Author Archives

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Grocery Shopping Isn’t a Spectator Sport

Grocery shopping is my least favorite chore in the world. Stuck in a fluorescent cave where the aroma of freshly baked bread battles it out with the stench of spoiled fish, confronted by carelessly discarded carts and poorly placed products, my anxiety level rises to Mount Everest proportions. As if the entire shopping experience isn’t designed to slow your pace to a crawl, lately I’ve noticed an increase in the amount of people that think grocery shopping is a spectator sport.

You’ve seen them. While one of them peers at the shopping list and looks for sales, the other dawdles, randomly stopping to block an aisle or access to items. They come around corners at sloooow speed, t-boning the carts of the people who are moving at a brisk pace. They grab a cup of complimentary coffee and then steer the cart with one hand, causing it to veer from side to side and making it impossible to pass them. While their significant other inspects every label on every brand of stewed tomatoes, they block the aisle and watch like it’s their job.

I assume the majority of grocery spectators are deaf or hard of hearing. They don’t move or otherwise respond to polite throat clearing, the rumbling of an approaching cart, or the plea “excuse me, I need to get by.” Once they’ve found an inconsiderate place to be, they’ll stand their ground until their partner moves on.

There are many reasons to hate this practice. For example, grocery store spectating promotes poor time management skills. Two people, one grocery store? Live a little and split the list in half. Or send the cart pusher off for heavy items while the other spirit communes with the cereal until they divine the right brand for their breakfast enjoyment. Better yet, send them to the magazine aisle, no one uses that one much. Or leave them in the car. Maybe they can clean it while you’re inside. There are much better uses of time than to be the vestigial tail of a shopping team.

And I don’t want to get started on those who take small children on a grocery shopping trip. I hope there’s a special circle of hell for them.

How to fix the problem? I don’t know whether there needs to be a special Facebook group, a Kickstarter project to educate people against it, or a twitter campaign to alert the masses, but the word needs to get out there – Grocery shopping isn’t a spectator sport. If a grocery chain wants to double the size of their aisles, provide viewing areas, and replace the overhead music with sports announcers, by all means, invite someone along to watch you shop.

Until then, come alone.

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Forget About It: Worrying about Illnesses You Don’t Have

Hypochondriacs are people who obsessed with the idea that they have an undiagnosed serious or life threatening disease. For them, every skin change indicates malignant melanoma, every change in bowel habits signals colon cancer, and every episode of dizziness becomes a fatal heart arrhythmia. Those who obsess about serious conditions are convinced their occasional memory lapses are Alzheimer’s, their feelings of fatigue are Lyme Disease, and their lack of coordination is multiple sclerosis. These are people seriously intent on receiving a medical diagnosis for their psychiatric disease. It’s easy to become frustrated with them as there’s nothing wrong with them, but it can take years of tests and specialists before someone flat out tells them that.

Luckily, the majority of people who worry too much about the vagaries of the human body suffer from, as I like to call it, petite hypochondria. Instead of obsessing over the specter of an undiagnosed life threatening illness, they obsess over minor ailments. This includes the young female who is certain her cough of one day is pneumonia, the older male who wants to describe the color and consistency of his stool because it’s not his “normal”, the first time mother who is worried her child’s temperature of 99.1 degrees signifies a serious infection, and the elderly female who gets dizzy when she stands up too quickly and becomes convinced she’s going to die. These patients can be time consuming, but they can be reasoned with.

Then there’s the patients who suffer from the disease of the month (or year or decade). Twenty years ago medicine saw an explosion in fibromyalgia, a disease characterized by fatigue, muscle aches, and “tender points.” After that, peanut allergies became the rage.  You couldn’t swing a bag of peanuts around without someone promising an anaphylactic reaction. Epi-pens were passed out like Halloween candy and peanuts were banned from most public places. Now a terrible epidemic of gluten allergy has descended upon us. Heralded by joint pains, diarrhea, abdominal bloating, and mental fogginess, gluten free diets have become the answer to a host of symptoms that may, or may not, be related to gluten. I think the universe reaches a tipping point on obscure diseases and suddenly everyone is convinced they have (insert name of disease of the month/year/decade). In these cases, the disease becomes a source of pride. It’s not surprising that there’s never been an epidemic of patients having herpes, hemorrhoids, or yeast infections in their fat folds.

How do you tell if your concern for your health is becoming a little overboard?  I have some easy questions.

1.) Does your doctor’s office try to talk you out of coming into the office or presenting to the ER?
2.) Have you been seen by more than three specialists in the last year who couldn’t find anything wrong with you?
3.) Do the people who draw your blood have to consult a reference book to determine what tubes your (obscure labs) need to be drawn with?
4.) Do you bypass the over the counter medication for minor ailments because you need to consult with the doctor in case it’s more serious than constipation or heartburn?
5.) Do you seek healthcare after vomiting once or for feeling like you have a fever?

If you can answer yes to two or more questions, it might be time to consider redirecting your energy on something other than yourself. Just saying. Leave some room in the healthcare system for patients who really need it.

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Don’t Put Your Faith in Antibiotics

This time of year sees an uptick in people who present to the doctor’s office for one reason, they want an antibiotic. It’s amazing how people think antibiotics are the cure for all their ills, even though antibiotics are only useful in treating bacterial infections.

People don’t want to hear how their viral illness won’t respond to an antibiotic. They don’t care that at the rate things are going, antibiotic overuse is going to make most antibiotics ineffective leading to deaths from minor bacterial infections. They certainly have no interest in treating themselves by increasing fluids, staying home and resting. No. An antibiotic prescription is the expected parting gift of the office visit and without it, well, try the Emergency Department. Maybe they’ll give you one to shut you up and get you out.

I think it’s a type of sickness hysteria fueled by the internet and symptom checkers. Have a sore throat? It must be strep! A stuffy nose for a week? Sinusitis! A cold that’s made you tired and run down? Bronchitis!

Problem is 85%-95% of sore throats aren’t strep, 90-98% of sinus infections are caused by viruses, and most upper respiratory infections aren’t bacterial. Antibiotics will do nothing for these infections. The bitter truth is that it takes time to recover from an illness. Colds, bronchitis and sore throats caused by viruses may last two weeks or more, time we’re not prepared to spend taking care of ourselves. It’s easier to throw a pill at it.

Instead of rushing to the doctor’s office (and exposing yourself to whatever germs are lurking there), the next time you’re sick, stay home and take care of yourself. A tincture of time is remarkably effective in curing much of what ails us and it’s safer and cheaper than an antibiotic.

Remember, antibiotics kill bacteria, not viruses.
No Antibiotics African American Poster

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Did You Wash Your Hands?

As part of my ongoing kitchen remodeling project, visitors to my home now have the option to relax on couches and watch me cook. I joke that it prevents me from serving anything I drop on the floor, but my real worry is that I’ll forget to wash my hands appropriately (between handling meat and vegetables or the like) and someone will call into question my ability to safely prepare food.

Now I have a pretty good record in that I have no reported instances of my guests contracting a food related infection (at least not that I’m aware of). Unfortunately many hospitals can’t say the same when it comes to healthcare acquired infections or HAI’s. The Centers for Disease Control (CDC) reports that for every 20 patients in the hospital, one gets an infection. That’s two million infections annually. The simple act of handwashing breaks the chain of infection. So why don’t healthcare workers do it every time?

A quick scan of articles on the topic show handwashing rates of 37% to 77% for healthcare workers. Interventions to increase these numbers, including education, posters, and even personal hand sanitizer dispensers that monitor the number of uses, have all met with limited success. When no one’s actively paying attention to handwashing compliance, handwashing rates drop and infections increase.

Some institutions have encouraged patients to ask healthcare workers whether they’ve washed their hands before a treatment is given. I contend that the majority of hospital rooms and outpatient exam rooms have sinks or are equipped with hand sanitizing dispensers. It’s clear to most patients who has, and hasn’t washed their hands, but they’re too intimidated to demand only clean hands be placed on them. Since healthcare workers have shown they’re unwilling or unable to consistently wash their hands, patients need to demand it whether it’s comfortable or not.

No exceptions.

You can be polite:  “Did you want to wash your hands before you examined me?”
Belligerent: “Hey, I don’t want the cooties from your last patient. Wash up!”
Indirect:  “Did you see that Dr. Oz episode on handwashing? Amazing how many doctors don’t follow the guidelines.”
Matter of fact: “I don’t want to walk out of here with an infection, so please wash your hands.”

It doesn’t matter how you want to phrase it, if you value your health, you’d better say it. Every time. Don’t wait for your healthcare worker to protect you, protect yourself.

Clean Hands Save Lives

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Pray Rain

Recently I read an article about a Pray Rain Journal. Basically you write a daily page about your ideal life as if it’s already happening. Here is my Pray Rain Journal for the healthcare system.

Today we were overwhelmed writing prescriptions for acupuncture, massages, and hypnotherapy. Now that insurance pays for this, our providers and patients turn to alternative medicine rather than narcotics. Not once during this entire day did a patient receive a prescription for oxycontin, vicodin, or percocet for chronic, non malignant pain.

Our diabetic patients came in armed with questions and information. They all had their blood glucose logs and their food journals. There was time to review them and work with the patient to make good choices to improve their blood sugar control. They checked their feet daily so it was another month without foot ulcers. Several of our patients had lost weight as they’d instituted an exercise program. No one gained weight today.

Our hypertension patients took their medications faithfully and monitored their blood pressure. A few of them had experimented with biofeedback and meditation as a way to control their stress.  They all knew the correct way to take a blood pressure and insisted it be done that way, politely, of course.

Our patients with mental illnesses continued to work with their therapists and psychiatrists to gain insight into their problems and work through them. Everyone who needed a referral to our therapist, got one, and got in the same day. Our patients on medication acknowledged the role of talk therapy in their recovery. None of them self medicated with tobacco, alcohol, or illicit drugs.

People with coughs, colds, and sore throats came in without the expectation of an antibiotic prescription and left armed with self care tips and the knowledge that their illness would get better with time. They all promised to take time off from work to get well, rather than return to work and sicken their coworkers. 

No one left our office today with a prescription without knowing what it was for, what the side effects were, and what they should look for in order to judge it’s effectiveness.

My coworkers and I had a great day of teamwork as we tried to meet our patient’s needs in a polite, respectful way. At the end of the day we all went home tired, but we felt good about the job we’d done.

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Are We Safe Yet?

Sitting in a hard plastic chair, waiting for someone to show up and pat search me,  I look at the mass of people going through airport security around me and wonder if we’re safe yet.
I remember what air travel used to be like.  One went to the airport with a identification and a ticket, checked in at the desk, and leisurely walked to the gate, oftentimes accompanied by family members or loved ones. I have fond memories of my grandparents waving at the window as I boarded my flight in Tuscon. I have pictures at the Manchester airport with my firstborn as she waited to board her first flight alone to college. Back then, airports were happy places. Security, if there was any, was hidden in the background.
When my mother traveled to Italy one year, she was struck by the fact that airports there had security officers that carried guns. Machine guns. My mother was a cop, so it wasn’t the guns that scared her. It was the fact that it seemed reasonable to expect an event requiring an armed response.
Something we thought would never happen here.
And then 9/11 happened and all of a sudden U.S.airports had armed men and woman. I remember the first time flying through Charlotte and seeing men, who I assumed were National Guard or the like, positioned throughout the airport with casually held machine guns and rifles.  It lent a different tenor to the trip, but deep down I was more scared of the men with guns than I was of terrorists. The guns I could see. The tension I could feel. How many times has a simple misunderstanding escalated into violence? Enough to know that men with guns frightened me and had no place in the airport.
The guns were only the first change. Suddenly only “authorized travelers,” meaning those with tickets and boarding passes, could enter the gate areas. Metal detectors and x-rayed luggage became the new standard. We all learned the ever changing rules of travel: Laptops out and turned on, shoes, jackets, and belts off.  No nail clippers, no lighters, no scissors. The area around the screening checkpoint became choked with the belongings we left behind in order to go forward.  We packed our bags and hoped the inadvertent tangle of cords and batteries didn’t get mistaken for a bomb.
We became afraid to say the word bomb in the airport terminal.
Then one sunny day I traveled back from Myrtle Beach and discovered liquids were the new enemy. Forget carrying drinks on the plane, let alone shampoo or conditioner.  Security made us dump them at the gate. Liquids in our carry-on bags were first forbidden, and then “after extensive research and understanding of current threats” (TSA website) were allowed  in 3.4 ounces containers in a ziplock bag. Security checkpoint trashes overflowed with oversized shampoo bottles, liquid foundation,  and discarded drinks.
Then full body scanner machines were introduced. Touted as a noninvasive method to detect items hidden under clothes, we learned to stand with our arms outstretched and our feet on the yellow outlines. We took off our shoes, jackets, belts, hats.  We took our laptops out and put them in a separate bin. Our liquids,  too. We watched as TSA officials scrutinized our identification cards and checked our boarding passes. At least they didn’t have guns. We endured pat downs in public. We endured pat downs in private.  Trigger the metal detector or refuse the body scanner and assume the position.
So as I waited at Charlotte airport recently on a hard black, plastic chair for someone to pat me down, I saw people pass with dogs, cats, small children, strollers and wheelchairs.  Surprisingly, none of them  went through the metal detector or the body scanner. They, and their owners were pulled aside, I assume for a pat down, but what good is patting down a cat? A dog? A stroller? A wheelchair?
If a determined person wants to get a bomb, a gun, or an airborne virus on a plane,  do we have the technology to stop them?  I don’t believe our security can keep up with human ingenuity. If someone wants to do it bad enough, they’ll find a way.
I think of all of the liberties we have given up, all of the dignity we have lost, all of the changes we have endured, and I have to ask, are we safe yet? I think not.