Tuesday, August 28, 2012

On Stepping from the Edge

by Dr. Margaret Aranda

I woke up twelve nights in a row, and I went to my laptop.  It's a MAC, of course, since my training is at Stanford and the Silicon Valley left its imprint on me and my fingers.  The screen glowed in the dark with Safari, iTunes, iPhoto, and iCalendar icons and the light cast its glow upon my bed.  No one noticed.  This was good for me, as I wrote.  And I wrote.



The words came to me in phrases that turned into sentences that turned into paragraphs that turned into Chapters.  Twelve Chapters in twelve days.

Stepping from the Edge is a succinct and concentrated Program for getting your Christian life back on track, or for starting your walk with a bang.  It is compelling, riveting, moving, and busting at the seams with motivation and inspiration for you.  The focus?  Really believing.



If you really believe that there is a God, and if you really believe that you can have a personal relationship with Him and with Jesus Christ, then this book is for you.  If you are going through hard times and are unsure of your walk yet you strive and pray and seek and yearn, then this book is for you.    And if you need to know that God works through hard times, and that God is really there with you and for you, and if you want to try to understand His Ways and perhaps more importantly, our ways of learning His Ways, then wait until Christmas.

Try Twelve Days of Stepping from the Edge instead of or in addition to the Twelve Days of Christmas.  Betcha you'll be glad that you did.



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Dr. Margaret Aranda's Books:

No More Tears en Espanol
Face Book Page: Stepping from the Edge
Little Missy Two-Shoes Likes to go to School
From Menarche to Menopause: A Journey through Time



To Order Dr. Aranda's books, please click here:
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Sunday, August 19, 2012

Book Authors and Me!

Friends, nothing like making this world go around a little better!  
So I am so proud and thrilled to introduce my Author friends to you...
Let's expand our horizons.  
Muaaah!





Books by Dr. Margaret Aranda
BUY IT NOW: www.drmargaretaranda.tateauthor.com/other-works/


No More Tears: A Physician Turned Patient Inspires Recovery
Stepping from the Edge
Archives of the Vagina: A Journey through Time
Little Missy Two-Shoes Likes a Ladybug
Little Missy Two-Shoes Likes to go to School





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Dr. Margaret Aranda's Books:

No More Tears en Espanol
Face Book Page: Stepping from the Edge
Little Missy Two-Shoes Likes to go to School
From Menarche to Menopause: A Journey through Time



To Order Dr. Aranda's books, please click here:
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Saturday, August 18, 2012

"Words of Wisdom" Contest Winners Announcement



First Prize goes to:

Mike Goss for:

"Never Give Up or In on Your Life!"



Congratulations!  First Prize is an Autographed, Out-of-Print 
Self-Published Book,
By Dr. Margaret Aranda


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Second Prize goes to:
MaryBeth Cacio-Luy for:

"Believe, Have Faith, Hope, Dream ... 
A Better Tomorrow Will Come!"


Third Prize goes to:
Judy Hardt Contos for:

"You Can Beat this Illness ~ 
Stay Strong and Fight Hard!"

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Honorable Mention goes to:
Debbie Shaw for:

"Today, You Can Change Your Future!"


...and Most Creative goes to:
Jonathon Burchard for:

"I would be Supportive, Understanding, and Loving."
______________________________________________________

Thank you for all the fine Submissions.  We know Chronic Illness because We Live it!   Next time you or someone you know has a great Saying, please forward it to us and/or Post a Comment here!   We are smart enough to conjure up our own, Original Sayings that have Meaning and Purpose.   So the next time you hear a Great Saying,  don't forget to send it here! 



No More Tears: A Physician Turned Patient Inspires Recovery
by Dr. Margaret Aranda
BUY IT NOW: www.drmargaretaranda.tateauthor.com/other-works/
ISBN: 978-1-62205-838-2

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Dr. Margaret Aranda's Books:

No More Tears en Espanol
Face Book Page: Stepping from the Edge
Little Missy Two-Shoes Likes to go to School
From Menarche to Menopause: A Journey through Time



To Order Dr. Aranda's books, please click here:
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Thursday, August 16, 2012

Contest Winner to be Determined, and Line Up Again!

Many people post and re-post sayings to their FB page.   Additionally, one can "Share" some one's post, making that a re-post.   So, I thought, why not think of our own Words of Wisdom for some one who just got a new diagnosis?  So many of us truly have words of wisdom that are gleaned from years of experience.   So, the Contest Submissions are over, and Judging has begun.   The final selections will be determined on Aug 18th!   Good luck to all, thank you for your submissions, and stay tuned for the Final Winner!


...and after that, get in gear to Tweet and re-Tweet, as the next Contest will be coming soon!  The Prize?  A free book, hot off the press!  
Muaaah!


To Order Dr. Aranda's books, please click here:







Wednesday, August 15, 2012

Who is Little Missy Two-Shoes?

Ah, yes.  Little Missy Two-Shoes is my daughter.   The affectionate nickname was coined when, as happens with most children perhaps, the one-year old tried on a pair of my high-heeled shoes.   She sauntered into the family room, stumbling yet smiling with great pride.   The high heels were on the wrong foot, and in a fashion-wise sense, they were accessorized with a large purple straw hat!

That picture took our little "Missy" nickname to a new level,  "Little Missy Two-Shoes".   And when Missy was turning two years old, I gave her a Ladybug-themed Party.   Everyone had to wear black and red.   Haha, and if they did not, there was a Hostess at the door with a basket of antennae (black and red and multicolored) just in case of the need.   There were so many smiles that many people took a pair of antennae anyway, and when it came time for the Book Reading of Little Missy-Two Shoes, a group of two-year olds had just enough time to stay enraptured with this short story.  It was perfect, and each child received one book as their parting gift.

At the end of the Book Reading, we had some real ladybugs from the local nursery that were contained in a little covered dish.  One of my sisters cheerfully volunteered to sit on a chair and let them all loose one her!  While that was not a planned event, let me tell you that the two-year olds were intrigued.  Their eyes were simply glazed with awe.

Once again, their eyes spanned the next view: three Ladybug cakes.  I baked each one in a large bowl, then turned it upside down to reveal the perfect Ladybug shape.  Top that off with Oreo Cookie eyes and a pair of antennae (you guessed it), and Wala!  Cut into the cake and it is Red Velvet.  Oooohh!   Ahhhhh!  Many local Californians had not tasted a Red Velvet cake much before, and we made new fans out of Red Velvet Cakes, Ladybugs, and Little Missy-Two Shoes!  All in all, a great day!



To Order Dr. Aranda's books, please click here:

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Dr. Margaret Aranda's Books:

No More Tears en Espanol
Face Book Page: Stepping from the Edge
Little Missy Two-Shoes Likes to go to School
From Menarche to Menopause: A Journey through Time



To Order Dr. Aranda's books, please click here:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Tuesday, August 14, 2012

Hope in a New Direction

Well, I'm doing it.  Actually, I did it.  The nice lady just left my house after three sticks.  Eight tubes of blood, urine in a cup, and this time guess what?  It is not because of being sick or in the hospital.  Butterfly needle was 23G, tourniquet was the same tan yellow elastic band, and definitely the smell of an alcohol swab has not changed.  But this time, everything was different.

I am entering a new phase of healthy aging.  All my attempts to get better are at the forefront of my mind, and encapsulated therein is a need to find the best way, enter the best program, try something new.  So I have nothing to lose and everything to gain.  Since I'm a doctor, I have researched female hormones, the process of aging, the natural declines in muscle mass and the natural increases in body fat.  It's all about losing the good stuff, it seems.  But wait!  I'm just getting started here.  My life is ready to enter another Chapter and I want to gain.

Enter Cenegenics Medical Institute.  Going to get body fat, bone scan, and a host of additional evaluations and tests that will halt time to capture a picture of me, inside and out.  I see there are mostly men in this Program, so here I go again, being different.  Women need strength and healthy aging, too.  We never know about estrogens and progesterones and science sways this way and that on birth control and risks of breast cancer, etc.  Well, I'm going to learn about it and be in a position to forge my own path.

Come along with me.  I do think I will have the "Before" picture that begets lots of room for improvement.

Before and After Pictures, Cenegenics


I don't know if I will "like" the program, nor if I will agree with its science.  But I will promise you one thing.  I will find out what it is, how it works, and what it has to offer me.

Maybe, just maybe, it can offer some Hope in a New Direction.


No More Tears: A Physician Turned Patient Inspires Recovery
Stepping from the Edge
Archives of the Vagina: A Journey through Time
Little Missy Two-Shoes Likes a Ladybug
Little Missy Two-Shoes Likes to go to School


by Dr. Margaret Aranda
BUY ONE NOW: www.drmargaretaranda.tateauthor.com/other-works/

Saturday, August 11, 2012

How to Save Money Running the ER: "Mobilization"




Well, as an former ER doctor and a former, avid ER-user for bouts of hypotension from dysautonomia, my first implementation would be to educate ER doctors about what dysautonomia is.   It is just like it sounds, -dys for "dysfunction", and "autonomia" for the autonomic nervous system (ANS).  Patients get syncope from standing up.  ER Diagnosis?  Orthostatics.   Treatment?  Fluids, 0.9% NS at 70 ml/hr.  Titrate to alleviate orthostatics.

I would also educate ER doctors on a cluster of Invisible Disabilities:  Chiari MalformationMultiple Sclerosis, Interstitial CystitisLyme DiseaseFibromyalgiaLupus, Mastocytosis or Mast Cell DiseaseMultiple Chemical SensitivityIrritable Bowel SyndromeChronic fatigue syndromeCoeliac DiseaseCrohn's Disease, Inflammatory Bowel Disease, Metabolic SyndromeSclerodermaSj√∂gren's syndrome



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That being said, here are my real thoughts:  I think the concept of "Triage" is too segregated.  It is time for a more holistic approach that will also save money.  I call it "Mobilization".

So, it is "Triage for Trauma, and Mobilization for Medicine".

First, the doctor needs to be the first person to see the patient.  No more RN doing an evaluation in the Holding Area, and then sending a hypoxic patient back out to the ER waiting room (while the patient is in AFib, brewing with renal failure and a pneumonia).

The doctor needs to be the first one to see the patient, and needs to write orders before (s)he walks away from the patient.  Oxygen, EKG, chest x-ray, blood labs, sputum.  Well.  That only takes 10 min, and let's see....we have mobilized how many people (n = 4; nurse for oxygen, EKG tech; x-ray tech, phlebotomist)...and how many machines (n = 8; ) oxygen tubing, EKG machine, x-ray machine, chem lab, CBC lab, blood gas lab, microbiology lab, bleeding time lab).  12 Forces are being "Mobilized" within the first 10 min.  That is the goal:  Mobilization of efforts within a minimum amount of time.

One can see that the doctor is the grand orchestrator, mobilizing both machines and humans to descend on the patient.  This is quality time, discovery time, assessment layout.  Mobilization of forces is required so that the patient is worked-up and treated at the same time.  No need to segregate everything into separate steps.  (And, the iv can go in through the same venipuncture as the blood draws for labs.)



"Mobilization" works for all patients, but is geared for the Medicine Patient with underlying pathophysiology of the pulmonary, renal, ANS,  or other major system disorder.  It's all about spotlighting the Doctor at the Patient's bedside, folks.


For the Trauma patient, Triage works, just like it does in the Military.  Minor trauma can wait while the full Trauma Team of Surgeons, Anesthesiologists, and other professionals get the Major Trauma Patient to the OR, or if needed, the Team can do procedures in the ER.


And don't forget to alert the ICU, as that patient is sure to need a bed there.




Decrease the waiting times for everything:  the time for the patient to see the doctor, the time for labs and studies to be ordered, the time for labs and studies to be completed, the time for definitive treatment, the time for the first unit of blood to go in, the time for OR personnel to arrive, the time for an OR, the time for an ICU bed.

How is the best way to do this? 
Simply Think Ahead.  
Mobilize.



No More Tears: A Physician Turned Patient Inspires Recovery
by Dr. Margaret Aranda
BUY IT NOW: www.drmargaretaranda.tateauthor.com/other-works/
ISBN: 978-1-62205-838-2


Additional Articles by Dr. Margaret Aranda

Medical Disclaimer: Nothing on this website is meant to diagnose, treat, or practice medicine. You must be seen in person by a physician for appropriate and individual medical treatment. If you have an emergency, call 9-1-1 in the USA.

Link Disclaimer: We are not responsible for any links that go outside of this website.

Full Disclosure: Margaret A. Ferrante, M.D.  is an Institute Physician with Cenegenics Medical Institute.  She receives no monetary compensation for hosting this website you are on, which is independent and not affiliated with Cenegenics. The information presented is for education and awareness.  Dr. Ferrante currently sees patients out of the Cenegenics office in Beverly Hills, CA. 
To book an appointment for a free Consultation, please email her at: mferrante@cenegenics.com





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