jvlgato

Shoveled a lot of snow. Worked on taxes. Hung out with the wife and kids while trapped in the house - Watched 'Empire Strikes Back', played Plants vs Zombies, kid's Xbox games. I kind of wouldn't mind being trapped like this more often!

Looking out the window, looks like our streets are not plowed at all. I'd guess about 2-3 foot drifts, not sure how much actual snowfall. Maybe 10"? Mostly it's the wind creating massive drifts. I'll have to dig a path out for the pugs since the drifts are higher than they are! Right now, looks like a lull in the storm, but I think they predict another full day of this. School today was already cancelled as of yesterday afternoon. Fortunately, both of our hospitals have cancelled all outpatient visits and said we don't have to come in, since all we do is outpatient. Good thing, since I had already told our nanny not to risk driving to us today. Although both hospitals said they reserve the right to call us in if they are desperate for doctors in other areas like the ER or inpatient. Assuming we can even drive on the streets! Our assistant medical director apparently stayed overnight in the hospital, to be sure at least one person in our department was there. So, might actually be a nice family day inside for us!

The pipes leaving our kitchen sink and laundry got completely stopped up last night. I am hoping my plumber is at my house right now, as promised, because otherwise, no plumber for a while! I guess I should be glad it happened last night, rather than tonight or tomorrow ...

I've cancelled my entire afternoon and evening patients in anticipation of what they are calling a blizzard of historic proportions. Quoting the weather service: UNNECESSARY TRAVEL SHOULD BE AVOIDED AT ALL COSTS THIS AFTERNOON THROUGH EARLY WEDNESDAY MORNING AS MORE THAN HALF OF THE FATALITIES IN PREVIOUS ILLINOIS BLIZZARDS HAVE OCCURRED AS A RESULT OF TRAFFIC ACCIDENTS. BEFORE MAKING THE DECISION TO TRAVEL... CONSIDER IF GETTING TO YOUR DESTINATION IS WORTH PUTTING YOUR LIFE AT RISK. I gave people the option to 'visit' by phone, which three have accepted. Except that I'm coming home to send the nanny home, so I'll probably be at home alone with two 6 year olds. Should be interesting.

Ryan Bingham. Junky Star.

Schlafly Coffee Stout. Cheers, grawk and absorbine!

Sorry about sour work weeks! I totally get the fleeting joy of kids' stages. I am just counting the days before mine don't want to be with me and hate being hugged! Vicki, IMHO, this is a huge topic for us in the near future. It's a little bit of a fringe thing right now, but I've gotten a lot of people better after multiple previous failures, based on this principle.You know that 10% of patients who just don't respond to meds, or who can't look at a med without having profound side effects? (Maybe for you, it's the one who can drink or shoot up 10 times more than anyone else on the planet!) I suspect a bunch of them are the outliers in how they metabolize their meds. Right now I rely on asking a lot of questions, then trial and error. There are blood tests for this, but they're really hard to access, and expensive, and often not covered by insurance. Bah! You can do a Medlit Search, term pharmacogenomics: (I just did Google here) http://www.ornl.gov/sci/techresources/Human_Genome/medicine/pharma.shtml http://www.ncbi.nlm.nih.gov/pubmed/17269892 http://www.amazon.com/Psychiatric-Pharmacogenomics-David-Mrazek-MD/dp/0195367294/ref=sr_1_1?ie=UTF8&s=books&qid=1296305889&sr=8-1-spell http://www.amazon.com/Pharmacogenomics-Discovery-Development-Methods-Molecular/dp/1617378259/ref=sr_1_2?ie=UTF8&s=books&qid=1296305954&sr=8-2-spell http://www.ncbi.nlm.nih.gov/About/primer/pharm.html

Yes, a certain percentage of the population (about 8-12%, I believe, and could be more or less depending of ethnicity) can be slow or fast metabolizers based on several of the cytochrome P450 isoenzymes, and 2D6 is the isoenzyme related to the narcotics. But a 2D6 deficiency would make one a slow metabolizer of medications metabolized by the 2D6 system, and therefore overly sensitive to those meds, whereas a 2D6 overactivity would make one a fast metabolizer and therefore under sensitive, since the medication is metabolized, inactivated, and excreted very quickly. Depending on how fast a metabolizer one is, that person may need much higher doses of that med, or it can be completely ineffective. There are lab tests becoming available now which test for this, but they're not so widespread yet. A lot of psychiatric meds are metabolized by this system, so it's becoming a hot topic in my field. Edit: I should add that this is purely related to genetics, what you are born with. You can also rev up your liver enzyme system through environmental factors, for example, drinking a lot of alcohol. But we'd know nothing about that around here ...

Good health to all!

Who knows what evil lurks in the hearts of men?

Blech. Although I hear it's good exercise!

Aha! I found the immediate notification option! It's tucked away a bit, and because of the layout, I thought it related to 'watch every topic I reply to' rather than to notifications in general. I didn't want an email every time someone posted a reply to a topic, so I left it on 'No notifications'. But looking more closely, it appears this options relates to notifications in general. I switched it to immediate notifications, and will see how it goes. Maybe it's just me being an idiot ... but if anyone else is having trouble finding it, it's under Control Panel(‘My Settings’ by clicking on user name in upper right hand corner)>Settings>Notification Options>Notification Preferences, just under ‘Watch every topic I reply to’ where it says ‘If enabled, choose default notification type:’

I don't see 'Immediate Notification' as an option anywhere. Also, I don't see a way to file PMs into different folders. I can create folders, but do not see a way to move the PMs into those folders.

I get email notifications at unexpected times many hours later.

Jacob, nice knife! I know nothing about knives, but I know that sho' looks purty! Jim, good luck with the doggie! Pics when able! cetoole, grats on the Apogees! I loved my Centaurs when I had them. x2 on placement and room control, can't emphasize that enough with Apogees! I've heard some nice Hafler setups, but have not heard them with Apogees. Don't think Centaurs are as hard to drive as their other models. May want to pick up a sub, though. Shelly, nice looking bottles! Look forward to impressions! Fitz is Japanese? I had no idea!

I love those. I could go through a whole bag in one sitting.

Well, happy bday fellow Capricorn! Or are you now something else? Guess we have to get together for drinks again ...

I'd just hate that. One advantage of not having a driveway.

Madison, a bit west of Austin. You'll gain back all the weight you've lost in the last year, and have a heart attack on the spot. Waffle could have been better, it was a bit soft, and I like crisp, although my son gobbled up his waffle in about two seconds; the fried chicken was really good. And if you really want to go for it, they have fried giblets! We've been tracking this place for two years now, and they finally opened in December! http://chicago.metromix.com/restaurants/american/chicagos-home-of-chicken-oak-park/983103/content Oh, and Meiji Hello Panda's? Again, I say, you are far more Asian than I am.

I'd like to have been a fly on the wall and heard this conversation! I enjoy hearing musicians talk music. A whole different level of knowledge ...

Hadn't even heard of them until New Years when my buddy brought a six pack mix to our gathering. Really good stuff, I especially liked the coffee stout! Although, I drank it while standing inside my house. Perhaps I missed the full experience. My thermometer currently says '0.1'. If it's better that way, let me know and I'll go stand outside and drink one.

Nice pickup, Al! Look forward to your impressions.

Sounds nice! I'll bet you learned more about violins than you thought was ever possible!

*Sigh* I really have to find a way to join the travel team. I hope it gets easier as the kids get older. Either that, or I just have to start planning way ahead to budget time for it.

Cool dog! Cool 'doo!