March 3rd, 2008 by Dr. Val Jones in Uncategorized
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Ok, it’s no surprise why Dr. Val is leading a weight loss group
here at Revolution Health. She is a serious food lover. And for those of you who are equally smitten with all things gastronomical, check out the list of folks that I’ll be schmoozing with next month:
Daniel Boulud
Gary Danko
Dean Fearing
Gael Greene
Jess Jackson
Thomas Keller
Sirio Maccioni
Danny Meyer
Robert Mondavi
Robert Parker
Jacques Pepin
Paul Prudhomme
Wolfgang Puck
Ruth Reichl
Phyllis Richman
Mimi Sheraton
Martha Stewart
Jeremiah Tower
Charlie Trotter
Jean-Georges Vongerichten
Alice Waters
Tim and Nina Zagat
It’s the 30th Anniversary Celebration of the Inn at Little Washington! Let me know if you’re planning to be there… or if you’re just jealous.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 1st, 2008 by Dr. Val Jones in True Stories
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I was reading Keagirl’s latest post about a urology consult that she did in the psychiatric lock-down unit. Her patient was hearing voices – specifically that his left testicle was speaking to him. The good doctor was able to maintain a straight face through the exam and interview. There have been times when I suspect that my expression has given away my underlying feelings. A few of my awkward moments:
***
Dr. Val: Hello, Mr. R. I understand that you’ve had thrush in the recent past, and that your CD4 count has been as low as 25. Have you had any problems with thrush lately?
Mr. R: Oh, not at all. I found a way to cure it.
Dr. Val: Oh, very good. Tell me what works for you [expecting to hear ‘nystatin swish and swallow’ or ‘diflucan,’ I smile hopefully at the patient].
Mr. R: Well, basically since I started drinking my own urine the thrush has gone away.
Dr. Val: Oh… [pregnant pause] I see [scribbles note on clipboard as she takes one step back from the bedside.]
***
Dr. Val: [interviewing new patient in the inpatient drug detox program] So tell me a little bit about what brings you here today, Mr. S.
Mr. S: Well, you know, I have a real problem with crack cocaine, heroine, and alcohol.
Dr. Val: Yes, I see. Well, it’s good that you’re here now. [I smile genuinely].
Mr. S: But doc, I have to tell you why this all started.
Dr. Val: [Leaning forward, expecting a potentially important insight] Yes, what do you think is behind the drug addiction, Mr. S?
Mr. S: Well, I was born with a deformed penis and I think a lot of this has to do with my low self-esteem.
Dr. Val: Hmm. Well, I can see how that might be very challenging to overcome [eyebrows furrowing in a concerned expression mixed with mild awkwardness and some surprise].
Mr. S: I’d really like to show you what I’m talking about.
Dr. Val: Um… well, I uh… don’t think that will be necessary at this time. I trust you…
***
Nurse: [calling from psychiatric lock-down unit]: Is this the rehab consultant?
Dr. Val: Yes, I’m on call for rehab today.
Nurse: We have a man here with difficulty swallowing and we were wondering if you could take a look.
Dr. Val: Ok, what brought him to the psychiatric lock down unit?
Nurse: Well, he tried to kill a nurse at the transferring hospital – she got too close and he got a hold of her neck. But he’s not too hard to pry off because he has no eyes.
Dr. Val: No eyes?!
Nurse: Yeah, he cut them out several years ago during a psychotic episode. He used a piece of broken glass to gouge out his eyes and cut off his nose and ears too.
Dr. Val: Oh my gosh… that’s really terrifying. [Pauses with images of Silence of the Lambs floating through her mind] May I ask why he can’t swallow?
Nurse: I don’t know why he can’t swallow. That’s why I’m calling you.
Dr. Val: Well, I mean, how do you know he’s not swallowing? Did you see him choke?
Nurse: No he’s not drinking at all.
Dr. Val: Well, is there a cup next to him? Does he know it’s there?
Nurse: [silence]
Dr. Val: Ok, I’ll put him on my consult list…
***
You can’t make this stuff up.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 29th, 2008 by Dr. Val Jones in Uncategorized
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Happy leap year everyone! The Revolution Health experts have been blogging away furiously, and I haven’t done a Revolution Rounds in a few weeks (naughty) so without further ado – here’s a nice round up of the best of the Revolution Health blogs…
Health tips
Most vitamins and supplements are not necessary if you’re eating a healthy diet. Dr. Joe Scherger summarizes Harvard’s Men’s Health Watch and concludes that only Vitamin D supplements may be warranted for the general population.
Relationships require pruning. Mira Kirshenbaum suggests that if you’re in an unhealthy relationship, it’s best to get up the courage to cut it off.
Ever wonder which arthritis treatments work best? Dr. Jim Herndon has distilled the latest research.
Children need to be vaccinated against the measles. Dr. Stacy Stryer explains that measles can be deadly in 20-30% of the people who get it.
Calcium can strengthen your bones, but may clog your heart? Dr. Vivian Dickerson cautions women about taking too much of this vitamin.
Did you know?
Only one in four people recognize the symptoms of a heart attack. Dr. Joe Scherger describes how you can tell if you’re having one.
Restless legs syndrome might increase your risk of a heart attack. Dr. Steve Poceta explains why.
Stem cell research could be the key to unlocking the mysteries of how cancer develops. Dr. Heinz-Josef Lenz describes some promising new research.
Pit viper venom might be useful in reversing strokes. Dr. Olajide Williams explains that the venom can dissolve blood clots in the brain.
There is a real mind-body connection in health and disease. Dr. Joe Scherger explains how it impacts men with erectile dysfunction.
Nighttime anxiety might convey a survival advantage. Dr. Steve Poceta wonders if we worry more at night because the ancestors who did so, lived to procreate.
A hospital is being sued for denying a surgical procedure to a transgender female. Dr. Cole Brown is not sure that this is fair, since the procedure was not emergent.
Orthopedics Corner
Dr. Jim Herndon is a faithful friend and blogger. He has had a particularly fine week – so many of his posts are great that I thought I’d give you a little summary of them all in one place…
Americans spend as much on back and neck pain treatments as they do on cancer treatment. Jim discusses the incredible financial burden of back and neck pain and the disappointing efficacy rates of treatments.
Neck pain is fairly common and particularly resistant to treatment. Jim describes the prevalence of this condition.
Glucosamine does not seem to improve hip arthritis. Jim discusses the mounting evidence that the benefits of glucosamine are very limited if they exist at all.
Patients with spinal stenosis (narrowing of the canal that contains the spinal cord) may benefit from surgery.
About 10% of total hip and knee replacements require revisions. Before you have yours, be sure that your surgeon is experienced with revisions.
Kiddie corner
Dr. Stacy Stryer is also a faithful friend and excellent pediatrician and blogger. Her sound advice and empathic tone is a key to her success. Here’s what she has to say this week:
First of all, Dr. Stacy reports on the strange practice of a nursing mom on America’s Next Top Model TV show: she’s drinking her own breast milk. Yuck!
Studies show that parents spend more time with their first child. Stacy wonders if she’s been a neglectful parent of her younger child.
Measles is a fatal illness for up to 30% of children who get it. Sadly, measles is on the rise because parents have opted out of the MMR vaccine due to unsubstantiated fears of vaccine harm.
Depression in a parent might be a risk factor for poor health among their children. Dr. Stacy takes a fresh look at how to keep America’s children healthy.
Dr. Jim Hill explains why children who don’t exercise regularly may perform worse on academic tests.
And my final post of Revolution Rounds is from a couple of neurologists who relay a compelling story: they saved a woman’s arm from a mistake made by an orthopedist in Serbia!
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 28th, 2008 by Dr. Val Jones in Book Reviews
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In Fixing American Healthcare
, Dr. Rich explains that the major cause of rising costs in healthcare is an aging population that requires more resources. Though some have proposed that fraud and waste/inefficiencies are the primary sources of costs spiraling out of control, the truth is that they likely play a minor role compared to the tremendous costs of providing cutting edge treatments to an older and sicker US population. Dr. Rich argues that we don’t hear that much about the escalating cost of caring for older Americans because it makes us squeamish, so we instead focus on curbing costs due to fraud and waste. However, when fraud and waste are not the primary cause of increasing costs, enhanced attempts to quash them do not actually move the savings needle. Since certain groups are tasked with reducing escalating costs due to fraud (in particular), and their work does not result in savings, they must strive harder to find and punish those accused of fraud, perhaps even seeing fraud where it doesn’t exist.
Dr. Rich argues that true fraud is fairly rare, and that the majority of “fraud” cases involve people not complying with rules they had no knowledge of (in many cases even after asking about the rules from the people who made them). Other cases of “fraud” involve retroactive application of rules and then fining hospitals for not being in compliance before the rules were made. His assessment of the PATH audit debacle is quite interesting.
Now, obviously we want to decrease fraud and waste as much as possible – but in the midst of our desperate attempts to curb healthcare spending, we’ll need to have some honest and frank discussions about the elephant in the room: America is sicker than ever before, and we have developed expensive ways to cure/treat those sicknesses – ways that we can’t afford to offer everyone.
What should we do? Dr. Rich suggests that we come together as a nation and decide on some rationing rules. He argues that we’re already rationing our healthcare dollars in covert ways – let’s bring it out into the open so that it’s fair to everyone. Now, I doubt that this will sit well with Americans – but our current “system” is so dysfunctional that maybe the time for a rationing discussion has come?
In this climate of unlimited treatments and limited resources, the best option is to stay healthy as long as possible. That’s why I believe in preventive medicine, healthy lifestyle changes, and doing all that we can to avoid getting sick. In many cases (but certainly not all) eating healthy foods, exercising regularly, controlling our weight, getting our vaccines, and sleeping well each night can go a long way to keeping us out of the hospital. It’s not easy to get Americans to take care of themselves in this way, but I’d rather spend my efforts trying to get us fit than to have to debate rationing rules. In the end, however, we may need to do both. What do you think?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
