Recovering from a difficult surgery, a prolonged hospitalization, or dealing with a chronic and complicated illness is a challenge.  It often gets a bit disheartening as the weeks and months trudge on.

It’s just such situations that remind me of Aesop’s fable of the ‘Tortoise and the Hare’.   We all remember the story of the slow plodding tortoise being raced by the fast hopping hare, but I think because bugs bunny and other rabbit icons have become such fixtures in our minds, that we tend to think that the rabbit made out; well, he didn’t.   It is the slow and steady tortoise the reaches the finish line first and wins the day.

So….when it’s seeming like the challenges keep coming, always remember what I tell my patients……”Remember…the tortoise won the race.”


Macular Degeneration is the most common cause of vision loss as we age.   The conditions runs the gamut of mild findings in the eye on examination by the ophthalmologist (called drusen of the retina), to more severe changes that include new blood vessel development.

New treatments, injections into the eyeball that stall the vision changes and reverse the blood vessel growth, have been a major advance, but identifying this condition before it becomes more active is a key component.

To identify if you are developing issues with Macular Degeneration, use the famous AMSLER GRID.   This simple printed graph paper will allow you to monitor your vision and to identify Macular Degeneration early or to monitor any changes in it.

Download an AMSLER GRID >>>HERE<<< and put it on your refrigerator or in your bathroom, to keep an eye on your own vision.


This year, for the first time in my career, I have had three adult  patients seek hospital treatment for significant scorpion bite symptoms affecting their bodies more generally, including generalized tingling and numbness.

This is very unusual to me, and suggests  that the potency of neurotoxin in the current scorpions in Scottsdale is greater than in past years.

Typical symptoms of scorpion sting consist of pain as the site of the sting as well and numbness and tingling in the affected limb.  These are by far the most common symptoms.  This is considered a Grade I level of symptoms and requires only Ibuprofen or painkillers for pain relief and a tetanus shot if not had within 10 year (this can wait a few days until given).

Grade II symptoms include the above as well as generalized numbness and tingling.  These can occur within minutes to a few hours and can last several hours.  Treatment is the same as above and many patients will seek hospital attention for these generalized symptoms.  This is reasonable to do, but care is once again supportive and no additional medications are given.  Monitoring of the patient over the next several hours is the key Emergency Room treatment to make sure symptoms do not progress.

Grade III and IV symptoms are much more dramatic and include:  blurred vision, trouble swallowing, excessive salivation, fever, trouble breathing.  If these develop it is a critical emergency and 911 needs to be summoned.  I’ve never seen this in my career, but it is important to be aware.

Remember, nobody has died from a scorpion sting in Arizona since 1968, so that is some comfort….but do be aware that scorpion stings are more potent currently.



Many of you heard me planning to go  to the Great American Eclipse ….well…we made it.

It was an awesome experience, as you’ve heard from many quarters, and I would echo those reports, but even stronger in me was my feeling of a connection to those discoverers in the past (ancient and more modern), as well as the every day scientists who develop knowledge and determine the nature of our universe with such precision, that the entire event was understood and timed to such accuracy.

I like to tell patients that I am a Hopkins-trained medical scientist, and that connects me to the scientists of the past and present, who use knowledge to gain power over the world we inhabit.   Einstein, Salk, Darwin….these are heroes to me and the eclipse is a validation that the universe is knowable and that those who pursue such knowledge and who share it with us all, give us power to control our destinies.


Choosing healthy food is a challenge.  Not because unhealthy food tastes so good, but because some things that seem healthy may not be.   As I’ve said  many times before in this blog, writers such as Gary Taubes have exposed the lack of proven research to demonstrate the healthiest aspects of diet. Gary Taube’s Good Calories, Bad Calories is probably the most enlightening book on this topic.

Among the latest trends that are of questionable value is the explosion of juice bars across the country.  Although juicing vegetables and grasses can be healthy, if that flavor appeals to you, more often people are ordering highly caloric and highly sugary juices that are more harmful to your health that you realize.   Yes….fruit is healthy, but removing the pulp, skin, and other nutrients and just drinking the juice, can be no better than drinking soda pop.

This recent article in the Washington Post exposes the concern and has some good insights on the topic.   Read >>>>HERE<<<< and reconsider before you splurge on that tasty fruit juice at your local juice shop.



The world of healthcare is in flux in many ways; more in the delivery and payment than in the scientific aspects of the enterprise.   This is leaving the  public and physicians themselves uncertain about the future of how medical care will be delivered and how insurance will provide coverage for that care and support the system that underpins its delivery.

The changing landscape will be filled with a lot of new ideas and developments, but during this time-frame, our office will remain very much as it always has; a place of high quality and ‘high touch’, delivering the best healthcare in the valley in a authentic manner that is familiar to anyone who has seen their doctor over the past few decades.

I’m confident we are on our way to a better system that is more comprehensive in the care of everyone in the U.S., but during this transition time, we will remain steady and certain in our approach.   Expect…and get….the excellence.



Statin medications (Lipitor and Crestor) have been mainstays in the treatment of cholesterol for the past 30 years.  They have a proven track record of safety and effectiveness in preventing heart attacks and strokes.  Although serious side effects from these medications are very very uncommon (I’ve never seen any in my practice over 30 years), minor side effects, like muscle aches happen fairly frequently.   This is definitely something we’ve observed, but a recent study has called this connection into question.

In a seminal study in THE LANCET, a major British Medical Journal, patients who were on statins and were told that they might cause muscle pains, experienced more muscles pains (even though they were not on a statin….they were on placebo.)   We call this the NOCEBO effect, which is the opposite of the PLACEBO effect.

In the PLACEBO effect, being told that taking a medication can cause positive/curative symptoms, patient tend to feel better.  The NOCEBO effect, is just the opposite.  When patients are told a prescription can cause negative side effects, they are more likely to experience those.

Read more about this study >>>>>HERE<<<<



With Senator McCain’s diagnosis of glioblastoma just announced, I think it will have each of us thinking about this unlikely condition and the possibility that we might have symptoms that suggest a brain tumor.

Patients often worry about such diagnosis when they have persisting headaches or strange head pains, but doctors know that such symptoms will likely connect to a brain tumor in only 1 or 2 patients during an entire 30 year career….in other words, headache is rarely a symptom of this condition.

The type of brain tumor Senator McCain has occurs 1 in 10,000 people per year, which makes it very uncommon, and although serious, it is a condition I have seen only  rarely among my patients (5 times in 30 years so far).

Keeping a rational perspective about such conditions is important so that we don’t spend time worrying unnecessarily.   I will often perform CAT scans for patients to eliminate their worry about such conditions, as it is just the ongoing thoughts  that make them feel poorly.   Having objective evidence that their brain is ‘fine’ is an immediate relief and also tends to resolve symptoms rapidly.

So….don’t worry that brain tumors are common….they are not.   Like everyone else in the country, we wish Senator McCain the best in dealing with his health issues, but let’s not let us worry about ourselves too much in this regard.



When I speak with patients and mention that they need to cut down on salt, they will usually tell me they do not use the salt shaker at all.

That is not a surprise….I don’t think many of us use the salt shaker anymore at the table, at least  not much.   Only about 12% of your salt comes from adding it in this way.  The most common way we get salt is hidden in prepared foods and it’s important to know where those high salt items are.   The AHA has made a list of the SALTY SIX, and I though it would be good to share to that we all are aware of the hidden salt that is in our food.   Watch my video on salt for further information….you can see that  >>>>HERE<<<<