I am a big fan of having people eat a healthy diet. The best of all possible worlds, doctors would know more about diet and have the time to talk with/educate their patients about this. Additionally everyone would have access to a nutritionist/Registered dietitian and access to healthy foods. Lastly, people would not buy into fad diets or believe all of the mis information out there. Here is a list of some things to keep in mind.
Sleep disturbances are common. Sometimes patients have come in with sleep problems that are clearly related to temporal issues (such as stressors like a death in the family, work stress, etc).
It is the people that come in with chronic issues which I think are challenging. Some patients have come on while on medications chronically to help with sleep. One concern is that they end up being too dependent on medications to sleep. When seeing things like this, it makes me wonder if patients on sleep medications chronically are altering their sleep architecture enough that it still puts them at risk for things.
Some sleep issues, such as obstructive sleep apnea, do put one at risk for things like high blood pressure, irregular heart rhythms, etc. luckily for that things like weight loss, CPAP machines, etc can help without the use of medications. This article does make the case for getting good sleep regularly!
What goes in your stomach can influence countless disorders, from cancer to asthma. Dr David Johnson surveys the latest data underlining the ever-increasing importance of a low-fat, high-fiber diet.
Anyone who’s been reading my blog probably won’t be surprised by my linking to this article (you may have to subscribe to medscape to read the full article).
Basically, the gist is that diet effects the kinds of bacteria in one’s GI tract. The good kinds of bacteria (that promoted by a low fat, primarily plant based diet) helps reduce risk of diseases like colon cancer, breast cancer (the former by producing short chain fatty acids and the latter by altering the reabsorption of estrogen that has been chemically altered by the liver and secreted into the GI tract).
Just something to think about.
I came across this article in linkedin. It’s an interesting idea because when a physician uses the term “challenging patient” (s)he is likely referring to one of two kinds of patients. One kind is one with a lot of health problems, some of which interfere with the treatment of others (or perhaps just a couple complicated health issues). However it is often used to refer to patients who are hard to reach/not very compliant/have poor insight to how their behavior affects their health.
Many times I ask myself how did the latter kind of patient get to where they are. I haven’t yet used this with any of my patients, but it does seem like an interesting way to help patients.
Fairly often I see articles claiming sugar causes cancer, or that something else causes it. I figured I’d post this for people to read.
As someone who’s learned some Brazilian Portuguese (and still has a lot to learn), something like this has been on my mind for a while. One of the things that us physicians are supposed to have is cultural competence. I think that before I started learning Portuguese, when I heard the term Latino/a or Hispanic, Spanish speakers typically came to mind. Granted I realized that encompassed people from many places as cultures (a patient of Puerto Rican decent who’s family has been in the U.S. Mainland for a generation or two might not have all of the same concerns as people who came from Columbia, Peru or Mexico).
Even people who come from the same country might be very different, though more similar to each other than they are to the ‘average’ american. In this I think of people from China where there are many languages and dialects spoken. Even in the U.S., someone who grew up in New England might have a much different outlook than someone who grew up in the Mid West or South East of the U.S. They might have different dietary proclivities as well.
Does that mean it’s useless or futile to try to be culturally competent? No. But it does make it more interesting at times. I think it just means keeping an open mind and remembering people from other cultures might have different expectations of time, needs from their physicians, etc. It is also helpful to know who a patient might – or would – rely on for decisions and for help. What might be considered to be “on time” for an appointment for a physician, might not be for someone where the sense of time is more fluid.
Another reason for being culturally aware – and here I am also including having a knowledge of a country’s or ethnic groups history – is risks for certain diseases. For example, if one doesn’t know much about the colonization of Cape Verde, one might not know to test a patient for Cystic Fibrosis mutations in a couple who are concerned about genetic diseases before getting pregnant. In Jewish populations, one might think of Tay Sachs as being a “Jewish Disorder”. However the genetic disorders jewish patients who trace their ancestry to Spain prior to 1492 (Sephardim) or to the near east (E.G., Persia) actually mirrors the countries they come from (For example,they can carry mutations for certain forms of Muscular Dystrophy). Knowing this kind of history helps inform decisions about testing and treatment.