Testing new account with Ping.fm for postings to several sites I use (i.e. FB, LindedIn, WP blog). Stay tuned!
Blogs….
Way overdue for an update and have been posting directly to my FB page. Will do better and WP won’t allow for integration into my website/FB page without an act of Congress it appears.
Stay tuned….
“colds”
As I struggle through the day today with upper respiratory and evolving sinusitis symptoms, I am inclined to share my thoughts on this rather ubiquitous set of symptoms.
- rinse, rinse, and rinse some more (saline!)
- decongestants, mucolytics, and antihistamines….all depends on which symptoms are most predominate
- cough rx (o.t.c. such as Robitussion DM typically not too helpful – tussionex is the best but controlled and requires physician rx)
- vitamin C seems to help some but MUST be used in fairly high doses (greater than 3,000 mg daily) to be very effective; GI side effects usually kick in too early for it to be of use although a 500 mg or 1,000 mg daily might help with prevention
- antibiotics – this is where things get grey; still way too many people get antibiotics for viral upper respiratory infections. Thusly, we have a huge problem with resistance out there with only limited reinforcment on the way.
Why is juduicial use of antibiotics needed? I see several different types of bacteria cultured out from urine, blood, wounds each week that have very few options for treatment. One in particular, Vancomycin Resistant Enterococcus or VRE, has a couple of IV options or a pill called Zyvox which costs $500 PER PILL!!
Because antibiotics aren’t repetitive drugs (such as those for high cholesterol or high blood pressure) the new ones will be very expensive. Remember….it costs $1 billion (yes, with a “b”) to bring a new drug to the market.
Get rest. Push the H20. Do the above bases upon your symptoms…..I have my patients call me to discuss. I rarely have to see them in person and usually can get symptoms to resolve in 3-5 days completely without antibiotics.
Good news!
Women who ate chocolate frequently were less likely to be hospitalized for or to die from atherosclerotic vascular disease.
I haven’t seen the study and do not know how accurate the numbers are but if true this will bring a smile to every woman I know. This with a good glass of red wine and a movie….now that’s an evening to look forward to!
Leadership OKC
Excellent forum last Thursday @ Leadership OKC. Other panel members included Mike Fogarty, Stan Hupfield, and Susan Relland (new Assistant VP @ Fidelity). Much focus on Health Care Reform (HCR) and rightfully so. Much interest in The Rothwell Group’s services as a viable and healthy solution to issues plaguing primary care at this time. More to come….
Lung Cancer Screening
A post from Journal Watch (a resource I use that compiles articles from many different medical sources):
Annual low-dose computed tomography cuts more lung cancer deaths than chest radiography among high-risk patients, according to early, as-yet unpublished findings from the National Lung Screening Trial released by the National Cancer Institute.
More than 53,000 current or former heavy smokers (aged 55 to 74) without signs or symptoms of lung cancer were randomized to undergo low-dose CT or chest radiography at baseline and then annually for 2 years. During follow-up, lung cancer mortality was 20% lower with CT than with radiography. (Based on this finding, the trial’s data and safety monitoring board recommended stopping the study.)
The NCI’s Dr. Christine Berg said: “This is the first time that we have seen clear evidence of a significant reduction in lung cancer mortality with a screening test in a randomized controlled trial. The fact that low-dose helical CT provides a decided benefit is a result that will have implications for the screening and management of lung cancer for many years to come.”
A spiral (low-dose helical) CT is a quicker scan that, for a chest, takes less than a minute on average. Thus, another nice benefit to this study is that the radiation exposure is much less. An regular CT of the chest is equivalent to 400 chest xrays! Insurance will NOT be paying for this anytime soon but if you or someone you know is a smoker speak with your physician about this ASAP. This is great news since there are no other remotely decent ways to screen for lung cancer at this time. Ask your PCP to negotiate the cost of a spiral CT scan for you if you have to pay out of pocket.
Qliance of Seattle
Here’s a link to a video about Qliance in Seattle. Dr. Bliss, Qliance co-founder, is a fellow member of the American Association of Private Practitioners. We have been stanch advocates of direct primary care practices and restoring the patient-physician relationship.
The Rothwell Group is doing much the same here in Oklahoma City. After 2 years of fine tuning the concierge model (I don’t care for the name but that’s what most seem to connect with), I have evolved my practice into one that can accommodate many more patients. I feel just as Dr. Bliss and many other primary care physicians that people should have better access and exceptional care. This just cannot be accomplished consistently with today’s insurance model controlling most of the $$ in health care.
Colon Cancer
I continue to see far too many patients, friends, aquaintences, etc. affected by colon cancer and especially before the age of 40. This has been suggested as a lifestyle related cancer but certainly is not on the whole. There are definite familial tendencies with colon cancer but a new analysis of thousands of colon cancer patients shows that improved lifestyle can make a difference for some.
Here’s a quote summing up the study:
In the analysis, almost one quarter of colorectal cancers might have been prevented with adherence to all five lifestyle recommendations (not smoking; daily physical activity for at least 30 minutes; avoiding heavy drinking; eating a healthy diet; and waist-circumference control — i.e., <40 inches for men and <35 inches for women).
Recommendations for screening remain the same. Everyone by 50 y.o. (before if you have concerning symptoms and/or + family history of polyps or cancer) and colonoscopy is the best way to screen although it can be $$. Negotiate with your GI physician if you have a high deductible. Otherwise, best of luck getting your health insurance to cover…they generally do not in spite of their lip service to having your health in their best interests.
Diabetes in 2050
Report out this week shows a huge shift towards Diabetes in the U.S. over the next 40 years. This will be in spite of new health care legislation that will NOT help prevent this inevitable march towards a very preventable disease. To prevent Diabetes (and by Diabetes I am referring to Diabetes Mellitus Type II or the Adult Onset variety), you need time with patients to educate, encourage, and follow up. A new system that floods primary care with 30 million plus patients and doesn’t provide remuneration for Primary Care to educate in a true medical home environment will only exacerbate this problem.
Diabetes does not happen overnight. On average, when someone is diagnosed with Diabetes they have had it for 5-10 years. Wow!! This is an insidious disease. It is preventable. Lifestyle changes, weight loss, medication involvement (prescription and over-the-counter) are mainstays. Most people remain unfamiliar with the term “metabolic syndrome” which is unfortunate. Why? Their brief PCP encounters don’t include education about this stepping stone to frank and overt Diabets.
What is Metabolic Syndrome? 3 of 5 of the following qualifies someone:
- Waist circumference over 35″ in females and over 40″ in males
- Triglycerides over 150 (or on treatment for high triglycerides)
- HDL below 60 in females (women have a naturally higher HDL) and below 40 in males
- High Blood Pressure (or hypertension) – this counts as one if you are on BP medication
- fasting blood glucose over 100
MANY people qualify for this syndrome yet have no idea. Get these tests/measurements done now and know where you stand. Don’t wait for Diabetes!! Do something today while you can.
The Luke Commission
Harry and Echo VanderWal are coming to OKC Nov. 27-Dec. 2. We are greatly looking forward to their visit and plan a fundraiser for them on Tuesday, November 30, 6-9 pm. Details are pending but we hope to make Will’s Theater on Western the venue. Carl Milam has done a great job on renovations there and the food is always great.
If you want to be a part just contact me through my website.
