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Grand Rounds Poll

For you Grand Rounds readers out there, if you haven't checked out the discussion on Emergiblog yet, please do so. Here's a sample of the quotes from over there.

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Here’s my thoughts on the matter of GR these days.
1) It’s too long. GR is supposed to be the BEST of medical blogging, not everything that every blogger wants to submit.

2) Don’t let your theme obscure the posts. Sometimes the host doesn’t tell you about the post itself, but rather, they come up with a “cute” blurb that may or may not be representative of the post’s content. Theme’s are great, but the posts are why we read.
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I think you are right on, Kim. I am pretty new to the blogosphere and in my short experience with grand rounds I would have to say it is way too long. I don’t have hours and hours to sit in front of the computer so I pick and choose rather than taking it all in.
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Kim- You’re on gal, right on the money and said it well to boot. Giving permission to those who host to edit what they want to include would be a big start. Maybe there should be a limit of 25 or 30 that is about my limit for reading and probably way over what most hosts want to provide. Thanks for this.
--
Having also hosted twice, I have to say that it was much tougher to get excited about the quality of the writing the second time around.

All of the posts I included (and it was nearly everything submitted) had merit, and most of them were well written.

What the majority lacked, and what I read Grand Rounds for, is heart. I want to develop greater understanding of the humanity of medicine.

I would support a maximum number of allowable posts - no more than 30. It gives the host a bit of leverage for picking and choosing. As it is everyone expects to be included, and as host, you do hate to disappoint anyone.
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Things I would like to see more of on GR: More stories, more literary posts. I like the multidisciplinary approach - I enjoy the perspective of the MD, the patient, the pharmacist, the pastoral care representative - Reading these always brings a fresh approach to my own practice.

Things I would like to see less of: Themes (yes, some are clever but overall they are too cutesy - they take away from the posts, themselves). And less posts! I would skim it down to no more than 20. That would in theory ensure more quality.
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Kim, first let me say that this post has all the elements…well written, brave, and something to say. Way to go! I feel grand rounds should be edited. And sure, it’s no fun to be left out but I don’t think a professional medical forum should hold ‘don’t want to hurt feelings’ as a criterium.

I thinks themes need to be handled delicately…some people get so wrapped up in their theme, that the content almost becomes secondary.
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I, too, like the more anecdotal posts. The posts that are patient information and educational, I close immediately and don’t read. (in otherwords, they might have gotten my hit, they did not get my readership, and if it was a first time visit, didn’t even get enough of my recognition for me to return visit). I get enough patient information from my doctor’s, nurses, physical therapists and the like as it is. What I don’t get, I can look up … I don’t need it unsolicited. I have email support groups for my specific conditons.
--

Since I'm hosting next week, and since I'm curious, I've put two poll questions in my sidebar for your consideration when it comes to Grand Rounds themes (yes or no) and the ideal number of Grand Rounds links per week. Please vote. This information will really help guide me in what I'm going to do.

One of the things I love about the internet and the blogosphere is the interactivity with the reader. So, place your vote now and tell your friends about this poll because it's important. Thanks so much!

Press Conference


Thanks so much for attending today's much awaited press conference. I know that there has been a lot of rumors about me on the internet over the past week:
Is Doctor Anonymous ok?
Why has he not been posting as much lately?
What's the big announcement?

First of all, you've probably heard the latest news on people like Iowa Governor Tom Vilsack, Wisconsin Senator Russ Feingold, and Arizona Senator John McCain.

I would like to put the rumors to rest. I am definitely not going to seek either the republican nor the democratic nomination for President of the United States in 2008. I have decided to spend more time with my family and with my blog. I feel that I can better serve the country doing fake political announcements like this so that I can announce what I really wanted to say.... HA!

So, I got this e-mail last week that piqued my interest.

I've been meaning to contact you, to see if you were interested in
hosting Grand Rounds -- your blog is excellent, and you're a frequent
contributor to the weekly carnival.

We are booked into 2007 -- but the scheduled host for 11/21 has just
dropped out. Would you be interested in stepping in to fill this role?
I and some of the other hosts have prepared some tips and pointers to
guide you through it, if you're interested.

Please let me know, Nick Genes

Who is Dr. Nick Genes? He is the illustrious "grand pooba" of Grand Rounds - the wildly popular and most prestigious medical blog carnival out there. The self-described "best that the medical blogosphere has to offer."

I've been toying with the idea for weeks of contacting Nick myself, but I really didn't know if I could handle putting something like that together. I've even commented in the past that the work load in preparing Grand Rounds - especially to maintain its high quality, could maybe be too much for me. Plus, I'm on call next weekend. So, it was probably the worst time for me to try to put something together.

So, what did I do? I said yes. What am I nuts? Probably. Last week, after I accepted, I started doing a lot of research and reading a lot of past GR posts. I also read advice from previous hosts on how to make the experience not too crazy. I mean, hey, if someone as busy as Kim Emergiblog can do it, maybe even on call, I could make it happen.

So Tuesday, head on over to The Rumors Were True to check out GR 3.08. Then, get ready for me! My goal is simple - To make this the best Grand Rounds, ever! Not too much pressure on myself, huh?

I'll have the GR 3.09 posting rules and deadline up Tuesday. But, for now, I'm still figuring out how I'm going to do this and still remain sane. I'll have to stock up on Diet Coke. But, hey, I'm Doctor Anonymous, and I'm a blogaholic....

Addendum: I just ran across this interesting post from said Emergiblog. She listed some concerns and some suggestions on how to make Grand Rounds better. I invite you to make comments over there. I'm going to be watching that discussion very carefully.

Major Announcement


Sorry I haven't been around this weekend. No, I wasn't at THE Ohio State University Vs. Northwestern game yesterday - although I wish I was (sorry Dr. Wes). I've been working on a very exciting project that presented itself last week. I can't wait to tell all of you about it. But, not until tomorrow. How's that for a tease? Hope all of you are having a wonderful weekend. Til tomorrow....

Why I do this

Tuesday night was crazy on call - more busy than usual. Then, on Wednesday, I had a 7am hospital meeting, morning office hours, a noon hospital meeting, then afternoon office hours, then back to the hospital to finish my hospital rounds. Sheesh!

Don't get me wrong, I'm not complaining. It's just the fatigue was more than usual - kind of interesting now that I re-read my post on jetlag. Hmmmmmm...

Wednesday afternoon, I was just totally dragging and could not wait to go home and go to bed. I was not really in that great of a mood - kind of cranky. And, I did not have any tolerance for whining and excuses from my patients or my staff.

I walked into the exam room and saw Russell and his wife. I haven't seen Russell for about two months. Russell usually sees another doc in our practice. In fact, the last time we saw each other we had a spirited disagreement on why I thought tobacco use is unhealthy. So, my first thought was that I really did not want to go through that discussion again - especially today.

In addition to smoking, during our last visit, he reported symptoms of mild chest pain which he attributed to his "chronic bronchitis." After another heated discussion, he was agreeable to a stress test which occured the next week. I was quite surprised by the abnormal result. Russell was immediately referred to our local cardiologist and I kind of lost track of what happened after that.

His wife told me that Russell was seen by the local heart doctor and immediately referred to Huge Legendary University Medical Center where he underwent triple bypass heart surgery about a month ago. He just returned home following some cardiac rehabilitation at Huge Medical Center.

We talked some more. And before the visit ended, Russell's wife said, "You know, they said up there that Russell's heart was right on the edge of something bad happening. I know he can be difficult sometimes, but I'm glad you ordered that stress test. Doc, you probably saved his life and I wanted to thank you."

Russell looked right at me, didn't say anything, but noded his head. At that moment, all of my fatigue disappeared.

Catching up

Had a busy night on call. Took all day to catch up on my work.
Now, time to catch up on sleep. More soon.
Thanks as always for stopping by today.
(Photo Credit: Dave Martinidez)

Jetlag death

I admit this title is a little misleading, but now since you're reading...

So, I'm on call tonight. Typical disrupted night of sleep, and usually takes me a day or two to recover. I'm now learning that in animal experiments, those subjects who experienced changes consistent with jetlag or shift work changes had increased rates of mortality. (BBC News)

We all know that the body has a certain sleep/wake cycle called the circadian rhythm. And, those who cross more than one time zone traveling, or those who work different shifts, or those who may be up all night on call, or those who actually stay up to watch tv for the US election results (me), or those who call themselves bloggers, may have difficulty sleeping. Our bodies are used to a certain length of time with daylight and a certain length of time with darkness.

Researchers at the University of Virginia put mice to this test. They put some mice's clocks forward and other mice's clocks behind by altering their sleep/wake cycles.

Separate groups of young and old mice had normal [sleep] cycles. Younger animals appeared unaffected by alterations to their schedule. But only 47% of the older mice whose "nights" were shortened survived, compared with 68% of those whose nocturnal time was lengthened and 83% of those who remained on a normal schedule.
Yeesh! The only thing I can gather from this data is this -- Glad that I'm not an older mouse! I wonder if they have any data on lice or chickens, or the fly? (oh my!)

Fowl foam

Breaking news out of Washington, DC. Not to worry, if the United States happens to have a bird flu outbreak (I personally think it's not going to happen), now we have a way to limit it. (Chicago Tribune)

The US Agriculture Department approved a firefighting foam to kill chickens quickly if an outbreak happens in commercial poultry. This is an alternative to using carbon dioxide gas because gassing involves more workers and potentially more exposure to infected birds. Of course, peta prefers gassing verses foaming fowl because it's more humane (They're chickens, not humans - Sheesh!)

Why am I mentioning this story? Just another example of the priorities of the federal government. I'm glad they are concerned about bird flu, but why can't I still get human flu vaccine for all of my patients? Why can't they still fix the broken Medicare system? Why are they're still 45 million uninsured Americans (some of them going overseas for their health care)?

Sorry for the rant. For those in the US, don't forget to vote today!

Grand Rounds

Grand Rounds 3.7 is up and running at MSSP Nexus Blog. Here's my contribution:

Dr. Anonymous joins the Walmart Free Antibiotics discussion and reminds docs to have the courage to 'just say no' to unnecessary antibiotic prescriptions, and patients to hold back their wrath if you don't get the prescription you were hoping for.

Check it out! It is the best the medical blogsosphere has to offer. Next week, Grand Rounds will be hosted by The Rumors Were True. That is an interesting blog, if you haven't already had the chance to check it out.

Peace on Earth


Since it is November 7th in most parts of the world, I thought I would make my post a little early (at least in my time zone). Peace on Earth is more than just a day someone picked out and a graphic that you put on your blog. Yes, it's idealistic, but it's an idea of hope - In a world that needs all the hope that it can grasp. Thanks Mimi for your leadership in all of this - for having an idea and passionately making sure that it is followed through. I'm looking forward not only to seeing this graphic scattered all over the blogosphere, but also, hopefully, someday, seeing your dream come true of Dona Nobis Pacem -- Peace on Earth.

Got lice?

Are you sick and tired of meticulously combing out all the lice from your child's hair? Are you sick and tired of using those messy lice lotions and shampoos? Well, have I got the solution for you.

Dale Clayton from the University of Utah has found a unique way to get rid of nits without the muss and fuss. His solution? A hairdryer. Yes, a hairdryer. It is called the LouseBuster and it blows air heated to 140F/60C to kill the critters. A "rake-like attachment" is then used to comb out the lice. Here is the detailed explanation below -- picture and article from Times Online.

Now, when I saw this concept, it seemed vaguely familiar to me. Before I started blogging, I did a lot of television watching late at night - mainly infomercials. And, I vaguely remember the Flowbee Vacuum Haircut System. This is a vaccum cleaner thing that also cuts hair. Yes, I'm serious. This is so funny, I even remember seeing this talked about on an episode of Friends. Here's the promo picture (what would Chandler say about this?).

Conincidence? You be the judge! How about taking this concept to the next level? You know, I'm such the enterperneur -- in the spirit of The Apprentice (the first season is still my fave). Why not combine both of these products? What would you call it? Of course, the Flowbee LouseBuster! Remember, you heard it here first. Get rid of your kid's lice while giving him a trendy haircut. Call right now! Tell your friends and neighbors! Operators are standing by.... HA!

Addendum: Welcome to all of you from the WeKnow Parenting Forum! I heard I was linked there. If you liked this, then feel free to check out the rest of my blog. You might like it!