Bucket List! Mount Rushmore and the Badlands

I must admit, before I came out here I had no idea where Mount Rushmore was and had never heard of the Badlands. I'm so glad I took this assignment because I'm getting to see a part of the country I may never have seen. Let's face it, the Midwest doesn't make my top 10 list of vacation spots. Mount Rushmore has a little museum and video that tells you all about it. At the time it was built people seemed to have so much pride in America. I've grown up in a time where people just constantly complain about our country. It seems like most people hate our President, no matter who it is, not build giant monuments to honor them. I think it is kind of sad, really. 

On the way to The Badlands, I had to stop for a 5 cent cup of coffee at the famous Wall Drugstore.  The business opened in the 30s and made it's success by offering free ice water to travelers. It's now a cheesy tourist trap, but still offers free ice water and 5 cent coffee!

Jon and I had to take a selfie....or 10.

Who needs a tourist trap when you have this?! The Badlands is just amazing. This landscape developed starting with glaciers. Then over time the wind and rain formed the unique hills. The layers are different colors due to various minerals. The park is also full of protected wildlife. During my 3 days in The Black Hills and and The Badlands I saw (in the wild) bighorn sheep, antelope, bison, prairie dogs, mountain goats, pheasants, turkeys, mule deer, and white tailed deer. Pretty awesome!

 These guys were right in the road, and they were not in a hurry to move for you.

 (#nofilter)

 The cutest!

They had horns. I promise.

Something Bigger

 One of my friends claims she doesn't like hiking. She doesn't see the point. That's cool, to each her own, but it got me thinking about why I love hiking. It's not like running where you have a goal that you work toward to accomplish. You can never complete it or check it off your list. For me, it's not about an accomplishment or even exercise. It's about an experience. My experience varies based on location, scenery, or company, but what always occurs is my inevitable change in focus. Without trying, my thoughts shift away from myself as I am overwhelmed with the "bigness" of the world. Whether I am taking in 12 different colors of tiny mushrooms growing alongside the rushing waterfalls of Blue Ridge, GA or the expansive blue skies contrasting against the white snow-covered Rocky Mountains, a powerful feeling of "there is something bigger out there" overtakes me. It doesn't make me feel insignificant necessarily, but thankful to be a part of such an amazing world, to be a part of something bigger.

 I was lucky enough to have several of these moments as I explored the Black Hills of South Dakota this past weekend. I drove up through Wind Cave National Park to an adorable log cabin outside of Custer, SD. Here was the view off the front porch where I watched cows and deer graze while eating breakfast:

Needles Highway runs through Custer State Park and Black Hills National Forrest. This narrow road twists and turns through tunnels that have been cut into the hills revealing tall spire-shaped rocks rising into the landscape. I even saw Billy Goats climbing around on the mountain!

 At one of the highest points along the highway you reach Sylvan Lake. I hear its a frequent spot for "polar bear jumps". Brrrr!

Saying goodbye to the Black Hills. Coming up next: Mount Rushmore and The Badlands!

Antibiotics and Obesity: Medicine Not Without Consequence

Medical providers and patients alike have been hearing for years about the dangers of over-using antibiotics. We all have heard that too many antibiotics circulating around turn the bacteria into super bugs that are now resistant to many antibiotics and causing deadly diseases like MRSA, C. difficile, and now even Vancomycin resistant staph. But could there be even more dangers to antibiotic use?

In my prior post I mentioned that calves were injected with antibiotics. To my surprise the purpose of the injection is not to fight or prevent infection, but to put more weight on the cows.  As a medical provider who prescribes antibiotics everyday, this concept really sparked my interest. Could my prescribing be a contributing factor to American obesity?

According to a New York Times article, farmers have been fattening up livestock since the 1950s. Studies were conducted on rats and humans in the 50s and confirmed that both species gained more weight when given antibiotics. In fact, in one study children gained about 5 lbs a year more when given the antibiotics than children who did not take the medicine. That may not sound like much, but for a 2 year old to gain 20 extra pounds in 5 years is significant.

Research presented at Obesity Week 2013: The American Society for Metabolic and Bariatric Surgery and the Obesity Society Joint Annual Scientific Meeting found that infants given broad-spectrum antibiotics (meaning ones that kill many different strains of bacteria) had a 20% increased risk of becoming obese by the time they were toddlers. Of course, there are other life style factors that will increase ones risk of obesity, but as the Medscape article stated, it is a modifiable risk factor that we can do something about and shouldn't ignore.

Because of this evidence linking antibiotics to obesity, Europe has banned its farmers from using antibiotics in livestock feed. Although, I haven't seen any evidence of humans who eat the animals who were fed antibiotics becoming obese.

So how exactly do antibiotics make us fat? Many scientists are starting to study human "gut flora". This refers to the collection of microorganisms that live in our intestines and keep our bodies in balance with the bad bugs of the world. You may have heard of fecal transplantation curing a deadly intestinal bacteria, C. difficile? They don't quite get it yet, but scientists are learning that having a healthy gut flora is vital to our health and prevention of all kinds of diseases, including obesity.  Obese people have a less diverse flora than people of a healthy weight.

Ok, so I know antibiotics are not without consequence. I also know that many illnesses frequently treated with antibiotics are viral and don't respond to antibiotics. So why do I keep prescribing them? Tough question for us providers.

There is a belief by most of the community that antibiotics are the magic trick to curing them and getting them back to work, school, volleyball, their cousin's wedding, or their beach vacation. They act like if I don't prescribe them it's just to be mean and if I only understood that they didn't have time to be sick then I would give them my magic pill. This is not true guys. I'm always here to do what's best for you. Majority of the time if you have a cold, the flu, a sinus infection, cough, bronchitis, or sore throat the antibiotics will do you no good. Yes, even bronchitis and sore throat. They will keep you from arguing with me and coming back to the clinic the next day hoping for a different answer. I promise, the CDC and FDA backs me up on this.

I did say "majority of the time". So how can I know for sure if an antibiotic will help? Currently medical providers don't have fast and inexpensive testing to prove to you, or us, if it's viral or bacterial. You can get blood work done, but it will usually take a day to come back.

This leads providers to prescribe out of fear. We want to protect you from the worst thing it could be, so, we'll prescribe the antibiotic just in case. And since we don't really know what we are treating, we will give you one of those "broad spectrum" ones to just kill everything. (The ones that made babies and rats obese, remember?) Seems like the best thing to do for the patient, especially if you fear they may not return if complications develop. Now that we are learning we may be causing long-term health complications from our attempts to help, we must re-examine our decision making process.

I would encourage all of you to help us out. If you see a medical provider, I hope that you are seeking their professional opinion and advise, not asking for "what always works in the past". A very frequent scenario: you come down with cold symptoms, deal with it for 3 or 4 days, and then finally go get an antibiotic. In the next couple of days you start feeling better so you assume the antibiotic worked. When, in fact, it was viral all along, and upper respiratory viruses usually resolve in 7-10 days.

Somewhere in your visit with your provider mention that you don't want antibiotics unless you really need them. It's sad, but we have come to assume you are going to demand them. If we don't have the energy to argue we will prescribe them.

Let's all approach antibiotics with a bit more caution. Please remember that there is no magic pill nor substitute for a health diet, exercise, and adequate rest to keep us healthy and ready to enjoy life.

*Stepping of my soapbox now*

Thanks for listening, I hope you learned something new. I welcome questions and comments, just be nice :)

This is nuts! *graphic content*

*Warning- if you happen to be eating at the moment or are an animal rights activist the post below may bother you*

I'm all about new experiences and boy was today one! I was invited by a co-worker, Michelle, to come out to her family's ranch for a calf branding day. In the spirit of adventure of course I said yes. Today three different families came together to get the job done. Branding is important so that no one can steal other people's cows. The brand is required when the cow gets sold to prove it belongs to the person selling the cow. So here's how it's done:

The branding irons heat up over hot coals.

The poor babies await their fate.

The momma cows are pissed that someone took their babies away and are quite vocal about it. #mooooooo

Two people wrestle a calf to the ground, then several other people run over and brand the calf, inject antibiotics (which make them fatter), and if they are unfortunate enough to be a baby boy cow....well it's an especially bad day.

"Rocky Mountain Oysters" can be enjoyed right off the branding iron coals or saved and prepared for later. No, I did not try them.  #eeeewwwwww

When the work is done everyone gathers for a big potluck meal. Branding days are big social events that bring the whole family together a few times a year.

After the traumatizing part of the day was over, my friend Stacey and I took a tour of the farm:

It was a very educational experience, but I sure am glad I'm not a cow!

Thankful

This was the first Easter Sunday in several years that I hadn't spent weeks planning and leading worship. I wanted to find a way to celebrate God's love for me even if I wasn't in church. For me, the next best thing to singing my heart out in worship is spending time in His beautiful world outdoors. So Chippy and I found Nebraska National Forest and Chadron State Park. The surprising beauty of the landscape took my breath away.

And here are a few Instagram pics I got:

It was a pretty great Easter Sunday!

Lattes and Craft Beer?!

I get two whole days off this weekend and have no idea what to do with myself. Sleeping and reading gets kind of boring after a few hours, so I have made plans to venture into the nearest “city” of Chadron, NE (which does have some cool history going back to the fur trade).

It’s about 30 miles from Rushville and my co-worker says I can get my oiled changed there. I drive into town and see a Walmart AND a McDonalds…woah, look out! Usually these things don’t get me excited, but it means that I, in fact, AM in civilization! I get my errands run and meet some new friends for lunch. It was a pretty good little Mexican place. I have now determined A) You can find Mexican restaurants anywhere in the country and B) There is no such thing as bad Mexican food.  Back to the story… I wanted to find a good Internet connection so I could ramble on to you folks on this new blog. I asked around and was directed here:

Bean Brokers
They have great coffee in addition to craft beers and good wine. They host open mic nights on Wednesday with the local college fraternity. The place is decorated with all kinds of antiques and has a really neat vibe. After ordering my latte I sent an excited text to my coffee loving friend Michael , “Civilization found in the form of lattes and craft beer!

4/18/14 Blurred Lines

My first day with patients went very well. The outpatient clinic here is actually in the hospital.  This provides me with alot of support from multiple other providers as well as the rest of the departments in the hospital such as pharmacy, radiology, and lab. Everyone I work with is more than happy to help and seems to just appreciate me being there.

My view for 13 hours a day.

As expected, I saw many people who were in some sad situations today. What I found most interesting was a conversation with the head of social services. As you can imagine there is great need for social services in this the 49th poorest county in the US.  Some of the support needed includes child protective services, elderly assistance, keeping people's electricity on so their oxygen machines work, helping patients and their families get to and from larger hospitals when referred, and so much more. Some funding for these programs comes from the government. Indian Health Services (IHS) is a hospital funded through The Department of Health and Human Services (like a VA Hospital), but doesn't receive funding for all the social services listed. Here is where the tribal government comes in, but the line gets blurred, funding comes in short, and people are left in need with no resources. There are also no long-term care facilities or hospice services on reservations, so family members and primary care providers carry the heavy burden of providing end of life care.  It really is a very different world, even different from very poor and rural Alabama and Georgia that I have experienced.