Flu Update

So far this flu season for our Region (AL, FL, GA, KY, MS, NC, SC and TN), incidence of flu remains below the national average for this time in the season.  However, our numbers are increasing. There have been 226 reported cases of proven flu to the CDC.  1 of those resulted in a pediatric death.  6 of those cases were the H1N1 strain from 2009.  It’s important to protect yourself  before you are exposed to the virus. Come get your flu shot!  To read more about the safety of this year’s flu shots, click here.  

Choosing Wisely- more tests are not always better

Choosing Wisely is a new campaign designed to help patients and physicians understand when certain tests need to be done and when they don’t. Nine different speciality societies (including the American Academy of Family Physicians) have been looking at evidence and providing resources published to the public through Consumer Reports. You can access these resources online at http://choosingwisely.org/?page_id=13.

The campaign has published lists of specific tests for medical problems that are often ordered but frequently are not needed. For example, one of the most common reasons I see patients in my office is for back pain. While back pain can be extremely painful, most often acute back pain resolves on it’s own in 6 weeks. However, many patients end up getting imaging tests done such as X-rays or MRI’s during that first 6 weeks. In our American medical culture, we often have the perception that more information will help you get better faster. But, that is not always the case. In fact, imaging of the back in patients within the first 6 weeks of back pain does not improve the outcome for the patient and often leads them to have procedures done which likely they did not need. In fact, I see many patients who have even more back pain after surgery which likely did not need to be done in the first place. Thus, the AAFP has recommended in their Choosing Wisely list to avoid imaging for patients with back pain within the first 6 weeks of the onset of their pain.

I agree with this recommendation. The problem is that many patients do not. And in an effort to satisfy the patient, doctors end up ordering the tests anyway. Also, in our litigious society, doctors are afraid if they wait to order the tests and it turns out a patient does need a further procedure, they will be sued for delaying the diagnosis (despite the fact that studies show it does not affect patient outcomes.)

These lists are an effort to encourage patients and doctors to discuss when tests are actually needed. And, I encourage my patients to recognize that more tests are not always the answer for your discomfort. Ordering more tests is a large part of the reason that America has the highest cost of medical care and the most unhealthy patients.

Are you feeling worn down?

One of the most common complaints I hear from patients is that they are feeling worn down and tired.  They feel they just don’t have the energy they used to have.  This can be a symptom of many medical diseases that need to be checked out by your doctor.  However, if those are checked and everything comes back normal, there are other things you can do to get that energy back!

Let’s take a look at the average American lifestyle for a moment…it can be summed up in four words: sedentary, poor diet and stressed.  Do you see that in your own life?  How do we expect our bodies to function properly when we fill them with unhealthy foods and become so sedentary that even a walk through the grocery store can be difficult .  And, when our minds are racing constantly with thoughts related to stress in our lives (“I need to get up earlier to get more done” “My house is a disaster” “My job is taking up too much of my time” “My family is driving me crazy!”) it puts stress on our bodies as well.  Our minds never slow down and just rest.  If our minds are not rejuvenated daily, our body will not be either, especially if it’s already struggling to overcome the fuel we are feeding it.

You cannot expect your body to feel energized unless you are caring for it properly.  It may hang in there for a while, but eventually it will catch up to you and you will begin to feel worn down.  I notice that for many people who feel that way, it’s because they ARE worn down.  Give your body a break and stop expecting it to function at 100% when you’re only giving it 1%.

Get active, cut the trash out of your diet and find a way to de-clutter your mind.  Your body will thank you for it.



Vitamin E linked to increase in Prostate Cancer

A recent article in JAMA reviews an updated report from a trial called the SELECT trial looking at the effects of Vitamin E on prostate cancer.  The study began in 2001 looking at the effects of prostate cancer in three groups of men: men taking just Vitamin E, Vitamin E plus Selenium and just Selenium. The results published in 2008 revealed there was no decrease in the number of men who developed prostate cancer in any of the three groups.  In fact, there was a trend toward an increase in the number of people who developed prostate cancer.  This was studied further over the past three years and now the results are out…there is a 17% increase in the incidence of prostate cancer in men taking Vitamin E (400 IU per day).

Just a reminder that just because something is “natural” or over the counter does not mean it is without the risk of side effects.    Make sure your doctor knows what supplements and over the counter medications you are taking.


“Bath Salts” now illegal substance in US

Psychoactive Bath Salts (PABS) are becoming one of the more frequent drugs that Emergency Departments are seeing patients abuse and lead to overdose.  Bath Salts go by names like Zoom 2, Aura, Vanilla Sky, Ivory Wave and White Rush and can be found in gas stations, truck stops and on the internet.  The DEA has now banned these drugs as of  Sept 7, 2011 and moved to make these a controlled substance in the US.   In fact, the DEA used its emergency scheduling authority to temporarily control the substances in bath salts, giving them a year to decide with the US Department of Health and Human Services if it should be permanently made illegal.

PABS are made with a main ingredient called methylenedioxypyrovalerone which gives them their stimulant effect. (This ingredient is not found in aromatherapy bath salts used for bathing.) These drugs are abused by taking them orally, intranasally, intravenously or rectally. PABS are a stimulant and give a high similar to meth, causing symptoms such as paranoia, hallucinations, psychosis and delusions. Overdose can lead to renal failure or death.

Are you getting enough sleep?

Most studies suggest that an average of 8 hours of quality sleep per night is what people typically require to maintain their mental and physical health. Not getting quality sleep in the right quantity for your body can have detrimental side effects on your well being.  Some of these include decreased cognitive function, depression or anxiety, low energy, decreased libido, poor judgement, increased risk of dying (especially from motor vehicle crashes or work place accidents), increased blood pressure and heart disease, decreased immune function and increased appetite!  Our sleep is important to rejuvenate our bodies so that they can work properly for us.  Here’s a quick test to see if you have excessive daytime sleepiness which may be related to poor sleep quality at night.

How likely are you to doze off or fall asleep in the following situations?  Use the following scale to answer the questions then add up your score at the end.

0= would never doze    1= slight change of dozing   2= moderate chance of dozing   3=high change of dozing


1. Sitting and reading

2. Watching television

3. Sitting inactive in a public place ( a theater or meeting)

4. As a passenger in the car for an hour without a break

5. lying down to rest in the afternoon

6. Sitting and talking to someone

7. Sitting quietly after lunch

8. In a car, while stopped in traffic


If you score a 10 or greater, check with your doctor for an evaluation. You may have a sleep disorder preventing your body from getting the good quality sleep it needs, not to mention making you cranky and overweight!


New scorpion antivenom drug approved by the FDA

The FDA approved this month for the first time ever a new antivenom, Anascorp, used to treat Centruroides scorpion stings. These scorpion stings are especially dangerous to kids and can cause blurred speech, blurry vision, difficulty swallowing,even fluid in the lungs leading to breathing problems. This drug makes history by being the first drug developed in Latin America (Mexico) and approved by the FDA.  It’s also the first drug approved by the FDA to treat this type of Scorpion sting.  Anascorp is made from the  plasma of horses immunized with scorpion venom.  98% of the children treated with this drug in clinical trials had their symptoms resolved in 4 hours or less.  This is a huge difference from the prior treatment which often involved keeping kids in the ICU for days!

Avoiding NSAID’s? Here’s a list of what to avoid.

While NSAID’s (Non-steroidal anti-inflammatory drugs) are excellent anti-inflammatory pain medications, they can have severe adverse side effects.  Some of these include kidney failure, GI tract/stomach bleeding, decreased platelets in your blood, liver damage, and high blood pressure. Many patients have been instructed to avoid anti-inflammatory drugs or NSAID’s but it’s important to recognize what medicines are actually NSAID’s. The common over the counter agents with NSAID’s are: Advil, Midol, Motrin, some types of Dayquil and Dimetapp and other cold and sinus medications,Aleve and Goody’s powder. But there are a lot more than that!  So, it’s important to check the ingredients in each medication you buy over the counter or the generic name for a prescription you are written to see if any of the following drugs are in them.   Here’s a list of what to look for:

Aspirin, Ibuprofen, Naproxen, Naprosyn, Ketoprofen, Flurbiprofen, Oxaprozin, Diclofenac, Etodolac, Tolmetin, Sulindac, Indomethacin, Toradol/Ketorolac, Meloxicam, Piroxicam, Meclofenamate, Nabumetone, Celecoxib/Celebrex

Finding trustworthy medical information online

Sometimes mass media medical reports feel just about this random. It seems like everyone is using Dr. Google to diagnose or treat their medical ailments; but, how do you find quality health information online?  Here are some accurate, authoritative online medical resources that are user friendly too…

1) www.mayoclinic.com

2) www.familydoctor.org – patient information from the American Academy of Family Physicians

3) MedlinePlus – great health information from the National Institutes of Health.  This site has video tutorials for lots of different medical procedures like an MRI.  So, you can check these out before your procedures to have an idea what it will be like.

Another tip for finding trustworthy medical information online is to use the Google “Advanced Search” option.  Click on “Advanced Search” to the right of the Google search bar at google.com.  On the next page, there will be an option to “search within a site or domain.”  If you enter .edu or .gov in this box, it will limit your search to more reputable sources than just anywhere on the world wide web.

Of course, nothing can take the place of asking in person your own doctor, but perhaps this will give you a place to start researching.  Good luck!

Note: Cartoon by Jim Borgman, first published by the Cincinnati Inquirer and King Features Syndicate 1997 Apr 27 and reprinted in the New York Times, 27 April 1997.

How to avoid weight gain when you quit smoking

One of the most common reasons I hear from patients regarding why they don’t want to quit smoking is a fear of gaining weight.  Since cigarette smoking is the #1 most avoidable cause of death in our society, quitting is crucial for your well-being.  Let’s examine what to do about the weight gain.  It is true that smokers who quit gain on average 5-8 lbs over the first year that they are no longer smoking.  Part of that is because some smokers replace a smoking addiction with a food addiction when they feel those cravings hit.  But, that’s not the only reason it happens.  Nicotine is the addictive substance in cigarettes.  It binds to nicotinic receptors in the brain and elsewhere in the body in just 11 seconds after you light up.  Nicotine is mostly a stimulant.  It increases your heart rate, cardiac output, blood pressure, and thus increases your overall metabolic rate (or how many calories your body burns).  The net effect of this is that on average a smoker’s body burns about an extra 200 calories a day.   So, when you stop smoking, you will stop burning through these 200 calories a day. ( Don’t forget- you’ll be healthier without artificially increasing your heart rate and blood pressure to burn those 200 calories.  That’s what makes heart attacks and strokes so common in smokers. )

When you quit, you need to have a plan in place for how to eliminate 200 calories a day from your diet or to get some extra activity to make up the difference.  There are 240 calories in one 20 ounce coke so eliminating just that 1 drink a day would do it.  The key is, have a plan for those 200 calories.

Call 1-800-QUITNOW for more help on how to quit smoking.