Tuesday, December 27, 2011

We all have trap doors.

Dr. Claire McCarthy writes an eloquent blog about her life as a primary care physician and parent. This post about trap doors hits the mark for me and I am certain many others.

Trap doors, illusions, memories, recollections, secrets, things we will never understand.

She writes about the hidden triggers that lie in wait for us when personal losses are tied to events, holidays and memories.  This year my mother died at 2:30am on the day after Thanksgiving. I was alone with her here at home.  We had hoped to have a Thanksgiving dinner that included her this year, as we knew it would be her last, and my grandmother who was in a nursing home ten miles away at that time.  But my Mom took a sharp turn for the worse early Thanksgiving morning and had to be on IV morphine that day.  She was really beyond even being lifted into a wheelchair even before that.

So what do you do with the memories of those last days?  There are hurtful memories, a few good ones and many questions that must be categorized and left behind.

One answer:  Keep reading about other peoples experience with loss and grief (see Dr. Claire's post above) and keep writing about mine.

Thursday, December 22, 2011

Mrs. Claus and rural fitness levels.

Mrs. Claus visits Oak Haven Nursing Home in Centerpoint, LA      
Mrs. Claus not withstanding, I have noticed that the observed fitness level of rural Southerners isn't what it used to be.  Gone are the days when farmers and their families were kept lean and mean by their work on the farm.  Nowadays, combines and tractors are air conditioned with TVs and you are more likely to see farmers with guts than not.

Total Health Gym & Fitness Center in Marksville

Total Health Gym

Diabetes and hypertension seem to be prevalent here.  There are no sidewalks here, no place to walk, and gyms are few and far between.  And don't forget, my gym in Marksville (seen at left), doubles as a U Haul rental truck facility!  So if your behind is too wide to get in the door of your double wide trailer, you can rent a U Haul truck at the Total Health Fitness Center in Marksville.

Wednesday, December 21, 2011

Town and country...differences. Marksville vs. Buffalo

Ok, so my gym in Marksville, LA doubles as a U-Haul rental center!  Yes, really!  You can work out then rent a truck. 

My Uncle Beanie (aka Dr. Bryan McCann) feeding alligators near Marksville.  

 When you google "Marksville, LA" images, right off the bat--you get the picture above of my uncle feeding gators!  And he doesn't even say "Just Choot 'em!" like Troy on Swamp People.
Me apres workout in Marksville, LA.

Neuroprotective effects of caffeine...Get me another cup of Joe!

Coffee drinkers rejoice!

Genetic Basis for Coffee's Protective Effect in PD Discovered

This study shows that heavy coffee drinkers with a specific gene have a reduced risk for Parkinson's Disease.  I read this with my third black cup of coffee of the day in hand.

It's always heartening to learn that a behavior that one chronically engages in could be even slightly good.  (Examples are eating dark chocolate and drinking coffee.) This study looks at the long observed neuroprotective effects of caffeinated coffee.  Haydeh Payami, PhD, professor of genetics and neurology, State University of New York, states "people who drink a lot of it seem to have a lower risk for PD."  Dr. Payami then began to look for the genes that interact with coffee in an effort to ultimately find a treatment or prevention for Parkinson's Disease that would take advantage of the biomarkers on these genes.

My father suffers with Parkinson's Disease

So just in case, I'm getting another cup of coffee.

Tuesday, December 20, 2011

Enfamil vs. Bourbon or town and country

Enfamil vs. Bourbon

Infant formula certainly has its place in our world.  The question is, "Is it on the liquor aisle?"

Apparently it is in Marksville, LA at Harvest Foods grocery store.  The picture below was taken at a recent visit to the grocery store depicting a large display of Enfamil on the counter, right at the front when you enter the store, directly in front of the liquor (kept behind the counter to safeguard against shoplifters, I presume).  I have shopped at Harvest Foods frequently over the last month and this display has persisted.

The infant formula display in front of the liquor

As a life long proponent of breastfeeding and a lactation consultant, I am sensitive to infant formula marketing techniques and strategies.  Their advertisements and marketing ploys often get my dander up.  But this display really brings up so many issues.  Is it a "pick your poison" message?  Or is it "first the formula, then the liquor?"  Or is it "baby bottle to bottle of booze?"  I could go on and on.

Don't misunderstand, I am not at all opposed to a well mixed cocktail or a glass of wine, but in a town where it is difficult, if not impossible, to find whole grain bread, lettuce other than shriveled heads of iceberg, this was an especially compelling commentary of the shopping habits of Marksville's inhabitants and, indeed, much of the southern United States where breastfeeding is often viewed as an unusual if not abnormal human function and activity!

Saturday, December 17, 2011

Prenatal screening marker pen

     This is a fascinating glimpse into what some fabulous geeks at Johns Hopkins are doing to serve not only under served populations of pregnant women in need but all pregnant women with a prenatal health screening pen.

Johns Hopkins students win 2011 Invention Award for Prenatal Screening Pen

The pen contains enough reagents to perform 400 tests that will help diagnose preeclampsia and other prenatal syndromes and diseases.  By simply marking on a piece of filter paper and then dropping a single drop of the pregnant woman's urine onto the mark and observing for a color change, a clinician can be quickly and economically alerted to protein in the woman's urine that can be a signal of preeclampsia.  (Other pens can screen for glucose in the urine, as well.)

What an inspiration these students are!?  There is so much hope for the future when you look at what these students are envisioning and making happen.  The sky's the limit! 

Their work inspires me to think about what I can do to support new mothers in their breastfeeding and neonatal parenting.  I may re-certify as an IBCLC by taking the exam this summer.

Prenatal screening pen identifies protein in urine

"In the U.S., the most common way for doctors to screen expectant mothers for preeclampsia and related complications is with a 50-cent dipstick. But in developing countries, dipsticks are too expensive for widespread use. With their marker, Monagle and his colleagues created a prenatal test that’s simple enough to be used and interpreted by anyone and costs only a third of a cent per use." Source: http://www.popsci.com

Saturday, December 10, 2011

Me and Alvin

Me and random Chipmunk (aka Simon)!

Sometimes you just have to be silly!  And movie theaters and large animated characters make me feel silly.

Alvin and me at the movies.

Friday, December 9, 2011

The Rat Pack & Go Griffs!

Canisius College Rat Pack -- Brooke, Chris, Katie & Eddie

I am privileged to have my very own Rat Pack (see above)!
These students are a vocal part of my freshman writing course that I taught this Fall at Canisius College in Buffalo.  Good luck on finals and thank you for helping make the semester fun!

Canisius College quadrangle
Two of my Canisius College juniors in the Medical Lab Science major have created blogs as their final projects for their clinical lab science junior seminar. Their blogs are about their journey toward their clinical year in clinical lab science.

These two students will be doing their clinical internship at Rochester General Hospital in Rochester, NY.
Have a look at Will and Melanie's blogs.  Good work you two!

Lyons Hall at Canisius

Thursday, December 8, 2011

More interviews

Le Moyne College

Daemen College
I now have two more PA school interviews scheduled! Le Moyne and Daemen College's are next on my interview radar.

This will be something to look forward to in the new year and an excuse to continue my search for that perfect basic black pump that doesn't hurt my feet!
Practical, walkable choice.

The crazy, hot, impractical choice

Another type of interview

Monday, I will continue interviewing sitters to bring my grandmother (age 93) home from the nursing home to my home, what was my mother's home in Effie, LA.  We will need 24/7 sitter coverage to help care her.

Managing 24 hour sitters in the home for my grandmother's care will be a continuation of a learning challenge for me.  Managing employees in my maternity/lactation business was one of the most challenging aspects of being a small business owner.

When I think of all the things my grandmother, Capitola, did for me as a child and throughout my life, this is the very least I can do for her in a time when she can no longer help herself.

Camp Effie


Tuesday, December 6, 2011

Red Pajamas & the Red River

My mother had a keen dislike for the color red.  My great grandmother, Luella Delilah Deville Clark (known as Mama Lula), loved the color red and was sure to give my mother a red bathrobe, sweater or nightwear for Christmas every year.

"Camp Effie" -note the M on chimney for McCann
(Mom's maiden name)
My mother was of Scot-Irish heritage and a true resident of Pointe Maigre (pronounced "Point Meg") in Avoyelles parish, as the area here at Effie is known, and she did not part with items lightly!

Pointe Maigre is a french term meaning poor point.  Effie is just north of the Red River, which is the dividing point between the French (Cajun) part of Louisiana and the "English" side.  Pointe Maigre was so named because our ancestors in this area were from England, Ireland and Scotland and they were known to be very frugal people who lived off the land and made do with scarce means.  But when they passed away, they were often found to have had substantial sums of money stashed in their homes.
Buffchic at Camp Effie with Rudolph

Red River as it goes through Alexandria, LA

So subscribing to this method of frugality, my mother wore the red night clothes that were given her despite her distaste for them.
But shortly before her death, my mother asked me for "no more red pajamas."  So I immediately gathered all her red pajamas and nightgowns in a bag and donated them right away.

When decorating the house for my mother's memorial, I avoided red Christmas decor and ribbons.  Though we received many beautiful red poinsettias and we put up multicolored Christmas lights on the front of the house, I have otherwise just said "no" to red this year.

Mantel without the color red

Red River

The Red River traverses the state of Louisiana

Thursday, December 1, 2011

Marjorie's memorial and cat love.

GC Tanuk Preshus
I am preparing for my mother's memorial on Saturday (she was also named Marjorie).  Her beloved Cornish Rex, Grand Champion Tanuk Preshus, is now my constant companion.  She is sweet and expressive in a delicate way, but insistent that you see her point of view on important matters.

Odette with one of her favorite blankies.
Preshus' aunt, Tanuk Odette, is flying home to see her today from Buffalo.  I hope that Odette is happy to see Preshus!
Odette with other beloved blankies.

Odette, named for the white swan in Swan Lake, has been snug in her new Buffalo, NY home and will temporarily relocate to her winter home in Effie, LA-- affectionately known as Camp Effie.

Since my mother was a lifelong cat lover and cat fancier.  We are asking family and friends who wish to honor her memory to visit Cat Haven and remember her with a donation to their efforts to rescue cats in the Baton Rouge area.

Saturday, November 26, 2011

Passed on Black Friday

My mother is gone...as of yesterday morning at about 2:30.
We were able to keep her without pain at the last.
Cattle under a tree in Central Louisiana.

Winter in Louisiana can be a source of solace and renewal.
Flights of geese overhead, honking as they travel, the pop and boom of hunter's rifles and shotguns in the near distance punctuate the air.

I am filling bird feeders, planting house plants, hanging family photographs and readying the house with a fir Christmas wreath on the front door.  Colorful Christmas lights will play a role in the memorial I am planning for next weekend for my mother here at her home.

The great state of Louisiana
I am gathering myself to move forward by first addressing my personal and immediate landscape.  Readying myself and my mother's home to greet her family and friends.

Wednesday, November 23, 2011

Father Paul saved the day, twice!

Gumbo on the fly
Today I cooked a chicken, duck and sausage gumbo.  Had to make three rouxs for it because I burned the first one.

Nearly set the house on fire, smoke was everywhere, when I was saved by my mother's parish priest calling for me in the living room (he had come in the kitchen door) while I was in my mother's room tending to her.  I threw the roux off the kitchen stoop into the bushes, put the skillet down on the steps and started over.

Father Paul likes crazy hats.

A proper roux in the making.

Father Paul, after alerting me to the near fire, in his subdued, calm, even-paced manner came back to talk with my mother when I interrupted him to ask, "How do you feel about spiders?"  He unflappingly replied that he did not particularly like them but said that he did not share my grand aversion to them.  I said, "Great, then you are the man for the job!"  And he scooped up the giant spider (two inches across--no lie!) that I had previously blasted with Raid on the bathroom floor.

(I also made a berry cobbler and a pork roast.  Both excellent.)

Father Paul later came back in the kitchen to observe my therapeutic cooking and we swapped gumbo know-how. Father Paul is from Pakistan and is not a completely active participant in South Louisiana cooking.  But he has learned to make chicken gumbo for himself and we compared notes on our favorite roux making techniques.

Black bellied whistling duck
I put a black bellied whistling duck, that my uncle shot in the field yesterday, in my gumbo today.

Gumbo in the water
They are a pretty duck often found in Mexico that actually recycles wood duck's nests in the early summer time in Louisiana swamps and marshes.  My Uncle Beanie says they fly slow and are rather stupid (though I think they are pretty).  He got two with one shot yesterday! I guess that is evidence of flying slow and being stupid.

And I am in the waiting pool for Yale's Physician Associate program. Boola Boola!  Go Bulldogs!

Monday, November 21, 2011

Winter at Effie

Satsumas ripen in late fall and winter in Louisiana

My mother's Satsuma tree, outside her kitchen door, is heavily laden with ripe fruit.  They are sweet and seedless.  I brought in a bowl for the table as a centerpiece for the dining table.

Louisiana Satsumas

I learned today what the extra five pounds on my hips is for.
They are for days like today, when I can't remember if I ate or not and I had to give my mother a shot.

I cooked today to relieve stress.  I made red beans and rice, tomato stew with okra and bacon (the best), and pimiento cheese.  I didn't eat all that;  I just cooked it.  Very therapeutic.

I plan to make a blackberry (dew berry, actually) cobbler today. Don't know yet if I will eat it.

After I cook, I will work on some more PA school supplemental applications.

Red beans and rice with Tabasco

Friday, November 18, 2011

I'm on my way to Avoyelles Parish

I am headed to Alexandria, LA tomorrow (have a one way ticket) to be with my mother as she heads into her last time with us.
Effie, Louisiana in central Louisiana
This will be a difficult time certainly (especially since my father is an invalid and not able to participate).

However, I am looking forward to helping my mother with her "bucket list," which she is currently on page two of listing her things to do.

I am also anticipating many visits and calls from family and friends who want to see her and share their love for her.  This will be good.

Avoyelles Parish Louisiana
My mother has always been an Avoyelles Parish girl,   steeped in the rich, French culture of Louisiana's past.  She grew up along the Red River in Vick, Louisiana and after enduring thirty plus years of hard winters in NYC and other parts of the Northeast, she happily retired to her family home in Effie, Louisiana where she resides now.

So I am exiting life in Buffalo, for the moment, and entering life with her in Avoyelles.  Not sure exactly what is in front of us, but I will engage it to the best of my ability.

Wednesday, November 16, 2011

Impending loss

Preparing for my mother's death, has evoked thoughts about who she was as a young person and who she has become and how she arrived there.

(My mother was diagnosed in January with a cholangeocarcinoma that has proven to be unresponsive to chemotherapy and radioactive micropellets.  She is in hospice care now beyond treatment options and has just been advised to prepare for her last weeks.)
A bed similar to my mother's.

Sitting on my mother's antebellum family heirloom bed in her childhood bedroom, a teenager, visiting my grandmother's house at Christmas time, I guiltily read her diary from high school and LSU years while listening for footsteps in the hallway.  I recall the smell of the leather diary, yellow-brown pages, faded blue fountain pen ink as dry and sweet.  The diary smelled like another time.  A time I never knew but was hungry to understand and picture.

The antique furniture and lace curtains of my mother's childhood room are no longer there because thieves broke into the home several years ago with a truck and emptied the house of rooms full of antique furniture, silver and family heirlooms.

My mother is there now in that very room--now austere, curtainless, no headboard, no ornaments.  She likes it that way--it is her style.  (The robbery never seemed to anger her as it did me.)  Where is the young lady from Effie, Louisiana who attended LSU medical school on a Betty Crocker scholarship? 

How does the quaint vision of my Mom at LSU in the 1950s, wearing heels and dresses at football games, photographed astride her bicycle in The Gumbo (LSU yearbook) as part of LSU's promotion of biking on campus, connect with who she is today?  

I remember a lamp, much like this one but larger, on my mother's bedside table (all lost in robbery)

I am thinking about how as a PA, I may interact with patients and families going through what I am experiencing now and how one connects clinical care with compassionate care and makes those one in the same.

I know that I do not want to be the kind of clinician who does not return phone calls and who delivers bad news abruptly and coldly.