Sunday, June 17, 2018

Reflections, new directions, and pet photos (!)

Tonight is the residency graduation ceremony at many OB/GYN programs across the country, and marks approximately a year since I finished residency and and we moved across the country. I've struggled a bit to get back into the swing of the blog, in part because we've gone through a tremendous number of transitions this year and I think we've hardly had time to process one before another is upon us. I posted earlier this spring about the evolution of the blog, but it was a bit of a half-hearted attempt that left me feeling even less certain about the direction going forward. Here's a short list of some of this year's transitions that I'm hopeful to share more about in the coming year.

I'm so close to being finished with medical training - That's right, folks, it's really happening. For those you who thought I had been in college for the past 17 years, you should stop lamenting my slow progress and start celebrating the fact that in that time I have earned three (3) degrees, one (1) certificate, three (3) medical licenses, four (4) DEA numbers, including a special one for prescribers of medication assisted treatment for opiate use disorder, two (2) bilingual provider certifications, and eligibility to take my general obstetrics and gynecology board exams this winter. I also have a job. I think it's okay to let you all know at this point that I'll be joining my current division of general obstetrics and gynecology as an assistant professor in August. In the coming year, you can expect more thoughts about medical education, work-life balance, and the challenges of providing health care in the prison system.

The weather here is completely different - And it turns out that biking with seasons is a whole different ballgame. It's one that I had blissfully and intentionally forgotten while living in the Bay Area. Aside from the occasional rainy day, I could count on being able to use whatever portion of my free time I desired to ride a bike. Although the fall and early winter in North Carolina were seemingly designed for cycling, the "spring" and "summer" have been nearly indistinguishable and have involved temperatures and humidity that make me hesitant to leave the house walking, much less cycling. Despite this, I have lots of cycling goals for the year to come, so you can look forward to more NC scenery views from the saddle.

We have an extremely anxious dog - Walter's entire life was chronicled on the blog, and it still makes my throat catch a bit to see his name as a label option for each post. Cyril, too, has struggled with the loss mightily. He had some significant anxiety issues when we adopted him, and they worsened appreciably after the attack. It turns out that veterinary medicine offers some of the clearest evidence that medications for anxiety change lives. Our little dog is a patient at the NC State Behavioral Medicine Clinic and in addition to the equivalent of doggie therapy, he is now on lots of anxiolytics. He is making great progress, and you can anticipate some reflections on the challenges of a totally differently high needs dog from our last one.

Eighty-five years of questionable decisions in our house - The "what were they thinking" posts will not stop. I have a back log of "before" and "in the midst of it" photos to share, including some demolition photos from what we have been calling "the forbidden bathroom" due to it's lack of non-rotted structural support. This week will also mark the start of the first professional work on the house.

Suffice it to say, there is a lot going on right now and so I'll share some photos of the pets relaxing to remind you (and me!) to do the same.

Cyril loves relaxing in a lawn chair. He tends to cycle between the sunny grass, the shady grass or pavement, and the lawn chair as his temperature needs demand. 

Eli is perhaps the most effective pet at reminding me to take a break. Here he is, seemingly saying "Now it is my turn to use the computer."

This is not some high-tech cat bed that we are using now. It is a high tech washing machine that the cat is using as a bed. I may or may not have started placing a folded bath mat in the washer for him to sleep on. In my defense, it needed to be washed anyway...

Wednesday, May 16, 2018

Summer comes to Durham

Although it seems like only a few weeks ago it was 40F and we were feeling chilly, we've had high temperatures above 90F for the past few days and it doesn't exactly feel like spring. Instead, it feels like we've been catapulted into full-on summer. I know that some of you will say that I'm weak after living in San Francisco for four years, and while that is in general a fair criticism, it has already been  up to 97F this week, and that is hot by pretty much any standard. To make the most of this new warmth (or, to survive in this burning hellscape, as Lynn has been calling it), I've been doing a few things.

Bicycling: Riding in Durham is the full experience of road biking. There are busy urban streets with lots of people and cars, protected multi-use paths for pedestrians and cyclists, and long stretches of rural roads with varying degrees of shoulder for safety. I've enjoyed exploring since we moved, although definitely overestimated my capacity to bike in the heat...

Essentials any bike ride... I highly recommend the goddess garden which has a lovely lavender sent and is extremely gentle. The others are great for the body, but leave my face feeling chemically burned...

I'm too far out from my kindergarten days of encylopedic dinosaur knowledge to determine whether this is a brontosaurus, diplodocus, or apatosaurus. Apparently we've all agreed that all three of these actually exist now, in case you missed the dust-up over whether being a brontosaurus was really a thing...

I've biked portions of the American Tobacco Trail, a rails-to-trails conversion that boasts many miles of beautiful (and relatively flat) cycling, the South Ellerbe Creek Trail, which is most notable for having a large dinosaur statue nestled into the trees next to the trail, and the Stadium Drive Trail, which is actually a glorified sidewalk that is great for safe walking and cycling away from cars for beginning cyclists or children, but is not really ideal for a road bike over about 8 mph.

Enjoying our backyard: "Yard" should really be in quotation marks there, as we don't have much grass at all. That said, "enjoying our backyard morass of sand and gravel" doesn't have the same ring to it. Since getting our fence installed, we've loved letting Cyril run around unencumbered by the stresses of other animals, cars, and similar distractions that are profoundly distressing to our tiny, sweet dog. The things we have taken out of the backyard in order to improve it's function and appearance include:
  • One third of a phone pole
  • An old fence post which was sunk into concrete but not attached to anything else
  • Several dump-runs worth of cement chunks, broken bricks, and large rocks
  • Five garbage bags filled with poison ivy
That's right, the ground cover that was flourishing that I may have mentioned to some of you was actually just poison ivy. We suspected that there was some after Lynn got a rash, and it was confirmed when our amazing neighbor who installed the fence informed us that our entire yard consisted of poison plants and that he would recommend treating the entire area with herbicide. We may yet use chemicals to kill the remaining plants, but opted for mechanical removal of most of them. 

The before... You can see the green patch in the back near the fence, and you'll have to trust me that it's ALL poison ivy...

 The offending plant itself. You can appreciate how lush and three-leaved it is. 

Rainboots - check, Tyvek suit - check, garden gloves - check, innate immunity to poison ivy - check. That's right, despite walking around in it unawares in my sandals, I have remained unaffected. I also accidentally brushed some of it onto my face during removal, and emerged unscathed.

Cy enjoying the one small patch of non-poison ivy (notably, it's clover, not grass) in the yard. 

Tuesday, May 08, 2018

The evolution of the blog

May is the month when "Blogiversary" pops up on my calendar alerts and this year brings us to lucky thirteen. I'm a few days late, but I like to pause for at least one post in May in which I reflect on what brings me back to the blog, and maybe what draws you all. I wish I had access to some of the content trackers and analytic software that the media researchers use to follow trends, because I would love to use data to watch the evolution of the blog, but I don't. Back in 2011, I used a web applet called Wordle to make some cool word clouds from my blog feed. Unfortunately, that website no longer accepts RSS feeds, but I've found a less sophisticated one, TagCrowd, that I think will nonetheless give some interesting insights into the focus of the blog over the years (2005-2018).

Some things to remember as you scroll through:

  1. The words are alphabetical, which is not as aesthetic as the Wordle clouds. 
  2. The app doesn't recognize words like "San Francisco" or "shave ice" as one word, so you'll see those words pop up separately, which seems out of place. 
  3. There isn't one for 2014. There were no posts that years as it was the second half of my intern year and the first half of my second year of residency. This was a low time.
  4. Some of the words that show up in the formatting of the posts, like "pm" for the time of day, are among the most common. I tried to exclude some of the most obvious (like "comments"), but got a little lazy as I went on with this. I've selected a threshold of seven appearances, and included a maximum of 100 words in for each year, so take them with a grain of salt. 
  5. The filter on this applet for "regularly used words" is not as good. For example, it highlights "really" in many of these clouds. I suppose I should broaden the range of adjectives I use, but it should also use a better filter, really. 
  6. Some years there just aren't a lot of posts. The first year (2005) is one of these, which is why it looks like buying eggs was in fact the most significant thing that happened all year. 
Here they are, from stratus, to cumulus, to cirrus, the word clouds of Someday I'll be Dr. Dre...

Saturday, April 14, 2018

Return to Step 1: There was/is more stuff on the floors than you could possibly have imagined

Work on the house is, as you might expect, somehow both fast and slow at the same time. Although things are accomplished every day, and we are making plans for some of the huge changes (hello, new roof!), it often feels like parts of it will take forever. Like the floors.

You'll recall that I posted about removing the horrifying flooring early. We pulled up carpet in the whole downstairs, and removed some random paneling and plywood that were on the floors also. This revealed some incredible peel-and-stick tile in the living room, dining room, guest bedroom, and the entire upstairs. Lynn is basically an adhesive removing machine with the heat gun as her bionic hand, but it is slow work! Let this be a lesson to everyone - If you have nice hardwood flooring and don't want to refinish it, put a layer of something that is easily removed, like weird wood paneling or plywood down on the floor before you semi-permanently adhere linoleum to it. You will be happy you did if you later recant your objection to refinishing, and I would argue that if you could refer people to this blog that it would actually increase the resale value of the home. What are a few small nail holes between friends?

NB: If you use giant nails that leave 1/4" holes in the wood, no one will like you. You have to use something small that doesn't require a hammer, a pry bar, and a miracle to get out without leaving a huge chunk missing from the floor. 

This is early days in this project...

The heat gun in action!

After the heat gun, the industrial vat of coconut oil makes an appearance. It does a remarkably good job of un-sticking the last little bits of adhesive and the dog loves it! 

Ultimately the floors are lovely. Unclear whether they are stained different colors in different rooms, but we can work with that. 

Progress in the living room...

Massive progress in the study!

Friday, March 30, 2018

In loving memory

As some of you already know, and most of the rest of you have guessed after reading the title of this post, Walter died on March 25, 2018. He fought valiantly in the hospital, surprising all the staff with his impressive recovery after all of his surgery and his ridiculous demeanor in the most challenging of circumstances. Despite their amazing care, on Sunday morning he suffered a catastrophic neurological event that left him not himself and working hard to breath. We waited through the day, and it became clear that he would not get better. We said goodbye in the evening. He was the best dog we could ever have hoped to have, and we will love him forever.

These are just a few of the photos of Walter that have graced the posts of this blog. You can find more here

Friday, March 23, 2018

One of the worst things ever...

As some of you know, earlier this week Walter was viciously attacked by two much larger dogs while he and Cyril were out for a walk. I'm not going to describe that horror here, as I wasn't there and it was traumatizing for all involved. Suffice it to say that Walter suffered major injuries to his back half in particular, and was immediately taken to the closest veterinary hospital to us with critical care services. Everyone else is okay physically, but will require some time before dog walking is a relaxing activity again.

Once Walter got to the hospital, he had an x-ray to confirm his spine wasn't fractured (it wasn't) and an ultrasound to confirm there was no bleeding or fluid in his belly (there wasn't). He was admitted to the ICU and then under anesthesia they shaved most of the hair on his back half and washed and dressed his wounds. Over the last four days, he has undergone the following:

  • Four surgeries with general anesthesia for wound debridement, closure, and drain placement
  • Placement of seven drains into his wounds
  • Placement of a central line (a special IV for fluid management)
  • Placement of a feeding tube
  • Transfusion of one unit of blood and one unit of FFP (plasma)
Despite all of these interventions, we are uncertain whether he will regain complete use of both of his back legs, and the threat of infection is ever present. The staff at the Veterinary Specialty Hospital of the Carolinas in Cary, NC have been incredible, and have cared for Walter as they would their own animals. They would never let us know if they tired of our frequent visits and calls, and have been honest and reassuring when possible about his clinical status. 

We were able to connect with the heroic mail carrier that used pepper spray to stop the attacking dogs and save Walter's life, and we feel forever in his debt. He said that this was the first time in his entire career that he had ever had to intervene in a a situation like this, and his presence of mind and quick action were the difference between losing Walter and where we are now. We are preparing a thank-you gift, and if you'd like us to include a message from you, please send me a note, leave it in the comments here, or otherwise let me know. We are also so appreciative of the neighbor who provided a ride to our injured baby.

Walter looking so much perkier after a few days in the hospital!

Sunday, March 04, 2018

Introducing Cyril

For years, we have been discussing and debating getting another dog. We considered adding a mutt to the family in order to avoid the myriad health problems associated with a purebred dog. We thought about getting a big dog, maybe a pit mix, since we have the space and both enjoy walking with the dogs. We perused the options endlessly on PetFinder before and after it was referred to as "something that resembles Tinder for dogs" on This is Us.

As an aside, in attempting to find a link to that clip I googled "Tinder for dogs" and came up with the following:

  • BarkBuddy: An app designed to help you "find fluffy singles near you," BarkBuddy connects people "with cute pups that need a home."
  • Tindog: This may or may not be defunct, but looks like it was an app to help people with dogs meet dogs (and their owners). It may or may not match both the dogs and the owners.
  • Dog Date Afternoon: More explicitly connects single people who want to date but want to make sure that their dogs are compatible before they invest any more energy into a potential relationship. 
  • Allpaws: Another app to facilitate pet adoptions.
  • Twindog: Looks suspiciously similar to Tindog, and I wonder whether there wasn't some sort of lawsuit that resulted in a name change here... 
After so much going back and forth and listing the pros and cons of getting another dog, we decided to move forward and applied to adopt another Boston Terrier. We wanted Walter to have a buddy in the autumn and winter of his years, and after we saw this little guy and realized that he had been returned multiple times due to behavior issues, we couldn't say no. We found him through the East Tennessee Boston Terrier Rescue. Having adopted Walter through the Midwest Boston Terrier Rescue, we were committed to a rescue dog. 

And here he is:

Cyril is a 2.5 year old brown/brindle Boston Terrier.

From the moment he arrived, he and Walter bonded over their shared love of blankets. They are shown here in the heated throw they both adore.

 In the morning sunshine, there's no need to burrow...

 And sometimes when Cyril gets too hot under the blankets, he hops out and sprawls out on the floor to cool down.

Of the cats, only Aleks has condescended to snuggle NEAR Cyril. I know he'll eventually learn that they can snuggle just like he does with Walter, but for now he's a bit standoffish. Eli has barely condescended to come downstairs since Cyril arrived...