doctor wanting to do numerous tests on me.  I went in for one concern and the doctor wanted to test over $5,000 in testing that with my medical knowledge was not related to my concern.  I tried to ask for the reason for some of the testing.  I don't have a problem paying for something that is beneficial, but from personal experience, I do have a problem with unnecessary testing.  If you are on a fishing expedition, you are bound to catch something.  It could also be completely unrelated to whatever you were looking into.  It could (and it has) in my case sent me down rabbit holes of unnecessary diagnosis, treatment and consequences.  As I say often to my patients, "There is some truth in- if it aint broke, don't fix it."

Astonishingly, when I asked the reasoning for the tests, the answer I got was, "Because the doctor said so."  I guarantee you if I ever used that as a reason for doing anything to my patients, that would not go over well.  After 2 weeks and about 5 phone calls,
I was able to get in contact with someone who had a little bit more knowledge.  We discussed that my medical issue they wanted to investigate was well managed and of little concern to me at this time.  Furthermore, I informed them that my husband and I were trying to get pregnant and I knew that the medical treatment they were interested in putting me on would be contraindicated.  It was a nice, civil conversation in which I basically said, "Please investigate the issue I came in for and maybe I will look into those other things later, but not at this time."

I share this information not because I enjoy putting my personal experience out there, but I realize that I'm blessed to have the medical knowledge and experience to understand these situations and articulate them with the medical profession.  I share this information to empower others.  I'm not discouraging people from doing diagnostic testing and I recommend tests far more often than I discourage them in my profession.  I do believe though, that one of the keys to improving our healthcare situation- the cost of healthcare, the care that we get; is to empower people to have conversations with their doctors.  It is your right to understand what is being done, what the consequences are and if the treatment is worse than the disease.  Empowerment to understand and own your healthcare is a key to better healthcare.

This post is NOT designed to give medical advice.  I am not a licensed human medical professional and am not qualified to give people medical advice.  Every reader should consult with their doctor regarding the best decision for them.  This post is just advocating that you HAVE a conversation with your doctor regarding the best decision for you, as an individual.

Tuesday, October 2, 2018

Are we called to be "spicy"?

I used a term the other day to describe a patient of mine, "spicy".  I obviously was not using it in the version of taste, but of temperament.  The kitty did not like us.  It had sass.  He was "spicy."  I thought it was a more agreeable term than, "cranky, nasty" or other terms.  It wasn't derogatory.  It was acknowledging the innate nature of the being.  All of us respect peppers, right?  We know not to cut them and then rub our hands in our eyes.  We know if we are unfamiliar with the pepper we take a tiny bite until we know how much to respect it's power.  A tiny bit of pepper can add a blast of flavor to a recipe.  A pepper is not innately bad, it just needs to be respected for it's potency.  I liken cats who are "opinionated" to that.

My techs liked this term to describe a cat.  They created a scale of "spiciness".  They said I was "chipotle" because I had just stood up to a client who tried to attack me for the fact her pet had an illness another vet in the practice had been unable to diagnose.  I calmly and respectfully explained that there are not always easy tests, sometimes we had to investigate further and it required multiple tests.  Sometimes problems aren't easy and don't have easy fixes.  She was looking for sympathy and I gave it to her.  I also didn't give in to her.  There's a difference.  Earlier on in my career, I would have given her a ton of sympathy and I would have been made meek.  According to my tech, there was no meekness in that room.  There was controlled spice.

In life, we are called to be merciful and just.  Sometimes it's easy to fall into one or another camp.  Everyone gets mercy, it's all good, it's all ok or rigid justice.  It's sometimes hard to separate the two and it's often on emotional issues.  Just look at current events.  I need not say more.

We are called to be a people who seeks justice.  There is such a thing as righteous anger.  There are things so horrific that they need to be called out and there needs to be consequences.  At the same time, there needs to be mercy.

Parenting also calls for mercy and justice.  It's a hard tightrope to walk sometimes.  When my kid does something bad, I know there needs to be justice, but I so want to give him mercy.  When my patients get "spicy"  I can give them a calming pill.  There's not something nor should there be something like that for my 5 year old.

Justice is difficult with parenting.  While you don't want to make rash, emotional judgments, you know that whatever the bad act was needs to be responded to immediately or else the kid won't understand cause and effect, won't understand that there is a consequence for the action.  I find mercy, easier to give as a parent.  I want my kid to do right, to heal and to know he's at heart a good kid.  If the left hand is justice and the right hand is mercy, they need to work together.  Like a jalpaeno and cream cheese.  My son actually likes slightly spicy food and I do as well.  We are not called to be a "bland" people.  We are also not called to burn the tongues of others.  Do you have any recommendations on balancing mercy and justice in family life?

Who knew I could discuss spiciness, difficult cats, parenting and mercy and justice all in one blog post?  Hopefully it's not too disjointed, but I think often we can find crossover between God's natural world and human nature.

Tuesday, September 25, 2018

What I'm Reading Now

I read a fairly eclectic mix of books.  Fiction, non-fiction, spiritual.  I'm in the middle of several right now.  Whenever I see an interesting book referred to, I add it to my library "Wish List".  I think I'm near 1,000 on my wish list.  Not sure I'll ever be able to read them all, but keeping these books in this place has brought some new books into my life that I would've never read otherwise.

If my library doesn't have a book, I will often "request" or recommend it for purchase.  They are a pretty big library system and not all of my requests get purchased, but a fair amount do.  A while back I requested a book, Chesapeake Requiem: A Year with the Watermen of Vanishing Tangier Island.  I was excited when my library purchased it and I discovered three other people had requested it too.  I was on the waitlist and then I got the book and started reading, along with the 5 other books I'm currently in the middle of.

Then the news of Hurricane Florence came and there was an article in a major newspaper interviewing the author of Chesapeake Requiem.  My copy that I had checked out was about ready to expire (the library gives me 21 days to read a book and it normally takes SEVERAL cycles for me to make it through a book).  I thought, "no problem, I'll put it on hold again."  Apparently I wasn't the only person who had read the newspaper article.  The book that I had started reading and was getting into now had 150 people ahead of me on the waiting list.  I told my husband of my angst.  "By the time I get the book back, I will have totally forgotten what I read!"

I worked diligently to read it at every chance I got and as it was really rather engaging and interesting, I made it through.  It's a non-fiction book about a rather liberal journalist who lives on a VERY conservative, dry island where pretty much everyone can trace their family back to a guy who lived there pre-revolution.  With facts about crabbing, boating and small-town life and politics mixed in with the global warming debate (it's not a debate for the journalist, but he is respectful of the islanders having a different view) and personal stories, it was a very engaging read.  I think one thing I enjoyed about it was the fact the journalist and islanders did co-exist and become friends, a nice reminder in this divisive time that there is co-existence possible with polar opposite views.

I've also been getting into some "mystery" and "spy" historical fiction books.  The World War II time period has always fascinated my sister and me and I've been enjoying the Maggie Hope Mysteries.  I don't have a whole lot of time for reading, but I try to squeeze a few minutes here and there, whether I'm in the carpool line or waking up a little earlier in the morning or staying up a little bit late, I get to step outside of my life for just a little bit (and sometimes realize just how blessed I am).  I have way more books on my wish list than I probably will ever be able to get through but I definitely have some good reading to look forward to.

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