Eggs: Average 6 gms of protein in egg and only 4 gms of fat and 30 calories. It is known to control your cravings all day! Hint: Protein does that!
Salad: Make and eat a good salad before your meal. Cut the pieces into small bite size morsals and look for a low fat dressing that you like. I like to dip my salad into my dressing. That way I get what I like on the bite!
Apples: An apple a day keeps the doctor away...Great Preventive Medicine Food. It has 3 gms of fiber and also pectin (which is know to stabilize blood sugar). So this is the perfect snack for the midafternoon cravings.
Green Tea: Did you ever see a fat Japanese person? They drink green tea daily. This speeds up metabolism and helps burn fat. Have a hot cup of green tea for breakfast instead of coffee. You'll get the hang of it soon and eventually wont miss the Joe!
Grapefruit: Remember the grapefruit (diet)? A study showed that if you ate even 1/2 of a grapefruit before meals (or drink the juice) - it increases metabolism and weight loss (and appetite). See Florida is good for something!
Lean Beef: We are back to the importance of protein. Remember the high protein diet (I loved that one! Steak all the time!) amino acids(aa) are necessary for body building (and muscles) so this goes go with the exercise routine that you just started - right? It has Leucine (an aa) that helps you lose weight without losing muscles.
Hey are you hungry? Lets go eat lunch!
Wednesday, January 25, 2012
Who wants to DIEt?
The word diet always makes me SAD. (and depressed!) Its that time of the year that we punish ourselves for being overweight, out of shape, and not what we think we are supposed to be. Our self esteem has taken one last lick after Xmas (and the guilt of holiday meals) and now its time to suffer! How come we find ourselves in this situation every Jan.?
One reason is the media (and advertizing) but that is a soap box to mount some other time.
Perhaps we went in for our annual physical and were told to lose weight and exercise. Preventive Medicine - that is a good- and another conversation for another time.
So you have to ask yourself when we DIEt-
1. What are you doing?
2. What is the purpose?
3. Does this make you feel good ? (come on kids - be for real - diets feel good?)
4. Does this plan have sustainability and accountability for long term results?
Wikipedia defines dieting as the deliberate selection of food to control body weight or nutrient intake. How depressing can that be...socially we are taught food is good, we are rewarded for good behavior with a 'treat', we celebrate with food, we socialize with food. So therefore, to be without food, we are lonely, mis-bahaving bad creatures.
Is it easier to take DIET out of our vocabular than go for extensive psycho-couseling for the rest of your life! Besides we all know that diets do not work. There is no magic pill or potion, no instant machine or exercise and no 'one of a kind, start of the year diet product' that is going to work!
Do you ever see the ads on TV where someone lost 100lbs or even 20lbs in a month...it says in small writing 'this is not typical for this product.' Where do they get these people? Are they for real? Maybe some of them...but what I would like to see is that same person off that magic pill, or product - a year later, six months later, even three months after the thrill has gone and the hubby wants more twinkies.
The basic concept in healthy living is just that....healthy living. You are not going to lose 20 lbs in a month and perhaps will have to not plan going to the buffett bar after Church on Sunday, but in the long run...we all know the way to go...sensibly.
One reason is the media (and advertizing) but that is a soap box to mount some other time.
Perhaps we went in for our annual physical and were told to lose weight and exercise. Preventive Medicine - that is a good- and another conversation for another time.
So you have to ask yourself when we DIEt-
1. What are you doing?
2. What is the purpose?
3. Does this make you feel good ? (come on kids - be for real - diets feel good?)
4. Does this plan have sustainability and accountability for long term results?
Wikipedia defines dieting as the deliberate selection of food to control body weight or nutrient intake. How depressing can that be...socially we are taught food is good, we are rewarded for good behavior with a 'treat', we celebrate with food, we socialize with food. So therefore, to be without food, we are lonely, mis-bahaving bad creatures.
Is it easier to take DIET out of our vocabular than go for extensive psycho-couseling for the rest of your life! Besides we all know that diets do not work. There is no magic pill or potion, no instant machine or exercise and no 'one of a kind, start of the year diet product' that is going to work!
Do you ever see the ads on TV where someone lost 100lbs or even 20lbs in a month...it says in small writing 'this is not typical for this product.' Where do they get these people? Are they for real? Maybe some of them...but what I would like to see is that same person off that magic pill, or product - a year later, six months later, even three months after the thrill has gone and the hubby wants more twinkies.
The basic concept in healthy living is just that....healthy living. You are not going to lose 20 lbs in a month and perhaps will have to not plan going to the buffett bar after Church on Sunday, but in the long run...we all know the way to go...sensibly.
Tuesday, January 24, 2012
This just aint right...who do we blame for meth addiction?
When a 23-year-old Fresno woman fatally shot her two toddlers and a cousin, critically wounded her husband, then turned the gun on herself last Sunday, investigators immediately suspected methamphetamine abuse in what otherwise was inexplicable carnage. It turned out the mother had videotaped herself smoking meth hours before the shooting.
In family photos, the children are adorable, the mother pretty. They lived in a large apartment complex near a freeway with neatly clipped lawns and mature trees. The father was recently laid off from a packing-house job.
"When you get this type of tragedy, it's not a surprise that drugs were involved," said Lt. Mark Salazar, the Fresno Police Department's homicide commander. "Meth has been a factor in other violent crimes."
A Bakersfield, Calif., mother was sentenced Tuesday for stabbing her newborn while in a meth rage. An Oklahoma woman drowned her baby in a washing machine in November. A New Mexico woman claiming to be God stabbed her son with a screwdriver last month, saying, "God wants him dead."
"Once people who are on meth become psychotic, they are very dangerous," said Dr. Alex Stalcup, who treated Haight Ashbury heroin users in the 1960s but now researches meth and works with addicts in the San Francisco Bay Area suburbs. "They're completely bonkers; they're nuts. We're talking about very extreme alterations of normal brain function. Once someone becomes triggered to violence, there aren't any limits or boundaries."
The Central Valley of California is a hub of the nation's methamphetamine distribution network, making extremely pure forms of the drug easily available locally. And law enforcement officials say widespread meth abuse is thought to be driving much of the crime in the vast farming region.
Chronic use of the harsh chemical compound known as speed or crank can lead to psychosis, which includes hearing voices and experiencing hallucinations.
The stimulant effect of meth is up to 50 times longer than cocaine, experts say, so users stay awake for days on end, impairing cognitive function and contributing to extreme paranoia.
"Your children and your spouse become your worst enemy, and you truly believe they are after you," said Bob Pennal, a recently retired meth investigator from the California Bureau of Narcotic Enforcement.
Meth's availability and its potential for abuse combine to create the biggest drug threat in the Central Valley, according to a new report from the U.S. Department of Justice's Drug Intelligence Center. From 2009 to 2010, methamphetamine busts in the Central Valley more than tripled to 1,094 kilograms, or more than 2,400 pounds, the report says.
Most law enforcement agencies don't keep statistics on how many homicides, burglaries and thefts are meth-related, but those responding to the National Drug Intelligence Center's 2011 survey said the drug is the top contributor to violent crimes and thefts.
In family photos, the children are adorable, the mother pretty. They lived in a large apartment complex near a freeway with neatly clipped lawns and mature trees. The father was recently laid off from a packing-house job.
"When you get this type of tragedy, it's not a surprise that drugs were involved," said Lt. Mark Salazar, the Fresno Police Department's homicide commander. "Meth has been a factor in other violent crimes."
A Bakersfield, Calif., mother was sentenced Tuesday for stabbing her newborn while in a meth rage. An Oklahoma woman drowned her baby in a washing machine in November. A New Mexico woman claiming to be God stabbed her son with a screwdriver last month, saying, "God wants him dead."
"Once people who are on meth become psychotic, they are very dangerous," said Dr. Alex Stalcup, who treated Haight Ashbury heroin users in the 1960s but now researches meth and works with addicts in the San Francisco Bay Area suburbs. "They're completely bonkers; they're nuts. We're talking about very extreme alterations of normal brain function. Once someone becomes triggered to violence, there aren't any limits or boundaries."
The Central Valley of California is a hub of the nation's methamphetamine distribution network, making extremely pure forms of the drug easily available locally. And law enforcement officials say widespread meth abuse is thought to be driving much of the crime in the vast farming region.
Chronic use of the harsh chemical compound known as speed or crank can lead to psychosis, which includes hearing voices and experiencing hallucinations.
The stimulant effect of meth is up to 50 times longer than cocaine, experts say, so users stay awake for days on end, impairing cognitive function and contributing to extreme paranoia.
"Your children and your spouse become your worst enemy, and you truly believe they are after you," said Bob Pennal, a recently retired meth investigator from the California Bureau of Narcotic Enforcement.
Meth's availability and its potential for abuse combine to create the biggest drug threat in the Central Valley, according to a new report from the U.S. Department of Justice's Drug Intelligence Center. From 2009 to 2010, methamphetamine busts in the Central Valley more than tripled to 1,094 kilograms, or more than 2,400 pounds, the report says.
Most law enforcement agencies don't keep statistics on how many homicides, burglaries and thefts are meth-related, but those responding to the National Drug Intelligence Center's 2011 survey said the drug is the top contributor to violent crimes and thefts.
Tips for Seniors with Diabetes
Tips for Managing Diabetes
Diabetes is a lifelong, total-body problem. Manage your condition, and your overall health, effectively with these smart tips.
Monitor your blood-glucose levels every day
Some people resist checking their blood-sugar levels, but daily monitoring really is the only way to know if they are under control. Foods, activity level, medications, illness, and even stress can affect blood glucose. Unless you check, you might not know whether your levels are holding steady or spiraling out of control.
Take Medication as Directed
Diabetes symptoms are silent, so you may not notice an immediate repercussion when you neglect to take your medicine, and that means far too many people decide against taking prescribed medications (or forget to take them). Don't be one of them! Untreated diabetes carries the grave risks of heart disease, nerve damage, and other complications. Take medications or insulin as directed by your physician.
Diabetes is a lifelong, total-body problem. Manage your condition, and your overall health, effectively with these smart tips.
Monitor your blood-glucose levels every day
Some people resist checking their blood-sugar levels, but daily monitoring really is the only way to know if they are under control. Foods, activity level, medications, illness, and even stress can affect blood glucose. Unless you check, you might not know whether your levels are holding steady or spiraling out of control.
Take Medication as Directed
Diabetes symptoms are silent, so you may not notice an immediate repercussion when you neglect to take your medicine, and that means far too many people decide against taking prescribed medications (or forget to take them). Don't be one of them! Untreated diabetes carries the grave risks of heart disease, nerve damage, and other complications. Take medications or insulin as directed by your physician.
Friday, January 20, 2012
Patient Accountablity : This is the only thing that will rescue Health Care~
While payers and providers are usually in the spotlight when it comes to accountable care, the most successful models will be the ones that place a strong focus on patient accountability. More and more frequently patients are selecting doctors with the best outcomes, asking proactive questions, and taking an active role in their lifestyle and behaviors. Empowering patients with the support and tools to be responsible for and more involved in their own health is critical to improving outcomes and reducing costs as part of any accountable care environment.
Currently, patients navigate the medical system to achieve the best outcome in the shortest amount of time, but physicians are incentivized to provide more services. If the decision-making process of the physician and patient are not fully aligned, then it is not reasonable to deploy a strategy focused solely on stimulating greater accountability in the patient. An alignment of goals for the highest quality and most financially efficient care can help to ensure patients are never in a position to make a health decision against the advice of their physician. The burden of responsibility has to be directed equally at all stakeholders. Once alignment is established, strategies to stimulate greater patient accountability can be deployed.
Establishing a primary care relationship is key for patients because it provides them with the opportunity to view care more holistically, gain a better understanding of medical alternatives, and feel supported by an advocate for better personal health. Group visits can also encourage patient accountability by allowing patients to connect with others who have similar conditions, and providing physicians with an opportunity to educate and promote better overall patient health. In addition these strategies, tools to enable patient engagement are paramount. I’ve bucketed these accountability enablers into three categories:
•Demand management: Stakeholders too often demand a greater intensity or frequency of service than necessary to achieve clinical success—experiencing more readmissions, ER visits, and MRI or CT scans than needed for example. It may sound simple, but asking discharged patients questions such as “Where will you go post discharge?”, “Are you certain any equipment or physical therapy has been arranged?” and “How can we reach you?” counters some of the system inefficiencies and better moderates unnecessary demand in the medical system. In fact, such efforts can cut in half the readmit rates.
•Population management: According to a commercial insured 2010 population analysis, half of high cost claimants had minimal to no engagement with the delivery system in the prior year, indicating that providers need to better engage with individuals who are not active in the system, not just at the point of care. This is a significant challenge that can be overcome by partnering with organizations that specialize in identifying and engaging individuals who will become future sources of medical costs. It is particularly important for providers to reach out to individuals with a low intensity of need that don’t consider themselves patients and individuals with immobility or lack of access to care.
•Network management: Oftentimes, individuals choose to access care at the wrong place. Transparency of information on physicians and specialists ensures that patients are receiving the best care at the lowest cost. By facilitating transparency providers can influence patients’ decisions, increase patient involvement and open the door for better communication across the care continuum.
All patients across the care continuum need to be participants in their own care, and providers should be implementing strategies to encourage this accountability both at the point of care and, more importantly, once the patient goes home. The focus should not be directly on changing a physician’s practice or reducing a hospital’s patient load, but instead on implementing an accountability model that aligns both physician and patient expectations to improve the health care system as a whole.
Miles Snowden is Chief Medical Officer of OptumHealth.
Currently, patients navigate the medical system to achieve the best outcome in the shortest amount of time, but physicians are incentivized to provide more services. If the decision-making process of the physician and patient are not fully aligned, then it is not reasonable to deploy a strategy focused solely on stimulating greater accountability in the patient. An alignment of goals for the highest quality and most financially efficient care can help to ensure patients are never in a position to make a health decision against the advice of their physician. The burden of responsibility has to be directed equally at all stakeholders. Once alignment is established, strategies to stimulate greater patient accountability can be deployed.
Establishing a primary care relationship is key for patients because it provides them with the opportunity to view care more holistically, gain a better understanding of medical alternatives, and feel supported by an advocate for better personal health. Group visits can also encourage patient accountability by allowing patients to connect with others who have similar conditions, and providing physicians with an opportunity to educate and promote better overall patient health. In addition these strategies, tools to enable patient engagement are paramount. I’ve bucketed these accountability enablers into three categories:
•Demand management: Stakeholders too often demand a greater intensity or frequency of service than necessary to achieve clinical success—experiencing more readmissions, ER visits, and MRI or CT scans than needed for example. It may sound simple, but asking discharged patients questions such as “Where will you go post discharge?”, “Are you certain any equipment or physical therapy has been arranged?” and “How can we reach you?” counters some of the system inefficiencies and better moderates unnecessary demand in the medical system. In fact, such efforts can cut in half the readmit rates.
•Population management: According to a commercial insured 2010 population analysis, half of high cost claimants had minimal to no engagement with the delivery system in the prior year, indicating that providers need to better engage with individuals who are not active in the system, not just at the point of care. This is a significant challenge that can be overcome by partnering with organizations that specialize in identifying and engaging individuals who will become future sources of medical costs. It is particularly important for providers to reach out to individuals with a low intensity of need that don’t consider themselves patients and individuals with immobility or lack of access to care.
•Network management: Oftentimes, individuals choose to access care at the wrong place. Transparency of information on physicians and specialists ensures that patients are receiving the best care at the lowest cost. By facilitating transparency providers can influence patients’ decisions, increase patient involvement and open the door for better communication across the care continuum.
All patients across the care continuum need to be participants in their own care, and providers should be implementing strategies to encourage this accountability both at the point of care and, more importantly, once the patient goes home. The focus should not be directly on changing a physician’s practice or reducing a hospital’s patient load, but instead on implementing an accountability model that aligns both physician and patient expectations to improve the health care system as a whole.
Miles Snowden is Chief Medical Officer of OptumHealth.
Article about Hospice Care: Important to think about today!
Dear Doctors:
I am writing no less than 45 days after my mother died from a GI bleed from ovarian cancer. Not once did my mother’s team of doctors mention palliative care. It was not until days and even hours before her death that hospice was discussed and implemented. Our family was blind sighted by this.
While no one likes to talk about the topic of death, it is important to remember that this is a natural cycle of life. Doctors are always on the cutting edge of medicine and talking about the possibility of death seems like failure. In reality not talking about the services available to family is the ultimate failure.
Here are the top 5 reasons why:
1. Pain. Patients may get to a point where pain is not manageable with the regular visits to the office. To know that there are potential solutions from a team that understands the full situation and can target medicine toward avoiding suffering is key. It can make a huge difference in quality of life and the person’s overall attitude toward the options available. It puts the patient in the driver’s seat.
2. Quality of life. Running from doctor to doctor, balancing prescriptions at the pharmacy and not tending to one’s overall quality of life can be draining. If more attention were paid by doctors to palliative care during serious illness the patient would feel a sense of relief that there is a friend on the sidelines ready to work with the entire team to manage symptoms and if need be start discussing hospice.
3. Hospice gives the patient comfort at a time of great stress. Hospice should not be a last-minute option. It should be done with great thought and care with the patient’s needs in mind at all times. To be able to stop all treatments and procedures and focus on the remaining days ahead without pain and suffering is often a relief.
4. Families are grateful for palliative care and for hospice. The patient’s families are often in the dark about these services. Their stress on trying to do the best for their family member is truly overwhelming because they worry about what they can do to help. Knowing that these services are there is half of the battle. Even if they are not going to be needed in all likelihood, families deserve the right to know about them.
5. Dignity. While we are so busy “fixing” the patient we should also look to giving that person a sense of dignity. No one wants to suffer in death. Patients want the ability to have time with their family members and to peacefully convey last words and more.
Consider creating a simple sheet describing palliative care and hospice and handing it out to patients as they start treatment for a life-threatening illness. Make it clear that you plan to do all that you can to help them but in that same vein you also want them to be completely informed of their rights to extra services should the illness become complicated. More often than not, you will find patients and their families grateful for the “road map” for their full treatment, successful or not. It is the ultimate gift.
Deb Discenza is co-author of The Preemie Parent’s Survival Guide to the NICU and the founder and former publisher of Preemie Magazine.
I am writing no less than 45 days after my mother died from a GI bleed from ovarian cancer. Not once did my mother’s team of doctors mention palliative care. It was not until days and even hours before her death that hospice was discussed and implemented. Our family was blind sighted by this.
While no one likes to talk about the topic of death, it is important to remember that this is a natural cycle of life. Doctors are always on the cutting edge of medicine and talking about the possibility of death seems like failure. In reality not talking about the services available to family is the ultimate failure.
Here are the top 5 reasons why:
1. Pain. Patients may get to a point where pain is not manageable with the regular visits to the office. To know that there are potential solutions from a team that understands the full situation and can target medicine toward avoiding suffering is key. It can make a huge difference in quality of life and the person’s overall attitude toward the options available. It puts the patient in the driver’s seat.
2. Quality of life. Running from doctor to doctor, balancing prescriptions at the pharmacy and not tending to one’s overall quality of life can be draining. If more attention were paid by doctors to palliative care during serious illness the patient would feel a sense of relief that there is a friend on the sidelines ready to work with the entire team to manage symptoms and if need be start discussing hospice.
3. Hospice gives the patient comfort at a time of great stress. Hospice should not be a last-minute option. It should be done with great thought and care with the patient’s needs in mind at all times. To be able to stop all treatments and procedures and focus on the remaining days ahead without pain and suffering is often a relief.
4. Families are grateful for palliative care and for hospice. The patient’s families are often in the dark about these services. Their stress on trying to do the best for their family member is truly overwhelming because they worry about what they can do to help. Knowing that these services are there is half of the battle. Even if they are not going to be needed in all likelihood, families deserve the right to know about them.
5. Dignity. While we are so busy “fixing” the patient we should also look to giving that person a sense of dignity. No one wants to suffer in death. Patients want the ability to have time with their family members and to peacefully convey last words and more.
Consider creating a simple sheet describing palliative care and hospice and handing it out to patients as they start treatment for a life-threatening illness. Make it clear that you plan to do all that you can to help them but in that same vein you also want them to be completely informed of their rights to extra services should the illness become complicated. More often than not, you will find patients and their families grateful for the “road map” for their full treatment, successful or not. It is the ultimate gift.
Deb Discenza is co-author of The Preemie Parent’s Survival Guide to the NICU and the founder and former publisher of Preemie Magazine.
Monday, January 16, 2012
Little Plates, Smaller Portions - Save health and your wallet!
Little Plates, Smaller portions
When I was traveling Europe, one man asked me if all of the people in the US were obese. (I guess I was one of them!) Another man in Germany commented on the amount of food that was served at American Restaurants. (We are the home of the buffets!)
I remember growing up when the whopper came out. We all thought that was shameful and evilly delightful – a hamburger that big (and I think back then the whopper was bigger). But then again is bigger better?
Not when it comes to eating. We are now in the habit of eating large, expecting a plate full (or more than one plate full) and with the goal of getting our money’s worth when eating out. Is it really our money’s worth when we think of the expenses that come with obesity?
Habit – yes we just have to put it in our mind to break the habit. One way to do that is to set a goal for 21 days (or longer) to eat less at each meal. For those who love to eat out like we do, order a smaller portion. I applaud the restaurants that are now offering the “smaller plates”. It used to be that all you could order was the kiddie meal if you were lucky or perhaps just an appetizer plate. However, now eateries are offering the “senior” “kiddie” or even the just the smaller plate for those who don’t want to eat like little piggys. They usually come with a smaller price tag too- so there we are, saving our budget as well as our health.
At home try cutting your recipes into smaller portions. I know at our house – dinner for two, was usually dinner for four. Now I cook for two and try to fill up the meal with more salads or other veggies. This also saves on the budgets and leaves less left overs to throw away.
Also try to serve on smaller plates. I love a pretty table – try flowers and music, colorful mini-plates, cups, colorful napkins and no TV! Try to plate your meals with mindful enjoyment. Garnishes and decorative plating also make eating fun. Put the emphasis on the food not the quantity. Eat slowly and enjoy!
When I was traveling Europe, one man asked me if all of the people in the US were obese. (I guess I was one of them!) Another man in Germany commented on the amount of food that was served at American Restaurants. (We are the home of the buffets!)
I remember growing up when the whopper came out. We all thought that was shameful and evilly delightful – a hamburger that big (and I think back then the whopper was bigger). But then again is bigger better?
Not when it comes to eating. We are now in the habit of eating large, expecting a plate full (or more than one plate full) and with the goal of getting our money’s worth when eating out. Is it really our money’s worth when we think of the expenses that come with obesity?
Habit – yes we just have to put it in our mind to break the habit. One way to do that is to set a goal for 21 days (or longer) to eat less at each meal. For those who love to eat out like we do, order a smaller portion. I applaud the restaurants that are now offering the “smaller plates”. It used to be that all you could order was the kiddie meal if you were lucky or perhaps just an appetizer plate. However, now eateries are offering the “senior” “kiddie” or even the just the smaller plate for those who don’t want to eat like little piggys. They usually come with a smaller price tag too- so there we are, saving our budget as well as our health.
At home try cutting your recipes into smaller portions. I know at our house – dinner for two, was usually dinner for four. Now I cook for two and try to fill up the meal with more salads or other veggies. This also saves on the budgets and leaves less left overs to throw away.
Also try to serve on smaller plates. I love a pretty table – try flowers and music, colorful mini-plates, cups, colorful napkins and no TV! Try to plate your meals with mindful enjoyment. Garnishes and decorative plating also make eating fun. Put the emphasis on the food not the quantity. Eat slowly and enjoy!
Friday, January 13, 2012
LIFE
Last night was clear with full moonshine and the owls were busy hunting on our farm, calling back and forth to each other, comparing notes on where to find prey.
Thankfully they were not calling my name. At least I don’t think so, nevertheless their hoots haunted me.
A coastal tribal legend has it that if you hear an owl call your name, your death is imminent. I’ve had no recent brushes with death, thank goodness, but as a doctor turned patient over the last two weeks, I’ve had cause to consider the preciousness of life and preservation of health.
The first was dutifully going in for my annual screening mammogram which became a two hour marathon of the radiologist asking for various wedge and coned down views, finally resorting to an ultrasound to determine that a small simple cyst had developed under a nipple and did not, from its appearance, need further investigation. Whew. My worry meter, working overtime through all the imaging, slid back to zero.
Then a subtle vision change in one eye resulted in an appointment with my optometrist who confirmed new vitreous floaters and opacities, but also noted an abnormal retinal artery in that eye. The next stop was the retinal specialist who documented a small retinal “wrinkle” and tear, but was more concerned about the artery which appeared to show some previous injury, whether from a clot or atherosclerosis was not clear. Initial screening lab work for diabetes, lipids, sed rate and metabolic functioning looked okay so more specific testing was ordered (D-dimer, C reactive protein) with elevated levels suggesting I am at risk for clotting, cardiovascular disease, and stroke, not to mention possible hidden malignancies causing a hypercoagulable state. As a 57-year old with hypertension whose family history contains plenty of cancers, wayward clots, unfortunate strokes and one sudden death heart attack, this certainly got my attention. The worry meter has gone into overdrive. Now I’m going through testing of my legs (no clots but lousy incompetent deep veins), carotids (no plaque) and next week my heart (to look for valve issues and emboli). Whether more testing is warranted beyond that has yet to be determined, so I’m sitting in the uncomfortable position of feeling just fine, thank you very much, but that is my denial kicking in.
There are no good reasons for retinal artery problems. They are all bad reasons. As someone on blood pressure medications for a decade and having gained weight I don’t need over the years (just in case of an unexpected serious food shortage, right?), I consider myself sufficiently warned. Besides aspirin, fish oil capsules and lipid lowering agents, I must change how I take care of myself or things will change for me without asking permission first. The doctor turned patient has been given a chance to make a difference in at least one patient’s future, or I’ll be no use to any patient.
The owls may not be calling my name but their hoots haunt for good reason. I’m listening.
Emily Gibson is a family physician who blogs at Barnstorming.
Thankfully they were not calling my name. At least I don’t think so, nevertheless their hoots haunted me.
A coastal tribal legend has it that if you hear an owl call your name, your death is imminent. I’ve had no recent brushes with death, thank goodness, but as a doctor turned patient over the last two weeks, I’ve had cause to consider the preciousness of life and preservation of health.
The first was dutifully going in for my annual screening mammogram which became a two hour marathon of the radiologist asking for various wedge and coned down views, finally resorting to an ultrasound to determine that a small simple cyst had developed under a nipple and did not, from its appearance, need further investigation. Whew. My worry meter, working overtime through all the imaging, slid back to zero.
Then a subtle vision change in one eye resulted in an appointment with my optometrist who confirmed new vitreous floaters and opacities, but also noted an abnormal retinal artery in that eye. The next stop was the retinal specialist who documented a small retinal “wrinkle” and tear, but was more concerned about the artery which appeared to show some previous injury, whether from a clot or atherosclerosis was not clear. Initial screening lab work for diabetes, lipids, sed rate and metabolic functioning looked okay so more specific testing was ordered (D-dimer, C reactive protein) with elevated levels suggesting I am at risk for clotting, cardiovascular disease, and stroke, not to mention possible hidden malignancies causing a hypercoagulable state. As a 57-year old with hypertension whose family history contains plenty of cancers, wayward clots, unfortunate strokes and one sudden death heart attack, this certainly got my attention. The worry meter has gone into overdrive. Now I’m going through testing of my legs (no clots but lousy incompetent deep veins), carotids (no plaque) and next week my heart (to look for valve issues and emboli). Whether more testing is warranted beyond that has yet to be determined, so I’m sitting in the uncomfortable position of feeling just fine, thank you very much, but that is my denial kicking in.
There are no good reasons for retinal artery problems. They are all bad reasons. As someone on blood pressure medications for a decade and having gained weight I don’t need over the years (just in case of an unexpected serious food shortage, right?), I consider myself sufficiently warned. Besides aspirin, fish oil capsules and lipid lowering agents, I must change how I take care of myself or things will change for me without asking permission first. The doctor turned patient has been given a chance to make a difference in at least one patient’s future, or I’ll be no use to any patient.
The owls may not be calling my name but their hoots haunt for good reason. I’m listening.
Emily Gibson is a family physician who blogs at Barnstorming.
Subscribe to:
Posts (Atom)