Two Girls

I haven’t dusted off the blog in awhile.  I’ve been talking with a lot of people lately about the obvious differences between my two daughter’s personalities already apparent at ages 7 months (Amy Elizabeth) and 2.5 years (Ruth Hazel).  I’m finding this aspect of parenthood to being one of the most satisfying and interesting- having the opportunity to look back and see aspects of their personalities present even at very early ages.  Ruth’s personality traits were almost present from the moment she was born.  Amy it’s harder to tell only because she is younger and her “real personality” isn’t as clear yet. I’ll start this brief discussion with pictures of both girls at age 6 months.  It’s important to realize that looking at the pictures side by side you can see some difference in their faces, but if you show us (me or Dorothy) a picture of one of the girls at any certain age we can probably only tell who it is by the outfit.  Although as I thumbed through picture after picture of both girls as I was preparing for this blog post, I now think I have cracked the code.  Here’s two pictures right around 6 months of life.

IMG_0188 IMG_1491

Both girls were exactly the same weight 13#7oz at their 6 months visit.  Amy was 1.5 inches longer and was born heavier (that’s a different post on her poor rate of weight increase and the efforts we have gone through to improve that).   They are both bald, same color and complexion, very similar eye color, very similar cheeks, similar eye brows, mouths the same (though not the shape they put them in- which we’ll talk about) and the main difference is a slight difference in nose structure.

But I chose these pictures because I think they effectively display what is now very obvious from the pictures- Ruthie has that same look in almost all pictures she has taken and Amy has that same smile in almost all pictures taken.  To date those looks pretty well sum up the differences in personality.

We don’t know as much about Amy- she naps well, is generally happy when fed (which has been a slight problem in the afternoons when the milk supply just wasn’t keeping up), and smiles all the time.  If fact it’s hard to find a picture of Amy not smiling because if you are looking at her that much to take a picture she’s probably going to smile at you. She’s very likeable.  Which is a different word than you’d use to describe Ruthie, who’s also likeable, but there’s several other traits that describe Ruth better.

So what is that look in Ruth’s picture?  Intensity!  That would be the word that Dorothy and I would use to describe Ruthie.  In fact that very same intensity could already be seen in the very first picture have of Ruthie seen here in the pictures at the bottom of this post.  Both pictures have that look, even at 5 minutes of life she was looking around.  In fact every picture we have with her is like that.  She is smiling in almost none of her pictures before 1 year of life.   We used to think of her as “social” because she loved being in a crowd and around other people. Now we know that Amy is actually social, she wants to be around people, make eye contact, smile, etc. Ruthie wanted to grab the name tag off your shirt, pull your glasses and investigate the pen in your pocket. Eye contact only with that intense look that you see in the picture above.  People commented from day one about how alert she was.

Ruthie is now a lovely girl, social, engaging, and loves talking with people. But she is still incredibly intense. She is very emotional. Several people have commented about having “adult conversations” with her.  When she is playing it’s like “get back Jack I got a job to do”. She will frequently just begin running laps around things.  If Mommy and Daddy are not done having dinner at the table, she’ll begin to run laps around the table.  If I’m lying on the floor she’ll begin to run laps around me.  She’s 2.5 years old and can spell her name, she knows her birthday, and can do 50 piece puzzles.  She’s intense.  She didn’t nap during the day until she was 9 months old, she would cry for an hour in her bed.  She has slept three times in public that we can remember- once on my beloved Aunt Liz’s (RIP) bosom, once recently when she inexplicably fell asleep while playing stickers on the airplane.

I look forward to getting to know Amy.  I have a feeling that she will be much easier to get along with.   It’s hard not to enjoy someone that smiles continually.  She has some of the intense, focused features that Ruthie has and is actually louder in many ways.  Ruthie is to focused on things to be really loud (unless she was bawling about being in the car seat, which she did every time as a baby), but Amy is often very loud because she has realized that it gets her more attention (and smiles).

We only have one mold to create kids in our house, but they have very different flavors.

Published in: on February 16, 2013 at 5:22 am  Leave a Comment  

Always a wrestler….

I was out running with my dog today and I couldn’t help but think “The human body is amazing.”  I ran roughly 7.2 miles today with my dog which was twice as far as her previous long run with me (we’ve had the dog for less than two weeks).  While she was significantly stronger this go round then our 3.5 mile run (it was a lot cooler today) she was still definitely dragging a little by the end.  I look at my stocky, wrestler-pretending-to-be-an-endurance-athlete body and then my dog and think, how’s it even possible that I can out run her?  Our physiology is amazing and I got to remembering about how humans can outrun horses in distance races.  Say What!?!?  No really, take a minute (after my blog) to go read this:

All Men Can’t Jump

But I was also thinking this week (thanks to a question by Tim Sinnett) about my habitus.  I was a pretty scrawny, short kid with a reasonable amount of innate talent in running, but where I grew up outside Chicago during the peak of the Jordan years there was only one sport- basketball. That wasn’t the best for me given that only one girl was shorter than me in my 8th grade class.  When I moved to Washington I joined cross country.  I ran too much too fast, suffered through shin splints, didn’t know how to suffer athletically and really didn’t like the coach. I never went back which was probably a mistake in the grand scheme of things, by the end of high school I posted a few *almost* collegiate level running times in local races and ran a marathon a few days before my 18th birthday.  BUT I never did really run again for a team other than my wrestling team. Wrestling was fundamental to my development as me.  I’ve discuss this before, but it also probably changed the way I looked.  I wrestled 101 pounds my freshman year, really weighed 99 and didn’t need to worry about making weight ever.  By my senior year I was about 150-155 pounds (wrestled at 135) and could bench over double my body weight 315lb one rep max on bench, I did 405lb x 3 in back squats AND ran a marathon a few months after my senior wrestling season.  I was a machine.  I was a terrible wrestler but great at training for wrestling.     My sophomore year at 115 varsity I was 5-15 and my senior year I was something like 13-13 for the season.  I was probably at to low of a weight class but I would have been JV behind our very good 141 wrestler but that’s a different story.

The summer after high school (before heading off to college) I basically worked out all day.  I rode my bike to Godfather’s Pizza (my only fast food job ever) and on break had all-you-can-eat pizza buffet every day.  After work I rode my bike to Gold’s gym and worked out hard (including long runs).  I did this until around the start of August when I got sick.  In retrospect I realize it was mono, but all I knew then was I was to sick, tired to workout.  In-fact I think I couldn’t even ride my bike to work for that next month.  I remember being all but couch bound from exercise.  Then I went off to college, lifted weights, ate to much, partied to much and shortly after college I was 205 pounds (at 5’6″).  I certainly didn’t look super fat or anything, I have some unflattering pictures of me with a bit of a gut but I still basically looked like a muscly wrestler.  I got into medical school (accepted spring 2001) and knew that I needed to return to cardiovascular fitness. That led me to a several year path of pursuing greater and greater levels of fitness and eventually hitting ~155 pounds again during winter of 2006 while training for bike racing. That next year I had my early season crash, hurt my AC joint and never really had a great season (though I did race all year) and the next year we moved to Jerome and I basically stayed around 168-170 average until early this year.

During all of that though I’ve always looked more like a wrestler faking it in endurance sports.  During medical school my VO2 max was tested somewhere around the mid to high 50’s ml/kg/min, which is pretty good by today’s standards though certainly not elite athlete levels.  Average males today are under 40.  They have detailed information from ancient Rome on soldier’s gear, height, weight and march times, etc and have calculated that the average Roman legionaire was over 40  (here’s the article I remember though they don’t mention what the average must have been in that) and I recall reading in one place that the average was probably closer to 55 for the legionarres. So I wouldn’t have made the height cut off, but I maybe could have hung in a forced march with them.  Even at my skinniest post-college fitness my back and legs in particular looked like a scrapper not a bike racer.  It’s pretty clear in my post crash photos (here) what I mean (especially my back).  I was right at my current weight (~160) in that picture though from several years of bike racing my habitus was a little different in that today I have bigger arms by a long shot, so it’s a little unclear where all that extra weight was in that crash picture, legs maybe?

So to sort-of go somewhere with all this discussion about my body habitus: do I look like a wrestler because I was a wrestler or if I had run all along would I have eventually looked like this?  I have no idea.  I certainly have a significant tendency toward muscle development, I’ve never been worried about my testosterone levels, but I really prefer endurance sports.  Right now I really don’t care very much because I really do enjoy lifting weights also.  I’m not really willing to only run and shrink down that muscle mass that I continue to carry.    I’ve also become convinced that muscle is super important for long term health.  There’s several controversial population studies that suggest being in the overweight range of BMI (25-29.9) is associated with lower mortality then normal (even when corrected for smoking).  This could be from it being bad for your health to be “frail” as an elderly person?   Mortality rate after a hip fracture is 25% that first year.

Either way what I can say is that “you can take the wrestler off the mat, but you can’t take the wrestler out of the man.”

Published in: on August 18, 2012 at 10:17 pm  Leave a Comment  

Round #2

5 days of life.

I’m a pretty outspoken non-lover of the early months of a babies life.  Seriously is there any reasonable answer to the question “How’s your baby doing?”  Um….she cries, interrupts my sleep, and needs a diaper change a lot of the time.  She doesn’t roughhouse or draw or talk or ….do much of anything fun.  Someone taught me the response “Pretty helpless still” I think I might adopt that.

Well that’s not totally true she’s a month now and has really started smiling, that’s pretty cute.  Despite all my ranting…I definitely love this little girl sooner than my first.  It’s not just that she cries less than our first did, it’s not that she sleeps a little better than the first did, it’s not that she actually likes the car seat.  Because those things are all true and really, really nice.  It’s more that I know what to look forward to.  I love my oldest so much it’s actually crazy sometimes.  We were wrestling on the carpet yesterday and her giggles filled our house with joy beyond description.  Dorothy was feeding the youngest in the rocking chair and Ruthie was playing her double knee drop on daddies genitals game.  High comedy.  Don’t worry- hands for protection and it’s actually pretty hilarious.  I’m sometimes amazed at the fact that I haven’t really ever injured or hurt her because she really plays very aggressively and I’m 8x her mass.

Knowing that down the road I’ll have a similar experience with this new Baby Amy makes me more relaxed about the whole thing.  Some if it may simply it being “round 2” and being a more experienced father, but I don’t think so.  Ruthie smiled at me when she was 1 month old but it still took until this post when Ruthie was almost 4 months old to really “fall in love with her”.  I really know what’s in store and I have stronger feelings about this second baby at a younger age than with the first.

I might even consider doing this again, even though I suspect I’m destined to have 3 girls….

About to start crying actually.

Published in: on August 15, 2012 at 4:02 am  Leave a Comment  

Do we love our bodies?

The Bible is a living document in part because our understanding of the text changes as we change. One can read a passage multiple times and read it a certain way and then read it from a different perspective and have a significant epiphany. This happened to me with a passage I have probably read 20+ times. Ephesians is one of my favorite epistles and I’ve read it many, many times in part because of the passages on marriage. It also contains the longest passage that I have memorized. I’ve been reading it for the last few weeks and read this passage again with a completely different insight then I have ever had:

Ephesians 5:28 In this same way, husbands ought to love their wives as their own bodies. He who loves his wife loves himself.

It’s a beautiful call to husbands to love wives as much as they love themselves. Coming from a Reformed and relatively Calvanistic background it’s been assumed that husbands love themselves. In-fact here’s part of what Calvin says about this passage:

“An argument is now drawn from nature itself, to prove that men ought to love their wives. Every man, by his very nature, loves himself. But no man can love himself without loving his wife. Therefore, the man who does not love his wife is a monster.”

Almost every sermon or commentary I’ve heard/read take it for granted that we (as husbands) love ourselves, tend to be self centered and selfish and we are to love our wives in the way that we already love ourselves. I agree with that sentiment but….I realized this week that it actually says something a little more than that. Here I’ll include the next verse:

Ephesians 5:28-29 28In this same way, husbands ought to love their wives as their own bodies. He who loves his wife loves himself. 29 After all, no one ever hated their
own body, but they feed and care for their body, just as Christ does the church—

The passage is not really telling us to love our wives as we love “ourselves” meaning the “our personalities” or “our Ego” (in the Freudian sense). It’s literally saying love our wives as we love our “physical bodies”. It’s not implicit, it’s actually explicit when taken with verse 29. Calvin seems to take it for granted that this would be true, but he’s never met an American. It’s clear that most of us hate our bodies! We don’t get the rest, exercise or fuel that our bodies need. We choose TV and facebook over sleep. We choose convenient frankenfoods (“because they taste better”- what a crock) over healthful homecooked meals. We say “when I get home from a long day of work I’m too tired to exercise” though what we really mean is “I want to watch TV when I get home even though a walk would actually make me feel better while the TV makes me feel even less energetic.”

Anyone who has been cornered by me recently knows that I’ve been pouring an incredible amount of energy into thinking about the root of the American obesity epidemic, while also getting back into “fighting shape” myself. Dorothy and I hit a low of fitness about March 2011. It had gotten pretty bad. After Ruthie was born June 2010 we really let our exercise go. We were tired, I was still figuring out how to juggle my schedule here, and by the time Ruthie started to sleep it was the brutal Jerome winter. Starting around April 2011 when I started doing Kung-fu and Dorothy started going to the YMCA to work-out. After a series of energy sucking meetings that ended in spring 2012 I upticked even more in my exercise and have really basically gotten back into what I would consider very good condition again. In many ways I would consider this my “normal” as I spent many years through the end of medical school and residency in this kind of shape when I was racing triathalon or bikes. I’ve also got my diet and appetite more in line with good health simply by not eating so much dang dessert (our diet was pretty clean all along). It turns out from review of my old exercise journals that I spent a long time around this weight also (averaging about 162 right now).

One outcome from this has been a noticeable increase in my libido and more specifically finding my wife much more attractive and desirable than I had while my fitness had been less. Not to say I didn’t find her attractive before (seriously she’s hot) but I found myself wanting to spend more time and physical energy on her as my fitness improved. I’m using the multiple definitions of attractive here, not just in the sexual/physical way. I’ve also find myself wanting to support her return to fitness. We likely have many, many years of marriage ahead of us and it would nice to enjoy them with energy and without the disease of poor health that I see plaguing Americans wholesale. Arthritis, diabetes, heart disease, poor balance, nursing homes….these are the realities of retirement in America. I never hear those that maintained good health and fitness say “the Golden years aren’t so Golden” it’s usually former smokers or the obese who can’t figure out how they got to this place of debilitation.

So men: this passage is first an explicit call to “love your body”. Not self worship, not narcissism but getting it the rest, exercise and fuel it needs. CHOOSE health. From there we are to love our wives as we love our bodies. If you are married, make the changes needed because I can tell you from personal experience it becomes easier to love your wife better. If you are unmarried make the changes ahead of time, health probably won’t hurt in helping you find a wife.

Women: I’d guess that if men are called to love their bodies….the same is true for ya’ll. Likewise if (which is usually true even in two income homes) you do all the shopping or cooking you can do your part by making better choices about what fuels are even available in the house. Take control: a household that contains no soda, cookies, or frankenfoods makes it much easier for everyone living there to make good diet choices.

Perfect hair night for delivery. My gorgeous wife.

Published in: on August 11, 2012 at 3:21 pm  Leave a Comment  

My Girls



Amy Elizabeth is born!  Technically it’s been almost a month, but I haven’t blogged in a bit, so better late than never. She was born July 9th 7lbs 5.5 oz 20 inches.  So here’s some background on that night and my feelings so far.

Sunday July 8th was starting to feel like do or die time.  My schedule was essentially changed to take that next week off.  Dorothy’s mom had been here for 10 days already and in her own words “Family is a little like fish, after too many days they both start to stink.”  We were past her due date and Ruth was born on the due date so we had been expecting a little before her due date. That and her very, very dilated cervix.  Dorothy had been having contractions for weeks, but nothing to “write home about”.  So Sunday we decided to try to help things along a little.  Prayer at church, check.  Nipple stim- check. I even ran out to the store and got real Raspberry Leaf Tea.  She had few cups of that.  Then in the evening after dinner we went for a short walk down our lane, Ruthie in the carrier on my back.

Our “neighbors”…

[..side note that we took to calling them our “neighbors” because originally we were calling them “the Mexicans” and we decided that it just seemed too racist for some reason.  I mean they are all latinos in the little run down house that’s the only house on our road, we have yet (see below) to have any of them speak English to us.  It’s a little unclear how many live there actually, but they have always been friendly in the form of waves….]

…were outside cooking food which smelled great. We all waved at each other.  I’d say there were 7-8 men, which is more than is typical.  We walked about .5 mile up the road and came back, waving again.  As we got about halfway from our neighbors house to our house a car pulled up next to us.  The driver said “Here’s some carne asada.  When we see a pregnant woman walk past we give her carne asada.”  He hands us a plate with two pounds of meat covered by a paper towel.  The smell was amazing. We had already eaten dinner but ate half the plate on the walk home.  

So..walk- check, .carne asada- check.  We went to bed really hoping to have the baby the next day so I didn’t have to go to work  on Tuesday.  We went to bed about 10:30.  About 1:05 AM Dorothy wakes me and says “Josh, I think we need to go to the hospital.”  I’m like “Ok, how many contractions have you had?”  “Four”.  

“Four?!?!?”  “No I’m serious these are really strong.”  She had one at 12:30, one at 12:45, one at 12:55 and one at 1 AM and felt it was time.  I was skeptical. Then she started having them every two minutes and needing to kneel on the ground with them, then she says “I think I need to poop.”  to which I responded “Get in the car”.  The drive to the hospital was punctuated by rupture of membranes and by a brief pause for her to try to puke out of the open passenger side door. 

We got to the hospital about 1:40 AM and had Amy at 2:12 AM.  I actually called the OB nurse cell phone on the way because of that body language that anyone that does OB knows as “this lady is going to have a baby soon.”  

So first labor with Ruthie started at 11 PM and ended at 7:30 AM with two hours of pushing and was 6 pounds. Amy was 1:40 from first hard contraction to delivery with about 3 pushes at 7lbs 5.5 oz.  What a difference!  It’s interesting that the fast labor was sort of making Dorothy freak out about having to push. She didn’t have time emotionally to get ready for that last pain.  Right before pushing she was saying “I’m freaking out, I can’t do this, I’m not ready.”  Of course it was coming so fast it was pretty well out of her hands.  

My feelings toward baby #2 are very different also, I’ll plan on posting those thoughts soon.  

Published in: on August 4, 2012 at 3:32 pm  Comments (4)  

Speed limit

11 Dear friends, I urge you, as foreigners and exiles, to abstain from sinful desires, which wage war against your soul. 12 Live such good lives among the pagans that, though they accuse you of doing wrong, they may see your good deeds and glorify God on the day he visits us.
13 Submit yourselves for the Lord’s sake to every human authority: whether to the emperor, as the supreme authority, 14 or to governors, who are sent by him to punish those who do wrong and to commend those who do right. 15 For it is God’s will that by doing good you should silence the ignorant talk of foolish people. 16 Live as free people, but do not use your freedom as a cover-up for evil; live as God’s slaves. 17 Show proper respect to everyone, love the family of believers, fear God, honor the emperor. 1 Peter 2:11-17

A pretty remarkable passage. A passage that I’m sure has been used on many (and opposite) sides of various arguments. It hit me hard about a week or slightly more ago. Strangely what the passage convicted me of was speeding. I’ve been convicted of that before but didn’t really act to strongly on it. I am not a reckless driver by any means, but I tend to always drive about 4 miles over the speed limit (not in town- on the highways and freeways). Sometimes more like 7 over, when we are driving to the airport in Boise as an example.

Historically I’ve had some tendencies toward road rage, but I think that dates back to a much more angsty, pre-Christian time in my life. From a self analysis (which is always somewhat suspect) stand-point I think I’m a pretty calm driver. So it’s not that I was feeling convicted of “rage” or aggression, literally that passage seemed to be telling me to obey the law.

So about 10 days ago I stopped speeding. Let me re-phrase. I tried to stop speeding. The very first day I was going to stop speeding I took a left onto I-95 to go to work and sped up to get ahead of the traffic coming North. I’m cruising along and look down and I’m going 8 over the limit. Just simple matter of speeding up and not CONSCIOUSLY being aware of my speed. Over the last 10 days I have been much better at it and really the last two days can say “I don’t speed anymore…for now”. But what makes this relevant is the broader application to sin in general.

To not break the speed limit I had to be constantly aware of my speed. I think sin is very similar. To avoid sin we need to be constantly in Christ and constantly striving to avoid sin. Sin is too easy in our world. Sin is everywhere on the internet. I don’t even mean full on porn surfing- even 5 minutes ago I went to the weather site I use and the advertisement on the right of the screen featured an attractive woman with a tee-shirt that did not fit appropriately. It’s easy to spend 10 seconds longer looking at that then you should. It’s easier to click the link and see “what other T-shirts they have for sale”- but that’s how we lie to ourselves.
Likewise it’s easy on internet forums to say and act in ways not representative of our God. I once belonged to a forum online through my old church and the things and beliefs that people espoused on that forum routinely amazed me- and that was on a site for and by Christians.

15 Anyone who hates a brother or sister is a murderer, and you know that no murderer has eternal life residing in him. 1 John 3:15

Yikes. We need to gird our minds and stay sharp to avoid sin- even of that of hating our brother or sister. Keep your eye on your speed if you don’t want to break the speed limit.

Published in: on May 4, 2011 at 8:07 pm  Comments (1)  


I saw some of my dear friends Kate and Josh this weekend. I forget how much I miss some of my old friends until I see them. Josh, Kate and I have a way of talking about things and thinking about things that I don’t have with other friends. It’s probably a combination of having been through medical school together but also all having been athletes (Josh having competed at the highest level of the three of us). The course of our 3 hours of socializing brought a few related ideas to the surface of my mind. For clarity I’ll break them apart into two seperate sub-sections:

The approximate quote from Josh: “Rowing was good for de-*&%^ification.” The word there being another word used for a cat. I’ll use the word *sissy* from now on for what Josh was refering to when he was quoting another of his friends related to the benefits of having been a rower. I am however thinking of that other word every time I use it. Josh competed as a rower at a very high collegiate level, having been teammates with Olypiads and having competed in national level competitions. He is not a *sissy* for many reasons but rowing certainly didn’t hurt. It made me again think of what *sissies* most Americans are. I can’t tell you how often people’s excuses for various things I’m advising them on could be tranlsated as “I”m a *sissy*” (if they could only realize what it was they were actually saying).

A few brief examples: 1) “Health food is to expensive” in response to my advice to eat less food. I’ll go on to argue with them that making a whole wheat sandwhich at home is the same or less money then a fast food meal and they’ll look at me like I have 4 arms. What they really meant was “I’m a *sissy* and fast food is easy, tastes good, and I’d rather watch tv after eating in the car on the way home then have to “make a sandwhich” when I get home.” 2) “I get to hungry (insert other adjective like “weak”, “dizzy”, “low blood sugar”, etc) when I try to diet.” when I advise people to try to lose weight. Again could be translated as “I’m a *sissy* and I’m incapable of tolerating any mild discomfort other then being stuffed from over eating or being constipated from my terrible diet. “Oh…and I’ll probably come see you for medicaiton about my reflux or constipation which is brought on directly from eating to much”.

This American diffuse and pervasive *sissiness* could be cured by giving PE teachers the green light to actually push kids in gym class again. Now most schools don’t even have PE and you certainly couldn’t push a kid to their limit, in fact the 1 mile “run” is school is actually a “let the obese teens walk”. Or make all teens work for a summer on a farm. Let a farmer be their parent for a summer, *sissiness* reduced by 50% in 3 months guaranteed. Manditory 2 years of service in the National Guard after high school? Most kids need boot camp, the problem is that they need to be de-*sissyfied* before their 18. Many kids are obese before they are teens now. The wide availability of food, the sendatary life styles of their parents, and kids are often way behind before puberty hits.

Pain Tolerance
The second related idea is this: people who tell you (as a physician) that they have a high pain tolerance: probably do not. I’d say that 9/10 times that someone tells me “I have a high pain tolerance” it probably means a) I have a low pain tolerance and a moderate injury that most people wouldn’t need pain medication for or b) I’m a pain medicaion seeker/abuser/addict/salesman and I don’t really even have an injury. With that said I had been smuggly thinking in my own mind “I have a pretty high pain tolerance” though I would never say it outloud because of the above required translation.

I took only 6 of my opioid pain medications after my surgery on Monday. I was getting around petty well and felt I had recovered quickly enough that I was thinking I was pretty tough. Then I saw Kate yesterday and realized I’m closer to being a *sissy* then actually having a high pain tolerance.

She had a similar procedure surgery to my laprascopic appendectomy and took NO pain medication. She also was back to work 5 days after her surgery (which was yesterday for me and I was still moving pretty stiff). I do feel loads better today, bordering on normal at times, but I’m sure glad that I don’t have to go to work for another two days still. There’s always somone tougher then you. Being smug usually ends with you looking a fool.
Proverbs 14:22-24
22 Do not those who plot evil go astray?
But those who plan what is good find love and faithfulness.
23 All hard work brings a profit,
but mere talk leads only to poverty.
24 The wealth of the wise is their crown,
but the folly of fools yields folly.

Published in: on April 3, 2011 at 6:59 pm  Leave a Comment  

On The Other Side

I’m about 30 hours out from joining the legions of appendectomied people. For me the actual appendicitis wasn’t that terrible of an experience. Sunday afternoon had a vague feeling of abdominal discomfort. Largely right sided, though somewhat more around the belly button. (For anyone not medical reading this: my description of symptoms is basically directly out of a textbook for presentation of appendicitis.) We went walking around 3:30 PM and my babies bottom bouncing against my lower abdomen was sort of uncomfortable. I tend toward constipation so I was thinking constipation or gas pain.

As the evening wore on I developed increasing (right lower quadrant) RLQ pain. Around 9 PM I emptied my bladder which evoked a somewhat more significant but brief RLQ pain. I came out to the living room and was lying on the floor examining myself and telling Dorothy “I wonder if I have appendicitis” to which she responded “shut up”. I went back to playing at the computer and about 11 PM I took a shower and was starting to feel vaguely ill- like mild body aches. Dorothy has had a cold so I started hoping “please start getting a sore throat”. I was asleep for about 30 minutes when I was awakened to terrible nausea, significant chills, and somewhat increase RLQ pain. I still only rated the pain at 3/10 at the worst. The nausea is what sent me to the ED. That was terrible. I knew at that point what I had. I called up to St. Ben’s to make sure that we didn’t have a surgeon available (we didn’t) so I drove myself to St. Luke’s for evaluation.

What a strange, bordering on fun (if having appendicitis and eventually getting a few thousand $ bill can be called fun) experience being a patient. I had been to the ED once before for something minor, never for anything major. I have a vague memory of getting stitches in the ED at age 3. Early Monday morning about 1:45 AM: They got met settled in, IV placed, the Physicians Assistant came and evaluated me (listened to my heart and lungs through my gown). Labs drawn. Then I carried my IV bag to X-ray and had my first ever chest x-ray and abdominal flat plate. Lying on the X-ray table was very uncomfortable with appendicitis. It’s a very flat and hard table that they must chill to about 10 degrees. I gave a urine sample after that, which was tricky with a gown on and my IV bag slung over my shoulder. Then I saw the ED doc (also examined me through my gown). He was basically like “you’ve got appendicitis and the surgeon is on his way in”. Yup, I sorta thought the same thing. WBC was 10.5 (barely elevated), CRP was 2.9 (very elevated- a general marker of inflammation).

I also saw Garth, whom is my favorite Murse of all time (one of my favorite nurses over-all too, but that’s largely because he acts and sings and I saw him in a local show of Jekyll and Hyde and he killed it as the main role of Jekyll/Hyde- unfair advantage), in the ED. He gave me a shot of promethazine after the 2 shots of Zofran had not touched my nausea at all. I did not enjoy the promethazine. It made me very altered (keep in mind it’s now about 2-2:30 AM and I haven’t really slept). Drowsy but not exactly falling totally asleep. I was slurring my words and couldn’t think straight. I think next time I’ll just stick with the nausea. It was bugging me that I wasn’t clear headed enough to pray. I later wondered if they had given me some morphine or something too, though I don’t think so, I told them I wasn’t having much pain and didn’t need anything.

It dawned on me later that I was never afraid. I wasn’t just being tough or stoic. I knew what was wrong with me and I just simply wasn’t afraid. My personality is somewhat like that (see my post about bike racing- I had to quit doing that because I had become afraid) I don’t get nervous about much anymore, which definitely comes from surviving the experience of medical school and residency- it changes you. It also just never really felt life or death to me, I pretty much felt like it was going to turn out fine. I really never was that “sick”.

Sometime after the promethazine I saw Dr. Blair, who’s quite a young guy. He’s a very calm person, I liked him immediately. I could barely follow him because I was altered. They took me to the pre-op area, which I can’t remember well because of the promethazine kicking my butt. I had to stip down (I left my socks on) and pee in a urinal so I didn’t have to get a foley catheter. I peed all over the edges of my gown. I think I was having more pain at that point and being all altered from the promethazine, not being able to stand up straight from pain, and trying to pee in a urinal in front of people was pretty awkward. I could feel my pee from the bottom of my gown on my leg.

They wheeled me back to the OR and I vaguely was aware of the anesthesia person giving me something in my IV. I scooted over to the OR table and my next memory is about 3 hours later with a nurse asking me all these questions and me falling asleep. The nurses were turning over at 7 AM and the outgoing nurse was trying to get her work done before the next nurse came on. It was sort of comical. I’m pretty sure I asked “Is my appendix out” which is so classic- ahhh anesthesia. Then about 8:30 I really woke up. Another very strange feeling. I was really awake. I was feeling pretty comfortably tucked into a bed and knew where I was and was clear minded. No pain to speak of, no nausea. I hit the button and called the new nurse in because I felt I needed to pee. Jessica was my nurse for the rest of the day and she was very nice. Getting out of bed was awful. I’d rate it as the worst pain I’ve ever felt. What’s weird was the pain was now in the LLQ (left lower quadrant) where the biggest of the laparoscopy ports was. I imagine that pain is what it feels like to be stabbed. If the appendicitis pain was 3/10 this pain standing up was about 8. Peeing in a bed-side urinaral while a female nurse is 6 inches away was pretty weird. Trying to get the flow of urine started with 8/10 pain and a female nurse standing 6 inches away was not easy. I got about 600 cc and struggled my way back into bed. She gave me 2 mg morphine IV and two hydrocodone right after. I slept away much of the morning. I called various family members and eventually my wife and baby came to visit which was nice. Later I micturated an amazing 750 cc of urine!

I improved quickly through the morning. Getting out of the hospital bed was still a 6/10 pain struggle, but even walking or sitting up wasn’t that bad. I had solids for lunch and walked 150 feet in the hall without much trouble. I even danced a little jig for Jessica near the nurses station. Eventually I saw Dr. Blair and he discharged me home. I was home 13 hours after getting my appendix out.

I’m home now. I’m doing ok, still pretty painful moving around, but it’s a different kind of pain now, more like “man I worked out to hard” type of pain. I let myself go a little long without pain meds last night and had a weird response to the pain- shivering. Happened again in the middle of the night after I had slept soundly for 5-6 hours. Shivering for about 10-15 minutes until the pain medication kicked in. Very weird. At first I was getting a little spooked that I was having a sepsis response or something, but it definitely faded with my pain and it didn’t start until I tried getting out of bed in the middle of the night. It’s amazing how much you use your abdominal muscles. Even weird little things like passing gas or flushing the toilet uses a surprising amount of abdominal muscle.

I can’t say that I really learned much about how to be a better doctor or about how we can provide better health care at our hospital as a result of my experience. I’ll probably just have a bit more empathy going forward. I really feel for C-section patients more then before. The amount of pain I have from these little port sites, I can’t imagine the C-section incision- even more so because you want to get up and take care of your little baby. Less c-sections! Actually the one thing I think I’d like to see is a change to how we handle the call light at St. Bens. Every time I hit the call light someone (upwards of three different CNA’s and three different nurses) came in within 1 minute to see what I needed. At St. Ben’s the ward clerk hits the button to try to found out what the person needs- often the TV is blaring or there’s background noise, the person not talking loud enough, etc. I think a personal drop in by a CNA would be better patient care and patient’s would feel more responded to.

The worst part for me (besides the eventual bill) is not being able to play with Ruthie. I really can’t get down on the floor yet and I definitely don’t feel up to picking her up yet (she’s very squirmy). Just picking a shirt up off the floor is tough! I’m also sad about having to take several weeks off from Kung-fu. I was really starting to get into shape again. I imagine I’ll be able to practice some of the forms again in a few weeks, but I definitely won’t want to do anything aggressive for 6 weeks. That sucks.

Our first major medical situation as a family! I can’t thank my wife enough, I can’t imagine trying to get through stuff like this without her. Even just knowing that if I needed her to she would get me something without griping about it- that’s love.

Published in: on March 29, 2011 at 3:39 pm  Comments (1)  

Something more…

Listen here first:

Easy in the summer time

If that doesn’t work try this:
NPR article
click on the link on the left for “Easy in the summertime”

It’s a gorgeous song. It’s actually very sad. The background history of the song is that those are two sisters who’s father shot and killed their mother and then himself. That song is about that summer that it happened, almost 30 years ago. The song helped push me to think more about something I had already been thinking about: how do families get so messed up?

I look at my current family: wife and daughter, age 7 months. We so happy it’s almost ridiculous. The degree of peace and harmony we have I know can only come from God. We’ve definitely dropped into a rhythm of life that is enjoyable, sustainable and full of love. The thing I keep worrying about is: how to keep it that way. I look at families I know and there’s so much tension. I myself was raised in a somewhat chaotic feeling family of divorce and re-marry. The classic split family of my generation. It didn’t feel good around age 10-14. I really sensed that my family was sub-optimal.

I was deeply wounded when I didn’t make the little league team around 7th grade despite the fact that my step-dad had played baseball in college. We practiced exactly once leading up to the big try-out. I’m not sure that wound has ever healed completely. At times during high school I was pretty sure my wrestling coach ended up filling the roll of “father” for me: the male authority figure that taught me what being a man was.

And yet my father also didn’t kill my mother. I was never abused, I never went without breakfast or dinner. I got a Christmas every year. I had all books I wanted. Two week driving vacations across the county. Never a doubt that I would go to college or be “successful” in life. I can’t complain about my life, how I turned out, or even my relationship with my family now.

But I listen to that song and I think that aiming for Ruthie growing up with her parents not divorcing or literally killing each other may not be aiming high enough. I don’t want to aim for “well at least I didn’t molest her”. I want to aim for genuine love. I want my daughter to love me and her to know and really feel that I love her. I want to aim for her to be able to trust me with her inner thoughts. I want her to know that we are there for her and for her to think “I want my marriage to be like my parents”. I want to aim higher…and I suspect that most people do when they get married or have a child, but somewhere along the way it often goes to pot.

Bluntly I think the issue is human sin. Infidelity, greed (working too much and not seeing your kids), selfishness (a parent’s life or activities being more important to them then supporting their child), laziness, boredom, are all things that I suspect erode everyone’s goal for “doing it better”. I have to keep remembering that. As work gets busier and more expectations and requirements fall on me. As more Boards ask me to be president (I’m about be elected president of the Board I sit on). As I get more hobbies (I still want to pick up fly fishing) and resume my normal ones after having the baby (backpacking), I need to keep holding on to the fact that what I really want is loving family and loving God with those other things coming second.

This is a two part post the next to come sometime next week…..stay tuned!

Published in: on January 7, 2011 at 8:08 pm  Leave a Comment  


Today I’m full of fire and brimstone. Let me preface what I’ve prepared here by saying that my leanings are more Calvanist then Armenian. A brief summary of my understanding of the basic difference between Calvanist and Armenian theology would be that a Calvanist generally believes that salvation is in the hands of God alone and can’t be “lost” while an Armenian would say that salvation is a choice made by man and man is capable of turning his back on it. I think the truth lies fundamentally in both stances, which we’ll discuss that later, but I do believe fundamentally that I’m not capable of “saving myself”.

Going to a basically Calvanist church the issue that has me worried is that we can come to the conclusion that we are saved and now we don’t need to “worry” about it. The problem is that Jesus didn’t really feel like that. The Pharisees are the cautionary tale. They felt confident in their salvation too. They along with the Romans, crucified Jesus in their confidence. What if we are the Pharisees?

I don’t think the Armenians totally have it wrong, which a staunch Calvanist would say is heresy, but let’s look at what Jesus has said:

Matt 7:71-27 21 “Not everyone who says to me, ‘Lord, Lord,’ will enter the kingdom of heaven, but only the one who does the will of my Father who is in heaven. 22 Many will say to me on that day, ‘Lord, Lord, did we not prophesy in your name and in your name drive out demons and in your name perform many miracles?’ 23 Then I will tell them plainly, ‘I never knew you. Away from me, you evildoers!’
24 “Therefore everyone who hears these words of mine and puts them into practice is like a wise man who built his house on the rock. 25 The rain came down, the streams rose, and the winds blew and beat against that house; yet it did not fall, because it had its foundation on the rock. 26 But everyone who hears these words of mine and does not put them into practice is like a foolish man who built his house on sand. 27 The rain came down, the streams rose, and the winds blew and beat against that house, and it fell with a great crash.”

The punch line is that calling yourself a Christian (or even driving out demons in his name) and going to church on Sunday does not assure your salvation.
Jesus says we’ll be separated based on our behavior:

Matt 25:41-46 41 “Then he will say to those on his left, ‘Depart from me, you who are cursed, into the eternal fire prepared for the devil and his angels. 42 For I was hungry and you gave me nothing to eat, I was thirsty and you gave me nothing to drink, 43 I was a stranger and you did not invite me in, I needed clothes and you did not clothe me, I was sick and in prison and you did not look after me.’
44 “They also will answer, ‘Lord, when did we see you hungry or thirsty or a stranger or needing clothes or sick or in prison, and did not help you?’
45 “He will reply, ‘Truly I tell you, whatever you did not do for one of the least of these, you did not do for me.’
46 “Then they will go away to eternal punishment, but the righteous to eternal life.”

So what Jesus do we worship? Do we worship Buddy Christ from the movie Dogma? Maybe we like the Universal Sky Fairy that my old pastor in Seattle would talk about being so popular- the Hippy Jesus that’s about [cue hippy voice] looooovvvvve maaaaaannnnn…
Or do we also worship the Jesus that returns with a sword coming out of his mouth and robes dipped in blood. The Warrior King:

Revelation 19:11-16 11 I saw heaven standing open and there before me was a white horse, whose rider is called Faithful and True. With justice he judges and wages war. 12 His eyes are like blazing fire, and on his head are many crowns. He has a name written on him that no one knows but he himself. 13 He is dressed in a robe dipped in blood, and his name is the Word of God. 14 The armies of heaven were following him, riding on white horses and dressed in fine linen, white and clean. 15 Coming out of his mouth is a sharp sword with which to strike down the nations. “He will rule them with an iron scepter.”[a] He treads the winepress of the fury of the wrath of God Almighty. 16 On his robe and on his thigh he has this name written:

That’s a Jesus to fear and Prov 1:7: The fear of the LORD is the beginning of knowledge, but fools despise wisdom and instruction.

Or are we idolators that worship food, porn, pop stars, sex, alcohol, money, our lives, our jobs, our families, etc. Jesus again:

Luke12:49-53 49 “I have come to bring fire on the earth, and how I wish it were already kindled! 50 But I have a baptism to undergo, and what constraint I am under until it is completed! 51 Do you think I came to bring peace on earth? No, I tell you, but division. 52 From now on there will be five in one family divided against each other, three against two and two against three. 53 They will be divided, father against son and son against father, mother against daughter and daughter against mother, mother-in-law against daughter-in-law and daughter-in-law against mother-in-law.”

If there are things in our lives that impair our relationship with Jesus, then we may be worshiping idols and falsely assuring ourselves of our salvation and calling ourselves Christians. We may be lukewarm Christians ready to be spit out (Revelation 3:16). At the day of judgment we may be found to be goats crying out “Lord Lord” and getting no response.

Published in: on November 19, 2010 at 7:55 pm  Comments (1)