Dr. Maller’s Blog

It’s been six weeks since my last day at the Vanowen office and I’m way overdue to check in. I am in the beautiful central coast area of California, covering a practice very much like my old one while its owner enjoys a well-deserved European vacation.
The pace is so relaxed, the scenery and weather so lovely that it’s almost like a vacation for me too, especially while Cynthia and Gucci were here the past two weeks. I’ve seen interesting patients too.
A 7-year-old boy who while normal in every other respect has never eaten anything but liquid (he nursed for three years) or pureed foods..I had the luxury of an extra half hour to talk to him and his 43-year-old engineer mother. Q: what do you eat for school lunch? A: yogurt and pudding. Q: what about birthday parties? Do you eat cake? A: no- too much sugar. He has been referred to a therapist in San Luis Obispo. My guess: obsessive-compulsive disorder (his uncle has it). Prognosis? I wish I knew.
Three kids have had pre-op exams for dental surgery for nursing-bottle mouth. The worst was a 3-year-old going for his second surgery. Usually I can barely contain my anger when I see such severe and preventable disease; it’s the main reason I’m so strict about weaning from the bottle. But this mom seemed so sweet that for once I resisted being judgmental. Turns out this youngster never had a bottle! Mom breast-fed him day and night for two years. No one told her she could damage his teeth just as badly that way as with night bottles.
A 20-year-old college girl came in worried about hypoglycemic symptoms and I realized she was the first patient I’d ever seen after a gastric bypass. She had lost 90 pounds. That’s the good news. The trouble is she’s still 90 pounds overweight with medical problems more typical of a Medicare patient. Obesity is the great scourge not only of our overindulged society, but of us doctors. We can treat and often cure almost everything – except the morbidly obese. The long-term cure rate is less than 10% and the future cost burden is incalculable.
After 44 years running a mostly solo practice, the changes have been remarkable in medicine. The science has jumped ahead enormously but the art remains a big challenge. Will the patients of tomorrow have personal physicians to talk with? I fear not, especially under Obamacare.
Earlier I was reading a book review about a gentleman who is now a PhD and directs a major ink tank. As a college student he dropped out to pursue his passion of playing classical music in a small touring group. After six years he took what he thought was a dream job playing in a state orchestra in Spain for better money. He hated it. I can relate at this time in my life to what he discovered. The joy was gone; he had to obey the conductor. “The more control you have over your life, the more responsible you feel for your own success (or failure). And as we’ve seen, the more you feel you’ve earned your success, the happier your life will be.”

There are over 200 wineries around here. So far I’ve only tasted two. Sounds like it may be time to try another. Be well, friends.

That’s baby talk for “See you later.” At least it was in my house when my first-born began imitating adult speech. You’ve probably also found yourselves so delighted at your first child’s early attempts at conversation that you’ve added several new expressions to your lexicon. Now he’s 50 and I’m still imitating him imitating me. My surviving lovebird, Clyde, now a widower since his mate Bonnie died recently, is at home where I call him “Boorp” because that’s the way Steve said “bird.” When I find my glasses, phone, keys, or remote I often yell “Ee-dee-dee” for “Here it [...] Continue Reading…

I’m not referring to pizza but to politics.

In the last 24 hours the equivalent of a tsunami has hit health care in the form of a sweeping “reform” passed by one party in Congress, despite growing opposition from the public. I’m disappointed and like most of you, frightened of the long-term implications of this enormous change that will, if it stands, affect every person out there, most of all the young.

I cast my first vote on the south side of Chicago. It was not an experience likely to elevate my opinion of the process. I learned first-hand what a [...] Continue Reading…

What? The title is spelled wrong? And you noticed! You must have gone to an expensive private school.

The state of education is like the weather. Everyone talks about it but no one has any idea how to fix it. But it is too important to ignore.

I’ve been more than a spectator but less than an expert. I’ve been taught by unforgettable teachers in grade and high schools; I’ve graduated from an Ivy League college and an even better medical school. My children have ranged from college dropout to law school, all of them doing well with no [...] Continue Reading…

This time of year it’s hard on us Southern Californians to bear the slings and arrows of our friends and family living almost anywhere else, watching not one but two Rose Bowl games played in glorious warm weather while they shiver and sulk, shovel and skid through an unusually harsh winter.

I’m feeling pretty smug about the weather, but not because of where I live. The Climategate scandal was our Christmas present du jour and wasn’t it a beaut?

Just before the Al-Gore crowd was to assemble in Copenhagen it came out that major weather “experts” on both sides of [...] Continue Reading…

The course I most enjoyed in college was Greek Drama. It was a rare treat to choose an elective, pre-med being the challenge it is. It was also the one class I shared with my wife-to-be.

The word I refer to is hubris, the hero’s fatal flaw, the arrogance, the lustful pride that would be his undoing. Nemesis was the instrument of his destruction. There are some forty surviving Greek plays by Aeschylus, Sophocles and Euripides. A few were funny (e.g. Lysistrata) wherein the wives band together to withhold matrimonial pleasures from their husbands until they stop fighting wars, but [...] Continue Reading…

That’s “wring” with a “w”, not a typo. 2009 was a sloppy mess of a year and I say “good riddance.”

It’s been two years since I started blogging and I’ve been looking back at my off-and-on efforts with a mixture of pride and embarrassment. Forty posts plus some instructional entries aren’t as much as I’d hoped. But my readers tell me to keep at it. Tomorrow is two years since Gucci, then a one-pound fuzzball, appeared unexpectedly at my front door tucked into my wife’s cleavage, which is still her favorite hangout. Now she’s a seven-pound wonder dog whom [...] Continue Reading…

The influenza strain formerly known as swine flu has now been with us for about five months and the first vaccines are arriving, so it’s time for an update.

We are experiencing several unusual events. The last pandemic was in 1968. Influenza rarely occurs during the summer, but this pandemic has continued throughout the hot months. Will it replace the seasonal flu which generally appears about now, or will they occur side by side? We continue to vaccinate high-risk patients with the ordinary flu vaccine but it offers no protection against H1N1. Folks over 60 are immune. Deaths have [...] Continue Reading…

As many of you already know, important changes are occurring in my office these days. The good news is that I’m not retiring. The bad news is that I’m not retiring. Just kidding – really.

Kids & Teens Medical Group Inc. in the person of Dr. Janesri DeSilva is absorbing my practice, which will be one of three locations. I will continue at Suite 102 (that’s Practice 5.0) as I have been since 2004. Her office is at 10550 Sepulveda in Mission Hills, and the other is nearby at 14608 Victory Blvd. This will allow growth and modernization that would [...] Continue Reading…

At the suggestion of a new mom who has sent me a list of some 11 “old wives’ tales”, I shall try to shed some light in these dusty corners.

1. Doubling your toddler’s height at age 2 will give you their adult height.
That’s the rule for boys; for girls it’s eighteen months. I’ve had hundreds of patients grow up to adulthood, and it’s a pretty good estimate. But everything in biology falls on a bell curve. The eventual height can be influenced by early or late puberty; “late-bloomers” may keep growing through their teens. [...] Continue Reading…