Good for business?

The Walgreens near our home now has a Take Care Clinic.

The sign out front advises folks driving by to "come on in to get healthy."

The sign also had the following:

Flu shots now available
Ice Cream 2/$6.00
Lays Chips 2/$3.00
Coke 2/$2.50

Letting go

I'll be honest...having my son go off to college has been harder than I thought.

While our home is a lot cleaner and quieter, I miss being able to talk to him everyday about sports and other things.

I even miss getting annoyed with him about stuff.

I just haven't been able to get my words out.

It's been two weeks and things are starting to feel better around here, probably because we know he seems to be settling in so well.

He weight-lifted this morning before class, went for a run between classes, is planning to go watch the Men's soccer game at 5 PM and then he's playing Ultimate Frisbee from 7-9 PM.

That's my boy.

My daughter's still home for one more year and she's been talking more than ever.

My wife and I are talking more also.

Things are good!

I just wish I could get them both a little more interested in sports.

Life sustaining collapse

It’s an honor, and a history lesson, to get to know WWII Veterans.

We admitted a gentleman today who was a POW and contracted Tuberculosis in the early 1940’s.

Prior to the development of the antibiotic streptomycin in 1946, the only treatment, other than going to a Tb sanatorium for “fresh air and relaxation,” was surgical intervention, including the “pneumothorax technique,” which involved collapsing an infected lung to “rest it” and allow the tuberculosis lesions to heal.

He was treated with pneumothoraces.

He gets easily winded if he walks too far; he has since 1942. 

He turns 93 years old next week.

An uplifting lunch

My wife and I had a somewhat emotional good-bye at about noon Saturday with our usually tough and seemingly self confident son.

He had a difficult week leading up to the start of his first year in College-our family dog of 13 years died the day prior to leaving and he was also being separated from his girlfriend of almost two years. As we left to drive back home he was upset and questioning his decision to enroll. He missed lunch to try and compose himself prior to an afternoon class meeting.

It was a silent ride home for my wife and I.

He texted us at about 250 PM to let us know he was feeling much better.

My wife called him back.

After the meeting he went to get lunch.

The woman at the front register told him the cafeteria was closed to get ready for dinner.

As he turned to walk away she asked if everything was alright.

He said that he was fine but was just hungry because he hadn’t had anything to eat since about 8AM.

She told him to “come on in and get yourself some food."

My wife and I really feel this simple act of kindness played a significant role in helping him through a difficult transition and we are very thankful.

I don’t know the name of the woman, unfortunately, but this simple and kind gesture did not go unnoticed.

Where's the pig sty?

I woke up this morning and things were different.

There weren't clothes and shoes thrown all over the house, all the kitchen cabinets weren't open and there wasn't a pile of dishes all over the place from a late night snack.

Then it dawned on me...we took our 18 year old son to college yesterday.

It's sure a lot cleaner and quieter around here.

I guess this will be the new norm...better get used to it.

Drop off day!

We're driving our son to his first year of college today. He's ready and we're ready. He's a great guy and we're excited to see what his future holds.

Bailey (2000-2013)

Our Beagle, Bailey died early this morning at home. She was an imp and a great member of our family for the last 13 years (this picture was taken about 11 years ago).

A room with family?

Mr. W. is an 85 year-old man who lives in an assisted living facility (ALF).

He has severe dementia but it hasn't stopped him from talking.

His social graces are intact and he gets a sparkle in his eye when being engaged in conversation.

He has errors of commission-he answers a question with an answer that has nothing to do with the question that was asked.

"How are you doing today?" I ask.

"You bet I do. Back when I owned a bar in Hartford Connecticut I pretty much did everything so that's why I have 21 shirts now, all different colors for when I worked for the post office and my wife was having an affair and I only get one egg and a piece of toast."

"Are you happy with the food here?" I then ask.

"Not as well as I used too 'cause I've got one bad ear and I like to walk as much as I can and I had a good bowel movement today and I wish we had a television in our room."

This went on for awhile.

"You have a great day!" I say while shaking his hand preparing to leave.

 "Are you going to take me with you?" he inquires.

"You have a great day also," I respond with my own error of commission.

He had a big smile on his face when I left.

I was sort of bummed on my way back to the office again trying to contemplate why he doesn't have a family member, somewhere, who would open up their home to him.

I think of this frequently whenever I leave an ALF.

No turning back

I saw a patient recently who has a condition called elephantiasis nostras verrucosis (ENV), a rare and unfortunate result of chronic lymphedema (in his case due to excessive weight). His ENV involves both lower extremities as well as his lower abdomen and scrotum. It very unlikely that his condition will improve much, unfortunately. He's miserable and depressed. He rarely leaves his home.  I know he so wishes he could turn back the clock. I wish the same for him.

He has my complete empathy. It's the least I can do.

Up for an alternative?

There's always a free magazine at the "Y" every month (the "Y" doesn't sponsor).

It's devoted to alternative medical therapies.

A lot of former traditional Medical Doctor's have transitioned into alternative care and it still doesn't surprise me.

Over ten years ago I wrote a short article for the local newspaper and my thoughts haven't changed that much:

http://articles.orlandosentinel.com/2003-02-06/news/0302060096_1_shui-traditional-medicine-alternative-treatments

I've got to admit, however, that I would love to be a fly on the wall and watch former colleagues perform Visceral Manipulations, Emotional Freedom Techniques, Detoxifications, and Colon Hydrotherapies. 

Try to be kind

Here's an excellent graduation speech by George Saunders at Syracuse University this past June:

http://6thfloor.blogs.nytimes.com/2013/07/31/george-saunderss-advice-to-graduates/?smid=fb-share&_r=0

They're movin on up

Mr. and Mrs. M. are proud of being simple country folk.

They have thick southern accents and talk real s----l----o----w.

I asked them about their children.

Mrs M. answered.

"The oldest lives up in Pennsylvania with his family...he's a nuclear engineer. My oldest daughter lives a few miles from here with her family... she's a family nurse practitioner. My youngest lives in the next town over with her family...she's a pharmacist..she's head of the pharmacy at the regional hospital."

To be completely honest, I wasn't expecting that answer.

It was awesome!

Their song

Nearing the end of my visit I had concluded that 83 year-old Mr. E. and 75 year-old Mrs. E had a very poor quality of life.

I didn't verbalize my thoughts.

He's been bed-bound and poorly responsive for a couple of years, after a series of devastating strokes, and she's been his devoted caregiver 24/7.

He spends his days in a hospital bed.

She sleeps in a single bed in the same room in case he needs anything during the night.

Their bedroom was filled with his medications, creams, diapers, and pads.

"Can I show you something?" she asks.

"Of course."

"Honey, honey (she says as she gently shakes her husbands shoulders until he opens his eyes), I love you..."

"A bushel and a peck and a hug around the neck," says Mr. E., as clear as day.

"Why are you the luckiest man in the world?" she then asks him.

"Because I'm married to you," he says with a slight grin.

Mrs. E. smiles as she strokes his hair while he closes his eyes and drifts back off to sleep.

"That was really great," I say, " thank you."

"Oh it's just something we've done since we were married," she says.

They recently celebrated their 55th wedding anniversary.

It was also another excellent reminder for me to not be so quick to judge a persons quality of life.

Better know these facts!

Here’s an interesting study from Spain:

Asking patients two questions: “How old are you?” and “What year were you born?” had a specificity (the probability that a person not having a disease will be correctly identified by a clinical test) of 97.8% and a negative predictive value of 98.9% in helping to rule out dementia.

(Reference: JAMDA, Volume 14, Issue 8, August 2013)

I just quizzed myself and passed...phew!

Mom, Dad?

I went to an excellent talk today.

It was part 2 of a series on taking care of transgender patients.

He presented many terms used by the "trans" community but never mentioned the term transvestite.

I inquired.

He let me know that the politically correct term to use now was "cross dresser," since the term transvestite was usually used, in the past, to describe men who dressed as women and who usually also had sexual fetishes.

He reported that there is a large group of men and women who simply enjoy to dress as the opposite sex occasionally and who often gather socially to discuss clothing, make-up tips, etc. with each other and then return to their families and their gender correct roles as husbands, wives, fathers and mothers.

It's all sort of bizarre, but it was some interesting information nonetheless.

Mirror, mirror on the wall

Narcissism is characterized by extreme egocentricity, vanity, pride, and an excessive focus on meeting one's own needs, even at the expense of others.

Here's an interesting study that looks at a possible correlation with watching reality TV shows and increased narcissistic traits:

http://www.medscape.com/viewarticle/805064

I enjoy some reality TV shows such as Survivor and The Amazing Race.

It's time to do a little self reflection...

I just can't reflect too long since I'm going to watch the final episode of The Bachelorette with my daughter tonight in about 1/2 hour!

My back hurts-make it stop!

Here's a brief article on back pain and the needless diagnostics that are often performed:

http://www.sciencedaily.com/releases/2013/07/130729231551.htm

Diagnostics for back pain (without worrisome clinical findings) are very similar to antibiotics for viral infections-patients can't stop demanding them and many health care providers can't stop ordering them.

Unfortunately there's not an easy solution for both!

Same ol' results!

I went to the driving range two days ago and hit great.

I was thinking, that at age 53, I had finally mastered the secrets of the golf swing.

I played 18 holes today and played horrible except for the last three holes (3 pars).

Nothing new; the story of my life in regards to golf.

Funny thing, however, is that the last three holes will probably be all I will choose to remember and the good memories are sure to bring me back for another day.

Now if I could just figure out why I played so great on the last three holes...

Maybe next time...

3-in-1

Mr. and Mrs. S. have been married for 61 years.

Although Mrs. S. was not Catholic (Mr. S was) they went to Catholic church, as a family, throughout their marriage and their children were brought up in the Catholic church.

She never took part in the Sacrament of the Eucharist-Communion.

When she was in her 70's she decided to join. She reports being Baptized and going through First Holy Communion and Confirmation all on the same day.

It was a busy day and she reports to being a little embarrassed, "with everyone watching," since it was Easter Sunday.

She laughs when she says she suspects the Priest wanted to make sure she didn't change her mind.