WILL POWER

Have you seen my friend, Will Power?  Will and I have been hanging out together since I published my book.  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 dinner.  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!

MY BLOG

In 2013, I wrote, “The problem is that I can’t quit!  Not caring for my patients would be like not breathing!  I’m a doc and I’m old school.  I believe my profession is a calling, not a business to be run by corporate America or the government.  I can’t imagine not taking care of Nolan, or JJ, or Hadley, or 1,000 other souls I am entrusted with.”

Six years later and I’m retired, not by choice, but out of necessity. Nine months into retirement and I still can’t breathe. I wake up every morning wanting to dress and go to the office.  Instead, I go to my computer and write.

This blog is my way of communicating with my patients old and new (readers). It’s also helping me breathe.  In reviewing my old articles, I have a rare opportunity.  I get the benefit of listening to a younger me lecturing the old me on how to live with Parkinsons and recover and maintain as much “Wellth” as possible.

Unfortunately, my blog is poorly organized, making it next to impossible for a new reader to see what’s available.  There are 121 articles published so far.  While they contain 40 years of accumulated knowledge, you have to scroll through a lot of material to find what you are looking for.  If any of you know WordPress and want to pitch in, let me know.  In the meantime, please make sure you are sending links to your friends and family.

NEW YEARS PART 2

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

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

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

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

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

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

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

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

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

NEW YEARS PART ONE

While I don’t understand why New Year’s Eve is such a big deal, I’ve always appreciated the magic of wishing others well. Every year at Christmas, Chanukah, and New Year’s, people find joy and happiness in wishing others a “happy and healthy New Year.” On the third of January, everyone goes back to their hurried lives and the kindness and joy of the season evaporates. The other New Year’s phenomenon, the New Year’s resolution, takes two weeks longer to fade away than the season’s goodwill!

Why can’t we manage to keep the season’s spirit and happiness throughout the year? If we could identify the essence of the holiday season and use it liberally throughout our lives, wouldn’t we all be happier? In looking for the key to daily happiness, I have started wishing people a “Happy and Healthy New Day!”

It’s working! The essence of the Christmas/Chanukah/New Year’s miracle is the giving spirit! Wishing people well is the key. In essence, wishing someone a “Happy and Healthy New Day” confers a blessing on them! In doing so, the person conferring the blessing gives the gift of a smile to the person receiving the gift. Might this simple salutation perpetuate the joy of the holiday season? I think so!

As to the matter of the “New Year’s resolution” that is so easily forgotten year after year, a New Day resolution has a real chance of being accomplished. Recently, I published “Tomorrow.” Many of us spend our lives living for and planning tomorrow. We put off doing today, promising ourselves that we will get it done tomorrow. Does tomorrow really exist? If we have a “New Day Resolution” every day, and when we wake up it is “Today,” then we should be able to stay resolved and finish what we promised to do.

So, resolve to enjoy each and everyday and whatever time you are blessed to be on the earth.  Work hard at being happy and bringing your happiness to others and 2020 will be a very good year.

So, each and every day, wish someone a “Happy and Healthy New Day.” Start your new day with a “New Day Resolution” to be happier and “Wellthier.” If you like this idea, first try it out and then share it with everyone you meet.

PRAYING HANDS

In order to understand this article, I need you to do the following:  put your hands together, fingers extended as if you were in prayer.  Next, interlace your fingers, making one large clenched fist.  Now imagine that your fingers represent different parts of your life or problems that you are having.

Life is complex and the problems my patients come in with are rarely simple.  On a daily basis, I see patients with the metaphoric clenched fist I described above.  My job is to find the key that will open the clenched fist and relax the fingers into a peaceful, happy set of praying hands.

On July 25th,2011, I wrote about Mrs. “X”, a patient with diabetes, hypertension, kidney problems, and arthritis.  Mrs. “X” is also depressed; wouldn’t you be?  Imagine that each of her problems is represented by a finger on her hand.  The other fingers represent other parts of her life: her relationship with her family, her friends, her finances, the excessively hot weather and her aging eyesight and hearing.  Mrs. “X” is miserable and can’t tell me why.  She is confused about which of her many problems she should address first.  She is frustrated!  Every time she fixes one thing, something else breaks.  Her fingers are interlaced and clenched into a painful death grip of a fist!

Now, interlace your fingers and tighten the grip for as long as you can, until it hurts.  When you open your hands and pull them apart, note that your fingers are tight and sore.  The tighter and longer you keep your fingers locked together, the harder it is to pull them apart.

Mrs. “X” has allowed her multitude of intertwined problems to lock together for so long that she can no longer separate one from the other on her own.  My job is to pry her fingers apart, one by one until each has been addressed and healed.  The process is time consuming and frustrating.  As her doc, I think I know what the primary issue(s) is, but I may be wrong.  I am searching for the key that will more readily unlock her hands and place them in a relaxed, healthy, praying stance.

I start with her index finger, depression.  I have written about depression before.  Depression is a normal state of life but can be severe, affecting everything else in an adverse manner.  Healing depression is often a potent key that allows one to more readily heal everything else.  Mrs. “X” fights the idea of depression; it is a stigma no one wants.  I explain that she can either admit to depression, as a sane person would in her circumstance, or be insane.  I pry her finger open.  I pray that by doing so, I can unlock the rest of her fingers.

Today, I work with her arthritic pain, prying a second finger open.  I work on opening a third, allaying her fears of the theoretical worry about NSAIDS.  Eventually, finger by finger, I will help Mrs. “X” open her hands and live with the burden of age.  I help her recognize her blessings and build her blessing list.

Oh yes, I work on one more finger today.  I talk to her about “An Attitude of Gratitude.”  Now, I’ll place my hands in a praying position and say a prayer that I get this right the first time.

PS – If this article sounds like you, it would not surprise me.  Mrs. “X” represents thousands of people I have seen over the last 28 years.  I have interlaced my fingers into a fist, assigned a multitude of attributes to each finger, and then unfolded my fingers into praying hands every week, painting a picture of the healing process for those in need.  I hope to do so for another 28 years!

THE HAND

My family, my friends and my patients think being selfish is bad!  I bet you do, too.  I used to think so, as well.  Thirty years in practice has taught that being selfish is good.  Actually, selfishness is essential to an individual’s health.

I saw a selfless young woman who was ill.  She had an assortment of complaints.  She had not felt well in months.  If she was the CEO of a Fortune 500 company, she would have been diagnosed with executive burn out and given two months at Canyon Ranch, an executive retreat.   Unfortunately, she is the CEO of a typical American family.  She is married, has five children, a dog and works full time.  She has living parents who are aging and require help.  She is a hard worker, dedicated to caring for her nuclear and extended family, as well as excelling at work.  She has no time for self.  She is one of hundreds of such mothers in my practice.  She is stressed to the max but does not have the luxury of going to Canyon Ranch.

I often tell the story of the hand.  The thumb is you.  When you are young, you are self-centered, egocentric.  The world revolves around you and only you.  One day you realize that you have parents (your index finger), and you are responsible to them, as well as yourself.  As you age, you meet the love of your life (the middle finger) and are responsible to your mate.  In time, children come along (ring finger) and they need lots of your time.  You become very responsible for them.  Then you have your job (little finger).  As you grow in your job, responsibility grows as well.  You are a good person and want to excel at everything.  Your parents are aging and require more attention.  Your children are aging and require more attention.  Your job is growing more complex.  Your mate, who is often responsible like you, is in the same position.  

So, what do you do?  Things are out of control!  You have to take care of your parents, your mate, your children and your job.  The only thing you control is you, so you sacrifice yourself.  Try using your hand without using your thumb.  What you find out is, without the thumb, your hand is useless.  No matter how hard you work to make your four fingers function, without the thumb, the hand falters.

If you are not healthy, you cannot help those who need and depend on you.  If you are not selfish enough to save time to care for and nourish yourself, you will get sick.  Those around you will have to function on their own.  Why wait until you are exhausted, burnt out or sick?  The answer is simple.   Your parents taught you not to be selfish.  They taught you to be a responsible individual.  It is time you teach your loved ones to be responsible to themselves, to set healthy limits, to take time off, to laugh and be happy.  Set a good example: get healthy.  At first, those who are used to getting all of you will rebel.  They may call you selfish.  Teach them that a part of a healthy you is better than part of an unhealthy you.  In the end, by being selfish, everyone will be better off.

A CURSE

For centuries, man has believed in the “evil eye”, curses and spells.  In the movies, an evil being places a “spell” on the heroine who suffers horribly until that spell is broken.  I believe in the “evil eye,” curses and spells.  They actually work!  Let me explain.

In modern times, doctors curse people.  They don’t mean to, but it happens.  It’s not just doctors; there are many offenders.  In medicine, Google may be the worst!  A patient comes to the office with a complaint.  The complaint leads to a diagnosis of cancer.  A diagnosis of cancer leads to testing and specialty care.  In the process of finding out the extent of the cancer and exploring treatment options, the patient is smothered in information.  Doctors, performing their duty to inform the patient, start talking about percentages.  The percentages include calculations regarding the risk and side effects of the treatment and one and three year survival rates.  Patients, trying to figure it all out, turn to the internet, friends and relatives.  They see more doctors.    Ultimately, it all boils down to population statistics and calculation of odds.

My patient, once a unique individual, becomes a statistic.  The system “cursed” him and the curse became real.   I have seen people die because they gave up.  For them, the odds were overwhelming.  One day, not too many years ago, I was making more morning rounds at the hospital when the nurse called and asked me to come to her floor stat.  She told me Mr. A, in room 424, was dying.  I told her that was impossible; he was to be discharged home that morning! He was well!  When I arrived at his room, I was dumbfounded.  Mr. “A” was, in fact, dying.  I examined him, reviewed all of his lab and x-rays and could not find one reason for his failing health.  When I told Mr. A that I could not find the reason for his dying, that he should be going home, he responded stating he was certain that the day before, he had heard the nurse tell his wife that he was going to die.  I explained that there was absolutely no reason for him to die; but that, if he did not get out of bed and decide to live, I was going to lose a healthy patient. 

Mr. A taught me the power of a curse.  Ever since that day I have reminded my patients that they are unique individuals, not “average patients with a disease.”  I have reminded them that they have never been average and pleaded with them not to become a statistically average patient at this stage of their lives.  I have asked them to gather evidence and knowledge so that they can make the best decisions they can for themselves, but not to let the evidence overwhelm and curse them.

Odds are a funny thing.  If the odds of living with a given diagnosis are 1 in 100 or 1 in 100,000 for the general population, are they the same for you?  Not really!  I see it is either you are going to live or not.  That’s 50/50 in my book.  I want my patients to choose to live.

So, if you are given a potentially bad diagnosis, turn it into a potentially good prognosis.  Don’t be suckered by statistics.  Don’t become a statistic.  Become an outlier.  Live long and be happy.

SCI FI

The following article was written when I was healthy.  What I didn’t understand then, I now do.  Once you are obese, out of shape and hurting, dragging your butt to the gym is next to impossible.  When you live in the Midwest, walking outside in the heart of winter is dangerous.  

“Yes, I know.  You’re too busy, too tired, too sore, or too sick to exercise.  You have hundreds of excuses for not exercising; and you promise that, when things are better, you’ll exercise.”  I have lots of excuses, all very real.  Even though I’m retired, I’m still to busy.  I’m too busy napping!  Reading this article was a unique experience.  A younger healthier me lecturing the older sick me right out of a Sci Fi movie.  I’ have to be a fool not to listen to myself.  So, I’ll just have to find the motivation and strength to exercise or stop complaining.

I have addressed the fact that many of my patients paid more attention to what they feed their pets than to what they put into their own bodies.  Today, I want to continue to explore the relationship between man and his pet in order to try and figure out why pets get more attention to nutrients, exercise and healthcare than humans.

“Jack, I really need you to start exercising.  Your blood pressure and cholesterol are both quite elevated, and exercise and weight reduction will help.”

“Doc, I walk my dog every day!  Isn’t that enough?”

If you were to watch Jack walking his dog, you would see Jack walk 50 steps and then wait while Fido takes a leak or just sniffs the bushes.  This process of walk, sniff, pee goes on for 30 minutes or more and Jack feels like he has done a day’s work.  In actuality, neither Jack nor his dog has done any exercise.  If Jack wants to exercise with his dog; then he needs to run alongside of his dog as Fido races across his lawn barking at passing cars.

Exercise is the fountain of youth and most of my patients won’t do it!  Why?  Mr. Wonderful and I often pondered that very question and failed to come up with an answer.  It’s as if my patients are sleeping behind the wheel!  They hate the idea of taking medication; yet, they’d rather take a pill than go to the gym 2-3 days a week.

Yes, I know.  You’re too busy, too tired, too sore, or too sick to exercise.  You have hundreds of excuses for not exercising; and you promise that, when things are better, you’ll exercise.  Unfortunately, until you start to exercise, things will only get worse.  You will get more out of shape, take more medications and get much older.

Like the man who falls asleep behind the wheel of his car, you are heading for an accident.  Wake up.  Walk your dog for your dog’s health.  Walk by yourself or with friends for your health.  You don’t have to join a gym, you can start tonight.  When you get home from work, don’t go into your house.  Instead, explore your neighborhood.  The journey starts with just a few steps in the right direction.

I DON’T WANT TO BE RIGHT

While I wrote this article in 2011, it is still very relevant today.  Last night at my friend’s Christmas Eve celebration, one of his guests and I actually had a conversation about this very topic.  When I got home, I dug this out of my archive.

A lot has changed since 2011. The most important thing is that now I am dealing with a progressive neurological disorder that is slowly stealing my life away.  My own thoughts change on a daily basis, but one thing is for sure; I do not want the government/Medicare to determine how long I live and how I die. Those decisions belong to my family and me.  

The second thing that I know for sure is that life without quality is not really life.  Each of us has to decide what quality of life means and, perhaps, when our lives should end.

July 20, 2011

Sometimes you just don’t want to be right.  Over the past many years, I have seen an alarming pattern arise in my profession.  Many of my patients have heard me talk about “Soylent Green”, an old Charleton Heston movie.  I have even written about it on this blog.  The premise of the movie seems absurd.  Can you imagine the government of the United States providing for all the needs of its people including healthcare, food, clothing, and even death (Food Stamps, Medicaid, Medicare, Social Security)?

David Brooks’ opinion piece in the New York Times on July the 15th (http://www.nytimes.com/2011/07/15/opinion/15brooks.html?_r=1) makes my fear of a “Soylent Green” society frightenly real.  While I recommend you read the entire piece, for the purpose of this blog, I want to highlight the following:  

Mr. Brooks writes, “This fiscal crisis is about many things, but one of them is our inability to face death _ our willingness to spend our nation into bankruptcy to extend life for a few more sickly months.”  He quotes S. Jay Olshansky as saying, “our main achievement today consist of devising ways to marginally extend the lives of the very sick.”    He then closes his piece with “we think the budget mess is a squabble between partisans in Washington.  But in large measure it’s about our inability to face death and our willingness as a nation to spend whatever it takes to push it just slightly over the horizon.”

In “Soylent Green”, the citizens dutifully walked into the death chamber when it was their time.  Mr. Brooks would be proud of how those brave souls faced their demise for the good of society.  Rather than “marginally” live another month or two, costing society a fortune and threatening a budgetary crisis, the citizens of “Soylent Green” did as prescribed, they follow the “protocol” created to save society (prescribed “outcome” equals death).

My question for Mr. Brooks is who defines what “marginally extends the lives of the very sick” is?  Who decides who shall live and who shall die?  I can’t!  Not long ago, I met a “very sick” patient in the emergency room.  He was critically ill having had a catastrophic event.  He was comatose with signs of profound damage.  The neurologist told the family he was “brain dead”.  While Mr. Brooks believes that medical science has made very little progress in extending life, my patient benefited from a remarkable new invention, the “Artic Sun Hypothermic Unit”, and fully recovered.  I spoke to him this a.m.  He was at work! Editor’s Note: He’s still alive today, 15/26/19.

The procedure and hospitalization cost in excess of $300,000.  Saving this one life cost a fortune!  In Mr. Brooks’ world, should we have forgone this patient’s treatment and helped his family “face death”?  Are we “spending our nation into bankruptcy” by working hard to save lives?  Maybe so.  But who are we if we don’t care for our ill?  What do we become when we arbitrarily decide what a life’s value is?  

Mr. Brooks obviously doesn’t practice medicine.  If he did, he would know that an individual life is worth everything to that person and his family.  Mr. Brooks would know that patients survive against all odds and recover to enjoy meaningful lives.  He would know that statistics lie!  A patient with a life ending cancer is told he has three months to live without treatment and 6 months with treatment.  Despite the tremendous expense both financially and physically, he accepts treatment.  Seven years later he is thriving!

Respectfully, Mr. Brooks doesn’t know what he is talking about.  The problem is the policy makers aren’t doctors.  The policy makers are Mr. Brooks’ cronies.  “Soylent Green”, here we come!