What am I up to?

“Not always this laid back”

“Not always this laid back”

Thank you for asking. I am asked this question so often. This phase may just be a salutation, but I have learned many have a curiosity about my various endeavors. A blog seemed like the best way to answer this question on a regular basis. In addition, this blog provides a means for me to keep track in an organized fashion of what I am up to.

The purpose is to record and relate what I am up to these days. The information will be in one place for recording memoirs and historical events. It will be a place to document the present and consider the future.
I expect to regularly make entries concerning various categories: physician/surgeon; medical research and development; the golf adventures and Life. You may see a recent post or follow the topic that might interest you.

Let me know what you think as this blog will becomes my “Lectronic Legacy” in what ever time remains.

Physician/Surgeon

“30 years at the bedside” circa 1980

“30 years at the bedside” circa 1980

In the course of my practice I was one of the pioneers in arthroscopic surgery. This resulted in hundreds of surgeon visitors, such that Ingham Medical Center in Lansing created the first operating room dedicated to arthroscopic surgery including a glass wall for visitors to comfortably observe surgery.

Arthroscopic Suite Ingham Medical Center

Arthroscopic Suite Ingham Medical Center

First and foremost I am a physician/surgeon. No matter a physician’s special interest, the medical license says physician/surgeon. In the course of my medical practice, medicine became very specialized, me included. I went from medical doctor, to board certified orthopedic surgeon to arthroscopic surgeon. My business card indicated such. I did not go so far as to do only left knees and right elbows. When I saw this unfolding, I changed my business card my roots, a “new” specialty called Physician/Surgeon.

 

 

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Inventions/Patents

Inventions/Patents

Official Patent Document

Official Patent Document

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Golf

My friend and partner on the PGA Tour; Howard Twitty

My friend and partner on the PGA Tour; Howard Twitty

I started golf at age 11 a Burroughs Farms, a family recreational area for employees of Burroughs Adding Machine Company. This facility is now called Oak Pointe, west of Brighton, MI. I played on Royal Oak High School team which won the Michigan State High School Championship in 1951 (not a misprint on year). My last year at Michigan State and sfter I was admitted to medical school, I played #3 man on Michigan State College (at that time) golf team. My best competitive score was two under 70 against Notre Dame. I have enjoyed 3 holes in one, the longest being 265 yards in 1955. I played a few local country club invitationals over the years, winning once at the Lansing Country club with Otto Schubel.

Long hiatus in golf due to medical school and practice, but in 2002, I slipped on the ice after a Michigan State basketball game and dislocated my shoulder. This resulted in rotator cuff repair and exploring one handed putting. This led to interest in putting and putter design. This led to meeting Howard Twitty, former PGA tour player and the rest is history and daily documentation of new events now reflected in this blog’s “What are you up to in Golf”

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Life & life

Open Bible

Open Bible

These are musings about Life and life. Notice the capital letter on the first Life. The reason is that it is a synonym or code name for the person of Jesus Christ of Nazareth. He called himself the Way, The Truth and the Life. Over the years I have lived an imperfect life (not capitalized) which is one of the qualifications for becoming and remaining a Christian. There is a fun scripture that rhetorically says, “Does a well man need a doctor?” Only those with faults need apply.

I have written a number of manuscripts about Life and life. One such many people Christian or not have appreciated is my insight to what goes on in the operating room which resulted in a prayer for those undergoing surgery. (use the form to the right to sign up and get this free)

I have written a short manuscript on “A Physician Looks at Scriptural Healing”. Being a medical doctor and a Christian it was of interest to me, what the Bible recorded about healing. So it was important to me to make this study in light of my clinical experiences. I want the proceeds from this to go directly to Fresh Wind Christian Community in Benzie County, MI.

This section will have many other reflections on Life and life as we go along.

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Answering the frequently asked question (FAQ) of what am I up to now?

A BLOG seemed the best and most efficient means of answering the FAQs on a regular basis.  It might be said that I wear multiple hats or have many interests.  Discovery in medicine will always be the main topic.  However there are other categories; Golf Adventures, Inventions, and some Christian writings.  Hopefully the BLOG will be a format to tell what I am up to in each of these main endeavors.  It seems almost daily there are interesting events; at least to me. Perhaps the events may be of interest to others.

I want to make it clear, I am not retired.  Retirement it is bad for one’s health.  I concluded my clinical practice in 1995, but work regularly in these various endeavors.  I do not see anywhere in the Bible where retirement is to be desired or realized.  I have told my daughters that I will not be speaking at my retirement party.

From time to time I will answer publicly herein those questions that recently surfaced and may be of general interest.  I will not be recording what I had on my hot dog at a ball game, let alone focus on mundane events.

I trust I will accomplish the intended goal of answering “What am I up to?”

Consider the Source

5/23/2020: Considering the Source is more important today than ever before. There seems to be more agenda driven information, hidden agenda stuff, conspiracy theories, deception, deceit and out right lying than ever before. One does not have to look very far for confirmation.

This has forced me to return to the common denominator; consider the source. I want to learn about the source and “where are they coming from?” Knowing the source allows me to put in perspective the information. Most false information has some plausible factual basis weaved into the story line. This serves as the “hook” to get us to buy into the argument. Discernment is necessary to avoid advancing to the “line and sinker” stage, the response the author is seeking.

We are searching for the “truth of the matter”. Interestingly, the ancient literature indicates that truth is a person. (John 14:6) Truth is not the end result of reason or scientific research. It is a person; really? Test the hypothesis and settle this for your self.

Jerry Sloan; one of my first famous athlete patients

5/22/2020: I saw in the press that Jerry Sloan, famous basketball player passed away.

www.msn.com/en-us/sports/nba/hall-of-fame-nba-coach-jerry-sloan-dies-at-78-he-led-utah-jazz-for-23-seasons/ar-BB14sWMI

He was one of my first famous athlete patients to undergo arthroscopy in the mid 70’s. I remember it well as I was lecturing at a meeting in Chicago suburb and his agent arranged for me to come down town and perform a diagnostic arthroscopy under local anesthesia. I did not tell anyone where I went and as my custom I created no publicity. I forgot about it until today.

Malaria Drug? Yes or No?

5/22/2020: Malaria drug; yes or no? The results are based upon patient selection, the common denominator of medical treatment.

That is why reports and opinion are widely diverse on the use of hydroxychloroquine; yes or no. The latest today in very respected journal: Lancet.

www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext

The conclusion was no benefit and in fact worse results than not using it.

The subjects (research word for patients) were all sick enough to have been placed in the hospital. They were not patients who showed early symptoms of coronavirus infection. Those so sick they are hospitalized: NO!

Those treated early in the disease get a YES when this is the patient selection criteria.

Allow me to give you an analogy. Aspirin has been reported as beneficial as a preventative for heart disease. Aspirin is not the primary treatment for a patient hospitalized in heart failure.

Michigan Governor’s Folly Continues

5/21/2020: Michigan governor’s response to the Midland flood is that she will sue the responsible party.

Guess who? The State of Michigan who has oversight and determined the structure was sound.

The following responsible party information from: en.wikipedia.org/wiki/Edenville_Dam

“Following the federal government’s 2018 license revocation, the Michigan Department of Environment, Great Lakes, and Energy (EGLE) took oversight of the dam, which involved temporarily lowering the lake by 7 feet.[11] EGLE determined that the dam was structurally sound.[12]”

“[12] Erin Ailworth; John D. Stoll (May 20, 2020). “Failed Michigan Dam Lost License in 2018”. The Wall Street Journal. Retrieved May 21, 2020. After its license was revoked by FERC, regulation of the Edenville dam was taken over by the Michigan Department of Environment, Great Lakes and Energy in 2018. Spokesman Nick Assendelft said the agency inspected the dam in October 2018 and found it structurally sound.”

Incomplete data analysis on Coronavirus Incidence

5/20/2020: The incidence of coronavirus cases are increasing because the frequency of testing is increasing. That should not be surprising nor unexpected. The magnitude of the condition is not reported; asymptomatic or symptomatic patient, just positive or negative test.

The incidence of coronavirus cases with hospital admissions are high perhaps for this contributing reason.

Reimbursement has always been the name of the game in medical economics. Now there is bonus money for coding as COVID-19 for billing purposes. Medicare will pay hospitals a 20% “add-on” to the regular DRG payment for a billing coding of a patient with the new government COVID-19 billing codes.

Medicare has determined that a hospital gets paid $13,000 more if a COVID-19 patient on Medicare is admitted and $39,000 more if the patient goes on a ventilator with the coronavirus diagnosis.

www.statesman.com/news/20200422/fact-check-do-hospitals-get-paid-more-to-list-patients-as-having-coronavirus

This is in addition to the base reimbursement. What you incentivize you will get more of. Ever wonder why the high incidence of COVID-19 patients?

The real numbers may never be known.

Test post

Testing to Facebook

Malaria drug evaluation: some facts

5/8/2020: There are many factors to be considered in evaluation of a drug. The first issue is safety. Hydroxychloroquine has met that standard for 50 years in treatment of malaria, lupus and rheumatoid arthritis. The main potential side effect is adverse effect on the heart and that is infrequent.

A prescription for any treatment selects the intended patient based upon certain criteria. Is the patient without the disease? In this case the treatment is called preventative or prophylactic.

The treatment should be disease specific and in this case the physicians considering the use of hydroxychlorquine for the coronavirus symptoms is called “off label (not FDA approved for this use). It is not being proposed as virilcidal for SARS CoV 2. There is no such certified drug at present. It is being prescribed to affect the symptoms of a specific patient.

The next consideration for a use of a drug is for those presently affected by the disease is the disease stage at time of onset. Did it just start or is the disease progressive?

The magnitude of the disease in the patient is the next factor.

So why all the controversy concerning reports of hydroxychloroquine? So far the answer appears simple and logical. There is a difference in severity of the condition and the amount of the drug given.

The success reports have a patient population that are at the early stage of the disease and treated with low dose.

The failure reports are the use of those advanced to hospitalization and/or very high doses known to be toxic.

The complication in the negative reports are related to the amount of the dose. Those taking 200 mg twice day are not as sick and have fewer complications than those taking greater amounts. There also is the caveat that those getting the higher dose are those most severely effected and with other conditions.

For emphasis, the patients not likely to get a benefit are those in the hospitalized group. They are those (recent New England Journal Medicine) who are the sickest and those with most comorbidity (other disease conditions) and on the highest doses. This is not unexpected adverse result.

The two opposing views, may be agenda driven, but both have credible logical medical rationale. However, but each is based upon different patient selection and treatment parameters.

Bottom Line: It is legal for a patient and their doctor to decide on the individual’s treatment and/or prescription. You may decide with the advice of your physician.