Age Before Beauty

There was shocking and disturbing news at the recent American Stroke Association conference-strokes rates have risen dramatically between 1994-5 and 2006-7 but only in the younger populations!  While there are many explanations for the data (51% rise in 15-34 year old males, for example) but certainly in part, this is related to the obesity crisis coming home to haunt.  Strokes are sad because:

1. Even with early warning signs and advanced medical therapeutics, strokes remain devastating in terms of quality of life-they less often kill than maim
2. Stroke rates can be dramatically impacted by lifestyle decisions-obesity, smoking, sedentary lifestyle, etc.

This study should serve as the shot across the bow-we can no longer ignore the dangerous health trends in this country-a FAST FOOD NATION is doomed to egregious health outcomes, stroke being a prime example.  Each one of us has to commit to trying to live healthier lives and help others to do so as well,

I have long been an exercise enthusiast and have been proud of my locavore/healthy cooking style.  Nonetheless, like many 50-somethings, found my weight had crept to dangerous levels.  I have made further adjustments and am proud to say, have dropped 25 pounds over the last 6 months.  But then I decided to take an even greater step and try to turn my new awareness to greater purpose.  I have set a challenge in both of my offices related to sustainable weight loss.  I decided that as a physician I have to both walk the walk AND talk the talk.  I hope everyone will try and think of at least one thing you can do in your own life or for those you love to help reverse these dangerous trends.

My Nudge Contest

nudge 
tr.v. nudged, nudg·ing, nudg·esTo push against gently, especially in order to gain attention or give a signal.
nudge or nudzh or noodge Slang (Yiddish)
n.  One who persistently pesters, annoys, or complains.

Of these definitions, my Yiddish-flecked childhood reflected primarily the latter. So, thanks to Howard Luks for first bringing the notion of using the nudge (ie first definition) to medical use and studies that have shown the clear effectiveness in areas such as diet and exercise.  For those who haven't had the time to absorb the ever-expanding global world of nudges, I can recommend the nudge blog by Thaler and Sunstein devolved from their book of the same title.  The concept has acquired so much traction there has been a serious call for research into the effective use of the nudge in medicine.  Already in Australia, when filling a prescription, an Aussie can enroll in a nudge club that will prompt proper use of the medication.  The daily nudge is a service you can use to create your own health inducing nudges.

So here is my challenge: Submit you best idea on how to use THE NUDGE  to promote health!  Think big or small, technical or spiritual, systems or individual.  Humor welcome.  Please submit to: womenneurosurgeo@aol.com

7 Post Challenge

If I have a blogger hero it has to be Suture for a Living-she single handedly inspired me to pursue my own blog, to understand how to make it work for me, and her blogs are always interesting, informative, well written and linked to others who help make the medial blogosphere worth being a part of.  As usual, she led me to the 7 Post Challenge which I just couldn't resist.

Polish Kebab Anyone???

1. My first post now seems like such a novice effort.
2. The post I enjoyed writing the most allowed me to combine man aspects of storytelling that I most like and tries to demonstrate how I as a woman/person/mother/neurosurgeon deals with the variety of patients I encounter every day.
3. A post which had great discussion...well I have to say I haven't been the most popular but writing about medical malpractice seems to generate the most notice.
4. You can always visit TBTAM for a wonderful mix of food, travel, musings or Toni Brayer, MD for insightful medical thinking.
5. Obviously none of my blogs have been life-changing-but that isn't why I am blogging so I would offer up Exercising Your Brain and Rage Against Golf as ones I think would be helpful if more people read them.
6. Titles? Perhaps I should spend more time thinking about them, I am usually most concerned with getting my thoughts down but I did have fun writing Pop, pop, fizz, fizz when Congress was failing miserably in addressing the Medicare cuts.
7. I wish more had read my blog about JAMA review of Heart of a Lion, Hands of a Woman: What Women Neurosurgeons Do because I am so proud of this book and wish the blog would encourage more people to buy it and discover the amazing talent of this group of women neurosurgeons.

Exercising Your Brain

If you are between the ages of 40 and 65 and sometimes wonder if your brain will make it through another day (without forgetting an important name, what you went to the basement to retrieve, etc), take heart-you are not alone! Take heart, it seems that close inspection reveals that while there may be many of these little slips, the middle age brain is doing more than fine.  In this regard, we who are "middle-aged" often feel isolated in our forgetfulness, constantly worried about the threat of dementia so I was thrilled last week to tuned into NPR and listened to Barbara Strauch (NY Times science writer) talk about her new book, The Secret Life of The Grown-up Brain. 

She relates that studies show that "in this middle span, we get higher scores on all our tests in a whole range of areas, including inductive reasoning, verbal memory, vocabulary -- we're better in that span than we were in our 20s." Middle age wisdom then is , "Because the brain sees connections, it sees the full picture."

For me this all makes perfect sense-I often feel like I "get the whole picture" and understand the solution to problems (or diagnoses with patients) in an instant but then may have to write it down so I don't forget it before I can put into action.

And the imporant lesson is that we really must keep exercising our bodies and our brains-beyond crosswords and books.  She even advocates at least a little of intellectual conflict to "juice the brain".  Maybe that explains why I am enjoying my blog so much-it does keep me on my toes.

I read the following excerpt from the book and now know I will get the book (available at all the usual palces like Amazon, Barnes and Nobel, etc):

Indeed, despite long-held beliefs to the contrary, there's mounting evidence that at middle age we may be smarter than we were in our twenties.
How can that be? How can we possibly be smarter and be putting the bananas in the laundry basket? Smarter and still unable, once we get to the hardware store, to remember why we went there in the first place? Smarter and,despite our best efforts to concentrate on one thing at a time, finding our brains bouncing about like billiard balls? (Viking Press, copyright 2010)