1) Demerol: I'll never forget a lecture I attended as a resident by a well known toxicologist who said Demerol should be pulled from the market...that it doesn't work any better than any other pain medication and patients love the high it gives them. The American Pain Society said in 2003 that Demerol has no role in acute pain management because it "offers no advantages over other opiods as an analgesic and has unique neurotoxicity." This same organization has said Demerol is "not recommended for the management of chronic pain." It is a terribly addictive drug and I cringe when I hear it's possible Michael Jackson was getting Demerol injections daily for pain. In my previous blog I addressed prescription drug abuse http://www.dailystrength.org/blog/532-danny-gans-dilaudid-and but Demerol use is really tragic to me and I blame this partly on those of us in medicine.
2) Pick a Doctor who is board-certified. There are many strange things about Michael Jackson's personal doctor including that he was paid 150,000 a month, now we learn that MJ's "cardiologist" wasn't board certified. Neither was the plastic surgeon who performed Kanye West's mom's surgery. Yes, doctors who ARE board certified get in to trouble as well and yes, getting certified and re-certified in your specialty is a PAIN...it costs money and requires many long hours of study prior to your test but DON'T YOU WANT THAT COMMITMENT FROM YOUR DOCTOR! We should all want to know that our contractors, architects and physicians stay current and up to date because they become certified by the Board in charge of their specialty. People please pick a doctor who is currently board certified!
3) So much is out of our control, let's try and control the things we can control: eating right, exercising, getting enough sleep, doing your form of a 5-10 minute meditation every day (bath, walk, prayer) and SCREENING...mammograms, pap smears, PSA tests, colonoscopy, bone density scans...let's screen for the things we may be able to see coming.
4) Billy Mays dead at 50. All of these stories have been so sad and I saw the interview of him the day before his death. My first thought was that he looked a little weary and gray during that quick interview and his wife reports he went to bed at 10 PM that night because he didn't feel well. If this turns out to be sudden cardiac death from coronary artery disease I suspect he felt nauseated and just not right the night before. I hear this story all the time from patients and their loved ones prior to suffering heart attacks. Remember angina is not always substernal chest pressure or pain radiating down the arm, it can be a vague sense of doom, nausea, sweating, weakness, pain or pressure in the throat or jaw. If you feel weird and you know its "weird" trust your instincts and go for help. My patients who say to me "I just don't feel right" scare me the most.
5) Leaving your job for 5 days: This story should get us all thinking about priorities, unrequited love and responsibility. If I were on call at the hospital and left town for 5 days I would be fired on the spot when I returned. I care less about the affair though it is an assault on his wife and sons; I care more about bailing out of the country when you are the Governor. There are so many times my interns and residents could cut corners in the middle of the night just to get 15 minutes of shut eye...and they don't......because when you have a job that carries responsibility (pilot, firefighter, doctor, nurse, Governor) you should know where your moral compass points.
"Why can't we get all the people in world that we really like and then just stay together? I guess that wouldn't work. Someone would leave. Someone always leaves. Then we would have to say good-bye. I hate good-byes. I know what I need. I need more hellos."
I'd love to hear your thoughts.
UPDATE 8/9/09: Well, it seems Billy Mays had Cocaine and Dilaudid in his system at the time of death and it appears likely the Cocaine contributed to his hypertensive heart disease which took his life. Another sad story of drug use and possible abuse.