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Latest Posts

How To Reach Your Fitness Goals Wirelessly

I recently come across BodyTrace, a nice way to combine a bathroom scale that wirelessly uploads and displays your weight and BMI and a website where you can track all the changes with visualized solutions. An excerpt from the description:

We are using the GSM network to transmit your weight to our website. We use these measurements to create weight and BMI charts and by combining this information with additional data that we collect (from food tracker, for example) we can better evaluate your progress and give you feedback on how to reach your goals.

They also have a collaboration with DailyBurn. You can read the whole story from the first idea on the blog.

See more examples of how Web 2.0 or social media can be used in fitness here.

*This blog post was originally published at ScienceRoll*

Can My iPad Help Me Be Healthier?

If you follow me on Twitter or read my personal blog, you probably know by now that I bought myself an iPad this week. The main reason I got it is because I’m a sucker for shiny new technology, but I also wanted to see if I could use it to help myself become a little less sedentary.

As I mentioned in my first two posts about fitness this month, there’s a growing body of research suggesting that a sedentary lifestyle is harmful to your health. I was interviewed about one such study a few months ago on the PRI show “The Takeaway,” and the evidence is fairly convincing: People who spend more hours watching TV also have a higher mortality rate than those who watch it less, even after accounting for exercise. Granted, it’s only a correlation, but the evidence converges quite well with several other studies.

But what am I supposed to do about it? My job requires me to spend long hours in front of a computer screen. If exercising a 30 or 40 minutes a day can’t prevent me from getting heart disease or cancer, what will? Some researchers, including David Dunstan, the lead researcher on the TV-watching study, suggest that just standing periodically, rather than sitting all day, can help a lot. That’s where the iPad comes in. Read more »

*This blog post was originally published at The Daily Monthly*

Home Or Office, Women Can Get Fit Anywhere

By Barbara Ficarra, RN, BSN, MPA

Good news: You can get fit and toned anywhere with simple exercises.

My good friend works at a major company in NYC and she’s fortunate since she’s able to hit the gym on her lunch hour. If you have a job that allows you the time to go to the gym, that’s great. Not everyone is that fortunate.

As women we have so many responsibilities and we’re so busy. Trying to juggle work, family and friends can be a struggle and it’s not always easy to find time to exercise.

Truthfully, you don’t need to belong to a gym to exercise. Just keep moving. Whether you’re a stay-at-home mom or if you sit behind a cubicle, it doesn’t matter who you are. There are simple exercises that you can do anywhere.

I asked fitness expert Karen Ficarelli to share some simple tips to help keep you toned, whether you’re at home working or at the office. Karen suggests these easy moves to help tone your butt, thighs, calves, abs, waist, back, arms, shoulders and thighs. Read more »

*This blog post was originally published at Health in 30*

Healthy And Fit Without Ruining Your Life?

I consider myself a relatively fit person. Of course, “relatively” is still relative. I try to watch what I eat. I usually exercise five days a week. Heck, I’ve even run a couple half-marathons. But the rest of my days are pretty much sedentary. I sit in a climate-controlled office staring at my computer screen. I make dinner in my highly-automated kitchen. After dinner I sit in the living room sipping wine and watching TV or talking to Greta. Then I go to bed and start the process over again.

That’s not a whole lot of activity for a creature that evolved for endurance. Over a 50 mile course, a race between a man and a horse can be quite competitive. Millions of people all over the world do hard manual labor day in and day out. But millions of others don’t set aside any time for exercise. In my half-marathons, I’ve finished in the top half of competitors, so compared to a lot of people, I must be doing something right. Right? Or do my sedentary days outweigh my occasional bursts of activity? I exercise an average of 4 hours per week. That’s less than 4 percent of my total waking time. Is that really enough to stay fit? Read more »

*This blog post was originally published at The Daily Monthly*

Latest Interviews

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work

It s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction burn out and even suicide. In fact some believe that up to a third of the US physician work force is planning to leave the profession…

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Latest Cartoon

Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

***

Click here for a musical take on over-testing.

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Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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