Cast & Curious

Tag: CME

  • Ironic absurdities for Bonedoc: A Mini-Series of some sorts…

    Last night when I was reading Bongi‘s blog (Other Things Amanzi), I came across his brutally hilarious (but freakishly realistic) post on (his sort of) “surgical principles”. Bongi is a general surgeon based in South Africa and though I see striking similarities between our “surgical worlds”, I found the guy’s witty and humorous ways of narrating his surgically bugged life, intriguingly interesting. Anyhow I’m particularly inspired (nah, copycat) by his post on how he came up with “his principles”. Not that I subscribe to all of  these but most went straight out of his operating theater making it egoistically fascinating for us surgeons and surgeons neck peckers. The one thing that strike me most was this “flat” referral to his bloody (or organically graphic) reality and how he finds way to “enjoy” it ( at least once ) to the point of gas-tronomic absurdity.

    So I thought, why not write about disarming eccentricities of provincial orthopedics too? I surely can make up a few wigwams out of my usually unusual orthopedic (mis)encounters. Obviously, these are anecdotal too and are tested only by me. Some may even be unique to the proverbial orthopedics to which I am helplessly thrown into. So Bongi, don’t care about my being a copycat. I call mine ‘ironic absurdities’ (instead of your principles) for Bonedoc anyway.

    1. You are (not only) the captain of your ship.
    2. Slowing down makes (near) perfect. Haste makes waste.
    3. Schedule surgeries on your vacations (and not on patient’s ‘ workdays).
    4. Flirt, to make surgeries less boring.
    5. It is always the some other surgeon’s fault. I mean, your “other” surgeon.
    6. Exercise outside OR.
    7. Have lots of fun, even when your obviously exploding in rage.

    Somehow those are the more common situational ironies I can think of for now. Others, I will add (or subtract, depending on my gut feeling) up as soon as they hit me hard with a hammer. Some I actually relish now. I will link each of these absurdities to their individual post as soon as I figured it out of my mind and into my computer’s main memory. Hopefully,I will not kill my practice and blogging career with this ghastly concoction of experiential ironies .

  • How much weight should kids carry on their backpacks?

    I overheard this conversation over one radio/tv show that made me gulp in disbelief. Probably pressured by parent’s questions regarding how much weight should kids carry on their bags going to school, the lady anchor asked one orthopedic surgeon from a known celebrity hospital in Manila. Frankly, I found the good surgeon’s answer a bit complicated and technical.

    The simple answer should have been within 10-15% of the kids body weight, assuming that kid use a backpack to carry his/her school stuff. Beyond this carrying weight “cap” the kid will probably experience back strains and muscle strains NOT a slipped disc or arthritis as the anchors are trying to insinuate. Of course if you let this kids carry tables or chairs regularly, then probably!

    In choosing backpacks for your school kids take note of that weight limit and the following important pointers:

    1. Find a “lightweight” pack, usually made of water repellent (not necessarily waterproof) material but not leather. Leather weighs heavier.
    2. Get a double strapped well padded pack. Find  a pack with a well padded back. This will ease back pressure a bit.
    3. It’s preferable to have multi-compartment packs as they promote organization. But make sure the heavier objects are placed nearer the kids back so they won’t stoop back often and get back strains.
    4. Waist belts keep the pack from “jiggling” on their back, preventing weight shifting that hurts their back.
    5. Don’t get bags that are too large (meaning the bag “material” is bigger than the kids back) nor buy packs higher than his neck. With large bags, comes the tendency of kids to just load everything in there.
    6. Lastly, dont buy packs with too much plastic and paints on the outside. Some of them easily peel off and contain lead materials.

    Why do I know this stuff? Well I’m an orthopedic surgeon and a frequent mountaineer/backpacker too. We use this “guides” to pick our bags and gears. This will at least prevent back sprains and strains from carrying to heavy stuff.

    For more ideas on buying and choosing your packs wisely, visit this site (www.kidshealth.org). They’ve got more tips for kids’ backpacks.

  • H1N1 A (Swine) Flu Infects the (Philippine’s) web

    Nope, those quarantined people in Vicente Soto Memorial Medical Center (Cebu, Philippines) are just “suspects”. No confirmed cases yet in the Philippines. At least, that’s what our quick responding health secretary Francisco Duque III is telling the nation. Despite the virus’ inability to spread biologically online Swine flu frenzy in Philippine web is exploding. And its spreading like wildfire.

    Taking cues from viral spread of the flu online abroad (US and Europe) you can now read about H1N1 seconds after a Google search, minutes after someone “tweeted” any topic related to it, or map it out in Heath Maps like this one and even discussions on Facebook!

    US Swine Flu Discussion Map according to Facebook

    Perhaps the busiest site would be U.S. Center for Disease Control and Prevention (CDC)H1N1 Flu site detailing all possible topics related to this pandemic. The site provides virtually things you need to know about the outbreak in the language even a fifth grader would understand.

    Our very own Department of Health didn’t escape the online viral fever. It did published an online guide to Influenza A (H1N1) in the Philippines and is coming up with a workable preparedness plan for a possible Swine Flu infection in the Philippines.

    The online counterparts of media moguls ABS-CBN and GMA (the major harbinger of news in a nation whose internet usage is below half its population) publishes frequent updates about Swine Flu cases here and abroad. Online newspapers Inquirer.net among others run swine flu news like hotcakes.

    But the two most easily understood write ups about Swine Flu here in the philippine blogosphere came from medical bloggers. Doc Ian Gomez tackled Swine Flu extensively in his blog So Far So Good. Doc Emer of Parallel Universes wittingly and graphically demystified “unknowns” about H1N1 virus. I stumbled upon a dozen more blogs discussing Swine Flu and I think, we don’t lack information about it.

    The thing is, how much of our readership reaches the “majority” of Filipinos? This implosion is actually nothing if the poor Juan couldn’t be properly educated about Swine Flu. The media hype and blogosphere frenzy is good for two things-educate and take action. For any other disease to which the human species is not “acquainted” to or doesn’t have any idea how it came about, maybe online information is as vital as preventing the spread of a disease itself.What do you think???

  • Web and health 2.0 : What is web 2.0 to us physicians?

    I’ve been asked several times by colleagues and friends alike what do I get from blogging and joining social networks as a physician-surgeon. My honest to goodness answer was,

    I’m dabbling at web 2.0 tools to enhance my practice, my delivery of health care and sometimes, earn from sponsored ads.

    I get blank stares when I mentioned web 2.0 but the words “earn” seem to catch astute ears. I usually don’t get enough talking time to expound on this, especially with the web 2.0 and health 2.0 part. Thus, I am making a series of posts to elucidate what web 2.0 is to us physicians and how is it changing the medical practice and our delivery of health care. (Forget the earning part, the web is replete with how-tos on this topic)

    I must warn physicians reading these series of posts, that even if I try to be as concise and simple in my explanations, a few thoughts may sound technical to those unfamiliar with the digital lingo. Try copying the word or phrase that you don’t understand and place it in the Google search bar and click search. You will be surprised by the heaps of explanations and answers to your queries.

    I understand that despite the increasing trend of physicians using the internet, most physicians here in my country knew a little beyond emails, online medical and entertainment news (please correct me if I’m wrong here). A few, more engaging doctors knew about the powers of Google-ing. But learning web 2.0 (and its tools) to enhance your practice will need a lot more than line reading and the “I’m always busy I don’t have time for this” attitude most physicians here succumbed. If this is your learning perspective, I suggest you don’t bother reading this post and return to your usual mode of practice and lose an opportunity to enhance your delivery of health care. You wouldn’t even know what you’ve missed anyway.

    Going back, here are the basic questions I’ll try to answer:

    1. Whats web 2.0 anyway?
    2. How is it different from web 1.0?
    3. What are those web 2.0 tools you are talking about?
    4. Whats web 2.0 to medicine and how is it changing the medscape?
    5. Is it here to stay or will there be a web 3.0 and so on?

    I’ll answer the first two question in this post and the other questions in my succeeding posts related to web and health 2.0

    Web 2.0 is a concept (or a tool) describing the use of internet (world wide web) and web designs (or platforms) to ENHANCE creativity, communication, collaboration, sharing, security and functionality of the internet. I also must add that this concept imply that such tools will be used to attain certain goals that may differ (or converge) to many individuals or groups taking advantage of it. Improvement of health care delivery is just one of it. Here’s a sideshow of what web 2.0 is all about.

    Web 2.0

    View more presentations from satyajeet_02. (tags: internet 2.o)

    Ironically, web 1.0 ‘s definition is an offshoot of web 2.0- to contrast what web 2.0 is all about. But the salient points are ; web 1.0 is static, not interactive and is proprietary. Note the direct contrast of these two concepts. Nonetheless, it is safe to say web 2.0 is an evolutionary cousin ( or revolution) of web 1.0 in the net.

    Take note of the words internet collaboration, improvement and user empowerment. Democratization of the net is another personality of this concept. To some these are the distinction of web 2.0 to web 1.0. And that’s where the powers of web 2.0 lies. It is within our capabilities as physicians to grab this tool and opportunity to improve our practice and delivery of health care.

    This answer the queries what physicians can do with their online: No it’s not just about advertising your profiles and online directories. It’s not just emails and one way communication. It’s not even just the act of putting up a website for your practice and doing nothing about it. More than that,Web 2.0 tools allows us better collaboration, communication, feedback (between patients and physicians for example) and improvement of health services. And here in the Philippines, we haven’t taken off from web 1.0 yet!

    I’ll discus web 2.0 tools in my subsequent posts.

    (For additional readings on web 2.0 read the web 2.0 wiki or O’Reilly Media’s article on web 2.0. For articles regarding internet usage of physicians, kindly read the results of this research)

  • Some horrendous claims of herbal supplements may kill you…

    It’s not only irritating to hear horrendous “cure all” claims of some food supplements manufacturers and advertisers about their “drug” but the lack of advertisement control also nauseates me to no end. The sickening charade of food supplements jumping out of nowhere and claiming to heal all kinds of human afflictions thinkable (just so they can corner the poor man’s pocket) is staggering to say at least. Taking these supplements at advertisement value is already one big step to your sick bed. Deceiving someone with false hopes and killing the patient in the process is another “crime” worthy of harakiri.
    (Photo taken from Science Blogs.)

    In almost everyday that I listen to the radio, some airtime (at times lasting a full 15 minute!) is spent on miracle cure throttled by exaggerated personal testaments of complete strangers.

    What happened to “PANA: Truth in advertising?” or the KBP’s commitment to “Nothing but the truth, so help us GOD?”

    Here’s BFAD guides on how to spot false claims by these unscrupulous supplement manufacturers.

    1. The product is advertised as a quick and effective cure-all for a wide range of illness.
    2. Certain key words like “scientific breakthrough, miracle cure, all natural without side-effects or ancient remedy” are used.
    3. The promote claims that medical professionals and scientists have conspired to suppress the product.
    4. Adverts contain undocumented, anecdotal cases, but with amazing results. No science involved.
    5. These products sell falls hope for extreme physical attractiveness and shortcuts to weight loss. They will never emphasize the value of healthy lifestyles, like avoiding smoking, excess drinking of alcohol, eating appropriately, adequate rest and sleep, and regular exercise.
    6. Remember that legitimate health supplement products will never carry claims for quick cures; claims such as cancer prevention, good for arthritis, good for diabetes or good for hypertension, should be high suspect.
    7. The product is advertised as available from only one source.
    8. There is a money-back guarantee promise.

    The usual excuse laid for such drug supplements goes along the lines of herbal medicine being natural and hence, is the best form treatment. Another sad excuse propagated by these unscrupulous manufacturers and advertisers is the soaring prices of BFAD certified drugs. Both of these excuse “prompts” the ignorant listener to buy the cheaper, food supplements that claims healing every imaginable human disease yet lacking in rigorous scientific testing! It’s like jumping on a plane hoping your jacket will save you (it may even get tangled in the plane’s props) instead of your chutes. Stupidity does have its additive effect remember. It might not only rob you of your hard earned money but it may sometimes kill you or your patient!

    To argue that some drugs or supplements need not pass rigid testing to be effective is an outright lie. Often, these are Russian Rolette type solution to a worsening health economics. Licensing and BFAD approval of any drug aims at at least two basic goals. Rigid and scientific testing makes sure the quality and quantity of any drug is not only safe for human consumption but should also be effective against the illness(es) it claims to combat.

    At the very least, any drug must be tested for its safety profile and efficacy. Remove the first and your taking in a poison. Any dubious drug efficacy even in rigorous scientifically studied drugs, is nothing but pure waste of money. Take out both, and you make yourself poor on your way to your deathbed.

    One (or two) person’s testimony, no matter how famous that person, is not tantamount to a safe and effective medicine.Some physicians or physician’s name is even attached to these claims. In the current recommended evidence based approach to treatment and procedures, anecdotal testimonies ranks the lowest in the strength of evidence.

    Now would you want any food supplement giving you all these complications? Would you even dare to give food supplement to someone you love and risk losing his life base on false claims?

    Think again…