This is so cool!

Problems with obesity

I know the topic isn't an easy target and many strong emotions rise when bringing it up. For those who feel offended I'm not in top shape myself and I've been bullied at school for this very same reason. But still it's worth writing for. Just to see a glimpse from doctor's point of view.

Currently I'm working at anesthesiology and to see heavily overweight patients makes me sigh because I know there's trouble ahead.

I'm writing this just to tell obese people view why physicians are so obsessed about their patient's weight. It's not about appearance, trust me. It makes our job extremely difficult in some cases and the cost of that just might be.. Well you know.

With obesity one is more likely to suffer from high blood pressure, lower limb osteoarthritis, sleep apnea etc. Making just about any diagnosis can be challenging. Listening to hear murmurs through a thick subcutaneous layer with your stethoscope, trying to locate a painful spot around the stomach, examining a chubby knee and realizing your muscles aren't big enough to lift it.

Then again we have all sorts of tests we can do, right? Lab results are rather reliable if one takes into account the size of the patient. In some cases the plasma is carrying too much lipids which can alter some results. X-rays are hard to read because the fat layer impairs the quality. Same goes for ultrasound. With CT or MRI scans the staff has to take into consideration whether or not the patient fits the cylinder.

Surgery and later physiotherapy repeat all these challenges from their own point of view.

So why does an over weight patient make my blood pressure rise? When putting patients to sleep for an operation you need to take care of their breathing. Usually this means intubation. Just because there isn't much space inside the throat this is difficult. Always. Then again there's extra weight above the lungs pulling them down. Ventilation machines are always fighting back when I make my adjustments. Heavy obesity also affects drug doses, blood pressure stabilizing, recovery and so on.

Westerns society is suffering from obesity. And the answer to the problem is not alone in the hands of medical doctors, but we do have our share. Information is one part of it.

For any overweight reader. I don't wish to overbear you. I'm sure obesity in your case is not a simple thing. I don't think it ever is. But you could be healthier and you could feel better. Sometimes the first step is like a baby step. How about turning to your physician? We don't know everything but we do know a lot. And we can help.

American Glass Paintings

Oh how I like. These are from New Orleans St. Louis Cathedral.

Don't stop me now

Three years ago I realized that in order to do some extra shifts as a doctor I desperately needed wheels. The Internet was full of alternatives and I was puzzled. Finally dad offered his help and before I knew it I was the proud owner of a beautiful Toyota. (Though I didn't really own it. I owned a long payment deal, but that's not the point.)

I loved that car! It meant freedom. I could go and do what I wanted. A whole new world opened. 

Gradually that car became natural part of my life. I used it everyday. On holidays I did amazing road trips. I've eaten and slept in it. Used it as a dump or a closet. Done my make-up and changed outfits. And music. There is nothing like driving your car on a summer night listening to your favourite band. 

And that car never failed. I always got home safe. Not once did it break down.

Here comes the but.

I started to wonder what it would be like to live without a car. I was surprised how hooked I had become. Even with more eco friendly alternatives to make a trip again and again I ended up on taking the car. I gained weight. And then there's the money issue with taxes, insurances etc.

Last August I said it out loud. "I'm thinking of selling my car."

For the last few weeks I've been cycling to work. It's not always pleasant, but I've enjoyed it anyway. A whole new home town has opened to me with the public transport and calling a cab is quite normal. I can't believe how easy it feels - a transition of this magnitude. (Though snow and cold cold winter are coming so regrets are likely.)

I'm not saying that I'll never buy another car. But this kind of change is refreshing.

All the leaves are brown

Thank you Lord for colouring this chilly time of year.

Survival of the smartest

A few nights back I was watching a television debate on religion. The setting was somewhat unusual and the comments much wittier than we're used to hearing. At one point intelligence was raised on the table referring to claims that atheists have higher IQ than believers. "Huh? I didn't get that," was the funny reply by the visiting pastor. Later one mouth said that this is proven by the popularity of religions in developing countries. !!! No one blinked or raised their eyebrows and the talk continued.

I was surprised how such comment can be acceptable in the year 2013.

In his book Guns, Germs and Steel Jared Diamond is arguing against such a claim. What seems to us as less developed does not imply to less intelligent. An example would be a New Guinean who knows thousands of plants and their possible uses. Or an aboriginal in Australia, who can easily survive in hot desert where yours truly would dry out in few hours. And he's not the first or the last making this point. 

Apparently the whole book is there to explain why Europeans attacked and conquered other continents. Many have used the concept of IQ in justification of this history. Diamond's explanation is more or less due to things like chance, evolution, environment and climate. Somehow it's not enough. Though very understandable for a firm believer of evolution.

Biology does not explain greed, oppression, violence or hatred. Conquer of the New World was not about survival of the fittest it was about the dark nature of human being.

I believe that given the chance anyone of us could be the oppressor to some extent. This is where we need religion. Smart are those who realize it.

Best bit of the day

 This is amazing. Rokia Traoré knows what she's doing.

Whose point of view

Few days before our departure from the US we heard what had just happened in Boston. It felt like for the first few hours everyone was in a state of anticipation. I personally thought the bombs were a diversion for something much more horrid just like in Norway. Luckily they captured the bomber and whatever plans he had are now belied.

All major TV channels were all about Boston - naturally. But literally this one event excluded every other piece of news. After the first day one might have like to hear wether or not North-Korea is attacking anyone or say know if there still is a Europe with all its' financial problems. Did the senate pass new laws, was there any natural catastrophe going on, how were things with the army or the legal system?

What is shown on TV is always someone's point of view and those making the decision have their interests and motives. (OK I admit I've been watching The Newsroom lately.) With Boston there were hours when nothing new truly happened, they were just repeating the same news, showing one runner take a fall again and again and finding people who commented jus how terrible it was to set a bomb in Boston.

I don't think I was the only one hoping to see or hear something else. Or was I?

Food for the soul

Enough with the traveling for a while now. These are from Sculpture Garden at New Orleans. One of the best parts in town. 

From the top by: Robert Indiana, Jaume Plensa, Coosje van Bruggen and Claes Oldenburg, Arman

Big easy

Rainy day in New Orleans gives a good reason to stare at your laptop. I've had a wonderful holiday here, seen and done plenty. People in the South are friendly and open. I've been talking to strangers the past week more than last year altogether.

Everywhere you go one way or the other the discussion is turned to Katrina, the hurricane that hit here hard in 2005. You can still see the results of the storm nearly anywhere you go. Abandoned houses big and small, remnants of various buildings and sad looking port.

There's also sunnier topics, plenty of them. I've been watching one family nearby in the neighborhood lifting their house. It's literally raised on poles so that if the water level goes up they'll be safe. I like that kind of attitude. "Come what may but we'll make it."

Louisiana baby!

Quick change from Africa to the South. Here's my theme song for the past few days. Overwhelmed.

Wild Africa... well almost

 Don't do safari if it's rainy season. These were my top shots. 

We had fun though.

Oh and saw some of the cast from Lion King.

Refugees

How desperate is your situation when you end up seeking refuge in Malawi? I mean were talking about one of the poorest countries in the world. Value of Kwacha went down I don’t know how much in only three months I spent there, big percentage of the population suffers from starvation and let’s not even start the HIV.

A refugee in Malawi has to have good reasons to leave ones’ country. And there’s over 20 000 reasons.  I had the privilege to visit Dzaleka refugee camp – a privilege cause at the end of the day I could leave the place. Several others can’t.

Some of the inhabitants of the camp have lived there close to 20 years. They consider it as their home as shabby as it is. Just before you reach the camp coming from Lilongwe there's a small hill with some trees and bushes. It's a cemetery for the refugees. Cause in Africa people want to be buried close to their home.

Where do men go to cry?

Though I’m not in Malawi as a clinician I get a peak, every now and then, of local hospital life. The compound is formed of too main buildings and a few smaller ones. Often in the morning one can hear loud, desperate crying that echoes from shelter that was built close to the hospital as a house of grief. Far too often a corpse is rushed there on a gernie followed my crying women. Their mourning is loud and by no means reserved. Sometimes I wonder, if they want to show their sorrow properly there and then so that they can move on with their lives as soon as possible. After a while the gathering accompanies the deceased for the last journey. Nearly always they’re ladies. Men are there mainly as drivers or play otherwise minor part.

Back home grief is often silent and somehow shameful as if emotions are to be hidden. To be strong in times of sorrow has become almost a standard.

When the former North-Korean leader died news footage showed crowds of people loudly crying after him on the streets. My heart broke as I saw them. Was it genuine or done because of fear?

I’d like to learn from Malawians on this. Cry with those who are in grief. Men included.

Girl in Lilongwe

Feeling like a hick in a big city right now. I'm not a fan of countryside living but just realized that's what I've been for the past weeks.

Lilongwe is a growing town with international dwellers. ..And that's about all I can say of it. I have a sense that the foreigners either work here or consider it a s a place to fill their stocks right on their way to visit a safari or the lake. Pretty much my strategy as well.

But it does feel good to watch TV in a long while and eat oranges. (Yeas I can be lavish.) Guess if I had friends here who knew good places to visit, would make it a whole different experience. In a way that's the case where ever you go in Malawi, or that's at least how I feel. Annoying as is can be that's also a way for people to connect. I've made good friends here thanks to needing their help and advice.

Yesterday someone asked me what I think about Malawi. My response was full of positive adjectives and none over exaggerated. Living here is not all rose pedals, but there's so much good that it helps to get through the rougher stuff.

I Heart Lake Malawi

My eyes are hurting for this beauty. 

No wonder the first missionaries tried to settle down around here.

Only downside being bilharzia, Lake Malawi is incredibly beautiful. 

Thank you God for creating it.

Fly me to the moon

This view was waiting for me couple of weeks back as I got home. 

I'm one lucky girl.

Meet my imaginary Boyfriend

It’s not easy to be a woman blah blah blah. This week I’ve read about human trafficking, domestic violence and how men in power grope very single woman they meet – just because it’s possible.

After those my own encounters seem small but nevertheless they have been from awkward to plain disgusting.  If you’re a single woman travelling around and most of the time in countries that haven’t heard of the women’s movement, you allow yourself one or two white lies.

My little white lie got big. These days it’s living a life of its own. Yep. It’s my imaginary boyfriend.

Last time today I was asked, if I’m single or not. The question came from a man who was very friendly but his motives to hear my answer were… Let’s not go there. Anyway I’ve been saved so many a times by the loveliest man in the world. (Who usually is staying in a nearby town or waits for me just around the corner.)

Meet Jayson. Lovely Brit who has even lovelier accent. He’s dark haired and has a great personality. He always laughs at my jokes and what’s even better makes me laugh. We share a passion to work in developing countries in the health sector. He is the one. And I’m not ashamed. Though if Mr. Right comes along I’m ditching Jayson.

Is it winter somewhere?

This was only two months ago.

Thank you Fia!

I met these wonderful pieces by Fia Backström last year at Stockholm's Moderna Museet. 

Guess who is missing her artsy hobbies

Then the rains came

Hope the villagers won't loose their homes tonight.

Strangers

I’ve always admired people who have the ability to be hospitable without much effort. I’ve considered it as a virtue, which I must learn since it’s not springing from me. Away from home in a strange country this thought rises to a whole new level.

I just finished reading “A thousand splendid suns”, a novel by Khaled Hosseini. (Pause and a sigh.) What an amazing story and an eye-opener. I cried during the last pages, but not as much as the characters and real life Afghans with their suffering would deserve. The story tells about people who don’t feel entirely at home, miss it or have to flee.

The next day my thoughts were filled by Bible characters who faced somewhat similar situations. I was surprised how many of them I came up with. Adam and Eve had to flee Paradise and Kain was escaping God’s wrath. Jacob escaped his brother’s anger and later he brought his huge family to a country they did not own. Joseph found himself in the middle of strangers in Egypt and later none of the Israelites were considered as Egyptians but as strangers though hundreds of years had passed.

David had to run away from Saul and later his own son as well. Daniel and his friends were forced to leave home and later the rest of Judeans followed. Even baby Jesus and his parents were refugees in Egypt since a certain king didn’t want to see little boys in his sight.

God’s attitude towards strangers is also revealing. All through Psalms and other scriptures he tells to accept strangers and treat them well. Christians are even told they’ll be judged by how they treat these people. I know I have plenty to learn with this issue. But still I find this gravity intriguing. Maybe Jesus felt like a stranger when He walked on earth. Even His own people didn’t recognise him.