Month: December 2022

I don’t get it!  Sure, New Year’s Eve is a great excuse to party but what’s with New Year’s resolutions?  Today, my patient proclaimed, “On New Year’s Eve, I’m quitting!  It really didn’t matter if he was quitting smoking, eating, or drinking alcohol.  New Year’s Eve is his magic moment to correct his last 20 years of sins against his body.

“It’s the New Year. You resolve to diet tomorrow. For sure! Tomorrow you will feast on tofu lumps and carrot chunks and swear off nachos for the entire millennium. Never again will a chocolate éclair or an ice-cold beer greet your lips. At dinner, you will munch on fricassee of algae while dishing up crispy fried chicken for the family. When you go out to eat, you’ll graze on cauliflower and kale stalks, oblivious to the ambient aroma of sizzling sirloin and the mouthwatering sight of the chocolate truffles at the next table. In the evening, you’ll sip your second gallon of water for the day while you catch the news, the weather report, and the commercials for juicy burgers with cheese fries. You’ll quit smoking, give up the booze, and never cuss again.

As for exercise, you’ll sign up for triathlons and join the local boxing gym.  No more driving to work. You’ll park the car 5 miles away so that you can sprint through the crowds, perfecting your jumping jacks as you go. You’ll leap up the stairs, 2 at a time, to your 10th floor office, skip down the hall to the water cooler, and practice squats at your desk. After work, it’s off to aerobics class before you race home to pedal to Peoria on your exercise bike. Tomorrow! Absolutely! Positively!  You are looking forward to it as much as having a root canal except root canals are quicker. 

You’ll run away with your wife, go to Paris, make love from dusk to dawn.  When you get back, you’ll take the kids to Disney.  Since you are going to be fit, you’ll climb Mount Everest.  You’ll do everything you’ve ever dreamed of tomorrow.  Today, you’ll work to pay for it. 

Today is the day you make a killing in the market!  You’ll quit your job, buy expensive cars and houses.  You’ll spend a few hours a day managing your funds.  Today is the day!  You would pray on it if you had not forgotten how.” (excerpt from “Diets and Other Unnatural Acts”).

So, why is New Year’s Eve so special?  Is it that the new year brings new hope?  If so, why wait until January 1 to resolve to change your life for the better?  Why can’t your new year and new life start today?  It seems to me that any day is a good day to quit whatever unhealthy habits you have and resolve to find happiness and “Wellth!”  Wouldn’t it be better if every day brought hopes of a better and healthier future?  Rather than resolving to change our lives for the better once a year on January 1, wouldn’t resolving to do better on a daily basis have a more enduring effect?

New Year’s Eve is a time when we let go of the past and look to the future.  We wish our friends and family a happy and healthy new year.  We even greet strangers by wishing them well.

When you wake up every morning, try letting go of the past and look to the future.  Resolve to have a better day than yesterday.  Wish someone well.  I know people may look at you as if you are weird but wish everyone you meet a happy and healthy new day.  I bet you’ll feel better.  

New Year’s resolutions are often short lived.  New day resolutions only need to survive 24 hours!  This new day, resolve to be happier and healthier.  Resolve to find “Wellth!”  May every day be better than the last!  May every day bring you hope and joy!

Here’s today’s joke:

My New Year’s resolution is to help all my friends gain ten pounds so I look skinnier.

In 5 things that I want my patients to know, by Leana Wen, MDpublished in 2012 on KevinMD.com, Dr Wen states:

1. Antibiotics will not help the common cold.

2. A CT scan will not improve a headache.

3. Every test has potential side effects.

4. Lifestyle changes make a huge difference.

5. Aspirin is one of few medications that’s been definitively shown to help you. (recently under attack, may be harmful)

Dr. Wen’s advice is indeed wise and in many instances, parallels the advice I have been expounding on in this blog for the last 2 years. Other things I want my patients to know include:

6. Immunizations work! Immunizations prevent disease and, while they have potential side effects, are very safe.

7. The Flu vaccine cannot cause you to get the flu, cannot give you a cold, and does not weaken your immune system.

8. Doctors want to help you get well and improve your health. We would not offer a treatment to you or your family if we thought that it would hurt you.

9. The only truly foolish question is the one you didn’t ask. Feel free to ask me anything without the fear of embarrassment, just not at 3 in the morning if it’s not an emergency.

10. Doctors have on-call services to assist you in an emergency/urgent situation when we are not in the office. Please do not call after hours to get a refill or dodge an office visit.

11. No two insurance policies are the same. Know what your policy covers and what it does not. 

12. Stress is a disease and is contagious. Learn to manage yours and don’t transmit it to others.

13. Donating blood is the gift that keeps giving! When you donate blood on a regular basis, not only do you help others but you help yourself build the ability to make new blood more efficiently.

14. ‘Chicken Steps” work. You can become the person you want to be by setting your course and taking one tiny step after another in the right direction.

15. Diets are truly unnatural acts.

16. Because you have never had something is no guarantee that you won’t get it. As you age, you are likely to have a lot of new experiences. Work hard to make them healthy experiences.

17. You can change for the better. Define who you are and then refine who you are.

18. Love more, hate less!

19. Thirty minutes a day of exercise is not too much to ask of your body. It will pay off in spades!

20. Enjoy today and every day. No one really knows what tomorrow holds. Count your blessings in the morning and at night.

My list could go on and on but I will stop here and spend some time with my family, Facetime with my children, and count my blessings. 

Here is today’s joke:

Redhead tells her blonde stepsister, “I slept with a Brazilian….” The blonde replies, “Oh my God! You slut! How many is a brazilian?”

We are all jugglers. At every age and stage of life, we juggle from the time we get up to the time we go to sleep. Some of us are really proficient at juggling, others struggle. Often, the young juggler finds the act of juggling entertaining, even exhilarating. As time passes and life becomes more complex, juggling becomes stressful. By now, you are probably confused, wondering where I’m going and if you should close out of this blog. Stay for a minute more. 

We juggle personal, family, work and social issues. Think of each task you have to do today as a baton in the air. When you catch it, you need to finish it so you can catch the next one. In your early life, you have just a few batons in the air. In time, you add new ones. So, your wife asks you to buy play tickets. You finally have a chance to do so. You have that baton in hand when your boss comes in and tells you he needs those figures he asked for yesterday, right now. So, you toss the play tickets in the air and catch your boss’s baton. You start churning out the needed figures when your mother calls; her computer is broken. You catch that baton and toss it in the air with the one labeled play tickets. The baton the IRS tossed you last month won’t leave you alone. You’ll tackle it later; so, for the time being, you keep catching and tossing it back into the air. In time you have so many batons in the air, that as soon as you catch one, you have to toss it back for fear of dropping the next one.

Boom, you dropped one and it shatters. Boom, boom, boom, you drop more. Welcome to a midlife crisis. When you are juggling so many items that you can’t possibly keep them in the air, you crash and so do those around you. I treated midlife crisis all too often. Sometimes my fed up, overwhelmed patient simply quits juggling, turns and walks away (or gets admitted to the hospital). ALL, THE BATONS COME CRASHING DOWN AT ONCE! IT’S A DISASTER! Family, friends and work suffer simultaneously. Other times my patient manages to safely deposit enough items on the floor to maintain some semblance of life and tries to rebuild.

So, what can we jugglers do? One recipe for success looks like this:

1. On a regular basis, everyone should take a break from juggling. 

• Put each baton carefully down on the table and step back. 
• Analyze what is on the table. 
• Get three boxes and label them past, present and future. 
• Sort the batons in to three piles: those that you can do nothing with; those that need immediate attention; and those that you can’t do anything with but will need to be handled in the future. 
• Fill the boxes. 
• Only juggle the items in the current box. 

Too often, my patients have old items (guilt, regrets, hurts) in the air, catching and tossing them to no avail. Getting them out of the air and into the past box is a big relief. Putting them away frees up time to work on the current box.

Often, my patients are tossing and catching items that are coming up at some time in the future (jury duty, a visit from the dreaded in-laws, colonoscopy). They cannot do anything with those items now, but they can’t quite let them go either. Putting them in the future box frees up time to work on current items. 

With added time and less batons in the air, you can get proficient at finishing and throwing away those items that need present time attention. As you deal more efficiently with the present box, you’ll find time to go into the future box, remove and finish those items and avoid that dreaded midlife crisis. When you are really doing well, empty the items in the past box into the waste basket.

What if the above recipe doesn’t work? That’s when you turn to counseling, family and community. A skilled counselor will help you safely get the batons out of the air. The counselor will help you sort each item and move it to a place of safety for future action. Perhaps you need to toss a few items to your family and your community. Perhaps you need to say NO to those who are tossing their batons to you. There are many ways to avoid the crisis. Whatever you do, just don’t quit and walk away!

Here’s your joke:

A man turned 40 and had the classic midlife crisis. He went out and bought a red convertible sports car. While driving his new car on the highway he decided to speed up and have some fun. Sure enough he heard the siren and saw the flashing lights behind him. In a panic he pushed the gas to the floor and started pulling away starting a proper police chase. After a minute of heart pumping speed, he realized just how dumb that was and he pulled over while the cop caught up.

The cop gets out of his car and does that cocky cop trot we all know. At the guys window the cop stares at him with a mean look. Not knowing if he was going to get a ticket or be thrown in jail for running away the guy rolled down his window and starts apologizing.

The cop stops him and says “ I have been a police officer doing traffic for 20 years. Today is my last day on the job and the last thing I wanna do is haul your dumbass off to jail ruining the rest of my day. I’m gonna give you one chance to get out of this. Doing traffic for 20 years I have heard every excuse in the book. If you can come up with a convincing reason why you just sped off like that, I’ll let you go. If not you’re going to straight to jail.”

The man thinks for a moment, then looks the cop directly in the eyes and says “Sir, three weeks ago my wife left me for a police officer. I just thought you were trying to give her back. “

The cop puts his pen is his shirt and says “Sir you have a great day.”

I’m sure you’ve heard it said before that laughter is the best medicine. If you Google laughter and medical care, you’ll find lots of articles supporting that premise. There are also lots of projected benefits of laughter. So, assuming that laughter is the best medicine, how should it be taken?  Over the years, I have used laughter on multiple occasions to lighten the mood, lessen the pain, and relax the patient. I even had one patient who called me prior to every yearly pelvic to remind me that I needed to put together new material for her exam as the humor lessened the stress of the physical by keeping her laughing during the pelvic exam.

Those of you who were my patients know that my sense of humor is often off color and that I freely use sexual innuendo to get a laugh. While my colleagues might think my use of off-color humor is unprofessional, I found that I got better results with raunchy humor than I did with clean humor. It would be interesting to do some research as to my raunchy humor outperforming clean innocent humor; but, at this stage in life, I’m beyond research and more into practicality.

I have provided a joke at the end of almost every article as I believe that the proper dosing of humor to promote wellness is at least daily and probably twice daily (depending on how raunchy the joke is).  Fart humor is probably the strongest of all humor. At the front of the office (in the checkout area), we had two chairs where we usually put pharmaceutical reps waiting to see me. For years, one of those chairs had a remote-control fart machine taped to the bottom of the seat.

There was a manager who we really didn’t like. He often took over his rep’s conversation, stepping on the rep’s toes and pushing medication on the medical staff. Pharma reps who came to my office knew that the last thing they wanted to do was try to push their pills. Their job was to present the science behind their product.  Mine was to decide if the benefits outweighed the risks and expenses.

So, one day,

 we sat him in the chair with the remote -control fart machine. I had just finished up with an 82-year-old female patient of mine (who had a great sense of humor) and was happy to play along with us. She went to the desk to check out at which time I pushed the button creating one loud fart. She looked at the manager scornfully and proceeded to finish checking out. I hit the button the second time causing the sales Rep to stand up and leave and the old lady to turn to the manager and pronounce how disgusting that was and then leave as well.  My patient was marvelous. She maintained herself well and didn’t start laughing until she got out the front door. The sales Rep realized what had happened and started laughing as he walked out the front door as well. The manager was dumbfounded not having any idea what happened to him and never came back to the office. Even today, I smile when I remember this episode.

Remote control fart machines are inexpensive and a great source of healthy laughter. I highly recommend buying one and using it freely. I think that if you do, you will find that you feel much better, smile more often, and giggle from time to time. Actually, I think giggling is better than laughing.

So, here is today’s joke:

An old couple were sitting in Church and the wife noticed that people were staring at her.

She leaned across to her husband and whispered, “I’ve just let go a silent fart. What do you think I should do?”

He said, “I think you should get fresh batteries for your hearing aid.”

One of the most common mistakes we make in life is waiting too long. Over the years that I practiced medicine, I lost many a patient to this phenomenon. When my patients put off going in for recommended screening tests, they ran the risk of missing important diagnoses and the time when something could be done about them.

Colonoscopies, done on a regular basis, can often find precursors to cancer and allow the surgeon time to prevent the onset of serious disease. Screening mammograms can uncover early disease, again allowing the oncologist or surgeon time to prevent the onset metastatic or late disease. While physicians disagree on how often the prostate exam should be done, checking the prostate may also save you a lot of discomfort and grief.

My recommendation is that you see your family physician once a year and discuss preventative maintenance with him/her.  Most of my patients did better maintenance on their cars than they did on their bodies. If your heart is the equivalent of your car’s engine, it makes more sense to take care of your heart than the motor in your car. To work on your heart, one often has to cut open the chest, do the work necessary and then wire the chest shut. With your car, it’s as simple as is popping the hood, replacing parts as needed, repairing parts as needed and then closing the hood making sure that the latch is tight.

That brings me to today’s article: moving into assisted living. Again, waiting too long can cause problems. If you move into assisted living now while you are still active and thriving, then the staff gets to know who you are, to develop a relationship with you and, when you need their skilled assistance, they will “care for/about you.”  Too many people wait until they are no longer themselves and need care.  The staff never really gets to know who you were and only see you as the shell of the person you used to be, now just lying in bed, eating and pooping and not doing much else.  Unfortunately, they failed to bond with you and the care you receive may suffer.

So, if you are contemplating the need to move into assisted living, please do so early in your old age, while you are still the person you have always been. SOB’s, PLEASE ignore the above advice.  You’ll probably get better care if the staff Never has a chance to see that side of you.

Ask yourself, “When was the last time I changed the oil in my car?” Then ask yourself, “When was the last time I saw my doctor for preventative testing?” If you know exactly when the last time was you had an oil change and lube  but can’t remember the last time you saw your doctor, you’re definitely a male. Now ask yourself, “Why are there so many widows as opposed to widowers?”  The answer is that women take better care of themselves than men!

After my prostate exam, the doctor left. The nurse came in later, with a worried look on her face, and said the three words I was dreading to hear. She said, “Who was that?”

When I started writing again, I promised myself that I would work hard at being upbeat. So earlier this month, I published what I thought was a cute article on my eating disorder which I called the “F It” diet. The next day I found myself on the floor looking up at Renee’s face. I had no recollection of what happened. Apparently, I had been in the refrigerator, left the door open and collapsed on the floor either banging my head knocking myself out or passing out falling to the floor and banging my head. Regardless of what the mechanism was, I spent the next 24 hours in the hospital under observation. Luckily, the doctors couldn’t find anything wrong other than a broken right index finger and some contusions to the scalp on the left.

Unfortunately, I am thoroughly right-handed and find it very difficult to function without my right hand as my finger is in a soft cast. So today marks the first day of learning a new program which allows me to convert speech to text.  Please forgive me if you find grammatical errors or misplaced words like the Umm at the beginning of this sentence um as I’m getting used to um the new program.

The real topic for today is how much I dislike being the patient. The transition from doctor to patient has been difficult. The hospital I was taken to by the paramedics is a new hospital owned by Atrium Healthcare and was quite impressive. The nursing staff was attentive, the ER doctors were sharp, and the hospitalists had a good bedside manner and excellent background in medicine. Advocate health care has just merged with Atrium.  I hope they don’t ruin Atrium!

The major problem with the current delivery of medicine is that the specialists have become so specialized that the finger specialists cannot take care of the hip, the hip specialists cannot take care of the back, and the back specialist cannot take care of the knees leaving me with a specialist for every bone in the body. I miss the days when your primary doctor could take care of almost everything that bothered you. Nowadays, it seems the primary doctors are referral agencies, and I was referred to a neurologist, a cardiologist an orthopedist and a Parkinson’s specialist. What a pity!

To make a long story short, my Parkinson’s is worse and functioning without my right hand makes life even more difficult. Thank God for the bidet! I read an interesting article today that projected that Amazon was going to become a major player in the healthcare industry and was currently looking to buy physician practices. I’m not quite sure how their model will work for medicine; but, if it works as well as it does for buying commodities, it should be interesting.   At least you’ll be able to buy a bidet at the same place that you get your COVID test.

I want to wish you all happy holidays and a healthy and happy new year. With the start of the new year, I plan on working on a new book, “Humor in                                     Medicine.”

When my patient was miserable with the flu and brought to the office by their spouse, I would look at the spouse and say, “I told you to give him  all of the poison at once, otherwise he  would suffer even more.” Even the sickest of patients would laugh, making them feel better if only for a minute. On one occasion, the wife’s reaction was undeniable.  Her facial expression was clearly,” How do you know?”  Yep, she WAS poisoning him and a little joke went a long way to healing him.

HELP! I’M Drowning! There’re cookies and cakes, galore.  There’s ice cream and whipped cream, oh my!  There is flan and Crème Brule and cheesecake to name a few!  I did well on my diet for 6 days, then the food started oozing through the door.  And that’s just dessert.

We found a new crepe place, a good pizza place, hot dogs, smoked pork, and hamburgers. Firebirds prime rib was to die for or to die from.  I found my old friend, Will Power, sitting at the table, pouring calories down his throat.  I couldn’t get Will to leave the table.  He started breakfast at 7 am and intends to finish breakfast around 9 pm.

Holiday eating is part of almost every religion and social institution.  So, I eat and get fatter.  I look at myself in the mirror and am disgusted by my obesity and the number of food products staining my shirt. It’s a lost cause.  Within view from the chair I’m sitting in, there are silver bells, Mounds, Milky Ways, toffee coated popcorn, onion soup dip, fruit, pretzels and BBQ potato chips.

In past years, I’ve given sagely advice on how to deal with holiday eating so here goes:  EAT TODAY AND WORRY ABOUT LOSING THE WEIGHT LATER.  Eventually, either Will will come to his senses, or I’ll get so discussed with myself and lose weight.

There is a new medication for diabetes that takes weight off.  It’s very expensive and I’m afraid that the weight will come back when you stop the medication.  I don’t recommend drugs for weight loss.  I also don’t recommend gluttony.  There’s got to be something in between.  Meanwhile, I’m on the “F It Diet” whose rules are simple.  If you can’t F it, eat it!  F it is preferable 6because you get points for exercise.

Seriously, I have a fantastic holiday season!

Here’s your joke:

Honey, I look in the mirror and all I see is a fat, ugly, old man. I need you to pay me a compliment.

Ok. Your eyesight is damn near perfect!

Is it possible to know too much? The long and the short of it is that it is possible to know too much, but not enough.  As a retired Doc, I have thousands of patient stories of rare and abnormal circumstances leading to disease or disorders you would never expect to see.

An example is the story of Mr. P.  Mr. P’s son brought him to the office complaining that “Dad’s just not right.  He can’t write and he’s walking kinda funny.”  I scanned Mr. Ps head and found a large subdural hematoma (bleed in skull).  The neurosurgeon took him to surgery and evacuated the hematoma.  Once the blood was removed, the patient remembered passing out in the barn and hitting his head, six months earlier.

So, I fell in Mexico and hit my head on asphalt.  I abraded my scalp, did not pass out, and got up quickly without even a headache.  Despite not having symptoms, I started worrying.  Slowly, my gait disorder worsened. Was the worsening due to Parkinson’s, subdural bleed, or anxiety?

In the meantime, my friend Facetimed me and asked what’s with my eye.  My answer was, “Nothing”.  Then I looked in the mirror and, sure enough, my left eyelid was swollen.  I saw an optometrist who thought my eye was bulging a little.  Again, I had no symptoms other than being nervous.

My symptoms seemed to worsen as the night wore on.  At midnight, Renee took me to the ER.  I know too much.  I convinced myself I had a blow out fracture of my left eye socket and a subdural hematoma. 

I know too much, yet I didn’t know enough.  I knew the mechanism of injury should not cause the ocular or gait disturbance, so I put off going to the ER.  My brother pointed out that, if it was him, I’d recommend he go to the ER.  Putting off going to the ER worsened my anxiety.

As it turns out, my CTs were normal!  I was worried about nothing.  I saw the eye doc today and he diagnosed a swollen eyelid.  The moral of the story is:

See your doctor and let him/her/other decide what to do.  Ignore Dr. Google and your gut and see your doc.  Seeing your doc will most likely spare you the anxiety of over diagnosing yourself. 

Here is today’s joke:

Doctor: “I have some bad news and some very bad news.”

Patient: “Well, might as well give me the bad news first.”

Doctor: “The lab called with your test results. They said you have 24 hours to live.”

Patient: “24 HOURS! That’s terrible!! What could be worse? What’s the very bad news?”

Doctor: “I’ve been trying to reach you since yesterday.”

It’s amazing! I’m becoming my mother.  She always thought she was unlucky; and because she felt unlucky, she was.  I’ve fallen into the same warped thinking.  I’m learning to play bridge and am the self-titled, King of “Pass”.  Yep, I get lousy cards.

Today, I played 8 hands and passed 8 times. My partners get frustrated because they get zero support from me.  The other day my partner bid 1 spade.  I had 6 spades, two through seven, but no points.  Talk about frustration.  Today, I caught myself saying, “If I didn’t have bad luck, I would have no luck at all. 

Luckily, I quicky realize how ridiculous that statement was!  I’m lucky to have grown up in Norfolk, with a loving nuclear and extended family.  I was lucky to go to UVa and Mexico for my education.  I was the luckiest man alive when I met and married Renee.  I’m lucky to have the kids and grandkids I have.  I’m lucky to live in a retirement community where I’ve made new friends.  Talking about friends, I’m lucky to still have my childhood friends and their wives.

Most of all, I’m lucky my big brother looks after me.  Alan calls daily to make sure I’m ok.  A few years ago, he had a stroke, and he calls to show me how important it is to have a sense of humor and a positive attitude.  He stops me from becoming my mom and dad.  My dad had Parkinson’s and I look like him, walk like him, talk like him, but I’m not him.  Alan reminds me of all the good things in life.

So, when you feel “unlucky”, pull out your blessings list and update it.  Then count your blessings.  Unlucky at cards but lucky at love is definitely acceptable.  I’d still like to bid and win a slam.  Funny, when I was young, it was “slam. Bam. And thank you!”  Now, its “PASS!”

Here’s a joke:

A woman’s husband had been slipping in and out of a coma for several months, yet she had stayed by his bedside every single day.

One day when he came to, he motioned for her to come nearer.

As she sat by him, he whispered, eyes full of tears:

‘You know what? You have been with me all through the bad times.

When I got fired, you were there to support me.

When my business failed, you were there.

When I got shot, you were by my side.

When we lost the house, you stayed right here.

When my health started failing, you were still by my side…

You know what, Martha?’

‘What dear?’ she gently asked, smiling as her heart began to fill with warmth.

‘I’m beginning to think you’re bad luck…’

From upjoke.com

First, a disclaimer.  What you about to read is my opinion and should not be taken as gospel.  With new technology and scientific findings, more genetic disorders can be identified now than was possible in the past.  Deciding to do genetic testing can often be a difficult decision.  The answers to our questions may help us, they may depress us, they may give us information to improve our health, or they may leave us waiting for the sky to fall.   If you break genetic disorders into three categories, deciding whether to do testing is easier.

Category one is treatable genetic disorders. If there is a treatment plan which will make a positive difference in your life, then do the genetic testing.  Pre-natal and post-natal genetic testing for treatable disorders is mandatory.

The next group covers non-treatable genetic disorders.  It’s my personal opinion that there is no reason to do genetic testing if nothing will change regardless of the test being positive or negative.  Parkinson’s falls into this category.  Sure, if you have the gene for Parkinson’s, exercise and a good diet may help but exercise and good diet helps everything.  So, why worry about a positive gene test that may or may not mean that you are going to develop the disease associated with the test.  As with everything, exceptions exist.  If you enroll in research for a particular disease, genetic typing is helpful to the researchers.

My third group is those disorders where, if positive, treatment protocols save lives.  Breast cancer falls into this category.  Certainly, knowing the results of gene testing in genetically inherited disorders is helpful in deciding whether to have children or not, whether to treat them with meds or surgery and help you counsel your children and siblings as to their needs for monitoring.

Remember, a positive test does not mean you are going to develop the disorder you tested for.   When you are uncertain about what to do, see a geneticist.