Grrr...freaking out

If you read this site now and then, you know I am a total hysteric.

I am not centered. I am not calm. I am not sanguine. I am not even particularly rational.

The only thing left is funny and with some common sense sprinkled in.

My internet connection has been down for 4 hours. Imagine my state.

The first two hours were OK—I breathed deeply. I contacted the phone company—they offered to email me when it came up. Well, if they could frickin’ email me, I would know it was up, wouldn’t I?

Then…I said, OK will do desk work. I did desk work.

More desk work.

Desk work is so weird—there is no typing.

So I wrote this.

I cursed the day electricity was invented. That made me feel a little better. Actually a lot better—I like gravity, but electricity has kicked up some problems.

I tried breathing again. Nothing.

Why are some of us such idiots? Man, I would be rich if I knew that.

I do know with all our tweeting twatting phoning commenting browsing surfing texting sexting drilling down blogging—this is gradually killing us, not enlightening us.

Ommmmm.

So now I am one with everything?

Well, everything would include internet—so no.

By the way, do you think it’s true that the internet is God’s brain?

Docs may overdo it--they admit it

According to a survey of primary care physicians in Archives of Internal Med (Sept 26), many believe they provide too much medical care—and that malpractice reform and realignment of financial incentives would prevent this.

What the US pays per patient is twice that of the average industrialized country.

A large part of this is unnecessary.

Six hundred twenty-seven doctors were surveyed.

Nearly half—42%--said they were providing “too much” care.

Twenty-eight percent said they were more “aggressive” than they would like.

Why? Well, three-quarters said to protect themselves against lawsuits. Clinical performance measures, said 52%, made them do more than strictly necessary.

Doctors believe they are paid to do more and exposed to punishment if they do less.

You know what frosts me—when they do these big expensive things, such as MRIs, then don’t send the results to other specialists and these are repeated—and patients just go along, la-de-dah, my doctor must really care about me—ANOTHER MRI, my my.

A doctor asked to comment on this study said longer time with patients and increased communication could substitute for excessive testing. The patient would feel cared for at less expense.

Fewer people have insurance, those who do are hosed

I don’t get it. Somehow it’s ducky that “kids” can stay on their parents health policies—couldn’t a healthy 20-yr-old maybe do better on an individual policy—paid by the parent of the child? Sounds like a big gift to the insurance co’s to me.

Also, as many Americans are inching along trying to survive, those with jobs are being whacked with bigger insurance costs, bigger copays, deductibles, coinsurance…on and on.

Up 10% this year—why? Can anyone say why? Because they can? Because they want to have it as high as possible before someone starts looking at it again in 2012?

Personally, on Medicare Advantage, I can’t go because specialists are $35. My insurance is for some big baddie hitting me. I am not even sure it includes a flu shot—after four calls.

Bah! Every time I see an insurance envelope for Mom, for me—I think, “Aw, Jeez, this won’t be good.”

Could your kid have a bum ticker?

The Pediatric Heart Center of Children’s Hosp at Montefiore in NYC is worried about the heart ills than can befall kids coming back to school.

And you thought those vaccinations were the big woo.

People with heart probs in the family should be extra careful to get the kids checked.

Sudden Cardiac Death on the playing field—yes, it sounds bad and is bad—is devastating. It’s the leading cause of death in young athletes—not gangs or car wrecks.

Sometimes it's triggered by genetics—so that has to be taken into consideration.

I remember my parents getting bent out of shape because I was told I had a heart murmur—95% of these are nothing. But this can come from a defect or functional problem. Doctor!

Schools should have automatics external defibrillators on hand and staff should be trained to use them. Getting shocked into a normal rhythm, however, is a dice roll—it works a minority of the time, but should be an option to try.

Parents should also learn pediatric CPR. Do you know it?

OK—scared to...um...death? Now, do something about some of this!

Too much optimism sucks

When people tell me to think positively--I say, "I am POSITIVE I am depressed."

Alina Tugend, NYT, Sept 23, 2011, like me, is optimism-challenged. Expect the worst, I say, and when it happens, at least you were right!

But society values optimism…unicorns, Winnie the Pooh, the disease is gone, you can sell your house.

Yet, the numbers show Americans haven’t been this bummed about the economy in three decades. Fewer than 20% expect their finances to improve (Thomson-Reuters-Univ of Mich).

Optimism (they say) is not about repeating cloying stuff to yourself—everyday in every way I am getting better and better.

One expert says optimists think of bad things as temporary—pessimists the opposite.

Pessimists often do what I call catastrophize—generalize the specific to a huge generalization. My friend put me on voicemail—my friend hates me…that sort of thing.

Still, the experts say EXTREME optimism is not good.

An extreme optimist may think he or she is living way longer than health would dictate. Or think they don’t need savings—things will work out.

In the end, both come out the same, apparently. Too much faith in the future, no safety net. Too little—why bother with a safety net.

Oh, man.

That glass half empty-full gambit--I don't even think there is a glass anymore.

They call that thinking outside the glass.

What comes next

A hospitalization, a surgery—what are you looking at when the fun wears off?

Ah, after care. I once wrote part of a book on “care between the venues,” meaning the discharge instructions from ERs, hospitals, or rehab centers either to other facilities or to the patient’s home.

There are many possibilities for errors in this. Often, meds given in the facility are sent with the patient in bottles or prescription form. Should the patient take the meds already at home, prescribed by various doctors, or the new ones? Surely not both…but often this is hazy.

I have a relative facing knee surgery—one website said no driving for 2 weeks—her doctor says 4 weeks.

I was facing horrible eye surgery and was told I had to be facedown for a week or more. I had no idea what this meant. The internet yielded no info—just offers from commercial companies to rent me various weird pieces of furniture to keep my head down.

I was so confused and terrified, I sent my bouncy dog to a friend’s and he ended up dead—the dog and the friendship, both.

My advice when leaving a facility is to ask questions, get clarifications—try to do this before a surgery when you feel clear and able to think…

Try to amass the supplies you need for wound care, if that is an issue. Thrash things out with the insurance company while you are pain free or feeling lucid.

I can at least help on how to do “facedown recovery”—this is used after detached retina and macular hole surgery. I interviewed top docs (not mine) and wrote up their ideas, plus my own—and I put in pictures. I like pictures, don’t you?

You can get it for a nominal fee of $10.

Now I may need to do one on knee surgery.

Order FACEDOWN now…

Self-treating pain

My relatives and pals and I are all gimping around and ooo-ing and ow-ing…is it the
“Arthur-it-is” as we used to joke (when it was funnier)? Probably. I also stepped on my foot wrong and now it hurts or threatens to. Everyone I know has some back pain.

Apart from the usual mantra of lose weight and sleep at night (both tall orders), what can a person do?

In the book End Back and Neck Pain by Vincent Fortanasce, DPT, David Gutkind, and Robert Watkins, MD, they recommend deciding if you are feeling pain—or is it stiffness? Pain means a cold pack, but stiffness can respond to heat. Heat promotes circulation to the area, carrying off substances in your muscles from spasms. If you use a heating pad on your back, be careful not to have it too hot or to fall asleep—people get burned from those!

Analyze your activities. Maintain activities you can tolerate. Poor posture may be an element.

Properly done exercise can almost work magic. Common sense + professional instruction.

Sleep well. When you sleep deeply, you get painkilling serotonin. If you are anxious or angry, painy cortisol spurts.

Long slow stretches before sleeping have a neurological effect.

My sister scoffed at all this….but when I spray hot water on my knees in the morning, I swear they squirt out more goo inside and hurt less.

Pie-schmy

Not just for carving or pie anymore. That’s old school.

Dr Helen Lee, a ChicagoHealers.com practitioner, says the jolly orange fruit is full of nutrients—Vit C, E, iron, zinc, magnesium, potassium, all those antioxidants, and lutein for eyes…to name a few.

Pumpkin also aids kidney, bladder, and prostate function.

The seeds kill tapeworms. Ew.

The seeds also are high in protein.

Take raw pumpkin seeds as a snack or put them in trail mix.

Make the pie—but also eat the filling as pudding, pancakes, in waffles.

Or bake or brown pumpkin with spices and put it in risotto, chili, rice and pasta.

This ought to start you off… http://www.pumpkinrecipes.org/

Is it lunch time?

Thinking inside the ring

My sister and I go out to lunch with Mom every Saturday and right outside in the mall is a boxing gym. Boxing is popular—if it ever wasn’t.

Max Jerner, AZ Republic, Sept 11, 2011, says fitness centers and gyms are nicheing out big time.

Instead of big layouts with juice bars and every machine under the sun, centers are opening that concentrate on:

Low cost. Short or no contracts.

Doing the Crossfit system—a strength and conditioning regimen. The spaces are called “boxes.” So this would be “think inside the box.”

Working with a personal trainer, such as FIIT.

Suspension exercises with ropes and pulleys.

Centers for older people or larger people.

People are tired of paying for pools, racquetball courts, daycare, and other frills they don’t use.

I can see that. I sure wouldn’t want to groan and sweat next to some studmuffin.

Easier but a bad idea

The American Academy of Pediatrics says kids should stay in rear-facing car seats until they are 2 years old.

The Univ of Mich did a look-see and found that 73% of parents in their sample turned the kid around before that age. About a third turned them around before age 1.

Rear-facing is five times safer for toddlers. In a crash, the child’s back spreads out the force if the baby is facing the rear. If he or she is facing forward, the force goes along the straps.

Almost ¾ of the parents got info on when to switch the child from the instruction manual—which says 20 lbs. BUT—this does not mean change to forward facing—it means get a convertible seat that faces either way.

If you are short on funds, forget the infant seat and go straight to convertible, which can be used as the child gets older.

I have also seen commercials for a seat for kids up to 4 feet tall.

Yes, it’e easier to put in a pacifier or make faces at a fussy baby if the child is facing forward—but resist the temptation.

What, us worry?

Ken Alltucker, AZ Republic, Sept 11, 2011, says getting foreclosed can be bad for your health.

One for The Big Book of Duh.

Foreclosures are up—the banks backed off for a while then resumed tossing people out.

A show is starting on Discovery—where people buy foreclosed homes—sorta like Pawn Stars or Storage Wars. That’s a perky idea.

I know someone who was foreclosed who is still getting letters from the homeowners association saying pay this, a lien on that, we hate you, etc—and she is long out of the apt and done with bankruptcy.

Anyhow, economists at Princeton and Georgia State linked foreclosures with hospital admittance increases in AZ, CA, FL and NJ.

High foreclosures—more stress-related illnesses, with the biggest impact in people 20 to 49.

Yeah, not sleeping, all that crying, that can’t breathe all the way in feeling, overeating or no appetite—it can’t be good.

And it’s not like this is ending.

Care about your care--harder than it sounds

Recently, Laura Landro wrote about a site called Care About Your Care, careaboutyourcare.org.

Care about your care…hmmm…well, we do, or should, but this is complicated.

I sort of am skeptical of care these days. Out here, we seem to have pretty rushed, non-English speaking, or disappearing doctors that leave the insurance or practice in a twinkling.

So that is hard to care about.

The hospitals are creepy germ boxes with 10-hr waits.

They run tests over and over, so you figure someone is amortizing a machine or something. But if the results are all in one place, on a computer, you figure someone will leverage those against you somehow by denying insurance, making it cost more, or having some nurse call and nag you.

Americans get immunizations only 55% of the time. The shingles vaccine you have to order somehow and get it sent to a fridge at your doctor—devilishly difficult.

Everyone from the president’s wife down tells you to lose weight (you, not her).

Sooo…when you think of the doctor, does Dr Welby come to mind, or a failed surgery or some cluster-you-know what?

The site, Care About Your Care, is amazingly candid: Its tenets are:

Care Varies
More is not better.
It’s a coin toss.
We get what we pay for.
We know what works.
Finding the right fit is key.
And it’s up to you.

Darn, back to that. I care—but I doubt. At least, I am not alone.

Plantar's fasciitis--ouch!

I had this once… the fascia, or thin tissue that fastens the heel bone to the metatarsals in the ball of the foot, gets inflamed. Sometimes there is a sharp bone fragment called a spur.

You first feel it when you get up, then it lessens, then if you walk or run, it starts up again during the day. Usually this is caused by walking on cement.

You need to support the hurting fascia with some heel supports from a doctor or drugstore.

Ice the area by rolling the arch over a bottle of frozen water.

Learn a good Achilles tendon stretch that will not stress this sore tissue.

Maybe you can wear a splint or boot at night—ask your doctor.

I wrote about this some years ago on this site…
http://healthsass.blogspot.com/2006/11/magic-little-exercise-to-prevent-heel.html

I don’t have a picture of the exercise…but some people seem to have figured it out.

Check out this video:

http://www.youtube.com/watch?v=t2KkdMlqRZU

Are your devices remodeling you?

Those two in the pix look normal, don't they? Don't be fooled!

Phyllis Korkki, NYT, Sept 10, 2011, says we are turning into crabbed little trolls from all our electronic devices. Our hands are claws, our thumbs becoming huge and scary, giving small children nightmares.

Well, not the last part.

But people are straining their bodies to carry around heavy laptops and type with their thumbs.

Still, I interview via phone—I get the old ones, with a clunky receiver so it will sit in the crook of my neck—eBay, look under Vintage. I hate headphones.

Korkki says laptops are jot ergonomic at all. Place the keyboard in typing position—oops the screen is not in viewing position.

Touch screen are hard and don’t move down like keys. They can hurt fingers.

And our thumbs! They have three bones, not two. They are vulnerable. You can get tenosynovitis—it hurts.

Try to figure out what you are doing that is causing the strain.

Living! That’s what I am doing!

At the moment, I have hard-wooden-chair-butt from not using the desk chair that plunges down.

What a deal.

Someone sick? Become a "Friend of..."

Dear Abby ran a letter the other day from someone whose friend had had a stroke. His wife was caring for him, and working, cooking, everything. The wife said friends often asked if they could help. Then did nothing.

So they formed a “Friends of Jim” group. Everyone committed to 2 hrs a month. The time slots are set and recorded.

Could you do something like this in your life?

I remember a contemporary of mine who was sick 20 yrs ago—pancreatic cancer. Her girl friends spent time with her like this—did her laundry, light housekeeping, chitchat, took her to doctors.

Some people don’t have children who can or would do this.

And—if you want to look at it like this—in some cases, the commitment will be limited because the person’s lifespan may be limited.

Sad, but true—but a big help while it lasts.

Medical tweetment

Does your doctor(s) wield the old electrons now? My current primary is some woman from India, the second one from there, I have gone once, name starts with a K, but I don’t remember her using the computer. The attendant who “roomed” me did, maybe.

Is medicine getting even more impersonal? Ya think?

The NYT Well Blog took this up—people didn’t like doctors entering info into the computer without ever looking at them, much less touching their bodies.

This can happen in the hospital—so-called hospitalists may never talk to you at your sickest and scaredest—just check your “numbers” in the hall at the nurse’s station. Often the info is entered in the hall—the computer cart is too big for bedside.

I had an eye surgeon once who would not type or could not—probably would not. He used voice recognition and kept crossly trying to make the computer type his words…He never talked to me about my ruined eye—sent a letter instead to the referring doctor (who did not know me)…”I had the pleasure to see Miss Lawrence and…” When the computer could not spell a term, he would say, TRY AGAIN..[pause]…TRY AGAIN! Eventually, I guess, the little scamp spelled the word.

What a farce. My eye ended up blind. Not that the two things are connected, but I sure wanted to sue as much for this as anything else.

Yes, electronic records can be helpful if you show up at the hospital and can’t remember why you came last time or was it the time before. They can help with bad handwriting and probably keep some medicine from killing you.

But even in the hospital—they ask you stuff…Do you still live at… Are you still self-employed… Did you have a flu shot?

You tell me if your computer is so smart!

Speaking of germs

See below—the little buggers are still a threat.

Bryan Alexander, USA Today, wrote an amusing story on the cast of the new movie CONTAGION, starring Matt Damon.

They became so germ-conscious they could hardly make a move, much less a movie.

The movie features a woman eating nuts from a bowl in a bar and transmitting the crud that way. No one would touch nuts on the set.

The director said the movie would do for elevator buttons what Jaws did for swimming.

The consultant was Laurie Garrett, author of The Coming Plague. She would not hug or shake hands. “We have to observe social distancing,” she said.

The director got freaked about how many people had touched the camera.

They wiped down their hotel rooms, the remotes from the TVs.

Sometimes thinking is the worst impediment to life. Just sayin’.

Yicko germs still reign

Germs, viruses, bacteria…these seem kinda retro, don’t they, in these days of cancer, MRIs, PET scans, etc.?

Someone I know got infected with a weird bacteria from the intestinal tract (not e.Coli) and had to go to the hospital for an IV of antibiotics every day for 10 days. Who knows if it’s really gone or just strengthened for the next person to fight off? They are "checking."

Now is the time to line up for your flu shot, too—I am kind of a believer in the past decade and do get these. This time, though, with my Medicare Advantage Plan, no one can decide whether I am covered for the littler clinic in the grocery store.

The flu shot became crazy hard—websites, calls to my plan, to my so-called primary (some woman who doesn’t speak much English), etc.

Two people here died of West Nile virus—from a passing skeeter.

Yes, germs, still some fun.

I guess drag out the hand sanitizer and try not to think about it.

PS Many of those are ineffective. Bugs 1, Goo 0.

"Peanut" ball could help you deliver

Ken Alltucker, Arizona Republic, Sept 4, 2011, says a local hospital chain here—Banner Health—is so convinced that a peanut-shaped pillow eases labor and statistically prevents C-sections that it has ordered a batch.

The nurses at Banner liked the weird exercise tool. After an epidural when a woman cannot “feel” to push as well, the ball between the legs opens the pelvis.

The device also shortened labor—especially the really painful parts. And best of all, it cut C-sections 13% in the ball-using group.

OK—small sample…but hey, you could ask. The things cost about $40.

I ended up with a C-section…and my device was a lot of complaining and wailing.

Geometry lovers are covered--but did it help you?

I know this is old news—the stab at creating a better federal health pyramid of how to eat.

Ancient Egypt is out metaphor-wise and Baby’s First Plate is in.

Remember—those divided baby plates—so nothing touched?

Well, the Choosemyplate.gov thingie is like that.

The problem is—it’s not like a pie—the relative sizes of the spaces are hard to determine.

Dairy is off to the side—apparently a glass of milk or yogurt dessert. Maybe ice-cream? Nah, probably not ice-cream.

The idea, I guess, is to downplay grains (bread and carbs) and play up veggies.

It’s supposed to connect with all ages and languages.

I think if you try to do too much, it falls apart.

Did you go to the website for more info? Did you not hear someplace that it’s good to eat raw fruit and veggies and bad to eat the Fries of the French?

Yeah—that rumor has been going around.

Jobhunters: Could you puke?

A friend of mine has a fabulous health resume—she has worked at most of the heavy hitters in health care—household word places—has had her own business—knows health and insurance marketing, the whole niner.

She was applying for a job at the Cleveland Clinic—and got hit not only with being asked to submit a res and then regurgitate it all back into a form, but to take a timed “pre-assessment test.” “Pre”?

This turned out to be a nightmare of math word-problem-like questions, interspersed with popups of emails she would supposedly be breaking into her work to read—and then popup questions thrown at her about the contents of these emails, all while she was working the other problems, or trying to.

“It was ridiculous!” she moaned to me. “I am organized—I would never throw everything together like this on a job.”

She says she ended up feeling like she was horrible.

And the worst part—She was completely qualified for the job.

Like that matters anymore.

If this was PRE-assessment, which is the real assessment? Sensory deprivation? Calculus? Plasma physics?

Come on, employers--we are freaked out enough. Be real.