When it comes to a wound and pain,
Think of gravity to help and to drain
Leave out the drugs
Prop up with some rugs
And cut out Big Pharma’s gain.
Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, travelled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I am back having adventures in temporary positions until they have an Electronic Medical Record (EMR) system I can get along with. I spent the winter in Nome, Alaska, followed by assignments in rural Iowa. This summer included a funeral, a bicycle tour in Michigan, cherry picking in Iowa, a medical conference in Denver, and two weeks a month working Urgent Care in suburban Pennsylvania. Any patient information has been included with permission.
Sunday went slowly till the last, a patient or two an hour. I got time to eat lunch and supper without rushing.
I saw a lot of respiratory ailments today. Most people get a runny nose, a low-grade fever, and after about 4 days a sore throat and a cough. So far, the strep and influenza tests keep coming back normal. I counsel patients about Tylenol, rest, and fluids; antibiotics would have a greater chance of harming than helping. And, indeed, recently I saw a couple of bad reactions to antibiotics.
One of the non-respiratory patients, extremely sharp and quite elderly, came accompanied by an offspring. The therapy recommended a couple of weeks previous had failed to resolve the problem I observed that swelling in a limb puts the skin under tension and makes wound healing impossible. Thus to fix an ulcer on a swollen ankle, one must first fix the swelling. In the majority of cases gravity will drain the edema. During my 23 years of private practice, I regularly hospitalized patients for non-healing diabetic foot ulcers. I called in a podiatrist consultant, whose therapeutic mainstay consisted of keeping the patient’s feet elevated above the level of the heart. It always worked. So I told the patient to stack blankets and towels on the recliner to keep the foot higher than the heart by at least 12 inches and preferably 18. Pillows don’t work, I explained, because they compress. And if we can just keep the part involved elevated, chances are you won’t need other therapy. And if you don’t keep it elevated, all the antibiotics in the world won’t help.
I needn’t have worried about unselling the drugs; the offspring currently studies naturopathy. The patient related a family member’s story, full of drama and irony and reflecting poorly on my industry, as the background for a low enthusiasm for medication. I couldn’t argue with the conclusion. And my approach, using a low-cost, low-hazard, readily available commodity (gravity), met with great approval.
I had barely finished the documentation when the evening rush started with six patients checking in after 7:00PM. I still managed to get my charting done by 8:17PM, and walked out into the darkness.