The Joy of a Foodie Child
I do not have a foodie child. Not one living at home, at least. (Though I’m not sure if promising to try one new food a week but being an accomplished cookie maven qualifies as a true foodie. Sorry, DinoDaughter.) However I found myself jealous of a patient the other day on account of hers.
There’s a game in my family. We call it the “What do you want for dinner?” game. The object of the game is to be the first to ask the other, “What do you want for dinner?”, thus forcing the other person to make the decision. (This doesn’t always work. DDS’ answer is often, “I don...
Source: Musings of a Dinosaur - January 18, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Food Source Type: blogs
Here We Go Again: Flu and Flu Shots
<Sigh>
Patient-linked article on Facebook about the tragic case of a 26-year-old woman in Wisconsin who died of sepsis from pneumonia as a complication of the flu, despite having received a flu shot. Somehow this now becomes a reason not to get flu shots. Say what?
Maybe she ate tomatoes. Did you know that everyone born before 1890 who ate tomatoes is now DEAD? Tomatoes are deadly! Don’t eat tomatoes.
Actually, the first thought that popped into my head was to wonder if she was pregnant. It’s known that pregnancy greatly increases the risk of serious complications from the flu.
The real take-home lesson f...
Source: Musings of a Dinosaur - January 18, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Senior Immunization Update
First patient this morning began with a question:
What’s this new coxie vaccine something-or-other I’ve been hearing about? Can you explain that to me?
Cox? Oh, you must mean Pneumococcus. Yes, I can explain that:
There’s a very common germ that lives on our skin and in our noses, and usually doesn’t cause us any trouble. It’s full name is streptococcus pneumoniae, but we usually call it by its nickname: Pneumococcus. It originally got the name because it’s a fairly frequent cause of pneumonia (lung infection), though it also causes other kinds of infections, like skin, bloodstream, an...
Source: Musings of a Dinosaur - January 15, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Luck
Dumb luck.
Turns out most cancers are probably the result of random mutations. Bad luck; nothing more. Sure, things like smoking don’t help, but, if we’re being honest, isn’t it always among the first questions we ask when we hear someone has cancer? Talk about adding insult to injury to blame the victims of plain dumb luck.
Blind luck.
When you stop to think about it, just about everything of any importance in life comes down to luck. Born American; born white; born affluent. #WhitePrivilege is real. The lasting advantages in life from a first-rate education, paid in full? Largely luck. How much credit ...
Source: Musings of a Dinosaur - January 14, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Pizzelle Fail?
They weren’t brown enough, or thin enough, or crisp enough. But the anise oil (not extract) gave them a flavor that was magnificent, and aside from the color, they were pretty enough. But they weren’t all consumed at the party last night, so what was I to do with 16 leftover too-light, too-thick, too-soft pizzelles?
Pair them up, slather on a thick layer of Nutella™, refrigerate for a while, then cut into quarters.
Yum. (Source: Musings of a Dinosaur)
Source: Musings of a Dinosaur - January 11, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Food Source Type: blogs
Too Many Notes*
Doc, can you write me a note?
All depends; what for?
1. I forgot to get a note for work (or school) when I was in to see you yesterday.
No problem.
2. I’ve been out sick for three days. Just a cold, nothing you can really help me with, but my work (school) insists on a doctor’s note.
Sure, I can do that. Some employers can be really anal about doctors’ notes.
3. Can you write me a note to go back to work after an injury that was treated by another doctor?
No, sorry. You have to go back to the other physician (ortho, workman’s comp doc) for that.
4. I’m looking for another job and I have an in...
Source: Musings of a Dinosaur - January 10, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
How to Kill a Doctor
It’s really quite easy to kill a doctor. Here’s a step-by-step process guaranteed to succeed at least 400 times a year:
Start early.
Be sure to denigrate medical students whenever possible. Even if they’ve come to the profession later in life and have accomplished all kinds of amazing things personally and professionally (which don’t count, of course, since those are other professions) they don’t know squat about medicine and you do. Make sure to emphasize their ignorance and inexperience at every turn, because it’s the only way to prove that you know more than they do, which of course...
Source: Musings of a Dinosaur - January 8, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Patients Showing Appreciation
Everyone knows doctors are only in it for the money. Not.
The most rewarding thing about the practice of medicine is making a difference in the lives of our patients. Whether it’s saving a life with surgery in the middle of the night, handing over a newly-delivered baby, or just reassurance that it’s only a cold and not bronchitis and everything will be all right; those are the moments we all treasure.
Patients have many ways of showing their gratitude, almost all of which are warmly appreciated. From flowers in the dead of winter:
to homemade holiday cookies (even store-bought), or just the sincere “Tha...
Source: Musings of a Dinosaur - January 7, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Relative Value
How much would you pay a valet to park your car?
Certainly a job consisting of getting into a car not your own, safely navigating it from point A and parking it at point B, then reversing the procedure at your request is a service that deserves compensation. The question is how much?
Does it depend on the car? Or the skill of valet?
I would say, talking to various people, that the appropriate amount lies somewhere between five and twenty dollars, depending on the specific locale.
Now consider how much you would pay someone to draw your blood, a job that consists of the following steps:
Wrapping a tourniquet around your ar...
Source: Musings of a Dinosaur - January 6, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Mammograms for 40-Somethings
My New Years *Resolutions* are going well…five days in. The cat box is immaculate, I’m more than halfway through The Lost Gate, I’m on track to post here every single day for at least a week, and I just finished the paper today.
Speaking of today’s paper: What should I espy in the Health section of my Philadelphia Inquirer but a familiar name! My good friend Margaret Polaneczky (I get to call her Peggy), my old blog-buddy from those heady early days of medblogging quoted in an article about helping women in their 40s make informed decisions about mammograms. And here it is: Breast Screening Decision...
Source: Musings of a Dinosaur - January 5, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Beyond First World Problems
First world problems: Problems complained of by those living in a wealthy, industrialized nation that third worlders would probably roll their eyes at. Things like which car to take when going out to dinner, or where to go out to dinner, or what to order when going out to dinner.
The other day I was chatting with a gent who was fretting about getting his tax information together for his accountant. He was bragging complaining that a stock with a large capital gain was forcing him to forage around for capital losses to offset it.
That’s not just a First World Problem; that’s a “1% problem.” (Sour...
Source: Musings of a Dinosaur - January 4, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Funnies Source Type: blogs
Affordability vs. Value
I’ve been enjoying Twitter for a while now (@DinoDocLucy for any wannabe followers). It’s providing me with links to all kinds of fascinating things I never would have found otherwise. It’s also really cool how often I come across things that have nothing to do with medicine but everything to do with my practice.
“Six Mistakes Your Sales Reps are Making”
I thought the title looked interesting, so I clicked through. It turned out that the reps in question were calling on libraries, as the post was on a blog about scholarly publishing. Still, several points (sort of) applied to pharma and othe...
Source: Musings of a Dinosaur - January 3, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Diets and Denominators
News non-flash: comparison of various diets (low carb/Atkins, low carb + low fat/South Beach, low calorie/Weight Watchers, and whatever-the-hell-the-Zone-diet is/protein-carb ratio) shows no difference in long term outcomes, defined as sustained weight loss, with the attendant presumed decrease in cardiovascular risk factors and events.
Sorry; no great surprise here. But I think it’s because nutrition research has a huge blind spot: not adequately controlling for type 2 diabetes/metabolic syndrome.
Let me explain.
I have a hypothesis that people with the inborn error of metabolism (insulin resistance) that in the se...
Source: Musings of a Dinosaur - January 2, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
New Years “Resolutions”
Happy New Year to all. New month; new year; new calendar. Everything begging to be new and fresh, even while the days are still too short and the air too cold, with the worst of the winter yet to come. What cheer!
Lots of people talk about why New Years resolutions don’t work and they’re right. Hence the quotation marks.
Technically what follows aren’t Resolutions. They’re not goals, or vague aspirations like “get in shape”, “lose weight”, or “Be nicer to your sister.” (Hi, Dr. Kensingon!) They’re more like items I want to add to my daily to-to list. Thin...
Source: Musings of a Dinosaur - January 1, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Miscellaneous Source Type: blogs
What Doctors are Thinking
Ever wonder what your doctor is thinking while taking your history? If we’re doing it right, we’re looking at you instead of a computer. We’re making appropriate eye contact while displaying welcoming body language. And we’re letting you tell your story with as few interruptions as possible. Clearly we are listening intently, but did you ever wonder what’s going through our minds while you’re speaking?
I’ve been thinking about this lately in the context of teaching medical students about history-taking. They’re being taught all the right questions to ask and how to ask them (...
Source: Musings of a Dinosaur - December 31, 2014 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
