Geriatrics

This is the cold that never ends…

Posted on by Fat Geriatrician

…it just goes on and on my friends….

No, I’m not talking about the weather. I live in Sunny San Antonio, and I wore capri pants and no jacket to work today–comfortably. (Jealous anyone from up north?)

I’m talking about the eternal winter cold that comes with having 2 kids in daycare. At least one person has been ill in our household since November. Things have really picked up in January with GI bugs (yes plural), colds, ear infections, etc. I spent today in a Dayquil and pseudoephedrine haze–and I STILL can’t breath through my nose.

If Oprah was in the Powers Household Right Now….

At the beginning of the month, I hadn’t updated the blog due to the impending Geriatric Academic Career Award (GACA) deadline. I spent all of my time (staying at work until midnight or later, even on weekends), writing for the GACA. I even brought my sick little guy with me to work on the submission day because he had an ear infection, his daddy was out of town for work, and daycare wouldn’t take him until his fever broke. I now feel compelled to write a post here just because it has been so long, but my mucus addled brain is not cooperating.

So instead, I’ll just post a picture that I put together several years ago from images I found on the internet. It was a connection my brain immediately made when I saw the T-Rex meme for the first time, but I couldn’t find a pre-made version of it anywhere. The T-Rex/walker analogy could also be extended to hearing aids/personal sound amplifying devices, low vision rehabilitation/tools, appropriate medication management, caregiver burnout, or any treatment for a geriatric syndrome. (My mind went to the first two examples immediately because my GACA proposal focuses on acquired sensory impairment in older adults. If I get it, there WILL be a “pocket-talker” version of this meme coming. Fingers crossed!)


If all you have is a hammer, every problem is a nail. Geriatricians have the full toolbox at their disposal. We help make our patients, Unstoppable!

Pretty Good with a Bow Staff

Posted on by Fat Geriatrician

A few weeks ago, I got to live the dream.  I was invited by a fellow geriatrician to a screening of one of my favorite movies ever.  We even got to meet the cast!

Pedro, Fellow Geriatrician, Napoleon, Me, Deb

That’s right–we saw Napoleon Dynamite!  

Besides being a hysterical movie, Napoleon Dynamite has some cool lessons about aging.  I will enlighten you on 3 of those lessons here.  

What?  How am I going to turn a discussion about Napoleon Dynamite into a geriatrics post?  WATCH ME!

I’m going to assume many of you have seen the movie–but for those of you who haven’t here is a quick run down.  

Napoleon Dynamite is in high school in a small town in Idaho.  He lives with his 32 year old brother named Kip and his grandmother.  He is insanely and endearingly awkward.  He makes friends with the new kid at school–Pedro, and has a crush on an awkward girl–Deb, who tries to sell him boondoggle keychains while raising money for college.  His grandmother suffers an injury, and asks her son, “Uncle Rico” to come and look after Napoleon and Kip. Uncle Rico is obsessed with “the ’82,” and trying to take State in Football.  Kip is an internet geek, who meets and falls in love with LaFawnDuh online–eventually marrying her.  Napoleon, Pedro, and Deb become friends while Pedro runs for school president.  Napoleon draws ligers, is pretty good with a bowstaff, and dances Pedro into the presidency.  There is more to it–or not really.  If you haven’t seen it, you need to.   

Geriatrics lesson #1 from Napoleon Dynamite:  Older people still have lives.  Those lives may surprise you.  Napoleon’s grandmother goes 4-wheeling in the sand dunes with her boyfriend, and injures herself.  Just because someone is older–don’t count them out for anything.  

Geriatrics lesson #2 from Napoleon Dynamite:  Caregivers generally fall into that role because nobody else will do it.  Uncle Rico doesn’t have to care for the injured older adult.  He has to care for a 32 year old man-boy, and a high-school kid.  He is not happy to be in the role, but steps up anyway.

Geriatrics lesson #3 from Napoleon Dynamite:  Caregivers may not be any more competent or cognitively intact than the person they are caring for.  Again–see Uncle Rico.  He is so obsessed with “the ’82” he has Kip buy him a time machine online.  He truly believes it will work, but the only thing the time machine does is electrocute his private parts.  Napoleon finds it and does the same.  He gets Kip into a pyramid scheme, and knocks Napoleon off his bike with a steak.  

Here’s an extra one for you

Geriatrics lesson #4 from Napoleon Dynamite:  DANCE!!!

Original Dance from Napoleon Dynamite
14 Years Later…

Reminds me of another famous dancer…

Keep moving and dancing, y’all!  Until next time from your favorite Fat Geriatrician!  

Q&A with a Geriatrician

Posted on by Fat Geriatrician

I get asked a lot of questions about geriatrics. Most frequently I get, “what is a geriatrician,” and “when should someone see a geriatrician?” See my answer to these questions on seniorific.com!

Q. What is a Geriatrician?

A. Geriatricians are doctors trained in either Internal Medicine or Family Medicine who have spent at least one extra year training specifically to care for the needs of older adults.

Q. Why do I need a Geriatrician?

A. Geriatricians are experts in aging. We focus on the physical, mental health, and social issues that are unique to older adults. Most of our patients are over the age of 65, but age is not a requirement or a barrier for seeing a geriatrician. We are experts in complexity; most of our patients have multiple chronic diseases. As such, we often have longer appointments than most doctors and work with a team to care for our patients. We work hard to keep our patients as functional and independent as possible, and are experts in areas like falls prevention, cognitive changes/dementia, streamlining medication lists, physiologic changes in aging, and frailty.

Q. Aren’t Geriatricians doctors for old people?

A. Yes and no. Geriatricians are your partners in the medical community to fight ageism. A life well lived is constantly developing and changing. Just as pediatricians are experts at the developmental issues at the start of life, we geriatricians are the experts for those lucky enough to have made it past middle age and have the desire to continue to thrive. We are specialists in prevention of functional loss that many associate with “being old.” To do this well, we need to see you early—before you feel “old.” But don’t worry if you or a loved one didn’t see us before age related decline set in. When this time comes we are also experts in helping patients and families navigate the complexities of repeated hospitalizations and institutionalization in a respectful and dignified way that maximizes function and health.

Q. OK, you won me over. How do I find a Geriatrician?

A. There aren’t many geriatricians out there. To ensure your geriatrician has had rigorous training ask for a Board Certified Geriatrician. In the San Antonio area, veterans can contact the South Texas Veterans Health Care System at 210-617-5183 and ask to be seen in the Geriatric Evaluation and Management (GEM) Clinic at Audie L. Murphy Memorial Veterans Hospital. UT Health San Antonio also has geriatric clinics and may contact them at 210-450-910 or 210-450-9890.

Source: Q&A with a Geriatrician

5Ms and Hand Turkeys

Posted on by Fat Geriatrician

Thanksgiving is just around the corner.  With 2 kids in daycare, that means one thing.  HAND TURKEYS!

Daycares LOVE making artwork using kids hands and feet.  Hearts made of footprints for Valentines Day and Christmas Trees made of handprints are cute.  But Thanksgiving is the holiday where hand artwork is King!

Seeing all the little handprints on display reminded me of a new “branding” campaign in Geriatrics–the 5Ms.

5Ms Geriatrics

It is an attempt to explain what geriatricians do in a simple and easy to remember way.  The words in the campaign are well thought out/on point.  However, what makes me chuckle is that the published visual representation is a hand turkey template?!?

Descriptors of the different Ms can be found in the table below (lifted from this website).

5Ms table

I was unaware of this attempt at rebranding until a recent meeting where it was discussed like it was old news.  Whoops!  Bad on me for not paying attention.

It may be captured somewhere under multi-complexity, but I think we are also experts at multi-locations of care. Hospital, clinic, home visits, nursing homes, PACE programs, hospital in home, etc. But then that would be a six-fingered turkey, and we didn’t kill Inego Montoya’s father…in fact we are all about NOT killing people’s fathers!

download_20181110_214437

Despite my somewhat joking tone, I do really like the 5Ms, and I need to find a way to incorporate them into my teaching.  They really do capture the essence of what we do as a specialty (and why we are different from internists and family med docs who also “see older adults”).

And hopefully, someone somewhere will be thankful for a geriatrician this Thanksgiving!

Thankfful for Geriatricians