Month: November 2020

“Do as I say, not as I do!” Whoever said, “Do as I say, not as I do,” was brilliant.  I wish I had taken it to heart.  In response to yesterday’s article, my daughter pointed out that I wrote a book expounding the benefits of moderation in diet and a Wellthy lifestyle.  Had I stayed the course and followed my rules, I wouldn’t be 40 pounds overweight and looking forward to a year or more of serious dieting and exercises.

I spent 40 years offering sagely advice and teaching about health and “wellth”.  I also spent 40 years quietly breaking the rules and expecting immunity because of my position as a physician. Well, physicians don’t get any free passes and I’m living proof that ignoring the rules has a cost.

Looking back in time, it’s easy to see one’s mistakes and that’s why “sagely” advice is worth listening to.  My sagely advice is to do everything you can to preserve your health.  Work to increase your physical attributes.  Invest as much in your emotional health as you do your financial health.  Follow the “Wellthy Plan” laid out in, “Diets and Other Abnormal Acts.”

Playing catchup or repair is hard and at times, impossible.  It really will take over a year to lose my 40 extra pounds and fill my physical and emotional accounts.  That estimate assumes that I don’t get derailed by injury.  Being 40 pounds overweight and old and frail makes not getting derailed unlikely and sure enough, I just tore my hamstring.  Oh well, that’s the way it goes.

So why am I writing about this now?  Christmas and New Year’s are coming up and it’s a perfect time to set realistic expectations and find the resolve to establish a healthy lifestyle.  While not a particularly outstanding book, the premise of “Diets and other Unnatural Acts” are worth reviewing.  If you are a Kindle reader, it’s free.

2020 has been a rough year for most individuals.  Start planning for a better 2021. Wear your masks whether you believe in them or not!  Keep your distance!  Wah your hands!  And get psyched and prepare for the availability of a vaccine.

Here is your music for the day and a joke.

A man went to the hospital to visit his mother-in-law, who was in serious condition. On the way back the wife, very worried, asks: “So, honey, how’s my mom doing?”

He replies: “She looks great! She is in good health! She will still live for many years! Next week she will be released from the hospital and will come and live with us, forever!” 
“Wow that’s amazing!” – says the wife – “But this is very strange, dear… yesterday she seemed to be on her deathbed, the doctors said she should have a few days to live!” 
“Well, I don’t know how she was yesterday” – he replied – “But today when I arrived at the hospital, the doctor told me that we should prepare for the worst”

Those of you who read my blog regularly know Will Power.  Will and I weren’t talking for a few months, but we recently made up.  I am proud to say that, with “Will Power” at my side, I successfully made it through Thanksgiving without breaking my diet!

I’ve got to admit, it was not easy.  My youngest daughter played the role of saboteur, offering all sorts of delicious, sugary dishes.  Each time she attacked, I dug in and refused her offering.  In her defense, she loves me and knew that I loved everything on her menu.  

Loved ones often play the role of saboteur.  Like Lisa, their sabotage is done in the name of love, but ultimately hurts you.  Saboteurs have an arsenal of weapons and techniques.  Your good friend who drinks with you despite the fact that you are an alcoholic is a saboteur!  Your mother who picks up a few packs of cigarettes for you when she goes shopping is a saboteur.  Your son, who buys you a birthday cake smothered in sugary frosting and cuts you a double wide piece says, “Come on, mom, it’s only one slice.   You can take an extra dose of insulin,” is a saboteur!

It’s important to identify the saboteurs in your life and learn how to manage them.  Well-meaning people can kill you with love. Will Power helps a lot; but, often, Will can’t be found when you need him the most.  My suggestion is you handle saboteurs by advising them that, despite good intentions, they are sabotaging your path to wellness and asking them to back off.  If despite your request to back off they persist, find out if they have taken out a life insurance policy on you (just joking, or am I)?

It’s also important to never lose sight of how important being friends with “Will Power” is.  I tore my hamstring while exercising and will spend the next few months healing. Inactivity will make losing weight even more difficult so I’ll need a lot of help.  Attention, saboteurs! This is your first warning, “BACK OFF!”  WILL, I’M GOING TO NEED YOU MOST DURING CHANUKAH, CHRISTMAS AND NEW YEAR’S.  

Here’s your music and a joke. 

I was offered sex with a 21 year old girl today…

In exchange, I was supposed to advertise some kind of bathroom cleaner. Of course, I declined, because I am a man with high moral standards and strong willpower. Just as strong as Ajax, the super strong bathroom cleaner. Now available in lemon and vanilla scent.

This time of year, I always repost the “BLESSING LIST.”  With Covid-19 ruining so many Thanksgiving plans, I thought today would be a perfect day to review the following:

Do you ever feel overwhelmed? Do you have too much on your plate? Your husband is out of work. You have a full-time job during the day and you are mom at night. Your parents are getting old. Your house needs work. You have too many bills and your children are needy, whiny and unappreciative. Dinner conversations are all about “needs,” that four-letter word. Life needs balance!

Often, we are so focused on our curses and problems that we can’t see our blessings. By adjusting your viewpoint, you can reduce your stresses and better address your problems. Try this exercise:

1. Your husband is out of work; you are blessed to have a husband.
2. You have too much on your plate; you have a table to put your plate on and food to put on that plate.
3. You have a full-time job during the day and are a mom at night; you are lucky to have a job and blessed with children.
4. Your parents are getting old; your parents are alive.
5. Your house needs work; you have a roof over your head.
6. You have too many bills; You can spend less and live with less as long as you have a roof over your head, food on the table to feed the children and a husband to love.
7. My children are too needy; they will learn the difference between wants and needs and learn to be appreciative of what they have.
8. Whiny kids are healthy enough to whine and they will grow up eventually.  
9. We can’t get together for Thanksgiving due to Covid; there will be many more Thanksgivings to celebrate together.

So, make a blessings list. Include everything you are lucky enough to have, everything that makes you smile. Place that list on your bathroom mirror and every morning and night, brush your teeth for two minutes. While you brush your teeth, count your blessings. If you start the day blessed and end the day blessed, whatever happens during the day won’t be too bad. By the way, count the fact that you have teeth to brush as a blessing!

Here’s your music and a joke.

The doctor says, “Larry, everything looks great. How are you doing mentally and emotionally? Are you at peace with God?”

Larry replies, “God and I are tight. He knows I have poor eyesight, so He’s fixed it so when I get up in the middle of the night to go to the bathroom, poof! The light goes on. When I’m done, poof! The light goes off.”

“Wow, that’s incredible,” the doctor says.

A little later in the day, the doctor calls Larry’s wife.

“Bonnie,” he says, “Larry is doing fine! But I had to call you because I’m in awe of his relationship with God. Is it true that he gets up during the night, and poof, the light goes on in the bathroom, and when he’s done, poof, the light goes off?”

“Oh, no,” exclaims Bonnie. “He’s peeing in the refrigerator again!”

 

 

Are you fed up with politics?  Are you fed up with Covid? I am!  I’m just plain, old fashioned fed up!  First on my list is the virus.  It’s not bad enough that the news is constantly updating the numbers of infected and dying patients, but many of the most popular TV shows are now incorporating horrific scenes of overtaxed hospitals, exhausted and demoralized medical staffs and the stories of the families who have lost their loved ones.

I’m also fed up with those individuals who don’t believe the pandemic is true.  Then there are those who don’t believe that masks and social distancing work. They are quick to tell you that the figures are being inflated by doctors who are padding their pockets with Corona dollars or some other ludicrous conspiracy theory.  While these individuals may be experts in their own rights in such noble professions as construction, law, sales, etc., they are not doctors nor scientists; yet, after doing some internet research on their own, you would think that they held PhDs in public health and infectious diseases. 

I am fed up with the constant bombardment of my email account with film clips and supposed news articles supporting the ridiculous notion that Covid is really not harmful and the government is just using it to control our behavior and take away our rights.  I’m fed up!  I’m at the point where I think the best solution for the doubters is to have them prove their points by simply asking them to kiss a Covid patient on the lips and see what happens.

I’m fed up with the presidential election and the never-ending news reports and lawsuits.  I’m fed up with those who are delaying the peaceful transition of governments we have been famous for.  I’m a lifelong republican who is ashamed that no one in the republican party is willing to stand up to Trump and tell him to get off the golf course and get back to work on stopping Covid and to start the transition of power, preparing the new government for day one of their existence.

I’m fed up living in a body that is constantly malfunctioning.  My 3-year-old granddaughter recently said, “Zadie, you’re falling apart.”  She’s right!  It seems like I develop a new problem daily.  A few nights ago while watching TV with Renee, a piece of tooth popped out of my mouth.  I suspect that being fed up with the election and Covid had me clenching my jaw, breaking my tooth.

If it wasn’t bad enough that I lost part of a tooth, my mood worsened when I found out the dentist’s office was under 2 weeks of quarantine due a staff member’s infection with a “fake” virus.

If I’m fed up, I can’t imagine what it must be like for those workers who have lost their livelihood to Covid shutdowns or illness.  I can’t imagine what it feels like to lose a loved one to a viral infection that, according to the internet, doesn’t exist.  I can’t imagine what it must feel like to be hospitalized and not allowed to see your loved ones.  

I guess I’m not as fed up as I was when I started writing this article. I’m actually feeling blessed to be sitting here with Kenzie and Renee planning out our day.  I’m blessed to be able to silence my TV and play Barbie.  While others are reading crap on the internet, I’ll be learning how to smile from Kenzie and Hudson.

If you’re fed-up, take a lesson from me.  Spend some time with a kid and lose yourself in the innocence of childhood.  Hopefully, by the time you come back to earth, things will be better.

Here’s your song and joke for the day. 

A farmer was fed up with drivers speeding down the road where he lived, so he asked the police to put up a sign…

They put up a “Slow down, speed limit” sign – with no effect. Then, “Danger, road hazard!” sign was put up, but had no effect, either. Then the police tried a sign stating “Children crossing” – and still nobody slowed down.


Finally, the farmer asked the police if he could put up his own sign. They agreed, and to their surprise, just days later a passing officer saw a row of cars moving very slowly past the farmer’s place. The policeman approached the farm, and saw a new, hand-painted sign stating: “Nudist Colony”.

I was watching NBC news this am when I heard a doc refer to herself as a fireman during an interview about the impact of Covid-19.  Further, she referred to her patients as arsonists, constantly pouring gas of the COVID fire and getting burned.

Many years ago, I published, “Fireman,” addressing the same issues. Nothing has changed and people continue to die.  Below is my original article.

As many of my readers know, I often think of myself as a fireman, working to put out fires before they do serious damage.  My patients come in screaming, “FIRE!  HELP ME!”  Unfortunately, many of my patients are arsonists, actively feeding the fire I am trying to extinguish.  Being a doc/fireman can be awfully frustrating sometimes.

As a doc/fireman, I have a variety of fire extinguishers.  My main extinguishers are medications.  Others include an assortment of therapies (physical, occupational, and psychological).  A three-alarm fire requires not only my full assault with the above therapies but the help of others, my consulting group.

Unfortunately, the arsonists I treat often have their own ideas about how they want to put out their fires; and, many times, their unique demands only serve to fuel the fire that is injuring them.

Some patients refuse medications believing that pills are harmful.  It amazes me when a smoker refuses medicinal help due to an irrational belief that pills are toxic; yet, he voluntarily inhales hundreds of known toxins 20 times a day.

Some patients demand medication and shun therapy, even when therapy is a better alternative.  “Doc, I just want my tranquilizer, it solves all my problems.”  Not really!  In many cases, tranquilizers are firewalls, temporarily protecting my patient from being burned by the raging fire.  In the case of anxiety, the psychologist has a much better chance of eradicating the fire than I do.  In the case of a three-alarm blazing anxiety, my deploying medications along with the psychologist’s therapy is necessary.  “Doc, I ain’t seeing no psychologist!  They can’t help me” means just “give me my pills”.  

Using the wrong extinguishers may cause as much harm as just allowing the fire to burn on its own.  Years ago, we had a fire alarm go off in my office.  Firemen streamed through the front door with axes in hand.  Luckily, there was no fire and no ax was used.  Those axes could have caused a lot of damage if used inappropriately.  Giving in to the demand for tranquilizers can lead to a lifetime dependency on those very medications.  Being a doc/fireman can be frustrating.

Still other patients come in yelling “FIRE, HELP ME”, then refuse all treatments.  They want something “all natural.”  What’s more natural than sitting with a therapist, talking about what ails you?  “I don’t want to see a therapist.”  “What about valerian, it’s all natural?”  “Pills”, published earlier this year, addressed these totally unnatural, unregulated, non-FDA approved, manufactured pills.  Despite the fact that no one really knows what’s in the capsule, what effects it may have on an individual, how the body processes it, and how it interacts with other substances the patient ingests, people have really bought into this form of witchcraft.  Being a doc/firefighter can be very frustrating!  By the way, I have a bridge for sale.  It’s all natural, made from wood.  It’s located in Long Grove.  Any buyers?

Being a doc/firefighter can be extremely rewarding!  I saw a smoker who was being consumed by a raging fire.  His ears hurt, his throat hurt, his lungs hurt, and he couldn’t stop coughing.  Just as the real firefighters and paramedics have to deal with victims of fires and just as those victims often succumb to smoke inhalation, my patient had succumbed to smoke inhalation.  His was no accidental fire! He actually lit his fire 20 times a day for the last 10 years!  I put out his fire and rescued him from smoke inhalation.  Once his burns are healed, he will never again smoke.  Why?  The answer is easy.  He loves his wife and children.  He would never cheat on his wife or children.  When I pointed out that he was cheating on his family 20 times a day, the expression on his face was one of horror.  He had never looked at it that way.  Sometimes, you win one!

Attention, arsonist!  Help me help you!  Do not feed the fire that is consuming you!  Help me help you by listening to the wisdom of my 40 years as a doc/firefighter.  Use all the tools available to you.  The life you save may be your own.

PLEASE, WEAR A MASK AND KEEP YOUR DISTANCE!

The doc being interviewed on TV stated that patients hospitalized with Covid-19 still believe that COVID is not real and all they have is a bad case of the flu.  How amazing is that?

The internet has become a powerful weapon, propogating lies and conspiracy theories in such a way that fiction becomes fact and facts get buried in the ground.  Why are we so quick to buy what the internet is selling?  I don’t know why we buy into such obvious crap but I know how we buy in.

Over the years I practiced medicine, I often heard my patient say, “Doc, I ‘ve never been sick. I exercise everyday, I eat right and have a clean family history.  I can’t have heart disease.”  It makes sense that, if you’ve done everything right, you can’t get sick, doesn’t it?  It makes sense that, if you’ve never been sick, you’ll never get sick, doesn’t it?  (If it made sense, then a healthy baby would live forever.)

Everyday on TV, the numbers are posted, the graphs displayed, and projections of future deaths are presented.  At first, months ago, everyone reacted.  Toilet paper and disinfectants disappeared.  As time passed, people developed “Covid fatigue.”  Do you know anyone with Covid?  Are your family, friends or neighbors sick?  When you’re in the grocery store, do people look sick.  The answers to these questions are a resounding “no!”  

Other than seeing masked individuals, the world appears safe.  So, after nine months of Covid, those of us who have yet to be touched by Covid can’t be faulted for questioning the reality behind the pandemic. “Covid fatigue” leads to letting down your guard or worse, to buying into conspiracy theories. “Covid fatigue” leads to the ”It can’t happen to me” attitude that leads to super spreader events.

What’s my point?  CDC and multiple experts are asking us not to get together for Thanksgiving.  They are responsible for the data, graphs and predictions seen constantly on TV.  You have two choices:

1.  Heed the CDC recommendations and say thanks with those in your personal bubble while following the masks, social distancing and handwashing rules; or
2. Have an old fashioned Thanksgiving with extended family and friends and roll the dice.  Odds are you’ll be fine.  Right?

MY ADVICE IS TO HEED THE WARNINGS.  That makes me the bad guy.  The doc that ruined Thanksgiving 2020.  It’s an easy choice for me.  I’m the doc who has cared for patients who died from rare diseases.  I’ve even cared for an individual who rolled the dice and lost, becoming one of seven such cases in the world.

The cure for “Covid Fatigue” is nasty.  Unfortunately, the cure entails experiencing a Covid infection firsthand or seeing family and friends stricken by Covid.  Spending time in the ICU will surely wake you up (if it doesn’t kill you).

Participating in a patient’s first heart attack can be an extremely stressful event. Forty years ago, I was an ER doc.  At the end of a typical shift, I would come home to my wife and, often, would remark about how nervous family docs got when dealing with emergencies like heart attacks.

Many years later, I was the family doc and heart attacks were unnerving.  Yes, I knew what to do.  We had an emergency protocol and handled heart attacks well.  Even though we never lost a soul, it was still unnerving.  In an article published nationally in 2012 I wrote:

Today’s heart attack was textbook perfect.  I’m in room one with a patient.  Three rapid and insistent knocks on the door and the door opens.  “Doc, I need you in room three now!”  The look on Ginny’s face said it all.  The patient in room three was conscious, pale, sweaty, and in pain.  It takes 90 seconds to ask a rapid-fire procession of questions.  Heart attack, for sure.  Rapid fire orders, nurse one brings oxygen, aspirin, and nitroglycerin: all lifesaving treatments in a heart attack.  Nurse two is on the phone with the paramedics.  The front desk gathers information the paramedics will need and won’t have to waste time collecting on their own.

After reassessing vital signs, 325 mg of aspirin are given to the patient.  “Chew this please.  It will taste lousy.”  Oxygen canulas in place, nitroglycerin given.  “You are going to get the worst headache you’ve ever had.  How’s your chest pain?”

Minutes seem like hours, but Lake Zurich’s paramedics arrive promptly.  They go into action.  Monitor, IV’s, EKG done efficiently.  Lake Zurich’s paramedics are, literally, a lifesaver.   Their training, skills, and equipment make them indispensable.  Heart attack confirmed; ER notified of “cardiac alert.”

Time is of the essence as prompt care preserves heart function.  “Cardiac alert” is the equivalent of “Defcon One.”  The cardiac catheterization lab goes into motion.  The on-call cardiologist is notified and is in transit.  The ER gears up for incoming.  As the ambulance rolls into the ER, everything is in place.

When it all comes together, it’s a beautiful thing.  The call comes in from the cath lab.  The patient is stable; the blocked artery is open.  All is well.  I finally can breathe.

Time is of the essence. Paramedics are well-trained (actually, they are incredible) and drive around in a mobile intensive care unit.  If you think you are having a heart attack, stay where you are and call the paramedics.  The minutes you save may well be what saves your life. Remember, please don’t drive.  Please don’t take a “wait and see” attitude.  Make sure you survive your first heart attack by acting quickly.  Then work hard on being healthy so that you don’t experience a second one.

Now, in retirement, it all seems like a dream. In reviewing my past articles, I came across this one.  For the briefest of time, I found myself back in room one.  The young and vital Dr. Segal doing what I was trained to do, doing what I was destined to do!  For that brief moment, I was alive again!  Then reality sets in and I’m old and fairly useless.

I write in hopes that someone who needs care finds it in my words.  My hope is that you, the reader, will share this article with your loved ones and perhaps, since time is of essence, will save another life.

(Editorial note: He is not old and useless.  Yes, we have gotten older; but we are still valuable human beings with vast knowledge from our many years of knowledge, education and experience. Dr. Segal still has much to offer, even if he can’t practice medicine as he did in the office as a younger man.  I thank God every day that he is my man and partner in this journey called “life.”)

Bottom of Form

Why?  Why won’t you tell me why?  I need to know!  If I know, I can help!  I’ve been practicing medicine more than half of my life.  You would think I would know why, but I don’t.

I’m frustrated.  I’ve learned so much, studied so hard and worked all my life to provide the best care I can.  No matter!  Unless I can find this last piece of the puzzle, it may all be for naught.  Why?  Tell me why!

Why won’t you take care of yourself?  Is a little exercise too much to ask for?  Is cutting back on bacon and salt so hard that it’s worth cutting your life short?  Life is so precious!

Why must you harm yourself?  Sure, smoking is an addiction.  Shouldn’t living “well” be an addiction?  Isn’t the risk of cancer enough of a threat?  Tell me why you won’t listen to your body.  You cough every morning.  You’ve been coughing for months.  You want a cough medicine.  You’ll take a cough medicine, but you won’t stop smoking.  Why?

I’m frustrated.  I don’t get it!  You’ll take medicine for your diabetes, blood pressure or emphysema but you won’t take care of yourself.  You’ll suffer through surgery and chemotherapy for your cancer, but you won’t take care of yourself.

Proper diet and exercise is the one prescription you won’t follow.  Why?  Why suffer at your own hand?  Why make your family suffer?  Why?  Please tell me why.

Is exercise really good for you? I’ve spent the last 40 years encouraging patients to exercise on a regular basis.  My brother owned a gym and exercised every day of his life.  He swears by it. I have exercised off and on for years.  I swear at it!

It seems that every time I exercise, I get hurt.  The latest episode started when I started back in physical therapy.  The therapist has me doing bridges and I sprained my right groin and hip area last week doing bridges at home. My gait was already poor from Parkinson’s and the addition of a limp from the right groin sprain has flared my back.  If exercise is good for you, you certainly couldn’t prove it by my experiences. Is it any wonder I hate to exercise?

My brother who has exercised his entire life had a stroke anyway.  Now, if you are a proponent of exercise, you’d say that exercising for a lifetime has allowed him to survive his stroke and recover faster.  You might be right.  (Certainly, exercise did not keep him from stroking.)

On the other hand, some of my patients believe that you have a fixed number of heartbeats to use in your lifetime and that when you run out, you die.  They would argue that exercise uses up their precious heartbeats faster, ending in a quicker demise.  I wish I could agree with them.  By agreeing with them, I could eliminate my need to exercise. (Of course, sex elevates my heart rate.  If they are right, at least I’ll die smiling.) The main problem I have is that if I don’t get back to exercising, my weight will continue its upward spiral and either I’ll have to give up eating or get a crane to help me get into bed.  Frankly, I love eating almost as much as I love sex so I can’t give up eating. I guess I’ll take a walk. 

Eating and napping are the two tasks I have become expert at and the only enjoyable things left since retiring and getting old.  With advancing age, my third love, sex, is starting to resemble exercise.    Renee, it’s time to exercise.  I think I’ve got a few heart beats left to spend!

Here’s your joke and a song. 

The only reason I would take up jogging is so that I could hear heavy breathing again.

WHY?  Over the 40 years I practiced medicine, the most difficult questions to answer were always the “why” questions.  Why me? Why her? Why him?  The what, when, and how questions were straight forward, all you had to do was follow the science.   The “why” questions were the ones that haunt you.  They were also the ones that needed answering the most.

We started asking “why” during our childhood.  Mommy, why is there a moon?  Why do you have to go to work?  Why can’t we have a dog?  If you have raised children, you know what I’m talking about.  In early childhood, whys grow in intensity and while the answers are relatively easy, they are rarely satisfying to the inquisitive mind.  Why? Why? Why? It seems every answer provokes another question.

As we age, most of us become less interested in the why and more interested in the practical solutions to the why.  Confused?  I am.  As a physician/scientist, the “why” is just as important as the who, what, when and where questions.  As a physician, being able to answer the “why” is often critical.  The “why” I referred to above, the most difficult one is the one that starts with “why do I/she/him/they have to have Parkinson’s/cancer/diabetes/stroke/etc?”

Sooner or later, shit happens to most people. For this article’s sake, shit is synonymous with whatever disease ails you. Why me/you/etc. appears to be a universal question and almost never has an answer.  The question, “Doc, why does he have cancer?” is almost always followed by a statement that I can only define as a defense attorney’s summation.  The preamble is, “He is a loving husband, father and the best friend you could ever have.”  This statement is followed by the story of a saint who doesn’t deserve whatever illness is destroying him.  Does there have to be a reason we are stricken?  Did I do something to deserve Parkinson’s?”

As a physician, how do you answer this universal question?  Do you stand silent?  Do you turn to God? Do you apportion blame?  “I told him if he kept smoking it would be the end of him!”  Or do you simply tell the truth?  The truth is that no one knows why!  In reality, each choice is right for someone and figuring out how to console your patient and their family and friends takes a great deal of care.

Personally, I like the concept I learned while studying in Mexico.  In Spanish, the word for why is “Por que?”  The word for because is “porque.”  They are pronounced the same. When I asked my teacher “por que”, the answer as almost always was, “porque”.

Why? Because!”

Why do I have Parkinson’s?  Because!  Why does he have cancer? Because!  I’ve got to believe that getting sick is not punishment for prior acts.  Unfortunately, the real answers await us on the other side, if that exists.

The next few articles will further explore the “why’s” having to do with health.

No jokes today!  Here’s something to listen to.