Actually, that is the current media health hype of the week. It comes right after the headlines stating your cell phone can cause brain cancer, and ice cream can cure infertility (actual news topics, by the way). Seriously, I wish the media didn't jump to publish such sensational headlines, because even if it had truth behind it, such remarks tend to cause unnecessary panic among the population. Apparently, some leading baby bottle manufacturers use Bisphenol A in their polycarbonate plastic, which according to an environmental group, leaches out in concentrations found to be dangerous in laboratory animals. Of course, I had to see if this was validated by any good scientific studies, so I did a brief PubMed search and concluded that there is probably no harm based on the current published information. I guess the NIH is forming a review panel on March 7 to review current findings, so it will be interesting to hear if there are any changes. The brands involved include Avent, Dr. Brown's, Evenflo, Gerber, and Playtex (all the major brands). We've used Dr. Brown bottles for both our kids (I'm planning on writing a review at some point), and I would be rather disturbed to hear that they leaked harmful chemical concentrations that can cause neurologic damage. I highly doubt that this is the case though. I mean, it seems unlikely that they would be more harmful than say, drinking from a plastic cup or eating with a plastic spoon. In any case, I'll post more when I find out more about it.

Tags: health

I'm going to place I just placed another order for diapers, since the deal ends tomorrow. At the beginning of the month, I posted about Amazon's Pampers promotion. Apparently, it must be quite popular (and unfortunately, their prices fluctuate accordingly!) so the boxes are just shy of $40 now, which is actually not the greatest deal, just an average one. However, with the promotion, you save $25 instantly off a $99 purchase, or about $8 off each box (making each box around $32), which is a great deal. They sell Economy Plus packs (which are bigger than the ones you find at Target and Wal-mart). A size 3 box has 160 diapers, and a size 4 box has 140 diapers. I'm getting two size 3 boxes and one size 4 box, and using the code PAMPERS2 for $25 off my total.

I also noticed that they have a new service on Amazon, Subscribe and Save. Interesting concept. You subscribe to regular delivery of certain items for 1, 2, 3, or 6 months, and you get free shipping and save a percentage (currently 15%) on each order. If their percentage savings changes over time, it'll be in your favor (they'll increase it but never decrease it on current subscriptions). And you can cancel at any time. Intriguing. We might have to start doing that at some point. They have diapers, as well as a bunch of other stuff (laundry detergent, cereal, vitamins). Wow, now if that's not a timesaver, I don't know what is. I just don't think I am organized enough (yet) to figure out when we need to refill on stuff at home. Plus I think our usage and consumption varies a lot. But I guess I could always change the subscription at any time. I'll have to consider it, but right now, I am still happy placing orders as we need them. Besides, with our current Amazon Prime status, there is no minimum order to receive two-day shipping, which is great. And I can place an order for stuff we need in just a few minutes. But that sounds like a neat new service. No more waiting for sales or coupons, just pay a fair low(er) price. At 15% off, the diaper boxes come out to around $34, which is not as good as the promotion, but not bad considering you can order anytime.

Tags: Amazon, diapers

I know this sounds really silly, but I had to post about it, since it seems like one of those things that many people might need, but don't know where to find. Everyone should have one of these. A long time ago, I had purchased this soap dispenser from an online store that specialized in ergonomic products, mainly for seniors. It took a little bit of digging around online and in stores before I finally found it. J and I wanted a soap pump for the dish detergent that had a nice long nozzle so it would be easy to use with the kitchen sponges, and not cause a goopy mess. We had already tried other soap pumps, but found that many of them would rust or get really gross because of how difficult it was to clean them. This was the perfect solution.

Recently, our bathroom soap dispenser started to fall apart, so I figured I'd order another one of these. The store I had purchased it from before no longer carried it, but I did a random Amazon search, and lo and behold - there it was! It cost under $7, less than what I got it for the first time. I immediately bought two of them (one for my mom, since she had commented on how great it was the last time she came to visit). In any case, it's really nice, since you can always see how much soap you have left. It's really convenient for dishwashing, though I sometimes wish it were a little bit bigger, since I have to refill it every two weeks or so (we wash a lot of dishes, pump parts, bottles, etc.). It holds 12.5 oz, and has a rubber base to prevent slipping (and rust). I hope they don't ever stop selling it, since we'll probably use them at every sink in the home from now on, and I'm not even sure where else I'd be able to find it. I even considered buying an extra one, but decided against it - no place to store extra stuff in our home.

If you don't have Amazon Prime and don't want to pay extra for shipping, consider buying a few books to make the $25 free shipping minimum. I just bought a few books from their 4-for-3 special promotion, which includes a ton of children's classics like "Goodnight Moon" and "Brown Bear, Brown Bear, What Do You See?"

Tags: Amazon

I missed a practice question today about this syndrome, which I had never heard of before. It's also called "herpes zoster oticus," which is essentially varicella zoster virus (VZV) reactivation in the geniculate ganglion of cranial nerve VII. The classic triad of symptoms includes peripheral unilateral facial paralysis, ear pain, and vesicles in the auditory canal. Ouch. In any case, I didn't realize that VZV reactivation in the ear had a special name, other than shingles. Treatment is with antivirals (acyclovir) and analgesics. Some people like to use prednisone. Pretty picky question if you ask me. I don't think VZV reactivation in the other cranial nerves has a special name, or at least I hope not. The possibilities would be endless.

J has meticulously reviewed some of our more gadgety purchases (Zooper Boogie, Burley Solo) and now he's done a fantastic job with our biggest purchase so far (other than the car): our new digital SLR. We went back and forth about whether or not to get it, since it was a pretty hefty purchase (total cost of everything together came out to over $1000). Most of the time, our shopping habits have been dedicated to saving time, money, and space, but this was indeed a splurge, if you will. That said, I have not once regretted this purchase, even with the high price tag. It's a long-term investment that I feel will give us visual treasures to keep, long after the boys are grown. From day one, we have noticed a drastic improvement in the quality of our photos, especially indoor ones. But even the outdoor ones were superior. And with an active toddler and soon-to-be crawling baby, our point-and-shoot just wasn't working well in all circumstances. I was tired of getting blurry shots, or clear ones with a washed-out flash look. We still find it useful to have the small camera (Canon Elph), as it's handy when we don't bring the SLR with us. The Elph takes good photos in ideal lighting conditions (sunny day, outdoors) while the SLR does well overall. Most photos on this site were taken with the SLR (we bought it in November). Any early photos of A or M were taken with the Elph.

To give you an idea of the difference between the two cameras when it comes to outdoor conditions, take a look at these pictures of M riding a tricycle at daycare. Short of doing a side-by-side comparison experiment of the two cameras, it was the best example I could come up with of the subtle but (what I believe to be) striking difference in clarity and background blur (bokeh). I realize that they weren't taken the same day and with the exact same lighting conditions (however, coincidentally, M is wearing very similar clothing), but you'll get the idea.





See how the first shot is grainy and somewhat plain? Most everything is in focus, but he doesn't really stand out against the play structure behind him. In the second photo, there is some blurring of the background and he seems to stand out more. The colors also seem a tad more vibrant in the second photo. There's nothing wrong with the first photo at all, but it just looks somewhat average compared with the second one. This is an example of a subtle difference we've noticed in our photos. We are quite amazed with some of the striking "winners" we've taken as well - some of them come out looking like they were taken by professionals (which, believe me, we are not).

Here's one you've seen before, the first photo of M I took with the SLR:




And this indoor photo could never have been taken without flash on the Elph:


A few things I wanted to mention that I like about the new camera, before you get into the more technical things. It's fast - no more delay between the time you press the shutter button and the time it takes the photo. That's more important now that M is running around. Also, it's pretty easy to use, even for me. I'm sort of a technology junkie, but not so much with cameras. We've taken thousands of new photos with the SLR (really) and had many more keepers than we ever had with the Elph.

In any case, you can read all about the details in J's comprehensive review.

Tags: Amazon, Costco, photography

We went to the zoo today for a special Chinese New Year celebration, complete with lion dance and acrobat (there was only one). It was very difficult to see anything and was quite crowded so it wasn't nearly as exciting as it could have been. I grew up in the middle of a very culturally diverse city, and my memories of Chinese New Year are much more festive (although I guess it might have seemed bigger because I was a lot younger then). It seemed like the whole city would be involved. In any case, I think M enjoyed the animals (he especially liked watching the ostriches run), and A enjoyed being strapped to my hip for most of the time. For me, it was just nice to be outside on a cold (but sunny) day. We don't usually do anything big for Chinese New Year (or any New Year, for that matter), but every now and then try to preserve some (albeit minimal) ties to our distant Chinese heritage.

Tags: holiday

Sounds like some crazy snowy weather across the country. Part of me wishes we had snow (grew up with lots of it), but my head spins just thinking about all the bundling we'd have to do to get the kids outside. It's nice to be able to play outdoors as often as we do, since there isn't much space indoors to burn off all the toddler energy.

Basic formula for adorable kid accessories: Take an everyday object and put eyes, ears, feet, and smiley faces on them. Voila!

Here's M and his new umbrella, which he loves (can we get those in a family size?):

Tags: M

One year after its announcement to release the vaccine (Merck's RotaTeq), the FDA made a statement warning about 28 infants who got intussusception after receiving it. A previous vaccine (Wyeth's RotaShield) had previously been pulled for that same reason. I've heard similar announcements before regarding medication warnings, but of course it's a whole new ball game when it involves yourself or your loved ones (very easy to become obsessed about searching for details). A has had 2 doses of RotaTeq, with the final one scheduled in a few more weeks. I was initially concerned when we were offered it, because of the previous vaccine effects, but was moderately reassured that a study was done in about 70,000 babies (and published in NEJM) before the FDA approved it. I'm honestly worried (and what parent wouldn't be?) about whether or not to give the last dose (does it even matter now that we have given him the other two?) and will probably do some searches today about how long the risk lasts (is A still at risk considering he got the second dose about a month ago? I think that NEJM study followed the kids for at least a year). As someone in the medical profession, I see a lot of hand-waving about the issues parents have with immunizations, and I'll be the first to admit that my personal bias is pretty medically-bent. However, I can totally understand the concerns a parent might have and the decisions they make regarding immunizing their children. In the grand scheme of things, it's all a risk-benefit decision. Is A more likely to get rotavirus if not vaccinated, or intussusception if vaccinated? Probably the former. Both can be fatal. But it still freaks me out anyway, and now I'm going to be paranoid about any bowel issues he might be experiencing (or that I perceive him to be experiencing). Now that I think of it, he has been a bit more colicky at night and daycare has mentioned that he seems to have belly pain at times, and of course, then there is the fact that he is now sick with a fever. I don't think he looks septic, as fever is a late finding. Isn't this insane? I'm going to watch him like a hawk today. I'll probably end up calling the pediatrician this morning too. If anything, he can reassure me about the fever. This is probably a classic example of how a little extra knowledge (but obviously not enough) can cause more stress than it should.

Tags: health

"Hi, it's (insert daycare provider's name here). I just wanted to let you know that (insert child's name here) has a fever."

Sigh. Luckily I am not officially on a rotation right now (best not to schedule anything in December or January for illness reasons alone), but I am supposed to be doing research and studying for Step 2. I am happy to bring A home to take care of him but it's stressful to have so many other things to have to worry about. I wish I could stop time! I'll always willingly choose family over medicine but it is not without consequences (other people have to cover for you). Ideally, we'd all cover for one another in terms of taking time off, but there's often someone who likes to lay on the guilt. The one or two times I've had to take days off during a rotation (either because my kids were sick or because I was really sick), I've always offered to make it up on the weekend, or in some other way. I think it shows that I appreciate the flexibility but don't want to seem like I am entitled to walk out every time I get a call. After all, the work has to get done somehow. But I digress.

So, I picked A up and he was pretty warm. He was so sad looking, I felt awful for him. I changed him and gave him some infant Motrin and fed him a semi-cool bottle of milk while wiping his forehead with a cool washcloth until he fell asleep on me. Sigh. He's actually been sleeping for almost 3 hours now (I have since placed him in his crib so I could fold some laundry and have some lunch. I even managed to do some studying!). In any case, he'll be my date for Valentine's Day tomorrow (24 hour fever-free rule at daycare). I'll try to sneak in some reading while he naps, but I'm not going to expect to get too much done, which means I should really crack down on the books tonight while they're all asleep. Ah, the life of a medical student mom is never uneventful.

Tags: health, A

One fun thing about blogging that I didn't expect was how much I get to peruse our photos and reflect on the things we've done. The other day, I said to J, "Wouldn't it be fun to have this as my day job?" He said, "Yes, but then you wouldn't really have anything to blog about." Oh right. I guess what makes part of this interesting is that there are lots of other exciting things going on. If my job was just to blog every day, it probably would be hard to come up with stuff to write about. ("Today I blogged again...").

The boys are constantly cracking me up. They are just so hilarious. I wish I could write all the funny stuff down or capture all of them on film - what I write here is just the tip of the iceberg. M comes up with the funniest things sometimes. When we're near something dangerous (a lawnmower for example), I say to him, "That is a lawnmower. It's used to cut grass. Only grownups or big people can use them because they are dangerous and not toys." Today, we went to the hardware store to pick up some plant food and we saw some lawnmowers. M said "Cut grass. Big people do it. Not a toy." It was very cute. I guess he really remembers stuff I tell him.

And A was really funny today too. He had a fit of the giggles which we happened to catch on video. The tape ran out on the actual video camera and I didn't have time to grab another one, so we had to use the video feature on our Canon Elph, which makes it a bit grainy. In any case, it was pretty infectious giggling, and I am thankful we captured it on film. One day, he can appreciate how much laughter he brought into our lives. I have to say, if this doesn't make you laugh (or at least crack a smile), then you are in desperate need of a good vacation.

By the way, J is the one making goo goo noises at A, and you can hear me giggling in the background.

Tags: video, A

I have a little break before my next rotation (hand surgery), so I am trying to accomplish a few different things. I have a couple of research projects in the works, and I'm also studying for the USMLE Step 2 exam, which I'm going to schedule in the winter. I'm trying to get everything done early so that by this time next year, I will be coasting, and spending as much time with the kids as possible before I start residency. I'm also thinking about taking Step 3 early (is that even possible?) just to have one less thing to worry about when I am an intern.

I thought I'd occasionally write about some random facts I've learned during my studies. Today I read a bit about dermatitis herpetiformis, something that sounds familiar but I have no idea how to diagnose. It's an autoimmune vesicobullous disorder that presents as intensely pruritic papules, vesicles, or wheals (medical speak for itchy spots). The skin has IgA deposits along the dermoepidermal junction, and usually occurs on extensor surfaces of the elbows and knees, as well as the face and neck. The one factoid I didn't know was that there is an association with gluten-sensitive enteropathy (celiac disease). So you should suspect it and remember to ask about diarrhea and weight loss. Treatment is with dapsone or sulfapyridine, as well as a gluten-free diet.

I don't know how much stuff I overlooked in my preclinical years, or how much I have forgotten, but all of that sounded pretty new to me when I read it. In any case, for my med school friends, maybe it'll stick in your head now too!

Here's a random photo of the boys being cute:

Tags: M, A

1. Sleeping in.
2. Going to the movies (I think the last one I saw in the theater was King Kong).
3. Long showers.
4. A nice quiet meal once in a while.
5. My kids (when I am at school).

I love it when babies (particularly this baby) fall asleep on you. It's so snuggly and warm. And it forces me to sit down and rest for a little bit and enjoy the moment. We don't do that enough.

Tags: me, A

We bought this play gym when M was one month old, and are still putting it to good use today. Brief Review

Tags: toys, Costco

What a crazy month January was, for many reasons. It certainly was not a great month for us in terms of health. I think everyone in our household got sick last month, especially A. Three exposure notices went up in his room at daycare this past month (roseola, coxsackie, and conjunctivitis). Just last week, we visited the pediatrician four times in eight days. Fortunately, we live pretty close to everything we need to go to (school, daycare, hospital). And he is finally starting to feel like his normal self again (his appetite is certainly growing). I'm hoping he will start sleeping through the night again (we haven't had an uninterrupted night's sleep in quite some time). Unfortunately, I think Matthew is coming down with a cough now. Will it never end?

Here's happy A, as opposed to wheezy, rashy A:

Tags: A, health

I'll write a more detailed comment once the clerkship is over, but I had a few thoughts to share about things I've come across in Family Medicine. First of all, it was a great rotation to start on after A's birth, since I felt a bit out of the loop, having not been on the wards for 4 months. People are generally very nice, which is always makes a big impression on me. Not just nice, polite and cordial, but just good people. I am sure that people in other fields are good people too, but at least from my experience, I've felt like the goodness was appreciable in everyday interactions. It's sad how it's not really the norm to be surrounded by nice people in medicine (at least not as a medical student). We had an interesting lecture the other day about how to break bad news to patients, and the main take home point by the physician was "Don't be an a** hole." Words to live by.

Tags: school