While schlepping all over SOMA and the Mission district today to file my county/state EMS application and SPCA Therapy Dog application, I walked by a sweet looking little taco shack.  You know me- of course I stopped to try it out!

I ordered a grilled chicken taco and diet coke.

“It’s on me, Mami,” said the cute latin guy taking my order.  Nice!  I tried to pay be he wouldn’t let me.

Freaking great taco, too.  He even threw in some chips.

Free Taco!

It was CRAZY good, too!  Must be a new place, I wasn’t able to find any info about it online, but it’s a little taco shack on the northwest corner of Mission and South Van Ness.  ¡Muy bueno!  I will certainly be back, and hopefully they’ll accept my money next time.

Things are moving along!  After minor cacophony at the San Francisco DMV two weeks ago, I finally recieved my new CADL in the mail yesterday and have my appointment with the San Francisco EMS Agency tomorrow afternoon.  This is my final step!  Tomorrow I’ll be filing my state of California and San Francisco county certifications.  You should see the paperwork for this stuff- it’s about 30 pages long and filled with confusing doublespeak.  Earl has a fun job tonight when he gets home from work to proofread and make sure I am filing everything correctly.

Also tomorrow, I have an appointment with the San Francisco SPCA Animal Therapy department to hand in my Therapy Dog volunteer application!  That’s right!  At last, Linus and I will be on our way to becoming a therapy dog team!  Earl is not that thrilled about this development.  He’s convinced that we’re both going to come home with a horrible contagious disease… and forget about me, but more importantly that LINUS will then cost us hundreds of thousands in vet bills.  He keeps IM-ing me articles like this one from the NY Times.  Keep in mind that this is the same boy who refused to kiss me hello when I visited him after my clinicals until I had taken a shower.    In his defense, Earl never, EVER gets sick, so perhaps he’s onto something.  In the meantime, I am fighting a losing battle to lobby him to become Therapy Dog certified with Linus and I, so we could all volunteer together.  He’s not really feeling it, however I still have a few weeks to change his mind.

What else is new?  Well, the next thing coming up on my itinerary is HUGE- actual, gainful employment!  (!!!!!)  Can you believe it???!?!  Granted, I’ll only be making about $10 an hour as an EMT, but I am just so, so excited to start working in a field I am passionate about and getting some medical experience out there on the streets.  I am chomping at the bit not only to have something to do all day, but to learn and absorb and gain exposure to everything I can.  As busy as I’ve tried to keep myself lately, I’ve been somewhat bored and restless these last couple weeks; I think because this giant change was looming, I’ve been rather antsy… sort of that taper before an Ironman feeling.  Still have a couple weeks to go- apparently it can take up to 14 business days for my state & county certifications to clear!  AGGGGH!  All this bureaucratic “lag time” is super frustrating, because I had a tentative job offer lined up during EMT school, however nothing can be officially extended until all of the certifications come through.  Hopefully that will still eventuate, however there are several EMS organizations here in San Francisco, so worst case scenario it’s nice to have options.

Would you be surprised to hear that I have already planned out 50 things to spend my first couple paychecks on?    Most of all I am just excited to be able to start contributing to our financial bottom line again (however meager my salary), and also to be able to treat my sweetheart to the occasional dinner out.  He’s been so incredibly supportive as I navigated this career change; I don’t even know where to begin to thank him.  I do, however, have something extra-special planned out for his birthday next week.  It’s something I’ve been ruminating on, scheming towards, and furtively planning for months now.  As Earl is an administrator of this blog I’ll have to keep you all in the dark, but I will give you this small hint:  it’s a merry little adventure that combines advanced mathematics and sunsets over the ocean.  Ack, giving too much away?  I’ve never been one for keeping secrets- I just get too excited and can barely contain myself.

aren’t my scrubs cute????? (!!!!) ????

Oops, doofy grin and eyes closed in this picture, but I have to get running out the door to catch the bus and no time to snap another!

Emergency Room scrubs!

You know you have a corgi obsession when your friends all across the country snap corgi pictures on their phones and send them to you   Happens to me with surprising frequency, from multiple people!

Gary spotted this adorable pup somewhere in New Jersey:

corgi puppy in New Jersey

That face!  Those little white paws!  Thanks, Gary for the smiles.

During lunchtime this afternoon Earl and I were lucky enough to steal away to the Commonwealth Club and hear a lecture by former FDA Commissioner Dr. David Kessler, focusing on his new book The End of Overeating.

The funniest part is at the beginning of the lecture when Dr. Kessler had us examine his new bookcover, and asked, “to which part of this cover is your attention immediately drawn?”

What part of this cover are your eyes immediately drawn to?

Now, I don’t even LIKE carrot cake, but I’d be lying if I told you I wasn’t sitting there in my uncomfortable lecture-chair thinking, “now hmm, I wonder if that frosting is cream-cheese based?”  Oh, and how cute is that little frosting carrot?  Just adorable!  Frosting carrots are like, way more fun to eat than boring ole real carrots…amiright?

I’m going to try and sum up a few of the more interesting points I took away from Dr. Kessler’s talk, although please note these are just my interpretations of what he presented, and based off rough scratch notes I took in my planner.  Any inaccuracies or misinterpretations are my fault alone.

The first thing he opened with were some staggering statistics highlighting the “pernicious epidemic” of obesity which the world population is facing.  I took this to be the “scare the audience into paying attention” introduction. You’ve heard all these statistics, of rising diabetes and obesity among the world, even in children and infants.  One interesting tidbit- did you know on average Americans used to chew 20 times per bite, and now we chew only THREE times per bite?!  It’s a combination of both us gulping down our food more and also declining quality of food (Dr. Kessler referred to it as “adult babyfood” that we are eating).

Effectively what the talk centered on is the brain-altering addicting properties of the combination of sugars, fats and salt.  Examining a study jovially titled, “Deconstructing the Vanilla Milkshake,”  we learned how, when a food delivers both sugars AND fats at the same time, it creates a synergistic effort.  In other words, the “crave” factor increases.  This rises even more when you pair sugars, fats, AND salts together in one vehicle.  The dopamine in our brains make these foods capture our attention and we become focused on these particularly salient stimuli.

(SUGARS + FATS + SALTS) = do not satiate us, they stimulate to make us eat even more!

An interesting finding Dr. Kessler discovered during his tenure at Yale is that, when in the presence of a varied and limitless diet, animals and humans will eat excessively.  In other words, think of a typical “supermarket diet.”  If you offer a rat a variety of limitless amounts of cookies, some peanut butter, some chips, the rat will NOT going to satiate itself and effectively will keep eating forever.  On the other hand, present the same rat with unlimited plain kibble, and Ratty becomes tired of the food and stops eating when he is satiated.  [Note-- I am not sure if Linus would apply to this, I am pretty sure he is impossible to satiate even when faced with never-ending kibble.... and only in his wildest dreams will we be testing this experiment out on him!]

Now here was the part of the lecture that really spoke to me, because I fall prey to the EXACT THING Dr. Kessler was telling us about.  He shared how, when he’s travelling and his plane touches down at SFO, he immediately becomes excited and anxious, anticipating hitting up his favorite Chinese dumpling cart parked in the SFO terminal.  He then told us how when he drives along 101N his car will frequently “mysteriously” end up at In & Out Burger.  These things- the plane landing, his car pulling onto 101N, they are cues that prompt a dopamine response to food.  I have the same reaction more than I care to admit!  For example, take me anywhere near Manhattan’s upper west side and I am a Pavlov Dog dreaming of the flawless egg salad sandwich from Lenny’s… or a memory happens to drifts through my mind of working on trading floor at 245 Park and I can practically taste that Monday/Friday Ess-a-Bagel habit!

We learned that many Americans operate on a Reward Based Eating System; these people can also be called “Conditioned Hypereaters.”  They constitute the following three factors:

1. loss of control in the face of highly palpable food
2. preoccupation with food (thinking about food between meals)
3. lack of satiation when eating

Hello, World, my name is Courtney, and I operate on a Reward Based Eating System!

I am not alone.  When Dr. Kessler broke down the statistics, we saw the following numbers for Conditioned Hypereaters:

- 50% of obese people

- 30% of overweight people

- 17 % of lean people

Interestingly, the 17% of lean people who are Conditioned Hypereaters, Dr. Kessler told us, can “maintain their weight, yet live in a state of constant torment.”  In a conditioned hypereater, the amygdala (the part of the brain that responds to cues), is not only enhanced with presented with sugary, fatty and salty food, but it actually does not shut off!  That is a large part of the reason people are not able to achieve satiety when consuming these kinds of foods.

So, you’ve determined you are a Conditioned Hypereater.  Are you forever doomed to not be able to control yourself in the face of your trigger foods?  Well, kind of.  Think of it as an alchoholic- that person is always going to be an alchoholic, but he can learn ways to manage his life.  Here are a few of the tools we picked up:  First, know what cues you have to food.  Be aware of the sights, smells, times of day that trigger a response.  Then, distract yourself.  What Dr. Kessler does when he lands at SFO to avoid that dumpling cart is he heads immediately straight to baggage claim.  The next thing we learned were some ways to “cool down the stimulus,” in other words to put yourself in food rehab.  Some techniques:

1. Reduce the chances of being stimulated-  ie avoid cues, avoid being primed for cues, and avoid being deprived so you are sensitive to the cues
2. Reduce the power of the stimulus- develop a set of rules, structure & plan your eating so that the stimulus is not applicable to your life
3. Change the value of the stimulus- have a critical perception shift of what the stimulus means to you- in other words, associate the stimulus with a negative thing (unhealthy)

Finally, we were left with how learning and applying the information we garnered from his lecture is not going to be a 30 day, 60 day, or 90 day change, that eating control must be a lifetime decision.  One must bring it under control for life and there are no short fixes.  What Dr. Kessler stated as the main objective for his book is that he’s trying to change the perception of the combination of fats, sugars and salts in the American diet.  He wants people to be able to look at food as a stimulus and not just a yummy object.  I believe with this new knowledge, I can accomplish this… yet must admit this new perspective is certainly going to take the joy out of chowing down those plates of nachos!  Although doesn’t that seem to be his objective?

COURTNEY, from afar (in kitchen putting away pizza):

Are you talking to me?

EARL, also from afar (in bedroom finishing up some work):

What?

COURTNEY (louder):

Are you talking to me??

EARL:

No! I’m talking to the dog! (or cat)

COURTNEY:

Oh!
(Evening Resumes)

I’m thinking hoping everyone with pets goes through the same thing.

A few weeks ago Earl shared a Washington Post article on food-science findings from the former commissioner of the FDA, David Kessler, that we both found rather interesting.  A large chunk of my undergrad days in New Hampshire were spent waitressing at TGI Fridays, so I particularly riveted having always wondered about the calorie makeup of some of the dishes!

I’m going to quote a portion of the article below, but I advise you to pop over and read it in its entirety here:

Kessler was on a mission to understand a problem that has vexed him since childhood: why he can’t resist certain foods.

His resulting theory, described in his new book, “The End of Overeating,” is startling. Foods high in fat, salt and sugar alter the brain’s chemistry in ways that compel people to overeat. “Much of the scientific research around overeating has been physiology — what’s going on in our body,” he said. “The real question is what’s going on in our brain.”

The ingredient labels gave Kessler information the restaurant chain declined to provide when he asked for it. At the FDA, Kessler pushed through nutritional labels on foods sold through retail outlets but stopped short of requiring the same for restaurants. Yet if suppliers ship across state lines, as suppliers for Chili’s do, the ingredients must be printed on the box. That is what led Kessler, one of the nation’s leading public health figures, to hang around dumpsters across California.

The labels showed the foods were bathed in salt, fat and sugars, beyond what a diner might expect by reading the menu, Kessler said. The ingredient list for Southwestern Eggrolls mentioned salt eight different times; sugars showed up five times. The “egg rolls,” which are deep-fried in fat, contain chicken that has been chopped up like meatloaf to give it a “melt in the mouth” quality that also makes it faster to eat. By the time a diner has finished this appetizer, she has consumed 910 calories, 57 grams of fat and 1,960 milligrams of sodium.

Instead of satisfying hunger, the salt-fat-sugar combination will stimulate that diner’s brain to crave more, Kessler said. For many, the come-on offered by Lay’s Potato Chips — “Betcha can’t eat just one” — is scientifically accurate. And the food industry manipulates this neurological response, designing foods to induce people to eat more than they should or even want, Kessler found.

So the exciting result of reading the article is we learned Kessler wrote a book, The End of Overeating, and is currently doing a speaking tour.  Tomorrow he’s speaking at the Commonwealth Club downtown, and Earl and I snagged tickets and are going to see him speak!  The Commonwealth Club is right around the corner from Earl’s office, so I’m picking him up for our lunch date and we’re walking over.

As an avid overeater (heh), I’m excited to hear Dr. Kessler present his findings and hopefully can garner some tools to reign in my often insatiable appetite from the book.  I’ll let you know how the lecture goes!

Sorry for the disruption.  I really should dig up a real admin.  In any case, note to anyone who may find this: when someone using scripts written by dxil or z1cx@hotmail.com defaces your site, make sure they didn’t add valid remote ips to your mysql config.  Hopefully this takes care of the mess.

Most mornings I take Linus on a quick three mile jog around our lovely little neighborhood.  We hit up two dog parks where he runs around off leash with other dogs, climb a couple of very steep hills, run some stairs and come home.  He’s a good little guy to jog with, normally.  If I’m doing a longer jog in the city- anything above 4 miles, I won’t him along, mostly because in that case I’m probably going somewhere to run to explore a new hill, park, or staircase, which means I’ll be taking an unknown route and don’t know if it’s safe for him.

However, on our little three mile morning excursion, he’s fun to run with and seems to have a great time.

The exception to this is when – god forbid- it’s RAINING.  When it’s raining, oh boy, does Little Pain in the Ass NOT want to go outside, nevertheless run.  It’s somewhat amusing.  If it’s pouring and he needs to go out, he will literally tentatively tip toe down the staircase outside our apartment, immediately do his business at the VERY FIRST TREE 5 ft away, and without missing a beat turn around and hustle back up the stairs.  He does NOT like being outside in the rain.  Niet, nein, non!

This morning, it is lightly spritzing here in San Francisco (very lightly), so upon my AM window assessment I determined it was fine for a little correr con perro.  But man, did freaking Dog have other ideas!  Most days when we run he’s very mindful to my “heel” command and we trot along at a reasonable pace.  He doesn’t become distracted by much and never really jerks my arm around behind me on the leash, staying right by my side.

TODAY, on the other case, he went slooooow.  He would not heel!  He dragged behind!  He lagged back!  He would not come!  He did not want to play at the dog park (which btw was empty guess other dogs don’t care for rain either).  It was like trying to run with my own personal 27 lb, floppy eared, boat anchor.  All because of a couple of leettle spritzy rain drops.

I did not lose heart.  I channeled Cesar Millan and attempted to calmly, assertively reel in the boat anchor and through my energy command the boat anchor to “heel.”  Boat Anchor was having none of it, so with me exasperated and vowing to go on a longer run later with NO Linus, we turned back towards home.

The amusing part here is, apparently Boat Anchor who Doesn’t Care for Rain knows our neighborhood and route very well, because the SECOND we turned around and headed down the hill we were on back towards our house, oh boy did he take the lead, run out front and attempt to pull me all the way home.  He even sprinted up the stairs to get into the house.

guilty party, post run and- the horrors!- a tad bit wet from the rain

As I noted last week, I’ve been busy slogging through EMT paperwork.  This week I completed my livescan background check, finished up at the DMV, passed my ambulance driver’s test, got the ambulance driver’s license and am now waiting for my new CADL to be sent in the mail (so long, ye wonderful and beloved Riverbend Drive of Mystic CT license!  Oh, how I adored that photo! — ed. note: who ever lucks out with an absolutely great license photo? so rare!).

In the meantime, I have my paper temporary license and now nothing to do but, as my friend Nils was so fond of sighing, “hurry up and wait.”  Because all of this rigmarole is annoyingly and tediously sequential, I can’t process my state or county EMS certifications until I have the actual CADL in hand.  Then those two certifications apparently take about two weeks to process themselves, so I’m looking at about a cool month before I can actually start working as an EMT.  @##&%(@!!

I have, however, been busy having a lot of fun in the ER at St. Lukes.  This Thursday was my busiest shift yet!  We were so slammed that I stayed an extra two hours, and the entire shift just flew by.  Saw a lot of interesting stuff, although I don’t think I can talk about it here.  I believe if later I am so inclined to share any ER stories, I’ll have to go the way of some of the cool EMS blogs I’ve been reading (example: here, here, and here) and insert a hearty disclaimer.

Okay enough boring paperwork talk!  Let’s have some photos and updates, shall we?

Earl and I were thrilled to finally have a weekend all to ourselves- we immediately stole off on a daytrip to our favorite escape.  We loaded up Linus and the beach gear, snagged sandwiches from the stupendous Colombo’s Deli in Pacifica and camped out on highway 1 for an oceanview picnic.

Now this- as my friend VJ would declare- is a sangwich.

my fav, the tomoso- turkey, melted swiss and cheddar, bacon, roasted red peppers and lettuce, on sourdough with mayo

Linus shows off his “MANNERS” trick where he balances a treat on his nose. He is REALLY good at this- he will sit there with the treat on his nose while I leave the room or cook an entire meal. As soon as you announce “okay!” he will chomp it down.  [And make a puddle of drool while he waits. -- earl]

Linus, do you have good manners?

Mmm, that was good, gimme some more.

post-nosh

Apres picnic, we hiked down to the beach which was practically deserted. This beach is never crowded and it’s just so serene and gorgeous. We bring books, water and snacks, park ourselves in a hidden enclave between rock outcroppings and while away the day reading, playing with Linus and cuddling.
But first, a rousing game of fetch!

the squeeky kong toy is a big hit

Phew, safe from the oncoming waves!

here it is, throw it again! and again, and again, I could do this all day.

Earl tests out the water- it was FREEZING.

shortly after this photo was taken, he got pwned by a big wave

Linus just adores exploring the rock bands which envelope the beach.

rock dog loves playing on rocks

He found a few salamanders which hurriedly scurried away from CERTAIN SLOBBERY DOOM!

hey! check out what I found over here! c'mere check these crawly things out! hey, hey! lookat this!

How gorgeous is the California coast?! I can’t get over how this beautiful beach is only 20 minutes away from our San Francisco home. We are so lucky to live here!   Full disclosure:  I attempted a spontaneous cartwheel immediately after taking this shot (couldn’t resist a frolic in all that glorious untracked sand!) and kinda crashed right onto my head. Hopefully after a few more weeks of crossfit I’ll have a bit more upper body strength and can pull off a more graceful maneauver.

empty beaches are made for cartwheels

Linus and Earl hold down the fort at our happy little camp.

taking a rest

I think we need a bigger beach blanket, especially since this lazy beach day is quickly becoming a cherished routine.  I don’t know if you can make it out from here, but Earl is actually reading Finite-Dimensional Vector Spaces, by Paul Halmos. On the beach. His “beach reading” is literally linear algebra. By way of stark contrasts, my beach read was a breezy (yet fascinating!) biography of Jackie O which I borrowed from my Aunt. But I mean, hello, Earl… get with the program here. The whole point of a beach read is it’s supposed to be light and fun. And not HARDCOVER for pete’s sake. Take it down a notch! Maybe… switch to something easier… like trigonometry.

bigger blanket?

After an hour or so of reading, snoozing and chilling it’s time for …. ANOTHER ROUSING GAME OF CHASE!!!

Now you can't catch me, Baby, you can't catch me 'cause if you get too close, You know I'm goin' like cool breeze

A day at the beach is only complete if EVERYONE is salty, sweaty, and sandy.

tuckered out and ready for home