This is my last week of my family medicine preceptorship (reflections to come), after which time I will be focusing on vacation preparation!!! We are all very excited.

Part of this preparation began with the end of spring semester. I believe I mentioned that my friend-study-workout-partner, Krystal, and I ferociously began Jillian Michaels’s 30 Day Shred. It is not a joke. With vacations and a few missed days in between, we decided to go some extra time and thus we technically are well past 30 days.

So despite a few misgivings, I took some “before” pictures. It was humbling. At the end of level 1, I took some progress pictures. I had made progress. Things were tighter, smaller, more proportional. I felt good. I felt strong. (Zoe was getting easier to carry longer distances – turns out, after her recent week-long stomach virus, she has lost 4 pounds…) I was on track to have wowza results in ample time to be fit as ever for our upcoming cruise and the big 3-0.

I honestly can say that I do not know what happened after that. When I really think about it, the only reasonable answer is lack of quality sleep to help my body recover. Whatever it is – I am more giant than when I began. Muscle weighs more than fat, retains water as it’s breaking and building, yadayadayada… This is little consolation to the girl in the mirror. Brain knows if I get the fat off, I have a good base of muscle, so that’s what I have to do, but damn if it isn’t super disappointing to work so hard and weigh more and not fit into clothes. I am stronger, so I can focus on that.

What’s funny to me is that – it turns out – this fat ass gets more attention. Today on my walks to and from the bus stops, I got 50% more honks than the thinner me used to. It’s such a shame to me that I’m on foot and they’re in fast vehicles – if only I could run fast enough to catch one of those superfly winners who can both honk AND whistle. I’ve put a lot of thought into scenarios in which I’m able to reach them, and for which one I would leave my husband and beautiful child. In the end, it doesn’t matter: either way, I’ll get a creative guy who is so overcome by attraction to the blur of girl-shaped mass sweating her way down the street that he must make this grand romantic gesture befitting a true lady. And that’s exactly what I want. Exactly.

Come a little closer. I’ve just disembarked the luxurious Metro bus, where I acquired a wide array of water-borne microbes due to my and every other passenger’s swack*. In fact, I’ve spent the past 60+ days sweating constantly – indoors, outdoors, no place is cool enough. Hot, right? Do you still want to honk? By all means.

I’ll tell anyone how much I love Houston. I really do. And it would be a great place to stay for residency in terms of the medicine I could see. But they say to pick a place based on location first – do you want to live there? I’m strongly considering limiting my search to more temperate, or even cooler, climates. That’s probably the summer sweats talking. On that note, I think I’ll go grab Zoe for our daily swim now.

*sweaty back. Thank you, Rachel Brady, for the rights to use this concept; its flexibility ensures a whole vocabulary worth of combinations, using any noun for which “sweaty” could be an adjective. Try it – you’ll see.

When I was practicing for my comprehensive physical exam for class, she was my willing patient many, many times, so she picked up a few things. (I’m fairly confident she could do the full exam, and she clearly has down the blood pressure, deep tendon reflexes, heart, lung and belly sounds, eyes and ears, and Babinski testing.) Here’s how it goes when we pretend for a focused exam and she’s the doctor:

Z: [knock, knock, knock]
B: Come in!
Z: Hellooooo! How are you today? What’s going on?
B: (I explain an injury or complaint.)
Z: Oh! Okay. Let me wash my hands right away and take a look. [She washes her hands thoroughly and reaches out to shake my hand.] I’m Doctor Zoe. Okay. Now. Okay. Let me see. Mmmhmm. Okay. You’ll need a shot. And a sticker. And here’s your lollipop.

So for posterity, her stats are as follows:

Height: 35 7/8 inches (25th percentile); “The doctor says I’m growing very well and very tall.”
Weight: 32 pounds (50th percentile); (How long until I can’t post her weight?)
And according to her school report, she’s excelling by standards for someone almost a year older than she is. Not to brag or anything. Maybe a little bit.

The sweet little bug thanked me several times over the next two days for going to the doctor with her. No shots were sustained, only because I didn’t have a copy of her shot record with me (still need to go get that… Mama oops, but it just has to be done sometime in the next year), much to her relief, though that appears to be her panacea, especially when coupled with a sticker.

But not today. No. Today they were 1. out of non-dairy creamer, and – what’s worse – 2. completely unapologetic about it. In addition, 3. their potato tacos, which most days are worthy of high praise, were not hot. And by hot I mean temperature, which is all the more important now that I’m more aware of what bugs may lurk in less-than-hot food. Thus they have been sacked. This was just the thing I needed to get myself out of bed earlier to make my own breakfast. Maybe now I’ll get to the bus on time.

First, a little background.

Overall Block I exams went alright but, as usual, less well than I had hoped. The quickness and the breadth of material, especially for immunology, got the better of me, and while I held it together fairly well (i.e., I only called my sister in tears once and threatened to quit via no more than four texts), by Friday I was sure that after turning in my micro test I would walk over one building and check myself in, either at Hermann for exhaustion/septic strep (I lost my voice during the week) or at the Harris County psych ward. Not to be dramatic or anything.

Friday night I ended up doing my post exams routine of cleaning and attempting to prepare ourselves for a nice weekend at home without staring at a couch full of laundry or a pile of dishes or lying around on dog-hair-carpet. Because that’s how we roll most days. (I’ve learned to let it go, superficially, until I have time to deal with it, but deep down it’s still on my hamster wheel of concerns.)

I was excited to retrieve Zoe, who was in excellent spirits after school. The evening was pleasant and uneventful, and we went to bed late, in my hopes of sleeping late.

Saturday, 7 AM: Zoe is awake, for good, and she wants to “watch a few shows”. I oblige and return to sleep; when she gets cranky, Joel sweeps her away so I can rest. I am grateful. A few minutes of light sleep later, I tire of hearing her protests and requests for me, and I stomp out grumpily, and we begin our day of nothing. Glorious nothing. We played play-doh, watched shows, napped, and generally enjoyed each other’s company. At 6 PM we ventured out on some errands: Goodwill donating, recycling, and groceries. Across from the recycling center was a Chick-Fil-A, and Zoe excitedly requested dinner there. It was delicious, and she loved playing on the playground with a rambunctious young chap called Ian, or Phillip, or Bill. NOT Kevin, NOT Steven, which he thought Zoe was saying, which she wasn’t. Target was a blast, and we saved 10% with coupons = bonus.

Sometime around 3 AM we were awakened by a Zoe in mild distress. I’m not sure how we knew, because she wasn’t making much noise. Joel figured out that she was lying on her back and pointing to her mouth, which was piled high with vomit. The poor baby. We cleaned her up, stripped the bed, decided she needed a full bath, did that, and got her all ready for bed again. Laundry was begun, and into clean sheets we went. Less than half an hour later, we repeated the whole thing, with the variation that the vomit landed almost entirely on my person, and the two of us took a shower. Putting our last set of sheets on the bed, we decided to put a few extra blankets below Zoe and to keep a pan by the bed.

She learned quickly, warning us when she would vomit in time to place the pan, keeping us updated with, “Here it comes… I have more… I’m almost done…” I was aching for her and so proud of her at the same time. And so it went throughout the night and next day. The laundry never ceased. Despite her illness, she remained in good spirits while awake, though mostly she slept. Family required status reports, particularly my squeamish-only-when-it-comes-to-vomit sister, whose fascination/repulsion necessitates description of the quantity and quality. This provided much comic relief to me, as did Zoe’s comments. After a Dora popsicle: “Hey! Pink throw up!” Apropos of nothing: “Mom? Throwing up is not fun.”

Sunday night went a little better, with evidence that whatever-it-was was moving down the GI tract. I’ll spare you the details except to say that the laundry.continued.all.night. The last incident for which I was present occurred at 5:30 AM before my alarm went off at 6 AM. Joel kept her at home on Monday, which I am so grateful he can do. I trudged off to school, embittered that my post-exam “relaxation” and “preparation for block 2″ weekend was neither of those things, and I began yet another block completely exhausted. A bright spot in the day: Joel texted me with a Zoe quote that I will hover for you in order to protect her privacy somewhat. Hilarious.

Amidst the chaos, there were many moments like that, actually. She’s amazing. And we’ve learned some things, mostly that we should get a plastic sheet.

Now it’s Wednesday, and perhaps for the best, I have forgotten most of the things that inspired my irritation and grumbling and today’s post’s title. I do recall that I broke yet another backpack. And that I missed my morning bus by 30 seconds, thus missing my first class which turned out to be quite important, setting me behind before I even started. Dispersed throughout the day were various and sundry instigators, coming full circle with missing my evening bus, only after running for it like a total moron with my two bags of 70+ pounds of crap, arriving at the bus door only to remain unseen by the driver and amuse the other waiting bus patrons with my misfortune. And THEN I studied while waiting for the next one, putting away my materials when I expected it to arrive, only to wait an additional half hour because for some reason, it never came.

I know these things seem small. But in aggregate… wasting my time and feeling behind already and suffering a severe sleep and mental stamina deficit… It was a little much.

Plus I’m really over my commute.

Long story short, I’m quite difficult to live with. And I’m sorry about the preposition there. I know I have several balls in the air, none of which I’m prepared to let drop, though they have been pruned in the past year. I have to work on grace, and on the schedule and routine. One might say I am hell bent on implementing some consistency, ideally for the whole family, and at least for myself. I did order a new backpack, so instead of hauling around my pigpen in multiple bags like a hobo, I can run for the bus in a streamlined fashion.

To procrastinate I just wanted to update here. Zoe has been ill lately, and after three antibiotic shots from the doctor this week (in lieu of liquid medicine, which she absolutely refuses to take, clamps down her mouth, and if some should enter, it is immediately vomited; we are all better off with the shots). She seemed to be better until last night, when she spiked a fever and generally had a very fitful sleep. This morning between the hours of 7AM and 11AM, at which time she is STILL sleeping, she has stated the following, after which she returns to sleep:

“I want to go to the zoo.”
“Let’s Skype with Gigi.”
“Chuggachugga CHOO CHOO!”
“No, no, no, no, no. Hmm-mm. No.”
“Whatcha doin? I love you.”

Her sleepy head companion and Dad has shown himself in the past minute. This is a good three hours, at least, past her usual wake-up time. I hope this is recovery sleep and not sick sleep… She even let me listen to her heart and lungs, count her beats and breaths per minute (172 :/ and 40), and percuss her chest without waking. I’d like to say for the record that I have either a hunch or a delusion of med student hypochondria regarding her condition. Either way we’re going to push fluids and rest today.

Though I look like an utter goof, so far it doesn’t hurt too badly – I haven’t had to take any ibuprofen or acetaminophen. It only hurts a little in my actual teeth. I read online that it takes 72 hours for the tension to break down the bone and 90 days to build it back up. We’re taking a picture every few days so we can see the progress over time. The first couple of days I had this claustrophobic, cagey feeling, but that’s lessening.

One side effect is that eating is no longer fun. At all. Not that I ate for sport before, but the inconvenience of actually chewing and then cleaning my teeth afterward has severely curtailed my snacking. And of course, I have eliminated the foods and behaviors that could cause a bracket to break, which ultimately benefits my long term health. No nail biting or ice chewing. White flour is gone. Sugar is ALMOST gone. Flavored, unsweetened tea has become my very, very good friend. Cold soy milk. Baked fish. Tofu. Soup. Pureed beans. Pureed hot brown rice cereal. Mashed plantains. I have returned to eating only enough to make me not hungry anymore, which before required willpower, and now is a pain-saving mechanism.

After discussions with Jenna about gluten and dairy, I ditched gluten and am limiting dairy to my Greek yogurt, which doesn’t seem to bother me. I’m also mammal-meat-free, and I don’t miss it. My skin has cleared up, my fatigue is considerably less, and my abdomen is flattening. In fact, today my belly saw the light of day for the first time since Zoe entered our lives. I spent some time in the pool swimming laps, floating, and generally acting like a kid for about a half hour, and it felt phenomenal. I could spend my whole life in water. I’m probably half mermaid. I guess that would be the top half. I wore my favorite vintage two-piece – Mom’s bikini from the 1960s. I’m not ready to don that in more public than there was today (the girl who was frying her skin while reading a book), but given a little more time… Perhaps.

Some of these improvements could be attributed to the fact that Sophie has a new home in Brenham. I am getting good reports from her new family that she is doing very well, and they love her. Zoe’s nose runs less, and I’m breathing easily, completely off my Zyrtec and Flonase. And I rage less.

I kind of wish I had been more scientific about these things so I could figure out which made the biggest improvement, but then I might be obnoxious about it. My family has always said I have infomercial potential. So I’ll just say that they’re all very good changes, and it’s nice to feel more normal.

Y’all! I am totally amazed and touched at the response to my cause. From the bottom of my heart, I am so thankful for the help in not only reaching, but nearly doubling, my original goal.

There was a great turnout for the Sprint for Life this morning, and a total of $130,674.70 will bolster M. D. Anderson’s ovarian cancer research program. As Zoe would exclaim, “Sixshty dah-yas!” (This is apparently her go-to quantity of money.)

THANK YOU!

I’m quite close to my goal in an amazingly short time! As always I am beyond grateful for all the support I have in family, friends, and an extended network of people who are truly good-hearted.

If you would like to support the cause, click here to go to my donation page. My friend Kerri (who is doing some fundraising of her own!) suggested an enticement of baked goods for donors, which I believe to be an excellent idea and will honor.

I know I benefitted from the people who went before me and all the incredible research that went into the treatment that made me – and keeps me – cancer free. This is a small thing I can do to give back in some way.

Times are hard and families are large – one free thing you can do is help the women in your life be confident in their bodies and encourage them to see a doctor if they think something is wrong.

And dudes, gonads are gonads – what’s good for the goose is good for the gander.

A Cleaner Pancake

3/4 cup oatmeal flour (blended old fashioned rolled oats; I used a food processor)
1/2 cup whole wheat flour
1/4 cup whole dark rye flour
1 tbsp corn meal
1 tbsp brown sugar
2 tsp baking powder
1/4 tsp kosher salt
2 eggs
1 tbsp extra virgin olive oil
1/4 cup sour cream (or Greek yogurt)
1 tsp lemon juice
3/4 cup 1% milk
1/4 cup sliced almonds (toasted, if you prefer)
(1 tbsp ground flaxseed would have been a good addition.)

Preheat nonstick griddle or lightly greased/sprayed pan to 400 degrees F. Mix dry ingredients together. Mix wet ingredients together. Combine dry and wet and mix well. Fold in the almonds. Let batter sit for five minutes while you cut veggies for an omelet or something.

Spoon thick batter onto hot griddle; let cook. Flip when it looks ready, and cook a little longer. (Cut into your first one so you know – that’s what I usually do with a new recipe.)

Try it with some fresh berries or a simply-fruit-type jam. Four adults and a Zoe had plenty with this batch and some sides – I think it made 9 or 10 4-inch pancakes. I’ll edit if I find that to be different in the future.

Edit: They taste good! See comments.

I rode the rail to and from downtown before and after getting my card. Instead of getting off at the school and riding the bus home, I took it all the way down to Reliant. There I planned to walk from bus stop to bus stop until a bus came.

Well no bus came while I was walking. I had worn shoes inappropriate for walking more than a mile and began to get a blister, so I took them off and watched my steps. There was mud. I got squishy. It was kind of fantastic. Joel met me on the sidewalk a few blocks from our place, tennis shoes and socks in hand, to spare me additional foot harm.

Yesterday I had my check-up ultrasounds (would be a CT if I weren’t STILL nursing), blood work, and chest x-rays. For the ultrasounds I had to fast through lunch, which really was not a big deal, but since I snack all day long I complained more than I probably should have, and then there was free Chik-Fil-A and brownies available, the regrettable refusal of which felt like a cardinal sin.

Everything went fine; I expect to have results soon and will share them here, if for no other reason than to have a record later. I find that the things that are so important one minute are easily forgotten by the next appointment. I would like to reiterate, also for the record, that MD Anderson is a fantastically impressive monstrosity. Walking there from the school put a very fine point on that – I felt so small, but in a good way, like I will be protected by this huge, powerful thing. Who knows what will happen along the way, but I would love to be a part of that caring force some day.

Back to gross anatomy.