See the Tatas

Today's the first day, oh, since this time last year, where I came home from work and actually felt like publicly sharing my day. Progress!

Last night, at 10:39 pm, I finished my Franciscan Leadership program work. Nineteen essay questions, in the midst of my usual 250+ email Hades and operational madness that always arises each day. I "celebrated" my success in fully completing the two-year program this morning by allowing myself to sleep in past 6 am. I'm not sure where the days and weeks have gone. The old rumors are true- never go into an area of the hospital and say, "Man! It's QUIET!" It's an evil curse; once someone utters the "Q" word, it's all over. Then all of the sudden, it's Sunday night and time to start the madness all over again.

Like, today. I have seven total campuses and visited one of the smaller, community hospital settings to A) catch my breath, B) visit with my second-favorite radiologist (who kind of reminds me of an older rockstar), and C) help out during the employee Mammothon. This is where we open up the Breast Center and allow walk in appointments for the community. Local media usually visits and we have enough freebies to overwhelm a used car salesman. Our community Mammothons are in October but we wanted to highlight the staff and offer them the same opportunities. After all, most of the healthcare workers in the US are women. So off to "Gonzovent" I went. It's not uncommon to actual see episodes of Andy Griffith playing in the cafeteria- the pace of life is far slower at Gonzoville. I spend most of my waking hours at the primary St. Gonzo campus so the break was welcome.

After visiting with my second-favorite radiologist (after all, my most-favorite radiologist gives us free tickets to huge concert events...don't worry, each "free" ticket is paid for a lot of problem solving and conflict resolution- ugh!), I rounded on the department's employees and had a great one-on-one chat with the manager.

Then I got an urgent page that St. Gonzo's imaging department (the main one across town) flooded. Noah would've been proud. I was then treated to text message pictures of used linen and old towels baracading the water from the VERY expensive CT and Nuclear Medicine panels. After a few calls, I got the right people to respond but I don't like to risk about $12M in imaging equipment because of a faulty toilet (or three). Soon after, I received a 911 that not one, but two of our three MRI's went down at the primary campus.

Back at Gonzoville, I relaxingly talked with the Breast Center employees who were preparing for Mammothon. Our delightful conversation was interrupted by an urgent page from another imaging department reporting a bed bug infestation.

Bed bugs? Seriously? What's next, an interview with 20/20? Maybe just a plague of locusts?!

Returning to my Breast Center conversations, I succumbed to at least three employees peer pressuring me to get my annual mammogram, too. I shrugged it off, uncertain of whether I wanted one of my technologists to see my tatas. I soon realized that it was a unique opportunity to 'walk the walk.' By letting them run car tires over my girls, I could influence others to get their mammograms, too. And I did! I had my exam and then was able to convince six other imaging employees to get theirs. Strange, violating, exposing mission accomplished.

And now I can never look that technologist in the eye again. Yikes.

I have a strange hang-up about being too vulnerable in front of my staff. Yes, I want them to see my humanity and relate to me as a fellow human. But I'm very protective of my off hours. I don't like going to church with my staff. It's too intimate. I dislike going to the store and seeing employees. They peer into my shopping cart, analyzing my food choices and counting my servings of veggies. And the gym? Forget it. I rock out to my music and pound through my workout and really don't want to sweat with colleagues. It's just gross.

But I finally conceded and agreed with Jack that it was time to move into an actual house. After moving to Indianapolis (as renters!) over eight months ago, we had completely transitioned to our new home, new dentist, new friends, new Meijer, new church, etc. I even found a primary care provider I can stand. So what will we do? MOVE! It's a nice house and I'm proud that I finally got over myself and my vulnerability phobias. Dangit, I will soon have to pray, shop, and sweat with my colleagues.

So I came home tonight to a list of pre-new-house activities from Jack. I again lamented my fear that the contents of my Meijer cart were going to be public knowledge again and he looked directly at me and said, "REALLY? Are you kidding? Your employee saw your breasts today and your radiologist saw INSIDE your breasts today! You have no excuse as to why you can't go to the gym with your employees now!"

Touche.

So much for a relaxing day at Gonzoville. Maybe tomorrow will resume the busyness?!

(And that's what I've really been up to! In the last eight months, I have stricken the word "normalcy" from my vocabulary!)

The Root of All Nerves

The dentist did not go well today. Actually, the experience itself wasn't too awful, but now that my anesthetic is wearing off, I'm a painful, pathetic mess. There aren't enough Wendy's Frosty's in the world.

I went in to work for 6:45 this morning and led a few meetings (note to self: we need a new template for root cause analyses). Then I dashed back across the IN border to the dreaded dentist. I was seated in a deluxe dentist chair (it even had lumbar support) and handed a pink rubber mask (I kept thinking "a piggy nose!") and was instructed to breathe deeply. I'd never had nitrous oxide before and they said it was like having a glass of wine. Or three!

I'm a wreck when it comes to the dentist. They knew this and because the dentist is best friends with Elvis, I received a bit of the VIP treatment. This translated to a lot of laughing gas. Four hours' worth, to be exact.

So I took my first few deep breaths. The room started spinning (what does this stuff do to your brain?). The dentist came to numb my gums and jaw with the big, fat needle and I had this chorus in my head:

"Oh, it's time for the big, fat needle. Don't open your eyes, you don't want to see the big, fat needle."

[The Hendrix song "Purple Haze" comes over the speaker. Not even kidding.]

"Chill out, Dorrie. Breathe deeply."

[Inhale deeply. Room resumes its spinning.]

"Okay, the anesthetic is taking effect [drool]."

[Time passes. Thinks about work. Considers dinner options. Questions the end of civilization at 12/21/12.]

"This isn't so bad! Dentists are overrated and this one's niiiiiice! Weeeeeeeeeeeeeeeeeeeeeeeee!"

[Inhale deeply. Room keeps spinning. More time passes.]

"Gee, that hurts! Why is that hurting?"

The dentist announces that he's really close to the nerve and if it hurts, to let him know.

[Dentist lightly brushes the nerve and I jump 2 feet up in the air as if struck by lightning.]

Dentist says, "Oh, I guess you need more anesthetic. I wonder why your body is metabolizing this anesthetic so quickly?"

[I ponder the sign language needed to adequately answer this question. Then I have what seems to be a brilliant idea in my nitrous haze...We should devise a sign language methodology that patients can use to answer their dentists when they insist on asking you questions during your cleaning/exam/procedure. We resorted to the SCUBA communication signs and that worked well. I FELT like a SCUBA diver, with my big pink rubber mask across my face, and a mouth full of instruments.]

The lightning maneuver revealed the fact that I needed my first root canal. The doc offered me one on the spot, since everything north of my bra was completely numb. I went with it and asked the dentist and the assistant to please tell me stories. Or jokes.

They told me dirty jokes (probably shouldn't advertise that!) but they got me through the first root canal of my life. And the procedures were dragging on so long that we needed an Intermission (sort of like this post!). I'll spare you the exact details, but the other side of my mouth transpired the exact same way. Yes, even the root canal. The right side was apparently jealous of the left side.

When I woke up this morning, I had no idea I'd be losing two tooth nerves. I had no idea I'd be sitting here with paralyzing, throbbing pain shooting through my skull. My prescription pain killers aren't touching the pain and I have no idea how I'm going to run three meetings tomorrow. Can I quickly learn ventriloquism so I don't have to open my mouth?

It's Not Rocket Science...

...It's Brain Surgery!

I had two lunches with a bunch of incredibly smart people today. The first one was at the Inpatient Rehab open house, to introduce a new physiatrist to the fold. I talked to Dr. PrettyEyeLashes for over 20 minutes about the stroke program and the data collection methods we are using to drive volume our way. He had some great ideas about standardization of our volumes, especially from academic medical centers' inpatient rehab needs. I intend to segue this to a system-level discussion regarding standardized scorecards for all referral streams.

Then I had dessert (while they had lunch) with a group of brain surgeons today. Actually, they were neurosurgeons, but they all specialize in brain surgery. We will soon be offering brain surgery at St. Fozzie's. Yeah, it came as a shock to me, too! They use this very fancy, very expensive linear accelerator that allows the brain neurosurgeon to yuwhifj jilq a swlie bieflp dqpzls sa rac gkalsi. That means they were talking so far over my head I cannot even relay the story to you and it sounded like gibberish to me. Regardless, it's a referral stream for our primary care physicians and inpatient rehab.

I led a Physician Partnership Team meeting and while it was good, I feel like I need to inject more energy into the group. So I recruited one of our lively durable medical equipment salespeople to come in and talk to the team about value propositions and selling St. Fozzie's. She's a lot better at it than I am; might as well use her charisma and experience to light everyone on fire.

After that, I had my one-on-one with EVOO. I got my first job offer! It's a Director-level position and while it's great that I have an offer on the table, I'm still going to show my career matrix to Elvis and Jim Henson. I have no idea what they're thinking about my future...but showing the senior leaders my grandiose plans and ambitions is already off to a great start.

Quilting Jewels in Surgery

Boy am I happy I "pre-wrote" the last few days' blogs. I haven't made time to eat or sleep or do most of life's basic necessities since Sunday evening. I've worked...(counting on fingers)...well, too many hours. You guys don't care how many hours I've worked; that is old news. Plus, you'd probably yell at me!

I simply must detail the last two days I've had. I spent all of Tuesday and most of Wednesday in Surgery at St. Fozzie's. I'm doing the current state analysis for my Six Sigma project. I do not know what to focus on until I observe the current processes and document their work flow. I've spent some time in the OR (a few times as a patient) and twice as a fellow at St. Fozzie's. Most surgeries start to look alike, procedurally. I'm getting used to the OR and no longer feel like I'm on Mars when I visit.

[In the back of my brain, I'm wondering if I'm trying to make sense of my own OR experiences and understanding what I went through as a patient.]

Anyway, I documented at least seven possible process improvements, just in Intra-op alone. I didn't even observe Pre-Admit Testing, Pre-op, Holding, Regional, Post-Anesthesia, or Phase II Outpatient. So my middle name on Tuesday was "Information Overload."

While I was up in surgery, I watched four complete cases. One was a gastric lap banding, during which a laparoscopic incision was made in the patient's belly button. The surgeon, using a camera to guide, placed the lap band around the top of the patients' stomach. It's a weight-loss procedure and the patients lose drastic amounts of weight. The second case, same surgeon, was a repair of the port they use to tighten or loosen the band itself (allowing the stomach to increase or decrease in size). It was transitioned to a full laparatomy and I was actually not faint as I gazed at a person's insides. Honestly, what got to me was the Bovie, the laser surgeons use to cauterize the blood vessels to stop the bleeding. Burning flesh is a scent you never want to smell.

So on Wednesday, we went back up in the OR to follow two additional cases. Learning from the previous day's flesh-smelling terror, I used the ol' doctor trick and put a dollop of Vick's under my nose. Worked like a charm! I was able to observe the orthopods reset a boy's arm (the cracking together of bones was a little gross) and then I watched a procedure that no man should have to endure...

The gentleman had a cancerous area between his testicles on the seminal tube that runs between them (I'll wait while you go check your Gray's Anatomy textbook). The surgery entailed a cutting open of the scrotum, removal of the cancerous area, insertion of "support" ligaments to keep the testes in place, and a re-sewing of the scrotum. I tried averting my eyes from the case (it was just weird), but how many people can really say they've seen a scrotum being cut open? And better yet, being sewed back up again? I really admired the surgeon who completed the suturing...she looked as though she was sewing her mother's quilt, not a poor guy's jewel case.

After the time in Surgery and a couple of meetings to discuss our preliminary results, I slipped out of my scrubs and back into my suit. I climbed in my car and drove across town for a big strategic planning meeting with the Chicago Boards. The planning meeting went well, but it went until almost 10 p.m. Again, I was acutely aware that I was the youngest in the room by 20-25 years, but I've beginning to develop a good rapport with several physicians (I *am* their kids' ages, after all). I learned a lot but by the time I staggered through the door to my house, I was among the walking dead. I honestly don't remember what I did last night...and 5 a.m. the next morning came awfully fast.

Is it bad that I hate my alarm clock with every cell of my body?!

Short Circuit

I know things are getting dire when I no longer consider Starbucks coffee to be strong enough. I have to brew my own coffee now...only I would appreciate a full half cup of designer ground beans for my two-cup coffee brewer. That's the realization I had this morning as I lingered over my morning coffee.

[sound of record being scratched by a needle!]

What? I lingered over my coffee? YEP. For a whole 10 minutes. It was only because I had to represent St. Fozzie's at the Muppet corporate Quality meeting today. I was stuck at the hospital last night until almost 8pm CST and drove back to SB with my eyelids propped open with toothpicks.

The Quality meeting was so neat; the system is entertaining the idea of implementing telerobotics in the hospital setting. St. Gonzo's is our system's "hub" hospital for the stroke network we're trying to get off the ground. St. Kermit's and St. Rowlf's both have bids in for the telerobotics program to become "spokes" in the stroke network. St. Fozzie's is also going to apply for stroke designation and may join the system's stroke network. We're just not sure if we want to credential all the necessary physicians at all the Indiana and Illinois hospitals.

The robot reminded of Johnny 5 in the cheesy 80's flick Short Circuit. It was about the height of a human, had a blue base and a flat screen television where the head should be. A programmer from California "beamed in" and assumed the robotic identity. His head filled the screen and the robot made us feel connected to the programmer...because he could reach out its arm, take someone's pulse with the attached stethoscope, look down (the screen pivoted), and even plug it back into the wall by himself. It was eerie, just how human that robot appeared.

The point behind the telerobotics is to allow one super-specialist to reside in Nassau, Bahamas, for instance. We can actually build programs around these super-specialists, even if they are not on site. The telerobotics utilize high-capacity wireless bandwith and despite the geographical distance, there is very little latency. Specialists can easily interact with patients and their families and get this...they can even access the patients' electronic medical records from afar and toggle between the patient encounter and his/her health record. It's amazing and this technology may bridge that gap created by a lack of specialists in every field.

The only weird thing is that CMS (Center for Medicare/Medicaid Services) considers this a 'face to face' encounter and allows the hospital to bill for a full patient encounter. Isn't that bizarre? What's next, drive-through dentistry?

Rules Surgeons Live By

Last Thursday, I rounded in the Surgery department. St. Fozzie's has a couple requirements of the folks in leadership, one of which is that they regularly and consistently "round" on other departments. It gets you out there and allows you a first-hand look at what other departments do on a daily basis. That, and if anyone has issues, they're much more likely to tell YOU than they are their regular management team. It's weird, but it works.

So I rounded in Surgery this week. Because it's sterile, you have to get into scrubs to just walk in the door. My first mistake was that I forgot my sneakers and ended up fitting the sterile booties over my heels. Once I got over that, I was able to meet and touch base with the managers of the holding area, surgery, and post-anesthesia care. In surgery, I hung out in the docs' lounge for a while. That's where you go to get the REAL scoop of what's going on; the docs hang out in there between cases and gossip about anyone and anything. THAT should be the next sitcom on NBC. Just put a teddy cam in that room and hire an SNL writer to transcribe and insert a few slapstick remarks!

Anyway, I chatted up one of my favorite surgeons. He's old and gray and about to retire. But he possesses this amazing fount of wisdom and other surgeons/students revere him as a sage of surgery. He told me that there are three key rules to live by and if anyone adopts these three rules, they will succeed:

1. Be fully prepared.

2. Be on time. Always.

3. Have a personality (or preferably, a sense of humor).

I wonder if the Boy Scouts of America appreciate his take on their central facets! He punctuated this conversation by offering me a piece of pineapple upside-down cake...which was really a gross-looking, squishy orangey-brown, donut-shaped positioning device that they put under peoples' rear ends in surgery!

Had to Stop and Refocus

Thank you for your understanding as I took a brief blogging break. I had to stop and pull my head out of, well, the sand. I had to re-examine my motivation, my ambition, and the course I pursued. In short, I felt like I was becoming a bit of a jerk. So I took this week to give my job literally everything I have. I worked 53 hours in four days. Because my 'fridge was empty with company coming in this weekend, I had to hit the grocery store. I about fell asleep on my feet as I waited for my turn at the deli.

Oddly, it feels great to "give it all I got." Plus, I received a raise this week, so I felt motivated to work even harder. Weird how that "carrot and stick" thing works!

I had a few noteworthy experiences this week. In addition to my usual list of administrative meetings, I observed in the Cath Lab (Cardiac Catherization Lab), where they unclog arteries around the heart. I watched three patients' procedures: one diagnostic, one where the cardiologist ballooned and stented three arteries, and one that had an aneurysm and the patient was shuttled directly back to Open Heart. I'm not kidding around anymore; I'm finished with the cheese fries!

It's amazing to see what medicine can do these days. Every procedure started with a large I.V. in the femoral (groin) vein. The cardiologist snakes a 3-4 foot wire up the vein, moves over to the artery, moves a sheath up the wire, and all the images pop forth on a panoramic HD screen. From there, the doc can scan all the arteries in all four chambers of the heart, checking for blockages or disease. Instead of my stereotypical fear of passing out, I found myself transfixed at the images of patients' beating hearts.

I love being able to get back into the clinical areas. The administrative side is often limited to meetings and boardrooms. The clinical side really has the front-line responsibility to the patients and I think all administrators should have this exposure to the patient care setting.

Meeting Isabelle

*LONG POST ALERT*

I spent the day in OB today and would like to blog about my day as a way of processing the info. I went up there around 7:30 this morning, right after shift change. I decided to shadow Monica and Rachel, two RN's in Labor and Delivery. They were great and they thrust me right into the action.

Three patients were already in labor at that time. One was 23, one 25, and one 14. Yes, 14 YEARS old. She just graduated eighth grade and her boyfriend, the baby's daddy, was still IN eighth grade. They both looked young for their ages. She was scared and alone and I spent a little over an hour at the bedside, trying to distract her from the pain. She wasn't far enough along to do the epidural, so she lost herself in the Disney Channel. My eighth grade patient was watching, "That's So Raven."

All three labors progressed similarly and Anesthesiology came up to administer the epidurals for all three. I had the awesome luck of having met Dr. Doctor at last week's golf outing, so he invited me to get an up-close and personal view of the epidural. Honestly, I was fine until I realized that the epidural is a tiny tube going into the patients' spines. I always thought it was a big, long injection. Like, a shot. Not a continuous thing! I steadied myself against the wall and was fine until the doctor pulled the tube out just a bit and there was a bit of spinal matter in the tube. Seeing that spinal matter upset me and I had to step out of the room.

I was okay while watching the other two epidurals; I knew when I look away and avoid the spinal situation!

So things calmed down until lunchtime. We heard the ambulance arriving and it was a hemorrhaging woman, 27 weeks along. It was...gruesome. They took her right into the OR as Monica and Rachel started the blood transfusion and the docs ran ahead to scrub in for surgery. They asked me if I was coming and I answered with a wavering, "sure, why not?" I scrubbed in, full regalia, and was a fly on the wall in the OR.

I watched as they cut an emergency Caeserian, separated a layer of fat and muscles, cut the through the uterus, and pulled out a 1.3 pound baby. As soon as the baby was out, they did a hysterectomy or the mother may have well bled to death. Watching surgery ended up being like watching a trainwreck...I couldn't NOT watch. Sure there was blood and internal tissue waiting to go to Pathology, but I was weirdly okay. I eventually turned my attention to the Neonatal doc, as he stabilized, intubated, and ventilated the baby. Mom survived the surgery and baby was transferred to one of the medical centers downtown after a short tenure in the NICU. However, it was organized chaos and to my untrained eye, it resembled madness in there!

After that little adventure, all three of the "regular" births progressed accordingly. It amazed me to watch those births...One mom gave birth at 4:08 pm and by 4:25, the room was cleaned up, instruments and lights stowed, baby's vitals recorded, and mom was left to snuggle with the newborn. They're so...efficient! My eighth-grader gave birth a little before 6pm, a healthy daughter (with an even healthier set of lungs!) whom she named Isabelle.

So today, I spent 12 hours in OB, watched four births, and met Isabelle.

Type C

Here's my quote for the day:

"Leadership is the ability to hide your panic from others."
-Unknown

I saw this on the VP of Clinical Innovation's bulletin board the other day. I think it's true; leaders are the managers who keep their emotions under wraps. I have another theory to share with you. This one is in regard to personality types:

Type A: OCD, perfectionistic, ambitious, over-achieving, competitive, workaholics who multi-task and drive themselves with deadlines. I just learned that Type A's have a much-higher incidence of coronary heart disease. Fantastic. Should I just recruit a cardiologist now?

Type B: Patient, relaxed, easy-going, unshakable, tolerant, serene.

Type AA: "stress junkies" who have small bosoms.

Type BB: super-relaxed folks who procrastinate and have an affinity for toy guns.

Type C: This is my *new* classification. Type C's have the best of Type A and Type B. They are ambitious, competitve, and perfectionistic, but their exterior is one of calmness and tranquility. They're unshakable even in the midst of insane stress. However, the stress doesn't paralyze them, it motivates.

The best business leaders I've met so far have this Type C personality. I wonder if I can acquire the Type C personality? I'm definitely a Type A, but I wonder that with enough practice, I might be able to cultivate that calm and poised exterior?

Y'know, without sedatives!?

Teehee

Stop! Hammer Time!

I've been having an online discussion with another one of my dear friends of the heart, Euchre Star. Euchre Star is my neighbor, fellow church-goer, and we've been talking about the desensitization that medical professionals must nurture in the field. She told me about an experience she had when she passed out while watching a bone marrow biopsy. Is it bad that I felt myself getting faint just thinking about a bone marrow biopsy? I've heard that anything pertaining to bone marrow procedures is extremely painful and scarring.

I can even make myself lightheaded when I think about this news segment that Jack and I watched, where an orthopedic doctor replaced a patient's vertebrae with a little piece of plastic (rubber? resin? silly putty?). The doctor hammered the plastic vertebrae into place, with a regular hammer out of my garage, and it dramatically echoed in the OR...so much so that you would have thought he was nailing up drywall.

I don't think so, Tim!

Is it bad when we start utilizing Ace Hardware items in the OR? Is it bad that I'm kind of flushed just writing about these issues?! Nurse Starbucks, Euchre Star! I think I now need advice on how to revive myself, as passing out seems pretty inevitable! Do they still make smelling salts?

Whine and Cheese

Boy, was I whining in the below posts! Yikes, sorry about that. Usually, "wining" is a good thing. At least that kind of wine is pretty and offers anti-oxidants. "Whining" is not necessarily a good thing. I do, however, appreciate your pep talks. Nurse Starbucks, you rock! I always marvel at how much difference a day can make. Things are on the up-and-up and I feel the microns of sanity repopulating.

I presented my research thesis last night and did pretty well...despite a failing voice! I have been talking a lot at work, training The Edge (who is learning the ropes quickly). And I've had a weird throat thing that hasn't materialized into anything. I saw my doc this morning for my yearly physical and she gave me antibiotics "just in case." I love docs who aren't afraid of antibiotic resistance! However, these antibiotics are HUGE. Y'know that Pill Cam? Wish I was exaggerating. I felt like I should have greased my esophagus with a Big Mac before horkin' back that bad boy.

In other news, I heard from the Boss (my new Fozzie boss, not Bruce Springsteen or my mob boss). Apparently, I really will be a nomad between the hospital campuses. He said I'll have two offices, two computers, and two voicemails, between which I'll have to bounce on a daily basis. This cracks me up for two reasons: first, I've made 294 jokes about living in my car, plugging my coffee maker into the dash, and keeping my professional wardrobe in my trunk. Second, this TOTALLY fits the sci fi adventure I'm percolating in my brain. You know how I want to export my unnecessary thoughts to a thumb drive? Well, now since I have to effectively clone myself, I can download the song lyrics and middle school memories into Dorrie Part Deux for survival into oblivion.

I'm off for a quick jog...[looks outside at gray clouds and plump raindrops]...make that a glass of vino!

Who Names These Things?

I just finished watching a CDC report on CNN (what is with the acronyms? IDK! LOL!). The report detailed the origin of and inherent pandemic risks of the Swine Flu. Swine Flu? Seriously? They kept panning to a penned-in heard of pigs, surrounded by cornfields, in what looked suspiciously like Iowa. Pigs of the Corn? Now that's scary.

Maybe Babe spread his piggy flu to Mexico while on his annual holiday?

Couldn't medical officials have named this scary disease, one that will surely initiate humankind's demise, something a little more scientific? Diseasese such as Ebola, hepatitis, and gastroenteritis sound terrifying. Anything ending in "itis" is intrinsically scary.

Even Lyme Disease sounds a bit corny...like you've had too many tequila shots without the trademark lime chaser. I even heard of a Coronavirus plaguing children in Greece. Does this mean they ran out of Ouzo and forced the Mexican beer of relaxation upon their young?

But Swine Flu? Don't tell me this was named after a Dr. Swine. It more reminds me of the tummyache and corresponding intestinal distress brought upon by a "pigging out" during a huge meal or candy-gorging session!