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.
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<<<<
Getting approval from insurance companies for medications has become a Herculean task. In an effort to control costs, there is a lot of ‘denying’ going on by the insurance companies. What is most frustrating, is the challenge of meeting the criteria insurance companies set for medications patients have been on for years and that have provided stable and effective treatment. To fight that battle, Jeff Gibbons is our specialist in insurance approvals. Thank you Jeff, our medicine approval guru, for doing all you can to keep ‘ringing that bell’.
It’s always exciting to find something on the internet, either a source of information, or a new shop that carries products you’ve always wanted and never could find.
Dealing with swelling of any sort can be bothersome and medications are often an imperfect solution to eliminating excessive fluid accumulation in the legs or another body part. Compression garments, if comfortable, can be a great alternative. The newest site I’ve found is www.compressionguru.com They carry a vast list of products for patients with lymphedema, edema, and varicose veins to help them with special needs, custom products, and more day-to-day products.
We keep a list of such websites on our FAVORITES page on our website. The link is >>>>HERE<<<<
Perhaps you’ve heard about boxing as a therapy to help with Parkinson’s patients, but if you haven’t, it’s an interesting connection. Of course, when we think of boxing we tend to think of Muhamid Ali and his Parkinson’s disease that was perpetuated by repeated blows to the head. But there is evidence that the coordination needed for boxing has a protective effect on the brain that stimulates nerve communication and increasing the chemicals (dopamine) that are depleted in Parkinson’s. Check out our patient, Steve Shenkman, and his efforts at fighting back.
We all feel a loss in the office when one of our patients passes away, and when that person is as lovely and personable as Al Golin….it’s particularly hard.
Al was an amazing individual whom we came to respect and care about. Our loss is minor compared to that of his family and friends, but his his philosophy of life and work is something we can all learn from. We are inspired by each of our patients and Al’s passion for work and life are wonderfully expressed in a tribute that can be seen at his company’s website. Don’t miss seeing and sharing his vision and ideas. Look >>>>HERE<<<
Used to be that the most dangerous trouble-makers in the country could be found on the wall of the post office. The list of the FBI ‘Ten most wanted’ was always fascinating to me. A chance to see a picture of the most heinous criminals still on the loose.
Today’s ‘Top Ten’ is actually a Top Twelve, listed by the World Health Organization(WHO) as the Superbugs that are on the highest priority hit list for focus by medical science.
What is a superbug? It is a bacteria that has become strongly resistant to our common antibiotics and which can only be defeated by multiple non-traditional antibiotics in a combination that can be toxic. These combinations are capable of beating the superbugs in most cases….but not always. Although rare, they are becoming increasingly noticeable across the US and the world and will become an increasing problem over the coming years. A future in which bacterial germs are untreatable is unlikely, but a focus on developing new treatments now is essential for a future that does not become a bacterial dystopia.
There have been recent reports of the Avian Influenza among birds in China, termed the H7N9 strain. Such outbreaks are common, and they are monitored closely by public health officials due to the potential for an epidemic starting from such outbreaks. Current human strains are much different: H1N1 and H3N2. A change to H7 would have profound consequences.
Influenza is a specific seasonal virus that has a worldwide distribution and it has been the source of deadly epidemics in the past. The last major worldwide epidemic was in 1918, 100 year ago when the population was less then 2 billion people. Now, with the population of 7 billion and billions of people living in cities with exposure to animals and birds in close quarters (particularly in the developing megacities of China, Africa, and South America, the potential for an explosive epidemic is much greater. The canary in the coal mine will be these initial avian (bird flu epidemics). If they spread widely among chickens, then if they can infection humans and transmit easily from human-to-human, we have the makings of a worldwide pandemic.
Monitoring is key to prevention, and rapid development of specific flu vaccine with stockpiling, also is critical to avoid such an outcome. So…when you hear about the initial spread of such outbreaks, it’s worthwhile keeping an eye out for such information. It will often be a false alarm, but we need to be prepared if it is more than that.