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

Latest Posts

More than skin deep

A few weeks ago I tripped and fell on the sidewalk.  I went down on hands and knees and scraped my left knee pretty badly.  The onlookers pretended not to notice, I suppose sparing me the embarrassment of asking if I was ok.  I dusted myself off and bled down my leg en route to work.

Since then I kept the wound moist with neosporin and band aids, allowing the skin to heal with minimal scarring.  But as I marveled at how painful this little patch of road burn is, I remembered a young girl I met about a decade ago who had a much more serious burn.

Inga was camping with her parents in a synthetic tent.  They had spent the day fishing and canoing near a campground somewhere in Eastern Europe.  They were huddled together inside the tent in the cool of the evening, speaking animatedly about the day’s events and the beauty of nature when Inga accidentally knocked over the kerosene lamp situated near the exit flap.  The kerosene spilled out onto the tent and the fire ignited immediately.  The tent began to melt in the fire and the zipper got stuck in the hot plastic material.  The unimaginable screams of her dying parents as they burned alive, trapped in this tent, brought help just in time to save Inga’s life.

But Inga was horribly disfigured by the fire.  She spent nearly a year in the hospital, receiving skin grafts and fighting off infections.  She was eventually able to return to school, but was treated like an outcast.  Her former friends were too horrified by her appearance to welcome her back and she spent most of her days sitting alone in the corner, covering her face with a scarf, blaming herself for the death of her own parents.

Her story reached the compassionate ears of a plastic surgeon friend of mine.  He traveled to Eastern Europe to meet Inga and see if he could help her.  As it turns out, she had no living relatives and was dirt poor.  He could see that the medical team taking care of her had carefully covered the defects in her skin, but had not attempted to restore a normal appearance with modern plastic surgery techniques.

The surgeon knew that it would take many surgeries over many years to give her the best result possible.  After some debate and soul searching, he decided to sponsor Inga to come to America where he committed to taking care of her financial needs and to giving her a new life.

I first met Inga after she had been in the states for several years.  She looked like a burn victim, with tight facial skin and abnormal contours – but compared to how she appeared in the photos of when she first arrived (with no nose or cheek flesh at all) this was a huge improvement.  She was meeting with the surgeon to have a seroma evacuated from under her left cheek.  He had to remove the extra fluid with a large syringe.

As I watched him numb the area and sink a deep, large bore needle into this young girl’s face, I cringed internally but tried to appear unphased for her sake.  She didn’t flinch, but sat staring forward bravely, her grey eyes fixed on the wall in front of her.  I saw a tear well up and trickle down her disfigured cheek during the procedure and I instinctively reached for her hand.  The tears continued in silence.  This burn had penetrated so much deeper than the skin.

I haven’t seen Inga since, though I’ve heard that she’s doing well in school, has made some good friends, and is planning to become a nurse one day.  Her decision to devote her life to caring for others is a beautiful example of “paying it forward.”This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Spider saves man from cancer

In my last blog post I was describing how adversity can be used for good, and as I was reading the medical news this morning I found another great example. While gardening, a British man was bitten on the neck by a spider. Now, the report doesn’t say exactly what type of spider this was, but judging from the outcome it was probably not a black widow or brown recluse. I’m assuming that the insect was some sort of common garden spider, though it must have had “fangs.” (Imagine my sister recoiling in horror here.)

As it turned out, the spider bit the man right next to a growth on his neck that he hadn’t noticed before. When he went to the doctor’s office to have the bite inspected, they found the growth and decided to biopsy it. The growth was cancerous, and the medical team was able to remove it before it had spread anywhere.

The little spider inadvertently saved a man from cancer. As he weaves his web, nestled between the coarse, hairy leaves of turnip plants, this tiny creature may never understand his contribution to humanity. Small actions can have a positive ripple effect, and a seemingly bad experience can save a life.

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Are socks dangerous?

Clothes make the man. Naked people have little or no influence on society.

–Mark Twain

Today I realized that I have spent the majority of my adult daytime hours enduring a continuous, sock-induced lower extremity discomfort. Socks feature a type of tourniquet system that slowly squeezes calf flesh into red indented rings, crowning edematous ankles. Why must socks be so painful? The manufacturers believe that their ability to “stay up” far outweighs the importance of comfort – and so like the sock zombies we are, consumers continue to purchase them under the assumption that painful elastics are simply part of the sock experience.

I decided to search the Internet for sock commiserators, and lo and behold, I found a comment in a diabetes forum about the dangers of tight socks. This person argues that socks can predispose to blood clots, and promote ulcers in those who have preexisting circulatory problems. She goes on to recommend a special type of diabetic sock that is non-binding, manufactured by a company called “sugar free sox.”

I performed a Medline search for articles about “socks” and “stockings” and there were surprisingly few articles. In fact, the majority of articles only mentioned a specific type of medical sock known as “compression stockings” (or T.E.D.s). I didn’t see any studies confirming the potential dangers of the garden variety sock, but it does make intuitive sense that anything that acts as a tourniquet cannot be a good thing for the circulatorily challenged.

Therefore, my recommendation is that if you are diabetic or have any known problems with your circulation, you should do your best to avoid tight socks. I myself am planning to try out these diabetic soft elastic, stretchy socks – and I will wear them proudly about the office in utter contentment and comfort.

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Rare skin disorder may be triggered by wart virus?

For those who are faint of heart, please do not click on this link (via KevinMD). This poor man living in Eastern Europe developed a rare disorder (called Lewandowsky-Lutz dysplasia) where he had growths appear on his hands and feet starting at age 14. Many years later the growths are quite disfiguring and difficult to remove.

Some speculate that this may be similar to a warty disorder in rabbits. Either way, it is a little disturbing to me that this condition could be triggered by a virus. Viruses, of course, can be quite contagious…

Any dermatologists out there want to weigh in?

This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Dermatologists more elusive than ever…

Thanks to med blogger Kevin MD for highlighting an interesting, though cynical, comment about the extended wait times that many people have in getting an appointment to see a dermatologist.

“It’s just as well that there’s a long wait. Someone who comes in with a rash is likely to be biopsied and end up with a scar. If they wait until an appointment is available the rash will probably have cleared up.”

The Boston Globe explains why consumers are having a hard time getting dermatologist appointments:

“In dermatology, the waits are created both by patient demand and, some believe, by dermatologists’ shifting their time to new, more lucrative or complex procedures. Public service campaigns have heightened fear of skin cancer, and melanoma cases are rising, meaning more people are seeking appointments.

At the same time, some dermatologists are devoting time to cosmetic procedures, or to skin cancer surgery that used to be done by general surgeons. Meanwhile, the federal government limits the number of residents hospitals can train, and hospitals would have to create more dermatology slots at the expense of other specialties. This means the number of dermatologists entering practice each year has remained flat, at about 300 nationally, making it difficult for practices to hire new doctors. Just as many have been retiring in the past five years.”

Have you had a hard time finding a dermatologist?


This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

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 »