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Grace Growth Happiness Parenting Purpose Relationships Wisdom

What’s your story?

Imagine running into an old friend whom you had not seen since childhood. What story would you tell? Where are you now, and what has brought you to this point in your life?

Whether we recognize it or not, we make sense of our lives through our personal stories. Our stories help us make sense of our world and provide meaning and continuity.

Stories may also limit how we see our lives, others and our selves. To be conscious of the unwritten stories of our lives is to open up our potential for more positive experiences and growth in every area of our lives.

We inherit the stories told by our families. They may be of struggle against adversity, reactions to negative experiences, mistreatment by others and often a simplified approach to history, politics and people who are different from them.

The stories of our parents can form the foundation of our personal stories that are also influenced by personal experiences, how we react to them and – most importantly – how we conceptualize them.

Our stories may empower us, enhance our relationships, promote healthy living and foster happiness. Our stories may limit our experiences, get us stuck and be the ultimate source of our unhappiness.

Although we do not control every aspect of our lives, we are at least coauthors of our own life stories. We are not responsible for every event and circumstance, but we are responsible for how we meet them and how we act.

Totems in Alaska - Davidicus Wong
Totems in Alaska – Davidicus Wong

In medicine, I have the privilege of hearing many personal stories. My wisest and happiest patients have shared those that are infused with three key features: appreciation, empowerment and purpose.

The happiest people accept the good and bad aspects of their lives but reflect back with appreciation for what has been right in their lives. Engaging each day with an attitude of positivity and gratitude, they give forward.

They are able to let go of self-limiting feelings of resentment and embrace their personal responsibility to choose their own thoughts and actions. They recognize the aspects of their lives that they can control in a positive way.

The wisest storytellers are able to reflect back on their lives, learn and look forward beyond their own self-interests. They find meaning in the past and present – and purpose for a positive future.

In the story of your life, where have you found meaning? What has been your calling at each stage of your life? Your story is never finished, and you remain its author today.

The Tapestry Foundation for Health Care www.tapestryfoundation.cais hosting a public forum, Stories of Aging at the Vancouver Convention Centre. I will be part of a panel sharing unique perspectives on aging at 7 pm on Friday, April 4th.

Dr. Davidicus Wong is a family physician. He will be speaking on “Achieving Your Positive Potential in Life: Finding Meaning & Fulfillment in Every stage of Your Life” at the Douglas Park Community Centre at their Young at Heart program’s Wellness Show on Saturday, April 5th. For more information, call (604) 257-8130.

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Caregiving Empowering Healthcare Exercise Growth Healthy Living Physical Activity Positive Change Positive Potential

You’re not as old as you think you are . . . 4 myths about aging

My earliest memories as a toddler and preschooler were of my family’s home on West 20th in Vancouver. We lived there before moving to Burnaby. Across the street was expansive Douglas Park with its towering trees, playing fields, playground . . . and my nursery school.
My first traumatic memory was of falling head first from the monkey bars and losing my two front teeth. In those days, monkey bars were stainless steel towers built over cement foundations. I waited years to grow up and grow new front teeth.
Not knowing my painful past association with Douglas Park, the community centre has asked me back to speak at their Young at Heart program’s Wellness Show on Saturday, April 5th. I’ll present “Achieving Your Positive Potential in Life: Finding Meaning & Fulfillment in Every stage of Your Life.”
Now at the midpoint of life, I note our mixed messages about growth and aging and the changing connotations of “growing older.” Growing older is a good thing if you’re a child – getting taller and stronger, learning more and maturing.
Growing older is not quite as desirable to most past 40. They associate it with a loss of youth, vigour, opportunity and growth.
Every week, an older patient will tell me, “Don’t every grow old.” I used to think this “advice” was an unintentioned curse. Isn’t it better than the alternative? At the time, I thought the only alternative was to die young.
But I know that they were referring to the conditions we associate with advancing years: the chronic pain of osteoarthritis, the progression of multiple chronic conditions such as diabetes, atherosclerosis, and the decline in cardiac and kidney function.
Seniors are the frequent flyers in the health care system because of their increasing needs, and for many, much of their days revolve around the scheduling of tests and appointments and the taking of multiple medications.
With the passage of time, we witness the loss of old friends and loved ones, and reminisce about the days of youth and promise.
Yet growing older not a downhill decline. Many of my patients age well and are ever happy with each passing year. They recognize the realities of their physical health, appreciate growth in their relationships, and remain engaged and empowered in every aspect of their daily lives.
They see through some of the Myths of Aging.
1. Myth: You are your age. This is only a partial truth. Your chronological age is based on the date of your birth. Different organs age at different rates depending on use, abuse and genetics. I have to remind some patients that although their knees may be worn down, their other joints are working like new. It’s also nice to point out to many that their kidneys and livers are functioning as if they were 20 years younger.
The cells of your body are constantly being renewed. The cells of your skin are continually being replaced. None of your red blood cells is over 120 days old. It wouldn’t be a lie to say you were younger than your chronological age . . . or that parts of you are newborn.
2. Myth: You can’t teach an old dog new tricks. Although dementia is more likely as we age, it is not inevitable for most of us. There tends to be a decline in short-term memory with age (The last things learned are the easiest to forget).
Although we may have a gradual decline in the number of neurons in the brain in adulthood, it is the connections between neurons that influence cognitive function. In the process of neuroplasticity, with new experiences and new learning, each of us is capable of developing increasingly complex connections between neurons.
At any age, you could learn a new language, dance or musical instrument.
3. Myth: Becoming physically weak and inactive is inevitable.
Our bodies were meant to move . . . at every age. With disuse and inactivity, we lose strength, flexibility and balance. Daily physical activity, including walking is a mainstay of continued fitness.
Studies have demonstrated that seniors can increase both strength and muscle mass with safe resistance exercises, such as supervised seniors weight training programs.
4. Myth: Old people repeat the same old stories.
If you are lucky enough to have older relatives, you will remember hearing the same stories multiple times. We are creatures of habit and our brains like to be efficient in following the same neural pathways ad infinitum.
But new research in neuroplasticity shows that the human brain can change itself. We can create new connections between neurons, and this translates into new more positive habits and new ways of seeing others, our world and our selves.
If you’re a child, never stop growing up. If you’re an adult, never grow old. Instead, grow stronger, grow wiser, grow new interests and points of view, and grow in your relationships. Remain an active participant in the story of your life.
The Tapestry Foundation for Health Care is a non-profit organization that raises funds for Providence Health Care facilities, including  Mt St Joseph, Holy Family and St Michael’s Hospitals. Tapestry whose vision is to enhance the living and aging experience for patients and seniors is hosting a public forum, Dialogue on Aging.
I will be part of a panel moderated by writer, Peter McKnight at 7 pm on Friday, April 4th at the Vancouver Convention Centre. With our topic Stories of Aging, we will share unique perspectives on aging. For more information check Tapestry’s website at http://www.tapestryfoundation.ca.
Dr. Davidicus Wong is a family physician and Physician Lead of the Burnaby Division of Family Practice. For more information about the Douglas Park Community Centre programs, call (604) 257-8130. You can read more about achieving your positive potential in health at davidicuswong.wordpress.com.

Happy Birthday, Dad!
Happy Birthday, Dad!
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Empowering Healthcare patient-doctor relationship Uncategorized

Writing Safer Prescriptions

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This week, I’ll be spending a few hours with second year medical students. As part of the Advanced Family Practice curriculum, family doctors take time from their own practices to meet with small groups of medical students to discuss topics including the management of diabetes, headaches and congestive heart failure.

This week’s topic is prescription writing.

No, this isn’t the class where budding young doctors learn to write illegibly. There’s actually no such course. Messy writing is a side effect of a doctor rushing to get things done.

I’ve spent many hours trying to help nurses decrypt the handwritten notes of colleagues. This is less of a problem in family practices where a growing number of doctors type or dictate all their notes into their computers in what we now call EMRs (electronic medical records) and send prescriptions wirelessly to a printer.

Occasionally, I might take out the old-fashioned prescription pad for old time’s sake (The feel of the paper has a pleasant nostalgic feel) . . . or when I encounter a computer problem.

Yet illegible writing remains a problem – and a risk to patients – in most hospitals.

In spite of technological advancements in other areas of inpatient care, doctors continue to put pen to paper in the writing of their chart notes and their orders. Fortunately, most consultations are dictated and eventually hospitals may eliminate handwritten orders.

In the meantime, our hospitals have banned some of our traditional medical abbreviations.

As medical students, we loved to learn the abbreviations of Greek and Latin words along with the vocabulary of the language of medicine. Sometimes, a handwritten prescription may not make sense to a layperson because of our abbreviations rather than handwriting.

If a medication is to be taken before meals, we would write ac for ante cibium, meaning “before meals”. Similarly, pc means post cibium or “after meals”. A bedtime medication would be followed by hs (hora somni). Orders for a drug taken by mouth, would include the abbreviation po (per os). One for drops for the right eye would include od for oculus dexter.

The abbreviation, od may also mean “once daily”.

Hospitals are now banning more easily misinterpreted abbreviations. The alternative abbreviation, qd intended to mean “each day” may be confused with qid which means “four times a day”. QOD may be intended to mean “every other day” but may be misinterpreted as “every day”. In both cases, the patients would take the drug too frequently.

Similarly, we now avoid “U” because when handwritten it may be misinterpreted as O or zero. Instead, the full word “unit” should be used.

In the case of dosing, a zero after a decimal point must be avoided. If the tiny decimal point isn’t noted, a patient may receive 30 mg instead of 3.0 mg.

Similarly, to avoid missing a leading decimal point, a zero should be written in front so that a dose of 0.5 mg will not be dispensed as 5 mg.

If you’re in the hospital, all this takes place behind the scenes without your awareness. As your healthcare providers, we have to be conscientious and write clear, unambiguous notes and orders. If we’re not absolutely sure what a doctor has written, we have to confirm the orders.

Outside of the hospital, it’s good to review your prescription before you leave the clinic to confirm the dosage of your medication and how you should be taking it.