Our canine addition!

Introducing: Pepper!

We have a dog!!!!

In the past few months, I have been looking (some times more actively than others) for available dogs. Our visit from Serena, Brad and Shabu back in November reinforced that I love having a pooch around! Despite enjoying hiking and running quite a bit back when I was not on call all the time, I am not a large-dog person. I love little lap dogs who you can cuddle!

We had a miniature schnauzer ("Toccata") growing up after, when I was about 10, I went on a (successful) campaign lobbying for a family pet. Now, my parents have two little Cairn Terriers, the first of which (Duncan) replaced Toccata soon after she passed away. I love playing with them when I am able to go home. However, until this point in my "adult" life, haven't felt like I had the time to devote to a pet.

Kelvin and I were not super partial towards any particular breeds, or pure-breds for that matter; however Serena was instrumental in promoting the high points of shih tzus. They are incredibly loyal and great companion dogs. Our interest in doggies was re-kindled ("a sign!" I thought) when we saw some shih tzu/poodle puppies advertised in the North Coast Journal (paper); however, the timing didn't work out to view them, and I'm not sure we could handle the housetraining that comes with having a new puppy around!

We also looked at a few shelters-- the McKinleyville shelter, the one in Oakland (when we visited the Lees-- there was a pre-Christmas special on adoption fees), as well as one in Eureka. At the time I saw the dogs there, we weren't quite ready to "commit" (i.e. the Oakland one required you to be in the area to be able to pick up the dog right after neutering/spaying-- which would have been difficult given we live 5 hours away), and may have missed out (a little mutt I had my eye on at the McKinleyville shelter was adopted the same day as my visit-- we saw him walking around the pet store with his new owner as I was shopping for my dog supplies, wanting to be very prepared before we even brought home a pooch!). However, the timing wasn't quite right.

In doing a search for shih tzus in the northern California area, I came across a hobby breeder who was looking to downsize her program and had a 16-month old dog to adopt for a great price. We drove to Happy Camp (about 3 hours from here) to check her out on the 17th, and were sold! The dog (named "Winda" at that point) was a bit quieter than the other rambunctious dogs the owner had, and she felt she'd do better in a quieter home with more 1-on-1 attention. We planned to bring her home after Christmas, not wanting to leave her alone (or at a boarder) so soon after getting her due to our already-planned Christmas getaway.

So, on our way back from Ashland, we picked up little Winda (who we renamed "Pepper") at Happy Camp, and swerved to avoid all the pebbles in the road the whole way back (my car is STILL at the shop). Michelle gave us her dog bed so she'd have something of "home" to accompany her to her new surroundings, and I held her the whole drive back.

I won't lie. I was pretty nervous when we first left. She shivered in my arms for the first 20 minutes or so. When I tried to have her go potty outside the car, she kind of freaked out and tried to slip out of her collar (highway-side...which had my heart racing). She hadn't previously been used to a collar/leash, as the dogs were previously let out of the house to play in a fenced yard. When we got home to our neighborhood, she was really shy, did not really want to walk around, and would cower when she heard our footsteps next to her. I had to drag her up our steps and carry her across the street for her first few trips outside. When she was in our house, she just lay in her doggie bed and didn't really explore. She did not want to eat. She seemed depressed and scared. I wondered if she'd come out of it.





She has. She has really perked up in the last few days. She doesn't really enjoy walking in the rain (despite our dry December overall, we'd kind of made up for it in the last few days! Do doggie raincoats work?). She usually only goes to the bathroom when I walk her, which frustrates Kelvin (I think she's a bit more nervous around him and is not relaxed enough!). But she follows us around from room to room, and wags her little tail whenever she sees us or comes out of her crate. She has also demonstrated that she is quite a Houdini!

We were having her sleep in the crate, and stay in the crate for half-days at a time when we both returned back to work on Wednesday. Despite reading about how it actually is quite a good method of both house-training [we're not sure if she is 100% trained]) and of housing a new dog, it still seems kind of inhumane to me. And because had been so good (i.e. no accidents in the house) and kept overturning her crate food/water dish, I thought she might do okay penned up in our mudroom/entryway, with pet gates blocking it off from the kitchen. We tried this out when we went to bowling last night; however, when we returned home, our cute, calm, "obedient" doggie was hanging out in the living room, waiting to greet us when we entered the house from the garage. She had managed to dislodge our wooden pet gate and escape! Nothing was chewed or anything, but I think she just got bored in the front!

The gate of escape


The other side (untouched)


I left Pepper in the entryway again this morning when we went to work, this time after using a good-sized ottoman to block the gate. When I came home at lunch to take her out, there was no dog in sight. She is usually pretty good about coming right when one of us calls her and we usually can hear her collar jingling, and I was extremely puzzled. She was nowhere to be found downstairs but was clearly out of the gate. And, until today, we did not think that she was able to climb our stairs (she certainly hadn't before, getting "stuck" half-way and being too scared to continue!). But upstairs I went to search. She was not in our bedroom, nor in our office or guest bedroom. I was a bit concerned she'd gotten stolen (before we got the microchip in her!); however, when I checked the bathroom (with door closed!), I found her hanging out by a bunch of towels she'd pulled down from the shelf and amidst which she had likely been nestled (before shutting the door on herself and locking herself in!).

Re-creating her escape (live)
Nudging + Thinking


Thinking more


The escape (caught!)


I put her in the crate for the afternoon and, when Kelvin came home, he again found that she'd escaped from the metal-gated crate!!! I must have gotten lazy in latching it but GEEZ! This girl is probably going to keep us on our toes!

Caring for her surely adds extra time to our days (grooming included!) and more planning; however, we are so in love with her and it has been definitely worth it. I love coming home to see her. She is a sweet, quiet dog but who definitely has a mischievous side (I wish I could videotape her antics when we're gone). She is a bit skittish and shy with strangers, but is already showing more personality, and is a wonderful companion.

Hanging out with Daddy


Momma's Girl


We hope she will be with us for a very long time. Welcome home, Pepper!

Oregon Christmas Getaway

We did not have enough time off this year to make a Christmas trip to visit either of our families. Last year, we were really lucky to be able to spend a week out in Virginia, but this year, it just wasn't in the cards with the times and prices of the airfare. Rather than stay in Arcata and mope that we live in the middle of nowhere, we decided to take a weekend trip-- to Southern Oregon, which is really accessible from where we are.

We had made a trip to Crater Lake back in the spring of last year (where there was still about 10 feet of snow in May!), but did not stop or spend any real time in the Rogue River Valley towns of Medford or Ashland, which are only about a 4-hour-drive (some of which is on big I-5-- we are getting a bit weary of small, winding county roads!) from Arcata.



Southern Oregon is really beautiful, and Ashland is a very cute town! From February until November of each year, it is home to the Oregon Shakespeare Festival with an impressive schedule of performances. Unfortunately, visiting in the off-season, we could not catch any shows, but we hope to be back in the summer months.



We spent some time on Christmas Eve wandering around Lithia Park near downtown. It is a gorgeous park of 93 acres, named after "lithium oxide," which is found in the stream water pumped to the park, and includes an outdoor theater, tennis courts, an ice-rink, and a nice (now-frozen) pond, which we were wary but excited to try walking on (after a few people had gone before us and NOT fallen in... remember that I am a huge fan of It's a Wonderful Life and suspicious of seemingly-frozen ice).













Pretty fountain


Resting ducks


We got our first real taste of winter with snow on the roadside!


This outdoor skating rink was open for open skating, but we did not feel like sharing it with hockey players, and so just watched for a bit.



We walked around Main Street and checked out the Ashland Springs Hotel, a historic hotel open since 1925.




In the evening, we enjoyed a 6-course "Dickens Feast" at our Bed and Breakfast, the Winchester Inn.

Our meal consisted of a Relish Plate, Hot Brandied Cider, Champagne, Mushroom Wellington, Blue Cheese & Onion & Soup, Maison Salad, Prime Rib with Yorkshire Pudding, and an Almond-Cherry Trifle, and between courses, we listened to the Winchester Singers, a wonderful and entertaining caroling quartet (in period dress), who performed classic and contemporary Christmas tunes, and even performed a "Ashland Christmas Carol" skit (a la Dickens) for us :). We were definitely satisfied by the end!







We made an excellent lodging choice in the family-owned and run Winchester Inn. While we are usually pretty thrify travelers (and we did get "off-season" prices), we splurged a bit this time on our "Christmas getaway," and were very happy. Our Eastlake room was extremely cozy, with a really comfortable bed, soft pillows, a nice sitting area and TV, a spa-like marble bathroom, and a mini-kitchenette.



As you can see, Kelvin got very cozy in the provided robe (as he watched his Saturday football)


Since they gave their employees Christmas off, the Inn provided us these breakfast gift baskets to keep us well-fed on Christmas morning.





Christmas was a really relaxing day! Most things in town (including the wineries, which we were hoping to try) were closed for Christmas, so we decided to head up to Mt. Ashland to check out the slopes!

While this winter has also been quite dry up here in Oregon (apparently this is the driest winter in 100 years in Humboldt Co!) and there wasn't a lot of snow cover, I still reeeally wanted to ski and braved the mountain's slopes. One of the lifts was closed, and there were some small trees poking through the snow that we had to dodge, but I still enjoyed a half-day of skiing on the Shakespeare-themed slopes (Juliet, Romeo, Tempest, Avon, etc.), without any lines.







On the road to Mt. Ashland




We spent the rest of Christmas Day relaxing in our cozy room, watching NBA basketball, Green Bay football, and (how could I not?!) It's a Wonderful Life, eating take-out from a Thai place in town that happened to be open on Christmas, and feeling very removed from the pressures of everyday life. It was a sweet trip, and we hope to be back to Ashland sometime soon!

The Minor Theater

Arcata (and Humbolt County in general) is filled with unique, historic buildings and original businesses.

One landmark of Old Town Eureka, the Carter House, is a lovely Victorian landmark which is easily spotted from the road or from kayaks on the Bay.


We have not stayed there nor tried their first-class restaurant, but I'd like to someday (when my car repairs have been paid off :)).

However, in the last couple of weeks, we stumbled on another historic building, the Minor Theater in Arcata. As you can see by the plaque below, the theater is the oldest feature-film theater in the U.S., built just 18 months after feature films appeared, and opened on 12/13/14.



Kelvin and I have caught two movies there in the past month-- New Year's Eve (cheesy, but entertaining if you like romantic comedy [of which I am definitely guilty]), and then, last night, Girl with the Dragon Tattoo (which impressed me with FANTASTIC acting in a breakout role by Rooney Mara as Lisbeth Salander and, while I was a bit skeptical of how the quality would be, compared to the more authentic Swedish-made movie and Larsson's book, I was pleasantly surprised).

Although the Minor Theater a very old, historic theater (with three screens), it tends not to be busy. Even with the large HSU student population in this town, we have never had more than eight people in the theater when we've been to one of the films. While Kelvin still likes to go early to movie theaters "in case there's a parking issue or a line," I keep having to remind him that we live in Arcata, a town of 17,000 (and, at this time of year, most of the students are on break!). Apparently, though, at its opening in 1914, when the feature film shown was The Chimes, the theater was packed (with all 524 seats, representing about 50% of the population of Arcata, filled!).



Another really gorgeous historic theater I have visited is the Byrd Theater in the Carytown district of Richmond, Virginia, where I attended college.


While it was built in 1928, about a decade and a half later than was the Minor Theater, it is truly a more "opulent" cinema experience (but at a bargain price - $1.99 or so!), complete with chandeliers, red velvet seats and curtains, and a functioning Wurlitzer organ!

It is truly a blessing that these theaters are still operating and standing (Zoey's efforts to "Save the Arcadian" on the series How I Met Your Mother comes to mind), and it is a privilege to view a film in their seats. You should too, if you have not yet had the opportunity!

A Rock and a Hard Place (Not So Happy Camp)

On Saturday, Kelvin and I drove the 120 or so miles to Happy Camp, CA (just a few miles, as the crow flies, to the Oregon border) to check out a doggie. More on this later, but let it be said that we have been actively looking for a family pet and will likely bring our baby home just after Christmas!





It was a lovely drive there on Highway 96, known as "Big Foot Scenic Highway" (with the most the Bigfoot sightings of any region in the country), alongside the Klamath River, and through the Trinity and Six Rivers National Forests. The weather was clear and fabulous and despite the curviness, we made pretty good time through the small towns and Hoopa Indian land.
We were amused by this decorated pine tree highway-side!



On our way home, we had a most unfortunate thing happen-- my Prius went over a rock in the road, which immediately caused some impressive smoke to spew into the car, and which triggered the "PROBLEM" light and an oil signal. We appeared to have a pretty good oil leak. Now, it was around 4:20 p.m., and just about 4 miles south of Happy Camp (population 1100) , which was about the biggest town (and with the best cell-phone reception) for 50 or so miles, so we actually had a few things going for us.

It could have been a lot worse:
- It could have been dark already
- It could have been rainy or snowing instead of clear
- We could have been in MN and not CA in December
- We could have not had our warm coats with us
- We could have had children (or a dog) in the car with us
- We could have had NO cell phone reception, rather than just spotty reception
- We could have had to work that night
- We could have been farther than the 120 miles away from home

However, what ensued was still rather frustrating. We called AAA immediately, who reported that they should have someone out to us by 5:00 pm and, since we were by a highway, they'd make us a priority. That was fine. It was still light out and my phone still had battery life. But when 5:30 came and went, we got a bit nervous. We called them back and the ETA was moved to about 7:00. Then, at 7:15, the ETA was around 9:30. I understood that we were in a rather remote area, but we really felt like we were getting the run around. We had no idea if anyone was going to get us, or where we'd go from there-- we were sure there were NO mechanics in about a 50-mile radius. (As a side note, we were worried, but let me put things in perspective when Kelvin reported that he still felt that "This is WAY better than when we were in India!").

We were also freezing (thankful, though, for blankets we kept in the car, warm jackets, and gloves). We were touched my the number (no fewer than seven, actually, and probably 60%) of cars which stopped when they saw our emergency flashers, to ask us if we needed help. There wasn't a whole lot they could do, but we needed a tow truck to get us out of there!!! We had a couple of "false alarms" with a Cal Trans snow plow truck that passed us, one time in each direction, which we really thought was our tow-savior, but alas, it was not (either time).

FINALLY, around 9:40 p.m., over five hours after our original call, a tow truck from Ft. Jones, CA, close to Yreka (one of the northernmost towns on Ca's Hwy 5) rescued us. We were so elated to see that truck. We discussed that at 10:00 p.m. in middle-of-nowhere, CA, there were no mechanics that would probably look at the car until Monday (and I was on call today), and so we were kind of stuck with towing the car back to Arcata which, at $4 per mile (apparently my AAA basic membership covers a measly 5 miles of towing), was not cheap! I also got quite carsick on the very winding roads on the way home, but our driver, David was quite good-natured about having to hose off his truck's side after I tossed my cookies. Ugh. David had the bright idea to tow our car straight to the Eureka Toyota dealership which has looked at my car before (and which has an after-hours key drop), and then he dropped us back at home. We were in bed by 3:00 a.m., after a very looong day.

Lessons learned:
1. Do not drive over rocks
2. Always have your phone charged
3. We need to invest in a better AAA membership

I'll probably find out tomorrow how much damage there was to my car but we are thankful to be home, safe and sound.

Brass Makes it Better

I had a rough day today. I am not sure many people (outside of my medical and residency friends!) know/appreciate how stressful and exhausting it can be to be a family doctor, especially in a new system and where more than 50% of patients are "new patients to establish care." It is not a big deal to see and treat a new healthy person in 30 minutes (and enter all of their information to our medical record), but when you have someone (or back-to-back people) with not only a mile-long list of meds to enter to the EMR and then their own laundry list of complaints to address in one visit, along with our documentation requirements (which sometimes takes more time than the actual patient visit itself!) and their 50 pages of outside records to review, it all adds up. It can be totally exhausting and it is on days like these that I envy people who have "normal" jobs.

For just one post, I'd like to vent a little and to speak some words of advice to all of you who may be patients at some point-- some dos and don'ts, if you will, of how we (or I) feel patients should act.

1. DO arrive on time.
We ask patients to arrive 15 min before their scheduled appointment time. I really feel strongly that this is one of the most important rules to adhere to in terms of patient etiquette. Your time with the doctor starts at the time your appointment is, so if you arrive 2 minutes before that and don't get into a room until 7 or more minutes later, you will (well, should) be limited in your time spent discussing your concerns. Of course, most of us providers feel bad/rude about cutting patients off, so basically late patients throw off the rest of our day, making other patients (who may have been on time) suffer, and requiring us to use our lunch hour to finish charting or stay late at work when we also have other things to do. I know that doctors sometimes run late. But most doctors run late because late patients make them late.

2. Don't bring a laundry list
We have "annual/new patient" 30 min time slots, and we have 15-min "acute" time slots (which should be quick visits like blood pressure follow-ups, colds, UTIs, etc.). When patients in a 15-min slot (or even a 30-min one) bring a "list" of concerns to discuss, I really, really cringe. Just make a longer appointment, please. Patients may feel that doctors prefer them to space out the intervals between visits and just cover more at the more infrequent visits. No, no, NO. I would rather see you daily or weekly for one concern each time than have you "bolus" me with multiple complaints in a short visit. Do you honestly think I can do a good job of treating your asthma/diabetes/foot pain/skin lesions/ vaginal discharge all in one appointment?!?! And please avoid the "by the ways" (which include adding on a work note, etc.) at the end of your appointment when your doctor has physically and mentally moved on-- bring it all to our attention up front, and you will make our lives 100% easier.

3. Know what medications you're on
Do you think I will have a good understanding of how to treat your blood pressure if you don't know the medication OR dose that you're on? It boggles my mind how rarely patients will think to bring a medication list, or the medications themselves (which is what I'd recommend if you're on more than about 3 meds) to the doctor's office. Please do. You will be better treated.

4. Take your doctors' advice
It frustrates me when patients (and parents of children) decide against recommended vaccines and then are frustrated by the frequency of (largely) winter infections. The flu shot will NOT give you the flu. The TDAP shot IS strongly recommended (I had a case of pertussis last week) regardless of how much you hate shots. For a humorous take on vaccine-refusal, read this article here. I spent a good part of my Tuesday (my day off) coordinating an outpatient infusion for a patient who then refused to go get it. Please know that medical school does teach us something, and that there are good reasons for what we recommend.

5. Be accurate with your allergies
Please don't tell me you're "allergic" to penicillin because you have a family history of it. Most "penicillin-allergic" patients are not, and, until you have severe hives, swelling, or anaphylaxis, I'm likely to offer you amoxicillin or keflex. Please also don't tell me that you're "allergic" to poison oak (which you can actually list as a bona fide allergy in our EMR). Really, who isn't allergic to poison oak? I certainly haven't been prescribing a lot of poison oak lately. There are also big differences in "allergies" and "side effects."

Okay, I think I'm done. Deep breath.

After today's clinic day, I really needed the relaxation and joy that was brought to me with tonight's concert at Humboldt State, which featured the Canadian Brass.

I LOVE brass music. I love holiday music. And to have them both in the same evening was such a gift! Seeing the quintet up on the stage really made me wistful for and miss the time of my life devoted to music and music performance, but it is still great to be able to appreciate the music from the audience. This show was a fantastic way to spend an evening-- the group demonstrated superb musicianship, and was additionally extremely entertaining, with real singing and dancing (they did a "Ballet Tribute" at the end) amidst/during the musical numbers. The program included various Bach highlights including the "Little Fugue," as well as some less traditional arrangements (i.e. Brahms) for Brass and even a Tango.

If you have time, listen to this You Tube clip [with group members of yesteryear] of their finale, "Saints' Hallelujah" (a mash-up of "Oh When the Saints Go Marchin' In" and Handel's "Hallelujah Chorus" from "Messiah."



Ah. Brass does make it all better.

Pre-Christmas Reunion in Oakland

(can you spot us in this photo-from-above, taken by Wai Kiu?)

We made another trip to Oakland this past weekend to stay with Wai Kiu, Hanh, and Mason and enjoy a post-residency reunion of sorts! The Lees hosted a White-Elephant-type Christmas party (a bit of a residency tradition), with lots of delicious food and a good amount of gift-stealing (but less than in previous years' parties!). We got to reconnect with lots of our old residency friends, some of whom work in the SF Bay Area, and others who made the trip from Sacramento. Wai Kiu definitely gets credit for a few of these pictures-- the lighting didn't work so well with my lens. We loved his 11-foot (real) Christmas tree!

The array of gifts to start the exchange


Tony holds up Operation!


Katherine tries to hold on to the "Tea Posy"....


... which Serena then snatched up


... so Katherine "went fish."


Steve ended up with a Christmas cookie sheet...


Joe + Abigail


Mason was perfectly happy to play with Serena's Ipad for the night...


... while Abigail pushed around "Lightning McQueen"




Vin tried all night to get rid of his Emergency Kit...


... but I think he went home with it.
I came away with a battery-powered cow-print foot-massager which, I admit, I actually stole from Steve; however, I have not tested it out yet!

On Sunday, we stopped by the Montclair Village Farmers' Market (which goes year-round!) and found these odd-looking "Budda's Hands" (part of the lemon family).



Mason had the opportunity to get on the Fire Truck, but was not really digging it (particularly the hat)...


And, all you parents out there, do not be alarmed by this photo:


We are definitely MDs who believe in carseats and all that good stuff. Kelvin was just moving our car out of the driveway, and Mason enjoyed beeping the horn :)

It was a fun weekend!