April 19, 2014 Today’s story is about the three wise men. I saw the three wise men this month and, while each wise men’s story was uniquely different, they share one commonality. First, I should give you a little background on these three wise individuals. They weren’t always wise. As a matter of fact, they just recently attained their “wise man” status. Prior to becoming wise, each of my three patients had been quite ordinary. I don’t mean that as an insult. What I mean is that they were ordinary patients, taking an assortment of medicine for an assortment of medical conditions. Some were taking medications to control their cholesterol, some to control their blood sugars and others to control their blood pressure. Of course, their knees or backs hurt so they were also taking an assortment of anti-inflammatory medications. One thing they all had in common was that they hated seeing me! Yes, they were sick and tired of hearing me telling them that improving their diet, exercising and taking off some weight might make all the difference in the world. Of course, they ignored me. After all, their problems stemmed from their genes, didn’t they? After sitting through the obligatory lecture about lifestyle changes and the long term effects of diabetes, hypertension, hyperlipidemia, arthritis, and heart disease, each would promise to do better and each would begrudgingly return for their follow up appointment in worse shape. If the story ended there, it would be pretty depressing. Unfortunately, many patient stories end at this point and I’ve come to expect that my teaching/cajoling/threatening/pleading is for naught. In the case of the three wise men, something clicked! It was if they were sleeping behind the wheel of their car and suddenly awoke, avoiding a major accident and saving their lives. In their own unique ways, each found “the gym” and their motivation to be healthy. Each changed their dietary habits, lost significant weight and found a youthful feeling they thought they would never have again. This month, I weaned them from the bulk of their medicines and promised to take away more pills as their journey progresses. I fully expect that two of the three wise men will be able to shed all of their medication before summer arrives. For years, I have complained that the bulk of what I treat is self-induced illness, my pills dispensed as a first line defense against bacon, salt and smoke. The three wise men have proven my point. So, when you’re sick of hearing me preach about the benefits of healthy living, take this story to heart. Don’t avoid me; but instead embrace me and let me help make you a wise man/woman.
Category Archives: Preventative Medicine
Ultrasound
January 15, 2014 In May of 2011, I published the following article and I am happy to announce that ultrasonic exams are now available in the comfort of my office. I want to spend a little time talking about the diagnostic tools that are useful in the day to day practice of medicine. Ultrasound is one of my favorites! Ultrasound (USS) is relatively quick, inexpensive, harmless, and, most of the time, painless. This miraculous device uses sound waves to safely create images of your body. Those images can diagnose a host of medical problems. Ultrasound is useful for the diagnosis of everything from blood clots in the legs to narrowing of your major arteries supplying blood to the brain. Common ultrasound exams include: These are just a few of the exams that can be done with the ultrasound scanner. Ultrasound, in the hands of a good technician and radiologist, can save your life. It is truly a modern day miracle. When used for the proper reasons, it is also covered by most insurance companies and Medicare. How healthy are your carotid arteries? Your heart? Your liver? Ask your doc!
A work of love
December 6, 2013 I was talking to one of my most successful patients a few days ago about how much work is involved in maintaining one’s health. Mr. X has lost significant weight over the last few years leading to a marked decrease in his medication burden and a dramatic improvement in his overall health. He works out on a regular basis at The Exercise Coach, and, up until recently, was doing excellent at eliminating unhealthy fats and sugar. Recently, Mr. X has started to backslide into old, unhealthy eating habits. He has gained 6-7 pounds and seen an increase in his blood sugars and a decrease in his own self esteem. In common terms, Mr. X has hit a wall, better known in the healthcare field as he’s reached a plateau. Unfortunately, most of my patients succeed at getting healthy only to fail. Failure comes when they reach a long plateau and, despite herculean efforts, can’t lose any more weight and fail to reach their goal. In fact, most will gain back all of their weight plus 10! Mr. X is not my usual patient. He continues to work at losing his weight, exercising and fulfilling his quest for health. In reviewing his past successes and failures, Mr. X and I came to the realization that what was holding him back was that the very nature of the work he was doing had changed! Getting and staying healthy takes work! At first, Mr. X’s task was a work of love. Every pound lost was a point of pride. Every obstacle overcome was a miraculous feat. Every medicine withdrawn was a major reward. After a while, weight loss slowed. While there were fewer obstacles, those that remained were tougher. There was less opportunity to stop medications because those that remained were there for a lifetime. What once was a work of love had become a laborious and thankless job. Mr. X and I had made a mistake. We had not reset our goals commensurate with Mr. X’s accomplishments and new found health. In essence, we set him up for failure. Luckily, failure is not in his vocabulary! We’ve reset Mr. X’s goals and he will do great. The moral of this story is that weight loss should not be a goal. Your goal should focus on your overall health. Weight is only part of the problem and yet it is often our only focus. In the years to come, make being healthy a work of love. Cherish your health and do whatever it takes to preserve it. Live long and be Wellthy!
The Flu and Heart Attacks
September 15, 2013 Influenza Vaccination and Acute Myocardial Infarction, published in Consultant360 today, reviews the results of an Australian study done from 2008 – 2010 on the effect of the influenza vaccine on acute MI (AMI). According to the article, “Influenza vaccination was, however, significantly protective, with an estimated vaccine effectiveness for the prevention of AMI of 45% in patients aged 40-64 years and 33% in patients aged ≥65 years.” Now, I know that people have all kinds of misperceptions about vaccines in general and the influenza vaccine in particular; but, if you were between the ages of 40-64 and had a 45% chance of winning the lottery, wouldn’t you be buying tickets at this very moment? Not having an acute myocardial infarction is like winning the lottery! Fear influenza more than you fear the vaccine and see your doc soon! You only have to buy one ticket a year to be a winner!
Stress and anxiety
September 1, 2013 When was the last time you used an algebraic equation? The last time you discussed the Gettysburg Address? The answer is simple: in high school. When was the last time you felt stressed or anxious? That answer is also simple: sometime last week. So, why do we spend so much time in school learning about things we will never need and so little time on things we need on a daily basis? That answer is too complex for this blog to cover. Suffice it to say that everybody is stressed and nobody takes the time to learn how to be effective stress managers. Happiness and success are highly dependent on a person’s innate ability to manage stress. I treat patients for stress-related problems on a daily basis. I refer patients to counselors (stress management experts) on a daily basis. Do you want to guess how many people actually go? Ten percent will consider getting help but only one percent will actually take the time to seek counseling. By the time you’re an adult, time management becomes your chief stressor. You have family responsibilities, work stresses and financial issues to deal with. Counseling, while holding the promise of helping, becomes one more stress. So, what’s the answer? Parents need to teach their children effective stress and time management techniques. Parents are hesitant to teach stress management mostly because they have never been given any formal management training. The logical answer is that part of parenting should be reading and learning techniques for managing stress and then passing that knowledge to your children. Of course, if society takes my advice and learns to become effective stress managers, my stress will increase as thirty percent of my patients will no longer need my services!
Immunization, part 2
July 1, 2013 On the front page of Sunday’s Daily Herald was an article I found frightening. In Fighting vaccinations Elgin mom represents anti-shot movement, James Fuller writes about a mother who posted on Facebook that “she was looking for a chickenpox party” in order to expose her toddler to the disease. During my residency and again in the early days of my practice, I had the unfortunate task of treating kids suffering from chickenpox meningitis. I can tell you the experience was unforgettable and horrifying. I have also treated many children with significant, lifelong scars from their pox infections. Most of my patients are too young to remember the effects of full blown chickenpox, measles, whooping cough, diptheria, and tetanus. As a matter of fact, I’m too young to have seen tetanus. In the 30 years I have been in practice, I have treated chickenpox, measles, mumps, diptheria and whooping cough and can truthfully say I never want to see another case of any of these diseases. Vaccines work! Despite all of the fears parents have over the perceived risk of vaccinations, I have been fortunate enough to have never witnessed a bad reaction or side effect. In my early days in practice, I admitted children with whooping cough, measles, chickenpox, mumps, and meningitis to the hospital all too frequently. Since the advent of vaccines for each of these diseases, treating kids has been much more rewarding and the pediatric ward at the hospital has become a ghost town. I understand the fear that package inserts, the internet and informed consent instill in parents. I also understand that everything we do in life carries risk. The American Academy of Pediatrics, the American Academy of Family Physicians, the federal government and the Illinois Department of Health are among the many organizations who have weighed the risks and benefits of immunizing our children and found that the benefits far outweigh the risks. Yes, I believe that parents have the right to refuse to immunize their children for whatever reason they choose. I only hope that, if they refuse immunizations based on the fear of causing their children harm, then they also refrain from putting their offspring in a car. While in my 30 year tenure as a physician I have never witnessed a significant side effect from an immunization, I treat injuries from automobile accidents on a monthly basis and have helped multiple families deal with the loss of a child in such an accident. Please review your children’s vaccine status and make sure they are up to date. Don’t wait until the last minute. Young adults going to college for the first time often need Menactra (meningitis) and Gardisil (HPV) immunizations. While you are at it, when were your last Tdap, Pneumovax, and Shingles immunizations given? Yes, parents need to practice what they preach!
A responsible patient
June 15, 2013 In 2011, I published the following article. I don’t know why I failed to act on it. I should have. I’m sure my readers have noticed the negative, almost hostile tone of my articles lately. In assessing my practice, I am currently treating an increasing number of disorders related to poor lifestyle habits. I am also spending way too much time on the phone chasing after patients who have not followed up as directed. I hope you will print and sign the article below and take its intent to heart! 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: 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___________
How sick were you?
May 29, 2013 “Doc, I was so sick over the weekend that I almost went to the emergency room,” is a statement I hear all too often. The fact that the patient is in my office and telling me about it is the good news. The bad news is that, sometimes by delaying going to the emergency room, my patient misses an opportunity to avoid disaster. I know going to the emergency room is time consuming and expensive. I’ve heard it all! What amazes me is how casually people gamble with their health and their lives. How sick do you have to be to go to the emergency room anyway? Do you have to be on death’s doorstep? I think not. Yet many of my patients wait until they are knocking at death’s door to call 911. How much pain do you have to be in before you seek help? The guy with the ruptured appendix waited until the pain was a 12 on a scale of 0 to 10 with 10 being the worst pain he had ever felt. Actually, he only decided to go when his temperature hit 104! How long do you have to suffer before you seek help? Would it amaze you if I told you that a patient seen recently waited a full week before coming in to be treated for his chest pain? I understand not wanting to go to the ER. So, if you don’t want to go to the ER, how about calling the on call doc? Every practice has an on call service. If you thought about going to the ER and weren’t sure what to do, don’t you think calling your doc would be a wise decision? While I’m on the subject, another thing I hear way too often is straight from the spouses mouth. “I told him I was calling the paramedics but he said if I did, he would never speak to me again!” Wake up! If he dies, he’s never going to speak to you again! My advice is that if you think about going to the ER, go. If you decide not to go, call your doc. Then pack a bag because he’s probably going to send you to the ER. What happens if you go to the ER and everything is ok? I guess you get to live another day. Sound better than dying or spending an extended amount of time in the ICU? I think so!
Doc, what’s my blood type
April 17, 2013 “Doc, what’s my blood type” is a common question I hear from my patients. My answer is usually, “I don’t know.” There really is no reason I should. Once upon a time there were two typing systems, the ABO and the Rh. Now, blood typing is very complex and done at the time of donation both on the donors and the recipient’s blood. “Doc, while you are drawing my blood, please type it for me. I want to know my type.” “Not a problem, however, it is expensive and your insurance company is not going to pay for it. The best way to have your blood typed is to donate blood!” In the past I have written about the miraculous ability the body has to respond to its environment in order to survive. In response to environmental stresses, your body can make new bone, muscle and blood vessels. It can thicken your skin (calluses) to create a protective exoskeleton. It can also learn to make new blood more efficiently. The donation of blood and blood elements may well be the gift of life for another individual. Giving blood costs you some time and nothing more. What you get in return is more than helping another soul survive. You help yourself survive. Giving blood is a stressor like running on a treadmill. Your body has to replace what it has lost. If you give blood on a regular basis, your body will learn to make blood more efficiently and faster. If you are in an accident or bleed from an ulcer, your body will be better able to repair itself. Donating blood proves that, by giving to others, you improve your own lot in life. Sign up at your local blood bank. Give and give often!
Fiber
March 27, 2013 Laughter is good medicine. This morning on the way to work I was listening to a comedy channel and delighted to discover Anita Renfroe’s humor. “Fiber” is not only hilarious, it’s truly educational. Click on the highlighted name above and fast forward to 1:50. I hope you LOL like I did. Seriously, fiber will do everything Ms. Renfroe claims. There are over 20 articles on this site touting the health benefits of fiber. Here is one of my favorites: No, this article is not about Kellogg’s Fruit n’ Fiber. This article is about the health benefits of eating fresh berries and fiber. There are countless articles that extol the health benefits of eating fruits and vegetables. The literature is also full of articles touting the benefits of a high fiber diet. Today, Medpage Today reported on two new, promising studies. According to Medpage Today, the first study included 500,000 individuals and found those with the highest intake of fiber (29 grams of fiber per day for men and 25.8 grams a day for women) “had a 22% lower risk of dying from any cause over 9 years of follow-up compared to those with the lowest fiber intake (mean of 12.6 grams for men and 10.8 grams for women).” The study showed benefits in regards to cardiovascular, respiratory and infectious diseases. There are other studies that show fiber’s beneficial effects on the colon and reduction in the incidence of cancer. The second study today reported dietary data obtained from 130,000 men and women. The results showed a 22% reduction in Parkinson’s disease in those patients ingesting a diet high in berries. The authors attribute this remarkable finding to two compounds found in berries: flavanoids and anthocyanin. This is one of several studies that suggests compounds found in berries, such as blueberries and strawberries, may be neuroprotective. I have recommended a “caveman” diet to my patients for years. It is time we get out of the box and canned food world and eat whole foods packaged by nature. It is time we let our bodies do the processing, rather than vendors of manufactured food who process and package our meals. Diets high in fruits, vegetables and nuts are full of vitamins and cofactors, packaged by nature in bright, colorful containers full of taste and goodness. Roots are full of minerals, as well as vitamins and cofactors; they are abundant sources of proteins and fats necessary for health. Look for wild fish and hormone free meats. Use whole grains. Eat a balanced diet. Eat six colors a day. I once read an article that stated every color found in the food world offers a unique nutritional gift. Most of all don’t fall for the villain theory. Over the last three decades, each food group has taken a turn as villain. We have seen diets come and go. First, there was the “no/low carbohydrate diet,” then, the “no fat diet” (T-factor diet), followed by the all or only protein diet and the always present vegan diet. There are no bad foods, there are just foods abused by humans. So, tonight I’m having blueberries with granola for dessert. The berries sure are sweet. Hopefully their magic formula will keep me practicing into my 80s and still writing this column. The big payoff from the fiber will be in the a.m. The elders in the group will know what I mean!