Geridoc

Geriatrician, Hospitalist, Patient Advocate, Healthcare Educator

Find a Practice to Practice



A summary of the lessons discussed by Emily Saul:

Lesson #5 - Let obstacles become opportunities, challenges are opportunities to learn

Lesson #4 - Not doing something perfectly successful does not mean you are failing, every little step is part of the bigger goal

Lesson #3 - Motivation is directly related to meaning, frame your challenge around something that has purpose in your life

Lesson #2 - If you want to keep doing something, make it regular and give it structure. And if you want to keep enjoying something, make it unusual and give it variety

Lesson #1 - If there is something that inspires you and has has meaning to you, find the version that works for you and then practice being good at it day after day

Find your practice(noun) and practice(verb) it!

Physical Activity and Stroke Risk

Photo by Arek Adeoye

A new study published in JAMA June 3, 2022, suggests that more time spent being physically active, especially at moderate intensities, and less time spent being sedentary, particularly in longer bouts, may help reduce the risk of stroke.

The study involved 7607 adults who were 45 years and older from May 2009 to January 2013 with black adults and those residents of the southeastern states in the stroke belt oversampled. The study was done with the use of an accelerometer.

Findings include:

  • Those that took part in moderate to vigorous physical activity 25 minutes per day or 175 minutes a week had a 43% lower risk of stroke.
  • Those that had a sedentary time of 13 hours or more had a 44% higher risk of stroke. Larger amount of sedentary time of 17 hours or more was associated with a 54% higher risk of stroke.

In conclusion:

  • Those that were sedentary had the highest risk of stroke.
  • The more physically active, the lower the risk.
  • Replacing sedentary time with 4 to 5 hours of light-intensity physical activity or short bouts of moderate to vigorous activity can reduce stroke risk.

The key point from this study is that moving more and sitting less can reduce stroke risk.

Here are some helpful tips to prevent being sedentary and being labeled as having “sitting disease”

  • Stand or walk every chance you get! If you can talk on the phone standing or walking, do it
  • Look into a standing desk, treadmill desk, or bike desk as an addition to your office space if space permits. If you can work on your kitchen island standing for 30 minutes, take the opportunity
  • Take a break from sitting every 30 minutes or so and stand up and stretch. Set a reminder or alarm if you need to.
  • Listen to an audible book and take a walk instead of sitting down to read a book
  • Get up and walk during TV commercials
  • If you are going to play video games, try to incorporate some active video games

Retirement Healthcare Cost and Inflation

Per Javier Simon in “Today’s High Inflation Will Increase Retirement Health Care Costs…Forever” published in Money on March 17, 2022.

“Record inflation isn’t just hitting Americans at the supermarket and at the pump. It’s also driving up health care costs, and the current spike will have a lasting effect on retirement medical expenses even after inflation returns to normal levels, a new study finds.

The study of HealthView Services projects that health care inflation will remain elevated at an annual 11.9% over the next two years. This means that a healthy 65-year-old couple will have to spend an additional $85,917 on lifetime medical expenses over what they would if inflation had stayed at the historic norm. For a 55-year-old couple, those figures nearly double to $160,712. And for a 45-year-old couple, the extra lifetime costs jump to $259,808, according to HeathView Services, a Danvers, Mass.-based company that provides health care cost data to financial advisors. ”


The study is alarming to everyone! For those that are already retired, they did not have time to plan for this and already healthcare premiums have gone up as will other healthcare costs. The geriatric population is one that as a country we should be taking care of as most other countries do with universal health care and other services.

For those who are not retired yet, this means lots more saving and investing to plan for these increased costs in the future…

Enjoy Those Mangoes

Photo my Desirae Hayes-Vitor

Although native to Southern Asia, especially India, mangoes are the most widely consumed fruit worldwide. They are also commonly grown in Southern USA, Mexico, and the Caribbean. June is Mango month and a good time to enjoy this nutritious fruit and come up with interesting recipe ideas. Mangoes are considered superfruits. One whole mango is about 200 calories, but a serving size is about ¾ cup which is 70 calories. One serving contains 1 gram of protein, 2 grams of fiber, 19 grams of carbohydrates, is fat free, sodium free, and cholesterol free.

Health benefits of Mangoes

  • Rich in antioxidants as it contains beta-carotene causing yellow-orange color of fruit
  • Supports health health-has magnesium and potassium, lowers blood pressure, contains a compound called mangiferin which reduces inflammation of the heart
  • Rich in vitamins
    • Vitamin C -provides about 50% of daily recommended dose, reduces signs of aging skin, provides a glow to skin, helps with immunity and also promotes wound healing
    • Vitamin A-single serving has 8% of daily dose of vitamin A, helps in eye health
    • Vitamin K- helps your blood clot effectively
    • Folate-important for healthy cell division and DNA duplication
    • Vitamin B6-helps with metabolism, brain health, and immune function
  • Contains carotenoids lutein and zeaxanthin which protect the eye from sunlight and also blue light from digital devices
  • Helps in digestion as has fiber content
  • Helps with weight loss-makes you feel fuller for longer

Of note, mango skin contains urushiol which is also found in poison ivy. Mango skin contains less urushiol than poison ivy but we do need to be aware of contact dermatitis, or rashes and allergic responses that can occur, especially when peeling the fruit. However, this is rare.

Mango month is a perfect time to incorporate mangoes into our diet. Some ideas are:

  • smoothies
  • shakes
  • jam
  • ice cubes to add to water and cocktails
  • grilled mango
  • salsas
  • salads

What Is the Stroke Belt?



Interesting enough where you live in the United States may put you at a higher risk for strokes. The stroke belt or stroke alley consists of the Southeastern United States and has been associated with higher stroke prevalence. The rate of stroke is about 30% to 40% higher in this region. These include the states of Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia.

Per Twenty years of progress toward understanding the Stroke Belt, some of the contributers to the stroke belt included:

  • Poor dietary intake-fried foods, meats, processed food, added fats, sugar-sweetened beverages, bread
  • Higher risk factor burden
  • Higher levels of inflammation and infection
  • Lower socio-economic status
  • Lifestyle choices

About 80% of strokes are preventable and working on preventing and treating the risk factors such as diabetes, high cholesterol, smoking, obesity is important. Also, recognizing the signs of stroke and seeking medical attention quickly can make a difference.

May is stroke awareness month and therefore is a good time to evaluate what can be done to reduce the risk of stroke… be it getting back to losing weight, eating healthier, taking medications consistently, or watching that sugar intake. What we do today can change our tomorrow for the better.

Ease Your Stress

Photo by Joshua Woroniecki

There is always something or another going on, and what is life without stress, right? Stress can motivate us to do better and has been associated with better peformance at times. However, stress can have an impact on our mental and physical health. Stress is caused by stressors that are a part of our lives on a daily basis such as work related stress, financial stress, relationship stress, and the list continues….

How does stress affect your body?

Stress can cause decreased sleep, memory issues, weakened immune system, digestive issues, muscle tension, and low energy. Chronic stress can have long term effects such as elevated blood pressure, increased risk of heart attack and stroke.

Everybody reacts to the same stressor differently and deals with stress differently. Stress is unavoidable in life, but it is important to identify the stressors in life and develop a strategy to reduce it’s effects on our physical and mental health.

Some of the things that can help relieve stress:

  • Self care-you know your body best and what you need to do to take care of it, be it listen to music, small weekend get-away, a scenic walk, etc
  • Exercise-body releases endorphins which help with your mood
  • Healthy diet-limit processed food, try to eat a nutrient-dense diet
  • Meditate
  • Do something creative-cook, write, art, music
  • Spend time with loved ones
  • Get plenty of sleep/rest
  • If nothing else, go and enjoy a beautiful sunset

The Great Clinician Resignation

Photo by Markus Frieauff

The great resignation has taken a grip of the nation with the pandemic having changed our priorities in life. About 5 million US workers have quit their jobs. In healthcare, it is estimated that about 20% left.

There was a recent study related to COVID-related stress and work intentions in a sample of US healthcare workers which surveyed clinical and nonclinical workers in about 30 states in both rural and urban settings starting April 2020 and found that 1/3 of workers planned to reduce work hours in the next 12 monthsa and about 1 of 5 physicians and 2 of 5 nurses were likley to leave their current practice within the next 2 years.

So, why are healthcare providers quitting such a noble profession? There are alot of factors that are fueling this “Great Clinician Resgination”. Overall, there is a decrease in reimbursement, rent is up, gas prices are up, staff wages are up(that is if you are lucky enough to find someone with the staff shortage and lucritive nursing traveling jobs out there) and physicians are burned out! Physicican satisfaction and burn out were already issues before the start of the pandemic but the pandemic pushed things to the brink.

Unfortunately, there is no easy fix to the situation. A supportive environment, improved work load, along with some recognition and respect for the work healthcare workers do on a daily basis would be nice but likely not enough. On an individual level, working on preventing burnout and stress by other outlets besides work such as music, exercise, cooking, and actually getting some time off would go a long way….

Headphones That Tackle Air Pollution Too!



This is a really innovative product Dyson has come up to tackle what many cities are facing-pollution! It is estimated that 9 out of 10 people live in urban areas worldwide and are affected by air pollution. Air pollution causes oxidative stress and inflammation in human cells which may lead to chronic diseases and cancer. In fact, air pollution has been classified as a human carcinogen by the World Health Organization. It is said to increase the risk for emphysema more than smoking one pack of cigarettes a day. It can affect every organ of the body and exacerbate existing health conditions. Reducing air pollution involves everbody doing their part. Some things that can be done include:

  • Buy a lower-polluting (zero emission) car if making a new purchase
  • Drive less
  • Energy conservation-turn off lights when not using them, replace light bulbs with energy friendly ones, use the fan instead of the air conditioning when feasible
  • Recylcle
  • Avoid outdoor walks and exercise during high pollution days, instead opt for indoor activity

COVID Nasal Spray in the Works



This study was published in Nature.

Researchers found that in mice, a molecule called N-0385 was effective in preventing and treating COVID infection when introduced 12 hours after exposure. A California company, EBVIA Therapeutics Inc. is now in the processing of raising funds to start human trials.

This study showed promising results, so we may just have a nasal spray in the mix for prevention and treatment in the future.

Female Physicians Earn Less Than Male Physicians

Per study published in Health Affairs December 2021:

“data from 80,342 full-time US physicians to estimate career differences in income between men and women….. Over the course of a simulated forty-year career, male physicians earned an average adjusted gross income of $8,307,327 compared with an average of $6,263,446 for female physicians—an absolute adjusted difference of $2,043,881 and relative difference of 24.6 percent. Gender differences in career earnings were largest for surgical specialists ($2.5 million difference), followed by nonsurgical specialists ($1.6 million difference) and primary care physicians ($0.9 million difference). These findings imply that over the course of a career, female US physicians were estimated to earn, on average, more than $2 million less than male US physicians after adjustment for factors that may otherwise explain observed differences in income, such as hours worked, clinical revenue, practice type, and specialty”

The researchers looked at self-reported salary data and found that from the first day of the job to the end of a 40 year career, female physicians made less money for the same job. This is a group of highly educated women who are as capable as their male counterparts. They have spent the same amount of money to get through medical school and also put in the same amount of time in vigourous medical training before practicing medicine. The gender pay gap across most industries is narrowing, unfortunately the same can not be said about the health care industry.