Category Archives: Education

Chief Complaint: Top Reasons We Go to the Doctor

P1110588The Mayo Clinic reveals the top reasons for health care provider visits:

  • Skin disorders: acne/cysts/rash
  • Osteoarthritis, joint disorders, and back pain
  • Cardiovascular problems such as high cholesterol, stroke
  • Upper respiratory conditions: cough, sore throat, ear problems
  • Anxiety, Depression
  • High blood pressure
  • Headaches, migraine, and other neurological conditions
  • Diabetes

That’s what the research tell us. If I had kept tabs on the thousands of people I have seen over the years, my list would look more like this:

  • 6 month and annual check up: AKA you have to come in to get a prescription refilled.
  • Respiratory: cough, cold, ear ache, allergies (or can I have an antibiotic)
  • Back pain
  • Hypertension management: usually smoking and obesity related health issues
  • Routine health maintenance: vaccinations, women’s care, sports, and work physicals
  • Other: I would include depression and anxiety here.  Rarely did I see patients calling in with depression as a chief complaint.  It was something else that brought them in (joint pain, stomach problems, sleep issues), and through talking it was obvious clinical depression was the root cause.

And then there were the surprises that made for a challenging day: thoracic outlet syndrome, lacerations, shingles, really big hemorrhoids, genital warts, foreign body in ear or other body openings (always very interesting), mono, deep vein thrombosis, melanoma, scabies, lice.  Why did I always start to itch after seeing a kid with lice?

As much as you hate the automated phone tree, co-pays, wait time, and general inconvenience of going to the doctor, don’t neglect your health.  If you take good care of it will repay you in kind.

heart health


Top 10 Reasons to Keep Smoking Cigarettes + 1 Bonus

cigaretteI love to help my patients quit smoking.  Both smokers and non-smokers agree: smoking is a terrible habit and is horrible for your health.  Smokers tell me that all the time!

I know this stuff will kill me, and it’s nasty.  My kids are on my case to quit.  Why haven’t I quit yet? Well, I plan on it, yessiree.  BUT….

…right now’s not a good time.  One addiction at a time for me.  I’m under a lot of stress. I can’t afford to gain any more weight.  I have four cartons left, I have to use them up first.  My husband refuses to quit with me, as long as he smokes I can’t quit.

Those are actual statements patients have said to me.  I respond with empathy:

Yes, quitting smoking is hard work.  Certainly, you are under considerable stress. True, I want you to be successful in your opiate addiction recovery. Definitely, a partner who quits along with you helps tremendously.  Maybe next time we can revisit this?

Am I helping by being understanding, and reassuring?  Or am I just dancing around the truth.  The truth is


The truth is: you like smoking and don’t want to quit.

Can’t you just tell me the truth instead of coming up with the lame excuses? How can I help someone if they don’t want to change? Maybe I should reconsider my approach and try something like:

Top 10 Reasons to Keep Smoking:

  1. You keep me in business
  2. You keep dentists in business
  3. You keep tobacco companies in business
  4. You keep the government in business
  5. You get moody when you try to quit smoking –  keep smoking and stay happy
  6. Your Uncle Frank smoked 3 packs a day for over 50 years.  He lived to be 99
  7. Your wrinkles and puckered lips make me look better
  8. A husky voice is sexy
  9. You like being sick. It feeds your need for attention
  10. You already tried once to quit and you failed, why put yourself through that again, sheesh

Bonus: You get more frequent, longer work breaks than your non-smoking coworkers.

I don’t mean to sound harsh. Nah, maybe I do. When you see pregnant women smoking, dads hanging a butt off their lip while holding their child, teens parading their smokes in public, and folks in their prime of life dying from lung cancer, you get tired of the excuses.

And for the record, the average person only gains 10 pounds with quitting.

quit smoking

It is better to offer no excuse than a bad one. George Washington.

5 Common Health Beliefs Busted as Myths


Have you ever believed some health claim over the years and thought it was true because everyone repeats it? Did you ever question – really, where did you read that?  Or, how do you know that’s true?


It may be common knowledge, but it doesn’t mean it’s true.  Let the believer beware: next time your workout buddy tells you your exercise routine stinks because you didn’t break out a sweat, ask where he learned that from.

Debunked: 5 common health beliefs busted as myths

  • You must drink 64 oz of water a day to stay healthy or lose weight

Fact: you should gauge your fluid intake based on your thirst and the color of your urine. Clear non-yellow hues is what you are “aiming” for. Dark yellow, amber, cloudy indicates your fluid intake is inadequate.  And no, your fluid doesn’t just have to come from plain water –  liquid beverages and the water in foods all help hydrate. However, if you drink calories, you are setting yourself up for weight gain.

  • You’ll get sick if you go out in the rain or cold without a jacket.

Fact: You’ll feel colder but you won’t catch a cold.  We do lose heat through our heads, so  wearing a hat or drying your hair makes sense if you want to feel warmer.

  • Don’t swallow your gum: It will never digest.

Fact: It will digest just fine and will come out your other end in about two days.

  • You should take a daily multi-vitamin.

Fact: Studies have shown multi-vitamins don’t improve your health.  What does? Eating a colorful, balanced diet.  What you would spend on vitamins spend on real, non-processed food.

  • Never read in dim light or you will hurt your eyes.

Fact: Your eyes may get tired but you won’t damage your eyes or permanently affect your vision.

For tons more medical myth busting, visit UAMS or email them your question:

Mencken quote

Back Pain: Don’t Make These 5 Mistakes


Two days ago my dog spied his adversary chippy the chipmunk and pleaded for me to let him out. Since his discovery of the fawn nesting in our neighbor’s bushes, I’ve grounded him from all independent runs in our wooded back yard.  I put his leash on him and opened the door thinking the two of us would carefully walk down the back steps, he would do his business, and we would say hi to Chippy as we happily went back inside.

What was wrong with my brain?  Was it sleep deprivation? Perhaps my preoccupation with the days responsibilities? Whatever caused my sudden lapse in judgement is irrelevant now. I opened the door, and my dog bolted while I was holding tight to his retractable leash.


After one step down I knew I was in trouble so I let go. Thanks to the laws of motion, I flew over the remaining 3 steps and hit the ground with a thump.  I was sure I broke bones and would be forced to lay there helpless, at the mercy of our evil garter snakes and my dog’s sloppy wet kisses.  It was 7:15 am – my husband out of town and my three teen boys lay sound asleep two stories up, door shut, fan on, and a good chance noise canceling headphones were still attached to their ears.


If I couldn’t move I was doomed.

Surprisingly the only injury I seemed to suffer was wounded pride and a knee abrasion.  That was then. It took a day for my body to reveal the extent of the damage. Now, I write to you from my couch where I lie supine,  ice on my lower back and pillows strategically placed for optimal comfort.  It was not just my pride and knee that were hurt, but I messed up my back as well.  Back pain  sucks, but it is as common as vanilla ice cream. 85% of us will experience it at some time.  The problem with back pain is if it isn’t handled properly when it happens, it can result in over treatment, unnecessary diagnostic testing/referrals/surgeries, and can begin a spiral down into crippling disability and even opiate addiction.

The Don’ts of Back Pain:

  • Don’t ignore it – Pain is a warning sign that something is wrong.  Most back pain is mechanical, meaning it is from injuries such as the one I described, or its the result of poor body mechanics with lifting.  It is always a good idea to see your provider to have your back pain evaluated and so you can receive proper instruction on how to mend. Your provider will also assess for red flags.
  • Don’t baby it – The worst thing for back pain is bed rest. Give yourself 48 hours of limited motion, applications of ice, and Over-the-Counter pain relief, and then start rehabilitating through careful positioning, movements, and strengthening exercises. Avoid heat as it may feel good at first but can delay healing.
  • Don’t overmedicate it: No you don’t need narcotics.  I have many people in the addiction clinic that started on Oxycodone for their back pain.  Back pain can be adequately managed with Ibuprofen or other NSAIDs, and tylenol.  Use creative pain relief interventions such as trigger point massage, cold packs, gentle whirlpools, and distraction. According to U.S.

The use of opioids for managing low back pain remains controversial. Opioids are the agents of choice for managing severe acute pain and chronic pain associated with cancer.


  • Don’t underestimate the importance of prevention: Prevention is the key to all back pain.  Practice proper lifting techniques.   Strengthen your core muscles.  Recognize potential fall hazards and avoid them.

  • Don’t remain ignorant: learn the latest treatment and diagnostic guidelines for back pain management.  You are doing yourself potential harm if you don’t know the difference between good care vs quack care.  Millions of dollars are spent on unneeded surgeries and overzealous practitioners who take advantage of your mechanical back pain and pad their pockets with your money.

An ounce of prevention is worth way more than a pound of cure when it comes to your back.  So stand up straight, be smart (don’t use retractable leashes), and be safe.  If you treat your back right, you’ll be waltzing on your 95th birthday.

Here’s to healthy backs! P1020954

Prediction: The ADHD Fad Is About to Fade

allenfrances quote

Is ADHD really a fad diagnosis? Have you been told by your child’s teacher that your child, who is likely to be a elementary aged boy, is distracted, disorganized, forgetful? If you took away the requirement to be between the ages of 6-16, those traits could describe any of us.

My Prediction: The ADHD Fad Is About to Fade | Psychiatric Times

In the above article, Dr. Frances shares his research and makes a credible observation:

The tripling of ADHD rates in the last 20 years and skyrocketing use of stimulants are sure signs of a fad.

Dr. Frances also references to an eye opening piece written by Alan Schwartz of the NY Times. Mr. Schwartz exposes some rock solid evidence to support the inappropriate diagnosis of ADHD and the misuse of stimulants to boys to appease teachers who don’t have the time to deal with a kid who learns differently. How freakin’ sad is that?

Parents: Get enlightened.  This is your boy.  Fight for him.  Don’t cave in to the pressure to put your spirited, beautiful boy on meds unless he absolutely has the disorder and is suffering because of it.


Providers: Shame on you for giving out stimulants like they are some magic beans that will make all the kid’s problems go away.  How about looking at the evidence and do a let’s try these things first approach before you give the exhausted parent a quick script for Adderral.

Teachers: You are the reason I homeschool my three boys. No doubt you would have called me into a big old meeting and told me my son was not keeping up with the rest of his peers and had all the behaviors that pointed to classic ADHD.  Your expert psychologist would back you up with mumbo jumbo literature and intimidate me into making an appointment with my pediatrician and getting my son on medicine as soon as possible because after all, YOU are the expert. Not. You are so fortunate not to have had my sons in your classroom.

I am relentless when I need to be, which makes me good at what I do.

Adult dragons are,astute,powerful,and sure of their strength. Ciruelo Cabral
Adult dragons are astute, powerful, and sure of their strength.
Ciruelo Cabral

Are the drugs used to treat ADHD truly  “nuclear bombs, warranted only under extreme circumstances?” 

It’s tough being a parent. It’s tough being a kid in a public school system.  It’s tough to be a teacher in an overcrowded ‘teach to the test’ public school system. And, it is hard being the provider who has only fifteen minutes to listen, exam, and evaluate.

That’s why we all need to take a step back and look at the evidence.  Let’s not be quick to assume the problem is ADHD.  It could be. But it’s probably not.

If it’s my kid, I will try anything and everything before I resort to medications. If he is however, one of the 5% of kids who has true ADHD, then I will gladly take the prescription and once again thank God for modern medicine.


Blizzard! The Storm That Changed America


Having grown up in Upstate NY and now living in Western NY, snow is no big deal. Winters here sometimes last six months. Unless you are a skier, you get sick of snow soon after Christmas, but you learn to cope with it.P1040252

Only a handful of times can I remember experiencing a true blizzard, the kind that closes shopping malls, grocery stores, work, and schools. In this riveting book, Blizzard! Jim Murphy tells of the infamous blizzard of 1888, where not only towns came to a standstill, but also more than six hundred people died. Some people died in their own backyards. This storm was a monster, and he describes it with vivid details and historic accuracy. To give you and idea of how bad the storm was, check out this part where a boy sets off for school anticipating the storm to be a daring adventure.

At first, Sam liked the experience of being outside in a wild storm, fighting his way through belt-high snow and fending off the wind. His aunt and uncle had instilled in him a strong sense of self-reliance and duty. He had been told to go to the store and then to school, so he was going to do both, no matter what the consequences. Several blocks later, Sam came face-to-face with the violence of the blizzard. As he was crossing an intersection, the wind was on him like a wild animal. It picked him up and tossed him into a deep snowdrift. Sam struggled and clawed to get free of the snow, but he was in over his head. The more he moved, the more snow fell on top of him. He shrieked for help, but no one heard him above the wind’s mighty roar. His boyish romp had turned into a frightening trap in just seconds. 

P1110928This was one of the most incredible disasters in our nations history. I read with fascination and literally gripped the book as if the storm was in my living room. Thankfully with our modern day snow cleanup crews and weather satellites, we can prepare for snowstorms and stay safe. If you can’t get enough of the snow this is  a good book to read while safely tucked inside your warm houses with a toasty fire and a cup of hot tea.


Why You Should Say Yes to Immunizations

 By getting your immunizations you have protected not just yourself, but also the vulnerable members of the population.  If 84% of your community gets vaccinated against a specific contagious disease, then the odds of protecting the unvaccinated or immunocompromised, especially the elderly and young children, are favorable. This is herd immunity.

Why is it called herd immunity?  Think of it as safety in numbers, or a hedge of protection.  Surround yourself with armed mercenaries or a wall of people, and it will be pretty hard for an enemy to attack you.

Here’s a visual demonstration on how it works:

I am an advocate for immunizations.  I’ve kept my family up to date on their vaccinations, and I will always encourage my patients to get theirs.  Those who don’t get their shots have us to thank for keeping a host of diseases  like measles, small pox, polio, and mumps at bay.
On the fence about vaccinations? Take a look at the
10 worse epidemics in history.
We can protect ourselves against future communicable medical disasters through immunizations.
Me? Thankful for the advances in medicine, and proud to be a member of the herd.
herd member
Current vaccination schedules for adults and children here:

Flu Shot vs Death – Why Take the Risk?

flu shot

Which one: take your chances and risk getting the flu or get the flu shot? Getting sick with the flu is like getting hit by a truck, and you risk hospitalization or death, even if you are a healthy person. Getting vaccinated as insurance for protection from influenza is a no-brainer.

Unless you are in the rare exception group, everyone older than 6 months is recommended for flu vaccination.

Best time to get your shot in early fall so your immune system is ready by peak flu season.
Best time to get your shot in early fall so your immune system is ready by peak flu season.

No – you can’t get the flu from the vaccine: the viruses that make up the flu shot are inactivated (killed), therefore they cannot cause infection. 

The flu kills between 3,000 and 49,000 people every year.
The flu kills between 3,000 and 49,000 people every year.

The worst thing you get from the flu shot is a slightly sore arm.  There  is a 0.00001 % chance of experiencing a life threatening reaction to the vaccine.  I did the math for you.

Get your flu shot.

What the flu feels like.


Are you Dominant, Influencing, Steady or Conscientious?


Learn or you’ll be made to learn.  That’s old school.  New school: unlock your potential.  Determine your strengths, discover your learning style, and unleash your talents.


PeopleKeys, a company specializing in behavior analysis, offers instant access to a variety of behavioral profile assessments.  I had my twelve-year-old son take their online Student Strength’s Report. In less than thirty minutes he had fill out the eDISC assessment, and I had a thirty-four paged report that interpreted his answers. It detailed not only his primary learning style, but also offered tips on how to maximize his learning by focusing on his strengths.

The report assessed these areas:

  • Personality style: Are you Dominant, Influencing, Steady or Conscientious
  • Cognitive thinking: Which one are you? Literal, Intuitive, Theoretical, or Experiential
  • Perceptual learning:  How do you learn best? Auditory, Visual or Kinesthetic

Check out PeopleKeys for potential business hires, to assess your student, or to learn about yourself.

Maximize Strengths; Minimize Weaknesses..It’s that simple. If you know where your thinking excels, you can capitalize on those aspects, use your mind to do what it enjoys doing most. Know Yourself.

To know yourself sometimes requires that you stand outside of yourself and observe, objectively in a critical way. Your report has indicated that you prefer one thinking style. It is up to you to decide if it is “like” you or it is “not like you”. From our PeopleKeys Student Strengths Report


Read the rest of my post here at

Enjoy a very quick personality quiz on Blogthings.

Which one are you?
Which one are you?

What Did Ever Happen to Penny Candy?

not penny candy

If you are a baby boomer like me, do you remember walking to the corner store by yourself  and getting a ton of candy for just fifty cents? Bottle-caps, candy buttons, bubble gum cigars, sugar daddy’s, and waxy big lips. Fun.  Whatever Happened to Penny Candy?  I have no idea.



But Uncle Eric (Richard Mayberry) does, and he tells us in his classic book on economics .

Don’t worry about financial babble, the author uses straightforward talk and clear metaphors to explain things like:

  • The origin of money
  • Inflation
  • Recession
  • Depression
  • Wage/price spiral

This is a great, short (159 pages) read for kids, moms, dads, teachers, entrepreneurs, business-minded students, grandma, and grandpa. Yes, this is one of those rare books that both young and old will learn from.

So before you jump into your next lucrative business adventure, read a little of Uncle Eric’s advice first.