I remember as a kid staying overnight at my grandparents’ house during the summers. The days always seemed to start out with the two of them getting up at (what seemed to me) a ridiculously early hour. They’d sip black coffee and chat and my grandma would fry up some bacon and scramble an egg for my cousin and I when we finally rolled out of bed well after the sun had said it’s good mornings and roosters had crowed their songs.

“The early bird gets the worm!”

they’d say…or

“Early to bed early to rise, makes a man healthy, wealthy and wise.”

As intelligent as the two of them were and as much as I wish it was a joy for me to get up at 5:00am, this study researching circadian type or “diurnal preference” has left me feeling vindicated, to a degree, regarding my tendency towards late nights and mornings. Indicating the contrary of the old adage, the article seems to say that people who stay up late and sleep in are, in fact, a bit more intelligent. Did you really need proof in the form of a scientific study to show that you that night-owls are smarter? Yah, neither did I.

However, this study does say that “morningness” has a significant positive correlation with life satisfaction and I can definitely agree that I feel better and more productive when I get up early and get my day started with the sun (and a cup of caffeine).

So, what does all that tell us? Not much other than there are lots of studies out there looking into all sorts of things you’d never have expected. Interesting, to be sure – helpful, maybe not?

So, life satisfaction-wise and intelligence-wise, who do you think wins? Night owls or morning glories?

I’d love to stick around and see what you all have to say, but none of your answers will change the fact that it’s 10pm and my alarm is set for 4:45am tomorrow. Wonder what  forced early-rising is correlated with? I’m speculating a positive correlation with amount of caffeine consumed prior to 10am.

Image 1: photostock | FreeDigitalPhotos.net

I often see women around here questioning when others think would be the best time in medical training to have a baby. The most common answer is that there is never a good time, but that there are times that are worse than others (like right before Step 1 or the middle of intern year, for example).

Basically, the general consensus is to weigh your options and go for it when you decide you’re ready, while hoping the rest falls into place. Understandable, since you never really know what life could bring – infertility, job changes, the collapse of medicine as we know it.

Not understandable because, let’s face it, we’re medical students and doctors – we didn’t get to this point in our life by just going for anything…we planned. I have yet to find a person in this field who doesn’t appreciate a game of “What If…”

What if I fail out? What if I forget my pencil? What if my computer breaks? What if I get stuck in one city for 4 days and my luggage was on another flight? What if I need 35 pairs of underwear on my 2 day trip?

Don’t act like you haven’t done it. Do you really think we believe you put that many pairs of underwear in your bag without thinking about all the reasons you might get stuck in Seattle for 6 extra days?

A lot of us plan…some to a fault…we plan our days, our weeks and our years. Sure, they rarely turn out as we planned, but the simple act of having a plan can be calming to some of us (and by us I do not mean me…this is purely theoretical).

I recently ran across an old-er post in the MomMD forums talking about predictors for one’s ability to manage motherhood and medicine. As many before her had done, she was helping others to plan if (and when) they should have a baby in medical school or residency.

According to the insightful poster there were certain…

Positive Predictors:

• Flexible Husband (we’re talking work schedules and personality, people)
• Bonus points if flexible hubby is a stay-at-home dad
• Family Nearby
• Desire to go into a family friendly field
• Few commitments outside of family & medicine

And also some particular…

Negative Predictors:

• Husband in the medical field
• Child with special needs or chronic illness
• Being a gunner
• Desire to go into things like Surgery

She’s much more eloquent at explaining her ideas, so I urge you to take a look at the original post and replies.

So, are you a planner? How has it helped or hurt you in your medical training? What do you think are the best predictors of managing a career in medicine without neglecting your family? How have you managed? What adjustments did you make? What helped or hurt your efforts?

Image: Stuart Miles / FreeDigitalPhotos.net

It was 2004 – I was barely 18 years old and enjoying my first year of college at Texas A&M University. As I headed to a Psychology class through the Student Center on a beautiful October day I was handed a colorful plastic shower hanger for my dorm room. It was Breast Cancer Awareness month and the water proof hanger was designed with eye-catching colors and graphics to describe step-by-step how to do monthly self breast exams. The back quoted literature and websites indicating how important self-exams were.

My Nana was around 57 years old at the time and about to start her 3rd battle with breast cancer, one she would ultimately lose around a year later. I was so proud of the women for handing these out – doing something proactive to help young people detect breast cancer early. They were supporting early detection and promoting breast cancer awareness with action instead of words – saving lives one shower-hanger at a time. Or they thought they were – that was their goal, an admirable endeavor to be sure.

But, were they really?

Although I didn’t know who she was before last week, the recent news of Giuliana Rancic’s breast cancer diagnosis at the young age of 37 caught my eye. My interest in Fertility Medicine drew me in to learn more about her heartbreaking story and, from the media coverage of her diagnosis, it’s drawn in a slew of others as well.

In addition to attracting a very large group of supporters and well-wishers, the news has also prompted Rancic and an array of media outlets to remind women to do their monthly self-breast exams because, as many of them say and as most think, “early detection saves lives.” This recommendation is continually repeated by news outlets covering her story, despite the fact that self-exam played no part in Rancic’s diagnosis.

Self-exam has traditionally been touted as a method of early detection to improve outcomes in those with breast cancer, but recent literature has suggested that breast self-exams do not improve outcomes and may actually have some negative impact on the women who do them. This research was apparently so convincing that the U.S. Preventative Services Task Force currently recommends against it at a Grade D, indicating that harm outweighs benefit.

So, have we all really just been using self breast exams as a method of making ourselves feel better – like we’re in control of a situation we have no control over?

Do you do a monthly self-exam? Have you or someone you know ever detected a lump? Tell us your story – do you feel it did more harm than good? As a physician, do you still recommend self-exams to your female patients?

I’m so interested in everyone’s stories and opinions on this subject!

Photo: Flickr Creative Commons | glokbell

From a friend’s Facebook status:

“Times have definitely changed. Filling out my son’s paperwork for a well check with his new pediatrician & there’s a spot for your Facebook or Twitter account to receive non urgent info about the patient!”

We are clearly moving in the direction of social media and digital information, so I would love to hear your thoughts on the following (answers should assume consent from both parent and physician to use this type of interaction for non-urgent medical information):

• Is it legal?
• What about ethical?
• What considerations would be required regarding this interaction?
• What about privacy and security issues*?
• Would all these considerations be a problem if there’s been consent from all parties?

And most importantly…

• As a parent or patient, would you consent to transferring non-urgent medical information this way?
• What about as a physician or other healthcare provider?

 
*To play devil’s advocate, what makes these interactions any less safe than “snail-mailing” non-urgent info? Theoretically, can’t almost anyone open your mailbox and mail? Doesn’t snail-mail go through way more hands to get to someone than email? What makes them any less secure than cell phone voicemails? We learned from this incident that cell phone hacking is incredibly easy if you know the right people and technology. What do you think the differences are?

Image: Free Digital Images | Kookkai_nak

Last week my husband was watching the CNN Republican debate in our bedroom as I sorted articles of clothing from my overflowing closet into trash and donate piles. When I caught a second between “what was I thinking when I bought this” and “have I ever even worn that” thoughts I half-listened in to the comments coming from the TV. However, when Minnesota’s 6th district representative started talking about my state and the HPV vaccine she managed to recruit my undivided attention.

Once Michele Bachmann’s statements crossed the line between executive orders and entered the territory of science and health care it was obvious to anyone that she was out of her league. It doesn’t take a rocket scientist to know that anecdotal statements and political figures are not acceptable sources of medical or scientific advice.

Her statements at the debate were so deep in propaganda and “innocent little girl” statements that even Herman and Chomsky weren’t sure if we were still discussing recipients of a vaccine or had moved on to victims of kidnapping and cults.

But, then she fully strayed from politics and went on to say really bizarre things about the vaccine, like that it caused mental retardation. It hasn’t been officially confirmed, but I heard she won over Andrew Wakefield’s vote with that one.

However, despite the outright ridiculous nature of her statements, I’m trying to look on the bright side of her blatant disregard for research and reality.

Representative Bachmann has ignited a conversation about the HPV vaccine that has been quiet for some time. In the past week there has been an array of positive and factual information written about the HPV vaccine. My Twitter feed and blog roll has been inundated with information from people of much more qualified backgrounds regarding the purpose, safety and relative risks of this vaccine. If you want some quick, basic information with lots of sources in graphic format check out David McCandless’ infographic.

Here’s the thing – the group of people who would tend to take what Ms. Bachmann says to heart are those who are less likely to be discussing the HPV vaccine in the first place. While the conversation may have been ignited for the wrong reasons – inaccurate information from an unqualified source – maybe parents will at least bring this up with their child’s provider now. Or maybe they will happen upon one of the great news articles or blogs written on the subject since Bachmann took her bizarre stance on the vaccine.

The more liberal parents probably don’t believe anything out of her mouth anyway, so I’m not really concerned about it affecting their likelihood of choosing to to vaccinate against HPV.

Your view on the pros and cons of the HPV vaccine are just that – yours. The choice to vaccinate or not vaccinate against HPV is a choice to be made by parents and their teenagers with appropriate resources.

There are not many things in medicine that can actually prevent cancer, but the Hepatitis C and HPV vaccines can. I encourage using reliable sources to come up with your own views on if this vaccine is necessary. I hope that parents know the realities of HPV and cervical cancer and understand the proven benefits and side effects of the vaccine.

In the end, I’d ask that Michele Bachmann and other politicians refrain from spreading lies about potentially life-saving medical interventions for their own perceived gain. However, if they are going to continue to do it, which they most certainly are, I hope that we can use these types of statements as a reason to put factual information into the hands of those who need it.

Reliable Information on the HPV Vaccine:

• David McCandless Infographic
• Seattle Mama Doc Blog
• CDC Vaccine Safety
• CDC – HPV Vaccine in Young Women
• Cancer.gov Prevention Fact Sheet

Image: Koilocytes, Flickr Creative Commons | euthman.
Image: Child, Sura Nualpradid | FreeDigitalPhotos.net

If your refrigerator looks anything like mine on any given Sunday you might find something along the lines of Penicillin Potatoes and Gastroenteritis Gumbo with a side of whatthebobbyflayisthat on the leftover shelf. My husband and I have a bad habit of cooking way too much food (it is hard to cook for two people…everything comes in fours!) and subsequently leaving our left overs in the fridge long enough to make Oscar the Grouch turn up his nose.

We are proud budgeters, my husband and I, we keep track of our money to the penny and do everything we can to spend it efficiently while attempting to save a bit after our tithes and necessary expense. However, we got into the awful habit of throwing away what is probably a ridiculously large amount of money’s worth of spoiled food every couple of weeks. Here’s how we’ve been attempting to solve our funky fridge food problem.

Log Your Leftovers

  Using Excel I made a Leftover Log to put on our fridge. Everything that goes into the icebox as leftovers gets recorded and we are making it our life goal to consume said leftovers before they go bad, usually within a few days of being refrigerated or a few weeks of being frozen.

  This has cut down on the amount of food we throw away tremendously! Seriously, this little sheet has been pivotal in reducing our wastefullness. It is really helpful to have such an easily visible reminder of the food you need to consume first. We did notice quickly, though, that we don’t keep up with it accurately unless a pen is literally hanging with the log on the fridge door. So, if you are going to use the leftover log, attach your pens accordingly.

Here’s the log as a printable .pdf and an excel file to download and edit to fit your needs.

Get Your Creative On

  Another pivotal change in our leftover use has been realizing that we don’t have to eat leftovers as the exact same meal with a little added mushy staleness. We found that creatively integrating leftovers into exciting meals helps us use up the food without feeling like we’re eating the same thing three days in a row.

  Left over porkchops cut into small pieces, thrown in a hot skillet with a little oil & garlic plus a fresh chopped tomato, green chile and jalapeno pepper (or a can of Rotel if you prefer) becomes Spicy Pork Tacos. When everything is all mixed up and ready to go top it with some grated Colby Jack in a warm tortilla et voila! – (QUICK!) delicious dinner. If there’s still some left after our second dinner, as there occasionally will be, I’ll take it to the hospital with me and eat it over salad for lunch.

  If I’m making Mexican rice for a meal I like to make a large batch and freeze the leftovers in individual ziplocks for a quick addition to things like Leftover Spicy Pork Tacos. The baggies of rice hold up well in the freezer for a long time, thaw relatively quickly and taste fabulous heated up in a cast iron skillet.

  Leftover grilled chicken shredded in pieces & mixed with a little mayo, lime juice and pickle relish makes a fabulous fresh chicken salad.

What’s your favorite way to use leftovers?! How do my MomMD readers make sure they aren’t wasting all their money by letting leftovers spoil?

Image: Ambro / FreeDigitalPhotos.net