First off, let me say that I have strayed far from the medifast plan. With the stress of last week, I had wine more than I should (which is never), and that often led to late night munchies. Yes, I fell off the wagon. Weird, my back hurt worse this week than it has in a while, and I've felt yucky. Hmmm, any connection. Have I mentioned that I'm actually allergic to brewers yeast? Well, I am. Wonder why I feel bad when I'm drinking wine? It's a problem I may never solve.....
But, I'm back on the old wagon today! I had my medifast meals, and had lean and green for dinner. No wine tonight despite having the phones go out at the office today. Yes, indeed, last week the technology gods graced us with computer nightmares all week, and this week, the communication gods have taken out our phones. But, hey, we had incoming fax capability for a whole day!!! Woohoo!! Please be patient with your doctors, ladies and gentlemen, if they do not respond to your queries in a timely manner - we have to deal with stuff like this on a daily basis. UGH!
Phil made dinner tonight, and it was AMAZING! He made two different dishes because he couldn't figure out what he wanted. The first was shrimp with XO sauce and mushrooms. (XO sauce is made from fermented scallops, soy sauce, sugar, and some spices - sounds terrible, but it's SOOOO good!) He also made oysters in a scallion and garlic sauce with just a spoonful of hoisin sauce. He served both of these in "lettuce wrap" form with spaghetti squash, and cilantro as a filler and sriracha or garlic chili as a condiment. It was so good. Just like eating at a traditional Chinese restaurant - not local Chinese, but Chinatown Chinese. Yummy. I'm going to finish the night with some vanilla pudding with a little sugar free chocolate sauce and peanut butter mixed in. To drink - NO WINE - just big glasses of water.
The kids had steak and roasted fingerling potatoes with cucumbers. They are showering, homeworking, practicing piano, finishing projects, and getting dessert. It's SOOOO nice to be home in the evening for a change. Phil is sleeping on the couch as he's just gotten off of a nights only work week. 7pm-7am for 7 days, plus with the computers and wrestling tournaments, he wasn't able to sleep during the day much. He's exhausted. I am too, but feel kind of bad complaining after the week he's had. Good thing I have a blog.
Among my stresses in the past couple of weeks was a young girl who presented to my office after having had intercourse for the first time. I hope no one who reads this thinks I'm talking about their child. Honestly, at least once to twice a week, I see something like this. I wanted to bring this up in my blog because these things disturb me on so many levels. When I have a girl in the office for a well child appointment at age 12, I kick the parents out and have a good heart to heart with her. I discuss sex, drugs, and rock and roll. More importantly, I discuss respect for yourself and safety in sexual and party type situations. To some of you, age 12 might seem kind of young for this discussion, but after you've delivered a couple of babies to 12 year olds (realizing that they had sex at 11), you start to think differently. Anyhow, this was one of those girls that I'd had the discussion with some years ago.
I was upset because I always feel like I've failed when a young girl comes in after having made such a poor decision. I enjoy adolescent medicine because I am a big proponent of primary prevention. I really feel like if I can get involved in a young person's life and educate that person, I could really make a difference to them. I discuss herpes, genital warts, HIV, pregnancy, statistics, condoms, love, orgasm, and again, RESPECT. It's not so much the sex itself, it's the way it was handled. There was no protection used at all. I asked the girl if it was her boyfriend, and she said, "No, just some guy." It was very disappointing to me. Honestly, I would have felt better if the girl had said, "Yes, I really love him!" Even if she is young, I would have liked it better if there was a "good" reason. She was not upset about it, nor was she happy - it was what it was. So strange. I'm not old fashioned, I just wish that more girls would have more respect for their bodies and their reputations.
Anyhow, I was also upset because I realize how close my daughter is to that age. I've been discussing sex with her for some time. She asks questions and I answer them honestly. I'd rather that I answer them than have her ask her schoolmates and get poor answers. It is always in the back of my mind, though. Growing up, I thought that only the "bad" kids were having sex in Middle school and early high school. As a doctor, I realize that poor decision making does not have educational, socioeconomic, or religious boundaries. It scares the living hell out of me that my daughter and her friends are 1-2 years away from being faced with these kind of decisions. Some of Emma's classmates are already wearing padded bras, high heels, makeup, and suggestive clothes. There are a lot of middle school kids that look like they're in their 20s.
Maybe it was the circles that I ran in, but I don't remember as much pre teen sexuality when I was a kid. I know one girl who got pregnant in middle school, and she dropped out. We all thought she was a REALLY BAD girl. Maybe I'm wrong. Maybe it was going on and I just wasn't aware. I know people were having sex in high school. I wasn't, but I didn't think people were so bad who were. But, Middle School? Really? Are these kids mature enough to make that kind of decision? I certainly don't think so. I can't imagine Emma making this kind of decision next year or the year after or 5 years from now.
Maybe I am old fashioned. I don't know. I just hate to see these young girls coming into my office with such poor attitudes toward sex. I do have a lot of young girls who are making good decisions. I wish I could put my finger on what the difference is between these groups are. It's not education. It's not parenting. It's not socioeconomic status. What makes one girl have such little respect for herself and another girl not? I guess if I could figure this out, I'd be a millionaire and we'd have a lot fewer young women with pregnancies, cervical cancer, and herpes.
Anyhow, I guess this is for all the moms out there who have had to deal with this or will have to deal with it. I'm sending a big hug out to all of you because I know I'm going to need one when the time comes.
In the meantime, I'm going to enjoy Emma's youth and her youthful-ness and try really hard not to make her grow up too fast!
Dr. Mindy
Monday, February 28, 2011
Sunday, February 27, 2011
mi familia, or "musings with the top down"
Howdy!
It's a beautiful, sunny, 60 degree day today in Wild, Wonderful, West Virginia. I put the top down on the SAAB (1995, rotted seats, nothing works except the convertible top and the engine - who needs anything else?), and I drove my kids to Sunday School, then Kroger, then to the Old Brick Playhouse. OK, we all had coats on and the heater blaring, but it is spring weather, and I needed to bond with my heap of junk metal.
While cruising around, I had some time to ponder the last two weeks. They've been hellish, seriously. We've been running at full speed and had some amazing stress. It culminated yesterday at the Elkins wrestling tournament which Phil and I helped to host. Lee participated in the tournament AND he presented the colors in his Cub Scout uniform. He did an excellent job - didn't goof around with the flag at all. Emma participated in the tournament AND sang the National Anthem while Lee presented the colors. We were so proud of both kids.
The stress yesterday came because Phil had adopted a new computer program for the tournament. Everything was done online through Track Wrestling. It is a great program, and he really worked many hours over the last several months setting things up. All was set to run really smoothly. Unfortunately, just as we were getting started, we started having trouble with the Internet. It kept going down, and we all got nervous, so we started the tournament before we were ready. If we would have given Phil 30 minutes to do the brackets right, it would have been OK, but we were all pretty nervous about the whole thing, so we pushed him. SO, it was quite a mess for a while and people were really getting upset. In the end, we actually received a lot of compliments from coaches and parents. One man actually was very grateful. He said that his wife was ill at home, and she was able to log onto track wrestling from home and follow her son's progress in real time by watching the brackets. He said she was so excited - it felt like she was there. Despite all of the hassles, we managed to wrestle almost 300 kids and get all of them out by 3:00. Next year, we're going to have two wireless hubs instead of one, and hopefully, this won't be a big issue.
So, what does this have to do with the title of the post, you ask? Everything, I answer!
My mom and dad stayed the night Friday night so that Phil and I could set up. Also, we had to be there at 6:30 AM so that we could get the computers all set up and ready. Mom and dad were here to let the kids sleep in a little later. They came to the tournament with the kids, and kept them occupied when we were really having a hard time with the computers. Mom, ultimately, helped Phil to organize the bout sheets and to field questions that were being fired at him one after another. Dad made sure that the kids got to their mats and that they had someone cheering them on when it was their turn. Phil's brother Matt came by to help, too. He helped us troubleshoot some of the Internet problems and also acted as a runner - posting the brackets so that the parents could read them. Phil's parents offered to watch the kids when they were done wrestling so that Phil and I could finish working and cleaning up the tournament. Then, they watched Lee (who was completely exhausted) while Emma did her play that night and I attended.
The tournament takes a lot of people to run, and it turned out we needed even more hands because of the computer issues this year. If it had not been for our families turning up to help us, we couldn't have done our part of it. Every time I think about this, I get a little choked up. Seriously - I'm not even drinking right now. Phil and I are so insanely lucky in our lives. We have an amazing family who will do just about anything for us, and we would do the same in return. Often, we forget to let the wonderful people in our lives know how important they are to us, so we both took time yesterday to call our parents and Matt to let them know how much they were appreciated. Funny, they were all kind of like, "OK, whatever," because they didn't think that they'd done anything out of the ordinary. I guess they didn't. It's an ordinary thing to have a great family in this house.
Bottom line, as I was driving with my top down and my 6 year old was waving his arms and singing "Milkshake" in the back seat while something completely different was playing on the radio, and my 10 year old was grinning like a hyena, I gave a little prayer of thanks to the big guy. This is what life is all about.
Dr. Mindy
It's a beautiful, sunny, 60 degree day today in Wild, Wonderful, West Virginia. I put the top down on the SAAB (1995, rotted seats, nothing works except the convertible top and the engine - who needs anything else?), and I drove my kids to Sunday School, then Kroger, then to the Old Brick Playhouse. OK, we all had coats on and the heater blaring, but it is spring weather, and I needed to bond with my heap of junk metal.
While cruising around, I had some time to ponder the last two weeks. They've been hellish, seriously. We've been running at full speed and had some amazing stress. It culminated yesterday at the Elkins wrestling tournament which Phil and I helped to host. Lee participated in the tournament AND he presented the colors in his Cub Scout uniform. He did an excellent job - didn't goof around with the flag at all. Emma participated in the tournament AND sang the National Anthem while Lee presented the colors. We were so proud of both kids.
The stress yesterday came because Phil had adopted a new computer program for the tournament. Everything was done online through Track Wrestling. It is a great program, and he really worked many hours over the last several months setting things up. All was set to run really smoothly. Unfortunately, just as we were getting started, we started having trouble with the Internet. It kept going down, and we all got nervous, so we started the tournament before we were ready. If we would have given Phil 30 minutes to do the brackets right, it would have been OK, but we were all pretty nervous about the whole thing, so we pushed him. SO, it was quite a mess for a while and people were really getting upset. In the end, we actually received a lot of compliments from coaches and parents. One man actually was very grateful. He said that his wife was ill at home, and she was able to log onto track wrestling from home and follow her son's progress in real time by watching the brackets. He said she was so excited - it felt like she was there. Despite all of the hassles, we managed to wrestle almost 300 kids and get all of them out by 3:00. Next year, we're going to have two wireless hubs instead of one, and hopefully, this won't be a big issue.
So, what does this have to do with the title of the post, you ask? Everything, I answer!
My mom and dad stayed the night Friday night so that Phil and I could set up. Also, we had to be there at 6:30 AM so that we could get the computers all set up and ready. Mom and dad were here to let the kids sleep in a little later. They came to the tournament with the kids, and kept them occupied when we were really having a hard time with the computers. Mom, ultimately, helped Phil to organize the bout sheets and to field questions that were being fired at him one after another. Dad made sure that the kids got to their mats and that they had someone cheering them on when it was their turn. Phil's brother Matt came by to help, too. He helped us troubleshoot some of the Internet problems and also acted as a runner - posting the brackets so that the parents could read them. Phil's parents offered to watch the kids when they were done wrestling so that Phil and I could finish working and cleaning up the tournament. Then, they watched Lee (who was completely exhausted) while Emma did her play that night and I attended.
The tournament takes a lot of people to run, and it turned out we needed even more hands because of the computer issues this year. If it had not been for our families turning up to help us, we couldn't have done our part of it. Every time I think about this, I get a little choked up. Seriously - I'm not even drinking right now. Phil and I are so insanely lucky in our lives. We have an amazing family who will do just about anything for us, and we would do the same in return. Often, we forget to let the wonderful people in our lives know how important they are to us, so we both took time yesterday to call our parents and Matt to let them know how much they were appreciated. Funny, they were all kind of like, "OK, whatever," because they didn't think that they'd done anything out of the ordinary. I guess they didn't. It's an ordinary thing to have a great family in this house.
Bottom line, as I was driving with my top down and my 6 year old was waving his arms and singing "Milkshake" in the back seat while something completely different was playing on the radio, and my 10 year old was grinning like a hyena, I gave a little prayer of thanks to the big guy. This is what life is all about.
Dr. Mindy
Friday, February 25, 2011
projects and plays and wrestling, oh my!
I haven't been blogging much this week because it's been a very LONG and hectic week for us.
Phil is working as a hospitalist this week - nights. We've been like ships passing in the evening. He works 7pm-7am for 7 days straight. Normally, this works out OK. He goes home and sleeps for a while, then goes and runs errands that I'd normally have to do. It's actually kind of nice when he's on nights. The kids and I snuggle up in bed together and then we see him in the morning.
This week has been different. With the computers not working right, Phil has been up all night, then coming to the office to work on computers while I see patients. He's exhausted. I'm stressed because I'm totally type A and can't stand it when things aren't working right - especially if I have no control over it.
Plus, we've had Emma's social studies fair project to worry about, Emma is in a play that opened last night (quite cute), and Phil's wrestling team is hosting the home meet this weekend. We've been running around like crazy - crazier than usual - and we're both beat. My parents are staying with us tonight, though, to give us a little "break". Of course, this means that we have more time to go help set up for the tournament and get more of that stuff done, but it is well appreciated.
So, you ask, what has that done to our diet? Well, as for me, it was going really well until last night. I'd actually been so stressed that I didn't even want to eat. That's pretty helpful when you can only consume 1000 calories a day! Unfortunately, last night, a cheeky, cool, blonde Reisling began to flirt with me. In a moment of weakness, I succumbed to it's light beckoning. Just like all flirts, it just kept pushing me for more, more, more. Alas, once again, diet thwarted! Ah, well, better luck today!
I haven't had any really crazy good food ideas this week, either, because we've been running so much. I'm thinking about the Oscars and planning some food for that day. It would have to be fancy, and since Black Swan is so touted, I'm thinking duck....maybe in a plum sauce served cold over mixed greens with blueberry balsamic? Hmmm... I think I'm going to have to go find me a duck. Wonder if my shotgun's loaded? Is it duck season? Times like this, though, I wish I could have a little feta or blue cheese to crumble over the top of the salad. Mmmmmm...
I'm kind of hungry right now, and this is so not helping. It's time for my next medifast meal. I wanted the Maryland clam chowder, but Phil ate the last one, so I guess it's a shake.
That's it for today, I'll be back to somewhat normal next week.
Dr. Mindy
Phil is working as a hospitalist this week - nights. We've been like ships passing in the evening. He works 7pm-7am for 7 days straight. Normally, this works out OK. He goes home and sleeps for a while, then goes and runs errands that I'd normally have to do. It's actually kind of nice when he's on nights. The kids and I snuggle up in bed together and then we see him in the morning.
This week has been different. With the computers not working right, Phil has been up all night, then coming to the office to work on computers while I see patients. He's exhausted. I'm stressed because I'm totally type A and can't stand it when things aren't working right - especially if I have no control over it.
Plus, we've had Emma's social studies fair project to worry about, Emma is in a play that opened last night (quite cute), and Phil's wrestling team is hosting the home meet this weekend. We've been running around like crazy - crazier than usual - and we're both beat. My parents are staying with us tonight, though, to give us a little "break". Of course, this means that we have more time to go help set up for the tournament and get more of that stuff done, but it is well appreciated.
So, you ask, what has that done to our diet? Well, as for me, it was going really well until last night. I'd actually been so stressed that I didn't even want to eat. That's pretty helpful when you can only consume 1000 calories a day! Unfortunately, last night, a cheeky, cool, blonde Reisling began to flirt with me. In a moment of weakness, I succumbed to it's light beckoning. Just like all flirts, it just kept pushing me for more, more, more. Alas, once again, diet thwarted! Ah, well, better luck today!
I haven't had any really crazy good food ideas this week, either, because we've been running so much. I'm thinking about the Oscars and planning some food for that day. It would have to be fancy, and since Black Swan is so touted, I'm thinking duck....maybe in a plum sauce served cold over mixed greens with blueberry balsamic? Hmmm... I think I'm going to have to go find me a duck. Wonder if my shotgun's loaded? Is it duck season? Times like this, though, I wish I could have a little feta or blue cheese to crumble over the top of the salad. Mmmmmm...
I'm kind of hungry right now, and this is so not helping. It's time for my next medifast meal. I wanted the Maryland clam chowder, but Phil ate the last one, so I guess it's a shake.
That's it for today, I'll be back to somewhat normal next week.
Dr. Mindy
Tuesday, February 22, 2011
computers suck - period - kind of like school lunches
All hail my true blog followers. Sorry it's been a while. Our office is completely electronic. You now what happens when your doctor's office is completely electronic and the software fails? Your doctor ends up working 12-16 hours a day at the office taking care of computer issues instead of taking care of you. Yay government for forcing us to go to EHR!!! So, I've had two weeks with no fax, no labs, and only sparingly being able to use my medical record. Then, I spend the evenings trying desperately to get the practice partner support team on the phone to help me. What fun.
Anyhow, that's enough of that.
I think it's time for my school lunch rant. Bottom line, Jamie Oliver is my hero, and school lunches are horrible.
I don't know why the schools think that processed pre-packaged carbohydrate bombs are good for children. I had one educator tell me that they had to make sure that the school provided the daily caloric intake for children in two meals in case any children didn't have food when they got home. Don't get me wrong, I think that there are some kids for which this is an issue, but I think that this is completely ridiculous logic. Why should the 99 percent of the children be forced to eat large amounts of calories rather than taking the 1 percent on a case by case basis. Most of these kids not only go home to food, but are eating chips, little debbies, and chocolate milk when they go home.
The schools come back and say that they do have vegetables provided for the kids on a salad bar. True. And some kids actually do take a couple of grape tomatoes or cucumber slices to have with their mac and cheese and pepperoni roll. You know what else in on the salad bar? Ham chunks, jello (not sugar free), popsicles some days. You'd better believe that the kids take that stuff when it's available. I saw a kid the other day eating "soup". The soup was broth with chicken and rice in it - it could have been pretty good if they'd put a few veggies and less rice in it, but it was still an effort. Unfortunately, the kid took about 4 tablespoons of ham off of the salad bar and put them in the soup - he said it made the soup taste better. OK. It probably did. But, if he'd just had some veggies on the salad bar, that wouldn't have happened.
Jamie Oliver did his show from Huntington, WV, because it's the fattest city in the country. Oh, how we love these hills. The absolute fervor that his show caused was amazing. People were SO angry that someone would actually try to teach them how to cook healthful meals for the children. The cafeteria workers at first hated it because they had to actually, (gasp) cook! (Instead of just reheating). The schools didn't like it because they had all of the wonderful USDA food already in storage. BTW, the USDA food is really cheap for schools. It cannot be destroyed or given away once purchased, so that does put a school in a bind. Also, they feared it would cost much more. Turns out it didn't, and the project went well. The schools where the food was changed actually had over 50 percent reduction in discipline issues and an increase in test scores? Why? Probably less hyperglycemia post breakfast and lunch and less hypoglycemia 2 hours later. The kids interviewed at that school actually didn't know what certain raw vegetables were. Sad.
Another thing that blew my mind in this special was that the school considers french fries a vegetable. Potato = vegetable, therefore french fries = vegetable. That's the USDA for ya right there. Potatoes, peas, and corn are starches, people, not vegetables. You cannot give a child a hamburger, corn, and french fries and expect them to feel well as the day goes on!!!
As Jamie Oliver has seen, try getting anything changed in the WV school system, and you're in for a lot of heartache. I have mentioned my concerns before, and many people support me, but it's like climbing up a down escalator. Many of the parents are not educated, and many don't really care. We have such a huge problem with obesity in this state (and the country - something like 60% of people in the country are overweight?) and we just keep fighting this uphill battle.
I had a patient today that told me that she keeps gaining weight because she can't afford healthy food and she can't have 6 small meals a day because she has to make her food stretch. She gains weight every time she comes in the office. I try to be understanding, I know that healthy food costs a little more. I also know that you can make a big pot of beans for about 1.50 and eat that instead of the pasta or white bread sandwiches. Also, nuts are pretty cheap as is the Kroger brand yogurt. You can get meat at shop and save 5 packages for 25 dollars. Fresh veggies are expensive, but frozen ones can be cheap if you look for the sales. I don't think that not having enough money is an excuse to be fat. I think it's an excuse to be skinny. No matter what your income, if you consume more calories than you expend, you'll gain weight.
People today blame the obesity crisis on video games and television. Yes, this is part of the problem, but it's not the whole picture. Most of the people going on about it are sitting at their computer eating a bag of ruffles when they complain. Is this a generalization? Of course!!! That's my prerogative because it's MY blog! Ha!
I have been fired by more patients than I can shake a stick at because I tell them, there is no magic pill. There is no magic wand. You have to take responsibility for your health. I can't do that for you. I can't come to your house and clean out your cabinets and refrigerator. I can't make you eat less or better. I can only educate you (and I do) and ask you to try a little harder.
So, as for school lunches....
Another school in NY City (I think) had really poor test scores and discipline problems. The new principal made the school stop with the processed foods and simple sugars. They had whole foods only with breakfast and lunch as well as whole grains. The children were not allowed to bring in anything from home that didn't meet the guidelines. Within a year, they had very few discipline problems and the test scores improved dramatically. Why? Well, I think I've already addressed this.
There is protein in the urine of people who have schizophrenia and autism that goes away when gluten is removed from the diet. Symptoms also improve when this happens. Doesn't mean much by itself, but it does imply that the things we put in our body may affect our psychiatric condition.
How can we expect the schools to provide a healthful environment for our children when we aren't doing it at home? How can we expect anything when the FDAs food pyramid is based on grains??? It is completely asinine. We need to make changes within our own homes, then move to our friends, family, and then to the community. People need to understand that if they think health care costs are high today - wait until these children who are diabetic, hypertensive, and hyperlipidemic at age 10 turn 60. If they do. We are killing ourselves with school lunches, fast food, and supersized meals.
I feel kind of like Susan Powter (sp?) right now - STOP THE INSANITY! (I'm not going to give myself a crew cut, though.)
Phil and I would love to open a community center here in Elkins. We have a dream of a place where kids can go after school and have active things to do, nutrition classes, healthy snacks, education for parents - maybe some cooking classes for kids and parents. We have seriously considered this, but realized that we don't have the time to run it because we'd have to have full time certified helpers, food handlers cards, insurance, liability waivers, etc... God forbid we just try to make a healthful place for kids to go in the community. They Y does a good job, but they have to charge and not everyone can afford it.
Anyhow, that's my rant for today. I'm a little disjointed due to also working on computers during the writing of it.
Dr. Mindy
Anyhow, that's enough of that.
I think it's time for my school lunch rant. Bottom line, Jamie Oliver is my hero, and school lunches are horrible.
I don't know why the schools think that processed pre-packaged carbohydrate bombs are good for children. I had one educator tell me that they had to make sure that the school provided the daily caloric intake for children in two meals in case any children didn't have food when they got home. Don't get me wrong, I think that there are some kids for which this is an issue, but I think that this is completely ridiculous logic. Why should the 99 percent of the children be forced to eat large amounts of calories rather than taking the 1 percent on a case by case basis. Most of these kids not only go home to food, but are eating chips, little debbies, and chocolate milk when they go home.
The schools come back and say that they do have vegetables provided for the kids on a salad bar. True. And some kids actually do take a couple of grape tomatoes or cucumber slices to have with their mac and cheese and pepperoni roll. You know what else in on the salad bar? Ham chunks, jello (not sugar free), popsicles some days. You'd better believe that the kids take that stuff when it's available. I saw a kid the other day eating "soup". The soup was broth with chicken and rice in it - it could have been pretty good if they'd put a few veggies and less rice in it, but it was still an effort. Unfortunately, the kid took about 4 tablespoons of ham off of the salad bar and put them in the soup - he said it made the soup taste better. OK. It probably did. But, if he'd just had some veggies on the salad bar, that wouldn't have happened.
Jamie Oliver did his show from Huntington, WV, because it's the fattest city in the country. Oh, how we love these hills. The absolute fervor that his show caused was amazing. People were SO angry that someone would actually try to teach them how to cook healthful meals for the children. The cafeteria workers at first hated it because they had to actually, (gasp) cook! (Instead of just reheating). The schools didn't like it because they had all of the wonderful USDA food already in storage. BTW, the USDA food is really cheap for schools. It cannot be destroyed or given away once purchased, so that does put a school in a bind. Also, they feared it would cost much more. Turns out it didn't, and the project went well. The schools where the food was changed actually had over 50 percent reduction in discipline issues and an increase in test scores? Why? Probably less hyperglycemia post breakfast and lunch and less hypoglycemia 2 hours later. The kids interviewed at that school actually didn't know what certain raw vegetables were. Sad.
Another thing that blew my mind in this special was that the school considers french fries a vegetable. Potato = vegetable, therefore french fries = vegetable. That's the USDA for ya right there. Potatoes, peas, and corn are starches, people, not vegetables. You cannot give a child a hamburger, corn, and french fries and expect them to feel well as the day goes on!!!
As Jamie Oliver has seen, try getting anything changed in the WV school system, and you're in for a lot of heartache. I have mentioned my concerns before, and many people support me, but it's like climbing up a down escalator. Many of the parents are not educated, and many don't really care. We have such a huge problem with obesity in this state (and the country - something like 60% of people in the country are overweight?) and we just keep fighting this uphill battle.
I had a patient today that told me that she keeps gaining weight because she can't afford healthy food and she can't have 6 small meals a day because she has to make her food stretch. She gains weight every time she comes in the office. I try to be understanding, I know that healthy food costs a little more. I also know that you can make a big pot of beans for about 1.50 and eat that instead of the pasta or white bread sandwiches. Also, nuts are pretty cheap as is the Kroger brand yogurt. You can get meat at shop and save 5 packages for 25 dollars. Fresh veggies are expensive, but frozen ones can be cheap if you look for the sales. I don't think that not having enough money is an excuse to be fat. I think it's an excuse to be skinny. No matter what your income, if you consume more calories than you expend, you'll gain weight.
People today blame the obesity crisis on video games and television. Yes, this is part of the problem, but it's not the whole picture. Most of the people going on about it are sitting at their computer eating a bag of ruffles when they complain. Is this a generalization? Of course!!! That's my prerogative because it's MY blog! Ha!
I have been fired by more patients than I can shake a stick at because I tell them, there is no magic pill. There is no magic wand. You have to take responsibility for your health. I can't do that for you. I can't come to your house and clean out your cabinets and refrigerator. I can't make you eat less or better. I can only educate you (and I do) and ask you to try a little harder.
So, as for school lunches....
Another school in NY City (I think) had really poor test scores and discipline problems. The new principal made the school stop with the processed foods and simple sugars. They had whole foods only with breakfast and lunch as well as whole grains. The children were not allowed to bring in anything from home that didn't meet the guidelines. Within a year, they had very few discipline problems and the test scores improved dramatically. Why? Well, I think I've already addressed this.
There is protein in the urine of people who have schizophrenia and autism that goes away when gluten is removed from the diet. Symptoms also improve when this happens. Doesn't mean much by itself, but it does imply that the things we put in our body may affect our psychiatric condition.
How can we expect the schools to provide a healthful environment for our children when we aren't doing it at home? How can we expect anything when the FDAs food pyramid is based on grains??? It is completely asinine. We need to make changes within our own homes, then move to our friends, family, and then to the community. People need to understand that if they think health care costs are high today - wait until these children who are diabetic, hypertensive, and hyperlipidemic at age 10 turn 60. If they do. We are killing ourselves with school lunches, fast food, and supersized meals.
I feel kind of like Susan Powter (sp?) right now - STOP THE INSANITY! (I'm not going to give myself a crew cut, though.)
Phil and I would love to open a community center here in Elkins. We have a dream of a place where kids can go after school and have active things to do, nutrition classes, healthy snacks, education for parents - maybe some cooking classes for kids and parents. We have seriously considered this, but realized that we don't have the time to run it because we'd have to have full time certified helpers, food handlers cards, insurance, liability waivers, etc... God forbid we just try to make a healthful place for kids to go in the community. They Y does a good job, but they have to charge and not everyone can afford it.
Anyhow, that's my rant for today. I'm a little disjointed due to also working on computers during the writing of it.
Dr. Mindy
Friday, February 18, 2011
Goodbye double D's
Goodbye double Ds
Though I hardly knew you at all
Or had the strength to hold you up
When bending o-o ver
When you were there,
Oh, Dave he hounded you
You were something more than special
More than just two lumps of fat
It seems to me, you lived your lives
Like two melons on a stump
Never knowing where to turn to
When you hit a bump
Oh I would've liked to know you when I was just a kid,
But my hormones burned out long before
My weight gain ever did.....
Soooo, the downside of losing weight is losing the boobs that I had so long waited for. For the first time in my life (even when breast feeding) I was above a B cup! Even though I was heavy, at least I could wear tight shirts and feel a little better about myself. Ah, well, with everything there is a price.
I have now officially lost 22 lbs since January 6th, 2011. I am sticking closely with medifast with just a few slides - mostly for wine. This week has been tremendously hard as our computer system has been all kinds of screwed up and we've had less than optimal patient care because of it. We found out yesterday that do to an improper conversion from one server to the other, we have lost the entire week's worth of notes and billing. What tremendous fun. That being said, I only had wine on Monday night and not since, so I think that's a big step! I'm fully intending on having some tonight, though....
We did do an awesome dinner on Tuesday night. We made taco salad, and since I haven't had avocado in so long, we decreased the meat on the salad and added 1/2 of an avocado - still had salsa, cilantro, and lettuce plus beef, but the addition of a little avocado was amazing!!! Tonight we're going to go to Red Robin in Washington PA and get a turkey burger on a bed of lettuce. Doesn't sound great, but what are you going to do? It's impossible to go to a restaurant and order a salad because restaurants don't put much in the way of veggies on salads anymore. They have bacon, cheese, croutons, tortilla strips, wontons, whatever, but NOT veggies.
On a lighter note, Emma won first place in the school's social studies fair! Yay Emma! I was very proud. She did a great job with her presentation despite running a fever of 101 when she did it.
I was a judge for the social studies fair, and let me tell you, that's a tough job. I know a lot of those kids well, and it was hard to mark them down. It's also a little unfair, really, to make that mandatory. Lots of those kids had NO help whatsoever. I know that's kind of the point, but the schools cannot take the time to teach these kids how to do reports and oral presentations. The parents have to step in there somewhere. It's so tragic to see the kids that had no help. The spelling on the reports was atrocious as was the grammar. The lack of organization was also scary. On the other hand, it was very difficult to see the ones that the parents basically did for the child. The posters were excellent, the papers well typed, and the kids couldn't pronounce half of the words on the papers. Plus, when we asked them questions about the topic that wasn't in their report, they had no idea. Obviously someone worked hard on the reports, but it wasn't the kids. Maybe the parents all need a little lesson in fostering education in their kids.
I, for one, do not expect the school to teach my kids everything they need to know. The schools are overcrowded. The teachers are underpaid. And the schools have to cater to everyone - the very smart, and the kids with learning disabilities. If my kids don't go to college, I don't think its fair to say that it's the school system's fault. Do I wish that we had better things in the public schools here for my kids? Hell yes, I do. Do I wish I had a private school here? Hell yes, I do. But, in the end, it's up to Phil and I to take responsibility for our children's education. We take what they are learning in school and expand on it. You don't have to be a doctor to have the ability to do this. Anyone can try to enrich their children's minds. When we shop, I make the kids try to figure out what the item will cost and how much change they'll get back. When we travel, we stop at historic and educational places (often free to the public) and discuss the things we see. We all read voraciously - well, Lee still likes to be read to.
Accountability, that's what it all comes down to, and it's seriously lacking in our society. Kids need to learn to be accountable. It's not, "Well they didn't teach me that." My response is, well, why didn't you look it up. One kid had a term in his report that he read off. When he was done, I asked him what the term meant and he didn't know. I KNOW for a fact that Emma wrote her report with a dictionary by her side and if she came across anything that she didn't understand, she looked it up. It's not that much time in the grand scheme of things, and she learned a lot.
Just like my boobs, I can't blame my loss on genetics or anything else - it's simply a choice I made, and this is the repercussion I have to face for it. Accountability - I accept accountability for my weight loss and my lack of boobage.
Chew on that!
Dr. Mindy
Though I hardly knew you at all
Or had the strength to hold you up
When bending o-o ver
When you were there,
Oh, Dave he hounded you
You were something more than special
More than just two lumps of fat
It seems to me, you lived your lives
Like two melons on a stump
Never knowing where to turn to
When you hit a bump
Oh I would've liked to know you when I was just a kid,
But my hormones burned out long before
My weight gain ever did.....
Soooo, the downside of losing weight is losing the boobs that I had so long waited for. For the first time in my life (even when breast feeding) I was above a B cup! Even though I was heavy, at least I could wear tight shirts and feel a little better about myself. Ah, well, with everything there is a price.
I have now officially lost 22 lbs since January 6th, 2011. I am sticking closely with medifast with just a few slides - mostly for wine. This week has been tremendously hard as our computer system has been all kinds of screwed up and we've had less than optimal patient care because of it. We found out yesterday that do to an improper conversion from one server to the other, we have lost the entire week's worth of notes and billing. What tremendous fun. That being said, I only had wine on Monday night and not since, so I think that's a big step! I'm fully intending on having some tonight, though....
We did do an awesome dinner on Tuesday night. We made taco salad, and since I haven't had avocado in so long, we decreased the meat on the salad and added 1/2 of an avocado - still had salsa, cilantro, and lettuce plus beef, but the addition of a little avocado was amazing!!! Tonight we're going to go to Red Robin in Washington PA and get a turkey burger on a bed of lettuce. Doesn't sound great, but what are you going to do? It's impossible to go to a restaurant and order a salad because restaurants don't put much in the way of veggies on salads anymore. They have bacon, cheese, croutons, tortilla strips, wontons, whatever, but NOT veggies.
On a lighter note, Emma won first place in the school's social studies fair! Yay Emma! I was very proud. She did a great job with her presentation despite running a fever of 101 when she did it.
I was a judge for the social studies fair, and let me tell you, that's a tough job. I know a lot of those kids well, and it was hard to mark them down. It's also a little unfair, really, to make that mandatory. Lots of those kids had NO help whatsoever. I know that's kind of the point, but the schools cannot take the time to teach these kids how to do reports and oral presentations. The parents have to step in there somewhere. It's so tragic to see the kids that had no help. The spelling on the reports was atrocious as was the grammar. The lack of organization was also scary. On the other hand, it was very difficult to see the ones that the parents basically did for the child. The posters were excellent, the papers well typed, and the kids couldn't pronounce half of the words on the papers. Plus, when we asked them questions about the topic that wasn't in their report, they had no idea. Obviously someone worked hard on the reports, but it wasn't the kids. Maybe the parents all need a little lesson in fostering education in their kids.
I, for one, do not expect the school to teach my kids everything they need to know. The schools are overcrowded. The teachers are underpaid. And the schools have to cater to everyone - the very smart, and the kids with learning disabilities. If my kids don't go to college, I don't think its fair to say that it's the school system's fault. Do I wish that we had better things in the public schools here for my kids? Hell yes, I do. Do I wish I had a private school here? Hell yes, I do. But, in the end, it's up to Phil and I to take responsibility for our children's education. We take what they are learning in school and expand on it. You don't have to be a doctor to have the ability to do this. Anyone can try to enrich their children's minds. When we shop, I make the kids try to figure out what the item will cost and how much change they'll get back. When we travel, we stop at historic and educational places (often free to the public) and discuss the things we see. We all read voraciously - well, Lee still likes to be read to.
Accountability, that's what it all comes down to, and it's seriously lacking in our society. Kids need to learn to be accountable. It's not, "Well they didn't teach me that." My response is, well, why didn't you look it up. One kid had a term in his report that he read off. When he was done, I asked him what the term meant and he didn't know. I KNOW for a fact that Emma wrote her report with a dictionary by her side and if she came across anything that she didn't understand, she looked it up. It's not that much time in the grand scheme of things, and she learned a lot.
Just like my boobs, I can't blame my loss on genetics or anything else - it's simply a choice I made, and this is the repercussion I have to face for it. Accountability - I accept accountability for my weight loss and my lack of boobage.
Chew on that!
Dr. Mindy
Tuesday, February 15, 2011
P'shaw, you guys!
Those of you that are following this are making me blush. Keep it up!! :-)
I am at home right now enjoying a very rare moment of silence and serenity in my hectic life. I know I've been a bear today. We have had computer issues at the office since Friday, and our ability to effectively care for our patients is lacking. I know that might sound like a cop out - but for those of you whose job is computer based, you understand. I can't access labs, e-prescribe, access messages, bill, send orders, NOTHING. It's been straining. On top of that, we have wrestling, scouts, and this is the week of the all-encompassing 4th grade social studies project. We were out till 10 last night finishing everything up for that....and Lee's teacher wonders why his agenda book isn't in his backpack. He's lucky he got out this morning with pants on!
The Elkins wrestling tournament is coming up fast, and we've go so much to do for that it makes my head swim. I'm also "in training" as a pack master for cub scouts, so that's weighing heavily on me, AND we're having some special sessions on the YMCA board that are meeting this week. Tres stressful. So, anyhow, here I sit with a glass of (I know, bad dieter) EXCELLENT Pinot Noir (courtesy of the illustrious and witty Bob Crochelt and Donna Smith), and I write my blog.
The blog has been SO cathartic. I'm glad that people are reading it and getting something out of it. Actually, I wouldn't care if anyone read it, because I like writing it, but I'm glad that some do.
I had a great experience in the office today. Of course, it had to do with bioidentical hormone replacement. I have a patient who is complaining of low sex drive, fatigue, hair loss, and brain fog. I had gotten blood work on him in the past, and it showed a low cortisol. Now, realize that I don't believe in blood work. I check it more as a CYA (cover your nether regions) to make sure that there is nothing "clinically" wrong with the patient. He does have some symptoms of Addison's disease, so before we started BHRT, we did that workup. It was negative, but I was still pretty convinced that he had some adrenal issues given his symptoms.
We've tried a couple of things, and he's very sensitive to medications, so much of what I've tried has given him side effects. Armour thyroid has helped him a little, but not with everything. I had started him on sublingual DHEA for some of his complaints of lack of intitative and low sex drive, but that hasn't done as much as he'd like. He wanted to increase the dose, but last time I checked his blood work, his DHEA was actually in the high range, so I wasn't comfortable with that. So, I finally ordered a 24 hour urine hormone profile.
Now, many practitioners will say that this is just another form of voodoo. My experience is that the 24 hour urines are spot on consistent with symptoms. When our bodies produce hormones, we use them pretty quickly, so they don't stay in our blood stream long. When I draw blood, it just gives me a moment in time. We do this all the time to diagnose pheochromocytoma - a (generally) benign endocrine (hormone) tumor. We know in medicine that just checking a spot level for this doesn't give us enough information. So, WHY would it give us enough information when dealing with sex hormones???? Good question, huh? A 24 hour urine tells me what you have produced and how it has broken down over the last 24 hours. I can get more information from that and your symptoms than from any test out there.
Anyhow, I won't get too technical, but when I got this guy's 24 hour urine test back, things just really fell into place. I could really understand his symptoms better, and I was able to get him on a regimen that I think will help him a lot. It was also something that I wouldn't have thought of causing his problem, and I learned something about progesterone and 5 alpha reductase today that I didn't know (sorry for those not medical, but I had to include that for my naysayer doctors). It was exciting on so many levels! First, I think I may be able to help this person who has looked for help before and was not able to find it in traditional medicine. Second, I was able to put together the puzzle pieces and make a logical, endocrinological answer to this problem. It was way cool.
It kind of made up for the computer, the stress, the social studies project, the staff out on sick leave......kind of.
Thanks again to everyone reading my blog. I hope that if any of you feel like you need help, you'll feel free to contact me. I'll direct you to the office for an appointment, because I've learned not to do medicine over the Internet (the malpractice carriers don't look kindly on that), but I love this so much, that I'd love to see anyone who is open to it!!!
Have a good night and think of me enjoying a wonderful glass of wine in a quiet house - OMG!!!!!!! Glee is on tonight!!!!! WOOHOO!!!!!
Dr. Mindy
I am at home right now enjoying a very rare moment of silence and serenity in my hectic life. I know I've been a bear today. We have had computer issues at the office since Friday, and our ability to effectively care for our patients is lacking. I know that might sound like a cop out - but for those of you whose job is computer based, you understand. I can't access labs, e-prescribe, access messages, bill, send orders, NOTHING. It's been straining. On top of that, we have wrestling, scouts, and this is the week of the all-encompassing 4th grade social studies project. We were out till 10 last night finishing everything up for that....and Lee's teacher wonders why his agenda book isn't in his backpack. He's lucky he got out this morning with pants on!
The Elkins wrestling tournament is coming up fast, and we've go so much to do for that it makes my head swim. I'm also "in training" as a pack master for cub scouts, so that's weighing heavily on me, AND we're having some special sessions on the YMCA board that are meeting this week. Tres stressful. So, anyhow, here I sit with a glass of (I know, bad dieter) EXCELLENT Pinot Noir (courtesy of the illustrious and witty Bob Crochelt and Donna Smith), and I write my blog.
The blog has been SO cathartic. I'm glad that people are reading it and getting something out of it. Actually, I wouldn't care if anyone read it, because I like writing it, but I'm glad that some do.
I had a great experience in the office today. Of course, it had to do with bioidentical hormone replacement. I have a patient who is complaining of low sex drive, fatigue, hair loss, and brain fog. I had gotten blood work on him in the past, and it showed a low cortisol. Now, realize that I don't believe in blood work. I check it more as a CYA (cover your nether regions) to make sure that there is nothing "clinically" wrong with the patient. He does have some symptoms of Addison's disease, so before we started BHRT, we did that workup. It was negative, but I was still pretty convinced that he had some adrenal issues given his symptoms.
We've tried a couple of things, and he's very sensitive to medications, so much of what I've tried has given him side effects. Armour thyroid has helped him a little, but not with everything. I had started him on sublingual DHEA for some of his complaints of lack of intitative and low sex drive, but that hasn't done as much as he'd like. He wanted to increase the dose, but last time I checked his blood work, his DHEA was actually in the high range, so I wasn't comfortable with that. So, I finally ordered a 24 hour urine hormone profile.
Now, many practitioners will say that this is just another form of voodoo. My experience is that the 24 hour urines are spot on consistent with symptoms. When our bodies produce hormones, we use them pretty quickly, so they don't stay in our blood stream long. When I draw blood, it just gives me a moment in time. We do this all the time to diagnose pheochromocytoma - a (generally) benign endocrine (hormone) tumor. We know in medicine that just checking a spot level for this doesn't give us enough information. So, WHY would it give us enough information when dealing with sex hormones???? Good question, huh? A 24 hour urine tells me what you have produced and how it has broken down over the last 24 hours. I can get more information from that and your symptoms than from any test out there.
Anyhow, I won't get too technical, but when I got this guy's 24 hour urine test back, things just really fell into place. I could really understand his symptoms better, and I was able to get him on a regimen that I think will help him a lot. It was also something that I wouldn't have thought of causing his problem, and I learned something about progesterone and 5 alpha reductase today that I didn't know (sorry for those not medical, but I had to include that for my naysayer doctors). It was exciting on so many levels! First, I think I may be able to help this person who has looked for help before and was not able to find it in traditional medicine. Second, I was able to put together the puzzle pieces and make a logical, endocrinological answer to this problem. It was way cool.
It kind of made up for the computer, the stress, the social studies project, the staff out on sick leave......kind of.
Thanks again to everyone reading my blog. I hope that if any of you feel like you need help, you'll feel free to contact me. I'll direct you to the office for an appointment, because I've learned not to do medicine over the Internet (the malpractice carriers don't look kindly on that), but I love this so much, that I'd love to see anyone who is open to it!!!
Have a good night and think of me enjoying a wonderful glass of wine in a quiet house - OMG!!!!!!! Glee is on tonight!!!!! WOOHOO!!!!!
Dr. Mindy
Monday, February 14, 2011
me and my illness
So, I wanted to give a voice to the reason that I am currently incorporating bioidentical hormone therapy into my practice. For those of you who don't know what that is, I'll be writing more about it in the future, but you can satisfy your immediate curiosity by checking out the following websites:
bioidentical hormone society
http://www.ucprx.com/
http://www.a4m.com/ (this is where I have gotten my most recent board certification)
Suzanne Sommers and Dr. Oz also discuss this quite a lot.
The journey begins in November or so 2009.
I have to start by saying that I am I high stress person. I always have been. My mom wouldn't let me watch the news or anything with disturbing images because of my anxiety. I've always wanted to save the world and everyone in it. When I was small and thinking globally, I had a hard time coping with not being able to fix it all. I guess to a certain degree I still do. Anyhow, I'm medicated with a serotonin/norepinepherine reuptake inhibitor, and this generally keeps me from going completely crazy.
Anyhow, in November or December last year, I started to feel tired. I chalked it up to being busy and doing a lot with my kids. I figured that when winter rolled around in full force, I'd feel better. Unfortunately, it only got worse. At one point I'd hit my head pretty hard, and I started to think that I might have post concussion syndrome. In February, we had a trip to Disney (my happy place) planned, and I got pneumonia before we left. We went anyway, because I feel that I can be sick at home or sick at Disney. Either way I'm sick. At least there I'd be sick and happy. So, we went. When I came back, things really took a turn for the worse.
Over the next couple of months, I started being unable to do much of anything at all. I had stopped sleeping in my bed because I couldn't make it up the stairs to my bed. I had stopped driving, because I couldn't concentrate to drive. I had dropped out of all of the kids sporting and scouting because I didn't have the energy to do it. I was going to bed at 6-7pm every night and having a hard time getting up in the morning. I usually napped at lunchtime. I had also gained 50 lbs over the previous year. Towards the end of April or May, I had gotten out my disability paperwork and my life insurance paperwork. I was pretty sure that I was dying. I was absolutely sure that I couldn't continue to see patients anymore on a daily basis. I was completely unable to complete a thought, and could not concentrate on anything that my patients were saying. One day, I had an RN in the clinic as my patient. She looked hard at me and said, "Dr. Chua, you shouldn't be seeing patients like this - you're not making any sense." I think some people thought I was on drugs.
During this time, I was seeing my local practitioner. I love him. He's a great clinician - I have sent my parents to him as well. I had about 15,000 dollars in testing and everything came back normal. Believe me, I know that when things feel terrible, it's hard to be told that everything is normal. You WANT something to be wrong so that it's not all in your head. You NEED a diagnosis so you can start leading a normal life again. I really, truly felt that I was going to die before the end of the year and no one could figure out what was wrong. The basic answer was - "you are under too much stress and it's taken it's toll on you. You need to cut back your hours at work and you need to quit drinking wine."
Understand that Phil and I own our practice. We are in debt - like 500,000 dollars worth from our start up and taxes. We don't pay ourselves a salary from our office. We operate on a bare bones staff because we can't afford anything else. If I cut back my hours, that would mean shutting the practice down because we wouldn't make enough money to justify keeping it running. That caused a little stress....
So, here I was one morning. Phil had dropped me off to work, but I was so weak that he actually had to help me in the door. I sat down on the couch in our office. Actually, I was too weak and tired to sit, I had to lay down. Then, I couldn't get up. I just couldn't. I laid there and cried for what seemed like an hour. I had the girls cancel my patients that day because I couldn't get up. Right at that moment, another physician called. She'd heard I'd been feeling bad and wanted to know how I was. I could barely talk to her because I was crying so much. She told me that she'd been to a wellness center in Texas and that their motto was, "People don't lie, labs do." She told me that I should start on thyroid hormone NOW.
At this point, I was willing to do anything, so she called me in some armour thyroid and I started on it that day. Three days later, I was walking up my stairs again. Don't get me wrong, it has been a long process, but it's hard to believe that it has been less than a year since I was honestly thinking that I'd have to give up my practice. As of today, my TSH (thyroid lab) is exactly the same as it was when I started thyroid hormone - it didn't change at all. Why? Because labs don't mean everything. The late, great, Dr. Robert Hess used to try to tell us that when we were residents, but then, we knew everything then, so why listen to the old man? I wish he was still here so I could tell him that he was right after all.
I can so distinctly remember a day about 6 months into this when Phil called me at work and asked if I wanted to go to a movie at 9:30 PM with him. I immediately said sure and we hung up the phone. Then I started to cry. I cried because I couldn't believe that this conversation had happened. I had been so sick that not only would I not have been able to say yes to that, but Phil would have never asked. I just got hit with what this whole thing had done to my family. He asked me out on a date and I said yes! I would have had to really think about that in the past as far as - did I have enough time to take a nap before the date? Would I be able to get up? Would I be able to do anything the next day if I went?
So, here I am a year later. I am currently on 60mg of Armour thyroid. I am also on an herbal adrenal supplement as adrenal fatigue and subclinical hypothyroidism often go hand in hand. I take vitamin d, basic minerals, and progesterone at night. I feel better now than I did even two years ago. I have made some inroads with the weight loss that I now attribute to the thyroid dysfunction. AND, I have started studying wellness and bioidentical hormone replacement. I am very proud to say that I have received my board certification from the American Academy of Anti-Aging and Regenerative Medicine. I attend conferences hosted by the bioidentical hormone society. I am specializing in wellness, and I love it.
I am still board certified by the American Board of Family Medicine and the American Board of Osteopathic Family Medicine. These things are not mutually exclusive. I'd love to do wellness exclusively, but in this region, it wouldn't pay the bills. Much of what I do in wellness involves vitamins, supplements, and natural medicines that aren't covered by insurance. Unfortunately, in WV, most people do not make enough money to pay for these things. I try to incorporate as much as I can into my regular practice, then I hold a BHRT clinic for those people who want to only do wellness.
As for my original doctor? I still "see" him as much as any doctor sees another doctor. He's convinced that I had post-concussion syndrome and that it resolved. He thinks my TSH hasn't changed because armour thyroid isn't really medicine and doesn't change anything anyhow. That's OK. I was trained the same way and two years ago would have said the same thing.
Practicing medicine is 50% education, and 50% experience. My experience has made me decide that my education was sorely lacking. I'm happy with what I'm doing now, and I think a whole lot of people who I'm helping to feel better every day are glad that I got sick last year!
Dr. Mindy
bioidentical hormone society
http://www.ucprx.com/
http://www.a4m.com/ (this is where I have gotten my most recent board certification)
Suzanne Sommers and Dr. Oz also discuss this quite a lot.
The journey begins in November or so 2009.
I have to start by saying that I am I high stress person. I always have been. My mom wouldn't let me watch the news or anything with disturbing images because of my anxiety. I've always wanted to save the world and everyone in it. When I was small and thinking globally, I had a hard time coping with not being able to fix it all. I guess to a certain degree I still do. Anyhow, I'm medicated with a serotonin/norepinepherine reuptake inhibitor, and this generally keeps me from going completely crazy.
Anyhow, in November or December last year, I started to feel tired. I chalked it up to being busy and doing a lot with my kids. I figured that when winter rolled around in full force, I'd feel better. Unfortunately, it only got worse. At one point I'd hit my head pretty hard, and I started to think that I might have post concussion syndrome. In February, we had a trip to Disney (my happy place) planned, and I got pneumonia before we left. We went anyway, because I feel that I can be sick at home or sick at Disney. Either way I'm sick. At least there I'd be sick and happy. So, we went. When I came back, things really took a turn for the worse.
Over the next couple of months, I started being unable to do much of anything at all. I had stopped sleeping in my bed because I couldn't make it up the stairs to my bed. I had stopped driving, because I couldn't concentrate to drive. I had dropped out of all of the kids sporting and scouting because I didn't have the energy to do it. I was going to bed at 6-7pm every night and having a hard time getting up in the morning. I usually napped at lunchtime. I had also gained 50 lbs over the previous year. Towards the end of April or May, I had gotten out my disability paperwork and my life insurance paperwork. I was pretty sure that I was dying. I was absolutely sure that I couldn't continue to see patients anymore on a daily basis. I was completely unable to complete a thought, and could not concentrate on anything that my patients were saying. One day, I had an RN in the clinic as my patient. She looked hard at me and said, "Dr. Chua, you shouldn't be seeing patients like this - you're not making any sense." I think some people thought I was on drugs.
During this time, I was seeing my local practitioner. I love him. He's a great clinician - I have sent my parents to him as well. I had about 15,000 dollars in testing and everything came back normal. Believe me, I know that when things feel terrible, it's hard to be told that everything is normal. You WANT something to be wrong so that it's not all in your head. You NEED a diagnosis so you can start leading a normal life again. I really, truly felt that I was going to die before the end of the year and no one could figure out what was wrong. The basic answer was - "you are under too much stress and it's taken it's toll on you. You need to cut back your hours at work and you need to quit drinking wine."
Understand that Phil and I own our practice. We are in debt - like 500,000 dollars worth from our start up and taxes. We don't pay ourselves a salary from our office. We operate on a bare bones staff because we can't afford anything else. If I cut back my hours, that would mean shutting the practice down because we wouldn't make enough money to justify keeping it running. That caused a little stress....
So, here I was one morning. Phil had dropped me off to work, but I was so weak that he actually had to help me in the door. I sat down on the couch in our office. Actually, I was too weak and tired to sit, I had to lay down. Then, I couldn't get up. I just couldn't. I laid there and cried for what seemed like an hour. I had the girls cancel my patients that day because I couldn't get up. Right at that moment, another physician called. She'd heard I'd been feeling bad and wanted to know how I was. I could barely talk to her because I was crying so much. She told me that she'd been to a wellness center in Texas and that their motto was, "People don't lie, labs do." She told me that I should start on thyroid hormone NOW.
At this point, I was willing to do anything, so she called me in some armour thyroid and I started on it that day. Three days later, I was walking up my stairs again. Don't get me wrong, it has been a long process, but it's hard to believe that it has been less than a year since I was honestly thinking that I'd have to give up my practice. As of today, my TSH (thyroid lab) is exactly the same as it was when I started thyroid hormone - it didn't change at all. Why? Because labs don't mean everything. The late, great, Dr. Robert Hess used to try to tell us that when we were residents, but then, we knew everything then, so why listen to the old man? I wish he was still here so I could tell him that he was right after all.
I can so distinctly remember a day about 6 months into this when Phil called me at work and asked if I wanted to go to a movie at 9:30 PM with him. I immediately said sure and we hung up the phone. Then I started to cry. I cried because I couldn't believe that this conversation had happened. I had been so sick that not only would I not have been able to say yes to that, but Phil would have never asked. I just got hit with what this whole thing had done to my family. He asked me out on a date and I said yes! I would have had to really think about that in the past as far as - did I have enough time to take a nap before the date? Would I be able to get up? Would I be able to do anything the next day if I went?
So, here I am a year later. I am currently on 60mg of Armour thyroid. I am also on an herbal adrenal supplement as adrenal fatigue and subclinical hypothyroidism often go hand in hand. I take vitamin d, basic minerals, and progesterone at night. I feel better now than I did even two years ago. I have made some inroads with the weight loss that I now attribute to the thyroid dysfunction. AND, I have started studying wellness and bioidentical hormone replacement. I am very proud to say that I have received my board certification from the American Academy of Anti-Aging and Regenerative Medicine. I attend conferences hosted by the bioidentical hormone society. I am specializing in wellness, and I love it.
I am still board certified by the American Board of Family Medicine and the American Board of Osteopathic Family Medicine. These things are not mutually exclusive. I'd love to do wellness exclusively, but in this region, it wouldn't pay the bills. Much of what I do in wellness involves vitamins, supplements, and natural medicines that aren't covered by insurance. Unfortunately, in WV, most people do not make enough money to pay for these things. I try to incorporate as much as I can into my regular practice, then I hold a BHRT clinic for those people who want to only do wellness.
As for my original doctor? I still "see" him as much as any doctor sees another doctor. He's convinced that I had post-concussion syndrome and that it resolved. He thinks my TSH hasn't changed because armour thyroid isn't really medicine and doesn't change anything anyhow. That's OK. I was trained the same way and two years ago would have said the same thing.
Practicing medicine is 50% education, and 50% experience. My experience has made me decide that my education was sorely lacking. I'm happy with what I'm doing now, and I think a whole lot of people who I'm helping to feel better every day are glad that I got sick last year!
Dr. Mindy
Subscribe to:
Posts (Atom)