Hannah-NOT-So-Montana-Anymore

This week has been so busy. The kids headed back to school. Backpacks and notebooks. Crayons and pencils. Forms to fill out. The last thing I wanted was to have to have a conversation with my 7 and 9 year girls about Hannah-NOT-so-Montana-Anymore.

Now, before you get all judgmental on me, NO I did NOT watch the VMAs. I have no interest in them. For the most part as far back as I can remember there was some "artist" or another doing nasty stuff on that show. WHY in the world would I sit my kids down to watch something like that? But thanks to the hoopla and uproar even the evening news BOTH local and national and the morning news programs have had pictures of her splashed all over the place. When your daughter says, "But, Mommy, I thought she was on Disney. Why would she do that?" You have to address it.

We had a talk about how young women who respect themselves act. How acting like that in public is not appropriate. That showing your body in such a way in front of a bunch of people just isn't right. The girls agreed that nice girls don't take off their clothes in public and they don't dance like that. That wearing a NICE bathing suit was OK, but ONLY if you are swimming. Whew. Conversation over. (My girls are way too young to have the rest of the conversation regarding sex and PDAs, etc. Yet...thank goodness.)

However, the more I've thought and pondered on it over the past week, the more angry I've become. While I agree that the performance was downright icky, is it really that much worse than MANY other performances? All day every day our society is inundated with gyrating and scantily clad women. Heck, the Victoria's Secret fashion show is on prime time TV now. AND don't start with the, "It's classy and artistic" argument. It's women in sexy clothes traipsing around for large numbers of people's enjoyment. I'm no prude. I'm all for sexy clothes and ADULT women wearing them in appropriate context, but one only has to check the sales number from the porn industry to know that objectifying women and sex is very profitable. And that's just the legal stuff.

Why is the outrage just pointed at this 20 year old ADULT woman? Why not at all the others?  Watch any performance by nearly any female artist these days and I'll guarantee she's in nearly non existent clothing and dancing in a sexual way. You know what I think? I think it's because we all remember her as a little girl. How cute and smart and funny she was on that show. We see in her ALL our daughters. But, guess what? ALL those women on TV and in dance clubs and in movies and in strip clubs and porn are someone's daughter.

Maybe that's what we need to start thinking about. As the mother of young girls, I struggle to find clothes that are appropriate. Shorts are TOO short. Dresses too sexy. Tops with deep v-cuts. T shirts saying "I'm a princess" "I'm pretty" "Cheerleader" "Dance" All of which would be fine if you could also find ones saying "Athlete" "Math genius" "Reader" "Science Lover". You can't. Even those of us who TRY find it hard to dress our girls modestly. And why is that? Is it because of the media? Industry? NO. It's ALL of the mothers everywhere that buy that CRAP. They would not be making shorts that barely cover butts if we didn't buy them. Think about it.

And then I thought about the male half of this story. As far as I can tell, Miley Cyrus wasn't on that stage alone. As she was "twerking" there was a man, a MUCH, older man there touching her and pretending to do....well...watch the video.  I haven't heard ONE commentary about how a grown man shouldn't be doing that with a much younger girl on stage.  Once again the stereo type of SLUT vs STUD is more than obvious. It's OK for a man to have a video with multiple topless women singing about "I know you want it," but it is forbidden for a woman to respond in the only way a man wants her to when he says those words?

The funny thing is I actually kind of like that song. It's catchy. But, it's a perfect example of how hard it is to separate "fantasy" from reality. I don't think Robin Thicke who is married and father of a small child really dances around with naked women having sex with all of them all the time. At least I hope not. BUT, our kids can't separate that fact. We have got to start teaching our girls to value themselves. BUT we also have to  teach our boys to value our girls. If we don't do both, we have failed all our children.

This morning I read this post on my Facebook. And so the next conversation about this Cyrusgate I will be having will be with my 15 year old son. Reminding him that yes, there are some very beautiful and sexy women to look at but every one of those is a person with a brain and a soul. Somebody's mom or daughter or sister.  That real women of value are sexy and beautiful and desirous, but also smart and funny and honest and trustworthy and moral.  And that REAL men value REAL women.

Back to School Crazies

When I was a kid, the anticipation leading to the first day of school was unbelievable. I remember arranging all my supplies in my new backpack or bag. Pencils and pens in the pencil box. Rulers and protractors and sharp scissors. I remember not being able to wait to wear my new clothes, even if some of them might be for the wrong season. New shoes you couldn't wait to show your friends. The nervous butterflies in my stomach wondering if my best friend would be in my class. Would I know anyone? Would the teacher be nice or mean? And my lunch box with matching thermos that I insisted on drinking from as soon as I brought it home.

Yes, back to school was a wonderful time. By the time it arrived, I was bored with summer games and playing outside. Skating down sidewalks and riding my bike with friends. Even swimming was old hat. I didn't want anymore craft projects or books to read or games to play. No matter how many wonderful things my Mom presented to me, none of them seemed exciting. I'd said, "I'm bored" enough times that Mom was sick of it and ready to ship me off to school.

As a parent, I realize now there is so much to back to school. Between worrying about the kids and making sure my long to-do list is complete, I find myself a bundle of emotion.  I put on a brave face for the kids. I tell them how great it will be to see their friends. I see them just as excited about new back packs and lunch boxes as I was at their age. Inside, my brain is swirling.

It's really hard to be a parent. My Mom told me this many times, but of course I didn't believe her. She was a single working mom, sometimes working 2 jobs to support us. Knowing now what I didn't know then, my Mom's statement about parenting being hard seems like a HUGE understatement. Don't get me wrong. Being a parent is absolutely the single best thing EVER. My kids are amazing and funny and cute and smart and teaching me things everyday. I thank God everyday for them and the opportunity to be a parent. BUT, I'd be lying if I said every day is wonderful. ANY parent who tells you every minute is wonderful and they are enjoying every minute is a BIG. Fat. Liar.

For me the time leading to back to school is nerve wracking. There are forms to fill out and emails to answer. School supply lists that seem longer and more complicated every year. Now that my son is in (gulp) high school, there are summer readings and projects. Between school things and their outside activities,  I feel like my head is spinning.  Then there are the closets to clean out. Do they have shoes that fit?  Back to school meet the teacher nights and phone calls to make.

And then there's mommy guilt. Did they have a good summer? Did they read enough? Did they study enough? I'll bet that kid down the street was in a 4th grade college prep PSAT class.   I'll bet that kid's mom did interesting science experiments everyday. All that crap on Pinterest I see that looks so amazing, I'll bet SHE did ALL that. And took pictures of it. And posted it all on Facebook.

Then there are my insecurities. Will my kids have friends? What if they're bullied? What if they aren't popular? What if they are the annoying kid in class? What if they are the know it all kid?  What if they aren't as smart as I think? What if they are just (*GULP*) AVERAGE?

And these days, much worse worries than that. Will they be safe? Is there a tornado shelter? What are the school's emergency procedures for lock down? Do my kids know what to do if there is an emergency? Will the teachers follow protocol in an emergency? How does my kid's school protect against intruders?  What would my kids do if a stranger approached them? What would they do if someone they KNOW approached them inappropriately?  What about the internet? How can I be sure they are not doing things they shouldn't be?

All of these worries and more make being a good parent these days stressful. Protecting our kids and guiding them through school is our most important job. But, being a good parent means making sure they enjoy school and get to be a KID from time to time. Play with no plans. Be silly and messy and spontaneous. At the same time, we have to make sure they learn enough so that they will be competitive in a very competitive world. They have to develop their brains and their social lives.

Sigh........

And guess what?  We are only human. We can only do our best. Love them. Guide them and lead by example. Have faith that if we do our best, our best will be enough. That soemday we'll look at the children we've raised and realize it was hard, but we did good. I know that will be an awesome feeling.

But, for now, I'm going to shove all those worries aside. Do my best to teach my kids to be safe. Do my best to teach them to enjoy reading and math and science and just plain LEARNING. Show them how to manage their time and organize. Show them sometimes you screw up and learn from that, too. Do my best to be sure we enjoy these years of school and sports and band and Girl Scouts and Boy Scouts and ALL of it. Becuase after all, we only get ONE shot at that.

So bring it on BACK-TO-SCHOOL. We got this.

11 Ways to Keep Halloween from Being SCARY as Parents

I love Halloween. I have since I was a kid. I love dressing up in costumes. I love all the scary decorations. I love scary movies. I love the silliness of the whole holiday. Now that I'm a parent it is a lot of fun to see my kids enjoy the holiday as much as I always have. Of course as a parent, there are so many more things to consider. Now that my kids are getting a little older, they've started venturing out on their own more for Trick-or-Treating.  It got me thinking about some safety issues all of us need to consider for the holiday. Here are a few Halloween safety tips to keep your family safe.

1.  Costumes can be more than just scary to look at.  Check your child's costume to be sure your child has good movement, that they can walk in whatever they are wearing, and be certain that they have a good scope of vision.  Also, if you are using a store-bought costume be careful around any open flames, since most of these costumes are cheap and quite flammable. It’s not a bad idea to go over stop, drop, and roll if your kids are going to any kind of bonfire. The costume should be visible. Black vampire capes are cool and scary, but your child needs to be seen to be safe.
2.  Make sure you never carry real weapons. It might be tempting to carry or let your kid carry an unloaded  or scary-looking weapon to "complete the look" for his or her costume, but even unloaded guns can be dangerous. If you plan to allow your kid to carry fake guns for their costume, take a few minutes to talk about gun safety. Even a fake gun should not be pointed at anything you do not want to destroy. Act like every gun is loaded, even the fake ones.  This mostly applies to older kids, but use your judgement based on your child’s maturity.
3. Make sure your child and everyone in your group has a flash light or glow stick. This once again goes to visibility. It is especially important for kids, like mine, who might get anxious and in a hurry and separated from the group.
4. Emphasize road safety.  In our neighborhood there are a TON of kids. On Halloween night there are kids on bikes and scooters and motorized vehicles, not to mention cars carrying our little goblins to and fro. Halloween is very exciting and fun and THAT along with lots of sugar filled candy can lead to kids forgetting basic safety rules like: STAY on the sidewalk and LOOK both ways before crossing the street. Plus there are plenty of distracted teenagers on the road for Halloween fun as well so BE careful.
5. And on the subject of drivers...SLOW DOWN if you are behind the wheel. Neighborhoods are bustling on Halloween. if you're driving, keep your distractions to a minimum. There will be all kinds of little ones out who may not be watching out for your car. You need to have your mind and eyes on the road, not the cell phone or radio. Also turn on your headlights early to help increase the visibility of your vehicle
6. Before you leave the house make sure your children know their FIRST and LAST names, full address and phone number. Don't assume they can call you on their cell phone because you never know if it may get lost. Also, if they get lost, "I live in the brown house with my Mommy and Daddy" is not the best way to get them home.
7. Make sure your child knows it is OK to say NO to an adult.  It is not rude to runaway from someone if they are feeling bothered or uncomfortable. Make sure they know to yell and attract as much attention as possible if they feel uncomfortable with an adult.
8. Talk to your kids about the tricks predators use to lure children. These most often include bribes of money, toys, etc., or requests for help, such as help finding a lost pet, or maybe even coming in for the candy that is in the kitchen. Halloween is a night for getting things from people you barely know. There is no point in scaring your children before they go out, but this is a subject that you want to broach, especially if they are being let off the parental leash for the night.
9. Eat before you go out and accept only wrapped candy. Don't let your kids indulge in any of it until you've had a chance to look it over.  If you make sure your kids have ACTUAL food before they go out, they'll be less tempted to ignore this rule. PLUS, you might end up with a less sugar filled kiddo by the end of the night. We can hope, right?
10. Practice fire safety.  Don't overload outlets or overuse extension cords. Keep kids away from open flames. Better yet, use battery operated lights instead of candles. It's a great time to practice Stop-Drop-Roll. Make sure exits are clear of decorations and ensure nothing blocks a safe exit in case of emergency.
11. Make sure your child knows HOW and WHEN to call 911.

Halloween is a time for all kinds of fun.  But it is also great time to talk about safety rules that can keep them safe all year long.  Being prepared and knowing how to react to a situation is one of the best lessons you can teach your kids.We don't want to scare our kids, well.......maybe we want to SCARE them just a LITTLE at Halloween....but we don't want them in situations that could be dangerous.  Following just a few simple rules will keep them out of harm's way.

It's NOT About The Statue! What really matters in the Penn State Scandal

I've been a college football fan all my life. You don't get born in Norman, Oklahoma the home of Sooner football and not grow up a football fan. I love everything about college football games. My husband and I still have tickets and try to make as many games as we can.  I'm a sports nut. I love them all. I watch a lot of ESPN, read the magazines, listen sports talk radio and even blogs and websites. It's my thing.

You'd have to be hiding in a hole somewhere to have missed the news about the Penn State child abuse scandal. It is absolutely horrific. It's been a topic in the news and sports news for several months now.(Please stop reading now if the topic of child sexual abuse is disturbing for you.)

Joe Paterno has been the coach at Penn State since before I was born until his death a few months ago. That's a really long time to be a coach. I remember the times OU had played Penn State and respecting him as a coach. The older I've gotten, the more respect I've had for a man to be so seemingly devoted to doing things right. I remember watching scandals come and go over the years at many programs, yet here he was....Paterno: old Fashioned, upstanding and someone that seemed to be a man made of a different cloth. It was often said of him,  "They don't make 'em like that anymore." This sort of thing was always said with near reverence for the man and all he had done. Now, there are much different things being said about him and rightly so.

In the wake of one of the most devastating and tragic scandals to ever rock college sports, everyone is talking about the horrific acts done at Penn State by former coach Jerry Sandusky and the people who have covered it up. Worse it seems now with all the new information that no one, not even Joe Paterno, did ANYTHING to stop it from happening to more young boys. It is horrible, sickening, gut wrenching to think of even ONE young boy being raped and not stopped. Not to mention the 40 counts of which he was convicted.

As a family physician I am no stranger to abuse cases. Recognizing them, reporting them, dealing with the long lasting psychological  trauma caused by abuse of all kinds is part of my job, my responsibility. The fact that these so called "teachers"or "professors"or "educators" or even coaches KNEW that a child predator was in their midst and did not do everything in their power to stop it from ever happening again is revolting. 

Last week a new report from an independent investigation was released. Since then, many people have been calling for the removal of the statue of Joe Paterno on the Penn State campus. This week I've seen multiple reports discussing whether it should be taken down both in the sports and regular media.  Fact is, we're missing the point. Statue or no statue, child abuse is a REAL problem. We all ought to be spending more time disucssing it, how to recognize it and prevent it.

Every single one of these news reports talk about this as if it's an isolated incident. The sad truth is that children are sexually abused every day, every hour, every minute. Most perpetrators are someone the child knows and many times is a family member.  We should not think that child abuse is committed by some stranger. Just like in the Penn State case, it is almost always someone that is trusted by the family.

As a parent, the idea of what happened to all those poor boys saddens and enrages me. As a doctor it makes me want to be just that much more diligent about watching for signs and symptoms. But more importantly it reinforces the idea that prevention is key.

The American Academy of Pediatrics recommends that parents teach their children the name of the genitals, just as they teach their child names of other body parts. This teaches that the genitals, while private, are not so private that you can’t talk about them.

Talking to our children about inappropriate touching is also important. We cannot wait "until they're old enough" or be embarrassed or worried about talking about it. Protecting our children starts at home. We all must be sure kids know that if ANYONE touches them in ANY way that makes them uncomfortable they can and must tell someone and not fear ANY repercussions.  Sandusky often threatened his victims and their families as many sexual predators do.  We have to emphasize that they will be safe and not punished for reporting it.  It is so important to teach our children early and often that there are no secrets between children and their parents, and that they should feel comfortable talking with their parent about anything -- good or bad, fun or sad, easy or difficult.


Children who are victims of sexual abuse can display many or few behavioral symptoms. They may withdraw from family or friends, display poor school performance, experience depression, anxiety, or exhibit aggressive and self-destructive behavior. Or they may not display any outward abnormal behavior. It's important to use your instincts. If you are worried about your child, don't ignore that. See your family physician right away.

We also must educate ourselves about how to report and to whom. Every one of us, doctor, teacher or just regular citizen has a duty to report ANY suspected child abuse-sexual or physical. You can make reports anonymously. You can call 911 for any emergent situation. In Texas you can even file a report online.  Please don't be afraid to report. It is much better to make an error than live with the idea that you did nothing to protect a child who has been harmed.  It's only your job to report cases of suspected abuse. Investigators will do their job to see if the abuse really occurred.

The situation at Penn State is tragic and horrible. The victims and their families will face a lifetime of dealing with what was done to them. It is horrible. But, whether or not someone's statue is removed is irrelevant. The only thing that matters is that the victims receive the help they need, Jerry Sandusky never gets the opportunity to touch another child, and we ALL open our eyes and protect our children.

17 Years Ago Today

I was a third year medical student. I was tired and busy and nervous. I was engaged to be married in December. I was on my surgery rotation. One of the most hated. It meant long long hours. I had to be at the hospital and ready to "round" with the intern by 5am so we could round with the senior resident at 6am. Attendings at 6:30am.  Then surgical cases began at 7-7:30am. If you weren't scrubbed in on a case, you were studying, or supposed to be.

I remember it being one of those perfect spring days. A little chilly in the morning. Just enough to feel it and dew on the grass. The sun came up bright and lovely and we were all complaining about how we'd rather be outside than stuck in the stupid hospital.

At 9am that day I had just ran down to the floor to check on a patient. I was on my way back to the student lounge when it happen. The walls shook. There was a HUGE noise. I ran up the stairs to see if my friends knew what had happened. No one knew. A few minutes later we headed to check out the TV. The loud speakers in the hospital began to blare out a message none of us understood at first. "CODE BLACK. CODE BLACK. This is not a drill. Repeat This is not a drill.  ALL attendings, residents and medical students report IMMEDIATELY to the emergency room for assignments."  It repeated a time or 2 before we understood it meant us.

As we ran down the stairs scared to death, we saw nurses and doctors and people scurrying every which way. We were asking each other "What the heck is code black?"  Someone shouted, "DISASTER. It's a disaster. A major problem like plane crash or explosion or something." We ran faster down the hall. On the TV there was already aerial footage of the building and a big black cloud of smoke. The windows in the hospital lobby were blown out and there were people crying in the lobby, but we kept going headed toward the ER. No one knew what had happened yet.

I remember streaming in to the ER and seeing every attending physician in the hospital. All of them. Scariest thing I've ever seen. Ever. We all knew something really really bad had happened. We were given assignments. I was assigned to triage. We gowned up in trauma gear and headed outside where we were given cards to assign to patients-green, yellow, red.  Red was the most critical. We were supposed to start IVs, assign the cards and divide the victims into groups.

You have to understand. We'd only done a few IVs at this point. Sutured a few times. We were absolutely terrified. We looked at each other with excited, but also gravely serious looks on our faces. It was made even more terrifying by the looks on the faces of the surgeons and doctors we idolized and feared. They were scared, too.

Information began to trickle in. There had been an explosion at the federal building downtown. It was a couple miles from where we were. We tried to call friends who were on rotations at St. Anthony's which was closer to the blast. Getting cellphone signal was really hard. We stood and waited in the ambulance bay. And waited. And waited. The worst part. A few people came in cars and trucks. There were a few ambulances.

It was chaos as a few more bomb scares happened. Some of our friends had jogged and walked over to see what had happened. As time went on, it was clear. We were not going to get the injuries we thought. And later, we knew that it was because many were already dead.

A triage area was set up in the cafeteria where students and residents pulled glass out of people and stitched minor wounds and took histories and listened to stories. We gave tetanus shots and bandaged and reassured the terrified people. Then I finally got a phone call. It was my Aunt.

I wondered how strange it was that she called. I figured she knew I was in the area and was checking on me. She was, but then she told me. That building. That was the one my two cousins worked in. They were cousins, but they were much older than me. I called them my "uncles" growing up. I was confused.  She asked me to check to see if they were there because no one could find them.

So, I ran back to the ER. No one registered there by those names. No John Doe with their description. I called my friends in all the other hospitals. No one had them admitted. I tried to walk over to the site. I had heard that some of my friends were there helping triage close to the building. But by then, the streets were blocked and the police and FBI had shut down the scene.

I hung around a while and helped where I could and then I finally told my resident I was going home. I couldn't think straight and I needed to check on my family. I drove home to Norman where the family had started to gather together. We were glued to the TVs. Sat perched by the phones. We had the TVs on different channels in different rooms. We called everyone we knew that might have information. As the day wore into night, and they were trying to find anyone alive it got scarier.  I called my friends who were on call all night. No one had seen my family members. We had hope that maybe they were in a hospital and no one knew yet.

As we woke up the next day, that hope diminished. I drove to the hospital as I had all the days before. I was worried and scared. The first patient I was assigned to was a man from the bombing. He had a skull fracture. He had brain fluids leaking out on his pillow. He was in critical condition and probably wouldn't make it. I walked in the room and began to examine him. I proceeded to have a panic attack.

I was hyperventilating. I was shaking and dizzy. I thought I would pass out. The nurse in the room in the ICU noticed me. Normally this sort of reaction might elicit scorn from an experienced ICU nurse. Another med student freaked by a critical brain patient? But, not today. Today everyone was sad and scared and in mourning. She asked if I was OK. She escorted me out of the room and sat me down. I burst into tears. I couldn't talk.

Another student came over. Asked what was wrong. "My uncles." Was all I could get out. Finally I was able to calm down and explained they were missing and likely in the rubble. The clock was ticking and if they weren't found soon........well everyone there knew what it meant if they weren't found. I was mercifully sent home to be with my family. My fellow students said they would cover for me.

A center for the families was set up at a nearby church. The fire chief and rescue people and medical examiner and representatives from the hospitals were there. Counselors and ministers. We were all on watch hoping our family members would be found alive. We sat there for days waiting to hear and knowing that each minute that went by we were less likely to get good news. Then, we just wanted to know.

One cousin was found after a few days, the other not for weeks. I had nightmares for weeks, months after the bombing where I was looking for them, they were calling me, and I couldn't help them. I was terrified that my soon to be husband would leave and not come home one day. I was afraid of the hospital and sometimes the patients. It changed everything.  It changed me, our family, our state, our nation.

That day 168 people were killed, 19 were children. Nearly 700 people were injured.  It left 2 widows and 5 children without fathers in our family. It left me knowing that everything could end any minute. You'd better live your life the best you can. Love your family and at every opportunity tell them that you do.  I learned to be a better doctor. More empathetic to those that experience trauma.

It left me with more empathy for those that have anxiety and PTSD because it is something I battle even now at times.  I still do not leave the house without saying goodbye to my husband. For years after, I physically could not go anywhere or leave him without saying goodbye.  If I left and forgot to hug my husband, I had to turn around and go back. Had to. Now it's a habit I cherish.

Even now after all these years this day is a hard day. A day of remembrance. A day to be thankful. A day to count our blessings. A day to think about the fragility of life. A day that I will never forget.

Doctor Heal Thyself?

There's an old saying, "Doctors make the worst patients."  This may or may not be true, but I can tell you being both a doctor and a patient is......well a bit weird.  I'm not exactly sure why, but I have a few ideas. Tomorrow I'll have a chance to experience being a patient once more and maybe that will shed some light on the issue.

I have a condition called subglottic stenosis. This is a fancy way of saying I have scar tissue that has grown in my upper airway.  We're not sure why I got this. It is a condition which is usually congenital and usually diagnosed in children. In adults it almost always happens due to trauma to the airway, either being on a ventilator, or trauma to the neck. In my case, I have idiopathic subglottic stenosis. Idiopathic is doctor speak for "we have no idea why you have it".

At any rate, the condition causes a narrowing in my airway. This limits my breathing and makes it hard for me to tolerate any kind of physical activity or exertion.  It also means that any cold or allergy problems I have make it worse. Imagine breathing through a drinking straw all the time. Well, that's how I feel.  I was diagnosed with this problem in 2007. Tomorrow I'll have the procedure to fix it for the third time. It's a simple surgery where they use a laser to burn off the tissue and restore my airway to near normal size. It may or may not come back again, but at least for some time I'll get relief of my symptoms.

Here's some pictures of my first surgery

The picture in the upper right hand corner is before the procedure.That tiny little hole is what I breathe through. If you head straight down that hole you'd hit my trachea and then lungs.  This is about the size of a baby's airway. The picture in the upper left hand corner is the picture after the laser burns away the scar tissue. That is about 2/3 of what a normal adult airway should be but you can see it's a huge improvement.  The other 2 pics show after the doctor inserted a balloon to dilate the area before the laser. After the laser he injects medication into the area to try to reduce swelling and future scarring.

I think being a patient is hard for me and other doctors for several reasons. First, we know what happens backstage. Not to say there is anything scary or wrong going on, but we do know every conceivable thing that might go wrong. All the things that we would assure our patients hardly ever happen.  Like any other patient I have to realize that the benefits of the procedure outweigh any risks.

Second, our colleagues and people we supervise are going to see us naked. Yes, it is just weird having someone you will see next week in the staff meeting while in a gown and no undies. Just weird. At least a regular patient will hopefully never see the nurses or doctors again. With me, there's a chance I'll be chatting with them at lunch tomorrow.

Giving up control is very difficult for doctors. We're used to calling the shots, making the hard decisions. Naturally each of us thinks his or her way of doing things is the best. As patients we have to sit back in the passenger seat and let someone else drive. And anyone whose ridden while their spouse drives knows how hard that is. No matter how much you trust that person, sometimes you get jumpy if traffic piles up.

I think all doctors should have to experience being a patient at some point. It certainly has taught me a lot about how to help patients through their procedures. For instance, I always try to stay away from too much medical jargon.  When I've been a patient I notice so much doctor speak being used. Of course I know the language and I don't need an interpreter, but many patients won't necessarily know what intravenous fluid or endotracheal tube means.

And even with all my advantages knowing all the risks and benefits. Knowing exactly what the anesthesiologist will do, what drugs they will use, what the nurses will do, how the surgeon will perform the procedure, being a patient is just plain scary. I think it is so important for all of us healthcare providers to remember that. We deal with these things everyday. We live in this land of needles and x-rays and drugs and scalpels. Our patients do not. It's like being dropped on a different planet.....naked.

The biggest advice I can give to patients is that you should never be afraid to ask questions. Never be afraid to let your nurse or doctor know that you do not understand something they have said. If you feel uncomfortable about something, let someone know.  But also, choose physicians and hospitals where you can place your trust. It's important that when you are at your most vulnerable you know you have someone that is doing everything to help you. And then......try to relax. Being anxious and uptight can only make things more difficult.

Finally, do what your doctors say. Rest when they tell you, eat what they tell you and don't do things they've told you NOT to do. This is the hardest for doctors. We all think we're superhuman and that we can be back to work seeing patients sooner than we should. We all think we know better. Well....we don't. And we often tell our patient's one thing and do another. Of course not me. NO, no me. I promise I will do what I'm told. I want to feel better.

I want to get back to my workouts and Taekwondo classes and heck, being able to climb the stairs without sucking wind. I am thankful that my health problem is simple to fix. There are many way worse things that can happen. For the time being, I'm going to let my doctor self rest and turn myself into patient me. At least I'm going to try!

What's your excuse???

Right about now the new has worn off those resolutions. It's a little harder.  Maybe you're going a little longer between workouts. Maybe you're eating a little more than you were at first. I know how it goes. Two years ago I never worked out. Two years ago I was 75 pounds heavier. I can't tell you what made me do it, but I can tell you I just decided.  It's not like I didn't know what to do. I just never did it. I had ALL sorts of excuses for why I couldn't eat right and exercise.

Over the last 2 years the thing that surprised me most is how much I really do enjoy exercise now that I do it consistently. These days I'm working out 5-6 days a week, sometimes twice a day.  I have 3 kids and a full time career.  I have a very busy life, but I made the decision that my health was worth the sacrifice. I get up early for a cardio workout most days. I have a stationary bike and some weights at home. I also have videos and a treadmill. In fact I have a WHOLE collection of exercise do-dads collected over the years as I made resolutions year after year. All of them were gathering dust, but not anymore.

On top of that I started Taekwondo classes.  I go to class a minimum of twice a week. I am now half way to black belt. I don't know how long it will take me to get there, but I am absolutely determined to do it. That's going to take comittment and healthy eating and more weight loss. I have to be in better shape than I am now. That's OK. I'm not planning on going anywhere. I plan to be around working toward my goals for a VERY long time. And now.....there's a much better chance I'll make it.

I know what you're thinking. "Yeah, but...." I've used every excuse in the book to talk myself out of exercise. I didn't realize it at the time, but now I recognize it. Even now working out is sometimes a drag. I don't bound out of bed everyday and hop to it. No.....I STILL have to fight myself some days to get the workouts done. Even though I know how much better I feel. Even though I know if I don't do it I won't lose weight. AND even though I KNOW that once I get going I'll enjoy it.

I've complied a list of excuses I've used. Maybe you'll recognize a few of your own here. I can say this: Do.Not.Wait.  There will always be something standing in your way. ALWAYS. That's life. If you let it, it will rob you of your chance to have a longer healthier one. Make a commitment. SCHEDULE your work outs and stick to the schedule.

Here's a few of things I've used to justify NOT exercising:
I'm too fat. People will look at me. I might hurt myself. I don't have time. I'm too tired. Exercise is just not my thing. I'll never be skinny anyway. I have too much to do. I should be spending time with my family. I just need some alone time for me.

It's too hot. It's too cold. It's too windy. I can't find my shoes. I forgot my shoes. I need new shoes. My friend said she'd go with me and then backed out. If only I had an "accountability partner".  I'll lose a little weight first, then it will be easier and I can really focus on exercise.(huh?) It's too late at night. It's too early. I'm not sure what to do. I don't know HOW to do it. I don't have a gym membership. I have a gym membership but I'm too embarrassed to go.

My work out clothes are too tight. My work out clothes are too loose. My workout clothes aren't fashionable enough. My workout clothes are too nice and I might get them too sweaty. (No, really I actually had this thought once)

  I'm sick. I'm getting sick. I MIGHT get sick. I might get hurt. My back/ neck/knee/ankle/leg/elbow/3rd finger/ left big toe hurts. I have a migraine. I MIGHT get a migraine. It's too noisy in the gym. It's too crowded at the gym. There's not enough people there and the trainers will all be looking at me.  I'll have to take the kids to the childcare center and I'm already a working Mom, so I should spend more time with my kids. I should be spending time with my husband/pet/mom/cousin/neighbor.

My closet is a mess. Laundry. Dishes. Kids homework. My homework. I deserve a break. I've lost so much weight and am achieving my goals so I deserve a day off. (pretty twisted one, right?)  I'll start on Monday. I'll start on the weekend. I'll start after this semester/project at work/the busy season at work.  I'll start after the holiday/birthday/kid's birthday/trip/summer break/spring break/cruise/vacation/doctor's appointment. I'm depressed. I'm just in too good of a mood. (really??) I'm too hungry and I won't have time to workout AND eat (oh my!).

I'm on my feet all day at work and I never sit down so I'm REALLY active. I "ran late" at work. I have a meeting. I'm just too darned busy. By the end of the day, I work so hard I just don't have the energy to do it.

I've got my period. I'll be getting my period soon. I'm bloated. I'm dehydrated.  I don't want to have to change clothes and shower again. I forgot clean underwear/socks/my makeup/shampoo/pony tail holder/gym membership card.  I might be over training. I might get big muscles. I might not be building enough muscles anyway. EVERYONE needs a rest day.

I'll do it later. I'll catch up on my workouts over the weekend. I overslept. I slept too much. I didn't sleep enough. I forgot to track my food anyway today(how this relates to me working out, I don't know) I just can't face another workout. I screwed up my training schedule so I might as well wait until tomorrow and get back on track.  I'm really hungry. I just ate. I forgot my water bottle and I have no money. (Umm...can you say water fountain?)

My cell phone battery is really low so I can't listen to my music. I don't have my headphones. My headphones are broken. I never have time to make me a good playlist for working out. I forgot the book I was reading when working out.  I just want time to read my book.

I have diarrhea. I'm constipated. I have a rash. I might get a rash. I need gas (for the car, silly).  I have a flat tire.(OK so that one should probably be acceptable). I really wanted to DRIVE THROUGH the car wash (while sitting on my butt of course).

I don't want to make my husband feel guilty since he's NOT working out. (seriously!?!)  I don't want my BFF to be jealous if I work out MORE than her. (good lord) My BFF is so much BETTER at working out that me. I'll never be an athlete anyway.  Once I start I'll have to keep going or I won't STAY in shape (most twisted one EVER!!)

I SWEAR!  If I'd spent half the amount of time working out as I have spent finding reasons why I couldn't or shouldn't work out, I'd be at my goal weight by now.

Learn to recognize an excuse when you "hear" yourself make one. Spend more time thinking of ways to make getting in a workout easier and removing obstacles. Spend a little time planning workouts into your schedule and then treat it like you would a business meeting or doctor's appointment. That time should be committed  to exercise and if anyone or anything tries to interfere with it, make sure it's important enough that you'd cancel a meeting with your boss/lawyer/doctor/dentist.  Because it's THAT important. Because YOU are THAT important.