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My dietitian and me

My Dr G (G for gastroenterologist) sent me off to see a dietitian. Given weight management is also important for arthritic conditions, this was a sensible recommendation all around, I thought. We had a bit of a rocky start to our relationship, did Ms D and I. Our first appointment was changed three times before I got to see her! I sent her all my eating records from MyFitnessPal so she could analyse my current intake. My second consultation was yesterday morning and I have to eat more vegetables and more dairy. I knew about the vegetables already (guilty as charged), but the dairy I had been avoiding. Apparently women my age (there’s that damn age thing again) need lots of calcium. Ms D also noticed I have a weakness for the odd piece of chocolate (small, within my calorie limit).

Ms D is keen on legumes. I’m not. I blame that on my mother’s broad bean fetish (I hate the darn things). I’ll eat green beans, but Dr G wants me to stay away from them due to the fructose. I’ve agreed to eat baked beans every now and then.

Did you know a standard serve of porridge is 1/2 cup? HALF A CUP? I’ll starve to death. On the other hand, I am supposed to eat four serves of grain (cereal) foods a day. Oh, that includes bread I’ve just realised, so maybe achievable. I was envisaging eating muesli with my dinner. I think I can have two serves of porridge for breakfast!

I am to snack on walnuts or almonds, but brazil nuts (my favourite) were not considered as “fit for purpose”. Now, I like walnuts, but I wish the “Healthy Eating for Adults” and MyFitnessPal talked the same language. The former talks grams, the latter talks “walnut halves”. There is no correlation between what each thinks a serve is. The former says 30 grams, the latter says four halves. Four halves is nowhere near 30 grams. I’m confused. (NB: I did find another entry later for 25 grams, that will do)

Does Ms D know how expensive walnuts are?  Nearly $12 for 400 grams. Mind you, at 25 grams a day, that will last sixteen days. I hope. I have resident two-legged rats……. I’m hoping they don’t like walnuts……

HealthyEating

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The abrasiveness trap: High-achieving men and women are described differently in reviews

Originally posted on Fortune:

Not long ago I was talking to an engineering manager who was preparing performance reviews for his team. He had two people he wanted to promote that year, but he was worried that his peers were only going to endorse one of them. “Jessica is really talented,” he said. “But I wish she’d be less abrasive. She comes on too strong.” Her male counterpart? “Steve is an easy case,” he went on. “Smart and great to work with. He needs to learn to be a little more patient, but who doesn’t?”

I don’t know whether Jessica got her promotion, but the exchange got me wondering how often this perception of female abrasiveness undermines women’s careers in technology.

I focused on performance reviews for a couple of reasons. First, reviews provide written documentation of people’s perceptions. My friend called Jessica “abrasive,” but would he put that into her lasting professional record?…

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How safe is the patient safety net?

Team Oyeniyi:

Here is another health issue. This one impacts me too. Being a family, the safety net threshold is higher, but only one person is sick. Thankfully my meds are not too expensive and I’m still working, but I can see how this would impact pensioners or those on the DSP greatly.

Originally posted on Doctor's bag:

How safe is the patient safety net?

In the ‘Blogging on Demand’ series you get to choose the topic. If you have a great idea you want the world to know about, feel free to contact me. Perth GP Dr Jacquie Garton-Smith proposes a change to the PBS safety net to protect vulnerable patients.

“One thing that my patients with chronic disease on lower incomes find difficult,” says Dr Garton-Smith, “is that they have to pay for all their medications until they hit the safety net. Even if people are only paying the lower rate for scripts, it adds up if they are on a number of medications. I have seen it affect compliance at the beginning of the year when they have to decide which medications they need most.”

The general patient safety net threshold is currently $1,453.90, and the concessional threshold $366. When someone or their family’s total co-payments reach this amount, they only have to pay the concessional co-payment amount…

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It has been that sort of parenting day

I started my Saturday with a walk around the block and spotted these flying high in the morning sun over our suburb.

After I drooled over the idea of sailing across the sky, knowing the going rate for a trip is around the $428 mark, I settled back to flower spotting. These look so delicate, it is a wonder how they survive a day.

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Autumn flowers in Melbourne

I’m out walking again – slowly and for short periods of time. As during the GCC last year, I can’t resist collecting pretty flowers in my travels.

I am COMPLETELY “flora ignoramus” so I have very few names! I simply enjoy the beauty of nature. Readers enjoyed my shots last year, so I’m picking up the habit again. Makes a change from unwellness and political debate!

If you are interested in last year’s shots but missed them, here is a selection.

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Ethics and integrity in health blogging

A fellow blogger, Carly Findlay, has today published Health blogging, honesty and authenticity. I am not nearly in the same league as Carly when it comes to writing about health. It was never my intention to write about health at all, I wrote about civil rights and politics. Then I got sick and my health and political concerns merged with the battle to save our universal health system. I’ve morphed into a part-time health blogger by accident of circumstance.

Carly’s article is very timely and appropriate, as she highlights:

There’s a rise in health and wellness bloggers – many of which have reached celebrity status. And celebrities have now reached medical practitioner status. As my friend Anne Marie said, introducing this article, “get your medical advice from a doctor, not from a celebrity” (or blogger). These people are not qualified to dispense medical advice or treatments – they are social media celebrities.

The very wise Pip Lincolne wrote

“Being well-known does not mean you know well.”

Ain’t that true.

I worry that the alleged doubts of Belle Gibson’s cancer and charity donations (and also the death of ‘Wellness Warrior’ Jess Ainscough, Pete Evans, and actor Charlotte Gregg’s baby paleo book) will discredit genuine illness and certified health bloggers. Pete and these three women have online fame – many followers who believe in the lifestyle they’re selling. As far as I know, they don’t have medical or nutritional qualifications. They claim they’ve healed through food. (And Belle might not have had any illness to heal!) And that is alarming.

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eHealth – what is the future?

This is an extract from my latest article for The Australian Independent Media Network.

As a patient seeing multiple health professionals and having registered, in great hope, for eHealth, I was very interested to hear the doctors thoughts about their own profession. I understood the patients’ perspectives all too well.

There was a general consensus from the medical personnel about the silo culture of medicine in this country. As Dr Ranjana Srivastava said (in relation to repeat testing), “when doctors work in silos, you kind of don’t want to get into other people’s way”: we see this in many walks of life, not just medicine. Dr Charlotte Hespe spoke about the difficulties of getting results across barriers of fragmented communication, Dr Nick Bretland spoke of having to fax (yes, fax) forms to a public hospital to get x-ray results. I had an MRI and the films were available on my smartphone 5 minutes after the scan. Yet the GP has to fax forms to get the results? Bureaucratic red tape forms many of those barriers.

Professor John Dwyer stated ” … we do not have a patient focused health care system.” Assoc. Prof. Terry Hannan of Launceston General Hospital said, “patient centred care is the patient having their own record.”

Read the complete article ……..

 

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Hey doctors, here’s a new medical condition: Tough Cookie Syndrome

I’ve made a medical discovery, so listen up doctors! It is called tough cookie syndrome. It goes something like this for me, but feel free to adapt to your own patients’ particular circumstances.

Patient doesn’t feel well so you, the kindly general practitioner, start the diagnostic process. A scan or two here, a blood test or ten there. A specialist or two gets invited into the mix. Way too many tests come back positive. In the meantime the patient (that’s me in this case) is trying to lead a normal life: work, look after the family, balance the budget now ballooning with medical bills. You tell the patient to take three days off; patient says two will be plenty – then ends up crashing out of a meeting on day three. Yes, I know you have patients to whom you suggest three days rest and they plead for four. Those patients don’t have tough cookie syndrome. I’ve realised I often tell the doctors “I’m fine” when they ask how I am. Of course I’m not “fine”! That’s why I’m there!

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Calories in and calories out: supplements count

To minimise stress on my poor joints I am on the weight loss and then maintenance treadmill. I’m a firm believer in the simple maths approach: if one puts in more than one uses, one gains weight. If one uses more than one eats, hurray!

What I’ve discovered is the other things we can be taking for medical conditions have calories! They add up!

Knowing your Basal Metabolic Rate (BMR) is important. This is how much energy you burn just being alive: keeping your heart pumping, breathing, digesting food, blinking. The actual formula is quite complicated so it is handy that MyDr.com.au has a handy calculator. My BMR is around 1500 depending on the scales on any given day. I’m very jealous of the person on Twitter who has one of around 1200 – she is skinnier than me!

Setting myself a calories IN target of 1200 a day and using a minimum of 1500 OUT just being alive means the scales will gradually tip in my favour. I hope. Swimming a kilometre will earn me either a nice downward movement on the scales OR an ice-cream. Decisions, decisions.

Guilty Pleasure - Magnum

Guilty Pleasure – Magnum – a meal on a stick

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International Women’s Day 2015: MAKE IT HAPPEN

How would you feel if you were insulted by your partner on your birthday? Not wonderful? I didn’t think so. All Australian women should feel insulted by the Queensland LNP Women holding their International Women’s Day event at a “Men Only” club.

Now, I’ve read, very carefully, Peta Simpson’s rationale for holding the event at that venue. I agree with some of the points Simpson makes. I still think it as a highly inappropriate choice of venue given the battle for equality is far from over.

It pales into insignificance, however, against this behaviour of one Hani Al Seba’i, a London based “scholar” (very questionable description, if you ask me) who felt it was beneath him to be interviewed by a woman.

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