June 14th, 2007 by Dr. Val Jones in News
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It’s funny how cultures become obsessed with certain physical attributes. In the middle ages warts confirmed the identity of witches, a gap between the front teeth was considered pleasing, and a “heart shaped face” was the epitome of beauty. This past century we’ve vacillated between pleasantly plump to “rail thin” as a standard of loveliness… and in recent years women have become preoccupied with a new menace: cellulite.
Of course, no one had even noticed cellulite until the French coined the term 150 years ago. And unhappily that plague crossed the Atlantic in the 1960s, terrorizing pleasantly plump beauties from that day forward.
An entire industry has sprouted up to combat this dimpled foe – everything from massage to liposuction to caffeinated lotions claim that they will restore a smooth appearance to irregular thighs. Unfortunately, those promises are all empty.
Yes, that’s right – there is no research to suggest that any cellulite treatment has anything but the most modest of effects. The bottom line is that dimply skin is determined by your genes – same as your eye color – and that the majority of women have some degree of cellulite no matter how thin they are. Sure, estrogen can play a role – but basically there’s no escaping estrogen as a woman!
So if you’re one of those people who is a little more dimply than average – here’s what you can do:
1. Wear clothes that cover the dimples. Spanx and biker shorts can be worn underneath trousers and longer skirts to give a smoother appearance.
2. Adjust the lighting in your bedroom and bathroom – diffuse light doesn’t reflect shadows from skin imperfections as much. It’s amazing how lighting can emphasize (or de-emphasize) cellulite.
3. Stay fit and tone your body as much as possible. That way if the rest of your body is lean and firm, the cellulite won’t be that big a deal.
4. Recognize that you will always have cellulite. It’s not your fault, you didn’t cause it and you can’t solve it. Don’t waste your money on creams and treatments that don’t work.
5. Remember that the vast majority of guys don’t even notice cellulite (it’s virtually invisible due to their fixation on other anatomical parts).
6. Blame it on the French. If you fixate on your cellulite you are letting them win! Show those French your best laissez-faire attitude by completely ignoring this “disease” that they concocted.
I vote that we go back to the days before the invention of cellulite and live a carefree, confident existence.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 14th, 2007 by Dr. Val Jones in Health Tips
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Every once in a while a friend or family member is in a bind and asks me if I can prescribe them some medication. When people have a case of painful otitis externa (external ear infection), some tinea corporis (ringworm), or just need an allergy medicine refill, for example, and can’t get an appointment to see their doctor for weeks, I generally feel badly and offer to prescribe them something to tide them over. I know it’s not right to prescribe medications to folks who aren’t technically your patients, but it just seems worse to watch them suffer with a time-sensitive illness that has a simple cure.
Today I had to look up all the various and sundry treatments for ringworm. According to my Pharmacopoeia (and eMedicine.com) pretty much any antifungal cream on the market is a possible treatment for it… so how is a doc to choose the best therapy? Is it trial and error? Is it pick the cheapest medicine on the list and cross your fingers?
There are times when many different medicines are appropriate treatment options, and the best choice requires a bit of guess work mixed with past experience. Since I can’t find any literature suggesting that one topical treatment is more effective than another, I just chose a common, inexpensive cream. Sometimes medical decision making has its gray areas… Wouldn’t it be nice if everything had one clear answer?
Oh, and if you do have ringworm, keep in mind that 1) you can catch it from your dog – and yeah, Fido could catch it from you 2) you are contagious to others 3) it’s easy to treat with pretty much any anti-fungal cream or lotion (apply twice a day for 2 weeks or so) 4) if you can’t get to see your doctor, using over the counter Monistat may do the trick in a pinch. If your skin is not responding to the cream – better get checked out to make sure it really is a fungal infection and not something else.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 13th, 2007 by Dr. Val Jones in Humor, Medblogger Shout Outs
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Three of my favorite medical bloggers all posted hilarious observations about the differences between men and women. I’m not sure what got them thinking on the same wavelength – maybe it’s because Father’s Day is coming up?
Dr. Rob writes:
You may have also noted that x-chromosomes have many more genes than
y-chromosomes. Many scientists believe that the feeling by many women
that jeans make them look fat comes from the fact that there are more
genes in a women’s body, and this is actually a cry for help from the
chromosomal level. Other scientists think these scientists are just
full of hooey.
Dr. Au writes:
Michelle: You accidentally threw out your old med school ID tag, but I rescued it.
Husband: Yeah, I saw that on the table. I threw it out again.
Michelle: Why would you throw it out? Wouldn’t you want to save that?
Husband: (Perplexed) Why?
Michelle: Because…because it’s nostalgic! Your old med student ID tag! Don’t you want to save that? Think how cool that’ll be, when you’re some old crusty attending, to have your med student name tag from the turn of the century!
Husband: Not…really. Why would I want that?
Michelle: Well, why do people save anything? Why do you save your med school diploma?
Husband: I need that to get a job.
Michelle: OK, bad example. Why do you save your graduation tassels?
Husband: I didn’t.
Michelle: You threw out your med school graduation tassel?
Husband: Well, I don’t remember saving it. What would I do with it?
Michelle: Look, if I have to explain why you would save something like that, you probably wouldn’t understand anyway.
Dr. Leap writes:
They [women] think we want nothing so much as another pineapple wall hanging
that they saw in Southern Living. But men like gifts too! We just
like them to be a little different. We don’t want a day at the spa; we
want a day of quail hunting. We don’t need a pedicure; we need to go
to the Indy 500 time trials. We prefer to buy our own underwear,
thanks, but a pair of camouflage, Gore-Tex gloves for that winter
hunting trip would be really nice…
And over the years, I have developed a simple rule of three things that
almost every man will accept as a reasonable gift. They are: a pen, a
watch and a knife. This will cover the gamut of almost all men in the
Western Hemisphere, and most in the rest of the world. See, a pen
reminds us that our ideas and insights are meaningful, and sometimes
need to be recorded. (And is useful for writing checks to buy flowers
and silky things on Mother’s Day). A watch reminds us that our time on
earth is short, and we must use it well. (And that we’re late for
work). And a knife reminds us that we have capacity and usefulness;
that we are movers in our world, always armed with something that can
serve as tool or weapon as the need arises. (And that we probably need
a tetanus shot).
I wonder if Dr. Leap’s advice also works well for “Metrosexuals?” What do you think guys? Is the best Father’s Day gift a pen, a watch, or a knife?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 11th, 2007 by Dr. Val Jones in Medblogger Shout Outs
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Welcome to the latest round up of the best of the healthcare
blogosphere. Today it is my pleasure to offer you your weekly dose of Grand
Rounds, optimized for your state of mind.
I believe that there are two basic types of blog readers, and so you’re
getting Grand Rounds 2 ways (with a dash of cartoons thrown in for extra “feel
good” measure):
- Just
the Facts: Distractible, hurried, currently in between seeing patients –
or perhaps your kids, cats, dogs, llamas are begging for attention… or
maybe you’re an ER nurse or surgeon who has no patience for long winded
stories? You’re category one and
should proceed directly to Grand Rounds IR (immediate release – below).
- All
the Details: Calm, peaceful, you enjoy good prose and a cup of chai
latte. You like reading all the
juicy details of a grand rounds line up and will spend hours picking
through the references – or maybe you’re an Internist or Psychologist who
knows that the best medicine is found in the details? You’re category two and should proceed
directly to Grand Rounds XR (extended release – next post).
Many thanks to Nick Genes, father of Grand Rounds (who acts
behind the scenes to ensure the success of each host), and please check out
next week’s Grand Rounds at Code Blog: Tales of a Nurse.
Grand Rounds IR (asterisk
= honorable mention for great writing)
Happy Posts
*Starbucks Caters to Diabetics
Woman Saved by Bush Pilot in Frozen Tundra
*CEO Says He’s Sorry
Prayer Can Reduce Arthritis Risk?
*Disaster Unpreparedness [Cartoon]
Med School Graduation Ceremony [Cartoon]
Nurse uses Star Trek Mentor to Set Course for Kindness
Galaxy
Shrink Rap Podcast: Prank Call with Dr. Phil McGraw &
More [Cartoon]
*Cape Cod Vacation Derailed by Flood, Stroke, Famine & Infection
The Evils of Hand Washing
Sad Posts
Triage in the ED [Cartoon]
*Sad Cases in ED
Elderly at Risk of Death From Tranquilizers [Cartoon]
Life as a Nurse Assistant in Vermont
Hot Topics
Infanticide
Hucksterism
Healthcare Outsourcing (podcast) [Cartoon]
Blog Censorship A
Blog Censorship B
Arrogant Docs [Cartoon]
Should Kim See Sicko?
Helpful Tips
To Fend off Bears
To Get the most out of Medicine, Web 2.0 style
To Get into Medical
School
To Avoid Kidney Damage from Contrast Agents
To Perform A Pyloromyotomy [Cartoon]
To Diet Successfully – Gluten Free [Cartoon]
Case Reports
Wii-itis
Rare pancreatic tumor
Uncategorized
Cost-benefit analysis of genetic testing
Commencement Speech for Harvard Medical
School Graduation
New Alzheimer’s Research [Cartoon]
New Genetic Research
Book Recommendation for Type 2 Diabetes
For the full text version complete with cheerful commentary, please go to Grand Rounds XR
(next post)
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 11th, 2007 by Dr. Val Jones in Medblogger Shout Outs
5 Comments »
…continued from Grand Rounds 3.38…
GRAND ROUNDS XR
(asterisk = honorable mention for great writing)
Happy Posts
*Kerri from Six Until Me tells the heart-warming story of a
Starbucks Barista who understood her diabetic needs and treated her with
special care.
Traveling Doc from Borneo Breezes Blog, submits a post about
the bush pilots of the Canadian north.
Even though it’s summer time you’ll shudder at this arctic tale of a
native woman whose life was saved by a bush pilot and an Australian surgeon.
Tony Chen of Hospital Impact submits a post by Nick Jacobs, the CEO of Winder Medical Center.
In it Christopher apologizes for being ill tempered and snapping at a
woman who posted a paper sign on the wall.
Dr. Jolie Bookspan of the Fitness Fixer Blog offers a
fascinating look at the physical healing power of prayer. Jolie reports that the movements involved in
Muslim prayer (including standing, bowing, kneeling, and sitting) can promote
flexibility, increase quad strength, and burn up to 80 calories/day. She explains that similar prayer posturing
(found in Russian Orthodox prayer and some forms of yoga meditation) may be
equally useful.
Rita Schwab at MSSP Nexus Blog writes a really funny post
about disaster preparedness. She muses
about how she had been taught to hide under her school desk in case of a
bombing, and even then (at the tender age of 8) wondered how the desk vs. bomb
equation would really pan out for her.
But the real amusement comes when you click on her link to the CDC’s
recommended communication releases on such plagues as tularemia. Yes, the bacterium found in rabbits and
rodents (that perhaps 125 hunters succumb to each year in this country) is not
contagious from human to human and causes flu-like symptoms. I’d give this a fear factor of 1 out of 10. [Cartoon]
Dr. Bruce Campbell of Reflections Blog describes the medical
school graduation ceremony – the first time “doctor” is officially tied to the
graduate’s name. [Cartoon]
Mother Jones, RN from Nurse Ratched’s Place, confesses to
being a trekkie. She did find a good
role model in nurse Chapel, though. Now
here’s my confession: I’ve been known to utter a few “Damn it, Jim-s!” when
asked to do non-medical related work at my current job.
Roy
at Shrink Rap pulls a “Jerky Boys” style practical joke on Dinah. He uses prerecorded audio clips of Dr. Phil
McGraw to simulate a live Skype conversation with her, and gets Dr. Phil to ask
Dinah outrageous questions and give her bizarre advice such as, “I want you to
live as a gay woman.” Poor Dinah falls
for it for a short time… and it’s rather funny, especially if you enjoyed the
Jerky Boys prank call to Hooters with Arnold Schwarzennegger clips. [Cartoon]
Laurie at a Chronic Dose tells a hilarious story of 3 chronically ill family members who experience a comedy of errors during a vacation in Cape Cod. Somewhere between the brain aneurysm, flood, sunburn turned staph cellulitis, and cell phone lost in the ocean, there’s humor in the midst of tragedy.
Susan Palwick from Rickety Contrivances of Doing Good describes the evolution of hand washing requirements for all staff (including chaplans) at her hospital.
Sad Posts
ERnursey from ERnursey: Stories from an Emergency Room Nurse
gives us an eye-rolling perspective on exactly how emergency departments are
abused by drug-seekers and non-emergent cases of ridiculousness. Triage ain’t easy. [Cartoon]
*Type B Pre-med from the blog by the same name, offers a
tear jerking slice of life from the ED.
A woman with breast cancer finds out that it has metastasized to her
brain while a 9 year old sexual assault victim waits for the doctor to see him
next.
Christian Bachmann from Med Journal Watch reminds us that
tranquilizing medications are associated with shorter lifespans in the demented
elderly population. [Cartoon]
Matthew at Path Lab tells the sad story of a bariatric patient’s woes in the hospital, and what daily life is like for nurse assistants.
Hot Buttons
Dr. Tara Smith at Aetiology, discusses the tragedy of
infanticide, and the events that led up to the recent murder of a newborn in Iowa. She asks whether designated “safe havens”
(where mothers can drop off unwanted babies, no questions asked) are not
promoted enough by the media or if the state of mind of a woman who has just
given birth to an unwanted baby wouldn’t be receptive to that messaging.
Dr. Hsien-Hsien Lei interviews the CIO of Suracell Personal
Genetic Health to try to get to the bottom of whether or not nutrigenomic
testing is a form of hucksterism. This
quote followed an objection about nutrigenomic supplements costing more
than similar products in health food stores: “Well, our clients like paying
more for what they believe is something better than the cheaper versions.” Orac should take a look at this.
David Williams of Health Business Blog submits a
thought-provoking podcast of a recent interview he conducted with the founder
(founded in 2002) and creator of Planet
Hospital, Rudy
Rupak. Rudy starts the podcast
explaining that his company arranges surgical treatment for travelers who need
emergent care in foreign countries, but later on explains that the primary
income stream for Planet
Hospital involves
healthcare outsourcing for American women who are “too wealthy for Medicaid and
too young for Medicare” and want cosmetic procedures or IVF done at a lower
price. Rudy then explains that he has a
program called “the best of both worlds” where plastic surgeons travel overseas
to perform their procedures for cash – outside of malpractice laws and with
lower overhead. [Cartoon]
Henry Stern, at InsureBlog comments on the recent loss of
Flea and other medical bloggers. He says
that “There’s a creeping reticence in the blogosphere… and maybe that’s a good
thing.”
Amanda from It’s All About the Walls marries her frustration
with her own health issues with some frustration at the apparent censorship of
certain bloggers.
N=1 from Universal Health offers this challenge – doctors
should try to get outside of their egocentric shells and get to know (and learn
from) all of the knowledgeable, competent allied
health professionals around them, especially nurses. [Cartoon]
Kim at Emergiblog expresses deep inner conflict about going to see Michael Moore’s new movie, Sicko. If she goes, she donates $10 to his cause, if she doesn’t go she’ll be left out of a hot topic of conversation. This is a tough call, fair sister.
Helpful Tips
Dr. Auerbach from Healthline describes how to handle
encounters with bears. I didn’t realize
that humans should respond differently, depending on the kind of bear. Check out what to do if you run into a
Grizzly versus a Black Bear.
Bertalan Meskó from Science Roll lists some “Web 2.0”
activities for patients and physicians alike.
But Bertalan forgot about Revolution Health!
Sarah (a bubbly Aggie from Texas A&M) has some
practical tips on how to get into medical school.
Dr. Joshua Schwimmer from Healthline explains that
Gadolinium used to be the contrast agent of choice for patients with kidney
disease (since the regular iodine-based agents can cause “contrast
neuropathy”) but now new cases of a scleroderma-like condition (called
“nephrogentic systemic sclerosis”) have been associated with Gadolinium. Bottom line: if you have kidney disease, any
sort of contrast dye is risky!
Dr. Lisa Marcucci from Inside Surgery offers up the
technical how-to’s for an open pyloromyotomy to repair baby stomachs. Some little ones are born with a narrow,
thickened area in the junction between the stomach and the intestine so food
can’t pass through. But thank goodness
for surgeons like Lisa who can fix them in a jiff! [Cartoon]
Chronic Babe describes her impulsive eating habits and what
she’s going to do to try to avoid chocolatey, salty days in the future. [Cartoon]
Case Reports
Dr. Ves Dimov of Clinical Cases and Images – Blog –
discusses the New England Journal’s recent case report of Acute Wiiitis
(contracted as an overuse injury from the Nintendo video game Wii remote
control). He rightly points out that as
far as medical nomenclature is concerned, “itis” is more appropriately appended
to the name of the affected body part (e.g. tendon-itis). As far as we know, a Wii remote is not part
of the human body – though one can see how the NEJM editors couldn’t resist
accepting the resident physician’s title selection.
Dr. Iñarrito-Castro from Unbounded Medicine presents a
fascinating case report of an exceedingly rare pancreatic tumor. Beautiful imaging and photos.
Uncategorized
Dr. Keith Robison of Omics! Omics! Blog describes his
thought process of what it might take to determine the underlying genetic cause
for one little girl’s unknown syndrome.
In the end he suggests that it might cost $1 million (to map her entire
genome) and result in no clinically useful benefit. In this cost-benefit analysis, it looks as if
mom got it right – love the child as she is, and spend your money on mobility
enhancing equipment.
Dr. Joe Wright submits his commencement speech (for
Harvard’s graduating class of MDs and DDSs) for your consideration.
Girlvet from Madness: Tales of an Emergency Room Nurse
describes some promising research in Alzheimer’s Disease and how her own mom died in a nursing home from complications of the disease. [Cartoon]
Nurse JC Jones from Healthline, highlights the recent
Wellcome Trust announcement of significant advances in the genetic
underpinnings of several major diseases. She includes a recent photograph of
James Watson (of Watson and Crick fame), who is now 79 years old.
Rachel from Tales of My Thirties highly recommends a book
about Type 2 Diabetes.
SPECIAL BONUS POSTS
Now, because Dr. Val has a keen eye and is very meticulous, she has rounded up some savory morsels that she found on her own – these posts were not formally submitted to Grand Rounds 3.38, but will be included because she’s sure their authors wouldn’t object:
Dr. Richard Reece from MedInnovationBlog summarizes Regina Herzlinger’s arguments for consumer driven healthcare.
PandaBearMD explains why he believes that Chiropractors are quacks – and other controversial issues.
Kevin, MD points out that while websites designed to allow patients to rate doctors are gaining acceptance, websites that allow clients to rate lawyers are causing a legal meltdown.
Dr. Stanley Feld (former President of the American Association of Clinical Endocrinologists) takes a very well argued swipe at Dr. Steve Nissen’s recent article about Avandia in the New England Journal of Medicine.
Dr. Charles exposes the quackery of Dr. Heimlich (of the Heimlich maneuver).
Dr. Au from the Underwear Drawer accidentally summarizes the difference between men and women in a conversation with her husband about whether or not to save an old medical school name tag.
Dr. Rob from Musings of a Distractible Mind offers some hilarious genetic explanations for male/female differences.
Hallway Four captures a fascinating disconnect between what a patient thinks a doctor is doing and what a doctor is actually doing.
Dr. Hildreth at the Cheerful Oncologist gives us 8 ways to cope with a malpractice lawsuit.
Dr. Scalpel presents a case of a scratch (plus toenail fungus) sufferer presenting for a work excuse.
#1 Dinosaur argues that obese doctors are more empathic counselors for obese patients who wish to lose weight.
TBTAM recounts a sexual history dialogue in which a patient had condoms delivered at 5am from a local deli.
Ian from ImpactEDnurse continues the condom refrain with an interesting analogy: how practicing “safe nursing” is like practicing safe sex.
FLASHBACK: And for the all time coolest classic blog post… let’s go back to GruntDoc circa 2004 for a look at the scariest menace in the ED: “Some Dude.”
Thanks for reading! Hope you’ll tune in for our regular Wednesday feature of Revolution Rounds – the best of the 27+ person Revolution Medical Blogger team posts, organized and served up friendly by yours truly.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
