February 29th, 2008 by Dr. Val Jones in Uncategorized
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Happy leap year everyone! The Revolution Health experts have been blogging away furiously, and I haven’t done a Revolution Rounds in a few weeks (naughty) so without further ado – here’s a nice round up of the best of the Revolution Health blogs…
Health tips
Most vitamins and supplements are not necessary if you’re eating a healthy diet. Dr. Joe Scherger summarizes Harvard’s Men’s Health Watch and concludes that only Vitamin D supplements may be warranted for the general population.
Relationships require pruning. Mira Kirshenbaum suggests that if you’re in an unhealthy relationship, it’s best to get up the courage to cut it off.
Ever wonder which arthritis treatments work best? Dr. Jim Herndon has distilled the latest research.
Children need to be vaccinated against the measles. Dr. Stacy Stryer explains that measles can be deadly in 20-30% of the people who get it.
Calcium can strengthen your bones, but may clog your heart? Dr. Vivian Dickerson cautions women about taking too much of this vitamin.
Did you know?
Only one in four people recognize the symptoms of a heart attack. Dr. Joe Scherger describes how you can tell if you’re having one.
Restless legs syndrome might increase your risk of a heart attack. Dr. Steve Poceta explains why.
Stem cell research could be the key to unlocking the mysteries of how cancer develops. Dr. Heinz-Josef Lenz describes some promising new research.
Pit viper venom might be useful in reversing strokes. Dr. Olajide Williams explains that the venom can dissolve blood clots in the brain.
There is a real mind-body connection in health and disease. Dr. Joe Scherger explains how it impacts men with erectile dysfunction.
Nighttime anxiety might convey a survival advantage. Dr. Steve Poceta wonders if we worry more at night because the ancestors who did so, lived to procreate.
A hospital is being sued for denying a surgical procedure to a transgender female. Dr. Cole Brown is not sure that this is fair, since the procedure was not emergent.
Orthopedics Corner
Dr. Jim Herndon is a faithful friend and blogger. He has had a particularly fine week – so many of his posts are great that I thought I’d give you a little summary of them all in one place…
Americans spend as much on back and neck pain treatments as they do on cancer treatment. Jim discusses the incredible financial burden of back and neck pain and the disappointing efficacy rates of treatments.
Neck pain is fairly common and particularly resistant to treatment. Jim describes the prevalence of this condition.
Glucosamine does not seem to improve hip arthritis. Jim discusses the mounting evidence that the benefits of glucosamine are very limited if they exist at all.
Patients with spinal stenosis (narrowing of the canal that contains the spinal cord) may benefit from surgery.
About 10% of total hip and knee replacements require revisions. Before you have yours, be sure that your surgeon is experienced with revisions.
Kiddie corner
Dr. Stacy Stryer is also a faithful friend and excellent pediatrician and blogger. Her sound advice and empathic tone is a key to her success. Here’s what she has to say this week:
First of all, Dr. Stacy reports on the strange practice of a nursing mom on America’s Next Top Model TV show: she’s drinking her own breast milk. Yuck!
Studies show that parents spend more time with their first child. Stacy wonders if she’s been a neglectful parent of her younger child.
Measles is a fatal illness for up to 30% of children who get it. Sadly, measles is on the rise because parents have opted out of the MMR vaccine due to unsubstantiated fears of vaccine harm.
Depression in a parent might be a risk factor for poor health among their children. Dr. Stacy takes a fresh look at how to keep America’s children healthy.
Dr. Jim Hill explains why children who don’t exercise regularly may perform worse on academic tests.
And my final post of Revolution Rounds is from a couple of neurologists who relay a compelling story: they saved a woman’s arm from a mistake made by an orthopedist in Serbia!
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 28th, 2008 by Dr. Val Jones in Book Reviews
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In Fixing American Healthcare
, Dr. Rich explains that the major cause of rising costs in healthcare is an aging population that requires more resources. Though some have proposed that fraud and waste/inefficiencies are the primary sources of costs spiraling out of control, the truth is that they likely play a minor role compared to the tremendous costs of providing cutting edge treatments to an older and sicker US population. Dr. Rich argues that we don’t hear that much about the escalating cost of caring for older Americans because it makes us squeamish, so we instead focus on curbing costs due to fraud and waste. However, when fraud and waste are not the primary cause of increasing costs, enhanced attempts to quash them do not actually move the savings needle. Since certain groups are tasked with reducing escalating costs due to fraud (in particular), and their work does not result in savings, they must strive harder to find and punish those accused of fraud, perhaps even seeing fraud where it doesn’t exist.
Dr. Rich argues that true fraud is fairly rare, and that the majority of “fraud” cases involve people not complying with rules they had no knowledge of (in many cases even after asking about the rules from the people who made them). Other cases of “fraud” involve retroactive application of rules and then fining hospitals for not being in compliance before the rules were made. His assessment of the PATH audit debacle is quite interesting.
Now, obviously we want to decrease fraud and waste as much as possible – but in the midst of our desperate attempts to curb healthcare spending, we’ll need to have some honest and frank discussions about the elephant in the room: America is sicker than ever before, and we have developed expensive ways to cure/treat those sicknesses – ways that we can’t afford to offer everyone.
What should we do? Dr. Rich suggests that we come together as a nation and decide on some rationing rules. He argues that we’re already rationing our healthcare dollars in covert ways – let’s bring it out into the open so that it’s fair to everyone. Now, I doubt that this will sit well with Americans – but our current “system” is so dysfunctional that maybe the time for a rationing discussion has come?
In this climate of unlimited treatments and limited resources, the best option is to stay healthy as long as possible. That’s why I believe in preventive medicine, healthy lifestyle changes, and doing all that we can to avoid getting sick. In many cases (but certainly not all) eating healthy foods, exercising regularly, controlling our weight, getting our vaccines, and sleeping well each night can go a long way to keeping us out of the hospital. It’s not easy to get Americans to take care of themselves in this way, but I’d rather spend my efforts trying to get us fit than to have to debate rationing rules. In the end, however, we may need to do both. What do you think?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 24th, 2008 by Dr. Val Jones in Book Reviews, Health Policy
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Dr. Richard Fogoros wrote a fascinating book called Fixing American Healthcare: Wonkonians, Gekkonians, and the Grand Unification Theory of Healthcare. In the first two thirds of the book, he explains why our healthcare system is broken, and describes its dysfunction with exasperating accuracy.
One of the most important concepts in his book is that of “covert rationing.” As Dr. Rich explains, we Americans cling to two fundamental beliefs:
1. Everything that can be done for a sick person must be done, as long as there’s some small hope of beneficial outcome. (The belief in no spending limits).
2. Healthcare is an entitlement for all Americans. (The belief in universal access).
Since science and technology have provided us with incredible (and expensive) advances over the last several decades, doing all that’s possible for all who are sick is simply not financially possible. However, Americans are fundamentally opposed to rationing care, so the rationing occurs covertly, including cost-savings achieved by people being uninsured, by certain chemo drugs not being covered by Medicare, by physicians being coerced by HMOs to ration care, and countless other subtle and capricious ways.
Covert rationing is a little recognized but fundamental flaw of the current healthcare system, and it results in untold inequities in care. Dr. Rich believes that a fair system requires open rationing of resources, with rules agreed upon by tax payers. Would you agree?
In my next post I’ll discuss Dr. Rich’s thoughts on what’s really driving up healthcare costs…This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 17th, 2008 by Dr. Val Jones in True Stories
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As many of my regular readers know, my dear friend and Revolution Health administrative assistant (Seton) was diagnosed with stage IV colon cancer after giving birth to her first baby. She is doing well on chemotherapy, and working hard to shrink the liver tumors to a size that will allow her to have them cut out, and possibly be cured. On March 9th she’ll be participating in a Race for Colon Cancer walk/run in Central Park, and I’ll be joining her. This weekend I came to New York to practice the 4 mile run with a girlfriend of mine (Karen). Here’s what happened…
As I set out to meet my girlfriend at the southwest corner of Central Park, I became keenly aware that my light windbreaker/t-shirt combo was ill equipped to protect me against the icy wind chill. It was 8:30 in the morning, and as I bowed my head in the face of frigid temperatures, tears streamed down my cheeks while urban grit blew the very moisture out of my eyes. “Whose idea was this?” I asked myself, marveling at the occasional onlooker, bundled head to toe with hats, mittens and face masks. “Oh, yeah – mine. What was I thinking? Why didn’t I look at the weather report?”
About half a mile between my departure point and destination, I began to realize that my ears were in danger of freezing off. “I’ve got to find a hat” I thought… glancing at Citibank headquarters to the right and Meryl Lynch to the left. Where could one find a hat at this time of day, and in this neighborhood? Hmmm… a 24 hour pharmacy perhaps? As I marched towards what appeared to be a distant pharmacy I began thinking of ways to make a hat from cotton strips, Ace bandages, or maybe a shower cap. Severe cold can make a desperate mind exceedingly creative.
As I temporarily thawed myself in the warmth of the pharmacy, I began my search for a head covering. A fleeting moment of triumph gave way to disappointment when a hot pink Santa’s “little princess” elf hat (buried in a discount bin) proved to have the inelastic circumference suitable for a very small child or canine companion. But if there’s one kiddie hat in here, there must be others, I thought. So I combed through the drug store stock with a hopeful eye.
Ah-hah! I discovered a virtual treasure trove of kiddie hats, pinned to the backside of a pillar near the deodorant aisle. Of course, they were each painfully pediatric – with neon colors, gold stars, and little plastic Hello Kitty and Barney type effigies. But, I could see that they were stretchy, and came with some tiny gloves created to be a “one size fits most.” Worried that my girlfriend would have to wait in the cold for me, I hurriedly made my purchase, tore the tags off the hot pink hat and forced it down over the top half of my ears. The gloves covered my four fingers and half my thumb.
I arrived at our meeting place just in time. My girlfriend approached with a quizzical expression, noting the large “Strawberry Shortcake” girl (inside a plastic heart) emblazoned on my hat. I could see that she wondered if my fashion sense had taken a turn for the worse since my move from NYC to Washington, DC two years prior.
I assured her that I had no intention of wearing the hat again, but that desperate times called for desperate measures. She stood in front of me in a full running suit, complete with a layer of long johns, ear muffs, and two layers of Goretex. I felt utterly unprepared in my light cotton shirt and Lycra pants – but at least now that my head was half-covered, I figured that running would keep me from freezing to death outright.
And so we set off on a 4.5 mile jaunt, a hilly distance that neither of us had run in over a year. I had tried to prepare for this day with elliptical training, but wasn’t sure that my cardiovascular reserves would handle this new form of exercise.
Much to our surprise, the icy wind quickly numbed all sensation in our legs, allowing us to jog without much awareness of potential pain or exhaustion. We soon settled into a nice, slow jogging rhythm and took turns catching up on one another’s news. My uphill breathlessness tended to shorten my usually animated description of life-events, reducing me to caveman-like accounts. “Me take new job at hospital. Good.” Though I did much better on the downhill stretches.
In the end my girlfriend and I felt quite triumphant about the fact that we made it the full 4.5 miles without a break. We both knew that another 3 weeks of training should put us in good standing for the Colon Cancer Challenge, though my friend suggested that if I wore the Strawberry Shortcake hat again, she might pretend that she didn’t know me.
Today, of course, all my leg muscles are sore – but it’s nothing compared to what Seton is going through with her chemotherapy. I wish her all the best in her fight against cancer, and hope that my participation in the Colon Cancer Challenge will provide her with some encouragement, if not comic relief.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 4th, 2008 by Dr. Val Jones in Medblogger Shout Outs, News
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I learned something interesting today from Dr. Benabio’s Derm Blog: bacteria love to grow in skin cream. He said that it was kind of like cream cheese – leaving it out at room temperature would cause it to go bad pretty quickly, were it not for the usual preservatives. He described an outbreak of a deadly bacterial infection in a hospital ICU – caused by nurses using “all natural” European (preservative-free) skin cream on their patients.
So there you have it folks – deadly bacteria are indeed “all natural.”This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
