Do as we say. Not as we do.

As a physician I spend a lot of time discussing sleep hygiene. Which is similar to our regular hygiene but somehow harder to pull off. Every morning I floss, brush, shower, deodorant and then coffee. I have the routine down to a science. But sleep hygiene has hard for patients to get consistent with. This is the idea of doing things in a routine to promote restful sleep. Go to bed around the same time. Put your Iphone away. Turn off the TV. Make sure you are in a cool dark room. Before getting married make sure your partner does not snore or will at least wear a CPAP.

Yet physicians often have the worst sleep hygiene. It starts in medical school and then gets worse in residency. We have to be at surgical rotations at 5 AM. And I worked 30 hour shifts as a resident physician. After a 30 hours shift you were then expected to sit through a lunch time lecture. Here we are preaching sleep hygiene but treating ourselves like machines that do not need sleep.

I work in a practice with 4 physicians. Which means I am on call 25 percent of my life. I tell patients to put their phone away and hide it across the room. Yet I turn my ringer up so that I wake up in case of an emergency. Doctors do shift work. I have heard of emergency room doctors making separate walled in rooms with special walls to reduce noise so that one can get good sleep during the day.

It is time for self care. The CDC recommends that all adults try and get 7 hours of sleep. We need to make changes. I am going to turn off my computer earlier and make sure I get to sleep at a good time. Luckily hours have been changed for residents trying to get them more sleep. Physicians overall are known for pushing themselves but we need to realize that a well rested physician is a better physician. Sleep deprivation can affect our focus, mood and productivity.

We need to realize that there is only so much we can do in one day. But sleeping 7 hours should be one of our first priorities. I am done now. Going to take a nap.

The Doc is In

Debates

Debate Club

I was not in the debate club during high school but I have learned the art of the debate. And no, I am not running for office. I enjoy a good discussion but it is difficult to debate issues that are not debatable.

During my day my main goal is to be a good listener. Process symptoms and develop an evidenced based plan. But at times I debate. I explain why a Zpack is not needed for a viral upper respiratory infection. I discuss the issues behind opiates for back pain.

Patients at times want extra tests and imaging that is not needed. I try to explain the evidence and risk/benefits behind tests but they do not always care. No, I do not need to check your for systemic Candida or your thirteenth Lyme test. Yes I realize that you are tired and are having trouble losing weight but there may not be some rare hormonal imbalance that we have missed.

I try to remain evidenced based. I listen and process all the information. Then I present my assessment and plan. Then, at times, the debate begins.
But in one respect I have given up. Debating the flu shot. No it will not give you the flu. Yes, a coworker of yours may have gotten the flu shot and then died a year later. But is was not from the flu. But at the end of the visit when I ask if you want the flu shot I do not have the time in my day to debate. Not the flu shot. There is no debate. The flu shot helps save lives. I have had almost one patient per year die of the flu.

What I need is more time. I want to debate . Not politics but why everyone over 6 months should get the flu shot. In medicine we have so many things to discuss and document it has limited our time to debate.

Differences with my wife and the Flu shot. Two things that I will not debate. Get your flu shot.

The Doc is In

Juicing

The medical world always has a new answers to old questions. We are given recommendations to get a certain amount of fruits and vegetables daily to stay healthy. But it is hard to get them in. That is until we decided that we could just shove them all in a JUICER.

Is juicing healthy? We know that drinking too much fruit juice is not healthy for you. Fruit juice is packed with simple sugars. They refer to athletes that are taking steroids as being juiced. Also probable not that good for you.

But juicing can be a healthy alternative. It is basically meal replacement. We can add a little kale, broccoli, strawberries and apples and there you go. You have a nutritious meal replacement. Diet companies have been selling “healthy” meal replacements forever. If you make the decision to replace breakfast and/or lunch it could very well be a good replacement. If you prepare yourself a juice for breakfast that is full of veggies than it is absolutely a better alternative to a breakfast sandwich or donut.

Can one live off of juicing alone? Maybe. But who wants to. We do not get all the fiber and nutrients when we grind down certain veggies into juice. Also too much fruit added can actually make a drink very high in sugar. I like to eat. Food has texture. Veggies have texture.

Being healthy with eating is all about routine. Use meal prep. Stay in a regimen. If you want to juice make it a part of your health conscious. Kale smoothies are delicious but allow the vegetables to be eaten in their normal state at times.

The Doc is In

Kid’s Parties

Let’s all admit it your kids birthday party is terrible. We have a bunch of kids run around Bounce U or some other similar type venue for an hour followed by crappy pizza. We go because we want little Johnny to make friends though. We wander around chatting hoping to find someone to chat with that will not make you feel like a bad parent. What they do not usually have is booze.

There are slides and trampolines and ball pits. Here is the bad news. They did a study in ball pits in a physical therapy practice. What did it find? A lot. It found 31 bacterial species and one species of yeast. Enough stuff to give you pink eye, UTI, upper respiratory infections and even bloodstream infections.

Yet if you invite. We will come. I will allow my kids to jump around the dirt, drool and feces that is lurking.

Not at my house. Not for our party. My kids get a pool party. And open bar. Kid’s parties are terrible. But they do not have to be.

Double Dipper

I am focused on not spreading germs. Most times. I wash my hands all day long. I give out vaccines. I cover my mouth when I cough. And I make out with my wife less when I have a cold sore. But I have a flaw. I am a double dipper. If you have blue cheese or BBQ sauce or veggie dip. I will double dip every time. I cannot control it. So if you see me coming hold your salsa.
The Doc is In

Create a website or blog at WordPress.com

Up ↑