Author: wellthy

I’m bored.  I’m experiencing the effects of a writer’s block.  As a matter of fact, this is the longest writer’s block I’ve ever experienced.  I think part of the problem is the constant background noise of politics.  Yes, the political pundits, the journalists, the protestors, the candidates and the internet keep bombarding the public with threats, doom and gloom.

Covid-19 is responsible for the rest of the background noise.  The medical pundits, journalists and internet tsunamis of controversy and conflicting “facts” fill the airways with doom and gloom, also.  The end result is maddening.

I used to enjoy opening my emails and reading about my extended family and friends.  Now, my email is full of junk, political and medical video clips and articles.  Paranoia rules!  Everybody is either searching for the truth or selling their version of the truth. The way I see it, I’m going to die under a socialist regime or despot, all alone in an ICU kept from the ones I love by Covid-19.

A good example of the madness that has consumed my friends and former patients are those people who have already stated that they will not get immunized against Covid when the vaccine is available.  We know absolutely nothing about the proposed vaccine.  How can you make a decision based on a complete absence of information?

I’ve shut down.  I’ve put on my earphones and spent hours listening to books.  I listen to music.  I’ve sat outside and tried to meditate.  I’m spending more time cooking and cleaning.  I’m looking for something positive to do.  I’m failing.

The gym takes up 30 minutes.  Walking takes up another 30 minutes.  That leaves a lot of meaningless time.  I’m driving Renee crazy. I’m going crazy.  I used to read medical articles and listen to medical podcasts.  Now every article and podcast are on Covid-19. So, what’s a guy to do? Telling Covid to go to hell doesn’t work! That leaves me with:  First, stop whining. Second, take a nap.  Third, Renee let’s play! Fourth, ask for reader input. Fifth, take another nap!  Then, start all over again.

Here’s your music for the day and a joke or two. 

Insanity is hereditary. You get it from your children!

They say insanity is doing the same thing over and over and expecting a different outcome.  This is the 58^th time I posted this joke.

I want to wish everyone a very happy and healthy New Year.  This past year has been a year of change.  As happens every year, some of the changes have been good, some bad but most of the changes are mixed blessing and curses.

As we start the new year, we have settled in Indian Trail, North Carolina and are adapting to the many changes in lifestyle caused by both Covid and the southern lifestyle.  We seriously miss our Illinois friends.  Keeping up with the friends we left behind has helped keep us sane, but nothing will replace actually being with them.

We are actively meeting our new neighbors and I’m happy to say that my nextdoor neighbor has two beautiful dogs that I’ve become friends with.  Living in a community where everyone is old is certainly different.  The fact that everyone I’ve met is healthier than me is definitely upsetting but also has helped fuel my desire to exercise and lose weight.

Parkinson’s is a cruel companion and an ever-increasing body of research suggests that diet and exercise may delay the disease and lessen its impact.  I invite each and every one of you to be as fit and “WELLTHY” as you can by exercising as if your life depends on it.  Your life may actually depend on how buff you are!

There are many other diseases which may be prevented or improved with exercise, weight loss and a proper diet.  Please, dedicate this year and all future years to staying healthy and happy.

For those of you who are workaholics, all I can say is I’ve been there, done it and can tell you that the price you will pay for hours away from family and the gym won’t be worth it in the end.  Americans live to work while Europeans work to live.  Life is too short!  Learn to work to live and make the most out of the life you have.

Renee and I wish you all a very healthy and happy new year.  

The one thing my patients never wanted to hear me say was, “I don’t know.”  While saying, “I don’t know” was the appropriate and honest thing to say, it often meant the patient was going to leave my practice in search of the answer, a move that might get them into worse trouble than they were already in.  So, why bring this up now?

I just listened to a podcast by a professor at Stanford who reviewed his findings on Covid-19 and his thoughts about where the American medical system, government and the press went wrong.  Instead of saying, “we don’t know but we are actively seeking answers,” we broadcast our current knowledge as if it was the gospel.  

In time, our knowledge grew and each time we learned more, we published a new gospel.  The more versions of the gospel of Covid that existed, the more defenders of the gospel joined the conversation and the conversation eventually turned into a war of words and science. Currently, there are so many versions of the gospel that no one knows what to believe.

Do we wear mask or don’t we?  Do we keep our distance from others or don’t we?  Is it safe to send our kids to school or isn’t it?  Do we put your local mom and pop businesses out of business to protect the community or don’t we?  The list goes on and on and, as of right now, we still really don’t know.

What we do know is that the flip flopping of the world’s specialists, governments and journalists have created a mess.  That mess could have been avoided by simply stating, “we don’t know but we are actively seeking answers.”  Unfortunately, not having a reputable source of information has driven many to the internet for answers and the internet is full of mistruths and lies.

So, what do we know?  What we know is that it will take another 6-12 months to assess the world’s data and develop a true picture of what we are dealing with.  I don’t know enough to tell you what you should do.  However, I can tell you what I think.  I think we should err on the safe side whenever possible.

Wearing a mask is not going to harm you unless you have advanced lung disease.  Keeping others at a distance is not going to harm you unless you are prone to depression and social isolation is going to lead to a worsening of your depression and possible suicide.  Whether to send your kid back to school or not is highly dependent on your child’s personality and your family dynamics.  I can’t tell you whether you should get vaccinated as I don’t have any information on the Covid-19 vaccine. 

The one thing I know for sure is I want a doc who is not afraid to say, “I don’t know.”  Knowing what I didn’t know and admitting it was one of my best attributes as a physician. Often, to help my patient understand why knowing what I didn’t know was important, I would draw a triangle and divide it into thirds.  The tip of the triangle represented what I know.  The mid-section represented what I knew that I didn’t know.  The base, and largest area of the triangle represented what I didn’t know that I didn’t know.

Recognizing that a large part of the world’s knowledge falls in the base of the knowledge triangle is humbling.  It also is very helpful as it means that you can never stop studying and looking for answers.  It also provides hope that, being persistent in your quest for answers, will be rewarded.

When your doc says, “I don’t know,” thank him/her and then ask him/her what to do next.  When pressed for an answer, I would refer my patient to a specialist or even to Mayo Clinic.  Unfortunately, if I didn’t know the answer, my specialist/Mayo were highly unlikely to have the answer.

Confused?  It’s not uncommon to be confused when there is no obvious answer.  Again, err on the side of caution until you know more.

Here’s your music and a joke.

One day Grandpa was watching Junior playing with an earthwormGrandpa said, “Junior, I will give you $10 if you can put that worm back down in its hole.”

The kids thinks and thinks, then runs into the house and returns with a can of hair spray. He sprays the worn all over and as it gets stiff he stuffs it down into the hole. Grandpa gives the boy $10.

The next day Grandpa comes out to where Junior is playing and gives the boy $20. The boy looked up in confusion and asked, “What’s this for?”

Grandpa smiles and says, “That’s from Grandma!”

This article is very personal.  I find that most individuals are not willing to share this type of information and therefore quietly live in misery.  Hopefully, by being upfront about the problems older individuals suffer with, I can start a frank conversation and help you realize you are not alone.

The story starts when I was a young physician.  When we were young, our schedule was primarily based on our work schedule (unless you were a fulltime mother) and secondarily by our family needs.  Most of us set an alarm to wake us up in the am and had a defined bedtime as we needed to be awake and functioning at work.  On occasion, patients would complain that taking a diuretic adversely affected their lives and schedule.  I really underestimated the urinary problems caused by diuretics and the impact frequent urination had on my patients. I’d simply tell them, “That means the medication is working.”  Now that I’m on a diuretic, I’d like a do-over!

I always thought that, once I retired, I would no longer have a schedule nor an alarm clock.  Boy was I wrong.  My schedule now revolves around my medications.  I take a diuretic named Lasix (furosemide).  Diuretics cause you to urinate more than usual and once I take mine, I have to be near a bathroom.  What a hassle.  My urine output usually increases over 6 hours and God forbid I have to go somewhere after taking a Lasix, I’m in deep shit (should be deep piss).  While this is probably too much info for some of you, it is a real problem.  I spent years advising patients how to live with a diuretic but never really understood its true impact.

My solution is to start my diuretic at 4-5 am or not take it on days I need to go out in the morning.  I have to be very careful not to take my diuretic in the evening as it disrupts my already poor sleep.  When I practiced medicine, my favorite thing was to sleep to 9 or 10 on Sunday.  Now that I’m retired, I can’t sleep.  If I sleep until 4 am, I’m blessed.  That’s another topic for another day.

I have Parkinson’s which causes mobility issues.  Mobility issues and diuretics don’t go together well.  Having to go to the bathroom 6-8 times in the morning is fatiguing and humbling.  I can’t tell you how many times I’ve come close to wetting myself.  My crystal ball tells me that Depends are in my future.  I have to applaud the manufacturer of Depends.  The name is perfect!  When and if you wear Depends depends on how quickly you have to go to the bathroom and how likely you are to be incontinent.

One of the hardest things I’ve had to do to try to lessen my diuretic dose is cut back on my salt ingestion.  I am a salt-oholic and use all kinds of salts on a daily basis.  While reducing salt intake is supposed to help, I’m not convinced that it has helped.  I’m also not convinced that giving up salt is worth it.  

So, if you have a similar problem, make sure you discuss it with your doc and make sure he/she understands just how disruptive it is.  Certainly, if you have any ideas how to lessen the impact taking a diuretic has, please share them with me. 

Here’s your music for today and a joke.

You don’t appreciate a lot of stuff in school until you get older. Little things, like being spanked every day by a middle-aged woman: stuff you pay good money for in later life. Emo Philips

How the heck do you expect me to lose weight?  I was at the pool yesterday meeting new people. Of interest, the men all looked the same with guts hanging over their bathing suits and 2-day old scruff on their faces.  The women looked the same as well with varicose veins on their legs, paunchy waistlines and ample sagging breasts.

The community is made up of families from: New York, Chicago, Wisconsin, Ohio and an assortment of other cities.  Everyone has the same complaint and it centers around food.  The Pizza is not as good as New York or Chicago’s.  The deli is sorely lacking.  You can’t find a good 

Chinese restaurant anywhere.  Even the Carolina barbeque is not what one expects.  Hell, I met Jim from Norfolk who talked about Virginia white barbeque.

How am I supposed to lose weight when the conversation at the pool involves food and where to find food almost as good as back home (wherever home used to be)?  It’s kinda funny listening to everyone lamenting the lack of really good food while sunbathing in their extra-large bathing suits with their protuberant guts.

Next year, when I’m 20 pounds lighter, I’ll try the pizza joint up the road that the New Yorkers tout as being similar to a true New York pizza.   Next year, I’ll try the Italian deli that is “not quite as good” as the real thing.  I’ll have to fly back to Chicago to get Jewish deli and real Chinese food.  In the meantime, I’ll walk away from the pool conversation, drooling and dreaming of dishes never to be enjoyed again.

By the way, I’d like to lose 40 pounds, would accept 20 pounds and realistically will be happy with a 5-pound loss in the next year.  My readers have been supportive, sending me links to all the latest diets.  Yesterday, I read up on the Carnivore Diet (another version of the Keto diet).  I certainly appreciate the support but I’m hell-bent on eating a balanced diet that I can stay on forever.  

I’ll be patient and continue to refine my diet, increase my exercise and enjoy life as much as possible.  Sooner or later, the weight will decrease.  I’ll keep you informed of my progress in an attempt to help you improve your diet and wellbeing.

By the way, don’t forget to get your flu shot.  I felt rather punk for 2 days after mine.  It was worth it.  I’d rather feel punk for a few days than sick for a few weeks.

Here’s your music and a joke. A lawyer walks into a doctor’s office with a frog on his head.  The doctor says, “That’s a nasty looking growth on you’ve got there.”  “I’ll say,” replies the frog, “It started out as a pimple on my ass!”  

What do you do when there is no right choice?  Frankly, I don’t know!  Often, when there is no right choice, I find myself torn between the options.  Which option carries the greatest risk?  Which carries the greatest reward?  Which effects the most people?  Which can I live with?

Covid has created one more paradigm to fret over!  It’s holiday season!  In short order, I have Kenzie’s birthday, the Jewish New Year, Jeremy and Allyson’s birthday, Thanksgiving and Chanukah/Christmas.  

Ideally, my family comes together in celebration.  Erin’s family could come from Virginia and Jeremy’s family could drive up from Georgia.  Steve’s parents live here.  Fifteen strong, we should party late into the night celebrating the blessings of family, especially since we now live within driving distance of all of them.

Here’s the rub.  Each of my kids have a lifestyle of their own making.  Erin’s kids go to school with other kids.  Jackson plays baseball, Hannah is an active 12-year-old.  Each have risk of being infected by Covid.  Each may carry the disease that could devastate their family.

Jeremy’s family have a tight neighborhood social circle and come into contact with other families on a regular basis.  Jeremy and Allyson are excellent parents and have taken RJ on many trips to the lake and beach this summer.  Allyson and RJ go to school 5 days a week. They are highly cognizant of the risk factors for Covid and take active precautions. They still may carry the disease that could shatter the family happiness.

Renee and I are marooned at home.  We go to the grocery store, keep social distances, see Lisa and Steve regularly, see Steve’s parents weekly and interact with people at the pool and on our block always at a distance.  No matter how low Renee, myself, Lisa, Steve and his parents risk factors are, we still may carry the disease that is capable of causing serious harm to those I love.

So, do we physically come together to celebrate birthdays and holidays?  The odds of getting sick are small.  Do we play the odds, or do we isolate ourselves, honker down and wait for a vaccine? Again, I don’t know.  I know I want to/need to see my children.  None of us know how long we have to live but I suspect that I have less time than most.  

If I choose the safest approach, we celebrate the holidays on Facetime or Zoom.  I feel secure in my new house and absolutely miserable that my concerns kept my family from being together.  If I choose to gamble with my health, I get the pleasure of actually hugging my children and celebrating with them.  I may also have to pay a devastating price to be with them.

There is no right answer!  This scenario is not unique to the Segal household.  It’s playing out in multiple homes across the country. This promises to be a miserable holiday season no matter what decision you make.

As for me and Renee, we have chosen to stay isolated and sad that another year will go by without an in-person family gathering.  This sucks!  Perhaps, with proper planning, we will have a scheduled holiday family party after a 2-week, self-imposed, quarantine of all involved.  A 2-week quarantine is no easy feat when you have children ranging from 6 months to 14 years old.  

Every time I think life is bound to return to our old normal ways, something happens to point out that the new norm is likely to be foreign to all we know.

I know I sound morbid.  I am!  What are you doing this year?

Here’s your music for the day and a joke as well. 

It’s amazing how I could preach meal planning for years and yet, skip this most important task.  I’m a self-proclaimed food addict and a food addict should never go to the grocery store hungry.   A food addict should never wait until the last moment to decide on what he/she is going to eat.  Before going into a restaurant, a food addict should have studied the menu, and, when full, should decide what he/she is going to order.

There is a temptress around every corner in every grocery store and restaurant.  The food industry hires experts to advertise and place food in such a way that’s it’s almost impossible not to buy and eat it.  The Giant Open Air Market in Norfolk was a perfect example.  When they opened, they piped the smells of bakery fresh bread into the store entrance.  From the minute I walked into the store, I wanted hot bread even though it was not on my grocery list.

In order to protect yourself from buying and consuming the wrong types of food, you should plan your meals in advance.  Yesterday, I planned my meals for the week, went to the grocer, bought what I needed. Made six meals and froze extra for next week.

Last night, I prepped for my breakfast by putting measured amounts of oatmeal and water in a microwaveable bowl with Sweet N Low and cinnamon and left it in the microwave.  This am, I hit the on button and waited for the ding that signified the beginning of today’s eating orgy.  Actually, now that I have my meals setup for the week, it’s no longer a food orgy.  

So, it’s time for me to follow my own advice.  By planning my meals in advance, I should be able to control my appetite and improve my intake.  In the past, I would have told you, “the truth is in the pudding.”  Unfortunately, pudding is not on my diet and “the proof is in the fig” just doesn’t sound right.

Give me 1 month and I’ll report how I’m doing.  One thing is for sure!  I’m going to lose this weight!

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

The problem isn’t that obesity runs in your family.

It’s that nobody runs in your family.

It’s not uncommon for me to hear, “Doc, I passed out yesterday.”  As a matter of fact, I just received that very call, only my friend passed out earlier in the week.  When a patient loses consciousness, there are long list of things I want to know:

• Was the loss of consciousness witnessed?
• Did he/she hurt him/herself?  What injuries were suffered?
• Did they go to the ER?
• Were they confused when they awoke?
• Have they passed out before?
• Did they experience any chest pain?
• Did they soil themselves?
• How are they now?

These are but a few things I need to know in order to safeguard their wellbeing.  The immediate questions I need to answer are:

• Is there an immediate risk posed by their injuries?
• Why did they pass out and what risk does the underlying cause pose?
• Are they at risk of passing out again?
• Is there any evidence of a head/brain injury?

Again, these are but a few of the things I need to know.  The possible reasons for passing out are just about anything you can think of and, particularly on the first episode, need to be investigated promptly by a physician.  You would be surprised to know that a huge percentage of men will refuse to go to the ER.  In my experience, women are much more likely to be seen in the ER because their spouses/loved ones rightly call the paramedics.

Why are women less likely to dial 911?  The answer is simple.  Men can be stubborn assholes.  My favorite and most often heard interchange between loved ones is:

Women – I’m calling 911. You need to be checked out.

Man – “I’m telling you, don’t call the paramedics!  I’m fine!  I just passed out.

Women – “I’m calling the paramedics; you don’t look fine!”

Man- “If you call the paramedics, I’ll never speak to you again.”

I want to point out two critical flaws in the above conversation.  First, there is no such thing as “just passed out.”  Passing out needs to be treated seriously until proven otherwise.

Second is that, if you stay home and die from an otherwise treatable illness or injury, you will definitely never speak to your loved ones again.  Also, you will always regret not having dialed 911.

So, if your gut tells you to call the paramedics or take a loved one to the ER, do it!  If they are mad at you for caring, at least they will be alive.  If all else fails, call your doc and ask for his/her advice.

Here’s today’s music and a joke. 

A cucumber, gherkin, and cock are sitting around discussing how fucked their lives are.

“My life sucks,” said the cucumber. “When I get big and fat, they cut me to pieces and chuck me in a salad.”

“That’s nothing,” said the gherkin. “When I get big and fat, they squash me in a jar with the rest of my family and cover me in vinegar.”

“You two are living on easy street,” said the cock. “When I get big and fat, they pull a plastic bag over my head, stick me in a dark, damp room and bang my head against the wall until I throw up and pass out.”

Think for yourself was the theme of a recent podcast by Zdogg that I just listened to.  What a novel concept!  Lately, I’ve been barraged by video clips and articles posted on the internet, each one telling the world the gospel.  My patients want my opinion as to the veracity of the information.  I also have been bombarded by political rhetoric with the Trumpers telling me their side of the story; and the democrats, likewise, telling me their truth.

What amazes me is that, in many cases, the people who send me the above-mentioned information, aren’t really interested in my opinion.  Instead, they are selling me someone else’s opinion that they have bought in to.  Why would I say this?  At first, I responded to each and every article and video clip I received.  Often, after analyzing the information, I would find flaws in the material; and, naturally, I would point those flaws out.

After pointing out the flawed logic, false information and, in some instances actually debunking the report, I would then receive an email telling me why I was wrong and trying to sell their viewpoint.  It soon became apparent that the reason that there is so much shit on the internet is because people are buying the shit at face value.  Rather than critically assessing the material themselves, they buy in and then sell it to their internet community.

So, here’s what I know:  

Number one on the list is that this year should be named, “The year of the grand conspiracy.” There are so many conspiracy theories circulating on the web that I can’t keep track of them.

Number two is that the influence of the web and what it is telling you to think is unbelievable.  A clever individual with a particular mindset can sell his/her ideas on the web and influence millions of people and actually change history. You’d be shocked at the number of people who don’t believe that the holocaust actually existed.

Number three is that the divide between the Democrats and Republicans is so deep that both parties are ineffectual.  The divide between blacks and whites has also deepened to dangerous levels.  In reality, our country is on the verge of splitting apart. 

If you look back in history, all of the great empires ultimately destroyed themselves.  Are we about to do the same?  I think so!  One thing I sincerely believe is that we need to calm down and start thinking for ourselves.  We need to think before we react.  We need to research all sides of an issue, not just buy the best-looking podcast or journalists’ attitude.  We need to listen to every source with more than a grain of salt.

We also need to put aside political correctness and speak our minds.  There are evil people who have found new voices on the web and in the media and are succeeding at furthering the rifts in our country.  They need to be recognized for who they are and outed.

The holocaust did happen.  You have to obey the law.  The vast majority of the police are good people doing a thankless job.  All lives matter. The list is too long to post here.

The trick is learning to think for yourself again.  In the old days, learning meant going to the library and reading printed material.  It was a slow process and allowed time to digest what you read.  Reading has become a thing of the past. Information is dumped on your desktop in large volumes, repetitively, and opinions are prepackaged for you.

There is no music or joke that goes with this article.  It’s no joking matter.  

Failed again!  This time, I followed the dietary instructions to the letter.  After 1 month on Weight Watcher’s Green, I’ve lost a total of ZERO pounds. I’ve increased my exercise as much as I can tolerate and have yet to gain any endurance or strength.  I’m frustrated!  I am also not giving up.

I’ve quoted Bruce’s father many times and will do so again.  “If you fall down six times, get up seven.”  Well, I’m on my feet and ready to move on.  After careful research, I’ve decided to stay with WW and switch to the purple plan.  Those of you who read my book, know I don’t like diets.  Diets are temporary changes people make to lose weight, only to regain their weight when they resume their normal eating habits.

I’ve chosen WW as it allows me to eat food I normally eat.  WW is compatible with my Wellthy plan.  WW Purple is a diet I could stay on long term and be happy.  Now to figure out why I’m not losing weight. Either I’m still eating too many calories or not burning enough calories.

One problem with WW is the zero list.  My children always said that the Segal Motto was “Go big or go home.”  When given a Zero/free list of food, my tendency is to overeat.  This time around, I’ll concentrate on limiting serving size.  I’ll continue my exercise and increase in small, safe increments.

Health is a major part of WELLTH.  Wealth is worth working for, no matter how difficult. Frustration is my enemy.  My readers support has been one of my best tools and I thank you for your suggestions and support.  

If you need to lose weight and to increase your Wellth, develop your own diet and exercise program.  Define what your ideal diet should be and then refine your current diet until your weight begins to fall.  If you are not exercising, start.  If you are exercising, increase your exercise.  Whatever you do, do no give up until you’ve reached your goal.

Let your friends and colleagues know what you are doing.  Their support is priceless.Here’s your music for the day and a joke. Today at the bank, an old lady asked me to help check her balance