30 March 2008

More, and Final, Updates on the Cantaloupes

The FDA has finally put together this list, as the recall is continuously expanding.  So, if you are a concerned consumer, then please check back to that link, specifically.  It will have the most up-to-date info on the melons and bugs, as well as what is being done about them.  

Oh, and that will be the last that I will say on this topic.  :)

27 March 2008

Cantaloupe Recall Update

Apparently, the recall is continuing and branching out.  These cantaloupes were sold mainly on the East Coast, but may have been distributed out.  There is a common sticker of "Mike's Melons."  (The sad fact is that the recall states that the sticker 'may have fallen off.')

Further, and you knew this was coming, there are now some recalls of fruit mixes that may have included the aforementioned melon.

The infecting organism remains Salmonella;  please look at my prior blog for information on this bug.  

26 March 2008

Cantaloupe Recall

Apparently, there has been a cantaloupe recall, as this fruit is contaminated with Salmonella.  

Please note that the link covers ALL Salmonella infections, although, obviously, the one of concern, is nontyphoidal.  This usually presents as a diarrheal illness, often with fever and general malaise.  In the young and elderly, it can become much more serious.  Please see your physician, if you recently consumed the product and are experiencing any of these symptoms.  

The cantaloupe was sold in the U.S., as well as in Canada.  Please make sure to check what you are buying.  

21 March 2008

Continued Heparin Recall

So, maybe for now, (since I have so little time) I'll just do little blurbs here and there about FDA recalls. 

It appears that the heparin recall has not yet ended. Please be aware, and check this out. Wait, there's more--look here, too, for Baxter's information on their continued recall.

19 March 2008

Spelt Bread Recall

Not able to write much these days.  A little here and there, but this is very important:

Here is another FDA recall.  This one is for humans, and is on Spelt Bread from the Food for Life Baking Co.  If you know anyone with celiac disease (patients, family, friends), please pass this on, as it may seriously affect their health.  

15 March 2008


I just realized that I promised cooking here, and, well, there's none, so far.  So, for now, something simple.  Something I have been making A LOT of, lately... and we have loved it.  Home made yogurt.  It tastes so pure and clean.  So much better than store-bought, I think.  And very easy to make. 

You will quickly learn that I don't like to follow recipes much, I tend to change them often, and substitute what's in the 'fridge at the last minute.  So, when I originally read about this, it asked (I think) for whole or 2% milk.  All I had at the time was 1%, so that is what I used then, and pretty much have been using... although there was one time that, on a whim, I threw in a cup of cream...

you need:

1qt milk (whatever percentage is available)
2T yogurt starter or store bought yogurt  (Yogurt starter can be gotten at any health food store.  As for the store-bought yogurt, it should be plain yogurt--no flavors, not even vanilla.)

you do:

Place milk in saucepan and heat over low heat until bubbles form at edges and steam rises from the middle.  Do not allow to boil.  Transfer to large bowl.  Allow to cool to 110-115F on a cooking thermometer.  Don't have one?  Nor do I--just get it to a temperature where you can stand to keep your index finger in the milk for 20 seconds.  

Place the starter or yogurt in a small bowl, and add a few tablespoons of the warm milk.  Stir well, and return to the rest of the warm milk a small portion at a time, stirring well with each addition.  

Cover with a heavy towel and keep in a warm place at least 6 hours, or overnight.  My kitchen tends to be cold in the winter, so I preheat my oven to 200F, turn it off and place my mixture in the oven for the allotted time.  

Now, cover with plastic wrap, and place the yogurt in the 'fridge for at least 8 hours before serving.  I like a very thick yogurt, so I strain it through a cheesecloth in a fine sieve suspended in a bowl for another 6 hours or so.

Yes, it takes a long time--about a whole day, but it is not at all work-intensive.  And the reward is well worth it!!  Now, you can eat your yogurt as-is, mix with marmalades, fresh fruits and cinnamon, place in crepes (mine is VERY thick), the possibilities are endless.  

Eat well  :)

13 March 2008

I guess there was another one...

he could use.  So, did ya hear about the woman who sat on her boyfriend's toilet for so long, she got stuck to it?  Even to a surgeon, it's a little nauseating.  

I tried to find the corresponding medical info, but I'm sure it was pretty straightforward--debride and resect, for now.  I would probably place a wound VAC, and finish off with a nice flap.  I doubt you have to do anything fancy like tissue expanders.  The skin here is pretty stretchy.  Then again, I am kind of assuming that, to get stuck, she probably has some to give in the first place.  

It really is mind boggling.  She was there FOR TWO YEARS!!  I suppose there was another toilet in the house, or he would have been more adamant about getting her out.  But can you imagine it?  Eating, sleeping, LIVING on a toilet for TWO YEARS?!  I guess she's not working... don't let me get started on that.  She's in her 30s, 'nuf said.  And the fact that he entertained the idea... "Come out, honey."  The reply?:  "No, not today, maybe tomorrow."  (Because I'm stuck, you moron...No, really, I'm STUCK!!  But it's OK, I'll just hang out here.  The shower curtain's kinda purty...)  Really, it's very sad.  Maybe that's why it's so nauseating.  two years...

12 March 2008

Carpal Tunnel Syndrome

So, maybe now that a local newspaper has talked about it, my patients are more likely to believe me.  It still amazes me how many patients walk into my office and start the conversation with, "I have carpal tunnel syndrome, and I use the computer at work.  So, I need you to write a letter saying that this is work related."  

Some are more willing than others to listen.  Some initially get angry at me, "But my PCP told me..."  (My apologies to the PCPs that are well educated on the cause and effect relationships of CTS.)  The truth is that we still know very little about this syndrome.  We know that heredity is a big factor, as is hypothyroidism; we know that retired and disabled people are often just as likely to get it as anyone else.  We have recently found that people that are manual laborers--bakers, custodians, construction workers--are more likely to get it, and there are multitudes of computer programmers and the such that have no signs of carpal tunnel problems.  So no, just because you sit at a computer all day long does not mean that that is why you have carpal tunnel problems.

I spend MUCH time with each patient, explaining anatomy, pathology and their treatment options; trust me, they are thankful for that.  Unfortunately, there are still many physicians that are also poorly educated about this common problem.  I get so many referrals for "hand numbness" that is straight out of the text book, and it is obvious that the referring doc hasn't a clue.  These patients should stop by their friendly neurologist first for a baseline EMG, then come to me for treatment.  It's OK, we end up ushering them along, eventually, but sometimes they feel like a pinball--being pinged between different doctors.  

11 March 2008

how 'bout patients like this?

Crazy day today, and not the worst I've had, by far, but... Seeing patients from 8-7:30 straight through, does not a happy surgeon make. 28 of them, to be exact, no breaks. And then the phone calls. Ugh. So, you finally get a chance to breathe... and reflect. 2 patients stand out. Although, my medical assistant is always amazed that I seem to have a knack for remembering everybody, and I do. There are some that just strike a chord.

Mrs.___, who came with her husband; she has DEBILITATING median and ulnar neuropathy--bilaterally, although it's worse in the right. I know I can get her better with surgery. Wanna know why she's refusing? Not because she's scared of surgery, or because her neighbor or church friend told her a friend of a friend's aunt's sister had a bad outcome... But because she thinks that if she gets better, her kids will start using her for their chores and babysitting again. She's convinced that that's why they want her better.  The fact that she is pleasantly confused, 70, and quite forgetful doesn't make things any better.  I wanted to put my arms around her and hug her, or maybe just cry. I couldn't decide, so I just looked at her and blinked. Her husband sat next to her and comforted her, "No, baby, that's not it, I'll help you. We want you better because we don't want you in pain..." And ya know, it's hard to say...

And then there are the ones that just, well, surprise you.  I did surgery (CTR) on a (retired) physician last week.  She called today, frantic, that her hand was swollen and she had a blue thumb.  OK, "please come right in."  Yup, the thumb was blue, alright, as in BLACK AND BLUE, and the hand WAS swollen, because she immediately affirmed that she had not been elevating it, as per my instructions.  I changed the splint, as I would have done, anyway, at her scheduled appointment on Friday.  Disposition:  please elevate the hand as instructed, and wait for the bruise to resolve, keep your appointment in 2 weeks.  
You can eat extra pineapple, if you like...

They just sometimes catch you off guard, is all.  And I have to say that working for 'the group' doesn't make things any easier.  If I was making my own hours, my own money, well, I think it would just make me happier.  All in good time, I suppose.

10 March 2008

Cat Vitamins

I wasn't going to write any more right now, really.  But then, this came across my email:  "The Hartz Mountain Corporation Recalls Vitamin Care for Cats Because of Possible Health Risks."  Please check this out,  if there is a chance that your furry ones would be affected.  We have to help those who cannot help themselves.  



I have wanted to be a surgeon since I was knee-high to a tadpole.  When I was very small (maybe a year or two), my great uncle, from Australia, gave me a stuffed koala.  I still have it; it has a place on my vanity.  

I performed 'surgery' on it from the moment my parents allowed something remotely sharp in my chubby little hands.  There are slashes across the belly (I can hear the rant of one of my former attendings, "Horses have bellies, humans have abdomens!"  Well, Dr.___, this is a KOALA!!), and I had chopped off all of the claws (why?!).  I also had a doll (the chosen one), who came down with multiple imaginary ailments, of which I would repeatedly cure her.  My poor cats were also my experiments--don't worry, not surgically, of course, but--I would constantly check their noses to see if they were the proper temperature.  If they were the slightest bit warm, they were immediately subject to tea bag compresses and warm tea to drink.  The poor things were very tolerant, and I was smart enough, I suppose, to realize that a few sips of human tea to a cat, meant the world to me.  When I was in first grade, one of our teachers asked us to draw ourselves as 'What we would be when we grew up.'  There I was, by a patient's hospital bed, in scrubs, a white coat... I think I even had a mask on!  

Sure, I had little forays... I love to draw, so I seriously considered architecture.  I looked into schools.  But, the human body proved too fascinating to me.  One of my college professors suggested (much to the complete and utter horror of my parents) that I had "it" to be the next F.H. Netter.  An amazing compliment, to be sure, which left my parents speechless--literally, they wouldn't speak to me for days, nay, weeks.  I entertained a double major--BS in biology with a BA in fine arts, but settled on the aforementioned BS with a minor in fine arts/drawing... and, in the end, I found my way back to my original passion.  Medicine, in the true art form of caring for people, not just drawing them, and their ailments, and later:  surgery, in my true, and original calling.

(For those wondering, even with the above excerpts, it is much easier for me to care for humans than animals.  Humans can tell you (usually) more easily what's wrong... ditto for peds.  Note that I am NOT a pediatric surgeon.  Further, I have a hard time dealing with the parents of said patients.)

Less than 1 month to the boards...

and I decided to start a blog.  One of my oldest friends has always said that I don't know how to survive without pressure.  If it's not there, I create it.  That's not entirely true, but there are some things that I organize better when I have more to organize.  So, here we are.  

From perusing other's blogs, and looking at frequency of writings, I don't know if I'll be able to keep up... but I'll try.  Baby steps, at first, I suppose.  I guess I have to look around, see what all of these buttons mean.  That will take a little time.  Then, up, up, and away... or so I think.  

Oh, yes, and that private practice should be underway soon, as well... A few things on my plate.  :)  More to write about that way.  Well, I wanted to jot down SOMETHING here.  A little tidbit instead of an empty page.  

While I'm at it, was anyone else taken by surprise with the time change today?!?!  We did a quadruple take before one of us said, "Wait a minute, was there a time change?" while blinking at the time on the computer screen.  Someone stole an hour--terrible!