MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'health tips'. Sat, 03 Sep 2011 02:00:39 +0100 http://www.medworm.com/index.php?rid=5181802&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmisdiagnosis-happens-all-the-time-tips-to-avoid-it%2F2011.09.01 Billionaire Teddy Forstmann has apparently been diagnosed with a serious form of brain cancer.  There’s a tragic twist to the story: according to Fox Business News, Forstmann believes that for more than a year, he had been misdiagnosed with meningitis. ABC News wonders: How could such a misfortune befall a billionaire —- a man able to afford the best doctors, best technology and the most sophisticated diagnostic tests? They’re missing the point.  Misdiagnosis happens with shocking regularity – as much as (more…) *This blog post was originally published at BestDoctors.com: See First Blog* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5181802 Thu, 01 Sep 2011 12:00:03 +0100 5181802 http://www.medworm.com/index.php?rid=5181804&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthree-common-ailments-that-can-be-treated-with-regular-exercise%2F2011.08.31 It’s Wednesday, so I would like to tell you about some cool things I learned this past week about the science of how exercise can be used as a treatment for three common ailments. First, some background about exercise: The great thing about exercising every day that you eat is that this magic potion is not a shot or a pill. It does not involve a doctor burning or squishing anything in your body. There are no HIPAA forms, no insurance pre-certifications, and not even a co-pay. It’s as we say, easy and free. And drum roll please…exercise is active—not passive. Here’s the Mandrola take on how exercise might treat three specific medical conditions: (more…) *This blog post was originally published at Dr John M* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5181804 Wed, 31 Aug 2011 18:00:42 +0100 5181804 http://www.medworm.com/index.php?rid=5174619&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedical-news-stories-beware-of-insufficient-evidence%2F2011.08.28 After seeing the NBC Nightly News last night, a physician urged me to write about what he saw: a story about a “simple blood test that could save women’s lives.” Readers – and maybe especially TV viewers – beware whenever you hear a story about “a simple blood test.” And this is a good case in point. Brian Williams led into the story stating: “Two of three women who die suddenly of cardiac heart disease have no previous symptoms which is all the more reason women may want to ask their doctors about a blood test that can be a lifesaver.” Then NBC News chief medical editor Dr. Nancy Snyderman said: “It’s not a new test, it’s not an experimental test but nonetheless it’s a test not a lot of people know about and tha... Better Health blogs http://www.medworm.com/rss/comments.php?id=5174619 Sun, 28 Aug 2011 14:00:15 +0100 5174619 http://www.medworm.com/index.php?rid=5169547&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-importance-of-physicals-for-young-athletes%2F2011.08.27 Increasing numbers of young people participate in outdoor activities, including strenuous competitive athletics. In so doing, they subject their bodies to stresses that are more intense and prolonged than those presented by a largely sedentary life. Every story of a sudden death in a young person is a tragedy, and usually accompanied by commentary pondering the role and utility of pre-activity screening. Could the death have been prevented? What was the physiological condition of the deceased? Could the collapse, often attributed to a heart problem, have been predicted? Was there an examination or evaluation that might have indicated that the deceased was at greater risk, or should have been held out of the activity? These are all important questions, with no simple answers. Sudden collaps... Better Health blogs http://www.medworm.com/rss/comments.php?id=5169547 Sat, 27 Aug 2011 16:00:00 +0100 5169547 http://www.medworm.com/index.php?rid=5158997&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-athletic-heart-how-it-functions%2F2011.08.24 It may seem a little formal to say this, but I would like to start by stating my goals for today’s post: Introduce the concept of the athletic heart; Touch upon the notion of sudden death of the athlete; Explain what an ECG really is, and how it may help diagnose heart disease; Review a recent study about the common ECG variant seen in athletes…Early repolarization. Intro: The adaptations of the human heart never cease to amaze me. Physical training transforms our hearts into high performance engines. Repeated sessions of interval training, combined with longer aerobic efforts, and sprinkled with adequate rest maximize our ability to keep pressure on the pedals, or run the sixth mile of the 10k at the same pace as the first, or for you swimmers, to keep getting back to the wall on th... Better Health blogs http://www.medworm.com/rss/comments.php?id=5158997 Wed, 24 Aug 2011 18:00:14 +0100 5158997 http://www.medworm.com/index.php?rid=5158998&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcdc-outlines-injury-prevention-strategies-in-extreme-weather-conditions%2F2011.08.24 It may seem rather unusual to talk about injuries and weather in the same context, but extreme weather can pose significant risks for many kinds of injury.  Currently, many parts of the United States are experiencing a major heat wave, with record-setting heat and heat indices over the next few weeks.  As we have seen in the recent past, deaths are occurring from heat-related and possibly from participation in outside activities that increase the risk of heat-related illness. During the month of August, many athletes train for the fall sports season, sometimes participating in two practices a day over the course of a few weeks.  While training is necessary and important for athletes to build up their stamina and to improve their performance, health consequences can be deadly if (more&#8... Better Health blogs http://www.medworm.com/rss/comments.php?id=5158998 Wed, 24 Aug 2011 16:00:44 +0100 5158998 http://www.medworm.com/index.php?rid=5139737&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fdrlindagalloway.files.wordpress.com%2F2011%2F08%2F803342_pills_1.jpg A nurse recently asked a very important question that bears repeating: What effect does long-term use of pain pills have on pregnant women? She was concerned because of the increase in number of pregnant women who are taking pain pills on a long term basis based on previous surgeries, accidents or a history of chronic pain. The most common “pain pills” prescribed are opiates which effectively eliminate or reduce pain but have a great tendency to be abused. Opioids are natural and synthetic type drugs that have the characteristics of morphine. It can only be obtained with a prescription and unfortunately physicians contribute to the problem of dependency and abuse through their lack of scrutiny regarding patient requests. My present home state of Florida has the unsavory distinction of ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5139737 Wed, 17 Aug 2011 19:00:46 +0100 5139737 http://www.medworm.com/index.php?rid=5139738&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fresearch-shows-that-a-pregnant-womans-diet-might-influence-babys-palate%2F2011.08.17 Attention, pregnant women!  The foods you eat now might influence your babies’ palates after they are born.  New research published in the journal Pediatrics, shows that the fetus actually drinks amniotic fluid in the womb.  The amniotic fluid is flavored by the foods the mother has recently eaten and flavors can be transmitted to the amniotic fluid and mother’s milk. It makes sense that as the baby is developing, memories are being created by a sense of taste.  Could what a mother eats influence food preferences and odor preferences for life?  Researchers fed babies cereal flavored with carrot juice vs. water.  They showed that babies who experienced daily carrots in amniotic fluid or mother’s milk ate more carrot-flavored cereal and made less negative faces when e... Better Health blogs http://www.medworm.com/rss/comments.php?id=5139738 Wed, 17 Aug 2011 17:00:00 +0100 5139738 http://www.medworm.com/index.php?rid=5130745&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdo-you-really-need-6-8-glasses-of-water-each-day%2F2011.08.15 “Bueno es saber que los vasos nos sirven para beber; lo malo es que no sabemos para qué sirve la sed”. Proverbios y cantares.XLI. Antonio Machado (‘It’s good to know that glasses are what can help us drink; The trouble is, we don’t know What is the purpose of thirst’) The one thing you can’t afford to have missing when you start a scientific congress or any other professional meeting is not a notepad, a pencil or even an iPad – nowadays, it’s a bottle of water. Offices, airports, handbags and lecture halls, all of them are bursting with all kinds of bottles. It seems they are essential to work and even to stay alive. Bordering nonsense, some people desperately search for a bottled water vending machine as soon as they arrive at the airport, even if that means gobbling i... Better Health blogs http://www.medworm.com/rss/comments.php?id=5130745 Mon, 15 Aug 2011 18:00:20 +0100 5130745 http://www.medworm.com/index.php?rid=5130750&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-surgery-be-considered-for-a-persistently-hoarse-voice%2F2011.08.14 I was informed about this interesting concept on ABC news… With many aging baby boomers tapping into cosmetic surgery in order to look younger, some are taking it a step further to “sound” younger as well with a “voice lift”. For some, it’s not right to look 10-20 years younger after a facelift but still sound like 70 years old. A hoarse voice with aging is not unusual, but a surgical “voice-lift” is not necessarily the first step that should be taken. First things first… (more…) *This blog post was originally published at Fauquier ENT Blog* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5130750 Sun, 14 Aug 2011 18:00:00 +0100 5130750 http://www.medworm.com/index.php?rid=5130751&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-you-consider-surgery-to-improve-a-scar%2F2011.08.14 I have a wide scar on my leg that I got years ago. I have tried creams and stuff. When is surgery a good idea to improve a scar? Can a cream or a laser make it thinner? Scar improvement has several phases and the condition of your body and how the wound occurred have parts to play. Early on after wounding there is the question of whether or not to have surgery to repair the wound. If the edges are clean and close together, then surgery is not always beneficial. If they are apart or the wound is dirty a proper medical evaluation and/or surgery can make things better down the line. When in doubt, get that evaluation. Once the wound has started healing, (more…) *This blog post was originally published at Truth in Cosmetic Surgery* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5130751 Sun, 14 Aug 2011 16:00:56 +0100 5130751 http://www.medworm.com/index.php?rid=5125739&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmobile-application-shown-to-enhance-diabetes-care%2F2011.08.12 It seems intuitive (at least to Medgadgeteers) that mobile technology can be used to improve health outcomes, but we still need studies to actually put data behind this idea.  A recent study of the DiabetesManager mobile health platform from WellDoc is a step in this direction. We last reported about WellDoc’s mobile diabetes application in 2010, and since that time it has been tested in a clinical trial and was shown to reduce HgbA1c by 1.9%. The DiabetesManager is a behavioral coaching and clinical decision support system.  Patients enter details about blood glucose values, medications, and behaviors via mobile phone, and health care providers receive quarterly summaries based on this information. (more…) *This blog post was originally published at Medgadget* (Source... Better Health blogs http://www.medworm.com/rss/comments.php?id=5125739 Fri, 12 Aug 2011 21:00:14 +0100 5125739 http://www.medworm.com/index.php?rid=5118640&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fdrlindagalloway.files.wordpress.com%2F2011%2F08%2Fbreastfeeding.jpg Could breastfeeding kill a newborn?  That is the question a California district attorney will ask a jury at the trial of a breastfeeding mother. Most women do not intend to harm their children but substance abuse and addiction comes with a heavy price. Such was the case of Maggie Jean Wortman, who has been charged with second degree murder after medical tests revealed that her newborn son died from methamphetamine intoxication obtained through her breast milk. Wortman’s 19-month-old daughter also tested positive for methamphetamine and was placed in protective custody. How could this happen? The transfer of drugs from the mother’s blood to human milk depends on the chemical composition of the drug. Antibiotics such as penicillin will remain in the mother’s blood for long periods of ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5118640 Thu, 11 Aug 2011 21:00:00 +0100 5118640 http://www.medworm.com/index.php?rid=5107518&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fplastic-surgeon-weighs-in-on-anti-aging-medicine%2F2011.08.08 Reader Question: Do you do anti-aging medicine? I do not see it on your web site. If not, what is your opinion of it? I am not a fan or follower of the anti-aging medicine fad in so much that it promotes what I believe to be a false concept. An older person cannot be made into a younger version of herself by boosting certain hormones. There is really no good evidence that it works. Patients don’t live any longer. It might also be found to be harmful in the long run. Plastic surgeons will differ in their opinions as to what works with low risk to improve things. To me (more…) *This blog post was originally published at Truth in Cosmetic Surgery* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5107518 Mon, 08 Aug 2011 16:00:57 +0100 5107518 http://www.medworm.com/index.php?rid=5107519&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-soothe-that-itchy-sunburn%2F2011.08.08 Have you ever had a sunburn? First it hurts. Then it itches. And itches. And itches. Why is that? Sunburn is caused by ultraviolet (UV) radiation damage to your skin. Too much UV damages your skin cell’s DNA, and your immune system responds by killing off the bad cells. Because UV radiation doesn’t penetrate (unlike X-rays for example), it damages only the surface layer of your skin. This outermost layer happens to be loaded with special nerve fibers called C-fibers which are responsible for itch. Itch is a mechanism to (more…) *This blog post was originally published at The Dermatology Blog* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5107519 Mon, 08 Aug 2011 14:00:10 +0100 5107519 http://www.medworm.com/index.php?rid=5103340&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftips-to-beat-the-heat%2F2011.08.06 Dehydrated, cramped, limping? on a bike. Road nationals 2010. People who exercise outdoors face a new threat. It’s unrelenting. Consistent. Inescapable. Perhaps, even more dangerous than distracted or mean motorists. It’s the heat. Gosh, is it hot. If only I had a dollar for every time I heard someone say, “Doctor M, you aren’t riding in this heat; are you?” Well…Other than the fortunate souls smart (or lucky) enough to live in cooler climates, most of us are facing an extreme wave of hotness. As a Kentuckian, I live in the epicenter of this summer’s cauldron. Louisville sits in a wind-protected valley alongside the heat sink that is the Ohio River. Think hot and steamy. The excessive heat smacked me hard last evening. Normally, my highly-veined skin and northern European h... Better Health blogs http://www.medworm.com/rss/comments.php?id=5103340 Sat, 06 Aug 2011 14:00:01 +0100 5103340 http://www.medworm.com/index.php?rid=5103344&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fstrokes-are-quite-common-in-pregnant-women-how-can-they-be-prevented%2F2011.08.05 According to CDC, there has been a 54 percent increase in the number of pregnant women who’ve had strokes in 1995 to 1996 and in 2005 to 2006. While this may surprise some researchers, it certainly would not surprise clinicians who take care of pregnant women who have risk factors such as obesity, chronic hypertension or a lack of prenatal care. Ten percent of strokes occur in the first trimester, 40 percent during the second trimester and more than fifty percent occur during the post partum period and after the patient has been discharged home. Hypertension was the cause of one-third of stroke victims during pregnancy and fifty percent in the post partum period. Hypertension accounted for one-third of stroke cases during pregnancy and fifty percent in the post partum period. Many stroke... Better Health blogs http://www.medworm.com/rss/comments.php?id=5103344 Fri, 05 Aug 2011 16:00:21 +0100 5103344 http://www.medworm.com/index.php?rid=5096201&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwilderness-medical-society-publishes-prevention-and-treatment-tips-for-altitude-sickness%2F2011.08.05 Led by Andrew Luks MD and his colleagues, the Wilderness Medical Society has published Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness (Wild Environ Med 2010:21;146-155). These guidelines are intended to provide clinicians about best evidence-based practices, and were derived from the deliberations of an expert panel, of which I was a member. The disorders considered were acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). The guidelines present the main prophylactic and therapeutic modalities for each disorder and provide recommendations for their roles in disorder management. The guidelines also provide suggested approaches to prevention and management of each disorder that incorporate the recommend... Better Health blogs http://www.medworm.com/rss/comments.php?id=5096201 Fri, 05 Aug 2011 14:00:00 +0100 5096201 http://www.medworm.com/index.php?rid=5086168&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fdrlindagalloway.files.wordpress.com%2F2011%2F07%2Fgreys-nursery.jpg No one likes pain, least of all pregnant women. Although obstetricians do a great job providing prenatal care and childbirth deliveries, there is always room for improvement regarding patient education. The management of labor pain is usually delegated to the Anesthesia Department within a hospital or an ambulatory center. The goal of anesthesia is to eliminate physical pain and any suffering that might be a result of pain. However pain and suffering may not always be about cause and effect. To quote the literature, “Although pain and suffering often occur together, one may suffer without pain or have pain without suffering.” Some women want to eliminate pain and others view it as a normal process. However, to the well initiated, it is well known that women who are in pain and “suffe... Better Health blogs http://www.medworm.com/rss/comments.php?id=5086168 Mon, 01 Aug 2011 18:00:35 +0100 5086168 http://www.medworm.com/index.php?rid=5077686&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcardiovascular-problems-stay-out-of-the-heat%2F2011.07.29 The brutal heat wave gripping much of the country this week is unpleasant for healthy folks. For people with cardiovascular trouble, hazy, hot, humid days can be downright dangerous. Your body shouldn’t get too hot (or too cold). If your temperature rises too far, the proteins that build your body and run virtually all of its chemical processes can stop working. The human body sheds extra heat in two ways, both of which stress the heart: Radiation. Like water flowing downhill, heat naturally moves from warm areas to cooler ones. As long as the air around you is cooler than your body, you radiate heat to the air. But this transfer stops when the air temperature approaches body temperature. Radiation requires rerouting blood flow so more of it goes to the skin. This makes the heart beat fa... Better Health blogs http://www.medworm.com/rss/comments.php?id=5077686 Fri, 29 Jul 2011 16:00:46 +0100 5077686 http://www.medworm.com/index.php?rid=5077689&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-case-for-mammograms-friends-and-family-might-be-a-greater-influence-than-doctors%2F2011.07.28 Most women in their 40′s believe they should have annual mammograms, regardless of what screening regimen their doctor might recommend. So say researchers in Massachusetts who surveyed women (primarily white, highly educated) ages 39-49 presenting for annual checkups. They gave the women a fact sheet about the new USPSTF guidelines on mammogram screening in their age group, and asked them to read one of two articles either supporting or opposing the guidelines. The researchers then asked women about their beliefs, concerns and attitudes about breast cancer and mammogram screening. Here’s what they found - Women overwhelmingly want annual mammograms – Close to 90% of women surveyed felt they should have annual mammograms, regardless of what their doctor might recommend. Women... Better Health blogs http://www.medworm.com/rss/comments.php?id=5077689 Thu, 28 Jul 2011 21:00:16 +0100 5077689 http://www.medworm.com/index.php?rid=5077690&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-best-time-to-be-treated-for-a-dvt%2F2011.07.28 You know I am a cancer survivor – 15 years down the road from a leukemia diagnosis and enjoying a 10 year remission. So whenever something seems weird about my health it’s cancer coming back, right? Wrong! Just how wrong was proven last night. I am writing this from my hospital bed in Seattle. The first symptom of a possible problem came three days ago when I had soreness in my right calf. A pulled muscle? Maybe. But I had not noticed straining it. Back at the gym the next day I had soreness again but thought it was no big deal. Last night it was worse. It hurt some to walk. I got home and, after my wife and son were asleep, got ready for bed. I had a slight fever and then noticed the right calf was not only sore, but swollen and warm. Very strange. I’d never seen that before. Trying... Better Health blogs http://www.medworm.com/rss/comments.php?id=5077690 Thu, 28 Jul 2011 18:00:02 +0100 5077690 http://www.medworm.com/index.php?rid=5077691&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fswimming-may-not-be-as-safe-for-your-children-as-you-think%2F2011.07.28 As summer continues in North America, and for anyone who goes near the water during any time of year, prevention of drowning is very important. The American Academy of Pediatrics (AAP) takes its responsibilities on this issue seriously, and in 2010 issued a policy statement on prevention of drowning. This is a remarkable and well-thought out document that addresses all of the important issues associated with risk for and prevention of drowning. The online version of the policy statement, along with updated information and services, is available on the web. The document points out that, historically, drowning has been the second leading cause of unintentional death in individuals aged one to 19 years, causing more than 1,100 deaths per year in the United States alone. The AAP defines drowni... Better Health blogs http://www.medworm.com/rss/comments.php?id=5077691 Thu, 28 Jul 2011 16:00:00 +0100 5077691 http://www.medworm.com/index.php?rid=5077693&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffootball-helmets-which-ones-are-most-likely-to-prevent-head-injuries%2F2011.07.28 Courtesy of Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences: National Impact Database Adult Football Helmet Ratings – May 2011 A total of 10 adult football helmet models were evaluated using the STAR evaluation system for May 2011 release.  All 10 are publicly available at the time of publication.  Helmets with lower STAR values provide a reduction in concussion risk compared to helmets with higher STAR values.  Based on this, the best overall rating of ‘5 Stars’ has the lowest STAR value.  Group rankings are differentiated by statistical significance. If you’re in the market to buy a loved one a football helmet, or just curious, go and have a look. It doesn’t take long, there are only 10 helmets on the list. Go to the list. I got to this from ESPN’... Better Health blogs http://www.medworm.com/rss/comments.php?id=5077693 Thu, 28 Jul 2011 12:00:20 +0100 5077693 http://www.medworm.com/index.php?rid=5069479&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnsaids-might-be-risky-for-people-with-heart-problems%2F2011.07.26 As if people with the combination of high blood pressure and heart disease don’t already have enough to worry about, a new study suggests that common painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs) pose special problems for them. Among participants of an international trial called INVEST, those who often used NSAIDs such as ibuprofen (Advil, Motrin and others), naproxen (Aleve, Naprosyn, and others), or celecoxib (Celebrex) were 47% more likely to have had a heart attack or stroke or to have died for any reason over three years of follow-up than those who used the drugs less, or not at all. The results were published in the July issue of the American Journal of Medicine. Millions of people take NSAIDs to relieve pain and inflammation. They are generally safe and effectiv... Better Health blogs http://www.medworm.com/rss/comments.php?id=5069479 Tue, 26 Jul 2011 14:00:35 +0100 5069479 http://www.medworm.com/index.php?rid=5062243&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftummy-tucks-arent-just-for-lazy-people%2F2011.07.25 Recently at the gym (I workout three to five days a week mostly swimming laps in a pool,) I got into a conversation with a mom about tummy tuck surgery. This happens occasionally when you wear your CosmeticSurgeryTruth.com t shirt to the gym. “I would never get a Tummy Tuck. I would just workout more.” People do not see outside of their own experience very often. This pretty young mom would not benefit much by a Tummy Tuck as she had no “hanging apron” or much lose skin. Many gastric bypass patients or other women not as fortunate after pregnancy to have their bellies “snap back” have changes. And some of them workout several days a week too. Tummy Tuck surgery is not (more…) *This blog post was originally published at Truth in Cosmetic Surgery* (Source: Better... Better Health blogs http://www.medworm.com/rss/comments.php?id=5062243 Mon, 25 Jul 2011 12:00:00 +0100 5062243 http://www.medworm.com/index.php?rid=5062244&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsome-young-europeans-are-starting-to-eat-like-americans%2F2011.07.24 For years I have touted the health benefits of the “Mediterranean Diet” and encouraged patients to eat like the Europeans.   Fresh farm vegetables, olive oil, fish and red wine have been linked with longevity and good health.  I just read in NPR news that young Italians are forgoing the eating patterns of their elders and are imitating the “U.S. diet”.  The result is soaring obesity, just like in the United States. According the the article, young Italians ages 6-12 are sitting in front of the TV and are eating fast foods and soda.  In just three generations, the eating habits and activity of kids has changed from their healthy grandparents.  Italian health officials say obesity is reaching epidemic proportions. Part of the diet changes are a result of (more&#... Better Health blogs http://www.medworm.com/rss/comments.php?id=5062244 Sun, 24 Jul 2011 21:00:00 +0100 5062244 http://www.medworm.com/index.php?rid=5062247&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fliving-with-severe-chronic-pain%2F2011.07.24 Living Beyond Pain For people with severe chronic pain like Kelly Young and Teresa Shaffer—both of whom have become patient advocates—coping with agony is a fact of life.  Young suffers from rheumatoid arthritis while Shaffer’s pain is linked primarily to another degenerative bone disease. Chronic pain is one of the most difficult—and common—medical conditions.  Estimated to affect 76 million Americans—more than diabetes, cancer and heart disease combined—it accompanies illnesses and injuries ranging from cancer to various forms of arthritis, multiple sclerosis and physical trauma. Pain is defined as chronic when it persists after an injury or illness has otherwise healed, or when it lasts three months or longer. The experience of pain can vary dramatically, depending in pa... Better Health blogs http://www.medworm.com/rss/comments.php?id=5062247 Sun, 24 Jul 2011 14:00:04 +0100 5062247 http://www.medworm.com/index.php?rid=5062248&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdo-you-know-what-metabolic-syndrome-is%2F2011.07.24 People with metabolic syndrome are twice as likely to develop heart disease, and five times as likely to develop diabetes, as those who don’t have metabolic syndrome. But many people are not yet familiar with this relatively new term. Do you know what metabolic syndrome is? OECD Country Populations with a BMI > 30 (1996-2003) Metabolic syndrome is the combination of several medical problems associated with morbid obesity. In addition to obesity, these conditions include: (more…) *This blog post was originally published at Columbia University Department of Surgery Blog* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5062248 Sun, 24 Jul 2011 12:00:10 +0100 5062248 http://www.medworm.com/index.php?rid=5057719&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-im-afraid-for-anyone-to-enter-the-healthcare-system-ever%2F2011.07.23 Alright, I admit that the title of this post is a little dramatic. But it really does seem that most people I know socially have had a bad experience with the healthcare system lately. Take for example my friend whose 3- year-old went to the hospital for a common pediatric procedure – the little girl was overdosed on a medicine, aspirated, got pneumonia, went into respiratory distress (noticed first by her mom) and remained in the pediatric ICU for several days. The hospital staff swept the overdose under the rug, and outright denied it happened when faced with direct questioning. As outrageous as that all is, my friend chose not to pursue action against the hospital and staff for their error and behavior. She just “let it go” because no permanent harm had occurred. Anoth... Better Health blogs http://www.medworm.com/rss/comments.php?id=5057719 Sun, 24 Jul 2011 01:18:24 +0100 5057719 http://www.medworm.com/index.php?rid=5057723&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Favoiding-wild-animal-attacks%2F2011.07.23 By now, most everyone is familiar with the tragic circumstances in which a visitor on a trail in Yellowstone National Park on July 6, 2011 surprised a brown (grizzly) bear with cubs, provoking a fatal attack. Fortunately, events like this are rare. At the same time, they are also predictable by virtue of our understanding of bear behavior, particularly in the wildland-urban interface. It was not the victim’s fault, and our hearts go out to his family and friends. For the benefit of others who will backpack and explore in bear country here is an excerpt about avoidance of hazardous animals, in particular bears, adapted from the book Medicine for the Outdoors: Avoidance of Hazardous Animals Most wild animal encounters can be avoided with caution and a little common sense. Follow these rule... Better Health blogs http://www.medworm.com/rss/comments.php?id=5057723 Sat, 23 Jul 2011 14:00:00 +0100 5057723 http://www.medworm.com/index.php?rid=5057725&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftips-to-protect-the-most-sensitive-skin%2F2011.07.22 Baby skin is sun-sensitive. Everyone wishes they had baby skin. It feels so soft and smooth; it’s perfectly adapted to induce us adults to want to clean their diaper, no matter how many times they dirty them. Like their big eyes and cute noses, baby skin is part of the whole package of being adorable. But like their eyes, their skin, however beautiful, is immature. Baby skin is thinner, has less natural moisturizers and has fewer pigment cells, making it more vulnerable to the environment than adult skin. This is important especially in summer. How often do you see babies running around on the beach with just a diaper on? Although they seem indestructable, they are more vulnerable than the adult holding the pail and shovel. Studies have shown that up to 83% of babies get sunburned their ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5057725 Fri, 22 Jul 2011 21:00:24 +0100 5057725 http://www.medworm.com/index.php?rid=5050576&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fdrlindagalloway.files.wordpress.com%2F2011%2F07%2F2078708_f260.jpg When we think of skin changes in pregnancy, what immediately comes to mind are stretch marks or Striae Gravidarum . Stretch marks occur because of a breakdown of collagen, a substance that holds the skin together and is responsible for its stretching. Teen pregnant patients are more at risk for having stretch marks. Why is that important? Because, according to medical literature, stretch marks can increase the risk of having lacerations (or tears) during birth. Another fairly common skin condition during pregnant is called Pruritus gravidarum or generalized itching during pregnancy without the presence of a rash. Approximately 14% of pregnant women are affected by this condition and it is associated with twin pregnancies, fertility treatments and diabetes. As stated in my previous blog, it... Better Health blogs http://www.medworm.com/rss/comments.php?id=5050576 Thu, 21 Jul 2011 21:00:59 +0100 5050576 http://www.medworm.com/index.php?rid=5050581&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fone-of-the-most-common-infections-of-childhood-otitis-media%2F2011.07.20 Ear infections are the bane of childhood and can spoil many outdoor adventures. One of the most common infections of childhood, they provoke long nights of miserable children, sleepless parents, and unhappiness all around. They may be recurrent, and can also progress (rarely) to more serious medical problems, such as meningitis. What Are Ear Infections? Acute otitis (inflammation of the ear) media (“middle”) infection is caused by bacteria or viruses. When it occurs, there is redness and inflammation of the eardrum, frequently with a collection of  blood, serum, or pus behind the drum. To know whether or not this has occurred, and to precisely determine the anatomic diagnosis and severity, one needs to see the eardrum, which is what the healthcare provider does with an otoscope. With ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5050581 Wed, 20 Jul 2011 21:00:00 +0100 5050581 http://www.medworm.com/index.php?rid=5050582&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-are-humans-so-drawn-to-sunlight-despite-its-negative-consequences%2F2011.07.20 It doesn’t make sense: If sunlight causes cancer, why are human beings so drawn to it, flocking to sunny beaches for vacation time and hoping for sunshine after a rainy spell? One answer, says David Fisher, chief of dermatology at Harvard-affiliated Massachusetts General Hospital in Boston, may be that humans are literally addicted to sunshine so our skin can make vitamin D. New evidence suggests that we get the same kick out of being in the sun that we get from any addictive substance or behavior. It stimulates the so-called “pleasure center” in the brain and releases a rush of feel-good chemicals like endorphins. So there may be more than a desire to look good in a tan behind the urge to soak up the sun’s rays. This craving may be a survival mechanism that evolved over thousands ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5050582 Wed, 20 Jul 2011 18:00:34 +0100 5050582 http://www.medworm.com/index.php?rid=5028211&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fdrlindagalloway.files.wordpress.com%2F2011%2F07%2Fbookjpg.jpg A little knowledge is dangerous; especially when it relates to medicine. A recent article in the British newspaper, Daily Mirror discussed a medical study that attempted to prove there was a link between pregnant women’s sleeping positions and stillbirth. The author is of the opinion that the study was small and biased and therefore “there is a serious need for more research before we’re in a strong position to make ¬any recommendations.” Obviously this author has limited knowledge about the cardiovascular system of a pregnant woman. Our organs and tissues require oxygen to function. Without it, they essentially die. Blood from the lower part of our body flows back to the heart where it receives oxygen, compliments of a large blood vessel called the Inferior Vena Cava (IVC). The i... Better Health blogs http://www.medworm.com/rss/comments.php?id=5028211 Fri, 15 Jul 2011 14:00:04 +0100 5028211 http://www.medworm.com/index.php?rid=5028212&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-you-can-avoid-heat-rash-during-the-hot-summer-months%2F2011.07.15 I just flew back from Atlanta for the 4th of July weekend, and, boy, are my sweat glands killing me. Atlanta has a way of making your sweat glands work overtime, and overworked sweat glands can lead to dreaded heat rash. Heat rash is a common, annoying problem in summertime that develops when sweat glands are blocked, thereby preventing sweat from escaping and irritating your skin. Hot skin trapped under clothing is often affected, leading to red itchy or prickly bumps (hence it’s other name, prickly heat). Humid heat is worse than dry heat, and anything that blocks the sweat ducts such as lying on your back at night, wearing tight fitting clothing or even applying thick sunscreen is a sure way to bring the rash out. Prickly heat is commonly seen in babies who aren’t able to tell us w... Better Health blogs http://www.medworm.com/rss/comments.php?id=5028212 Fri, 15 Jul 2011 12:00:24 +0100 5028212 http://www.medworm.com/index.php?rid=5028215&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcdc-outlines-infection-prevention-in-outpatient-settings%2F2011.07.14 jQ(document).ready(function(){jQ('.bannerad').html("");jQ('#healthy_vision').parent().parent().parent().hide();});As healthcare professionals, we must recognize our responsibility to protect patients – care should not provide any avenue for the transmission of infections. By working together, we can ensure infection prevention practices are understood and followed by all, during every patient visit. Healthcare continues to transition to settings outside the hospital, and efforts to prevent infections must extend to all settings where patients receive care. Today, CDC is pleased to present the Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care. a summary guide of infection prevention recommendations for outpatient settings. Although these recommendat... Better Health blogs http://www.medworm.com/rss/comments.php?id=5028215 Thu, 14 Jul 2011 16:00:41 +0100 5028215 http://www.medworm.com/index.php?rid=5028218&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdengue-fever-mosquito-born-illness-now-found-in-texas-florida-and-hawaii%2F2011.07.13 Dengue fever is a viral (flavivrus) disease transmitted by Aedes albopictus and female A. aegypti mosquitoes. It is estimated that 50 to 100 million people in more than 100 countries are infected each year with dengue viruses. There are four different types of dengue virus, and there is no cross-immunity, so a person may be stricken with dengue fever four times in his life. The most active feeding times for dengue vector mosquitoes is for a few hours after daybreak and in the afternoon for a few hours just after dark (dusk). As opposed to the night-feeding mosquitoes that transmit malaria, these species tend to be “urban,” may also feed during daylight hours (also indoors, in the shade, and during overcast weather), and are known to bite below the waist. Dengue fever is seen chiefly in... Better Health blogs http://www.medworm.com/rss/comments.php?id=5028218 Wed, 13 Jul 2011 22:00:00 +0100 5028218 http://www.medworm.com/index.php?rid=5008195&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmammogram-frequency-should-be-dependent-on-more-than-a-womans-age%2F2011.07.07 I read the LA Times article by Shari Roan, Study urges more individual mammogram guidelines, with interest.  As Roan notes, guidelines to date have mainly focused on a woman’s age and not her other risks factors. The American Cancer Society recommends that healthy women undergo screening mammograms every one to two years beginning at age 40 regardless of risk factors. In 2009, the U.S. Preventive Services Task Force recommended a different schedule which urged the inclusion of an individual’s personal risks:  screening for women ages 40 to 49 should be based on individual risk factors and women ages 50 to 74 should be screened every two years. Monday, a paper was published in the Annals of Internal Medicine (full reference below) which argues for a more personalized approach to scree... Better Health blogs http://www.medworm.com/rss/comments.php?id=5008195 Thu, 07 Jul 2011 22:00:00 +0100 5008195 http://www.medworm.com/index.php?rid=5008197&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-to-do-if-your-doctors-appointment-isnt-soon-enough%2F2011.07.07 A friend of mine had a hard time getting in to see her doctor for an urgent visit last week. Reeling from an unexpected and sudden family upset, she was depressed and anxious, unable to sleep or function, and her therapist was advising an antidepressant.  She called her family doc, who works at a large hospital-based multispecialty group, and told the woman at the call center that she wanted to see the doctor on an urgent matter. She was given an appointment 6 weeks in the future. Summoning her courage, my friend told the woman her story – and that she was really worried about herself and did not think she could wait that long. “Sorry, that is the best I can do” was the reply. Increasingly upset, my friend told the woman that if she had to wait that long, she just might kill hersel... Better Health blogs http://www.medworm.com/rss/comments.php?id=5008197 Thu, 07 Jul 2011 17:00:32 +0100 5008197 http://www.medworm.com/index.php?rid=4997519&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-do-physicians-conduct-complete-physical-exams-when-you-have-a-localized-complaint%2F2011.07.04 One June 20, 2011, NPR aired a great story about how a person may not “see” a person getting beat up on the side of a jogging path when they are focused on a task (pursuing another jogger)… even if they pass RIGHT BY THE FIGHT!!! In fact, only a third of the subjects reported seeing this mock fight when the experiment was conducted at night. Even more surprisingly, broad daylight didn’t improve the statistics (only 40% noticed the fight). Though the situation and circumstances do not exactly correspond, there is a lesson to be learned here that applies to a medical visit. As an ENT, I often see patients for a very specific complaint… “My right ear hurts.” “I have a bad cough.” No matter what the complaint, unless it is for a specific ta... Better Health blogs http://www.medworm.com/rss/comments.php?id=4997519 Mon, 04 Jul 2011 16:00:00 +0100 4997519 http://www.medworm.com/index.php?rid=4997522&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-right-and-wrong-ways-to-strengthen-your-core-muscles%2F2011.07.03 What do slouching, back pain, and a middling forehand or weak shot off the tee have in common? Often it’s a weak core—the girdle of muscles, bones, and joints that links your upper and lower body. Your core gives you stability and helps power the moves you make every day. Whether it’s bending to pick up a laundry basket, swinging a golf club, paddling a kayak, or reaching to pull a vase from the top shelf of a cabinet, a strong and flexible core makes the move more fluid, efficient, and robust. Strong, well-balanced core muscles can also improve your posture and help prevent back injuries. And if back pain does strike, core exercises are usually part of the rehab regimen. Core Muscles Click image to enlarge. Your core is composed of many different muscles in the abdomen, back, ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4997522 Sun, 03 Jul 2011 22:00:55 +0100 4997522 http://www.medworm.com/index.php?rid=4997523&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-bottom-line-on-new-fda-sunscreen-guidelines%2F2011.07.03 Life is really simple, but we insist on making it complicated. -Confucius This is certainly true of sunscreens. “Broad spectrum, UVA, UVB, avobenzone, oxybenzone, parsol, sensitive skin, titanium dioxide, SPF 15, 30, 45, 50, 55, 60, 70, 75, 100, 100+, waterproof, sweatproof, spray, cream, lotion, antioxidant…” We spend about $700 million in sunscreens every year, and many people don’t have a clue as to what’s good or bad, or a waste of money. The Food and Drug Administration has been meaning to help you out with this problem for a while now. Actually for over 30 years (who says nothing gets done in government?). The F.D.A. has made a final decision on sunscreen labels. They’ve sought to make labels simple and accurate to help you choose the right one: 1. The sunscreen must pro... Better Health blogs http://www.medworm.com/rss/comments.php?id=4997523 Sun, 03 Jul 2011 21:00:40 +0100 4997523 http://www.medworm.com/index.php?rid=4997525&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fomega-3-fatty-acids-the-science-behind-their-potential-heart-health-benefits%2F2011.07.03 The Biology of Omega-3 fatty acids: (Just a little science:) When fish, flax-seeds or Brussels sprouts pass through the intestine, pancreatic enzymes transform the fat to free fatty acids. These acids are quickly taken up by the cells. Once in the cell, these fatty acids enter the mitochondria, endoplasmic reticulum and cytosol–places that you might recall because your mom helped you make a Cell sponge cake in 7th grade Biology. In the cells, the Omega-3 fatty acids (ALA, DHA and EPA) exert their healthy influence in three major ways: in the control of chemical messengers; in the flux of ions—cell electricity; in the smoothness and health of the cell membrane. That’s enough about cells. How do these (good) fats help our bodies? Omega-3 fatty acids reduce Inflammation: –Omega-3s ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4997525 Sun, 03 Jul 2011 16:00:49 +0100 4997525 http://www.medworm.com/index.php?rid=4992687&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbeware-of-potatoes-they-may-cause-you-to-pack-on-pounds%2F2011.07.01 Without meaning to, you’ve gained a few pounds over the last few years. How did that happen? Certain foods, especially the humble potato, may be partly to blame. In a fascinating study of 120,000 healthy, non-obese women and men taking part in long-term studies of diet and health, the participants gained an average of 3.3 pounds every four years over a 13-year period. When the researchers tallied up the foods that contributed most to this weight gain, potatoes topped the list—twice: potato chips potatoes sugar-sweetened beverages red meat processed meats Other contributors to weight gain included sleeping less than six hours a night or more than eight hours, drinking alcohol, and watching television. The results were just published in The New England Journal of Medicine. The study of... Better Health blogs http://www.medworm.com/rss/comments.php?id=4992687 Fri, 01 Jul 2011 22:00:50 +0100 4992687 http://www.medworm.com/index.php?rid=4992689&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2F5-important-reasons-to-protect-your-eyes-from-the-suns-uv-radiation%2F2011.07.01 A Pterygium Dermatologists have done a great job promoting sun safety. We all know that we should use sunscreen or sunblock to avoid burns, and to reapply it religiously when we plan to be outdoors for long periods of time. But how often do we think about protecting our eyes from the same UV rays? A dear friend of mine has been on a long-term medicine that makes her skin especially sun-sensitive. She did not take sufficient precautions to protect her eyes from UV radiation (though she always wore sunscreen on her skin), and she developed a pterygium that looks just like the photograph above. Her condition reminded me of the importance of eye protection, and I thought I’d offer you 5 excellent reasons to start shielding your eyes from the sun. UV protection is critical for avoiding: 1... Better Health blogs http://www.medworm.com/rss/comments.php?id=4992689 Fri, 01 Jul 2011 18:00:52 +0100 4992689 http://www.medworm.com/index.php?rid=4992690&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffourth-of-july-top-tips-for-fireworks-safety%2F2011.07.01 As the 4th of July approaches, I’ve begun to hear fireworks exploding in my neighborhood.  It’s been dry here, so in addition to the risk of injuring a person, there is a risk of setting the fields on fire.  I sure hope my neighbors are being responsible. I hope you will all have a safe and happy July 4th.  Be safe and stay out of the ER. Please use the following tips: Never allow children to play with or ignite fireworks.  A responsible adult should be in charge. Read and follow all warnings and instructions. Be sure other people are out-of-range before lighting fireworks. Small children should be kept a safe distance from the fireworks; older children that use fireworks need to be carefully supervised. Do not smoke when handling any type of “live” firecracker, rocke... Better Health blogs http://www.medworm.com/rss/comments.php?id=4992690 Fri, 01 Jul 2011 16:00:00 +0100 4992690 http://www.medworm.com/index.php?rid=4992691&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-be-a-good-doctor-10-rules-of-the-road%2F2011.07.01 He sat in a crisp white coat, staring at a computer screen, note cards in his lap. Occasionally, I noted him jot a note to himself as he compiled his list. A nurse sat next to him, pounding feverishly on the keyboard as she recorded her nurse’s note. He tentatively moved his mouse, then clicked, still staring. I recall my first day in clinical medicine: no computer, an ER rotation, a white board filled with names and abbreviated medical problems next to them with little magnetic color-coded labels nearby. Room 1: Head trauma. Room 2: Abscess. Room 3: UTI, Room 4: Rash. I got room 2. It was the biggest, bad-est infected sebaceous cyst on a guy’s back a newly minted doctor had ever seen. Can you say “softball?” “See one, do one,” they told me. And off I went. Much in medicine ha... Better Health blogs http://www.medworm.com/rss/comments.php?id=4992691 Fri, 01 Jul 2011 14:00:00 +0100 4992691 http://www.medworm.com/index.php?rid=4992693&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhelpful-breast-cancer-qa%2F2011.06.30 Attendees of the breast cancer awareness symposium “Bridging the Gap: Promoting Breast Cancer Prevention, Screening and Wellness” were given the chance to submit questions on breast cancer in the minority community. This is the first part of these questions answered by Dr. Preya Ananthakrishnan, Assistant Professor of Clinical Surgery and a host of the event. Q: I am a 51 year old Black women, whose mother died 13 years ago from breast cancer & her sister was diagnosed last year. I had a mammography 2 weeks ago and got the dreaded come back letter. Should I get genetic counseling? Dr. Ananthakrishnan: I would suggest that your sister with the breast cancer get tested first, and if her test result is positive then you should get tested. Furthermore, it is likely that even though you... Better Health blogs http://www.medworm.com/rss/comments.php?id=4992693 Thu, 30 Jun 2011 22:00:57 +0100 4992693 http://www.medworm.com/index.php?rid=4984448&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fosteoporosis-treatment-with-bisphosphonates-is-exercise-good-or-dangerous%2F2011.06.30 My 86 year-old mother, who is generally in good health, slipped and fell recently and suffered a fractured femur. She was unfortunate to have suffered the accident, but had the good fortune to be discovered quickly, treated promptly and well by the paramedics who responded to her, and then to have a swift and skillful operation by an orthopedic surgeon to repair the fracture. Almost miraculously, she was standing upright (with a considerable amount of pain) the next day and had begun the rehabilitation process. At her age—indeed at any age—a fractured femur is a very significant injury. This past year, I have learned of friends and others who have suffered falls and broken their legs, ankles, or backs, as well as others who suffered “pathological fractures.” The latter group had th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4984448 Thu, 30 Jun 2011 11:00:00 +0100 4984448 http://www.medworm.com/index.php?rid=4984449&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-complain-effectively-about-mistreatment-at-a-psychiatric-hospital%2F2011.06.29 For those who don’t follow the comment sections of posts, there have been commenters who have been telling us about the awful experiences they have had as psychiatric patients.  In particular (but not exclusively) as  hospital inpatients.  Commenters have used terms like “abuse” and “humiliation” and describe awful scenarios.  One person asked why the mean nurses don’t get fired, everyone knows they are mean including the staff.  Others throw the baby out with the bath water, one bad experience.  There is implication by at least one commenter that he/she would rather die (presumably permanently) rather than face a day on a psych unit again.  The suffering in these posts is palpable. To those who feel better after leaving comments on Shrink Rap, by... Better Health blogs http://www.medworm.com/rss/comments.php?id=4984449 Wed, 29 Jun 2011 23:00:00 +0100 4984449 http://www.medworm.com/index.php?rid=4984451&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoes-accutane-cause-inflammatory-bowel-disease-the-evidence-is-weak%2F2011.06.29 At home the kids’ current TV show of choice is How I Met Your Mother, supplanting Scrubs as the veg out show in the evening. Both shows are always on a cable channel somewhere and are often broadcast late at night. Late night commercials can be curious, and as I work on projects, I watch the shows and commercials out of the corner of my eye. Law firms trolling for business seem common. If you or a family member has had a serious stroke, heart attack or death from Avandia, call now. The non-serious deaths? I suppose do not bother. One ad in particular caught my eye: anyone who developed ulcerative colitis or Crohn’s disease (collectively referred to inflammatory bowel disease, or IBD) after using Accutane, call now. Millions have been awarded. My eye may have been caught because of ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4984451 Wed, 29 Jun 2011 17:00:47 +0100 4984451 http://www.medworm.com/index.php?rid=4975867&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-should-you-get-an-hiv-test-national-hiv-testing-day%2F2011.06.28 jQ(document).ready(function(){jQ('.bannerad').hide();jQ('#healthy_vision').parent().parent().parent().hide();});Note: Yesterday President Obama issued a statement on National HIV Testing Day Thirty years ago, at the beginning of the HIV/AIDS epidemic, there was no test for HIV, the virus that causes AIDS. For many, there was only the long and worrisome wait for the signs of infection. Once those signs appeared, no treatment for the virus was available. I personally cared for many, many patients in this era, and I am thankful that those days are over. Today, HIV testing is accurate, widely available, and often free—and treatment can help people living with HIV enjoy long, healthy lives, especially when they get diagnosed early. The good news is that more people are being tested fo... Better Health blogs http://www.medworm.com/rss/comments.php?id=4975867 Tue, 28 Jun 2011 13:00:40 +0100 4975867 http://www.medworm.com/index.php?rid=4968487&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-only-some-people-experience-high-altitude-sickness%2F2011.06.26 Hi! Greetings from Breckenridge, Colorado. At 10,000 feet, I am told it is the highest resort town in North America. The Rocky Mountain scenery is breathtaking. But there’s a problem for about one in four of us who visit here, especially people like me who live at sea level. We can get hit with high altitude sickness and a few days ago, I was one of the unlucky ones. What happens is your body isn’t used to the thin air and your blood has difficulty getting enough oxygen to your body. It usually happens at altitudes over 8,500 feet. You get an ongoing headache, you feel tired, you have insomnia (I was sleepless for two nights!), you could have nausea and certainly fatigue. Drinking lots of water and passing up alcohol can help, but even then some people have problems. When I finally sa... Better Health blogs http://www.medworm.com/rss/comments.php?id=4968487 Sun, 26 Jun 2011 14:00:35 +0100 4968487 http://www.medworm.com/index.php?rid=4968489&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffda-approved-drugs-are-not-always-effective-the-benefits-of-alternative-medicine%2F2011.06.25 On Saturday, while thousands of Boston Bruins fans gathered at Government Center to celebrate the team’s recent Stanley Cup victory, a hundred or so true die-hards met a few blocks away at a Massachusetts General Hospital conference to talk about complementary and alternative medicine for psychiatric disorders. While I hated to miss the Bruins parade, I’m glad I attended the MGH conference. I’ve always been a bit of a skeptic about so-called natural therapies for one simple reason: they don’t have to go through the same rigorous testing in clinical trials that medications do. At the same time, I realize that FDA-approved drugs don’t work for everyone. One in three adults with major depression, for example, can’t completely improve their mood and other symptoms even after trying... Better Health blogs http://www.medworm.com/rss/comments.php?id=4968489 Sat, 25 Jun 2011 21:00:31 +0100 4968489 http://www.medworm.com/index.php?rid=4968490&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffood-allergies-treating-severe-allergic-reactions%2F2011.06.25 An allergic reaction in an outdoor setting can rapidly become a life-threatening emergency. While most of us think of food allergies as annoyances, they can be quite serious or even life threatening. Itchy skin rashes can progress to breathing difficulty, swollen soft tissues (e.g., lips, tongue, throat) that compromise the airway, and low blood pressure or even shock. Therefore, it’s important to be familiar with the signs and symptoms of severe allergy and to be prepared to respond rapidly in the event of an emergency. An EpiPen (an epinephrine auto-injector) The National Institute of Allergy and Infectious Diseases has released Food Allergy Guidelines for healthcare professionals to help guide the care of patients with life-threatening food allergies. The full guidelines can be found ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4968490 Sat, 25 Jun 2011 18:00:00 +0100 4968490 http://www.medworm.com/index.php?rid=4960068&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-your-diet-might-interfere-with-prescription-medications%2F2011.06.22 When people talk about prescription medications, everyone is familiar with the concept of side effects from medication. But, did you know that there are things in your diet that may interfere with your prescription medication? In addition, your prescription medication may interfere with over the counter medications. In this video, there are two interviews recorded on Wednesday, June 8, 2011 on local TV news. If you find the information above helpful, I invite you to check out other TV interviews on medical/health issues at MikeSevilla.TV *This blog post was originally published at Family Medicine Rocks Blog - Mike Sevilla, MD* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4960068 Wed, 22 Jun 2011 16:00:54 +0100 4960068 http://www.medworm.com/index.php?rid=4960070&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-you-need-to-know-about-snakebites%2F2011.06.22 Eastern coral snake, photo courtesy of Norman Benton, CC-BY-SA 3.0 The Wilderness Medical Society held its annual meeting at Snowmass last summer July 23-28, 2010. There were numerous terrific educational sessions. In a series of posts, I am going to highlight some of what we learned from the presenters. Jonathan Allen gave a presentation on venomous snakebite management. Here are some facts to remember: Snakebite Statistics Approximately 15 percent of the 3,000 snake species worldwide are dangerous to humans. There are annually 400,000 to 2,000,000 envenomations from snakebite worldwide, with 20,000 to 100,000 deaths. In the U.S., there is at least one species of venomous snake in every state except Alaska, Maine, and Hawaii. There are approximately 20 venomous species, including pit vipe... Better Health blogs http://www.medworm.com/rss/comments.php?id=4960070 Wed, 22 Jun 2011 12:00:00 +0100 4960070 http://www.medworm.com/index.php?rid=4952843&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-study-supports-previous-evidence-that-autism-is-triggered-in-utero%2F2011.06.21 Science has found no evidence that vaccines cause autism; but the true cause(s) of autism have not yet been determined. So far the available evidence has pointed towards a largely genetic cause with possible interaction with environmental factors. A new study supports that interpretation. It also supports previous evidence that autism is triggered prior to birth, rather than at the time of vaccinations. Schmidt et al. published a study in Epidemiology on May 23, 2011, entitled “Prenatal Vitamins, One-carbon Metabolism Gene Variants, and Risk for Autism.” It was a population-based case control study of 566 subjects comparing a group of autistic children to a matched control group of children with normal development. They looked at maternal intake of prenatal vitamins in the 3 months bef... Better Health blogs http://www.medworm.com/rss/comments.php?id=4952843 Tue, 21 Jun 2011 14:00:43 +0100 4952843 http://www.medworm.com/index.php?rid=4952849&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcdc-reports-that-salmonella-is-still-a-major-problem%2F2011.06.20 Salmonella food infections continue despite success reducing disease caused by other pathogens, the Centers for Disease Control and Prevention reports. Salmonella should be targeted because while infection rates have not declined significantly in more than a decade, they are one of the most common, the CDC reports in its latest Vital Signs. Contaminated food causes approximately 1,000 reported disease outbreaks and an estimated 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths annually in the U.S. Salmonella causes 1 million foodborne infections annually, incurring an estimated $365 million in direct medical costs. Salmonella infections in 2010 increased 10% from 2006-2008. The same prevention measures that reduced Escherichia coli infections to less than 1 case per 100,000 ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4952849 Mon, 20 Jun 2011 12:00:00 +0100 4952849 http://www.medworm.com/index.php?rid=4934159&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-to-expect-from-the-new-sunscreen-labels%2F2011.06.16 Yesterday, the U.S. Food and Drug Administration released the new rules regarding labeling of sunscreen.  The goal is to make it easier for the average person to chose a sunscreen. The new labels will not be in place until next summer, so you need to be aware. When the new labels are in place, NO sunscreen will be allowed to be labeled as a SUNBLOCK or as WATERPROOF. Under the new labeling rules Products that have SPF values between 2 and 14 may be labeled as Broad Spectrum if they pass the required test. Only products that are labeled both as Broad Spectrum with SPF values of 15 or higher may state that they reduce the risk of skin cancer and early skin aging, when used as directed. A warning statement will be required on any product that is not Broad Spectrum, or that is Broad Spect... Better Health blogs http://www.medworm.com/rss/comments.php?id=4934159 Thu, 16 Jun 2011 16:00:00 +0100 4934159 http://www.medworm.com/index.php?rid=4934160&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fvitamin-d-for-copd-why-that-wont-be-enough%2F2011.06.16 I am frequently extolling the health benefits of Vitamin D because almost weekly there is a new study that correlates high vitamin D levels with reducing some disease.  The latest is from the American Journal of Respiratory and Critical Care Medicine and research shows that high doses of vitamin D supplementation improved respiratory muscle strength in patients with Chronic Obstructive Pulmonary Disease (COPD).  The patients that did not receive supplemental vitamin D had blood levels of 22.8 compared to 53.8 in the supplemented group.  The patients who were supplemented had improved respiratory function, strength and less shortness of breath.  It certainly didn’t cure or reverse COPD but the improvement was an encouraging trend in this terrible chronic disease. In reading about ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4934160 Thu, 16 Jun 2011 14:00:00 +0100 4934160 http://www.medworm.com/index.php?rid=4934162&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-to-do-about-runners-knee-patellofemoral-pain-syndrome%2F2011.06.15 My left knee hurts. When I put weight on it with my leg bent, like when I get out of the car, I feel a dull pain in my knee. My doctor and physical therapist have given me a diagnosis of patellofemoral pain syndrome, also known as “runner’s knee” or patellar knee-tracking syndrome. Simply put, my kneecap doesn’t run smoothly up and down its track—a groove called the trochlea. Anyone can get patellofemoral pain syndrome, but for some reason it is more common in women than men—especially in mid-life women who’ve been running for many years. The problem, say researchers who just published a study in the journal Gait and Posture, is that lots of “mature” women develop alignment problems with their knees. The researchers compared younger female runners to older female runners ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4934162 Wed, 15 Jun 2011 21:00:49 +0100 4934162 http://www.medworm.com/index.php?rid=4921421&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fannual-ovarian-cancer-screening-does-more-harm-than-good%2F2011.06.10 In a large multicenter study enrolling over 70,000 women, annual screening with transvaginal pelvic ultrasound and ca125 blood testing did not reduce deaths from ovarian cancer, and in fact led to an increase in complications due to screening. Investigators in the NCI-sponsored Prostate, Lung and Ovarian Cancer (PLCO) Screening trial randomly assigned over 78,000 women age 55-64 years of age to either annual screening with transvaginal pelvic sonograms for 4 years plus CA125 testing for 6 years or usual care at 10 study sites across the US., and followed the groups for up to 13 years. Over that time period, ovarian cancer rates in the screened group were 5.7 per 10,000 person-years vs 4.7 per 10,000 persons-years in the usual care group, with 3.1 deaths vs 2.6 deaths per 10,000 person year... Better Health blogs http://www.medworm.com/rss/comments.php?id=4921421 Fri, 10 Jun 2011 18:00:39 +0100 4921421 http://www.medworm.com/index.php?rid=4921424&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcell-phones-and-brain-cancer-evidence-of-a-link-is-limited%2F2011.06.10 If the recent announcement by the International Agency for Research on Cancer (IARC) that cell phones may cause brain cancer has you worried, you might want to wait a bit before trashing your mobile phone and going back to a land line. Last week, the IARC convened experts from around the world to assess what, if any, cancer threat cell phones pose to the 5 billion or so people who use them. After reviewing hundreds of studies, the IARC panel concluded that cell phone use may be connected to two types of brain cancer, glioma and acoustic neuroma. That sounds mighty scary. But the IARC said the evidence for this conclusion was “limited.” Most studies have shown no connection between cell phone use and brain cancer. In the relatively small number of studies that have observed a connectio... Better Health blogs http://www.medworm.com/rss/comments.php?id=4921424 Fri, 10 Jun 2011 12:00:11 +0100 4921424 http://www.medworm.com/index.php?rid=4921425&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-treat-horse-and-donkey-bite-wounds%2F2011.06.09 Earlier this week this tweet from @prsjournal caught my eye Most Popular: Management of Horse and Donkey Bite Wounds: A Series of 24 Cases: No abstract available http://bit.ly/lgNkCS I missed this article when it came out in the June 2010 issue of the Plastic and Reconstructive Surgery Journal.  As I have covered fire ant bites, cat bites, and snake bites.  Fellow blogger Bongi has written about hippo bites.  It’s time to cover horse and donkey bites. Dr. Köse, Department of Plastic and Reconstructive Surgery, Harran University Hospital, Turkey and colleagues presented a retrospective evaluation of 24 patients treated for animal bites (19 horse and five donkey bites) from 2003 to 2009.  The head and neck were the most frequent bite sites (14 cases), followed by the extremities (8 ca... Better Health blogs http://www.medworm.com/rss/comments.php?id=4921425 Thu, 09 Jun 2011 21:00:00 +0100 4921425 http://www.medworm.com/index.php?rid=4911479&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fstatins-reduce-heart-disease-risk-but-probably-not-because-they-lower-cholesterol%2F2011.06.08 When cyclists find out that I am a heart doctor, they most frequently ask about cholesterol numbers. “…My cholesterol is this…What do you think?” “…My doctor wants me to take a statin…But I read that these drugs might lower my functional threshold power 2.014 watts/40km.” All this focus on numbers saddens me. Remember, I am a forest guy, not a tree guy. What’s more, as a doctor that revels in the adrenaline rush of ablating rogue circuits with technology that would impress even a twenty-something, I find questions about biochemistry dreary–like eating quinoa. I wish folks would ask me about how to terminate AF with a catheter, or how an (evidenced-based) ICD saved a mom’s life, or perhaps even this: “Do you do heart surgery?” But more often than not people want t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4911479 Wed, 08 Jun 2011 21:00:58 +0100 4911479 http://www.medworm.com/index.php?rid=4911480&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmyplate-spiffy-new-nutritional-guidelines-for-americans%2F2011.06.08 The crumbling Food Pyramid and its hip successor (MyPyramid) fell into oblivion yesterday, eroded by the stinging winds of science. Their replacement? A quartered plate called—wait for it—MyPlate that was designed to visually convey the elements of healthy eating to Americans of all ages. The new icon consists of a white plate divided into four segments: green for vegetables, red for fruits, orange for grains, and purple for protein. Dairy has a prominent place, sitting where a glass of water should be. The hope is that the plate will nudge Americans away from meals dominated by meat and starch and towards meals made up mostly of plant-based foods. The original Food Guide Pyramid debuted in 1992. It was built on shaky scientific ground. Over the next few years, research from around the... Better Health blogs http://www.medworm.com/rss/comments.php?id=4911480 Wed, 08 Jun 2011 19:00:00 +0100 4911480 http://www.medworm.com/index.php?rid=4911482&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-dont-more-people-use-health-apps-for-iphones-and-droids%2F2011.06.08 I have been musing about why, despite our fascination with gadgets and timesaving devices, so few of us use the apps and tools that have been developed to help us take care of ourselves. The range of options is staggering – my iPhone coughed up 52 applications for medication reminders just now – but most of us don’t make use of the (often free) high-tech help available to us.  There are hundreds of websites and portals to help us monitor our diets, physical activity and blood sugar, talk to our doctors by e-mail and understand our test results.  Apps can help us watch for drug interactions, unravel our test results, adjust our hearing aids and track our symptoms.  Devices can monitor whether our mom is moving around her house this morning or continuously monitor our vital signs. I... Better Health blogs http://www.medworm.com/rss/comments.php?id=4911482 Wed, 08 Jun 2011 16:00:13 +0100 4911482 http://www.medworm.com/index.php?rid=4911483&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fegg-freezing-%25e2%2580%2593-not-as-successful-as-you-might-think%2F2011.06.08 NPR is running a typical media hype story on oocyte preservation (egg freezing), featuring the standard happy family photo with their “miracle” baby born after thawing and fertilizing a cryopreserved egg. It’s a heartwarming story and a pretty photo, but far from a complete picture of what women need to know about this still experimental fertility preserving procedure. Nowhere does the article tell women the actual success rates of occyte cryo-preservation. So before you run out to freeze your eggs, know this – the chance of having a pregnancy after egg freezing is less than a 50/50 shot – at most about 39%, according to the latest data.  That’s about the same odds you’d have if you just wait till 40 to try to get pregnant on your own. In addition, while somewhere between 1... Better Health blogs http://www.medworm.com/rss/comments.php?id=4911483 Wed, 08 Jun 2011 12:00:53 +0100 4911483 http://www.medworm.com/index.php?rid=4911487&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fscuba-diving-with-a-disability%2F2011.06.07 Outdoor recreation is intended for everyone, and can be enormously beneficial for persons with disabilities. I am in awe of disabled skiers, climbers, divers, and others who have learned to coordinate their bodies and take great enjoyment and a sense of accomplishment from their wilderness activities. It behooves everyone in the healthcare profession to be aware of certain special medical concerns for persons who are disabled physically or emotionally. Additionally, family members and friends are often well aware of what they can do to help in providing a joint effort to support the disabled. At the 2010 Wilderness Medical Society annual meeting in Snowmass, Colorado, JenFu Cheng, MD (a pediatric rehabilitation specialist from NJ), gave a wonderful presentation on the medical aspects of ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4911487 Tue, 07 Jun 2011 12:00:00 +0100 4911487 http://www.medworm.com/index.php?rid=4902416&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fdrlindagalloway.files.wordpress.com%2F2011%2F06%2Fbookjpg.jpg Of the 4 million babies born in the U.S. each year, approximately 12.3 percent of them will be premature and 3.56 percent will occur before 34 weeks. Premature birth is one of the leading causes of severe handicaps and has an annual cost of approximately $26 billion dollars. Although risk factors for preterm labor have been identified, there is still no cure. As stated in a previous blog post, when the cervix becomes weak (a condition called cervical insufficiency), the patient is at risk for second trimester miscarriages and preterm labor. Also, if a patient has a previous history of premature birth then she needs her cervix measured in a future pregnancy.  If her cervix is short and measures between 16 mm and 25 mm before 23 weeks, she is at risk for premature labor and delivery. The re... Better Health blogs http://www.medworm.com/rss/comments.php?id=4902416 Mon, 06 Jun 2011 21:00:23 +0100 4902416 http://www.medworm.com/index.php?rid=4902425&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fan-at-home-laser-hair-removal-system-that-works%2F2011.06.04 Without going into TOO much detail of how I know this… I have personally observed that the TRIA Laser Home Removal System does work after observing its use and its effects over a 6 month period of time. And before anybody asks… no… I was not paid to write this nor did I get a free one to try. Rather, someone I am close to bought it off Amazon.com and I was a skeptic on-looker. In any case, the caveat being that I know it works (admittedly anecdotal) as long as the hair is dark (ideally black or brown) on very light colored skin (ideally white). The way laser hair removal works is (more…) *This blog post was originally published at Fauquier ENT Blog* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4902425 Sat, 04 Jun 2011 18:00:00 +0100 4902425 http://www.medworm.com/index.php?rid=4893448&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhardened-breast-implants-capsular-contracture-a-reader-question%2F2011.06.03 I have had a capsulectomy due to capsular contraction, but now it has returned. I want an explant because they are uncomfortable and look unnatural. My doctor said that since the capsulectomy did not resolve the issue, he recommends having an explant and waiting about 6 months to a year. After my body has healed properly, he said that I can get implants again and will not get capsular contraction again. Is this accurate? Am I less likely to get capsular contraction or will I be free of capsular contraction? I’m also looking for a doctor experienced in explants. The subject of hardened breast implants (Capsular Contracture) comes up frequently as it is the leading cause of long term dissatisfaction with breast implants. If your breasts tend to hurt or look unnatural, you likely have sever... Better Health blogs http://www.medworm.com/rss/comments.php?id=4893448 Fri, 03 Jun 2011 22:00:35 +0100 4893448 http://www.medworm.com/index.php?rid=4893453&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fstop-watches-may-be-better-than-ct-scans-at-predicting-heart-disease%2F2011.06.02 It is hardly news to say that we need better means to predict who will die of heart disease. No matter how much you may hear about medical errors, hospital acquired infections, or even distracted driving, it’s still heart disease that kills the most of us. The inflammation that begins narrowing our arteries starts when we are young. It percolates quietly, stealth-like for years. The young usually skate by unscathed. But all the cookies, beers, chips, inactivity and work stress adds up. The tension of life squeezes our arteries, daring them to crack or fissure. This cataclysm is one of the ways that middle age may introduce herself. A friend, or colleague, or sibling dies suddenly of heart problems. Those of us that our “masters-aged” have likely felt these sensations of sadness, and ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4893453 Thu, 02 Jun 2011 21:00:39 +0100 4893453 http://www.medworm.com/index.php?rid=4876385&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmyth-buster-seafood-allergies-do-not-increase-risk-of-allergies-to-ct-contrast-dyes%2F2011.05.28 It is a prevalent belief out in the medical (and lay public) community that patients with iodine or seafood allergy can not receive contrast when undergoing certain radiological tests like CT or MRI scans. The concern is that contrast contains minute amounts of free iodide and as such, IV administration of this material puts the patient at risk of a life-threatening anaphylactic reaction. Contrast is often given in these tests as it traces out bloodflow enabling the physician to see organ and mass architecture much more clearly allowing for improved accuracy in seeing anything abnormal. Well… rest assured that patients with iodine and seafood allergy CAN receive contrast without any significant increased risk of an allergic reaction as compared to other allergies. In a large study en... Better Health blogs http://www.medworm.com/rss/comments.php?id=4876385 Sat, 28 May 2011 18:00:00 +0100 4876385 http://www.medworm.com/index.php?rid=4876386&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-less-is-more-how-to-improve-the-quality-of-primary-care%2F2011.05.28 On the NPR Shots blog, Scott Hensley writes, “Quality Prescription For Primary Care Doctors: Do Less,” about an article in the Archives of Internal Medicine. Excerpt: “A group of docs who want to improve the quality and cost-effectiveness of primary care tinkered with some Top 5 lists for of dos and don’ts for pediatricians, family doctors and internists. After testing them a bit, they published online by the Archives of Internal Medicine. Most of the advice falls in the category of less is more. So what should family doctors not be doing? The Top 5 list for them goes like this: 1. No MRI or other imaging tests for low back pain, unless it has persisted longer than six weeks or there are red flags, such as neurological problems. 2. No antibiotics for mild to moderat... Better Health blogs http://www.medworm.com/rss/comments.php?id=4876386 Sat, 28 May 2011 16:00:55 +0100 4876386 http://www.medworm.com/index.php?rid=4872089&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthree-good-reasons-for-healthcare-professionals-to-use-social-networks%2F2011.05.27 Social networking allows doctors, nurses and other health professionals to deeply connect and engage with the community and their colleagues. “We are standing at the precipice of a new online revolution in health care. As more and more health experts embrace the Internet and increase their social media activity, health information seekers will undoubtedly benefit in profound ways.” [Source: Mashable] Dynamic health and medical professionals engaged in social networking, using Twitter, Facebook, Blogs and YouTube are on the front-line of new modern medicine. Today’s modern medicine is all about the patient.  Participating, partnering and developing a professional relationship is paramount. While many health consumers are searching the web for support, reassurance and specific health ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4872089 Fri, 27 May 2011 21:00:03 +0100 4872089 http://www.medworm.com/index.php?rid=4872091&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-avoid-dog-bites%2F2011.05.27 Last year I didn’t write about dog bite prevention until the first week of June even though I know National Dog Bite Prevention Week is always the third full of week of May. The numbers shared by the American Veterinary Medical Association (AVMA) haven’t changed:   4.7 million people are bitten by dogs each year in the US with 800,000 of them requiring medical attention. If you have read this blog for very long, you know I dearly love my dogs — deceased ones (Columbo, Ladybug (photo), and Girlfriend) and the living one, Rusty.  Still, I have no illusions that dogs bite and given the right provocation, I think mine would though most of the time they are totally harmless and would just invite you in to rob me. Sadly, children are by far the most common victims of dog bites, occu... Better Health blogs http://www.medworm.com/rss/comments.php?id=4872091 Fri, 27 May 2011 16:00:00 +0100 4872091 http://www.medworm.com/index.php?rid=4872094&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-medical-blogs-may-be-more-reliable%2F2011.05.26 Last week Aaron Sorkin wrote for The Atlantic a piece in which he details his daily news feed, in What I Read. He’s not into blogs: When I read the Times or The Wall Street Journal, I know those reporters had to have cleared a very high bar to get the jobs they have. When I read a blog piece from “BobsThoughts.com,” Bob could be the most qualified guy in the world but I have no way of knowing that because all he had to do to get his job was set up a website–something my 10-year-old daughter has been doing for 3 years. When The Times or The Journal get it wrong they have a lot of people to answer to. When Bob gets it wrong there are no immediate consequences for Bob except his wrong information is in the water supply now so there are consequences for us. PZ Meyers, whose tagline f... Better Health blogs http://www.medworm.com/rss/comments.php?id=4872094 Thu, 26 May 2011 21:00:02 +0100 4872094 http://www.medworm.com/index.php?rid=4872097&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fblogging-guidelines-for-physicians%2F2011.05.26 There’s been quite a kerfuffle over the “Unprofessional” post Dr V wrote. A lot of people have been very shrill in denouncing physicians who write about their experiences using social media — blogs, twitter, facebook, etc — with particular emphasis on those who do not use their real names. So, while I won’t tell someone how they should blog/tweet, or try to impose my vision of professional standards on a community that clearly is still coming to consensus with public conversations by healthcare workers, I will offer you my personal guidelines and values that I use in determining what I am willing to put into the public domain. These are just my opinions; your mileage may vary. As a general principle: patients give physicians and nurses access to intimate... Better Health blogs http://www.medworm.com/rss/comments.php?id=4872097 Thu, 26 May 2011 14:00:00 +0100 4872097 http://www.medworm.com/index.php?rid=4872098&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdo-you-know-how-to-recognize-deadly-bacterial-meningitis%2F2011.05.26 One of the most feared infectious diseases for outdoor travelers—particularly children and young adults—meningitis caused by the bacterium Neisseria meningitidis (meningococcus). The infection can appear in outbreaks, most commonly abroad, particularly in sub-Saharan Africa and China. The infection is spread in the respiratory secretions of humans. The disease appears in many forms, the most common of which are meningitis, pneumonia, and disseminated bacterial infection. The typical presentation of meningitis is fever, headache, and a stiff neck. If the cause is meningococcus, the victim may develop a skin rash, which consists of red dots or bumps, or a flat, more patchy dark red discoloration. If the dark red dots begin to enlarge and coalesce into large purplish bruise-like... Better Health blogs http://www.medworm.com/rss/comments.php?id=4872098 Thu, 26 May 2011 11:00:00 +0100 4872098 http://www.medworm.com/index.php?rid=4862543&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-veterinary-supplement-industry-do-the-treatments-work%2F2011.05.25 An Embarrassment of Riches? Much has been written here about the dietary supplement business, a multibillion dollar industry with powerful political connections, and about the woeful inadequacy of regulation which allows widespread marketing of supplements without a solid basis in science or scientific evidence. The veterinary supplement market is a pittance compared to the human market, but still a billion-dollar pittance that is growing rapidly. Unfortunately, the resources available for good quality research in veterinary healthcare are also a pittance, and it is not at all unusual for our pets to suffer, or even be euthanized, as a result of treatable diseases for want of money to pay for needed care. So $1 billion a year spent on nutritional supplements may not be such a good deal if ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4862543 Wed, 25 May 2011 21:00:44 +0100 4862543 http://www.medworm.com/index.php?rid=4862544&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcontraception-i-pocketcards-med-student-cheat-sheets-for-iphone%2F2011.05.25 “A baby crying is the best birth control.” – Anonymous Despite a world full of crying babies, access to effective and timely contraception remains a pressing women’s health issue. All students in the health professions learn the basics of contraception.  Most health care professionals will prescribe contraception at some point in their training or clinical practice.  Some clinicians make contraception and family planning the primary focus of their practice. Contraception i-pocketcards is a resource for each of these health care providers – from the medical student working his first gynecologic clinic to the experienced ED doctor wondering which emergency contraceptive method to use in her patient with a history of DVT. Reviewed on the iPod Touch.  Also available on the iPhone... Better Health blogs http://www.medworm.com/rss/comments.php?id=4862544 Wed, 25 May 2011 19:00:32 +0100 4862544 http://www.medworm.com/index.php?rid=4862546&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fno-single-intervention-can-cure-poor-medication-adherence%2F2011.05.25 You are sick with something-or-other and your doctor writes you a prescription for a medication.  She briefly tells you what it’s for and how to take it.  You go to the pharmacy, pick up the medication, go home and follow the instructions, right?  I mean, how hard could it be? Pretty hard, it appears.  Between 20 percent to 80 percent of us – differing by disease and drug – don’t seem to be able to do it. There are, of course, many reasons we aren’t.  Drugs are sometimes too pricey, so we don’t fill the prescription. Or we buy them and then apply our ingenuity to making them last longer by splitting pills and otherwise experimenting with the dosage. Some drugs have to be taken at specific times or under specific conditions, posing little challenge when you are taking only ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4862546 Wed, 25 May 2011 12:00:37 +0100 4862546 http://www.medworm.com/index.php?rid=4862548&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-take-back-control-of-your-google-searches%2F2011.05.24 Eli Pariser talks at TED about how we’re losing the internet to algorithmic gatekeepers at Google, Yahoo, Facebook and even our news sites, which tailor search results to what they think we want to see. Which is why I often start exploring my search results on page 10 instead of page 1. But what if some search results don’t even make it onto my queue? The side by side comparison of two different users’ internet search on the term “Egypt” during the crisis there is a stunning example of how computerized gatekeepers choose for us what we see (and don’t see) when we log on. You can’t have a functioning democracy if citizens don’t have a free flow of information. I encourage you to watch the entire video, and hope the big mahoffs of the internet sitting in the TED audience hea... Better Health blogs http://www.medworm.com/rss/comments.php?id=4862548 Tue, 24 May 2011 21:00:16 +0100 4862548 http://www.medworm.com/index.php?rid=4862549&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-tell-if-your-doctor-is-talented-at-endoscopy%2F2011.05.24 I have noticed that we all think we are the best endoscopist around (in my case, that is indeed true!). However, we really never measured colonoscopy skill as a “patient-centered” metric and instead often use speed, efficiency, sedation needs, etc. when judging our colleagues. What is more important than these measures, however, is whether we find and remove adenomas, thereby preventing colon cancer downstream in our patients. A number of surrogate markers for quality colonoscopy and polyp detection have been used in the past, including scope-withdrawal time from the cecum. But the one measure that has been the best predictor of quality is an endoscopist’s ADR (adenoma detection rate). In fact, this is the most reliable quality measure yet determined, and it may become the basis f... Better Health blogs http://www.medworm.com/rss/comments.php?id=4862549 Tue, 24 May 2011 19:00:27 +0100 4862549 http://www.medworm.com/index.php?rid=4852856&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-stop-bleeding-the-combat-application-tourniquet-and-quikclot%2F2011.05.23 The Combat Application Tourniquet Dr. Brad Bennett provided an excellent workshop at the 2010 Wilderness Medical Society annual meeting in Snowmass, Colorado on how to manage severe bleeding, based on his work with the Committee on Tactical Combat Casualty Care. From time to time, wilderness medicine practitioners encounter situations of severe bleeding, so this information is essential for anyone responsible for the health and safety of outdoor explorers and adventurers. In a simple algorithm, we learned that the first attempt to control bleeding is almost always direct hand pressure. This is followed by application of a pressure bandage. If that is successful, the victim then is evacuated. If the pressure bandage does not adequately control bleeding on the torso of the victim, t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4852856 Mon, 23 May 2011 16:00:00 +0100 4852856 http://www.medworm.com/index.php?rid=4852861&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fburning-mouth-syndrome-may-be-cured-with-magnesium-supplements%2F2011.05.22 Patients with burning mouth syndrome (BMS) have two major findings: one, burning sensations in their mouth and two, no anatomical changes present in their mouth to relate to this burning. Dr. Henkin and colleagues at the Center for Molecular Nutrition and Sensory Disorders have clinically distinguished two major groups of patients with BMS. One group has burning limited only to their tongue – called GLOSSOPYROSIS. The other group has burning in their entire mouth, including their tongue, lips, palette, gums and pharynx – called OROPYROSIS. They have recently been able to distinguish these two patient groups biochemically. Patients with GLOSSOPYROSIS have lower levels of magnesium in their red blood cells (erythrocytes) than do patients with OROPYROSIS or normal subjects. (more…) ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4852861 Sun, 22 May 2011 19:00:00 +0100 4852861 http://www.medworm.com/index.php?rid=4852862&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-new-way-to-find-a-vein-vein-lights-for-iv-access%2F2011.05.22 Here’s how we used to find a difficult vein.  If a floor nurse could not get an IV in, they asked one of their colleagues to try.  If their colleague could not find the impossible-to-locate vein, they contacted an ICU nurse.  If the ICU nurse couldn’t get one, sometimes an ER nurse or a flight nurse would try.  If they still couldn’t get an IV, then I would be paged to ask if they could get an order for an anesthesiologist to try.  And if the anesthesiologist couldn’t figure out how to find a difficult vein, we got a PICC line with the PICC nurse or with the radiologist or I placed a central line if the patient could not wait for a PICC line. That’s how we used to find a difficult IV. How do we find one now?  If you’re on the floor, you use one of ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4852862 Sun, 22 May 2011 17:00:00 +0100 4852862 http://www.medworm.com/index.php?rid=4847956&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Finsect-killing-fungus-may-provide-basis-for-new-multiple-sclerosis-treatment%2F2011.05.20 A very well-written review of an orally-active drug for multiple sclerosis has just appeared in the April 25th issue of the Journal of Natural Products, a joint publication of the American Chemical Society and the American Society of Pharmacognosy. The review, Fingolimod (FTY720): A Recently Approved Multiple Sclerosis Drug Based on a Fungal Secondary Metabolite, is co-authored by Cherilyn R. Strader, Cedric J. Pearce, and Nicholas H. Oberlies. In the interest of full disclosure, the latter two gentlemen are research collaborators of mine from Mycosynthetix, Inc. (Hillsborough, NC) and the University of North Carolina at Greensboro. My esteemed colleague and senior author, Dr. Oberlies, modestly deflected my request to blog about the publication of this review. So, I am instead writing thi... Better Health blogs http://www.medworm.com/rss/comments.php?id=4847956 Fri, 20 May 2011 18:00:24 +0100 4847956 http://www.medworm.com/index.php?rid=4847958&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Finflammatory-bowel-disease-puts-patients-at-risk-for-some-skin-cancers%2F2011.05.20 I stumbled across this review article (first full reference below) earlier this week. Skin cancer is the most common form of cancer in the United States.  Most skin cancers form in older people on parts of the body exposed to the sun or in people who have weakened immune systems (such as inflammatory bowel disease patients on immunosuppressive therapy). According to the National Cancer Institute (NCI), in there were more than one million new cases of nonmelanoma skin cancers (NMSC) in the United States in 2010.  There were less than 1,000 NMSC deaths during the same time. NMSC includes  squamous cell carcinoma (SCC) and basal cell carcinoma (BCC).   Both occur more frequently on sunlight-exposed areas such as the head and neck. BCC is far more common than SCC and accounts for approxim... Better Health blogs http://www.medworm.com/rss/comments.php?id=4847958 Fri, 20 May 2011 14:00:00 +0100 4847958 http://www.medworm.com/index.php?rid=4841475&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-hide-an-insulin-pump-under-a-wedding-dress%2F2011.05.19 Yesterday I wrote about my wedding, focusing on the parts that meant the most to me:  the man I love, our families and friends, the church service, saying “I do,” and dancing ourselves silly at the reception. But diabetes was a part of my wedding day.  We did our best to keep it quiet and unnoticed, though, using several tricky methods.  I’m like a diabetes wedding magician … sort of. First things first:  the dress.  Wearing an insulin pump is the easiest and least intrusive way for me to take my insulin, and I wasn’t about to go off the pump just for the sake of fashion.  My solution?  Design a pocket to hold my insulin pump, hidden in my wedding dress.  I spoke with the seamstress at Ye Olde Bridal Shoppe and she and I designed something that left th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4841475 Thu, 19 May 2011 19:00:02 +0100 4841475 http://www.medworm.com/index.php?rid=4841476&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmaking-sure-you-have-the-right-diagnosis-tips-from-an-internet-savvy-patient%2F2011.05.19 People generally have a sense there might be information on the Web that can help them when they are worried about their health. They also have a sense there is a LOT of information and some of it may be wrong. All of that is true. What is a strategy to find the good and avoid the bad? This morning, I chatted with Mike Collins, host of “Charlotte Talks” on WFAE, public radio in Charlotte, North Carolina about The Web-Savvy Patient and some of my “Insider Tips” within. We talked at length about how you can get started looking for health information on the Web. First of all, if you’re worried about your health, make sure you get an accurate diagnosis, and make sure that diagnosis is specific to you. Don’t be satisfied if your health care team tells you that you have a “thyroid ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4841476 Thu, 19 May 2011 17:00:27 +0100 4841476 http://www.medworm.com/index.php?rid=4841477&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-review-of-the-most-common-physician-errors-in-thinking-and-judgement%2F2011.05.19 In my recent review of Peter Palmieri’s book Suffer the Children I said I would later try to cover some of the many other important issues he brings up. One of the themes in the book is the process of critical thinking and the various cognitive traps doctors fall into. I will address some of them here. This is not meant to be systematic or comprehensive, but rather a miscellany of things to think about. Some of these overlap. Diagnostic fetishes Everything is attributed to a pet diagnosis. Palmieri gives the example of a colleague of his who thinks everything from septic shock to behavior disorders are due to low levels of HDL, which he treats with high doses of niacin. There is a tendency to widen the criteria so that any collection of symptoms can be seen as evidence of the condition. ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4841477 Thu, 19 May 2011 15:00:33 +0100 4841477 http://www.medworm.com/index.php?rid=4841479&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmost-americans-dont-know-what-healthy-eating-means%2F2011.05.19 Only one in 10 respondents to a national survey could estimate how many calories they should consume in a day. Seventy-nine percent make few or no attempts to pay attention to the balance between the calories they consume and expend in a day. These and other piquant findings from the online 2011 Food and Health Survey fielded by the International Food Information Council Foundation (IFIC) struck home last week as I smacked up against my own ignorance about a healthy diet and the difficulty of changing lifelong eating habits. The confluence of my failure to gain weight after cancer treatment and a blood test suggesting pre-diabetes meant that as of last Tuesday, I have been on an eat-specific-types-of-food-every-hour-and-write-it-down regimen.  And despite a lifetime of recommending that p... Better Health blogs http://www.medworm.com/rss/comments.php?id=4841479 Thu, 19 May 2011 12:00:13 +0100 4841479 http://www.medworm.com/index.php?rid=4841482&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-new-dna-test-for-skin-cancer-scotch-tape%2F2011.05.18 “I hate needles.” Patients say this to me everyday. When you think about it, who “likes” needles? Skin biopsies are relatively painless, but they still involve the dreaded needle and always leave scars. The trouble is we dermatologists cannot guarantee that a mole isn’t skin cancer without sending a biopsy for pathology. That is, until now. Although it is not available in clinic yet, an almost incredible new innovation might allow us to determine if a mole is cancerous by testing the DNA of the mole. It sounds like it’s from an episode of CSI, but it’s real. Melanomas have DNA (messager-RNA to be exact, but it’s a little complicated) that differentiate them from normal moles, so testing the mole for melanoma requires only a tiny sample of skin. Fortunately, no needles are ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4841482 Wed, 18 May 2011 17:00:53 +0100 4841482 http://www.medworm.com/index.php?rid=4841483&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fdrlindagalloway.files.wordpress.com%2F2011%2F05%2F1031747_hospital.jpg At one time, a hospital would be called a 24-hour institution but now it’s a business. Within this business are shift workers that include nurses, technicians, clerical staff and even hospital employed doctors who are now called hospitalists.  In a teaching hospital resident physicians also work in shifts so the responsibility of patient care is always being transferred from one group of healthcare providers to another. Do they always communicate effectively? Regrettably, “no.” Sign-outs, handoffs, shift changes, nurses’ report. These are the multiple names for the process where a departing  provider is responsible for letting the arriving provider know what’s going on with the patient.  According to statistics, 80% of medical mistakes occur during shift changes and 50 to 60% ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4841483 Wed, 18 May 2011 16:00:13 +0100 4841483 http://www.medworm.com/index.php?rid=4828880&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-is-the-best-type-of-thermometer-for-babies%2F2011.05.17 A fever in an infant can be the first sign of an illness. While a rise in body temperature above 100.4 degrees Fahrenheit is part of a healthy immune system response, it does signal potential danger and need for further evaluation. Since a reading may lead to a call or visit to the child’s doctor or emergency room, accuracy is key. What is the best type of infant thermometer? A digital rectal thermometer. This is according to such authorities as the American Academy of Pediatrics, Consumer Reports, and the American Academy of Family Physicians. The definition of a fever is important as well. According to the AAFP: A normal temperature is about 98.6°F (37°C) when taken orally (in your child’s mouth) and 99.6°F (37.5°C) when taken rectally (in your child’s bottom). Many doctors def... Better Health blogs http://www.medworm.com/rss/comments.php?id=4828880 Tue, 17 May 2011 12:29:26 +0100 4828880 http://www.medworm.com/index.php?rid=4828881&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fheart-attack-survivors-should-avoid-certain-pain-medicines-nsaids%2F2011.05.17 This study looked at patients who had already had an MI.  But for those patients, the over-the-counter pain relievers should be avoided.  Many patients with heart disease also have arthritis or other pain syndromes.  We need to come up with safe treatments for pain or use “safer” NSAIDs like low dose Naprosyn or Ibuprofen only when the benefit is weighed with the risk. Just because something is sold without a prescription does not mean it is without risk.  Tell your doctor every medication you take. *This blog post was originally published at EverythingHealth* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4828881 Tue, 17 May 2011 12:00:00 +0100 4828881 http://www.medworm.com/index.php?rid=4828885&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmorgellons-when-people-mistakenly-believe-they-have-parasites%2F2011.05.16 I saw a patient recently for parasites. I get a sinking feeling when I see that diagnosis on the schedule, as it rarely means a real parasite.  The great Pacific NW is mostly parasite free, so either it is a traveler or someone with delusions of parasitism. The latter comes in two forms: the classic form and Morgellons. Neither are likely to lead to a meaningful patient-doctor interaction, since it usually means conflict between my assessment of the problem and the patients assessment of the problem.  There is rarely a middle ground upon which to meet. The most memorable case of delusions of parasitism I have seen was a patient who  I saw in clinic who, while we talked, ate a raw garlic clove about every minute. “Why the garlic?” I asked. “To keep the parasites at bay,” he told ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4828885 Mon, 16 May 2011 13:00:07 +0100 4828885 http://www.medworm.com/index.php?rid=4828831&cid=t_104949_87_f&fid=34935&url=http%3A%2F%2Fmedicine.com.my%2Fwp%2Findex.php%2F2011%2F05%2F16%2Fget-immunised%2F Great video by ZdoggMD (via Kevin MD) It is pretty unfortunate that the internet abounds with anti-vaccination misinformation, in part from pretty much discredited “work” by Andrew Wakefield. Malaysia is not spared too for there may be parents influenced by so much misinformation in the Internet about vaccination. In the past there have also been misguided communities such as the religious sect which refused vaccination resulting in a poliomyelitis outbreak in 1992. The only solution seems to be constant education but it is an uphill battle. Further reading: How pediatricians should handle families who refuse vaccines (KevinMD.com) from the Malaysian Medical ResourcesGet immunised! (Source: Malaysian Medical Resources) Malaysian Medical Resources blogs http://www.medworm.com/rss/comments.php?id=4828831 Sat, 14 May 2011 23:00:00 +0100 4828831 http://www.medworm.com/index.php?rid=4820853&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftips-for-physicians-on-handling-their-online-persona%2F2011.05.13 Like everybody else, physicians are expanding their online personal identities. At the same time, they are trying to comply with codes of conduct that help consumers trust them and their profession. There’s no problem so long as the personal online activities of physicians don’t jeopardize their obligations as professionals, which means that there is a problem, unfortunately. In a recent study for example, 17% of all blogs authored by health professionals were found to include personally identifiable information about patients. Scores of physicians have been reprimanded for posting similar information on Twitter and Facebook, posting lewd pictures of themselves online, tweeting about late night escapades which ended hours before they performed surgery, and other unsavory behaviors. A... Better Health blogs http://www.medworm.com/rss/comments.php?id=4820853 Fri, 13 May 2011 12:00:59 +0100 4820853 http://www.medworm.com/index.php?rid=4820854&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftips-for-physicians-dealing-with-difficult-colleagues%2F2011.05.12 Recently I attended a CME course entitled “Dealing with Difficult Colleagues.”  It was part of my medical malpractice company’s risk management series to teach physicians/nurses how to lessen our risk of being sued. This lecture was given by Linda Worley, MD who is a psychiatry professor at UAMS.  She is a good speaker, easy to understand, engages the crowd, and knows her subject. My only complaint would be that it focused only the “angry” or “frustrated” physicians who exhibit unprofessional behavior and did not include the ones whom you suspect might be difficult due to impairment (illness, drugs, alcohol). Difficult colleagues can impact a team (in office, OR, or hospital) by creating low morale, high staff turnover, inefficiency, decreased patient satisfaction, increase... Better Health blogs http://www.medworm.com/rss/comments.php?id=4820854 Thu, 12 May 2011 21:00:00 +0100 4820854 http://www.medworm.com/index.php?rid=4813285&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdo-you-look-good-in-a-bathing-suit-dr-val-offers-summer-fitness-tips-to-abc-news%2F2011.05.11 The weather is heating up, and soon most of us will be back in shorts and t-shirts…  and worrying about looking good in our dreaded bathing suits. I had the opportunity to offer some evidence-based weight loss and fitness tips to ABC News in Washington, DC. You can view the clip or read my summary below: (more…) (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4813285 Wed, 11 May 2011 22:51:19 +0100 4813285 http://www.medworm.com/index.php?rid=4813287&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcould-a-low-salt-diet-be-bad-for-your-heart%2F2011.05.11 In this study of 3,681 men and women from Belgium, Bulgaria, Italy, Poland, Romania and Russia whose health was followed for eight years, participants with the lowest sodium excretion (which is a good measure of sodium intake) were 56% more likely to have died from cardiovascular disease than those with the highest sodium excretion. Among the nearly 2,100 participants with normal blood pressure at the study’s start, sodium excretion (sodium intake) had no effect on the development of high blood pressure. These are startling findings. If true, they would undercut major programs by the U.S. government to reduce Americans’ intake of salt—the main source of sodium—from prepared and processed foods and at home. (more…) *This blog post was originally published at Harvard ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4813287 Wed, 11 May 2011 16:00:07 +0100 4813287 http://www.medworm.com/index.php?rid=4813290&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fdrlindagalloway.files.wordpress.com%2F2011%2F05%2F350by403.jpg If a pregnant woman finds herself scratching and itching during the third trimester, these symptoms should not be ignored. Each year, approximately 0.1 to 15% of pregnant women are affected by a liver disorder called Intrahepatic Cholestasis of Pregnancy or (ICP). ICP patients tend to develop symptoms of itchiness of their hands and feet that becomes progressively worse and then spreads all over their body. The itchiness usually worsens at night and if untreated can cause jaundice and several life-threatening complications to the unborn fetus. When a pregnant woman complaints of itchiness (pruritus) all over her body, the first order of business is to determine whether a rash is present. If a rash is absent, ICP should be suspected. The liver is the largest gland in the body and in additio... Better Health blogs http://www.medworm.com/rss/comments.php?id=4813290 Tue, 10 May 2011 21:00:28 +0100 4813290 http://www.medworm.com/index.php?rid=4803132&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fplavix-and-the-purple-pill-are-they-really-a-dangerous-combination%2F2011.05.10 When the medical press seizes a story, it can become an obsession. Any physician who is reading any journal is aware of the reported interaction between clopidrogel (Plavix) and proton pump inhibitor (PPI) drugs, including Prilosec and her cousins. PPI medicines are not exotic elixirs known only to medical professionals. They are known to any person with a working TV set or who still reads a newspaper, since ads for these drugs are omnipresent. Just google ‘purple pill’ and begin your entrance into the PPI Chamber of Advertising. PPI medicines are highly effective for peptic ulcers and gastroesophageal reflux, although I suspect that most patients on these medications do not have any true indication for them. (Disclosure: I’ve pulled the PPI trigger too quickly on many patients who d... Better Health blogs http://www.medworm.com/rss/comments.php?id=4803132 Tue, 10 May 2011 14:05:51 +0100 4803132 http://www.medworm.com/index.php?rid=4803135&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcalcium-supplements-good-for-your-bones-but-bad-for-your-heart%2F2011.05.10 Calcium is good for us, right? Milk products are great sources of calcium, and we’re told to emphasize milk products in our diets. Don’t (or can’t) eat enough dairy? Calcium supplements are very popular, especially among women seeking to minimize their risk of osteoporosis. Osteoporosis prevention and treatment guidelines recommend calcium and vitamin D as an important measure in preserving bone density and reducing the risk of fractures. For those who don’t like dairy products, even products like orange juice and Vitamin Water are fortified with calcium. The general perception seemed to be that calcium consumption was a good thing – the more, the better. Until recently. In a pattern similar to that I described with folic acid, there’s new safety signals from trials with calciu... Better Health blogs http://www.medworm.com/rss/comments.php?id=4803135 Tue, 10 May 2011 13:00:59 +0100 4803135 http://www.medworm.com/index.php?rid=4803136&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsafe-injection-protocols-are-not-being-followed-by-clinicians%2F2011.05.10 Thanks to Laura Landro for shining light on unsafe injections in her WSJ blog, “Unsafe Injection Practices Persist Despite Education Efforts.” Landro writes: “A new push is underway to eliminate unsafe injection practices, which remain a persistent safety problem despite years of efforts to educate clinicians about the risks of re-using needles, syringes and drug vials. In the U.S., failure to follow safe practices in delivering intravenous medications and injections has resulted in more than 30 outbreaks of infectious disease including hepatitis C, and the notification of more than 125,000 patients about potential exposure just in the last decade, according to health-care purchasing alliance Premier Inc.” As a registered nurse this is unthinkable.  Learning to administer injectio... Better Health blogs http://www.medworm.com/rss/comments.php?id=4803136 Tue, 10 May 2011 11:00:38 +0100 4803136 http://www.medworm.com/index.php?rid=4803137&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffree-iphone-app-for-cancer-patients-a-must-have-tool-from-asco%2F2011.05.09 Cancer.net, an oncologist approved cancer information site from the American Society of Clinical Oncology (ASCO), has released a free iPhone and iPad app — full of handy features for cancer patients. The free app allows cancer patients and their family members to look up pertinent information based on cancer type and download a wealth of oncology related information in the form of videos, podcasts, and up to date articles. Where the app truly shines is in there key features: Ability to store questions, medications and symptoms.  The way this app implements these key features is absolutely stunning, and makes the application a must have for cancer patients and their family members. This review will explore these features and how your patients can use this app. Questions (more…) ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4803137 Mon, 09 May 2011 22:00:57 +0100 4803137 http://www.medworm.com/index.php?rid=4797769&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffree-throat-head-neck-cancer-screenings-may-overstate-their-effectiveness%2F2011.05.08 All over the country in May, hospitals are offering “Free Throat Cancer Screening.” A Google search turned up dozens of results for that specific term or the related “oral, head and neck cancer screening.” Here’s one example, promoting “Oral, Head and Neck Cancer Awareness Week, May 8-14.” This promotion uses ominous warnings: Can you live without your voice? What about your jaw? Would you miss it if you couldn’t swallow food? Throat cancer can take all of those things away, along with your ability to eat, talk and breathe normally. These debilitating problems can be prevented, but you have to catch cancer early. Some promotions – such as this one – use celebrity pitches such as “If it happened to Michael Douglas, it can hap... Better Health blogs http://www.medworm.com/rss/comments.php?id=4797769 Sun, 08 May 2011 13:11:37 +0100 4797769 http://www.medworm.com/index.php?rid=4797770&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdont-believe-the-hype-about-smartlipo-a-laser-liposuction-procedure%2F2011.05.08 It frequently amazes me how patients can be wowed by technology and advertising hype. The attraction of newer technology in particular helps part many people from their money at times. The SmartLipo system is one of the laser-assisted liposuction systems on the market. I have blogged on it before having used it quite a bit a few years ago. The system is being marketed with phrases like “almost anyone can be a good candidate for SmartLipo.” That is simply BS. I saw an attractive young woman in the office who had had Smartlipo on her lower back. It looked like the Geiko Gecko had done it. Her smooth contour had been made irregular and discolored despite the fact that the surgery had happened quite a while prior. Her ribs had been a bit exposed by the loss of some of the fat that would no... Better Health blogs http://www.medworm.com/rss/comments.php?id=4797770 Sun, 08 May 2011 12:00:48 +0100 4797770 http://www.medworm.com/index.php?rid=4797772&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-we-women-cant-win-liposuction-and-fat-redistribution%2F2011.05.07 Here’s the tweet I posted Sunday evening: I’ve told pts this for years now>>> Liposuction Study Finds That Lost Fat Returns – http://nyti.ms/kheltN The New York Times article reports on a liposuction study published in the April issue of the journal Obesity (full reference below).   The NY Times article uses this photo as graphic illustration and a quote from a plastic surgeon who says he is surprised. Dr. Felmont Eaves III, a plastic surgeon in Charlotte, N.C., and president of the American Society for Aesthetic Plastic Surgery, said the study was “very well done,” and the results were surprising. He said he would mention it to his patients in the context of other information on liposuction. I have told my patients for years to consider the fat cells in their... Better Health blogs http://www.medworm.com/rss/comments.php?id=4797772 Sat, 07 May 2011 22:00:00 +0100 4797772 http://www.medworm.com/index.php?rid=4797773&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatient-education-at-its-best-an-example-from-griffin-hospital%2F2011.05.07 A vital aspect of participatory medicine is helping patients learn how to participate. This week I saw a great example of someone who’s doing it right. Here’s the story, including the patient aid for download. We hear a lot about “patient-centered”: patient-centered care, patient-centered thinking, everything. Frankly, a lot of it strikes me as patient-centered paternalism: people mean well, but patients sense that the thinking didn’t happen while standing in patients’ shoes, because the advice, policies, and publications just don’t hit home. It’s like somebody guessed what you want, instead of knowing (because they’re like you). A couple of years ago I learned about Planetree, a terrific, small organization in Connecticut that’s been thinking from the patient’s point... Better Health blogs http://www.medworm.com/rss/comments.php?id=4797773 Sat, 07 May 2011 20:00:15 +0100 4797773 http://www.medworm.com/index.php?rid=4789244&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-competitive-cyclists-undergo-cardiac-ablation-for-atrial-fibrillation%2F2011.05.06 The number of emails that come from fellow cyclists (and endurance athletes) with heart rhythm issues amazes me. I am more convinced than ever that our “hobby” predisposes us to electrical issues like atrial fibrillation (AF)—that the science is right. Obviously, my pedaling “habit” creates an exposure bias. I hear from many of you because we cyclists understand each other. Like you, I consider not competing a lousy treatment option. As a bike racer, I know things: that prancing on an elliptical trainer at a health club doesn’t cut it, and, that spin classes may look hard, but do not come close to simulating real competition. I know the extent of the inflammation required to close that gap, to avoid getting dropped when one of the local Cancellara-types have you in the gutter i... Better Health blogs http://www.medworm.com/rss/comments.php?id=4789244 Fri, 06 May 2011 08:38:25 +0100 4789244 http://www.medworm.com/index.php?rid=4789246&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-promising-new-treatment-for-blocked-ears%2F2011.05.05 Eustachian tube dysfunction is a phenomenon whereby a person is unable to pop their ears to relieve symptoms of ear pressure, clogging, or fullness. It is much akin to the ear pressure a person experiences when flying, but at ground level. Traditionally, treatment of this condition involved medications like steroid nasal sprays and prednisone along with active valsalva. Once medical treatment has failed, ear tube placement has been the step of last resort. However, a promising new treatment called eustachian tube balloon dilation has been described in March 2011 to address eustachian tube dysfunction at the source surgically rather than indirectly with tube placement across the eardrum. In essence, a balloon is inserted into the eustachian tube and than inflated thereby opening it up (the ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4789246 Thu, 05 May 2011 18:00:00 +0100 4789246 http://www.medworm.com/index.php?rid=4789252&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffluphone-tracks-super-spreaders-of-disease%2F2011.05.04 “Are you a super-spreader?” That’s the catchphrase for a new study out of the University of Cambridge. However, if you answered “yes”, you may want to stay home and cover your mouth, because the study was designed to track the spread of influenza using cellular phone technology. The study (and accompanying app) is called FluPhone, and it uses cell phones to collect information on social encounters within the study sample of participants in Cambridge. A phone’s Bluetooth antenna detects encounters with other participants and also records the proximity to each other. The built-in GPS chip tracks each user’s location, but this feature was disabled due to recent ethical concerns. Finally, the phone’s 3G/GPRS antenna sends all the proximity data a... Better Health blogs http://www.medworm.com/rss/comments.php?id=4789252 Wed, 04 May 2011 16:00:55 +0100 4789252 http://www.medworm.com/index.php?rid=4775396&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fjudging-illness-severity-and-the-financial-implications-of-dialing-911%2F2011.05.01 Nora misjudged the height of the stair outside the restaurant, stepped down too hard, jammed her knee and tore her meniscus.  Not that we knew this at the time.  All we knew then was that she was howling from the pain. There we were on a dark, empty, wet street in lower Manhattan, not a cab in sight, with a wailing, immobile woman.  What to do?  Call 911? Find a cab to take her home and contact her primary care doctor for advice?  Take her home, put ice on her knee, feed her Advil and call her doctor in the morning? Sometimes it is clear that the only response to a health crisis is to call 911 and head for the emergency department (ED).  But in this case – and in so many others we encounter with our kids, our parents, our co-workers and on the street – the course of action is les... Better Health blogs http://www.medworm.com/rss/comments.php?id=4775396 Sun, 01 May 2011 16:00:04 +0100 4775396 http://www.medworm.com/index.php?rid=4767994&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbeer-bellies-anyone-waist-measurement-can-determine-risk-for-heart-disease%2F2011.04.30 Extra fat that accumulates around the abdomen goes by many names: beer belly, spare tire, love handles, apple shape, middle-age spread, and the more technical “abdominal obesity.” No matter what the name, it is the shape of risk. Abdominal obesity increases the risk of heart attack, stroke, diabetes, erectile dysfunction, and other woes. The danger zone is a waist size above 40 inches for men and 35 inches for women. As I describe in the April 2011 issue of the Harvard Men’s Health Watch, beer is not specifically responsible for a beer belly. What, then, is to blame? Calories. Take in more calories with food and drink than you burn up with exercise, and you’ll store the excess energy in fat cells. Many studies indicate that people who store their extra fat around the midsection (ap... Better Health blogs http://www.medworm.com/rss/comments.php?id=4767994 Sat, 30 Apr 2011 12:00:10 +0100 4767994 http://www.medworm.com/index.php?rid=4767995&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Foops-pre-term-labor-drug-does-more-harm-than-good-to-pregnant-moms%2F2011.04.29 The Federal Drug Administration (FDA) recently issued a new warning about a medication that has been used for years and it has sent shock waves throughout my specialty. Terbutaline is an FDA approved medication that is used for asthmatic patients or patients who have significant narrowing of the airways. However for years it has been used as an “off-label” medication to treat preterm labor but now that’s about to change. An off-label drug means it hasn’t been approved for that specific use by the FDA. According to the FDA, the injectable form of Terbutaline should only be used for a maximum of 24 to 72 hours because the drugs association with heart problems and death.  The FDA goes on to say that the oral version (pills) should not be prescribed to treat preterm labor because it�... Better Health blogs http://www.medworm.com/rss/comments.php?id=4767995 Fri, 29 Apr 2011 23:00:30 +0100 4767995 http://www.medworm.com/index.php?rid=4762765&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmarathon-runners-may-benefit-from-a-carbohydrate-calculator%2F2011.04.28 Recently, about 27,000 runners began the annual 26-mile, 385-yard (42.195 kilometers) mass run from suburban Hopkinton to Boston. But if past marathons in Boston and elsewhere are any indication, perhaps up to 40% of these optimistic and determined souls will slam into a sudden sensation of overwhelming, can’t-do-this fatigue several miles (typically about five) before they get a chance to experience the glory of crossing the finish line. It’s called “hitting the wall.” Getting through, around, or over hitting the wall is part of the mystique of marathon running, although there’s a physiological explanation that’s not all that mysterious: when runners hit the wall, their bodies have run out of the carbohydrates needed to sustain intense physical activities like long-distance r... Better Health blogs http://www.medworm.com/rss/comments.php?id=4762765 Thu, 28 Apr 2011 23:00:06 +0100 4762765 http://www.medworm.com/index.php?rid=4762768&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmuscle-strain-should-you-treat-it-with-hot-packs-or-cold-packs%2F2011.04.28 Along with blisters and sprains, muscle strains are among the most common afflictions for active persons in the outdoors. Common medical dogma is to use the “RICE”  approach for sprains and strains of—rest, ice (application of cold), compression, and elevation. This is more applicable to sprains (e.g., an ankle sprain) than to strains, because the sprained body part is usually a limb (ankle, knee, wrist) that is amenable to this approach. Strains more often involve larger muscle groups, such as those in the back, chest, thigh or abdomen, or difficult-to-approach areas, such as the neck or groin. Prevailing theory for treatment of a muscle strain is that one applies external cold for 24 to 48 hours, and discontinues it after 72 hours, at which time one begins application of e... Better Health blogs http://www.medworm.com/rss/comments.php?id=4762768 Thu, 28 Apr 2011 15:00:00 +0100 4762768 http://www.medworm.com/index.php?rid=4758753&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-patients-attack-is-self-defense-legally-dangerous%2F2011.04.27 Sideways Shrink posed a great question recently in a comment on my post “When A Thick Skin Helps.” The question was whether or not physicians are allowed to hit a patient who tries to assault them. Certainly, physical assaults on patients are not the standard of practice in psychiatry or any other medical specialty. Psychiatrists do undergo some training about physical management of violent patients: I remember in residency we had to get trained in “take down” and restraint procedures. As a group we practiced applying pressure point joint locks on each other in order to make a patient break a grip on us, and to do two person restraints to hold someone immobile until security could arrive. None of this involved any “Crouching Tiger, Hidden Dragon”-type ku... Better Health blogs http://www.medworm.com/rss/comments.php?id=4758753 Wed, 27 Apr 2011 19:00:00 +0100 4758753 http://www.medworm.com/index.php?rid=4753690&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcan-you-catch-genital-herpes-when-there-are-no-lesions%2F2011.04.26 The answer might seem obvious, but I get this question often in clinic. In particular, patients want to know if genital herpes is contagious even if they or their partner is not having an outbreak. The answer is yes. Genital herpes is a common sexually transmitted disease and is highly contagious. Although the risk of infecting someone else is much higher if you’re having an outbreak, it is still possible to transmit the virus, called HSV, even if you have no symptoms. About 1 in every 6 adults has genital herpes. Once you have herpes, there is way to cure it. It is common to have recurring outbreaks especially in the first year, but in most people these lessen over time. The only way to ensure you won’t get herpes is to abstain from sexual contact or to be in a monogamous relationsh... Better Health blogs http://www.medworm.com/rss/comments.php?id=4753690 Tue, 26 Apr 2011 22:00:13 +0100 4753690 http://www.medworm.com/index.php?rid=4742384&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-minor-requests-a-labiaplasty-what-should-the-plastic-surgeon-do%2F2011.04.22 Reader Question: I am 16 in Orange County and want a labia reduction. Can I have it without telling my parents? For those of you who may not know, labiaplasty (sometimes called labioplasty) is an operation to change the shape of the labiae, a woman’s outer genitals. It can be performed for cosmetic or functional concerns. Some women with large labiae experience pain with tighter garments and in rare circumstances they can get in the way of sexual relations. The operations are different things to different surgeons and have been controversial to say the least. Quite a bit in the practice of surgery of the privates is a matter of the surgeon’s philosophy. This includes the design and scope of the operation as we’ve mentioned. Traditionally for any surgery on a patient under the age of... Better Health blogs http://www.medworm.com/rss/comments.php?id=4742384 Fri, 22 Apr 2011 20:00:03 +0100 4742384 http://www.medworm.com/index.php?rid=4742388&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthings-you-can-learn-from-a-bad-nurse%2F2011.04.21 My husband had a screening colonoscopy last Friday.  His nurse in the recovery is the only one I had issues with.  I, not my husband. All went well, but let me tell you he is not an ePatient Dave.  He did not read his instructions about when to quit eating and the prep.  I did.  I then reminded him along the way:  “Only clear liquids today.”  “You must take the Ducolax at 3 pm.  Do you want me to text you a reminder?” Sometimes the instructions we give patients are clear, but not always read. The staff at the front desk were very kind and organized.  Calls had been made the day before and I had insured the insurance information they had was correct.   I did not tell anyone I was a doctor.  I’m not sure if my husband did later or not. ….. When I was called back by th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4742388 Thu, 21 Apr 2011 23:00:00 +0100 4742388 http://www.medworm.com/index.php?rid=4734096&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhomeopathy-why-is-fraud-legal%2F2011.04.21 Imagine hearing a commercial on the radio: Send us money, and we won’t send you anything in return. No one would do that, right? How about this: Send us your money and we’ll send you an empty box. Better? Not much. Now how is that different from: Send us money and we’ll send you stuff we’ll call medicine that we claim will help you, but there’s no actual active ingredients in it at all. I don’t think there’s one bit of difference. Wouldn’t you agree that that commercial is fraud, pure and simple? The problem is that the general public doesn’t understand that the word “homeopathic” means “diluted beyond the point where it contains any active ingredients.” I’ve recently heard commercials for homeopathic vertigo treatments, eye drops for allergies, irritable bowel,... Better Health blogs http://www.medworm.com/rss/comments.php?id=4734096 Thu, 21 Apr 2011 15:00:16 +0100 4734096 http://www.medworm.com/index.php?rid=4734100&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fquiz-dont-let-look-alikesound-alike-medication-cause-you-harm%2F2011.04.20 Imagine your mother telling you she’s starting a new pain medicine, only to learn that she ended her life three days later due to a medication error. That’s exactly what happened to Linda Sanders, a 62 year old woman who thought she was getting the pain reliever Lyrica, but she accidently got Lamictal, an antiseizure medication. The mistake was probably caused by the similarity in the two medications names. Unfortunately, suicide is a known risk associated with Lamictal therapy. Medication mistakes involving pain-relievers have consequences that range from inconvenient to potentially deadly. Why are errors fairly common and potentially serious with this group of medications? There are an estimated 75 million Americans who suffer with chronic pain, which results in a lot of prescription... Better Health blogs http://www.medworm.com/rss/comments.php?id=4734100 Wed, 20 Apr 2011 21:00:17 +0100 4734100 http://www.medworm.com/index.php?rid=4723802&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsuggestions-for-stress-reduction-from-harvard%2F2011.04.18 It happens to everyone from time to time: a thorny issue sprouts up, a worry takes root. Soon those roots dig in so deeply and spread so wide that they leave little room for anything else to grow. Worrying, searching for a solution, and forecasting the future move from preoccupation to full-time work. When that starts to happen, it’s critical to call a timeout, explain stress experts Herbert Benson, MD, and Aggie Casey, the medical editors of Harvard Medical School’s Stress Management Special Health Report. Certain hormones fuel the body’s stress response (also dubbed “fight-or-flight”), speeding breathing and heartbeat, directing extra blood flow to the brain and muscles, perking up the immune system, and triggering other changes that prepare your body to respond to a perceived ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4723802 Mon, 18 Apr 2011 13:00:52 +0100 4723802 http://www.medworm.com/index.php?rid=4723804&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fyouve-heard-of-kidney-stones-but-did-you-know-you-could-get-a-salivary-gland-stone%2F2011.04.17 The Doctors TV show actually produced a great (and accurate) segment on a relatively new procedure called sialendoscopy. This procedure allows a surgeon to remove a stone that may be blocking your spit gland from draining saliva into the mouth. This is analogous to a kidney stone which blocks urine from draining from the kidney into the bladder resulting in painful swelling of the kidney (causing flank pain). How does a person know if they have a salivary gland blockage due to a stone? There is a painful swelling located right in front and/or below the ear if the parotid gland is affected, or under the jawbone if the submandibular gland is blocked. If the blockage persists long enough, it may lead to an infection of the gland itself (sialadenitis). (more…) *This blog post ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4723804 Sun, 17 Apr 2011 21:00:00 +0100 4723804 http://www.medworm.com/index.php?rid=4723809&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fct-scans-for-kids-is-the-radiation-exposure-dangerous%2F2011.04.16 There was an interesting study published this week in the journal Radiology: Rising Use of CT in Child Visits to the Emergency Department in the United States, 1995–2008 (Abstract) The results are not surprising to anyone who has been working in medicine in the US over the last fifteen years. Basically, in 1995, a kid visiting the ER had a 1.2% likelihood of getting a CT scan, and by 2008, that number was 5.9%. I had written about this general phenomon not too long ago, in defense of the general increase of CT utilization in the ER, largely on the basis that CT is a better tool: it provides diagnoses in a rapid and timely manner, and excludes many potential life threats, saving lives and mitigating malpractice risk. That was largely relevant to the adult population, though, and kids are ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4723809 Sat, 16 Apr 2011 17:00:00 +0100 4723809 http://www.medworm.com/index.php?rid=4723810&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fannouncing-a-health-journalist-toolkit-to-help-get-the-facts-straight%2F2011.04.16 Beyond just evaluation and constructive criticism of news stories, we want to reach out to help journalists. We know they often struggle with reporting on the costs of treatments, tests, products and procedures. It’s reflected in the facts: after 5 years and nearly 1,500 stories reviewed, we don’t like to report that more than 70 percent of stories fail to adequately address the costs of the stuff they’re covering. So we talked with journalists and others to assemble our first stab (and that’s all it is – a first stab) at an online list of resources to help journalists explore the costs of health care products and approaches. There are some links to websites, names, email addresses and phone numbers. This is just one of many primers and resources offered on ou... Better Health blogs http://www.medworm.com/rss/comments.php?id=4723810 Sat, 16 Apr 2011 15:00:27 +0100 4723810 http://www.medworm.com/index.php?rid=4714742&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpain-management-one-size-doesnt-fit-all%2F2011.04.14 When it comes to treating chronic pain such as arthritis or low back pain, it’s important to remember that what works for one patient may not work for the next patient. Some people are able to control their pain by taking a nonprescription medication such as acetaminophen (Tylenol), while others may need an opioid (also known as narcotics). Tablets or capsules containing the opioid hydrocodone plus acetaminophen (known as Vicodin or Lortab) are among the most commonly dispensed medications in the US. But remember: just because this medication is popular doesn’t make it the best pain reliever for everyone! For example, a recent study showed the older adults who were prescribed a short-acting opioid such as hydrocodone or oxycodone (e.g., Percocet) were twice as likely to break a bone in... Better Health blogs http://www.medworm.com/rss/comments.php?id=4714742 Thu, 14 Apr 2011 19:00:06 +0100 4714742 http://www.medworm.com/index.php?rid=4714744&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffood-and-migraine-headaches-triggers-are-hard-to-predict%2F2011.04.14 At a Harvard Medical School talk on migraine and food, a nutritionist from Harvard-affiliated Beth Israel Deaconess Medical Center delivered a message that people in the audience probably didn’t want to hear: “There are no specific dietary recommendations for migraine sufferers,” said Sandra Allonen. But she did have some advice to offer—and she emphasized that the connection between food and migraine is a very individual one. Several foods have been associated with triggering migraine. None of them has been scientifically proven to cause migraines, explained Allonen, but many people report a link between eating these foods and getting a migraine. Possible migraine triggers include: (more…) *This blog post was originally published at Harvard Health Blog* (Source: Be... Better Health blogs http://www.medworm.com/rss/comments.php?id=4714744 Thu, 14 Apr 2011 17:00:29 +0100 4714744 http://www.medworm.com/index.php?rid=4709204&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhat-makes-a-good-therapist%2F2011.04.13 This is for Dr. D. We were having lunch when Dr. D mentioned she wanted to write a book aimed at teaching residents how to do psychotherapy. It would start with a section on What Makes a Good Therapist? What does she thinks makes a good therapist? Real life experiences which impart an ability to empathize. Do we grow from our own difficulties? More specifically, do we grow in to better therapists? I asked another shrink this, and he said that people like to believe there is some meaning to their suffering, and perhaps it’s nice to believe that if you’ve been stuck suffering, then it makes you a better therapist, but he wasn’t so convinced it was true. Me? I don’t know, maybe. Or maybe not. Personally, I’m fine with the idea of not suffering, at all, ever agai... Better Health blogs http://www.medworm.com/rss/comments.php?id=4709204 Wed, 13 Apr 2011 20:00:00 +0100 4709204 http://www.medworm.com/index.php?rid=4704655&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhormone-replacement-therapy-what-weve-learned-from-the-womens-health-initiative%2F2011.04.12 This is the study that doesn’t end… The longterm follow up extends… Some people started studying hormones in menopause, And they’ll continue publishing more data just because… (repeat) In yet another paper in a major journal, we hear once more from the investigators of the Women’s Health Initiative. This time it’s the long term outcomes of women who took estrogen alone, now seven years out from stopping their hormones. What new information can we learn from this extensive analysis of new data? Nothing. Really. The WHI’s been telling us the same thing about ERT (Estrogen replacement therapy) and HRT (Combination estrogen/progestin therapy)  since 2002, and all each subsequent study does is reinforce and expand on that initial data. Unfortunately, it will probably take a fe... Better Health blogs http://www.medworm.com/rss/comments.php?id=4704655 Tue, 12 Apr 2011 21:00:20 +0100 4704655 http://www.medworm.com/index.php?rid=4696622&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdense-nasal-hair-may-reduce-asthma-risk-in-allergy-sufferers%2F2011.04.10 Researchers in Turkey found that there is an association between nasal hair density and risk of asthma developing in patients with seasonal rhinitis patients. No joke… They published their findings in the International Archives of Allergy and Immunology in March 2011. The rate of asthma found in patients with little or no nasal hair was 44.7% whereas only 16.7% of patients with a dense forest of nasal hair had asthma. They hypothesize that increased nasal hair improves allergen filtration thereby preventing the allergens from irritating the airway. The assumption here being that allergen irritation of the airway can potentially cause asthma. IF this is true (and that’s a big if)… patients with allergies should be encouraged to grow nice thick nasal hair to prevent future ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4696622 Sun, 10 Apr 2011 15:00:00 +0100 4696622 http://www.medworm.com/index.php?rid=4696623&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbaseball-safety-should-we-ban-non-wood-bats%2F2011.04.10 Opening Day, the first day of the 2011 major league baseball season, was March 31st. The first pitch was thrown a little after 1 p.m., and sometime after that baseball fans heard the first crack of the bat of a brand-new season. Even nonfans can rejoice at this sign of spring, and a promise that summer days are ahead. But you won’t hear the crack of the bat very much these days from other diamonds—Little League, high school, and college. It has been replaced by pings and thunks as most players at those levels now use metal bats or composite ones, which that are made with a mixture of materials, including graphite. Players started using metal (usually aluminum) bats about 30 years ago. They last longer than wooden bats and send the ball farther. The composite models have come on strong ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4696623 Sun, 10 Apr 2011 12:00:17 +0100 4696623 http://www.medworm.com/index.php?rid=4693289&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpositive-message-of-the-day%2F2011.04.08 Source: thatshappy.blogspot.com via Dawn on Pinterest *This blog post was originally published at On Becoming a Domestic and Laboratory Goddess* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4693289 Fri, 08 Apr 2011 12:00:16 +0100 4693289 http://www.medworm.com/index.php?rid=4684318&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-much-vitamin-d-do-you-need%2F2011.04.06 How much vitamin D is enough, and what’s the best way to get your daily dose of the so-called sunshine vitamin? It depends who you ask. I just attended the latest Forum at the Harvard School of Public Health. The title, “Boosting Vitamin D: Not Enough or Too Much?” was a tip-off that we weren’t going to get a simple take-home message. (Watch a video of the event beginning Wednesday, March 30.) Some background: Vitamin D isn’t really a vitamin. It’s a hormone. The body makes it when sunlight strikes the skin. This converts a cousin of cholesterol into a substance that ultimately becomes vitamin D. It is best known for helping the digestive system absorb calcium and phosphorus, so it is important for bone health. New research suggests—emphasis on suggests—that vitamin D may ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4684318 Wed, 06 Apr 2011 23:00:03 +0100 4684318 http://www.medworm.com/index.php?rid=4684322&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmaternal-death-why-is-it-four-times-higher-for-african-americans%2F2011.04.06 When we hear about maternal death, we immediately think of a third world country but in reality, 2 to 3 women die every day in the U.S. from pregnancy and childbirth. Unfortunately, African American women are affected disproportionately and are four times more likely to die than anyone else. The tragedy is that at least half of these deaths are preventable. In her article, Special Report: Black Women Die Nearly Four Times the Rate of White Women From Pregnancy Complications, Rita Henley Jensen, describes the dilemma of the acting chief of the maternal and infant unit of CDC, Dr. William Callaghan. Callaghan can’t sleep at night because he wants to know why pregnancy is more dangerous for U.S. African American women. During my residency training, I witnessed a maternal death. (more…... Better Health blogs http://www.medworm.com/rss/comments.php?id=4684322 Wed, 06 Apr 2011 12:00:37 +0100 4684322 http://www.medworm.com/index.php?rid=4684323&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fipad-cover-used-in-kitchens-could-also-be-used-in-hospitals%2F2011.04.05 Apple iPads are taking the clinical world by storm, but they’re not exactly built for a busy environment full of liquids, dirty hands, and pathogens. The Chef Sleeve is a plastic wrapping originally designed to help cooks prevent their iPads from getting hit by a splash of this and a dash of that. The plastic is compatible with the touch screen, provides basic protection, and won’t require you to sterilize it before bringing it home from the hospital. At $20 for 25 sleeves, your new baby can get the basic protection it deserves. Product page: Chef Sleeve… *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4684323 Tue, 05 Apr 2011 22:00:53 +0100 4684323 http://www.medworm.com/index.php?rid=4676784&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-psychological-price-of-surviving-cancer%2F2011.04.04 One of my closest friends is a two-time breast cancer survivor. Terry (as I’ll call her) has been cancer free for eight years—long enough to be considered cured (generally defined as being in remission at least five years). But in no way is she “free” of cancer. Every abnormal blood test, every callback for another mammogram terrifies her so badly she can’t sleep until doctors rule out a recurrence. In some ways, the ongoing psychological and emotional challenges she faces have been worse than the physical treatments she endured. I thought about Terry when I read the latest government statistics on the number of cancer survivors in this country. Nearly 12 million Americans—4% of the population—are still alive after a cancer diagnosis. In many respects this is terrific news, a... Better Health blogs http://www.medworm.com/rss/comments.php?id=4676784 Mon, 04 Apr 2011 23:00:47 +0100 4676784 http://www.medworm.com/index.php?rid=4676787&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fheartburn-bugs-have-become-antibiotic-resistant%2F2011.04.04 H. pylori dominated the GI news in the 1990s, and despite it disappearing from the front pages, it remains a common and important clinical problem. The dominant recommended initial treatment strategy has been a clarithromycin-based PPI triple therapy, with either amoxicillin or metronidazole as the third drug. This approach was based on clinical studies, ease of use, and tolerability factors. Bismuth-based quadruple therapy (a bismuth agent, metronidazole, tetracycline, and a PPI), despite demonstrating excellent activity, was usually relegated to second-line therapy because of the complexity of the dosing as well as compliance and tolerability issues. However, duringthe last decade, the widespread use of macrolides in the general population has led to rising resistance to clarithromycin (... Better Health blogs http://www.medworm.com/rss/comments.php?id=4676787 Mon, 04 Apr 2011 18:00:07 +0100 4676787 http://www.medworm.com/index.php?rid=4670112&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fphysical-activity-versus-physical-fitness-it-could-mean-the-difference-between-life-and-death%2F2011.04.01 My neighbor Ed was a thin man all his life. He maintained an ideal body weight by combining regular physical activity with a modest intake of calories. He was a “young” seventy year-old who looked the picture of heart health. Ed regularly read the newspaper while walking on his treadmill, he hit a golf ball straighter and longer than his peers, and he wore the same size jeans now than he did in college 50 years ago. What’s more, he bragged about his low blood pressure, normal cholesterol level and perfect blood chemistries. He took no pills. I think he went to his primary care doctor each year just to show off his health. The morning he woke with crushing chest pressure and shortness of air stunned him. “This couldn’t be a heart attack?” he thought. An hour later, minutes after... Better Health blogs http://www.medworm.com/rss/comments.php?id=4670112 Fri, 01 Apr 2011 20:00:20 +0100 4670112 http://www.medworm.com/index.php?rid=4789177&cid=t_104949_87_f&fid=34935&url=http%3A%2F%2Fmedicine.com.my%2Fwp%2Findex.php%2F2011%2F04%2F02%2Fradiation-dose-and-risks%2F Some facts and figures about the health dangers posed by radiation from Dr. David Quek’s blog - Japan’s Chief Cabinet Secretary Yukio Edano had at one point said radiation levels near the stricken plant on the northeast coast reached as high as 400 millisieverts (mSv) an hour. That figure would be would be 20 times the annual exposure for some nuclear-industry employees and uranium miners. - People are exposed to natural radiation of 2-3 mSv a year. - A typical chest X-ray involves exposure of about 0.02 mSv, while a dental one can be 0.01 mSv. - Exposure to 100 mSv a year is the lowest level at which any increase in cancer risk is clearly evident. A cumulative 1,000 mSv (1 sievert) would probably cause a fatal cancer many years later in five out of every 100 persons exposed to... Malaysian Medical Resources blogs http://www.medworm.com/rss/comments.php?id=4789177 Thu, 31 Mar 2011 23:00:00 +0100 4789177 http://www.medworm.com/index.php?rid=4664177&cid=t_104949_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmitral-valve-regurgitation-caused-elizabeth-taylors-death-could-it-affect-you%2F2011.03.31 I am saddened that Elizabeth Taylor died recently of heart failure. In his appreciation of her, film critic Roger Ebert said in the Chicago Sun-Times, “Of few deaths can it be said that they end an era, but hers does.” She is a star that many of us felt we knew. She was a great actress and a woman of great beauty who was a hard working champion of people with AIDS and always seemed to be a determined person who knew herself. Yet she always had a vulnerable side. So many marriages, so many illnesses, so many, many surgeries, over 40, I’ve read. And then her heart problem developed. Which leads me to talk a little about that problem, mitral valve leakage. The heart’s mitral valve The heart has four chambers and four valves that open to let blood through to the next chamber of th... Better Health blogs http://www.medworm.com/rss/comments.php?id=4664177 Thu, 31 Mar 2011 23:00:00 +0100 4664177