Medical Diagnosis Testing -Not Always Needed

MH900409552MH900432538You may often thought  do I really need all those tests – well finally medical professionals from 17 medical societies have addressed this issue.

They have identified tests and procedures that are likely unnecessary for the 26 medical specialties. Examples of unnecessary tests from the specific medical society include:

  American Academy of Pediatrics (AAP): Antibiotics for apparent viral respiratory illnesses such as sinusitis or bronchitis

American Academy of Neurology (AAN): Electroencephalography (EEG) for headaches

American Academy of Ophthalmology (AAO): Antibiotics for pink eye

American Society for Clinical Pathology (ASCP): Population-based screening for vitamin D deficiency

American Urological Association (AUA): Routine bone scans in men with a low risk of prostate cancer

Society of Hospital Medicine, Society of Nuclear Medicine and Molecular Imaging (SNMMI): PET/CT scans for cancer screening in healthy individuals.

The American College of Obstetricians and Gynecologists (ACOG), which is new to the list, recommended against performing annual Pap tests in women ages 30 to 65, since doing so offers no advantage over screening at 3-year intervals


Visit  for more information ‘Choosing Wisely’ 



Demodex Blepharitis (Demodicosis)

Simply put ‘Blepharitis’ means eyelid inflammation and ‘Demodex’ are tiny mites- hence eyelid inflammation due to mites = Demodicosis.

One of the most common causes of itchy eyelids (in 20% of the general population) is due to ‘mites’ on the eyelashes! Other symptoms include burning, foreign body sensation, crusting and redness of the lid margin, and blurry vision. Looks a lot like dandruff at the root of the eyelashes.

Sounds a bit nasty, but not to worry you can get rid of them! You will have to take steps to eradicate them. An easy action plan involves making an inexpensive solution, washing and then rinsing your lids. No fear it is not a prescription medication, but one you can make all you need is Tea Tree shampoo and Tea Tree oil (Trader Joes or you favorite health food store). Mix a handful of shampoo ( 2-3 oz.) with 20 drops of pure tea tree oil, paint the mixture on closed eyelid margins wait 45 seconds then rinse.


Mix a handful of shampoo ( 2-3 oz.) with 20 drops of pure tea tree oil, paint the mixture on closed eyelid margins wait 45 seconds then rinse. Apply this solution twice a day BE SURE to leave it on for 45 sec. (‘One-One Thousand, Two-One Thousand…45-one- thousand’) do this for 6-8 weeks. This length of time will insure that all the mites no matter where  in their life cycle are gone!

 TIP: use a squirt bottle filled with water and spray each closed eye with the eye down (turn neck) spraying from nose side out.

Huffing, Sniffing & Dusting

Alcohol lowers inhibitions and gives teenager’s courage and confidence that they may not have otherwise, often getting teens into trouble that they may have avoided if they had been sober. When using any product that allow for vapor inhalation expect rapid uptake with serious side effects. Examples include alcohol through a  “Vaportini”, computer cleaning duster, nail polish remover and butane. Well known is cocaine, glue and gasoline is worldwide. Often termed ‘huffing’, ‘sniffing’ (or glue sniffing), ‘dusting’ must be watched for in teens. Remember teens weigh less and will have quicker and more serious health side effects.

Social effects, cause teens to use inhalants or alcohol on a regular basis in order to cope with stressful situations. Once suspected or recognized the coping and emotional skills needed to protect against using drug ‘abuse’ as an easy coping solution. It everyone’s job to help!

Drunk on Alcohol Vapor

Listen Up – V_webpic_003The new way to consume alcohol. If you want to get the effects of alcohol faster or avoid the tell tail sign of consuming alcohol (breath odor), use a  “Vaportini”! A receptacle that allows heat from a candle (140º) to vaporize your alcohol drink so that the you can inhale and get alcohol into blood stream faster and more efficiently. More for less – since drinking alcohol results in only about 15% being absorbed into the blood.

A unique internet purchase –  “Vaportini” recommends only 1 oz. alcohol to be taken using this device.

Alcohol addiction and poisoning is very possible given its effects are much faster than drinking and less expensive.

Do not dismiss the potential for lung side effects. Alcohol is known for ‘denaturing’ tissue one of the causes of oral cancer.

Just wanted to give you all a ‘heads-up’ on new and possibly dangerous gimmicks.


Stroke-A Time Change for Care

MH900438746Guidelines were made 6 yrs. ago and now there is a consensus resulting in a new document for medical personnel with ‘21 new recommendations as well as 50 revisions’ of existing recommendations*. To give you an idea of the complexity of aggressive stroke care– another 42 recommendations remain unchanged. In the past many patients having a stroke were excluded from receiving a clot-buster, now many of these contraindications have been dropped. These include those with a minor stroke, a rapidly improving stroke, recent major surgery, or a recent heart attack. It was believed but now proven incorrect that patients with minor or improving stroke should not get clot-busters

EMS also needs to be ready to bypass hospitals that may not offer certain procedures, such as advanced CT or MRI imaging (which is recommended before intravenous (IV) clot buster – tPA  can be given)

As is so common in drug therapy progress – FDA has approved tPA to be given within a 3-hour window of symptom onset while in Europe, the clot-busting drug is approved for up to 4.5 hours.

Genentech, maker of tPA, asked the FDA to approve the drug for the extended 4.5-hour time frame and provided the agency with additional data. But the FDA last spring declined the request.

“For each minute the brain goes without blood flow, there are 1.9 million nerve cells that are dying, that affect 14 billion nerve connections and 7.5 miles worth of never fibers”.

Health care providers believe patients are eligible to receive tPA, within 4.5 hours of symptom onset.

“What this tells us is we should treat patients as quickly as possible to reduce the likelihood they will have disability from a stroke.”

*Jauch EC, et al “Guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association” Stroke 2013; 44; DOI: 10.1161/STR.0b013e318284056a.

Go Red – For Your Heart!

The 10th National Wear Red Day3D_vol_ren_of_LAD is Feb. 1, 2013 to bring awareness to heart disease in women.

More women than men have heart attacks! Heart disease is the No. 1 ‘killer’ in women more than all forms of cancer combined.  According to the American Heart Association (AHA)  ‘one in 31 American women dies from breast cancer each year, heart disease claims the lives of one in three. That’s roughly one death each minute’.

Here I go on my  ‘soapbox’:

Heart disease affects women of all ages.  Birth control pills and smoking boosts risk in young women by 20 percent. Yes risks do increase with age; things like obesity and/or inactive lifestyle contribute to clogged arteries later in life. Having high cholesterol and being thin is NOT a free ‘get of jail card’. The AHA recommends you start getting your cholesterol checked at age 20, or earlier, if your family has a history of heart disease. Also always watch your blood pressure readings.

Many women are either unaware of heart symptoms or may rationalize pains/aches as due to other causes. Examples for chest/arm, neck or jaw aches/pains include ‘my bra is too tight’, ‘I worked out too much’, ‘I over did it cleaning’. Some women experience dizziness, tiredness, lightheadedness or actually faint! Fainting without anything else is common elderly women. Know they all could be ‘screaming’ symptoms of a heart attack/disease. You do not have to have any symptoms over 60% of women who die suddenly from heart attacks NEVER had any symptoms! Yes it is possible they did have symptoms but either they themselves or their healthcare provider(s) ignored them. AGAIN women do not get the ‘classic’ chest pain described in medical books (based on studies of men).

For more listen to Doc Handal’s podcast channel –  ‘About A Woman’s Heart‘.

SO WEAR RED  ON Friday, FEB. 1 st.


Living Wills

 Do you have one? I suggest you do. Too often people confuse living wills with their personal wills, which describe how they want their assets distributed when they die. They’re completely different documents. A living will describes what type of medical and life-sustaining treatment you expect if you’re terminally ill or have been injured and your prognosis is poor AND you are unable to speak.

What efforts do you want the medical team to take to prolong your life? That’s the main question this document answers. In most cases, you don’t need a lawyer to prepare a living will.  Some hospitals and physicians provide information on how to prepare a living will. Or you can download a form off the web. Most states require someone to witness your signature. This document does not appoint someone to act on your behalf. That’s where the medical power of attorney steps in. Watch for DocHandal’s next blog.

As always Doc welcomes your comments!


Having Chest Pain-Is It Your Heart?

A few words on getting info across to Docs. Just watching the news can give you ‘agita’ (Italian slang for indigestion, so can your Aunt Sophie’s spicy casserole but intermittent chest pain (termed angina) can be caused by heart disease. Many use the term ‘pain’ others ‘discomfort’. It is important to decide if chest pain is caused by your esophagus in spasm, your stomach or your heart.

Most describe ‘angina’ (heart pain) as tightness, taking breath away, squeezing around chest. Many say they have a sense of ‘impending doom’. Others especially woman may describe a band around chest, indigestion or feeling faint. Elderly may just say they feel weak.

Not to miss/ignore Angina, describe to your Doc the pain/discomfort.

Pain is perceived differently. We are all unique hence our body talks to us in a different manner. By relating pain level to a past condition that was diagnosed (ex. broken bone, tooth abscess), your tolerance or lack of – to pain can be gauged.

Communication in a succinct, preferably written form, will help guarantee that your descriptions – the ‘what when where’ are heard. Be sure to mention if something relieved your pain.

It is up to you to try to get the best possible care.

Vitamin D

MH900409552The 1997 Dietary Reference Intake (DRI) values for vitamin D is too low, as are many of the recommendation from that year. Remember a vitamin is something your body needs but can not make. Emerging research supports the possible role of vitamin D in protecting against cancer, heart disease, fractures and falls, autoimmune diseases, influenza, type 2 diabetes, and depression.

Ultraviolet B rays from sun can allow our body to make Vitamin D from cholesterol! Need to get at least 15 minutes a day of direct sunlight, those of us that are dark skinned, obese or living north of the line from San Francisco to Philadelphia (latitude) need more sun exposure and/or Vit. D3 supplements. Most important function of this Vitamin is to maintain a balance in Calcium and Phosphorous -guessed it for bone health! Adults ages 50-70 were told to take 400 IU daily, but today a dose of over 1,000 IU is recommended.Doctors for a long time have been telling patients to take much more than the DRI. Number watchers believe over 1 billion people worldwide, (all ethnicities/ages), have a vitamin D deficiency. Very much a routine blood test, find out if you are deficient.