Month: December 2015

Hi all! I am back from my beautiful and restful travels; and want everyone to know that I am officially OPEN and READY to be your GO TO resource for acute healthcare questions and care! Whether old friend or new, past work associate or new travel contact, or of course even if we have never met before and you have found me otherwise; rest assured, I am eager to address, advise, and YES IN FACT TREAT most of your urgent health care needs.

Thanks to all of you who have preregistered through eVisit,  the easily accessed link to my virtual waiting room contained on this site. While certainly I have no desire for any of you to be ill or injured and need me (or of course your friends or family), at some point…WE ALL KNOW BETTER! ‘Tis the season after all for just about everything!! I am still offering the first eVisit telemedicine consult – whenever that may be needed -for $30 (1/2 the normal $60 fee) if you sign up before January 1, 2016.  So check out the link to eVisit, sign up before you need me, and save on the first time we may need to “meet” again!

Keep an eye on the site for my blog posts (lots of fun!!), and my frequent educational video posts on various healthcare topics. I will now also begin to answer questions on the site now that I am back from the agonizingly slow (one of the few complaints allowed!) cruise ship internet….Be well all, GREAT TO BE HOME! Clicking my red ruby slippers, There’s no place like home indeed!!

As I sail to the other side of the world, surrounded by fellow travelers from literally 34 countries, our similarities appear far more striking between us than the differences. The beating heart, coupled with the human spirit longing for adventure, is the most obvious similarities between us all. Further, our deference to both “Mother Nature” controlling the weather, the tides, and our daily rituals; as well as “Father Time” controlling our aging process has become quite obvious amidst the beauty of our passage around Cape Horn and through the Straits of Magellan. The courage of those explorers from the earliest of days astounds me, sailing into the complete unknown being beyond most of our capacities. How anyone could have survived not only the sailing to these destinations, but the settlement of these desolate locales, is beyond comprehension. I salute them for their sacrifice, and will remember these sights forever!

Most interesting has been my discussions with my fellow travelers in regards to their medical issues, mainly centered around past surgical procedures, some successful, some not;  as well as the acute daily health concerns faced on a 2 week cruise. From the sore throat, to the aching joints and feet, (head to toe), the similarities CONTINUE between us all! When we are 100%, the body is rolling along in a fluid and appropriate manner, all “ship shape”, as they say!! When we are not 100%, no matter WHERE we are not right, the bottom line is the same: something, somewhere, somehow has become inflamed!!!

Thus “-ITIS”, the Latin root for inflammation, is the ultimate enemy, both acute and chronic!! For example, tonsils and the back of the throat feel normal until one develops “tonsillitis” or “pharyngitis”. Your joints (arth being the root) don’t hurt until you develop “arthritis”. Similarly your stomach feels well until you develop “gastritis”, and your bladder works well until you develop “cystitis”.  Just find the Greek or Latin root for the body part, add that nasty 4 letter word,”- ITIS”, and it’s easy to define. Both acute and chronic (think tendonitis for the simple ankle sprain, rheumatoid arthritis for the chronic); the process is all about the inflammation!!! The treatment, on the other hand, can be much more challenging than the definition, certainly for the chronic conditions.

The hallmarks of acute inflammation are easy to recognize. Redness, warmth, swelling, and of course pain being the BIG 4! Think acute gouty arthritis, if you’ve ever seen a gouty toe or the back of your throat when you’ve had strep. Treatment always starts with rest, coupled with ice and elevation, compression with an ace wrap or splint of the body part if possible to reduce the swelling. Medications are used with various levels of success. ANTIBIOTICS, of course, are the solution if the cause is a bacterial infection; ineffective for viral infections although still often utilized. The strongest of the anti-inflammatory medications, the steroids (prednisone, cortisone), work great in general, but can’t be used every day without significant side effects. They still are used daily in certain severe inflammatory conditions (severe arthritic conditions, connective tissue diseases, etc.), when the benefit outweighs the risks. The NSAID’s (non-steroidal anti-inflammatory drugs), aspirin being the oldest (ibuprofen, naproxen, many others) are widely used with a great safety profile, but longer term, daily use should always be discussed with your primary care practitioner, as they too can have side effects over the long term. Interestingly, Tylenol (acetaminophen), while excellent for pain relief is not an anti-inflammatory drug, nor are the narcotics of course.

Chronic pain is tougher, a huge problem for many, especially as “Father Time” wins his battle as he always does, and a topic for another blog:  this one is long enough already! Remember, -ITIS  is the enemy, common sense with activities the best way to avoid it, but it’s just a part of our common human condition we all MUST face from time to time, no matter how healthy we are!! Remember R.I.C.E. as the treatment…rest, ice, compression/elevation for swelling, antibiotics for the appropriate infectious causes, and see your doctor if it persists or recurs!! Be well all!!

As I am privileged enough to be posting this blog entry from literally the other side of the world, many things are so strikingly obvious.

What a beautiful planet we reside on – the natural beauty of the sea and the vast nature of the water.  Both are hard to appreciate until you are fully surrounded and engulfed within it. The thought of what lies below is a metaphor for life itself, almost beyond one’s capability  to imagine the wonders. The land forms which arise from the sea are equally glorious, sometimes appearing without reason to expect their presence (the Falklands, Easter Island, etc) and of course the main 7 continents serving as the anchor for our existence on this Goldilocks zone we call Earth; under the sun’s radiant warmth.

On this level, every beating heart brings equality to who we are in this celestial dance. As I cruise onward towards the bottom of the earth, it’s important to realize how similar we all are, we have the heartbeat….that human spirit. Only we humans have the ability to appreciate this gift given to us from whoever or whatever you believe has granted it to us! It is not to be ignored or wasted away!!

Not all of us can be lucky enough to sail to the tip of the planet. I know how fortunate I am to experience it. I hope I can relate a few of my experiences to you thru my video posts, and I hope to carry this unique experience forward with a renewed spirit of teaching and caring.

On this cruise are people from all over the world, many of them world travelers with far more experience than I.  So willing to share their past travels, their stories incite both a desire to see more, and also a desire to share what I have seen with others.

Most striking to me has been the interest of others in my past 32 years as an Emergency Physician, a journey unto itself! My life stories and journey have not been to unique places in location, just to the unique circumstances of our American healthcare experience. What I felt to be routine and mundane after 32 years, absolutely fascinates and interests others far more than I could ever imagine.  So I have had something to share with these worldly travelers as well, much to my surprise!

So onward I will go, my stories will be told, other stories will be heard, stored and shared with others! Good to be alive!! I will be getting back to some more healthcare related topics as we go, but the message for today is simple enough! Look around, look closely, share what you see, listen to others. We all have the ability to create our own reality, PLUS the value in our stories to make other’s reality more colorful and real!! Never underestimate your value on this planet! We are all here for a reason!! We all only have one chance at greatness, however it becomes available to us every single day of our lives!!  Be well all, see you soon!!