March 13th, 2008 by Dr. Val Jones in Humor
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In case any of you aren’t familiar with The Onion, it’s a spoof newspaper whose articles range from hilarious to irreverent. Here are some recent health headlines that struck me as funny:
Depressed Cow Eats Entire Haystack
Nation’s Bachelors Demand Health Care Coverage For All Their Buddies
Pharmaceutical Company Says Its New Anti-Depressant Is ‘Worthless And Dumb’
Very Specific Food Pyramid Recommends Two To Three Shrimp Scampis Per Year
Disease-Free Water Tops List Of World’s Most Popular Beverages
Half Of 26-Year-Old’s Memories Nintendo-Related
Swanson Foods Launches Hungry Man Line Of Apparel
Area Man Thinks He Can Save Relationship With Pancakes
American Cancer Society Unveils 1.2-Megaton Anti-Cancer Missile
New Product Can Do All That, More
Barky Dog Just Going Bark, Bark, Bark
And for you scientists in the audience, here’s an Onion classic, mocking the medical peer review process. Enjoy!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 11th, 2008 by Dr. Val Jones in News
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I was surprised by recent recent findings from the CDC’s National Health and Nutrition Examination Survey– one in four teenage girls (ages 14-19, chosen at random in the US) tested positive for some sort of sexually transmitted disease, most commonly HPV (human papilloma virus) (18%), followed by chlamydia (4%), trichomonas (2.5 %), and herpes (2%).
I asked Revolution Health expert, Dr. Iffath Hoskins, (Senior Vice President, Chairman and Residency Director in the Department of Obstetrics and Gynecology at Lutheran Medical Center in Brooklyn, N.Y.) what she thought of this news.
“This relatively high infection rate is cause for concern. We need to increase our education efforts so that teenagers are more aware of the risks of sexually transmitted diseases, especially since women’s reproductive futures are at stake. Chlamydia infections can substantially decrease fertility rates, long after the infection has been fully treated with antibiotics.
As far as the high HPV rates are concerned, I’m not surprised since previous research has estimated that 80-90% of adults have been infected with at least one of 80 subtypes of this very common virus. Only 6 of these 80 are known to predispose women towards cervical cancer. But the HPV vaccine can substantially reduce the risk for contracting those 6, so it’s important to vaccinate young girls against this virus.
No teenage girl should be walking around with chlamydia or trichomonas. They are treatable with antibiotics.”
The study also found racial differences between STD infection rates in teenage girls, with blacks being infected at twice the rate of white or Hispanic girls. The CDC is calling for educational outreach to at-risk groups, and the American Academy of Pediatrics supports confidential teen screening.
I hope that these staggering statistics act as a wake up call to health care providers who may not have thought to screen their teen patients for STDs. Apparently, these infections are more common than we realized.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 11th, 2008 by Dr. Val Jones in Uncategorized
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As many of my faithful readers know, Dr. Val is a big fan of Web 2.0 principles (blogging, online communities, wikis, forums, chats, podcasts, etc.) I’m even leading a weight loss group online, and there are almost 1400 members already. Although I’ve been trying hard to lead by example, I’ve had occasional hiccups in my own weight loss due to the sweet lure of fine dining. Could YOU resist silky, black sesame panna cotta with butter crunch tuile and spicy cranberry compote? Well maybe you could. For me, resistance is futile.
But I digress.
What I really wanted to point out (before my thoughts were derailed by deliciousness), is that research is now confirming what many of us bloggers have known instinctively: social networking can improve the health care experience. In the Journal of the American College of Surgeons, post operative pain and length of stay were reduced for those who had more social support. This means that the more frequent and broad your social contacts, the less likely you are to be bothered by pain, and the more likely you are to get out of the hospital faster. Let’s hear it for using CarePages, FaceBook, and other online support groups while in the hospital, and perhaps as outpatients as well.
And if feeling supported isn’t enough to get you on the right track, more research in the Archives of Internal Medicine suggests that mail reminders can improve post-heart attack medication compliance. Perhaps email reminders would work just as well (and kill fewer trees?) One thing is for sure – Health 2.0 tools can make an impact on peoples lives and I’m excited to be a part of that.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 10th, 2008 by Dr. Val Jones in News, Opinion
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When I eat out at a restaurant I’m inevitably asked whether or not I’d like bottled water with my meal. My answer usually depends upon the city I’m in – New York water tastes great, so I ask for tap water in Manhattan. The water in DC tastes like a swimming pool (at best), so I usually order bottled water at Washington restaurants.
But little did I realize that the water I’ve been drinking (whether from DC, NY or even from the bottle) has small traces of pharmaceutical chemicals in it. A new investigation conducted by the Associated Press suggests that most major urban water supplies are laced with tiny amounts of prescription drugs. How do the drugs get in the water supply?
Remember that water cycle you (or your kids) studied in grade school? Well, the “underground phase” is where the action happens. Drugs that we swallow pass through our bodies and some is released in our urine and stool. We flush that down the toilet and the fluid debris is treated in a sewage plant and then the water portion is released back into the water supply. Sewage plants and water filters are not designed to remove trace chemicals like heart medicines and anti-depressants, so they remain in the drinking water. Kind of disturbing, right?
Well, the good news (if there is any) is that the amounts of chemicals in the water are pretty small – we’re talking parts per trillion. Just to put that in perspective, that’s more than 1000 times smaller than the minimum amount needed for therapeutic effect from the fluoride added to the water system. And the concentration is far below the therapeutic threshold in the bloodstream for these drugs. But how do we know that tiny amounts of drug exposure isn’t harmful in some cumulative way?
Research into the potential long term effects of these chemicals in the water supply has focussed mostly upon the presence or absence of the drugs, and the concentrations at which they’re present. Animal studies (such as the “feminization” of fish exposed to environmental estrogens) and cell culture research suggest that exposure to larger concentrations of these drugs can cause negative outcomes, but to my knowledge there are no long term studies of the potential impact of very small concentrations on human health. But before we become outraged at this apparent lack of investigation, let’s think about why it’s so difficult to gather this kind of information.
First of all, concentration-wise, pharmaceuticals represent a small fraction of the thousands of man-made chemicals in the environment, including everything from pesticides to personal care products. So it’s very difficult to prove a cause and effect for any one drug’s influence – we are each exposed to a very dilute cocktail of chemicals in our daily lives, whether through the water we drink, the food we eat, or the air we breathe. How can we tease out the potential damage of one chemical over another?
Secondly, it’s pretty likely that any potential harm (from chemicals at such small doses) would take many years of exposure before a clinically measurable threshold is reached. It’s very difficult and expensive to study large groups of people over time – and it’s hard to know what their lifestyle choices may contribute to their overall chemical exposure. Over time people change jobs, change what they eat or drink, change where they live… the complex interplay of environmental factors make it hard to interpret exposures and effects.
And finally, how do we know what outcomes to look at? It’s possible that these small doses of pharmaceutical products could affect our bodies in fairly subtle ways – which again makes it difficult to measure. It’s hard enough to study cancer rates in populations, but how would we study differences in physical or mental performance? Or slight changes in mood or heart function?
Since there’s no easy way to prove a connection between drugs in our water system and our general health and wellbeing, we are likely to be left with far more questions than answers. I think we all agree that we’d rather not be exposed to trace amounts of any chemicals in our water supply, but unfortunately the cost of filtering all potential contaminants from the water is exceedingly high. Reverse osmosis (a process currently used to reclaim fresh water from the sea) can cost as much as $1-18/gallon depending on the system in place and the country using it. While reverse osmosis could guarantee a chemical-free drinking water supply, we couldn’t afford to supply it to all Americans. And in the end, it’s still unclear if solving that part of the puzzle would improve our overall health.
I hope that we’ll find ways to reduce the chemical load on our environment, and that advanced water purification technology will become more affordable in the future. Unfortunately, trace amounts of chemicals, drugs, and pesticides are more ubiquitous than we’d like to believe. The impact they may have on our health is difficult to measure, and largely unknown at this point. Perhaps the bottom line is that we’re all connected to one another through our environment – so that granny’s heart medicines may yet live on (albeit in trace amounts) in your bottled water. All the more reason for Americans to pull together to live healthy lifestyles, control our weight, and try to prevent the diseases that are requiring all these drugs in the first place.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 5th, 2008 by Dr. Val Jones in Health Tips, Opinion
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I’ve wrestled with this question for many years: “When is weight loss surgery an appropriate option?” I used to do weight loss research prior to working at Revolution Health. My studies focused on using “natural” methods to reverse type 2 diabetes – in other words, weight loss via diet and exercise. My study subjects were all obese, and most had struggled with weight for decades.
At some point during the trial, people would often ask: “Can’t I just have surgery for this and not have to struggle so much?” And I would gently remind them that surgery was no picnic, and to try diet and exercise first. “But it’s so hard!” they would say. I would acknowledge their difficulties and offer lots of empathy, and firmly encourage them to stick with their diet. In the end I found that only half of my study subjects could manage to stay on the diet for months at a time. So what should the other half do? Give up and let their diabetes ravage their bodies?
My friend and colleague Dr. Charlie Smith rightly points out that weight loss surgery can dramatically improve the health of people who have been unsuccessful at losing weight through diet and exercise. Heart disease, diabetes, and cancer rates were dramatically improved for morbidly obese people after weight loss surgery. So there is a clear benefit for some people to have the procedure.
However, the caveats should not be overlooked. First of all, weight loss surgery does not guarantee long term weight loss. It’s possible to gain back all the weight lost if eating behaviors are not changed. The human stomach is amazingly stretchy, and even if it’s surgically reduced in size, with repeated overeating it can eventually stretch to accommodate large meals again. Secondly, some types of weight loss surgery (like gastric bypass) can affect the body’s ability to absorb critical vitamins. Without enough of these nutrients, one can end up severely anemic, and osteoporotic just to name a few serious side-effects. And finally, the surgery itself is quite dangerous, carrying with it a potential risk of death as high as 1 in 200!
So weight loss surgery can be life-threatening, and is not a quick fix for a long term problem. However, morbid obesity itself is so dangerous (with the increased risk of heart disease, diabetes, and cancer) that it may require this extreme intervention to actually save lives. For people who have more than 100 pounds to lose, and have sincerely tried diet and exercise without success for a prolonged period, then weight loss surgery may be an appropriate option. For those whose lives are not at risk because of severe obesity, it doesn’t make sense to undergo such a risky procedure.
Are some people successful at losing a large amount of weight and keeping it off without surgery? Yes! The National Weight Control Registry keeps a list of thousands of Americans who have lost at least 30 pounds and kept them off for at least 6 years. What’s their secret? You guessed it – regular exercise and a calorie controlled diet. Some other things that these “successful losers” have in common: 1) they eat breakfast 2) they have a cardio machine at home 3) they weigh themselves regularly.
If you’d like to meet a group of people who are working towards long-term weight loss success, feel free to join my weight loss support group. We have weekly challenges, tools and trackers, a vibrant discussion group, and free medical insights to help you along your way. Weight loss is really hard to achieve by yourself. It takes encouragement, support, and a community of like-minded folks who are determined to make a difference. You can do it!… and I’d be honored to support you along the way.
P.S. There’s a special group forming at Revolution Health for folks who need to lose 100 or more pounds. It’s called “Overweight But Not Giving Up.” Check it out.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
