RISK TAKING

Bear with me as I tell you a story.  If you read to the end, you’ll understand the point of my story.

When I turned 15, my father taught me how to drive.  When I turned 16, he bought me a car. That car came with a host of rules designed to keep me safe.  My first car was awesome.  It was a 1963 and ½ Ford Falcon Sprint with 4 on the floor and 276 horses under the hood.  It was FAST!   What it wasn’t was safe.  No seatbelts, no airbags and enough of an engine that we had to put sandbags in the trunk to keep the rear wheels on the ground.  I was damned lucky I survived and didn’t kill anyone.

When my children turned 16, I gave them each a car and a set of rules.  I also told them how lucky I was to be alive and that their mother and I would probably spend the rest of our lives worrying about them.  So, why did I give them cars?

Being able to drive gave them a great deal of freedom.  It also taught them how critical it was to drive responsibly and how dangerous a car could be.  I thank God they survived.  Each kid got speeding tickets, each wrecked a care.  All the three survived and thrived.

A car is a very dangerous thing.  If used responsibly, it provides tremendous freedom and potential.  No matter how responsible you are, it can kill you.  Yet, I gave cars to my children as did my folks.

Opening up society in the face of Covid-19 is very much like giving a teenager a car.  Opening up the USA comes with a new set of rules that, in order to survive, need to be followed.  Not following the rules can lead to death and just as is the case with a car, the person or persons who die may not be the driver, but people the driver runs into. 

Nonetheless, as a parent, there comes a time when you have to let your kids leave the nest.  You pray you have taught them well.  You pray they follow the rules.  You suffer along with them if they don’t.

The government and scientist are the parents and we are the children.  It’s time to give us a set of rules, an education and then set us loose.  We are suffocating locked in at home.  We are starving.  The greatest nation on earth is going the way of Rome.  Open up our society and let us prove we can be responsible.  God help us if we can’t. 

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STAY THE COURSE?

I wish I knew what to do.  On the one hand, we need to turn the economy back on.  People need to work, get paid, put food on the table and take care of the bills.  The economic downturn is crippling.

On the other hand, If we go back to business as usual, I can almost guarantee you that Covid-19 will return. ICU admissions will increase as will deaths.  A paycheck does not help if you are dead or spend a month intubated in the ICU.

In a perfect world we would have an effective treatment and a vaccine.  We don’t live in a perfect world.  One of my patients says, “Stay safe, stay healthy and stay the course.” I’ve got to agree with him.  As much as I want to get out and see my friends and patients before I move to NC, I’m staying the course.  Of course, Renee and I are in the risk pool.  If I was younger and healthy, I’d be in the office taking care of you.

Those of us who are “staying the course” are starting to suffer from cabin fever.  My patient’s advice for cabin fever is “Keep busy, stay busy and be busy today.”  While that is excellent advice, it’s been a disaster for me.  I’ve kept busy shopping for food on the internet, I’ve stayed busy cooking it and putting it in the fridge and I’m busy today eating the food I bought and prepared yesterday.  At least I walked outside today.

One of my favorite lessons I used to teach my patients is that the 3 keys to health and happiness are:

  1. A good attitude
  2. A good attitude
  3. A good attitude

I’m staying the course.  I’m staying busy. I’m working on my attitude.  Writing these articles and reading your responses help me. I hope they help you. 

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I HATE SLEEPING PILLS

During my early years in practice, I freely prescribed sleeping pills.  The evidence available during the 80s and 90s looked great. Sleeping pills appeared highly effective and safe.  As the years passed, I started to see more and more problems with sleepers.  By 2010, I dreaded using sleepers.  Sleepers can cause drowsiness, lethargy, drugged feelings, depression, memory problems and a multitude of other problems.

During the last decade of my practice, I had large numbers of middle-aged patients who couldn’t sleep without their magic pills.  Despite my admonishments about the risk of sleepers and their addictive potential, patient persisted in requesting/demanding them.  In the last 3 years of my practice, I started getting my patients off of Ambien and other sleepers.

Unfortunately, I still have patients who insist they need Ambien.  I talked to one yesterday.  She’s retired and has trouble staying asleep.  I explained that I can’t stay asleep either.  My sleep cycle is screwy!  I go to bed at 10:30 and sleep until 3 am.  At 3 o’clock in the morning, I go to the computer and write.  I watch a little TV or listen to a book.  By 7 am, my eyes start to close and I nap until Renee comes down at 10:30. I nap again in the afternoon and after dinner.

Since surgery and retirement, the above pattern has become my new normal.  I have two choices.  Choice number one is to ask my doc to prescribe a sleeper.  If I start on a sleeper, I can “normalize” my sleep cycle but will be on a pill the rest of my life.

Choice number two is to accept my new sleep cycle and live with it.  I chose to live with it.  If I had to work at a 9 to 5 job, choice number 2 would not be good, but I don’t have a work schedule.  Anything I can do during the day can be done at night or during the very early morning hours.

After 40 years of practice, I advise that you accept your sleep cycle as normal for you and learn to live with it.  So, what do you do if you have a sleep abnormal sleep cycle and have a fixed schedule that does not work with your sleep cycle?  Meditation is your best bet and while we are all sheltering in place, it’s a good time to learn how to meditate.  

Dr Belle Ruth Naperstak has some excellent material used to teach you to meditate through the use of guided imagery available at Health Journeys.com.  The Center for Sleep Medicine, in Libertyville, has a great program for treating Insomnia through behavior modification.  They can also assess if sleep apnea plays a role in your sleep architecture.  There are several easy screening assessments you can use at home to help diagnose sleep apnea.  Please look under the “For Patient” tab for those screeners.

If you must take a pill, melatonin seems to be the least harmful.  Unfortunately, the nutraceutical market is full of questionable products.  If you can, look for melatonin made by Douglas Labs, Metagenics or OrthoMolecular.

If all else fails, see your MD.  Well, it’s time for my morning nap.  

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MRS. FRIDGE

I’ve got to tell you the truth.  I’m a food addict.  I made an excellent dinner.  My three course meal consisted of a mixed salad with homemade Italian dressing, lean hamburgers grilled with onions and mushrooms, fresh string beans and a frozen banana for desert.  I’m full.

I ate 2 hours ago.  I’m sitting in the family room watching TV and all I can hear is Mrs. Fridge.  She’s at it again. “Hey, come here.  I’ve got a surprise for you.  I’ll make you happy.  I’ll make you smile.  I’m full of everything you like!”

She calls all night, every night.  She’s so hard to resist.  She’s voluptuous. Unfortunately, she really is loaded with everything I like.  I go to the grocery store once a week.  I’m intent on buying good healthy food.  I know what’s healthy and, in the past, my other friend, Will Power would go with me.  Unfortunately, Will is quarantined.  I’m on my own.

As soon as I walk into the store, Mr. Salami starts calling me. “Doc, you’re not going to live forever, might as well eat me.  I’m made from low fat salami, so grab me.  I love when you put me in your cart.”  As soon as I put him in my cart, I hear from Mr. Hotdog.  He’s jealous and gets along well with Mr. Salami.

The grocery store is Nirvana.  There are lots of hooker-like foods, all calling me.  Mrs. Gelato is quick to point out that my freezer is empty and needs filling.  Mr. Bagel begs me to get him some cream cheese and lox.  Sometimes its hard to get out of the grocery store.  There is so much to be eaten.

Lately, my addiction has been worse.  Any hint of a food shortage feeds into my foodie obsession.  My foodie obsession needs to be treated and I start off every day saying “Today is the first day of my new diet.”  Then Mrs. Fridge or Mr. Freeze calls me and I go to them.  

Today is my first day of my new diet.  This article is my version of an AA meeting.  Hi, I’m Stewart and I’m a foodie junkie. Since I make the rules, my first rule is to substitute something else for food.  RENEE . . .

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I CRY

Truth, I cry daily.  Every time I see a nurse or doc on TV complaining about the deplorable conditions they are forced to work in, I cry.  I’m crying right now.  These people are my tribe. I lived with them, shared bread, celebrated and cried with them for 40 years. 

I’m so helpless.  I should be in the ER working side by side with them. I took my oath seriously. I can’t be there but my heart and mind is standing next to my colleagues at bedside.  Would I be there if I could?  It’s insane to expose yourself to Covid-19 by working without adequate protective gear.  Working in the conditions described by providers in New York means risking everything; your life, your family’s life, and your career, yet you do it anyway.  Why?

You took an oath.  You have moral and ethical standards.  You cannot stand by and watch a person die without trying to save them.  I should be doing the same.  Parkinson’s has stolen my physical abilities from me.  I still have my mind.  How can I help?

I cry a lot. The question haunts me.  Would I work under the dangerous conditions that exist today?  The answer is yes.  But how could I jeopardize my family’s health and wellbeing?  How could I face them if I risked my life on a daily basis saving others?  What would my children and grandchildren say? What must they have thought every time I left the house, in the middle of a family event, to go to the hospital?

I am a doctor.  I must uphold my oath and ethically care for others.  In searching for the answers to my questions, I realize that my oath does not commit me to self-harm and potential death.  I cannot help others if I am sick.  I know that fact to be all too true.

Do you see the dilemma my tribe faces?  Do you see why I cry?  There are many heroes working in every hospital in this world who have to answer these very questions.  Unfortunately, after the war is over, they will have to deal with the physical and emotional injuries suffered in the ERs and ICUs that were at ground zero.

They will also have to deal with the anger that being so undervalued by insurers, hospital administrators and our government instilled in us.  Keeping with my recent theme, we have to find something good in all of this.  For me, I’d like to see my colleagues referred to by their appropriate titles; DOCTORS AND NURSES, NOT PROVIDERS.  THAT FUCKING DEGRADING TERM, PROVIDERS, NEEDS TO GO AWAY FOR EVER.

I THINK MY TRIBE HAS PROVEN ITSELF, THEIR ETHICS AND THEIR MORAL BY SHOWING UP EVERYDAY AND DOING THEIR JOB.  THANK YOU FOR WHAT YOU’VE DONE.  I PRAY YOU SURVIVE THE AFTERMATH.

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FINDING THE POSITIVES

Over the last 3 days I have been striving to maintain a positive attitude.  I’ve focused on what we can do to perk up.  My patients and friends are suffering from severe cabin fever and growing anxiety.  Loving couples are starting to get sick of each other. Parents of young children are running out of things to keep their children occupied and happy.

I’m going to make a prediction.  The next shortage is going to be in providing psychiatric care.  I don’t know anyone who has not been affected.  I know I’m at my wits end.  I’ve struggled all day to find something positive to write.  One of my good friends gave me a great theme, “Never waste a good disaster.”  In other words, make something good come out of something bad.

I’ll be damned if I can figure out how to make something good come out of Covid.  At first, I thought that, by closing America, families would spend more quality time doing things together.  Pictures of my son and grandson fishing and camping out in the back yard seemed to back up that premise.  But as the quarantine goes on, the anxiety, depression, and economic stressors seem to be draining people’s energy to the extent that they become incapable of enjoying anything.

Facebook jokes revolve around not bathing, not shaving, not dressing and not going out.  The nation, as a whole, appears depressed. I know I am.  So, what can we do?  Number one on the list is stop listening to the news.  Pictures of refrigerator trucks filled with corpses are not going to lift your spirits.

Number two is to reestablish a schedule.  Set the alarm every day for the same time.  Get up, shower, prep and dress. Go to work finding something positive to do.  Take an online course.  Work on a crossword puzzle, learn to play bridge or hone your business skill set so when this is over, you’re ready to go back to work.  Exercise!  Hug someone! Hum or sing a song!

Look for anything that puts a smile on your face.  My neighbor just called to see if I needed anything at the grocery store.  That single act of kindness made my day!

“Never waste a good disaster.”  Make something good come out of it.  Then share your idea with everyone else!  

Remember, it’s appropriate to be depressed and anxious at this time but, if those feelings become overwhelming, get professional help.  The National Suicide Hotline is 800-273-8255.

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LAUGH WITH ME

To continue my uplifting series, I want you to go to You Tube and watch Fluffy goes to India.  Laughter is every bit as important as hugging and is one of the only ways to counterbalance the doom and gloom spewing from CNN, MSNBC and Fox.

YouTube is a repository of some of the best humor in the world.  While Fluffy is my favorite, there are a host of other comedians that will appeal to almost everyone.  Try clicking on Drybar and feast on the content.  LOL is great if you are texting but let’s see if we can’t get you actually laughing out loud a minimum of 15 minutes a day.  I guarantee you’ll feel better and want to share your laughter with others.

When I was a kid, my father played poker every Tuesday night.  When the game was at my house, I would hideaway at the top of the stairs and listen to my father and his friends tell hilarious jokes, often with an old world, Yiddish accent.  Nine out of ten times I would be caught as I broke out into hysterical laughter.  Last night I discovered old Jews telling jokeson YouTube which brought back memories of the poker game with my father, Leo , Cecil, and Sheldon, seated around the table telling jokes and me almost wetting my pants.

Then there were my father’s records.  The jokes were off-color by today’s standards but outrageous in the 60s.  There were recordings from Moms Mabley and Red Foxx.  On my favorite album the comedian sang, “Show me a home where the buffalo roam and I’ll show you a home full of SHIT.”  Talk about LOL, I laughed until it hurt.

So, exercise your laughter with me every day and see if it will lift our spirits.  Share your favorites with me and I’ll share mine with you.

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HUG THE ONE YOU’RE WITH

Social isolation is slowly killing us. I can’t imagine what it would be like if I didn’t have Renee. “Shelter in place” may be what is necessary to prevent the spread of Covid-19, but the loneliness and depression attendant to being locked away from the rest of the world may be as destructive as the virus itself.

For some strange reason, songs keep popping up in my head.  This morning’s is by Stephen Stills and is called, “Love the One you’re With.”  Click on the link and enjoy the music; then, whenever they say love, substitute the word “hug.”

Hugs are very important, and, in the new world of social isolation, we need to find a new way to hug.  Any ideas?  You’ll figure it out as you hug the one you’re with.  Afterall, there are lots of benefits to hugging. Get inventive and share your ideas here.

Of course, if you can, love the one you’re with as well.  But don’t overdo it or the one you’re with may knit you a noose. Yesterday, Renee gave me the warmest hug I’ve had in a long time.  Boy, it was great.  Who knows?  Today she may love the one she’s with.

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SLOW DOWN

Hey lady, slow down.  You move too fast!  Where are you going in such a hurry?  It’s 7 am and there are maybe 10 people in the grocery store.  They are all old.  Shoot, if I’m old, you’re older than dirt!  We know you are not rushing to go to work.

What a bizarre sight.  Old people with masks and gloves shopping at 7 am.  We are supposed to keep 6 feet between us.  The store is empty enough you can actually avoid being in the same aisle as anyone else.  That is only possible if you slow down and let me clear the aisle.

It’s spring.  The sun is out.  We might as well make the best out of a bad situation. Spring is all about rebirth.  The world we lived in 8 weeks ago is gone.  We might as well make the present world as friendly as possible.  Something good from something bad!

In the words of Simon and Garfunkel, “Slow down you move too fast, got to make the morning last.”  At our age, making the morning last is pretty good.  Don’t you agree?  

The song goes on to say, “No deeds to do, no promises to keep, feelin groovy.”  There is one deed to do and that is to keep a safe distance from others.  There is one promise to keep and that is to make the best out of life.  Boy, I’d love to feel groovy again.  We both could if you would just slow down and quit invading everyone’s space.  In fact, now that I’m home, I’m feelin pretty groovy.

Kick back and click on the You Tube link and see if, for a few minutes, you can feel groovy too. (just click on underlined words). Have a great life. Live Wellthy!

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GOOD NEWS

I talk to my brother almost every day.  As many of you know, he is recovering from a stroke and I’m happy to say, he is doing well.  I’ve always said that if you make something good come out of something bad, the bad is not as bad.

In my brother’s case, he has become much more verbose since the stroke and his sense of humor has flourished.  Today, while we were reviewing the myriad of physical and emotional problems that we have developed with age, he mentioned that he is watching SGN/Some Good News with John Krasinski on YouTube.

Thanks, bro, for turning me on to the novel concept of good news.  In a world where every 10 minutes TV is interrupted with red streaming banners proclaiming disasters, misery and death, having a Good News Network goes a long way towards lifting ones spirits and countering the depression that is so prevalent in today’s society.

There are a host of networks/blogs/podcasts that concentrate on the good things in the world, brightening your day like Sunnyskyz.com and Feelgood.com.  Even the Today Show has a good news segment.

The hyperlinks above will take you to a few of the many good news stories that will brighten your day.  So, turn on and tune in to the good in the world.

Yes, good news does exist and now you know where to find it.

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