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Thyroid Cancer: A Hazard From Radioactive Iodine Emitted By Japan’s Failing Nuclear Power Plants

One of the most abundant substances in the cloud of radioactive steam released by a failing nuclear power plant is iodine-131 — a radioactive form of the element iodine that is found throughout nature. Iodine-131 poses a special health risk because of its cancer-causing effect on the thyroid gland.

The small, butterfly-shaped thyroid sits just below the voice box. From this perch, it controls how fast every cell in the body changes food into energy. The gland’s main product, thyroid hormone, governs the function of the digestive tract, brain, heart, nerves, muscles, bones, skin, and more.

Iodine is a key ingredient that goes into making thyroid hormone. We get this element from ocean-caught or ocean-farmed fish and shellfish, milk, cheese, yogurt, eggs, and fruits and vegetables grown in iodine-rich soil.

The human body is surprisingly good at absorbing iodine and storing it in the thyroid gland. That’s a problem when iodine-131 is released into the atmosphere. The thyroid stores it as readily as natural, non-radioactive iodine. As iodine-131 builds up in the thyroid gland, it emits bursts of radiation that can damage DNA and other genetic material. Such damage can remove the normal limits to cell growth and division. Unchecked growth of thyroid tissue is thyroid cancer.

Iodine-131 gets into the body several ways. A person can breathe in radioactive steam released by a nuclear power plant. Fallout — radioactive particles that fall out of the atmosphere and settle onto plants, soil, and water — further adds to the burden when a person eats iodine-131 enriched fruits and vegetables or drinks water containing the isotope. Milk is another vehicle — cows that eat grass sprinkled with iodine-131 make milk that contains it. Read more »

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

Does “I Know CPR” Mean You Can Do CPR?

While I was browsing the produce section of my grocery store the other day, the sound of a panicked voice coming over the store’s loudspeaker made me jump. “Does anyone in the store know CPR? Anyone? CPR? We need you in baked goods!”

I froze. In theory, I know how to perform CPR — cardiopulmonary resuscitation. I took a two-hour course on it nearly 25 years ago. But I hadn’t given it much thought since then and I certainly hadn’t practiced what I learned.

My mind started whirling as I tried to remember the sequence of steps. They’d changed the rules a few years back — I knew that much — so I wouldn’t have to do mouth-to-mouth resuscitation. But where exactly on the chest was I supposed to push? Should I form a fist and push down with my knuckles, or use the ball of my hand?

Suddenly, sirens wailed outside the store. The rescue squad had arrived. Too late, as I learned afterward, for this man, who was a victim of a sudden cardiac arrest. This type of heart attack strikes so fast that there usually aren’t any warning signs. You might see someone grasp his or her chest, collapse, twitch and gasp a few times, and then lie deathly still.

At that point, every minute counts. Enough oxygen remains in the person’s bloodstream to nourish the brain for several minutes — but a bystander has to circulate oxygenated blood to the brain and other organs by pushing down on the chest hard and fast, mimicking the heartbeat.

I’m a health writer. I knew this intellectually. But until those agonizing moments in the grocery store, I never really understood on a gut level just how important every minute is. Read more »

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

Shingles Recurrence: Can The Vaccine Help?

This month’s Harvard Health Letter has an article about getting shingles a second or even a third time. (Click here to read the full article.) The bottom line is that recurrence is a) certainly possible and b) if some recent research is correct, much more common than previously thought and about as likely as getting shingles in the first place if you’re age 60 or older.

I talked to Barbara Yawn, M.D., director of research at the Olmsted Medical Center in Rochester, Minn., for the article and mentioned results that she and her colleagues first presented at a conference several years ago.

Yawn reported a more complete version of those results in last month’s issue of the Mayo Clinic Proceedings (a favorite journal of mine). Full text of the study isn’t available unless you have a subscription to the journal, but here’s a summary (in medical publishing, such summaries are called abstracts.)

Melinda Beck, a health columnist for the Wall Street Journal,  had a column about shingles last week and this how she neatly summed up Yawn’s research:

For the new study on shingles recurrence, researchers at the Olmsted Medical Center in Rochester, Minn., examined medical records of nearly 1,700 patients who had a documented case of shingles between 1996 and 2001. They found that more than 5% of them were treated for a second episode within an average of eight years—about the same rate as would typically experience a first case.

And here is a link to the Journal Watch item of the study and a short comment by the Journal Watch editor. Journal Watch is a monthly newsletter published by the Massachusetts Medical Society that summarizes and comments on recently published research.

In the Mayo Clinic Proceedings paper, Yawn and her colleagues report that 95 of the 1,669 people with an “index” case of shingles got shingles again over the course of a follow-up period that averaged 7.3 years, which works out to about 5.6 percent of the shingles sufferers. Six people had two recurrences and two had three! The timing of recurrence varied from 96 days to 10 years after the initial episode. In 45 percent of those who got shingles again, the site of the recurrence was in a different region of the body than the site of the first case. They also noted that the single biggest risk factor for having a second case of shingles was having pain that lasted 30 days or longer during the first case. Read more »

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

Teens Who Smoke Pot: At Risk For Mental Illness Later?

Teenagers and young adults who use marijuana may be messing with their heads in ways they don’t intend.

Evidence is mounting that regular marijuana use increases the chance that a teenager will develop psychosis, a pattern of unusual thoughts or perceptions, such as believing the television is transmitting secret messages. It also increases the risk of developing schizophrenia, a disabling brain disorder that not only causes psychosis, but also problems concentrating and loss of emotional expression.

In one recent study that followed nearly 2,000 teenagers as they became young adults, young people who smoked marijuana at least five times were twice as likely to have developed psychosis over the next 10 years as those who didn’t smoke pot.

Another new paper concluded that early marijuana use could actually hasten the onset of psychosis by three years. Those most at risk are youths who already have a mother, father, or sibling with schizophrenia or some other psychotic disorder.

Young people with a parent or sibling affected by psychosis have a roughly one in 10 chance of developing the condition themselves — even if they never smoke pot. Regular marijuana use, however, doubles their risk — to a one in five chance of becoming psychotic.

In comparison, youths in families unaffected by psychosis have a seven in 1,000 chance of developing it. If they smoke pot regularly, the risk doubles to 14 in 1,000. Read more »

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

Pulmonary Embolism: If It Can Strike Serena Williams, It Can Ace Anyone

News that tennis star Serena Williams was treated for a blood clot in her lungs is shining the spotlight on a frightfully overlooked condition that can affect anyone — even a trained athlete who stays fit for a living.

Williams had a pulmonary embolism. That’s doctor speak for a blood clot that originally formed in the legs or elsewhere in the body but that eventually broke away, traveled through the bloodstream, and got stuck in a major artery feeding the lungs. (To read more about pulmonary embolism, check out this article from the Harvard Heart Letter.) Pulmonary embolism is serious trouble because it can prevent the lungs from oxygenating blood — about one in 12 people who have one die from it.

“No one is immune from pulmonary embolism, not even super athletes,” says Dr. Samuel Z. Goldhaber, professor of medicine at Harvard Medical School and one of the country’s leading experts in this clotting disorder.

Pulmonary embolism tends to happen among people who have recently had surgery, been injured, or been confined to bed rest for some time. It can also strike after long-haul flights.

Signs of a PE

How do you know if you’re experiencing a pulmonary embolism? The most common symptoms include shortness of breath when you aren’t exerting yourself, along with chest pain and coughing up blood. If you experience any of these symptoms, see a doctor immediately. Other worrisome signs include:

  • Excessive sweating
  • Clammy or bluish skin
  • Light-headedness
  • Fast or irregular heartbeat

The tennis star’s pulmonary embolism could have been the result of the perfect storm. After having a cast removed from a foot she cut at Wimbledon, Williams flew from New York to Los Angeles. It was in LA, after an appearance at the Oscars ceremony on Sunday, that she underwent emergency treatment at Cedars Sinai Hospital for a blood clot in her lungs.

A call to action by the U.S. Surgeon General says that pulmonary embolism and a related condition — deep-vein thrombosis — affect an estimated 350,000 to 600,000 Americans each year. Together, they account for somewhere between 100,000 and 180,000 deaths each year.

To learn more about pulmonary embolism, check out this information from the North American Thrombosis Forum.

- P.J. Skerrett, Editor, Harvard Heart Letter

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

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

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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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