Cardiovascular
Cruising With Cardiologists to Alaska, and What I Learned
I have a passion for ships so I’ve travelled and seen much of the world this way. But I’d never been to Alaska. So I recently joined a group of cardiologists on an educational cruise to a U.S. State blessed with magnificent scenery. It was a good learning experience, with one glaring omission. Towards the end of the conference I asked a specific question. For several days all the speakers had discussed the value of Cholesterol-lowering drugs (CLDs) to prevent heart attack. They had also discussed drugs to treat heart failure. But none had mentioned the vital importance of coenzyme Q10 (CoQ10) to either prevent or treat a failing heart. Studies show that CLDs decrease the amount of this enzyme, and...Read More
Alternate Treatments, Miscellaneous, Pain
How Can Hospitals and Doctors Be So Cruel?
Years ago I wrote that “The problems of the world are caused by supposedly intelligent people who are largely fools.” I haven’t changed my mind as I look at the problems surrounding the new law that allows Medical Aid in Dying (MAID). I will never understand how some hospitals and doctors can be so cruel to those who cry out for mercy. Recently, an 84 year old man, a patient in a Vancouver hospital, was afflicted with failing kidneys, heart disease and spinal stenosis, a narrowing of the spinal canal causing pressure on sensitive cord tissue. Aware of his agonizing future, he asked his doctor to apply for MAID. But Catholic hospitals and some non-Catholic facilities do not allow doctors or...Read More
Genitourinary, Women's Health
Mother’s Rx for Recurrent Urinary Infections
Is Mother sometimes right about medical treatment? This week a report in the Canadian Medical Association Journal shows that, at times, her batting average is better than that of doctors. Drs. Blayne Welk and Duane Hicklings report the case of a 35 year old woman with a 24 hour history of urinary frequency. She had experienced two previous urinary tract infections (UTIs) due to a common bladder infection caused by a bacteria called E coli. Doctors advised the usual recommendations, such as increased fluid intake and voiding after sex. But Welk and Hicklings say a large study showed these precautions had little effect on recurrent UTIs. Rather, it was the use of spermicidal jelly that was interfering with normal vaginal flora. The...Read More
Neurology, Pain
Why I’ve Never Forgotten a Japanese Girl
58 years ago I made an unfortunate decision. I was in the wrong place at the wrong time with the wrong Japanese girl. But the problem was not what you’re thinking! Rather, I was in Tokyo, travelling with my wife and her parents. My father-in-law and I decided to experience a Japanese massage at the Imperial Hotel. During the event a petite masseuse suddenly struck the side of my head with a hard blow. I swear to High Heaven I did not pinch her, and will never know why she acted this way. The following day I developed symptoms of injury to the ulnar nerve in my arm, and later neck pain. In recent years the neck pain has increased and...Read More
Lifestyle, Medicine, Miscellaneous, Nutrition
Losing Weight the Asinine Way
Has the medical world gone completely insane? A new medical device called “AspireAssist” to treat obesity has been approved by the Federal Drug Administration (FDA) in the U.S. Its approval is being studied by Health Canada. The British Medical Journal agrees with my reaction when it reported, “AspireAssist surely marks the end of civilization as we know it”. This remark sounds ominous, but it’s not about a nuclear threat. Rather, about obese people who thoroughly chow down a meal, then half an hour later physically remove one third of it! Not by inserting a tube down their throat. Instead, by an endoscopic surgical procedure in which doctors insert a pencil-sized tube into the stomach. Following the meal a pump...Read More
Philosophy
It’s Madness Not to Have a Living Will, Legal or Not
"It was the best of times and the worst of times." This is the first sentence in Dicken’s book, "A Tale of Two Cities" about the French revolution. The same could be said today. Never has there been a greater exodus of people escaping wars and poverty. And never before has there been a greater need for an updated Living Will, whether you live in Canada or the U.S. One that pulls no punches on how we wish to end our lives. I have a personal interest in this column. Consequently, it’s a hard one to write, as no one wants to discuss their demise. But as a physician in my 93rd year I have no delusions about my mortality. So...Read More
Lungs, Medicine, Vitamins
Hillary Clinton: Did She Receive the Best RX?
Do famous people always receive superior medical care? If this were a Trivial Pursuit question, the answer would be a big “Yes”. After all, they’re famous and have the money to demand the best medical treatment. But has fame and fortune guaranteed that Clinton has been given the best advice to treat pneumonia? This week I encountered several surprises. The first surprise was that Hillary Clinton, at age 68, hadn’t collapsed earlier from this disease. Or that Donald Trump, age 70 and overweight, hasn’t as yet collapsed from coronary attack. The grueling U.S. election campaign is not designed for seniors, so something medical is bound to happen eventually. It occurred this past week. What else amazed me? Everything I read...Read More
Genetics
If Clinton Becomes President Will Her Hair Turn Gray?
What is it that makes our hair turn several shades of gray as we get older? I’m sure many of us recall the first streaks of gray and realize we are older whether we like it or not. It’s a time when we start to wonder, “Is it age that’s causing the gray? Or have we been doing something wrong?” Maybe too much stress or excessive work? Or is the result, according to one 19th century dermatologist, due to overindulgence in sexual appetite? But why will Hilary Clinton never have white hair if she wins the White House? We’ve all heard stories about people going gray overnight due to overwhelming anxiety. For instance, there are historical reports that this happened to...Read More
Cardiovascular, Lifestyle, Miscellaneous, Nutrition
Are Hens An Endangered Species?
Headlines fool a lot of people. In March 1984 the cover of Time Magazine caught everyone’s attention. It read “Cholesterol, Now the Bad News”. It reported that cholesterol had been proven deadly and our diet should never be the same again. Researchers have since found little or no correlation between cholesterol in our food and our blood cholesterol. But since eggs contain more cholesterol than most other foods, hens have taken a brutal beating. So why have North American Egg Associations failed to defend hens more vigorously? And why have they ignored scientific facts about heart attack? At one point it looked like the hens were getting a welcome break. The Dietary Guidelines Advisory Committee (DGAC) has since ruled that it...Read More
Cancer
Waiting to Treat Prostate Cancer?
Doctors have stressed for years it’s vital to treat all cancers early to increase the chance of cure. But one rogue malignancy rarely obeys the rules. Now, a report in the Canadian Medical Association Journal says, “active surveillance” is increasingly used to treat prostate cancer. The big question is how many patients want to wait when told they have a malignancy? But why is this currently a choice? Autopsies show that 50 percent of men over age 59 have prostate cancer, and three in four over 85. One in seven North Americans will be diagnosed with prostate cancer in their lifetime, yet only one in every 28 men will die of it. Obviously, not all need to be treated. Why does this...Read More
Cancer, Medicine, Pain
Why Cancer Patients Will Suffer to Protect the Lives of Addicts
How history repeats itself! Today, politicians are once again ignoring the pain of terminal cancer patients. At the same time, they are shooting themselves in the foot by making illogical remarks about pain. This human folly takes me back 37 years. In January 1979, I wrote a New Year’s resolution in this column to petition the government to legalize medical heroin to ease the agony of terminal cancer patients. I knew that heroin had been used in English hospitals for 90 years, so why not have this painkiller available in North America? But rather than being applauded for my compassion, all hell broke loose. One well-known cancer specialist labelled me “a misinformed headline-seeking journalist”. The Cancer Society argued that morphine was as...Read More
Gastroenterology, Lifestyle, Medicine
An Update on the Risks of Heartburn Drugs
Pogo, the cartoon character, was right when he remarked, “We have met the enemy and the enemy is us.” A report in the Canadian Medical Association Journal shows that North Americans are devouring PPIs (proton pump inhibitors). These drugs decrease the amount of hydrochloric acid in the stomach to ease heartburn. But, as always, medical consumers tend to overdo a good thing and trigger a number of unintended consequences. Numbers tell the story. A few years ago doctors prescribed PPIs, such as Prevacid, Nexium and Priosec, to over 4 million Canadians and 15 million in the U.S. Now, the number is higher as some PPIs can be obtained over-the-counter. The cost? Over 80 billion! The winners are the owners of big...Read More
Alternate Treatments, Lifestyle, Miscellaneous
Keeping Well While Cruising
I should hate being at sea. In 1952, during my first trip as a young ship’s surgeon, I sailed to Germany to bring persons displaced by the war to Canada. I did not know that during the voyage I would have to remove the Captain of his command, for medical reasons. Nor did I realize how many medical problems I would encounter with 800 very ill passengers. Still, I’ve always loved being at sea. Now I’ve just returned from a cardiology seminar aboard a cruise to Alaska. During it I pondered how to keep well while cruising. First, get rid of misconceptions. Some people decide not to cruise for fear of Norovirus infection. But such infections are rare...Read More
Surgery
Unexpected Complications of Joint Surgery
It’s been said that, “All would be well if there were no buts.” Unfortunately, life is full of “buts”. A prime example is joint surgery. Today, an increasing number of people are being relieved of chronic pain by hip and knee replacements. Others are being helped by lesser laparoscopic procedures. But patients should be aware that these are major operations sometimes associated with unintended consequences. For instance, several years ago Dr. Justin de Beer, an orthopedic surgeon at the Henderson site of Hamilton Health Services in Hamilton, Ontario, reported this unexpected finding. A worrying number of patients after hip and knee replacements had suffered heart attacks following the operation. The majority of these coronary attacks occurred within three to five days of...Read More
Cardiovascular, Vitamins
What They Don’t Tell You about Baldness and Heart Attack
A Czech proverb says, “A good man grows gray and a rascal bald”. And Thomas Dekker wrote in “The Gull’s Hornbook” in 1609, “How ugly is a bald pate! It looks like a face wanting a nose”. Now, a Japanese report says that men with baldness should be less concerned about how it affects their looks. Rather, is the lack of hair associated with increased risk of coronary attack? The Japanese findings were published online in the British Medical Journal, “Open”. The study involved 40,000 males whose hair pattern was graded as either frontal, crown-top baldness or a combination of the two. The conclusion was that not all bald men are created equal. Men with frontal baldness had a 22 percent increased...Read More
Alternate Treatments, Sex
The Big T: Could It Get Me to 95 +?
Should aging males use testosterone therapy to increase overall health and longevity? It’s a question I’ve pondered after interviewing Dr. Malcolm Crowthers, an early pioneer of testosterone therapy, in London, England, years ago. Now, Dr. Abraham Morgentaler, Clinical Professor at The Harvard Medical School, agrees the benefits of “big T” should not be denied to men, even those with prostate cancer. And would big T get me to 95 +, I wonder? I vividly remember talking to Crowther’s patients. They were happy campers, hoping to be shot by a jealous lover at age 95! But sex is only part of the big T story. Low testosterone is present in 40 percent of men over age 45. Its loss is associated...Read More
Lifestyle, Women's Health
Wired Bras, Unwatchful Parents And Summer Tragedies
An African proverb says “There is only one kind of common sense, and 40 varieties of lunacy”. Unfortunately, this summer will again prove it right. There’s also an old song, “Summer Time and the Living is Easy”. But it’s theme can be a prelude to disaster. Every summer what’s supposed to be fun turns into a lifetime as a quadriplegic, or with other severe injuries. And it happens to all ages. It is mind-boggling that every year 1,400 children drown in wading pools!!! It could not happen if parents and grandparents were watching children every minute by the water. Women can fall victim to an unusual injury while water-skiing at high speeds. The impact of a fall is like hitting a brick...Read More
Women's Health
Who Sent You These?
Years ago in my medical office I was convinced that tight jeans and panties were causing repeated pelvic infections in women. So, in jest, I wrote a column about it suggesting that Yves St Laurent should design better jeans and panties. Then I forget about the article until my wife asked with astonishment “Who sent these panties?” One day a package had arrived at my office and I tossed it into my briefcase. Later that evening while enjoying a pre-dinner drink with my wife, I opened it. To my surprise, I pulled out a pair of pink panties. They were sent by a reader who had a design solution. It was not the ideal way to start the cocktail...Read More
Lifestyle, Sports, Vitamins
Fight Infection like an Olympic Athlete
How hard would be the disappointment? You’ve trained for years to acquire a medal at the Rio Olympics. And then the unthinkable happens. You develop a respiratory or intestinal infection just before the event. It’s an unmitigated disaster of unparalleled proportions, never to be forgotten. So, how do Olympic athletes avoid this catastrophe? An article published in the British Journal of Sports Medicine stresses it’s not just luck that prevents infection. Rather, according to Ida Svendsen, physiologist with the Norwegian Olympic Committee, it’s attention to detail. As Leonardo Da Vinci wrote centuries ago, “Trifles make perfection, and perfection is no trifle”. Svendsen reports that a study of 37 elite Norwegian skiers, over a nine year period, showed that those who had won...Read More
Alternate Treatments, Lifestyle, Miscellaneous, Pain
How Readers Would Treat 42,000 Addicts
Eureka! Last week I reported it was impossible to write this column. I had asked readers to respond to how I believe 42,000 addicts on methadone should be treated. Then my computer developed terminal cancer and I thought all your responses had been lost. Fortunately, the “Geek Squad” resurrected them. From a Times Colonist reader, “Your suggestion that sending addicts to northern Canada to chop wood caught my eye. I was impressed by your research. The addicts I have known have no interest in getting off methadone and improving themselves. I say, enough of this nonsense. Why not have them chop wood? We all do some form of work to eat.” This reader then added, “I initially believed that the practice of...Read More
Alternate Treatments, Lifestyle, Miscellaneous
Doctor Assisted Death
It’s been aptly said that “Wars are too important to be left to Generals. I would add that assisted death is too important to be left to politicians and doctors. One of the first columns that I wrote 41 years ago was titled, “Why cab drivers are smarter than doctors”. I was convinced then that on social issues taxicab drivers had more common sense than many in the medical profession. Now, looking at the unadulterated mess surrounding assisted death, I realize I was right 41 years ago. Now I would add bartenders, plumbers and those that pick up our garbage. I also wrote years ago that the problems of society are caused by so-called intelligent people who are largely...Read More
Cancer
Has Anyone Felt Your Testicles Lately?
How many women will have their breasts examined this year? I don’t know the exact figure but it will be in the millions. But how many men will have their testicles examined during 2016? Again, I don’t know the exact number but it will be miniscule compared to that of the fairer sex. Is this sexual discrimination? If so, we need a class action lawsuit to protect men’s rights or, more to the point, our testicles. But more important, an increase in TSE (testicular self examination) would increase the survival rate of this malignancy. We don’t know what triggers testicular cancer. But males at greatest risk are those between the ages of 15 and 35. There’s increased risk if the testicle...Read More
Lifestyle, Medicine, Miscellaneous
How To Cure 42,000 Addicts Quickly
How could this medical and social disaster ever be allowed to happen? If authorities had told me that Ontario, just one Canadian province, was treating 400 addicts in methadone clinics, I’d believe them. But, the actual number is 42,000. But how many of these addicts need methadone? And what is the solution for this madness? Dr. Theodore Dalrymple, is not an arm-chair commentator on addiction. Rather, he’s an internationally renowned expert, a British psychiatrist, and prison doctor who has treated thousands of addicts over years. In his book, “Romancing Opiates”, he writes that heroin is not as highly addictive as claimed, and withdrawal not as difficult as treating an alcoholic. He claims, “It’s a myth that treating the heroin...Read More
Miscellaneous, Pediatrics
Guarding Against a Devastating Telephone Call
What should parents fear most when raising children? You could compile a list as long as your arm. But, while travelling in the U.S, I happened to read a column written by Bruce Feiler in The New York Times. The greatest fear, he claimed, should be that fateful call that a child has been killed while driving a car. So how can parents decrease this risk? Feiler’s article reminded me of a night I’ll never forget. I was working on a column in upper state New York. It was high school graduation time. Following one ceremony a few parents and graduates decided to celebrate. One teenage girl, a new driver, offered to drive four other girls to the event. A short...Read More
Surgery
The Perils of Being a Patient
What is one of the major health hazards today? It’s being a patient. Because there are so many pitfalls, and it’s easy to fall into them. Modern medicine has much more to offer today which makes life better for millions of people. But it can also create problems, unless you know where the traps are and how to avoid them. I’ve never forgotten an incident that happened years ago. I’d completed a successful surgical procedure and returned to the recovery room to check on my patient. But I noticed several doctors crowded around one bed, which is never a good sign. A male patient had undergone a gallbladder operation and was experiencing difficult, labored breathing. His surgeon and anesthetist were concerned. They...Read More
