Cancer, Medicine
Potassium Iodide For A Nuclear Disaster?
What would happen if terrorists attacked a nuclear power plant? Or an accident caused fallout of radioactive iodine? If you were driving in the opposite direction your first reaction would be to step on the gas. But for those trapped in a large city there would be absolute chaos on roadways as people tried to escape. So is it time to provide potassium iodide (KI) to Canadians to protect the thyroid gland from cancer? A terrorist attack would expose thousands to thyroid cancer as a result of the fallout of radioactive iodine (I-131). And today there are over 400 nuclear power plants in the world. Some countries such as France derive 70 percent of their power from nuclear energyUnder current conditions...Read More
Neurology
Bell’s Palsy: The Mona Lisa Syndrome
"How could it happen so quickly?" a patient asked me. A day earlier she could smile, open her eyes and showed normal facial countenance. Now, her face drooped on one side due to a paralysis of the facial nerve. The cause? A condition known as Bell's Palsy. Sir Charles Bell, a 19th century Scottish physician, first described this upsetting malady that distorts the face, often freezing the mouth making it difficult to eat and the speech slurred. Bells' Palsy has often been associated with one of the most famous paintings in the history of art, the Mona Lisa. In 2003 she occupies occupies her own room at the Louve in Paris. And it's her slanted smile that attracts the viewer's attention. The...Read More
Cancer
The Good and the Bad of Cancer Screening
"Why did my wife die of breast cancer when she's had a mammogram every year?" Or "I went through hell after the mammogram revealed a possible cancer." Or "During a routine checkup examination the doctor discovered my 73 year old husband had an elevated PSA test. He didn't have any symptoms, but a biopsy revealed cancer of the prostate. A specialist advised a radical prostatectomy. Now he's impotent and in diapers." Every year I receive letters asking these questions. That's why it's vital to know the negatives as well as the positives about cancer screening. There is no doubt that cancer screening saves lives. But there is also a price to pay. Any woman who agrees to mammography has to understand...Read More
Gastroenterology
Think “Refrigerator” When Treating Hemorrhoids – Anurex
Would Napoleon Bonaparte have won at Waterloo if he hadn't been suffering from painful hemorrhoids? Directing the battle while on horseback with swollen hemorrhoids could not have been easy. We'll never know the answer to that question. But today there are solutions for treating this common condition. One answer is as close as the refrigerator door. But there's a major pitfall to avoid. While I was reading about Napoleon's life I received this letter from a reader. She writes, " I'm pregnant and have suffered for months from hemorrhoids. And even when not pregnant I'm always annoyed by rectal itching and burning. I'm at my wit's end as I've tried every over-the-counter preparation without relief. What can I do?" In all probability...Read More
Psychiatry
Depression – Everything is Black
So far we have not had an earthquake in Canada. I'm almost afraid to mention it! As Shakespeare wrote, "When troubles come, they come not single spies but in battalions." He could have been writing about Canada's problems of SARS, Mad Cow Disease and The West Nile Virus. So I can't imagine a better topic than depression when so many of us are thinking "Why, God, have you done this to our country?" Art Buchwald, the noted humorist, suffered from depression. He wrote about it, "Everything was black. The trees were black, the road was black. You can't believe how the colours change until you have it. It's scary." Dick Cavett, the late-night talk show host, fought depression. And Mike Wallace of...Read More
Alcohol
Sorry, James Bond, But You’re Wrong!
Why would I disagree with James Bond? He's ordered dry martini's for years and never seems to age. Hippocrates, the Father of Medicine, supported the use of alcohol. So did Jesus. After all, He transformed water into wine. And I never forget that, through the ages, polluted water, not alcohol, killed millions of people. That's why I never feel guilty about a pre-dinner drink. But is it actually the alcohol that helps drinkers live longer? A report in the American Journal of Clinical Nutrition casts a shadow over the alcohol longevity connection. It's researchers claim they've discovered the real reason why drinkers live longer. Dr. John Barefoot of the department of Psychiatry and Behavioural Sciences at Duke University in Durham , North...Read More
Gastroenterology, Neurology, Vitamins
How To Keep Your Brain In Shape
Are there some days you believe you need a brain transplant? You're getting those senior moments even though you're only 40 years age? Or starting to worry that at 70 you're forgetting things you shouldn't forget? These days with so much talk about Alzheimer's Disease it's easy to assume you may be losing it. Fortunately most people who worry about this disease don't have it. But today there are ways to keep the brain in better shape? Here's a story that shows you don't have to be a neurologist to understand what's happening to the brain. Rather, Dr. Robert Russell a gastroenterologist and Director of the Human Research Center at Tuft's University, cured this woman with a single pill. The patient, 70...Read More
Neurology
Brain-Computerized Thought the Best and Terrible Science
It's said that "a picture is worth a thousand words". And the one that I recently saw in The Medical Post is one that's hard to forget. The picture shows a man totally paralyzed due to Lou Gehrig's Disease. To me, in 2003, it illustrates the best and worst of science. Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrig's Disease is a frightful malady. It's an inch-by-inch paralysis that gradually and insidiously spreads throughout the entire body. The final phase is total paralysis. Patients are literally "locked in" inside their bodies. The only normally functioning organ is the brain. At the end patients with ALS require a respirator to survive and eventually drown in their own mucus. It must be...Read More
Cancer, Genitourinary
PSA Screening Results in 30 Percent Over-Diagnosis
For women, a telephone call reporting that mammography has detected an abnormality, and a second picture is needed, triggers instant fear of breast cancer. For men, an elevated PSA (Prostate-Specific Antigen) test has the same devastating effect. They dread the thought that they've developed cancer of the prostate gland with all its grim implications. But how accurate is the PSA test? And if a malignancy is present, what is the best treatment? A report in the Journal of the National Cancer Institute is hardly reassuring about the accuracy of the PSA test. Researchers studied men ages 60 to 84 between 1988 and 1998. They estimated the PSA test over-diagnosed prostate cancer 29 percent of the time in white men and an...Read More
Philosophy
Many Reservations For Thorupgaarden Nursing Home!
Some columns strike a particular note with readers. The one I wrote about Copenhagen's Thorupgaarden nursing home, struck high C. Every Saturday night pornographic videos are shown on the home's internal channel. If residents remain depressed after this therapy they can request that a prostitute be allowed to visit. The Danish medical community decided this treatment was superior to Prozac. I've received a response from readers, second only to the column on the fractured male organ. From Lethbridge a reader writes, "Go Danes go! Be prepared for the immigration of Canadian seniors. Our young people believe that our brain is dead when we our hair turns white. I may even become a Danish Lady-of- the-Night." A woman associated with the Alzheimer association...Read More
Gastroenterology
The Great Canadian Fart Survey
This week it's tough getting back to work. I've just returned from a cruise around South America's Cape Horn. Each day I was pampered on Holland America's ship, the Ryndham. Then a stay in Rio de Janeiro strolling Copacabana's magnificent beach. One doesn't forget the bikini-clad Latin ladies! So still in a vacation mood I've searched hard and long for a lighter topic for this week's column. I finally found The Great Canadian Fart Survey. This study will never be nominated for a Nobel Prize. It's certainly not a topic for a sedate dinner party. But there are some amazing facts suitable for Trivial Pursuit. Besides the problem is universal. Kings, Queens and the rest of us are all affected by...Read More
Vitamins
Vitamin A: The Bear Had The Last Laugh
I've always liked bears. So I find it hard to understand how hunters can slaughter them. That's why I like this medical story of how the bear, although killed, had the last laugh. Hunters tracked down a bear and shot it. After the kill they were looking forward to a meal. They all loved liver and consumed large quantities. But although great hunters, they were obviously babes in the wood when it came to bear's livers. They didn't know that bear livers contains massive amounts of vitamin A. And so I shed few tears to learn that they all suffered from vitamin A poisoning. Maybe they'll spare the next bear! Today there's a national mania to pop vitamins. There's no doubt that...Read More
Nutrition
Cats Love To Love Me
Millions of North Americans dearly love their cats. I've always preferred dogs and damn it cats instinctively know it. My wife and I laugh at how often romance blooms. We're at a friend's home with several guests and I see their cat out of the corner of my eye. I know exactly what's going to happen. The cat eyes the crowd, slowly circles the room and jumps up on the sofa right behind my head or in my lap as if to say, "You're mine". But so far none of them have infected me with cat-scratch disease. It's estimated that every year over 400,000 people in North America are bitten or scratched by cats. And cat bites are two to three...Read More
Cardiovascular
A New Technique For Coronary Bypass Surgery
How would you like to stitch together two small vessels the size of a piece of spaghetti while riding a bucking bronco? And realize that if you failed the patient would die? This is a tedious task under the best of circumstances. That's why cardiovascular surgeons have shied away from performing coronary bypass operations on a beating heart. Now, a new technique is being used for some bypass cases without the heart skipping a beat. This year over 500,000 coronary artery bypass grafts (CABGs) will be performed in North America. The majority will be done by placing patients on a heart-lung machine during the operation. This allows surgeons to suture tiny vessels onto motionless hearts while the heart-lung machine pumps well...Read More
Eyes, Ears, Nose & Throat
Careless Use of Contact Lenses Can Cause Blindness
It's estimated that 38 million people in North America wear contact lenses (that's 76 million eyes). Owners love the benefits. They're great for sports. They don't break, fall off or steam up. Most people find them more comfortable than glasses and more flattering. And they're a great boon following cataract surgery. But placing foreign objects anywhere in the body has a dangerous downside. I was recently in Washington D.C to attend a research seminar on the prevention of blindness. One of the speakers, Dr. Dwight Cavanagh, Professor of Ophthalmology at the University of Texas Southern Medical School, has been warning for years that users of contact lenses should use them the way porcupines make love, very, very carefully. And that failing...Read More
Philosophy
My E-Mail Nightmare
My daughter said, "Dad don't do it. You don't need the headaches. Just write your column". My three sons cautioned, "You have no conception of what you're getting into. There will be loads of technical problems. Stick to your column" Well I didn't take their counsel and they were right. Agreeing to provide readers with free medical updates by E-mail has given me E-mailitis. The response was massive, a bloody nightmare. And I keep hearing voices "don't do it". So what happened? I realized I might encounter some problems. But was I asking the computer an unreasonable request? After all, I wasn't demanding it to perform thousands of complicated tasks. I didn't need to know readers age, sex , address or...Read More
Genitourinary
New Treatment For The Fractured Male Organ
"So you're the doctor who wrote that column!" I'm still greeted by that remark even though it's 11 years since I first wrote about "The Fractured Male Organ". I know doctors shouldn't make light of a patient's medical problems. But I couldn't stop chuckling when I first researched this malady. Now there's a new treatment for this embarrassing problem. A man was admitted to the emergency department at 1:00 A.M. in obvious distress. He was agitated, his skin cold and clammy suggestive of blood loss. Doctors were shocked to find a markedly swollen penis as the cause which required immediate surgery to remove a large blood clot. The $64.00 question, how did it happen? He was reluctant to explain, but finally admitted...Read More
Neurology, Orthopedics, Psychiatry
Whiplash – Demolition Drivers Could Save Us Billions of Dollars
How much whiplash pain is in the mind and how much in the neck? It's an important question because a huge amount of money is involved. And it comes out of everyone's pocket. This year the diagnosis, treatment, litigation and insurance payments of whiplash complaints will cost North Americans 29 billion dollars. Now, a fascinating report about demolition drivers separates fact from fiction. It could be of use to defense lawyers. There are over one million low-speed rear impact collisions of automobiles every year in North America. During a rear end collision the head is suddenly whipped backwards, then swiftly forward. It's believed that most of the injury results from the backward motion as forward movement is limited when the chin...Read More
Neurology, Pain
Unroofing The Spinal Column to Treat Spinal Stenosis
Ask most people what causes back pain and you get a variety of answers. Many mention sciatica, lumbago, a slipped disk or chronic back strain. But few mention or have ever heard of a condition called "spinal stenosis". Yet it's a disease that we will hear more and more about with an aging population. Years ago spinal stenosis was called creeping paralysis .It was accepted that if you lived long enough you would eventually get it and learn to live with it. Today we know that spinal stenosis is due to a narrowing of the spinal canal (the cavity in the vertebral column through which the spinal cord runs). This can occur in the cervical and thoracic spine but is more commonly...Read More
Lifestyle
Would You Ask Al Capone to Reform the Criminal System?
How naive can you be? Premier Romanow has been touring the country for months trying to discover what's wrong with the Canadian health care system. His simplistic solution? 15 million dollars. He believes that tossing more bags of money into the failing health care system will save it. His foresight is appalling. Even a 14 year old girl could figure that out. During the flurry of interviews and newspaper reports following release of the Romanow report I kept waiting for someone to ask the obvious question. But neither CBC anchor Peter Mansbridge, newspaper journalists nor physicians posed the ultimate query. It took a 14 year old girl to state, "Canadians must exercise more, stop smoking, eat well and don't take illegal...Read More
Philosophy
Why Don’t You Publish Your E-mail Address?
How the years fly by. Years ago I started typing on a manual typewriter, then graduated to an electric one. Eventually I was shoved, kicking and screaming, to a word processor. Again reluctant, I accepted a more sophisticated computer with more bells and whistles than I would ever need. And unless you're a teenager, many of you know it isn't easy learning all the gizmos that go along with it. Some days I would have gladly shot the beast. Now I'm reasonably computerized and so are many others. That's why more and more letters from readers ask me, "Why don't you put your E-mail address at the end of your column?" The short answer is "fear". One week a newspaper in...Read More
Cancer, Gynecology, Nutrition
Milk Cuts Ovarian Cancer Risk By 50 Percent
How can we change these grim facts? That we can't diagnose early ovarian cancer. And that once this malignancy spreads to other organs, 85 percent of women are dead within five years. Every doctor asks himself this question when confronted with the tragic confirmation of this disease. Now a new study shows that drinking milk cuts the risk of ovarian cancer by 50 percent! It's logical for women to ask, "Why can't doctors diagnose early ovarian cancer?" After all, we live in an era of CT scans, MRI's, ultrasound and blood tests. Unfortunately none of these tests can spot "early" malignancies of the ovary. The problem is anatomy. The Creator was friendly to women when he or she placed the cervix at...Read More
Philosophy
The Prescription, Singapore, Not Safe Injection Sites
Aha! Inspiration for a Christmas column. At breakfast this morning I read the morning newspaper. Page after page of it was devoted to increasing urban crime, young people killed in gun fights in broad daylight and drug problems in Vancouver. But what made me dream of Prozac was how authorities intend to counteract all this. Publicly funded injection sites for illegal drug users, a committee to investigate the police and the right to vote for murderers. Am I dreaming? Of course proponents of safe injection sites point to the Swiss experiment. They argue that 10 years ago Platzspitz park in Zurich was better known as needle park. Hundreds of addicts came to buy heroin and inject it in broad daylight. Swiss police...Read More
Lifestyle
Put a Tape Measure In Every Christmas Stocking
The more and more complicated medicine becomes the greater the need to keep it simple. After all, how many people know the formula on how to measure body mass index (BMI) ? Luckily there's no longer any need to tax your brain on this matter. All you need is a tape to measure abdominal circumference. If your dimensions indicate a pot-belly, it's more important than BMI in gauging cardiovascular risk. Dr. Shankuan Zhu, a researcher at the Obesity Centre at Columbia University in New York, examined 4,388 males with an average age of 44 and 4,631 females with an average age of 47. The average BMI for both men and women was 26 which is within the healthy range. The average waist...Read More
Philosophy
Doctors Should Not Dress Like Used-Car Salesmen
"Thank God it's Friday." That's an expression we often hear in the workplace. Friday was once "dress down" day and everybody loved the relaxed dress code at the end of the week. Now it's relaxed clothing every day of the week. I have no idea how this casualness has affected the efficiency of the business community. But dressing-down has had an effect on how patients judge their doctors. Dr. Matt Kanzler and his colleagues recently reported a study in the Archives of Dermatology. They conducted a survey on 84 patients from a private practice setting along with 191 patients attending a county hospital clinic. And there were some surprising findings. Studies show that racial discrimination still occurs in many segments of our...Read More
