MEDITERRANEAN DIET

According to an article published in “The Journal Of The American College of Cardiology,” a meta-analysis (scientific review) of 50 studies including 535,000 patients showed major health benefits from being on a “Mediterranean Diet.”  Among the benefits of this diet are:

  • Improved systolic and diastolic blood pressure
  • Improved levels of HDL cholesterol
  • Improved triglyceride counts
  • Lower blood sugar levels
  • Improved waist circumference.

The “Mediterranean Diet” is rich in vegetables, fruits, whole grains and healthy oils, such as olive oil.  A handful of nuts daily are an added bonus.  Red meats are limited to a few servings a month.  Eating fish and poultry at least twice weekly is advised.  Another bonus is the diet allows for the ingestion of moderate amounts of red wine.

I have addressed diets in numerous previous articles and will continue to do so as an appropriate diet is a mainstay of “Living Wellthy.”  The foundation of the “Living Wellthy” lifestyle encourages you to invest in your physical, nutritional, emotional and spiritual health retirement funds with the same fervor that you invest in your financial retirement fund.  You should set a long-term goal for your nutritional account and that goal should be the healthiest diet that you can maintain long-term. 

The “Mediterranean Diet” and others that I will write about in the weeks to come should be viewed as potential goals that can be realized by careful planning and sculpting of your current dietary habits.  Remember, your diet is based on your family’s dietary habits, your national and religious heritage and your personal likes and dislikes.  Your diet has been around for a long time and is, essentially, encased in concrete!  Rather than trying to radically change it overnight, slowly chip away at it and mold it into something much healthier.  Remember, the life you save may be your own. 

FALLS

Have you ever called someone a DORK?  I have!  Do you know what a dork is?  According to the Collins English Dictionary, “If you say that someone is a dork, you think they dress badly in old-fashioned clothes and behave very awkwardly in social situations.”  Further, Collins states a dork is “a dull, slow-witted, or socially inept person.”  As of today, there is a new definition of DORK.  According to the Segal Dictionary, I’m a DORK.

Let me explain.  Between my massive belly, quadruple chin and beige grandma support hose, I’ve been approaching dorkdom.  Today, Amazon delivered my protective shorts.  Last week, I watched one of the members of my Rock Steady group fall.  I’ve fallen several times as well.  Despite my CRS, I remembered seeing a study showing that protective shorts were padded over the hips, back and buttocks and prevented breaks associated with falls.  I ordered a pair.  With my natural abdominal padding (fat) and bulges over my hips, buttock and thighs, I’ve crossed the line into the land of dorkdom. Add the support hose and I’m the king of dorkdom.   

Now that you have the picture I’ve described above, add one more item.  Occasionally, I have to swat at the fly-like floater that races across my visual field.  That action makes me look like a dangerous dork.  On days I go to Rock Steady and wear my protective shorts, I assume anyone who sees me will turn and walk in the opposite direction.

Of course, there is a silver lining in any cloud and my protective shorts make me look like I have a big package.  Now that I’ve completed painting a picture of what I look like, you can take a minute to puke and then I’ll get to my point.  The point of my self-deprecating article is that falls are common, as are fractures associated with falls and nobody except dorks where padded pants. I would rather look like a dork than have a broken hip.

If someone in your family is at risk of falls, buy them a pair of padded pants or shorts.  If they balk, have their doc review the care of a broken hip or wrist, etc. with them.  Hip fractures don’t just hurt, they can kill.

Now for a joke or two:

My wife told me she’ll slam my head on the keyboard if I don’t get off the computer. I’m not too worried, I think she’s jokinlkjhfakljn m,.nbziyoao78yv87dfaoyuofaytdf

My wife and I have reached the difficult decision that we do not want children. If anybody does, please just send me your contact details and we can drop them off tomorrow.

It turns out a major new study recently found that humans eat more bananas than monkeys. It’s true. I can’t remember the last time I ate a monkey.

PARTNERS

Yesterday, one of my neighbors and his wife stopped by to say hello and invite Renee over for tea with the girls.  This was the first time we had gotten together with this couple and it was a delightful experience.  For the purpose of this article, I’ll call him Mr. G for genius (and because I can’t remember his name right now).

In a short time, I discovered that G is a teacher, author and musician.  As is the usual for older people, the conversation drifted toward the medical field and G talked about the importance of having a physician for a partner in the management of his health.  I want to thank G for coming up with the idea for this article.

In past articles, I’ve discussed the doctor-patient relationship.  In my mind, the doctor-patient relationship was a sacred bond, every bit as sacred as that of a holy man and his congregants.  At least, that was the way I used to look at it.  Having transitioned from a doctor to a chronically ill patient, my new viewpoint has shifted (with the help of my new neighbor) and I’ve discovered a new truth.

I now believe that the doctor-patient relationship needs to be redesigned and called the Patient-Doctor Relationship.  Changing the order of those two words makes a huge difference.  In both versions, there is a partnership formed between doc and patient.  The difference is who is the managing partner.  From where I stand today, I can tell you that the patient should be and should have been the managing partner.

Yes, my role should have been strictly as a consultant, advising my patient in all medical options and consequences of those options (informed consent).  Therefore, the patient’s role should be to make the ultimate decision of what he/she was going to do.

One of the great mysteries of medical practice has always been the patients who both sought my advice and then ignored it.  Perhaps, had I given them the role of managing partner, they would have chosen differently. I know that, in my new role of patient, I am more likely to listen and follow my doc’s advice if I am in control, as opposed to if it is an edict from on high.

Being in control of yourself is extremely important on multiple levels.  My most feared consequence of Parkinson’s is loss of control over myself and my affairs.  Doctors beware, do everything possible to leave your patients in control for as long as possible!  Patients beware!  If you have a disease that will ultimately steal your ability to control your own life, make sure that, while you are in control, you leave detailed instructions for who is going to take control of you and how you want them to proceed.

Personally, if Parkinson’s dementia or some other disease takes away my ability to control my own life, my orders will be to let me die a natural death.  In the old days, we died from natural causes as we had no treatment for much of what ails us.  Accordingly, a natural death means that all treatments/medications are stopped.  In modern times, we treat everything and keep patients alive at all costs, moving them into long term care facilities where they languish, awaiting their death which we hold at bay.

Now, we really need a joke to get the foul taste this morbid paragraph leaves behind out of your mouth.

“He’s so old that when he orders a three-minute egg, they ask for the money up front.”—MILTON BERLE

A worried father calls the family doctor because he thinks his teen son has caught a venereal disease.

“I think he got it from the maid,” says the concerned dad, “and I’ve also been sleeping with the maid.”

“Okay,” the doctor replies calmly. “Well, when you bring him into the office we’ll take a look at you as well.”

“And that’s not all,” the father continues. “I think I might have given it to his mother.”

“Oh, no!” cries the doctor. “Well, now we might all have it!”

“Everything that used to be a sin is now a disease.”—BILL MAHER

FLOATERS

I’ve heard about floaters my entire life.  My parents had floaters, as did many of my patients.  My brother describes his as a fly that constantly crosses his visual field.  Having never had one, I could not appreciate the amount of distress a floater could cause.

I have written about my imaginary wheel of medical misfortune (wmm) before.  It seems that my wmm has various body parts on it; and every morning the wheel spins and whichever body part it lands on is the thing that is going to bother me the most that day.  Last week my wmm landed on my right eye and I got to experience my first floater.  It freaked me out!  A thin twisted worm started crawling across my visual field and it’s driving me insane.

Lucky for me, I already had an appointment on the books to see an ophthalmologist this week.  Unfortunately, yesterday I got more floaters and some bright flashes of light.  The two findings together represent a major threat to my vision.  I talked with the ophthalmologist on call and he is going to see me this am.  I’m on my way out the door now and I’m scared.  The lesson today is that you only have two eyes and if one or both malfunctions, be seen immediately. While common, floaters may represent trouble.  Bright flashes can be a real threat.  A curtain over your visual field or loss of vision is an emergency. 

I’m back. The eye doc did a thorough exam and my retina and pressures are fine.  I just have a maddening floater that may or not go away. Most floaters are benign, as is this one.  That damn wmm is going to be the end of me.  Meanwhile, I’m so fat that my fat has fat.  The technician could not get the equipment close enough to me to measure my intraocular pressures.  My belly was in the way.

As Mr. Wonderful likes to say, “If you fall down ten times, get up eleven times.”  I’m up again!  Part of my weight is definitely fluid retention.  I’ll start  a fluid retention study tomorrow.  I’ll record intake and output as well as salt consumption and see my gerontologist for further testing next week.  I’ll persist demanding an answer and most probably we will find one.  If not, then it’s back to Illinois to see my former docs.

Here’s your joke for the day:

After lunch today, Renee said, “Hey, you have something on your chin… no, the 3rd one down.  I found it but it was on the fourth chin.

LEADER

In an article published this week on KevinMD, Dr. Kevin Lamb put forth his 10 commandments of a “Servant Leader.”

1. People are your most precious resource; take care of them.

2. “Clothe yourself with humility.”

3. Eat and sleep last. (Your people’s needs come before your needs.)

4. “Open wide your heart.” (Being transparent.)

5. Trust is the foundation of all relationships.

6. Make a difference each day, one life at a time.

7. Encourage, teach, and mentor every chance you can.

8. Every day is a good day, and some days are better than others. (Having a positive attitude.)

9. Listen more and talk less.

10. Learn to follow. (Much about leadership, both good and bad, can be learned in being a follower first.)

I particularly liked number ten.  When leaders forget how to follow, they often lose touch with the people they are leading.  Many of our governmental leaders have been in politics so long it appears they have lost touch with reality. They argue over whether a relief check should be $1,200 or $1,600, while the people who need the money the most starve.

From earliest childhood and throughout life, leaders helped shape my future.  I’ve written on multiple occasions about the teachers and mentors I’ve been blessed to have had, as well as those teachers who were curses.  Dr. Lamb’s ten commandments should be required reading for teachers and mentors.

While I’m on this subject, teachers should be among the highest paid professionals.  Their role in society is critical and, unfortunately, often undervalued.  We trust them with our children’s future.  A good teacher can turn a child’s desire to learn on while a bad teacher can do the opposite, perhaps even stunting a child’s ability to learn.

I’ll end with the sixth commandment, “Make a difference each day, one life at a time.”  Even if you are not a teacher or mentor, work everyday of your life to make positive differences in every interaction you have.

Now for a few jokes:

Homework is the teacher’s way of knowing how smart the parent is.

Giving your kid a recorder and telling him/her to go home and practice is the teacher’s way of getting revenge for society under paying them so much.

Teacher – There is no such thing as a stupid question.

Student – Are sharks just men dolphins?

Teacher – OK, I was wrong.

PRIVILEGED LIFE

I had no idea I lived such a privileged life.  Afterall, I only have one life to live; and I lived it well, as did my patients and friends.  Living in Illinois was like being in a giant, plush cocoon.  I worked hard, played hard and enjoyed life to its fullest until I got sick.  Even then, I didn’t fully appreciate how good I had it.

In June, I moved to North Carolina.  My safe, plush cocoon ruptured.  I found myself in a foreign land, devoid of the privileges I had come to expect.  The first cold hard slap across the face was when I entered the medical world as a patient, devoid of my former credentials.

I loved being a doctor.  I hate being a patient.  I have to admit my shift in roles has taught me some very valuable lessons but has come at a cost.  No longer can Dr. Segal get put through to his doctor.  No longer does Dr. Segal get instant appointments.  My left hand is killing me.  I need surgery.  I’ve needed surgery for 2 months and my appointment is in mid-May.

Today, my car needs service.  Renee and I are supposed to go on the road this afternoon to dine with an old friend.  Motorwerks would have told me to come in ASAP.  They would have had a loaner for me. It’s time for a brief story.  One of my first patients was in for a URI.  He asked me if I had seen the new BMWs to which I replied, “No, and I’m not in the market for a new car.”  He handed me the keys and said “just drive it around the block once.  It’s outside.”  It was a slow day so I took a ride with him.  When we got back, he said, “Why don’t you take it home tonight?  Have some fun.”  That started a long love affair with BMWs.  Anyway, after multiple calls to the dealer here, I finally got them to agree to look at the car today.  They say the squeaky wheel gets the grease.  I squeaked loudly this am. 

Next, the homeowner’s association is responsible for lawn upkeep.  Their gardeners are sloppy, moving whatever they want to wherever they want it and never putting it back.  Complaining falls on deaf ears.  Thank you, Jason and John.

Lastly, I was privileged to be part of the finest families and community I could ever find.  Sure, my new community is great but there is nothing better than knowing and caring for multiple generations of the same families.  My professor at UVa once said, “If you want to be successful at any new venture, find a brand-new McDonalds and open up next door.  In 1984, there was a brand-new McDonalds right across the street from a brand-new Burger King; and Dr Best was right.  Lake Zurich grew into a thriving young community and then aged with me.

My list is a mile long.  There are two important points I want to make in this article.  One, be thankful for the people in your community who make your life easier; and two, thank them profusely!  Thank you everybody who made my Illinois cocoon a safe and comfortable.

I miss all of you!

Here’s your joke for the day:

A thief breaks into a house and finds a man and a woman home.  After tying them up, he demands that the man give him all his money and valuables.  The man starts to cry and pleads with the burglar, “Please, just untie her and let her go; and I’ll give you anything you want.  The thief was moved by the man’s pleas and says, “Wow, you must really love your wife.”  The man answers, “Not particularly, but she’ll be home any minute now!”

LONG HAULERS

In a recent internet article, Dr. Lydia Segal starts by stating, “What I write today is true today. New information is rapidly emerging and updates are forthcoming when relevant.”  No, I don’t think Lydia is related to me but, after reading her article, I would gladly claim her as a relative if I could.

Dr. Segal’s article is about “long Covid or long haulers,” a poorly understood entity wherein people who have recovered from Covid have persistent symptoms greater than 28 days post infection.  Their symptoms last 4-6 months on average and may be improved with the administration of mRNA vaccines.

Despite over 550,000 deaths from Covid, despite the existence of long haulers, despite post Covid depression and PTSD, there exists a large group of individuals who continue to believe that Covid is a governmental hoax perpetrated on the worlds’ population for some nebulous reason.  Some of these individuals are my friends. The only thing I know for sure is that Covid is real.

Covid is unlike any virus I’ve ever seen and is extremely dangerous.  Being vaccinated against Covid is critical and the doubters who spew their garbage theories on the internet could be labeled as bioterrorists.  My fear is that negative publicity surrounding the J&J vaccine will be used by the doubters to dissuade individuals from getting vaccinated.

Those of you who got their yearly influenza vaccine in my office will remember reading and signing an informed consent form prior to being vaccinated.   If you were one of the few who read the form, you will remember that 1 in 1,000,000 patients receiving the vaccine would get Guillian Barre Syndrome and that GBS was fatal in a number of cases.  I never had a patient refuse the flu shot because of the 1 in 1,000,000 life threatening risk.  The risk of the J&J vaccine is miniscule; and taking the J&J vaccine, if it is your only choice, is certainly acceptably according to NIH.

I wish Covid was an elaborate farce. It is not. Covid is a nasty adversary.  Please don’t let your guard down.  Get vaccinated!  The life you save may be your own.

Here’s today’s joke:

A woman told her friend, “I feel like my body has gotten totally out of shape, so I got my doctor’s permission to join a fitness club and start exercising.” She said, “So, I decided to take an aerobics class for seniors. I bent, twisted, gyrated, jumped up and down and perspired for an hour. But, by the time I got my leotards on, the

SPRING CLEANING

My neighbors are working around their houses: planting, painting and prepping for summer.  After all, their houses shelter their bodies, providing comfort, safety and sustenance.  While houses are built to last a lifetime, they need maintenance and, if you use my neighbors as examples, tender, loving care!

Your body is built to last a lifetime, as well.  Your body shelters your soul!  It, too, needs tender loving care!  The following article is one of my favorites.  Short and sweet.

WHAT’S EASIER?

What’s easier: caulking and painting your house’s exterior or letting it rot and eventually replacing it? The answer is simple, isn’t it?

What’s easier: checking and replacing the brakes on your car when they are worn or dealing with the carnage when the brakes fail? Again, the answer is obvious!

So, what makes sense: taking care of your body by eating the right foods, exercising and seeing your doc for yearly physicals and routine maintenance or letting your body go to fat, your belly sag over your belt and your muscles atrophy from disuse. The answer should be obvious, shouldn’t it? Unfortunately, it’s not!

Many of my patients take their health for granted! They feel well! They’ve never been sick a day in their lives. They work hard at making a living but invest little in staying healthy. Then catastrophe hits and they are sick! Their blood pressure is elevated. They are diabetic or worse; they have a heart attack or stroke. Recovery is a bitch!

It’s no secret. It’s easier to maintain your health than to restore it once you’ve lost it. So, this year, work hard at maintaining your health. Make sure your spring-cleaning list entails cleaning up your diet, tightening up your waistline and exercising. The life you save may be your own.

Here’s your joke for today:

A teacher asks the students the following questions:

“Who created the universe?”

Johnny, who’s sitting behind Jenny, pokes her with a pencil.

Jenny exclaims, “Oh, God!!”

Teacher says, “Excellent, Jenny”.

The teacher then asks again, “Who was the son of God?”

Johnny pokes Jenny again and she shrieks, “Oh, Jesus!”

Teacher, happy with Jenny, asks her another question, “What did Eve say to Adam after the birth of their 17th child?” Johnny pokes Jenny again, but this time Jenny outrageously shouts, “If you poke me with that thing again, I’ll break it in two a

THE BACK NINE

Once again, I find myself looking through my old blogs searching for inspiration and wisdom.  This morning, I found an article from 2014 that was inspired by Mr. Wonderful.  My old readers will remember Mr. Wonderful (W).  Let me take a minute to introduce Mr. W to my new readers.

Mr. W is an older gentleman who has turned his life and health around using a vast assortment of tools he keeps in a notebook.  He has hundreds of positive quotes and inspirational axioms that he uses to bolster his will power and keep him moving in the right direction.

I continue to feel lousy and uninspired.  I force myself to exercise in the morning but do not enjoy it.  I force myself to sleep with my CPAP and my night guard but really see very little benefit. The only things that come naturally and create joy are being with my family, writing this blog, Rock Steady and eating.

I’ve been warned by my neurologist that Parkinsonian meds can cause compulsive behaviors.  Eating has become a compulsion!  I’ve treated patients with compulsive eating disorders in the past.  It’s not easy (I’d gladly trade compulsive eating with compulsive sex but I’m afraid it would kill Renee.)

A great deal of my problem is my weight.  I am approaching the size of a blimp.  I need to shop in the “Big and Tall” section, only I’m not tall.  My shirt could serve as a tent and house a family of four.  My buddy, Will Power, still hasn’t shown up.  Hopefully, the article published on April 23, 2014 will help me find the will to get my weight down to a more respectable level and help me find the path back to health and Wellth.

I’m definitely on the back nine and I want to play every hole I can.  So, what can I do?  One thing Mr. W used to say is, “If you fall down five times, get up six times.” I didn’t fall down, I got knocked down by Parkinson’s, my back surgery and the loss of my profession/calling.  I keep trying to get up but, so far, have been unsuccessful. Every morning I tell myself I will get up!  Today’s the day!  Today I’ll eat healthy salads, grilled skinless chicken breast and have Renee for dessert.  That’s a good start!

I called Mr. W yesterday. I wish I could go to lunch with him.  Hopefully, he’ll send me another copy of his book.  He’s been a patient, mentor and friend for years.  I’m sure talking to him will help me get up and move on.

I hope this blog will find its way to others, like me, who need a bit of inspiration and wisdom to get them back on their feet.  If writing about the transition from doc to patient and the insights a patient/doc helps one person, then I’ve done my job.

Here’s today’s jokes:

I’m so fat I could provide shade.

There are more calories in my stomach than the local grocery store.

I’ve been told that inside every fat person, there’s someone beautiful… I’m just wondering who the hell I ate?

A RESPONSIBLE PATIENT

The following document speaks for itself.  Hopefully, you have already covered items 1-27.  If not, it is time to become a responsible patient so, sign up and get started.

I AM A RESPONSIBLE PATIENT

I, ______________, am a responsible patient.  As such, I take full responsibility for my health and my healthcare.  My responsibilities include but are not limited to:

  1. Learning how to promote my own health and wellness.
  2. Learning how to deal with illness, both acute and chronic.
  3. Actively working to eliminate those unhealthy habits I have acquired over my lifetime.
  4. Eating properly, exercising, and striving to eliminate those stressors within my control.
  5. Seeking medical advice when appropriate.
  6. Understanding the medical advice I receive.
  7. Asking questions when I do not understand the advice offered.
  8. Following the medical advice when mutually agreed upon by my doctor and me.
  9. Taking my medications as prescribed.
  10. Notifying my doctor prior to stopping my medication.
  11. Notifying my doctor should I have any adverse reaction from my prescribed treatments.
  12. Keeping a list of all medications, both prescription and non-prescription (including herbals, homeopathic, and nutraceuticals), that I take and who prescribed them.
  13. Bringing my medication list to the office at every visit.
  14. Knowing when I will need refills and not running out of pills.
  15. Completing diagnostic tests (lab, x-ray, EKG, etc.) in a timely fashion.
  16. Keeping my follow up appointments.
  17. Seeing consultants when necessary.
  18. Understanding my diagnosis, learning about its effects on my body and how I can help manage it.
  19. Studying and learning about my diagnosis.
  20. Being an active partner in my medical care.
  21. Notifying my doctor when I have added other professionals to my healthcare team.
  22. Being honest about what I am doing, taking, and who I am seeing.
  23. Paying the bill on time.
  24. Setting up a payment schedule when I cannot pay the bill and following that schedule.
  25. Know the rules of my insurance policy, what benefits are covered and what are not.
  26. Notifying the office if any contact information changes occur.
  27. Having an emergency contact listed should critical information need to be relayed to me.

My health is important to me, my family, and loved ones.  I will work hard to care for myself.  I understand that my doctor cannot help me if I will not help myself.  I expect my doctor to offer me his/her best advice based on his/her medical training.  I understand that, without my active participation, my doctor’s ability to help me is limited.  I understand that my doctor is the consulting partner, I am the working partner.  Working together, we can accomplish great things.

Signature____________________       Date___________

Here’s your joke for the day:

Arthur Davidson, of the Harley Davidson Motorcycle Corporation, died and went to heaven.

At the gates, St. Peter told Arthur, “Since you’ve been such a good man and your motorcycles have changed the world, your reward is, you can hang out with anyone you want in Heaven.”

Arthur thought about it for a minute and then said, “I want to hang out with God.”

St. Peter took Arthur to the Throne and introduced him to God.

Arthur then asked God, “Hey, aren’t you the inventor of women?”

God said, “Ah, yes.”

“Well,” said Arthur, “professional to professional, you have some major design flaws in your invention.”

   1. There’s too much inconsistency in the front-end protrusions.

   2. It chatters constantly at high speeds.

   3. Most of the rear ends are too soft and wobble too much.

   4. The intake is placed way too close to the exhaust.

and finally,

   5. Maintenance costs are outrageous.

“Hmmmm, you may have some good points there,” replied God, “hold on.”

God went to his Celestial supercomputer, typed in a few words and waited for the results.  The computer printed out a slip of paper and God read it.

“Well, it may be true that my invention is flawed,” God said to Arthur, “but according to these numbers, more men are riding my invention than yours.”