<?xml version="1.0" encoding="utf-8"?><feed xmlns="http://www.w3.org/2005/Atom"><title>THE DOCTOR BLOGGER</title><updated>2008-07-06T00:31:15Z</updated><id>http://thedoctorblogger.com/atom.aspx</id><link rel="self" href="http://thedoctorblogger.com/atom.aspx" /><link rel="alternate" href="http://thedoctorblogger.com" /><generator uri="http://app.onlinequickblog.com/" version="2.0">Quick Blog</generator><entry><title>Doctor Blog--Priorities During Major Disasters--Who and How</title><link rel="alternate" href="http://thedoctorblogger.com/2008/07/02/doctor-blogpriorities-during-major-disasterswho-and-how.aspx" /><id>tag:thedoctorblogger.com,2008-07-03:29c8aad0-fc35-423e-b15b-5ced22bbd7f9</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><category term="B. Day in the Life of a Doctor" /><updated>2008-07-02T12:10:54Z</updated><published>2008-07-03T12:00:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<A title="Hurricane Katrina from Space (hurricanekatrina)" href="http://www.flickr.com/photos/48135670@N00/97951579/"><IMG class=pc_img height=141 alt="Hurricane Katrina from Space (hurricanekatrina)" src="http://farm1.static.flickr.com/31/97951579_d7e765d679_m.jpg" width=240></A><BR><BR>This comment comes from one of my readers named Heather.&nbsp; She writes<BR>about <A href="http://thedoctorblogger.com/2008/01/03/wwwtechnoraticom.aspx">Dr. Anna Pou in New Orleans</A>&nbsp;in the days after Hurricane Katrina hit.<BR><BR>She brings up an interesting point which is that our priorities as a nation<BR>are reflected in this case.&nbsp; I would have to agree, unfortunately.<BR><BR>The questions brought up include how to triage in the setting of massive<BR>natural disaster, who is responsible, how to address limited resources,<BR>and how to determine how they are distributed (or who determines<BR>distribution).<BR><BR>It is a discussion worth revisiting.&nbsp; Let me know what you think.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <BR><BR>"I think if anyone should have been under attack it should have been the <BR>doctors that left those patients alone to die. I do understand that, given <BR>the circumstances, they were fighting to save themselves, however, it is <BR>the duty of any doctor to put their patients first. If, in this case the doctors <BR>had not left and stood by that duty...the situation never would have <BR>happened. Those nurses, along with Anna, were very courageous for <BR>what they did. <BR><BR>It is disgusting to be a 23 year old and see that, in a <BR>profession I hope to one day be in, this is what happens when you <BR>stand by your obligations. <BR><BR>We could very well point blame to anyone in that situation, including, <BR>FEMA, and the United states government for not responding sooner, <BR>or actually having a stable plan of action in place for a crisis such as this. <BR>It makes me afraid of anything else that could possibly happen and for us <BR>to not be prepared for. Why not prosocute the President of the United States? <BR><BR>It is so ridiculous living in the hypocracy of the United States at times. <BR>We can send soldiers out to kill and be killed, spending trillions of dollars <BR>a day to do it...however, when a doctor, who is willing to sacrifice themself <BR>to save another persons life, does the best she can in given circumstances <BR>and for the comfort of the patient, she is put on trial for murder..remind you..<BR>everyone else decided to run when faced with disaster.<BR><BR>Everything is such a mess, and no one seems to have the right direction/or <BR>priorities at this point. I think the point I am trying to make is that this case <BR>stems far beyond Anna Pou and those 3 nurses that acted in such a heroic <BR>manner. It stems back to what our priorities are as a nation."</P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--"Genetic Profiling"</title><link rel="alternate" href="http://thedoctorblogger.com/2008/06/30/doctor-bloggenetic-profiling.aspx" /><id>tag:thedoctorblogger.com,2008-06-30:bc0b9ca3-9d2a-4363-86ec-13bda0db2eff</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><updated>2008-06-30T20:46:30Z</updated><published>2008-06-30T20:06:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>I recently had a conversation with a woman in her mid 30's who has<BR>been diagnosed with breast cancer.&nbsp; She was unaware of any family<BR>history until her diagnosis when a long lost relative revealed that<BR>two aunts had been diagnosed with breast cancer in their 50's in <BR>the past.<BR><BR>The discussion was in a social setting so she was sharing from her<BR>sense of life view at this point in her experience.<BR><BR>The subject of genetic testing came up.&nbsp; She has a very young daughter<BR>who now is at greatly increased risk of contracting breast cancer herself.<BR>The question that is pressing my friend is whether or not she should have<BR>genetic testing herself and whether she should have her daughter tested<BR>as well.<BR><BR>Her concerns are real.&nbsp; What if the little girl has positive genetic markers?<BR>What would an insurance company who is looking at increased revenue<BR>for publicly traded investments going to view her child's positive genetic<BR>marker?&nbsp; Will there be a "pre-existing condition" exclusion whereby the<BR>little girl may be excluded from health or life insurance with such a<BR>marker on her record?&nbsp; What is the price of genetic testing?&nbsp; Does a<BR>doctor have to order the test or can a lay person ask for the test if<BR>they are paying out of pocket?<BR><BR>Well, <STRONG>The New England Journal of Medicine </STRONG>from June 26, 2008 has an<BR>article which addresses "genetic profiling".&nbsp; The article is entitled:<BR><STRONG>Polygenes, Risk Prediction, and Targeted Prevention of Breast Cancer</STRONG>.<BR><BR>The authors look at the potential use of <STRONG>genetic markers to "profile"<BR></STRONG>women at risk for breast cancer and thus create a personalized <BR>screening program.&nbsp; The idea is a good one in theory: figure out<BR>who has the gene that increases risk of disease and then be more<BR>aggressive in screening the person&nbsp;at higher risk&nbsp;for the disease--<BR>the earlier the diagnosis the better the chance for cure.<BR><BR>The article is based on the theoretical application in the United Kingdom<BR>which has a National Health Service Program to set guidelines for<BR>disease prevention and treatment that are used for clinical decision<BR>making.&nbsp; The authors acknowledge the chasm between the theory and<BR>the application even in a system like the one in the UK.<BR><BR>The question would be how would something like this apply in the<BR>United States where, at present, there is a for profit health care system<BR>for working Americans?&nbsp; That is, what is the incentive for an insurance<BR>company to provide coverage to a woman who tests positive for a<BR>gene&nbsp;which significantly raises her risk of breast cancer compared to<BR>her peers?&nbsp; What is to prevent insurance companies from using genetic<BR>profiling to deny claims related to markers as <STRONG>"pre-existing conditions"?</STRONG><BR>For profit, publicly traded health insurance companies appear to have a<BR>primary interest in profits for investors, many times at the expense of the<BR>patient.&nbsp; It seems that genetic testing would make it easier for insurance to<BR><STRONG>"screen out"</STRONG> of their plans individuals with negative genetic profiles in the<BR>pursuit of profiteering.&nbsp; <BR><BR>In fact, my friend is so fearful of the implications to her daughter's future<BR>healthcare coverage that she does not even want to mention it to her<BR>physician or her daughter's physician for fear that ANY mention in the<BR>record of a discussion about genetic testing would be picked up and used<BR>to "profile" her daughter's health risk.<BR><BR>How sad that a working woman who becomes ill in the United States has<BR>so little confidence in health insurance companies and, in addition to her<BR>illness, has to deal with the fear of medical insurance being&nbsp;withheld from&nbsp;<BR>her daughter as a result of her own illness or genetic link to her child.<BR><BR>Meanwhile, the CEO's of many for-profit medical insurance companies earn<BR>millions in salaries and millions more in stock options or profit sharing.<BR><BR>Let me know what you think of this issue...........<BR><BR></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Playing the Piano?  Impossible!</title><link rel="alternate" href="http://thedoctorblogger.com/2008/06/21/doctor-blogplaying-the-piano--impossible.aspx" /><id>tag:thedoctorblogger.com,2008-06-21:ff7c51bc-3fc8-4678-87cd-bfbc14c88d33</id><author><name>DrRima Bishara</name></author><category term="E. Inspirational" /><category term="C. Help My Parent Teach Me" /><updated>2008-06-22T21:03:45Z</updated><published>2008-06-21T18:03:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
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<P><BR>More on <A href="http://www.mclennan.edu/news/352.html">Dr. Ruth Pitts</A>.<BR><BR>For those of you who read the entries on the importance of music<BR>to children and for brain development and who also read the<BR>interview with Dr. Ruth Pitts,&nbsp;watch the video below and you will<BR>see her play a piece by Liszt.<BR><BR>She has a <STRONG>total </STRONG>of 5 (five) fingers on both hands.<BR><BR>&nbsp;<BR><BR><EMBED src=http://www.youtube.com/v/ZofZkoZ5O2I&amp;hl=en width=425 height=344 type=application/x-shockwave-flash></P></BLOCKQUOTE></BLOCKQUOTE></EMBED>]]></content></entry><entry><title>Doctor Blog--The Impact of Music on Children</title><link rel="alternate" href="http://thedoctorblogger.com/2008/06/18/2008069200833120070815musicandchildren.aspx" /><id>tag:thedoctorblogger.com,2008-06-18:8ff6693f-c3d9-4035-a014-b0e5ae9db1bc</id><author><name>DrRima Bishara</name></author><category term="E. Inspirational" /><category term="C. Help My Parent Teach Me" /><updated>2008-06-15T22:41:42Z</updated><published>2008-06-18T08:07:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <A title="Music Note" href="http://www.flickr.com/photos/illsaxophoneyou/76938761/"><IMG class=pc_img height=180 alt="Music Note" src="http://farm1.static.flickr.com/38/76938761_d37031734e_m.jpg" width=240></A><BR><BR><BR>To get a real world perspective on this subject, I interviewed <A href="http://findarticles.com/p/articles/mi_m2493/is_6_54/ai_n13825579">Dr. Ruth Pitts</A>,<BR>a very well respected and revered professor of piano in her community.<BR>She recently received the&nbsp;<A href="http://www.wacotrib.com/blogs/content/shared-gen/blogs/communities/breakingnews/entries/2008/05/01/piper_honor_going_to_mccs_pitt.html#postcomment">Piper Award</A>&nbsp;for lifetime achievement in music<BR>education.&nbsp; <BR><BR>The interview was conducted in writing and is presented&nbsp; as edited for form<BR>only.&nbsp; <BR><BR>Please read carefully what she says.&nbsp; Also, be sure to read the <EM>last part </EM>of<BR>the interview as you will be <STRONG>amazed at what you learn about her</STRONG>.<BR><BR><BR><STRONG>You are a piano teacher and have been for most of your career.&nbsp;What would <BR>you say are the&nbsp;most important things kids get from learning to play an <BR>instrument and the piano specifically. Why do you think music is such a powerful <BR>medium? <BR></STRONG>Important things children derive from learning to play the piano:&nbsp; <BR>a. Children develop the discipline of practicing to make something better-so <BR>important for everything they will ever do! <BR>b. Children develop eye-hand coordination as well as coordination of shoulder, <BR>hand and finger muscles. <BR>c. Children learn to express their feelings within the context of a work of art. <BR>d. Although there is still some concern about the validity of the tests, it seems to <BR>be the case that the study of music does enhance a child's I.Q. and consequently <BR>other studies as well.&nbsp;<BR><BR><STRONG>If you were counseling new parents, what would you tell them about music for <BR>their children? Is it important for children just to hear music or, is it important for <BR>them to play an instrument? <BR></STRONG>I think music is an essential part of a child's development. It helps them to become <BR>living souls; the knowledge and skills they gain provide an area of enjoyment for the <BR>remainder of their lives.<BR><BR><STRONG>What advantage does piano have over other instruments (if any that you see)? <BR>What instrument would you suggest for most children? <BR></STRONG>Piano is the basis for all of the instruments. Certainly any instrument study is better <BR>than none, but the piano requires learning both clefs and coordination of both hands <BR>(and ultimately feet as well); hence once they have learned the piano, they can transfer <BR>this knowledge to any other instrument.<BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<A title="Piano Island" href="http://www.flickr.com/photos/sandrino/136196604/"><IMG class=pc_img height=240 alt="Piano Island" src="http://farm1.static.flickr.com/52/136196604_7d822fd3b4_m.jpg" width=240></A>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <BR><BR><STRONG>What are the things that music provides that other media (reading, art, TV, <BR>computers, etc.) does not? <BR></STRONG>It is important that they hear, of course, but learning to produce music themselves is <BR>so&nbsp;very important. (see&nbsp;above).<BR><BR><STRONG>What age group do you teach? <BR></STRONG>I teach 5-year olds through 12th grade at home and college students at our local <BR>community college.&nbsp;<BR><BR><STRONG>What are your goals for your students when they are 10 and under?</STRONG> <BR>To learn to read music; to perform artistically enough to give themselves pleasure; to <BR>develop a love for music; and to be able to play well enough to get some praise for <BR>their accomplishments.<BR><BR><STRONG>Is there a particular age at which you recommend that children begin learning <BR>music or a musical instrument? <BR></STRONG>I normally suggest at least 2nd grade (when children have learned to read a little <BR>and have learned the importance of staying with the same things for 20-30 minutes) <BR>unless the parents have a little background in music and have time to spend with <BR>them in their practice at home.&nbsp;<BR><BR><STRONG>Are there certain habits that music cultivates? Are there certain habits that <BR>children have to cultivate to learn music? <BR></STRONG>Their dedication and willingness to spend the hours it takes to learn it well. Also their <BR>ability to listen to themselves to see if they are really making beautiful music and not <BR>just playing notes, and then critique themselves and make it better!&nbsp; Listening skills; <BR>the ability to focus; the ability to critique themselves and the ability to accept criticism <BR>as well as praise.&nbsp;<BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <A title="20/365:  Listen to the music" href="http://www.flickr.com/photos/blueeyes24/383122452/"><IMG class=pc_img height=240 alt="20/365:  Listen to the music" src="http://farm1.static.flickr.com/188/383122452_eed9bebb3a_m.jpg" width=161></A><BR><BR><STRONG>How hard is it to learn an instrument? Does it get harder or easier with age?&nbsp;</STRONG><BR>Not hard, but it does seem a little harder for older adults, particularly if they have never <BR>had any exposure to it as a child.&nbsp;<BR><BR><STRONG>What role do parents have in music education? What role would you like to see <BR>them play? </STRONG><BR>It is especially important for a very young child to have much help from parents. <BR>Older children may not need the constant help, but they still need support and nurturing. <BR>It is very important for the parents to set aside a regular practice time just as they set <BR>a time for homework, sports, church, etc.&nbsp;<BR><BR><STRONG>You have a physical impairment that most people would consider completely <BR>disabling as far as playing an instrument. What are the things that you want people <BR>to know about your commitment to piano despite your impairment?</STRONG> <BR>I have never really considered myself handicapped. My parents thought I probably <BR>couldn't learn to play the piano. (Both of them were very musical. Dad, who was a <BR>Baptist minister, had a lovely tenor voice and had been in a traveling college quartet. <BR>Mother was offered a scholarship to Julliard in piano and was the organist at the church.) <BR>However, at the end of the 3rd grade my teacher called to tell them how much they had <BR>enjoyed my performances on the piano every Friday at their talent shows. My parents <BR>then found a teacher and a piano, and no questions were asked or exceptions made. <BR>I have never known real problems. Of course there are a few things I can't play (big chords, <BR>etc.), but I am usually able to figure things out so that most people would not know that <BR>I have a disability unless they watch me play. I was playing for Sunday School and church <BR>after I had taken lessons about a year. I never had special training, just good old regular <BR>teaching!&nbsp;<BR><BR><STRONG>How has your impairment influenced your decisions for a career? </STRONG><BR>The only influence was in a round-about way. I had wanted to go to Africa as a <BR>medical missionary, but when I came to Baylor and started corresponding with the <BR>Foreign Mission Board, I found that they did not send handicapped people (of course <BR>at that time there would have been no one to fix my brace or artificial limb), and I was <BR>very sad! My friends and teachers all began to tell me that I really should look at a career <BR>in music because I was quite good at it. Then I became so involved in music courses, choir, <BR>etc. at Baylor that I didn't have time for anything else. The next thing I knew Dean Sternberg <BR>called me into his office and asked if he could recommend me for a <STRONG>National Defense Education <BR>Act scholarship for a Ph.D. in music at Peabody</STRONG>. I said that would be fine, although I had <BR>never considered getting a doctorate, and I felt sure that I wouldn't get it. The rest is history. <BR>I love piano and all kinds of music, and I love working with people.&nbsp;<BR><BR><STRONG>How did your impairment influence your children?</STRONG> <BR>I don't think my disability ever affected my children much.&nbsp;The only thing I ever remember <BR>hearing from Billy was when a child asked him why his mother had <STRONG>only 2 fingers on one hand <BR>and 3 on the other</STRONG>, he responded that it was so she could teach piano to other children <BR>that had only 2 fingers on one hand and 3 on the other! Of course I have never had that <BR>opportunity! Both of my boys play beautifully. Bill, of course, has little time for it as a <BR>cardiologist, but he loves being able to sit down and play when the opportunity is there. <BR>Jimmy is a concert pianist and teaches piano at SFA University.&nbsp;&nbsp;&nbsp;<BR><BR></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--The Current Medicare Debate</title><link rel="alternate" href="http://thedoctorblogger.com/2008/06/16/doctor-blogthe-current-medicare-debate.aspx" /><id>tag:thedoctorblogger.com,2008-06-16:c2192933-9bd8-484f-8037-7124d14c6e8f</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><updated>2008-06-15T22:40:34Z</updated><published>2008-06-16T22:33:00Z</published><content type="html"><![CDATA[<P><FONT face=Arial size=2><SPAN style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; FONT-FAMILY: Arial">Chris Stewart posted this information about the current&nbsp;Medicare debate.<BR>Chris is with a clearinghouse for information about fighting chronic disease.<BR><BR>The link is <A href="http://promisingpractices.fightchronicdisease.org/" target=_blank>http://promisingpractices.fightchronicdisease.org/</A><BR><BR>He forwards this information:<BR><BR>Baucus &amp; Grassley Debate Medicare on AARP's Blog</SPAN></FONT><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt">&nbsp;</SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">In a unique event, Senators Max Baucus and Chuck Grassley - the Chairman and Ranking Member of the Senate Finance Committee, the Committee in charge of Medicare in the Senate – have taken to the blogosphere to debate competing pieces of legislation with regard to Medicare. Below you'll see each of them explain their respective bills to readers of AARP's ShAARP Sessions blog.</SPAN></FONT><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">&nbsp;</SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">If you are so inclined, we would greatly appreciate you weighing in on the debate, regardless of what side you fall on in the complex issue.</SPAN></FONT><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">&nbsp;</SPAN></FONT></P>
<P><B><FONT face=Arial size=2><SPAN style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; FONT-FAMILY: Arial">Sen. Baucus: Going the Extra Mile for Seniors</SPAN></FONT></B><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial"> <A href="http://blog.aarp.org/shaarpsession/2008/06/senator_baucus_going_the_extra.html" target=_blank>http://blog.aarp.org/shaarpsession/2008/06/senator_baucus_going_the_extra.html</A></SPAN></FONT> </P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">&nbsp;</SPAN></FONT><B><FONT face=Arial size=2><SPAN style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; FONT-FAMILY: Arial">Sen. Grassley: GOP Medicare Bill Preserves Access to Quality Healthcare </SPAN></FONT></B><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial"><A href="http://blog.aarp.org/shaarpsession/2008/06/senator_grassley.html" target=_blank>http://blog.aarp.org/shaarpsession/2008/06/senator_grassley.html</A></SPAN></FONT></P>
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<P><B><FONT face=Arial size=2><SPAN style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; FONT-FAMILY: Arial"><A href="http://blog.aarp.org/shaarpsession/2008/06/senator_baucus_going_the_extra.html" target=_blank>Senator Baucus: Going the Extra Mile for Seniors</A> (Category: <A href="http://blog.aarp.org/shaarpsession/health_care/#008832" target=_blank>Health Care</A>)</SPAN></FONT></B></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial"><BR>The following statements from Senators Baucus and Grassley regarding their competing Medicare bills are unedited and do not reflect AARP's position.</SPAN></FONT><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">&nbsp;</SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">The laws governing Medicare have a big influence on seniors' access to health care, and on the quality of the care they receive. As Chairman of the Senate Finance Committee, I've introduced the "Medicare Improvements for Patients and Providers Act of 2008" to update Medicare laws and make the program work better for every single American senior. It's the best bill Congress can pass for seniors this year.&nbsp;</SPAN></FONT><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">&nbsp;</SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">The Baucus bill starts by helping more low-income seniors get help with their Medicare premiums. It has incentives for more primary care doctors to take Medicare patients. It allows for more preventive care in Medicare, to keep seniors healthier, and lowers co-payments for mental health services. It provides more money to rural hospitals, ambulance services, and other facilities to make sure seniors get quality care no matter where they live. It cracks down on shady marketers selling seniors on private plans they don't need or want. And it makes sure local pharmacists get paid promptly for dispensing medicines under the drug benefit, to keep affordable medications available everywhere.&nbsp;</SPAN></FONT><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">&nbsp;</SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">The Baucus bill is responsible, too, paying for these improvements with smart savings found elsewhere in Medicare. It's important for you to know that these savings in no way endanger any senior's access to health coverage, health care, or medical equipment. Rather, savings come from strengthening the rules applied to private fee-for-service plans – which are paid 17 percent more than the amount paid to other Medicare providers – and by reducing overpayments to wheelchair and oxygen providers, who sometimes receive more than 1000 percent of the cost of the equipment they supply. In most cases, these changes will even reduce seniors' out-of-pocket co-payments while also saving taxpayer dollars.&nbsp;</SPAN></FONT><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">&nbsp;</SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">The President threatens to veto this bill, but I believe Congress should do the very best it can for seniors, and pass the Medicare bill that does the most for all who use the program. The Baucus bill goes the extra mile – particularly for rural and low-income seniors – while giving doctors a decent payment increase that won't explode costs or inflate premiums. And the Baucus bill saves money in Medicare without endangering anyone's access to care. I'll work with other Senators and even the White House to get a good bill signed into law. But the Medicare Improvements for Patients and Providers Act is the right start to make Medicare better for every American senior.</SPAN></FONT></P>
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<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial"></SPAN></FONT></P>
<P><B><FONT face=Arial size=2><SPAN style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; FONT-FAMILY: Arial"><A href="http://blog.aarp.org/shaarpsession/2008/06/senator_grassley.html" target=_blank>Senator Grassley: GOP Medicare Bill Preserves Access to Quality Health Care</A> (Category: <A href="http://blog.aarp.org/shaarpsession/health_care/#008842" target=_blank>Health Care</A>)</SPAN></FONT></B></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">&nbsp;</SPAN></FONT><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">If Congress doesn't act, the physicians who treat Medicare patients will face a 10.6 percent pay cut, effective July 1. Such a dramatic cut would very likely hurt older Americans' access to their doctors. A big number of doctors might stop dealing with Medicare altogether.</SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">&nbsp;</SPAN></FONT><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">The Republican bill prevents the cut and gives a small payment increase to keep doctors serving Medicare patients. The physician payments are the same as in the Democratic leaders' bill. Neither bill is more generous than the other to doctors.</SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">&nbsp;</SPAN></FONT><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">The Republican bill has several other Medicare improvements. It increases payments to doctors who report quality data to the government to help link payments with quality. It promotes value-based purchasing, e-prescribing to reduce medication errors, and electronic health records. It includes responsible proposals to preserve Medicare access in rural areas, including much-needed payment improvements for rural hospitals and home health care. It returns the ownership of oxygen equipment to the supplier, not the beneficiary, so the beneficiary doesn't have to get the equipment serviced. It cracks down on abusive sales tactics by Medicare Advantage plans and makes plan quality information available to beneficiaries for comparison shopping. It improves cardiac and pulmonary rehabilitation, renal care, diabetes prevention, and outpatient therapy. It extends programs to help low-income seniors and families.</SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">&nbsp;</SPAN></FONT><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">Unlike the Democratic leaders' bill, the Republican bill does not:</SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">*cut payments for power wheelchairs;<BR><BR></SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">*reduce payments for oxygen;<BR><BR></SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">*make large, unwarranted cuts to Medicare Advantage, altering policy decisions designed to maximize patient choice;</SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">*eliminate the fund that Congress specifically created to help avert future physician cuts; or<BR><BR></SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">*expand eligibility for low-income Medicare programs, which although well-intentioned, would increase long-term entitlement spending and expand coverage under an already fiscally challenged program.</SPAN></FONT><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">&nbsp;</SPAN></FONT></P>
<P><FONT face=Arial size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Arial">Maybe most important, the President will sign the Republican bill. The President would veto the Democratic leaders' bill. Meanwhile, the Democratic leaders walked away from bipartisan negotiations and put a timely outcome of this effort in jeopardy. The Republican bill does everything Medicare beneficiaries need to protect their access to doctors and prevent a physician revolt. There's nothing in it that Democratic leaders would find objectionable if they put aside their political lens and looked at it as Medicare beneficiaries and taxpayers.</SPAN></FONT></P>
<P><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt">&nbsp;</SPAN></FONT></P>]]></content></entry><entry><title>Doctor Blog--Quote for a Lifetime</title><link rel="alternate" href="http://thedoctorblogger.com/2008/06/15/2008069doctorblogquoteforalifetime.aspx" /><id>tag:thedoctorblogger.com,2008-06-15:8dbf2cf7-0f99-433a-a513-3ff3ecefe000</id><author><name>DrRima Bishara</name></author><category term="G. Quotes of the Week" /><updated>2008-06-13T10:04:18Z</updated><published>2008-06-15T09:24:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><FONT face=Verdana size=2><STRONG><BR><BR>People may fail many times, but they become failures only when <BR>they begin to blame someone else.&nbsp; Experience is determined by <BR>yourself -- not the circumstances of your life.</STRONG></FONT></P>
<P><FONT face=Verdana size=2>Gita Bellin<BR><BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<A title="Sarah's Flowering Cactus" href="http://www.flickr.com/photos/lynnmorag/19285145/"><IMG class=pc_img height=209 alt="Sarah's Flowering Cactus" src="http://farm1.static.flickr.com/14/19285145_6173a592c9_m.jpg" width=240></A></FONT></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Music and It's Impact on the Human Brain</title><link rel="alternate" href="http://thedoctorblogger.com/2008/06/12/20080692008331doctorblogmusicanditsimpactonhumans.aspx" /><id>tag:thedoctorblogger.com,2008-06-12:b3bf9be0-9472-4b75-a39d-f4d846a5301a</id><author><name>DrRima Bishara</name></author><category term="B. Day in the Life of a Doctor" /><category term="C. Help My Parent Teach Me" /><updated>2008-06-09T22:06:10Z</updated><published>2008-06-12T21:04:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR>Music is everywhere.&nbsp; It is arguably the only universal language.&nbsp; It<BR>crosses all verbal, age, religious, cultural barriers.&nbsp; Music has a profound<BR>effect on humans and learning music is a value that every parent<BR>should&nbsp;encourage for their children.&nbsp; To further educate my readers<BR>about the importance of music, I've put together a summary in this<BR>entry that can outline why music is so important and how it can be<BR>used as a tool for education.<BR><BR>What is music?&nbsp; It is a <A href="http://en.wikipedia.org/wiki/Language">language</A>.-- a <A href="http://music.arts.uci.edu/dobrian/CD.music.lang.htm">form of communication</A>.<BR>Music has a language (tonal)&nbsp;component as well as a mathematical <BR>(rhythmic) component.&nbsp; <BR><BR>Music reaches human brains through the ears.&nbsp; Auditory signals are<BR>routed&nbsp;to the brainstem, then&nbsp;to the thalamus, and finally to the<BR>auditory cortex in the temporal lobes on both sides of the brain.<BR>However, research indicates that processing and learning music<BR>probably affects <A href="http://www.edu-cyberpg.com/music/braingrowth.html">many other parts of the brain</A>&nbsp;(presumably because<BR>it is such a complex activity).<BR><BR>For a more <STRONG>detailed explanation of the auditory system</STRONG>, click on:<BR><A href="http://www.brainconnection.com/topics/?main=anat/auditory-anat">http://www.brainconnection.com/topics/?main=anat/auditory-anat</A><BR><BR>For a detailed <STRONG>lecture on YouTube </STRONG>about the auditory system, click on:<BR><A href="http://www.youtube.com/watch?v=brOcjvubJoY">http://www.youtube.com/watch?v=brOcjvubJoY</A><BR><BR>"<A href="http://www.edu-cyberpg.com/music/INTELLIGENCE.html">The Mozart Effect</A>" is a theory that states that spatial reasoning<BR>improves after listening to Mozart's music.&nbsp; The original experiment<BR>was done in <A href="http://www.ncbi.nlm.nih.gov/pubmed/8413624?dopt=Abstract">1993 by Rauscher and Shaw</A>&nbsp;from University of California <BR>at Irvine.<BR><BR>Unfortunately, <A href="http://www.ncbi.nlm.nih.gov/pubmed/9656277?ordinalpos=2&amp;itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum">other researchers</A>&nbsp;have tried to replicate the experiment<BR>and have found no such effect.<BR><BR>Rauscher and Shaw did <A href="http://www.ncbi.nlm.nih.gov/pubmed/9090630?dopt=Abstract">another experiment in 1997</A>&nbsp;comparing children <BR>who received keyboard lessons with those receiving voice lessons, <BR>computer lessons, and no lessons.&nbsp; They found improvement in <BR>spatial-temporal reasoning among the children who took keyboard <BR>lessons only.<BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <A title="Sheet Music" href="http://www.flickr.com/photos/hlachenmayer/269552784/"><IMG class=pc_img height=160 alt="Sheet Music" src="http://farm1.static.flickr.com/79/269552784_b60ad9f37d_m.jpg" width=240></A><BR><BR>A Canadian program&nbsp;created by the Royal Conservatory of Music,<BR>(<A href="http://educ.queensu.ca/~arts/LTTA.April_final.30.doc">Learning Through the Arts or LTTA</A>) followed elementary children <BR>for 3 years.&nbsp; It incorporated art, music, drama, and dance into regular <BR>elementary school&nbsp;science and math curriculum.&nbsp; This program reported<BR>that math&nbsp;scores rose significantly among those students who were<BR>included in the program compared to students attending schools <BR>where the program is not used.<BR><BR><A href="http://www.edu-cyberpg.com/Music/Music_and_Brain_Informatio.html">Many articles</A>&nbsp;have been written about music, its effect on the brain,<BR>and how music affects us from birth to adulthood.<BR><BR>In an upcoming entry,&nbsp; I'll include an interview with a lifelong music<BR>educator who has instructed small children through adults in the<BR>language of music.&nbsp;&nbsp;We will get a view of her perspective on the<BR>role that music can play in a person's life.<BR><BR>&nbsp;<BR>For a good summary of the research and conclusions go to:<BR><BR><A href="http://www.veezyon.com/video/science-technology/music-and-the-mind/74/">http://www.veezyon.com/video/science-technology/music-and-the-mind/74/</A><BR><BR><A href="http://faculty.washington.edu/chudler/music.html" target=_blank mce_href="http://faculty.washington.edu/chudler/music.html">http://faculty.washington.edu/chudler/music.html</A><BR><BR><A href="http://www.edu-cyberpg.com/Music/musicsmart2.html">http://www.edu-cyberpg.com/Music/musicsmart2.html</A>&nbsp;<BR><BR><A href="http://educ.queensu.ca/~arts/research_reports.html">http://educ.queensu.ca/~arts/research_reports.html</A><BR>&nbsp;<BR><BR>&nbsp;<BR><BR><BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;</P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Fighting Chronic Disease</title><link rel="alternate" href="http://thedoctorblogger.com/2008/06/09/doctor-blogfighting-chronic-disease.aspx" /><id>tag:thedoctorblogger.com,2008-06-09:0dd44fc9-676b-4b6e-a8db-73a96ca6b2f8</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><updated>2008-06-09T22:05:30Z</updated><published>2008-06-09T21:58:00Z</published><content type="html"><![CDATA[<STRONG> 
<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>Write up of Health Care Conference by Chris Stewart.&nbsp; He writes:<BR><BR>"Dr. Val and the Voice of Reason"<BR><BR></STRONG><A href="http://www.revolutionhealth.com/blogs/valjonesmd/the-missing-link-in-h-14167">http://www.revolutionhealth.com/blogs/valjonesmd/the-missing-link-in-h-14167</A> <BR><BR><BR><U>The Missing Link In Healthcare Reform</U><BR>Posted on 06:45PM (EDT) on 2008-06-07<BR><BR>I recently attended a half day conference, "Fighting Chronic Disease: The Missing Link <BR>In Health Care Reform" sponsored by Emory University and the Partnership to Fight <BR>Chronic Disease (PFCD). It was an extremely well run event with an all-star political <BR>cast: Tom Daschle, Dick Gephardt, Dr. Mark McClellan, and Nancy Johnson were present. <BR>The key medical players included Dr. Nancy Nielson, president-elect of the AMA, and <BR>Dr. Otis Brawley, CMO of the American Cancer Society.<BR><BR>The purpose of the conference was to raise awareness about the cost of chronic <BR>disease - it accounts for at least 75% of healthcare spending, and 80% of that could <BR>be avoided with lifestyle interventions. Shocking, isn't it? Any discussion of reducing <BR>medical costs needs to begin at ground zero - getting Americans to adopt healthy diet <BR>and exercise habits.<BR><BR>One of the most entertaining panelists was Chris Viehbacher, the president of North <BR>American Pharmaceuticals at GlaxoSmithKline (GSK). Chris is a gifted speaker with a <BR>charming Canadian accent - and could probably be the head of a debate team. We <BR>had the chance to speak about lobster fishing in Nova Scotia during one of the breaks <BR>since we share a common Maritime heritage. He offered some amusing analogies about <BR>our healthcare system, and made some points that bear repeating here:<BR><BR>"Half of the people in the US have some sort of chronic illness. Health insurance is like <BR>having car insurance when 50% of people are having accidents. Of course nobody <BR>can afford it."<BR><BR>"We need to keep employer-based healthcare because when employers have 'skin <BR>in the game' they have the incentive to promote healthy behavior at a local level. <BR>Monolithic government programs aren't good at influencing people at the individual <BR>level. Employers know each of their employees by name, they are invested in their lives, <BR>they provide childcare services and other benefits to them, and each employee's health <BR>affects their bottom line. Employers are a critical force for promoting and facilitating <BR>healthy behaviors."<BR><BR>"Alternative energy sources aren't that interesting when gas is $1/gallon. But when <BR>gas hits $4/gallon suddenly everyone is very interested in alternative energy. The <BR>same goes for healthcare. It takes a cost crisis to bring it to everyone's attention. <BR>And now the audience is listening."</P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Tip of the Day--Exercise</title><link rel="alternate" href="http://thedoctorblogger.com/2008/06/06/2008066doctorblogtipofthedayexercise.aspx" /><id>tag:thedoctorblogger.com,2008-06-06:6d119b51-312a-4ab3-9923-81384cfeca20</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><updated>2008-06-07T19:12:06Z</updated><published>2008-06-06T16:54:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>One way to get more results with the same amount of time spent is<BR>to exercise with a <A href="http://www.visionarydance.com/weightbelt.html">weight belt</A>&nbsp;on.&nbsp; You might find one of these at a<BR>sports store in your community.&nbsp; The weight can be variable depending<BR>on how much you&nbsp;can tolerate.&nbsp; Increase the weight as you are able to<BR>handle.<BR><BR>By carrying weight, you can burn more calories while spending the same<BR>amount of time exercising, in general.&nbsp; It can also help build muscle<BR>which burns calories faster than other tissue.<BR><BR>Advantages to weight belts:<BR><BR>-There is no irritation to wrists or ankles such as with wrist or ankle weights.<BR><BR>-There is no irritation to any specific joint.<BR><BR>-It weighs down&nbsp;the <A href="http://en.wikipedia.org/wiki/Appendicular_skeleton">axial skeleton</A>&nbsp;which is what many women need to help<BR>strengthen bones in the spine and hips--the most vulnerable to <A href="http://en.wikipedia.org/wiki/Osteoporosis">osteoporosis</A>.<BR><BR></P></BLOCKQUOTE>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<A title=Weights href="http://flickr.com/photos/nadircruise/157666440/"><IMG class=pc_img height=81 alt=Weights src="http://farm1.static.flickr.com/71/157666440_8384532205_m.jpg" width=240></A>]]></content></entry><entry><title>Doctor Blog--Smoking and Peer Pressure</title><link rel="alternate" href="http://thedoctorblogger.com/2008/05/22/doctor-blogsmoking-and-peer-pressure.aspx" /><id>tag:thedoctorblogger.com,2008-05-24:37f25d17-10e2-4b80-8b76-65dd7fb21cc9</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><category term="B. Day in the Life of a Doctor" /><updated>2008-05-22T07:54:45Z</updated><published>2008-05-24T07:30:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>Most of the time, when someone says "<A href="http://en.wikipedia.org/wiki/Peer_pressure">peer pressure</A>", there are negative<BR>overtones.&nbsp; In the May 22, 2008 <A href="http://content.nejm.org/">New England Journal of Medicine</A>, researchers<BR>with the Framingham Heart Study detail their findings of how groups of<BR>people smoke together and quit smoking together.&nbsp; The title is<BR><STRONG>"The Collective Dynamics of Smoking in a Large Social Network"</STRONG>.<BR><BR>Smokers are most likely to be <STRONG>influenced to stop smoking </STRONG>by a spouse who<BR>quits smoking, a friend who quits, a co-worker who quits, a sibling who quits,<BR>in that order.<BR><BR>The strength of the influence is <STRONG>highest from a spouse </STRONG>and lowest from a sibling.<BR><BR>The conclusion is that smoking behavior spreads through close and distant<BR>social ties and that <STRONG>smoking cessation occurs in groups</STRONG>.<BR><BR>Smokers were found to be increasingly marginalized.&nbsp; <BR><BR>The implications are that there would be a public health impact with policies or <BR>programs that target groups of inter-related smokers (smokers can be <BR>encouraged to <STRONG>stop smoking by peer pressure</STRONG>).<BR><BR><BR>Who says peer pressure is bad?<BR><BR>Along the theme of parenting that seems to keep cropping up at this blog,<BR><STRONG>how might a parent apply this information </STRONG>as they are raising their children?<BR><BR>I suppose the most obvious first choices would be to encourage children to<BR>choose <STRONG>tobacco free friends </STRONG>and to make <STRONG>home a tobacco free environment</STRONG><BR>for those who live there as well as those who visit.<BR><BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<A title="Cigarette smoking is injurious to health" href="http://www.flickr.com/photos/rahulsadagopan/701735023/"><IMG class=pc_img height=188 alt="Cigarette smoking is injurious to health" src="http://farm2.static.flickr.com/1151/701735023_5b65bb75f3_m.jpg" width=240></A><BR><BR><BR><BR><BR><BR><BR></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Quote of the Week</title><link rel="alternate" href="http://thedoctorblogger.com/2008/05/23/doctor-blogquote-of-the-week.aspx" /><id>tag:thedoctorblogger.com,2008-05-23:feb5abe5-1a85-43dc-bb54-6e170a76e63f</id><author><name>DrRima Bishara</name></author><category term="G. Quotes of the Week" /><updated>2008-05-21T09:43:55Z</updated><published>2008-05-23T08:17:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><FONT face=Verdana size=2><STRONG><BR><BR>Self-respect is the root of discipline; the sense of dignity <BR>grows with the ability to say no to oneself.</STRONG></FONT></P>
<P><FONT face=Verdana size=2>Abraham Lincoln<BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<A href="http://www.google.com/imgres?imgurl=http://thomasjpitts.co.uk/hsx/images/lincoln_abraham_photograph-thumb-425x563.jpg&amp;imgrefurl=http://www.thomasjpitts.co.uk/hsx/&amp;h=530&amp;w=400&amp;sz=29&amp;tbnid=YjiWXSNZtEIJ:&amp;tbnh=132&amp;tbnw=100&amp;prev=/images%3Fq%3Dpicture%2Babraham%2Blincoln&amp;hl=en&amp;sa=X&amp;oi=image_result&amp;resnum=1&amp;ct=image&amp;cd=1"><IMG title=http://www.thomasjpitts.co.uk/hsx/ height=132 alt=http://www.thomasjpitts.co.uk/hsx/ src="http://tbn0.google.com/images?q=tbn:YjiWXSNZtEIJ:thomasjpitts.co.uk/hsx/images/lincoln_abraham_photograph-thumb-425x563.jpg" width=100 align=middle vspace=4 border=1></A></FONT></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Manners, Again.</title><link rel="alternate" href="http://thedoctorblogger.com/2008/05/20/doctor-blogmanners-again.aspx" /><id>tag:thedoctorblogger.com,2008-05-20:fe6ba689-05a9-44c1-a8b5-c68de148998f</id><author><name>DrRima Bishara</name></author><category term="B. Day in the Life of a Doctor" /><updated>2008-05-21T09:42:58Z</updated><published>2008-05-20T17:54:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P>&nbsp;&nbsp;&nbsp;&nbsp;<BR><BR>I completed an entry about <A href="http://thedoctorblogger.com/2008/29/01/wwwtechnoraticom.aspx">Manners</A>&nbsp;earlier this year.&nbsp; Interestingly,<BR>The New England Journal of Medicine, May 8,2008 issue, has an article<BR>entitled "Etiquette-Based Medicine" written by Michael W. Kahn, M.D.,<BR>a psychiatrist at Beth Israel Deaconess Medical Center and an<BR>assistant professor of psychiatry at Harvard Medical School.<BR><BR>He suggests that there needs to be more emphasis on <STRONG>"good manners"<BR></STRONG>rather than compassion in physician's interactions with their patients.<BR><BR>Primarily, his comments were targeted toward hospital based medicine.<BR><BR>So, rather than addressing attitudes among physicians, there would<BR>be <STRONG>checklists that would address behavior</STRONG>.&nbsp; Examples:<BR><BR>1.&nbsp; Ask Permission to enter the room and wait for an answer.<BR>2.&nbsp; Introduce yourself and show an ID badge.<BR>3.&nbsp; Shake hands (wear glove if needed).<BR>4.&nbsp; Sit down. Smile if appropriate.<BR>5.&nbsp; Briefly explain your role on the team.<BR>6.&nbsp; Ask the patient how he or she is feeling about being in the hospital.<BR><BR>I'm curious what a patient might think of this checklist.&nbsp; And, if a patient<BR>were asked, how would they want a physician to behave?&nbsp; <STRONG>Would a<BR>patient prefer good behavior or good manners over compassion?<BR></STRONG><BR>What do you think?<BR><BR></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Incest Dad</title><link rel="alternate" href="http://thedoctorblogger.com/2008/05/15/doctor-blogincest-dad.aspx" /><id>tag:thedoctorblogger.com,2008-05-15:f45a1946-124b-434b-8587-5e3d401c9f61</id><author><name>DrRima Bishara</name></author><category term="C. Help My Parent Teach Me" /><updated>2008-05-14T17:18:57Z</updated><published>2008-05-15T06:52:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR><STRONG>Incest dad</STRONG>, as he seems to have&nbsp;become known in the media, is a great teaching<BR>moment for parents and future parents alike.&nbsp; He kept his daughter in a dungeon<BR>with no windows beneath his house for 24 years and fathered seven children<BR>with her.&nbsp; He and his wife apparently adopted 3 of them to raise as their own.<BR><BR>For a Full Story, Click the following link:<BR><A href="http://www.cnn.com/2008/WORLD/europe/05/08/austria.fritzl.ap/index.html">http://www.cnn.com/2008/WORLD/europe/05/08/austria.fritzl.ap/index.html</A><BR><BR>He is quoted as having said:&nbsp; "I must have been crazy....I cared for them...."<BR><BR>In bits and pieces, reports of his story are as follows:<BR><BR>His reasons for <STRONG>locking her up</STRONG>:&nbsp; <EM>she misbahaved</EM>.<BR>His reasons for <STRONG>keeping her locked up</STRONG>:&nbsp; <EM>scared he'd be apprehended</EM>.<BR>His reasons for <STRONG>fathering children with her</STRONG>:&nbsp; <EM>unclear</EM>.<BR>His reasons for <STRONG>coming forward</STRONG>:&nbsp; he took care of the family and <EM>he cared about them</EM><BR>&nbsp; (one of the children got deathly ill and required hospitalization--he apparently<BR>&nbsp;&nbsp;&nbsp; feels he was benevolent in allowing the child medical care).&nbsp; I believe he<BR>&nbsp;&nbsp;&nbsp; said something like "I could have killed her and burned her body and<BR>&nbsp;&nbsp;&nbsp; no one would ever have known".<BR><BR>Having had nightmares about this situation,&nbsp; here are the questions that I would<BR>think might come up in a person's mind while examining <STRONG>the relationships</STRONG><BR>that make up this family:<BR><BR><STRONG>Grandchildren to grandmother</STRONG>--why was this OK with you?<BR><STRONG>Grandchildren to victim mother/daughter</STRONG>--you were powerless.&nbsp; Where does that<BR>leave me? What is going to happen to us now?&nbsp; I had no idea the sky was blue.<BR><STRONG>Grandchildren to grandfather/father</STRONG>--why did you think this was OK?&nbsp; <BR><STRONG>Daughter to mother</STRONG>--my having 7 children in a dungeon and giving 3 of them up <BR>for adoption to you was the right thing to do?<BR><STRONG>Daughter&nbsp;to father</STRONG>--so you believe you are benevolent?&nbsp; What now, since I have<BR>&nbsp; no knowledge of how to care for my family in the real world and I have no<BR>&nbsp; education or job skills?&nbsp; <BR><BR>Since the stated trigger for this horrific case was the daughter's apparent<BR><STRONG>misbehavior </STRONG>(with parents who punish a child by locking her up, the definition of<BR>misbehaving might need clarification),&nbsp; let's have a discussion about handling<BR>misbehaving children, especially in the teenage years.&nbsp; <BR><BR>(Let me say ahead of time, <A href="http://en.wikipedia.org/wiki/Incest">incest and the pathology behind it</A>, is way beyond the<BR>scope of this entry.&nbsp; Since parenting is a topic that is of interest to my readers,<BR>I will limit the discussion to that topic alone at this point).<BR><BR><STRONG>Let's think about all the options available for teaching a child how to behave<BR>"properly".<BR></STRONG><BR>How about <EM>positive reinforcement</EM>:&nbsp; you do this, I'll give you that.&nbsp; You don't do this, <BR>you don't get that.<BR><BR>Starting young with the <EM><A href="http://www.loveandlogic.com/"><EM>Parenting With Love and Logic </EM></A>&nbsp;</EM>philosophy of life's<BR>natural consequences and allowing children to feel them early in small doses<BR>while they are safely at home with loving parents.<BR><BR><EM>Negotiating</EM> behavior for the big things as kids get older and more capable of<BR>independent behavior:&nbsp; you can have a car but you have to pay the insurance.<BR><BR><EM>Group parenting </EM>with other parents of a child's friends who can be eyes and <BR>ears when mom or dad aren't around.<BR><BR><EM>Tough Love approach</EM>:&nbsp; you do this forbidden or undesirable thing, you lose<BR>financial or some other type of support--best for older children, I would think.<BR><BR><EM>The Fresh Baked Cookies approach</EM>:&nbsp; have a batch of chocolate chip cookies<BR>ready to pop in the oven as the misbehaving child is threatening to run away--<BR>the idea is that the smell of fresh baked cookies would overwhelm the desire to flee.<BR>Theoretically, this would work beautifully with young children.&nbsp; Although this<BR>might sound simplistic, children really like the comforts of home assuming they<BR>are not being abused.<BR><BR><EM>Get professional help </EM>if you can't figure it out.&nbsp; There are resources in almost<BR>every community for families with big incomes, little incomes, no incomes.&nbsp; <BR><EM>Get Help.<BR></EM><BR><EM>Love them and smother them with hugs and kisses</EM>.&nbsp; It has been reported that<BR>parents tend to stop hugging and kissing their teenagers perhaps because of the<BR>sometimes extreme emotional challenges they present.&nbsp; Teenagers crave<BR>affection like any other child and those who give advice on parenting suggest<BR>parents simply grab them and hug them even as they squirm.&nbsp; They need it.<BR>(Teenagers request that this be done when their friends are safely out of sight).<BR><BR><BR><BR><BR><BR></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--About Choices in Healthcare</title><link rel="alternate" href="http://thedoctorblogger.com/2008/05/13/doctor-blogabout-choices-in-healthcare.aspx" /><id>tag:thedoctorblogger.com,2008-05-13:4cc0697d-77d7-4d97-be51-1418685174d9</id><author><name>DrRima Bishara</name></author><category term="B1. 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<P><BR><BR>One of my readers sent me a link to this piece by <A href="http://en.wikipedia.org/wiki/Ted_Nugent">Ted Nugent</A>.&nbsp; It comes <BR>on the heels of the piece on <A href="http://thedoctorblogger.com/2008/05/11/doctor-blogthe-cost-of-chronic-disease.aspx">chronic disease</A>.&nbsp; I thought I would include it<BR>to see what you, my readers, think about this topic.<BR><BR>This is, of course,&nbsp;one opinion among many.&nbsp; <BR><BR><A href="http://www.wacotrib.com/opin/content/news/opinion/stories/nugent/04202008_wac_nugent.html">Ted Nugent</A>&nbsp;lets his voice be heard.</P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--The Cost of Chronic Disease</title><link rel="alternate" href="http://thedoctorblogger.com/2008/05/11/doctor-blogthe-cost-of-chronic-disease.aspx" /><id>tag:thedoctorblogger.com,2008-05-11:2cc948cf-a894-4594-acca-38b4fcea364b</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><updated>2008-05-10T21:48:58Z</updated><published>2008-05-11T05:49:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>I received this communication from Chris who works with the <BR><A href="http://fightchronicdisease.org/">Partnership To Fight Chronic Disease Blog Outreach.</A><BR><BR><STRONG>Chris writes</STRONG>:<BR><BR>I wanted to make sure that you saw this Revolution Health interview with former <BR><A href="http://en.wikipedia.org/wiki/Richard_Carmona">Surgeon General Richard Carmona</A>.&nbsp; Dr. Carmona has some interesting things to <BR>say about the costs associated with chronic disease.<BR><BR>Here is the link:<BR><A href="http://www.revolutionhealth.com/blogs/valjonesmd/a-surgeon-generals-o-13214" target=_blank>http://www.revolutionhealth.com/blogs/valjonesmd/a-surgeon-generals-o-13214</A><BR><BR>Thanks.<BR><BR>-Chris<BR><BR>Partnership To Fight Chronic Disease Blog Outreach<BR><BR></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Mother's Day</title><link rel="alternate" href="http://thedoctorblogger.com/2008/05/09/doctor-blogmothers-day.aspx" /><id>tag:thedoctorblogger.com,2008-05-09:5f104002-8fef-48b0-a576-342a9c59d11a</id><author><name>DrRima Bishara</name></author><category term="B. Day in the Life of a Doctor" /><updated>2008-05-09T07:09:38Z</updated><published>2008-05-09T07:02:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
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<P><BR><BR><STRONG>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; HAPPY MOTHER"S DAY!<BR><BR><BR><A title="Mother hippo and calf" href="http://www.flickr.com/photos/tambako/633374069/"><IMG class=pc_img height=180 alt="Mother hippo and calf" src="http://farm2.static.flickr.com/1042/633374069_9db086eb21_m.jpg" width=240></A><BR><BR><BR><A title="Happy Mother's Day" href="http://www.flickr.com/photos/gypsyflores/493313636/"><IMG class=pc_img height=171 alt="Happy Mother's Day" src="http://farm1.static.flickr.com/203/493313636_51e3e9f88f_m.jpg" width=240></A></STRONG></P>
<P><STRONG><A title="Being mothered" href="http://www.flickr.com/photos/dbarronoss/1274833597/"><IMG class=pc_img height=240 alt="Being mothered" src="http://farm2.static.flickr.com/1208/1274833597_ce08d2a808_m.jpg" width=207></A></STRONG></P></BLOCKQUOTE></BLOCKQUOTE></BLOCKQUOTE></BLOCKQUOTE></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Quote for the Week</title><link rel="alternate" href="http://thedoctorblogger.com/2008/05/08/doctor-blogquote-for-the-week.aspx" /><id>tag:thedoctorblogger.com,2008-05-08:9d85e32f-aa26-4b15-8c27-88366d9288d0</id><author><name>DrRima Bishara</name></author><category term="G. Quotes of the Week" /><updated>2008-05-07T09:26:25Z</updated><published>2008-05-08T17:13:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><FONT face=Verdana size=2><STRONG><BR><BR>It is not the cards you are dealt but what you do with them that counts.</STRONG></FONT></P>
<P><FONT face=Verdana size=2><STRONG></STRONG></FONT></P>
<P><FONT face=Verdana size=2>Anonymous<BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <A title=.play.your.hand. href="http://flickr.com/photos/random_shadow/383090629/"><IMG class=pc_img height=87 alt=.play.your.hand. src="http://farm1.static.flickr.com/145/383090629_4c03209aa5_m.jpg" width=240></A></FONT></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--How to Help Myanmar Cyclone Victims</title><link rel="alternate" href="http://thedoctorblogger.com/2008/05/06/doctor-bloghow-to-help-myanmar-cyclone-victims.aspx" /><id>tag:thedoctorblogger.com,2008-05-06:fb75115c-9284-4d7b-9a5b-a41e73261e48</id><author><name>DrRima Bishara</name></author><category term="B. Day in the Life of a Doctor" /><updated>2008-05-06T17:02:11Z</updated><published>2008-05-06T16:46:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>The cyclone that hit Maynmar has devastated the region beyond what was<BR>initially reported.&nbsp; There was a storm surge after the cyclone which <BR>contributed to the horrible outcome.<BR><BR>The link below will take you to the most recent information.&nbsp; Approximately<BR>22,000 are estimated dead and 41,000 missing.&nbsp; The area is&nbsp;difficult to reach<BR>and aid has been slow to arrive.&nbsp;&nbsp;Millions are without shelter.<BR><BR><A href="http://www.msnbc.msn.com/id/24478247">http://www.msnbc.msn.com/id/24478247</A><BR><BR>If you would like to help,&nbsp; go to one of the links below.<BR><BR><BR>American Red Cross<BR>International Response Fund<BR>P.O. Box 37243<BR>Washington, DC 20013<BR>(800) HELP-NOW<BR><A href="http://www.redcross.org/">http://www.redcross.org</A><BR><BR><BR>InterAction at (202) 667-8227 or <A href="http://www.interaction.org/">http://www.interaction.org</A>. This link lists<BR>multiple agencies that are accepting aid if you have a particular preference<BR>in how to donate.<BR><BR><A href="http://www.infoplease.com/ipa/A0107808.html">Myanmar is also known as Burma</A>.&nbsp; Click on the link to get more information<BR>about the country.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<BR><BR>Location:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</P>
<DIV class=floatnone><SPAN><A class=image title="Location of Burma" href="http://en.wikipedia.org/wiki/Image:LocationMyanmar.svg"><IMG height=125 alt="Location of Burma" src="http://upload.wikimedia.org/wikipedia/commons/thumb/5/5d/LocationMyanmar.svg/250px-LocationMyanmar.svg.png" width=250 border=0></A></SPAN></DIV>
<P><A href="http://en.wikipedia.org/wiki/Myanmar">Wikipedia has a great section</A>&nbsp;detailing Myanmar's history,&nbsp;geography, and government.<BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Music and Children</title><link rel="alternate" href="http://thedoctorblogger.com/2008/05/04/doctor-blogwhat-is-happening.aspx" /><id>tag:thedoctorblogger.com,2008-05-04:1a1414db-2eb0-4c8d-adc2-7d30d9ffebcc</id><author><name>DrRima Bishara</name></author><category term="C. Help My Parent Teach Me" /><updated>2008-05-08T17:51:26Z</updated><published>2008-05-04T12:30:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>Hello to my readers.<BR><BR>The past several days have been taken up with multiple events both in and out of town.<BR><BR>I have been slowly putting together information about the importance of music<BR>in a <STRONG>child's life </STRONG>and this can be the first entry to highlight <STRONG>music</STRONG>.<BR><BR>Let me share with you some of the quality that children are capable of producing <BR>given encouragement and time.&nbsp; <BR><BR>This child is 9 years old.&nbsp; She played for and won an international competition and<BR>will be rewarded with a recital in New York.<BR><BR>Click the link below for the performance.<BR><A href="http://www.youtube.com/watch?v=HGMAm-P4vGs">http://www.youtube.com/watch?v=HGMAm-P4vGs</A><BR><BR><EMBED src=http://www.youtube.com/v/HGMAm-P4vGs width=425 height=350 type=application/x-shockwave-flash></EMBED><BR><BR><BR><BR><BR>This child is 11 years old.&nbsp; He also played for and won an international competition.&nbsp; <BR>He will be rewarded with a recital in New York, at Carnegie Hall.<BR><BR>Click the link below for the performance.<BR><A href="http://www.youtube.com/watch?v=C90vSI2NR08">http://www.youtube.com/watch?v=C90vSI2NR08</A><BR><BR><BR><EMBED src=http://www.youtube.com/v/2S1_rqrrZZI width=425 height=350 type=application/x-shockwave-flash></EMBED><BR><BR></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Never Choke in a Restaurant in the South</title><link rel="alternate" href="http://thedoctorblogger.com/2008/04/26/doctor-blognever-choke-in-a-restaurant-in-the-south.aspx" /><id>tag:thedoctorblogger.com,2008-04-26:20d32317-a85d-4987-bc41-0e3e079b0049</id><author><name>DrRima Bishara</name></author><category term="F. Humor in Medicine" /><updated>2008-04-21T19:33:48Z</updated><published>2008-04-26T05:06:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>The following was forwarded to me by one of my readers.&nbsp; It is <STRONG>priceless</STRONG>.<BR><BR>*****************************************************************</P>
<P>Two hillbillies walk into a bar. While having a shot of whisky, they talk about <BR>their moonshine operation.</P>
<P>Suddenly, a woman at a nearby table, who is eating a sandwich, begins to <BR>cough. And, after a minute or so, it becomes apparent that she is in real distress.<BR><BR>One of the hillbillies looks at her and says, 'Kin ya swallar?'</P>
<P>The woman shakes her head no.</P>
<P>Then he asks, 'Kin ya breathe?'</P>
<P>The woman begins to turn blue and shakes her head no.</P>
<P>The hillbilly walks over to the woman, lifts up her dress, yanks down her drawers <BR>and quickly gives her right butt cheek a lick with his tongue.<BR><BR>The woman is so shocked that she has a violent spasm and the obstruction <BR>flies out of her mouth. As she begins to breathe again, the Hillbilly walks slowly <BR>back to the bar.</P>
<P>His partner says, 'Ya know, I'd heerd of that there 'Hind LickManeuver' but <BR>I ain't never seed nobody do it!'<BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <A title="hillbilly hoe-down" href="http://www.flickr.com/photos/sheeshoo/58678174/"><IMG class=pc_img height=180 alt="hillbilly hoe-down" src="http://farm1.static.flickr.com/28/58678174_4f29fac894_m.jpg" width=240></A></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--There Comes A Time....</title><link rel="alternate" href="http://thedoctorblogger.com/2008/04/24/doctor-blogthere-comes-a-time.aspx" /><id>tag:thedoctorblogger.com,2008-04-24:db04b246-7c84-41d8-a458-995ab978e388</id><author><name>DrRima Bishara</name></author><category term="B. Day in the Life of a Doctor" /><category term="E. Inspirational" /><updated>2008-04-21T19:29:47Z</updated><published>2008-04-24T08:59:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR>There are patients and then, there are patients you can't forget.<BR><BR>It has been my privilege to care for 2 such patients of mine over the past<BR>several years.&nbsp; This week,&nbsp;I learned again, what an impact illness can have on<BR>a family and the lives around the person who is ill.&nbsp; I also re-learned how<BR>it looks to pass through chronic illness with grace and humor.<BR><BR>One of the patients is the mom.&nbsp; Let's call her A.<BR><BR>The other patient is the daughter.&nbsp; Let's call her B.<BR><BR>B was run over by a car when she was a young child and survived, albeit with<BR>a number of problems, including loss of proper use of her legs, significant<BR>brain damage, and visual problems.&nbsp; She has been well cared for.&nbsp; She lives<BR>alone as an adult with her mom living right next door, available for any issues.<BR>B is now middle aged.<BR><BR>B loves cats of all shapes and sizes and has a great sense of humor.&nbsp; A couple<BR>of months ago, she was confronted by a delivery man while taking her morning<BR>walk in the neighborhood.&nbsp; "Do you like what you see?" he said as he dropped<BR>his pants and underwear in broad daylight.<BR><BR>She describes looking at his groin, then looking him in the eye and saying<BR>"NO!" as she walked away.&nbsp; She thought it was really hilarious that he thought<BR>she might fall to his wiles.&nbsp; He's now in jail...............<BR><BR>Over the past several months, it has become apparent that something is going<BR>wrong.&nbsp; After sub-specialty consultations and testing, it appears B has a<BR>cerebellum that is shrinking significantly.&nbsp; The implications are not good.<BR>There is no treatment.<BR><BR>A, her mom, is now making arrangements to find ways to spend more<BR>quality time with B while she still can.&nbsp; They are two of the most jovial and<BR>centered individuals that I see despite the illness that has challenged them<BR>They never enter nor leave the office with anything other than an upbeat<BR>attitude.<BR><BR>The last visit brought howls of appreciation from B because my nurse was<BR>wearing a Scooby Doo shirt.&nbsp; B loves Scooby Doo.&nbsp; We thought we might<BR>have to have the nurse give up the shirt for a minute there.........<BR><BR>What I appreciate most about these two very special people, is their close<BR>bond and their respect for each other.&nbsp; They are practical and they keep moving<BR>forward.&nbsp; "There is nothing better to do!" is the attitude.&nbsp; And this in the face<BR>of tragedy and challenge.<BR><BR>There are those who deserve a "tip of the hat", a standing ovation, a statue<BR>of some kind to commemorate their lives.&nbsp; <BR><BR>A and B will always have my gratitude and respect for their example and their<BR>ongoing and daily laughter.&nbsp; After all, the tears can fall another time.<BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <A title="hand in hand" href="http://www.flickr.com/photos/michelepedrolli/398985844/"><IMG class=pc_img height=160 alt="hand in hand" src="http://farm1.static.flickr.com/183/398985844_e82edadc92_m.jpg" width=240></A><BR><BR></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Medical Insurance for Profit</title><link rel="alternate" href="http://thedoctorblogger.com/2008/04/23/doctor-blogmedical-insurance-for-profit.aspx" /><id>tag:thedoctorblogger.com,2008-04-23:6250efb5-4998-4165-b489-e3f89e14b6c5</id><author><name>DrRima Bishara</name></author><category term="B. Day in the Life of a Doctor" /><updated>2008-04-21T19:19:04Z</updated><published>2008-04-23T09:20:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>The past couple of weeks, I've received 2 demands by insurance to<BR>justify the use of hydrocodone for patients over the age of 64.<BR><BR>They say that their data indicates this medication is "not indicated/approved" for the<BR>older population.&nbsp; <BR><BR>This medication is a low level narcotic often used in the setting of chronic pain.<BR>One particular patient has rheumatoid arthritis and has been on this medication<BR>for years.&nbsp; The medication controls the pain so she can perform daily activity.<BR><BR>So, hypothetically, a drug that has a generic formulation, that is effective, and<BR>that relieves suffering and pain, cannot be given to this patient because&nbsp;she has<BR>now become older than 64.&nbsp; Or is it something more sinister, like insurance<BR>trying to nickel and dime customers to death.........literally.<BR><BR>What shall we do with this patient?&nbsp; Push her over a cliff in her wheelchair?<BR><BR>Perhaps medical insurance companies that aim for profits can explain to the<BR>American public what people can look forward to as they get older.<BR><BR>I'm not talking about heart transplants.&nbsp; I'm talking about a generic (cheap) pill.<BR><BR>Of course, Viagra is covered by the same plan.........</P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--"What I've Learned" by Dr. Michael DeBakey</title><link rel="alternate" href="http://thedoctorblogger.com/2008/04/21/doctor-blogwhat-ive-learned-by-dr-debaky.aspx" /><id>tag:thedoctorblogger.com,2008-04-21:6d6e9860-feb8-4b2b-bb8e-d0106f7b1365</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><category term="E. Inspirational" /><updated>2008-05-20T09:24:52Z</updated><published>2008-04-21T09:14:00Z</published><content type="html"><![CDATA[<blockquote dir=ltr style="MARGIN-RIGHT: 0px">
<p><br>At the age of 99, <a href="http://www.debakeydepartmentofsurgery.org/home/content.cfm?content_id=287">Dr. DeBakey</a>,&nbsp; the venerable heart surgeon from Houston who pioneered<br>several procedures that have been life saving for heart patients, reflects on what he has<br>learned.<br><br>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <img height=325 src="http://www.debakeydepartmentofsurgery.org/home/content_images/debakeydesk.jpg" width=433><br><br>I've outlined the article but, for the full text from MSN by Cal Fussman, go to the link below.<br><br><a href="http://men.msn.com/articlees.aspx?cp-documentid=6564495&amp;GT1=32001">http://men.msn.com/articlees.aspx?cp-documentid=6564495&amp;GT1=32001</a></p>
<p><b>One of the rarest things</b> that we do is think. <br><br><b>There are questions</b> that I'd like answered.&nbsp;</p>
<p><b>If world leaders </b>were doctors, I think they would be more concerned with the welfare of people.&nbsp;</p>
<p><b>In any good society,</b> every member should be interested in the health of every other member.&nbsp;</p>
<p><b>What advice</b> would I give a doctor preparing for surgery?&nbsp;....walk into the right operating room.&nbsp;</p>
<p><b>I've done more than</b> sixty thousand heart operations....&nbsp;I've been fortunate in that I need <br>very little sleep.&nbsp;</p>
<p><b>Okra</b> is the key to good gumbo.</p>
<p><b>I'm not sure</b> I can answer that question specifically. But ...lots of doctors took the position <br>that you shouldn't try it. You've got to push ahead in spite of them. I learned that lesson early.</p>
<p><b>I don't think</b> the difference between ninety-nine and a hundred is important.</p>
<p><b>I scheduled</b> my last operation when I was ninety.&nbsp;</p>
<p><b>If you had</b> a heart problem right now and needed an operation and I was the only doctor <br>around, sure, I'd do it.</p>
<p><b>The best lesson</b> my mother taught me involves an orphanage we had in town.&nbsp;One Sunday...<br>she had put one of my favorite caps inside. I immediately protested...She told me I ought <br>to be glad that I could give up the cap. I never forgot that. </p>
<p><b>Being compassionate,</b> being concerned for your fellow man, doing everything you can <br>to help people<span style="FONT-SIZE: 12pt"><font face="Times New Roman">—</font></span>that's the kind of religion I have, and it's a comforting religion.&nbsp;<br><b><br>You can never</b> learn enough.</p>
<p><b>It's important</b> for a patient to go into an operation with confidence.&nbsp; </p>
<p><b>The worst thing,</b> of course<span style="FONT-SIZE: 12pt"><font face="Times New Roman"> </font></span>is when the patient dies during the operation. You die a little<br>every time that happens.</p>
<p><b>There was a historian</b> in the fourteenth century who wrote a book...the tribes that have <br>difficulty feeding themselves are lean and healthy, and those that have plenty of food are <br>fat, lazy, and unhealthy.</p>
<p><b>People often</b> use words in a loose way that covers over what they're talking about.&nbsp;</p>
<p><b>The doctor</b> who operated on me only a few years ago was one that I trained.&nbsp;</p>
<p><b>Never had a symptom.</b> The pain came like a bullet out of the blue. <br>Part of me was doing a diagnosis on myself<span style="FONT-SIZE: 12pt"><font face="Times New Roman">—</font></span>which, as it turned out, was correct. Aortic dissection. </p>
<p><b>I was a little surprised</b> to find myself recovering after the surgery.&nbsp;</p>
<p><b>During my recovery,</b> I played possum.&nbsp; Then I'd argue with them about the therapy.&nbsp;</p>
<p><b>I guess it's hard</b> to be my doctor.&nbsp;<br><br>&nbsp;&nbsp;&nbsp;</p></blockquote>
 If you’re interested in <a href=https://fortress.wa.gov/doh/hpqa1/HPS5/Medical/default.htm>helping people</a> then consider getting a <a href=http://www.guidetoonlineschools.com/nursing.html>associate degree in nursing online</a> from one of our <a href=http://www.guidetohealthcareschools.com/>accredited healthcare schools</a> such as the prestigious <a href=http://www.guidetohealthcareschools.com/alliedcollege.html>Allied College</a>.]]></content></entry><entry><title>Doctor Blog--Splenda</title><link rel="alternate" href="http://thedoctorblogger.com/2008/04/19/doctor-blogsplenda.aspx" /><id>tag:thedoctorblogger.com,2008-04-19:64dacc90-41aa-430e-b512-9aae6f7f4d7e</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><category term="B. Day in the Life of a Doctor" /><updated>2008-04-19T09:13:39Z</updated><published>2008-04-19T08:59:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR>This week, an older patient came in to have a third degree burn looked at after<BR>having spilled hot coffee on her thigh.<BR><BR>Initially, I thought it was a run-of-the-mill type of problem until I started talking<BR>to her.&nbsp; <BR><BR>She had poured herself a cup of coffee (hot, of course) and, since she sits in<BR>a wheelchair most of the day (she has rheumatoid arthritis), she put the <BR>coffee cup on her thigh to add the creamer and Splenda to it.&nbsp; She was<BR>steadying it with one hand and reaching for the Splenda with the other.<BR><BR>When she poured the Splenda into the cup of hot coffee, it began to foam.<BR>A lot.&nbsp; It foamed enough that it created a volcano effect and her hot coffee<BR>literally exploded onto her thigh.&nbsp; <BR><BR>She started developing blisters almost immediately.&nbsp; Fortunately, her Home<BR>Health Nurse came in at just about that time and was able to give her<BR>First Aid right away.&nbsp; <BR><BR>She told me that she contacted the company that produces Splenda and<BR>they confirmed that this type of thing has been known to happen.<BR><BR>Another friend of hers also confirmed&nbsp;that a similar incident had<BR>happened to her as well.<BR><BR>So, for those of you who use Splenda, you might be very careful when you<BR>add it to a hot liquid.&nbsp; Also, be very careful to keep a hot cup of anything as far<BR>away from skin as possible while preparing&nbsp;the beverage.<BR><BR>Let your friends and family know to take great care.<BR><BR>If you know of any other incidents, please incude them in the comment<BR>section of this entry.</P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Ten Things to Know About Diabetes</title><link rel="alternate" href="http://thedoctorblogger.com/2008/04/05/2008045doctorblogtenthingstoknowaboutdiabetes.aspx" /><id>tag:thedoctorblogger.com,2008-04-05:95200767-2c73-4b01-802f-ea628644a490</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><category term="B. Day in the Life of a Doctor" /><updated>2008-04-03T19:10:41Z</updated><published>2008-04-05T08:01:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>Of all the entries I've written, the one on <A href="http://thedoctorblogger.com/2007/03/02/insulin-pumpsdiabetes-controldoctor-bloghealth-and-wellnessinformation.aspx">Diabetes and Insulin Pumps</A>&nbsp;has<BR>generated the most comments.&nbsp; <BR><BR>To follow is more information about Diabetes and ten things a diabetic<BR>needs to know to prevent injury to organs and to live a full and<BR>healthy life.&nbsp; <BR><BR>1.&nbsp; There are <A href="http://www.lifeclinic.com/focus/diabetes/oral.asp">multiple oral medications</A>&nbsp;now available that can be used to<BR>control sugar levels.&nbsp; Insulin is not a necessity in adult onset diabetes.<BR><BR>2.&nbsp; <A href="http://www.endocrineweb.com/diabetes/2insulin.html">Insulin</A>&nbsp;is not, as is thought by many lay people, a choice of "last<BR>resort".&nbsp; In certain cases, it is <STRONG>ideal and recommended</STRONG>.&nbsp; When used<BR>in the proper setting and in the proper pattern, it can be the best<BR>thing for a diabetic.<BR><BR>3.&nbsp; The ultimate goal is to control sugar levels and keep them <STRONG>as close<BR>to the normal range </STRONG>as possible.&nbsp; The lower the sugars, the less chance<BR>of end organ damage (end organ being the heart, eyes, kidneys, blood<BR>vessels, nerves, etc.).<BR><BR>4.&nbsp; Diabetics that do the best <STRONG>eat and exercise in a regular pattern</STRONG>.<BR>This poses a challenge for those who prefer a random, spontaneous<BR>existence but can really make the difference between well controlled<BR>or poorly controlled diabetes.<BR><BR>5.&nbsp; A <A href="http://www.endocrineweb.com/diabetes/treatment.html">diabetic diet</A>&nbsp;<STRONG>is the best diet for everyone&nbsp;</STRONG>actually.&nbsp; Because our<BR>society in general has developed a taste for rich, fatty foods, it seems<BR>like a sacrifice to cut back on sugar, fat, and salt.&nbsp; But, truth be told,<BR>if everyone were on the balance of foods that diabetics should follow,<BR>we would all be healthier and closer to our ideal weight.<BR><BR>6.&nbsp; Remember portion control.&nbsp; The trick is not only <STRONG>what </STRONG>to eat but<BR>also <STRONG>how much </STRONG>to eat.&nbsp; A quick reference is that the <STRONG>closed fist </STRONG>is a<BR>close approximate serving size for an entree for the owner of the<BR>fist.<BR><BR>7.&nbsp; Always <STRONG>carry something that has sugar in it </STRONG>with you if you are diabetic.&nbsp; <BR>This might sound contradictory to the diet of low sugar but, it is very<BR>important if you are being treated for diabetes because you might<BR>have a too low blood sugar and need access to food instantly.&nbsp; If you<BR>have nothing to eat, you might lose consciousness before you get help.<BR><BR>8.&nbsp; See an <STRONG>eye doctor </STRONG>(MD Ophthalmologist) regularly (at least<BR>once per year) to prevent permanent eye damage.&nbsp; Treatment for<BR>diabetic side effects to the eyes has come a long way in the last<BR>20 years and preventive treatment is much better than salvage<BR>treatment.<BR><BR>9.&nbsp; Ask your doctor or their nurse for information if you don't know.<BR>One of the biggest mistakes diabetics make is assuming that what<BR>is happening to them is just something they have to put up with.<BR><STRONG>Ask</STRONG>.<BR><BR>10. Be prepared to <STRONG>check your sugars daily</STRONG>, possibly several times<BR>per day while you are becoming familiar with the treatment of<BR>diabetes.&nbsp; Learn how to operate a glucometer and write your<BR><STRONG>sugars down along with the time you checked the sugar</STRONG>.&nbsp; When <BR>you are still learning how to care for yourself as a diabetic, it can<BR>also be extremely helpful to <STRONG>write down what you ate at a particular<BR>meal </STRONG>so you can compare your intake with the sugar level that<BR>follows.</P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Identity Theft</title><link rel="alternate" href="http://thedoctorblogger.com/2008/04/03/2008043doctorblogidentitytheft.aspx" /><id>tag:thedoctorblogger.com,2008-04-03:a4335225-9fb8-450a-9b32-585b7d62d892</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><category term="B. Day in the Life of a Doctor" /><updated>2008-04-02T20:14:35Z</updated><published>2008-04-03T11:11:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>Although everyone has probably heard about identity theft, when it happens<BR>to someone close or to yourself, it brings a whole different perspective.<BR><BR>This week, an individual close to me discovered that her identity has been<BR>stolen and that an unidentified person has been using her Social Security<BR>Number to obtain education loans and cars and houses since she was 13 y/o.<BR><BR>Not unlike others, she discovered this breach when trying to get a loan<BR>herself and had to have a credit check on file.&nbsp;&nbsp;<BR><BR>When she got a copy of the credit report, she very nearly <BR>had to be sedated as she slowly realized all the charges that did not<BR>belong to her and as she came to terms with what had happened.<BR><BR>This breach can be very significant not only because it affects your credit,<BR>but also because&nbsp;they can&nbsp;access <STRONG>Social Security benefits including <BR>retirement income </STRONG>and start getting your money sent to them.<BR>When it comes time for you to apply, you can find that your benefits have <BR>been hijacked by someone else.&nbsp; Even though this is theft, it&nbsp;can take <BR>years to get corrected and may not ever be completely cleared.&nbsp; <BR><BR><STRONG><A href="http://www.experian.com/">Experian</A><BR><A href="http://www.transunion.com/">TransUnion</A><BR><A href="http://www.equifax.com/home/">Equifax</A><BR></STRONG><BR><BR>To follow are some of the <STRONG>things to do </STRONG>if you discover identity theft:<BR><BR>*Notify all three credit bureaus and ask them to put an alert on your <BR>account.&nbsp; This will give you opportunity to get notification if there is<BR>any activity on your credit and to possibly stop unauthorized activity<BR>in the future.<BR><BR>*File a police report with your local precinct.<BR><BR>*Call the District Attorney's office and find out what they can do to<BR>help you if criminal charges are to be filed.<BR><BR>*Call the&nbsp;<A href="http://www.ssa.gov/">Social Security Administration</A> and alert them to the problem.<BR>Get an appointment immediately to talk to an agent about what you<BR>should do to protect your current or future benefits.<BR><BR><BR><BR></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Darrell Green and What's Important</title><link rel="alternate" href="http://thedoctorblogger.com/2008/04/02/2008042doctorblogdarrellgreen.aspx" /><id>tag:thedoctorblogger.com,2008-04-02:3f06d5c5-eb13-4be6-95e4-88cebb7f97ef</id><author><name>DrRima Bishara</name></author><category term="B. Day in the Life of a Doctor" /><updated>2008-04-02T08:19:32Z</updated><published>2008-04-02T08:04:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>I had the opportunity to hear&nbsp;<A href="http://en.wikipedia.org/wiki/Darrell_Green">Darrell Green</A><STRONG> </STRONG>(former NFL star and Hall of Famer)<BR>speak&nbsp;at the National Convention of the American Red Cross.&nbsp; Let me say, he<BR>is short.&nbsp; But, he is a powerful short guy.<BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <A href="http://www.google.com/imgres?imgurl=http://www.silverscreentest.com/koala/eucalyptus/darrell.jpg&amp;imgrefurl=http://www.silverscreentest.com/koala/eucalyptus/february02.htm&amp;h=99&amp;w=108&amp;sz=15&amp;tbnid=4h-_BgPcdEUJ:&amp;tbnh=99&amp;tbnw=108&amp;prev=/images%3Fq%3Ddarrell%2Bgreen&amp;sa=X&amp;oi=image_result&amp;resnum=1&amp;ct=image&amp;cd=1"><IMG title="" height=99 alt="" src="http://www.google.com/images?q=tbn:4h-_BgPcdEUJ:www.silverscreentest.com/koala/eucalyptus/darrell.jpg" width=108 align=middle vspace=4 border=1></A><BR><BR>To summarize some of what he said:<BR><BR>Mr. Green suggests that a <A href="http://www.dgylf.org/">child needs four basic things</A>&nbsp;to have a chance to<BR>succeed in his experience.&nbsp; They are:<BR><BR>1. To be raised by a loving adult.&nbsp; This ideally, would be family (mom and dad) but<BR>could be an aunt or grandparent or, even a foster parent.<BR>2.&nbsp; An education.<BR>3.&nbsp; Subsidized support for things the family cannot provide (schools, hospitals, etc.)<BR>4.&nbsp; A moral compass (he favors church).<BR><BR>To hear a celebrity of his calibur talk about the <STRONG>importance of children </STRONG>and<BR>how they must be nurtured was truly inspirational.&nbsp; Particularly so since he<BR>comes from a disadvantaged background himself.<BR><BR>But <STRONG>more inspiring </STRONG>was his view of the importance of <STRONG>volunteerism</STRONG> and lending<BR>a helping hand to those around him.&nbsp; Interestingly, he reports that although<BR>he has heard the roar of the crowd at very exhilirating times in his career,<BR>the simple "thank you" or look of gratitude he has received from those that<BR>he has helped is the most profoundly touching experience to him.&nbsp; <BR><BR>Good guy.&nbsp; Good message.&nbsp; And, he volunteered at the <A href="http://www.redcross.org/">American Red Cross</A><STRONG><BR></STRONG>for years.&nbsp; He credits the ARC for instilling in him a sense of&nbsp;volunteerism<BR>during his formative years.</P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--The American Red Cross</title><link rel="alternate" href="http://thedoctorblogger.com/2008/03/28/doctor-blogthe-american-red-cross.aspx" /><id>tag:thedoctorblogger.com,2008-03-28:ce9acca5-a548-42c2-b6dc-9d69ccb3ebeb</id><author><name>DrRima Bishara</name></author><category term="B. Day in the Life of a Doctor" /><category term="E. Inspirational" /><updated>2008-03-28T20:03:41Z</updated><published>2008-03-28T19:20:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR>I am in Baltimore attending the National Convention of the <A href="http://www.redcross.org/">American Red Cross</A>.&nbsp; <BR>Having been a volunteer with this organization for a number of<BR>years, I decided it was time to get a closer look at the inner workings and<BR>national leadership that fuel the spirit of the thousands of volunteers that are<BR>the American Red Cross.<BR><BR>Despite the negative press that has sometimes dogged the ARC, the spirit<BR>of giving, sharing, and compassion is paramount and visible at every level in<BR>the organization.&nbsp; And, it is especially apparent with the people the ARC is<BR>partnering with to develop ways to meet the challenges of the future.<BR>These partners include sports celebrities, other outreach organizations,<BR>youth and students from high schools as well as colleges, and multi-ethnic<BR>groups.<BR><BR>The ARC has a <A href="http://www.redcross.org/search/search.asp">proud history</A>&nbsp;of volunteerism having been founded by Clara<BR>Barton in 1881 as a way to deliver care to soldiers at war.&nbsp; Since that time,<BR>congressional charters have solidified its role in American culture and it has<BR>become a symbol of the good in the American spirit--the spirit of giving and<BR>of charity.<BR><BR>If you have not looked at the ARC recently, you might be surprised to know<BR>that it has a congressional mandate to provide relief services to those in need<BR>when disaster strikes but it has no funding other than through the fund raising<BR>efforts of its staff and volunteers.&nbsp; Approximately 95% of people that make up<BR>the Red Cross are volunteers--either full or part time volunteers--who give of<BR>their time, resources, and effort to provide what is needed.<BR><BR>The culture of the Red Cross and its mission of compassion spans not only<BR>American soil but also reaches across the globe through the International<BR>Red Cross, providing vaccines to children in Africa, and tsunami relief to those<BR>devastated by the loss of loved ones and homes in the far east.<BR><BR>If you want your spirits lifted, talk to a Red Cross volunteer in your community<BR>and you'll find that the Red Cross not only provides disaster relief but also<BR>teaches life saving skills such as CPR and water safety.&nbsp; <BR><BR>And, very importantly, while our troops are at war, doing the bidding of our<BR>government on unfamiliar soil, the Red Cross provides a <A href="http://www.redcross.org/services/afes/0,1082,0_321_,00.html">link</A>&nbsp;of communication<BR>and resources to soldiers and their families.&nbsp; <BR><BR>The Red Cross also has a Holocaust Survivor's tracking unit that has helped <BR>many people find out about their loved ones and finally have closure after <BR>decades of not knowing.<BR><BR>To those who have never experienced a natural disaster or a medical<BR>emergency, the Red Cross might seem like a distant thought.&nbsp; But for <BR>anyone who has been touched by the dedication of one of these<BR>volunteers and the warmth they bring to their mission, the work this<BR>organization does can be life changing.&nbsp; <BR><BR>As one speaker said, <STRONG>the volunteers are not paid not because they<BR>are of no value, but because they are priceless</STRONG>.<BR><BR>And as the American Red Cross says: change a life today, starting with your own.<BR>Look around and see what difference you can make in the lives of those around<BR>you in times of need.&nbsp; You will probably find that the life you change most<BR>profoundly is your own.<BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <A title="A helping hand" href="http://www.flickr.com/photos/jimbaker/70750719/"><IMG class=pc_img height=240 alt="A helping hand" src="http://farm1.static.flickr.com/20/70750719_4487c32bb0_m.jpg" width=180></A><BR><BR></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Ten Patient Medical Words of the Month</title><link rel="alternate" href="http://thedoctorblogger.com/2008/03/26/doctor-blogpatient-medical-words-of-the-month.aspx" /><id>tag:thedoctorblogger.com,2008-03-26:46db2977-f8b0-451f-829c-d6b146e62cc4</id><author><name>DrRima Bishara</name></author><category term="F. Humor in Medicine" /><updated>2008-03-24T18:11:05Z</updated><published>2008-03-26T11:43:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>Barbera--<A href="http://en.wikipedia.org/wiki/Palpitation">Palpitations</A>&nbsp; (wonder how that one got going.....)<BR><BR>Shredmill--<A href="http://en.wikipedia.org/wiki/Treadmill">Treadmill</A> (Hmmm)<BR><BR>Vanax--<A href="http://en.wikipedia.org/wiki/Alprazolam">Xanax</A><BR><BR>Flibergator--<A href="http://en.wikipedia.org/wiki/Defibrillation">Defibrillator</A><BR><BR>Neurotica--<A href="http://en.wikipedia.org/wiki/Neuropathy">Neuropathy</A><BR><BR>Gore--<A href="http://en.wikipedia.org/wiki/Goitre">Goiter</A><BR><BR>Nexavin--<A href="http://en.wikipedia.org/wiki/Esomeprazole">Nexium</A><BR><BR>Cadillac--<A href="http://en.wikipedia.org/wiki/Cataract">Cataract</A><BR><BR>Genital Cattle Rack--<A href="http://en.wikipedia.org/wiki/Cataract">Congenital Cataract</A><BR><BR>Blaupoma--<A href="http://en.wikipedia.org/wiki/Glaucoma">Glaucoma</A><BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <A title=gallstones href="http://www.flickr.com/photos/em_flickr/89394768/"><IMG class=pc_img height=162 alt=gallstones src="http://farm1.static.flickr.com/17/89394768_f3c3d09c85_m.jpg" width=240></A><BR><BR><BR><BR><BR><BR><BR></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Triumph of Parenting</title><link rel="alternate" href="http://thedoctorblogger.com/2008/03/24/doctor-blogtriumph-of-parenting.aspx" /><id>tag:thedoctorblogger.com,2008-03-24:905f8a3b-efec-49dd-b92f-e3d7357f4f2d</id><author><name>DrRima Bishara</name></author><category term="E. Inspirational" /><category term="C. Help My Parent Teach Me" /><updated>2008-03-20T14:35:05Z</updated><published>2008-03-24T13:41:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P>&nbsp;&nbsp;&nbsp;<BR>&nbsp;&nbsp;<BR>Since children and parenting has been the issue of the month here, I<BR>thought I'd include a link that inspired me and continues to inspire other<BR>people.&nbsp; It is about an autistic boy and a basketball.&nbsp; I will let you injoy <BR>watching it yourself and I can tell you it is <STRONG>well worth </STRONG>your time.<BR><BR>&nbsp;&nbsp;<A href="http://uk.youtube.com/watch?v=NOiEHpoKIJA">http://uk.youtube.com/watch?v=NOiEHpoKIJA</A><BR></P></BLOCKQUOTE></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Travel Comedy</title><link rel="alternate" href="http://thedoctorblogger.com/2008/03/21/doctor-blogtravel-comedy.aspx" /><id>tag:thedoctorblogger.com,2008-03-21:1d0cd935-06e7-4b8e-b734-4afc406d755b</id><author><name>DrRima Bishara</name></author><category term="B. Day in the Life of a Doctor" /><updated>2008-03-20T14:28:08Z</updated><published>2008-03-21T09:32:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR>I recently took a trip from Texas to California for Continuing Medical Education.&nbsp; It was<BR>intended to be a quick in-and-out sort of affair.&nbsp; To follow is the comedy it actually was--<BR>and I mean "comedy".&nbsp; Please read to the end as you will miss the best part if you don't.<BR><BR>Thursday afternoon:&nbsp; <BR><BR>Finished a mass of paperwork getting ready for travel.&nbsp; Saw a full load in morning clinic.<BR>Ran home to pack at 1PM.&nbsp; It is now raining and cold (in the 40's).<BR><BR>Drove to the airport.&nbsp; Parked in Long Term Parking.&nbsp; It is raining, cold and windy.&nbsp; I'm<BR>close enough to the airport I can walk.&nbsp; I pull out my 2 pieces of luggage and one purse<BR>(big) and open my umbrella.&nbsp; The umbrella immediately catches the wind and flips<BR>upside down.&nbsp; I struggle and after 10 minutes of walking, I arrive, wet, cold, and<BR>forelorn to the airport terminal.<BR><BR>I get to the airline counter and meet with the word "Cancelled" on all outgoing<BR>flights for the day.&nbsp; <BR><BR>It is Spring Break travel weekend and all flights from Thursday thru Sunday are full.<BR><BR>They can get me out from Dallas (connecting city) Friday afternoon which would put <BR>me in California at 11PM missing half of the conference.&nbsp; I would have to drive to Dallas.<BR><BR>I arrange for a flight with a different airline that allows me to attend the lectures on<BR>Friday but it leaves from Austin.&nbsp; I arrange for a friend to ride with me and drive the<BR>car back to its original destination so that my car is at home.<BR><BR>Friday morning I am up at 5 AM and, without my glasses, it appears there is some<BR>haziness in the air.&nbsp; I put my glasses on.&nbsp; It is snowing.&nbsp; I cannot get thru to the<BR>alternate airline because their lines are jammed with callers.&nbsp; After an hour of<BR>trying, I get through--flights are on time.&nbsp; My 2 hour drive to Austin will not be<BR>in vain.<BR><BR>I get to California without incident.<BR><BR>I attend the conference without incident.<BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <A title="From the airplane" href="http://www.flickr.com/photos/alessioschiavon/534361886/"><IMG class=pc_img height=180 alt="From the airplane" src="http://farm2.static.flickr.com/1040/534361886_84e99c36b4_m.jpg" width=240></A><BR><BR>Sunday PM, I am dropped off curbside by a friend in California.&nbsp; I attempt curbside check-in.<BR>"I can't check you in ma'am.&nbsp; There is a delay in the flight and you might miss your<BR>connecting flight.&nbsp; You'll have to check in at the main counter."<BR><BR>At the main counter,&nbsp; the attendant confirms there is in fact a delay--only 5 minutes<BR>to catch the connecting flight.&nbsp; It is not possible.&nbsp; I call my husband and ask if<BR>he would pick me up in Dallas rather than having to stay overnight and chancing<BR>a problem coming home in time for Monday morning clinic.<BR><BR>I get to the gate and encounter a distinguished elderly gentleman wearing a leather<BR>jacket with snake skin shoes, holding a&nbsp;cane.&nbsp; He has obviously had a stroke having an<BR>obvious loss of function of the right arm and leg.&nbsp; He is limping heavily but is proud and<BR>determined to walk using the cane--he will not accept a wheelchair.&nbsp; I am<BR>immediately aware that someone on the flight has a medical problem and might<BR>need attention at some point.<BR><BR>The flight is delayed one hour longer because the third flight attendant is not there<BR>and has been dispatched from another airport to cover our flight and is caught in<BR>traffic--they realized she was not there as the first passenger started down the<BR>boarding tunnel.&nbsp; Now, we will be leaving 2 hours&nbsp;past the original flight time.&nbsp; <BR><BR>We finally board the flight.&nbsp; All goes smoothly until the pilot advises passengers that<BR>for the next hour we will need to remain seated as storms are moving into the<BR>Dallas area and a bumpy ride is likely.<BR><BR>We land without incident.&nbsp; As I leave the plane (one of the last to leave as I was<BR>seated towards the back of the plane), I encounter the gentleman who has had<BR>a stroke, struggling up the exit ramp still declining wheelchair assistance.&nbsp; He is<BR>breathing hard.&nbsp; <BR><BR>I inquire as to how he is doing.&nbsp; "Fine but I need a bathroom!"&nbsp; I offer advice as<BR>I am familiar with the airport in Dallas and he is not.&nbsp; We go our separate ways.<BR><BR>I call my husband who tells me he is still at least one hour away since he is<BR>caught in traffic because of the rain.&nbsp; I will do some work I have brought along<BR>while I wait for him to arrive.<BR><BR>I find some airport food (haven't eaten in several hours and it is close to midnight).<BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <A title=Airplane href="http://www.flickr.com/photos/davipt/163212084/"><IMG class=pc_img height=160 alt=Airplane src="http://farm1.static.flickr.com/54/163212084_2566b732ce_m.jpg" width=240></A><BR><BR>I head to baggage claim.&nbsp; The nice gentleman is there.&nbsp; He has found his son.&nbsp; They<BR>collect his luggage.&nbsp; I am waiting for the other passengers to clear out since I am<BR>in no particular rush to get my luggage.<BR><BR>The nice gentleman comes over, introduces his son and sends him off to get the<BR>car.&nbsp; He then proceeds to <STRONG>hit on me</STRONG>.&nbsp; I guess he has not noticed the ring on my left<BR>finger or has chosen to ignore it.<BR><BR>I am tired and totally unprepared for a romantic advance from a total stranger.<BR>My interest had been purely medical............Surreal.&nbsp; I compose myself.<BR><BR>"I am married, sir.&nbsp; Thank you for your kind offer but I am not interested."<BR><BR>I collect my own luggage and settle down to eat my airport food and do some<BR>work.&nbsp; <BR><BR>My husband calls.&nbsp; He has arrived at the airport.&nbsp; He is circling the terminal where<BR>we landed.&nbsp; I don't see him. He circles again.&nbsp; I don't see him.<BR><BR>He calls.&nbsp; "Don't you see me?" he asks.&nbsp; No cars in sight.&nbsp; I am now standing<BR>outside under an overhang.&nbsp; It is raining, windy, and cold with my luggage in tow.<BR><BR>I take a deep breath and look up seeking inspiration for the moment.&nbsp; I realize <BR>that even though the flight attendant had announced that our arrival was to<BR>be at Terminal D, there must have been a last second change.&nbsp; I am standing in<BR>Terminal A.&nbsp; My husband is circling Terminal D.<BR><BR>After an apologetic phone call to him, I see the familiar car and my poor husband<BR>with hair standing straight up and eyes bugged out.&nbsp; It has taken him 3 1/2 hours<BR>to make a 1 1/2 hour trip.<BR><BR>So ends the travel comedy.&nbsp;&nbsp;I am sure someone got a good laugh out of it.<BR>No bitterness here you understand.&nbsp;&nbsp;<BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <A title=Wet href="http://www.flickr.com/photos/kijal/106350576/"><IMG class=pc_img height=240 alt=Wet src="http://farm1.static.flickr.com/34/106350576_9ca3fec2e5_m.jpg" width=180></A></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Chinese Proverb</title><link rel="alternate" href="http://thedoctorblogger.com/2008/03/20/doctor-blogchinese-proverb.aspx" /><id>tag:thedoctorblogger.com,2008-03-20:0d74b56c-915d-4f00-910c-ca80d8b171f0</id><author><name>DrRima Bishara</name></author><category term="G. Quotes of the Week" /><updated>2008-03-20T14:12:55Z</updated><published>2008-03-20T14:09:00Z</published><content type="html"><![CDATA[<BR>
<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><FONT face=Verdana size=2><STRONG>A child's life is like a piece of paper on which every person leaves a mark.</STRONG></FONT></P>
<P><FONT face=Verdana size=2>Chinese Proverb</FONT></P>
<P><FONT size=2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <A title="child's hand" href="http://www.flickr.com/photos/10227913@N08/1369243227/"><IMG class=pc_img height=240 alt="child's hand" src="http://farm2.static.flickr.com/1043/1369243227_05d02f3a3d_m.jpg" width=154></A></FONT></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Ron Paul's Version of Freedom</title><link rel="alternate" href="http://thedoctorblogger.com/2008/03/17/doctor-blogron-pauls-version-of-freedom.aspx" /><id>tag:thedoctorblogger.com,2008-03-17:91864111-8106-4494-8a03-f0c8e6371f8e</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><updated>2008-03-15T15:59:10Z</updated><published>2008-03-17T14:12:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>To follow, you will find a video link&nbsp;of a controversial figure in politics--<STRONG>Ron Paul</STRONG>.&nbsp;&nbsp;<BR>I found the speech fascinating.&nbsp; These ideas are worth hearing and thinking about.&nbsp; <BR>Listen to the reasons behind the positions and you may gain a new respect for <BR>our individual freedoms.<BR><BR>Dr. Paul's perspective comes from 10 Congressional terms and a career in medicine.<BR>Do we have freedom in America today?&nbsp; You decide........<BR><BR><A href="http://www.worldhealth.net/p/las-vegas-conference-highlights-ron-paul-md.html">http://www.worldhealth.net/p/las-vegas-conference-highlights-ron-paul-md.html</A></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Can We Blame The Parents?--Part II</title><link rel="alternate" href="http://thedoctorblogger.com/2008/03/14/doctor-blogparenting-a-right.aspx" /><id>tag:thedoctorblogger.com,2008-03-14:9b9c8a71-2629-4e96-abf9-73ca343c772a</id><author><name>DrRima Bishara</name></author><category term="B. Day in the Life of a Doctor" /><category term="C. Help My Parent Teach Me" /><updated>2008-03-15T15:56:11Z</updated><published>2008-03-14T21:56:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR>YS, one of my subscibers, ponders whether we can blame poor parenting on<BR>"young, ignorant parents".&nbsp; See <A href="http://thedoctorblogger.com/2008/02/29/doctor-blogand-thats-the-point.aspx">Part I</A>&nbsp;for the first part of the discussion.&nbsp; I<BR>reviewed a book on Divorce and <A href="http://www.amazon.com/Unexpected-Legacy-Divorce-Landmark-Study/dp/0786863943">The Unexpected Legacy of Divorce</A>.<BR><BR>YS is obviously concerned about how we can help parents that might be<BR>disadvantaged suggesting obligatory parenting classes, school for a<BR>trade and being supported financially all the way.&nbsp; Because divorce has<BR>become such a big part of our society in general, I thought it might be useful<BR>to look at this particular aspect since the impact on children is prominent.<BR><BR>I believe the issue has multiple facets.&nbsp; Among them is the governement's<BR>role in our lives and our own choices.&nbsp; It has to be said that parents who<BR>have more money have a better shot at good parenting.&nbsp; It is easier for<BR>them to get quality help from sitters, day care, and nannies.<BR>So, how do we impact those that have limited knowledge and limited resources?<BR><BR>In the US, we seem to have come to the belief that a "right" is what we "want".<BR>We even&nbsp;seem to interpret "needs" as "rights" and have come to&nbsp;assume that we<BR>should have these rights regardless of whether we have earned them.&nbsp; Simply by<BR>existing, we have a "right".&nbsp;&nbsp;&nbsp;We have, in turn, charged our elected officials with<BR>the job of making sure we each get these "rights".&nbsp; Many personal choices<BR>have thus become political.&nbsp;&nbsp;Our politicians&nbsp;then make choices on how to<BR>allot the money it takes to provide these "rights".&nbsp; This is one facet.&nbsp; I will<BR>tie this perspective into the current topic further down in the article.<BR><BR>Another facet is that our society seems to have taken the sting out of poor choices.&nbsp; <BR>That is, our&nbsp;Federal or State government, has systems in place that keep people <BR>from feeling the consequences of their bad choices.&nbsp; I am not necessarily<BR>saying this is bad.&nbsp; It is great to have a contingency for really bad things.&nbsp;<BR>But, consider this: in life, we make choices.&nbsp; And some of them will be bad choices.&nbsp; <BR>And, it is always heart breaking to watch people live through consequences.<BR>But, consequences are the natural result of what we think, feel, and do.&nbsp;&nbsp;<BR>They are not&nbsp;random events--at least not often.<BR><BR>So, as difficult as&nbsp;they are to watch, consequences should make us think twice<BR>about our choices in the first place--getting married, having children, etc.<BR><BR>We are at least 2 to 3 generations deep in fragmented families--that is, single parents,<BR>divorced parents, estranged parents, absent parents, etc.&nbsp; In fact, it appears that<BR>divorce happens all the time and has become part of the fabric of our society.&nbsp; <BR>We no longer think of it as a tragedy or scandal in the way it was even 3 or 4 decades<BR>ago.<BR><BR>Consider this:&nbsp; <A href="http://www.amazon.com/Unexpected-Legacy-Divorce-Landmark-Study/dp/0786863943">Wallerstein</A>&nbsp;makes the comment that each child experiences<BR>divorce "single file".&nbsp; That is, there might be 15 kids in a classroom of 30 and<BR>each of them will be thinking to themselves "why me?".&nbsp; Volume does not<BR>lessen the pain nor the impact on the individual child.&nbsp; Even families who<BR>had more than adequate finances had children with an emotional sense<BR>of lack.<BR><BR>Let me be clear that divorce is not the only damaging thing that can happen<BR>to families.&nbsp; There is alcoholism, family violence, drug abuse, and any of a<BR>number of really bad things that can exist both within intact as well as <BR>divorced families.&nbsp; So, my intention is to highlight&nbsp;<STRONG>divorce </STRONG>but not to assume<BR>that it is the only problem that exists.<BR><BR>With regard to the "right to have children", it must be said that children should<BR>be considered to have rights also, should they not?&nbsp; <BR><BR>Children should have a right to good parents, good parenting, and good teaching.<BR>They should have a right to an education and the skills to make a life for themselves.<BR>They should have a right to a childhood unencumbered by their parents' mistakes.<BR>They should have a right to safety, security, a full stomach, and a warm bed.<BR><BR>Y hypothesizes that if we provide parenting classes and pay for an education,<BR>that parenting skills will improve.&nbsp; I think these are great ideas.&nbsp; The question<BR>would be how can we implement these ideas without regulating parenting?<BR>Who will be responsible to see that parents attend these classes, learn the<BR>material, implement what they have learned, and who will pay for it?&nbsp; How<BR>will we measure success?<BR><BR>We already have a number of programs to help disadvantaged families or<BR>parents in the US.&nbsp; These programs include Housing Assistance (government pays<BR>for housing for families that are underprivileged), Disability Income (government<BR>pays for those who claim an impairment that keeps them from doing work),<BR>Head Start Programs (government pays for small children to be in an educational<BR>environment with the theory that early intervention will help kids succeed),<BR>Medical Care for the disadvantaged (Medicaid--government pays for healthcare).<BR><BR>With all these programs, have we seen success in moving our society toward<BR>prosperous and healthy families?&nbsp; Or are we seeing a generation of children <BR>who are raised in poverty and&nbsp;near total dependence on government?&nbsp;&nbsp;<BR>My&nbsp;observations of the family structure over the past 20 years leads me<BR>to believe that we have fallen short in raising our children and that, despite<BR>our support programs,&nbsp;inadequate parenting has become generational (observation<BR>in my practice as well as observations of families that have been honest enough<BR>to share their decades of experience).<BR><BR>What I have seen repeatedly is:&nbsp; mom or dad are into drugs-or alcohol-or the<BR>fast lane-or just not ready to raise kids but they have kids, the kids grow up poorly<BR>attended, they themselves have children&nbsp;as teenagers&nbsp; By this time,<BR>mom or dad have realized their mistakes but have not acquired any more<BR>parenting skills.&nbsp; They try to help raise the grand kids on fixed incomes while<BR>the real parents are struggling thru their own lives.&nbsp; It is a family cycle that probably<BR>requires intervention for the whole family.<BR><BR><STRONG>Parent </STRONG>is a verb not a noun.&nbsp;&nbsp;To have children may be a right but, with having<BR>children comes responsibility that, if poorly attended, carries consequences.<BR><BR><STRONG>In the purest sense, I believe we can blame the parents.&nbsp;</STRONG> Parents are the ones<BR>that have make the choice to have children--parents choose to have sex, choose<BR>to carry a child, choose to have a child.&nbsp; It is not something that happens while<BR>they stand on a corner minding their own business.&nbsp;&nbsp;<BR><BR>Consider this: &nbsp;Children will <STRONG>grow up </STRONG>with food, clothing, and shelter.<BR>But to <STRONG>raise </STRONG>them&nbsp;takes time, effort, and some skill.<BR><BR>So, what of the parents that have been poorly parented themselves--they may <BR>not understand the importance of raising children nor where to go for information.&nbsp; <BR><BR>Can we go to the state and federal government and ask them to solve this?<BR>Government can do many things.&nbsp; Parenting is not one of them.&nbsp; That happens<BR>in the home, one on one between&nbsp;a parent and a child.&nbsp; There is no political<BR>fix for this problem because it has to do with spirit, soul, and aspiration.<BR><BR>As Mark Twain said, <STRONG>"What is done to children, children will do to society".</STRONG><BR><BR>Children are our greatest natural resource as a country and as an international<BR>community.&nbsp; It is my belief that if we pour resources into our children, we will<BR>secure our future.&nbsp; If we ignore the problem, we will also secure our future.<BR>Which future do we want?<BR><BR>My own conclusion is that the solution should likely come from within our communities--<BR>our local communities.&nbsp; We have churches, schools and hospitals in almost every<BR>community in this country.&nbsp; There is some argument that churches are losing<BR>relevance with the younger generations.&nbsp; Maybe there is a point here.&nbsp; <STRONG>Perhaps<BR>institutional relevance should be dictated by how institutions serve our communities<BR>rather than by which tradition or philosophy they espouse.</STRONG>&nbsp; <BR><BR>Maybe churches, schools, and hospitals can become conduits of information <BR>and centers for learning and resources for both children and adults.<BR><BR><BR><BR><BR></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Obsessive Compulsive Disorder</title><link rel="alternate" href="http://thedoctorblogger.com/2008/03/10/doctor-blogobsessive-compulsive-disorder.aspx" /><id>tag:thedoctorblogger.com,2008-03-10:a76e586e-faad-4e53-887e-b05721ba0480</id><author><name>DrRima Bishara</name></author><category term="F. Humor in Medicine" /><updated>2008-03-10T12:39:36Z</updated><published>2008-03-10T12:33:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR><BR><BR>A teenager&nbsp;talking about&nbsp;his father found his dad's way of doing things rather<BR>entertaining.<BR><BR>He pontificated that his father was so <A href="http://en.wikipedia.org/wiki/Obsessive-compulsive_disorder">OCD (Obsessive Compulsive Disorder)</A><BR>that his dad called the disorder CDO because that put the letters in alphabetical<BR>order.</P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Tip of the Day</title><link rel="alternate" href="http://thedoctorblogger.com/2008/03/04/doctor-blogtip-of-the-day.aspx" /><id>tag:thedoctorblogger.com,2008-03-04:d6c06908-21eb-4225-a199-ae07da25d2e1</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><updated>2008-03-04T17:04:21Z</updated><published>2008-03-04T08:52:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR>Anyone who has had to take pills on a regular basis runs up against the problem<BR>of remembering to take them at the right time.&nbsp; It is more of a problem when the<BR>pill is due to be taken multiple times per day.&nbsp; Fortunately, the pharmaceutical<BR>industry has developed preparations that can be taken either once or twice a<BR>day as opposed to 3-4 times per day on many commonly used medications.<BR><BR>A tip for remembering to take a once-a-day or twice-a-day medication is:<BR><BR>Put the pill bottle right next to your tooth brush.&nbsp; Assuming you brush your<BR>teeth twice per day (hopefully you do), this will be your reminder to take your<BR>pill at the right time.<BR><BR>Some patients have had to set the base of the toothbrush IN the pill bottle.<BR>Pick up the toothbrush, remember your pill.<BR><BR><BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<A title="Pills (white rabbit)" href="http://www.flickr.com/photos/erix/142789779/"><IMG class=pc_img height=180 alt="Pills (white rabbit)" src="http://farm1.static.flickr.com/51/142789779_7d6a5ab8a7_m.jpg" width=240></A></P></BLOCKQUOTE>]]></content></entry><entry><title>Doctor Blog--Can You Blame The Parents?--Part I</title><link rel="alternate" href="http://thedoctorblogger.com/2008/02/29/doctor-blogand-thats-the-point.aspx" /><id>tag:thedoctorblogger.com,2008-02-29:7c0ee08b-8d97-4c57-b2e6-d48f6b264b91</id><author><name>DrRima Bishara</name></author><category term="B1. The Better Health Question" /><category term="C. Help My Parent Teach Me" /><updated>2008-03-01T13:39:33Z</updated><published>2008-02-29T13:14:00Z</published><content type="html"><![CDATA[<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
<P><BR>One of my subscribers&nbsp;commented as follows:<BR><BR><EM>Hello Dr. Rima,<BR><BR>I've been subscribed to your blog for quite a while now. I thought its time for me <BR>to come here and thank you for the good job you are doing.<BR><BR>I particularly like these posts of yours:<BR><BR>-Medication Side Effects<BR>-Watch Your Manners<BR>-Unfit Parents<BR>-Parental Exercise<BR><BR>If you don't mind I would like to add a word or two. In my opinion, there are <BR>some cases <STRONG>where you cannot put all the fault on the parents</STRONG>. Sometimes society <BR>is at fault. Sometimes the grandparents are at fault. In some places the society <BR>and <STRONG>families are so screwed up </STRONG>you don't know who to blame for it so we put all <BR>the fault on the young ignorant parent when she or he might be a victim also. <BR><BR>Honestly, I do not know how such cases can be fixed. <STRONG>Having children is a right</STRONG>. <BR>Most of these parents would not be seeking help nor advice on the Internet,etc.<BR><BR>Instead of taking care of the children on behalf of the parents, why aren't the <BR>parents enrolled in <STRONG>obligatory parenting classes </STRONG>and if they are poor and <BR>uneducated enrolled in high school or college and of course </EM><EM><STRONG>supported all the <BR>way financially</STRONG>? (does this sound cheesy?)<BR><BR>I'm sorry for the long post.<BR>Regards!<BR>Y.S.<BR></EM><BR>YS,&nbsp; I am SO glad you posted&nbsp;this comment.&nbsp; You have hit on a most important<BR>topic--<STRONG><EM><U>raising children and the impact of parenting.</U></EM></STRONG>&nbsp; <BR><BR>I have no idea whether you are writing from the US or outside the US but,<BR>you make some excellent observations and comments about how to "fix" the<BR>situation we are in.&nbsp; I'd like to address <STRONG>one of the problems,</STRONG> in my opinion,<STRONG>&nbsp;</STRONG>that <BR>has put us in the situation you describe--<STRONG>divorce</STRONG>.&nbsp; As a physician, I have the<BR>opportunity to observe families over many years.&nbsp; Sometimes I treat the parents<BR>and their children.&nbsp; And, although this is only one aspect of the problem, I think<BR>it needs to be said that we are at least 2 generations deep into children who<BR>have been raised in divorced homes and, we are seeing some of the effects<BR>on our society in general.&nbsp; Children are raised with a lack of either financial<BR>resources or relational resources--I'll explain below.&nbsp; In other words, they<BR>are not as well equipped to be parents as they might be.&nbsp; <BR><BR>Please bear with me as I detail this topic.&nbsp; It is complex.&nbsp; My intention is to<BR>highlight a problem rather than place blame.&nbsp; Generally, though, if we can<BR>shed light on why things happen as they do, we can often find a solution.&nbsp; This<BR>is my hope.<BR><BR>As most of us already know, the US became a <STRONG>"no fault" divorce </STRONG>country in the<BR>1980's after much effort and lobbying to allow abused or miserable partners<BR>to get out of horrid marriages and start a new life.&nbsp; That is, our society has<BR>decided that it is important for adults who find they have made a grave<BR>mistake in their choice of spouse, to get out of the mistake and begin over.<BR><BR>Out of sheer coincidence (or maybe not), a good friend of mine recommended<BR>a book about divorce and its <STRONG>effects on children </STRONG>about the same time that<BR>YS made the above entry comment.<BR><BR>The book was <A href="http://www.amazon.com/Unexpected-Legacy-Divorce-Landmark-Study/dp/0786863943">The Unexpected Legacy of Divorce</A> by Wallerstein &amp; Blakeslee.<BR>My friend was so adamant I read it, that she brought a copy&nbsp;to my office<BR>herself.<BR><BR>She and I had gotten into a conversation about how children are cared for<BR>in the post-divorce years and how parents adjust their schedules and emotions<BR>in these situations.<BR><BR>I am a child of divorce&nbsp;and had read a lot about divorce and marriage but<BR>this book took me totally by surprise.&nbsp; Why?&nbsp; Because it is completely based on<BR>the perspective of the children--not the parents, not the grandparents, not<BR>the attorneys, not the courts--the children.<BR><BR>In summary, it details the study of children over a 25 year period starting from<BR>the day of the divorce and ending 25 years later.&nbsp; Most of the children were<BR>between the ages of 6-15 at the beginning of the study and were in their<BR>30's to 40's at the end of the study.<BR><BR>What made a <STRONG>particular impact&nbsp;</STRONG>on me (as a doctor and as a child of divorce) is<BR>the abiding effect of divorce on a child throughout their lives despite the best<BR>post-divorce arrangements that our courts can provide.&nbsp; The book details how<BR>the <STRONG>choices our courts offer</STRONG>, take the parents concerns into account but, essentially<BR>leave the children's concerns off the table.&nbsp; <STRONG>No one actually asks the children</STRONG>.<BR>There are states where there are "attorney-ad-lidum" arrangements but these<BR>systems do not appear to mitigate the silence that the children are forced to<BR>maintain in the divorce and its aftermath.&nbsp; They look at the situation from a<BR>"kids need both parents" viewpoint and enforce this no matter what the<BR>circumstances--violence, drugs, alcohol abuse, emotional destruction.<BR><BR>Most of the distress came not during the breakup (as many people imagine) but<BR>as children reached their adolescent and adult years.&nbsp; The author posits that many<BR><STRONG>children lose the learning that happens about relationships </STRONG>and how to maintain<BR>them within the boundaries of a safe, intact family.&nbsp; They reach adulthood and<BR>have to learn the social skills they have not absorbed.&nbsp; <STRONG>Children from intact<BR>families naturally absorb this information by being around it day in and day out.<BR></STRONG>Some were fortunate enough to end up in step families with a loving step-parent<BR>who helped model a relationship with the child's biological parent--not many.<BR><BR>Also, children were generally given <STRONG>no explanation of what really happened </STRONG>(other than<BR>the platitude "mommy and daddy cannot get along") and, in the silence, kids<BR>are left fearing loss--because they do not understand how this happened.&nbsp; That is <BR>not to say that very young children should be lectured to about the faults of the marriage.&nbsp;<BR> It means that parents should provide their children <STRONG>the opportunity to ask</STRONG> some <BR>perhaps painful questions and be prepared to <STRONG>provide very truthful answers </STRONG>about <BR>these questions--this is most likely to occur during adolescence and adulthood.&nbsp;&nbsp;<BR><BR>One example of&nbsp;the lack of information felt by kids that the author gave was that<BR>children did not make the connection between physical violence and the divorce<BR>even in cases where the husband was physically abusive to the wife in front of the<BR>kids.&nbsp; No one specifically explained it and they could not make the connection in<BR>their own minds.<BR><BR>Additionally, joint custody arrangements commonly used across the country <BR><STRONG>caused problems for kids who were required to travel some distance between <BR>homes&nbsp;</STRONG>for visitation and weekends.&nbsp; This caused disruptions in their school and<BR>social activities.&nbsp; They ended up missing their friends at either household.&nbsp; Most parents <BR>didn't&nbsp;think to consider this as important.&nbsp; For a fortunate few, both parents<BR>stayed in the same community and both parents&nbsp;shuttled kids to activities at school <BR>and with friends.&nbsp; This helped maintain a stable environment.<BR><BR>But, children universally expressed<STRONG> anger </STRONG>that they had trouble planning weekend<BR>activities beca