So, the baby’s starting to be a bit more fun since he smiles back now. I’m still looking forward to him being able to, you know, sit and hold his own head up against gravity, so that I can take something other than recumbent baby photos.
Presenting Avery Aegolius Ming-Jeh Logan.
Born 11/13/09 at 2225, weighing 7 lbs 11oz, measuring 54cm.
Our little guy sure didn’t make it easy on his mommy…
He’s in the NICU for sepsis rule out, only because Natalie had a little fever during the end of her 20 hours of labor leading up to the decision to proceed with a cesarean section. He’s fine. Perfect, in fact.
Mom and baby are doing well.
I’ve been accused of playing favorites with my nieces, since I’ve posted several pictures of Kailyn, the older of the two, but none of the younger one, Colleen. No favorites… just no time.
H1N1 hysteria is starting to affect daily procedures in the hospital. As you’ll appreciate below, although it was our patients who used to be in the bubbles, it is now the doctors who must walk around in a virtual contained atmosphere free of contamination from icky patients.
Here, Dr. Sulggi Lee models the new precautions we must employ for patients in respiratory isolation (ie, anyone in the hospital who so much as sniffles, coughs, or clears their throat in a conspicuous manner).
Be sure you are properly equipped when your chance to face down certain death from H1N1 comes:
3 masks, at least one of which must be a properly fit-tested N95
2 face shields
gown
gloves
booties
condoms (where appropriate)
cover any remaining exposed skin with ioban
(Rest assured that although Dr. Lee ran out of ioban here, she took a chemical shower after seeing the patient.)
Remember: Don’t Panic!
Generally, one would expect 3 years of internal medicine residency training to more than adequately prepare you to pass the American Board of Internal Medicine (ABIM) certification exam. Since everyone has to spend at least three years in post-graduate training before being eligible to sit for the ABIM exam, a funny thing happens if you ’short-track’ through medicine residency (ie, train in medicine for 2 years instead of 3) and end up spending a year in fellowship thinking about almost nothing related to general internal medicine for a full year before you’re allowed to take the exam: You forget a lot of things! Regardless of whether you short-track or go the long way, I suspect most people don’t have a lot of time to dedicate to studying for the boards. I’m no different, so I’m hoping my past year as a hematology fellow will help me in some regards. Here’s my strategy for the ABIM exam:
Infectious disease - Everyone can be treated with a fourth generation cephalosporin or carbapenem, right?
Neurology - Headache? Intrathecal methotrexate ought to take care of that.
Cardiovascular - We don’t deal with much cardiology in hematology, but since I was trained at Stanford, anyone with chest pain has takotsubo until proven otherwise.
Pulmonary and critical care - Is “Initiate goals of care discussion” an option?
Nephrology - Acute renal failure? If any of the answers involve $18K worth of rasburicase and giving you enough IV fluid to drown a Guatemalan polo player, I’m all over it.
GI - The gut is a black box (er, tube) from which blood sometimes emerges in various forms. “Check platelet count and coags (and for good measure, a complete iron panel) and then call a gastroenterologist,” better be an answer.
Rheumatology - I’m not too worried, since I’m pretty sure answers A-E will be “Predisone.”
Endocrinology - Hemochromatosis causes all endocrine abnormalities in my world. Hope phlebotomy is an option on the test.
General internal medicine - I could really be in trouble here if “Refer to primary care for diabetes and hypertension management” isn’t an option.
Heme-Onc - Been there, done that. (Well, half of it, anyways.)
Yeah. Everything is going to be just fine.
Testing out a new Zenfolio feature: embeddable slideshows.
When I read recently of someone’s disappointment that Wolfram|Alpha couldn’t tell them the average fuel efficiency of the Toyota Prius, I remembered I’ve been collecting this data since purchasing a Prius in January 2008, so I thought I’d share.
I have found that the Prius’s drive computer tends to overestimate fuel efficiency as compared to a calculation of real tank-to-tank MPG, but only slightly. After just over 14,000 miles, the calculated lifetime mean fuel efficiency for my Prius is 43.7 MPG. The lifetime mean currently reported by my Prius’s drive computer is 45.3 MPG, which represents a 3.6% overestimation. Not too bad. (Of note: Toyota advertises the Prius to get 48 MPG (city) and 45 MPG (highway), but as with all vehicles, those numbers come from testing in very controlled circumstances, and are generally a bit optimistic.)
When I was shopping for a new car last year, those familiar with my driving style were astonished when I told them I was considering a Prius. I, too, was worried that its 110 horsepower hybrid engine would leave me wanting more power, but I’ve been very pleasantly surprised. Sure, it would never make sense for me to try to beat, oh, say, a BMW M5 off the line, but I find that for everyday driving, the Prius has plenty of get-up-and-go. In other words, I can still pass all the idiots who insist on driving under the speed limit. And I can do so for less than 1/3 the fuel expenditure of the BMW.
The most amazing thing about the Prius isn’t actually the hybrid engine, though it’s still the most efficient drive train on the market right now. The Prius’s secret sauce is the user interface of its drive computer. It turns out real time reporting of your fuel efficiency does wonders for your driving style. You actually learn to drive more efficiently.
I find it somewhat peculiar that there’s so much volatility in the Prius’s tank-to-tank fuel efficiency, but I suspect that has something to do with my schedule—ie, when I’m very busy or have to be at the hospital earlier than I like to be, I tend to be a less patient driver, and thus degrade the fuel efficiency of my driving characteristics. I also suspect, but will never be able to prove, that the intertank variability was affected by the quality of fuel I purchased each time, which (I’ll also never be able to prove this) is probably less standardized than we’re led to believe.
All that being said, I am extremely pleased with the fuel efficiency of my Prius. Compared to my prior vehicle, I’ve saved about $700 in the past 12 months on fuel expenses. To be honest, though, that’s a somewhat difficult number to estimate given the fact that fuel prices have varied over 200% in the past 12 months. Had gas prices remained in the stratosphere, as they were just last summer, my savings would certainly be a bit higher.
If I had time, I could go on and on about how much I love the Prius, but suffice it to say it’s one of the best things I’ve ever spent money on. If you found this because you’re thinking about buying a Prius, stop thinking and just buy it. You won’t regret it.
“It was a somewhat frightening scene to see hard ice growlers the size of houses being tossed about like confetti in massive swells driven by gale force winds,” reported Captain Paul Watson. “I had to thread the ship between those bucking chunks of lethal ice knowing that if just one of them was tossed against our hull, we would be holed and sunk very quickly. I was not completely confident that we would make it, a thought that I did not share with the crew at the time.”
(Source)
Our friend, Eric, is on that boat.
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