Monday, October 1, 2007


Acute caffeine deficiency. Trying to cut back on caffeine is hard but it is helping the insomnia!

Some days it seems that you just can't win. I usually try to encourage patients to stop smoking and have heard all the excuses but I have had such good luck with Chantix. We had several people who work with us in the office stop smoking with it and it sure has helped many of our patients. Today I saw a heavy smoker with a large neck mass and after the biopsy and the thankful news that it did not appear malignant, I suggested that he stop smoking and explained how the medication works and the success that we are seeing. He said no way and that he saw a report on "Good Morning America" about how the medication caused someone to committ suicide. I then suggested that there are other medications and support programs to help stop smoking and he looked right at me and said "no way, that causes suicide". I so hard wanted to say, "if you continue to smoke, you will be committing suicide", but didn't. I haven't seen the "Good Morning America" report, but I am pretty sure that they did not elude that stoping smoking causes people to committ suicide but I am pretty sure that they didn't do anything to help people stop.


SeaSpray said...

Hi Throckmorton -That's funny!

I think my urodoc probably thinks I have "ACD" because of how I balk at cutting back on coffee. He's working with me on something and so that is "one" of his recommendations.

Now here's the thing. I am compliant about everything he asks me to do. Well... I was a bit obstinate about something last winter and I was wrong-just scared really and even if I were faced with the same thing,I know better now, but other than that... ok, I did kind of flunk a recent assignment in keeping track of something (he was nice about it though)-just couldn't wrap my mind around it at the time but then I went for the gold and the extra credit and made up for it and gave him more than he asked for and I think he appreciated it.

Actually, the visual helped "me" tremendously and I am going to do it again with something else he has me doing just because putting the info on paper like that really brings it all home for me. It's too easy for me to think abstractly because then all the info is "out there" floating around instead of concrete and me doing something about it. Hmmm...thinking out loud and on your blog now but it seems to me that I should have kept track of something else on my life and I sometimes wonder WHERE I WENT when I let that happen?

But I digress.

He said I could have 6 oz of coffee daily but I have been having 8 oz and I did tell him. That 1st cup of hot coffee in the morning in my Longaberger mug is one of the most pleasurable experiences. And if it is hazelnut coffee?? Oh dear God...heaven on earth! No sugar-just coffee and milk or cream. Yeah...I know...just the fact that I tried to bargain with him and can write this much about one cup of coffee makes me sound like an addict. ;)

I do NOT see me ever giving up coffee. But I only make a half pot of coffee. I rarely finish THAT mug of coffee because I get busy doing things and so it is with the other mugs too. Kind of like smokers that leave their cigarettes burning.

I wonder if decaff is any better? I don't know if it is still true but years ago I heard decaffeinated coffee was treated with formaldehyde and so I would never go near it anyway.

I wonder if HE felt like saying something to me like you did your pt? Actually, I think he did ask me if I would rather do something vs drink coffee and now I honestly don't remember what it was. DENIAL!

If you like coffee then I KNOW you understand that coffee is indeed nectar from the gods. ;) Do you ever open a fresh can of coffee and just inhale? I do...several times and then I thank God for coffee. True - I do!

My husband and girlfriend get their caffeine from Pepsi-YUK!! That IS their coffee! I rarely want soda!

Anyway, I have to be out of here by 6:30 am tomorrow, so I will be chugalugging that coffee pot tomorrow morning. :) I don't want to be non-compliant and no doubt I WILL hate myself later...but a girl's gotta do what a girl's gotta do. ;) Besides, my stuff isn't life threatening but rather that some behavior modification might help me avoid surgery, which actually is a big deal.

You know when a cup of coffee tastes REALLY good? On a busy ER shift. Not when your running around because then the adrenaline pumps you up but when you get that slump and you realize how tired you really are. :)

Urodoc had also suggested I use (ANNACIN?)if I got a caffeine withdrawal headache but I didn't have any problem. Actually, I went 86 1/2 hrs without coffee or food back in August and I am pretty sure the headache I got the last couple of days was from lack of food.

I am pretty deffensive about the caffeine, aren't I? I also,like tea and I always thought that both tea and coffee had healing properties for various reasons.

This is long and I still want to address the rest of your post. I may have bloggers remorse and delete this and like I tell Scalpel,I.U. and others just delete if you wish. :)

Chrysalis Angel said...

I kept thinking as I read this, you ARE committing suicide yourself! The logic just isn't there for some.

SeaSpray said...

Good Morning Throckmorton-the early morning sun has risen up over the mountains and I am here blogging with my morning cup of java (with cinnamon added-has healing properties)...all is right with the world. ;) Mom's appointment was canceled so I didn't chug-a-lug the half pot yesterday. Good thing I didn't too because things didn't go so well for me yesterday in that area but I digress.

I worked with an ER doc who was also a surgeon down in the city who told me once that if people saw what the inside of the arteries of a smoker looked like that they would never want to smoke again. He also said being overweight (Toxic dumpling)wasn't good either but that smoking was far worse.

I worked with people that were taking Wellbutrin to quit smoking. It didn't work for one woman. I am not judging and I feel bad for anyone struggling with any addiction but it was amazing to me that "everyone" all shifts, smoked in the respiratory department. Of course seeing MI's roll right past my desk (up close and personal because of construction)didn't deter me from eating dinner when I got home after my shift and then going to bed. Habit is habit I guess and denial strong.

What is this Chantix you speak of and how does it compare to wellbutrin for assisting in breaking the nicotine habit? You say it has helped your co-workers and patients?

I worked with a woman who was trying to quit smoking but she would also remove her patch to smoke and then put it back on. I don't know if that made any difference in the absorption of the nicotine but she did that.

My husband smokes and has this chronic cough. I don't get on his case but the cough scares me. he wants to quit ...but of course he doesn't want to quit.

Your patient just doesn't want to quit and so he has implemented selective hearing. Obviously not thinking logically!

I remember the first time I looked up something in the ER's PDR book and then started reading about other drugs too. I was alarmed to say the least but the way it was explained to me if there is even one remote incidence of some "possible" side effect happening -it gets reported in that book. Is that true?

Throckmorton...I think you could have said that to him. There was an interesting recent post over at "White Coat rants" where he as an ER doc took a reverse psychology approach with a patient about smoking.

BTW- I have always HATED that joke smokers use when they are going out to smoke- "I'm going out to put another nail in the coffin." Ugh! then of course I have this power with words thing i believe so I don't think people should say things like that!

SeaSpray said...

Goodmorning Throckmorton!

And so now I just finished chug-a-lugging a half pot of coffee as I am off to the races. As I said I only have a cup these days, but getting out of here so early on this dreary morning and I have a lot to do..I DO need that boost. I will hate myself later...

O.k., maybe I have a tiny bit of ACD...just a bit. :)

Have a great day! :)

SeaSpray said...

Paging Dr Throckmorton...Paging Dr Throckmorton...Throckmorton's Other Signs Blog..STAT! ;)

Hi Throckmorton...hope you don't mind being paged. I called for Dr Keagirl over at Urostream too. You both have good blogs and are missed when you don't post. Last we knew she was vacationing in Orlando and you are probably busy saving lives. :)

Funny how we bloggers really come to like certain blogs/bloggers and they really are missed when they don't post or comment. Of course when I go back to work (soon) I won't have as much time either. I love to write in mine and read/comment in other blogs.

If I hadn't gotten sick, I never would have known the blogosphere existed and could be so much fun or interesting. Now I am totally addicted and this awesome hobby is here to stay. Most of my real life friends aren't interested but I think you have to like to write to enjoy this hobby. Next month will be my one year anniversary (Nov 13th I think)when I wrote my 1st post. I had no clue back then I would become so interested in doing this.

Speaking of's our wedding anniversary today and so I'm out the door on some errands! :)

SeaSpray said...
This comment has been removed by the author.
Chrysalis Angel said...

I hope you haven't abandoned your blogging. You're missed.