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Wednesday, March 31, 2010

Two Things the Candidates did not Say

I sent a letter to the editor of our local newspaper. The content is self explanatory. I'll let you know if they print it:

As I paged through the Chronicle this week, it was with mixed emotions that I read about 2 individuals announcing their candidacy for county mayor. A third candidate had a half page ad. Indeed we have yet another election coming soon and I thought for a moment how our beautiful county will be defaced once again by huge, ugly signs in yards, on telephone poles, in businesses……all inviting us to vote for a candidate, running for this, that, or the other thing. I’m already thinking, “I’ll be glad when it’s over”.

I read about the candidates. A couple touted their previous experience in government as a qualification for the top job. Others talked about their long history as local businessmen. There was talk of the very long time they had lived in Decatur County. They spoke about “responsible management”, “the county budget”, “financial responsibility”, “creation of jobs”, “working together”…….all of those generic things you hear politicians say before each election.

Then they talk about their families and their churches and on and on and on.

One thing that none of them said was, “I will respect the Constitution of the United States. I will support no law which tramples the Constitution or diminishes individual liberty and freedom!” How refreshing such a statement would be! I remember just a few months ago when the county commission tried to pass a law that would prohibit firearms in county owned parks (a clear violation of the second amendment). They reversed themselves when public outrage over the ruling caused them to wake up. If they had been thinking of the Constitution, such a matter would never have been considered in the first place. I wonder how many of the candidates and current office holders have actually read the Declaration, the Constitution, and the Bill of Rights and actually understand the meaning of those documents? By the actions of many from the local to the federal level, some of them don’t have a clue or simply don’t care.

And the culmination of this is now evident in Washington, as the federal government has forced upon us a health care bill which is unconstitutional in its content and was passed in an unconstitutional manner against an overwhelming majority of American will. Of course it was never about health care. It was about big government. As we allow government to take over more and more of our lives, we slowly but surely relinquish our freedoms and liberty. And this all starts at home, folks. How many of our national politicians were once local or state politicians? The politicians will take as much rope as we will give them, and if we give them enough of it, they will soon have it around our very necks!

How about a statement from the county mayoral candidates, “I will not raise your taxes or impose any new taxes, EVER! Government is already too big and bloated! If we can’t balance the budget, we will have to make cuts! We are broke! We can’t afford to spend any more!” I did not hear this from ANY candidate so far. Most politicians are not willing to assume the tough choices imposed by such a pledge.

The country is heading down the path to socialism, communism and fascism (take your pick). America will soon cease to exist unless we stand up and say, “ENOUGH! We’re not going to stand for this anymore!” We must insist on a return to the things that have made America great and unique in the history of the world, life, liberty, the pursuit of happiness, and the Constitution. Our founding fathers were great men. I, for one, choose to look to them for future guidance.

Doctor's Day and the Death of a Possum

Last night while I was headed home, I ran over and most likely killed a possum (Opossum for all you yankees). Oh the horror!

Only through a fateful turn of events did this possum have to die.

Yesterday was Doctor's Day. The hospital was kind enough to get a fruit basket for me. Well I did not work yesterday, but I did have to go to a meeting in Jackson yesterday evening so I told the hospital I would swing by on my way home from the meeting and get my basket.

Normally, on my way home from Jackson, I would continue straight on through the town of Parsons to my house. Since I went by the hospital, I took a different route home through the town of Decaturville. Between Decaturville and home, I encountered a shape in the dark road. It was in the opposite lane and it was still. I thought it was a dead animal and continued my drive. At the very last moment, the shape suddenly charged over into my lane. THUMP THUMP! Dead Possum! Oh the horror!

If the possum's surviving family had a lawyer, he/she would not only sue me, but would also sue the people who set Doctor's Day on March 30. If there had been no Doctor's Day, there would have been no fruit basket, I would have taken my normal route home, and the possum would still be alive (maybe).

The lawyer would also sue State Volunteer Mutual Insurance Company (my malpractice carrier) for scheduling a seminar on this date. If they had not had the seminar, I would never have gone to Jackson, and the possum would still be alive (maybe).

I suppose the lawyer could also sue the fruit basket company. Had there been no fruit basket, I would have taken my normal route home and the possum would be alive (maybe).

And lets not leave the hospital out of the lawsuit. The hospital has got some nerve giving me a fruit basket! After all, I'm an evil rich doctor! I do not deserve a fruit basket! I have gotten everything I have by ripping off poor sick people! And now I have killed an innocent possum! Shame on that evil hospital!

Anyway, the whole point of this is to tell the surviving possums that I am very sorry, and to give you a little insight into how trial lawyers think.......

Come to think of it.........I guess I could counter sue the trial lawyers. Were it not for the trial lawyers, I would not have to go to the malpractice seminar (to learn how to keep from being sued by trial lawyers) and the possum would still be alive (maybe).

Sunday, March 28, 2010

It does not Compute

Someone sent me this and you may have already seen it, but maybe not:
1. Cost of a bowl of soup at a homeless shelter:                    $0
2. Cost of staying overnight in a homeless shelter:                 $0
3. Catching a homeless man taking a picture of Michelle Obama with his $300 blackberry (+ $100/month service) while receiving his free gubment provided meal:        PRICELESS!

Democrats That I Like

Saturday, March 27, 2010

Angry White Guy

That's me! An angry white guy! Well, I guess I'm at least mostly white. My momma told me I was 1/16th Cherokee Indian and who knows, some of my ancestors may have procreated with some of their slaves.............you never know.

Anyway, I was just reading on Drudge that "White Men Shun Democrats". Interesting concept.

The article states that in 2008 41 percent of white men voted for Obama. This was somewhat of a breakout as prior to 2008, the Dems had managed to capture a maximum of only 38 percent of the white male voters. Presently, only 35 percent of white male voters claim to support Democrats.

Women, on the other hand, consistently have much higher support for Democrats.

What is it about those angry white guys? Well, like it or not, it was angry white guys that caused this country to become great, and I think the notion of individual freedom and liberty, personal responsibility, the constitution, small gunment, and the right to life, are predominately an angry white male thing. Now I'm not taking anything away from the women down through our history that also did great things.

But what is it about women that make them different in the political arena? Sweet Wifey is more or less the same as me in her political beliefs, but that's not the case universally. In my experience, most of the people that I know personally who supported Barack Obama were women. Most of the people I know today who still defend him are women (although I find fewer and fewer every day that will admit they ever liked him at all).

Anyway, I'd be curious to hear about the gender differences. As for me, I'm an angry white male, getting angrier by the minute, and proud of it!

Just looking at Nancy Pelosi is enough to make anyone angry.

Fun With X-rays


Sometimes being an ER doctor can be exciting, but most of the time it is routine and even boring. Therefore we have to come up with ways to entertain ourselves. One thing that I have done over the years is figure out ways to have fun with xrays. Some of my favorite xrays are those of the abdomen. No two abdominal xrays will ever look the same. This is because as gas and poop (highly technical medical term, do not use this term at home)  move through the bowel, the appearance will change minute by minute. It's kinda like looking at shapes in the clouds. Allow me to share a few abdominal xrays with you:

The UBF
Even normal xrays can be fun. The film above gives a demonstration of the ubiquitous UBF also known as the unborn fart. Everybody has these......indeed even sweet Wifey, although she would deny it. They appear as dark bubbles or blotches in an otherwise grayish field. Air or gas always appears dark on a plain xray. It is always fun to nab a new nursing student or medical student, point to the dark blotches, and ask them for an explanation. They will look puzzled. When I tell them it is a UBF, they will still look puzzled. FUN! FUN! FUN!

The UBT
Wherever you find UBF's, you will also find UBT's (unborn turds). Everybody also has these, although sweet Wifey would have you believe she has "little flowers" up there instead. UBT's are a little harder to see than UBF's. They tend to have a rather sandpapery appearance against a field of uniform gray. Most solids appear gray on a plain xray. Bone and metallic objects appear white. Just when the new nursing student or medical student is strutting around like a rooster after mastering the recognition of the UBF, the wind will quickly come out of their sails when you confront them with the UBT! Hee! Hee! Hee!

One thing is for certain about UBF's and UBT's. They are almost always confined to the abdomen. If you ever find one on an xray of the leg or on a CT scan of the head, you've got major trouble, although I have known a few people with sh*t for brains, so I guess a cranial UBT is in theory possible!  Occasionally you will see UBF's and possibly UBT's on a chest xray. Hernias or holes in the diaphragm can cause this. These conditions are usually harmless although they can cause problems in some people.

Now, let's have some real fun:
Abdominal Foreign Bodies

UBF's and UBT's eventually are born and come out the rectum, enjoying momentary freedom until flushed or whisked away by the wind. There are only a very few things that are designed to go up the rectum. I can name them for you:

1. Suppositories.
2. The doctor's or nurse's finger.
3. Enema tubes or colon tubes.
4. Endoscopes to be inserted only by your favorite health care provider, or perhaps Barack Obama or Nancy Pelosi.

Other than that, I can't think of much else that should go up your rectum. However, you'd be amazed at some of the things we find from time to time.
The picture above shows a vibrator which has been so cleverly inserted up the rectum. It is made of metal. I can tell this because it is white on the xray. You can also see some surgical clamps in the process of trying to retrieve the rogue vibrator.

Let me give you some sound medical advice: If you stick a foreign object up your ass past the point where you can grab it with your fingers, there is almost a 100 percent chance you will not be able to poop it back out.

Above we see a vibrating dildo, cleverly inserted into parts unknown. The dildo itself is probably made out of some kind of rubber as you can barely see the outline of it. Very clear are the vibrator motor and the batteries, obviously made out of metal. We cannot tell on a plain xray if the vibrator is running or not, but I can guess. Based on the shape of the pelvis, the "victim" appears to be a female. Looks like she may be suffering from HCD (hole confusion disorder).
This next picture is very interesting. This person (appears to be a male) has gleefully inserted a beer bottle up his ass. I am wondering how many beers he had had before he attempted this. Another really cool thing is that the beer bottle is about half full as confirmed by the presence of an ABL (air beer level). Kinda gives a whole new meaning to the tern "rot gut beer" doesn't it? I'll betcha they had a helluva a time getting that sucker out of him. Have you ever tried to grab the bottom of a bottle with a surgical clamp? I would not be surprised if this dude did not go to surgery to have this removed.
Now this last picture is truly amazing. An empty bottle (vodka or gin possibly) has been inserted bottom end first into the rectum. I would think you'd have to be nearly unconscious to accomplish this task. Looks like the bottle is empty which is good. I'd hate to think of the consequences of a reverse gin enema. It might be possible to grab this one with a clamp.........whew!

When I was in Memphis I remember a dude came in with a potato up his butt. Well yall know what happens to a potato when it gets wet doncha? It swells big time! Anyway, he had to go to the operating room to have the potato removed in pieces.......sigh!

Well, I dunno about yall, but I have had loads of fun today sharing some of my work experience with you. The foreign body cases above most likely comprise a majority of people who are already on some kind of gubment health insurance or have no insurance at all. People who work and have good sense and actually have to pay for their health care generally will not do such things to themselves. In Tennessee, we call things like this STI's (stupid Tenncare injuries). For those who refuse to work, stay out all night, howl at the moon, get up at noon, spend the afternoon in court or at Walmart, rush to the ER in the evening for a mosquito bite.....etc etc etc etc.....sticking a bottle up their ass is just another routine life experience!

Anytime someone says, "Hey, hold my beer and watch this!" Get ready to pay for their health care.

Barack and Nancy are gonna make it happen!

Friday, March 26, 2010

Light Speed to Oblivion


In a previous post I said that the country was heading into debt at light speed. You know, light moves pretty fast. When you talk about the speed of light you quickly move into some mighty big numbers. When you talk about the national debt, you also quickly move into some pretty big numbers.

Our national debt is a little over 12.5 trillion dollars. Click on the debt clock and you'll see the numbers are continually going up. I dunno about yall, but it's hard for me to get my arms around a sum as large as 12.5 trillion.

I decided to do a little playing around with numbers to see if I could gain a better understanding. Let's pretend that we could take our national debt and convert each dollar into a statute mile.......12.5 trillion miles! Wow! How far is that?

Well, it's about 23.5 million miles to our closest planet, Venus, when Venus is at it's closest point to us.........heck that's just a drop in the bucket compared to 12.5 trillion. It's 93 million miles from here to the sun.......another drop in the bucket.

It's about 5.6 billion miles across our solar system if you consider the orbit of Neptune (sorry Pluto) to be the edge. 5.6 billion miles is pretty far. If we could fill a space ship with our national debt and get a mile of travel out of each dollar, we could travel back and forth across our solar system about 2240 times before we'd run out of fuel........whew! That's a long long way folks.

(I know that a region beyond the Kuiper belt is actually the true edge, but I wanted to keep it simple for the people in Rio Linda.)

If we took our solar system trips at the speed of 25000 miles per hour (Earth's escape velocity), it would take us a little over 57,000 years to make all the trips before the fuel ran out.

What if we had a ship that would travel at light speed? Light moves pretty fast, about 186,000 miles per second. We can make it to the moon in a little over a second. We can make it to the sun in a little over 8 minutes. I calculated that we could make our 2240 solar system excursions in about 2.1 years at light speed.......finally we'd run out of money....oops fuel.

I was relieved to see that we still could not make it to our nearest star, Proxima Centauri, with our allotted fuel supply. This simply accounts for the vastness of space and time. It's nice to know that there are a few things left in the universe bigger than our national debt....but at this rate I don't figure that will last too long.

All I know is that 12.5 trillion is a big big big number. If we don't get rid of the liars, crooks, and thugs in Warshington soon, we're all gonna be in deep doodie.

I thought I'd leave you with a picture that would make you smile.

Helicopter Crash Update

If any of you are interested, go here to read the bios of our friends lost in the tragic helicopter crash yesterday morning. These folks were right here in this very spot where I'm sitting, less than 24 hours ago, walking, talking, and helping us stabilize a patient and save a life. Now they are gone forever, in an instant. They had lives, friends, families,and loved ones, who right now cannot understand the loss they feel. They took risks every day so others might live. In my opinion, they are heroes. Please go read about them.

Death Spiral

I saw two interesting headlines on Drudge a while ago. The first says: Social Security Payout to Exceed Pay-in.......this year! The second headline: Personal Income Drops Across USA.

This whole economic debacle we're in is starting to unravel. Social Security is broke. As personal income declines and payroll tax collections fall, Social Security will become more broke. Since the gubment will have to rob Peter to pay Paul out of the general fund to keep Social Security afloat, the debt, already exponentially magnified by the stimulus and now another trillion plus with Obamacare will be even greater. We're going broke at light speed!

I don't see Social Security happening for me by the time I retire. I am 57. I started paying Social Security when I was 14. I figure I'll get nothing back on my investment. HELL IT'S ALL GONE NOW!

No worries, I have never planned on Social Security from the time I started planning my retirement many years ago. I have tried to make stable and wise investment decisions in the free market for my investment future. I should have been allowed to do this with Social Security. George Bush had the right idea on this one. He was demonized.

Unless Obama and his communist thugs figure out a way to wrestle my retirement money away from me (they may do it) I'll be alright. Unfortunately, there are a whole slew of people out there DEPENDING on Social Security. What a shock this will be. As I told a Facebook friend the other day, "When you put all your eggs in the basket of the gubment, your eggs will be broken every time."

What can I say? I am watching the death spiral happen right before my eyes!

Thursday, March 25, 2010

Seal of Approval

Our old pal Fidel Castro has praised our other old pal, Barry Obama (just two peas in a pod aren't they?) for passing Obamacare. Well of course Fidel is happy. Barry and the Dimocrat congress have succeeded in shoving our once great nation far down the path to communism in spite of the outrage of the vast majority of the populace against it. Barry should be pleased, receiving such adoration and praise. Ahhhhhh, but there's trouble in the People's Republic of Obama!

Coffin Placed in Front of Carnahan's House.
Clyburn: Healthcare Opponents Aiding Terrorism.
White Powder Package sent to Congressman Weiner's Office
Almost a quarter of Republicans think Obama may be the Antichrist

OMG the Dems are whining and squalling over the outrage directed at them, but really, what did they expect? Americans do not want a communist nation.  I am wondering if this is truly the beginning of another civil war? Perhaps a real war with shooting and everything? I dunno about Obama being the antichrist but I do think he is a natural born Kenyan and probably a Muslim. I've thought that all along. I have my gun, locked and loaded, for whatever trouble may come my way. It's getting serious out there.


Be Thankful for Each and Every Day of your Life

Sad news this morning. I heard that one of the Hospital Wing flights crashed early this morning. This aircraft had actually picked up a patient from our hospital and had dropped that patient off at the receiving hospital. It crashed shortly before returning to its base in Brownsville, TN. I don't know all the details. I heard that the pilot was killed but I don't know about any others.

Stuff like this is way too close for comfort for people like me. We know many of the people on these helicopters intimately and a loss like this shakes us to our core. Our prayers go out to the families of the crew of this ill fated flight.

Thank God for each and every day on this earth. It might be over sooner than you think.

UPDATE: 11:30AM CDT. I have been told there were no survivors.
More on the story HERE.

Sunday, March 21, 2010

No Rules?

Damn! And all this time I thought we had rules! Remember the Constitution?

Racial Slurs! Gay Slurs! OMG!

Well, the big news this morning is that a FEW of the tea party crowd in Warshington hurled anti-gay slurs at our boy lollipop, Barney Frank (the called him a FAG! OMG!). They also hurled racial slurs at black congressional members (the N word for all you people in Rio Linda).

Of course this was BIG news. If slurs had been hurled by some left wing group, we probably would not have even heard about it.

Those "F*CKING RETARDS" in congress can dish it out but they can't take it.

Saturday, March 20, 2010

Bad Google Earth! Bad Google Earth!


.

google-earth.jpe
Sometimes you just gotta smile. I read that the British SAS is just furious with Google for putting "street view" images of their "secret base" on the internet for all to see. This is just too funny.

If you have not fooled with Google Earth, you really ought to give it a whirl. It is an amazing program. In many places you can enjoy "street view" images which are nothing more than a massive compilation of 360 degree panoramic images taken by a car and a camera. That's right. The car drives down a road or a street taking panoramic pictures as it goes.

So.................if the SAS secret base is all that secret, how is it you can drive right by it and take pictures? Any chump with a cell phone could whiz by and, click, click, click.

In this day of cellphone cameras, anything is fair game.

Friday, March 19, 2010

At the Tipping Point

I haven't posted anything in a few days. I just have not been in the mood. I have been sitting, watching, in disbelief as the constitution is trampled by the communist left. It became apparent to me that we are going to have Obamacare, legal or not, constitutional or not.

The left does not even try and hide their corruption and deceit. Witch Pelosi and winged monkey Reid just plow right ahead saying what they are doing is good for the American people. It just makes me wanna puke.

With blood still dripping off the knife that has slashed the throat of freedom, they are already talking about more…….amnesty for illegals……cap and trade…….on and on……..and they have no shame suggesting that they will just deem the bills passed whether they have the votes or not.
This should be no surprise from a historical standpoint. The United States has lasted longer than most of the great empires of history. Our situation today in a way reminds me of ancient Rome, eaten away from within by corruption and despotism only to finally fall to the invading barbarians at the gate……..sad so sad, but really no surprise.

I am depressed but I have not given up hope. I hope Obamacare is challenged at every turn. I am hoping for a huge lawsuit against the federal gubment by the states, tying up every provision of Obamacare for years. I am hoping for a giant class action lawsuit on behalf of millions of Americans unconstitutionally forced by the federal gubment to buy health insurance. Or perhaps huge suits brought against the gubment by the insurance industry.

I hope even more that the Dimocrats are thrown out in huge numbers and replaced by true conservatives (notice I did not say Republicans) who will uphold freedom and individual liberty, the constitution and all those things that made America great.

Ultimately I hope Obama is thrown out in 2012 and the conservatives enjoy such huge majorities that the whole travesty of Obamacare is repealed. I hope. I hope. I hope.

It would really be cool if in 2010 the conservatives gained such a majority that Obama could be impeached and convicted. This scoundrel took an oath to defend the constitution of the United States. Instead he has trampled it and spit in the faces of the American people. If this does not constitute a high crime or misdemeanor, then what does? I won't hold my breath over this one, but it's nice to dream.

I think the very survival of this nation will be ultimately determined in the next 2 to 4 years. Will we go the way of ancient Rome or continue to be a shining beacon on the hill?

Monday, March 15, 2010

30 Years of Miracles - Diabetes

If you landed here first, go read my first post in this series, 30 Years of Miracles - Heart Disease.

It is a good bet that if you are reading this post that either you or some of your family members suffer with diabetes. If not you probably at least have friends that struggle with the disease.

Diabetes is a very common chronic ailment. Yours truly has had to contend with the disease since age 29. Actually diabetes care has come a long way in a very short time. Before 1922, most people with insulin dependent diabetes simply wasted away and died quickly. After 1922 when insulin became available, those who would have died before, ended up living longer, usually long enough to develop complications (vascular disease, kidney failure, neuropathy, blindness) down the road which would ultimately end up killing them anyway.

When I became a doctor, I was at first taught that it really did not matter whether or not someone's diabetes was aggressively treated. That person would still get complications and ultimately die from those complications. I wondered at first what was the point of treating the disease at all if the risk of complications would not be changed? As a young medical student though I remember reading an account of a subset of patients (several of them physicians) who preferred to give themselves multiple injections of regular (fast acting) insulin several times daily rather than using the more conventional treatments of mixtures of long and short acting insulin. According to accounts, these people generally had better outcomes, had fewer complications, and lived longer. I wondered how could this be???

When I was a new doctor, virtually nobody tested their own blood sugar. Most diabetics relied on urine testing to determine their diabetic control. The problem is that urine testing is pretty much worthless. Before you have sugar in your urine, blood sugar will have to approach about 200 milligrams-percent. Normal fasting is around 100. So back in the old days your sugar had to be about double the norm before you could tell it was too high. In the 1980's the idea of self testing of blood sugar took off. I remember the first test device I had. The blood letting device reminded me of something from an Edgar Allan Poe short story. It was a beastly thing that you cocked and launched at your finger. You could see the lancet coming at you. It kinda reminded me of a guillotine for the finger. I also had to extract a rather sizable blood drop and put it on a strip, wait a minute, and then manually read the color of the strip against a chart.

I coupled my blood sugar testing with use of multiple injections of regular insulin (I remembered reading about the diabetic doctors of old) and I was able to achieve near normal results.

Problem is that my efforts were time consuming, sometimes slightly painful, and very lifestyle intrusive. Many people would not endure the inconvenience of my method of controlling blood sugar. Eventually I was able to get off insulin with weight loss, diet, and exercise. For a while I took nothing for diabetes and then got on oral meds and eventually had to get back on insulin in 2001.
In the meantime, diabetes care progressed. The blood letting devices became much more user friendly and have now evolved into little penlike devices which are adjustable for comfort. The lancets are also hidden so that you can't see them coming at you. It's even possible to extract blood from the forearm rather than the finger which many people find a lot less painful. Instead of reading strips against a color code chart, high tech meters now allow for only a tiny amount of blood to provide a reading within about 5 seconds.

Regular insulin has been replaced by insulin analogs which act even faster than regular insulin and provide a more "physiologic" response than before. I use a device called a Novolog Pen which is a little cartridge containing insulin. It is convenient for someone on the go. Instead of drawing up medicine in a messy syringe, you just dial up a dose on the end of the pen.


Long acting insulins like Lantus have been developed which provide a slow, predictable, non-peaking, release of insulin to provide a baseline level for tight control of fasting levels.

New oral medicines have been developed which work in a variety of ways, from stimulating the pancreas to increasing the body' sensitivity to insulin to reducing the production of glucose by the liver to blocking absorption of glucose from the gut.

Some patients are candidates for insulin pumps, which deliver a continuous baseline dose of insulin to the patient while at the same time providing bolus doses to cover meals.

All of the above medicines and methods were unheard of when I first became a doctor.

To my relief, research finally revealed that tight control of blood sugar indeed was found to reduce or eliminate complications. It finally dawned on me that before blood sugar testing and all the new treatments developed over the past 30 years, that it was virtually impossible to obtain tight diabetic control. It just couldn't be done with urine testing and the medicines of old……..so, everybody got complications. Lousy control was about the best control that could be expected. It does not have to be that way now.

In spite of all these great new inventions, the sad fact is that tight control of diabetes requires some degree of intelligence and commitment. Even with all the new technology, some patients are just not teachable to the point where they will ever achieve good control. Others are simply not interested. Diabetes is a very intrusive disease and requires daily and continuous lifestyle modifications. Lots of folks prefer to eat their cakes and cookies and take their chances down the road.

The real tragedy is juvenile diabetes that strikes children at very young ages. Many of these kids have a very poor prognosis. Sometimes the kids and the parents are just not teachable to the point that long term good results can be expected. The disease robs kids of their very existence. Kids should only worry about being kids, growing up, laughing, playing…..not worrying about testing blood sugar, not eating candy and cookies, not worrying about taking shots. I've never seen a kid yet that liked to take a shot. What a terrible disease this is for a young person.

A lot of work remains for the future. I'd like to see a noninvasive way to test blood sugar. Work is being done here but results so far have been sporadic. It would be so cool to have a device that could read your glucose level through your skin and at the same time be coupled to some kind of pump that could provide continuous regulation.

The ultimate would be perfecting a way to cause regeneration of the beta cells in the pancreas or teaching other cells to produce insulin. Every cell in our body contains the genetic code for each and every physiologic process. All we have to do is to figure out how to unlock the secret of what causes a beta cell to become a beta cell. When this discovery is made, I can envision people growing their own replacement beta cells, kidneys, or hearts, or livers. Science fiction? Nope, I have every confidence the answers are out there.

A lot of miraculous discoveries have been made in diabetes care in the last 30 years. Who knows what the next 30 years may bring?

Red Robin Lays an Egg

Well, it never fails. Just when you think things are gonna get on an even keel and people are gonna start doing what they are supposed to do, you have an experience that again shakes your faith. Sweet Wifey, she is oh so sweet, and I went out last night for a movie and dinner. We went to see Hurt Locker. I had not really paid much attention to this, but after it won Oscars etc, and since I like war shows I thought we'd give it a try. It was pretty good. I'd recommend it if you like that sort of thing.

I had a craving for a gourmet burger, so afterward we went over to Red Robin. We were seated immediately and the waitress took our order. I ordered steak sliders, a new menu item, and they were oh so tasty......so I have no complaints about the food.

Problem is the waitress NEVER came back to check on us. The place was not that busy and I watched her spend most of her time at a table where her co-workers were sitting. They were laughing and talking and just having a good old time. I also watched her waiting on another group in a booth near the window. She just couldn't give them enough service, refilling their drink glasses, and I could swear she even wiped one dude's ass. In the meantime, we ate our food, our drink glasses ran dry and we never saw or heard from her.

We finished and wanted to pay. We waited and waited and waited and nobody came to bring a check. Wifey finally flagged down another employee. In a few minutes our waitress came running and she was oh so sorry! I told her that it was her responsibility to check on her customers throughout the meal and see if there was anything at all that they needed.

She proceeded to explain that she had just had a terrible night and that she usually was not assigned our booth and that she just simply forgot about us and um .....and um.......and um....and that she was really a great server......and um........and um.............

She said, "If you'll wait just a minute, I'll make it up to you."

"I'd rather you just swiped my credit card. We've waited long enough." I grumbled.

She wouldn't take no for an answer and she returned with a 20 dollar gift certificate to Red Robin.......and she was just oh so sorry.........and she hoped we'd keep coming back to Red Robin.

Well, the fact of the matter is, I love Red Robin, and we would have come back anyway. Seems like these places like Zzounds, Musician's Friend, and now Red Robin, have a propensity to hire all these pimply faced teenagers that just don't get it. If her head had been in the game, how could she have simply "forgotton" about us? Her mind was obviously somewhere else and not on the job. And if she was such a great server, instead of sitting at a table with her co-workers laughing and joking, she would have been going around to her tables checking on her customers.

I almost asked to speak to the manager, but that might have gotten her fired..........nah, probably not, the manager was more than likely not far above a pimply faced teenager. He/she probably would have said, "I'm sorry, there's nothing more I can do."

Sigh.......where do they find these people? Work is not a social hour. That's why they call it work. Oh well, I can use my 20 dollar gift card next time I get a craving for a gourmet burger. Life is good!

I did not leave a tip. I cannot remember when I have not left a tip, but I was not going to pay her for ignoring us. The moral of the story for servers is:

The guy at your table may be a rich doctor with a huge tip. Wipe his ass just to be on the safe side!

Saturday, March 13, 2010

Life Changing Decision

Well, based on Speaker Nancy Pelosi's suggestion, I have decided to quit my day job and take up art and photography. I think I'll specialize in the art of photoshopping. The rest of you chumps can pay for my health care. I think I'll spend the rest of my time reciting poetry to my beagle and then I'll just sit on my ass and watch the rest of you pay taxes.

Here is a sample of my work:

Wednesday, March 10, 2010

30 Years of Miracles - Heart Disease


The other day while I was working, we had a man come in who was having a massive heart attack. We sprang into action, administered life saving treatment, administered drugs to open his blocked coronary artery, and had him out of our ER and on his way to the tertiary hospital and the cardiac cath lab for definitive treatment in less than 50 minutes. When he arrived at our place he appeared near death. By the time he left, he was pain free and smiling and joking with the nurses.

I mentioned to the staff how lucky this man was to have had his heart attack today and not 20 years ago. I am entering my 30th year as a physician and this moment gave me some time to reflect on some of the true miracles I have seen happen in medicine in the relatively short time I have been a doctor. I’d like to share some of my observations with you.

Lets start with:

HEART DISEASE

When I first became a doctor, if you had a heart attack, we would stick you in an ICU somewhere. We’d give you nitroglycerine and morphine. If you didn’t die right away, you’d lay in the hospital “resting” for days or even weeks. In the meantime your blocked coronary artery would remain blocked and while you were “resting” and you’d croak off a significant amount of your heart muscle. If you didn’t croak off too much of it, you might be able to return to a relatively normal life until another one of your blocked coronary arteries got your goat. If you lost a lot of heart muscle, you’d spend the remainder of your days in a rather miserable existence in unrelenting and progressive congestive heart failure.

Bypass surgery was pretty new. A few patients got bypass, but in many cases, the damage was already done.

When I was a new doctor, if you had a heart attack, your outlook was usually pretty grim. My father suffered this fate. If we had had the technology in the 1970’s that we have today, my father would have survived a lot longer.

I remember in the 1980’s we began to see “interventional cardiologists” coming on the scene, and then we began seeing some of these cardiologists taking recent heart attacks to the “cath lab” where they would run a catheter up the patient’s groin to the heart, squirt some dye in the coronary arteries, and then put a balloon (angioplasty) into the blockage and actually open the offending blockage. At last, a way to definitively treat the problem. Unfortunately in many many cases the treatment was temporary and the diseased area would quickly become blocked again. A better solution was needed.

There was hope for us in the primary care area as well. New drugs were invented that we could give patients in a simple IV that would miraculously dissolve blood clots that formed in coronary arteries. We found that we could actually abort or reverse a heart attack in many of these patients. I can remember scores of people who would become pain free after these drugs and their grossly abnormal EKG’s would return to normal before our eyes. They still had to go to the tertiary hospital for either angioplasty or bypass surgery, but it was immediately obvious to us that we were giving hope to many who would have had no hope before.


Since balloon angioplasty frequently would fail after a short time it wasn’t long before the idea of the stent came along. The stent is simply a little flexible tube made of metal mesh. After the blocked artery is ballooned open, the stent is inserted and expanded into the blocked area. Although stents do clot off more times than we would like, the success rate was much higher than with angioplasty alone. More lives saved and more lifestyles enhanced! Many patients who had gone to bypass before could have angioplasty and a stent and be back to living life in a very short time.

Many new drugs have come on the scene as well. The statin agents which effectively reduce cholesterol have been a Godsend. In the old days, we used to torture people with ridiculous diets that most would not follow and I had my doubts about their effectiveness of them anyway. High cholesterol is for the most part genetic. Your eating habits probably have only a minor and secondary roll. The statin drugs have given us an effective way to manage the problem.

We have developed better understanding of drugs such as beta blockers, ACE inhibitors, and anticoagulant drugs and their relation to coronary disease. We know that when these drugs are properly used and prescribed that positive outcomes result in people with heart disease.

Today, even our small hospital is an accredited chest pain center. We have undergone many hours of training and developed protocols and relationships with the tertiary hospitals. The goal is to have patients at the cath lab within 90 minutes of the onset of their symptoms and in the interim provide life saving treatments that 30 years ago would have seemed like science fiction. We understand that “time is muscle”. The faster the blocked coronary artery can be opened, the better the outcome.
The advances in the care of heart disease in the last 30 years have indeed been miraculous. The work never stops. Seems like almost everyday we discover something new which makes life better for all.

I’ll cut it off here and come back with another installment where I talk about new miracles in diabetes care.

Tuesday, March 9, 2010

Racism at its Best!

Oh, sorry! That is the wrong picture! I meant to put up this picture to the left! I hate it when that happens!

Anyway, the people with way too much time on their hands and the people who live to be offended are now up in arms cause a certain Walmart store sold black Barbie dolls for about half the price of white Barbie dolls.

A spokeswoman for Walmart said,"To prepare for (s)pring inventory, a number of items are marked for clearance, "

"Pricing like items differently is a part of inventory management in retailing,"

Imagine that! Racism based purely on a bidness decision! Could it be that maybe the black Barbies did not sell as well as the white Barbies? I'm just asking!

OMG! OMG!

"both dolls were priced the same to start, one was marked down due to its lower sales to hopefully increase purchase from customers."

"But critics say Walmart should have been more sensitive in its pricing choice."

Give me a fracking break! (That's a little Battlestar Galactica lingo for all you people in Rio Linda).

This has to be a top contender for the "Who Gives a Rat's Ass?" story award of the year.

I dunno bout yall, but I'm getting pretty damn tired of having to be "sensitive" all the time.

I wonder if you can get the Barbie in the picture at the very top for half price? Hey! I'm just asking! Calm down!

Fun to Watch a RINO Squirm

I saw a little of this on Greta last night on the Fox News Channel. Florida gubner, Charlie Crist is behind in the polls in his senate contest against Marco Rubio. Crist is hurling accusations at Rubio over a $130 dollar haircut.

Crist has come under fire I think mainly because he was in favor of stimulus money for the state of Florida, saying it was, "the right thing to do." I think he's also taken a lot of heat from the right cause he endorsed fellow RINO, John McCain, in the last presidential race.

Gubner, how can you be in favor of taking stimulus money? The money is not there. The federal gubment is broke. To be in favor of taking stimulus money is to be in favor of driving us, our children, and our children's children further into the red.

I did not catch all of the dialog last night, but Greta asked him why he was not running for a second term as gubner and was running for the senate instead. In the reply he said something about going to Washington to "get things done for the American people".

Uh oh! I sure hate to hear that. "Getting things done for the American people" translated means, crossing the aisle to work with Dimocrats, compromising conservative beliefs, and creating stupid laws and sucking more freedom away from the American people.

Really, Gubner, is this the best you can do? Hurling accusations and insults over a $130 dollar haircut when you accepted billions of dollars of our money that we don't have?  Perhaps they should all get haircuts like mine! Cheap and easy!

I had to laugh out loud when he accused Rubio of perpetuating a fraud by "saying one thing and actually doing another".

I thought of Barack Obama, witch Pelosi, winged monkey Reid, and most of the 535 scumbags loafing around in the Capitol building...........the whole damn federal gubment is perpetuating a fraud on all of us!

The Wicked Witch of the Left

Thursday, March 4, 2010

First Anniversary

Well, one year ago today, about 9pm, I became a Morbid Stranger. I was expecting many flowers and gifts from the band last night, but didja know, they didn't even remember? Oh well!

Tuesday, March 2, 2010

The Fix has got to Start Somewhere

I just couldn't help but laugh yesterday watching all the Dimocrats whining and complaining and bloviating over Senator Jim Bunning's "objections" to more gubment spending.

Bunning's objections at least for now delays jobless benefits for the nation's unemployed and also forces furlough of about 2000 federal workers.

They were really trying to demonize Bunning as cruel and heartless, when in reality all Bunning is doing is trying to make the Dimocrats abide  by the laws they have already created (pay as you go). The Dimocrats want to of course provide the extra benefits but don't want to pay for it. Well we can see how serious the Dimocrats were about PayGo.....it's all a bunch of the usual BS.

"Why now?" Bunning said he's been asked, regarding his objection to the legislation. "Why not now?"

Indeed! Why not now? If not now, when?

I am sorry for those who are unemployed, but the sad truth is that the days of gubment bailout are coming to a close. We just don't have the money. As for the 2000 federal workers, I say show them the door permanently! Let them go find a real job. I'm tired of having to pay for them.

I heard a pundit on Fox yesterday saying that all this unemployment extension was bad anyway, that it tended to exacerbate the problem, that people would wait until the last minute before taking a job they might not otherwise take. Well, I think the last minute has come. If that means you gotta go flip burgers at Wendy's for a while then you gotta do what you gotta do. Time to get off the gubment dole. Time for gubment spending to stop.

Gubner Christie in New Jersey is experiencing the same kind of Demowhining for exactly the same reasons.

I say, lettem whine.

Monday, March 1, 2010

Demoporn

Some things are just wrong.....

RINO REMINDER


Senator Lamar Alexander is the traitorous senator from Tennessee who voted to confirm the racist judge, Sonya Sotomayor. Never again will I vote for Lamar Alexander. He is not up for re-election until 2014, but I intend to post this reminder each and every month until then. I hope he either resigns or they run a true conservative against him in the primary. I challenge my fellow bloggers to do the same if you have RINO's in your state that need to go. I may add my other senator, Bob Corker, to this reminder. I'm waiting for him to cross the aisle again and work with Dimocrats.