Hello, this is Peter Kim MD, and welcome to 5-Shot Friday, part deux.
1) Disaster Prep Can Be Fun, Sort Of
There are any number of ways to approach disaster prep. It depends on how you define “disaster.” Nuclear winter? Long lines at Disneyland? Jerry’s Dogs closing some locations? (The departure of Jerry’s Dogs had me reeling, I must admit.)
If the end of your worldly comforts means catastrophe, as in “serious disruption of major services across a wide area,” you could do worse than getting pointers from The Department Of Homeland Security.
DHS’s READY website covers Natural Disasters, including Earthquakes (with a video by Dwayne “The Rock” Johnson), Extreme Heat, Home and Wildfires, Floods, Tsunamis and Space Weather (which I had to look up), Tech and Accidental Hazards (power outages, hazardous materials accidents, and nuclear power plants), Terrorist Hazards (bio, chem, cyber, bombs, nuclear blasts and radiation dispersion)…
(deep breath)
…Making Your Emergency Plan, Building An Emergency Supply Kit, Planning For Your Business, Educating Your Kids, and then there are the getting involved, preparing your community, and social media links.
Wow. It seems like preparedness overkill, until you realize that in California, we’ve experienced pretty much every disaster on that list.
If you would like to focus on quakes, another great site is SF 72’s, based in San Francisco, arguably the American earthquake experts. Any kind of preparation against Cataclysms is a Good Thing.
(BTW, a tip for iPhone users: you may want to turn off the Amber Alert notifications, but don’t turn off the WEAs (Wireless Emergency Alerts, which are unaffected by network congestion. You may not be able to make calls during an emergency, but if the cell towers are still operational, you’ll get the emergency alerts.)
2) Arthur’s Inspirational Transformation
Arthur Boorman’s YouTube video has been viewed nearly 13 million times. In 4 minutes and 54 seconds, it demonstrates THE prime principle of exercise, activity, and losing weight, but most importantly, of starting down the path to transformation.
Start Where You’re At.
Discouraged that you can’t run for 20 minutes – because you can barely walk to the mailbox without getting winded? Walk halfway to the mailbox, every day. Then to the mailbox when halfway gets easier. Then to the mailbox plus 10 feet. Repeat and extend when able.
Can’t lift a 5 lb. dumbbell? Start with a 1 pounder. Don’t have any dumbbells? Grab a can of soup.
Great is the enemy of good, said Voltaire. The only guaranteed failure is never getting started because you can’t do “it” perfectly, or because the little bit you can do is “pointless.” Start wherever you’re at and you’ll build.
We live in conflicted times, with many more “powers that be” than ever before. In my parent’s generation it was almost unheard of to question your own doctor, because you assumed he knew the medical science and would always act in your best interests. With the onslaught of news releases, pharma campaigns, and political doublespeak, your doctor’s advice has become just one of many pings on your personal wellness radar.
Worse, you may wonder if your personal physician is an accomplice to larger organizations who want to hoodwink you for their own gain, hiding behind “science” and “studies” to justify whatever profits them. The recent pushbacks against statin medications to lower cholesterol, and of course, vaccinations, are but two examples. The biggest casualties may be your faith in your doctor and in the reliability of science itself.
Choosing Wisely is a campaign aimed at reversing this death spiral.
The American Board of Internal Medicine Foundation joined Consumer Reports to create the CW campaign, now partnered with more than 70 medical societies, to educate patients and physicians about the best tests, treatments, and procedures. Many of its recommendations advise against actions that would financially benefit a doctor, medical institution, or specialty group, because of unbiased analysis that reveals what truly helps patients, even if there’s a more expensive but less effective option. You may not need an annual physical, just because it’s time; most >respiratory infections are not helped by antibiotics; and whole-body CT scans aren’t so great for cancer screening. The website contains a searchable list of conditions that explain whether common medical practice (or patient expectation) may or may not be the best choice.
The ABIM Foundation was founded by the ABIM in 1989, as a charity “to advance the core values of medical professionalism as a force to improve the quality of health care.” With initiatives like Enhancing Primary Care (as opposed to far more profitable specialty care), Improving Care Transitions (where most “falling through the cracks” occurs: leaving the hospital or skilled nursing facility), and Addressing Conflicts Of Interest (oh yeah, ye who sell your trust for coin), the Foundation and its Choosing Wisely campaign are trying to clean house.
A chance to peek into the complexities of proverbial “brain surgery” that I mentioned in last week’s 5-Shot Friday, Snowball In a Blizzard is one physician’s eloquent discussion of why medical science is Complicated with a capital “C.”
As one reviewer on Amazon put it:
“In today"s world, both professional and lay person alike are bombarded with information. As humans we are predisposed to fit that information into a category of true/untrue. While this mode of thinking has many advantages (speed, simplicity) it also leads to placing too much confidence in some information and not in others which can in turn lead to bad choices.
“More and more we live in a society that deifies the role of the expert. When faced with a question outside of our own particular milieu, we place near 100% faith in the recommendations of one or more selected experts without appreciating the level to which that expert is or should be confident in that recommendation. In this book, Dr. Hatch helps us to identify when this type of mistake is likely to happen and provides us with a framework (the "spectrum of uncertainty") to place this information in a more rational context. Let"s hope we listen.”
Medicine tries to give specific advice – for you as the individual patient – based on studying lots of other individuals like you, but each with their own quirks, special circumstances, dietary differences, etc. It’s different from scientific fields where each thing is like every other thing in the known universe (H2O is still H2O, in your backyard or on Mars).
Medicine goes from the specific, to lots of specifics, to the general, and then back out again to the specific – like starting with a slab of beef, going to a herd of cattle, getting a jar of bouillon cubes, and finally using it to make a beef stew taste just the way your mom used to make it. It’s a complex process I wouldn’t wish on my worst enemy in the 9th circle of hell, and if there were any other way to find what works and what doesn’t in medicine, medical scientists would have adopted it a loooong time ago.
5) From @jessicahagy: I drew a gross thing. To post or not to post?
“Okay. I warned you,” she said.
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Dr. Bunten is originally from Huntington Beach, CA. He attended high school in Tokyo, Japan, went to college at UC San Diego and then to medical school in the Midwest. He returned home to California for residency training in Family Medicine at Long Beach Memorial Medical Center. His immediate family all reside in Huntington Beach.
Dr Fishbein has been in the practice of family medicine for over 35 years in Irvine. He received his undergraduate degree from Southern Illinois University, medical degree from Chicago Medical School, and completed his family medicine residency at Memorial Hospital of Long Beach.
Dr. Kim is the Medical Director of Family Care Centers, Chair of the Department of Family Medicine at Hoag Hospital, and a recipient of the Physicians of Excellence award from the Orange County Medical Association. He is Board Certified in Family Medicine, and has been practicing in our community for over 20 years.
Dr. Memon is a board certified Family Medicine physician and recently completed her fellowship in Geriatrics at the University of California, Irvine Medical Center. She attended Saint George’s University, School of Medicine and completed her residency at Arrowhead Regional Medical Center. Her interest in medicine started at an early age and has since evolved into a passionate career.
Dr. Gina Nguyen obtained her Bachelor of Science degree in Biology at UC Irvine where she graduated Suma Cum Laude. She went to USC Keck School of Medicine, and returned to UC Irvine for a Family Medicine Residency. Since 2005, she worked at Kaiser Permanente, VNCOC, and Family Care Center Urgent Care.
Dr. Williams is Board Certified in Family Medicine and Sports Medicine. He is a native to Orange County and returned home after completing his medical degree at the University of New Mexico, Albuquerque. After completing his residency in family practice he successfully completed a fellowship in sports medicine.
Dr. Hye Lee is a board-certified Family Practice Physician, affiliated with the American Osteopathic Association and the American College of Osteopathic Family Practice.She obtained her Bachelor of Science degree in Biology at UC Riverside and earned her medical degree from Des Moines University Osteopathic Medical Center. Afterward, she did her internship at Downey Regional Medical Center in California and has been a primary care physician since 2005.
Dr. Coyne is a board certified family practice physician and a California native. He completed his undergraduate degree at UCLA before earning his medical degree at George Washington University in Washington, D.C. Dr Coyne spent 6 years in the US Air Force at Andrews and Luke Air Force bases, eventually separating as a Major. He enjoys working with patients of all ages.”
Dr. Jay Friehling is a Family Practice physician who has worked in Orange County since 1981. Born in Florida, he received his undergraduate degree from Cornell University and then earned a Medical Degree at the New York Medical College.” His healthcare interests include Diabetes, Geriatric Care, and Hospice Care.
Dr. Jennifer Shoquist is board certified in Family Medicine. Her special interest is woman’s health and her practice accepts patients from 6 years old to seniors. Dr. Shoquist received her M.D. degree at The University of Texas Medical School at Houston in Houston, Texas, and did her residency with Memorial Family Practice at memorial Southwest Hospital in Houston, Texas.
Dr. Tom is a board certified family medicine physician and native Californian. He received his bachelors of science with great distinction in biochemistry and honors in chemistry. Dr. Tom was awarded a Regents Scholarship to attend medical school at UC Irvine.
Dr. Yan attended Kirksville College of Osteopathic Medicine and completed her Family Practice residency at Kern Medical Center in Bakersfield, California. She joined Family Care Center in 2001. She chose Family Practice because she enjoys working with a wide variety of people and because it provides a unique opportunity for continuing care.
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