Lessons for Male Allies

(by whizbang) Nov 18 2017

One episode of sexual harassment really stands out for me. I was 17, waiting tables to earn money during the summer. I worked at a family restaurant that did not sell alcohol, but it did attract a lot of drinkers who stopped for breakfast on the way home from the bar. We didn't close until 2 am on weekends to accommodate this population. I was a good waitress. Subtle flirtation with innuendo is my strong suit, and it brings good tips.

One night before a concert, I went out to a table of six twenty-somethings. As I set water and silverware on the table, one guy asked me, "Have you ever had sexual intercourse?" Those exact words.

This line was so brazen and clinical and unexpected I just stood there with my mouth open for a minute. I said I would be back to take their orders.

My manager was watching and asked what the guy said. When I told him, he threw the party out.

I was kind of surprised that he tossed them all out, but he told me no one was treating his employees like that.

What a great boss, and what a lesson for me! Even as a minimum wage waitress, I was more valuable than these inappropriate customers!

All bosses need to follow this example. No customer (or employee) is so valuable to a business to allow others to suffer.

3 responses so far

Green Shoefari

(by whizbang) Nov 14 2017

One of the more annoying things are Facebook ads. They pop into your feed, often hard to distinguish from other posts. One brand that kept entering my feed was Rothy’s, a line of shoes.

These are flats made of elastic yarn derived from recycled plastic bottles. They come in a rounded or pointed toe in a variety of colors and patterns. I bought my first pair just before Kidney Week in New Orleans. I wore them twice the week before I left town to make sure they didn’t eat my feet. They then toured several airports and walked a lot of streets and convention center hallways. When I got back home, they smelled a little funky and there was a dark spot on my right toe. I put them in my clothes washer, along with the removable insoles, then let them dry overnight on the counter. They look like new (see the photo after their wash-and-dry).

Yesterday I ordered two more pairs in a fun green and blue plaid as well as a practical beige with black toe cap.

These are not the least expensive flats available, but they are environmentally friendly and incredibly comfortable, as well as machine washable! I will have to let you know about their long-term wear and tear later.

Check them out here.

One response so far

A Bit of Sweetness for #KetoLife

(by whizbang) Aug 28 2017

I think you can pick out July 17...

Like a number of my Twitter buddies, I have been following a version of the ketogenic diet since July 17. Pediatricians often hear about this as a treatment for seizures in children; however, eliminating high-glycemic index carbohydrates from the diet makes the fat practically melt off some people. You can read more about the basics here. One of the challenges of the plan is to find foods that replace your favorite high-carb munchies with something healthier. Over the weekend, a bunch of us got to talking about this on Twitter. I mentioned this creation of mine and promised to blog it.

I purchased a couple of #ketolife cookbooks to start. This gave me ideas for how to achieve flavors and textures associated with forbidden carbs. Love breaded pork chops cooked with Shake-n-Bake? A mixture of almond flour and ground up pork rinds will give you the same texture! Barbeque pork rinds provide a similar flavor! (BTW, the cookbook used this mixture to crispy coat orange chicken).

Sweet things can also be a challenge. One of the cookbooks I bought included Triple Layer Fat Bombs. The layers included a mixed nut-butter bottom, a cream cheese middle, and a chocolate topping. They were frozen, and the nut-butters never really firmed up for me, while the topping layer got rock hard. After playing around with the perfectly textured middle bit, I came up with a chocolate cheesecake dessert.

The most important tool for this dish is a silicone mini-muffin tin. MIne is by Wilton and available at Bed, Bath, and Beyond. You will never get the finished product out of a traditional tin.

Frozen Chocolate Cheese Treats

Ingredients

6 oz cream cheese, divided

6 Tablespoons erythritol, divided

3+ Tablespoons heavy cream, divided

1 teaspoon unsweetened cocoa

  1. Divide cream cheese equally between two small bowls.
  2. Add 3 Tablespoons of erythritol to each bowl.
  3. Add 1 Tablespoon of heavy cream to one bowl and mix well. If sweetener does not dissolve easily, add a bit more cream and continue mixing.
  4. Add 2 Tablespoons of heavy cream and the cocoa to the other bowl and mix well. A bit of additional cream may be necessary for the mixture to be smooth.
  5. Divide the white mixture among the twelve mini-muffin cups. This mixture is thick; after dividing it, scoot the pan back and forth on the counter so the contents level out (see photo).
  6. Top the cups off with the chocolate mixture. Don't forget to lick the bowl.
  7. Freeze overnight.
  8. To serve, pop out of the muffin cup and let it warm up for a few minutes.

Nutritional Information

Serving Size: 1 Treat  *  Calories:  38  *  Fat (g):  4  *  Carbohydrates (g):  0.3  *  Protein (g):  0.5

I have entered these into the Lose It! database for tracking purposes. I hope you enjoy them as much as I do.

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Another Info Sheet to Comment On: Nephrotic Syndrome

(by whizbang) Jul 21 2017

Thanks to everyone who read and commented on my new improved biopsy handout. I have now tried to simplify my nephrotic syndrome sheet.

Once again, you can use the original sheet as the "exhaustive" lay handout with the complete information.

Original NS

New Nephrotic Syndrome

Thanks in advance for your comments!

One response so far

Your Feedback Works

(by whizbang) Jul 06 2017

I have integrated comments from here and elsewhere into a yet more improved information handout on kidney biopsy.

This should be viewed as a supplement to the detailed discussion with me or another nephrologist, not an exhaustive discussion of the procedure.

Go to it, WhizBangers!

Newer Biopsy Handout

2 responses so far

Compare and Contrast

(by whizbang) Jul 03 2017

I am trying to make my patient and parent handouts more user-friendly. I’m moving from text-dense to less wordy pieces, and I could use some beta testing from the WhizBanger Crew.

Wordy Original Handout

New Improved Handout

Please leave your views in the comments. Does the shorter less wordy handout capture the key points from the original piece? What questions do you have after reading the shorter one?

Thanks in advance for your help.

 

5 responses so far

Actual Conversation with Hospital Billing

(by whizbang) Jun 01 2017

The other day I got a bill for some of my husband's medical expenses. I went to my banking site to pay, and it was the same odd amount I had paid two weeks before. Figuring it was a duplicate bill, I called the billing office. According to their records, my payment had not been received.

My bank account had proof of payment posted on my account, so I asked about the process to get this fixed. The billing person explained that I had to send a clear image of the front and back of the cancelled check.

I had a PDF including that, along with all the routing information and dates of the electronic transactions. Damn, good digital information can be fun!

Now for the punchline; I could email this, but only within the body of the email. NO ATTACHMENTS.

Yes, the medical center was losing it's stuff* over ransomware about this time and requiring all emails with attachments be quarantined. Apparently the billing department had been told to trust no PDFs from their clientele.

I ended up printing a PDF and faxing it. In May 2017.

Collection agencies have not called yet.

*I'm trying to keep it PG here...

4 responses so far

My Crowded Nightstand: A Cry for Help

(by whizbang) May 25 2017

My bedside table is getting too crowded, and I need to get something off of it. This could be best accomplished by eliminating my clock radio. After all, I have an iPhone that has to be there when I'm on call. It has an alarm. It has access to my favorite radio station. In short, it can do everything my clock radio does.

Except wake me to a radio stream.

The system's built-in alarm can access music and playlists, but not radio streams that are present in the Music App. This seems to be the case for the third-party clock radio apps in the store.

If anyone out there knows how to make this happen, I would love to hear about it.

4 responses so far

Another Aspect of Pediatric Disease

(by whizbang) May 02 2017

Jimmy Kimmel gave an emotional monologue this week about his newborn son’s congenital heart disease and the implications it has for his life with a preexisting condition. His pleas for coverage of all children with repairable conditions are important; as he says:

If your baby is going to die, and it doesn’t have to, it shouldn’t matter how much money you make.

Now stories of babies will get the crowd going, and most of the poor will be covered by Medicaid, at least for their initial care. It’s actually more difficult for those with some money and some coverage.

Insurers often require the use of provider networks. There may only be a single hospital in your state that provides the sort of pediatric specialty care we are discussing here. Are they in your network? If not, new parents could face thousands of dollars out-of-pocket, even with “good” insurance.

I understand insurers trying to limit their  expenses through limited contracts. For well child care and a number of other conditions, there may be enough providers distributed about to make networks a good solution. For pediatric specialty care, that often is not the case.

I would like to see network requirements and penalties not be enforced when there is no appropriate provider in network. Perhaps we can get that added to those basic health coverage requirements.

Oh wait, never mind. This is one more thing to eliminate.

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#ExpBio - Cannaboids and the Injured Kidney

(by whizbang) Apr 26 2017

Cannabinoid receptors exist in many tissues, not just those fun neurological areas we all think about. The kidney contains type 2 receptors (CB2), and experimental data suggests they might play a role in acute kidney injury. With unilateral ischemia-reperfusion injury (IRI) CB2 receptors are dramatically upregulated after 72 hours, returning to baseline after 168 hours (7 days).

Could activating these receptors help the kidney heal itself?

Pressly et al used a novel CB2 agonist (SMM-295) in bilateral IRI, administering it just after ischemia and every 24 hours after. Kidney function and structure were examined 24 and 48 hours after injury.

Animals treated with SMM-295 did not have elevated creatinines after IRI. NGAL, a marker of tubular damage, also remained lower with treatment. Tissue analysis showed decreased staining for PCNA and TUNEL, demonstrating reduced apoptosis. Tubular damage and casts were reduced by 50% with CB2 agonist treatment.

Acute kidney injury is a major problem in hospitalized patients, especially those undergoing cardiac surgery requiring cardiopulmonary bypass. Any agent that shows this much promise deserves further study, even if it won't give you the munchies!

Click author name above for full abstract.

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