Philosophy
Six Things to Know About a Living Will
"Why should I have a Living Will?" a skeptical patient recently asked. I replied, "Because no one in this world will care as much about how you die as you will." So don't say "no" to a Living Will because of unfounded myths, such as the following. One "If I sign a Living Will it allows doctors to pull the plug and end my life!" In fact, the very opposite is true. North American doctors today spend much of their time worrying about lawyers when treating all medical dilemmas. But when faced with the decision of whether or not to terminate a life, they avoid it like the plague. They worry that any move to end a life may result in legal...Read More
Miscellaneous, Pain
Assisted Death: Its Time has Come
How ironic that Quebec, a Roman Catholic province, should lead the rest of Canada into the realm of dying with dignity and freedom from pain. But it's not shocking since the same province pushed for the liberalization of abortion and same-sex marriage. So, congratulations to La Belle Province for taking a stand on this contentious issue whose time will surely come. But I can hear the howling and irrational fears that will descend on Quebec. In 1984 I presented my view on assisted death to a committee of Canadian senators. It was a waste of my time and taxpayers' money. The outcome was pre-determined as several Roman Catholic senators served on the committee. That's akin to putting the fox...Read More
Surgery
Pros and Cons of Keyhole Surgery
What's the most advanced surgery of recent years? I believe most surgeons would quickly respond, "laparoscopic surgery", often referred to as keyhole surgery. But never let the word "keyhole" lead you astray. In 1991 Dr. Joacques Perissat at the University of Bordeau, in France, announced at the World Congress of Surgeons that he had removed a gallbladder (cholecystectomy) using optical instruments through small incisions. Now, a number of more complicated operations are performed by this method. Laparoscopic surgery has been a great boon for patients. Without a large incision there's less pain, speedier healing and shorter hospital stay. But as in any type of surgery there are unexpected pitfalls. One problem is that the term "keyhole surgery" leaves the impression that tiny incisions...Read More
Lifestyle, Nutrition, Pain, Vitamins
Have Arthritis? Try Eating Healthy
There's nothing good about terminal cancer pain other than the pain finally ending with death. But there's another type of chronic pain, arthritis that goes on and on year after year. It can be a living hell. It's estimated that over 50 million North Americans are afflicted with this disease. Now, a report from Tufts University claims that eating right can help the aching joints of both osteoarthritis, the wear-and-tear type, and rheumatoid arthritis. Dr. Miriam Nelson, an expert on nutrition, says, "You might be surprised how modifying the diet can decrease stiffness and inflammation". Her first suggestion is to start with water. This liquid provides moisture and structural support to joints. It also carries nutrients to where they are needed,...Read More
Cancer, Miscellaneous
Sorry Doctor, I’d Prefer an Opinion From The Dog
What do dogs have that's lacking in humans? Harry Truman, the straight-talking former president of the United States, remarked that, "If you want a friend in Washington, get a dog." But friendship is not the dog's only virtue. A dog's nose has 220 million cells that detect odours compared to a mere five million in humans. And although none have yet graduated from The Harvard Medical School, they can often outsmart doctors in recognizing serious disease. In 1989 the British Journal, Lancet, reported that a female Half-Border Collie was indeed a woman's best friend. Her dog kept sniffing at a mole on her thigh, but ignored other moles. In fact, the dog had actually tried to bite off the...Read More
Gastroenterology
Bull Elephants and Their Advice for IBS
Would you like to have your picture taken in the nude, sitting on a toilet? Then have the photo published in a national newspaper? Surely, we'd all sue for such an indignity. But once a photo showed Diew, a bull elephant, who'd been trained to sit on an elephant-sized toilet. No doubt the photo was meant to show that the irritable bowel syndrome (IBS) is an elephant-sized problem. But editors published the wrong photo. It's ironic that an elephant can be trained to sit on a toilet seat but humans can't be taught how to avoid IBS. It's estimated that 25 percent of North Americans suffer from this disconcerting disease. Diew, sitting on his throne, might question whether IBS is actually a...Read More
Lifestyle, Miscellaneous, Sports
Momentary Lapses Resulting in Injury or Death This Summer
There's an old song, "Summer Time and the Living is Easy". But it's theme can be a prelude to disaster. Every summer what's supposed to be fun turns into a lifetime of existence as a quadriplegic, or with other severe injuries. And it happens to all ages. Shriners Hospitals say that 300,000 people are treated every year in emergency rooms due to lawnmower and other garden tool accidents. 35,000 of these injuries involve children under 15 years of age who lose hands, legs or their lives. These accidents are waiting to happen when parents allow children to use power mowers. The kinetic energy imparted by the rotating blades of a mower is three times the muzzle energy of a 357 Magnum...Read More
Surgery
Appendicitis: It Nearly Killed King Edward VII
How would you like to be the young surgeon in 1902 who was asked to see Prince Edward who was to be crowned King of England in two days? His Mother, Queen Victoria, had reigned so long that Edward had become the playboy prince. Now he was obese, old, flatulent and a terrible operative risk. Young Dr. Treves diagnosed a ruptured appendix and recommended surgery, much to the consternation of other doctors. While Treves operated, officials were preparing for the king's funeral. But Treves got lucky. His decision proved prudent. He simply drained an abscess and left the appendix alone. No doubt Treves also lifted more than one prayer to the Almighty. Luckily, Edward survived and was later crowned King...Read More
Cancer, Genitourinary, Lifestyle
If Breasts Can Be Examined, Why Not The Testicles?
For years we've stressed to women the importance of an annual breast examination for the detection of cancer. Yet today little attention is paid to examination of the male testicles. It's time for women to remind their mates that what is good medicine for the goose is also good medicine for the gander. Routine testicular self-examination (TSE) is the answer. Dr. Joel Brenner, Assistant Professor of Sports Medicine at the University of Georgia, says, "There is a taboo about talking about the testicles, unlike breasts and mammograms that are discussed on prime-time television." Yet cancer of the testicles is one of the most treatable cancers. The case of Lance Armstrong is the best example. In 1996 this world class athlete and five...Read More
Genetics
A Diagnosis Missed 98 Percent of the Time
What's the diagnosis when a middle-aged man seems to be dying of heart failure, but his coronary arteries and heart valves are normal? I doubt that many have an answer. But don't feel bad as it's also missed by most doctors even though iron overload is the most common genetic disease of white males. I've heard this remark many times from patients."I'm so tired. Could the problem be that my blood is low?" Sometimes the patient is right and iron is needed to treat anemia. But if the diagnosis is hemochromatosis (iron overload), a prescription for iron is a death sentence. Trosseau, a French physician, first described this problem in 1865. At that time hemochromatosis was considered a rare occurrence. Now one...Read More
Cancer, Genetics
How Genetics Affect the Risk of Prostate Cancer
It has been said that "Blood is our destiny". Or that, "Bad hens have bad eggs". Or that, "He was not merely a chip off the old block, but the old block itself". Each year studies show that genetics play a huge role in whether or not we develop malignancy. But how big a role does genetics play in prostate cancer? Now, a world-wide study reports a major breakthrough, showing that some males seem to be genetically predisposed to this baffling cancer. Earlier studies reported five to ten percent of prostate cancers were due to genetics. For example, a man with one close relative, such as a father or brother, with prostate cancer is twice as likely to develop this malignancy...Read More
Cancer, Medicine, Miscellaneous
How Many Patients Would Agree to 500 Chest X-rays?
Does the doctor always know best? Normally the answer is "Yes". But when your doctor orders a CT scan (computed tomography), does he really understand the amount of radiation your body receives? A recent report from the University of California expresses concern about the overuse of the many types of scans performed in the U.S. Canada is not immune to this problem. So what can patients do to protect themselves from needless radiation? CT scans are used to diagnose cancer, heart problems, kidney stones and injuries. Obviously, a three dimensional view of the body saves lives. But the effects of radiation are cumulative. The more CT scans, the greater the danger, and your body keeps an accurate score. Today CT...Read More
Infection, Sex
New Facts About Genital Herpes
"How could this happen to me?" Or "How can I tell my partner I have genital herpes?" I have too often heard these questions, and the despair, guilt, remorse and fear of patients when told they have genital herpes. Now, a report in the journal, "Nature", may help to decrease the spread of this disease and result in an effective treatment for what is called "herpes simples virus Type 2 (HSV-2)" Today, it's estimated that 20 percent of the population is infected with HSV-2. But of this group 80 percent are unaware they have this infection. This means that 50 million North Americans have genital herpes and that every year another 500,000 are diagnosed with it. And once people are infected, no...Read More
Genitourinary
How to Protect Yourself from AKI
Many North Americans will unknowingly fall into a trap during 2013. It results in the law of "unintended consequences". Moreover, as medical treatment progresses every year, more of such consequences are waiting to happen. This week, what you should know about acute kidney injury (AKI). The kidneys, not the bowel, comprise the body's main disposal system. Like a chemist, each day they control water balance, keeping blood neither too acid nor too alkaline, help in the production of red blood cells, and every 30 minutes filter all of our blood. A report from Johns Hopkins Hospital says that 20 million Americans suffer from chronic kidney disease. Kidney dysfunction can develop silently for many years. But AKI can appear suddenly and be life-threatening,...Read More
Miscellaneous
We Should Not Need a One-Way Ticket
What would you do in this situation? The patient is paralyzed, incontinent of bowel and urinary functions, unable to take nourishment and obviously in pain. I doubt that anyone, regardless of race or religion, would disagree with a lethal injection if the patient were a beloved dog. But humans in most nations are denied this right. Currently, a tennis partner of mine is in this same condition, along with Alzheimer's disease. His has been a frightful sight to watch as it progressed as surely as night follows day. He no longer knows me, stares day after day at blank walls. I know from past talks he would prefer a dignified death. Alzheimer's disease has been labelled the "Grey Tsunami", and it has...Read More
Eyes, Ears, Nose & Throat
Is it a Floater, or a Medical Emergency?
People who tend to party too much on a Saturday night are apt to see pink elephants in their vision. But others who never misbehave may suddenly notice spots, threads or cob-web-like structures floating in front of their eyes. What causes these images and when are they a medical emergency? Eye floaters are those tiny flecks, spots or cob-web-like structures that appear to drift aimlessly around in your field of vision. A few people find them terribly annoying. Others fret that they may herald the onset of a serious eye problem. Or even end in blindness. What causes these floaters? The vitreous is a large chamber in the back part of the eye. Early in life it consists of a...Read More
Lifestyle, Miscellaneous, Women's Health
The DNA Protection Cream : A Far Cry From Granny’s Cold Cream
Would you believe it's possible to have a DNA anti-aging cream that treats the whole range of skin problems? Would you think it's too good to be true? A small Canadian company has developed a cream called "Reversa Multi-Tasking Care. (RMTC)" Clinical studies show this new Tepronone DNA based anti-aging cream attacks wrinkles, dryness, loss of firmness, dilated pores and redness. You don't have to be a cosmeceutical expert to know that Shakespeare was only half right when he coined the phrase, "Vanity, thy name is woman". Today, reports show that men, even construction workers, are seeking ways to get rid of aging skin. And I know that on the rare occasion when I write a column...Read More
Gastroenterology, Infection
The Worm, a Sight You Will Never Forget
"Would you like ice in your drink?" To this, I normally say "yes". But there are times when I say an emphatic "no". I know, when travelling in the less affluent parts of the world, having an icy drink may result in the "Hong Kong Trots" or "Montezuma's Revenge". On an unlucky day, even hepatitis B infection. Even in some North American locations, I sometimes decline ice. Why? Because I never want to see Ascaris lumbricoides in the toilet bowel. If it ever happens to you, it's a sight you will never forget. During my time as a family doctor, a family arrived with their young frightened son. Following a bowel movement he had noticed what he described as a "garden...Read More
Alcohol, Cardiovascular, Lifestyle, Nutrition, Vitamins
Non-Toxic Ways To Lower Blood Cholesterol
"Is a natural remedy as effective as cholesterol-lowering drugs (CLDs)?" Or "Is it possible to lower cholesterol by just dietary changes?" These and other questions routinely arrive in my e-mail. What everyone should be asking is, "What is the safest way to lower blood cholesterol?" Moliere, the French actor and playwright, once remarked that, "Nearly all men die of their medicines, not their diseases." This was a realistic statement nearly four hundred years ago. But, even today, in this enlightened age, many people suffer serious, and sometimes lethal ends, due to medication. So I always suggest taking drugs the way porcupines make love, very, very carefully. So can you as cautiously lower blood cholesterol? First, the good news, but only if...Read More
Gastroenterology
10 Things to Know About the Fire in Your Belly
Nietzsche, the German philosopher wrote, "The belly is the main reason why man does not mistake himself for a god." Heartburn reminds us we are quite human. It should also remind us that ignoring this common symptom can also be dangerous. So what should you know about it? One - It's common and expensive. The National Institute of Diabetes and Digestive and Kidney Diseases reports that, in the U.S., 50 million people suffer from heartburn every month. And the average person with this problem spends $3,355 a year on medication and other treatments. Two - If you have heartburn you're doing something wrong. Don't blame the restaurant for the fire in your stomach. You're obviously eating too much and often the wrong foods. This...Read More
Dental, Surgery
Antibiotics for Cleaning Teeth after Hip Replacement?
What should you do if a dentist or dental hygienist says, "I won't clean your teeth unless you agree to take antibiotics following surgical hip or knee replacement?" Today, over one million hip and knee replacements are done every year in North America. It's estimated that by the year 2030 this number will escalate to four million annually. But should dentists paint every joint implant patient with the same brush? The American Academy of Orthopedic Surgeons (ACOS) is adamant about this question. They claim that during the last 20 years the number of post-operative hip and knee infections has markedly decreased due to the use of antibiotics during surgery and the immediate post-operative period. Anyone scheduled for these procedures can shout "hallelujah"...Read More
Lifestyle, Miscellaneous, Vitamins
Adrenal Exhaustion The 21st Century Disease
Are you tired for no reason? Having a hard time getting out of bed? Or feel run-down and stressed all the time? If so, you may have the first symptoms of adrenal exhaustion and must learn to "adapt" before it becomes a steady habit that causes more than heartburn. As Charles Darwin, the British scientist remarked. "It's not the fittest that survive, nor the most intelligent, but those who can adapt to their environment." Or, as is often said, "It's not the work that kills, it's the worry". The thumb-sized adrenal glands are situated on the top of both kidneys and have been called the body's primary "shock absorbers". They produce a number of hormones such as adrenaline, cortisol and DHEA....Read More
Cancer, Genitourinary, Surgery
Cooking the Prostate Gland
How many angels can dance on the head of a pin? No one knows. Nor has anyone, to this point, found the answer to treating prostate cancer. Now, a treatment called high-intensity focused ultrasound (HIFU) is available. So could this procedure be the ultimate way to cure prostate malignancy? In North America, every three minutes, a man is diagnosed with prostate cancer and every 15 minutes a man dies from it. The major problem has always been, which men should be treated, and when should doctors follow a wait-and-see policy? Waiting to see what will happen has never been a logical move anytime cancer is diagnosed. The result is normally the spreading of the malignancy and eventually death. But prostate malignancy, unlike...Read More
Medicine, Vitamins
Health Canada : Where Are The Dead Bodies?
Do you know that every day 290 North American citizens are killed by prescription drugs? To kill the same number of people a jumbo jet would have to crash every day. So why are natural remedies being removed from health food stores while drugs that kill remain available? Dr .Zoltan Rona, an expert on natural remedies, recently told me that, "Health Canada has been raiding health food stores, terrorizing proprietors and confiscating natural food supplements." He asked, "Could you help to stop it?" Rona described a New York Times report that the government's primary suspect in 542 deaths was Pradax, a blood thinning agent. Moreover, when this drug causes bleeding there is no antidote to stop it. Yet Health Canada has...Read More
Cardiovascular, Gastroenterology, Medicine, Pain
How to Decrease the Risk of Pain Relievers
"Remember, you never get anything for nothing". That's a caution I've repeated over and over to patients. Why? Because some people naively believe it's possible to get health benefit without risk. Today, millions are popping a variety of over-the-counter pain relievers while ignoring important red flags warning they may result in death. Heart and Stroke Risk The American Heart Association reports that, with the exception of acetylsalicylate acid (Aspirin) and possibly naproxen (Aleve), non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin and Advil) increase the risk of heart attack and stroke. This is particularly true for those who have already suffered heart attack or are at high risk of cardiovascular disease. Now, a report in the Journal "Circulation" has more disturbing news. Dr....Read More
