THE DOCTOR BLOGGER

Doctor Blog--Quote for a Lifetime

DrRima Bishara — Sun, 15 Jun 2008 15:24:00 GMT

People may fail many times, but they become failures only when
they begin to blame someone else. Experience is determined by
yourself -- not the circumstances of your life.

Gita Bellin

Doctor Blog--Quote of the Week

DrRima Bishara — Fri, 23 May 2008 14:17:00 GMT

Self-respect is the root of discipline; the sense of dignity
grows with the ability to say no to oneself.

Abraham Lincoln

Doctor Blog--Quote for the Week

DrRima Bishara — Thu, 08 May 2008 23:13:00 GMT

It is not the cards you are dealt but what you do with them that counts.

Anonymous

Doctor Blog--Medical Insurance for Profit

DrRima Bishara — Wed, 23 Apr 2008 15:20:00 GMT

The past couple of weeks, I've received 2 demands by insurance to
justify the use of hydrocodone for patients over the age of 64.

They say that their data indicates this medication is "not indicated/approved" for the
older population.

This medication is a low level narcotic often used in the setting of chronic pain.
One particular patient has rheumatoid arthritis and has been on this medication
for years. The medication controls the pain so she can perform daily activity.

So, hypothetically, a drug that has a generic formulation, that is effective, and
that relieves suffering and pain, cannot be given to this patient because she has
now become older than 64. Or is it something more sinister, like insurance
trying to nickel and dime customers to death.........literally.

What shall we do with this patient? Push her over a cliff in her wheelchair?

Perhaps medical insurance companies that aim for profits can explain to the
American public what people can look forward to as they get older.

I'm not talking about heart transplants. I'm talking about a generic (cheap) pill.

Of course, Viagra is covered by the same plan.........

Doctor Blog--"What I've Learned" by Dr. Michael DeBakey

DrRima Bishara — Mon, 21 Apr 2008 15:14:00 GMT

At the age of 99, Dr. DeBakey, the venerable heart surgeon from Houston who pioneered
several procedures that have been life saving for heart patients, reflects on what he has
learned.

I've outlined the article but, for the full text from MSN by Cal Fussman, go to the link below.

http://men.msn.com/articlees.aspx?cp-documentid=6564495&GT1=32001

One of the rarest things that we do is think.

There are questions that I'd like answered.

If world leaders were doctors, I think they would be more concerned with the welfare of people.

In any good society, every member should be interested in the health of every other member.

What advice would I give a doctor preparing for surgery? ....walk into the right operating room.

I've done more than sixty thousand heart operations.... I've been fortunate in that I need
very little sleep.

Okra is the key to good gumbo.

I'm not sure I can answer that question specifically. But ...lots of doctors took the position
that you shouldn't try it. You've got to push ahead in spite of them. I learned that lesson early.

I don't think the difference between ninety-nine and a hundred is important.

I scheduled my last operation when I was ninety.

If you had a heart problem right now and needed an operation and I was the only doctor
around, sure, I'd do it.

The best lesson my mother taught me involves an orphanage we had in town. One Sunday...
she had put one of my favorite caps inside. I immediately protested...She told me I ought
to be glad that I could give up the cap. I never forgot that.

Being compassionate, being concerned for your fellow man, doing everything you can
to help people—that's the kind of religion I have, and it's a comforting religion.

You can never learn enough.

It's important for a patient to go into an operation with confidence.

The worst thing, of course is when the patient dies during the operation. You die a little
every time that happens.

There was a historian in the fourteenth century who wrote a book...the tribes that have
difficulty feeding themselves are lean and healthy, and those that have plenty of food are
fat, lazy, and unhealthy.

People often use words in a loose way that covers over what they're talking about.

The doctor who operated on me only a few years ago was one that I trained.

Never had a symptom. The pain came like a bullet out of the blue.
Part of me was doing a diagnosis on myself—which, as it turned out, was correct. Aortic dissection.

I was a little surprised to find myself recovering after the surgery.

During my recovery, I played possum. Then I'd argue with them about the therapy.

I guess it's hard to be my doctor.

Doctor Blog--The American Red Cross

DrRima Bishara — Sat, 29 Mar 2008 01:20:00 GMT

I am in Baltimore attending the National Convention of the American Red Cross.
Having been a volunteer with this organization for a number of
years, I decided it was time to get a closer look at the inner workings and
national leadership that fuel the spirit of the thousands of volunteers that are
the American Red Cross.

Despite the negative press that has sometimes dogged the ARC, the spirit
of giving, sharing, and compassion is paramount and visible at every level in
the organization. And, it is especially apparent with the people the ARC is
partnering with to develop ways to meet the challenges of the future.
These partners include sports celebrities, other outreach organizations,
youth and students from high schools as well as colleges, and multi-ethnic
groups.

The ARC has a proud history of volunteerism having been founded by Clara
Barton in 1881 as a way to deliver care to soldiers at war. Since that time,
congressional charters have solidified its role in American culture and it has
become a symbol of the good in the American spirit--the spirit of giving and
of charity.

If you have not looked at the ARC recently, you might be surprised to know
that it has a congressional mandate to provide relief services to those in need
when disaster strikes but it has no funding other than through the fund raising
efforts of its staff and volunteers. Approximately 95% of people that make up
the Red Cross are volunteers--either full or part time volunteers--who give of
their time, resources, and effort to provide what is needed.

The culture of the Red Cross and its mission of compassion spans not only
American soil but also reaches across the globe through the International
Red Cross, providing vaccines to children in Africa, and tsunami relief to those
devastated by the loss of loved ones and homes in the far east.

If you want your spirits lifted, talk to a Red Cross volunteer in your community
and you'll find that the Red Cross not only provides disaster relief but also
teaches life saving skills such as CPR and water safety.

And, very importantly, while our troops are at war, doing the bidding of our
government on unfamiliar soil, the Red Cross provides a link of communication
and resources to soldiers and their families.

The Red Cross also has a Holocaust Survivor's tracking unit that has helped
many people find out about their loved ones and finally have closure after
decades of not knowing.

To those who have never experienced a natural disaster or a medical
emergency, the Red Cross might seem like a distant thought. But for
anyone who has been touched by the dedication of one of these
volunteers and the warmth they bring to their mission, the work this
organization does can be life changing.

As one speaker said, the volunteers are not paid not because they
are of no value, but because they are priceless.

And as the American Red Cross says: change a life today, starting with your own.
Look around and see what difference you can make in the lives of those around
you in times of need. You will probably find that the life you change most
profoundly is your own.

Doctor Blog--Can We Blame The Parents?--Part II

DrRima Bishara — Sat, 15 Mar 2008 03:56:00 GMT

YS, one of my subscibers, ponders whether we can blame poor parenting on
"young, ignorant parents". See Part I for the first part of the discussion. I
reviewed a book on Divorce and The Unexpected Legacy of Divorce.

YS is obviously concerned about how we can help parents that might be
disadvantaged suggesting obligatory parenting classes, school for a
trade and being supported financially all the way. Because divorce has
become such a big part of our society in general, I thought it might be useful
to look at this particular aspect since the impact on children is prominent.

I believe the issue has multiple facets. Among them is the governement's
role in our lives and our own choices. It has to be said that parents who
have more money have a better shot at good parenting. It is easier for
them to get quality help from sitters, day care, and nannies.
So, how do we impact those that have limited knowledge and limited resources?

In the US, we seem to have come to the belief that a "right" is what we "want".
We even seem to interpret "needs" as "rights" and have come to assume that we
should have these rights regardless of whether we have earned them. Simply by
existing, we have a "right".   We have, in turn, charged our elected officials with
the job of making sure we each get these "rights". Many personal choices
have thus become political.  Our politicians then make choices on how to
allot the money it takes to provide these "rights". This is one facet. I will
tie this perspective into the current topic further down in the article.

Another facet is that our society seems to have taken the sting out of poor choices.
That is, our Federal or State government, has systems in place that keep people
from feeling the consequences of their bad choices. I am not necessarily
saying this is bad. It is great to have a contingency for really bad things.
But, consider this: in life, we make choices. And some of them will be bad choices.
And, it is always heart breaking to watch people live through consequences.
But, consequences are the natural result of what we think, feel, and do.
They are not random events--at least not often.

So, as difficult as they are to watch, consequences should make us think twice
about our choices in the first place--getting married, having children, etc.

We are at least 2 to 3 generations deep in fragmented families--that is, single parents,
divorced parents, estranged parents, absent parents, etc. In fact, it appears that
divorce happens all the time and has become part of the fabric of our society.
We no longer think of it as a tragedy or scandal in the way it was even 3 or 4 decades
ago.

Consider this: Wallerstein makes the comment that each child experiences
divorce "single file". That is, there might be 15 kids in a classroom of 30 and
each of them will be thinking to themselves "why me?". Volume does not
lessen the pain nor the impact on the individual child. Even families who
had more than adequate finances had children with an emotional sense
of lack.

Let me be clear that divorce is not the only damaging thing that can happen
to families. There is alcoholism, family violence, drug abuse, and any of a
number of really bad things that can exist both within intact as well as
divorced families. So, my intention is to highlight divorce but not to assume
that it is the only problem that exists.

With regard to the "right to have children", it must be said that children should
be considered to have rights also, should they not?

Children should have a right to good parents, good parenting, and good teaching.
They should have a right to an education and the skills to make a life for themselves.
They should have a right to a childhood unencumbered by their parents' mistakes.
They should have a right to safety, security, a full stomach, and a warm bed.

Y hypothesizes that if we provide parenting classes and pay for an education,
that parenting skills will improve. I think these are great ideas. The question
would be how can we implement these ideas without regulating parenting?
Who will be responsible to see that parents attend these classes, learn the
material, implement what they have learned, and who will pay for it? How
will we measure success?

We already have a number of programs to help disadvantaged families or
parents in the US. These programs include Housing Assistance (government pays
for housing for families that are underprivileged), Disability Income (government
pays for those who claim an impairment that keeps them from doing work),
Head Start Programs (government pays for small children to be in an educational
environment with the theory that early intervention will help kids succeed),
Medical Care for the disadvantaged (Medicaid--government pays for healthcare).

With all these programs, have we seen success in moving our society toward
prosperous and healthy families? Or are we seeing a generation of children
who are raised in poverty and near total dependence on government?
My observations of the family structure over the past 20 years leads me
to believe that we have fallen short in raising our children and that, despite
our support programs, inadequate parenting has become generational (observation
in my practice as well as observations of families that have been honest enough
to share their decades of experience).

What I have seen repeatedly is: mom or dad are into drugs-or alcohol-or the
fast lane-or just not ready to raise kids but they have kids, the kids grow up poorly
attended, they themselves have children as teenagers By this time,
mom or dad have realized their mistakes but have not acquired any more
parenting skills. They try to help raise the grand kids on fixed incomes while
the real parents are struggling thru their own lives. It is a family cycle that probably
requires intervention for the whole family.

Parent is a verb not a noun.  To have children may be a right but, with having
children comes responsibility that, if poorly attended, carries consequences.

In the purest sense, I believe we can blame the parents. Parents are the ones
that have make the choice to have children--parents choose to have sex, choose
to carry a child, choose to have a child. It is not something that happens while
they stand on a corner minding their own business.

Consider this: Children will grow up with food, clothing, and shelter.
But to raise them takes time, effort, and some skill.

So, what of the parents that have been poorly parented themselves--they may
not understand the importance of raising children nor where to go for information.

Can we go to the state and federal government and ask them to solve this?
Government can do many things. Parenting is not one of them. That happens
in the home, one on one between a parent and a child. There is no political
fix for this problem because it has to do with spirit, soul, and aspiration.

As Mark Twain said, "What is done to children, children will do to society".

Children are our greatest natural resource as a country and as an international
community. It is my belief that if we pour resources into our children, we will
secure our future. If we ignore the problem, we will also secure our future.
Which future do we want?

My own conclusion is that the solution should likely come from within our communities--
our local communities. We have churches, schools and hospitals in almost every
community in this country. There is some argument that churches are losing
relevance with the younger generations. Maybe there is a point here. Perhaps
institutional relevance should be dictated by how institutions serve our communities
rather than by which tradition or philosophy they espouse.

Maybe churches, schools, and hospitals can become conduits of information
and centers for learning and resources for both children and adults.

Doctor Blog--Quote of the Week

DrRima Bishara — Wed, 19 Sep 2007 14:45:00 GMT

Strength does not come from winning. Your struggles develop your strengths.
When you go through hardships and decide not to surrender, that is strength.

Arnold Schwarzenegger

Disclaimer

DrRima Bishara — Wed, 08 Nov 2006 17:58:00 GMT

DISCLAIMER

The information presented on this Blog and any related links is provided for educational, informational, and entertainment purposes only. You must never consider any of the information presented here as a substitute for consulting with your physician or health care provider for any medical

conditions or concerns. Any information presented here is general information, is not medical advice, nor is it intended as advice for your personal situation. Please consult with your physician or health care provider if you have concerns about your health or suspect that you might have a problem.