So I got married.  Can't say it went off without a hitch, but I would say overall it was a success.  Unfortunately all the people my wife (still getting used to that) and I paid to help underachieved (serving staff, party rental company)......and all the people we didn't pay (our closest friends) ended up overachieving and saving the day.  To them we owe our deepest grattitude.  And in times of great stress (like a wedding), your friends' true colors tend to shine. 

The honeymoon in Paris was pretty magical, with the pictures to prove it.  French food is amazingly good and constipating, and the insane amount of walking gave me horrible back pain.  I find it unbelievably ironic that these were the 2 medical issues I addressed in my previous blog entries. 

So I'm back at work now, and it's that time of year again.....colds, coughs, flu.  I don't mind so much though because they're pretty easy cases.  I've started to be able to sleep well at night again and the increase in patient load doesn't seem so bad yet.

Big recall on pediatric cold medicines announced a couple days ago.....creating a good amount of panic amongst the general public.  It doesn't mean Dimetapp is gonna kill your kid, just means that a lot of people don't know whats the right dose for an infant, and they'd rather not mess with it all together and avoid any further overdoses and possible bad cases.  So if you got a kid under 4, you're gonna have a problem getting cough or decongestant medicine for his/her cold.  Not a bad thing though, cuz to be honest, cold medicine just temporarily controls the symptoms anyway.  They'd get better with their cold with that age-old remedy......time.  Air vaporizers are good too......and saline nasal sprays.

All I can say is wash your hands, wear air filter masks, don't hang out with sick people, stay away from kids, and live in a bubble.  Otherwise, suck it up, realize you're gonna get a cold every once in a while, realize that it'll build up your immune system, and go drink some fluids and take some Airborne.  And if you're feeling really crappy....go see your doctor.....they got that magical thing called........a work/school excuse note.  Please....if you're sick with a cold.....stay home please.  Don't get everyone else sick.  Because then they come to me....and I get overworked....and my immune system goes down....and then I get sick.  And since we're ridiculously understaffed....I'll still have to work....and I'll get other people sick.  And then they'll get other people sick, and they'll come to me.  You see this nasty cycle here?

The French have it better......they seem to have more sick days.  Ok....au revoir till next time.

As anticipated, my shift yesterday (day after Labor Day) was ridiculously busy and painful. 

141 patients.  Not the most patients we've ever seen in one day.....but still not a whole lotta fun.  I knew it was coming, it always happens after a 3 day weekend.....especially Labor Day and Memorial Day weekends.  I'm not gonna make too many assumptions, but I have a sneaking suspicion that the large amount of alcohol consumption has something to do with it.  What I have got to figure out is how to get out of always working the Tuesday after those long weekends.  Its brutal.

So I get a variety of complaints yesterday....but mostly nausea, vomiting, abdominal pain, diarrhea.  I look at these patients....and its one of those "you know that I know that you know that I know" why you're here.  But I'm a nice guy.  I call it a stomach flu and I'll give you a day or two off work excuse.  It's sad.....I have the power of the work excuse but I can never use it on myself.  I guess that would be an abuse of a power i've been entrusted in by the forces above.  But on to better and more educational issues.

Okay....so I see a lot of back pain.  It's real common.  People get it all the time sometimes for good reason (lifting heavy objects), but usually for no reason at all (at least to them).  They don't understand why all of a sudden their back is sore.  Some people say all they did was bend over to pick up a feather, and it causes sudden excruciating pain.  Why does this happen?  It was only a feather!  Some people don't even have any event that precipitates it, it just started hurting.  So why?

I can't say for certain for every case, but I can say that a majority of the time......it's for a few basic reasons:

1) You're overweight.  I hate saying it (I actually never say this to patients...I say..."you need to lose a few pounds").  It's got such a bad stigma.  I'm not saying that I think all patients should look like Paris Hilton (although that would make my job perhaps a little more enjoyable), I'm just saying you know when you're overweight.  And that means the more belly fat you got, the more your back muscles have to support it to keep you upright like a Homo Sapien.  But I've been a little heavy my whole life you say, why would it start hurting now?  Because after the X amount of years that your back muscles have been supporting your gut (or ginormous boobs), they're finally getting tired.  Your lower back muscles have done as much as they can through your childhood and adolescence when you were packing in those double quarter pounders and supersize Cokes.

Solution A:  Obvious. Lose weight.  Easier said than done.  I know.  Here's a couple guidelines.  Stop drinking regular soda.  You know how many calories are in a can of soda? Let's just say about 4 cans of regular Coke is about the same amount of calories for a regular meal for an average sized woman.  So if you only drink a 12-pack of Coke a day, you're good (albeit probably a bit hyper with bad teeth).  Excercising might help.  I mean I'm not saying go train for a marathon, but a little something 2-3 times a week doesn't sound unreasonable does it?  Oh and one thing about exercise.......if you're a big cat, go easy on the knees ok?  You may be motivated, but it doesn't mean you should be jogging a mile a day.  You're just gonna pound the cartilage in your knees to a pulp.  Let's try something a little easier on the joints, like a stationary bike, or elliptical machine.  Actually, the best exercise you could do is swim.  And yes, the thought of you being at the neighborhood gym in a bathing suit not looking your best is not one you particularly cherish......but it is the lowest impact exercise I can think of.

Solution B: Okay....don't lose weight.  Your lower back muscles can handle your weight if you train them to.  Do lower back extension exercises.  Most people ignore this simple machine at the gym for mostly one reason.....it doesn't do anything for you cosmetically.  Nobody ever says.....look at how defined those lower back postural muscles are on that guy!  The arms/shoulder/chest/lats/abs get all the glory.  They're the sexy muscles.  Even calf muscles get a better rap than lower back muscles.  But if you wanna help your back pain, those 20 inch biceps ain't gonna do nothing for ya......except to lift up that bottle of Motrin.  Do you know what a lower back machine looks like?  Its the one with the pads you set your front hips on and you hang your upper body off of in a reverse V position.....kinda like you're ready to take a spanking.  I think thats also why people don't like using it.  Start off just raising your head from the ground slowly until your back is straight.....and keep doing it (slowly) until your lower back starts to feel the burn.  Do that 20 reps, 3 sets, maybe once a week......and you'll see how much better you'll feel in a week or two.  Keep in mind though, if you're totally abject to losing any weight, you're gonna hafta have some pretty damn strong lower back muscles to support ya.

Okay....back to the reasons for back pain.....

2) You sit at your desk at your job for 8 hours a day in front of your computer.  I'm lucky....the only time I really sit in front of the computer any extended period of time is to enter billing charges for patients (takes about 10 seconds per patient), check my stocks (not that many I assure you), and now....to blog.  If you're sitting in front of your computer for 6-8 hours my guess is that your posture is not so good.  Most people hunch over when they're on a computer.  I am right now.  Hours upon hours of that position equals.....your poor lower back muscles trying to keep your head from flopping over and hitting the keyboard.

Solution:  Get a lumbar roll.  Or just some sort of cushion to put on the small of your back so that it forces your spine to be straight when you're sitting there at work pretending to be working but actually playing Minesweeper.  (I guess people don't play Minesweeper anymore.....is it Bejeweled now?)  I don't know.

Okay there's much more to back pain than that.  Certainly if you're a female you should be a little more concerned if your back pain is your kidneys acting up and so you should pay attention to a fever or if you feel icky (can't really put it better than that).  But that's the best I can squeeze in for basic back pain for one day.  I still hafta work today......but last shift until the wedding and the honeymoon.  Thank goodness.

Okay.....I'll think of something else to medical blog about later....but if anyone has suggestions, I'm down.

Peace......Dr. Crump

(Oh I can't really crump.....I just fake it from what I see on "Stomp the Yard")