New Years Resolutions for Doctors and Patients

Below is an updated re-post of a blog from a few years ago.  I liked it then and I like it now.


#1 Doctor: Resolve to let patient speak without interruption and describe their symptoms.
Patient: Resolve to focus on the problem I am seeing the doctor about and not come with a list of 10 complaints for a 15 minute visit.

#2 Doctor: Resolve to keep a pleasant tone of voice when

Top 10 Articles Read by Doctors

Now that the end of the decade is near, we are hearing and reading about "the top this and that" from music to fashion to political downfalls.  Medscape has their own top 10 articles that were read by physicians on their site.  I find it interesting to see what my colleagues plug in to when they are not seeing patients.  The only surprise to me was the Brain Tumor "risk" because I thought that

Chewable Contraceptive

Just in the nick of time before this decade ends, the FDA has approved the first low-dose chewable birth control contraceptive. 

The daily chew will be marketed by Watson Pharmaceuticals, Inc.   Fred Wilkinson, executive vice president of Global Brands said "We believe this product is an important addition to the oral contraceptive category, and that its characteristics will make it a desirable

Henrietta Lacks and Her Immortal Cells

If you like science, true history and an engaging story, pick up the new book by journalist Rebecca Skloot, The Immortal Life of Henrietta Lacks and prepare for a great read.  I knew nothing about the young black woman whose cells were taken back in 1951 by a scientist at Johns Hopkins Hospital and how those cells have revolutionized modern cell biology and research.

The HeLa (named after

Answer to Gory Medical Challenge.

(Scroll down to see the challenge)

The Answer to the gory image from NEJM is #2, Ischemic gangrene.

This patient had a 4 month history of progressive gangrene.  Untreated diabetes can lead to lack of blood flow to extremities which causes the tissue to die.  This foot will require amputation.  Readers of EverythingHealth are smart and many of you got the answer.

Audio of a Doctor in the Making

This 5 year old has all the makings of a good physician.  Calm, reassuring, caring, and interested in dressing well.

Last Gory Medical Challenge Before Christmas

If the New England Journal of Medicine can do it right before Christmas, so can EverythingHealth.  This shocking pic represents what diagnosis?
1.  Ichthyosis
2.  Ischemic gangrene
3. Necrobiosis lipoidica diabeticorum
4. Phlegmasia cerulea dolens
5. Pyoderma gangrenosum

Make your diagnosis in the comment section and check back tomorrow for the answer.
(Better yet...sign up on the right as a

Health Care Reform Challenges

While most Republicans believe the new health law will be repealed, the Health and Human Services Secretary, Kathleen Sebelius says "there is no going back".  Reform is in turmoil after a federal judge in Virginia ruled the individual mandate unconstitutional.  Two other federal judges of equal stature have upheld it,  so confusion prevails with policywonks and the public.

The federal mandate

Macular Degeneration and Lifestyle

We now have another condition that may be prevented by eating a healthy diet, exercising and abstaining from smoking.  Age Related macular degeneration (AMD)!

Macular degeneration causes a loss of central vision and makes it difficult to recognize faces and read small print.  The macula degenerates with age and severe macular degeneration causes blindness.  Treatment is costly and doesn't work

San Francisco Gothic Merry Christmas

My uber talented friends, Martin and Brigitta Wolman created this Christmas card.  They are the best artists!!  This is a self portrait.

Raynaud's Disease

 


Thanks to modern technology (iphone) a picture is worth a thousand words in diagnosing a condition.  This young woman had been exercising outside by the Golden Gate Bridge in San Francisco (temp a chilly 49º F) and when she finished her hand looked like this.  It felt numb and began stinging when she ran hot water on it.

What is seen is classic Raynaud's disease.  It is a condition that

Answer to Yesterday's Medical Quiz

The answer to the Medical Challenge was #5  Tinea.

Tinea refers to a group of infections caused by fungus. Tinea is also known as "ringworm"..even though it has nothing to do with worms.  The ringworm infection is often a well demarcated ring on the face, scalp or body.


The culture of this lesion showed Trichophyton rubrum, a common fungal species that also causes nail infection (

Medical Challenge

I've been too busy to blog but not too busy to keep up with the New England Journal of Medicine.  Here is your medical quiz for the week.

What is the diagnosis for this finger lesion?  Make your best guess and the answer will be posted tomorrow.  Click on the image for a better view.

1. Anthrax
2.  Cellulitis
3.  Lichen planus
4. Psoriasis
5. Tinea

Ten Commandments For the Office Christmas Party

EverythingHealth offers sage advice to keep you healthy...both physically and mentally over the holidays.  The office or hospital Christmas party can be a treacherous place.  Observe these tips:

1.  Don't Get Toasted- A drink or two is fine and festive.  But when the booze flows freely so does the mouth and attitude.  Don't drink too much and regret (or worse yet..wonder) what you said or did

Women's Health Gets an F

The Oregon Health and Science University has published its 5th report card since 2000 and it grades and ranks the United States on 26 health-status indicators for women.   In 2010, not one state received an overall "satisfactory" grade for women's health and just two states (Vermont and Massachusetts) received a "satisfactory-minus" grade.  Overall, the nation is so far from meeting the goals set

Just follow the Money for Cardiac Stents

History repeats itself again with the new expose' in the New York Times about the Baltimore Cardiologist who inserted (at the least) 585 stents in patients who did not need them.  On one single day he inserted 30 stents!  I didn't know there was that much time even available in the cardiac cath lab but with Medicare reporting payments of $3.8 million for a two year period to Dr. Mark Midei,  I

Tinnitus-Ringing in the Ears

Tinnitus is derived from the Latin word tinnire meaning "to ring".  It is an extremely common complaint and 50 million adults reported tinnitus in the past year.  Up to 3 million people have symptoms that are severely debilitating. You would think that we know a lot about tinnitus and how to cure it but you would be wrong.  Here is what we learned from a study reported in The American Journal of

The Sound of Music Flash Mob Dance

The best of mobs.

Answer to Yesterday's Medical Quiz

The answer to the strange  lesions seen on the patient in yesterday's image challenge is #5 - bleomycin reaction.  The patient was treated with intralesional bleomycin for a lesion on her tongue.  Within a week she developed painless, non-itchy hyperpigmentation on her trunk. 

Bleomycin is a medication that is used for certain types of cancer.  Twenty percent of patients treated with

What is the Diagnosis

Here is your medical challenge for today compliments of EverythingHealth and the New England Journal of Medicine.  This 39 year old woman presented with these marks on her back.  You be the doctor.  What is the diagnosis?   Click on the image for a better view and the answer will be posted tomorrow.  (hint: 3/4 of the physicians got it wrong.  I got it right)

Save yourself from remembering to

Health Care is Not Recession Proof

I've heard people say that health care is recession proof.  Even when the economy is suffering, people still get sick and need service.  The current recession is entering the 3rd year and it has finally caught up to the health industry.  The latest Bureau of Labor Statistics reports that there were 16 mass hospital layoffs in October, up from 10 in September.  Mass layoffs involve 50 or more

Vitamin D Controversy

I have written before about the value of evidence based medicine and the need for doctors to alter their practice as new evidence comes in.  But I am totally thrown off by the new IOM report about Vitamin D and Calcium.  The report is 999 pages long.  Let me repeat that, dear readers...999 pages. (Available for purchase for $53.96)

The Committee was asked to review current data and make a

Good Health Simplified

You can't do anything about your genes but here is the formula for good health...simplified:

0           Cigarettes
5           Servings Fruits and Vegetables a Day
10         Minutes of Silence or Relaxation a Day
30         Body Mass Index below 30
150       Minutes of Exercise a week    


You knew this already...but are you really doing it?

Rabies 101

Rabies is a virus that causes neurologic encephalitis and is almost 100% fatal.  Since 2000, 31 cases of human rabies have been reported in the United States.  Seven of them were acquired from exposure abroad (Phillippines, Ghana, El Salvador, Haiti, Mexico and India).  Rabies is mainly contracted from an animal bite or saliva from an infected animal.  The most common animals are dogs, bats,

The Turkey Speaks

Health Care Reform Cannot be Stopped

Now that the Republicans have taken over the House, they are calling for repeal of The Patient Protection and Affordable Care Act (ACA).  They are calling it a "bad product" and a "monstrosity" and the airways are full of pundits telling the American people that they intend to "take back our country."  But what would repeal of the bill really do?

Overturning ACA would cause 32  million Americans

Total Knee Replacement in Younger Adults

The surgery that replaces the knee joint rose by 66% in American age 65-84 from 1997 to 2007.  And in Americans age 45-64, the rate tripled in that time.  The technology has improved and more surgeons are willing to perform this operation in younger people and the public has a greater familiarity with the procedure and its results.

We don't know if more patients age 45-64 are getting

Gastroenteritis and Hypertension

There is provocative new research from the British Medical Journal this week. They have made a strong connection between EColi infection and subsequent development of hypertension.  I'll try to break it down here into the "cliff notes" but to read the entire study go here to BMJ.

We know that most hypertension diagnoses have no etiology (cause).  We also know that in the U.S. escherichia coli

Answers to Derm Quiz

Scroll down to see the photos and here are the answers. If you cant see the images in the previous post, click on "EverythingHealth" and you'll see the entire blog.

#1 - Actinic Keratosis - these dry crusty bumps are on sun damaged skin and can be either flat or raised in appearance.  They occur after long periods of sun exposure and damage.  They are not life threatening and can be treated with

Dermatology Quiz

#1


#2


#3


#4
Let's see how many of these common skin lesions you can identify.  The answer will be posted tomorrow.
Match the diagnosis with the images:
Basal Cell Carcinoma
Solar Lentigo
Squamous Cell Carcinoma 
Actinic Keratosis   

                             

Medical Updates for Older Adults

New clinical trials and published research is giving us information on how to improve health in elderly patients.  Here are some brief points from The Cleveland Journal of Medicine that were surprising to me:
Each year 30% of people age 65 or older fall and sustain serious injuries so preventing falls and fractures is important.  Vitamin D prevents both falls and fractures, but mega doses of

Micro Loans and Your Health

Research has shown that giving to others can lead to a healthier, happier and longer life.  Generous behavior reduces depression and risk of suicide in adolescents.  Volunteerism on the part of older adults significantly reduces mortality.  Giving to others enables people to forgive themselves for mistakes; a key element in well-being.

One way to have a lot of fun on the internet and get a

Great Healthy Holiday Food Ideas

I have permission to share these tips from MD Anderson Cancer Center with the readers of EverythingHealth.  With the holidays coming up,  these choices make sense.  Enjoy! *********************************************************************************
Making healthy food choices can be tough during the holidays, especially at gatherings where festive snacks abound But who says holiday snacks

Doctors as Employees

The days of doctors running their own offices and starting practice are coming to an end.  As this graph from today's Wall Street Journal shows, since 2005 more doctors are becoming employees of hospitals rather than owning their own medical practice.

The reasons are not that hard to understand.  Medicine has become a complex and difficult business.  Dealing with dozens of different insurance

Surprises Ahead

I just like this photo!

Answer to Diagnostic Challenge

The answer is #4 - Median rhomboid glossitis.  This condition shows a round or rhomboid shaped patch of smooth tongue that lacks both papillae and taste buds.  It is usually located in the midline.  It is thought to arise from an embryologic defect but it doesn't usually cause problems nor does it require treatment.

This Weeks Diagnostic Challenge

This Weeks Diagnostic challenge from the New England Journal of Medicine is a good one.  What is the diagnosis for this unusual looking tongue?  Answer will be posted tomorrow so make your best guess. (click on the image to enlarge and get a better view)

1.  Atrophic candidiasis
2.  Erythroplakia
3.  lingual thyroid
4.  Median rhomboid glossitis
5.  Tertiary syphillis

Smarter Medical Care

The internet is a wonderful place to get medical information when and how you want it.  You may not be interested in the topic of "Coumadin" until you or a family member is prescribed the drug.  What does it mean when your father tells you his doctor wants to do a "laparoscopy" or that your mother has a "venous thrombosis"?  It is important to get your medical information from a reputable source

Medical Marijuana

When I was an Intern I took care of an elderly gentleman who was dying of lung cancer.  Mr. Washington had spent much of his life as a sharecropper in the deep South.   Mr. Washington was alone without family and his cancer had spread to his bones and his brain.   He no longer had a wife and his grown son had died several years ago. He had stopped eating and was just skin and bones.  I could see

Happy Halloween

Red Yeast Rice Supplements for High Cholesterol

People are always on the search for "natural" ways to stay healthy and reduce cholesterol.  Chinese red yeast rice supplements have been touted as a natural, safer way to lower cholesterol compared to statin medications.  The yeast that grows on a particular type of rice contains a family of substances called monocolins, which lower cholesterol by inhibiting cholesterol production in the liver in

The Man with the Eyeball Tattoo

There seems to be no end to stupidity and this man from Toronto, Canada is right up there at the top for crazy ideas.  He actually tattooed his eye by injecting the sclera with ink.  It took 40 injections of ink to complete the color transformation.  Despite the painful appearance, the eye can be easily anesthetized (numbed) so the needle does not hurt.

Despite the fact that this is reported as

What Caused This Woman to Faint?

 Dear Dr. Brayer;
My mother, age 66, fainted while she was at work.  She was taken to the emergency room and was evaluated for hours, including a CT scan of her head.  They could not find a reason and sent her home.  Could it have been a stroke that didn't show up?  
Thanks, Heidi

Dear Heidi,
The medical term for fainting or sudden loss of consciousness is syncope.  It occurs when the blood flow

First Do No Harm

One of the ancient principles of medicine is Primum non nocere, the Latin phrase that means "First, do no harm".  It means that sometimes doing nothing is a better decision than doing something that might cause more harm than good.  It is an ethical precept for physicians, but it becomes harder and harder to adhere to as more and more exotic tests and treatments are at our disposal. 

But just

Cholera in Haiti

I still follow the aftermath of the Haiti earthquake closely and have continued contact with our Haitian interpreters that I met this year on the Sutter Health Helps Haiti medical mission.  Our physicians and nurses worked in St. Marc, (three hours north of Port-au-Prince) at St. Nicholas Hospital, the epicenter of the new Haitian Cholera outbreak.  Boston based Partners in Health (PIH) runs the

How Do You Hide $100 From a Doctor?

How do you hide $100 from a surgeon?          Put it in the patient's chart, next to the lab.How do you hide $100 from an orthopedist?          Put it in a text book.How do you hide $100 from a neurosurgeon?          Tape it to his kid.How do you hide $100 from an OB/Gyn?          Tape it to the patient's head.How do you hide $100 from an internist?          Stick it under the patient's

How Not to Raise a Baby

I seem to be on a baby theme.  Here are Baby Dont's.  Remember to be safe with Baby.

Should You Share a Bed With Baby?

I've watched the pendulum swing back and forth on the wisdom of mom sharing her bed with a baby.  The American Pediatric Society has come out against the practice, because of a higher incidence of Sudden Infant Death.   But nearly half of all British moms sleep at times with their baby and 1/5 share a bed regularly during the first year.


According to a British study published in Pediatrics, the

Cool Medical Apps

The best thing about the iphone and ipad are the cool apps.  I am learning about new ones all the time but here are a few Medical Apps that I like and I think they are all free.

Lose it!  This is a great app for dieters.  It is easy to use and intuitive and you can track your caloric intake and exercise.  Just set your goal and how many calories you want to eat a day and it maps out how long it

Medicare Fraud

There are few things that grind my gears more than Medicare Fraud.  These scams pop up every couple of years and I am so glad when the perpetrators get caught and arrested.  The latest is a large crime syndicate lead by Armen Kazarian, the godfather of Armenian gangsters.  More than $160 million fake  Medicare invoices were generated from 118 fake medical clinics in 25 states, said U.S. Attorney

Drug Shortages in the United States

One of our pharmacists asked me "Are we now in Sudan?"

It seems like we are a third world country because we are dealing with serious and nationwide pharmaceutical shortages for needed drugs.  Medications like Propofol (yes, the one that killed Michael Jackson) and Succinylcholine, a neuromuscular drug that is commonly used in surgery, are in such short supply that we are canceling surgeries and

Get Healthy Compliments of Uncle Sam

It makes my blogging life easier if I can just direct readers to a cool site compliments of....drumroll...the U.S. Government! 

This site, called Smallstep Adult and Teen,  is filled with great health, eating and exercise tips.  Check it out and click around a bit.  Don't ya' just love the internet?

Positively Quit Smoking

I hold my breath when I walk into the hospital and see a small group of people in the "smoking area" puffing hard on cigarettes. The hospital (and other office buildings) are smoke free, but that doesn't mean everyone has stopped smoking.  They just have to stand out in the fog or the cold like lepers.  I know in other parts of the country, smoking is more tolerated and even more smoking occurs.

Internal Medicine Poem

I am frequently asked:  What is Internal Medicine?  The answer: "I am the doctor for adults" or I am the primary care physician", just doesn't seem to cover it.  I think this poem from the Journal of American Medical Association (JAMA) does:

Today I Saw

diabetes in a brown pantsuit
recently widowed, bringing her daughter
for the first time.

Bladder cancer still working
full time after surgery

Flossing Toothbrush

Being the world famous popular blog it is, EverythingHealth gets lots of solicitations to place ads, promote books, authors, medical supplies, drugs and other websites.  The answer to most of these requests is "Thanks, but no-thanks".  I like to keep the blog pure and you know that my advice is not tainted by outside influence. (Also known as $$$$)

But since October is National Dental Hygiene

Why You Should Get Enough Sleep

1915 Anti-Smoking

They had the right idea back then.  I wonder how cigarettes became so popular as the Century progressed?

Help Your Doctor Make the Diagnosis

When patients and doctors communicate effectively, the patient has the best result. Not every doctor asks the critical question that can cinch a diagnosis.  Yet good communication, coupled with good diagnostic skill can be worth more than $10,000 in tests and referrals to consultants.  You can help your doctor figure out what is going on by thinking and communicating like a physician.  Whether

Sign Up for EverythingHealth

Make it easy on yourself.  Look to the right and you will see an email sign-up to receive a message when there is a new post on EverythingHealth.  No spam...you simply get a link and never miss a fascinating topic.
(Don't forget to click and verify when feedburner emails you...a number of subscribers forgot that step) 

Coffee Gives the Buzz in Health Care

I could have told you without the study, but the results are in:  Coffee is the fuel that keeps hospitals and doctors and nurses going, both day and night.  OK, I admit the study was commissioned by Dunkin' Donuts, but I believe the results because I have witnessed it.  Health professionals are more dependent on coffee than any other profession.

The national survey included more than 3,600

Omega 3 and Green Tea

We have know for some time that there are health benefits from drinking green tea.  Research also shows that Omega 3 fatty acids have  beneficial effects on a number of organs in the body, including the cardiovascular system, brain and even depression.Dr. Fereidoon Shahidi, research professor in the Department of Biochemistry at Memorial University in Newfoundland, Canada is hoping to show that

Things Growing in Lungs

 (Image shows a nail clipper inhaled accidentally by a 20 year old man)

Last month an elderly man in Massachusetts developed a collapsed lung and pneumonia. Usually this means an undiagnosed cancer is lurking.  Imagine his relief and surprise to find out it was a pea growing in his lung.  That little accidentally inhaled pea started sprouting.  It seems that odd things found in lungs is not all

Musings on ESP

Extra Sensory Perception (ESP) is defined as reception of information not gained through the recognized senses but sensed with the mind.  Other terms are psychic abilities or precognition or even a "hunch" or gut instinct that can't be readily explained.  Haven't we all had experiences like that?  The scientific evidence is weak and inconsistent,  but this morning's events are causing me to

How Health Reform Helps Right Now

Obama and the Dems have done a terrible job at marketing Health Care Reform, also known as the Patient Protection and Affordable Care Act.  The statute that is now law has new provisions that go into effect as early as September 23, 2010 and millions of people will benefit.  Here are a few benefits that you probably haven't heard much about:




College graduates and dependents will be able to

Preventing Kidney Stones

Over the years I have had a number of patients with painful kidney stones and once they have passed (or been removed) I have felt at a loss to helping them prevent them.  "Stay hydrated" somehow didn't seem adequate, although we know fluid intake can help stave off recurrent kidney stone attacks.  Some textbooks said "avoid calcium"  since most stones are made of calcium oxylate.  High oxylate

Welcome International Blog Visitors

Every so often I like to give a formal blog welcome to visitors from around the Globe.  What a thrill it is to see how interconnected we are and to share knowledge so freely.  My hearty welcome to visitors within the last 24 hours from:
Oranjestad, Aruba; Tiaret, Algeria; Puntarenas, Costa Rica; Buenos Aries, Argentina;  Melbourne, Australia; Perth Australia; Aukland New Zealand; Abu Dhabi, UAE;

Heart Conditions We Don't Treat in Med School

This gave me a chuckle from Doc Cartoon. 

Hugs and Hand Holding in Medicine

The New York Times asks, "Should the Doctor Hold a Patient's Hand" during emotional times or if the patient is crying.  The comments that follow the short article are the most interesting.  Most readers say this question shouldn't even be asked and that human compassion should always win out.  Touch is a human gesture of comfort and understanding.

But some readers disagree.  One said she

Adult Chickenpox

We think of chickenpox as a childhood disease but there are adult cases and they tend to lead to more serious complications.  Chickenpox is caused by the varicella virus and it is extremely contagious.  Most people are exposed in childhood (or they receive the chicken pox vaccine) and so adults rarely contract it.  It is especially dangerous for pregnant women because the fetus can become

Kids Lack Opportunities for Physical Activity

One out of 3 children in the United States is overweight. Increased consumption of  nutrient-poor foods with high levels of sugar and saturated fats, combined with reduced physical activity, have led to obesity rates that have risen three-fold or more since 1980.  Our kids are not to blame. We are.

The Center for Disease Control has found that only 20% of blocks nationwide have parks within a

Overpriced Medicine

I took Tracy's (the faithful follower) advice and went to the link she provided in her comment from my blog on patients going to the Emergency Department for expensive health care.  The blog post  was a really good one that I wanted to share so click here and read a cost analysis from  young doctor Sara in Israel. 

And for those of you who think the U.S. has the BEST HEALTH CARE IN THE WORLD...

Emergency Rooms Used for Routine Care

The Patient Protection and Affordable Care Act (Our government's name for Health Care Reform) may make our already crowded emergency rooms swarm with more patients. A new study from Health Affairs
shows that more than a quarter of patients who currently visit emergency departments in the U.S. are there for routine care and not an emergency.  New complaints like stomach pain, skin rashes, fever,

I hate canker sores

Why do I hate canker sores?  First they are painful and mouth pain cannot be ignored.  Second, they are difficult to prevent and you just have to cope with them until they go away. And 3rd, we have no idea what causes them.  For a doctor, the 3rd reason is the most difficult to accept.  What the hell are canker sores?

The medical term is apthous ulcers and they are  round or oval painful ulcers

Michael Douglas Has Oropharyngeal Cancer

Michael Douglas announced he has"stage IV throat cancer" on late night TV this week.  Any announcement of cancer causes people to stop and take a deep breath but the idea of throat cancer is particularly scary.  So what exactly is throat cancer?  How is it diagnosed and treated? 

The clinical term is oropharyngeal cancer that involves the base of the tongue, the mouth, the tonsils, or the front

Katrina Racial Violence

I read an article in the New York Times about the post hurricane violence in New Orleans after Katrina and the stories that are finally emerging about vigilante white people, including police, who threatened and murdered innocent blacks.  These accounts, so many years later are difficult to believe and several police officers have finally been indicted in various cases.

It takes me back to the

Humane Farming to Prevent Salmonella Infected Eggs

More than a thousand Americans are ill from egg contaminated Salmonella and it has forced a recall of 1/2 billion eggs and increased scrutiny of the safety of eggs.  The Centers for Disease Control and Prevention have tracked the contaminated eggs to two Iowa facilities, one with over 1 million chickens.  It turns out that less than 200 big companies supply 95% of the eggs in the United States.

Weight Loss Requires a Major Change in Lifestyle

I know it is not politically correct to look at what other people buy at the grocery store, but as a physician I just can't help noticing.  Some baskets contain huge containers of soda pop, Doritos, frozen pizza and other packaged goods.  I'm not surprised because at the end of every isle is a display case that offers the giant soda for 89 cents or the Doritos on special for $1.29.  With this

Answer to Medical Challenge

The answer to yesterday's image and patient case was #3-Ludwig's angina.  Ludwig's angina is an infectious process involving the submental (chin), Sublingual (under tongue) and submandibular (under the jaw) spaces. The bacterial cause is usually strept.  It can rapidly progress and is considered a medical emergency because it can affect the breathing and airway.

The term angina means "

Medical Challenge

This weeks Medical Challenge from the New England Journal of Medicine is a tough one.  This patient had been treated with penicillin for a toothache the day before.  You be the doctor.  What is the diagnosis?

1. Acute parotitis
2. Angioneurotic edema
3. Ludwig's angina
4. Penicillin allergy
5. Peritonsillar abscess

The answer will be posted tomorrow.

Communication Gaps Between Doctors and Patients

In a surprising report from the Archives of Internal Medicine, we learn that most hospitalized patients (82%) could not accurately name the physician responsible for their care and almost half of the patients did not even know their diagnosis or why they were admitted.  If that isn't enough, when the researchers queried the physicians, 67% thought the patients knew their name and 77% of doctors

Osteoporosis Testing with DXA

One of the good things that has come out of the Affordable Care Act (the name for Health Care Reform) is that the payments to providers who do DXA screening for osteoporosis will increase immediately from Medicare and Medicaid.  Unfortunately these increased payments expire at the end of 2011.  To show how crazy the Medicare payment policies are, in 2006 the DXA service was reimbursed at $143.00.

Top 10 U.S. Pharmaceutical Sales

The top money makers for the U. S Pharmaceutical Industry might surprise you.  These are not necessarily the most prescribed medications (although some of them are) but they are the top products in terms of sales in 2009.  The revenues were in $ Billions:
Lipitor  -      used for high cholesterol                 $7.5
Nexium  -    a proton pump inhibitor for reflux     6.3
Plavix   -      a blood

Don't Wait After Miscarriage to Get Pregnant Again

About 15-20% of women who know they are pregnant will have a miscarriage.  The loss of a pregnancy before 20 weeks is considered a miscarriage. Many women suffer grief and shock after a miscarriage and fear there is something wrong with them or that they did something to cause it.  But the reasons for miscarriage are usually not known.  Women are often told to wait "a few months"  to get pregnant

Are Teens Overmedicated?

It is summer camp season for kids and well run camps require a medical history and record of prescription medications that the child is taking.  One prestigious camp for teens (ages 11 to 19 - average camper is 16) in Southern California had 153 residential teenagers last week.  These kids come from California and other states across the U.S.  Fifty percent come from out of state and a number of

Sun and Surf

I'll be blogging from a vacation site. (If I have the time and creativity).  Nothing too exotic this year...can you guess where EverythingHealth will be?

Bystander CPR Saves Lives

Nearly 450 people die each day of sudden cardiac arrest. Many times the bystanders, who witness a person collapse don't know what to do. They are afraid they will hurt the victim or they feel nervous about doing traditional Cardio-pulmonary resuscitation (CPR) with mouth to mouth breathing and chest compressions.

New information is published in the New England Journal of Medicine that

Irritable Bowel Syndrome From Structural Brain Changes

Irritable bowel syndrome (IBS) is a common disorder that affects women twice as often as men.  It is commonly seen in a general medicine practice.  It is thought to be chronic and involves cramping, abdominal pain, gas, diarrhea and constipation.  An old term for it is "spastic colon".   It is one of those frustrating conditions where we "don't know what causes it" and that means doctors often

The Pesticide Dirty Dozen

The Environmental Working Group is a non-profit focused on public health.  We know that the long term consequences of eating chemicals from pesticides used on our foods is damaging to our health.  The EWG analyzed data from the FDA and  found that people who eat five fruits and vegetables a day from the dirty dozen are eating 10 pesticides a day.  We want people to eat more fruits and vegetables,

Caffeine is OK for Pregnant Women

The American College of Obstetricians and Gynecologists have issued a statement that moderate caffeine consumption (<200mg/day - about a cup of coffee) does not increase a woman's risk for miscarriage or preterm birth.  The review of recent studies was published in Obstetrics and Gynecology and should reassure women about drinking coffee when pregnant.

Caffeine does cross the placenta but there

When a Professional Turns His Back

A few weeks before Christmas, Eutisha Rennix, a pregnant restaurant worker,  collapsed while working.  She started having a seizure and her co-workers were screaming for help. There were two EMT workers in line at Au Bon Pain shop in Brooklyn and they refused to help.  They told on-lookers to call 911 and they walked out of the store after picking up their bagels, presumably because they were on

The Most Amazing Flower in the World

This Agave Century Plant has the most amazing flower in the world.  I've been photographing the initial bloom spike since early June.  The plant takes about 15-20 years to finally put out a flower. Because so much of the plant's energy goes into this amazing bloom, the plant dies afterward.  But in nature's amazing way there are new daughter plants spreading from the original to keep the

How to Recognize a Competitive Medical Student

This cartoon is from a clever medical student blog.  I love finding out what medical students in 2010 are up to,  and reading about their struggles brings back my own nostalgic (read: horrific)  memories.  This cartoon of a Med School Gunner shows me that not much has changed and this type of student is still with us. 

(thanks Doc Cartoon)

19th Century Obesity Cure

I really really want to know what the treatment is that this "regular practicing physician" will send to the patient to reduce the surplus flesh. "Eat as much and as often as you please" and no "bandaging or tight lacing."  Bring it on!

(click on image to enlarge)

The Answer

The answer to yesterday's medical challenge is...(drum roll)...insect bites.  Many of you diagnosed correctly.  We don't know what type of insect caused the reaction because mosquito and chigger bites can look the same with red, indurated wheals.  The fact that they were on the exposed skin, and not under clothing gives a clue to insects too.

The photo here shows one of our nurses in Haiti with

What is the Diagnosis?

This 24 year old patient had the onset of these very itchy lesions on both upper arms.  She takes no medication and has no other medical problems.  She had just returned from a vacation where they had lots of outdoor dining.  She recalls eating shellfish and strawberries.  You are the doctor.  Make a comment and tell us what is the diagnosis?  Can it be treated?

The answer will be posted

Tips for Men Using Viagra

One of my journals, Mayo Clinic Proceedings,  (I read every night to keep up with the latest medical information) contained some clinical pearls that I wanted to pass on to my men readers who take medication for erectile dysfunction (ED).  They reported on a healthy 67 year old male who took 2 25mg doses of Viagra (sildenafil) but still did not get erections.  He was frustrated and inquired about

Obama Makes Don Berwick Head of CMS

In a slick move, President Obama appointed Donald Berwick, a pediatrician, to the top post at CMS (Centers for Medicare and Medicaid).  I am happy about this because Dr. Berwick is eminently qualified and has been a leader in the quality and safety movement and patient protection for decades.   With his focus on quality and his passion for improving health care, he is the right person at this

Doctor Sues for Lousy OnLine Ratings

I must say I think Dr. Kimberly Henry, cosmetic surgeon,  has made a big professional mistake.  She has filed a lawsuit to stop online reviewers from badmouthing her on the Internet.  She is seeking injunctions against at least 12 reviewers from sites such as Yelp.com  and DoctorScorecard.com.  Dr. Henry claims libel and defamation, invasion of privacy and interference with prospective economic

Top Ten Things Going through Isner's Mind

 

Did you see the mental and physical strength these player's demonstrated during the historic tennis match?  It shows just how important the mind is.  RESPECT!

Rare Condition of Lizzie Velasquez

 


Lizzie Velasquez is 21 years old and lives in Austin, Texas.  She suffers from a rare condition that prevents her from gaining weight, even thought she eats up to 60 small meals and consumes between 5,000 and 8,000 calories daily. 

She was born premature at 2 lbs. 10oz and remained tiny as a child.  She has a syndrome that prevents her body from gaining weight and putting on body fat.  She

Attack of the Dust Mites

Have a happy 4th of July Holiday!  

Doctor Fakes Research and Goes to Jail

A prominent 51 year old anesthesiologist pled guilty to falsifying research on the analgesic medications Celebrex and Vioxx for post-op pain managment.  He was sentenced in Massachusetts federal court to 6 months in prison and given hefty fines to be paid to the pharmaceutical companies who financed his research and paid him to promote their drugs.

Dr. Scott Reuben just plain faked the results.

6 Ways To Help Simplify Your Life

I like to pass on good tips and these six ways to simplify your life make a lot of sense.  The constant stress we feel because life is so complicated is not good for our health.  Here are six ways you can have a simpler lifestyle:

1. De-Clutter Your Home

Look around.  If you have piles of paper, too many "things" and nic-nacs laying around it is hard to think clearly and function. An open,

Good Lessons Come from McChrystal Debacle

General Stanley McChrystal's loose lips and ultimate downfall can teach us all some valuable lessons.  He was a career military man (West Point Graduate) who rose to the top of the heap as Commander of the International Security Assistance Force and Commander of U.S. Forces in Afghanistan.  People are scratching their heads about how a man who was in such an esteemed position could be so stupid

Omega 3 FFA for Depression

A study published in the Journal of Clinical Psychiatry has shown that supplementing Omega-3 fatty acids (FFA) can significantly reduce symptoms for patients with major depression.  This study looked at 432 adult patients (mean age 46 years, 68.5% female) and randomized them to receive either 8 weeks of omega 3 FFA or placebo.  40% of the patients were also taking antidepressants when they

Black Spot Poison Ivy

I love learning something new in medicine and this was a new one for me...black spot poison ivy.   Poison ivy (also known as rhus dermatitis) is a common contact allergic dermatitis.  Like poison oak and poison sumac, the chemical that causes a reaction is called urushiol.  When this plant sap touches the skin a pruritic (itchy) red rash appears with little blisters that are often in a line.

Weight Loss from Activity Only Works in Thin Middle Age Women

Talk about a cruel trick of nature!  A study funded by the National Institutes of Health (NIH) and published in JAMA shows that physical activity prevents weight gain in middle-aged and older women ONLY IF THEY ARE ALREADY AT IDEAL WEIGHT.  Did you read that?  It means that the recommended guidelines advocating 150 minutes of exercise a week isn't sufficient to prevent weight gain in most middle

SpaghettiOs Recalled

I know the readers of EverythingHealth would never eat Campbells SpaghettiOs but in case you know someone who does, you should know that the USDA has recalled 15,000,000 pounds of SpaghettiOs because of under processing. The recall includes 14.75-ounce cans with a use-by date between June 2010 and December 2011 of three varieties of the product: "SpaghettiOs with Meatballs," "SpaghettiOs A to Z

Email Alerts by Popular Demand

Dear EverythingHealth readers,
Many of you have requested an email alert when new blogs are posted.  It took me awhile, but now it is easy to sign up on the right hand side of the blog.  Check it out and never miss a fascinating topic.
Thanks for visiting and reading.

Senate Approves Last-Minute Delay for Medicare Physician Cuts

Yesterday's Medicare pay cuts for physicians have been delayed in a last-minute compromise deal today by the U.S. Senate.  The agreement was passed by "unanimous consent" without a roll call vote.  (I need to go back to 8th grade Government 101 to figure out how that is done!)

The last minute agreement means that the pay cuts will be reversed.  The House of Representatives will (hopefully) pass

The Doctor is Out for Medicare Patients

Breaking news tonight that in a last minute shocker, the Senate voted today against postponing a scheduled 21% cut in Medicare reimbursement to physicians and other health providers.  60 senators were needed to end filibuster debate and stop the cuts under Senate rules.  Fifty-six voted in favor, with 40 opposed. There was no Republican support. (And, of course, no support from Senator Lieberman,

Surgery and Radiation Therapy for Prostate Cancer Cause Lack of Ejaculation

The American Urological Association 2010 Annual Scientific Meeting was held in San Francisco.  One of the reports at the meeting dealt with the fact that nearly 90% of men who undergo radiation therapy for prostate cancer will eventually develop anejaculation (inability to ejaculate).  Additionally radical prostatectomy (surgery) is almost always associated with loss of ability to ejaculate.  It

Addiction to Tanning

According to the Archives of Dermatology, there are people who are addicted to indoor tanning.  That journal reported on a study of 421 University students in the northeastern United States.  Using self-reported questionnaires, they screened for alcoholism and substance use as well as anxiety and depression.  They also had a questionnaire about addiction to indoor tanning. 
If you are

Doctors Offices Not Keeping Up with Online Demand from Patients

At a time when more and more patients are using the internet to research doctors, hospitals and medical conditions, there are still few physicians who utilize on-line services for patient care.  Thirty eight percent of  US adults have researched a medical problem online in the past 12 months, according to a Forrester Research Study.  The survey also showed that 26% of adults researched a specific

Eight Secrets You Should Tell Your Doctor

It is important to have an open relationship with your primary care physician because the more she knows about your health and lifestyle, the better able she is to diagnose illnesses as they come up.  You wouldn't take your car to a mechanic and not tell him that the brake is sticking.  And a human organism is thousands of times more complicated than a car.  But patients are shy. They are

Are We Overmedicating Our Kids?

One of the blogs I read by Maggie Mahar, pointed out that a new study found that 26% of kids under age 19 are now taking prescription drugs for a chronic condition. The drugs include asthma medication, anti-psychotics, diabetes, anti-hypertensives and heartburn medications.  According to the Medco study (the largest pharmacy benefit manager), the incidence of type 2 diabetes increased over 150%

Keratosis Pilaris

This photo of the arm of a 17 year old girl showing tiny red rough bumps that were not painful or itchy.  She had similar bumps on her thighs.  This common condition is called Keratosis Pilaris and it peaks during adolescence in all races.  It goes away by itself as a person ages.

We don't know the cause of this strange phenomenon.  Since it is mainly seen in puberty there may be a hormonal

Extra Fees Help Physicians Stay in Practice

I was interested in an article in USA Today about the growing number of physicians, especially primary care doctors, who are boosting their revenues by requiring patients to pay new fees for services that insurance doesn't cover.  No longer is your insurance payment "all-inclusive". These fees can include annual administration fees, no-show fees, medical report fees, and extra fees for email or

Start Talking - a book for Teens and Moms

Raising kids gets really challenging when they hit the pre-teen age and there are few books that really help moms understand how maintain closeness with their teen daughters.   Authors Mary Jo Rapini and Janine Sherman offer a helpful book for young girls and their moms to read individually and together.  "Start Talking - A girls guide for you and your mom about health, sex or whatever" is a

More Medication Errors in July

We medical folks have always known that July is the worst time for a patient to be admitted to the hospital.  It has nothing to do with nice summer weather or staff vacations.  Although it cannot be proven, we think the answer to the mystery of July hospital errors is human...yes it's the new interns.

A new study published in the June issue of the Journal of General Internal Medicine looked at

Chin Slimmer

After yesterday's eyebrow post, I am on a cosmetic run. Here is a gimmick, "As seen on TV" , on which you should save your hard earned money.  The neckline slimmer claims to reverse the effects of aging without cosmetic surgery.  Simply hold this gadget to the chin area and it will exercise your neck muscles to reduce those jowls or sagging fat under your chin.  Just two minutes a day should do

Desired Shape of the Eyebrow

While my Internal Medicine Journals are filled with long studies about breast cancer, diabetes and optimal doses of Vitamin D, the Archives of Facial Plastic Surgery reports on the aesthetically desired position of eyebrows and the range of eyebrow motility.  Please understand, dear reader that  I am not poo-pooing the importance of eyebrows.  We all have two and I am sure how they sit on our

What You Should Know About Prostate Cancer

When Dennis Hopper died of prostate cancer at age 74, my husband asked me "Hey, I thought prostate cancer didn't kill men and it is slow growing".  Well, he is right  about it usually being slow growing, but prostate cancer is still the 2nd leading cause of cancer death in men.  His question made me realize that there are some facts that everyone should know about prostate cancer.

Prostate

Remote Telemedicine is Coming Soon to You

Imagine this, Dear Patient.  You wake up and feel like you were hit by a truck.  Your head aches and when you look in the mirror you are shocked to see a rash running along your left ribcage.  It is slightly prickly and tender and you are freaking out.  To make things worse, you are in day two of a long awaited vacation and hundreds of miles  away from your favorite doctor.

What do you do?  Try

Having a Baby in 1930

Flash back to 1930.  Look at this bill for childbirth.  10 days in hospital - $50
Circumcision - $3
Total - $53


According to Forbes, the total charge in 2009 for an uncomplicated birth with 3 day hospital stay at Cedars-Sinai in Los Angeles was $36,625.

That seems a little high but good luck trying to find out the actual charge ahead of time.  You better round up between $7,000 and $15,000 and

Brush Your Teeth or Risk Heart Attack

The British Medical Journal reported on a study of  toothbrushing and found that people with poor oral hygiene had an increased risk of cardiovascular disease and heart attack.  We have known for the last two decades that inflammation plays an important role in atherosclerosis.  Markers of low grade inflammation like C reactive protein, are also shown to be higher in heart disease.

The Scottish

Viagra and Hearing Loss

A study published in the Archives of Otolaryngology-Head & Neck Surgery reports that men who have taken sildenafil (Viagra) may experience sudden sensorineural hearing loss.  More than 2 dozen reports have indicated an association between sudden hearing loss and taking the phosphodiesterase type 5 inhibitor, Viagra.

This study compared subjects with and without hearing loss and looked at whether

Yoga Helps Cancer Survivors

Patients who carry a diagnosis of Cancer can be heartened by the results of a study that will be presented June 5 at the upcoming American Society of Clinical Oncology Annual Meeting.  The researchers found that the practice of Yoga helped cancer survivors improve sleep quality and reduce fatigue.

The lead researcher, Dr. Karen Mustian, professor of radiation oncology and community and

Answer to Medical Quiz

The answer to yesterday's medical challenge is #1 Basal Cell Cancer. These cancers are often slow growing and have a pearly appearance.   Basal Cell Cancers are easily removed by excision.

This group of Basal Cell Cancer's shows the different ways they can appear. The only way to confirm the diagnosis is by biopsy.

(photo from WebMD)

Doctor Pricing Upfront and Transparent

A company in the Los Angeles area called HealthyPrice has posted prices on its website for 400 procedures and over 100 physician office visit fees.  For patients without insurance or who have high deductibles, the ability to go online and really "shop" for the best deal is something long overdue.

Here is how it works.  The patient goes online and chooses the provider for the test.  It might be a

Skin Lump - You Be the Doctor

This 71 year old man comes to the office with a lesion on his cheek that has been there for several years. He thinks it is getting larger and it does not bleed or hurt.  You are the doctor.  What is your diagnosis?

1. Basal cell carcinoma
2. Squamous cell carcinoma
3. Wart
4. Seborrheic keratosis
5. Melanocytic nevus

Make your diagnosis in the comments and the answer will be posted tomorrow.

What Women Should Know About Fibroids

Fibroid tumors are benign growths on the muscular wall of the uterus.  They can be tiny in size, like a marble or grow huge and fill up the entire uterine cavity.  Some fibroids are as large as a five month pregnancy.  Here are some facts that women should know about fibroids:
Fibroids can occur at any age but are most common between ages 40-50.
Common symptoms are prolonged or heavy periods,

"Daily Affirmation"

This is how we should all start our day. Happy Monday!

What You Can Do to Lower Cholesterol

Your doctor has just informed you that you have "hyperlipidemia"  or high cholesterol.  She is mentioning lipid lowering drugs (statins) but you said you want to try some things on your own first.  She agrees and you will recheck the blood levels in 3 months.  What are you going to do?  The advise is all over the ballpark and your google searches come up with various supplements and diets that

The Winners!

Announcing the winners for the Subway gift cards.  Congratulations to SML,  Anon2 and Craig.  Each of you will receive a gift card in the mail if you will contact me and send me your address.  Enjoy the free healthy meals from Subway and EverythingHealth.

Keeping Kids Safe On Social Networking Sites

My mom came from the McCarthy communist hunt era.  She would always say,"don't write anything you wouldn't want everyone to read and don't sign anything without reading it...you might be admitting you are a communist".  As a kid, I had no idea what she was talking about but those words stuck with me.  I am careful about what I write and I am careful with emails and the internet too. 

Working Overtime Linked to Heart Disease

The European Heart Journal studied 6000 British civil servants and followed them for 11 years.  They found that working an extra 3-4 hours a day is associated with increased coronary heart disease.  The researchers controlled and adjusted for lifestyle, cardiac risk factors and other factors that would skew the results and still found that people who worked 3-4 extra hours a day had a 60%

Check it Out

Two things:  Head over to The Examining Room of Dr. Charles for this weeks Grand Rounds roundup and also scroll town a bit and enter the Subway free card give-away.  Hey...free is good for your health.

Some Gender Stereotypes are True

I get good info from my blog followers and SJ sent me a link that was pretty interesting.  Here are some gender stereotypes that have a basis in science that might be a surprise to you. 

Women spend lots of time with colors, calling them mauve, pure ivory and ecru.  Men see pink, white and yellow.  Are women just color obsessed?
 Science tells us that color blindness only happens in men because

EverythingHealth Giveaway Contest

We all know how important a healthy breakfast is.  But what do you do if you are on vacation? Or have a kid rushing to an early morning soccer or band practice?  What about those times that mom is just not available to get it together?   EverythingHealth loves a contest with a free healthy giveaway and here is your chance to win!

Subway (yes, that fast food subway!) has introduced a nutritious

Older Mothers

An EverythingHealth blog fan requested that this post from 2007 be reposted in honor of Mothers Day.   I've updated it a bit and here it is:
Something has dramatically changed in the appearance of parents from the 1960s and the parents of children in the 21st century. Looking around at the adults with kids at schools, parks and ballgames, I can't help but think, "Gee, is that the parent or

Mothers Day

Happy Mother's Day to all of us who are mothers or who have a mother.  That is everyone!!!  For some touching thoughts, check out today's Post Secret.  It's  Mom's Day tribute.

Things Your Kids Will Never Know About

The one thing we can all agree on is that nothing stays the same. We marvel at the customs and habits of our great grandparent's era and everything looks so grainy and antique.  Here are a few things that we took for granted that our kids and grandkids will never see, except in old photos:



a phone book
a rotary phone, a pay phone stand and eventually any land line phone
a record or

Gulf Coast Oil Spill

On Day 17 of the tragic oil spill from the drilling rig in the Gulf of Mexico, this is what it looks like from the air.  Oil continues to pour into the Gulf from the undersea well at about 210,000 gallons per day.  The pinkish oil is now at the shore of New Harbor island, a national wildlife refuge and nesting ground for sea birds.  West of the mouth of the Mississippi River, hundreds of dead

Men With Penis Enlargement Banned From Police Work

Ok, leave it to EverythingHealth to bring you news you can use.  Look, I scour the health news so you can be up to date and informed without leaving the comfort of your computer chair.  Papua is the largest province of Indonesia and men there use a local technique to achieve penis enlargement.   They wrap the penis with leaves from the "gatal-gatal" (itchy) tree which causes the penis to swell. 

Your Genes Determine Which Diet Works

Why do some diets work better than others?  Why can your best friend lose 10 lbs with a low carb diet and your weight just hovers?  Why can some people eat just about everything, and still stay skinny?  It's all in the genes.  Mindy Dopler Nelson, Ph.D., of Stanford U. reported the results of her study at the American Heart Associate conference.  She found that a single nuceotide polymorphism

When Doctors are Owners, Surgery Goes Up

More and more physicians are owners in surgi-centers, imaging facilities and GI labs.  Some have labeled these ownerships as the "triple dip" because the doctor collects a professional fee as well as the facility profits and the investment value.  A study by John Hollingsworth, MD, a Robert Wood Johnson Clinical Scholar,  shows this creates a potential conflict of interest.  The study showed

Gene that Regulates Pain

I've often wondered about people's pain threshold and why some people seem to experience more pain than others.  New research reported in the Proc Natl Acad Sci USA, shows that a rare mutation in a gene (SNC9A) that encodes a protein in a type of sodium channel is associated with disorders of either excessive pain or insensitivity to pain.  Those with a rare allele that is found in about 10% of

Healthy Senior Inspiration

Thanks to KM for turning me on to this inspirational 73 year old grandmother who runs marathons, trains with weights and has a passion for helping other women reach their peak conditioning also. She started at age 56 when she realized she didn't like the way she was looking in a bathing suit. She adamantly denies using performance enhancing drugs or special supplements. She does take Vitamin D

Primary Care shortage Predicted to Worsen

The new reform law which is called the Patient Protection and Affordable Care Act (PPACA) will be a huge disappointment to the millions of previously uninsured people who finally purchase insurance policies when they try to find a doctor. Primary care physicians are already in short supply and the most popular ones have closed practices or long waits for new patients. Imagine when 2014 hits and

Preterm Childbirth Caused by Physicians

Babies born between the 34th and 36th week have more complications and the cost in the U.S. is $26 billion annually. These children have more risk of death, cerebral palsy, cognitive impairment or respiratory problems. In the United States, nearly 13% of infants are born before they reach 37 weeks gestation. According the the Society for Maternal-Fetal Medicine (SMFM), that rate is much higher

The Uvula

That thing that hangs down in the back of your throat is called the Uvula. Like any tissue, it can get inflamed or infected and swell. This photo shows uvula edema. (or if you are a Brit it is called uvular oedma)This patient was hospitalized for acute pancreatitis and developed difficulty swallowing and a sore throat. He had been vomiting repeatedly and that may have been the cause of the

New York Senator Steals from Community Health Clinics

Citizens are outraged at the New York State Senate majority leader, Pedro Espada, Jr (Democrat), who has been charged with stealing more than $14 million from nonprofit health care clinics and using that money for apartments, Mercedes-Benz, meals, vacations and campaign expenses. Mr. Espada founded the organization and stacked its board with relatives and Senate employees. The foundation board

Aspirin for Migraine Headache

There are many expensive and complicated treatments for people who suffer from migraine headaches but a new literature review shows that a single dose of 1000mg aspirin is effective for more than half of all patients. Compared with placebo, aspirin reduced associated symptoms of nausea, vomiting, photophobia (lights) and phonophobia (sounds) and made severe or moderate pain into no pain after

Surgeon Removes His Own Appendix

You gotta love the British Medical Journal for their report of a surgeon in a remote area of the Antarctic who did emergency surgery on himself. Russian Leonid Ivanovich Rogozov was the only doctor on an expedition ship whose mission was to build a new Antarctic polar base island in 1961. The sea had frozen over and the 12 explorers were alone at the base when the 27 year old team doctor

Good Aspects of Heath Care Reform Bill

The large health care bill has some very good elements in it that should help the average American. One is a provision that will kick in in 2011 that says all health insurers will need to spend 85% of the premium dollar on actually providing care. This means people may actually receive benefits they pay for. What a concept! Before you worry too much about WellPoint and United Health Care,

Insurance Companies Invested in Fast Food Stocks

A new article published today in the American Journal of Public Health shows that U.S., Canadian and European insurance firms hold $1.88 billion of investments in fast food companies like Jack in the Box, McDonald's, Burger King and Wendy's/Arby's Groups. Both Health Insurers and Life Insurers have substantial holdings in these companies.One just needs to read "Fast Food Nation" or watch the

Head Lice

It's the phone call every grade school parent dreads..."Come and pick Johnny up from school. He has lice". Before you scream "Ewwww" and hang your head in shame, you should know that head lice are a very common problem. In fact, only the cold is a more common communicable disease that affects school age children. The medical term for head lice is Pediculosis capitis.This tiny insect is

Announcing The Winner

The Winner of the EverythingHealth Made From Earth giveaway contest is...drumroll....Country Midwife. She had an advantage because I am partial to women who work all night bringing life into the world and she has a painful spider bite.The other entries were also good and there will be more healthy contests in the future.Congratulations, Country Midwife. Please contact me with your name and

Surprises About Emergency Room Use

If you think the overcrowding in Emergency Rooms across the country is because of uninsured, think again. A new study in the Annals of Emergency Medicine reports that of patients who are frequent users (over 4 times a year) of Emergency Departments, the uninsured represent only 15% of those frequent users. Also the frequent ED users were more likely than occasional users to have visited a

EverythingHealth Give Away Contest

There may be "no free lunch" but there is a skin serum that is all natural and good for your skin and I'm offering a free give away! I wouldn't offer this to readers if I didn't try it first and love the products. The folks over at "Made from Earth" will send the lucky winner a Rosehip Face Serum and a citrus fresh organic lip balm for free!Made from Earth is an organic, holistic and healthy

Bad Dentist

Insane!!!

Report On The State of U.S. Health

The Centers for Disease Control and Prevention (CDC) issue an annual report on the state of health in the United States. The 33rd edition just came out and has some surprising findings, especially about the use of procedures, tests and medical technology. The life expectancy in the United States is now 77.9 years. Are you over that age? Congratulations, you beat the odds.Mortality from heart

Corporate Hall of Shame Award

With the United States undergoing the worst recession since the Great Depression and people everywhere worried about the cost of health care and how health care reform will affect them...isn't it great to know that some special corporate execs got a 51% raise in 2009? Angela Braly, the president and CEO of health insurer WellPoint, Inc, got a nice bonus that raised her salary to $13.1 million

Is Sexual Addiction Real?

Tiger Woods, Jessie James, Michael Douglas,Wilt Chamberlain (remember him?) are just a few of the celebs who admit to being plagued with "sexual addiction". With rehab centers springing up all over, it would appear this condition is on the rise. But is there really a disorder called "sexual addiction" or is it just bad behavior that finally gets caught? Is sexual addiction equivalent to

Ten Things You Didn't Know Are In the Health Care Bill

The health reform bill is 1,017 pages long but it contains a lot that will have an impact on Americans. I am one who believes we had to come into the 21st century and join with the rest of the civilized nations in beginning to provide health care to all citizens. You be the judge. Here are 10 things I bet you didn't know know are in the new Health Care Bill:Menu labeling. Restaurants with

Why Medical Care Costs So Much

The cost of medical care is high because the body is complicated and doctors and patients hate ambiguity. The cost is high because a missed diagnosis can lead to death and a large lawsuit. The cost is high because we have many specialists that view the body in tiny pieces and want to feel 100% correct about their piece. Let me give you a real life example:My patient, Rick is a brilliant

Ground Beef is Unhealthy and Contaminated

I am a bit obsessed this week with Celebrity Chef Jaime Oliver and his mission to reform the way Americans eat. I watched his new ABC show where he tries to reform the school lunch program in North Carolina where 50% of the town is obese. It is really a great show and it's great to see this type of "reality" TV rather than the usual fare. In honor of eating healthy, I am re-posting a blog from

Eating Healthy is High Cost

I watched a good documentary called "Food, Inc". It was nominated for an Academy Award . The promo says you'll never look at dinner the same way and they are right. Since I am a fan of Michael Pollan and have read "Fast Food Nation", I was already one of the healthy food fans, but seeing how agriculture and farming has changed over the last 40 years was still a shocker.There is no doubt that

Don Berwick to Head CMS

President Obama likes to shake things up. He has named Dr. Donald Berwick to head the Medicare and Medicaid Agency known as Centers for Medicare and Medicaid Services (CMS). This is a huge government agency with a budget of over $800 BILLION a year. That is more than most countries in the world. Dr. Berwick would be a major force in implementing the new health laws and changing Medicare to be

Corporate Hall of Shame Award

Thanks to reader m.scott for alerting me to this weeks Corporate Hall of Shame winner. Blue Cross and Blue Shield of Texas is the winner for it's egregious denial of care for a 10 day old baby who was born with a congenital heart defect. Coverage for surgery to treat transposition of the great arteries was denied for...are you ready for this....a "preexisting condition". Both of the Houston

New Approved Treatment for Dupuytren's

I did a blog on Dupuytren's contracture last year that got a lot of interest. There are a lot of men out there with this condition and, apparently, many of them are reading EverythingHealth. I mentioned a new biologic drug that was being developed as a non-surgical treatment for Dupuytrens. At that time, it was still in testing phase and not available for use.The product, collengenase

Are You Fat?

If you are wondering if you need to lose weight click here to calculate your body mass index (BMI). I am surprised that it applies to both men and women, especially considering the larger muscle mass of men, but it is an eye opener.

Health Care Reform Bill 101

Well, it is an historic day as health reform has finally passed. Yes, it is a watered down bill that leaves much to be desired but...it is a start. After months of stops, starts, rhetoric, fear mongering, empty promises and long, heated debate, many Americans are not sure of what just passed. It will have different effects on different people and many of the provisions are delayed until 2014.

"She Have AIDS"

I can't get the stories of Haiti out of my mind.A patient showed up at the Port au Prince hospital ward with a massive left sided paralysis, an obvious stroke. This 48 year old woman had collapsed the day before and was now accompanied by her three grown daughters, who were most attentive and worried. I examined her in the bed with other patients and families gathered around. (There is no sense

Answer to Medical Challenge

Yesterdays medical challenge answer was Herpes Zoster (aka: shingles). Shingles is caused by the varicella-zoster (chickenpox) virus which lives in the nerve roots and can become reactivated later in life. The blistering eruption can be painful and one distinctive finding is that it rarely crosses the midline of the body. Each nerve has it's own "dermatome" distribution and the infection

More Haiti Images

Reviewing the images of our Medical Mission to Port au Prince, Haiti brings back haunting memories.#1 - 2 Dramatic collapsed buildings..there are thousands like this#3 This man was outside of the emergency tent, lying alone and unattended#4 Families stayed with hospitalized patients, sleeping on cardboard on the floor. With no homes to go back to, we had no problem giving them shelter

Medical Challenge

Here is another medical challenge from the New England Journal of Medicine. Make your diagnosis and the answer will be posted tomorrow.1. Chemical Burn2. Cicatricial pemphigoid3. Epidermomycosis4. Herpes Zoster5. Squamous Cell Carcinoma

Haiti Medical Relief - Continued Need

(note family is caring for the patients)It has been two months since the disastrous earthquake in Haiti and the medical need is still dire. I just returned from a week in Port au Prince with a 17 person team of doctors and nurses to work with Partners in Health. We worked at the University Hospital, the only State hospital in this city of

Haiti Medical Relief

The January 12 Haiti earthquake killed over 200,000 people and The United Nations reports nearly 1.3 million people are now homeless. The devastated capital of Port-au-Prince is home to 762,708 of them, living in squalid tent camps without proper sanitation. Officials have worried about "donor fatigue", especially with the Chile earthquake. But the situation in Haiti is so much worse than

Healthy Comfort Food

Comfort food is usually home made and carries some emotional significance with it. During times of stress or illness people often turn to "comfort foods" to feel better. Most everyone has a favorite comfort food and comfort foods are not necessarily one's favorite food. Ask yourself...what is my favorite food? Then ask "At the end of a long day, when I'm tired and stressed or sick in bed,

How to Live to 100

Research from Denmark shows that life expectancy is increasing steadily and there is a good possibility that by controlling life factors, most everyone can live to be 100. Of course, living in a high income, first world country is the first factor. The Danish experts report that since the 20th century, people in developed countries are living about three decades longer than in the past.Check

Answer to Medical Challenge.

The answer to yesterdays Medical Challenge is...drumroll....#4 - Intraabdominal Cancer.The nodule is called a "Sister Mary Joseph's" nodule and is a lymphatic metastasis to the umbilical region. This 12 year old girl had decreased appetite, vomiting and weight loss. A CT scan showed a large pelvic mass originating from the ovary, hepatic metastasis, ascites and a mass through the

What is the Diagnosis?

How good of a diagnostician are you? This challenge from the New England Journal of Medicine is tough. (I missed it the first time).Q: This 12 year old presented with decreased appetite and vomiting. What is the most likely diagnosis?1. Endometrioma2. Hernia3. Keloid4. Intraabdominal cancer5. Urachal duct cyst.Click on the image for a better view and make your guess. The answer will be posted

King Tut Died From Malaria

In 1922 the intact tomb of King Tut was discovered in Egypt. Technology shows us that the boy died around 1324 BC and was probably around 19. Anthropologists from Egypt, Germany, Italy and other countries studied DNA and performed tests on 16 royal mummies and found that four, including King Tut, had contracted a severe form of malaria called Plasmodium falciparum. Tut also had a broken leg

Anthem Blue Cross Receives Shame Award

EverythingHealth feels justified in awarding this weeks Hall of Corporate Shame Award to California Anthem Blue Cross. California Insurance Commissioner Steve Poizner said Anthem Blue Cross "violated state law more than 700 times over a three-year period by failing to pay medical claims on time and repeatedly failed to respond to state regulators as they investigated complaints over the last

Mother's Diet May Prevent Infant Allergies

Why do some kids get allergies and some don't? A new study published in Allergy 2010 may give us some answers. The women who ate more green and yellow vegetables, citrus and high beta carotene while they were pregnant had fewer babies with eczema. They also found that foods high in vitamin E lessened the risk of having a wheezy baby.The researchers from Fukuoka University in Japan studied 763

Genius On The Edge is a Great Read

I am one who loves medical history and Genius On The Edge - the bizarre double life of Dr. William Stewart Halsted, was a captivating read. For those who don't know, Dr. Halsted is known as the "Father of Surgery" and practiced medicine after the civil war. Written by author physician, Dr. Gerald Imber, the medical facts are sound and the story is fascinating for any reader.We learn that in

Winter Blog Break

EverythingHealth will have a blog hiatus for the next week. For great reading, check out the links on the right side of this blog. The other health bloggers are excellent...but make sure you come back.

Stuttering Caused by a Genetic Mutation

Stuttering has always been a fascinating phenomenon to me. Stuttering is a speech disorder where the person repeats or prolongs a sound and doesn't have a normal flow of speech. I have known severe "stutterers" who have undergone speech therapy without much help. There have been famous singers (Mel Tillis is one) who stuttered severely when they spoke, but not when they sang.

Now for the

Modest Hospital Gowns

While the U.S. argues about health care reform and Blue Cross Anthem raises rates a shocking 39%, somehow our "socialist" brothers across the Atlantic are able to implement better hospital gowns.The British government of Bristol, England commissioned designers to develop a better hospital gown. The U.S. born designer Ben deLisi, who has designed for Kate Winslet and other stars came up with a

Colon Detoxification

The internet is full of colon cleansing methods that tout the benefits of colon detox. I saw one website that showed long "worms" that live for years in the colon that "need" to be removed with special expensive potions. One of the most common questions for GI doctors is about colon cleansing and if it is beneficial. I don't know any physicians who believe the colon needs "detoxification" or

Report a Doctor and Go to Jail

Two nurses in Texas reported a physician to the Texas Medical Board for unethical and unsafe behavior toward patients. They directed the Medical Board to six cases where Dr. Rolando Arafiles should be investigated for improper prescribing and surgical procedures. In one case he performed a failed skin graft without surgical privileges. He also sutured a rubber tip to a patient's crushed

Total Knee Replacement

This is why my knee is still stiff at 6 weeks post-op. ( Not for sensitive eyes.)

Can I Eat It Off The Floor?

Michael Jackson's Doctor Charged with Manslaughter

Dr. Conrad Murray, the Huston, Texas cardiologist celebrity doctor to Michael Jackson will be charged with involuntary manslaughter today in the Los Angeles courtroom when he voluntarily surrenders.He has been virtually underground since June 2009, after he gave the singer a powerful anesthetic (Propofol) and other sedatives that were blamed for his death.Propofol is a strong anesthetic that is

Beleagred Health Care Providers

I went to my physical therapist yesterday for knee treatment and we talked about the fact that Blue Cross is cutting their reimbursement to the point that the cost of providing care will not even be covered. All I could do was lament with him and listen. One insurer even told him (the owner of the business) to just "make the sessions shorter and don't give as much care." As if that is how it

Blog Followers

If every visitor to EverythingHealth signed up to be a "follower of the blog", I would have over 1,000 new followers a day. Come-on. Make my day!!!

Health Insurers Boom

One patient informed me today that her Anthem Blue Cross insurance premium went up by $89.00 this month. She is responsible for a large up front deductible and she is (thankfully) healthy and ends up paying out of pocket for her health care because she seldom meets the deductible.A 2nd patient sent me this from the Wall Street Journal:UnitedHealth Group Inc.'s fourth-quarter

Detecting Ovarian Cancer is Difficult

The thought of ovarian cancer strikes fear for many women. Although it is not the most common cancer for women (Breast, Lung, Colon and Skin Cancer are more common), it is one of the most deadly because we have no early screening tests for ovarian cancer and it is usually advanced when detected. Women have been told that paying attention to "symptoms" and informing their physicians may be the

Cool Science for the Day

Check out the water droplet. Who knew?

Do Doctor and Hospital Ratings Matter?

The organizations that rate hospitals and doctors have proliferated as the internet has become mainstream over the past 5 years. I'm sure you have seen some of these: U.S. World & News Reports, Consumer Reports Health, Health Grades, Leapfrog, Hospital Compare, Americas Best Doctors and 100 Best Hospitals. My local magazine lists the "top doctors" along with full page paid ads and promos that

Get More Sleep to Avoid a Cold

It is always great when medical research supports the common sense that grandma knew decades ago. A study published in the Archives of Internal Medicine show that poor sleep increases our susceptibility to the common cold.The researchers studied men and women ages 21-55 and monitored their sleep duration and efficiency (amount of time in bed actually sleeping) for 14 days. They then quarantined

EverythingHealth 3rd Anniversary

Thanks to KM for the 3rd Anniversary card for EverythingHealth. I can't believe it has been three years since I became obsessed with this little blog hobby. With readership now approaching 40,000/month I find I just can't stop. Thank you to all the followers and commenters and readers. Please let me know if there are subjects you would like explored.

Does Hourly Pay Bring Happiness?

New research shows that money makes people happy and if someone is paid by the hour they are even happier. This strange study was done by Jeffrey Pfeffer at the Stanford Graduate School of Business and Sanford DeVoe of the University of Toronto. They studied both British and Americans who were paid hourly vs. salary wages and compared their general happiness. The surveys showed that pay