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Monday, January 27, 2020
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  • If your shoulder hurts these may be some reasons why
    Monday, January 20, 2020 12:20 AM
    The next two weeks, I’d like to address shoulder pain and injuries. Most people experience shoulder pain at some point in their life. Doctors typically see it in athletes, people who overuse their shoulders, and others who may have fallen directly on their shoulder or on an outstretched arm.
    To understand shoulder pain, it’s important to know the basic anatomy of the shoulder joint itself (see diagram of the front view of the right shoulder). The shoulder joint is one of the most complex in the body. Most joints permit only a fairly limited range of motion. The anatomy of the shoulder joint, in contrast, allows for a vast range of movements. To be so versatile, It has to be relatively unstable compared to our other joints.
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  • Don’t Believe Everything You Hear!
    Saturday, January 18, 2020 8:31 PM
    We are definitely living in a post-truth world. It’s not just in the political sphere that we have to be careful of facts and “alternative facts.” It also extends to the scientific world as well. The public is being constantly bombarded with scientific information through popular media, especially the Internet. How is a non-scientist supposed to filter through all this information and figure out what to believe? I want to give you some tips to use when evaluating what you see or hear.
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  • Antibiotics are good – Right?
    Sunday, January 5, 2020 10:48 PM
    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 since Alexander Fleming who discovered penicillin warned of it in his Nobel Prize speech in 1945. Dr. Sally Davies, the former Chief Medical Officer of the United Kingdom, equated the critical health threat of antibiotic resistance to the risk of terrorism.
    Each year in the United States two million people are infected with antibiotic-resistant bacteria and 23,000 die. An excellent updated CDC report was published last year and can be downloaded at bit.ly/2QlCpep. The primary cause of resistant bacteria is the overuse of antibiotics, both in medicine and agribusiness. This is also complicated by the fact that very few new antibiotics are being developed – there’s little profit in drugs that will quickly become ineffective as bacteria become resistant.
    1 comment(s)
  • Complementary and Alternative Medicine
    Monday, December 30, 2019 2:59 AM
    I’m frequently asked by patients to comment on the use of “non-traditional” treatments or remedies they have heard or read about. I usually have to respond that I have limited knowledge about the product, but I will sometimes try to help the patient research the product or its ingredients.
    The business of complementary and alternative medicine or “CAM” is booming. This is largely an outgrowth of patient frustration with traditional medicine, as well as the ease with which CAM is promoted and sold via social media and the Internet. People are fed up with the high cost of medications and other treatments as well as the perceived loss of empathy in the American health care system.
    Many are looking for less expensive “natural” ways to deal with illness and health promotion. However, a government survey in 2012 revealed that Americans spent $30.2 billion on CAM treatments in the preceding 12-month period. This accounted for 9.2 percent of out-of-pocket health care spending and 1.1 percent of total health care spending.
    2 comment(s)
  • Screening for Heart Disease & Lung Cancer
    Sunday, December 22, 2019 10:15 PM
    Primary care providers are noticing an uptick in patients asking hospitals and imaging centers to perform heart and lung CT screening tests, usually after seeing them advertised by the facilities doing the testing. The results often into their doctors’ in boxes without the providers having any prior knowledge that their patients had the examination(s). The scans typically have out-of-pocket costs in the $49 to $99 range and are usually not covered by insurance. They are promoted to identify early heart disease and/or lung cancer.
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  • Influenza
    Tuesday, December 17, 2019 4:00 AM
    The cold weather is settling in and it’s time to prepare for the flu. 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. Annual statistics since 2010 reveal the number of deaths from influenza has ranged from 12,000 to 79,000 and hospitalizations between 140,000 and 960,000.
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  • Hearing Trouble?
    Monday, December 9, 2019 4:00 AM
    A patient whose mother is having hearing difficulties asked me to write about the best way to purchase hearing aids. I’d like to begin with some background on hearing.
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  • Monday, November 18, 2019 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 $582 billion in payments for services and medications in 2018, accounting for 14% of the federal budget. The Office of Management and Budget (OMB) reports that 8.12% of those payments were “improper,” meaning the services were not necessary, did not meet Medicare guidelines, or were downright fraudulent (a decrease from 9.51% in 2017).
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  • Monday, November 11, 2019 4:00 AM
    This week I want to address a specific variant of a condition that I’ve been seeing a lot 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 feel faint or lightheaded or when they feel like their environment is spinning. This latter sensation is called vertigo, from the Latin vertere meaning “to turn.”
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  • Monday, November 4, 2019 4:00 AM
    Someone told me the other day that they thought “restless leg syndrome” (RLS) was a conspiracy created by pharmaceutical companies to sell more medications. You may have seen the commercials for Requip® and Mirapex®, both drugs used to treat this condition.
    People have described symptoms suggestive of restless legs since the 17th Century. The Swedish neurologist Erik Ekborn initially coined the term in the 1940’s. We estimate that between ten to fifteen percent of Americans suffer from restless leg syndrome to some degree. The incidence in women is about twice that of men. About 40 percent of people develop symptoms prior to age twenty. Since symptoms tend to be mild initially and worsen with age, most sufferers are not diagnosed for 10 to 20 years after they start having symptoms.
    The symptoms of RLS are highly variable, but most people describe a bothersome, irresistible urge to move their legs. This urge is worse during periods of inactivity and often interferes with sleep. About 85 percent of sufferers have difficulty falling asleep. Stress and fatigue can also exacerbate the symptoms.
    2 comment(s)
  • Tuesday, October 22, 2019 3:43 AM
    “All parts of the body if used in moderation and exercised in labors to which each is accustomed, become thereby healthy and well developed, and age slowly; but if unused and left idle, they become liable to disease, defective in growth, and age quickly.” - Hippocrates
    Few things benefit the body more than maintaining physical fitness. While doctors routinely recommend exercise for younger patients, we’re realizing how important it is for our older patients as well. Regular exercise, even in one’s senior years, can still reduce your risk of a number of health conditions, particularly heart attacks, strokes, and falls. It also may be one of the few things to slow the onset of dementia.
    Most communities are blessed to have many options available for exercise, especially programs that are supervised. I prefer these activities because a trained professional typically leads the group. This person can make recommendations to get the most out of a program in the safest way possible.
    Why is regular exercise so important for seniors? You may have noticed that as our bodies age a number of physiologic changes occur. We lose muscle mass and tone that leads to weakness and problems with balance. Flexibility becomes an issue (the most common cause of night time leg cramps). Our bones become weaker from a lack of weight-bearing activity. Balance problems and weak bones can lead to falls and fractures. Our hearts and lungs can get out of shape, resulting in reduced stamina and difficulty breathing with activity. This can lead to a reduced level of confidence & independence.
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  • Monday, October 14, 2019 4:00 AM
    The title of this column, a quote from comedian W.C. Fields, refers to his penchant for drinking alcohol. So what do alcohol and W.C. Fields have to do with my topic of rosacea? Read on. 
    Rosacea is a common skin condition usually found on the face, which can be a great source of consternation. It is a disease with various clinical signs. These can include redness/flushing, coarse skin, and bumps and pustules resembling acne. It may also present with visible superficial blood vessels called telangiectasias. 
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  • Monday, September 16, 2019 3:55 AM
    I recently had to remove some toenails. Why on earth would someone want that done? Because they were infected with fungus. The medical term for a fungal infection of the toenails or fingernails is tinea unguium, also known as onychomycosis (OM).
    This condition is generally more of a nuisance than a real health threat. However, infected nails can become quite enlarged and painful. Diabetics and people who have poor immune system functions need to be concerned about OM. Infected nails in these folks can lead to inflammation of the skin around the nails and entry of skin bacteria that can lead to serious skin and even bone infections.
    Most people visit their doctors for OM because of the disfigured nails. It is the most common nail disorder in adults and affects up to 13 percent of North Americans. It is 30 times more common in adults than children.
    OM is caused by two major genera of fungi, Trichophyton rubrum and Trichophyton interdigitalis. These fungi invade and feed on hair, skin and nails. These organisms are called dermatophytes and account for up to 99 percent of OM.
    Yeasts and molds cause the remaining cases. It’s often difficult to tell what organism is causing the infection without doing a culture or DNA testing in the lab.
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  • Monday, September 9, 2019 4:00 AM
    The weather is finally starting to break a bit allowing many of our readers to get back out in the yard to prepare for fall. This has resulted in a lot of rashes showing up in our office. Most of these rashes were caused by poison ivy, one of three plants in Indiana in the genus Toxicodendron. This genus also includes poison sumac, and poison oak.
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  • Monday, September 2, 2019 4:00 AM
    Doctors nationwide have been seeing a definite uptick in patients going to hospitals and imaging centers to have various screening tests done. The most common are heart and lung CT exams and possibly ultrasound tests to evaluate for blockages in the arteries in the legs. The scans typically have out-of-pocket costs in the $49 to $99 range and are not covered by insurance. They are promoted to identify early heart disease, artery blockages and/or lung cancer.
    People usually ask for these tests after seeing them advertised by the facilities doing the testing. While screening can save lives, it can also lead to unnecessary additional testing and worry for patients. Many of these scans are done inappropriately without a prior discussion of their utility and limitations and determination if there is actually an evidence-based need to do the test. 
    It is important to know the risks of any screening test including false positives (seeing things on the scans that have no medical significance, yet may cause a great deal of angst for patients), false negatives (not seeing something that is actually there), as well as exposure to radiation.
    The coronary artery calcium (CAC) scoring test involves doing a CT scan to see if calcium deposits are present in the walls of the coronary arteries that supply oxygen and other nutrients to the heart. The test produces a cardiac calcium score that can give some indication a person may have coronary artery disease, with an increased risk of suffering a heart attack. 
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