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Showing posts from May, 2010

Remote Telemedicine is Coming Soon to You

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Imagine this, Dear Patient.  You wake up and feel like you were hit by a truck.  Your head aches and when you look in the mirror you are shocked to see a rash running along your left ribcage.  It is slightly prickly and tender and you are freaking out.  To make things worse, you are in day two of a long awaited vacation and hundreds of miles  away from your favorite doctor.

What do you do?  Try to find an emergency room? Go back to bed and hope it is a bad dream?

It won't be long before you can log into your computer (with a polycam), dial up your favorite doctor and have a telemedicine visit.  The physician can get your history and you can even show her the rash.  Of course you have an electronic thermometer with you and you show the doctor that it is just a little elevated.  Your doctor diagnoses Herpes Zoster (shingles) and prescribes medication to be started immediately.  She electronically submits the prescription to the closest pharmacy to your vacation destination.  You clic…

Having a Baby in 1930

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Flash back to 1930.  Look at this bill for childbirth.  10 days in hospital - $50
Circumcision - $3
Total - $53


According to Forbes, the total charge in 2009 for an uncomplicated birth with 3 day hospital stay at Cedars-Sinai in Los Angeles was $36,625.

That seems a little high but good luck trying to find out the actual charge ahead of time.  You better round up between $7,000 and $15,000 and that will not include the circumcision or prenatal visits, ultrasounds and other modern perks.  It may or may not include the epidural which will likely be billed separately by the anesthesiologist.

Of course the obstetrician pays between $100K and $200K for annual malpractice insurance (depending upon the State) to make sure you have a perfect baby.  Nothing is the same as 1930...except the great depression and the current great recession.

Brush Your Teeth or Risk Heart Attack

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The British Medical Journal reported on a study of  toothbrushing and found that people with poor oral hygiene had an increased risk of cardiovascular disease and heart attack.  We have known for the last two decades that inflammation plays an important role in atherosclerosis.  Markers of low grade inflammation like C reactive protein, are also shown to be higher in heart disease.

The Scottish Health researchers looked at the general population (n-11,869) and followed a large subset with questions about their oral health.  They asked about frequency of dentist visits, tooth brushing, and controlled for many co-variables such as general activity, hypertension, smoking, height and weight.  They also collected blood for studies of  C-reactive protein as a marker of inflammation.  They removed from the analysis 3685 participants who were edentulous(no natural teeth) and 386 with existing cardiovascular disease.

This elaborate and lengthy study showed that tooth brushing is associated wi…

Viagra and Hearing Loss

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A study published in the Archives of Otolaryngology-Head & Neck Surgery reports that men who have taken sildenafil (Viagra) may experience sudden sensorineural hearing loss.  More than 2 dozen reports have indicated an association between sudden hearing loss and taking the phosphodiesterase type 5 inhibitor, Viagra.

This study compared subjects with and without hearing loss and looked at whether the men had used the erectile dysfunction medication before the loss.  During a 2-year period, 11,525 men age 40 and older provided information in 5 total interviews.  They were asked about health, health care activities, prescription medications and any hearing difficulty and use of hearing aids.  The overall incidence of hearing impairment was 17.9% and, as one would expect, it increased with age.

The results showed that men taking Viagra were more than twice  as likely to suffer hearing loss, even after controlling for other health factors.  No hearing loss was associated with Cialis or…

Yoga Helps Cancer Survivors

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Patients who carry a diagnosis of Cancer can be heartened by the results of a study that will be presented June 5 at the upcoming American Society of Clinical Oncology Annual Meeting.  The researchers found that the practice of Yoga helped cancer survivors improve sleep quality and reduce fatigue.

The lead researcher, Dr. Karen Mustian, professor of radiation oncology and community and preventive medicine at the University of Rochester in New York,  followed 410 patients who had already completed treatment for cancer but who experienced sleep disturbance that required medication.  Seventy-five percent of the patients had a diagnosis of breast cancer and none had sleep apnea.  The patients who started a yoga program (75minutes twice a week), were able to decrease their use of sleep medication by 21% after just four weeks,  compared with the control group who did not do yoga.  The yoga patients also experienced less fatigue and a reduction in daytime sleepiness.

It seems like a simple t…

Answer to Medical Quiz

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The answer to yesterday's medical challenge is #1 Basal Cell Cancer. These cancers are often slow growing and have a pearly appearance.   Basal Cell Cancers are easily removed by excision.

This group of Basal Cell Cancer's shows the different ways they can appear. The only way to confirm the diagnosis is by biopsy.

(photo from WebMD)

Doctor Pricing Upfront and Transparent

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A company in the Los Angeles area called HealthyPrice has posted prices on its website for 400 procedures and over 100 physician office visit fees.  For patients without insurance or who have high deductibles, the ability to go online and really "shop" for the best deal is something long overdue.

Here is how it works.  The patient goes online and chooses the provider for the test.  It might be a lab study or an MRI or a colonoscopy.  The patient pays in advance and receives a billing code to bring to the physican's office.  HealthyPrice handles the payment, minus a billing fee, and pays the doctor or lab via check or Paypal.  The doctor has no paperwork to handle and HealthyPrice has an arrangement in place for discounted laboratory testing.

Obviously people are not going to be able to use this type of discount service for emergencies, nor does it guarantee any type of quality care.  But for blood tests, imaging tests or even some procedures, knowing what it will cost up…

Skin Lump - You Be the Doctor

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This 71 year old man comes to the office with a lesion on his cheek that has been there for several years. He thinks it is getting larger and it does not bleed or hurt.  You are the doctor.  What is your diagnosis?

1. Basal cell carcinoma
2. Squamous cell carcinoma
3. Wart
4. Seborrheic keratosis
5. Melanocytic nevus

Make your diagnosis in the comments and the answer will be posted tomorrow.

(Image from Consultant, May 2010)

What Women Should Know About Fibroids

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Fibroid tumors are benign growths on the muscular wall of the uterus.  They can be tiny in size, like a marble or grow huge and fill up the entire uterine cavity.  Some fibroids are as large as a five month pregnancy.  Here are some facts that women should know about fibroids:
Fibroids can occur at any age but are most common between ages 40-50.Common symptoms are prolonged or heavy periods, pelvic pain and pressure, abdominal swelling, pressure on the bladder leading to frequent urination, pressure on the bowel leading to bloating and infertility  (note: these can also be the symptoms of ovarian cancer so seeking a diagnosis is critical).Fibroids are almost always benign (non cancerous). Fibroids do not increase the risk of cancer.There is a possible link between fibroid tumors and estrogen production and 40% of women over age 35 have fibroids.Women who are African-American or who have a mother with fibroids are more likely to get fibroids. Women who are overweight or eat red meat are…

"Daily Affirmation"

This is how we should all start our day. Happy Monday!

What You Can Do to Lower Cholesterol

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Your doctor has just informed you that you have "hyperlipidemia"  or high cholesterol.  She is mentioning lipid lowering drugs (statins) but you said you want to try some things on your own first.  She agrees and you will recheck the blood levels in 3 months.  What are you going to do?  The advise is all over the ballpark and your google searches come up with various supplements and diets that are confusing and overwhelming.

EverythingHealth is here to give you specific recommendations, based on evidence,  that will help you lower cholesterol.
Decrease saturated fats in your diet to less than 7% of your calories and increase your polyunsaturated and monounsaturated fats instead.  Start reading labels. Teach your kids to read labels.Eat more fiber, for instance 3oz of oats a day or use a psyllium supplement.Eat almonds, walnuts or pecans every day. (only 1-2 oz which is about 10-12 nuts)Increase your soy protein like tofu or soy foods to replace meat.Limit alcohol drinks to 1-2…

The Winners!

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Announcing the winners for the Subway gift cards.  Congratulations to SML,  Anon2 and Craig.  Each of you will receive a gift card in the mail if you will contact me and send me your address.  Enjoy the free healthy meals from Subway and EverythingHealth.

Keeping Kids Safe On Social Networking Sites

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My mom came from the McCarthy communist hunt era.  She would always say,"don't write anything you wouldn't want everyone to read and don't sign anything without reading it...you might be admitting you are a communist".  As a kid, I had no idea what she was talking about but those words stuck with me.  I am careful about what I write and I am careful with emails and the internet too.  Unfortunately our kids don't have the same concerns and they need help to stay safe on social networking sites.

Kids as young as 10 are now on Facebook or other sites where they sign up and communicate with their friends and strangers.  It's time to have the "safe network" talk...even before you have the "safe sex" talk. Here are a few tips to help:
Only join sites where you can control the users or "friends" who view your information. Help kids with the security settings to control the restrictions and information. Keep information private.  Do…

Working Overtime Linked to Heart Disease

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The European Heart Journal studied 6000 British civil servants and followed them for 11 years.  They found that working an extra 3-4 hours a day is associated with increased coronary heart disease.  The researchers controlled and adjusted for lifestyle, cardiac risk factors and other factors that would skew the results and still found that people who worked 3-4 extra hours a day had a 60% increase in risk for heart disease.

These results were for both women and men (ages 39-61) and the outcome measure was fatal myocardial infarction (heart attack) and non-fatal MI and proven angina.  Other risk factors like smoking, elevated lipids, diabetes made no difference in the results.

The conclusion:  "Overtime work is related to increased risk of incident coronary heart disease independently of conventional risk factors. These findings suggest that overtime work adversely affects coronary health".

Yikes.....

Check it Out

Two things:  Head over to The Examining Room of Dr. Charles for this weeks Grand Rounds roundup and also scroll town a bit and enter the Subway free card give-away.  Hey...free is good for your health.

Some Gender Stereotypes are True

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I get good info from my blog followers and SJ sent me a link that was pretty interesting.  Here are some gender stereotypes that have a basis in science that might be a surprise to you.
Women spend lots of time with colors, calling them mauve, pure ivory and ecru.  Men see pink, white and yellow.  Are women just color obsessed? Science tells us that color blindness only happens in men because the gene for seeing red is on the X chromosome.  Women have 2X's and consequently have a 40% chance of having a wider range of color perception.  We really do see those differences in color.

    2.  Women love to talk and process and talk some more.  Men get to the point and talk only to  solve problems (or clam up completely...right ladies?) 

Science tells us that the brain locus for language is 17% larger in women than in men.  The corpus callosum may also be larger in women (there is some debate about this) and this connects the right and the left hemisphere, allowing for more language proce…

EverythingHealth Giveaway Contest

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We all know how important a healthy breakfast is.  But what do you do if you are on vacation? Or have a kid rushing to an early morning soccer or band practice?  What about those times that mom is just not available to get it together?   EverythingHealth loves a contest with a free healthy giveaway and here is your chance to win!

Subway (yes, that fast food subway!) has introduced a nutritious fast breakfast egg  wheat muffin melt that will solve those times when you just want a breakfast "on the go".  The Egg White Muffin Melt has 140 calories and 3.5 g of fat.  The Black Forest Ham Egg White Muffin Melt has 160 calories, no transfats and 4g of fat.   Add apple slices and Dannon Light Yogurt and you are starting the day off right.

So tell us why you want to win a Free $5 Subway eat fresh gift card and we will award three (yes three) winners.  Comment below and the winner will be announced Thursday so check back every day.

Older Mothers

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An EverythingHealth blog fan requested that this post from 2007 be reposted in honor of Mothers Day.   I've updated it a bit and here it is:
Something has dramatically changed in the appearance of parents from the 1960s and the parents of children in the 21st century. Looking around at the adults with kids at schools, parks and ballgames, I can't help but think, "Gee, is that the parent or the grandparent?" Most of the time, it is the parent. The older parent (gray-haired, donned in Dockers, holding a cup of Starbucks coffee) who is holding hands with a fourth grader or pushing a stroller,  seems to be the norm these days at least in the Bay Area.. Perhaps I am more aware of this phenomenon because I am one of these older parents. But I have an unusual perspective because I was also a "young mom" in 1969 when I had my first child, a daughter. There is a 26-year time lapse between my two children, as my son was born in 1995.   I feel distinctly …

Mothers Day

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Happy Mother's Day to all of us who are mothers or who have a mother.  That is everyone!!!  For some touching thoughts, check out today's Post Secret.  It's  Mom's Day tribute.

Things Your Kids Will Never Know About

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The one thing we can all agree on is that nothing stays the same. We marvel at the customs and habits of our great grandparent's era and everything looks so grainy and antique.  Here are a few things that we took for granted that our kids and grandkids will never see, except in old photos:


a phone booka rotary phone, a pay phone stand and eventually any land line phonea record or turntable (so far preserved by D.J.s in clubs)a car radiatoran instant (kodak) cameraa typewritercarbon papersony walkman  thick polyester pants (we hope)glass reusable syringeslibrary dewey decimal system cardsthe milkman, or iceman (I did see an ice-cream man the other day)Let me know what I've missed. What are some things your kids (grand kids) will never know about?

Gulf Coast Oil Spill

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On Day 17 of the tragic oil spill from the drilling rig in the Gulf of Mexico, this is what it looks like from the air.  Oil continues to pour into the Gulf from the undersea well at about 210,000 gallons per day.  The pinkish oil is now at the shore of New Harbor island, a national wildlife refuge and nesting ground for sea birds.  West of the mouth of the Mississippi River, hundreds of dead jellyfish were seen.  Shrimping has been suspended in the area.

Louisiana's secretary of wildlife and fisheries is credentialing out-of-state veterinary specialists to help rescue oiled birds and animals.  There is concern that the slick could spill around Florida into the Atlantic Ocean and foul beaches and kill marine life on the East Coast.

There has been no success in stopping the flow of oil at this time.

(photo: NYT)

Men With Penis Enlargement Banned From Police Work

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Ok, leave it to EverythingHealth to bring you news you can use.  Look, I scour the health news so you can be up to date and informed without leaving the comfort of your computer chair.  Papua is the largest province of Indonesia and men there use a local technique to achieve penis enlargement.   They wrap the penis with leaves from the "gatal-gatal" (itchy) tree which causes the penis to swell.  When a man applies to the police force he is asked whether or not his organ has been enlarged and if it is, he is considered unfit to join the police or military.  The ban was applied since the unnatural size causes "hindrance during training", according to a police spokesman in Jakarta.

Many of the men in Papua New Guinea wear Penis Sheath Gourds for ceremonies.  I wonder how the police verify if a man has used the penis enhancer.  I can see how the gourd might get in the way of meaningful work but most likely it is a way of making sure the local natives do not get the plum…

Your Genes Determine Which Diet Works

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Why do some diets work better than others?  Why can your best friend lose 10 lbs with a low carb diet and your weight just hovers?  Why can some people eat just about everything, and still stay skinny?  It's all in the genes.  Mindy Dopler Nelson, Ph.D., of Stanford U. reported the results of her study at the American Heart Associate conference.  She found that a single nuceotide polymorphism caused women to loose 5X as much weight on the Atkins diet, compared with women who did not have the gene.

(A single nucleotide polymorphism is a DNA sequence variation that can create a copying error for proteins that change how a gene works and can be the site of certain disease processes)

Dr. Nelson studied women on 4 popular weight loss diets.  (Atkins, Zone, Learn and Ornish)  Within each of the diet groups, there were women who had lost over 15kg as well as people who gained 5 kg.  These women had no statistically significant differences in body mass index, blood pressure, cholesterol…