Feedback is not just for Hi-Fi Systems

Wanna tell me what you think? Email me at zentner@gmail.com and I may just devote an entire entry to your comment.

Why Tuesday?

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

Tuesday, September 28, 2010

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….

Tuesday, September 21, 2010

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….

Tuesday, September 14, 2010

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.

Tuesday, September 7, 2010

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.