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Jun. 25 2010 — 4:02 pm | 160 views | 1 recommendations | 0 comments

Ride your bike, gain less weight

Women Cyclists

Image by richardmasoner via Flickr

I dusted off my bike a few weeks ago and have been riding it to and from work 2-3 times per week, weather and schedule permitting.  I’m fortunate to live less than one mile from our city’s bike trail system, I’m doubly fortunate that said system also deposits me within four blocks of my clinic, and I’m triply fortunate that it is a gorgeous ride.  For an activity that only adds a total of twenty minutes to my day (round-trip car ride takes twenty minutes, round-trip on the bike is forty) but burns close to 500 calories, it’s probably the most high-yield calorie-burning thing that I do.  Plus it gives me an excuse to wear some really obnoxious cycling gear, and in a profession like mine, you need a place to let out your crazy every now and then.

As an added bonus, in the latest edition of the Archives of Internal Medicine, bicycling has been associated with less weight gain in premenopausal women.

Bicycling, similar to brisk walking, is associated with less weight gain and an inverse dose-response relationship exists, especially among overweight and obese women.

Lusk A, Mekary R, et al.  Bicycle Riding, Walking, and Weight Gain in Premenopausal Women.  Arch Intern Med.  2010; 170 (12) 1050-1056.

Really, in my situation it’s almost silly not to.



Jun. 21 2010 — 4:07 pm | 11 views | 0 recommendations | 0 comments

Why I’m not complaining

The thunder and lightning

Image via Wikipedia

It has been uncharacteristically damp in my part of the Midwest lately which, while good for farmers, positively stinks for people like me who like a lot of outdoor activities.  Especially in an area where sub-zero temperatures force most exercisers indoors for several months of the year, not being able to exercise outdoors when the temperature is finally non-frigid is excruciating.

So this morning I awoke to thunder and lightning and slogged my butt to the gym, internally whining about the cosmic unfairness of thunderstorms that seem to occur only during prime workout time.  As I pedaled away on the stationary bike and mentally catalogued my misery, I began to overhear snippets of the conversation between one of the gym’s personal trainers and her client.  At the age of 32, this particular trainer had been recently diagnosed with metastatic breast cancer.  She was telling her client about how her scalp was bothering her and how she suspected it was a harbinger of imminent hair loss from her chemotherapy.  She was also talking about a recent wig-shopping trip, how she found one in a style she’d always wanted to try, how fun it would be to be blond one day and brunette the next.  How she wouldn’t wear them while working out—too hot, too itchy.

So I went an extra ten minutes on the stationary bike.  I will never complain about the rain again.



Jun. 18 2010 — 10:16 am | 84 views | 0 recommendations | 0 comments

Yeah, about that sunscreen…

Sunburn, photographed 2 days after a 5-hour su...

Image via Wikipedia

…it might not be as effective as you think.

The Bee Gees were topping the charts with “Saturday Night Fever,” the first test-tube baby had just been born and gas cost 63 cents a gallon when the Food and Drug Administration began writing regulations for sunscreens.

Thirty-two years later, the agency has yet to issue its final regulations.

That means sunscreen manufacturers are not legally required to prove that their products meet advertising claims such as “waterproof,” “broad-based” or “lasts all day,” or that they offer a specific sun-protection factor, or SPF.

via After more than 30 years, FDA has yet to issue final regulations for sunscreens.

That’s great news for someone like me who has been relying on sunscreen for the past 20+ years so I can enjoy my usual outdoor activities.  For all I know I could have been slathering on expensive moisturizer.

On the other hand, a brief review of the medical literature seems to suggest that most sunscreen failures are more operator-dependent than product-dependent, so even with the strictest FDA regulations on sunscreens we are still our own worst enemies.  And anyway, while sunscreens (properly used) help reduce squamous-cell and basal-cell carcinomas, they don’t seem to have as much of an impact on the development of the more worrisome melanomas.

Fortunately, they also make sun-blocking clothing, although now that I think about it, I’ll bet no one’s making these manufacturers prove their products work, either.  Do they have an FDA equivalent for clothing?

Maybe I’d be better off with a parasol and a dermatology appointment.



Jun. 16 2010 — 10:40 am | 28 views | 0 recommendations | 1 comment

I knew it! My dog *is* dumb!

Labrador Retriever

Image by emildom75 via Flickr

But sadly, it’s probably my fault.  The twice-a-day feedings, the spontaneous belly rubs, the treats just for being freaking adorable, all have conspired to make domestic dogs the intellectual rivals of their squeak toys.

Domestic dogs have become so dependent on humans, they can no longer pass simple intelligence tests or solve problems which their counterparts in the wild find easy.

via Easy living dumbing down our pooches – oddstuff | Stuff.co.nz.

So my dog couldn’t find a bowl of food in a maze if his life depended on it.  So he’s scared of large serving bowls and lawn ornaments.  So he once ate an entire terra cotta planter.  So what?

Clearly I don’t own a dog for the intellectual stimulation.  I own a dog because he is genuinely thrilled to see me when I walk in the door.  I own a dog because he is the most reliable and enthusiastic running partner ever.  I own a dog because frankly, it’s hilarious to see an 85-lb beast run for his life when I take out a bowl to make pancakes for my kids in the morning.  I own a dog because he curls up at my feet and flops his head on my lap even if I’ve been a cranky pain in the butt. 

He’s a doofus, and I think he’s great.



Jun. 15 2010 — 1:00 pm | 36 views | 0 recommendations | 0 comments

When is “board-certified” not board-certified?

Rand Paul portrait by Gage Skidmore

Image via Wikipedia

Perhaps when running for office?

U.S. Senate candidate Rand Paul says he is a “board-certified” ophthalmologist — even though the national clearinghouse for such certifications says he hasnt been for the past five years.   Rand Paul, who practices in Bowling Green, says he is certified by the National Board of Ophthalmology, a group that he incorporated in 1999 and that he heads.  But that entity is not recognized by the American Board of Medical Specialties, which works with the American Medical Association to approve such specialty boards.

via Rand Pauls ophthalmology certification not recognized by national clearinghouse | courier-journal.com | The Courier-Journal.

Frankly, I don’t care whether Rand Paul is board-certified or not.  Political leanings aside, I would have no problem with a physician running for office who wasn’t board-certified.  If he were operating on my eyeballs, yes, I’d be concerned; running for office, not so much.  But as a (legitimately) board-certified physician, I get a little cheesed when a physician claims to be board-certified when he is not, or at least not by the organization that is implied by the phrase “board-certified”.

This article states that Paul created the National Board of Ophthalmology, presumably the “board” that ”certified” him, out of frustration with the American Board of Ophthalmology’s requirements that younger physicians get re-certified every ten years.  It’s not an uncommon sentiment.  I had to re-certify last year; meanwhile a number of doctors with whom I work haven’t sat for a board exam since 1973 yet still maintain their certification.  It doesn’t seem right, I agree.  But the way I see it, my options were to not have board certification out of protest, or suck it up and take the exam.  I chose the latter.  I respect anyone’s decision to choose the other path, as long as they don’t present themselves as having done otherwise.  Which, sadly, does not appear to be the case here.

The issue is not so much ability as it is integrity.  Mr. Paul is quite possibly a fine ophthalmologist; I have no way of knowing for sure.  But to claim “board certification” based on a board of his own making when patients and employers alike rely on board certification to make important decisions seems a little troubling to me.


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    I grew up on a farm and worked my way through college slinging pizzas, walking dogs, and assisting with autopsies. I received my M.D. from the University of Chicago-Pritzker School of Medicine and completed my residency in internal medicine at Boston's Beth Israel Hospital. I then took a faculty position at the newly-merged Beth Israel Deaconess Medical Center, but after two and a half years of commuting in Big Dig traffic with a screaming toddler in tow, I thought I'd try moving back to my home state of South Dakota. I am currently Associate Professor of Internal Medicine and Program Director of the Internal Medicine Residency Program at the Sanford School of Medicine of the University of South Dakota.

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