Spring Cleaning

It is definitely springtime in Sacramento-- my terribly itchy eyes and runny nose indicate this quite well. It seems like the rain may have stopped, and now we will be blessed with cloudless/sunny 70-80 degree weather which is perfect for frisbee.

But in addition to frisbee-playing (which unfortunately, last week, gave me a left knee contusion and sprained right shoulder--- ouch!), I have been a bit manic in recently doing some extensive spring cleaning.

I am overall quite a neat and organized person by nature. When I was younger, I used to compulsively clean my room and run around the house in a "Cinderella" apron. I remember that our "attitude towards cleanliness" was one of the questions on our college (roommate- matchup) questionnaire. I remember that Cathleen's mom would not let her send in her form with her original reply, "moderately neat," as she felt it was untruthful! In fact, our room often (well, mainly her side ;), was often in a state of quite disarray; however, it didn't tend to bother me, because it wasn't my stuff. We got along extremely well as roommates and continued friends!

I have been frustrated lately by the clutter that has accumulated in my small one-bedroom apartment, which lately has been feeling way too small. My living room includes the storage of: my bike, which I refuse to leave outside for fear that it (my reliable transportation to work) could get stolen, an electronic keyboard I bought last year, as well as various items of now-necessary "gear," including skis/poles, snowshoes, a tent, camp chairs and Thermarests, sleeping bags, etc. I have a lot of stuff which I just don't think is dispensible!

However, after visiting grandma in MN in April and watching various TV shows on the "pathology of hoarding" (yikes- eye openers indeed!), I have vowed to make my place neater. When my Dad stayed with Grandma after her hip surgery in February, he basically either chucked, or relocated (she's still not sure which) her various cluttering knickknacks, decorations, etc. to the spare bedroom (which was impassable, necessitating my sleeping on the couch). When she moved from the farmhouse to this apartment in town, she tried to hold onto a whole lot of stuff which she's found it hard to part with. I hope I never accumulate so much "junk" over my lifetime.

While we were in Vancouver, Rocky told us a story about one of her patients who recently died. Probably due to an absence of close family and due to Rocky's name being all over papers and medications, the police called her, as the patient's primary care doctor, to go to the patient's house. In short, the patient was found lying down in the only patch of free floor space in the cluttered apartment, which was stacked high with magazines and other junk, her various pill-bottles (most unopened) piled high on her bed. This was a sad story, but combined with the various shows I watched on "why people hoard," was incredibly motivating to me to never ever get that bad. I know that moving frequently tends to initiate purging of "stuff," and perhaps since I've stayed put for the last 3 years here in the same apartment, I have gotten a bit lazy. However, in anticipation of the possibility of moving again next year, I thought I'd start weeding stuff out now.

So I have spent the better parts of the evenings over the last few weeks, sometimes staying up well beyond my preferred 9:00 bedtime, going through the various parts of my apartment, trying to organize and jettison large amounts of stuff. I was very successful with my desk and vertical file rack; my desk is now incredibly clear and open. My notes from med school classes are now recycled (I always find it so hard to throw away "knowledge"!), and several textbooks have found new homes with UC Davis med students. A few Target "gray bins" later, my "kitchen corner" looks drastically neater. My closet is organized (it hadn't been this way since last March, when Cathleen [formerly the messy one!] voluntarily arranged all my clothes for me!), my dresser is cleaned, and clothes given away. The bulky (and not that effective) foot/calf massager that sat under my desk, and the aerobic stair-stepper I schlepped from MN (and have used a grand total of about two times) are on the market on Craigslist (where I had never attempted to sell anything before now). Even if no one buys them, they are going to go.

These are big steps. Now, if I can only stay away from spring and summer yard sales :)

Computer update

So my premonitions that my Dell laptop was on its last legs was correct. I've had the Macbook for a few weeks but it only came out of its box last week. Its use has dramatically increased, though, since my laptop screen seemed to bite the dust on Thursday. Now, after I boot up my old PC computer, I have a blank, black screen making everything on it inaccessible. Luckily, I had backed up my harddrive about a month ago, but now have lost everything saved on the desktop since then (unless one of you computer geniuses out there can help me figure out how to blindly save things from my computer onto another form of storage).

We were able to get Microsoft Office loaded successfully, making it possible to use word processing and excel spreadsheets (surprisingly, I haven't had any issues with compatibility), and I surf the internet quite well.

All the icons at the bottom of the screen sort of freak me out, I haven't gotten used to the "one toolbar at a time per application" feature, I still automatically hit "CTRL + ***" rather than the funky "command key," and I don't have the "two finger touch to right click" thing down yet, but I'm learning.

I've had some frustration (well, frank failure) trying to load the Linksys wireless router CD setup in order to broadcast wireless in my apartment, but, with Char's help tonight, might be able to get this feature up and running.

Despite the above, I have to admit that the computer is quite fast. I like the feel of the keys on the keyboard. And, most importantly, the computer is very sleek and pretty :)

Crater Lake and Coastal Redwoods

I have to say that I am loving being a third-year resident, in contrast to my many months spent as an inpatient slave my first two years of residency. My inpatient and call schedule was a bit "front-loaded" this year, so I have had so many free weekends this spring (just two calls [acting OB chief] left) to be able to travel (before I look forward to 5 months on OB next year...)!

This weekend, Kelvin and I decided to do a "northern" trip to explore Southern Oregon/Crater Lake National Park, and also see some of the California coast. While I was lucky to have Kelvin to do the driving (I absolutely hate long drives but am happy to navigate), the scenery, from start to finish, was absolutely breathtaking, as you can see from the numerous pictures below.


Our view of Mt. Shasta (14,179 ft) on our drive up the I-5 North to the CA/OR border


I could not snap enough pictures!!

Vista point (with sun going down)

We stayed overnight in Medford, OR (in the Rogue River Valley), before heading out on Saturday the further 70 miles to Crater Lake National Park. The park, which was founded on the volcanic crater of Mt. Mazama, is the sixth oldest national park in the U.S. and houses the gorgeous lake, which, at 595m deep, is the deepest lake in the U.S.

The elevation is 7000-8000 feet at the caldera rim, and most of the rim trail is closed between July and October; however, the park is open year-round for the winter activities snowshoeing and cross-country skiing (assuming the roads are clear enough to reach the rim). Since I'm not sure how much free weekend time I will have next year, we decided to just go enjoy the park, winter-style, on the 7-8 feet of layered snow.

Sign at entrance to the one open visitors' center

Kelvin, southern-CA boy, by the snow-wall

Views from snowshoeing around the rim

Wizard Island sits in the middle of the lake

Don''t these look like postcards? :)

Some self-portraits...

... until we broke down and asked someone to take a picture of the two of us :)

Snow-angel ...

... and a face plant? :)

From Oregon, we returned back to California via the coastal road 101 through the hundreds of miles of Redwood forests. A John Steinbeck quote summaries my feelings about these trees, which I believe is one of the most spectacular sights in the world: "The redwoods once seen, leave a mark or create a vision that stays with you always...from them comes silence and awe. The most irreverent of men, in the presence of redwoods, goes under a spell of wonder and respect."

This was my second trip to the redwoods, my first being during my first intern vacation; however, I had never seen the northern most parts that stretch to the Oregon border and it was Kelvin's first time to see the coastal redwoods (Sequoia sempervirens), trees which have been around for 20 million years, live up to 2000 years, and grow up to 370 feet high. They are truly amazing.

These two pics give a sense of how massive these trees are:

We camped in Prairie Redwoods State Park (Elk Prairie Campground, which was appropriately named by the wild elk that wandered by our campsite)

Today, we drove the remainder of Hwy 101 in northern CA and through the Avenue of the Giants, seeing more great trees.

This gives you an idea of the expansiveness of one tree's root base

Founders' Grove

We had to go to one drive-through tree park; you can see Kelvin in my Prius going through the Chandelier Tree)

I took a picture in the same tree when I went solo in 2007. We obviously can both fit easily in this hollowed trunk!

What a great trip! The natural wonders of California and the west coast never cease to amaze me. Come visit, and I will show you :)

Rotation Dreams

I am on my last day of my two-week block rotating on Urology (well, 3 days a week of Urology, and then FP clinics for the rest of the time). I always think it is so great when, after spending time in a specialty, I start thinking of myself as "one of them," or at least imaging what it could like to be a xxxx-ogist. I think this is part of the reason that I found it so hard, during my fourth year of medical school, to decide on a "specialty," because (with a few exceptions-- radiology, pathology, anesthesia [sorry, Hans]), I really liked just about everything (which is why I am here in Family Medicine, which is a great fit!)!

I have similarly had a great time on many of the "specialty" outpatient rotations we do as part of family medicine training (dermatology, ENT, ophthalmology,etc.). This Urology block, however, has probably been my favorite rotation of residency yet! The doctor who I've been working with has been out in practice for over 30 years, and is a wealth of information. He also has an excellent sense of humor, is very good to his patients, and is, additionally, very well travelled and well-rounded. In addition to getting a lot of prostate exam experience, learning vasectomies (a procedure I really want to do when I get out of residency), and learning how to competently manage a ton of urologic problems, including BPH, kidney stones, hematuria, scrotal masses, hypogonadism, incontinence, erectile dysfunction, prostate cancer and more, I have gotten to hear about and see pictures of a bunch of the countries he has recently visited and listened to Tom Lehrer's songs on his office ipod speaker system.

It has been a great two weeks! A few patients kicked me out of their rooms when the time came for the exam... I guess this was expected, and I sympathized with my male colleagues who often get rejected from women's rooms for GYN/cervical exams or deliveries. In any case, if I wasn't a family medicine doc, I think I could totally be a urologist :). I may come back for a few half days in August when there is not another resident on with him because it has been a joy!

In other "rotation dreams"... I have elective time in August and have been dreaming, for many years, of going to Alaska. When we put in our schedule requests for next year, I specifically asked for elective time during the summer so that, if I was able to go up north to be able to complete a rural medicine rotation, I wouldn't freeze off my rear end. After moving to CA from MN, I am somewhat worried about wintry weather, although perhaps I could again get used to it if I were to spend a significant amount of time up there. However, I've been told that, due to residency/clinic requirements, I am only able to take 2 weeks that block to spend away.

I have emailed and called a bunch of different places, including in Nome (where one of my medical school classmates, Marla, rotated last year), Bethel, and around Anchorage and Sitka, but I'm not having much success in getting "accepted," because I am not able to sign on for four weeks. I just submitted one more application and am communicating with a smaller private practice to see if they will be able to accommodate me. I have my fingers crossed. Let me know if you have any inside connections to doctors/practices up there, so that I can spend time in what I imagine is an unbelievable state with great opportunities for practicing medicine.

Approved texting

I'm still not a big texter, but I've gotten a LOT better.

It feels a bit strange to promote an activity that I have so often denounced, but I thought I would post a quick note on something which has come up a few times in recent conversations and reading: the TEXT4BABY Campaign.

As someone who takes care of a lot of pregnant women and has a particular interest in maternal and infant health, as well as someone who is rather jealous of 99.5% of the population that is superior at texting than I am, I thought I would mention what a great idea this seems to be.

This campaign is a new (as of February) private-public partnership which pays for free texts to expecting and new moms to remind them of various pregnancy milestones and tips for newborn care. All a Mom has to do is text BABY (or, in Spanish, BEBE) to the number 511411 and enter her due date in order to be registered. The idea came from a chairman of a tech firm that planned to send texts as health reminders in developing countries, where the apparent access to cell phones exceeds the access to health care.

Pass this word on to your friends and patients!

Vancouver STFM Conference

This past weekend's adventure was to Vancouver, B.C., for the STFM (Society of Teachers in Family Medicine) Conference.

It had been over 10 years since I had been to Canada (ah, band trips...), and it was a blast, both educationally and sightseeing-wise!

There was great FM faculty and resident attendance, despite some of our only being able to "be gone" for limited periods of time, due to clinic/hospital responsibilities (Char flew in for less than 24 hours!)

Jeremy, Ashby and I got on a 6:15 AM flight from Sac, through Portland, to Vancouver on Saturday AM (I don't think I'd been at the airport that early... ever!!), and arrived at the hotel by noon-time. We checked in, got our badges for the conference, and got to do a bit of exploring of this beautiful city!

While the weather wasn't the greatest, we did walk around a bunch Saturday afternoon.

Vancouver has a very neat, clean downtown, with a nice waterfront.

Above is the CANADA sign above the "Canada Place" convention center by the waterfront.

Here are Ashby and Jeremy, posing by the maple-tree flags :)

Vancouver (like much of the west coast) has a large Asian population, and one of the largest Chinatowns of any city I have been to. We wandered amidst the streets, shops, and visited a pretty garden in the center.

Ashby, Jeremy w/ the guarding lion

Park Pagoda

Weird sign we saw in a mall:
You're right, I won't let you have Oxycontin over the counter!

Sunday morning, we went to a fabulous speech by a doctor who spoke about his challenges and joys, as a patient who suffered a devastating accident but who is now snowboarding and skiing with a prosthesis. I went to a lecture/discussion about a global health curriculum, and then got to visit the posters of and speak to other residents and clinicians about their experiences with important clinic topics such as continuity in FP clinics (a topic about which I am very passionate). Ashby and Kyla also presented an awesome poster about the factors going into graduates' decisions to practice/not practice OB after residency.

We took a short ferry ride across to Granville Island, which was filled with cute shops, markets, and galleries.

Ashby, Jeremy, Kyla, and me with Harry the Hippo.


A gelato cone, and view of Vancouver city (can you see the snow-capped peaks in the distance?)

We had a wonderful seafood dinner on Sunday night, with the whole UCD crew (about 20 of us!!)down by the waterfront and "Gastown" district, which is the main historic part of Vancouver.

Monday morning, I ventured to Stanley Park on a run, and had great views of the mountains!

Then, Char, Rocky, and I presented our poster on Obesity Management (we have a weight-mgmt clinic within our FP clinic which is efficacious in improving patients' 1- and 2- year weights). We had a lot of visitors!

Char, me, Rocky (pic stolen from Char)

Jeremy and I then had to try the Japadog stand outside our hotel, where there was always a n extremely long line!!! I had a yummy "Oroshi" dog, with Japanese mayo, horseradish, and the works! MMM.

Ashby and I then had to book it back to the airport, via Sky-Train, to fly back to Sac.

A short trip, but very worth it! I learned and saw a lot!

Now, if I can only figure out how to get off OB to be able to attend next year's conference in ..... NEW ORLEANS!!!

Earth Week and Sonic Boom

Tomorrow (4/22) is Earth Day! I have loved recognizing "Earth Day" ever since I was little.
I am not sure exactly how or why I became such an enthusiastic conservationist, but sometime around the end of elementary school, I decided to create a "scrap paper drawer" and ever since have extended my anti-wasting attitude towards many things ... including fruit and foods that most people argue should not be salvaged :) Before I forget to mention it-- in honor of Earth Week, ALL national parks are offering free entrance this week (4/17- 4/25) so, if you live near one, GO!!!

In addition to cutting down on waste, I also thought that, this month, I would try to do a little "cutting down" on some other vices. Kelvin and I were overseas in Asia in February and I kind of missed the Lent bandwagon this year in terms of "giving something up." I have also been, with travel and long hospital hours in March, not doing very well in the healthy eating department, finding myself overdoing it with sweets and sodas (I have become quite a little Diet Coke addict). So, with these various factors in mind, as of last week, I planned to give up both sweets and soda for at least a month. This probably doesn't help the earth in the slightest, but it is in the spirit of anti-indulgence that I thought it was somewhat relevant to this post.

I am also going to try something which some might find weird: giving up daily hair-washing. I don't know what most girls (or guys?) do, but I have been, for as long as I can remember, a daily-hair-washing person. I so envied my college roommate, Cathleen, who, despite working out daily with the track team, only washed her (always gorgeous-appearing) hair a couple of times per week. I truthfully am not sure I can get away with this due to my "hair type" because I always think it looks a bit weird and greasy after about a day, especially with attemped workouts in the mornings. However, I am going to give it a shot. I have located a very stylish shower cap from some hotel I stayed at once. I will still shower daily, but think I will save water by not washing the hair as much. Reducing the hair-washing frequency may make my hair healthier (?), but I wonder if I'm going to have to start straightening it or something to make it look presentable, which would kind of negate the environmental purpose and the health-purpose of such a stunt. I was told that my scalp will "get used" to the less-frequent washing, and reduce its grease production accordingly. Amy told me that there exists "dry shampoo" which might be worth trying. True stuff? I welcome any and all tips about surviving with q.o.d. hair-washing.

With all that "saving," it was about time that I did a little indulging, right? Well-- the indulgence was at a little fast food place called Sonic, which I have heard so much about (esp from my Florida friends), but which I had never tried. I didn't think that they existed out here, except in Fresno (about 2-3 hours south of Sacramento); however, Kelvin found out that there is one in Roseville, 20 miles from Sac and just down the street from the Urology office where I am currently rotating. The "jumbo" popcorn chicken was not so jumbo, but the jalapeno burger was awesome, and the drinks (cherry slush and a lime "chiller," which made me feel quite a bit guilty because it was kind of dessert-y and so tasty) definitely got gold stars. I will definitely head there again!!

Happy Earth Day, everyone! [Maybe you can celebrate at the Sonic by you :) ]