Eleven Steps: HOW TO FEEL BETTER MORE OF THE TIME AND REDUCE YOUR CHANCES OF A MAJOR ILLNESS

The Daily Apple™© Volume 2, Number 7

Friday, June 28, 2013

PGY #40  Day #363

Take The Best Care™© of Yourself

From Dr. Mike and Infinity Health Solutions

HOW TO FEEL BETTER MORE OF THE TIME AND REDUCE YOUR CHANCES OF A MAJOR ILLNESS 

From The Stress Management Workbook: An action plan for taking control of your life and health

Pages 156 and 157

The last blog post made reference to these pages, so here they are.  These 11 rules will help you get healthy and stay healthy.

Dr. Mike

HOW TO FEEL BETTER MORE OF THE

TIME AND REDUCE YOUR CHANCES

OF A MAJOR ILLNESS

The following list of rules gives you a general summary of what we

think is reasonable health behavior. Review them and keep the list

for future reference.

1.  Awareness of Behaviors You Can Change:

You have control over many factors that may significantly affect your health. Take advantage of the opportunity to learn how your own behavior

affects your health. Strive to change your behavior in such a way

as to promote your health. Learn to differentiate between those

things you can change and those you must accept.

2.  Preparation for Conditioning:

Establish a relationship with a physician whom you can trust. Make sure .you are able to communicatewith your personal physician. Visit your physician annually in order to continually assess your health status. Do not

start an exercise program without a health evaluation and advice

from your physician.

3.  Immunizations:

Be sure you are fully immunized. Diphtheria/tetanus

should be received at least every 10 years. Other immunizations

may be necessary under certain circumstances.

4.  Exposure:

Avoid physical, chemical, and biological hazards in the

environment. This is the essence of risk reduction. Some things

are obviously more hazardous than others depending on your age.

The major health hazards for the 30- to 40-year-old individual

are the automobile, alcohol, smoking, and weapons. There are

other significant factors such as drugs, air and water pollution,

and food additives that have adverse health effects, although they

may be difficult to quantify.

5. Diet:

Learn what you are eating and what you should not be

eating. Food additives, such as flavor enhancers, artificial flavors,

artificial colors, artificial sweeteners, and preservatives, as well

as hormones and antibiotics, are chemicals. Some are known to

be hazardous and others are suspect. These should be avoided. In

addition, excess sweets, starches, and fats should be avoided.

Your diet should contain fresh fruits and vegetables, lean meats,

fish, and low-fat dairy products. Excess salt can be a problem.

Obesity or overweight is a major health hazard.

6. Drugs:

Avoid the use of drugs unless absolutely necessary. All

drugs are potentially hazardous. Their benefit must be carefully

weighed against their danger. Discuss this with your physician.

7.  Exercise:

Develop a regular exercise program and go through

your daily activities in a way that promotes fitness. Exercise, if

done regularly and under supervision, reduces the risk of hypertension

and heart disease.

8.  Recreation and Relaxation:

These two are critical to your sense of well-being. They probably also prolong your life.

9.  Sleep:

When you are tired, go to sleep. Distractions such as television

that keep you awake during your period of greatest evening

fatigue are the single greatest cause of insomnia.

10. Goals and Expectations:

Examine your personal expectations and

the expectations which you have of others very carefully. Make

sure that they are reasonable. If unreasonable, they should be

changed. If you are unable to examine or change them on your

own, seek help.

11.  When and How To Seek Aid:

A serious, or persistent problem deserves prompt evaluation by your personal physician, or, if necessary, the physician who is on call.

The Daily Apple™©: Take The Best Care™© of Yourself

The Daily Apple™© Volume 2, Number 6

Friday, June 28, 2013

PGY #40  Day #363

Take The Best Care™© of Yourself

From Dr. Mike and Infinity Health Solutions

 

For our final blast of PGY 40 I take you back to The Stress Management Workbook.  In fact, I take you to the end of the book, page 162, which I have reproduced here.  There is ONE critical point to make with regard to altering your life and lifestyle to promote optimal health and well being.  It takes time to do it right.  

This is true for many reasons, not the least of which is this: we are programmed to behave in a certain way.  Not completely hard wired, humans have the capacity to change and to change themselves, but the biology of change involves reprogramming the brain and nervous system and that does take about two years.  This is about a mix of genetics and biology that amounts to "plasticity" of the nervous system.  If you eat well, sleep well, and get proper exercise, your body will enable the necessary changes in the nervous system that facilitate your ongoing path to health. I will not dwell on the science of this phenomenon now, but ask if you have questions about it.

The point is this: You can change.  Don't give up.  Take the time necessary to make the change stick.  If you screw up, fall down, make a mistake, go out of line, fall off the track ... get back on track ASAP.  The more time you spend on track, the easier it will be to stay there.  Do not give up ... do not surrender.

Below is the relevant page from The Stress Management Workbook.

Enjoy!

Dr. Mike

162 THE STRESS MANAGEMENT WORKBOOK

PITFALLS ON THE PATH TO HEALTH,

OR WHY CHANGE IS DIFFICULT

Change is not always easy to implement. There are several reasons

for this. You have been practicing your present style of thinking and

behaving for many years. Much of your behavior and attitude has

become habit. You will have trouble realizing you have engaged in

the habit until after the fact. 

Do not make your goal the immediate

and total elimination of the old behavior or the addition of new ones:

You will set yourself up for failure and add to your stress. A realistic

goal would be to reduce the frequency of the behavior(s) or increase

the frequency ofnew behaviors over time so that one or two years from

this date you can recognize substantial change. 

You can change habits

faster by  

(1) asking friends to tell you when you are engaged in the

old behavior; 

(2) deliberately engaging in the habit in an exaggerated

manner several times a day so that you become supersensitized to it;

and 

(3) keeping a log with you and writing down each time you or a

friend notice the habit-reward yourself for specified reductions in the

frequency of the behavior.

Often people will not change even if the present situation is not

satisfactory because the discomfort of the known is not as great as

their fear of the. consequences of unknown behavior. If you become

more assertive, for example, you will have to deal with the reactions

ofthose around you, some ofwhom may prefer that you stay meek and

docile. If you discover that you seem reluctant to change even though

intellectually you believe you would be better off altering your lifestyle,

then list all the consequences you can think of that would occur

if you did make the specified changes. Which of these would present

new problems for you? How can you decrease your fear of being different?

If this problem seems to have you stymied, seek professional

counseling or medical care.

Refer back to your Action Plan for Change (page 158). Ifthe number

of changes you believe you have to make is substantial, where to start

and how to achieve so much may seem overwhelming. This may give

you the excuse you need to avoid beginning. Do not be upset if you

have found yourself with a long list of changes to make as a result of

reading this workbook. Look at it as a long-range plan. Make a list of

the priorities and work away at it over the next couple of years, rewarding

yourself at each step. Gradual change is better for you than

sudden major shifts in thought, behavior, job situations, etc.

Do not give up. You may review the material and revise your plans

repeatedly without harm. Take your time and remember to enjoy yourself

along the way to your goals.

Tick Season Again: One more reason to avoid tick bites

The Daily Apple™© Volume 2, Number 6

Saturday, June 15. 2013
PGY 40, Day #350

Tick Season Again: One more reason not to get tick bites ... Red Meat Allergy

I found at least one of the nasty creatures on me each day this this week.  Fortunately, none of them had stared feasting on me.  Nevertheless, it is a reminder that this is the time to be especially careful about ticks and the troubles they can cause.

It is is not bad enough that they are nasty creatures that can transmit Lyme Disease, and a long list of other infectious diseases (below), tick bites are now found to be associated with RED MEAT ALLERGY.  So, if you did not have enough reason to protect yourself from tick bites before, you can now add the risk of red meat allergy to your list. 

That's right, you have one more reason NOT to get tick bites.   New science has emerged from researchers at the University of Virginia the associates tick bites with RED MEAT ALLERGY, including, but not limited to life threatening anaphylaxis.  The symptoms of red meat allergy usually occur several hours after eating the red meat, because the offending agent, alpha-gal is most abundant in animal fat, so absorption is delayed.

Beware tick bites!

Have fun and be careful out there.  StepWisely®™© with us and Go to Health™©

Dr. Mike
Michael F. Mascia, MD, MPH

REFERENCES

CDC LIST OF TICK BORN DISEASES:

• Anaplasmosis is transmitted to humans by tick bites primarily from the blacklegged tick (Ixodes scapularis) in the northeastern and upper midwestern U.S. and the western blacklegged tick (Ixodes pacificus) along the Pacific coast.

Babesiosis is caused by microscopic parasites that infect red blood cells. Most human cases of babesiosis in the United States are caused by Babesia microti. Babesia microti is transmitted by the blacklegged tick (Ixodes scapularis) and is found primarily in the Northeast and upper Midwest.

Ehrlichiosis is transmitted to humans by the lone star tick (Ambylomma americanum), found primarily in the southcentral and eastern U.S.

Lyme disease is transmitted by the blacklegged tick (Ixodes scapularis) in the northeastern U.S. and upper Midwestern U.S. and the western blacklegged tick (Ixodes pacificus) along the Pacific coast.

Rickettsia parkeri Rickettsiosis is transmitted to humans by the Gulf Coast tick (Amblyomma maculatum).

Rocky Mountain Spotted Fever (RMSF) is transmitted by the American dog tick (Dermacentor variabilis), Rocky Mountain wood tick (Dermacentor andersoni), and the brown dog tick (Rhipicephalus sangunineus) in the U.S. The brown dog tick and other tick species are associated with RMSF in Central and South America.

STARI (Southern Tick-Associated Rash Illness) is transmitted via bites from the lone star tick (Ambylomma americanum), found in the southeastern and eastern U.S.

Tickborne relapsing fever (TBRF) is transmitted to humans through the bite of infected soft ticks. TBRF has been reported in 15 states: Arizona, California, Colorado, Idaho, Kansas, Montana, Nevada, New Mexico, Ohio, Oklahoma, Oregon, Texas, Utah, Washington, and Wyoming and is associated with sleeping in rustic cabins and vacation homes.

Tularemia is transmitted to humans by the dog tick (Dermacentor variabilis), the wood tick (Dermacentor andersoni), and the lone star tick (Amblyomma americanum). Tularemia occurs throughout the U.S.

364D Rickettsiosis (Rickettsia phillipi, proposed) is transmitted to humans by the Pacific Coast tick (Dermacentor occidentalis ticks). This is a new disease that has been found in California.

   REFERENCES FOR TICK ASSOCIATE RED MEAT ALLERGY:

http://uvamagazine.org/research_and_discovery/article/ticked_off_carnivores/

http://online.wsj.com/article/SB10001424127887324634304578537203916053308.html

REFERENCE FOR PREVENTION AND TREATMENT OF LYME DISEASE

http://cid.oxfordjournals.org/content/43/9/1089.full

CDC LYME DISEASE LINK

http://www.cdc.gov/lyme/

This is Personal: The Patient-Physician Relationship

PGY 40, Day 344

"This is Personal: The Patient-Physician Relationship", was written by me and it is, simply, my opinion ... perhaps not? 

I sent it to the Veritas Health Care Working Group on June 8, 2013, and it is posted here so anyone who wishes can read and respond.

TO: Veritas Health Care Working Group (VeritasHC.org)
From: MFM
Regarding: This is personal.

Please respond, be critical and tell us about your personal experiences inside "The Business of Medicine."

Thanks,
MFM
This is Personal: The Patient-Physician Relationship
by
Michael F. Mascia, MD, MPH

Why would I put my life in the hands of someone whom I do not trust?  Why would I put my life in the hands of a Physician who is forced to cut corners on care by hospitals and third parties?  Don't do it!  Elective? Put it off.

I work with all the casualties ... I see the ones that come in off the street and I see those that come from the hospital.  What I see is very disturbing.  It is NOT RIGHT and it has to change.  Help us change it.

Picture this: Imagine you are the patient. You come in for elective surgery first thing in the morning.  Your attending anesthesiologist is with you and there are no records to reflect preoperative clearance.  He has 2 other patients ... 2 other cases to start at 7:15 ,,, the same time your case is scheduled to start.  So he is hustling and he has little help.  Your "anesthesia provider" is an inexperienced resident and the attending anesthesiologist has to teach and verify that everything is done properly to minimize the risk to you. And, the anesthesiologist knows this: standards of care dictate that certain information in addition to his history and physical is required to meet BEST PRACTICE STANDARDS.  These STANDARDS also dictate certain preconditions.  But the anesthesiologist does not have that information ... he requests it.  And ... your blood sugar is a little high ... got to bring it down before we go.  And, we have to make sure we have blood available in case of a disaster.  Big surgery = high risk.

BUT, the factory pushes ... all eyes are on this anesthesiologist ... because he is SLOWING THE LINE DOWN.  Yes, that's right, you are being treated like a hunk of meat on a production line.  That's the way you are seen ... A HUNK OF MEAT BEING PROCESSED ... and, God forbid the Anesthesiologist hold up the line, or STOP THE LINE for the sake of good OUTCOME.  Yes, I have been that anesthesiologist and when I work that line, I put myself in the position of the patient ... that is the only way to guarantee BEST PRACTICES.  But, if I stop the line, I become "THE PROBLEM" and all the pressure is on me, and they just want to REPLACE ME with someone who does not know any better.  They call this "Production Pressure" and it is an evil reflection of Profit over People that is rampant throughout US hospitals ... every day ... across the country.

Yes, the Business of Medicine in conjunction with third party payers has violated our trust.  By undermining the Physician, they undermine the Patient-Physician Relationship and "Best Care" in favor of Profit.  We all feel it and some of us know it.  That's why everyone I ask ... Patient, Physician, Nurse, other provider ... is disgusted by it.  And, that's why Veritas Health Care is working to create alternatives to Business as usual in Health and Healthcare.

It is the allegiance between patient and physician, and yes, the strength of the bond between Patient and Physician that dictates the healing power of the Patient-Physician relationship.  Over the last 30 years, third parties have systematically disrupted this bond, in favor of "medicine by the numbers", corporate doctoring, third party power and profits over patients.  There is increasing awareness of the problems

Veritas Health Care recognizes the values of the physician-patient relationship and is dedicated to supporting others who value it.

This is personal.

Please join us.

We have tools that will help you Take The Best Care™© of yourself and we will teach you how become an equal member of the healthcare team ... how to help your doctor Take The Best Care™© of you, if and when that becomes necessary.

Dr. Mike