25- Unicorn Farts

Many moons ago I made Moose Farts for a December Cookie Thursday is a Thing. I made them because I thought they were funny.

And they were popular.

It’s a simple recipe, graham cracker crumbs, coconut, sweetened condensed milk, chocolate chips, more graham crackers crumbs for rolling. But it was a lot of fun to do.

Now we are in August and the theme is No Heat. I considered resurrecting the Moose Farts when I saw a similar recipe for Unicorn Farts.

This tickled my funny bone.

Similar recipe with white chocolate chips and rainbow sprinkles to roll the balls in.

But if I am not experimenting then why am I making cookies?

Enter edible glitter!

Part of the baking pantry. I picked it up because I thought it would be useful for CTIAT at some point. In reality, this is why half of the stuff is in the baking pantry. You know, just in case I figure out how I’m going to turn it into cookies or I have an idea for a theme and I need to start gathering supplies.

Thankfully, I have a baking pantry and I have the disposable income to be able to pick up interesting (to me) ingredients with the eye to a someday cookie.

But finally, it is the edible glitter’s time to, well, shine.

The resulting make is hilarious and just plain fun to look at. Although the colors were not as sparkly in the batter as they were in the jar, it is still fun to do.

I hope they make my coworkers smile.

Call Secrets of the OR #4- Every call shift will end… Tomorrow!

The shift will end
Tomorrow
Bet your bottom dollar
That tomorrow
There’ll be sleep!

Just thinkin’ about shift end
Clears away the cobwebs
And the sorrow
’til there’s none!

When I’m stuck in a shift
That’s long
And forever
I just stick out my chin
And grin,
And say,
Oh.

The call will end
Tomorrow
So I’ve got to hang on ’til tomorrow
Come what may!

Tomorrow!
Tomorrow!
I will sleep
Tomorrow!
Sleep’s only a shift away!

Apologies to Martin Shaman and Charles Strouse for co-opting and re-writing their hit “Tomorrow” from the Broadway musical Annie.

As a night shifter, I know that sleep is very important. And some nights we don’t get a lot of it. But that is the nature of the call shift. Sometimes there isn’t a lot of sleep, and sometimes it is a full night of it. You have to be able to roll with the schedule.

The first thing my university advisor asks when she sees me is “How’s the sleep? Are you getting enough of it?” Yes, Dr. Advisor, I am getting enough sleep. I have data points to share if you are interested. Maybe I should make it into a graph for show and tell purposes.

That being said, and knowing that not everyone tracks your own sleep patterns, there are some things that can be done in your sleep environment to prepare yourself for good sleep.

Is the room cool enough? A University of Texas sleep specialist, Dr. Okeanis Vauu, reported that sleeping in a cool dark room is recommended. After all, our brain wants a cooler temperature while we sleep. This information is from a UT article on sleep after the spring forward time change.

But it is definitely appropriate for sleeping after a call shift.

The dark room during the day may be harder to accomplish. I have purchased black out curtains until I am blue in the face but they are never dark enough. Next I found and purchased black out blinds that you cut to size. I cut and installed these after the first month I was on call.

Instant bliss. Not to mention cooler.

In the summer, I also put up heavy curtains in the adjoining bath because of the afternoon sun that 1) heats up the small room, and 2) is blindingly bright.

My husband works afternoons/nights and is glad for the additional window coverings.

We don’t have children to get off to school or children at home. Unless you count the cat, who insists that I get out of bed by 0800 every morning, whether or not I’ve worked the night before. But I have heard that can be a barrier for some.

Sleep when you can. Some people can go right to bed when they get home and this is a good habit to get into.

Because you never know when the next case will pop up. There have been times that I’ve been home and in bed for 15 minutes and the darned pager went off again. And I head back to the hospital for another case.

Thankfully those kind of nights are hopefully far apart. And if it is a string of late nights just remember that day shift will be in a 0700 to relieve you so you can go home and sleep.

No bad pattern lasts forever. Some last longer than most but that’s call life.

I find it best not to focus on the sleep you’re missing but instead focus on the good sleep you will get the next day because you won’t be responsible for day cases. And the hospital won’t be ringing you up with add ons.

Remember, there is always a shift end. There is also a finite amount of time that the case volume can hurt you and stop you from sleeping.

These tips are coming from a call afficionado: make your room as dark as you can, and make your room as cool as you can. Fans are a good help here.

And take the afternoon nap when you are able to. Especially if the house is still and silent because everyone else is away at school or work.

Pay attention to your sleep hygiene and practices while on call. Well, any night really, but especially on call.

Call is only a sleep debt if you want it to be.

Tuesday Top of Mind 8/12/2025- Vaccine lies lead to deadly shooting at the CDC

The original title of this post was Panic at the CDC, with a subtitle of no, this ain’t no disco.

Then I thought better. Time to call the vaccine lies what they are, lies. According to the Merriam Webster dictionary the definition of a lie is to “make an untrue statement with the intent to deceive”.

We need to start naming the lies.

None of this namby-pamby “mistruths”, “states without evidence”, “mislead”, “false”, and “fabrications”. All of those words mean the same thing. That someone is not being honest with you *cough, cough, RFK Jr., Fox News* for their own benefit.

Use the word lie(s). Tell it like it is.

It is a good rule of thumb to interrogate your feelings about what you are being told. And also consider the motive behind the one telling you these “truths”. Is it to make you mad? Is it to make you do something that you would not normally do? Such as shoot up the very place that works, and has worked since 1946, to keep the public safe.

This is about a man who was poisoned by the media he was ingesting, not the vaccine that he receive. He thought, probably because that is what he was told, that the vaccine was making him depressed and suicidal.

So, emboldened by the lies that were being told to him at the highest levels and the news, the shooter gathered up his guns and went to kill the very thing he blamed for how his life had gone off the rails.

Never mind that the CDC had been actively working to keep him alive and in good health.

No.

He went to the CDC campus in Atlanta, Georgia and fired 180 rounds into the buildings. He broke 150 windows by firing indiscriminately at four buildings. He was not on the CDC campus, instead firing from the second floor of a CVS across the street.

He also killed a first responder, a Dekalb police officer by the name of David Rose. This was a man who will be missed by his wife and children. He was shot responding to the shooting.

This is an ongoing story and investigation. However, it is also a moment of reflection.

I certainly hope those who are spewing anti-vaccine lies and rhetoric do not sleep easy knowing that their reckless lies and breathless new reports caused this.

According to the CDC website, and the various vaccine makers such as Pfizer and Moderna, depression and suicidal ideation is not a side effect of the vaccines.

And no, I will not be naming the coward who thought it was a good idea to listen to the lies and act upon them. That is readily available.

As always when you are confronted with a news report, Facebook post, text from a friend, consider who your anger benefits.

For fuck’s sake, stop calling it misinformation and use the word lie!

FFS Friday 8/8/25- Forced Removal is Fairness Denied

I have thought about this all day. I have thought about how to approach writing about it. I have thought about all the the F words I wanted to use. I have felt compassion for these individuals impacted. I have felt rage at those who deny those who have bled for this country and served it honorably.

I am referring to the announcement that the Air Force is early denying retirement to all of its transgender members who have between 15 and 18 years of military service. They are being forced out with no retirement benefits. According to a Guardian article even those who were approved for temporary early retirement has had the rug pulled out from under them.

And then I remembered that cruelty is the point with this bastards.

No matter that the enlisted swore to uphold the Constitution, and would obey the President and the officers above them. All they wanted to do was continue to serve their country.
No matter that the oath of office for officers (yes they are different) is that they will support and defend the Constitution, while bearing allegiance to the country.

No, these individuals served as trans members of the military, proudly, for YEARS. And then an ill wind appeared and blew it all to hell. Because the ill wind is a petty little bitch and must destroy what they don’t understand.

To recap, trans members of the Air Force who have served the country and upheld their oaths, enlisted and officer alike, have bled in service of the country, have died for their country, have continued to serve under those who do not understand, who have done their best for the Constitution and their country were targeted for attack under the current administration. Some held strong to get to their 20. Others opted to take early retirement, unable to bear the strain of the unrighteous attacks from those who should be supporting them.

To me, they were forced out. In fact they were told to leave, that they were an abomination.

All they wanted to do was serve.

In 1993, 18 year old me, newly graduated, newly moved across the country to Nebraska, newly a college student, newly dressed in uniform, stood proudly on the wool rug in my detachment’s captain’s office, raised my right hand, and swore the oath of office. I was determined to be a career officer, to study hard, to be the best nurse I could be, to protect and care for servicemen in my care. I was excited to be among other cadets as we all learned what it meant to be an officer and how to support the Constitution to the best of our abilities and with our lives if needed.

This was not to be as I suffered an Air Force career injury due to some ripped up dorm stairs the next year and I was invited to leave as I could no longer fulfill my part of the oral contract. I was weeks away from bootcamp.

What they are doing now is barbaric and is spitting on the graves of all who willingly served before.

Forced removal is fairness denied. No matter that they took the enlisted oath or the oath of office. No matter that they were under attack by those who should have cared for them. No matter that as they had the country’s back in war times, the country decided they were nothing and flicked them off like a cigarette butt when you are done smoking it.

Are you paying attention yet?

I fear that next target will be the women of child bearing age so that they can go home and have babies.

Cookie Thursday 8/7/2025- S’mores treats

August is, as is traditional for Cookie Thursday is a Thing, No Heat Month.

Of course, you wouldn’t know that by the weather this past four days.

Rainy, humid, slightly cooler.

Slightly.

It is tradition, as I’ve said, for August to be the month where I do not turn on my oven.

Like, at all.

With the Thursday before the start of school for most of the schools around here on August 21 and the department has an ice cream social on that day, that leaves me only 3 CTIATs.

This week is a Rice Krispies knock off. Well, the same recipe with a different cereal.

What is more summer late night than s’mores?

Not much.

You know when the temperature is a bit cooler in the evenings but still dark enough to see the fireflies? Yeah, that.

And what goes best with summer late night around a campfire?

S’mores.

I happened upon a Malt-O-Meal bagged S’more cereal. Graham cracker cereal, mini marshmallows, and chocolate balls. Perfect for a Rice Krispies knock off.

But, me being me, I added chocolate chips as I was stirring in the cereal.

Because why not?

Call secrets of the OR #3- Positivity is a must

This is what I alluded to all the way back in call secrets of the OR #1 when I told the surgeon that I approach each case with optimism and I do not dwell on the possibilities.

Not a lot of people like call.

I get this.

However, I think it is because their attitude is wrong.

In case after case after case, the surgeon talks about what can go wrong during the surgery. Before the incision is even made.

I let them grouse and complain and say that they are missing sleep. They list off the complications that could happen. Not will, but could. Yes, yes, we all are missing sleep. I let them get it out of their system. There is a LOT of complaining.

And then I hit them with “But what if none of that happens?”

What if the appendix is sitting on top of their bowel, just ready to be plucked?

What if I have everything in the room for every eventuality and therefore you are not delayed?

What if I can get you back in bed in 90 minutes, 60 if it is an uncomplicated appendix?

Don’t get me wrong, sometimes the nights are very long and I don’t see my bed until after day shift starts. And my cat, who has boundary issues, demands that I get up and touch the food in her dish at 0800, even if I’ve just gotten into bed. Sometimes the case devolves into a messy one and I don’t have everything they need. Sometimes the case devolves into a real shit show and now I have to man the phones to arrange for a higher level of care bed in the intensive care unit.

Sometimes not cool stuff does happen. But not every time. And certainly, not every night.

What if by naming the bad outcome you are dreading makes it happen? What if by naming the bad outcome you are dreading makes it not happen.

Call is a craps shoot. With a 20 sided die. Sometimes you get a natural 1 and it all goes to hell. But there is an equal chance of a nat-20 and the incarcerated hernia reduces itself as the patient goes off to sleep.

Yes, this can happen.

Don’t you see? By steeling yourself that the bad thing will always happen, you cut yourself off from the possibility that it won’t.

I admit that sometimes I am aggressively positive. Which can irritate a surgeon or a coworker. I know this and I will not be working on it.

I just shrug and say, “Oh well. Better luck next time.”

Tuesday Top of Mind 8/5/25- Raw milk does NOT do a body good

Before the ubiquitous “got milk” complete with milk mustache campaign of the 1990s, there was the “Milk Does a Body Good” campaign of the 1980s. Both of these were to promote milk as a healthy drink that builds strong bones.

Don’t get me wrong, milk does have a lot going for it. It has protein, vitamins, and other nutrients that your body and your bones need to be strong and withstand life. The habits that promote bone density will have a pay off well into middle age and older adulthood.

Kind of like blood sugar, it is the cumulative high blood sugar that does the damage, it is the cumulative wear and tear and not giving the osteoclasts enough raw material to work with that can lead to troubles down the road.

Believe me, I’ve been in enough broken bone surgeries to identify, at a glance, who does not keep up with their diet and exercise.

Exercise also stresses bones, which makes them stronger.

It is the entire package. And is an investment in your future bone health.

I am, of course, speaking to the benefits of pasteurized milk. Never raw milk.

Pasteurized milk is milk that has been exposed to temperature and time. The milk is heated up to ensure that the bacteria and viruses are killed, for long enough. This has the added benefit of preventing spoilage because the same bacteria and viruses are what causes spoiled milk. Some of you have never gotten the milk out of the fridge and poured yourself a glass of spoiled milk that you promptly spat out in the sink and it shows.

The process was developed by Louis Pasteur who was a 19th French chemist and microbiologist. His pasteurization process (spot the name similarity) made milk safe to drink. It also made beer and wine safe to drink. In short, he saved France. Or the industries that made France famous.

Just think of how many lives he has saved.

In this current day, it is the fashion to ignore medical advice. Shocking!

[insert extreme eye roll here]

The ingestion of raw milk for its nonexistent “powers” has been gaining in popularity.

To be clear, raw milk can be sold to feed livestock.

But *wink, wink, nudge, nudge* people have been lying to get their hands on the white stuff. And all the bacteria and viruses it contains.

Why?

Because they’ve been lied to and told it was the healthier way.

To be clear, pasteurization does nothing to the nutritional value of milk. Raw milk has been linked to miscarriage, stillbirths, kidney failure and death since 1987. Definitely before that as well.

Someone is making money off the sale of raw milk and telling gullible people that it is the healthier way. Consider who profits from the sale of raw milk.

That is a round about way of informing you that there is a current raw milk crisis in Florida. At least 21 people, including 6 children, people have been sickened from ingesting raw milk. Probably because of contamination at the farm. Raw milk has to be handled in an extremely professional manner, as does the farm that it is from.

Those who drink raw milk are you sure you know all of the inherent dangers? Were you told?

Those who have been sickened, often to the point of hospitalization, was raw milk worth it? Just so you could stick it to “Big Dairy”?

Medical fiction and non-fiction book report 8/3/25- Little Miss Diagnosed by Dr. Erin Nance

Something happened during the pandemic.

People got bored.

A lot.

Even healthcare professionals.

And they turned to YouTube and Instagram and TikTok to make reels as a way to release the pandemic pressure and to make us smile.

Dr. Erin Nance was one of these.

She is a double board certified orthopedic hand surgeon. This is her story.

She is also big into treating the undiagnosed and unheralded medical problems of women. Because, you see, she was also dismissed because of her gender in her internship selection. And she knows that many women are dismissed because of their gender when they seek medical care.

I like and admire that.

We all know that surgery is my favorite. But my especial favorite is hand surgery. I have stared down other orthopedic surgeons who wanted to bump a finger amputation because to them it is just a hand. Yeah, that is like calling brain surgery easy.

Shortly after starting at the regional orthopedic hospitals after we moved across the country I was offered and subsequently took on the hand service line. This means that I was responsible to knowing everything about the hand surgeons and the hand surgeries. I also ordered specialized sutures for the hand surgeons. Healthcare being healthcare I was also handed the trauma service line and the pediatric service line. This means that I had to know all of the fixation types to fix a broken bone or to fix a tendon.

It was a lot.

Hands hold and sculpt and cook and soothe and comfort. Hell, the opposable thumb is what allows for much of what the hand is capable. Opposable thumb means that you are able to bend, twist and touch the tip of your thumb to all of your other fingers. This allows us to hold a pen, or a paintbrush and create art or books. When they talk of fine motor skills, this is what they mean.

Put your hand out and take a look at it. Spread your fingers wide and note which muscles of your forearm control which finger. There are 23 bones in your hand. The bones of your fingers, we call these phalanges, each have a tendon attached to them that enables their movement.

I waited and waited and waited to get this book from the library. I have seen a few of her videos on Facebook and I found her to be warm and genuine and have really great stories. I was very excited to read her book.

I received and read her book in one sitting. Not hard because it is less than 250 pages.

As much as I was looking forward to this book, I didn’t like it as much as I was expecting.

There isn’t much of a narrative throughline. There is her brother Kevin who suffered a devastating spinal injury with spinal cord fracture on her very first day of her internship. The scenes written with him were warm and just on the side of Pollyanna puke that I live on. He pops up periodically as Dr. Nance celebrates his wins.

The stories are not told in a chronological order. This kind of bugged me and some of the stories I am familiar with through her stories were missing. Ones that I think would’ve made compelling reading.

Her very short chapter on the other denizens of the operating room left much to be desired. According to her explanation I, as an OR nurse, comfort patients and fetch them warm blankets and are a soothing presence as anesthesia is started. And my mood sets the mood for the entire room.

Yes, but.

She could have definitely gone deeper here.

The book was less surgery details focused and more her process focus through internship, residency and hanging out her shingle immediately after residency. This means that she opened her own practice because she couldn’t find a niche.

I can respect that.

But I didn’t like this book as much as I expected because it was so shallow. There isn’t a lot of detail that screams real life. This is a good book for those who are not in the know. There isn’t a lot of gore or death or broken bones.

I picked up the book expecting some of that and it did not deliver. That is what I meant by shallow. There are depths that I wish had been plumbed.

School Me Saturday 8/2/25- It’s AUGUST, you know what that means?

The summer is winding down.

To the college student that means that the Fall semester is just around the corner.

Back to school things have been the stores for a minute. Yesterday I heard a mom frantically looking for extra long twin sheets and I thought to myself, “Someone is sending their first kid off for their first colleges days.”

The Fall semester will start before you know it.

Make a list of necessary dorm things. Extra long twin sheets, a caddy for the shower, some rudimentary kitchen stuff, and probably a mini fridge. Definitely a microwave.

Make a second list of necessary school things. In my day, this was notebooks and pens and paper and my very first computer.

Don’t forget clothes for the changing temperatures.

Don’t forget quarters for the washing machines. If they even do that anymore that is.

Don’t forget your chargers.

Don’t forget notebooks and pens. You know, just in case.

Don’t forget to download your syllabus when available.

Don’t forget to make a schedule of your classes.

Don’t forget to check out the nearby restaurants or, if you are eating on the meal plan, the hours of the cafeteria.

Don’t forget to be excited about this new chapter in your life. It is okay to be a little scared too.

Above all, don’t forget to reach out for help when you need it.

But these last few days before the hustle and bustle truly starts give yourself permission to finish that book you’ve been reading. Give yourself permission to enjoy this time.

It will be over before you know it and you will be an old hand a the dorm thing. Or at the off campus house thing.

Before the Fall semester starts take a moment and remember yourself just as you are because you will be a different person when you next are home. Also remember to give your parents grace as they learn to understand and accept the new you.

After all, to them, you were just in diapers.

FFS Friday 8/1/25-F-in Cowards #4

Oh, my god, they pulled up the corpse of Elmo and shot him again.

Shield your eyes, children.

And just like that the path in childhood has been closed to CHILDREN. No more education programs that are not ads for toys or ads for movies or just plain ads.

The Corporation for Public Broadcasting announced today that it has begun shut down procedures. People are being laid off, with the corporation shuttering in January 2026.

The CPB was authorized by Congress in the 1967 Public Broadcasting Act to ensure that everyone, and I mean everyone, has access to non-commercial, high-quality content and telecommunications. They used 70% of their own funding to support more than 1500 locally owned radio and television stations.

This means that the shows and the broadcasts are not trying to sell you anything.

Unlike the rest of the world.

Every minute of every day.

But, alas, this is no more because congress yanked its funding in order to give money to millionaires and billionaires in the form of tax credits.

“But, but you will get a tax credit too!”

pffft, I’ll believe it when I see it.

We certainly did not receive any money during the pandemic and those 2017 “tax cuts”? Our taxes went up. By a lot. Many thousands of dollars a lot.

No, I don’t believe you when you tell me that it was worth it.

Fucking cowards.

Mr. Rogers is very disappointed in you.

I believe Horatio in Hamlet said it best “Now cracks a noble heart. Good night, sweet prince/and flights of angels sing thee to thy rest.”

Or maybe Inigo Montoya when he is advancing on Count Rugen, “Hello, my name is Inigo Montoyo, you killed my father, prepare to die.” Count Rugen pleads for his life in the final duel, offering Inigo all that he wants, money, power jewels anything Inigo wants.

And Inigo, stabbed, bleeding, facing down the man who murdered his father twenty years before, tells him “I want my father back, you son of a bitch.”

Let me tell you, we are all Inigo.

We want our PBS and NPR.

Again, Mr. Rogers is very disappointed in all who voted for this.