DON’T PUT OFF THE HAPPY!

As a family doc, I am acutely aware of the stages of life each of us eventually go through.  I counselled young sleep deprived parents of a colicky baby.  I reassured the parents of teens pointing out that their irresponsible child will go to college, go to work and become a success.  I helped 50-year-olds survive their mid-life crisis.  I also worked with the elderly helping them through an assortment of losses and eventually death.

Knowing what’s coming really doesn’t help. I really expected that I would skip this stage of life. Instead, I become more like my father every day.  My dad started life as an optimist and ended life as the world’s greatest pessimist. I think Parkinson’s and the unavoidable, degrading losses of motor function does that to you.  At least I haven’t started reading the obituaries yet.  He started his day looking at who died.  Of course, the internet and Facebook bring that info to your desktop in real time.

Yes, I’m in the “Golden Years.”  I’ll share a little secret with you.  They are golden years because you need gold reserves to pay for your medications, nursing home and funeral.  Are you depressed yet?  Are you ready to exit my blog and do something else?  Read on.  I promise it will be worth it!

Here’s my gift.  I’ve often told my patients that the devil exists, and his greatest accomplishment is the concept of tomorrow.  By giving us tomorrow to worry about, save and plan for, the devil ruins today.  Today is the only thing we really have.  Don’t waste it.

They say, “No one knows what the future holds.”  I do.  For most of my patients, it holds regrets.  Most of my patients put off happiness and work their lives away so that “one day” they will be secure and realize their dreams.  Don’t wait for “one day!”  It may not come.

I am amazed at how bright I was in 2011.  It’s as if I could predict the future and left myself notes in the form of my blog to help guide me through rough times.  Below is an article published August 26, 2011.

Last night, I watched “The Big C”, a TV show about a woman diagnosed with an advanced stage of melanoma, a nasty skin cancer.  The show follows Cathy, the main character, through the various stages of dealing with a life-threatening disease.  The show is funny and sad, uplifting and depressing.  Living with and dying from cancer is often a rollercoaster ride.

In last night’s episode, Cathy, while counseling a friend, remarked, “Don’t delay the happiness!”  Too often, we delay the happiness while dealing with today’s stressors and tasks.  We promise to get together with friends and family.  We promise to call mom and dad.  We plan to run away from it all and be selfish.  We will do it all, one day.

Sometimes, there are no more “one days.”  I have seen patients die for no reason.  One day they are here, the next day they are forever gone.  “Don’t delay the happiness” is sagely advice.  One thing is for sure: today is your day to find happiness.  Today is a good day to make that call, see that friend, and make definitive plans for your runaway vacation.

Yes, you have to work, to make a living, and provide for yourself and your family.  Yes, you are a responsible individual who others rely on.  Yes, you have a list of problems a mile long.  You also have time to count your blessings and you need to make time to do something nice for you and your special ones.  Recently, I wrote about regrets.  Don’t set yourself up for regrets.

Most of my patients are so focused on retirement that they forget to live.  Don’t live to work; work to live.  Your job tomorrow, and every day, is to find happiness.  Happiness is best when it happens spontaneously, but life’s complexities means that finding happiness often requires some work.  Work hard to be happy and then share it with others.  “Wellthy” is not just about being physically healthy; it is also about being emotionally happy.

Horace wrote, Carpe diem, quam minimum credula postero – “Seize the Day, putting as little trust as possible in the future.”   Yes, you have to plan for the future, but not at the cost of the here and now.  

I wish you many years of happiness and no regrets. Here’s your music and a joke.

Rodney Dangerfield – “I told my doc I didn’t want to get older.  He gave me a gun.”

Carrie Fisher – “as you get older the pickings get slimmer, but he people sure don’t.”

Joan Rivers – “You know you’re getting older when you buy a sexy sheer nightgown but don’t know anybody who can see through it.”

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FINDING A NEW DOC

I did it!  I had my first visit with a geriatrician (specialist in taking care of of people).  Yep, I’m old so since I needed to find a new doc. I thought I might as well look for a doc who focuses on taking care of the aged.  I was impressed(she didn’t even wince when she saw my lengthy list of complaints)! 

Her office staff was very welcoming despite the fact that we were late. I hate being late, but being new to the area, Renee and I had to rely on the GPS.  I think the GPS is doing drugs.  It took us to the wrong office, the long way.  Eventually, we found the right office.  

They assigned me a patient counselor who took Renee and I back to the exam room and reviewed my medical history, meds and allergies.  She took my vital signs (her technique was excellent).  After introducing me to her various functions (scribe, diet advice, communicator), she brought the doc in.

Dr. Rosen is young (she wasn’t born when I got my MD).  While I’m the first to tell you that 35 years of experience is invaluable, I’m also a realist.  My cronies are retiring.  I wanted a young physician who would outlast me.  She is also a good communicator who proudly points out the benefits of her practice style.  I was pleased to find that her practice is run very much like mine was.  While she is a specialist by training, her philosophy appears to be more in line with that of a generalist.  She has same day availability.  She encourages her patients to call after hours when they need care, avoiding urgent care centers and ERs. Her skill set allows her to meet the majority of your needs in her office without being referred out to other specialists.

Following my own advice, I brought her a chart summary, med list, review of systems and the names of the docs on my prior care team.  I strongly recommend that, if you are seeing a new doc, you compile the above-mentioned documents and bring them with you to your visit.  If you are like me and have CRS, the chart summary and med list will help you avoid forgetting essential facts (and bring your spouse with, as well).  She certainly appreciated the written info I had for her and listened to Renee when she related the things that only a wife would note.

She ordered lab and her lab tech drew my blood.  She was extremely personable, and her technique was perfect.  Her office promised to post the results on the patient portal and call me with them.

As a physician, I was nervous about seeing a new doc.  When you are used to being in charge, giving up control is difficult.  Dr. Rosen made it easy.  She was accepting of my advice and answered all of my questions.  I was particularly pleased to find that she could inject my trigger finger rather than send me to an orthopedist.

I know many of you still haven’t found a new doc.  I recommend looking for a young doc, specialty trained, down to earth who is an excellent communicator, appears to enjoy being a doc, and welcomes you to their practice.  You also need to find a one-stop-shop with same day availability and an on-call doc who will actually respond to your call.

Good luck!  Finding the perfect doc is not easy but can be done.  When you do find that special doc, go to the internet rating sites and give the doc a five star review.  If the doc is only 4 stars, keep looking.

Next on my list is a dentist.  Now that’s really scary. 

Here’s your music.  It’s a parody and hits close to home.  Residency at Lutheran General was a bitch.  Below is an article I published in the past which is worth reading.

In 1980, I was an ER doc at a local hospital.  I was so amazed at how many non-emergency patients came to the ER that I started asking every patient that I saw one of ten questions as to why they were there.  I took the top 5 reasons, found the solution to each, and opened the Lake Zurich Family Treatment Center. Searching for my patients’ medical needs and finding solutions for them proved to be one of my best things I ever did.  Forty years later, I’m on the other side of the fence looking in.  What I see is not pretty.  The medical world I grew up in is extinct and the new world (and those who inhabit it) are radically different.

Below is a checklist created to enhance your next patient visit.  It was created by Dr. Segal, the physician, and will help you interface with your doctor and his/her staff more effectively.  Now that I’ve transitioned to a patient role, I feel that it’s time to make a list of things I need from my doctor.  What do you need from your doctor?  If you will include your answers in the comment box, I will collate and publish the responses.

The better prepared you are for an office visit, the more you will get out of it.  The following are my top recommendations:

  1. Come prepared with clear objectives.  Define your first and second most important problems by going through the: who, what, when, why and how of your issues and know what you want.  If you are having chest pain or breathing problems, that is number one!
  2. Stay on track.  So many of my patients come in for one specific problem and then do the “Oh, by the way, while I’m here” spewing forth six other problems.  It is hard to do justice handling seven chronic medical problems during the course of an office visit.  Attend to your top two and set up time to do the next two and so on until the list is empty.
  3. Prioritize your list.  It is important to know what the top two are.  Your doc needs to know everything that is on the list.  Sometimes, what you think is the most important problem really isn’t.  Sometimes the doc will re-prioritize your list.  Use an “A” next to a problem to delineate a current/active problem.  Use a “P” to delineate an past/old/resolved problem.
  4. If you are seeing other doctors, tell the nurse who you are seeing and tell her what you are seeing the doctor(s) for.
  5. Bring your medications with you.  “I’m on a blue oval pill, two yellow ones and a green one” is not only worthless, it is dangerous.  Keep the pills in their original bottles.  Make sure you bring all of them, even if someone else prescribed them.
  6. Bring your supplements and vitamins.  They may impact your treatment.
  7. Wear appropriate clothes.  If you are modest, wear your bathing suit under your clothes.  If your knee is killing you, don’t wear tight jeans.
  8. Don’t forget to ask questions.  If you don’t understand what the doctor is telling you, ask for clarification.
  9. Ask for a written set of instructions if they are not provided.
  10. Know which pharmacy you want your prescription sent to.  In the world of electronic medical records, prescriptions are sent over the internet.
  11. Have a written list of your known allergies.
  12. Bring your insurance cards.  Different plans have different rules and panels.  Also, bring your driver’s license and co-pay.  Don’t be angry at the front desk when you are asked to present these at each visit. 
  13. Bring your old labs and x-rays if they were done elsewhere and they are available.

What I need from my doc:

  1.  Listen to and address my objectives.
  2. Re-prioritize my list when necessary to address more threatening problems as rapidly as possible.
  3. Tell me what you think I have and what you need to do about it.
  4. Tell me what I need to do about it.
  5. If you need to do tests, tell me which ones you are ordering and why.  Let me know how I get my results.
  6. If I need meds, which ones do I need and why.  How should I take them?  What are the risks?
  7. When do you want to see me again?
  8. What warning signs, if any, do I need to watch for?    When should I call you or your nurse if any warning signs show up?

We know these simple tips will help make your office visit a more fulfilling experience.

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OUR WORLD HAS CHANGED

The world really has changed!  I don’t think it will ever be normal again. I wonder what life will be like for my children and grandchildren as they get older.  Do you? If you would have told me that I would go into a bank with a mask on, I would have laughed at you.  If you had told me that I would have had a telemed visit with my doctor, I would have suggested that you stop smoking weed and drinking alcohol.  It all seems like a bad dream.  Obviously, it’s not.

I live in a new community in North Carolina.  Everyone on my street is new to the area.  Some wear masks, most practice social distancing.  Getting to know your neighbors under the present Covid rules of engagement is not easy.  We meet in the street as we go for our daily walks.  We talk about getting together but getting together is potentially risky. Nobody suggests that we come to their place for a getting to know you party. 

I’ve decided to have a driveway cocktail hour once a week.  I got the idea from my cousin Bruce’s Facebook page.  Bruce and Judy live in Florida and often post pictures of their neighborhood get togethers.  Each couple sits in their own yard and maintains a yard’s distance from their neighbor while trying to be social.  Where I live, we really don’t have backyards, so we’ll sit in our driveways and try to be social.

However, gone are the days when we would go over to a neighbor’s house for cocktails, appetizers and fun.  Gone is the handshake or hug between good friends.  Playing bridge or Rummy Q sitting 6 feet apart is not going to be easy.  As for wife swapping, that’s the same!  Never have, never will!

We will survive these changes.  We are old and have our memories of pre-Covid days.  What will it be like for our off springs?  They had already started to disengage socially.  They already preferred texting over talking.  They already are used to playing games with their friends over the internet.

Pre-Covid, Renee and I were in Sullivan’s, a ritzy restaurant in Illinois. Sitting across from us were four thirtyish individuals who texted each other through the entire meal.  I swear, I never heard them talk once.

I’m afraid Covid is the nail in society’s coffin.  I’m afraid my progeny will find themselves sitting in a sterile capsule, married to the internet and internet relationships, all the while thinking that it is normal.  Actually, I’m afraid that it will be normal for them.  I don’t want to imagine a world without human touch or one where a total body condom is the rage.  It’s just too sad.

I know, there will be a vaccine.  Will I take the vaccine?  I won’t know until I see more information about it.  If it truly is rushed to the market and shows up this year, I doubt there will be enough safety information to make me want to try it.  I’ll probably wait until a million have been given.  Regardless of the safety and effectiveness of a vaccine, the changes we are experiencing are probably permanent.

While Pandemics are rare, the fear of Pandemics, let’s call it Pandemania, will probably persist.  Working from home and living on Facebook and Zoom just is not healthy; yet, appears to be the way of the future.  At first, I was torn over the issue of sending kids back to school.  Part of me sided with the argument that kids need socialization along with their education.  The other part of me worries about the potential of Covid to do both immediate and long-term damage to the body. While socialization is crucial to development, the move towards internet socialization and texting was firmly entrenched in society pre-Covid. 

I’m glad I don’t have young children to make decisions for.  Unfortunately, there are no universal right and wrong answers.  As for Renee and I, we will continue to live in isolation, having wild parties for two on our driveway and going crazy locked in our house 22 hours a day.  She really does love me, so she puts up with my chasing her from room to room.  On occasion, I text her even though she is sitting next to me.  I confess, I don’t see why the kids love texting.  It’s awfully hard to be nibbling on her ear while I’m texting her, “do you want to make love?”  

Today’s take away is that life, as we knew it, has changed rapidly since March, and all we can do is try to adapt and stay alive.  Since there are no right and wrong answers, I’m going to stop worrying about the future and just worry about what I’m going to do once I finally corner Renee!  She’ll probably have a different idea.

Here’s your music and a joke.

The elderly Italian man went to his parish priest and asked if the priest would hear his confession. “Of course, my son,” said the priest. “Well, Father, at the beginning of World War Two, a beautiful woman knocked on my door and asked me to hide her from the Germans; I hid her in my attic, and they never found her.” “That’s a wonderful thing, my son, and nothing that you need to confess,” said the priest. “It’s worse, Father; I was weak, and told her that she had to pay for rent of the attic with her sexual favors,” continued the old man. “Well, it was a very difficult time, and you took a large risk -you would have suffered terribly at their hands if the Germans had found you hiding her; I know that God, in his wisdom and mercy, will balance the good and the evil, and judge you kindly,” said the priest. “Thanks, Father,” said the old man. “That’s a load off of my mind. Can I ask another question?” “Of course, my son,” said the priest. The old man asked, “Do I need to tell her that the war is over?”.

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CHANGE

Life just got exciting.  I am living with a younger woman and, for the most part, love it.  It’s a little weird when at 3 am, this other person is in my bed.  It takes me a minute or two to figure out what’s happening, then I smile and go back to bed.

Let me clarify things for you.  Renee decided to go gray, so she did!  Being a man, I had been taught early on, to never comment on a woman’s hair.  She looked great and, when I was sure it was safe, I told her. I survived the compliment and she conditionally agreed with me.

“The color is good but it’s too long.  I’m going to have her cut it shorter.”  Again, I withheld my comments and supported her decision.  WHAT A WIN!  Gray and short turned out to be a great combination.  She got younger, feistier, and while I think she is Renee, I’m not sure that some magical power didn’t swap out my wife for a newer model.

So, what’s this got to do with anything.  Number 1, I’m smiling, upbeat and energized by my new bride.  Number 2, what you see in the mirror affects how you feel and act.  Years ago, a good friend asked me about plastic surgery.  She wanted a face lift.   I talked her out of it.  Yes. Her face had aged but she looked good anyway. I pointed out that the surgery was elective and carried significant risks.

Ultimately, my friend went away for several weeks and came back with a new face.  She sat me down and explained what she could not explain prior to the surgery.  “Stewart, when I would wake up every morning, I felt like I was 50.  Then, I’d look in the mirror and feel 90! Since the face lift, I wake up feeling 50, and, when I look in the mirror, I am 50!

Cutting her hair and letting it go natural saved $30,000 in surgical costs and revived my wife.  She’s 50 again.  Unfortunately, she’s living with a 69-year old who needs a fatectomy.  I’ve noticed that I no longer shave everyday and often dress like a slob.  I fit right in at Walmart.  It’s time I start taking better care of me.  This is day five on WW and I’m doing well.  I’m walking or riding daily.  I need to change who I see in the mirror.

For years I’ve told you to do as I say, not as I do.  It’s time for me to take those words to heart!  Are you feeling old? Are your friends aging poorly?   You can do something about it.  Sometimes you have to go out on a limb like Renee.  Sometimes, it takes sweat equity. Sometimes, you actually need a plastic surgeon.

Here’s your music and a joke. 

recent study has found that women who carry a little extra weight live longer than the men who mention it.

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MY SECRET WEAPON

I have a new secret weapon in my war against obesity.  When I was a child growing up in Norfolk, Va., one of my favorite things to do was to go to City Park.  City Park was our local zoo and there were two attractions which I loved.

The first attraction was the monkey cages.  There was an old chimp who loved to spit at people.  At times, the chimp would resort to other, more grotesque behaviors, including throwing his poop or even masturbating (I’ll leave the rest to your imagination).  As a child, his outrageous behavior was funny, especially if you were with an out-of-towner who didn’t know he/she would need to duck.  As an adult dealing with HMOs, I often thought of that chimp and I had a lot in common (locked in a cage and put on display) and how much fun it would be to throw stuff at the insurers of America.

But this article is not about spitting on the insurance companies.  It’s about the second reason I loved going to City Park.  My dad would take me to the concession stand (an old log cabin) and buy me a root beer snow cone.  On a hot summer day, there was nothing better than a root beer snow cone.  Fast forward to three weeks ago.  I had failed multiple times in my quest to improve my diet.  I had just discovered The Snow Cone Cabin and fell in love with it.  It made me feel like a child again.  It was also too crowded and many of its patrons ignored the Covid rules to such a degree that I was uncomfortable being there.

So, I came home and surfed the net.  I found exactly what I was looking for.  My Zeny snowball machine is fantastic!  Now, any time I want a snack, I make a snowball. Unfortunately, I have not found a diet root beer syrup yet, but diet cherry or grape suffices. Filling, refreshing and zero calories, my secret weapon is my new best friend.  Stop by and enjoy one with me anytime!

Now, all I need to do is find that chimp!  There are some insurers I’d love to introduce him to.

Here’s your music and a joke.

When I was five, my dad put Snowball into the blender to make a slushie.

I miss Snowball.  She was a good cat

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GOLD LIST

Doctors are problem solvers.  After 10,000 hours of training, they still need to consult journals, textbooks and specialists in order to develop the best solution to their patient’s problem.  During the first 8 years of practice, I had a library in my office.  The computer world changed everything.  Books gave way to computer searches.  The most up-to-date research became available at the click of a mouse.  Consultants, carrying pagers at first, then cell phones, became available 24 hours a day.

Despite all of the above advances, the most precious resource a physician has are his own patients.  I called it my “Gold List.”  In a large practice such as mine, there were leaders.  As a group, these individuals wielded immense power and knowledge.  They had access to an unbelievable list of resources and the ability to use them.  Yet, my profession looked down on tapping this resource.  As many of you know, I did whatever I needed to care for my patients including, if necessary, tapping into the resources that my “Gold List” could muster.

I learned, early on, the cost of inappropriately using the “Gold List.” We were closing on the house in Long Grove and had a 24-hour window where we had to finish the sale of our Buffalo Grove house and close on our Long Grove house.  We were strapped for money and didn’t think we could get an interim loan if everything did not go smoothly.

The builder called the day before closing and informed us that we would not be able to close as a vital transformer had not showed up and we did not have electricity.  I freaked!  I went to the office and search my patient files for someone who had the resources necessary to fix the problem.  I found the name I was looking for and the next morning we had power.  We closed on time.  What a relief!  Disaster avoided!

Two weeks later I walked into room 3.  The patient was a young woman who was distraught, crying and needed something to sleep.  It seems that the generator that the generator that was to provide power to her house disappeared.  Her closing was delayed.

God had sent her to my office to teach me a lesson.  Naturally, I didn’t charge her.  I didn’t sleep for weeks.  I had learned my lesson. From that time on, I was very careful about how I used the “Gold List.”  I will forever be indebted to the people on that list.  When charity was needed, they were always there.  When a talented patient I delivered needed a leg up in the business world, an interview was available.  When new medical technology became available, the president of the company that pioneered the technology brought it to Lake Zurich and made it available to the rest of my patients.

One story that always makes me smile has to do with Motorola.  At one time, close to 30% of my patients had ties to Motorola. Being a boy at heart, I love electronic toys and my Motorola patients often used me as a test subject.

I was in an elevator in Las Vegas.  A bunch of suits excitedly got on the elevator.  It soon became apparent that they worked for an electronics firm.  They were excited because they were about to see the newest innovation in cell phones.  It was a major breakthrough in cellular technology.  I felt like such a bigshot.  I wanted to tell them that I had one in my pocket.  I had used it for 6 months and it was even better than they thought it was.  I had signed a non-disclosure agreement, so I just stood there and smiled.

Life was awfully good then.  The point of my story is that a doctor has lots of resources available to help his patients thrive.  One of those resources is his own patients.  Like the strongest of my medicine, I had to learn when it was appropriate to utilize a patient’s skills and when it was not.

Currently, the power of my Gold List is being turned on me.  Everyone of my patients was worth their weight in gold and now they call me to cheer me up, to comment on this blog and to offer their love and care.  Thanks for an awfully good ride. I miss you and wish I could open an office at 504 South Rand Road.  I would love to be there for you again and I appreciate your being there for me now.  

PS – Thanks Jim for being a great landlord.  You were an unseen member of my practice and supported me through lean times.

Here’s your song and a joke.

Three vampire brothers decide to hold a competition to see which one of them is the most powerful. The first brother is the strongest.

“Watch this,” he says, and takes off at nearly 100 miles per hour. Two minutes later, he returns, his mouth covered in blood.

“What happened?!” his brothers exclaimed.

“You see that mansion over there?”

“Yeah?”

“Well, I went over there and sucked each and every last family member dry. They are all dead.”

“Wow!” his brothers say. “As expected, for you are the strongest.”

The second brother to go is the oldest.

“Watch and learn, boys,” he says, and takes off even quicker, at 150 miles per hour.

Five minutes later, he returns, both his mouth and his neck covered in blood.

“What happened?!” His brothers exclaimed.

“You see that village over there?”

“Yeah?” They said.

“Well I went over there and killed every last person in the entire village. There is not one left alive.”

“Wow!” his brothers say in awe. “As expected, for you are the oldest and have the most experience.”

The third brother is the fastest. Not to be outdone, he says “Watch this, and don’t blink or you might miss it.”

He flies off, faster than the rest of them, going at *least* 200mph.

In only ten seconds, he returns. His entire mouth, nose, and neck are covered in so much blood, it stains the front of his shirt.

“What happened?!” his brothers exclaimed.

“You see that giant tree over there?”

“…Yeah?”

“Well I sure fuckin’ didn’t.”

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FIVE STARS

Did you ever kick yourself for having an idea and not following through on that idea?  I just kicked myself.  I just saw a commercial for Reputation Defender.com. I created Reputation Defender.com years ago.  As the internet grew, it became apparent that your reputation could be destroyed, in seconds, by an angry individual.

If you go to any of the physician ranking sites, you’ll find physicians who have 5 stars out of five.  On the surface, five stars is impressive.  The only problem with an all five-star rating is that, when you see 40-50 people a day, you are bound to come across someone who doesn’t like you or your staff.  Patients who like their docs rarely go to the internet to rate their docs.  Patients with a grudge can’t wait to get home and post an unflattering review.

Several years ago, I met a truly pompous A-whole who wrote an outrageous review of my ability as a physician.  The one thing he failed to comment on was the fact that he had never been a patient in my office.  He had come in with a friend, several textbooks, a stack of articles (none from a legitimate medical journal) and a chip on his shoulders.  He lectured me on his diagnosis of his friend’s condition, and he was prepared to spend the rest of the day trying to sell me on a non-existent parasitic disease. After trying to address each of the friend’s suggested diagnoses, it became clear that the friend wanted Dd. Google’s answers. At that point, I had no choice but to ask my patient’s friend to wait in the lobby.

He was upset when I asked him to wait for his friend in the lobby and gave his friend an ultimatum; either he leaves with him or he was on his own.  Unfortunately, my patient left with his friend and I never heard from my patient again.  I certainly heard from his friend in an internet review.

In olden times, there were no reputation builders that you could hire.  Luckily, when I need help, I could always go The Spring.  The Spring is the source of love and kindness and always knows how to fix anything that is broken or just plain messed up.  Anyway, The Spring reached out to many of my patients and they responded by posting lots of five-star reviews. Within a couple of days, the A-hole’s review disappeared and my rating went to 4.9.

That’s when I came up with the idea to start a reputation repair service.  Over my lifetime, I came up with lots of viable business ideas.  The problem was that I was always too busy being a doc to work on anything other than patient care.  My plan was to provide doctors’ offices with patient surveys and then post the positive remarks on the physician ranking sites.  My staff would monitor the online reputations of the docs that hired us.  I wish I had acted then.  I would have something to do now!  There I go again lapsing into the “woulda, coulda, shoulda.”

The take home point today is that, if you like your doc, go online and give him/her five stars.  Your doc will benefit from positive reviews.  If you can’t give him/her a five, drop them a note and let them know why.

As for me, I still go to The Spring when I need a wise and caring opinion or help finishing a task.  I’m lucky to have found The Spring.

Here’s your music and a few one liners.

The road to success is always under construction.

If at first you don’t succeed, we have a lot in common.

Being a hypochondriac is going to save my life one of these days

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MY FOOD AFFAIR

It’s the start of a new day and it’s already much better than yesterday.  For the most part, my body is functional today.  Renee and I had a nice ride on our tandem bike this am.  I’ve decided to go back on Weight Watchers so I’m doing some diet planning.

I tried my introductory shipment from Daily Harvest and loved every smoothie and oat bowl.  Unfortunately, it’s expensive and I can’t figure out how to calculate WW points as there are lot of ingredients in each product.  There are a few listed on the WW site but their point counts are unbelievably high, representing a quarter of my daily allotment of points.

I don’t understand why food has to be packed with calories.  Food should be like sex.  There is no such thing as too much!  You should burn calories by eating and digesting food.  The act of consuming an Italian Sub from Publix should be pure pleasure and amount to minus 1500 calories.  If I was designing the relationship between mankind and food, you would have to eat 4,000 calories a day just to maintain your weight.  Essential food groups would be sweets, fats and sausage.  In addition to the standard salt and pepper shaker, there would be a bacon shaker.  Bacon goes with everything.

Unfortunately, I’m not in control.  Eating sweets, fats and sausage with a sprinkle of bacon cause weight gain and illness.  Thinking about living without my essential group of three is depressing.  There are two types of people with depression.  Type one medicates themselves with food.  They gain weight, and, as they gain weight, they get more depressed.  The more depressed they are, the more they eat.  I’m a group one member.

Group two lose their appetite when they get depressed.  They also lose weight.  I’d love to be a group two member but, having never lost my appetite, doubt that I will ever be allowed to join group two.  

Weight Watchers allows me the luxury of eating anything my heart desires.  It allows me to eat my usual food groups, while limiting quantity. Quantity is another problem I deal with on a daily basis.  In Segal Motto is “Go Big or Go Home!”  On WW’s “Green Plan” I get all the fruit I want.  Fruit is considered to be a free food (NO POINTS.)  Last night, I ate ½ of a large watermelon.  I don’t think I was supposed to eat ½ of a watermelon.

The more I write about food, the more I realize that I’m not committed to dieting at this time in my life.  I’m having an affair with food and enjoying it.  I will continue on WW as I work on stabilizing my weight and imposing some limits on quantity.

Diets are unnatural acts.  When I come to my senses, I’ll design a new Wellthy Plan and get healthier.  Until then, I’ll increase my exercise, enjoy eating and use WW to help deal with quantity issues.

Here’s your music and joke for the day.

Ate salad for dinner! Mostly croutons and tomatoes. Really just one big, round crouton covered with tomato sauce. And cheese. Fine, it was pizza. I ate a pizza.

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POLYPHARMACY

With all my knowledge about medicine and Parkinson’s. I’m still amazed at how one minute I can be fairly normal and the next, completely abnormal.  Today is my worst day yet.  Not only am I miserable, but it started that way at 4:15 a.m. and is just now improving (2:00 p.m.).

So, what’s miserable?  Miserable is when every muscle in my body is stiff and my legs don’t want to walk.  I stutter step and feel like I’m going to fall. Usually, within 20 minutes of taking my pills, I’m better.  Today was as if I hadn’t taken my medication.

As a doc, I know how easy it is to make medication errors.  To guard against taking too many or too few pills, one day a month I set up my pill dispensers.  They have 4 slots for pills; morning, noon, midafternoon and night.   Each day I take out a full day’s worth of pills and if there are pills in a given slot, then I haven’t taken them. If the slot is empty, I took them.

As you age, it’s critical that you develop a means of monitoring your use of medications.  I set a recurring alarm on my phone and watch to remind me it’s time to take my medication.  Renee carries a back-up set of pills wherever we go just in case my CRS is active. Yep, I feel older than Methuselah.

Are you old enough to be on multiple medications?  If so, do you have a system set up to protect you from overdosing or of underdosing?  If not, please set one up.  Amazon has a large variety of pill dispensers.  Find one that fits your needs.  If your memory sucks, have a family member take over the task of loading your pill dispenser on a monthly basis.  If you are computer savy, set up a recurring alarm on your phone or watch.  If not, have your grandchildren program your devices.

When you pick up your medication at the pharmacy, make sure the directions on the bottle are the same as the directions given to you by your doctor.  Any discrepancies should be handled immediately. It’s important that you learn the names and doses of your medication. “Doc, I’m taking 2 white footballs, 3 yellow round pills and a beige triangular pill,” just doesn’t cut it.  There are lots of white football shaped pills and yellow round pills.  If you can, take a picture of each pill bottle and store it on your phone.

Unfortunately, medication errors are a persistent problem in our country, many leading to death or disability.  Being an active member of your medical team is essential.  Mistakes can occur in the doctor’s office, the pharmacy or in your own home.   It’s your responsibility to find them and have them corrected.  You are the end user.  You are the one who actually swallows the pill so if you think something is not right, don’t swallow the pill.  Talk to your doc and the pharmacist as soon as you’ve identified a problem.

Epocrates is an app that I’ve used for years.  It tells me everything about the medication I’m taking, including a physical description of the pill and the number embossed on the pill.  I believe the basic version of Epocrates is still free.  You will also need to download GoodRX.  GoodRX will give oney saving coupons to use in buying your medications.  The program is especially helpful when you are in the donut hole.

Lastly, on a yearly basis, it’s wise to verify that you still need your medications. As a resident, I used to be blown away by the number of unneeded medications the older docs had their patients on.  It seemed like once a medication was prescribed, its need was never reassessed.  I swore I would never do that to my patients.  Then I got older and found I was falling into the same trap my predecessors fell for.  Once started, there is a tremendous clinical inertia pulling on the patient and the doc.

“Doc, I feel good.  I’m afraid to stop ABC medication.  I don’t want to relapse and I’m so busy at work that, if I relapsed, it would be a catastrophe.  When things settle down, we can try stopping ABC.”

Invariably, the doc goes along with the patient’s request.  Things never settle down at work and the medication is never stopped. And that, my friends, is how you end up on 12 medications a day.

Here’s your song for the day and a joke.

An old woman walked into a dentist’s office, took off all her clothes, and spread her legs. The dentist said, “I think you have the wrong room.” “You put in my husband’s teeth last week,” she replied. “Now you have to remove them.”

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WRITER’S BLOCK

It’s another day in the 90s and, without a pool to swim in, I don’t want to go out.  It looks like my community’s pool is going to open in 2 weeks.  I have no idea when it will close.  They are working on the vegetable garden now and I probably won’t plant anything until next year.

Renee and I met one of the neighbors last night.  She seemed nice and we talked about having a driveway cocktail party with all of the other new neighbors.  Looks like we’ll sit in our driveways and yell across the street.  Whoopy!

I have writer’s block; I’ve not gotten very far with my book ideas.  I’ve also not found a job I can do from my home office yet.  I had my telemed visit with Dr Bianchi last week and it was better than expected.  Of course, knowing him for 20 some years helped.  Other than being grossly obese and having extreme fatigue, I passed with flying colors.

I’ve finished everything good on the 3,000 (maybe I’ve exaggerated a little) channels I have access to and now I’m doing comedy on You Tube.  There are some interesting pod casts on You Tube in addition to the comedy.  Maybe I should do stand-up comedy.  In my case, I’d have to call it Lean-on comedy, as, I can’t stand long periods of time without leaning on something.  Shopping carts are great for bad backs.

I’m sick of Covid-19.  I want to go to Nueva Vallarta and spend 2-3 weeks on the beach. They actually have as many problems as we do.  I want to go to Hilton Head and lounge on the beach or at the pool but I’d have to worry about exposure there as well.

I’d like to fly back to Chicago and see my friends, go to fine restaurants and do a little boating on the Chain of Lakes, but again, it’s too risky. The longer this virus stays active, the longer my list of things I want to do gets.  Also, the closer I get to going insane.

Actually, going insane doesn’t sound so bad right now.  It feels like I’m living in LaLa Land. Baby sitting on Monday and Tuesday helps some.  Smiles and kisses from Mackenzie are better than drugs.  Hudson is a crier but still a lovable.  Luckily, I’m half deaf and can nap right through one of his fits.

We close on the Illonois house August 31.  My friend Barb ran a 3 day yard sale which flopped.  No one came.  What a pity!  I left some really great stuff to sell but Covid kept everyone home.  A local church group is going to take everything and give it to the needy.

If I had listened to my mother, I would have been able to keep both the Illinois house and the Carolina home.  I can still hear her. “Stewart, you spend too much on the kids.  You need to save more for retirement.”  

I love summers in Long Grove!  I’m not going to get into the “shoulda, coulda, woulda” conversation.  I enjoyed spending money and still do.  My three great loves are sex, food, and spending money.  At 69, eating is the easiest of the three.  I have sex almost every day of the week!  Almost on Monday, almost on Tuesday, almost Wednesday, etc.  Spending money out of my retirement fund is not wise.  That leaves eating.  I’m still a world class cook and eater.  Lucky for me, North Carolina’s restaurant scene is not nearly as good as Chicago. 

So, when I can’t think of anything to write about, I turn inwards and start looking at myself.  I’ve been overly indulgent with food and it’s not healthy.  I seem to find enough will power for 2-3 days of healthy eating, then relapse.  As Bruce taught me, if you fall down six times, get up seven.  So, I’ll get up again and again until I get it right.

Time to go for a walk.  It’s been too hot to ride the bike.  I’m looking forward to fall and cooler temperatures.  In 10 years, I’ll probably write about missing snow.  NOT!

Here’s your music and another joke.

Little Timmy was sitting on the front porch with his grandpa when he saw the man take a sip of whisky.

Little Timmy looked up at him and said “Hey, PopPop?”

The grandpa looked down at him and asked “What’s on your mind, boy?”

“May I please have a sip of that whisky”? He pleaded. 

Thoughtfully, the aged man stroked his beard and asked “Well, can your dick touch your butthole”?

Unsure of his point, Timmy said, “No?”

The grandpa laughingly chortled, “Then you’ll have to wait when you’re older”!

Little Timmy was upset as he saw his grandpa light up a cigar. Little Timmy asked with a hopeful voice “Hey, PopPop? May I please have a suck on that cigar”? 

Amused by his persistence, he repeated “Well, can your dick touch your butthole”?

Upset, Timmy just sighed as he looked at the floor. Smiling still, the old man said, “you’re going to have to wait until you’re older, Tim”.

Little Timmy moped his way inside the house where his grandma saw him in such a dreary state. Thinking to herself that she knew exactly how to cheer him up, she started making his favorite chocolate chip cookies.

Waking up from his nap outside at the smell of cookies, the weary man stood up out of his rocking chair and followed the smell inside where he laid eyes upon his grandson eating cookies to his heart’s content. Strolling over to the boy, he quietly mused “Gee, Timmy. Those are some awfully good smelling cookies. Mind if I have one”?

Pondering this for a couple of seconds, Little Timmy finally asked “Well… Can your dick touch your Butthole”?

Smiling, the grandpa slowly said “Why, yes it can. “

“THEN YOU CAN GO FUCK YOURSELF! GRANDMA GAVE THESE TO ME”!

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