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The Growing Awareness Of Gluten And The Problems It Can Cause

I love bread, pasta, and many other foods made with wheat. Luckily, I can eat them all without having to worry about gluten. But I have to admit that the growing public awareness of gluten and the problems it can cause has got me thinking.

Gluten is an umbrella term for the proteins gliadin (in wheat), secalin (in rye), and hordein (in barley). Bakers know it as the substance that makes dough resilient and stretchy. In some people, gluten triggers an immune reaction and causes inflammation of the lining of the small intestine, which can eventually interfere with the absorption of nutrients from food. This is called celiac disease. Some of the more common symptoms of celiac disease are:

  • Gas
  • Bloating
  • Abdominal cramps
  • Diarrhea
  • Foul-smelling stools
  • Fatigue
  • Weight loss
  • Skin rash

Some people have Read more »

*This blog post was originally published at Harvard Health Blog*

School Nurse Gives Some Insight Into Her Job

Well, what better time to post my interview with Erin at Tales of a School Zoned Nurse than now, when everyone’s headed back to the classroom?

Erin is a school nurse in the “cash strapped state of California.”  Her position covers two elementary schools and a middle school – almost 2000 students!!  She has been blogging since last year and her blog has definitely become one of my favorites.

She says she was never too set on working in a hospital.  After nursing school, she worked at a couple of summer camps, which gave her the idea to look into being a school nurse. She was hired right away and “leapt in without a second thought.”  She is starting her second year in this position.

Erin’s daily schedule is quite varied: Read more »

*This blog post was originally published at code blog - tales of a nurse*

Preparation For Surgical Patients With A Latex Allergy

A couple of nice articles recently on latex allergy have crossed my path – one in a journal I subscribe to (Aesthetic Surgery Journal) and the other via twitter and @Allergy (Ves Dimov, M.D., blogs at Allergy Notes).  I’ve put both full references below.

Latex allergy became widely recognized in the late 1980s and early 1990s.  The increase in latex allergies cases is felt to be associated with the increase use of latex gloves and implementation of universal precautions (now known as standard precautions) in the 1980s.

Management of possible or confirmed latex allergic patients begin with history and suspicion:

All patients who present for surgical procedures or exams which require latex gloves (pelvic exam, dental exams, etc) should be questioned about possible latex allergy.

Patients at highest risk include those who Read more »

*This blog post was originally published at Suture for a Living*

Food Allergies: Treating Severe Allergic Reactions

EpiPen 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 at Here are some key points: Read more »

This post, Food Allergies: Treating Severe Allergic Reactions, was originally published on by Paul Auerbach, M.D..

A New Twist On Food Allergies In Kids

The current New Yorker unfolds an engaging story on childhood food allergies. As related by Dr. Jerome Groopman, there’s a shift in how some doctors think about how these conditions  are best managed and, even better — might be prevented. The article feeds into recent discussion that medical science, and even dogma, too-often turns out to be incorrect.

Groopman interviews Dr. Hugh Sampson, director of the Jae Food Allergy Institute at Mount Sinai Medical Center in New York:

…“This increase in the incidence of food allergy is real,” Sampson said when we spoke recently. He cannot say what is causing the increase, but he now thinks the conventional approach to preventing food allergies is misconceived. For most of his career, he believed, like most allergists, that children are far less likely to become allergic to problematic foods if they are not exposed to them as infants. But now Sampson and other specialists believe that early exposure may actually help prevent food allergies.”

I recommend the full read if you can get it: Groopman probes potential causes of discordant food allergy rates in children of different geographic regions. I learned a number of details on how some doctors in the U.S. use protein-breakdown methods to desensitize children to food allergies, how in Israel newly-speaking infants are said to ask eagerly for Bamba, a manufactured, peanut-containing snack (which, for the record, I don’t particularly endorse), and how in some cultures parents chew their young children’s food in a manner that might that might facilitate breakdown of complex proteins by enzymes in saliva.

All interesting. Of course it’s hard to know exactly what’s true in this, and the causes of allergies are likely to vary among children. There’s a randomized LEAP study (Learning Early About Peanut Allergy) in the U.K. that may provide some hard evidence on this, one way or another.

*This blog post was originally published at Medical Lessons*

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…

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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…

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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…

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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

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…

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