Category Archives: teach

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Shim Sham Shimmy

I had to choose shim as my Ragtag Daily Prompt today because I am relearning the Shim Sham!

I learned it years ago, but forgot it. Now the dance group that I hang out with on Fridays does the Shim Sham as the end of their dance evening. This is a line dance but it’s a line dance from Harlem in the 1920s and 30s. It started from tap dance. “At the end of many performances, all of the musicians, singers, and dancers would get together on stage and do one last routine: the Shim Sham Shimmy.” Here.

I am learning it from this teaching tape. The individual moves are not that hard, but it is fast and it’s the transitions that I really have to work on. It is fast enough that it has to be memorized and automatic, I can’t think about the next step.

Frankie Manning was an American dancer, instructor, and choreographer. Manning is considered one of the founders of Lindy Hop, an energetic form of the jazz dance style known as swing. I got to take lindy hop classes with him in the 1980s in the Washington, DC area, when swing and lindy hop were having a revival. It is still going on, and what better exercise is there than dance?

And the photograph is Jonathan Doyle and friends playing in late March 2023. I love dancing to live music!

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Tool

I don’t wear livery at work
and anyhow that’s a uniform for men
or a place to board horses
though the horses can be male or female.
Once I go to my daughter’s second grade
for a bring your parent day
and bring part of my uniform,
or perhaps it is a tool or instrument,
my stethoscope. The children all want
to listen to my heart
or at least touch this magical tool.
Afterwards I receive thank you notes.
I think that every one, except my daughter’s
thanks me for bringing the stethoscope
to their classroom. I did not know how
special and magical a tool can be.

__________________

For the Ragtag Daily Prompt: livery.

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Shapes and songs

The Ballad of the Shape of Things is one of those songs that I learned very young and from my cousins, so I did not know who recorded it. Another “dead girl song” only this one is a “dead guy song”. I loved the puns: “They say he died of the chickenpox. In part I must agree, one chick too many had he.” I also liked songs with words I didn’t know: transom, in this one. We were fairly bloodthirsty kids and happily learned songs about death, unfaithful lovers, murder, betrayal, noble suicide to save the highwayman, and so forth. My Darling Clementine, another dead girl song. We had a very educational childhood in song.

We needed the triangular “garment thin that fastens on with a safety pin” explained at the end of the song, because the cloth diapers we’d experienced were rectangular. I find memorizing things that rhyme and especially if there is a story and a tune, much easier than memorizing the varied side effects of drugs such as ACE inhibitors. The story behind the side effects escapes me, though maybe there is one! Think of that, a ballad of the ACE inhibitors, with each one having its individual good and bad effects! I am certain that I could make up a story, even if we don’t really understand all the effects.

For the Ragtag Daily Prompt: triangle.

Here is a side effect song, though not quite what I have in mind.

The photograph is my sister Chris and me, at my father’s 70th birthday, 2008, taken by my friend Malene.

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Tongue twisters and counting rhymes

My mother taught us the tongue twisters that she learned growing up. My favorite is “the mistle thrush whistles in the thistle bush”. There are mistle thrushes in Europe but not in the United States. It is also found in temperate Asia and North Africa, here.

A counting rhyme that we learned is this:
“Intry mintry cutetry corn
Apple seed and apple thorn
Wire briar limber lock
Three geese in a flock
One flew east, one flew west
one flew over the cuckoo’s nest
Sit and sing, by the spring
One, two, three
Out goes he.”

Here is another version, from 1920: https://etc.usf.edu/lit2go/74/nursery-rhymes-and-traditional-poems/5204/intery-mintery-cutery-corn/.

We also learned some of my grandfather’s songs. A piece of this one:

Only we learned it as “chop, chop” not clap, clap. It’s like a 1960s line dance, isn’t it? Shirley Ellis, 1965.

For the Ragtag Daily Prompt: whistle.

And here is a version with the clapping:

I would bet that there are way more elaborate versions of the clapping.

Before that, a song called Little Rubber Dolly was recorded in 1930.

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G6PD deficiency and diabetes

Today I follow an online trail to this article on diabetes from Nature Medicine here.

It is talking about a genetic variant that is found in people with African-American heritage called G6PDdef. This genetic pattern makes the HgbA1C test inaccurate. It will look low and “in control” even when blood sugars are high. Since the blood sugars are NOT in control, complications from diabetes can happen: damage to vision, to kidneys, to nerves in the hands and feet.

I have been reading articles about current and changing guidelines about diabetes. The current guidelines say that checking blood sugars at home doesn’t make a difference. I REALLY disagree with this and at the same time, I don’t think that physicians are approaching blood sugars in a practical manner.

I saw a man recently who is diagnosed with “insulin resistance”. His HgbA1C is in between 5.6 and 6.0. Normal is 4.5 to 5.6. Over 6.5 is diabetes. He has prediabetes. He has not checked blood sugars at all, but he is on metformin.

There is evidence that metformin is helpful, and still, I think it is putting the cart before the horse. I ask my people to go buy an over the counter glucometer. Ask for the one that has cheap strips, 6 for a dollar instead of a dollar apiece. Then we go over the normal and abnormal blood sugar ranges and I ask them to start checking blood sugars. If I give them a medicine right away, they don’t learn how to control their blood sugar with diet. ALL of my patients can figure out how to bring their blood sugars down with diet. If we can’t get to a good range, then we will add metformin. I do explain that the guidelines say use a medicine right away, but I ask, “Would you like to see if you can control your blood sugars with diet?” The answer is overwhelmingly “YES!” I have never had someone say no. If we do not give them the chance and explain the goals, why would they even try?

Also, I read the dietician handouts for diabetes yesterday and I am not satisfied. I do not think they explain carbohydrates well. Foods have fats, proteins, and carbohydrates, and anything that isn’t fat or protein has carbohydrates. I think of carbohydrates as a line, from ones with high fiber that do not send the blood sugar up fast, to ones that shoot it way high. At the low end is kale and lettuce and chard and celery. Then the green and yellow and red vegetables that are not sweet. Then beets and sweet peas. Next come the fruits, from blueberries up to much sweeter ones. Fruits overlap with grains: bread and pasta and potatoes and rice. The whole grains have more fiber and are slower to digest. Candy then sweet drinks (sodas are evil) and sugar.

Sugar has 15 grams of carbohydrate in a tablespoon. Kale has 7 grams of carbohydrate in a cup. That’s a pretty huge difference. A small apple has about 15 grams of carbohydrate and a large one 30 grams. Read labels for grains. There is a lot of carbohydrate in a small amount. The issue with fruit juice is that most of the fiber is gone, so the sugars are broken down and absorbed much faster. A 12 oz coke has 32 grams of carbohydrate and a Starbucks mocha has 62! I quit drinking the latter when I looked it up.

Most people with diabetes are supposed to stay at 30 grams of carbohydrate per meal, or 45 if it is a big person or if someone is doing heavy labor. Snacks are 15 grams.

Avocados are weird. They have about 17 grams of carbohydrate in a whole one, but they also have a lot of fat. They do have a lot of fiber, which surprises me.

Diet control takes a combination of paying attention to what is on the plate and serving amounts. Three servings of pasta is not going to work, unless you are out fighting forest fires or are on the swim team. Fire fighters are allotted 6000 calories a day, but most of us do not get that much exercise.

At the same time that articles are telling me that home blood sugars are not useful with a glucometer, everyone is pushing the continuous glucose monitors. I think we like technology. And other articles say that diabetes can be reversed with major lifestyle changes.

Articles: about not using home glucose checks, here. Starting metformin, here. Starting with one of the newer medicines, here.

I think people feel a lot more successful if they get a glucometer and can bring their blood sugar down by messing about with diet. I tell them to check after what they think is a “good” meal and after a “bad” one. How much difference is there? Contrast that with being handed a pill to control it, while someone talks about diet and says all the same stuff that we’ve heard for years. Nearly all of my people want to avoid more pills and are willing to try a glucometer to see if they can avoid a pill. People who have been on diabetes medicine for a while are less willing to try, but sometimes they do too. And sometimes they are surprised that some meals do not do good things for their blood sugar.

This is all type II diabetes. For type I, we have to have insulin. If type II has been out of control for a long time, sometimes those people have to have insulin too. Right now insurances will usually cover continuous glucose monitors for people with diabetes who are on insulin, both type I and II. I do hope that they really make a huge difference for those people!

The spectrum from the low carbohydrate vegetable, the green and yellow and orange ones, up to the really high simple sugar ones is also called the glycemic index. There are lists of low to high glycemic index foods. Perhaps some people with diabetes find that helpful, but I think it’s simpler to say, ok, the stuff that doesn’t taste sweet will send the blood sugar up less. Also, since we are all genetically different and then our gut bacteria and microbiome are all different, it is individualized care to say how does this person at this time respond to this food? We change over time!

There are other examples of the HgbA1C not working to track diabetes. A resident and I looked over a person with diabetes and spherocytosis. The HgbA1C was nearly normal but the blood sugars were in the 300 range. Spherocytosis is a genetic blood cell abnormality, and the red blood cells don’t live as long. People with a past bone marrow transplant also have red cells that live for a shorter time. The G6PD deficiency is thought to help people survive malaria, so persists in the population, like sickle cell anemia. Isn’t genetics fascinating?

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Dance!

I took this at the 2023 Swinging by the Sound Dance weekend in Port Townsend, Washington. This is the dance contest at the live band dance in the evening. The ballroom is at our American Legion Hall and has a fabulous floor to dance on. I was volunteering, since my lungs still were not up to that much dancing.

I do love to dance, though, and plan to for as long as I can. It helps with balance and reduces fall risk, too! My ex says it’s the most fun you can have with people standing up.

Jonathan Doyle led the band and they were and are fabulous.

For the Ragtag Daily Prompt: ballroom.

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Fear and Finials

The word finial takes me straight to Portland, Oregon and Family Medicine Residency. My grandmother loaned us the down payment for a house and we were in Southeast, on Belmont Street. The neighborhood was coming up rapidly. My son was six months old when we moved there.

Across the street were two houses owned by two couples. All four worked for the Oregon Shakespeare Festival in the summers. One woman quit and started a landscaping business. She had six foot tomato plants in her back yard by the end of the summer. She had a gorgeous flower garden in front. She also put up a decorative fence with elegant plexiglass finials.

One day all the finials were smashed. We were all sure that it was Mike. Mike lived in a duplex next to us and was terrifying. Initially it was his mother living there with a potbelly pig that would use a ramp to go down in the yard. The son moved in with his wife and child. His mother and the pig left and then the wife and child did too. Before the wife and child left, Mike knocked on my door and asked about exchanging baby sitters. I explained that we had an arrangement with someone and could not do that. After he left, I told my husband, “Don’t let that man into our house ever.”

As a neighborhood, we discussed what to do if Mike came at one of us. We figured he was on crack, he was terrifying, and we should go for head or knees, because we did not think pain would slow him down. This sounds over the top, right? Nope. My little family was in Eastern Oregon for a ten week rotation. “You missed the fun,” said our neighbors. “Mike threatened to shoot himself, they called out the SWAT team. He shot himself but he missed and only creased his head. He’s in the state hospital for six months.” Except he was back in three months. I’ve also written about him chasing his upstairs neighbor into traffic stark naked, trying to hit him with a five iron. Rush hour traffic stopped dead to watch the show.

We thought the 5 iron probably took out the finials. The owner of the house next door sold it and Mike left. We were all terribly relieved. And that is what the word finial brings up.

For the Ragtag Daily Prompt: finial.

The photograph is not from Portland, Oregon in the 1990s. It is from London in March 2022.

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The New Old Time Chautauqua

Funny how our brains work. I think of going to the other computer and then think I will look in this one for a moment. I have photographs from years past of the New Old Time Chautauqua. I open the file of Nikon photographs. There are 28 subfiles. I go to July 2018. At the end of the file, here is this motley parade. The New Old Time Chautauqua with our local Unexpected Brass Band and Other Friends.

I didn’t “know” that these photographs were even on this laptop. At least, not consciously. These are taken at the fairgrounds, August 11, 2018, in Port Townsend, Washington.

The New Old Time Chautauqua is the last one on the road. They are fundraising to go work and play with the Blackfoot Confederacy in Canada and the US. There are too many people dying from fentanyl, so the Chautauqua is part of the healing process. They are fundraising as they hit the road. I wish all of them the best.

And here is the Unexpected Brass Band at THING last year. You can hear them even if you can’t see them!

To donate to the New Old Time Chautauqua, go here. No, I mean back there. Right.

For the Ragtag Daily Prompt: Chautauqua.