MEDICINE & THE INTERNET

If you like reading about things medical then you already may have found the website KevinMD.com. And if you haven’t found it yet, you really should.

KevinMD is Dr. Kevin Pho. His blog runs a daily collection of writings by those in the medical professions. Of special interest to me is watching the docs and the administrators try to figure out how to bring the best of medicine and the best of electronic charting into a workable relationship that is accurate, quickly available and constantly up to date (something I always wonder about, since as yet my own doc doesn’t always have in my computerized chart what I am asking him about.)

I had to laugh at one blog the good doctor wrote about last week. He starts by giving the illustration of doctors rolling their eyes when patients bring in a handful of printouts gleaned from a Google search. Right off the bat this blog captured me, because I have been known to do just that, although the last time I considered doing it was when I speculated I had Sjogren’s Syndrome and printed out what MayoClinic.org had to say about it. (However, I used my better judgment and did not take it to the appointment with me, instead opting to stick it in my own “pending” file for future reference, just in case…).

Dr. Pho then commented on an article by Zachary Meisel in TIME.com where he describes such an eye-roll coming from a medical intern who mentions a patient had some blood in the toilet that morning and came in armed with internet printouts listing a bunch of diseases and conditions that blood in the toilet might indicate. The intern then offered that she herself thinks the patient might have a hemorrhoid.

I just laughed my head off. That could have been me. Me, the patient.

The point of the blog is that whether doctors like it or not, the internet is here to stay and because so much undocumented junk gets put on the internet for everyone’s eyes, it would serve medicine better if doctors stopped the eye-rolling and give some thought to providing the inquiring patient with sites that “exclusively present current, peer-reviewed and evidence-based health information,” which is Dr. Meisel’s recommendation and has Dr. Pho’s concurrence.
And in fairness, I think probably those people who might fit the term “cyberchondriacs” would be just as well served by putting more of their own printouts in their pending files.

And you can learn more about Dr. Pho here:
http://traackr.com/blog/2010/02/influencer-of-the-month-feb-kevin-md/

OH NO! NOT THE DENTIST!

I am going to the dentist today. I have always had very nice dentists, but I still hated to go see them. Today I am having my first appointment with a new dentist. Well, she isn’t new, but she is different than the one I had been going to for the past 10 years.

The reason I am changing is that our senior advantage plan has added dental insurance as a benefit. Our former dentist was in Loma Linda, near where we lived for the first five years of our retirement but about twenty miles away from where we have been living since then. It was comfy to think of staying with the same dentist, but with the new plan it made sense financially to change to someone who was a provider (the old dentist wasn’t) and who would be much nearer to where we live now. I met this new dentist, a “she” in Riverside, at an introductory appointment last week, and I start my dental work today.

I like to think of myself as fairly laid back and accepting of what has to be done, but I’ll confess that I simply hate going to see the dentist, any dentist, even if he/she is someone that I like personally. There is nothing about going to a dentist that is pleasant. What they do usually falls in one or more of these categories: deliver bad news, cause discomfort or pain, and most especially lighten a wallet. I know, it is not the dentist’s fault that I need a root canal; actually it’s not mine either. Teeth just don’t last as long as they should. Also, although it probably isn’t a fair comparison, with the co-pay system my senior insurance plan has, I could see 50 specialist MDs for the price of what I will pay for my root canal. To be honest with you, I hate the idea of investing $500 in a single tooth, especially when I am getting of an age that I just might not get my money’s worth out of it. If I didn’t have to chew food, I might simply have this tooth pulled. However, drinking meals for the rest of my life is not something I want to seriously consider.

I asked my last dentist if it was true that dentists had the highest suicide rate of all professionals. He said he couldn’t prove or disprove it, but he’d known a lot of dentists in his life and he’d never known one to take his or her own life. He said he thought some studies had been done but there really was no agreement on whether or not the data was interpreted correctly. He did say that dentists are in a fairly solitary profession; that is, there may be an office full of young office help, most of whom are female and, he says, hoping to find a dentist husband, but there are not usually professional peers to provide a more collegial atmosphere. He added that dentists know people hate to come see them, which is a somewhat depressing in and of itself. Dentists also know they are, in the long run, making people feel and look better. Now from a patient’s standpoint that is true, but most of us still don’t like to go to the dentist!

The worst dental trip I ever had really had nothing to do with my teeth. I was sitting in the chair having a cleaning when the receptionist came in and asked if I was the owner of the blue Oldsmobile in front of the office. When I said I was, she indicated that a neighbor had just come in to report two young teenaged boys had broken the passenger side window and run off with a tote bag I had left in the front seat. She said they disappeared down the alley. I burst into laughter in spite of myself, because all that was in that bag was a used washcloth, a toothbrush and a tube of toothpaste that I had brought to work with me that day to brush my teeth before my dental appointment. In spite of that broken window, I just had to laugh wondering what those little twerps thought when they found my accoutrements!

So off I go this morning, ready for the needles and the prying and the grinding. You know the old saying, “No pain, no gain.” Well I guess this is just going to be one of those times when I have to bite the bullet and do what has to be done.

However, I don’t have to like it!

WITH A WORD, WORD HERE & a WORD, WORD THERE...

I have been saving up a few odd words to share with you.

I particularly like words I might easily haul out of their resting place in my brain to use in the blog, or in conversation with some ordinary person – that is, not an egghead. I don’t want to seem pretentious when I use them so they need to be words that trip off my tongue without a big “to-do” and seem to be a comfortable resident in my existing vocabulary. I think these fit.

In case you too are one of the odd people for whom words provide a great source of fun, you can surely have fun with these.

The first one today is “horripilate,” which means to have your hair stand up on end (goose bumps) from cold or fear. “Look, ma, I’m horripilating!” Now I do think this is pretty much a eggheady kind of word, but I do like to know exactly what the hair on my arms is doing when I watch a scary movie, although I must admit I don’t watch those kinds of movies anymore. But if I ever do again, at least I can now talk intelligently and precisely about my physical reaction if anyone wants to know.

The next word I found and fell in love with is pelf. Now this word has been around a long time, but I’ve just become aware of it and once understanding what it means I find it all around our society:

pelf
late 14c., from Anglo-Fr. pelf, from O.Fr. pelfre "booty, spoils" (11c.), of unknown origin, related to pilfer (q.v.). Meaning "money, riches," with a pejorative overtone first recorded c.1500.

The TV and radio news lately has talked about WikiLeaks receiving, and possibly later making public, financial information about well-known personages around the world with Swiss bank accounts and who shelter their wealth to avoid taxes or whatever. I think it’s entirely possible this money could be considered pelf. But certainly the riches accumulated by all those sleezy guys at the top of the “pyramid” scams could be considered pelf.

Anyway, it’s good to know this word. I don’t think any of my friends have pelf, and I certainly don’t, but if I find any at least I’ll know what to call it.

The final word today is ort or more commonly, orts. If you do crossword puzzles you may have come across this word, which is where I first saw it. Scrabble is where you’ll find another use of this word. Orts simply means scraps of food.

When we had our dogs, there were rarely any orts left on our plates after dinner. When we ceased having dogs, Jerry stepped in and took over, until his doctor insisted he stay on his diabetic diet. That was about the same time we had to use a dictionary to discover what an “ort” was when we got stuck at a crossword puzzle. So now we are pretty much ortless; if you don’t cook too much you won’t eat too much, I learned.

I do find the definition of orts is not totally restricted to leftover food scraps. I find it is also used for leftover scraps of yarn and embroidery thread that those of us who do needlework end up with. I personally have lots of orts in my yarn storage box. Never give away an ort; the minute you do you’ll need it again.

So today I’m pleased to share with you three new words. “Horripilate,” “Pelf” and “Orts.”

You may not find a way to comfortably use them in the next few days, but you still can be very proud of yourself for adding these three new words to your storehouse of knowledge.

DOING A NASTY CHORE!

Every woman who doesn't have a cleaning lady to do some of the nasty chores for her will recognize the setting above. Yes, it's that area under the sink where all kinds of "miracle" cleaning products are stored.

Keeping it neat and tidy is a thankless task. Nine times out of ten when you reach for something in this area either 1) you won't have the right product, or 2) you are almost out of what you need, or 3) what you've bought and stored there - and haven't used yet - is discolored or so old it not effective anymore.

I had been aware for some time that this area in my little apartment needed cleaning, but I find it such a distasteful job that I'd just been putting it off. I finally told myself that I simply had to bite the bullet and get it done. So yesterday was the day. As it happened, I had also arranged to meet my two cousins for lunch, so I asked Jerry if he would get everything out of that cupboard while I was gone. I wanted him to save a few pages of the morning newspaper for me to use in relining the cupboard, and then I asked him to bring in the little plastic stool that was serving as a temporary base in the living room for a large rubber plant. I needed the stool in the kitchen to sit on so I wouldn't have to kneel on the floor while I cleaned. My ulterior motive (knowing how I often can come up with some excuse NOT to do a distasteful chore) was to be forced into cleaning up the mess that Jerry would create.

I shared with my cousins at lunch the directions I gave Jerry regarding his part in helping me. They looked at me like I was a idiot. "Why didn't you just ask him to clean it?" they both asked. I had to admit the thought crossed my mind, but for some reason I just felt I should do it myself. It probably was a subconscious punishment for my not having done it sooner.

Nancy, Sharon and I spent about half an hour laughing and sharing about the kinds of things we find when we clean under the sink. You can see in the picture that there are two boxes of "Dip-It" for cleaning our one little percolator coffeepot. I have enough furniture polish to clean all the furniture in "Living Spaces." I have ammonia to use for something I can't remember -- and at any rate it is a half-gallon of ammonia which for our 780 square foot apartment is enough to last far longer than we will. And so it goes.

Sharon shared that she bought a special polish for her stainless steel refrigerator and by the time she got around to using it the contents of the bottle were as hard as a rock. I know how that feels. We also talked about how there was nothing, absolutely nothing, under any of our sinks that could be used to remove soot. My latest try is with Murphy Oil Soap for Wood Furniture. And of course if your sink itself is an old white cast iron sink, the kind they put in when the apartment complex was built in 1962, it is impossible to find any cleaner - Ajax, Comet, Barkeepers Friend - that will make it white again. The only thing that works is straight bleach.

I always seem to want to blame a lot of this on my apartment itself, but it really is a ubiquitous problem experienced by those who don't have a big back porch or a big pantry of some other specific place where all the cleaning supplies and equipment go.

The picture above at least shows that I did follow through with what I said I was going to do. My pledge to myself, which I say every time I do what I consider such an onerous chore, is that I will keep it neater, cleaner, nicer, more organized, and clean it more often. I will get rid of duplicates, things that don't work, things I don't need any more and things I'm likely not to ever use or ever use again. That about covers the pledge, I think.

All I have to do now is live up to it. I do have the consolation of knowing that I am not the only one who has this "under the sink" problem! Misery loves company, they say.

A LIFELONG LOVE AFFAIR WITH BOOKS

I remember this well: I was about 9 years old and already an avid reader. Mother always read to us when we were small, and in those days it was thought that kids weren't ready to read until first grade, which was when I was taught to read. (Educators later realized that plenty of kids can read at age four!) But once I started reading on my own I made up for lost time. Then, as now, I was almost never caught without a book in my hand. My sister and I walked to and from school each day, reading as we walked. I do remember once walking into a wooden post that held up a bus stop sign and after arriving at school with a big red knot on my forehead, having to call my daddy to come get me because the school nurse thought I should stay home for the day.

Now I don't walk and read any more but I do keep a book in my car. I think waiting anywhere is such a waste of time and it begs to be filled with reading. I generally have at least two books going at the same time. And I rarely go anywhere without a book in a tote bag hanging from my arm.

I know I am not alone in this love of books, so today I've picked out my 20 favorite books from my 2010's list of "Books Read" and will share them with you. Since I am not writing a review of them, just so you'll have some idea of what kinds of books that I read I'll tell you this: I don't normally read romance or gothic novels, westerns, science fiction or fantasy. I read more non-fiction books than fiction. I read lots of book reviews (NY Times, LA Times, and a few online lists) and almost always choose my reading material based on a review. I don't seem to be any good at plucking books off the library shelves. I do follow certain authors, whose names appear almost yearly on my own lists of "books read." And in the non-fiction category, I pick my books more for subjects of interest than for excellence of writing, but I must admit that if a book isn't well written I am just as apt to "quit" midstream as to continue to plow through it.

So with that all said, I'll give you my 20 favorites for 2010:

FICTION:
Ireland by Frank Delaney
Remembering the Bones by Frances Itani
The Postmistress by Sarah Blake
The Irresistible Henry House by Lisa Grunwald
Cutting for Stone by Abraham Verghese
My Name is Mary Sutter by Robin Oliviera
The Last Days of Ptolemy Grey by Walter Mosely
Oscar Wilde & A Death of No Importance by Gyles Brandreth

NON FICTION:
Dorothea Lange by Linda Gordon
The Man who Loved Books too Much by Allison Hoover Bartlett
The Immortal Life of Henrietta Lacks by Rebecca Skloot
We Two: Victoria and Albert by Gillian Gill
188th Crybaby Battalion by Joel Chasnoff
Exiting Nirvana: A Daughter’s Life with Autism by Clara Claiborne Park
Furious Love: Liz Taylor & Richard Burton by Kashner and Schoenberger
Lives Like Loaded Guns – Emily Dickenson by Lyndall Gordon
The Secret Life of Marilyn Monroe by J. Randy Taraborrelli
Robert College: The American Founders by Keith Greenwood
The Sisters of Sinai:How Two Lady Adventurers Discovered the Hidden Gospels by Janet Soskice
Orange is the New Black by Piper Kernan

So there it is. One of the nicest things about being retired is that I can read to my heart's content. I always have time to talk "books" with anyone who has similar interests in reading matter, and welcome suggestions from any of you for something I've just got to read!

SUFFICIENT UNTO THE DAY...

The first thing I noticed about living in a senior complex - and this has been true both in the Loma Linda Springs apartments and Country Village here in Mira Loma - is that people are always being carted off in an ambulance. It is very disconcerting, since in all the years I lived in ordinary houses in ordinary neighborhoods, I never laid eyes on an ambulance in our area. That was probably just luck of the draw - and perhaps that is what made it so downright discouraging for me to live in the midst of ailing and aging people. In the first year we lived in Mira Loma, the fellow in the apartment that adjoined ours on the east was taken to the hospital a couple of times, luckily to return but more incapacitated each time. The fellow in the apartment abutting ours on the west was carted off only once, and he died shortly thereafter. And a woman in the apartment across the street was in such fragile health from diabetes that the paramedics arrived weekly, sometimes leaving her at home and other times taking her to the hospital, at which time she screamed bloody murder not to take her. Within a few months she disappeared, whether she died or just moved to another place I don’t know.

Now mind you, Country Village is advertised as "resort living" for seniors over 55, the same nomenclature used at the Loma Linda complex too. Neither were in any way assisted living facilities. But I have to tell you that I see some pretty funny things going on here that I can't imagine seeing in the "under 55" world.

One day Jerry and I were having a small afternoon treat at our "Country Village” coffee shop when I saw a lady in the booth across and down a bit from ours licking her dessert plate. No, she wasn’t lapping at it like a dog would, or running her finger around it to catch all the melted ice cream. She was holding it up to her face and was licking every square inch of it with her tongue. I was horrified and revolted. She was a decent-looking lady, well groomed and alone. She was probably in her late 70s and obviously was able to function well enough mentally to dress herself appropriately and take herself to a restaurant. But licking a plate? My God! I wondered if her mother just didn't teach her that this was not polite thing to do, or if she was just senile.

In a grassy area out in front of our apartment is an old, unusable shuffle board court, with benches at each end where the players used to sit in between their turns on the court. Nowadays it is used only by people needing to rest a minute on their walk around the complex. A few days ago I heard some strange loud vocal noises outside, and when I looked to see what was happening, I spied a fairly substantial older woman coming down the walkway headed for one of the benches. She was wearing a headset and though I couldn’t see a Walkman I figured she must be singing along to some music in her ears that I couldn’t hear. She sat down with her back toward the apartments and began throwing her hands up in the air and singing “Hallelujah” rhythmically at the top of her lungs and then she launched into a gospel song with handclapping. The only thing was that she could not carry a tune. It sounded so funny that I had to quit looking at her so I wouldn't burst out laughing. After she sat for about 20 minutes, she resumed her walk, still singing away. You have to give her credit for having a cheerful spirit. As for a singing voice, she gets only an E for effort. As far as I was concerned she really made a spectacle of herself, but maybe that is just my repressed side’s interpretation.

Now this morning I was out early working in the garden. The rain and cold weather we’ve had recently is headed east and it was a lovely day to do some trimming. I had on my old Levi cut-offs (just above the knees), a tank top and a baseball cap. I also had on a pair of brown Crocs, which you all probably know are not the most beautiful of shoes. I know that I looked really stupid. There is no 75 year old that isn’t going to look ridiculous in that getup, even me. But I was going to get dirty, I knew, and I was going to work up a sweat. I decided I didn’t need to look like a Martha Stewart gardener. The concern I had was that I wanted to avoid leaning over with my backside pointed toward the street. I did not want that picture to be what people saw when they walked or drove by my apartment. Bad enough that I was bare-armed with baggy upper-arm skin hanging in plain sight. And my resolve to not wear shorts anymore, which came about because I happened to see the back of my legs in a 3-way mirror in a dressing room, apparently didn’t apply when I was gardening. After all, large rear end and varicose-veiny legs were not the way I wanted myself noted. Yet here I was, out in the open doing everything I said I wouldn't do -- and frankly, at the moment I didn't care. It was hot, I wanted to get the job done dressed as comfortably as I could, and the neighbors be darned.

So I ask myself, why is my gardening in shorts and a tank top any different than a lady licking her plate? Or singing in an off-key voice in front of God and everyone in the neighborhood? I suppose in the long run it really isn’t. Or at least I shouldn’t put myself in the position of deciding that one is probably senile and one probably just doesn’t give a damn! So I was reminded once again that I really am far more judgmental than I should be, and I resolve again to take it as easy on other people as I do on myself. I always laugh when I think of my very favorite bible verse that says, “Sufficient unto the day is the evil thereof.” I have enough to take care of with myself without having to look for others to whip into shape, right?

WHAT'S GOING ON?????

Did any of the rest of you happen to notice that Murphy's Law (If anything can go wrong, it will!) was especially active yesterday?

Jerry and I set out yesterday with a list of "chores" to accomplish. First was a visit to a new dental office, as our former dentist was unwilling to accept the new dental plan we were provided by our HMO. We had phoned this new dentist ahead of time to make sure she was accepting new patients. I had my initial visit with x-rays, and as she prepared a suggested plan for what work needed to be done (the first being a root canal) she discovered that the new dental plan was unworkable for her and that we would have to pay the full amount for each procedure. The items she had on the "must have done" plan (nary a cosmetic procedure in the bunch) was over $7,000. So that was that. No dental work for us at the moment. We are still recovering our breath and trying to decide what to do.

Next we went to Staples to purchase a small packet of 160 Avery #8395 White Name Badge Labels to be made on the computer. I needed 20 and only had 8 left. As most of you probably know, with the advent of big box office stores, the small stationery stores just don't exist anymore, and what we found yesterday was that the only packs they carried consisted of 600 cards and cost $35.00. We went out of the store empty handed.

Pep Boys was next on the list. The battery gauge on our car had been reading very high, almost into a red area at the top. Since the usual loss of battery power puts the needle into the red area at the bottom of the gauge, Jerry made a phone call to his usual mechanic in San Bernardino (20 miles from us) to ask what that meant. He was advised that it meant the battery needed replacing. So Pep Boys was where we headed. Of course they were busy and said there would be a half-hour wait, but before they did any replacing they'd check the battery to make sure it needed replacing. As it happened, we had to wait an hour, but when they finally pulled the car in the bay their check showed the battery still had full power and certainly didn't need replacing. They did not know why it showed so high and suggested we see our mechanic. So there.

Finally, on the last stop before we called it a day, we swung by the library to pick up a book I had on reserve. It showed on my computer that it was in, and we had received a phone call to that effect also. But alas, in true Murphy fashion the book was, in fact, not in. No one knew where it was, or why it wasn't on the shelf for reserved books, nor why we had been notified at all. No one knew anything!

What's going on??????

I don't know anything. I go about my business trying to take care of chores, problems, exigencies, and the like .... and it seems Murphy is there working harder than I am.

What's a poor girl to do? I don't know if I am irritated, discouraged, distressed, dismayed or just plain irked. Seems to me that yesterday was a wasted day, and I am not happy about wasted days.

We have another list of things to do today. My optimistic side says I couldn't have two bad days in a row. But I wonder.....