Panic Attacks: The Gripping Truth

Panic is a sense of overwhelming fear, triggering physical and mental reactions so severe that a person might believe he is dying. Symptoms include palpitations, pounding fast heart beat, shaking, sweating, choking, dizziness, rapid breathing, and tight chest.

The cause of the panic can be real, or imaginary. Unless you are a vulcan, you have experienced panic at some point in your life.  For instance,



  • After stumbling upon a lone bear cub in the woods, the mama spies you, goes berserker and charges.
  • You run out of gas late at night during a blizzard. Oh yeah, and you’re on the Interstate and the next exit is 50 miles away.
  • While hiking in the mountains you suddenly hear a distinct rattling sound.
  • You are about to give a speech to a packed auditorium.
  • It is your turn to audition in front of the judges of American idol.
  • You speed by a well hidden police car. He immediately pulls out lights on, siren blaring
  • You wake up and remember your anniversary was yesterday.

In those circumstances, your panic is normal, it is not pathological and you will quickly return to a normal state once the stressor passes or the situation is dealt with.  If however you experience recurrent episodes of panic, often for no apparent reason, you may have a panic disorder.  Here are some descriptions of what people feel during an attack:

I start shaking, I find it hard to breathe and my eyes go all funny. eveything seems to be so sereal.


My heart beats against my chest and it feels like it’s going to break out, I get stomach pains, trembling, noise seems amplified, and I freak out. The world is swirling, I get confused, my mouth goes dry and I can’t breath.  I am sure I am about to die.


I see spots and my vision gets blurry. I think that I’m going insane, it’s like I am on a bad acid trip.

In his book, The Loss of SadnessDr Kenneth Kendler writes:

If an individual experiences a full-blown panic attack when . . . he looses his grip and falls 40 feet before his rope catches him . . . no psychiatrist I know would consider this to be a psychopathological phenomenon. A panic attack is not—in and of itself—psychopathological. It only becomes pathology when it occurs in certain contexts—at times and in places when it should not.

One panic attack, not a problem. A couple more here and there, still can be dealt with.  If your panic is starting to interfere with your lifestyle or work, then you need to see your doctor.  There are medical conditions that can mimic a panic disorder, and you should have those ruled out.  Also, it is safer to err on the side of caution.  If you feel you are having a heart attack, call 911. Chest pain or tightness should always be taken seriously.

The good news: through a combination of medications and good cognitive therapy, you don’t have to be a victim of panic.  Don’t be ashamed or afraid to seek help – it is more common that you probably know, and don’t think it can’t be treated, because it can.

For more information check out the Mayo Clinic page on panic disorder.


Top 12 Quotes of 2012

 Every saint has a past, every sinner has a future. Oscar Wilde



Do what you can, with what you have, where you are. Theodore Roosevelt


Don’t wait.  The time will never be just right. Napoleon Hill



Out of suffering have emerged the strongest souls; the most massive characters are seared with scars. Khalil Gibran



Chains of habit are too light to be felt until they are too heavy to be broken.  Warren Buffett



Remembering you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart. Steve Jobs



The supreme quality of leadership is integrity. Dwight Eisenhower



Many of life’s failures are people who did not realize how close they were to success when they gave up. Thomas Edison



Kind words can be short and easy to speak, but their echoes are truly endless.  Mother Teresa



Whatever things are true, noble, just, pure, lovely…if there is any virtue and if there is anything praiseworthy, think on these things.  Paul the Apostle



Leadership is influence…nothing more…nothing less.  John C. Maxwell



In three words I can sum up everything I’ve learned about life……

It goes on.  Robert Frost

The Fifth Element and The Cure for The Common Cold

are five elements:







Louis Diat




Garlic has a history.

The buff Egyptian pyramid builders were fueled by it, and 18th-century frenchmen added it to wine to prevent plague infection.

Docs gave it to World Wars I/II soldiers to prevent gangrene. Marco Polo documented its use for food preservation. Hippocrates prescribed it to treat lung disease and cervical cancer.

Garlic has amazing properties – anti-oxidant, anti-inflammatory, antibiotic, antifungal, lnhibits placque formation, lowers blood pressure, helps digestion, regulates cholesterol and blood sugar, stimulates the immune system, increases metabolism, and may help improve erectile dysfunction.


It’s easy to grow and great for keeping away garden pests like deer and vampires.

I know, it’s the smell that concerns you – me too.  But unless you bathe in it (some do), or dab it behind your ears as a pheromone to attract old italian guys, then it shouldn’t cause a problem.







All garlic is good, but fresh is best. I can testify it works better than anything I have tried for cold prevention.  As soon as I get that sore throat feeling I run for garlic. I pop a clove, chew and swallow.  Yeah, it burns and even the dog won’t kiss me but it sure beats dealing with a cold. Long live allium sativum!

Head’s up: Garlic has blood-thinning properties. if you are on meds or have upcoming surgery consult your PCP before adding it to your diet.

Check this site out for an ode to garlic and a must have recipe.

And all garlic lovers need this: a good Garlic Press.



Why Pneumonia Deserves Respect

To keep the body in good health is a duty… otherwise we shall not be able to keep our mind strong and clear. Buddha

Pneumonia, an inflammation of the lungs (air sacs), is one of the most disrespected illnesses around. It is a baneful monster of a disease that is the leading single cause of death in children worldwide. 156 million new cases every year with 9% needing hospitalization. 50K annual deaths in the US. Most likely to die: children in third world countries. The truth is any one of us could get it any time. Arm yourself with the facts so you don’t become a statistic. Here’s an excerpt from a recent phone interview I did with Streptococcus Pneumoniae, a bacteria often involved.

KD: Thanks for taking the time out of your busy schedule to talk with me. It’s been a good 25 years since we first met. Remember, you laid me up for over 3 months?  I’m willing to put that aside for the sake of my readers health. Can you tell us about yourself?

Strept: Thank you Ms. Davis for having me. Sorry for the trouble back in the 80’s, just doing my job. And let me clarify for the audience, I am not the sole culprit behind all the pneumonia infections.  50% belong to me and my partner H. Flu. The rest can be credited to various fungi, virus, and other well known bacteria: Staph Aureus, Klebs Pneumo, and Myco Plasma.

KD: How do you do it? How can such a tiny organism like yourself cause such catastrophic results?

Strept:  It’s complicated. But, it boils down to good genes. Watch this 3 minute video for an easy explanation: The best way to avoid me? Prevention.

KD: A pneumonia vaccine is recommended for those 65+, smokers, or those with a chronic illness.  Does that really prevent you from attacking them?

Strept: Most of the time, but I might still cause them a milder illness.

KD: Do antibiotics work?

Strept: Yes, but I am resistant to some. I have the capability to adapt. The sooner the treatment is started, the better the outcome for the patient.

KD: How will someone know they are infected with you?

Strept: They become ill quickly: Fever, shaking chills, sweating, productive cough tinged with blood or shades of green, fast heart beat, headache, no appetite, malaise, shortness of breath. The old often get confused, may fall. People think they have the flu, and don’t bother going to their doctor.

KD: How can we stop you?

Strept: Nothing is guaranteed, but you can try keep your body defenses strong. It’s the weak that can’t put up the fight. Don’t smoke, wash hands, eat well, breastfeed newborns, get all recommended immunizations, and if you think I might be making you sick, get to your PCP (Primary Care Provider) quickly.


The Prima Donna Student

Talent is God given. Be humble. Fame is man-given. Be grateful. Conceit is self-given. Be careful. John Wooden

2012 has got to go down as the year of the prima donna student. I have yet to meet a more nervy group. I have thrown books, knee jerked obscenities, and contemplated quitting to take up dog walking.  Yup, caring for canines would be peachy compared to working with some of these pseudo-nobles.

According to urban and  “prima donna” refers to someone (male or female) who is vain, arrogant, unreasonable, and difficult to work with. This person is temperamental and expects privileged treatment, and reacts with petulance to criticism or inconvenience.  Sure, everyone has known someone like this. And nurses who have been in the field a long while (like me) have met a couple of docs/interns/professors/managers who are huge P-D’s.  But multiple students in consecutive semesters? And I’m not talking just a freaky few, this is more like the recommended daily amount of almonds. Tell me this is not the norm.

Possible explanations? He said-she said, high cost of graduate credits, Generation Y upbringing differences and learning styles? High stress multi-tasking lifestyles, mob mentality? Is this common place behavior in present day America, or is this simply an unprecedented coincidence luck of the draw group?

The majority of my students are phenomenal professionals: hard-working, endearing, highly skilled wonderful people who I am happy to pass the baton to. You know who you are, and you can count on me to give you a good reference, match you with amazing preceptors, and when job opportunities come across my desk I will think of you.  As for the prima donnas, I hope your ego deflates, you change your perspective and realize you are not monarchial. The world doesn’t owe you anything, and if you really are as great as you think, you would realize you know nothing.

Top Screwups Doctors Make and Drop Dead


Do not read, as children do, to amuse yourself, or like the ambitious, for the purpose of instruction. No, read in order to live. Gustave Flaubert



Drop Dead Healthy By  A.J. Jacobs is my number one pick this week.  He chronicles his quest to achieve maximum health by personally trying all the toted popular advice for getting in shape physically, mentally, and nutritionally.  Not quite finished reading it, but loving his dry sense of humor, and enjoying his blunt honest feedback on flavonoids, exercise, and the art of chewing food.

The New Writer’s Handbook 2007 By Philip Martin (editor) features the best advice on the craft of writing. Contributors include some of my favorite authors – Jane Yolen, Neil Gaiman, Linda Sue Park, and others who have experience, insight and are able to sift through the hooey out there and give us their jewels and writer’s wisdom. I am so getting Volume 2.

Developing the Leaders Around You: How to Help Others Reacher Their Full Potential By John Maxwell will teach you how to help those in your sphere of influence to be better leaders. I read anything by John Maxwell.

The Honest Truth about Dishonesty By Dan Ariely takes a look at why all sorts of people cheat and steal. I picked this one up on a whim, thinking it would give me insight as to why my 12-year-old is lying to my husband and me.  Not sure I like this book yet, instead of offering me insight into my son’s problem, it’s making me feel a little uncomfortable with some aspects of my own behavior. Plus, it has too many studies and experiments – I know I should find that stuff interesting, but I’m happy to let researchers do their thing and just give me the concluding evidence.

Top Screwups Doctors Make and How to Avoid Them By Joe Graedon validates what I already knew.  What I didn’t realize was how many mistakes get buried.  The author experienced a tragic screwup with his own mother, but instead of pursuing a million dollar lawsuit he used his powerful situation to make impacting changes in a major health institution.


The Bell Jar By Sylvia Plath is a classic that I’ve always wanted to read.  I’m 50% done and doubt I’ll finish it. Terrific writing, compelling. I was really most interested in learning more about Plath, and understand what led her to commit suicide at such a young age. I work with clinically depressed patients with varying stages of illness, anything that might help me better understand the illness in order to help them is worth my attention.


Save Your Life in 20 Seconds

The air moves like a river and carries the clouds with it; just as running water carries all the things that float upon it. Leonardo daVinci

Killer germs like staphylococcus and streptococcus pneumoniae are spread when infected people cough, sneeze, and spew airborne droplets into your breathing space.


They wipe their noses with their fingers and shield their cough with their hand – then touch your keyboard, use your phone, press elevator buttons, and push public shopping carts. Pneumonia and influenza account for 56,000 US deaths annually.


In 2011, TB killed 1.4 million people worldwide.

Protect yourself from those deadly pathogens and other potentially fatal infectious diseases by simply making proper and frequent hand-washing your priority.

On a busy work day, I wash my hands at least 25 times. No, I am not obsessive compulsive (ok…maybe a little). I do it to keep you and me safe.

There are lots of things you can do to keep yourself healthy, but nothing tops regular good old-fashioned sudsy soap and water hand washing. And if your hands aren’t obviously soiled, alcohol based hand cleaners will do. But proper hand washing is vital.  No prissy hand dipping, fingertip only splash n’dry, quick soap rinse and go stuff.  Your technique must be perfect.

Wet your hands, generously apply soap, lather and clean under your finger nails outside the stream of water for at least 20 seconds – about the time it takes to sing happy birthday twice – in your head please. Rinse under running water.

Hopefully you’ll have the automatic paper towel dispensers to finish the job.  Avoid the air dryers – they just recirculate germs.  Use your sleeve to open the door or patiently wait for someone else to do it for you.

And for those of you who need a reminder:  keep your germs to yourself. Cough into your arm instead of my face. Don’t take your runny noses to church, the store, school, wherever. Wash your hands too. Teach your kids.

If you cough in my path I will hold my breath until I turn blue so I don’t breath in germs.  I would never insult you by refusing to shake your hand, but as soon as the coast is clear, I am using my Purell.

For you visual learners, here’s a short demonstration on hand washing, complete with toe-tapping big band soundtrack.

The Art of Lifting Burdens

No one is useless in this world who lightens the burdens of another. Charles Dickens

The thought of adding more burden to my life frightened me. Putting into practice freed me. There will never be a day where I can walk through life and not see a burden that needs bearing. The traffic of daily encounters reveal so many who suffer. Some, in silence. Others are on display to the world as the media brings their pain to our living rooms. Even though everyone knows, they may be bearing their burden alone.  We assume they are being cared for. But are they?

We are all frightened by burdens, who wants to carry another’s load? Aren’t our own troubles enough?  Won’t our back break under the weight of shouldering more? Will we spiral down? No, I don’t think so.

Our burdens become less when we carry another’s.  We become liberated of our own encumbrances and our vision becomes clearer. To know you have lifted the burdens of another, made the road easier, shared the pain-eases our own.  Don’t recoil or be afraid of rejection. Though the heavy laden have not asked for help they cry for it when alone. “God help me get through tonight, give me the strength to get through tomorrow.” If you are quiet enough, you can hear them. They are considerate people, the burdened, they don’t want to let you know the weight is too much.  You have to look with your eyes and see with your heart. You are thinking of someone right now. You may know them well, or they may slip past you like time. But you see them, right? Even though they think they are invisible.

Break the ice, tell them you know about the burden, and you want some of the weight. Take them out to coffee. Be quiet and let them talk. Send a note with a prayer or a comforting quote, clean their house, make a meal, drop off a care package, give a bonus, a day off. Say hi to someone you pass in the halls. Introduce yourself. Don’t give advice, don’t say anything really, just listen. Take the weight.  Your back can take it.  Remember to use your knees when you bend, it helps.

10 Tips for Better Sleep and the Best Cure for Insomnia

The best cure for insomnia is to get a lot of sleep.

W.C. Fields

The average person requires 7-9 hours of sleep nightly to feel refreshed in the morning and productive during the day. Cheating yourself of sleep?  Not a good idea. Your body will keep tabs and eventually force you to pay back the debt.

  1. Improve sleep environment: good mattress, comfy pillow, clean room, dark, cool temperature.
  2. Reduce light exposure in the evening, use night lights for bathroom runs, but get good day light exposure during waking hours.
  3. Use the bed only for sleeping and a 3 letter word that starts with “s”.
  4. No naps after 3pm. Gary, are you paying attention?
  5. Wear light cotton loose PJ’s (fun fact: 31% of men sleep in the nude).
  6. Don’t eat a heavy evening meal or 2-3 hours before going to bed.
  7. Don’t sleep with lights or TV on.
  8. No evening alcohol or caffeine. This includes chocolate.
  9. Exercise every day, early is best.
  10. Talk to your primary care provider if you are constantly tired, snore loudly, or are over using an over-the-counter sleep aid.

Check out the National Sleep Foundation for more sleeping facts and advice.


10 Best Weight Loss Tips

Subdue your appetites, my dears, and you’ve conquered human nature. Charles Dickens

Here’s a list of my ten favorite weight loss tips.  I give this as counsel, and in writing to any patient I see whose BMI is in the high end overweight, or obese (30+ )range.  Which is probably 2 out of every 3 patients I see.

  1. Always start your day off with breakfast. It fuels your body for the day. This will help you lose weight and keep it off. Oatmeal, turkey bacon, greek yogurt, high fiber cereals.
  2. Eat 3 small meals and 2 light snacks a day. This will help you not feel hungry and keep blood sugar stable. Skipping meals reduces your metabolism and increases your risk of eating excessively after a long fast.
  3. PLAN meals and snacks ahead of time. MAKE the time. Eat fresh fruit, vegetables, nonfat yogurt, cottage cheese, low-fat granola bars or peanut butter on whole grain crackers. Make fresh salad and top with raw nuts, tuna or a skinless chicken breast or a sandwich with fresh veggies for lunch. Set some time aside to ready a menu of meals you’ll have for the week. Prepare dinner ahead, have ingredients ready.
  4. Keep a food diary. Studies show that people who keep a continuous food diary successfully lose weight and keep it off. Know how many calories you need. Try MYFITNESSPAL.COM 
  5. Measure your portion sizes and servings. Too much of any food will result in weight gain, even fruit and low-cal snacks.
  6. Choose highly nutritious, low-calorie foods. Chicken, turkey, vegetables, fruit, limit red meat, and if you eat meat pick sirloin or lean cuts.
  7. Clear your cupboards of high calorie snacks like tortilla chips, cookies, candy, baked goods. Have whole wheat pretzels, low-fat granola bars, fruit canned in it’s own juice, nonfat pudding, dried fruit, almonds available. Eliminate as much white flour and sugar products.
  8. Do not drink beverages with calories. Some people drink over 500 calories a day from sugar-sweetened sodas, teas, juices or alcohol. Drink water instead. Aim for 8, 8-ounce glasses of water each day – add a splash of lemon or orange. Don‘t mistake dehydration for hunger. Drink water.
  9. Eat until 80% full, and take your time when you eat. Focus on being satisfied after a meal–not full. You will be surprised at how much less food it’ll take to satisfy you.
  10. Avoid eating 2 –3 hours before you go to bed.  Eating before bed is like putting gas in a parked car – you don’t need the fuel so it’s going to sit in your tank and be stored as fat.

BMI Calculator

BMI Categories:

  • Underweight = <18.5
  • Normal weight = 18.5–24.9
  • Overweight = 25–29.9
  • Obesity = BMI of 30 or greater

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