A forced retirement policy is illegal for most professions in the US. Fact, we aren’t ‘what’ we used to be! When should doctors retire? Fact, 1 in 4 physicans are over 65 and completed medical training over 35 years ago! Listen Up, as Doc Handal thinks out loud about this potentially life-threatening reality. What are should there be requirements? Who decides when a medical doctor needs to hang up the stethoscope. A podcast you must listen to, as you might be the first person to realize it’s time.
Can a woman’s fertility problem dependent on the clothes worn! Women that presented to an ‘in vitro fertility clinic’ in MA. were found to have chemicals of three clothing flame retardants by-products in their urine. The chemicals were:
– diphenyl phosphate (DPHP),
– bis(1,3-dichloro-2-propyl) phosphate (BDCIPP)
– isopropylphenyl phenyl phosphate (ip-PPP).
These chemicals are not bound so they are released into the air and dust and your body. It is known that not washing your hands several times a day especially before eating increases levels of chemical in your body.
Interestingly this study was not designed to look for this but an incidental finding in women average age 35 seeking fertility care.
BTW – Well known is the fact that many chemicals can disrupt normal hormone function including phthalates and pesticides.
The longer you sit the more you put your health at risk. In adults older than 45, who sit for more than 12.5 hours day (without more than 10 minutes walking) put all around health matters at tremendous risk. In a studied population (just shy of 8000 B/W) over 4 year study. Not just watching TV, lying around, sleeping combined with sitting greater than 12.5 hours in 24 has negative effects. Even if exercise is done for 30 minutes/day, body metabolism such as glucose (sugar) control was negatively impacted and risk for all causes death increases by 50%. An increase risk of 25% for heart problems results from sitting more than 12.5 hours a day so much. The study did not include people with high blood pressure and smokers.
Learn correct way to sit, do some fidgeting while sitting and use wearables to help remind you and improve your chances for a longer healthier life.
Advise: Stand when talking on phone, at lunch.
Every once and a while research is done to show if today’s health care is positively impacting patients outcome. Are outcomes better now in common medical conditions versus decades ago? Not so for:
^The rate of stroke deaths has changed. It had dropped 38% from 2000-2015 but the pattern since is decided up – 4% per year according to Robert Merritt, MA, a health scientist at the CDC. Hard to swallow, despite attention to prevention an increase in this debilitating result of vascular disease.
^In the past decade lots of advances occurred in preoperative cardiac care, BUT postoperatively suffering a myocardial infarction (MI) has been consistently linked to poor clinical outcomes.In a ‘cohort’ (a group of people with common statics) study* of just over 90,000 adults who underwent either open aortic surgery or bypass, this event after surgery was associated with a 3.62-fold to 11.77-fold increased odds of cardiac arrest and a 3-fold to 6.66-fold increased odds of mortality, researchers wrote online in JAMA Surgery*.
^ A building designed to be energy efficient and environmentally friendly is not therefore healthier for those who work or live there. A ‘green’ award to a housing remodel in Boston** was found to have nearly 100 chemicals that are of health concern. The building still emitted toxic substances that leech out and cause such medical problems as asthma and allergies– also furnishings and household chemicals brought in by residents add to the mix.
^ Life expectancy in the US grew 1% from 2010-2016. We are ranked 58th country for a life expectancy at age 78.8!***
*** Source CDC
+ A sniff test may soon be available to help identify if someone is at high risk for Parkinson’s disease! The 2004 Nobel Prize in Physiology went to scientists (Richard Axel and Linda B. Buck) who ID’ed 4-10,000 odors we can recognize. The nerve for human smell – olfactory nerve (cranial nerve-1 -CN1) contains 6–10 million receptor cells. Impressive! Parkinson’s is a neurodegenerative disease, the study* followed people for 9.8 years with poor ability to smell indicating in the short and intermediate term likelihood of developing the disease.
+ A new online therapy program** was developed to remedy insomnia but it incidentally helped to improve hallucinations and paranoia conditions.
**Source Reference: Lallukka T and Sivertsen B “Sleep improvement by internet-based cognitive behaviouraltherapy might help prevent mental health disorders” Lancet Psych 2017; DOI: 10.1016/S2215-0366(17)30360-7.
A breakthrough! A DNA test looking for EBV (Epstein Barr virus) in the blood can detect with 100% sensitivity and specificity a diagnosis of nasopharyngeal cancer. EBV is also known as herpesvirus 4 – the culprit in infectious ‘mono’. In China where 35 of 100,000 people develop this cancer a recent investigational study of 20,000 people identified individuals before they developed a visual painless neck mass. A simple blood test – liquid biopsy can make all the difference as by the time a mass can be seen the disease is already at Stage II (spread to right or left sides of throat and lymph node(s) or III (spread further to sinus and bones nearby).
FYI: In US incidence is 1/100,000
Do you want to be resuscitated? Who will decide your medical care when you are unconscious? If you can’t speak on your own behalf who is going to assist in all medical decisions? Medical staff look for a living will and or a medical power of attorney (MPA).
In the USA, 2 of 3 adults have completed advanced directives. Many older and seriously ill individuals have them but not all. Please read and consider completing for your self and your circle.
Living Will (think of as end of life care) specifies what exactly you want to be done should you become unresponsive ex. resuscitation (CPR), intubation (a tube placed) so machine can breathe for you, tube feeding. Such terms as ‘comfort only’, ‘limitations of treatment’, ‘direction to prolong life’ are found. In a living will you predetermine, if not medical staff will look for direction from family, even ex-wifes’, relatives. Will they just be guessing think you might want done. In addition, organ donation is an option to address.
In health care a MPA document names an individual to act, as your medical decision maker should you become incapacitated. This should be a person who knows you well, the person that you put in your contact list as your I.C.E. contact -In Case of Emergency. A person who knows your health conditions, medications, allergies, and your end of life wishes.
Pragmatically many states have combined both documents. In Arizona ‘The advanced directive registry’ is free to electronically file and store your medical directives. Please check in your state what resources are available to download and complete. Notarization is usually necessary.
Please explore this sample “Living Will’
Please let us doctors know what you want!
How do you get this the most common form of arthritis. Inflammation of joints from too much uric acid in your blood is excruciatingly painful. Listen to key factors about this condition from Doc Handal – as only she can distill the important elements. What is it? What to Do? How to prevent! Medication that can cause ‘the gout’.
At this point you have heard all mass media tout the benefits of alcohol from light to moderate regular intake. Based on article in Journal of the American College of Cardiology, online August 14,2017, it reports the results of a 8 yr. study of 333,000 adults.
Definitions: light drinker – less than 3 a week; moderate – more than 3 less 14 in men, less 7 in women; heavy – obviously greater; binge drinker 5 or more per day.
Findings: moderate drinkers are 20% less likely to die from any cause inc. cancer then those that abstain. Heavy drinkers and binge drinkers had in increased odds of dying compared to those who abstain. Cancers from breast, colorectal, oral are decreased.
This study is similar to large Chinese study findings.
Exactly how alcohol protects is not clear but it is intuitive that it may improve the health of your blood vessels by reducing inflammation and it is known to aid your ability to form blood clots, increase levels of good cholesterol, and promote antioxidant pathways.
Naturally regular activity, no smoking, weight control using dietary wisdom inc. Mediterranean diet.
Better odds are noted from years of light to moderate alcohol consumption. all physicians agree if you never drank age 60 is not time to start.
Some technology can lower medical costs and increasing the access to care. AI thru deep learning programing and building information paths algorithms so neural networks in computer can arrive at decisions. Inputed data is passed thru many transformations (linear and non linear) before an ‘output’ is generated. Popular with the media is ‘Watson’, IBM’s supercomputer working on best cancer treatment based on inputed condition/details of the patient. AI is at forefront, I have blogged in the past regarding this. Every medical speciality is exploring its use with Dermatologists and ophthalmologist at forefront.
Computers using artificial intelligence (AI) have equaled dermatologists in diagnosing skin cancer! AI has nearly matched retina specialists in recognizing diabetic retinopathy from fundus images. In a recent paper, researchers at Google used 9,963 images from 4,997 patients to train a computer to recognize diabetic retinopathy. The computer achieved 97.5% sensitivity and 93.4% specificity.
Impressive will Dr. AI come before self-driving cars?