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

Latest Posts

Avoid Surgeons Without Accredited Training: It Could Save Your Life

Three young mothers under the age of 40 are dead because they wanted to be beautiful. Kellee Lee-Howard wanted a slimmer body. Ditto Maria Shortall and Rohie Kah-Orukatan. Shortall worked as a housekeeper; Lee-Howard was the mother of six kids and Kah-Orukotan died at the same place where she received manicures. What do these women have in common besides being minorities? They had liposuction procedures performed by men who offered a discounted price for an elective surgical procedure. These men professed to be competent in performing the procedures but never had accredited training.

I knew this day was coming. I saw the storm long before the clouds emerged. As the insurance payments for professional medical services decreased and declined, physicians began to look for alternative ways to earn money. But was it ethical? Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Diabetic Considers All She’s Learned In The Last 25 Years With The Disease

What I’ve learned in the last twenty-five years with type 1 diabetes:

  • Some of what “they” said is wrong.  It just is.
  • There are times when “they” make a good point, and it’s up to us as patients to figure out what information we react to.
  • The needles don’t hurt as much now as they did then.  Lancets have become smaller and sharper, syringes can make the same claim.  Insulin pump sites, once they’re in, usually go without being noticed.  Same goes for Dexcom sensors.  (But “painfree” is a misnomer and so subjective that medical device advertisers had best just steer clear of that word entirely.  All needles pinch at least a little bit.)
  • Progress isn’t always shown in tangible technological examples.  Sometimes progress is being able to look at a blood sugar number without feeling judged by it. Or to look in the mirror without wishing you were different.
  • There is life after diagnosis.
  • Diabetes is sometimes funny.  It has to be. Read more »

*This blog post was originally published at Six Until Me.*

Chinese Study Compares Flu Treatments: Prescription Drug Vs. Herbal Remedy

During the early days of the 2009 H1N1 influenza A pandemic, the popular herbal formula maxingshigan–yinqiaosan was used widely by TCM practitioners to reduce symptoms. (It’s hard to pronounce and spell, so I’ll refer to it as M-Y.) A new study was done to test whether M-Y worked and to compare it to the prescription drug oseltamivir. It showed that M-Y did not work for the purpose it was being used for: it did not reduce symptoms, although it did reduce the duration of one sign, fever, allowing researchers to claim they had proved that it works as well as oseltamivir.

“Oseltamivir Compared With the Chinese Traditional Therapy: Maxingshigan–Yinqiaosan in the Treatment of H1N1 Influenza” by Wang et al. was published in the Annals of Internal Medicine earlier this month. The study was done in China, which is notorious for only publishing positive studies. Even if it were an impeccable study, we would have to wonder if other studies with unfavorable results had been “file-drawered.” It’s not impeccable; it’s seriously peccable.

It was randomized, prospective, and controlled; but not placebo controlled, because they couldn’t figure out how to prepare an adequate placebo control. They considered that including Read more »

*This blog post was originally published at Science-Based Medicine*

Hardened Breast Implants (Capsular Contracture): A Reader Question

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 severe encapsulation (Baker Grade III or IV.) When contracture redevelops quickly after capsulectomy (assuming the operation was thorough,) this is worrisome as it may indicate a high tendency for recurrence. The main question when severe contracture is present is whether or not a cause can be identified. Bothersome contracture doesn’t happen to all patients. This kind of reaction is associated with cigarette smoking, bleeding, infection, silicone gel implants, poor soft tissue coverage and radiation exposure as well as a previous history of contracture. Some of these issues can be minimized in an attempt to reduce the tendency for encapsulation. Preventing the problem is the best solution. Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

Should The U.S. Limit The Number Of Embryos Transfered?

Everyone knows about “Octomom” and her octuplets born after in-vitro fertilization (IVF).  That was an extreme case, but multiple births resulting from unregulated artificial reproductive technologies have skyrocketed over the last decade.  The increased rate of twins, triplets and even higher multiples are due to in-vitro treatments and those women and infants are at much higher risk of pregnancy complications, premature birth and long term health problems.

New research,  published in theJournal of Pediatrics, looked at admissions at just one hospital in Montreal, Quebec and found multiple embryo transfers was responsible for a significant proportion of admissions to the neonatal intensive care unit (NICU).  These infants were born severely preterm.  Six babies died and 5 developed severe intraventricular hemorrhage or bronchopulmonary dysplasia.  The researchers extrapolated their data to the entire country of Canada and said that a universal single-embryo transfer policy would have prevented 840 NICU admissions, 40 deaths and 42,488 days in the NICU.  The cost was $40 million annually. Read more »

*This blog post was originally published at EverythingHealth*

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 »

Commented - Most Popular Articles