Doctor, Heal Thyself

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One thing I never thought about before I went to medical school was how much I would be exposed to various illnesses as a physician. I guess you could say it’s an occupational hazard, but it can be downright frightening when you are exposed to some of the most virulent microbes which circulate in communities and in hospital environments. You’re bound to catch something at intervals.

Most people think of hospitals as disease-riddled, and they’re pretty much correct. But there are other places which have the potential to make you too weak to whip a gnat.

One of the worst environments is the pediatric setting, in which walking Petri dishes, also known as children, traipse into the clinic and somehow fling their nasty germs onto you. Before you know it, you are struck with a horrific infection that require an army of medications before you begin to feel human again. I remember spending the majority of my time in every single pediatrics rotation I completed, whether it was as a student, intern, or resident, so ill that I spent my days feeling like I had been hit by a truck, with a pressure cooker for a noggin, fuzzy-brained and miserable from whatever pathogen those little brats had brought to me.

Another microbe-filled gathering place is urgent care, a setting in which I have worked regularly over the past couple of years. Last year, when I was working more shifts than ever, I contracted three upper respiratory infections which progressed to bronchitis, and developed acute gastroenteritis (stomach flu) twice. Thank goodness I always get a flu shot every fall, otherwise I am sure I would have been hit with influenza as well. I see patients who are so sick that they can barely stay awake during their exams, people who have no business being out in public.

I recently saw a young female patient with a 103 degree fever who looked very ill, so I tested her for strep throat and influenza A&B. The nurse on staff asked if I wanted both, to which I replied, “Absolutely. I wouldn’t be surprised if both tests lit up like Christmas trees.” And they did. She actually had both influenza A and streptococcal pharyngitis. Poor girl.

It’s my duty as a physician to care for others, and I take it very seriously. But I will admit that my attitude towards my own illnesses is similar to the attitude of the Black Knight. My attitude is that it’s “only a flesh wound”, or “just a scratch” when I am ill or injured, so when I finally break down and admit that I am ill or injured, I am definitely in a bad place physically.

I suspect this attitude is similar to that of other physicians. So keep that in mind when you see that your provider is under the weather. We are only human as well.

Take Care of Your Girlie Parts

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Copyright : Olena Kachmar

As a follow-up to one of my more bizarre blog posts which dropped last week, I’m posting information on a couple of skin care products for a woman’s private parts. Though I have been involved in cosmetic dermatology for over 16 years, such products are honestly a surprise to me, and I wonder how gimmicky they are. I am of the strong opinion that ladies needn’t trouble themselves with detoxifying and pH-balancing an area which does a pretty good job of balancing things out on its own. I also can’t see why anyone in their right minds would be willing to blow $20 a pop on the Blackout Mask. The design of Janna’s Intimate Mask seems much more appealing, and has a more reasonable price point (about $6.50 USD), but of course it is only available in specific countries in Europe.

One use which makes complete sense to me is after IPL or laser hair reduction treatment, or waxing, since the masks would probably do an excellent job of soothing the skin post-treatment.

Here are the products:

https://www.jannauk.co.uk/product-page/intimate-mask-ph-balancing-skin-essence

Intimate Mask + pH Balancing Skin Essence
Janna’s Intimate Mask is our first anytime wearable mask that gently cares for your intimate skin. Each mask comes individually packaged with our delicately formulated essence made from natural, organic and skin loving ingredients to give you that fresh all day feeling.

Blackout (Activated Charcoal Vulva Mask)

BLACKOUT (ACTIVATED CHARCOAL VULVA MASK)
$28.00 SGD
The world’s first vulva mask. Blackout’s 4-step process soothes, detoxifies, brightens and moisturises the vulva with the help of infrared activated charcoal to boost lymphatic drainage to rejuvenate the skin.

Made with organic ingredients without sulphates, parabens or petrochemicals. Gynaecologically and dermatologically tested.

Now ordinarily I would be willing to serve as a guinea pig for any skincare products, but I’m not sure how I feel about sacrificing my goodie bits for the sake of dermatological scientific query. I’m very curious to know what the gals across the ocean think of such products?

Doctors Are Detectives

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There is tremendous responsibility in being a physician, and I take it very seriously. Any time I walk into a medical facility and see patients, I know that the patients and staff are all counting on me to assess patients fully, make proper diagnoses, and provide appropriate treatments. Basically, I know that I MUST make the right decisions at all times and be at the top of my game. Talk about pressure! Nevertheless, the thrill of solving a problem is so rewarding that it quickly eradicates any feelings of anxiety.

I just read Atul Gawande’s excellent book, Being Mortal, and I love this passage in which he very aptly describes the satisfaction which can come from being a physician:

“You become a doctor for what you imagine to be the satisfaction of the work, and that turns out to be the satisfaction of competence. It is a deep satisfaction very much like the one that a carpenter experiences in restoring a fragile antique chest or that a science teacher experiences in bringing a fifth grader to that sudden, mind-shifting recognition of what atoms are. It comes partly from being helpful to others. But it also comes from being technically skilled and able to solve difficult, intricate problems. Your competence gives you a secure sense of identity. For a clinician, therefore, nothing is more threatening to who you think you are than a patient with problem you cannot solve.”

The truth is that pretty much every physician has come across a case which he or she could not solve, one which necessitated a discussion with a specialist, or a lengthy literature review to aid in diagnosing the zebra who walked into the office that day. Physicians are human, fallible, and though they usually have the answers to the puzzles which are constantly presented to them, they may find themselves stumped every now and then, and that is a dreadful feeling.

It is an honor to serve humankind as a problem-solver, and I will always strive to keep my clinical acumen as sharp as possible in order to provide the best medical care.

When Your Arms Are Too Short…

 

As someone who grew up with myopia (nearsightedness), I never imagined that my reading vision would fail me.  Yet I have spent the last four years holding menus at arm’s length to make it easier to read the food selections.  Within the past year, I adopted the habit of grabbing my reading glasses first thing in the morning when I grab my phone.  Do you know why?  Because my close-up vision has become so dim that if I dare to construct a social media post without my glasses, I end up finding typos on my caption or hashtags.  I’ve even gotten to the point where I wear my glasses when sitting at the computer and reading a considerable amount of material, because it reduces eye strain.  

The end result is that I either grab glasses, or wish that my arms were longer.  I also wish that restaurants filled with romantic ambience would scrap the low light conditions in favor of slightly brighter light which would make it possible for all but the most elderly and vision-challenged to see.  

Presbyopia (the age related stiffening of the lens of the eye, which interferes with its ability to contract and diffract the light) has reared its ugly head and taken up residence permanently in my daily life.   And despite the fact that I had the knowledge base to realize that presbyopia would color my life after the age of 50, I am still surprised at how sudden and noticeable the vision changes have been.  

I went from not being able to see the big E on the Snellen eye chart from my childhood into my late 40’s, to struggling to read receipts in my 50’s and wondering,  “Is that a 6, or an 8?”, or, “Is that a 3 or a 5?”  It’s pretty frustrating.  There have been instances in which I have picked up products with the intention of reading the product ingredients, but I often cannot read them at all.  

What’s really strange is that it makes me feel a bit disconnected from the world, since once sense is noticeably dulled. Who else feels that way as a result of having age-related loss of near vision?

Disrespect

Last month, while working an urgent care shift, I caught a bug from one of my patients which progressed very quickly from a viral upper respiratory illness to a bacterial infection. Because I was so congested, the infection also seeded in my upper airways, and I developed bronchitis. Whenever bronchitis sets in, I am in for a world of hurt, because the coughing jags are so violent that I almost pass out from them since I can’t get a breath in.

In an effort to keep social media world happy, I posted my health status just so people would know why I sort of backed off from social interaction during that time. I felt horrible, and my voice was reduced to a strange, congested baritone mumble.

What irritated me was that several people jumped onto social media with health advice. I understand that people were concerned and trying to be helpful. However, there were two facts which kept floating through my head, and which left me scratching my head over how people thought it was appropriate to post advice.

FACT #1: I never asked for any advice from anyone. I was merely posting facts about my condition.

FACT #2: I am a board-certified family practice physician who works regularly in the urgent care setting. Don’t you think I would KNOW how to take care of myself? Why would anyone offer unsolicited health advice to a physician?

I couldn’t help but be bothered by the influx of posts suggesting things like, “drink tea with honey”, or “take zinc”. As an urgent care doctor, I am just as likely to give general, common sense advice about upper respiratory infections as I am to give prescriptions for medications and order in-office nebulizer treatments. I know all about zinc, tea with honey, vitamin C, salt water gargles, etc.

Besides, I ended up needing a course of antibiotics, two prescription inhalers, two prescription cough medications, and three over-the-counter decongestants. No amount of tea with honey, zinc, or salt gargles would have fought off the infection and reactive bronchitis I had developed. One person on Facebook hounded me via Messenger, and when I said I couldn’t chat, sent me a bizarre set of instructions for a concoction which included red wine. I became irritated and berated him for giving me health advice, whereupon he took the opportunity to insult me for no good reason. His disrespect was so blatant that I blocked him. I don’t need that kind of hostility in my life.

Sorry, but I think it is presumptuous and insulting to attempt to give health advice to doctors. In the age of Google, so many people fall under the assumption that they are suddenly experts when it comes to just about everything. Don’t trust everything you read on Google!

When I really think about it, I doubt that people would give automotive advice to an auto mechanic, or financial advice to their CPA’s. So why insult someone with 7 years of medical training and 14 years of experience as a practicing physician?

I believe I have made my point.