Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

10 Tips for a Healthy Wedding

Here’s a copy of the Press Release, for those interested…

As an experienced June bride myself, I can tell you that
your wedding may be one of the happiest times of your life, but for a number of
reasons, health problems can crop up on and around this special day.  But with some advance planning,
you can make sure that you and your guests remember the day for the right
reasons, and not the wrong ones.

1.      Beat the Heat – Many June weddings are
planned months in advance (at a cooler time of year), when the prospect of
being outdoors is inviting.  But when
June arrives, wedding guests find themselves spending hours exposed to peak sun,
heat, and humidity.  And since weddings
often involve older relatives and younger children, the risk from sun and heat
exposure is higher than many expect.  If
you’re getting married outdoors, keep an eye on the heat, especially for your
oldest and youngest guests.  Have
sunscreen and plenty of water available.
Consider moving older guests to a shaded area.  To recognize the signs of heat exhaustion, visit:
symptoms and find treatments for heat exhaustion

2.      The Size is Right – Many brides buy
their wedding dress a size smaller, with ambitious plans of weight loss – or
perhaps the dress fit well when it was bought, but  run up to the wedding (with the related stress),
has led to a slight weight gain.  Either
way, too many brides try crash dieting in the days and weeks before the wedding
to squeeze into that gown – and find failure, anxiety, and health problems.  If you want to lose weight for your wedding,
start in advance, and stick with a healthy, safe weight loss plan.  Crash diets are fittingly named:
you smack into a wall and find yourself worse off than before.  Brides also should keep an ear tuned to
bridesmaids engaged in crash dieting, and try to talk their friends out of such
bad habits.   Find
smart strategies for healthy weight loss.

3.      Sober Dialing – While many people don’t
think of drunk driving as a “health issue,” drinking and driving is one of our
county’s leading preventable causes of death.
A healthy wedding is one where the guests get home safe and sound.  Wedding planners should ensure that everyone
has a designated driver, arrange with a cab company to have a certain number of
cabs available at the end of the evening.
Or you can arrange for transportation to take guests back to their
hotel.  That way no one has to worry
about drinking and driving.  And make
sure you have plenty of non-alcoholic beverages for any guests who have alcohol
dependency issues

4.      Celebrate with a Healthy Meal
Everyone wants to treat their guests to a wedding meal to remember – but make
sure it is remembered fondly.  If you’re
holding your wedding outside, make sure that food, like potato salads and
shrimp, are properly cooled or kept on ice.  I know of a wedding where five of the guests got food poisoning from
this type of mistake.
And consider a lighter, healthier meal:
your guests will appreciate the chance to celebrate with you (without
needing to go on a diet the next week), and will find themselves feeling less
weighed down during the celebration.  Learn
about food poisoning and how to handle food safely.

5.      Get the Glow – Every bride wants to
look perfect on her wedding day.  But
that “glowing, radiant” skin can’t be had via makeup:  healthy choices make a big difference.  Try to keep your stress under control to
avoid an
acne breakout
.  And drink plenty of
water on the day before and the day of your wedding to keep your skin looking
great and your body feeling great. Check
here for more information on the importance of staying well-hydrated

6.      Dealing With Family Issues – Weddings
pose challenges not just to physical health, but emotional well-being,
too.  Unresolved family
issues have a not-so-funny way of erupting at a wedding, exacerbated by the
stress of the event
and intensified by the gathering of relatives who may
not often encounter one another.  Ask a
trusted relative to try to resolve these disputes before the wedding day, and if
you suspect they may nonetheless erupt at the wedding, have a “designated
diffuser” – a relative who can soften family conflicts or at least keep them
from ruining the celebration.

7.      Take Care of Yourself – You can’t have
a “healthy” wedding with an “unhealthy” bride.
Schedule some time to do things that help you relax.  Yoga, massage, a day trip, hiking or reading
a good book are all great ways to de-stress.
about other stress management tips.

As you prepare for your upcoming event, make sure you are getting 7-8
hours of sleep per night.  Being
well rested can help you avoid feeling irritable and anxious and can reduce
your chances of becoming ill

8.      Countdown
—  Maybe it’s not romantic,
but a comprehensive  physical exam is a
good idea for couples preparing for marriage.
Before you ask someone else to
say that they will love you “in sickness and in health,” you owe it to them to
know just where on that spectrum you stand.  Together you can plan to support one another
in long term, healthy lifestyle goals. Get a complete check up a few months
before the wedding, so you can understand and address any health issues before
you are at the altar.  Both women
and men
need complete and regular physicals.

9. A
Healthy Honeymoon
– Ok, you’ve made it all the way through the wedding in
good health, and now comes “the fun part:” the honeymoon.  But a surprising number of brides and grooms
wind up too sick to enjoy this first taste of wedded bliss.  Key tips:
make sure you don’t overindulge in food and drink at the wedding; plan
for the honeymoon like you would any other trip (with sunscreen for warm places
and precautions about drinking safe water and eating safe food); and make sure
you’ve had all necessary vaccinations well in advance of the wedding so you
aren’t suffering from vaccine side effects on wedding day.  Learn
more about health and travel

10.  Waiting to Exhale – Take a deep breath
and remember that in the end, marrying the person you love is more important
than having a perfect ceremony or reception.
The wedding is just the start of the marriage – and hopefully, not the end.  The happiest and healthiest wedding is the
one that leads to a happy, healthy marriage.  Check out some great
for keeping your marriage strong long after the wedding’s over.This post originally appeared on Dr. Val’s blog at

Eye infections caused by parasites

There’s a new contact lens solution scare this week.  Last year it was fungus, this year it’s parasites.  Apparently there has been an increase in amoebic infections in the eyes of those who use a type of moisturizing contact lens solution.  These amoebas are pretty common (and relatively harmless?) in the water supply, but put them in your eyes with a few moisturizing drops and you’ve got yourself a dangerous infection that can even result in blindness.  Scientists are puzzled as to why this mixture might increase the risk for infection – some speculate that the moisturizing chemical sticks to the amoebas and keeps them in the eye (rather than having them drop out in your tears).  But at this point, no one really knows why there have been increased infection rates, or what the contact lens solution has to do with it.

I guess my advice would be – never put tap water in your eyes or on your contact lenses, and switch to a different brand of contact lens solution than Advanced Medical Optics, Inc.’s Complete Moisture Plus until further notice.This post originally appeared on Dr. Val’s blog at

Women in medicine

Even though the gender gap in medicine is closing quickly (about 50% of medical students are female), young female physicians in practice are often viewed with suspicion.  Dr. Michelle Au, an anesthesiologist and graduate of my alma mater, is regularly asked if she’s “a real doctor” or if she’s the nurse or a student of some sort.  This week she blogged about her experiences, and there was a large volume of interesting responses.

I myself have had a rough time of it in the past (now I guess I look old enough to “be a real doctor”), and was routinely assumed to be a nurse, physical therapist, or even pharmaceutical rep.  I actually wasn’t that offended by being miscast – mostly because I took it as a compliment not to look like a doctor.  Although it’s somewhat unclear what a real doctor is supposed to look like, I have a feeling he’s older, balding, and paunchy.

But one day I was a little annoyed when my age and gender was equated with incompetence, which crosses the line for me.  Here’s how the conversation went between me and the parents of a toddler with a small cut on his forehead:

Me: “Hi, Mr. and Mrs. X, I’m Dr. Jones.  I see that Johnny bumped his head and will need a few stitches.” [Enter long history and physical discussion here].

Mrs. X: “Are YOU going to put in the stitches?” She asked nervously, scanning the ED for other physician suturing candidates.

Me: “Yes, I assure you I will be very careful.  I’ve sutured many similar lacerations.”

Mr. X: “Yeah, but don’t you think he needs a plastic surgeon?”

Me: Looking at the small cut that only required 2 or 3 sutures.  “I understand that you want the best possible cosmetic outcome for your son, but I assure you that this cut is so small that the plastic surgeon wouldn’t close it any differently than I would.”

Mrs. X: Spotting a tall, male intern fiddling with some bandages on a supply cart.  “Well, can’t he do it?”

Me: Viewing the clumsy medicine intern.  “Well, yes, he could.  Shall I ask Dr. Big Hands if he can come and suture your son’s forehead?  He’s never closed a lac before and has been dying to try one.”

Mrs. X: Um… Well, maybe you should just do it.

Outcome: I did a beautiful, delicate job of closing the small laceration, and the parents watched in awe as I used the tiniest needle and thread to create a seamless finish.

Mr. X: Thanks for your help.  You did a really great job.

Have any of you readers had similar experiences?This post originally appeared on Dr. Val’s blog at

Honesty: a new policy for drug companies?

I was struck by two different news stories today – one in the New York Times, and the other in the Washington Post.  Although the topics were different, the underlying theme was unified: drug companies (particularly Glaxo Smith Kline?) are coming clean with research data and marketing messages.  Sure, it might have taken a law suit by Eliot Spitzer to shine a light on the common practice of witholding negative research information from scientists… and it also may have taken a costly failure of an over-hyped diet pill by a competitor drug company to cause GSK to take the honest marketing track with Alli… But I like this new honesty, however we got to it.

Did you know that drug companies spend billions of dollars to research the safety and effectiveness of their drugs, but then are under no obligation to share what they learn with the general scientific community?  No, they share what they want to – generally the studies that show the largest effect or the greatest safety profile.  But now, physicians have been given access to the raw data collected in all the trials (showing benefit, no benefit, or harm) conducted by GSK.  And they’re having a field day!  A new study published in the New England Journal of Medicine is based on an analysis of GSK’s research, where they have found that Avandia (a popular diabetes drug) may put people at higher risk for heart attacks and heart related death.

Now here’s the devil in the details (as Dr. Charles rightly points out): the potential harm has been blown way out of proportion – the media has been citing “a 43% increase in heart attacks/myocardial infarctions and a 64%
increase in death from cardiovascular causes” when another way of stating what the authors found is that 86/14,371 patients or 0.598% of the patients taking Avandia had a heart attack, while 72/11,634 or 0.619% of people
not taking Avandia also had a heart attack.  Gee… which sound bite seems more scary?

Honestly, I feel worried for the general public who are now (with the new full disclosure of drug company data) sure to be victims of an onslaught of media hype around all sorts of small differences found in research studies.  Believe me, it’s important to sift through all this data to look for early signs of potential drug related health risks – but I think we should be careful before we terrify our patients with scary statistics.

Maybe in the midst of all this new honesty – we can have medical bloggers like Dr. Charles and the Revolution Health team help patients get to the bottom of things without having to have a PhD in biostatistics.  We need a voice of reason to translate research data for public consumption.  I’ll do my part – but since there are ~6000 research studies published per day in this world… I need some back up.  Any takers?This post originally appeared on Dr. Val’s blog at

The right balance for good health

I realize that my last post has probably left you wondering what on earth bulldozers and ballerinas have to do with medicine.  Well, let me lead you down my little mental garden path here and explain.

The dancing event took place right next to the National Academy of Sciences, where the Institute of Medicine (IOM) holds its regular meetings.  It was all the more humorous to see these bulldozers (with rose petal-filled buckets) participating in this awkward dance – right in front of the hallowed halls of medicine’s most prestigious scientific body.  As I thought about what the IOM stands for – the pursuit of truth through objective scientific analysis – and what these ballerinas were up to (reveling in the whimsy of life) it struck me that good medicine might actually combine the two.

Clearly, there are aspects of a healthy life that cannot be well defined by science.  Love, peace, and joyfulness are all nourishing to the mind and body – but quantifying them is rather difficult.  The things that grandma taught us – get your beauty rest, be kind to others, get lots of fresh air, marry a loving man (or woman) – are great medicine, and should be the foundation for a life in balance.

However, the science of medicine is also critically important.  The media thrives on exaggeration and controversy.  If there were a mountain of sand in front of us, and we had the choice to move it with a bulldozer or a teaspoon – the media would have us convinced that the spoon was equally effective.  And this is why we are constantly misled about treatments – we hear about efficacy, but we don’t hear about the relative effectiveness compared to other therapies.  So cinnamon, for example, is touted as a great new treatment for diabetes, when in fact it is only a teaspoon compared to the bulldozer of insulin.

And so I guess I would summarize my musings this way: good health is a dance near the IOM, with bulldozers instead of teaspoons.This post originally appeared on Dr. Val’s blog at

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »