PARIS'S FEATURED DOCTOR BLOG

This post comes with a free quiz!

2007-11-05T13:50:38-08:00

Read this HealthDay article, then quiz your kids! (Not to brag, but I scored 90%).

Why? Because according Dr. Thomas R. Kimball, pediatric cardiologist at Cincinnati Children's Hospital Medical Center, children are not getting enough exercise or eating enough healthy foods. Dr. Kimball who has authored a study that highlights the importance of monitoring childrens' BMI levels to avoid childhood obesity, states, "Plump is not good. We're seeing adverse cardiovascular risk factors developing in early childhood...the obesity epidemic of kids today is going to be the heart disease epidemic 20 years from now."

While pediatricians can help by being educated about the importance of measuring BMI, for children Dr. Kimball prescribes the same old regimen of healthy diet and plenty of exercise.

Dr. Thomas R. Kimball is a pediatric cardiologist at Cincinnati Children's Hospital Medical Center. His special interests include Congential Heart Disease, Echocardiography, and Cardiac Imaging.

CAM - medicine's "new song."

2007-11-01T15:06:25-07:00

You could say in a sense, that some physicians are approaching their practice like rock stars. Much like music mashup artist Girl Talk who in essence takes samples of several songs and remixes them into a "new song," that's what physicians who embrace both alternative medicine and conventional medicine are doing with an approach called CAM - Complementary and Alternative Medicine.

In cases of serious, threatening conditions experts recommend conventional medicines such as antibiotics. But natural and herbal compounds need not be seen as mutually exclusive with conventional medicine. In fact, they are being used more frequently by Americans (more than a third according to a survey done in 2005) in conjunction with prescribed medicines. (Forbes)

However, natural does not always mean safe! Forbes' health article "Alternative Medicine Myths Exposed," highlights some of the precautions necessary when using natural remedies:

Natural and herbal compounds vary in strength. Dr. Wendy Biggs, a family physician at Midland Family Medicine Residency in Michigan, draws an analogy between dietary supplements and wine.

"Every year vineyards will produce wines of a different character," she says. "[Likewise] herbal supplements such as St. John's Wort may be of different strengths each year."

Kava, often taken for anxiety, can in rare cases cause liver failure, even from a single dose. Ginseng, ginkgo biloba and garlic supplements all make you bleed more freely, in a way similar to aspirin. You shouldn't take them before surgery. Consider, too, that all-natural supplements can interact with the conventional medicines prescribed to you, causing side effects.

The article suggests consulting "German Commission E," a government regulatory agency in Europe that provides information on alternative medicine.

A further suggestion is to speak with a conventional-medicine-based rock star in your local area.

Dr. Wendy S. Biggs's special interests include medical education, primary care gynecology, family-centered obstetrics, and mental health issues. She is Associate Director of the Midland Family Medicine Residency Program in Midland, Michigan. She is also Associate Professor in the Department of Family Practice at Michigan State University College of Human Medicine and has lectured annually about obstetrics and gynecology at the university�??s National Family Medicine Board Review since 2003.

A fright night for monsters!

2007-10-31T15:28:20-07:00

Happy Halloween, everyone! but not too happy...I write this post bearing a message of warning to all parents and adult-children of awesome Halloween memories who are donning costumes tonight in the spirit of the cryptic and the corpuscular: be sure to disguise yourself as a ghoul, a goblin, a vampire ...a zombie even...but DO NOT under any circumstances arrange the fake blood and applied stitchings that may imply that you're the M-word. You may be in danger of being snatched away in the middle of the night by GIANTS!! (Corporate, that is) Quite possibly to NEVER RETURN.

That's right. According to CNN Money, monsters...more specifically, Gila Monsters, are being captured by scientists (mad ones?? I hope not!!) and drained of their saliva for the sake of making Diabetes medication. Byetta has been on the market since 2005, and is one of the many new medications out there for the management of Diabetes.

Knowing which medication is right for you can be confusing. Good thing there are physicians like Dr. Steven Nissen who is chief cardiologist of the Cleveland Clinic, who is studying the effects of these medications. He has co-authored research findings in The Journal of the American Medical Association that has found that between two types of competing Diabetes medications, Actos and Avandia, they both pose cardiovascular risks. However, Actos proves to be safer than Avandia.

If you're unsure or confused about what medication might be right for you, I recommend that you:

A) Speak with your physician about these new drugs
B) Read the literature and stay abreast of current medical news
C) Read warning labels. And heed them.

That includes this one! Seriously. If you're reading this dressed in a rubber suit that may liken you to a a rare venomous lizard from the American Southwest/Mexico area, it may be a good idea to recycle the Borat costume from last year.

Dr. Steven Nissen is Chairman of the Cleveland Clinic Department of Cardiovascular Medicine and Director of the Joseph J. Jacobs Center for Thrombosis and Vascular Biology. Board-certified in internal medicine and cardiovascular medicine, he specializes in intravascular ultrasound, digital angiography and computer image processing, and coronary intensive care. He practices in Cleveland, Ohio.

Pin a pink ribbon on Thomas Jefferson

2007-10-30T08:46:39-07:00

Not only was Thomas Jefferson the third president of the United States, he is also remembered as the principal author of the Declaration of Independence, an influential Founding Father, and a lover of fish ponds (this last part is a testament to the delightfulness of Wikipedia).

Today, his namesake hospital, Thomas Jefferson University's Kimmel Cancer Center in Pennsylvania is leading the way in the fight against breast cancer.

Dr. Anne Rosenberg, dedicated breast surgeon, has recently told ABC news about the exciting developments at the Center where she has specialized in breast cancer for the past 20 years:

ABC News:

The diagnostic advances have seen much more use of ultrasound, MRI, and a new technique called breast specific gamma imaging.

This is a test that's new in this area, new all over the country and we're enrolling patients in different studies related to that as well as MRI studies to look at the role of MRI in treating breast disease. These are active studies both locally and on a national basis.

With relationship to treatment of breast cancer there have been incredible advances not only with the surgery but also with radiation therapy and medical oncology.

With radiation therapy here at Jefferson, we do participate in different trials related to partial breast radiation, focused breast radiation -- which would hopefully limit any injury to the rest of the breast tissue.

The Kimmel Center also participates in national trials in breast cancer treatments including different drugs and chemoprevention. This is an opportunity for women to speak with oncologists specializing in breast cancer about the possibility of participating in clinical trials that test these new treatments.

Hopefully with enough success, these trials will one day lead to a world that is free of breast cancer.

Now there's something more useful than a two dollar bill.

Dr. Rosenberg specializes in breast surgery at Thomas Jefferson University's Kimmel Cancer Center, PA. Jefferson�??s Kimmel Cancer Center is a National Cancer Institute (NCI) designated cancer center. This recognition for excellence in cancer research and treatment allows patients access to the very latest in care. Doctors at Thomas Jefferson University Hospital have been cited as among the nation�??s best for cancer treatment by �??Best Doctors in America.�??

Terrible Two's? Check twice for Autism!

2007-10-29T14:47:13-07:00

A terrific thing to do during the terrible two's!

According to The American Academy of Pediatrics, have your children tested for autism. Not once...but TWICE!

(Add outlandish characters, and rounded drooping landscapes here for a full on Seussian adventure).

A recent CNN article regarding autism prevention draws testimonials from mothers and autism experts who regret to see that children with the condition are often not being screened early enough.

From CNN's Pediatricians Urge Early Autism Screening:

Dr. Pauline Filipek, a child neurologist at the University of California-Irvine, said she hears much too often that even when parents push pediatricians, the doctors miss the signs of autism.

"I hear this from parents all the time, that the pediatrician said, 'Don't worry,' or 'You're imagining things' or 'Let's wait,' " Filipek said. "When I give lectures to pediatricians, I tell them, 'Get these phrases out of your lexicon. Get them out of your vocabulary.' "

Earlier diagnosis is crucial, she said, because it means earlier treatment.

So heed these words! They're not for the birds! Remember the two's! It's not a time just for screaming! It's a time for autism screening!

Dr. Pauline A. Filipek clinically specializes in children with developmental disorders. She has received many grant awards from the National Institutes of Health and other foundations such as the National Alliance for Autism Research. Most recently, Dr. Filipek was the recipient of a $6+ million grant from the Children and Families Commission of Orange County to improve early recognition and treatment of young children with autism. She practices at the CHOC UCI NeuroDevelopmental Center in Orange, California.

Not so easy-listening about Folic Acid

2007-10-26T10:05:45-07:00

If you're an Angeleno who listens to 103.5 Love Songs On the Coast as much as I do (Karen Sharp, hollah!), you may be lead to believe that 'love is all we need'...or 'love will keep us alive'...not true turns out. Love is NOT the only thing that keeps us alive, or even healthy for that matter. Especially for women, regardless of race, creed, or musical taste, a daily intake of folic acid is a necessity, particularly during pregnancy.

Dr. Michelle A. Bholat, Latina family physician at UCLA, has contributed her opinion to the LA Times article, "Folic Acid Use Declines Among Latinas" that reveals that Latina women are not getting enough folic acid. According to the article, despite a decade-spanning public health effort to raise awareness among white, black, and Asian women of childbearing age, studies show an increase in folic acid intake among these women, but a decline in consumption among Latinas who birth more than 50% of babies in the state of California.

Dr. Bholat expresses that there should be concern over these findings. She offers that a possible explanation may be cultural. A traditional view among Mexican women is that "when you are pregnant, you don't take anything into your body, even a little pill that the doctors give you." (LA Times)

Failing to consume the recommended amount of folic acid - 400 micrograms for young women - can have unfortunate results, including infants born with neural tube defects.

Bottom line: love is great. But pre-natal care and proper diet are key in ensuring the health of newborn babies. I think we should all be writing letters to Lionel Ritchie about this. Because I personally would sing along to "All Night Long...Folic Acid"..."Folic Acid Lover"..."Easy Like Folic Acid"...I could really do this all day...you get the point.

Dr. Bholat is Vice Chair of Family Medicine at Les Kelley Family Health Center and UCLA Family Medicine Center. She speaks both English and Spanish.

Dr. Strangelove

2007-10-25T13:44:09-07:00

One of my favorite bits of movie dialogue occurs in the war room scene of the movie Dr. Strangelove: Or How I Learned to Stop Worrying and Love the Bomb. You may remember it, it's when U.S. President Merkin Muffley (played by Peter Sellers) has an I'm-sorry-off with the drunken Soviet Premier:

President Merkin Muffley: "The... wha-whe, the People... you, sorry, you faded away there... The People's Central Air Defense Headquarters... Where is that, Dmitri?... In Omsk... Right... Yes... Oh, you'll call them first, will you?... Uh-huh... Listen, do you happen to have the phone number on you, Dmitri?... Whe-ah, what? I see, just ask for Omsk information... Ah-ah-eh-uhm-hm... I'm sorry, too, Dmitri... I'm very sorry... All right, you're sorrier than I am, but I am as sorry as well... I am as sorry as you are, Dmitri! Don't say that you're more sorry than I am, because I'm capable of being just as sorry as you are... So we're both sorry, all right?... All right."

Among the three brilliant characters that Peter Sellers plays in this movie, notice the character who is full of apologizes is the president and not the movie's namesake character, Dr. Strangelove. Well, if the genius-doctor was holding his tongue for fear of litigation, perhaps he could have benefited from reading HealthDay.

Admitting wrongdoing for doctors is a highly sensitive issue and one that is covered in HealthDay's article 'Doctor-Patient Bond Frays After Medical Mistake.' According to the article, admitting a medical error in some cases may help a physician avoid a medical lawsuit and may even lead to strong, long-lasting bonds with the patient and the patient's family.

Dr. Tom Delbanco, a professor of general medicine and primary care at Harvard Medical School states, "trust is an enormously important part of medicine -- if people aren't straight with you, you do not trust them...so, being upfront and honest, indicating that you want to do something about what happened, makes all the difference in the world." Dr. Delbanco continues to tell HealthDay, "I think that doctors are very confused about what they can and cannot say," despite the fact that they may be harboring feelings of guilt, shame and fear.

I don't know if there's a term for that sort of situation. For the purpose of this blog, let's call it, strange-love.

Dr. Delbanco's word of advice for patients is to "be very aggressive in asking for communication. Patients should not be afraid of opening their mouths." And if that communication is not forthcoming, "Ask why and with whom can they speak?" (HealthDay)

Let's hope Dr. Delbanco's advice will aid doctor-patient relationships everywhere into peaceful resolution. Because let's face it, none of us want to drag each other into the war room. Much less be fighting in it.

Dr. Delbanco is the Richard and Florence Koplow �?? James Tullis Professor of General Medicine and Primary Care, Harvard Medical School. He is the author of a recent article in the Oct. 25 New England Journal of Medicine which he co-wrote with Harvard colleague Dr. Sigall Bell. He practices internal medicine at Beth Israel Deaconess Medical Center/East in Boston, Massachusetts.

Happy sharers

2007-10-24T14:35:38-07:00

I admit it. I don't really like to share. Maybe something went awry in my kindergarten class that I've successfully blanched from memory, or maybe it's because I'm a female and my main experiences with 'sharing' have involved other women wanting to borrow my clothes. And then returning them not dry cleaned and stretched out and smelling like Clinique's 'Happy.'

Despite what the smell of my rumpled sweaters may suggest, the situation of sharing rarely has left me feeling happy.

One woman who's found more positive ways of sharing is family physician, Dr. Maura J. Sughrue. She, along with her colleagues at Fairfax Family Practice in Maryland, have adopted a style of practice called 'shared decision-making.' If this is a term you've only heard bantered about in marriage counseling, it will behoove you to know it is also a term that has emerged in the medical community to mean physicians equipping their patients with tools that help with 'filling in the gaps in knowledge that patients routinely face when their doctors either don't know about or don't fully explain the uncertainties of a test or a proposed course of treatment.' (Washington Post)

According to the Washington Post article 'Giving Patients A Larger Voice,' shared decision-making may involve 'short videos, brochures, questionnaires and interactive computer programs, which patients may take home and go through at their own pace.'

Shared decision-making is slowly catching on among physicians and hospitals around the country. Along with Dr. Sughrue and the physicians at Fairfax Family Practice, Dartmouth-Hitchcock Medical Center in New Hampshire has adopted the practice with funds set aside specifically for decision aids for patients considering procedures such as mastectomy and lumpectomy, prostatectomy and back surgery.

It is believed by researchers that shared decision-making will become more widely adopted with further research, and also when Medicaid and other payers begin reimbursing physicians for adopting the practice.

Hopefully one day we will all be happy sharers. And not the kind of happy that's smeared on Banana Republic merino wool blend V-neck sweaters, but the kind that comes from working more closely with our healthcare providers in making fully informed decisions about our health.

I also hope this type of happy will have a more flowery rather than a spicey bouquet. It just seems to work best with my particular chemistry.

Maura Sughrue, M.D. joined Fairfax Family Practice in 1983. She is a board certified family physician who earned her medical degree from the University of Maryland School of Medicine.

Do as I say...but here's what I do...

2007-10-23T15:52:56-07:00

The Wall Street Journal's resident medical blogger Dr. Benjamin Brewer has voiced his opinion regarding cold medication for children:

�??It�??s just a virus, and, unfortunately, there is no safe and effective cold medication on the market that I can recommend to you.�?? (WSJ)

Beyond this official statement, Dr. Brewer revealed that when his 3-year-old boy was battling a cold, he and his wife, after a sleepless night, gave him a dose of cold medicine with positive results. In his latest blog entry he writes, �??I have found that the advice to hold off on a kid�??s cold medicine is much easier to give than it is to heed.�??

Disburden yourself of your own well-meaning but contradictory behavior here at Dr. Brewer's online forum.

Dr. Brewer is a full-time practicing physician at Gibson Area Hospital and a medical journalist. His column The Doctor's Office appears regularly in the Wall Street Journal Online.

Pollen Nation

2007-10-22T14:18:59-07:00

Child and Adolescent Psychiatrist Dr. Mauricio Infante and colleagues at the University of Wisconsin are finding that adolescents with internalizing disorders such as anxiety and depression are more prone to having allergies. In a study of 184 young people being evaluated for psychiatric disorders and allergies, 57% had a history of allergic disorders, including asthma, hay fever, hives and eczema. (Reuters)

Dr. Infante writes in the Journal of Clinical Psychiatry, "these findings add to the growing body of evidence supporting an association between anxiety, depressive, and allergic disorders."

Researchers are hoping that the studies will lead to effective treatment and prevention strategies that target both disorders.

So the next time you're in a drugstore, keep an out for medicine labels that read "for sniffling, sneezing, moping, heartaching, stuffy life outlook, so you can look forward to your future" medicine.

Dr. Infante earned his medical degree from the Universidad del Valle Medical School in Colombia and completed his residency at the Mayo Clinic in Rochester, Minnesota. He speaks English and Spanish and practices Child & Adolescent Psychiatry at University Of Wisconsin Hospital.