Cancer, Medicine, Obesity
For Men, Don’t Disregard a Lump in the Breast
Few findings cause women as much fear as discovering a breast lump and wondering if it’s cancer. But what about men who notice a mass and pain in the breast? Male breast lumps are not commonly discussed in the locker room. But confusion and embarrassment can delay diagnosis of a malignancy. Breast cancer is not entirely a woman’s disease. Although it occurs in males in less than one percent of cases, diagnosis tends to be late. In 2022, of the 2,710 American men expected to be diagnosed with breast cancer, about 530 will die. But male breast lumps are not always dangerous. There’s a condition called “gynecomastia” derived from the Greek root for female and “mastos” for breast. In fact, studies of...Read More
Genitourinary
Urinary Incontinence in Women
Some women say, “You only know a place well if you know where the restrooms are located.” They’re suffering from urinary incontinence (UI). They know if they delay too long, there’ll be an accident. But there are ways to correct this nerve-racking problem. A report from the University of California claims that only one in four women with this trouble seeks help. This is due to embarrassment and the common but illogical notion that it is part of aging. Another account from the Journal of the American Medical Association is hard to believe. It says that 17 percent of women ages 20 and older have moderate or severe UI. This number doubles for women over 60 years of age! There are two main...Read More
Alternate Treatments, Pain, Philosophy
Common Sense in End-of-Life Choices
Few want to think about it. But there are choices to make about death. Doing nothing is one option. Life will, inevitably, one way or another, come to an end. But making common sense decisions about personal preferences for end-of-life should not be taboo or disallowed. And politicians should get out of the way. In Canada, the would-be “just society”, the vast majority of citizens, about 80%, have repeatedly affirmed support for people who wish it to have the option of medical assistance in dying. In the U.S., over the past decade, polls have ranged from 55-75% in support. But why are there still restrictions on who is eligible? In the U.S., there is a hodgepodge legislation, as only some states have...Read More
Nutrition, Orthopedics, Pediatrics
Building Up Bones for a Lifetime
What’s one of the worst errors that young people make early in life? It’s the failure to practice preventive medicine. So, let’s have a talk with young people about how to protect their bones for a lifetime. We know that kids of all ages break bones playing sports. It’s annoying when this happens, leaving them sidelined from sports and play with friends for a few weeks. But breaking a bone becomes more than an inconvenience for adults, as full recovery becomes less likely. The older one is, the more breaking a bone may have life-changing consequences, including being forever consigned to a wheelchair. But why do bones become brittle with age, and can it be avoided? Many people think bones are hard and...Read More
Alternate Treatments, Neurology
Music for the Mind
Music may be the world’s greatest medicine. From infants to centenarians, people love music and the way it makes them feel good. In tribute to its universal qualities, Hans Christian Andersen said, “Where words fail, music speaks.” Even without lyrics, songs certainly convey feelings. Among healthy people, researchers have shown that across cultural divides, people can readily place vastly different types of music into emotional categories ranging from sad to heroic, annoying to beautiful, and desirous to indignant. But the miracle of music is in its healing qualities. Scientists studying people with brain injuries and neurological conditions such as dementia and Alzheimer’s disease are making remarkable discoveries. Music, for example, can improve the gait of people relearning to walk after a brain injury....Read More
Miscellaneous, Philosophy
Decarbonizing Healthcare
Last week we wrote about the environmental disaster of plastics choking the world’s oceans and the consequences for human health through the food chain. This week let’s look through a different lens at another environmental disaster of our own making – the carbon footprint of healthcare itself. Here’s something you may not know. If the global healthcare sector were a country, it would be the fifth-largest greenhouse gas emitter! A report from Health Care Without Harm calculated that the environmental impact of healthcare amounts to 4.4% of global net emissions – the equivalent of 514 coal-fired power plants. So far, North Americans are among the main culprits. By way of example, the report notes, “The United States health sector, the world’s number one...Read More
Miscellaneous, Philosophy
Plastic Soup a Disastrous Meal
Why is humankind so bent on destruction? Why so apathetic in the face of annihilating warfare, repeated massive oil spills and choking urban smog? Equally awful is the “Plastic Soup” in our oceans. A picture of a Hawaiian beach reveals the folly of humans. It shows a huge amount of plastic washed ashore – an insult to a beautiful beach. Such ocean garbage is a serious hazard for sea life. Don’t believe the rest us are immune to this environmental disaster. Our lives, too, depend on our oceans. Small planktonic organisms, through photosynthesis, transform carbon in air and seawater into organic compounds, an essential element of Earth's carbon cycle. They generate about half the atmosphere's oxygen, as much per year as all...Read More
Cardiovascular, Vitamins
Why Wouldn’t You Take Care of Your Heart?
Diana Gifford-Jones: You are starting your 99th year. To what do you attribute your good health? Gifford-Jones, MD: I’ve been fortunate, but it nearly didn’t happen. I suffered a major heart attack when I was 74. My cardiologists insisted on cholesterol-lowering drugs to fight heart disease. But I knew of two-time Nobel Prize winner Dr. Linus Pauling’s research on high-dose vitamin C. I opted for a regimen of 10,000 mg daily which I still continue. Diana: Why not take cholesterol-lowering drugs? Giff: There are side-effects I preferred to avoid. Everyone needs to make their own decisions with their doctors, but mine was anchored in the belief Dr. Pauling was right. He knew that animals produce vitamin C and humans do not. This is...Read More
Cardiovascular, Lifestyle, Nutrition
Do You Have an Inflammatory Lifestyle?
Chronic inflammation is unlike what happens with a cut or an invading germ when the immune system mounts a fight and then stands down. In such cases, inflammation is part of the healing response. But when lifestyle issues have the immune system active all the time, there may be no symptoms, but plenty of costs. Dr. Erin Michos, Director of Women’s Cardiovascular Health at Johns Hopkins Medicine, explains, “Sustained low levels of inflammation irritate your blood vessels. Inflammation may promote the growth of plaques, loosen plaque in your arteries and trigger blood clots — the primary cause of heart attacks and strokes.” Rheumatoid arthritis and diabetes involve chronic inflammation. Immune cells and the antibodies they produce create swelling to help isolate the...Read More
Cardiovascular
A Wave of Heart Disease Among Healthcare Workers?
There has always been a lot of heart in the practice of medicine – literally and figuratively. Typically, the focus is on the beating heart of the patient. But has the pandemic, unlike any challenge to the medical profession before, impacted the hearts of front-line healthcare workers themselves? Medicine is “a calling in which your heart will be exercised equally with your head.” These words of Sir William Osler, a founding figure of modern medicine, were a warning as much as a motivation. A contemporary of Osler, Dr. Maude Abbott, a cardiac pathologist, was one of Canada’s earliest women in medicine. Her calling was challenged by refusal of entry to medical school. (She was barred from entrance to McGill’s medical program...Read More
Medicine, Miscellaneous
Grandma Took the Wrong Pill
Unintentional poisonings are on the rise. Deaths from poisoning occur at double the rate of motor vehicle deaths. It’s a heartbreaking fact that many deaths and injuries are completely avoidable, especially when young children are the victims. Yet, it may be surprising to know this: while children under age 5 account for about 40% of poison exposures requiring contact with emergency services, preventable poisoning deaths are near entirely within the adult population. Many factors are contributing to these tragedies. The opioid crisis is one of the problems. But there are other issues arising from increased isolation and the impact this is having on overall well-being, including among older adults. Changes in age, health status, and many other considerations can make adjustments to prescriptions...Read More
Cancer, Cardiovascular, Diabetes, Gastroenterology, Lifestyle, Neurology
Stand Up To Read This Column
Get up on your feet. Seriously. It will be good for you. Sitting is something we have all become accustomed to doing a lot more of lately. Just prior to the pandemic, studies showed that the average adult spent about 6.5 hours a day sitting – an hour longer than had been the case a decade earlier. In 2019, teenagers were sitting for upwards of 8 hours a day, and for some much longer than that. During the pandemic, a study in the UK found that people were spending more than eight hours a day sitting. Canadians are reportedly sitting around for 10 hours a day! Dr. Jennifer Heisz, associate professor of kinesiology at McMaster University, surveyed over 1600 people to compare physical activity...Read More
Cardiovascular, Infection, Lungs, Neurology
Who Has Lost the Logic in the Vaccine Debate?
Why would any logical person choose to face severe medical complications of COVID if they could be avoided? Most of us have weighed the issues and decided to follow vaccine recommendations. But some flatly refuse. Why? No issue is crying out louder for resolution than this vaccine debate. Now governments are set to mandate COVID vaccines to force hesitant citizens to comply. It’s been done before time and again – for childhood immunizations, for example. That’s one way to go about it. But a look at the medical evidence should help compel sensible people to opt in. A growing stack of studies shows that vaccinated people are much less likely to die from COVID than the unvaccinated. Do not people desire to stay...Read More
Miscellaneous, Pediatrics, Philosophy
How Much Longer Can Parents Take It?
Remember the movie, “Network”? Howard Beale, the TV news anchor, encouraged viewers to go their windows and yell out, “I’m as mad as hell and I’m not going to take this anymore!” How many parents feel that way about school closings? Uncertainty about openings and closings is bad enough. But now schools face severe staffing shortages. Entire classes may be disrupted because teachers are falling sick or required to isolate. Substitute teachers are nothing new, but the scale of the problem is concerning. Just as hospitals can shut down due to insufficient workers, so too can schools. School boards are scrambling to figure out what options they can offer students for online learning. Some offer synchronous learning (in real-time). Others offer asynchronous learning...Read More
Alternate Treatments, Miscellaneous
Is Virtual Healthcare the New Normal?
The current pandemic is deeply affecting many aspects of society. Accelerated usage of virtual healthcare is a good example. While frontline healthcare workers serve patients needing essential in-person care, some doctors and patients are meeting up over the phone or on video calls. Virtual healthcare is well known to those living in remote communities. But during the pandemic, it has become an option for everyone. A debate has ensued about whether such care is good or bad. Proponents of either side are lining up evidence to prove the case. How can you argue with the fact that curable cancers in children have been missed in the absence of face-to-face consultations? But how many lives have been saved by “seeing” the doctor virtually,...Read More
Cardiovascular, Miscellaneous, Neurology, Sports
Ring in the New Year with Your Inner Mountaineer
It’s not what we were hoping for at this time of year. The doom and gloom of Omicron has many people feeling down. But casting your gaze upwards might be just the right move. For a New Year’s Resolution, this might be a good time to channel your inner mountaineer. Christmas and New Years should be the season for celebration, not hibernation. Families should be together, not torn apart by differing views on vaccination. Charitable giving should be the theme, not clamouring for rapid test kits. Yet so it goes. Even among those getting out for a would-be joyous wintertime walk, you can see, in the narrow space between their toques and their masks, the melancholy in their eyes. So, what’s the...Read More
Eyes, Ears, Nose & Throat, Miscellaneous
What Could Go So Wrong at a Holiday Luncheon
The immortal Shakespeare wrote in the play Macbeth, “Each new morn new widows howl, new orphans cry, new sorrows strike heaven on the face.” He was not wrong. Readers may wonder how I am faring as I near the start of my 99th year. I am glad to report, while getting older is rarely much fun, my medical training remains useful! At a holiday luncheon with long-in-the-tooth friends, one started to cough. It was nothing to attract attention. But the situation suddenly changed. His coughing became intense and breathing more difficult. Food had become stuck in his throat, probably lethally so. I knew what I had to do. As a surgeon, I’ve faced many crises: heart attacks, strokes, and other life-or-death situations. But during my...Read More
Gynecology, Pediatrics, Philosophy, Surgery
The Changing Nature of Birth
We said goodbye to a beloved 17-year-old dog this week. She had rapidly lost quality of life. As sad as it was, few would have any qualms whatsoever with the vet’s provision of humane, painless, and sensible euthanasia. But what’s going on with medical interventions at the great miracle of birth? It’s no secret that humans commonly push the boundaries of scientific possibility – for better or for worse. Traditionally, interruptions in the natural birthing process have been overwhelmingly in the “for better” category. Caesarean sections may not have been a desirable option for women prior to the advent of modern surgical techniques – uterine suturing, for example – not to mention anesthesia. But in the modern era, there can be no...Read More
Lifestyle, Miscellaneous
Happy Hour with a Hedgehog?
These days, too many things are all wrong. But now and again, everything that’s right in the world comes together. We found such a place in a local neighbourhood restaurant recently, where good food, good music, and good company combined to make everybody happy. But was it healthy? Almost, but not quite. What would be the perfect conditions for a neighbourhood restaurant to score top marks in offering good times, good food, and good health? Start by thinking about the eating and socializing places within walking distance of your home. Not everyone is so lucky to have such options. But most do. And if you do, how often do you walk there? When it comes to dining out, it’s well said “health is...Read More
Eyes, Ears, Nose & Throat
What’s Wrong with Hearing Aids
Peter Drucker, the management theorist, who wore hearing aids later in life, famously remarked, “The most important thing in communication is hearing what isn’t said.” The hearing aid industry would be wise to listen in. For all the big noise about what can be heard when people with hearing impairment are fitted with aids, is an important message being missed? Hearing aids, in general, make life better for people with mild to severe hearing loss. But has the development of ever smaller technology made it needlessly difficult for people to enjoy the benefits? Does it seem as though the aids are designed to hide, for vanity’s sake, or worse, as if in shame, a hearing disability? The focus should be on ease...Read More
Lifestyle
Goodnight Moon and Goodnight Doctor, Whispering “Stop it!”
This column, over 45 years, has begged people to make the lifestyle changes that will help them avoid the development of type 2 diabetes. Failing that, there’s mounting scientific evidence that natural supplements supporting glycemic control can help mitigate dietary obstinance and lack of exercise. And in the event diabetes takes hold, then give thanks to Banting and Best for their discovery of insulin 100 years ago. But is there one more opportunity for Gifford-Jones to get the “prevention, prevention, prevention” message out? How about the publication of a Gifford-Jones timeless classic for children? A book as good as Goodnight Moon. A story as meaningful as Ferdinand the Bull. Perhaps, a variation on The Very Hungry Caterpillar? A story of “moderation...Read More
Cancer, Endocrine
You’ve Discovered a Thyroid Lump, What Does It Mean?
Waking in the morning, the last thing you want is a health shock before you begin the day. If you are like most people, feeling a lump for the first time at the Adam’s apple, the thyroid gland, you will immediately jump to one conclusion, “I have a cancer.” But is this the right conclusion? So, let’s report some good news that will decrease anxiety while you have your morning coffee. Fortunately, the majority of thyroid nodules are not cancers. Besides, the majority don’t even require removal. Thyroid nodules are common in elderly people. In fact, a report from the University of California states that if you’re over the age of 60, there’s a 25-to-50 percent chance of developing a thyroid lump. The...Read More
Gastroenterology
Celiac Disease: Has the Diagnosis Been Missed?
Some health problems can be hard to pinpoint. An accurate diagnosis of celiac disease can be easily missed. Among adults in particular, symptoms can be so subtle it can go undetected for years, causing other problems that further complicate a definitive diagnosis. Researchers at Duke University examined a randomized sample of 2,835 people over the age of 55, finding 2.13 percent had this disease but didn’t know it. Today, celiac disease affects one percent of the population in Western countries. Celiac disease is an autoimmune disorder. Sufferers encounter trouble when eating foods containing gluten, found in wheat and other grains. The immune system attacks small, finger-like protrusions, called villi, lining the small intestine, causing inflammation and scarring of the intestinal wall. As the...Read More
Lifestyle, Miscellaneous, Philosophy
The Ultimate Disease: Too Many Rats in a Cage
What catastrophic event could end all lives on this small planet? Some say nuclear war; others, another pandemic worse than the current one that’s caused over 700,000 deaths just in North America. Still others, the failure to tackle the problem of climate change. But here’s a surprise. The ultimate disease is a population time bomb that keeps ticking every second of the day – and we all ignore it. It took 123 years for the human population to grow from one to two billion people. Then, only 40 years to reach six billion, and now the population is 7.8 billion. This year, 82 million people will be added to an already packed planet. It’s like adding another city the size of...Read More
Infection, Medicine, Vitamins
The Case for Vaccination is Clear
What helped to shape my career? As a small child I became spell bound when I read Paul de Kruif’s book “Microbe Hunters”, published in 1926. It offers a sweeping history of the earliest microbiologists and immunologists, dating back to the discovery of microbes in the 17th century. Louis Pasteur features prominently as the researcher who discovered how to make the vaccine that neutralizes the microbe that causes rabies. Scientists were producing vaccines to treat many other viral diseases. It became my burning desire to be a doctor. Vaccines have saved countless lives. This is clear. Three years ago, my column discussed vaccination. I explained that, as a surgeon, I could never guarantee that operations were 100 percent free of complications. I...Read More
