EXPECTATION

This article is just as pertinent today as it was when I published it in 2011.  My hand is getting better and I will begin writing new articles soon.

I just read an article about expectations in medicine.  Expectations can make or break a relationship.  They can be the source of great excitement and joy or of great disappointment and sadness.  Expectations, in medicine need to be clearly defined and, when possible, successfully met.

Several years ago, I did a full physical on a new patient.  Patient “X” had been referred to me by a mutual friend and I did my usual, thorough job.  I was dismayed when my friend called me to report how disappointed patient “X” had been!

I called patient “X” to discuss the results of his exam and why he felt I did a “crappy” job.  Mr. “X” started with, “Doc, I like you but you did not do/order a stress test, Carotid Doppler, lung function test, PSA or colonoscopy.  I went to Dr. “Y” and he ordered them for me!”  To Mr. “X’s” surprise, I asked him why he thought he needed those tests.  Mr. “X” responded, “My partners’ docs ordered those tests.”

In retrospect, the problem was obvious.  Mr. “X” had expectations I did not meet.  I had expectations, as well.  My expectation was that Mr. “X” wanted a thorough, customized physical.  “Mr. “X”, I’m sorry you were unhappy.  Let me venture a guess:  your partners are all in their mid sixties.”  His answer was “yes”.  “Mr. “X”, had you been in your sixties, I would have ordered those tests and perhaps more.  You are 41 years old and, with your personal and family history, as well as excellent physical condition, I did not feel you warranted any of those tests.”

Mr. “X” cancelled all of his tests and sees me yearly for his exam.  I learned a valuable lesson.  My patients’ expectations may not match mine.  Setting realistic expectations are an important part of any doctor-patient relationship.  Patients must recognize that doctors have expectations and doctors must realize that patients have their own, distinct expectations.

Expectations can range from fantasy to reality.  In the medical arena, it is crucial that expectations be founded in reality.  As your doc, I expect you to follow my instructions.  I expect that, if you are going to vary from my instructions, you will let me know.  These are realistic expectations.  

An example of false or unrealistic expectations would be if you were 75 pounds overweight, drank a bottle of wine and six cocktails, and smoked two packs a day; and I expected you to lose your excess weight while giving up smoking and alcohol simultaneously within 6 months.  (I would give the above patient at least 6 1/2 months). 

Sometimes I set unrealistic expectations for myself and my patients.  When the stakes are high enough, you do what you have to do in order to survive.  Unrealistic expectations can be met when truly necessary!

Patients often set unrealistic expectations.  The most common example of an unrealistic expectation is when the patient, mentioned above, expects his doc to cure his cough, repair his damaged liver, and save him from the heart attack he is about to have.  Doctors don’t heal patients, they help patients heal themselves.  Expecting your doc to save you from a sinking ship while you are punching holes in the hull is another example of false expectations.

So what can you do?  Discuss your expectations with your doc.  Let him/her know exactly what you want; what you are thinking.  Be sure of what your doc expects of you.  Expect that your doc will work at meeting your expectations.  If he/she falls short, discuss it with him.  Work at meeting your doc’s expectation.  Expect that your doc will confront your shortcomings, as well.  Most of all, be honest with yourself and your doctor.

P.S. – I believe in miracles.  I have been blessed to see many miracles in the last 28 years of practice.  It is ok to have false or “fantasy” expectations, as long as you know that the only way they will come true is to receive a miracle.  It is not OK to sell yourself on false hope as the vast majority of time it will end in disaster.  

Here’s your joke for the day:

A man walks into bar with a dog and orders 2 Glasses of Whiskey.

He & his dog empty the Glasses.

The girl behind the bar is surprised and asks – Can your Dog perform any other tricks?

Man-Yes, He can fully satisfy a Woman.

The girl is too curious.. Deciding that she’ll test the dog, she undresses and lies in down spread eagle.

Dog looks at her and does nothing….

Man to Dog: It’s always the same with you, now this is the last time I am showing you how to do it!

FIBROMYALGIA

Good News, It’s official!  You are not crazy.  Fibromyalgia is real!

Let’s take a trip back to the 1980’s in my time machine.  My patients were actively having and raising their children.  For the most part, mothers worked at home with their kids and dads went to work at the office. Both parents poured themselves into their respective jobs.

My family was no different.  I worked from 5:30 a.m. to 7:30 p.m., 5 days a week, with shorter hours on Saturday and Sunday.  Renee ran the office and raised the kids. By the time our family grew to 3 kids, Renee was having an assortment of pains in her neck, upper and lower back and marked pain in her thighs.

Of interest, I was seeing a fairly large number of women with similar pains and similar exams in the office (on a daily basis).  My patients and Renee were miserable.  The only positive findings on exam were trigger or tender points along the spine and the diagnosis of trigger/tender points was very subjective.  I diagnosed these patients as having Fibromyalgia and treated them with an assortment of muscle relaxants, anti-inflammatories, sleeping meds and physical therapy.

I hypothesized that Fibromyalgia was cause by a sleep disorder caused by the mothers frequent awakening with her infant, as well as neck and shoulder injuries from lifting the children out of the crib/car.  Most of my colleagues thought that Fibromyalgia didn’t exist and that the proper diagnosis for women suffering with the symptoms listed above was hysteria or anxiety. 

I saw a large number of patients (mostly women) with Fibromyalgia who were tired of doctors treating them as if they were nuts.  Frankly, I was tired of listening to my colleagues denigrating patients with Fibromyalgia.  Over the ensuing years, Fibromyalgia became a recognized entity but continued to be associated with a fair amount of doubt.

Flash forward to today and a group of researchers from the University of Illinois have come up with a blood test (The Fibromyalgia Test) that reliably diagnoses a very real disease.  They are also working on understanding what causes Fibromyalgia and new treatment.

It’s official!  You are not crazy.  Fibromyalgia is real!

Here’s your joke for the day:

Two students, both 5 year old kids are peeing inside the male toilet.

Boy 1: Hey, what’s wrong with your pee-pee?

Boy 2: What do you mean?

Boy 1: It doesn’t look like mine, why is there no skin thingy?

Boy 2: Oh, i was circumcised when i was 2 days old. The doctor removed the skin.

Boy 1: (Grimacing) Oww, was it painful?

Boy 2: Painful? I wasn’t able to walk for a year.

WORRY

This article was originally published in 2011.  It is just as relevant today as it was when first published.  I hope you enjoy it.

Do you worry? Does worrying ever keep you awake at night? Does your worry make you less effective at work and home? Does your worrying about this and that accomplish anything positive?

Most people worry. I worry about a lot of things! Worrying about lots of things is usually unproductive and downright unhealthy. Tonight, I saw a patient who was exhausted due to being sleep deprived. He wanted a sleeping pill or something to take the edge off. He stated that when he went to bed (11 p.m.), he couldn’t turn his mind off. He would toss and turn until he finally fell asleep at 2 a.m. Three hours of misery and wasted time.

Mr. W has a lot to worry about. The economy stinks. He has bills to pay. His health is failing. His friends are in trouble. He worries about what goes on in Washington and the Middle East. The list goes on and on. When I asked him what he has been able to accomplish by worrying, he realized that he always worries about the same things. Nothing ever changes.

Years ago, one of my mentors taught me an excellent technique for helping worriers. I told Mr. W that a sleeping pill or tranquilizer was like patching a leaky pipe with chewing gum. Instead, I asked Mr. W to schedule an hour of “Worry Time” every night.

“Worry Time” is the solution to sleepless nights. The first half hour of worry time is spent making a list of everything you are worried about. Once you have the list, divide it into those things you can control and those you can’t. The second half hour of “Worry Time” is spent designing solutions to the problems you are worrying about. The solutions to those problems that are totally out of your control are to take them off your list or give them to someone else to worry about. Once your list is complete, you can go to bed knowing that your concerns have been addressed.

“Worry Time” is only part of the solution. Mr. W’s second task was to schedule a half hour of “Resolution Time” during his morning breakfast. During “Resolution Time,” Mr. W is to start acting on the solutions he designed the night before.

Mr. W’s first impulse was to insist he did not have one-and-a-half hours to work on a worry list, solution list, and resolution action plan. I pointed out that he had been wasting three precious hours every night in unresolved worries. My plan would not only free up one-and-a-half hours but, for the first time, effectively relieve some of his worries. I think Mr. W is going to do great.

So, if you worry a lot, can’t sleep, and never resolve the issues that plague you, schedule yourself a little “Worry Time.” Let me know how it goes. On my list of worries today was writing tomorrow’s article. I can go to sleep now. 

Here’s your jokes for the day:

I called my mum and told her not to worry cause I was in the hospital. She said you’re a goddamn doctor and it wasn’t funny the first time!

A male patient is lying in bed in the hospital, wearing an oxygen mask over his mouth and nose. A pretty, young, student nurse appears to give him a partial sponge bath. ‘Nurse’, he mumbles, from behind the mask. ‘Are my testicles black?’ Embarrassed, the young nurse replies, ‘I don’t know, Sir. I’m only here to wash your upper body and feet.’ He struggles to ask again, ‘Nurse, please check. Are my testicles black?’ Concerned that he may elevate his blood pressure and heart rate from worry about his testicles, she overcomes her embarrassment and pulls back the covers. She raises his gown, holds his manhood in one hand and his testicles in the other. Then, she takes a close look and says, ‘There’s nothing wrong with them, Sir!’ The man pulls off his oxygen mask, smiles at her and says very slowly: ‘Thank you very much. That was wonderful, but, listen very, very closely…… ‘Are my test results back?”

SELFISH

My family, my friends and my patients think being selfish is bad!  I bet you do, too.  I used to think so, as well.  Twenty seven years in practice has taught that being selfish is good.  Actually, selfishness is essential to an individual’s health.

Not long ago, I saw a selfless young woman who was ill.  She had an assortment of complaints.  She had not felt well in months.  If she was the CEO of a Fortune 500 company, she would have been diagnosed with executive burn out and given two months at Canyon Ranch, an executive retreat.   Unfortunately, she is the CEO of a typical American family.  She is married, has five children, a dog and works full time.  She has living parents who are aging and require help.  She is a hard worker, dedicated to caring for her nuclear and extended family, as well as excelling at work.  She has no time for self.  She is one of hundreds of such mothers in my practice.  She is stressed to the max but does not have the luxury of going to Canyon Ranch.

I often tell the story of the hand.  The thumb is you.  When you are young, you are self centered, egocentric.  The world revolves around you and only you.  One day you realize that you have parents (your index finger), and you are responsible to them, as well as yourself.  As you age, you meet the love of your life (the middle finger) and are responsible to your mate.  In time, children come along (ring finger) and they need lots of your time.  You become very responsible for them.  Then you have you job (little finger).  As you grow in your job, responsibility grows as well.  You are a good person and want to excel at everything.  Your parents are aging and require more attention.  Your children are aging and require more attention.  Your job is growing more complex.  Your mate, who is often responsible like you, is in the same position.  

So what do you do?  Things are out of control!  You have to take care of your parents, your mate, your children and your job.  The only thing you control is you, so you sacrifice yourself.  Try using your hand without using your thumb.  What you find out is, without the thumb, your hand is useless.  No matter how hard you work to make your four fingers function, without the thumb, the hand falters.

If you are not healthy, you cannot help those who need and depend on you.  If you are not selfish enough to save time to care for and nourish yourself, you will get sick.  Those around you will have to function on their own.  Why wait until you are exhausted, burnt out or sick?  The answer is simple.   Your parents taught you not to be selfish.  They taught you to be a responsible individual.  It is time you teach your loved ones to be responsible to themselves, to set healthy limits, to take time off, to laugh and be happy.  Set a good example; get healthy.  At first, those who are used to getting all of you will rebel.  They may call you selfish.  Teach them that a part of a healthy you is better than part of an unhealthy you.  In the end, by being selfish, everyone will be better off:

Here’s your joke for the day:

The French may be selfish, ungrateful Anglophobes, but you gotta give ’em credit.They are always there when they need us.

Neighbors

Renee and I are on the final leg of a fantastic journey called life.  We’ve chosen to live out our lives in North Carolina and look forward to being active members of our over 55 community.  I had made a promise to myself years ago.  I promised to never be governed by an HOA (Homeowner’s Association) again.  I broke that promise when I moved to Heritage.  Let me explain:

My neighborhood in Illinois was governed by an HOA and neighborhood politics could get nasty.  Actually, nasty is not a strong enough word. Vicious is a better word.  At one HOA meeting, the board was impeached for building magnificent stone mailbox enclosures at both entrances.  Rumors of malfeasance were rampant as the disgruntled group went for the jugular with the intent of destroying the reputation of those who worked voluntarily on behalf of the neighborhood (the board). My good friends and neighbors were hurt and subsequently moved.

Oops, I’m living under an HOA again and I’m upset!   A few weeks ago, I wrote an article about how special my new neighborhood was!  Most nights you can find groups of neighbors sitting on chairs on their driveways, sipping bourbon, conversing with each other and laughing.  Now, that’s the way you should spent your latter years, surrounded by friends.  Until tonight, I felt truly blessed.  I have spent many evenings on my neighbors’ driveways and very much can’t wait for our nightly foray.  I envisioned a time when we’d have block parties.  Setting up a progressive dinner is already underway.

I knew something was wrong as soon as I sat down.  Ms. “B” (for beautiful) was upset and talking about moving.  She had started the group and her driveway was set up as a porch, welcoming all.  As the story unfolded, “B” got a call from the HOA telling her she couldn’t keep her chairs on her driveway.  Apparently, a neighbor who chose to remain anonymous, reported her to the HOA; and, even though it’s not in the HOA rule book, the HOA put her on notice that she had to get rid of her chairs.

Here we go again!  My idyllic neighborhood is not so idyllic.  Why can’t people respect the needs of others?  Why can’t they talk to one another?  There are two sides to every story, aren’t there? I certainly would like to hear the other side.  Even better, I would love to have “Anonymous” join the group and voice his/her opinion openly.

Anonymous may not understand why “B” doesn’t simply keep her furniture in the garage.  Remember, we are a group of older individuals and moving furniture around on a daily basis is not as easy as it was 10 years ago.  I won’t go into specifics, but joint problems abound in my new community.  Right now, I feel like I’ve crawled out of the pan and into the fire.  Unfortunately, I know what it’s like living in a community where neighbors attack neighbors by throwing the HOA rule book at them.

I’ve met most of the people on my street and really thought Renee and I had lucked out.  I still believe we can turn our block into a unique place to live where neighbors talk to and live in harmony with each other.  A neighborhood of people who sit on their driveways and welcome all comers to their home. A neighborhood where people work together to come to an accord respecting each other’s individuality and property rights.

We are 55+ years and on the downside of life.  We should be enjoying what life we have left, not fighting over an HOA rulebooks.  Lately, I’ve been accused of being too negative.  Having met the residents of Manor Stone Way, I am optimistic that we have everything we need to create an idyllic community.  I don’t often quote the Bible but, “Love your neighbor as yourself” seems very appropriate.  At the very least, work at liking your neighbors by getting to know them.

Here’s your joke for today:

After downing half of his glass of milk, my ten-year-old son declared, “I am an optimist: “The glass is half empty!”

“Looking at the glass as half empty is a sign of pessimism, son,” I said.

He smiled and corrected me: “Not if you don’t like what’s in it!”

MENOPAUSE

Peri Menipause was a 46 years old and having a very rough time when I last saw her.  She was not sure, but she thought she was going crazy.  She complained about wild mood swings, inappropriate crying, and being a “bitch” to her husband and children.  She was sure it was not menopause as she still had her “curse”, and she had her hormones tested at the local lab and they were “normal”.  To make matters worse, her curse had become irregular and heavier than usual.  She wanted her thyroid checked.  She gained weight and had heard that a poorly functioning thyroid will cause all of her symptoms.

Peri does not want any medication; she just wants answers.  If you haven’t figured it out yet, Peri is premenopausal.  She is not crazy.  I wished she was.  Treating a “crazy” woman is much easier than treating a perimenopausal or menopausal woman.  First of all, there are no rules.  Every woman does menopause differently.  The lucky ones don’t even know they are in menopause; life just goes on uninterrupted.  The unlucky ones, like Peri, trade one “curse” for another.  

Menopause and its forerunner can be very destructive.  Not only was Peri in trouble, but her husband and children are, as well.  It seemed like they could not do anything right.  I was in trouble, as well.  Since she was still menstruating and her hormone tests were normal, Peri was not buying the diagnosis.  She wanted more tests.  The more tests that came back normal, the more frustrated Peri was going to be.  When Peri is frustrated, her moods swing; and I’m right in the middle of those swings.  I’d rather get hit by a golf club.

I’ve gave Peri a reading assignment.  I informed her that normal hormonal levels mean nothing.  I offered her an assortment of medications, including hormonal support.  I need a Staples, “That Was Easy” button.  When I mentioned putting her on SSRIs, the tears flowed.  “I must be crazy.  You want me to take anti-depressants!”  I tried to explain that SSRIs are used to relieve symptoms of menopause.  She’s not buying.

At this point, I wanted to refer her to a specialist.  When all else fails, a second opinion is helpful and gets me off the hot seat.  I had taken care of Peri for 27 years, so I didn’t refer her.  It’s my job to work through her problems with her.  I was sure she would survive. 

We drew her thyroid panel and set up our next visit.  We discussed medicinal, as well as bioequivalent, hormones.  The all-natural approach is to go through menopause sans medication.  Peri needs meds.  We discuss nutritional support and exercise.  I had requested a family conference so that I could explain things to her husband and children and enlist their aide.

If you are like Peri, rely on what your body and doc are telling you.  No tests are perfect; all have false positives and negatives.  Everyone will go through menopause in her own, unique way.  There is no shame in taking medication or hormones when needed.  Medications best known as antidepressants are often useful in menopause, not because your doc thinks you are depressed, but because they influence your neurotransmitters.

Peri, take a deep breath.  You will endure, survive, and have a bright future.

Here’s your joke for the day:

A middle-aged woman seemed sheepish as she visited her gynecologist. “Come now,” coaxed the doctor, “you’ve been seeing me for years! There’s nothing you can’t tell me.” “This one’s kind of strange…” “Let me be the judge of that,” the doctor replied. “Well,” she said, “yesterday I went to the bathroom in the morning and heard a plink-plink-plink in the toilet and when I looked down, the water was full of pennies.” “I see.” “That afternoon I went again and there were nickels in the bowl.” “Uh-huh” “That night,” she went on, “there were dimes and this morning there were quarters! You’ve got to tell me what’s wrong with me!,” she implored, “I’m scared out of my wits!” The gynecologist put a comforting hand on her shoulder. “There, there, it’s nothing to be scared about.” “You’re simply going through the change.”

https://www.ba-bamail.com/jokes/dad-jokes/?jokeid=332

COULD?

Due to my impending surgery on my left hand, I will be re-publishing some of my past articles as typing is painful.  Today’s article was first published in May, 2012.

“Could” is a word I would do without if I had my way!  Unfortunately, my patients love it! 

“Doc, could my headache be from stress?”

“Doc, could my husband be suffering from depression?”

“Doc, could my son have ADD?”

“Doc, could …?”  is a question I hear multiple times a day.  The funny thing is the answer is always the same.  Realistically, anything “could” be true.  So every time a patient asks the question, “could,” the answer is yes. 

“Yes, your headache could be from stress.”

“Yes, your husband could be suffering from depression.”

“Yes, your son could have ADD.”

Unfortunately, the “could” question often misleads my patients.  While the answer to a problem could be stress, depression, or ADD, often those are unlikely sources of the problem at hand.  Explaining why they could, but are unlikely, is time consuming and stressful for the patient and the doctor.  I particularly hate when a parent ask the “could” question in front of their child.  It is not uncommon to see fear immediately consume the patient’s face.

The question my patients should be asking is, “Doc, what is the probability that stress, depression, or ADD is the problem?”  Differential diagnoses are based on probabilities.  A differential diagnosis is a list of the probable causes for an illness ranked from most likely to least likely or most dangerous to least dangerous.

Knowing what my patients’ concerns are is critical.  Cyberchondria is real and the internet stirs up trouble on a regular basis.  Learning to avoid the word “could,” and using “probable” instead, helps allay a lot of fears!

Could this article help you find the answer to what’s bothering you?  I hope so!

Here’s today’s joke:

Joe wanted to buy a motorbike

but he doesn’t have much luck until one day, he comes across a Honda road bike with a ‘for sale’ sign on it.

The bike seems even better than a new one, although it is 10 years old. It is shiny and in absolute mint condition.

He immediately buys it, and asks the seller how he kept it in such great condition for 10 years.

‘Well, it’s quite simple, really,’ says the seller, ‘whenever the bike is outside and it’s gonna rain, rub Vaseline on the chrome. It protects it from the rain.’

And he hands Joe a jar of Vaseline.

That night, his girlfriend, Sandra, invites him over to meet her parents. Naturally, they take the bike there.

But just before they enter the house, Sandra stops him and says, ‘I have to tell you something about my family before we go in.’

‘When we eat dinner, we don’t talk. In fact, the first person who says anything during dinner has to do the dishes.’

‘No problem,’ he says. And in they go.

Joe is shocked. Right in the middle of the living room is a huge stack of dirty dishes.

In the kitchen is another huge stack of dishes. Piled up on the stairs, in the corridor, everywhere he looks, dirty dishes.

They sit down to dinner and, sure enough, no one says a word.

As dinner progresses, Joe decides to take advantage of the situation.

So he leans over and kisses Sandra.

No one says a word.

So he reaches over and fondles her breasts.

Still, nobody says a word. So he stands up, grabs her, rips her clothes off, throws her on the table, and shags her right there, in front of her parents.

His girlfriend is a little flustered, her dad is obviously livid, and her mother horrified when he sits back down, but no one says a word.

He looks at her mother..

‘She’s got a great body,’ he thinks.

So he grabs the mother, bends her over the dinner table, pulls down her knickers, and screws her every way possible right there on the dinner table. After she has a big orgasm, he sits down again.

Now his girlfriend is furious and her dad is boiling, the Mother is pleasantly beaming.

But still, Total silence.

All of a sudden there is a loud clap of thunder, and it starts to rain.

Joe remembers his bike, so he pulls the jar of Vaseline from his pocket…

Suddenly the father shouted….

‘OK I’ll do the fucking dishes!

DOGS

I want a dog!  I’ve been hassling Renee for months, trying to get her to say yes.  She is adamant.  Her answer is no!  She is quick to point out that I fall all by myself without the help of a dog getting under foot.  She also lovingly reminds me that caring for my needs is a fulltime job and that she has no time to walk or feed a dog.  Like most young men, I use “magic think” and assure her I can walk and care for a dog.  She asks me to read the letter I wrote to my mom when I was sixteen.

My mom saved that letter and gave it to me years later.  In the letter, I made all kinds of promises.  If she would get me a dog, I would feed it, walk it, bathe it, groom it and use my allowance to feed it. Yes, it was “magic think” at its best.  Of course, I did not keep my end of the contract and the work and expense fell on her shoulders.

This past weekend, Renee and I went to Atlanta to see Jeremy, Allyson, RJ, our 11 year old grand dog, Roxie, and our new grand puppy, Bishop.  Bishop is a 7-week-old Doberman and he’s precious.  He also proved to be way too much for me to handle.  As usual, Renee was right.  While dogs exude love, they take a lot of work, none of which I’m capable of doing.

Dogs are good for the heart and soul.  Sitting on the couch patting Bishop and Roxie (Jeremy’s adult Doberman) was better than Xanax.  At the same time, not being able to play with the dogs, feed them, and walk them broke my heart and spirit.  So, it’s back to sitting out on my driveway and feeding the local dogs Milk Bones in exchange for a little love.

As always, there are downsides to loving a dog.  Two of my friends just lost their dogs to old age and disease.  Both dogs had become part of the family structure and the losses will be felt forever.  I still miss my Ginger and Rocky. 

Over my lifetime as a physician, I prescribed a lot of tranquilizers.  In retrospect, I wonder if prescribing a dog would have done the same (or better) as my medication.  The one thing being a patient with a chronic illness has taught me is that prescribing medications is too easy and that finding non-medicinal treatments, while more difficult, is better in the long run.

One last story.  When I was in my residency, my fellow residents and I would sit at the lunch table and criticize the old docs for prescribing medicines to treat the side effects of medicines they had prescribed.  I became an old doc and did the same thing I criticized the old docs for doing.  Now I’m even older and I’m taking medication to treat the side effects of the other meds I’m taking.  Around and around we go, where it stops we all know, the graveyard.  Whenever possible work at finding a non-medicinal alternative.  Buy a dog.

Here’s your joke for today.  I need a good laugh!

Two dog owners are arguing about whose pet is smarter. “My dog is so smart,” says the first owner, “that every morning he goes to the store and buys me a sesame seed bagel with chive cream cheese, stops off at Starbucks and picks me up a mocha latte, and then comes home and turns on ESPN, all before I get out of bed.” “I know,” says the second owner. “How do you know?” the first demands. “My dog told me.”

CONSTIPATION

I want to apologize for my tirade about divorce, but it irks me to see people locked in mortal combat as they try to win every asset they can while sacrificing their emotional and physical health.  And, yes, there are good attorneys who help their clients avoid prolonged battles while draining the assets the parties are fighting over; but they seem to be few and hard to find.  Remember, the one thing you lose while fighting for your “rightful” assets is your life.  Yes, you can’t get on with your life until the final decree is signed. So, bend over, take it and move on!

While we are talking about bending over and taking it, my patients and friends are battling constipation that comes with age, medications and poor diet.  Constipation and a bad marriage seem to have a lot in common. Both leave you feeling like you’re full of excrement and need a good dump to relieve your distress.  Both cause significant abdominal and emotional distress.  Both are hard to treat. (No, Renee and I are not in trouble.)

In the case of constipation, medicinal treatments available are glycerin suppositories, bulk laxatives, osmotic laxatives, hyperosmotic laxatives, stimulant laxatives and other less used laxatives.  There are a host of foods that act as laxatives, as well.

If your constipation is chronic, you should see your family doc or a GI specialist.  I suffer from chronic constipation related to my Parkinson’s and medications I take.  My favorite, non-medicinal approach is my bidet.  I’ve got to tell you that no description I could write would do my bidet justice.  My neighbor in Illinois used to brag about his bidet.  If you were invited to his house for any reason, you would be encouraged to try his bidet.  If you tried it, you bought one for yourself.

It’s hard to admit but Renee has to help me shower and dress.  Thanks to my BB2000, she doesn’t have to help me with toileting.  Trust me, if you are in your 60s or 70s, with or without constipation, you’ll want to get a BB2000.  No, they are not paying me for writing about them.  As always, my goal is to help my readers enjoy a healthier and happier life.

Here’s your jokes of the day:

Q. Why did the apathetic old man hope he’d finally die of constipation?

A. So that people would know he didn’t give a shit, all the way to the bitter end.

Children are like farts. Your own are just about bearable, but everyone else’s are horre

DIVORCE

So, you’re getting divorced.  Ask yourself a question.  What do you want from your divorce?  If your answer is revenge, you can stop reading now.  Do you want your fair share?  Who determines what’s fair?  Certainly, not you!  If your spouse thought you could be fair, you probably wouldn’t be getting a divorce.

While we are talking about getting your fair share, ask yourself what you want a fair share of.  Obviously, you want your fair share of money.  What about your fair share of the children? The dog? The timeshares? The ashes of a marriage lost?  Your parents’ ashes? Or maybe you just want control.

Do you both want a divorce or is it being forced on you?  Are you forcing it on your former mate?  Is it making you sick? You’ve just boarded a flight to God only knows where.  Who’s flying the plane? Again, it’s probably not you.  If you had control, the divorce would have ended when it started!

“Tower, this is JD A. Hole, piloting Flight 666 to hell, requesting clearance for takeoff.”

“This is your pilot, JD A Hole.  Buckle your seatbelts and prepare for the ride of your life.  We will be taking off as soon as your enemas are completed and you have paid the flight crew.  Installment number one is $3000.”

“This is Hole, we are approaching 30,000 feet and flying into a hurricane.  Puke bags are in the seat pocket in front of you.  Should you puke, please give the bag to the flight attendant so it can be included in personal assets. The flight crew has reported that one or more passengers are full of shit. Unfortunately, we can’t land until this situation has been cleaned up.   Payment number two for $15,000 is due at this time.  Please pay prior to your next enema.”

Get the picture?  Divorce can be a trip into the twilight zone or worse.  So, how do you avoid getting on that plane?  No matter what you do, there is going to be a purge.  Refuse to get on the plane.  Instead, bend over and take your enema without a fight.  Forget about fault.  Forget about revenge. Marginalize the attorneys and buy back your life by paying whatever your spouse wants to end the marriage.

I know you are worried about the children. Trust me, the best thing you can do for them is to avoid the fight.  The longer the battle goes on, the worse it is for the children.   

Once free, you can recover your losses. 

Here’s your joke for the day:

My husband and I divorced over religious differences.

He thought he was God, and I didn’t.