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Showing posts from March, 2007

Chronic Stress- Surging Glucocorticoids

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In some ways we are not so different from a zebra on the Serengeti. If we are threatened with bodily harm, just like the zebra being chased by a lion, our adrenal glands kick into high gear and secrete adrenalin and glucocorticoid hormones. These hormones can keep us alive in an emergency. Blood rushes to our most needed organs (heart, lungs, muscles). Digestion shuts down and we stop salivating. Our attention gets very focused. We have no need to get an erection or urinate (save that for later if we live). These fight or flight hormones can keep us alive in an emergency. But they are meant to turn off quickly when the event has passed. Where humans differ from animals is that we can suffer from chronic worry and keep those hormones surging through our system for days on end. Heart disease, depression, diabetes, obesity, immune dysfunction, learning disorders, headaches, irritable bowel syndrome,... what do these diseases of modern man have in common? They have all been linked to chro…

Multitasking

Yesterday's post on DWD, Driving While Distracted, now has more to back it up. I'm always happy to think my musings could be universal. Today, the New York Times has a great article on why it is not in our best interest to multitask. I have thought for some time that we are becoming a nation of people with ADD the way we drive, read, talk on the phone, drink lattes and apply eye makeup,all without missing a beat. Can this be good for our brains? Even more, can it be good for our spirits? Check out today's NYT and "slow down, you move to fast, gotta make the moment last"
Slow Down

DWD - Driving While Distracted

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According to the National Highway Traffic Safety Commission, 500,000 drivers a day are talking on handheld cell phones while they drive. The National Mutual Insurance Company reported 73% of the people they surveyed talked on phones while driving and 19% of motorists did text messaging while driving. Driving and talking on hand held phones make us 4X more likely to have a serious crash. It is debatable whether hand free talking is much better because of the distraction factor. Other serious distractions are reaching for a falling cup, reaching for CDs or music or just about anything in the glove box or disciplining the kids or even rubber necking as we pass something of interest.

Although all drivers can be distracted by anything that goes on inside the car, clearly digging for a ringing cell phone, tucked in a purse or pocket has got to be numero uno for big time road attention lapse. I can always tell when I am behind a cell phone driver. They are speeding up or slowing down or creep…

Embryo Ethics

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Advances in medicine always bring challenges that are unexpected. Embryo screening before in-vitro fertilization usually helps parents have a healthy child. We can test for hundreds of fatal birth defects, childhood diseases and even some diseases that don't occur until adulthood. These tests are done before implantation of an embryo in infertility clinics and parents can now even choose the sex of the child. As the field advances, the ethical questions become even more important with different stakeholders having different opinions. Parents, bioethicists, disability groups, anti-abortion groups are all demanding different things. Once you choose the sex, what about other genetic features? At this time we can't identify the genes for hair color or muscles, but there is a concern that preimplantation genetic diagnosis (PGD) will lead us on a slippery slope of "designer babies".

An American public opinion survey about PGD was done in 2004 and 68% of people supported tes…

New Innovations in Colonoscopy

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Colonoscopy, the screening scope test that looks for polyps and cancers in the large bowel, may be replaced with new methods for diagnosing colon cancer. We've all been waiting for a new technology that will eliminate the awful cleansing prep the day before, the IV sedation and the hassle of spending an entire day undergoing an expensive screening test for colon cancer.
Yes, screening colonoscopy is a great way to find polyps and growths before they become invasive cancer. Yes, it is relatively safe and effective but, jeeze, what a hassle. And for a screening test, it is quite expensive, therefore millions of uninsured and underinsured people just don't get screened at all.

On the horizon is virtual colonoscopy, a high-resolution CT scan with a software program that allows you to recreate or simulate the colon. This computer-aided diagnosis will shorten the time frame and allow more screenings to be done. Currently you can get a virtual test but the prep remains the same. Soon &…

Buy Dove Soap

The new Dove Soap campaign is not only brilliant marketing, it is Madison Avenue with a mission. These commercials break down the classic stereotypes of beauty in our society and empower women to accept themselves as they are. What would really make a difference is if you men out there would call your pre-teen or teen daughter to the computer and show her this video. Young girls are facing images of sexy, tall, thin, airbrushed, surgery enhanced bodies everywhere they turn. When they look in their own mirror they see something completely different and feel inadequate. Having your dad open the conversation about real beauty and what men like about women could have an impact that would last a lifetime.

Dove is making it easier on all of us. Let's support the companies that are making this crazy life a little gentler.

Seniors vs. Children

I was alarmed to read a new study released by the Urban Institute that reported how children are becoming a diminishing national priority in America. The report examined federal spending from 1960-2006 and found the share of domestic spending targeted to children's programs declined from 20.1% in 1960 to 15.4% in 2007. At the same time, the spending on adults is eight times greater than spending on children. As a percentage of GDP, the adult portions of Social Security, Medicare and Medicaid (The big three entitlements)are expected to grow to 9.5% by 2017, while children's programs will drop to 2.1%.

I like our seniors as much as anyone and, gee, by 2017 that money will be spent on me! But I don't want the future of America, our children, to be ignored just because they have no political power. Marian Wright Edelman, president of the Children's Defense Fund, said, "Children are a voiceless, voteless constituency. They don't lobby, and they don't make campai…

Another Order of Poison Please

http://www.youtube.com/watch?v=ZfbTO0GlONU

If you are interested in EverythingHealth, this video speaks for itself. The main fat guy (sorry to be pejorative but it is deserved in this case) is probably only 40 years old. As my mother used to say "Just because it is there, doesn't mean you put it in your mouth". People, people....this is poison to your body.

Drug Ads-Illness of the Month

One reason President George Bush is so beholdin' to the pharmaceutical industry may be because their drug ads on TV and in magazines are keeping this economy going. If those ad revenues stopped, we might see some major broadcasting networks shutting down their lights. The next time you are watching prime time TV, just notice how many ads are for pharmaceuticals or medical devices that require a prescription. There is even a new ad (shown over and over on American Idol) that advertises a new knee replacement device made "only for women".

A new study shows that prescription drug advertising on television is rarely educational, and mostly uses emotional appeals to entice consumers. According to Internal Medicine News, Dr. Dominick Frosch, Ph.D at UCLA, analyzed ads shown during prime time on the 4 major networks and found seven of the top ten bestselling drugs. 95% of the ads showed characters who were happy and some were practically ecstatic after taking the product.

T…

Heel pain - Plantar Fasciitis

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My right inner heel is killing me. It started a few weeks ago after playing tennis and each time I play I wake up limping the next morning. I can press on one area of my heel (calcaneous) and "ouch" that's where it is. I have the most common cause of heel pain in adults....plantar fasciitis.

Plantar fasciitis occurs more frequently in women and is often seen in runners and dancers who use repetitive, flexion of the ankle and foot bones (metatarsophalangeal joints). It can be caused by improper footwear, change in intensity of physical activity or a change in the walking surface. Other causes are reduced flexibility, tight achilles tendon, discrepancy in leg length or sudden weight gain such as pregnancy. I think I know where mine came from...new tennis shoes and increased activity.

The plantar fascia is a band of tissue that fans out across the sole of the foot from the heel to the bones of the foot. As the heel strikes, the leg bone (tibia) rotates internally and the foo…

It's Time to Quit Smoking

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No-one has been able to answer my question of why Hollywood still has so many attractive characters smoke in movies. I suspect the tobacco manufacturers use "payola" to have the most beautiful stars light up. A study was done that shows there are more smoking scenes in movies now than there were in the 1950s. Just be aware the next time you watch a movie and notice if the cigarette adds anything to that particular scene or dialog. Most of the time it adds nothing. Clearly, it is featured for the insidious purpose of glamorizing smoking. And yes, even in 2007, it still works! Since Hollywood movies are seen and loved worldwide, the effect is profound.
I hope none of the faithful readers of EverythingHealth smoke but, believe me, there are a lot of closet smokers and 3000 teens start each day. The tobacco manufacturers have increased the addictive additives in cigarettes and smokers are really trapped once they begin. The "stop smoking" industry is huge with biofeedb…

Under the Knife- Tips for Surgery

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In any given week I have several patients or friends who are having surgery. "Come and go", outpatient surgery is the fastest growing type of surgery. Even though surgery has become about as common as getting a haircut, patients should not be cavalier about it. There is a growing awareness nationwide about patient safety and improving quality and surgery is one area that is getting a lot of attention. The patient safety movement brings the patient into the partnership with doctors and nurses as members of the care team to help improve surgical care overall. When we work as a team, patient care is safer. If you or a relative is contemplating surgery, this is what you need to know:

* Tell your surgeon about other problems you may have...allergies, diabetes,smoking history. How you are handled in the operating suite may be different with this knowledge.

* Ask if you will be receiving antibiotics. Patients have better outcomes when antibiotics are given within 60 minutes be…

What Are the Medical Journals Saying?

This weeks brief synopsis from the medical journals:

Antioxidant Supplements and Mortality

Many people are taking antioxidant supplements, believing it will improve their health and prevent diseases. Researchers in Copenhagen did an extensive review of all studies published worldwide and to see if antioxidant supplements improved health. They included 68 randomized trials with 232,606 participants from 385 publications. The antioxidant supplements were taken orally. Some of them were taken in combination, some alone. Here is what they found: Treatment with beta carotene, vitamin A and vitamin E given singly or combined with other supplements, did not improve health and, in fact, significantly increased mortality. Further randomized trials are needed to establish the effects of vitamin C and selenium. The authors stressed that these results examined only synthetic antioxidants and not the effects of fruits and vegetables.
Jama

Pain in Children

Researchers looked at children ages 6-17 who ca…

The Future is Here

When I was first practicing medicine, the cell phone had not yet been invented. There was no such thing as a calling card. I had to have dimes and quarters with me at all times and I knew where every phone booth was located from Marin to San Francisco. If my beeper went off, I needed to be prepared to find a pay phone quickly so I could phone the patient or hospital. Often I needed to turn my car around and head back to the city. It sounds like the dark ages, but it wasn't so long ago. My how times have changed!

The "new new thing" in patient care is robots. This new technology allows physicians to hook up their laptop anywhere and see a patient at a distant hospital. A growing number of doctors are using robotics to connect with patients and their high-tech circuitry lets a stethoscope be attached so a doctor can hear some one's heart from a remote location. These machines are dispatched to emergency departments, operating rooms and intensive care units.

About 100 r…