BROKEN HEART

My niece’s daughter had her Bat Mitzvah today.  Due to Covid-19, we couldn’t be there. What really broke my heart was the group picture they posted on Facebook.  Everyone had mask on.

My grandson, along with millions of other children,. have been in and out of school for the last year.  Hearing my son talk about the damage not going to school has caused his son and his son’s friends just breaks my heart.

Facebook posted a private picture from 5 years ago today.  The picture shows my Bichon, Rocky, dressed in a University of Virginia shirt.  Rocky was suffering from tumors and we had to put him to sleep.  Putting him to sleep broke my heart and seeing his picture today added salt to the wound.

Yesterday, we sat outside on our neighbor’s driveway with 4 other couples.  We had a lot of fun.  This evening, we were walking out the door to sit with our new friends again when my Parkinson’s flared and I became immobile.  Every time I freeze up, it breaks my heart.

Not being able to truly play with my grandchildren breaks my heart.

Knowing that I will spend the next year fighting my weight breaks my heart.

Not being able to dress myself in the morning breaks my heart.

Having a broken heart is common if you’re alive.  Life is bound to suck at times.

The trick is knowing what you need to mend your broken heart.  Renee and I have been married for 43 years.  She’s the best medicine for mending my heart when it breaks.  My children and grandchildren are at the stage in their lives where being with them is a heart saver.

Over the last year, hearing from so many of my former patients soothes and nourishes a broken heart.

My sense is that many of my new neighbors will be there to help as I age and deal with heartbreaking events.  Unfortunately, one of my new neighbors is a foody like me and everything he makes sounds mouthwatering.  The other night he talked about his smoked oysters with love in his voice.  His pickled eggs were yummy, which points out the fact that food can heal a broken heart.  How’s your heart?

A Blessings List is potent medicine for a broken heart.  Do you have one?

Here’s your joke for the day.

A husband and a wife over their marriage had eight kids. One day the husband notices that their sixth kid, Billy, looks very different from the other seven.

The husband goes to his wife and asks her, “Honey, I noticed that Billy looks different from the other children, did you have an affair?”

The wife starts to break down into tears and nods her head.

The husband, heartbroken, quietly asks his wife, “So who is Billy’s father?”

“You.”

THE POWER OF THE MIND

When an old memory returns, sometimes it unveils a lesson, while forgotten, is highly pertinent to today.  Since finding my “Milo,” my attitude has been much better.  My body continues to be a decrepit mess but my reaction to the physical problems has remarkably improved.

Yesterday, I was thinking about a patient I haven’t thought of for years.  I realized that I had used his story many times over the years in order to teach patients how powerful (and potentially destructive) a human brain is.  The story that follows is a true story and one worth telling.

Mr. “X” was a fifty year old admitted to the hospital with a severe bilateral pneumonia, COPD and hypertension.  The first few days were rough and the patient was transferred to the ICU and intubated.  Mr. “X” did well in the ICU and, in short order, was transferred back to a routine medical bed.

On the day prior to his anticipated discharge home, the floor nurse called me, requesting that I come in to see my patient.  She said the patient was crashing and it looked like he was going to die.  I almost laughed.  I had seen my patient around 11 pm the night before and he was fine.  I told the nurse that she needed to double check his vitals and reassess him and that I would be in to discharge him after I closed the office (it was a very busy day).  I could hear the anger in the nurse’s voice building.  She again asked me to come, restating her findings.

I informed the office that I had an emergency at the hospital and hopped in my car.  I was pissed as I was sure I was right and I truly did not need to disrupt my office schedule but I knew the nurse’s skill set and that she was both caring and highly competent.  As soon as I got there, I examined my patient, reviewed the notes, lab and x-ray and determined that the patient was truly at risk of dying and, apparently, dying from nothing.  Everything except the patient was normal.

“X”, I don’t know what’s causing your failing health, but, as we discussed yesterday, I was planning to send you home today.  Now, despite a normal chest x-ray and tests, I may need to move you back to the ICU.”

Mr. “X” responded with, “But Doc, you came in around 1 am and told me to get my affairs in order and that I was dying!”

“In the first place, I didn’t know you had an affair.  That’s a joke. (“X” smiled a little).  I was sound asleep at 1 am.  My expectation was to send you home today.  You are well on paper and dying in person. Now I know why.”

“X” had a vivid dream and was convinced he was dying, so much so, that he was dying.  I told “X” that he had two choices, either believe his dream and die for no real reason or believe me, eat, get out of bed and go home in the morning. He went home the next day.

The mind is a very powerful structure.  My Parkinson’s is not better but the way I am coping with it is better.  A positive attitude can be a powerful natural medicine. a negative attitude can be deadly. Remember Mr. “X’s” story and, one day, it could even save your life.  Remembering it is certainly helping me cope.

Here’s your jokes for the day”

  1. If smoking marijuana cause short term memory loss. . .

Then what does smoking marijuana cause?

  • A man goes to the doctor to report a serious memory loss problem

Man: Doctor, I have a serious memory loss problem

Doctor: Hmm.. and since when did you have this problem?

Man: What problem?

SPOON THEORY

My neighbor sent me an article that she thought might interest me.  The article outlining “Spoon Theory” is excellent.  No matter which disease process you are dealing with, if part of your problem involves fatigue, you should read this article.

Like the author, I had a treasure trove of analogies I used in my practice to help patients and family understand what was happening to them.  Now that I’m a patient, sometimes I have trouble getting friends and family to understand what I mean when I say, “I’m exhausted/tired/fatigued.”  In response to any physical complaint, I usually hear, “You look good.”  As far as I’m concerned, anyone who thinks I look good must be blind.

I’m fatigued all day and night.  I really can nap anywhere and at any time.  If you are healthy, you can’t possibly understand what it feels like to be exhausted after putting on your pants.  Renee usually has to do my socks. Hard to believe?  Absolutely, but real!

My fatigue is multifactorial.  Parkinson’s causes fatigue.  The medication for Parkinson’s cause fatigue.  Fatigue contributes to obesity and obesity causes fatigue.  Sleep apnea, even when treated appropriately, can cause fatigue.  Ever see a dog chase his tail (another useful analogy)?  That’s me!

The treatment for fatigue, Parkinson’s and obesity is exercise. It’s a real life Catch 22!  Yesterday, I saw the gastroenterologist.  I look like I’m carrying twins (maybe I should have seen an OB/GYNE).  Essentially, he said I was fat and he prepared me for a long and arduous battle, fighting the fatigue, further cutting back on intake and resuming exercise.   Had I read this article prior to my appointment, I would have shared it with the doc.

So, what can I do?  “Diets and Other Unnatural Acts” has the answer. It’s time to dust off my book and follow its instructions.  I’m in this for the long hall.  It’s time to stop chasing my tail and make small deposits in my health account on a regular basis.  My goal is to lose just 5 pounds! 

Spring will be here soon!  My grass will green up, trees will sprout leaves and flowers will blossom; and I’ll go for a short walk twice a day, lengthening my walk as I can.   When the pool opens, I’ll swim laps.  Eventually, I WILL hit the gym and, believe it or not, start boxing.  Boxing is good for Parkinson’s.

Here’s your joke for today and a song.

During a visit to my doctor, I asked him, “How do you determine whether or not an older person should be put in an old age home?”

“Well,” he said, “we fill up a bathtub, then we offer a teaspoon, a teacup and a bucket to the person to empty the bathtub.”

“Oh, I understand,” I said. “A normal person would use the bucket because it is bigger than the spoon or the teacup.”

“No” he said. “A normal person would pull the plug. Do you want a bed near the window?”

A STRANGE NEW WORLD

It truly is a strange new world.  While Covid-19 has devastated the world we live in, it has, in a perverse sense, improved the delivery of medical care.  Let me explain.  First, let me state the obvious.  I was a provider of medical care for 34 years.  When I set up my office, my goal was to deliver the best of care, promptly and efficiently on a walk-in basis.

I failed!  “Prompt and efficient” went out the window with lengthy registration processes, insurance demands and government regulation.  I dreamed of creating a system that would allow a patient to walk into my office, be seen immediately and leave with a smile on his/her face.  While I knew it wasn’t possible, I strived to create such a system.

What I couldn’t accomplish, Covid did.  Yep, last week I went to the surgeon’s office to have a curative office surgery.  My appointment was at 11 o’clock.  I registered from home the day before.  I entered the lobby at 10:45 as directed by her office staff, had my temperature taken, signed two papers and was in the surgical suite at 11.  The doc came in at 11:08 and I was out by 11:42. I had a smile on my face that no one saw due to my mask.

Yesterday, I went to the dentist for fillings.  Again, I registered the day before online.  As instructed, I texted the office to let them know I was in the parking lot.  At 9:20, I received a text asking me to come to the front door as they were ready for me.  I paid in advance as I do not have dental insurance and was in the room at 9:30. The dentist came in at 9:40 and filled two teeth.  While I don’t like the business practices of this practice, I understand them.

Today, I have an appointment with the GI specialist.  Yes, I’m not aging well.  Again, I’ve preregistered and fully expect that they will be on time and smiling.  So how did Covid accomplish what I could not?  Covid’s 500,00 death toll, the six foot social distancing rules and the masking mandates have scared the crap out of everyone.

I used to scratch my head and wonder why many of my patients came in so early for such trivial, self-limited illnesses.  Those patients no longer come in.  Telemed has supplanted office visits.  While I loved seeing my patients no matter whether they should have been seen or not, I, like other physicians, would be scared to see them in a Covid world.  So, the volume of office patients has decreased.  The lobbies of the physicians I’m seeing are empty due to Covid.  In most cases, less demand means more availability and happier patients.  And, when it takes a month to get an appointment with a super specialist, people are more understanding as the staff can now blame “Covid Precautions.”

Finally, the software companies have gotten their acts together and provided working platforms for preregistration, making the necessity of doing 20 minutes of paperwork in the office a thing of the past.  I’ve also noted that the front desk personnel in my doctors’ offices are much friendlier and relaxed than mine was.  I should tell you that my staff was the friendliest, caring individuals you would ever want to meet. At least that’s how they were the first 15 minutes of every day.  After that were yelled at because patients had to fill out paperwork or because they had to inform patients of overdue bills or because there was a long wait (all things they couldn’t control), they tended to be less friendly!

Hopefully, Covid can be conquered and eradicated.  Hopefully, when Covid is gone, it will have left behind a better way of delivering care.  I never thought I would say this, but Telemed is an efficient and appropriate of delivering care for the more minor, self-limiting illnesses.  Using technology to register patients, in advance, will shorten your time in the doctor’s office. And, hopefully, when the masks come off, there will be more smiles.

Nonetheless, when I go to the doctors’ offices, I carry paperwork.  Today will be my first visit with this gastroenterologist.  I will give his nurse print outs of my medication list, past medical history, social history, allergies and review of systems (my complaints).  I also have copies of my former GI’s notes and studies.  The problem with computers is that, on occasion, they crash.  Paper doesn’t.

The moral of today’s article is that, if you can find something good in something bad, the bad is not quite as bad.  The second lesson is that, when you do go to the doctor’s office, give them a summary of your health history on paper.  It may be invaluable and, perhaps, save your life.

Here is your daily joke and some music.

A woman and baby were in The doctors examining room, waiting for the doctor to come in for the babies first exam.

The doctor arrived, and examined the baby, checked his weight, and being a little concerned, asked if the baby was breast-fed or bottle-fed.

‘Breast-fed,’ she replied.

‘Well, strip down to your waist,’ the doctor ordered.

She did. He pinched her nipples, pressed, kneaded, and rubbed both breasts for a while in a very professional and detailed examination.

Motioning to her to get dressed, the doctor said,

‘No wonder this baby is underweight. You don’t have any milk.’ ‘I know,’ she said, ‘I’m his Grandma, but I’m glad I c

THE MAN IN THE MIRROR

It’s 1:30am and my incision hurts enough to wake me up.  In addition to the pain in my surgical site, I’ve got miserable indigestion.  Careful not to wake Renee up, I rummage through the medicine cabinet and find the TUMs.  That’s when it happened.  I looked in the mirror.

Who the hell is that?  I know I am the only person in the bathroom but there is somebody else staring me in the face.  I wink and the image in the mirror winks.  I smile and the image smiles.  No, I’m not hallucinating!  Yes, the image I’m looking at is me.  The question is how I got to the point that I didn’t recognize myself in the mirror and what am I going to do about it.

Yesterday began as usual, I opened Facebook and went to my high school page.  My graduating class has been very active online and it’s fun to read about who is doing what and see photos of people you haven’t seen in years.  The first picture up yesterday was Jodi’s.  Jodi was my first-grade crush and I’ve never forgotten her.  I’ve also never corresponded with her.  It was Jodi’s birthday so I sent her a brief “happy birthday from an old friend.”

Next, I received a message from Elaine. Elaine read my note to Jodi and wrote me a note.  She thought I was in her first-grade class at Town and Country and I reminded her that she was in my kindergarten class but that I went to Suburban Park Elementary School for first grade.  I have a picture of my kindergarten class in Robinhood costumes with tap shoes on (Elaine has the same picture).  A conversation ensued transporting both of us back in time.

I’ve been reliving my youth through Facebook and it has been enjoyable.  Frankly, I’m amazed that I survived growing up.  My nickname in college was Milo.  Milo was a character in the book, “Catch 22.”  Milo was a wheeler dealer who could fix anything. The younger version of me had been described as a bull in a “china shop.”  There was nothing I couldn’t accomplish.  When I didn’t get admitted to a US medical school, I got in my car, drove across the US and Mexico and registered in medical school in Guadalajara, Mexico.  Later, when I wanted to open the office, Renee and I were broke so we turned to the banks for a loan to open LZFTC.  Seven banks turned us down.  The eighth granted our loan request.  I believed that, if there was a concrete wall blocking me from what I needed, all I needed to do was knock down the wall.  In fact, every time a wall was placed in front of me, I’d hammer at it until it came down.

So, how did I get to the point that I no longer recognized the man in the mirror?  My father and his father had Parkinson’s and Parkinson’s was the boogeyman hiding in my closet.  Rather than confront the bastard head on, I pulled my covers over my head and hid from him.  When the boogeyman actually showed up, “Milo, the Bull” disappeared and the little kid who was afraid of the monster in the closet showed up.  Frankly, the boogeyman had his way with me.

My trip down memory lane reminded me of who I was; and, once my memories of Milo surfaced, I could see vestiges of Milo in the person in the mirror.  It’s time to give birth to Milo version 2.0.  It’s time to look the boogeyman in the face and lock him in the closet. 

A lot of damage has been done, much of which is irreversible.  What is fixable is my attitude.  It’s time to make the most of what is left of me.  In future articles, you will see less of my self-pity and depression and more of Dr. Segal and his healthy, helpful advice. 

Today’s advice:  Don’t eat between meals.  Set up a fixed schedule for meals and stick to it.  Fast at least 12 hours nightly.

Here’s your music and a joke.

Sherry lost her husband almost four years ago and still hasn’t gotten out of her mourning stage. Her daughter constantly urges her to get back into the dating world. Finally, Sherry says she’ll go out, but doesn’t know anyone.

Her daughter immediately replies, “Mama! I have someone for you to meet.”

Well, it’s an immediate hit. They really like one another and after dating for six weeks, he asks her to join him for a weekend in the mountains.

Their first night there, she undresses as he does. There she stands nude except for a pair of black lacy panties, he in his birthday suit.

Looking at her he asks, “Why the black panties?”

She replies, “My breasts you can fondle, my body is yours to explore, but down there I am still in mourning.”

Obviously, he knows he’s not getting lucky that night.

The following night the same scenario. She’s standing there with the black panties on, and he is in his birthday suit…except… that he has a black prophylactic over his manhood.

She looks at him and asks, “What’s with the…uh…black prophylactic?”

He replies, “I want to offer my deepest condolences.”

Read more on page: http://www.jokesoftheday.net/joke-Black-Panties/2013022640

AHA

I had an AHA moment this am.  Two things came together provoking the AHA I moment.   The first came while watching “Halt and Catch Fire” on Netflicks.  The show is all about the creation of the early computers and the internet.  In today’s episode, a husband and wife were communicating, long distance, over a dial up line.  Do you remember sitting at the keyboard, typing messages to friends or loved ones, over a dial up line?  Long distance calls were expensive, computers were novel; so I guess it made sense.  Before I left my parent’s home in Norfolk to drive back to Charlottesville, my mother always made me promise that I would call her when I arrived safely.  I would dial the operator and tell her I wanted to make a collect call to my parent’s home.  The operator would call saying, “I have a collect call from Iam Okdookie, will you accept the charges?”  Naturally, my mom would say no, hang up and tell my father they could relax.  “Stewart called, he’s back at school.  Do you remember collect calls and using a bogus name to save money?  Can you still make a collect call?  If you get a collect call from Jack Mehoff, it may be me.

The second event that provoked my AHA moment occurred while I was reading my cousin’s response to yesterday’s blog.  Despite the fact that long distance calls are now free, we still sit at the keyboard and carry on conversations with others rather than calling.  So much is lost when you can’t hear a person’s voice or see his/her face.

My AHA moment was when I recognized that the internet is a great way to communicate with the masses and a horrible way to communicate with individual friends and family.  So, I’ll keep writing my blog, sharing my ideas with as many people as I can and I’ll call (or Facetime) my cousin tonight. I’ll send less personal email and make more phone calls.

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

On the Internet you can be anything you want.

It’s so strange that many people choose to be stupid.

TRANSITION TO DEPENDENCE

OMG!  I thought when I retired, the stressful decision making that a family physician is tasked with (on a daily basis) would go away.  OMG, it doesn’t.  My workday started at Good Shepherd Hospital around 6 a.m.  Patients needed admission workup, specialist consults ordered and reviewed, plans (sometimes lifesaving) formulated, and orders written.  Then it was off to the office for a day of decision making as simple as ordering an x-ray for a smashed finger or as complex as dialing 911 and starting CPR. 

Wouldn’t you think retirement would lessen the decision-making load/stress?  OMG, it doesn’t. My work day starts at 6 a.m. It’s 12:30 p.m. now and I’ve already been stressed deciding what to eat for breakfast and lunch. Renee did a great job making a cheese and ham omelet for breakfast and heating a can of soup for lunch. Now, I have to tackle the really big decision: what to do for dinner.  Do I thaw some chicken?  Do I go to the grocer with Renee and get some fresh beets and chuck so I can teach her how make a hot borscht?  Or do we order in food from a local restaurant and have Uber Eats deliver it?

Then there’s the really, really critical question.  After I’ve decided what we are going to eat, will my body allow me to make it?  Some days it will, most days it won’t.  While I’ve always been the chief cook and bottle washer, Parkinson’s is eroding my ability to shop/ cook and, OMG, led to dumping these tasks onto Renee’s shoulders.

Yes, my hardest decision is whether I can go shopping, prep and cook meals and work around the house, or if I should stay home and leave it all to Renee.  I still have some good days.  The problem is a good day can turn bad in an instance.  In most instances, transitioning from independent to dependent is not easy.  Thank God, I’ve got Renee!  So far, she’s taken over bathing and dressing me.  I’ve got to admit, turning over bathing responsibilities to her has been enjoyable.  The dressing part is not fun.  More and more, she is taking over shopping and cooking (and everything else).

So, I’ve promised myself I would concentrate on the positives.  When I no longer can shop and cook, I’ll have more time to plan and execute my napping protocol.  I am the best napper you’ve ever met.  My napping protocol goes like this:

  1. Fall asleep in lift chair
  2. Wake up in lift chair
  3. Decide if Renee is up for a little whoopy
  4. If she is, it’s a good day
  5. If she isn’t, open the fridge and snack a little
  6. Resume napping

Then start all over again!  So, as promised, I’ve ended on a positive note. 

Here’s your music and a joke.

Little Sandy always slept through her Sunday school classes.

One day the teacher called on her while she was napping, “Tell me, Sandy, who created the universe?”

When Sandy didn’t stir, little Bobby, seated behind her, took a pin and jabbed her in the rear.

“GOD ALMIGHTY!” shouted Sandy and the teacher said, “Very good” and Sandy fell back asleep.

A while later the teacher notices Sandy with her head down again and asks, “Who is our Lord and Saviour?” But, she didn’t even stir from her slumber.

Once again, Bobby came to the rescue and stuck her again.

“JESUS CHRIST!” shouted Sandy and the teacher said again, “very good,” and again Sandy fell back to sleep.

Then the teacher asked Sandy a third question.

“What did Eve say to Adam after she had her twenty-third child?”

And again, Bobby jabbed her with the pin.

This time Sandy jumped up and shouted:

“IF YOU STICK THAT FUCKING THING IN ME ONE MORE TIME, I’LL BREAK IT IN HALF AND STICK IT UP YOUR ARSE!!”

WHAT TO DO

A friend asked me what I thought was the best treatment for prostate cancer.  He had researched all of the available options on the internet and was confused.  I told him that, several years ago, I went through a prostate cancer scare.  I, too, was confused!

The treatment for prostate cancer varies depending on the type of prostate cancer present, the physicians treating you, and your own personal needs and wishes.  For many men, the fear of the potential aftermath of treating prostate cancer is greater than the fear of the cancer itself.  The options available at the time I retired ranged from a “watchful waiting” approach to radical prostatectomy and hormonal therapy.  Options also included laparoscopic surgery and radiation treatment.

I used to give my patients four referrals: one to a University of Chicago professor who was famous for open, radical prostatectomy; one for a local urologist who had done more laparoscopic surgeries than anyone else in the area; one to meet a radiation oncologist; and lastly, one to a prostate cancer support group.  Armed with firsthand knowledge of their options, most patients were able to find a treatment option that satisfied their need.

While most patients were able to decide on an approach to treating their cancer, almost all remained highly anxious about the possible aftermath.  Tell a man that you are going to cut out his prostate and he’ll schedule the surgery.  Tell him that he may not be able to get an erection or that he may be incontinent and he will leave your office as fast as he can and put off whichever treatment he had decided on.

The reality is that most men do well with whichever approach they take. Post treatment physical therapy and the Viagra class meds have been very successful in treating the aftermath.

So, how did I help the patient who couldn’t make a decision?  I asked him which specialist did he like/trust the best.  Once he identified the physician he felt safest with, then the decision became a slam dunk.  Simply follow your physician’s advice and let him/her care for you with the approach he/she gets

the best outcome from.

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

When I was a teen, my dad showed me a 30 minute PowerPoint presentation on why one should always wear a condom during sex.

All the slides were just pictures of me.

CONCENTRATE ON THE POSITIVE

I know I’ve mentioned how much I miss living in Long Grove; but, after looking at the weather report, I’ve changed my mind.  It’s 3 degrees in Chicago and 39 degrees here.  There is snow on the ground in Chicago.  There is grass on the ground here.  On a day like today, I’m glad I moved.

Realistically, it matters not where I live as Covid 19 has limited my excursions.  Indoors in Indian Trail, NC is the same as indoors in Long Grove.  Yes, I miss my former neighbors, my favorite restaurants and stores; but, in my new abode, I have new neighbors to get to know.  My Covid-19 weight gain of 40 pounds turns the loss of my favorite grocers and restaurants into a blessing.

I’m working hard on finding the positives in life, pushing the negatives away.  Three nights ago, one of my dearest friends, Susan, was texting with me.  Susan is like a sister, having grown up with me in Norfolk.  My earliest memories include Susan.  Anyway, I was in a dark mood having had a very bad day (trouble walking) when Susan asked me if I was suicidal.  Truthfully, I was not!  Her question shocked me and made me assess the effect my foul mood has on others.

Everyone I know is dealing with depression.  Many will not admit it, most try to hide it.  Hiding depression and negative thoughts is the worst thing you can do.  That’s why I write.  Sharing depression with others can be almost as bad.  That’s why I’m writing this article.  Writing is my therapy.  I have to be very careful that my therapy doesn’t negatively impact you, the reader.  If it does, please drop me a note or call.

By the way, it has been my experience that patients, intent on committing suicide, will not admit to it.  Pay attention to your “gut”.  If your “gut” is telling you that a friend or family member is at risk of committing suicide even though they deny it, be vigilant, caring and do whatever you can to protect and support them.  At the same time, recognize that, no matter what you do, you can not stop them from killing themselves if they are determined to do so.

Here’s your song and joke of the day.

What’s the difference between a G-spot and a golf ball?

A man will actually search for a golf ball.

What is 6 inches long 2 inches wide and makes everyone go crazy?

$100 bill.

How do you spot a blind man on a nude beach?

It’s not hard.

“GUT FEELING”

Apparently, I was pretty bright at one time.  Last night, I was talking to one of my former patients when she reminded me of some of the advice I had given her over the last 36 years.  At the top of the list of advice that had served her well over the years was my offering to teach her enough about her body so that she would be comfortable knowing whether she should be seen by me or not.

It was my belief that a portion of every visit to my office should be an educational event. I believe that the more patients know about themselves, the healthier they would be.  One of my favorite lessons was teaching patients to trust their “gut” feelings.  “Gut” feelings are really based on a person’s inherent knowledge of themselves. 

You’ve lived a lifetime in your body.  Even if you are a typical male and ignore your body, subconsciously you learn how it feels and, if prompted by your doctor or wife, can recognize imbalances and abnormalities.  Over the years, I’ve made multiple brilliant, sometimes life-saving diagnoses, by believing my patients “gut” feelings.  My best was a young lady whose complaint was vague, “something is not right in my head.” She had no physical findings and no real symptoms of disease other than just not feeling normal.

Her “gut” was telling her something bad was happening to her.  I told her I could not find anything wrong but I pay attention to the “gut” so I would get a CT of her brain.  In the early years of my practice, I could actually order a test and have it done without talking to the insurance company. The aneurysm was found in time and surgically repaired.  She is still alive and kicking.

In today’s medical world, in order to get any test done, you must justify it to the insurance company.  “The patient’s gut is telling him/her that something is wrong” just doesn’t cut it. Nonetheless, follow your “gut” and tell your doc what’s going on.  Understand that your doc has limits to what he/she can do without sufficient findings but that, if necessary, you always have the choice of paying cash for non-covered tests.

I know that CTs can be expensive and money is always tight.  Insurance companies never say “no” to a test, they simply say they are not going to pay for it.  When it comes to a bad, leaky roof, most people will find the money necessary for a new roof or repairs even if they have to borrow it.  When it comes to their body, most patients will not do necessary tests or repairs on their bodies if the insurance company refuses to pay.  I’ve got to admit, I’m “most people” some of the time.  I’ll assess what the value of the intervention is, the risk of not doing it and the cost and,  on occasion, skip the intervention and save the money. 

Inbrija is an inhaled levodopa used by patients with Parkinson’s for its rapid onset of action and its ability to quickly relieve symptoms.  Levodopa is a very old medicine (fairly cheap); but because Inbrija is a modern remake of levodopa, its manufacturer charges a fortune for it.  My co-pay is $16,000 a year.  LOL! On average, for $16,000 a year, Imbrija will improve my motor function 15 minutes quicker than the pills I’m currently taking, which cost $240 a year.  I’ll just have to wait for my old medicine to kick in.

Here’s today’s joke.

A cop parks at the bottom of a bridge, waiting for a speeder. He pulls a man over for doing 40 over the speed limit, and says, “Son, I’ve been waiting for you all day.”

The man quickly responds, “Well, I got here as fast as I could!”

Here’s today’s music.

👍🏼