Medical New Year Wishes

1. Increased access and affordability of health care.
2. More self-helpers when it comes to health. People exercising, eating right, taking responsibility for their own healthy lifestyle.
3. Decreased influence of the pharmaceutical companies.
4. Cleaner air and water.
5. Greater use of integrated medicine practices.
6. Increased availability of truly dark chocolate.

Care to add yours?

Christmas in Sedona

Sedona, Arizona. Land of red rock spires, ancient homes and, if you believe the loco locals, spiritual vortices. Whatever your orientation, it was absolutely beautiful there. We enjoyed hiking, running and exploring, when it wasn't snowing!



This is on the way in to Palatki ruins, which are very well protected by the National Park service.



Palatki was the only place I've ever seen "black on black" pictographs. The volunteer ranger told us these were originally white, like other pictographs, made of ground rock painted on with human hair brushes. They turned black when the soot from fires lit beneath the overhang settled into the white. He said they'll be black for the forseeable future.



The view from Jerome, a little ghost town on the side of a big hill.

Happy Holidays!

To anyone who happens by,

May your holiday season be joyous and calm, and your 2009 be filled with peace and good health!

With love,

Peg

The doctor is out sick

I'm sick! Started with a sore throat, progressed to body aches and fatigue, then the sinus pressure and congestion kicked in. I'm miserable! All I want to do is sleep, but my nose is so stuffed up that I have to breathe through my mouth, which dries out my throat, which hurts worse and wakes me up. If I take a decongestant pill, the nose clears up, but I can't sleep because the decongestant is a stimulant. My sinuses hurt unless I press on them constantly and take enough ibuprofen to endanger my kidneys. This is the weekend I was supposed to do all my Christmas shopping, and I don't even want to leave the house. Not only that, I'm falling behind on my training for the half marathon in January, mere weeks away! Boo hoo and waaah!

Why am I moaning out loud on a blog? Because I think there's a lesson in all this. For me and other docs, that is. I'm usually very healthy, and manage not to catch most of the germs that are coughed in my face daily. But every so often something gets me. When that happens, I invariably find myself surprised at how miserable I feel, and humbled thinking of how miserable all the patients must feel. No wonder they came in! No wonder they couldn't do their homework or sit for their exam! This sucks!

We docs tend to get a little numbed by numbers. When we see ten people with respiratory infections in one day, they blur together, and the process becomes rote. Listen to the symptoms, swab the throat, recite a list of comfort measures, make a sorry face, then go on to the next patient. Part of rote-ness is remote-ness. Distance from the feelings of the patient. I hear them moan like I did above, I see their lips moving, but it doesn't really land after a while. I nod and smile, but I don't really, well, honestly, care as much as I should.

Now I know I'm just talking about a cold here. But as I have relearned this week, even "just" a cold can be devastating in its own way. More serious illnesses are more devastating, but those can be subject to the same doctor numbness if we're not careful.

The Universe is offering me an opportunity to share an experience with my patients in order to be a more compassionate physician.

It's not an illness; it's an opportunity! Yeah, that's it! A Universal lesson.

Okay, I get it already. I'm miserable. They're miserable. Can I please get better now?

Viral vs. Bacterial ?

Q:

If you are feeling “sick” is there a way to determine if you have a bacterial versus viral infection without going to the clinic? For example, temperature? Swollen glands? Green snot? Coughing up stuff?

A:

The short answer is no. There is no sure fire way to tell without going to the clinic. However, if I were a betting woman, I’d put money on a virus, and I’d win big. Viruses cause the vast majority of respiratory infections. That includes most colds, sinus infections, bronchitis, and most ear and eye infections. It includes most cases of fever, swollen glands, green snot, and coughing up stuff.

For those readers who need it, I’ll explain the difference between viral and bacterial infections. Very broadly speaking, viruses are more common, and bacteria are more dangerous. The practical difference comes in with the question of antibiotics. Antibiotics kill bacteria. Antibiotics do not kill viruses. Your body does, for free. No clinic charge, no pharmacy charge. All it needs is some rest and time.

Now, everyone has a story of going to the doctor for a respiratory infection and leaving with a prescription for antibiotics. We hear it all the time. “Last time I had the same symptoms, and I got antibiotics, and it cleared right up.” Naturally, the patient wants the same treatment this time. The truth is she probably would have gotten better anyway. The timing of the antibiotics with her improvement convinced her that the antibiotics were responsible for her recovery.

Unfortunately, sometimes doctors prescribe antibiotics when they aren’t needed, “just in case.” This causes a couple of problems. For one, it sets up a patient like the one above to expect antibiotics for viral infections. That creates busy clinics and dependent patients, who think they can’t get over a simple cold without professional help.

On a wider scale, when we carpet-bomb bacteria with antibiotics, most bacteria will get killed. But a few will develop resistance to the antibiotic, and survive. Those will multiply and create a whole new group of tougher germs. Now science has to create a stronger antibiotic to kill these super-bugs. There have been some very scary germs created by this exact scenario.

I trust I’ve made my point about viruses. But remember, I said most respiratory infections are caused by viruses. That means some are caused by bacteria. For example, the bacterium Streptococcus pyogenes causes a throat infection commonly called Strep Throat. That definitely requires an antibiotic, to kill the bacteria and prevent dangerous consequences of the infection. Some kinds of pneumonia require an antibiotic, as do some ear and eye infections and, rarely, sinus infections.

If you’re looking for criteria, I suggest the following. If you get a respiratory infection, with the usual sore throat, congestion and cough, give your body a few days to work on it. Take over the counter remedies if you like. Drink lots of liquids to keep the mucous flowing. Try a sinus rinse. But if you have a high fever, a really bad sore throat that lasts for more than a few days, trouble breathing, or symptoms that last longer than a week, come in to the clinic for evaluation. Err on the side of caution, and come in anytime if you have doubts. Call ###-#### for advice or for an appointment.

Heroin and Opiate Addiction

Dear Dr. Peg,

I have been addicted to heroin for over six months now. While I have never used the drug intravenously, I still must smoke every day to function normally. I have wanted to quit since school has started but I’m so scared my school work, job and general life will suffer. I have researched multiple treatments but haven’t yet tried using one. As a doctor what would you recommend as a course of action? At the moment I am only engaging in counseling at the student health center. Thank you.

Sincerely,
Anonymous

Dear Anonymous,

You have several things going for you already. You want to quit. You have only been addicted for 6 months. You are already in counseling. Those are three giant steps along your new path, and you are to be commended. I’m going to answer your question, but first I’ll fill in some background for those who don’t know.

Heroin got its name from the fact that users feel powerful and invincible, like a hero. It is one of a class of drugs called opiates, derived from the opium poppy. Some other opiates are prescription narcotic painkillers like oxycodone and hydrocodone, Narcotics are addictive, like heroin, and are sometimes sold on the street and used illegally. Narcotic addiction is a huge and growing problem, with an estimated 2.2 million new non-medical users in 2005.

Ironically, heroin was developed originally as a treatment for morphine addiction. Oops! As soon as it was discovered that heroin was in fact more addictive than morphine, heroin
was made illegal, and remains so.

Of all the opiates, heroin is the most addictive. Called “dope,” “horse,” “smack,” and “tar” on the street, it gets into the brain easily and quickly, resulting in peak levels shortly after injection or inhalation. This is called a “rush.” After the rush, active metabolites stick around in the body for several hours, resulting in a prolonged but less intense “high” than the initial peak, described as a relaxed, contented state.

So what’s not to love, right? Wrong. The problem is, your body gets very attached to those sensations, and it complains when it can’t have them. That’s called addiction and withdrawal. Addiction leads to physical problems, discussed below. Not only that, the more you get high, the less useful you are, to yourself and to others. Eventually the addiction takes over your life, and you spend a huge amount of energy and money feeding it. You might even commit more crimes in this pursuit.

Heroin can be injected in the veins, smoked, or snorted. In the 1960’s, when heroin use was highest, most users injected it. Injection is the most efficient if the heroin is low purity, but can result in nasty skin infections and blood borne diseases like Hepatitis B and C and HIV if needles are shared. Overdose is most likely from injection, partly because the purity of the drug is so variable.

Nowadays, as the heroin supply is generally more pure and the risks of injection are well-known, more people are smoking it and sniffing it. Smoking gets it into the brain fastest. Snorting requires the least equipment but can eat a hole through your nose lining. However you get it into your body, it is highly addictive.

Lest you think you’re the only opiate addict on campus, here are some stats. According to the Office of National Drug Control Policy, in 2003 one percent of college students reported using heroin at least once during their lifetime. Another survey, done by the National Household Survey on Drug Abuse, reported that among users 17-22 years old, the rate of use was higher for college students than for non-students. The rates of prescription narcotic use are higher. Abuse of prescription drugs for non-medical purposes went up by one third in 18 to 25 year olds in just one year from 2000-2001, and most of that increase was due to OxyContin and other painkillers. This is according to the National Survey on Drug Use and Health.

Back to you. It sounds like you are still in the early stages of addiction, where you are still able to manage a job and school. You say you’re worried that your life will suffer if you quit. It is hard to quit: I won’t lie to you. But your life will suffer much more if you don’t quit but stay on what will surely become a downward spiral.

How to quit? The old tried and true is the methadone clinic, which basically replaced one addiction with another, less dangerous one. That is still available, but a new drug called buprenorphine has made narcotic addiction treatment more successful. Buprenorphine is a prescription drug, available only from health providers who have special training. It attaches to the same receptors that opiates do but has a less intense effect. The idea is to avoid withdrawal symptoms while you slowly taper down the dose, meanwhile going through counseling to help you recover from your addiction.

Ask your counselor about "bupe." And hang in there; you can do this!

Halloween Party with Albuquerque Fit

Our illustrious host and hostess.



Um...remind me...Mylie Cyrus and ??




Meow!




Queen Marlene, her Holy Gail, and - hey, is that Heather Wilson?





Count Rod Dracula extinguishes his birthday candles.





Oh, do have another drink, Lady Catherine!





The Blind Date. Get it? Blind.....Date. No, he's not a fig newton.





"My moustache flies in your general direction! Ni! Ni!"





The little devil. Ain't she cute?




Coach Marc executing a perfect demi-pirouette.





Angel Tracie...pure as the driven snow. [Who's laughing? Stop laughing!]



Pretty Pixie. Notice the blind date took off his shades to check her out.




Birgitty Kitty.



Me as the scariest thing that has happened all year.


(I'm the stock market. Get it?)

Half Marathon Celebration

This is the year I turned 50.

"Turned," we say, like milk turns sour, or a secret agent turns against her own side. Not the most appealing turn (sic) of events, is it?

This is the year I achieved 50. That sounds better. I reached 50. I hit 50 (hmm...no, that sounds too much like a brick wall).

I celebrated. There it is. This year I celebrated fifty years of life on this earth. As a way to mark a half century's worth of living, I decided to train for and attempt to run a half marathon. I have mentioned this before. Starting in February, by running one minute and walking for four, I increased my run time gradually with the Albuquerque Fit training program. Every week we did a little more, and a little more. Before I knew it, I was running 6 miles, then 8, then 11...

I'll get to the point. I did it! On September 7, 2008, I completed my first half marathon run, the Chips and Salsa race in Albuquerque, NM. Thirteen point one miles. I made it in 2 hours and 50 mintes, for an average of 13 minute miles. Nope, I wasn't last, either! Close, but not quite. I'm very pleased and proud. My goal was to finish, and I did it.

With only yards to go, my daughter Serena and son Derek and friend Anne came out to join me and encourage me. In this picture, I'm sandwiched between the two kids, with Anne out front egging us on.



Serena stuck with me all the way to the finish line. "Come on, Mom, you can do it!" Here she is, in the red shorts, making it look easy, while I, in the pink hat, put on a last little blip of speed (well, relatively speaking) to get across the line. I placed 177th overall (out of 194), and 7th in my age group (out of 7). Not half bad for my first time, say I.




My wonderful hubby and both my parents were also there, cheering for me and taking pictures as if I were some kind of celebrity. Talk about the power of love!

It has been two weeks since the Chips and Salsa half marathon. I took a week off, then rejoined the group, just to keep active, so I thought. Until last Saturday, when coach Mike asked for a show of hands for who plans to run the Duke City half marathon October 19. Zing! My hand was up before I realized it. And now I'm dreaming about Phoenix in January, Denver next year...

I guess I've found a new passion. It's great to have a fun way to stay fit, a goal to work toward, and an excuse for partying after!

Run for the Fallen

This morning people all over the country ran a mile in honor of each fallen soldier from Operation Iraqi Freedom. Run for the Fallen is " a collective of runners whose mission is clear and simple: To run one mile for every American service member killed in Operation Iraqi Freedom...We refuse any political affiliation or agenda, but simply honor those who have fought, and those who have fallen under the American flag." They ran, across the country, a mile for every soldier, sailor, airman and marine killed. Today they ended their run in Arlington National Cemetery, and on this day they asked people all over the country to join them.
A small group of New Mexican runners gathered at USS Bullhead Park to run in honor of the 35 fallen New Mexicans. We each pinned on a named bib, stuck a flag in our hat, and ran half mile laps on the grass in the New Mexico morning sun. We were grateful to be alive, and honored to run in memory of those who lost their lives so far from home.

Tonsillar Abscess Day

Warning: this post contains pus.

Another one. A day of three. This time it was three tonsillar abscesses. Unrelated, but with the same story. "I was fine until yesterday, when one side of my throat just blew up!"

When I looked in said throat, sure enough, the opening was lopsided, with one half practically obliterated by a big red bulge coming in from the side and covered in pus. Nice. Fortunately, pus doesn't bother me. Well, pus rarely bothers me, I should say. I have learned, however, not to use that word when discussing someone's throat with them. People don't like to hear that they have pus in their throat. I told one gal that and the next thing I knew I was scraping her off the floor. Oops.

So, what happened in the throats that day was that an infection dived deep, under the tonsils, like prairie dogs digging a labyrinth of safety under the earth. The result? Tissue swollen with prairie dogs. Or, rather, with Streptococci. And fluid. And pus. And pain. That s^^t hurts! People with tonsillar abscesses also talk funny, as if they have a- well, a mass in their throat, which they do. We in medicine give this the technical term, "hot potato voice." And they make a face every time they swallow, because they are in pain.

Back in the day, we used to call the Ear, Nose and Throat people to come and stick a very long needle--uh oh, there went another reader. Someone scrape her off the floor, would you? Yep, a very long needle into the prairie dog town and drain out all the sewage. Yowser. Nobody's idea of a picnic, right? Thankfully, nowadays we're much more humane. Someone figured out that the Strep dogs can be flushed out with chemicals. Mere pills! Who knew? So now we give heavy duty antibiotics, steroids to decrease the swelling, and, of course, last but far from least, narcotic pain medication. Decreases pain, misery and awareness of misery, for which the patient will thank you profusely when you see them back two days later for a recheck.

Two days later, I hardly recognized any of them, which reminded me how pain changes one's whole appearance and demeanor. Fevers down, pain at bay, and a throat as open as San Francisco Bay. Whew! Thank goodness for chemistry!

Wonder what "threebie" next week will bring?

Olympic Thrills

Every time I watch Olympic games, I have at least one "Olympic Moment" of my own. This usually occurs at the end of a competition. Athletes from all over the world have just given the most they have, done the best they can do, stretched their own personal limits of strength, agility, or speed. They collapse at the finish, sweating, spent.

Somebody won the gold. That's thrilling, sure. Everyone pushed hard and achieved what I could never hope to. That's thrilling too.

But what really lifts me up is watching the athletes congratulate each other. They hug, kiss cheeks, high five, shake hands. With genuine appreciation, they are acknowledging each other's efforts and achievements. It's a moment of salutation and mutual respect.

Gives me goosebumps.

Cades Cove and Abrams Falls

This is a broad view of Cades Cove, a historic area settled and farmed in the 1800's and early 1900's.

We went there to hike through the woods to Abrams Falls. Once again, evidence of water's work everywhere.
Yummy-looking white mushrooms springing out of the forest floor. Don't worry: we didn't try them!

Lichen on a big tree trunk.


The Galax plant.



Some crusty ol' tree .

And, finally, the water itself. I hate to say it, but I had to wait for just the right moment and crop the picture well to get a picture with no people in it. There were lots of folks there, from oldsters dipping their tootsies to young bucks jumping off the falls into the water below.

Smoky Mountain Run

Greetings from the Smoky Mountains of East Tennessee! It is so different here from the New Mexico desert. The forests are lush with growth and rot, and the air is heavy with moisture. So heavy, in fact, that after about 2pm all we want to do is sit in front of a fan or dunk ourselves repeatedly in the pond, a murky but beloved tradition formed when my grandfather dammed up one of the hollers. My parents, who have built a lovely summer cabin here, are purists, who don't want to block out nature with something so roaring as an air conditioner. Dad looked like he might consider relenting when I reminded him that we haven't had to go down the hill to the double-seater outhouse for several years, since they installed indoor plumbing. So maybe next year they'll upgrade to temperature control! *

A 9 mile run was on my training calendar for yesterday, so I headed for Great Smoky Mountain National Park. I set out at dawn, drove to the park headquarters, silent and empty at that hour, and spent just over the next two hours running the trails nearby. I ran this trail twice, back and forth. Thanks to my esposo who gave me a Garmin GPS watch for my 50th, I could tell exactly how far I had run and how fast, in addition to my heart rate and speed. My plan was to upload photos here, but the dialup connection in the cabin won the staring contest. I'll post them after I return.

By the time I got back, drenched and depleted, the parking lot was full of tourists coming and going from the visitor's center. Some looked at me askance as I emerged, dripping, from the forest like some kind of creature of the deep. I was still on my feet, though, and proud of myself for having made my longest run yet, and all by myself.

The cabin is at the end of a one-lane gravel road. When you're here, you can imagine how life used to be in these hills, before Dollywood, before all the tourist attractions that choke the parkway. At night, the tree frog chorus screeches, and, in the early morning, the forest silence is broken only by birdsongs. These woods are old, old, old, yet in a constant state of renewal. It's oddly rejuventating.

*News flash! They got two window air-conditioning units while I was there! Bliss!

Intensity

In the past five days I have felt deep joy and deep sorrow. Equally intense feelings, opposite poles. It got me thinking about the very nature of intense feelings and how, regardless of which pole they originate from, they invigorate us. Feeling anything with your whole self is being alive, painfully, exquisitely alive.

My family had a birthday party for me last weekend. The big five-oh. We finally celebrated officially, with bells and whistles. Dear friends gathered, from work, soccer, neighborhood, book club, even childhood. My kids showed a retrospective slide show they had put together. I felt lucky and loved, intensely happy, warmly alive.

Yesterday, I hugged my friends Patch and his wife Cookie, knowing it could be the last time I see Patch alive, or conscious, or talking. He'll have brain surgery on Monday to remove a recurrent tumor. Last time he came through it with flying colors. We all know it could be very different this time. Or it could be the same. I felt fear and sorrow, hope and pain. Again, intensely alive.

It seems odd to be grateful for heart-wrenching fear, yet I am. Right along with happiness and hope. I want to live this life, all of it, to feel all of it, to have every experience with my very bones. And that means being open to all of it. If you're open to deep joy, you'll get it, and the sorrow that may follow. And that is rich living. Give me no other kind.

Cat Bite Day

I haven't seen a cat bite in months. Tuesday, we had two, one right after the other! Different patients, different households, different cats. One was already infected, less than a day after the bite. The patient had fever and bodyaches, all from a little puncture in her finger. The other gal's forearms were covered with scratches and bites. Her kitten wanted a cupcake, believe it or not, and was not happy to be told "no!"

Eighty percent of cat bites get infected. This is in contrast to about fifteen percent of dog bites. Surprising, isn't it? You might think those nasty canines, who chew everything from your stinky shoes to roadkill, would have mouths teeming with germs. You might think precious, preening kitty has nary a germ on her tongue. The truth is the opposite.

Finger Puncture came back yesterday, much better on a simple antibiotic. Cupcake Withholder is doing fine too. I bet it'll be Christmas before I see another cat bite.

Professional Distance

I have this patient. I wish she were my friend. But, of course, she cannot be my friend, because that would violate the principle of professional distance.

You know what that means, right? A doctor isn't supposed to get "too close" to her patients. Although that phrase is not well defined anywhere, there is a tacit understanding that getting "too close" or "too involved" is bad for both parties.

Bad for the doctor because you lose your objectivity and can't think straight. Not to mention, you might end up getting hurt if there's a negative outcome. And, of course, there's the time-honored practice of putting ourselves on pedestals, which is hard to do if you're down in the muck with the patient.

Bad for the patient because the doctor loses her objectivity and can't think straight. Not to mention, it's hard to fire a doctor if they're also your friend. And, of course, there's the possibly comforting traditional role of doctor as boss, abrogating you, the patient, of responsibility, which is hard to maintain if you're equals.

All that said, albeit somewhat with tongue in cheek, I find it hard at times to maintain this distance. This patient is a case in point. She came to see me a couple weeks ago. We clicked immediately. She's friendly, casual, comfortable with herself, funny, smart. I am seeing her for a minor but persistent problem that has required her to come back several times, and each time I have a really good time, as if we were meeting socially for coffee or something. Don't get me wrong: I am treating her, and successfully too. But the treatment gives us time to chat. I even told her the story about the time I spilled trichloroacetic acid on...but that's fodder for another post.

I know we'd be really good friends if circumstances were different. It makes me feel sad.

She's moving away soon, to the other side of the country, taking dilemma and possibility with her. I wish her well, and I'll miss her.

Eight Mile Run

We did it! We ran 8 miles. The longest run yet. Not only that, it was out in the country, on a rather hilly road. We started at Jemez Dam, for those of you in the know, and ran back toward Bernalillo. Here's the view from the starting point:


Coach Marc, a.k.a. "Iron Man" gives his customary safety speech. Only this one included "watch out for bulls!"



And we were off! Hard to complain about running in such beauty.




Thankfully, Scott, the photographer extraordinaire, took his photos at the beginning of the run, while we were all still smiling. That's me in the middle, with leggy Jen on my left and Coach Lori, a.k.a. "Tofu Lori," on my right.




We all finished, and were very proud of ourselves. Still hard to believe we'll be able to run half again as much in September, but I have faith.

Training for a Half Marathon

Round about December last year, I started to fidget. No exercise to speak of since my car crash in August, and I was getting soft and grumpy! My neck and back were feeling enough better that I really wanted to try something, anything, to get my bod moving again. After all, I'd be 50 soon, and we all know it gets harder to get in shape the older you are!

I went to my friend Sue, a marathon runner who is 54 and looks 44, to ask her advice. See, my usual exercise "regimen" included playing adult soccer once or twice a week, and that was about it. I know the value of exercise and keeping in shape. I am an educated medical professional, after all. But, I tell you, if it isn't fun, I simply won't do it. Laps at the pool? Bo-o-o-ring! Routines at the gym? Spare me.

I wasn't sure I was up for soccer yet. The only kind of soccer that goes on here in winter is indoor soccer, which is notoriously rough and risky. I figured I better start with something kinder and gentler. I was hoping to be back in good enough shape for the Spring women's soccer season.

I might have predicted Sue's response. "Try running!" Ugh. Running was right up there with pool laps and machine weights.

"Wel-l-l," I waffled. But Sue persisted. She told me about the program and group that got her running. Albuquerque Fit.

I checked it out. Their beginner program is called In Motion. They met every Saturday for an hour, starting in January. I decided to go. The first day we "ran" a half hour as follows: run for one minute, walk for four minutes, repeat. Wow, I thought. I can do this. So I continued.

The next week, we ran for two minutes and walked for four. And so on. Bit by bit, the running time increased and the walking time decreased. We hardly noticed our muscles growing and our endurance increasing. By the end of the program, 11 weeks later, we were running for eight minutes and walking for one.

By then I was hooked. Not only did In Motion give me people to run with once a week, they gave me a proscribed schedule for running during the week. This, I failed to mention, is the other way to get me to exercise. Tell me what to do. Give me instructions, a task, a schedule. Make it so I don't have to motivate myself and I'll do it. Of course, I still have to get my own rear out the door and move it, but having a formula really helps me. Get up, go do the run, check that one off, shower, go to work.

When that program ended and the next one, Albuquerque Fit, began, I stuck with it. ABQ Fit trains you for one of three races: marathon, half marathon or 10K. The coaches, who are regular guys and gals who started just like we did, encouraged us to aim high, saying it was easier to shift down than up partway through. So I went for the half, thinking from the beginning that I'd probably end up changing to the 10K, but secretly hoping I could make the grade for the half marathon. It just seemed so perfect. This is my half century year. Running a half marathon in honor of that was fitting.

So here I am. Several weeks into it, and still hanging in there. People do drop out, by the way, naturally. But a couple weeks ago Coach Mike informed us that, statistically, of those of us who had made it to that point, over 90 percent of us would finish our target race. We had made it over some kind of hump.

Tomorrow, our long Saturday run will be 8 miles. I have never run that far in my life. But, thanks to the incremental training technique, I have run 6.6 miles, and 7 miles. My weekly totals (long weekend run plus three weekday runs) are now up over 13 miles. Now I run for a mile before I walk for a minute, because the run/walk technique is what they teach. We're aiming to finish, not to break any time records here. So far my old bod is holding up pretty well. A few aches and tweaks here and there, but --knock on wood--nothing that has laid me up.

My target half marathon is in early September. Wish me luck! I'll let you know how it goes.

Butt Boil Day

Today in clinic it was Butt Boil day.

Seriously.

You know how they say things come in threes? It's true. At least, in medicine it is, or seems so much of the time. Weeks will go by with not a pimpled posterior in sight. Until suddenly, one day, boom, boom, boom! Three in a row.

Did these people know each other? No. Did they all sit on the same seat on the bus, or bench in the park? I seriously doubt it. So why did they all develop boils on their behinds today? It's a medical mystery.

We've had other odd days as well. Among others: Eye Scratch Day, Jock Itch Day, and, my personal favorite, Ingrown Toenail Day. (What can I say? I love procedures. I'm a wannabe surgeon at heart.)

Stereo Mammograms

The other day, our local paper had a story about a new and improved, up and coming technique for imaging the breast. See, the way they do it now, a mammogram, is two-dimensional. And the breast, of course, is three-dimensional. Yes, in spite of all their efforts to squash it into one less dimension, it remains stubbornly round. Well, once it recovers from the mammo, that is.

This new technique involves taking two mammograms, from two slightly different angles, so as to create a stereoscope of the breast. The result is two pictures, slightly off kilter from each other. The radiologist, in order to read the two mammograms as one round image, will don a pair of those weird stereo glasses like from the 60's. I kid you not. Remember those things? Or the plastic binocular-shaped gismo that you'd pop a round slide card into and look through, to ooh and ahh at the 3-dimensional image inside.

I had to laugh. And, at the same time, shake my head. Why on earth didn't someone think of this sooner? We had higher technology for our toys 40 years ago than we do for our breasts today. What is wrong with this picture?

Give me an "A!" Give me another "A!" Give me an "R!" Give me a "P!"

On the way back from Crested Butte, I stopped for the night in Gunnison, Colorado. Little motel on the edge of town, one of the few not filled up by the softball tournament that had packed the area for the weekend.

The plump young woman behind the desk said, "Two queen beds, $59."

I nodded, "Okay."

"Got any discounts or anything?"

"No." I never have discounts. If I ever manage to clip coupons, I always leave them wherever I'm not. "Oh, wait! I'm a member of AARP! Does that count?"

"Sure does," she smiled.

I was psyched! My first discount as an Elder American! Woo hoo!

I felt like I had made a rite of passage. Small, but significant.

You see, for years I heard my friends complain, "I got an invitation to join AARP! Man, do I feel old!"

As each of them passed the fifty year mark, we'd razz them. "Did you get your AARP card yet?" Ha ha ha.

So, when it came my turn to see the big 5-0 on the horizon, I decided to get pro-active. I joined them before they could recruit me. I had my membership before my 50th birthday. Embrace the change! Be proud of your age! Bounce right out of your 40s and into AARP!

And here I was, reaping the benefit already. I signed my name with a flourish and strutted down to my room.

Book Event at Blue Moon Books in Crested Butte

Here are some pics from the reading and signing event at Blue Moon Books in Crested Butte last Saturday. It was a nice, intimate gathering. This is the sandwich board out front. Can you make out where it says "Tonight Only!" I love that. As if authors normally do nightly appearances for a month or something. Anyway, it made me feel special.





Here's David, the owner and proprieter of Blue Moon Books. See how he cleared off the back wall to display our book? Nice, eh? He also hopped on his town bike (everyone rides everywhere in "CB" as the locals call Crested Butte) and rode up to the liquor store to come back with wine and a 6 pack of............drum roll please...........Blue Moon Beer! He was very hospitable. Thank you David!



And here we all are - the intimate gathering of which I spoke. Five guests made it a close and casual event. That's me in the middle in purple. Some of the others are locals, some were visiting from other parts of the state. I talked a bit and read a bit and we had some nice conversation about aging and other life topics.



Thanks again to Blue Moon Books! I highly recommend this cozy shop if you're ever in the area.

Book Event Tomorrow

Tomorrow at 5pm I'll be doing an author event for 50 Ways to Leave Your 40s in Crested Butte. The picture above is the Crested Butte City Hall. Probably just like it looked a hundred years ago (plus a new coat of paint).



This is a shot of Blue Moon Books from across the street. I tell you, all the buildings in Crested Butte are like this. Colorado Quaint. Isn't it great?




If you look very closely, you can see a poster for 50 Ways on the door of Blue Moon Books, just above the political action sign. I'll post more after the event. Fingers crossed for some attendance!