NEW Wonder Drug

Aspirin is probably the best drug ever invented.  If you are allergic to it or have certain bleeding tendencies, ulcers, and many other conditions, it is NOT FOR YOU.  You can die from taking aspirin. Most people don't die or get sick from it and most people get all sorts of benefits from fever reduction (don't forget about Reye's Syndrome that has been associated with aspirin) to pain relief and reducing the tendency to get blood clots in your circulatory system.  Many folks who have heart issues are advised to take low dose (baby size) aspirin daily.  In a well respected orthopedic journal that I just received, there is a featured article that states that aspirin is a better drug post-surgery to prevent the side effects of deep vein thrombosis (blood clots in your veins) than the more expensive anti-clotting drugs.  And it has fewer side effects.  I used to prescribe aspirin (acetylsalicylic acid or ASA) following total hip or knee surgery, then the expensive drug protocols became the "party line" and if you did not use Warfarin and heparin and other drugs, you were a dinosaur.  Now it seems we might be going back the other way.  While I am on the subject of blood thinners and anti-clotting drugs, there are some really expensive ones out there that are used to prevent clots in Atrial Fibrilation and other conditions.  They are often wonderful until they are not.  If you get bleeding from some of them, it can't be easily reversed by giving an antidote like  you can with some of the old fashioned and cheaper drugs. Ask your doctor.  I am not giving you medical advice, I just want you to ask questions of those who are caring for you.  

MEDICAL FLIP FLOPS

"NOT ALWAYS RIGHT, BUT NEVER IN DOUBT." The medical profession is very dogmatic. Just thinking back over my years in the field, I can think of some major 180 degree reversals.  Take for example the  dogma of how your baby should sleep.  When my children were infants 35 plus years ago, our pediatricians scared us to death with admonitions against letting our babies sleep on their backs.  We were told to roll them over instantly on their bellies so that if they spit up, they would not aspirate milk and food into their lungs and get pneumonia or worse yet, choke and be unable to breath.  in 2013, if you let your child sleep on his stomach, the Department of Children and Family Services will be called because the American Academy of Pediatrics says that babies have to sleep on their backs, NEVER on their bellies.

Older people can get a high blood pressure problem called systolic hypertension. This is different from  other types of high blood pressure disorders.  When you get your blood pressure checked with a sphygmomanometer cuff that is blown up on your arm, there are two numbers registered.  The upper one is the systolic pressure which is how much pressure is in your blood vessels when the heart contracts, and the diastolic number (lower one) is when the heart is between contractions (beats).  Isolated systolic hypertension is when the lower number is normal but the upper one is too high, over 140. It was medical dogma, undisputed truth, that as long as your lower number was below 90 you were OK and it was fine if the upper number were a little high all the time or occasionally even higher. in 2013, doctors now KNOW  that having a high upper number and a normal lower number can be even more serious, leading to heart attack, stroke, dementia, and kidney failure. The difference between the upper and lower number is called the pulse pressure and that can do a lot of damage if it is too great. We were certain 20 years ago that it was not important, and today that is it very important. Who knows what will be true in 10 years.

When I was training in surgery there were a lot of partial gastrectomy operations being done (stomach removals) for ulcer disease.  Today we believe that ulcers are caused by the presence of a bacteria, Helicobacter pylori, and we treat it with antibiotics and drugs like Zantac, and Prilosec.  Partial or complete stomach removals are rare.

Every other medical ad on TV is for either Erectile Dysfunction or low T (testosterone).  We have a "pill" solution for everything that ails you, except that most medications when studied, are not much more effective than PLACEBOs.  Placebos are sugar pills.  Medical trials for drugs always involve dividing patients into two groups, one that gets the real drug and the other that gets the sugar pill. It should come as no surprise  that sugar pills are effective a large percentage of the time, sometimes more than the real drug, and have no side effects. The FDA reports the sugar pill success rate and compares it to the real pill success.

This list is endless.  From the "remission" rate for chemotherapy, in which oncologists don't tell you that it is often not much better than alternative medicine , yet can kill you with side effects, to the promise that a pill can help you stop smoking but one of the minor side effects is that you might commit suicide.  The smart yet profit driven drug companies no longer go as often to doctors offices with armloads of samples like they used to, they market directly to patients on TV and the internet.  They want you to go to your doctor and demand their product.  Depressed? Fat? Smoke? Tired? We got you covered.  Just ask your doctor for XYZcillin, and you will feel better and live forever even if you continue to eat three meals a day at McDonald's.  Unless, you get one of the side effects like acne, itching, death, etc.  I just love it when they advertise antidepressants and one of the side effects is depression and suicide.  As for the sleeping pills (the one with the butterfly for example) you might get out of bed in the middle of the night, without knowing it, a go out and hold up a convenience store.  Now that's a side effect I can do without.  There are safe alternatives to most medical care.  There are some medical procedures and drugs that are absolutely life saving.  Knowing the difference and not just accepting medical dogma without doing your own research can cost you dearly.  If you are smart enough to shop online for a new computer or fashions, you are smart enough to learn about your health.  Pick wisely and go to websites that are government of famous universities like Mayo Clinic for example.  You will get the best information available today, but tomorrow the medical dogma may be a complete 180 degree reversal.  It's happened before.

MIRACLE in the Liquor Department

T E X T I N G WHILE DRIVING

If you are driving along in traffic and you are tempted to TEXT while driving, remember that sometimes the vehicle in front of you can come to a stop and you may run into or under a big truck like the Corvette in the photo above unfortunately did.  The outcome to the driver in the Corvette is obvious.  Use your head, don't lose it.

TAKE THE DOORS OFF

MORE than a metaphor but ALSO a metaphor for life, in the JEEP community, aficionados take the doors off their Wranglers to get closer to nature.  Next time you drive down the highway in your car, looking at the world through the windshield, surrounded on all sides by glass and steel, try to think about the difference between experiencing the world this way and the world you get by watching TV. For me, they are both two dimensional with all of my senses dulled.  With TV you get electronic sound, usually from 5 watt speakers, a flat screen which is still flat even if you simulate 3-D, and no smells or tastes unless you have a bowl of chips in front of you.  The same goes for the enclosed car.  In nature, you get all the sounds and smells, both good and bad, you feel the wind and the temperature and it is all in 3 dimensions.  There is depth to the world.

When you are out at dinner and you toast with glasses or wine, you clink them together.  Do you know why? You can see the wine, smell the wine, taste the wine, and with the "clink" you hear something too.  It completes the sensory experience.  Why go through life in other areas incompletely savoring the moment? Sure, it is comfortable watching MTV in the comfort of your media room with its nearby bathroom, but can it compare with being in the front row of  a rock and roll concert?  Or being at the game on the 50 yard line?  Some of these things may be impractical because they are so expensive compared to picking up the remote, but if we do that in everything because we don't want to leave the comfort zone or have some other rationalization,  our lives will be 2 dimensional.  Why not just look at a picture of a glass of wine? Facebook is not real life.

Take the doors off, fold down the windshield and start living in a 3-D world, and I mean the real one, not the one Steven Speilberg sells.

What next? Rubber Knives?

An article in our local newspaper about another school tragedy begs the question(?)...  Is it the weapon or the jerk behind the weapon that the law must deal with?  Personally, I do not want to live in a society where they take away all sharp things, things that go "Bang!" or pointed objects.  First of all, Lady GaGa's or Madonna's metallic bullet bra would be history Katey Perry would have to retire.  Bang-Bang Shrimp at Bonefish Grill would require a background check.  And being sharp witted with an acerbic tongue would likely be illegal, at least in New York.  The world would not be a fun place to live.  Watching LeBron stuff a NERF basketball just won't have the same impact, but then again, those hard basketballs can be dangerous.  We already removed dodge balls from the curriculum.  Pass the butter.

DUMB BELLS

No, I was not making social commentary as I usually do, this article is about fitness and resistance exercises.  It is  incontrovertible that some from of fitness activity is necessary for a healthy life.  What form that takes is up to you.  The best overall fitness activity is taking a long brisk walk with some friends.  All you need is a comfortable pair of walking shoes or sneakers, and if you do not wish to be arrested for indecent exposure, I recommend some clothes.  TV advertising tries to get you to buy some fancy-schmancy product or other that will magically get rid of all manner of physical imperfections from thunder thighs to muffin top. There is no form of exercise that targets a particular area of the body to spot reduce.  For a person to reduce a large bedonkydonk (country and western term) or booty, overall weight or fat loss is needed.  Of course you can always change your name to Kardashian and celebrate it.  Same goes for waist lines, and beer bellies.  You can do sit-ups 'til next year and your "spare tire" will remain as long as your body fat percentage remains the same.  Those people with six pack abs got them from being slender not using the magic gut-buster wonder chair.

Pure weight loss is not desirable if you lose as much muscle as you do fat.  Ideally, changing the body fat percentage in the direction of leanness is preferred even if your weight remains the same (assuming you are in a normal range), you will be healthier and more attractive.  To do this it takes more than starving oneself or eating Nutrasystem or similar foods (which have their place).  A fitness activity that has the potential to increase muscle strength and size and reduce the fat content of the body works for two reasons.  Muscles are more dense and take up less space than fat, and when you have more muscularity, these muscles require more calories to keep them alive than fat which sits there like a cactus in a clay pot requiring little or no attention.  Muscles burn calories day and night even when they are not being used.  Women, don't worry, you won't bulk up doing weight lifting exercises unless you consider Michelle Obama's arms "Bulked-up." If that is the case and you are offended by Mrs. O's sleeveless dresses, stop reading and go to Ben and Jerry's.

Those grotesque muscle magazine men and women have done everything they can to look that way.  They reduce their body fat content to dangerous levels (we need body fat to survive) work out incessantly, and take performance enhancing drugs and supplements in most cases. They think it looks good to have veins standing out everywhere like a 3-D road map. If that is not for you and you just want to feel better and look better, in addition to being involved in some sport like tennis or swimming if you wish, and taking the aforementioned long walks, a few "resistance" exercises might be a good idea.  They can be done without any weights at all by doing push-ups, chin-up, deep knee bends, and let's not forget the most important of all...putting down the fork and pushing yourself away from the dinner table before the second helping.  But I digress.  The photo at the top of this article is of a pair of dumb bells.  They are inexpensive and easy to operate.  A hat is also easy to operate and yet we see folks everywhere who can't figure out that the bill or brim goes in the front so I will briefly explain about weights and resistance.  First of all, I am not talking about political resistance I refer to resistance against gravity.  A dumb bell weighs from one pound to 100 pounds or more and you pick the weight to use based upon the exercise you are doing and how easy the dumb bell is for you to lift.  If you can only lift it once it is too heavy.  If you can lift it 50 times it is too light. Somewhere in between is the weight for you for that exercise.  I will help you figure that out  In the next article I will tell you more about why resistance is good.  In the mean time, it is also good to have "sales" resistance when it comes to giving your credit card number to the TV hucksters selling you the latest gizmo that they imply will make you look like the supermodels on their advertisement, become popular, have great sex, and drive a BMW.

SUNSHINE STATE CARS

Not all cars in Sarasota are Mercedes but in some parts of town it seems that way.  What is an almost universal truth is  that the vast majority of cars of all brands are white.  This is not so much a style choice but a deterrent to people who want to fry an egg on the hood of your car.  In the summer, one could be a short order cook on the black car, not so much on the white ones.  This group of 5 cars is pretty much statistically correct... in Florida, 4 out of five cars are white and the black one is probably some visitor from Canada.  Eh?

They call it the sunshine state for good reason.  They wanted to call it the "You Will Spontaneously Combust in July" state but it would not fit on the license plates. Hence the reason that when the Canadians head north to go back to the temperate climate of Ontario, folks like us go north to the mountains of North Carolina, or our beloved Nantucket.

The ART and SCIENCE of MEDICINE

The guy in this photo is Andrew Weil, M.D.  He is a "guru" of integrative medicine, a pop culture doctor who combines Eastern (oriental) science and medical traditions with Western (he graduated from Harvard College and Harvard Medical School) medicine and technology. Clearly he has a style all his own with the Santa Claus beard and the mandarin collar shirts.  Though I keep up with the major technological advances in medicine and society, I have never fully bought into the "newer is better" approach to anything.  Cars that almost drive themselves are nowhere near as fun as a gas guzzling V-8 powered stick shift hot rod with an a.m. radio.  Computers are fun but often I just enjoy writing longhand in a journal.  MRIs and CT Scans can tell you a lot but they are no substitute for spending time talking and listening to patients and doing a really thorough physical exam.

We could shut down half of our hospital beds in this country if Americans would make some common sense life style choices and show some discipline.  In today's society where nobody is responsible for their lot in life, morbid obesity and type 2 diabetes run rampant though our population.  Being 100 pounds overweight is never your fault and the only way to solve everything is another government program. Between smoking, drinking, illicit drug use, overeating, under exercising, not wearing helmets (motorcyclists) and seat belts, and unprotected sex of the type we are taught is normal on TV (typical hook-up involves instant sex with total strangers) our hospital beds and emergency rooms are overflowing.  None of this is our fault, everybody gets a trophy, and high self-esteem is our most important goal. Let's just spend more money on medical care and give it to everyone.  It's only fair. Pounds and pounds of cure and not an ounce of prevention.

As a weak human being myself, filled with flaws and moments of disciplinary cluelessness, I understand.  Nevertheless, each and every one of us is responsible for our lives and health.  We get to choose the McDonald's cheeseburger (250 calories and $1) instead of the  $5 Humongo whopper with three burgers, bacon, extra cheese and ranch dressing. You have to be an anaconda to open your mouth wide enough to take a full bite of one of those sandwiches.  Dr. Weil is far from perfect and he admits to this in his teachings and writings.  But, he tries to do the right thing most of the time and sincerely instructs others to do the same.  So next time you get in your car, buckle up your seat belt.  Pass on that Frapuchino and have a plain coffee instead with a little cream.  I do not advocate a life of lettuce and rabbit food, but at least when you go to Wendy's, Mickey D's, or any other fast food place, try not to order the half cow on a bun dripping with melted cheese, a side of 1000 calories of french fries, and a 64 ounce cup of High-Fructose corn syrup.