Grand Rounds

Grand Rounds 4.31 is now up and running over at Dr. Val and the Voice of Reason. She has grouped the post by feeling, which I don't think has ever been done before. And, she added a little cute tagging system to point out the especially good posts of the week.

I admit that I have been a slug and not writing as much and contributing to Grand Rounds. I feel badly about that. But, I'm feeling a little resurgence, so maybe the posts will start flying again. Thanks to Dr. Val for including my post this week:

Dr. A from Doctor Anonymous wonders if peace and contentment come from accepting one's lot in life. His post is called, "With Age Comes Happiness?"

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? Next week, Grand Rounds moves to the site called Doc Gurley.

Pee brings the world together

Now, you're going to think that I'm totally making this story up and that it's untrue. Well, it's from MSNBC, so you can make your own conclusions there. Anyway, here's the first sentence from the story, "Pee from more than 4,000 volunteers shows that people from different nations often have spectacularly different metabolisms."

And, off we go! Ok, so, I'm trying to visualize the newspaper ad that had to go out on this one: "Seeking pee from people worldwide for research study." And, they got 4,000 people to participate? Fascinating. What did they find? Well, different people from different nations had different metabolites in their urine (no kidding).

"For instance, Chinese and Japanese people are almost identical genetically, which isn't surprising, since they diverged culturally only a few thousand years ago — but they are very different metabolically," said researcher Jeremy Nicholson, a biological chemist at Imperial College London.

"We know there's a huge difference in the diseases that different nations risk — broadly speaking, the Japanese tend to die of strokes, the Chinese of heart attacks — and we see those differences reflected in their urine," he added. "Of course they're different in terms of lifestyle — the Japanese tend to eat more fish than the Chinese as a whole do — but their gut bacteria are also very distinct as well."

Now, why is this important? According to the article, the substances found may help shed light on things like diabetes, vascular diseases, obesity, and even cancer. Sure, that's great. But, I'd hate to be the poor freshman college student asked to do all the grassroots work on this paper. Is getting a published research paper worth it to work with all this urine? I guess so. Wonder what the follow-up research will hold?

Surgical "Cure" for Diabetes

So, one of my patients today asked me about a surgical cure for diabetes. The only things I ever heard about were experimental procedures with the islet cells of the pancreas or something along those lines. But, then, the patient said something about gastric bypass surgery. I was mildly intrigued.

This person said that they they saw a report on 60 minutes. "Oh great," I thought to myself. So, I checked out the website over there and there is not one but about four videos over there talking about this. You're going to love this. The titles of the reports are the following: The ABCs of gastric bypass surgery; Diabetes cure?; Immediate relief; and Here's the hitch.

So, if for anything else, to get me up to speed with what my patients are watching, these reports claim a "cure" for diabetes - meaning to them that their patients leave the hospital following their surgery without any diabetes meds. And, one of the final reports says that it's a shame that more people (meaning non-obese people) do not qualify for this surgery. No wonder a lot of people asked me about this surgery today at the office.

Now, I know that I may get beat up by some people out there, but this situation is so much a reflection of our society today. People are looking for the quick fix and then everything will be better. "All I need is this surgery and then I can start living my life again," people think to themselves.

It's so interesting how people think. I can't give away flu shots or pneumonia vaccines because "they cause the flu" or "I get a rash from it." For gastric bypass surgery, just reading from the webmd website, has risks for blood clots and infection. And, something called "dumping syndrome" which goes something like this.

Another risk of gastric bypass is dumping syndrome, in which food is "dumped" from the stomach into the intestines too quickly, before it's been properly digested. About 85% of people who get a gastric bypass have some dumping. Symptoms include nausea, bloating, pain, sweating, weakness, and diarrhea. Dumping is often triggered by sugary or high-carbohydrate foods, and adjusting the diet helps. However, some experts actually see dumping syndrome as beneficial, in that it encourages people to avoid foods that could lead to weight gain.

But, the same people who won't take this pill or that pill because of the 10 page side effect list they received at the pharmacy - these same people - would like to be considered for gastric bypass surgery. Can someone explain this to me? I'm confused....

Blog Fatigue and Podfading

The Clinical Cases and Images blog picked up on my recent post named "The Pressure of Posting." They raise the question of whether blogging in general has kind of become passe and yesterday's news. With so many different ways to express yourself like Twitter (guilty of being on too much), Facebook, and other social networking sites, has the blog become kind of ancient?

In the world of podcasting (of which I would call myself a very minor player), there is a term called "Podfading." It is a situation in which a podcast either becomes more and more infrequent or just stops abruptly - thereby leaving the audience not quite knowing what to do. A definitely parallel can be made with blogs, video blogging, or any other new media product.

In applying all of this to me (since this is my blog, you know), I guess a hobby or a project like this - something that you think about almost every day - has a cycle of increased interest and decreased interest. In what I call "the old media world" (meaning everything not considered new media), either your career is considered rocketing to the top or fading back to the oblivion where you came from. The main stream media loves to build people up, tear them down, hype up the comeback, and tear them down again. One day you're the best thing since sliced bread and tomorrow you're a has-been hanging on to the past.

For me, I sometimes have to ask myself, what is the core of all of this? I don't blog to make money. I do not seek sponsorship for any of the new media stuff that I do. Some people do, and I don't begrudge them for that. I write, or record audio, or shoot video, just for the joy of doing it. And, I guess, there are times when I'm not as interested and other times when I am very interested. But, just like life, I have to take the good with the bad.

At least for this second, I don't see myself going anywhere. I guess I just have to keep challenging myself in this world of new media. And, I encourage all of you out there to do the same. If you have a blog, consider recording some audio and make a podcast. For those of you with that, consider shooting some video and express yourself that way. Don't know what Twitter or Facebook are? Check them out - you may actually like it.

Hmmm. Maybe I will talk about some of this stuff on the show this week. Doesn't hurt to be introspective every once in a while...

Misuse of 911 emergency

For the state of affairs around these parts, this story from our local newspaper is shocking, and yet, sad at the same time. I'll let this story speak for itself...

Warren – A man who police say kept them busy searching for his missing 2-year-old son has been charged with misuse of 911. Police reported that [the man] called 911 Saturday afternoon to report his son missing. 

Six police officers searched the area for an hour, but couldn’t find the boy. When his wife returned home with her son, [the man] reportedly told police he knew his son was with her. According to the report, [the man] was under the influence of drugs and alcohol.

The pressure of posting

This post is going to ramble. So, consider yourself warned. It doesn't take a genius to figure out that I have not been writing that much on this blog. And, I just wanted to get some thoughts out there so that they don't keep smoldering inside me.

Every time I sit down to try to write something, I feel nothing there - at least lately. The evolution of this blog is such that I started talking about patients a little bit. Then, move onward to talking about current events and topical things. And, now, I'm experimenting a little bit with a live internet radio show format and video blogging.

Especially in this latest chapter of my blogging life, I've always wanted to continue with writing on this text blog. I just don't know what I do to myself. I know I have written about this feeling here before. Of course, I want to write what I think is quality stuff. But, when I've sat down in the past 3-4 months, when I start typing, I have the thought of "If this is not the best thing you have ever written, then stop writing."

Now, it doesn't help that life has (definitely) been getting in the way of blogging over the past few months. But, when you think about it, everyone has a life outside of blogging (don't they). So, pretty much everybody has to find that balance between blog life and real life.

Since I have no scheduled guest this week on the show, this is something that I can talk about. It probably sounds too simple, but maybe the solution to writers block is - just writing. I think back to when I started this blog. I didn't care who was reading this. But, as people start to read and subscribe to this blog, something happens to the blog writer. I just have to continually remind myself that I blog for the joy of blogging and not for anything else....

With age comes happiness

Every day, older people come to see me in my office saying, "Doc, I don't know why they call this 'The Golden Years' because there is nothing golden about them." And, then, they go into their medical concerns that, hopefully, I can help them out with. But, I do have good news for older Americans because there is new research being released stating that the happiest Americans are the oldest (Associated Press).

A certain amount of distress in old age is inevitable, including aches and pains and the deaths of loved ones and friends. But older people generally have learned to be more content with what they have than younger adults, [researcher] Yang said.

This is partly because older people have learned to lower their expectations and accept their achievements, said Duke University aging expert Linda George. An older person may realize "it's fine that I was a schoolteacher and not a Nobel prize winner."

The rest of this article goes into examples of people and their point of view at the older part of life. The balance between being hard-charging to succeed and being content is something that I struggle with everyday. That stress level really bothers me sometimes. Maybe the lesson from this study is that sometimes (only sometimes) that it's ok to lower expectations and accept achievements. My life would be a a little more content and less stressful.

Show 31 Wrap-up

Thanks so much for Vijay from Scan Man's Notes for being on the show. (Video post above) He has been a long supporter of the show and I appreciate that. We talked about the training system in his country to become a physician. Did you know that radiology was not his first choice? We talk about that a little bit as well. And then, he started exhibiting some of the typical radiology arrogance that I see every day and I just had to shut him up (just kidding).

Thanks also to Mexico Med Student for flying in the co-pilots seat tonight for the show. At the beginning of the show, he talked about his current status as far as from an educational standpoint. And, then we talked about his recent post from today in which he very poignantly described his health scare. Somethings things happen the way that they do for a reason, and we reflected on that as well.

Finally, thanks so much to Dr. Val for calling into the show at the point when I most needed her. There was definitely a lull in the show while Vijay was trying to find a working connection. Tomorrow, Val is going to have an exclusive interview (probably not exclusive, but sounds good) with the former surgeon general Dr. Richard Carmona. Good luck Val!

Next week, we'll see. I have some e-mails out there. So, we'll see if I'm able to get a guest. If not, then we'll talk about anything (almost). Thanks so much for your support of the show (don't forget to rate the show here)! Have a great weekend!

Dr. A Show 31 tonight

Thursday, April 17th, 2008 at 9pm Eastern Time

Join us tonight for The Doctor Anonymous Show . Our guest will be radiologist medblogger Vijay who is author of the blog Scan Man's Notes. It will be early morning on April 18th when Vijay calls in live from India. I'll be taking your phone calls, and who knows what we'll talk about.

You can even take part in the chat room, or what I affectionately call, "The MedBloggers Lounge." A great opportunity to interact with medbloggers you've only read about. See you for the show!

For first time Blog Talk Radio listeners:
*Although it is not required to listen to the show, I encourage you to register on the BlogTalkRadio site prior to the show. I think it will make the process easier.

*To get to my show site, click here. As show time gets closer, keep hitting "refresh" on your browser until you see the "Click to Listen" button. Then, of course, press the "Click to Listen" button.

*You can also participate in the live chat room before, during, and after the show. Look for the "Chat Available" button in the upper right hand corner of the page. If you are registered with the BTR site, your registered name and picture will appear in the chat room.

*You can also call into the show. The number is on my show site. I'll be taking calls beginning at around the bottom of the hour. Hope these tips are helpful!

Dr. A Show 31 Preview

Never before in the history of The Doctor Anonymous Show has a guest done his/her own promo - until now. Vijay from Scan Man's Notes has discovered video posting for himself. In his video post above, he shares that he will be a guest on the show on Thursday, April 17th, 2008 at 9pm eastern time (6:30am 4/18 in India). It's a cute intro and it looks like he recorded it on the moon from a lunar landing. But, no criticism here. I really appreciate Vijay having the courage to post a video to talk about his own guest appearance on the show. He shares written comments on a post today entitled, "scan man on BTR." See everyone tomorrow night (or at whatever time the show is where you're at)!