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Latest Posts

Migraine With A Visual Aura: It Might Be Scintillating Scotoma

Nothing like experiencing a medical condition first-hand to really help a doctor understand it from the patient’s point of view. After all these years, I had my first (and hopefully last) scintillating scotoma while sitting on the couch playing “words with friends” on my ipad and watching TV. A scotoma is a partial loss of vision in a normal visual field. Scintillate is flashing, sparkles. Put them together and you have moving, flashing sparkles with a blind spot in your eyes.

This visual aura was first described in the 19th century by a Dr. Hubert Airy who had migraine headaches. The visual sparks and flashes are in a zig-zag pattern and they can precede a migraine headache or occur without any pain. The scotoma affects both eyes and closing one or the other does not make it go away. Sometimes Read more »

*This blog post was originally published at EverythingHealth*

Why Only Some People Experience High Altitude Sickness

Andrew in Colorado, Summer 2011

Hi! Greetings from Breckenridge, Colorado. At 10,000 feet, I am told it is the highest resort town in North America. The Rocky Mountain scenery is breathtaking. But there’s a problem for about one in four of us who visit here, especially people like me who live at sea level. We can get hit with high altitude sickness and a few days ago, I was one of the unlucky ones.

What happens is your body isn’t used to the thin air and your blood has difficulty getting enough oxygen to your body. It usually happens at altitudes over 8,500 feet. You get an ongoing headache, you feel tired, you have insomnia (I was sleepless for two nights!), you could have nausea and certainly fatigue. Drinking lots of water and passing up alcohol can help, but even then some people have problems.

When I finally saw a family doctor – Doctor P.J. – he told me it’s genetic. Some people have trouble “acclimatizing” and others don’t, but there’s no easy way to know who will be affected before you make the climb. Now that I know I have difficulty I will take a prescription medicine (Diamox) ahead of coming up here again.

Doctor P.J. says even Read more »

*This blog post was originally published at Andrew's Blog*

New Jersey Attempts To Outlaw Cosmetic Botox For Minors: Will The Legislation Work?

TRENTON — Minors in New Jersey wouldn’t be able to get Botox injections unless a doctor says it’s medically necessary and documents the reason, under a bill moving through the Assembly. The Assembly Health and Senior Services Committee approved legislation Thursday to clamp down on doctors injecting people under 18 with botulinum toxin for cosmetic purposes. The Federal Drug Administration already bars anyone under 18 from getting Botox for cosmetic reasons. The new state legislation would go further by requiring doctors to document in a patient’s chart the noncosmetic medical reason for performing the procedure on a minor. Botox is used widely to smooth out facial wrinkles, but also can be used to treat headaches and spasms.

This prospective law in New Jersey would make Botox injections illegal in minors without a doctor’s statement that it is medically necessary. Unfortunately this is not to say such a law would have the desired effect. There are docs who will write those “permit slips.” Watch how many of these Botox-using minors get headaches.

I am not really a fan of laws restricting the flow of medicines. I do not believe they work well. Then again Read more »

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

Concussions In Younger Athletes Are On The Rise

Young athlete holding headA study published earlier this week by the American Academy of Pediatrics states that “the number of sport-related concussions is highest in high school-aged athletes, but the number in younger athletes is significant and on the rise.” Why is this? Many believe this is from better recognition of the symptoms and the need to be medically evaluated.

I did a couple of interviews with local TV news to talk about the subject (Video 1 and Video 2). In my research on this subject, I found an article from the Dayton Daily News stating that the Ohio High School Athletic Association (OHSAA) passed a policy in May 2010:

Any athlete who exhibits signs, symptoms or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion or balance problems) shall be immediately removed from the contest and shall not return to play until cleared with written authorization by an appropriate health care professional.

In addition, on the OHSAA website there’s an entire section devoted to concussions and head injuries. I have also read that other states have taken similar steps, especially with high school and younger athletes.

If you find the videos in this post helpful, I encourage you to see my other interviews on health-related topics at MikeSevilla.TV

*This blog post was originally published at Doctor Anonymous*

Dodged One: Meningitis Discovered By Trusting One’s Instincts

Saw a nine-year old with a headache today.  His dad brought him in, and explained that all the men in his family get migraines; he figured this was his son’s first one.  The kid seemed perfectly well, with a positive Cheetos sign and my gut instinct was that I would discharge him with no work-up.  But when I flexed his neck fully, he winced. Read more »

*This blog post was originally published at Movin' Meat*

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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