organicgreendoctor: my story revisited #80- i went from my world to yo...

organicgreendoctor: my story revisited #80- i went from my world to yo...: MY STORY REVISITED #80-FROM MY WORLD TO YOUR WORLD   after i quit practicing medicine and retired my medical license i went to the other sid...

my story revisited #80- i went from my world to your world

MY STORY REVISITED #80-FROM MY WORLD TO YOUR WORLD 

after i quit practicing medicine and retired my medical license i went to the other side
the patients side
even though i am on the pateints side now i will admit that there is an advantage to being a doctor even a retired one

living in the austin area i knew all the different doctors i had to see like primary care urology orthopedic neurology ophthalmology dermatology and cardiology

i either worked with them or referred patients to them so i knew if they were good or now
i wanted good and pleasant
so
i knew when i saw them how competent they were

i also knew to be patient waiting on my appointments
as
more than one was notorious for being late staying on schedule

i knew that and accepted it

since moving to santa barbara i have entered even deeper into your world since i dont have any prior knowledge about any of the providers i see
i do now but before i didnt so i relied like you on word of mouth
so far
so good

below was my perspective almost 9 years ago as i reply to a moms facebook posting about one of the doctors that i chose to see for my care

i knew he was always behind on schedule
but
i knew how competent he was though
so
i chose competence over other things
__________

12-06-2012
DOCTOR VS PATIENT

i was a family practice doctor for 30 years
and enjoyed almost every day that i practiced

early in my career i delivered babies took care of icu patients
covered the emergency room for admissions for pediatric
and adult patients took care of sick newborns and pediatric patients
and worked extra in the emergency room

it was a hectic schedule during those earlier years
keeping my office schedule flowing each day was not easy

about 15 years ago i stopped all hospital care and only worked
in the clinic
this made my life less hectic and made my office schedule more
flexible and much easier to flow each day since there were
not all the interruptions from delivering a baby a new icu patient
helicoptering a patient out of the emergency room to a tertiary care
hospital or taking care of a new admission

things were just better in the office the last 15 years
better for me and better for the patient

that said
it sometimes is harder to stay on schedule in the office
the day can be unpredictable
a broken bone an asthma attack sick kids a heart attack
counseling a dying patient counseling a depressed patient
an abused child an abused wife a flu outbreak and all
those other things that can disrupt your day
phone calls lots of phone calls charts labs xray reports lots
of chart reviews
yes
it is hard to stay on schedule almost every day in the office

i spent a lot of time reviewing different schedules and what
made them more efficient and tried to incorporate them into
our schedules
some worked and some did not

i was the guru of scheduling and of insurance coding so that
we would get paid and so that your insurance would pay your
bills
i taught those things to other doctors

so from a doctors view
it is hard to stay on schedule every day
that said
there is no excuse for not starting on time and maintaining some
resemblance of a normal schedule
if you start behind the day only gets worse
some are chronically infected with this disorder
not me

remember if your doctor always always stays on schedule
he she is new he she is not well liked he she is just not busy
he she is in a very competitive market and
maybe he she may not be a good doctor

that should be some type of red flag

i usually stayed on schedule but because of what else can
happen in the day it was hard to maintain it

now im on the other side and sometimes have another perspective
your perspective

my primary doctor i know real well
i chose him
not because he stays on schedule all the time
he may be one of the worse
but because i worked with him for several years
read his charts
saw his patients
saw how he manages patients
sat in medical meetings with him
so i know what kind of doctor he is
hes probably one of the smartest one in the group
he doesnt miss much
and i felt like he would provide the best care for my health problems

that said
hes one of the worst offenders of the being late on his schedule
im willing to accept that
knowing how competent he is

one way i beat the system is for my routine appointments is i
always get the first appointment of the day
that has worked well over the last 3 years usually

another doctor i see is a specialist who is busy and is in
a surgical specialty
i chose him because my patients liked him and because he
had good results from his surgery and treatments
he also had a good bedside manner
but i knew when i went to see him
he would not be on schedule
its usually a 1-2 hour delay when i go in
i accept that because i know ill be getting good care

my ophthalmologist i see i selected for the same reason
however although she is busy she is generally always on time
i know though that she is good

my neurologist i see i selected from her involvement with the
alzheimers research center and the universitys memory clinic
shes always on time with the early appointments but can
be later with a later in the morning or afternoon appointment
again i know she is good

so what triggered all of this is a facebook posting of a former
patient who was left in the waiting room for 30 minutes then
in the exam room for 30 minutes before she was seen
glad i wasnt the one who had to see her

one suggestion to patients
do not piss off the receptionists or the doctors nurse
i repeat dont piss off those two people
make someone else mad at you even the doctor but
not those two people
thats reality thats just the way it is
speaking from years of experience

but if you feel mistreated talk to the clinic supervisor
and or to the doctor
they do listen
its a competitive market now days and administration
listens to complaints
but remember
do praise them when they do good

my suggestion if you are like this person who has experienced
this before
change doctors to one who is more schedule friendly for you
but be choosy whom you see
or accept the delays like i do within reason

i know a busy mom who works has kids who are sick
takes care of most of the work at home doesnt have
a lot of time to be wasting on late appointments
but try earlier appointments in the morning or afternoon
as later in the morning and later in the afternoon things get worse

consider an acute care place for some illness if appointments
arent available and yes complain if lateness is chronic
they do listen
but if you are not happy with them change providers

ive found its not fun on this side of medicine
the patients side
see this blog posting of my recent experience
or
this posting by my blog friend who was in the er
with her sick child and later went to see his doctor
the next morning

i sure wish i could go back to practice medicine now
i would do a lot of things differently
all for the patients benefit

i hope you get your situation with your provider fixed
he is a good one
as
he is my doctor also

but if you cant tolerate the lateness then change providers
there are a lot of good competent ones to choose from
who do a better job on their schedule
just be careful whom you choose

what do you think
__________
so if the doctor i am seeing is behind schedule
i just sigh and say 
i remember those days
and
just wait

the organicgreen doctor 

organicgreendoctor: out of this world duct tape

organicgreendoctor: out of this world duct tape: OUT OF THIS WORLD DUCT TAPE i am always on the look out for duct tape stories people over the years have sent me examples of uses of duct ta...

out of this world duct tape

OUT OF THIS WORLD DUCT TAPE

i am always on the look out for duct tape stories
people over the years have sent me examples of uses of duct tape
some even called me dr duct tape

one brand of duct tape is even called duck tape
yes
i have been given a roll of it multiple times

i will admit though when i really really want to use the best duct tape
i go buy gorilla duct tape


this chair represents my proudest duct tape use
this old chair was either bought by my wife she 
or
more likely she found it on the side of the road
it could spin around and lay back
it was sort of like a mini barber chair
the covering was all wore out
so
i got the idea of using black duct tape the good stuff like gorilla duct tape
i lost count of how many rolls i used on it
when completed i commonly sat in it to relax or read or visit with my wife she while she was in the kitchen

it was a favorite of ms b when she came to visit
as 
she would spin around and around in it like a mary go round

one of the hard parts of moving was leaving this duct tape chair 
we gifted it to a friend who appreciated its worth

when we decided to move we agreed we would only take what would fit in our two cars
everything else would be donated or sold
the duct tape chair wouldnt fit in our cars

you can do a search to the right of my blog for duct tape to read more duct tape stories
or 
just google organicgreendoctor duct tape

the roll above in that picture is the one featured in the video below
its the one that went into outer space with the astronauts

in the video below you can see how he uses it by dispensing it from the special duct tape dispenser invented by us high school students

the duct tape is used frequently on the space craft
however
if you tear off a piece of tape you cant just set the roll down somewhere
since
it will simply flot away in the weightlessness of outer space

thus
the use of the us high school invented tape dispenser
the dispenser latches back onto the side of the wall when its not needed

 

duct tape has been used for years in space by nasa
the big problem was the duct tape roll floating away
the high schoolers solved that problem
here is a link to an article about the space duct tape problem

i still think though that my favorite duct tape use is my duct tape chair

the organicgreen doctor

organicgreendoctor: covid 19-you may need this vaccine passport

organicgreendoctor: covid 19-you may need this vaccine passport: COVID 19-YOU MAY NEED THIS VACCINE PASSPORT we are not out of the woods yet things have plateaued in the us with a now 7% uptick in cases na...

covid 19-you may need this vaccine passport

COVID 19-YOU MAY NEED THIS VACCINE PASSPORT

we are not out of the woods yet
things have plateaued in the us with a now 7% uptick in cases nationally
some states are worse than others

this last week the texas longhorn football team had to cancel its outdoor spring football because several of their players took a trip to florida for spring break
bringing back the virus to the football team
several of the springbreaker football players tested positive

spring break may be the catalyst for this next surge if it occurs

its still a race of the variants vs the vaccines
28% of americans have had at least one vaccine
we need about 50% more vaccinated 
on friday they gave 3.3 million shots
at that rate another 100 million will be vaccinated this next month
here in california and texas anyone over 16 can get the vaccine

remember its the younger folks who are mostly spreading this virus
many have no symptoms

last night i watched a 2 hour special on cnn where they interviewed the top experts involved in the covid response last year

they were candid in their responses
here is a link to an article reviewing what all the experts these pandemic doctors said

basically the problem with this virus is its mainly spread by folks mostly younger folks who have little or no symptoms
thats what made this virus spread so fast

its important we vaccinate those over 16 folks if we want to slow this down

again
every day when we see those 1000 americans die 
they died while we had a prevention that could have kept them from getting sick and dying
each death should not have happen

one threat to us all is brazil
their mismanagement of their covid 19 is probably the worst in the world
the variant there the brazilian one is a bad one
the vaccine may not work as well on that one
its here in the us now
but
it will only get worse here

here is a picture of my covid 19 vaccine record
since that picture was taken it has been updated to show that i got both my shots
i made a photo front and back of my card
i made copies for my medical records file and my important papers file
it sits next to my will
a copy will be kept in my wallet

i plan to laminate it 
and
place it inside my passport

it will be my covid 19 vaccine passport
it may be needed to
travel
go to concerts
attend college
work
go to church
go to a long term care facility to visit or stay
go to restaurants
visit folks in a hospital

when the liability issues start up from all the lawsuits that are coming
this vaccine passport may be even more important

when a digital vaccine passport becomes available and is widely accepted 
i plan on adding it to my cellphone

until this pandemic is under control
we still need to 

wear a mask even though we are vaccinated
wash our hands
avoid large gatherings
keep a safe distance

do your part get your vaccination
help protect the rest of america

the organicgreen doctor

organicgreendoctor: alzheimers news-a new alzheimers website for infor...

organicgreendoctor: alzheimers news-a new alzheimers website for infor...: ALZHEIMERS NEWS-A NEW ALZHEIMERS WEBSITE FOR INFORMATION when i first entered the alzheimers world was when my mother was diagnosed before s...

alzheimers news-a new alzheimers website for information

ALZHEIMERS NEWS-A NEW ALZHEIMERS WEBSITE
FOR INFORMATION

when i first entered the alzheimers world was when my mother was diagnosed
before she died my younger brother was diagnosed also
i started searching for more information on alzheimers

i knew some from being a physician but as i later learned i really didnt know much about the disease

i looked at the alzheimers association website www.alz.org
its a wealth of information on all aspects of alzheimers from research to treatment to education to caregiving to whatever you need to know about alzheimers

i also looked at these websites for a more local flavor
 alzheimers texas 
alzheimers arkansas
alzheimers los angeles

i also searched the nih website for information 

then i looked at clinicaltrials.gov for clinical trials

my search led me to the adni study which lead to my diagnosis which lead me to my treatment trial with the biogen aducanumab

now
the nih has a new website for alzheimers
alzheimers.gov

its simple and stream lined

when you click on the page
there are headings
alzheimers and related dementias
life with dementia
taking action
find clinical trials
for professionals

then lower down on the page are recent news and updates on alzheimers

just click click and there is your information

clicking on clinical trials
you click on what topic you are looking for eg alzheimers
add what state and or city 
there is a list of studies on alzheimers
eg 
in texas there are over 90 studies available
many of them treatment studies

i clicked on the for professional tab to see what it was like
there was a long list of resources for physicians to assess in the care of dementia patients

i clicked on the one for caregiving
there was a section on tips for caregivers
linked here

if you are a caregiver or will be one you should read this
it is on how to take care of yourself as a caregiver

if you are now entering the alzheimers world you will find this website useful
alzheimers.gov

the organicgreen doctor

organicgreendoctor: garden news-how to plant a tomato

organicgreendoctor: garden news-how to plant a tomato: GARDEN NEWS-HOW TO PLANT A TOMATO   this is my tammy tomato named after the person that donated a tomato two generations ago this is the gra...

garden news-how to plant a tomato

GARDEN NEWS-HOW TO PLANT A TOMATO 

this is my tammy tomato
named after the person that donated a tomato two generations ago
this is the grandchild of that original tammy tomato
it grew like crazy last year and produced a ton of tomatoes
i have no idea of its original source

so i was asked this last week 
how do you plant your tomatoes to make them grow so well

i take a 5 cent tomato and put it in a 5 dollar hole
its that simple

here is how i plant my tomatoes
following how i do it is two tomato experts methods
you will see similarityies since i learned from them

i start with a healthy plant
i grow it from seed or buy from a good nursery
this year i will grow 6 tomatoes only
i promise thats all 
two i grew from seeds
one i took as a cutting off a neighboring plot holders tomato that is still producing a year later
two tomatoes from our community gardens annual veggie sale
one tomato from a local nursery 

in my garden bed 
i add 4 inches of compost plus an organic fertilizer
this is forked in with a garden fork or a broadfork
this is watered in with a fish emulsion plus seaweed plus molasses mixture
the bed is left fallow for as long as i can 
then
i dig a hole deep enough to plant the tomato
i plant the tomato up to its lower branches
sometimes well usually i remove some of the branches
sometimes there is more plant underground than above ground

in the hole i put worm compost i make in my garden area
when i lived at the country n i bought worm compost from the nursery
i add a scattering of an organic fertilizer in the hole
then
i plant the tomato
i water the tomato in well with that fish emulsion seaweed molasses solution
i add a layer of mulch under the tomato to hold in moisture and to keep water from splashing dirt up on the tomato leaves which can lead to fungal diseases on the leaves 

every two weeks i water it with that fish emulsion mixture

i also bury a 3 gallon pot beside the tomato plant
i add compost about a third full
i water that on a weekly basis based on the rainfall we have had
here during tomato season we get zero rainfall

i place a wire cage around my tomatoes held in place with a 6 ft tpost since we can get some high winds down off the mountains
i learned to do this the hard way
last year my tomatoes all got blown down in a bad wind storm

i usually dont trim my tomatoes much i just let them grow
all my tomatoes are indeterminate so they grow most of the season

thats how i do 
i am usually successful each year with my tomato crop

i plant 
early girl
sun gold the kids love these yellow sweet tomatoes described as candy 
black krim the heirloom does well in my garden
cherokee purple another heirloom does well also
tammy tomato my unknown small to medium tomato
linda tomato from my neighbor plot holders tomato cutting

most of how i plant my tomatoes is from john droomgoles natural garden classes
here is his link on how to plant and grow tomatoes
here is the excellent handout that i have kept in my garden notebook for years

then
here is a link to the tomato man talking on the central texas gardeners show about how he grows tomatoes

if you want to be successful growing your tomatoes
then
these three methods will make you successful

the organicgreen doctor

organicgreendoctor: my story revisited #79-on death and dying

organicgreendoctor: my story revisited #79-on death and dying: MY STORY REVISITED #79-ON DEATH AND DYING when i wrote this blog 8 years ago it was not long after my good friend gf had died from huntingto...

my story revisited #79-on death and dying

MY STORY REVISITED #79-ON DEATH AND DYING

when i wrote this blog 8 years ago it was not long after my good friend gf had died from huntingtons disease
a fatal neurological disease that he knew he had for 20 years before his death

i thought about him a lot this last week after rereading this old blog
then
a patient whose dad has alzheimers disease had to place him in a long term facility since that time had come
i told her i have instructed my wife she to do the same when my time arrives
dont even think twice about it i told her

i also told the former patient that i had visited many of the long term facilities in the austin area over the years
many i did sessions with families and patients where they could ask me questions 
which
i answered as a family doctor a family member of loved ones with alzheimers a patient myself and an alzheimers research subject

i told her the place her dad was in was one of the two i would want to be placed in had we remained living at the country n

as i read that blog and watched the video 
i thought a lot about my mother and father and my younger brother who all had alzheimers and my rainwater brother who died almost a year ago and my friend gf and his wife sf who died a few years later

yes
i again shed a tear for each of them this morning

thanks to those who took care of them when they were ill
__________
01-07-2013

dr ll a friend and director of a hospice
sent me this youtube video

at my friend gregs memorial service last year i
was asked to read a blog i had written about
visiting greg a few months before he died

i was unable to finish reading it so dr ll
graciously took over and read it for me
using the same inflections that i would have
had i been able to read it out loud

if you have a family member or friend who has died
or if they are dying now or
if you have a terminal illness like i have

i recommend you stop and take the few minutes
to watch this video

i cried when i watched it and cried several times
later and cried again this morning when i wrote
this blog

this makes me think of my friend greg
my mother and father
my younger brother who has alzheimers
and
myself as i face the possibility of the same

this blog and video is dedicated to them and to
my wife she
she has been there for me the last two years and
will be there for me in the future

thanks
..

__________

yes ill be up there with those two dots when my time comes



the organicgreen doctor

organicgreendoctor: here is hoping this one is better than the last one

organicgreendoctor: here is hoping this one is better than the last one: HERE IS HOPING THIS ONE IS BETTER THAN THE LAST ONE that is a picture of me walking in our condo complex about 3 weeks after my last birthda...

here is hoping this one is better than the last one

HERE IS HOPING THIS ONE IS BETTER THAN THE LAST ONE

that is a picture of me walking in our condo complex about 3 weeks after my last birthday
i had lost about 25 lbs in those 3 weeks after being sick with what i think was covid 19
i had just been let out of quarantine after 3 weeks
i got real short of breath walking in that complex
i still couldnt hardly eat anything
my heart rate was irregular and faster than normal
my blood pressure was up and down
i felt washed out much of the day 
my energy level was zippo 
i had just spent my 70th birthday in lockdown in our back bedroom

reviewing my blog from a year ago this is what i posted

__________
MY BIRTHDAY PRESENTS

by now most of you can recognize what is is the picture
covid 19

in two days i will know if i got this for my birthday present this year

here is my story

about 3 weeks ago i developed a stomach bug that left me with nausea and diarrhea that lasted for 24 hours then i was left with nausea that lasted for several days
eating crackers and drinking a lot of soup
that cleared but i was left with a marked fatigue that lasted for about a week

three days later i had an episode of vertigo that lasted for a day but after that i felt ok for about another 2 weeks

this first week i stay at home mostly in bed
later in the week i went to the garden when i was symptom free

it was about that time that i got more aggressive about isolating myself in general because of the covid 19 outbreak
i washed my hands a lot
i sprayed down the doorknobs on the door at the bottom of our stairs twice a day
i scrubbed down our counter tops in the kitchen and in the bathroom more than once
i left mail and packaging on our porch in the sun for 24 hours before i touched it again
i washed my hands afterwards

i even sprayed the gate lock in the garden coming and going with lysol
i only used my tools in the garden with gloves that i also sprayed before and afterwards

i went to the bank but only used the atm machine

i shopped at the grocery store twice during that time being careful to stay away from folks
i shopped at cvs twice to get supplies and my medications

every time i came in the front door i washed my hands real well on arrival

during that 3 week time period i had a runny nose and sometimes watery eyes
this i have had for several weeks with cold weather and working in the garden making it worse

i also have had a mild cough that has been present for over a year now
it was evaluated and felt to be a habit cough

two weeks ago i felt fine
i went with hudson to his transplant appointment at cedars sinai
i worked with the kids in the garden

last week on monday we traveled to a lawyers office to do some legal paperwork
we only encountered 3 people in the office
we all stayed 10 feet away from each other
i used the ethanol gel three times while i was there

since that monday i self quarantined myself except for helping babysit hudson for two days this week

on saturday i felt fine and went to my garden to garden as i had tomatoes and peppers and beans to plant in the garden
as i entered the garden i sprayed the lock with lysol spray then walked down to my garden plot
i sprayed my work gloves and my garden tools with the lysol

when i left i went to the sink washed my hands with soap and water then with some ethanol gel

as i was planting my tomatoes i noticed i started to feel bad
i felt weak
i had some chills
i felt a little nauseated
i felt short of breath when i was walking

so i left spraying down the lock real well as i left

when i got home i removed my clothes and showered then ate some soup
then
i had diarrhea
the nausea got worse
i got fever and chills
i got a headache
i coughed some but not any more than i usually do
i had a runny nose

as the day went on i got worse and worse

by nighttime i was having shakes when my fever went up

i decided after talking with the emergency room nurse about my symptoms and about my grandson awaiting a transplant about being seen and getting tested

i arrived with my wife she but she had to stay outside
they took me to a tent that looked like it belonged with a mash unit
oh i had a n95 mask left over from the fires that were around here
i wore the mask as i left the house

my temp was low at 96 my blood pressure was elevated my pulse rate was 100 my oxygen saturation was 98%

they did a chest xray and blood work that was all normal
they did a respiratory panel for the various viruses that can cause these symptoms like the flu and rsv
this panel should be back today

and yes they did the covid 19 test
the results on that will be back in 2-3 days

so i went home to wait
i have fever and chills and rigors although since i am on acetaminophen regularly those have lessened quite a bit
i have a headache that lessens with the acetaminophen but is still there
the diarrhea is gone
the nausea is till present in fact i didnt really eat anything for 24 hours until last night
i actually feel like an egg and toast this morning i might even try some coffee maybe
my runny nose has not gotten worse
my cough hasnt got worse
i feel washed out
the first night i couldnt sleep at all i felt like i had drank a pot of coffee
my blood pressure and pulse has returned to normal
i occasionally feel like i have a fever but it quickly goes away

i think i have the covid 19
stomach upset is not common but it can happen
it usually means the covid 19 can get more aggressive

the test is what i call 70% accurate
30% of the time when its negative you really have it
usually the exposure is 1-14 days before symptoms start

so here on the start of day three i wait
i have quarantined to my bedroom
we live in a 1 bedroom i bath condo that is over 1000 square feet
this is where i will live for at least the next 2 weeks
if i go to the bathroom i wear my mask since my wife and i share the bathroom
we have two sinks
she has moved most of what she needs out of there
she is also quarantined for two weeks
we text back and forth and talk through the door

so as i write this i feel a little washed out
i do occasionally get a wave of nausea and fever
but i do feel better

so my sister in law sent this picture of her birthday cake
i showed it to my wife
this is the cake i want for my birthday
it is iron skillet cornbread

i hope all of you are taking this covid 19 serious
i was being more careful that most of you and i still may have got it

the only thing that seems to help slow down the disease in our world is if all of us follow the rules and recommendations of our medical and political folks

__________
the real highlight of the day last year was when ms b came to the sidewalk below the bedroom window
and
sang happy birthday to me
she wanted to see for herself that i was ok

it made me feel good that day and it makes me feel good this day

little did i know what this last year would be like
all those people dying
my symptoms getting worse over the next several months so that i lost another 20 lbs
luckily for me sometime in the fall things seem to kick in and i feel much better today 

so 
today
i feel better than i have felt since i moved here four years ago
i have gained 20 lbs back 
hudson has a new kidney and is doing well
mr n is almost 8 months old and is cute and healthy
mr b is cuter than ever and is doing well in virtual kindergartener class
my wife she is doing well and promises to be good today 
all the adults around mr hudson and in our group have now been immunized against covid 19

when asked by my wife she 
what do you want to do today 
i said
i want to go and work in my garden all morning
since
last year i couldnt even get outside my bedroom

what do you want for your birthday meal
i said
i want homemade chicken and dumplings with homemade iron skillet cornbread
you can stick a candle in the cornbread for me

what do you want for your birthday 
i said
that one is easy
i already got it 
i am just glad to be alive since last year on my birthday i was worried i was a goner

so
yes
i am hoping this one is better than the last one
it wont take much to make that happen
since
the last one was the worst one i ever had

the organicgreen doctor