This little girl is AMAZING! She’s got some mad dancing skills for sure! Check out her moves here:
There’s another incredible video of her doing freestyle to Truffle Butter, which has a great beat but is a nasty song. I can’t post the actual video here, but you can look it up on YouTube under: Sarah lil’Mini Phoenix | Truffle Butter | #immaBEAST
I recently saw this post on a friend’s Facebook timeline, and was compelled to write a response to it. The thing is, most of these chart notes ARE funny, but some are taken out of context. In addition, the language used in several of the notes are completely appropriate when spoken within the medical world, so I clarified those notes in a comment which I posted. Here is the original list of chart comments, followed by my clarifying remarks.
http://www.tickld.com/x/jaw/30-actual-sentences-found-in-patients-hospital-charts
1. She has no rigors or shaking chills, but her husband states she was very hot in bed last night.
2. Examination of genitalia reveals that he is circus sized.
3. Since she can’t get pregnant with her husband, I thought you might like to work her up.
4. The patient is tearful and crying constantly. She also appears to be depressed.
5. The patient has been depressed since she began seeing me in 1993.
6. Discharge status: Alive but without my permission.
7. Healthy appearing decrepit 69 year-old male, mentally alert but forgetful.
8. The patient refused autopsy.
9. The patient has no previous history of suicides.
10. Patient has left white blood cells at another hospital.
11. Patient’s medical history has been remarkably insignificant with only a 40 pound weight gain in the past three days.
12. Patient had waffles for breakfast and anorexia for lunch.
13. Between you and me, we ought to be able to get this lady pregnant.
14. On the second day the knee was better, and on the third day it disappeared.
15. She is numb from her toes down.
16. While in ER, she was examined, X-rated and sent home.
17. The skin was moist and dry.
18. Occasional, constant, infrequent headaches.
19. Patient was alert and unresponsive.
20. Rectal examination revealed a normal size thyroid.
21. She stated that she had been constipated for most of her life, until she got a divorce.
22. I saw your patient today, who is still under our car for physical therapy.
23. Both breasts are equal and reactive to light and accommodation.
24. Patient has chest pain if she lies on her left side for over a year.
25. The lab test indicated abnormal lover function.
26. The patient was to have a bowel resection. However, he took a job as a stock broker instead.
27. Skin: somewhat pale but present.
28. The pelvic exam will be done later on the floor.
29. Patient was seen in consultation by DR. Blank, who felt we should sit on the abdomen and I agree.
30. Patient has two teenage children, but no other abnormalities.
As a physician, I know that some of these chart notes actually make perfect sense to those who work in the medical field and who are on the hospital wards.
For example, “Since she can’t get pregnant with her husband, I thought you might like to work her up.” refers to a physician referring a patient to a fertility specialist who would be able to “work up” a patients to see what the issue might be with respect to difficulty getting pregnant.
Here’s another one: “The patient is tearful and crying constantly. She also appears to be depressed.” Crying “constantly” does not automatically infer that someone is depressed. Ostensibly the patient is distressed over something, but the clinical diagnosis of depression has a set of criteria which must be met on evaluation of the patient.
“The patient has been depressed since she began seeing me in 1993.” Really, just stupid. This patient had depression beginning at the very latest in 1993, and this clinician had begun seeing the patient at that time. So snicker all you want, but the clinician’s presence in the patient’s life is NOT the causative factor in her depression.
“The patient was to have a bowel resection. However, he took a job as a stock broker instead.” If I could count the number of times a patient was advised to have a surgical procedure, only to evade medical advice, I’d be a millionaire by now.
“The pelvic exam will be done later on the floor.” The “floor” refers to a hospital ward. This patient was most likely evaluated in the emergency room, so the plan was to do a full work-up, including a pelvic exam, once the patient was transferred to a regular bed in the appropriate ward or section of the hospital.
“Patient was seen in consultation by DR. Blank, who felt we should sit on the abdomen and I agree.” The phrase, “sit on the abdomen” means that the clinicians who were evaluating the patient had decided to hold off on any interventions with respect to the abdomen, most likely because they were confident that there was no imminent danger, and no need for surgical intervention.
The remaining chart notes ARE funny, and I could see why lay people find them amusing.
Hope this clears up some of the confusion regarding some of the notes which were perfectly sound within the medical world.
Did you know that stress can do a number on your skin? You are probably familiar with the stress-induced breakout, but prolonged, chronic stress can also prematurely age the skin. Stressful situations trigger the release of cortisol, adrenaline, pro-inflammatory cytokines, and angiotensin, all of which rob your skin of collagen and weaken its cellular repairing capabilities. Circulation is diverted away from the skin during stressful situations, which explains the dull, pale appearance of the skin in people who deal with constant stress.
Cortisol in particular inhibits the growth of fibroblasts which are responsible for making collagen, so they can’t keep up with the constant breakdown of old tissue. The result is skin which is collagen deficient, resulting in thinner, more wrinkled skin. Free radicals are formed in response to stress, which then damages skin cells and adversely affects the condition of the skin.
So how can you fight the effects of stress on the skin? There are three keys:
1. Exercise:
Every cell in the body benefits from exercise, including skin cells The pores of the skin dilate during exercise, and when you work up a sweat, trapped dirt particles are released. In addition, the increased circulation which results from exercise delivers more oxygen and other nutrients to skin cells, as well as carries away waste products and free radicals.
2. Relax:
We all know how frustrating it can be to have a big event looming, only to have an acne breakout right before the big day. The fact is that the stress associated with preparing for the event can trigger excess oil production in the skin, which clogs pores and sets up the perfect environment for an acne flareup. Even other skin issues, like psoriasis, are linked to stress. However, by practicing relaxation techniques, you can increase blood flow to the skin and offset any triggering factors (such as buildup of oil or free radicals) which contribute to skin maladies.
3. Use topicals:
Some of the best friends for your skin are topical agents such as antioxidants and retinoids. I am a big fan of vitamin C, not only because of its general antioxidant benefits, but also because it has a tendency to lighten up brown spots and impart a brighter appearance to the complexion. Retinoids are great for increasing cell turnover, and are potent anti-aging compounds.
I have always been a decent writer, and have prided myself on having a substantial vocabulary. So when my mind completely draws a blank and can’t find a simple word which I am trying to remember, I become rather frustrated. I will stand there with a vacant expression on my face, sifting through the memory banks, hoping for some kind of trigger. I have become accustomed to the random brain fog moment, which is followed up about an hour later with the word innocently floating into my conscious mind, as if to say, “Here I am…looking for me?” For example, I couldn’t remember the word “cryptic” the other day, but it suddenly appeared after the situation in which I needed to the remember the word had passed. I was heating up a meal, and there it was, POP, in my head. What the hell? Where were you when I needed you?
Instead of struggling endlessly to find a word, I usually give up after less than a minute. It turns out that stubbornly trying to remember a word makes it more difficult to recall that word in the future, so I guess I am giving my brain a break. Perhaps I am also mellowing with age, sinking into a resigned state, and knowing that my noggin will have its misfirings every now and then.
I have made the delayed word recall which occurs into a bit of a game now so that the word sticks. When “cryptic” came back to me, I immediately thought of Tales From The Crypt so that the word would stick, sort of like a memory glue so that the synapses might fire correctly next time and give me the word on demand. It seems to work pretty well, so I will continue to do it.
Another thing which I do is to play a word game on the Lumosity website, in which I have to enter words based on a given word root. I figure this is a good exercise for any writer, and will keep me actively thinking about vocabulary. I will say, however, that I have stepped away somewhat from the scientific mode of writing which has been required of me when I write clinical papers. I love complex vocabulary, especially multi-syllabic words which have a way of twisting the tongues of most people. Yes, I am weird that way, a bit of a science nerd. These days, though, I am not writing for an audience of physicians or scientists, so the vocabulary I turn to is a bit more basic. After all, I am not trying to talk over people or blind them with science. I am trying to inform, educate, and communicate, so I want my work to be completely accessible and easy to understand.
Even with all this word training, I still feel like a complete idiot when my mind is desperately fishing for a word or name. It can be downright frustrating to give up on trying to find a word, and settling for a synonym instead. What’s even worse is when I can’t think of a word, and can only think of a phrase which describes what I am trying to say with that one, elusive word. In that situation, I redirect my writing so that I avoid the roadblock. However, if it happens when I am speaking with someone, I am sort of screwed!
Pet dogs and cats have a tendency to get into mischief. I have seen my cats firsthand poking their heads into cabinets, gnawing on plants, and stealing food, despite the fact that they know full well that they are not allowed to do so. My male Burmese is defiant enough to look at me a moment before knocking something off a shelf or biting one of the other cats on the head! Though I berate him immediately, I also chuckle, because the defiance is truly amusing to me.
My cats are very dog-like and intelligent, and they know when they are doing something they aren’t supposed to do. They also know that all I can do is either spray them with water, yell at them, or remove them from the area. However, most cats really don’t seem to respond to discipline or conditioning, and will repeat offending behaviors over and over again.
Here is a very popular video of a guilty cat:
Dogs, on the other hand, usually know when they are misbehaving, and will show remorse when they are reprimanded. There are a number of funny videos on YouTube which demonstrate this, so I will share a couple here for everyone’s enjoyment.
I will always get a kick out of animal antics, and am willing to put up with my cats challenging me, since their behaviors are rather benign. After all, it is pretty unusual to find a perfectly behaved pet!
After relying on Palm and Palm Pilot PDA’s to organize my calendar for the past 14 years, I was forced to walk away from a deeply entrenched habit. Why? Because my most recent Palm finally gave up on me, and since I hadn’t been able to back it up this entire year, there was no point in holding onto what is now considered obsolete technology.
I received my first Palm PDA during my medical residency training, and was instructed to enter my patient clinic schedule on it, as well as anything hospital-related. My obsessive-compulsive need to be on top of my schedule all the time fell in love with the technology, so I continued to use the Palm after I completed my residency training.
I would regularly HotSync with my computer, safely backing up the data on the Palm. However, my Mac stopped supporting the sync software due to 2015 Mac operating system upgrades, and since my Windows 7 laptop didn’t support the Palm OS, I was pretty much screwed this year. I kept dreading dropping the Palm or somehow damaging it. What happened, though, was so weird. I had the Palm with me, and at one point when I had it on a tabletop, it beeped, turned on, then off. After that, I discovered that ALL of my data, my entire calendar as well as notes, were deleted. Thanks Mercury retrograde! I then spent about two hours on Google Calendar, trying to remember everything which was on my calendar. Not fun!
Over the years I have become completely accustomed to using the handwriting tablet on the Palm, and have considered the Palm a sort of security blanket. I loved not having to rely on an internet connection to access my schedule, and I loved having my calendar separate from my phone, especially since my phone has a horrible time holding a charge. Unfortunately, I have been forced to abandon my trusted Palm, and must now get used to using Google Calendar, then accessing it either on my Android, or on a tablet which I reluctantly purchased for the sole purpose of holding my schedule.
I am also ready to stop being teased about carrying a Palm around! For those of you who have engaged in the teasing, I just want you to know that I am updating my life with the tablet and Google Calendar. I know, it’s about time! But guess what? Palms are considered the predecessors to Smart Phones, so have a little respect for the technology! 🙂
Image by B-House Photography. All rights reserved.
Original post can be found at:
http://npcnewsonline.com/ashley-kaltwasser-wins-nordic-pro-record-14-ifbb-bikini-pro-wins/227266/
This girl is unstoppable! She has 14 IFBB Bikini Pro wins now, getting the most recent one at the Nordic Pro yesterday. I am so thrilled for her, because she is definitely most deserving of all her titles. Go, Ashley, go!
Here are her Pro wins:
Ashley’s 14 IFBB Bikini Contest Wins.
1. 2015 IFBB Nordic Pro
2. 2015 IFBB Olympia
3. 2015 Arnold Sports Festival
4. 2014 IFBB Russia Pro
5. 2014 IFBB Korea
6. 2014 IFBB Olympia
7. 2014 Toronto Pro Supershow
8. 2014 New Zealand Pro
9. 2014 IFBB Australia Pro Grand Prix XLV
10. 2014 IFBB Arnold Classic
11. 2013 IFBB Sheru Classic
12. 2013 IFBB Olympia
13. 2013 IFBB Toronto Pro Supershow
14. 2013 IFBB Powerhouse Pro
Breaking stereotypes!
I am always being challenged to pick one career that defines me, and it drives me nuts. When people find out that I am a medical doctor, they struggle with the stereotype of what they expect doctors to be like, in other words, very conservative in dress and demeanor, and without any flavor or personality. Well, I’ve got news for you. I will NEVER be a typical doctor. And please don’t doubt my credentials or schooling. I am NOT a nurse (not that there is anything wrong with this highly respected profession), I am a fully licensed and board certified physician.
A huge project came my way recently, and I was selected for it, only to have the decision-maker flip out over my fitness and modeling images and reverse the decision. I was stunned and dejected, but after reflecting on the whole incident, I began to get angry. Part of the problem was that the decision-maker was a complete hypocrite, pretending to be squeaky clean, but who openly praised one of the dirtiest human beings to ever alight on the entertainment scene. To coin an analogy, at the root of this was a case of the bride being upstaged by another lady wearing white. Mind you, I never intentionally wore white, but hey, my doctor’s coat is white.
I am every bit as much about fitness as I am about medicine, and I shouldn’t have to choose one over the other. I am damned proud of what I have accomplished in fitness, especially because I took things to the next level in my forties, not when I was a young whipper-snapper. If people are confused by the sampler plate philosophy by which I live, too bad. Yes, I am a board certified physician AND a degreed fitness professional, IFBB Pro, certified nutrition coach, writer, sponsored athlete and contest prep coach. I know it’s unusual, but why is that so hard for people to grasp? I mean, here I am, doing all of that, sending a message to the world that no one should have to be one-dimensional and boring.
I don’t hide from myself. I am honest. I have sass, and I speak my mind. I am proud of what I have achieved in my life, and I will NOT hide parts of myself which some overly judgmental people may have a problem with. I am NOT going to apologize for having a sense of humor, for using cuss words here and there (though I don’t use them while seeing patients). I am not going to paint a false picture of who I am. If you don’t like what I am doing, no worries. Move on.
If you find that you are compromising your own vision, dreams, or goals, perhaps you need to re-examine why you are allowing that to occur. If you subscribe to the no limits philosophy, then you would never even consider pulling the reins back. I will always encourage driven people to go for whatever they want, and if it doesn’t fit in with the conventions of one of their chosen careers or hobbies, even better. Break stereotypes and show people what you are made of! Don’t hide all the facets which make you who you are!
Please check out my latest article for American Fitness Educators which discusses minimalist footwear! Original post can be found at:
http://www.fitnesseducators.com/blog/minimalist-footwear/
Less Is More
Are there benefits to training in minimalist footwear? Studies have demonstrated that training while wearing minimalist shoes results in enhanced performance due to greater foot pliability and a closer approximation to a barefoot stance. Since our feet adjust to wearing raised heels over time, it can be incredibly challenging to keep our heels on the ground while performing exercises like deep squats. Proponents of minimalist footwear may even argue that barefoot is best for heavy weightlifting, but the risks of exposure to microbes or hazardous fragments of glass, metal, or rocks, make minimalist shoes a much more feasible choice while at the gym.
Dysfunctional movement patterns become established throughout the body over time. Conventional athletic shoes can often contribute to ankle and foot dysfunction because they inhibit natural foot action. If you don’t believe it, then try to perform some of your physical activities barefoot and see how well, or poorly, you perform. Chances are that the impaired mechanics in the feet and ankles will make it difficult at best to perform those activities. By gradually switching over to minimalist footwear, an athlete can essentially correct improper foot mechanics and optimize kinetic feedback throughout the body during movement.
Benefits Of Minimalist Shoes
Conventional athletic footwear features a cushioned heel which also can compromise power. In contrast, minimalist footwear features little to no heel, and the soles are very thin and malleable, so they allow the joints in the foot to move and adjust to weight loading movements. In addition, the heels and midfoot make solid contact with the floor, causing more activation in the glutes and hamstrings. Studies have demonstrated that people who wear minimalist footwear develop greater strength in their legs and feet, since more power is transferred from the working muscles, through the feet, and into the movement. Plyometric movements and sprint power will also be enhanced while wearing minimalist shoes.
A 2011 study by Squadrone and Gallozzi assessed the ability of experienced runners to estimate the degree of inversion, eversion, dorsiflexion, and plantarflexion, of a slope surface board placed under their right foot while standing. They found that the degree of proprioceptive feedback which subjects received while wearing Vibram Five Fingers® was much more accurate than in subjects who wore a standard running shoe. In conclusion, cushioned shoes conferred a distinct disadvantage when compared to minimalist shoes during assessment of foot position awareness.
How To Transition Into Minimalist Shoes
Anyone who is transitioning from conventional athletic shoes to minimalist footwear needs to do so gradually, since the body has to adjust to radically different proprioceptive input. There have been cases of metatarsal stress which developed after converting too quickly to minimalist shoes. However, once the transition is made, noticeable strength gains should occur. Try spending about 15 to 30 minutes, twice a day, wearing minimalist shoes around the house. After about a week or two, you can try them out at the gym one to two days a week until you become accustomed to the feel of the shoes. Be aware that your gait and foot stance will probably change as you acclimate to this type of shoe.
REFERENCES:
Squadrone R, Gallozzi C (2011) Effect of a five-toed minimal protection shoe on static and dynamic ankle position sense. J Sports Med Phys Fitness Sep;51(3): 401-8.
dr. stacey naito's blog 