Friday, August 20, 2010


Isaac has already been home 3 weeks now. Unofficially, I think we first laid eyes upon him irl on Thursday, July 29 somewhere around 12:15 am. Time flies. Of course, Karen has written about him a lot already. I do want to include a link from a photographer/friend of Karen's who took pics the night he came. Great pics, great entry. So touching.

About that night, everything was fairly routine--friends, family around, waiting on the flight, construction going on in the terminal right next to where we were, trying to keep Kate occupied. It all hit for me when I first got word that the people walking by were from his flight. After that, we only looked straight ahead where people were coming from the flight. I looked at Karen, she was crying. Emotions were stirring. Then he came around the corner with the escort. So calm. We talked with the escort, she handed him to Karen, mom translated some but the escort spoke a decent amount of English so we communicated a little bit directly. Not too long after, he got a hold of one of the balloons we brought and that seemed to help calm whatever discomfort he may have wanted to express. The escort left and we began our new lives as a family of 4. I mentioned before that it's so surreal. Being after midnight made it even more surreal. One minute we're standing around minding our own business, the next minute a child from halfway around the world ends up in our hands. Who are you? What is your story? How did you end up with us?

Isaac has adjusted remarkably well. In less than a week, his sleep schedule seemed to be back on track from the 13 hour time difference. He eats fairly well, poops well (always important). Karen's gonna get mad at me for sharing but his routine is to get down on all 4's and grunt loudly (and I mean, sometimes, loudly!) in order to evacuate the sigmoid colon. She won't let me video it so this is my payback. If I remember correctly, Kate would just get red in the face and make a few noises but not quite as loudly as Isaac.

Kate has also adjusted to Isaac well for which we're very thankful ... for. Don't get me wrong, she doesn't exactly like to share with him. When he has something, she'll just go over and take it from him (in a loving way) and either say "no, no" or "that's mine" or something similar to that. When she does this we tell her she has to share and give it back so now, if there's something she wants, she'll take it from him or us and say "you have to share." Well, at least she's being polite about it.

Isaac has taken well to his noona/nuna (big sis in Korean). It's funny to watch him chase after her. He can only do that by crawling so he has to hustle but he'll keep following her. He usually wakes up before she does so sometimes either in the morning or after afternoon naps (when Kate takes them) I like to put him on her bed and let him crawl over to her and wake her up. Instead of being cranky about it, she actually seems to enjoy it and will greet him with a "hi brother" or something similar.

He can be a cranky eater at times, not wanting to stay in his high chair, continually turning around. Amazing that the kids aren't related genetically but share some (many) of the same habits and behaviors.

The first few days he was very clingy. Not a surprise. My guess is that he was afraid we would leave him as others already have. He has gotten better about this. If he's not ready (like if he just woke up) and you put him down, he will start crying. However, after holding him for a minute, usually he's ready to explore as evidenced by him squirming to get down, and if you put him down at that point, he's fine. He'll go chasing Kate around, go to the toy room, kinda go wherever and explore. He's definitely in the "oral" phase and pretty much everything goes into the mouth. The teething isn't exactly helping, several coming in, so he's drooling like crazy. It's funny how he'll put blocks, blankets, puzzle pieces, and many other things into his mouth to soothe the teething but he won't chew on his teething-specific toys.

Initially he hated diaper changes and bath times. Overall, he's gotten better about diaper changes and usually doesn't cry now. Thanks to the baby whisperer ("bw," that is, me), he now enjoys baths. I do credit Karen a bit because we went to the spraygrounds in Roswell and he at least didn't cry while he was there. Then I thought it was time for the bw to strike. The next bath night, I took him to our bath in case there was trauma with the other bathtub. Then I put a few things in there he might like (toy, straw, etc.) and stood partially in the tub, holding him over it. He then indicated he wanted to play with these things so I put him down (sans clothes by this point) and turned on the water slowly. He did well. Now we can have him in the kids' tub and tonight he was splashing around and having a good ol' time. Yes, I am available for consultations at a discount friend/family rate.

My friend Burt and his wife came by last week and we were talking about Isaac's personality. He's a serious kid. Doesn't smile much although he's warming up a little bit. Doesn't really laugh much either. He's got a lot on his mind you know, how to solve the world's ills, etc. Now, he does love a good balloon like many kids. Recently he got a hold of one and bounced it around like crazy, laughing. I remember when Kate was a similar age and she got a hold of a balloon for the first time and she went wild! She was laughing and screaming so hard while bouncing the balloon around, it was hilarious. We had not seen her like that before. Same with Isaac although to a slightly more subdued level. It's also funny that when you look at pictures that came with him, he has a very serious look in many of them. It's like he's thinking, "I can't believe you guys are playing with dolls and trucks when we have famines and war going on out there, people!" However, I can always get a smile or even a laugh with "upside down kisses" just like I can with Kate.

In other mundane news, he does do well (so far) in the car seat. He's starting to stand unassisted for a brief couple of seconds. He's got a big head and protruding ears, in a lovable way of course. All in all, we are blessed.
life is short

Our pastor's nephew. Happened upon the link. Sad. Looks like he just celebrated a birthday too.

Thursday, July 29, 2010


Our little Isaac has finally made it home after a 20+ hour day of travel. He and Karen are both asleep on our bed and Kate's supposed to be asleep but is reading books out loud. But at least she's in bed ... except when she's getting out to get more books. With what will likely be a rare window of semi-stillness in the days ahead, I decided to post a few thoughts. Nothing better to do that with than a glass of scotch in hand, my way of celebrating Isaac's arrival. I should be trying to catch up on my own sleep but oh well.

The whole experience is surreal. I keep asking myself, "What in the world just happened? Someone went and dropped us off a kid!" Our family instantly grew by 33%. It's even more odd that we have this 10 1/2 month-old on our hands and we don't really know much about him. Sure, we got well-baby reports over the past few months but his habits, mannerisms, daily activities, likes and dislikes we have to discover on our own and we have a lot to catch up on! They do send some info with him about naps, meals, etc. but that can only help so much.

I don't think I have the time to go into the whole adoption idea and philosophy, especially how it pertains to Korea, right now but I do plan on doing that in the future. Suffice it to say, as joyous as it was to see the escort bring him down the runway, there are of course many sad aspects to the adoption process. One I didn't think about much until a friend of mine recently asked what stuff will come with him. Essentially, it's not much--a small carry-on bag, half of it filled with toys and other gifts that we sent over to him while he was in Korea. It's sad that adoption even needs to exist, it's sad that he was born in a culture that makes it so hard for single, unwed mothers to raise a child alone and it's sad that this little boy traveled halfway around the world, seemingly with nothing to his name, his worldly possessions fitting inside a small carry-on. Such a stark contrast with the roadtrips we take where we have the trunk and most of the backseat full of stuff.

I say seemingly nothing to his name because the truth is he has a lot going for him. Most importantly, he has love--from us, the adoption agency, the foster families, the escort who brought him here, his biological mother who made such a difficult decision, and most importantly from his heavenly Father. He has an adoptive mother who would and will sacrifice her own life for his.

I posted this video on my fb.
It's by MercyMe, one of the better bands to come out of CCM (contemporary "christian" music, another topic itself) in the past 10 years. I read all the comments, mostly on Karen's fb page, about the tears shed on hearing and seeing pictures of Isaac's arrival. So much emotion. And as touching those tears and kind words are, I think of how much sweeter our final reunion in heaven will be. It definitely fuels the fire of longing for that time and to have others share in that journey.

The other interesting, unexpected thing is how much bigger Kate seems all of a sudden. Not just in size, because as we all know, she is a giant, but it's like she aged 5 years instantly. She's a big sister now. You forget how dependent these little ones are. I call Kate a big baby all the time when she's whiney but she can feed herself, throw things away in the trash, count, solve some puzzles (sort of), talk, sing; all things that seem light years from where Isaac is. And she just turned 3! I can't imagine when they really grow up.

We decided on his name Isaac some time ago. After we pared down the list to a few names, I started taking a liking to Isaac but I kept Karen out of the loop until it was time to turn in the official papers. She kept bugging me for days but I just acted like I hadn't thought of it much. Cruel, I know. I like Isaac for several reason. In Hebrew, it means "he laughs," a reference to ol' Abe having a child so late in life and he found it pretty freakin' hilarious. Laughter is something that I feel describes our family well. Karen is probably the funniest woman I have ever met so Isaac will fit right in. Kate's a pretty funny little girl as well. Also, as far as other famous Isaacs are concerned, who can forget Isaac Newton? Hello, I invented calculus. I mean, who does that? So, Isaac has a good name pedigree. Don't let us down little man, you and Kate have to make it big so we can live off you in our old age.

Monday, July 05, 2010

Happy 4th

It's actually the 5th so happy belated 4th. I didn't realize it was so long since my last post. I guess I got so depressed once healthcare reform passed that I took a hiatus. Nothing a good ol' patriotic 4th of July can't fix however.

I ran the Peachtree Road Race for the second consecutive time this year. Not really sure why I decided last year would be my first race but it was. Maybe because it was the 40th running. Who doesn't like an anniversary? I semi-trained last year, slowly increasing my run times. Pause here. In case I haven't mentioned before, I hate running. I love the feeling after running, that I've improved my cardiovascular risk profile, improved my stamina, burned some calories. It's also cheap so that's another plus. But running to me is so boring. It requires no skill. Okay, sure there are proper techniques of running, etc. but it's not like you're hitting a golf ball 300 yards and trying to land it within a strip of grass. Also, you start and end at the same place and you have nothing to show for it. Big deal, so I live a few extra years at the end of my life. The demented years? No thanks. If I ran and ended up at the grocery store and back with food so I didn't have to waste gas, now we're talking but that's not very practical.

Having said all that, I am sensing a bit of my mortality so I run--mainly because I can do it spur-of-the-moment, I don't need to call up someone else or a group of people like with basketball (I can actually shoot around alone for a while and find it somewhat fun but after about 30 minutes of it, you want to start playing in a game) and I can feel it make a difference in my blood pressure and cholesterol. Along with running, it may be difficult to believe with all the buffets I've been to in the past year but cutting down calories has brought my weight down to 157.6 lbs. Aside from a diarrheal illness I had a couple of years ago, this may be the lowest weight since before med school. Of course it fluctuates but at the least, I've been consistently below 160 for a few weeks now.

Getting back to the running, using headphones and listening to music does make it barely tolerable. For the race last year, my training never consisted of more than 2-3 miles at one time until I busted out the 10k on race day. We lived at the Habersham last year so I stopped near the now defunct ESPN Zone and talked with Karen and the baby for a minute. Then, heading up cardiac hill I spotted a port-a-potty and waited a minute to get in but it was taking too long so I just kept going. I frequently get a big urge to pee while running, even if I recently went. Eventually it goes away but the uncomfortable feeling slows me down a bit. I walked all of cardiac hill and some of the uphill areas after that and finished in 67:36.

I just remembered that Karen became a fan of the road race on FB and I think if you became one of the first x number of fans, you got a free number so she signed me and herself up. I think that's how we ended up in the race.

Training this year started a little later because I didn't realize how close to race time it was. "Training" last year was mainly so that I wouldn't be one of those poor guys who ends up in the hospital in multi-organ failure from rhabdomyolysis. Had one a couple of years ago at our hospital. This year, I was trying to actually post a better time, ideally sub 60 minutes. I ran a 5k earlier this year ("1st Annual" Shoebox Derby) in under 24 minutes but one of the top runners said the course was short. Based on later training and times, I think it was a lot shorter than I realized.

Anyway, for this year, I woke up, ate 2 frozen waffles, drank some coffee and since we live in Brookhaven now, Karen dropped me off. Peachtree is blocked off a couple of blocks north of Peachtree Dunwoody so it's easy to walk from there to the start areas. I essentially ran the whole distance this year and finished in 56:30. Not bad but I think I can knock off at least another couple of minutes. For next year, notes to self:

1. If you drink coffee (mainly as a cathartic) before the race, either drink only half a cup or drink it a lot earlier. Again, I had a crazy urge to pee (surprise) just before the start so the first mile or so I was really dragging because I didn't feel so great.
2. If I resolve 1., then try to run the first 3 miles much faster (but not too fast to get worn out). The first half of the race is mostly downhill so you really have to take advantage of it.
3. No ipod next year. I think it slows me down. I love pouring water over my head during the race and because of my earbuds, I had to slow down a little to make sure I didn't get them too wet. Next year I can just pour it all over more quickly. Plus, there is a lot of music along the course so there is less need of an ipod.
4. Walk when I drink water. It will only take a few seconds and it's easier to coordinate than trying to jog and drink at the same time. And you don't get any in your lungs accidentally.
5. Don't carry anything. There was a BP giving out bottled water so I grabbed one thinking it would be more efficient and helpful since I wouldn't have to wait for the water stations to get water. Well, that backfired because it slowed me down while I tried to drink it
(I didn't want to waste the water since it's bottled so I'm trying to drink it for a much longer time than I should have), plus it slowed me down because I'm carrying the thing.

So those are my tips for next year. We'll see how much time I can shave off.

Monday, March 22, 2010

"Odd Things" Part 1

The historic bill has passed. I've been perusing it (H.R. 3590, search for the bill online here) and looking for random things that made their way into the bill. Here is part 1 of "Odd Things That Made the Cut As Healthcare Reform:"


    Section 7 of the Fair Labor Standards Act of 1938 (29 U.S.C. 207) is amended by adding at the end the following:
    `(r)(1) An employer shall provide--
      `(A) a reasonable break time for an employee to express breast milk for her nursing child for 1 year after the child's birth each time such employee has need to express the milk; and
      `(B) a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, which may be used by an employee to express breast milk.

First of all, if you breastfeed more than a year, you're screwed. Also, I can see some unscrupulous business owners sticking women into closets and the lawsuits rolling in claiming this misses the spirit of the law when it says a place "other than a bathroom."

I'm glad this provision made the cut. The current bill just wouldn't be the same without it.

Sunday, March 07, 2010

"Why Men Like Porn"

This is the title to a WebMD article, found here. The article is short but it's hard to believe so much garbage could be packed into so small a space and be found on what I thought was a relatively reputable website. I even used to refer patients to this site for additional medical information. No longer. They make porn sound benign, like you're trying to pick between a plasma tv and LCD. Here is one ridiculous line from the article: "If you're spending too much of either [time or money] on porn, it often reflects a larger problem, like marital difficulties or a job loss." Yeah, it has nothing to do with addiction or the sin nature or deep psychologic issues--you're just having some bumps in your marriage or job. Because porn itself would never BE the cause of the marital difficulties, right?

I love the "Exploring Pornography" section at the end. "Honey, after dinner and the kids are asleep, what do you say we spend some good quality time looking at hard core porn? Or we could make it soft core night if you prefer." Unbelievable.

Friday, January 08, 2010

Delusional (statements by) doctors

Lest I be accused of libel, note that I believe the following statements are delusional, not the actual physicians themselves. First, see this article. One of the Mayo Clinics in AZ will no longer be accepting Medicare patients. What is disturbing, however, is a statement by Robert Berenson, a fellow at the Urban Institute and proclaimed expert in Medicare. Apparently, when you are out of practice for some time (I did a limited search and had trouble finding out the last time he actually took care of patients but I bet it's been a while), it gets easier to make such blanket statements about the everyday doctor. From the article:

Robert Berenson, a fellow at the Urban Institute’s Health Policy Center in Washington, D.C., said physicians’ claims of inadequate reimbursement are overstated. Rather, the program faces a lack of medical providers because not enough new doctors are becoming family doctors, internists and pediatricians who oversee patients’ primary care.

“Some primary care doctors don’t have to see Medicare patients because there is an unlimited demand for their services,” Berenson said. When patients with private insurance can be treated at 50 percent to 100 percent higher fees, “then Medicare does indeed look like a poor payer,” he said.

This is some twisted, convoluted logic. Why does he think there aren't enough providers going into primary care? There are many reasons but one is certainly because they get paid less than specialists, which includes reimbursement from Medicare and other insurers. So, Dr. Berenson thinks that Medicare doesn't really underpay, it just looks like it does because other insurers pay more? That gets into the question of how much he thinks physicians should be compensated. What is the fair market value of a physician? Oh wait, he doesn't really believe in the market when it comes to the medical profession. After these ridiculous comments I did a little research and came across the following from a letter in the Journal of the American Medical Association, May 27, 2009 (subscription required; in response to original article January 21, 2009):

We did not express opposition to health care competition per se, but rather to a specific form of competition core to the "consumer-driven" approach that encourages patients to shop for discrete health services to find the best match of quality and costs.

Anytime someone says they don't agree with something per se, yeah, that means they don't agree with it but they're afraid to admit it outright in case others might think they're crazy. Then in the letter, they (includes Dr. Cassel, more on her later) use direct-to-consumer advertising of drugs with its evils as an example of why competition among physicians is concerning. Talk about a non sequitur. How are these even related? As mentioned before, they still completely ignore other areas of competition such as LASIK and cosmetic plastic surgery which has improved care while lowering rates with little insurance penetration (until lately).

I love how Berenson later quotes his own article to bolster his claim: "See, read this article from another smart man; what I'm saying is true."

The other part of the "they" is Christine Cassel, current president of the American Board of Internal Medicine which certifies most internists in this country, including me. Scary.

Berenson's comment on the "unlimited demand" for primary care MD's is equally bewildering. If there is such an unlimited demand for something, how is it that people are moving AWAY from it? Oh yeah, it's because you're trying to cut their pay. Completely opposite of free market but apparently this type of thinking is common. Note this comment by Senator Conrad recently:

And let me say, if I can, on this question of reducing Medicare, there are $500 billion of savings to Medicare. Most of those savings have been negotiated with the providers. They're going to get less than they were anticipating. They've agreed to those savings because they know they're going to get 30 million more customers. That is a dramatic increase in business for them, and they are sharing some of the savings so that we can pay for this bill. There's not unreasonable.

This kind of comment highlights how clueless non-physician legislators are about physician practices. As if physicians are just sitting around twiddling their thumbs and so excited about all these new patients that will be filling their offices. No, physician offices are typically busy. Why? Because of this unlimited demand? No, because they have to cram 40 patients a day into 15 minute slots in order to make a buck. And why do they have to do that? Because of overhead, administrative and insurance junk they have to deal with that take up so much time and money. Add to this complex patients, late patients, more insurance problems and a whole bunch of other junk and there you have your overflowing waiting room. No wonder why many doctors aren't taking insurance anymore. They can spend more time with patients, treat them properly and still break even. Here's one example.
Twynsta in da haus

Yes, the geniuses at Boehringer Ingelheim have come up with the name "Twynsta" for their new hypertension drug. This could be quite possibly one of the worst drug names in recent memory. Check out this thread on Cafe Pharma. Funny stuff.

Monday, December 28, 2009

Happy Holidays

I recently got a generic holiday card (I won't say where from) spewing with relativistic thought. I guess that's what it takes to survive this pluralistic world. Here's the text:

Whatever is beautiful,
whatever is meaningful,
whatever brings you happiness ...
May it be yours this Holiday Season
and throughout the coming year.

So if you're a child molester and that's what makes you happy, go for it this holiday season!