Members get a daily Covid-19 topic focused on Covid in Tennessee.
Supporters are part of a self-improvement sub-group where value is dispensed daily on personal growth in all aspects of life, informed by many sources. New members welcome!
I have to admit it: I'm sick of talking about Covid. I'm sick of hearing about Covid. I'm sick of the angst, the debates, the conspiracy theories.
Sorry, just had to put that out there, lest you folks imagine that this gives me any joy at all. It does not.
But I've taken on this role of trying to help this mess make sense to folks who aren't necessarily as familiar medical topics, and so we soldier on. If it were up to me, we'd move on to other topics, but Covid isn't going away, no matter how much advice we give. People are dying of preventable complications, and don't seem to understand math.
The virus continues to be driven by human culture.
How could we stop it? I don't think that's possible.
Part of the drama now is the result of a trend toward reducing available beds, controlling the supply of healthcare through Certificate Of Need schemes in the various states that have interfered with the market, keeping it from responding to opportunity.
We only have x number of beds because regulators have not given permission for more. This creates scarcity, which has consequences like what we have now, where we have a huge disruption in needed but not-urgent procedures because the supply of beds, nurses, and doctors is limited by regulation and educational opportunities.
If you want to see what the free market can do, look at Surgery Center of Oklahoma. Price-up-front services for a variety of surgeries, in a state that does not require a certificate of need for acute care facilities.
Medicaid and Medicare payments do not track with inflation, and, in some cases, are a loss for facilities. Along with that, there is a cost-of-living correction (I forget the specific term) that adjusts the reimbursements from CMS by a formula that, for my corner of Northeast Tennessee, is about 75% of the national average, or was when I last heard. As a result, our area has suffered for many years from depressed nursing wages (60-70% of national average), and so nursing mobility has been only one direction for our region - away.
One thing that may become necessary (I'm not hearing this discussed yet) is more beds, designed for Covid overflow, and staffed flexibly. We can't be held captive by uncontrolled spikes from the next variant or the one after that. It's not fair to any of our patients to not adjust as needed to community need.
As importantly, one of our national priorities needs to be meaningful attention to mental health. We need to return to appropriate use of inpatient facilities for acute and some chronic psychiatric illnesses. We need to move away from a focus strictly on pharmacologic therapy and renew focus on psychotherapy (talk therapy) with therapists trained to dig deep and not paid strictly by number of patients seen. Meaningful help for patients takes TIME. There is no substitute for it.
We've had a growing mental health crisis for several decades, but it has been greatly accelerated by Covid and our policy responses to it.
Humans need meaning. The damage done by stealing from people their livelihoods and their freedom has been severe. It will take a lot of work to turn things around for many, and many others will never recover.
Sorry for the random nature of this post.
Stay healthy!
I'm on a weekend night call schedule this weekend, which always leaves me feeling under-rested and generally icky.
But I wanted to remind you that outdoor exercise without screens is really good for your mental health.
Go outdoors, preferably into the woods.
Get in tune with those surroundings, the sights, the sounds, the smells, even the movement of air and the varying temperatures as you walk.
We were made to be outdoors.
We were definitely not made to work in cubicles.
One Degree!
What you want from your body will dictate what you need to set as goals, and the goals will determine what you'll end up having to change to attain them.
I've spoken many times about systems being better than goals, and my position has not changed.
But goals are easier to discuss and to understand, so for this week, we'll be very specific about goals.
Do you want more muscle mass?
Do you want to be stronger?
Do you want to run faster?
Do you want to gain weight?
Do you want to lose weight?
Do you want to improve general fitness?
Do you want longevity?
Do you want strong bones?
Do you want to earn a Black Belt?
Understanding the benefits and costs of each particular goal may help you decide what you want.
For example, if you want to compete in body-building competitions, you'll not be doing the same thing as if you were focused on longevity. Same with strength competitions.
But general fitness and longevity go fairly well together.
Running is great but will increase the likelihood of needing knee or hip ...
I'll make this one short and to the point.
Spring time change is hard on all of us. Having to get up an hour early doesn't make going to bed an hour earlier much easier.
Yes, it's nice to have more productive time in the evening.
But it's at the cost of forcing us out of be an hour earlier, as we all know.
Our challenge is to adjust our circadian rhythm to match the world's expectations around us.
My main strategy is supplementing with a dose of melatonin about a half hour before I need to be asleep. It helps most people fall asleep more readily.
If you need a nap during your day, take it between mid-morning and early afternoon. Limit it to 20 minutes.
Taking a longer or later nap may make it even harder to get off to sleep in time.
All of the other normal advice applies even moreso:
- Take a 20-minute walk after supper.
- No screen time for the last hour before bed.
- Listen to calm music after supper.
- Don't eat for 2 hours before bed.
- Don't have conflict-laden conversations ...
