Displaced Dog Blog

Gus is a little miffed with me today. Somehow, while I was at the office yesterday, he managed to find out that I posted the pic of Steven Seagal instead of the Wednesday pic of him. While Gus doesn't actually like getting his picture taken, he enjoys being the celebrity around here. He is really mad because I cut his toenails this weekend, too. So, in order to make peace with the king of the house, I told him I would post his dog blog today. Hopefully, this will keep me safe from the evil eye, the looks of recrimination, and the feelings of guilt. You've never experienced this until you've experienced it from a spoiled Dachshund. :-)

Wednesday Steven Seagal Blog

I, Elizabeth Green, have actually spotted a celebrity here in Memphis. You never know who you'll see on Beale Street on a weeknight. Some of my friends from our Tempe, AZ office were in town last night, so we went down to Beale to show them Memphis night life. We wandered into B. B. King's Club, and guess what? Steven Seagal was sitting on the balcony. He lives here. (Honestly, I have never watched one of his movies. They seem to be the kind that involve a lot of grunting and sound effect noises & no real plot) He was very cordial when he left and stopped to get pictures taken with fans and to talk to them. My friend from Tempe actually got her picture taken with him. He looks different in person. He doesn't have that olive skin and brown eyes. He actually has a ruddy complexion and blue eyes. I did get a quick profile shot of him as he left. That bald dude was pissing me off because he kept stepping in front of him & I couldn't get a great shot.

Wednesday Dog Blog

According to Gus, the best way to beat the heat is to lie in his mom's bed under the ceiling fan all day, turn some soft music on her TV, and snooze until the sun goes down.

This is him on one of our recent triple digit heat days.

Remembering Steve Irwin

1962-2006

Today is the first anniversary of the death of Crocodile Hunter Steve Irwin. Australia plans to remember him with public ceremonies. I thought it might be nice to offer those who enjoyed watching him a chance to share some of their thoughts about him here.

I enjoyed watching The Crocodile Hunter because of the vast amount of knowledge I gained from it. I was always afraid of snakes and lizards until I started watching the show and seeing him talk about them as you would about other animals. Other reasons why I liked the show and Steve Irwin:

• his enthusiasm for his work and for nature
  
• learning new things about animals that I'm familiar with
• learning about new animals I'd never heard of
• watching him climb trees (too funny)
• his love for animals
• seeing him talk to animals as if they were people
  

Feel free to share your thoughts/memories in the comments.

Eating Healthy & Cooking

No I am not becoming the food police!

I was diagnosed with Fibromyalgia in the Spring. Since then, I have been trying to work on dealing with the other things going on in my life so that I could really focus on getting off my extra pounds. My doctor was adamant about keeping within my normal weight range, exercising, getting enough sleep, and eating a nutritious diet. It's all stuff you regularly hear and the doctor's office. Who really cares if they have a 10 or 20 pound range of play surrounding their ideal weight besides the doctor? You're supposed have more fluctuations after you start college and a career, right?

Well, apparently, health care professionals know more about the risks of that extra weight now than they did back in the 80's when I was in college, and they know it definitely matters. So, I have finally made it to a point in life where I can make taking this extra weight off a priority. I am hoping to feel better and, of course, being the vain creature that I am, look better as a result. Last week, I embarked on my quest. I have done Weight Watchers before, so I know that most of my diet has to me made up of fruit & vegetables because they give you a bunch of nutrition and have next to no calories. Then you can spend your daily points on meat, carbs, startchy vegetables, good fat, and dairy. Oddly enough, you really don't starve by doing this. When I was on WW, I had to eat all day long to get my points. It's true that you'll use them pretty fast if you go out for hot wings & fries, but if you eat a sensible diet, you will go to bed full and wake up that way, too. For this reason, I chose to go back on this plan.

I think that following the WW plan is great, but it does require some lead time and, for me, it involves frequent trips to the grocery store in order to get produce while it is at its freshest. On Saturday, I made a delicious chicken cacciatore, and the only things in it that counted against my points allowance were the chicken and the pasta sauce. My mouth is watering just thinking about it.

I made an interesting observation while I was out shopping today. Has anyone else ever noticed how many aisles there are in the grocery store that you can avoid totally when you are trying to shop for nutritious, healthy, and calorie sensible food? Today I noticed that there were at least three aisles that were simply for drinks, most of which contained massive amounts of sugar and corn syrup. Tropicana is now selling a new product, fruit water. One bottle has 60 calories (not that many), but why can't I just slice up a lemon or a lime, squeeze it into my glass of ice water and save the money & the calories? I can, and that's what I did. There are usually two aisles for chips, one aisle with cookies and crackers and similar items, one for snack cakes, one for ice cream, and one for unhealthy types of lunch meat and cheese.

I read in Time magazine a few years ago that Americans, as a culture, are the fattest people in the world and our average weight is higher than it has been in our history. I'm sure it's worse now because of the intervening years. I also live in a city that is regularly voted the unhealthiest city in the nation. Once I saw a little girl in the grocery store. She must have been about 6, and she probably weighed over a hundred pounds. I was looking at her from the back. She turned around, and I saw that she was holding a box of snack cakes, a bag of chips, and some sort of crappy looking kids' drink. I saw her put them in the cart with her mother's other purchases--lots of hot dogs, bologna, frozen dinners & entrees, chips, etc. If parents are eating like this, what hope to kids ever have of not starting out unhealthy?

My theory about this American weight problem is simple--as our lives in modern America become more and more hectic, we want more and more convenience, so why should a busy mom bake a lasagna from scratch when she can buy a frozen one at the store and just throw it in the oven? And when would she find time to chop fruit and veggies so her kids could have healthy snacks available after school. Of course, she couldn't trust them to use the microwave when she isn't there, so that rules out some low fat microwave popcorn. Besides, the kids want to slather the stuff with butter, anyway, and they'd just make a big mess doing that, so chips or cookies are the best option.

I am not trying to be overly negative here because I know most people are trying to do the best they can. I have a busy life, too, and I am thankful some days that I am not dragging kids down into my unhealthy habits with me. I like junk food as well as the next person. Maybe the difference is that I realize how bad it is for me, and I want to mend my ways?

I have thought a great deal about this matter as I have been struggling with keeping a healthy weight for quite a while. I've decided that the best way to do it is to buy as many fresh things as possible. When I was in Europe I noticed that the food there went bad more quickly than it does here. This bugged me because I thought their food tasted so much better than ours. When I read the labels, I noticed that they don't put in nearly as many preservatives and other additives as we do. I wonder if some of those ingredients are indirectly responsible for weight gain or, at least, if they inhibit us from losing weight.

When I was staying in London, there was a fruit stand on the corner close to my flat. I was a regular customer. Every morning I went and bought fresh fruit from the "fruit man" as we called him. Then I went across the street to the bakery and got some fresh bread. I would go home and eat them and drink some breakfast milk (a milk which has a little cream left to give you an extra portion of protein in the morning) and a cup of tea. The breakfast milk might sound like a bad thing, and I thought that originally (I bought it because I was looking for a small container of milk). However, it's actually a pretty good idea. I left my flat every morning, took the tube to the part of London I wanted to see, and then walked around the area to see sites, shop, etc. The breakfast milk actually did make me feel more full, and I was easily able to refrain from snacking until my lunch. Also, I had time to work off the calories from that extra cream.

These days, I generally try to buy as much fresh produce and as many fresh products as possible. For one thing, it makes everything taste better. It also helps you to avoid extra calories, salt, and chemicals in your diet that may lead to weight gain, bloating, etc. Most prepared foods have enough added salt to boggle the mind. The more control I have over my food preparation, the more I know exactly what I'm eating. This method does, however, require more lead time. So, I have worked out a plan for this. I spend some time on a weekend day or time when I am cooking getting things ready for the week.

For example, it can be overwhelming to me tomake a salad on a busy day, I keep chopped vegetables and bagged lettuce in the refrigerator, and salad becomes an easy, quick addition to a meal or a meal itself. I also boil or bake chicken breasts on the weekend, season them, shred them, and put them in a container in the refrigerator so they'll be ready to put in salads, stuff inside a fat free pita with some veggies and fat free salad dressing, or to use for chicken salad. For other recipes, I try to chop things ahead of time. While I'm cooking Monday night's dinner, for example, I can be doing prep work for Tuesday. It's also a great idea to keep a pot of homemade vegetarian vegetable soup in the refrigerator. It makes a great addition to a salad for lunch or a healthy snack by itself. One study found that people who start their meals with soup tend to eat about 20% less than those who don't. I think you just have to figure out what works best for your family & your routine. If you don't use pasta or starchy vegetables and you start with fat free broth as a base, this doesn't count against your caloric intake.

Also, I've learned not to beat myself up if I screw up. If it's someone's birthday and they are having cake, I eat some cake. I just eat a small piece (about 1/2 inch by 2 inches), and unless it's really good, I scrape off almost all the icing. I can't drink skim milk, so I drink the 2% and scrimp on something that doesn't bother me, like fat free dressing instead of regular. It works for me.

I think you also can't forget to treat yourself. There are a lot of ways that you can do this with food without involving an excessive amount of calories. I love ice cream and milkshakes, so here is a substitute I have evolved:

Fruit Smoothie Shake

1 cup of fruit or berries
1 cup of milk
1/2 cup of Fat Free Cool Whip
ice

Put the fruit & milk in a blender and hit liquefy until the fruit is thoroughly chopped & the milk turns the color of the fruit. Add the Cool Whip and hit liquefy until the mixture is smooth. Add ice and chop or use ice crush until the mixture is the thickness you want. This would have about 3 WW points, and it tastes great! Plus, it's good for you. Enjoy.

The Plan B "Dilemma"

The new over the counter morning after pill has barely hit the market and is already causing a great debate in our society. Fundamentalists are saying it's a sign of moral decay; pro-life groups are calling it abortion; parents are worried that it will cause their children to engage in sex at an earlier age (illogical because condoms have always been available).

These arguments are age old, and we hear many of the same things in the pro-life/pro-choice debates. I wasn't surprised to hear these things from right wingers and from Fundamentalist pulpits. I was, however, very surprised that it is causing controversy in pharmacies around the nation because many pharmacists do not want to dispense it or even carry it on their inventory.

I have worked in pharmacy for 12 years. During that time, I have done a great deal of work in a high-volume retail setting. We regularly dispensed contraceptive products to women. Prior the the Plan B controversy, there was the Depo-Provera controversy. I knew pharmacists who wouldn't stock or sell Depo-Provera in their stores because they considered it a form of abortion. This was because Depo-Provera causes a fertilized egg to detach from the lining of the uterus and "die". Depo-Provera also has a number of side effects. It can aggravate certain mental illnesses, and it tends to cause massive weight gain.

I was glad to hear that Plan B was approved for consumer use. It is a special dosage of hormones that are commonly used and reasonably safe. Unlike Depo-Provera, Plan B does not act by causing a fertilized egg to detach from the uterine wall; thus, it doesn't result in the "death" of a potential fetus. Plan B simply keeps a fertilized egg from attaching to the uterine wall where it can grow into a fetus. This should squelch the arguments of pro-lifers. Actually, I recently learned that most scientist don't really classify a fertilized egg as a living thing until 14 days after conception.

A few days ago, I heard about a pharmacist at a Kroger in Georgia who refused to dispense Plan B to a 42 year old woman. I have also read that pharmacists working for a particular chain of pharmacies in Washington state were banning together to get their chain to refuse to dispense Plan B. When I hear these things, it makes my blood boil. Not only does it go against my personal belief that the only people who have an opinion in the reproductive choices of a man or woman are that man and woman, it goes against my feelings about the way pharmacy personnel are supposed to behave in relation to patients.

Like a doctor, a pharmacist has a responsibility to do no harm to the patient. A pharmacist is responsible for weighing the risk/benefit profile of a drug for a particular patient and intervening with the prescriber when the risks outweigh the benefits.

The five Rs of pharmacy are

• right patient
  
• right medication
  
• right dosage
  
• right prescriber
  
• right directions
  

These are very important because with some drugs a very small discrepancy in dosage or directions can mean life or death. Pharmacists literally take lives into their hands every day with every prescription processed. This is part of the reason for their high level of monetary compensation. They are being paid for assuming that risk.

The pharmacist also has an additional duty to provide counseling to the patient in terms of the proper usage of the drug and potential harmful side effects, signs of allergies, things that you can't eat or drink when taking the medication, etc. In most cases, pharmacists handle their duties well and have earned their reputation as the most trusted professionals in this country. After a long an arduous six years of school, most pharmacists come into the career world as trained professionals who care about their patients and themselves.

Therefore, I find it very odd that these same people cannot separate their professional lives from their individual moral values. Health care professionals have to maintain professional distance. For example, if you, a pharmacist, and you feel sorry for a patient who doesn't have the money to buy a drug and you pay for it, you will soon be paying for the meds of half the town. There are other ways you can help, and you learn them.

Professional distance is essential in pharmacy practice. I work in hospice, so if you don't have professional distance in that setting, you will end up losing your mind. I still get a lurch in my stomach if I'm working on meds for a child, someone my own age, or someone with a name that is the same as mine or that of one of my friends. If I let it "freak me out", I won't be able to help all the other patients who need me.

I believe the pharmacists who don't want to dispense Plan B should remember their professional distance. If there is no clinical reason why the patient shouldn't use it, a pharmacist has no right to withhold the drug from the patient. I had a discussion once with my former friend, Joe, who is a pharmacist. He didn't want to dispense Plan B for moral reasons.

"Joe," I said, "your professional duty is to dispense it and to counsel about it."

"But I don't think it's right for people to use it, especially young girls."

"What do you consider the right reasons for using it? Is it better to use Plan B, to you, or to get an abortion?"

"Neither," he said.

"BUT," I said, "you don't know why they are buying it. The woman could be a rape victim, an incest victim, too poor to support another child, or there could be a history of genetic disease in her family. You never know what's going on in a patient's personal life if they are not your regular patient."

"There are other methods of birth control," he countered.

"OK, suppose they used a condom and it broke. Weren't they making an attempt to do other things? Maybe the woman was on birth control and had to go on an antibiotic that interferes with it. She many have just wanted to be sure."

"She may just be doing it because she is too lazy to use any other birth control."

I wanted to slap him at that point. "That's HER choice, then, not yours. You dispense the same hormones every day as a different drug. Why are you having a problem with this? You have a daughter. Suppose she got raped, would you want her to use Plan B or have the child? What if she was having sex with her boyfriend and they had an accident? Would you want her to use Plan B or try to raise a child and go to college? Do you really want to be a grandfather at the age of 45?"

"No, but what I am supposed to tell God if I am held to account for this when I'm judged?" (Joe can be revoltingly Fundamentalist at times; he was brainwashed by them when he was young).

"First, you' re not the one using it, so if there is a judgment for that, it is the man and woman who will be held to account for it, not you. No one is making you use it, and you don't get pissy like this when people ask for Sudafed or anything else you keep behind the counter. If you are called to account for it, tell God that you looked to your professional knowledge base and your clinical training because those were the ONLY places you were allowed to look."

I feel this is true not only of Joe but of any other retail pharmacist. I think that pharmacy managers and district supervisors need to take a firm hand on this. Any pharmacist who refuses to dispense to the patient without a clinical reason should be subject to disciplinary action. If a group of pharmacists en masse attempt to refuse, they should be terminated. I realize that this won't happen due to the current pharmacist shortage, but I firmly feel that if a pharmacist has an issue with selling Plan B, he or she should move to a non-retail setting where it won't be an issue. I also believe that any pharmacist who doesn't provide Plan B when asked (unless the store is legitimately out of stock) should be reported to the Board of Pharmacy in that particular state for disciplinary action. (If you are a patient trying to get Plan B and you are denied, remember that you have this option).

In my opinion, the Plan B "dilemma" is no dilemma at all. Politically active pharmacists need to restrict their political activism to their off work time, and take care of their patients while they are at work.

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Liz