michelle

Aspiring writer, physician, and responsible adult. Sharing my thoughts, personal happenings, and stuff that I think is funny, cool, awesome and/or worth learning about.

fallontonight:

Jimmy Fallon’s Olympic Thoughts

You’d never guess what these Olympians were REALLY thinking while competing, 

— 1 month ago with 718 notes
foodandwine:

© Lucy Schaeffer
DIY Happy Hour Soaking the peanuts in lime juice before frying them adds extra tang to this addictive happy hour snack.
Recipe: Fried Peanuts with Asian Flavors

foodandwine:

© Lucy Schaeffer

DIY Happy Hour Soaking the peanuts in lime juice before frying them adds extra tang to this addictive happy hour snack.

Recipe: Fried Peanuts with Asian Flavors

— 2 months ago with 100 notes
nprglobalhealth:

5 Simple Habits Can Help Doctors Connect With Patients
I pulled back the curtain, ready to meet the next patient on my hospital rounds.
"Why are you standing there?" she asked me. "Come, have a seat, let’s talk."
Lenore could have been my grandmother. She was 77 years old, and all of 93 pounds. What she lacked in girth, she more than made up for in chutzpah. She was one of the patients from intern year who I’ll never forget.
After four years of medical school, I could recite biochemical pathways, genetic mutations and the ways all sorts of drugs work. But all the cramming suppressed most of my common sense. Perhaps manners, too.
Lenore was offering me a refresher course. How could I refuse her polite but firm invitation?
I’d never been encouraged to sit at a patient’s bedside — to stop hurrying for even a moment.
Our medical teachers put a premium on accuracy and efficiency, which became conflated with speed. Everything had to be fast.
In 2014, doctors still value speed and technical accuracy, but we also do more to consider the quality of care we give and whether patients are satisfied with it. Those goals aren’t just the right thing to do. There are often financial strings attached to getting them right.
Even so, interns today don’t sit much more often than they did back in my day.
In a recent study, Johns Hopkins researchers followed two groups of medical interns for a month and found they sat down at the bedside only 9 percent of the time.
Sitting down, which would seem like one of the simplest things to do, is the least practiced of five communication skills for doctors that Lenore would have endorsed and that research has shown can make a big difference in patient satisfaction.
The others include introducing oneself to the patient and explaining your role in the patient’s care. Touching the patient — whether it’s a handshake, a gesture of comfort or part of a physical exam — makes a difference, too.
And the old art of good conversation never goes out of style: Ask open-ended questions, like, “How are you feeling today?”
Medical educators should be role models for these common courtesies, says Dr. Leonard Feldman, the senior author of the study and director of an urban health residency program at Hopkins.
"Trainees take their cues from us," he tells Shots. "These behaviors are what constitute ‘bedside manner.’ " More than that, he says, sitting at the bedside projects body language that tells a patient, "I’m here for you. How can I be of service?"
Feldman prizes these basic but often overlooked human interactions in his trainees. He suggests simple solutions like making sure there’s a chair available next to every hospital bed.
During my own intern refresher course with Lenore those many years ago, I tried to sit in the chair next to her bed. She’d have none of it. “Here,” she said, patting the mattress and telling me where to park it. “Now, how is your day going?” she asked. An open-ended question. What a pro she was.
Illustration by Katherine Streeter for NPR.

nprglobalhealth:

5 Simple Habits Can Help Doctors Connect With Patients

I pulled back the curtain, ready to meet the next patient on my hospital rounds.

"Why are you standing there?" she asked me. "Come, have a seat, let’s talk."

Lenore could have been my grandmother. She was 77 years old, and all of 93 pounds. What she lacked in girth, she more than made up for in chutzpah. She was one of the patients from intern year who I’ll never forget.

After four years of medical school, I could recite biochemical pathways, genetic mutations and the ways all sorts of drugs work. But all the cramming suppressed most of my common sense. Perhaps manners, too.

Lenore was offering me a refresher course. How could I refuse her polite but firm invitation?

I’d never been encouraged to sit at a patient’s bedside — to stop hurrying for even a moment.

Our medical teachers put a premium on accuracy and efficiency, which became conflated with speed. Everything had to be fast.

In 2014, doctors still value speed and technical accuracy, but we also do more to consider the quality of care we give and whether patients are satisfied with it. Those goals aren’t just the right thing to do. There are often financial strings attached to getting them right.

Even so, interns today don’t sit much more often than they did back in my day.

In a recent study, Johns Hopkins researchers followed two groups of medical interns for a month and found they sat down at the bedside only 9 percent of the time.

Sitting down, which would seem like one of the simplest things to do, is the least practiced of five communication skills for doctors that Lenore would have endorsed and that research has shown can make a big difference in patient satisfaction.

The others include introducing oneself to the patient and explaining your role in the patient’s care. Touching the patient — whether it’s a handshake, a gesture of comfort or part of a physical exam — makes a difference, too.

And the old art of good conversation never goes out of style: Ask open-ended questions, like, “How are you feeling today?”

Medical educators should be role models for these common courtesies, says Dr. Leonard Feldman, the senior author of the study and director of an urban health residency program at Hopkins.

"Trainees take their cues from us," he tells Shots. "These behaviors are what constitute ‘bedside manner.’ " More than that, he says, sitting at the bedside projects body language that tells a patient, "I’m here for you. How can I be of service?"

Feldman prizes these basic but often overlooked human interactions in his trainees. He suggests simple solutions like making sure there’s a chair available next to every hospital bed.

During my own intern refresher course with Lenore those many years ago, I tried to sit in the chair next to her bed. She’d have none of it. “Here,” she said, patting the mattress and telling me where to park it. “Now, how is your day going?” she asked. An open-ended question. What a pro she was.

Illustration by Katherine Streeter for NPR.

— 2 months ago with 511 notes
"Medical professionals should not take anyone’s side. They should treat those who need help."
Dr. Roman Fishchuk, an ear, nose and throat specialist working at a makeshift hospital in Kiev, Ukraine, setup for those injured during protests. (via nprglobalhealth)

(via nprglobalhealth)

— 2 months ago with 463 notes
How I feel about the snow

whatshouldwecallme:

The first day it snows:

Every time after that:

— 2 months ago with 2542 notes
neurosciencestuff:

Can Fish Oil Help Preserve Brain Cells?
People with higher levels of the omega-3 fatty acids found in fish oil may also have larger brain volumes in old age equivalent to preserving one to two years of brain health, according to a study published in the January 22, 2014, online issue of Neurology®, the medical journal of the American Academy of Neurology. Shrinking brain volume is a sign of Alzheimer’s disease as well as normal aging.
For the study, the levels of omega-3 fatty acids EPA+DHA in red blood cells were tested in 1,111 women who were part of the Women’s Health Initiative Memory Study. Eight years later, when the women were an average age of 78, MRI scans were taken to measure their brain volume.
Those with higher levels of omega-3s had larger total brain volumes eight years later. Those with twice as high levels of fatty acids (7.5 vs. 3.4 percent) had a 0.7 percent larger brain volume.
“These higher levels of fatty acids can be achieved through diet and the use of supplements, and the results suggest that the effect on brain volume is the equivalent of delaying the normal loss of brain cells that comes with aging by one to two years,” said study author James V. Pottala, PhD, of the University of South Dakota in Sioux Falls and Health Diagnostic Laboratory, Inc., in Richmond, Va.
Those with higher levels of omega-3s also had a 2.7 percent larger volume in the hippocampus area of the brain, which plays an important role in memory. In Alzheimer’s disease, the hippocampus begins to atrophy even before symptoms appear.

neurosciencestuff:

Can Fish Oil Help Preserve Brain Cells?

People with higher levels of the omega-3 fatty acids found in fish oil may also have larger brain volumes in old age equivalent to preserving one to two years of brain health, according to a study published in the January 22, 2014, online issue of Neurology®, the medical journal of the American Academy of Neurology. Shrinking brain volume is a sign of Alzheimer’s disease as well as normal aging.

For the study, the levels of omega-3 fatty acids EPA+DHA in red blood cells were tested in 1,111 women who were part of the Women’s Health Initiative Memory Study. Eight years later, when the women were an average age of 78, MRI scans were taken to measure their brain volume.

Those with higher levels of omega-3s had larger total brain volumes eight years later. Those with twice as high levels of fatty acids (7.5 vs. 3.4 percent) had a 0.7 percent larger brain volume.

“These higher levels of fatty acids can be achieved through diet and the use of supplements, and the results suggest that the effect on brain volume is the equivalent of delaying the normal loss of brain cells that comes with aging by one to two years,” said study author James V. Pottala, PhD, of the University of South Dakota in Sioux Falls and Health Diagnostic Laboratory, Inc., in Richmond, Va.

Those with higher levels of omega-3s also had a 2.7 percent larger volume in the hippocampus area of the brain, which plays an important role in memory. In Alzheimer’s disease, the hippocampus begins to atrophy even before symptoms appear.

— 2 months ago with 303 notes
foodandstyleclub:

Cumin-crusted oven friesThese oven fries are scrumptious on their own and make a great side dish. To enjoy them tapas-style, serve them with a homemade mayonnaise on the side.

foodandstyleclub:

Cumin-crusted oven fries

These oven fries are scrumptious on their own and make a great side dish. To enjoy them tapas-style, serve them with a homemade mayonnaise on the side.

— 3 months ago with 405 notes
neurosciencestuff:

Breast cancer spreads to brain by masquerading as neurons
Often, several years can pass between the time a breast cancer patient successfully goes into remission and a related brain tumor develops. During that time, the breast cancer cells somehow hide, escaping detection as they grow and develop. Now City of Hope researchers have found out how.
Breast cancer cells disguise themselves as neurons,  becoming “cellular chameleons,” the scientists found. This allows them to slip undetected into the brain and, from there, develop into tumors.
The discovery is being heralded as “a tremendous advance in breast cancer research.”
Although breast cancer is a very curable disease – with more than 95 percent of women with early-stage disease surviving after five years – breast cancer that metastasizes to the brain is difficult to fight. In fact, only about 20 percent of patients survive a year after diagnosis.
"There remains a paucity of public awareness about cancer’s relentless endgame," said Rahul Jandial, M.D., Ph.D., a City of Hope neurosurgeon who headed the breast-cancer-and-brain-tumor study, published online ahead of print this week in the Proceedings of the National Academy of Sciences.
"Cancer kills by spreading. In fact, 90 percent of all cancer mortality is from metastasis," Jandial said. "The most dreaded location for cancer to spread is the brain. As we have become better at keeping cancer at bay with drugs such as Herceptin, women are fortunately living longer. In this hard-fought life extension, brain metastases are being unmasked as the next battleground for extending the lives of women with breast cancer."
He added: “I have personally seen my neurosurgery clinic undergo a sharp rise in women with brain metastases years – and even decades – after their initial diagnosis.”
Jandial and other City of Hope scientists wanted to explore how breast cancer cells cross the blood-brain barrier – a separation of the blood circulating in the body from fluid in the brain – without being destroyed by the immune system.
“If, by chance, a malignant breast cancer cell swimming in the bloodstream crossed into the brain, how would it survive in a completely new, foreign habitat?” said Jandial in a recent interview with New Scientist.
Jandial and his team’s hypothesis: Given that the brain is rich in many brain-specific types of chemicals and proteins, perhaps breast cancer cells that could exploit these resources by assuming similar properties would be the most likely to flourish. These cancer cells could deceive the immune system by blending in with the neurons, neurotransmitters, other types of proteins, cells and chemicals.
Taking samples from brain tumors resulting from breast cancer, Jandial and his team found that the breast cancer cells were exploiting the brain’s most abundant chemical as a fuel source. This chemical, GABA, is a neurotransmitter used for communication between neurons.
When compared to cells from nonmetastatic breast cancer, the metastasized cells expressed a receptor for GABA, as well as for a protein that draws the transmitter into cells. This allowed the cancer cells to essentially masquerade as neurons.”Breast cancer cells can be cellular chameleons (or masquerade as neurons) and spread to the brain,” Jandial said.
Jandial says that further study is required to better understand the mechanisms that allow the cancer cells to achieve this disguise. He hopes that ultimately, unmasking these disguised invaders will result in new therapies.

neurosciencestuff:

Breast cancer spreads to brain by masquerading as neurons

Often, several years can pass between the time a breast cancer patient successfully goes into remission and a related brain tumor develops. During that time, the breast cancer cells somehow hide, escaping detection as they grow and develop. Now City of Hope researchers have found out how.

Breast cancer cells disguise themselves as neurons,  becoming “cellular chameleons,” the scientists found. This allows them to slip undetected into the brain and, from there, develop into tumors.

The discovery is being heralded as “a tremendous advance in breast cancer research.”

Although breast cancer is a very curable disease – with more than 95 percent of women with early-stage disease surviving after five years – breast cancer that metastasizes to the brain is difficult to fight. In fact, only about 20 percent of patients survive a year after diagnosis.

"There remains a paucity of public awareness about cancer’s relentless endgame," said Rahul Jandial, M.D., Ph.D., a City of Hope neurosurgeon who headed the breast-cancer-and-brain-tumor study, published online ahead of print this week in the Proceedings of the National Academy of Sciences.

"Cancer kills by spreading. In fact, 90 percent of all cancer mortality is from metastasis," Jandial said. "The most dreaded location for cancer to spread is the brain. As we have become better at keeping cancer at bay with drugs such as Herceptin, women are fortunately living longer. In this hard-fought life extension, brain metastases are being unmasked as the next battleground for extending the lives of women with breast cancer."

He added: “I have personally seen my neurosurgery clinic undergo a sharp rise in women with brain metastases years – and even decades – after their initial diagnosis.”

Jandial and other City of Hope scientists wanted to explore how breast cancer cells cross the blood-brain barrier – a separation of the blood circulating in the body from fluid in the brain – without being destroyed by the immune system.

“If, by chance, a malignant breast cancer cell swimming in the bloodstream crossed into the brain, how would it survive in a completely new, foreign habitat?” said Jandial in a recent interview with New Scientist.

Jandial and his team’s hypothesis: Given that the brain is rich in many brain-specific types of chemicals and proteins, perhaps breast cancer cells that could exploit these resources by assuming similar properties would be the most likely to flourish. These cancer cells could deceive the immune system by blending in with the neurons, neurotransmitters, other types of proteins, cells and chemicals.

Taking samples from brain tumors resulting from breast cancer, Jandial and his team found that the breast cancer cells were exploiting the brain’s most abundant chemical as a fuel source. This chemical, GABA, is a neurotransmitter used for communication between neurons.

When compared to cells from nonmetastatic breast cancer, the metastasized cells expressed a receptor for GABA, as well as for a protein that draws the transmitter into cells. This allowed the cancer cells to essentially masquerade as neurons.”Breast cancer cells can be cellular chameleons (or masquerade as neurons) and spread to the brain,” Jandial said.

Jandial says that further study is required to better understand the mechanisms that allow the cancer cells to achieve this disguise. He hopes that ultimately, unmasking these disguised invaders will result in new therapies.

— 3 months ago with 282 notes
Why I Don’t (Always) Like Cancer Culture

Cancer culture is often on my mind and often featured in the media. It’s an important part of society. I don’t want to talk about specific people who have publicized their fight against cancer, but rather the general “trending topics”, if you will. The common language you hear surrounding this culture. The terminology you become familiar with when you become a part of this culture. And why sometimes I really don’t like it.

Don’t get me wrong. I greatly support raising cancer awareness. Yes, cancer is a very well-known and publicized disease. That doesn’t mean people know of the proper steps to take in order to maximize chances of survival—i.e., early detection and prevention. And even if someone is aware of this medical advice, that doesn’t mean they will follow it. I’m NOT here to give medical advice—I’m not qualified in any way (hopefully someday, but definitely not now). There are huge benefits to “cancer culture” being an integral part of our society in the United States (and worldwide, but I have not lived in those cultures). It takes money to fund research for treatments and possible cures. It takes money to provide screening tools. I’ve read articles and literature on certain organizations and what they are doing to further research and advance our care for cancer patients. There’s also literature that strongly challenges “Pink Ribbon Culture” (the “pink”ing of breast cancer) and argues that breast cancer has turned into a money machine and it does not actually benefit cancer patients the way people think it does. I’ve participated in various charity events to raise money for cancer organizations and I always found the experience to be positive and rewarding. They also make me sad though, so I’m not always up for it. But where is my money going? I really don’t know. I hope it actually goes to a good cause, but I don’t really KNOW.  

Anyways, I’m not here to talk money either. I want to write about the common phrases I hear regarding cancer culture that don’t sit well with me. Why I feel like we shouldn’t say certain things.

I have not had cancer. I do have a fair amount of medical history and I live with a chronic illness, but it has never involved cancer. I do not know how it feels to hear the words, “You have cancer.” There are some similarities between other chronic illnesses and cancer, and cancer is really a thousand different diseases. I’m intrigued by a lot of stories about cancer survivors. We all know someone or know of someone who has dealt with cancer, whether they are cancer survivors or family and loved ones of cancer survivors. In cancer culture, anyone who has been diagnosed with any type of cancer is a “cancer survivor,” whether they are in remission or newly diagnosed and undergoing treatment. My mother died from breast cancer almost 9 years ago, when I was 15 years old. That’s how I became a part of cancer culture. It’s always been a struggle for me to decide how much I tell people about my experiences, how much I open up. It’s an uncomfortable topic, but I feel that I am getting better at how I handle uncomfortable situations as I get older. For me, talking about my experiences is helpful. Support is essential. But why don’t I always like cancer culture?

Phrases like these:

"Jane has breast cancer, but she’s not afraid. I’m not worried because she’s a fighter and she’ll get through this."

"Bob is so strong and has so much to live for. He has the best attitude. Cancer picked the wrong person to mess with."

I am not putting down the power of positive thinking. There is proof that laughter, humor, positive thinking, positive emotions, etc. have beneficial effects on physiological health. However, it is not a cure for cancer.

The reason I have a problem with phrases like these is because I think of those who have lost the battle and died from cancer. Or those survivors who do NOT feel optimistic and hopeful and cheery. Are these people lesser because they don’t have a positive attitude? Did that man or woman who died from Stage IV lung cancer just not have enough people to fight for? Not enough love to stay alive? Just not enough of a fighter? Just not strong enough?

That’s my problem. We cannot determine our emotions. And, our emotions do not determine our medical outcomes.

We cannot control how we feel. Emotions are NOT always logical. Can we CHOOSE to be happy when we are miserable? Can we choose to fall in love? Can we choose to feel or not feel? No. We feel how we feel. 

Who can prove who has a tougher battle in this life? Life is hard for everyone. Hard is hard. Yes, I do find it admirable when people overcome obstacles with strength and grace. But not everyone is so lucky. I will not judge you if you are scared. I will not judge you if you feel sad or hopeless or angry. I will not pressure you to be more determined or to have a positive attitude or to fight harder. I will not tell you everything is going to be okay, because I don’t know how things will go.

I may not understand how you feel, but I will listen.

Be well,

Michelle

— 3 months ago

tedx:

Watch the whole talk here»

Ash Beckham believes we all need to come out of the closet — regardless of our sexual orientation. In this powerful talk at TEDxBoulder, she explains how we each isolate ourselves by avoiding honest conversations about who we really are, and makes a case for coming out of these emotional closets, no matter how comfortable they seem.

Loved this TEDtalk.

— 3 months ago with 5181 notes