Category: Medical

Now that April 15^th is taken care of (unless you’re like me and filed a request for an extension), April 16^th is the national day set aside annually to address healthcare decisions. The goal is to (1) encourage and empower people to begin or continue conversations about their wishes for care through the end of life, and (2) educate people on the importance of advance care planning. Unlike missing a tax deadline, there’s no penalty if you don’t take action on April 16^th, but there’s a clear advantage to observing the day so that healthcare professionals respect and meet your wishes.

Notably, healthcare decisions involve more than end-of-life issues. Anytime a person is incapable of making sound decisions an advance directive is critical for choosing care that matches the choice a person would make for themselves. When a person is unconscious, medical professionals often turn to next of kin to make treatment decisions on issues such as mental health, blood transfusions, and amputations, to name a few.

According to a 2018 National Survey by the Conversation Project®, 92% of Americans say it’s important to discuss their wishes for end-of-life care, but only 32% have had such a conversation. Dr. Susan Nelson suggests that “our delay in having these conversations is because it often seems too early, then, suddenly, we find it is too late.” The Conversation Project® promotes the kitchen table as the place to begin such conversations, not the ICU.

I recently found myself in this position when my husband Robert was struggling to breathe in a hospital Intensive Care Unit (ICU). I was asked to give consent for him to be connected to a ventilator to avoid his lungs from collapsing and then to begin dialysis treatment to clear the fluid from his lungs that his chronic kidney disease was preventing. I hated to make either decision because of the risk and skill needed to successfully intubate someone with his type of dwarfism—Spondyloepiphyseal Dysplasia—and the life sentence to dialysis treatment.

Yet despite my reluctance to make these decisions for Robert, I knew what choices he would make. Thankfully, we had not only had the conversation about our end-of-life care but also had taken the next critical step of formally documenting our decisions with an estate attorney. Robert appointed me as his Health Care Surrogate and signed a Living Will.

So how far along are you with advance care planning?

For useful resources go to:

• National Healthcare Decisions Day. https://nationaltoday.com/national-healthcare-decisions-day/
• Erica Costello. “National Health-Care Decisions Day.” March 28, 2024. https://www.americanbar.org/groups/law_aging/publications/bifocal/vol45/vol44issue5/nationalhcdecday/
• Susan Nelson, MD. “National Healthcare Decisions Day 2024: What You Should Know.” March 4, 2024. https://blog.ochsner.org/articles/national-healthcare-decisions-day
• “10 Ideas of Things to Do for National Healthcare Decisions Day (in 10 Minutes or Less).” Posted on 04/07/2022. https://theconversationproject.org/tcp-blog/10-ideas-of-things-to-do-for-national-healthcare-decisions-day-in-10-minutes-or-less/
• Conversation Starter Guide. https://theconversationproject.org/wp-content/uploads/2020/12/ConversationStarterGuide.pdf

• Begin the Conversation. https://theconversationproject.org/wp-content/uploads/2020/02/BTC-NHDDToolkitHandoutversionck.pdf

Providentially God placed all the right people around Robert—the family sharing our banquet table included a respiratory therapist, nurse, and nursing student! All three joined hotel security staff in our hotel room to assess Robert’s breathing. The therapist even had a Pulse Oximeter to read his blood oxygen level. And indeed it was low enough for him to need oxygen. It was time to call 911!

Robert used the hotel’s portable oxygen tank until the ambulance arrived to take him to the Denver Health Medical Center and admitted to the ICU. The medical consensus was that the most likely cause of Robert’s breathing trouble was the cumulative effect of being in the Mile High City for a week. As a sea level resident of Florida, Robert was classified as a flatlander, and would be fine once he got back to sea level. And they were right. He used a portable oxygen concentrator for the flight home and, as predicted, he was fine soon after touch down in West Palm Beach, Florida.

All credit goes to God for taking care of us both during this stressful time. “God’s angel sets up a circle of protection around us while we pray.” Psalm 34: 7, Message

If this incident had happened 50 or so years earlier it would have been harder to call an ambulance. There was no coordinated 911 number and you had to know the local number of the emergency service you needed—fire, police, or medical. Also, the emergency number was often the same as the non-emergency number, meaning a busy signal was common.

In the United States (U.S.), the first 911 call was placed on February 16, 1968. However, it has taken years for this emergency number to go nationwide. Coverage has only increased gradually —17% in 1976; 50% in 1987; almost 93% in 1999 and 99% in March 2022. So as we appreciate this wonderful service, let’s bone up on some useful 911 facts:

1. If you’re not sure about your location, 911 can usually track cell phone callers.
2. Although texting to 911 is available in select areas, it’s better to call so operators can gather more information.
3. Amazon Alexa can not directly call 911, but Google and Siri can call via voice command.
4. You can call 911 even if your phone does not have a current service plan.
5. In an average year, around 240 million 911 calls are made in the U.S.

Image by F. Muhammad from Pixabay

https://pixabay.com/photos/first-responders-ambulance-3323385/

You may also want to read:

• For a full account of the 911 Denver story, go to Chapter 14, Let Me Ride in “ALWAYS AN ADVOCATE: Champions of Change for People with Dwarfism and Disabilities” by Angela Muir Van Etten. https://angelamuirvanetten.com/always-an-advocate/
• “The History of 911: Celebrating More Than 50 Years of Emergency Calling.” August 7, 2023. https://www.911.gov/about/the-national-911-program-celebrates-50-years-of-911/
• Macy Meyer & Cynthia Paez Bowman. “Your Guide to Calling 911: Helpful Tips When Reporting an Emergency.” September 11, 2023. https://www.cnet.com/home/security/your-guide-to-calling-911-helpful-tips-when-reporting-an-emergency/

• “10 Things You Might Not Know About the United States’ 911 Emergency Telephone Number.” https://www.waldenu.edu/online-masters-programs/ms-in-criminal-justice/resource/ten-things-you-might-not-know-about-the-united-states-911-emergency-telephone-number

African Americans age 40 and over; and (2) those with a family history of glaucoma, elevated intraocular pressure, diabetes or high blood pressure (hypertension), myopia (nearsighted) or hyperopia (farsighted), eye injuries, or steroid use.

Despite having severe myopia and wearing glasses or contacts since my 20s, no eye doctor ever told me about being at risk for glaucoma. My great grandmother did go blind in her late 70s, but no diagnosis was made or shared with us grandchildren. As to family history, I do have an aunt with severe myopia being treated for glaucoma.

The first time glaucoma was mentioned to me was after my November 2021 vitrectomy surgery for a hole in the macula and retinal tear in my left eye. Notwithstanding surgical repairs, the optic nerve was irreparably damaged leaving me completely blind in that eye. In numerous post-operative visits, the surgeon repeatedly referenced my glaucoma as a possible explanation for the vision loss. Every time he did this, I told him I didn’t have a glaucoma diagnosis. After checking his notes, he agreed and apologized. However, I suspected he backed off because as a retina specialist it was outside his specialty to diagnose glaucoma. Yet I knew it was within his skill set to see telltale glaucoma indicators.

Consequently, I was highly motivated to do everything in my power to preserve vision in my one and only sighted eye. In addition to reliance on the Great Physician, I consulted with a glaucoma specialist for a diagnosis. At a specialty eye clinic, I had another immersive experience with inaccessible diagnostic equipment: Tonometry to measure eye pressure; Visual Field (Perimetry) to check peripheral vision; Fundus camera to observe the retina, optic disc, blood vessels, macula and fovea, and posterior pole; sonogram eye scan; Pachymetry to measure cornea thickness; and Gonioscopy to measure the drainage angle in my eye.

The conclusion? I am a glaucoma suspect! Even though a glaucoma diagnosis is uncertain, good follow-up care is the key to determining changes or “progression” over time. My vision, eye pressure, fluid drainage, and optic nerves will be checked at regular intervals. Meanwhile, I use topical eye drops to lower eye pressure. I will not be silent prey to this disease.

How about you? The Glaucoma Awareness month in January is a great time to check your vision status.

You may also want to read:

• Angela Muir Van Etten. “Tackling Inaccessible Medical Equipment, Part II.” Blog post. March 28, 2022. https://angelamuirvanetten.com/tackling-inaccessible-medical-equipment-part-ii/
• Angela Muir Van Etten. “Tackling Inaccessible Medical Equipment.” Blog post. April 19, 2021. https://angelamuirvanetten.com/tackling-inaccessible-medical-equipment/
• Angela Muir Van Etten. Dwarfs Don’t Live in Doll Houses; Pass Me your Shoes; and Always an Advocate. Dwarfism Memoir Trilogy. https://angelamuirvanetten.com/books/

Additional Resources:

• American Academy of Ophthalmology, https://www.aao.org
• American Glaucoma Society, https://www.americanglaucomasociety.net/home
• Bascom Palmer Eye Institute, https://umiamihealth.org/bascom-palmer-eye-institute.
• The Glaucoma Foundation, https://glaucomafoundation.org.
• National Eye Institute, https://www.nei.nih.gov.

• The Glaucoma Research Foundation, https://glaucoma.org.

The natural tendency is to resist PT because it hurts! Indeed that’s a common excuse for refusing to do assigned exercises. But as counter intuitive as it sounds, PT can help reduce pain and discomfort. For example, by strengthening muscles, tendons, and ligaments strain on the joints is eased. Therefore we need to be stronger than our excuses and follow the example of various patients:

“Instead of giving myself reasons why I can’t, I give myself reasons why I can.”

(Proactivept.com)

“Today it hurts, tomorrow it works.”

(teepublic.com).

I know this from experience. At age 36, I had severe pain and immobility in my left shoulder. I’d had it before but, this time, rest and over-the-counter medication didn’t solve the problem. I was skeptical when an orthopedist referred me to PT. But after three months of anti-inflammatory pills, heating pads, ultrasound, stretching, and exercise, I was pain-free with improved range of motion. I also learned how to manage future frozen shoulder threats and flare-ups.

PT also helps with post-surgery rehabilitation. After my husband Robert’s bilateral hip replacements in 1997, he not only grew an inch, he also worked hard on his therapy. His discharge from the hospital to home depended on him being able to climb stairs into the house. He was so determined to achieve this goal that the therapist observed that he must be a workaholic. And she was right. Once at home, he continued his hard work and dedicated himself to reach his new goals of returning to the office and driving his vehicle.

After my aortic valve replacement open heart surgery in 2013, I imagined I would entertain visitors reclining on plumped up pillows in the bed. Instead hospital staff had me on my feet and walking circuits within a couple of days. The patients who stayed in bed instead of doing their daily walks were jeopardizing their recovery. I understood the connection between movement and healing, used all six of my PT home visits, and diligently did my exercises. Thankfully my therapist was very adept at modifying the exercise regime to my orthopedic limitations. He taught me how to stay physically active without breaching sternal precautions.

PT can also be an alternative to medication and surgery. It can increase endurance and strength, improve balance and breathing, and reduce joint inflammation. If you want independence without disabling pain, consider PT. Be ready to “push yourself; no one is going to do it for you.”

 “The work you do today determines where you will be tomorrow.”

(k2-healthcare.com)

The therapy examples in this post are excerpted from “PASS ME YOUR SHOES: A Couple with Dwarfism Navigates Life’s Detours with Love and Faith,” book II in my dwarfism memoir trilogy. go to https://angelamuirvanetten.com for book details and retail links.

The first thing I remember hours after my brother-in-law Rob carried me down the stairs on the way to the hospital, was hearing the word “intubation.” Although I was saying “no,” the decision not to intubate had already been made. Thankfully, a specialist had previously rejected this ventilation method. I speculate that my sister Deborah’s disclosure of my dwarfism type contributed to understanding that intubation came with the risk of cutting off my airway.

Fervent prayers were offered on my behalf and God graciously answered when an ER team of eight stabilized me. I was assigned an isolation (negative pressure) unit in the ICU. Among other treatments, a BiPAP machine pushed air into my lungs to improve the blood oxygen level.

Fully alert on the morning of my 70^th birthday, I was cut off from typical communication lines. The wall clock was hidden behind the nonfunctioning TV screen and I had no phone, computer, or Bible. All I could do was sit quietly like a well-loved fish in a bowl looking out through the glass at the workstation of my one-on-one nurse.

I contemplated my first bout with COVID and the unraveling of birthday plans:

• Cancelled family dinner.
• Scrubbed trip to New Zealand.
• COVID restrictions on interaction with people.

Despite extreme disappointment, I knew God doesn’t make mistakes! He made this clear when He walked beside me every step of the way:

• Caring ICU visits from Deborah and my brother Greg fully garbed in personal protective equipment.
• Covering medical expenses with my travel insurance policy.
• Enjoying slices of an indulgent, chocolate birthday cake.
• Limiting my hospitalization to two nights and three days.
• Using credit from my cancelled flight to New Zealand for my matron of honor to visit me in Sydney instead of me visiting her in Christchurch.
• Celebrating the birthday of my friend from kindergarten days.
• Saving one week to savor Sydney sights.

Within days of returning home to Florida, a head injury from a fall required another ER visit. Hospital Chaplain Bob prayed with me and played a hymn favorite, “Great is Thy Faithfulness,” on his harmonica. My confidence in God’s faithfulness was twice confirmed. First by the lyrics—

“Morning by morning new mercies I see;
All I have needed Thy hand hath provided
Great is Thy faithfulness, Lord, unto me!”—

and second by the source of the lyrics in Lamentations 3:22-23. (Providentially these verses were in my August 27 Sunday School lesson.)

God’s protection and timing are perfect!

For more of my writings, go to https://angelamuirvanetten.com where you can subscribe to my weekly blog and find retail links to my dwarfism memoir trilogy.

When we flew to Sydney, Australia for more family visits, it was my turn to adapt. Shortly after a surprise 50th birthday celebration—where I was crowned the queen—I was rudely reminded of my advancing years. I fell and severely sprained my wrist the day before we flew home. I had one night to ice it, then fellow passengers across the Pacific suffered with me as I massaged myself with penetrating and aromatic extra-strength heat cream. The healing process was impeded by the need to continue lifting myself on and off chairs, toilets, and in and out of the car.

I was also losing range of motion in my ankles. The pain interrupted my sleep, reduced my limited walking distance, made stairs and curbs impossible to climb without a railing, and required avoidance of uneven surfaces like grass and gravel. After looking at x-ray images, an orthopedist came into the patient room and looked around for my wheelchair. He was amazed I could walk independently. He diagnosed severe arthritis and prescribed a scooter and lift to get it in and out of the car.

I followed up with the opinion of an orthopedist with dwarfism expertise—Dr. Mary Matejcyk, the same orthopedist who replaced Robert’s hips in 1997. She advised that the spontaneous fusion of my ankle joints was causing the pain. This sounds bad, but it was actually good news. Surgical intervention would be to fuse the joints and my ankles were doing this on their own. The only concern was that the ankles fuse in the right position for standing; thankfully, this appeared to be happening. When the fusion was complete the pain would end. And she was right.

Fast forward 20 years and we are both fully retired and have achieved our allotted three-score-and-ten years. Aging issues are more prevalent with daily medications, numerous doctor appointments throughout the month, and reliance on scooters for distance. Although our schedules are more flexible, declining mobility and stamina doesn’t allow for as many activities. Indeed we wonder how we ever had time to go to work!

As we navigate our bonus years (70 and beyond), we remain thankful for the resources God has provided and whatever comes next.

[In recognition of National Senior Citizens Day on August 21, 2023, this post updates “Adapting to Changes in Climate and Age.” Angela Muir Van Etten blog (August 23, 2021).]

You may also want to read:

• “Unforgettable 60^th Birthday.” Angela Muir Van Etten blog. July 10, 2023. https://angelamuirvanetten.com/unforgettable-60th-birthday-in-alaska/#comments
• STAY SAFE: Avoid Slips, Trips, and Falls.” Angela Muir Van Etten blog. June 19, 2023. https://angelamuirvanetten.com/stay-safe-avoid-slips-trips-and-falls/
• “Lessons From My 40-Year Law Career.” Angela Muir Van Etten blog. October 10, 2022. https://angelamuirvanetten.com/lessons-from-my-40-year-law-career/
• “Ruby Wedding Anniversary.” Angela Muir Van Etten blog. November 29, 2021. https://angelamuirvanetten.com/ruby-wedding-anniversary/

• Angela Muir Van Etten. “PASS ME YOUR SHOES: A Couple with Dwarfism Navigates Life’s Detours with Love and Faith.” 2020. https://angelamuirvanetten.com/pass-me-your-shoes/

Although falling is prevalent among seniors, this post focuses on the fall risk among little people. Although I don’t have data on how many of us are falling, I suspect the fall risk is greater than in the average population. Several factors and conditions contribute to our risk, including the following:

1. Physiological

• Impairment in the lower body due to spinal issues or orthopedic limitations. For example, my knees and ankles are fused so I can’t catch myself when I trip.

• Foot conditions like pain, neuropathy, and hard-to-find well-fitting footwear.

• Balance problems.

• Use of mobility devices.

• Vision problems like retinal detachments.

• Lack of sleep due to sleep apnea or pain, for example.

2. Environmental

• Clutter.

• Throw rugs or loose carpet.

• Uneven walking surfaces, like pavers or cracked concrete.

• Cords on the floor or jutting into the path of travel.

• Poor lighting.

• Stairs that are broken, uneven, or without handrails.

3. Pharmaceutical Agents

• Taking five or more medications per day.

• Tranquilizers to treat anxiety and insomnia.

• Narcotics taken for acute or severe pain.

• Antihistamine side effects causing drowsiness and reduced coordination, reaction speed and judgment.

• Over-the-counter medicines affecting balance and gait.

The good news is that with appropriate interventions little people can drastically reduce the risk of falling.

Physiological contributors can be mitigated with assistive devices like a cane or walker; sensible shoes that fit well, give good support, and have nonskid soles; grab bars for the shower or tub; a shower chair and hand-held shower nozzle. Exercise can improve strength, balance, coordination and flexibility. Annual vision checks and eyeglass updates are key to spotting and avoiding perilous situations.

Environmental hazards can be reduced by clearing the floor of anything someone might trip on—clutter, electrical and phone cords, small furniture, throw rugs, and the like. Immediately repair loose, wooden floorboards or carpeting, and clean spilled liquids, grease or food. Install handrails on both sides of a stairway. Maintain good lighting indoors and out. Limit the need for stools by keeping things used often on lower shelves. Use stools with a handle to hold onto. Never stand on chairs, tables or any surface with wheels.

Pharmaceutical risks can be eased by a doctor or pharmacist medication review.

What fall prevention tips can you add?

You may also want to read:

• “Injury Facts.” Copyright 2023 National Safety Council. https://injuryfacts.nsc.org/all-injuries/overview/ 
• “Make Fall Safety a Top Priority.” Copyright 2023 National Safety Council. https://www.nsc.org/workplace/safety-topics/slips-trips-and-falls/slips-trips-and-falls-home
• “Facts About Falls.” Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Last Reviewed: May 12, 2023. https://www.cdc.gov/falls/facts.html
• “Check for Safety: A Home Fall Prevention Checklist for Older Adults.” Center for Disease Control and Prevention. https://www.cdc.gov/steadi/pdf/check_for_safety_brochure-a.pdf
• Mayo Clinic Staff. “Fall prevention: Simple tips to prevent falls.” February 03, 2022. https://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/fall-prevention/art-20047358

• Angela Muir Van Etten blog and dwarfism trilogy memoir. https://angelamuirvanetten.com.

Some Little People have been declined surgery until they reduce their BMI. When employer wellness tests identify obesity based on an employee’s BMI, insurance can be denied or premiums increased. Anxiety episodes can be triggered and serious body image issues can develop.

As 33-year-old Sammy said, “There’s a fine line between health information and body shaming, and I have felt like I have been balancing that tightrope my entire life.” When Kobie’s BMI classified her as overweight, she responded by exercising too much and eating less. As a result, she was undernourished, constantly thought about food, and couldn’t concentrate properly when studying.

BMI is widely used in the medical community because it’s an inexpensive and quick method for analyzing health status and outcomes. Critiques that it doesn’t account for body composition, ethnicity, race, gender, age, or dwarfism are largely ignored. For instance, in 2013 the American Journal of Medical Genetics published a letter from several doctors—including Dr. Julie Hoover-Fong, the Chair of the Little People of America Medical Advisory Board. They advised against applying current BMI guidelines to adults with dwarfism as “inaccurate as a surrogate of body fat or predictor of health outcomes.”

So how does a person with dwarfism assess a healthy weight? My husband Robert was denied entry into a Weight Watchers program because his doctor had no standard for calculating a goal weight!

The weight for age charts published in 2007 for children with Achondroplasia dwarfism cuts off at age 16 and Achondroplasia only accounts for 60 percent of the dwarf population. What about adults and little people with one of the other 399 dwarfism types? We have no data to guide us.

If I followed the weight chart for a 16-year old female with Achondroplasia, I’d be huge and barely able to walk. At the 50^th percentile, I’d weigh 99 lbs (45 kgs) and have BMI of 43.5; at the fifth percentile, I’d weigh 92 lbs (42 kgs) and have a BMI of 40.

So without an accurate measure of a healthy body weight, little people turn to alternative measurement standards, like hydrostatic (underwater weighing), skinfold pinches, waist-to-hip ratio, waist-to-height ratio, and neck circumference. But the accuracy and applicability of these measures to dwarfism is also questionable.

Ten years have passed since it was reported in the American Journal of Medical Genetics that “Studies to address these issues are underway.” It’s time to move the BMI research needle from talk to research to results!

Ready to dig deeper? Read:

• “Calculate Your Body Mass Index.” National Heart, Lung, and Blood Institute, National Institutes of Health. https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

• Julie Dickson, ABC Sport Intern. “If the body mass index stops measuring health and starts causing shame, change the game.” ABC News, Australia. April 3, 2022. https://www.abc.net.au/news/2022-06-04/body-mass-index-fitness-health-short-stature-disability-gym/.

• Reviewed by Erica Ramirez, PA-C and Yvette Brazier. “How much should I weigh for my height and age?” Medical News Today. Updated on November 29, 2021. https://www.medicalnewstoday.com/articles/323446.

• Kerry J. Schulze et al. “Body Mass Index (BMI): The Case for Condition-Specific Cut-Offs for Overweight and Obesity in Skeletal Dysplasias.” Letter to the Editor, American Journal of Medical Genetics, Volume 161, Issue 8, August 2013. Pages 2110-2112. https://onlinelibrary.wiley.com/doi/full/10.1002/ajmg.a.35947.

• Julie E. Hoover-Fong, et al and Charles I. Scott. “Age-appropriate body mass index in children with Achondroplasia: interpretation in relation to indexes of height.” The American Journal of Clinical Nutrition. 2009. https://www.lpaonline.org/assets/documents/Age-appropriate%20body%20mass%20index%20in%20children%20with%20achondroplasia.pdf.

• J.E. Hoover-Fong, et al. “Weight for Age Charts for Children with Achondroplasia.” American Journal of Medical Genetics. October 2007. https://pubmed.ncbi.nlm.nih.gov/17764078/.

• Angela Muir Van Etten blog and dwarfism trilogy memoir. https://angelamuirvanetten.com.

Not all of our hearing aid stories have such a happy ending. Take the 1990s hearing aids that were crushed when I drove over them in the garage or washed and dried in the pocket of Robert’s pants. For some reason, they didn’t work after that. Thirty years later, I still check the pockets before placing his clothes in the washer.

Advances in technology have transformed hearing aids from clunky devices costing hundreds of dollars to mini computers with sophisticated circuits and microchips costing thousands of dollars. They even have Bluetooth connectivity to cell phones, music players, and TVs. Crushing or washing today’s hearing aids—excluded from health insurance plans—would make this a very sad and expensive story.

Yet misplaced hearing aids remain a common phenomenon in our household. After taking them off, Robert puts them down in various places. A couple of times, I’ve retrieved them from a recycle bin next to the dresser where they were placed. For the most part, they are spotted within a few hours. But not always. Recently, when one hearing aid was missing for a couple of months, Robert’s brother Mickey reminded him the aid was covered by a 3-year warranty. Thankfully, Robert made a successful claim to replace it two weeks before the warranty expired.

The obvious solution would be for Robert to routinely put them on when he gets up and take them off when he goes to bed, takes a shower, or goes swimming. Not only would this habit give a predictable place for storing the hearing aids, it would also eliminate the stress of looking for them. Apparently it would also reduce the risk of developing dementia, falling, declining mobility, depression, social isolation, and anxiety. And the bonus would be improved communication with his wife! And if this routine breaks down, he could pay the extra for GPS locators on the aids.

Robert counts among the estimated 48 million Americans with hearing loss, including the more than 30% of people between the ages of 65 and 74. His loss is attributed to a complication from his Spondyloepiphyseal Dysplasia Congenita (SEDC) dwarfism diagnosis. Although he’s been wearing hearing aids since he was in college, the severity of his hearing loss has increased since he retired.

So how do you relate to Better Hearing and Speech Month?

Read more of our marriage adventures in the second book in my dwarfism trilogy, PASS ME YOUR SHOES: A Couple with Dwarfism Navigates Life’s Detours with Love and Faith. https://angelamuirvanetten.com/pass-me-your-shoes/.

Doctors invest a decade or more in medical training and have student loans averaging around $200,000. Despite healthy physician salaries—averaging $223,000 for primary care and $329,000 for specialists—these loans take years to pay down. Doctors typically work 60 to 70 hours a week thereby sacrificing time with their families and for personal needs.

It’s in the patient’s interest to appreciate the doctors we depend on for our health care needs because they’re quitting medicine in alarming numbers. Nearly half of doctors experience physician burnout caused by bureaucratic tasks, insufficient time with patients, and long hours, to name a few. The 10 to 20 hours a week spent on administration detracts from the most rewarding part of a doctor’s job and their reason for being drawn into the profession in the first place—patient care.

A doctor shortage is exacerbated by the growing number of aging patients and physicians. Patients age 65 or older generally require more specialty care and, in the next five years, 35% of working physicians will be of retirement age. And even before retirement, about one third of doctors report their intention to reduce work hours in the next 12 months. The effects of this shortage are already being felt. Patients often have to wait weeks to get an appointment with a specialist.

There are several steps patients can take to encourage physicians to continue practicing medicine. Please consider doing one or more of the following: 

• Since physicians rely on online reviews to bring new patients through the front door, take the time to write a fair and accurate review that reflects the positive aspects of your patient experience with the doctor. This will help offset your doctor’s worry about receiving negative reviews.
• Send thank-you cards to physicians you value.
• Bring your doctor a red carnation, the representative flower of National Doctor’s Day.
• Follow your doctor’s sound medical advice so that they don’t feel like you’re wasting their time.
• Ask your doctor how they’re doing. When I did this at my annual cardiology check-up last month, I was surprised when my cardiologist disclosed his personal struggle navigating a divorce with two teenage children.
• Pray for your doctors.
• Make an honorary donation to an organization that would recognize the doctor you honor. For example, worthy candidates would be doctors on Little People of America’s (LPA) Medical Advisory Board, https://www.lpaonline.org/index.php?option=com_content&view=article&id=106:medical-advisory-board&catid=19:site-content&Itemid=103. They volunteer their time at free medical clinics and workshops at LPA national and regional conferences.

Image credit: https://pixabay.com/photos/operation-operating-room-doctor-540597/

For more of my writings, go to https://angelamuirvanetten.com where you can subscribe to my weekly blog and find information and buy links to my dwarfism trilogy memoir.