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By Michael Miller DO, FACOS, FAPWCA, WCC

As we enter this New Year, I have several resolutions which I hope will act as a sextant for my upcoming wound care voyages. I promise to be less critical of my colleagues who do horrendous, insipid, unprofessional, unethical, unintelligent, profit-motivated things to patients in the name of good care…OK, maybe not. I have promised to continue my Sinbad-like voyage to find my much sought after ball-laden juggler for whom to send my much needed debridements and IV port placements. I understand that surgeons prefer to evaluate patients before elective procedures to assure that they have no potential problems and that they are low risk candidates for the requested procedure. But asking a 300 lb. paraplegic to come in to a poorly accessible office to vet them and then schedule them days later rarely identifies a reason to defer on the procedure but moreover, places the patient, their family and others at high risk and considerable inconvenience. Can you not arrange to see them early and help them later the same day?

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RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 18

By Michael Miller DO, FACOS, FAPWCA, WCC

One of the problems with writing a blog is not the lack of material on which to vent, vex or vociferate. Rather, I deal with the much desired situation in which there are simply so many aberrancies that appear before my now trifocaled vista, that I have to decide which of many potential entities to offend.

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By Michael Miller DO, FACOS, FAPWCA, WCC

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 17

It has been said that even a blind squirrel finds a nut once in a while. Like Isaac Newton who discovered gravity courtesy of an apple hitting his noggin and Ben Franklin discovering electricity by flying a key laden kite into a Philadelphia storm, even lowly rambling wound care guys trip over the truth. So many questions and so few answers until…there amongst the trees appears a forest. And so, in the spirit of the Indianapolis Colts finding a diamond in Andrew Luck, I am pleased to announce that I have recently identified the presence of a multi-tribal primitive species existing amongst us. Based on their aberrant business behavior, their ability to masquerade as Homo sapiens, their will-o-the-wisp flashes of humanity (interspersed with maniacal idiocy) and their unquenchable thirst for complexity and deception, I have proudly named them after our current governmental medical overlords.

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By Michael Miller DO, FACOS, FAPWCA, WCC

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 16

As I write my blog, I wonder whether anyone really reads it. I know that my wife and daughters do, because they have no choice. For all the foibles my 24 year old is quick to point out --Dad, you’re not really going to wear that; Dad, you have a stain on your shirt; Dad, you need to empty the cat litter (to which I reply, “why, they didn't eat what I poured them yet!”)--, she has commented on an occasion or two, “That was funny” or, “Yeah, it’s pretty good this time.”

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By Michael Miller DO, FACOS, FAPWCA, WCC

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 15

First and foremost, I don't want any of you to think I am a fatalist. I always look for the silver lining while recognizing that a dark cloud at one point may engulf it. Nor do I want the reputation as a harbinger of doom. Like the Monty Python Troupe singing in their movie "The Life of Brian", I always look on the bright side of life. Need there always be a lesser of two evils? Yogi Berra resolved this dilemma by stating, "If you come to a fork in the road, take it."

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em>By Michael Miller DO, FACOS, FAPWCA, WCC

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 14

Most of us are familiar with Genesis 4:9, in which, after Cain murders Abel, God questions him about his brother. His famous reply is “Am I my brother’s keeper?” Cain’s response (framed as a question) has led scholars to consider the consequences of assuming responsibility for the actions of another over whom you may or may not have a modicum of control.

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By Michael Miller DO, FACOS, FAPWCA, WCC

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 13

There is a particularly memorable scene in the 1976 Film “Network” in which Anchorman Howard Beale (played by acting maven Peter Finch), learns that he has just two more weeks on the air because of declining ratings. His angst finally comes to the surface and in a burst of splenic venting ecstasy, he persuades his viewers to shout out of their windows "I'm as mad as hell, and I'm not going to take this anymore!"

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em>By Michael Miller DO, FACOS, FAPWCA

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 12

There are many colloquialisms we use to describe a variety of situations. When someone appears to make a real commitment, we call it “full bore” or “going whole hog” or to use the gambling epithet, “all in”. Commitment is an important part of what we as health care practitioners stand for. You have all read ad infinitum, ad astra, ad mortem of my strongest belief that patients must take an equal role in their care. We provide the recommendations, the rationale and the risks (and benefits, of course) and they decide which of our offerings best suits their beliefs, their desires and for better or worse, their purses. The marketing profession has made millions of consumers purchase items they do not need based on the sex appeal of the turn of a phrase, changing a question of doubt into “iron clad”.

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By Michael Miller DO, FACOS, FAPWCA

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 11

I have always had a penchant for the ironic. I love a great joke well told, an amusing anecdote well written or a cartoon well drawn. Charles Addams, creator of the Addams family in the New Yorker magazine introduced his “unusual” family by drawing them poised several stories above and looking down upon a group of happy, singing Christmas carolers as they prepared to pour boiling oil on them. I still chuckle when I think about it. I love unusual sayings such as “You have a firm grasp of the obvious”, “You may not be good, but at least you’re slow” or “I can’t see the forest because of the trees.”

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By Michael Miller DO, FACOS, FAPWCA

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 10

A house call to a delightful 78-year-old lady revealed a history of a hip prosthesis placed three years earlier that unfortunately had become infected. When the first surgeon could not be found (he had moved out of state just in time), his associate opened the hip, carefully lavaged out the “Root Beer Float” material (per the family, an interesting description if I ever heard one), and then closed the hip primarily.

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