In several of my posts I have mentioned that I felt that one of the main problems that needs to be dealt with as we approach healthcare reform is the shortage of primary care physicians. There is a shortage of these doctors now. Who is going to see the approximately 46 million new patients who suddenly have health insurance?

I want to post various articles as I come across them that addresses this issue. Todays comes from the South Bend Tribune and was an opinion written by a physician.

 http://www.southbendtribune.com/article/20100128/Opinion/1280356/-1/googleNews      bjmdjd

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health · Healthcare Reform · shortage of primary care physicians · wellness

Red yeast rice is a product of yeast grown on rice and is served as a normal part of the diet in some Asian countries. Extracts of red yeast rice have been used in China for hundreds of years to treat patients with circulatory and digestive disorders. It also has been known for many years to lower LDL cholesterol (the bad stuff).

Researchers writing in the January 15, 2010 issue of the American Journal of Cardiology reported that red yeast rice lowered LDL comparable to the cholesterol lowering prescription drug pravastatin (Pravachol).  Certain types of red yeast rice cultivated with a specific mold actually contain lovastatin which is the cholesterol lowering drug Mevacor!

These findings show great promise in patients who are forced to discontinue various cholesterol lowering drugs because of the fairly frequent side effect of muscle aches and pains. In these patients  the red yeast rice was well tolerated and could be a treatment option in the future.

One of the main problems now is making the determination as to whether to classify red yeast rice as a drug or as a dietary supplement which would then involve the Food and Drug Administration. Their involvement would be necessary in order to regulate and control for contaminates and consistency between different manufacturers.

If you have high cholesterol and either can’t tolerate the current cholesterol lowering drugs or you would rather take something that is thought to be better tolerated in many patients, discuss it with your doctor.  bjmdjd

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American Journal of Cardiology · cholesterol lowering drug side effects · health · healthcare · high cholesterol · LDL · lovastatin · pravastatin · red yeast rice · wellness

Most of us realize that diabetes is a very costly disease. Both in dollars and in mortality and mobidity numbers. Several months ago the U.S. Dept. of Health and Human Services (Nov. 2009) released the following staggering numbers concerning diabetes.

• 24 million Americans with diabetes
• $174 billion spent on diabetes in 2007
• $11,477 average annual cost in 2007 to an American with diabetes
• $60 average cost of a box of 100 blood glucose test strips
• $70 average cost for a vial of insulin

One of the scariest facts is that the number of Americans diagnosed with diabetes is growing everyday. I think that there are 2 main reasons for this. (1) Lower lab number results are now used to diagnose the disease. Until recently the medical community found that it was missing too many diabetics using the old numbers. (2) And the growing problem of childhood obesity. Many young people are now being diagnosed with Type II diabetes which is something that rarely ever happened in the past.

Educate yourself, get plenty of exercise, watch what you eat and maintain a healthy weight. As the old T.V. commercial used to say, “The life you save may be your own.”  bjmdjd

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diabetes · exercise · health · healthcare · lose weight · wellness

The Food and Drug Administration (FDA) announced January 21, 2010 that the weight loss drug marketed as Meridia (generic = sibutramine) in the U.S. is now contraindicated in patients with a history of cardiovascular disease. There was already a warning against the use in those patients but the company has agreed to add the contraindication to the labeling. Cardiovascular disease refers to patients with any of the following:

If you are a patient with cardiovascular disease and you are taking Meridia (sibutramine), contact your prescribing physician immediately.  bjmd

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cardiovascular disease · Food and Drug Administration · health · healthcare · Meridia · sibutramine · wellness

One of the major public health problems that has gotten a lot of press in the last several years is childhood obesity. Along with the obesity the onset of Type II diabetes in a much younger population is really taking off. Now in the January 22nd issue of U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report comes news that 20% of U.S. youths have abnormal lipid levels. That’s 1 in 5 of young people in the U.S. between the ages of 12 to 19 years old have at least one abnormal lipid value.

The authors of the study evaluated data gathered during a survey conducted from 1999 – 2006. Even though it is not a new thought the study suggested that there is a subset of youth in which early intervention might help avoid cardiovascular disease in adulthood. I can’t remember the name of the article but I do remember reading many years ago about a study of autopsies conducted on youth below the age of 16 who had died from various causes. A significant number of these children already had changes of early atherosclerosis in their coronary arteries. And this was before the various risk factors had become more prevalent.

It appears that moving the snacks and soft drink machines out of our schools might be a good idea. Also getting off of the couch and playing outdoors might help. Education is the key. Not only for the children but also for their parents and caregivers.  bjmdjd

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early atherosclerosis changes · health · healthcare · lipid abnormalities in youth · Type II diabetes in youth · wellness

Well, the voters in the bluest state in America have elected a republican to the long held “Kennedy senatorial seat” in Massachusetts. Many feel that the election is a statement on the job being done by President Obama. Even if you don’t believe that it’s hard not to believe that at least it is a statement on “Obamacare.”

It will be interesting to see what Pelosi and Reid try to do to get a healthcare billed passed before new Senator Brown arrives in town. His vote will assure a republican filibuster and an inability for the democrats to force their bill through without the approval and help of the republicans.

It will get ugly very soon. I would suspect that any democrat that helps on forcing a bill through before the new senator is seated may as well go ahead and start packing. Everyone, including me, supports healthcare reform but let’s sit back and take our time to get a good bill. Remember the rush to get the stimulus plan passed? As Dr. Phil says, “How’s that workin’ for ya?”

I say a resounding YES!!!!!!! to healthcare reform but let’s hope they pass a bill that will help the most Americans with the least negative impact on our national deficit. Wouldn’t that make the most sense? In the end though…something must be done!  bjmdjd

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health · healthcare · Healthcare Reform · Massachusetts · Senator Brown

I will be the first to admit that I really don’t care for Oprah or her show. Everyone says, “But Bob, she does such good things with her money!” Yes…and there’s always a camera there to record it. I grew up being taught if you do something good for somebody and you tell it doesn’t count.

But I’ve got to give kudos to Oprah! On her show today the topic was on the dangers of talking on a cell phone or texting while you’re driving. While many folks want to jump up and down and say it’s their right to do both if they want to and it’s not the governments place to pass any laws that govern it. You may feel that way but you can’t actually deny that both are dangerous. How many of us have looked up and been driving in the wrong lane or at least drifting over the center line?

They presented a study which showed that talking on the phone while driving increases your chance of having an accident x4, the same as having a blood alcohol of 0.8 which is legally drunk. Texting while driving increases your chances x8!! No distinction was made between a regular cell phone and a hands free unit with one person stating it’s not what you do with your hands but your head.

I may not be a fan of Oprah but I am a fan of most anything that improves public health. Click on the following link to sign Oprah’s pledge not to talk on your cell phone or text while driving. Regardless of how you feel about the governments intrusion into our lives it might be worth taking a close look at this topic until drivers can use some common sense.   bjmdjd   (D3M5R2CWAJDZ)

http://www.oprah.com/questionaire/ipledge.html?id=4

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government intrusion into our lives · health · healthcare · Oprah Winfrey · public health policy · talking on a cell phone while driving · texting while driving

One of the first decisions that parents of newborn baby boys have to make is almost totally without medical direction. Doctors and various medical groups along with activists have argued for years over whether or not this circumcisions should be performed.

This past week two well known medical journals published studies which came to opposite recommendations. The Archives of Pediatric and Adolescent Medicine says that new guidelines should be published by the American Academy of Pediatrics stating that there is evidence that supports the health benefits of circumcision. The Annals of Family Medicine article says that there is insufficient evidence to recommend routine circumcision.

Well! That is certainly helpful to new parents. The thing that is even more strange is that the two research groups essentially studied the same information and came up with completely opposite recommendations! Sounds a lot like politics.

There are arguments on both sides. Many feel that there is some evidence that circumcision may reduce the risk of bacterial skin and sexually transmitted infections, HIV, herpes, human papilloma virus (some strains which can cause cervical and penile cancer), and urinary tract infections.

Some researchers feel that the procedure removes foreskin which has many nerve endings and is therefore removing erogenous tissue. They also claim that circumcision can lead to bleeding and infection. One thing that has changed in recent years is that many newborns are at least given pain medication either before or after the procedure. This was hardly ever done in the past.

One thing that is for sure. With all of the confusion in the medical literature the one deciding factor that is most important in the parents decision is whether or not the father was circumcised. Also with 4 out of 5 boys being circumcised in the United States, what will the uncircumcised young man think when he showers after his first gym class? 

Either decision is the correct decision. Now, doesn’t that help?  bjmdjd

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Annals of Family Medicine · Archives of Pediatric and Adolescent Medicine · circumcision · health · health benefits of circumcision · healthcare

The January issue of Physicians Practice magazine has a great article about health courts. These specialized courts have long been suggested by some as possibly helping medical malpractice cases be resolved in a more equitable manner.

Several points include:

• Experienced Judges – judges might be able to better make determinations based on facts as opposed to juries who many times are affected by emotion
• Neutral Expert Witnesses  – no more “hired guns” who are often times paid for their “opinions”
• Scheduled Awards – many injured patients receive little or no compensation while a few small number of cases end with huge amounts of money being awarded

In order to read the entire interesting article click on the following link:

http://www.physicianspractice.com/index/fuseaction/articles.details/articleID/1431.htm

bjmdjd

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health · health courts · healthcare · Medical Malpractice · Physicians Practice magazine

Just a short note today. I just read an article about lawmakers wanting to forbid gifts and free meals between drug companies and doctors. Are you kidding me? Politicians fly all over the world and get who knows what from various lobbying groups all of the time. They are actually brash enough to admit in public that they think there is a problem with drug companies buying an office staff a pizza and giving them free plastic ink pens and sticky notes? Healthcare reform should worry you if that’s a major concern of our elected leaders!  bjmdjd

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drug companies · drug company and doctor financial relationships · health · Healthcare Reform · political lobbying groups