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Triple Meme

Dona nobis pacem in the Blogosphere from Mimi Writes: The events of Thursday, October 12 inspired Mimi to come up with the idea of a global post on November 7, 2006. I invite you to check out her compelling post...

"If you'd like to help me get the word out, please email. Or simply link this post on your site, in your emails, mention it in your comments. Tell people to save the blank picture (right-click, save, open in a photo editing program to write or draw on) and simply post it on November 7, 2006."

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Irene from Pregnant Pauses tagged me for this extensive meme:

1. 5 things I would do if I were a millionaire
* Get more Easy Buttons from Staples!
* Have a huge Blogaholics Anonymous meeting!
* Actually take some golf lessons.
* Finally pay off my medical school loans.
* Two words: plastic surgery (yeah right)

2. 5 bad habits
* Take a while to do my memes. HA!
* Drink too much Diet Coke
* Waiting until the last minute to do things
* Work too much, sleep too little
* Stress eating - not a good idea

3. 5 things I hate doing
* Working out, although I know it need to.
* Going out in the cold. I don't mind 90 degrees, but 9 degrees, forget it.
* Confronting people
* Going to a party where I know no one - that's tough for me.
* (couldn't think of another one)

4. 5 things I would never do
* Wear khaki - ever
* Walk through a cemetary at night - too scary
* Curling - what's the point
* Run for political office
* Buy a PC. Hi, I'm a Mac. HA!

5. 5 things I regret doing
* Not appreciating what I have until it's gone.
* Focusing too much on myself and at times forgetting about friends/family
* When upset, I say/do things I regret
* Not taking an overseas experience when I was in high school or college
* (couldn't think of another one)

6. 5 favorite toys or things.
* My trusty Apple stuff: iMac, iBook, iPod (can I count that as three things?)
* Golf clubs - when I use them
* Food - maybe too much at times

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Finally, Kirsten from All About Me - And Then Some tagged me for "Nine Weird Things/Habits about Myself":

1. I have this thing for wicker "furniture". I'm hypotized by it.
2. I'm anti-khaki pants. No khaki. Never. Don't even think about it.
3. Some people can't wake up without their first cup of coffee. Me? Diet Coke.
4. I'm a news junkie. I'm kind of embarrassed by it. I used to watch sit-com tv, dramas, and movies. At night, I'd rather watch news channels.
5. Golf. I can't play it, but I follow it closely. If I'm not watching news, then it's the golf channel.
6. Definitely not a fix-it guy. I hyperventilate if I have to go to the Home Depot.
7. Sometimes I'd rather send an e-mail rather than pick up the phone to contact someone.
8. My attention span is nanoseconds these days. I haven't read a fiction book all the way through in years. Sometimes, I don't even listen to an entire three minute song on my iPod.
9. Actually cooking is something that makes me anxious. If there is an option to go out to eat, I'll take that.

Freaked out yet? Whew! That took a lot out of me. Do you feel like this too much information? Me too. I think I'll take a nap. Oh yeah, I can because I'm off this week. Yay! Sorry, no tagging. Til next time, I'm Doctor Anonymous. HA!

Distracted

This is going to be an interesting week for me. I'm not in the office this entire week. And, this is the first time in quite a while that I've taken this much time off. Usually, it's a long weekend (meaning three days) here or there. But, not stepping foot in the office for an entire week is kind of foreign to me.

I'm going to a conference this week beginning on Wednesday and back on Sunday. I'll let all of you speculate where that's going to be. I may even leave a hint where I'm going. (maybe i'll try that blogcast thing again)

Anyway, ever since I got home yesterday, I've been helping a friend out with a project that has been a pleasant distraction from the day to day grind of medicine. This plays out perfectly because for the most part, I'm not going to think about my job for a week.

I'm a little concerned about this because it may impact my blog this week with less "hard core" medicine topics, or even less postings in general. We'll just have to see.

I've always been fascinated with the topic of leadership. The project I'm helping my friend with has to do with leadership and the conference I'm going to this week has to do with leadership.

Thanks to all of you who have just discovered my blog. This will definitely be an atypical week for my postings and my blog. If it seems like I'm distracted, it is because I am, and I'll admit that up front. (Don't worry, I didn't forget about my assigned memes.)

So, I appreciate everyone being patient with me as I kind of change gears for a week. Who knows? I may lose my entire audience and have to start from scratch again. (I've already seen that in the last five days) Or, I may even get some new readers. Time will tell.

Blogcast update

I just did get home safely. Thanks for all the feedback and positive comments about the blogcast. Also thanks for letting me know about the download problems. If there are still problems, let me know that also.

I've been tinkering with this idea for the past few weeks. And, yesterday, I just decided to do it. I have to tell you, it takes a different type of preparation for a podcast verses a blog. I really didn't know what kind of format that I wanted to take. I literally just made things up on the fly to try to make some sense.

Maybe I'll try again in the next week or so. There still seems like there's something missing, but I haven't quite figured it out yet. Working with the technology is a story in itself. I had no idea about track volumes, master volumes, how close or far to sit from the microphone, or any of that stuff. It's fun, and challenging.

I initially thought that podcasting would be my thing. But, I now know that podcasting for me will only be intermittent. Blogging will remain front and center as my way of expression - because, hey, I'm addicted. Thanks again for all your support.

Blogcast

I have a surprise for all of you! I've been working on this all day and all night. Yes, I've went off the deep end and tried to do a podcast, er, blogcast. What's a blogcast? What city am I in? What have I been doing? All your questions will be answered.

Just a warning: This is a 10MB file. So, if you don't have a high speed connection, then forget it. Yes, this is my actual voice. If there are any problems with the download and/or the playback, let me know. Also FYI, it's about 8 and a half minutes. Hopefully, I'll be back home safe and sound by Friday night.

Click here and download DABC1 (Doctor Anonymous Blogcast) -- Enjoy!

Forget HRT

HRT, or hormone replacement therapy, has traditionally referred to estrogen replacement therapy in women going through menopause. As you have probably heard, estrogen has fallen out of favor for menopausal symptoms because of estrogen's association with blood clots, stroke, and breast cancer.

Now, testosterone is now taking a hit, according to a study from the Mayo Clinic (ABC). What were the important clinical questions that they wanted to answer: In 150 people over 60 years old, does testosterone replacement therapy slow the aging process and does testosterone replacement increase libido?

At the end of two years, the hormone-taking men and women did have increased levels of sex hormones in their blood compared with those who had received fake pills or fake patches. But these hormone increases didn't make the volunteers any younger, as the supplement industry often promises.

"We found no difference in quality of life, including sex drive," said Dr. Sree Nair, lead author and professor of medicine at the Mayo Clinic.

Uh, I'm thinking that this is really interesting to know, but maybe I don't want to know how they conducted this study. It's kind of like TMI, or too much information. I can kind of just see a bunch of Alfred Kinsey wannabes flying around the Mayo Clinic with clipboards and questionnaires. Kind of amusing to think about actually.

Side Effects

One of the most common questions I get is about side effects of medications. Don't get me wrong, this is a good question to ask, especially if you're not familiar with the medication that is being prescribed.

In today's Journal of the American Medical Association, there is a study which estimates approximately 700000 medication complications each year (Chicago Tribune). I know what you're thinking, "Yeah, it's that Food and Drug Administration again. They're working for the drug companies. They just push all medicines through and don't care about side effects."

It's true that, in the study, the most common classes of medicines that sent people to the ER for treatments were insulin for diabetes and blood thinners like coumadin. But, the problem was not with the prescription medicine itself, but with interactions with other medicines, specifically over the counter pills and herbal supplements.

Dr. David Soria, chairman of the emergency department at Florida's Wellington Regional Medical Center, said patients should tell their doctors about drugs they have been prescribed by others, as well as over-the-counter drugs they take, such as aspirin and herbal remedies.

Soria said older patients seem to be taking more herbals because they're easy to get and there is heavy marketing of products that patients think will help to keep their minds sharp or give them more energy.

"Patients don't typically tell us what herbal medications they're on because they don't consider it a drug. They think it's a vitamin," Soria said.

Some studies have found that herbal products, including ginseng and gingko, can cause bleeding, and that others, such as St. John's wort and kava, can react negatively with other medications. St. John's wort also can interact with Plavix, a blood thinner, and cause bleeding.

But monitoring them can be a problem because few studies have been done on the herbals, and because there can be inconsistencies in the batches coming from different manufacturers, Soria said.

I'm not placing blame here, just re-emphasizing the fact that good patient-physician communication is essential for good medical care. I realize, especially for older people, who may see a lot of doctors, to try to remember who prescribed what and why. (Just a plug for the job of a good primary care physician.)

Herbal supplements are marketed as "safe" because they're natural. And, this may be the case when used by themselves. In addition, over the counter medications are safe when used correctly. Problems occur when people take prescription medicines, OTC meds, and herbal supplements. Interactions among all these chemicals could be a problem - thus the 700k medication complications each year. So, be careful out there!

Pass the fish

One of the questions I got today during my talk had to do with seafood. I was mentioning omega-3 fatty acids and that they can have a beneficial effect on a person's cholesterol. "I thought that fish was bad for you," someone asked me, and they heard that there were a lot of contaminants in seafood. The Institute of Medicine, in a new report, tries to clarify the confusion (CNN).

"The benefits of cardiovascular health from eating seafood, including farm fish, far outweigh the risk of cancer from environmental contaminants," said Dr. William Hogarth of the National Oceanic and Atmospheric Administration, the group that commissioned the report.
The environmental contaminants they're talking about include mercury, dioxins, and PCBs. The study found that the levels of these substances were so low in seafood, that there is no danger in consuming it, even a potential cardiac benefit.
The committee members say they aren't sure why fish reduces the risk of heart disease. It could be a direct effect of the omega-3s, or it could simply be that it is lower in saturated fats than other meats, and by adding more fish to the diet, individuals are eating less of the fattier meats.
I do not live close to the ocean. So, one of the many things I look forward to is having fresh seafood when on vacation. Finally, a news story about food that has nothing to do with spinach, ecoli, carrot juice, botulism, recalls, or any of that bad stuff. Order up some broiled salmon and veggies for me tonight. Yum!

Grand Rounds

Grand Rounds 3.4 is up and rolling over at Emergiblog. Kim, the Queen of Carnivals, has what seems like a HUGE number of links over there today. Grab a BIG cup-o-joe and enjoy! Next week's host is listed as Health Care Law Blog.

Can't get enough of blog carnivals? I know Kim can't because she's hosting Change of Shift: A Nursing Blog Carnival in just two days. How does she do that? Sheesh!

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I just got back from my talk about cholesterol at the hospital. Thanks to all of you who gave suggestions on what I should say. I definitely used your comments as I prepared this talk. The audience was the cardiac support group. We have a small cardiopulmonary rehab center at the hospital, and the support group makes up the patients in this program.

Tough crowd, let me tell you. Don't get me wrong, not mean or anything like that. They were very well informed and had a lot of good questions about diet, exercise, and medications. I've done these talks before and the most questions are usually about medications.

Before leaving, the staff gave me a bag of caramel corn as a thank you for speaking. Following my earlier post today, the first thought that came to my mind was, "Whom can I re-gift this to?" HA!

Re-gift

So, I walk in my office yesterday and I see an envelope. I open it and it's a card that says, "Happy Boss's Day!" I didn't even know it was boss's day (check out Michael C for more comments on this). Who made up this "holiday" anyway? Probably the same people that made up Sweetest Day. I have an entire rant on fabricated "holidays," but I'll leave that for another time.

Anyway, inside the greeting card I see a gift card to one of our local restaurants. "Gee, that's nice," I think to myself. Then on the back of the gift card I see a little mark in the corner. It looks vaguely familiar to me. I think for a few minutes, and I figure it out. I'm the one who made that mark a few months ago when I bought this gift card on behalf of the docs here. These gift cards were given to the staff for another fabricated holiday.

Actually, I thought it was kind of funny. I walked into the nurse station and one of the staff members say, "Do you like your card?" I snickered and said, "This is a re-gift isn't it?" I never saw staff members scatter out of the room so fast.

I first heard the term re-gift on an episode of Seinfeld. All of you have done this before, I'm sure. It's when you receive a gift that you particularly don't want. And, instead of returning it or throwing it away, you give it to someone else.

Re-gifting is more common than you think. Cnn.Com reports a study which polled about 1500 Americans. More than half of the people polled said that they re-gifted in the past. In addition, a whopping 78% of respondents said it was acceptable to re-gift.

Nancy Wong, a spokeswoman for Harris Interactive, said she was surprised by the number of people who admitted to re-gifting.

"It's not something I've thought about and when I saw that nearly half had done it -- 52 percent have re-gifted and or would re-gift -- it's quite a significant number," Wong told Reuters.

I'm going to come clean and say, yes, I've done this before. The problem is accidentally re-gifting back to the same person, and getting caught. This has happened to me before when I give a gift, and that person says, "Didn't I give this to you last year?" So, that's why I wasn't upset when I got the card yesterday. Any funny re-gifting stories out there?