Thank you

Thanks for all the compliments and encouragement re: Flynn that you all have sent my way recently. It has been quite an experience to be a dog owner - full of pleasant surprises and interesting lessons. This afternoon, for example, I learned that carrying an empty and appropriately sized bag on walks is absolutely necessary. Without the aforementioned item, cleaning up after your dog when he goes to the bathroom becomes a gross, messy and somewhat traumatic experience. No worries though - only minimal psychological trauma was sustained and an important lesson was learned! Raul and the dog have really bonded - they are quite the cute pair. Unfortunately, I am single parent for the next couple months while Raul is completing out of town rotations. Both Flynn and I are very sad. Wish me luck!

Otherwise, life is going well. The VA continues to provide very interesting and odd experiences. I admitted a patient yesterday with a diabetic foot ulcer. Have any of you seen a diabetic foot ulcer? They are not pretty. With poorly controlled diabetes (especially type II, or adult onset, diabetes mellitus), you have consistently elevated blood sugar levels. All that extra sugar in your blood sticks to everything, and you wind up with damage to your blood vessels and your nerves - especially in your feet. So, you can see how if you can't really feel your feet, you could easily get a sore from wearing uncomfortable shoes or stepping on something. And if your blood vessels in your feet are damaged, then the sore will not heal as well or as quickly as it might in a non-diabetic person. These sores often get infected, and if the infection cannot be controlled, part or all of the foot often has to be removed. My patient had had that sore on the bottom of his foot for over six months, and it got infected - it was pretty bad, and it really smelled. Infections with anaerobic bacteria really smell. He was also having fever and chills indicating that the infection may have spread to his blood stream. These ulcers are big deals - if you have DM, controlling your sugars is really important. It is not an easy task, but trying for tight glucose control is one of the biggest favors you can do for yourself now and later in life. And take good care of your feet. Wear good shoes, check your feet nightly for sores and see a podiatrist regularly. Okay, stepping down from soapbox, sorry for the lecture.

Hope all is well with everyone!