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Showing posts from February, 2008

Christine Aguilera - Perfect C-Section

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Christine Aguilera is a talented, beautiful young woman who is all over the magazines and internet with her beautiful new baby. It is a lovely sight to see and I am sure she influences young women around the world on the wonders of new motherhood. But my eyes and ears perked up when I read that she had a planned, elective (read "Doctor, I want that!") C-section at 37 weeks because "I'd heard horror stories about tearing. I really wanted a calm and peaceful environment. I didn't want any surprises."

Now I don't blame a 27 year old narcissistic diva for how she feels. I also understand the fears new prospective mothers have about their changing bodies, new responsibilities and major life changes a child brings. But where are the doctors in all of this? Is this the new trend? C-Sections, rather than nature's natural childbirth for anyone who asks?

Cesarean Section childbirth is major surgery. The abdominal wall and muscles are cut as well as the…

Electronic Health Record - tick tock, tick tock

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Go into most doctor's offices or clinics across the United States and you will see racks of messy files, patient charts, stacks of paper ready to be filed and lots of little messages and bits of paper that have no home. You could not differentiate if it is a chart room from 1943 or 2008, except that now there is 20 times the paper to be filed.

There is unanimous agreement from doctors, hospitals, patients, academics and Yes! our own government that Medicine is far behind other industries in automating with an electronic health record (EHR aka: electronic medical record). The push for the EHR has been around for 10+ years, continuing today from Pres. Bush and each of the presidential candidates in their "reform health care" platforms. Despite the unanimity around the benefits to society with a universal EHR, only 14% of doctors use a "minimally functional" EHR...one that captures clinical notes, orders for prescriptions, lab and radiology tests and results.

Answer to Medical Quiz #7

The answer is #3, Leprosy. Leprosy, also known as Hansen's disease, is a chronic infectious bacteria that affects peripheral nerves, the respiratory tract lining and skin. Interestingly, only about 5% of people who are infected with the disease actually develop any symptoms. The mode of transmission is unknown, thought to be by respiratory droplets. Treatment with oral antibiotics is effective in treating Leprosy.

Medical Quiz #7 -How Smart Are You?

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I'm back from Costa Rica with another New England Journal of Medicine challenge for you.

This patient is an immigrant from Pakistan. These lesions are not pruritic (itchy) or hypoesthetic (decreased sensation). What is the diagnosis? Click on the image for a better view. The answer will be posted tomorrow.
1. Granuloma annulare
2. Scrofula
3. Leprosy
4. Pityriasis rosea
5. Tinea Corporis (ringworm)

A Little Time Off

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The family and I will be taking a little trip so I'll not be posting EverythingHealth for about a week. Please click on some of the links to the right for a great potpourri of the medical blogs (and other favorites). Can you guess where we are going? (No it's not Hawaii)

Blue Cross-Outrageous Behavior

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Blue Cross Insurance has now sunk to a new low. They have written letters to their "preferred providers" (I resigned from being 'preferred' years ago!) asking them to inform on patients who had preexisting conditions so they could rescind a patient's health care coverage.
The insurer is sending letters to doctors with the patient's insurance application, asking doctors to tell them immediately if the patient is seen for any condition they didn't disclose on the application. The letters say, “We ask your assistance to identify medical omissions because you, being the primary care provider, will have first-hand knowledge of services provided and/or requested.” This includes pregnancy and any other condition not disclosed.
The California Medical Association (CMA) has urged State Regulators to immediately order Blue Cross of California to stop. Asking doctors to share private health information with insurers is probably unlawful, unethical and disturbs the doct…

Todays Chuckle - Cheap HMO

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Thanks to MichaelClark for our joke of the day. How do you tell you have a Cheap HMO?
The Top 10 Signs You've Joined a Cheap HMO10. Annual breast exam conducted at Hooters.
9. Directions to your doctor's office include, "take a left when you enter the trailer park."
8. Tongue depressors taste faintly of Fudgesicle.
7. Only proctologist in the plan is "Gus" from Roto-Rooter.
6. Only item listed under Preventive Care feature of coverage is "an apple a day."
5. Your "primary care physician" is wearing the pants you gave to Goodwill last month.
4. "Patient responsible for 200% of out-of-network charges" is not a typo.
3. The only expense covered 100% is embalming.
2. With your last HMO, your Viagra pills didn't come in different colors with little "M"'s on them.
--And the Number 1 Sign You've Joined a Cheap HMO...
1. You ask for Viagra. You get a popsicle stick and duct tape.

One Year of Blogging

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It was about a year ago that I became a blogoholic and started EverythingHealth. I've learned there are three different types of blogs. Anonymous bloggers that can say just about anything and rant and rave in an interesting fashion, companies or commercial blogs and blogs like mine that are transparent (you know who I am) and just want to express a point of view. Because I do a medical blog, I am particularly careful that the facts and information I give are accurate and have the best science behind it. I try to stay non-political (gosh that has been hard!!!) and kind.

I've learned that I get the most visits when another blog links to one of my posts (Thanks Kevinmd,Grand Rounds). I've learned that most people get to my blog via a search engine (Thanks Google and Yahoo). My wish, of course, is that people will be regular visitors and check every day or so and read everything! You can sign up for new posts via alerts. It's easy and safe with no spam.

I ha…

Sweet Soft Drinks, Fructose Linked to Gout

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The British Journal of Medicine reported on a 12 year study that showed sugar-sweetened soft drinks and fructose increased the incidence of gout.

Gout is the most common arthritis in men and its prevalence has doubled in the United States within the past few decades. Coincidentally, that is the same period in which fructose sweetened soft drinks represent the largest single source of calories in the U.S. diet. The researchers found that men (study age 40-75 years) who drank more sweetened drinks had more gout proportional to the number of drinks a week. It included sweetened fruit juices and soft drinks but not diet drinks.

What is interesting about this study is that we were never taught in Med School that soft drinks are a trigger for gout. If you research gout, you will find advice to avoid meats, gravy, tofu and purine rich foods such as seafood, oatmeal, peas, lentils, spinach, asparagus and cauliflower. The idea of limiting or eliminating fructose is rarely (or never) mention…

Answer-Medical Quiz #6

The answer is (drumroll....) #2 Pearly Penile papules. These are multiple tiny smooth, skin colored bumps that surround the coronal sulcus of the glans penis. They are completely benign and of no concern. Lots of smart people out there!!!

Medical Quiz #6

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Here is our latest medical challenge and it is very common. What is the diagnosis? Click on the image for a better view and check back tomorrow for the answer: 1. Molluscum contagiosum 2. Pearly penile papules 3. Secondary syphilis 4. Obstruction of smegma-producing gland 5. Condyloma accuminatum

Lack of Primary Care Will Derail Reform

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Health care reform is dead in the water unless we fix what is going on with primary care medicine in this country.

Let's just play this out. We have about 47 million uninsured folks in the U.S. There aren't too many people who disagree with the need for universal coverage for all Americans. (How we pay for it is another topic... but expanding coverage is just good policy). At the same time as we are expanding coverage, the numbers of physicians in training who are choosing primary care medicine has fallen to 15%. That means 85% are deciding that specialty medicine is the way to go.

Most patients will not have a comprehensive primary care doctor who knows them, knows all of their health issues, makes sure they get preventive care and coordinates care. There just won't be enough primary care doctors to go around and the ones that have experience and good bedside manner will limit the number of patients in their practice by charging retainer fees (AKA: concierge medicine).

Seven Medical Myths

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I love theBritish Medical Journalbecause it is filled with wit and just good interesting stuff. Those Brits know how to keep it real! The December issue addressed medical myths that we've all heard for so long that everyone believes they are true. They chose seven to research and found no evidence to support them:

1.People should drink 8 glasses of water a day. They found that most people get water in their food and usual beverages and there was no evidence to force drinking 8 glasses.

2. We only use 10% of our brains. I found myself repeating this to my son just the other day. Metabolic studies that track differential rates of cellular metabolism within the brain show no dormant areas.

3. Hair and fingernails continue to grow after death. I think "CSI" on TV already dispelled this myth. It is dehydration and shrinking of the skin that makes it appear to grow.

4. Shaving hair makes it grow back faster, darker, coarser. It sure seems that way to me but, in fact, it …

Answer - Medical Quiz #5

The answer to the tongue lesion image below is #1- herpetic glositis. A severe herpes virus infection can inflame the entire oral cavity and cause multiple lesions on the tongue, lips and oral mucosa.

Medical Quiz 2008 - #5

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Here we go again with another medical challenge. What is the diagnosis for this condition? Click on the image for a better view. The answer will be posted tomorrow. 1. Herpetic glossitis 2. Apthous ulceration 3. Pemphigoid 4. Scurvy 5. Oral candidiasis