Breast Cancer Awareness

It’s been awhile since I’ve updated my blog – but I wanted to remind everyone that it is still Breast Cancer Awareness Month. There are conflicting recommendations out there – bottom line – talk to your doctor, know your body, and if something doesn’t seem right – get checked out.

With that introduction, I’d like to post this note from my wife who completed another phase in her treatment of Breast Cancer.

Dear Chemo,

I’m just not that into you. We’re done. Our 4 months together needs to end. It’s been a one sided relationship. You took my hair, my eyebrows, my eyelashes. Because of you I needed 5 units of blood. You sucked the energy out of me, left me with fevers, a barking cough, severe nausea that had me vomiting in mid sentence. Not to mention you consumed most of my thoughts. My hands peeled off and now my cellphone won’t recognize my fingerprints! You tried to strip me of my identity, my dignity and my pre-menopausal status. But I’m still standing! So after 4 long months I am so glad this relationship is ending today. My only request, you did your job. You killed any remaining cancer cells. If you did, then the past 4 months with you was worth it.

Signed,

Breast Cancer Survivor

P.S. we are never, ever, ever getting back together.

#lastchemo #finishedontime #cancersurvivor #fightlikeagirl #halloweenchemo

The circle of life (or Kreb’s)

This is a time of year when people think back over traditions and nostalgia flows as freely as eggnog and holiday cheer.  Of course, in my house, with a teenager ending her semester we have to get through exams and projects before there is anything to cheer about.  I was very excited this year – after I struggled mightily to help with math – apparently I don’t do it right – she is taking biology.  I figured even if there is “new bio,” as a physician I should be able to handle any questions.  When the Kreb’s Cycle was the topic this week I had a flashback to medical school, where we studied every detailed reaction to generate ATP.  The nostalgia began, and I can’t get the Farnesol song out of my head – sung to Jingle Bells.  This tale of how Acetate can become cholesterol is riveting.  Not as universally appealing as the Preamble on Schoolhouse Rock, but still fun. So I present the only online version I could find.  And a few, more modern takes on biochemistry in today’s world. Enjoy!

 

Wishing everyone health and happiness!

The path to wellness begins with a proper diagnosis

Happy 2016

Wishing everyone a Happy and Healthy 2016!

To wrap up the year, some New Year’s Health Tips:

  • Moderation – in both food and drink will make 2016 easier to start
  • Make a commitment to exercise on January 1 – even a walk will give a sense of accomplishment
  • Dress warm if you will be at an outdoor event – layers and hats
  • If improving your health is part of your plan for 2016, do a set of body measurements – weight and waist circumference – you can’t know how much you improve unless you know where you start
  • Put your exercise commitments into your calendar
  • Don’t do another set of measurements for at least a month – you can see bigger change if you don’t micromanage things
  • Get a physical – baseline your health as well as your size

I’m not making any resolutions this year – but I am setting some goals

  • Exercise more during the work week
  • Unplug from electronics occasionally
  • Write 2 posts a month

What are your goals for 2016?

The path to wellness begins with a proper diagnosis

2015 – A time to reflect

2015 has been a year filled with change, and as I reflect back on all the events – both professional and personal – I thought I’d share some highlights and observations and maybe an insight or two.

Highlights of 2015

Observations of 2015

I’ve always been a fan of data – it helps me professionally, and I’ve been tracking my running (Runkeeper) since 2010, and have been tracking activity with a Fitbit since mid 2013.  What I realize that I do professionally that I don’t often do personally, is reflect on the data.  As a physician, at every patient encounter I reflect on information about a patient – medications, lab tests and symptoms – which can lead to insight for  their condition.

So I took a moment to reflect on my own data – so far in 2015

  • over 3,700,000 steps taken (some bigger than others)
  • I’ve run over 350 miles this year
  • My best running month was April, I ran 50 miles
  • My worst running month was July – I ran less than 10 miles
  • My average pace was 9:28 per mile
  • I average 6.3 hours of sleep a night
  • I wrote 17 blog entries
  • TheDiagnosisMD has been visited by over 1300 people

Insights

As I reflect, I draw connections

  • My running decreased over the summer significantly – partly because it was summer in Arizona, but also because there was a lot of transition being planned.
  • My running pace varied with the temperature – slower in the Arizona summer heat
  • Running in NYC involves more traffic and hills than in AZ!
  • My more popular blog posts are those that I write either from a more personal perspective or give an opinion, rather than a pure medical topic for the sake of education

So, as we move forward to 2016 I hope to stay consistent in running, and reflect on my data to see how I can improve.

I will write from a more personal voice, and hope to combine education with perspective to keep this blog interesting

I hope in my new role as Medical Director I can apply the same lessons – reflect on data to gain insight and improve they way we practice – allowing my colleagues and I to work smarter, deliver outstanding care to our patients and make our office one of the pre-eminent practices of Internal Medicine in New York City.

The path to wellness begins with a proper diagnosis  

Remembering

As I head to the office this morning, my first September 11 in NYC in 3 years, like most Americans I reflected on that day 14 years ago.  My wife was about 10 weeks pregnant, the Giants played Monday Night Football the prior evening and we had just put in a bid on an apartment the day before. 

I was seeing patients when my wife called to tell me the first plane had struck.  At first I thought it was a joke, and waited for the punchline. Then I saw reports on a news website. The internet became so congested, we couldn’t get updates, and the office turned a radio to an AM news station for updates. 

After a couple of hours, as the City began to organize its response, myself and 2 of my partners were driven across 23rd St in a police car to Chelsea Piers where the medical response area was being established.  At each intersection was a National Guard armed vehicle manned by soldiers with machine guns and serious expressions. We walked into an empty catering hall set up like a scene from MASH – rows of operating tables without dividers. The medical lead went through triage procedures, and we waited for the wounded to arrive.

And we continued to wait. No one came – the immediately wounded and rescued were brought directly to hospitals before we were set up.  Almost everyone else walked away – or didn’t. We couldn’t reach our families as cell phones were not working. After several hours, we were off duty and I walked home to the Upper East Side as all transportation was shut down. Later, I would find out the numbers of people who didn’t get to go home that night; the patients I lost or who lost spouses, high school classmates and family friends. 

Being out of NYC for the past 3 years I always felt guilty not being here. So today, back home again, I recall the day, the response, and the numerous stories similar to mine of those that were here.  Remembering  that everyone’s experience was so intense that they can’t be compared. And grateful to be in New York City.

Start Spreading the News…

Start Spreading the News…

I am thrilled to announce the next phase in my journey as a Physician.  After 3 years in Arizona, I am returning to NYC and will be practicing at NYU Langone Medical Center’s Internal Medicine Associates.

I have thoroughly enjoyed living in Arizona – it was a wonderful experience for my family, and I have grown as a physician.  I learned new skills, encountered diagnoses that I don’t often see on the East Coast and saw a two health care system merge and deploy a new Electronic Health Record system.  All changes that helped me see the challenges that both physicians and patients face in the coming years.

As I shared the news with my colleagues and patients in Arizona, the response was usually “sad for me, happy for you” and jokes about getting out of 119 degree summer days.  I am grateful for the support I have received!

Since I trained and had been affiliated with NYU since graduating from medical school, the news of my return has been like coming home – incredible enthusiasm from colleagues and former patients alike.  A response that again makes me feel grateful for the relationships I have built over the years – and reminds me of why I chose Internal Medicine as a career.

So I will say goodbye to excellent Southwest fare (best guacamole ever), and hello to Atlantic Ocean sushi, real bagels and pizza!  And look forward to NYC saying “AAHH”

Wishing health and happiness to all, and to more blogging now that my summer of transition is coming to a close.

The path to wellness begins with a proper diagnosis

Happy 4th of July – Keep it SAFE

As we enjoy the 4th of July, a reminder from TheDiagnosisMD to stay safe this holiday weekend.

Fireworks are beautiful to watch – the sounds, color and spirit evoke great memories for many.  Some of my favorite 4th of July memories

  • 20 years ago on call during my 4th day of Internship at Bellevue Hospital watching 2 minutes of fireworks on the East River from the cafeteria window
  • A fireworks show at Pine Hollow in Long Island, NY with friends after a BBQ dinner
  • Fireworks at my daughter’s camp while serving as the camp doctor

What each of these events had in common was that they were done by professionals, with firefighters on standby to be sure that everyone was safe.

Emergency Rooms see over 5000 firework related injuries a year, with half of them in people under age 20!  Fingers, eyes and burns are the most common injuries.  Even sparklers burn at close to 2000 degrees – so children should not use them without close supervision!

So lets enjoy the show – let those who are trained entertain you – and keep it safe!

http://www.cpsc.gov/en/Safety-Education/Safety-Education-Centers/Fireworks/
http://www.cpsc.gov/en/Safety-Education/Safety-Education-Centers/Fireworks/

Something personal

For the past year and change, I’ve used this forum to educate and demystify medicine, and to introduce myself as a physician to everyone.   Today is a little different.

I have been involved with the Crohn’s and Colitis Foundation of America for the past 5 years. Now I am proud to say my daughter is getting involved too!

She has organized Team EmGo in honor of her Bat Mitzvah/ 13th Birthday for the Take Steps walk to raise money to support research for Crohns Disease and Ulcerative Colitis.  To learn more about her team:

online.ccfa.org/goto/teamemgo