This one's for the ladies....do your shoes make you look fat?

On a recent evening flight I was reading a magazine and came across a Charla Krupp interview (I wasn't familiar with her but per the article, she has a new book out - "How to Never Look Fat Again").  The focus of the interview was cleaning out your closet and getting rid of what she calls "high fat" clothing.   In the interview, she says that wearing sneakers with jeans is a mistake - that it is a "high fat" combination.  Who knew?

As I walked through the airport after we landed, I started checking out women's shoes....wondering how many women were wearing that "high fat" combination....and did she have a point? 

I saw many many shoe styles (and boots!).  I'd have to say that the majority of shoes were sneakers followed by some other type of flat/comfort shoe.

Curious to see what reactions I would get, I stopped some of the women (ok it was evening and I had time to kill between flights) and asked them about their shoes, why they were wearing them, would they sacrifice comfort for style?  I also asked if I could take a picture of their shoes.  The reactions were surprising....well maybe not so surprising given how women feel about shoes....they loved it!  Not only did they let me take the picture but they were interested in sharing details about their shoes. 
 
 

One woman showed me the peace sign on the bottom of her shoes

One woman took her shoe off to show me the brand...and to share that she'd had her eye on this particular shoe for a few months (Nordstrom's) and that she waited until they were on sale to make the purchase ($500 shoes).  She swears they are as comfortable as wearing flats. (this was a flight attendant - wonder if she wears these throughout the flight?  I've noticed some flight attendants wear their "sexy" shoes through the airport and during boarding, then they change into more comfortable shoes for the rest of the flight).

This combination would no doubt get the approval of the book's author...jeans and heels.

Then there were the boots....lots of different boots

Boots with flowers

Cowgirl boots

Lace up boots

My favorite shoes were those worn by a very cute baby.








 Kate - notice her mama showed me the bottoms of the "shoes" (really socks) so I could find some for baby Stella




Personally, I don't wear sneakers when traveling because 1. they are a pain to take off and put back on during the security process and 2. they take up a ton of space in a suitcase.   I'm lazy...I wear slip on shoes that make the "take off and on" security process quick and easy.

 That said, not sure I'll ever put sneakers on with jeans and not wonder.....do these shoes make me look fat?

Sylvia - from Belfast - travel problems delay vacation

I flew to Minneapolis on Wednesday.  I met Sylvia in the hotel shuttle bus waiting area.  Sylvia and her family were enroute to Phoenix.  Due to mechanical issues on two separate flights, they were already 3 days into their 10 day vacation and they weren't anywhere near Phoenix.

Their original flight (Continental Airlines) was delayed 8 hours leaving Belfast (Ireland) due to mechanical problems.  When they arrived in Newark (Tuesday) they had missed their connection to Phoenix by 30 minutes.  Continental got them a hotel room and booked them on a USAirways flight to Minneapolis (Wednesday) , where they were supposed to catch a  flight to Phoenix.  They arrive in Minneapolis and encounter another mechanical problem for the connection to Phoenix.   They are informed there is no way to get them to Phoenix that day, they are provided another hotel room and are booked on a Delta flight to Los Angeles for Thursday.

I have to say Sylvia was calm and cheery which rather amazed me.  She plans to follow-up with Continental airlines once she gets home.....following the instructions the gate agents gave her (apparently if you want to complain you have to go online and write out your complaint).  What ever happened to employees being empowered to "fix" the problem?  I guess providing a hotel room is considered the "service recovery" in a situation like this.  Imagine being on a 10 day vacation and losing 1/3 of it due to mechanical problems with two different airlines?  Sylvia, I hope you do follow-up with Continental and get some form of compensation for their having screwed up your vacation!!

Carolyn Suazo - Serving our Country - Army

Wednesday, March 24
O'Hare airport
Gate K8

Carolyn Suazo was enroute to Dallas, Texas.  She's been in the Army 23 years and is a communications specialist.

Home is upstate New York.

She has been to Iraq and will be deployed soon to Afganistan.  She plans to retire after that.

Carolyn, thank you for serving our country.  We pray for your safe return.

Christopher Smalley - Serving our Country - Army

Gate G12 - O'Hare airport
Friday, March 26

I met Chris Smalley boarding a flight to Champaign.  He started his travels yesterday, in Iraq, and this was the last leg of his trip.  He's headed home (Sheldon, IL) for a 2 week "vacation" with his family and fiance.

Chris has been in the Army for 5 years and plans to stay until retirement.  He is an all wheel vehicle mechanic.

When his 2 weeks is up, he's headed back to Iraq.  Chris, we thank you for your service to our country and pray for your safety.

Chicago - great place to visit

I spent a couple of days in Chicago this week attending a conference.  4000 healthcare executives - you can imagine the buzz on Monday due to the passage of the healthcare reform bill Sunday night.  Several speakers said they had to scrap portions of their presentations and re-write them.  Let's just say it was lively with lots of different perspectives.  I'm not going to focus on that - I want to focus on the city.

I've never quite understood the rationale for having a conference in Chicago in March.  The weather is unpredictable (snowed Saturday) and even if the temperatures aren't bad, its usually super windy.  That said, I love Chicago and always enjoy a visit.

My youngest son, Ryan, lives in Chicago.  Had dinner Sunday evening with him, his fiance - Stella, and her mom.

Stella's mom is also a nurse.  She works in surgery, specializing in open heart procedures.

Took a walk down Michigan Avenue and stopped to gawk at the window washers.  I have no idea how much money they make for essentially hanging from a rope, but I hope its a lot!

The crane messing up my picture is on the site of the future high rise condo building being built by the Ritz Carlton.  I'm very sad about this as its on the former site of the Garrett popcorn shop (BEST caramel corn anywhere!).  The good news is there is now a Garrett's shop in terminal 3 at O'Hare.  I'm a purist - I like the caramel corn all by itself but I think I'm in the minority as most people seem to order it mixed with the cheese corn.  If you haven't tried it, you're missing out.

Played tourist Monday evening and met a friend at the top of the Hancock building.  In all the years I've been going to Chicago (actually spent the last 3 years of my undergrad program up there) I've never taken the time to do this.    If you're in Chicago on a clear day/evening, head on up - its well worth the short elevator ride (and the expensive beverages!)

Took the Amtrak train home this evening.  Interesting mix of people riding the train although the majority seemed to be college kids or families on spring break.  Can't say I'd want to do a really long train trip, but for $27 round trip, what a deal!  (especially when the Chicago hotels downtown are charging $50/day to park your car.)  I hear we're getting a high speed train that will reduce the 2 1/2 hour trip to 40 minutes....wonder if that's just a rumor.

My "2 cents" on healthcare...as a traveler

Probably the most frequent question friends and family ask me about my job is "doesn't it make you nervous flying so much?"  My answer?  "Flying is a whole lot safer than being a patient in a hospital." 


I heard this comparison recently - if airline quality was the same as hospital quality, there would be a 747 airline crash EVERY WEEK!

There have been numerous publications since 1999 focusing on the subject of preventable deaths in hospitals.  The Institute of Medicine's "To Err is Human"  raised a lot of awareness about this issue.

11 years later (Feb 2010) an article in the Archives of Internal Medicine reports that from 1998 to 2006, 48,000 patients died from hospital-acquired pneumonia or sepsis, at a cost of $8.1billion.
If my math is correct, that puts the risk of dying at
-1 in 1437 if you're in a hospital (and that's just for the 2 conditions mentioned in the article)
-1 in 11,000,000 for air travel (if you fly one of the top 25 safest airlines vs. 1 in 724,000 for worst 25)
-1 in 8000 for auto travel (or 1 in 12,300 depending on which reference you use).
Note:   I googled the "odds of dying" and I want to stress that I found varying numbers, so please keep that in mind!!  The healthcare ones I could source.

Enough statistics.  Hopefully you can understand why, if I was concerned at all about traveling, my concern would be which  hospital I would wind up in should I have an accident or become ill and not have a say in the matter.

I travel coast to coast consulting in hospitals.  I'm still seeing some that are very resistant to performance measurement.  Many have the mindset that local differences justify their average or "worse than expected" outcomes.   I hear things like:
-our patients are different
-all of our patients are fat
-all of our patients smoke
-all of our patients are non-compliant (ie its not our fault)
-if we force doctors to standardize care, they'll take their business elsewhere
-our doctors are different (a recent comment was "our doctors are cowboys - they do what they want")

One doctor said to me "we aren't interested in state-of-the-art healthcare" - to which I replied "then you need to put a billboard outside the hospital that says...If you're interested in state-of-the-art healthcare, keep driving...... so that consumers, including travelers like me, can make an informed choice."

So my "2 cents"....I think Americans should be able to make informed decisions about which doctors and which hospitals to go to for healthcare services.  As it stand today, you can look up the "lost luggage" stats on airlines, but not much data on healthcare quality.  Medicare has a website http://www.hospitalcompare.hhs.gov/ that contains some hospital data. Though its pretty minimal in terms of content so far, it is getting the attention of hospital administrators who don't want their hospitals to look bad. (its data specific to Medicare patients).  Some states also publish hospital data (google Pennsylvania Healthcare Cost Containment Council).
Try finding outcome and volume (ie "how many times have you done this?") information about physicians. 

There are many things to debate regarding what is taking place in Washington but it seems to me that improving hospital safety and quality should be a big priority as it would be a great way to reduce costs and save lives.  In the meantime, Washington is spending a lot of time and money on the Toyota issue (48 deaths?) while thousands of preventable deaths occur in hospitals every year.  Does this make sense? 

My advice..."shop" carefully for healthcare services.

Houston, we have lift off

My mom is 87 y/o, soon to be 88.  She's an active, independent senior citizen who maintains a social schedule that few half her age could handle.  Her hobbies include golfing, playing cards, bingo and her current passion - dancing.  She's adventurous - never hesitates jumping on the back of a Harley or onto a wave runner. 

It took a while to convince her to fly to Houston, Texas to visit my brother and sister-in-law as she didn't want to miss her Thursday and Saturday evening outings to dance to her favorite country band.  Saturday, my brother, sister-in-law and I drove her to the St. Louis airport for a flight to Houston.  St. Louis isn't the closest airport to us but I picked it because I wanted her to have an easy, direct flight which Southwest offers from that airport.

At the airport, we get her, her huge suitcase and her golf clubs checked in and I get a security pass so I can escort her to her gate.   Before we go through security, we stop and ask a SW pilot who happened to be standing near us, what exactly the numbers on her boarding pass mean (I never fly Southwest..so I wasn't quite sure what A 37 meant).  Turns out it means she is in the first group to board at #37.  He explains their new boarding process.  Because some of my co-workers fly SW, I knew the key was checking in exactly 24 hrs before the flight to ensure you aren't last to board.  We thank the pilot for explaining the process...my mom tells him he's really good-looking....I'm surprised she didn't invite him to go dancing.

I ask my mom if she has any liquids in her carry on...she assures me she doesn't.  I decide to go through the bag anyway and sure enough, several large items...lotion, toothpaste etc.  We get those sorted out and head to the security line.  That was pretty non-eventful except I was wearing an Illini sweatshirt (we were playing in the Big 10 Championship game that afternoon)...and the TSA agent asks if I could take it off (its bulky and it was a ligitimate question).  I say, "well I can take it off as long as you promise I won't get arrested for indecent exposure".  First time I've ever made a TSA agent blush. Shoes, off, liquids out, we get through.

I have to say the people at Southwest were really friendly and helpful (I can't always say that about all the other airlines I fly).  We were about an hour early and I was hesitant to leave her at the gate by herself....honestly, she has never met a stranger and I envisioned her getting side-tracked by a conversation with someone and totally missing  the boarding announcement.  We went over the process again.  Still nervous I asked the gate agent what she should listen for in terms of the numbering system.  He says "how old is she?".  When he hears her age, he says "let's give her a priority boarding pass and she can get on first".  Not only was that great news,  they also have a great set up in that they put these passengers in seats right next to the jet bridge entryway. 

I explain to her that she gets to pick whatever seat she wants.  I advise she not sit in bulkhead as she'd have a hard time getting her carry-on in the overhead storage area (she's 5'2" ).   In the meantime, she's in a conversation with another elderly lady  - mom saying "I hope an interesting/good-looking guy sits next to me."  The other lady says, "if he does, I'm going to trade you seats".  I walked away thinking "that's my mom".

2 hours later we get confirmation from my niece, Wendy, that Grandma arrived safe and sound. 

I'm hoping she has a grand time in Houston ...I'm also hoping I have her gene pool!!!!

PLEASE don't infect me with your 60mph cough!!

This is a longer blog than I know is ideal, so bear with me!  I have a cold.  I'm assumming I acquired this virus on one of my recent flights (although to be honest, it could have been from any of the numerous people I socialized with or worked with the past week while in Florida or North Carolina).  I'm going to focus on the airplane. 

Have you ever wondered how at risk you are for "catching" a bug when you fly?  A few months ago, I was meeting with a group of people at a hospital in California.  One of them was obviously sick....nasty nasty cough...the kind where you want to get up and move to the opposite end of the room.  Sensing the discomfort of several in the room, one of the physicians (a pulmonologist) gave us a mini-lecture about the germ transmission process specific to respiratory infections.  Some of the info pertained to air travel since he knew I fly quite a bit.

He talked about  a study that was done on aircraft, comparing infection rates when air was exchanged with fresh air vs. planes using re-cycled air.  The study concluded that recycled air didn't result in a higher rate of infection.  They concluded its often the flat surfaces on the planes that infect people. 

Years ago, per the doc, the turnaround for an aircraft (time to unload and reload passengers) was close to 2 hours.  Now the turnaround is often 20-30 minutes which is NOT enough time for the plane to be thoroughly cleaned, or enough time for all the bugs to die...the bugs that are sitting on all the hard surfaces...think armrests, tray tables, the light switch and air control.  So when you board, you're entering a contaminated zone!
How do those bugs get on those hard surfaces?  Two primary ways:
1.  coughs and sneezes
2.  contaminated hands

Coughs and sneezes first.  I assumed that the spray from a cough or a sneeze could travel quite a distance on a plane.  I looked it up (what did we ever do before Google??) and here's what I learned:
-a sneeze may produce 40,000 aerosolized droplets and those droplets travel around 47mph (that's 69 ft/second). 
-a 737 jet (common for American Airlines) has a cabin that is around 12 feet wide and 98 feet long (also Googled).  So, essentially, someone in the back of the plane can sneeze and 2/3 of the passengers are going to be exposed along with all those hard surfaces -  in a single second. Unless they'covered their mouth, of course.

A cough is a little more powerful - 60mph.

Now to the hands - "Cover your mouth when you cough" has been mothers' mantra for decades, which, as it turns out, may be just as bad as not covering your mouth at all.  Instead of flying through the air, those droplets are now on your hands and will contaminate everything you touch unless you immediately wash your hands prior to touching anything.

How do we teach people the safe way to cough?  I have a couple of ideas:
First, as part of the flight attendants' pre-flight safety speech, they could include a demonstration of appropriate cough/sneeze etiquette.  It could come right after they tell you how to unfasten your seatbelt...( "lift the plate on the buckle...") . It would go something like this....." Ladies and gentleman, as part of our mission to keep our passengers healthy, we'd like to demonstrate the proper way to cough.  Failure to follow this procedure may result in prosecution" (ok that's a stretch but they have a similar threat posted in the bathrooms to warn you against smoking, and I'm thinking this is just as important). 

I'm assuming everyone is familiar with the "dracula cough"...where you essentially cough into your bent elbow.  I recently witnessed a pilot friend do this better than anyone I'd previously seen (wish I had taken his picture to post here!)

 . 

Since the likelihood of the FAA adding coughing instructions to the safety speech is zero (and probably shouldn't be their highest priority at the moment given the recent incidents of children operating as air traffic controllers)  what can we do?  Here's what I do.  Anytime a passenger next to me, or across the aisle, starts coughing, I ask them "do you smoke or are you sick?"  I get a variety of reactions to this question.  The most recent was a hostile "what do you think?" to which I replied "actually, it really doesn't matter to me what is triggering your cough...but I do care about the fact that you're not covering your mouth and are therefore exposing me to 40,000 droplets of potentially contaminated spray traveling 60 mph".  You can imagine his reaction - as I mentioned in a prior blog...someday I will be found dead in a parking lot. At least I didn't take his picture which I have to confess I was very tempted to do...as an illustration :). 

You're probably thinking "she's crazy!"...but imagine the impact if all of us took the time to dissiminate this same message, not just on a flight, but anywhere.  I think it could seriously have an impact on sick time/productivity.  Might be one of the more logical ways to reduce healthcare costs.

In the meantime, at the suggestion of the California doc, I carry these anti-bacterial wipes with me.  Now you're probably thinking if I used these on my recent flights they must not work since I have a cold.  I'm wondering the same thing....

Too much news? The Good, The Bad, The Ugly

One travel habit I have is reading the paper (usually the USA Today because that's what the hotel leaves outside my door) while I'm waiting for the flight attendant to announce that its ok to "turn on approved electronic devices".  On the way home from Charlotte last night, I read the paper and by page 3, began to think I should have left the paper at the hotel.

The Good
Not sure its actually "good", but it was nice to see Captain Sully's picture and his retirement announcement (for those that missed Monday's blog (3/1), I met him Monday when I was checking into the hotel).  Side note:  he's really tall.

Full page ad paid for by Target - congratulating Shaun White and other olympic athletes (fun cartoonish ad)

The Bad
Three, 26 foot tall waves hit cruise ship - 2 dead.  Guess where this happened?  Exactly where I will be in a few weeks - near the French port of Marseille, having sailed there from Barcelona.  And people tell me riding a Harley is dangerous.  Geesh.

Facebook and other social networking sites can be "an invitation to crime".  It warns, if you get a message like "LOL is this you?" followed by a link, don't click on it! This was a large article filled with technical terms like:  botnet, Koobface, Monkif-A, Clickbot, phishing, Kneber gang, ...I could go on (its like a foreign language).  Anti-virus software is IMPORTANT!!!  Makes me wonder if there's a problem with all those Facebook things people pass around...the ones that require you to get all  your friends to participate.  (I ignore those).  Facebook - 400 million members - biggest target.

The Ugly
Slaughterhouse breaches - reported by a USDA veterinarian.  Things like:  butchering conscious pigs (apparently they are supposed to be stunned and unconscious before they are slaughtered - that made me wonder if "butcher" and "slaughter" are used inter-changeably, ....shouldn't the animal be dead before they start cutting them up???).   The article goes on to describe problems with contaminated meat from "downer cows" (cows too sick/weak to walk)and moving cattle with electric prods.  Its all pretty grisly - not just how the animals are treated but also how the actual meat is treated.  If I gave this much thought, I'd have to become a vegetarian. 

And, drum roll, the worst of the articles - In California, Steven Willett, 57, is receiving $126,000 of tax payor "support" and he's had 4 felony convictions for sex crimes and is considered a sexually violent predator.  Now he's living in a trailer out in the desert, receives  $2000/month in treatment and here's the kicker, he has no internet access but does have satelllite TV.   Yesterday, I had a conversation with one of my co-workers, Anna, whose son recently joined the Navy and is finishing up his basic training.  Get this, while we're funding satellite TV for this criminal, her son has no access to TV during basic training, has limited phone access AND had to spend 2/3 of his first paycheck for uniforms/clothing.  (actually this was a little bit of a surprise to me....wouldn't you think we'd at least pay for an initial set of uniforms?) I'm not suggesting the military approach is wrong (well except the cost of the uniforms...wow).  But why are we paying for this sexual predator to watch TV?  Side note - the article did say it costs more....$185,000/year...for the ones they keep in an inpatient state facility.   Notice he's sort of smiling in this picture...no wonder.

P.S The funny
OK, I can't help but add this one....in the sports section, there is a quarter page ad for a "male enhancement" liquid technology...claims to deliver hours and hours of uninhibited please and satisfaction on demand.  800 number so you can get your risk FREE bottle.  The lady in her undies in the picture guarantees satisfaction.  I've not seen an ad like this in our local paper. 

Now, don't you feel uplifted??

A lively travel day - dusted off my nursing license and met Captain Sully

March 1, 2010

While it doesn't always feel this way, most travel days are pretty much uneventful.  (ok, so this time of year it doesn't feel this way - think winter, snow, Chicago).  Today was a little more "interesting".  I helped a sick passenger on a flight AND met Captain Sullenberger.

I traveled from Tampa, FL to Dallas, TX, to Charlotte, NC.  My original flights would have had me in Charlotte around midnight.  However, I lucked out and got on earlier flights - even got upgraded (hmmm....in hindsight I should have bought a lottery ticket tonight as luck seemed to be with me!).

Back to the flights....about an hour into the first flight, the flight attendant gets on the intercom and asks anyone with a medical or nursing license to press their call light.  I didn't initially respond, figuring there probably were some physicians on board.  No responses - so I let the flight attendant know I am a licensed RN.  (they actually checked my license..which I fortunately had with me...I don't always carry it). 

Side note:  last time this happened, there was a lady in the back of the plane having a heart attack. She was very fortunate that there were 3 doctors on board who initiated some treatment and monitored her during the time it took to divert the plane to Colorado Springs (instead of our Calif destination).  I've never seen  a plane get on the ground so fast, with such cooperative passengers.  Amazing!

Today's issue - there was a passenger in the back of the plane who kept passing out.  I won't go into the clinical details of the situation, but it was interesting on a number of fronts - from her being sick, to participating in decisions about whether or not the plane needed to be diverted.  I learned that its impossible to take a blood pressure the normal way when you're in the back of the plane due to the noise of the jet engines.  I also learned that you shouldn't assume a passenger is a U.S. citizen - as I did when I was asking her questions to see how oriented she was ("what's your name?",  "who is the president?" etc).  She knew the name of the president but her husband was quick to point out she's Canadian which lead to an interesting discussion about how many U.S. citizens would know the answer if asked "who's the prime minister of Canada?"

I finally get to the hotel and am checking in when I hear a familiar voice...one that I immediately recognized having heard him on TV many times.  I looked to my right and sure enough...it was Captain Sullenberger (Hudson River landing).  He was very nice and let me get a picture.  An American hero!!

Meet Camara Garrett - Serving our Country - Army

3/1/2010 - Dallas airport, Gate A15.

Camara Garrett has served 17 years in the United States Army, and plans to serve several more years.  He is a chemical specialist, working with soliders to make sure they are protected from exposure to chemicals.

He just returned from Iraq for 2 weeks of "R & R" and was enroute to Junction City, Kansas to see his 1 year old son.

Camara, thank you for serving our country!

As a side note, I'm always so impressed with how quickly other passengers jump to accomodate soldiers...from offering their own seats if the soldier is trying to go standby, to offering them aisle seats or exit seats, or even first class upgrades.  Way to go fellow Americans!