Nailed it!

I saw a funny cartoon yesterday.

It had what looked like an old man down on one knee, proposing to what looked like a much younger woman.

He had the ring box open, revealing what looked like a huge diamond ring.

Underneath was his proposal, "would you be my primary caregiver?"

It makes me laugh every time I think about it.

The afterlife?

Outside of the 6 story senior complex I visited yesterday was a sign that read:

                                                                      The Plymouth
                                                                      Senior Living
                                                              "Life begins at the Plymouth"

It's a nice facility and appears to be filled to maximum capacity with very old people.

Their web site also states that "if you lived here you would be within minutes to Florida Hospital and Medical Clinics."

The quote on their sign makes me grin whenever I think about it.

95% for 10%?

Last Thursday night I attended an excellent talk on “Myths and Truths of American Health Care.”

The speaker, Dr. Arthur Garson, asked the question, “What percentage does medical care play in preventing premature death?”

As the audience was mainly health care providers the answers varied between about 50-80%.

The data he presented was humbling. The correct answer was approximately 10%.

Genetic predisposition is felt to be responsible for approximately 30% of premature deaths; behavioral patterns 40%, social circumstances 15% and environmental exposures 5%.

Currently, about 95% of the money spent on health in our nation goes to direct medical care.

Here’s the article in Health Affairs from which the statistics were quoted:

http://content.healthaffairs.org/content/21/2/78.ful 

This diet is killing me!

OK...now that you've figured out your BMI, where do you fit?

If you're like almost 70% of Americans (based on the last data released by the CDC in 2011) you are either in the overweight or obese range.

But here's some interesting news (until the next study is released that refutes the findings):

http://jama.jamanetwork.com/article.aspx?articleid=1555137&link=xref

Being overweight (a BMI of 25 to less than 30) or having grade 1 obesity (a BMI of 30 to less than 35) was associated with a significantly lower mortality rate than was normal weight (a BMI of 18.5 to less than 25).

However, grade 2 obesity (a BMI of 35 to less than 40) and grade 3 obesity (a BMI of 40 or greater) were associated with a significantly higher mortality rate than those of normal weight.

I'm in the overweight range.

My wife made some great lemon squares last night.

I celebrated the news by having a second helping!

What's your number?

A useful site for helping to easily figure out your body mass index (BMI) is:

http://nhlbisupport.com/bmi/bminojs.htm

BMI Categories:

• Normal weight = 18.5-24.9
• Overweight = 25-29.9
• Obesity = BMI of 30 or greater

I'm 6'3" and currently weigh 235. 

My calculated BMI is 29.4. 

Therefore, I'm in the upper range of the overweight range.

What about you?

Hail Mary's

Mr. D. is 88 years old.

He has 5 children, 35 grandchildren and a "handful" of great-grandchildren.

He said he grew up Catholic and although he admits to not always being the best Catholic, feels like he really paid homage to Genesis 1:28- The whole "Be fruitful and multiply" part (he laughs).

He also reports being very thankful for confessionals over the years-Bless me Father for I have sinned...

He laughs again.

I grew up Catholic...I can relate.

Sleep hobbyist

I was reviewing a note today, written by a nurse practitioner I work with, on a 60 year old male.

Under hobbies it stated sleeping.

Most define a hobby as an activity that is regularly undertaken for pleasure, typically during one's leisure time. A hobby is whatever you do in your free time. A person who engages in an activity solely for fun is called a hobbyist.

So, depending on how you emphasize the definition sleep could be considered a hobby: undertaken for pleasure and during one's leisure time.

I guess the sticky point is whether or not sleep represents an activity.

I'm pretty sure I would have considered sleep a hobby in college...I'm just not quite sure about the rest of my adult life.

2 for 2 at Harvard

I overheard my daughter and a friend talking the other day.

They were discussing a girl in the 12th grade who had just been accepted into Harvard.

Her older sister had been accepted the year before and is currently in school there.

My daughters friend: I sort of bet their parents look at each other every once in a while and say, "we've done a really good job raising our daughters."

My daughter: Yep, I bet they do.

Yep, I bet they do.

The chicken or the egg?

Both of my brothers are taking Jusuru: http://www.jusuru.com/www/default

Previously they took MonaVie but Jusuru is marketed unofficially as "MonaVie on steroids."

A lot of their friends and acquaintances also take it.

It's a multi-level marketing distribution plan.

Both of my brothers already have pretty healthy lifestyles as, I suspect, most of their friends do as well.

I wish them all the best.

The biggest question I have remains the same: Don't most people who take nutritional supplements already have healthy lifestyles?

I've never come across a person who takes a product such as Jusuru who has an unhealthy lifestyle (doesn't exercise, drinks alcohol excessively and smokes) have you?

Which comes first?

A Slow Medicine Approach

Dr. Dennis McCullough makes some great points concerning medication use in the elderly in this article:

http://webpages.csus.edu/~fcc25/Module%201_files/Slow%20Medicine.pdf

Think about taking the time to read it when you get a chance.

Off and running with a bunch of tests

A conversation overheard at the YMCA:

Male #1: I had some burning in my chest so I went to see my family doctor. He did an EKG on me and I had a right bundle branch block. He told me it could be worse. A left bundle branch block is the widow maker, you know.

Male #2: So what did you do?

Male #1: I went to my cardiologist and he told me that I've had the right bundle branch for years but that I might as well get some tests done. I had a heart catheterization a few days ago. Afterwards he said everything was fine and that my chest burning isn't due to my heart. He told me I should go see a gastroenterologist.

Male #2: Wow, it still sounds pretty serious; hope you find out soon what it is.

I held off from speaking but here were my thoughts:

"A left bundle branch is not a widow maker. A severe narrowing of the left main coronary artery or proximal left anterior descending coronary artery is called the widow maker. If your family doctor really told you that you need to see a different family doctor. He should have asked about your diet, caffeine intake and if you smoke or drink alcohol. He should have found out you can run 5 miles at over 4 MPH and not have any chest pain of shortness of breath. He should have advised a trial of an over the counter medication such as zantac or prilosec. He should have advised you to avoid eating too late at night and to not lie down too soon after eating. He also could have advised you to elevate the head of your bed."

His feetwork

I heard an interview today with a soon to be graduate of our states best university who is predicted to be a first round pick in the NFL draft.

I can't remember all the quotes but here are just a few of my favorites:

"If I'ze don't succeed, I won't make no excuses."

I'ze look forward to playing in the NFL."

I'ze been working on my feetwork so I can play multiple positions on defense."

I wish him nothing but the best and I hope he does succeed.

Last year, only 1.7% of college football players made it to the pros.

Hopefully a lot of the others are taking advantage of everything a great university can offer, including English and public speaking courses.

A daughters opinion

A daughter called to give us a head-ups prior to seeing her Dad as a new patient.

"He's been a curmudgeon lately."

Definition: someone who is irritable or stubborn; somebody considered to be bad tempered, disagreeable; a crusty, ill tempered and usually old man.

I decided to hold off on judgement until I met him myself.

I'm pretty sure my kids have probably described me as being a curmudgeon at times because, as all fathers know, we are always wrong and our kids are always right!

Tripling in size!

Mr. H. was born 89 years ago in Dublin, Pennsylvania.

He let me know it's the fastest growing town in the U.S..

"It keeps doubling in size!" he stated before laughing.

(I wondered how many times he's told that joke over the years)

Later that night I ran it by my wife. She laughed as well.

A quick Google search, believe it or not, shows there are currently 21 towns in the United States called Dublin.

I wasn't able to find any towns called Triplin!

Home remedies

Mr. P. seems like a pretty practical fellow.

He's made many modifications in his home that allows him to remain as functional as possible.

I noticed his very thick fungal toenails were well trimmed.

He let me know he does it himself by using wire cutters.

He had a truss for a large umbilical hernia that I had never seen before.

He let me know he made it himself with a standard belt and a piece of leather from a gun holster.

Maybe when I get to know him better I'll inquire if he likes to write.

He could put together a guide on how to use things around the home to cut down on the need for and the costs of using a medical supply company.

Salsa for 7

My wife made some great salsa yesterday.

We were about to dig in.

For some reason, for the first time ever, I decided to look at the nutritional information on the back of the Tostitos Restaurant Style chip bag that we just opened.

A serving size was seven chips!

It didn't make me stop eating but it did make me start to wonder how many thousands of calories I've consumed during many previous feedbags.

Seven chips...you've got to be kidding!

$3.07

It's a tough decision.

My subscription for Men's Journal is about to expire.

I received a nice letter from the publisher, with this months magazine, thanking me for being a loyal subscriber for the last few years and offering me a special renewal price of only $14.95 for the year.

I felt pretty special.

In the same issue, however, there was a offer for all readers to get a year subscription for only $11.88.

What should I do?

I wasn't expecting to have to make such a tough decision so early in the morning! 

Will the publishers be upset if I choose the cheaper price?

Attention!

The Boston Medical Group-The World's #1 Choice in Men's Sexual Health-has been running an add in the sports section of our local newspaper:

"Make this Valentine's Day about her. Not your E.D. (erectile dysfunction)."

The add goes on to state:

"Immediately last up to 60 minutes. 98% effective for men of all ages."

There's only one form of therapy for E.D. that's 98% effective-intracavernous pharmacotherapy (ICP).

ICP involves an injection, with the use of a needle, of vasodilators directly into the spongy tissue of the penis.

Side effects include penile bruising, pain or tenderness, scarring and a prolonged erection (known as priapism).

So...if you don't mind sticking a needle directly into your penis and enduring the possible side effects listed you can make this valentine's day all about her.

Best of luck.

And by the way, doesn't the ability to "last" for up to 60 minutes sound just a little excessive?

And hopefully you won't experience priapsim.

I won't go into any details about the possible treatments for that condition-I've probably already freaked you all out enough!

Odd he is!

I've been acquainted over the years with some "eccentric" physicians.

Recently a patient had a skin related concern (a basal cell cancer) and I needed to get him set up to see a dermatologist.

Me: Have you ever seen a dermatologist before?

Patient: Yes I have, but I can't remember his name, but I'll tell you this, when the two of us were in the exam room together, one of us was a little odd, and it wasn't me.

I immediately knew he was talking about. When I mentioned the doctors name he confirmed it.

We laughed.

He also agreed for me to get him back to see Dr. Odd again.

His description was right on the money and it helped to reconfirm that being odd is not always a bad thing, even in medicine!

Thank you wery much!

I recently went to a medical talk given by an Indian born physician who has practiced in the United States for the last twenty years.

It was an excellent talk but I'll admit I was sort of distracted at times by his accent.

In Hindi, Punjabi and many other native languages from India, the "V" sound is not used.

When speaking English, therefore, ventilator becomes wentilator, viral becomes wiral, overused becomes owerused.

One web site entitled The Indians Abroad has a whole section on how to make the "V" sound.

Here are the instructions:

"To pronounce the "V" sound correctly, place lower lip gently against the upper front teeth and make the sound. Don't press it hard, you should be able to exhale through, while making the sound. You will need lots of practice if you are not used to it. Remember, the "V" is a hard sound; make a tone, don't breathe out. Just breathing out makes the "F" sound."

Try it yourself. I actually have no idea what they are talking about.

They have my complete empathy.

Pickle slice

I went to see Mr. P. today. He has a boxer, "Pickles," with a significant underbite, who stays faithfully by his side. It was the second time I have seen both in their home. He's an extremely gentle dog but I've got to admit, I still flinch every time I look at him while re-convincing myself that he has no plans to take a bite out of me!

His second choice in 1943

Mr. H. is an 88 year old WWII veteran.

He had a long career in the ARMY.

Me: How did you decide on the ARMY?

Mr. H.: When I enlisted I was asked if I wanted to be in the ARMY or the NAVY. I said the NAVY. The officer responded, "OK the ARMY it is." I wasn't confident enough to speak up at the time but like the rest of my life, GOD has always shown me the way.

Battle to stay home

Mr. L. reports that he is ready to die and he wants to die at home.

He's tired of going back and forth from the hospital.

He has end stage emphysema.

I've known him for about a year.

He was about the same age as my son, during WWII, when he was in the second wave of the Omaha Beach invasion on June 6, 1944 and fought in the Battle of the Bulge.

We will try to honor his wishes to spend his final days in his home, with his wife of over 60 years, surrounded by his life time of memories.

He deserves it.

A new day-hope it's a great one!

Old friends pass away, new friends appear. It is just like the days. An old day passes, a new day arrives. The important thing is to make it meaningful: a meaningful friend or a meaningful day-Dali Lama

You are never too old to set another goal or to dream a new dream-C.S. Lewis

Fall seven times, stand up eight-Japanese Proverb

Courage is going from failure to failure without losing enthusiasm-Winston Churchill

Another Sunrise, Another New Beginning-Jonathan Lookwood Huie

My Mama always said you've got to put the past behind you before you can move on-Forrest Gump

A three-way

We were supposed to have a conference call yesterday that included three separate sites.

The person who usually coordinates the call was running behind and not yet back in her office.

Another person, at one of the sites, was trying to be helpful and sent out the following e-mail:

"Has anyone else ever done a three-way? We should be having a three-way."

I decided to just answer "no" and keep it completely professional.

It made me laugh, however, wondering if anyone else was also resisting the temptation to answer with an inappropriate comment.