Doctor Kara's Blog

Kate, Victoria, and the Quest for a Good Shoe

doctorkara@doctorkara.com — Wed, 28 Sep 2011 06:00:00 GMT

Good Morning Readers!

I'm sorry I have been neglecting the blog for the past week. Getting back to the routine after vacation was more than I thought. There have been a few changes at the office and much longer work days, so I haven't been active online this week.

I woke up this morning thinking about high heels. Not quite as weird as it sounds if you know that I have been searching for a good pair of dress shoes lately. I've been to local stores and searched online for a good quality dress shoe. It's harder to find than you might think. I gave up high heels years ago and here's why:

When I was 21 years old I was working in an Orthopedic/Neurology Surgical Unit. Dr. Quinn, a very skilled orthoepdic surgeon, was sitting at the nurses station enjoying a rare moment of peace and quiet. I asked him "what is the best thing that has ever happened to you as a surgeon?". Without blinking or hesitating to consider his answer, he looked me straight in the eye and said, " High heels, baby, high heels. Permanent job security!" From the next day forward, I have always worn a sensible heel: birkenstocks, Naots, Danskos, etc. I rarely and I do mean rarely, wear a high higher than 2 inches.

So imagine my suprise when I walked through the local store and found nothing but those darn 5 inch stilletos with the small platform under the ball of the foot ( like that's supposed to make the high height more tolerable! ) LOL. It appears that shoe designers have gone mad or the average female has fallen under the delusion that what the celebrities wear is really meant for every day life.

I have a solution: get a clue! Those heels are only meant for two things and one of them requires a bed. They aren't shoes for every day reality. And if you think I'm crazy, then browse these links (one,two, and three) and then tell me who's crazy: me or the woman who insists on damaging her body for the sake of fashion. I mean if Victoria Beckham can't live with a reasonable heel, then we are all doomed. She wore the most awful shoes to the royal wedding, even after being told by surgeons that she shouldn't and she was stunningly pregnant at the time. That's the type of insanity I am talking about!

Thankfully there is Kate Middleton, the sensible future Queen to help us reasonable women. She is certainly fashionable but wears reasonable shoes most of the time. There's hope the shoe designers will take her lead and bring back lovely dress shoes that won't cripple us. In the meantime, I will continue my search. I'll probably end up with yet another pair of Danskos, but I'll keep looking and hoping there's more out there than a dull archless pair of flats, which are equally bad for the foot BTW.

To Your Excellent Health!

Dr. Kara

Back to the Routine

doctorkara@doctorkara.com — Tue, 20 Sep 2011 06:00:00 GMT

Good Morning Readers!

I just enjoyed my first vacation in five years and now I understand the lament----vacations are never long enough. I think I would have enjoyed one more day with my hubby. I spent two Saturday mornings of my vacation listening to awesome neurololgy lectures that were only available during those two days. It was very worthwhile, but indicative of all the other time off I have attempted in the past----work always creeps in and I'm never away mentally from work.

No matter how much in advance I post my absence, there are always patients and situations that demand attention. I think that is the nature of health care and burn out. I've been practicing as a solo practitioner for five years now and doing my own call for those same five years. Its getting harder and harder to do personalized health care. No matter what I know is the right thing to do I still have to contend with the influences of government involvement in my business.

Sometimes I think that being in healthcare is a losing proposition, since I alone will not win against a large government with a political agenda and human nature's thirst for freebies at the expense of others. Yesterday, someone asked me why I continue to fight the odds. My answer wasn't surprising, but it is, unfortunately, becoming more rare: I know I serve an awesome God who designed me to be a nurse practitioner in this day and age. He appointed my time of existence and my purpose. When I think about what He did to restore my relationship with Him, the choice is simple. I serve at His will for the time He appoints. That's why I fight the odds of doing the right thing against a political machine that focuses on the wrong things and lies while seducing you into believing it tells the truth.

My clinic has been in existence for the last five against enormous odds. I celebrate my fifth anniversary as of the 16th of September. I am still in business because I serve an awesome God. He reigns and has me in the palms of His hands. He protects those He loves and who love Him in return. The clinic will continue to serve people for as long as the clinic is needed.

So readers, if you are having doubts about what you should be doing and what your life means, I kindly recommend a long conversation with the one in charge. It isn't the easiest path to follow, but it is one of fulfillment and purpose.

To Your Excellent Health!

Dr. Kara

Time Away to Play!

doctorkara@doctorkara.com — Fri, 09 Sep 2011 04:00:00 GMT

Good Friday Morning Readers!

I'm so glad its the beginning of the weekend for me. Every one needs time away from daily routines to change their scenery, change their routine, and recharge the mind and body. This week is my week to do all that. I'm looking forward to hiking, swimming, and soaking in the hot tub for a whole week.

I'm really looking forward to spending time with those I love, trying out my new Coolibar sun gear, and reading the book of Nehemiah while I'm away. A friend reminded me that OctoberFest is also going on this weekend, so I'll have to fit that in too.

Its really tempting to pack alot of activity into a vacation, but that would be foolish. My daily life is already packed to the gills and why should vacation seem like a job?

There's one advantage to not being a mountain biker like my hubby, I can relax and do nothing while he is biking. LOL.And he wonders why I don't bike? But you probably do not want to see what's on my KIndle.....my reading list sends most people running and screaming towards the hills.

I hope all of you are planning some time for yourself. Its good for the mind and body.

To Your Excellent Health!

Dr. Kara

Pain Pills: More Than What Meets the Eye

doctorkara@doctorkara.com — Thu, 08 Sep 2011 04:00:00 GMT

Good Morning Readers!

Did you know that Utah is #1 in the nation for death related to accidental overdose? Yep, we are. So if you are wondering if you should ask for a narcotic for pain, think twice and again a third time. You are borrowing more trouble than you may know.

Did you know that narcotics actually lower your pain threshold, so you feel more pain? Did you know that the addiction risk is much higher than thought? The risk is estimated at about 35% in a recent study. If you have a brain that is inclined genetically toward addiction, you are playing with fire.

So here’s your sound advice for the day: believe me when I say that narcotics are not what you may think they are. There are many ways to deal with pain, most of which have little to do with narcotics. Do yourself a favor and when someone like me recommends a non-narcotic for pain control, believe them. We don’t like accidentally dead people. It’s bad for business.

To Your Excellent Health!

Dr. Kara

Humor Good, Drama Bad

doctorkara@doctorkara.com — Wed, 07 Sep 2011 04:00:00 GMT

Good Morning Readers!

Here’s just another little something to show us just how wrong the nay-sayers are when it comes to the mind-body connection. Watching stressful movies changes your endothelial function in negative ways whereas watching comedies helped vascular function.

What is endothelial function and why is it important? The endothelium is the innermost lining of the blood vessels in your body. Smooth ones are good. So are slick ones and unclogged ones. Everything we do and eat changes the internal environment of that lining. Get some vasoconstriction, some plaques to roughen things up and make blood cells stick to the lining, and some thinning of the lining and you have a perfect storm for heart attacks and strokes.

Keeping your endothelium happy is the best thing you can do for your physical health. So the next time you have a stressful day, go home, dial up a comedy on your TV and enjoy.

It will do your heart a lot of good. As does positive thinking and caring for your spiritual well being. Knee time also helps.

To Your Excellent Health!

Dr. Kara

Something to Ponder before Winter Illnesses Hit

doctorkara@doctorkara.com — Tue, 06 Sep 2011 06:00:00 GMT

Good Morning Readers!

Fall is just around the corner and so are the ubiquitous germs that cause our winter-times blues. Here’s some food for thought. We are doing better, but not good enough in using antibiotics appropriately—especially in children.

I know it’s a real pain in the butt to have a kid home sick from school or for you to be home from work with a cold, but giving an antibiotic when one isn’t necessary only makes sense if you value ineffective treatment. In fact, it does more harm than good. Plus you’ve spent money that you didn’t need to spend on a treatment that isn’t effective. Most pharyngitis, sinusitis, bronchitis, and otitis is viral in cause. Antibiotics don’t help viruses. You already know the common cold is a virus, so don’t expect to get an antibiotic.

Where can you spend money that will help shorten the severity and duration of a viral illness? Spend it on fluids, soups, and other appealing foods so you can safely use the Tylenol. Your liver needs glutathione to metabolize the Tylenol. So make sure the ill person stays hydrated and fed so they have sufficient glutathione on board to use the Tylenol for symptoms control. The reason for the office visit is for the provider to look for clues that the illness isn’t viral, so give your provider the chance to see what needs to be seen and arrive at a proper diagnosis. Spend the money on the babysitter, the humidifier, the chicken soup, the nasal rinse, the decongestant, the cough suppressant but don’t ask for antibiotics for viral illnesses.

To Your Excellent Health!

Dr. Kara

Perfect Peace and Happiness: Get Yours Today : )

doctorkara@doctorkara.com — Thu, 01 Sep 2011 04:00:00 GMT

Good Morning Readers!

Today I am freestyling and just writing about something that makes me happy. No research, no scare messages, no health or illness information, just plain ole what makes me happy kind of blog today. Its Friday and I choose to feel happy and childlike today.

Wanna know what really makes me happy? The belief in something greater than myself. It takes the burden of perfection away, it instills in me a sense of hope, a sense that I am so small in the world that I don’t have to worry about anything beyond the moment. That’s what it was like to be a kid. None of the adult worries about controlling everything and making something happen, but just living in the moment and taking it as it comes.

For me, the best thing that ever happened in my childhood was living with a very devout deaf couple named Gladys and Noah Fleming when I was 4-5 years old. They are both dead now. Noah went before Gladys. I miss them both. I remember living with them for a couple of years and learning about God, specifically about Jesus. Jesus is easy to accept when you are a kid, because you haven’t been so far from heaven that the mark of the Creator has been beaten out of you by the world and its evil nature. Being told by adults that Jesus loved me and singing those songs about how much He loved me seemed very simple and very comforting. I didn’t have a care in the world then; even though my world had fallen apart. My mom was too young to raise a child and I lived with 6 or 7 families by the time I had really spent any time with my mom at age 8. After Gladys and Noah, there was Hazel Haught with whom I spent two years. She died when I was 13. The first time I ever heard the word cancer. I still have the bible that she marked up for me. I cherish that book even though it is falling part. It has her handwriting and notes all over it. I think she knew I would need it later and prepared it for me. When I was a kid, I felt abandoned and alone, but there was Jesus. Gladys, Noah, and Hazel made sure I knew that He loved me. Now that I am 48 years old, I still know it. I have a lifetime full of His fingerprints all over my life. Only now it means a lot more to me than it did then as a kid. Making it to adulthood was solely because of a few good adults’ investments in me as the lost and lonely kid I was. Now I am old enough to understand that Jesus truly laid everything on the line simply because He loved me. I had no ability of my own to ever lay claim to a place in a perfect and holy eternal presence of my Creator. But my Creator loved me enough to send Jesus to be the link between man and God so I could have it all again. I can’t tell you how happy that makes me to know that God is always with me, even during my heaviest moments of adult-sized worry and stress. He is always there. He speaks to me every moment of every day as the Holy Spirit and I am never ever alone in this world.

Personally, I can’t think of a better recipe for happiness. The Holy Spirit is the cure for depression, for anxiety, for insomnia, for stress, for anything that steals my present and in-the-moment joy. What makes me happy is the relationship I have with the One who never lets me down and who never abandons me. I am truly grateful for the gift that Gladys and Noah shared with me. It wasn’t something my mom valued, so now you know why I loved living with Gladys, Noah, and Hazel.

If you want peace for yourself, come visit me at my office and I’ll be happy to share the prescription for perfect health and perfect peace. It’s the same one I use every day. I’ll even give you a copy of the love letters He wrote to us, for us.

I really did mean it when I advertised as a full service family clinic. It also means spiritual care and I can introduce you to the One who makes all things new again. Happy Friday! Happy Day!

To Your Excellent Health!

Dr. Kara

Another Thought about my Day at the Water Park

doctorkara@doctorkara.com — Wed, 31 Aug 2011 06:00:00 GMT

Good Morning Readers!

Yesterday I talked about my day at the water park and how surprised I was that I looked more normal than not---that there were fewer normal weighted people and more overweight/obese people. I also mentioned some of the children who made me sad, because of their obesity.

Here’s why I am sad: those kids have more health concerns to worry about earlier in life. My worry about fatty liver disease didn’t start until age 45. Imagine what it must feel like when a 10 year old is told they have fatty liver disease. A 10 year old! One third of American children are overweight and 16% are obese. Who is that 10 year old? My money is on the child of an obese parent who has a lot of abdominal fat and also had fatty liver disease. In the past we didn’t worry about fatty liver disease because we thought it didn’t cause much problem. Boy were we wrong! Did you know its possible to have such severe fatty liver disease that you can need a liver transplant? I think its important to identify those at greatest risk before the damage is done. Once fatty liver disease starts, you must slow the progression down to avoid more serious complications. You cannot cure fatty liver disease, as far as we currently know.

Unfortunately a liver biopsy is still the gold standard for confirming the stage of fatty liver disease and fibrosis (scarring). I think there is much to be done short of liver biopsies for everyone.

First, look at the parents and their histories. If the parent has fatty liver disease, then screen the children. Look at the lipid profile, the BMI, and the lifestyle. If fructose and fatty foods are a staple in the diet, get rid of them. By the way, fructose is not your friend. Read for yourself and become a believer. Not only is it bad for the liver, but your pancreas doesn’t like fructose either.

Second, parents must set the example. Putting your head in the sand about your health problems will kill your kids. You may have developed diabetes at age 50, but your overweight children will become diabetic sooner. If you can’t do it for yourself, then start doing it for your kids.

Third, eating fresh foods is cheaper than eating bad foods and fast foods. Don’t believe me? Try the food co-operatives in Utah. My hubby and I cut our food budget in half by picking up a basket from the food coop every week and eating less meat. Not only does your wallet benefit, but so does your health and well-being.

To Your Excellent Health!

Dr. Kara

Prunes Are Your Friends

doctorkara@doctorkara.com — Tue, 30 Aug 2011 04:00:00 GMT

Good Morning Readers!

OK have your laugh. Make it a real big belly laugh, the kind of laugh that would make Santa Claus proud! It turns out that prunes really are your friends. All joking aside, a recent study has shown that women who eat 10 prunes a day have better bone quality and less osteoporosis than those who don’t cuddle up with Mr. Prune.

We have it really good these days compared to our mothers and grandmothers because SunSweet has made it possible for us to enjoy flavored prunes. Personally I like the cherry and orange ones. While we worship the porcelain goddess, we will have the last laugh on those with painful hemorrhoids and now we can gloat because we will also have stronger bones!

To Your Excellent Health!

Dr. Kara

Health Messages and Emotional States

doctorkara@doctorkara.com — Tue, 30 Aug 2011 04:00:00 GMT

Good Morning Readers!

This weekend my hubby and I finally made it to the water park. It was a blast! Like every woman who doesn’t have the bikini-perfect body, I spent a few minutes dreading the donning of the swimsuit and appearing in public. It turns out in the decade since I have put on a swim suit, the world had changed a great deal. Bear with me because my circular argument today will come back to the title of today’s blog.

I was worried about being the proverbial “fat lady” at the pool. I remember when I was a kid, there was always one “fat lady” that everyone made fun of. It turns out that Americans really are fat. I was shocked to realize that I was not the memorable “fat lady”, as it was more remarkable how few normal weighted people I saw in suits on Saturday. Here in Utah, the haven of outdoor sports and wilderness living, most people are moderately overweight.

Of course I was relieved that I fit in and I was going to have a good time instead of worrying about the excessive jiggling of my body fat. I went down the waterslides without getting stuck---of course we will not mention how much water was displaced at the bottom of the slide! And that swim shorts over a suit does prevent mooning of those observing you as you get up while adjusting your suit into proper places.

I felt most badly for the overweight and obese children I observed. I know they will struggle with their weight all of their lives and will most likely be diabetic by the time they are 25 years old and will be the young heart attack victims I will treat near my retirement. It made me think about the article I read on emotional states and health messages. It turns out we will eat more fruits and vegetables if we hear messages of what can be lost when we are in a fearful emotional state. The opposite is true about anger states; we only eat more fruits and veggies if they are messages about what we gain in changing our behavior.

From my observations at the pool, I’d say that health messages in general are not being heard, regardless of emotional states. I am not convinced that emotional states are stable enough to time a health message for being heard and heeded. I think the research is most useful in knowing what works better and waiting for the time that an emotional state is sustained. This would explain why some dieters get an “AHA” moment from a health scare and adopt lasting changes. If you haven’t seen “Fat, Sick, and Nearly Dead” by Joe Cross, you should view it to understand what this last statement is really about. It’s a great film.

I’m just saddened by the fact that waiting for the best time usually involves waiting until a preventable crisis (think heart attack or some other deadly illness) happens. I spent the early part of my Clinical Nurse Specialist career designing health messages and eventually gave up and went into disease management as a Nurse Practitioner because no one was listening. I daresay they are listening now. I’m not sure that I really have any power to make anyone listen, but I’d like to believe that I do and still try to open up a conversation about health promotion and disease prevention. I’ve got the science of cellular biology on my side.

To Your Excellent Health!

Dr. Kara