biotics explained

Are you confused about BIOTICS? Is your neighbor taking more Mysterious Healthy Pills than you? We can help! We are marketers posing as scientists from Mega Super Good For You and the Planet CoreValuePoration! Look! We have white coats and ours are clean!

PROBIOTICS: These are GOOD and GOOD FOR YOU! You should take them, you should take ours! We have capsules and we stuff them full of good-for-you biotics. We don’t call them bacteria, because bacteria are gross and yuky and cause infections. You know ours are best because they are the most expensive, the health food co-op sells them, and they have to be refrigerated. Take one everyday! You can never have too many biotics in the teaming mass of millions in your gut!

Conbiotics: These are BAD FOR YOU! They are sold by the other companies. They lie. They get biotics from prisoners poop. They will turn you criminal. They will make you fight with your mother and disinherit your first born, lie, drink too much and cook meth. You will know they are conbiotics because they are cheaper and not refrigerated. And some of the biotics in their tablets are bacteria! Do you want to take bacteria? DEAD BACTERIA, they don’t even give you live ones.

Antibiotics: THESE KILL PROBIOTICS. BY THE MILLIONS. THESE ARE PASSE, OUT OF FASHION, EVIL AND YOU REALLY DON’T WANT THEM (unless you have strep throat or pneumonia or sepsis, and even then, the antibiotics suck because the sepsis mortality rate is 28-50%, THAT MEANS HALF THE SEPSIS VICTIMS DIE EVEN WITH ANTIBIOTICS, DOES THAT PROVE THEY SUCK OR WHAT?)

UNCLEBIOTICS: Now MEGA SUPER GOOD FOR YOU AND THE PLANET COREVALUEPORATION is developing THE NEWEST AND BEST BIOTICS OF ALL! UNCLEBIOTICS ARE BETTER THAN ANTIBIOTICS BECAUSE THEY ARE MALE AND UNCLES ARE MORE FUN AND RARER THAN AUNTS AND THEY ARE WAY LESS LIKELY TO HUG YOU INTO WEIRD SMELLING BOSOMS, except that uncle that wears the boa and the weight lifter uncle, too many illegal steroids, he has fine manboobs.

SUBSCRIBE TODAY TO OUR MONTHLY POOBIOTIC, WE MEAN PROBIOTIC SERVICE AND YOU WILL RECEIVE FREE SAMPLES OF UNCLEBIOTICS AS FAST AS WE CAN GET THE UNCLES TO POO AND THE RATS TO SURVIVE THE CAPSULES.

All ingredients generally recognized as safe http://www.fda.gov/Food/IngredientsPackagingLabeling/GRAS/, you should listen to us, don’t listen to your mama, she says “Don’t eat poo!” but what do mamas know, Mother’s Day is so OVER for the year and we have WHITE COATS!

Deep Vein Thrombosis

Our clinic had a band back before 2009. Me and 4 of the nurses. We were into heavy metal. This was when I was working for Port Townsend Family Physicians. The county let me go and PTFP changed their name. Could not have been because we wore our band regalia to work, right? After all, it was Halloween.

Maybe they were afraid that the songs would catch on.

Little blue pill

Don’t code in the waiting room

Evidence based BM

Probiotics make you psychotic

Better that way

Alcohol is better than benzos

Mr. Sable is Unable

Buprenorphine: better n morphine

EMR means Eat My Rear

The 18 Patient Blues

Idaho Gigolo

I played flute and saw. J played fiddle and air siren. The others, well, you should ask them. I think all the tapes got burned by the hospital. Too bad, so sad.

I can’t credit the photographer. I don’t know who took it.

Quota

Quota

honestly
I feelΒ despair
when I try
to think about the newΒ schedule

Twenty four slots
Of 20 minutes
See three people
For 40 minutes
Twenty on the schedule

UnansweredΒ questions
Wake me on Sunday morning
If I am called to a labor patient
Must I make up that clinicΒ face time?
What ofΒ holidays?
The clinic is closed.
Night callΒ is nowhere addressed
Will they hire more and more
Who don’t take call
Until I am the last woman standing
Red rimmed eyes staring
Numb with fatigue

What of my nearly deaf patient
WhoΒ reads lips
May we take forty minutes?
All the fairly deaf elderly?
New parents, anxious
Questions pour out like
Coins from a jackpot win
What of the tearfulΒ brokenhearted
And anxious?
I shrink at the thought
Of crushing their hearts
Into twenty minutes

And what if I’mΒ sick?
(sick leave & vacation all one)
It’s not aΒ holidayΒ if I’m on call
No make-up day off
If I cancelΒ clinic
For illness
Do I make up those days
A quota of patient face days

I am in theΒ factory
TheΒ mines
People are the shirts I must sew
TheΒ tons of coalΒ I must load
I mustΒ meet a quota

Doctors die younger
Our life is measured out
InΒ patients
I won’t let theΒ quota
KillΒ my love

Quimper Family Telemedicine

Quimper Family Medicine is open and half or more visits have gone to telemedicine.

People are staying home, and hooray for that, many thanks to everyone who is trying to protect themselves and others. We have seen our patient numbers drop by more than half. We have intensified cleaning and discuss whether a clinic visit needs to be in person or can be via telemedicine. I am using VSee, Zoom and in a pinch, Messenger. At the same time I am still seeing some patients in person. We are extending refills, putting off labs, trying to walk the tricky balance of sharing decisions for each particular person.

Many thanks to everyone who is working with us. I am deeply thankful for all the people who are staying home and also for the people working in the grocery stores, supplies, garbage, electricity and medicine. Thanks to the Health Department and to the University of Washington lab and to Jefferson Healthcare’s Covid-19 testing. Thanks for the stimulus package that just passed and I hope will help everyone.

The photograph is Mount Baker on a hike with my daughter. It’s not in sharp focus, just like what will happen in the next week or two is not in focus.

Be careful out there.

blue gate in sun

For Norm2.0’s Thursday doors.

We are having a week of gorgeous sunny weather, where the waiting plants explode into bud and bloom. The sun and shadows are amazing after lowered clouds and soft coolness right above us. Bright contrast with the color and shadows on this gate and everything else!

I took this last weekend. This time I am shaking influenza quickly, hooray.

Influenza: check your pulse!

This year influenza is bad. My key test in influenza is not a chest x-ray. It is taking a resting pulse and a walking pulse.

Why? Influenza can cause a walking pneumonia. Walking pneumonia is where the lungs are infected throughout and there is tissue swelling. It is different from a lobar pneumonia. In lobar pneumonia people run a higher fever, look sicker, and on the chest x-ray, that part of the lung is white: infection, not air.

In walking pneumonia, the chest x-ray may be read as normal. This is because all the lung tissue is equally swollen. The swelling means that there is less air space. The person may feel ok at rest. They feel exhausted when they walk because the heart must take up the slack for the missing air space, the swollen lungs. At rest this week one person’s heart rate is 84. After walking it is 124. Normal is 60-100, so 124 is like running a marathon: exhausting and hard on your heart and body.

I have patients saying “I was sick two weeks ago and I am still exhausted.” If their pulse is much over 100 after they walk, they cannot work until it comes down. If they work and wear themselves out, the lungs can’t heal. The treatment is rest. If they are at work with a pulse of 114 or 124, then they risk getting a secondary infection in already damaged lungs. They could die.

Check your pulse at home. Count the number of heartbeats in 60 seconds. That is your pulse. Walk around, sit down, and check again. That is the walking pulse. Over 100 is not normal.

This is a bad influenza. The tamiflu (oseltamivir) helps but works best in the first three days of flu. Check your pulse, be seen, rest and get well.

http://www.peninsuladailynews.com/news/three-die-of-flu-on-peninsula-public-helath-officals-say-a-fourth-death-said-to-have-been-in-seattle/

many flags

For the Ragtag Daily Prompt: language.

I spent three days with the Rotary President Elect Training this past weekend. I am part of District 5020, which stretches from the end of Vancouver Island, BC, Canada down the Olympic Peninsula, WA, United States. There were people from ten districts.

The Rotary’s Polio Plus program is working hard to eradicate polio. This year the match from the Gates Foundation will be 2 dollars for every dollar the Rotary brings to end polio.

The flags from all the different countries and people working together: that speaks the language of peace and hope to me.

cracks

For the Ragtag Daily Prompt: fault.

I realized last night that I had not put up the prompt, and got back up to do it. My daughter called while I was thinking and told me about segmentation faults. I wrote the poem this morning.

cracks

people talk about me

whisper gossip
social skills aren’t right

they only see now

I had to grow in cracks
hold on tightly
find nourishment where I could
not fall
survive

if they could see my roots
if they could see
where I had to grow
no choice

maybe they would be kinder