Gynecology
New Technique Prevents Needless Hysterectomies
Why would a woman agree to surgical removal of the uterus when a hysterectomy-saving procedure, "endometrial ablation", is available? Given this choice the answer is obvious. But today thousands of women have never heard of this less invasive procedure due to political bureaucracy, short-sighted financing and a lack of trained doctors. So what should female patients and their families do to correct this situation? After all, good sense indicates it's madness to cut off an arm when amputating a finger will do. Today one woman in five over the age of 35 will have a hysterectomy. This requires several days of hospitalization, is more risky than endometrial ablation and requires several weeks of convalescence. But following endometrial ablation patients are back...Read More
Lungs, Surgery
Reduction Surgery to Treat Emphysema
"Damn those cigarettes," an angry Johnny Carson repeated over and over as he slowly died from emphysema. Unfortunately, Carson should have said "damn those cigarettes" years ago. The former star of the Tonight Show could have stopped destroying his lungs. But Carson, like so many others, failed to realize that once damage has occurred nothing can restore lung tissue. However, a new surgical operation, lung volume reduction surgery (LVRS), can help to improve the quality of life for some patients suffering from emphysema. Emphysema has always been frustrating to treat. Sir William Osler, one of North America's most famous physicians, was once asked how he treated emphysema. He facetiously replied, "I send them to Egypt." "For the climate?" a young doctor...Read More
Genitourinary
ED drugs + Testosterone = End of ED – Levitra
"Sex is not only for Valentines Day" was the message awaiting me when I arrived in London, England. And to drive home the point, the fearless British racing car driver Sir Stirling Moss had just announced that he used erectile dysfunction (ED) drugs. And urged others to seek treatment. So the timing for the 4th International Meeting of the Andropause Society to discuss ED and testosterone couldn't have been better. Moss had two brushes with ED, the condition that men fear. His first followed a racing car accident in 1962. He refused to see a doctor about it, but met a cute nurse who said, "Don't worry, it will be all right." And it was. But following an operation for prostate cancer...Read More
Gastroenterology
The Do’s And Don’ts of Rectal Bleeding – Anurex
General Douglas MacArthur on his retirement from the U.S army reminisced, "old soldiers never die they just fade away." I've now written over 1,500 newspaper columns and some never seem to die. For instance, a previous article dealing with a unique way of treating hemorrhoids and anusitis continues to trigger letters from readers every year. Readers who say they remember the column but can't recall the cure. But these letters also show that many people have failed to learn a basic rule; never, never, ignore rectal bleeding. Anurex is one of the best-kept secrets to treat these conditions. It's a reusable probe containing a gel that's gently inserted into the rectum after being cooled in the freezer for a minimum of...Read More
Cardiovascular, Nutrition
The Anti-Inflammatory Diet: A Diet for All Ages
What is the most prudent diet to follow today? Some swear it's the Atkin's high protein diet. Others believe the low fat Ornish diet is the answer. And I've often stressed that a high fiber diet promotes health. But what about The Anti-Inflammatory Diet? A report from Tufts University in Boston has an entirely new twist on nutrition and health. It claims that if we can decrease inflammation in our body we can also decrease the progression of disease. We all know that something is amiss when we have an inflamed throat. But no one would give inflammation a second thought as the cause if the doctor diagnosed high blood pressure, heart disease or arthritis. Yet inflammation may be the culprit. Today hypertension...Read More
Lifestyle
Who Says 10,000 Steps a Day?
How many steps do most people take daily, and how many are needed for good health? I had no idea how many I take and thought it would be interesting and prudent to find out. And who is right about exercise, Mark Twain or the Earl of Derby? The first step was to purchase a pedometer. It's a small battery operated device (the cost $30.00) that fits on the hip and counts your steps. Mine has more gizmos than I need. But the main button counts steps and another the calories burned up. My normal day involves a 25 minute walk to my office and the same route home in late afternoon. During the day I don't run a marathon in the...Read More
Nutrition
What You Should Know About the “Difficult Infection” – Clostiridium Difficile
John Dillinger, the notorious bank robber, was asked why he robbed banks. He logically replied, "It's where the money is". Today if you asked infection control specialists where many infections are, they would say, "It's in the hospitals". Hospitals can be dangerous places. You can occasionally, be given the wrong medication or have the wrong leg amputated. But more commonly, patients acquire a debilitating and sometimes serious hospital infection called Clostridium difficile. How do you become infected and how can it be prevented? A report in the Journal of the Canadian Medical Association states that C. difficile associated diarrhea (CDAD) is now the leading cause of diarrhea in hospital patients. It suggests that CDAD infection should be suspected if patients with...Read More
Neurology, Psychiatry
REMEMBER-fX : The Smart Pill
Will a pill make you less befuddled next time you try to master the control panel of your new digital movie camera? Will it make you as intelligent computer-wise as your 10 year old child? Are you continually losing your keys and glasses, feel less alert and concerned about Alzheimer's Disease? A U.S study involving 750 average people showed that memory impairment affects the majority of people over 40 years of age. Now Canadian scientists say they've developed a super ginseng pill called "Remember-fX" that prevents us all from "losing it". Today there are many ginseng products available, but they've always been hampered by a complication. Ginseng in stores isn't just ginseng. Rather, it contains many other active ingredients. Therein lies the...Read More
Lifestyle, Psychiatry
10 Ways To Beat Stress In 2005
Voltaire was right when he wrote, "Most men live lives of quiet desperation". As we enter another year the desperation seems to be getting worse. There's the escalating violence in Iraq, the concerns about our economy and more headlines warn us of another prescription drug that causes heart attack and stroke. So here are 10 non-prescription ways to help you relax in 2005. One The laying-on-of-hands cures more stress and sore muscles than a cartload of pills. In fact, this message has not been lost on industry where anything to help the bottom-line becomes top priority. Some companies are now using massage as a form of stress management to decrease fatigue, headache and back strain in their employees. This results in greater...Read More
Lifestyle
What You Don’t Know About Tylenol Can Kill You
Socrates, the Greek philosopher, cautioned in 410 B.C. "Nothing in excess". Others since that time have added, "Too much of a good thing is worse than none at all." But North Americans don't believe it. Every year people unwittingly poison themselves with excess acetaminophen, better known by the brand name, Tylenol. It's easier than most realize to damage the liver and cause death. They do it to themselves and sometimes their children. In the U.S. Federal health officials report that 56,000 Americans end up in emergency rooms each year due to a Tylenol overdose. And that 16,000 die from complications related to over-the-counter painkillers. These figures may be higher since some cases are not reported. The U.S. Food and Drug Administration (FDA)...Read More
Philosophy
I’ll Loan You My Daughter If This Doesn’t Worry You!
`What can we learn from history as we start 2005? Thirty years ago I filed away an article and forgot about it. An editorial in The Ontario Medical Review claimed that people were becoming obsessed with health. It suggested that if the U.S Declaration of Independence were written today it would declare that it was the pursuit of health, rather than the pursuit of happiness, that would be the third inalienable right of Americans. Another old clipping reminded me of Kissick, his Law and his daughter. The OMR article written by Dr. Samuel Vaisrub claims that years ago people tended to disregard symptoms, fight off problems themselves, were lackadaisical about disease prevention, and doctors had to prod people to look after...Read More
Nutrition, Orthopedics
It’s “Calcium Balance” That Causes Osteoporosis
Why would I give my wife a new cook book when she's often threatened to turn the kitchen into a den? I took a calculated risk that I wouldn't end up stirring the pot. But I believed that she would see the benefits of "The Everyday Calcium Cookbook". It's loaded with sound advice on calcium-rich nutrition for whole-body health. And why normal amounts of calcium in the blood is causing an epidemic of osteoporosis (brittle bones). Helen Bishop MacDonald is Assistant Professor at the Universite de Moncton and nutritionist for the Calgary Flames hockey team the year they won the Stanley Cup. She says, "It's no secret that most Canadians do not get enough calcium for optimum bone health". TV talk shows,...Read More
Medicine
Amevive – A New Biologics Drug to Treat Psoriasis
It's been a long time coming. But finally there's a new revolutionary treatment to ease the suffering of those afflicted with psoriasis. This infuriating skin disease plagues one million Canadians and treatment has never been easy. But recently at the annual meeting of the Canadian Dermatology Association, doctors reported that a new drug Amevive would help subdue this physically and emotionally taxing disease. What causes psoriasis has been debated for years. In normal skin it takes 30 days for the deepest layer of skin cells to reach the surface where they are eventually cast off. But for patients with psoriasis these cells reach the surface in a mere seven days. This accelerated growth results in the typical raised, thickened, circular, red plaques...Read More
Cardiovascular
Vioxx – Super Aspirin Not So Super
In 1673 J.B. Moliere wrote, " Nearly all men die of their medicines, not of their illness". And while imprisoned on the island of St. Helena Napoleon commented, "Take a dose of medicine once and in all probability you will be obliged to take an additional hundred afterward". So neither party would be surprised at the bombshell announcement that Vioxx, heralded as the "Super Aspirin" for arthritic pain, has been found to increase the risk of heart attack and stroke, and removed from the market. It's the old story of "caveat empor", let the buyer beware. But think again if you naively believe Vioxx is the only problem. Remember that the new kid on the block is not necessarily a better...Read More
Eyes, Ears, Nose & Throat
The Tight Necktie Syndrome
A 55 year old businessman complained of headaches, blurring of vision and a tingling sensation in his right ear. Harvard professors failed to make a diagnosis. So he journeyed to the Mayo Clinic , then to a famous Harley Street doctor in London, England. But none could diagnose his problem. Several years later he was at a convention in Atlantic City still suffering from these annoying symptoms. Having forgotten to pack enough shirts, he walked into an unremarkable men's store and asked for a size 15 shirt. A young salesman suggested a size 16. Irritated, the man replied, "Look here, young man I've been buying shirts since you were in knee pants. I want a size 15". The salesman replied, "That's fine...Read More
Medicine
A New Treatment For Difficult Rheumatoid Arthritis
For people free of pain it's hard to envision the problems suffered by those who have severe rheumatoid arthritis (RA). Those with joints so swollen and tender they're unable to do simple things like buttoning up a shirt, unable to walk down stairs unless they do so backwards holding railings with both hands. The psychological trauma when the condition gets steadily worse is also crippling. Now, a new drug, Humira, is restoring these patients to a normal life. Many famous people have suffered from RA. Pierre-Auguste Renoir the famous 19th century painter developed RA in mid life. His hands became so crippled that his paint brush had to be wedged between his fingers. But he kept his sense of humour. He...Read More
Archive, Philosophy
The Math Of Medical Ethics 101
"What an incredible story" I thought as I read the article. But it wasn't published in a prestigious medical journal. Rather, it was an article in the New Yorker Magazine written by Ian Parker about about Zell Kravinsky. Zell had given away almost his entire 45 million real estate fortune to charity. Then he donated a kidney to save a young stranger's life. He had even considered donating his other kidney and subjecting himself to kidney dialysis to save another young life. This is Sacrifice with a capital S! Yet thousands of his fellow citizens refuse to donate organs even after their death to those who desperately need of them. Why did Kravinsky do it? He says people simply don't understand...Read More
Cancer, Genitourinary
Darling, I Decided To Get a Second Opinion – Prostate Cancer
"How many angels can dance on the head of a pin?" That's a tough question to answer. Almost as hard as providing logical answers to questions of the PSA test used to detect prostate cancer. A recent report in the New England Journal of Medicine (NEJM) claims that the accepted normal PSA value of 4.1 misses 15 per cent of prostate malignancies. To correct this problem it's been suggested that the normal level for PSA should be lowered to 2.5. But a Texas study of 3,000 males aged 62 to 91 revealed that 6.6 per cent of these males with PSA levels of only 0.5 had prostate cancer! It appears no value is totally safe. The PSA test measures the level in...Read More
Cancer, Philosophy
A Bus Advertisement May Be The Answer
"Why must I wait so long for a cataract operation?" one reader asks. Another angrily asks why her mother had to die in agony from terminal cancer. This past year I've received an increasing number of letters from readers dealing with this type of problem. And during a recent trip to Oxford University in England a bus advertisement could help to solve these troubles. The bus ad read, "Now you can have the hospital you've always wanted". Since there's so much debate in this country about our deteriorating hospital system I couldn't resist calling the number on the bus and visiting Acland Hospital. I was surprised to find that Acland Hospital in Oxford was merely one of their 45 Nuffield "private hospitals"...Read More
Lifestyle
Super Aspirin Not So Super – Vioxx
What can we do to shorten the long waiting lists for surgery? How can we stop the massive increases in the cost of health care? Politicians and health care workers continue to struggle with this dilemma. They always conclude that more money is the answer. But this approach is doomed to failure. How can it work when it's taken 40,000 years for humans to get into such horrible shape? How did it happen? And is there a solution? Dr. Barry Bogin is a professor of anthropology at the University of Michigan. He says we all envision our Paleolithic ancestors as being short, bent- over people with small brains. Actually they were a tad taller with brains as large as ours. And...Read More
Gynecology
The Yo-Yo Effect: Why It Results in Needless Mastectomies
Why don't doctors learn from history about breast cancer? Over 50 years ago a Scottish surgeon reported that radical removal of women's breasts did not improve their survival rate. Yet for decades many surgeons have continued to do this mutilating operation. Now it's been reported that whether a lumpectomy (removal only of the cancerous lump) or mastectomy (whole breast removal) is done also depends on where you live. What's happening in this country, and the U.S., is partly due to the Yo Yo effect. A study published in the Canadian Journal of Public Health shows that women living in Prince Edward Island are three times more likely to have a breast removed for breast cancer than women living in Quebec. Dr Ineke Neutal, an...Read More
Lifestyle, Philosophy
It’s Okay To Inhale To Stop Smoking
An economist, analyzing financial disasters, remarked that "If you keep going to hell you'll eventually get there". This warning equally applies to the millions of people who still smoke and eventually die from this addiction. Today, there is no greater madness than smoking when research proves that smoking kills. Fortunately, there's a new treatment that can help to save these needless deaths. In this case it's okay to inhale to quit smoking, with the newest smoking cessation, the Nicorette inhaler. Sir Walter Raleigh, a favourite of Queen Elizabeth I, introduced tobacco into England. But if he tried this today, authorities would hang him from the yardarm for even suggesting its use. Tobacco would be immediately banned as a hazardous substance. Now...Read More
Cardiovascular
President Clinton And Cholesterol-Lowering Drugs
Former President Clinton has joined 400,000 Americans who required coronary bypass surgery in the last year. Clinton had high blood cholesterol and took cholesterol-lowering drugs (CLDs). But these drugs, along with superb medical care, neither prevented nor cured his disease. And nothing was said of the risk of taking CLDs? Today it's like attacking motherhood to question the value of CLDs. But there are scientists who believe it's a myth that cholesterol is the major risk factor for heart disease. They say there's blind addiction to these drugs and occasionally serious side effects. But with billions of dollars at stake studies questioning the benefits of CLD tend to be buried. A major study called Prosper showed you can exchange one devil for...Read More
Eyes, Ears, Nose & Throat
The Do’s And Dont’s of Sinusitis
I must confess I've been putting off writing this column for a long time. Sinusitis seems to be such a dull, boring, uninteresting topic compared to most medical troubles. But nevertheless this condition affects millions of people and it's a damn annoying condition when it strikes. There are also some important do's and dont's in treating sinusitis. Dr. Ron Fenton, Otolaryngologist-in-Chief at St. Michael's Hospital in Toronto, reports in the University of Toronto Health News that one in 200 colds will be complicated by an attack of sinusitis. And the number of cases is increasing. Sinusitis normally starts as a viral infection which causes inflammation and blocks the sinusues. Patients then often get a bacterial infection on top of the viral infection.Dr...Read More
Genetics
Genetic Family History 101
How much should you worry if your father died of a heart attack at age 50? Or your mother developed breast cancer at 40 years of age? Or a brother required surgery for malignancy of the colon at an early age? Or there's a strong family history of diabetes or osteoporosis? In these cases how beneficial is genetic testing? Today, with an aging population, it would be most unusual for a family to say none have died from cancer, heart attack, stroke, diabetes or suffered from mental illness. So there's no need for sleepless nights unless there's an unusual strong family history of one of these diseases. And if the death of a relative occurred at 40 years of age, it...Read More
