family practice issues and general life events

Posts tagged ‘health’

I am not going to wear pink for breast cancer awareness

Being that this is breast cancer awareness month, this is probably enough of a statement to get me hung out to dry, but I am going to make it.  Because I am not going to go pink.  I am not going to post it on my Facebook status, and I am not going to like a page to have Dr Pepper, Coca Cola or any other industry to turn their product pink.  Why?  Because that doesn’t matter.  Why have a company spend money to turn their product pink for breast cancer awareness, I am pretty sure we are aware of breast cancer.  Why not ask them to spend the money that you are asking them to spend to turn pink (or purple or yellow or whatever other awareness campaign) to donate for research.  Because in reality that is what is going to help eradicate cancer.  Actual cash donations, not merely buying a plastic bracelet that says “BOOBIES” for $3.  (Most of those I have seen on teenage boys who like the idea that they can wear something that says “BOOBIES” at school and get away with it)

What I am going to do instead, is check and make sure you have had a mammogram in the past year if you are over 40 and under 70, and a baseline at 35.  I am going to do your breast exam with your pap, if you don’t have your gynecologist do it.  I am going to ask you about risk factors for breast cancer, colon cancer, ovarian cancer, and almost every other type of cancer you can imagine, and try to make sure that you have had a screening colonoscopy at 50 or before if warranted.  I am going to talk to you about obesity, diabetes, smoking and hepatitis.  And I will recommend that you get the appropriate vaccines.  And I am going to look for all cancers not just breast cancer.

And me personally, I am going to write a check.  Probably not to Susan Komen, and this has nothing to do with the uproar earlier in the year.  It has to do with where there money goes, and less that 15% has gone to research over the last 10 years.  I see nothing wrong with their “Race for the Cure” events, many of them have helped provide fellowship for survivors and their families.  Though they were cut throat in promoting these events, even shutting down, walks for heart disease.

No I am going to give my money to organizations such as American Cancer Society and St Jude’s hospital.  I am going to donate to American Red Cross, and American Heart.  There might be others, but I am going to give to organizations that do more for research or in the case of American Red Cross and American Heart Association provide not only research but much needed community assistance and support.  Because heart disease is still the number one killer in this country.

I will give money to the March of Dimes, and I may even do a Run for Breast Cancer.  I am not opposed to any of those, but I just don’t see the point in a football player wearing pink shoes.  If he is doing it for a family member fine, but there is just not a lot of money that goes to research or even community assistance in the wearing of pink shoes.  It makes you feel good, and while that is important, I would rather focus my money on things that actually do good.

Breast cancer awareness is important, but I would suggest that it is time to take the next step.  We are all aware of breast cancer.  If you really want to do something for breast cancer send a check to a worthwhile organization.  Make sure that you do your monthly exams, yearly mammograms and make sure that your loved ones do the same.  But thinking that by clicking like on a Facebook status to turn Dr Pepper pink for the month you are making a difference, well you aren’t.

Do something that will make a difference, whether it is breast cancer or some other worthwhile cause.  Because cancer has never been cured by just wearing pink.  (Or whatever other designated color for that particular cancer)


Attitude is everything

Or my self serving whiny post, which does nothing, teaches nothing, and is merely in existence for no other reason than it makes me feel better.

Sometimes I have days like today. Where when I walk into the room, and ask the patient how they are doing, and today is the worst day of their life. If it is one or two, well that is well not ok, but feasible, because at some point you will have the worst day of your life. This morning however, it seemed like it was everyone’s worst day ever. It improved somewhat this afternoon, in that only half of the patients were having their worst day ever, the rest just have multitudes of complaints

In reality, dealing with a couple patients who view everyday as the worse day ever is tiring, a whole morning is exhausting and mind numbing. It is enough to wish for a fully stocked bar in the office. (I said wish, I rarely drink, so much more that a glass or two of wine would make for a bad idea, especially in the middle of the morning, er I mean the afternoon.

Anyway, it is in those patients you realize how important one’s attitude is to their health. Patients who believe that everyday is terrible never seem to be getting better, and while it might be my doctoring skills, I have patients that seem to improve. So that gives me some hope for my skills. I have patients who have their diabetes under control, their blood pressure looks good, and sometimes walk in and say “I am all better.”

And then there is the others. The ones that despite running ALL the possible tests, you still cannot find a reason for their worst day ever, which by the way is worse than their previous visit that was also the worst day ever. They have pain that is a 12 on a 10 point scale where 10 is being caught on fire currently. And then the mention a random surgery were half of the bowels were removed 15 years ago, that they forgot to mention previously. (Not really, pretty sure I would have seen that scar) But there are unmentioned surgeries, medications, and dietary factors that they neglect to mention. Or other doctors that are prescribing medication. (Sometimes the same medication and sometimes one causing side effects that you are treating.)

And then when you do the workup for a condition, you find out that even though their symptoms scream gallstones, they had that removed 5 years ago, and well they didn’t think it was important to mention. I mean after all they no longer have that organ so how can it be the problem? Though I have been told that they didn’t mention it, because they thought that it might have grown back.

Back to the attitude mentioned in the title. Those with an overall positive outlook in life really do seem to heal better, they are healthier. They try, they are not hoping for a magic pill to cure all. And some of them have significant medical diseases. They have the belief that things can get better, that there is something in life worth living for. And they are living life. This does not mean that they don’t have pain. They may, they might not, but they are trying to experience and live. There is some purpose to their lives.

It is not that they don’t have pain in their lives, some have significant tragedies. Death of spouse, child, fighting disease, but they are looking for a greater meaning. They accept that bad things happen, and maybe just maybe these events help you to appreciate the good times. The understand the need to experience everything that life has to offer. And just by seeing them, you feel better. They make your world better just by them being in it.

Attitude is not the end all, cure all. But it is a necessary component to improve one’s life. It helps with healing, it helps to give strength and motivation. It is what makes one successful in life.

Soda intake and health

Throughout my day, I spend a lot of time trying to counsel patients on how to lose weight, eat healthier, decrease their blood sugars.  And it has not ceased to surprise me the amount of people that don’t seem to realize the problems with drinking large amount of sodas.  We will focus on the non-diet variety to start with.

Empty calories, no benefit

Sodas are terrible for diets because of the amount of calories that have no nutritional value.  Now Coca Cola likes to advertise that they contain 100 calories per serving.  I guess that helps to go with the fad of the 100 calorie packs, but are you aware of what a serving size is?  It is not the 12 ounce can nor the 20 ounce bottle.  It is 8 ounces.  How many of you stop at 8 ounces when you drink a can.  I know I don’t, and I admit I am a coca cola addict.  (well actually cherry coke or cherry Dr. Pepper) But I have had to force myself to cut down, and most days to remove it completely out of my diet.  And most of the sodas are similar in calories.  There is some differences in the amount of sugar and caffeine neither of which in high amounts are great for the diet.

And people who drink high amounts of sodas tend to have increased risks of urinary tract infections and fibrocystic breast disease.  The greater amount of caffeine increases the risk for both.

For those of you who are drinking a 2-liter (or more) a day, well since you don’t want to have a massive caffeine withdrawal for about 5 days (Been there done it, got the t-shirt) I would recommend cutting down. by 8 – 16 ounces every three days.  But seriously consider cutting down.

Diet Sodas

With the studies that have come out over the last several years it is important to know that there are significant health issues that have contradicted previous theories on diet sodas.  Initially I used to advise patients to change from regular soda to diet to help with their weight loss.  We told diabetics that diet sodas were ok.  They aren’t.

About 3 or 4 years ago, studies first came out showing that there was not a significant difference in weight gain between drinking diet and regular sodas over the long term.  There is a belief that it is something in the soda itself that triggers the appetite.  In fact, diet soda might even be worse with the artificial sweetener increasing the desire for a sugary snack.

For years, there have been reports from individuals that diet sodas and aspartame with headaches, abdominal pain and cancer in rats.  The last is probably the least worth discussing.  For one thing the amounts introduced in rats is more in quantity than a human would intake in actually amount, increase it to the size of a human body would be a ridiculous amount.

As for the headaches, it can trigger migraines, whether it is the aspartame or the caffeine well in those cases it is best to avoid all together.

The most damning of all came out in the journal Circulation about 2 weeks ago, linking diet sodas to increased risk of heart attack.  This was done in a study of 42,000 men over a period of 22 years.  One serving a day increases the risk for a heart attack 19%.  19% this is incredible.  People get upset about a 0.1% risk in vaccines for side effects, or a 1% increase risk in breast cancer.  This increase risk is that out of 5 people that drink diet sodas, 1 person will suffer a heart attack.  And this was after controlling for factors that include smoking, age, exercise and family history.  Twenty percent.

A similar study came out 2 years ago which illustrated the same changes and risks in woman.  These drinks both sodas and diet sodas have adverse risks on HDL (good cholesterol), triglycerides, and c reactive protein (which is a marker for inflammation in the body)  Elevated C reactive protein is found in disease states such as cancer and heart disease.

As a side note, I would also like to mention fruit juice, while one cup a day can provide some nutrients and vitamins, making them slightly better than sodas, they are packed with sugar.  And giving your child more that 8-16 ounces in a day is not any better than the coca cola in a bottle.

I would also like to discuss that sports drinks are not necessary for anyone who is not actively competing at the time of intake.  If you have just run a marathon, it is an ok way to help replace vital nutrients lost through sweat.  However, sports drinks are not healthy.  They are packed full of sugar and carbohydrates and if you are trying to eat healthy and lose weight or maintain, routine intake of these drinks will not help you.  They will actually increase calories because many who are drinking them are viewing them as a health drink and therefore free.  But they are not.  Gatorade has 50 calories and 14 grams of sugar for an 8 ounce serving.  G2 is better with 20-30 calories and about half the carbs.

The brand names selected are examples of their group.  I am not saying that pepsi is better, it is not.  And none of the other sports drinks are better than gatorade for the calorie and nutritional information.

Let’s be honest, any excessive amount of calorie intake will cause you to gain weight.  So limiting these drinks are better, and just cutting intake in half will often help.  But these are sneaky calories, they tend to be overlooked during the day, because they are liquid.  Fruits are better than their juice counterparts.  The initial fruit is healthier and allow for fiber without sugar added.  So for health reasons alone, try to limit if not eliminate them from the diet all together.

The Power of Positive Thinking

I know it is cliche, but there really is something to thinking positively.  That point hit me in the face yesterday- though in reality I notice it most days.  People who dwell on the bad, tend to appear to have more chronic problems, while those that say life is good, seem to be healthier.  Or at least they seem to deal with even chronic illness better.  That is not to say that everyone is not entitled to having bad days, but if every day is “the worst day of your life”  well people are not going to want to be around you.  And that will include those that have to, family, physicians, etc.


I have patients, that literally spend their entire visits complaining about every aspect of their lives.  That is fine, it is my job to at least listen.  But those visits are exhausting, and if it is an every visit event, after a while, I will start to dread their visits.  Sorry but I am human.  This is not just someone who complains about their aches and pains, but their sons and daughters, who have moved away, and everything in life is against them.  That is how they view the world.  That it is against them, and that they don’t have this or that.  They focus on the don’t haves.  How exhausting it must be to go through life focusing on what you don’t have.


The other side at least attempts to find some good.  It may not always be easy- trust me once you tell a patient about their cancer, nothing else that visit matters.  But usually if they are a generally positive person they will undergo treatment a little easier.


Looking through the internet, trying to find out what is wrong with you, while their may be some legitimate cause to do so, focusing on diagnosis that you may or may not have, not only hurts your emotional well being, but it also will eventually hurt you physically.  Not to sound like a pharmaceutical commercial but depression does hurt.  Usually leads people to the doctor for pain, not depression.  Rarely does anyone come in and say “I’m depressed.”  Sometimes a spouse will drag them in saying that they are depressed, but usually the presenting complaint is “I’m tired.” “I hurt” “I have no interest in anything, anymore.”  It is true that pain can lead to depression, but it is also true that depression can lead to pain.


Life needs to be something to savior, to experience, not something to dread.  If you aren’t happy where you are in life, figure out what you should do to fix it.  No one will do it for you.  While I hesitate to tell anyone to leave their job today, remember that if you are looking for a new path in life, it is you who must sell yourself.  Anyone hiring for jobs that require customer service, don’t want to hire the negative person with all the qualifications.  Though if you do hate your job, find something outside of it that is your calling that gives you joy.  There is not a pill for happiness, it has to come from within.  Find out what it takes to be the best you that you can be.  It doesn’t have to take much, baby steps will go a long way.  And see if with time you start feeling better, start having better health.  While it will not take care of everything, having a positive outlook will go a long way towards better health and prosperity.

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