Month: September 2019

September 6, 2019

The start of a new stage of life should be exciting.  Today marks the transition from living within a scheduled world to one in which every day is a Sunday. I should be excited.  I’m not!

I should also be excited as one of my mentors and smartest docs I have ever known paid me a high compliment.  In his words, “Jesus Christ, you have become a writer! You have graduated to introspection and clarity.” I’m not!

Retirement is what everyone works for and looks forward to.  Not me! I truly belong in the office, caring for those who put their lives in my hands. Getting up to go to the office was easy. Getting up now requires self-motivation. Frankly, it hurts to get up.  My back is at its worst after lying on it through the night.  My Parkinson’s is at its worst upon awakening as my medications have worn off.  It took 45 minutes to dress today.  Now I’m supposed to follow the exercise routine set up for me by my physical therapist.  My brother loves to go to the gym, I don’t.

I’m not looking for pity.  I’m describing what countless people go through every day. When I first recognized that I had Parkinson’s, I got mad at G-d.  Then I rationalized it, believing it was a gift given to me to help me better understand chronic illness and better care for the chronically ill.  Then I realized that Parkinson’s was going to stop me from caring for others and give me the option of caring for myself or languishing in self-pity.

Languishing in self-pity is not my style.  I can still care for others by writing this blog. Can I care for myself?  Years ago, I wrote an article about my friend, Will. You know him as Will Power. Will Power is a great friend. I need him to stand by my side now more than ever. Will, are you out there?  If you are, join me in the gym.  While I don’t want to stretch and workout, I need to. I need to be healthy enough to put words on the internet that, perhaps, will help someone else who is entering my stage of life. 

Here’s an article from January of 2012 about my friend, Will Power.  It was also about losing weight and following a healthy diet.  Losing weight is just one more thing on my list of things to do. It was also one of my favorites:

January 9, 2012

Have you seen my friend, Will Power?  Will and I have been hanging out together since I published my book(Diets and Other Unnatural Actrs).  Will’s my best friend.  He’s the sensible one, always keeping me out of trouble.  With Will Power at my side, I have flourished.

Today, Will and I walked into the Garden Fresh Super Market together.  Will thought we should stop for lunch first but I was in a hurry to get home and prepare for my mother’s 90^th birthday.  On entering the store, I noted an attractive young woman standing at a table selling her goods, so I stopped to see what she was offering.  Will was with me one minute and gone the next.  I figured he wandered off for a moment and would return shortly.  Mr. Will Power is a loyal friend; he wouldn’t abandon me!

Anyway, this young woman was sampling a multitude of cheese spreads on delicious, gluten free, crunchy, whole grain crackers.  Any idiot knows not to walk into a grocery store when he is hungry but I figured I was safe since Will Power was with me.  Unfortunately, with Will missing in action, I was doomed!  They sure were delicious.  All seven varieties!

I quickly gained my composure and started searching for Will.  Searching the aisle at Garden Fresh was like maneuvering through a mine field.  One aisle over was another sampling of cheesy treats.  Two more aisles to the north and I was accosted by samples of fresh baked goods.  

I figured Will Power would be waiting for me in the healthy produce area so I ate my way through the mine field, seeking refuge in the green leafy aisles.  They were waiting for me and Will was nowhere in sight!  Taco, salsa and guacamole dip and chips tripped me as I turned the corner.  They assaulted my mouth with jalapeño peppers.  Over by the celery was another woman, offering tastes of hot dogs and queso blanco.  I searched for Will while working my way towards safety in the fruit aisle and the hope of getting to the checkout counter without any other treats.

I’m home now.  I’m calling everyone, asking for help finding my friend.  I’m not worried about Mr. Will Power.  He’s tough and can handle himself.  I’m worried about me.  Without Will Power, I’m afraid I’ll fall off the wagon.  I know what they say, “If you fall three times, get up four;” but, without Will Power’s help, it’s going to be tough.

When I find Will, I’ll apologize for not listening to him.  I’ll never go grocery shopping when hungry again.  I’ll also walk right by pretty young women peddling their wares.  

If you see my friend Will, tell him I miss him!

September 6, 2019

WOW!  When I decided to write again, I perked up!  I realized that I wasn’t “invalid” after all.  I could make something good come from something bad. I realized I could still help others by sharing my 40 years of experience as a physician with my former patients and those who choose to read this blog.  What I didn’t realize was how much reviewing my prior works would help my current circumstances.

The following article from June 2011 will help make my point.  While it focuses on Attention Deficit Disorder, it is truly pertinent in regard to disabilities in general.  

Today I graduate from an intensive rehabilitation program at the Shirley Ryan Ability Lab, formerly known as The Rehabilitation Institute of Chicago (RIC). I spent 3 weeks in their inpatient program and months in the outpatient program.  The staff has been phenomenal and: while I have improved somewhat, I still have a lot of work to do.

One thing that I didn’t understand until this very moment is why a renowned center of excellence like RIC would change its name and attempt to rebrand itself.  Writing this article has given me the answer.  RIC rehabilitated people with handicaps/disabilities.  Shirley Ryan Ability Lab focuses on peoples’ abilities and how to use those abilities to improve one’s own life.

I’d like to thank the team at the ABILITY LAB for all the hard work they put into improving my life.  I hope you enjoy the article below and share this blog with others. 

June 25, 2011

One of the best lessons I have learned is if you can make something good come from something bad, the bad was not so bad after all!  I have taught that lesson to countless patients over the last 28 years.  Today, I want to share my lesson with those readers who have been branded with “learning disabilities” (LD).

Yes, I said “Branded.”  Like those individuals with attention deficit disorder (ADD), individuals with LD often feel branded, even cursed.  During the formative years of life, patients with LD often struggle in school.  LD students receive “accommodations” in the form of special classes, tutors, and attend special testing centers.  Accommodations can make an adolescent feel inferior and damaged.  

I have a learning disability.  When I went to school, there were no special classes, accommodations; you either survived on your own or you failed.  I have a form of Dyslexia.  Reading has always been agonizing for me.  My disability is not readily apparent;  I can read aloud to an audience and they will not detect a single problem.  I just can’t process what I read!  I always failed standardized tests.  Not because I didn’t know the answers, but because I could not process the questions.

I have the gift of being able to process and retain everything I hear.  Over the years, I have learned many tricks that help me deal with my dyslexia.  Modern technology has been a G-dsend.  My texts and journals are now available in audio format.

One of the most traumatic events in my life was my failure to get into the University of Virginia Medical School.  I was an honors student with a 3.5 something average and medical school was a slam dunk!  I was a cocky young man and only applied to three top East Coast schools.  Unfortunately, I bombed on my MCATs (entrance exam).  Scoring in the 14^th percentile in English should not have been a surprise.  I can’t read!  Ultimately, I moved to Mexico and graduated from La Universidad Autonoma de Guadalajara Medical School.

Making something good come from something bad is today’s lesson!  Going to a Mexican medical school was an embarrassment.  It also was one of the best things to ever happen to me.  During my four years in Mexico, I learned a lot about myself and the world I lived in.  I learned to talk and think in a different language.  I learned that what Americans believed was not what the rest of the world believed.  It was a humbling experience and I needed to be humbled.

I also learned that I had a learning disability.  I learned that, if you work hard enough, you can learn to live with LD and you can make LD work for you and others.  This article is proof positive.  I have had a long career helping others and working with many of my patients and their children.  I help remove the stigma of ADD and LD by finding the good in the bad.  

If you have a reading disability, develop your listening skills.  If you have problems with the spoken word, thrive on the written word.  All of us are blessed with being unique individuals.  Within all of us is a gift.  Don’t get bogged down with being labeled LD or ADD.  Find your gift and celebrate it.  Don’t be ashamed of needing accommodations.  Use them as tools the same as I use the CD/DVD player.  Most of all, learn to be happy with yourself.  Yes, it may be harder for you to succeed but success will come.

If you are having problems coping, see your doctor or counselor.  If you are envious of others, recognize that they are unique individuals and have their own problems.  If others mock you, feel sorry for them, not for yourself.  They mock you out of ignorance and you are not ignorant.  

Posted on www.livewellthy.org

September 5, 2019

After talking to several new readers today, I realized that I had started my new blog at the end of my career, leaving new readers lost in concepts I have taught for many years.  Those of you who have known me for the last 30 years should be comfortable with the term “wellthy” and many of the concepts I will present to you over the next few months. For those of you who are newbies, feel free to contact me with your questions and issues you would like me to address.

“Wellthy” is a concept that I developed over the last 30 years with the help of my patients and staff.  Yes, my patients want to be wealthy.  They work long hours, invest wisely, and often become financially wealthy.  Unfortunately, they often spend all of their health obtaining their wealth and, in the end, are miserable.

To help you understand the concept of “Wellth,” my book, “Diets and Other Unnatural Acts,” presents the case of Workaholic Willy. Willy worked 16 hour days amassing his empire and a personal worth in the millions.  He had no time for exercise.  His meals consisted of fast foods 

at McWhatever. His family time was non-existent, never even vacationing with his wife and kids. 

Willy thought he was working to accumulate wealth so that his wife and kids would live the easy life.  At least, that’s what Willy told himself.  As Willy became wealthier, his health deteriorated, as did his relationship with his family and friends.  In the end, Willy was the poorest wealthy person I had ever met.

Instead of getting wealthy, I want you to get “wellthy.”  A “wellthy” person invests, not only in his/her financial wellbeing, but also in his/her physical, nutritional, emotional and spiritual wellbeing. Hopefully, this blog will help you find the tools you need to live a truly wellthy life.

I will be incorporating articles I published in the past into material more appropriate for present times.  I have spent way too long looking back at how I got to where I am today.  Frankly, it’s depressing.  In some ways I had become Willy.  Today I came across the following article published in 2011.  It’s time for me to look forward.  It’s time to stop asking why and instead, say what are you going to do about.

What I’m going to do is work at getting “wellthy!”

November 2011

Many years ago, I was blessed to receive an invitation to serve on a national advisory board for a pharmaceutical company.  I was privileged to sit in a room with 15 experts in their fields of medicine and share in their knowledge.  Since then, I have been to many such meetings and, each time, I have harvested clinical pearls to be used in my practice of medicine.  At the most recent meeting, a well known family doctor talked about the “look backwards” approach to medicine and contrasted it to the “look forward” approach.  The difference between the two styles is remarkable and I look forward to sharing my newfound pearl with my patients.

The “look backwards” approach is what I have done for 27 years.  Mr. A comes in for his blood pressure, blood sugar and cholesterol check.  I look back over the chart and determine that Mr. A has not done anything we discussed at our last visit.  His numbers are not good and I point out to Mr. A that his behavior is fueling the fire that is going to burn him.  I inform Mr. A that I am going to increase his current medications and add one new one.  Mr. A feels guilty and does not want more medication and says he will do better.  “Doc, give me three months.  I can do better!”   Five months later, Mr. A returns, nothing has changed and we start the cycle over.  

The “look forward” approach identifies the current problem and puts an action plan in place.  Medications are adjusted appropriately.  Plans are made for behavioral and dietary changes when appropriate.  A care team is constructed.  Nursing support is set up with a predefined call back schedule being arranged and the patient knows that, if he experiences any problems, he can call his team nurse for help.  Referrals for nutritional and exercise counseling are arranged.  Deadlines are set.  The patient commits to the team approach and returns in one month for a follow up visit and assessment of the success or short comings of the treatment approach.   At each visit, future treatment objectives and changes in current treatment options are reviewed.  

Most patients mean well.  They are going to work on their diet, but the boss calls them in, gives them a new assignment and their personal plans get pushed back.  They are going to exercise; but they are working 16 hour days and they are exhausted when they get home.   They are going to eat fruits and vegetables and whole foods but they are in a hurry and the drive in window at McWhatever restaurant is more expeditious than parking and running into the grocery store.  

A care team and “look forward” approach is going to solve the harried life of today’s worker.  What it will do is help develop realistic work-arounds to the above problems.  

1. You need to diet to lose weight.  You stress eat. Your boss stresses you.   Currently, you pledge to work on your weight loss as soon as the stress lets up. Realistically, the stress never lets up.  The answer is better stress management.  One goal of your care team is to find stress relievers other than food. 
2. You need exercise but your 16 hour day is exhausting.   You promise to exercise as soon as work gets better.  Work doesn’t get better.  Another goal of your care team is to find novel ways to build exercise into your work day.  
3. You need to eat a healthy diet but your car won’t stop pulling into the drive-in window at McWhatever.  You know you shouldn’t; you feel guilty, but your hunger gets the best of you.  Your care team’s goal is to counsel you on food choices and meal planning.  They advise you to eat healthy snacks more often so your hunger doesn’t get the best of you. 

Looking forward to something is much better than looking back and lamenting.  After the heart attack or stroke, looking back at what was not accomplished is truly miserable. I look forward to shedding the “look back” approach.  I look forward to working with you.  I look forward to helping you improve and maintain your health.  I hope you will look forward to the same.

September 4, 2019

Invalid.  If you break the word into its components it becomes “in” (not) “valid.”   That’s how I felt as I woke up on March 18^thknowing that I was unlikely to ever practice medicine again.  It took me a long time to get out from the “in valid” label I had placed on myself to where I am now. 

Now, as I set out on my journey to recreate myself and find purpose as a retired physician, I marvel at how insightful my younger self was.  While I can no longer care for my patients in the office and hospital, I hope that this blog will provide a new level of care.  

Below is one of the articles I published in 2011. The article is even more germane to my present circumstances than it was at the time I wrote it.  Unfortunately, I don’t have the 30 years mentioned at the end of the article; but I’ll make the best out of what I have. 

Monthly Archives: June 2011

CHANGE

Posted on June 30, 2011 by livewellthy

June 30, 2011

Sometimes things just fall into place.  Over the last 6 months, I have written on an assortment of topics.  Most of the time, my patients or the news provide me with ample material for future publications.  Last night, while flipping through the TV stations looking for something good to watch, I chanced upon two artists singing “Man In The Mirror” by Ballard and Garret.  For the first time, I actually heard the words and realized how important the message this song delivers is.

I was discussing the importance of the song with my first patient of the day and he introduced me to his morning prayer, “Dear G-d, I have a problem and it’s me!”  The lyrics to “Man in the Mirror” begin with:

“Ooh ooh ooh aah
Gotta make a change
For once in my life
It’s gonna feel real good
Gonna make a difference
Gonna make it right…..”

The chorus goes like this:

“I’m starting with the man in the mirror
I’m asking him to change his ways
And no message could have been any clearer
If you wanna make the world a better place
Take a look at yourself and then make a change, yey
Na na na, na na na, na na na na oh ho”

If we are to fix our broken medical system, we are going to have to make a change!  That change does not start with electronic medical records, with expensive testing and medications, not with visits to the doctor’s office, nor in the vitamin aisle of your local merchant.  That change cannot be legislated by any government nor is it coming from the insurance industry.

The change needs to start with “the man in the mirror.”  As long as people neglect their own bodies, fail to take responsibility for their own health and the health of their families, no amount of medical care or money will suffice.  

“If you wanna make the world a better place”, then for once in your life make a difference, make a change and feel really good.  Look in the mirror and decide that your health is the most important thing you own.  Start small; change something from unhealthy to healthy.  Feel really good about the change.  Then change something else.  Take responsibility for your own health.

Be happy, be healthy.  Then enlist your family, your friends and co-workers in a campaign to make a real change.  Health costs relatively nothing to maintain and a lot to lose!

If you are not sure what needs changing or what’s unhealthy, see your doc.  I’m sure your doc will be glad to assist you in your quest to be a healthy, responsible patient.  If getting healthy means taking medications, take them.  If being healthy means giving up vices, give them up.  In the end, you will be glad you did!

I’ve started with the man in the mirror.  I’m much happier with the man I see in my mirror today.  I have a ways to go.  It’s a long journey.  I have thirty more years to practice medicine and I look forward to continuing this journey with all of you.

Posted in Opinion, Philosophy of Care| Leave a comment | 

EUREKA!

September 3, 2019

As many of you already know, I’ve been forced to give up my practice of medicine due to health matters.  One of my favorite expressions is, “Man plans and G-d laughs.” I guess G-d is laughing.   I fully expected to die while working in the office, not to spend the rest of my life at home or in the doctors’ offices and pharmacy.  The transition from doctor to patient has been a real eye opener (to be further discussed in a upcoming book I am writing).

Besides my back pain, Parkinson’s, swollen legs (lymphedema), constipation, and self pity, I have gained 25 pounds and look pregnant.  Needless to say, I’ve been asking G-d the “why me” question a lot lately!

So what do you do when you need to be in the office practicing medicine and you can’t?  I decided I’d start my blog up again.  That’s when I discovered my prior articles had been lost. WHY ME???

To make a long story short, today an IT person at GoDaddy helped me recover my old articles and my blog, www.livewellthy.org.  Recovering my earlier works was a minor miracle.  Finding, in those documents, the answer to my questions, was a true blessing. The first article I read is from September 2011 and can be found below. 

Sometimes, when you question G-d, you get an answer!

“September 2011

How many times have you asked, “Why me?” Ever been lucky enough to find the answer? Most of the time there is no answer. Most of the time life feels random. Today, I told another patient he had cancer. I told him he needed to see an oncologist, have more testing, and undergo chemotherapy, then surgery. During our consultation, he asked, “Why me?”

I answered, “I’m still trying to figure out why you were lucky enough to get married to such an amazing woman, or have such great kids, or rise to the level you have in the business world. You always led an exceptional life while appearing quite ordinary.” If you are going to ask the “why me” question when bad things happen, shouldn’t you ask it when good things happen, too?

Cancer is a random act of terror. Whether G-d has some plan we are privy to or not, the real answer is most of the time we don’t know why things happen the way they do. Sure, we blame cancer on smoking, drinking, exposure to toxins and genetics among a host of other possible contributing factors. As Americans, we have been led to believe someone or something must be at fault when something bad happens. 

Playing the blame game after the fact is counter- productive! If you get tied up in the “why me” mentality, you become depressed and ineffective at a time in your life when you have to be at your best. You’ve been drafted; you are going to war. You need to get in shape if you are going to war. You need to focus on what is important. You need to be alive and stay alive.

In Spanish, the word for “why” is “por qué” and the word for “because” is “porqué”. Both words are pronounced the same. When you ask why, you have actually answered your own question, because! With a diagnosis of cancer or a host of other tragedies, ask the question just once, “Why me?” Answer your question, “Because!”, then move forward.

Live your life, Fight your battles, Win the war.

Sometimes we are lucky enough to find the answer. I always tell my patients that, if they can make something good come out of something bad, it won’t be so bad. Sometimes when your life or the life of a loved one is threatened, families and communities come together in unimaginable ways. Lives actually get better. It may sound cliché, but sometimes my patient whose life is threatened by cancer really had stopped living prior to the diagnosis. He had simply gotten into the proverbial rut; up at 6, coffee, go to work, home at 6, dinner, TV and sleep. The threat of losing his life actually makes him find a new, more fulfilling life.

We all know about the movie, “The Bucket List.” Don’t wait for tragedy to wake you up and make you act on your bucket list. Enjoy now. Be happy. Work at being healthy. Have an attitude of gratitude. When something good happens, ask “Why me?” Then smile and say “Because!” and enjoy it. When something bad happens, do the same, and then work through it, looking for something good to come out of it. 

As a final note, it can’t hurt to say a little prayer of thanks for the good things and for the new opportunities brought by the bad things.”

It appears that I was sagely in 2011, answering my own questions and needs before I actually asked them.  Porque!