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Saturday, October 7, 2017

VSGAnn2014
on 10/7/17 4:08 am, edited 10/7/17 5:00 am
VSG on 08/14/14

Weight: 131.8
Macros: Cals - 1,623, Carbs - 178, Fat - 40, Protein - 107, Fiber - 24
Veggies/Fruits (goal 8): 6
Sleep (goal 8 hours): 6.5 hours
Exercise: Aquarobics

Yesterday's V/Fs were Romaine lettuce, black beans, tomatoes, kale, spinach, pinto beans, and strawberries.

I was hoping to stare up at the lovely harvest moon this morning, but it's only occasionally peeking through the low cloud cover. Maybe the sky will clear a bit before the sun comes up. Happily, the tree frogs are chirping away. We won't have many more of these warm fall mornings to walk out onto the porches in our bare feet with impunity.

Here's hoping Nate is kind to NOLA and the Gulf Coast. That part of the world and those who help them recover could use a big break!

Y'all all have a good weekend, whether you're hiking, walking the dog, mowing, lunching out, grilling and cooking, running errands, traveling, attending football games, or doing the simple things that renew your resilience.

P.S. Come back to the Five and Dime, Devon!

P.P.S. At 7 a.m. Central Time ... The cloud cover has parted, and the setting moon is yuuuuuge! West Coasters, it's worth getting up early this morning to catch it. :)

ANN 5'5", AGE 74, HW 235.6 (BMI 39.2), SW 216, GW 150, CW 132, BMI 22

POUNDS LOST: Pre-op -20, M1 -10, M2 -11, M3 -10, M4 -10, M5 -7, M6 -5, M7 -6, M8 -4, M9 -4,
NEXT 10 MOS. -12, TOTAL -100 LBS.

Liz WantsHealthForAll
on 10/7/17 4:39 am - Cape Cod, MA
VSG on 03/28/16

Good morning! Looks like Nate is category 1 but with a lot of rain? So it will be water more than wind causing issues. I hope it isn't too bad for the gulf coast.

Weight 116, calories 1682, which isn't too bad considering that wine and a pumpkin muffin sneaked in. Both completely worth it (and I did well the rest of the day).

Today we are celebrating SIL's birthday (Elaine), so it will be a fun day with my BSFs (Best Sister Friends). Elaine and I didn't have sisters. Though Jane does, they aren't close. So the 3 of us are lucky to have a great friendship! Tonight the 2 husbands (Elaine's brothers) will join us for dinner (Elaine has been a widow for about 15 years).

Have a superior Saturday!

Liz 5'3" HW: 219 SW: 185 GW: 125 LW: 113 Desired maintenance range: 120-123 CW: 120 (after losing 20 lb. regain)!

Shel25
on 10/7/17 8:59 am, edited 10/7/17 2:05 am

Good morning!

I'm back from my 6am gym workout. I would like to do legs up the wall but I know I would spend the whole time thinking "I stink." So, coffee/computer then off to the shower.

Advise about mentoring, please. I have a pharmacy resident starting with me on Monday. Pharmacy residents are already pharmacists (usually newly graduated) and fully credentialed. They will be will us for just one year of advanced training and they rotate thru various services. (I am primary care.) These positions are highly competitive across the country. It is hard to get an interview much less a position. These peeps are all impressive on paper and in person.

The problem: over the last several years, many of the female residents can't take any sort of feedback without running to the program's director in tears. So, being who we are, the preceptors have worked hard adjust our feedback delivery to get the message across as gently as possible (As a group, the people who do my job are genuinely decent people who strive to improve our craft and that includes being better preceptors.)

This newest resident has already been in tears because of direct feedback that had to squeezed in because of time constraints. It wasn't overly personal feedback....literally "you need to review the next chart in 3 minutes instead of 10"

So now that preceptor is on the hot seat and this particular resident is transitioning to my service for 6 weeks as part of the normal rotation

My question: Are we doing these women a disservice by making it the preceptor's problem when direct, concise, neutral feedback hurts their feelings? By the way, this has never happened with a male resident. And not even the women residents see the feedback as overly personal although there is a common thread where the preceptor states there is room for improvement and the resident will literally say "that is unfair, I rocked!"

The director keeps telling us "these people have never had negative feedback." I'm thinking the real world doesn't give out medals for showing up. And the feedback we give almost always relates to time management in some manner, effective communication with patients, etc.

Once I told a resident that she couldn't have a banana on the desk when she sees a patient face to face. That was a whopping big deal. Too direct. I mean, it was a banana on the desk. Does there NEED to be a big ol' discussion about understanding the how and why of the banana and all the potential places to tuck the banana out of sight?

I don't think this is about the banana but I can't quite figure out what it IS about. And why is it only the female residents?

Anyway, have you folks noticed a difference in how feedback is perceived these days? If the preceptors have been truly engaged in improving the feedback process, am I the one of out step for just thinking that the tears/hurt feelings are just a stress response? Ok to feel them but you just gotta move on? And I keep coming back to life skills.....I am glad they have the director to vent to, it IS a very stressful year, both professionally and emotionally. I just don't know that our group response is moving them forward as adult human beings.

Or maybe I am just mean.

All off topic, but I think a lot of you have helped newbies along. Would appreciate thoughts.

Hug your skinny, even if a bit stinky.

Shel

PS: moonwatch: cloudy this morning, still pretty.

HW:361 SW:304 (VSG 12/04/2014)Mo 1:-32  Mo 2:-13.5  Mo 3: -13.5  Mo 4 -9.5  Mo 5: -15  Mo 6: -15  Mo 7: -13.5  Mo 8: -17  Mo 9: -13  Mo 10: -12.5  11/3/2015 Healthy BMI Reached Mo 11: -9  Mo 12: -8    12/27/2015 Goal Weight Reached!

Paula1965
on 10/7/17 9:16 am
VSG on 04/01/15

Shel, unfortunately, I think the problem lies with how the generation as a whole has been raised - coddled, entitled, given an award for everything, told they are doing "great" at everything even if they are just doing mediocre or even poorly. I sure see it in my kids and their friends and I know my DH sees it in his students. Professors have been called by parents of college students to find out why "Johnny" didn't get an "A" on his paper. Seriously? And my own kids can't pick up a phone to call someone for information, make an appointment, etc. My middle son "jokes" that the government should just hand out money and cars.....the youth "deserve" it. If I knew then what I know now, I would have raised my children differently. Today's young people live in an alternate reality.



5' 4" tall, HW: 242, SW:215.4 Weight Loss - pre-op: - 26.6, M1: -15.4, M2: -16, M3: -11.4, M4: -11.2, M5: -12.2, M6: -7.4, M7: -7.8, M8: -2.0 Goal of 130 lbs. reached at 8 months, 2 days post-op!












Shel25
on 10/7/17 9:31 am

I just can't imagine a work culture where that works. Maybe I lack imagination for a different world?

However, the local tech companies (homeboys microsoft/amazon as well as google's regional offices) give massive in-office perks like free chef-prepared food, free gym memberships, etc etc etc, playful work spaces. So, I can see that part of company culture matching our kids.

However, tech management structure/teams seem cut throat to me. Members on the same team are so competitive that it can sabotage the whole team. Apparently companies see more benefit than risk.

I do see more emphasis on work/life balance in our new doctors. (As you know, the doctors rule our healthcare system.) I rather like that. And, I see leadership making deliberate changes culturally to make that happen.

HW:361 SW:304 (VSG 12/04/2014)Mo 1:-32  Mo 2:-13.5  Mo 3: -13.5  Mo 4 -9.5  Mo 5: -15  Mo 6: -15  Mo 7: -13.5  Mo 8: -17  Mo 9: -13  Mo 10: -12.5  11/3/2015 Healthy BMI Reached Mo 11: -9  Mo 12: -8    12/27/2015 Goal Weight Reached!

VSGAnn2014
on 10/7/17 10:16 am, edited 10/7/17 3:20 am
VSG on 08/14/14

Boy oh boy oh boy! Do I have a lot of information about this and experience with this.

But first -- if this is a systemic, gender-specific response, I would suggest that the preceptors get in front of this behavior, overtly, before it happens, by describing it and discussing it with the residents. Pre-warned is fore-armed, eh? Candid, specific feedback must be defined and acculturated as NOT abuse and NOT hazing, but critical information without which the residents will not progress.

There are long-standing gender issues in professional settings that are well documented. In my professional life I was a business consultant to huge corporate law firms. As you might imagine (and Diane and BB, you already know this from personal experience) women in corporate law firms and, generally speaking, in the practice of law face some serious uphill battles in gaining functional parity with men for client access, promotions, choice assignments, etc.

About 20 years ago I moderated a panel in Washington, DC, about these gender parity issues in law firms. The panelists were not lawyers, but high-performing women in other professional settings, e.g., real estate (Barbara Corcoran, who's now a "Shark Tank" investor), public accounting firms (a woman partner at the world's largest accounting firm, Deloitte), real estate development (a woman who headed up one of DC's largested RE development firms), and ... I forget who the fourth woman was.

Anyway, here's the relevant part: The Deloitte's partner said they'd recently figured out a major factor why young men and women who enter Deloitte's matched up in many ways (grades, interview results, psychological profiles, etc.) differentiate during the next 8-9 years with the result that very, very few women are offered partnership. When they looked at the male/female differences during those 8-9 years and the kinds of mentoring they got during that time, they found that men got a helluva lot more direct, candid feedback ("You did this right. You ****** up there.") than women did. It turns out male mentors absolutely refused to give candid feedback to women accountants because they were terrified the women would cry -- regardless of whether the women actually did cry. In other words, some cried, some didn't. But the fear of a woman crying was too tough for men to confront. Women mentors also didn't want to deal with the younger women coming unglued either; they didn't fear the tears -- they just didn't want the hassle.

As a result, young women simply didn't get as many career-building experiences as the young men did -- because everyone wanted to avoid the tears.

Boomer and Gen X women who've done well in the business world all know the Basic Rules of Working While Female:

- There's no crying at work.
- Don't take it personally.
- Work harder than any man.
- Don't apologize for anything ever.
- Speak up in meetings.
- Argue (respectfully and appropriately and privately) with the boss.
- Don't ever let anyone else take credit for your personal accomplishments.
- Play well with others.

Does nobody teach these rules to young women anymore? Do they really believe that it's a post-feminism world? Have they ever had any training in how to get ahead in business?

If not, somebody needs to make this happen and do it well.

My two cents' worth. (Because I don't have kids, I can't speak to how kids are raised these days.)

Ann

P.S. One of my best friends is a Google Venture partner who's very involved in creating more and better opportunities for women at Google/Alphabet. I could reach out to him and ask how they're dealing with this issue -- if you'd like.

ANN 5'5", AGE 74, HW 235.6 (BMI 39.2), SW 216, GW 150, CW 132, BMI 22

POUNDS LOST: Pre-op -20, M1 -10, M2 -11, M3 -10, M4 -10, M5 -7, M6 -5, M7 -6, M8 -4, M9 -4,
NEXT 10 MOS. -12, TOTAL -100 LBS.

Liz WantsHealthForAll
on 10/7/17 12:29 pm, edited 10/7/17 5:29 am - Cape Cod, MA
VSG on 03/28/16

Exactly! I lived by those rules (and have encouraged the women I've mentored and my daughter to do the same).

Liz 5'3" HW: 219 SW: 185 GW: 125 LW: 113 Desired maintenance range: 120-123 CW: 120 (after losing 20 lb. regain)!

LeapSecond
on 10/7/17 10:24 am, edited 10/7/17 3:53 am - AR

From the world of nursing, where we eat our young, they need to grow up. You really do not want that kind of behavior in a co worker. If a director or supervisor presses you, turn it back on them with a question. Like, do you ultimately want to hire someone that is going to come crying to you because they did not do their job? Or, how would you like for me to handle her... lie and then tell the truth to only men?

HW=362(6/14) SW=314(9/14) GW=195 CW=270 (1-26-2020)

Shel25
on 10/7/17 12:17 pm

exactly. The last resident was a presumed shoe-in for an open position in my group. She wasn't hired (much to the director's shock) because no one wanted her on the team. "Too much of a project" was my direct manager's comment.

Inpatient pharmacy hired her per-diem so she is still around. She still has no clue.

HW:361 SW:304 (VSG 12/04/2014)Mo 1:-32  Mo 2:-13.5  Mo 3: -13.5  Mo 4 -9.5  Mo 5: -15  Mo 6: -15  Mo 7: -13.5  Mo 8: -17  Mo 9: -13  Mo 10: -12.5  11/3/2015 Healthy BMI Reached Mo 11: -9  Mo 12: -8    12/27/2015 Goal Weight Reached!

Liz WantsHealthForAll
on 10/7/17 12:26 pm - Cape Cod, MA
VSG on 03/28/16

Wow! Having to be that careful seems like coddling to me. How are they going to be able to deal with frustrations or difficult patients? When I was just out of college, I was often the only women at meetings with men in higher level positions. At that time it was acceptable for them to be rude or tell dirty jokes to make women uncomfortable (old boys club stuff). I learned to speak up for myself and be tough (and ultimately compete with them).

Liz 5'3" HW: 219 SW: 185 GW: 125 LW: 113 Desired maintenance range: 120-123 CW: 120 (after losing 20 lb. regain)!

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