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07/29/2010

 

A Closer Look

Paging Doctor Internet

Some people seem to cleave to a bad diagnosis. The worse it sounds, the more they marry it.

They love to banter about all their “itises.” Arthritis, bursitis, sinusitis and a recent bout of appendicitis may round out any random conversation. In great detail they may recount symptoms, the current course of action for each and the details of life with so many “itises.” > More

Some people just seem to cleave to a bad diagnosis. The worse it sounds, the more they marry it.

They love to banter about all their “itises.” Arthritis, bursitis, sinusitis and a recent bout of appendicitis may round out any random conversation. In great detail they may recount symptoms, the current course of action for each and the details of life with so many “itises.” Woe to be them.

The rest of us count wellness among our greatest gifts.

The Internet hasn't helped with the number of armchair clinicians. The Internet, with its ever-growing boon of information, puts self-diagnosis only a few mouse clicks away. Websites give vast amounts of information, sometimes with an unexpected result: anxiety and a brand new patient.

I've seen my massage-therapy clients insist they have everything from spinal arthritis to sciatica to hormonal problems based on what they've read on the Internet. The thing is, they may have none of these, but armed with the information, start living like they do.

I've seen clients become increasingly sedentary when they believe a serious back condition plagues them. It may only be deep muscular tension that needs movement, stretching and circulation.

I've seen patients stop exercising altogether when they become certain they have inherited a heart condition, without any real evidence. The palpitation they felt may well have been the triple-dose coffee they drink daily.

Overdiagnosis of illness often creates not only needless anxiety and sometimes more-threatening lifestyle changes, such as Couch Potato-hood, but may also lead to unnecessary medical testing, treatment or the self-administering of non-prescription supplements.

Do I think medical websites are bad? Of course not. Understanding wellness is a key to maintaining it, and many medical sites, including Health News Florida, offer valuable consumer information. It's when we shut out the real people and start making medical decisions based on the limited capability of the online databases that we find trouble.

There's also the matter of those who seem to love to receive a diagnosis. I would suggest some among us embrace the “patient” label with great ease, somehow relishing that they are “different,” and in need of personalized attention.

I don't run to my doctor for every little ache and pain. I believe in the body's ability to heal itself in an effort to return to balance, and I won't go if I don't need to. 

Just for fun, I took a 30-plus question survey online. Turns out I could have diabetes (I don't) or hypothyroidism or maybe just a bum mattress. Guess if I really want to know, I may have to visit my family doctor.


Kumari Kelly is a licensed massage therapist (ma56756) and can be reached at kumari_kelly@yahoo.com
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We all lie

“I’m feeling better now doc. I’d like to go home.” Bill G. uttered these words to me less than 24 hours from the time he was admitted through the emergency room with chest pain. He had not sustained a heart attack, but he had a weak heart muscle and heart surgery in the past.

“I’m feeling better now doc. I’d like to go home.” Bill G. uttered these words to me less than 24 hours from the time he was admitted through the emergency room with chest pain. He had not sustained a heart attack, but he had a weak heart muscle and heart surgery in the past.

“I don’t know Bill,” I said. “Your pains could have been your stomach but then again it might be your heart. Why don’t you stay in another day for some tests?’

“Oh come on now. I know it was just indigestion. Can’t we do the tests as outpatient?” Since I first met him, Bill and I had a stormy relationship –– he thought I was too controlling, and I thought he was too demanding.

Over the next several hours he would pace around the nursing station, badger the nurses and had them call me several times. Busy at another hospital, I finally relented and discharged him. Within six hours of his release he had severe chest pain, suffered a cardiac arrest and died on the way to the hospital.

This is every cardiologist’s nightmare. It happened to me over 20 years ago and I will never forget it. Bill’s mind and ego denied the obvious, and in a moment of inattention and over-busyness, I bought the lie, too. Not wanting to strain our relationship further, I let him leave without making him sign out against medical advice. His son, who was a trial attorney, later sued me for malpractice, and ultimately my insurance company settled for a few thousand dollars.

Since then I have learned to listen more closely to what my patients tell me. I now realize that it is of utmost importance to separate their symptoms from what they think might be the cause. Some patients fear the worst in everything, but many others downplay and deny what is truly happening. Their minds are lying to them constantly. It is my job to get objective clarity about their condition and not buy into their delusions as well.

We all lie to ourselves sometimes, and most often it is to cover up an addiction, admit fault, or shame. My mind tells me this all the time.

“I can have two cookies today because I exercised.” Or, “I can drive home safely because I only had one drink.”

 I’m sure you recognize the thoughts, because most of us have had them.

My goal is to achieve less ambiguity when my mind, or that of my patients, is lying to me. This takes some work, patience, and practice. However, the rewards are enormous.


David Mokotoff, M.D., is a St. Petersburg cardiologist. Check out his blog at www.davidmokotoff.com.

Supplement makers, feds ready to rumble

I’m glad to see that the Council for Responsible Nutrition is continuing to identify itself as a trade group representing dietary supplement manufacturers when it takes a stand on public issues, as it recently has.

There’s nothing wrong with trade groups making points for their members, but it can be confusing when such a group takes on a name that glows with independent objectivity. CRN unquestionably has such a moniker. > More

I’m glad to see that the Council for Responsible Nutrition is continuing to identify itself as a trade group representing dietary supplement manufacturers when it takes a stand on public issues, as it recently has.

There’s nothing wrong with trade groups making points for their members, but it can be confusing when such a group takes on a name that glows with independent objectivity. CRN unquestionably has such a moniker.

Years ago, as a young reporter, I fell into the trap of not fully investigating the source I was quoting. That’s a mistake I won’t ever make again.

It involved CRN and its stand promoting supplements. I took its position at face value. Justifiably, I was lambasted by a sophisticated reader who also happened to represent another Washington-based agency that took the other side on the CRN issue.

So, now, when I see those initials pop up, I check to see that the council correctly identifies itself, as it did in a recent statement. The statement was in response to the recently released draft report of 2010 dietary guidelines being circulated by the United States Department of Agriculture.

Those guidelines take a controversial stand.

They state that “a daily multivitamin/mineral supplement does not offer health benefits to healthy Americans. Individual mineral/vitamin supplements can benefit some population groups with known deficiencies, such as calcium and vitamin D supplements to reduce risk of osteoporosis or iron supplements among those with deficient iron intakes. However, in some settings, mineral/vitamin supplements have been associated with harmful effects and should be pursued cautiously.”

These are fighting words. And it is not surprising that the CRN has responded, calling these proposed guidelines a “step backward, without scientific justification, when it comes to vitamin and mineral supplements, by failing to recognize how the multivitamin can address dietary inadequacies for nutrients.”

The CRN also notes that the draft report, which is available at www.cnpp.usda.gov, recognizes that there are multiple “nutrient shortfalls” but “in effect says that living with (them) is preferable to filling nutrient gaps with reasonable dietary supplements.”

Look for those promoting the new guidelines to answer back. And I’m sure many other agencies will offer comments on the draft report, as well.

We should have at least as much interest in how the government views our eating habits and its suggestions for improvement as do those who make big bucks on what we pick up at the grocery or pull out of vending machines.

We should educate ourselves about this debate and know who stands to profit when the final guidelines emerge. Ideally, it should be the public.

 
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Write to Carolyn Susman

 

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CONSUMER CORNER

Frustrated with the health-care system? Don’t know where to turn for help? Want more on the human side of health care? We’ve got you covered.

Chest compressions alone OK for CPR

7/29/2010 © Healthday
Good news for bystanders who are reluctant to do mouth-to-mouth resuscitation. Chest compressions alone seem to produce the same results.

Looking for reliable early-detection lung cancer test

7/29/2010 © St. Petersburg Times
Scientists already know that chest X-rays and sputum tests don't work well for early detection of lung cancer. So doctors are awaiting results from a huge study to find out whether the answer might be spiral CT scans.

Internet support groups help in weight loss

7/28/2010 © Orlando Sentinel
A federally funded study published this week suggests that people who regularly participate in a web-based weight-loss support group increase their chances of keeping off weight they’ve lost. 

When do stents triple your risk of dying?

7/28/2010 © Orlando Sentinel
For patients who have already had a stroke, opening the carotid artery with a stent triples their risk of death compared with the old-fashioned method of clearing the blocked artery with surgery, according to a new study. 

Want to donate your body to science? UCF added to list

7/28/2010 © Orlando Sentinel
Florida is designating the University of Central Florida’s College of Medicine as a receiving institution for donated bodies, joining those previously established in Miami and Gainesville, UCF officials announced Wednesday. 

Chemo patients trying chill caps alleviate hair loss

7/27/2010 © McClatchy News Service
Some chemotherapy patients have been trying out a gel-filled cap that freezes their scalps. In theory, the caps prevent drugs from killing the cells in hair follicles. Studies have shown that scalp cooling does work in many cases but some doctors are skeptical.

Kids, parents get fit together

7/28/2010 © Tampa Tribune
As parents head to spin class or weight machines, most kids end up watching TV, playing video games or just hanging out in the kids zone. But some fitness centers are offering classes that let the entire family workout together.

New site helps teens wade through health issues

7/28/2010 © Orlando Sentinel
Teens talk about sex, dating and drugs on a new website launched by the Florida Department of Health. The episodes on Teen Truth feature actors talking about issues, pausing to ask the viewers questions.

Medical devices hurt thousands of kids a year

7/28/2010 © The Associated Press
More than 70,000 children and teens go to the emergency room each year for injuries and complications from medical devices, and contact lenses are the leading culprit, the first detailed national estimate suggests. 

Teens with ADHD more likely to drop out of school than others

7/28/2010 © Orlando Sentinel
Teens with attention-deficit/hyperactivity disorder are less likely to finish high school on time than students with other mental-health disorders that often are considered more serious, according to a national study. 

Add these products to your sunscreen routine

7/28/2010 © Miami Herald
In addition to lathering up with sunscreen, take a look at these products that can prevent sunburn, melanoma and even crow's feet.

Pediatrics academy: Kids with head lice shouldn't be kept home

7/27/2010 © MedPage Today
Children should not be kept home from school because they have head lice, the American Academy of Pediatrics reaffirmed. Although many schools still have "no-nit" policies, they have not been shown to be effective for reducing its spread. 

PSA screening can lead to overtreatment

7/27/2010 © MedPage Today
Many men being treated aggressively for low-grade prostate cancer -- particularly if it was detected during PSA screening -- are unlikely to benefit from the intervention, a new study suggests. 

Don't overdo it on dietary fiber

7/27/2010 © Miami Herald
Can too much of a good thing be too much? In the case of fiber, the answer could be an embarrassing yes. If high fiber is causing stomach grumbles, there are ways to fit it in comfortably.

Baby recliners recalled after infant death

7/26/2010 © The Associated Press
Nap Nanny portable baby recliners, which are supposed to help fussy babies sleep better, are being recalled after the death of an infant. The CPSC announced the recall of 30,000 recliners made by Baby Matters. 

Studies look at how time affects blood used in transfusions

7/29/2010 © The Associated Press
This summer, hospitals nationwide are launching research to try to settle if fresher blood really is better for some transfusion patients. And if so, they're hunting ways to turn back the clock for older blood and offset deterioration. 

Bone implant for kids grows as they do

7/26/2010 © Ivanhoe
Young patients who lose part of a bone to sarcoma can be treated with an implant that expands as they grow -- if they have $30,000. Insurance doesn't cover it. 

An app for monitoring women in labor

7/25/2010 © St. Petersburg Times
Obstetricians can see dozens of patients, get a night's sleep or complete an operation while monitoring a patient in labor from afar with a new smart-phone application that delivers patient waveform data to remotely access fetal heart rate in real time.

It isn't just vapor, and it isn't soothing

7/25/2010 © Bradenton Herald
Four interns have spent the summer trying to raise awareness about the dangers of a new fad. CDC says a one-hour hookah session can involve inhaling 100 to 200 times the smoke from a cigarette.

Therapy to take with a grain of...?

7/23/2010 © WUSF
In Tampa, people are paying to sit in a room made of salt blocks to clear their sinuses, a treatment made to mimic the salt caves of Eastern Europe. An allergist points out that it hasn't been proven. 

Study questions ACL knee surgery

7/23/2010 © NPR 
A torn ACL ligament usually means a rush to surgery, but a study that compared two groups -- one got surgery, one just rehab -- found results were equal. 

E-mail consults can improve doctor, patient communications

7/23/2010 © South Florida Sun Sentinel
A new study by Kaiser Permanente reveals e-mail exchanges between doctor and patient can help patients stay on track with treatments, which in turn leads to significant health benefits.  

More window shades, roller shades recalled

7/22/2010 © The Associated Press
Smith and Noble is recalling 1.3 million Roman shades and roller shades, after a 5-year-old boy became entangled in an unsecured continuous loop bead cord on a roller shade. 

Melanoma up among dark-skinned Floridians

7/21/2010 © Reuters
Melanoma is on the rise among dark-skinned Floridians, new research shows. Melanoma remains rare among blacks and Hispanics than among whites, which helps explain why public health efforts to prevent melanoma target the light-skinned. 

Shopping for shades? Focus on safety

7/21/2010 © Tampa Tribune
A recent study found that most people choose style and price over UV protection when buying sunglasses. Big mistake! Overexposure to UV rays can lead to cataracts, cornea burns, cornea degeneration and other eye diseases. 

Bill targets hazardous cosmetic ingredients

7/21/2010 © Palm Beach Post
U.S. Rep. Jan Schakowsky introduced legislation this week that would toughen safety standards for cosmetics, including requiring regular government testing of products for hazardous ingredients.

Recalls of pet food, supplements over salmonella concerns

7/21/2010 © Los Angeles Times
Three pet-product manufacturers -- Feline's Pride, Merrick Pet Care and United Pet Group -- have recently issued or expanded voluntary recalls of some of their products over concerns about possible salmonella contamination. 

Florida Citrus wants the whole story on food labels

7/21/2010 © Lakeland Ledger
The Florida Citrus Commission says that calories alone don't tell the whole nutritional story of a product and want nutrient density as part of proposed food labeling changes. 

Brain food? Turns out, fish may be eye food

7/22/2010 © Orlando Sentinel
In a new study, older adults who ate fatty fish at least once a week were 60 percent less likely to develop age-related macular degeneration. 

Keep it simple for a healthy colon

7/22/2010 © St. Petersburg Times
Oral supplements, teas and colon irrigation all are touted as ways to clean out your system. But in general, experts say people don't need to "clean" their colon and that a high-fiber diet may be all you need for colon health.

Health clubs offering better deals

7/21/2010 © South Florida Sun Sentinel
Health clubs are fiercely competing as consumers remain cautious about spending. Some offer bargain rates on stripped-down programs, while others dangle services such as free child care. And most clubs have ditched the restrictive contracts and allow people to pay month-by-month.

Perdue recalls 90,000 lbs. of chicken nuggets

7/21/10 © Tribune Interactive
Perdue is recalling about 91,872 pounds of frozen chicken nugget products that may contain foreign materials, the U.S. Department of Agriculture's Food Safety and Inspection Service announced. They were all shipped to Wal-Mart.

Firm unveils portable dwelling for sick or elderly

7/20/2010 © Washington Post
A firm hoping to revolutionize the way Americans care for aging family members has unveiled its first prototype of a portable, high-tech dwelling that would provide temporary shelter for a sick or elderly relative in the family's backyard. 

Rethinking the '5-second rule'

7/20/2010 © Chicago Tribune
The controversial “five-second rule” — the one that allows us to eat dropped food if quickly scooped off the floor — is a fallacy, says food scientist Paul Dawson, who stirred up the in this month’s National Geographic

How to choose the best nursing home

7/20/2010 © Florida Times Union
The question of how to judge nursing home quality is on the minds of many after the Times-Union reported on allegations of abuse at one Jacksonville center. So how best to choose a facility?

Gel gives women more control over HIV

7/20/2010 © Orlando Sentinel
A vaginal gel which contains the anti-HIV drug tenofovir reduced HIV transmission among women in South Africa by 39 percent, researchers said. Transmission was cut in half for those who closely followed instructions.

Therapy dogs bring comfort to hospital patients

7/20/2010 © Miami Herald
Designed to bring smiles to patients, the Paws for Smiles dog therapy program travels to the rooms of patients in nine South Florida hospitals. 

Top five summer injuries for kids

7/19/2010 © St. Louis Post Dispatch
Some of the most common summer dangers for children are a big part of summer's fun: bikes, pools, trampolines and campfires.  But with those joys can come injuries. Here are the five most common problems.

Publix rolling out healthier kids' lunches

7/18/2010 © Orlando Sentinel
Starting July 29, Publix will begin selling healthier, ready-to-eat kids' lunches at its delis, joining other stores already offering or planning to sell similar meals. The meals will feature items like baby carrots and organic yogurt.

Skip the SPF 100, experts say

7/17/2010 © Tampa Tribune
Buying a sunscreen with a high SPF isn't as important as using enough, experts say. A 15 SPF is sufficient for most Floridians as long as they apply it early and often.

Romaine recall over E. coli strain

7/16/2010 © MedPage Today
Several romaine lettuce products with past-due use-by dates have been voluntarily recalled by Fresh Express due to potential E. coli O157:H7 contamination after a random FDA screening found the bacteria in a sample of greens. 

What to know about dengue fever

7/15/2010 © South Florida Sun Sentinel
Dengue fever has been confirmed in South Florida. But no one is suggesting you cancel your vacation. All you have to do is guard against mosquito bites. Here are some common questions, and the answers.

Safety panel toughens rules as Pottery Barn recalls cribs

7/14/2010 © The Associated Press
The Consumer Product Safety Commission has proposed rules that would ban the manufacture, sale and resale of drop-side cribs. The push to ban the cribs came as the CPSC announced the recall of 82,000 cribs from Pottery Barn Kids.  

Packaging chemical caused smell in cereal recall

7/14/2010 © The Associated Press
Kellogg Co. said that higher-than-normal amounts of certain chemicals in its package liners caused the unusual smell and flavor that prompted a recall of 28 million boxes of its cereal in late June. Those chemicals include methyl naphthalene.

Running an inexpensive way to fit in fitness

7/15/2010 © Seattle Times
Running is booming in the U.S. as more people seek inexpensive ways to manage stress amid economic uncertainty. The boom also can be seen at running stores, where sales of shoes and accessories remain at or above pre-recession levels. 

Take away kids' chocolate milk? Not so fast

7/14/2010 © Orlando Sentinel
In the push to eradicate childhood obesity, some have suggested getting rid of chocolate milk at school. But a new study finds that eliminating flavored milks from schools resulted in a dramatic drop in milk consumption and a reduction in nutrients. 

Users report nasty effects after using pot alternative

7/15/2010 © Gainesville Sun
An herbal product known as "spice" -- plant matter sprinkled with synthetic cannabinoids -- has been growing in popularity. But medical centers have been seeing side effects such as anxiety, hypertension, nausea, hallucinations and seizures.

Flying with peanut allergies

7/14/2010 © St. Petersburg Times
The day after an attack, an Oldsmar man boarded his flight back to Tampa and found the cabin covered in peanuts and wrappers. The only thing he could do was walk out and pay for a new flight.

137,000 tween pieces in cadmium jewelry recall

7/14/2010 © The Associated Press
About 137,000 pieces of imported children's jewelry sold at two stores popular with preteen girls -- Justice and Limited Too -- were recalled Tuesday for high levels of cadmium, the latest in a series of recalls involving the toxic metal. 

CDC: Many outbreaks linked to fresh salsa, guacamole

7/14/2010 © USA Today
Close to one in 25 outbreaks of foodborne illness in restaurants and delis can be traced to contaminated, freshly-made salsa or guacamole, the CDC is reporting. All were from fresh-made salsa or guacamole from restaurants or delis.

Resources

We’ve collected a list of resources for you, including federal and state agencies and private associations. This is a free listing, without paid advertisers. Read More

Government site outlines new health-care law

A new government site, aimed at individuals, Medicare recipients and small employers, explains how the new health-care law works for the consumer as well as for seniors on Medicare. Click here to visit.

 

FDA site lets public find drug safety info

The Food and Drug Administration launched a website where patients and health-care professionals can find safety information about recently approved drugs and vaccines. Click here to access.

Florida sets up oil spill info line

 Florida has set up a toll-free telephone line to provide residents and visitors with information about the Gulf of Mexico oil spill. When you call 888-337-3569, operators will answer questions about the state's response activities, volunteer opportunities and health, safety and protective tips.

Complaints against licensees now online

Public administrative complaints filed against licensed health-care practitioners are now available on The Florida Department of Health Web site. Consumers can see if a public complaint exists for any health-care professional licensed by DOH at this site. 

Consumer Reports looks at reform

Consumer Reports has a guide to health reform, with videos, Q&As, viewpoints and in-depth papers. Access it here.

Online resources for information on health reform

The Washington Post has compiled a handy list of guides to the new rules. Access it here.

Summary of new health-reform law

Here is a summary of the provisions of the Patient Protection and Affordable Care Act (adjusted by the reconciliation act that followed.

And here is the timeline for implementation.

Updated Medicare primer

The Kaiser Family Foundation has updated its Medicare primer that explains key elements of the program. It describes characteristics of the Medicare population and how much people pay out-of-pocket. The updated 2010 Medicare primer is at www.kff.org/medicare/7615.cfm.

Consumer health information

The FDA has created a partnership with Everyday Health to deliver FDA's consumer health information to the 30 million users who visit EverydayHealth.com each month. EverydayHealth.com/FDA will offer health information from FDA on food and medical product safety as well as prevention and wellness topics.

Mesothelioma cancer risks in FL

A national group that seeks to inform the public about this type of cancer lists environmental risk factors in Florida.

State offers flu hotline

The Florida Department of Health has launched a toll-free hotline, 877-352-3581, to provide public health information and updates on the H1N1 "swine" flu.
It is open from 8 a.m. to 8 p.m. daily. Information is available in English, Spanish and Creole.

Information can also be found at the department's website, doh.state.fl.us.

New consumer guides

Spanish-language consumer guides are now available from the Department of Health & Human Services's Agency for Healthcare Research and Quality for consumers and clinicians. To access the guides in Spanish as well as English, go to effectivehealthcare.ahrq.gov. Audio versions of many guides also are available.

Suspect insurance fraud?

Call Florida's Fraud Fighters Hotline at 800-378-0445. It's operated by the Insurance Fraud Division of the state Department of Financial Services. 

Helpful hint

Did you know the state offers a Web site where you can quickly find the best price in your local area for the drugs you take? The Drug Finder can save you money.

Thanks to Health News Florida Sponsors!
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