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Why Tuesday?

The Girlfriend's Guide to Health will be updated every Tuesday.... Stay tuned dear readers and let me rock your world.

Tuesday, December 29, 2009

Who's New?

Can you smell it my dear girlfriends? As distinct as Chanel No.5, or apple scented deodorant, here it comes, like a boxing day sale in hell, the New Year. Make no mistake, I am a fan of rebirth (my closet is a testament to the very fact). And when it comes to change, I welcome it with an open mind and an AMEX card. Of course I will continue to embrace the new years as they come as long as the following conditions are met:

1. I can still call it “Dick Clark’s Rockin’ New Year’s” and do not have to refer to Ryan Seacrest’s participation in said event in any way shape or form.

2. I am not subjected to an obligatory New Years Eve Party where the scrutiny and expectation of the evening forever outweigh the night’s enjoyment. But I maintain, I must be able to watch the BALL drop from wherever I decide to ring in the new year.

3. Real Champagne will always be provided, preferably pink. A sparkling wine substitute will just not do.

4. My outfit is my choice. This is the one night of the year where if I want to wear pajamas and a tiara, then by God I will. The occasion will not chose the attire- I will. (Those of you who do not understand this last statement, think about how you were- on picture day in grade school and you will now know what I mean) .

5. If I so chose, I am able to ring in the new year as any grown adult past the age of 35 should be allowed to; fast asleep in my bed, belly full, alcohol coursing its way through my veins as I sleep my way towards a morning hangover.

Having made my list and checked it twice, I continue to be baffled by inventories of another kind… the ever dreaded New Year’s Resolution. Truth be told, I hate New Year’s resolutions. Each year we spend a good month of valuable planning time (you know who you are and be frank you time would be better spent cleaning your bathroom) anticipating the person we would like to be in the future.

Make no mistake, as human beings, anticipation is truly a key to our happiness. I myself can wait for the 2010 Olympics, the Oscars, The Golden Globes and Fall’s Ready to Wear collections. But I realized long ago (probably around age 30) that planning for a change only delays it further.

Here’s what the evidence shows…

There is actually a study called the New Year’s Resolution experiment done in 2007 on 3000 people in the UK. This research shows that while 52% of participants in a resolution study were confident of success with their goals, only 12% actually achieved their goals. Men achieved their goal 22% more often when they engaged in goal setting, a system where small measurable goals are used (lose a pound a week, instead of saying "lose weight"), while women succeeded 10% more when they made their goals public and got support from their friends

Professor of psychology at Deakin University, Bob Cummins, says making New Year's resolutions helps us feel better about ourselves.

"One of the fundamental features of human beings is that we need to feel good about ourselves. It's a very, very strong need that we have," he said.

In fact, Professor Cummins says making a New Year's resolution is our way of seeking forgiveness and clearing our guilty consciences.

"The end of the year constitutes a kind of secular absolution that people earnestly say to themselves and their friends and their dear ones, 'I'm going to change'," he said.

"This turns them into not only a good person because they've got these good ideas, but it also makes them feel very good because they're absolved of their sins during the past year and they're not going to do these things any more.

"So in a way it's like an addiction in itself. People just must make these very ambitious personal claims of absolution at the end of each year."

And so, some years ago, I stopped it all. I refused to spend another year standing on ceremony willing the change to come. And my New Year’s Resolutions faded into oblivion as I decided to take on each day…

And so, today really is the day. Whether it is a ten pound weight loss or an exercise regimen; quitting smoking to embracing bargain shopping; from bad habits to bad dating… today is the day to get off “The Tomorrow Merri-go-Round”. I will not spend another year with resolutions to fill as empty as champagne flutes.

So my dear cyber sisters, my advice on this dawn of a decade and for all other new years to come is this… Be it resolved that we will live each day in a celebration and promise. I will think of you all as I done my tiara and my flannels and settle in for my date with Dick and his big crystal ball. And that is the best (and only) resolution I’ve made in a long time…..

Sunday, December 20, 2009

Small Town Dreams

Truth be told, I really am a small town girl. My Grandmother came from a tiny village somewhere in Poland, my mother was born in Esterhazy Saskatchewan and although my birthplace (Winnipeg, Manitoba) boasts a population of 600,000 it still would be considered by many as a relative village of sorts. In fact, my mother was born in Melville, Saskatchewan because when my grandmother went into labour, there nearest hospital was 100 kilometres away and so Melville was where she came into the world. I tell this story with nostalgia and pride at times and I venture into this small town world of thinking because here I sit on a snowy night in December in Trail, British Columbia, population 7000.

There is really not much to say about Trail. It is a sweet little town in the Kootenay (pronounced /ˈkuːtni/ KOOT-nee) mountain region of the Rockies, which according to Wikepidia and a sign in my hotel lobby comprises the southeastern portion of British Columbia. It takes its name from the Kootenay River, which in turn was named for the Ktunaxa (or Kootenai or Kutenai) First Nation first encountered by explorer David Thompson.

There is not a great deal to do in Trail as I have learned over the last 72 hours. From a sporting perspective, there is a great ski hill, several cross-country ski trails, and an aquatic centre. I have a cross country skiing lesson tomorrow with a man called Eric who was born and raised in these very mountains. It should prove to be a highlight of my holiday season. Entertainment-wise I have one movie theatre to chose from as so my movie choice is automatically made for me. There is a Wallmart and a Zellers should I chose to shop and finally and most severely, the nearest Starbuck's is 45 kilometres away.

I have met a dozen people who do not own televisions and an equal number who do not drink coffee. It has been, overall, an adventure. Needless to say, I am out of my element. So I could not help but wonder if small town folks have a lower mortality rate? Without all the stress and the shoe departments and caffeine highs would these folks in Trail be on to something?

Unfortunately, as I have found out.... Trail is not only lacking for television and good coffee...
According to Health Canada (the stats are from 1998- I love a good bureaucrat) 31% of this country lives in rural communities where the average distance to a family doctor is 25km away and the average distance to a specialist is over 60km away. I myself am here for the next 10 days on call in the Intensive Care unit because there is such a lack of medical care. Overall 200 people die every year in rural Canada from farming related accidents and large majority of the rural Canadian population is over the age of 60.

Yes I know I sound bitter and perhaps a bit outraged. I find myself raging against the machine for what we have done to ignore this country's "little people". And now it pisses me off that my grandmother had to drive 100 km to the next town holding it in because they did not have a local health care facility! No longer will I tell the story of my mother's birth with the same charm and nostalgia!

Since it's inception, I have tried not to use the Girlfriend's Guide to Health (GGTH) as political "soapbox". I wanted this sight to inform and entertain and to be a beacon of internet positivity in a sea of negative freaks and anger balls. I do apologize and I will try before Boxing Day (the holiest of holey days) not to be so negative but I will blame it on the fact that I have not had a decent coffee since last Thursday. I have gotten so desperate that I begged one of the ambulance attendants who lives in a neighbouring town to stop by the only Starbuck's for miles on her way into work today and pick me up a Venti mild just so I could face the dawn....

I know it is the holiday season and as the GGTH winds down for the year I find myself a bit nostalgic for the days when life was simpler. Yes, there are parts of this town where there is no cell reception. Yes, there are only two grocery stores and one dry cleaner. Yes, there is really only one hotel and it is 2 stars. But despite all of this and my cable and caffeine withdrawal... there is an uncomplicated kindness about this little rural place that is making me smile.... Perhaps it is because I have spent the last three days watching the entire first and second season of Friday Night Lights and I am bathing in a warm glow of small town wonders. Perhaps it is because it cost 5 cents to park for 15 minutes in downtown Trail and the metre takes nickles. Or, perhaps it is because the unit clerk in the Emergency Room thinks I am a superhero because I have real PRADA snow boots.

What I have found here that you don't see in the big cities can be summed up in the following story...
A man walked into the Emergency Room at the Trail hospital last night wearing only a pair of socks and holding his white fluffy Lhassa Apso (yes it was his actual dog and not a euphemism for his penis) on a leash. He was a schizophrenic from a neighbouring town who had been living up the mountain in his truck and had been off his medication for some time. It was 2 degrees celcius outside and he had taken his dog for a walk wearing nothing but sport socks and a smile. The nurses persuaded the man to stay the night and got him and his dog something to eat. He was given a hot shower, and a bed to sleep in and even though the hospital has a "no pets policy", the little fluffy ragga muffin slept with the man in the emergency room all night long. This morning, the Psychiatrist was consulted and the man was admitted to the Psych ward. His dog was allowed with him. The entire staff of the Emergency room took up a collection and sent someone out on their coffee break to buy dog food, chew toys, a water dish, pet shampoo and a flea collar.

After rounding on my patients in the ICU and admitting a woman with heart failure, I was given the honour of giving "Jake", the Lhaso Apso a bath. Instead of a Sunday afternoon filled with big city brunches and big city dreams, I spent a few hours in a Psychiatry Ward in a rural hospital in the middle of the mountains giving a white fluffy dog a much needed bath under the watchful eye of his owner. Both dog and owner were equally appreciative. I placed the community flea collar around the dog's neck and knew that this moment truly was one of the highlights of my career.

So despite the disparity between big city shoes and little town hospitals, tonight I proudly proclaim myself a rural kind of girl. For here is where I can not find a latte for love or money, but there is enough good will to get me through the longest of days.

Tuesday, December 15, 2009

A Much Needed Rest

My dear Girlfriends.... working too hard these days as are many of my cyber sisters. Between training for a Half Iron Man, to updating my shoe closet to fighting H1N1, I am beat. As such, I am taking this week off and will be back next week with not one, but two fabulous posts. So as with the September Issue of British Vogue.... all good things come to those who wait... xo, az

Tuesday, December 8, 2009


Truth be told, I am now an addict. I know what you are thinking and the subject of my addiction is not SHOES. Let us clear that up. Make no mistake, I have a rather extreme fondness for expensive footwear, but such a relationship can NOT be classified as an addiction for the pure reason, that one does need shoes to live.

No, my new found unhealthy relationship is to.... wait for it.... a video game. This may possibly be one of the signs of the Apocalypse and after seeing the movie 2012 this past weekend, I realize we don't have much time left. However, I honestly thought I would take a liking to prescription medication before a PlayStation 3 and so I was the first to be shocked and awed when a certain little video game called Ratchet and Clank became a part of my vocabulary and my personal belief system.

This relationship was in short, a whirlwind. We are not talking years of getting to know the game and then slowly making it a part of my life. No, I bought my husband a 52 inch television for his birthday based solely on the premise that:
1. He is a challenge to buy gifts for at the best of times and when I find something he wants.... I jump on it (from a retail perspective, of course)
2. Our new found and newly dear friend bullied me into a bigger television on the premise that my "pathetic" 36 inch television was an eyesore and an insult to the large wall it hung on. Apparently having a TV that is too big is like having too many shoes.... enough said.

And so the day the massive television appeared so did the PlayStation 3 and several video games. And in an event to not let this "black box" kill the fabulous relationship Jason and I had spent the last 15 years building, I decided it was high time for me to "break out" my inner "thumb-blaster" and grab the joy stickey thing and yes, play on

And so I slipped the game, Ratchet and Clank (let's be clear, I have been calling it Ratchet and Crank for the past two weeks and only yesterday did I learn its real name.... but like all drugs of choice, we often use euphemisms). The first thirty minutes seemed quite benign. I was a complete idiot at working the controls and felt (and still do) that lurching my body to either side of the couch would somehow will my character to jump higher, run faster or shoot farther. Let's be clear.... the last time I operated a "joystick" was during the Carter administration. It was a plastic stick on a black plastic box and if you wanted to go up, you pushed the stick up, left WAS left and right WAS right and so on. There was a little red button on the box that was considered your "fire power" and really that was it.

Operating the controller for the PS3 is more challenging than performing a colonoscopy. Trust me- I have learned to do both.... I would honestly say, (and no disrespect to my Gastroenterology colleagues) that maneuvering through an alternate PlayStation universe is more of a challenge than transversing the Sigmoid colon any day of the week. In fact.... I do think the guys at Sony may very well be on to something...

And so, ever a type A personality, I have spent the last two weeks of my life perfecting my joystick abilities. I do believe my right thumb will never quite be the same but thanks to Advil and perseverance my grip strength has improved considerably.

For those of you who like the "me of two weeks ago", have little experience in all things PlayStation, I will take you through the baby steps....

Firstly one needs a gamer name and mine of course was an obvious choice. I am ShoeGirl_Z and when I turn on the PS3 my screen is a lovely purple. I tell you this just in case you should be wandering in some alternate video game universe and come along my tag name.... please tell me to get off the damn game and get some real work done. I am slowly losing the self control to auto regulate....

The game in question, Ratchet and Clank (or Crank- call it what you want in the privacy of your own home) is about a pussycat and a robot who are friends. There is an evil villain and a labyrinth of space to traverse and various missions at every turn. I do believe I am doing the game little justice. The truth is, I leave the details of the story line of the game to my beloved, Jason, while I, just like shooting things.

Truth be told, I LOVE shooting things. I spent an entire day on the couch last weekend, pajamas unchanged, hair unwashed, shooting things. I have now had to set the oven timer on the stove to 60 minutes in order to restrict my shooting pleasure. I am officially allocating no more than one hour of cyber ass kicking per day in order that I may continue to function as a somewhat productive human being.

Make no mistake I am not begrudging my fellow blasters their healthy amount of thumb time, but after 3 hours my hands are killing me and I am up way past my bedtime....

I must admit, I thought that medicine would be very much against my video gamer alter ego. In fact, the evidence FOR game play is more abundant that against it. Video game play has been shown to increase hand- eye coordination and is now being used in the management of chronic pain, post stroke and the elderly. Make no mistake there is evidence to show that in children, video games may increase tendency to violence and contribute to a more sedentary lifestyle, but interestingly, video games provide children with more "activity" than just watching television. A wonderful editorial in the British Medical Journal by Dr. Mark Griffiths shows that,

"On balance, given that video game playing is highly prevalent among children and adolescents in industrialised countries, there is little evidence that moderate frequency of play has serious acute adverse effects from moderate play. Adverse effects, when they occur, tend to be relatively minor and temporary, resolving spontaneously with decreased frequency of play. More evidence is needed on excessive play and on defining what constitutes excess in the first place. There should also be long term studies of the course of video game addiction."

(BMJ 2005;331:122-123 (16 July), doi:10.1136/bmj.331.7509.12)

Until those studies come about, however, my own 60 minute rule applies. The oven timer now has a loftier purpose and order has once again been restored. Yes, My name is ShoeGal-Z and I am an addict. But like any healthy relationship, be it shoes, or wine, or chocolate, I have now established limits to keep me sane and for now... that will have to be enough.

Tuesday, December 1, 2009

The Big O

Truth be told, I blame Oprah. I know she is a cultural icon, a hero and truly a life-force for many women all over the world, but Oprah, the WOMAN is killing me. She is quoted more readily these days than the Old and New Testaments combined. In fact I would argue that my patients respect and in fact solicit Oprah's medical opinion more often than they do mine. I am not trying to pull rank here, but do they teach medicine at broadcasting school?

Up until last week, Oprah and I had a pretty decent relationship. I respected her as a legitimate voice of the "post-menopausal" fifty somethings. She tried at times to speak to my generation as well but often lost me when she had shows about "working moms". In fact there were often times where I could even identify with Oprah. She had a weight problem, I had a weight problem. She had no kids; I had no kids. She liked expensive footwear, I like expensive footwear. She was a woman in a man's world and I could draw a similar parallel. IN fact when her dog died, I felt badly for her. I could count on one hand the times I have watched her show this year, but I never miss her "favorite things special" or her "post-Oscars debrief". In short, Oprah and I were okay. We were never going to hole up in some high rise penthouse in Chicago and talk about our connection to the universe but we did have a "live and let live" relationship.

Secretly I wished I had been a guest on her show or a member of her book club, but I could easily contain my feelings of misgivings and coexist long enough to watch one of her shows that promoted one of her movies based on one her books.

And then Oprah dropped the gauntlet and announced her retirement in 2012. It was then one of my patients, "Mrs. Smith" walked into my office and asked in desperation, "what am I going to do? Who will give me medical advice?". And it was in that moment that I broke up with Ms. Winfrey and promptly asked for my "stuff back".

I know we live in a world where there is just too much to process and I know that the media IS the message. I know that on some level it is the very Oprahs of the world who help many make sense of the planet. But did she really have to steal MY thunder? Could she not be content with her one of many homes in Hawaii or Chicago or Florida or New York or wherever? Did she not already have it all? Did she have to be a doctor as well? Here she was a cultural icon, a prophet even and now she was practicing medicine from the comfort of her own HARPO studio? She already was best friends with Barak Obama and Mary J. Blige. She had advised everyone from popes to presidents. Could I not have just one little "Mrs. Smith" of my own.

And so I smiled at "Mrs. Smith" and handed her a tissue amidst her grief for Oprah's impending "office closure". I reassured her that in the absence of the great and powerful Winfrey, I would try my best to scrounge my very little medical brain and measly 20 years of training and practice and do my best to give her MY opinion. And maybe, over time, the wounds would heal and I would just have to be enough of a doctor to make up for the Oprah version she was currently using... We will have to wait and see. After all, fortunately, like the Aztec calendar, we have another 2 years until the world and the Oprah Winfrey show ends, and maybe by then my patient will have found another set of TV land advisors to listen to in lieu of the live blooded human being sitting before her. One can only hope...

Monday, November 23, 2009

Fear of Flying

Truth be told I travel more than some. These are not extravagant gestures of adventure. There is nothing sexy about a domestic flight on Air Canada Jazz from Vancouver to the BC interior. The flights are usually less than an hour and en board service consists of apple juice, orange juice or bottled water. There is no in flight movie and regardless of the time of day, a packet of “Rocket Chips” is provided as a snack. Inevitably the planes are of the smaller variety. Now, I am not afraid of flying. I am fully aware that it is safer than driving and that (contrary to what my beloved believes) turbulence is in fact not a sign that “the god-damn plane is going down”. However these smaller variety planes are just the sorts that in a pinch could plummet from the sky somewhere over the Rockies and would only become a bi-line on the six o’clock news. Heaven forbid, or allow, should my airbus 120 fall from the sky; CNN would be none the wiser.

This is not my problem with flying. The size of the planes is never an issue. It is however, the size of the airports. I HATE small airports. Not for the obvious reasons however. Yes, there is never a place to buy coffee after you have made it through security without a drop of liquid on your persons. This of course is the least of my problems. After much research, and far too many short haul flights, I can safely conclude with “Freakinomics” accuracy that airport security is inversely proportional to the size of the airport.

Here is my point. In Vancouver Airport, I can safely bring a yogurt through security and even a dozen apples through US customs without anyone batting an eyelash. It takes me 10 minutes if I use the express line (which I always do) and I can be on my way. This is however if the security line is serviced ONLY by men. If there are women working the line, my time can easily be doubled as inevitably my purse (yes it’s REAL) will be subjected to the usually female scrutiny.

These female security personnel will check the contents of the bag. They tell me it is because my metal tweezers have flashed on the screen- but I know better. They are inspecting the lining to ensure the PRADA (or Gucci, or Burberry Prorsum, depending on the trip) is in fact the genuine article.

I know women are in fact the toughest critics of other women. I have, in fact, attempted many a time to try to get to the root of this issue and have come up with a variety of theories- none of which make me feel as satisfied as, “it’s a girl thing”. My readers lacking a Y chromosome will understand me profusely, if you do not, ask one of your girlfriends, she’ll likely try and explain it to you. This being said, there really is no justification for the strip search I inevitably endure for the sake of fashion at the hands of many a female security personnel. I know this to be true because as these “mean girls” are inspecting my bag, the inevitably comment, not on its contents but on its make, model and colour.

Yes people, the female security personnel at most small scale airports are in fact the “mean girls” you knew in high school, all grown up and with nowhere to go… literally.

Here I am in Kelowna airport, with a purse that made it through Vancouver airport without the batting of an eyelash. It is 6 o’clock in the morning; I am dressed to attend my clinic, which starts in Vancouver at 9 am. I will land at YVR at 7:30 and be safe and sound at my office with much time to spare. I have removed my shoes, belt and dignity and I am waiting for my one handbag to come through the X-Ray machine. It contains a pair of pajamas, 2 pairs of underwear, my wallet and my cell phone. I have my make-up case in a separate bin along with my laptop and a small bottle of moisturizer, shampoo, conditioner and face wash (all less than 3 fluid ounces) in a transport Canada approved baggy.

In what world would any of this bags' contents be questionable? And yet, I am called over by the woman reading the X-ray so she can inspect my bag. What the #$%%!!!

“Is this your bag, Ma’am?” she asks, “I need to check inside”. She announces before waiting for me to answer.

She pulls me over to the counter further downstream and proceeds to swab the bag down for gun powder or c14 residue or swine flu- I have no idea. And then she admits to what I suspected all along when she asks the damning question,

“Nice Bag, Is it real?” she smiles as she looks at the lining inside.

I can’t help but smile, satisfied that my husband is wrong and I am not a paranoid hater. Unfortunately, Jason is safely at home in bed 600km away and unable to witness my fresh hell. He will again, just have to take my paranoid word for it.

“Yes it’s real”, I admit, almost ashamed.

And then she actually made the most contemptible sound there is when she uttered, “Humph”.

I hate that sound. It is the vocal equivalent of scorn and as such should be on a list somewhere of sounds you can no longer make in public. I am now ashamed that I own a real Prada Bowler and this is not something anyone should be ashamed of! Yes, I paid too much money for a purse. Yes, I have no values. But I am still a good person?

And with that subtext still looming in the air, my security guard lady pulls my dirty underwear out of my bag with her latex gloved hands and puts them into a grey plastic bin. She tries not to make a face but it is there. She is less than happy and I smile smuggly to myself as she takes a seat down next to me in hell.

Over the next ten minutes, my lovely Prada Fall 2007 Bowler has now had more x-rays than most people do in their lifetimes. Finally after the fourth run through the machine, I am told that it was the metal lock on the bag that was the problem. I am handed my boarding pass, my grey bins filled with my dignity and sent on my way.

An article in the Independent in January 2009, support my “mean girls” theory. According to Kate Figes, there is a not-so new wave of “bitch bullying” that has existed for some time in this girl on girl world of ours.

Bitch bullying result when as Ms. Figes states “ grow up with contradictory and confusing messages. They are expected to look good and be good. They want to look sexy and are as interested in, and as in need of, sexual experimentation as much as boys, but their reputation still hangs upon abstinence. "Good" girls don't. They are still expected to be kinder, more supportive and enabling of others. But we are human too, and with too much self-sacrifice resentment flourishes that cannot be expressed – because "good" girls don't get angry… By bitch bullying, girls can express all their anger, insecurities and unhappiness at growing up, but in veiled ways. When you are unhappy, you feel much better if someone else hurts too…. Instead we harbour resentments, often for years.”

According to this theory “bitch bullying” allows these grown up girls to express their anger and natural resentment without getting caught. It is the passive-aggressive get out of jail free card.

And so… my security guard sister in theory was just bitch bullying me in response to not being able to sleep with the prom king some 20 or so years ago….

I felt the anger leave me as fast as a Holt Renfrew gift card…

And as such the next time I go through security and me and my Prada Bowler bag are faced with some poor woman who fits the bill and pulls us over for “being fabulous in an average zone”. I will not rage against the special gunpowder machine detector she swabs me down with. Instead, I will look at her with all the compassion I can muster at 6 am before a coffee and when she asks, “is it real?”… I will utter the words she really needs to hear right then and there…

“Absolutely not.”

And peace will be restored.

Tuesday, November 17, 2009

Girl Talk

Truth be told, I eavesdrop a lot. I am fascinated by what people talk about and find myself listening to their conversations with and ease and a frequency that might alarm you; especially if you are sitting next to me. Perhaps I am fascinated by the human condition. Perhaps I am used to people telling me their secrets. Perhaps, ever a fan of entertainment- I just want to be entertained and I view the conversations of others as just another version of my television, blazing on in the background, filling the air with soothing sounds that I may focus on, or ignore at my choosing.

I tell you this because I have learned a great deal sitting in the coffee shops of my fair city, tapping along at my laptop keys. All lattes, for example are not created equal. Some are complex and marshmellowy, some are watery and disappointing.
Conversations, like Italian coffees are also predictable depending on the composition.

For example, I have learned that when two or more women get together, their discussion tend to focuss on relationships, feelings and the procurement of STUFF. In fact, I will take the literary leap and generalize when I say: Women talk more than they listen. Women talk a lot. At least women who drink coffee. Walk into any coffee shop in North America sit down next to two or three women (it can only work if it is an all-girl crowd) and just listen….. You are bound to hear some variation on the following conversations:

1) The Relationship Talk:

This involves two women discussing why HE could not commit. He was scared, he was not ready, he was wounded, his childhood scarred him, he had trust issues…

2) The XX Talk:
The Double chromosome talk involves two women openly discussing (ie:judging) a third. Her relationship is twisted, her hair cut sucks and her values have been questionable since the day you met. Furthermore, can you believe she asked to borrow my Manolo Blahniks and has yet to return them?

3) The Morning After:
Do you think he will call? I texted him but he has a really big meeting today and his schedule this week is insane. He said he would call me today but it’s okay if he doesn’t. I mean we had a bit of a connection but I think I like this other guy at work better.

4) The Verbal Debrief:
I can’t believe she said that to you?! What did you do? That is not acceptable, no I am sorry, I don’t care how long you two have been friends…. Oh, by the way, did you get your shoes back from Kathleen?

5) The Visual Debrief:
Did you see what she was wearing? I mean I know she’s lost some weight but, seriously, could the skirt be shorter? Did she think she could get away without a bra? I don’t think so…. Oh, An by the way, Kathleen finally gave me me My Frickin shoes back after I went to her house to get them!.

6) The Emotional Debrief:
I mean, I’m an emotional person. I feel things very deeply and relationships take work. It’s not like I did not give him what I had to give….

7) The Financial Debrief:
Where did you get that bag? Winners? Are you kidding me, of course I won’t tell anyone…. It’s amazing. Winners, holy shit? Really… do you think they have any more?

8) The Caloric Debrief:
I ate to much. Do you want the rest of my scone? Oh my god, I have to go to the gym. My ass is huge. I hate it. I tried on these pair of jeans the other day and if I keep this up they are not going to fit. I wish I had your will power.

9) The Environmental Debrief;
We’re redoing the upstairs and I said to Rob, if we’re going to really do this, it is a one time investment, I mean why not spend the extra money and get real hardwood. Laminate looks so cheap after a while….

10) The Egg versus Sperm:
I mean it’s been six months and we’re still not pregnant. How long did yiu guys try for? Because sex is starting to get to be routine…. I tried the temperature thing but I’m just getting so frustrated.

There are many a variation on this theme. Women are definitely the more verbal of the sexes. I have sat next to men in the same vain and really- not as much chatting. There is not nearly the ability to stereotype their conversations. One would think it is all about sex and sports or video games, computers, Blackberry vs. the I-Phone , a hockey pool or some sort of football/basketball/TSN debrief with scores and pools and overs and unders. It really is not that typical. Where men’s conversations tend to be a varitable buffet of unpredictability, girl talk is truly like ordering off the menu.

In fact there is scientific evidence to support my caffeine induced observations. Dr. Dr Luan Brizendine, a psychiatrist and specialist in neuropsychiatry says women devote more brain cells to talking than men do. In her book, The Female Brain, Brizendine, has shown that women’s barins develop earlier and in response to more verbal stimuli than do men’s. In fact, women talk almost three times as much as men, with the average woman chalking up 20,000 words in a day - 13,000 more than the average man.

She goes on to provide claim after scientific claim that shows both physiological and environmental reasons behind this disparity. Anyone on estrogen can not deny, it is one hell of a hormone and it does make you do the damndest of things….
I am fascinated, I am amazed. I am smarter than I ever was before. While men may still rule the world, women rule the silence. Make no mistake, I am not criticizing, I am in awe. Any species that has that kind of mastery of a language deserves my utmost respect. Here’s to us ladies, in coffee shops across this great continent…. Long may we speak our physiologically different minds….

Monday, November 9, 2009

The Pursuit of Happiness

Firstly apologies abound for my silence last week. Truth be told- I am silent only when I sleep and even there amidst the slumber- I have been known to chat up the pillow. This if course is according to my beloved- if you have doubts- take them up with him.

Excuses, excuses- I was busy, I was tired. Yes, I could blame the swine flu (hell everyone is) - and yes- I will eventually, "bite that bullet" and post a witty banter about the vaccination debate that seems to the topic of conversation among so many. We have grown weary of discussing the weather, the economy and the yes, it must be said.... movies and the spring collections have been, well, downright disappointing. One must have an opening line at the upcoming holiday parties and so "are you vaccinated?" is as good a question as "How are the kids?".

But let's ascend from the swine trough for just another week... I have another chip on my shoulder pad that must be shared...

My longtime girlfriend- and she truly is a good one emailed me today, and really this became the inspiration for the following entry. Firstly my girlfriend.... she really does exist (I am not just using my own agenda here- truth be told- this entire experience is my own agenda so I need not pretend, n'est pas?), and she is one of those REAL women- beautifully flawed who celebrates her fabulousness in such a real way that you can't help but join the parade. All that and she has a British accent- which I do maintain, automatically adds an element of sophistication to her wit. She has mastered the art of what I would call "cynical optimism" - she has the capacity for hope- but it is grounded in such a way that even the best nihilist fells compelled to come along for the ride without sacrificing his belief system to the core. Maybe it's her unassuming "live and live" attitude or maybe it's that despite life's kicks to her soul- she has found the right place to put things. Maybe it's just the accent and the fact that she has trained her daughter how to behave in the best restaurants (seriously- at four years of age- this child was better than most blind dates) that endears me to her- regardless... we don't speak often, we live in different cities and we usually connect more by chance than anything but for whatever it is worth- our friendship works.

So I was perplexed when her latest email told the tale of women who secretly want things and are paralyzed to act. You know who you are ladies- you, in the back row- who wants great skin but falls asleep with a full set of makeup on. You, my dear girl, who wants a day to herself but agrees instead to help plan your girlfriend bridal shower. You, who has not seen a movie without a seven year old since before that seven year old was made but continues to allow her progeny to chose her entertainment. When will the madness end? When will we as women take what we want in life? Why do we as women, sit and wish? What it is about our makeup that forces us to want and want and then fail to make things happen? Why are we paralyzed by our desires for things that we don't have?

Industries have come and gone all in the name of a woman's need for that which she does not have. Fashion (and no I am not mocking fashion), beauty, fitness, those organizational stored that sell you just the right boxes to put all your crap in so you appear organized..... it is all in the name of that which we COVET.

I have looked for the right psychological study.... but I think it is much simpler.... I blame Barbie- Yes, 1956 Barbie.... the bitch had everything. She had any job she wanted (doctor, lawyer, secretary, model, hairdresser and ballerina), she had Ken, she had several multiracial best girlfriends, a phenomenal closet and a pink camper van. This "woman" was our generation's cultural icon. She fulfilled our every fantasy. We went to school, did our chores, ate our vegetables, drank our milk and then we spent hours upon hours playing with Barbie- and she was everything we could not be.

Then we grew up and we gave away the fantasy. We stopped dressing up and started dressing down. We pack up the pink camper van and bought green minivans. We lost sight of the friends and settled for members of the PTA and work colleagues. We became buried under work and obligations, kids and playgroups and accessorizing was just that- an accessory.

So now we lie in bed at night- faces full of MAC concealer and wonder where the perfect skin has gone? We watch Oprah and Ellen. We hope they will shed the light. We comb self help book isles for answers that allude us. What happened to the dream? Why can't I get what I want? Why am I paralyzed but that which I want? Why do I sabotage my dreams?

It is quite simple dear cyber sisters... we have lost the skill to dream. We have forgotten HOW to just dream. It has become about that which we can touch, feel, taste. How many of you have been to an art gallery lately? Just walked through the place and looked at pretty things without ever the hope of owning them? Instead we go to home and garden shows and dream about how a couch will look in our living rooms. We have lost the joy in the act of wishing. Now wishing has to be about the result.

When I played with my Barbie in my basement- every day was different.... Did I honestly think I was going to be all the things that Barbie was? Hell no. But I dreamed the dream, gave up the ghost and then was called up for dinner.... I moved on. I flexed my "fantasy muscles".

So here's what I think has happened... in the pursuit of the life, we have become too task oriented. We have lost the pure art of play and so instead of enjoying the dream itself we find misery in the wish itself. We have poisoned ourself with wanting and forgotten how easy some things can be. We have learned to fear change, relish routine and embrace the misery that comes with it... all shadowed in a convenient theory of responsibility.

I am not suggesting we all leave our lives, buy a Barbie and start over.... My solution is quite simple... You want great skin? Wash your damn face! If you skin still sucks, it is yet another thing you can blame your mother for. You want to see a good movie? Hire a sitter- leave the kids for two hours every two to three weeks and go see a flick BY YOURSELF.... it truly is emancipating.

You want more time to yourself? Lock the bathroom door. Stop wanting the simple things in life. THOSE things are attainable. Don't poison the dream with big words and talk shows. Keep it simple. We are women... get the job done efficiently and stop the chatter. It's time the sisterhood reclaimed our greatest talent- the capacity for wonder. Cherish the ability to dream big and save the real dreaming for the important stuff.... a malibu camper with pink wheels and the perfect taffeta ballgown.

Monday, October 19, 2009

Dog Day Afternoon

Truth be told, my dogs have been in more home movies than the Empire State Building. We live in downtown Vancouver and these two little fluff mutts have been the subject of many a Canon Sureshot on their various walks about town. I usually don't realize how many people take their photos or giggle (yes, grown men have been known to giggle at these animals) at the sight of two long haired chihuahuas prancing down Robson street on a Saturday morning. It was just the other morning that we were out for our usual daily walk when a group of Japanese tourists approached me and asked for photos with my dogs. This has become such a common occurrence that I did not think anything of it. I was, at the time, on my cell phone with my girlfriend when I asked to hold on so that my pups could get ready for "their close up".

"What?" she asked , almost shocked.
"The dogs are getting their photo taken." I responded, rather casually.
"Are you freekin' kidding me?"
"No, it happens all the time..." I remarked. It was then that I realized how much of a habit this had become. I was now immune to the fact that perfect strangers the world over had photos of my dogs among their vacation pictures on various facebooks and twitters the world over. (Incidentally, I still stand by my claim that TWITTER sounds like a sex toy.)

Make no mistake, my dogs are adorable. In fact Lola and Ruby are so cute that they have become the "cute measuring stick" by which I compare all other things.

So the other day while purchasing a fabulous Missoni dress at Winners (yes, Winners- I too was shocked, which is why the dress had to come home with me), I was almost rendered speechless when a man essentially scoffed at my fabulous pups in public. He turned to the dogs sitting patiently in line in front of him and said,

"Couldn't you have left them outside?" At first I was shocked that I had thought I misheard him.
"I'm sorry?" I asked, for clarification more than anything.
"I asked, " he emphasized slowly as if English was my second language, "Could you not have left those rats outside?".

Now, dear reader, lest you judge, in his defense this man was an asshole. I had heard him talking to his shopping partner earlier while standing in line that he "hated shopping." Any man who hates shopping and verbally kicks puppies on a Sunday afternoon either has a personality disorder or is just a bad person.

And so I responded with as much grace as I could muster for a Sunday afternoon in a designer outlet clinging to a dress that was 70% off... The key here was to be witty but polite. I could not have a huge scene in the store, lest I be kicked out before the purchase could be made. So I reached into my bag of witty banter and pulled out the best I could muster...
"Are you normally this rude or are you just having a bad day?", I asked. "And as for my rats... this is designer discount shopping... get a grip."

Make no mistake, I still stayed in line. The dress definitely trumped the obnoxious "dog hater". Just because he was "anti-retail" did not mean I had to be. But the event made me wonder, why do people feel dogs are warranted to the outside? Are dogs really as unhealthy as this man had suggested?

A study in the Journal of Hypertension showed that dog owners with high blood pressure had significantly lower blood pressure responses to stress than non-dog owners by as much as 6-8 mmHg. The study randomized 48 patients with high blood pressure, half were given a dog the other half were left to their own devices. Both groups of patients were placed on medication to control their blood pressure and were evaluated with regular blood pressure monitoring and blood work. At the end of one year patients were compared and the dog owner group of patients had significantly lower levels of certain stress hormones , lower blood pressure and lower triglyceride levels (a form of cholesterol). Another study in the American Journal of Cardiology showed that dog owners had a higher one-year-survival rate after a heart attack than non-dog owners.

Both studies concluded that the physical requirements of owning a dog (walking the dog) and the emotional connection to the dog were both important factors in improving the lives of the dog owners.

And so as I left the Winners store dress in bag and dog in tow, I could not help but rejoice in the fact that not only did I have a new treasure to add to my dress collection, I had the secrets to a long and happy life trailing behind me on fabulous pink leashes. And nothing, not even the passing comments of a "hater" could change those facts. And as if on cue, a group of tourists stopped me on the way home and asked if they could take a photo of my little fountains of youth...

Monday, October 5, 2009

The Day Carrie Bradshaw Broke my Heart

Truth be told, I am a bit of sucker for old movies. Make no mistake I am not a fan of the often-archaic roles relegated to women in these vestiges of the “Golden Age of Cinema”. However, if you look past the stereotypes and chauvinism, you can really see a clear “take home message” - the clothes were fabulous. On my top ten list of Must See flicks has to be Aunty Mame with Rosalind Russell. Dear readers, anyone looking for a little wardrobe inspiration need only rent the movie and fall in love with all that was and is truly fabulous. The woman made wearing a power suit a work of art. She put on a fur muff and a Chanel and had all the swaggart needed in today’s day and age. Almost as important as her wardrobe was Mame’s verbal wit. I will even admit to stealing a few of her lines and using them in my everyday conversations.

Trying to stay interesting and looking for some fashion inspiration, I spent last weekend watching Auntie Mame for perhaps the 10th or so time. Amidst the fabulous lines (words and fashion combined) I realized something pretty disheartening about my style icon. The woman SMOKED! I was floored. She had perfect hair, perfect skin, perfect taste and a perfect (insert irony here) cigarette in her mouth! I felt cheated, betrayed and inspired for my next healthy ranting.

What exactly is the “skinny” on smoking? I’d like to think that cigarettes have been relegated to the relics as easily as stirrup pants but truth be told the statistics have caused me pause. Almost 19% of Canadians smoke (4.9 million Canadians overall). This means about two out of my ten readers (and I know who then ten of you are… thanks for your support) are lighting up as I write this. The numbers vary by province with the highest amount of smokers in Saskatchewan at 23.7% and the lowest numbers in BC (16.4%) and Ontario (16.6%).

Yes, I myself dabbled in the nicotine. I blame being awkward in high school and needing a definite statement to affirm my sense of rebellion. Hell enough with the pedantic word findings, I smoked because it was cool. As a socially uncomfortable chubby 16 year old with good grades and great ambition, I was most certainly in need of something to gently shove me over into the dark side of teenage angst just far enough to emerge one day fairly unscathed with aspirations intact. I needed something that would give me an edge socially but would not jeopardize my future. At first I tried piercing my ear three times but that did not seem to be enough and so, naturally I came up with smoking as the solution. This irony is not lost on me now, after 10 years of being smoke free, I am fully aware that I did sacrifice my lung function at the alter of cool.

The doom and gloom of it all is that smoking kills one in two smokers. In fact there does not exist another government licensed product that knocks off half of its consumers. Female smokers according to the Nurses Health Study have three times the risk of premature death compared to non-smokers. Unfortunately this “death risk” is not dose dependant. Several recent studies have shown reducing the amount of cigarettes one smokes does not lower a person’s risk of heart attacks or strokes.

Why do I nag, you ask?

Well, because according to a recent study in the Canadian Journal of Respirology, I SHOULD. The study shows that 60% of people who do smoke WANT to quit. Furthermore, one randomized control trial of smokers showed that a one-on-one motivational talk with a doctor was 5.2 times more effective at getting patients to quit smoking than simply providing anti-smoking pamphlets.

There it is people, precise evidence that nagging helps. I am no longer a “pain in the ass”, I am a woman of science.

Furthermore, a 2001 study in the Lancet done by doctors at Dartmouth Medical School looked at the 25 top U.S. box office releases for the years 1988 to 1997 -- 250 movies in total. They found that more than 85 percent of the films featured tobacco use and specific tobacco brands appeared in 28 percent of the movies. Hollywood still pushes the smoking agenda and I like so many other vulnerable and easily influenced fashion victims will no longer be sold. You can lead the horse to the PRADA outlet but you can not make her smoke a Marlboro.

SO to my fashion icons of the silver screen… be it Mame Dennis, or Carrie Bradshaw I hereby proclaim…. Please put on your best Dior suit and make an appointment with me immediately. We need to discuss your smoking cessation program. With that, another blog is laid to rest as thousands of smokers stub out their LAST cigarette. My work here is done.

Tuesday, September 29, 2009

Put down the Google and step away from the computer...

My mother insists on diagnosing herself. Truth be told, she is not alone. Now, I am a sincere fan of technology. I am not one of those Luddites who feel that we've "lost our way of communicating with each other" due to the "mass of media" so to speak. in fact just last night, I used the Internet to cancel dinner with friends and then backed it up with a text message for extra effect... I use my computer for most things. Thanks to the Internet, I have been able to redecorate our bedroom, spare room and hallway, complete with wallpaper and carpeting without ever leaving the comfort of the couch I bought on eBay. I have spent more time shopping in cyberspace than most people do in a mall and rejoice in my lap top's ability to support my need to multitask at all times. I stand firmly in the belief that MY Internet has not only made me smarter but more efficient. Give me a WiFi connection, a cup of coffee and 45 minutes and I think I can make magic. However, the Internet, like accessories can be very dangerous when put in the wrong hands. I believe cyberspace was invented for three basic things...
The exchange of ideas

I draw the line at self diagnosis. Mother if you are reading this.... do not shut off your computer. I regularly have patients present to my office with a list of their symptoms and a list of possible diagnoses, only to tell me what they have "come up with" as far as the Internet is concerned. Make no mistake, I am all for patient empowerment and people being a part of the healing process. i am a firm believer that a patient is best served when the treatment process is a team effort. That team, however does not include some My Space with a need to diagnose perfect strangers.

I can't help but think it is a sad reflection on how we as physicians have lost touch with our patients. We've have gotten so overwhelmed by the disease and the work that we forgot how to just sit and talk to people. Maybe it's because we are working too hard. Maybe it is because there is more disease and more treatment than ever before in our profession. Maybe it is easier to give someone a website and the name of their disease and let them "have at it".

I'm all for people learning about treatment options and what lays before them once they have been diagnosed with an illness. BUT, last week a woman walked into my office and told me she had used the Internet to diagnose herself with Addison's Disease, an illness where your adrenal glands don't make enough stress hormones. She had been fatigued for sometime and had gone on several websites and entered her symptoms and POOF! There it was... her diagnosis. Furthermore, she had been able with a few clicks to send away for steroids and was now going to start treatment. I kid you not.

Needless to say, I did screen this woman for Addison's and she does not have the disease. I spent an hour trying to reassure her that she did not have Addison's and I would not be surprised if she is still taking her cyberspace steroids. This is not meant as a cautionary tale. I know this is an EXTREME case, but it is there. Internet connections are like children.... A fever is not Swine flu until proven otherwise and a headache is often just a headache. I'm a huge fan of people taking their own blood pressure and keeping a list of their own medications. This is not about self-breast exams. I am talking about googling symptoms and coming up with a diagnosis (you know who you are). My mother, and I do love her, Diagnoses herself all the time. She often seeks a second opinion through the help of friends who have similar symptoms. So, I had to know.... what is the evidence behind self diagnosis?

According to a 2008 research report by Microsoft concerning the escalation of medical concerns in web searches, of the 8 in 10 American adults that have searched for health care information online, “75 percent refrain from checking key quality indicators such as the validity of the source and the creation date of medical information”. A recent report by the BBC says that by 2020, 35% of people will use the Internet to diagnose their ailments. Furthermore, a study published in the Journal of the American Medical Association Looked at the accuracy of people searching for medical information online. The study surveyed over 15,000 people searching for medical information online looking at the accuracy, completeness and design of health-related websites. It showed that in 70 percent of the studies examined, the quality of health-related Web content was low at best.

So, if 80% of people search the web for medical information and only 30% of them get descent advice, That leaves 6 out of 10 people thinking they know more than they really do... The story rings as loudly as ever. Sure, search the net- but BACK IT UP! We should be talking to a doctor for medical concerns. I have yet to hear of people fixing their cars with only online help... So for all my cyber sisters out there... Don't take my word for it! Before we go any further... please don't use me for diagnosis. I am merely a weekly amusement. I may be a stylish dresser and a witty woman, but I am also most certainly full of shit. That is unless you are a patient in my office and then, yes, like all doctors... I DO know everything.

Monday, September 21, 2009

The best part of my day...

It has recently come to my attention that I spend a small country's Gross National Product on coffee and I am not alone. This became ever apparent when my beloved home grind and brew machine ground to a halt, so to speak and I have decided NOT to replace it. We live in downtown Vancouver. There are more coffee shops in our area than there are trees and we have the largest rain forest north of the Equator just a short 10 minute walk away. This is not a proud statement about the times we live in, no judgement here people, just truth. I can chose from Starbucks, Tim Hortons, Artigiano's (phenomonal lattés BTW- not a plug but a fact), BLENZ, WAVES, The Wicked Cafe and the list goes on. I could sustain a caffeine high for 14 hours a day without ever using the same coffee shop twice, all without leaving the comfort of my 20 block radius.

I am not complaining. I am quite pleased with my current coffee situation. I like not having a coffee maker. It takes up a great deal of counter space, it needs to be cleaned and cared for and most importantly I make shitty coffee. I'd like to think I have a modicum of other talents, being a barista is not one of them. I can never get the coffee to water ratio right. Is it a one scoop to one cup thing? Does this vary according to blend of coffee? I have been told by many that I need to use distilled water and the right beans but have failed to pursue any of this. It is far too much work for my true drug of choice. And so as any fiercely independent woman would do in this situation, I have donated my old coffee maker to Salvation Army and now rely on someone else to make my coffee for me.

It has been over six months into my "Don't do it yourself" venture and it has dawned on me that I am racking up quite a bill. Shockingly, I am NOT a fancy coffee girl. I prefer a good, plain, large drip coffee. The occasional low fat latté is a bit of treat but only when I can sit in a café and drink it like a civilized person while the world passes by. Otherwise for my Daily Fix I prefer a standard mild blend. This has of course been financially advantageous but nonetheless, I am spending upwards of $2-$4 per day (depending on the amount of work I need to get done) on coffee. I justify my $1500 a year habit with the usual "I work hard, I deserve it", that many of us will use to justify anything worth purchasing. Every now and then it dawns on me that if I gave up the caffeine ghost I could broaden my shoe closet? In fact as I sit in my local café, espresso coursing through my veins, trying desperately to be witty for just one more week, i am painfully aware that Italian drink to my left is impeding my ability to enjoy the true gifts the Italians have given to society... expensive footwear.

Apart from my footwear realization it has also come to my attention among my java journeys that coffee is truly a personal choice. One's coffee choice is one's fingerprint on life. I am a "Venti Mild blend, 2 fingers of cream with 4 artificial sweeteners" or as I like to call it. "Venti mild, Skinny with legs". My husband prefers an Artigiano Machiatto (I still have no idea what is in it). My friend "K" is a die hard for a good Tim Horton's double-double. Our coffee choice is as much a personal statement as is our choice of car, bank, hair colour or religious affiliation. We develop it over time and stick with it almost militantly. It is our little declaration to the world about who we are. For example, people who use travel mugs care about the environment and like their coffee very hot. Low fat choices declare one's interest in healthier choices and one's overall high maintenance. In my experience people who like Mocha's are embracing their inner child and those with a taste for an Americanno have really good taste in handbags. There is no science to this- it is purely speculation on my part.

Where there IS science, thankfully is in the health benefits to coffee drinking. Firstly, the average cup of coffee contains about 200 milligrams of caffeine. In short it is about 2% caffeine, 98% "other stuff". It is likely that other stuff that offers it some benefit. There is an overwhelming amount of observational studies showing a benefit of coffee consumption of 1-4 cups per day to reducing Parkinson's and Diabetes. Twenty studies worldwide show that coffee, both regular and decaf, lowers the risk for Type 2 diabetes, in some studies by as much as 50%. Researchers out of Harvard University say that is probably because chlorogenic acid, one of the many ingredients in coffee, slows uptake of glucose (sugar) from the intestines. (Excess sugar in the blood is a hallmark of diabetes.) Chlorogenic acid may also stimulate GLP-1, a chemical that boosts insulin, the hormone that escorts sugar from the blood into cells. Yet another ingredient, trigonelline, a precursor to vitamin B3, may help slow glucose absorption. The take home message here is that a drink once thought to cause harm may even be helpful!

And so always a fan of science, another day, another four dollars. I finish my cup and this weeks' Girlfriend's Guide with the knowledge that life is about choices. I choose to leave my coffee in the hands of those who have the proper respect for the bean. I choose my Venti with cream and chemicals in the hope that all those antioxidants will cancel out whatever crap I put in the coffee in the first place. I order my coffee, make my personal statement about who I am and what I want and move on into the world knowing I may have prevented disease with yet another cup. Am I drinking coffee to PREVENT Diabetes? No. That is what healthy eating and exercise is for. But at least I can justify my $1500 a year as a health expense. After all, health really is priceless. My next mission is to find a study showing that Manolo Blahniks are good for your cholesterol.

Monday, September 14, 2009

The Geek shall inherit the earth

My beloved is a geek. Not the old school kind with pocket protectors, coke bottle glasses and a "Revenge of the Nerds" laugh. He does however have an almost romantic connection to his computer and as for video games? They are not only his source of income but a true life force. He works as a technical artist for Relic Entertainment, a video game company. At many a party he is the coolest "dude" in the room. When asked of my career many people respond with a longing look as if to say "will you be my family doctor?' To which I respond "I am not family doctor" and the conversation is over. Jason, however, when asked of his job inspires many a man to become a boy again. Nobody wants to play doctor anymore.... they all want to play real time strategy (RTS) with Role Playing Game (RPG). Throw in a little MMO (Massive Multiplayer Online) and my ability to prescribe narcotics can no longer compete with the degree of this sexiness. I always thought it was awesome that our careers were so vaslty different. And really unless he had a game that was making people have seizures our two career paths would not likely converge.

First, as always, there is the fashion. Jason's uniform is a t-shirt either with some recent alien having its head blown from its face or a hoody in praise of a war time stretegy game which allows every twenty year old to kill a Nazi from the comfort of his/her own living room. I like my fashion more off the runways where he goes to work as a marketing statement mixed with just the right pair of jeans and shoes which are funky because they were bought by his wife.

Make no mistake, I am so proud of his work and his passion for his craft. Rarely will one meet someone who TRULY loves his/her job and much as my beloved. But I never thought HIS work would change mine. That was until last week.

I was waiting for my next patient in clinic. I have changed some of the features of her case to keep things confidential, of course. She was seeing me for high cholesterol and her 19-year-old son came with her to the appointment and was waiting in the waiting room as well. I went out to the room to get her (we'll call her Debbie, although this was not her name) and sitting next to her was her son "ZacK" (not his real name). She was reading one of the shitty magazines I encourage my patients to steel from my office, Zack was reading World War Z by Max Brooks. I am not entirely farmilar with the book only to say it is the Warren Commision equivalent in the event of a Zombie attack. It sits on my husband's bedside table and he talks of it with as much respect as I do British Vogue. I do know that it is by the same author as the Zombie Survival Guide and incidently Mel Brooks's son.

So as charming as ever I said to my patient's son,
Good Book? I hear it is almost like a 911 investigation into the Zombie wars." He looks up at me with awe.
"Have you read it?" he asks.
"No, " I reply, "but my husband is really into that stuff. In fact have you seen the movie District 9? I just saw it last week... great film."
"I am going to it tonight" he says almost in a whisper.
"You will love it> "
He was dumbstruck. And as if that is not enough, I take out my light-saber and issue one final geeky blow.
"I can't wait to see AVATAR in December. I hear there was a 25 minute clip at comic-con this year that was amazing. 310 million on a movie.... better be worth it." I say with confidence.

Make no mistake, I really did like District 9. In fact, I like it more than my husband did. I also am looking forward to seeing was 310 million dollars will buy you in a movie these days. I was not just feeding this 19 year old a line, I was, however embellishing my "Geek Mystique" learned, nay, absorbed from years of living with a "Tech-E Monster" in order to further my patient-physican relationship.
"How do you know all this?", Zack asked in wonder
"My husband does FX for a video game company" I reply
It turned out that Zack's favorite game was the one my husband worked on and I told Zack. A five minute conversation had cemented me as this geeks new Wonder Woman, complete with laso of truth and fabuous wrist bracelets.
"You my Mom's Doctor?" he asked.
"yes" I smiled

Zack and his mother came into my office and so began a long debate about whether this woman who had high cholesterol and had already had one angioplasty would take her cholesterol medications. I was ready for a head to head throw down ahead of me. I would quote statistics, the benefits of secondary prevention and give her the evidence on a silver platter. I was ready. But before I could intervene her son put down his book and calmly said to his mom, "Mom she totally knows what she is talking about. You really should listen. You've already had one heart attack, you don't want another."

From then on it was like a dream. I wrote a prescription for a cholesterol medication and SHE TOOK IT! No messy talk, no power struggle. No quoting studies, no proving how much I knew. I was a monkey who did not need to dance! WHY? Not because I was a strong, intelligent, accomplished and trusted physician. No, 9 years of clinical practice had not given me shit in this situation. I had clinical credibility right then and there. Thousands of hours spent studying and in conferences were reduced down to the simple fact that I knew what RTS (real time strategy) stood for. It did not matter that secondary prevention with statins reduces cardiovascular events further as much as 50%. What mattered was that I knew what World of Warcraft was and I was sleeping with the guy who was doing the technical art on Spacemarine.

This got me thinking about what makes a patient trust a physician? What makes any of us trust any authority figure at all? Had I not known the ins and outs of the gaming world, would Debbie leave her diagnosis to Google? Science has some evidence to suggest that a patient remembers only 50% of what a patient tells them. In fact several studies both in the New England Journal of Medicine and in the American Journal of Psychology suggest that a patient's compliance rest in their relationship with their doctor long term and in other social factors such as their family make-up and whether they have had a bad experience in the past. This all seems logical to me, the fact is there is evidence to back it up.

Today, however, science begone, tonight a gamer and not a doctor was king. And so life in that instant became a video game itself. In the battle to save the universe my avatar was not a 39 year old doctor with great hair, logical arguments and a killer shoe closet. No I was "game-boys" wife; with Wonderwoman hair and just enough knowledge of the geek to get one young man to convince his mother to take a potentially life saving drug. There was all the drama of World of Warcraft and Gray's Anatomy was nowhere to be found. And when I arrived home that night and kissed Jason on the cheek. I realized how much I had to be grateful to the geek. For although there are days where I mock his laptop in bed or the fact that he is physically attached to an ipod at all times, today would not be one of them. I often joke that I send a 35 year old man to work every morning only to have him come back as 16 year old boy each day. Today, however, was a revelation. Today, Jason sent a 38 year old doctor off to work and she returned home a Superhero. And so dear reader, today was the day, where video saved the medicine star...

Monday, September 7, 2009

What to Wear After Labour Day?

This Labour Day, I let more than 400 people with less than 10% body fat pass me by. Truth be told it may have been more than 400 hundred, I lost count somewhere around the 357 mark. It was the Vancouver Triathlon – Sprint Distance and I had a point to prove. I am not sure to whom this point was proven but now muscles aching, calories burnt and the best post race brunch I have had in a long time I am glad I did it. To top it all off, The New England Journal of Medicine says I will live longer.

I am not one of those people who instantly gets the “runners high”. In fact four years into running, I am still waiting for anything other than pain and the guilt free consumption of carbohydrates to occur after any exercise. I am not complaining. Nor am I minimizing it to make my lazier friends feel better. Triathlons are physically, mentally and fashionably a challenge. To begin with there is the obvious commitment of at least an hour or two a day to all three sports; swimming, cycling and running. You train constantly. Fortunately the activities to chose from (cycling, swimming and running) are varied enough to banish away any boredom of doing the same thing day in and day out. On race day there is still the challenge of 750 metres of swimming in the ocean, a 20 km ride through Stanley Park followed by a 5 km run. It truly is the axis of evil.

Mentally there is no other battle like it. Let us begin on the shores of Second Beach where at 6:45 in the morning I realized the water was a breezy 14 degrees Celsius. Regardless of a wet suit and all my formative years spent in Winnipeg, Manitoba, this would be cold by all standards. After my “practice swim” in the ocean lasting only 10 minutes, my face grew numb, my left foot froze and my resolve grew firm. I would finish this bullshit if it killed me. Sixty minutes later the starter horn sounded and I along with several hundred of my crazy sisters threw ourselves into the ocean for twenty minutes of sheer exhilaration and terror. It was ice and salt and fear and fabulous.

When I leave the water there is a run up the beach to the transition zone, where the cold and the dread melt away as perfect strangers cheer on my victory and in that moment I feel like a rock star. In the transition zone, I collect my bike, run to the start of the cycling course and I am off for twenty kilometers through the best rainforest north of the equator. It was on this ride that I have time to let my mind wander. I mentally clean out my closet, at least twice, virtually write this article in my head, and figure out what I will wear tomorrow as the world falls away in the fifty minutes I spend alone with my thoughts. Whizzing by me is every four thousand dollar Cervelo bike (The Porche of Cycling) and on it a phenomenal display of the human form. I am not embellishing when I say that in the span of 20 kilometres I must have seen more muscles than I did in a year of Anatomy class.

Finally the race ends with a 5 kilometre run that really is like having a salt bath after being sand blasted. Everywhere you have skin you have pain and mentally you do everything in your power to just “be in the moment” and “visualize the finish”. If not for the volunteers and spectators cheering me on I would have sat down midcourse for a latte and a nap.
These are the physical and the mental hurdles that face us all in any of life’s races. But in triathlons there is the added concern of the fashion challenge. As my readers know, I do love the gear. I am not a sporty girl but any activity that allows for an outfit deserves at least give an honest effort.

Triathlons are the quintessential “gear sport”. You have to respect a sport that allows for two costume changes. First there is a wetsuit, which really is a superhero costume. Rarely is neoprene a fabric worthy of praise but apart from keeping me relatively warm at 14 degrees, it truly is the best body lift money can buy. If the suits were thinner and more functional, I would take one in every colour. After emerging from the water the wetsuit is stripped of in the transition zone and I essentially get naked in front of hundreds of strangers.

This is one of the reasons I have dubbed triathlons "the naked sport". Essentially it is a group of insanely fit people with 8% body fat wearing almost no clothing running around from sport to sport in their underwear for several hours. As for me, I am in a racing bra and cycling shorts but I am soaking wet and a bit chubby- this is not a good look for me. I am however shameless or brave, depending on the audience, as I put on my cycling jacket and my cycling shoes. It is a magical costume change that is seconded only by the running outfit that follows. A headband replaces my cycling helmet, the cycling shoes with runners. The true challenge of triathlons really is not the multiple sports but the ability to remain fresh looking at the finish line after several hours, three outfits, an ocean swim and a wicked case of helmet head. Master this and one can rule the world.

And so master it I did, with a smile on my face and a song in my heart. Despite the pain, the cold and the preponderance of “wet spots”, it truly was a glorious was to spend a morning. Always one to challenge my brain, it was a nice twist to challenge myself from the neck down, and to see just what I was made of.

My best friend in Toronto has taken up running. She has two kids, a full time job and easily 500 better things to do with her time. But every morning she gets up at an ungodly hour to meet the dawn and the neighbours for forty plus minutes of a walk/run. She tells me I’ve inspired her with my newfound fitness madness but I truly think it’s become a mutual inspiration. Here I am on one side of the country, swimming, riding or running and there she is on the other with a group of mothers trying to get their fitness in before the madness of their day begins. The polarity of this has never been clearer and yet in my mind it has brought us closer together.

The Nurses Health Study (NHS) is the largest and longest study to date looking at women and risk factors for heart disease. The NHS began in 1976 and to date has followed over 276,000 adult women aged 27 to 44 years. One aspect of the NHS by Dr. Frank Hu and colleagues examined the association between exercise and risk of death among women in the Nurses' Health Study over a 24-year period. The study was published in the New England Journal of Medicine in December, 2004 and showed that women who exercise more than three and a half hours a week have almost half the risk of cardiac death independent of body size than those who exercise less than an hour a week.

I am sure there are days where my friend in Toronto wants to hit the snooze button until it breaks, but she doesn’t (and after reading this she most certainly won’t). There are days for me, when the water is too cold, the road too long, my butt too sore. But a long and healthy life is like anything worth fighting for. It may not be a series of maddening exercises through water wind and fire, so to speak. It may come down to an early morning power walk with the local PTA. As I rode those twenty kilometers through Stanley Park on Labour Day morning, I mentally removed the white from closet and had a little mental connection with my BFF in Toronto, we'll call her "K". In those moments alone with my thoughts and the hundreds of naked muscles whizzing by me on overpriced cycling machines, I was inspired; by the fabulous commitment of the people around me, by a mother of two somewhere in Toronto who was likely finished her morning power walk and sitting down to eat breakfast with her family. Mostly, I was just inspired to spend the coming winter months training for the next great race, when I will endure the madness and the monotony all over again and all for the perfect costume change.

So forgive my indulgence, dear reader, never one to “play favorites”, but this one’s for “K” wherever she may be. Thanks for making me your “inspiration”. According to the evidence, we're both likely to live a little longer despite the fact that most times when I exercise I feel like I’m dying. And here is to you, my dear friend, post this Labour day.... May our outfits be fabulous (even if they are white) and may we both hit the snooze button a little less often…

Monday, August 31, 2009

Choose Bike!

Always a fan of labels, I have added another one to my list. I’m a commuter. Dior, Gucci, Prada and Cannondale? I have decided to use my powers for good and now cycle to work. Make no mistake; this was not an immediate decision. FIRST, there was the gear. Shopping for a new bicycle is not an easy task. This is made even more difficult when your last bicycle was a Schwinn Cruiser Deluxe one speed with a banana seat and pink tassels on the handlebars. Apparently, tassels are to a bicycle what socks are to sandals; cute on a child insulting on an adult. Thus tassels be gone, I was in need of a respectable bicycle and a trip to the local specialty bicycle store was made in order to achieve cycling maturity.
Make no mistake I did not “cold call” the bike store and walk in without the faintest idea of what I wanted. I was, at the time, training for my first triathlon and was fully aware that Lance Armstrong had won the Tour de France for the seventh time while riding a Trek. If it was good enough for Lance…
So when the lovely woman at the cycling shop asked if she could help me find something, I spoke with an air of confidence. I knew what I wanted and I knew what I was talking about. I wanted a Trek racing bike. This would seem simple enough to the non-cyclist. Apparently asking for a Trek racing bike at a specialty bike store is like asking for an ice cream cone at Baskin and Robbins.
“What kind of Trek racing bike are you looking for,” the woman asked. Her name was Hannah or Anna, I really can’t remember. I think it was Hannah or at least that it what I called her for the rest of the interaction and she never corrected me either because that WAS in fact her name or she was being polite and desperate for a sale.
“I’d like a really nice Trek racing bike.” I replied confidently. What kind of an idiot did she take me for? No, Hannah/Anna I’d like a piece of crap Trek if you have one?
“Okay,” she said with trepidation knowing full well this was going to be a sale she’d have to walk me through. I should point out that in my defense, Hannah/Anna should have seen this coming. I do not own “sporty clothes” as they are often called. I go shopping in heels and to me “casual wear” could easily be anything formal as long as it paired with a jean jacket. So there I was shopping for my Trek in a fabulous little black dress and a jean jacket. I mean really! Did Hannah/Anna think I actually knew what I was talking about?
“What would you like to use your bike for?” Hannah/Anna asked coming closer to me. It was then that I realized she was very petite. At five feet tall and maybe 90 pounds I could easily take this woman. My confidence immediately grew. She would clearly kick my butt cycling up a an incline but in an arm wrestle I would be the victor.
“I have a triathlon coming up and would like a proper racing bike.” I said with an athlete’s pride. She smiled and I watched her eyes look me up and down. Hannah/Anna was giving me the “you are a triathlete?” look. I get this a lot. I do not have an athlete’s body. Yes I am built more for comfort than for speed however I do get extra points for both effort and fashion. I may not finish in a timely manner but I do finish and pride myself on looking impossibly fresh in the photo afterwards.
“Okay,” said Hanna/Anna, after her once over was complete and she walked to the back of the store to find the first bike for me to try. She emerged a few seconds later and I knew that Hanna/Anna was going to need more than just a little arm wresting contest for me to show her my point of view. There in front of me was a Bumble Bee Yellow Cannondale with black writing and a red seat.
“Hanna?” I said, although the “H” might have been silent, “we need to have a chat.”
“Try it for size.” She said confidently.
“Yah, I don’t think so.” I said surveying the large lemon of a thing.
Allow me to explain...Yellow is the kind of color that is great in food and bad in everything else.
Yellow fruit, fabulous, yellow shirt, not so good. Yellow pie is delicious; a yellow bike is a migraine. And so when my little Hanna/Anna tried to soothe me by suggesting that there were even yellow jerseys to go with the yellow bike, I decided to school her in the colour wheel according to Ali Zentner.
“Hannah, I know you are really trying to help and I am not what you would call knowledgeable in the bike department but I must tell you, I need a pretty racing bike. Black or blue, maybe even turquoise with a lovely accent colour. Something that would look sporty but still is fabulous. Do I look like someone who would be happy on a big bumble bee of a bike?” I was trying to get through to this woman when I looked down at the floor and noticed she was in Birkenstock sandals with, yes, woolen socks in the middle of June.
“Let me get Mike to help you. He is much better with this sort of thing.” She sighed. And with that Hanna/Anna gave up on the sale and on me and walked behind the desk. She turned to the twenty something sitting behind the desk who I could only assume was Mike, pointed in my direction and said “Trek racing”. With that, she picked up a copy of Cycling World magazine and banished me from her memory. Mike was now tag teaming it in her plan and headed in my direction.
“Hey there,” Mike said, “I hear you want a Trek racing bike.”
“Do you guys work on commission?” I asked.
“Yeh,” Mike said.
“Okay,” I answered somewhat vengefully. I was now what my husband would call a “hater”. I was buying a bike from Mike just to give him and not little miss socks and sandals the commission.
Within three minutes, Mike returned from the back with the perfect creamsicle delicious tangerine and white perfection that was to be my Trek.
“Try this one.” He said proudly.
“It’s beautiful.” I said almost with a sigh, “How did you know I wanted a pretty bike?” I asked like a woman opening a Tiffany's box for the first time.
“ My sister is a fashion journalist and I bought her a bike for Christmas. Went through the same thing with her. She has the same purse as you have.” He said shyly.
I did not know what pleased me more; that my new bike fit perfectly, that it really was practical AND pretty, or that there was a fashion journalist out there carrying the same bag as me.
And so my love affair with the bike began. My Trek and I have now been together for over a year. We have shared many highs and lows. I have learned how to signal properly in traffic rather than just swearing at cars about my directional intentions. I have completed a triathlon and lived to tell the tale. I cycled my way through a rain filled Vancouver winter and learned that when you pedal too fast in the rain the water really does fly up your backside and not in a good way. Through a determination bordering on shear stubbornness I have learned how to use “clip in” pedals where you wear special shoes that clip to the pedals of the bike. Truth be told I learned to clip in not for the extra power it offers the cyclist when riding a bike but for the fact that if there was an occasion to buy special shoes- I would NOT be denied. I have fallen off my creamsicle fabulous perfect bike a total of 21 times (all learning how to use the “clip in” pedals) and managed only a nasty scar on my left knee that refuses to heal. I now own four pairs of cycling shorts all with extra padding in the crotch area, two sets of cycling rain gear and all of my cycling jerseys curiously look wonderful with the colour tangerine.
So, when the Archives of Internal Medicine published a study about the results of cardiovascular benefits of commuters I felt all of my hard work would be now justified. The trial done out of Chapel Hill, North Carolina by Dr. P. Gordon-Larsen and colleagues studied young people who commuted to work by walking or cycling over a one year period versus those who drove their cars. This cross-sectional study included 2364 participants enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study who worked outside the home. The study looked at the relationship between walking or biking to work with body weight, obesity, fitness levels, and risk factors for heart disease. A total of 16.7% of participants used any means of active commuting to work. All other things being equal, male commuters had 50% less like likelihood of obesity than men who drove to work. Unfortunately this difference was not observed in female commuters which only proves my theory that God is a woman without a sense of sisterhood. Female commuters however did have significantly greater fitness levels than non-commuters. So as I ride my Trek rain or shine over the Lion’s Gate bridge and back again day in and day out I can rest assured in the scientific knowledge that I am losing absolutely no weight but if ever I decided to have a foot race with the “old me” (the one who used to drive her car to work) I would definitely kick her ass. No, I may not live longer (the evidence remains to be seen, the studies about longevity are still ongoing) but I do feel better about my cycling ability and my relationship with spandex.
As for the future? Studies come and go and science changes as often as hemlines. Health is transient and we all have to do our part. Someday my love affair with all things tangerine will be replaced with a carbon-fibre turquoise Trek that I can neither afford nor justify at this moment. Someday there will be a study that shows that women who cycle to work on said carbon-fibre turquoise bicycles not only live longer but also are easier to live with. And on that glorious day tassels will be affixed to bicycles everywhere and all will be right in the world once more. No one will go hungry and no one will wear leggings ever again. So it is written, so it shall be done.