August 23rd, 2011 by Elaine Schattner, M.D. in Opinion, Research
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There’s so much weird and exciting cancer news this week, it’s hard to keep up!
Double-kudos to Andrew Pollack on his front-page and careful coverage in the New York Times of the hyperthermic intraperitoneal chemotherapy (Hipec) technique that’s being used at some name-brand health care facilities to treat colon cancer.
First, he spares no detail in the Times describing the seemingly primitive, crude method:
….For hours on a recent morning at the University of California, San Diego, Dr. Andrew Lowy painstakingly performed the therapy on a patient.
After slicing the man’s belly wide open, Read more »
*This blog post was originally published at Medical Lessons*
August 23rd, 2011 by KerriSparling in Opinion
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I have several One Touch meters, a Freestyle one, and a Dexcom continuous glucose monitor that I consult on a regular basis. (Not usually at the same time, but I have been doing multiple checks recently. More on that below.) I also have an Agamatrix meter and an Accu-chek one, somewhere in the diabetes cupboard in the bathroom, only without any strips that aren’t expired.
And I have a lot of anxiety when it comes to glucose meters. The variability of these machines makes me crazy in the head, and it caused me a lot of grief when I was pregnant, because my blood sugar goal range at that point was so tight and so specific, and any variability was huge for me. (I shared some samples of wonky results in this post.)
In the last few weeks, I’ve been doing some experimenting with my meters, Read more »
*This blog post was originally published at Six Until Me.*
August 22nd, 2011 by Dinah Miller, M.D. in Opinion
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I’ve been at it a long time, and one thing (of many things) that I still have not gotten down is scheduling. I seem to have a method to my own madness, but somehow I imagine it’s not how other people do this. I’ve heard other shrinks say, “I’m booked for the next 4 weeks” or say they aren’t taking any new patients. Some people put a “no new patients” message on their answering machine. Wait, so no appointments for 4 weeks? What if a patient calls and needs to be seen very soon? Like this week? If you can’t wait, go to the ER? I thought the point of having a private doc was that you didn’t have to go to the ER unless something couldn’t be handled safely as an outpatient. And if you tell the world that you don’t take new patients, then don’t people stop referring to you? It seems to me that patients will come in and announce, “I’m doing better and want to come less often,” “I’m moving,” “I’m done,” or they will cancel an appointment, not call back, and not be heard from again for weeks or months. Sometimes it all happens on very short notice and life can be very unpredictable.
In my pre-shrink days, I thought that psychiatry worked such that patients came every week (or twice a week, or whatever) and had their own slots. Tuesday at 1, that’s me! So a psychiatrist had every slot full with patients this way, and could be “full,” until a patient finished and stopped coming, and then another soul was let in to the Tuesday at 1 slot. Gosh that would be nice, but it doesn’t seem to work that way. Read more »
*This blog post was originally published at Shrink Rap*
August 22nd, 2011 by Glenn Laffel, M.D., Ph.D. in Opinion, Research
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Way back in 1946, the chartering documents for a new agency of the UN—the World Health Organization—defined health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
We have made astounding progress in medicine and public health since the WHO charter was crafted, yet we have actualized only part of its comprehensive vision for health. What we call health care today is really just illness care. Even our disease prevention and health promotion programs focus on reducing risk factors for disease. It is the rare initiative indeed that encourages good health for its own sake. Read more »
*This blog post was originally published at Pizaazz*
August 22nd, 2011 by Steve Novella, M.D. in Health Policy, Opinion
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In 1994 Congress (pushed by Senators Harkin and Hatch) passed DSHEA (the Dietary Supplement Health and Education Act). As regular readers of SBM know, we are not generally happy about this law, which essentially deregulated the supplement industry. Under DSHEA supplements, a category which specifically was defined to include herbals, are regulated more like food than like medicinals.
Since then the flood-gates opened, and there has been open competition in the marketplace for supplement products. This has not resulted, I would argue, in better products – only in slicker and more deceptive claims. What research we have into popular herbals and supplements shows that they are generally worthless (except for targeted vitamin supplementation, which was already part of science-based medicine, and remains so).
A company can essentially put a random combination of plants and vitamins into a pill or liquid and then make whatever health claims they wish for their product, as long as they stay within the “structure-function” guidelines. This means they Read more »
*This blog post was originally published at Science-Based Medicine*
