Doctor808 Plastic Surgeon Honolulu Hawaii

Swine Flu  is a serious disease and authorities are worried about its spread in the United States. The reason is that as of this writing there have been already reported 150 deaths in Mexico. Here in Hawaii there has not been a reported case yet.  However there has been at least one reported death in the USA.

A flu epidemic is caused by a virus which is spread typically by person to person contact. Sneezing, coughing and spread by air , are the usual methods.  It also can be picked up on door knobs if touched right after someone contagious has spread the droplets there for example. In the case of swine flu the virus has made the jump from pigs to humans and the DNA has become mixed up. There was not thought to be a spread of the virus beyond 3 successive people but now that has been dismissed. 

For a more detailed description of the swine flu check this out CDC SWINE FLU report from CDC.

As a Plastic Surgeon in Hawaii,  I do get reports from the local health department and there have not been any reported cases here,  but caution is advised. Hawaii has a lot of incoming visitors as it is a vacation paradise. At my clinic we come in contact with a lot of people and we take extreme precautions not to contribute to the spread of virus or any germs. I have not decided yet but I am considering carefully,  to mandate wearing of mask by staff when in contact with public. Its a balance of saftey and giving the appearance of friendliness that I try to maintain from my staff.

Any of my plastic surgery staff who is sneezing, coughing or shows signs of illness will either be sent home or at a minimum wear a surgical mask. We are tight knit group and everyone is concerned about saftey for our patients and ourselves. 

What can you do to prevent swine flu or any other cold or flu? Well common sense is the first order of business. That  is stay away from where there are reported cases if possible. Next when traveling especially by air or any other cramped condition wear a surgical mass. It may look funny or feel odd,  but better than being ill. Vitamin C of course is always a good overall immune system booster, I take 1 gram a day but that is not advice to you as that can cause diarrhea unless you build up to it slowly. Any medical suggestions here are not my advice to you as a doctor,as that would require a lot more knowledge of you , but you can ask your doctor his opinion. Wash your hands frequently , you may want to aquire a hand sanitation agent.

There are surgical mask commonly seen being worn by people in travel through airports and very common is Asia due to avian flu. I think now is the time to consider such precautions although it is not known how effective. Personally I think its a good step to take.

You can obtain surgical mask here:

Japanese Study

                     A quite morning of study  for Doctor808 ???

This morning I was up at the crack of dawn determined to get in my Japanese study time. I left the house early after  I spoke with my significant other and did the morning dog routine. I jumped  into  my hummer, drove to Starbucks and then sit down for an hour of study before work.  It was going very well, I had two pages of lesson completed both spoken and written. THEN THEY CAME……

A Gang Of Cantonese!!!

I have nothing against Chinese people , in fact my significant other is Chinese. Yet here I am trying to study,  enjoy in a  nice tropical breeze, the peaceful quite with my favorite coffee. This is all  very  conducive to study. All of sudden an Asian man walks up and starts pulling outside tables together near me.  He not only pulled one but then two and then a total of five tables and 15 chairs.   He lined them up all in nice neat row , next to me.  A t first I thought he was crazy as sometimes homeless people come around there and do strange meaningless things such as that. Then I realized —OH MY GOD –NO NO NO, it was evident he was preparing for a crowd and getting chairs and tables together for THEM. 

 I am not against Chinese per se,  but when you are trying to study a gang of Chinese having  social event next to you  is not a great idea. To make matters worse they were not just any Chinese,  but CANTONESE speakers. The difference is huge when compared to the  main land Chinese who speak Mandarin. Cantonese speakers when in a group sound like a major fight is going on as they talk. Its not that they are fighting , but it is the nature of the dialect. This is much different than Chinese Mandarin dialect which actually  is very calm , sweet and like a song. Chinese are much like Italians, my ancestry, they are very loud when being social.

I had to end my study as the loud sound of Cantonese chatter was overwhelming. First one person yakking then another  then all talking at the same time. It appears as if there is strong competition for talking!! I found  myself thinking back when I worked in China Town in New York City and the words I had learned in Catonese  from those days were entering my head without permission.

No longer could I think to myself “Genki Desu KA? ” but now I was thinking ” Ne Ho Ma ?“  My thoughts were taking a beating , my blocks to the environmental distraction were failing and had failed. As the cloud of asian languages were confusing, overwhelming and non stop swirling about in my brain—I was having second thoughts about learning Japanese , maybe I should learn french.

drmap

Well the recent troubles with Ushers wife going to Brazil and having a cardiac arrest make this a very topical topic. Many people travel to places other than their home towns to have  procedures. Here in Hawaii I have spoken to many patients who come to my office after travel for cosmetic procdures. Some go to Korea, Thailand and other parts of Asia. Recently a woman told me she was going to Mexico to have the procedure we discussed at half the cost. 

Basically there are good plastic surgeons all over the world which is not the problem. You can find good surgeons in Mexico or in any of the other countries I mention no doubt. The problem is when there is some difficulty. Not only are you miles away from family or any support, but the money you would have saved now is lost  and most likely has become so much more than the original cost quoted locally.

What comes to mind was doctor and her husband who went to Brazil to have the LASIk procedure done to correct some vision problem. She and her husband both had the procedure at a substantially reduced cost,  than they would have in the States. Yet she had a problem after surgery which she had to travel to London eventually to correct. As london indeed had the only expert in her problem. Although she saved money with the initial surgery it cost her over 8 times more and she is still receiving treatment.

This story has been repeated many times in my practice a girl who traveled to Thailand who had some rubber unknown sack used as a breast implant which I took out for example. She wasted her money. Even when people have quality plastic surgery done away from home if they have a problem they have to fly back to the place which cost additional money.  It can work but dont think you will save in long run , the numbers do not work out.

I have patients fly in to see me as well. Yet we require them to stay till everything is ok. Even then we tell them that if they are from Japan for example  we may have a doctor they can see there,  but it may require a plane trip back to Hawaii. Its not that I condemn the practice,  but I want to make sure they are appraised of the risk and know that in long run saving money will not be one of the benefits.

Well these are some of my thoughts Summary: You can fly far away to have plastic surgery and it may be good idea if you find the right surgeon. Yet do not think you will save money and you best be able to be prepared if something goes wrong to pay extra. The only reason I can see to take this risk is that you are traveling for special expertise. You pay for that, so going for cheap is not a good reason.

Doctor808

Well today was the first formal Japanese class I have ever taken. I have studied on my own for a few years and learned a little yet i finally decided to truly discipline myself and take formal training. I had to tell my Muay Thai Kru , that I would not make training on Tuesday and Thursday but promised him to do other training those days. He nodded his tacit approval……I am not sure what that means yet.

Michael san wa gakusei desu

Well the class is made up of 5 individuals who all seem very interested in this study. There is the young business man, the filipino gal and another white guy who I am not sure what he does yet. The most interesting fellow is the pony tailed rastiferin looking chap. As these characters develop I will let you know. 

The first class was easy for me as I have learned most of this of this by self teaching. There were a few words I needed clarification on pronoucing. The teacher helped me with that. However I will forget within a few hours as these words are appareently blocked in my brain from learning. Why I am not sure but they appear so.  The first word is ” Oyasuminasai” which is the romanji spelling in japanese  of  english  ”good night”.

Oyasuminasai for some reason is one of my blocking words which I can never pronounce correctly it seems. I try it slowly Oya-sum-in-a sai but maybe its Oya-su-mina-sai.  I dont know, it drives me crazy it could be Oy-as-um -in -sai, I listen to the tape many times slowly dissecting what they are saying and trying to mimic the way they pronounce it. I always end in failure it seems.

Oyasuminsai– I try to say it quick and that seems best,  because no one can hear my bad pronunciation that way. I have tried that with my japanese friends so  I know that it works. The problem is I have many blocking words—another one is “okaerinasai” this means welcome home. I cant spell it in romanji sometimes so I make up my own pronunciation. Thats stupid but unless I have someone around to correct me I do it!!!

Well now I must study so all I can say is Oyasuminasai

This is a rather personal writing not too much exciting but gives the reader a little insight.

What is Monday ?

Monday Hair

What is Monday? It is the start of the week after Sunday, family day. As a plastic surgeon who also CEO of a web development firm and one who trains in a the sport of Muay Thai almost everyday my time is limited. Thus, I usually divide my day up in sections, of what to get accomplished. Each day of the week I have also designated for particular things to get done. Monday is revision surgery and small cases with staff a meeting, tuesday is big case day , Sunday is family day and so on……. Let me dissect Mondays for you to see if you find it interesting. Monday I am up at 5 or 6 am as most days and I go to computer, check emails. look at schedule and fool around with my three dogs. Samantha is my oldest dog who is 12 years old and needs the most attention. I try to do stretching every morning although when I am training hard I go to the gym. So after taking care of Dogs , computer work , planning some things I go to pick up one of my employees on the way to work before 8 am. We discuss our web business , google news, SEO stuff , our clients etc. I get to office and my nurse will have the first patient ready along with my operating assistant. I check the patient and do what ever was required. Today for example we did a scar revision, a liposuction touch up and lower lid blepharoplasty ( lower eye lid surgery). Everything went smoothly this morning as usual. After 20 years of doing this stuff, it better go smoothly one would think and it does. Then the fun starts–the mandatory staff meeting at lunch. This occurs every monday and even though its mandatory I spend an inordinate amount of time being irritated because certain people dont feel the same way I do about it. Yet with legitamate excuses what can I say. Every monday we go through the same thing….where is so and so. “Dont you recall Doctor she has school or her child is sick or bla bla bla”. Anyway that is always an irritation. So Monday is irritation time at least for few minutes, regular, steadfast and like clockwork every monday i get irritated at the start of the staff meeting.

The dreaded staff meeting.

Some Staff

Next we have our staff meeting, we review new patient statistics, we talk about supplies which are needed and not in yet, we discuss any issues at hand and finally we review how to make things better for our patients, staff and all concerned. The staff meeting usually ends around 1 pm and the rest of the day is spent seeing a few patients and taking care of the important things that cant wait. I try usually unsuccessfully to take Monday afternoon off. Today for example I left at 3:30 pm which is early for me. If I am lucky as I was today I can make it to Muay Thai training on time 5pm or so. I train for minamum two hours and by then its usually 8pm. I travel home , say hello to my other half who inevitably makes a nasty comment about how I am getting too old and will hurt myself about full contact Muay thai. Its hard to argue with the truth, but I pretend to even though she is probally right I don want to admit that I am getting older and few people my age do such a sport. I take a shower and then head to the computer again getting my web work done. Oh I usually don’t eat much after training, but a small meal and plenty of fluids. After this I checked some search terms on google analystics tonight, answered some emails and then worked on my latest web site. Monday is never that exciting and I am glad really. I work on the internet to about midnight and then off to sleep. When I look at this I think I am rather simple guy. Not exactly 9-5 but kinda, as my internet work is play as much as it is work. I enjoy it that much designing , content writing and even thinking how I can take over the internet world of plastic surgery web site design and marketing……

Oh I forgot to tell you I always try to listen to my Japanese language disk to and from work and Muay Thai. I have listened to them so many times that I am sure I speak like a japanese female as opposed to a male since the voice is female on the disk.

Future Monday?

Future of Monday

I think in a few years I will change my Monday’s I look forward to that. Yet after many years of these Monday routines I may become confused or something. How is your Monday dear reader ?

I have been trying to find use for twitter which is the MicroBlog or semi instant messages service which people sign up for and send each other quick and short phrases. The web community sends a lot of messages about Internet stuff. Typically seo types send messages about their business and offer help on optimization of web sites. You click on the message called a tweet and it may take you to the persons twitter profile. From there you may click to a real web site or other information. It is somewhat but limited customizable. Others tweet back and forth personal messages about their lives” I just finished my second load of laundry” and other tid bits of info. Now who exactly is interested in that I am not sure but when I look at twiiter I see that type of thing all the time.

Well my purpose is to promote both our web site business and plastic surgery. So I am thinking about how to apply this media. I send some facts about plastic surgery sort of a factoid which may interest people like “breast augmentation by silicone is increasing dramatically” if they read this and are interested they can drill down to my web site eventually etc.  Other ideas are news blurbs about plastic surgery or maybe something interesting I have come across. I placed on the side of this blog a twitter widget which list some of my recent twits and you can follow my twits by clicking there as well.

Where this will all go I am not sure but it is interesting to try and figure how to use this in promotions or just fun. Recently I was following the twits from Bangkok when they had the political unrest which provided a new perspective as things happened. So I guess I had a ring side view from people on the streets of Bangkok.

More information can be found at www.twitter.com .

Duplicate Content Police

As most  SEO types  know , duplicate content is a problem with web site marketability and ranking. What exactly the effect of duplicate content will be is not entirely known or understood, but we do know that its not good.

My team and I discovered today while researching another issue  that a major web development firm has sold duplicate content containing web sites to many individuals and sold them as ‘unique” and individual. We know the prices they charge for web sites and they are very high priced , high end custom web sites.  The expectation would be that it would be unique content as well. The fact that these high end web sites have failed to use unique content and bypass the wage they would pay a content writer to our company is shocking. 

The next question is what to do about it?  Well first I asked our attorney and he stated he was “interested ” and since he is contingency type who only takes fruit bearing cases it gives an indication.  Since this is a large web development firm which makes a lot ( I mean a lot) of money for what was thought be good work has now its dirty secret discovered it makes us wonder who else.

When a client pays  for a high end web site ( in the $6000-$20000 range) a ethical company would give them what they pay for. Yet here is an example of where a company obviously saves itself money at the expense (ranking, marketability, creditibility and thus money) of the less sophisticated consumer. As a professional you would expect a self described leader in the industry not to engage in such practices. The simple duplication of content on at least a dozen of the high end web sites is shocking.  This is not china or india but the good old USA and the content was not changed in the least, I mean duplicate exactly, word for word!!!

Well we are not the web police but we do plan to pursue this rapidly.  We will keep you informed as to the outcome.

I wonder if any one else has seen this from not some kid in a basement from a major major player….???

Please let me know.

Well 3d-plasticsurgery.com ( one of my web companies)  just finished a project for a plastic surgeon in Portland. This doctor is a very good plastic surgeon whom I have had personal expirence with. His technique is meticulous and he is a trained microsurgeon such as myself. In fact that is how I know him from our microsurgery training in one of the most difficult fellowships of our generation. This was with Dr. Julia Tezis at the microsurgical institute in Virginia. 

The problem is that he does not believe in showing pre and post op photos of his work on the internet. Bad choice I believe but never the less its his decision and one he has to make. Patients these days from my experience are even taught to ask to see the photos. We have them all over our sites. Its great marketing and the consumer of plastic surgery services wants this. 

Well we compromised and simply added a link to his web site which shows generic before and after photos from the main plastic surgery societies web site. This was my stroke of genius in that we also clearly added a disclaimer stating his position. We solved two problems at once, respected our clients wishes and gave the consumer what they wanted. Such a fine line we walk in advertising and trying to do our best for our client.

If any of you want to see the web site  www.fortesplasticsurgery.com .  Comments to me are always welcome.

drmap