My heart is no longer in your kidneys…

Your heart is now in my hands!!

I just started my Cardiology rotation last Monday…

and tomorrow morning I get to assist inserting a cardiac pacemaker!!!

I love what I do!!

gretch

This is a short film Gretch & I have just made. The film is called “2008 (A Retrospective)”. That’s right. It’s more of a test than anything, but now we can post videos to our blog. Let us know if you like the idea as much as I do and we can continue rolling footage for you! Talk to you soon – Dennis

p.s. Gretch is responsible for some of the most famous shots, like the church.

Hillary or Obama? Part 2

*****At this point I (Gretch) am leaning towards Obama… but if I find good reason to vote for another candidate or to not vote for Obama… my mind could change. If you have discovered facts from a reputable source for or against… PLEASE SHARE!!!****

******Dennis had no part in writing these blogs as he is not sure how he feels about Obama… I do agree with him in the fact that Bill Clinton did a LOT for our country, so maybe he would influence Hillary? I wish that it was Bill that was on the ballot!!*****

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Did you know?

Obama is the only democratic front runner who never voted for the invasion of Iraq.

Barack Obama’s Record

• Barack Obama opposed the war in Iraq from the beginning. In 2002, as the conventional thinking in Washington lined up for war, Obama had the judgment and courage to speak out against the war. He said the war would lead to “an occupation of undetermined length, with undetermined costs and undetermined consequences.” In January 2007, Obama introduced legislation to responsibly end the war in Iraq, with a phased withdrawal of troops engaged in combat operations.
• Obama has a plan to immediately begin withdrawing our troops engaged in combat operations at a pace of one or two brigades every month, to be completed by the end of next year. He would call for a new constitutional convention in Iraq, convened with the United Nations, which would not adjourn until Iraq’s leaders reach a new accord on reconciliation. He would use presidential leadership to surge our diplomacy with all of the nations of the region on behalf of a new regional security compact. And he would take immediate steps to confront the ongoing humanitarian disaster in Iraq.

Hillary or Obama? Part 1

I am determined to stand strong in my decision when the November elections are knocking at my door. That gives me.. ummm about 10 months to really research the candidates and make a strong argument for Obama. So I thought every once and awhile I would cruise through each website looking for issues that will sway my mind.

Here is my first find:

Healthcare.

Being an Almost Doctor is stressful and makes me want to know what kind of Healthcare World it will be when I am done. Who really knows? As I was reading through Hillary’s plan… I could not find a darn thing about how her plan will impact physicians. All you non-physicians may not really care… BUT! it is imperative that you do! GOOD… no wait SUPERB folks are NOT entering medicine because of all of the bureaucratic hoops that must be jumped through to be said doctor.

• $200,000 dollars in med school debt (yes that’s an accurate number),
• SKYrocketing malpractice insurance,
• HMOs tell us docs what tests are best for YOU the patient (they [HMOs] have absolutely NO education in how to take care of your serious illness, but they dictate what tests we are allowed to order for you unless you want to pay out of pocket),
• doctors are also reimbursed for NUMBER of patients seen or NUMBER of lymph nodes extracted if you have possible cancer, even if they are not necessary… therefore you have less time with the doctor (because they have to meet a quota for the insurance company) and you have less lymph nodes (which if extracted from certain places like extremities, can cause tremendous edema and loss of use of limbs)!
• pharmaceutical companies who won’t stop adding their corporate 2 cents…
• and the list goes on and on.

So… Hillary: missed the boat on this one…

Obama: YAY! Here is what he has planned for some of these issues, of course I can’t list his ENTIRE list here… but here are a few… (you can also read more on www.barackobama.com)

1. Align incentives for excellence. Both public and private insurers tend to pay providers based on the volume of services provided, rather than the quality or effectiveness of care. Providers who see patients enrolled in the new public plan, the National Health Insurance Exchange, Medicare and FEHBP will be rewarded for achieving performance thresholds on outcome measures.
2. Comparative effectiveness research. Obama will establish an independent institute to guide reviews and research on comparative effectiveness, so that Americans and their doctors will have the accurate and objective information they need to make the best decisions for their health and well-being.
3. Tackle disparities in health care. Obama will tackle the root causes of health disparities by addressing differences in access to health coverage and promoting prevention and public health, both of which play a major role in addressing disparities. He will also challenge the medical system to eliminate inequities in health care through quality measurement and reporting, implementation of effective interventions such as patient navigation programs, and diversification of the health workforce.
4. Reform medical malpractice. Obama will strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance and will promote new models for addressing errors that improve patient safety, strengthen the doctor-patient relationship and reduce the need for malpractice suits.

Lowering Costs by Increasing Competition in the Insurance and Drug Markets: The insurance business today is dominated by a small group of large companies that has been gobbling up their rivals. There have been over 400 health care mergers in the last 10 years, and just two companies dominate a full third of the national market. These changes were supposed to make the industry more efficient, but instead premiums have skyrocketed by over 87 percent.

1. Barack Obama will prevent companies from abusing their monopoly power through unjustified price increases. His plan will force insurers to pay out a reasonable share of their premiums for patient care instead of keeping exorbitant amounts for profits and administration. His new National Health Exchange will help increase competition by insurers.
2. Lower prescription drug costs. The second-fastest growing type of health expenses is prescription drugs. Pharmaceutical companies are selling the exact same drugs in Europe and Canada but charging Americans more than double the price. Obama will allow Americans to buy their medicines from other developed countries if the drugs are safe and prices are lower outside the U.S. Obama will also repeal the ban that prevents the government from negotiating with drug companies, which could result in savings as high as $30 billion. Finally, Obama will work to increase the use of generic drugs in Medicare, Medicaid, and FEHBP and prohibit big name drug companies from keeping generics out of markets

UNTIL THE NEXT STONE IS OVERTURNED….

My heart is in your kidneys…

OK, maybe not for real… but I’m on Nephrology service… and it is soooo incredibly interesting.  Our patients are not doing too well, they have mostly cardio-renal issues & it’s hard to fix multiple major organs that are failing

Thought I would share a bit about my day…..

I have been on the service this entire week, which begins with me arriving at the hospital at around 7am to pre-round on our patients.  I talk with the staff to find out how their night was, I talk with the patients and do a focused history and physical and I sit down with my iced-soy white mocha to write a S.O.A.P. note.  (Subjective, Objective, Assessment, Plan)  The majority of our patients have been in the ICU, and on tele and just don’t seem to be improving.  One pt is s/p MI and had an anoxic event and is not doing very well, others just have long standing heart trouble (usually CHF) which is a decreased cardiac output which then can act on the kidneys as hypovolemia and decreased profusion.  Not a good situation.

So the Dr. meets me around 10am and then I report to him my findings and we round together…. we save about 45 minutes to discuss different Renal issues, such as fluid hemodynamics, the renin0-angiotensin-aldosterone system, acute renal failure vs. chronic, acid-base disturbances…. the kidneys do a lot!  Then I have a lunch lecture on a completely unrelated topic, and will head back to the floors to do full H & Ps on any new consults.

Today.. Saturday… I got to the hospital a little after 6am, and after prying my eyes open… I had a really good time!! I LOVE this service.  The physiology is mind boggling… it is so much fun to unravel the mysteries of the kidneys!  So… I just got done, I’m taking a shower and heading for a nap.

Dennis is working right now and will be home in a couple hours… he has been so wonderful and supportive, and always listens to my long medical stories (thank you)… he starts his EMT Basic course on Tuesday.. and I’m really excited for him..  he has been anxiously awaiting it!!!

Much love all, keep in touch….

and keep your kidneys healthy!!!

-g

Yay! Thanks Iowans!!

Jon Orlando

A great photographer and old mutual friend, Jon Orlando, has some new photos/projects…check out his email below.. and new link! Much love all!!! ~~~~

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Hello All-  I wanted to update you on a photo project that I’m working
on.  Some of you have seen portions of this project but new images
have been added recently and more will continue to be added in the
upcoming weeks.  The project is a portrait series of Iraq War veterans
who are resisting the war.  It is an attempt to understand who these
individuals are, and why and how they are resisting a war they were
once a part of.  It is a work in progress that is currently focused on
veterans here in Colorado but will hopefully expand nationally soon.
I have been deeply moved by the courage, determination and humility of
these individuals and I can only hope my photography does their
efforts a bit of justice.
http://www.jonorlandophoto.com/IraqVet.htm
To find out more about The Iraq Veterans Against the War- www.ivaw.org

Also, I was recently awarded first place in the people category of a
photo contest put on by Popular Photography for a portrait I did of my
lovely girlfriend Candice.  Here’s a link.

Enjoy and Cheers- Jon O.

www.jonorlandophoto.com
303-827-5434.