Tags: A, holiday

We went on this ride several times:



It's a cute ride, and extra points to Disneyland for making it interactive. There's a little lever that you can push up or down to make your elephant move in that direction. M really enjoyed that quite a bit:



I'm not sure what the age/height restrictions were, but A was able to ride on it too. It was definitely a family favorite.

Tags: travel

I apologize - I said I'd post more vacation photos yesterday, but now it's technically the next day. For some reason, A had a tough time getting to bed tonight, and so everything got pushed back a bit.

But, back to the photo. What was A looking at?



It's the Disneyland Parade of Dreams. We watched it on the first night of our Disneyland trip (three days long).

Tomorrow: flying elephants!

Tags: travel

I don't have much time to surf the internet, but when I do, this hilarious comic site, xkcd.com, is one that I check out. I don't think J finds it as funny as I do - maybe it's my geeky mathematics background or my weird sense of humor. I have to admit, I don't understand all the computer programmer lingo though. But the ones that I do get often have me laughing out loud. The guy who draws this comic (Randall Munroe) is pretty talented. I wish I had more artistic abilities. The comics are cute and witty, and a great 15-second humor break in my day (because sometimes that's all you have!).


Today's comic is "Mattress" (it made me chuckle):


This one makes me feel a bit old. But given my interest in surgery and the memory of playing NES with my younger cousins, this one cracked me up. It's called "Nintendo Surgeon":


And I haven't forgotten about the vacation photos - they'll be posted later today.

Tags: website

I'll be posting more about our recent vacation over the next few days. I'd do it now, except I should probably be sleeping. Instead, I am trying to research some new diaper options for A, since it seems as though he finds the waistband on the Pampers Cruisers to be itchy these days. I did take a little nap from 8:30pm to 10:30pm, which partially explains why I am awake at the moment. In the meantime, here's an introductory photo to start things off. Try to guess what A is looking at. I'll post the answer tomorrow.

Tags: travel, A

I'm up late catching up on email, and various projects I'm involved in. And procrastinating by looking at old photos and posting here, of course. I just saw this older photo, and now I'm ready for bed!

Tags: A, M

This classic multiple sclerosis (MS) sign is named for a French neurologist, Jean Lhermitte (1877-1959). It describes sudden transient electric-like shocks which extend from the neck down the spine when the head is flexed forward. It can be due to a disorder such as compression of the cervical spine (the portion of the spinal cord within the neck), and suggests a lesion of the dorsal columns of the cervical cord or of the caudal medulla.

Other possible causes include Behçet's disease, trauma, radiation myelopathy, vitamin B12 deficiency (subacute combined degeneration), and compression of the spinal cord in the neck (spondylosis, disc herniation, tumor, Arnold-Chiari malformation).

Over the weekend, I caught up on a few things that I've been meaning to do for a while, which included giving the boys haircuts. M doesn't really look thrilled, but he's actually doing just fine and is watching Elmo Visits the Firehouse on J's laptop. Haircuts in this neighborhood can get quite costly, so we end up saving a decent amount of money if we do them at home. I realize at some point it'll be easier to take them to a barber, but for now, it's working out well for us. I even cut J's hair too (he's not picky). He doesn't cut mine though, because it's really thick and difficult to layer through. My mom is the real pro, so she usually gives me a quick trim every time I visit my folks (which is not often enough). I've been on the hunt for a good, affordable salon, but haven't found the perfect place yet. I'm also thinking about trying something different, since I pretty much have had the same haircut for my whole adult life. Any suggestions?

Tags: M, me

Okay, so I am quite bit behind in posting about these rotations (next one up is Family Medicine). In any case, I did my core pediatrics rotation last summer, right before A was born. It was pretty rough, but I had a good time, and I ended up delivering A exactly one week after I took the shelf exam. Read more

A huge window display of toys. I should have taken a photo of those too!

Tags: A, me

Look at that washcloth. It's almost bigger than M. It's so funny to look back at these photos. I must have been tired (little did I know how relatively easy one baby was). Sleep is totally underrated.

Tags: M, me

A has a few favorite stuffed animals, and this cow is one of them (we also have an extra one which is not pictured here). He's been photographed with it before (here and here). He always smiles when he sees it, and he likes to chew on its tail.

I actually bought it at a Gymboree store when he was a newborn. I don't shop there that often just because I think their clothing is a bit on the expensive side. I believe Janie and Jack is the upscale sister store, which is even more expensive. It was a total impulse buy, the kind you make right at the register. There was only one left and it was on sale for some ridiculously low price ($3 or $4) probably because it was from an older season (I'm sure he doesn't mind). In fact, A really took quite a liking to it, and when I saw another one at a different store a few months later (this one had a couple left), I picked up an extra just in case. I also picked up a matching shirt. Pretty silly eh? What a cutie.

Tags: A

It's been a long time since I've posted one of these random medical facts (just goes to show how little I get to study these days). I am now cramming for the neurology shelf, which is probably going to be quite challenging, since my knowledge base for neuroanatomy is pretty weak right now (it's been several years). I still have a few days, so we'll have to see how it goes.

LEMS is a autoimmune disease, with the the main symptoms being slowly progressive proximal muscle weakness with hyporeflexia. Autonomic dysfunction is often present as well, with dry mouth being the most common complaint. It can also be a paraneoplastic syndrome associated with small cell lung cancer. It is due to autoimmune attack against voltage-gated calcium channels (VGCC) on the presynaptic motor nerve terminal, causing impaired released of acetylcholine (ACh). Because the presynaptic stores of ACh and postsynaptic response remain intact, repetitive nerve stimulation actually improves symptoms (unlike in myasthenia gravis, where repetitive nerve stimulation causes muscle fatigue).

It is a clinical diagnosis, but can be confirmed with both VGCC antibodies and nerve conduction studies. The differential diagnosis is broad, covering any diseases which present with proximal muscle weakness, but the most common consideration is myasthenia gravis.

Therapy includes both symptomatic (guanidine, 3,4-DAP, pyridostigmine) and immunologic (plasma exchange, IVIG, oral immunosuppressive agents) options.

A little while ago, we celebrated M's third birthday (I'm pretty behind in posting right now). I can't believe it's been over three years. I know I say it a lot but my, how time flies. It really doesn't seem that long ago that we brought him home to our tiny little one-bedroom apartment. He was so little then. And now he's talking up a storm, doing things on his own, and every bit as adorable to me as the day he was born. It's amazing how parents always think their kids are at their cutest age ever, no matter how old they are. It just keeps getting better and better.

We had a quiet celebration at home, which really consisted of a nice lunch and then ice cream cake, followed by the opening of some new toys (more photos and reviews to come soon). Pretty low key, but I figure the boys had tons of fun without the added stress of a big party. I'd like to hold off on organizing a bigger birthday party for as long as we can. Around here, they can really get quite impressive (clowns, magicians, balloon animal makers, bouncy houses, pony rides, etc). I prefer the idea of making a cake and having a barbeque in the backyard or at the park. Maybe next year (when I'm an intern?).



The cake was pretty cute. Having just moved, I didn't have time (or enough unpacked kitchen supplies) to make one, so I opted for an ice cream cake from Baskin Robbins (I haven't been there since I was a kid). They have a lot more designs than are available on their website, and the one nearby is owned by an adorable elderly couple who have really great customer service. I tried Cold Stone Creamery first, but I guess not all their stores make the character cakes offered on their website, and their customer service (at least at the local store) is mediocre at best. In any case, M loved it (chocolate cake with vanilla ice cream), and loves to play with the little Thomas wind-up train and track decoration. Even though I think the ice cream isn't as yummy as some of the homemade ice cream shops around here, I'd definitely order from them again.

Tags: M, A, J, food

I'm in a rush this morning, so I'll have to leave you with just a photo of the cake we had for M's third birthday. We celebrated at home, just the four of us. More to come soon.

Tags: food, holiday

These guys crack me up. Gosh, are they a handful though. Many of my friends comment about how they get email from me at odd hours (namely, in the wee hours of the morning). How does this happen? I don't really plan to be up, but take today for example. I got home from evening lecture (after a clinic day) around 6:30pm. I made dinner while J bathed the boys (one at a time). By the time dinner was over, it was almost 7:30pm. We played in the living room for a while, and then got the boys ready for bed. By the time they were both tucked in, it was almost 8:30pm. Before rushing off to cleanup the monster mess from dinner (you should see the dining room table - A is a food squisher), I like to do something relaxing and quiet for about 20 minutes, so I can be sure the boys fall asleep. That often means lying down on the sofa or in the bedroom (right next door to the boys' room) so I can hear any complaints for a drink of water, or a tissue, or whatnot. If I start kitchen cleanup, it's hard to hear them over the running water, dishwasher (which I love having again - we didn't have one at our old place), etc. So I laid down for a "few minutes" and when I woke up (to both boys crying about something), it was midnight. J had done the same thing, so we were now both awake. We cleaned up, had some dinner (it's hard to eat while we help the boys eat), and now J has gone to bed. I am taking care of email, reading stuff for tomorrow, and thinking about breakfast and lunch (what to make). That's why I post at these odd hours (procrastinating from my studies).

In any case, I'm going to try to read a little bit about glioblastoma before heading back to bed again. Three more hours until it's time to start the day again. Whew.

Tags: M, A

We're still unpacking. Actually, we've slowed down considerably, since we need a few pieces of furniture to unpack the rest of our stuff. We are short one closet compared to before, and that was where we stored toys that were not in rotation. So, it'll have to wait until I am done with this clerkship, since my hours run about 8am to 6pm (not bad, as clerkships go). I pretty much don't have time to do anything in the evenings since the boys go to bed around 8:30pm. And while my weekends are free, the last thing I need to do is take the boys to IKEA and then try to haul some furniture home (and build it). With the move and everything, I really want the weekends to be fun for them, and not filled with chores. So, we'll just have to coexist with the boxes a little bit longer. At least M doesn't seem to mind.

Tags: M

Amazon is having a promotion on baby items through October 13, 2007. You automatically get 10% off orders of $75 or more, which is not bad. I wouldn't go looking for something to buy, but if you've got something in mind, now might be a good time to get it. Some restrictions apply, so read the fine print.

Tags: Amazon, gear, toys

My handy-dandy dish soap dispenser was cracked during the move, so I had to order another one. I'm relieved that Amazon still carries it, since it truly is amazing (so much so that I am posting about it again). Try this out, and you'll never go back to anything else.

Tags: Amazon

Over the weekend, we visited the local park. With this new move, we're now within steps to a lot of great places, including the park (which has a pool and tennis courts), community center, police station, fire station, library, downtown, you name it. So that's really nice. I have a feeling we'll be doing a lot of walking on the weekends, which is great, since I could really use the exercise. The boys loved the park (just look at the tanbark that stuck to A's fleece pants), since it has structures geared towards young children and toddlers. On the way home, they shared a snack (Sensible Foods Organic Dried Fruit - good stuff), which was very cute. M even specifically picked out the apple pieces for A, since those are his favorite (the blueberries aren't that easy for A to eat). It really made my day to see them sharing, even if it was one tiny piece at a time.

It's amazing - from these photos, it almost looks as though A is bigger than M. I think it's the way they are sitting in the stroller. M is smaller than average and A is bigger than average, so they do tend to converge size-wise, but M is still quite a bit taller. In any case, we often get asked if they are twins when they are in the stroller (it's a BOB Duallie Revolution - a review is still pending, but we really like it so far).

Tags: M, A

There have been many toy recalls this year, especially with all the concerns about lead in products from China. I have a hunch that many more toys are contaminated with high levels of lead (and have been for years), but have just not been appropriately tested.

In any case, we don't have these blocks, but I do know several families who do. Apparently, it's the blue block that is the culprit. You can find more details here and check to see if your product is affected here. I'm trying to be extra careful about what A puts in his mouth these days, since I really have no idea which toys are actually safe. He's much better now than he was a few months ago (he was practically tasting everything in sight), thank goodness.

Tags: toys, health, safety

I can't wait for another break. The last two weeks have really been something. I think we are usually able to withstand a lot of stress and chaos, but we're really pushing the limits at the moment. We're doing a lot better now that we've handed back the keys to our old place, but there just seems to be so much to do. I'm on a neurology rotation now and really have to send off my ERAS before it gets too late. We're more unpacked than not, which is nice, but it's still tough right now, since there are a few key pieces of furniture we need to get to maximize the storage in the place, but we won't have a chance to do that for at least a few more weeks. Just getting lunches ready in the morning and dinner on the table at night is a challenge right now.

I realized that moving becomes exponentially harder with kids, especially little ones. They're small, but they come with a lot of stuff. And stuff that needs to be unpacked quickly. If we didn't have the kids to worry about, we could take out dinner late every night and live among packed boxes until the end of my neurology rotation. But the kids are on a schedule. They need their clothes and toys and bottles and sippy cups and what not. And while I have no qualms eating cereal for breakfast, lunch, and dinner for three days in a row, I'd feel pretty bad feeding that to the kids. Well-rounded, toddler and baby friendly-meals are pretty hard to think of (and make).

Anyhow, here's a calm-looking photo that I picked out from a few weeks ago, before we even planned to move. Peaceful. Like this one. I've got lots of ideas for posts (reviews of new toys, books, and medical stuff) but that'll have to wait just a little bit longer. ERAS is my first priority after the family right now. Then neurology. If I've got any extra time after that (ha), I'll post a bit more. But for now, photos will have to do.

Tags: A