December 14th, 2011 by AmyGivlerMD in Health Tips
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Many of my patients, over the years, have taken melatonin. Many other patients have asked me about it, but I’ve never had much to say. I hadn’t heard anything particularly bad about it, but couldn’t really recommend it. “Research melatonin” has been on my “To Do” list for a long time.
So here’s what I’ve discovered: Melatonin is a hormone. I’ve known that since medical school, of course, but that fact has struck me as peculiar these past few weeks. Why? Because it’s sold over the counter, and many people take massive amounts of it. No other hormone is available like this. The use of other hormones, such as insulin and thyroid hormone, need careful monitoring. Is melatonin so universally safe that it can be taken at any dose, for however long? The more we learn about melatonin, the less that seems to be the case. Read more »
*This blog post was originally published at Making Sense of Medicine*
December 14th, 2011 by Dr. Val Jones in Expert Interviews, Health Policy, Research
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It is estimated that as many as 10 million U.S. adults have ADHD (Attention-Deficit/Hyperactivity Disorder). A recent research study (publication-pending) suggests that the economic burden of ADHD on America could be as high as $250 billion annually. I attended a recent briefing on Capitol Hill and interviewed one of the study’s co-authors: Tufts economist, Dr. Peter Neumann as well as congressman (and psychologist) Tim Murphy about ADHD in America.
I learned from Dr. Neumann that cost these high cost estimates are most strongly influenced by reduced productivity in adult workers with ADHD rather than direct costs of treating children with the disorder. Productivity costs include absenteeism, and reduced work output due to difficulty focusing. Dr. Neumann explained that ADHD has many “spill over effects” in that it impacts the educational system, the justice system, the healthcare system, and our work environments. Please check out our interview video for the full story.
Congressman Tim Murphy is a clinical psychologist with three decades of experience in treating people with ADHD. He is also Co-chair of the Mental Health Caucus and GOP Doctors Caucus where he regularly works to raise awareness of healthcare accessibility needs. I had the chance to interview him also at the event.
I learned from Rep. Murphy that the costs of ADHD multiply when patients are untreated. Getting the correct diagnosis is critical, because impulsivity and problems with focusing are not always caused by ADHD. These symptoms can be caused by lead poisoning, damage to the limbic system of the brain, metabolic disorders, or even sleep apnea. Children who are inattentive should not be put on medications for ADHD without first confirming the diagnosis by ruling out other possible causes.
Rep. Murphy recommends a team approach to the management and treatment of ADHD and he believes that costs related to ADHD are escalating because some physicians are not managing children holistically, but resorting to prescribing medications without involving counselors and family directly. He sees lack of health insurance coverage for behavioral health services as a threat to comprehensive and effective ADHD treatment.
Please watch the video for the full interview with congressman Murphy.
*Please note that the panel event, and Better Health’s participation, was made possible by a grant from Shire Pharmaceuticals.
December 13th, 2011 by AndrewSchorr in True Stories
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Film adaptation of "Tuesdays with Morrie"
Many of you know about, or have read, the highly recommended book, Tuesdays With Morrie. I am reading it now with my 14-year-old son, Eitan, as part of an assignment for his ninth grade English class. Morrie, a college professor in Boston, was dying, withering away with ALS. Each Tuesday he would have a visit from one of his favorite former students, Mitch, a journalist from Detroit. Morrie, a man in his 70’s, mused about many things including the meaning of life and the inevitability of death. He was prepared for his end.
The other day I spoke about that book with a former high school English teacher – not Eitan’s. The circumstance was not good. The woman, 37, had been diagnosed with stomach cancer just six weeks ago. She’d been having heartburn and it wouldn’t go away. Endoscopy showed the cancer and other tests revealed its spread to her liver and lung – stage 4. The woman and her husband, her high school sweetheart, sat across from me at lunch. They have three young children, age Read more »
*This blog post was originally published at Andrew's Blog*
December 13th, 2011 by Peggy Polaneczky, M.D. in News
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After cautiously clearing Yaz for continued use Thursday, an FDA Advisory Panel Friday addressed post-marketing data showing similarly increased blood clot risks among users of the contraceptive patch. The committee, after having been clearly quite extensively briefed, heard testimony from Ortho Evra’s manufacturer and experts in epidemiology, gynecology and hematology. They also heard moving testimony about a young woman who died from a massive pulmonary embolism while using the Nuvaring, whose parents argued that not only the Patch, but most of the newer methods carry an increased clot risk that no woman should be allowed to take without being adequately informed.
The committee ruled that despite limitations of the data, the patch most likely carried a 1.5 times relative risk of blood clots compared to 2nd generation levonogestrel pills, but not necessarily higher than that of newer pills containing 3rd and 4th generation progestins and drosperinone. With a few dissenters, the committee voted to allow the Patch to stay on the market, but asked for Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
December 13th, 2011 by Shadowfax in Opinion
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A must-read piece from Ken Murray:
Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.
Worth the full read.
And so true. I’ve joked about getting the above tattoo when my times comes. (I would quibble that the modern CPR success rate is better than infinitesimal, especially with hypothermia, but it still ain’t great.)
It may have to do with Read more »
*This blog post was originally published at Movin' Meat*
