#Drinking Latte while black

Intersection of race and health while drinking a latte.

 

I’m going to take my blog in a different direction for a bit to discuss a difficult topic;  there are so many #whileblack posts going through social media.  Thank goodness, my story didn’t involve the police, but I felt its worth discussing.

My mother and I are visiting beautiful Santa fe, New Mexico. We decided to get brunch at a popular spot called the Tea House. While enjoying a lavender honey latte (which was wonderful as it was beautiful) a well dressed caucasian woman approached our table. She had been looking very intently at our table. Here is the best recollection I can give of our conversation:

Well Dressed Caucasian Lady: “Did you notice the picture behind you?”

Me: “No I didn’t” at which point I turn to observe a painting. All I notice is that there is a Black man drinking coffee.

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I did not get the name of the artist that made the painting; photo by Charlyce Davis

Me: “oh…I guess it’s nice”

Well Dressed Caucasian Lady: “its so interesting that your sitting beneath that picture during a time like now”

My mother and I : open mouth stare…

Well Dressed Caucasian Lady: “don’t you agree?”

Me: “I’m not sure what you mean”

But unfortunately I am sure what she means. For some unfortunate reason the well dressed lady felt a need to point out that I was Black drinking out of a coffee mug sitting beneath a painting of a black man drinking out of mug.

Well Dressed Caucasian Lady: “We need democracy now…don’t you think?”

At this point the atmosphere is very awkward. I sip my latte while my mom continues to look at the lady waiting for clarification.

I frequently discuss race issues among my black friends and family but not much with others. Being part of a minority group means very often you are the only black in an establishment. I think most of us don’t consciously think about this moment to moment. But being approached in a coffee shop and having it pointed out to you that you are a minority is taxing. We simply wanted to enjoy brunch, not get into a in depth discussion on race because we were the only blacks in the establishment.

As a physician, I am somewhat removed from many of the race issues going on. Although I have felt the effects of discrimination every step of the way, being a physician is skills driven, and many steps are blinded along the way. I am keenly aware everytime I read the news and see the ever more divisive language used that race relations are becoming more stressful all the time. But once I’m seeing patients, there is a veil of color blindness that comes. All lives matter to the healer, which makes my job easy. Every patient is important so there’s no stratifying who gets what.  The challenges of caring for patients, worrying about tackling  administrative task in a busy practice are so overwhelming, there simply wouldn’t be space for discrimination.

As a black woman on vacation without my white coat, I feel the ever present baseline vibration of racial tension.  I recently shared with friends that I am frequently followed while shopping in stores, a practice that is still very common place.  I have been blessed not to have been called any racial slurs directly to my face, I like all others of any color can sense the “Me”, “them”, “us” and “not us” that is pervasive.

I believe the Well Dressed Caucasian Lady meant no harm.  I believe that she came into the Tea House, noticed a table with two black women and probably caught herself staring.  I think she backfilled a reason with the picture, which wound up going to far and ending on an awkward note.  I certainly wish her no ill will, and honestly, she had on a beautiful turquiose necklace that was probably made locally.

My mother and I weren’t upset.  The brunch was wonderful and we were otherwise treated very well in Santa Fe.  This incident made me curious about race and health and what the current research shows.  In a future post, I will delve deeper into what the consequences racial discrimination, and how this low vibration affects health.

Insomnia #3: What Happens When you Sleep

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Photo by Kristin Vogt on Pexels.com

The Awake Brain

Your brain is designed to work in cycles. In the morning, your brain is in its it’s full functional state. Your sensory organs are fully engaged, allowing for sight, hearing, touch, taste and scent. Your eyes will operate normally, and your blink reflex (the response to a fast moving object coming towards your face) is active. You are also in complete control of your motor cortex, so you have full control of your muscles, allowing for normal movements.

Your heart beat is on an automatic system but gets outside input from the vagus nerve. Your heart rate will rise when physical demand requires more blood flow. Your breathing is automatic as well. You can override the automatic breathing cycle yourself by doing something like meditation or breath holding. Your respiratory system will go back to your default automatic program as soon as your conscious brain moves on to something else.

During the awake state, your digestive system is ready to work, and particularly during the day hours the stomach, small intestines, and colon work in coordination to digest for and extract nutrients as well as eliminate waste.

The Drowsy Brain

You begin to register the sensation of feeling sleepy when your blood pressure begins to drop. Your heart rate will also begin to slow down. Your ability to form new memories decreases, and any new information that reaches your brain will not be stored. The electrical activity in your brain begins to change as well which can be seen on an EEG. This corresponds to an alteration in your eyes, which will start an automatic slow back and forth movement.

Light Sleep

N2 or light sleep will follow the first stage of sleep. The electrical activity of the brain will continue to change, reflecting a lower amplitude of activity on EEG’s. The eyes will stop moving at this point, tending to stay in one place. Breathing is now automatic. When your awake, if you hold your breath, you will get a strong urge to breathe within a few seconds due to your body’s mechanism to respond to elevated carbon monoxide levels in the blood stream. In N2 sleep, your body may not do this. You will spend about half of the night in this stage of sleep.

N3 sleep

In this deeper stage of sleep, brain activity continues to slow even more. Your brain will cycle between N2 and N3 several times throughout the night. The body is even less responsive to rises in carbon dioxide in the blood stream than in the lighter stages of sleep.

REM sleep

REM, or Rapid Eye Movement, is the necessary sleep stage that allows for true rest. It is during this phase that the all motor control is frequently lost; This is the stage of sleep when dreams occur.

Waking up

After going through several cycles of sleep throughout a night, your body will prepare to wakes itself. In the early morning hours, your blood sugar will rise. This effect can become exaggerated in diabetics, leading to the Dawn Phenomenon, or early morning high blood sugars despite being in a fasting state. The cycle starts again

Sleeping is a complex process, and as you can see, there are many steps in the process to ensure a good night’s sleep. I frequently discuss an abbreviated form of the the sleep process with patients because many people don’t realize that the highly coordinated process is deeply disrupted with alcohol, several medications, as well as bad habits such as ruminating at bed time.

Once again, I am so appreciative for readers that stop by to read my blog. Being a practicing physician, many of these important topics I often rush through, so it’s nice to spend a little more time on issues.

In my next insomnia post, I will start delving deeper into how to analyze your sleep issue and approaches to deal with them.

Resources:

Goldman, L., & Schafer, A. I. (2016). Goldman-Cecil medicine. Retrieved June 2, 2018.

Why I won’t touch your cell phone…it’s basically a bodily fluid

Cell phones can add an amazing dimension to healthcare. Whereas patient used to tell me about a rash that’s now gone, now a savvy patient can snap a picture from their cell phone that I can use to make a diagnosis. Patients can keep track of blood sugars, blood pressures, activity levels, migraine attacks, sleep, etc on their cell phones. They are social tools, their with you at every outing, capturing awesome pictures and updating your social media.

They are filthy. Literally.

In a study, cultures from cell phones were found to grow Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphlococcus aureus, Enterococcus feacalis, and Bacillius¹

 

Just for kicks and giggle:

Escherichia coli and Enterococcus feacalis are coliform bacteria…yep….they’re in your poop.

Pseudomonas aeruginosa causes serious skin and blood stream infections.

Its for this reason that:

If I’m seeing you as a patient in the clinic, I will do everything possible not to handle your phone.

Before I touch your cell phone, I will wear gloves as if handling any other bodily fluid.

Keeping your phone clean:

Some studies show that a case on your cell phone can reduce the amount of bacteria.

You can reduce the amount of bacterial contamination by wiping the phone down with diluted rubbing alcohol.

I personally use commercially available eyeglass cleaner wipes once or twice a day.

While patients are not suprised to see me put on gloves for a variety of reasons, I’m now gloving up to touch your personal electronics.

Thanks for reading! I appreciate all the readers that stop by an spend a few minutes here.

  1.  Akinyemi, K. O., Atapu, A. D., Adetona, O. O., & Coker, A. O. (2009). The potential role of mobile phones in the spread of bacterial infections. The Journal of Infection in Developing Countries,3(08). doi:10.3855/jidc.556

 

Ginger

via Ginger | NCCIH

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The National Center of Complementary and Integrative Health recently sent out an email about ginger.  I thought this would be a good excuse to get back to my blog.

I frequently recommend using ginger to patients.   There are ginger supplements available in many forms, but its pretty easy to find raw ginger root in the grocery store produce aisle.  I use raw ginger in stir fry or make a “tea” (herbal infusion) with hot water, ginger root and water.

Ginger is a great remedy for motion sickness, Meniere’s Disease,  or morning sickness.  Simply inhaling the spicy scent gives  you instant relief.

I often recommend ginger to help stabilize blood sugars. Ginger has been shown to reduce A1c (blood sugar average) and fasting blood sugars in diabetics.¹

Ginger essential oil  has a much longer shelf life than the root, and its easy to carry when you travel.  One very strong recommendation is that ginger is a “hot” oil, meaning it has a lot of kick.  I strongly recommend diluting essential oil in a carrier oil if your going to use it topically.

 

 

1. The Effects of Ginger on Fasting Blood Sugar, Hemoglobin A1c, Apolipoprotein B, Apolipoprotein A-I and Malondialdehyde in Type 2 Diabetic Patients. (n.d.).

Resource for High Deductible/Uninsured Patients

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via MDsave – Feels Better Already

 

I was reminded today of this excellent resource for patients who have high deductibles of don’t have insurance.  MDsave.com is a free service that can assist you if you are needing labs, x-rays or other medical procedures.  Although the procedures are still expensive, you can save a lot of money on necessary medical care.

Prostate Cancer Screening and Men’s Health

Photo from wordpress...representation of male patient afte he finds out there will be no prostate exam.
Photo from wordpress…representation of male patient afte he finds out there will be no prostate exam.

I see both male and female patients. Women are accustomed to some sort of yearly exam, typically related to women’s health.

I’ve found over my years of practice that men typically present at the ages of 30, 40, or 50 wondering what is required of their health. Unlike women, the average healthy man may not have a specific need for a physician. It’s not unusual for a male patient to go over 20 years without seeing a physician. After going so long without seeing a physician naturally, they are very nervous about the prospect of meeting a physician and getting a rectal exam immediately.

These medical headlines are extremely helpful. The current recommendations are that for the majority of men, prostate cancer is not recommended.

My approach is education. Every man should be aware of symptoms of prostate enlargement, such as frequent urination or trouble emptying the bladder. Men should also be prepared discuss issues with sexual health, as any issues with having an erection could signal issues with cardiovascular disease. Checking PSA or performing a prostate exam won’t be necessary UNLESS a patient wants to do this. Patients that want a more rigorous screening exam have the option once we discuss the risks and benefits it prostate screening.

Internal Medicine News

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