Fitness 101

If six-pack abs were as easy as every fad exercise and diet pill and marketing gimmic out there claims, why are there so few people that have them? When was the last time you saw some six-pack abs besides on one of those infomercials? The answer is six-pack abs don't just happen and certainly not because of any "quick fix" plan that exists. Six-pack abs take work and some genetic blessing. For those of us without genetic blessing in that area, it just takes more work.

The other notion that targeting a specific muscle group burns the fat directly over it is ridiculous. Burning more calories than you consume is the only way to trim body fat and it doesn't fall off a specific area all at one time. You can't crunch your flabby gut area or "buns of steel" yourself into a smaller pair of jeans.

So before you spend any more money on the next gimmic, pill, colon cleaner, or "six-pack maker", do a little reading on the science behind weight loss. Or, if you're lazy and just want to watch TV, at least watch "Biggest Loser". They may have special circumstances with trainers and gourmet health food but the premise remains. Weight loss is simply a product of burning more calories than you consume.

Patients Lie

I saw a 20 something female patient in Urgent Care for a possible urinary tract infection (UTI). Its a fairly common diagnosis based on symptoms and a simple lab test. As I was telling her about her lab findings, I mentioned that she wasn't pregnant. She and her boyfriend were relieved but she was also surprised that we had checked for that. I told her it's done routinely on women of childbearing age because it may affect the choice of antibiotics in a situation like this.

The other reason it gets checked is because patients lie. She seemed a little shocked by this but its true. I was shocked by this myself until I encountered enough patients that do in fact lie. People lie to each other so lying to a doctor is apparently no different.

For example, I saw a patient with an unusual rash on his private area and despite a thorough Q&A session, we could not come up with a reason for it. Herpes was top of my list but as we sat there in the presence of his long time girlfriend, they both REPEATEDLY denied any other sexual partners so there was no way it could be herpes. It wasn't until I had my hand on the door knob and was ready to leave that the girlfriend casually mentioned she had tested positive for herpes a few days earlier at her doctor appointment. Surprise, surprise. We had a diagnosis in no time that was confirmed in the lab a couple days later. Unfortunately for this gentleman, it wasn't the diagnosis he was hoping for.

Patients lie.

Solicitors

So I'm at home last Saturday night watching a movie with my wife. It's 8pm, my kids are in bed, and someone rang the doorbell. Expecting a solicitor but vaguely curious about who would actually come to my house and ring the doorbell at 8pm on a Saturday night, I got up to answer the door. I looked through the peephole at some random teenage kid standing in the dark on my front step. I turned the light on, opened the door, and got a weak military salute and fake muscle flex from this punk. (It was warm so I didn't have a shirt on and he saw "NAVY" on my gym shorts so apparently that prompted the salute and muscle pose.) He proceeded to try and sell me a carpet shampooing for my house. I politely said "No, thank you" and then "no" a few more times as he continued to ramble on. And despite his whining, I closed the door, turned the light off, and went back to our movie.

In retrospect, I should have told him (and anyone who cold calls my house) this: I have a computer and its connected to the Internet. (Amazing, I know in this day and age.) There is absolutely nothing that you can offer me that I can't find faster, cheaper, and more to my liking on the Internet. When I find something I can either order it online and since I also have a phone (another modern marvel), I have the option to call and order it on my time, on my terms.

Please don't ever come to my house or call my house trying to offer me anything. You can't possibly compete so don't waste my time.

Smoking and IQ

When I see someone smoking, I automatically deduct 20 IQ points and here's why.

#1 for 10 points off. You would have to be living under a rock to not know how bad smoking is for your health. I won't belabor the point here because if you're living under a rock, you're not reading this anyway. If you're NOT living under a rock, you already know.

#2 for another 10 points off. In this economy with the government talking about a $700 billion bailout and the price of food and gas continuing to climb, anyone who continues to fork over money for cigarettes doesn't have their priorities figured out.

I know nicotine is an addiction and it's tough to quit smoking. I also know long term health doesn't really motivate people to change. But when we start talking money, that's something that should motivate anyone and never more so than now.

Entitlement

It’s pretty safe to say everyone wants excellent health care, they want it to cost less, and they want it now. In fact it’s often referred to as the “right” to healthcare. Most “expert” opinions look to the existing medical system or government to provide solutions. However, most people don’t get it. The answer is not regulations, surveys, think-tanks, and policies. Sure, there are certainly system and government problems that adversely affect healthcare but let’s not start there. That only avoids the real issue.

The problem with the current system is entitlement. Everyone feels entitled to instant healthcare answers from the best specialist any time of the day or night no matter how minor their problem. No where is this more apparent than in the ER. My personal favorite entitled patient came to my ER with chronic, mild GI pain. He had already seen his PCM and had an appointment scheduled with GI in a couple weeks. I asked the important ER question for chronic problems, “What’s different tonight?” His answer was an earth-shattering, “Well today’s actually a good day.” I really didn’t know what to say. He wanted an expedited GI work up and didn’t want to wait for his appointment. That’s entitlement and that’s the problem.

Entitlement comes in many forms. From the overly concerned parents who want antibiotics for their kid with one day of sniffles to the short, 300-lb lady who wants an MRI for her chronic back pain because “there’s got to be something broken.” The possibilities that the cold will get better with time or that carrying an extra 150 pounds around may be to blame aren’t even entertained. The most concerning group of entitled patients are those that abuse their bodies and make no attempts to stop. These people treat their lungs and livers as toxic filters and then expect 21st century medicine to fix whatever ails them.

Uncle Ben explained to Spiderman that “with great power comes great responsibility”. I think the reverse is true and is the answer we’re all looking for…”with great responsibility comes great power.” Individuals actually taking responsibility for themselves will provide the power to change the system. Here are some simple ideas to start with.

You have the responsibility to:
Exercise.
Not smoke.
Not eat and drink excessively.
Keep your kids safe and healthy.

People are the answer…you and me and everyone else. The sooner we shift our focus from the easy targets like HMOs, pharmaceutical companies, and government, the sooner we’ll be able to fix what’s really broken.

Recycling

My philosophy on recycling is simple. I can't save the world but I don't have to make it worse. Does it take much effort to consciously think about and actually throw things into a recycle bag vs. the trash? No. Does it take a few minutes to collect my cans & bottles at work and bring them home? Yes. Is it too expensive to buy reusable grocery bags? No. Does it take a few minutes to collect my own recycleables at work and bring them home. Yes. Is it any extra effort to throw recycleable things in the "blue" trash can vs. the "black" trash can for garbage pick up day? No. Does it take a few minutes to take my cans & bottles to the recycling guy behind the grocery store every couple months? Yes. Will I get rich saving $0.05 per item? No. Is it worth recycling? Yes. Can I save the world by myself. No. Do I have to make it worse. Also, no.

Money is Meaningless

With the national debt upwards of $8 trillion and most news quoting figures in the millions to trillions on a daily basis, that amount of money has lost all meaning. "Health care costs trillions every year". "The war in Iraq costs millions/day". "Social security is going to cost billions to fix". Who's counting? Who's actually paying? Schools don't have money for teachers. Cities don't have money for police officers. Students can't afford college. Doctors can't afford insurance. Where did all the money go? Who has all the money? Who spends all the money?

I make around 80K/yr. That's more than enough to live comfortably, even where I'm at in CA. I can't imagine what I'd do with $250K let alone millions or even billions.

The figures on the news are quoted to get a reaction but it doesn't even get a reaction anymore- it's just too much money. "Everyone" is apparently spending it but "nobody" has it.

Economics

You'd think someone with my salary and my debt would care about economics but I don't. Maybe someday when I have more money I'll worry about it. As it is, it makes no difference to me what the stock market is doing because I don't have enough savings/stocks/property/etc. to matter. Politicians can promise whatever they want but my cash flow will change very little regardless of who wins the White House. I have a friend who worries a lot about money and I'm very happy I don't share his stress.

Gas prices don't concern me either. Whether gas is $2/gal or $5/gal, I still have to go to work while my wife has to drive 2 kids around. That means 2 cars: a 1999 compact pickup and a 2005 minivan that are both paid for. I'm not thrilled with our average MPG but I can't afford new vehicles- hybrid or not. I can't bike to work. I can't not go to work. I can't carpool. My wife can't stay home all day every day. We'll stay a 2-car family and when one of the cars dies, maybe then we'll get to upgrade our average MPG.