January 21st, 2008 by Dr. Val Jones in Uncategorized
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Health tips
Are you struggling with depression? Mira Kirshenbaum suggests that talk therapy may be more effective than medications.
Does your child have mono? Dr. Stacy Stryer explains that mono has very different symptoms depending on a child’s age.
Be careful of vitamins and supplements – some of them may negatively affect your other medications. Dr. Julie Silver offers a list of the most common supplements that interact with medications.
If you see flashing lights or floating objects in your visual fields, see an ophthalmologist right away. Dr. Jackie Griffiths explains why the symptoms of retinal detachment can be quite ominous.
Are you about to have surgery? Dr. Jim Herndon suggests some questions to ask your surgeon before and after the operation.
Don’t be shy about asking for help when you have cancer. Dr. Heinz-Josef Lenz highlights some great advice from the Colon Cancer Alliance.
Looking for ways to enhance your sex life? Mira Kirshenbaum has some creative suggestions.
Do you have diabetes? Exercise might be the most important “treatment” for type 2 diabetes. Dr. Jim Hill explains.
Did you know?
Fertility decreases by 5% for every 1 point increment in BMI over 29. That means that getting pregnant becomes more and more difficult as you gain weight! Dr. Mark Perloe explains.
Men can suffer from post-vasectomy pain. Dr. Joe Scherger describes this problem and what to do about it.
Could having children increase a man’s risk for prostate cancer? Dr. Mike Glode reviews the evidence.
Your brain needs sleep to recharge its neurotransmitters. Dr. Steve Poceta explains the exact reasons why sleep is so important for the health of the human brain.
Approximately 1 in 25 children will have at least one febrile seizure in their lifetime. Dr. Olajide Williams explains that a seizure that occurs during a time of fever does not mean a child has epilepsy.
Siestas and/or power naps could reduce your risk of heart disease. Dr. Joe Scherger highly recommends this regular form of stress reduction.
There are fat zip codes and skinny zip codes. Dr. Jim Hill explains why thinner people congregate in certain places. Think upper east side, Manhattan!
A recent study suggests that calcium supplements may put older women at higher risk for heart attacks. Dr. Jim Herndon explains why he’s skeptical of this potential link.
Medicare will not pay for in-hospital complications believed to be due to errors. Kelly Close wonders how they know for sure that an adverse outcome is related to an actual error or not.
Do you know someone who engages in repetitive, jerky movements? Dr. Olajide Williams is a neurologist who explains what “tics” are and what can be done about them.
Around the globe
China: How many autism experts are there in China? About 30 for 1.3 billion people. Robin Morris describes how bleak the prospects are for parents of children with autism.
United States: In an outrageous court ruling, a physician was held responsible for the death of a young boy who was run over by a patient (while driving his car) on blood pressure medicines. Dr. Cole Brown wonders how much of a patients’ actions can be blamed on his physician?
Africa: “River blindness” is caused by a parasitic invasion of the eye. These parasites can be killed with a medicine called ivermectin, but apparently the wily larvae have developed a genetic mutation that renders them resistant to the only known medicine that can kill them. Dr. Jackie Griffiths reminds us all how tenuous our antibiotic victory over microbes and parasites really is.
Personal perspectives
Some people use diet coke in their CPAP machines! Dr. Steve Poceta tells the story of how one of his patients preferred this type of humidified air. Not sure what that will do to your lungs…
Ever wonder how to weigh the pro’s and con’s of chemotherapy in a terminally ill patient? Dr. Mike Rabow describes how he advises patients about this difficult decision.
Dr. Rabow describes some tear jerking true stories from a hospice in Florida.
From the blogosphere at large: this week’s grand rounds is hosted by Alvaro Fernandez at SharpBrains.com. The theme is: briefing the next US president on healthcare. Some really important information in there folks, so go ahead and have a good read!
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
January 19th, 2008 by Dr. Val Jones in Uncategorized
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As you know, the annual MedGadget medblog awards are underway… nominations have been made, finalists were chosen, and now YOU get to vote for your favorite in each of 7 categories. Polls close at midnight Sunday, January 20th EST… so head on over now and cast your vote! I’m up for the Best New Medblog 2007.
And don’t forget to join Dr. Anonymous and the MedGadget team live Sunday night for the final coverage of the race. The special edition of the Dr. Anonymous show starts at 9pm EST.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
January 18th, 2008 by Dr. Val Jones in True Stories, Uncategorized
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A coworker (we’ll call her Tina) approached me yesterday for what she called “pseudo medical advice.” Apparently she had gone to a local sandwich shop with a friend, and purchased some bottled water to compliment her deli item. As the two sat down at a table and prepared to have a leisurely lunch, Tina twisted off the water top and took a big swig.
To her horror, she had taken a large gulp of what tasted like lemon soda instead. She checked the plastic bottle – it was marked as pure water. She instantly recalled that the bottle top had come off rather easily and she heard no characteristic suction noise as air first entered. She was gripped with fear – could this be a poisoning? Did someone tamper with the bottle to inflict harm on unsuspecting victims?
Tina’s friend advised her to call the Poison Control Center. The woman who answered asked if Tina was having any symptoms – nausea/vomiting, headache, dizziness, abdominal pain… She denied each of these, complaining only of some tingling around her mouth (probably because Tina was so worried that she was hyperventilating). The Poison Control Center recommended that she keep the bottle, call the water manufacturer, and go to the ER immediately if she experienced any symptoms.
Tina asked me if she had done the right thing and if I thought she might have been poisoned. I told her that calling the Poison Control Center was a good idea, and although the thought of drinking out of a stranger’s water bottle is fairly disgusting, here’s what I thought about her actual risk:
1. The most likely scenario is that someone was using the water bottle for their daily drink – refilling it with soda from home and taking it to work each day. They probably left it on a counter by accident and a clerk reshelved it in the cooler. I give this an 80% chance of being the cause of the SNAFU.
2. The second most likely scenario is that some kids wanted to pull a prank and intentionally filled the water bottle with soda to see what would happen when someone drank it. I give this a 19.99% likelihood.
3. The third potential explanation for what happened, which is very unlikely, is that a nefarious random killer is masking poison with Sprite or 7-Up in water bottles around the city. I give that a 0.0001% chance on the high side.
The reason why I don’t think Tina’s drama is consistent with a poisoning is three-fold:
1. Most poisonings are directed towards specific individuals – renegade spies, abusive spouses, unwanted kids, that sort of thing. It’s quite rare for people to bother to try to poison random individuals. In the rare cases where this has happened (take the Tylenol debacle of 1982 for example – where cyanide was carefully planted in non-tamper resistant bottles) the idea was to make the person think that the product they were taking was totally NORMAL. Otherwise, why would the person take the full dose? A water bottle filled with soda is a real red flag.
2. The most common deadly poisons are flavorless and odorless (cyanide and arsenic) so there would be no need to use lemon soda to cover the taste. Styrchnine is incredibly bitter and can’t be covered up easily – anthrax, ricin, and sarin have to be inhaled so they wouldn’t be as successful in a bottle form.
3. Tina had no immediate symptoms. Arsenic poisoning causes symptoms within 2-24 hours of exposure, with abdominal pain, headache, weakness, dizziness being the most common initial symptoms. They are followed by bloody urine, jaundice, and severe abdominal pain. For cyanide, the effects are very rapid – causing confusion, fainting, collapse and potential coma. Again, after 24 hours Tina was completely asymptomatic.
After discussing this with Tina she said she felt much better and she perked up nicely. Then tilted her head thoughtfully and asked, “could I catch an infectious disease from drinking out of someone else’s bottle? Like, could I get herpes?”
“Oh yes, that’s possible. Cold, flu, and herpes viruses can be transmitted from glasses and bottles.”
A look of horror crossed her face.
“Um… well (I tried to save all the reassuring I’d done about the poisoning) it’s probably unlikely… I uh, don’t know how long the bottle was sitting in the fridge, maybe the viruses dried up and died?”
“Well, thanks, Val. I guess we’ll just have to wait and see what happens.”
“Yep. You’ll probably be just fine. Did you have your flu shot this year?”
“Uh, no.”
“Oh, never mind.” I said.
And Tina turned around and left with about the same level of anxiety that she had arrived. We’d just switched poisoning for herpes or the flu. Oh well?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
January 16th, 2008 by Dr. Val Jones in News
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We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.
– The US Declaration of Independence, July 4, 1776
When I was in college I spent my summers working with mentally and physically disabled adults in group homes and camps. Many of the patients had IQs<75, which presented a unique communication challenge. Emotional outbursts were not uncommon as the adults used the only form of communication that seemed to draw attention to an immediate need. I spent a lot of my time trying to predict needs before frustrations bloomed, and after getting to know the peculiarities of each individual, I could generally keep the group in a fairly content state.
Most of the adults were on a long list of medications – some were for epilepsy, others were for heart defects, but many were antipsychotics and sedatives. At the time I didn’t realize exactly what each medicine was for, and wondered why these relatively young men and women needed so many pills.
In retrospect I believe that many of the medicines were a misguided attempt to control behavior. It’s analogous to giving someone, with their hand in a bucket of very hot water, a pain medicine instead of removing their hand from the bucket. And now new research in the Lancet suggests that antipsychotic medications (such as haldol or risperdal) do little or nothing to control aggressive behavior in the mentally disabled (though not psychotic) population.
So why have we been giving mentally disabled individuals antipsychotics for decades? Sadly, we thought that these pills would provide a quick and easy way to conform their behavior to our sensibilities, without having to get to know the reasons for their frustrations. And of course, these people weren’t intellectually sophisticated enough to question the utility of this approach or to decline the use of such medications.
I find it terribly sad that it has taken us this long to realize that giving anti-psychotics to mentally impaired people is not in their best interest. Surely more evidence would have been gathered prior to subjecting “normal” adults to such treatments. In this imperfect world, it does seem that those without a voice are less often heard. It is our responsibility as healthcare professionals to look after their interests and not take the easy way out. Mentally disabled individuals have the right to express themselves, and to be free of unproven and unnecessary drug treatments. Life, liberty, and the pursuit of happiness. Our own Declaration of Independence argues as much.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
