I think that diet coke actually pulses through my veins rather than blood. I truly am addicted. In fact, I can hardly function after lunch if I don’t drink my daily can of diet coke. In medical school, while on my psychiatry rotation, I even approached one of the addiction specialists to help me get over my ‘diet coke dependence’. I tried so hard to avoid diet coke, and I only lasted a good solid month. For some of us, diet caffeinated drinks just get us through the day, or night (especially when you’re on call!).
If you’re an avid diet soda drinker, listen up. People with diets filled with artifically sweetened sugars or sodium, may be at risk for faster kidney decline. A recent study conducted at Brigham and Women’s Hospital and presented at the American Society of Nephrology’s annual meeting revealed a very significant twofold increase in quickened kidney function decline with 2 or more servings per day of artificially sweetened soda. The mechanisms by which artificial sweeteners affects the kidney is at this point yet unknown.
A second study using the same 3000 female participants showed that in women with well-preserved kidney function, high dietary sodium intake was associated with greater kidney function decline as well.
The actual data is not published yet, but you can read more here. And, for all my regular coke-drinking-friends who are saying I told you so, don’t think that regular sodas are innocuous!
For the record, the ‘artificially sweetened drinks’ category also includes iced teas, juices, and anything that contains aspartame or even splenda.
Pictured below: My co-intern, Dave Svec, and I having way too much fun on call. Clearly someone has an addiction. Let’s just say, it isn’t me, haha.
If you’re as insane about sushi as I am, maybe this story will make you think twice about eating some tasty raw salmon. More likely than not, though, if you really are that insane, you won’t care. A gentleman in Chicago recently sued a restaurant for serving him tapeworm-infested salmon after he found out that the 9-foot-long parasite was growing inside him. (gross!)
So, there seems to be a new worm in town and his name is Diphyllobothrium nihonkaiense or more affectionately known as the salmon tapeworm. And, he’s rapidly infesting yuppies with a hankering for sashimi and ceviche. This parasite which can grow in the human GI tract and reach up to 39 feet in length, started popping up in North America in 2006, but has been a growing problem in Japan for years.
So how do you avoid this problem, but still enjoy some salmon? These tapeworms live in fish muscle and die when the fish is cooked. It’s probably best to eat fully cooked salmon. And, if you have a sashimi craving, go for the tuna!
Seems like I’ll be avoiding salmon sashimi for a while!
According to a Danish study published in the British Medical Journal last month, people with naturally thin thighs may be at higher risk for for developing heart disease and early death. Researchers took detailed measurements and studied the body composition of over 2700 men and women, and then tracked their health for more than a decade. They showed that people with the thinnest thighs have a two-fold greater risk of heart disease and resulting death. These risks rise as thigh size declines.
It is thought that the adverse effects of thin thighs arise from decreased muscle mass which affects fat and sugar metabolism. However, randomized controlled trials are needed to further study whether interventions that may increase thigh muscularity would actually decrease cardiovascular risk.
One less reason to hate naturally skinny model types!
Today President Obama declared H1N1 a national emergency. So far, at least 95 children have died from H1N1 in the U.S. And the percentage of children dying from H1N1 compared to adults is much higher than with the regular seasonal influenza virus.
The federal government has hyped up the availability of the H1N1 vaccine, promising that we’d have millions of doses by now, but far fewer doses have been delivered so far. In my home state of California, about 1.3 million doses have been shipped, but some states like Mississippi have received fewer than 75,000 doses. Here’s a link to the CDC’s report on H1N1 vaccine supply.
Medical students are twice as likely to suffer from depression than the general population ( 21.2% vs 10% for the general population) according to a large study which came out earlier this year in Academic Medicine. The study also found that black students in medical school were more prone to have suicidal thoughts.
And, just imagine, this is before they know what they’re in for after graduation and during residency.
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In case you haven’t noticed, tattoos are the newest and perhaps oldest craze. I myself haven’t experienced anything other than a henna tattoo, but with TV shows like L.A. Ink on the air, its apparent that tattoos are super popular. For some, tattoos are more than body art. They are a lifestyle!
About 1/4 of adults 18-30 years old have at least 1 tattoo. And that percentage will definitely increase in years to come. 65% of people with tattoos are women, so it’s not a guy thing anymore either. With such high numbers of people getting tatted up, it’s important to discuss the health risks.
But first, let me illustrate how tattoos aren’t just green-inked body art. There are so many types of tattoos.
1) Amateur tattoos: made by pricking ash, charcoal or ink under the skin with a needle. With these, there’s a high risk of infection because of lack of sterile conditions.
2) Cultural/Religious tattoos: these may serve many purposes for members of various ethnic/tribal groups. Many different techniques can be used to achieve these.
3) Professional tattoos: Done by a licensed/registered artist often using a tattoo gun.
4) Cosmetic tattoos including ‘permanent make up’ : Women may get their eyeliner, lip liner, blush or eyebrows tattooed on. Often, touch ups are needed every few years to keep the colors crisp and vibrant.
5) Medical tattoos: For instance, after breast reconstruction surgery after a mastectomy, doctors typically simulate the appearance of a nipple using tattoo methods. Some patients with chronic medical conditions also get tattoos to alert others of their condition in the event of an emergency.
Do doctors think you should get tattoos? No, most doctors advise against tattoos because the use of unsterilized needles can cause the transmission of diseases like Hepatitis C from one person to another. Also, people often get their tattoos at a young age and down the road they may not want it anymore. A tattoo on the body of a 20 year old looks very different than it does on the body of a 70 year old.
If you really really want one, then at least be safe! Make sure that the tattoo studio you choose is as clean as a doctor’s office. And, make sure that your tattoo artist has a valid business license. If you have doubts, go with your gut feeling and find a different studio.
Safety Tips:
- Watch your artist remove all needles from sterile packaging. Make sure the artist washes his/her hands and puts on sterile gloves before getting started.
- Don’t drink alcohol or take any drugs including over the counter drugs like aspirin the night prior
- Ask for a list of specific pigments used, the manufacturer, lot number and color.
- After getting your tattoo, follow healing instructions and make sure to use antibiotic ointment.
- Do not get a tattoo if you’re at all sick!
What Kinds of Infections can you get from Tattoos?
The most serious risks include life -compromising infections like HIV, Hepatitis C ( a virus which attacks your liver). You can also get skin infections like impetigo caused by bacteria like staphylococcus or MRSA (methicillin resistant Staphylococcus aureus). If you notice that the skin around your tattoo is blistering, oozing pus, red or tender for an extended period of time please see your doctor.
Photo of Kat Von D, courtesy of Getty Images.
I know. Everyone loves this show. The romance. The drama. The medical clashes. Oh, and all women between the ages of 18 and 65 adore Mcdreamy. (I once stood next to him in Whole Foods Market for nearly 2 minutes before realizing who he was.)
So, Grey’s Anatomy. I may have watched a few incomplete episodes here or there over the years, but really, I cannot get myself to watch it. I think it’s because I’m intimately reminded on a daily basis of how far it is from my medical reality. Let me explain why:
1. These are supposed to be surgery residents? Why do they have so much free time to hang out together? Real residents spend all their time sleeping and don’t have any free time.
2. Supposedly there are 5 surgery interns in the entire general surgery class and on any given night, four of them are hanging out at a bar and drinking together? That means that this show is full of sh*%.
3. Why the heck are the surgery residents seeing patients in the ER, aren’t there Emergency medicine docs for that?
4. I love how Izzy fell in love with one of her cute, endearing patients. I have never seen any of my co-interns fall in love with/marry/or even be remotely attracted to any of the obese, jaundiced liver failure patients with multiple fungal infections found at the county hospital.
5. These folks are surgical interns. I understand that they go the extra mile for their patients, but really, don’t they have any better way to spend 4-5 hours than perseverating on one of their patient’s treatment when they have like 40 patients?
6. I know this show isn’t representative of reality because there aren’t enough unattractive, dorky people.
Photo of Grey’s Anatomy cast courtesy of abc.com.
I’ve had H1N1 (gasp! or less affectionately known as the swine flu). And, I survived.
Late one night a few months ago, I was on call running around the hospital taking care of my newly admitted patients when over the course of a few hours I began feeling fatigued. While I passed it off as sleep deprivation taking a toll on me, a horrible headache set in. The next day there were muscle aches, fevers, and diarrhea. I had been clued in to the possibility of H1N1 because some of my colleagues were out sick with documented cases of this ’swine flu’. I spent the next several days lying on the couch watching quality television, drinking orange juice and getting more than enough sleep. I must admit, it was pretty miserable, but I tried to keep myself hydrated, well-rested, and calm.
Typical Adult H1N1 symptoms include:
- fever
- cough
- sore throat
- stuffy/runny nose
- body ache
- headache
- chills
- fatigue
- +/- diarrhea, vomiting
H1N1 has become of buzz word of sorts. It invokes panic because of the unknown surrounding it and also because of its comparison to the 1918 Spanish influenza epidemic. As a doctor and a patient, too, I’ve seen both sides of the H1N1 spectrum.
Here are some important points:
1) Wash your hands religiously and frequently with soap and water. Avoid contact with individuals who may have a fever or cough. Remember that H1N1 is transmitted mainly from person-to-person via respiratory droplets. It is possible for it to be transmitted by contact with contaminated computer keyboards, doorknobs etc, but that is less likely as the virus does not survive on inanimate objects for extended periods of time. It can survive for 2-8 hours on environmental surfaces.
2) If you do get sick, don’t panic but see your doctor. In the event that you become sick with a flu-like illness, the CDC recommends that you stay home for at least 24 hours after your fever disappears except to seek medical attention. Seeking medical attention in the early hours of symptom development may allow you access to antiviral medications like oseltamavir (Tamiflu) and zanamivir (Relenza). Your doctor may be more likely to prescribe these drugs earlier in the course of your illness, rather than later. They may shorten the course of illness and prevent complications.
3) The Vaccine. The seasonal flu vaccine is different from the H1N1 vaccine. In fact, the seasonal flu vaccine will offer you no protection against H1N1. The H1N1 vaccine comes in two forms: the inactivated vaccine and the live attenuated intranasal vaccine.
- 2009 H1N1 inactivated ‘flu shot’: Appropriate for use in people 6 months of age and older, including healthy people, people with chronic medical conditions and pregnant women.
- 2009 H1N1 live attenuated nasal spray vaccine: Approved for use in healthy individuals age 2-49. Not to be used in pregnant women!
Who should get vaccinated?
The CDC’s Advisory committee on immunization practices (ACIP) recommends vaccination in 5 target groups:
- pregnant women
- people who live with or provide care for infants younger than 6 months
- health care and emergency services personnel
- people aged 6 month-24 years
- people aged 25-64 years who have the following medical conditions with place them at risk for complications- Cancer, blood disorders (ie sickle cell), chronic lung disease (ie asthma, COPD), diabetes, heart disease, kidney disorders, liver disorders, neurologic disease (ie epilepsy, developmental delay, brain injury), immunocompromised patients (ie HIV/AIDS).
This posting is by no means a comprehensive source of information, but hopefully it can clarify some salient points and be of help.
For those interested in reading about epidemiologic H1N1 trends: http://www.cdc.gov/flu/weekly/
Everyone gets the blues at one point or another, but millions of Americans battle the blues on a regular basis. Depression is a real medical condition with effective treatments available in the form of behavioral therapy, counseling, and medications known as antidepressants. If you think that you may be depressed, it is important to see your doctor sooner rather than later.
After seeking medical attention, there are many effective ways to battle the blues on your own.
1. Exercise: Although this may sound obvious, when you are down, you hardly feel like exercising. If you can get to a gym or at least outdoors for at least 30 minutes three times a week you may find your mood improved and your energy level soaring. Aerobic exercise, specifically, is ideal for heart health, but yoga is an alternative form of exercise that mirrors meditation and may actually improve your circulation and balance.
2. Redecorate your workspace: Many people feel down particularly at work. Adding a plant to your office or desk space will help increase the oxygen content of the air. Another tip is to add a bowl of regular barbeque charcoal to your desk. Charcoal attracts dirt and dust through negative ions and can lift your mood. The key is to make your work space, an aesthetically pleasing and zen-like environment.
3. Establish a spiritual connection: Whether or not you are religiously affiliated, figure out how to incorporate spirituality into your life. Research shows that spiritual people report being happier.
4. Community Service: Do something good for your community or those with some type of need. It will in turn make you feel happier and more fulfilled.
5. Eat right: Try not to use food as a crutch. Oftentimes, depressed people cling to comfort food to self-medicate. You need to eat to live and not live to eat. Take care of your health by only feeding your body nutritious fare.
6. Think Positively! : This may be the most important tip anyone can give you. It may be a battle at first, but positive thinking can change your life. If you can get yourself to stop thinking about problems and start thinking about solutions, you are already better off.