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Dosing Exercise: Choosing What’s Right For You

It is risky.

Stay fresh. Avoid repeating yourself. Don’t rant. Never preach. These would be the ‘rules’ of supposedly good blogs.

And, of course, doctors that dare to take a stance on health issues risk being perceived as pretentious. I get this.

So it is with trepidation that I write a follow-up to last week’s CW post about right ventricular damage immediately after an extreme race effort. Notwithstanding the pompousness concern, I also wish to avoid being labeled anti-exercise. Few believe more strongly in the healing powers of exercise.

But last Wednesday’s comments (both on the blog, Facebook and here on Dr. Val Jones’ BetterHealth blog) were just too good to let rest.

On the assessment of studies: Read more »

*This blog post was originally published at Dr John M*

Atrial Fibrillation: When The Questions Outnumber The Answers

You may have heard that AF is a tough disease to understand. Questions far outnumber answers.

What causes AF?

Why do some not feel it at all, while others are incapacitated?

What’s the best treatment? Drugs? Ablation? Surgery? No treatment?

Should I take a blood thinner…and which one?

Where should one go for the best AF care?

This short email from a reader captures the essence of AF support group mayhem: Read more »

*This blog post was originally published at Dr John M*

Research Suggests More Damaging Effects Of Endurance Exercise On The Heart

Dear Endurance Athletes,

Accept an apology in advance. You have endured so much from me.

Sorry.

Let’s at least start by agreeing that I can’t control the data.

Yes, you guessed it. There is unfortunately more bad news pertaining to the deleterious effects of endurance exercise on the human heart.

Again, I am sorry. Maybe re-phrasing the previous sentence will soften the blow. How about this: “Yet another study on endurance athletes suggests that exercise, like everything else in life, has an upper limit.”

Here goes, buckle up. Read more »

*This blog post was originally published at Dr John M*

If All Physicians Were Salaried, Would Access To Care Decrease?

My last post centered upon the funny-sounding word, ‘parallax.’ I was using it to describe how middle-age athletes see their sport.

But it seems to me that parallax relates to healthcare policy.

First, the definition:

Parallax: an apparent change in the position of an object resulting from a change in position of the observer.

Here goes…(in less than 360 words!)

As America and its government grapple with how much austerity can be tolerated, the cost of healthcare consumption holds center stage.

And…

Everyone knows a portion of the rising costs of healthcare stem from paying doctors a fair wage. (Worry not; I’m not prepping you for a rant about declining reimbursement and higher regulatory costs. This would be too fatiguing. Plus, doctors’ wages lie way beyond the scope of a clinician’s blog.)

Let me tell you a real-life story about a recent situation? It’s meant to illustrate one of the many healthcare policy conundrums. And it shows how one’s views of healthcare policy may depend–on the position of the observer. (ie, parallax) Read more »

*This blog post was originally published at Dr John M*

Study Confirms Safety Of Statin Drugs

There was important news this month on statin drugs. As one of the world’s most effective and commonly used medications, statins provide great writing topics. Lots of people have high cholesterol–including cyclists. Lots of people are interested in avoiding our mostly deadly disease.

I’d like to tell you about a recently-published (Lancet) landmark study that should quell safety concerns over statin drugs.

The punch line after I tell you the study’s results are short and sweet. Scroll down if you wish. But first, statin drugs are misunderstood enough to warrant a little blog-like simplicity. Let’s start with some background.

A brief statin review:

Statin drugs are best known for their cholesterol-lowering properties. The notion is simple: Read more »

*This blog post was originally published at Dr John M*

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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…

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

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