connectivity

Structure Sunday: The Structure of Friendship

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Tonight I had dinner with a friend I have known since early high school, about 40 years ago. I love the the idea that we have been friends that long. I actually don’t like the idea of ever losing any of my friends, regardless of time or distance. And there has been a great deal of time and distance between me and most of my friends. Nonetheless, I think old friendships hold the world together. 

This friend took the initiative to keep in touch. We went to the same small high school and left there in 1977 and 1979 respectively.  Our high school was an intense, supportive and inspiring place, and as a group, we departed there meaning to do good in the world. He and I went off to separate colleges a continent away, and went about marrying, having kids, going to school, school, and more school. I became a physician and he became a researcher for the World Health Organization, among other things. 

After Facebook reunited many people, he decided it would be nice to visit. And so he did, especially since I live in eminently visit worthy place. Of course, truth is stranger than fiction, so during his visit, he naturally he fell right in love with my wonderful neighbor and returned later to stay many months with her. Eventually they parted ways as friends and he still visits to this day. 

So tonight I had my good neighbor and my old friend over for dinner since he is visiting. It was such a treat since I also invited my niece and nephew over as well so they could meet my old friend. For you see, my friend did go out and do good in the world, and I wanted to share it with these kids. 

He recently finished his residency in Anesthesia, as he decided later in life to become a doctor. At the end of his residency, the Ebola outbreak began, so he departed for Sierra Leone, one of the hardest hit areas, to help. He spent six weeks there, and at tonight’s table, he told us about all we wanted to know and more, from the percentages that lived, to the special suits he wore, to his American co-worker who contracted the disease and lived. I was so pleased that he could share all this, especially with the kids present. It not only tied us together, it tied us together with all the Ebola fighters, and even put us degrees closer to the Ebola patients themselves, and helped us understand their humanity in a near first hand way. Best of all, he told us about the preliminary announcement from about three weeks ago, that an effective Ebola vaccine is on the horizon. 

So as the night wore on, and the topic of Ebola played itself out, we realized that my nephew plans to travel to just the area of Italy where my old friends and my neighbor have visited: Venice. So I was the happy recipient of colorful descriptions of Venice. My nephew was given numerous recommendations about places to visit, things to do, and travel strategies to use. I got to listen to exuberant descriptions and enthralled questions about this place, which at this point, to me, is nearly mythical, yet now more real. 

So because of this long friendship, tonight, at my own table, I traveled from darkest Africa to brightest Venice. We were able to appreciate each far flung place as the real place that it is, and understand that hope blooms in both. We renewed bonds, and shared all this with the younger generation. 

Are your friendships in good shape ? They are so important to our collective well being, that I suggest having a look. 

 

 

 

 

 

Wellness Wednesday: Dealing with Disappointment

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The other day, I inadvertently backed up into my husband's truck, for the second time in one month.  Both times it was parked in an atypical location, but both times I should've seen it. Both times I was going about 1 mile an hour. I have incurred enough damage to pay for two round-trip airfares to Europe. This was a disappointment.

 

My initial reaction was that I was sad and dismayed. However I was on my way to a delivery, so I knew I had to be sharp. I knew it was nobody's fault really and that there was nothing to be done about it at that moment. The necessity to get out of my funk in short order was actually a really positive exercise. It caused me to think about the best way to deal with disappointment.

All the sources that I consulted on the subject indicated the same basic set of recommendations. Here is my personal redux on the matter. 

  • Pause and breathe before reacting. Take a couple of minutes if need be.
  • Acknowledge your own feelings of disappointment or anger, but do not act out.
  • Accept the present state of affairs.
  • Deliberately avoid blame and invoke an attitude of neutrality.
  • Take responsibility for what you can.
  • Remind yourself that all problems have solutions or at least strategies.
  • Deal constructively with what you have to and postpone the rest until the initial shock wears off.
  • After the initial shock wears off, reach out to others who you know will be helpful and supportive.
  • After any big disappointment, stay in your basic routine. Observe a good sleep schedule and stick to your three meals and three snacks every day as well as your workout.
  • Go out of your way to remind yourself about all the good things in your life. 

 

Keeping this routine will help keep your stress levels down and help you recover from disappointments. 

 

 

Structure Sunday: The Structure of Childhood Memories

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Childhood memories are an important part of who we are. It is up to parents to engineer varied and happy memories into their children's lives. This weekend we went down memory lane by virtue of hosting a wedding reception for the son of some of our closet friends. You would not think a wedding would focus a great deal on childhood memories. And yet, this weekend, it was a veritable memory fest. Of course there was the requisite slideshow of the childhood pictures of both bride and groom. But more than that, at the reception, clusters of conversations ensued, conversations between people who had done much together as children but little recently as adults. 

My extended family is large and we ourselves have three grown children. But, and this is one major point of this post, we have so many friends who are like family. These are families we have known for 20 to 30 years, and whose children have grown up with ours. Back in the day, we gravitated toward them because they were good and interesting people. More than that, they were creative and adventurous, and despite the fact that we were college students of modest means, we had adventures: us, our kids, our friends and their kids. These people have stayed our good friends all this long while. It feels like a tribe, or the proverbial village, the village it takes to raise a child. 

These adventures we had took time, planning and some wherewithal, but it all paid off in ways which we did not then entirely anticipate. Today we have grown kids who sit around the table and marvel at all they got to do as children. We look at old pictures and tell tales of glory. They know their experiences have shaped them. These children have grown to be inventive and resilient from their experiences. These are two of the greatest gifts a child can have. And now they are taking their kids out too.

It is fewer and fewer kids who have these experiences of rafting, camping, hiking or traveling for the sake of seeing a new place. I am writing to encourage you to find good people for your village. Find them and set off on adventures. You will have to take time off work, plan, get some gear, and maybe even learn a few new things. But that's all part of it. Go make some great memories for yourself and your children. You will get more out of it than you realize. 

Medical Monday: ACOG weekly news

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What's an Ob/Gyn site without a little OB/Gyn news ? I like reading the Ob/Gyn News and I like translating science information into clear non medical language. So I'm going to give Medical Monday's another go. 

A large Finnish study has show that those who have depression and who are treated for it in pregnancy have lower rates of preterm labor than those who have it and are not treated for it. 

Most everyone has heard of BRCA1 and BRCA2, the genes conferring increased of breast cancer. Unfortunately there are many more gene mutations which are associated with the development of breast cancer. Fortunately, testing for 20 more of these genes may soon become available for select patients with strong family histories of breast cancer. 

Fully one quarter of American women 65 and older have osteoporosis. Thank our marginal diet, heredity, Big Soda, Big Tobacco, alcohol and our sedentary lifestyle. 

One third of ovary cancer patients are living in excess of 10 years. This is a substantial improvement over the last several decades. 

Finally, stats are in through 2013 and infant mortality in the US has dropped to a record low. Wow, finally ! I'm going to try to end on a good note, so with that, stay tuned until next week. 


Structure Sunday: The Structure of Education- Preschool

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Education has been of foremost importance to our family. Most of my life has included  receiving education or supervising the education of my children. After all of this I have some definite ideas about education and I would like to share them with you.

I've been thinking about education because it is, of course, back to school time. As you know from my last post on school related matters, I'm a parent who believes that parents should be involved in their children's education. 


To me a child's education involves not only their scholastic pursuits. It also involves their sports, extracurricular activities and even the home schedule and enrichment activities the parents plan with family. This particular blog post will focus on a child's education before the school years even start. 

In the years before school there is a lot you can do for your child to enrich them. First and foremost, have a loving and orderly household. For example, try to have a peaceful sit down family dinner every night. 

Make sure your child is included in as many of the family activities as possible according to their stage of development. Once you reconcile yourself with the fact that doing things with the child takes more time and preparation, you will simply be more relaxed and so will the child. 

Here is a controversial and challenging recommendation: get rid of your TV. Those who know me well know that I am a big fan of certain forms of media such as music, internet and film. However, I believe in mindful consumption. TV decides your content for you, whereas if you have a screen connected to some sort of input device and parental controls you decide. I think it is critically important for children that mainstream commercial television not become their default activity or God forbid, their default reality. Where video content for children is concerned, I am a big fan of high-quality nature and science oriented programming. It doesn't matter if kids understand every scientific word; they learn very quickly to put it all together. 

When you have no TV, it behooves you to put many wonderful things in its place. Children before the age of school have a limitless sense of wonder and can be enthusiastic about anything good. Make plans to expose them safely and comfortably to all aspects of the natural environment, such as mountains, lakes, rivers and ponds. This may mean something as simple as going to the neighborhood park.

Get them involved in sports and other athletic pursuits. Before you do however, make sure you know what the sporting lifestyle entails. Getting young children involved in soccer, ballet, martial arts, equestrian pursuits, or skiing are all very different undertakings. In an ideal world, we would simply cater to the tastes and talents of our children. For the time being, we have to simply say, "where there's a will there's a way." I am a particular fan of ballet and a martial arts since they are available in most towns and are relatively reasonable in cost as sports go; Plus they give children great physical poise for the rest of their lives.

The great indoors also holds many fascinations. Teach children to play board games with other.  Give them access to all kinds of art and science materials. Absolutely every child should have a box of paints and a bug jar.

Consult with your local music teachers to find out what age their music education should begin. Consider taking lessons alongside them. 

Key among my recommendation is this: read to your child until he or she can read. Then, keep reading to them until they are absolutely fluent. Try using your fingers or their finger to track the words. All along the way provide them with a wealth of reading material. Take them with you when you go to the library or to the bookstore and consult with the staff about the best in children's literature.

Young children should be exposed to live theater, live music, museums and outdoor festivals such as county fairs, horse shows, farmers markets, and Renaissance fairs. 

All of these activities for children will stand them in good stead socially, intellectually and physically for the future. Each of these activities, if done in an appropriate and supportive way, will enhance your child's skills and confidence. These traits will transfer over into all the other areas of his or her life. 

Food Friday: On the Glories of Summer Fruit

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Summer fruit is not just something to eat. It is a family project. It is a creative endeavor, and it is Holiday preparation. Finally it's a great bargain. 

Most people think of boxes of ripe summer fruit as the mere predecessors of pies and cobbler. I love fresh pie and cobbler as much as anyone else, but there is only so much you can eat and stay healthy. 

Consider the price of frozen fruit at the grocery store, even Costco. Frozen fruit is a premium item, and if you have ever tended a tree or picked a bushel of fruit you will know why. But, to go to a produce vendor for a box of ripe fruit in season, you will pay a fair price for an excellent product. But you must buy it by the box or bushel, which might be daunting to some. 

Take courage ! To freeze you need only freezer worthy ziplock bags, some time, and some lemon juice. Freeze by the quart or by the gallon. 

To dry, you need patience, an oven, a very hot day, or a dehydrator. With a little more cleverness and maybe a recipe, you can make fruit leathers, which are a most welcome gift. Now is the time to get some made to give at the holidays. 

Jam has less sugar than jelly and is a suitable treat or gift when home made. Delve into the exotic fruit spiked salsas, and you will have serious trouble keeping it around. 

To be fair, you will need some equipment. First you will need large bowls and pots. You will also  need many hands to help wash and slice. The thrifty among you will want the largest good freezer you can afford. Canning pots and tools are relatively inexpensive, and jars are a common item at garage sales. Just be sure they are in good condition and not chipped. Finally for the connoisseurs, you will want a proper dehydrator. And by all means indulge yourself in one of the many beautiful books about preserving. You may as well get the gold standard, the Ball Blue Book Guide to Canning and Preserving. 

If you do this sort of kitchen magic with the kids, they will be fascinated. Photo document your fun and you will be blog- worthy and an instagram hit ! You will also have a really good spoon to lick. 

 

Ball Complete Book of Home Preserving
$15.30
By Judi Kingry, Lauren Devine
Buy on Amazon

Food Friday: Summer Guests

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Summer should be full of guests. Where there are guests there should be great food and drink. And yet, it is important that the work of food preparation not get in the way of entertaining. Here are simple, easy ideas for summer entertaining. 

 

 

1. Give at least a week of notice, so the gathering is informal but not too informal. Be open to drop ins. 

2. Be aware of any food intolerances or limitations. Have at least three dishes everyone can eat. 

3. Incorporate the out of doors somehow. 

4. Invite guests to contribute a dish but let them know to come even if they are too busy to prepare something. You may also simply ask them to bring soda water if you suspect they are busy. It is a good idea to invite guests to bring what they are good at cooking, within the constraints of your theme. 

5. Favor foods which can be prepared in advance, especially the main dish. An example would be meatballs in a slow cooker. 

6. Favor food which are presented, more than actually prepared, i.e. fruit and vegetable platters with dips. Similarly, favor foods which are assembled by the guest, i.e. a taco or fajita bar. 

7. Serve buffet style. 

8. Have a great selection of drinks, especially in hot weather. People love a big punch bowl. We make ours with 2 parts club soda with one part 100% fruit juice such as apple raspberry juice from frozen concentrate. We cool it with ice, but also frozen berry mix. We may also float some citrus slices. The variations on this punch can be endless, and it the flavors can morph as the bowl needs refilling. 

9. Don’t be afraid to decorate a little. You can be fun, festive or sophisticated at your whim. 

10. Finally, don’t forget the most important part of entertaining: Making your guests feel welcome. 

Wellness Wednesday: Healthy Communication Skills

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Communication skills are intrinsic to our wellness. They are central to our relationships and our effectiveness in life. I have distilled a list of six main steps in healthy communication. I discovered I have lots of room for improvement. Hopefully you will find something helpful too. 

1. Attitude adjust.

  • Consider your purpose in the conversation. 
  • Assume the best intentions in everyone. 
  • Stay positive - honest, patient, optimistic,  sincere. 
  • Value everyone equally. 

2. Check physical factors.

  • Put away distractions like phones. 
  • Make comfortable eye contact.
  • Watch your body language.  
  • Watch your tone. 

3. Listen actively.

  • Listen first.
  • Ask open ended questions.
  • Set aside judgement while listening. 
  • Listen actively -  Don’t interrupt; read back, aka clarify and reflect. 

4. Guide your reaction. 

  • Use empathy; Try to see the other person’s point of view.
  • Practice self awareness -recognize emotions and stresses as they arise and rather than react to them, handle them appropriately. 

5. Say your piece. 

  • Pause and ponder. Think before making a point.
  • Understand how your message might be received.
  • Tailor your message to your listener.
  • Use empathetic assertiveness. 
  • State needs, express feelings; Value your own point of view as well. 
  • Be direct; Be BRIEF - Give the "b"ackround, "r"eason,"i"nformation, "e"nd, and "f"ollow-up.

6. Connect and conclude. 

  • Connect personally.
  • Encourage the other.
  • Focus on the result.
  • Ask for input and feedback. 
  • Follow up with a plan. Close the loop. 
  • Show appreciation for the person and the conversation.  

 

Awesome references that expand on these tips: 

http://lifehacker.com/top-10-ways-to-improve-your-communication-skills-1590488550

http://www.lifehack.org/articles/communication/9-tips-to-improve-communication-skills.html

http://www.wikihow.com/Develop-Good-Communication-Skills

http://www.skillsyouneed.com/ips/improving-communication.html

http://www.skillsyouneed.com/general/emotional-intelligence.html

http://www.skillsyouneed.com/ips/improving-communication.html

http://www.inc.com/kevin-daum/8-ways-to-improve-your-communication-right-now.html

http://www.citehr.com/11334-6-good-tips-increase-your-communication-skills.html

http://advancedlifeskills.com/blog/14-very-effective-communication-skills/

http://www.wfm.noaa.gov/workplace/Comp_Conf_Handout_1.pdf

http://www.helpguide.org/articles/relationships/effective-communication.htm

Food Friday: Food Joy and Fat ?

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Food joy. Does all this enthusiasm about food contribute to the obesity epidemic ? Consider everything hot now in food : food magazines, the food channel, food trucks, street food, farmer's markets and local food ! Vegan, Paleo, Pegan, organic. 

I say a resounding NO. All this food joy is a great step in the right direction. It does not contribute to the obesity epidemic. I have no data here. I only have 30 years in medicine, most of which is focused on women’s health. 

Those with poor nutrition and problems with obesity are most often those who have not discovered the joys of food. Many times they are those that eat whatever food they can get. This ends up being the stereotypical top ramen, soda pop and boxed mac and cheese, or the iconic white bread. I remember unkind comments from adults I knew as I was growing up, as they wondered how people with so little money could get so much food to get so big. This reflects a profound misunderstanding of nutrition poverty and obesity.

Many times overweight people do not eat very much. They have little and eat little. What they do have is cheap carbohydrate, and they need to eat it as their whole meal since protein sources and fruits and vegetables are or are perceived as less available. Because of this diet, these folks suffer from chronically low metabolism and have low energy. They therefore become less active. Their extra weight compounds their insulin resistance, which results in more fat deposition. It is very hard to get out of this vicious cycle.

Many times I see young women in this predicament while they are pregnant. In this instance they have access to better resources such as food stamps as well as nutrition teaching. I have found that they are as eager and able as anyone else to learn. Once they do learn about the correct composition of meals, as well as the correct timing and quantity, they are astounded about several things. First, they are astounded about how much they enjoy their new diet. The are almost universally shocked at what large quantities they are supposed to eat. And, given this, they are amazed that their pregnancy weight gain levels out appropriately. Finally, they begin to enjoy food preparation, but note that it is a time commitment that they did not have before.

Some have odd reactions from significant others, and find themselves isolated. The partners may not want to change the way they eat. Sometimes partners even make fun of the one trying to be healthy and tease or taunt them back down to their level of poor nutrition. 

Most of the time this change toward nutrition awareness, and eventually toward food joy, is life altering. They never want to go back. Sometimes it becomes a source of pride and accomplishment in the family, and mealtimes become social in a way that they had not been. 

To me, the final stage of food joy is the social and cultural aspect. I took a walk down my own Main Street. I was amazed at what our little town had to offer. We had artisanal breads, real sushi, Thai food, genuine French macarons, and handmade watermelon chili sorbet all on one block. Granted, most of these delicacies were treats. But they were foods that made people appreciate food, other people, and other places. I saw people clustered in cafes, and out on the sidewalls. I saw people working on laptops, socializing, and flirting, all the while over special foods and drinks. They all seemed rather vibrant. 

It appears that people who take the time to walk about to find beautiful food like this are not apt to “ waste” their calories or carbs on junk. They become conoisseurs who are interested in the best for themselves. 

It is always a step in the right direction when people start to focus on quality, in nutrition, food, or even cuisine. When people focus on quality in one dimension of their lives, it tends to spread to others. My favorite part of this whole process is watching patients start to embody quality and enthusiastically take good care of themselves. 

 

Structure Sunday: The Structure of Your Home Office

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Today's women have to do it all. Homemakers and professionals alike need a home office to do all that they need to do. Here are my tips for what goes into a home office, and what should take place there. 

I have also included some great resources about home offices. 

 

. 

Three setups tailored to your budget:

The Essentials:

  • A place to write and store your life management things. 
  • Day runner with addresses, calendar, and notes or smartphone with same features. 
  • Backup for your smartphone if you have one. ( ? cloud) 
  • Writing implements, pens, pencils, highlighters, markers 
  • Spiral notebook to centralize and keep notes ( instead of sticky notes everywhere)
  • A few sticky notes even so 
  • Filing box and files 

Nice to have: 

  • Laptop with internet access 
  • Software 
  • Spreadsheet like Excel for Windows or Numbers for Apple  
  • Word processor like Word for Window
  • Photo storage and processing software. 
  • Bulletin or marker board for ideas, art and planning 
  • Bookshelves 
  • File cabinet 
  • A decent camera

Deluxe: 

  • Printer/fax/scanner
  • Nice speakers
  • Nice headphones 
  • IOS device like ipad 
  • an extra monitor 
  • A good camera

 

Ideas for your home office schedule

 

At the beginning of your day...

  • Leave your home office alone. Get your health related things done first, like working out, bathing, and eating a healthy breakfast. 

 

 In your home office work time… 

  • Check your email twice per day. Don’t do it reflexively. 
  • Leave social media closed until tasks are finished. 
  • Add every new contact into your address book AS THEY COME IN.
  • Keep a spread sheet of your budget. 
  • Use accounting software like Mint, which is free, ibank, which is cheap, or Quicken, to keep your bank, loan and credit card accounts in order. 
  • Set up bills to pay automatically or put reminder notices in your calendar program. 
  • Store your photos digitally, and backup those and your other documents two ways, the cloud, and a cheap external hard drive. 
  • Work on your projects in sessions about 45-90 minutes long. Then get up and stretch and drink some fluids. 
  • Develop a system of file keeping. You may like Evernote which is free. You can organize anything into albums. In side the albums are notes where you can put text, documents, picture, sound, movies, links, or anything. 

 

At the end of the day

  • Review your calendar and plans for the next day. 
  • Chart any nutrition or fitness data that you are working with on a daily basis. Make sure the method is simple and fast. 

At the end of the week

  • Review your calendar and plans for the next week. 

 

Home offices can be a lot of fun. They are ground zero for domestic creativity. Think recipes, projects with kids, projects for the house, tracking that workout and budgeting for that vacation. Knowledge is power and organization will put it to work. 

Tools4Wisdom Planner - Life. Simplified.
$29.97 $34.97
Planners by Tools4Wisdom
Buy on Amazon

Wellness Wednesday: Beyond Relaxation to Renewal 

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Most of us are familiar with the recommendation to relax on a regular basis. We are all familiar with the ravages of stress and the problems associated with insufficient sleep. We generally think of relaxation as the antidote. To most people this means to physically rest or sleep , and to be quiet and still. There is no doubt that some of this kind of time is good on a daily basis, especially if it is done in a mindful fashion such as in meditation.

But sometimes we need more than relaxation. We need renewal. Renewal goes beyond relaxation. It is similar to relaxation in that it is a break from the usual work routine. However, after that, the similarities end. Renewal is more planned. It may involve physical activity, such as exercise, or an outdoor adventure. It may even involve a challenge. It often involves other people, especially people who are new to you. It involves unfamiliarity, learning and even getting outside of one’s comfort zone. 

Productivity experts are extolling such “ strategic renewal” as the newest productivity tool in the success toolbox. This concept can be utilized on different time schedules: daily, weekly , monthly, quarterly. 

Daily Renewals 

  • exercise 
  • meditation 
  • reading 
  • connect with close family and friends 

Weekend Renewals: 

  • connect with farther flung family and friends, socialize and entertain
  • patronizing the arts 
  • sports 
  • spiritual observance
  • volunteer
  • outdoors 
  • reading 
  • exercise 
  • creative pursuits outside of work 

Monthly or Quarterly renewal: 

  • adventures 
  • conferences 
  • different kinds of work projects 
  • travel

See to the basics first: adequate sleep, regular exercise, and good nutrition. Ensure some relaxation on a daily basis. But go beyond all this and try to start thinking about renewal as well. 

To learn more :

See our sections on Sleep Yoga and Meditation 

LIfehacker

Huffington Post 

New York Times 

Stanford University Cafe Science

What Most Successful People Do On the Weekend, by Lauren Vanderkam 


Structure Sunday: The Structure of Your Media Consumption

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Omigosh I must be so easily amused. I have flown planes, climbed mountains, and swam with sea lions, but today, I got the biggest rush from organizing cookbooks in their new shelves. I just adore their beautiful pages full of recipes like magic spells waiting to be cast. A beautiful recipe transforms you as you make it, and your family as they see what has been prepared for them. 

I am reading a riveting book right now. It is called Seveneves. I found myself reading it at a stop light. Not good. I chose it based on the genre, sci fi, but also because of the reviews on Amazon, and finally because of what I was able to learn about the author, for instance that he double majored in Physics and Geography. I learned all this on the internet.

Seveneves: A Novel
$21.00
By Neal Stephenson
Buy on Amazon

 

 I did all that research because I wasn't going to devote several hours of my life to something less than totally worthwhile. You see, I get absorbed in my books, fiction and non-fiction alike. They transport me. I don't hear things around me when I am reading. If something is going to affect me like this, it better be quality and it better have redeeming value. I want to finish the book a better person. 

I feel the same way about film, but there are far fewer good films than there are good books. Still, the depths of Netflix and Apple TV are unplumbed, and I look forward to it whenever I have time to dive deep. I don't know if my approach is correct; I save film like candy or ice cream, and cannot watch it until I eat all my vegetables, i.e. work, housekeeping, bills, and exercise. 

Music, however, is like water to me. I have to have it all the time. Patients know it plays all day long in all our clinic rooms, and we try to make it wonderful. We try to make people enjoy their time with us. I want to turn more people on to fine music.

I believe music puts you in touch with yourself. If a song makes you melancholy and wistful, it is touching something within. You may gain from this awareness, and perhaps be able to give the issue more attention. Likewise, if you hear something that makes you feel like dancing, it's because that dance is already in you; the song merely helps release it. 

When I was growing up, all this was so expensive. Books were bought in bookstores, and records required expensive equipment to play well. Regarding films, well, you had to make arrangements to go to a theater, providing you were old enough. But nowadays, the widespread availability of all this media is astonishing. I believe it is world changing. 

I have a great personal interest in the lives of those with low income and high aspirations. I respect these people. I want to understand how they can realize their dreams. I think one big piece of this puzzle is widespread high quality media: books, film, and music. These are not just      niceties in life. They nurture the soul and enlighten the mind. 

Media like music, film and books are not about living vicariously or being passive. They are about learning and getting inspired to go out and live life to the fullest. That is why I think everyone should have access to all the good stuff all of the time. 

So I wondered how much it would cost to have unlimited access to all this media all the time. Here is a rough calculation: 

 

  • Amazon Prime costs $99 per year. You get access to 41,000 movies and TV episodes, and 350,000 Kindle books. Of course the Kindle app is free for any platform. Just be aware these are like Netflix titles, not necessarily the hot new releases, but still very good. 
  • Netflix has a somewhat different set of movies, all for $7.99 per month,  all released several months after they hit theaters. 
  • Apple Music, is $9.99 per person  or $14.99 per family per month. For this you may stream the entire Apple music catalog. Or, you could get Pandora with ads, for free, or without ads, for $4.99 per month. 
  • Let's say you actually want to buy a few physical books because, like me, you think cookbooks should be physical, or because you want to have a paper book to pass around, then you must budget a few dollars for that. Let's say you, like me, buy used books on Amazon, and you decide your budget is one book per month, at $5 per book used, plus $3.99 per book shipping.

If you have a smartphone and internet already, then we can ignore those costs. If we say, for purposes of argument that you "want it all" , the tally is as follows: 

Amazon Prime = $99/yr

Netflix annually = $95.88/yr

Apple Music for one = $119.88/yr

Paper books one year, as detailed above = $107.88

Total = $422.64 per year or $35.22 per month. Aren't numbers interesting ? 

Let's say you are really on a tight budget. You pick only Amazon Prime for Kindle books and streaming video, together with free Pandora for music. Your cost is only $99/year or $8.32 per month. Honestly, that is two lattes. What an amazing time we live in. 

 

Food Friday: Fruit Stands and Farmer's Markets

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My dad and I didn't always get along. He was an old school businessman from the midwest and I was a California city girl. So much was off base. Nonetheless, I recall our trips to fruit stands with affection.

Whenever we drove out to the countryside in search of fruit stands with beautiful produce, everything became right. My dad had a childlike enthusiasm for such things. He would inspect everything that was set out, checking color and smell, and then speak earnestly to the farmers about the season and their particular varieties and cultivars. He would direct me to examine each astounding thing.

 He was particularly concerned with tomatoes. He could remember all their names, and was thrilled to see the varieties with unusual colors and dense sweet flesh. He liked nothing better than to slice the finest deep red ones onto a plate with a little salt. 

All this is brought back to me at this time of year, as I look forward to the farmer's market each week. I would encourage you to pack up and go. Bring some cash, some bags, a camera and the family.

Here are several great reasons to get out to the farmer's market: 

  • You will see what is being produced in your area. 
  • You will get the best tasting fruits and vegetables. 
  • You can get large quantities for "putting up" ,i.e. canning, freezing, and drying. These projects can be simple like applesauce, pickles or jam, or complicated like salsa, relish or chutney. They can be for your families' delight or for use as coveted gifts at the holidays. 
  • You can meet new people and see ones you already know. 
  • You can get gardening tips. 
  • You can find some unique gifts or get inspired to make your own. 
  • You can use your fancy stroller and wear a big hat. 

My dad made the acquaintance of an old Japanese man who sold a particularly fine dense large red tomato. He had brought it from afar, and developed it. It had no name. Late in my dad's life, he saved some seeds from this tomato and put them in an envelope scrawled with the following, " Gina, Hope these seeds produce. If so save some for me. " 

Many years later, after his passing, I found the envelope. I did not trust myself to grow them out, so I gave them to a neighbor who is very careful gardener. To our surprise they germinated and produced the lovely tomato. 

 

Wellness Wednesday: Generativity 101

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I must have missed a day during my Psychology rotation. If I could have planned it, I would have missed the part about Freud and psychoanalysis. Give me a social or a cognitive psychologist any day and I will be much happier. These types of psychologists study the development of personality and cognition, or the thinking process throughout the lifetime. One of the great social psychologists, Erick Erickson, viewed our lifespan as occurring in stages, eight to be precise. They are depicted in the graphic taken from the pages of simplepsychology.org. ( See reference below.) 

I am writing tonight to introduce a new concept: generativity. It is the eighth stage in Erickson’s concept, and this seems to indicate it pertains only to people who are middle aged. I think it pertains to all adults, young or old, and maybe even certain adolescents. In a prior post I highlighted the evidence behind the importance of creativity to health. In this post I would like to highlight the importance of generativity to health and wellness.

Generativity is a term created by Professor Erickson to denote "a concern for establishing and guiding the next-generation." It has to do with creating something beneficial for those who come after you. It has to do with making the world a better place. In both Japanese and western culture it has to do with making your mark. Steve Jobs famously use the phrase "put a dent in the world". 

I have a hard time seeing that this kind of altruism is restricted to middle-aged people. The literature says that this personality trait does not have to be there initially to manifest itself later in life. But what if we were to hold it up as a desirable value? What if we were to make it trendy? Would more people embrace it and do so sooner in life? In Jewish thinking there is a phrase which I think relates to this. It is “Tikkun Olam”. This means to repair the world. It is something we are taught from early on.  It is one of the highest Jewish values.

In the field of psychology, there is actually a scale to measure generativity in a person. It is called the Loyola Generativity Scale or LGS. It is a point system in which the subject answers the following six questions:

  1. I tried to pass along knowledge I gained through my experiences.
  2. I have made and created things that have had an impact on other people.
  3. I have important skills that I try to teach others.
  4. If I were unable to have children of my own, I would adopt children.
  5. I have have a responsibility to improve the neighborhood in which I live.
  6. I feel that my contributions will exist after I die.

You get a zero if the statement does not apply to you, a 1 if it sometimes applies, 2 if the statement often applies, and 3 if  the statement always applies. The higher the score, the more generative you are. And not surprisingly, the happier you are. There is real research that indicates that a high score on the Loyola Generativity Scale is positively associated with life satisfaction.

Generativity is a new term for me. However it is an old and very useful concept. I am writing today to do my part to put it a little more on the map, and to encourage a conversation.

 

References:

What's generativity and why it's good for you at HuffingtonPost

Kristensargsyan’s Blog

Simplepsychology.org

Foley Center for the Study of Lives at Northwestern University

Psychology.about.com

Generativity in the Young, Midlife, and Older Adults. McAdams, et alia. Psychol Aging 1993;8(2):221-230.

 

 

 

Food Friday: Cooking With Family

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You can't have enough cooks in the kitchen. 

I reflect back on having kids, now that all mine are grown and I have become a grandmother. One of the most gratifying family times for me has been cooking with my kids and their friends. I think I stumbled upon this as an awesome parenting strategy. It turns out that it gives you time to talk. Because it also keeps you occupied, it helps to keeps the tone light.

Cooking a meal teaches everyone tolerance, though slowly. It promotes cooperation, planning, safety skills... the list goes on. It settles people's energy back on the home life and shows how much fun you can have together. I cannot recommend it enough. 

Start early and be relaxed about messes. Having said that, don't be afraid to teach kids to tidy up before beginning to cook; The French call it  "Mise en Place", or to put in place. Likewise, don't be afraid to teach them enthusiasm in cleaning up. And in this matter, lead by example. And to help yourself, have a great collection of cookbooks or Pinterest Pins at the ready for inspiration. 

 

For a great guide on age appropriate cooking activities, click HERE. This is from Rutger's, entitled "Cooking Brings Kids and Families Together".

Cornell Cooperative Extension has a great article HERE, titled "Cooking Together as a Family has Multiple Rewards". 

And from WebMD, "Cooking With Your Children" HERE. 

 

Here are some books on the subject: 

"Cooking Time Is Family Time: Cooking Together, Eating Together, and Spending Time Together", by Lynn Fredericks 

"The Table Comes First, Family, France and the Meaning of Food", by Adam Gopnik

 

And here are some fun blog posts on the subject: 

The Kitchn

Playground Dad

Toca Boca

It's fun to start in the kitchen with small children. But the good news is, it's even more fun when your kids have grown.

Bon Appetite!

Wellness Wednesday: Quantify Yourself

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I have always said that knowledge is power. This is especially true in this digital age since we have access to so much searchable knowledge. I have also always said that one of our primary goals in our medical practice is to empower women to take charge of their own health.  It is therefore natural that I am very interested in helping women to empower themselves through the use of technology.

It turns out that one of the most powerful things we can do to take control of and change our own behaviors is to observe, record and track them. This habit is called quantification. People who do this regularly as a part of their self improvement are participating in the "quantified self’ movement. Livescience.com defines the quantified self movement as a “movement which aims to measure all aspects of our daily lives with the help with technology.” 

Quantifying ones habits such as hours of sleep, minutes of exercise, or calories eaten, does not necessarily need to be done with a high tech device. It can be done with paper and pencil. However, since smart phones are nearly ubiquitous, these records are most often kept on these small powerful personal devices.  Of course there is a proliferation of different apps for this, one for every topic and several for many parameters. Not only is there a proliferation of different software apps to help with quantification, there is a proliferation of different hardware such the Apple watch and the FitBit. 

If the patient and I decide to follow some detail of her health such as her blood sugar, we begin some sort of record keeping. The patient makes the measurements, records them and naturally evaluates them herself as she goes through the week. This alone often results in substantial improvement in her numbers, since she can begin to discern patterns and the reasons behind them. Taking measures to push the data toward better performance is gratifying day by day. It becomes like a game that the patient is determined to win. This is called ”gamification" and it too, it is powerful in behavior change.

When the patient comes in to review her data, she can get even more benefit when we analyze her data together. If we add another layer such as her diet, and superimpose it graphically on the blood sugars in her records, we can see a cause and effect relationship between what she eats and her blood sugars over time. Sometimes a third layer of data such as activity can be added into her records and we can use this variable to improve her blood sugar control even more. 

This kind of record keeping puts the facts and the control in the hands of the patient. It is much more effective than a doctor simply telling her to eat better and exercise more. It has been my consistent observation that all sorts of patients have success with this type of approach. Moreover, in reading about this "quantified self movement" it seems apparent that this technique can be used for many types of conditions, like weight, exercise, autoimmune activity, sleep problems and even mood disorders. It can also be used for broader issues of life performance, in relationships and on the job. 

I hope this introduction into the quantified self movement has inspired you to learn more. Here are some fun references which makes for very interesting reading.

The Quantified Self, a TED talk by Gary Wolf

The Quantified Self at Livescience.com

The Beginners Guide to Quantified Self, at Technori

Why You Should be tracking Your Habits ( and how to do it well) at Lifehacker.com

The Quantified Self: How Cold Hard Data Improves Lives, at Bloomberg.com

The Data Driven Life, at the New York Times 

How Self-Tracking Apps Exclude Women, at The Atlantic

Structure Sunday: The Structure of a Family Road Trip

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Family road trips are traditionally fraught with stress. But yours doesn't have to be. The road trip season is upon us and you will want to prepare.

irst of all let the kids in on the plan. Get them involved in the preparations. It won't hurt them a bit to learn the organizational skills necessary for a small vacation. In fact you can delegate age appropriate chores to kids from 5 To 95 and that will make everyone all the more engaged. 

  • Pick a destination. 
  • Pick a route. 
  • Research attractions along the route and at the destination. 
  • Make sure everyone gets some say on the activities.
  • Go over the fine art of packing light and packing layers. 
  • Make sure everyone has a duffle and a backpack of their own.
  • Choose some activities for traveling. Choose a mix of electronic and paper content. 
  • Choose a mixture of packed food and culinary stops along the way. 
  • Always plan for minor illness and inclement weather. 
  • Plan your stops if there is any question of availability of lodging. 
  • Encourage each traveller to document the trip in their own way, i.e. Diary, sketchbook, iPhone, camera, etc. 
  • Confirm you have necessary charging and connectivity cords, batteries, etc. 
  • As the trip leader, personally confirm the travel arrangements from the condition of your car to the AAA membership.  
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What could go wrong? : ) We ourselves are on the road heading down to Missoula for the Lindsey Stirling concert. It is turning into a bit of a culinary tour since when I left home, I stopped by the natural food store and got a bag of healthy car foods and drinks. Then going past the lake, grandma offered us waffles with berries. In Ronan we stopped by a little red and white taco place and I just knew the tacos would be crispy and hot. They were. Our intentions were then set on a bakery further down the road whose reputation had preceded it. Alas it was closed, but it made a good picture. (See photo.)

 

 

Travelling is an important family activity when learning takes place and memories are made. Takes these steps to make sure that both are good. 

 

 

 
 




Wellness Wednesday: Enthusiasm

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I like to think that that when someone close to us passes on, that we can pick from among their good traits to inherit. Recently, my father in law, Dr. Van Kirke Nelson passed on at the age of 83. He was an Ob/Gyn, but also a business person, philanthropist, and art collector.

I studied the stages of grief in medical school just like everyone else, but I'm not sure where I am in the official stages. However, I can say that I am in a stage of deliberate inheritance. I am remembering all of his wonderful traits:  diplomacy, devotion, optimism, energy for endless projects, cleverness at crafting the win-win solution, and above all enthusiasm.

There are several of these traits on which I have dibs. I am hoping to inherit quite a bit of his diplomacy. I have always been short there. Then there's the optimism. I am the cup half empty girl, and to some extent I own that.  I am always trying to figure out what could go wrong so I can keep it from happening. I guess that is written into my job description. So I would like more optimism. Not the blind unreasonable kind. Not the kind that says things are always going to work out fine. Instead, I'd like the kind that says we can almost always find a solution. And even though I'm pretty darn enthusiastic, I'd like some more of that. You can't have enough of that. Grandpa, as I called him, was a great inspiration to be enthusiastic, and that is not going to end. 

In that spirit of enthusiasm, I'd like to share with you some simpler sources of enthusiasm. I have started work on our links page. There is already enough inspiring material on there to keep you awake all night. But take a page from Grandpa's playbook: Read about cool things other people are doing.. and then do some of your own. 

Check out our inspiring links HERE. 

 

Structure Sunday: The Structure of a Website and ….YOU

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Just last week Google lowered the boom and decreed that sites that are not mobile friendly will suffer in search rankings. At first I felt a little threatened, but after a little research, I have discovered that it is all about….YOU! Yes you. As they say in TRON, “I fight for the users.”. 

I love nothing better than to come into a patient’s room and see her on a smartphone. Do you realize any garden variety smart phone of the present day is literally powerful enough to have run the entire Apollo space program that landed a man on the moon? A smartphone is a very powerful computer and almost every girl and woman I know has one, even the ones of modest means. It is fantastic. Not only do I remember the Apollo missions, but I remember the days when women did not touch technology, not even stereo components. 

Technology is empowering. Information is empowering and the whole world of information is at your fingertips. Patients read about diagnoses, medications, and communicate with others who share their experience. So it is with great satisfaction as I watch my patients as they not only use technology, but make it. I have in my practice graphic designers, filmmakers, website designers, software engineers and IT administrators. I do believe it is technology combined with the goodwill of people, that will solve many of the world’s problems and inequities. As a force in neutralizing gender inequalities, technology is formidable. 

In blogging, and in making this website, I have wanted to provide easy access to what I would like my patients to know. My education has made me  familiar with the best sources of medical knowledge, i.e. institutions like the National Institute of Health (NIH), and the Center for Disease Control (CDC). It has enabled me to tell the legitimate from the bogus. So I feel obliged and enthusiastic to give you all key to all the doors that lead to the best paths to all this valuable information. I want to make it easy, and I want to make it fun. Additionally, I want to make it beautiful. Perhaps this last goal is a universal desire for website designers of all genders, but I think a beautiful website is more welcoming to women. 

And that user experience, in short, is what Google’s directives have been all about. I see from my website analytics that over 50% of you view the site on mobile devices. Had I looked to author my site looked on mobile? Not enough! The main page was cluttered, the font was too small, links were too small to push and you had to scroll way too much. All this gave me a very bad mobile rating on Google. Plus, page loading times were a bit long, and I admit, that is because of the higher definition photos that I chose to upload. This was all a very unpleasant but useful revelation. I felt bad but grateful for all of you devoted readers on mobile who slogged through all of that. 

I read a great deal in Google’s website design and mobile responsive design guidelines. At their heart, the recommendations are meant to enable you, the user, to see the site clearly, and to get the information you want as conveniently as possible. It is all about enhancing the user experience. I spent this weekend changing things around, using fewer main pages, and tucking more within them, so now you will do more clicking and less scrolling. And I promise, if you have a little wait for a photo, it will be a good one. More mobile friendly changes are coming next week. I fight for the users! Those of you who really want to get your geek on can learn the origin of the phrase in this clip from the movie TRON Legacy.