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The other day I was in the elevator at a major Boston hospital heading to the 16th floor.  The elevator was full of people; visitors carryi...

Tuesday, October 26, 2010

Don't believe the hype.




Every day, I receive an email from various health and beauty web sites I have signed up for that talk about health, diet, fitness and general grooming, such as skin care. And every day I read about the newest, the latest, the greatest. And you know what? It is all just hype.

There really is not too much that is so new as to be earth shattering. They have simply taken the old ways of doing things and repackaged them to make them look new.

Like skin care for example. There are hundreds of skin care lines. Walk through any Sephora and you will find a special cream or lotion for just about any body part. They have special creams for kids and men as well.

And guess what? You don't need any of it. Not really. All you really need to do is to cleanse your face at night, moisturize to prevent it from looking like old, dried out leather and occasionally you need to exfoliate.

And that is it.

The trick, and there is a trick, is to do it routinely, every single day and night. And that is where so many fail.

It is not necessarily the product that is helping you. It simply that you are taking better care of your skin.

And you don't need to spend a fortune to do it. Personally, I use a cleanser from Walgreens that dermatologists love. It is called CeraVe and it is an inexpensive, awesome cleaner. You don't need a fancy, expensive cleanser. You just need to clean your face.

I have an elderly patient who has great skin who uses Dove soap. And Vaseline. For about the past 60 years. And very few wrinkles at all. (she recently signed off of hospice---she got better and she's 88)

Now, that said, I must confess I use an expensive face cream. It is called SK-II. It is remarkable, in my opinion. But I use it as a day and a night cream. And I use it under my eyes as well. Along with using a vitamin E stick that I purchase for about three dollars. And I exfoliate with a scrub from Target 3 or 4 times a week, from Boots. That is it. And my skin looks pretty good for being 50. Not perfect, but okay. But I never go to bed without washing and moisturizing. I do it religiously.

And that is the trick. Doing it consistently.

Consistency is the name of the game.

Now, if I could only apply that same logic to exercise....but I digress.

The next big hype is diet. I read every single day about a new food that will cure whatever, a new supplement that we all should be taking or a new diet book that promises you can eat all you want and still have a flat stomach.

But they are selling nothing new. Blueberries have always been good for us. As a matter of fact, eating fruit has always been a great idea. And veggies, too. Do I really need to spend time reading about this? No. I know what to do. And so do you. There are no secrets out there to learn.

Eat real food in smaller portions. Don't eat food your grandmother would not recognize. Don't eat food that has a list of ingredients you cannot pronounce. Eat whole foods.

And if you want to drop weight, eat less and walk more.

(That will be $29.99. Thank you.)

But they are still selling these books and exercise videos and special eye creams and neck creams and, well, I could go on and on.

And we are all still buying them.

Go figure.

Anyway, I am not buying into the hype anymore. If you want to lose weight, you have to eat less. If you want to stay healthy, you should walk more and not smoke or drink to excess. You shouldn't drink 7 Diet Coke's every day, drink water. You should get out in the sun to get vitamin D. But just not too long unless you put on sunscreen. You should learn to relax more, have fun friends to hang with, get a good night's sleep and worry less. A baby aspirin a day is a proven winner. So is a regular multivitamin. And a glass, one, of red wine cannot hurt. Cutting back on sugary foods is also important. Excess sugar and sodium causes our body to have an inflammatory response. And inflammation causes problems like cardiac disease and cancers. That is a proven, scientific fact.

Anyway, I am not saying that any of this is easy. I struggle with it too. But we all know the things we need to do.

The hard part is doing them.

And not buying into all the hype.

Life expectancy would grow by leaps and bounds if green vegetables smelled as good as bacon. ~Doug Larson

A good laugh and a long sleep are the best cures in the doctor's book. ~Irish Proverb

To avoid sickness eat less; to prolong life worry less. ~Chu Hui Weng

Those obsessed with health are not healthy; the first requisite of good health is a certain calculated carelessness about oneself. ~Sydney J. Harris

Saturday, October 23, 2010

Didn't he see the warning signs?



I am often asked about how people die. Not specifically how their actual death occurred, but what lead up to it. What the warning signs were. And why they were missed.

Most people ask me this because they want to make sure that they do not have the same issues.

For example, if a young patient has melanoma, people will ask me, did they sit in the sun a lot, did they have a lot of moles, did they have a family history, did they wear sunscreen?

Or a stroke victim. Did they have high blood pressure, was there a congenital anomaly, did they suffer from headaches?

Most of us do this. It is how we justify death. When someone who ate and drank everything they wanted to dies, we often shake our heads and think, well, they just didn't take good care of themselves. That won't happen to me.

But I see a lot of people who die and they seemingly did everything right. Exercised, went to the MD yearly for a check-up, ate healthy food, had parents who lived to be 90, put on sunscreen, kept their weight normal.

But they developed cancer or heart disease and they died. Usually way too young. And it is these types of deaths that give us a chill. Especially as we enter middle age.

So, what can we do? Are there warning signs that they missed?

My answer to that would be a yes. They did. And we all do as well.

So, what warning signs can we look for. What can we do to protect ourselves?

We can start by paying attention to the warning signals in our car and remember to always wear a seatbelt. Many healthy people die this way, in stupid accidents. We don't often think about it, but most motor vehicle deaths are totally preventable. We drive after a couple glasses of wine. We don't always pay attention and become distracted by cellphones and kids. We text. We don't always wear a seatbelt. And we place ourselves in peril. Sometimes daily.

Stop it. Be more aware of the risks here.

We also need to understand that our body talks to us. It is quite wise. It tells us when we need to slow down, take a rest, get more sleep. But we hardly ever really listen to it until we are ill. We just stop at Starbucks for another jolt of caffeine to get us through the day. But we need to rest. We need to sleep. These are preventative measures we should all be taking. But don't.

And pain. We often dismiss it. But it tells a story as well. Don't ignore it.

There are other things that happen to our bodies as we age and they are silent. High blood pressure being one of them. We need to have it checked and keep it around or below 120/80. High blood pressure leads to a myriad of problems if left unchecked.

And our weight. I am not saying we all need to be thin. On the contrary, there are many studies that suggest a little bit of fat can be protective. But we still have to keep it in check. We need to stay away from excess sodium and sugar. We need to walk more. Drink more water.

Many cancers are not related to any one cause. We would like to think they are, but they are seemingly random. And that is simply the truth.

Our bodies have to be equipped to fight aberrant cells. The best way to do that is to listen to our body and take good care of it. From the inside out.

That means we should take a vitamin pill, take an aspirin every day to alleviate inflammation in our body (which is deadly), not feed it too much junk and processed foods, not overwhelm it with too many chemicals and pharmaceuticals. We need to balance things better. Mom was right; everything in moderation.

You have to watch out for the warning signs yourself. Your MD may say that things look great, but only you know yourself. Only you can really judge.

I don't know everything for sure, but I do know one thing; we will all die. I see it all of the time. But we can prevent an early, premature, needless death if we take certain precautions. We can.

So, start to tune into your own warning system. It may in fact save your life.


First we make our habits, then our habits make us.
~~~Charles C. Noble


Nobody ever did, or ever will, escape the consequences of his choices.
~~~Alfred A. Montapert


The name of the game is taking care of yourself, because you're going to
live long enough to wish you had.
~~~Grace Mirabella

Sunday, October 17, 2010

Medical professionals who are anything but.




We have all met them. Or worked with them. Or have heard stories about them. Bad medical professionals. Be it nurses, MDs, dentists, physical therapists. You name it. They are out there. Everywhere.

And just because someone has MD after their name, or RN, it simply does not make them a compassionate, caring person. No. Not by a long shot.

Nor does it mean they are necessarily competent. No matter how impressive their credentials are.

I could tell you stories, scary stories that would make you sad. And afraid. But I won't.

I would have to say that most medical professionals are good people. They know their limits and ask for help when necessary. But there are a few out there with an ego as big as Sputnik, and those are the ones that give all the rest of us a black eye.

Nurses know what I am talking about. The arrogant resident, for example, who thinks he knows it all. But he is merely book smart with a fancy degree from a Ivy league school who could not cut his own toenails well, let alone know what to do for a patient in crisis. But he refuses to listen to an RN because, well, we are just beneath him. We could not possibly know anything. And he is dangerous. 007's we call them. Licensed to kill.

Or the RN who gets the best accolades from management because she never calls in sick and works extra shifts and always charts perfectly. Unfortunately, she is awful with any practical patient care and actually puts patients in harm's way. But you cannot say anything, no one is listening. So you just clean up after her as much as you can and hope for the best.

It is maddening. It is what stresses out nurses and MDs and others more than anything else. I always say that it is not the job I hate at times, just the people I am forced to work with that make the job hard.

That is not to say I think myself perfect or that I have never made a mistake. I have. But I try to learn from any mistake I make. I also ask for help when needed. And I always, always, put the patent's needs first.

And that is what you should look for when you are looking at care providers. Putting your needs first. Treating you as a person. Not a diagnosis, not a 4:00pm appointment, not a simple home visit.

They should greet you warmly and look at you. In the eyes. They should listen to you without interrupting or putting words into your mouth. They should explain things thoroughly and not look at their watch every time you ask another question. That is simply rude.

Most people know when something seems not quite right. They realize their concerns are simply being dismissed. They may have a gut feeling that someone is doing something wrong. But most are too intimidated to say anything.

But I will tell you this; be the squeaky wheel. Complain. Put complaints in writing. And repeat as necessary.

The one thing that I can say for sure after being a nurse for 30 years is this; medical professionals do not police their own. We see it all. We know who is bad. We have all witnessed things that we have found to be quite incredulous. But many of us have not said a word. Or we have said something, only to be shot down. They kill the messenger. See if we do that again. It is frustrating, but true.

So, beware. Don't assume that because you are going to a well respected institution for care that everyone there is top drawer. They aren't. Ask around. Get referrals from friends or people with the same medical issues. Go online and search.

I know people who ask for more information about a veterinarian for their dog or a hairdresser for their hair. And I have seen people change their hairdresser after a bad cut, but not too many who will change their MD after a bad diagnosis. It is crazy. It really is.

There are many good, hardworking, excellent medical people out there. Start with the MD and the hospital of course. You cannot always choose your nurse, but you can unchoose her by stating your concerns. Trust your gut. Follow your own thinking.

It could save your life.


All men make mistakes, but only wise men learn from their mistakes.
~~~Winston Churchill

Guard against the prestige of great names; see that your judgments are your own; and do not shrink from disagreement; no trusting without testing.
~~~John Emerich Edward Dalberg Acton

You gotta know when to hold 'em, know when to fold 'em, know when to walk away, know when to run
~~~Kenny Rogers

Monday, October 11, 2010

Deciding to be happy.



I was driving to a patient's home the other day and was behind a car with a bumper sticker that said, "Life sucks, be happy anyway." Truer words have never been spoken, or written.

Life indeed can and does suck. You do not have to be a hospice nurse to understand that. I see a lot of misery. I see a lot pf pain. But I also see something else; happiness despite all of it.

Anti-depressants are the number one prescribed medication in the world. I am sure that self-medicating with alcohol or street drugs trump those numbers 2:1. And why shouldn't people be unhappy. After all, life is hard. People disappoint us, money is tight, people get sick, the news is always bad, work is awful, things never seem to live up to the hype. Some days it seems that we need to just stay in bed with the covers over our heads and hide from the world.

But no one said life would be easy. No one said that we have a right to happiness. So, we should just grab happiness anywhere we find it. We can and must choose to be happy.

I was at the home of an 8 year old patient the other day. It is a sad scene. Here is a beautiful 8 year old with an inoperable brain tumor that will kill her in a few short months. It came on suddenly, and will kill her suddenly. She is still attending school. She has all of her hair. She does not look sick at all.

I look at her young mom. She is devastated. So is the dad. But in that house also lives a 12 year old sister. One with a full life ahead of her. So, do they succumb to doom and gloom? No. They grab any moment of happiness and go with it despite the pain they are feeling.

They choose to be happy.

Happiness is not something that we can feel all the time. But when we feel it, we should immerse ourselves in it. Really feel it. Ask yourself, when was the last time you felt pure happiness?

Many of us do not allow ourselves to be happy. Many wallow in misery and look for others to share their misery with. They are the Debbie and Donald Downers, and they are everywhere. They are hard to avoid. And they usually find a reason to be unhappy about any circumstance. I try to avoid them whenever possible.

Abraham Lincoln once famously said, "Most folks are about as happy as they make up their minds to be." And he was surely right about that. But he also said something better, that is not often quoted. He said, "I want it said of me by those who knew me best, that I always plucked a thistle and planted a flower where I thought a flower would grow."

So, look at happy thoughts as a way of planting a few flowers in a yard full of weeds. Sometimes that is the best we can do. Life will always be hard. Bad things do indeed happen. Misery abounds.

But happiness is there, too. We just have to look for it and embrace it when ever we can.


My advice to you is not to inquire why or whither, but just enjoy your ice cream while it's on your plate. ~Thornton Wilder

The best vitamin to be a happy person is B1. ~Author Unknown

Jumping for joy is good exercise. ~Author Unknown

Happiness always looks small while you hold it in your hands, but let it go, and you learn at once how big and precious it is. ~Maxim Gorky

Let us be grateful to people who make us happy, they are the charming gardeners who make our souls blossom. ~Marcel Proust