December 27th, 2007 by Dr. Val Jones in News
Tags: Hospitals, News
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A hat tip to KevinMD’s guest blogger, JoshMD for this great link. The British Medical Journal offers a short historical analysis of 7 common medical myths, sometimes perpetuated by physicians themselves:
- People should drink at least eight glasses of water a day
- We use only 10% of our brains
- Hair and fingernails continue to grow after death
- Shaving hair causes it to grow back faster, darker, or coarser
- Reading in dim light ruins your eyesight
- Eating turkey makes people especially drowsy
- Mobile phones create considerable electromagnetic interference in hospitals.
To find out why each of these commonly held beliefs are either untrue or unsubstantiated, check out the original journal article. It’s a lot of fun.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
December 11th, 2007 by Dr. Val Jones in News
Tags: Infectious Disease, News
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I was troubled by an article that I read in the Washington Post today. Apparently a common cold virus (adenovirus) has mutated unexpectedly into a killer strain (with a death rate as high as 23% for those infected in Oregon). The CDC has been carefully tracking this virus over the past year, and has noted outbreaks in Oregon, Washington State, Texas, and New York. Genetic studies of this virus suggest that it is similar to adenovirus 14, first described in Holland in 1955, but has very recently mutated into a more virulent form.
The interesting (and frightening) thing about this virus is that it’s so strong that it can kill young, otherwise healthy people, rather than the usual “at risk” populations of the very young and the very old. There’s no way to know if this virus will spark an epidemic, or whether it will die down and disappear for now.
Those who have had the virus, and lived to tell about it, say that it came on like a usual cold but then instead of getting better at the usual 4-7 day point, their symptoms got worse, and high fevers, cough, and difficulty breathing ensued. Some folks have even required mechanical ventilation in the ICU setting to help them breathe.
This virus reminds me that we are very vulnerable to unexpected attacks from infectious diseases. All the while we docs had our eyes on bird flu and SARS, this little cold virus mutated into a killer. If you have a high fever with difficulty breathing, please see your doctor right away. Let’s hope this epidemic threat dissipates before it can gain a real foothold.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
November 14th, 2007 by Dr. Val Jones in News, Opinion
Tags: Alzheimer's, Geriatrics, News, Relationships
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“Grow old along with me! The best is yet to be, the last of life, for which the first was made.”
— Robert Browning
As a rehabilitation medicine specialist I do a lot of work with cognitively impaired men and women. The brain is a fragile and fascinating organ, and perhaps the most perplexing one to treat. Alzheimer’s disease, of course, has no known cure – and those who contract it meander through a frustrating cognitive web towards a final common pathway of dementia, dependence and eventually death.
Former Chief Justice Sandra Day O’Connor has been in the news lately because her husband, an Alzheimer’s patient who requires nursing home assistance for activities of daily living, has forgotten who she is. But even more emotionally difficult is the fact that he has fallen in love with a fellow nursing home resident, and has been behaving like a love-sick teen – holding hands, staring into her eyes and kissing her tenderly.
The New York Times reports that Ms. O’Connor is “happy for her husband” that he has found joy in the midst of his cognitive decline. I wonder if there truly isn’t part of her that mourns the loss of those kisses that were once for her.
My fondest hope is that I can grow old with my husband, and that we will enjoy our final years together, in possession of all our faculties. I hope that Robert Browning’s poem will ring true at the end, and that I never have to watch my husband forget who I am. Sadly, since my grandmother passed away from Alzheimer’s – I wonder if it will be my husband, and not me, who watches the other decline?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
November 13th, 2007 by Dr. Val Jones in Expert Interviews, News
Tags: Infectious Disease, News, Surgery
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Sadly, four transplant patients in the Chicago area recently discovered that their new organs were infected with HIV and hepatitis C. This is the first case of infected organ donation in the past 20 years, with over 400,000 successful, healthy transplants completed in that time period.
I’m actually a little surprised that this is the only known case of infected organ transplants in the past two decades, since the tests to rule out HIV and hepatitis C rely on antibodies. It takes the body at least three weeks to produce antibodies to these viruses, and so people who are infected with HIV and hepatitis C have false negative tests for the first few weeks. So there is always the risk that an organ donor could have contracted these viruses within 3 weeks prior to his or her death.
I asked Dr. David Goldberg, an infectious disease specialist in Scarsdale, NY, to weigh in:
Are there any tests available now that can detect the viruses themselves, or only antibodies? How early after infection could we detect them?
Traditional serologies measure antibodies against the viruses which take weeks or months to develop, whereas there is a more rapid test, called “PCR,” that is a direct measure of the number of viruses in the blood.
HIV reproduces rapidly, so the virus can usually be detected in the bloodstream within 8 days of infection. By contrast, hepatitis C virus replicates more slowly, so the virus may not be detectable until as long as 8 weeks after exposure. So the use of the HIV PCR test in addition to antibody tests would pick up almost all cases of HIV, but the hepatitis C PCR might still miss a number of early infections.
How can we protect future organ recipients from such a tragic event?
PCR is not generally performed because the test is time-consuming and many organ donors are trauma victims, which leaves little time for testing. However, PCR testing could theoretically reduce the number of HIV infected organs that are transplanted (from recently infected individuals), but would not improve the odds in hepatitis C because of the slow growing nature of the virus. In the end there’s no perfect test or 100% guarantee that organ donors don’t have HIV or hepatitis C.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
November 13th, 2007 by Dr. Val Jones in Health Tips, News
Tags: Diabetes, News, Physical Medicine And Rehabilitation, Podiatry, Research
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Diabetes is a tricky disease. Sugar build up in the blood stream can damage tiny blood vessels that supply nerve endings, resulting in skin numbness. The feet are at the highest risk for nerve damage (neuropathy) and folks with diabetes often cannot sense pain in their feet.
How many of us have gotten blisters from ill fitting shoes? Painful, right? Well imagine if you didn’t feel the pain of the blistering and kept on walking, oblivious to the injury. Eventually you’d have a pretty bad sore there. This is what happens to people with diabetes who don’t choose their shoes carefully. In addition, sores don’t heal well because of the decreased blood supply to the area (from the damaged blood vessels). And to top it off, the high sugar levels in the sores provides additional sustenance to any bacteria that might be lurking on the skin. It’s pretty easy for diabetics to develop infected wounds, which can grow larger and even require amputations of dead tissue.
A recent research study suggests that the secret to avoiding this downward spiral is in choosing shoes that fit well – though they estimate that as few as one third of people with diabetes actually wear optimal fitting shoes. This may be because there is a strange temptation for people with diabetes to choose extra small shoes due to their neuropathy. When normal sensation is lost in the feet, tight fitting shoes actually feel better because they can be sensed more readily by the brain. So even though spacious shoes that don’t cramp the toes or cause blistering are the best footwear, they don’t always feel as comfortable. However, patients with diabetes who are properly fitted for orthopedic shoes with the help of a physiatrist or podiatrist, may substantially reduce their risk of ulcers.
So the bottom line for people with diabetes: choose your footwear carefully, and get professional help to make sure that your shoes fit well. Proper shoes could help to decrease your risk for foot and leg ulcers and potential amputations.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
