Cardiovascular, Medicine
Why Diabetic Patients Need Aspirin
Why do diabetic patients die? Over 60 years ago, Joslin, the founder of the world famous Boston Diabetic Clinic, remarked, "With an excess of fat diabetes begins, and from an excess of fat diabetics die." Years ago diabetic patients died in coma due to a lack of insulin. Today, since the discovery of insulin, patients are dying from premature cardiovascular disease. Why does this happen and can Aspirin save many of these deaths? November is Diabetes Month in North America to promote awareness of this disease. And justly so. Every year I see diabetic patients making a potentially fatal mistake. They're usually prudent about maintaining normal blood sugar levels, but imprudent by not taking a daily Aspirin. Aspirin's job is the...Read More
Vitamins
To E Or Nor To E
Should I believe the study that links vitamin E to a possible premature death? I couldn't resolve this question and finally gave up. Possibly I needed a holiday from deadlines as during a cruise along the west coast of Mexico on Holland America's Ryndam, the sea air cleared my mind. It occurred to me that researchers had forgotten vital historical facts. The study causing all the hubbub was a Johns Hopkins report that analyzed 19 clinical trials. It concluded that 400 or more international units (IU) of vitamin E per day increased the risk of dying from all causes by about four percent. In addition, a Canadian study showed that more people taking vitamin E developed heart failure. So it appeared...Read More
Philosophy
A Letter From Singapore
This week, something I've never done before. I've often published comments from readers, but never an entire letter. But I believe this unsolicited letter from Singapore is interesting, thought-provoking and too important to toss away. As the lawyers say "Res ipsa loquitor". This letter speaks for itself. The letter reads, "I now live in Singapore, but have lived in Ontario for over 50 years. This year when I was home I read your article about Singapore justice. Why you agree with Singapore officials that we have become "irresponsibly permissive" about law and order in North America. Why our namby-pamby approach adversely affects patients emotional and physical health. And why we need a dose of Singapore justice in Canada. In Singapore the streets...Read More
Genitourinary
Scotty Bowman’s Teaching More Than Hockey – Levitra
There's a funny cartoon in the New Yorker magazine. It shows an elderly couple at the pharmacist's counter. The man is saying, "I want the night-before- pill and she wants the morning-after-pill! Let's hope these cartoon characters had a pleasant and successful evening. But what happens to real people? And also can the world's most famous hockey coach make a difference for males too embarrassed to seek help for erectile dysfunction (ED)? Unlike cartoon characters the majority of men do not seek help for erectile dysfunction (ED). It's estimated that one million Canadian males suffer from ED and only 20 percent are being treated for this condition. This in spite of the huge public promotion of ED drugs. Since sex is such a...Read More
Lifestyle
Bugs Bunny Carrots to Lose Weight
What is the best incentive to lose weight? We've all heard numerous ways. But Alberta's new Health Minister thinks that people need a new approach to be svelte. Her formula? Give people financial incentives to shed pounds. And unlike me she's not being tarred-and- feathered, and called obeseophobic. Iris Evans says, "We need to create an atmosphere of wellness". And unlike most politicians this one is practicing what she preaches. The 62 year old former nurse has lost 60 pounds in the last two years. So what's her idea? The Minister suggests giving tax write-offs, like a carrot to a donkey, to those who sign up for gym memberships and other athletic activities. Her idea is still in its early stages, but...Read More
Miscellaneous
The “Jug Test”, Sacred Cows! and is High Cholesterol Good For You?
My Father was a Scot who may take a whack at me from the hereafter for this item. But I believe it might also make him wonder what's happening to his beloved Scots and others. Today we hear more and more about the medical problems of obesity. But a report from Edinburgh illustrates that obesity has many other rarely mentioned ramifications. Doctors told the Scotland on Sunday newspaper that obesity was straining hospital budgets. Beds, mattresses and chairs were all too small. Radiologists reported that some Scots have become so overweigh it's impossible to squeeze them into CT and MRI machines. Surgeons found that operating tables were too narrow and surgical instruments too short when trying to operate through layers of...Read More
Medicine
Hyperbaric Oxygen Therapy (HBOT) to Treat Chronic Conditions
What treatment would you choose, a leg amputation or increased amount of oxygen? Foolish question. But according to a recent report diabetes patients who develop diabetic leg ulcers are too often facing needless amputation because of a failure to use hyperbaric oxygen therapy (HBOT). Today an epidemic of obesity in North America has triggered an epidemic of diabetes. And a major complication of diabetes is gangrene of the legs. I'll never forget seeing Ella Fitzgerald, the famous singer, being led on stage after losing her sight to this disease. Later, diabetes cost her both legs. For diabetes patients foot problems are the number one cause of hospital admissions. It's estimated that 25 percent of diabetes patients develop foot problems and one in...Read More
Genitourinary
A New Treatment For The Overactive Bladder
Have you ever heard of "Toilet Mapping"? The best description of this comes from a patient of mine who asked, "Do you know how to get to know a city well?" I replied, "I guess when you've lived there a number of years". "No" she responded, "It's when you know where all the bathrooms are located." This patient like millions of other people suffered from overactive bladder (OAB). And she knew where every washroom was located in downtown Toronto. Now a new novel skin patch has helped her with this common problem. OAB has been called the "closet disorder". The reason is it's socially acceptable to discuss cholesterol at a dinner party. But who wants to admit that they often wet...Read More
Genitourinary
What Men and Their Wives Don’t Know About Andropause
Has your husband become grumpy, sad, lacking in energy, falling asleep after dinner and finding less enjoyment in life? You may even have noticed that his pants are longer than they used to be. And that for the first time he's having sexual problems. If so, he may be suffering from the male change of life, known as Andropause. And a wee dab of AndroGel may be all that he needs. Dr. Jean Mailhot, endocrinologist and Director, Laval Andropause Center, says that one million Canadian men suffer from testosterone insufficiency. And that in the U.S. as few as five per cent of American men with low testosterone are being treated. It's not surprising. In 2002 a national survey showed, that of Canadians...Read More
Psychiatry
Stress You Get Paid For
It appears there are epidemics and there are epidemics. Few of us will forget the anxiety and economic loss this country suffered during the SARS outbreak. Now reports indicate we face another one. It's a disease that strikes the brain with profound effects on some and leaves others unscathed. Recent reports say that thousands of ex-soldiers, some of whom haven't even been in conflict zones, are receiving disability pensions for Post-Traumatic Stress Disorder (PTSD). Soldiers claim they suffer from anxiety, depression, insomnia and have nightmares when they relive traumatic events. And often they seek refuge in alcohol and drugs. Since Canada doesn't have a large army, the fact that 9,000 Canadian veterans are receiving tax-free pensions for psychiatric problems is alarming. Last...Read More
Miscellaneous
Insomnia – How “Sleep Debt” Affects Your Health
William Shakespeare, in his play Julius Cesar, referred to sleep as "the honey-heavy dew of slumber". Just reading this makes me drowsy. But for millions of people a good night's sleep is elusive. And new research shows that insomnia may lead to several chronic diseases. A report from Tufts University reminds us that the greatest disasters in recent history, the explosion on the Challenger space shuttle, the crash and spill of oil by the Exon Valdez and Chernobyl nuclear disaster were related to sleep deprivation and fatigue. And that thousands of car accidents share the same cause. Dr. William Dement, a renowned sleep researcher at Stanford University in California, says there is compelling evidence that how well and how long you sleep...Read More
Cancer, Genitourinary, Psychiatry
The Prostate Dilemma In Treating Cancer
What should I do? I've been diagnosed with cancer of the prostate gland and my doctor has suggested a radical prostatectomy. He claims that a new report shows that surgery is the best way to ensure a cure. Of all the letters I receive this question is always the hardest one to answer. The New England Journal of Medicine recently published a study from Sweden in which doctors followed men with an average age of 65 years with prostate cancer for 10 years. 695 men with prostate cancer were treated with radical surgery. In radical prostatectomy surgeons remove the prostate, as well as surrounding tissue and lymph nodes. Another group of 347 men with the same problem were treated by watchful waiting. At...Read More
Gastroenterology
Alcoholic Cirrhosis From Eating?
I'd bet a thousand to one that 99.9 per cent of readers have never heard of nonalcoholic fatty liver disease (NAFLD). Yet a recent report from Johns Hopkins University claims that 25 per cent of North Americans suffer from this disorder. What is it and how can it be prevented and treated? Today you would have to be living on Mars not to know that obesity is often related to heart disease and diabetes. Now excessive pounds are also causing liver disease. We all tend to forget that whether we're dealing with war, love or medicine one problem often leads to a greater one. In 1640 George Herbert hit the nail on the head when he wrote, "For want of a nail...Read More
Surgery
A Surgical Assembly Line to Repair Hernias
To ask what goes on at The Shouldice Hospital is like asking, "Is the Pope Catholic?" This hospital situated in Thornhill, near Toronto, is a world-famous center for the repair of hernias. But is its reputation as good as they say? If so, why? And why is it possible for surgeons to repair an obvious hernia and miss another one? To find the answers I observed Dr Casim Degani, chief of surgery at Shouldice, perform one hernia operation after another. A hernia is a protrusion of bowel through the abdominal wall. There are various types of hernias and 90 percent occur in men. The Shouldice success rate is outstanding, virtually 100 percent if there's been no previous surgery and 98 percent if...Read More
Surgery
The Benefits and Risk of Laparoscopic Cholecystectomy
In 1991 Dr. Joacques Perissat at the University of Bordeau, in France, announced to the World Congress of Surgeons that he had removed a gallbladder (cholecystectomy), using optical instruments inserted through a few small incisions. Now, 90 percent of of gallbladder operations are done by fiber-optics. What are the advantages and what is its most devastating complication? And the crematorium is the cure for some gallstones. An emergency cholecystectomy is required when a stone blocks the common bile duct (CBD) resulting in an acute inflammation of the gallbladder. To prevent this from happening, patients are often advised to have a cholecystectomy before this complication occurs. It's technically easier and safer to remove a gallbladder when the organ isn't inflamed. In the past it...Read More
Cardiovascular
Osler’s “Defective Rubber” Kills Us – Hypertension and Aspirin
We all know that serious consequences can result when a tire blows. But today most people have little knowledge of human blow-outs. The fatal strokes that kill or paralyze people with little or no warning. Moreover, many people at high risk are not taking Aspirin that can often prevent this tragedy. A recent survey showed that 50 percent of Canadians 35 and older were unable to describe a stroke. 48 percent could not identify a symptom of stroke, 19 percent did not know that high blood pressure was the most critical factor and only 36 percent would seek emergency help if they were experiencing symptoms. Normal blood pressure is 120/80. The upper figure, the systolic pressure is the force at which blood...Read More
Neurology
Cholesterol-Lowering Drug Caused Memory Loss in Astronaut
What had happened to Dr. Duane Graveline former astronaut, medical researcher and aerospace scientist? His wife found him walking aimlessly about their property. When she spoke to him he didn't recognize her. He was rushed to a neurologist and six hours later his senses returned. The diagnosis? Global transient amnesia (GLA). His only medication, Lipitor? But doctors refused to believe this cholesterol-lowering drug (CLD) was the cause of this incident. A year later Dr. Graveline was urged to retry half the dose of Lipitor. Six weeks later his entire life was eradicated from memory. He had no recall of his children, medical school, years as a flight surgeon or his time as an astronaut. This black pit of amnesia lasted 12...Read More
Genitourinary
Operation Helps Men Urinate Like Teenagers – Benign Prostatic Hypertrophy (BPH)
What should men and their wives know about the New Gold Standard? No, not the one associated with the London England Gold Market. Rather, the new gold standard of treating benign prostatic hypertrophy (BPH) in men. A report from The Mayo Clinic in Rochester, Minnesota, is good news for hundreds of thousands of males who every year require surgery for this condition. And worry that it may affect their sexual health. Normally during male urination the size of the stream is about one-quarter of an inch. But as men age the prostate gland enlarges and squeezes the urinary tube, its size may decrease to one-sixteenth of an inch. And if it reaches zero it obviously requires emergency surgery. For years the gold...Read More
Lifestyle, Philosophy
Eight Good Reasons to Make Love
Are you fed up reading about war, our failing health care system and crooked CEOs? If so, let's discuss a more pleasant topic, the way to ensure a long and healthy life. Some are convinced that jogging, a variety of diets or a daily glass of red wine is the answer. But what about sex? The fact is that making love is downright good for you. Here are eight reasons why you should put more amore into your life. It's Good Exercise Since making love involves some interesting acrobatics having sex three times a week burns about 7,500 calories in a year. This is the equivalent of jogging 75 miles! And vigorous sex consumes up to 200 calories each time. At three...Read More
Genitourinary
The Testicles Top Song: “It’s Too Darn Hot”
There's a story that should have made headlines around the world, but somehow it collected dust. In 2002, the British Journal Lancet, reported that a scientist had suffered burns to his penis and scrotum while using a laptop computer. You might quickly conclude that he was naked and had fallen asleep with his laptop on his lap, but that was not the case. Rather, he was working with his trousers and underpants on. For want of a better word he had simply been "lap-scorched". The report doesn't mention how long it required for his burned parts to heal. But being lap-scorched is one thing. Now, another report says it's also possible to be "fertility-scorched" by prolonged exposure to laptop computers. Dr. Yefim...Read More
Neurology
Shake Martinis but Not the Baby
What do I know about babies? Not much, and that's why I rarely write about babies. But I recently learned a devastating fact about them. James Bond always insisted that his martinis had to be shaken. But a report in The Medical Post shows that shaking a crying baby can be lethal. But who caused the brain damage? The parents or the baby sitter? Dr. Ron Barr, a British Columbia pediatrician, is Director of the British Columbia Research Institute for Children's and Women's Health, in Vancouver. He recently presented shocking evidence on the extent of injury to shaken babies at a medical meeting in Montreal. Barr told doctors that studies show the incidence of shaken babies is 30 per 100,000 per year....Read More
Philosophy
Why we Should Allow Sterilization of a Mentally Retarded Person
If these people cannot care for themselves how can they care for a child? Would you employ them as a baby-sitter to look after your own child? If we assume that abortion should not be a method of contraception then it is morally wrong to refuse these people a sterilzation procedure The fact they cannot provide informed consent is not a valid point. Neither can they give informed consent to any other procedure such as an appendectomy or the need for an antibiotic. If there is no law it cannot be an illegal act until such a law is passed Those opposed to sterilization should take a retarded child into their home for a few weeks. They would soon change their mind. There s nothing more...Read More
Cardiovascular
Why Cholesterol-Free Foods Can Be Dangerous
Today the word "cholesterol" has become as familiar to Americans as motherhood and apple pie. But unlike these two it's unloved and meant to be avoided. So if you're a marketing whiz kid, would you try to increase sales with a red label stating your product is "cholesterol free"? Unfortunately, life is never so simple and there are several marketing conundrums for both promoters and unsuspecting consumers. And do cholesterol-lowering drugs (CLDs) exchange one devil for another? Dr. Khhursheed Jeejeebhoy, professor of medicine at the University of Toronto, reported in The Medical Post that consumers don't realize that many cholesterol-free foods contain large amounts of sugar and trans-fatty acids . This is not a healthy combination. Too much sugar and excess calories...Read More
Cardiovascular
Aspirin to Prolong Life
How long does it take for good news to reach the public? It appears a long, long time. For several years the medical community has known of the multiple benefits of Aspirin. Yet, I still see patients whose lives could be extended by Aspirin who are not taking it. This is tragic when it can also help patients escape several deadly diseases. The most recent example was a 55 year old woman who had been suffering from diabetes for 35 years. In addition, she was overweight, a bad combination for a heart attack. Yet, no one had told her she could decrease the risk of a coronary event by taking Aspirin. It's estimated that six million diabetics in North America are headed...Read More
Gynecology
New Technique Prevents Needless Hysterectomies
Why would a woman agree to surgical removal of the uterus when a hysterectomy-saving procedure, "endometrial ablation", is available? Given this choice the answer is obvious. But today thousands of women have never heard of this less invasive procedure due to political bureaucracy, short-sighted financing and a lack of trained doctors. So what should female patients and their families do to correct this situation? After all, good sense indicates it's madness to cut off an arm when amputating a finger will do. Today one woman in five over the age of 35 will have a hysterectomy. This requires several days of hospitalization, is more risky than endometrial ablation and requires several weeks of convalescence. But following endometrial ablation patients are back...Read More
