Senator John Kyl reports Democrats likely to pursue nuclear option in Senate

Breitbart has audio of John Kyl on the Hugh Hewitt show Thursday night. (H/T ECM)

Kyl says the Democrats will try to pass Obamacare with 51 votes:

This is kind of breaking news. As you say, we’re just hearing it. We haven’t been formally advised, but we have it on relatively good authority. And this would be what they call the nuclear option. This would be we can’t do it with 60 votes, because now we have a new Senator from Massachusetts, so we’ll do it with 51. Now it’s called the nuclear option, because it really upsets all of the tradition and precedent within the Senate which on a really big bill on the magnitude of health care, would always have strong bipartisan support, and therefore the 60 vote requirement really doesn’t matter.

They’ve learned nothing from the election of Scott Brown, and their other setbacks.

[Via http://winteryknight.wordpress.com]

The Future of Medical Education in Canada (FMEC): A Collective Vision for MD Education - The Association of Faculties of Medicine of Canada (AFMC) - 28 January 2010

The Future of Medical Education in Canada (FMEC): A Collective Vision for MD Education – The Association of Faculties of Medicine of Canada (AFMC) – 28 January 2010

“Just as Abraham Flexner’s report did 100 years ago, The Future of Medical Education in Canada (FMEC) project looks at how the education programs leading to the medical doctor (MD) degree in Canada can best respond to society’s evolving needs. In turn, the FMEC project is rooted in the Association of Faculties of Medicine of Canada’s (AFMC’s) articulated social accountability mission for medical schools.

Health care has become increasingly complex and faces enormous challenges in providing quality care to diverse populations. An important need has developed for a cohesive and collective vision for the future of medical education in Canada. While Canada’s Faculties of Medicine are leaders in medical education, continually adapting to changing expectations and requirements, the physician of the future requires skills that will involve further adaptations and reforms to our medical education system.

The 10 FMEC recommendations for MD education (also known as undergraduate medical education) are grounded in evidence and emerge from a broad and rigorous consultative process. They are as follows:

1. Address Individual and Community Needs
2. Enhance Admissions Processes
3. Build on the Scientific Basis of Medicine
4. Promote Prevention and Public Health
5. Address the Hidden Curriculum
6. Diversify Learning Contexts
7. Value Generalism
8. Advance Inter- and Intra-Professional Practice
9. Adopt a Competency-Based and Flexible Approach
10. Foster Medical Leadership

They are accompanied by five enabling recommendations that will facilitate the implementation of the FMEC recommendations:

A. Realign Accreditation Standards
B. Build Capacity for Change
C. Increase National Collaboration
D. Improve the Use of Technology
E. Enhance Faculty Development”

…continues in the document

[Via http://kinwahlin.wordpress.com]

Seriously? 2nd Pregnant Man!

This amazes me. I’m transgendered and can not wrap my own head around this. Pregnant Man and his transgendered husband are expecting. Ok so I had to put my 2 cents in on this. Cause from my own personal view I can not imagine doing this. I have such a problem with being female I can not begin to think I would do this. EVER. I’m planning to have my stuff yanked out. Hopefully in May!

It brings me to a question. How can you be pregnant and still be male? I’m all about gender being fluid. But to me pregnancy on the complete feminine end of that spectrum. To me it’s a maternal thing. I guess I can’t understand this.

To me, this is good and bad for the community. It brings an awareness to the community, but not all press is good press. This man and family just like the last pregnant man will face a lot of ridicule. I will see how the world reacts to it.

[Via http://sethisaboy.wordpress.com]

Day 19 ~ 19th January, 2010

Today I have finally gotten around to talking about GlucaGen, unfortunately this is due to the fact I had to use it this morning.  I woke up this morning and noticed that James was sweaty and hadn’t moved when the alarm clock went off.  I grabbed the meter and checked his level – 1.2mmol/L.  I loudly said his name and shook him and got no response.  I then grabbed the GlucaGen box that lives beside the bed and administered the injection.  Around 10 mins later James’s level was thankfully heading upwards.

This little orange box contains a lifesaving injection of glucagon.  There is a syringe of saline, and a vial of powder.  This is used when a person with diabetes is unconscious or cannot have glucose orally.  It works by causing the liver to convert stored glycogen into glucose and release it into the bloodstream, raising blood glucose levels.

The first time I ever used this injection I was so worried!  I read the information in the box, injected the saline into the vial, shook it up to mix, drew it back up into the syringe, got rid of the air bubbles and looked at James’s leg…..

looked at it….

looked at the huge needle in my hand….

and looked at his leg again.

I knew that I had to give the injection, but I was worried about hurting him.  Then I finally realised that he was unconscious, he wouldn’t feel it and that the injection wouldn’t make things worse.   So I did it.  A few minutes later James came to.

Since then, I have unfortunately had to give this lifesaving injection a number of times.

Caring sometimes involves doing things that will hurt the one you love, so that you ultimately save their life.

[Via http://acaringproject.wordpress.com]

Anti Aging Benefits from Omega 3!!!

In a recent study published by UCSF, research has shown omega-3 fatty acids may slow biological Aging.  We already knew omega-3s help fight belly fat and over all body inflammation but how know anti- aging would be added to the list?  The study was focused on patients with established cardiovascular disease and found it is a very strong possibility “omega-3 fatty acids may protect against cellular aging in patients with coronary heart disease”.  In addition to the positive effects of omega-3’s individuals who took a daily multivitamin saw similar anti-aging effects on cellular turnover and re-growth.  The test run on study participants were repeated after 5 years.  A prescription grade omega-3, such as the Zone Omega Rx carried by execuSlim, is an excellent tool to help fight aging, belly fat, heart disease and stress.  Stop by the office to pick up your prescription grade omega-3’s today only $50.00 + Tax.  Call Today 310.657.0366!

 Journal of the American Medical Association
2010, Volume 303, Issue 3, Pages 250-257 “Association of Marine Omega-3 Fatty Acid Levels With Telomeric Aging in Patients With Coronary Heart Disease” Authors: R. Farzaneh-Far, J. Lin, E.S. Epel, W.S. Harris; Elizabeth H. Blackburn; Mary A. Whooley

[Via http://executiveer.wordpress.com]

Links from the Weekend

* Slate devotes a column to criticizing the U.S. military-based approach to Haitian emergency relief. There’s some attempts at push-back, with varying success, in the MetaFilter thread, particularly about the specifically helpful capacities of the ships that have been sent there,but what can you say about facts like these:

Air-traffic control in the Haitian capital was outsourced to an Air Force base in Florida, which, not surprisingly, gave priority to its own pilots. While the military flew in troops and equipment, planes bearing supplies for the Red Cross, the World Food Program, and Doctors Without Borders were rerouted to Santo Domingo in neighboring Dominican Republic. Aid flights from Mexico, Russia, and France were refused permission to land. On Monday, the British Daily Telegraph reported, the French minister in charge of humanitarian aid admitted he had been involved in a “scuffle” with a U.S. commander in the airport’s control tower. According to the Telegraph, it took the intervention of the United Nations for the United States to agree to prioritize humanitarian flights over military deliveries.

Meanwhile, much of the aid that was arriving remained at the airport. Haitians watched American helicopters fly over the capital, commanding and controlling, but no aid at all was being distributed in most of the city. On Tuesday, a doctor at a field hospital within site of the runways complained that five to 10 patients were dying each day for lack of the most basic medical necessities. “We can look at the supplies sitting there,” Alphonse Edward told Britain’s Channel 4 News.

The much-feared descent into anarchy stubbornly refused to materialize. “It is calm at this time,” Lt. Gen. Ken Keen, deputy commander of the U.S. Southern Command, admitted to the AP on Monday. “Those who live and work here … tell me that the level of violence that we see right now is below pre-earthquake levels.” He announced that four—four, in a city of more than 2 million—aid-distribution points had been set up on the sixth day of the crisis.

* Some good news: the IMF claims it is “pursuing” the total elimination of Haiti’s foreign debt. And some terrible news: by one estimate (highlighted by Marginal Revolution) a full 8% of Haiti’s population may be orphaned children.

* 11 Things You Didn’t Know About Pinball History.

* From the comments: The Five Dials tribute to David Foster Wallace.

* David’s Cross’s The Increasingly Poor Decisions of Todd Margaret has been picked up by the BBC. My friend Bill posted a clip from the pilot not long ago, which he played at his recent show at Raleigh.

* Fan art gone terribly wrong/terribly right: Seinfeld Star Wars.

* Auto-appendectomy in the Antarctic: a case report. (Thanks Neil!)

* Via Ezra Klein, I see Tom Toles has somehow gotten hold of the Democratic playbook.

* Glenn Greenwald has a balanced piece largely in favor of the Citizens United v. FEC. Others are saying this decision may give foreign multinational corporations the right to participate in the American political process. Citizens United is by all appearances the first major domestic political crisis of the ’10s, and it came early; if I had sway in the progressive blogosphere I would suggest we devote ourselves to demanding the introduction of a constitutional amendment that reverses this decision by modifying or eliminating corporate personhood. That fight would not be easy—as Matt points out the total spending on Senate campaigns in 2004, $400 million, was just 17% of the marketing budget of a single American bank, which means our already corporatist ruling class would have every possible incentive to ignore such a campaign—but I don’t see much choice; it’s hard to imagine any sort of functional democracy existing in America while Citizens United remains in full effect.

* Republicans believe that Obama’s problem is that he’s pushing so much government intervention in the economy. That’s undoubtedly part of the story. But Obama’s larger difficulty is that he’s pushing so much change at a time when filibuster threats are so common that it requires 60 Senate votes to pass almost everything — and the minority party won’t provide the president votes on almost anything. We are operating in what amounts to a parliamentary system without majority rule, a formula for futility. Steve Benen has a post on the filibuster reform recently proposed by Tom Harkin here.

* Are Republicans “irrationally exuberant” about November? God, I hope so.

* For what it’s worth Obama’s poll numbers continue to match Reagan’s, and he beats nearly all comers in 2012. The one possible exception is the affable, if politically odious, Mike Huckabee, who beats Obama 45-44 in a PPP poll. And it was Huckabee himself who predicted just this week Obama will win again in 2012.

* NASA says 2000-2009 was the hottest decade on record. Good thing climate change is a myth.

* The immortal Neil Gaiman is profiled in the New Yorker.

* The last days of Philip K. Dick.

* And if my estimates are correct, we could hit Peak Crayola as soon as 2018.

[Via http://gerrycanavan.wordpress.com]

44-D's LIVE Blogging: "<em>Hope for Haiti Now: A Global Benefit for Earthquake Relief</em>"

Posted by: Audiegrl
As you may have heard, tonight’s multi-network 2-hour “Hope for Haiti Now: A Global Benefit for Earthquake Relief” telethon is being held to raise funds in the wake of the devastating earthquake last week. In part of our continuing coverage of Haitian relief efforts, 44-D’s will be live streaming and blogging the program tonight, Friday, January 22, at 8pm ET. Please feel free to join us to help promote awareness of this important cause.

The two-hour commercial-free telethon will be featuring the following performers and participants:

[Via http://the44diaries.wordpress.com]

We Need a God Who Can Teach Us How to Be Old

Here is a conversation between the main character/narrator and a dying Jesuit hagiographer:

     “I have not yet found a God to teach me how to be old,” I said.  “Have you?” 

     “Shhh, not so loud.  The nuns must not know in what a spiritual state I am.  Yes, yes, I have found Him, and He is the very best of company.  Very calm, very quiet, but gloriously alive.  We do, but He is.  Not in the least a proselytizer or a careerist, like His sons.”

Not really an amazing book, but a book with amazing sections, writing, and ideas.  And it’s not just because I’m a chaplain.  Truly, we need a god who can teach us how to be old.

[Via http://tasersedge.wordpress.com]

THE FUTURE OF INTEGRATED HEALTH CARE

he future of Health Care is a subject that has been under intense speculation and debate in recent times across different forums. For the first time ever, Ergonomidesign have made it possible to actually experience the future of Health Care. Following the launch at the Medica/ Compamed trade fair in Germany, Nov. 18-20, Ergonomic design will present and demonstrate a future application that brings together 40 years of design experience in the Life Science industry. Combining a fully functioning prototype with a well resolved service-ecosystem, Ergonomic design will demonstrate “The Future of Integrated Health Care”. The application- “Helping Hands” (a Natural User Interface developed on a MS Surface table) enables an experience of how we will manage our health in the future. The concept combines the benefits of ubiquitous computing with a merger of Health Care services with Internet service providers. This merger gives rise to an exciting ‘ecosystem’, one that will bring cure to our doorstep or literally to the palm of our hand. Much like the mobile ‘app-world’, pharmacies would be able to sell a variety of Health Care devices containing embedded software that synchronizes with relevant devices and our body automatically. By the year 2015, vast amounts of personal data will constantly be uploaded in real-time to the “Cloud” – for others to use, share and benefit from. Through embedded sensors in our clothes, wrist watches, necklaces, shoes etc. it will be possible to constantly monitor our biometric data. These vast amounts of data pushed to the Cloud, is accessible to a network of ’smart objects’ e.g. mobile devices and ’smart’ homes, furniture and environments. Our biometric data will be accessible everywhere, constantly – to us and those who we have granted admission, e.g. our doctors, family and relevant networks. The Cloud also allows constant access to contacts and services in our vast directory of doctors, fellow-patients and other daily health-care programs such as diet, exercise and prescription medicine. The experience comprises lucid scenarios, personas and a working prototype. It has been developed by the Ergonomic design Life Science Team, including interaction designers, design strategists, graphic designers and health care professionals. Their challenge is to envision a complex future and develop user friendly solutions for the world to understand and use. By “The Future of Integrated Health Care” the designers have created an experience that combines intuitive gestural interactions with well-resolved service scenarios for the Life Science industry. ( Source: dexigner.com )

[Via http://5magazine.wordpress.com]

Marrow Drive for 8-month old son of National Semiconductor Employee

Barry Pham, the 8-month old son of National employee Linh Truong, is fighting for his life.  He has been through chemotherapy for biphenotypic acute leukemia and is now in need of a bone marrow transplant to survive.  His family members have all been tested, and unfortunately, there is no match.

Linh and her entire family have been working tirelessly to get as many people tested to see if they might be the one to save Barry’s life.  To help her, National is partnering with the Asian American Donor Program (AADP) to hold marrow drives for Barry and others in need of transplants.  We are hosting a drive at National THIS Thursday, 1/21 from 11am – 2pm at the Cafe Store. We are expecting over 150 employees, their family and friends to participate.  Any of you are welcome to come – just let me know.

As you can imagine, Barry’s story has touched us all and I promised Linh I would do whatever I could to find more possible donors for Barry and others like him.  I am emailing today asking you to consider holding a drive at your company.

We will make holding a drive easy for you!

-There is no cost to your company or your employees

-The test is painless and takes only 10 minutes (a simple mouth-swab)

-The Asian American Donor Program provides and covers the cost for the kits, staff and materials

-National has created marketing materials that can be revised and used to promote the event

-We would be happy to send some volunteers to help with the drive if needed

-Possible attendance by Linh, Barry’s mom

-People of all ethnic backgrounds are encouraged to participate

-Participants become part of the National Marrow Registry

Attached is a flyer that we are using to promote our drive that has more information.  I also attached some of the materials provided by the Asian American Donor Program.

Please let me know if there is a chance you can join us in this effort to save Barry and others like him!

Joan Scott

Director of Community Relations

(408) 721-6437

[Via http://firstthursdays.wordpress.com]

Clomid: Tell Me About It

Okay, first things first,  here is my general disclaimer:  This information is not to be interpreted as expert advice.  I am only speaking from my personal knowledge and experience.  As always, please speak to your physician and pharmacist about your medical questions and concerns.  Second, credit for the inspiration of this posting goes to mrsowens1216 from YouTube.  For anyone wanting to find someone relatable out there on your TTC journey, MrsO is a super sweet gal who I found one night and am following on her TTC journey.  I am going to embed her first vlog at the bottom of this posting if you are interested in meeting someone else on this journey.

My articles on TTC and Clomid always are continuously searched and read, so I know there are a lot of you out there looking for information on Clomid.  Some of you are not yet to the stage where you need Clomid, but maybe are starting to research it as your first option.  I have taken a couple pictures for you who are wondering what it is going to look like, and how big it is.  I always have a problem with large pills, but fortunately my tablet is nice and smaller sized.  I take the generic, clomiphene citrate, manufactured by Par Pharmaceuticals.  MrsO described it well when she said it reminded her of taking an uncoated asprin.  In the picture above you can see its size along with my prenatal vitamin and vitamin D tablet.

Your first month will probably begin with a 50 mg dose.  This dosage raised my progesterone from almost non-existant to 4.  The next month my doctor increased my dosage to 100 mg and that did the trick for getting my progesterone levels up to +30.  Now I am on my third month and she stuck with the same dosage.  Most pharmacies only keep the 50 mg tablet in stock, so if your dosage is increase you take more than one pill to add up to your dosage.  The cost for my 10 tablets (100mg every day for 5 days) was $17.97 through my husband’s insurance.

My perscription’s insert lists Clomid’s major side effects as stomach upset, bloating, abdominal/pelvic fullness, hot flashes, breast tenderness, headache and dizziness.  Personally for me the worst side effect is the breast tenderness!  Way bad!  Second would be hot flashes. I thought I was coming down with the flu the first time I experienced a hot flash.  I would go from sweating hot to freezing cold a couple minutes later.  This is an unusual side effect for me since I am ALWAYS cold.  And then I would have to say I get extremely moody on Clomid.  One blogger said that Clomid’s real name should be CloMood and I couldn’t agree more.  It turned me into an angry PMS monster and then a teary, blubbering mess on cycle day 1.  But I can handle the side effects for up to six treatments if it leads to a baby.   A last note, my side effects were much more noticeable on the 100 mg dose versus the 50 mg dose.

I have to close this post (I’m totally procrastinating doing my homework, but I can’t put it off any longer).  If you have taken Clomid or are currently on Clomid please share your side-effect experience to other readers and the dosage that you were on.  Thanks to all my readers!  Don’t forget to subscribe or add me to your blogroll.

Such a sweetheart, MrsOwens1216

[Via http://autonomousblogger.wordpress.com]

Science & Soul: Book Review: Ishmael

I have read a number of books over winter break and would like to take some time to review them and hopefully give my readers some more reading!

–

Humans are actively destroying the natural world because we are captives of a cultural system that compels us to do so.

• Takers as people often referred to as “civilized.” Particularly, the culture born in an Agricultural Revolution that began about 10,000 years ago in the Near East; the culture of Ishmael’s pupil.
• Leavers as people of all other cultures; sometimes referred to as “primitive.”
• A story as an interrelation between the gods, man, and the Earth, with a beginning, middle, and end.
• To enact is to strive to make a story come true.
• A culture as a people who are enacting a story.

Our creation stories, be they Creationism or the Big Bang theory, all make the claim that man is the end product of creation; man is the creature for whom everything came to be.  However, we are not the culmination of evolution!  The universe went on as before.  Our ultimate evolution did not change much of anything.  The premise of this story, however, is that the world was made for man.  And we do whatever we please to this world because of this assumption: man was made to rule the savage world.  To do this, he had to conquer the world.  Under human rule, the world should have become a paradise, but we wound up slowly destroying it.

We say that it is our nature to do so, but I believe differently.  There are still people who live in peace with the natural world and they are no different than us.  There is nothing fundamentally wrong with humans.  Instead, given a story to enact that puts them in struggle against the world and they will do so.  We were fed a story in which the Earth was a foe to be conquered (we are conquering the oceans, we are conquering mountains, etc) and now, we have very nearly conquered it, but at what cost?

How does one achieve flight?  One must understand, or at least abide by, the laws of aerodynamics; it could be through trial and error, but you must abide by the law.  The people of our culture are learning to live by trial and error and we are not knowledgeable about the laws of life.  Imagine an early flier: one with a crankshaft atop his craft.  He takes off from a cliff and for a moment, he stays in the air.  He sees the ground approaching and says, “I just need to pedal a bit harder and will make it.”  He sees dozens of crafts just like his scattered, broken on the ground.  ”What fools.  They simply did not pedal hard enough.”  Unfortunately he crashes because his craft did not abide by the laws of aerodynamics.  Ten thousand years ago, we too began on a path to flight.  We have tried and failed many times with civilization before (ie the Mayans, Aztecs, Romans, etc), but fell each time.  We believe ourselves to be flying, but we are only falling because we are not living in accordance to one of the great laws of life…

Takers destroy their competitors to make room for their own.  In nature, the rule is take what you need, and leave the rest alone.  Takers will deny their competitors access to food; to life.  In nature, you may deny competitors what you eat, but not food in general.  Takers think everything on this planet belongs to them.  In nature, you are a part of this planet, not its owner.  All of this points to a law: “You may compete to the full extent of your capabilities, but you may not hunt down competitors or destroy their food or deny them access to food. In other words, you may compete but you may not wage war.” All species inevitably follow this law, or as a consequence go extinct. The Takers believe themselves to be exempt from this Law.  Any species that exempts itself from the rules of competition will destroy the community to expand itself.  Since we do not believe in this law, we believe that we can grow without bound.  Some new scientific breakthrough will save us in the future; we will enter the Star Trek age.  Unfortunately, like those early pilots learned, we are not exempt.

Now, let me say, civilization as we know it, in and of itself is not against the laws of competition outlined above, but it is subject to the laws.  In fact, one need not return to hunter gather society to make right the wrongs we have perpetrated on the environment.  We just need to throw away the veil our culture: one of mastery, oppression, and exploitation to see how to fix the system we have.  We must relinquish the idea that we know best about everything and that we have the knowledge, power, and right to bend everything to our wills.

—

"With gorilla gone, will there be hope for man?"

Above I have outlined the main premises of the book Ishmael by Daniel Quinn.  Ishmael is a gorilla. And Ishmael is a teacher who communicates with humans telepathically.  I know it sounds insane, but instead of a goofy SciFi novel, you take a philosophical journey as a pupil who looks at humanity from a different perspective.  I loved every minute of this book and it is definitely an interesting, thought-provoking read.

Grade: A

[Via http://scienceguy288.wordpress.com]

Medical Prayer Need

This morning, a friend of a friend of a friend as it seems has contacted one of MFM’s leaders in America about the plane that he flies. He tacked down Ronnie after some years of no contact and wanted to let him know about his willingness to work through MFM and take a medical group down and fly in as well as much needed medical supplies. At this, it would be needed to find an airport that would be able to take the plane since the PAP Airport has been shut down/limited to aid organizations. It seems to be a small enough plane to land outside of PAP. From there, the medical team/supplies would be taken to our mission to serve any hurt and sick in the mountains (as presumably people will begin to travel into the mountains in order to be treated since the PAP medical needs are limited at the time).

Dr. Charles is the pastor at the church in Laboul, as well as a practicing doctor at the medical clinic through MFM.

Presently, I have contacted another mission just outside of Hinche – the Solt Haiti Mission – who is finding out information about the landing strip in Hinche, Haiti – northeast of MFM’s compound and HQ. 

Please be in prayer as this has completely fallen into the lap of MFM and is a great opportunity to serve and treat people. Pray that things work out to bring aid to people. Continue to check back for more information.

[Via http://run4haiti.wordpress.com]

How to Beat a Committee, or, an Unexpected Life Lesson

My dad ended up in the hospital a couple of days ago, after a catscan found two emboli on his lungs. The good news is that he’s going to be fine, and instead of being stuck in the hospital for four or five days, he was released after just one. The bad news is that he’ll have to take anti-coagulants every day for the rest of his life.

Evidently, there are four major anti-coagulants, each with their own issues. Heparin is given through an IV, so that was out. Coumadin can be taken in pill form, but is very hard to regulate – if you sneeze, if you sit down, if you eat a PB&J, you need to change the dosage – so that was out. Of the other two possibilities (I don’t know the names – perhaps Wilson can comment), one required one shot a day, the other required two shots a day. The one shot version is more expensive, but my dad’s health insurance covers it, so price wasn’t really relevant.

So, given the choice, you would choose one shot a day over two, right? I mean, I don’t know about you, but sticking myself with a sharp object on a regular basis is something I try to minimize. Which is why it was strange that the doctors prescribed the drug that required two shots a day. Now, my father (who is a doctor), thought about this, and thought back to his interactions with the medical team. For the most part, he’d seen the medical student. He’d seen the resident less, the fellow less still, and the attending physician only once or twice. And furthermore, the attending had admitted that he didn’t really know that much about anti-coagulants.

How had they come to the conclusion that the two-shot drug was better for him than the one-shot drug? And how important was this difference? So my father said, p0litely but assertively, that he was OK taking the two-shot instead of the one-, but first he wanted to talk to the individual who had made the decision, and get an explanation as to why that choice had been made. He had been very happy with the treatment, he felt that things had gone very well, and he was happy doing what they said he should… BUT, he first wanted to talk to the one person who had made the decision, so he could understand why.

So, they went away, and (presumably) conferred, then switched him to the other medication, no explanation provided. Which is fine, as that’s what he wanted, and clearly they didn’t have an objection. What happened? His interpretation was that in a collaborative setting like that hospital, the group gets together to discuss a case, and different ideas are tossed around. Clearly wrong ideas are flatly rejected, but if  a reasonable suggestion is made and goes unchallenged, it’s adopted by the group without anyone taking responsibility for it. Asking for one person to take responsibility forced them to reevaluate the decision, and since either option was fine and no one thought of him or herself as the responsible party, no one was going to defend the position.

p.s. It must be said at this point that my dad is very happy with the treatment he got, and has no quarrel with the hospital or the staff. But he’s also very happy to only be taking one shot a day.

[Via http://slankr.wordpress.com]

Evolutionarily Yours

Long time readers here, know that I suffer to a degree with SAD, seasonal affective disorder. During these past couple of weeks, with temperatures hovering near or below zero most days, I’ve spent time sitting at the window, since blessedly the sun was out most days.

I handled the intense cold and resultant miseries rather well, and was mostly upbeat and happy during our self-imposed snowbound exile.

With the return yesterday of vastly warmer temperatures, I found myself strangely depressed and grouchy. It got me to thinking, and you know what that means–I have something to say.

I’ve said often enough that one of the reasons why I can see God’s hand in creation so very clearly, is that life is tenacious. Spotting a lone dandelion growing in the cracks of an old sidewalk proves that. It seems that evolution does it job in providing mechanisms that protect our lives in various circumstances.

I came to the conclusion, that this was just one more instance of that. In the midst of the perceived “danger” the brain somehow protects us from the depression that such events should precipitate. After the danger is past, the natural depression descends since we can now afford to give attention to it. 

This led to something I remembered from a three part show on PBS regarding the brain and how it functions. The Emotional Life describes a variety of brain mechanisms, often illustrating the working by showing dysfunctional brains where the mechanism is faulty.

One such is the amygdala, that small portion in our more primitive brain that operates to alert us to danger. A life-protecting mechanism in and of itself, it prepares us for “fight or flight,” flooding our bodies with adrenalin. This information is then sent to the frontal lobes, site of our rational cognitive thinking.

Here is where the problems begin. The prefrontal lobes examine the evidence and assess the danger. However, they are behind the game at this point. The amygdala is already in action, and the pathways from frontal lobe to amygdala, are not direct as they are from amygdala to frontal lobe. They are convoluted, containing a fairly round about way of getting there.

The amygdala thus functions to push the body to respond before the frontal lobes can get the information back to it, that it can relax. It has already poured forth its adrenalin. Interesting you say, but so what?

The commentator suggested that this portion of the brain, the FL to A pathway is not yet evolutionarily developed. We are on the way to a better connection, but not there yet. Evolutionarily speaking, it was better to be ready to act than to mull it over first. Makes perfect sense.

A couple of other fascinating things also are explained. It probably comes as no shock to most people that during a crisis (something fear inducing or terrorizing), we seem to have heightened senses. We hear, see, smell, feel, taste, more acutely. This apparently has something to do with the adrenalin or other chemicals that are released during such crisis conditions.

This means, that every single thing that happened during the moment of terror is exquisitely recalled in perfect detail. One can literally, upon proper cuing, smell the smells, and hear the sounds. Of more serious consequence, the memories are literally seared into memory. This has important implications for PTSD (post traumatic stress disorder). Here a particularly frightening episode is  cued, and the person feels for all practical purposes as if they are once more actually there, within the event again.

Each and every recall brings on the adrenalin flow and the terror is relived in 3D . For years, given the military’s desire to downplay the disorder, and because we knew very little of the inner workings of the mind, no real treatment was effective. Now there is some hope. Namely, the patient is forced to recall and describe again and again in detail what they are experiencing. And the frontal lobes slowly help the person accept that the signals are but memory. In other words, the patient’s own mind signals back sooner that all is well.

In time, hundreds of thousands of years no doubt, we will have the capacity to shut down the amygdala much quicker when there is no real danger present. So we live with the disorders that faulty connections allow for now.

Why is any of this interesting? Well quite simply to me, understanding the inner workings of my mind is one of my ways of understanding God. I have come, over time, to the conclusion, that being made in the “image of God” can only mean having a brain that thinks like God’s does.  Surely we all recognize that God is not the image of Michelangelo’s in the Sistine Chapel. Yet most of us do recall that image when we think of God.

Yet, I believe God is not corporeal but spirit. As such it would seem to me that we would have no reference point at all to “think” of God unless our minds were similar in nature. This is not to say that God does not have multiple “minds” each designed to the species (earth bound or otherwise). And in some sense, the evolutionary development of the human brain moves toward a more God-like orientation as it develops. Cats, as far as we know, don’t meditate on God, humans do.

It suggests to me that we are moving toward God as we move away from war, hate, anger, anxiety, selfishness, vanity, sloth and all those “sins”. As our brains develop, we move away from them as well. The frontal lobes take over and are the cop on the block, as it were.

Which is all to say that I appreciate my brain for its protection of my psyche during the great ice age just endured, saving my “depressing” day for a “safe” one. I look forward to the day when my brain doesn’t need this safety net, but can control itself by reason. Evolutionarily speaking the time needed is but a drop in the ocean of time. See ya there!

[Via http://afeatheradrift.wordpress.com]

Case 3

Male, Race unknown (can be Malay), Age unknown (around 20 to 30)

Presenting Complain:
- Backache

Prescription:
- Muscle relaxant & NSAIDS

My notes:
- The whole session is very very fast, I was curious and the reason Dr.Tan gave me is that through experience, just one glance, he knew that the patient faked it (maybe not) just to get MC.
- It proves that the doctor is correct when the patient quarreled with the doc because he failed to get the MC ‘due to the policy of the clinic’.

[Via http://iwalkmylife.wordpress.com]

A Trip to the ER - Part One

“Beep! Beep! Beep!”  The pager went off, followed by an alert on the Nextel.

“714, Dispatch.”

A slight feeling of annoyance overcame him, but only for a fraction of a second.  He reminded himself that he signed on for this job to help people, not to sit in the ambulance and stare at his phone all day.  He put his phone in the dirty cup holder and reached for the Nextel clipped to the sun visor, as his partner simultaneously slid the pager out of its case and anxiously searched for details.

“714, go ahead.”

He came to the quick realization that his initial angst was more a product of his nervousness than his reluctance to run another call.  Practice yields confidence, he said to himself over and over.

“714 I need to show you in route to Mercy General, picking up out of ER bed 7, for a 78 year old female, status-post fall, history COPD, dementia…O2, suction precautions needed; this is a BLS transfer.”

At least it’s not another gurney transfer, he thought.  Now I can practice putting someone on oxygen, and maybe I’ll get to suction the patient in route.  I just pray she is not incontinent.

“Copy, show us in route, Mercy Gen.”

“Do you want me to start the paperwork,” his partner asked.  “Sure, thanks.”

As they accelerated onto the freeway, he reviewed the procedures in his head for using the portable oxygen tank.  Make sure valve is opened with O2 wrench; turn flow regulator on to make sure gas is flowing; make sure there is enough O2 in tank for the transfer; turn on main O2 in the rig; make sure gurney is stocked with a nasal cannula and non-rebreather mask.

They pulled into the ER ambulance bay and he scanned for a spot to back into.  He counted three fire medics, an AMR rig, and a First Responder crew.  Damn, he thought, they must be slammed! A little extra patience, he encouraged himself, mentally preparing for his encounter with uptight nurses and doctors.  He opted for a spot furthest away from the ER entrance,  leaving the closest parking spots available for ALS crews dropping off the most critical patients.

He reached for the radio, turned up the volume, and waited for all traffic to clear.  When silence filled the air waves, he pressed the transmit button down and, feeling cool like the first responders in the movies, let dispatch know that “714 is 10-97.”    His partner suddenly stopped writing, he clicked the radio volume up two more notches, and in a synchronized effort they both sat as still as possible in silent anticipation.  After a brief pause, dispatch responded in a faint voice that reminded the EMTs that the dispatch center was in a completely different city, about 45 miles away: “copy, 714 is on scene.”

Reaching across the center console, his partner unclipped the Nextel from the driver-side sun visor and clipped it to her cargo pocket.  “Got your keys?” he asked her.  Yep, she assured him by shaking her keys back and forth.  He clipped the pager to his belt, reviewing in his head the information he would need to pull from it during the call.  Bed 7, he recalled as his partner pulled the gurney out from the rig.

The EMTs pushed the gurney into the ER, wheeling it up against an unused wall.  Pagers buzzing, alarms sounding, and phones ringing.  The steady, alternating beep of a hundred different heart monitors resembled the midnight chorus of a bullfrog colony, the source of whose ribbets you could not pinpoint.

The hallway beds were full, not surprisingly.  They’ll be happy we’re freeing up one of their beds, he thought to himself.  Some patients were quietly sleeping, some chatting with family members, while others screamed out in pain.  Some stared blankly into the wall, most likely sedated by the liquid pain-killer making its way down the plastic tubing, through the needle piercing the wall of the vein, into the bloodstream, and eventually into the heart which then pumped the medicine to all systems of the body.

The crew exchanged a quick smirk, as they took note of the usual ER commentary: “What is going on?  Give me my pills!  I need to leave!  I have been here for 12 damn hours!  Get me out of here!”  Nurses and Doctors trotted smoothly around the emergency room like a group of Tennessee Walking Horses, juggling paperwork, clipboards, needles, drugs, and stethoscopes.

He approached the nurses’ station.  “Who are you here for,” snapped an RN.  “We are here for Bed 7, Smith I think.”

Like a chameleon that changes its colors and emerges from its guarded state, after realizing that foe actually turned out to be friend, the nurse replied “Oh great!  Thank goodness.  We really appreciate it!  I think that’s Regina’s patient.  Just a moment.”

[Via http://spurioustransmissions.wordpress.com]

New Jersey to Homosexuals: No thanks

As Ace (or some other blogger in there) says, I think it’s time people realize that it is not only fundamentalist christians who oppose homosexual “marriage”.

From Ace of Spades

The state Senate rejected a same-sex marriage bill today, a major victory for opponents who contend the measure would infringe on religious freedom and is not needed because the state already permits civil unions.The 20-14 vote defeating the measure followed an hour and a half of public debate inside the packed Senate chamber. The nearly thousand supporters and opponents of the bill held rallies on the Statehouse steps.

Statewide polls have shown New Jersey residents closely divided on same-sex marriage, and leading up to today’s vote, indicators showed a majority of the senators opposing the measure.

DrewM comments:

When will these hateful people, like their Christianist neighbors in NY just stop standing in the way of progress?

BTW-noted opponent of same sex marriage Barack Obama was unavailable for comment.

[Via http://lovingword.wordpress.com]

Total Thyroidectomy

During total thyroidectomy for papillary carcinoma, bilateral parathyroid galand can be preserved. Ten milliliters of 10% solution (1 g) of calcium gluconate may be administered over 10 minutes.  10ml10% calcium gluconate ivi q8h.  A calcium infusion may be started at a rate of 1-2 mg/kg/h if symptoms do not resolve. Titrate the infusion to the patient’s symptoms and calcium levels. Start oral calcium when the patient is able to tolerate it. One to two grams of elemental oral calcium should be supplied each day. Calcium carbonate 1250 mg provides 500 mg of elemental calcium; therefore, the patient should take 2500-5000 mg/day. The patient needs concomitant replacement of vitamin D with calcitriol (Rocaltrol) 0.25-1 mcg/d.

[Via http://mdoncall.wordpress.com]

When does 'being a Doctor' all click into place?

Former nurse now medical student at Nurse to Doctor was wondering when it all starts to click into place. I thought as a final year medical student, almost a doctor I would be able to do most things a doctor could do! Instead I didn’t feel that it could do much at all. In fact when I qualified I was still at that rabbit in the headlights stage – where I didn’t feel I  could do anything useful. I remember feeling that the nurses could do almost anything I could do and feeling pretty low about things. But over time things have clicked into place. There’s several things that click in one by one to mean that you feel comfortable about being at work and feel you could do a good job.

In the good old days this happened much more quickly, final year medical students were allowed to locum as junior Doctors, and if you were working 100 hours a week you fairly quickly got up to speed. Now some of the House Officers we get are up to speed, and some aren’t there just yet. It doesn’t matter too much  - if they can’t do the job the rest of the team pick up the slack, it’s just frustrating for us, but we  manage to keep it safe for the patients.

Confidence in diagnosis – this comes with practice of getting ’stuck in’ seeing patients and making a diagnosis. Clerking, devising a management plan, presenting to the seniors and seeing if they agree. In the old days at medical school the students would spend on a lot time on ‘take’ doing just that.

Some juniors don’t have the confidence in themselves to write their management plan so write ‘obs / bloods / sr rw’ as the plan for every patient they clerk!  This is totally unacceptable – because if you don’t start to make a diagnosis you’ll never get there.

Confidence in prescribing: this really comes with practice. It’s all very well to know that diclofenac, tramadol and aspirin are all painkillers but which is best for pain from kidney stones? and at what dose. Often the ward nurses know what tends to work in this situation and will often advise what they would like prescribed. (Do check yourself in the BNF if you’re not sure of the dose).Prescribing really does get easier as you get more of a feel for how drugs work and what effect they have.

Not getting overwhelmed with the workload. There is sometimes a lot of things to do at once so this can be quite scary, a ward can appear to be a chaotic environment and it takes a lot of effort to manage to focus on one thing at a time with constant interruptions. You  may have 20 or so patients under your care and you need to know what is wrong with them, what the plans are, what tests they have had done, what they are waiting for , what their Haemoglobin and potassium are.

Confidence talking to relatives – again this comes with time – you can be taught communication skills at medical school but until you are sure you  know the medical issues this isn’t as much use as you’d think, though it is a very useful grounding.

Then there’s the confidence that you can deal with the worse case scenario – to the level expected of your grade. For instance if a house officer can do the ABC things competently and start of some management whilst calling for help then that’s pretty good. That takes time as well.

So bit by bit it will click into place for most doctors.

[Via http://doctorz.wordpress.com]

Of coke and GAMSAT prep

Coca-cola, I was talking about. Not ‘coke’ coke….. Gotcha…. I think.

HAPPY NEW YEAR to one and all! Trust you’ve had a great start to 2010! (:

Another decade has gone by. I feel so….. Dusty. Oh. Old, I mean. Haha. Justjared.buzznet.com’s junior website has the effect of making me feel that much older. I mean, like, seriously, (flips hair back with fingers à la reese witherspoon in legally blonde ), the ages of the young ‘uns making it big in Hollywood just keeps getting smaller these days. Millionaires before twenty! Nice. No. Wait.

The internet has played a huge role in this cultural change…. If current trends are anything to go by, ‘prodigies’ might soon become a ubiquitous descriptor because our generation has so much resources available to us at the click of a button. That’s prob why experience is not a pre-requisite for fame anymore. It’s a good thing…. Resources in the right hands  can = missions work (:

But I digress. I’m supposed to be writing about prep for GAMSAT (graduate australian medical school admission test) for those on the internet who are interested. exactly 2 years ago I was – rampaged google and yahoo for tips on how to study for the GAMSAT. Haha.

Here goes!

GAMSAT prep:

• I took the MedPrep course and found it really useful practice especially for sections 1 and 2.
• Visit pagingdr.net’s forum for helpful GAMSAT, interview prep tips
• Section 1: I found this really helpful book recommended by a user in the forum… Have forgotten the name – ordered it online from amazon.com and it’s a prose/ poetry practice book that’s based on the American syllabus.
• Section 2: Keep writing and get someone you trust, with good writing skills, to proof-read your work.
• Section 3: If you don’t have access to a prep course, visit the library or ask a uni mate to borrow some basic chemistry/ physics/ biology textbooks (with exercises) for you. These should work fine (better than the ones offered by prep courses, in fact)

Just before the GAMSAT:

• Sleep early the night before
• Stay healthy – drink lots of water, eat lots of fruits – don’t fall sick like I did
• Allow ample time to get to the examination venue (there will prob be lots of other candidates travelling to the same place)
• Pack sufficient water, sweets/ chocolates/ fruits – whatever you need to stay alert
• Know the allocated times for each section – break them down so you know how much time you have per question

Sitting the GAMSAT:

• Time is of the essence. Can’t stress that enough.
• If you can’t answer a question within the allocated time, mark it, circle the most probable answer and move on…. No mark deduction for incorrect answers.
• Time your toilet breaks. Sounds trivial but…. With at least half the candidates vying for a handful of toilets, it’s almost…. Survival of the fittest. True story…. Plus, eating into your writing time to answer nature’s call’s prob not the best idea.
• Relax. Better to think clearly than to answer all the questions haphazardly! (:

All the best in your future endeavours, whether you’re aiming for med or dentistry. If you do chance upon this and you’re about to sit the GAMSAT, best wishes to you. (:

[Via http://thevotary.wordpress.com]

Monstrous Weather

The dark skies over head, chilled wind blows through the trees. Water covers the ground, mud and muck replace the trails we once traveled. Dreary is the day the rain comes down. Weary do the souls of mankind become. Its as if God has cried for our lost hearts, and the crying can not stop. Damned are souls and bodies have become. The flood waters rushing down. The earth soon to be wiped clean, rid of man and his machines.

[Via http://whistorian22.wordpress.com]

BIOMEDICAL ENGINEERING JOBS AT BANGLORE

Experience: 3 – 8 Years Location: Bengaluru/Bangalore Compensation: As per hospital standards Education: UG – B.Tech/B.E. – Biomedical PG – M.Tech – Biomedical Industry Type: Medical/ Healthcare/Hospital Role: Lab Technician/Medical Technician/Lab Staff Functional Area: Healthcare, Medical, R&D

Job Description

To maintain the Bio medical equipments and other equipments of the hospital Desired Candidate Profile To maintain,Service,calibrate all the equipment in the hospital Company Profile A premier healthcare provider in bangalore city

Contact Details

Company Name: Mallige Medical Center Website: http://www.mallige.com Executive Name: Administrator Address: No.31/32 Nr To Bangalore Internet,Crescent Road BANGALORE,Karnataka,India 560001 Email Address: jobs@mallige.com Telephone: 80-91-22203333 SOURCE
NAUKRI.COM

[Via http://kushtripathi.wordpress.com]

My Funniest Christmas Pressie Yet! A "Dysgraphia Pen!"

You wouldn’t necessarily think such a thing would exist, would you? Well, okay.  Such a thing doesn’t.  Unless you consider every pen that I own, and will ever touch in my entire lifetime! *laughing* No, that is just what I called it: “My Dysgraphia Pen!”

If you don’t know what Dysgraphia is, what it boils down to is a difficulty, to some degree, regarding one’s ability to write.  You can also have other problems with fine motor skills, but not always.  I do to some degree there, as well.

I have Asperger’s and it is quite commonly associated with that Developmental Disorder, and with the other various Disorders on the Autistic Spectrum.  However, it is not limited to the Autistic Spectrum alone.  It can also be tied to AD(H)D, plus more.  I have been dx’d with ADD, too.  Inattentive Type!

My Dysgraphia? I reverse letters, numbers…sometimes my writing will become less legible, even if I do manage to get the letters and numbers in their correct order.  It’s very frustrating, and I have to concentrate a fair bit if I need to write something down that absolutely needs to be legible! Even if it’s something, perhaps less important, I may be forced to give up and just leave it “as is,” with several scratched out words on the page!

Embarrassing.

I also write in Block Caps.  Much easier for the entire world to decipher what I am trying to relay.  That way, people hopefully won’t have to spend twice as many hours “de-coding” my missives.

So, my pressie? I got it from my friend J.  He knows about my Dysgraphia.  We both even call me, “Dysgraphia Girl.” *rolls eyes*  That said, boy did he get a chuckle out of this pressie! It wasn’t even for him!

Oh, wow.  I’m actually smirking as I type this.  It’s a plastic, battery operated, “vibrating” pen.  I know, naughty jokes all around!!!

It has several, little (also plastic), pen nibs in different colours.  You pop them into a hole at the bottom of the pen, and when you write, everything comes out all “squiggly!” I was just dying when I was trying to use it!

And…  It’s also kind of stimmy! There’s a clear bubble on top with an orange disc inside.  It spins like nuts when you turn it on! WHOO!

J. knows me far too well.  In fact, while I was there? I was getting a bit stimmy, so I grabbed one of my Tangles®. What did J. say to me?

“Stimmy, Stimmy, Stimmy.  Tangle, Tangle, Tangle.”

I just looked at him and said, “Yep.” *laughing*

[Via http://patientanonymous.wordpress.com]