The good old days...

This was forwarded to me: For those of you born between 1930 - 1979: First, we survived being born to mothers Who smoked and/or drank while they were Pregnant. They took aspirin, ate blue cheese dressing, Tuna from a can and didn't get tested for diabetes. Then after that trauma, we were put to sleep on our tummies in baby cribs covered with bright colored lead-based paints.  We had no childproof lids on medicine bottles, Locks on doors or cabinets and when we rode Our bikes, we had baseball caps not helmets on our heads. As infants & children, We would ride in cars with no car seats, No booster seats, no seat belts, no air bags, bald tires and sometimes no brakes. Riding in the back of a pick-up truck on a warm day Was always a special treat. We drank water >From the garden hose and not from a bottle. We shared one soft drink with four friends, >From one bottle and no one actually died from this. We ate cupcakes, white bread, real butter and bacon.. We drank Kool-Aid made with real white sugar. And, we weren't overweight. WHY? Because we were Always outside playing...that's why! We would leave home in the morning and play all day, As long as we were back when the Streetlights came on. No one was able To reach us all day. And, we were O.K. We would spend hours building our go-carts out of scraps And then ride them down the hill, only to find out We forgot the brakes. After running into the bushes a few times, we learned to solve the problem. We did not have PlayStations, Nintendo's and X-boxes. There were no video games, no 150 channels on cable, No video movies or DVD's, no surround-sound or CD's, No cell phones, No personal computers, no Internet and no chat rooms. WE HAD FRIENDS And we went outside and found them! We fell out of trees, got cut, broke bones and teeth And there were no lawsuits from these accidents. We ate worms and mud pies made from dirt, And the worms did not live in us Forever. We were given BB guns for our 10th birthdays, Made up games with sticks and tennis balls and, Although we were told it would happen, We did not put out very many eyes. We rode bikes or walked to a friend's house and Knocked on the door or rang the bell, or just Walked in and talked to them. Little League had tryouts and not everyone made the team. Those who didn't had to learn to deal with disappointment. Imagine that!! The idea of a parent bailing us out if we broke the law Was unheard of. They actually sided with the law! These generations have produced some of the best Risk-takers, problem solvers and inventors ever. The past 50 years have been an explosion of innovation and new ideas. We had freedom, failure, success and responsibility, and we learned how to deal with it all. If YOU are one of them...CONGRATULATIONS! You might want to share this with others who have had the luck to grow up as kids, before the lawyers and the government regulated so much of our lives for our own good .

Flights to honor

Honor Flight is an organization whose mission is to take WWII Veterans to the WWII Memorial in DC.  There are Honor Flight hubs across the country and I urge you to look into whether there is a group in your area.   

The national web site is:  http://www.honorflight.org/

You don't remember, really?

The Centers for Disease Control and Prevention is urging Hepatitis C testing for all Americans born between 1945 and 1965, as new data indicate that the baby boomers account for the largest proportion of cases yet are largely ignorant of their status.

“The take home message from the report is that you may not remember everything that happened in the 60’s and 70’s, but your liver does,” said CDC Director Thomas Frieden at a press conference.

Who knew the Director of the CDC had a sense of humor?

I think the quote could have said "the take home message from the report is that you may not want to remember everything that happened in the 60's and 70's..."

Only a nonagenarian

Mrs. C. comes from some good stock.

She's currently 82 years old, the youngest of 4 children.

She has a brother who's currently 96, and two sisters ages 86 and 87.

Her Grandmother and Grandfather, who lived on a Greek island, lived to be 113 and 114 years old, respectively.

Her Mother lived to be 108 years old.

"My dad died young...he was only 93."

She didn't smile or laugh so neither did I.

Longevity is a pretty serious topic in her family.

I couldn't help but wonder...maybe her Dad was a smoker...I didn't ask.

"Sea" what happens when you stay at home

Mr. C. loved being in the Navy.

After almost 7 years he was a ME (Metalsmith)-3 and trying to decide if he should stay in for a career.

(A Metalsmith was a U.S. Navy rating established in 1948. ME's performed the metal work necessary to keep all types of shipboard structures and surfaces in good condition. They also maintained shipboard plumbing, sanitation systems, repaired small boats, and maintained the ballast control systems.

In 1957 ME's were redesignated as Shipfitters.)

His first daughter was born while he was at sea.

When he came home she was almost 1 and "cried at the site of me because she thought I was a stranger."

He decided then that he preferred to be a family man so he separated when his time was up.

He went on to a very successful furniture making business.

He even reports doing the waiting room sectional sofas for both Bob Hope and Michael Jackson.

He has no regrets.

He feels like he made the right decision.

He's been married for almost 61 years, has 6 children and a combined 35 grand and great-grandchildren.

He's a family man for sure.

One of the amazing WAVES

Mrs. V. was part of the WAVES (Women Accepted for Voluntary Emergency Services) in WWII.

The official name was the U.S. Naval Women's Reserve, but the nickname of the WAVES stuck.

She was 25 years old at the time and, due to her previous education and training as a school teacher, was put in charge of running the women's living quarters while stationed at the Naval Training School in Georgia.

She served for 2 and 1/2 years.

She's now 96 years old and crippled with arthritis but is still very quick witted.

Once she got rolling, it was one funny or sarcastic comment after another.

I was cracking up and she had a satisfied smirk on her face.

The presence of women in the military was very controversial in the 1940's and many, even though they were performing vital duties at home so as to free up men to fight overseas, were subjected to ridicule and crude remarks.

I suspect her wit and sarcasm served her well back then and that many men left an encounter with her with the short end of the stick.

I would love for my daughter to spend some time with her.

We need to talk

Here's a well done video on how to deliver important (often bad news) to a patient or to loved ones:

http://www.youtube.com/watch?v=7kQ3PUyhmPQ

Probably the biggest take home points for me were the reminder that up to 70% of  human communication is nonverbal and the importance of ask-tell-ask.

Transcatheter Aortic Valve Replacement (TAVR)

Mr. H. (at age 92) is planning to have a TAVR procedure performed for critical (and very symptomatic) aortic valve stenosis.

The attached 2-minute video reviews how the procedure is performed:

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

It’s a procedure performed for patients who are not necessarily a candidate for an open aortic valve replacement due to age, frailty and underlying medical problems/co-morbidities.

As with many other procedures that are being performed on our elderly population (left ventricular assist devices, ICD’s, etc), the TAVR procedure is not without controversy. Below is one blog site that comments on the same:

http://www.geripal.org/2012/08/tavr-life-prolonging-and-palliative-or.html

Too easy?

Electronic cigarettes continue to be very controversial.

I completely agree with ALL attempts to not allow children/teenagers to have access to them.

I always try to make sure patients are aware of the controversies, along with the current FDA and other Federal warnings.

However I will, off the record, admit to being amazed at observing patients of mine who were smoking 2-3 packs of cigarettes a day being able to transition completely to the E-cigarette.

While the jury remains out as to their safety, without fail, the patients and the family members are thrilled, and in general there has been a considerable cost savings.

In my experience, the "E" should stand for "Easy" way to quit smoking tobacco.

Only further follow-up will reveal if in fact they have less health consequences.

Location, location, location

A study in 1971 revealed that about 20% of the American soldiers in Vietnam were addicted to heroin at some point during their term of service overseas.

Almost half (45%) had used either opium or heroin at least once during their tour of duty.

I've often wondered, if/when faced with the prevailing conditions in Vietnam, if I would have been part of the 45%.

Interestingly, however, when re-examined a year after their return home, only 5% had resumed heroin use.

Prior to this study, the conventional wisdom was that heroin addiction was a disease and typically had very high relapse rates (close to 90%).

For soldiers in Vietnam, heroin use had become associated with being in Vietnam. Back home (in their homes, workplaces or classrooms and associating with their family and friends) they did not have the same cues and opportunities for heroin use.

To a behaviorist, context is a critical component in the formation and shaping of behavior.

They hypothesize that heroin use was a habit, not a disease. Like all habits, it's best broken by avoiding people, places and things that are linked to the habit.

It seems like a pretty sound hypothesis to me.

Let's make a deal

The Mamasan in charge of cleaning the Hooch, that Mr. O. lived in for part of his tour in Vietnam, had a lot of connections.

He reports that he could give her 4 cartons of cigarettes in exchange for an extra-large sized garbage bag of marijuana pods.

Mr. O. didn't smoke cigarettes and had no use for the easily obtained and inexpensive cartons.

He did smoke marijuana, however.

The cartons of cigarettes had a high trade value on the streets for the Mamasan.

She could trade them with street dealers for money or other goods.

They in turn would roll the cigarettes back and forth to loosen and remove some of the tobacco in order to "spike" them with a vial of heroin, which was then re-sold at a much higher cost.

The Mamasan and Mr. O. were each others best customer.

Mr. O. also reports that he had a very clean Hooch.

I believe

I went to a conference on Friday.

One of the talks was on the high percentage of marijuana and heroin use by members of the armed forces while serving in Vietnam.

This article from 2002 is long but does a fairly good job of reviewing many of the prevailing conditions at the time:

http://www.library.vanderbilt.edu/central/Brush/American-drug-use-vietnam.htm

I happened to see a Vietnam veteran today.

In the midst of taking his history I asked him about the drug culture during his time in Southeast Asia.

He remembers what he was told by a member of his unit when he first arrived in Vietnam:

"Man made booze, God made grass; I believe in God. Do you believe in God?"

He went on to say, "I was 18, scared to death, and looked up to those guys. I started smoking marijuana soon after I arrived."

"Hey Dad..."

Happy Father's Day to all men who are truly Fathers.

A man is only a Father if he grasps all aspects and responsibilities of Fatherhood.

I had a great Father.

It's a privilege to be a Father-I'm thankful I've been given the opportunity and for having had such a great role model.

Horse show summer for my daughter

Just one of many trips/events from last weekend:

http://www.youtube.com/watch?v=XNtbgjFwVcA&list=PLTBnGbJXjIC7DVngfRRNCe0ngtwlJzEpD&index=3

The beginning and the end

Mr. W. lost his wife, of almost 60 years, a few years ago. 

She was the love of his life and reportedly loved by many others as well.

He let me know four different times what an amazing memorial service they had after she was created.

He meant to say cremated but I obviously didn't correct him.

On further reflection, however, it's pretty amazing what a difference one "m" can make.

Odd man out

The 2012 University of Michigan study, Monitoring for the Future, reported that 36.4% of current high school seniors had either smoked Marijuana or Hashish.

Back in the 1970's, during my first year of college, I shared a dormitory suite with nine other guys.

Of the ten of us in the dormitory suite, 90% smoked marijuana.

I was the other 10%.

Maybe the incidence of marijuana has actually decreased since the 1970's?

I'll have to check some references.

Ya man!

PRN

My son asked a simple question: What does prn mean (he read his Rx for an allergy treatment after a recent doctors visit)?

"It means as needed," I said.

"What does the prn stand for?"

I couldn't remember, even though I also use it on many Rx's a day.

I looked it up.

It's Latin and stands for Pro Re Nata.

I took three years of Latin, years ago, in high school at my Mom's insistence.

She would not be pleased to know I had forgotten.

I never did have much of an aptitude for foreign languages, much less a dead language.

One of the greatest

Maximino is an 82 year old man.

I mentioned he was the first Maximino I had ever met.

He let me know it's not a common first name for a reason.

It originated as an Italian name and means the "greatest."

"There can't be too many of the greatest walking around you know."

He laughed and I certainly agreed.

Manja

Mr. Z. hasn't cut his grass for many years.

He still lives in a home with a large lawn.

His wife was cutting it until a few years ago (they hire someone to cut it now).

"She doesn't do grass anymore; my wife doesn't do grass anymore."

He then let out a hearty laugh.

I pretty much assumed he was making a reference to weed.

It didn't seem like I needed to get him to further clarify.

He seemed like a pretty hip 90 year-old.

Loving green

Mr. Z. spent over 20 years, working on a cargo ship, making the trip from NY to Central America and back for the Chiquita Banana company during the mid 1950's to the late 1970's.

Each round trip would take two-three weeks. He would be home for a week and then head back out. He never missed a trip due to illness and never took an extended vacation.

It brought up the obvious question.

"Do you like bananas?"

"I can't stand bananas. I can't even stand to look at them. The only good thing about bananas is that they allowed me to earn a living for many years. They were green when we picked them up-the same color as money."

He laughed and so did I.

Back in the day, I'm sure he laughed all the way to the bank.

Lifesaver

Mr. Z. is 90 years old and has some cognitive impairment.

He has complete recall, however, concerning July 25, 1956.

He was a (33 year old) radio operator on a cargo vessel that was carrying a loud of bananas back to New York City from Costa Rica.

He was the first to hear the S.O.S. from the SS Andrea Doria after it collided with the Swedish ocean liner, the Stockholm, off the coast of Nantucket.

Over 50 people died but his actions were instrumental in alerting others to allow the rescue efforts to get underway as quickly as possible.

He acknowledges that day as being the most significant day of his life.

I completely agreed.

Three out of four

Mr. A.'s older brother was killed while serving in Vietnam.

Mr. A. was medically discharged after his 5th tour in Vietnam from multiple shrapnel injuries. He was awarded multiple Purple Hearts, Bronze and Silver stars and two Distinguished Service Crosses during his service.

One of Mr. A.'s younger brothers lost a leg after stepping on a land mine in Vietnam.

All were in the Army.

"How old are you?" he asked me.

"53," I replied.

"I'm glad you were too young to go to Vietnam, " he said, "you're the same age as my youngest brother. He never had to go either."

I've always been glad as well. So were my two brothers.

"Thank you for your service. Thanks to you and your family."

Needing to know

Forwarded from a friend:

A male patient is lying in bed in the hospital, wearing an oxygen
mask over his mouth and nose. A young student nurse appears and
gives him a partial sponge bath.

"Nurse,"' he mumbles from behind the mask, "are my testicles black?"

Embarrassed, the young nurse replies, "I don't know, Sir. I'm only
here to wash your upper body and feet."

He struggles to ask again, "Nurse, please check for me. Are my
testicles black?"

Concerned that he might elevate his blood pressure and heart rate
from worrying about his testicles, she overcomes her embarrassment
and pulls back the covers.

She raises his gown, holds his manhood in one hand and his testicles
gently in the other.

She looks very closely and says, "There's nothing wrong with them,
Sir. They look fine."

The man slowly pulls off his oxygen mask, smiles at her, and says
very slowly, "Thank you very much. That was wonderful. Now listen
very, very closely:

Are - my - test - results - back?"