How Can I Find a Good Doctor?

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Finding a doctor is serious business—whether you’re looking for a primary care physician, a specialized doctor, or even a dentist—picking the one who’s right for you is critical. Unfortunately, it’s not as easy just checking into Yelp and finding out who has five stars. Web sites like Health Grades, Doctor Finder, and RateMDs do exist, but most physicians suggest these ratings aren’t a good representation of a doctor’s skill. Instead, to find a good doctor, you’ll have to do some legwork.

Decide What Kind of Doctor You Need

We all need a different kind of doctor at different times of our lives. If you have special medical needs, you might even need a specialist, or at the very least, a primary care physician who has experience with your needs. Even still, speaking with Dr. Pamela F. Gallin, The New York Times notes that your best starting place might be a primary care physician:

“Do you have special medical needs, such as cardiac problems or rheumatology problems, or do you just need routine checkups? Do you have diabetes? Does your lifestyle put you in a certain category of risk?”

While some internists have additional training in cardiology or rheumatology… primary care physicians also have a network of trusted specialists for referrals.

You want to find a doctor that suits your medical needs, and who has dealt with your issues before. If you’re completely stuck on who to go to, a primary care physician is a good starting point because they can refer you to a specialist.

–Thorin Klosowski, Lifehacker

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Generosity: What’s in It for You?

Link: Volunteer for SARDAA

Generosity is no longer the selfless act we’ve long thought it to be. Studies now suggest that one of the biggest benefactors of generosity is the person who is dishing it out.

Like a healthy diet, exercise, and good genes, generosity may increase your life span. A 2003 research study at the University of Michigan reveals that the positive effects of generosity include improving one’s mental and physical health and promoting longevity. In another Michigan study, which traced 2,700 people over 10 years, researchers found that men who did regular volunteer work had death rates 2.5 times lower than men who didn’t. Generosity can help reduce stress, support one’s physical health and enhance one’s sense of purpose.

So what is it about generosity that makes it so vital to a happy and healthy life? First, it’s important to note that the form of generosity that most benefits us isn’t measured in a dollar amount or a physical gain. What matters is the sensitivity we offer another person. The more directly we see our personal efforts impact someone else, the more we gain from the experience of giving.

The second direct benefit we gain from giving is that generosity inherently shifts our focus off of ourselves. While it’s important to maintain a healthy level of self-awareness and sensitivity to oneself, often the focus we put on ourselves is filtered through a negative lens. Many of our thoughts about ourselves are tinged with criticism, stress, doubt, uncertainty and obsession, none of which do any good for our level of confidence and success.

People often mistakenly assume that being self-centered means being egotistical or vain. However, being self-centered can mean spending too much time listening to a “critical inner voice” inside our heads that critiques our every move and tells us we are failing in one or another area of our lives. Generosity distracts us from the scathing insults of this inner voice while creating quite a strong argument against it. It is difficult to prove we are worthless when we are watching someone else benefit from our actions.

Generosity is a natural confidence builder and a natural repellent of self-hatred. Not only does it make use feel better about ourselves, but it actively combats feelings of isolation and depression. People who battle depression have been shown to benefit from volunteering, as it gives them a sense of value and purpose while placing them in a social environment.

–Lisa Firestone, Huffington Post

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Modern Love–Providing Comfort When a Cure is Out of Reach

THE first time my younger brother, Takkin, said his teeth were falling on the floor, my family was concerned, but we believed it was a passing manifestation of anxiety from the dental surgery he had recently been through.

When he complained that his teeth were sliding down his throat and that he didn’t have a mouth, we exchanged uncomfortable looks. But when he started walking around with a mirror in his hand and his finger in his mouth for days on end, we knew hoping for the best was no longer sufficient.

Within six months, Takkin had lost both of his jobs and had become violent at times, throwing dishes and grabbing the steering wheel and swerving the car when riding with my parents.

“You’re not doing anything to help,” he’d scream at them. “I’m in pain. My teeth are gone. You don’t care.”

My parents took him for consultations to see if other dentists recommended more procedures to deal with his mouth pain, but it was clear to me this was no longer about dentistry.

“Enough,” I said to my parents. “We need to consider psychiatry.”

By TARA EBRAHIMI, The New York Times

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Is It Bipolar Disorder or Drugpolar Disorder?

With prevalence rates as high as 50%-70%, substance abuse is highly prevalent in patients diagnosed with bipolar disorder. [1,2] As such, bipolar disorder and substance use disorders are often considered to be comorbid with the primary or leading diagnosis, on the basis of the patient’s ability to recall whether emotional lability pre- or postdated their use of substances. Because bipolar disorder and substance-induced mood disorders can acutely present in an identical manner; differentiating between the 2 can be very difficult, if not impossible, when mood lability is manifested. [3-5]

As a medical expert for the Social Security Administration for over 25 years, I have had the privilege of reviewing thousands of medical records with the directive to determine whether substance abuse is a material factor leading to mood lability when another axis I diagnosis has also been made.

What I have learned over the years has firmly changed my thinking on the determination of the impact of substance use disorders on mood lability. I have come to appreciate that there is little to no value relying on a patient’s recollection of when their emotional lability began, because memories falter and substance abusers invariably lie about their history of substance abuse. The diagnosis of a substance-induced mood disorder — drugpolar disorder, for short — should always be considered in patients with mood lability because it may be the primary, and possibly the only, true diagnosis.

–Nathan R. Strahl, MD, PhD, Medscape.com

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Preventing Impaired Driving During the Holidays

So how do we keep people who’ve consumed alcohol off the roads during the holiday season? If it’s not you who’s had a drink or two, it’s a loved one, a friend, or a coworker. Maybe the person is noticeably inebriated. If so, intervening is usually pretty easy. You simply take away the individual’s car keys and say something along the lines of, “Hey, buddy, you’re drunk. Why don’t you call a cab or ask someone who’s not drinking take you home?”

The situation can be more difficult when the individual who’s been drinking is not noticeably impaired. A “buzzed” person is much less likely to voluntarily relinquish his or her keys. He or she may say, “I’m fine. It’s no problem.” Sometimes buzzed people — foolishly and mistakenly — argue that they’re better drivers after a couple of drinks because “they’re on their toes, paying attention because they don’t want to get pulled over.” The fact that they can make that argument with a straight face is a pretty good indication of how clouded their judgment actually is! One useful trick is to remind these folks that local law enforcement agencies nearly always step up their drunken driving patrols during the holidays. You can even outright lie if you need to, saying something like, “My pal the police officer told me on the sly that they’ve set up roadblocks tonight.” The fear of arrest will cause most people, even buzzed people, to exercise caution.

Happily, there are numerous other steps you can take to protect buzzed and/or drunk individuals from their own bad judgment. Most of these steps involve setting ground rules for the party in advance. For instance, if you’re throwing an office party that includes booze, make it a rule that to get your first drink you must relinquish your car keys, and make sure everyone knows the company will pay cab fare or otherwise provide rides so drinkers can get home safely after the party. At family gatherings and neighborhood parties, make sure everyone knows up-front that anyone who drinks, even a little, will not be allowed to drive home. Ask around before the party to find out who doesn’t drink — there will be more people than you think — and enlist them as designated drivers. If you have teenagers with driver’s licenses, hire them as a taxi service. You’d be surprised how much fun they’ll have babysitting the “sloppy” grown-ups! Plus, it’s a great way to subtly teach “monkey see, monkey do” kids a lesson in responsible drinking.

Of course, even with precautions, someone will get behind the wheel of a car having had one drink too many. Hopefully the worst that will happen is he or she ends up in jail for drunk driving. If this person has an obvious problem with alcohol, this is an excellent time to leverage their predicament by refusing to bail them out until they agree to go straight into a treatment center, or at least to a certain number of AA meetings. You might consider planning an intervention when the rest of the family is in town. Most alcoholics need to hit a “bottom” before they become willing to face their problem, and for many the humiliation (and expense) associated with an arrest can serve as the needed catalyst. If you truly care about this person, now is the time for action.

 –David Sack, M.D., Huffington Post

In the wake of another horrific national tragedy, it’s easy to talk about guns. But it’s time to talk about mental illness.

Three days before 20 year-old Adam Lanza killed his mother, then opened fire on a classroom full of Connecticut kindergartners, my 13-year old son Michael (name changed) missed his bus because he was wearing the wrong color pants.

“I can wear these pants,” he said, his tone increasingly belligerent, the black-hole pupils of his eyes swallowing the blue irises.
“They are navy blue,” I told him. “Your school’s dress code says black or khaki pants only.”
“They told me I could wear these,” he insisted. “You’re a stupid bitch. I can wear whatever pants I want to. This is America. I have rights!”
“You can’t wear whatever pants you want to,” I said, my tone affable, reasonable. “And you definitely cannot call me a stupid bitch. You’re grounded from electronics for the rest of the day. Now get in the car, and I will take you to school.”
I live with a son who is mentally ill. I love my son. But he terrifies me.
A few weeks ago, Michael pulled a knife and threatened to kill me and then himself after I asked him to return his overdue library books. His 7 and 9 year old siblings knew the safety plan—they ran to the car and locked the doors before I even asked them to. I managed to get the knife from Michael, then methodically collected all the sharp objects in the house into a single Tupperware container that now travels with me. Through it all, he continued to scream insults at me and threaten to kill or hurt me.
That conflict ended with three burly police officers and a paramedic wrestling my son onto a gurney for an expensive ambulance ride to the local emergency room. The mental hospital didn’t have any beds that day, and Michael calmed down nicely in the ER, so they sent us home with a prescription for Zyprexa and a follow-up visit with a local pediatric psychiatrist.
We still don’t know what’s wrong with Michael. Autism spectrum, ADHD, Oppositional Defiant or Intermittent Explosive Disorder have all been tossed around at various meetings with probation officers and social workers and counselors and teachers and school administrators. He’s been on a slew of antipsychotic and mood altering pharmaceuticals, a Russian novel of behavioral plans. Nothing seems to work.
–The Anarchist Soccer Mom

Mass Disasters, Trauma and Loss

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Some individuals are more vulnerable to serious stress reactions and lasting difficulty, including those with a history of:

  • Other traumatic experiences (such as severe accidents, abuse, assault, combat, etc.)
  • Chronic medical or mental illness
  • Chronic poverty, homelessness, unemployment, or discrimination
  • Recent or earlier major life stressors or emotional strain (such as divorce or job loss)

People affected by disasters should try to:

  • Focus on what’s most important to themselves and their families TODAY
  • Try to learn and understand what they and their loved ones are experiencing, to help remember what’s important
  • Understand personally what these experiences mean as a part of their lives, so that they will feel able to go on with their lives and even grow personally
  • Take care of themselves physically, including exercising regularly, eating well, and getting enough sleep, to reduce stress and prevent physical illness
  • Work together with others in their communities to improve conditions, reach out to persons who are marginalized or isolated, and otherwise promote recovery

How would I decide if I need professional help? If after the end of a disaster, these normal experiences do not slowly improve or if they worsen with time, it is helpful to find professional support:

  • Intrusive re-experiencing (terrifying memories, nightmares, or flashbacks)
  • Unsafe attempts to avoid disturbing memories (such as through substance abuse or alcohol)
  • Complete emotional numbing (unable to feel emotion, as if empty)
  • Extended hyperarousal (panic attacks, rage, extreme irritability, intense agitation, exaggerated startle response)
  • Severe anxiety (paralyzing worry, extreme helplessness)
  • Severe depression (loss of energy, interest, self-worth, or motivation)
  • Loss of meaning and hope
  • Sustained anger or rage
  • Dissociation (feeling unreal or outside oneself, as in a dream; having “blank” periods of time one cannot remember)

–International Society for Traumatic Stress Studies (ISTSS)

 

Psychological First Aid

(PFA)—NCTSN and the National Center for PTSD provide an evidence- informed approach for assisting children, adolescents, adults, and families in the aftermath of disasters and terrorism. The manual includes handouts and tips for survivors and providers and can be downloaded in English, Spanish, Japanese, or Chinese. http://www.nctsn.org/content/psychological-first-aid

Our Most Sincere Sympathy To All Who Are Grieving After the Newtown, CT School Shooting

How To Talk To Your Kids About The Conn. Shootings

by SCOTT HENSLEY, NPR

When acts of violence against children become national news, it’s natural for kids to worry and wonder what it means for them.

So amid the coverage of the shootings in Newtown, Conn., that have claimed the lives of 20 schoolchildren, what should parents do for their kids?

“The key thing is limiting their exposure to news media, TV,” says Dr. Daniel Fagbuyi, medical director for disaster preparedness and emergency management at Children’s National Medical Center in Washington, D.C. “We’ve found this over and over in different disasters.”

Kids, especially older ones, will have questions. “You do have the dialogue with them about it,” says Fagbuyi, a pediatric emergency specialist.

Be ready to give reassurance and support. “You want to make them feel secure,” he says. ” ‘Yes, this happened. It was wrong, but here’s what we’re doing to protect you.’ ”

guide from the federal Substance Abuse and Mental Health Services Administration has advice tailored for kids of varying ages.

Infants and toddlers can’t really grasp the details of a traumatic event like this one. But they’re highly attuned to adult caregivers’ emotional reactions and may echo them. Be aware of that.

Preschoolers can understand the basics. “Keep the message simple,” Fagbuyi says. Reassure them, but don’t lie.

Grade-school kids are smarter and more mature, he says. “Be honest with them,” he says. Children this age can handle the facts, but don’t make the details too specific. They may be afraid. “Ascertain what are their fears and then address them,” he says.

Fagbuyi says parents can share their own feelings with kids this age, too, but be sure to explain what adults are doing to keep children safe.

For older children, their own emotional development can come to bear on how they make sense of the news. Some teens may reflexively say everything is OK, even when it’s not.

“For high-schoolers, you have to be upfront and candid,” he says. “They’ll act out. They may be angry.” Let them know it’s all right to express their feelings. “Help them do it in a healthy way that’s not all bottled up.”

If you’ve got older kids, be with them when they are getting information about the shootings from the TV, radio or Internet. Let them ask questions and talk about the coverage. Don’t let them overdo either the talking or the media monitoring.

http://www.npr.org/blogs/health/2012/12/14/167269582/how-to-talk-to-your-kids-about-the-conn-shooting