Family Medicine Doctor Comments on Increasing Scooter Accidents

Due to the proliferation of electronic scooters in the past year, there has been an increase of accidents and even several deaths in the San Diego area.  In April 2019, The Mission Beach Town council released a referendum on scooter recommendations to the city of San Diego, and organized a protest in the Mission Beach area.  They contacted San Diego Sports Medicine and Family Health Center for comments on the scooter situation and requested that doctors make an appearance at the protest.

San Diego Sports Medicine and Family Health Center physicians Dr. Alexandra Myers and her colleague Dr. Elizabeth Williams were then asked to speak during the protest and report on their observations of scooter related injuries.

On ABC 10 News in San Diego they provided comments and statistics:

“We see concussions, cuts, broken bones, and recently a severe neck injury. Someone almost lost their vision in their eye,”

Sports Medicine Physician, Dr. Alexandra Myers said.

“UCLA published a study over a year, and they’ve noticed over 250 injuries. 40% are causing head injuries. 5% have elevated levels of alcohol in their blood. And 98% of people are not wearing helmets,”

Dr. Elizabeth Williams said.

Watch the news cast on ABC 10 News

Ironically minutes after the rally the news reported on a Teen injured in e-scooter accident hours after e-scooter protest

Interview: Getting Eating Disorder Treatment in San Diego

San Diego doctor Alexandra Myers recently gave an interview to her  colleague Dr. Marianne Miller about her family practice and also her experience treating patients with eating disorders, including athletes and a range of ages.

This interview first appeared on Dr. Marianne Miller’s blog, visit her to read the full interview:
Meet San Diego Sports Medicine and Family Physician Dr. Alexandra Myers, D.O., Specializing in Eating Disorders in Athletes

A portion of  the interview is below, added to this page for convenient reading:

This week’s interview is with Dr. Alexandra Myers, D.O., who works with athletes with eating disorders in San Diego. I think there is a misconception that in order for athletes to recover from eating disorders, they have to give up their sport completely. That is simply not the case. Dr. Myers is THE medical professional in San Diego who can help people heal their disordered eating and return to the sport they love. She is especially gifted in treating high-level athletes. Dr. Myers specializes in sports medicine, and she is the Director of Women’s Athletic Medicine at San Diego State University (SDSU). She also works with US Olympic athletes, other college and high school athletes, people who are active only on the weekends, and even non-athletes! She is incredibly supportive, compassionate, and non-judgmental. Plus, she’s an all-around nice person to know!!!

Why did you choose to become a sports medicine specialist and family practitioner in San Diego?

I came to San Diego to complete my Sports Medicine Fellowship at San Diego Sports Medicine and Family Health Center. I enjoyed working with a dynamic group of people and I stayed. I was particularly interested in taking care of athletes of all levels, of which there are many in San Diego.

What kind of treatment do you provide?

I provide full spectrum family medicine care – everything from a general physical, shoulder pain, colds, etc. I specialize in Sports Medicine, which encompasses the overall care of the athlete, including nutrition and wellness. I also perform Osteopathic Manipulative Treatment to help relieve pain in my patients.

How long have you been treating SDSU athletes?

I have been working with SDSU athletes since 2013. As the Director of Women’s Athletic Medicine, I focus on taking care of the wellness and psychological aspects of the athletes at SDSU.

In what capacity do you work with SDSU athletes?

I am the Team Physician for the Women’s Basketball, Crew, Swim/Dive, and Water Polo teams. I have clinic there once a week, and I oversee the athletic trainers that work with each of those teams.

Do you work with athletes who aren’t SDSU students?

I work with many athletes outside of SDSU: US Olympic athletes—especially USA Rugby Men’s and Women’s Sevens, Major League Rugby, San Diego Christian College, San Diego City College, Cuyamaca College, Santa Fe Christian High School, and many people who are weekend warriors.

What kind of eating disorder symptoms can appear in athletes?

Most athletes who I see for suspected eating disorders have noticeable, rapid weight loss and fatigue. It is often initially referred to as “female athlete triad,” which is usually a misdiagnosis. Sometimes they come to me for decreased performance or mood changes, which can be an early sign of poor nutrition.

Do you treat people in San Diego who aren’t athletes who have eating disorder symptoms?

Yes, I do have patients who have eating disorders who are not technically athletes. A lot of them have backgrounds in athletic pursuits such as dance and gymnastics, and most of them are active.

Who are your favorite types of patients to work with?

I love working with people who are motivated to be healthy—no matter where they are starting from. I take care of babies up to 90 year olds, and they come in all shapes and sizes.

What happens during a first appointment with you?

I try to get to know my patients – their personal history, their family history, their current lifestyle and goals. I try to gain a perspective on where they are and where they want to go.

What do you wish both athletes and non-athletes knew about getting treatment for eating disorders?

I would love for athletes and non-athletes to know that treatment for eating disorders is aimed at helping them be healthy and that it is non-threatening. Everyone involved in their care is there to help them, and no one is judgmental.

How can people learn more and contact you?

They can come see me as a patient and check out my website here.

Share one fun fact about you.

I played college soccer and softball at Cornell College, and grew up ski racing, playing tennis, BMX racing, and running track. I like to surf, SUP (Stand Up Paddle), and cycle all around San Diego.

Photo by Gardie Design & Social Media Marketing on Unsplash

Haiti Revisited, reflections on the 2018 medical mission

On my third trip to Leon, Haiti I truly began to understand the mystery that is Haitian culture. The trip began with a bang – we had barely settled into our living quarters when I was called to the clinic to deliver a baby. We were a mixed group – two Nurse Practitioners, a retired ER doctor, an Internal Medicine specialist, and me, the Family Practice/Sports Medicine doctor. No one was jumping at the chance to deliver a baby, including me. It has been at least 5 years since I have delivered a baby, and after volunteering to evaluate the patient I almost immediately regretted it. How would I perform? Would I remember the stages of labor? What would I do if there were complications? The clinic in Leon is rudimentary – there are none of the tools that would normally be available for a delivery here in the U.S.  Most importantly, there was no OB/GYN ready to perform a C-section if necessary. I have a couple of good friends who practice OB/GYN and in the States I would normally call them. Unfortunately I had no cell service and even with the best of advice, I wasn’t going to transform into an expert with a simple phone call.

Examining my 15 year old pregnant patient, on the first night in Leon. Nurse Carol is tending to the patient while I try to plan the next step.

As I arrived at the clinic I saw a group of 10 Haitians waiting patiently.  It was a bit chaotic, but we quickly evaluated the woman in distress. Carol, the nurse that accompanied me, was excited – she was hoping to transition her career to labor and delivery.  Bob, the Lab Tech who was also our Team Leader, was on hand to keep us calm and make sure we were set up. He arranged for a local translator, affectionately known as Little Richard. With his assistance, I learned that our patient was 15,  in her first pregnancy. She had started having contractions 1 hour prior. She was in pain and uncomfortable. I did a bedside ultrasound – the baby’s heart rate was normal and he was in the right position to deliver. I did an exam – the baby was still high up in her pelvis and wasn’t quite ready to come down.  Bob did labs which were all normal. After thorough discussion with our team we determined that she wasn’t going to deliver the baby any time soon, so we sent her home to labor with a midwife. The excitement had drawn to a close, or so I thought.

First thing Monday morning we were up and ready to get an early start for 8 am clinic. Our team was enthusiastic to get to work. When I walked into clinic I saw my pregnant 15 year old patient. I was once again confronted with my fears: what would I do if there was a complicated delivery?  Would I be able to handle the situation? I re-examined her and she was still far from being ready to deliver. Both the nurse and the midwife said that they thought she needed to go to the hospital to deliver, and that likely she would need a C-section. I had no reason to doubt their evaluation, so we called the Haitian Health Foundation who sent an ambulance to transport her to the hospital. I regretted that I didn’t have the skills or resources to help her, but relieved she was in good hands.

Once she was gone my translator “No-No” – short for Jeanot – and I got to work. Our team of five saw about 180 patients a day, and today was set to be a busy one. The clinic was full of people needing their chronic disease medication refills as well as those with more acute needs. Throughout the week we saw a melange of typical Haitian injuries: machete wounds, and skin infections gone awry. There were still people needing assessment for injuries sustained in Hurricane Matthew which struck in October 2016.

Inside the remains of the Catholic Church that adjoins the rectory that we stay in. Hurricane Matthew took the roof, as well as the ornate detailing on the interior of the church. One thousand parishioners used to meet here each Sunday for mass, and they have been displaced to a temporary building for nearly 2 years.

After each clinic day we had a team meeting to discuss our most interesting and difficult cases.  One of the Nurse Practitioners was devastated that on the first day of her first trip to Haiti she had to tell a patient she had HIV.  In total there were 3 patients newly diagnosed with HIV. Fortunately, HIV patients in Haiti have access to free care – which is rare in a place that lacks much government support.

My clinic for the day – out on he porch stoop in the middle of the jungle.

My most interesting patient came on the second to last day. By Thursday of each week we are in a flow – the nurses are efficiently triaging and taking care of patients. As providers we are in the groove – we have become familiar with the most common ailments, and what limited resources we have to provide. A woman came to triage with a large pregnant appearing belly and the nurse ordered pre-natal labs.  We screen for anemia, urinary infections, HIV, and syphilis. The woman ended up seeing me and I quickly reviewed her chart. She had been seen in February by another Global Health Team group and had an ultrasound that showed she was pregnant. It was her first pregnancy, and she was excited. I asked her several questions – was she eating well? How did she feel? Was she having any bleeding?

She said that she was bleeding every day of her pregnancy. This is not uncommon and can be a sign of the placenta being low in the womb. I quickly took her to do a bedside ultrasound, but couldn’t find a baby in her large belly. I had my colleague Dr. Mike come look at the ultrasound and both of us worried that we had broken the machine – all we could see was scattered grey and black images swirling around the screen. My first thought was how did I break this very expensive machine?  I was so careful with it and was upset that I would leave a defective machine for the next team. Dr. Mike took a try at the ultrasound, and again we saw nothing. I told the patient it was broken and that we would just have to proceed without the ultrasound.

Working with Dr. Mike on a foot injury and infection. The ultrasound was a blessing – without it we would have been lost!

Surprisingly, my next patient was also pregnant. I thought perhaps I could do an ultrasound on her and see if the machine would work again. Of course the minute I placed the probe on her belly, I clearly saw a little baby, about 5 months in size. The hands, feet, and face were clearly defined, and the mother was overjoyed to see her baby. At that point I brought the other woman back to use the newly functional ultrasound machine. Except this time I put the probe on her belly and again saw no baby, but a mix of grey and black ill-defined images.

At this point I was confused. Her belly looked and measured to be about 7 months along, and she had been diagnosed with a pregnancy 4 months before. I checked her chart and discovered there had been no urine pregnancy test, so I ordered one. It was negative.  We found ourselves in an odd situation – a woman with a large pregnant appearing belly, a negative urine pregnancy test, and a peculiar ultrasound. Dr. Mike and I conferred and decided that she needed further imaging and consultation. The reality is that this level of care is non-existent in that region of Haiti. There is no MRI machine, and there was no one who would be able to figure out what exactly was going on in her belly.

I was heartbroken to look into her eyes and tell her that not only was she not pregnant, but that she might have a difficult to diagnose condition. We had no resources readily available for her. To my surprise she took the news stoically. She said she understood what was going on, and agreed to come back the next week to see our Medical Director who would be able to connect her with any resources in Haiti that were available. Dr. Mike, the nurse, and I were all confused and sad about the situation.  What must it be like to be a childless woman in rural Haiti, looking pregnant – but with no baby coming in several months – or ever. Women in Haiti are expected to produce children, many in fact, so they have family to support them in old age. A childless woman would have a tough life unless she had a very kind sister who would take her in (and could afford to).

Although the not quite pregnant woman cast a pall over the mostly joyful experience in Haiti, I left with more hope than despair. On this trip to Haiti I saw indications of economic improvement. There were actual garbage trucks picking up the piles of trash in downtown Port-au-Prince. The government had graded the long dirt road to the airport in Jeremie, so that it was passable. Wealthy Haitians occupied our hotels and frolicked in the pool, spending money on alcohol and treats. Despite the grim overall economic picture in Haiti, perhaps there is hope for recovery and transformation. Maybe there will be a day when we travel to Leon only to give expert consultation, and when the local medical system will meet the everyday needs of Haitians. Hey, a girl can dream.

If you are interested in hearing more about how you can help in Haiti, please check out Global Health Team at You can also fill out the form below.