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Showing posts from April, 2007

A Bump on the Head

Even a minor blow to the head can lead to serious trouble. A close relative of mine is an active, sharp guy in his 80's. He was hospitalized a few weeks ago with an infection and like many older folks, he wasn't aware of how weak he was and he tried to get out of the hospital bed and go to the bathroom and "whoops", he slipped and fell. Hospitals all have procedures in place to prevent falls and they monitor the number of patient falls and try very hard to get to zero. But, try as they do ...falls happen. OK, he got a bump on the forehead and a bruised shoulder but, fortunately no broken bones.

Fast forward 4 weeks. One weekend Allen was slurring his words and not walking well. You would think they would rush to the hospital to get things checked out, but they decided to wait and see if he was better the next day. This is a HUGE mistake. In a prior post I wrote about stroke and the need to seek immediate attention for any change in speech or one sided weakness. I am …

Update from the Medical Journals

This should be welcome news for all those parents who have been saying "Stop playing those video'll never amount to anything...."

Impact of Video Games on Training Surgeons
Surgeons in the 21st century need to have different skills than in the past. Laparoscopic surgery requires a different hand/eye coordination that is similar to the equipment maneuvers and screens that kids use in playing video games. Researchers looked at the link between playing video games and surgical skill and suturing. They did an analysis of the performance of surgical residents and attending physicians with past experience with video games and current level of play. They controlled for the number of laparoscopic cases performed , their level of surgical training and the number of years in medical practice. Guess what? They found that video game skill and experience are significant predictors of laparoscopic skills. Past video game play in excess of 3 hours/week correlated with 37% fewe…

EverythingHealth Depends Upon a Clean Environment

I took these photos last year in Alaska. We saw the melting icebergs up close.

It is so great to hear someone like Lee Iacocca admit that Vice-President Al Gore had a major impact on him and he is now hip to the reality of global warming and the fact that American needs a real energy/environmental policy. If the former chairman of Chrysler Corporation, the origin of America's love of gas guzzling SUVs, can admit Hybrids are the future, there is hope that America can develop a new energy economy. A quote from his new book "Where Have All the Leaders Gone" says "Stay the Course? You've got to be kidding. This is America, not the damned Titanic. I'll give you a sound bite. 'Throw the bums out'"

A recent study conducted for the Center for American Progress found only 27% of people feel that our current energy policy is headed in the right direction, while 65% say our energy policy is seriously on the wrong track. A majority of Americans believes the U…

The Supreme Court-against medical opinion

The U.S. Supreme Court has put the health of women at risk with their 5 to 4 decision to uphold a congressional decision banning intact dilation and evacuation (D&E) abortion this week. Despite the fact that there is clear medical consensus that intact D&E is safer than alternative procedures for the mother in certain circumstances, the Supreme Court overruled six Federal courts that said the 2003 Federal law is an "impermissible restriction on a woman's constitutional rights".

The Supreme Court of the United States is the highest body to review legislative findings and they need to be especially thoughtful when fundamental constitutional rights are restricted. Every Federal Court that reviewed the 2003 law found it to be "unbalanced, unreasonable and not factual."

It is important to note that this decision does not affect Roe v. Wade. Ninety percent of all abortions still occur within the first 12 weeks and are not affected by this decision. But they hav…

Chondroitin for Arthritis - save your money

I'll give you the take away summary first: A new study from the Annals of Internal Medicine shows that chondroitin sulfate does not work to relieve arthritis pain. Before you fire off a comment that mentions how much it helped Aunt Tilly....the postscript is that there were no frequent or severe adverse affects so go ahead and take it if you think it helps you.

Osteoarthritis affects millions of adults and the most popular OTC (over the counter) supplement for pain relief is glucosamine plus chondroitin. Chondroitin alone is a $1 billion/year market in the U.S. It is a large molecule that is only 12% absorbed into the bloodstream. It is not incorporated into the cartilage and arthritis affects the entire joint anyway, not just the cartilage. Inflammation plays a large role in arthritis pain and numerous past trials have suggested that chondroitin may act as an antiinflammatory. Some past trials showed benefit and one even showed it worked better than joint replacement!!

This meta-an…

When Boss Lives Large - time to sell stock

I was on vacation this week and catching up on reading some non-medical journal news. I came across one piece in the Wall Street Journal that I wanted to share. It ties into EverytingHealth because losing hard earned money is usually not good for one's mental health.

It seems that when a CEO of a publicly traded company buys a trophy home, investors should use that as a clue to sell their stock. It is called the "mansion effect": the bigger the CEO's home, the worse the company stock performs. Researchers from Arizona State University (my alma mater) estimate that if investors sold the stock when the CEO moves into a palatial home, they would reap returns of 29% after one year, and 46% after two years.

Top Executives who pay for their trophy homes by selling company stock also underperformed compared to market benchmarks. The reason can't be related to the number of shares sold since those numbers are small compared to the total number of shares. The researchers…

Recall Mouthwash

Just a quick note to let readers know that Johnsons and Johnsons has recalled 4 million bottles of Listerine Agent Cool Blue Glacier Mint and Bubble Blast (for kids) mouth rinse. Both show contamination with bacteria.

The Uninsured - Don't think it won't be you!

Today I got a copy of a letter a daughter of a friend sent to Blue Cross of California Insurance:

"Today I was notified that my healthy, young, family of four was denied further health coverage on our current plan because we went to the doctor for routine health appointments. We are not sick. We have no history of sickness. We work, we exercise, and we eat right. We pay our premiums on time. We were denied the most minimal of coverage.

As I write this we have no health insurance. I know we are not alone. In fact we are a rapidly growing population. What are families with even minor health issues doing? What are people with major health issues doing? Should I lose my house to pay the hospital bill if I have an accident? Is this the American way?

My children’s pediatrician that we have gone to since our children were infants had to close his practice and join an HMO because he could not afford to sort out the insurance issues while in private practice. My internist does not take any…

Calcium and Your Bones - Mini Medical School

One of my patients said she heard calcium supplements are not that important in post menopausal women. She couldn't be more wrong. Read this and you will be as informed as most physicians about calcium and bone health.

2/3 of our bone mass is made up of the mineral calcium phosphate. Because bone is alive, there is constant removal and replacement of calcium, called bone remodeling. The parathyroid gland secretes a hormone called PTH and that determines the amount of calcium that gets pulled from the bone into the bloodstream. When we have enough calcium in our bloodstream, it decreases PTH and more is absorbed to preserve bone. Vitamin D is also important to absorption of calcium into the bone mass. Inadequate amounts of calcium and Vitamin D cause reduced bone mass and weakness leading to fractures. Reduced bone mass is called osteopenia and severe bone loss is called osteoporosis. Have you noticed that older people seem to shrink with age? That is largely because the skeletal …

Cost of The War - wouldn't you rather have health care?

It is hard to get my head around the figures that are published about how much the War in Iraq is costing. At the end of 2006, BEFORE the surge, the total cost to America was somewhere between $750 billion (conservative estimate) and $1.2 trillion. I don't know what a trillion is. It's like counting grains of sand or stars in the sky. But I do know what treating disease costs and the comparisons are staggering.

Currently, the Iraq War is costing Americans $200 billion a year. For a fraction of that money we could provide health care for all the people in the U.S. that are uninsured. We could provide treatment for every American whose diabetes or heart disease is going unmanaged. We could immunize the entire World's children against measles, pertussis, tetanus, TB, polio and diphtheria. We could provide 3,733,163 new housing units. That would certainly take care of the Katrina victims as well as the Tsunami victims.

After we provide these health services, we still have lots o…

High Blood Pressure - The Silent Killer

So much has been written about hypertension (high blood pressure) that we physicians think patients already know all there is to know. We forget that of the 50 million Americans that have hypertension, 1/3 don't even know they have it. Also, it is human nature to pay attention to something only when it has a direct connection to our lives. As we age, high blood pressure becomes more of an issue. In case one of the readers of EverythingHealth has just been diagnosed or has never even had their blood pressure tested, I offer this information....and I hope it is useful.

Blood Pressure is always reported as two numbers and normal blood pressure is 120/80 or below. The top number is the systolic (blood flowing through the arteries when the heart is contracting). The bottom number is the diastolic (pressure of the arteries when the heart is resting between the beat). Hypertension is a reading of 140/90 or above. If a persons blood pressure is over 140/90 on 3 testings, it is hypertension…

Life after Katrina - The Disaster Continues

It has been 18 months since Hurricane Katrina hit New Orleans and Mississippi. Within a few days of the flooding, as the city was being evacuated, I went to New Orleans and Baton Rouge to offer medical help. It was a life changing experience to be in the heart of such a disaster and I am keenly interested in how the people are getting their lives back.

Katrina took a terrible toll. Fifteen hundred lives were lost, 780,000 people were displaced and 200,000 homes were totally destroyed. The medical community...doctors, nurses, hospital facilities were also destroyed. When I was there we set up makeshift medical clinics serving 5,000 homeless men, women and children who were shell shocked, without their medications and displaced from loved ones. You might remember them as the "rooftop people" and each family had a horrific story to tell. The city was under water and communication was impossible. We had basic supplies and needed to use common sense and compassion as our first lin…

Journal Update

It's been a confusing week with two different studies on breast MRI. I have already had a number of patients call, trying to figure out what it means.

MRI for Screening

The American Cancer Society released new guidelines for use of MRI breast screening. They recommend screening for women who have been tested and are positive for the genotype BRCA 1 or 2 or for those that are first degree relatives of BRCA carriers. A first degree relative is a parent, child or sibling. They also recommend annual MRI screening for women who have had prior radiation to the chest between ages 10-30(for instance treatment for Hodgkins Disease).
The ACS does NOT recommend MRI for women with dense breasts or women with a personal history of breast cancer. They do not recommend MRI for women with atypical hyperplasia of the breast or lobular carcinoma in situ.
(American Cancer Society)

MRI in Opposite Breast after diagnosis of Breast Cancer

A 2nd report was released that looked at using MRI in the opposite (co…