Tuesday, January 24, 2017

New treatment for sweaty armpits

About three percent of the world's population suffers from hyperhidrosis--doctorspeak for medically excessive sweating. (The term means excessive water, go know.)

When the sweat collects under the arms, odor-causing bacteria can breed--and ewwww.

Now the FDA has approved a device from Miramar Labs called miraDry (get it--miracle and Miramar).

It's a device that applies microwave heat to your underarms, destroying the eccrine and apocrine glands that produce the excessive sweat.

It would hurt but you get some numbing first.

The treatment takes about an hour and lasts up to two years, according to Joshua Fox, MD, of Advanced Dermatology PC in New York state.

Writing in the Wall Street Journal, Laura Johannes says 22,000 to 30,000 sweat glands are destroyed in the process. She says the 2-3 sessions are needed and it lasts a year. Fox says the glands do not come back.

But a Miramar exec quoted by Johannes says only 82% of the sweat is stopped.

Another of her sources says miraDry is less effective than botox for this.

It is not known, apparently, if the remaining glands will start producing more sweat to compensate.

I checked--for Phoenix, the treatment can be in the area of $2500.

About 89% in one study were thrilled.

Fox recommends quizzing any doctor offering this:

--How often have you used the miraDry system? Were you specially trained?

--What other options might I have?

--What if I get soreness and bruising? (Suction brings the glands to the surface)

---What downtime is involved?

.So...it's up to you. I would say wait--they are tinkering with higher heat and other changes.

Or--just don't sweat it.

Monday, January 23, 2017

Arthritis HURTS and you don't want to walk

I have arthritis in both knees, Everything hurts--going in the kitchen, sitting down in a chair, venturing out to a doctor even. Pain, pain. You don't want to take too much Tylenol because it's not a benign drug and can hurt your liver. I don't think oxycontin is a great idea (though some of my older friends take it).  I won't get knee surgery because I know people who had a bad result--and I had a terrible experience with surgery on my detached retina. So I gimp around, yowing and ouching all day.

Every piece of advice is that older people need to move, walk, in order to stay independent.

Federal guidelines say 150 minutes a week of moderate activity (brisk walking as an example) to prevent premature death and serious illness. That's what--20 mins a day?

Only one in 10 older people with knee arthritis meets this goal.

But now researchers at Northwestern says 45 minutes a week might be enough.

In one test, a third of the participants improved or had high function after two years.

Even a little activity is better than none, the researchers say.

The key seems to be do a little at a time. Federal guidelines (150 mins) says do it 10 minutes at a time.

Still they say the activity has to be moderate. Pushing a grocery cart (which I call the cheap person's walker) is apparently too low key.

I walk around the house...I can no longer get to the mailbox at the end of the driveway because there is nothing to hold onto (besides pain, I have bad balance from my failed eye surgeries).

I probably walk 7 mins a day--but briskly? Probably not...hanging on the walls for balance seems to preclude speed.

Friday, January 20, 2017

Chain restaurants broke pledge to improve kids' menus

In 2011, national restaurant chains, under the aegis of the National Restaurant Assn's Kids LiveWell program, promised to cut calories, saturated fat, and sodium in so-called kids' meals.

By 2015, the restaurants numbered 150 chains in 42,000 locations.

Some major chains did take soda off as the beverage and add yogurt or fruit as side, but according to a study done at Harvard, more changes are needed (Am J of Preventive Medicine).

The researchers said they saw very little meaningful progress in the nutritional quality.

For one thing, the soda has often been replaced by other sugar-sweetened bevs. Sugar-sweetened drinks are still 80% of the options.

Those apple slices? That yogurt? Apparently not the whole answer. The kids will still be offered fried nuggets and cheese, burgers, and other "kid" tasty items.

But what is the answer? Not all kids will chow down on a salad.

It guess it's back to the parents. How about splitting an adult fish meal between two kids. Or choosing the roasted chicken sandwich instead of the fried? Insist on milk or water? Veggies with a dip?

Got any other suggestions?

Thursday, January 19, 2017

Third of asthma patients may not have it

According to a study of 613 randomly selected Canadian asthma patients (JAMA), 33% of them were being treated but did not have asthma. This meant they were needlessly taking strong medications.

Half had not been properly tested. In other words, the doctor listened to a report of trouble breathing and handed over an inhaler--without doing a spirometry test, which tells how well the lungs are working.

In some cases, the patients might have had asthma but it had become inactive--although they kept taking the meds.

Both Canadian and American guideliness recommend doctors reassess asthma patients every so often. If the symptoms are under control, treatment could be tapered down.

But most doctors, the researchers said, do not do this.

Taking the steroids in the medicines can have bad effects over time.

In this study, a third of patients had nothing wrong at all. Two had heart disease, and 65% had minor conditions like allergies.

I was told once I had late-onset asthma--but it was a medication reaction. I kept saying I don't have asthma--and 9 months after stopping the med, I was back to normal...not a wheeze since.

Wednesday, January 18, 2017

Berating your child's doctor can be very bad

Does he look like he's getting
over it?
I know this sounds like a given, but remember, when someone is sick, emotions run high.

Parents, especially, can get desperate, feel out of  the loop, outmatched by the knowledge of those around their child, and can get upset.

A University of Florida management professor and a doctoral student have found that "rudeness" can have a "devastating effect on medical performance."

Lack of sleep on the part of doctors, they found, can account for 10%-20% of medical errors--but rudeness and (I guess) hurt feelings on the part of the doctor account for 40%.

Rudeness from the patient or loved ones changes the doctor's cognition--doctors don't "understand" or "just get over" certain behavior.

The studies--done in Israel--involved neonatal teams challenged by parents played by actors. The teams that had been berated performed badly in all 11 measures of performance.

The negative effects lasted all day--meaning they could have affected other patients, too.

The researchers also tested pre-test "interventions," such as a computer game to raise the threshold of sensitivity to anger. There was also a post-test intervention--writing about the experience from the mother's perspective.

These worked! The teams were "immunized" from the effects of rudeness.

OK...but what about the doctor's rudeness toward the family and even the patient. I had one of my mother's doctors say old people smelled bad...referring to my mother. I answered back. Did she get worse treatment for that? Who knows. Maybe.

I guess this "fraught" stuff goes both ways.