MediaMedico

Concussion, 4 stitches, sprained hand and the mother of all black eyes (image by digitalart)

FacePlant. Full stop… dog bites, pulled muscles, sprains, strains, fractured bones, runners get them all, it’s enough to make you wonder why we do it.

Halfway thru a 16k half-marathon training run I tripped on an uneven curb running downhill. In the blink of an eye I mashed my head into the pavement landing on my face—out cold. Concussion, 4 stitches above the left eye, massive abrasions on left side of my face, shoulder, sprained left hand, and sundry other abrasions on knees etc.

The thing is, I didn’t do anything different—or wrong. It was gorgeous day, I was running with 3 friends (fortunately—another good reason to run with other people). I tripped on a curb (so I am told, I don’t remember). In a millisecond I became a patient. The kindness of a stranger driving by whisked me to the ER where I was promptly assessed by a Paramedic and triaged into a room until the pleasant young woman Emergency Physician came to see me, and ordered tests. I was quickly taken to X-ray and back. The physician sutured my face and we waited, and waited until everyone felt I had been observed long enough to go home. The alternative was to wait longer for a CT scan, which we all knew, would be normal anyway.

Of all the injuries a concussion is the worst I think because you can’t see it, people don’t see the problem but often there are lingering subtle effects such as mood or even personality changes (in some cases). Patience and a tincture of time are the only options.

The lingering embarrassment and the never-ending explanations of your highly visible facial contusions framed by that award winning black eye are always met with a persistent, nodding suspicious doubt. Isn’t it always the case, your witnesses are never there when you need them. Someday perhaps we’ll be able to Google-up a video to prove our version of events!

In the meantime the Universe can slap us all around on occasion which is why hermeneutics or the art of interpretation is the road to wisdom.

Cryopreservation hopes you'll thaw out in the future (image by digitalart)

There probably isn’t anything more bizarre in humanity’s search for immortality than the phenomenon of cryopreservation after death. Cryopreservation freezes the body in liquid nitrogen to preserve it in the ‘hope’ someday that science and medicine will be able to revive them.  One of the challenges of course is that nobody has ever been revived; not a dog, a cat, a rat or a chimpanzee (perhaps with the exception of a Nematode worm).  To further complicate the picture, you have to be legally dead to be a candidate for cryopreservation. It would legally be a form of euthanasia if the person wasn’t already dead since nobody has ever been revived, they would be killed in the cryopreservation process. So, not only would we be hoping science can find a cure for what killed us we’re hoping one day science will be able to raise the dead and immortality will reign supreme (image the traffic in Florida!). There are a heap of technological challenges to overcome in the meantime but if you’re interested in freezing yourself or a loved one for about a quarter of a million dollars in the hope science will someday be able to raise the dead this could be a viable option. Will that be Visa or MasterCard?

Our Moon has very long nights (image by Idea go)

What’s up with all this talk about colonizing the Moon? Lunar nights are just over 2 weeks long (354 hours). I suppose that could be good. One could certainly get a good night’s sleep on the moon. Newt Gingrich would be President of the Colony. By decree everyone would dress up as a Pilgrim. Every day would be Thanksgiving except you’d have to work at finding food; turning over every rock. There would be lots of crooks and crannies and plenty of places to get away to.  Real turkey would be hard to find, except the one you brought; it would be in the colony zoo. Newt wouldn’t let anyone eat it. Grumbling would break out. There would be official services reciting the World According to Newt as everyone gazed at the big blue planet in the sky. Eventually people would want to go home, back to Earth that is. Newt would laugh a big Newt laugh and shout, “Losers!” It’s okay, you’d wake up… just another lunatic dream. It’s Saturday.

What if Feng Shui informed health care facility design? (image by Simon Howden)

The Lab rats have been restless. It’s Friday and we’ve been scurrying about analyzing and researching hundreds of articles, reports and papers in order to find the informative and sometimes offbeat you expect from MediaMedico.

Feng Shui, the ancient Chinese spiritual approach to design has sometimes been used to construct health care facilities. Whether or not you think that’s a good idea, stopping to think about how we design health care facilities from hospitals to nursing homes warrants some consideration. Our western construction process is all about the efficient and cost-effective use of space but many times long after the construction crews are gone, and sometimes years later those left in the space wonder: just what were the engineers thinking? Many of the space problems in hospitals arise as new technology enters the scene, technology that wasn’t even invented when the building was constructed. All this new stuff ends up clogging hallways or rooms meant for other purposes.

Could we learn from a Feng Shui approach in both the design and in the renovation of our health care facilities?  MediaMedico Labs thinks this is an area worth further study.

Yogurt might be the ticket (image by Master isolated images)

Not everyone likes yogurt. However, yogurt-containing probiotics (Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, and/or Bacillus) may have a potentially important role in the prevention and treatment of antibiotic associated diarrhea according to a review of 82 randomized controlled trials published in the Journal of the American Medical Association. The outstanding question is which probiotics work better than the others. At this point nobody knows the answer to that question. So meanwhile, MediaMedico Labs suggests you might as well learn to like probiotic yogurt. You can always add healthy fruit.

Mondays are a great time to practice positive thinking (image by digitalart)

Most goldfish live in a small glass bowl until they can’t take it anymore and finally take the big jump.  It’s Monday.  Sometimes the goldfish in a us wants to find a better place, one with more meaning, a better view, nicer weather, more time to do the things we really want to.  You’ll hear people say, “Just another pensionable day,” without understanding the irony. Mondays like these are a perfect time to practice positive thinking. Yeah, that’s right. Why? When everyone else is in a Monday funk, it’s the perfect time for fun, and what could be more fun than putting a positive spin on Mondays. Imagine you work on Wall Street and the market is taking a ‘hair cut’ again. You say to your pinstriped boss in the stiletto heels, “Red is so your color!”

Oh, and don’t forget to smile. It’s Monday. Think positive, Friday’s coming.

The majority of confidentiality breaches in health care happen the old fashion way (image by Photostock)

In this world of cameras on almost every street corner are we too concerned with confidentiality in health care? Really, in this day of cookies that monitor our every keystroke and as Google Analytics follows our every web move, are we collectively any more worried about our health information than the security of our bank account information? Should the standard for health information be any higher than for our money? Our money flows around the world with the stroke of a key but progress toward interconnected health records are clogged by a confidentiality juggernaut. In this Wi Fi world do we need to think again about what we’re trying to achieve? In the FaceBook era how important is confidentiality to most people anymore? Is it time to rethink the risks versus the greater good?

Primary health care is cost-effective care when and where people need it (image by graur razvan ionut)

Primary care physicians and nurse practitioners are highly trained providers who contribute to  health by focusing on the needs of the whole person, rather than on a single organ; they emphasize prevention and wellness screening, which can reduce the life-expectancy gap between rich and poor, currently about a decade or more depending on where you live; acting as gatekeepers to more expensive specialty services; controlling costs by referring only patients who truly require the skill of a specialist. After all, 86% of medical needs can be managed in the community. Primary care provides continuity, coordination of care, and constant ‘clinical companionship’ in the search for wellness. The polls consistently show that the public has trust in their own doctors and nurses, which allows primary care providers to absorb diagnostic risk, reduce hospitalizations, excessive investigations, and potentially at least, inappropriate prescribing.  Patient satisfaction and health outcomes should give us the best evidence needed to justify the shift in investment from institutional care to community-based primary care. Now is the time for action.

My friend Patch Adams said, "Make'em laugh at every meeting."

Clowns are all the rage in pediatric hospitals these days but what about in nursing homes or medical wards?  In the literature, reports suggest positive effects on people with dementia and on their caregivers. Yes, through the Patch Adams-like clown doctor it is possible to obtain access to and interact with someone with dementia, which leads to an increased sense of well-being and can significantly contribute to a reduction of problematic behavior needing “medical restraint.” It also has a positive effect on the working atmosphere for the nursing staff. Pediatric hospitals have known this for a long time. Maybe it’s time we got serious about clowning around in hospitals and nursing homes too.

Storm brews on health care horizon (image by Jennifer Ellison)

There is an ethical clash of Titans gathering on the health care horizon. Not since Roe v. Wade has there been such saber rattling. The issue is what we can do in medicine versus what is appropriate. The debate will be about “waste.” As is often the case, the central issue will be rarely articulated because it involves money, filthy lucre; that is one person’s expense is another person’s income. An ethical mandate to prioritize waste avoidance won’t address the political hurdles, of course.  There will be lots of demagoguery and exaggeration. Medicine’s role in this campaign will pose a serious challenge to physician professionalism. Will physicians commit to putting patients first, that is will physicians speak out about the harm of inappropriate care, while working to achieve affordable care for all? Fasten your seat belts.