30 things before 30

I turn 29 very soon, very very soon.  Here is my bucket list of things I want to accomplish before I turn the big three-zero.  I'm posting it publicly to keep me accountable.  I imagine that a lot of these things will absolutely happen and some will not.  What fun would it be to have a completely obtainable list?  Here is to a year of adventure and personal growth!

Health:
1. Challenge myself physically (current plan is a 120 mile bike ride)
2. Learn a new sport or exercise
3. Have an a1c < 7.5
4. Learn to consistently use, and fully utilize, a CGM / my dexcom sensor
5. Loose the last 20 pounds to fully get to my goal weight

Career:
6. Have a manuscript published
7. Finish my MPH requirements
8. Get a job (match into residency)
9. Graduate medical school (should happen within a month of turning 30)

Community & family:
10. Send at least one real (snail mail) letter to a friend each month
11. Call my grandmother more
12. Reach out to my borther
13. Reach out to my cousins
14. Be more patient with my mom
15. Talk to my dad

Religion: 
16. Create a ritual for clinical practice around performing births & abortions
17. Say yes when asked to lead kiddish
18. Read from the Torah again
19. Davin in shul at least once a month
20. Wrap tfillin at least once a month
21. Join a chevra kadisha

Misc:
22. Address my fear of heights
23. Travel to a new place, besides residency interviews
24. Renew my scuba certifcation
25. Go on at least 1 date every two months
26. Do at least 5 touristy things in the city I go to medical school in
27. Spend a night out dancing without caring that I can't dance
28. Learn embroidery 
29. Stop wearing clothes that I've had since high school
30. Relearn Spanish

And one for good luck:
31. Save the world 

March: women's health, gay marriage, & liberation

image from: http://www.motherjones.com/politics/2013/03/anti-woman-march-madness

 

 

You should read the whole Mother Jones article on the absolute political chaos that is currently going on.   This is bad.  Very bad. 

 

Also, from today's Daily Women's Health Policy Report, this article gives more insight into the horribleness that is being voted on in North Dakota.   Even scarier.

 

Plus, tomorrow, the Supreme Court hears the prop 8 case and the DOMA case on Wednesday.  All the possibilities of what might happened, which The New York Times expertly delineated, make my head spin.  It is going to be a long wait until June.  I wish I could be a fly on the wall for the debate & discussion between the judges.   

 

In the meantime, I'm going to disappear into the world of freedom and liberation with Passover.  I'm grateful that this year off from medical school means I can actually celebrate Jewish holidays with friends and family; without [too much] guilt that I'm slacking or making someone else cover for me.  I realize that this might be one of the last years, at least through residency, that I can take off and travel for the holiday.  May it be a true festival of freedom this year!

 

Sybil's death

Being a few days after the showing of Downton Abby season 3 episode 4, I hope I'm not spoiling it for anyone.  However, consider yourself warned that this could be a spoiler for someone living completely under a rock, or maybe in 3rd year or residency or some other all life-consuming activity.

Sybil's death brought with it a flood of emotion for me.  I always find myself crying when a character dies regardless of the medium.  This dates all the way back to my obsession with "doom and gloom" and reading Luriene McDaniel books in middle school.  I still love books that make me cry and I often find myself crying in movie theaters (though airplanes are the only movie theaters I have time for now a days) so it comes as no surprise that tears flowed as Sybil died. 

The flood of emotion though was because of HOW Sybil died- in childbirth, from eclampsia.  While skewed in accuracy, especially with modern monitoring and treatments for pre-eclampsia and eclampsia, is still brings light to the gravity of birth.  Evolutionary pregnancy and birth have to happen for us to continue and so it does, but it does with great risk.  According to the CDC, "at the beginning of the 20th century, for every 1000 live births, six to nine women in the United States died of pregnancy-related complications".  Reported rates in Brittan were closer to 40 in a 1000 births.  Today, the rate is closer to 12.6 per 100,000 births in the United States, putting us at a rank of 21st in maternal mortality.  21st!!!  That's pretty shitty.  The rate is even more horrific in other parts of the world, and often from preventable and/or treatable causes.  We need to do better.

I believe the episode also brought to light the fact that practicing medicine is an art and not a science.  It requires knowing your patients and trusting your instincts.  Doctors are human and make mistakes.  Communication between doctors, patients, and families is key.  So are medical surrogates, medical power of attorney, and living wills.  If you don't already have one, take this as a sign to make one!  Have conversations with your loved ones about what you might want/not want to happen to you if you are ever in a situation where you can't decide for yourself.  Talk about organ donation. 

I know, I know.  It's only a television show.  Maybe I'm reading too much into the plot, or transposing too much of my daily life into it.  Oh well, so be it. 

Also, before anyone starts blaming western medicine on the risks of childbirth (I too have seen Business of Being Born), that is not what I'm implying.  To say this again: birth more often than not is VERY safe and does not require much, if any, medical intervention.  But, when things go wrong, they tend to go wrong fast and can have dire consequences.  Even during my 3rd year clerkship I saw both the beauty of birth and the devastation from horrible unexpected tragedy.  I try to focus on the beautify and fragility of human life in this amazing feat of the body; humbly remembering that I cannot always be in control of, or know what to expect from, every situation.

7.7!

While not the best number ever, and not even the goal, I'm proud to announce that my A1C last week was 7.7!  This is 0.7 lower than it was at my last visit.  In fact, lower than it has been since I started medical school!  It's been a long time since I've had my A1C in the 7s...

Controlling my diabetes in medical school has been challenging at best.  I don't test my blood sugar nearly enough.  I keep myself slightly high on the wards out of fear for hypoglycemic episodes while dealing with patients or in surgery, or just fear of taking out my pump to bolus in front of residents and attendings.  I don't change my pump often enough and therefore have a higher than average rate of kinked tubes, pulled out sites from tape giving up, and ketonic episodes. I use expired insulin because I don't have time or energy to refill my prescription.  Stress alone bumps up my numbers because of excess cortisol release.  Basically, I am so busy trying to learn to take care of others' health that I neglect my own. 

But, oh, at last!  The golden 7.0 A1C is in sight!  The even more allusive 6.0 [in order to contemplate pregnancy] is right beyond it.*  Between ordering a shinny new continuous glucose monitor (that I hopefully wont be allergic to), a new bicycle to exercise on, and adopting a low-er carb diet... I guess we'll just have to see what my next  A1C has to say for itself.

*Not that I intend to get pregnant right now, or anytime in the near future. But it might be on my 5-10 year plan... It better be, after all, I'm already 28 and well aware of the risks involved with increasing egg age.

Forty years later, the same damn fight

Next Tuesday will mark 40 years since Roe v. Wade, and yet, access to safe abortions is majorly limited.  Women's rights in the US are being chipped away at daily, little by little, state by state, with no safety net in sight.  I'm honestly scared to see what happens with the abortion debate over the next 40 years.  If we continue on the current trajectory... I don't even want to imagine.  I'm going to keep fighting for my rights.  Are you?

Here are what other people are saying 40 years after Roe v Wade:

Happy Birthday to Roe v. Wade—What's Left of It

Forty years after Roe v. Wade, most under 30 don’t know case was about abortion

Roe v. Wade at 40: Most Oppose Overturning Abortion Decision

Roe at 40, in 2 Charts

Abortion poll: Keep Roe v. Wade

If Roe v. Wade Goes

Recalling the world before Roe v Wade'


Resources / Take action:
ACLU's list 
Unitarian Universalists (UUs) list

PS totally frustrated that when researching events and articles for this post, the anti-abortion movement has a FAR greater amount of content online (as least in a google search) than the pro-choice movement.  Arg!!! 

Ugh!

That moment when you have a brilliant and inspired research idea, only to search google scholar/pubmed/etc to find that it has already been done,  and done exactly the way you wanted to do it.  Ugh! is both validated that it was a good enough idea to be published and yet disappointed that someone beat me to the punch. 

2013, mixed feelings

I have totally mixed feelings about this New Year.  2012 was an emotional roller-coaster.  The death of my grandmother, a rather jarring car accident, 2 trips to the Emergency room (as a patient), all the emotions of 3rd year clerkship, a hard break-up, then meeting someone new (and extraordinary), deciding to take a research year, moving to a new state, 2 cross country road trips, a trip to India... it has been a BIG and overwhelming year.

2013 was supposed to be the year I graduated medical school.  A huge part of me wishes it still would be the year I graduate medical school.  Instead, it is now becoming the year I figure out 4th year electives, begin residency applications, and try to *hopefully* get a publication out of all this research.  Ideally it will also be a year full of seeing my family, nurturing my relationship, taking better care of my health, and finding time to have fun.  Maybe I'll also make some art and learn some Spanish.