April 18th, 2009 by CodeBlog in Better Health Network
No Comments »
This story was related to me from a coworker:
I was taking care of a man who was on bipap. (Bipap is a form fitting mask that goes over the mouth and nose to help augment breathing. It has successfully been used numerous times in place of intubating patients and putting them on ventilators.) He was becoming restless and tired of the mask. I had to wait for the doctor to come and see him, though, before I could remove it.
Due to his medical condition, it was very important that he get an aspirin that day. Since I couldn’t give it to him by mouth (because of the mask), I had to explain to him that I’d need to give it rectally as a suppository.
He nodded his consent and I proceeded to give the aspirin.
A short while later, the doctor came to see the patient and agreed that we could take the bipap mask off for awhile. I happily entered the patients room to take the mask off… and before it was even off his face, he stuck his finger in the air and said,
“FOR THE RECORD, that is a hell of a way to take an aspirin!!”
It’s a hell of a way to give one, too.
*This blog post was originally published at Gina Rybolt, RN’s Code Blog.*
April 17th, 2009 by John Briley in Expert Interviews, Uncategorized
No Comments »
Midway through the third quarter of an April 2 NBA game between the Cleveland Cavaliers and Washington Wizards, a Cleveland guard tossed a lob pass toward the rim. Most of us sitting in the Verizon Center, in downtown Washington, D.C., had an idea what was about to happen.
Lebron James, the 24-year-old heir apparent to the NBA’s Best Ever moniker, elevated from the left baseline, caught the pass and, as he floated through the lane like a bird on wing, dunked the ball behind his head. The crowd roared its appreciation and even some of the Wizards’ players nodded in approval.
But the theatrical dunk, which came at a point when Cleveland was trailing by double digits, was one of only a small handful of highlights James – the leading candidate for league MVP for the 2008-2009 NBA season – had produced to that point in the contest.
He spent a good portion of his on-court minutes on the periphery, loping up and down the court with little urgency, distributing passes and setting an occasional pick but otherwise leaving the driving and scoring burden to his teammates.
The Wizards held on to win, despite a late flourish by James that left him with 31 “quiet” points.
The outcome hardly mattered: The Wizards were nearing a merciful end to a season that tied the franchise’s worst-ever record. The Cavaliers had all but wrapped up the top seed in the Eastern Conference for the playoffs.
Loafing or saving energy?
But from a health perspective, the on/off performance of James raised a question: How is it that NBA players – and many other professional athletes – are able to switch gears so readily and (seemingly) with few physical repercussions? How can someone go “half speed” without risking injury and still appear competitive on a court with some of the world’s best athletes?
I posed this question to Nick DeNubile, MD, who served as an orthopedic consultant to the Philadelphia 76ers for more than 10 years, and is author of Framework: Your 7-Step Program for Healthy Muscles, Bones and Joints (Rodale Books, 2005).
DeNubile made an important distinction between going half-speed and being tentative. If you’re tentative – in any sport at any time – that’s when you risk injury.
“You need to be relaxed,” DeNubile said, to ensure that all of your faculties are there when you need them (for example, to leap to the rafters of an arena and throw down a reverse dunk). But “relaxed” doesn’t mean you’re not ready to go full speed on a moment’s notice. It’s similar to the difference between a cat stalking prey (relaxed but alert and focused, ready to strike) and a skier standing atop a cliff, doubting that he can navigate the leap (frightened and tense, and becoming increasingly less focused). Skilled athletes can go partial speed and still stay relaxed, DeNubile notes.
But this doesn’t apply to all sports. Diving, for example, or pitching a baseball require a focused anaerobic punch that would be very difficult to perform lackadaisically.
Why players hold back
For NBA players, the decision to occasionally temper their effort is not always bad.
“Recovery is so important for the players [and] metabolic recovery can vary from athlete to athlete,” DeNubile said.
“A lot of players come into the season three-quarters fit and use the season to get in shape for the playoffs. You’re better off if you come into the season fit,” but in an 82-game season even some of the fittest players have low-intensity nights. They may do it for selfish reasons – a contract dispute, for example. But in most cases they do it because they have to keep some reserves in the tank to stay competitive throughout a season that, for playoff teams, can span almost three-quarters of the year.
DeNubile recalled the 2001 NBA Finals, when his 76ers faced the Los Angeles Lakers.
“When we went to finals some players were dangerously over-trained,” he explained. “We did blood work [on the team] and you could see the guys who were on the brink. When you push too hard the body can start to break down. It’s the reverse effect” of training well.
DeNubile didn’t name players who were over-trained but he did cite Allen Iverson as one player who rarely gives reduced effort. “Every game of the year he’s giving 100 percent, 150 percent, diving for loose balls, playing as hard as he can,” DeNubile said. “That guy is incredible. He just doesn’t have an off switch.”
Somehow Iverson has stayed competitive for 12 (and counting) NBA seasons, defying predictions from many analysts that his all-out, physical style of play would result in a truncated career.
Are you over training?
Most of us will never play professional sports. But that doesn’t mean we can’t learn from those who do.
While the great majority of Americans is in no danger of over training (see: obesity epidemic, 21st century), some of us become addicted to strenuous exercise and tend to push ourselves harder than we should. One easy marker to check for over-training is your resting heart rate. Check it in the morning, right after you wake up, DeNubile says. (If you fear you are already over-trained, take a week off and see if that morning heart rate drops by 10 to 15 percent; if yes, you were likely over-training.)
Most are NBA players are incredibly fit and have resting heart rates around 60 beats-per-minute.
“When you see it start to bump up 10 beats per minute, that’s one of the signs over overtraining,” he says. “Or if a player says he’s getting a good night’s sleep but is still feeling tired.”
This made me wonder how much fuel NBA players burn during a game.
Interestingly, they’re burning about the same number of calories – 10 to 12 calories per minute – as you or I would during vigorous exercise. But because they are so fit their bodies use available energy stores much more efficiently than would a less-fit body, and thus they can accomplish more physically with less energy.
But DeNubile says that doesn’t make NBA players immune to basic exercise risks. “It can get dangerous when you’re tank starts to get low. People who sweat big can get dehydrated. You’ll see a player come off [the court] and he’s not happy about how he was playing or whatever and the trainer will offer him water or Gatorade and he’ll wave it off. That always worries me.”
These guys need to replenish lost fluid just like the rest of us. It’s nice to know we have at least that in common.
April 16th, 2009 by eDocAmerica in Better Health Network
No Comments »
Stroke is a major cause of disability and death in the U.S. and worldwide. Modern medicines like statins (and old ones like aspirin) are helpful in preventing both initial and secondary stroke in patients at risk. But, are there simple things you can do to lower risk?
Yes, you say! Well, indeed, you are correct. Twenty thousand men and women (age range, 40–79) without histories of stroke or heart attack were recently analysed in the U.K. for the effect of 4 simple behaviors: not smoking, regular physical activity, moderate alcohol intake (1–14 drinks weekly), and high fruit and vegetable intake .
Patients engaging in 3 or 4 of the activities were significantly less likely (2 times!) to suffer a stroke over the next decade. Patients who slipped up a bit and only did 1 or 2 of the activities did have significant stroke risk, though not quite as much as those who sat on the sideline and engaged none of the behaviors.
So, grab the baton and step up to prevent stroke. As always, questions and comments are welcome.
*This blog post was originally published by Jerome Ecker, MD at the eDocAmerica blog.*
April 16th, 2009 by Dr. Val Jones in Opinion
No Comments »
I’ve been covering a lot of health and medical conferences lately, and experiencing a wide range of reactions to my work. For those in the media who “get” blogging – I’m treated with honor and respect. One conference organizer kindly lined up the key note speakers for me to interview, not allowing them to leave until I’d asked them all the questions I desired.
A different conference PR team forbade me to Twitter during the conference believing that “Twittering” was code for recording the conference and selling it to those who didn’t want to pay the high attendance fees. One CEO enthusiastically beckoned me over to speak with him (seeing my bright green press ribbon) and then looked at my title “blogger” and said in an irritated voice, “oh, you’re not real press.” At yet another conference I was invited as press and then asked to pay $30/day for Internet access. When I asked if I could interview the keynotes I was told, “I’m sure they won’t want to talk to you.”
As you can see, my experience has varied from being treated like a second class citizen, to being critical to the PR strategy. As a physician and a member of the National Press Club, I find it amusing to be “shattering the categories” in all kinds of ways. Most people find it hard to reconcile that I’m a “real doctor” who is also a full time blogger. I see patients once a week, and I cover conferences/conduct interviews/evaluate news on my blog the rest of the time. “But you can’t be a real doctor,” they say, peering at my press badge, “you don’t look like one.”
For PR and communications strategist in the know, medical bloggers are powerful way to reach their target audience. Better Health, with its partner sites and blogger network, reaches over 11 million unique viewers per month. As the CEO, I have been invited to speak at AMA sponsored conferences, on CBS and ABC news, at the National Library of Medicine, and have been quoted by the Wall Street Journal, and LA Times. A PR executive told me recently, “forget the Today Show, Better Health reaches a larger and more targeted health demographic.”
And yet, blogging and new media are ahead of industry, traditional PR, and communications efforts in healthcare in terms of reach and influence. Very few have figured out how to work with medical bloggers in any consistent way, even though there’s a great new channel to do so: the Better Health network.
As I have often said, blogging is upstream of mainstream media. It’s a great place to be, though misunderstood by some. I’ve grown a thick skin and expect confused looks – because I know that in a year or so, medical bloggers will be an integral part of health conference coverage, probably upstaging their current mainstream counterparts. One day soon blog networks like Better Health will be in a position to hire journalists as part of a new hybrid team of reporters and scientists, better able than ever to communicate the significance of health news.
Imagine getting immediate commentary from a researcher who understands the complex science behind a medical breakthrough? Even the best health writers are often ill-equipped to know how to interpret author spin or biostatistics. But by combining those trained in journalism with those trained in medicine – and producing content that is conversational and accurate – readers gain access to a deeper understanding of health information. The old journalism mantra “we report, you decide” becomes “we interpret, you decide.” And for those without a medical background, the interpretation can add tremendous value.
As the world adapts to the Internet age, watch for a fundamental shift in the way health information is reported. Adding physician, nurse, and scientist writers into the mix will only enhance the quality of what we read. In a world grieving the loss of newspapers and health beats, I remain optimistic – because I believe we’re on the verge of a rebirth in health communications, and we’ll all be better for it.
