Tuesday, June 29, 2010

Next blog posting will be July 6th due to the Holiday. Happy 4th!

The Wrong Treatment is Common in Children with Abdominal Pain

Dr. Ghasson Wahbeh, a gastroenterologist at the Seattle Children’s Hospital, made a strong point at a recent pediatric meeting about children with abdominal pain. Many are being treated with PPI drugs, like Prilosec, Nexium and Protonics. The children usually have functional bowel problems triggered by bacterial imbalance, allergies, reactions to medications, constipation, or other insults. PPI drugs are specific for GERD (gastro esophageal reflux). They are expensive and can cause side effects over time. Once you stop PPI drugs, acid secretion rebounds, giving the impression that the patient continues to need the drug. Nutritional treatments are effective in treating abdominal pain, but treatment over months might be required. Even if GERD is present, recent reports indicate that melatonin might be just as effective and much safer than PPI drugs.

See Family Practice News (click here), May 1, p. 41.

Thursday, June 24, 2010

Frequent Skin Exams Might Eliminate Fatalities from Malignant Melanoma

Dermatologist, Dr. Ronald N. Shore, reported his remarkable experience over a 17 year period in private practice. He visually examined the skin of all of his patients every six months, and biopsied the lesions that he felt were suspicious. He found several melanomas but all were of such recent onset that they were curable. Looking through the scientific literature, Dr. Shore found two other papers in prominent journals with the same findings. This is remarkable because malignant melanoma can be a deadly cancer, especially in its nodular form. Its incidence is rising, presumably related to sun exposure in the past. Your family doctor could very likely get the same results with frequent examinations. Just ask.

See Family Practice News(click here), May 1, p. 26.

Wednesday, June 23, 2010

Most Patients Who Get Heart Attacks are Considered Low Risk

A 2003 article in the British Medical Journal clearly showed that 60% of patients who had heart attacks were considered low risk by the famous Framingham criteria. In fact almost 2/3 of cardiac events occurred in patients with low to intermediate risk. About 10% of those who are considered low risk have abnormal ankle/brachial blood pressure ratios. This is an easy and cheap test for peripheral artery disease that should be offered in most family practice offices, according to a JAMA article in 2008. Those who have abnormal peripheral circulation should now be considered at higher risk for heart attacks. Ask your doctor for A/B ratio for circulation problems.

See Family Practice News(click here), May 1, p. 15.

Thursday, June 17, 2010

Inflammation Anywhere Might Increase the Risk of Cardiovascular Disease

A 10-year Danish study reported that the more severe the inflammation from psoriasis, the higher the risk of cardiovascular disease. Similar studies have linked Rheumatoid arthritis with heart disease. I wonder if we should have Inflammation Clinics, that treat inflammation regardless of the cause. Especially if we can quiet inflammation with natural treatments that do not have side effects, we will likely improve circulation and immunity, which are crucial factors in most chronic degenerative diseases. This sounds like getting more toward controlling the basic mechanisms of disease rather than treating just the symptoms, along with the side effects that the drugs often contribute.

See Family Practice News, (click here)May 1, 2010, p. 14 referencing a poster presentation at the American College of Cardiology spring meeting, 2010.

Wednesday, June 16, 2010

Excess Salt Consumption is a Major Public Health Problem

Jane E. Henney, chair of an Institute of Medicine issued a strong report in April, 2010 identifying excessive salt consumption as a major cause of hypertension, strokes, and heart attacks. Whereas the maximum amount recommended per day is 1500 mg for most people, men consume about 3X that amount and women and children consume about twice that much. School lunches, restaurant food, especially fast food, snacks, and processed food (even frozen vegetables) are major culprits. The FDA, the NIH, HHS, and the Centers for Disease Control all plan to take action on the IOM report, which was commissioned by Congress. Aggressive action might save 100,000 lives and billions of health care dollars each year. Start now to reduce your salt intake. It really makes a difference.

See the Institute of Medicine Report, April, 2010.(click here)

Thursday, June 10, 2010

Blood Pressure Variability is a Dangerous Risk Factor

A massive study in London (ASCOT) was reported at the spring meeting of the American College of Cardiology, indicating that blood pressure that varied a lot from visit to visit was more dangerous than consistently high BP. Patients were not previously thought to be at as high risk if their BP was down to normal levels at least a good portion of the time. Not so. The risk for labile BP that goes up and down is 4X as high for strokes and 3X as high for heart attacks. Calcium channel blocking agents had the most consistently good results. Although not tested, extra magnesium might be effective as well, because of a similar mechanism of action.

See Family Practice News (click here) May 1, 2010, p. 1.

Tuesday, June 8, 2010

Family Docs Not Skilled in Weight Loss Techniques

Patients want information on weight loss, but physicians say they don’t have enough training, according to a Family Practice News article in April. This was based on a survey by Harris Interactive. Many patients can lose weight by increasing exercise and reducing calories. A lower carb diet has been shown to be successful for more people than other diets. Some people do not lose a significant amount of weight, when they cut back on food and increase exercise. Some of these have food allergies that hold weight on their bodies. Others slow their metabolism when they cut back on food. Not infrequently, the latter group has a metabolic problem such as not enough thyroid or an imbalance of neurotransmitters or hormones. HCG injections are not approved for weight loss, but many who are having difficulty find them very helpful. Appetite suppressants are not very helpful because they are temporary, and the pounds are usually regained fairly soon.

See Family Practice News(click here), April 1, 2010, p. 5.

Thursday, June 3, 2010

Family Practice on the Upswing

Family Practice News reported that there was a 9% increase in Family Practice residency matches this spring. 91% of residencies were filled, 45% by US graduates. The health care reform law provides incentives for family practice, including fee increases. There also will be a need for significantly more family physicians because of more people having insurance. I attended a seminar in Los Angles in April by the NCQA about becoming a Medical Home. The Medical Home puts family docs at the head of health care teams that all work together for the benefit of the patient. Conventional evidenced-based care is offered, but patients have the right to choose the type of care they want, including alternative medicine. Medical home certification is accepted by medical boards as the highest quality of family practice. We will apply for certification this summer.

See Family Practice News (click here), April 1, 2010, p. 2.

Wednesday, June 2, 2010

Chelation Therapy and Cardiovascular Disease

The Townsend Letter’s May, 2010 special issue is devoted to cardiovascular disease. John Parks Trowbridge, Garry Gordon, Majid Ali, Robert Rowen, and myself all had articles about the benefits of chelation therapy. Jonathan Wright discussed the great benefits of using salt with potassium, magnesium and lysine added in Finland. Stephen Sinatra highlighted the awesome foursome of CoQ10, l-carnitine, magnesium, and d-ribose to enhance ATP production in heart muscle. I am pleased to be in such esteemed company for a very worthwhile project.

You can order the issue for $7.50 at the Townsend Letter (click here) or call 360-385-6021.