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The good thing about the modern world is the improvement in the distribution of research results. Before the internet came along, the only way of keeping up with all the latest scientific work in your field was to pay a subscription. This would bring the copy of the latest printed journal to your door. So expensive were these journal subscriptions that hospital libraries would buy in all the journals and make them available to staff. If you were a doctor in practice on your own, the only good thing about this system was the subscriptions were tax deductible. But there has been a change. Although many journals are still behind pay walls, i.e. the same high subscriptions are still in place, an increasing number now make free copies available online. Sometimes this is only the abstract. A pleasing number of times, you get a full report of the research and its findings. Doctors hate this because, in some cases, you may know as much as them. After all, it’s your body and if there’s something wrong with it, you are motivated to find out more about your own problems.

There’s an unfortunate problem called Chronic Obstructive Pulmonary Disease (COPD). This is a long-term problem with your lungs. It may start off minor, but it steadily worsens and makes it harder for you to keep breathing. At first, it sounds and feels like asthma or bronchitis. Your chest feels tight, there’s that terrible wheezing, you grow short of breath and cough. For those of you who like statistics, COPD is the cause of 10% of all hospitalizations. It’s the fourth most common cause of death in the US.

Because this is a really serious problem, the standard treatment in a hospital or clinic has been corticosteroids delivered intravenously. This is one of those shock and awe treatments. To be honest about it, IV lines are quite painful, inconvenient and risky. Once in place, they deliver what, by most measures, are high doses of the drug for a relatively short period of time: usually between one and two days. Overall, this leads to longer periods of stay in hospital and, for the benefit of the hospitals, justifies a higher bill. If you have one, you are relieved you have a health insurance policy. If not, you hope the credit card will absorb the bill. Read the rest of this entry »

When the sun is shining it’s easier to think everything is right with the world except, no matter what the weather, life is never straightforward. It can be a little like the training courses you see in the movies for rookies to go through. Whether training for the police force or the military, we have to be able to run when necessary, jump, and shoot the terrorists and not the good guys. For those who are good at it, this is both exciting and fun. There’s a satisfying challenge in getting through to the end with the maximum points scored. But for ordinary mortals, this can be a terrible trial. Bits of us wobble when we run and we have never been good at jumping. Most of the time it feels like the rest of the world is shooting at us. These feelings point to negativity in our lives. This makes it hard for us to enjoy the good things when they come along. When you feel more positive about yourself and your life, it’s easier to be happy.

The negativity can be both inside us and directed at us by strangers, colleagues and supposed friends alike. One of the first signs of internal tension is when we start to grumble. This is showing our unhappiness. More importantly, we may be taking the first steps to becoming our own worst critic. This is like turning off the light. A simple flick of the switch plunges us into darkness. Yet, so long as we have not moved, it’s easy to reach out again and turn the light back on. Easy in the sense of a physical action. But the mind does not always cooperate. It’s a bit like sailing one of these giant container ships or oil tankers. While they are under full power, they cross oceans fast, but they take forever to respond to the wheel and turn. Stopping them takes miles of sea. In the other direction, it takes enormous energy to get them to move from their moorings. That’s why you always see clusters of tugs towing them out of port. Without that outside help, these giants would never get started. That can be our lives. Some of us are not for turning. Some of us find it so hard to stop. Cognitive behavioral therapy can show people how to deal with negativity. It will always be a struggle, but it’s possible to sail ships around the world. It’s the same when it comes to dealing with negativity from others. If you learn coping strategies, you can respond more positively when people make suggestions or offer advice. Learn this is not necessarily hostile criticism. Read the rest of this entry »

When the sun is shining it’s easier to think everything is right with the world except, no matter what the weather, life is never straightforward. It can be a little like the training courses you see in the movies for rookies to go through. Whether training for the police force or the military, we have to be able to run when necessary, jump, and shoot the terrorists and not the good guys. For those who are good at it, this is both exciting and fun. There’s a satisfying challenge in getting through to the end with the maximum points scored. But for ordinary mortals, this can be a terrible trial. Bits of us wobble when we run and we have never been good at jumping. Most of the time it feels like the rest of the world is shooting at us. These feelings point to negativity in our lives. This makes it hard for us to enjoy the good things when they come along. When you feel more positive about yourself and your life, it’s easier to be happy.

The negativity can be both inside us and directed at us by strangers, colleagues and supposed friends alike. One of the first signs of internal tension is when we start to grumble. This is showing our unhappiness. More importantly, we may be taking the first steps to becoming our own worst critic. This is like turning off the light. A simple flick of the switch plunges us into darkness. Yet, so long as we have not moved, it’s easy to reach out again and turn the light back on. Easy in the sense of a physical action. But the mind does not always cooperate. It’s a bit like sailing one of these giant container ships or oil tankers. While they are under full power, they cross oceans fast, but they take forever to respond to the wheel and turn. Stopping them takes miles of sea. In the other direction, it takes enormous energy to get them to move from their moorings. That’s why you always see clusters of tugs towing them out of port. Without that outside help, these giants would never get started. That can be our lives. Some of us are not for turning. Some of us find it so hard to stop. Cognitive behavioral therapy can show people how to deal with negativity. It will always be a struggle, but it’s possible to sail ships around the world. It’s the same when it comes to dealing with negativity from others. If you learn coping strategies, you can respond more positively when people make suggestions or offer advice. Learn this is not necessarily hostile criticism. Read the rest of this entry »

It’s estimated there are about four million people with Obsessive Compulsive Disorder (OCD) in the US. This is a disorder where people find their lives dominated by repeated behavioral patterns and rituals, and it’s often associated with depression. According to the International OCD Foundation, the disorder mainly affects adults with only about 2% of children and teens at risk. One of the difficulties faced by those who suffer this disorder is the element of social shame. As the condition progresses, the rituals become more dominant and so harder to hide in everyday life. Take insecurity about whether a door is properly closed. Around the home, it might not be immediately obvious that one family member is now opening and closing doors “just to make sure”. But, as the pattern develops, it will slowly reveal itself to the others who share the same space. This is not something that would immediately spread outside the home. We can lives our everyday lives without feeling responsible for checking that all the doors we pass are properly closed. The difficulty is that, once one ritual is established, others can follow. It can therefore become necessary either to explain or suffer the bemusement of people outside the home. Left untreated, this can lead to social anxiety disorder or, in the worst cases, agoraphobia.

Individual therapy is considered the best long-term hope for those with OCD. As the disorder is becoming better understood, not the least because of TV programs like Monk, it’s easier to admit the disorder and feel less hostile judgements. There are also an increasing number of support groups being established as more people with the disorder reach out for fellow sufferers and establish a network for self-help. Read the rest of this entry »