July 28th, 2011 by AndrewSchorr in Health Tips, True Stories
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You know I am a cancer survivor – 15 years down the road from a leukemia diagnosis and enjoying a 10 year remission. So whenever something seems weird about my health it’s cancer coming back, right? Wrong! Just how wrong was proven last night. I am writing this from my hospital bed in Seattle.
The first symptom of a possible problem came three days ago when I had soreness in my right calf. A pulled muscle? Maybe. But I had not noticed straining it. Back at the gym the next day I had soreness again but thought it was no big deal. Last night it was worse. It hurt some to walk. I got home and, after my wife and son were asleep, got ready for bed. I had a slight fever and then noticed the right calf was not only sore, but swollen and warm. Very strange. I’d never seen that before.
Trying not to be stupid I called the 24-hour consulting nurse. She immediately began to focus on deep vein thrombosis (DVT), a worrisome condition that affects about two million Americans a year and can lead to a life threatening situation. She had a doctor call me. Normally those doctors would rather make a house call then send you to the more costly emergency room. But not this time. “Dr. Steve” urged me to go to the ER rather than let a DVT progress and endanger my life. An ultrasound exam would determine if it was really a DVT. Read more »
*This blog post was originally published at Andrew's Blog*
May 4th, 2011 by Peggy Polaneczky, M.D. in Health Tips, Research
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Two studies published in this weeks’ British Medical Journal, one from the US and the other from the UK, report that users of drosperinone containing oral contraceptives (Yaz, Yasmin and their generics) have increased relative risks for non-fatal blood clots compared with users of pills containing levonorgestrel.
While neither study is perfect, and indeed have some very major limitations, they add to a growing body of evidence that pills containing drosperinone may impart higher risks for blood clots than older pills. Yaz is not alone in this regard – other studies have suggested that pills containing the newer progestins gestodene and desogestrel also impart slightly high clot risks than the so-called first and second generation pills containing the older progestins norethindrone and levonorgestrel.
I won’t go into the studies’ limitations here, but will say that trying to get our hands around comparative data on clot risks between various pills is an extraordinarily difficult process given that the diagnosis of blood clots is not always straightforward (or correct), pill choices are not randomized and fraught with prescribing bias, and confounding risk factors for clotting are numerous and difficult to control for. I wish folks would stop trying to answer these questions on the quick and cheap using claims and pharmacy databases without requiring chart review and strict diagnostic criteria. But that’s the way these studies are being done, and that’s the data I am being forced to contend with in my practice, so let’s talk about it. Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
April 28th, 2011 by Elaine Schattner, M.D. in News, Opinion
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A few days ago I read that Dr. Lazar Greenfield, Professor Emeritus at the University of Michigan, resigned as the president-elect of the American College of Surgeons over flak for authoring a Valentine’s Day-pegged, tacky, tasteless and sexist piece in Surgery News. The February issue is mysteriously absent in the pdf-ied archives. According to the Times coverage: “The editorial cited research that found that female college students who had had unprotected sex were less depressed than those whose partners used condoms.
From Pauline Chen, also in the Times:
It begins with a reference to the mating behaviors of fruit flies, then goes on to discuss studies on the menstrual cycles of heterosexual and lesbian women who live together. Citing the research of evolutionary psychologists at the State University of New York, it describes how female college students who had been exposed to semen were less depressed than their peers who had not, concluding: “So there’s a deeper bond between men and women than St. Valentine would have suspected, and now we know there’s a better gift for that day than chocolates.”
Not that I’m OK with any of this, as I’ve known the ickiness of older male physicians who don’t even realize when they’re being inappropriate. Read more »
*This blog post was originally published at Medical Lessons*
March 10th, 2011 by RyanDuBosar in Better Health Network, Health Tips
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For those of you planning air travel to your next medical conference (and ACP Internist isn’t too shameless to plug Internal Medicine 2011 — we hope to see you there), TIME reports that there are five health risks that are rare yet have recently happened. Tips on avoiding these maladies include:
— E. Coli and MRSA on the tray table. Microbiologists found these two everywhere when they swabbed down flights. Bring your own disinfecting wipes.
— Bedbugs in the seat. British Airways fumigated two planes after a passenger posted pictures online about her experience. Wrap clothes in plastic and wash them.
— Sick seatmates. Everyone has experienced (or been) this person. Wash your hands.
— Deep vein thrombosis (DVT). Tennis star Serena Williams experienced a pulmonary embolism, possibly related to recent foot surgery. But DVT can happen to anyone restrained to a cramped position for long periods of time. Move around in-flight (but not during the beverage service, of course.)
— Dehydration. Dry cabin air may make it more difficult to fight off infections. Drink more water.
*This blog post was originally published at ACP Internist*
The first symptom of a possible problem came three days ago when I had soreness in my right calf. A pulled muscle? Maybe. But I had not noticed straining it. Back at the gym the next day I had soreness again but thought it was no big deal. Last night it was worse. It hurt some to walk. I got home and, after my wife and son were asleep, got ready for bed. I had a slight fever and then noticed the right calf was not only sore, but swollen and warm. Very strange. I’d never seen that before.
