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Monday, January 16, 2017

  • Monday, January 09, 2017 4:00 AM
    I continue to be amazed that, when asked what the number one killer of women is, the majority of women respond, “breast cancer.” While breast cancer is the number one cancer killer of women, and is estimated to have claimed about 40,000 women last year, it is not the biggest threat women face. Heart disease kills 10 times as many.
    Cardiovascular disease is arguably the most important women’s health issue and is largely preventable. How can women be so aware that they have a one in 31 chance of dying from breast cancer, but not the much higher one in three chance of dying from heart disease? Could it be that breast cancer is so much more visible in popular media? Perhaps it’s that breast cancer is generally more frightening and potentially disfiguring. Let’s face it, heart disease is just plain boring to talk about.
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  • Thursday, January 05, 2017 4:00 AM
    There is no doubt that antibiotics have saved millions of lives. But, is it all good news? I hope our readers have been noting the increasing number of news stories related to problems with the overuse of antibiotics and the development of resistant bacteria. We have known this was coming for decades, but it has now reached a tipping point. Sally Davies, the Chief Medical Officer of the United Kingdom, has equated the critical health threat of antibiotic resistance to the risk of terrorism. 
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  • Wednesday, December 28, 2016 4:00 AM
    My patient Jim asked me to re-run my column about warts. It’s estimated that up to 12 percent of people worldwide have had warts and that 10 to 20 percent of school-aged children have them at any given time.
    Warts are caused by a group of viruses called human papilloma viruses or HPV. When people hear HPV they often think of genital warts that are caused by certain strains of HPV virus, some of which can cause cervical or even mouth and throat cancers. There are over 100 known types of HPV, all of which share the characteristic of being able to infect skin cells.
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  • Monday, December 19, 2016 4:00 AM
    An adult patient has asked me to write about night terrors. While night terrors can be seen in adults, they are much more common in children. It’s hypothesized that this is due to brain development.
    Night terrors are a subclass of sleep disorders called “parasomnias.” Rather than focus specifically on adults, I’d also like to talk a bit about kids. People who exhibit parasomnias often have family members who suffer from them as well. Virtually all of these conditions go away with time.
    Parasomnias are a category of sleep disorders defined by abnormal and unnatural movements, behaviors, emotions, perception, and dreams. They occur while falling asleep, sleeping, between sleep stages, or arousal from sleep. They are further classified by when they occur in the sleep cycle – during REM (Rapid Eye Movement) sleep or during non-REM sleep.
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  • Monday, December 12, 2016 4:00 AM
    Winter has arrived and hopefully that means you have all received your flu shot. Most people us the term “flu” in a very generic sense, meaning anything from cold symptoms to having a case of vomiting and diarrhea. The “flu” in this column refers to respiratory influenza.
    Two particular types of influenza viruses, Type A and Type B cause the majority of influenza infections. Type B typically does not cause severe disease whereas Type A can be lethal, particularly in the young, elderly and in those who have compromised immune systems.
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  • Monday, December 05, 2016 4:00 AM
    A patient who’s mother is having hearing difficulties asked me to write about the best way to choose someone to fit hearing aids. I’d like to begin with some background on hearing.
    It goes without saying that hearing is one of our most important senses. It is critical for our quality of life as well as for safety and social interaction. There are an estimated 30 million Americans who have some degree of hearing loss, 65 percent of whom are younger than 65 years of age. It’s very concerning that one in 14 younger adults and one in 20 adolescents have measurable hearing loss. Since 1971, the number of Americans over age three with hearing disorders has doubled.
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  • Monday, November 28, 2016 4:00 AM
    Winter cold and flu season is rapidly approaching. This week, I’d like to talk about a different kid of flu, “stomach flu.” I have to start by dispelling a common misconception that all flu is the same. “Stomach flu” is not caused by the same viruses as “respiratory flu.” Flu shots, given to prevent respiratory influenza, will not protect you against viruses affecting the gastrointestinal tract that can cause an infectious malady known as viral gastroenteritis.
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  • Monday, November 21, 2016 4:00 AM
    This week I want to address a malady that I’ve been seeing a fair amount of lately – dizziness. Primary Care doctors in the U.S. see about six million patients a year with dizziness. 
    Dizziness means different things to different people and can be a symptom of many different medical conditions. People usually describe being dizzy when they either feel faint or lightheaded or when they feel like they or the room are spinning. This latter sensation is called vertigo, from the Latin vertere meaning, “to turn.” 
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  • Monday, November 14, 2016 4:00 AM
    This week I’d like to write about a problem that costs taxpayers billions of dollars each year – Medicare fraud and abuse. Medicare paid out $505 billion in payments for services and medications in 2014, accounting for 14 percent of the federal budget. The Office of Management and Budget (OMB) reports that 12.7 percent of those payments were “improper,” meaning the services were not necessary, did not meet Medicare guidelines, or were downright fraudulent.
    Medicare fraud refers to individuals or companies who obtain payments from Medicare under false or illegal pretenses. The OMB has been making a concerted effort to limit Medicare fraud, but Medicare is an easy target since it is such a complex program. It’s like playing the lottery for those who are intent on defrauding the government, but with a much higher chance of a payoff.
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  • Monday, November 07, 2016 4:00 AM
    Someone told me the other day that they thought “restless leg syndrome” was a condition made up by pharmaceutical companies to sell more medications. Many of you have probably seen the commercials for Requip® and Mirapex®, both drugs used to treat this malady.
    People have described symptoms suggestive of restless legs since the 17th Century. The Swedish neurologist Erik Ekborn, initially coined the term “restless legs syndrome” (RLS) in the 1940’s. It is estimated that between 10 to 15 percent of Americans suffer from RLS to some degree. The incidence in women is about twice that of men. About 40 percent of people develop symptoms prior to age 20. Since symptoms tend to be mild initially and worsen with age, most sufferers are not diagnosed for 10 to 20 years.
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  • Monday, October 31, 2016 4:00 AM
    I still occasionally hear the topic of “death panels” come up in conversations with my patients. The Affordable Care Act of 2010 “Obamacare,” described the “Advance Care Planning Consultation.” It was written to provide reimbursement to physicians to take the time to sit down with their patients to discuss end of life care.
    As a family physician, I see it as my professional duty to discuss end of life care with my patients. In fact, I would consider it negligent to not hold these discussions when appropriate.
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  • Head lice treatment takes patience, persistence
    Monday, October 17, 2016 4:00 AM
    I’m starting to see a few cases of head lice now that kids are back in school. Head lice are white and about the size of a sesame seed. They are known as "obligate ectoparasites." Obligate means they require a placental mammal host to survive (i.e. humans) and ectoparasites means they live outside the human body. They must feed on the host’s blood to survive and can't live off of a body for more than a day or so. Lice are spread by direct contact of a person's head or hair with an infested individual or through sharing personal items such as hats, towels, brushes, helmets, hair ties or even car seat headrests. They do not jump or fly and are not transmitted by pets.
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  • Generic or name brand?
    Monday, August 22, 2016 4:00 AM

    This week I want to tackle the subject of generic vs. name brand medications. There are a number of reasons this topic is important. First of all, medications in general are becoming prohibitively expensive for many patients. Insurance companies are also pressuring patients and physicians to prescribe generics whenever possible to reduce health care costs (not necessarily a bad thing, but certainly a pain in the rump at times).

    I receive many questions about generics in the office. People want to know why every medication doesn’t have a generic substitute and if not, how long will it be until one is available. They also want to know if they are safe and effective.

    First let me describe what generic and name brand drugs are. Generic drugs are chemical compounds that never received patent protection or the patent on the name brand drug has expired. In contrast, name brand drugs are protected by a patent, meaning no other companies can produce or sell that particular drug.

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  • Monday, February 04, 2013 9:00 PM
    I've had some questions recently about ovarian cancer so I'll try and tackle this complex subject. This cancer is frightening because it often has very few signs or symptoms before it becomes very advanced.
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  • Friday, February 20, 2009 9:30 PM
    The "flu" has made its return to Indiana a little later . . .
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The Paper of Montgomery County,
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