This is such a huge relief. We’ve been working on it for probably 18 months. He showed interest early on but then, maddeningly, completely abandoned that interest for a long long while.

The key with Jamie, as usual, is to not push him and let him decide for himself when he’s ready. So we kept asking and encouraging, but not forcing. None of that “potty train your kid in one day!” crap. I can’t even imagine making him sit on the pot for hours on end until he went. I guess it works for some kids; definitely not this one.

He’s been urinating on the toilet most of the time since early March, and then “doing number two,” as they say, since the very end of March.

Now if only we could figure out how to get him to consistently pull up his undies and pants afterwards. He’d much rather run around in just his shirt.

Anyone have any good crochet resources? I had beginner knitting experience like 30 years ago, but no crochet experience at all. Also, I am impatient. I want to dive right into making those flowers.

Guest Post: A Doctor on Transvaginal Ultrasounds

MARCH 20, 2012 BY JOHN SCALZI 380 COMMENTS

A friend of mine is a physician who wants to speak about transvaginal ultrasounds but whose position makes it precarious to speak publicly about it. So I’m letting this doctor borrow my site for an entry to speak anonymously on the matter. Obviously, I will vouch for the doctor being a doctor and being qualified to speak on the subject.

Update, 9:14pm: This post is being linked to far and wide, so we’re getting lots of new readers and commenters. It’s important that before you comment you read the site disclaimer and comment policy. I delete comments I find particularly stupid. Try not to write one of them.

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Where Is The Physician Outrage?

Right. Here.

I’m speaking, of course, about the required-transvaginal-ultrasound thing that seems to be the flavor-of-the-month in politics.

I do not care what your personal politics are. I think we can all agree that my right to swing my fist ends where your face begins.

I do not feel that it is reactionary or even inaccurate to describe an unwanted, non-indicated transvaginal ultrasound as “rape”. If I insert ANY object into ANY orifice without informed consent, it is rape. And coercion of any kind negates consent, informed or otherwise.

In all of the discussion and all of the outrage and all of the Doonesbury comics, I find it interesting that we physicians are relatively silent.

After all, it’s our hands that will supposedly be used to insert medical equipment (tools of HEALING, for the sake of all that is good and holy) into the vaginas of coerced women.

Fellow physicians, once again we are being used as tools to screw people over. This time, it’s the politicians who want to use us to implement their morally reprehensible legislation. They want to use our ultrasound machines to invade women’s bodies, and they want our hands to be at the controls. Coerced and invaded women, you have a problem with that? Blame us evil doctors. We are such deliciously silent scapegoats.

It is our responsibility, as always, to protect our patients from things that would harm them. Therefore, as physicians, it is our duty to refuse to perform a medical procedure that is not medically indicated. Any medical procedure. Whatever the pseudo-justification.

It’s time for a little old-fashioned civil disobedience.

Here are a few steps we can take as physicians to protect our patients from legislation such as this.

1) Just don’t comply. No matter how much our autonomy as physicians has been eroded, we still have control of what our hands do and do not do with a transvaginal ultrasound wand. If this legislation is completely ignored by the people who are supposed to implement it, it will soon be worth less than the paper it is written on.

2) Reinforce patient autonomy. It does not matter what a politician says. A woman is in charge of determining what does and what does not go into her body. If she WANTS a transvaginal ultrasound, fine. If it’s medically indicated, fine… have that discussion with her. We have informed consent for a reason. If she has to be forced to get a transvaginal ultrasound through coercion or overly impassioned argument or implied threats of withdrawal of care, that is NOT FINE.

Our position is to recommend medically-indicated tests and treatments that have a favorable benefit-to-harm ratio… and it is up to the patient to decide what she will and will not allow. Period. Politicians do not have any role in this process. NO ONE has a role in this process but the patient and her physician. If anyone tries to get in the way of that, it is our duty to run interference.

3) If you are forced to document a non-indicated transvaginal ultrasound because of this legislation, document that the patient refused the procedure or that it was not medically indicated. (Because both of those are true.) Hell, document that you attempted but the patient kicked you in the nose, if you have to.

4) If you are forced to enter an image of the ultrasound itself into the patient chart, ultrasound the bedsheets and enter that picture with a comment of “poor acoustic window”. If you’re really gutsy, enter a comment of “poor acoustic window…plus, I’m not a rapist.” (I was going to propose repeatedly entering a single identical image in affected patient’s charts nationwide, as a recognizable visual protest…but I don’t have an ultrasound image that I own to the point that I could offer it for that purpose.)

5) Do anything else you can think of to protect your patients and the integrity of the medical profession. IN THAT ORDER. We already know how vulnerable patients can be; we invisibly protect them on a daily basis from all kinds of dangers inside and outside of the hospital. Their safety is our responsibility, and we practically kill ourselves to ensure it at all costs. But it’s also our responsibility to guard the practice of medicine from people who would hijack our tools of healing for their own political or monetary gain.

In recent years, we have been abject failures in this responsibility, and untold numbers of people have gleefully taken advantage of that. Silently allowing a politician to manipulate our medical decision-making for the purposes of an ideological goal erodes any tiny scrap of trust we might have left.

It comes down to this: When the community has failed a patient by voting an ideologue into office…When the ideologue has failed the patient by writing legislation in his own interest instead of in the patient’s…When the legislative system has failed the patient by allowing the legislation to be considered… When the government has failed the patient by allowing something like this to be signed into law… We as physicians cannot and must not fail our patients by ducking our heads and meekly doing as we’re told.

Because we are their last line of defense.

The deck also got a fresh coat of paint (red like the house). So did the garage door, front door, back door, and kitchen door (pale cream).

I’m just trying to ignore how much it cost. It had to be done… no way around it.

We still need to get two sets of shutters for the front windows. I think we’ll paint and install those ourselves to save labor costs.

Saturday morning we noticed that the carpet in the living room was… wet. And stinky like bath towels that have gone sour. It turns out that our water heater, in the garage on the other side of the living room wall, had gone kaputt and leaked voluminous quantities of water through the wall.

Doc turned off the cold water supply to it, which is where he had traced the leak to. He also turned off the gas, drained the tank, and suctioned the standing water out of the closet. We thought maybe we just needed to replace a washer or gasket in the supply line, but in fact, the tank had failed. Who knew that those units have a lifespan of something less than 12 years? Now we do.

We had no hot water all weekend. O! The horror! (See me complain about my first-world problem, there?)

So we got a new tank installed today. The installer also brought the tank and closet up to code (i.e. installed a drain pan with a drain to the outside wall of the house — smart thinking, those code guys!).

I am looking forward to a hot shower in the morning. Today I left the house early, went to the gym at work and washed my hair there. Ick – it’s a fairly new building but those showers are pretty gross. Hope I don’t have to do that again.

(As a side note, I had about 10 minutes to spare when I arrived at the gym so I ran 1/2 mile around the indoor track… and pulled the same ligament or tendon in my left hip that had JUST healed up. GRRR.)

Anyway, now we just have to deal with drying out and destinkifying the carpet. Thank goodness we purchased a steam vacuum last year – that’s going to help tremendously.

12 ounces white vinegar
12 ounces liquid, blue dawn detergent

Directions:

Heat vinegar in microwave until hot and pour into squirt bottle.

Add the Dawn soap. Put the lid on and gently shake to incorporate.

You now have a powerful cleaning product that will melt soap scum and tub and shower buildup, clean sinks, appliances and just about anything. Just spray it on, scrub, rinse and be amazed. For tough soap scum build-up, spray the mixture on and allow it to sit as long as overnight. Then, scrub and rinse.

via Tub And Shower Magic Recipe – Food.com – 434275.

We sat in an exam room for four hours this morning. I was expecting the worst (extra energetic 3 year old cooped up in a tiny room where he can’t touch anything? AWESOME.) He behaved remarkably well, though. At all previous doctors’ appointments since he learned to walk, his main focus has been attempting to leave the room. This time, he didn’t try to open the door, not even once during the whole four hours. For distraction purposes, we brought a supply of books and toys as well as the iPad, and they had a small TV and VCR in the room with some kids’ movies.

(We had to explain to Jamie what a VHS cassette was.  I am so old.)

He drank four rounds of increasing amounts of egg white powder dissolved in Koolaid. He had to be bribed/coerced into drinking the last three rounds, but for all of it, he showed no immediate signs of allergy. They told us we were “in the clear” and even wrote “Congratulations! You may begin enjoying eggs” on his exam checkout sheet. That is misleading, though, since he has never shown any immediate allergic reactions to the things he’s sensitive to. His particular manifestations of his sensitivities are eczema and intestinal distress, and that tends to show up a few days to a few weeks after the fact. I’m not convinced that eggs won’t affect him. We’ll just need to wait and see.

Here’s what it said:

DON’T BE HATIN’
GOD IS THE ONLY ONE WHO CAN JUDGE ME

I’M
GETTIN’
$ MONEY $

And then, the pièce de résistance: Adorning both the right and left sides of the window were decals of that mischievous imp Calvin, peeing on the word “HATIN’”.

Nice, eh?

Saturday I didn’t get much accomplished save grocery shopping and having the Prius’ tire pressure adjusted (I suppose that’s better than nothing).

Today, we took a trip to the hardware store, discovered that replacement bathtub drain levers are inexpensive but cheaply made and available only in shiny chrome finish (thanks but no thanks), and found some heavy duty storage bins and new doorstoppers.

This afternoon, I replaced the electrical outlet by my bed with an adapter that gives me six outlets (no more extension cord tangle by the bed). I also began — and am about to go finish — the process of reducing the tangle of cables in our and Jamie’s bedroom closets by running the existing CAT6 cable from the attic into an ethernet outlet. Sounds fancy, doesn’t it? I think Doc could do this stuff in his sleep but I wanted to attempt to tackle a home improvement project myself, and this one seemed fairly straightforward.

I’m not even going to describe the myriad of problems I ran into. Suffice it to say, I am now quite familiar with our house’s internal structure, and also am completely comfortable traipsing around in our unfinished attic (unfounded fear, conquered!). Who knew that ceiling studs are only 18″ apart and easy to walk on? Anyway, I now need to install the box and faceplate on the wall and then patch up the… um… numerous holes I made in the ceiling and wall. Spackle FTW!

Doc taught Jamie to say a new phrase, so now his response when we say, “Jamie, we have a league game next Saturday!” is “Dude. I don’t roll on Shabbas.”