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doctor, physician

Happy National Doctors Day!

What a wonderful day to celebrate! National Doctors’ Day was first observed in 1933 when general anesthesia was used during surgery for the first time & was officially made a national day of celebration in 1991 (Public Law 101-473.)

Check out my blog post on KevinMD from 2014 for more fun facts about doctors:

Doctor’s Today: Young, Broke and Human 

and don’t forget to show your favorite doctors some love on this special day!

 

PSA: You don’t need antibiotics for your cold

We are amidst the cold and flu season, and the expectation for antibiotics is so common that I find myself spending most of my time explaining why antibiotic use for colds are inappropriate. It’s time that I feel people would benefit from resting at home, letting their bodies recover. Sometimes I wish I could create a PSA or scream at the top of my lungs that

Colds are caused by a virus! Antibiotics are for bacterial infections. Get some rest, fluids and let your body heal naturally!

             (I also have a few choice words for anyone who continues to inappropriately prescribe antibiotics for a cold and perpetuate the unreasonable demand… Should I tell you how I really feel?)

I am absolutely thrilled that the American College of Physicians (ACP) and the U.S. Centers for Disease Control and Prevention (CDC) recently published an article in the Annals of Internal Medicine that gave specific recommendations to physicians for appropriate scenarios to prescribe antibiotics. The article recommended the following valuable guidelines:

Clinicians should

  • NOT prescribe antibiotics for patients with the common cold. (AND I REPEAT, CLINICIANS SHOULD NOT PRESCRIBE ANTIBIOTICS FOR THE COMMON COLD)
  • NOT perform testing or initiate antibiotic therapy in patients with bronchitis unless pneumonia is suspected.
  • Test patients with symptoms suggestive of strep throat by rapid antigen detection test and/or culture for group A Streptococcus and should treat patients with antibiotics ONLY if they have confirmed streptococcal pharyngitis.
  • Reserve antibiotic treatment for acute rhinosinusitis for patients with:
    – persistent symptoms for more than 10 days
    – onset of severe symptoms or signs of high fever (>39 °C)
    – purulent nasal discharge or facial pain lasting for at least 3 consecutive days
    – or onset of worsening symptoms following a typical viral illness that lasted 5 days that was initially improving (double sickening).

The article also states that sinus infections usually clear up without antibiotics even if bacteria are to blame, and that antibiotics in these cases cause more adverse effects. The guidelines also recommend the following remedies for symptom relief:

Analgesics for pain
Antipyretics for fever
Systemic or topical decongestants
Saline nasal irrigation
Cough suppressants (dextromethorphan or codeine)
Expectorants (guaifenesin)
First-generation antihistamines (diphenhydramine)
Decongestants (phenylephrine)
Beta-agonists (albuterol)
Intranasal corticosteroids

The cold virus will eventually run its course. Often catching a cold happens during times of high stress and lack of sleep, so it’s important to allow yourself to rest.

Antibiotic resistance is a serious health threat and not to be taken lightly. Again, it requires a commitment from both physicians and patients. So save yourself some time and healthy gut bacteria and stay home and rest. Your cold will get better and if not, I’ll be here to help.

Read more about the 3 Main Reasons You Don’t Need an Antibiotic for a Cold and 10 Natural Ways to Stay Healthy this Cold and Flu Season.

Let me know your thoughts in the comments!

 

 

 

doctor, healthcare, medicine, prescription, erectile dysfunction

Are you frustrated with your doctor?

Doctors and the Healthcare System

Many people are frustrated with the healthcare system and rightfully so. The doctor may not always be to blame however. Many people tell me how they have had doctors who don’t have time to listen or “do anything” for them. Like with anything in life, there are different levels of professionalism, however, there are also many things that go on behind the scenes of medicine that you may not know. Read more at my article on KevinMD.com: Before visiting the doctor, consider these 5 things you may not know.

Let me know your thoughts in the comments section below.

5 Surprising Things You May Not Know About Doctors

Times have definitely changed 1946 Camel Cigarette Ad Source: http://tobacco.stanford.edu/tobacco_main

Times have definitely changed
1946 Camel Cigarette Ad
Source: http://tobacco.stanford.edu/tobacco_main

 

“Oh, you’re my doctor? A woman?”

Who do you picture walking through the exam room door at your new doctor’s office? Is it the Norman Rockwell depiction of an older, jolly looking male with white hair? After residency I was alarmed at how many patients commented on my age and gender:

“<Expletive>, how old are you, 12?” or, “Oh, you’re my doctor? A woman?”

I know that I lived under a rock during my medical training but I am pretty sure Scrubs, the Mindy Project and Grey’s Anatomy were on TV then. (Scrubs is the most realistic medical TV show by the way.) This got me thinking about misconceptions people have about doctors, and I thought I could share a few things you may not know about your favorite neighborhood doc.

1. We are young

According to the Association of American Medical Colleges (AAMC), of the active physicians in the US in 2012, about 60% were under the age of 54. With baby boomers retiring, someone has to take over the roles of older doctors (who by the way, were at some point young too.) Physicians fresh out of residency have had several thousands of hours of experience in addition to seeing several thousands of patients. Yes, while more experience is an advantage, so is knowing about the latest health guidelines and technology. In fact, a study published in the Annals of Internal Medicine in 2005, showed that younger physicians are more likely to order necessary tests and appropriately counsel patients on preventive health than their more experienced colleagues.

"Before the Shot" by Norman Rockwell Source nrm.org

“Before the Shot” by Norman Rockwell
Source: nrm.org

2. We exist in female form (Shocking I know!!!)

While 70% of physicians in the US are male, the number of females entering the medical field continues to grow. Not only do females have to jump through the same hoops as their male colleagues when it comes to medical training, they may even have a slight edge. A study done by the University of Montreal showed that female doctors score higher on quality and care measures and are more likely to follow evidenced-based guidelines. Another study showed that female physicians tend to show more empathy and are better listeners. NOTE: This is not meant to bash male physicians. There are very talented male physicians practicing medicine. The whole point is that female physicians are also good at what they do.

3. We are not as rich as you think

It’s true that doctors make a salary that is well above the national average. However, after about 10-15 years of education and training, making little to no money, we find ourselves in hundreds of thousands of dollars in debt. It takes about double that amount of time originally invested to repay a debt, which can end up costing more than twice as much due to accrued interest. It’s no wonder why doctors are fighting health care reimbursement cuts. I tell people all the time, don’t become a doctor if you are trying to be rich. Become a doctor because you can’t see yourself doing anything else and you are willing to put in the sacrifice. Believe me, there are a lot of easier ways to become rich.

4. We know more than medical websites

It’s wonderful when people are involved in their own health and want to be informed. While there are many great medical websites out there, there is also a lot of false medical information on the Internet, and believe me, nothing replaces a formal medical education. Doctors learn the information you read about online at an advanced level and take it a step further by applying that information to each individual. A cough in Mr. A who smokes, may be related to something completely different than a cough in Mrs. C who may have other health problems and be taking different medications.

Scrubs: One of the best medical TV shows ever! Source: http://www.tv.com/shows/scrubs/

Scrubs: One of the best medical TV shows ever!
Source: http://www.tv.com/shows/scrubs/

5. We are human

Believe it or not, doctors are people too. I hate getting my blood drawn and I also happen to do a mean robot dance. In all seriousness, doctors have a lot of responsibilities placed on their shoulders, which is why becoming a physician is not easy; we are dealing with human lives after all. That being said, doctors don’t always have all the answers either. It’s called the “practice” of medicine for a reason. Sometimes we have to try a few things and rule some things out, which may require a few tests, additional appointments or even referrals to other physicians.

The stone age has passed…

Regardless of our age, gender, skin color, nationality, student loan debt, USMLE, NBME, board exam, or state license, doctors have all taken an oath. An oath promising to value and respect human life, do no harm, maintain confidentiality and ultimately do what is best for patients and our community.

So the next time a young doctor walks into the room, give her the benefit of the doubt. She may be 20-something, driving a 2000 Toyota, with half of her paycheck paying off student loan debt. If you look hard enough you may see the “age lines” she and the next generation of young doctors acquired through the many sleepless nights and delayed gratification invested in taking care of you and your loved ones.

 

 

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Preview for upcoming first episode of #HealthyVibes with Dr.

Sneak Preview

 

Dr. Aunna’s first episode of #HealthVibes airs next week. What will it be about? Sign up for email updates if you haven’t already. Tune in for more…

Delicious Flour-less, Butter-less, Egg-less, Naturally Sweetened COoOkiEs!!!

photo 2-1I am all about healthy eating but I also love chocolate and sweets too. I found this recipe for vegetarian-friendly, protein-packed cookies (no flour, no milk butter, no white sugar, no eggs) that came out so yummy I had to keep myself from eating all of them! The secret ingredient that holds it all together: chickpeas!

Yes, Cookie Monster, Dr. Aunna says it's ok to eat some of these cookies (I think he would definitely approve )...

Yes, Cookie Monster, Dr. Aunna says it’s ok to eat some of these cookies (I think he would definitely approve )…

Ingredients

–       One 16 oz can of chickpeas, drained, rinsed and patted dry
–        ½ cup + 2 tablespoon natural nutbutter of your choice (peanut, almond, sunflower seed, etc). Make sure there is no added sugar or salt
–        ¼ cup honey or agave nectar
–       2 teaspoons vanilla extract
–       1 teaspoon baking powder
–       1 pinch of salt
–       2 teaspoons vegetable protein powder (optional)
–       ½ cup of dark chocolate chips
(To make this a totally vegan recipe use agave nectar and vegan chocolate chips)

Directions

1. Preheat the oven to 350°F
2. Combine all the ingredients, except for the chocolate chips. You can use a regular blender or hand blender. Make sure the mixture is smooth and that there are no chunks of chickpeas left. I added the vegetable protein powder for extra protein and to help the mixture be less sticky and more like a dough.
3. Transfer mixture to separate bowl if necessary and mix in chocolate chips
4. Form 1½ inch balls with wet hands. Place onto a Silpat, piece of parchment paper or lightly greased cookie sheet. These cookies will not spread and rise like normal cookies so pat down on them in the shape you would like them to look.
6. Bake for about 10-12 minutes.

Enjoy with a glass of almond or soy milk! Next time I am going to add dark chocolate cocoa powder to make it extra chocolatey. Try it and let me know what you think!

*Note: I am not aware of the calorie content of these cookies. Nuts are high in calorie in fats (healthy fats). It also depends on the type of chocolate chips you use (dark vs milk). Many types of chocolate chips are made with sugar. This recipe does however minimize refined carbs and unsaturated fats and maximizes protein, making this cookie a healthier option. With anything I always advise moderation!

All Year’s Resolutions- Part 2

From one of my faves: Lululemon Athletica

From one of my faves: Lululemon Athletica

Hello 2014! Are you still waiting until next week to start working on your resolutions? Well, why? Why have you waited for the past year? Last month I wrote in my post All Years Resolutions- Part 1 that we shouldn’t have to wait to make changes that benefit our lives. Of the 45% of Americans that make New Years Resolutions, only 8% are successful in achieving them. Chances are, many of our resolutions have been carried on from year to year. The following are some of the reasons that keep us from achieving our goals.

Unreasonable expectations: We as human beings are incredibly hard on ourselves and it does not help that we are constantly trying to be “better,” “fitter,” “richer,” etc. We constantly strive for this different version of ourselves and are never satisfied. How many of us finally reach our goal only to find something else to try to “fix?” Many of us are also striving for perfection, which is unattainable; so when we don’t achieve this we feel disappointment. (For those of you struggling with your body image, I suggest you watch this video on airbrushing in advertising). There is nothing wrong with having high standards, but make sure it is an attainable goal. I also encourage you to look at your goals from the perspective of improving meaningful attributes of your life. Instead of wanting to be a certain size or shape, think about wanting to be healthy. If you approach it this way you will achieve your goals in ways that are directed at self-respect rather than at superficial ideals. For example, wanting to be healthy rather than “hot” will help you make the choices that will eventually lead to a healthy looking body.

Wanting instant results: Certain issues did not happen overnight. We are creatures of habit so changing habits takes some time (they say it takes 21 days…) Healthy life changes should be part of a daily regimen, not to be packed into 2 months of the beginning of the year. Remember, delayed gratification is important. Let’s take weight loss, for example. While a weight loss pill may take the weight off in a short period of time, you still have not made the changes to your diet and lifestyle that will lead you to gain the weight back once you have stopped the pill.

Trying to do too much too fast: New Years Resolutions are exciting. It gives us something to talk about and something to look forward to starting off the new year. Sometimes, however, the excitement drives us to do everything at once and this can be overwhelming. This can lead to not being able to balance everything else in our lives and eventually to burn-out. This in turn leads to frustration and may prevent us from taking any more steps to making changes or moving toward our goals. Instead, focus on what you are capable of fitting into your schedule and prioritize. Cleaning the attic can probably wait. Make a daily commitment to yourself and set short term goals. Let’s take a look at some common resolutions and some examples of how to make daily changes related to each:

– Weight Loss: It’ s probably not a good idea to start P90X if you haven’t been physically active for awhile. You may either injure yourself, or feel ill afterward and hate the thought of any exercise in the future. A better option would be to start off slow with walking or light exercise to build up both endurance and strength and then gradually increase the intensity of your workout. Also get in the habit of exercising when you get home on certain days of the week. Don’t forget to choose the healthy food options on your lunch break.

This is not considered exercise

NOTE: This is not considered exercise

– Organization issues: Everyday throw away a few things you don’t need. Get in the habit of putting things away right after you use them. Clean up any messes before going to bed so that you can wake up to a fresh start!

– Debt issues: Cancel a subscription to that magazine you never read. Cook instead of eating out (this will also help with weight loss!)… who knows, with the money you save you may be able to take that dream vacation on your list after all!

These are only a few examples of little things you can do, and these changes will add up in the long term. Remember, change takes time and if we do not achieve all of our goals in one month we still have a whole year and a whole life to do so. (This does not mean putting things off however!)

ExcusesAnyone can make time for what they prioritize. TALK is cheap. The time you spend talking can be time spent doing. Avoid procrastination. Get started on your goals now. If you don’t start your exercise regimen today, when will you?

Focusing only on the outcome: Remember, it’s about the journey, not the destination. It’s important to have your goal in mind but the way there may not pan out how you expect. And if you do achieve your goal, how much satisfaction will you have if the process was tedious and stressful? Let it flow. Make it fun. Want to eat healthy? Find fun recipes or make cooking an enjoyable family affair. Are you dreading the gym? Why not join a dance fitness class or walk outside and enjoy the scenery?

The next post is about the mental and emotional obstacles that prevent us from achieving our goals. Until then I ask you, what has kept you from accomplishing your goals?

 

Aunna Pourang, MD is a board certified family physician who lives in Jacksonville, FL. It is her journey to wholeness that she learned the importance of healing the mind, body and spirit to bring true happiness and health to her life. It is through this blog she wishes to help others do the same. 

The Magic Pill

photo-20

Can I get a side of pills with that?

According to the CDC, 48.5% of Americans have taken at least one prescription drug in the past 30 days. 21.7% report taking three or more prescription drugs. Why is it then that chronic diseases such as diabetes and high blood pressure continue to increase in our population? The answer is complicated, but to keep things simple for this discussion, one main reason has to do with what I call “under-diagnosis” and “over-mistreatment.”

A “Pillemma”

Typically we go to the doctor when we experience a physical symptom, and after a few encounters and possibly some tests, we are often prescribed pills. If we are fortunate enough to afford the medication or compliant enough to take it, we may or may not experience relief of our symptoms. Oftentimes we don’t feel any better, and if anything, worse from the side effect of a pill. Then we may become disappointed that our doctor could not “fix” us.

What if there is something deeper than just the symptom we are experiencing? Let’s take a headache, for example. There are many causes for headaches, but the most common reason I encounter with patients is usually related to stress. When I examine patients with headaches, I find many of them have tense shoulder and neck muscles; hence why it is called a “tension headache.” So yes, while a pill can inhibit the pain, it still is not treating the muscle tension, which is being caused by stress!

Pills are not always the answer. Unfortunately with the limited amount of time doctors have to see patients these days, the only option is the “easy fix”, which is usually a pill. It doesn’t help that our society is always looking for this “easy fix”, so instant gratification wins, but in the end we are often back where we started. So what’s the solution, you may ask? Let’s take a look at how disease is diagnosed: Typically we see illness like this:

Disease Approach

 

We often forget that WE ARE NOT JUST A BODY. WE ARE NOT ROBOTS. Here is a more realistic diagram of a human being’s existence:

 

Holistic Approach

 

The real the dilemma our healthcare system is facing has to do with the following:

Underdiagnosis– Not addressing the whole person

Over-mistreatment- Treating only a part of the problem with a “solution” (pills) that creates more problems (side effects, death, etc.)

While pills are effective at the physical level, they do not address all of the other factors that contribute to illness. Often the underlying cause is related to something completely different than what is seen on the surface (see arrows above). I am not saying that we should all stop taking medication. Medication is effective and has a place in treatment of illness, but it is rather one of many tools to be used. Prevention is the best way to avoid illness in the first place, and many times healthy lifestyle habits are enough to heal.

How to begin healing

Until we address the underlying causes that contribute to illness, will we then find complete healing. Like in the headache example, Aleve or Tylenol can relieve pain, but so can massage and stretching. Nothing will be as effective as managing stress, however.

True health can only occur when the mind, body and spirit are integrated and healthy. It involves more than a pill and what a doctor tells you. It involves healing your body and mind. It involves honoring your emotions. It actually involves YOU. Yes, it’s complicated and takes a little more effort than a pill. But we are complicated creatures, and, in my opinion, some delayed gratification and a commitment to our well-being is well worth it for a happy and healthy life.

Share your health secrets in the comment below.

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