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January 4, 2025 | SUBSCRIBE
Good morning.
I hope you all had a wonderful holiday break. Mine was full of family time, frosted sugar cookies, and can-you-take-this-bump-off-before-my-deductible-resets surgeries.
We figured out how to go to the moon, but we clearly haven't won the battle against arbitrary deadlines.
** This newsletter features occasional affiliate links, meaning I will earn a small commission (at no cost to you) if you purchase a linked product. These small amounts will always be re-invested directly back into Rules of Thumb to improve the experience for all.**
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☝️ First Hand
The question seems simple enough: "When can I drive after surgery?"
But the answer reveals an unexpected gap between medicine and the law. Despite how common orthopedic surgeries are, there are virtually no official US guidelines (I wrote an academic paper on this one) about returning to driving — leaving surgeons, insurance companies, and even state vehicle departments struggling to provide clear guidance.
Unfortunately, research shows this uncertainty leads to concerning decisions. 35% of post-op patients return to driving while still on narcotic pain medications!
Through examining recent studies and real-world cases, in this week's article, we'll explore exactly how different surgeries affect your driving ability, what science tells us about safe recovery times, and why that half-second difference in reaction time could matter more than you think.
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Newsletters Galore
Each week, I receive four or five email newsletters that I basically can't wait to read. They usually pertain to whatever newest rabbit hole I'm learning about or long-held interests I prefer to explore over time.
And I'd say I found about 60% of them through this service called Refind. It's 100% free and basically is a directory of newsletters in various areas of interest. Plus it will learn what you like and recommend newsletters to you in a simple daily digest, if that's your thing.
Anyways, if you like newsletters as much as I do, you can explore here at no cost to you. Enjoy!
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👀 X-ray of the Week 👀
Believe it or not, this is about the best kind of fracture you can leave the scene of a car accident with.
This person's leg slammed into the brake pedal and...well, snapped.
As dramatic as this fracture looks, it can be easily stabilized with a long nail, or rod, down the center of the bone. I would take this any day over the shattered ankle, shattered knee, or impacted hip/pelvis fracture that this same crash could have caused...
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🙋 Raise your hand if you're: Tired
For the umpteenth time, Congress recently voted to decrease payments to physicians and increase them to hospitals. There are only so many healthcare dollars in the pie, and the hospital lobbies have won again.
And when Medicare does this, all the private health insurance companies follow suit.
I don't know how this can go on. Over the last 20 years, physician reimbursement is 40% behind the baseline level of inflation. Yet we're still expected to run an office, hire staff, and well, care for patients...
This is why that private practice specialist you recently saw had walls with peeling paint and waiting room carpet with questionable stains...
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🕰️ Meme Time 🕰️
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12:17 AM • Nov 30, 2024
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🩸 Finger on the Pulse 🩸
🙈 Shameful: The fact that Blue Cross/Blue Shield even considered limiting paying for patient's time under anesthesia is abhorrent. Fortunately, they have reversed this decision...for now.
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📚 What I'm Currently Reading 📚
We could all do with a little more reading and a little less swiping. Or that's my opinion, at least 😀. So I'm starting the conversation. Chime in if you like!
Right now, I'm working my way through "The Anxious Generation" by Jonathan Haidt. Basically, it's now been about 15 years since the front facing camera (think selfies), the like button on Facebook, and multiple social media platforms became mainstream.
Which means we have 15 years of data on what it is doing to our teens' and pre-teens' brains. Spoiler alert: it's not good.
As a parent, I very much fear the day my wife and I will need to make the decision of when our kids get smartphones, social media accounts, etc. And while this book has some helpful suggestions, it really has served more to demonstrate the magnitude of the issue and the essentially uncontrolled mental health experiment we have unwittingly thrust upon a generation of children.
If you have the answer...I'm all ears!
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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!
-Dr. G
PS. 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 🙏.
**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.**
Rules of Thumb Archive • www.nickgolinvauxmd.com
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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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