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Are you taking your medications? Do you smoke? How much do you drink? Do you have risky sex? Is there heart disease in your family? We’ve all heard these questions before — every time we visit the doctor.

If you’re like most of us (about 70 percent, according to some estimates), we don’t answer truthfully. It’s no big deal though, right? Plenty of patients want to skirt a scolding about how bad it is to smoke, drink or eat crappy fried food. We don’t want to be embarrassed by describing our symptoms. Fibbing on the exam table might not seem like a big deal, but it is, and it’s dangerous.

Remember, the doctor isn’t there to berate you, she’s there to treat you. Doctors need to know the truth so they can have a clear picture of your health. Here are a few lies commonly we tell our doctors:

Lie # 1: I don’t smoke.

Jane smokes occasionally, maybe one or two cigarettes a week. She’s read that it’s the heavy smokers who are at increased risk for cancer and heart disease. So, to avoid a lecture from her doctor, she tells her she never smokes. What Jane doesn’t realize is that smoking just one cigarette a week can have deadly consequences for her. Because she’s on birth control pills, smoking increases Jane’s risk of serious blood clots and stroke. If the doctor knew the truth, he would strongly encourage her to stop smoking, or suggest she switch to another form of birth control.

This is the most common lie doctors hear. Not only is this one bad for your health, it prevents your doctor from being able to treat you properly.

Lie # 2: I rarely drink

Bob doesn’t drink all week, but watch out for the weekends! That’s when he really gets going. But, because Bob doesn’t want his doctor to think he’s an alcoholic, he tells him he doesn’t drink at all. On a recent visit to his doctor, Bob told him he was depressed; he and his wife had been fighting a lot. His doc prescribed a type of anti-depressant known as a SSRI (selective serotonin reuptake inhibitor).

Bob’s doctor probably would have selected another type of antidepressant, or suggested counseling, if he only knew the truth about Bob’s drinking. You see, alcohol is incompatible with SSRIs. Drinking not only counteracts the benefits of antidepressants, it can also result in short term memory loss, confusion, hyperventilation, coma and death.

It’s amazing how many of us are teetotalers as soon as we enter the doctor’s office. This is especially surprising given that about 70 percent of us drink occasionally and one out of six binge drink, like Bob. Many classes of prescription medications can negatively interact with alcohol, including antibiotics, antidepressants, antihistamines, barbiturates, benzodiazepines, histamine H2 receptor antagonists, muscle relaxants, nonnarcotic pain medications and anti-inflammatory agents, opioids and warfarin. In addition, many over-the-counter and herbal medications can be life threatening when taken with alcohol.

Lie # 3: I take all of my medications.

Harold’s doctor didn’t understand why his cholesterol levels remained elevated after prescribing a cholesterol-lowering statin at his last visit; Harold told him he was taking the pills. Little did he know that Harold never even filled his prescription because it was too expensive and he didn’t have health insurance.

If his doctor only knew the truth, he may have prescribed a cheaper, generic medication. Instead, Harold leaves the office with a prescription for a higher dose of the same expensive medication that he never fills. His blood pressure remains elevated increasing his risk for heart disease, kidney disease and stroke.

You shouldn’t stop taking you medications for any reason without telling your doctor. If you lie to him, he may mistakenly believe that his clinical judgment was wrong and proceed on a different course of action that could be detrimental to your health. If you stopped taking your meds because of bad side effects, your doctor can prescribe a different medication with fewer side effects.

Lie # 4: I only take the drugs I’m prescribed.

David went to the doctor for his annual exam. The doctor was surprised that his blood pressure was elevated because, up until now, it had been under control with medication. What the doctor didn’t know was that David started taking the herb ginseng because his buddies told him that it increased mental awareness and boosted sexual performance (although he took it mainly for the sexual side effects). However, what David didn’t know was ginseng can elevate blood pressure, counteracting the effect of his hypertensive medication. Without the right information, David’s doctor is left in the dark about what to do next.

Lie # 5: I feel fine.

Barbara went to the doctor for her annual physical. She told her that there was nothing new since her last exam, which was a lie. If truth be told, she would have said that she had been experiencing shortness of breath and pain in her left arm and jaw for the past month. Barbara suspected something was wrong with her heart, especially since her dad, brother and sister had heart disease at a young age (which she also neglected to tell her doctor).

But she was in denial — heart disease wasn’t going to happen to her. Not knowing her symptoms, her doctor didn’t perform the right tests to detect heart problems and sent her on her way. A few days later, she suffered a heart attack. Lying to your doctor about your symptoms and family medical history is a surefire way to sabotage your overall health down the road.

I think you get the idea that lying to our doctors won’t make our illnesses or symptoms disappear. Indeed, quite the opposite — things will only get worse.

By lying, we loose the opportunity to prevent a bad outcome. If we’re really serious about our health, honesty is the best policy.

[Photo By bryanrmason]

By Jeffrey Kreisberg

I bet you’re like me and didn’t know that, in 2004, the Surgeon General declared Thanksgiving “National Family Medical History Day.”

The purpose of this new “holiday” was to encourage families to talk about and write down known, genetic health problems. Learning about your family’s health history is one sure way to help ensure a longer, healthier future together.

A recent survey found that 96 percent of Americans believe that knowing their family history is important. If it’s so important, why have only one-third of us has ever tried to gather our health history?

We may have missed Thanksgiving, but with family gathering events like Easter and Passover right around the corner, I thought it was important to review why discussing our medical histories is important:

1. If your doctor is trying to match your symptoms with a possible disease, knowledge of existing genetic disposition might help them pinpoint the problem.
2. Many diseases can be passed along to our children due to our genetic make-up (vulnerability due to genetic make-up). Knowing you’re more susceptible can help you prevent (or monitor symptoms of) various illnesses.

Doctors have known for a long time that common diseases like heart disease, cancer (think about the BRCA gene mutation in breast cancer) and diabetes, as well rare diseases like hemophilia, cystic fibrosis and sickle cell anemia, can run in families. If one generation of a family has high blood pressure, it is not unusual for the next generation to have similarly high blood pressure.

Tracing the illnesses suffered by your parents, grandparents and other blood relatives can help your doctor predict the disorders you may be at risk for, so you can take action before it’s too late. For instance, you might be more compelled to control your high blood pressure before it causes a stroke or kills your kidneys.

This is called preventive medicine, and it cannot be successfully accomplished unless you know your family medical history.

To help focus our attention on the importance of family history, the Surgeon General, in cooperation with other agencies within the U.S. Department of Health and Human Services, has created an online tool to help us create a portrait of our family’s health.

At the next family gathering, please go to this website and organize your family medical history and share it with your healthcare providers. It’s an easy way to make sure all of us continue to lead a healthy, and long, life.

[Photo By melanerpist]

The prevalence of obesity in United States children has reached epidemic proportions. The most recent national estimates suggest that the prevalence of at-risk-for-overweight continues to remain alarmingly high, with no signs of decreasing. Currently, 31.0% of children 6 to 11 years of age are estimated to be at-risk-for-overweight or obesity, and 16.0% are estimated to be overweight. From a public health perspective, childhood obesity is also particularly concerning because it has been documented that obesity in childhood tracks into adulthood and leads to premature death.

The current obesity epidemic is even more pronounced in minority children and children with low socioeconomic status, likely the result of poor food choices and decreased opportunity for physical activity.

One of the challenges when combating obesity in low-income neighborhoods is that the urban environment can discourage children from being active. According to the advocacy group Transportation Alternatives, which has long been concerned with the character of New York’s streets, high crime rates and heavy truck traffic often make such streets unsuitable for play. Local parks too often lack simple amenities like spray showers.

More generally, the habits born of living in these environments can create a vicious cycle in which children become more and more accustomed to staying inside and watching TV or playing video games. New York City is now doing something to promote physical activity in some of its most disadvantaged neighborhoods.

During a two-month period last year, seven civic coalitions in New York neighborhoods like East Harlem and the South Bronx got permits from the city to close certain local streets to traffic for designated periods of time. Working with the police and other city agencies, they re-designated the areas as temporary “play streets,” encouraging neighborhood children to use them for exercise and offering a range of free games, athletic activities and coaching.

They call them “pop-up” playgrounds.

Data collected from the sites indicates that families visited local play streets for one to two and a half hours on average — time that many would have otherwise spent inside, according to a majority of the parents surveyed. This was a resounding success!

Encouraged by last year’s results this summer the city is running 12 pop-up playgrounds, which offer instruction in activities as varied as yoga, running, tennis, rugby and jump-rope. All the sites are in low-income neighborhoods with high rates of childhood obesity.

Hopefully this idea will be implemented in urban communities across the country. Julia De Martini Day, who works on health issues for Transportation Alternatives, says that a new survey this year aims to link the success of the play streets to campaigns to pressure lawmakers to make land-use changes in these neighborhoods, be they better street lighting, more park benches, designated bike lanes — or even permanent play streets.

Get involved in your community to encourage physical activity. Contact Transportation Alternatives for more information. Healthy habits can become a vicious cycle that will lead to healthy lifestyles.

[Photo By stevendepolo]

As many serious medical errors happen in the outpatient setting (doctors’ offices) as in hospitals.

Invasive and high-technology diagnostic and therapeutic procedures are increasingly being performed in the outpatient setting so researchers decided to compare the number and seriousness of adverse events in inpatient and outpatient settings, as reflected by malpractice claims. And, to the researchers surprise the numbers are pretty much the same.

In 2009, the last year of the study, there were 4,910 payments due to inpatient errors, 4,448 due to outpatient errors, and 966 involving both settings. Together, these payments were worth more than $3.3 billion. And these weren’t trivial errors — death and major injuries were the most common reason for malpractice claims.

The researchers said the most common errors were different across the two settings, with surgical mistakes dominating the claims for hospitalized patients and misdiagnosis being the biggest problem at the doctor’s office. The problem in the outpatient setting is that rigorous, effective programs for controlling the risk of errors don’t exist right now.

Misdiagnosis, on the other hand, can be largely prevented if we take control of our healthcare. You see, misdiagnosis is often the result of poor doctor-patient communication. Approximately 15% of all patients are misdiagnosed, which results in serious harm to about half of them.

In Dr. Jerome Groopman’s book, “How Doctors Think,” he writes that most doctor errors are due to mistakes in their thinking. Doctors can make mistakes because of snap judgements based on the first symptom, physical finding, or lab value, or by stereotyping or categorizing patients’ symptoms.

Therefore, it is very important to provide your doctor with all the information she needs to make an accurate diagnosis — no holding back — and, to ask the right questions so she can focus her attention on you! Some of these questions include:

• What is my diagnosis, and what does it mean?
• What else could my diagnosis be?
• Could there be more than one thing going on to explain my symptoms?
• Is there anything in my history, physical exam, or test results that does not fit your diagnosis?
• How serious is my diagnosis?

Additionally, patients can help lower the chance that their doctor will make a mistake by learning about the tests and medications they get, and keeping their doctor up to speed about what’s happening to them between visits. “I do hope that patients will realize that it’s important to take control of what happens in their healthcare,” one researcher said. It’s the best way to stay safe.

[Photo By Rosmary]

If I told you that, every year, about the same number of women under the age of 55 die from heart attacks as from breast cancer, would you be surprised?

If you are, you’re not alone; most women and many of the doctors who care for them are clueless that a woman’s heart can pose such a huge health risk. Young women with heart disease account for nearly 40,000 hospitalizations and 16,000 deaths each year — ranking it as the leading cause of death in this age group. Overall, one in four women die from cardiovascular disease, compared to one in 30 from breast cancer. But I haven’t seen any ribbons or car magnets highlighting this cause.

If you have a family history of heart disease, if you smoke, have high blood pressure, high blood cholesterol levels,  or diabetes, or if you are obese, you are at increased risk for heart attack. Also, if you have had pre-eclampsia during pregnancy, your chance of a heart attack more than doubles later in life.

Heart attacks don’t just happen to post-menopausal women. Women in their 30s and 40s are increasingly developing heart disease, so be on the lookout for these risk factors and get screened and treated. Also, many physicians fail to recognize the importance of these risk factors in young people, so we, as patients, must be proactive when it comes to our health. The longer these risk factors wreak havoc on our bodies, the worse our heart and vascular health will be.

Have your blood pressure checked every two years, beginning at 18 years of age. High blood pressure is 140/90 or higher and, if left untreated, can cause stroke, heart attack, kidney and eye problems and heart failure. Know your numbers! Blood pressure can be managed with medications.

And, beginning at age 20, have your cholesterol checked regularly if:

• You use tobacco.
• You are obese.
• You have diabetes or high blood pressure.
• You have a personal history of heart disease or blocked arteries.
• A man in your family had a heart attack before age 50 or a woman, before age 60.

High cholesterol can be managed by lifestyle changes, like eating healthier and exercise, or medication.

Be aware of the symptoms of a heart attack. Many of us expect the stereotypical signs: clutching chest, gasping for air and screaming out in pain while dropping to a knee. Although chest pain is the most common symptom of heart attack, women are more likely than men to experience other symptoms such as shortness of breath, unusual fatigue, abdominal discomfort, nausea and pain in the back or jaw. Patients and doctors sometimes mistake these symptoms as panic attacks, fatigue, sweating, indigestion and over-exertion and often wait until it’s too late to get treatment. Because of this, twice as many women than men die in the hospital following a heart attack.

Many women don’t seek treatment with these symptoms because they question whether they’re real, or they are embarrassed by their symptoms, they are not taken seriously by their doctor, they don’t have the time due to family demands or they fear they’re symptoms are real and don’t want to know they have a life-threatening condition.

These symptoms won’t just go away on their own. You know best when you’re not feeling well, so listen to your body and get the proper treatment. Ignoring them may cost you your life.

[Photo By Yampy Yankee High Dynamic Ranger]

As many as 50 to 60 million Americans could get the flu this season, resulting in 200,000 hospitalizations and 30,000 deaths.This makes flu, an illness often and mistakenly regarded as a slight step above the common cold, the seventh leading cause of death in the USA.

The best way to prevent the deadly disease is by getting a flu shot each year. Although careful attention must go to high risk groups—people over 50, the very young (under two), pregnant women, and people with chronic conditions—the CDC recommends that everyone six months of age and older be vaccinated.

Many people are also worried that the vaccine contains toxic chemicals, like mercury. Concerns about mercury have revolved around a preservative called thimerosal, once commonly used in vaccines but generally phased out of use since 2001. Today, no thimerosal is added to FluMist nasal spray, or to flu shots from single-dose containers.

In the United States, flu season occurs in the fall and winter. It is caused by influenza viruses that infect the respiratory tract—the nose, throat, and lungs. The peak of flu season occurs anywhere from late November through March. Unlike many other viral respiratory infections, such as the common cold, the flu can cause severe illness and life-threatening complications in many people. The flu virus is highly contagious—it is passed on by coughing up or sneezing the virus onto someone or by direct contact, such as kissing or sharing kitchen utensils. The typical incubation period for the flu is one to four days. Adults can be contagious from the day before symptoms begin through five to 10 days after the illness starts.

The CDC reports that approximately 20,000 children are hospitalized in the United States annually with complications of the flu. For the overwhelming majority of children who come down with influenza, it is an uncomplicated viral infection that resolves in three to seven days. While doctors know that children with chronic illnesses, such as asthma, heart disease, cerebral palsy or mental disabilities, are at increased risk for complications and death arising from the flu, some healthy children also develop flu complications and even die. The problem is, we cannot predict which children will have such an extreme reaction, and, hence, the recommendation is that all children over six months be vaccinated.

Despite the overwhelming evidence that flu vaccines save lives and reduce healthcare costs, only 30% of Americans are getting the shot. It’s unbelievable that so many of us turn our backs on disease prevention. (No wonder our healthcare costs are so high!) Put it this way: if you don’t care about your own health, how about your infant son, grandson, pregnant wife or immuno-suppressed co-worker?

Another common excuse for not getting the vaccinated is, “I didn’t know I needed it.” Huh? You can’t go into a grocery store or pharmacy without seeing a sign reminding you to get the flu shot, and many stores even offer incentives, like 10% off groceries if you get the shot.

Do the right thing for yourself, your family and your community: get the flu shot. It may save your life—or the life of someone you love.

Please stop with the excuses! No, you can’t get the flu from the vaccine. It’s not just a bad cold—a bad cold doesn’t send you to the hospital. And, the flu shot is not just for the sickly. Actually, the most vulnerable members of society, such as newborns or those with weak immune systems, often can’t get flu shots. The only way to protect them is to vaccinate everyone around them, keeping flu viruses out of circulation.

[Photo By itsv]

By Jeff Kreisberg

It is crystal clear to me that PSA is not a good test to screen asymptomatic men for prostate cancer. Although it has been used as a screening tool in the US for more than 2 decades, it wasn’t until 2009 that the results of a clinical trial, called the PLCO trial, revealed that it does not save lives from prostate cancer.

Some symptoms of prostate cancer include:

• Trouble urinating
• Decreased force in the stream of urine
• Blood in your urine
• Blood in your semen
• Swelling in your legs
• Discomfort in the pelvic area
• Bone pain

We in the medial community waited decades for this study and what did the urology community recommend based on it? They now recommend dropping the age to begin screening from 50 to 40! They ignored their own study and pointed to a european study that showed a small statistically significant increase in survival with PSA screening. It was so small, that the European medical community did not recommend screening!

Screening men without symptoms with PSA has always been and continues to be controversial in the medical community, with the prestigious American Cancer Society withholding its recommendation of this test

Remember, an elevated PSA is not diagnostic of prostate cancer! An elevated PSA just starts a cascade of tests and procedures to determine whether cancer is present. If 100 men had their PSA measured, 15 will found to have elevated levels. Further testing of those 15 men would reveal that only 3 have cancer. Men have an overall 16% chance of being diagnosed with prostate cancer in their lifetime, but only a 4% chance of dying from the disease.

PSA was originally intended to be used as a tool to detect prostate cancer recurrence. Following prostatectomy after cancer diagnosis, men would be followed with periodic PSA screening. When the prostate is surgically removed (prostatectomy) PSA would be zero (because PSA is a protein that is primarily found in the prostate), but if PSA was detected it meant that the cancer had returned.

Urologists turned it into a screening test for men with no symptoms of prostate cancer.

The best thing tom do is to follow the recommendations by the USPSTF that PSA testing on asymptomatic should be done only after you have all the information you need from your doctor to make an informed decision. Namely, 1. Understand that PSA is not diagnostic of prostate cancer. 2. If you have an elevated PSA you will need a biopsy which has it’s own complications. 3. If you are diagnosed with cancer you will have to choose a treatment option which could have serious side effects for a cancer that probably wouldn’t have resulted in your death. Such side effects include, among other things, erectile dysfunction and incontinence.

You will probably have to initiate a conversation about PSA screening with your doctor because its the family care physician who usually orders the test without even telling the patient. He just draws your blood and checks off PSA on the list of lab tests without thinking twice about it. Speak up! Once the test is drawn you’re on the PSA train and there’s no going back.

If you do go ahead with PSA screening and are subsequently diagnosed with prostate cancer, get a second opinion. If the pathologist doesn’t see enough prostate cancers where it has become routine in his practice, he may not have the experience to make an accurate diagnosis. Also, if the diagnosis is confirmed and you decide to go ahead with treatment be sure your doctor has done the procedure hundreds of times. For example, that it takes at least 250 prostatectomies for a urologist to be an expert.

Get involved with your care so you don’t have any regrets later on!

[Photo By Horia Varlan]

By Jeff Kreisberg

Earlier this week National Heart, Lung and Blood Institute issued new guidelines for testing cholesterol levels in children. They recommended all children ages 9 to 11 should be screened at least once for high cholesterol.

The new recommendations were spurred by the increase in childhood obesity which is accompanied by high cholesterol and heart disease later in life. The early testing is intended to prevent heart disease in adulthood-children don’t have heart attacks.

This recommendation makes no sense to me, because unless the kids have a genetic predisposition to high cholesterol — such as familial hyperlipidemia — we’re not going to put children on cholesterol-lowering medicines, are we? We’re going to tell their parents that their kids need to loose weight-why do we need cholesterol levels to do this. Fat kids leads to fat adults which results in hear disease and diabetes.

What we should be doing instead of measuring cholesterol is promoting lifestyle changes to reduce childhood obesity. A study published this week in the New England Journal of Medicine reported that obese children who lost weight as adults lowered their risk of heart disease and diabetes to the levels observed in adults who never had problems with their weight.The key is a healthy lifestyle. Reduce calories consumed and increase calories expended!

So, if we can all get on the same page and, for example, serve children healthier school lunches (which our congressmen don’t believe they deserve since they rejected a proposal by the Department of Agriculture to replace starchy foods on school lunch menus with fruits and vegetables), and make sure they exercise 30 minutes a day, they’ll stay healthy and not be at increased risk for developing heart disease later in life.

There’s no magic pill to replace living a healthy lifestyle.

[Photo By Gilabrand]

The department of housing and urban development announced that when women were relocated from the projects to wealthier neighborhoods the incidence of obesity and diabetes was significantly reduced. This is a no brainer.

There are 5 determinants of overall health: personal behavior, social factors, healthcare, and the environment. Among the 5, inadequate healthcare accounts for only 10% of premature deaths, yet healthcare receives the greatest share of our resources and attention (Schroeder S. NEJM 357:1321, 2007). Behavioral factors of health include, smoking, obesity and inactivity, alcohol, and motor vehicle incidents, among others. It is the largest determinant of health and greatest contributor to premature death (accounting for nearly one million premature deaths per year).

Not surprisingly,the people who suffer the most, are the poor. Because of less access to better choices of food and recreational activities they suffer from increased rates of obesity, diabetes, and cancer, poor environmental conditions, and inadequate access to healthcare. The poor are easily forgotten and there are not many advocacy groups taking up their cause for better health.

Many Americans believe it is not their problem-people should be responsible for their own behavior. However, I’m sure poor folks didn’t ask to be born into poverty. Poverty is a breeding ground for nutrition-related diseases such as heart disease and diabetes and is a significant risk factor for Alzheimer’s disease and certain cancers.

There are some states that are tackling the problem of poor nutrition. You see, low income neighborhoods do not even have access to fresh fruits and vegetables because there aren’t any supermarket grocery stores in these neighborhoods. They rely on convenience stores and foods high in fat, sodium and sugar which result in premature death from diet-related illnesses.

Thanks to the Council of State Governments some states have passed legislation to increase the number of supermarkets in underserved areas. For example, in Pennsylvania 50 supermarket projects have opened across the state to serve poor neighborhoods. This is part of the Fresh Food Financing Initiative that was funded in Pennsylvania in 2004.

It appears that only when the problems of the poor become the problems of the middle class do we take notice and act. Now with healthcare reform underway let’s shift our focus to promoting good health. With health as our goal, we will decrease our healthcare costs and provide happier and healthier lives to all Americans. We must all put our prejudices aside and work to hard to achieve this goal.

[Photo By povertyinitiative]

If current trends continue, about 50 percent of Americans will be obese by 2030, according to a new study.

This would increase the total number of obese people in the country from 99 million to 164 million, the study said. Such a rise would hike up health care costs— an additional $66 billion per year would be spent on obesity-related diseases, the researchers said. Spending would increase by 13 to 16 percent per year over the two decades.

This level of obesity would mean 7.8 million more cases of diabetes, along with 6.8 million cases of coronary heart disease and stroke, and 539,000 more cancer cases than what would be expected if obesity remained at its current level.

Yesterday the CDC came out with a report that says drinking too much soda is a major contributor to obesity. The numbers they reported are staggering:

• About half of the population drinks a sugared beverage evey day.
• On average, males ages 12 to 19 drink the equivalent of nearly two cans of soda each day.
• Low-income adults get about 9 percent of their daily calories from sugary beverages; compared to high income adults which is 4 percent.
• Blacks and Latinos get more of their calories from sweetened beverages than other racial and ethnic groups.

Soda consumption is associated with the presence of sodas in school vending machines, as well as fast food consumption. Greater fast food consumption is tragically associated with eating fewer healthy fruits and vegetables.

Communities that have banned vending machines that sell sugary beverages from their schools have observed less obesity and better consumption of healthier foods.

Parents, be proactive and be sure to limit your child’s consumption of soda! It winds up leading to poor eating habits across the food spectra and obesity soon follows. Work with your communities to ban sodas from schools. Don’t give in to pressures from the beverage companies who are fighting tooth and nail to preven this from happening.

[Photo By AJamison]

Cancer is expensive — the American Cancer Society estimates that the 2010 total cost of cancer in the U.S. soared to $263.8 billion (The Huffington Post Oct 12, 2011). Along with these costs can come financial ruin.

A Fred Hutchinson Cancer Research Center study showed that cancer patients were twice as likely as the general population to go bankrupt a year after their cancer diagnosis, with many people going bankrupt two and a half years after they were diagnosed with cancer.

“Patients diagnosed with cancer may face significant financial stress due to income loss and out-of-pocket costs associated with their treatment,” study researcher Dr. Scott Ramsey, a health-care economist at the cancer research center, said in a statement. He added that on average, the rate of bankruptcy went up four times within five years after being diagnosed with cancer.

Ramsey and his colleagues used data from 232,000 people with cancer between 1995 and 2009, and found that 1.9 percent of those people declared bankruptcy, compared with 0.28 percent of the general population.

Researchers found that age affected bankruptcy risk, with people overage 65 (and usually on Medicare) being less likely to go bankrupt than younger people.

Another study by the Agency for Healthcare Research and Quality estimated that between 2001 and 2008, 13.4 percent of adults younger than 65 who had cancer spent more than 20 percent of their income on health care, including premiums. That compared with 9.7 percent of people with other chronic conditions and just 4.4 percent of those with no chronic conditions.

Life saving treatments shouldn’t lead to financial ruin. You have enough to worry about. Personally, I do not understand, outside of the greed to make as much money as possible, why it’s so expensive? Taxpayer dollars fund many of the discoveries that led to these treatments and 10% of the NIH budget (taxpayer $$) goes to fund clinical trials to test the therapies. We’re paying for something we already paid for!

This is what happens with a profit-driven healthcare system. This is one big reason we need Medicare for all!

[Photo By Taking Control of Your Healthcare]

Okay, parents, let’s be honest. How many of you buy the candy you like for the trick-or- treaters? What’s your favorite? Three Musketeers? Mounds? Gummies? For me it’s the Candy Corn and Snickers. If you’re honest with yourself, you choose your favorites because you know you’re getting the leftovers.

I would eat hundreds of candy corns, many of them before Halloween even arrived and I would dig out my favorites from the kids stash when they went bed. The next day the kids would go right to their bags of candy and ask who took my candy? I told them, “the candy fairy.” That was when they were young and naive. By the time they got to the second grade they knew better and hid their candy from daddy.

I was happy to learn that I wasn’t alone in my gluttony. 71% of parents admit to behaving the same way — the other 29% were most likely lying!

Okay, so we have two problems, how to limit the amount of candy the kiddies eat so they don’t rot their teeth out and daddies don’t gain five pounds over Halloween? Remember, it’s all about moderation! If you limit the amount you eat to say one or two pieces a day for a few of days, everything should be fine.

Not to put a damper on the most popular holiday of the year, but too much candy may result in hyperactivity, weight gain, tooth decay, chipped teeth or damaged braces. I had to say this, because, after all this is supposed to be a column on health!

So, what do you do with the rest of the loot? Here are some suggestions I came across:

• Exchange candy for coupons the kids can use to “purchase” a trip to the zoo, to exchange for more story time, buy a video or do some other favorite activity.
• Some dentists are buying candy from kids to send to the troops overseas; ask your dentist about this.
• If your kids are very young you can help them box up the leftovers for the “candy fairy” and toss it in the garbage when they go to bed :-)

If you eat in moderation everyone will have fun and stay healthy.  Just remember to give your child’s teeth a good brushing! And,

Happy Halloween!

References:

• http://www.ivillage.com/parents-buy-eat-kids-halloween-candy/8-a-395723

[Photo By respres]

If we have any hope of our children living longer and healthier lives than us, we must do something about childhood obesity. One in three children are obese and obese children are likely to be obese adults, with chronic diseases like diabetes and at risk of dying ten years or more before their time is up!

Food as a reward is a tradition we must break now!

Using food as a reward for good behavior, good test scores, as a soother of hurt feelings and skinned knees sends the wrong message: that food is a source of comfort. That message stays with children throughout life. For example, how many times are there donuts at the office to help you get through difficult times? If we are going to wipe out childhood obesity, parents and teachers must control what children eat and we should begin by not using food as a reward.

It’s hard for us to see the harm in rewarding children with food, but the fact is that it does exist. Consistently rewarding a child with food instead of with love or other intangibles creates problems that you and they will have to deal with later on in their lives. It is better to find other ways of coping early on, before such behaviors become entrenched in your parenting style. This is an especially difficult behavior to resist because we all have grown up with these unhealthy behaviors. It’s part of our fabric.

Rewarding children with candy or food,

• Encourages over eating of food high in sugar and fat.
• Teaches children to eat when they’re not hungry.
• Teaches children to reward themselves with food.
• Teaches children to connect food with mood.
• Contributes to poor health.
• Undermines healthy habits.

It’s okay to offer your child food rewards from time to time as long as you can keep it under control. If it’s done spontaneously and unexpectedly, so that your child doesn’t learn to predict or expect it, it can actually be quite useful. Offering a child a cookie to stop a tantrum in a public place is much more likely to be effective, if they still regard the cookie as a rare treat.

Teachers have a role to play, too.

Research has shown that healthy children learn better. To provide the best learning environment for children, schools must provide an environment that encourages healthy behaviors. Finding alternatives to food rewards is an important part of providing a healthy school environment.

Teachers, instead of food or candy, reward elementary school children with extra recess, stickers or school supplies, a fun video or reading a special book out loud to the class. How about rewarding middle school children with a five minute chat break at the end of class, a field trip or a fun video? For high school students how about a reward with extra credit or bonus points, reduced homework or donated coupons for book stores, video stores or movies?

As parents and teachers we must all do our part to promote a healthy lifestyle for our children. After all, we wish nothing but the best for them which cannot be accomplished without good health.

References:

• http://healthymeals.nal.usda.gov/hsmrs/Connecticut/Food_As_Reward.pdf
• http://www.momswhothink.com/behavior/food-as-a-reward.html
• http://www.betterschoolfood.org/

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Is your radiologist an expert in reading mammograms? Unfortunately, in many cases, the answer may be no.

Every year, 200,000 women are diagnosed with breast cancer and 40,000 don’t survive. October is National Breast Cancer Month. It is dedicated to increasing awareness of the importance of early breast cancer detection. If properly conducted, mammography is the best tool for early detection of cancer.

In an effort to standardize care, the FDA requires physicians who interpret mammograms to read at least 40 mammograms per month over a 24- month period. Failure to have adequate documentation would jeopardize a physician’s eligibility to interpret mammograms, as well as subject the facility to a finding of noncompliance at the time of inspection.

However, 480 mammograms a year may not be nearly enough. According to studies, doctors need to read at least 2,500 films each year to stay sharp!

The dreaded mammogram that women over 50 are recommended to have every other year is bad enough, but getting a call to return for more studies is really scary. On average in the United States, one mammogram in 10, results in the patient being called back for further testing.

A woman who gets 10 mammograms at an average testing site will have a 65% chance of being called back at least once because of what is called a false positive test result. Quality of care guidelines for mammography facilities recommend aiming for a callback rate of 5-10%.

Only a small fraction of suspicious abnormalities turn out to be breast cancer.

A false positive is a test result that was originally diagnosed as “suspicious” turns out to be negative. Many mammograms are read as “suspicious”, but only a small fraction of suspicious abnormalities on mammograms (5–10%) turn out to be breast cancer. Regardless, each suspicious mammogram requires a follow-up medical visit.

Each such false positive test involves a 30% chance of having a sonogram (ultrasound), a 30% chance of a repeated physical exam or surgical consultation, and a 30% chance of having a biopsy.

Here are some ways to lower your risk of a false positive mammogram:

• Find a clinic where doctors read large numbers of mammograms (many more than the FDA’s 480).
• Insist on having your films read by the “lead interpretive physician,” who oversees a clinic’s quality controls.
• Look for clinics where two board-certified doctors independently interpret every film.
• And, above all, ask lots of questions.

Ladies, you have only yourselves to rely on to get a good mammogram reading, so you must take an active role in your care. Get the right information, so you can take control of your mammography and get the right care!

References:

• http://nytimes.com/2002/06/27/health/27MAMM.html
• http://www.pbs.org/now/science/mammogram.html

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