June 3rd, 2011 by John Di Saia, M.D. in Health Tips
Tags: Breast Augmentation, Breast Implants, Capsular Contracture, Complications, Hardened Implants, Plastic Surgery, Silicone, Surgery, Treatment
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I have had a capsulectomy due to capsular contraction, but now it has returned. I want an explant because they are uncomfortable and look unnatural. My doctor said that since the capsulectomy did not resolve the issue, he recommends having an explant and waiting about 6 months to a year. After my body has healed properly, he said that I can get implants again and will not get capsular contraction again. Is this accurate? Am I less likely to get capsular contraction or will I be free of capsular contraction? I’m also looking for a doctor experienced in explants.
The subject of hardened breast implants (Capsular Contracture) comes up frequently as it is the leading cause of long term dissatisfaction with breast implants. If your breasts tend to hurt or look unnatural, you likely have severe encapsulation (Baker Grade III or IV.) When contracture redevelops quickly after capsulectomy (assuming the operation was thorough,) this is worrisome as it may indicate a high tendency for recurrence. The main question when severe contracture is present is whether or not a cause can be identified. Bothersome contracture doesn’t happen to all patients. This kind of reaction is associated with cigarette smoking, bleeding, infection, silicone gel implants, poor soft tissue coverage and radiation exposure as well as a previous history of contracture. Some of these issues can be minimized in an attempt to reduce the tendency for encapsulation. Preventing the problem is the best solution. Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
June 2nd, 2011 by John Mandrola, M.D. in Health Tips, Research
Tags: Changing Outcomes, Coronary Angiogram, CT Scan, Fitness, Healthy Living, Heart Disease, Predicting Heart Disease, Radiology, Reducing Heart Attacks, Running, Timed Mile
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It is hardly news to say that we need better means to predict who will die of heart disease. No matter how much you may hear about medical errors, hospital acquired infections, or even distracted driving, it’s still heart disease that kills the most of us.
The inflammation that begins narrowing our arteries starts when we are young. It percolates quietly, stealth-like for years. The young usually skate by unscathed. But all the cookies, beers, chips, inactivity and work stress adds up. The tension of life squeezes our arteries, daring them to crack or fissure. This cataclysm is one of the ways that middle age may introduce herself.
A friend, or colleague, or sibling dies suddenly of heart problems. Those of us that our “masters-aged” have likely felt these sensations of sadness, and then the reality that they may be next.
“I should probably come in and get a check-up,” is something I hear frequently in the doctor’s lounge after such a tragedy.
I agree. When you are old enough to use reading glasses it is time to think about what lurks inside your heart’s blood vessels.
But herein lies the catch. Read more »
*This blog post was originally published at Dr John M*
June 1st, 2011 by Paul Auerbach, M.D. in Health Tips, Research
Tags: Bag-Valve Mask, Cardiopulmonary Resuscitation, CPR, Emergency Medicine, EMT, Masks, Mouth-to-Mouth, Rescue Breathing, wilderness medicine
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When a person performs cardiopulmonary (heart and lung) resuscitation (CPR), it is sometimes recommended to provide rescue breathing. This is certainly the case when the primary cause of the victim’s difficulty relates to failure to breathe adequately, such as with a drowning episode. When CPR first arrived on the landscape, laypersons were trained to perform mouth-to-mouth breathing (for adults) or mouth-to-mouth and nose breathing (for infants and small children).
Following growing concern about transmission of diseases from blood and body fluids, laypersons were introduced to using masks or something similar to allow them to provide breathing assistance (“artificial respiration,” “artificial ventilation,” “rescue breathing,” etc.) to non-breathing persons. Masks have been used for decades by professional rescuers for ventilating patients, often in conjunction with the use of bags in a “bag-valve-mask” configuration. The valve between the mask and bag provides for one-way flow and prevents the backwash of vomitus, blood, liquid from the lungs, or other fluids that might diminish the effectiveness of the technique.
A number of excellent masks and face shields are available on the market for rescuers to be able to (relatively) safely blow air into a victim’s lungs. One example is Read more »
This post, CPR: Mouth-to-Mouth Breathing May Have Some Advantages Over Mask-Assisted Breathing, was originally published on
Healthine.com by Paul Auerbach, M.D..
May 31st, 2011 by Jessie Gruman, Ph.D. in Health Tips
Tags: Care Coordination, Doctor Patient Relationship, Doctor-Patient Communication, Institute of Medicine, National Alliance on Mental Illness, Patient-Centered Medical Home, Referrals
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“The most important thing I learned was that different doctors know different things: I need to ask my internist different questions than I do my oncologist.”
This was not some sweet ingénue recounting the early lessons she learned from a recent encounter with health care. Nope. It was a 62-year-old woman whose husband has been struggling with multiple myeloma for the last eight years and who herself has chronic back pain, high blood pressure and high cholesterol and was at the time well into treatment for breast cancer.
Part of me says “Ahem. Have you been paying attention here?” and another part says “Well of course! How were you supposed to know this? Have any of your physicians ever described their scope of expertise or practice to you?”
I can see clinicians rolling their eyes at the very thought of having such a discussion with every patient. And I can imagine some of us on the receiving end thinking that when raised by a clinician, these topics are disclaimers, an avoidance of accountability and liability.
But all of us – particularly those receive care from more than one doctor – need to have a rudimentary idea of what each clinician we consult knows and does. Why is this clinician referring me to someone else? How will she communicate with that clinician going forward? How and about what does she hope I will communicate with her in the future?
Why does our clinician need to address these questions? Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
May 31st, 2011 by ErikDavis in Health Tips, Research
Tags: African Plum, Alternative Medicine, Cochrane, Evidence, Feverfew, Health, Herbal Remedies That Work, Horse Chestnut, Medicine, Red Yeast Rice, Saint John's Wort, Science
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Here at Skeptic North, we’ve often been a sharp critic of those herbal remedies that are unable to withstand the scrutiny of science. Yet nature does indeed house many pharmacologically active compounds, and it stands to reason that some of them will have medicinal value. So today, we’re going to turn the tables and look at 5 herbal remedies that have held up well in repeated studies and are generally regarded as effective.
1) St. John’s Wort for Depression
If there’s one herbal medicine that consistently gets high marks for effectiveness, it’s St. John’s Wort as a treatment for mild depression. A 2008 Cochrane Review looked at 29 trials totaling over 5000 patients, including 18 comparisons with placebo and 17 comparisons with synthetic standard antidepressants, and found significant effects in both cases. The Natural Medicines Comprehensive Database indicates that St. John’s Wort is likely as effective as both first generation antidepressants (low-dose tricyclics) and the current generation of selective serotonin reuptake inhibitors like Prozac, Zoloft, and Paxil. Read more »
*This blog post was originally published at Skeptic North » Erik Davis*
