cat palace

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Got Nukat an over-the-top cat palace and finally put it together today. It is massive and heavy and much taller than I anticipated… How much do you want to bet that she ignores it completely and plays in the box?

making time

It’s the month of setting new goals and resolution. I find that when we’re talking about  resolutions, people tend to talk in terms of things they want to add to their lives. I want to work out. I want to read more. I want to write/draw/paint/spend more time with friends. Etc.

Often, these resolutions don’t stick. There are hundreds of articles circulating the internet about why. About how to set goals. About specificity and actionability. But one thing that I think we need to spend more time thinking about is this: what are you going to give up to reach that goal?

Given that you are a living person (an assumption, but a relatively safe one, I think), you are already using up all the time that you have in each day. That’s not to say that you’re using it wisely or productively, but it is, most definitely, being used, simply because you are traveling forward through time (another assumption, but again…). So it’s all well and good to want to add to your life or pick up a new hobby or do more more more, but unless you’ve got a time-turner or can somehow freeze time, something has to give way.

For me, it’s useful to frame it this way because I want to be more mindful about what I’m doing with my time. There are things that I do way too much of (read Twitter, watch Netflix, the internets) because they are easy or habitual or I just need that sweet, sweet dopamine kick. But there are also many things that I would rather be doing, that I feel badly about not doing. I imagine that this is a nearly universal feeling.

So in addition to identifying the things we’d like to do more, we should deliberately figure out what we are willing to give up. Identifying the things that you want to cut down on this year will also give you a series of cues to check in with yourself.

Once you have a list of the things that you’d like to do less of, the next step is finding the time. That requires being honest about how you currently spend your time. And we all have a tendency to fudge the numbers. Some of the things we do are mandatory and regular (e.g. jobs, childcare), and that amount of the time varies from person to person. And some things are mandatory, but not fixed (e.g. self-care). But when you take a good, truthful, granular look at how you spend your time, you can usually find a hour (or five) here and there that isn’t being used the way you like.

That’s the place to start. What are you doing with those minutes or hours? Is that what you want to be doing? What else could you be doing with that time that would prioritize your goals and well-being?

And sometimes, maybe the answer is watch TV/movies, veg out, and otherwise give your brain a break. That’s totally fine too. I have plenty of those moments. But if I’m watching Netflix, I want it to be because I chose to watch Netflix, not because I fell into a bad habit loop. I don’t want to have those behaviors be thoughtless and automatic.

Tim Urban (Wait But Why) did the calculus: we have roughly 100 ten minute blocks in each day (assuming you sleep 7-8 hours a night). How do you want to spend each of those finite blocks?

all of the histamine

I have an appointment to establish care with an allergist today. The plan is to get allergy testing done and then re-initiate allergy shots. I had a truncated course of shots back during medical school when it became impossible to mesh the schedule of the shots (weekly and then monthly) with the schedule of clerkships (all over the fucking place, changing from week to week). I think I had maybe a two year stretch of them? Optimistically, three at the most. The usual course is five years, I think.

So I want to start getting them again because they did make my allergic rhinitis symptoms so much better. It’s a self-imposed problem, of course. I’m somewhat allergic to cats, but I’ve always had cats. And I anticipate that I will keep having cats in the house. I’m also allergic to dogs, and everyone I care about in my life right now has dogs. So… Yeah…

In any event, in anticipation of the appointment and allergy testing today, I’ve been off cetirizine (Zyrtec) for five days now. And IT. HAS. BEEN. FUCKING. MISERABLE. My original allergist in Dallas advised me to take it daily, not so much for allergies, but for my dermatographia (aka skin writing). Basically, minor trauma/pressure (i.e. scratching, poking, nudging OR hell, too much heat or too much cold) to my skin causes a histamine response, leading to hives along the trauma. It’s called skin writing because you can literally write out words and my histamine response will follow.

This is not my skin. From Healthline.com.

Not only does it lead to unsightly welts, EVERYTHING IS FUCKING ITCHY. It’s torture. I’d rather be in pain than be itchy like this. I try to refrain from scratching–it only makes it worse seeing as the scratching causes more hives causes more itching causes more…–but there’s only so much a person can take before the claws come out. There is a small line of petechiae (from broken capillaries) along my right inner arm from a self-attack in my sleep last night.

I can’t fucking wait to be back on Zyrtec. Being off of it has left me irritated (literally and figuratively), grumpy, sleep-deprived, distracted, and, of course, itchy. Medicine is the goddamn best–I will fight you.


Edit @ 2:41p

I ended up having a blood test done instead of skin testing. The allergist tested my dermatographia, took one look at the response, and was like “yeah, that’s going to be too hard to interpret.” I said that I didn’t care how the allergy testing got done as long as it was done today, so she sent me to the lab. She mentioned that you didn’t need to be off Zyrtec for the blood test.

WISH SOMEONE HAD TOLD ME THAT WHEN I MADE THE APPOINTMENT.

I totally would have opted for the blood test straight off the bat and avoided the last five miserable days. But I suppose this is something that the appointment schedulers aren’t trained in.

ow, my legs

This year, I’m trying to work on prioritizing my health and fitness. I have a tendency to let exercise be the first thing to go when I get a little stressed, or when my routine/framework/structure gets stressed (i.e. travel). Prior to the Europe trip last year, I was pretty good about consistently exercising, but as soon as we went on a trip, everything fell apart and I could never quite get back on the bandwagon.

My cardiovascular fitness is terrible. Just, pretty terrible.

I’m planning to jump back into a full routine starting next week. As part of that, Adam and I are going to do a couple of workouts together (for accountability reasons and because otherwise I will be highly unlikely to drag my ass to a group exercise class), and we decided to try Orangetheory because Sam absolutely loves it and recommended it to us.

We went to our first class on Sunday, and my legs are still dying from it. So that’s… good? The HIIT involved treadmill stuff, and I hate treadmills. So, so much. Mostly because I hate running. Mostly because my cardiovascular fitness is terrible. It’s all just a full, slow, wheezy, intermittently nauseous circle. But in theory, the slowness and wheeziness and nausea will get better with practice. (Right?) And then maybe I will hate treadmills less.

Either way, we’re doing it. (Time to find more supportive sports bras…)

2019: looking forward

Resolutions, goals. Goals, resolutions. Who knows.

I went back and re-read my resolutions from last year, and they still generally apply. I think I’ve done a pretty good job with my mindset this year, but there’s still always more work to be done. Most of my systems started degrading and falling apart after the Europe trip, and it was hard to get things back on the rails totally. Which makes sense, but I want to figure out how to make my own systems and structures more robust and much less fragile.

But resolutions are different from goals.

I think of goals as discrete tasks that can be accomplished. I think setting goals is almost more difficult than making resolutions (though the difficulty of execution may be flipped there) because it’s very easy to fall into a trap of working towards something that isn’t actually helpful.

For example, word count. It’s important to recognize that a word count and a complete, coherent work are two different things. Fulfilling a word count doesn’t necessarily mean that you’ve completed a story. Which isn’t to say that word counts aren’t helpful — they very much can be if you are using them to measure what they should measure. But I think that there has to be a clarity there that is often missing when I talk to other people about their goals and when I’m thinking about my own.

My plan this year is to have three month goals, revisit and re-evaluate, and then refocus periodically throughout 2019. Most of the three month goals are project related goals. Originally, I had come up with some deadlines for certain things, but then I realized that most of those were completely arbitrarily decided. I don’t have enough context for how I work and what this whole writing process is to set reasonable timeline goals.

Continue reading

spider-man

Last night, I saw Spider-Man: Into the Spider-Verse, and it might be the best movie I’ve seen in… I don’t even know how long. Ages. It is now one of my favorite superhero movies, and might be the best Spider-man movie (as much as I love Tom Holland’s Peter Parker — sorry, Tom). It was non-stop entertaining all the way through but also substantive. Seriously, it’s just so, so good. And it’s also GORGEOUS.

There are many more things that I could say about how amazing it is, but really, you should just go see it.

Here’s the trailer, if you haven’t checked it out yet:

hey docs, the ama is selling your info

My brief blurb about digital age privacy reminded me of something that I discovered recently.

Anyone who has gone through medical training to obtain an MD or a DO has had the experience of receiving an absurd amount of spam related to the medical field. You’ve probably received, something like once a month, a mailer from the AMA (American Medical Association) asking you to renew your AMA membership, even if you aren’t a member of the AMA.

I get these, and they annoy the fuck out of me. It’s bad enough that it’s real life spam delivered to my door and shoved into my house, but don’t try to trick me into “renewing” a membership I never had in the first place. They mostly just fill my recycling bin, and I have to go through the trouble of shredding stuff with sensitive info on it. Fucking mailers.

Finally, I decided to look into how to stop getting these things.

It turns out, if you go through an accredited medical training institution, i.e. to get your MD or DO, your information is placed into a file with the AMA, into a database called the Physician Masterfile. This record includes lots of demographic and biographical information, like oh, training institutions, licensing stuff, etc. It also includes stuff like your home address.

The best bit is that this information is shared with third parties as a default — you have to contact the AMA (in a somewhat difficult to find and convoluted way) in order to opt out and protect your private information.

From the AMA website:

“The types of licensing organizations that use the AMA Physician Masterfile database include hospitals, medical schools, pharmaceutical companies, medical equipment and supply companies, consultants, market researchers, insurance companies, commercial organizations, medical publishers, CME providers, physician recruiters and investment firms and other entities.”

These companies aren’t necessarily vetted, as far as I can tell. That’s also why you can get mailings for scammy medical school loan forgiveness bullshit. I imagine that’s part of what’s covered by “other entities.”

So, if as a medical trainee (or ex-medical trainee), you’ve ever been confused as to why you’re suddenly getting random pharmaceutical companies contacting you, or various institutions trying to sell you CME credits, well. Now you know how they are finding you.

Here’s some more info, if this is relevant to you or if you’re curious, with some links to the “no contact” form and some instructions on how to restrict access to your data. I had them put a “no contact” restriction on my file by contacting them through a “contact us” form on the site, so that’s also an option apparently.

WTF, AMA.

new phone, who dis

I got a new phone! It’s a Pixel 3. I’m finally retiring my good old Nexus 5x to the fields of factory reset and minimal trade in value.

So far, it’s pretty nice. Very slick interface, highly responsive gesture navigation, amazing camera. It also really, really, really, really, really wants me to use Google assistant and let it “learn my voice” and whatnot. Which… no? Thanks?

Not that I really have any illusions about the digital age whatsoever — I know all my info has been sold to the a bidder, probably not even the highest one. And likely both Google and Amazon already have plenty of voice recordings of me, even though they both say they aren’t storing them. But lots of people say lots of things.

It’s mostly that I just don’t really see myself actually using the voice assistant whatever thing. Like, I’m not usually trying to text or look things up while I’m also doing something that I literally can’t put down for two seconds. So it just seems unnecessary to me. Maybe it won’t be and I’ll change my tune a few weeks down the line, but until then…

Here’s the other kind of funny thing. I’ve been trying to stay off my phone for most of the day, trying to be less tethered to it. I’m working on recognizing that when it notifies me of something, it’s usually not urgent and doesn’t require me to drop what I’m doing to respond. I still have a tendency to carry it around though and just look at it sometimes when I’m at a loss for what to do. Which is a habit I’m still in the process of breaking.

But since I got the new phone and I haven’t gotten my case for it yet, I’ve been leaving it safely in my office for fear of dropping this expensive, shiny piece of hardware. I always get a case and a screen protector because I drop my phone at least once a week, probably more (my Nexus 5X + case tolerated this with great aplomb) so I don’t want to risk it. Which means that I’m not carrying it around.

Which makes me wonder if I should cancel my order for a phone case…