re-su yukata Sweater

I undertook this challenge back in October 2011.  I recently finished it.  I love/hate it. 

The sweater is a shortened version of the re-su yukata pattern from the book Knit Kimona Too. The yarn is The Fibre Company Terra in black walnut.

I like how the sleeves fit.  I like how the back looks.

I’m not happy with the tension of my band edge which always it to “wave.”  The neck looks unsymmetrical to me.
I love the button and the I-cord closure.

I’ve put it aside for now.  Trying to decide whether to keep it or give it to someone who wouldn’t see the flaws and would love it.

Sitting All Day is Damaging

I take this type of information even more seriously than I used to given my new job which is very sedentary.  Thanks DoctorMama for the link to this LifeHacker article:  How Sitting All Day Is Damaging Your Body and How You Can Counteract It

Related posts:

Pedometers and Physical Activity  (November 30, 2007)

Getting Back Into Shape  (November 13, 2008)

Exercise Only Good if Done (March 18, 2009)

Finger and Wrist Exercises (April 19, 2010)

Get Up and Move (January 28, 2010)

Mindful of Two Breast Implant Scandals

This year began with a breast implant scandal.  This one has brought back memories of the one early in my private practice.

The current one involves the PIP-branded breast implants produced by the French company Poly Implant Prothese and rebranded by the Dutch company Rofil as Rofil M-implants breast implants.  The first one involved silicone implants made by American companies including Dow Corning who no longer makes breast implants.

This picture of 3 implants includes:  top -- an old McGhan double lumen (silicone gel implant surrounded by a saline implant); bottom left – Dow Corning textured silicone implant; and bottom right – Dow Corning smooth silicone implant.  Dow Corning has not made breast implants since approximately 1992.

My post Breast Implants -- Some History (March 3, 2008) covers much of the history of implants in the United States.  Kira Cochrane, The Guardian, wrote about the first patient to receive a breast implant:

It was in 1962 that Timmie Jean Lindsey was offered a solution to a non-existent problem. A factory worker from Texas, ….. And the doctors had another proposal. Had she ever thought about breast implants?

Lindsey had not. ….

……...She's 80 today, still living in Texas, working night shifts in a care home, and those first, experimental globes remain in her chest. ……

I would love to know if they are soft or have become hardened by capsular contractures.  The article doesn’t say.

In the current breast implant scandal, I haven’t noticed anyone urging a class action lawsuit against the French company Poly Implant Prothese or the Dutch company Rofil.  The big issues are 1. do the implants need to be removed or just checked and 2. who will pay for the removal, the government or the private clinics.  The issue isn’t just a European one, it affects women in South American, Mexico, and the United States.

The old scandal in the early 1990s was handled by a class action lawsuit.  I had not been in practice long enough for it to truly affect my then current patients, but I saw many who’s doctors were no longer in practice or non-plastic surgeons who has decided due to the scandal to quit doing breast implants.  I did exams for free, but not the surgeries.  I did, however, not raise prices or take advantage of the situation. 

When I was in practice, I encouraged my breast implant patients to return every year or two for a complimentary breast exam.  This keep us in contact so if anything (ie ALCL and implants, or faulty implants) came up I had current addresses.  I made sure each woman had the information on her implants and encouraged her to keep up with it.  I also encouraged the extended warranty on the implants.  This helps settle who pays for what, at least for the first 10 years.

Women and their doctors need to be mindful that implants are foreign bodies we are placing into the human body.   Women and their doctors should be mindful of future costs that might be incurred from breast implant surgery.   In the United States, many things related to implants, especially those placed for cosmetic reasons only, are not covered by insurance or the extended warranty.

Related posts:
Breast Implants -- Some History (March 3, 2008)
FDA Updates Safety Data for Silicone Breast Implants  (June 23, 2011)
ALCL and Breast Implants  (January 31, 2011)

REFERENCES
1.  Breast implant scandal: now women with Rofil M-implants 'are at risk';  The Telegraph, Matthew Holehouse, January 5, 2012
2.  Breast implants – a brief history of the first 50 years; The Guardian, Kira Cochrane, January 11, 2012
3.  Q&A: PIP breast implant s health scare; BBC Health News, James Gallagher, January 11, 2012
4.  Confusion Reigns Abroad Over Faulty Breast Implants; MedPage Today, Cole Petrochko, January 13, 2012
5.  PIP breast implants: European Commission says reform needed;  BBC Health News, James Gallagher, January 14, 2012
6.  Keeping patients safe: The case for a breast implant registry; The Atlantic,  Anna Yukhananov, January 5, 2012

WIP -- African Whole Cloth Quilt

A friend from high school gave me some gorgeous fabric from her travels.  She was cleaning out her closets and I won the lottery.  This gorgeous fabric is from the African continent (the stickers fell off so I don’t know for sure which country).   It measures approximately 56 in X 76 in (photo only shows part of it).  I couldn’t bring myself to cut it up into smaller pieces so have decided to make a whole cloth quilt. 

I felt the animals and trees needed to be three dimensional, so have opted to use the trapunto method of sewing polyfil batting to the fabric and then trimming around each piece to remove the batting from areas that aren’t meant to “stand out.” 

I then made a quilt sandwich of the quilt front, cotton batting (Hobbs), and the quilt back (which is a lovely green though the below photo has washed it out).  I am now in the process of machine quilting the piece.  I’m using outline or echo quilting.

Shout Outs

Updated 3/2017--all links removed as many no longer active. 

Gina (@geeners), Code Blog: Tales of a Nurse, is this week’s host of Grand Rounds. You can read this week’s twitter edition here.

How’d we get to Volume 8 already?! I think hosting this Grand Rounds finally ties me up with GruntDoc, who has hosted 7 times. Grand Rounds is the weekly round-up of blog posts by medical bloggers.

Whereas in the past the host would post nearly every link they received, it appears that we are now moving towards more curated content. I said in my previous post that I wasn’t going to institute a theme, but I was definitely more drawn to the personal-story type posts. Thanks to everyone that submitted! ……..

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Dr Rob is finally back blogging! His recent Musings Post explains: Plugging Back In.

This post is to announce two things:

1. I am back blogging again.


2. I am not blogging on this blog. I have a new blog called More Musings (of a Distractible Kind).

I also have a new project, Llamaricks, which is a blog that will hopefully draw audience participation. It’s a place for poetry; poetry by me and poetry submitted by my readers (assuming I have any). Hopefully there are people talented and/or shameless enough to submit their prose to me on that site.

OK, so I am already being untruthful. I really had three announcements. ……..

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There’s a nice discussion going on over at doc2doc: Poll: Should doctors self prescribe? Various opinions. Here are a few:

Probably antibiotics for infections would be ok, and something like Voltaren for artritis, or celebrex, but no controlled substances, this is where the water gets muddied.

……..

Doctors should not self prescribe nor under any obligation prescribe any medication for a family member or friend without their own "clinical consent" in regard to the medical condition in question.

……..

Generally doctors should not prescribe for themselves and any narcotic prescribing for self or family is a definite No. There is a saying that 'the doctor who treats himself has a fool for a patient' ….

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Then there’s this via @skepticscalpel: “Why internists shouldn’t operate MT @hhask @writeo After-hours surgery resulted in woman's death http://bit.ly/AA2DHL”

The link is to an article in The Oregonian by Nick Budnick: Oregon Medical Board sheds light on cosmetic surgery by Northeast Portland doctor that led to woman's death

For botching an after-hours cosmetic surgery that caused her friend's death, a Northeast Portland physician faces administrative charges and could lose her license.
Soraya Abbassian committed "gross or repeated" negligence while performing the Dec. 15, 2010 surgery, including administering what an autopsy found to be a fatal overdose of local anesthesia, according to a disciplinary complaint issued by the Oregon Medical Board on Thursday. ……….

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H/T to @scanman for the link to this letter written by John Steinbeck to his eldest son, Thom: Nothing good gets away

In November of 1958, John Steinbeck — the renowned author of, most notably, The Grapes of Wrath, East of Eden, and Of Mice and Men — received a letter from his eldest son, Thom, who was attending boarding school. In it, the teenager spoke of Susan, a young girl with whom he believed he had fallen in love.

Steinbeck replied the same day. His beautiful letter of advice can be enjoyed below. …..

Dear Thom:
We had your letter this morning. I will answer it from my point of view and of course Elaine will from hers.

First—if you are in love—that’s a good thing—that’s about the best thing that can happen to anyone. Don’t let anyone make it small or light to you.…………..

And don’t worry about losing. If it is right, it happens—The main thing is not to hurry. Nothing good gets away.

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Jordan Grumet Interviews Himself on his blog In My Humble Opinion (twitter handle @jordangrumet)

…….

Q: Taken as a whole, what is your blog about? What are the major themes?
A: If you asked me this question a few years ago, I would have said that my blog is a love letter to my patients. As I grow wiser, I realize that it is more accurately a love letter to my father.

When my father (a prominent oncologist) died, I was seven years old. As silly as it sounds, I spent a great deal of my childhood and young adult years trying to forgive myself for his death. Even though I knew I wasn't responsible for his aneurysm, I struggled with issues of being worthy of love.

As I read my own writing, I'm struck by the parallels. I fight to be protect my patients and lead them through the dying process, much in the way I wish I could have done for my father. …………

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Via Jackie-ES blog post: Join Patternfish and HeartStrings in Supporting WomenHeart (photo credit). I purchased the pattern, now to finish the projects I have started so I can knit this beautiful scarf.

Patternfish also launched a monthly charitable support initiative starting this month where the Designer of the Month picks a favorite charity and to which Patternfish will make a contribution. And I am the first to help kick off this initiative by choosing WomenHeart, the lifeblood organization devoted to improving the quality of life and the healthcare of women living with heart disease.

Patternfish will be donating $1.00 for each Thinking of You Scarf pattern sold during January to WomenHeart and I will match that dollar for dollar.

More Surgeon’s Caps

These are caps I made between just before Christmas and the first part of January. 

The first ones went to @doctorwes after he made his request for photos of Christmas themed clothing seen at work. 

I then decided I needed to use some of this lovely fabric from Africa given to me by an old high school friend to make @Bongi1  and @globalsurgeon surgeon’s caps.  I gave bongi his choice and he chose the colorful ones.  No photo of him wearing his, but received this nice tweet.

@globalsurgeon did share a photo of @ReinouGroen via twitter wearing one of his (theirs):   yfrog.com/kk54exnj

These two went to @bramzo after he made an innocent comment in regards to @Bongi1 receiving his.


I have shared my pattern via google docs (pdf file).
Related Posts:
Surgeon’s Caps  (April 18, 2009)
Razorback Surgeon's Caps for a Colleague (Oct 17, 2010)

Stephen Hawking, ALS, and Disability

Updated 3/2017--all links removed as many no longer active. 

Stephen Hawking turns 70 today.  He was diagnosed with ALS almost 50 years ago when he was only 21.  It’s very unusual for someone with ALS to survive more than 5 years after being diagnosed.  It is because of this dire prognosis that SSI gives a person who meets the listing (11.10) for ALS begins benefits without having to endure the normal waiting period (pdf file).

………individuals with disabilities must wait five-months before receiving SSDI benefits. Finally, after receiving their SSDI benefits, individuals must wait an additional 24 months before they receive Medicare coverage. (Exceptions to the waiting period have been
made for individuals with ALS, and for those with end-stage renal disease.)

Scientific America has a very nice article by Katherine Harmon:  How Has Stephen Hawking Lived to 70 with ALS?

Stephen Hawking turns 70 on Sunday, beating the odds of a daunting diagnosis by nearly half a century.

The famous theoretical physicist has helped to bring his ideas about black holes and quantum gravity to a broad public audience. For much of his time in the public eye, though, he has been confined to a wheelchair by a form of the motor-neuron disease amyotrophic lateral sclerosis (ALS). And since 1985 he has had to speak through his trademark computer system—which he operates with his cheek—and have around-the-clock care.

But his disease seems hardly to have slowed him down. Hawking spent 30 years as a full professor of mathematics at the University of Cambridge. And he is currently the director of research at the school's Center for Theoretical Cosmology.  …….

Handmade Journal

I follow (loosely) the blog Sketchbook Challenge.  It is a great source of inspiration (and intimidation). Several months ago I noticed the instructions  (pdf file, link removed 3/2017) for creating a fabric journal from Sue Bleiweiss.  Here is my first attempt at creating a handmade fabric journal.  It’s purple, so of course I mailed it to @purplesque.

Here is the base of the journal with the fabric fused to the pelmet vilene, bound, and pressed.

Here it is folded, prior to adding the paper.
Paper added.

I wasn’t sure how to do the closure.  Will have to get more creative if I make another one.  I sent two options:  elastic gold ribbon

or tied with more purple ribbon.

Shout Outs

Updated 3/2017--photos and all links removed as many no longer active. 

Peggy (@tbtam), TBTAM, is this week’s host of Grand Rounds.  You can read this week’s twitter edition here. 

ONCE UPON  TIME…

Before Facebook and Twitter and Google+, and long before the word “social media” became religion, something called the Medical Blogging made its appearance on the world-wide web.

In those days, there was a small, close-knit community of medical bloggers ……..

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H/T @jilltomlinson  for the link to this Lost Angeles, CA blog post which gives a great viewpoint on disfigurement, identity, perception & reconstructive surgery.  It is from December 2010 but worth the read:  MIRRORINGS: The late great Lucy Grealy on her face, tragedy, beauty and identity

There was a long period of time, almost a year, during which I never looked in a mirror. It wasn’t easy, for I’d never suspected just how omnipresent are our own images. I began by merely avoiding mirrors, but by the end of the year I found myself with an acute knowledge of the reflected image,  …….

Long-term plastic surgery is not like in the movies. There is no one single operation that will change everything, and there is certainly no slow unwrapping of the gauze in order to view the final, remarkable result………

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Medpage Today’s article by Michael Smith, Face Transplants Offer High Yield With One Procedure:

Despite enormous complexity, full-face transplants can repair functional defects and improve major surface deficits that would otherwise take multiple reconstructive procedures if they were possible to do at all, researchers reported.

That conclusion comes in a report, online in the New England Journal of Medicine, on three full-face procedures carried out this year at Brigham and Women's Hospital in Boston…….

The NEJM article:  Pomahac B, et al "Three patients with full facial transplantation" N Engl J Med 2011.

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H/T to @jordangrumet for the heads up on a new blog by @WilliamDale_MD.  The blog is entitled WilliamDaleMD.  His nice first post is Medical Health Record:  a Personal Journey Down the Rabbit Hole

The Problem
“They told me I had to get the information myself,” she said.
“What? Why?”  I responded, annoyed.
“They said it wasn’t in their computer, and that I’d have to get it myself. They said since you’re a doctor here, you could easily check the computer yourself and get it from medical records,” my wife continued.
“That’s crazy! I’m not allowed to look at the computer records; I could lose my job!  And it’s much easier for them to get the paper records than me! ” I was incensed.…………….

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From DinoDoc, Musings of a Dinosaur , comes a thoughtful post:  In the Trenches: Quality of Life

Why is it easier to talk about quality of life with patients who are dying? Why don’t we factor these considerations into the decision-making for patients with conditions that aren’t fatal?

The presence of a terminal illness serves to focus everyone’s attentions. Widespread cancer metastases? Concerns about tight blood glucose control fade away. End-stage liver disease? Blood pressure control doesn’t matter so much any more. Bony pain from prostate cancer? Narcotic and sleeping pill addiction doesn’t even occur to anyone. …….

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H/T to @tbtam for this tweet:  “The year in street photography wp.me/p1Gna5-gh via @wordpressdotcom A young photographer hones her craft. I envy her.”  So do I.  Please check out her photography (better on a screen larger than your iPhone).

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A couple of weeks ago CBS Sunday Morning had a nice feature segment on the art of shopping bags.   Check this out:  The Museum of Bags