Author: wellthy

Yesterday, I was talking to a neighbor/psychologist about depression and anxiety.  Most individuals are unaware of the fact that both depression and anxiety are normal human emotions/responses.  Let me explain.  Imagine you are walking in your neighborhood when you notice a beautiful German Shepherd about fifty feet in front of you.  You love dogs so you approach.  As you get closer, the dog growls and bares its teeth.  Do you get anxious?  Most individuals would. 

In this case, anxiety serves as a burglar alarm, warning of impending danger and hopefully keeping you from being bitten.  Therefore, being anxious about a current threat to your wellbeing is normal and healthy.

Now let’s look at a similar situation.  Every time you get ready to go for a walk, your fear of being bitten comes to the surface and you have an anxiety attack.  There is no current threat, no growling dog, yet you cannot control your anxiety and decide to stay home. 

In scenario number one, your alarm goes off and you weigh your options. Options allow you to reduce your anxiety.  You might notice that the dog is wagging his tail and stops growling as you get closer, or you may simply cross the street and walk away from the threat.

In scenario number two, you are projecting yourself into a future situation that does not exist anywhere other than in your mind.  Your alarm goes off but there is no real and present threat. As you scan for danger, you become progressively more anxious and start worrying about other, threats.  If you live in the future, you are most likely going to experience anxiety.

Now, let’s look at depression. My sister-in-law just died.  Being depressed over the loss of a loved one is appropriate, right?  So, what about being depressed over some distant loss or event.  Is that appropriate?  When you live in the past, you are most likely to experience depression.

You cannot change the past.  Playing the “would have, could have, should have” game is emotionally perilous and, in addition to depression, leads to guilt, another destructive emotion.  By the same token, you really can’t change the future.  Your best chance at being happy and healthy is to live in the present.  The present is a gift that only lasts a short time.  Use it, enjoy it now; as tomorrow, it becomes the past.

The above ideas are not novel.  Psychologists teach them to people on a daily basis, yet depression and anxiety are rampant today.  Anxiety is stoked by the 24/7 news cycle which constantly looks to the future of the stock market, our country, the cost of items, the availability of commodities, the risk of infection, etc. 

Personally, I get depressed every time my Parkinson’s flares, every time I look in a mirror, every time I realize that practicing medicine is gone forever.  I find my mind drifting towards the past way too often.  My children and grandchildren, Blessings List, neighbors, Rock Steady Group and former patients that I stay in touch with all help keep me in the present.  I work hard each day to keep an “Attitude of Gratitude” and the right perspective, reminding myself that to be happy is a choice, just like living in the now is a choice.  What’s your choice?

Here is today’s joke:

I’ve been sleeping with my maid for the past 3 years.

Just don’t tell me wife, she hates it when I call her that.

How do you know who to trust?  In the old days, most people trusted their docs!  The internet did not yet exist.  Medical breakthroughs were reported in journals which came through the mail and sat in piles on your doctor’s desk waiting to be read.  The major TV channels had actual programs that reported the news as news, not commentaries.

When you saw or were examined by your doctor, he/she actually was a doctor, not a provider/NP or PA. You trusted that your doc would stay up-to-date and give you the best advice available.  If you wanted more information, you went to the library, not your friend’s house.

Today, the world is radically different.  The internet offers up a plethora of medical advice.  Your neighbors have become medical specialists based on what they read on the internet and anyone can find “facts” to justify any belief system they adhere to.  Anti-vaxers can find volumes of information disparaging vaccines and proving that they are harmful to humans and sponsored by a government that uses vaccines in an attempt to enslave its constituents.  Emotions run high!

Doctors still talk about “peer reviewed” studies as being the pinnacle of research; yet true peer reviewed, published research is often boring with page after page of written material describing every protocol and tool utilized before getting to the data which is described in a language foreign to most.  The material is presented in such a manner to allow scientists and doctors to draw their own conclusions.

Material on the internet is usually presented with just enough information to support the author’s opinion.  It is often sensationalized/politicized; and the goal appears to “go viral” rather than inform those who need the information to make the appropriate patient care decisions.  People from all walks of life have become their own experts, bypassing their docs and treating themselves according to their own belief systems.  It used to be said that only the fools treated themselves.  If that dictum was true, then we have become a society of fools.

People I respect, friends I enjoy being with and truly like, have schooled me in Covid management.  Some believe that a dysfunctional government is inserting itself into their lives, forcing vaccines down their throats.  (Yes, the government is dysfunctional.  Democrats and Republicans seem bent on tearing this country apart.)  Others believe that the vaccines, themselves, are evil.  No matter what their beliefs are, they are entrenched and willing to fight to make their point.

I try to avoid getting into the fray.  The old days are gone, no matter how closely I follow the actual data and research. Afterall, I’m a retired doctor. What do I know? Once again, I am trumped by Google! 

Sometimes, I can stay out of the conversation.  I always regret entering the fray.  Emotions run high and friendships can be fragile.  It’s a pity.  Covid has caused so much damage and loss of life.  Now its coming between friends and families.  Unfortunately, we are at the beginning of Covid, not the end.  Unfortunately, Covid has become more than a killer virus; it has become a political infection. 

One of my most vivid childhood memories is standing in line in my high school gym with thousands of people.  I was scared and excited at the same time.  The nurse used a futuristic air gun to shoot the polio vaccine in my arm.  Polio was crippling people and we came together, as a nation, to fight it.  We succeeded!  We have come together to fight measles, mumps, and chickenpox with remarkable success, as well.

What’s different now?  Back then, we trusted our docs.  Now we don’t trust anyone!  What a pity.

Here are your jokes for today:

My girlfriend invited me to her house, I found her sister alone in the house, she was unbelievably sexy, she whispered in my ear, “i have feelings for you, shall we have sex” , I immediately turned around and walked to the front door to go to my car, I found my girlfriend standing there, she hugged me and said: “you’ve won my trust”… Moral of the story: always keep your condoms in the car.

5 Important Qualities to have in your women:

1. It’s important to have a woman, who helps at home, who cooks from time to time, and has a job.

2. It’s important to have a woman, who can make you laugh.

3. It’s important to have a woman, who you can trust and who doesn’t lie to you.

4. It’s important to have a woman, who likes to be with you. 5. It’s very important that these four women do not know each o

Wouldn’t it be cool if there was a fact check organization that monitored commercials for truthfulness?  I think so!  My car is in the shop awaiting repairs following a rear-end collision (more about that later).  I’ve been with the same insurance carrier for close to 40 years.  If their commercials were true, my car would have already been repaired and returned to me.  It’s not even close to coming home with me.

Are the commercials true?  Is the management of my claim simply an outlier or is it the norm?  Currently, there is no way of knowing.  So, the commercials continue to sell what may be a falsely represented product.  If you are a programmer or research analyst, perhaps you can make a bundle by holding the advertising world’s feet to the fire.

Can I really take an over-the-counter pill that will maintain or improve my memory? Research shows that an old product called Obecalp (placebo spelled backwards) works 30% of the time. I used to prescribe Obecalp but it was taken off the market.  What a pity; placebos are great meds! Research will show that they are effective (30 % of the time). 

According to the commercial I’ve watcher hundreds of times, I can improve my memory by taking a jelly fish extract!  If I could only remember the name of the product.  The commercial accomplished one thing; I remember it comes from jelly fish and I can vividly remember being stung by jelly fish at Ocean View. See, the commercial is effective at improving my memory.  If you try to validate its effectiveness, you’ll find very little peer reviewed, validated research; but you will find that it is effective.  Remember, placebos are effective 30% of the time.

Again, a fact check, unbiased appraisal of the claims made by the manufacturer, would be very helpful. Figuring out what’s real and what is not is going to be tricky.  Ever hear a commercial state, “Recommended by more doctors than any other product on the market?”  I’ll share a secret!  While the commercial implies that the product is better than the competition, it fails to tell you that the product’s sales representative leave tons of samples in physicians’ offices and that when a physician gives samples of their product to a patient, it’s considered a recommendation.  Very clever, heh?

Isn’t it interesting that the competing cellular companies all claim to have the best coverage at the cheapest price?  Obviously, somebody is lying, But which company is it?  Sure would be nice if one of my readers created a fact check organization that looked at commercials!

Here’s your joke of the day:

“That wife of mine is a liar,” said the angry husband to a sympathetic pal seated next to him in the bar.

“How do you know?” the friend asked.

“She didn’t come home last night; and when I asked her where she’d been, she said she’d spent the night with her sister, Shirley.”

‘So?’ the friend replied.

‘’So, she’s a liar. I spent the night with her sister Shirley!”

I had a lot of fun earlier this week. A neighbor, who was having trouble understanding her surgeon’s explanation of the causes of her symptoms and her options, asked me to accompany her to her visit.  I felt like a racehorse (I’m almost as big as one), who was sent onto the track for one more race before being put out to pasture.  I know what it feels like to be put out to pasture and I don’t like it.

Back to my story, the surgeon was 45 minutes late, as expected.  As a physician, you can either answer your patient’s questions and be late, or you can cut the visit short and be on time.  I always preferred to be late and take care of each patient’s needs while they were in my office.  Obviously, I didn’t complain about waiting.

The surgeon was an older gentleman, probably in his 60s.  He reviewed his findings and all available options.  He was thorough but used a great deal of medical terms and abbreviations.  I understood what he said and what existed “between the lines.”  My friend got the gist of the conversation but missed some of the finer points.  I particularly like when he used the term, “phlegman.”

According to Wikipedia, “A phlegmon is a localized area of acute inflammation of the soft tissues. It is a descriptive term which may be used for inflammation related to a bacterial infection or non-infectious causes. Most commonly, it is used in contradistinction to a “walled-off” pus-filled collection, although a phlegmon may progress to an abscess if untreated. A phlegmon can localize anywhere in the body. The Latin term phlegmōn is from the ancient Greek”.  The word Phlegmon just sounds so exotic and descriptive that only very bright people use it.

Back to the story again, the surgeon hedged his bet discussing the current indications for treatment versus the old protocols for surgery.  I sat silent as I listened to this master surgeon cover all options while giving his patient a complete informed consent and leaving the ultimate opinion in the patient’s hands.

Later, I reviewed what I heard the surgeon say and explained his approach from a physician’s point of view.  I believe the surgeon would have preferred to do surgery despite current guidelines which advised a wait and see approach. 

The surgeon scores a 4 out of 5.  He would have been a 5 of 5 had he used more common/lay words and less abbreviations.  My bet is that he is a 5 of 5 in the operating room (OR).  GOD, forbid, I need a GI surgeon, I’d be happy to have this surgeon care for me.

The lesson for patients is to take an extra set of ears (patient advocate) with you when you are seeing a doc.  Your advocate’s job is to listen intently and then be prepared to discuss what he/she heard while in the exam room.  You’ll be surprised at how much difference exists between what you heard and what your advocate heard.

Here is your joke for today:

A man goes to visit the doctor.

Man: Did the test results come back?

Doc: Yes, and the prognosis isn’t good.

Man: Well, how long do I have?

Doc: About 10.

Man: 10 what? Years? Months?

Doc: 8… 7….

First, I am not a biblical scholar.  That being said, I wonder if we are entering the “end times.”  If you don’t believe that climate changes are caused by man’s rape of the earth or you believe that Covid really is the government’s attempt to control us, stop reading here. 

In the last few days, I’ve watched a movie in which a Rabbi discusses the negative affects of climate change and man’s role in causing climate change, I’ve listened to another Rabbi discuss the same topic and the urgency of the situation, and I’ve marveled at the fact that despite having an effective vaccine against Covid, 50 percent of the US population have yet to be vaccinated.

Personally, I believe in the concept of free will.  I have to!  Afterall, if everything is preordained, then nothing we do matters, and it looks like we are fucked.  So, assume we have “free will.”  That means we can choose to combat Covid and climate change or we can choose to ignore it.  Right?

Let me tell you why I think we are entering “end times.”  I’ve been expecting a pandemic for years.  Pandemics are cyclical and we’ve been overdue for one.  I also expected that Covid, like other viruses, would mutate and that the war against Covid would be lengthy and hard fought with lots of casualties.  I did not expect that we would have a vaccine in a timely manner.  I also did not expect a significant mutation would occur so quickly.

Here’s where free will enters the game.  The best way to delay or prevent more significant mutations in the virus is to refuse to harbor and nurture the virus.  That means that we need to immunize everyone ASAP and continue to work on new and novel ways to make vaccines.  Unfortunately, a significant percentage of our population have exercised their free wills and decided not to immunize themselves or their families.

If you think Delta is nasty, wait until Delta gives birth to another mutant with an even greater ability to kill humans.  If we wait long enough, our expression of free will may well lead to an untreatable viral enemy that makes Noah’s flood look like child’s play.  Sure, there may be future, unforeseen consequences of the vaccine; but there are unforeseen consequences to everything we consume or do.  The consequences of not taking the vaccine are real and include death. If you die, that’s your choice; but if you turn into a killer and give Covid to a friend who dies from it, that’s unforgiveable.   Remember, your freedom ends at the tip of my nose.

Regrettably, I think climate change is a done deal.  We may be able to rescue our planet but it’s going to take years.

Here’s today’s joke:

The real reason not to do anything against climate change:

Just think how dumb we’d look in front of our children, if twenty years from now we discover climate change was in fact not real. We’d have cleaned the ocean and the cities, preserved the rain forests and millions of species, innovated in multiple industries, made the air breathable again, created a more sustainable lifestyle for the decades to come and a better world for our children, completely for nothing. I’m pretty sure we’d all doom the fool that made us do all that.

Yesterday, my sister-in-law, Martha, and my niece, Alli, posted updates on Facebook, reviewing the progress my brother has made since having a stroke 2 years ago.  Alan has worked hard at recovering the use of his left hand and leg and his continued improvement is miraculous.

Alan is no stranger to work.  He worked out in the gym for most of his life.  As a matter of fact, I can’t remember a time when he didn’t go to the gym.  Martha credits the docs for saving his life and aiding in his recovery.  The years Alan invested in building his body and preparing it for combat have been the foundation upon which his progress continues beyond the original projected prognosis.

I also credit his spirit/attitude.  Unlike me, Alan has refused to give in to depression.  He focuses on what he can do as opposed to what he can’t do.  His sense of humor has flourished.  I look forward to his Australian weather reports and our daily conversations during which he works at lifting my spirits.

My big brother is my hero!  Every time I find myself falling into the pity pit, I think about Alan and what he has accomplished and then I crawl out of the pity pit and count my blessings.  In response to a recent article, Lisa reminded me of how lucky I was to have my family walk me into the ocean and swim with me.  She was surprised that I had not made mention of that.

I have been a swimmer my entire life.  While on land I’m a klutz; in the water, I was always graceful.  Having to have my son, son-in-law, brother-in-law and daughter walk me into the water reminded me of how severe my losses have been.  It should have reminded me of how lucky I am to have a loving, supportive family.

Yep, Alan is my hero and I’ll keep working at being more like him.  It’s the Jewish New Year and I want to wish all of you a happy and healthy year full of love and joy.

Here’s your joke for the day:

What is a New Year’s resolution?  It’s something that goes in one year and out the other.

I had a great afternoon yesterday.  My Rock Steady group had a pizza party celebrating a successful fund-raising campaign.  We are all about the same age and all of us are either dealing with Parkinson’s or the spouses of someone dealing with it.

As usual, when you get a bunch of Medicare patients together, the conversation eventually turns to Covid and vaccines.  Naturally, everyone has a different opinion and quote different sources.  There are few things that everyone agrees on. 

First, everyone agrees that the authorities are constantly sending out mixed messages.  Early in the pandemic, it was easy to understand why the messaging was so confusing.  Covid represented a new disease; and, as in a boxing match, we received a blow by blow description of who was winning the fight (Covid vs. humanity).  As expected, there was a sharp learning curve leading to humanity taking a lead late in the first round.

Unlike prior fights between humanity and viral infections, Covid found itself with a new champion in its corner and its new champions have proven to be more powerful than its ability to mutate and adapt to its environment.  So, who are these champions of Covid that are keeping it firmly in the fight?  Believe it or not, the new champions of Covid are the Democrats and Republicans we elected a few short years ago.

Yes, Covid has become politicized and rather than the CDC, WHO and local health authorities deciding on the best defense against Covid, The Democrats and Republicans have taken opposite sides and fed confusing messages to the public, stifling our ability to fight this enemy.  Compounding the matter even further, the internet has weighed in, mixing facta and physicians into a noxious slurry that too many people have swallowed.

On a daily basis, I receive lots of questions about Covid, vaccines and treatment options.  They are from former patients, and all appear to have consumed the noxious slurry mentioned above.  Many are scared, not knowing what to do.

Until we settle on one set of medical facts and one unified plan to fight Covid, I fear it will continue to plaque us, or worse, end our rein on earth.  In my lifetime, I’ve seen the eradication of Polio, Chickenpox, Measles, Mumps, Tetanus, Diphtheria, Whooping Cough and many others.  We succeeded because we had a unified approach to vaccinations and treatment approaches.  I am not surprised that we need a Covid booster.  None of the vaccines I’ve used over the last 40 years were one and done.  All came with rare risks and all hurt someone.  However, the greater good was accomplished by vaccinating those at risk.  The greater good this time won’t be accomplished until we get politics out of medicine!

Here’s your joke for the day:

A very old man was sitting on his porch when he notices a small boy walking past. “Whatcha got there, sonny?” asks the old man. “Cat wire,” replies the youngster. “Gonna catch me some cats!” The old man starts laughing hysterically.

But sure enough, 3 hours later, the boy walks past the old man’s place with a sack full of cats.

Two days later the old man sees the boy again.

“Whatcha carrying there, boy?” he asks.

“Duct tape. Gonna catch me some ducks!” replies the youngster.

Well, the old man laughs even harder, so hard, he falls out of his chair.

But again, a few hours later, the boy walks past the old man’s house with a sack full of ducks.

Three more days pass and the old man is keeping an eye out for the boy. He finally appears.

“Now what are you carrying?” the old timer inquires.

“Pussy willow,” says the boy. “I’ll get my coat!” the old man snaps bac

“You’re not as smart as you think you are — and neither is your doctor,” by Claire Unis,MD and published on KevinMD is a must read.  Just click on the hyperlink above.

Here’s today’s joke:

A very successful attorney parked his brand-new Bentley in front of his office, ready to show it off to his colleagues. As he was getting out, a truck came along too closely and completely tore off the driver’s door.

Fortunately, a cop in a police car was close enough to see the accident and pulled up behind the Bentley with his lights flashing.

Before the cop had a chance to ask any questions, the attorney started screaming hysterically about how his Bentley, which he had just purchased the day before, was completely ruined and would never be the same, no matter how any car body shop tried to make it new again.

After the lawyer finally wound down from his rant, the cop shook his head in disbelief. “I can’t believe how materialistic you lawyers are,” he said. “You are so focused on your possessions that you neglect the most important things in life.”

“How can you say such a thing?” asked the lawyer

The cop replied, “Don’t you even realize that your left arm is missing? It was severed when the truck hit you!”

“OH, MY GOD!!!”screamed the lawyer.

“My Rolex!”

Up, down, up, down and on and on. Life appears to be a series of ups and downs and when it stops nobody knows. Ups and downs can be good.  At the heart of everything, ups and downs represent the rhythm of love and leads to procreating in a most enjoyable way.

On the other end of our existence, ups and downs are bad being the rhythm of depression and sadness.  August was a particularly rocky month and a good example of the ups and downs.

My August “Ups” list goes as follows:

August starts with road trip in my convertible.  My first stop is Richmond to see Abe and Linda.  Seeing them is always uplifting. 

From Richmond, we travel to northern Virginia for a Bat Mitzvah and family celebration of life.

Next comes Norfolk and my 90 plus year old uncles, my sister-in-law, and other lifelong friends and cousins.

Returning home is usually in the “Ups” category but this time leads to the “Downs.”

My weight is down14 pounds.  That’s a good down!

My August downs not-so-good list goes like this:

My father died in August.  I try to celebrate his life; but, instead, I’m living it.  Parkinson’s is no party!

I came to the conclusion that I’m not physically comfortable anywhere other than home. Yep, I need my lift chair, zero threshold shower, bars and, of course, my bidet.

While visiting my sister-in-law, Renee and I discovered that she is dying and in horrible pain.

Even though Renee and I are driving in a convertible, the top was up.  It was too hot to put the top down!

My car was rear-ended and no longer drivable.

Shortly after returning home, my sister-in-law died and we returned to Norfolk for a funeral.

My uncle tried to serve us cookies and fell flat on his face, breaking his nose.

I regained 6 pounds eating comfort food.

Yep, life is full of “ups and downs”.  It’s what you do with them that counts. I write and talk about them. Life is like riding a roller coaster; once you are in motion, you must ride it to the end.  You might as well enjoy the ride rather than fretting about what’s around the bend or at the bottom of the next hill. RIP, Chrissie.

Here are a couple of jokes:

I went on a roller coaster and the woman next to me would not stop screaming.

Seriously, it was like she had never seen a penis before.

A man was sitting on the edge of the bed, observing his wife, looking at herself in the mirror. Since her birthday was not far off, he asked what she’d like to have for her birthday.

“I’d like to be six again”, she replied, still looking in the mirror.

On the morning of her birthday, he arose early, made her a nice big bowl of Lucky Charms, and then took her to Six Flags theme park. What a day! He put her on every ride in the park – the Death Slide, Wall of Fear, Screaming Monster Roller Coaster – everything there was.

Five hours later they staggered out of the theme park. Her head was reeling and her stomach felt upside down. He then took her to a McDonald’s where he ordered her a Happy Meal with extra fries and a chocolate shake.

Then it was off to a movie, popcorn, a soda pop, and her favorite candy, M&M’s. What a fabulous adventure! Finally, she wobbled home with her husband and collapsed into bed exhausted.

He leaned over his wife with a big smile and lovingly asked, “Well, Dear, what was it like being six again??”

Her eyes slowly opened and her expression changed, “I meant my dress size, you dumbass!”

I went with Renee to the physiatrist today to discuss what we are going to do with Renee’s neck.  Renee and I are competing for the “Who Has the Worse Neck Award.” You might say we are neck and neck coming into the home stretch.  The physiatrist said something that is worth repeating:

“There are two types of docs.  There is the doc that treats the patient with a problem and the doc who treats a problem with a patient attached.” While it may sound like a simple play on words, it is a significant play on words.

Back in the dark ages, when I went to medical school, we were taught to take care of the whole patient.  The doctor-patient relationship was sacred and practicing medicine was a calling.  Unfortunately, everything changed with the onset of the computer age.  The focus shifted to problem management and checking as many boxes as possible became the goal.  The doctor was demoted to the status of provider and the patient was demoted to the person who delivered the problem to the computer.

The story is sad but true. During my tenure as physician, I worked long hours caring for people.  Today’s provider works long hours poring over computer algorithms, assuring that the proper boxes have been checked and coding is completed.  By the way, the doc Renee saw today used two novel tools, paper and pen, to record her history and findings. Rather than looking at the monitor while he talked, he actually looked at us and talked to us.  Being cared for as a human was a pleasurable experience.

I feel sorry for Dr W. as I’m sure he’ll spend his night inputting his notes into NextGen.  Boy, I miss the good old days. I’ve now been on hold for 15 minutes.  I’ve been on the phone for 1 hour and twenty-four minutes with Verizon trying to correct a bill I received after terminating my service.  They claim that, once their compute generates a bill, nothing can be done to correct it.  They want me to pay $81 for zero service or else . . .  The computer, even when wrong, has to be fed. 

What next?

Here’re your jokes of the day:

Verizon made a new minimum-security prison; and, despite what many would believe, it’s very successful. It’s got no bars but you still can’t get out of it for 2 years.

What does Verizon wireless and abortion clinics have in common?  They both have early termination fees.

For more Verizon jokes go to: https://jokojokes.com/verizon-jokes.html