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November 30, 2024 | SUBSCRIBEβ
Good morning. I hope you all had a wonderful Thanksgiving!
I got a lot of great feedback from my Thanksgiving turkey carving article last week, with one very notable exception.
I'm pretty sure my mom unsubscribed after my 'dry, tasteless' turkey comment. Which unfortunately brings my subscriber count down to roughly two.
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I'll see if I can win her back, but it's not looking good.
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βοΈ First Hand
The healthcare landscape of 2025 is more complex than ever, with specialist visits becoming increasingly precious and hard to secure (more on that another time). While technology has revolutionized many aspects of medicine, the fundamental challenge remains: how to make the most of your limited time with a doctor.
After seeing thousands of patients, I've identified the key strategies that can transform a rushed 15-minute appointment into a productive medical visit. What's surprising is that the most impactful changes don't happen in the doctor's office β they happen before you ever walk through the door.
βIn this guide, I'll share the insider tactics that can help you navigate our modern healthcare system and get the care you actually need.
PS. We now have subscribers in the thousands! If you're new here, it's great to have you! Each week I also read my article out loud via podcast (links below) if you'd prefer to listen instead of read.
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π X-ray of the Week π
Ok, this one deserves a story. Probably in my top ten wildest things I've seen in orthopedics.
What you're seeing above is an xray of a pelvis. And that big white thing on the left? Those are the handlebars of an ATV.
This person was riding an ATV when it flipped and, somehow, one of the handlebars went through the person's belly.
And not only did it go through their belly, but it kept going until it went through their iliac crest, the big heart-shaped pelvis bone.
To get this person to the hospital, the EMTs used the 'jaws of life' tool to cut the handlebars off the ATV and then rushed the patient to the ER by helicopter. So when I was called to the patient's trauma bay, there they were with handlebars sticking up out of their belly.
Fortunately, our very talented trauma surgeons safely removed it and they found there was essentially no damage done. This patient was by far one of the luckiest I ever encountered. They were left with a perfectly round hole in their pelvis for a few months, but other than that made an uneventful recovery.
Few injuries surprise me anymore in medicine, but that one was certainly an exception.
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Newsletters Galore
One of my favorite things about email is the freedom to explore new niches via newsletters like this one. There's always something new to learn.
If you like newsletters as much as I do, check out this free resource to browse through what's out there and find something new to explore!
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** This section features an affiliate link, meaning I will earn a small commission (at no cost to you) if you use this discount code **
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π Small change | BIG impact π
Given how many people work in computer-based jobs these days, I continue to see a lot of people in my clinic who come in with numbness and tingling in their pinky fingers.
Did you know that any time your elbow is bent at 90Β° or more, you are pinching your ulnar nerve (your 'funny bone' nerve)?
Well, it's pretty easy in our modern era to spend the majority of the day with your elbows bent that much. Think of the elbow position you use for typing, talking on the phone, texting, swiping, reading, curling up sleeping....
That's all time that your ulnar nerve is spending with decreased blood flow. Eventually, this will lead to numbness and tingling in your pinky finger.
So here's your little hack. Especially for those with all-day typing jobs.
Each time you pause typing to think or answer the phone or take a sip of coffee, let that arm hang down at your side. Get that elbow straighter than 90Β°. Even if just for a few seconds at a time, making this an instinctual habit will make a massive difference in the health of your ulnar nerve. This position opens up the little micro blood vessels that feed your nerve. Let the blood rush back in!
In fact, I struggle with this in my left elbow in particular. I have it checked once a year and have successfully fended off any ongoing nerve damage with exactly this strategy.
And if this change doesn't fix your symptoms after a month or two? Straight to the doctor for you! Permanent nerve damage is at risk if you ignore these symptoms over time.
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π°οΈ Meme Time π°οΈ
In case you missed the Mike Tyson fight last week...
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π©Έ Finger on the Pulse π©Έ
πΆ Smells like wet dog: I'm sure you already knew this, but in case you didn't, researchers have recently confirmed what makes dogs shake vigorously when they're wet. It's a reflex mediated by their C fiber low-threshold mechanoreceptors. Or, as you likely refer to them when discussing with your friends, their C-LTMRs.
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Support "Rules Of Thumb"
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- Share! Just forward this email to a friend or send them to rulesofthumb.nickgolinvauxmd.com/join. The more this grows, the more I can invest in it!
- Support! Rules of Thumb is a completely free resource to all those who want to learn more about the human body. Support Rules of Thumb here π.
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-Dr. G
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**Please do not use this email to try to obtain medical advice. I cannot legally or ethically provide that. If you are having a medical emergency, please call 911 and do not attempt to contact me through email.**
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βRules of Thumb Archive β’ www.nickgolinvauxmd.comβ
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Disclaimer (because, you know, lawyer stuff)
If you are having a medical emergency, call 911. Do not attempt to contact or obtain medical services through this site. This content is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this site or materials linked from this site is at the user's own risk. The content of this site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their healthcare professionals for any such conditions. The content is my own and does not necessarily reflect the views of OCC.
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