Friday, February 13, 2009

Roller Boogie

Had a 60 year old come in via stretcher holding her left wrist. Had a bag of ice over it but as I got the history, patient was skating at a roller rink and slipped and fell onto her butt, and outstretched left hand. Judging from the way the wrist now looked like a hockey stick, she was fractured, just had to see how bad on xrays. Went ahead and called the orthopedic surgeon on call and it happened to be the husband of an old residency partner from West Sub Hospital. He came in to try and reduce it with a local injection. (Sometimes we can inject the area of the break with the same numbing medicine used as the dentist-with these fractures, if we can pull the broken bones apart and cast the area-may be able to hold the two broken pieces in a straight line to heal faster)

The same hour, a 72 year old lady also came in holding her right wrist and stated she just came from a roller rink party and fell on her butt and outstretched left hand. Taking off the ice pack, wrist looked ok, mild redness to where the ice was but no swelling. Her xray showed a thin line of a fracture along the same bone as the first lady. I placed her into a splint and sling and told her to see the ortho in the am. Very little pain and very healthy lady.

Obviously, there are some variables that would change the fall in both ladies; angle of the fall, speed, exact position of the extremity in addition to the health of the patient. The only tangible thing I could deduce was health. The 60 year old didn't take supplements, drank coffee, and had cholesterol "issues" was still working fulltime and was not an "exerciser". The 72 year old exercised regularly, even pointed out with her daily walking, she would take a small handheld weight and rotate it one direction then the other for the entire 20-30 minute walk. She claimed her girlfreind she walks with keeps her laughing and claims she has no stress. She gets physicals regularly and had a recent bone scan that was normal.

It was amazing the 72 year old didn't break her hip and she only suffered a small stress fracture. Being a man that sees life with the "cup half full", I would believe her exercise and stress reduction played an important part in keeping her bones thick and strong. This just backs up the Saguil Approach in utilizing preventive medicine not only before the disease is found but even after the disease has been controlled with medicines or surgeries. I have always taken pride in the patients that would take my advise to control weight, exercise and change the way stress is dealt with. Many get a false sense of security when the "lab test result" is brought back to normal with a pill. Now a days, diabetics come to the er with 2-3 pills (on average) state the last blood tests looked great at the last quarterly visit, but yet they are overweight and don't follow their carbs or calories. I even remember a diabetic I was counseling about smoking, I told him the tobacco will kill him, he answered "I know I will die, my wife will die at some point and even you (pointing to me) will die sometime. At that point I knew he wasn't listening but if I only had enough time or another visit with him, I would find another way to approach this denial. Bottom line is I always believe, no matter how many pills, medical issues or lack of money, there is a particular way to get healthier for everyone before during and after a medical issue is discovered.

Thursday, February 5, 2009

From the Heart

The heart is considered a muscle in "concrete" terms. The muscle beats for about 80 years; 70 beats a minute that will sometimes speed up with stress and exercise and slow down with relaxation and sleep. The more in tune the heart is, the slower the resting heart rate. (It is rumored that Michael Jordan had a resting heart rate of 40!) During high stress it can go up to 180.....just like the Steeler's James Harrison last week during that 100 yard return! Getting the heart fit will usually reap rewards in time. I always thought running was good enough but now with the way my mixed martial arts practitioners are pushing the envelop with full body involvement like the concept of "peripheral heart action", work outs like "the 300". These practitioners are showing the medical community that a different form of exercise is being utilized to keep the heart in excellent condition. And it's not just the 20 year olds.....more boomers are adapting this form of exercise. At Contender Boxing in Aurora where I trained last year, Mike Bardash was developing routines for conditioning the legs as well as the torso. (never thought 5 minutes of throwing hands would be so exhausting).

My point is that if I medically clear a patient for heart disease, sky's the limit! Pushing the envelop will yield a healthier heart and a more grounded spirit from the triumph of making through the routine. With a healthier outlook, stress is seen in a calmer vision and easier to neutralize. I speak of the healthy heart this month since it is "heart month". The concept of getting on a treadmill, bike or in a gym is the western way to figuring out what a goal should be and if we are hitting the goal 20-40 minutes, 5 days a week. The oldest exercises, Tai Chi, QiGong and Yoga have rewarded practioners with longevity without targeting the heart muscle as goal. As I have referenced in previous blogs, I started incorporating meditation into whole body healing when a patient of mine who had high blood pressure started with yoga. In three months, he actually gained weight, got off his medicine and lowered his blood pressure. I could see the transformation over 3 months and soon after I enrolled in Medical Acupuncture with UCLA. I have seen this repetition with several other patients.

The Saguil Approach would be, ask a doctor first. Once cleared, find an activity that is interesting and easy to perform (without going broke), find a group of others with the same mind set, stay away from those with bad karma, and eat things you dont feel guilty of. Don't fall into the mind set that age limits activity, embracing challenge is one of the ways people endure. The best anti-aging drug I can prescribe is "exercise".