Sunday, August 31, 2008

Book Review - Medical Myths That Can Kill You: And the 101 Truths That Will Save, Extend, and Improve Your Life

As a practicing family doctor and author of Stay Healthy, Live Longer, Spend Wisely: Making Intelligent Choices in America's Healthcare System, I am a strong believer in empowering and educating patients so that they can make the right decisions to get the most out of life. As the only doctor in my family I don't think it is fair that only the people I know or care for are privy to the truth about staying healthy, so I looked forward to reading Medical Myths That Can Kill You: And the 101 Truths That Will Save, Extend, and Improve Your Life, by Dr. Nancy Snyderman, chief medical correspondent for NBC News, which has a similar same perspective.

Overall, the book was a mixed blessing. It has interesting factoids, ideas we should all take to heart, but at times is misleading. As a consumer and a patient, I thought the truths and news you can use pieces were interesting. As a primary care doctor and patient advocate, however, I felt that many parts of the book were misleading. Perhaps one of the faults is it tries to be too ambitious and attempts to cover too many topics, which often are not in depth enough to be of much value.

Dr. Snyderman points out correctly multiple times that the path to good health is through prevention by adopting healthy habits, staying physically active, and maintaining a sensible weight. The structure of the book reflects this preventive focus and chooses to debunk many myths with these clever chapter titles - Annual Checkups Are Obsolete, Vaccinations Are Just For Kids, Doctor's Don't Play Favorites, Only Old People Get Heart Disease and Stroke, We're Losing the War on Cancer, Natural Means "Safe", and You Can Just Snap Out of Mental Illness. She tackles the truth about herbal and dietary supplements, the unproven value of full body scans, as well as the importance of vaccinations and preventive screening tests for cancer, heart disease, and diabetes.

Throughout the book there are plenty of truth tidbits including, "you cannot catch sexually transmitted diseases from toilet seats; you do not need to drink eight glasses of water every day", among many others and news you can use segments that will make some readers hopefully more aware of what is myth and what is fact. These small sidebars were very interesting. I think patients and consumers will find these factoids topics of conversation.

As a practicing doctor, however, there are many areas which are misleading and others that provide information too superficial to be of value. Dr. Snyderman is correct in one of her chapters that heart disease and stroke are the leading causes of death in this country. However, she uses two individuals, a twenty-six year old former beauty pageant winner, who suffered from a stroke, and a forty year old woman, who died suddenly from swimming, as reasons why we should be concerned. The problem is that these type of occurrences are extremely unlikely and rare for these age groups and gender. The typical cause of these problems, atherosclerosis, or hardening of the arteries didn't cause these cases. The former was most likely due to a heart wall septal defect or a blood clotting disorder, known as a hypercoagulable state. The latter was probably due to sudden cardiac death from a fatal arrhythmia, like ventricular fibrillation.

In the area of stroke, she talks about atrial fibrillation, a heart arrhythmia, as the leading cause of stroke. It is a cause, but this heart condition is typically found in patients over age 60 and far more common in people over 80 years old. She doesn't say that and one would naturally and wrongly assume based on the prior patient stories that it can happen at younger ages, which again is extremely unlikely.

Other areas that are covered superficially include when Dr. Snyderman discusses cancer and mental illness. She pushes for prevention as well as clarifies myths that still exist among the public. Unfortunately in the chapter on cancer, she also talks about various cancer treatments which isn't thorough enough and doesn't seem to fit in a book with this preventive theme. For the mental illness, one of the best written sections because of her personal experience, again the book is rather too ambitious and tries to cover anxiety, depression, and bipolar disorder and the various treatment options even as she admits that "it is impossible to go into as much detail as I would like to". Though she gives a website reference, perhaps it may have been better only to cover depression as she and her husband both had experienced it, and acknowledge the other conditions.

Overall, I wanted to like this book as I believe the intent of giving the public the facts about what they can do to stay healthy and well is vital. I think as a practicing doctor and insider, however, the book at times it is misleading, in some areas is too light in content and in others the information deviates from the book's intent of wellness and health promotion.

Monday, August 25, 2008

Wishing For Natural Therapies Can Kill or Injure

A couple of news reports reminds us about how as a society we have very short memories - one involves measles and the other involves raw cow milk.

The CDC reported a large increase in the number of measles cases. An outbreak in Illinois occurred in home-schooled children and none were vaccinated. Already in 2008, 131 cases were reported, which is three times that of 2007.
  • "Before the measles vaccine in this country, there were 400 deaths of U.S. children each year caused by measles," says Dr. William Schaffner, department of preventive medicine chairman at the Vanderbilt University School of Medicine. "Measles carries serious complications, including pneumonia and encephalitis, which is a life-threatening inflammation of the brain tissue that can be caused by viral infections such as measles. Measles is a serious illness. To be cavalier and not vaccinate shocks someone like me, who has seen the devastating effects of this disease."
  • So far this year, 15 patients have been hospitalized as a result of measles. They suffered symptoms such as high fever, dehydration and pneumonia. Four of those who were hospitalized for measles were infants.
Although there has been concern, but yet to be proven scientifically, a link between vaccinations and autism, it appears many parents refuse to have their kids immunized. Unlike Dr. Schaffner, who has evidently witnessed the complications of measles, since the vast majority of us have never seen it, we wrongly assume that it can't happen. One option parents can consider is delaying the measles vaccine until their child is older as the shot is given at 12 months of age. Since autism is picked up at about 18 to 24 months, one could ask the pediatrician if it would be ok to delay for a few months. For older children, vaccinating them will make it less likely they can carry it and give it to vulnerable infants.

The other story was about raw cow milk and how 15 people became ill and one woman became partially paralyzed! This frankly is unbelievable and sad. Louis Pasteur, the famous French scientist, who figured out that organisms invisible to the naked eye caused diseases, was also the one to understand and learn how to kill them and make things like milk safer for consumption. This is where the word- pasteurized - came from.

  • The raw milk came from Alexandre Family EcoDairy Farms, which supplied the product to 115 customers.
  • The county's Department of Public Health suspects at least 15 people were sickened by Campylobacter, a common bacteria found in domesticated animals. The department has confirmed three cases, and are awaiting test results for the other 12.
  • Alexandre EcoDairy voluntary stopped its raw milk program June 15 after learning one of its customers was hospitalized. That woman later became partially paralyzed by a rare disorder often associated with Campylobacter infection.

In a high-tech world where many of us wish for simpler times, we must not forget that these more natural methods had major problems as well. The leading cause of death about a hundred years ago was due to infectious diseases. Like the example of measles, just because we don't witness illness or problems ourselves doesn't mean that the problems still don't exist. Many of the reasons we live longer than generations ago is because of high immunization rates and more sterile and hygenic food processing techniques. Are some of the foods perhaps less natural and less safe than the past because of pesticides and hormones? Hard to say, but in that case, purchase organically grown products. Don't ignore basic common sense.

Here's the other question. If people became ill because of an accident or food poisoning, then I don't think anyone would argue we should take care of them. However, what if a person out of ignorance gets ill from a very preventable infection, should we as a society pay of their healthcare? If the woman, who is partially paralyzed doesn't regain full use of her body and requires resources from the community, is that fair for the rest of us?

Monday, August 18, 2008

Michael Phelps' Diet - Don't Try This at Home

Like everyone else, I've been in awe of Michael Phelps' accomplishments at the Beijing Olympics with his unprecedented eight gold medals at a single olympic game. Certainly, it doesn't hurt that he appears to be a team player, grounded, as well as being hypercompetitive.

What is more fascinating is the amount of calories he ingests daily to keep up with his training regimen. If anyone of us tried to eat the same amount he does, we would gain about 3 pounds per day and definitely would not have his sculpted physique!

He has 12,000 calories per day. A typical American is supposed to have 2,000 calories per day. Given the increasing numbers of obese children and adults it would be safe to assume many of us are exceeding that suggestion.

For breakfast he has:
  • three fried-egg sandwiches loaded with cheese, lettuce, tomatoes, fried onions and mayonnaise.
  • two cups of coffee
  • a five-egg omelet
  • a bowl of grits
  • three slices of French toast topped with powdered sugar
  • three chocolate-chip pancakes
And that's just breakfast!

As a quick reminder, it takes about 3500 calories to equal a pound. So for those of us who are inspired to lose weight, a brisk 30 minute walk uses about 200 calories. Therefore, if one walks this amount three times a week for a total of 600 calories, it would take six weeks to lose one pound! It's no wonder weight loss is so difficult.

Of course, you could do what Michael Phelps does and swim his intense training schedule where he burns 4,000 calories per day!

Monday, August 11, 2008

Learnings from Private-Label Groceries - Generic Drugs

Reports surfaced recently that growth from private-label (i.e. store brand) versions of groceries has risen dramatically as the economy has worsened and gas prices have increased. Even though thought to be inferior in quality or perhaps more importantly taste, these days the products are as good or perhaps better than brand names.

"Store brands have come a long way," said Tod Marks, a senior editor at Consumer Reports, which has tested store brands against national brands for quality and customer response. "Over the years, retailers realized that store brands were not just something to be floated out during hard times."

With consumers very price conscious these days, they should have no hesitation in asking their doctor for generic medications. These are medications that are proven but no longer have patent protection so the price is affordable. The public should not be fooled in thinking that newer is better. Most of the latest drugs are "me too" cholesterol, blood pressure, allergy, diabetes, and heartburn medications. Pharmaceutical companies spend millions of dollars equal or exceeding marketing budgets of alcoholic and soda companies to influence you to prefer their brand.

Evidently the makers of Ambien CR is acutely aware of this as in a television ad they note that Ambien CR is not available as a generic, even though there are plenty of helpful generic sleep aids that can provide sleep at a price that people can feel good about.

Monday, August 4, 2008

The Myth of Moderate Exercise

A recent article in Time magazine titled "The Myth of Moderate Exercise" I hope catches the attention of the public. It shows why moderate exercise, that is 30 minutes of activity most days of the week, is NOT enough to lose weight. It is no wonder why so many people feel frustrated they aren't losing weight fast enough. With the obesity problem now prominent among children as well as adults, it is important we all learn the following.

Although it is clear that more physical activity not only helps lose weight, but also it is important that the increased activity is sustained lifelong to maintain the weight. Calorie restriction also helps immensely as well. The trick also is that is too must be lifelong.

Find out how much activity you must do if you eat certain foods by reviewing the fun, interactive, and eye-opening experience Portion Distortion Quiz.

If we as a country are going to be healthier, then we all need to realize that the way to lose weight and keep it off is simply and as hard as eat less and move more.


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