Earth Day!

Yes, today is Earth Day.

Just another reminder for us all to be mindful in how we use disposable things in our day to day life. Yes, everything has an environmental impact. Yes, one person making lifestyle changes can make a difference. Yes, the problem is very real.

How does this affect our health? Simple. Pollution, waste, and negligence will impact the environment negatively and it will all come back around to bit us in the butt by providing us an enviroment harmful to our health.

What can YOU do? Simple.

-Recycle. Plastic, paper, alumium cans.

-Use napkins or towels in the bathroom? Grab 1 or 2 instead of 3, 4, 5, 6, 7... I have seen people grab about a 3-foot long piece of paper towel to simply dry their hands in the bathrooms. Overkill.

-Get by by using less to do the same amount. I am sure there are ways in which you can do the same task using less resources. Like shower for 5 minutes instead of 10.

-Drink water from a reusable bottle instead of buying bottled water. Water is water, it might taste a little different from bottler to bottler, but it is all the same, you will get used to it (or just be content with it) and you pee it out anyways.

-Promote awareness. Long-term enviromental damage is not something to be taken lightly or think that we won't be directly affected by it (that's just being selfish).

-Make simple changes. See how easily one can make a difference.

Exercise Prescription: just do it

Want patients to actually do something when you tell them to exercise for their own good? Write them a prescription for it!

http://www.webmd.com/fitness-exercise/news/20090417/exercise-prescription-coming-your-way

This is AN EXCELLENT PRACTICE to get used to. Typically, patients come to their doctor with a complaint and expect to leave the office with SOMETHING in their hands, the solution. Usually, it would be a prescription for an actual drug that you can pick up at the pharmacy.

Here, the complaint can be anywhere in series of other health problems caused by being overweight. Therefore, it follows that the solution is to lose weight via exercise!

The beauty of this is that the patient can't even complain that they didn't get a "prescription" from the visit. Sure, they can grip and demand an alternative. But! I am sure that to anyone's "medical expertise" that the best solution to the problem is indeed EXERCISE and not a simple pill they can pop once a day.

The effect is two-fold. You treat the underlying cause, and this will ameliorate the presenting complaints over time. Two birds, one stone, right? It is much better than managing ONLY the complaint with a drug and dismissing the true problem.

Exercise. It works. It's cost-effective. It's simple.

Write it. Sign it. Tear it. Give it.

Lose weight without doing anything!

Looks like there IS any easy way out.... but not just yet...

Researchers have found that you can activate brown fat to help burn off white fat!

http://www.webmd.com/diet/news/20090407/can-brown-fat-make-you-thin

What does this mean? America can keep with their sedentary and lazy life style, and just pop a pill and everything will be alright. Unless the increased calorie burn increases your appetite, and hence, you eat more, negating its effect.

Flip side: Popping pills could prevent obesity overall, lowering the prevalence, and therefore, less chronic problems would result. Maybe some good can came from this after all? Sure, less work for all of us. Then we can deal with patients with REAL medical problems, ones they didn't set themselves up for.

Cardio and NSAIDs don't mix

Just something I picked up from our renal module.

You know how drinking and driving don't mix? Well, the same applies for doing cardio workouts and NSAIDs, or non-steroidal anti-inflammatory drug. 

The reason being is that when you undergo sustained cardio workout, such as running, the blood is shunted, or displaced from your kidneys to tissue with currently higher oxygen needs, such as your leg muscles and heart. Because of this, the blood pressure in your kidneys drop, decreasing its ability to filter your blood. As a regulatory mechanism to maintain sufficient filtration pressure, the vessels in the kidneys constrict to increase the pressure. However, under conditions of excessive vessel constriction, it will essentially cutoff blood flow to the kidneys, and now the kidneys will be oxygen deprived and begin to die.

To prevent this from happening, there is a counter-regulatory mechanism to keep the vessels from closing off too much. A compound called prostaglandins, which causes dilation of the vessels, is produced when there is reduced blood flow to the kidneys. However, NSAIDs inhibit prostaglandin synthesis and therefore adequate blood flow is not able to be reestablished.

Repeated bouts of this kidney abuse, and you can say goodbye kidneys and hope you can get a transplant.

Now, why might you be taking an NSAID? Perhaps, you have some kind of inflammation, such as a tendon which has gotten irritated from repetitive movements, such as sustained running resulting in tendinitis of an ankle tendon. Funny thing is this happened to me in my training for a half-marathon coming up... so it's a good thing I found out about this early enough before serious harm was done.

Friends don't let friends do cardio on NSAIDs...

Final exam grade woes

So yesterday I got my exam grade back for the GI module... and needless to say, I didn't do so hot. I got by but what the heck, I studied for it fairly rigorously and I felt pretty confident that I knew the material, but it didn't amount to anything on the exam...

Am I the only one who feels like this?

It is super discouraging and is telling me that studying has no effect on the outcome, so I would almost be better off not studying as hard and enjoying some time to myself everyday, no? I hope it is not the case that the amount of studying I am doing now is the bare minimum I need to do to just pass the class........

However, in the end, it doesn't matter... honors or just passing. It all comes down to the USMLE anyways. I've been doing qbank questions for the GI module and it isn't too bad, so I hope that is more reflective of the fact that my studying is amounting to something at least... I just hope my downward trend this year doesn't carry over to the boards coming up... yikes.

They say to do well on the boards, you should do WELL in your class... well that is certainly not the case for me. They say, don't study for boards ahead of time, and that what you learn in class is what will be relevant to the boards... Each organ module grade tells me that I have to study harder for the next module, but this time around, my grade for GI just told me that I suck at life. Something isn't working and something has gotta change. At this point, I just hope I crush the step 1.

I have so many goals with my medical career, and I am just afraid that these stats are going to hold me back. lame.

Smoking equals bad nightmares

So last night, I had a nightmare that my dad had quit smoking, but only because he was diagnosed with lung cancer... it was quite emotional, all the thoughts of my dad pretty much knocking on death's door, and I woke up crying. But then I realized it was all a dream and fell back to sleep.

But, however, my dad did recently quit smoking last week, again. It's his 3rd time so far. He has a 20+ year history of smoking, probably a 1/4 pack-year rate. You are probably thinking that it isn't very much, but the fact of the matter is it still exists and has its risk factors and that is the thing with risk, you can be low-risk and it just MIGHT happen to you. The question is, are you willing to take that risk?

Anyways, back to the story. I do find it encouraging because knowing it is his 3rd attempt means he is that much more likely to quite for certain. According to the literature, relapse occur pretty often, and the best way to quit smoking for good is to keep trying. I think it was an average of 4-5 attempts before it is gone for good.

If you smoke and are trying to quit (you really should), there are so many resources out there to help; support groups, family support, help lines, pharmacology, self-benefits... It is never too late to quit, there are short and long-term benefits to quitting.

In all seriousness, quit. There are just so many diseases out there where smoking is a risk factor. And I am SURE that smoking is not your only problem, so you are just compounding more risk factors. The pharmacology available is quite good in increasing your chances of quitting, however, you have to put in the effort as well. Chantix, nicotine patches, bupropion are all out there, some to help you quit, some to keep you from getting back on the habit. Consult your physician. So do yourself (and us as well) a favor, stay healthy so we don't have to clean up your mess, it will saves us all a lot of work.

Comment if you have any questions or whatever.

A new beginning

Let's see how this goes...