Followers

Wednesday, November 24, 2010

The human body was designed to survive. The way it survives during times of famine is to:

1) Lower metabolic rate, to use as few calories as possible.
2) Burn off lean tissue (muscle) as fuel.
3) Store as much fat, as possible, in order to have a reserve of calories on hand.

Most people skip meals or eat too few calories during the day, by doing this you are putting your body into starvation mode, which the body treats as a famine and lowers metabolism.

And most people also come home at night and eat a big meal followed by a few snacks, by loading up on calories at night you are signaling your body to store up fat.

The right thing to do is eat several small meals throughout the day to let your body know there is plenty of food available and so will raise metabolism and burn more calories and not feel the need to store fat.

These meals should be the types of foods the human body was designed to use, such as lean meats, fish and fowl, along with fresh raw fruits and vegetables.

Early humans ate what they could hunt and gather, they ate no refined foods, no sugar, no wheat, no grains and they did not drink milk past infancy and that was human milk not the milk of another species.

When modern people stray from this, by eating refined foods, candy, bread, chips, cows milk, ice cream, etc., they tend to get fat and develop all kinds of health problems.

Strength training is very important because it builds or at least maintains lean tissue and therefore keeps your metabolism high thus burning more calories.

Monday, November 08, 2010

Over the years I have shared my "SOAP" notes with all of you assuming everyone knows what a SOAP note is and why it is used.

For all aspiring doctors, the SOAP note is the standard for medical evaluation entries made in clinical records. The SOAP note is written to improve communication among all those caring for the patient to display the assessment, problems and plans in an organized format. SOAP is an acronym. The letters S-O-A-P stand for SUBJECTIVE, OBJECTIVE, ASSESSMENT and PLAN.
SOAP notes are brief and to the point. For example, they give:

1--Date and purpose of the visit
2--The patient’s symptoms and complaints
3--The current physical exam: patient's height, weight, temperature, pulse, blood pressure, visual acuity, lab data and results of studies, reports, assessments
4--The current formulation and plan for the patient
S - O - A - P


1. SUBJECTIVE — These are symptoms the patient verbally expresses or as stated by a significant other.
2. OBJECTIVE — These objective observations are what the doctor assesses and include symptoms that can actually be measured, seen, heard, touched, felt, or smelled. Included in objective observations are vital signs such as temperature, pulse, respiration, skin color, swelling and the results of diagnostic tests.

3. ASSESSMENT — Assessment is the diagnosis of the patient's condition. In some cases the diagnosis may be clear, such as a contusion. However, an assessment may not be clear and could include several diagnosis possibilities.

4. PLAN — The plan may include laboratory and/or radiological tests ordered for the patient, medications ordered, treatments performed (e.g., minor surgery procedure), patient referrals (sending patient to a specialist), patient disposition (e.g., home care, bed rest, short-term, long-term disability, days excused from work, admission to hospital), patient directions (e.g. elevate foot, Return to clinic in 1 week), and follow-up directions for the patient.
Here is an example of a SOAP note:
Patient Name: Jane Doe DOB: 12/31/1961


Record No. K-6112r809

Date: 09/09/1999

S—Pt. states that she has always been overweight. She is very frustrated with trying to diet. Her 20 year class reunion is next year and she would like to begin working toward a weight loss goal that is realistic.

O—WT = 210 lbs HT = 60 “ BW = 115 lbs Chol = 255 BP = 120/75
HEENT is neg, Heart is RRR without murmurs, Lungs are clear, abdomen is soft, nontender, with active bowel sounds. Extremities reveal no edema

A—Obese at 183% IBW, hypercholesterolemia

P—Risk Factors of diabetes and heart disease discussed. Weight loss is in her best interest. She may want to consider a personal trainer. Names of local trainers given. Long Term Goal: Change lifestyle habits to lose at least 70 pounds over a 12 month period. Short Term Goal: Client to begin a 1500 Calorie diet with walking 20 minutes per day. She was also encouraged to start a resistance exercise training session. Instructed Pt on lower saturated fat food/carb choices and smaller food portions. Follow-up in one month.

Friday, November 05, 2010

Yesterday was my little girl's birthday. I remember the day I got Squirt. She came as a "buy one, get the second one half price." Who could turn away those eyes and those kisses? I took them both...Nitro AND Squirt! They have the same daddy...a stout little yorkie who did time with his daschund live-in, and then a few days later his baby momma maltise! Quite the little "run-around!"




There are so many things I love about my Squirty. Those nine little pounds of Dorkie has more love in her than most people I know. No matter what is going on she is always right there with those eyes saying "I love you!!!" She has a HUGE personality for a little dog!!! 

Squirt celebrates when I get home from work. Her whole body is wiggling from her excitement. She leaps into my arms and no matter how much her breath smells, her smiley face beams and she licks me all over. She lets me know when I’ve been on the computer too long. She also let's me know when a stranger passes by the house, when commercials come on (ALL commercials!), and actually is quite vocal ALL the time. "Shush" isn't working on her anymore!

Her happy place is snuggled up wherever I am. She loves to dance with me in the garage. I hold her tight to my chest and we twirl around to the beat of the music. Squirt may not understand the meaning of birthdays, but I do. Another year with her is a good year!