Category Archives: Featured

Is your life in Harmony?

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We humans seem to have a unique capacity for music. Birds may seem to sing but each of their songs conveys a particular message. Bird songs are more like phrases. “I am looking for you.” “Get out of my territory.” And other messages,

Some years ago my cousin and I went camping in the Boundary Waters here in Minnesota. As we drove up we listened to a tape of Loon calls. Loons are birds that live on Northern Lakes. They will let out a call and then dive below the water. Thus, as you look across the lake for the source of the call, you feel you are going “Looney”.
Each Loon call has a particular meaning. Since, loons are nocturnal animals. My cousin and I got little sleep as we listened to the messages the loons were giving to each other.
So much for loons. Neither they, nor the wolfs that howl, seek to harmonize. Yet people do, both in our personal lives and our relationships to others.
So, how can we harmonize our lives?
A chorus will have several voices, typically Sopranos, Altos, Tenors and Bases. As they construct a chord one voice will sing a note. Each of the other voices will then sing a note that has a unique relationship to that first note. These notes will resonate with the first so that they regularly reinforce and cancel the first one out. This creates an other note. The whole things are pleasing to hear.

Our lives have several parts just like a choir. I divide them into Physical, Emotional, Social and Spiritual. We can choose any one of these to be the basis our life. When we are socializing, our physical body allows us to relate in ways pleasing to others. We adjust our emotions to support the social interaction. (How often do you catch yourself when tempted to make an unwelcomed remark?) The spiritual also takes a back seat to the social.
Like a musical composition the various voices of your lives take turns being the basis of the harmony in our lives. Sometimes we care for our body, like eating or bathing. At other times our bodies have the melody, like in playing sports or dancing.
When the various voices of our lives are not in harmony we get a dissonance. That comes out in the form of physical illness, emotional stress, social discord or spiritual isolation.
How do you find this metaphor in your life?
In future blogs I will explore this metaphor more if you share your experiences I will try to incorporate them into the blogs.

As All Ways, Seek Joy,
Coach Dr. Dave

Ways to be Likeable

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“If you’re unlikeable, it’s you against the world.
If you’re likeable, it’s you with the world at your side.”
@DaveKerpen

This is so true, but how often do we feel liked? What ways might you try to behave to be more likeable? Where might you look for ideas?

I bet you are like most people. So who do you like? What characteristics do you see in those you that you don’t see in those you dislike?
The first thing I notice when I look at those who I like is they like themselves. They are not sad and upset with themselves. I naturally
want to comfort those who are sad, but I tire of doing it all the time. I would rather be with those who feel happy.

People who are happy seem to be easier to be around. They are comfortable meeting others. They say hi and are offering their hand, if not a hug. They seem kind and courteous. They say Please and thank you, just like they were taught.

Yet they seem to be able to go beyond the simple courtesies our Mothers taught us. They seem to be able to fit into the group. They notice how others around them behave. They don’t cut others off in conversation, unless everyone is doing that. If others always let certain people talk, they do the same.

If you really want to be liked remember,
“It’s easier to see what someone is really like
By how they treat their inferiors, not their equals.”
(S. J.K. Rowling)

Likeable people seem confident. They give an air of positivity. They know they can do what it takes to get the job done. That doesn’t’ mean they won’t get help and recruit others in the task. I would rather join in a task than just stand there and watch, even when the other person can do it by them self.

Some mistake arrogance for confidence. What is the difference between
confidence and arrogance? Both know they can do the job. Arrogant people seem to have an attitude that others can’t do the job, or do it as well as them. This can be difficult for those who have struggled to master a task. You naturally want to show off. When kids do it we praise them, but as adults we need to unlearn this. Otherwise we will come over as Arrogant.

Confident people are also relaxed. They aren’t afraid to let others try.
That doesn’t mean they let others struggle unnecessarily. They might say, “Would you like a hand with that”, instead of “let me do that.”
We tend to like people who we can trust. That means many things but goes back to courtesy. They don’t let us down. If we are trusted, we know what is expected and do that.

When we speak we expect others to listen. Do you like to be ignored?Then don’t ignore others. Some people don’t know when to relax and stop talking. Then we have to find a nice way to ask them to, “let others play, too.”Yet, do you like others that ignore what you just said? Instead

acknowledge what they dais and if you don’t know much, ask a question? Be careful not to challenge their point of view, until you know they won’t feel attacked. There is a time for debate and never a time for argument.

People also like to be known, use their name. If they wish to be formal the be formal and say MR. or Mrs. This goes back to the blending into

the group. Informality may be accepted from some people and not others. I noticed this among fellow physicians. To the general public they were Dr. and to each other we used first names.

People always likes to Laugh. A sense of humor is liked. But this can be difficult if you don’t know your audience. Some people are sensitive about things that others take for granted. Puns usually are safe, but putdowns are very dangerous. They might be offended for an absent friend.
Lastly, we enjoy being with those who enjoy us. In addition to laughing we enjoy being enjoyed.

So if you wish to be liked:
•Like yourself
•Be courteous
•Blend in and accept the group’s standards
•Be confident but not arrogant
•Be trustworthy
•Know who you are with
•Make them laugh, and
•Enjoy them

As All Ways, Seek Joy,

Vitamins are they Vital?

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Do you feel like the person you would like to be? Do you eat like you know you should? Does your diet lack some important nutrient? Of course you feel the answer might be yes. So take vitamins and you will correct this flaw in your life.

That is why vitamin and mineral supplements are such a big business in the US. The average American spends over $100 a year on such products. In fact I took my vitamin this morning. But then, is that really necessary?

As I have aged my metabolism has slowed. If I eat like I did at twenty, I would really be obese.В In fact I doubt I could avoid obesity if I eat as the dieticians recommend.В I am probably missing some vitamins or minerals.

Yet, much of the vitamin and mineral supplement I take shows up in my very yellow urine. Yes urine is yellow, but not that yellow. If you doubt this stop your vitamins for a week, and then restart them. Your urine will go from pale yellow to a bright yellow.

Is the American diet deficient in some vitamins and minerals?

Yes, the American diet is deficient. That is why milk is fortified with Vitamin D and salt with Iodine.В We debate about adding Calcium to orange juice.В The limited usual dietary supply of these three elements cause health problems in many Americans.

The average person suspects they are suffering from some other vitamin or mineral related ills and takes supplements “just in case.” These illnesses are not as dramatic as scurvy or rickets. Neither are the vitamins or minerals toxic.

There are many problems with this debate. The science lacks the rigor of most medical studies. The products fail the quality standards of prescription medications. The motivation to correct these flaws is lacking.

Faced with all the marketing and uncertainty what are we to do?

What is causing you trouble? Is it the worry or the lack of vitamins? That is hard to tell. Worry and stress are part of our lives. Worry leads to many illnesses. Those illnesses are common and have many causes. They also have many potential ways of prevention. One can’t do all that might be done, without spending so much time worrying as to have the worry become the problem. So, relax. Listen to a trusted source. Try to follow that source’s advice. Being relaxed will often help you better than more or less vitamins or minerals would.

When you get a cold you will want to do something. If you think Vitamin C will help take some. Just be sure to drink plenty of water. The first problem with high dose vitamin C is the possibility of kidney stones. Lots of water will reduce that risk. It is really hard to get too much water, and with a cold mild dehydration is common.В The second is possible rebound Scurvy when you stop. The Scurvy is transient and will be in the form of cracking at the corner of your lips. Now that your worry about whether or not to take Vitamin C is over, you will relax. Relaxing will help your body heal quicker.

As All Ways, Seek Joy,

Coach Dr. Dave

Ps. I welcome sharing and commenting.

The Hospice Cure?

Featured, In the News, New, Spotlight

People in hospice are living longer than expected, according to a recent Washington Post article. Why is that? It’s because for-profit hospice companies are recruiting less ill patients, or patients not really dying. In my experience as a geriatrician, many chronically ill people have lost most incentives to keep them alive.

Why might Hospice Cure a dying person?

In my experience as a geriatrician, I saw that seriously ill patients often became isolated. As we become ill we cut back on our social contacts. With a cold or flu that is certainly wise. However, after heart attack or stroke there is no reason to avoid social contact. Yes it might take more effort, but can yield benefits that make it worth it. Have you ever gone to a party feeling bad only to enjoy yourself and forget your ills?

As we get older our bodies stiffen up. We are aware of more aches and pains. Most people past 60 have some osteoarthritis but for some people it doesn’t cause problems. Doctors can’t explain this. I have seen very deformed knees that did not ache and seemingly normal knees that were crippling. It seems that some people with osteoarthritis have adapted very well and others not as well. Those who adapted live full lives, the others are shut up in their illnesses.

What are the benefits or remaining active?

The main benefit of an active life is the self-image of health. When I can shop and do other things by using a bus I don’t feel the loss of driving. When I get to the gym I am among others who are enjoying strengthening their bodies.

There is a large social benefit from getting out. I go to a book group regularly. The others bring their printed books. I recall what I heard while listening to the book and my thoughts about the book. In the time I have attended this group I have made several friends. If I had let the difficulty of transportation and low vision stop me, I would have missed out on the friendships.

Those who are shut in by illness are cut off from friends and family.В When people recognize that they are dying, they enter hospice, which brings renewed support. The hospice teams are available in person and by phone. They have a network of supporters who will sit with a person and do chores.

Hospice changes the focus from Cure to Care. This was the biggest change I noted when I became a Geriatrician. No longer could I expect to cure an illness. In fact I often had to decide which symptom to address, recognizing that other illnesses would be left to run their courses.

Our society is very isolating. We no longer live in multigenerational groups. Families are separated by distance. Many divorced or widowed people live alone with personal contacts limited to what they can organize.В If someone misses a group gathering, soon they will be forgotten.В The news of their entry into hospice may bring renewed contacts.

Humans are social animals. Infants who don’t get physical contact with care givers soon die. Kids are always in contact with each other. They wrestle and roll together on the floor. Adults too need physical contact. Hugs are usually welcomed and enjoyed. Even a hand shake can enhance the experience of meeting a stranger. We can take stock of someone we meet by the strength of the handshake. Physical labor makes one’s hand strong and well-muscled. Confidence is communicated by willingness and taking the lead.

Thus the social supports and contacts Hospice Care provides might be just the Cure a person needs.

As All Ways, Seek Joy,

Coach Dr. Dave,

Author of the forthcoming book: “Recipes for Lemonade (thriving through disability): Dr. Dave

S Personal Recipe”

www.www.bsmk-med.com

Food Stamps and Tough Love

Featured, Stress

In Thursday’s New York Times article “On the Edge of Poverty, at the Center of a Debate on Food Stamps” the author talked about how the food stamp program was being used as an instrument for tough love. Those in Congress who want to cut funding feel most of the people should return to work. The author gave several examples of people who are disabled and dependent upon food stamps.

If they are disabled how can less nutrition make them more able?

“What you eat is what you will become.” If we make people starve or choose calorie dense junk foods over a variety of healthy food we will not help them be healthier. We knew know that good nutrition is important for the body to function. We also know that if people are stressed the body will function poorly.

Our bodies use food to replace and restore the tissues. It is not just a source of energy in the short term but the building blocks for our future body. Our cells are constantly turning over in periods from days to weeks. I recently saw the effect good nutrition can have when my cats became ill.

We have two cats that are 17 years old. Over a period of months they stopped eating solid food and even stopped eating moist food. They lost weight; their previously soft fur became matted and knotted. After a visit to the vet and removal of some bad teeth they started eating again. Now their fur has returned to its normal soft consistency. No longer do we have to cut the gnarls out of their hair.

Similar things happen to our bodies. What we eat affects our cholesterol, blood sugar, and blood pressure in a fairly short time span. We are aware of the effects coffee has on us. Most parents can tell when the kids have gotten too much sugar. With my restless legs I have to avoid chocolate and caffeine in the evenings or my feet won’t settle down.

Emerging research in nutrition shows that what we eat determines what bacteria grow in our guts. These bacteria (and yeasts), help us to digest our food and either produce toxins or prevent them from getting into our bodies. Thus people talk about using diet to affect our mood and even treating depression. Some forms of arthritis can be helped by glycogen supplements or reducing the toxic load in our diets.

How do you function under stress?

I know I don’t function well under stress. My 91-year-old mother became ill on New Year’s Eve and died in May. I am now picking up the pieces from things I did during that period.  With the stress declining, I now feel more creative and energized than I did for the first half of this year.

Is the tough love approach creating a vicious cycle, poor nutrition leading to poor health leading to poor functioning and for thinking? If so isn’t it time to come up with a better way?

I would love to hear your thoughts and comments which you can post below. If you know anybody who might like to consider this please share.

 As All Way, Seek Joy,

Coach Dr. Dave

Author of the forthcoming book, “Recipes for Lemonade (Thriving through Disability): Dr. Dave’s Personal Recipe “

Www.www.bsmk-med.com

Loneliness: how to overcome Loneliness

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Everyone feels lonely some time, but how can we stop feeling lonely? Researchers investigated this in a study recently reported on by NBC news. The question was does loneliness make us seek things or do things make us lonely? They found for some it works both ways, but not for all. Do you use shopping as a way to combat loneliness?

Loneliness is surprisingly common, with 20% of Americans saying their lonely at any one time. About one third suffer from chronic loneliness. Loneliness increases stress high blood pressure and possibly premature death. So how can we combat loneliness?

In this study they divided people’s approach to material items into three groups. There were those who liked having things for the sake of the things themselves. Second group like things for the social status they brought. And the third group never felt they could have enough stuff.

Those who like things for the sake of the items tended to be happier and not as lonely. For them getting new things did not make them lonelier nor did loneliness seem to make them want more stuff.

For the second group that sought items for social status shopping brought only short-term gains their increase in social status was short livedВ and they soon felt lonely again. В This seem to be a recurrent spiral. Loneliness made them seek things. Things eventually made them lonely again.

The third group seemВ to beВ stuck in loneliness. Buying things did not make them happier. And being unhappy seem to cause them to be alone with the things. They could neither have enough stuff or enough friends.

How can you become less lonely?

We can think of several ways to be less lonely. Shopping was the example in this study. But we can think of the lonely man sitting in a bar. Or “all those lonely people” sitting in a church in the Beatles song. These may be attempts to get ourselves out among other people but are they really satisfying our need?

What lonely people seek this connection with others. While watching a movie in a theater may seem more connected than watching at home is it really satisfying our need? Isn’t what we really need, getting together with those people and talking about how we feel about the movie and how the movie made us feel?

It would seem that the solution to loneliness is in connecting with people and sharing with people. Not in just being around people. How do you connect with others?

As always feel free to comment and share this blog.

As All Ways, Seek Joy

coach Dr. Dave

author of the upcoming book “Recipes for Lemonade (Thriving through Disability): Dr. Dave’s personal recipe”

www.www.bsmk-med.com

Nice guys, Do they make us all winners?

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In a recent Christian science Monitor blog  James Norton referred to research done at Michigan State University. It suggests that nice guys make us all winners. It even suggests that being nice is a winning strategy even if you don’t finish. What has been your experience?

We are all aware of the old adage nice guys finish last however if we think about it for a minute being nice is probably a better strategy than trying to win at all costs. Only one can come in first. We all know there are risks in running the race. We might need help along the way. Who is apt to get the help the nice guy or the greedy guy?

I recently noticed this on the city bus. As I got on with my white cane a woman said, “to your right”.

A little girl said,  “right here”, tapping the seat next to her. As I sat down next to her I noticed how contented she was. Her mother settled their fare and join her on the seat. This preschooler seem very happy and contented. Her mother did not need to entertain her. The girl had ribbons and curls in her hair. Yet, her shoes lacked laces.

This nice little girl lives in a nice world. By some standards the world was nice to her, but obviously there were material things she lacked. Was she a winner or a loser?

Looking at the girl I think she felt like a winner. I see many other children her age who are always needing attention. They whine, and keep moving around on the seats and require the attention of an adult. This little girl seemed very contented in her own little world. In our materialistic and competitive world I doubt anyone will ever consider her to really be in the race. However, I doubt she will ever feel deprived for long.

In college I played in the band. To promote the University we would take a bus tour during spring break. We would sleep in the homes of high school students where we were performing. I remember one warm and friendly home in particular. They seem to be one of the poorer homes but one that I felt more comfortable with than most. I was raised in an upper middle class suburban family. Yet this family, which obviously didn’t have the education or opportunities that I had enjoyed, enjoyed great love. This was something my parents also strived for.

The researchers at Michigan State University were considering evolutionary biology. They had concluded that niceness in the forms of cooperation and forgiveness helped individuals and communities survive. Personal greed and self-interest leaves the individual vulnerable to those groups that can organize themselves.

We all remember the childhood game of King of the Hill. Everyone strives to be the king and keep everybody else off the hill. Soon two or more attack at the same time. This overwhelms the king. If the new Kings cooperate they are much less vulnerable to the next round of attack. If however it was just coincidence, then they start fighting among themselves, and the cycle continues.

So would you rather be the king or a nice guy?

As All Ways, Seek Joy,

coach Dr. Dave

author of the forthcoming book, “recipes for lemonade (Thriving through disability): Dr. Dave’s personal recipe”

www.www.bsmk-med.com

Trauma from Healthcare

Featured, Health caring disciplines, Stress

 

 We all know some things in healthcare can be traumatic such a surgery. However to articles in the New York Times suggests healthcare is more traumatic than we expect.” Nightmares I.C.U.

“and the related letter “Diaries Aid Mental Recovery” suggests as much more common than I would’ve been expected. Have you experienced nightmares after healthcare?

In my years as a physician I was often called upon to manage delirious patients. Sometimes I could calm them down the path that of I by just talking to them. Often I had to physically restrain them, until medications could do the job. I thought little of how the patient might remember this. I probably should have known better.

As an infant I came to hate shots. Then age 3 a bout of whooping cough landed me in the ICU. The pain from a shot of penicillin got me to take a deep breath. I coughed out the mucus and breathe better. after I returned home I experienced night terrors for a wild. I can still recall some of the content of those nightmares. I still do not like getting poked with needles, but decided to not let it bother me when I started drawing blood and starting IV’s.

The New York Times articles suggest that some of the things we do are not as helpful as we think. As a geriatrician I tried to look for the cause of delirium as soon as possible. After the anesthesia from surgery we usually figure it’s the residual sedation from the anesthesia. Thus we would strive to avoid additional sedatives. In an ICU setting especially with the respirator the treatment can cause major panic. Patients have told me it’s next to impossible to breathe with the machine. As we try to get the patient off the respirator we set the machine to breathe with the patient. When this doesn’t work we use a variety of drugs some of which are supposed to cause amnesia.

These drugs do not cause a perfect amnesia. Often their use for such common procedures as colonoscopies. Many patients have told me they remember the whole thing. At least they don’t recall any pain. So I guess they’re effective when used this way.

Does healthcare cause other traumas?

When I was confronted with a new illness that might be cancer, I was never quite sure what to tell the patient. Even when I would’ve bet the lump was cancer, I hesitated to say so. This situation has been discussed much among physicians.

The idea of posttraumatic stress occurring from healthcare offers much room for study and improvement. This study can also be expanded to veterinary medicine. My cat in the associated photo was Seeking refuge on top of the kitchen cabinet. I was about to take her to the veterinarian. She had serious dental problems and would not eat or drink. She is about to get her teeth extracted. I have found she will eat cooked chicken  and drink chicken broth.

Healing from Healthcare Trauma

Most people get over the trauma of healthcare fairly quickly, but not all. There are several things you can do if you are wondering about what might be after effects of healthcare. First, talk to your provider. He or she can review the official report and explain what happened. This will allow you to compare your recollections with that history.

If your family of someone set up a Caring Bridge site for you there will be another record of your stay in the hospital. This can be helpful to family and friends as well.

If these leave you needing more a coach or councilor can help. Because they are attuned to your feelings and not the system that caused the trauma they may be better. SAs always You can consult me about your options thru my website.

As All Ways, Seek Joy,

coach Dr. Dave,

author of the forthcoming book, “recipes for lemonade (thriving through disability): Dr. Dave’s personal recipe”

www.www.bsmk-med.com