Disease

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I just did one of those continuing medical education courses — in psychiatry, my very own field no less. It says that people who get a bout of depression are twice as likely to get a bout of back pain. What I read is a meta-analysis.  That means some clever person who probably needed the publication on his (or her) resume did a statistical (and critical) analysis of research other people did. This a noble attempt to asymptotically approach “the Truth and the Light” on a subject. It is also a delightfully erudite way to do research and get a publication without using a lot of time and money that the author had to scrape up.

Look, the relationship between depression and low back pain is something I have seen from every imaginable angle. As a neurosurgeon, it did not take me terribly long to figure out that surgery was not a very good solution for back pain. Of course, we rigorously restricted ourselves to operating focalized sciatica.  Cases where we could reasonably infer that an intervertebral disc seemed to be compressing a distinct (lumbar) nerve root that formed part of the sciatic nerve (plexus) that descended from the spinal cord to the leg and foot. There was the physical examination.  If someone were lying flat on his (more rarely, her) back and their straight leg was raised toward the ceiling, pain would appear on a trajectory anatomically consistent with one of those nerves. This was the sign of Laseque.  And we took it to be as solid as money in the bank. Read more on Depression and Low Back Pain…

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She was an active patient, who I am still trying to see once a week until I direct her in how to survive and flourish in the universe. She was in her forties, depressed and anxious.  She had “a little panic attack,” some chest pain and the feeling her breath was cut off. I wasted no time sending her to an Emergency Room, (or, if she really did not feel it was that bad, to an Urgent Care — what we used to call it a “doc in a box”) because it is cheaper, sounds less foreboding, and any doctor who is sentient and has a pulse and is on duty would send her to an Emergency Room if anything was really wrong.

Chest pain or tightness or shortness of breath or a “tight feeling, like a vice” could always be a heart problem, and could always be life threatening until proven otherwise.  I tend to send  even the most mild discomforts of this nature, that people had for years to primary physicians for a “cardiocentric examination.”  For “auscultation,” the old fashioned Latin-origin word for a good listening to the well as generally an electrocardiogram and sometimes even an echocardiogram.

Read more on Don’t Ignore Chest Pain…

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Too many Americans can’t afford to and simply do not–take their medicines as prescribed. That estimate is based on information from the (American!) Centers for Disease Control). I have had patients come into my office who take their medications –in both cases, for life-threatening infectious diseases — only every other day, simply because that is all they can afford. I explained to each one individually the idea of the half-life of a drug. They only stay in your body for a certain length of time, then they leave your body in waste products.  That is why taking a drug every other day is not really effective. They both gave me almost exactly the same response — It was all they could afford, and it was probably better than nothing. Read more on Big Pharma Is Capitalism Out Of Control…

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I was about three years old when I enjoyed tending our backyard with her.  I had been a marvel to her, since she was a little girl, earning her keep as an agricultural worker in the Ukraine, it what was then known as Russia.

Read more on What You Eat Makes You Who You Are (Smart!)…

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I think I was in my teens when I heard the playwright Edward Albee interviewed.  It was one of those interviews that sears your soul and that you remember over 40 years later. He said something about people who get older, like when their children who are adults and start having families of their own.  They all ask themselves the same question, which is “Did I do it right?” — meaning “Life” definitely with a capital “L.”

Read more on Don’t Live A Life Of Regrets…

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Lots of trees in the great Golden State seem to have Dutch Elm Disease. I said “seem” because I only see them from my automobile window as we are whizzing by on some highway. The trunks are smooth and grayish and they are not palm trees.  Maybe they are elms.  I don’t know — trees are decidedly outside of my scope of practice. When you see a smooth gray tree, a fungus carried by a “bark beetle” has killed the outer bark, which is the living part of a tree that transports nutrients and water to the places that need it: leafy twigs and fruits and such.

Read more on Dutch Elm Disease For People…

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What you have been through makes you who you are.
A man abused by his father told me he all too often finds that he has abused his own son.  He did not want to.  He did not mean to.  He realized he was becoming his father and he trembled.

Read more on Breaking The Chain Of Abuse…

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She was, and is, a close and cherished friend. Someone decided she had Alzheimer’s.  At least somebody said she did.  She had wonderful plans for retirement.  Now the retirement community she had been dreaming of did not seem to want her and her husband around.  She has just made the decision (I don’t know with who’s help) that it is a better idea she does not drive. She would surely not remember the details of how the diagnosis was made.  I wonder if it had been made properly.  Probably not.

Read more on All That is Demented is not Alzheimer’s…

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Natural treatment of obsessionality. “Estelle, you’re such a little worrier.  Yes you are.” When I was little, I never understood why my Auntie Charlotte always addressed me this way.  I did know that my family had “adopted” her which seemed to give her the right to “adopt” me.  Her orthodox Jewish family had rejected her because she wanted to marry a guy who had been married before, even though he was very Jewish. I was not supposed to know or care about such things.  But I did know she was the first person in my life to tell me I worried too much about things that didn’t need worrying about.

Read more on Obsessions…

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Everyday health advice. If I read any more “health advice,” mental or physical, that is supposed to be practical advice but is totally wrong and built on mythology, I might explode. Given the “mainstream” unproven drivel that gets reproduced in popular magazines, I think it is pretty amazing any Americans are still alive at all. A little relaxation (deep breathing and focused meditation) — I am doing a lot better.  After all, we still have freedom of speech, although it sometimes gets fragile and needs loving protection.  And you have me, the Renegade Doctor, to tell you what is truthful and right. I didn’t start out to trash “Reader’s Digest” (RD).  My parents of blessed memory had some kind of lifetime subscription, and kept it with a very few cherished books by their bedside, on top of my mother’s premarital “Hope Chest,” which she told me contained clothes she could only “hope” she would fit into again one day. She never did. Read more on Everyday health advice drives me nuts!…