JCrew sales finds

worth it?

Be Done With It!

Next Fall, I'm going to be a crazed fool. I've never taken more than 6 credits while still working, I have no choice but to take 9 credits in Fall while attempting to hold onto my job. The main class is Adult Medicine which is 6 credits, there is a seminar attached to that which is 3 credits, and in addition to that there is the 'lab' which is the 15 hours per clinical that I'm required to do for which I get zero credits.

Dear God!!!

SF eats

Restaurant list for SF so far, interesting enough to look into further:

Absinthe--Hayes Valley
Belden Place--lots of restaurants
Chow--Castro, cheap eats!!
Delfna--Mission, Italian

This is What I'm Talking About

Clete's weekend in summary:

Got into treat drawer, he and his compatriot destroyed the bag and ate until their hearts desire.

Solution: Treats are now in plastic container with screw on lid.

Dragged my bathrobe from our bedroom into the living room

Solution: Hung it up in bathroom which is where it normally lives.

Got into treat drawer, was foiled by earlier solution.

Here's the evidence that he can open it....

Zocalo

Tried a new Mexican restaurant last night: http://www.zocaloarlington.com/home.htm

It was good, it seemed more authentic than most places. Read: Don't go here if you're looking for cheese and sour cream laden entree and peach flavored margaritas. In fact, they don't have ANY margaritas because the town only allows beer and wine licenses.

It was good, although M's dish tasted like it had nutmeg in it which gives him some GI issues, so he had a stomach ache the rest of the night.

Menu
Guacamole en Molcajete
Freshly prepared traditional guacamole dip with corn tortillas.$8.50
Carnitas (M)
Slow coocked shredded pork with herbs & spices topped with pickled onions.$10.95
Gambas al Ajillo
Sauteed shrimps in garlic, pico de gallo & ajilo sauce.$9.95

Eco-Stim

Recent purchases:

We are paying the mortgage at this point..

Boigie had his bimonthly trip to the vet yesterday to see if the adjustments in his insulin level are working, this time it was too much! Poor BBC needed an IV to give him dextrose because his blood sugar dipped very low mid way through the day. He came home with a very cute little bandage and a shaved leg. He now looks like he's wearing one mitten or an Ugg boot.



He gave us really no signs that he was hypoglycemic the night prior to, but of course, hind sight is 20/20. We did notice two things but didn't really think anything of it because they were exaggerations of his normal behavior. He seemed slightly more lethargic in the evening and then began meowing for food at 1am instead of 3am. That was it though. The vet said that even as his blood sugar was low he was acting normally for them too and apparently exhibited quite an appetite!



So now, we are holding insulin because his fructoasmine level which is the average of his blood sugars over the past week was also low. There is a slight chance that with the diet switch and the loss of some poundage, our young Boigleston's pancreas has started making it's own insulin again and we won't need to provide it for him. We are holding on the insuling for two weeks, he'll go back and have another fructosamine level drawn and we'll go from there.

Bottomed Out on the Top Down

Ah...The joy and frustrations of knitting a sweater from the top down. The sweet: you can try it on several times throughout it's creation by putting it on salvage yarn and trying it on. The bitter: You work on it for weeks and it's hitting your hips and you realize there is some funky thing going on with your decreases. You try to look past and keep on working but then you finally can't because you can envision it lying lonely and abandoned on a shelf like countless other sweaters. I decide, with a heavy heart, to frog 90% of it, basically to the point were I had divided for the sleeves. I think the problem was that I tried to decrease for the waist too drastically and it was bunching. I'm now working the decreases again but only every fourth row and I just tried it on again, thank god no weird bunching.

I finished the Tangled Yoke Cardigan oh....last summer and noticed that the buttonholes were a bit too big, I would button it and the buttons would slip right back through. I finally reinforced the button holes with some thread and they finally stay buttoned. I think that's one of my better pieces, although there seems to be some unevenness toward some of the top buttons, too much on side and it bunches when it's button. My solution, go for the casual look and don't button it.

In spring related news, we have a teeny tiny white flower in our front 'yard'. It looks like a cross between a lily and a tulip...also we have some bushes that flower and they are starting to poke through. I'm really awful with plant names so I can't tell you what they are, hey, I'm just glad that I noticed. Usually I'm sadly oblivious to things like that, guess I'm really yearning for Spring!

I'm continuing to do research on hotels for our Cali trip, currently working on the San Fran leg. We got a tip on a decent hotel from a friend but it doesn't have AC! How does a hotel in California exist without AC? I was wondering how it could be so incredibly cheap and I finally figured it out....I don't think we're wiling to take that gamble so the search continues. If anyone knows of a nice, clean, close to things hotel that won't break the bank, leave me a comment!

This and That

Friday M's band played at the art gallery mentioned in the previous post with two other bands they frequently play with. It was a fun night, although driving that distance in unfamiliar territory is somethign I could have done without. Even with my GPS, I still manage to take wrong turns. I ended up getting there as they were about to go on, luckily I made it in time. I was thinking back to those high school kids that were there and how young they looked and then I dared to wonder how old they would even think I was....were they looking around thinking how much older everyone else was than them? Yikes...don't go there....

Saturday afternoon I did some shopping because I had a 30% off coupon for Old Navy and the Gap Outlet and found this:

I have no idea what possessed me to buy a sweater with a bird on it....totally unlike me. It's far too whimsical. Actually, I blame it on the art gallery show and seeing those kids, nay, children there. It made me yearn for my youthful self...so what do you do with that? You buy a sweater with a bird on it.

Saturday night, we met some friends out for bbq....he apparently won a gift certificate somehow but has the unfortunate circumstance of being a vegetarian so he invited his carnivorous friends. It was good, but bbq is not something I would ever suggest going out for. I think I'm too much of a spice wimp. I had the buffalo shrimp which was good but waaay more spicy than I would normally order. After that, we headed out to hear our band friends play another show.

Sunday I went to the gym and was hopped up on a combination of adrenaline and caffeine and decided to clean off our back deck to put up our new wrought iron cheapo outside table and chairs. Clearly, we hadn't been out there for awhile. Coolers from the party we had last September were still out there. This weekend, for the first time in a long time, I baked. I haven't really been able to rally on that front since Christmas because I baked my brains out for three full days. But, alas, a rotting banana begs to be made into a tasty bread so there you have it. It turned out well, the last recipe I used had an odd baking soda taste, this recipe is much better.

With the rest of my time, I finally took pics of my sluggish knitting progress....For your pleasure.

In school news, I have done the only presentation required of me this semester and did fine. It's always something I dread, but luckily I do well once I'm up there. I am about 3 hours ahead of my required clinical hours at this point which is good because not this week but next, my preceptor will be gone on the day I do my clinical hours. I've decided to revert back to my normal schedule for the week operating under the assumption that I will continue to do some extra time each week and that by the end of the semester I'll have enough hours without making up that day....it will be a pure thrill to leave work at 430p a full two hours before I normally do. I'll be able to go to the gym after work! Not something I would normally be excited about, but now that I can't I of course, long to.

And per request...cat's at play, cat's at rest. Boigie lacks the little white boots....

Snort, Don't Shoot!

Last night, M's band played at an art gallery which was fun. It was a late night which means I got a late start on the day today which is ok...that's what weekends are for. I had a disturbing conversation with one of our nation's youth last night. M's band has played an art gallery show before and since they don't serve alcohol, it's BYOB. Also, because it's an art gallery show, there is no age requirement, hence there were about 4 lads of about 17-18 there grabbing beers from the cases that people brought in. The nurse in me came out and I was worried about how they were getting home...and I'm not sure alcohol is the only thing they were on.

I managed to cozy my way up to the one that I was the most concerned about...I was assured that he had a ride and that one of the kids he was with was not drinking. And then I was quickly appalled by the next turn in our conversation. I was trying to be 'cool' and not interrogate the kid so I asked him how old he was and he said he was a senior in high school somewhat sheepishly. I told him that we didn't care how old he was, just that he was not going be driving himself home. I jokingly told him he was going to have a rough day today and he said that he drinks all of the time and he never gets hangovers. I asked him why he drinks that much and he said he's bored. THEN, he pulls out a little baggie with a binder clip on the top and says, I do a lot of coke too. I tried not to react too much, and just said 'do you shoot anything up? if you do, at least don't share the needles'. He told me he drew the line at heroin. Hopefully he does....Yikes!

There is a god...

It's Friday and mercy has been bestowed on my soul.

This weekend is looking like it will be a busy one...

Friday: M's band is playing a show at an art gallery so I'm stopping home to feed the cats and then I'll be heading to the show.

Saturday: Dry cleaning, gym, stop at the Gap Outlet because they sent me a coupon...I'm such a marionette. Dinner with friends at night.

Sunday: Laundry and cleaning. Poor M has not had white socks in several days...we have an agreement in our house...I'm the laundry person, he's the dishes guy. We both hate the other chore so it works out well....except when you're wife is a burned out grad student and can't keep up. I'm lucky that M is so helpful, in truth, he's the dishes, garbage, litter cleaner, and occasional food runner/preparer guy.

Robot Mode

Sorry for the sporadic posting.

I've hit the point in the semester where I feel that I'm on autopilot and start counting the weeks until my life is my own again. I feel like I get up, go to work, get home, eat dinner, chill out for a minute, go to bed repeat.

Anyhoo, presented last night in class, my only one for the semester so I'm glad that's done. The next hurdle will be my instructor coming to see my in clinic, I'm not sure what she does when she's there...if she comes in to see patients with me or what.

Cat update: they're doing well. Not the best of friends quite yet, but they are playing with each other somewhat, but inevitably, one gets annoyed at the other and smacks him in the head and one walks away.

Trip planning: I am in the middle of looking up hotels in San Fran. I asked one of my friends who used to live there about the best places to stay in terms of neighborhoods. She steered me away from the super touristy areas and into either the Castro or Mission neighborhoods but I'm having problems finding a selection of hotels in those areas, and hence, reviews. And tripadvisor.com is my friend...Also, SF isn't the bulk of the trip so I will want to do more of the touristy things than exploring eccentric neighborhoods so I'm leaning towards staying in Union Square of the Financial District because it seems that's where most of the attractions are.

Real estate: M and I went to 6 open houses last week in a town about 20 miles from where we are now because it's the closest affordable town to our current jobs. Out of the 6, we liked one and luckily we both agreed. Not that we are even quasi serious at this point. We have too many things going on...the overall economic strife, me being in school, the housing market still tanking, still saving up for a nice downpayment. But at least we agree at this point what we are looking for and the price range we want to be in. Incidentally, two of the houses have an offer pending..one I saw online and one via a phone call I got from the real estate agent who is soliciting offers for the house based on the sign up sheet. He left me a message saying that he got an offer and just wanted to give everyone at the open house a fair shot...me thinks there either is nothing cooking with this property or they did get an offer and it was totally low ball.....needless to say we didn't call him back. It was one of our least favorite houses.

Busy busy busy

In short, until I can expand, the week in review:

Cats are integrated, no more hissing

Presentation due for class today

Open houses this past weekend

Sick this past weekend

Need to finish planning San Fran trip

Us Vs. Them

For the complete background on the NP role (as seen through the MD lens) read the following:



http://www.acponline.org/advocacy/where_we_stand/policy/np_pc.pdf



This is a position paper by the American College of Physicians on the Use of Nurse Practitioners. Embedded within are all of the insecurities that ACP has about NPs 'encroaching' on physicians work. They repeatedly state that MDs have more extensive training (I don't think anyone in the NP world argues this point, but the MD side constantly states this) and that NPs should not be seen as a way to replace physicians.



I see this as a lot of double talk. The article acknowledges that very few med students go into primary care which is how the NP role sprang to life, along with PA's in the 1960's. It goes on to say that NPs provide an invaluable service in rural areas and areas where medical needs exceed demand. Then it also says that the NPs shouldn't be replacing physicians and that they should merely be an adjunct to the MD. They also seem to say about a dozen times, that NPs should not practice beyond their scope, but then they also go on to say that NPs can meet 60-90% of needs in primary care so it would seem that they are acknowledging that primary care is within the scope of the NP's practice, right after they fretted about NPs practicing beyond their scope.

They state how patients that have NPs may have better outcomes than when they see the MD, but then go on to poke holes in the study that found this to be true. They state that NPs are nursing and MDs are medicine and that they are practicing two different arts and that certification exams should be drawn from each background, but yet state that they are not opposed to a NP centered health care team in addition to the physician centered one but that the NP team must be held to the same standards as the MD centered team although they are quick to say in other parts of the paper that NPs and MDs are different animals. If they are truly so different, why should the same standards be used to measure the success of the NP led team?



As early as 2012, the DNP certifying exam could be a close relative of the US Medical Licensing Exam, which could show the MDs that NPs can also pass the exam. Needless to say the AMA and ACP both do not want NPs sitting for the MD medicail licensing exam since some MDs have long held the belief that once NPs take the same certifying exams that MDs take, they will be treated as true colleagues. With this possibility approaching, the AMA and the ACP have put out position statements saying that nurses should not be taking a medical licensing exam, they should be taking a nursing licensing exam. One could theorize that the AMA and ACP are afraid of the success rate of NPs taking a medical licensing exam so they oppose the use of 'their' test.



All of these leads me to believe they are running scared and noticing that Medicaid is recognizing the NP as a primary care provider (there is a new bill now which would require Medicaid to reimburse NPs and PAs at the full rate instead of at 85% of the MD rate), more and more retail clinics are opening up, and most primary care offices employ NPs. Now there is a possibility that NPs will be able to sit for a similar exam to the medical licensing exam.



With position statements like these, it's hard for me to not take on an us vs. them mentality, statements like these put people on the defense...or at least it puts me on the defense.

Throw Caution to the Wind

I am not spontaneous...this is something I have always known about myself, I thrive on stability and routine. I increased my level of spontaneity by booking a vacation. Wait, you're saying to yourself, how is booking a vacation spontaneous? You're planning months ahead of time for something. Well, dear one, it's spontaneous for me because I am not giving a thought to the money we're spending, the time I'll be off work, or the school work that will be piling up while we're away. Perhaps spontaneous isn't the right word, but it feels deliciously reckless!



We're going to fly into San Francisco and spend a few days there either at the beginning or end of our trip. The rest of the time, we want to spend traveling to places like Monterey and Carmel seeing the sights and not having much of an agenda at all.



I can't tell you how much I'm looking forward to this! I really feel like we haven't been on a real vacation together. Sure, we went to Chatham for our honeymoon which was a great relaxing get away but it didn't feel like a real vacation. The other places we have gone together have been centered around my work and were places that I've been to before. M's been to San Francisco briefly for work but didn't get a chance to sight see, neither of us have been down the coast.



110 days!

Kitty Clete!

Our new kitty Clete has arrived today! Unfortunately, I was at work when he arrived but M was here to get the skip on his very interesting diet ( more about that later) and his other specifics. Apparently there was some growling from Clete's side of the door when Boigie would scratch looking for M, the same thing happened when I was home with Clete and Boigie at night.

I tried to spread my time evenly between the two because Clete is being confined to M's music room so that he's not overwhelmed with the new space AND with a large and in charge cat the likes of Boigie.

Clete is very friendly and social and was instantly purring and flopping over and letting me pet home. I was sitting on the floor and he was basically doing little lap circles around me on the floor. Interestingly, after I would leave Boigie didn't really smell me like I thought he would. I do believe that pretty much the entire night Boigie has faced M's room trying to bore holes through the door with his eyes from a variety of vantage points around the house, always with a rug underneath to cushion his bootie.

Tomorrow we hope to go to Phase II of Cat Integration....using....a pieced together Baby Gate from Clete's previous owner. The thought is that they can see each other now without actually touching each other to get all of the growling out of the way. This will make way for Phase III of Cat Integration...Mingling, Kitty Style.