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Showing posts from October, 2009

Blog Plagiarizing

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I was just alerted by a fellow blogger (thanks, Yesmeen) that another site is stealing my posts and posting them as if it is their content. The blogs are completely posted, titles, graphics and all, on this other site that has health advertising also. There is no contact info so I cannot contact the blog administrator.

Blogging is a passion and a hobby for me and I spend a great deal of time researching the information I post to make sure it is accurate and as clearly written as possible. I also try to think of topics that are of interest to a wide variety of readers.

With permission, I allow my material to be re-printed at other credible sites because my goal is to educate and reach even more readers. Those sites attribute my blogs to EverythingHealth.

If anyone knows how to top this practice, I would be grateful to have information.

SSRI Withdrawal Syndrome

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Karen is a 38 year old new mother (baby girl 8 months) who came to me with unusual symptoms that were of concern. She began having "episodes" of a buzzing, electrical feeling in her head and neck. It felt like a "shock" in her head. At times she would feel so dizzy and off balance that she had to pull over in the car or sit down. There was no headache but she felt some numb patches on her arms and legs. There was a vague depersonalization that accompanied the spells. It would happen for several days, then disappear for weeks and then come back. The "spells" lasted a few minutes to hours but seemed to be increasing over the past week.

When patients present with strange symptoms like this, a doctor has to start at the beginning with a detailed history. Any new medications? Any over the counter medications? Any drugs or alcohol? Any visual changes or blurry vision? The answer to all of these questions was no.

The work up progressed with blood tests…

What Medical Condition Costs the Most?

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What medical condition costs the U.S. Health system the most in disability and overall costs? If you said heart disease or cancer or pulmonary disease you would be wrong! I would have said one of those myself.

The answer...slow drumroll....is musculoskeletal disease. Yes, 50% of the adult population reported having a disabling musculoskeletal condition in 2008. The expenditures for these problems include the costs of preventive care, the cost of direct care, the cost of care in hospitals, by physicians, therapists and other caregivers. It also includes the loss of productivity. In 2004 it was estimated that the cost of care for musculoskeletal problems was $840 billion. (Hey, isn't that about equal to the bank bailout?)

What are musculoskeletal conditions? They include that old nemesis: Low back and neck pain. Spine problems are among the most common problems that bring patients for medical care. That's why the chiropractic industry is booming.

Another leading cause of d…

Need Surgery, Travel Abroad

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Medical Tourism has been a growing phenomena since the cost of health care is increasing by double digits each year in the United States. The Journal of American Medical Association (JAMA) reports that up to 750,000 U.S. patients have traveled to other Countries for surgery. Patients in other countries like Canada and the U.K. travel even more for surgery and medical care. Some health insurance companies will even pay you to travel because they reap the value of lower cost procedures for the insured. How much value? A patient who needs a spinal fusion would pay $90,000 in the U.S. compared to just $7,000 in Thailand.

Medical centers in Thailand, India, Singapore, Argentina, Costa Rica, Brazil, Mexico, Hong Kong, the Czech Republic and Hungary are popular worldwide destinations. Need a new dental bridge? It would cost you $5,500 in the U.S. but only $500 in India. A full facelift can be obtained in South Africa for $1,200 compared to $20,000 here.

Many of the surgeons in thes…

Victorian Health

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In the Victorian Era, a doctor could have a carriage trade of just a few wealthy women invalids that he visited every day. It was a status symbol for a wealthy gentleman to have a personal physician come to the house to minister to his wife. Now we know what kind of treatment was being offered!

Shameless Corporation of the Week Award

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This weeks Shameless Corporation Award is shared by Horizon Blue Cross Blue Shield of New Jersey and the company it contracts with to manage claims, Magellan Health Services. Magellan is notorious for denying benefits to the Blue Cross patients. In this case, a young woman who was a victim of date rape was unable to receive mental health benefits even though she was insured. Magellan stopped paying for her mental health visits with a psychologist for no reason. They just said "no"and appeals were met with further denial.

Lois Gorwitz is a psychologist who worked for Magellan for two years as a claims reviewer and she said the culture and pressure from supervisors was to deny claims. Gorwitz said the company denied claims because they are in the business to make money. She quit because she was uncomfortable with the pressure to deny valid claims. Magellan is expecting 2009 profits of $210 million, exceeding predictions.

Horizon Blue Cross Blue Shield is the states largest…

Nurses, Lawsuits and H1N1

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Only in the United States could a virus like H1N1 bring out the worst in medical politics and greed. We are facing a "pandemic" that requires coordination, communication and the best of medical practice. But what are we getting? Strikes, lawsuits and anything BUT putting patients first!

The strong nursing union, California Nurse Association (CNA), is taking this opportunity to call a strike on three large Catholic hospital chains (including 34 hospitals) throughout California and Nevada. The union bosses say the chief concerns are a lack of protective gear, improper isolation techniques and staffing that requires nurses to work (oh horrors!) 12 hour shifts during the flu crisis.

Although the nurses seem to want to walk out during a pandemic to "protect patients", the nurses in New York and Washington also filed a lawsuit over the idea that they should be required to get the flu vaccine. You can't have it both ways, nurses! You either want protection or you …

Copperhead Snake Bite

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Ever wonder what a copperhead snake bite will do? This patient was bit on his finger 4 days prior. The venom causes local tissue destruction and a secondary infection can set in. Copperhead snake bites are usually not fatal but, as you can see, the damage can be extensive.

(hat tip to copperhead-snake.com)

Too Tired to Blog

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Good News for Proton Pump Inhibitors (PPI)

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Proton Pump Inhibitor drugs (PPIs) have been used since the 1980s to reduce gastric acid secretion and to treat ulcers and reflux. They are now among the most widely prescribed drugs world wide and Prilosec and others can be obtained over- the- counter. Any time drugs are used long term, we should be re-evaluating their safety. The good news for PPIs, is that they are safe for chronic use.

PPIs do their work on the parietal cells of the stomach. They bind at the "proton pump" and prevent secretion of acid into the stomach. The effect is prolonged (24-48 hours) and the drug is cleared by the liver with very little effect on the kidneys.

The side effects are few so these medications (Prilosec, Aciphex, Prevacid, Protonics) are often prescribed to hospitalized patients and for patients with GERD, gastritis and ulcers. Patients take these medications for years and there have been numerous studies that looked at potential long-term effects of PPI use.

The studies have shown th…

The Water Giver

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EverythingHealth strongly recommends a wonderful new book called "The Water Giver" and I predict you will not be able to put it down. Author Joan Ryan is a remarkable writer who takes the reader on a journey she lived when her son, Ryan, sustained a near -fatal severe head and brain injury on a skateboard. It is both a medical drama and a meditation on motherhood.

The book begins with Joan's description of her son's learning difficulties and years of psychological and developmental testing. Her style as a mother was to intellectualize, do research and try to fix what was "wrong" with her son. The years went by with family stress and teachers conferences and medical consultations but it wasn't until the day he fell, that Joan realized some things are too big to be studied and fixed.

The nightmare began when he was 16 and went skateboarding without a helmet. The fall on a hill near their home caused a huge brain bleed that obliterated much of his…

All You Need To Know About Scabies

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While playing tennis last weekend, one of my partners whispered, "Hey you should blog about scabies. There is an epidemic going around." I don't know about a scabies epidemic, but catching scabies is common and it can crop up just about anywhere. People don't like to talk about parasite infections, so here is all you need to know.

Scabies are tiny borrowing skin mites with a scientific name of Sarcoptesscabiei. The little female mite burrows just beneath the skin and deposits eggs that mature in about 10 days. New mites hatch and spread to other areas of skin or other people. Symptoms appear 4-6 weeks after infection unless a person has had scabies before. Then the symptoms appear right away.

Scabies are contagious and spread through close physical contact in families, schools or nursing homes. The victim has severe itching, usually worse at night and sometimes you can see little burrow tracks or tiny blisters on the skin. The itching is not caused by the mi…

Shameless Corporation of the Week Award

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This weeks Shameless Health Insurer Award goes to American Community Mutual Company. The saga of 17 year old Brianna Rice starts in the summer of 2008. Her dad lost his job as a business consultant and also lost his group insurance. Continuing coverage with COBRA was too expensive so they took out a new policy with American Community Mutual in Illinois. Because the 17 year old was healthy, the monthly premium was only $130.00

In February, 2009, Brianna was diagnosed with celiac disease. On May 12 the insurance company rescinded her insurance and said it was a pre-existing condition and they would not cover any of the doctor or lab bills. Doctor visits from the distant past had mentioned dizziness, high cholesterol (a lab error), fatigue and a cough. They attributed those mentions to celiac disease and said they would not pay for treatment. A physical exam performed on July 2, 2008 showed no major health concerns.

Celiac disease is a digestive disorder and is treatable by elimi…

How to Make Health Reform Work

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It is still uncertain what we will get from the Congress and Senate for Health Care Reform this year but I see some major problems with the bill as it is currently being discussed. They say something is better than nothing but I am not so sure. Politics, partisanship, big money and industry influence are all playing a role that is not good for the American public.

Here are the problems with the current legislation that must be fixed if we are to win:
It still leaves 25 million Americans uninsured. 100% coverage is a must and if other countries can do it, so can we.Insurers are allowed to charge older customers 5X more than younger. If you are in your 50s you may pay $10,000/year. Is that affordable for anyone?Insurers can maintain any profit margin they want. $6.5 billion in "insurance fees" (to help make it financially palatable) will be passed on to consumers in higher rates.There are no cost controls on what insurers can charge.There are no restrictions on denial of ca…

Where Would A Doctor Like to Practice?

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Medscape has a physician portal and they asked the question: "Where would you like to practice medicine?" The responses from physicians were varied with lots of complaining and joking like "Dubai", but this reply from a family medicine doctor got my attention. I think he speaks for many physicians.

I would like to work in a fantasy world.
One where I didn't have to worry about someones economic status.
Where I could diagnosis and treat and feel confident the patient would actually follow my advice. Where their education level allowed them to be able to read a Rx bottle. And remotely comprehend what I take so long to explain, over and over to them.
Where we worked to benefit people as best we could, while not being burnt out or abused.
Where we didn't have to work for a life time to pay off overwhelming school debts.
Where 3rd party payers, in business to make a profit not provide health care, were a myth.
Where the legal profession spent time trying to help pe…

Signs of Ovarian Cancer

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Ovarian cancer has the worst prognosis of all gynecological cancers and it accounts for 4% of all cancers in women. Ovarian cancer has been called the "silent killer" because it was thought to have few symptoms and it is difficult to diagnosis in early stages. There are no good screening tests for ovarian cancer, including Ca125. The Ca125 test is not recommended as a screen for ovarian cancer and is mainly used to look for recurrence in previously treated cancer.

Several recent studies have shown that we were wrong to think ovarian cancer is "silent". There are seven symptoms that have been found to be associated with ovarian cancer and they are often overlooked by physicians and patients. Since only 30% of women are diagnosed in early stage of cancer, these symptoms, especially in combination, can be a clue.
Abdominal distension (an increase in abdominal girth)
Abdominal painIncreased urinary frequencyLoss of appetitePostmenopausal bleedingAbdominal bloatingRe…

Rules for Eating Well

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After reading about the "10 Most Dangerous Foods" (sloppy journalism) and the E. coli hamburger gross-out, it is refreshing to read some simple tips from my food hero, Michael Pollen. Michael's readers sent in rules for eating well and some were quite thought provoking. Check it out, but here are EverythingHealth's faves:
If you are not hungry enough to eat an apple, then you are not hungryAvoid snack foods with the "OH" sounds: Doritos, Fritos, cheetos, Tostitos, Ho Hos, etcIt's better to pay the grocer than the doctorNever eat something that is pretending to be something else; fake meat, fake butter, low fat sour cream, chocolate-flavor sauceMake and take your own lunch to workDo you have any rules for eating well ?

Laxative Abuse and The Colon

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The New England Journal of Medicine showed this appearance of the inside walls of a colon found on colonoscopy. The answer to the image challenge, of course, is laxative use. (click on the photo to see up close). The 2nd image shows the appearance of a normal colon. Note the pink skin and the normal folds which are quite different in appearance than the first image.

Laxative abuse causes a condition called Melanosiscoli. It causes a dark brown pigmentation that occurs with laxatives containing anthraquinone, such as senna. After a few months of use it is seen and it will disappear when the laxative is discontinued.

Laxatives should only be used for short periods of time. Chronic constipation is a problem for many people. After a visit to the doctor to rule out motility disorder, thyroid disorder or other medical problems, most constipation can be resolved with increased fiber, fluids and exercise. Abdominal massage and relaxation techniques also help to restore good bowel hea…

Health Email Scams

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The people who send fraudulent scams and viruses are sinking to a new low. I got a message today on my email network that has super firewalls. Despite that, the email from Mrs. Lauren Smith arrived and was titled "Please Read Carefully".
The message, directed to Dr. Brayer, caught my attention. It read:

"Hi,
My name is Mrs. Lauren Smith, a 66 year old lady, and I have been diagnosed with lung cancer and the doctor said that it is a disease of uncontrolled cell growth in tissues of the lung. This growth has lead to the invasion of adjacent tissue and infiltration beyond my lungs. The doctor has told me that I would not last for long due to my condition. Having to know my present condition, I have willed and given most of my property and assets to my immediate and extended family members as well as a few close friends.

I have now decided to give away my personal jewelry box for a non profit cause. I was a collector of gold jewelry for the past 30 years. I am willing to…

Shameless Corporation of the Week Award

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This weeks Shameless Health Care Corporation is Cigna. This story involves two identical twin girls who developed cancer at age 4. They were treated with total body radiation and chemotherapy which damaged the hypothalamus and pituitary gland. Those glands are responsible for growth and their endocrinologists determined that they needed growth hormone at age 7 when the damage was evident. Growth hormone is only needed until the bone endplates have developed.

During this time, their dad's employer switched insurance carriers from Aetna to Cigna. Cigna did a medical review and determined that the girls simply had "idiopathic short stature" and did not need growth hormone. Despite letters and "peer to peer" consults with their endocrine specialists, Cigna would not budge and refused to pay for the drug they were receiving.

According to the girls mother, the proactive physicians are very used to dealing with insurance companies and managed to get the drugs fre…

Shocking- Ground Beef is Not Safe

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It takes a lot to shock me, but the article in today's New York Times about E. coli in ground beef is truly eye opening. I want you to read the entire article but here are some scary highlights and facts that show our meat sources are not safe for consumption:A single portion of hamburger meat bought at most supermarkets is not from meat run through a grinder. It is an amalgam of various grades of meat from different parts of many cows and even from different slaughterhouses.There is no federal requirement for grinders to test their ingredients for E. coli pathogen.Hamburger meat might be labeled "Angus Beef" but it can be made up of low grade ingredients cut from areas of the cow that have contact with feces, which carries E. coli.Many big slaughterhouses will only sell to grinders who agree not to test their shipments for E. coli because they fear that discovery will set off a recall of ingredients they sold to others.Meat grinders buy trimmings of fatty edges sliced …