March 19th, 2009 by Stacy Stryer, M.D. in Uncategorized
Tags: April Fool's Day, Children, Humor, kids, laughter, Stacy Beller Stryer, stacy stryer, Stress
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It’s already March 19th and I don’t have any ideas for April Fool’s Day for my kids. I am desperate and need help. In previous years I have put gummy worms in their sandwiches, short-sheeted their beds, convinced them school was cancelled, given them mashed potatoes that looked like ice cream sundaes, and offered cookies with (fluoride-free, of course) toothpaste as the filling. Last year I tried to pretend I had broken my arm. While my adult friends believed me, my kids just rolled their eyes. So, as you can see, my ideas are not working anymore and I need something grand and convincing.
Humor has always been an important part of our family. When my children were younger, we used humor to convince them to do things they didn’t want to do. For instance, in order to get them to clean their rooms we would put shoes on our heads, walk to their rooms, and dump them in the closet. My older daughter’s favorite game was to dress up as Cinderella (in rags, of course) and have me shout orders at her — I was not allowed to say “please” because I was, obviously, the evil stepmother. It’s amazing how clean the playroom could become those days.
When my husband had a brain tumor, I used humor to temporarily destress an incredibly difficult time period. Those days it was not uncommon to see us eating jello through a straw, dessert before dinner, or ice cream without a spoon. One desperate day we all dressed up in our rain gear, with umbrellas, and took a shower together while singing, “I’m singing in the Rain.”
Last year my daughter had 2 friends spend the night before presenting a history project in a county contest. They had worked incredibly hard on this project while continuing their other demanding curriculum, and they were exhausted, nervous, and stressed. So I went to the store and bought shaving cream and whip cream. After dinner I sent them outside in old clothes and let them spray each other. They ran around for over an hour in the dark, laughing and playing. To this day they still talk about it.
Humor and laughter are an important part of our lives. They relieve tension, reduce stress, and provide us with a temporary distraction from unpleasant thoughts or lives. They allow people to forget about anxiety and pain, even if it’s momentary. Scientific studies that have even shown that humor improves overall health and, more specifically, the ability to fight off infections, decrease the risk of developing a heart attack, and improve blood sugar control . Psychologically, it has been related to decreased loneliness and depression, and improved self esteem and feelings of hopefulness . Laughter clubs and therapy have been developed and exist in and out of hospitals throughout the United States.
humor in our family (response to "smelly" fish)
So, now you understand why it is so important for me to find some new, more exciting April Fool’s Day gimmicks for my family – ones that will really make them laugh! I am willing to share my “Vanilla” Sundae recipe with you, which has been used by many extended family members and friends.
April Fool’s Day Ice Cream Sundaes
Ingredients:
1. Instant mashed potatoes
2. Chocolate sauce
3. Whip cream
4. Maraschino cherry
5. Vanilla ice cream
Make the mashed potatoes according to directions and let them cool. Use an ice cream scoop to put 2 scoops in a bowl. Top with chocolate sauce, whip cream and, of course, a cherry. Serve. Have real vanilla ice cream available to serve so the victim can actually enjoy dessert in the end.
March 3rd, 2009 by Dr. Val Jones in Health Policy, Opinion, Uncategorized
Tags: AHRQ, Candidate, Democrat, Dr. George Lundberg, HHS, Lundberg For Surgeon General, Obama, Severed Trust, Surgeon General, WHO
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Rumor has it that Sanjay Gupta is no longer in the running for the office of Surgeon General. Many people had voiced their concerns about his potential nomination (including Paul Krugman, Maggie Mahar, Gary Schwitzer, Dr. David Gorski, and myself) and it looks as if his lack of experience or training in matters of public health, along with a history of industry ties has put the kabosh on his nomination.
So who will be our next Surgeon General? It’s hard to say, but a petition is circulating on behalf of Dr. George Lundberg – a fine nominee for the position in my opinion. Let me explain why.
A review of Dr. Lundberg’s curriculum vitae easily establishes his professional qualifications for the position. Not only has he been one of the longest standing Editors-In-Chief of all the American Medical Association journals (including JAMA), and the founder of the world’s first open-access, peer reviewed online medical journal (Medscape Journal of Medicine) but has served in an advisory capacity to everyone from the World Health Organization, to AHRQ, the Joint Commission, Harvard’s School of Public Health, the Department of Health and Human Services, Food and Drug Administration and the Surgeon General of the US Navy. He is also a prolific and influential writer, having authored 149 peer-reviewed articles, 204 editorials, and 39 books or book chapters. Dr. Lundberg has a large and devoted national and international audience and is highly esteemed by all who know him.
Dr. Lundberg has provided editorial leadership since the mid 1980s in American healthcare reform, campaign against tobacco, prevention of nuclear war, prevention and treatment of alcoholism and other drug dependencies, prevention of violence, changing physician behavior, patient safety, racial
disparities in medical care, health literacy, and the ethics of medical publishing and continuing medical education.
However, what may not be obvious from Dr. Lundberg’s list of extraordinary accomplishments, is his extraordinary character and wisdom. I had the privilege of working with George at the Medscape Journal of Medicine and reported directly to him. From this vantage point I was able to to observe his impartiality, his commitment to honesty and integrity, and his ability to walk the line between inclusivity of opinion and exclusivity of falsehoods. George is a defender of science, a welcomer of ideas, and an impartial judge of content. He can capture an audience, nurture imagination, and see through deception. George is exactly the kind of person we need as Surgeon General – he can be relied upon to discern truth, and maintain his faithfulness to it under political or industry pressure.
But best of all, George understands the central role of trust in healthcare. In his recent book, Severed Trust, George analyzes the policy decisions that have shaped our current healthcare system, and laments their inadvertent collateral damage: the injury to the sacred trust between physicians and patients.
If we want to come together as a nation to restore hope and trust in America – and we want to create an equitable healthcare system that leaves none behind, restores science to its rightful place, and heals the wounds endured by both providers and patients, then we need a Surgeon General like George Lundberg to help us.
I can only hope that his candidacy will be given the full consideration it deserves.
February 23rd, 2009 by Dr. Val Jones in Expert Interviews, Health Policy, Uncategorized
Tags: AARP, AMA, Becky Patton, Bill Novelli, Dr. Nancy Nielsen, Fiscal Responsibility Summit, Rich Umbdenstock
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Today there was a Fiscal Responsibility Summit held at the White House. Bill Novelli, CEO of the AARP attended the summit as part of the work group on health. Bill reported what he observed in his work group (which consisted of notables such as Senators Baucus, Rangel, and Specter, Nancy Pelosi, Nancy Nielsen, MD, Becky Patton, RN, Rich Umbdenstock and others) on a special media conference call today.
The over-arching theme of the work group discussion, according to Bill, was prevention and wellness. The group agreed that the key to improving Americans’ quality of life and controlling the costs of chronic disease lies in preventive health efforts. In addition to this belief, the group agreed that:
1. Healthcare reform must be achieved as quickly as possible. The path to long term entitlement sustainability requires healthcare reform. Simply expanding access to a broken system is not the solution.
2. The American people need to be engaged in reform efforts – not just as patients, but as tax payers and voters. They need to understand what they will gain and lose.
3. We must reward adherence to best practices and healthcare quality.
4. A public-private partnership is critical to achieving reform.
A few interesting points were raised by various stakeholders in the meeting:
1. Arlen Specter – believes that changes in medical approaches to end-of-life care could decrease costs substantially. He called for more advanced directives, and education about end-of-life care options.
2. Dr. Nancy Nielsen – called for Medicare to fix the physician fee schedule.
3. Becky Patton – called for increasing the nurse and healthcare workforce.
4. Rich Umbdenstock – requested that more attention be focused on pay for performance and administrative simplification initiatives.
I asked Bill how many providers were included in his work group, and he mentioned three (Nielsen, Patton, and Umbdenstock – not really a provider himself). Best I could tell, there was only one physician and one nurse at the meeting. And that is fairly shocking to me.
If healthcare reform is happening without much input from the primary providers of care (doctors and nurses) – will the reform decisions made by these well-intentioned individuals make good clinical sense?
Another reporter asked Bill what he thinks will happen with healthcare reform in the near term. His answer was telling: “We don’t know.”
February 19th, 2009 by Dr. Val Jones in True Stories, Uncategorized
Tags: Bob Schieffer, Dr. Val Jones, Face The Nation, HUD, Shaun Donovan
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Shaun Donovan
Bob Schieffer may be dipping his toe into the micro-blogging phenomenon that is Twitter. I can only imagine how little time he has for this kind of thing, being that when I last interviewed him, he had about 500 emails/day to triage.
But he tried an interesting experiment today – asking the Twitterverse what they’d like him to ask HUD Secretary Shaun Donovan on Face The Nation this Sunday. I suggested that most Americans were probably curious to know who qualifies for federal assistance with their mortgages.
What would you like Bob to ask Shaun? You can make suggestions or follow Bob on Twitter: @bobschieffer
And for a bit of trivia – it’s a small world after all – Shaun Donovan’s younger sister went to medical school with me. She has kindly hosted me at her apartment in New York City on numerous occasions – so it seems that her whole family is directly involved with housing people of all walks of life – even bloggers.
January 29th, 2009 by Stacy Stryer, M.D. in Health Policy, Uncategorized
Tags: dangers of vaccines, haemophilus influenza, haemophilus influenza vaccine, Hib, pneumoccoccus, pneumococcal vaccine, Stacy Beller Stryer
1 Comment »
By Stacy Beller Stryer, M.D.
Just last week three parents in my practice either refused or asked to alter the recommended vaccine schedule for their infants, and so far this week there have been another two. None of them have had good reasons, and none had truly researched the pros and cons of having their child receive each vaccine. The other day there was a memo on my desk, from the American Academy of Pediatrics, which discussed 5 children under age 3 years who had developed haemophilus influenza (Hib) in Minnesota last year, one of whom died. Three of the children who became ill, one of whom died, were unimmunized because of parent refusal. Another had a recently diagnosed problem with the immune system, and the last hadn’t finished the Hib series at the time of illness.
It is difficult to hear these parents refuse the vaccine, and, although asked by parents, I cannot choose which vaccines they should get now and which they should get later because all are potentially deadly. If only parents could see what I saw as a medical student and resident, before there was the widespread use of the Hib vaccine, and before the development of the pneumococcus vaccine. If only they could see the infants and toddlers admitted with terrible infections, such as meningitis, where some developed permanent brain damage or total hearing loss, and others were not so lucky. Or the children who developed epiglottitis and could barely breathe, where even asking them to open their mouths or agitate them by examining them was risky and could cause respiratory collapse. Or those who developed arthritis in their hip or bones and received antibiotics for weeks, hoping that they would not need surgery or develop permanent damage. And, of course the many children who were admitted to the general ward or intensive care unit with pneumonia and significant respiratory distress. These are just some of the things I saw before the development of these two vaccines, most of which I just do not see anymore.
According to the Centers for Disease Control, before the widespread use of the vaccine about 15 years ago, Hib occurred in over 20,000 children per year, and about one in 200 children under age 5 years developed meningitis, with 25% of those affected developing permanent brain damage. Since the use of the vaccine, the number has dropped dramatically but is now beginning to increase again because parents are not immunizing their children adequately. The Hib vaccine prevents against infections such as meningitis, epiglottitis, septic joints, bone infections, soft tissue infections and pneumonia. There are no known serious side effects to this vaccine. The pneumococcal vaccine prevents against pneumonia, sinusitis, ear infections, meningitis, and soft tissue infections, among others.
Not only do parents harm their own children refusing a vaccine, but they also harm others. If parents don’t immunize their children, they are at greater risk of becoming ill with serious illnesses, are more likely to infect others with these infections, decrease the general “herd” immunity in the community, and may need to be excluded from school or other activities during outbreaks with vaccine-preventable illnesses. I am asking you to read about these vaccines, look at the research on their association with autism, ask your physician questions (we did spend seven years in medical school and residency learning about this), and make an informed decision. I am confident that, if you educate yourself, your decision will be the right one.
