HealthCare

Doctor's Morning Routine: Coffee, Inbox Zero, and Dinner Plans

Okay, so here's a morning in my life when I'm not seeing patients clinically. I have an administrative day and it's match day. I wake up, take in the view, then I have gotten in the habit of having both a hot and a cold coffee in the morning. A hot while I'm getting ready and a cold for the road. I use something called Comiteer, which makes it very easy. I often try to start my day with black coffee and not a lot else, and then I have this habit of really needing to have my email in basket down to zero. So this is my Gmail, which I have gotten down to zero this morning, and then I already have also tackled my work email in basket this morning. I do cheat and I mark every email that has to get handled that day and put that in the today folder. I have two there today, full disclosure, that I couldn't manage this morning. Then I get to enjoy the rest of my coffee and by 9 a.m. I'm set up with my emails for the day. I'm thinking about dinner tonight. That's last night's Diet Dr. Pepper. Have a good day, everybody.

I have a morning routine of having two coffees, checking my emails, and making a plan for the day. I always make sure to get my emails down to zero, and then I can relax and enjoy the rest of my coffee.

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On a morning when I don't have clinical sessions and have administrative tasks, here's my routine. I wake up and take a moment to appreciate the view. As part of my morning ritual, I enjoy both a hot and cold coffee. Using Comiteer makes it convenient. I prefer starting my day with black coffee and keeping things simple. One habit I have is aiming to clear out my email inbox completely. I've already managed to reach inbox zero for both my Gmail and work email this morning. To stay organized, I mark emails that need attention on the same day and place them in the today folder. Today, there are two remaining emails in that folder which I couldn't address earlier. With my coffee finished and by 9 a.m., I'm ready to tackle the emails for the day and start thinking about dinner plans. Wishing everyone a great day!

Melatonin: Less is More for Optimal Sleep

One of the interesting things about melatonin is that it's often sold in 10 milligram capsules over-the-counter, but there's actually the most data for efficacy in the 3 to 5 milligram range, and so often you can save yourself some money and you may not need as much as actually is being sold in the pharmacy. Remember that over-the-counter supplements don't have as tight of FDA regulation as sometimes none at all compared to other things that you may be getting in the pharmacy. So while yes, you should stick within the therapeutic range, actually less is often more with melatonin than I tell my patients to start low in the 1 to 3 milligram range, and that often there's no real need to go above 5, and at that range you may sort of be having some of the side effects without the benefits for sleep. So try not to go high, stick to the lower doses, and certainly there are some medications that interact with melatonin where you might want to be careful if you're thinking about an overdose, but I would say less is more and save yourself some money at the pharmacy.

Melatonin is often sold in 10 mg capsules over the counter, but there is the most data for efficacy in the 325 mg range. It is important to note that less is often more with melatonin and to start low with doses of 1-3 mgs and not exceed 5 mgs as side effects may occur without the benefits for sleep. Additionally, some medications interact with melatonin so it is best to be careful when taking an overdose.

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Melatonin is commonly sold in 10 milligram capsules over-the-counter, but the most data for efficacy exists in the 3 to 5 milligram range. It's interesting to note that you may not need as much as is being sold, allowing you to save money. It's important to remember that over-the-counter supplements have less FDA regulation compared to other pharmacy products. While sticking within the therapeutic range is advisable, less is often more with melatonin. I typically recommend starting with low doses, around 1 to 3 milligrams, and there's generally no need to exceed 5 milligrams. Higher doses may lead to side effects without additional sleep benefits. It's crucial to be cautious of potential medication interactions when considering melatonin overdose. In summary, it's best to opt for lower doses and save money at the pharmacy.

What are the daily habits you have to remain grounded and also happy?

Small daily habits for a grounded and happy life

The daily habits that keep me grounded and also happy, first involve making sure to stay in touch with my friends, my family, my loved ones, and making sure that they're a big part of my life because they help remind me of who I am and what my dreams are and who I've always been. The second is that I really believe in small acts of self-care. And some people think this is kind of crazy, but I really introduce small things into my life that make me feel valued. So really good pens, having a nice cup of coffee in the morning, or buying coffee beans that I like the most. I think those really small things actually add small jolts of happiness into my day every day. Having a playlist that you know makes you happy for your drive to and from work. And then I think the third thing is I've been trying really hard to practice gratitude and to wake up every morning. Some days I don't wanna go to work, but when I have those days thinking to myself, what are the two to three things that I'm really thankful for today? And while that sounds silly, it really does create a grounding to my day that makes it easier to get through the day. And that also reminds me of all the things that I have to be thankful for. Working and being an adult in life in America are really tough sometimes. And I think those small things help me feel pretty good on most days.

I stay grounded and happy by staying in touch with family and friends, doing small acts of self care, having a playlist that makes me happy for my commute, and practicing gratitude every morning.

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To remain grounded and happy, I prioritize daily habits that involve staying connected with loved ones, such as friends and family. They remind me of my identity, dreams, and values. Additionally, I believe in incorporating small acts of self-care into my routine. Simple things like using high-quality pens, enjoying a good cup of coffee in the morning, or choosing my favorite coffee beans bring bursts of happiness to my day. I also create playlists that uplift my mood during my commute to work. Another important habit is practicing gratitude. Every morning, I reflect on two to three things that I'm thankful for, even on days when work feels challenging. This practice grounds me and helps me appreciate the blessings in my life. Life can be tough as an adult in America, but these small habits contribute to my overall sense of well-being on most days.

Why are statins one of the most prescribed drugs?

Preventing Bad Outcomes: The Power of Statins

Statins are prescribed for many indications in people who have had a cardiac event happen. However, a lot of patients are on them for preventative reasons and that often is tied to their risk factors for cardiac disease down the road. So a lot of people are on statins because doctors are trying to prevent patients from having bad outcomes later in life. We have a tool that helps to guide us and most doctors will put patients on a statin if they have a risk factor for cardiac disease and their calculated risk of having something bad happen from a cardiac perspective in the next 10 years is more than 10%. The risk factors then that would put you in that bucket of people who should be prescribed a statin would include high cholesterol, having diabetes, having high blood pressure, a history of smoking, things of that nature. And we really have found over time that these medications are tolerated really well and have immense benefit of preventing really bad outcomes down the road. If you think you'd qualify, a primary care doctor often can help to prescribe or decide if you should be prescribed this medication.

Statins are prescribed for many reasons, but often for preventive reasons to help prevent bad cardiac outcomes. Risk factors for cardiac disease that suggest someone should be prescribed a Statin include high cholesterol, diabetes, high blood pressure, and a history of smoking. These medications are usually tolerated well and have immense benefit in preventing bad outcomes. A primary care doctor can help determine if someone should be prescribed this medication.

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Statins are commonly prescribed drugs for various indications, including prevention of cardiac events. Many patients are prescribed statins as a preventative measure based on their risk factors for future cardiac disease. Doctors use a tool to assess the calculated risk of a patient experiencing a cardiac event within the next 10 years, and if it exceeds 10%, they may prescribe statins. Risk factors include high cholesterol, diabetes, high blood pressure, and a history of smoking. Statins have been found to be well-tolerated and offer significant benefits in preventing serious cardiac outcomes. If you believe you may qualify for statin prescription, consulting with a primary care doctor is advisable to determine if this medication is appropriate for you.

What are some things l should know before entering medical school?

Insider advice for surviving and thriving in medical school

I think that while medical school is so hard and is so busy and is so stressful and it can be really tough to take care of yourself when it feels so performative at times, at the end of the day you're gonna make it through and you're gonna have a career that you really do love on the other side. I think advice that I wish I knew going in would be to really try and find mentors and people that you look up to that you want to be like and that will help sort of figure out what path you want to be on career-wise and that it's really important to start setting up habits that help you take care of yourself whether it's exercise, nutrition, sleep habits, finding things that make you feel valued every single day and small acts of signaling self-worth can be really helpful because to be quite honest it can be really hard as a student in medicine to always feel like you're adding value but at the end of the day you're adding meaningful care to patients and it's really an extraordinary journey. I love med school and I hope you have the best time.

To make it through medical school, find mentors and people to look up to and set up habits to take care of yourself such as exercise, nutrition, and sleep. These small acts of self-worth can help you appreciate the journey of providing meaningful care to patients.

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Before entering medical school, there are a few things to keep in mind. While medical school can be incredibly challenging, busy, and stressful, it is important to remember that you will make it through and have a fulfilling career on the other side. One valuable piece of advice is to seek out mentors and role models who can guide you in figuring out your desired career path. Additionally, establishing habits that prioritize self-care, such as exercise, nutrition, and adequate sleep, is crucial. Finding activities or practices that make you feel valued on a daily basis can also be beneficial for maintaining a sense of self-worth. It's important to recognize that as a student in medicine, it may sometimes be difficult to feel like you are making a significant impact. However, remember that you are providing meaningful care to patients and embarking on an extraordinary journey. Overall, medical school can be challenging but also rewarding, and I wish you the best in your journey.

What ethical considerations must be taken into account when making decisions regarding end-of-life care?

Understanding patients' values: Ethical considerations in end-of-life care

Taking care of patients at the end of their life is one of the most meaningful and humbling and powerful things that we have the privilege to do as physicians. I take that responsibility really seriously and try really hard to meet my patients where they're at when we realize that they've reached the end of their journey through life. Ethically, there are so many situations that come up at the end of life and while there are all sorts of principles that we adhere to in that setting, I actually think that the most important thing is to try and understand who the patient has been across their lifetime. What would they have wanted? What are the religious values? What are the personal values? What are the things that have mattered to them throughout their life and how can we make sure that their care at the end of life aligns with who they've always been? We also think a lot about trying to offer interventions that only would bring benefit and not cause harm and also recognize that we have a tendency to want to help. Sometimes that means offering interventions to patients or their families that at the end of the day may give more days but not days that are of quality to the patient. I try really hard to understand what does quality of life actually mean to my patients and how can we make sure that their care aligns with that.

Taking care of patients at the end of their life is a humbling and powerful privilege. It is important to understand who the patient has been, what would they have wanted, and how to make sure that their care aligns with who they've always been. Interventions should only bring benefit and not harm and we need to consider quality of life when making decisions for the patient.

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When it comes to making decisions regarding end-of-life care, there are several ethical considerations to keep in mind. As a physician, I consider it a privilege to care for patients during this sensitive time. One essential ethical aspect is understanding the patient's background and values throughout their life. What would they have wanted? What are their religious and personal beliefs? It's crucial to ensure that their end-of-life care reflects who they have always been. Additionally, we strive to provide interventions that offer benefit without causing harm. It's important to recognize our inclination to want to help, even if it means offering interventions that may only prolong life without maintaining its quality. I work diligently to understand what quality of life means for my patients and how we can align their care accordingly. Taking these ethical considerations into account helps us provide meaningful and compassionate end-of-life care.

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Dr. Kathleen M Mcfadden is an Internal Medicine Specialist in Boston, Massachusetts. She graduated with honors from University Of South Florida College Of Medicine in 2017. With 6+ years of experience, she affiliates with Massachusetts General Hospital and Newton-wellesley Hospital, and cooperates with Newton-wellesley Medical Group, Inc. and Massachusetts General Physicians Organization Inc.

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Dr. Kathleen McFadden, MD