February 11th, 2011 by John Di Saia, M.D. in Health Tips, Opinion
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Liposuction (aka “lipo”) is plastic surgery’s “gimmick procedure” having had more angles applied to it than a child’s toy. But there’s money to be made in fat reduction, so the gimmicks will just keep coming.
Enter “tickle” lipo, a new technology superimposed on the liposuction game. In this newer version of the basic liposuction technique, the cannula — the instrument used to remove the fat — vibrates like a whip inside your fatty layers. This supposedly helps remove the fat more evenly and with less pain.
Tickle lipo looks like a hybrid between two other forms of lipo already on the market: Power-assisted liposuction (PALS) in which a motorized cannula breaks up the fat, and ultrasonic liposuction in which sound waves do it. Will tickle lipo be better or worse than its fat-sucking competitors? That will likely depend upon the technology and the skill of those who use it.
However, a funky high-tech instrument won’t make a non-surgeon into a master plastic surgeon, just like a hot race car won’t make you into Jeff Gordon. Check the credentials of anyone who wants to use this tool on you. At this point I would consider tickle lipo an experiment.
– John Di Saia, M.D.
*This blog post was originally published at Truth in Cosmetic Surgery*
February 10th, 2011 by RyanDuBosar in Health Tips, Research
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Physicians said in a survey that noncompliance with advice or treatment recommendations was their foremost complaint about their patients. Most said it affected their ability to provide optimal care and more 37 percent said it did so “a lot.”
Three-quarters of patients said they were highly satisfied with their doctors. But they still had complaints ranging from long wait times to ineffective treatments.
Those are just some of the findings from two surveys, the first a poll of 660 primary care physicians conducted by the Consumer Reports National Research Center in September 2010 and the second a poll of 49,000 Consumer Reports subscribers in 2009. The magazine reported its results online.
In the doctors’ poll, physicians named these top challenges:
— 76 percent of doctors said when it came to getting better medical care, forming a long-term relationship with a primary care physician would help “very much.”
— 61 percent said being respectful and courteous toward doctors would help “very much,” while 70 percent said respect and appreciation from patients had gotten “a little” or “much” worse since they had started practicing medicine. This was a two-way street, since patients reported the same feelings.
— 42 percent physicians said health plan rules and regulations interfered “a lot” with the care they provided.
Also noted in the poll, 37 percent of physicians thought they were “very” effective when it comes to minimizing pain and discomfort for their patients, though 97 percent thought they were “somewhat” effective. But, 79 percent of patients said their doctor helped to minimize their pain or discomfort, according to the Consumer Reports blog. The gap might be explained by doctors thinking of their overall effectiveness with all of their patients, including those with chronic pain conditions that are difficult to diagnose and treat, and who are as a group less satisfied with their physicians. Read more »
*This blog post was originally published at ACP Internist*
February 10th, 2011 by Elaine Schattner, M.D. in Better Health Network, Opinion
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[Recently] I came upon a Jan 24 op-ed, “A Fighting Spirit Won’t Change Your Life” by Richard Sloan, Ph.D., of Columbia University’s psychiatry department. Somehow I’d missed this worthwhile piece on the sometimes-trendy notion of mind-over-matter in healing and medicine.
Sloan opens with aftermath of the Tucson shootings:
…Representative Giffords’s husband describes her as a “fighter,” and no doubt she is one. Whether her recovery has anything to do with a fighting spirit, however, is another matter entirely.
He jumps quickly through a history of the mind cure movement in America: From Phineas Quimby’s concept of illness as a product of mistaken beliefs — to William James and “New Thought” ideas — to Norman Vincent Peale’s 1952 “Power of Positive Thinking” — to more current takes on the matter. These ideas, while popular, are not reality-based.
In his words:
But there’s no evidence to back up the idea that an upbeat attitude can prevent any illness or help someone recover from one more readily. On the contrary, a recently completed study* of nearly 60,000 people in Finland and Sweden who were followed for almost 30 years found no significant association between personality traits and the likelihood of developing or surviving cancer. Cancer doesn’t care if we’re good or bad, virtuous or vicious, compassionate or inconsiderate. Neither does heart disease or AIDS or any other illness or injury.
*Am. J. Epidemiol. (2010) 172 (4): 377–385.
The New York Times printed several letters in response, most of which point to pseudo-evidence on the matter. All the more reason to bolster public education in the U.S. — people won’t be persuaded by charismatic, wishful thinking about healthcare.
It happens I’m a fan of Joan Didion’s. I was so taken by the “Year of Magical Thinking,” in fact, that I read it twice. Irrational responses — and hope — are normal human responses to illness, disappointment, and personal loss. But they’re not science. It’s important to keep it straight.
*This blog post was originally published at Medical Lessons*
February 10th, 2011 by PJSkerrett in Health Tips, Research
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As a youngster, I loved being part of the baby boom — it meant there were dozens of kids on my block who were ready to play hide-and-seek or join mysterious clubs. Now that I’m of an AARP age, there’s one club I don’t want to join: The one whose members have bypass scars, pacemakers, or other trappings of cardiovascular disease. The American Heart Association’s (AHA) gloomy new forecast on cardiovascular disease tells me it won’t be easy to avoid.
The AHA foresees sizeable increases in all forms of cardiovascular disease (see table) between now and 2030, the year all of the boomers are age 65 and older. Those increases will translate into an additional 27 million people with high blood pressure, eight million with coronary heart disease, four million with stroke, and three million with heart failure. That will push the number of adult Americans with some form of heart disease to 110 million.
(Percentages refer to the percentage of Americans aged 18 years and older.)
If the AHA’s projections are accurate, the cost of treating cardiovascular disease would balloon from $272 billion today to $818 billion in 2030. Add in the cost of lost productivity, and it jumps to more than $1 trillion. Yikes!
Although obesity and inactivity are part of the problem, much of the increase comes from the graying of the baby boom. We can’t stop boomers from aging, but we can fight cardiovascular disease, a condition the AHA calls “largely preventable.” Read more »
*This blog post was originally published at Harvard Health Blog*
February 10th, 2011 by Medgadget in Better Health Network, Research
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Following from the somewhat common sense idea that women who were less stressed during in vitro fertilization and embryo transfer (IVF-ET) had better outcomes, the journal Fertility and Sterility published a study out of Israel that claims “medical clowning” improved pregnancy rates compared to a group not exposed to a clown on the day of implantation.
From the abstract:
This experimental prospective quasi-randomized study examining the impact of a medical clowning encounter after ET after IVF found that the pregnancy rate in the intervention group was 36.4%, compared with 20.2% in the control group (adjusted odds ratio, 2.67; 95% confidence interval, 1.36–5.24). Medical clowning as an adjunct to IVF-ET may have a beneficial effect on pregnancy rates and deserves further investigation.
In the methods section, the researchers describe the study design. For the intervention group (n=110) a “professional medical clown” visited the patient immediately after the procedure for about 15 minutes and performed the same routine including “jokes, tricks, and magic” while dressed as a chef.
While the study itself only uses one routine, presumably similar effects could be experienced by a patient bringing in a personal media device and watching something they know will amuse them right after their own procedure. Hopefully, no need to bring your own clown if the office won’t provide one for you. Read more »
*This blog post was originally published at Medgadget*
