Tuesday, September 30, 2014

New cancer diagnosis procedures may be coming

Melinda Beck, WSJ, Septe 15, 2014, writes that 596,000 Americans may die of cancer this year--but many will die of fast-moving lethal forms.

In the meantime, with all the "preventive" measures to detect early (not prevent), many other people may be undergoing unnecessary treatment that can affect the rest of their lives.

One doctor said we are detecting too many slow-growing cancers and too few fast-growing ones.

A National Cancer Institute advisory panel is calling for major changes. Included are new screenings for deadly forms, registries to track the slower forms, and new language to remove the word cancer from
"pre" conditions.

For example, as much as 60% of prostate cancer is so slow-growing, the man will outlive it. But the treatments can change the man's whole life. Some think the percentage of those who have cancer cells in the prostate equal age--age 70, 70% of men have them.

Scientists now estimate that 30% of invasive breast cancers, 18% o f lung cancers, and 90% of papillary thyroid cancers pose no lethal threat.

No no no, say people diagnosed early and "saved."

The key is figuring out who is at risk--and screening those people early on.

Should you refuse screening? Personal decision. For breast and prostate cancer, you have a 2.7% chance of dying of it. Screen 10,000 women in their 60s for breast cancer every year and between 5 and 49 cases will be averted. Ninety women will die of it anyway. And 64 to 194 will be treat unnecessarily.

Your call. In the meantime, the research continues. Stay tuned.

Monday, September 29, 2014

Groceries by mail?

According to Eric Katz, Government Executive, Sept 24, 2014, the US Postal Service is rolling out a pilot program to deliver groceries to people between 3 am and 7 am. They are calling this Customized Delivery (which says nothing, in my opinion--why do they NEVER ask me to name?)

This will only be in a few cities--not yet announced.

You don't have to wake up--they will leave it without knocking or ringing. Hmmm. This BETTER be pretty nice cities.

This will be tested for two yrs unless it's a clear loser.

Nice to be optimistic, isn't it?

I get groceries delivered from Safeway--$50 minimum. If I give them four hours to get here--it's $7 tacked on. Less time, more tacked on.

I do it for bulky (paper towels, tissue) or heavy stuff (kitty litter). It works pretty well and I hope they don't end it. The guys are really nice and put everything in the garage or wherever without eyerolling. And tipping is forbidden.

Friday, September 26, 2014

Warm bottled water in your car--don't drink it

Everyone has half-full bottles of water lying around in their car, boat, or garage.

At the University of Florida, they did a study on bottled water from China. Hello? Dollar Store?

Plastic bottles are made of polyethylene terephthatlate--when warm, this releases antimony and bisphenol A--BPA.

Bad stuff.

The FDA continues to study this,  but even at Mayo they think this may be bad for children.

In the study, worst case scenarios were tested--16 brands at 158 degrees F for four weeks.

Only one exceeded the EPA standard for antimony and BPA. Other brands--who knows?

The longer stored in a hot place--the worse. A garage or car trunk in summer perhaps?

My sister sips hot GatorAid--bleh. To me it tastes like sweat lemonade.

Thursday, September 25, 2014

My experiment in consulting with a doctor

Even though I am sure you, my readers, think I am an expert user of medical care, I am not.

When they told me I had atrial fibrillation--irregular heartbeat--I went eek, heart trouble, and dutifully took the pills they prescribed in the ER. For nine months I was deathly ill from this medicine and almost died after finally getting hospitalized.

They they put me on a blood thinner--you must have this to prevent a stroke. My dad died of a stroke. So I was on thinners for yrs--monthly tests--got a bad bleed inside, then my retina detached and four operations later could not be reattached because of clots. I quit that on my own.

At the beginning of the summer, I could not breathe. Pneumonia. The ER doc spent about 10 secs with me and said you have pneumonia and probably congestive heart failure. CHF? What? I took the diuretic pills like a good girl.

Every morning for months, I was sweaty, nauseated, dizzy--for hours. I got up six times a night. Awful.

My doctor said my kidney numbers were bad--maybe kidney failure--Stage Three Kidney Disease. He referred me to a kidney specialist.

BUT--I called the place and asked for the office manager. I said I wanted to TALK only. She said, "A consultation?" I said yes. She suggested a doctor in the group who spoke perfect English.

The staff was bossy and nervy and I almost walked, but the doctor was breezy, pleasant, and shrugged off my numbers. She said I did not need the diuretic and certainly not TWO of them. She said come back in three months to repeat the blood tests (the other office, OF COURSE, did not send them all) and to do an ultrasound.

I dropped the heavy duty pill, spaced my BP pills and aspirin through the day, and feel normal!

Don't be afraid to question the system. Talk! See were you stand.

Wednesday, September 24, 2014

If you sleep during surgery, you could be sorry

Who are you again?
You will have no idea what the heck is going on. Yet, unconsciousness, shall we say, is a must in most surgeries. Sooooo....

Elisabeth Rosenthal, NYT, Sept 20. 2014, tells an extremely long "who shot John" story about a guy who negotiated payments to his hospital, anesthesiologist, and orthopedist before neck surgery--but was rather shocked to get a $117,000 bill from some doctor he never heard of and never consented to.

The man was in pain, sick, scared, had negotiated and called around--and still, bam!

This even has a name--driveby doctoring. In this case, the guy was an assistant surgeon brought in.. This made him out of network--meaning a huge fee.

The patient ended up paying $3K--on a $6,200 bill (negotiated).

You can be lying on a gurney before surgery or after and every face you see may bill. Or docs may drop by and ask how you are--wait for it--they will bill. Who called them? No one ever knows.

This whole deal is wacky! I remember having a eye infection and they put tape on the lid to keep it closed--the rate they wanted to cut that tape in a crescent and slap it on was $6,500. they didn't get it, but you see where I am going.

One guy with back surgery was billed by 10 providers in 24 hours.

The person who walks you to the john after surgery may be a physical therapist who wants $400 for this little stroll.

Tuesday, September 23, 2014

Dr Beep Beep

Elisabeth Rosenthal, NYT, Sept 20, 2014, writes about computers and artificial intelligence replacing our doctors.

There are all sorts of gadgets now you can put on your phone to look into ears, check blood alcohol, heart rate. There are home cholesterol kits.

But does this promote better health?

One expert said so far the outcomes have been sorta disappointing.

Those fitness trackers are fun--but where does the info lead? To guilt? To fear?

The ability to collect data has already outpaced medical understanding, is how Rosenthal put it.

MRIs can show bulging disks--yet the patient is fine--do you treat the MRI?

Technology is just a tool.

Today I am reluctantly going to a specialist. I hate going to doctors. They make you feel fat and stupid. I asked to TALK only. Not be sent for "tests" just to get me out of the office.

Gosh, what could go wrong? I wish it were a smartphone!

Monday, September 22, 2014

Even without kids, couples eat dinner at home

Somehow the notion got started that empty nesters or couples with no kids lead a glam life--tripping from restaurant to restaurant.

Now, researchers in Ohio looked at 14,000 adults, comparing households with kids to those without. Apparently Ohio is representative of the whole US.

Studies have shown that kids in families that dine together regularly experience health benefits. Would this hold true of adults? (J of Public Health Nutrition)

Half the households in the US have no minor children. The survey asked during the past week, on how many days did your family eat at least one meal at your home or residence?

Half of the Ohio families ate at home 6-7 nights a week. Surprisingly this included couples with no kids.

Could it be the cost of eating out, the lack of convenience of going out?

More work needs to be done, vowed the researchers.

How about you? My kid (well, she's 32) works nights--is not here. We never eat together. That put us in the 5-7% of groupings that don't.

Friday, September 19, 2014

Here's an idea--exercise instead of drugs for ADHD kids

Of course, it's not that simple. Some kids have weird brain wiring, apparently. But personally I think a lot of children are just "a handful." They spin in place, whirl about, never still for an instant. I used to offer my daughter a quarter if she could stop moving for 15 mins.

They have lots of energy, certainly more than grown people. And if you put a child and a grownup in a room, the child will drain the grownup. We all know this.

Sumath Reddy, WSJ, Sept 9, 2014, says they did a study that showed that half an hour of strenuous exrcise before school helped ADHD kids be more attentive. Online at J of Abnormal Child Psychology.

Many schools incorporate short bursts of activity for all kids. I think this is good.

Sure, some kids may still "require" meds--but I think this should be looked into.

At least with your own child--maybe a walk (I mean, scamper or furious trike pedal) before dinner?

Thursday, September 18, 2014

The phasing out of the long-distance runner

Kevin Helliker, WSJ, Sept 9, 2014, says more and more athletes may concentrate on a faster "mile" rather than those 26-mile slogs. Or those 100-mile marathons.

Less is more (impressive)?

Recently a guy ran the 3 minute 58 second mile.This gained him respect at his office, which was full of jocks.

A study (of course) showed that adults who ran less than an hour a week over a 15-yr period lived longer than those who ran three hours.

Even little kids can run a mile, although some PE teachers have to be convinced.

And--when you run a marathon, one runner said, they ask you what your mile pace is anyhow.

So why take all day to prove something?

Wednesday, September 17, 2014

Uh-oh--eat right and make greenhouse gases worse

You can't win. Face it. Even if you buy into global climate fickleness (or whatever), what to do?

Researchers at the University of Michigan's Center for Sustainable Systems says if we all ate what the Dept of Ag says to, greenhouse gases would increase.


Check out the Sept 5, 2014, Journal of Industrial Ecology.

In the 2010 dietary guidelines, Americans should eat more veggies, fruit and whole grains, fat-free and low-fat dairy and seafood.

Implied--less meat.

But even if we ate less meat, increases in the others would increase emissions.

Also--throwing out food (say in lunchrooms) is equivalent to adding 33 million passenger vehicles to the roads.

I have to lie down now. To conserve energy. Not eating seems to be the only answer.

Tuesday, September 16, 2014

What a good idea--urgent care "ambulance"

I heard about a woman who thought she was having a heart attack, but the EMTs said no and charged her a ton for the ambulance call since she did not need to go to the hospital.

According to Government Executive Magazine, Sept 12, 2014, in a story by Eric Whitney, South Metro Fire Rescue Authority in the Denver suburbs has a specially equipped vehicle--basically a station wagon--that can treat minor injuries on the spot.

A mobile care unit.

They carry a nurse practitioner so can prescribe. They can suture minor cuts. They also have a lab better equipped than some urgent cares--blood counts, strep throat checks, flu.

They call up records on patients electronically.

So far the insurance companies won't pay. So for now, they work for free.

They expect with an emphasis on cutting costs, this will change in the future.

Denver, huh?

Monday, September 15, 2014

Football can make you ill

Football stress, that is. The excitement during, the anticipation leading up...according to Jody Gilchrist, a nurse practitioner at the Univ of Alabama Birmingham's Heart and Vascular Center.

Time for yogurt.

Tight games, crushing defeats...these produce heightened sensory inputs that release adrenaline and increase BP.

The body does not know from good and bad stress--it's all stress.

Then people eat and drink more--and more "bad" things. Two drinks should be the limit, the docs say.

Some other tips:

Watch the game with people you enjoy.

Do some pushups and situps during the breaks (does anyone do this?).

Take a walk at half-time.

Veggies instead of chips.

Keep salt to a minimum.

Forget sodas--high in sodium

Are you having fun yet?

All probably good advice--you decide.

Friday, September 12, 2014

Babies born in winter crawl sooner--or so they say

There is a new study at the Univ of Haifa in Israel that seems to show babies born between December and May start crawling sooner than those born June-November.

Small study--fewer than 30 babies. They used the reliable Alberta Infant Motor Scale (AIMS) measure of development.

The average age of crawling was 31 weeks. Babies born in winter crawled off at an average of 30 weeks. The summer-born at 35 weeks.

The bigger the difference between winter and summer in a place, the more this held. In a cold place like Canada with a lot of indoor heating, the difference was not pronounced.

What does this mean? Just interesting. Maybe it's cold on the floor and they learn to crawl fast to a warmer place.  

What does crawling itself mean? Your life will never be the same. Wait'll walking. These little suckers are fast!

Thursday, September 11, 2014

One in five nurses quit after a year

A study in the current issue of Policy, Politics & Nursing Practice shows that 17.5% of newly licensed RNs leave their first nursing job within the first year.

One in three leave within two years.

Hospitals tends to retain them better than other healthcare organizations.

The study was funded by the Robert Wood Johnson Foundation.

RN turnover is costly for hospitals and other orgs and affects the care you get.

Boy howdy! Nurses who are experienced and know the hospital and how to work the system can keep you alive!

Is it money? Shifts? Office politics? Insurance? Someone better find out.

Wednesday, September 10, 2014

People over 65 may need two pneumonia vaccines

If you are creaking around or maybe have a parent who is, you might want to ask about the pneumonia vaccine situation.

An advisory panel to the CDC recently recommended that people get a second vaccine called Prevnar 13 in addition to the older one, Pneumovax 23.

Both are usually given once in older people--or sometimes every 10 yrs. They both protect against the strep form of pneumonia--but work different ways.

Almost a million people a year get this pneumonia each year and up to 7% die from it.

The vaccines also protect against bacteremia (bloodstream disease) and meningitis.

BUT--the CDC did say it would revisit the decision on Prevnar 13 in 2018 if the number of people getting sick declines enough.

Prevnar 13 has been used in kids and enough were vaccinated to prevent outbreaks (herd effect).

This 13 stuff is also expensive--$135. The other one is $68. Medicare may not cover it or at least not until 2016.

About 60% of oldies have had the first shot.

I have no idea where this is going. I hate to say it--but ask your doctor.

I have had two of the first shots--and got pneumonia.

Tuesday, September 09, 2014

Do re mi--mi...mi...

Ann Lutkis, WSJ, Aug 19, 2014, says people with decreased manual dexterity--stroke, aging, Parkinson's--would benefit from some piano practicing.

Of course, there was a study in Neuroscience.

Moving a finger affects the fingers next to it. The setup of the study--10 Japanese students--was crazy complicated--look it up if you want.

Daily practice improved independent finger movement, especially in the ring and little finger, which have low independent movement.

Or maybe you could just do it for fun, for enjoyment, because you have a piano no one uses--why not?

It might help with typing, who knows.

Monday, September 08, 2014

Prevent school lunch ennui

Cheryl Lu-Lien Tan, WSJ, Aug 28, 2014, writes about a chef--winner of Bravo's top all stars--who makes lunch for his 3- and 6-year-old.

No uneaten food in the lunch box--that's his motto.

What's his secret? He makes them what they like--one likes cucumber sandwiches, so he makes then 3 times a week. Vegan mayo or hummus, of course.

Another likes peanut butter and jelly--whoa, too much sugar. So he substitutes ricotta and fig jam. That would NOT have been considered okay at my house.

Sometimes he tops the breakfast buckwheat pancakes with tomato, turkey and lettuce. No comment.

My Mom used to make lunches for summer camp and always put in a few pastel-colored Jordan almonds with a perfumey candy coating. We loved that little treat.

Some parents put in notes. Do they teach reading anymore?

I used to make little salads for my kid--in a plastic tub--shake to coat with dressing. Once I asked did she like her salad? She said, "What salad...Oh, I trade that."

Friday, September 05, 2014

Dangers to babies on planes

Scott McCartney, WSJ, Aug 21, 2014, takes on an awful subject--the death of babies on airlines.

Wait wait--inflight pediatric deaths are VERY rare, don't panic. They occur mostly on long flights between continents.

But--the reasons for many are unclear.

Some get tossed out of their parent's lap by turbulence.  Sleeping in an adult's arms can result in smothering.

Oxygen levels are lower in planes--this may affect some little respiratory systems.

Infants are protected better closer to the window seat.

Carseats are recommended for babies under age 2, but carseats are heavy and you haved to buy a ticket.

Talk to your doctor--if your child has asthma, respiratory or heart issues--he or she may need oxygen. See what's involved.

There is a device called LapKidz--light easy to use--but not approved for takeoffs and landings--just durings.

Thursday, September 04, 2014

One old doctor watching out for you

An allergist named Joseph Leija, MD, performs the Gottlieb Allergy Count for us.

He is concerned about the flooding in the Midwest of the US--bad in recent days. The Gottlieb Count is very high for mold (Alert!) nothing for trees, low for grass and high for weeds.

One in five people have an allergy or asthma. Fewer than half of those with asthma have not been taught what their triggers are.

Staying indoors, running the air, and taking prescribed allergy meds prevent trouble.

Every day at 4 am, Dr. Leija, 84, climbs the stairs to the rooftop of the Gottlieb Memorial Hosp just outside Chicago and catches pollen.

Then he looks at it under a microscope. And puts out the results for free.

If you have asthma you need to know your triggers--same for allergies. We can't have rain and mold everyplace without consequences.

To get the count, call 1-866-4-POLLEN.

4 your own good.

Wednesday, September 03, 2014

Do expiration dates on pills mean squat?

Look on your amber bottles--you will see expiration dates. This has been required by the FDA since 1979.

What does it mean? Answer: The final date where the medicine will have full potency.

It does not mean the medicine is useless after that date. They actually don't test that. One Defense Dept study, though, showed some drugs in a stockpile were good 66 mos after the expire date.

Expiration dates are from a year to five years after manufacture.

Seventeen states put on a "Discard after..." This is required by those states--but there is little science behind it.

One doc says if your life depends on a drug--like an EpiPen--look at the date and replace. If it's cold pills, who cares if they are old.

Tablets and capsules tend to be most stable. Drugs that need to be refirgerated go bad sooner.

Ointments with crusts or crystals--toss.

People usually keep stuff around. One reason is people like me blogging that you can't throw it in the trash, no not the toilet either, etc.

So you put it back.

Tuesday, September 02, 2014

What about "puke" pops?

Laura Johannes, WSJ, Aug 26, 2104, writes about lollipops that reportedly cut nausea.

I need these. Wonder if they work. I have heard of hard candy for morning sickness so maybe.

These are called Preggie Naturals ($5.95 for 15) and Natural Chews. Queasy Pops are for chemo patients.

They contain Vitamin B6, among other relievers such as ginger.

Ginger has quite a good rep in the nausea area. But the amount in these candies seems to be fairly low.

When I take my morning BP pills, I think my ACEs don't want to be blocked, nor do my betas. I get the urps.

I have been taking an over the counter chew called Nauzene--which works pretty well. Or maybe it's just a big ole placebo, who knows.