Risks in Medical Care: Understanding Benefits and Harms

The Dr Synonymous Show Tuesday January 31 8-9 PM ET on Blog Talk Radio.

You're welcome to join us as Dr Jonas, your host on The Dr Synonymous Show, reviews two patient blogs, Medical Mojave-Why Everything Tastes Like Soap to Me: The Correlation Between Hyperolfaction and Adrenal Insufficiency  and Anaphylaxing-Still Friable
 as is our tradition before introducing:

Daniel E. Jonas, MD, MPH Associate Director RTI-UNC EPC* and Assistant Professor, Division of General Medicine, UNC-CH will be our special guest.  He will clarify and expand on Risks in Medical Care, including comments on ethical aspects of patients and physicians communications about benefits and harms of medical diagnostic and therapeutic practices and procedures.

We're currently being exposed to confusing health statistics that make clinical decision making much more difficult and costly than need be.  What are some ways this is happening?  How might we patients and physicians get more clarity and better understanding of health statistics that impact our decisions?

We'll review these issues and many others on this show which is stored as a pod cast to download or listen to 24/7 shortly after completion of the live show.

Join us live via the chat room which enables continuous listener participation (if you have a BTR listener registration-which is easy and free).

Confession:  Dr Jonas is my son (of whom I'm quite proud) so I may be biased (or we may have a few family comments during the show).

*Research Triangle Institute International- University of North Carolina at Chapel Hill Evidence-Based Practice Center

"Peace in Vietnam" 39th Anniversary: Reconciling the Memories

This date pops up once a year.  I reflect and comment to many of my patients about the significance of the date, usually feeling a sense of relief.  Then, I reflect on the aftermath of the "Peace Accords" as noted below.  Then I think again of twenty West Point classmates from the Class of 1968 who died as a result of the Vietnam "Conflict", honored and forever remembered on The Wall, The Vietnam Veterans Memorial. And I feel the sadness and wonder if their loss and the whole Vietnam experience has been reconciled in the individual and the national brain of those touched by the "Vietnam era".

Classmates wrote about Vietnam experiences and the fallen as part of Both Sides of the Wall,  Reflections of the West Point Class of 1968 , written as part of our 40th reunion celebration.  Sandy Cohn wrote in "The class of 1968 Remembers Posterity is Their Ally" of gathering at The Wall: 

"...perhaps it is a combination of pride, grief, and bitterness that makes the memories so emotionally draining, that makes the inanimate Wall so animate. ... We knew these things, and yet how many among us- having now lived long enough to know regret- regret having served in Vietnam ?

Words were spoken (at the Wall), but symbol surpassed ritual as pride mixed with pain....

They knew they might die young.  They assumed they would be remembered by loved ones.  They never dreamed, amid the divisiveness and bitterness of the times in which they died, that their nation would one day immortalize them on a gray granite wall in Washington....Posterity is their ally."

In reference to the fallen, Dutch Hostler wrote in "Dedicating the Wall" :

  " In stoic silence stood that dour day upon a matted, misty mourning national "front lawn", and heard the coursing lofty words...muttered, uttered, whispered, spake and shouted out...by us...about us...and them...and us...while silent echoes answered all.  And saw the yawning black and granite gash that tallied up the cost.  A void that bleeds a list of names...of lives untimely lost.

   An off'ring scorned...but no less nobly put than those that stand in stone at Bunker Hill, Bastogne, Inchon, the Arizona...sites most intimately known...to muted lips...and them alone.    

   And dry was I in throat and eye, the words well meant caroming near...but missed the mark.

   Weeks later, the hoopla, din and crowds dispersed, I went alone to find again a friend I'd lost, last seen in jungles green a half a world away.  And he, the Wall and I...we wept." 

From Wikipedia:  "On 15 January 1973, Nixon announced a suspension of offensive actions against North Vietnam. Kissinger and Tho met again on 23 January and signed off on a treaty that was basically identical to the draft of three months earlier. The agreement was signed by the leaders of the official delegations on 27 January at the Majestic Hotel in Paris.

The Paris Peace Accords had little practical effect on the conflict, and were routinely flouted mainly by the North Vietnamese, as well as the Saigon government, which enlarged the area under its control in 1973. North Vietnamese military forces gradually moved through the southern provinces and two years later were in position to capture Saigon.

Nixon had secretly promised Thieu that he would use airpower to support the Saigon government should it be necessary. During his confirmation hearings in June 1973, Secretary of Defense James Schlesinger was sharply criticized by some Senators after he stated that he would recommend resumption of U.S. bombing in North Vietnam if North Vietnam launched a major offensive against South Vietnam. However, Nixon was driven from office due to the Watergate scandal in 1974 and when the North Vietnamese did begin their final offensive early in 1975, the United States Congress refused to appropriate the funds needed by the South Vietnamese, who collapsed completely. Thieu resigned, accusing the U.S. of betrayal in a TV and radio address:

"At the time of the peace agreement the United States agreed to replace equipment on a one-by-one basis. But the United States did not keep its word. Is an American's word reliable these days? The United States did not keep its promise to help us fight for freedom and it was in the same fight that the United States lost 50,000 of its young men."^[12]

The North Vietnamese entered Saigon on April 30. Schlesinger had announced early in the morning of 29 April 1975 the evacuation from Saigon by helicopter of the last U.S. diplomatic, military, and civilian personnel."

[edit]

Coffee Benefits, Breastfeeding Infants, Blog Review and Transparent Risk Communication

If you want to feel good about drinking lots of coffee, this episode of the Dr Synonymous Show is for you.  If you want to get more familiar with the way numbers are used to discuss medical risks, this show might be for you, too.  Comments about patient blogs are the usual fare for Dr Synonymous.  We'll go into more depth about health literacy next week on our Tuesday night show at 8 PM.


Dr Synonymous Show January 25, 2012

Dr Synonymous starts this special morning show with comments about coffee from "Discovering Coffee's Unique Health Benefits" by Michael Downey, an article in Life Extension Jan/Feb 2012 edition.  It includes a long list of disease reduction stats related to various amounts of coffee ingestion.  Then Dr S covers a few issues in infant feeding, followed by comments about blogs by Dr Fatty and Medical Mojave.Common Sense Family Doctor blogs about the cost of having a baby.  

He introduces "Helping doctors and Patients Make Sense of Health Statistics" by Gigerenzer, et.al.,and the concept of "transparent risk communication."  This prepares the way for next weeks interview with Dan Jonas, MD Associate Director of the Center for Evidenced Based Medicine of the University of North Carolina.

Best wishes for your best health.

Holistic Health: A Day of Breath

On The Dr Synonymous Show January 10, I will review this material 

(www.blogtalkradio.com/drsynonymous)

A Day of Breath January 14, 2012 Dayton International Peace Museum

 Here is my presentation outline for this Saturday's Day of Breath presentation

"Doctor and Patient DYAD- Breathe New Life into an Aging Health Care System One Relationship at a Time" 

                                                                                                                                                                                                                                                                              

Introduction me, them and the session

Review situation in health care and where they are relative to the situation and information and skills overview. 

What have they noticed in personal interactions in health care?

                                                                                                                                                                                                                     

Overview the session and outline of information covered

HCHH: RPCDCR

Breathing:  Coherence

The Dyad

Changing System via Breathing in the Dyad

                                                                                                                                                                                                           Breathe with commenters ARPI

Presentation

               Human Centering

               The HCHH

                              Respect, Protect, Connect, Detect, Correct, Reflect

               Breathing Entry into the autonomic nervous system

                              How

               Coherence

                              Three Steps

               The Dyad

                              Roles

                                             Human

                                             Patient

                                             Doctor

                                             Teacher

                                             Learner

                                             Consumer

                                             Consumer Coach

                                             Steward of Valuable Resources

               Changing the System by Breathing in the Dyad

Exercises

Appreciation

Breathing

Coherence

Dyadic Roles

Dyadic Breathing

Dyadic Appreciation

Dyadic Coherence

Summary

The Dr Synonymous Show: New Year, New Energy on Blog Talk Radio

Dr Synonymous Review:Blog, Day of Breath, EMWave, FMRocks - Jan 04,2012

This post summarizes my Health Care Blog review and discussion, which started with patient blogs of Dr Fatty Finds Fitness, Medical Mojave, and Warm Socks. 

Physician blogs starting with Dr Mike Sevilla's Family Medicine rocks (FMRocks) who challenges us to "re-brand" for the New Year. 

Dr Jonas (aka, Dr Synonymous) is analyzIng his "coherence" with EMWave Desktop during the first 20 minutes of the show, basically getting feedback on his stress. He discusses the concept of coherence and their software (available at www.heartmath.com) that is endorsed by the PGA and used in a variety of settings, including medical and counseling environments. 

Dr Jonas introduces "A Day Of Breath" Workshop:
From the Dayton International Peace Museum Newsletter: "On January 14, 2012, 9am-3pm The Dayton International Peace Museum will be cosponsoring A DAY OF BREATH. The daylong workshop will offer an introduction and experiential exploration of many 
paths to peace and wellness through the power of human breath. A variety of healing practices will be offered. The workshop will also be a fund-raising effort to advance the Peace 240 goals. Half of the workshop fee of $50 ($25) will be a donation to the DIPM. 
Ancient wisdom meets 21st century technology in this workshop. Learn many ways of using the healing power that is most accessible - your breath. HeartMath, the phenomenal biofeedback system, Pranayama (yoga) breath exercises, Stephen Elliotʼs 
work with Coherent Breathing for achieving autonomic nervous system balance and the deep 
emotional healing of Transformational Breathwork will be just some of the practices presented. Yoga teacher, Jean E. Farkas; local Holistic Family Physician, Dr. A. Patrick Jonas; Judith Wilson, LPCC, and Qi Gong practitioner; Janet Lawson, Certified Facilitator of Transformational Breathwork, Licensed HeartMath Provider will be some of the 
presenters guiding you in a deeper understanding and experience of their work. Every participant will have two opportunities for experiential learning in a morning session and an afternoon session. You choose from a variety of sessions! Give yourself the gift of this workshop. For more information contact Janet Lawson at janetlawson@woh.rr.com."


He is especially excited about the Heartmath trainer, among others who will present and train the participants. 

Dr Synonymous blog about Spritiual Sensitivity Training in Family Medicine is discussed by Dr Jonas. He also reviews and comments on his post "Corporatizing" Hospice- More Heart Needed. Hospice management may need to get more nurse leaders in charge of hospices. 

Dr Jonas expounds on breathing and reviews the breathing and autonomic nervous system perspective of Leonard Laskow, MD in his book Healing with Love.

The Dr Synonymous Show


My weekly show airs live on Tuesday evening from 8-9 PM ET. 
Here's to a wonderful, blessed and peaceful New Year for all of you, and me,too.