Showing posts with label Pulmonology. Show all posts
Showing posts with label Pulmonology. Show all posts
Saturday, December 29, 2012

Physician Heal Thyself


Let's face it, as physicians, we make the worst patients! I don't have high blood pressure! Eh, I'll go on a statin next year. My blood sugar isn't that high! Let me put off my colonoscopy until next year. And I'm not any better! For years I was struggling with fatigue. I blamed it on everything else outside of me—my job is too stressful, I have to wake up too early, I was on call, etc. And for years, my wife kept urging me to get a sleep test. There's no way I have sleep apnea, I reasoned to myself, I'm not overweight, I exercise daily, and I don't snore (at least not that badly). Finally, when I could take the fatigue no longer, I acquiesced and got my sleep test done. After the test was over, I felt stupid! There's no way I have sleep apnea! What a complete waste of time! There goes a hugh deductible thrown out the window. The next day, the result came back: I stopped breathing over 80 times that night!

Wow!

Yet, in a way, I was totally relieved! There was a possible cure for my fatigue. The first night I started using the CPAP machine, my brain started making up for years of lost sleep!—I had a crazy and vivid dream about standing on an cliff beside a frothing ocean teaming with sharks. It was so cool! That's when I realized that this was my first dream in years! YEARS!

Now I'll admit it... Using a CPAP machine is not the world's sexiest thing. But, since I am a Star Wars fan, there is something really cool about looking like a Kotobukiya Star Wars TIE Fighter Pilot! And beside, my kids dig it (and I like to chase them around the house with my mask on).


Of course, I'm just exaggerating—the mask and machine are much smaller than I anticipated! Frankly I was shocked by how far technology has come. And the CPAP machine is no bigger than a "breadbox" (whatever the hula hoop that is). It's a cinch to take on vacations.

So the take-home-message for me is this: Physician heal thyself! Before I can heal others, I need to work on healing myself first. 

So good night and pleasant dreams! Oooooooooo... SHARKS!!!!  
Monday, July 30, 2012

Refills on Albuterol Inhalers

Each albuterol inhaler has 200 puffs. And since we advised patient to give themselves TWO puffs per treatments. There are about 100 "treatments" in one inhaler. Knowing this, I rarely give out more than 1 inhaler at a time (and I rarely give refills). The reason is that I can use the patient's refill history to give me a rough estimate of the patient's asthma control. If the patient is requesting a refill of their albuterol inhaler every three months, that means they are using their inhaler on the average 1 to 2 times a day (definitely not in control). And if they are requesting their refill only after one month, that means that they are using their inhaler at least three times a day! Yikes!