Pak Doktor a.k.a. Mr Doctor!

National standards are needed to protect patients from doctors so sleep starved they might as well be legally impaired, Canada’s leading medical journal says.

Studies have found a near doubling in the rate of complications — including massive hemorrhage or organ injury — when surgeons operate with fewer than six hours of sleep after a night on call.

The problem of sleep-deprived physicians is poised to only get worse, states an editorial published in a recent issue of the Canadian Medical Association Journal.

Working while sleep deprived is neither “normal nor acceptable,” the authors write.

Limits have been imposed on how long residents and medical students can go without sleep. But, for practising doctors, there are virtually none, the authors of the editorial say.

What’s more, unlike doctors-in-training, fully trained doctors usually have no one looking over their shoulder “to catch their mistakes.”

In understaffed community hospitals, doctors can work days in a row with minimal backup and sleep, says Dr. Paul Hébert, the journal’s editor-in-chief and a critical-care doctor at The Ottawa Hospital. But even in big city hospitals doctors frequently work “long, long hours, and often on call, and the next day still do clinics,” Hebert said.

It’s difficult to make hard and fast rules, he says. Several of his colleagues sleep, on average, four hours a night “and they function just fine.” Others can become completely dysfunctional. “The things that go first are executive function and judgment.”

Strategies are needed to restrict how long doctors can work without sleep, the journal says, including strict policies on going home after being on call and not scheduling cases the day following a night on call. “Ultimately, licensing, accreditation, insurance and government institutions need to establish minimum best-practice standards for maximum work and minimum uninterrupted sleep hours.”

According to the CMAJ, less than six hours of uninterrupted sleep from overnight calls impairs a doctor’s judgment and motor performance similar to a blood-alcohol level above 0.05 per cent.

– Postmedia News

(WTNH) – Future Health Strategies is a Connecticut company who helps you record your legacy, but it also helps you to express your health care desires in the event you are unable to communicate them as you get older.

Ethel Comisky is 91 years young. Her daughter Allyson wants to make sure her grandchildren can know Ethel the way she is now, positive and happy.

“We can learn so much from each other, but just to capture her essence is such a gift,” Allyson said.

The assisted living home where Ethel lives, The Saybrook at Haddam, is taking part in a project with a unique Connecticut company called Future Health Strategies. Everyone who lives here will put their legacy and memories on video record. In their interview, Allyson found out how hard it was for her Mom to find a job as a young woman.

“My maiden name was Simon, so everyone thought I was Jewish, and at that time, there was a lot of prejudice versus Jewish people,” Ethel explained.

But there’s another very important part to this: the lifestyle video care plan. How you want to be treated, if someday you cannot speak for yourself, due to dementia, stroke or something else. The company founder Holly Doherty came up with the idea after working as a long term care nurse for years.

“I didn’t want to just go down the hall and take care of the ‘alzheimer’s in 26′. I wanted to know who the full human being was,” Holly said.

So there are questions about if you like to sleep in, or get up early, if you exercise, what you like to watch on TV, what foods you like or don’t like.

“Do you like fish? You’ve been a person who’s hated fish all your life, and now you can’t speak, and we’ve got someone feeding you and you are spitting it out. ‘she’s not eating, c’mon Mrs. Smith you gotta eat,” Holly said.

It’s the story of you, told in your words to aid in your nursing care later.

What if vacation shouldn’t be seen as a luxury, but as a necessity?

According to the 2011 Work Stress Survey conducted by Harris Interactive on behalf of Everest College, 77 percent of Americans are stressed about at least one thing related to their job. The study surveyed more than 1,000 adults and found top stressors included low pay, commuting, unreasonable workload and fear of being fired. Others on the list were annoying coworkers, boss, poor work-life balance and lack of opportunity for advancement.

But despite the stress, just 57 percent of Americans use their vacation time, one of the lowest percentages in the world, according to a 2010 joint survey by Reuters and the Paris-based research firm Ipsos Group. Rather than using earned vacation time to take a break and recharge, many workers continue the wearying routine of work. This may be due in part to the difficult job environment, says Dr. Thomas Thorsheim, a licensed psychologist and executive coach. “In the job climate of the past couple years, workers may be increasingly motivated to work excessively in an attempt to prove their value and to establish that they are indispensable, believing that this will increase job security,” he says.

According to Thorsheim, other common reasons employees avoid vacation are a culture of workaholism in many companies in which people take pride in endlessly working; a belief that loyal employees don’t take vacation time; a belief that vacations are too expensive; or an inflated sense of responsibility — the idea that a company can’t function properly without one’s presence. For some, the roadblock may be even more basic: they no longer remember how to play.

Technology’s constant calling also influences today’s work-driven culture, says Jim Banting, author of “Get a Dog: Don’t Work Like One — Think Differently About Your Work-Life Balance” (Marshall Cavendish, 2010). Individuals are expected to answer calls and e-mails almost immediately. As a result, it takes more effort to switch to vacation mode.

“We are more accessible than ever at all hours of the day and night,” he says. “There is an increased expectation on us to react to communications without delay. It has left many of us feeling strained, under more pressure and unable to switch off from work commitments.”

Yet vacation time continues to be valuable. Many research studies support the idea that proper self-care builds productivity, such as the scholarly article, “Manage Your Energy, Not Your Time” by Tony Schwartz and Catherine McCarthy (Harvard Business Review, October 2007). Banting says everyone needs time to hit the reset button.

“Continuous working can lead to an inability to put things into perspective and poor decision-making in the long term,” he says. “Vacation helps refresh our personal cache.”

Though vacation can mean a big trip with plane rides and hotel stays, Thorsheim points out it can even take place at home — as long as it fulfills its purpose. He advises planning regular mini-vacations, while also saving some time and money for an extended retreat.

“Vacations serve to reenergize and rejuvenate,” Thorsheim says. “It could be as simple as taking a day off to lounge around the house, go for a hike, plant some tomatoes or read a book.”

For those who prefer the busier pace of work compared to lounging for days at a time, Banting advises seeking activities that are stimulating and relaxing.

“Everyone relaxes differently,” he says. “Try to look at vacation as a perfect time to learn something new, such as cooking, white water rafting, creative writing or yoga.”

If time off is scarce, take a look at evenings and weekends. Thorsheim warns that these weekly “vacations” can unconsciously become consumed with work-related tasks.

Just remember, taking advantage of time off benefits both the employee and the employer.

Taking a break from work “can be life-changing,” Banting says.

OF late there have been a number of complaints from senior citizens that the waiting time to see doctors in government hospitals and to get their medication is getting longer.

They have to spend the whole morning for this purpose.

It is a burden to this group of people who have served the country well in their younger days.

Such a phenomena should be an eye-opener to the younger generation.

If you do not want to spend hours waiting in hospitals during your senior years, take care of your health immediately by exercising regularly, eating right and leading a healthy lifestyle (quit smoking and drinking).

Certainly the adage “prevention is better than cure” is very apt here.

Instead of spending time, effort and money visiting doctors and hospitals (and in some cases staying in hospitals), you could be visiting places, friends, parks and enjoying your senior years doing what you like.

It is important that youngsters realise that they have to make time for their health.

Believe me there is no greater wealth than your health and wellbeing.

Hence, it is important to take care of one’s health at an early stage. Begin exercising right now.

If you have no time, make the time.

Otherwise you will not only be waiting at the hospital but you would be spending your hard earned money paying for your recovery.

The sooner one recognises this the better.

PAUL SINGH,

Kuala Lumpur.

PIA Press Release
Monday, May 30, 2011

Feature: Smoke gets into your life

by JCMesa

Iloilo City, May 31 (PIA6) — “I smoke because it releases tension,” says Eduardo who has been smoking for almost 40 years now and has no intention of stopping.

He adds, “I started smoking when I was in college, not because I really wanted to but because all my barkada were smoking and soon it just became a habit.”

Christine is a chain smoker who started smoking because it seemed sophisticated and “cool.”

She says, “I was an intern in one of the dorms in the city and at night we would smoke under cover of darkness without anyone being the wiser.”

Eduardo and Christine are just two of the countless Filipinos who started smoking because of peer pressure, because it seemed the “cool” thing to do and simply continued on and on.

When asked why they smoke when they know its bad, they say it is hard to break a habit, that has become part of life.

May 31 is “World No Tobacco Day” which is intended to focus on the increasing widespread prevalence of tobacco use and its effect on health. It is estimated that about 5.4 million deaths worldwide are caused by the effects of smoking.

Non-smokers welcome the day, to once again focus on the need to stop smoking, while smokers say forcing them to stop is a violation of their human rights.

Across the globe, countries have come up with their laws on how to stop or ban smoking, citing not only the effects of smoking on the smoker himself or herself but on the effects of second and even third-hand smoke on the people around them.

In the Philippines, per Republic Act 9211, smoking is completely banned in enclosed or confined areas of all hospitals, medical clinics, schools, public transportation terminals and offices, and building such as private and public offices, recreational places, shopping malls, movie houses, hotel, restaurants and the like. The Act also bans smoking in modes of transportation like elevators, airplanes, buses, taxicabs, ships, jeepneys, light rail transits, tricycles and similar vehicles.

Advertising and promotion of tobacco products except for some exception is also banned in the country. The government has also required the putting of warning text on cigarette packs “Smoking is hazardous to your health”.

There have been moves to slap tobacco with a much higher tax because in the country, tobacco is taxed very much below the recommended 65 to 80 percent of retail price, which is done by countries with effective tobacco control policies. However, this move was met with a howl of protest from the smokers and from tobacco manufacturers.

The often-repeated warning of the Department of Health that tobacco smoking contributes to a number of cancers and diseases and causes increased heart rate and blood pressure has it seems fallen on deaf ears if we go by statistics of smokers in the country.

Statistics reveal that heart disease and strokes are also more common among smokers than non-smokers. Smoking causes around one in five deaths from heart disease.

In younger people, three out of four deaths from heart disease are due to smoking.

Its effects are so far-reaching that a doctor was heard to comment, “Its not how long you have stopped but how long you have smoked.”

When the Millenium Development Goals (MDGs) were adopted at the Millenium Summit in 2000, it sought to address extreme poverty – especially income poverty, hunger, disease, lack of adequate shelter, promotion of gender equality, education and environment sustainability.

It has been recommended that tobacco control must be integrated into the Millenium Development Goals because reducing tobacco use, especially among the poorest of the poor will improve individual health, increase household spending on food and education and improve productivity.

But in the meantime, more stringent implementation of The Tobacco Regulation Act of 2003 must be made or else smokers will just smoke their life away and worst smoke the life of others around them too. (JCM/PIA6)