Stretching Exercises

Often physicians advise their patients to do stretching exercises but due to time constraints on their schedule, they don't have the time to explain the exercises in detail. Here's a quick tutorial on stretching different muscle groups that may be helpful. This site has been a useful tool for many of my patients who are not familiar with proper stretching techniques.

Primary Care Physicians - Quarterbacks of Your Health Care

I have learned never to assume anything in medicine. This is particularly true in coordinating my patients' care when more than one doctor is involved. Communication is essential for a successful outcome in medicine. This has become increasingly difficult in the health field for multiple reasons. Patients do not establish with a primary care doctor or they change doctors frequently, multiple facilities or specialists may be involved, and overburdened and overworked physicians lack the time needed to follow through on consultations as ideally as possible. The following case unfortunately demonstrates the poor outcomes which may occur as a result of a lack of communication.

A 37 year old man presented to the emergency room (ER) with a severe headache. He was examined by the ER physician (provider#1) who ordered a CT scan of the brain. The scan was reviewed by the radiologist (provider #2) who saw evidence of a blood clot but thought that it was an old injury. He did not contact the ER doctor with this information. The ER doctor then transferred the care of the patient to the new ER doctor (provider #3) at the end of his shift. He did not follow up with provider #2 regarding the results of the scan. The new ER doctor (provider #3) determined that the patient needed cardiac catheterization and transferred the patient to the cardiologist (provider #4). The cardiologist administered a blood thinner to the patient in preparation for a stent placement. The procedure was then performed by another cardiologist (provider #5). After the procedure the patient complained of a severe headache. At this point provider #5 reviewed the chart and found the radiology report which showed the old blood clot. The patient died of brain hemorrhage after the administration of the blood thinner.
Multiple failures of communication compromised this patient's safety.

To optimize your medical care, establish with a primary care doctor if you have not already done so. If you think that you have a good primary care doctor who is responsive and conscientious then stay with them when possible. A long-term relationship goes a long way to establish your doctor as your advocate. Keep your doctor informed if you seek medical care outside of his or her office. The medical system is a confusing one, and it becomes even more complex when you enter it during a crisis. Ideally a doctor who knows you will be in your corner and will help guide you through the maze by communicating and coordinating your needs with all who may be involved in your care.

reference: case from Norcal.

Thanksgiving Notes

Happy Thanksgiving.

Happy Halloween.

Please don't over do it on the candy.

Image courtesy of: healthline.

Google's Top 50 Blogs

It's nice to see that health does count in the tech world.

Love

Love and compassion, "loving-kindness" and not just romantic love, have been shown to have many benefits on both physiological and psychological levels. It can reduce chronic pain, decrease stress and anger, improve the immune system, and help us face life's many challenges.

The Science in Common Sense

There is value to any good experiment, but did we really need proof for these conclusions? Here are a few of the most self-evident studies listed in the May issue of Popular Science.

• Combining Drugs and Alcohol is Bad for You.“Differential effects of cocaine and cocaine + alcohol on neurocognitive performance,” Neurology, June 2000.

• Smoking Cigarettes Costs You Money.“The wealth effects of smoking,” Tobacco Control, Dec. 2004.

• Gun-toting Drivers are More Prone to Road Rage.“Is an armed society a polite society? Guns and road rage,” Accident Analysis and Prevention, Jan. 2006.
  

• Too Many Meetings Make You Grumpy.“The relationship between meeting load and . . . well-being of employees,” Group Dynamics, March 2005.

For more "no brainers" see the article.

Happy Holidays.

I wish everyone happy and healthy holidays.

Night of the Crazy Teen

Who needs to go on a roller coaster ride when they live with a teenager. Usually when I write my blogs, I think about what may help my readers. However, I admit that I'm writing this one so that I don't spontaneously combust after having another head to head encounter with my teenager.

I know I'm not the only one at this moment and time in this universe who is inches away from taking an argument into a tailspin of no return so I'm taking a breather to review what my intellect should know, but what my emotions won't allow me to do.

Here are some helpful reminders from the very sensible Public Health Agency of Canada.

• --It is important for parents to see the instability in the teen's behavior as part of the teen's development in separating from his or her parents. In other words, it's normal.

• --The last thing an out-of-control teen needs is an out-of-control parent. Parents should ask themselves "How do I behave when I'm angry at my teen? Would I want my teen to imitate me?"

• --Teens are out of balance at the same time as their parents are struggling with their own mid-life pressures, not to mention the holiday stresses.

• --We need to help our teens control their anger and express it safely especially their anger at parents. Remember that feelings like helplessness, hurt, frustration, confusion and guilt are often expressed as anger. Does the teen have a safe way of expressing his anger safely? He can stomp off to his room, pound the pillow, but not yell or hit

• --Remember to listen to the teen twice as long as you talk.

There are more tips to read but this gives us the idea. There are some suggested readings : Fleming, Don. How to Stop the Battle with Your Teenager. Toronto: Prentice-Hall Press, 1989, and Patterson, Gerald and Marion Forgatch. Parents and Adolescents Living Together: Part I. Eugene, OR. Castalia Publishing Co, 1987.

These may seem outdated at first glance but clearly the tortured teenage dilemma is time-less.

Photo: courtesy of add-um-g. Please note these teenagers are innocent bystanders to my post.

Thanksgiving Note

~ Maquinna, Nootka Chief, early nineteenth century ~
"Once I was in Victoria, and I saw a very large house. They told me it was a bank, and that the white men place their money there to be taken care of, and that by and by they got it back, with interest. We are Indians, and we have no such bank; but when we have plenty of money or blankets, we give them away to other chiefs and people, and by and by they return them, with interest, and our hearts feel good. Our way of giving is our bank. "

I was reminded by this quote that giving may have physical as well as metaphysical benefits. A study at John Hopkins University, for example, showed that older adults who volunteered in troubled urban schools demonstrated an improvement in their own mental and physical health. So how can it not be win-win for everyone to be thankful and to be giving.

Happy Thanksgiving Day.

References: please see specific links.
Photo courtesy of: greatdreams.

What Could Be Scarier? Happy Halloween!

With all due respect to the sane, insane, and semi-sane as well as to all the spectrums of the red and the blue states.

Photo: courtesy of politicalhumor.

A Step Back

Iran bans fast internet.

This came up in a Google discussion today. If I may paraphrase a Googler, it reminded us that "those of us who are fortunate enough to have easy access to information tend to take it for granted and forget just how important access to knowledge is for those people who don't have it".

The empires of the future are the empires of the mind.
Sir Winston Churchill, Speech at Harvard University, September 6, 1943

The Meaning of Life

The true meaning of life is to plant trees, under whose shade you do not expect to sit.-- Nelson Henderson.
All the gardening that I did today must have made me feel philosophical. Ultimately, why do I take care of patients, family, and my garden?

Back to hard data in the next blog.

Photo: courtesy of Fatima's Photos.

Thank You

Dear Bloggers,

I would like to thank all of you for your very kind comments and thoughts.
I have been truly moved by the many positive feedbacks, but unfortunatley due to time constraints I have not been able to reply to every one as I would like to be able to do. I hope that this note will express my gratitude and appreciation to every one.

I look forward to many more blogs and exchanges with you.

Photo: courtesy of Fatima's Photos.

وبلاگ‌نویس‌های عزیز
می‌خواهم از همه شما به خاطر کامنت‌ها و اظهارنظرهای محبت‌آمیزتان تشکر کنم. واقعا تحت‌تأثیر واکنش‌های مثبت شما قرار گرفته‌ام. ولی متأسفانه به خاطر محدویت‌های زمانی نمی‌توانم به همه جواب دهم ، دوست داشتم که قادر به انجام دادن این کار بودم. امیدوارم که این یادداشت مراتب قدرشناسی و سپاسگزاری‌ام را به همه ابراز کند.
منتظر دیدن وبلاگ‌نویس‌های بیشتر و تبادل نظر با شما هستم.
منبع عکس : Fatima's Photos

Giant Girl Doll

Let's do a video Rorschach test. How does she make you feel? Sad, scared, stressed, entrapped, freaked out? Well it's not exactly a Rorschach since it's not an inkblot, but your perception of this image or others may be a projection of your internal state. It's good to take a moment to take inventory of those feelings and to address them appropriately.

If you can't start the video try this link: http://video.google.com/videoplay?docid=-1522158746296131750&q=giant+girl+doll