Q:

Any ideas?

A: Okay, first of all, this website is “Your ER Doc” not “Your Insurance Agent,” and certainly not “Your Congressman” but I’ll take a stab at it. You have to have insurance in case something catastrophic happens, so I favor a relatively inexpensive PPO plan with a very high deductible. This will deal with large bills that could result from hospitalizations, surgeries, etc. Under ordinary circumstances however, most healthy people will not get close to their deductible. This means that you now have to avoid getting sick or hurt as much as possible to save costs. It is absolutely imperative that you take full responsibility for your health. First read my top 10 list, “How to Stay out of the ER,” and also follow the following rules below.
Here’s how many cigarettes you can smoke per day: 0.
Here’s how many alcoholic beverages you can have per day: 1.
Here’s your new diet plan (which by the way I completely stole): Eat food, not too much, mostly plants.
Here’s your list of high impact sports you can participate in: Chess.
Here’s how much faster than the speed limit you may drive: 0.
Here’s how much exercise you need: 30 minutes aerobic every other day.

I’m sorry this is restrictive my friend, but at least it’s cheap.

Quite a few years back, a male patient presented to an ER in very serious condition after an elective face lift. He had developed post-operative swelling and it became so severe, that it occluded his airway. He ended up starved of oxygen and suffered permanent, disabling brain damage as a result. I know that cosmetic surgical procedures are improved, and safer now, but you really need to be sure that even a small risk is justified.

I have recently learned of a new facelift procedure known as “Energy facelift” which is apparently less invasive. It can be performed under local anesthesia, and the surgeon uses a laser to “shrink tissue.” This does sound better than the complete facelift, but I’ve got a better idea–Let’s all reset our beauty standards. Here’s what we do: First, throw out all your fashion magazines and clothing catalogues. Next, get a coffee table book of famous circus freaks. You might also consider an atlas of bad skin diseases. Finally, don’t watch any TV shows that feature attractive people. Andy Rooney is fine, and you may safely watch Larry King. Just make sure he’s not interviewing Cameron Diaz or Brad Pitt.

After a few weeks of this, I guarantee we will all feel very attractive, and isn’t that the whole point after all?

Q:

Dear ER Doc,

I have been hearing about the low carb diet lately and am thinking about trying it out.  Is this just another fad diet or is there some science behind it?  I need to lose about 50 pounds.

Lisa, Fresno CA

A:

Lisa, there certainly are a lot of fad diets out there that don’t have any scientific basis, but low carbohydrate diets are not among them.  Recently, a study was published in the New England Journal of Medicine which compared 3 diets against each other–a traditional low fat diet, a Mediterranean diet, and a low carbohydrate diet.  The low carbohydrate diet was based on the “Atkins diet” which has been in use for many years.  In this study, the low carbohydrate diet compared very favorably to the other diets, both in total weight loss and improvement in cholesterol profiles, despite the fact that calories were not restricted in this group.  There were some limitations to the study, and further research will be required (as usual), but overall, this is helpful information.  If you are interested in pursuing this option, I urge you to speak to your physician and get more information regarding both diet, and exercise.  I applaud your desire to make healthy changes, which include weight loss, and I’m sure it will lessen your chance of visiting me in the ER!