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Saturday, May 25, 2019

Why Does Coffee Make Us Poop? Scientists Gave Coffee to Rats to Find Out

Increases sympathetic activity which activates the lumbar plexus of the rectum and anus. As with most cause-effect stimuli, a pavlovian response may occur. Indeed, once the association is made, bowel activity may be triggered simply by the scent of coffee.
from Rajesh Harrykissoon, MD

Saturday, May 18, 2019

Why am I always cold? 5 possible causes

I would add #6, sedentary. If we spend more than 50% of our waking hours seated or in bed, we are likely to feel cold. It's simple, there's not enough movement to raise metabolism and generate body heat. As a start, get up every hour. Avoid sitting for more than an hour continuously while awake. Work up to walking at a brisk pace 30 minutes daily at least 4 days weekly. #GetUpandGo
from Rajesh Harrykissoon, MD

Saturday, May 11, 2019

Minnesota Medical Association - MN Supreme Court Rules Physician-Patient Relationship is Not Necessary to Sue Docs for Malpractice

What a harmful decision which excises the heart of who we are as caring, compassionate healers. When I think of all the random calls and "curbsides" I, and just about every physician, gets in a day, it's frightening to think that any of those cause lead to legal jeopardy. Think of all the family, friends and even random encounters who "pick our brains." For instance, I had vehicle trouble on my way to work this week. I called roadside assistance. As the man was looking at my truck and chitchatting, he picked my brain about some medical topics. Can he now sue me? Can Aunt Velma who asked me about her diabetic neuropathy at Thanksgiving sue me? Can anyone reading a medical blog, article or watching medical broadcast sue? Imagine if you can sue a plumber, a roofer, a bartender just for "picking their brain" without having a customer-client relationship? Physicians and nurses who got into the profession because we like human-to-human interaction, we want to offer the comfort of a touch and to serve mankind through sharing of our knowledge and skill, are we are to become more insular, more aloof, more distant to our calling, more distant to our hearts, more distant to humanism, more distant to the community we serve? How do you all feel about Minnesota's decision?
from Rajesh Harrykissoon, MD

Friday, April 26, 2019

How to Properly Mulch Around a Tree | This Old House

The Best Time to Plant a Tree was 20 Years Ago. The Second Best Time is Now. -Chinese Proverb Happy Arbor Day! Plant a tree. Plants produce oxygen which is good for your lungs. 🌱
from Rajesh Harrykissoon, MD

Saturday, March 30, 2019

Why narcolepsy is an autoimmune condition

Narcolepsy is a rare condition, but it’s not as uncommon as you might think. About 1 in 2000 people in the US is estimated to have narcolepsy. That means in Brazos County, which has a population of 223,000, there may be approximately 110 cases of narcolepsy. The challenge is recognition and diagnosis. It is thought that up to 50% of narcolepsy goes undiagnosed due to failure of recognition.
from Rajesh Harrykissoon, MD

Monday, March 18, 2019

Doctor on Video Screen Told a Man He Was Near Death, Leaving Relatives Aghast

Hmmm...something is amiss with this situation. Terminal lung disease rarely sneaks up on anyone. Terminal lung conditions tend to be chronic and progressive over years. So, either the patient didn't present to medical attention until the very end (unlikely) or we never had a serious illness conversation with the patient and family about the expected progression of the lung disease. Having an initial serious illness conversation during an acute hospitalization is not the ideal circumstance as studies have shown increased patient and family anxiety and PTSD-like symptoms even when a live human-being trained in palliative and hospice care does so face to face. Thus, the response this family had to such news from the tele-ICU doctor is the same type of reaction experienced with an in-person conversation. For serious, progressive health conditions from which one may succumb, the serious illness conversation is best initiated in the outpatient setting. The inpatient conversation should be a continuation of the outpatient conversation (not a newly initiated one). Simple outpatient questions such as: 1) Have you considered your wishes if your disease progresses despite ongoing best medical treatment? 2) What goals and objective do you have for the remainder of your life? 3) How much independence are you willing to give up and how much suffering are you willing to endure in order to meet those objectives? 4) Would you wish to be intubated and kept alive on a mechanical ventilator? 3) Would you desire nutrition via an artificial feeding tube if you are no longer able to feed yourself? 5) How long are you willing to try "heroic" life support measures before determining a different focus and strategy would be appropriate? The answers to these questions aren't really the issue. It's the consideration of the questions which is meaningful. The patient may go home and ruminate on these questions. They may discuss with family members. If and when they are finally hospitalized due to progression or sequelae of their disease, the continued seriously illness conversation will not be psychologically or emotionally shocking.
from Rajesh Harrykissoon, MD

Saturday, March 16, 2019

Food labeling combats obesity in low-income communities - Vital Record

Information isn't sufficient to change behavior. For instance, the mandated inclusion of caloric value and the common labeling of healthier options with a red heart or green leaf icons on menus have not curbed the obesity epidemic. People make choices psychologically by what offers "joy in life." If something offers joy in life now but may harm later, we tend to choose joy now. Eating what you want and what you like now offers a bit of joy in life now. We'll deal with potential downstream consequences later...we'll practice self-restraint with the next meal or go for a jog tomorrow. And, we know how those self-promises tend to work out. Curbing the obesity epidemic will require more than labels and posted calorie counts. It will require acceptance by an entire culture that an alternative lifestyle offers more joy in life than the current.
from Rajesh Harrykissoon, MD