Tag: restrictions

Get RID of post op restrictions? I think not.

As most of you may or may not know, I have to renew my board certification for obgyn on a yearly basis, often with a multitude of articles and modules that require completion and a series of tests to take. I think they think that it is a good reminder to stay invested and keep up to date. I personally feel that I am capable of that on my own without paying exorbitant fees, but oh well.

Anyway, I regret to say that it is rare that one of these required articles contains information that is either brand new to me or significantly useful. Most of the time I am looking at them and having to read them for credit and just go with that approach. Some of the articles I feel are downright potentially harmful. I need to tell you about one of them.

Most recently, I read an article in a very reputable journal suggesting that we abandon all post op restrictions. Post op restrictions are the what I feel is very necessary guidelines to maximally assure a good recovery after surgery. They include things like holding off from sexual activity for six weeks. No lifting, pushing, pulling anything over a full gallon of milk for six weeks and no driving for a car for at least one week. Yes, I know, it potentially sets a patient up for ultimate boredom and frustration. You are watching your house get dirty. You are watching your kids run amuck. You are missing out on your normally awesome cooking, etc.

However, having said that, I have found that, in my almost thirty years of experience, that these recommendations, while not popular, are the way to go. It is my way of helping to ensure a good recovery for my patients. So, I read this article, claiming that all these recommendations are anecdotal/heresay at best and have no scientific evidence or backing. This article also says that there is the same change in intrabdominal pressure with getting out of a chair as lifting something heavy. I am sorry, but that cannot possibly be true.

So, I started doubting myself. I thought maybe I am being too strict. Maybe these “experts”( that probably haven’t treated an actual patient in years) were right. So, I gave it a try. I gave up the post op recommendations for one set of surgeries for one day. You know what happened? Two of my patients ended up bleeding after wrestling with a dog or picking up their kids since they couldn’t stop….and one ended up back in surgery after tearing their vagina open. That was a definite turn off for me. I guess my anecdotal self realizes after thirty years that not all incisions are created equal. I can see that with a visible abdomen incision you might get a heads up if you are about to make a big mistake and tear your incision open. With a vaginal incision, there is nothing you can monitor visually and no good prior warning signals you have to to tip you off before it’s too late.

The bottom line is, I tried to follow this nonsensical potentially dangerous advice and it backfired almost immediately. So, we are officially BACK to the post op restrictions!

Dr. Katz

Let’s Goooo!

Ok guys. Here is all the latest and greatest updates. My brain is cancer free and looks positively boringly normal! Yesss!

My vision is 20/15 with my glasses on and I am able to get rid of my bifocals! Yess!

My memory is doing pretty awesome and a lot of the short term loss has returned. Yess!

I am able to do complex puzzles and remember strings of 12 numbers. Yess!

My energy is good. I still have to have the occasional power nap, but who doesn’t? Yess!

My hemoglobin is finally in the normal range! Yess!

I am inches away from being granted full functioning privileges at the hospital with no restrictions! All the paperwork is in. Yess!

Obviously, I still have some precautions to follow with my baby immune system and all and I still need to get revaccinated for everything. But, it is truly time for everyone to bring the level of worry down to a healthier level. I totally get and appreciate all of it and I understand all of it. But, it is time to climb down from def con five level. We have done it folks! It is time to celebrate and live! I promise everyone that I am not going to do anything that I don’t truly feel ready for or that could put myself or anyone else in danger. Let’s do this! Have a great day!

Dr. Katz

Pandemic apathy or…I think I’m getting too used to being by myself

Cancer plus pandemic has forcibly reduced my level of human contact over the last year. Whether it was due to government regulations or physical restraints from my illness, the effects were the same: less people were physically in my life at any one time. At first I fought it. I felt angry and restricted, especially when I was still healthy. Then when I got sick, I still felt resentful every time I had to be left behind when my family went somewhere or left out of a favorite activity. After awhile though, it started to feel easier to bow out of things, easier to just stay home and sit with my dogs, watch TV, and have no expectations. It started to become too comfortable. It is still too comfortable. Traditionally I am a social person who needs people, who savors life and interaction. Now, it seems like I have to force myself to leave the house and carry out any kind of responsibility. Now granted, I have the plethora of chemotherapy side effects like pain, neuropathy, and intense gastrointestinal distress that legitimately get in the way sometimes. That is true. However, I find myself wondering if I will still have reluctance to gather even after those excuses are out of the way. This is concerning. The words lazy, lackadaisical, and apathetic have never before graced my daily life vocabulary. I don’t really like them setting up residence now, but I am not sure what to do about it. I don’t really think that it is fear anymore that is keeping me inside. I think it’s something worse: apathy. I am just over it. I am just over all the panic and the restrictions, but at the same time I am out of the energy to discuss them, fight them, or act against them. What I need is a strategy for emergence that makes sense for me, my sanity, and my particular set of circumstances and limitations, not anyone else’s. Here’s hoping that I develop a good one and I hope you do too.

Dr. Katz

Takin it easy is not the same thing as being a prisoner.

Oh man am I having trouble with that distinction lately! First of all, limitations have never really been my jam to say the least. I have been a patient more than I care to admit in my lifetime. You know, multiple surgeries, medical emergencies, accidents, time off work, the whole nine yards. I am usually the one who is walking the halls just hours after emergency surgery. I am not a stay tied down kind of person. Now that the universe decided that cancer with chemo plus a pandemic was a good idea, I am looking at a whole lot more than just some temporary limitations. There is no way around it. I feel like I am looking at house arrest for months. Let’s face it, I will be immunosuppressed, on top of having cancer, in the midst of an ongoing pandemic. I can’t afford to take chances so I need to suck it up.

Yes, I exaggerated. I won’t exactly be on house arrest. I am going to work when I can. I will need to leave the house for doctor appointments. I just won’t be going out of my way to go out to dinner or take unnecessary risks. I probably won’t be doing any hospital procedures either. It’s just being smart. To be honest, it won’t be that different from what is going on now, except for the fact that the chemo I will be on shoves me from the mild risk category to the top of the highest risk category when it comes to death from infection and Covid. Yippee! This is not the kind of line that I wanted to cut to the front of.

In my rational moments, it all makes sense. There is no point in fighting hard to dodge the cancer bullet if I am just going to open myself up to the Covid one. That would be ridiculous. The restrictions are in place to help keep me safe and see this thing through to the end. I choose to follow them. I know that. And, it’s not as if there isn’t enough Netflix to go around to entertain me.

There are other things that I worry about though. Yes, believe it or not I worry about being bored, even though I am working on a book, a podcast, a blog and I try to post daily updates. I worry about having too much time to think which runs the risk of being counterproductive and focused on worrying with nothing to distract me. I worry about resenting my family and friends as the pandemic restrictions lift and life resumes again while I watch vicariously through a proverbial window. I worry about being consumed with guilt from letting people down. I realize that everyone is being tremendously understanding now, but everybody has their limits. See! I wouldn’t have so much time to overthink all of this unless I was on restrictions!…lol

Oh who am I kidding? No one really has to enforce my restrictions. My body takes care of that nicely. I never know which version of me is going to lift her head off the pillow in the morning: the one that is raring to go for several hours or the one that gets short of breath after about three steps and has to sit back down. It is a real Wheel of Fortune going on around here and I am definitely not the big winner the majority of the time. I am kidding myself to think that I could really change that even if I wanted to right now. It is what it is. The only real choice that I get to have control over is my attitude and my willingness to accept the advice of my doctors. I have to realize that this is not their first rodeo and that they do actually know what’s best based on experience, knowledge, and training. Like I am always saying, I need to be a team player in my healthcare. If coach says I need to sit on the bench for a bit, well then I better just sit.

Dr. Katz

The Art of Slogging

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OK, now that I have your attention. What the hell is slogging? The word slog is a verb meaning to work hard over a period of time. It also means to hit forcefully and typically wildly, especially in boxing. For the purposes of this blog, we are going to stick with the first definition. Personally, I also find the word imbued with a trace of difficulty or struggle as well, as if the work being done is innately more challenging than usual and that more effort is required. I also think that it implies a certain lack of joy in the task to be completed. Even the word itself has a heaviness to it, at least mentally and emotionally. I don’t find myself using it unless I am referring to a state in which I am struggling to get the basic requirements completed day to day. One final potentially positive component of the word slog is the implication of a necessary process, like slogging to get somewhere.

I think that this word perfectly describes the world at large today with all of the changes in restrictions, work environments, and day to day life. The level of unpredictability and the lack of control has brought out the worst in some and brought out the best and most altruistic in others. I even find myself struggling to get up, get dressed, and get psyched up to face the day, not knowing if I am going to be at the hospital for 25 hours or 4 hours, or if anyone is even going to show up. It is a conscious, sometimes burdensome mental effort to go to work and strive each day. This is by no means a reflection of how much I love my job. I LOVE MY JOB. I always will. I LOVE MY PATIENTS. I am grateful to even have a job. I have always embraced the role of the uplifting, caring, compassionate superhero to women. It’s my favorite thing in the whole world to help save someones life, make it better or bring new life into the world. It’s just that the positive level of variety that first attracted me is not the same. The variety I now encounter has more to do wondering who if anyone is going to show up on a given day. On top of that, my hands are tied with regard to what services I am ALLOWED to provide for patients. Some of the best aspects of my job in terms of preventative care and early diagnosis are severely limited right now because I do not have a crystal ball to predict what a patient needs without a procedure, exam or surgery. It is very frustrating to go to work every day knowing that I am not able to give patients everything they need. I worry every day about what I am potentially missing because of these limitations. Last, but not least, let’s not forget the mental burden of economic insecurity. There is no unemployment for bosses and business owners. There are some loans with a mountain of paperwork and extensive stipulations, but even those have no guarantee of ensuring the survival of your business of 20+ years. There you go, slogging at it’s best. I am getting through every day and working hard, but it is a struggle and the joy factor is more limited, not because I don’t love what I do, but because I am not allowed to completely do what I do. And yet, I keep slogging away in order to be able to eventually get back to running my practice as I see fit.

I get the same kind of feeling at home too. Most days, I manage to get myself motivated to at least attempt a project that has been hanging over my head( sometimes for years) and then other times I feel like I would rather scream than clean one more thing and I just don’t feel like doing anything. The difficulty rating of just going to the store has now been elevated to a ten out of ten between masking, gloving, making lists and figuring out a strategy to get the most with the least trips, knowing that I might not leave the house for an errand for another few weeks at best. Then there is the daily feeling hanging over your head that leaves you wondering if this truly is the new normal? On top of that is the constant barrage of input from all directions of conspiracy and control theories that only serve to add to the overall panic and disrupt any logical progression of thought. You cannot get away from them. You turn off the news and they appear on you social media instead. You turn away from social media and just listening to music and your broadcast is interrupted with another update. Whew! It’s a bit much. Again, slogging at it’s best. But, right now, there is no other choice. I have to keep slogging through on my way back to the way things used to be. It’s part of the process right now. It’s part of the process of doing my part in order to flatten the pandemic curve. If I quit or rebel, I am not making anything go any faster. Maybe if we all slog together, we may just get to the end of this thing a little faster. Let me leave you with this quote from Walter Annenberg, philanthropist, businessman, and ambassador:

” I want to remind you that success in life is based on hard slogging. There will be periods when discouragement is great and upsetting, and the antidote for this is calmness and fortitude and a modest yet firm belief in your competence. Be sure that your priorities are in order so that you can proceed in a logical manner, and be ever mindful that nothing will take the place of persistence.”

Dr. Katz

How’re we doin?

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Hi everybody! Shelter in place day 1. How’re we doin? I am feelin the panic from everyone. I even felt a little creeped out last night when I went for my walk and suddenly my phone was overtaken by a reminder of the executive order…complete with a notice about unnecessary travel being prohibited. It literally gave me the chills for a second, like I was in one of those weird future dystopia movies or something. Then, I shook it off. You know why? Because it is not really any different than what we were supposed to be doing anyway! I know what you’re going to say. Hey! Before we could still get take out and go to the mall, etc. Hey! This is even a bigger crush on small business. Yes. Yes. All that is true. My business is being severely affected too. I can’t do any surgery, unless it’s an absolute emergency. I can’t see any people that are sick who actually need me. They have to go through the ER or stay at home. I can basically only see well patients or OB patients, if I can even get them to come in. I am not immune to this process. The scary flipside is, that I also have to risk exposure to COVID everyday. If a COVID positive OB patient comes in, we still have to figure out how to deliver them safely with the least exposure to the least amount of people and keep their newborns safe as well.

However, if you think about it, we were already supposed to be restricting unnecessary trips and travel. We really should have been following our social distancing, not going to restaurants, not going to the movies, not going to the mall anyway. There was no dire need to get our nails done or go to the tanning salon. These are not basic life needs. Before you get all ruffly, let me explain what I mean about basic life needs. They are things that are life or death dependent. Your life or death does not depend on how brown you are or how good your nails look or if you got that extra candle or how gray your hair is ( Trust me, I am battling that one as we speak). It just doesn’t, if we are being honest. I am of the opinion that if we were truly following instructions in the first place, there would have been no need to issue an executive order. (Having said that, I also get that a politician’s need to appear like they are actively doing something in a crisis may, in fact, supersede the actual need for action.) If we hadn’t panicked and hoarded all paper products, in reaction to a virus whose main symptoms are NOT GI symptoms, except for a small percentage, those of us that have been working like crazy might have had an option to wipe our asses besides the wipe with the left, eat and shake hands with the right method. C’mon people! I am looking at all the fear-mongering, crazy Facebook posts. They are unnecessary. They are not helpful. They are not helping anyone get through this thing.

I took it upon myself to break down the governor’s executive order announcement into a less than five minute summary. I will do the same right now for you. Here are the main bullet points. Stay at home whenever possible. If you have an essential job (defined on the Michigan.gov website), you can go to and from work. Essential businesses are still open. You can go to get gas for your car. You can go to the pharmacy or grocery store. You can still get money. You can still go to the doctor or to the hospital if you need to. You can still go outside. You can still go for a walk. Maintain your social distance of 6 feet at all times. No crowds. Have meetings remotely. All your basic needs can still be met. Amazon is not shutting down like rumors have said.(JK, she didn’t really address that…lol..but it is true.) Don’t panic. Don’t hoard. That is it in nutshell…in two minutes or less. Let’s just all screw our heads back on properly and dig into our common sense reserves and we will get through this together! Have a fantastic day everyone!

Dr. Katz

Just when I thought I could stop being anxious

I saw the news today celebrating no new corona virus cases in Wuhan. Whoohoo! That means there is an end to this thing at some point, right? It sounds good doesn’t it? Now take a quick step back and remember that this cycle took several months….that we know of. Also consider that China was months ahead of us. This means we are not done with this for awhile folks. This means it is more important than ever to listen to the EXPERTS like the CDC…not google…not your friends( unless they are healthcare workers on the front lines maybe)…not your chiropractor or the kid at the grocery store. Pay attention to Dr. Anthony Fauci! Who is Dr. Anthony Fauci? He is the director of the National Institute of Allergy and Infectious Diseases. If he starts talking, be quiet and listen for a minute. He says think twice before you get on a plane. He says we have to take this seriously. He says that there are no PROVEN safe and effective therapies for the Corona Virus yet. That does not mean that possible treatments are not being looked at. He doesn’t say to panic, but he does say that we all need to do our part to stay at home when possible, not to make unnecessary trips and to stay away from crowds to decrease the chances of spread. Every time I see the latest beach vacation pic lately with hundreds of people in sunny Florida, defiantly partying, I just scratch my head in bewilderment and disgust. What the heck do people think they are doing? Have we become so egocentric that we think that nothing can permeate our own little bubbles? Do we think our actions have no consequences? Newsflash! There are no bubbles right now! Every single unnecessary exposure just puts more people at risk like gigantic ripples on the ocean. I can’t help looking at those pictures with some resentment as I am going straight home from work and then straight back to work the following day. I think about the vacations that are now cancelled and everything my kids are missing. But guess what? All those things are survivable and worth it! I realize that the government is not just trying to ” control” me or “mess with me.” They are trying to take what steps they can to stop the spread of this thing. Believe it or not, the same folks that are defying the guidelines while complaining about being controlled are the same folks that are taking the one element that we can control( social distancing) and throwing it to the wayside, unilaterally deciding for all of us how the course of this virus will go. I had to go to the store today for the first time in awhile. I was standing in line and these two people stumbled up next to me, obviously under the influence of something and were making out in line. Then they decided to plunk their items down almost on top of mine and then snatch them back, run back to the aisle and pick out something else and then plunk that down on top of my purchases. They were also both coughing with no attempt to cover whatsoever. I looked at the guy and said,” What are you doing? Now is not the time for that.” They just stared at me, shocked, as if it completely escaped them that I would not want to be coughed on, bumped against, watch them slobber over each other, or have our purchases hang out together like some kind of slumber party in the middle of a pandemic! Imagine that! To be honest, I wouldn’t enjoy any of those behaviors even if there were no pandemic, but who’s counting..lol) It is just this kind of ignorant and belligerent behavior that is going to get us all into trouble, make this pandemic last longer and completely close the small window of opportunity for us to get back to our normal lives a little sooner. Please people. We have to do better. It won’t kill us to stay in our houses more, cook at home, stop making unnecessary trips or avoid crowds. Life will go on temporarily without trips, festivals and concerts, but if we don’t try a little harder to follow these temporary guidelines, we will end up having to forcibly surrender all of the autonomy that we thought we were fighting for in the first place.

Dr. Katz