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And, speaking of messes, our new electronic medical record system (Allscripts Touchworks) still sucks and continues to slow us down. We're actively looking into ways to get it working the way that it's supposed to or we'll have to chuck it. Please note that because of all of this, I'm dreadfully behind on responding to e-mail communications. Simply not enough time in the day lately (12-14 hour days in the office). The messages have not been lost and I will do my best to respond to them all. Please bear with me. I hope to get back up to speed again, soon. My dog, Apollo, also had a bad day. Sometimes, even a game of fetch even goes bad... :) Remember, try to make every day a FUN day! 30 January 2009Metamorphosis...
Please stay tuned.... 27 January 2009Please note that the office will be physically closed this Friday, January 30, for demolition and reconstruction of reception/back office areas. Staff will be in meetings off site. Docs will be available by pager if needed.19 January 2009Dr. Giesemann will be out of the office this week. Dr. Lovell will work Tues through Friday in her absence. Also, I have a meeting in San Diego so I will be out of the office all afternoon this coming Wednesday.The Monster Jam hit San Diego this past Saturday at Qualcomm Stadium. I took my son to watch all of the monster trucks with some friends. Now that my hearing has returned, here's a photo of a big truck in action!
23 December 2008Dr. Pearson will be out of office in the morning only to attend an important meeting in San Diego.Incidentally, colonoscopy was fine - no discomfort whatsoever. Patients take note! [The prep sucked big time, though....]
17 December 2008
Short day today, stopping
appointments at 3 PM. Practicing what I preach, gotta begin my prep for
tomorrow's screening colonoscopy!
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Along
the lines that laughter is truly the best medicine, I remind all of you
about
my joke exchange program. Quite simply, be sure to bring in a funny joke
so that I can steal it and add to my repertoire of atrocious puns and whatnot.
In turn, I'll share jokes gleaned from others. For instance: Why do
sharks prefer to swim in salt water? Well, apparently, pepper water
makes them sneeze too much!
Finally, it's book report time! This week, Good Calories, Bad Calories will be released in paperback form. Note that this is NOT a nutrition or diet book - it's a science book that everyone with an interest in nutrition, weight problems, health should take a look at. Author Gary Taubes is not trying to sell a diet program. Rather, this book stemmed from research that he was engaged in while looking at "bad science" for an article that he was writing for the journal, Science.
"Good science" occurs when an individual comes up with a theory and then tests it to make sure that the results are accurate and reproducible. The individual then publishes his/her findings in a manner that correctly summarizes the experiments' conclusions. When experiments are conducted and the published results are not what the tests demonstrated, that would be considered "bad science" (think propaganda).
During the course of his research into instances of "bad science," Taubes was startled to find that many nutritional/diet studies were just that - bad science. He then went back and examined studies of diet/nutrition, exercise, diabetes, lipids (cholesterol), etc and learned that almost everything we've been taught about obesity and diet is not supported by the evidence. For example, some people have been promoting low fat diets and increased exercise as what's best for humans to live long and healthy lives. It turns out that this is pretty much the opposite according to the legit scientific studies. Fat is not the evil that it's been made out to be. Instead, the culprit is sugars (and refined carbohydrates such as white flour) and their inherent ability to stimulate insulin production.
Insulin, as most are aware, lowers blood sugar. Most people are not aware, however, that insulin also deposits fat in the body (including inside of the blood vessels). This is an evolutionary thing. If you're, let's say, a saber tooth tiger that is eating it's fresh kill. It will gorge and the excess calories must be stored for another day because - after all - who knows just how long it will take before it can make another kill (days or weeks)? Insulin does this.
On a practical basis, many people snack on sweets (soda, cakes, candy) and eat meals that contain starches e.g. potatoes. This results in nearly elevated insulin levels throughout the day doing what it does best - deposit fat on the body. This is just one reason for why it's so hard for many people to lose weight. The excellent movie, Supersize Me, demonstrated this nicely. Most of Spurlock's McDonald's meals included large sodas and French fries. However, the guy who ate only the Big Mac's every day (Big Mac Man) did not gain weight!
High fructose corn syrup is another culprit in our lives. While it may not stimulate as much insulin as sucrose, it directly stimulates the liver to put out triglycerides which screws up the good cholesterol (HDL). This leads to heart ailments and strokes.
Taubes also discusses the impact that sugars (et al) have on common disease states. Just a few hundred years ago, missionaries and doctors studied native tribes in Africa, South Pacific Islanders, and Eskimos (among many others around the world). All consumed diets relatively high in fats and protein (and low in carbs). Think coconuts and ocean fish, for example. None of these groups suffered from heart disease, diabetes or any other chronic diseases. Even cancer rates were very low. Enter their exposure to western diet through trading: "Here. Try some of this sugar stuff. Let us show you how to make bread from this white flour." You get the idea. Soon after, all of these populations started to develop problems with obesity, heart disease and diabetes. The evidence is very compelling.
Be aware that I just over-simplified these concepts, but Taubes does a great job of laying out what the science really says about what really works for losing weight (cutting down sugars, refined carbs, etc) and what doesn't (dieting, exercise). Check out the Borzoi Reader's review of the book here. They summarize Taube's findings and even list what the science bears out. Better yet, if you have a difficult time controlling weight, diabetes, heart disease, etc, then pick up a copy and read/study it. I strongly recommend it.
[NOTE: As a result of my reading this book, I will have to revise much of the information that I had written on weight loss and fitness in the Patient Education section of this web site.]
25 August 2008
Sorry!!! We just found out that the telephone service person put the wrong pager phone # in for Dr. Pearson so no calls went thru to him. This has been rectified today.
25 July 2008
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Well, I'm back in town following a much needed family vacation up in Grand Teton National Park, only to find myself inundated with e-mails and labs/charts to review. Please bear with me as it will take me a few days to a week to get all caught up!
Dr. Lovell will be out of town for all of next week in order to visit family back east.
12 July 2008
Dr. Pearson will be out of the office for summer vacation beginning Tuesday, July 15 and returning to the office on Wednesday, July 23. Drs. Giesemann and Lovell will be in the office on their usual days with Dr. Lovell working this Friday.
30 June 2008
The office will be closed on Friday, July 4th.
Dr. Allison Lovell started with us last week! A board-certified general internist with a strong family medicine background as well, she will be in the office on Tuesday, Wednesdays and alternates Fridays with Dr. Giesemann. I hope to have her web page up and running soon! In the meantime, here she is:
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Have a fun (and safe) holiday!
10 June 2008
I will be out of the office Thursday and Friday this week and will work 1/2 days (mornings only) Monday, Tues, and Thursday next week. My daughter is graduating from high school and my folks will be visiting from out of town. Likewise, Dr. Giesemann will also be out of the office on Thursday (only) to attend her son's program. Staff will be in the office and physicians will be available by radiopager.
If you've been in the office lately, you've probably noted that appointment times felt like 'best guesses' at times. We apologize for this and thank you all for bearing with us as a lot is happening behind the scenes that will ultimately help us to meet the increased demand for our services and make us more efficient. For one, we just installed a new computer network and are in the initial stages of transforming into "the office of the future" i.e. taking the plunge into electronic medical health records. In other words, we're ultimately looking at replacing our current paper chart system with computerized records. This is a BIG process and will take many months (if not longer). There is a steep learning curve as our staff learns new appointment scheduling software and the docs learn the new electronic charting program. Still to come: new cabinetry and office carpeting. Please bear with us as we go through these "growing pains."
Also, we're pleased to announce that Dr. Allison Lovell will be rejoining us on a permanent basis. Many of you will recall that she covered for Dr. Giesemann during her last pregnancy. She is a board-certified general internist with tons of experience in family medicine/kids as well. Tentative first day for Dr. Lovell will be June 24th, but this is subject to change as we're awaiting word from the various insurance plans that all administrative work is OK. Dr. Lovell will also work part-time (like Dr. Giesemann) and they will generally work on days opposite each other. This allows them to care for their families/children, but also permits us to offer two doctors in the office most days of the week. This will open up more schedule openings for our patients - we can't wait! We'll post more information when it's available. Stay tuned...
Finally, Dr. Giesemann and myself attended the Pri-Med Conference last month and had the honor of listening to a lecture by Dr. Patch Adams. It was a wonderful talk about the joy of caring. You can learn more about Dr. Adams and the Gesundheit Institute here.
27 May 2008
Power outage knocked out our building and has affected telephones all AM - apparently a Mylar balloon shorted out a power line. We're back up as of 1 PM.
26 May 2008
The office is closed today for Memorial Day Observances. Doctors are available by radiopager.
11 May 2008
Happy Mother's Day to all!
Both physicians will be out of the office on Thursday and Friday as they will be attending the annual Pri-Med conference, in Anaheim. The Pri-Med conferences are designed for primary care physicians (family docs, pediatricians, internists) whereby we stay abreast of the latest advances in the medical arts. We will both be available by radiopager for emergencies and patients will be directed to urgent care if they absolutely must be seen by a physician. [As an FYI, the nearest urgent care for our SCMG HMO patients is the Sharp-Rees-Stealy clinic on Via Tazon in Rancho Bernardo.] Our staff will be in the office on both days if you have any questions or problems. I'm not sure if I'll have e-mail access for those few days so please hold all messages if possible. (Thanks!)
23 March 2008
I will be out of the office this week in order to attend one of my annual sports medicine meetings (AMSSM, AOASM). I will be leaving Tuesday 3/25 and will return to the office on Monday 3/31/08. Later on that week, I'll also leaving the office from Thursday 4/3 until Monday 4/7/08 in order to attend the Niagra Comedy Magic Seminar at Niagra Falls, Canada! Dr. Giesemann will take office call in my absence. [E-mail connectivity during my absence is not a given so please hold all e-mails until I return to town.]
Because of this, Dr. Giesemann's work days this week will be WED, THURS, and FRIDAY. There will not be a physician in the office on TUESDAY, but staff will be in and Dr. Giesemann will be available if needed. Urgent care clinics may be considered, if necessary.
Finally, this week we bid adieu to our Nurse Practitioner in training, Ms. Barbara Beam. We truly enjoyed having her spend the past month or so with us and will miss her. :(
7 March 2008
Nothing new going on in the office, but I wanted to share a few YouTube videos with you all. Make sure that your sound is on!
2 Inspirational:
Jason McElwain: watch this autistic teen's contribution to his high school basketball team!
The last lecture of Randy Pausch: Attitude is everything, even when you're dying. A kindred spirit...
And in the spirit of Randy's lecture, some fun videos:
Cooties: a public health service announcement; check out these cute kids!
Wedding Dance: watch the first dance of a newly married couple! This got them invited onto the Ellen DeGeneres show where they were surprised with the a gift of a harbor cruise along with 20 of their friends!
Jaws Theme: Who comes up with these? A parody sung to the theme from the movie "Jaws!" From the same guy who did parodies of Superman, James Bond, Batman, and the Back to the Future theme songs.
Life IS too serious at times. Take a break and read the Funny Times monthly. You won't regret it. Now, please excuse me as I must return to surgery...
Don't forget the time change coming up this weekend ("Spring ahead")!
21 January 2008
We are open today (Martin Luther King Day). Please be aware that Dr. Giesemann will be out of the office all week long. There will not be a physician in the office on Thursday.
Most of you are aware that we often participate in the training of future physicians by mentoring medical students (M.D. and D.O.) from schools around the country. Over the past months, we've welcomed 4th year students Zach, Kira, and Dan for one month stints with us. We try to set good examples as role models for these young docs as well as for the pre-medical students that occasionally "shadow" (observe) us to see if medicine is really the right field for them. This week, we're welcoming Barbara Beams, a licensed nurse practitioner. Ms. Beams is working towards her Family Nurse Practitioner (FNP) designation. She's an absolute delight and will be with us on Mondays, Wednesdays, and Fridays for the next few months.
Finally, I've been accepted as a non-resident magician member of the Academy of Magical Arts (Magic Castle) in Los Angeles. That's all for now. Until next time.....Alakazam!
23 December 2007
First things first: holiday office hours will be as follows:
Monday, December 24, 2007 - office open for the morning hours only. Both docs in.
Tuesday, December 25, 2007 - office closed.
Wednesday, December 26, 2007 - back to work!
Friday, December 28, 2007 - Dr. Pearson out of office for a meeting (really). Dr. G. is in.
Monday, December 31, 2007 - office open for the morning hours only. Both docs in.
Tuesday, January 1, 2008 - office closed.
Wednesday, January 2, 2008 - back to work!
Didn't get the holiday gift that you were expecting (despite the hints)??? Well, it's still not too late to pick up The Original Chick Magnet (patent pending) from our office. [National sales are pending.] Only $10 (Cheep!). Comes complete with instructions!
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The Kid Nation finale has finally aired and we're all very proud of our niece, Sophia, for doing so well on the show. It was a great show for parents to watch with their kids. Thank goodness that Project Runway is still on Wednesday nights to feed my reality show addiction...
Tired of presidential campaigning already? Join the club and re-listen to my song, Elections, from my "Dad's a Dork" on-line album here.
Well, this should wrap up 2007 for us. From all of us at Medicine-in-Motion, may 2008 be a prosperous year for you all!
20 November 2007
Things have finally gotten back to normal following the fires. Amongst the Medicine-in-Motion staff, only one porch was lost, the home saved by local firefighters. How appropriate that Thanksgiving comes round this week?
Because of the holiday, the office will be closed on both Thursday (11/22) and Friday (11/23). Both physicians will be in the office on Wednesday (11/21) and will be on call by pager for the rest of the extended holiday weekend.
Want to improve your chances of staying reasonably healthy through the upcoming flu season? Wash your hands or use a hand sanitizer gel (such as Purell) frequently. Most germs are spread via water droplets. During the holiday season, millions of shoppers will be hitting the malls touching nearly everything in sight with hands into which they've coughed or sneezed. Prefer not to catch influenza or winter diarrhea? Clean your hands frequently particularly if you're touch lots of items, banisters, etc.. Also, be sure to get your flu shot if you're at risk. [For more information on influenza and flu vaccines, click here.]
Upcoming fundraiser on Saturday, December 1, for Scotty Eveland, the Mission Hills H.S. Football player who sustained a head injury resulting in a prolonged hospitalization. See flyer here for more information. [And while on the subject of the inadequacies of the U.S. health care coverage, be sure to rent Michael Moore's Sicko.]
Finally, one can never have their fill of turkey jokes. Find your fill at:
http://www.thanksgiving-day.org/thanksgiving-day-jokes.html
http://hometown.aol.com/Panda34911/Thanks/HolidayFunPg12CThankJokes.html
http://www.theholidayspot.com/thanksgiving/jokes.htm
http://humormatters.com/holidays/Thanksgiving/thanksgivingjokes.htm
http://www.ahajokes.com/thanksgiving_jokes.html
http://www.basicjokes.com/dtitles.php?cid=30
http://www.101thanksgiving.com/jokes.html
24 October 2007
Due to the prolonged evacuations and destruction due to the fires, the office will remain closed for the rest of this week. We anticipate re-opening on Monday, October 29.
We are unable to do anything regarding scheduling until we are able to return to the office and get the computer systems up and running. Please do not page Dr. Giesemann regarding appointments as there is nothing that she can do about them. Thank you for your patience.
22 October 2007
OFFICE IS CLOSED DUE TO THE FIRES. Fire and smoke has prompted evacuations of the region. Our telephone answering system should be working (unless power is cut) so you should be able to reach Dr. Giesemann in case of emergency.
Because of the intense smoky air throughout the region, use of paper masks or bandanas to cover your nose and mouth is advised. Protective goggles may be necessary depending upon your location. If you have breathing problems normally, be sure to keep your inhalers handy and use them as often as necessary. Eye drops, such as Visine, can be used to treat eye irritation. Try to avoid heavy exertion outdoors because of the poor air quality.
Above all, be safe and don't panic.
15 October 2007
It's that time of the year again. Time for me to venture back east to recharge my accent while I attend the Board of Editors meeting for Patient Care magazine in NJ/NYC followed by a family visit. I'll be out of the office as of mid-Wednesday afternoon (10/17/07) and will return on Monday (10/29/07).
Dr. Giesemann will be in the office on the following days: Thursday and Friday this week and Monday THROUGH Thursday next week. There will not be a physician in the office on Friday, but Dr. Giesemann will be available by pager. My e-mail connectivity will be hit and miss so no one should expect speedy replies while I'm away.
Looking for a fun thing to do this week? Check out John Carny's comedy magic show in Oceanside on the 19, 20, and 21st only. John is a wonderful entertainer/performer - check out his bio here.
30 September 2007
I will be attending the American Osteopathic Association Annual Convention next week and will be out of the office Monday through Wednesday. I will return to see patients on Thursday and Friday. Dr. Giesemann will see patients for me on WEDNESDAY, but no physician will be in the office on TUESDAY. We will be available by radio pager, though, and patients that need to be seen by a physician right away will be referred to appropriate urgent care facilities (e.g. Sharp-Rees-Steely clinics for SCMG patients).
On a fun note, we took an office "field trip" to the SD Charger game today. We had a great time (thanks to our friends Court and John for use of their box)!
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24 August 2007
Several staff members will be away on vacation (or for other reasons) for the next week or so. Dr. Giesemann and Jackie will be out for a week and Kathy will be gone for 2 weeks. Dr. Pearson and the rest of the staff will hold down the fort, so to speak.
1 August 2007
Damn, I'm getting old. Time to take a few days off to look at colleges with my daughter. Dr. Giesemann will be covering me until I return to the office on Monday.
22 July 2007
Dr. Giesemann will not be in the office this week as she is preparing to take her recertification examinations for Family Practice. Because of this, there will not be a physician in the office on Thursday, but Dr. Pearson will be available by pager for emergencies.
4 July 2007
We're obviously closed today in order to celebrate the 231st anniversary of the adoption of the final draft of the Declaration of Independence by the Second Continental Congress at Philadelphia in 1776. Both docs are available by pager through the office, if needed. Dr. Giesemann will be back in the office tomorrow. [We can hardly believe that Dr. Giesemann has been with us for 2 years now!]
Speaking of patriotism, the Men's Club at Lake San Marcos recently sponsored a picnic and golf outing for the "Wounded Warriors" from Camp Pendleton. This was to demonstrate appreciation for all that they've done to serve their country. Several of us entertained the troops at the picnic with some close-up magic.
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Also, last week, we attended the 119th (!) annual fundraising dinner for the San Diego Center for Children. It's theme was "The Magic that We Do" and featured performances by close-up magician Steve Dacri and illusionist Chuck Jones. Hosted by Marty Levin from local NBC News 39, it was a fun way to raise money for this worthwhile organization.
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And finally, from the "not a pretty sight" department:
28 May 2007
The office is closed today for Memorial Day. Both physicians are available by pager for emergencies.
Many patients are inquiring what to do about their Avandia/Avandamet prescriptions. Last week, a somewhat alarmist article was made public by the New England Journal of Medicine that generated a safety alert from the FDA (Food and Drug Administration). The article was a meta-analysis of 42 different drug study trials, many of which tested different things, but had the medication rosiglitazone (Avandia) in common. The authors then calculated what they thought to be the risk of having a heart attack while taking the medication and allege that it is very high. This article was published despite the editors of the New England Journal acknowledgement that the work contained important weaknesses.
On the other hand, according to a recent editorial in the Lancet, it's important to note that two reliable studies (A.D.O.P.T. and D.R.E.A.M.) failed to show a statistically significant increase in risk in heart attack or stroke between rosiglitazone and placebo (although there were more episodes of congestive heart failure seen in these patients when compared to a less effective medication, glyburide).
So what to make of this all? Per the Lancet:
Taken together, these results, although based on very small numbers of events, certainly raise a signal of concern and indicate the need for more reliable information about rosiglitazone’s safety. But the FDA, physicians, and patients can reasonably await the results of RECORD, a phase III trial designed specifically to study cardiovascular outcomes. Until the results of RECORD are in, it would be premature to overinterpret a meta-analysis that the authors and
NEJM editorialists all acknowledge contains important weaknesses.To avoid unnecessary panic among patients, a calmer and more considered approach to the safety of rosiglitazone is needed. Alarmist headlines and confident declarations help nobody.
Bottom line: for now, we're looking at patients on an individual basis. For those at high risk for cardiovascular events, we'll consider a change in medication. For others, we'll take a wait and see attitude. For many, Avandia has made a significant improvement in the control of their blood sugars and the risks of uncontrolled diabetes are well-known (including heart attacks and strokes) and significant. [Also, while we're well aware of the relatively recent heart problems with Vioxx, many of us also remember the widespread misreporting of the Women's Health Initiative study that blew the risks of estrogen replacement out of perspective, scaring millions of women needlessly.]
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The recent Pri-Med conference went well. Besides updates on current medical topics, we got to hang out with some cool characters:
Looking for good book on healthy eating? Check out 30 Secrets of the World's Healthiest Cuisines - a very informative and interesting read.
And finally, don't forget the upcoming San Diego Rock n Roll Marathon. See below (May 8) if you're interested in working with us as a medical tent volunteer.
8 May 2007
Neither physician will be in the office this coming Thursday and Friday as they will be attending the Pri-Med conference up in Anaheim. This large conference is devoted to keeping family physicians up-to-date on the latest medical advances and standards of care. Staff will be available in the office and the physicians will be paged for consultation if needed. Patients that need to be seen by a physician will be referred to local urgent care clinics (e.g. Sharp-Rees-Steely in Rancho Bernardo).
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Last week, Elaine threw me a surprise birthday party at Remy's on Grand in Escondido. As you can see from the picture, I was so excited that I had to be restrained! Highlights of the evening included spectacular magic by magicians JC Wagner and Terry Lunceford, both veterans of the Magic Castle. Thanks to all of the friends that attended and a special thanks to magician Michael Johnson for helping to arrange this fun night! |
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The San Diego Rock 'n Roll Marathon will be held on Sunday, June 3rd and I'd love to have friends join us as volunteers in our medical tent at approximately mile 19.6. Our teams typically consist of physicians, nurses, athletic trainers and anyone else who may be interested in helping out (no medical background is required). If you're interested, go to http://www.rnrmarathon.com/volunteer.html and click on the medical volunteer icon. Be sure to list Dr. Pearson as your referring medical team leader. All race volunteers will receive a free ticket to the concert that night featuring Seal (Cox Arena at SDSU).
17 April 2007
I will not be in the office this Friday as I will be covering the American College of Physicians Internal Medicine 2007 Scientific Program for Patient Care magazine. Dr. Giesemann will be in the office on both Thursday and Friday this week.
The Carlsbad 5000 was run this past April 1st and I helped provide the medical coverage for the event. The best part of it all was covering the kid's races on Saturday (March 31) - they even had a diaper dash for infants!
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19 March 2007
We've been made aware of the fact that there were some telephone problems last week relating to a computer glitch and the time change. I believe that we have it fixed now, but if you have difficulty reaching the office, you can page me directly [follow the instructions under "Contact the Office"].
We apologize for any inconveniences.
16 February 2007
I'll be out of the office today and most of next week (I'll be in office Monday only) to celebrate my son's Bar Mitzvah with family. Dr. Giesemann will work additional days in my absence.
2 February 2007
The end of January marked the end of my second term on the Board of Directors of The Elizabeth Hospice. It's been a pleasure serving with such dedicated individuals over the course of the past 6 or so years. We've continued to grow as we serve North County patients with end-stage diseases and/or chronic pain. As I step down, I leave the organization in very capable hands.
In my July 31 2006 entry, I noted that I was privileged to accept an award upon the behalf of Patient Care magazine from the American Academy of Dermatology. The awards were presented by Robert Wagner and the (still beautiful) Jill St. John. I recently received proof that this was a real event and not a dream...
Finally, on a philosophical note: While going through some old boxes of books, I stumbled upon one of my favorite quotations that I borrowed for a psych paper on dreams. It's from Erich Fromm and my calligraphic version can be found here in PDF format. Until next time...
22 January 2007
Dr. Giesemann will be out of the office all week for vacation with her family.
Last week marked Leslie's last day working with us in the office. Elaine and I are extremely grateful for all of her work over the past year or so as our billing/collections specialist. CHMB, a local firm, will be taking over her duties.
Flu (influenza) season is in full swing. Learn more about it here. Best defense against catching this, as well as the Winter Diarrhea bug (rotavirus) and others is frequent hand washing (or use of sanitizer solutions). There is a treatment for influenza (amantidine) that will shorten its duration (5-9 days) by about 2 days. However, its only effective if initiated within the first 48 hours of "when the truck hit you" (i.e. extreme fatigue, muscle/head aches occur in addition to upper respiratory symptoms). Be aware that the extreme dry air conditions (we live in a desert; non-stop Santa Ana conditions for the past 3-4 months; heating systems dry out air in the home) have affected many people as well. The best way to combat this is via humidity (e.g. breath steam in while showering, run humidifier/vaporizer type machine in bedroom at night, consider use of nasal saline (salt water) spray such as Ocean). Besides the sinus discomforts, the dry air is also responsible for the sudden increase in nose bleeds and dry, itchy skin. In addition to the previous recommendations, consider application of some Vaseline to the inside opening of your nose at bedtime and use a good skin moisturizer.
Reminder: We've had an unofficial joke exchange program for quite some time. Please bring new jokes for the doctors and staff when you visit - otherwise you may be subjected to Dr. Pearson's puns such as: What did the pregnant lady say to the obstetrician upon meeting for the first time? "I'm very dilated to meet you, doctor!"
For example, two of my young patients (about age 5-6) brought in the following jokes for me:
1) What parts of your body are the most musical?
2) Where do boats go when they get sick?
3) Why did the dog go into the freezer?
Answers:
1) Your organs!
2) To the doc(k), course!
3) Because it wanted to be a chili dog!
[If you're hard up for some jokes, you can always check out "E-Mails Greatest Hits" here.]
Yesterday, Curtis (one of our pre-medical students and joke researcher) and I covered one of the medical tents for the Carlsbad Marathon. Here are a few picture:
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Also, last Thursday I made my annual visit to the NAMM Show up in Anaheim where my friend introduced his new line, Baden Guitars. Lots of fun playing with my friends and visiting all of the music industry booths all day long. [If you're bored, feel free to check out some of my original material here.]
Finally, Happy New Year to all!
16 December 06
Dr. Pearson will be out of town all week due to a death in the family. He will not have internet access so please do not send e-mails to him. Dr. Giesemann will be in the office on Monday, Thursday, and Friday. She will also be available by radiopager through the office at other times.
7 December 06
Just a quick note: I've had a computer glitch and have been unable to respond to e-mails for the past few days. I should have things straightened out by the end of the weekend. Sorry! (jp)
22 November 06
The office will be closed on Thursday (11/23) and Friday (11/24) for the Thanksgiving Day holiday. The physicians will be available by radiopager if needed (simply call the office and follow the prompts.
Also, Dr. Pearson will be away from Thursday 11/30/06 until Monday 12/4/06. He will be attending his dad's retirement party.
6 November 2006
 "Oh Auntie Em, there's no place like home!" It sure is nice to be back in southern California after my whirlwind trip back east. New Jersey was getting pretty damn cold in the last day or so before my return home. My internet connections had been spotty and I'm still getting caught up on the e-mails from the trip. Sorry! |
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"All work and no play makes Jack a dull boy." |
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OK, so I did manage to sneak in some fun things while I was away. While in Las Vegas, my magician friend Mike flew up and joined me. We caught some great magic shows notably the Rick Thomas and Mac King shows. [Rick is packing up his show and taking it on a world tour. I can't recommend the comedy magic of the Mac King show high enough - it's been called the best afternoon in Vegas. Go see it the next time you're there!!!]
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In New York/New Jersey, I had the good fortune to spend some time with other great magician/teachers. I visited David Roth (arguably the best coin manipulator in the world) and Mark "Magick" Blay at the Fantasma Magic shop at Penn Station and spent some quality time at the Jackson Hole diner in Leonia (NJ) with Bob Fitch. I also stopped by Meir Yedid's place in Elmwood Park (NJ).
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More important than the magicians, however, was the time that I got to spend with my family. My dad had just been discharged from the hospital and we celebrated his 76th birthday together. He's going to retire from private practice at the end of this month after nearly 50 years of family medicine! What's next? He hopes to get back to his songwriting.
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For Halloween this year, we offered the tricks of magician Bob Elliott to our patients. Bob was David Copperfield's teacher and has taught countless others, as well, over the years including David Blaine and Criss Angel. Needless to say, our patients were wowed by his performances and made waiting fun (for a change)!
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Finally, back to business: Dr. Giesemann will be in the office on Monday and Tuesday. [It's unclear whether she'll be in on Thursday or Friday due to her kids' schedules. We will know soon, though.] Also, we WILL be open this Friday (Veteran's Day holiday).
Regarding influenza vaccines (flu shots): We have received only a few shots for very high risk patients. All HMO patients need to go through the flu shot clinics sponsored by Sharp Community Medical Group at North County Fair. I think that they're held every Tuesday, but you can contact our office directly to get the straight scoop from our receptionists. If you have an opportunity to get a flu shot from one of the many pharmacies and stores providing them, we suggest that you get your vaccination there.
Reminder: the best way not to catch the flu (and most other infections for that matter) is to wash your hands often (or use hand sanitizer liquids), especially while shopping at crowded malls/stores. For more influenza facts, check our patient education handout piece here.
14 October 2006
Dr. Pearson will be out of the office (as of Monday October 16) to attend the American Osteopathic Associations annual convention in Las Vegas, followed by meetings in NYC (Board of Editors meetings for Patient Care and Medical Economics magazines). He will return to see patients again on Thursday, October 26. [Local parrotheads will note that Jimmy Buffett will be playing at the Coors Amphitheatre in Chula Vista that night - perfect timing for an office "field trip."] While he's away, Dr. Giesemann will see patients every day except for Tuesdays.
We continue to make adjustments in our office policies in order to best accommodate our patients needs. As such, we will now try scheduling some appointments in advance for the 8:30 AM - 10 AM and 4 PM - 5 PM blocks. The downside to this is that it will make it more difficult to get a same day appointment, but we're willing to give this a try to see how it works.
Another recent event that has impacted our office is the recent takeover of the Sav-on pharmacies by CVS. We've literally been inundated by irate patients who had been told that we had not called in (or faxed) their prescriptions into the pharmacy. In every case, we had called in the prescriptions promptly and documented the date/time. [One CVS employee confided to us that not only are they having problems adapting to the new software, but in some cases where a phone # or birth date did not accompany the message (which is NOT a requirement), then the tech would delete the message!] It seems that nearly all CVS pharmacies that we deal with have been affected by this problem (i.e. not "receiving" our telephoned prescriptions). Bottom line; please do not scream at our receptionists (yes, some patients have actually screamed at them!) about things that are beyond our control. Our staff works hard to serve our patients and treat them all with the utmost respect. Please do not be rude to them in kind!
28 August 2006
Dr. Giesemann will be out of the office this week for vacation. Dr. Pearson will cover for her in the office on Thursday. Also, the office will be closed on Monday, September 4th, for Labor Day. Dr. Giesemann will be back in the office on Thursday, September 7th.
Also, Dr. Giesemann and I have finally decided to employ the Hospitalist Service at Palomar Medical Center to handle all of our admissions. we have known these physicians for several years and have confidence in their skills. While we both really enjoy the challenges associated with hospital work, it's simply become too difficult to manage a busy office practice and make rounds/emergency visits to the hospital at the same time. [For those of you who may not be familiar with hospitalists, these are physicians who spend all of their time in the hospital, managing care throughout the days and nights, hence they're always available to deal with unexpected emergencies.] Dr. Giesemann and I will continue to make "social rounds" to visit our patients and continue to monitor their care from the office via the hospital's computer network. If you have any questions regarding this policy, please do not hesitate to contact our office.
31 July 2006
Computers are up and running again (finally). Well, let's get caught up...
First,
we're thrilled to welcome Jackie to our
office as our new medical assistant.
Jackie
has many years of experience working in a family medicine setting and she's also
bilingual (Spanish). We're sure that you'll all like her as much as we do!
The office continues to get busier and so we recently brought on a practice management advisor who has provided us with many excellent suggestions. We will begin to implement them as we're able to and will post any significant changes here if warranted.
The insurance industry continues to change and we've had to adjust accordingly. We dropped Pacificare PPO (not the HMO product) last year because their reimbursement rates dropped too low. United Healthcare then purchased Pacificare and subsequently lowered their reimbursement rates as well. As has been the trend with many other medical practices, we've decided that we can no longer participate in the United Healthcare PPO product and have terminated our contract with them.
What does this mean for our patients? For the typical patient, it turns out to be not much difference. These patients can still be seen in our office through their "out of network" coverage and their out of pocket costs often remain the same. For example, a hypothetical insurance plan may provide 70/30 coverage whereby they'll pay 70% of the medical charges and the patient will be responsible for the remaining 30%. If an office visit charge comes to $75, 30% comes out to about $22. This is pretty close to the now common $25-35 co-pays that most PPO plans require for in-network providers.
The only difference is that the patient pays the full office visit charge at the time of service and get reimbursed later on from the insurance company (we'll submit the claims electronically for our patients). If you have any questions about your particular PPO out of network benefits, call the member services on the back of your insurance card to find out what your payment responsibilities would be. If you have further questions about this topic, please feel free to contact the office and we'll do our best to try and help you.)
The heat wave is finally breaking it seems. I covered the archery event at the California State Games down at the Olympic Training Center (Chula Vista) a few weeks back and it was toasty. Good time to remind everyone about the importance of hydration and staying cool. An electrolyte replacement solution such as Gatorade is recommended for long exposures to hot weather. Drinking cold water is fine if you remember to boost your salt (sodium) intake to prevent hyponatremia. [Please scan down to the 28_July_2005 "Latest News" for the full scoop on this subject.]
Also, don't forget to apply sunscreen daily. I advise making it a habit to apply sunscreen lotion in the morning when you brush your teeth so that you don't forget. In addition to your face (including ears and neck), you should consider your forearms because they absorb a lot of ultraviolet light rays while driving, for example.
On a related matter, this week I was proud to accept a Golden Triangle Award upon behalf of Patient Care magazine for a skin-related article that we published last year. The event was held as part of the American Academy of Dermatology meeting at the San Diego Marriott last week. This gave me an opportunity to receive a congratulatory hug from one of the very first "Bond Girls," Jill St. John (while her husband, Robert Wagner, looked on). They both looked great and I'll post a picture when I receive it.
Cruisin' Grand continues to run every Friday night in Escondido through September. Be sure to drop by the Grand Magic shop and be entertained by magician JP Scirica and friends (myself included).
Finally, we really liked Dr. Allison Lovell when she covered for Dr. Giesemann. Her Borrego Springs office is being closed so we're inviting her to see her patients in our office. More on this when it happens.
23 June 2006
My laptop has been out of commission for the past 4 weeks on intermittent basis, hence I've been unable to post to this site, as well as answer e-mails on a regular (prompt) basis. Please bear with me until I get the bugs worked out.
In the meantime, please note that I will be out of the office all of next week on a much needed vacation (will be watching my daughter's club volleyball tournament!). Dr. Giesemann has been back in the office since the beginning of the month and will cover for me in my absence. She will be in the office from Tuesday through Friday. This means that there will be no physician in the office on Monday 6/26/06. Our staff will be in and Dr. G. will be available by page if needed. We're sorry for any inconvenience that this may cause.
17 April 2006
Happy Birthday to the newest little Giesemann! [Both mom and son are doing well, by the way!]
Attention diabetics: The Eli Lilly pharmaceutical company has offered to sponsor a free lecture for our patients in our office. "Managing Your Diabetes" will be presented by Cindy Martin on Tuesday, April 25 over the noon hour. This will be an excellent opportunity to ask questions regarding your condition. Please RSVP to Mary Carden (619-885-6462) by 4/21/06 so that we may reserve a space for you.
I still receive compliments on my weight loss and am continually asked how I manage to keep it off. Aside from running 4x/wk with Apollo, the secret also lies with choosing slimming outfits such as:
Finally, I'll be away at a medical conference this week and will not be in the office on Friday. Dr. Lovell will be in the office both days (in addition to her usual Wednesday hours).
27 March 2006
The countdown continues...
Dr. Giesemann will begin her maternity leave the first week of April (unless the baby has other plans) and is currently planning to be out of the office for 2 months. An old friend and colleague, Dr. Allison Lovell, has agreed to fill in for her during this time period. Dr. Lovell will see patients in the office Wednesday, Thursday, and Friday of each week.
On the magic front, I was accepted as a member in the International Brotherhood of Magicians (IBM). Also, some of you have been lucky enough to have been entertained by retired magician, Bob Elliott, when he drops by the office. Despite many television appearances, he is not a household name, however he has many famous students including David Copperfield, Chriss Angel, and David Blaine to name just a few. We enjoy watching him perform his sleights of hand (and mouth) whenever he's visits!
23 January 2006
Please note that Dr. Giesemann is away on vacation this week. I will be taking evening and weekend call for her until she returns.
I just received notification that I passed my sports medicine re-certification examination (taken during Hurricane Wilma in October). I'm good for another 10 years - hurray!
Some years back when I was deciding upon a name for the practice, I (very) briefly considered plagiarizing the 3M name (in my case representing medicine, magic, and music). Earlier this month, I was fortunate enough to attend an intimate session with one of close-up magic's greats, Eugene Burger, at The Grand Magic Shop in Escondido. If you've been in the office recently, you've probably seen some of the fun things that I had learned from that session.
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This past Thursday, I made my annual pilgrimage to the NAMM Show, up in Anaheim, the largest music industry trade show. It's easy to feel like a kid in a candy store there - so many musical instruments to try, so little time. Here is a glimpse of what went on inside:
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And now back to the practice of medicine...
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