Joey M.D.

If you are interested in a workout that makes your muscles look more defined and better-looking, there’s a program I’m currently checking out that you might be interested in.

The P90X is a high intensity 90 day program by celebrity trainer that you can do at home.  It claims that it could sculpt  your muscles and “get you ripped” in that amount of time.  It includes 12 DVDs, a 3 phase nutrition program, a detailed fitness guide and online peer support.

Aside from the P90X program, there’s also the 10 minute trainer programs which look promising for busy people who have to squeeze their exercise into their packed schedule.  This I’m particularly interested in, since I simply have a difficult time setting a huge chunk of time for exercise, so small 10 minute chunks seem more manageable.

The Power 90 Master Series claims to give you even more dramatic results.  Celebrity trainor Tony Horton will guide you through this series.  This is supposed to focus on specific muscle groups so that no trouble area is neglected.

I haven’t tried any of the above programs so I cannot say how it actually works, but I guess it’s worth a try.  After all, a gym membership would cost so much more and would require more of your time.

Today is the third World Glaucoma Day.  This was started 3 years ago to raise public awareness of this blinding disease.

I’ve written a series on Glaucoma.  I’ll post the links as soon as they get published, so do stay tuned.

In the meantime, here’s my old post on glaucoma (click here).  You might want to check it out if you want to learn more about this blinding disease.

Sometimes society is so unfair and expects a lot of the so called fairer sex.

Take for instance hair.  The image of a beautiful woman is oftentimes one with long lustrous locks — on her head that is.  A mane that’s smooth and shiny and does not seem to get messed up in the wind.

However, any hair elsewhere on the body of a woman is considered “ugly”.  Hair on the upper lip, hair under the armpits, hair on the legs…these are OK for men, even macho looking, but in women they are considered to be unaesthetic.  I remember that a few years back, there was a photo of popular actress with the initials JR circulated.  She was raising her arm at that time, revealing hair under her armpits.  I do not know if it’s just here in the Philippines, but it certainly elicited a lot of “ewwww”s and “why doesn‘t she just have a Los Angeles Laser Hair Removal– she can very well afford it!”

To be fair, I do not like seeing excess hair on women either.  It’s good that since mine’s fine, they’re not very obvious and thus do not need a lot of “maintenance”  — definitely no need to look up a Los Angeles Dermatologist at all — just a little shave here and there when needed.

But if you’re contemplating permanent hair removal, do go to the experts.  You can check out Celibre on Facebook.  I believe you can ask questions there too, if you have any.

Obesity is now a global problem.  People are getting fatter because of the plethora of unhealthy foods and a sedentary lifestyle.  Of course, we all know about the health risks posed by being obese.  Some of these are:

• Ischemic heart disease
• Type 2 diabetes
• Hypertension
• Osteoarthritis
• Breathing difficulties esp during sleep
• Abnormal cholesterol levels
• Strokes
• Migraines

…among other things. There is also the social stigma of being overweight, especially among women but also in men.  Thus, overweight people are also prone to depression.

Of course, the best way to deal with being overweight is to watch your diet and increase your physical activity (exercise).  But to lose weight in a healthy manner, one should not engage in crash dieting or going hungry.  Experts do agree that a slow but steady weight loss is healthy.

Not only that, it’s imperative that maintains the weight through a sensible lifetime eating program and enough physical activity to keep the weight from coming back.

For some individuals who are morbidly obese, meaning they are more than 100 pounds over their ideal weight, dieting and exercise just takes too long.  In the meantime, they are still subject to the health problems of the obese.  For these individuals, it is best to check with a doctor who specializes in weight management.

What the doctors may opt to do is to prescribe some medications which would help in burning the excess fat and/or curb the person’s appetite.  Or consider Weight Loss Surgery.  Of course, we have to understand that these measures are to jumpstart one’s weight loss.  We can’t take medications for weight loss forever.  There’s a limit to that and what follows should still be — you guessed it — a sensible diet and exercise program — to maintain the ideal weight.

Bariatric Surgery is is a type of procedure performed on people who are dangerously obese. This weight loss is usually achieved by reducing the size of the stomach with an implanted medical device (gastric banding) or through removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by resecting and re-routing the small intestines to a small stomach pouch (gastric bypass surgery).  It’s not for everybody who wants to lose “just wants to lose a little weight” but for those who are morbidly obese, have health problems as a consequence and need to lose weight fast and also need assistance for weight control.  Of course, as with any surgery, it has its problems, hence it’s important to know who should have it and who should not.  It’s different from liposuction where fat tissues are suctioned off.  The latter is more for shaping and a quick fix, while the former is more long term.

One serving of alcohol in the form of red wine is fine, even healthy.  I repeat, in moderation.  According to the Dietary Guidelines for Americans, drinking in moderation is defined as having no more than 1 drink per day for women and no more than 2 drinks per day for men. This definition is referring to the amount consumed on any single day and is not intended as an average over several days.

But a lot of people go beyond what is considered moderate drinking. Mindless of the fact that it cause a lot of problems.

There are health problems associated with alcohol.  Chronic diseases such as liver cirrhosis (damage to liver cells); pancreatitis (inflammation of the pancreas); various cancers, including liver, mouth, throat, larynx (the voice box), and esophagus; high blood pressure; and psychological disorders are some of these health problems.  There’s also alcohol intoxication, which means “getting drunk” and results in impaired brain function resulting in poor judgment, reduced reaction time, loss of balance and motor skills, or slurred speech.

Drinking and driving is a no-no.  Statistics on victims of drunk driving should make people more careful, but many still choose to be complacent.

Drinking when pregnant cause problems with the fetal development.

Drinking causes problems in relationships and in social activities.

It’s sad, but most people with an alcohol problem do not even think that they have a problem and that Alcohol Treatment is possible.

For people who know that they have a problem and want to get Alcohol Rehab but are ashamed of their condition, it’s also possible to Private Alcohol Rehab. I’m just not sure if this is already available here in the Philippines, though.

But the first step to rehab is to recognize that you have a problem.  Otherwise, you won’t decide to seek help and you won’t get out of the cycle.

I’ve posted earlier about a doctor’s cell phone, why I give out my number and the guidelines to calling or texting your doctor.  That being said, a doctor does need a reliable cellular phone and a reliable cell phone plan.  That’s because we’re dealing with real emergencies out there and people’s lives are at stake.

It does not have to be the most expensive plan out there.  I don’t use a prepaid cellular phone because I’m afraid I might not always have the time or remember to put in load.  but the plan I’m using is one of the cheapest cell phone plans available.  I make sure it’s from a reliable network (not Sprint since I’m in the Philippines but if I’m in the United States that’s probably what I will be looking up since I’ve heard a lot of good reviews about it) and so far I have no complaints about it.

It’s not really how much you paid for it but it’s important that service is more or less continuous.  That’s so you can be sure that you will be reached when your patient is in the emergency room and the resident needs to inform you about it.

I am so busy lately.  But I’d like to think that that’s good.  I’ve started going to a new clinic which looks very promising.

But I’ve realized that I dress to casually for work.  People want to see a doktora looking a little bit on the glamorous side.  They want an image of a successful woman (or man, for that matter).

Since I’ve given birth though, I haven’t exactly maintained my already-not-too-perfect figure.  But I suppose I do need to buy a few pieces of clothes.  I’m eyeing some summer styles since it’s the most practical style here in the Philippines, us having only 2 seasons.  And maybe get some accessories that would suit those new clothes.  I’m so glad we can actually shop online nowadays, with great sites like shopwiki, as my schedule has been VERY packed lately.

I am also browsing through some men’s clothes since I do believe that my husband also needs to update his wardrobe.  He lost a lot of weight (which is good because he used to be overweight) so some of his clothes hang loosely on him.  He’ll look better with clothes that are better fitting.

The reality for us doctors is that no matter how competent we really are, we do need to project an outward image of professionalism and success.  People do equate success with outward appearance.  So do dress your part.

I’ve given my viewpoints regarding the doctor’s cell phone as a doctor and as a patient.  It’s really the doctor’s prerogative whether or not to give out the cellphone number, but if he/she does, do use the info wisely.

• Please don’t call at unholy hours of the night for non-emergencies. Of course, doctors and patients do have different views on what an emergency is, but getting advise for what’s the best vitamin supplement is definitely NOT an emergency and is best texted during working hours.
• Please don’t expect a doctor to ALWAYS text or call back immediately. He/she might be attending to another patient, or doing surgery.  If you are the patient he/she is attending to at the moment, you really won’t appreciate it if your doctor replies to text messages while he’s supposed to be focusing on you, won’t you?  Or, like any other person, it might be inconvenient to reply immediately — he/she may be driving, or answering the call of nature, or in the shower, or even doing his/her darnedest to soothe his/her crying baby.
• If it really looks like an emergency, bring patient to the emergency room. You may text your doctor to inform him/her that you’re on your way to the ER (or you can just leave the informing to the ER doctors, who will update your doctor with the workups).  Don’t expect the doctor to be able to manage the patient through the phone.  Besides the hospital is better equipped to handle emergencies and there are ER doctors on standby who can see and manage the patient’s case immediately, even before your regular doctor reaches the hospital.
• Don’t assume that the doctor memorized everything there is to know about your case.  Try as we might, we can’t memorize every small detail about our patient’s cases.  If the patient is someone we see a lot of times, we have a pretty good idea but don’t expect us to remember the EXACT details.  If we just saw you once a long time ago, we probably have to look at our charts again.  So, there, it’s still best to go to the clinic.
• Identify yourself. There is a limit to cellphone memory and don’t assume that you are there (you might be, but again you might not).
• Don’t consult on the phone! I know people think this saves time and money, but there is really no substitute for actually seeing the patient.  Verbal descriptions are vague and we still NEED to see the problem to give a good assessment of your case.  The phone is for general advise only, not for the particular individual case.

Here in the Philippines, it is now a trend for doctors to give out their cellphone numbers.  Some patients would feel bad if the doctors don’t give out their cell numbers.  So now, most doctors do.  But please use phone the right way.

To give or not to give a cellular phone number?  That is the question…

I do give my cell phone number to my patients. There are certainly pros and cons to doing so, but for me, the pros outweigh the cons.  But then I’m in a specialty (ophthalmology) that does not have a lot of emergencies.  That’s unlike other specialties who deal with more emergencies.  Here are the pros and cons of giving out a cell phone number to patients.  Of course, this is from a doctor’s point of view.  Don’t worry, I’ll be coming up with another article in another blog, this time from the point of view of a patient or a parent (for pedia patients).

Pros:

• Doctors are perceived to be more concerned and caring when they give patients a way to contact them whenever they want to.
• Patients are assured that the doctor is just a call or a text away.
• Patients can look for still look for their doctor even if he/she changed clinics or clinic hours.
• If the medication prescribed by the doctor happens to be out of stock, the patient can immediately ask the doctor about what other medications can be substituted.
• Patient can set or confirm appointments with the doctor.

Cons:

• Patients can call at all hours…even during the times when we are supposed to be resting or sleeping.
• Patients call for emergencies…but sometimes emergencies need to be addressed not by a phone call or text but with a trip to the ER where the proper physical examination and subsequent management can be done.
• Patient use the text/phone call as a substitute for an actual consultation.  There is no substitute for an actual face to face consult with physical examination.  A text or phone consult is good only for general advise, but of course we know that health conditions are NOT the same for everybody.

So, should doctors give out their cell phone numbers to their patients?  It’s up to you, really.  But in this day and age of easy communication, patients will feel much better if they do have a way to contact you.  My view as a patient here.

My experience with giving out cellular phone numbers is not all bad.  In fact, I do believe that I reap more benefits than troubles.  Most of my patients text only when they want to confirm my schedule (I actually encourage them to do especially if they came all the way from a faraway province).  Some patients call me just after the consultation because the medicines I prescribed just happened to be unavailable at the drug store.  Some patients call when there are floods or storms to reschedule appointments.

Maybe it’s because of my specialty, which is Ophthalmology.  We do not really too many emergencies, so I figured that it would be okay if I give out my number.  And true enough, while I have one or two calls about their conditions and who would be happy enough to see me at the clinic or at the ER, I don’t believe I’ve gotten any call that woke me in the middle of the night for some trivial matter.  I guess the case would be different for doctors in specialties like OB, Pediatrics, or any of the Internal Medicine or Surgery sub-specialties.  I know of some doctors who actually get calls at 3 o’clock in the morning asking for breastfeeding advise.  I mean, come on…that is hardly an emergency!  For really really emergency cases when medical attention is needed ASAP, the emergency room is the place where proper consultation and management should be done.  Not an SMS message or a phone call!

As a patient / mom of patient / daughter of a patient myself, I do appreciate it when a doctor gives me his/her cellular number and as much as possible, I try not to abuse the “privileged” information and just use it when there is really a need to.  Here are the guidelines for “proper” cell phone use.

It’s over 5 years since the tsunami which claimed the lives of my uncle and his two young children.  While they were not able to survive that calamity, it’s admirable how the Thais managed to give maximum help to those who were affected.  One of my cousins, who was found with severe injuries but still alive after the tsunami, spent close to 3 weeks in the intensive care unit.  No expense was spared.  She was given the best antibiotics, was hooked to a respirator during all that time, had chest tubes for her hydropneumothorax and was eventually hooked to a dialysis machine, all in the vain effort of trying to save her life.  My aunt, her mom, wasn’t billed anything at all.

While we mourned and continue to mourn for her eventual passing at the young age of 10, we often thought that if it happened in one of the outlying islands here, her chances of survival would even be slimmer, since we really do not have the resources for this sort of calamity, especially outside the major cities.

Now, with disasters happening all around the world, there is a need for an “instant” hospital which would address the need for emergency medical services in such conditions and with so many people affected.  I came across an article describing so called emergency inflatable hospitals (big tents that could accommodate hospital beds) and I thought that we should have something like that here in the Philippines, so that we can immediately address the need for a wide scale calamity.

Maybe the government can add this to either their Disaster Preparedness Fund (or whatever appropriate division), aside from rubber boats for floods and helicopters for rescue missions.

Source:  http://news.discovery.com/tech/creating-hospitals-from-thin-air.html