The Most Wonderful Time of the Year

IT’s that time of year my cyber sister…. The holiest of holy.

Yes, You know what I am talking about…. Boxing Day.

Some have Christmas or Yom Kippur or Ramadan or Oscar Night…. I have The days between December 26th and January 7 which in the ever reliable world of excess have become the BOXING WEEK.

I love that in the world of shopping, a weeks is really more like 17 days.

Now let us be clear. I never shop on Boxing Day itself. I’m a tough broad. Hell I can handle a mountain climb and a good triathlon. I can battle a good shoe sale like any other woman of distinction.

I always obey the cardinal rules of MAJOR discount shopping:

Rule number 1: Wardrobe.
Ladies, Yoga pants or some sort or leggings are a must. I am talking about a base layer that can easily accommodate an entire outfit being worn/tried on over it should the line to the fitting rooms be completely unacceptable.

You find yourself waiting for 2 1/2 hours to try on that Prada suit now discounted at $225, You better be sure you will find a nice quiet corner in the store and put the whole suit on over your legging and t-shirt.

Here, you use your imagination to adjust for what the fit would feel like without the “base-layer” beneath.

Rule Number 2: Fluids

The key here is to bring a coffee that is big enough to provide the needed energy and enjoyment for a day of shopping endurance but not too big to have you draining your bladder periodically throughout the day.

A full bladder can be the difference between a pair of Christain Louboutin Prive peep-toe pumps for 80% off or the need for a bathroom break.

Chose wisely my young Jedi- a happy bladder or jubilant feet. Hint- no one care about bladder incontinence if it is done in red soles…

Rule Number 3: Music

I love to shop with my i-pod. I listen to books on tape or a great mix. I find the music or the story take me away and allow me to shift my focus to the clothes at hand and not the greed in the store.

Rule number 4: Attitude is Everything.

Ladies, Boxing Week is not for the faint at heart. There is no sisterhood. This is not the place to make lasting friendships or find a play group for your Mommy and Me class. The store on Boxing Week is an endurance challenge. Keep your head down, smile, be polite put really…. Expect service personnel to treat you like shit and fellow shopper to be greedy and nasty.

Maybe you will be surprised. Maybe a lovely fellow retail sista will let you have the cashmere she was eyeing that looks way better on you. However as in medicine- Hope for the best but expect the worst.

This way when someone shoves you down in a Holt Renfrew accessories department you are not disappointed or even surprised- you are merely able to get up, align your chakras and love on to buy the Lanvin crystal safety pin that you have been having an affair with since you saw it walk down the Fall runway in Paris.

I know it sounds brutal… but I love it. I love it all. I love the physical emotional and retail thrill of a good Boxing week blow out. I love the waiting that went on for my perfect dress all season only to find it 70% off and in my seize waiting to come home with me like a puppy in a window.

Turns out, there is science to back up my retail euphoria….

In a paper published in 2007, researchers at the UK's Brunel University noted that shopping is associated with increased activity in the left prefrontal cortex, a part of the brain that has been linked to pleasure and positive thinking. In fact, levels of dopamine, a neurotransmitter released during pleasurable experiences including sex, can rise sharply even when you're merely window shopping.

In another study, published in the journal Neuron, researchers at MIT, Carnegie Mellon, and Stanford strapped volunteers to an MRI machine and showed them photos of products. When shoppers saw something they wanted to buy, a flood of dopamine to the nucleus accumbens--the brain's reward center--lit up their MRI images like a dashboard.

And it's not only about pleasure. Shopping may also help women maintain their mental acuity in old age, says Guy McKhann, M.D., a professor of neurology at Johns Hopkins University and a co-author of Keep Your Brain Young. "People who are doing really well as they get older tend to be mentally engaged, physically active, and socially involved," he says. "And women are all of those things when they shop."

Who new my shopping would help me train for my mature years.
Studies show that picturing several different outfits engages the brain and the prefrontal cortex which are all important activities as we age….

So the key to eternal youth and happiness really can be found in my closet…
Forget the big holidays and bring on the Boxing Week…. My health, my well being and hell, the science of my longevity depend on it.

And who says you can buy happiness. Well the obviously haven’t found Manolos at half price…

Now get out there ladies… and make me proud. Going into 2011 never forget… GOOD CLOTHES OPEN ALL DOORS…

The Reviews are In...

Twas the week before Christmas, I looked back at my blog.
Reflecting on girlfriends and my little cyber log.
I thought of the year and the topics we’ve shared
I thought of the science and good style we’ve declared.

So I picked out my favorites and put them to rhyme,
A Guide in Review, cyber sisters- it’s time.
The shoes in my closet were laid with such care,
They were safe for my feet- the evidence was there.
There was reasons for blood pressure and weight loss and bike
There was hope for the future and the coffee I like.

There was the one about sleeping and how much we should get.
Eight hours is the key – if you have not read it yet.
The nails I bite are my dear mother’s fault.
There’s the cat on the net and the Moustache in the vault.

There’s the risk of a clot at 30,000 feet
And high fructose corn syrup – where you are what you eat.
Of the bad dreams that happen, I am still so amazed.
Or the nightmare of menstrual every twenty eight days.

There’s Mama and her skin still so perfect and clean
Her Dove soap and genetics the best stuff that I’ve seen.
The mix tape that takes my right back to childhood…
Where I was my own rock band at each chance I could.

The fact that the tunes are good for my heart
Make me want to continue and to play every part.
Then there’s patients and GOOGLE and the challenges there
Where you look up your symptoms and wait for the scare.
Where 60% of this country of ours
Is out “playing doctor” in restaurants and bars.

Then there’s second hand smoke and the diseases it brings.
Heart disease and Emphysema among other things.
To the lovely German tourist who lit up without fail,
Standing behind her, I could not help but inhale.

To the mini-van driver who ran me down in the rain.
Her 80’s style lipstick is still seared in my brain.
My beautiful Lucy, a bike fender crack,
And some kick ass bruises to my arms, leg and back.

While on line at a bathroom at a great New York play,
I got more of a show than all of Broadway.
The talk was surreal, it made my head swirl.
I’d have listened for hours, but my bladder’s a girl.

The BAD DAY I had and the rant that then followed.
The minivan hit and the Americano swallowed.
Then there is the lovely patient who puked on my Choo,
While the insurance on the car I hit has yet to come due.

My rant about shopping and locking up bags,
What has the world come to with these retail drags.
Then there’s texting and Twitter and my own lasered hair,
My EAT, PRAY, LOVE, RANT and elite underwear.

There’s the power of the sun and the effects on your skin,
Then the Ride to Conquer Cancer,
And my Pride in Team FIN.
I sat at Kits beach and watched high body art.
Where nothing says, “I love you” like my name inked on your heart.

There was Bitchy and Blogging and Busy, oh my!
And my issues with Q Tips and how my Beloved hates to fly.
The BP oil spill, my swearing and screams…
My love for the Y,
And my new hair colour schemes.

It was a year filled with coffee and mental health days.
The effects of a nap and my Triathlon ways.
I’ve been blogging bout driving, and botox and more.
Hell I even got inspired by that damn Jersey shore.

Now the year’s almost over
And a new one just begun.
I’m looking for inspiration and hoping for fun.
SO here’s to you my sisters, may your style be just right.
Happy Blogging to all and to all a good night.

One High Mile

Man or Woman really was not meant to fly. Never mind the physics of it all and the fact that we have neither the wings nor the fortitude for that kind of altitude and stamina. Put a group of people in an airplane and you really can see the human race at its worst.

In theory, an airplane should be the happiest place on earth. It is a seated mode of transport where you are protected from the perils of the outside world. There is something both liberating and reassuring of having to turn your cell phone OFF for the duration of a flight.

The seats on a plane are small, but the air is oxygenated and for the most part there is always a movie or two that you have not seen and have always wanted to. The washrooms are clean and every once in a while someone comes around and offers you something to drink.

If you have the luck and superiority of sitting in business class, there is even nice plates to eat off of and on flights more than 5 hours, cookies are often baked on board and served by someone who pretends to care about you and tries to be pleasant despite his or her better judgment.

In practice, however, an airplane is a Pandora’s box of the worst human condition has to offer.

People are invariably at their worst on a plane. Babies cry at will, children whine and run up and down isles. No one is on his or her best behaviour. Fear of flying, being contained or just the lower oxygen content makes a group of seemingly well behaved human being transform into a group of cranky, rude animals who don’t regard the comfort of others for any considered period of time. I am fairly certain if any plane I am on goes down… I am on my own as far as exits and emergency evacuation. This pissed off mob will not stop to help me with my seatbelt or life vest. It will be Lord of the Flies at high altitude, rest assured.

Putting people on a plane forces them into a confined space where they must interact AND share with strangers. Let’s be frank, people as a rule SUCK at sharing with others. We left the sandbox long ago as a species and took all of our toys with us. Most people treat Socialism like a side dish. They don’t mind it in their medicine or in their educational system, a sprinkle here or there. However, no one wants all things equal all the time, 24/7. No one wants Socialism as his or her main course in life.

I myself love to fly. I find it the perfect solution for getting things done. Never am I more productive than strapped to a seat at 35,000 feet with only a laptop and an in-flight entertainment to keep me amused.

I do my writing, my billing, hell my taxes all while the world passes by below. No worries about what calls I might be missing, no concerns that the laundry needs to be folded or the dogs needing to be walked.

In fact if they would put a treadmill on my next flight and I could go for a run somewhere between Vancouver and Toronto, I would spend my life commuting.

But I do have some reservations….

For example:
What is with the arm rests? I once read an article on armrest etiquette on a plane (in my defense it was in the in flight magazine and I had nothing else to read) and it clearly stated that the person in the middle seat GETS BOTH ARM RESTS. I realize this is not a well know fact, dear girlfriends so please spread the word…

I often sit in the middle seat in an Emergency Exit isle. I like having more legroom and don’t mind sacrificing latitude for longitude. Inevitably I am sat, however next to some businessman (no I am not generalizing, it is usually a businessman and he is most often from the land of “Overwhelming Self-importance”).

He wears comfortable business loafers with dress socks that usually match his trousers and he has a laptop case the size of an eight year old. This is the man who ruins my perfect airplane experience. He uses both arm rests with abandon and spread out across the row of seats as though it were his living room couch.

I often wonder about the whole sitting/leg room issue on a plane.

I am not one to “sit still” on a good day. I have long prescribed to the belief that “objects at rest tend to stay at rest, objects in motion tend to stay in motion.

I am fast approaching 40 and I have a lot to do in this life. Sitting still is for babies…. I gotta move.

Furthermore, one of the risk factors for D.V.T.’s or deep vein thromboses (blood clots in the leg) is immobility. We were taught in medical school to ask patients about any long haul travel when they presented to hospital with symptoms suspicious of a DVT.

A trial published in the British Journal of Hematology in 2002 examined the risk factors for DVT among 568 consecutive patients presenting to a British Hospital with blood clots in their legs. They found now significant risk of DVT among people who had been on long haul flights (anything over 3 hours) unless they had other risk factors for blood clots (such as smoking or a family history.

An effect is seen once travel duration exceeds 6 to 9 hours and becomes obvious in long-haul passengers traveling for 12 or more hours. A recent study published in 2005 in the International Journal of Hematology found that increase in thrombosis rate among arriving passengers peaked during the first week and was no longer apparent after 2 weeks. Long distance (more than 8 hours) travelers had a 2-4-fold increase in relative thrombosis risk compared with nontravelers, but the averaged absolute risk was very small. There was approximately one DVT for every 2 million travelers and there is no evidence that thrombosis is more likely in economy class than in business- or first-class passengers.

Furthermore, laboratory studies show that these patients likely all have an underlying clotting disorder of some degree and the long flight just “bring it out” in them.

My family has no history and I quit more than 10 years ago. Yay for me.

And so here I settle in to the middle seat on the 7 am from Vancouver to Toronto. There is the latest Woody Allen movie for viewing (the one I really wanted to see) and a man to my left who computer is as large as his elbow. Both are now in my personal space.

I have four hours and fourteen minutes (4:36 gate to gate) and a lot of work to be done. I’ve taken my Cold FX (who knows if it really works) and a baby aspirin. I breathe deep and face the radiation like the brave soul I am and flex my legs every few minutes in the name of good circulation. And just for good measure, I move my elbows onto the armrests into the “UP AND LOCKED POSITION”. I am soooo ready for take off.

28 Days

I am not a bitch. Contrary to popular opinion I am as nice a person as the next woman (that is if the next person is relatively pleasant).

As a doctor, I try my best to be somewhat level headed at all times. Sure I’m emotional (and somewhat self aware) but I try to maintain some sense of existential decorum.

However, once a month, my head splits and an emotional demon from hell emerges.

Yes, I’ll say it proud, dear girlfriends, I suffer (or rather those around me do most of the suffering) from Premenstrual Syndrome.

Don’t feel sorry for me, my cyber sisters. This is my plight and my permission. I really don’t need your pity- I am making my bitchiness work. Why just last week I felt the need amidst my Progesterone wrath to call American Express and unleash the “dogs of hell” over an error made to my list of charges. Rest assured my hormones did not go to waste, as only this week; I received an apology from the president and a $100 gift card for my troubles.

What good is a uterus if you can’t use it to buy shoes?

For those of you who don’t experience the “cycle of sad and hate” that is indeed the hallmark of any good lunar bitch-fest let me talk you through it…

Day one begins with a bang…. A crushing bang to the midsection, to be precise. This is where I feel like I have the flu AND I broke my pelvis all in one morning. The only thing keeping me positive throughout the mind numbing cramps is that the moodiness and anger of the preceding three to seven days can now justifiably end.

Five or so days later the glory of womanhood be gone and I can start wearing my good underwear again. I go about my daily life and almost forget that I have two ovaries and a uterus secretly plotting against me, like some evil stepsisters.

The days turn into weeks and before I know it, I start feeling a little sad. By day 24 this sadness has blossomed into an irrational flurry of emotions and I am crying at everything from a Disney preview to a Kleenex commercial.

Day 26 ushers in a wicked case of “veldtshmertz” (what the Germans would call world sadness) and I can no longer watch CNN or any news program for that matter. Suddenly, any world event has me reeling on the verge of an existential crisis.

Days 27 and 28 are spent with a full-blown case of the “bitchies” and if my beloved is reading this… I apologize for the 24 days a year he has had to endure said wrath over the last 16 years. When I sit down and do the math- that is collectively over a years supply of prime grade evil.

I will pick fights just to have them. I will make unholy requests of any relationship around me. Even more “untrue to form” is the fact that during this period of time, I develop an insane craving for all things deli and M&M pretzels.

Yes, dear sisters, me, the health freak spends 2 days a month fighting off the inner pull for chopped liver on rye and candied covered salt. It’s a world gone mad.

But it turns out; none of it is my fault…

A recent study presented at the American Society for Reproductive Medicine in Denver, Colorado in October, 2009 shows that the women’s’ brains are significantly affected at various stages of the menstrual cycle.

The study took MRI’s of more than two dozen women while they were looking at different pictures and had them rate the photos as pleasant, unpleasant or neutral. The same photos were shown to all women at different stages during their cycle.

At each instance an MRI was taken of their brains while they were viewing the photos.

In the early stage of the menstrual cycle (called the follicular phase- my days 7-12), no areas of the women's brains showed significantly increased activation while viewing the pictures.

During the midpoint of their menstrual cycle, when hormone levels were higher, the women had increased activity in the lateral prefrontal cortex and other areas of the brain involved in processing emotional information, the researchers found.

By the later phases of the cycle (days 20-28) the activity in the lateral prefrontal cortex was at its highest.

The prefrontal cortex plays a huge role in goal oriented behaviour and emotional response.

The fact that this study shows a correlation between hormonal levels and certain activity is no surprise to most women out there.

Who among us has not felt freaking crazy during the later parts of our monthly cycle??

Previous studies have found that the rate of affective disorders (mood disorders) is two times higher in women than in men. Many experts believe this difference is from sex hormones. Perhaps there is some truth to this, but further studies need to be held before we can blame our “girly parts” for all things crazy.

SO science wins again! I am not a bitch…. It’s just my prefrontal cortex in a bad episode of GIRLS GONE WILD. Whatever will I do?

For now, I’ll count out my life in teaspoons of hormones to paraphrase T.S. Eliot. I’m sure he suffered from a great deal of sadness. If only the dude had a uterus…. He’d have someone to share the responsibility.

Too Sleep, Perchance to Dream

Do you remember when you were little and you had a nightmare? When you woke from sleep with a start and the room was dark and the world was terribly frightening and the fear tasted like a metal popsicle at the back of your throat? And all you could do was run to your parents bedroom and ask to be allowed into bed?

There I was at five or six or even eight years old, standing at the foot of my parents bed at some unholy hour with my feet digging into the shag carpet hoping that they would wake up to my whispers….

“Mommy?” I said in a whimper, “I’ve had a bad dream. Can I sleep with you and Dad?” There it was. A plea and a prayer. Please let her not banish me back to my own bedroom where God knows what freak of my imagination was waiting to cut me up.

It was the 1970’s girlfriends. Horror movies were a whole different genre. We’re talking Friday the 13th, part one, Halloween, part one and Steven King before he has a family and antidepressants. These were frightening times.

I think one of the older kids in the neighbourhood had convinced me to see Carrie the night before and my subconscious had feasted on blood and terror while I snacked on licorice. Between the sugar high and the jarring scenes, I was just ordering the perfect slumbertime scare straight off the menu.

As a professional multitasker, I am die hard fan of the power of the subconscious. I love it that while my body sleeps, my brain tries to make sense of the previous days’ events. It seems like a very efficient way to work through ones psychological baggage.

Why just last week I had the most amazing dream. Having spent the evening watching web casts of the spring fashion shows on Style.com, I had the pleasure of dreaming that I was in a Chanel fashion show.

Let’s be clear, I have neither the hips nor the bank account to support anything Chanel has to offer, but in my dream it did not matter. I met Karl Lagerfeldt and he told me in perfect French (yes, in my dream, I was fluent) that I was his new muse. LOVE IT!

But then there are the nights when I’m a little too tired or a little too stressed and I make the mistake of watching a little too much HBO before bedtime. And before I know it, it’s three in the morning and I’ve woken from a really shitty dream. I empty my bladder and try and recollect myself as I fall back into bed and try not to think too much so that I can be back asleep before I know it.

The eight year old in me is alive and well. And now I crawl back into bed with my boy and snuggle into him. My pups fall into line; one next to my head and the other curls up by my side. I listen to everyone snore and try to sync my breathing with theirs and pretty soon, before I know it, it’s morning.

Overall, half of adults experience nightmares - women twice as often as men. Studies show that we start having nightmares around the age of five. Children ages 5-15 have on average one nightmare per week. The frequency of this drops off after the age of 25. Between the ages of 25 and 50, 25-50% of people have about one nightmare per month.

The cause of nightmares remains unclear. However, previous research suggests that stress may play a key role and that nightmares may actually serve a beneficial function. A study published in DREAMING in 2002 examined the overall relationship between stress and frequency of nightmares. The study’s hypothesis was that nightmares in fact may serve as a coping mechanism for stress.

The study looked at a group of 412 psychology students with low, medium, and high nightmare frequency. The students were separated into one of three groups according to nightmare frequency as well as low, medium, and high nightmare intensity groups.

Comparisons were then conducted for daily stressors, life stressors, social support, and coping. Most notably, this study demonstrated a positive association between nightmares and coping with stress.

The group with the highest coping mechanism had the highest frequency of nightmares, suggesting that nightmares may be a mechanism to alleviate stress.

One of the questions the study could have answered was whether people who develop better coping mechanisms actually develop more nightmares? In other words, can your frequency of nightmares reflect your ability to cope with stress as well? As you get better with stress, do the nightmares decrease?

Studies show that alcohol consumption and certain medication as well as certain foods (those with higher sugar content) can increase the incidence of nightmares. Further studies have suggested that people with increased frequency of nightmares may have residual effects of feeling anxious the day after the actual bad dream.

SO there you have it. I’m working out my life’s problems through my freaky dreams.
Maybe I am a bit bitchier on the morning after, maybe not; A small price to pay to working out life’s challenges.
As for me, a margharita and HBO before bed tend to increase the risk of a “bad ass” dream. Some herbal tea and a good fashion magazine and I am guaranteed a good night’s rest and a fantasy walk in Paris fashion week.

So goodnight dear girlfriends, I'm off to sleep. Perhaps, I’ll cope, perhaps not. Regardless, I hope my subconscious has something to entertain me with.

Skin Deep

My mother has perfect skin. If she is reading this right now she is undoubtedly touching her face. At seventy she has a few wrinkles (what woman without Botox doesn't?) but she has this perfect creamy white skin that is as soft as can be. My mother does not deserve her perfect skin. Make no mistake- she's a lovely woman; a saint in fact. But she washes her face with.... wait for it.... Dove soap and water. This is not a product placement, this is a fact. She has not used moisturizer on her face as long as I have known her.

Perhaps she avoided the sun in her youth and no she never smoked. But she does not adhere to a special diet. The woman keeps mini York peppermint patties in her purse (again no product placement, just fact) and a Jeannie's Cake (Winnipeg's famously beloved birthday cake) in her freezer at all times.

As her daughter, I thought some of these kick ass skin genes would cross the womb, so to speak. As a teenager, I used Mama's tried and true Dove soap and water. I was relatively unscathed in the acne department.

Sure once a month my face broke around the time I became an irrational evil person but things would settle down and my skin was none the wiser.

Now on the verge of 40 (how many blogs will I mention the fast approaching four-oh?) I have developed adult onset acne.

Prior to writing this I spent a good fifteen minutes staring at my pores in one of those bastard close up hotel bathroom mirrors. These mirrors really are assholes. Firstly, they are undoubtedly placed in a location in a hotel bathroom that involves several yoga classes and unrealistic core muscles in order to view your pores properly.

Let’s be clear- I’ve been training to climb a mountain and so I am physically better prepared to stand in my underwear crouching tiger over a mirror and a sink arms poised in assault on any blackhead that dare to show its… well its head. And now, fully stretched across said sink, I am looking into a mirror that has magnified my face 20 fold when it dawns on me that perhaps nothing, not even one’s skin should be viewed at such a magnification.

Were we ever meant to see any part of our body “up that close”? Or is this yet another contraption made by some marketing bitch that serves only to make you feel both fascinated and ashamed at the state of your current physiological affairs.

So hear I am fumbling towards forty and Rather than wrinkles, I’m facing a state of acne that only a teenager could really sympathize with. Good news is, my middle age has afforded me just enough apathy and neuroses to make the current state of my skin fill me with a mixed bag of emotion.

Part of me could not care less. I have the means to buy the really good cover up and a sample cupboard at my office to provide me with enough pharmaceutical grade acne creams that would make the teenage version of myself swoon.

The other part of me is just neurotic enough to wonder how long will this dermis rebellion last. Am I the girl who is going to have zits instead of crows feet? Or worse yet? Both?

I had long come to terms with my looks somewhere after age 35 when I learned that anything can be beautiful with the right pair of footwear. That being said… when your red spotted face matches your red soled shoes… life gets rather complicated.

A study published in the American Journal of Dermatology show that I am not so alone with my face up against a cruel and judgmental bathroom mirror....

The study looked 749 people over the age of 25 as a community-based study to investigate the current prevalence of facial acne in adults.

The group of people were examined at random and found that some degree of facial acne was recorded in 231 women and 130 men, giving an overall prevalence in women and 40% in men. The prevalence of acne did not substantially decrease until after the age of 44 years in this patient population.

A further study published in 1998 in the British Journal the showed that the rate of the referral of patients over the age of 25 years with acne has significantly increased over the past 10 years.

In this study the prevalence of adult acne in women was significantly higher at 76% of women and 24% of men. The mean age of the patients was 35.5 years (range 25-55 years). The acne was mild or moderate in severity. Most patients had persistent acne; but true late-onset acne (onset after the age of 25 years) was seen in 18.4% of women and 8.3% of men.

Thirty-seven per cent of women with adult onset acne had features of hyperandrogenicity ( increased testosterone) with other clinical features like male pattern hair growth (see my previous rants about my mustache) This may be an indicator of other disease states in some women including polycystic ovary disease.

External factors, such as cosmetics. drugs and occupation, were not found to be significant causal factor. A family history revealed that 50% of patients had a first-degree relative with post-adolescent acne.

So... Here I am in another hotel room bathroom mining my black heads with the pride of a Chilean miner. My mother's Dove (soap) has long flown the coop and I know spend far too much on facial promises that make promises they can not nor will not keep.

I have resorted to flirting shamelessly with the drug reps who frequent my office pedaling their high grade pharmaceutical facial creams in the hope that one day.... I will have Mama's dermatological legacy.

According to the evidence my skin should improve in the next 5 or so years..... Just about the time the wrinkles fully take hold.

Until then, If you need me, I'll be in the bathroom crouching tiger, hidden dragon over a magnifying mirror. It may do nothing for my face but my character and my abdominal muscles have never been stronger.

And the Band Played On...

The power of music has always fascinated me. As a kid I can remember standing in front of my living room window and performing the entire score to the Broadway musical Woman of the Year on a regular basis.

It was more than a make-believe moment for me. Some kids played sports after school, others road their bikes in the street. I stood in front of a living room bay window and played “musical theatre” all on my own. I would put a tape into our cassette recorder and belt out the score for the entire front yard to see and hear.

Let’s be clear…. This was the 1970’s. Musical theatre was still relatively underground among eight year olds. I memorized all the parts to “A Chorus Line” well before it was cool.

In 1979, my parents went to New York City and brought me back the soundtrack to “Woman of the Year” starring Ms. Lauren Bacall. I fell in love with her before the end of the opening number. I sang the part of Tess so many times that to this day I have the words emblazoned on my brain. My living room was host to easily 120 performances of “Woman of the Year” with yours truly bringing down the house each night.

I played the damn thing so much, I warped the tape. For those of your reading this who have no idea what a tape cassette is, safe to say, that’s a lot of times.

It was not just musical theatre that caught my musical attention. I remember playing 33’s of Journey, Air Supply and Trooper and singing along as though I was the world’s greatest groupie. From Mr. Roboto to the Boys in the Bright White Sports Car, I memorized every note and every lyric.

I sang into a hairbrush, a curling iron or a can of hairspray. I was my own rock star.

In my teenage years, the tapes moved into CD’s. Stacks of the things filled my life like little towers of tunage in various combinations around my bedroom.

Then there was the MIX TAPE. Remember the MIX TAPE? That one perfectly crafted combination of tunes of all shapes and sizes put onto one tape/CD as the ultimate measure of self expression. Who you were in life was who you were on a MIX TAPE. Want to tell someone you think they are THE ULTIMATE? Say it with the perfect combination of Peter Gabriel, Stevie Nicks and some Supertramp. No need to say what you feel.... put it in a MIX TAPE. Wrap it up with a home made cover page and you have yourself the ultimate piece of self-expression.

Every mix tape I made was inevitably called "A to Z SPECIAL MIX" I thought I was being so clever.

My twenties saw the birth (and death) of Napster and the digital music movement. I sang my way through it all. In my head I sounded like Beyonce. In reality, I carried a tune across the bedroom and just barely made it.

I’m not a bad singer (there’s a healthy sense of self esteem) but I’m not a good one. How shall I put this? If I auditioned on American Idol, I WOULD NOT make it to Hollywood, however, there would also NOT be a You-Tube video of me singing some sort of freaky rendition of “Poker Face”. Nuff said.

But I do love my music. I like the beat of anything, the rhythm that fills up your brain and instantly puts you in a better mood.

Even at this moment I am listening to my latest I-Tunes download (yes I paid for it, thank you very much) and tapping my heels while I pen this little bit of magic.

Of course I am sitting in a café and mouthing the words to Eminem’s “Not Afraid”. Those around me likely think I am some sort of psychotic writer. I like to think of myself as “creative”.

A study presented in New Orleans at the American College of Cardiology Annual meeting in 2008 showed that my mp3 player might be on to something.

Ten healthy, non-smoking volunteers participated in all phases of the randomized study. There were four phases. In one, volunteers listened to music they selected that evoked joy. The volunteers brought recordings of their favorite music to the laboratory. Another phase included listening to a type of music that the volunteers said made them feel anxious. In a third session, audiotapes to promote relaxation were played and in a fourth, participants were shown videotapes designed to induce laughter.

Each volunteer participated in each of the four phases, but the order in which each phase occurred was determined at random.
Prior to each phase of the study, the volunteers fasted overnight and were given a baseline test to measure what is known as flow-mediated dilation.

This test can be used to determine how the endothelium (the lining of blood vessels) responds to a wide range of stimuli, from exercise to emotions to medications.

The theory behind this is that the endothelium has a powerful effect on blood vessel tone and regulates blood flow. It also plays an important role in the development of cardiovascular disease.

After the baseline test, each volunteer was exposed to the music or humorous video for 30 minutes. Their endothelial function (or “stretchiness”) was measured periodically during each phase of the test.

In other words, they were listening to Madonna and having their endothelial function measured. Additional dilation measurements were obtained throughout each phase to assess changes from baseline. Compared to baseline, the average upper arm blood vessel diameter increased 26 percent after the joyful music phase, while listening to music that caused anxiety narrowed blood vessels by six percent.

During the laughter phase of the study, a 19 percent increase in dilation showed a significant trend. The relaxation phase increased dilation by 11 percent on average.

Further studies have shown that music therapy can be beneficial for patients undergoing chronic treatments such as chemotherapy or dialysis.

So there you have it.

Right and left brain unite. Strike up the band…. And cue music please. If you need me, I’ll be in my shoe closet lip-syncing for head AND heart’s sake.

Role Play

When I was five years old I played “doctor” with “Michael N.” in the basement of our neighbour Karen’s house. I can remember it as if it were yesterday. Actually my memory of the basement room is far more accurate than that of the activity that took place in it. There was an empty dog harness hanging from the ceiling that Karen’s father told us was an “invisible dog”. I no more believed in the validity of the dog as I did about my medical skills at the time put given that we were pretending I figured it could not help but imagine Karen’s family pet hanging from the ceiling in the basement.

I always insisted that Michael be the patient. He was 2 years my senior and I was a rather ambitious 5 year old. This made for an agreement on both our parts.

My point is that “Playing Doctor” is a ritual that I would argue many of us have done in our lifetimes. Usually it is well before the age of maturity and child behaviouralists claim it is a way in which children explore their bodies.

Michael would present with a bunch of imaginary symptoms.
“Hello Dr. Ali” he would say, “I have a cough” and down we would go to Karen’s Basement aka: my exam room past the imaginary/invisible dog into our play room where I would examine Michael with a Fisher Price Doctor’s kit and diagnose him with anything my imagination could conjure at the time.

Let it be know that I never made Michael show me anything more than his underpants. One might say that even back then I was adamant that my patients preserve their dignity.

Last week I met a woman who insists on preserving her inner child. By this I mean, that at 73 years of age, she is till playing doctor. Although I suspect her office is somewhat more the likes of her den or home office and there is no invisible dog. There she sits in her living room or extra bedroom on her computer “Googling” her symptoms and waiting for the word “cancer” to appear on the screen.

She was kind enough to come to her doctor’s appointment armed with the fruits of her Google searched. I kid you not. She handed me a four-page print out of her symptoms and a cross-referenced list of what the Internet had to offer in terms of her diagnosis and her treatment.

The mind-altering thing about this experience was not THAT it happened. But that this has happened, nay happens easily once a month in any doctor’s office in any town across this great land. Safe to say that this happens to me easily once a month to some varying degree.

A population based survey out of a major pharmacy chain in the UK shows that 81% of people have researched their symptoms on the Internet and made a self-diagnosis BEFORE they ever see a doctor.

A further Australian study shows that 1 in 4 Australians use their Internet searches IN PLACE OF a doctor’s visit for self-diagnosis.

According to the 2009 Health Care in Canada Survey, 84% Canadians are online Internet users (24million). Seventy percent of Canadians have visited a health care website in past year in order to achieve a diagnosis or information about a medication or symptom.

Many online Canucks (almost 60%) are using the Internet to conduct their own self-diagnosis. Fortunately, 51% of those playing “cyber doctor” say their own diagnosis via the Internet is confirmed as correct after consultation with a doctor.

One in five Canadians say they visit their doctor less often because of information they received on the Internet.

Look, I’m a fan of the Internet. It is by far one of the greatest vehicles of information there ever was. Yah, and I can shop from the comfort of my own bed. Buying shoes while lying down? That’s genius.

But should we not draw the line somewhere? Shouldn’t you have to take some sort of medical intelligence test before you can just punch in all your symptoms on a screen and wait for the word “cancer” to pop up in response?

I do think self-diagnosis has its place. It does make patients more informed and offers them and avenue to have many of their fears alleviated. Furthermore, it provides them with a volume of resources that as a single physician I could only dream of providing.

In reality, most of the time the Internet makes my job a hell of a lot easier. People come to my office with informed questions and a place where they can often find added resources.

But then there are those extremes. Those “one in a hundred” cases where someone really uses their high-school biology powers for evil and not for good.

I’m not sure what the solution is. I’m not sure there is a solution.

All I know is as long as human beings have had a quest for knowledge we have found ourselves in some sort of curious situation in some sort of basement, trying to find the secrets of the universe.

Maybe that should be enough for me? Maybe it should be a comfort to me to know that all of this… the google searches and cross-reference lists are a sign of humanities quest for wisdom? Maybe we’re all just a bunch of six-year-olds just trying to play doctor in a world we all want to make sense of.

Maybe I’m full of shit. All I know is that I have the BEST of memories of that basement/doctor’s office so many years ago where dreams and diagnoses were made under the watchful eye of an invisible dog. And just like back then, as long as no one gets hurt, is there really any harm in pretending once in a while?

Smoke and Mirrors

I was having the most lovely day on a date with myself in New York City. Picture it dear girlfriends…. I began with a run in Central Park followed by breakfast at my hotel. Early morning was spent at the three major spiritual centres of worship (Saks Fifth Avenue, Bergdorf Goodman and Barney’s) followed by lunch at the Plaza hotel.

Feeling fashionably, physically and nutritionally nourished I thought my soul could use a pick me up and so I found myself standing in line at the Museum of Modern Art. I was having just a perfect day thus far and was looking forward to a little bit of French Impressionism to add to my day of Italian Footwear appreciation.

Just when I thought I would be all the better for this experience, the woman in front of me in line lit up a cigarette and began to puff away. Why must so many smokers always flaunt their habit? Is it that “bad girl image” she was trying so hard to uphold? Wan’t it this very “bad girl image” that got her smoking in the first place?

I know I have blogged once before about this “Butt”, however this bears a “second hand look” so to speak.

There she was some twenty something European tourist (she was speaking German and Europe seems to be the place to be if you are a smoker) literally blowing smoke up my ass and in my face.

Now, I am not a religious person, spiritual, yes, but religious no. I am rather shamefully proud of the shallow part of me that feels that Sunday brunch IS sacred and that Barney’s (the store, not the dinosaur ) is indeed a house of worship. All this being said, I believe I did in fact have a True belief in a higher power in that moment in line at the Museum of Modern Art. For there I was standing in the face of “cancer by proxy” and it started to rain.

And so my little German smoker who was blowing her Marlboro’s up and around for all in line to experience had not come prepared and was without an umbrella. She smiled at me sweetly as I promptly opened my big black “W Hotel” umbrella (on loan from the lovely concierge) and I smiled back waiting patiently for the downpour to wash away her cigarette’s ember, her unhealthy habits and of course her sins.

Moments later, her cigarette was soaked and she finally put the damn thing out. She looked over at me from her puddle of shame and like a little drowned cat with big sorrowful eyes she appealed to my sense of humanity,

“Do you have an extra umbrella?” she asked me. I think she asked me because I was literally staring at her grinning at my climatary luck, so speak.

And I opened my eyes equally wide in order to match her gaze and responded with a degree of mutual respect that was worthy of the situation.

“Nope.” I responded.

A few minutes of rain later, she soaked, me dry, the line moved and in we went to appreciate the works of this world’s masters.

Why did she have to smoke in line? If only she had walked away some 50 feet or so, had her cigarette and then come back to the line…. I would have been happy to share my umbrella with her.

But alas that was not the way it went down. I was not trying to teach a lesson, I was not trying to avenge. It was simple. I wanted that cigarette out and rather than ask this woman to put her cigarette out, I was going to allow Mother Nature to do my dirty work.

Make no mistake, dear girlfriends, I am NOT a heartless cow. I DO indeed care for the common man and woman. But, I love my lungs more than I love this stranger’s blow-out. Thus my umbrella, on this day was purely a table for one.

The interaction was a selfish one on my part…. But hey, she started it? Right?

Tobacco smoke contains more than 4,000 different chemical compounds, more than 50 of which are known to cause cancer. It is undeniable that smoking significantly increases one’s risk of developing a variety of cancers (including lung, breast and bladder) and heart disease as well as lung disease and stroke.

When you breathe in smoke that comes from the end of a lit cigarette, cigar, or pipe (sidestream smoke) or that is exhaled by a smoker (mainstream smoke), you're inhaling almost the same amount of chemicals as the smoker breathes in.

Further more, equally mounting evidence shows that second hand smoke increases a person’s risk of developing cardiovascular disease, lung disease and cancer. An estimated 50,000 Americans die each year as a result of second hand smoke.

According to the American Cancer Society, nonsmokers increase their risk of developing lung cancer by 20% when they are exposed to secondhand smoke.
This equates to about 3,000 deaths annually from lung disease in nonsmokers caused by secondhand smoke exposure.

A review article published in Circulation in 2005 confirmed that second hand smoke increases a person’s risk of heart disease by about 30%. Furthermore, the study looked at all research on second hand smoke published from 1995-2005 and found that second hand smoke affect the cardiovascular system very much the same way that first hand smoke does.
The evidence shows that the cardiovascular system—from blood vessel stiffness to atherosclerosis to oxidative stress, inflammation, heart rate variability, and energy metabolism, are all exquisitely sensitive to the toxins in secondhand smoke. The effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking.
Let’s be clear dear girlfriends, I was not spending hours training for triathlons because it was good for my personality. All that sweat and tears was not going to be flushed down the proverbial toilet just because some lovely German girl needed a “nic fit”.

And so yes it was very mean of me to leave one of my foreign sister “out in the rain”. It was cold and I was cold hearted. But I was putting my lung function before her well being and that was something I would have to live with.

Hours later wandering through the Impressionists’ hall at the MoMA my soul refreshed I took a long deep breath as I stood in front of Van Gogh’s famous Starry Night.

Inhale. Exhale. Inhale. Exhale.

It felt so good to breathe and the air was pure. I forgot about the rain and the smoke and noises in my head for just a moment and the world was new again.

Bike Me.

Last week, Tuesday in fact, a car hit me. Yes Mother, if you are reading this, I never told you because somehow you would only worry and likely make some attempt to “forbid” your 40-year-old daughter from ever riding a bike. I was hit by a car while riding my bike.

Here’s the scene. I was making a right turn from a bike lane into a bike lane. A minivan (yes, my hate for the damn minivan is now deepened AND personal) came up from behind and side swiped me. My elbow made contact with their side view mirror (nice bruise to show for it) and I was knocked to the curb all in front of the Hermes store. Incidentally they were having a red carpet party (balloons and all) at Hermes that night and the lovely security guards out front were very helpful in getting me to my feet and making sure I was okay.

The van did not miss a beat and drove off. I too did not miss a beat and got back on my bike, made the right turn and rode up to the offending bullshit vehicle ready to let them know that in the cosmic scheme of things…. They were now on watch.

I took off on Lucy (my tangerine dream of a bike) and rode up to the van as it was parked at the next red light. Fueled by a sense of self righteous indignation I banged on the window.

Now understand please that I am now going to be mean. I was hit by a car, dear girlfriends, this should allow me at least 200 words of unjustifiable venom.

The driver of the car was not a real blonde. I myself have been dabbling in hair dye, but this woman had a platinum do that was just plain trashy. Think Jersey Shore not Marilyn Monroe. Further more, she had that really pastey pink lip stick thing going on that made her look like she was suffering from a wicked case of herpes and was putting some weird cream on her mouth to prevent an outbreak.

One final observation…. Her eyebrows had been plucked into near oblivion.

So when she pointed one of her shoddy acrylic nails at me and said with a bit of chuckle,
“I barely saw you, you know.” I did in a moment of sisterhood feel a bit sorry for her lack of style.

Then I remembered that her lack of style had just hit me with her minivan and I recovered.

“Well, you hit me with your car.” I said.

“Well, you came pretty close to the car, you know.” This was from her boyfriend
who was riding shot gun. I could not help but notice his “What’s Jersey Wearing” homage to fashion complete with a fake tan and an ever popular tattoo art type t-shirt.
And yes, my cybersisters, I lost my shit.

“Dude, (I did call him dude) are you insinuating that I hit your car with my bike?” Perhaps they did not understand what “Insinuating” meant, because they told me where I could shove my bike and proceeded to drive off.

Now, my beloved always tells me that I do have a bit of a horse-shoe up my backside. Well thank my lucky stars that riding in the car behind these upstanding citizens was an off duty police officer who in a good Samaritan move stepped out of his car and took down this lovely couples information in order to file a report.

I left the scene feeling a bit mournful for the future but with a renewed respect for our “boys in blue” and a renewed and more personal detest for minivans.

The left side of my body hurt like a mother-fun-house but nothing says pain killer like a cross to bare, a bone to pick and a cracked bicycle fender.

A week later, Lucy- my beautiful tangerine dream of a bike (you may remember her from a previous post) has survived the event and apart from some kick ass bruises which make me feel very butch, I am relatively unscathed.

A study published in the British Medical Journal in 1998 looked at
data on 1462 injured bicyclists aged 1–19, obtained over a period of five years from the British Columbia Children's Hospital. Cycling injuries comprised 4% of all injuries seen in the five year study period. The proportion of admissions was 12.7% among bicyclists. Boys were injured more often than girls. The proportion of admissions for boys was 13.8% compared with 10.2% among girls. More than 70% of injured bicyclists reported no helmet use. The proportion of admissions of injured bicyclists who did not use helmets was two to four times higher than the proportion of admissions of those who used helmets. Head and face injuries occurred more often among those who did not use helmets. Of the 62 concussions, 57 occurred to non-helmet users.

You should know, I always wear a helmet. Firstly, it reinforces my need for an outfit. I have always maintained that a headpiece of any kind, will always tie a look together. Secondly, nothing says sporty and fit like holding your helmet once you’ve parked your bike somewhere safe. Finally, I have huge hair. When I am riding to work and back, the helmet tends to “tame my mane”. Fashion, sport good grooming and a statement piece…. It’s a process…. Nuff said.

According to a study published in the New England Journal of Medicine in 1989, bicycling accidents cause 1300 deaths each year in the USA. This is compared to 26,000 deaths from motor vehicle accidents. A case control study looked at the use of helmets in reducing head injuries among cyclist. According to this one year study, of the 99 cyclists with serious brain injury only 4 percent wore helmets. In regression analyses to control for age, sex, income, education, cycling experience, and the severity of the accident, the study found that riders with helmets had an 85 percent reduction in their risk of head injury and an 88 percent reduction in their risk of brain injury.

A further population study in the Journal of Trauma showed that bicycling accidents happen less frequently per capita in communities with a higher proportion of cyclists. In other words…. The more bicycles…. The safer.

Seven days later, several bruises (to my cycling mojo more than anything) and a new relationship with anti-inflammatories and I am a new woman/cyclist. Lucy has been to the bike shop and back with a clean bill of health. I have my guardian angel/off duty cop to thank for defending my honour.

To top it all off, I bought myself a new top of the line fabulous helmet. It’s light as a feather and strong as an ox…. All in the name of safety and science I found myself another statement piece. Life has a way of always working itself out.

Bathroom Antics

Have you ever listened to women chatting while standing on line at a
public washroom? Well in the name of research I have on many occasions.
As recently as this past weekend, in fact in
New York City at a Broadway production of time stands still.

Let's be clear. Broadway is most definitely the shit. I saw some amazing
theatre that most definitely deserves the hype. The theatres however were built 50
or so years ago when women apparently did not have to pee as much.

Perhaps they drank less? I can only surmise that portion sizes were
different back then and perhaps socially speaking we were conditioned
to hold things in more.... Our opinions, our vote, our voice and yes,
our urine.

An so there are only 4-5 stalls in each single washroom in any given
Broadway theatre. Well we now no longer hold anything back... Our
opinions fly freely. We vote, we hold offices of power and politics
and we drink venti americannos like they ate our life blood. Thus we
pass urine as readily as we pass judgement.

And so the line up for the ladies washroom at this Broadway play was
long... I mean Oliver stone movie kind of long. It went down a flight of
stairs, across a powder room and into a small sub chamber towards 3
stalls 2 sinks and some lovely smelling hand soap. I had spent the
preceding morning subsisting on coffee and retail and I had to pee.

I learned a lot in that line up of line ups.

I learned that all New Yorkers sound like they are my Jewish Aunt Ethel. This is due entirely to the stereotype that all Jewish women talk they are from NYC. But seriously (said in a Brooklyn twang and with a hand gesture) it’s true.

I learned that New York women as a rule have had a lot of work done. Forget California- this little island of Manhattan had more silicon than a Microsoft conference. Botox and Restylene and Juvederm, oh my! In a line up of 27 women I counted 12 sets of cheek implants, 8 face lifts (4 of them dreadful) and at least a dozen nose jobs. As for Botox- New Yorkers don’t smile much to begin with…. It was hard to tell…. But I would estimate double digits easily.

I learned that women talk in details. Mostly regarding their health and use terms like “They say….” To begin sentences where they want to convey a sense of authority. For example….
“Sally Hershberg had her spinal surgery, you know. She spent 4 hours in the operating room and another 2 hours in recovery. They operated on her face down and she had a puffy face for 4 days afterwards. They say she’ll be flat on her back for at least 3 months. She’s still going to try and host book club. We’re reading Lovely Bones again. I think it’s too depressing but the girls want to do it. They say you remember details better when you read a book twice.”

Most of all, I really wondered what is it about the female bladder? This was not the first time I had stood in a line somewhere in some theatre listening and waiting and holding it in.

I would leave, having emptied my bladder, having washed my hands and reapplied my lipstick and I would pass the entrance to the men’s room and of course… it was as empty as could be. In fact as a little girl I can remember going to the ballet with my parents. I can remember lining up at the women’s washroom at Winnipeg Concert Hall during intermission as the line snaked around the lobby. I remember glancing over to the men’s room and seeing men come and go in and out like bees to a busy hive without a delay or a care in the world.

It was only in those moments that I wanted so badly to be a boy. Do not worry- this passed as soon as I discovered the power of a good Handbag.

But I had to pause in this old theatre on this wonderful day amidst the women of Manhattan and wonder…. What the hell is with my girly bladder??

A study in the Journal of Urology published in 1991 had just the answer for me.

The study looked at urination among almost 700 patients. The patterns and frequency of daily urination were studied in 412 male and 244 female participants in the Baltimore Longitudinal Study of Aging. Men urinated less often (mean 4.8 voids per day) than women (mean 5.6 voids per day).

There was no main effect for age decade. However, an age by sex interaction showed that urination in men increased across the decades and in women it decreased.

Women in their 30’s urinate on average 6.2 times per day. Men in their 30s urinate 4.3 times per day. As people aged their bladders meet somewhere in the middle. In fact, men and women in the 70 and older age group had the same urination frequency of about 5 times a day.

In men frequency of urination was related to benign prostate enlargement and 2 of 4 symptoms of urinary obstruction (change in the force of the urinary stream and having to urinate again shortly after voiding).

In women a decrease in frequency was related to a lack of pregnancy complications. In other words, men peed more if their prostates were bigger and women peed less if they had easier pregnancies and less trauma to their urinary tracts during childbirth.

in both sexes frequency was unrelated to the reported daily ingestion of coffee, tea or diuretics, and no relationships were found with a history of an anxiety disorder.

And so I realized that by this argument the problem with a Broadway show was thirty something women who brought their bladders to the show.

Studies show that men and women have the same size bladders yet, women urinate more often due to the pressure of the uterus on the bladder causing less bladder control and retention.

Make no mistake…. I loved my Broadway experience, bathroom and all. I learned more in those lines than I did in some high school classrooms.

I’m now home safe back on the west coast where the women still pee like racehorse but talk like Canadians. I am comforted that the years will advance and my bladder will grow better so to speak as my male counterparts will eventually catch up to me,

I take comfort that my 70’s will be my great bladder equalizer. I will have to wait another thirty years in lines at washrooms while the men’s room remains relatively free….. until then…. I will always have Broadway.

Good Girl Gone Bad

Girlfriends... safe to say, I've had a bad day. Yes I know you can't help but sing it, but allow me to explain.

This past weekend was spent with a 72-hour stint on call in an Intensive Care Unit in Southern Alberta. I slept a total of 12 hours in three nights. At four in the morning on Monday a man threw up on my Jimmy Choo motorcycle boots. I am not complaining. It was not his fault. He was having a heart attack and I take full responsibility at all times for putting any of my shoes at risk of encountering all bodily fluids.

My refusal to wear appropriate footwear for the last ten years of practice is the cross (or in this case, vomit) my Manolos must bear.

On Monday while buying a coffee a the local Starbuck’s I tried maneuvering my rental car into a parking stall that was far too small, taking out a minivan’s brake light in the process.

Here. I take some of the responsibility but not all. Yes, I was sleep deprived and my spatial relations are questionable on a good day (my shoe closet be damned). And yes, I get behind the wheel of a car at best 4 days a month. Furthermore, I don’t own a car and am obligated to, when I do drive, use rental cars, which inevitably are huge beasts to begin with. This one was a Chrysler 300 or something…. I only name drop here so you can see that this was in fact a big car; they would never give that high a number to a little shit box, you see.

Finally, the woman who had parked this minivan (yes, I hate minivans… you can sense my contempt and it is real) used more than her fare share of a parking spot. All things considered… contact was made. My Chrysler 300 smashed the brake light of her bullshit minivan and took out the plastic light.

Make no mistake, after exchanging information, I still went inside and bought myself and Americano. Safe to say however, it was a BAD day. Between the lack of sleep, the stress of the job, the puke stained Choo and the brake light carnage, my week was starting with the kind of day that makes most of us want to crawl back into bed an embrace a fetal existence.

But amidst my BAD day I am forced to ponder how many other sisters out there are sharing my pain. What make a day BAD? As a doctor I realize all too well that there is no monopoly on sorrow. I no longer can count the amount of death certificates I have signed in my decade of a career thus far. I have been the bearer of many a bad news and created my fair share of BAD days.

I think of my patients at the hospital having GOOD days and BAD days. I think of their families at home stressed and worried or relieved and grateful having similar BAD and GOOD days respectively and my shoes and my sleep and even the brake light are irrelevant.

In 1964, a Psychologist by the name of Helson coined the term of the adaptation level theory. He sited that people react more to changes than to stable conditions and are thus more sensitive to new things. Change, therefore, produces strong reactions, but the circumstances that result from the change gradually cease to elicit a reaction and eventually become taken for granted. By this theory we tend to adapt to either that which is good as long as it lasts long enough or that which is bad as long as bad is the norm. Applying this theory to human happiness, Brickman and Campbell (1971) postulated a "hedonic tread- mill" by which long-term happiness will remain roughly constant regardless of what happens because the impact of both good and bad events will wear off over time.

How long the impact of everyday events lasts was studied by Sheldon, Ryan, and Reis (1996). Bad events had longer lasting effects. In their data, having a good day did not have any noticeable effect on a person's well-being the following day, whereas having a bad day did carry over and influence the next day. Specifically, after a bad day, participants were likely to have lower well-being on the next day.

Although the results are technically correlational, something must cause them, whether it is the bad day itself causing the subsequent bad day or some other cause producing the consecutive pair of bad days. Either way, the bad has stronger power than good because only the bad reliably produced consecutive bad days.

So there you have it. I am indeed not alone in a world where life changes on the turn of car wheel. Forgive me dear girlfriends if I wax philosophical this week. Perhaps the lack of sleep has made me a bit existential. Perhaps I really am this deep and it has taken a few dozen blogs to get it out of me. Perhaps I’m just a woman who had a BAD day and needed her girlfriends to lend and ear….

And so armed with this data, I stood on the crest of Science trying to break the theory. This morning I boarded a plane to New York City and spent the last three hours window shopping on 5th avenue. Take that! And yes…. I did wear my newly cleaned (no vomit here) Jimmy Choo motorcycle boots….

Tomorrow I will get up, put on a different pair of inappropriate footwear and walk off head held high into the future. Who knows what the days will hold….

When life give you Lemons.... You buy shoes to match.

My dear girlfriends, I have always maintained that the GGTH would be true to the themes upon which it was founded…. A Medical Rant on a Girlfriend’s Way in the World…

Today I come to you with more much less medical and much more OH MY GOD! Today I abandon the science and sling the shit all for a cause so dear to my heart… shopping.

Cybersisiters, are we not in a recession? Is this not the time when walking into a store should bring a heightened sense of customer service? What the hell is happening? Just today, I decided to breeze my way through Aritizia in the hopes of finding a cute little something to update a look with. You know, a new blouse or age appropriate piece of lace to make MY Fall/Winter 2010 runway sparkle. I had found a few pieces (I mean really, if you are going to get naked in a change room, you had might as well make it worth you while) and was making my way to the dressing room when a lovely little twenty something stopped me dead in my tracks…

“Excuse me,” she chirped. Make no mistake, she seemed quite sweet. Her lipstick was the wrong colour for her face but other than that I am sure she is a very nice person, “we have a no bags in the fitting rooms policy. You’ll have to lock your purse up in a cubby hole”. She then walked me over to a wooden filing cabinet and opened a drawer where she motioned for me to put my Balenciaga and my laptop in.

Too stunned to talk, I placed the bags in the drawer, she closed it, locked it and handed me the key hooked onto an elastic slinky thing that I could put on my wrist.

“My name is Brittany, “she smiled and yes there was lipstick on her front teeth. “Let me know if you need any sizes”

I stared down at the locked filing cabinet with my belongings in it and was dumbstruck. Thirty plus years of hard core shopping on almost every continent and this was the first time I had my bags locked up. When I investigated further (research, you know) I was told that I could not bring my purse into the fitting room with me and was assured that this was in fact for my own safety as my bag could get stolen by a fellow customer.

I realize this may seem trivial but when did it become commonplace to put my things in “lock down” while I try on a pair of jeans? I have often had a lovely sale associate at a higher end store offer to store my things in the back while I browse around (shout out to Marianna if she’s reading this) but this has never involved a locker room type establishment where I put my bags in a drawer and get a key to GO INTO a change room with.

Incidentally, there was a great dress amidst the trauma of having been in lock down but I left before I could buy it. There was an unsightly line up and I had a blog buzzing in my head. On some level I felt I should withhold my American Express affections from Aritizia due to its blatant misbehaviors.

I decided to cool my emotions in a shoe store. If anything could talk me off a ledge it was footwear. The store was Browns (yes I will name names) and there were 4 sales associates in the store. One was on a cell phone, two were staring into space and one lovely woman was helping two people at the same time.

I spotted a pair of fabulous Robert Clerige Boots. I walked over to the counter to ask for my size when the one busy sales woman in the place called,
“Can I help you?”
“Yes,” I replied, “Could I trouble you for these in a size 40?”
She disappeared in the back and the three remaining sales clerks resumed their activities. On to the cell phone and two to space. Cue crickets chirping.

My lovely sale woman returned from the back with the bad news. No size 40. She could order them for me from Ontario but I would have to pre-pay for them.

This is when I realized that we were watching the second horseman of the Apocalypse ride into retail town. First we’re locking up people belongings and now we’re asking customers to pre-pay for a shoe in their size just for the honour to try them on. Make no mistake…. I could return the shoes if I did not like them but, I would have to put the money down just for the honour of putting them on my feet….

Of all times in history, is this not the time when the consumer gets to call a bit of the shots? Is this not the time for customer service above all?

Truth be told, I love shopping. I see it as the perfect combination of cardiovascular endurance, style and self-indulgence. It is truly a marriage of self-expression, art appreciation and the study of human behaviour; not to mention the support for the economical well being of our nation.

Very few activities in my life have seen me through life challenges and triumphs as much as retail therapy.

I remember starting Medical School and getting my first student loan. I never knew if I would make it through the whole academic challenge alive. Would I finish with my soul intake and be able to pay back that loan? The stress was immeasurable. What did I do? I drove my car to Sherway Mall outside of Toronto with my best friend, Katina and spent easily 20% of that loan on some of the best outfits I had even seen. I may not be fabulous as a doctor, I thought, but the least I can do is to dress the part. Sure enough it is 16 years later, the loan is long gone, the fear and uncertainty too…. I still have a fabulous navy blue suit from Holt Renfrew that is now considered vintage.

Eight years later I found myself spending weekends flying from Calgary (where I was living at the time) to Winnipeg to visit my father in the Palliative Care ward at the hospital. My father was dying from the cancer that his doctors had promised would kill him five years earlier. I spent my weekdays working in Calgary in the ICU and weekends sleeping at the Palliative Care ward at St. Boniface. It was some of our best times together. We rented movies, drank milkshakes without guilt and talked about life as only we could. On Sunday afternoons I would let my dad have a little nap while I spent a few hours at the Holt Renfrew last call bargain store in downtown Winnipeg. I would return to the hospital with discounted Gucci and Armani in tow ready for a fashion show for papa and then an evening flight home to Calgary to start my week.

It was a surreal time in my life where sorrow and love and the sweetness of something lost and something gained all sat down at a dinner table each weekend. I have a vintage Gucci jacket from Tom Ford’s last collection that reminds me more of my father than the bathrobe he wore. Both hang in my closet, side by side and I will put them on any given day when I just need a bit of strength and the world seems to set itself right again.

Some of my best black jackets came from that period in my life. Ironically I had nothing to wear to my father’s funeral, but no one ever said life was not a motherfucker.

When after the horrors of 911 George Bush told America to go shopping, I thought he was an insensitive asshole… but I did. I shopped.

Shopping has settled my fears, bandaged my wounds and made my crocked little life a bit more in line.

When I weighed 320 pounds, I spent my money on shoes. Now so many miles and inches later, I rejoice in the skinny jeans. My body has seen itself reinvent and redesign as the decades and the fashions have followed. I have watched my chest get smaller, my waist immerge and my booty hold on for dear life. I have learned what shapes look good and what not to wear. But through it all, big and small, I shopped. I bought and I returned, online, overseas, across the border. Empty suitcases came to Italy with us and returned full of the best that country had to offer. I bargained and bought and declared. The decades have been a blur of the best Pretty Woman montage my life had to offer.

So when Aritzia locks up my bags like I am some sort of criminal and hands me the key on a scuncie and I feel, well, a bit rebuffed by a community that I have been a part of for so many years. When I have to buy a pair of shoes just to try them on, I feel, well quite frankly let down, disappointed for a system that I have supported and defended through thick and thin.

There is no study to make you smarter this week dear girlfriend, no science to sort the world through. It is the end of an era and the dawn of a new day. If you need me, I’ll be spending the next 6 days in my closet living in the past and trying on the memories….

WTF?

It is my firm belief after much debate and research that the decline of manners everywhere is in part due to text messaging. I have tried, dear girlfriends to like this means of communication. Truth be told it has taken me a year to “get the hand of it”.

At first, I seriously could not wrap my fingers, so to speak, around this form of technology. I understand that texting came about as a cheaper form of communication for cell phone users. Perhaps this was the first flaw for me. As a woman with an addiction to high end footwear, how could I be economical when it came to communications?

Was human discourse the time for pinching pennies? A huge fan of language and a life spent trying to master it suggested that this was not MY new means of interconnectivity.

I realize I am still a dinosaur. I send birthday cards and thank you cards when I REALLY want to say Happy Birthday or Thank You.

Furthermore, I am not physically text friendly. I have really chubby fingers and terrible spelling. The two combined make all of my messages seem as though they were sent by a drunk 17 year old girl. Furthermore, As forty approaches like a bullet train from hell, I am now in need of reading glasses.

This triumvirate of inadequacy makes a tiny keyboard and a void of silence a really shitty way for me to tell people how I am, where I am and what time I will meet them for lunch.

Isn’t a phone call so much better? You can judge the nature of someone’s response in an instant. Ever a fan of gauging human behaviour, I strongly maintain that how a person answers a question is as important as the answer itself.

Enter the text….

Do you ever notice that texting has become the “cowards manifesto” for communication.

Don’t have the balls to tell someone you can’t make lunch? Try saying it in 30 characters or less….

Wanting to just “check in” with a “friend” that is really more of connection that a relation? Text a cute “hello” and be done with it.

Just had a one night “experience” with a pseudo stranger and don’t want to face the morning after call? No need…. Nothing says “I am a gutless wonder” like “THX 4 LAST NITE. WUZ FUN ;)”

How did fall so far as a species? We are the only animals on the planet to have the true gift of language? We are blessed with an armoury of telecommunications and the gifts of being able to in an instant hear another’s voice at will. And yet, we have reduced much of our “back and forth” to an economized version of human contact.
“Reach out and Touch Someone” has been replaced with “reach out, but don’t come too close”.

Nonetheless, I was willing to give this means of communication a chance. After all,
texting has been shown to improve patients’ compliance in taking asthma medication and applying sunscreen.

And then the hammer came down…

A study published in the American Journal of Obstetrics and Gynecology last week showed that test messaging offered no benefit for women in remembering to take their contraceptive pills.

Missed birth control pills account for about one in five of the 3.5 million unintended pregnancies in the USA every year.

A study out of Boston Medical Centre randomly assigned 82 new oral contraceptive users to either receive a daily text message reminder to take their birth control pills or to receive no reminders. The average age of the women in the study was bout 22 years old.

During the three-month study, both groups missed a monthly average of about five pills, as recorded by an electronic monitoring device on the pill packs. None of the women became pregnant.

In both groups, the rate of missed pills was nearly double the average estimated by previous research, hinting that adherence in the general population of Pill users may be overestimated.

I suck at remembering to take any medications. I remember having strep throat and being on a four-times-a-day antibiotic regimen for about a week…. It was truly humbling.

The fact that I don’t have to get a text to remind me to be a better patient is truly and emancipation.

I don’t suggest we abandon the keyboard entirely… My advice, cybersisters as will all things in health is one of moderation.

Some guidelines perhaps?

Text wisely, dear girlfriends, not often.
Text appropriately and with caution.
In social situations, be social?
When in doubt, a phone call will do.

And of course, if I’m not in, do leave a message and I will get back to you in a timely manner.

On a Wing and a Hair

Truth time, dear girlfriends…. I am one hairy cybersister. I would bet my best set of tweezers that there are so many of us bearded ladies across this great nation. Hell I’m sure given the wrong attention to grooming and we could start some freaky revolution. Take away our bleach and our wax and our laser hair removal and we are just asking for the kind of facial hair uprising that the likes of even Frida Kahlo had never imagined.

My grandmother lived with us when I was little. One of the clearest memories I have as a child was sitting on the couch with my grandmother and painstakingly plucking her chin hairs while we watched Sunday afternoon football. I was really good at it. I took pride in cleaning up her chin, meticulously plucking and pulling every last family heirloom as though my ancestors’ honour depended on it.

Would I ever grow up one day and be able to grow my very own bit of facial hair? Could I be so lucky to have a little mustache or goatee of my own someday?

And like all little girls in pink bedrooms all over this great nation, I went to bed each night and said a little prayer to the goddess above that someday I too could have something of my very own to pluck at each day…. A little unsightly black peach fuzz above my bottom lip or dare I ask? Was it too much to ask for five to ten black freestanding single hairs around my chin and jaw line?

And then almost overnight, all my dreams came true… I remember it as though it were only yesterday…. I was twelve years old. I stood in front of the bathroom mirror in the home I grew up in. There it was just under the nose on my face…. My very own mustache.

I could not wait to have my mom drive me to the drug store so that I could spend my hard earned allowance on Jolene’s cream bleach. Like a kid on Christmas morning I rushed home and ripped open the white and blue box with enthusiasm and vigour. I could not wait to slap this pungent white frothy shit on my face. I could not wait for the burning. I couldn’t wait for my eyes to water from the distinct bleach smell.

The moment itself holds fast in my memory to this day.

Life carried on from there. I moved from bleaching to waxing and back again. And then sometime just after the turn of the century I discovered the future.

LASER HAIR REMOVAL

I was working in Southern Alberta at the time when I found out that there was a new technique that could only serve to enhance my facial hair dreams.

One afternoon after clinic I rushed over to my neighbourhood plastic surgeons office. I lay down on a lovely clinical couch, donned my protective eye wear as a state of the art laser zapped away my Eastern European legacy.
Don’t let anyone tell you differently… it hurt like a motherfucker. Anyone who says otherwise has either never had laser therapy or is just plain lying. I’m a tough broad. This hurt. Enough said.

Twelve treatments later and you’d never know my old country roots. I even had my armpits done for good measure. And now every four or five months I go for a “touch up”.

It turns out that laser hair removal has as much of a legacy as my familial mustache.

Laser hair removal operates based on the principle that light is absorbed by dark objects, so laser energy can be absorbed by dark material in the skin (but with much more speed and intensity). This dark target matter, or chromophore, can be naturally-occurring in skin in the form of melanin. The laser targets the melanin in a hair follicle which gives the hair its colour and therefore damages the hair follicles preventing growth.

Since 1996, there have been numerous advances in hair laser removal that utilize melanin as a chromophore. All of the devices on the market may be used in patients with light skin and yield hair reduction near 75%.

The ruby laser, alexandrite laser, diode laser and Nd:YAG laser as well as intense pulsed light are commonly used devices for hair laser removal. Each varies in terms of the length of the wavelength of the laser used. As a rule… the longer the wavelength, the darker the skin.


A study published in the Journal of the European Academy of Dermatology in January 2006 looked at over 30 separate trials regarding the safety and efficacy of laser hair removal.

A total of 9 randomized controlled (RCTs) and 21 controlled trials (CTs) were identified. The best available evidence was found for the alexandrite lasers, followed by the ruby and Nd:YAG. Based on the best available evidence the study concluded the following:
1. Hair removal with lasers and light sources induces a partial short-term hair reduction up to 6 months after the procedure.
2. The efficacy is improved when repeated treatments are given
3. The efficacy of laser removal is superior to conventional treatments (shaving, wax epilation, electrolysis
4. There is evidence that exists for a partial long-term hair removal efficacy beyond 6 months postoperatively after repetitive treatments with alexandrite and diode lasers and probably after treatment with ruby and Nd:YAG lasers,
5. To date there is no evidence for a complete and persistent hair removal efficacy
6. The occurrence of postoperative side-effects is reported low for all the laser systems.

And so the dreams I had on a couch on the prairies in the middle of a Sunday afternoon football game burned away with a ruby laser as quickly as my hair follicles. Like every little girl it was time for me to grow up and face reality. I would never be that little white girl with a fabulous face full of hair. I would never have my very own mustache and a chin full of isolated black hairs. The bearded lady at the circus was a pipe dream…. It was time for me to to grow up don my protective eye wear and kiss my Jolene bleach goodbye.

No it would never be the same. I’d miss the mess and the smell and the maintenance but when a girl gets to take 700 nanometres of wavelength laser to her face in the name of self preservation she owes it to herself to join the new revolution. In Frida’s name. Amen.

The Real Deal

Is anything real anymore my dear girlfriends? Have we witnessed the loss of all authenticity? From hair extensions, to breast enhancements, from cheeks and teeth and chin implants. From highlights to brow lifts and everything in between. There are the “chicken cutlets” in my bra at this very moment and the colouring I have “touched up” every 6 weeks to cover all things grey.

If I want 100% natural these days, I had best find it at an organic food market.

And just when I thought I had seen it all I found out that yes, even eyelashes can be extended! Is there nothing in the world of beauty we can’t learn to live with? My hair is curly…. I can get a Brazilian blow out. My hair is graying… bring on the dye. My bottom lip does not exist. Should I decide to forgo my “lip-plumping lipstick” I could have my pucker permanently plumped with a collagen injection every 8-10 weeks.

And now my eyelashes can be treated with fuzzy little caterpillar made of chinchilla hair that can be semi-permanently glued on for about a month. I know I sound like I am raging against the beauty machine.

I am not.

I am a fan of my lip plumping lipstick. I like that after sitting in my colourist’s chair every six weeks affords me the opportunity to look five years younger.

I am a huge fan of said chicken cutlets nestling comfortably in my push up at this very moment. The only time I liked being an “A" was in academics. In all matters of the bra, I am happy as a “C-student”.

That being said, I now have to ask people if their eyelashes are real. Before such questions could be relegated to breasts and hair colour. Now we have broadened the field….

I was at a dinner party last week and was seated across from a lovely woman with equally lovely brown eyes…. This was a girl crush waiting to happen. I remarked that she had beautiful eyes and the longest eyelashes I had ever seen when she took a sip of her Sauvignon Blanc and said quite matter-of-factly, “They’re fake.”

“Really?” I said between bites…. I mean what do you say? My girl crush had just told me her eyelashes were fake. What is the polite response?

“Yes,” she remarked, “I have eyelash extensions put on every 8 weeks.”

“Wow.”

Bad news was nothing was real anymore. Good news…. I had a subject for my next blog. Every bleak life realization has a silver lining. If beauty is an artificial illusion, the least I can do is investigate.


Unlike false eyelashes, where synthetic lashes are applied to the eyelid and then removed after usage, eyelash extensions are applied directly to the natural eyelash with a bonding agent and can last up to six weeks. These bonding agents and glues are irritants and can cause discomfort and potential eye damage in severe cases.

Repeated use of eyelash extensions can cause Traction Alopecia, a condition where the hair falls out due to excessive tension placed on the hair shaft. As a result this can damage the hair follicle, which can slow down and even cease production of hair.

The risk of this from patent application papers appears to be about 1% of patients.

In other words…. For every 100 sisters with beautiful doe eyes…. There’s one unfortunate soul with a bald set peepers….

I’ve noticed lately on my way to fourty that my eyelashes are not as robust as they used to be. Actually what really happened is that I arrived home from that dinner party and studied my eyelashes, as only a truly neurotic woman can, in one of those awfully judgmental magnifying bathroom mirror.

The judgment is in…. my lashes are definitely thinner than in years past…. But I will not succumb to extensions. Firstly I will need two hours every 8 weeks in which I must sit still and pay $200 for the experience. Secondly… this will be a permanent time commitment that I will need to repeat every 8 weeks for the rest of my life.

I suck at sitting still. Hell, I’m on holidays right now and trying not to lose my mind from the veritable thrill of relaxation. Sitting still without pharmaceuticals is a chore best left to the lazy and the infirmed.

There is another option. A drug known as bimatoprost ophthalmic solution 0.03% or Latisse (it’s trade name) has been developed and shown in randomized trials to provide effective and significant eyelash growth.

Back in 2001, a pharmaceutical company called Allergan developed a medicated eye drop used to treat ocular hypertension. In addition to successfully lowering eye pressure (the only treatable risk factor for glaucoma), many patients using this medication experienced a side effect — they began to grow longer, fuller and darker lashes.

One woman’s glaucoma is another woman’s Max Factor.

This led Allergan to begin its study of this medication’s active ingredient, bimatoprost, for the sole purpose of generating lash growth. After conducting a clinical trial on safety and efficacy for 4 months on 278 patients, LATISSE® earned its FDA approval in December 2008.

The drug is due to launch in Canada in September, 2010.

And so another week ends with another realization. Nothing lasts forever and much of what we see is a manufactured illusion. I can accept that. Hell, I can even be a part of the wave…. WE can make our hair darker and longer, our breasts larger and higher and our eyelashes thicker and fuller.

Designer clothes for designer body parts… Before you judge too harshly, make sure you check on the inside. As with all luxury items you’ll be sure to find a label that confirms said item is in fact the real deal.