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We overestimate our sleep


Think fast! How much sleep did you get last night? Six hours? Eight hours? Ten hours? More? Less? (Why do many questions? Hm....) This post is so apropos, because I'm writing this on call, and I have no idea how much sleep I'll get tonight.

Anyway, a new study from the Journal of Clinical Sleep Medicine finds that Americans overestimate the amount of sleep they get. (abcnews) They studied about two thousand people and the subjects were over forty years old.

"As we have progressed, people are losing sleep time," explained [lead author Graciela] Silva, who is concerned that a sleep deficiency may affect daily functioning. "Physicians should take into account that people overestimate their sleep time," Silva said.

[Phyllis] Zee [director of a sleep center] agrees, and added that doctors often rely on subjective reports. "So, doctors need to be cognizant that older adults may be overestimating, and if they are actually getting less sleep, [it] may be associated with increased risk for cardiovascular, metabolic conditions that have been associated with short sleep duration."

Now, if I told you I have gotten three hours of sleep while on call this evening, what would you say? Do I need help? Do I have a problem? I thought the paradigm in medical school training is that people tend to underestimate when giving numbers -- like alcoholic drinks, cigarettes smoked, etc. Shouldn't that apply here as well :-)

Thanks so much!


I appreciate everyone who visited my blog today. Thanks for making this the best day in the past month for this blog. I'm humbled by all the hits today. You're the best!

Obesity inevitable in modern world


No, Mr. Peace Prize winner (image credit) didn't say this. That punch line comes later. Now, before people start throwing things at me, I did not say this either.

According to today's report from Reuters, a UK government think-tank states that obesity is a consequence of modern life, and not due to over-eating and lack of exercise. Huh? What's up with that?

It found in a report that the technological revolution of the 20th century has led to weight gain becoming unavoidable for most people because our bodies and biological make-up are out of step with our surroundings.

"Stocking up on food was key to survival in prehistoric times, but now with energy-dense, cheap foods, labour-saving devices, motorised transport and sedentary work, obesity is rapidly becoming a consequence of modern life," said Sir David King, the government's chief scientific adviser and head of the Foresight programme.

The article goes on to say that it may take three decades to reverse the "so-called epidemic." What needs to happen, according to the study's authors, is a change in the entire society, because this problem is too complicated to leave to personal responsibility. Here is my favorite paragraph of the entire thing.
Tackling obesity, like tackling climate change, requires a range of changes in society, from increasing everyday activity through urban design and transport systems to shifting the drivers of the food chain and consumer purchasing patterns to favour healthier options.
Comparing obesity to global warming? (Apparently now, climate change is now code-speak for global warming.) If that's the case, then Mr. Nobel Peace Prize winner should make a musical out of it - An Inconvenient Fast Food Nation! He can then win the Tony in addition to his Nobel, Oscar, Emmy and Webby. LOL

Largest Medical School Class Ever


Who says that no one wants to be a physician? The Association of American Medical Colleges announced that there will be a record 17,800 (approximate) first year medical students this year - a 2.3 percent increase verses last year. There was also an 8.2 percent increase in applicants. Approximately 42,300 individuals applied for medical school in 2006. (Newswise)

The article also says that a handful of schools (image credit) also increased their entering class size verses 2006. I think this is good news for medicine and for the public. Now, to burst this bubble, there is no mention of how many people wash out in the first year and how many actually finish med school after previous record numbers of first year students. Now, those would be interesting numbers to see.

Dr. A Show: The Shrink Interview


On Thursday at 10pm eastern time, The Doctor Anonymous Live welcomes Roy from MyThreeShrinks and the Shrink Rap blog. I'm very excited about this interview. I was on the My Three Shrinks podcast about a month ago, and I had a great time. I encourage you to take a listen before Thursday's show.

Over the past couple of weeks, Roy has had some very informative posts on various topics like postpartum depression, the Virginia Tech findings report, panic attacks, mental illness awareness week, topamax used in chronic alcohol consumption patients, and a post called "Sunday Brain Soup," that you'll have to check out. Click here to read these over before the show.

Or, we might just take the discussion in an entirely different direction. You have to be sure to listen live, join the live chat room, and/or call in to harrass, er, ask us a question about the above topics or anything else that comes to mind. Write it down! Thursday night at 10pm eastern time. Roy, me, you, and Doctor Anonymous Live - Don't miss it!

MRSA kills Virginia teen


It used to be that MRSA, or methicillin resistant staph aureus, a bacteria, was the rarely even seen. It was talked about as a hospital acquired illness and patients were usually elderly with many complicating medical problems. Unfortunately, now, it's being seen more and more commonly. (image credit)

The Associated Press is reporting that Ashton Bonds, a 17 year old Virginia high school student, died yesterday after being diagnosed with MRSA last week. Officials closed down 21 schools for cleaning to prevent spread of the bacteria.

Many of the infections are being spread in gyms and locker rooms, where athletes — perhaps suffering from cuts or abrasions — share sports equipment. Ashton Bonds played football last year but was not playing this season.

Ashton went to Bedford Memorial Hospital on Oct. 4 after complaining of pain in his side, his mother said. He was sent home after doctors ruled out appendicitis, but was readmitted three days later and transported to Carilion Roanoke Memorial Hospital.

Last week doctors diagnosed Ashton with a MRSA infection that had spread to his kidneys, liver, lungs and the muscles around his heart.

Early Thursday morning, Ashton had to be sedated and put on a ventilator. He was about to undergo surgery to drain the infection from his lungs when doctors detected a blood clot near his heart. Bonds said the clot was inoperable.

In my community, of course, we're not having tragic outcomes like this one. But, when looking at emergency room visits, community acquired MRSA infections are becoming more and more common. Almost every patient coming from a nursing home to the ER with an infection is assumed to have MRSA until proven otherwise.

This is becoming a major problem. MRSA is no longer a problem of the big cities and big university hospitals. It's occurring more and more in grassroots America. So, next time you have an infection that's not going away, don't ignore it - Have it checked out...

500th Post: Halloween Meme


According to the friendly Blogger ticker, this is my 500th post. Yay me! This is merely 485 days since my first day of blogging. So, what I'm going to do is go back into the Dr. A archives and dig up a post from last year.

Hm. Since this is a recycled post, would that mean this is not the 500th post? I guess we'll need to rules officials for that one. Anyway, for those of you who are wondering - YES - I used to participate in memes. And this one from last year was a good one. Enjoy this flash from the past all the way from October 5, 2006! (Don't forget to check out the comments from back then as well.)
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I was tagged my Morgan (gee, thanks) who started his own meme. What is it that I'm always the first person picked when a meme gets started? (Was that whiney enough for you?) Anyway, this is a 13 question theme that goes like this...

1. What's the scariest movie you've ever seen?
Howard the Duck. Just kidding. Ever see this movie? Nope, not many people did -- I think in grade school, they showed a dracula movie around this time of year. I couldn't sleep for days. I think it scarred me for life - really. *smile*

2. What was your favorite Halloween Costume from childhood?
I was a superhero guy. My fave was Superman. Had the cape, had the big "S" on my chest, had the tights. I was 18 years old - just kidding. But, my mom has pictures somewhere of me. Don't worry she has them carefully hidden and will only reveal them at the worst possible time for me, like when I make my long awaited guest appearance on Gray's Anatomy (playing myself of course).

3. If you had an unlimited budget, what would your Fantasy Costume be for this Halloween?
Without a doubt, I would be giving some love to Pluto. I mean the planet, and not the dog. It'll be part of my "Save Pluto" campaign.

4. When was the last time you went Trick Or Treating?
Last year, did you know, I went to a neighborhood and they were giving out iPods? Yeah right. The last time I remember was probably junior high. I remember because my friend went as Michael Jackson. That explains a lot about where he's at now in life.

5. What's your favorite Halloween Candy?
Any time of year, my fave candy is M&Ms. This time of year, of course, the Halloween colors. And, for giving out candy, the M&M minis. Is that too much information?

6. Tell us about a scary nightmare you had.
I was out of town without internet access. Oh yeah, that really happened. Read here.

7. What is your Supernatural Fear?
That slimy ghost from the Ghostbusters movies is going to get me some day. Who you gonna call?

8. What is your Creepy-Crawlie Fear?
Everyone who comes to my office stating they have a spider bite is always fearful of the brown recluse spider. Why? Because the bite injects a venom that literally eats away at your skin and has the potential (although rare) of causing a fatality. Scared yet?

9. Tell us about a time when you saw a ghost, or heard something go Bump in the night.
The first house I lived in following residency was in the woods. Beautiful landscape, although it was hard to maintain. Anyway, one night, I think it was in October I heard something on the roof. I was definitely freaked out. The wind was swirling and you could hear the leaves outside the window. What happened? Just some squirrels on the roof. Funny now, but not that night.

10. Would you ever stay in a real Haunted House overnight?
No. Let me think about that - No. Wait a sec --> Still no!

11. Are you a traditionalist (just a face) Jack O'Lantern Carver, or do you get really creative with your pumpkins?
Just a face. I'm not much more creative than that.

12. How much do you decorate your home for Halloween?
Decorate? What's that? I'm lucky to "celebrate the season" by wearing a Halloween tie to work. I'm kind of a minimalist that way.

13. What do you want on your Tombstone?
That's easy: I'm Dr. A, and I'm a blogaholic...

Cleveland school shooting update


I briefly discussed this last week. In the aftermath of this tragedy, the Associated Press released a story talking about a teacher from SuccessTech Academy in Cleveland -- Michael Grassie. The student he was talking about was Asa Coon, 14, who wounded two teachers and two students before taking his own life.

Grassie, sitting in a wheelchair, said Coon was doing poorly in his class at SuccessTech Academy and risked failing.

"I know that made him really mad," he said. "He just seemed really troubled, really troubled."

Grassie said Coon came into his classroom Wednesday holding two revolvers and said something Grassie didn't understand, and then Coon said, "Now what have you got to say to me?"

"He just shot me," Grassie said.

"I remember the expression on Asa's face," he said. "Anger, total anger. Real hatred. It's something I haven't seen on a 14-year-old's face before."

Now the title of this article is this: Cleveland School Shooter Upset About Failing History. That's what drew me into this story initially. I was asking myself, "How can just failing a class drive a student to take shots at others and then take his own life?"

It's clear that there was more going on in this student's mind. And, this teacher, unfortunately, said what is commonly said in tragedies like this one, "All the warning signs were there. No one picked up on them." There will be a lot of finger pointing and blame passed around. Hopefully, a definite solution can be developed to prevent something like this in the future.

Grand Rounds


Grand Rounds 4.04 is now up and running over at the NY Emergency Medicine blog. The theme this week is everything to do with emergency medicine. I wasn't able to write anything for GR this week (how can I get more time in my week?).

If you don't know what Grand Rounds is, it is a weekly compilation of the best posts from the medical blogosphere that moves to different sites each week. And, who doesn't like reading about medicine and science?

Be sure to check out the new Blogborygmi template, and the ability to put future GR hosts into your Google calendar (it's cool). Next week, Grand Rounds moves over to PalliMed.