His angel

Met Mr. M., a 69 year old, recently.

Unfortunately, he has severe end stage multiple sclerosis.

His ex-wife is his 24/7 caregiver.

They were married for 35 years and had two children together.

He left her years ago and got remarried to his high school sweetheart.

His multiple sclerosis was diagnosed and his high school sweetheart left.

They were married for one year.

He was alone and, unfortunately, his disease progressed quickly despite all attempts at inducing remission.

His ex-wife offered to care for him.

He accepted.

She does get some assistance through a home health agency for baths since he is bed bound, but otherwise meets all his caregiving needs.

She sleeps in a recliner next to his specialized hospital bed EVERY night.

She's an amazing, loving, forgiving person.

A short military career, unfortunately

A male always has a high and tight hair cut and always wears a US Marine shirt.

I had known him for a number of years.

Finally, I asked: "when were you in the Marines?"

Patient: In 1977.

Me: How long were you in?

Patient: I was medically discharged.

Me: How did you get hurt?

Patient: I hurt my right shoulder on the 4th day of bootcamp doing physical training. I got medically discharged on the 9th day.

I KNOW he would have loved to have had a much longer career.

A wonderfully odd feeling

     Years ago, when my daughter was finishing elementary school, she pretty much swept the awards assembly. It was a great day for our family but, I guess, not so great for many other families attending.
     This past Saturday, my daughter pretty much swept the end of year awards banquet for her horse riding show circuit. Again, it was an amazing night for my daughter and our family, but, I suspect, not so great for many of the others attending.
     Having your children do well in anything is a wonderful thing. The fleeting moments of feeling bad for all the others (who didn't win) is normal, but still a little odd.

A weird style trend

I recently went to buy some men's dress shoes (you would obviously have some questions if I went to buy some women's dress shoes!).

For some reason, most of the dress shoes now have a significant amount of space in front of the toes ( you've seen them haven't you?...they are real long and narrow at the end).

I have wide feet, and always prefer to have a lot of room in the toe box, but not 4 inches worth of space.

What's up with that?

Why are clown shoes "in style?"

A coaches popularity can change quickly

It's that time of the year again...whenever a college football team has a down year everyone calls for the coach to be fired.

     In 2007, Al Groh won the ACC coach of the year while at Virginia. That season his team won 9 games, 5 of which were won by less than three points. Two years later, he was fired after a "disappointing season."  The University paid him over 2 million a year for the next two years "to not be their coach." He also found employment immediately when he became the defensive coordinator at Georgia Tech.

     Last year the University of Central Florida (UCF) won the Conference USA 2010 title and the Liberty Bowl.  This year UCF has lost 6 games by seven points or less, including a pair of losses by two points or less. The coach still has 4 years left on his most recent contract extension. Everyone is calling for the coach to be fired.

     The difference between a good/great season and a disappointing season is often not much. Injuries, a missed field goal, a lost fumble and sometimes just bad karma can change a team’s fortune quickly.

     Alumni and University Administrators need to accept the good with the bad, as long as you are fielding competitive teams and as long as you are running a "clean program."

     Either that or stop giving the coaches such long term contracts (the golden parachutes). It just gets too expensive to keep giving coaches extensions on their contracts, sometimes after one good season, when the win-loss percentage can change so quickly.

If I only knew then what I know now

An 82 year old man made the following statement:

"I look back on my life and ask what really happened? There are a lot of things I would have done differently, but I'm not sure what I could have changed given all my life circumstances."

I let him know we have all probably had similar thoughts over the years and was then able to re-direct him by letting him talk about all his many successes over his life (being a husband, father, having a successful career, etc.).

I think we BOTH felt better after that.

Thanksgiving Day 2011

I'm thankful for so MANY things.

Because I spend such as great deal of time with patients who are ill emotionally or physically (often both), I'll try to keep it as simple as possible today: I'm thankful for HEALTH of mind and body.

My future?

I spent time with a couple recently who has been married for almost 70 years.

The wife pretty much finishes all her husbands sentences.

Whenever I would him a question he would seemingly take a moment to scan his memory banks prior to answering.

Then, often after he said just a few words, his wife would interrupt to see how much time I had left to spend with him because she knew a particular answer would take some time.

"Doctor, are you sure you have enough time to hear the whole story...I've been hearing the same stories now for almost 70 years...if you let him keep on talkin', he will just go on and on and on.

My wife finishes a lot of my sentences and we've only been married for twenty years.

Is this a glimpse into my future?

A 1943 version of a match service

I met Mr. R. recently.

He's an 88 year old man that lives with his wife of 66 years (she's 84 years old).

His wife was from New Jersey and he was from North Carolina. They have three children.

Me: How did you meet?

Wife: When I was in high school we were all asked to write letters to U.S. service men overseas. I wrote to a fellow who was from my home town in New Jersey. He wrote back thanking me for the letter and let me know one of his buddies was real lonely and could also use a letter. I sent a letter to Elbert (her husband), he wrote back and we just kept on writing each other. We got married when he returned. I ran into the boy from my home town years later and we joked about it. He said, "I told you to write him, not marry him." We've had our ups and downs over the years but in general, have been so blessed.

Now that's an awesome story!

Fill a void

A 71 y/o male: I need you to refill my cholesterol and blood pressure medication and then also throw in a little Viagra as well, will ya?

Me: Have you taken Viagra before?

Patient: No, but I just met a real nice lady whose husband died a few years ago and she says she wants me to fill a void in her life. I'm hoping the Viagra will allow me to do just that (he laughs).

2 chairs separated by a table

Every home I've been to, while making home visits, in which the husband and wife are still living, seems to have a common furniture arrangement, in whatever room they use as a den.

Do you remember the show "All in the Family (the main characters were Archie and Edith)"?

They all have an Archie and an Edith chair (seen below on display at the Smithsonian National Museum of American History) in front of a large TV, separated by a small table that has a potpourri of stuff (opened and unopened mail, magazines, remotes, pill bottles, etc.).


One evening recently I informed my wife about my astute observational skills (in terms of noticing the furniture arrangement).

She walked me out into our living room (that serves as our den) and reminded me of our furniture arrangement.

"Oh, you're right...thanks Edith."

#52

It's my birthday today.

I'm going to try and have a great day.

Actually, everyday is a great day.

Hope yours are as well.

What a surprise

I guess everything needs a formal research study to be done.

A recent study, published in the Annals of Surgery shows that elderly nursing home residents suffer more complications from major operations (abdominal surgery, including removal of the gallbladder, appendix or colon, or surgery for bleeding ulcers) than other people their age, who don't live in nursing homes.

I wonder if someone is also in the midst of studying if folks living in nursing homes are more impaired or physically ill than others their age who still live at home?

A great reminder

I made a home visit to see Mr. I..

He is a very thin 80 year male with end stage Parkinson's disease, a previous stroke, is unable to swallow, has unintelligible speech, multiple joint contractures and pressure areas (early stage decubiti).

His wife and I had a wonderful conversation (she's 78 years old).

Before I left, she asked if she could show me some family pictures. Seeing Mr. I. when he was a distinguished looking, burly, younger family man and full of life was an honor and a privilege...also it's a great reminder of the wonderful times they shared in their life together.

A positive spin...I like it!

An 80 year old male (who had been married for the last 58 years) made the following statement:

"My wife and I haven't had sex for the last 18 years because of her stroke (she still has significant residual disabilities) and because GOD stopped giving me the ability for my penis to get hard at about the same time. We're fine and thankful to be alive and to still have each other."

That sure was a great way to look at an issue that is often so troublesome for SO MANY others I see everyday.

Dr., Dr.

A program support assistant recently made me some business cards.

It was greatly appreciated.

My name was listed as Dr. William T. Sheahan M.D..

I thanked the individual.

I'll wait until a later time to point out that the next time around I don't have to be a Dr., Dr..

Just one Dr. is enough.

For now, however, it will be interesting to see if anyone else notices whenever I hand one out.

A true statement

A fellow at the "Y" recently was wearing a T-shirt with the quote: "Talk is cheap unless you are talking with a Lawyer."

I'm sure anyone who has ever hired an attorney and seen how quickly money can disappear from even just "phone calls" alone would agree.

A snip-snip expert

While driving on the interstate recently I saw a large sign that was an advertisement by a urologist.

It had a picture of the relatively young looking physician.

He was advertising "no needle, no scalpel vasectomies."

It stated that he had performed the procedure over 20,000 times.

It got me thinking.

If he had been in practice for 15 years, and worked 365 days a year, he would have already performed over 3.6 vasectomies a day (I admit that I did use a calculator).

Talk about being able to perform a procedure in your sleep!

However, given the delicate nature of the procedure and the psyche of those undergoing the procedure, I understand why he didn't add this additional information to the advertisement.

Even though I think I would be bored out of my mind, I do have to acknowledge that he must be pretty darn good by now (after performing my second vasectomy in residency training, I felt pretty confident!).

So true

My daughter has competed in a horse show weekly for the last three weekends. Over the last few years, she has usually only done one horse show a month, until recently.

As her skill and riding goals increase, so do the available shows in which to compete.

Riding is her passion and she's an amazing 15 year old.

When I was parking our Van yesterday, at the horse show, I noticed a rear bumper sticker on the Van parked next to us.

It said, "The driver of this vehicle carries no cash. It's all been spent on the horse."

It gave me quite a good bout of laughter.

I'll wait until later to tell my daughter why I was laughing.

A Veterans Day tribute

We have lived next to Louie (and his wife Mary) since 1993.

Louie was born 1/14/1918 and has been an amazing neighbor.

He's also a WWII veteran and was on the 2^nd wave of the Omaha Beach Invasion.

He’s been a hard working man his whole life and has been married to Mary for about 70 years.

He retired from the post office as well.

His daughter, Rosie, literally lives right around the corner.

He has some great stories to tell about WWII, but only when asked.

He was a communication man during the invasion and when the LCVP (Landing Craft, Vehicle, Personnel) opened, Louie (a little over 5 foot tall) jumped into water a depth of 6 feet with a large spool of wire over his shoulder. He was sure he was going to drown.

In fact, Louie has always said to never believe anyone who says they weren't afraid in battle-they’re all lying.

Louie and Mary have always remembered our kids birthdays; Tom and Ellie always know to expect a card, on their birthday, with $1.00 in it.

Louie has ALWAYS tried to prevent me from hiring any help; whenever I've had an electrical or plumbing concern in my house he has always had the necessary tool available to fix it.

He still tries to get out for a ride on his tri-cycle everyday.

Happy Veterans Day Louie, you're the best!

Success

Along the same lines as yesterdays post, I read an article on Ronald Reagan, years ago, in which he stated, "if I only had studied harder in school, maybe I could have made more of myself."

I'm sure he also laughed.

If I only knew...

I had the pleasure of meeting a 92 year old man and his 90 year old wife recently.

They still (with the help of home care agencies) lived in their home.

After reviewing his past medical history he did state "if I knew I was going to live this long I would have taken better care of myself when I was younger."

We ALL laughed.

A simple request

I have many patients who continue to be snow birds (spend the winters down south and the summers up north).

I have a request:

If you are in the middle of a work-up and evaluation for, for example, a possible malignancy, it would be best to delay your return either down south or up north until the work-up and evaluation is complete.

Simple enough, right?

Stuck in the middle

It's pretty common for two specialists to have different opinions, despite thousands of dollars of testing.

I have a patient with neuropathic quality foot pain, for example.

A Podiatrist will not back down in stating the foot pain is referred from the patients back.

A Neurosurgeon will not back down in stating the foot pain is coming from the foot, not the back.

It's not so fun for the patient.

It's not so fun for me either.

Usually don't forget after a reminder

Many urinalyses show microscopic blood.

When I inquire, most folks tell me they just peed into the sample cup.

All are given a towelette (to clean) and instructions (collect a mid stream sample) but most report:

1. The person in the lab said something but I wasn't really listening

2. I wasn't sure I would be able to pee and wanted to make sure I had enough for a sample

3. Oh, now I remember. I forgot. I thought the towelette was to clean my hands after peeing. I do sort of remember being told to use it to clean down there

4. Etc., Etc.

I then always offer, when the urine sample was not properly collected, to repeat the sample.

I let folks know that I would love to spend the rest of my life without having to have a cystoscopy (a fiber optic scope is put up the urethra into the bladder), if possible, and that part of the work-up for microscopic blood is to have a cystoscopy.

Both, especially men for some reason, don't seem to forget the proper instructions for future collections when informed of this possibility.

Strength

Mr. L. is a 33 year old male who, unfortunately, has ALS.

He walked into his home 6 months ago and is now already wheelchair bound.

They (he and his wife) have a 9 year old son and his wife is currently 6 months pregnant.

They were  incredibly strong, hopeful, but also realistic.

They know his chances of living more than another two years are slim.

He openly talked about end of life plans as well as funeral arrangements.

While I know they have had many a sad day individually and as a couple, their strength was amazing.

It was an honor to meet them.

A three color uniform

A 64 year old male, a Vietnam veteran, made the following statement:

"My uniform was green, Army issued green; red, from the red dirt and clay; and brown, from going to the bathroom on myself."

I got the visual.

Glad I'm not a fly on the wall at their house

I can't begin to estimate the number of folks I've seen, over the last twenty years, who decided, on their own, before seeking medical advice, to stick their fingers up their rectum to help relieve a bout of constipation.

In most cases, I'm able to help with the problem and offer advice on how to prevent the need to perform such a maneuver in the future.

Still, I always have a recurring thought (see the title of this post)...

Wants his cake and eat it too

An male reported a recent home fire.

His step daughter (who was an adult) left a stove top cooker (that was on) and a bottle of oil (that was too close to the heat) unattended.

By the time the fire was controlled, the kitchen was a total loss.

He reported that they received a $65,000 settlement from the Insurance company for repairs (it must be quite a kitchen!).

He reported the money received would more than cover the cost of the repair/re-model.

He was still annoyed.

"They are compensating me for our loss, but not for my time and all the phone calls I've had to make."

I decided to just say "yeah, I understand," instead of what I was really thinking.

Nuts

Another interesting thing about driving through some southern, rural areas of Florida (was at a horse show with my daughter this past weekend), are all the road side businesses, set up in the back of, usually, a pick-up truck.

I've asked a bunch of folks, but have never come across anyone who has tried the Boiled Nuts that are often for sale.

This past weekend there was one fellow who had placed hand made signs, every hundred yards or so, about his Nuts for sale:

"Just ahead, Boiled Nuts..Just ahead, Cajun Nuts...Hot Nuts soon...Ready for Nuts?...Nuts in 400 yards...Nuts in 200 yards...Nuts, almost here...STOP FOR NUTS NOW."

I love Nuts but how many Boiled Nuts can one eat?

Can these folks earn a living selling Nuts?

Are the Cajun Hot Nuts more expensive than the Boiled Nuts?

If anyone knows, please let me know.

I decided not to stop, but the unanswered questions are driving me Nuts!