Monday, July 31, 2017

Do docs spend more time on the computer than on you?

I wrote about the "electronic chart" 35 yrs ago--it was to be the wonder of the future...Well, we are still wondering.

First, your information is hardly universally available. One doc has to call another still to get your chart.

But the most common complaint from patients is that the doctor fools with the computer and uses time he or she could be devoting to the patient.

Some doctors lament this, and do some patients, according to a Reuters story.

One doctor said they either must turn their eyes to the computer and enter patient answers and data or do this later, which results in overtime on each patient.

Some researchers at Brown did a study that ran in the J of Innovation in Health Infomatics.

They asked doctors how the electronic chart (or EHR-Electronic Health Record) affected their patient interactions.

--Most said the EHR undermined their connection with patients. One doctor said it was like someone at a dinner table texting.

Of the 3,761 physicians, 68% responded. More than 87% of those uder EHRs. About 744 expanded on their answers.

--Most of those were older and more likely to be in primary care.

--There was a divide between docs who say people in the hosp and those who saw people in the office. The hosp doctors sai the EHR disconnected them from patients--but the office docs said the EHR degraded their relationship to patients. (Some hosp doctors said having lab results in the computer improved relations.)

Some doc said the EHR format was not as easy to use and intuitive as other computer systems, resulting in multiple clicks and disorganization.

--Also training on using the EHR is missing from medical school.

Let me think. I just got a new primary. He was standing in the hall looking at the computer and my clipboard...I don't think he used the computer in the room.

But I had some guy--my eye surgeon--who tried to double up on responding about me to the referring doctor and talking to me about my eye. He would TALK INTO the computer, using a program with medical terms to spell for him--and say, "I saw Ms Lawrence today and blah blah" to the other doctor and I was supposed to hear what he said and that was MY fill-in. All without looking at me.

And to make matters worse, the darn thing could not spell terms he used--he could say TRY AGAIN over and over until the machine came up with what he wanted. What a mishmash.

Friday, July 28, 2017

Men doing the grocery shopping

Shocker--according to Men's Health, 84% of men are now the primary grocery shoppers in their household. Other surveys put the number lower, but there is no doubt that men are now pushing the cart more than in the past.

Abah Battarai, writing in the Washington Post, says yes, men are taking on more chores, but also men are putting off marriage longer and must eat in the meantime.

Implications:

--Men are less strategic--they buy what is needed for a day or maybe even that evening. Women buy a 12-pack, men a 6-pack.

--Men take the hunter attitude--kill fast and leave. Score!

--Men are more impressed by brands. And interesting displays--which stores now are eager to provide. Some have lunchbox aisles, dinner aisles.

--Stores try to make shopping more fun on the assumption that men get frustrated more easily.

--Of course, men think they are great shoppers...and well, women...they take a more moderate view of what men drag home.

My ex- was the cook and I was the breadwinner, which led to his tossing in every luxury item he could find and me taking it back out. But I think that may be a different subject.

Yesterday, a woman friend of mine said her husband had just left for Costco. "I try to keep him out of there," she sighed,

Thursday, July 27, 2017

Why not talk to yourself?

You are good company, right?

Yet, there used to be a joke about how talking to oneself did not mean you were crazy--but answering yourself did.

Fulll disclosure: I talk to myself all day. I ask myself questions. I encourage myself to stand and walk when my arthritis is bad. I maybe even utter an oath if something hurts or annoys.

Chatter chatter.

Researchers at Michigan State and the University of Michigan say talking --silently they said--to yourself in the third person ("A woman can do this"...etc.) can exert self-control and is pretty effortless.

In short, it makes you think of yourself as you would another person and the brain picks up on this. You get distance from the emotion.

In one experiment, they show participants disturbing images such as a gun being held to a head, and when the subjects referred to themselves in the third person about the image, the brain activity decreased quickly.

In another experiment, the participants went to a traumatic experience from their past using first and third person..third-person self talk resulted in less brain activity.

So...I guess it can't hurt a person, Star. Babble away.

Wednesday, July 26, 2017

Will you be "chipped" in the future?

A Wisconsin company called Three Square Market is offering employees rice-sized under-the-skin microchips to scan them into the building and pay for food.

So far--these are voluntary.

They slide them under the skin between thumb and forefinger.

The company says "this is the next thing that's going to happen" and they want to be part of it. They  insert the $300 chips in those who want them at "chip parties."

The company,  which provides technology for break rooms and other small markets, foresees Radio Frequency Identification (RFID) to gradually be used for many purposes--copying machines, unlocking phones, business cards, storing health info, and other uses.

Of course, this technology is already used on pets. And some have suggested it for tracking wandering dementia patients.

This company swears no tracking will be involved. But who knows?

One question (among many) I had was what if you go from company to company with this stuff under your skin...What reacts to what?


Tuesday, July 25, 2017

Are we ready for plumper mannequins?

Clothes hang on hangers and I always think models are chosen because they show the clothes as if the garments were on a hanger. In other words--the models are crazy skinny. Some of their insect-like legs hardly even look human. (By the way, the male mannequins tend to be freakishly brawny.)

Some designers have defended this, but there is a growing trend (I learned) toward more realistic mannequins--even some depicting disabled people.

Lorynn Divita, PhD, co-author of Fashion Forecasting and associate professor at Baylor's Robbins Colleges of Health and Human Sciences. She answered some questions recently. Paraphrasing...

Why are mannequins so skinny--doesn't this discourage average size or larger women?
Mannequins are expensive--more plastic more cost. The average mannequin costs $500 to $900--and repairs can also run high. Also smaller mannquins are easier to "dress."

Wouldn't it still be worth it to create more realistic ones?
Sixty-five percent of American women are Size 14 or larger. Yet they only buy 17% of the apparel. As the plus-size market grows, the mannequin situation should change.

Who do the mannequins resemble?
Sometimes a celebrity with a popular shape. There are no standards, just as women's sizes also do not conform to a set of standards.

What other ways will mannequins evolve?
With active wear being more popular, mannequins will have to be doing more than standing or sitting--running, doing a yoga pose. Some swimwear has diving mannequins. Some mannequins may be suspended from the ceiling.

Also available--stickers to change facial expressions, fake eyelashes, and stick-on makeup changes.

Have you seen any of these new mannequins? Let me see if I can find a picture.

Monday, July 24, 2017

What makes sensitive teeth sensitive?

Do you fear an ice cream cone on a hot day or a steaming cup of java in winter? You may have sensitive teeth.

Jane Cotter, RDH, MS, assistant professor, Texas A&M College of Dentistry, says over time, enamel may wear away, exposing the dentin layer of the tooth and the dentin tubules--the fluid moving in the tubules triggers a pain response. Yow.

The biggest cause is gum recession. Other causes included toothbrush abrasion (brushing too hard or with too hard a brush), periodontal therapy, tooth decay, fault restorations, or excessive bleaching.

Foods that heighten sensitivity:

--Sodas (diet and regular)
--Energy drinks
--Fruit juice
--Wine
--Coffee

When it's cold out, the temperature actually affects the sinuses and then the teeth underneath respond.

Cotter says having sensitive teeth makes life dull. No ice-cream, cold weather running...

Treatments?

She recommends over-the-counter toothpaste containing potassium nitrate or calcium phosphate. Fluoride gels or rinses can also help.

If this doesn't do the trick, talk to your dentist. This goes especially if you are changing your life over the pain in your teeth.

Ice-cream is just too important.

Friday, July 21, 2017

Hiphop community embracing health as the new wealth

The late Pfife Dawg--dead of
diabetes.
Story in Healthy Living. Malik (Pfife Dawg) Taylor of A Tribe Called Quest died of complications from Diabetes 2.  Not crack, not heroin, not oxy, not "lead poisoning"--diabetes.

--Heavy D, Big Pun, and the Beastie Boys' Adam Yauch, Prodigy of Mobb Deep, and 2 Live Crew's Fresh Kid Ice--all died of things like sickle cell or stroke...What people could call natural causes, but which need not be so natural at young ages.

Quincy Jones III and Shawn Ullman have made a hiphop documentary called: Feel Rich: Health is the New Wealth."

There seems to be a new trend toward healthy living in the hiphop community. Styles O is opening juice bars in the Bronx, Other rappers are opening health clubs and gyms.

The organization Feel Rich, founded in 2011, which is connected to the film, collaborates with the American Heart Association, the American Diabetes Association, and various corporations and brands. Among other things, the organization has funded urban gardens. In the film, the weight loss journeys of Fat Joe and Crystal Wall are outlined.

The idea was to make health fun and aspirational.

But--the founders point out--hiphop has been around a while now--the rappers are getting older and health is more of an issue.

Boy is that true.

Thursday, July 20, 2017

How much healthy choices prolong life

I read a study this morning done by the Lancet that said worldwide Alzheimer's cases could be cut by one-third if people controlled weight, exercise, blood pressure, hearing loss and some other factors.

I think they sort of confused cause with association, but even then, it still left two-thirds of cases unexplained...not to mention sliding over whether all cases were Alzheimer's or other forms of dementia.

A study done by Health Affairs, on the other hand, took a different approach. They said 80% of those who smoked or were fat reach their fifties alive. BUT if you had not smoked or been fat, how long will you live from then on without disability?

The researchers looked at nationwide data from 1998-2012, among Americans 50 to 89.

They found the impact of a health lifestyle was large.

The average American who was not fat or did not smoke lived an additional seven years free of disability. This was better than Japan, even, where people are thought to be healthy longer.

I looked at the bar chart by risk factor...Seems the women lived longer (which we knew) but disabled was the category at the end of life, even though the disabled part may have commenced a little later than for men.

Oh, and "moderate drinker" seemed to confer a few more good yrs for both genders.

Cheers!

Wednesday, July 19, 2017

Don't forget--your teen may be due for a vaccine

Most parents muddle through all the baby vaccines OK, even in this current environment of questioning vaccines--but the need is lifelong.

It's not just "puppy" shots and you're done. The schools will tell you what is needed by school age--but then what?

The University of Michigan's C.S. Mott Children's Hospital looked at this.

They queried 614 parents with at least one teen--age 13-17.

Little kids are usually scheduled for vaccines, but doctor visits are less regular as kids grow up.

Sometimes a doctor can only bring up vaccines if the youngster is brought in for an accident.

As a result, vaccines are below targets in the adolescent area, especially those that require more than one dose.

--Only one-third of teens have received a second dose of meningitis vaccine by age 17.

--Half of boys 13-17 have completed the HPV series.

--Fewer than half of adolescents get a flu shot.

Parents are unclear on what kids should be getting. They say they only knew because the doctor scheduled a visit or mentioned it.. In 11% the office sent reminders.

I am way far from being a teen, but just got a second type of pneumonia vaccine.

You have to look into this and decide for yourself--and your teenager.

Tuesday, July 18, 2017

Do you prefer a fit doctor?

According to a story by Lauren C. Howe in the New York Times, some physicians include their gym and marathoning activities in their profiles. One doctor said he preferred to "lead" his patients by example.

But--Howe pointed out--this can be a turnoff to overweight or unfit patients who fear a "healthier than thou" attitude or lectures.

Negative attitudes about weight, according to other studies, are prevalent among doctors.

Howe and her team (J of Personality and Social Psychology) used the short doctor descriptions Kaiser offers Some doctors talked about their own fitness, others did not.

They found that overweight participants preferred doctors who did not emphasize their own fitness.

The participants also brought up stories of doctors lecturing about weight the second they walked in--despite whatever the presenting complaint was.

The results were lessened if the doctors in the study added that they thought healthy lifestyles come in different forms.

Federal guidelines urge doctors to lead by example and some organizations even want them to pledge to do so.

The researchers concluded that the docs could be subtler.

Now--the responses. There were many. I would say about a fourth said they would never take diet advice from a fat doctor. But others said they thought that doctor would know more about what was involved.

There were many stories--including some from yours truly--about doctors jumping right to weight as the cause of everything wrong with the patient--which could lead to other things being missed.

What do you think?

Monday, July 17, 2017

Yes, a tight ponytail can give you a headache

The same for a tight bathing cap or an aggressive braid (think rows or dreads).

There is a real type of headache called "ponytail headache syndrome."

Allodynia is docspeak for an uncomfortable sensation interpreted by the brain as pain.

People who have this can get a tap on the arm and jump in pain. Allodynia, by the way, is associated with fibromyalgia.

In the case of tight hairstyles, the scalp is overly sensitive.

Hair itself has no nerves, but the place it grows out of does.

A ponytail pulls back on those hair follicles--which scream in pain.

Some aspects:

--Not everyone has this. Migraines and tension headaches can make you prone. It can come out more when you are menstruating.

--Stress and lack of sleep can make it worse.

--If you must have a tight style--say for a special event--take some ibuprofen ahead of time.

It your ponytail begins to plague you..--let your hair down. But you would have thought of that, right?

Friday, July 14, 2017

Reasonably healthy diet while camping

Some people like to go camping. Actually millions do. Me, put the tent in The Four Seasons. But I digress.

I recently saw a story on how to eat well while camping. I guess the message is that S'mores are not a steady diet that will get you up and down hills and mountains and swimming across lakes.

And--remember--there is something about being outside all day that revs up the appetite.

Some tips?

--Be sure to include fiber. The usual camping foods--roasted meats or even S'mores contain little fiber. The last thing you want in the wild is constipation. Ouch! So pack a lot of carrot sticks, apples, whole grain bread, and other fibery treats. Watch for farm stands and get fresh produce.

--Make meals ahead of time. The campsite often lacks the pots, pans, and other utensils to make multiple items...you can even pre-cook burgers and just add the "flame" taste onsite. Or make nutrient-dense soup, freeze it to use as a cold pack, and then heat it.

--Stay on top of snacks. Trail mix, nuts, dried fruits--nice and portable--but can be calorie-dense. Check out the count before you load up on these all day. A handful of  nuts can be 200 calories. This is not to say you should be on some big "diet" while camping, but be mindful.

---Stay hydrated. This is important whether you are camping or not. Try to stick with water (and not from a stream, no no no). Sodas and sports drinks make you thirstier.

The key is to have fun, enjoy the fun of eating outdoors--and yes, even to have A s'more or two...Life is for living!

Thursday, July 13, 2017

Trip to the beach? What pills do you take?

I took pity and did not post the many
pix with huge yellow blisters. Ugh.
Did you know many medications increase your sensitivity to the sun and can result in intense sunburns with peeling and blistering?

This is called drug-induced photosensitivity.

The seriousness of the reaction depends on the potency of the drug and amount of sun exposure--but it can occur within minutes or pop up 72 hours later.

In the case of antibiotics, the meds deposit in the skin and the sun causes are chemical reaction leading to inflammation.

Pharmacists often warn you about this, but many people forget it and go in the sun anyway.

The most common drugs with this problem are antibiotics, but antidepressants can also cause trouble.

If you experience a dramatic burn, you can stop antibiotics, but if you think it's from anti-depressants, call the doctor for instructions. "You don't want a psychiatric episode," one researcher said.

If you are taking photosensitive meds:

--Avoid direct exposure to the sun, especially during 10 am and 3 pm.

--Wear sunprotective clothing, long sleeves, long pants or skirts, sunglasses.

--Apply sunscreen of at least SPF 15.

--Use topical remedies such as cool, wet cloths and cortisone-like drugs.

--If it gets really bad, go to the ER. Bring the pill bottle.

Always something, isn't it?

Wednesday, July 12, 2017

You don't need a hydration clinic

As people grow older (erg), they experience thirst less...and thus can get dehydrated...even those of us who stay indoors out here in the Sonoran Desert. I don't always drink as much as I should and I have a fellow oldie who says the same.

Actually I don't know if "hydration clinics" are aimed at the older set. I suspect they are for the wanta-be-hip contingent.

Clayton Bradshaw recently wrote about these clinics in the Phoenix area.

Basically these facilities hook you up to an intravenous line and shoot in saline mixed with vitamins and various nutrients.

An IV! Seriously?

These treatments reportedly make people feel refreshed and are recommended by the owners of the clinics for chronic fatigue and migraines. And--don't count this out--as a cure for hangovers.

This approach has been around since the 1950s--when a doctor named John Myers offered "Myers Cocktails" to improve digestion.

Opponents of this approach say most health people can digest perfectly well and the less healthy--say those with congestive heart failure or metabolic diseases--could be harmed.

One thing for sure--these treatments are SPENDY, runnng up to $200 a session.

Drink some water--and if you must, that vitamin water stuff...

Remember, whatever is in that IV is going directly into your bloodstream...Are you sure you know what's in it?

Tuesday, July 11, 2017

Free drug testing at music events

By free testing, I don't mean your buddy throwing down a pill and promising to tell you what it did to him.

Johns Hopkins actually studied the experience of volunteers who test pills at raves and other music events.

Yes, such services exist.

Among the findings, which were published in the J of Psychopharmacology, was that the stimulant known as MDMA--or Molly--had as many harmful additives as Ecstasy. The most common adulterant--bath salts.

The best thing is to not take street drugs, the researchers said. Second best--no fault testing on-site.

One such testing group is called DanceSafe. The volunteers come with test kits and scrape a teeny amount off a pill for testing. Chemicals are added that change colors when various elements are present. The drug colors are matched against a chart of colors.

This can show adulterants, but not which ones.

The researcher emphasize that almost drugs are e mixture--no matter what the purveyors say.

According to the study, almost half took the drug anyway if it contained Molly or MDMA.

So, I would say, the result of the testing was to confirm a more predictable drug, but not to turn partygoers away from all party drugs.

Still, it's a start.

Bath salts and a dangerous form of amphetamine called PMA were found in some samples.

Monday, July 10, 2017

Every 21 seconds--medication error

A friend and I were emailing about "pills" and how we didn't want to take them, much less "ask our doctors if they would be right for us."

Then I read that every 21 seconds, someone in the US calls Poison Control because the effects of some medication--not street drugs--medications.

The study, done by the Center for Injury Research and Policy and the Central Ohio Poison Center, and published in Clinical Toxicology, says med errors have doubled since 2012. The only age group that went down was children younger than 6.

Most associated with serious outcomes:

--Cardiovascular drugs (21%)

--Painkillers (12%),

--Hormones and hormone antagonists (11%). (Involving insulin)

The most common errors were:

--Taking or giving the wrong medicine

--Incorrect dosage

--Taking twice by accident

One-third of these mistakes resulted in hospitalization.

Some tips for avoiding these issues:

--Write everything down. Parents and caregivers or even the patient should not what was given and when.

--Ask questions. Ask the doctor, Ask the pharmacist. Does four times a day mean every six hours, even at night--or four times in waking hours?

--Child resistant packaging. Most pills come in child-proof bottles (supposedly childproof), but often adults transfer a days pills to another receptacle--use a child resistant one of those and keep it out of sight.

Pills, pills, pills...I just think we have too many...Ask your doctor if some of yours can be eliminated.

In the 1960, there were 600 meds. Now there are thousands.

Friday, July 07, 2017

Opioids--Savior and scourge

We have someone in the family with painkiller issues. I know another person who is taking a "big" painkiller for arthritis on a long-term basis.

The fruit of the poppy--or synthesized variants--have been with us for millennia.

Opioids can be effective for moderate to severe short-term pain, but even then are  risky.

Addiction, overdose, children left orphaned, communities left hopeless and destitute.

Are there alternatives?

If you find yourself staying on pain killers long after surgery or asking for them for chronic pain and even considering getting them on the internet, ask yourself:

---Why did you get them prescribed in the first place? Yes, they are strong--for strong pain. But sometimes other things work almost as well. (I had a huge incision for my hernia a few months ago, and while people's pain tolerance varies, I realized the cuts were sore but not like being ripped into anew--so I sneaked by on Tylenol.  I also did not want to use the self-administer gizmo full or Fentanyl--which is many times stronger than vicodin.)

Yet, I have bad arthritis--and do want some relief--so I know a little how chronic pain people feel. Maybe Tylenol is not their answer.

--Ask your doctor how long you will be on opioids. If this seems open-ended, ask about alternatives.

---Are opioids affecting the quality of my life? The side effects range from horrible constipation, fogginess, nausea, to depression--and sometimes to overdose and death.

--Why would you NOT stop? Do you fear being judged? Are you afraid to stop because you don't know what the pain would be like without them?

What alternatives might be available:

--Injections or nerve blocks.

--Electrical stimulation and spinal cord stimulation.

--Physical therapy--including whirlpools, ultrasound and massage.

--Acupuncture.

--Biofeedback, meditation, deep breathing.

--Surgery--Correcting the pain-causing abnormalities.

You can always ask!

Thursday, July 06, 2017

Pink eye? Probably getting the wrong stuff

My daughter and I both had this kind of disgusting eye infection once--curtains of green slopping down our faces.

Pink eye--or conjunctivitis--is treated with antibiotic drops in 60% of cases--and about 20% of those patients get a drop with steroids that can prolong or worsen this condition.

The study, done at the University of Michigan and published in Ophthalmology, the journal of the American Academy of Ophthalmology, is the first to study a diverse section of the US.

Besides 20% of those given drops being given the wrong drops, the study showed that whether the patient filled the prescription depended on socioeconomic status, rather than the risk of a more serious infection--say in those with contacts or those with HIV/AIDS.

Pink eye--which hits 6 million people in the US each year--can be caused by a virus, a bacteria or an allergy.

Most are caused by viruses and allergies--antibiotics are useless.

Most pink eye clears up in 1-2 weeks without treatment.

Other interesting facts:

--Primary care doctors diagnose 83% of cases.

--Those diagnosed by a primary care doctor or urgent care center were more likely to get the drops than patients diagnosed by an eye doctor.

--Those who filled prescriptions were more likely to be white, younger, better educated, and richer than patients who did not fill the prescriptions.

Some doctors prescribe antibiotics "just in case." This, of course, gets more antibiotics out there building up resistance.

Still, I remember the disgusting green stuff--I did want it gone.

Wednesday, July 05, 2017

Sure--buy a fun toy to cripple your kids

Trampolines always look like fun on ice! Soaring, twisting, laughing, defying gravity.

But did you ever see a video of a bear on one--and the bear goes flying off the side onto a rock or concrete?

It's always fun and games until someone breaks a wrist.

Sure you can over-protect children--I think we do as a society. But trampolines account for thousands of emergency dept visits each year, according to Monica, Kogan, MD, a pediatric orthopaedic surgeon at Rush.

Most fractures and dislocations involve kids under age 16.

Ninety-five percent of these occurred on tramps at home.

Forearms, wrists, elbows, legs, ankles--snap snap snap.

Even with netting, trampolines are not safe, Kogan scolds. She won't her kids play on them

If kids are going to bounce, it needs to be supervised and in a controlled, well designed area.

Oh--and this applies to "jumpy houses," too. And to grownups--often the parents participate, too, and can fall  on the child.

That would be a bad break.

Monday, July 03, 2017

Kind of gross--the Corn Test

Anything for science.
Kate Murphy, reporting in the New York Times, says if you get an upset tummy it might not be from something you just ate--it could be from something you ate up to 48 hrs before.

How can you tell?

Eat some corn, which passes right through, and see how long it takes to "appear." That is your personal clearance rate, supposedly.

According to Murphy, the Centers for Disease Control and Prevention says people get a "gastrointestinal event" a couple of times a month (NYT readers thought that was too often, at least for them).

--The stomach takes 4-6 hours to empty a full meal, then the small intestine takes another 6-8 hours to squeeze out the nutrients and then pass the rest on to the colon, where "the rest" can liner for 1-3 days, fermenting, before leaving.

But mileage may vary--so try the corn thing to see what your total time of passage is.

--If you throw up but nothing is amiss down below, it could be the offending item was consumed 4-6 hours ago.

--If you wake up with diarrhea and cramps, think 18-48 hours before.

Of course, the trouble could also come from pathogens on your hands, or from FODMAPS (google it), fermentable so-called healthy foods such as broccoli, brussels sprouts, asparagus, beans, whole grains and other foods.

Yes--healthy.

And don't forget stress and allergies...yipes.

I say--Imodium is your friend...Never leave home without it.

Now--how about some corn?