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Showing posts from September, 2010

Help Your Doctor Make the Diagnosis

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When patients and doctors communicate effectively, the patient has the best result. Not every doctor asks the critical question that can cinch a diagnosis.  Yet good communication, coupled with good diagnostic skill can be worth more than $10,000 in tests and referrals to consultants.  You can help your doctor figure out what is going on by thinking and communicating like a physician.  Whether you have a new problem or something that has been bothering you for a long time, here are some things that the doctor will want to know.

1.  What are the symptoms?  Be specific.  Don't just say "Sometimes I have a pain in my stomach."  Since more than 80% of health problems can be diagnosed based on information that you provide, make sure you can verbalize what you are feeling.  Is it crampy?  Does the pain come and go?  Where is it located?  Is it sharp or more like an ache?  These specifics are giving information that your doctor can use as she thinks of the anatomy, physiology a…

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Coffee Gives the Buzz in Health Care

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I could have told you without the study, but the results are in:  Coffee is the fuel that keeps hospitals and doctors and nurses going, both day and night.  OK, I admit the study was commissioned by Dunkin' Donuts, but I believe the results because I have witnessed it.  Health professionals are more dependent on coffee than any other profession.

The national survey included more than 3,600 workers and the results showed the professions most dependent on coffee.  Here they are:
1.  Nurses
2.  Physicians
3.  Hotel Workers
4.  Designers/architects
5.  Financial/insurance sales reps
6.  Food preparers
7.  Engineers
8.  Teachers
9.   Marketing/public relations
10. Scientists

They also found that younger workers were more dependent on coffee and nearly one in four younger workers said they buy coffee as a way to treat themselves for a job well done.

Thirty seven % of workers said they drink two or more cups during regular day and 43% of younger workers said they have lower energy if the…

Omega 3 and Green Tea

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We have know for some time that there are health benefits from drinking green tea.  Research also shows that Omega 3 fatty acids have  beneficial effects on a number of organs in the body, including the cardiovascular system, brain and even depression. Dr. Fereidoon Shahidi, research professor in the Department of Biochemistry at Memorial University in Newfoundland, Canada is hoping to show that green tea polyphenols, particularly epigallocatechin gallate (EGCG), may also prevent colon cancer and even have anti-viral effects when combined with certain Omega 3 fatty acids.. “We know from experience that green tea is not well absorbed by the body,” he said. “Our premise was to see if by adding something to it that has its own benefits, like Omega 3 fatty acids, we might get an entity that would have improved properties in terms of its absorption and health benefits,” Dr. Shahidi said. Their research proved that it was indeed the case, but further testing on animals provided other…

Things Growing in Lungs

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 (Image shows a nail clipper inhaled accidentally by a 20 year old man)

Last month an elderly man in Massachusetts developed a collapsed lung and pneumonia. Usually this means an undiagnosed cancer is lurking.  Imagine his relief and surprise to find out it was a pea growing in his lung.  That little accidentally inhaled pea started sprouting.  It seems that odd things found in lungs is not all that rare.  The trachea and the esophagus are really side by side and it is easy to "aspirate" and have food, liquid or objects head into the trachea and then to the bronchus, where it should not be.

What other things have been found in the bronchi and lungs?  One surgeon found a belly button ring.  Fishbones as well as nuts, beans, little candies or food particles are easily inhaled into the bronchial tubes.   Balloons are common as are hot dogs and even small toys.  Even partial dentures are found and many times the elderly person didn't know where they lost it.

Children are esp…

Musings on ESP

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Extra Sensory Perception (ESP) is defined as reception of information not gained through the recognized senses but sensed with the mind.  Other terms are psychic abilities or precognition or even a "hunch" or gut instinct that can't be readily explained.  Haven't we all had experiences like that?  The scientific evidence is weak and inconsistent,  but this morning's events are causing me to ponder about it again.  Here is what happened:

I was slowly getting dressed and doing early weekend chores while waiting for a notary public to come to our house to sign some loan documents.  I have some neat Massai bracelets that are a remembrance of the wonderful Massai warriors that we hosted from Kenya over the past few years.  I haven't thought about or worn these bracelets for over a year.  This morning I put them on my wrist in a cluster.

Imagine my surprise to find that the Notary was a young woman from Nairobi, Kenya.  When she saw me she said "Oh, you know a…

How Health Reform Helps Right Now

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Obama and the Dems have done a terrible job at marketing Health Care Reform, also known as the Patient Protection and Affordable Care Act.  The statute that is now law has new provisions that go into effect as early as September 23, 2010 and millions of people will benefit.  Here are a few benefits that you probably haven't heard much about:




College graduates and dependents will be able to stay on their parents' insurance until they are 26 years old.  Since many young adults can't get their own insurance, this gives them cheaper rates and coverage as they try to enter the real world.No insurance plan can place lifetime limits on health coverage or catastrophic events.  This is huge and should give us all comfort that we won't be dropped if we get sick.All insurance plans are mandated to have a medical loss ratio that is at least 80-85%.  This means they have to spend more on our care and less on wall street profits.There is no co-pay or deductible for preventive care un…

Preventing Kidney Stones

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Over the years I have had a number of patients with painful kidney stones and once they have passed (or been removed) I have felt at a loss to helping them prevent them.  "Stay hydrated" somehow didn't seem adequate, although we know fluid intake can help stave off recurrent kidney stone attacks.  Some textbooks said "avoid calcium"  since most stones are made of calcium oxylate.  High oxylate levels can be found in some fruits and vegetables, as well as in nuts and chocolate.  Yet there was no real scientific evidence that these foods caused stones.  The evidence for who got kidney stones was all over the ballpark and for a physician, that means no prevention advice is really proven.

A new study published in Clinical Journal of the American Society of Nephrology says that calcium rich foods - such as low-fat milk and yogurt-can be protective.  What?  Eat more calcium to prevent calcium containing stones?  It seems that higher intakes of calcium are actually as…

Welcome International Blog Visitors

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Every so often I like to give a formal blog welcome to visitors from around the Globe.  What a thrill it is to see how interconnected we are and to share knowledge so freely.  My hearty welcome to visitors within the last 24 hours from:
Oranjestad, Aruba; Tiaret, Algeria; Puntarenas, Costa Rica; Buenos Aries, Argentina;  Melbourne, Australia; Perth Australia; Aukland New Zealand; Abu Dhabi, UAE; Delhi, India; Seremban, Malasia; Edmonton, Canada;  Veracruz-Nave, Mexico; Guadalajara, Mexico; Monterrey, Mexico; New Westminster, BC, Canada; Halifax, Nova Scotia;  Invermere, BC, Canada; Paris, France; Moscow, Russia; Ankara, Turkey...

And others I may have missed.
Greetings and visit Everythinghealth again soon.

Heart Conditions We Don't Treat in Med School

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This gave me a chuckle from Doc Cartoon.

Hugs and Hand Holding in Medicine

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The New York Times asks, "Should the Doctor Hold a Patient's Hand" during emotional times or if the patient is crying.  The comments that follow the short article are the most interesting.  Most readers say this question shouldn't even be asked and that human compassion should always win out.  Touch is a human gesture of comfort and understanding.

But some readers disagree.  One said she recoiled when the doctor reached out to touch her hand after telling her that her cancer had returned.  It felt really creepy to her.  Another asked, "What if the physician is also a Catholic Priest or a pediatrician and a Priest."  Whoa, it becomes more complex when you get into the psyche of  the abused.

I have often thought that one of the appeals of chiropractors is that they "lay on hands" and touch and manipulate patients.  With 21st century modern medicine, physicians can treat entire episodes of illness with tests, scans and robots and never actually touch…

Adult Chickenpox

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We think of chickenpox as a childhood disease but there are adult cases and they tend to lead to more serious complications.  Chickenpox is caused by the varicella virus and it is extremely contagious.  Most people are exposed in childhood (or they receive the chicken pox vaccine) and so adults rarely contract it.  It is especially dangerous for pregnant women because the fetus can become infected.  The latency period from infection exposure to disease is 10-21 days.

Some people call Shingles adult chickenpox.  Shingles (Varicella Zoster) is caused by a latent chickenpox virus that has lain dormant for years in the nerve root and rears it's ugly head later.  The cause of the reactivation of the virus is usually never found and it occurs most commonly in people over age 60.  Shingles does not spread over the skin like chickenpox and stays in one discrete nerve dermatome area.  It can be extremely painful, causing burning pain and skin sensitivity.


Shingles can be contagious to peop…

Kids Lack Opportunities for Physical Activity

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One out of 3 children in the United States is overweight. Increased consumption of  nutrient-poor foods with high levels of sugar and saturated fats, combined with reduced physical activity, have led to obesity rates that have risen three-fold or more since 1980.  Our kids are not to blame. We are.

The Center for Disease Control has found that only 20% of blocks nationwide have parks within a half-mile of their boundary.  Fifty percent of kids say they lack access to parks, community centers and sidewalks in their neighborhoods.

Only 17% of high school students report getting the recommended 1 hour of exercise per day.  Only 20 states require or recommend that elementary schools provide scheduled recess.  Let me say that again.  The majority of states do not even require scheduled recess for grade school kids.

Too many kids live in neighborhoods that aren't safe and have no access to sports leagues or after-school activity programs.

Our nation needs to realize that all of the h…

Overpriced Medicine

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I took Tracy's (the faithful follower) advice and went to the link she provided in her comment from my blog on patients going to the Emergency Department for expensive health care.  The blog post  was a really good one that I wanted to share so click here and read a cost analysis from  young doctor Sara in Israel. 

And for those of you who think the U.S. has the BEST HEALTH CARE IN THE WORLD...think again.  We lag behind other nations in terms of access, quality outcomes, infant mortality and prevention.  Despite that, we are the most expensive.  Read her article and ponder....

Emergency Rooms Used for Routine Care

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The Patient Protection and Affordable Care Act (Our government's name for Health Care Reform) may make our already crowded emergency rooms swarm with more patients. A new study from Health Affairs
shows that more than a quarter of patients who currently visit emergency departmentsin the U.S. are there for routine care and not an emergency.  New complaints like stomach pain, skin rashes, fever, chest pain, cough or for a flare up of a chronic condition should not be treated in emergency rooms.  They are best worked up and treated by an Internist or Family Physician...preferably one who knows the patient.

So why are these patients waiting for hours and spending up to 10 times as much money for Emergency Department care?  The study shows it is a problem of limited access to primary care services.  Patients cannot get in to see a primary care doctor or it is on a weekend when they are not open.  Two thirds of the minor acute care visits to emergency departments took place on weekends o…

I hate canker sores

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Why do I hate canker sores?  First they are painful and mouth pain cannot be ignored.  Second, they are difficult to prevent and you just have to cope with them until they go away. And 3rd, we have no idea what causes them.  For a doctor, the 3rd reason is the most difficult to accept.  What the hell are canker sores?

The medical term is apthous ulcers and they are  round or oval painful ulcers that appear on the tongue, inner lips, side cheeks or palate of the mouth.  Up to 40% of people have experienced canker sores.  So why have the remaining 60% never had them?  We don't know.

They are more common in young people and occur more frequently in white people, non smokers and people with high socioeconomic status.  Why?  We don't know.

What we do know is that they are not contagious and they are not caused by the herpes virus.

Once a person has had a canker sore they are easy to self-diagnose going forward.  Some diseases cause canker sores to coalesce and form larger ulceratio…

Michael Douglas Has Oropharyngeal Cancer

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Michael Douglas announced he has"stage IV throat cancer" on late night TV this week.  Any announcement of cancer causes people to stop and take a deep breath but the idea of throat cancer is particularly scary.  So what exactly is throat cancer?  How is it diagnosed and treated? 

The clinical term is oropharyngeal cancer that involves the base of the tongue, the mouth, the tonsils, or the front and back walls of the throat.  Michael Douglas says he has a walnut-size tumor at the base of his tongue.  This is actually a pretty common site and it is usually caused by smoking or chewing tobacco.  The combination of smoking and alcohol use increases the risk and we know that Mr. Douglas battled alcohol addiction and smoking years ago.  There has been a steady increase in oral cancer and recent studies show the cause is infection with human papillomavirus (HPV).  Sixty percent of all oropharyngeal cancers are associated with the virus.

Cancers that start at the base of the tongue …