Questions

Questions?

Questions?  I have a lot of them.  I woke up at 4 am, again.  Why can’t I sleep past 4?  I don’t know. My doc has me on a machine for sleep apnea.  Yes, I’ve added sleep apnea to a litany of other problems.  

I think CRS may be the worst of my ailments. Most of my friends have CRS.  Just in case you don’t recognize the name, it stands for “Can’t Remember Shit.”  Yesterday, Renee and I totally blew off some very important people due to our CRS and an assortment of other problems.  No excuses! If you read this, I’m sorry!

If exercise is the fountain of youth, why do I hate doing it?  Why did my brother have a stroke?  He rarely ever missed a day in the gym.  Obviously, my brother’s stroke is foremost on my mind.  Don’t get me wrong.  As a doc, I highly recommend a regular regimen of exercise and healthy eating. Of course, there are those, like my best friend Robert, who believe that humans have a fixed number of heart beats in a lifetime and that when they run out, they die.  Robert thinks its foolhardy to waste heart beats in a gym.

Hallelujah!  Last night on the news, they announced that napping decreases your risk of heart attack and stroke.  Finally, a beneficial side effect from the mass of pills I take.  I am the napping king!  Of course, this may be the notorious fake news we’ve heard so much about.

I really don’t like being a patient.  There are too many docs to see.  Too many pills to take.  Too many side effects.  Too many tests.  Too much money spent.  Oh G-d, I have discovered a new ailment, the “Toos.”  Luckily, I have CRS and will have forgotten all of the above by noon.

One last question.  Is anybody reading this blog?  If you are, let me know.  If you’re not, its ok.  As a retired doc, I highly recommend finding something meaningful to do with all the empty hours you spend waiting to see your next doc or take your next set of pills.

Here’s an interesting view from 2011.

October 24, 2011

Sometimes I amaze myself.  Apparently, there is now a name for what I have been doing for the past year: “Patient Engagement/Activation.”  KevinMd recently published “Physicians should embrace patient engagement” by Dr Ken Bottles (http://www.kevinmd.com/blog/2011/10/physicians-embrace-patient-engagement.html).  

This blog has been my way of engaging/activating patients.  Knowledge is power and providing my patients with the knowledge they need to become active participants in their healthcare has been my goal.  

In Dr. Bottles’ article Jessie Gruman, a cancer survivor is quoted as saying, “As a savvy and confident patient who is flummoxed by so much of what takes place in health care, I am regularly surprised by how little you know about how little we patients know. You are immersed in the health culture. But we don’t live in your world. So we have no idea what you are talking about much of the time. One way to help us feel competent in such unfamiliar environments is to give us some guidance about what this place is and how it works. What are the rules?”

In August, I published, “I Am A Responsible Patient.” (https://livewellthy.org/2011/08/31/i-am-a-responsible-patient.aspx)  The article outlined “the rules” for my patients, as well as for any of my readers who were interested in taking an active role in their health.  I have published multiple articles over the last year designed to help patients “feel competent in such unfamiliar environments is to give us some guidance about what this place is and how it works.” (Bottles)

According to Dr. Bottles’ article, “The ten categories of the Engagement Behavior Framework are:

  1. Find safe, decent care
  2. Communicate with health care professionals
  3. Organize health care
  4. Pay for health care
  5. Make good treatment decisions
  6. Participate in treatment
  7. Promote health
  8. Get preventive health care
  9. Plan for the end of life
  10. Seek healthcare knowledge.

I agree with each of these 10 principles.  It is critical that, as physicians, we engage and activate our patients.  The article goes on to report, “Recently Klick Pharma invited 19 health care activists from a wide variety of disease states to participate in a conversation about an ePatient Bill of Rights that would support patient engagement and activation. After four hours of conversation, this group reached consensus on the following key messages of such a bill of rights:

  1. Shared access to my data
  2. Attitude of collaboration and overall respect
  3. The patient is the largest stakeholder
  4. Transparency and authenticity across all areas
  5. Voice of the patient is a legitimate (clinical) source
  6. The right to efficient communication with providers who utilize the technology we need”

I think the key remark in this entire conversation is number three, “The patient is the largest stakeholder.”  The patient is the largest stakeholder, the one with the most to win or lose.  In this ever-changing world, it is incumbent on the patient to take an ever growing and active role in his/her health.  

Investing the time and effort in “self” is critical.  “Seeking healthcare knowledge” (Bottoms) is time consuming and difficult but well worth the investment. Getting “preventative health care” (Bottoms) is important but practicing “preventative health care” (Bottom) is more important (Segal).  

What is missing from Dr. Bottles’ article is the importance and key role of the concept of “continuity of care.”  Communicating with your healthcare provider and forming a longstanding, health care team is essential in optimizing your health.  Long term patient-physician relationships promote trust and trust is the critical factor that allows for “safe, decent care.” (Bottoms)

Dr. Bottles’ article goes on to state, “Experts in patient activation/engagement suggest that hospitals and medical practices provide each patient with a short guide that explains how best to be a patient in that unique setting.”

A “short guide” on “how best to be a patient in that unique setting” does not exist.  There are now 326 articles on this blog and more to come.  Each article hopefully will enable you to be the best patient you can be.

If only there was a “short guide” to being the best doc you can be!

Don’t Delay the Happiness

September 9, 2019

As a family doc, I am acutely aware of the stages of life each of us eventually go through.  I counsel young sleep deprived parents of a colicky baby.  I reassure the parents of teens pointing out that their irresponsible child will go to college, go to work and become a success.  I help 50-year olds survive their mid-life crisis.  I also work with the elderly helping them through an assortment of losses and eventually death.

Knowing what’s coming really doesn’t help. I really expected that I would skip this stage of life. Instead, I become more like my father every day.  My dad started life as an optimist and ended life as the world’s greatest pessimist. I think Parkinson’s and the unavoidable, degrading losses of motor function does that to you.  At least I haven’t started reading the obituaries yet.  He started his day looking at who died.  Of course, the internet and Facebook bring that info to your desktop in real time.

Yes, I’m in the “Golden Years.”  I’ll share a little secret with you.  They are golden years because you need gold reserves to pay for your medications, nursing home and funeral.  Are you depressed yet?  Are you ready to exit my blog and do something else?  Read on.  I promise it will be worth it!

Here’s my gift.  I’ve often told my patients that the devil exists, and his greatest accomplishment is the concept of tomorrow.  By giving us tomorrow to worry about, save and plan for, the devil ruins today.  Today is the only thing we really have.  Don’t waste it.

They say, “No one knows what the future holds.”  I do. For most of my patients, it holds regrets.  Most of my patients put off happiness and work their lives away so that “one day” they will be secure and realize their dreams.  Don’t wait for “one day!”  It may not come.

I am amazed at how bright I was in 2011.  It’s as if I could predict the future and left myself notes in the form of my blog to help guide me through rough times.  Below is an article published August 26, 2011.

Last night, I watched “The Big C”, a TV show about a woman diagnosed with an advanced stage of melanoma, a nasty skin cancer.  The show follows Cathy, the main character, through the various stages of dealing with a life-threatening disease.  The show is funny and sad, uplifting and depressing.  Living with and dying from cancer is often a rollercoaster ride.

In last night’s episode, Cathy, while counseling a friend, remarked, “Don’t delay the happiness!”  Too often, we delay the happiness while dealing with today’s stressors and tasks.  We promise to get together with friends and family.  We promise to call mom and dad.  We plan to run away from it all and be selfish.  We will do it all, one day.

Sometimes, there are no more “one days.”  I have seen patients die for no reason.  One day they are here, the next day they are forever gone.  “Don’t delay the happiness” is sagely advice.  One thing is for sure: today is your day to find happiness.  Today is a good day to make that call, see that friend, and make definitive plans for your runaway vacation.

Yes, you have to work, to make a living, and provide for yourself and your family.  Yes, you are a responsible individual who others rely on.  Yes, you have a list of problems a mile long.  You also have time to count your blessings and you need to make time to do something nice for you and your special ones.  Recently, I wrote about regrets.  Don’t set yourself up for regrets.

Most of my patients are so focused on retirement that they forget to live.  Don’t live to work; work to live.  Your job tomorrow, and every day, is to find happiness.  Happiness is best when it happens spontaneously, but life’s complexities means that finding happiness often requires some work.  Work hard to be happy and then share it with others.  “Wellthy” is not just about being physically healthy; it is also about being emotionally happy.

Horace wrote, Carpe diem, quam minimum credula postero – “Seize the Day, putting as little trust as possible in the future.”   Yes, you have to plan for the future, but not at the cost of the here and now.  

I wish you many years of happiness and no regrets. 

Posted in Philosophy of CareLeave a comment | 

Why Him?

September 8, 2019

I’m at a loss for words.  In August of 2011, I publish “I AM A RESPONSIBLE PATIENT.”  I actually have patients who follow the health contract as closely as possible.  Despite living a “Wellthy” lifestyle, they get sick.  Really sick?  What do you say to them?  To their families?  

“Bad luck dude,” just doesn’t cut it.  “G-d works in mysterious ways,” really doesn’t help either.  Do you tell them how scared you are for them? How sad you are that they are sick? In this circumstance, rather than asking “why me?”  the question is “why them?” So what wise and helpful thing can you say?

My brother is in the hospital.  He’s in trouble.  He’s the Segal that has spent pretty much every day of his adult life in the gym. He’s the one that eats a healthy diet, is happily retired with a thin muscular physique. He’s active; cutting his own lawn and walking the dogs daily.  He skipped the family curse, Parkinson’s.  Yet, he is now in a hospital fighting for his life.

Why him?  I have no answers.  What I do know is that his years of exercise and healthy living hopefully have given him the physical reserves necessary to fully recover and resume a normal life.

As to what you say.  Nothing at first.  At first, just listen.  Then let them know that you are there for them.  Let them guide you.  Sickness takes away your control of your life.  Make sure in your attempt to help your loved one, you grant them as much control as they can handle.  

Many of my patients have reached out to me since my surgery.  Their thoughts and care have been uplifting.  Thanks, guys, for caring.

Below is a copy of my healthcare contract.

Monthly Archives: August 2011

I AM A RESPONSIBLE PATIENT

Posted on August 31, 2011 by Stewart8022

August 31, 2011

I often refer to myself as a fireman pouring water on the flames that are burning my patients.  Often, I view my patients as arsonists, pouring gas on the fire I am working to put out.  Taking personal responsibility is a critical component of success in any of life’s ventures.  While my patients are very responsible business and family men and women, they often take no responsibility for their own health.  This blog has been successful at helping many individuals recover and maintain their health.  It has failed to help those who continue to be irresponsible.

In an effort to clearly define my patients’ role in their healthcare, I have developed the following contract:

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___________Posted in Philosophy of Care2 Comments

The start of something new

September 6, 2019

The start of a new stage of life should be exciting.  Today marks the transition from living within a scheduled world to one in which every day is a Sunday. I should be excited.  I’m not!

I should also be excited as one of my mentors and smartest docs I have ever known paid me a high compliment.  In his words, “Jesus Christ, you have become a writer! You have graduated to introspection and clarity.” I’m not!

Retirement is what everyone works for and looks forward to.  Not me! I truly belong in the office, caring for those who put their lives in my hands. Getting up to go to the office was easy. Getting up now requires self-motivation. Frankly, it hurts to get up.  My back is at its worst after lying on it through the night.  My Parkinson’s is at its worst upon awakening as my medications have worn off.  It took 45 minutes to dress today.  Now I’m supposed to follow the exercise routine set up for me by my physical therapist.  My brother loves to go to the gym, I don’t.

I’m not looking for pity.  I’m describing what countless people go through every day. When I first recognized that I had Parkinson’s, I got mad at G-d.  Then I rationalized it, believing it was a gift given to me to help me better understand chronic illness and better care for the chronically ill.  Then I realized that Parkinson’s was going to stop me from caring for others and give me the option of caring for myself or languishing in self-pity.

Languishing in self-pity is not my style.  I can still care for others by writing this blog. Can I care for myself?  Years ago, I wrote an article about my friend, Will. You know him as Will Power. Will Power is a great friend. I need him to stand by my side now more than ever. Will, are you out there?  If you are, join me in the gym.  While I don’t want to stretch and workout, I need to. I need to be healthy enough to put words on the internet that, perhaps, will help someone else who is entering my stage of life. 

Here’s an article from January of 2012 about my friend, Will Power.  It was also about losing weight and following a healthy diet.  Losing weight is just one more thing on my list of things to do. It was also one of my favorites:

January 9, 2012

Have you seen my friend, Will Power?  Will and I have been hanging out together since I published my book(Diets and Other Unnatural Actrs).  Will’s my best friend.  He’s the sensible one, always keeping me out of trouble.  With Will Power at my side, I have flourished.

Today, Will and I walked into the Garden Fresh Super Market together.  Will thought we should stop for lunch first but I was in a hurry to get home and prepare for my mother’s 90th birthday.  On entering the store, I noted an attractive young woman standing at a table selling her goods, so I stopped to see what she was offering.  Will was with me one minute and gone the next.  I figured he wandered off for a moment and would return shortly.  Mr. Will Power is a loyal friend; he wouldn’t abandon me!

Anyway, this young woman was sampling a multitude of cheese spreads on delicious, gluten free, crunchy, whole grain crackers.  Any idiot knows not to walk into a grocery store when he is hungry but I figured I was safe since Will Power was with me.  Unfortunately, with Will missing in action, I was doomed!  They sure were delicious.  All seven varieties!

I quickly gained my composure and started searching for Will.  Searching the aisle at Garden Fresh was like maneuvering through a mine field.  One aisle over was another sampling of cheesy treats.  Two more aisles to the north and I was accosted by samples of fresh baked goods.  

I figured Will Power would be waiting for me in the healthy produce area so I ate my way through the mine field, seeking refuge in the green leafy aisles.  They were waiting for me and Will was nowhere in sight!  Taco, salsa and guacamole dip and chips tripped me as I turned the corner.  They assaulted my mouth with jalapeño peppers.  Over by the celery was another woman, offering tastes of hot dogs and queso blanco.  I searched for Will while working my way towards safety in the fruit aisle and the hope of getting to the checkout counter without any other treats.

I’m home now.  I’m calling everyone, asking for help finding my friend.  I’m not worried about Mr. Will Power.  He’s tough and can handle himself.  I’m worried about me.  Without Will Power, I’m afraid I’ll fall off the wagon.  I know what they say, “If you fall three times, get up four;” but, without Will Power’s help, it’s going to be tough.

When I find Will, I’ll apologize for not listening to him.  I’ll never go grocery shopping when hungry again.  I’ll also walk right by pretty young women peddling their wares.  

If you see my friend Will, tell him I miss him!

September 6, 2019

September 6, 2019

WOW!  When I decided to write again, I perked up!  I realized that I wasn’t “invalid” after all.  I could make something good come from something bad. I realized I could still help others by sharing my 40 years of experience as a physician with my former patients and those who choose to read this blog.  What I didn’t realize was how much reviewing my prior works would help my current circumstances.

The following article from June 2011 will help make my point.  While it focuses on Attention Deficit Disorder, it is truly pertinent in regard to disabilities in general.  

Today I graduate from an intensive rehabilitation program at the Shirley Ryan Ability Lab, formerly known as The Rehabilitation Institute of Chicago (RIC). I spent 3 weeks in their inpatient program and months in the outpatient program.  The staff has been phenomenal and: while I have improved somewhat, I still have a lot of work to do.

One thing that I didn’t understand until this very moment is why a renowned center of excellence like RIC would change its name and attempt to rebrand itself.  Writing this article has given me the answer.  RIC rehabilitated people with handicaps/disabilities.  Shirley Ryan Ability Lab focuses on peoples’ abilities and how to use those abilities to improve one’s own life.

I’d like to thank the team at the ABILITY LAB for all the hard work they put into improving my life.  I hope you enjoy the article below and share this blog with others. 

June 25, 2011

One of the best lessons I have learned is if you can make something good come from something bad, the bad was not so bad after all!  I have taught that lesson to countless patients over the last 28 years.  Today, I want to share my lesson with those readers who have been branded with “learning disabilities” (LD).

Yes, I said “Branded.”  Like those individuals with attention deficit disorder (ADD), individuals with LD often feel branded, even cursed.  During the formative years of life, patients with LD often struggle in school.  LD students receive “accommodations” in the form of special classes, tutors, and attend special testing centers.  Accommodations can make an adolescent feel inferior and damaged.  

I have a learning disability.  When I went to school, there were no special classes, accommodations; you either survived on your own or you failed.  I have a form of Dyslexia.  Reading has always been agonizing for me.  My disability is not readily apparent;  I can read aloud to an audience and they will not detect a single problem.  I just can’t process what I read!  I always failed standardized tests.  Not because I didn’t know the answers, but because I could not process the questions.

I have the gift of being able to process and retain everything I hear.  Over the years, I have learned many tricks that help me deal with my dyslexia.  Modern technology has been a G-dsend.  My texts and journals are now available in audio format.

One of the most traumatic events in my life was my failure to get into the University of Virginia Medical School.  I was an honors student with a 3.5 something average and medical school was a slam dunk!  I was a cocky young man and only applied to three top East Coast schools.  Unfortunately, I bombed on my MCATs (entrance exam).  Scoring in the 14th percentile in English should not have been a surprise.  I can’t read!  Ultimately, I moved to Mexico and graduated from La Universidad Autonoma de Guadalajara Medical School.

Making something good come from something bad is today’s lesson!  Going to a Mexican medical school was an embarrassment.  It also was one of the best things to ever happen to me.  During my four years in Mexico, I learned a lot about myself and the world I lived in.  I learned to talk and think in a different language.  I learned that what Americans believed was not what the rest of the world believed.  It was a humbling experience and I needed to be humbled.

I also learned that I had a learning disability.  I learned that, if you work hard enough, you can learn to live with LD and you can make LD work for you and others.  This article is proof positive.  I have had a long career helping others and working with many of my patients and their children.  I help remove the stigma of ADD and LD by finding the good in the bad.  

If you have a reading disability, develop your listening skills.  If you have problems with the spoken word, thrive on the written word.  All of us are blessed with being unique individuals.  Within all of us is a gift.  Don’t get bogged down with being labeled LD or ADD.  Find your gift and celebrate it.  Don’t be ashamed of needing accommodations.  Use them as tools the same as I use the CD/DVD player.  Most of all, learn to be happy with yourself.  Yes, it may be harder for you to succeed but success will come.

If you are having problems coping, see your doctor or counselor.  If you are envious of others, recognize that they are unique individuals and have their own problems.  If others mock you, feel sorry for them, not for yourself.  They mock you out of ignorance and you are not ignorant.  

Posted on www.livewellthy.org

Wellthy

September 5, 2019

After talking to several new readers today, I realized that I had started my new blog at the end of my career, leaving new readers lost in concepts I have taught for many years.  Those of you who have known me for the last 30 years should be comfortable with the term “wellthy” and many of the concepts I will present to you over the next few months. For those of you who are newbies, feel free to contact me with your questions and issues you would like me to address.

“Wellthy” is a concept that I developed over the last 30 years with the help of my patients and staff.  Yes, my patients want to be wealthy.  They work long hours, invest wisely, and often become financially wealthy.  Unfortunately, they often spend all of their health obtaining their wealth and, in the end, are miserable.

To help you understand the concept of “Wellth,” my book, “Diets and Other Unnatural Acts,” presents the case of Workaholic Willy. Willy worked 16 hour days amassing his empire and a personal worth in the millions.  He had no time for exercise.  His meals consisted of fast foods 

at McWhatever. His family time was non-existent, never even vacationing with his wife and kids. 

Willy thought he was working to accumulate wealth so that his wife and kids would live the easy life.  At least, that’s what Willy told himself.  As Willy became wealthier, his health deteriorated, as did his relationship with his family and friends.  In the end, Willy was the poorest wealthy person I had ever met.

Instead of getting wealthy, I want you to get “wellthy.”  A “wellthy” person invests, not only in his/her financial wellbeing, but also in his/her physical, nutritional, emotional and spiritual wellbeing. Hopefully, this blog will help you find the tools you need to live a truly wellthy life.

I will be incorporating articles I published in the past into material more appropriate for present times.  I have spent way too long looking back at how I got to where I am today.  Frankly, it’s depressing.  In some ways I had become Willy.  Today I came across the following article published in 2011.  It’s time for me to look forward.  It’s time to stop asking why and instead, say what are you going to do about.

What I’m going to do is work at getting “wellthy!”

November 2011

Many years ago, I was blessed to receive an invitation to serve on a national advisory board for a pharmaceutical company.  I was privileged to sit in a room with 15 experts in their fields of medicine and share in their knowledge.  Since then, I have been to many such meetings and, each time, I have harvested clinical pearls to be used in my practice of medicine.  At the most recent meeting, a well known family doctor talked about the “look backwards” approach to medicine and contrasted it to the “look forward” approach.  The difference between the two styles is remarkable and I look forward to sharing my newfound pearl with my patients.

The “look backwards” approach is what I have done for 27 years.  Mr. A comes in for his blood pressure, blood sugar and cholesterol check.  I look back over the chart and determine that Mr. A has not done anything we discussed at our last visit.  His numbers are not good and I point out to Mr. A that his behavior is fueling the fire that is going to burn him.  I inform Mr. A that I am going to increase his current medications and add one new one.  Mr. A feels guilty and does not want more medication and says he will do better.  “Doc, give me three months.  I can do better!”   Five months later, Mr. A returns, nothing has changed and we start the cycle over.  

The “look forward” approach identifies the current problem and puts an action plan in place.  Medications are adjusted appropriately.  Plans are made for behavioral and dietary changes when appropriate.  A care team is constructed.  Nursing support is set up with a predefined call back schedule being arranged and the patient knows that, if he experiences any problems, he can call his team nurse for help.  Referrals for nutritional and exercise counseling are arranged.  Deadlines are set.  The patient commits to the team approach and returns in one month for a follow up visit and assessment of the success or short comings of the treatment approach.   At each visit, future treatment objectives and changes in current treatment options are reviewed.  

Most patients mean well.  They are going to work on their diet, but the boss calls them in, gives them a new assignment and their personal plans get pushed back.  They are going to exercise; but they are working 16 hour days and they are exhausted when they get home.   They are going to eat fruits and vegetables and whole foods but they are in a hurry and the drive in window at McWhatever restaurant is more expeditious than parking and running into the grocery store.  

A care team and “look forward” approach is going to solve the harried life of today’s worker.  What it will do is help develop realistic work-arounds to the above problems.  

  1. You need to diet to lose weight.  You stress eat. Your boss stresses you.   Currently, you pledge to work on your weight loss as soon as the stress lets up. Realistically, the stress never lets up.  The answer is better stress management.  One goal of your care team is to find stress relievers other than food. 
  2. You need exercise but your 16 hour day is exhausting.   You promise to exercise as soon as work gets better.  Work doesn’t get better.  Another goal of your care team is to find novel ways to build exercise into your work day.  
  3. You need to eat a healthy diet but your car won’t stop pulling into the drive-in window at McWhatever.  You know you shouldn’t; you feel guilty, but your hunger gets the best of you.  Your care team’s goal is to counsel you on food choices and meal planning.  They advise you to eat healthy snacks more often so your hunger doesn’t get the best of you. 

Looking forward to something is much better than looking back and lamenting.  After the heart attack or stroke, looking back at what was not accomplished is truly miserable. I look forward to shedding the “look back” approach.  I look forward to working with you.  I look forward to helping you improve and maintain your health.  I hope you will look forward to the same.

Invalid, In Valid

September 4, 2019

Invalid.  If you break the word into its components it becomes “in” (not) “valid.”   That’s how I felt as I woke up on March 18thknowing that I was unlikely to ever practice medicine again.  It took me a long time to get out from the “in valid” label I had placed on myself to where I am now. 

Now, as I set out on my journey to recreate myself and find purpose as a retired physician, I marvel at how insightful my younger self was.  While I can no longer care for my patients in the office and hospital, I hope that this blog will provide a new level of care.  

Below is one of the articles I published in 2011. The article is even more germane to my present circumstances than it was at the time I wrote it.  Unfortunately, I don’t have the 30 years mentioned at the end of the article; but I’ll make the best out of what I have. 

Monthly Archives: June 2011

CHANGE

Posted on June 30, 2011 by livewellthy

June 30, 2011

Sometimes things just fall into place.  Over the last 6 months, I have written on an assortment of topics.  Most of the time, my patients or the news provide me with ample material for future publications.  Last night, while flipping through the TV stations looking for something good to watch, I chanced upon two artists singing “Man In The Mirror” by Ballard and Garret.  For the first time, I actually heard the words and realized how important the message this song delivers is.

I was discussing the importance of the song with my first patient of the day and he introduced me to his morning prayer, “Dear G-d, I have a problem and it’s me!”  The lyrics to “Man in the Mirror” begin with:

“Ooh ooh ooh aah
Gotta make a change
For once in my life
It’s gonna feel real good
Gonna make a difference
Gonna make it right…..”

The chorus goes like this:

“I’m starting with the man in the mirror
I’m asking him to change his ways
And no message could have been any clearer
If you wanna make the world a better place
Take a look at yourself and then make a change, yey
Na na na, na na na, na na na na oh ho”

If we are to fix our broken medical system, we are going to have to make a change!  That change does not start with electronic medical records, with expensive testing and medications, not with visits to the doctor’s office, nor in the vitamin aisle of your local merchant.  That change cannot be legislated by any government nor is it coming from the insurance industry.

The change needs to start with “the man in the mirror.”  As long as people neglect their own bodies, fail to take responsibility for their own health and the health of their families, no amount of medical care or money will suffice.  

“If you wanna make the world a better place”, then for once in your life make a difference, make a change and feel really good.  Look in the mirror and decide that your health is the most important thing you own.  Start small; change something from unhealthy to healthy.  Feel really good about the change.  Then change something else.  Take responsibility for your own health.

Be happy, be healthy.  Then enlist your family, your friends and co-workers in a campaign to make a real change.  Health costs relatively nothing to maintain and a lot to lose!

If you are not sure what needs changing or what’s unhealthy, see your doc.  I’m sure your doc will be glad to assist you in your quest to be a healthy, responsible patient.  If getting healthy means taking medications, take them.  If being healthy means giving up vices, give them up.  In the end, you will be glad you did!

I’ve started with the man in the mirror.  I’m much happier with the man I see in my mirror today.  I have a ways to go.  It’s a long journey.  I have thirty more years to practice medicine and I look forward to continuing this journey with all of you.

Posted in OpinionPhilosophy of CareLeave a comment | 

EUREKA!

Why Me?

September 3, 2019

As many of you already know, I’ve been forced to give up my practice of medicine due to health matters.  One of my favorite expressions is, “Man plans and G-d laughs.” I guess G-d is laughing.   I fully expected to die while working in the office, not to spend the rest of my life at home or in the doctors’ offices and pharmacy.  The transition from doctor to patient has been a real eye opener (to be further discussed in a upcoming book I am writing).

Besides my back pain, Parkinson’s, swollen legs (lymphedema), constipation, and self pity, I have gained 25 pounds and look pregnant.  Needless to say, I’ve been asking G-d the “why me” question a lot lately!

So what do you do when you need to be in the office practicing medicine and you can’t?  I decided I’d start my blog up again.  That’s when I discovered my prior articles had been lost. WHY ME???

To make a long story short, today an IT person at GoDaddy helped me recover my old articles and my blog, www.livewellthy.org.  Recovering my earlier works was a minor miracle.  Finding, in those documents, the answer to my questions, was a true blessing. The first article I read is from September 2011 and can be found below. 

Sometimes, when you question G-d, you get an answer!

September 2011

How many times have you asked, “Why me?” Ever been lucky enough to find the answer? Most of the time there is no answer. Most of the time life feels random. Today, I told another patient he had cancer. I told him he needed to see an oncologist, have more testing, and undergo chemotherapy, then surgery. During our consultation, he asked, “Why me?”

I answered, “I’m still trying to figure out why you were lucky enough to get married to such an amazing woman, or have such great kids, or rise to the level you have in the business world. You always led an exceptional life while appearing quite ordinary.” If you are going to ask the “why me” question when bad things happen, shouldn’t you ask it when good things happen, too?

Cancer is a random act of terror. Whether G-d has some plan we are privy to or not, the real answer is most of the time we don’t know why things happen the way they do. Sure, we blame cancer on smoking, drinking, exposure to toxins and genetics among a host of other possible contributing factors. As Americans, we have been led to believe someone or something must be at fault when something bad happens. 

Playing the blame game after the fact is counter- productive! If you get tied up in the “why me” mentality, you become depressed and ineffective at a time in your life when you have to be at your best. You’ve been drafted; you are going to war. You need to get in shape if you are going to war. You need to focus on what is important. You need to be alive and stay alive.

In Spanish, the word for “why” is “por qué” and the word for “because” is “porqué”. Both words are pronounced the same. When you ask why, you have actually answered your own question, because! With a diagnosis of cancer or a host of other tragedies, ask the question just once, “Why me?” Answer your question, “Because!”, then move forward.

Live your life, Fight your battles, Win the war.

Sometimes we are lucky enough to find the answer. I always tell my patients that, if they can make something good come out of something bad, it won’t be so bad. Sometimes when your life or the life of a loved one is threatened, families and communities come together in unimaginable ways. Lives actually get better. It may sound cliché, but sometimes my patient whose life is threatened by cancer really had stopped living prior to the diagnosis. He had simply gotten into the proverbial rut; up at 6, coffee, go to work, home at 6, dinner, TV and sleep. The threat of losing his life actually makes him find a new, more fulfilling life.

We all know about the movie, “The Bucket List.” Don’t wait for tragedy to wake you up and make you act on your bucket list. Enjoy now. Be happy. Work at being healthy. Have an attitude of gratitude. When something good happens, ask “Why me?” Then smile and say “Because!” and enjoy it. When something bad happens, do the same, and then work through it, looking for something good to come out of it. 

As a final note, it can’t hurt to say a little prayer of thanks for the good things and for the new opportunities brought by the bad things.”

It appears that I was sagely in 2011, answering my own questions and needs before I actually asked them.  Porque!