In the News 2023 - Sandweg & Ager PC

In the News 2023


Here we address interesting and important issues affecting the delivery of medical care and related topics from 2023.

We cover additional, related issues and discuss them in more depth on our blog.

In The News: 2020, 2021, 2022, 2023, 2024

December 22, 2023

We know so little about the brain and how it does what it does.  The latest discovery is that daydreaming may help the brain with learning and memory.  Here is an article on the issue.

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December 21, 2023

One of the great threats to our health and well-being is the rise of antibiotic-resistant bacteria.  If antibiotics no longer work to keep us safe from harmful bacteria, we return to the bad old days when people died routinely of what are now easily treatable bacterial infections.  It now develops that air pollution is a significant factor in spreading antibiotic-resistant bacteria.  These bacteria get into the air from hospitals, farms and sewage treatment facilities and from there travel far and wide.  So particulate air pollution is doubly dangerous.  It affects our lungs and spreads harmful bacteria to boot.

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December 20, 2023

More on the subject of universal health care.  In 2022, the United States government alone spent more money on health care than Germany, the U.K., Italy, Spain, Austria and France combined spent on universal health care for their entire populations.  The U.S. expenditures would have been primarily for Medicare and Medicaid and do not include the billions spent by private insurers on health care for their members.

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December 19, 2023

If you have high blood pressure, there is a good chance your spouse has it too, especially if you are older.  A recent study showed that in the United States, in 38% of married couples, if one spouse had high blood pressure, so did the other.  Take good care of your blood pressure.  High blood pressure is the leading cause of death due to and heart disease.

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December 12, 2023

The Medicare enrollment period is closed for the year.  If this year was like previous years, only about 10% of the beneficiaries enrolled in Medicare Advantage plans changed their plans.  The vast majority of beneficiaries probably did nothing and simply allowed their current plan enrollment to renew.  This could be a big mistake as plan benefits change from year to year and there is reduced willingness on the part of many providers to accept some advantage plans.  There are free services out there to give you unbiased advice about your options.  If you are in a Medicare Advantage plan, next year during open enrollment, do yourself a favor and at least look around to see if there is a better fit for you.

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December 11, 2023

Back in September I did a blog post about ticks and Rocky Mountain Spotted Fever (RMSF).  They are in the news again.  Five patients in California have been diagnosed with RMSF since July of this year.  All were hospitalized and treated with the best available medications.  Of the five, three died.  Significantly, all five had been to the Mexican state of Tecate within two weeks of the onset of their fever and disease.  Ticks carrying RSMF are widespread in northern Mexico and in Baja California.  Be careful whenever out in the woods or grasslands and check yourself for ticks.

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December 8, 2023

The salmonella outbreak tied to cantaloupes keeps on growing.  More sites have been identified as sources for contaminated cantaloupe and the number of people stricken has increased as well.  The number of new victims has doubled since the last report a week ago and five new states have seen cases.  Cases have been reported in Canada as well.  The old and the very young have been especially hard hit in this outbreak.

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December 7, 2023

The Biden administration is taking another step toward reducing drug prices.  It is promising to exercise its authority to “march in” and license patents to other drug manufacturers, if the patent holder charges too much for a drug that was developed with federal money and assistance.  Needless to say, the sky is falling and the drug companies will fight this tooth and nail, as they are fighting Medicare’s authorization to negotiate some drug prices.

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December 6, 2023

The manufacturer of a titanium part used in hip replacement surgery is being sued in multiple cases for the failure of its part.  The part, which connects the replacement ball to the stem that is inserted into the thigh bone, has fractured in a number of instances and has now been recalled by the manufacturer.  Patients whose hip replacements fail must undergo surgery to remove the failed implant and to replace it with a different one.  Many in the medical community have criticized the manufacturer, Profemur, for being late to report the failures to the Food and Drug Administration and late to recall its product.

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December 5, 2023

Doctors and pharmacists are not the only healthcare providers feeling the squeeze of being asked to do more with less.  Nurses are even more upset about their working conditions than doctors and pharmacists.  Staffing issues were terrible during the pandemic and many nurses left the profession.  Although patient loads have trended down, nurses are still under tremendous pressure, pressure which they say sometimes results in unsafe conditions for patients.  Some nurses are striking.  There have been 27 nursing strikes this year alone.  Something has got to give.

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December 4, 2023

Once considered above the cares of most other working people, doctors and pharmacists are feeling workplace pressures like everyone else and they are not happy about it.  Nor should you be as we depend on doctors and pharmacists to be focused on providing us the best services they can in protecting and preserving our health.  Private equity and hospital chains have taken over many doctor practices and are requiring their new employees to meet certain standards of profitability or else.  This very often means less time with each patient.  Pharmacists who work for the big drugstore companies complain they are short staffed and overworked and that this increases the chance they will make a mistake with a prescription.  A decimal point in the wrong place or the wrong medicine in a container can be deadly.  Independent pharmacists have the pressure of competing against the big chains and mail order pharmacies.

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December 1, 2023

Medicare Advantage ads are flooding television by the thousands as open enrollment season ends next week.  Although there are new regulations aimed at reducing the amount of misrepresentations found in many of these ads, the government would like you to report any misleading ads you see or hear.   You can contact the Centers for Medicare and Medicaid Services (CMS) at 800-MEDICARE, its 24-hour information hotline.  Here is a link to a story which identifies some common misleading pitches.

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November 30, 2023

More evidence of the link between hearing loss and dementia.  Don’t let this happen to you.  Get your hearing tested and get hearing aids, if needed.

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November 29, 2023

Beware the Medicare Advantage plans.  Their ads are everywhere during this open enrollment period, but they are not for everyone.  In return for perhaps getting some additional benefits, members give up certain rights and agree to certain restrictions.  Many Medicare Advantage plans require pre-approval for treatment that traditional Medicare does not and one of the criticisms of the plans is that they too often deny treatment that members need and which should be approved.  Another complaint often made by doctors and hospitals is that the plans deny payment or make it otherwise difficult to collect.  For these reasons, some doctor groups and some hospital chains are refusing to accept Medicare Advantage patients.  It is just too costly and too frustrating.  A Medicare Advantage plan may be right for you, but do your homework before signing up to be sure.

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November 28, 2023

Next time you think about advances in diagnostics, maybe you should thank a veterinarian.  Vets are using artificial intelligence to examine and report on a variety of laboratory tests.  The experience they have gained is being used by doctors to identify areas where AI can do similar analysis of human lab tests.  The future is coming and coming fast.

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November 27, 2023

There has been an outbreak of salmonella related to cantaloupe.  Over 100 people in 32 states, including Arizona, have been sickened and two have died.  Arizona is one of the states with the highest number of cases reported.  Three more brands have been added to the existing cantaloupe recall as cases have doubled in the last week.  Many people with salmonella infections do not report them, so the total number of cases is believed to be much larger than the 100 known to investigators so far.

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November 21, 2023

Strawberries are both good to eat and good for us.  We already knew that.  Now there is some evidence, although not very strong, that certain substances in strawberries can have a neuroprotective effect and ward off mental decline to a certain extent.  Blueberries contain the same substances.  So while strawberries and blueberries may not actually prevent mental decline, eat them anyway.  They are bound to do something good for you. even if it is not the prevention of dementia.

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November 20, 2023

There was a large verdict returned by a Maricopa County jury last week in a medical malpractice case arising out of the birth of a baby who was severely damaged due to an alleged lack of oxygen to the brain during the final stages of labor and delivery.  The jury returned the verdict against both the treating obstetrician and the Banner hospital at which the birth took place.  It assessed 47% of the fault to the doctor and 53% of the fault to the hospital for the conduct of the nurses.  The verdict was just over $31,000,000.  There will certainly be post-trial motions by the losing defendants and an appeal, if those motions do not succeed.  As I have written in our blog on a number of occasions, the plaintiffs rarely ever see all of the money the jury awards in these large verdict cases.  Stay tuned.

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November 17, 2023

A sentinel event is an adverse patient event that causes death, permanent harm or severe temporary injury.  Every accredited health care organization (these are mainly hospitals) is encouraged but not required to report sentinel events that occur at their facility.  For calendar year 2022, there were 1,441 sentinel events reported to the Joint Commission, the entity which oversees and accredits hospitals.  While this number is an increase of 19% over the number of reports made in 2021, it is a woefully small number compared to the amount of harm that occurs in hospitals every day.  The most recent estimates of avoidable patient hospital deaths is between 44,000 and 98,000 per year.  If these numbers are anywhere near accurate, you can see that hospitals are not reporting even a tiny fraction of the sentinel events that occur inside their walls.  We all pay a price for hospital secrecy.

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November 16, 2023

Efforts to reduce overall health care costs continue to struggle to make progress.  One of the main roadblocks to efficiency is “fee for service,” which means that providers get paid for care whether it is the right care or not and whether the care helps the patient or not.  Simply put, doctors, hospitals, and clinics have a financial incentive to order tests and provide treatments that may not only not help the patient but may actually expose the patient to risk.  We have to continue to work toward payment systems that reward the best care and discourage care that is of little or no value to the patient.

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November 9, 2023

This is open enrollment season when employees can change the benefits they receive from their health plans.  The choice of benefits can be important both in terms of the care the employee receives as well as in terms of the cost of that care.  In spite of this fact, most employees spend very little time on this once a year task, usually less than 30 minutes.  By contrast, those same employees spend on average over two hours each day on social media.  Go figure.

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November 8, 2023

Lung cancer is the leading cause of death from cancer worldwide.  In the United States, it is the second most common form of cancer after skin cancer.  On the basis of a large study of people from many countries, researchers found that low dose CT scans used to screen for lung cancer were both safe and effective in diagnosing lung cancer in its early stages.  The earlier diagnosis greatly improved the five year survival rates for those people who developed lung cancer.  If you are a smoker, a former smoker, or just someone who has been exposed to second-hand smoke, you might want to consider these scans for screening purposes.

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November 7, 2023

Medicare is once again tinkering with Medicare Advantage plans and the regulations surrounding them.  One change is intended to reduce the incentive for an insurance agent to recommend one plan over another.  Although there has always been a prohibition against commissions based on such recommendations, some plans had been offering lavish extras to agents who steered business to them.  Misrepresentations were common.  The new regulations will also require plans to notify their enrollees around the middle of the year to remind them of benefits they may have remaining during the plan year.  Needless to say, any benefits not used by enrollees go directly into the pocket of the plan owner so there is no incentive to remind enrollees of the remaining benefits.

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November 6, 2023

Medicare has released its listing of the hospitals in every state which have been penalized for either too many readmissions or too many hospital-acquired infections.  Here is the list.  You can look up any hospital in Arizona or any other state.  From the list it would appear the most penalized hospital in Arizona is the Arizona Orthopedic and Specialty Hospital in Chandler, which has led the list for years.

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November 3, 2023

Pharmacists at CVS and Walgreens have complained for some time now that their employers have not staffed their pharmacies with enough people to handle the volume of prescriptions, immunizations and patient consultations they must deal with.   They correctly point out that the current situation not only stresses them, but increases the chances that they will make a mistake in filling out a prescription.  Prescription errors can be fatal.  Now some pharmacy employees have stopped complaining and begun acting.  At scattered pharmacies across the country, employees are staging walkouts.  We will have to wait and see what effect this has on the big pharmacy chains, but it is an issue that is important to all of us.

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November 2, 2023

You may have noticed that the x-ray equipment being used at your dentist’s office is getting smaller.  New technology has enabled dentists to take x-rays that do not expose the patient to any significant scatter of the x-ray beam.  The American Academy of Oral and Maxillofacial Radiology has concluded that dental x-rays are so safe now that the old lead apron and the thyroid shields are no longer necessary as they provide no additional protection to the patient.

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November 1, 2023

The Food and Drug Administration (FDA) is warning consumers not to use certain eyedrops, which are intended to be sterile but which have been contaminated.  Here is a list from the FDA. Use of these drops can expose the user to eye infections, which can cause partial loss of vision or blindness.

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October 31, 2023

Add Medicare Advantage plans to your list of scary things for Halloween and beyond.  They are growing like weeds.  Over 50% of Americans eligible for Medicare are enrolled in a Medicare Advantage plan.  They were authorized by Congress in the hope they would compete with regular Medicare and bring more efficiency to the process of providing care to Medicare-eligible patients.  It did not work out that way.

Audits by Medicare routinely show these plans overcharge Medicare for the care they provide.  They also routinely deny claims for reimbursement for medical care that has been provided.  This routine practice of denying claims is killing many rural hospitals that have Medicare patients.  They cannot afford to wage reimbursement wars with the large plans and also cannot afford to provide care without reimbursement.  Rural hospitals, upon which so many people rely, are being driven out of business by rapacious Medicare Advantage plans.  Tough luck for people who live in rural areas.

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October 30, 2023

Researchers have identified a new therapy for the treatment of advanced prostate cancer that has proven resistant to other treatments.  The new approach involves white cells, which, under normal circumstances, are part of the body’s immune system arsenal to attack cancers.  The aggressive cancer, however, is able to coax the white cells into the tumor and to use them to help the tumor grow.  Without the aid of the white cells, the tumor would stop growing and might even die.  The new therapy blocks the white cells from entering the tumor.  Although the sample size was small, the researchers were encouraged that there were a number of patients whose cancer tumors responded and actually shrunk.  There is a long way to go before this therapy is ready to be used on patients, but these results are encouraging.

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October 23, 2023

Pharmacy deserts are spreading.  Due to a number of factors, including opioid lawsuits, strong competition, and the bankruptcy of Rite Aid, many localities will be losing their local pharmacy.  Walgreens and CVS have signaled their intention to close over 1,500 stores over the next few years.  The bankruptcy court may order the closing of many Rite Aid stores.  Experts predict that lower income neighborhoods are the ones most likely to lose their pharmacies.

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October 13, 2023

Good article in the New York Times today that offers a slightly different way to think about taking care of yourself.  The doctor being interviewed argues that, if you want to live to be 100, give thought, not to your life span, but to your “health span.”  By “health span” he means the number of years you live without a major health issue affecting your life.  He posits that, if you train for a long “health span,” you will increase the chances for a long life span and one which is enjoyable to boot because you are healthier and feel good.  Unsurprisingly, training for a long “health span” involves the usual suspects of good sleep, nutrition and exercise.  If you can’t make time for exercise to increase your “health span,” he asks what can you make time for?

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October 6, 2023

If you have obstructive sleep apnea (OSA), you have an increased risk of a cardiovascular event.  Using a positive pressure CPAP machine at least 4 hours a night reduces the risk of this illness. It also reduces blood pressure in people with OSA.  Yes, it can be uncomfortable and yes, it can look funny, but it provides a lot of health benefits.

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October 5, 2023

It seems as though it is always something.  High Density Lipoprotein (HDL) is the good form of cholesterol.  Its evil twin is LDL (Low Density Lipoprotein).  High levels of HDL are considered a good thing and protective of heart health, which is what makes the result of a new study troubling.  The new study found an “association” between elevated levels of HDL and dementia.  The study could not say there was a causal relationship or determine why the association existed, but it is troubling nonetheless.

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October 4, 2023

The largest health care strike in US history is underway.  75,000 unionized employees of Kaiser Permanente Health walked off the job today.  Kaiser Permanente is one of the nation’s largest non-for-profit health care providers.  Most of the striking workers are in the state of California.

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October 3, 2023

Want to live longer?  Go to college.  New studies are showing that those who have a college degree have a significantly longer lifespan than those who do not.  There is a lot to unpack here.  Among the explanations are that college graduates tend to come from a better financial background than those who do not attend college.  This often means more and better health care and better diet growing up and after reaching adulthood.

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October 2, 2023

Hospitals continue to merge and create more and larger chains.  And when they do, prices go up.  The worst part is no one seems to be minding the store.  There is little push back when a hospital chain adds acquires a new hospital or when two chains merge.  The problem is complicated by the fact that many hospital chains are still refusing to make their prices freely and easily discoverable so patients can price shop.  Greedy, greedy, greedy.

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September 19, 2023

I can’t believe this is happening again, but that is my naivete speaking.  Of course, it is happening again because there is money to be made.  Today’s story involves major dental work on a four-year-old gone wrong.  The dentist administered anesthesia to the child and the child got in trouble with low oxygen levels.  When the child began to seize, the dentist gave more sedative, which probably made matters worse.  She failed to call 911 for over 7 hours, while repeatedly assuring the child’s mother that her little girl was going to be fine.  The child suffered permanent brain damage due to lack of oxygen and will never see, hear or walk again.  In addition to the usual questions about why a doctor with a patient in trouble won’t call 911 for the assistance the patient desperately needs, is the question about what kind of dentist does major work on the baby teeth of a four-year-old.  The dentist was recently convicted of committing a reckless injury to a child by omission but was only sentenced to 5 years of probation and community service.  If insurers would refuse to pay for these major procedures on baby teeth, the practice would almost certainly stop.

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September 11, 2023

Some good news.  As you probably know, every year’s flu shot is different and is based upon estimates of what strains of flu virus are likely to be the most prevalent in the coming year.  Looks like they did a good job of predicting this year.  Based on data from the southern hemisphere, this year’s flu shot appears to be effective against serious disease caused by the flu virus.

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September 7, 2023

At least for older women, maintaining a stable weight increases the chances of living to age 90 or older.

September 6, 2023

Cardiac arrest is different than a heart attack.  A person can have a heart attack without the heart ever stopping.  Heart attacks may lead to a cardiac arrest, but do not always do so.  Cardiac arrests are very likely to be fatal.  About 90% of people who experience a cardiac arrest die right then.  Even though most cardiac arrests occur without warning, recent studies have shown that half the people experiencing a sudden cardiac arrest had at least one warning sign in the 24 hours preceding the arrest.  For men, the most common warning sign was chest pain.  For women it was shortness of breath.

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September 5, 2023

Stop me if you have heard this one before.  A woman goes into the hospital for a Cesarean Section.  Her baby is successfully delivered.  For months afterward, she suffers from stomach pains and no one can figure out why.  Finally, after x-rays of her abdomen failed to reveal a problem, doctors ordered a CT scan, which showed a large, metal retractor had been left behind during the C-Section.  Needless to say, this is not supposed to happen, especially at a hospital in the developed world.  This was in the capital of New Zealand.  Come on doctors and hospitals, you can do better than that.

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August 31, 2o23

Ladies first.  Studies covering 13 years of surgeries in two countries and involving over 1.2 million patients show that patients of women surgeons have somewhat better outcomes than patients of male surgeons.  There is a lot of speculation about why this is, but the amount of data leaves very little doubt that the difference, while not great, is real.  Keep that in mind next time you are looking for a surgeon.

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August 29, 2023

Congress finally gave Medicare the power to negotiate drug prices with the pharmaceutical industry.  Congress limited the negotiations to only ten drugs at first.  Medicare has just announced the names of the first ten drugs that will be subject to negotiation.  They are drugs which treat blood clots and insulin drugs.  This should save Medicare a lot of money.

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August 28, 2023

One of the largest unions of health care workers is considering authorizing a strike vote.  You should care for a number of reasons.  The union members are extremely unhappy about staffing levels, which they contend are too low and which prevent them from giving patients like you the care you deserve.  They are also unhappy about pay in the health care sector, which is not keeping up with raises in retail and food.  The health care industry is still reeling from the effects of the Covid pandemic and may be for a while.

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August 25, 2023

Watch out!  There have been at least five men arrested and convicted in California in the last six years for pretending to be plastic surgeons and performing procedures on patients.  Most of the procedures have been minor in nature, but even minor procedures can cause major problems.  Some of the “doctors” apparently were interested in seeing women with their clothes off and touching them as part of the “treatment.”  In any event, do your homework.  These people are in every state.  Check on licenses and medical board histories.  Be a careful consumer of medical treatment.

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August 24, 2023

24 years for men.  23 years for women.  That is how many years researchers found were added to a middle aged person’s life expectancy, if they adopted 8 habits, as compared to men and women who adopted few if any of the habits.  That is a lot of years.

The habits are:  (1) Quitting smoking; (2) Being physically active; (3) Managing stress; (4) Eating a healthy diet; (5) Having good sleep habits; (6) Avoiding binge drinking; (7) Not being addicted to opioids; and (8) Having positive social relationships.

Pretty standard advice for healthy living.  What makes it newsworthy is the number of years of difference it can make.

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August 23, 2023

Teva Pharmaceuticals, a large, foreign-owned drug manufacturer, has entered into a settlement with the federal government of a criminal case against it arising out of allegations of price fixing.  Teva will pay a fine of $225,000,000 and will divest itself of its role in manufacturing a generic statin reducing medication.  The other company involved in the alleged price fixing has also agreed to pay a fine to the government.  Although both companies denied any wrongdoing, actions speak louder than words.

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August 22, 2023

Maryland has reported a case of mosquito-transmitted malaria.  There is leprosy in Florida.  What are we coming to?

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August 21, 2023

The English nurse who murdered 7 infants in her care has been sentenced to life in prison.  Deservedly so.

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August 18, 2023

There is a very interesting development taking place with regard to pharmacy benefit managers (PBMs).  These businesses are contracted by health plans to negotiate drug prices with manufacturers.  They take a cut naturally.  Blue Cross/Blue Shield of California has fired its longtime PBM and is trying a new model, which it hopes will reduce costs for it and drug prices for its insureds.  Under the new model, BC/BS will divide up the functions of its PBM among a number of companies.  The new model won’t go into full effect until 2025.  In the meantime, it is getting some mixed reviews.

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August 17, 2023

There has always been a shortage of organs available for transplant.  A large supply of readily available organs has been the Holy Grail of transplant surgeons.  We may be getting closer to the day when all who need an organ transplant can get one.  A pig kidney was transplanted into the body of a brain dead person and has been functioning well for over a month.  This holds great promise for the future.

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August 16, 2023

The latest rage in weight loss involves the use of medications developed to address Type 2 diabetes.  A side effect of the use of these medications is rapid and substantial weight loss.  It is believed they act on the part of the brain that informs us when we are hungry and when we have eaten enough.  Researchers are sounding the alarm about these drugs, at least when they are used by patients over 65.  All of the testing of these drugs was done on younger people and researchers warn that rapid weight loss in older people may have unintended consequences, such as bone loss, malnutrition, hypotension, and loss of important muscle mass.  The message is just be careful.  As I have often remarked, there is no free lunch.  All medications carry some risk.

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August 15, 2023

It’s not just people that are preyed upon by fake doctors.  There are people out there pretending to be veterinarians and performing operations on pets, with all-too-expected disastrous results.  Check out your vet’s credentials before entrusting your pet to someone for surgery, or really anything significant.

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August 14, 2023

I have posted on our blog about the perils of going to Mexico for medical care.  Recent news reports highlight some of the problems.  Authorities in Mexico visited a number of pharmacies in the tourist areas around Cancun.  The United States State Department had issued a warning about fake pills being sold in Mexico back in March.  This investigation by Mexican authorities found that fake pills were being marketed specifically to U.S. residents and that there were many medications being sold for which there was no record of its point of origin or who made it.  Many of the pills being sold as oxycodone or Percocet were actually fentanyl, heroin or methamphetamine.  There is a real risk of overdose and contaminated drugs involved in purchasing these drugs in Mexico.  Using illicit drugs is never a good idea.  Using illicit drugs purchased in Mexico is an even worse idea.

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August 11, 2023

If you are of child-bearing years, I hope you do not live in a “maternity desert.”  The term refers to an area in which maternity services are not readily available.  Maternity deserts are spreading rapidly.  The reasons are mostly economic, but the reasons behind the economics vary.  Hospitals and doctors cannot make enough money to justify providing maternity services in some areas, usually those that are more rural.  Women are having fewer babies and obstetricians are locating their practices in areas where there are lots of women having babies.  This is usually an urban area.   A lack of obstetricians often leads a hospital to shut down its maternity ward.  In some states, obstetricians claim that the political climate is unfavorable and they are reluctant to practice there.  Whatever the reasons, the absence of maternal care increases the risks of having a baby in the first place.  In the event of an emergency, an expectant mother is in trouble, if she is a long way from medical help.  Just another way in which Americans who don’t live in urban areas get poorer health care than those who do.

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August 10, 2023

A psychiatrist in Northwest Arkansas and the hospital for which he worked have been named in 31 lawsuits and counting for complaints that he improperly committed patients to a locked psychiatric ward without good reason and against their will.  Lawyers say more suits are in the process of being filed.  The doctor has resigned his position with the hospital.

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August 2, 2023

More and more evidence is emerging about the importance of our body’s circadian rhythms.  These are the rhythms that govern when we sleep, wake and eat.  The most current research suggests that, if we disrupt these rhythms, we undermine many aspects of our health.  For example, people who work the night shift are at somewhat higher risk of certain types of cancer.  It is important to get a good night’s sleep.  You can do that best if you have a regular time to go to bed and to rise.  Don’t look at screens in bed and don’t get up for a midnight snack.  Take care of your body and you have the best chance that it will take care of you.

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July 31, 2023

They are out there.  Do not let down your guard.  Police in New Jersey just arrested a woman who used a family member’s medical license for over a year to practice medicine and order prescriptions.  I am not sure how you would be able to protect yourself from someone like this but be vigilant when dealing with new doctors, or for that matter any doctor.

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July 27, 2023

According to a story on CBS News, health care giant Cigna has been accused of using a computer algorithm to review and deny health care insurance claims.  Once the computer program rejects a claim, a Cigna doctor signs his or her name to the rejection.  There is no human review at all.  There is a class action suit by Cigna insureds claiming this is Cigna’s practice and that it violates California law requiring an insurer to conduct a “thorough, fair and objective” investigation into each health care insurance claim.

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July 26, 2023

Evidence is piling up that engaging in activities that use the brain, such as reading, doing puzzles, volunteering, and the like, can help stave off the effects of aging on the brain and delay the onset of dementia.  So in addition to exercising your body to keep it fit, exercise your brain and keep it fit as well.

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July 25, 2023

Omega 3 fatty acids, found in fatty fish, such as salmon, anchovies and sardines, as well as in some nuts and plants, such as spinach, appear to improve lung function.  Although the mechanism is not clear, researchers believe it may be due to their ability to reduce inflammation in the body.  Another good reason to eat fish.

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July 24, 2023

Good piece in the New York Times about the overlooked reason the health care system harms patients.  In its zeal to save money and make sure people aren’t getting expensive care they may not need, the system has so much paperwork that often patients don’t get any of the care they need, much less expensive care.  Paperwork can and often does mean delays and, in health care, delays in treatment can make a routine, manageable problem a big emergency.  It goes without saying that big emergencies cost more for the system to fix than routine problems.  We have to do a better job.

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July 18, 2023

Chronic inflammation leads to diseases such as diabetes, dementia, cardiovascular disease, and arthritis.  Although there are a number of causes of chronic inflammation that we can minimize with life style changes, aging is one we can’t do much about.  However, researchers have found that older people with vitamin D deficiency have higher levels of chronic inflammation and vitamin D supplements can reduce at least some of the inflammation.

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July 17, 2023

“Dr. Roxy,” the plastic surgeon who live streamed some of her surgeries on Tik Tok and who was the subject of a blog post earlier this month, has been stripped of her medical license by the Medical Board of Ohio.  Finally.

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June 27, 2023

It is no secret that the internet has been less than a pure benefit to society.  It has fostered and enabled conspiracy thinking and the ability to harass others who might not agree with you.  Increasingly, it has been used to harass healthcare providers and scientists, who dare to question misinformation.  In a recent survey, over 60% of doctors and scientists surveyed reported on line harassment.  If the doctor was female or non-binary, the odds of harassment were even greater.  Sometimes the harassment went from being virtual to actual physical confrontation, attempts to damage the doctor’s career, and even false reports to governmental bodies and the police.  Under no set of circumstances is this acceptable conduct.

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June 26, 2023

One of the reasons for the shortage of certain important chemotherapy drugs is that they are no longer patent protected.  Many of the drug manufacturers are unwilling to produce drugs that are not patent protected because they don’t make enough money selling them.  We need a system that makes sure we have the drugs we need.  The current profit-driven system is failing us.

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June 23, 2023

This morning’s Wall Street Journal has a front page story about the increasing incidence of dangerous fungal infections, many of them fatal.  The two factors mentioned as driving this are increasing resistance of the infections to available anti-fungal medications and climate change making humans better hosts for these infections.

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June 22, 2023

In psychiatric news, a woman who spent twenty years in a catatonic, trancelike state, was “awakened” from it by treatment directed against her immune system.  Treating physicians concluded there might be a relationship between her lupus erythematosus and her psychiatric condition.  In other words, they thought her immune system might be causing inflammation in the brain which was producing at least some of her psychiatric symptoms, including the catatonia.  The treatment reduced the immune system activity in the brain and reduced inflammation there.  This discovery adds a great deal to the knowledge about the relationship between physical changes in the brain and mental illness.

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June 21, 2023

A Pro Publica investigation has found that an extremely well-respected liver transplant surgeon at an extremely well-respected transplant center had an unacceptably high rate of complications, including death, and that the complications were often preventable.  Big consequences followed.  A good and illuminating read.

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June 16, 2023

Ready for a surprise?  People who are well-off, have health insurance, and have cancer have better outcomes than poor people without insurance.  Whether you live or die should not depend on whether you can afford health insurance.

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June 15, 2023

What is the world coming to?  The head of the morgue at the Harvard Medical School is one of a number of people indicted in Massachusetts for stealing and selling body parts.

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June 14, 2023

Texas has adopted a new, bipartisan law overhauling its medical board in an effort to improve patient safety.  The law was the product of an investigation by television station KXAN that showed at least 49 doctors practicing in Texas despite having their licenses suspended, revoked, or restricted in other states.  Despite a legal requirement that these adverse actions be reported to the medical board and appear on its web site, none of these doctors had any such information listed.  Hopefully this law will make things better for patients in Texas and will be adopted elsewhere.

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June 13, 2023

As they usually do this time of year, the doctors at the CDC are looking at flu rates in countries in the Southern Hemisphere for clues to how severe the coming flu season might be.  While not a perfect predictor, there is often a correlation between what happens there in their winter and what happens when our winter rolls around.  At least in Australia, flu season has been more severe than usual with a sharp rise in flu cases among children.  Get your flu shot when they become available in the fall.

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June 12, 2023

“Stop criminalizing medicine.”  That is the message from the delegates to this year’s convention of the American Medical Association.  And it is not just abortion they are talking about.  A number of doctors are in jail or under indictment for prescribing pain medications off label, a practice that the Federal government says makes their actions outside normal professional activities and, therefore, subject to prosecution.  On the reproductive medicine front, it is already hard for states with strict abortion laws to recruit and retain OB/GYNs and it is only going to get tougher.  Who wants to run the risk of jail time to do what they think is right for their patients?

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June 9, 2023

Taurine is an amino acid found in meat and fish.  Researchers are looking at its role in retarding the aging process in lab animals and in humans.  Taurine levels decline in the body as we age.  Lab mice given Taurine supplements experienced a slowing of the aging process.  It appears as though it may have the same or a similar effect in humans.  More research and testing is ongoing.

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June 8, 2023

I reported on the shortage of cancer chemotherapy drugs on May 30.  A follow up story states that 9 out of 10 cancer centers are experiencing shortages.  This is more than previously reported.

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June 7, 2023

They call it kangaroo mother care.  It refers to creating skin-to-skin contact between mother and newborn.  It is nature’s way and it holds lots of benefits for premature and low birth weight babies.  A large study shows that for any premature or low birth weight infant for whom it is possible, 8 hours a day of skin-to-skin contact with the mother or a surrogate significantly improves the chances for survival.  It even helps stimulate milk production for mothers intending to breast feed.

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June 6, 2023

Americans pay more for drugs than any other country in the world.  Congress finally took a baby step towards changing that by allowing Medicare to negotiate drug prices for a small number of drugs, with more drugs on the negotiating list in future years.  Now pharmacy giant Merck has filed a lawsuit seeking to invalidate the law and protect the huge profits it makes selling drugs to Medicare patients.  Keep an eye on this suit.

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June 5, 2023

More than 9 million Americans are cutting corners with their prescribed medications due to cost issues.  Some of the cost-saving strategies involved taking less medication than prescribed, skipping doses, or delaying doses.  Each of these cost-saving strategies has the potential to make the condition for which the medication was prescribed more serious and more expensive to treat over the long run.  Women were more likely to cut corners than men.  People who were uninsured or on disability were the most likely to cut corners.

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June 2, 2023

A new study released by the American Medical Association reports that female doctors are sued only about half as often as their male counterparts.  While there is a  lot of speculation about why this significant difference exists, there is no question that men and women doctors interact differently with their patients and that, on balance, patients of female doctors express more satisfaction with those encounters than do patients of male doctors.  Female hospitalists also have better outcomes and fewer readmissions than male hospitalists.

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June 1, 2023

The latest research shows that it is never too late to begin an exercise program to improve your brain health.  The study subjects were 70 and 80 year old individuals, who had been inactive.  Some had already begun to experience cognitive decline on brain function testing.  Walking four days a week for four months improved scores for the participants.  A control group that remained inactive, experienced no improvement on cognitive testing.  Get out there and get moving.

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May 31, 2023

Nerve stimulation devices use small amounts of electrical current to stimulate nerves and interfere with pain signals traveling to the brain.  For patients in whom they are effective, they reduce or eliminate the need for narcotic painkillers.  The start up maker of a new design stimulator came out with an updated model that featured a small plastic piece, which the manufacturer claimed made it both more effective and more expensive by thousands of dollars.  After over 8,000 units were sold with the new plastic part, a company whistleblower came forward and informed authorities that the part was medically unnecessary and had been added as part of a scheme to inflate prices and profits.  The company was forced to agree to pay the federal government $10,000,000 to reimburse it for losses suffered by federal healthcare programs, such as Medicare, and the CEO has been charged with conspiracy to commit wire fraud.  Given the bankruptcy of the company, its ability to make good on the promise to pay the fine is questionable.

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May 30, 2023

There is currently a shortage of drugs used to treat cancer.  Doctors are having to ration the drugs that they do have in the hope that the reduced doses will still be effective.  Doctors are being urged to use the lowest recommended dose and the longest recommended interval between doses to help alleviate the situation.  The shortages, which are being attributed to “supply chain difficulties,” are hitting small, rural hospitals hardest but even big city hospitals are feeling the squeeze.

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May 26, 2023

There has been an outbreak of meningitis in a Mexican hospital in Matamoros, just across the border from Brownsville, Texas.  According to reports, the outbreak arose from the contamination of a medication that was being used in cosmetic surgeries.  So far it appears that as many as 300 -400 people may have been affected with 10 deaths.  Two Americans were among the dead.  See my blog post on the dangers of seeking elective medical treatment in Mexico. 

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May 9, 2023

The pace of consolidation in medical care is proceeding at an increasing rate.  The most recent focus is on primary care physicians.  More and more primary care groups and practices are being purchased, either by private equity groups or by hospital chains.  Either way, it spells poorer care and higher prices for patients, based on investigations that have been done of the effect of prior episodes of consolidation on quality of care and price.

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May 8, 2023

A story in today’s Wall Street Journal discussed still another reason nurses and other non-physician personnel are leaving the field of medicine:  Threats to their physical safety.  The number of attacks on health care professionals has been increasing for years.  Some assailants blame the doctor’s office or the hospital for collecting on bills or for the death of a loved one.  There are just so many angry people out there with such easy access to the means to hurt someone else.

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May 2, 2023

They are out there so be careful.  Authorities just arrested another person for pretending to be a doctor and treating patients.  This one was in the Los Angeles area and had been seeing and treating patients for years.  The District Attorney’s office released a statement saying that he had treated “thousands” of patients, some of whom he treated for cancer.  Always do a background check with the state medical board before seeing a new doctor.

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May 1, 2023

Doctors are beginning to use artificial intelligence (AI) to assist them in responding to patient messages.  Since the onset of the Covid pandemic and with the increasing use of patient portals, which create a vehicle for messaging physicians, more and more patients have been sending messages to their doctors.  Doctors, who already consider themselves overburdened, say they are having a hard time responding to the increase in messages and questions.  Enter AI chat programs, which can read the question, review the patient’s chart, and prepare a draft response for the doctor.  The doctor can edit the response, scrap it altogether, or send it as is.  As these chat programs continue to evolve the ability to mimic human communication and do so effectively, their use in doctor/patient communications will only increase.

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April 28, 2023

The evidence is pretty irrefutable.  Drivers over 70 are more likely to have an at fault accident than younger drivers.  The statistics are much worse if the older driver has been using alcohol, marijuana, stimulants, narcotics, or depressants.  These substances affect the judgment and reactions of older drivers to a greater extent than they do younger drivers.   Be safe on the road and don’t drink (or take other substances) and drive.

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April 27, 2023

Some people experience repeated urinary tract infections (UTI).  Women in particular are susceptible to recurrent UTI’s.  Cranberry juice has long been touted as a foe of UTI’s and research has confirmed its beneficial properties.  It is not a cure for UTI’s but can help prevent them, if taken regularly.   So, if you have a history of recurrent UTI’s, you might want to take cranberries to help prevent them.  Cranberries can be taken as juice or as powder or in pill form.

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April 25, 2023

Here is an excellent series of articles from Kaiser Health News about the effect of private equity investment in health care.  The desire of private equity for a return on its investment often runs contrary to the needs of the patient and the requirements of good medical practice.  This is an important issue, which is making health care worse in many ways, and which does not get the attention it deserves.

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April 24, 2023

After a two year delay, the FDA has finally approved Medtronic’s new Mini-Med pump and sensor system.  The pump communicates with a wireless sensor and can automatically adjust insulin infusions in response to rising blood sugars around mealtime.  It is intended for use by Type 1 diabetics.  Users are expected to continue to bolus themselves prior to meals based on their intended consumption but the pump can cover for them to a certain extent, should they forget to bolus.  There is still a long way to go before we have a system that closely mimics the actual human pancreas but this is a welcome step in the right direction.

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April 17, 2023

If you want to know what the hot areas of medicine are, follow the money.  According to an article on the front page of today’s Wall Street Journal, the big pharmacy companies are investing heavily in companies that are developing treatments for immune system illnesses, such as rheumatoid arthritis, lupus erythematosus, and Type 1 diabetes.

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April 14, 2023

If you lie in bed long enough, you will probably develop blood clots in your legs.  These clots, called deep vein thromboses (DVT), can cause life-threatening pulmonary embolism, if pieces of the clot break off and travel to the lungs.  Bears hibernate all winter but don’t get nasty blood clots and researchers think they know why.  Bears have low levels of a protein that helps blood clot.  Most interestingly, so do people who have medical conditions that make them immobile for long periods, such as people with paralyzing spinal cord injuries.  Now that they know what they are looking for, researchers can focus on trying to manipulate this protein level to prevent unwanted blood clots but preserve the important ability of the blood to clot when necessary.

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April 13, 2023

Don’t try to use long naps to make up for disturbed or too short nighttime sleep, according to a study in Spain.  People who napped more than 30 minutes a day had a significantly increased risk of developing atrial fibrillation, a heart dysrhythmia that sets the stage for strokes.  Get those 7 or 8 hours of sleep each night.

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April 12, 2023

Good thing I like blueberries.  A recent study out of Great Britain found that just 12 weeks of drinking smoothies mixed with powdered blueberries improved short term memory, executive function and reaction times.  Blueberries accomplished this by improving blood flow in the heart and brain.  The participants were all between 60 and 80.  They received the equivalent of 75-80 blueberries a day.

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April 11, 2023

According to a story on the front page of today’s Wall Street Journal, the weight loss industry sees the new drugs being used for weight loss to be an existential threat.  Huge amounts of money are spent by Americans trying to lose weight.  Most of it goes to companies that offer diets, regular weigh ins, exercise regimens and the like.  The new medications, which are primarily intended to treat Type 2 diabetes, have weight loss as a side effect.  More and more people are choosing to take these medications and, when they do, the flow of money to the traditional weight loss companies stops.  The new medications are pretty pricey, however, so if you don’t have Type 2 diabetes, you may have to pay for them yourself.

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April 10, 2023

Know your CPR and how to use an automated external defibrillator (AED).  You just might save someone’s life.  AED’s are becoming more common.  It is not unusual to see one on the wall inside a public building.  You should probably look around your work and see if there is one present so you can get to it quickly in an emergency.  An AED is used to restore rhythm to a heart which has stopped due to a cardiac arrest.  As I have written before, cardiac arrests are different than heart attacks.  While you can sometimes have a cardiac arrest as part of a heart attack, you can also have a cardiac arrest without a heart attack.  Only a small percentage of people who suffer a cardiac arrest outside the hospital survive the experience.  When they do it is because someone administered CPR while someone else brought an AED to the scene and shocked the victim’s heart back to normal rhythm.  Do your part.  You never know whose life you might save or who might save yours.

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April 7, 2023

Some interesting news on the heart attack front.  When a heart attack occurs, it is usually because blood flow to a part of the heart has been blocked, which causes the part of the heart not receiving oxygenated blood to die.  The larger the area blocked, the more likely the heart attack is to lead to death or a badly damaged heart that cannot pump well.  Once heart cells die, they do not come back to life, nor are they replaced by new cells.  Scientists are exploring a gene therapy that shows promise in allowing the heart to produce new heart cells and thereby restore pumping function.  Here is a link to a story about the efforts.

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April 6, 2023

The gut microbiome is back in the news.  Researchers trying to understand why some people are able to be cured of or at least live for more than a few years with pancreatic cancer have discovered that those lucky few have larger populations of certain bacteria in their guts.  Coincidentally, patients who have positive responses to immunotherapy for advanced melanoma also have enriched populations of this bacteria.  Researchers believe this is evidence that the gut microbiome plays a role in immune system response to cancers and other invaders.  At present, there is no known way of increasing the population of the bacteria of interest and no clear understanding of how or why it leads to better immune response and survival.  Lots more to do to investigate this.

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March 31, 2023

Flexible duodenoscopes are used to examine the stomach and the upper part of the small intestine.  There have been problems with cleaning the devices between uses with disease being spread from patient to patient due to difficulty with getting them fully clean.  As a result, some manufacturers have switched to disposable parts, which don’t need to be cleaned after use.  In a good example of Murphy’s Law, the disposable parts are coming of in patient’s mouths and stomachs.  The edges on some of these disposable parts are sharp enough to cause internal bleeding.  The FDA has threatened the companies with action unless they do more to effectively address the problem.  As usual, stay tuned.

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March 30, 2023

Well, it was nice while it lasted.  The era of effective antibiotics is just about over.  More and more drug-resistant bacteria are infecting us and we have only ourselves to blame.  Careless use of antibiotics, overuse of antibiotics, routine use of antibiotics in animal husbandry, even when the animals were not sick, all these have played a role in the development of superbugs that eat our antibiotics for breakfast.  Not much to do but wash your hands often and pray you don’t get infected.

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March 29, 2023

You might want to put that probiotic back on the shelf.  With all the talk about the importance of a healthy gut biome, retailers are flooding the store shelves with probiotics, products they claim will make your microbiome healthier.  Not so fast.  Recent studies have shown that, while some people are helped by commercial probiotics, others are not  and some are even hurt by them.  Your gut biome needs to be varied and balanced.  There is just no way a probiotic can contain all of the bacteria, viruses, fungi and the like that make up a healthy biome.  They may have some but not all.  Taking a probiotic can therefore overwhelm your existing gut biome and crowd out the good things that are in there.  If you eat lots of fiber, fruits and vegetables, and modest amounts of fermented foods, such as sauerkraut and yogurt, your gut biome will take care of itself.

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March 24, 2023

According to a story on KJZZ, the deadly, drug-resistant fungus, Candida auris, which I wrote about on Tuesday, has been discovered in four Arizona counties so far.  The counties are Maricopa, Pima, Cochise, and Mohave.  Most of the cases have been in Maricopa County.  There have been 19 reported cases and 18 of them have resulted in bodily colonization, which is the more advanced form of the infection.  Wash your hands carefully and use hand sanitizer, especially if you are in health care settings or have contact with a person who is immunocompromised.

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March 22, 2023

Many rural areas are losing their obstetrical care and becoming what experts call “maternity-care deserts.”  Obstetrical care is expensive and offering it requires having staff members on call 24 hours a day to respond to emergencies.  Hospitals that offer obstetrical care almost always lose money on it.  When rural hospitals find themselves in financial straits, as many of them do for reasons I have addressed elsewhere, dropping obstetrical care is an easy way to save a lot of money.  Add this to the long list of problems facing rural Americans in need of health care.

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March 21, 2023

An extremely virulent, drug resistant, fungus is spreading in hospitals in the United States.  The fungus, Candida auris, can be carried by people who do not become infected by it.  Even if infected by it, healthy people with functioning immune systems should be able to successfully resist it.  Hospitals, however, hold lots of people with weakened immune systems due to age, chemotherapy, or diseases.  Fatalities are common in weakened patients if the fungus gets into the bloodstream.  Once the fungus gets a toehold in a hospital, authorities say it is very difficult to dislodge as it hides in nooks and crannies and evades disinfectant protocols.  Many of the usual disinfectants are not effective against the fungus.

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March 20. 2023

OK, I give up.  There doesn’t appear to be a bad health condition for which the Mediterranean diet is not protective.  I am exaggerating a bit but here is an article discussing the components of the diet and the research supporting its many benefits.  The best part of all is that the Mediterranean diet is not a diet at all in the sense of depriving yourself of good food.  It has some of the best tasting food you can find.  Eat well, live long and prosper.

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March 17, 2023

The final shoe has dropped in the insulin price drama.  Sanofi, the third major maker of insulin, has announced a significant decrease in the price it charges for its insulin products.  In light of the drops previously announced by the other two major makers, it was probably just a matter of time before Sanofi would feel so much pressure that it had to go along.  Hopefully, these price decreases will be passed along to the patients and improve the lives of the many people in the United States who depend on insulin to sustain their health.

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March 15, 2023

More good news in the insulin wars.  Another major producer has announced a dramatic price decrease.  Earlier in the month, Eli Lilly announced a major price decrease.  Now Novo Nordisk, another major insulin supplier, is following suit, although its price decrease will not take effect until January of 2024.  These reductions cannot come soon enough for the many insulin-dependent patients who cannot afford their insulin at today’s prices and are forced to choose between eating and managing their diabetes.

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March 11, 2023

Autopsies results show that following the Mediterranean diet or the MIND diet reduces the risk of Alzheimer’s disease in older persons.  There had been some suggestion in prior research that diet might affect the risk of Alzheimer’s, but these results are thought to be confirmatory.  The MIND diet calls for lots of green, leafy vegetables, berries and a couple of servings of fish each week.  The Mediterranean diet calls for three servings of fish each week, nuts, and fruits.  Both diets call for modest amounts of wine.  As one researcher remarked, the two diets are safe and effective methods of addressing the threat of Alzheimer’s.

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March 6, 2023

Instagram, Tik Tok, GroupOn.  What do these three things have in common?  Answer:  They are all terrible ways to find a cosmetic surgeon.  Cosmetic surgery promises a lot, but sometimes fails to deliver on those promises.  There is only one way to escape growing older.  I don’t recommend it.  At some point, if you live long enough, you are going to look old.  You may be able to put that off for a while, but not forever.  The more procedures you have, the more likely it is that one of them is not going to give you the result you had hoped for.  If you do opt for cosmetic surgery, look for a board certified plastic surgeon.  When you find one, you will at least know that she or he is well-trained and is a real doctor.  Do not be swayed by pretty pictures or sharp videos.  There are charlatans out there.  Do your homework before you entrust your appearance to someone who wants to perform surgery on you.

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March 1, 2023

Artificial intelligence (AI) is being used more and more frequently in medical treatment.  I have written about its success in detecting lung cancer tumors that might be missed by a human radiologist.  Its use in diagnosing other illnesses is getting more attention.  There is a problem, however, and it relates to the data used to educate the AI.  If the data is flawed or otherwise unreliable, the AI results will be flawed and unreliable.  Some studies have found that data used in AI programs has been racially biased or is not applicable to all racial groups.  This has affected the accuracy of the AI diagnosis when applied to non-white groups.  Companies bringing AI programs to market are aware of the problem and looking to fix it.

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February 28, 2023

Statins are a family of drugs that reduce levels of bad cholesterol in the blood.  Elevated levels of bad cholesterol create plaque deposits in the arterial system which can lead to heart attacks and strokes.  Surveys have shown, however, that up to 20% of the people with known elevations of bad cholesterol refuse to take statins that have been recommended to them.  Some continue to refuse even after having had a heart attack or a stroke.  It makes no sense.  If you haven’t had your cholesterol levels checked, do so.  If your bad cholesterol levels are elevated, talk to your doctor about statins and, if she or he recommends them, take them.  They could significantly extend your life.

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February 27, 2023

Are the end times here?  I hope not but there are some troubling signs.  After years of concerns about indiscriminate use of antibiotics, more and more strains of antibiotic-resistant bacteria are emerging.  The Centers for Disease Control recently warned about an antibiotic-resistant form of Shigella, an intestinal bacteria which causes bloody diarrhea and abdominal cramping.  Populations with weakened immune systems are at particular risk.  According to the CDC, these “superbug” infections “are a serious public health threat, and we want to ensure that providers are aware of the increasing potential for antibiotics to fail.”

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February 25, 2023

Plant-based diets are all the rage.  They offer the promise of healthier eating and possible weight loss.  While some live up to the hype, many do not.  There are a lot of ultra-processed foods out there that are plant based but do not lead to healthy outcomes.  As a general rule, the less processing a food has, the better it is for you.  Keep that in mind and avoid ultra-processed foods, even the ones that promise great benefits.

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February 24, 2023

Medicare has been directed by Congress to penalize hospitals that have too many patients readmitted for avoidable reasons.  Here is a link to a finder that allows you to see whether your local hospital has been penalized and by how much.  The maximum penalty is 3%.  On the basis of avoidable readmissions, it appears as though the most heavily penalized hospital in Arizona over the last eight years has been the Arizona Orthopedic and Specialty Hospital in Chandler.  It has been penalized the maximum amount in 7 of the last 8 years.

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February 23, 2023

The United States Air Force is conducting a study of cancer occurrences among its ICBM crews after clusters of non-Hodgkin lymphoma have appeared among the crews.  Nine officers who worked with the missiles, either at launch silos or at command centers in Montana, have been diagnosed with non-Hodgkin lymphoma.  Other missile crew members have reported cancer diagnoses as well.  The Missile Community Cancer Study will be conducted by the Air Force School of Aerospace Medicine.

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February 22, 2023

Still more contradictory findings on the question of how good/bad alcohol is for you.  There is no question that excessive drinking is bad for your health.  It leads to all kinds of illnesses including dementia, liver disease, heart disease and cancer to name only a few.  I have written about studies that conclude even small amounts of alcohol are bad.  Here is one which found an association between light drinking and a lowered risk of dementia.  It is not clear if this is an outlier or if there is indeed some benefit to be had.  In any event, if you don’t already drink, don’t start.

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February 14, 2023

I have lost a number of friends to pancreatic cancer recently.  According to the studies, the rate of pancreatic cancer is increasing in the United States.  Men are more likely to get pancreatic cancer than women but the rate of increase is slightly higher among women now, especially young, black women.  No one knows why at this time.  The best advice for reducing your risk of contracting this deadly cancer is to stop smoking, reduce alcohol consumption, exercise, eat healthily and manage your weight.  All reasonable suggestions we probably ought to be doing anyway.

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February 13, 2023

More on sudden cardiac arrests.  Although it often seems as though they come out of nowhere, recent research shows that, looking back, almost 60% of patients who suffer a sudden cardiac arrest contacted or visited their doctor in the two weeks preceding the arrest.  In short, there was usually something going on prior to the arrest.

Second, in the women just can’t catch a break category, women who are resuscitated have a lower overall survival rate than men.  Doctors are not sure if this is related to their gender or to their anatomy or to some combination of the two.  Some speculate that responders administering CPR may be reluctant to push as hard on a female chest as on a male and it takes a good two inches of compression to move the blood and keep oxygen flowing to the brain.

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February 10, 2023

New research shows that it may not be necessary to remove an entire lobe of the lung in patients with early lung cancer.  Data from almost 30 years ago showed better results and less reoccurrence when the entire lobe was removed.  Due to advances in detection and treatment, that appears to no longer be the case.  Being able to retain part of the lobe results, unsurprisingly, in somewhat better lung function.

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February 9, 2023

A heart attack and a cardiac arrest are two different things.  A heart attack (or myocardial infarction) occurs when the heart muscle does not get enough blood and some of it begins to die.  A cardiac arrest, on the other hand, is an electrical problem, which causes the heart to either stop beating or not beat effectively.  Some heart attacks lead to cardiac arrest but you can have a cardiac arrest all by itself.  Of the two, cardiac arrest is the more deadly.  Some people will live through a heart attack, even without treatment.  You don’t usually live through a cardiac arrest unless someone intervenes to help you by administering CPR and using a defibrillator to shock the heart back to normal rhythm.  Here is a nice article about the importance of people recognizing when someone is having a cardiac arrest and taking action.

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February 7, 2023

This is scary.  Authorities in Mexico have arrested an anesthesiologist and charged him with causing an outbreak of meningitis that killed 35 patients and sickened an additional 79.  The doctor administered spinal blocks to patients using what the prosecutors say was contaminated morphine.  Our procedures in the United States are different so we should hope that a disaster like this cannot occur here but never underestimate the human capacity for error.

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February 6, 2023

Medicare Advantage plans have been taking advantage of us in more ways than one.  Advantage plans receive a set amount from Medicare to care for those Medicare beneficiaries who enroll in the plan.  If the beneficiary is sicker than average, the plan gets some additional money on the grounds that it is going to cost more to care for this person.  Audits by Medicare going back to 2011 have shown that many of the plans are consistently falsifying the records of their plan members to make them appear sicker than they really are so that they can collect the extra money.  The overcharges by the plans run into the hundreds of millions.  It is unclear at this point to what extent Medicare will require the plans to reimburse it for the overcharges.  Just another reason to keep a close eye on Medicare Advantage plans.

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February 3, 2023

Another story of greedy doctors and opiod pill mills.  Two brothers in Florida set up pill mills and hired doctors to prescribe pills to their “patients.”  The doctors were paid by the number of “patients” they saw and the ones who prescribed the most pills received bonuses.  Lots of lives ruined.  Many lives lost.  When the operation came crashing down, thirteen doctors were charged with various racketeering counts.  All but two ended up pleading guilty to lesser charges of money laundering and fraud.  Hopefully, they all lost their licenses, but don’t count on it.

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February 2, 2023

Machine learning is coming.  Machine learning is coming – and that may not be a bad thing.  Researchers have given computers thousands and thousands of x-ray images of patients with and without lung cancer to study.  Lung cancer is deadly and the earlier it can be recognized and treatment begun, the better the patient’s chances for long-term survival.  Lung cancer on chest x-rays is often difficult for human radiologists to recognize, especially when it is early in the process and the signs of lung cancer are so subtle.  Enter the computers.  After studying all these images, the computers were able to go back and look at early chest x-rays of lung cancer patients and identify the presence of the cancer as much as 6 years before the human radiologists were.  Lots of work yet to do but this development is encouraging.

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January 31, 2023

You are what you eat.  It seems as though every day there are more research findings to support that old adage.  Today’s news reports on the ever stronger links between the health of our gut biomes and our mental health, particularly depression.  The researchers have found that people with depression do not have the same levels of some healthy gut bacteria and, at the same time, have higher levels of some other bacteria, which may be associated with depression.  Our gut biomes are driven by what we eat.  Lots of fruits, nuts and fiber is good for our biomes.  Lots of processed foods is not.  Take note.

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January 30, 2023

As part of the infrastructure bill, Congress finally gave Medicare the power to negotiate prices on the most expensive drugs.  The change was long overdue.  Even now it is only baby steps.  Medicare cannot begin to negotiate until 2026 and then only on prices for the ten most expensive drugs.  Fifteen more drugs will be added to the list of drugs eligible for negotiation in 2027, fifteen more in 2028 and 20 more in every year after that.  It is expected that this power will save the taxpayers tens of billions of dollars every year.  It will also provide substantial savings to seniors who have to pay drug co-pays or deductibles.  Keep an eye out for drug companies, which will continue to lobby heavily to overturn or blunt this grant of authority.

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January 27, 2023

A large Chinese study published in the BMJ and reported in the Washington Post makes some not-so-surprising findings about how to avoid dementia and slow memory decline.  According to the researchers, there were six things you could and should do:  1) Eat a balanced diet; 2) Exercise your body; 3) Exercise your mind; 4) Socialize with others; 5) Don’t drink alcohol; and 6) Don’t smoke.  Nothing new here but getting people to follow this advice is not easy.  The high levels of obesity, Type 2 diabetes, dementia and early death in this country show that, while we know how to slow or stop these things, we have a long way to go to actually make it happen.

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January 26, 2023

Here is a research finding that should not be that surprising, I guess.  Japanese researchers studied 4,400 older adults for over four years to determine the extent to which exercise produced cognitive benefits.  It was not clear from the summary I read the ages of the participants.  In any event, those subjects who exercised at least twice a week reduced their risk of developing impaired thinking or a decrease in learning skills by more than 15%.  Knowing that socializing also had a beneficial effect on brain health, the researchers examined its effects with the same group and found that those who exercised at least twice a week with a partner or in a group almost doubled the benefit to a 29% risk reduction.  The moral of the story is to get up off that couch and get moving and, when you do, call a friend to go with you.

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January 17, 2023

With the increasing legal availability of marijuana has come its increasing use by seniors to deal with pain, insomnia, anxiety, the effects of chemotherapy, and other issues.  Some seniors used marijuana in their younger days and believe they are familiar with it as a result.  Professional tip:  This is not the same marijuana they used back in the day.  Today’s weed is more potent than the weed they bought back in the 60’s or 70’s.  Furthermore, their bodies cannot handle the active ingredients in marijuana they way they could when they were in their 20’s.  As a result, doctors are seeing more patients over 65 in the emergency department after ingesting marijuana either the traditional way by smoking it or by eating it.  Since 2005, emergency department visits by seniors have increased by over 1,800%.  If you are going to use marijuana and you are a senior, be careful.

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January 16, 2023

We are making progress in the battle against cancer.  According to the American Cancer Society, the rate of cancer deaths has dropped by 33% since peak cancer deaths in 1991.  Among the reasons cited for the improvement is a 65% drop in the rate of cervical cancer in young women who were vaccinated against HPV, a virus that causes cervical cancer.  Other factors identified as leading to the improvement were early screening, better treatment and a drop in the rate of smoking.

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January 13, 2023

The State of California is going after the big drug companies over the outrageous price of insulin.  Over the last ten years, the price of insulin, a necessary, life-saving drug for Type 1 diabetics, has gone up dramatically for no apparent reason.  It is a huge moneymaker for the big three drug companies that sell most of the insulin in this country.  Recently, Congress passed and the President signed legislation that will begin to force the companies to reduce the price, but that is not immediate.  This suit by the California may not only force the companies to reduce prices, but may also force them to disgorge some of their past profits.

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January 9, 2023

Like many of you, I saw Buffalo Bills safety Damar Hamlin collapse on the field following a cardiac arrest.  The cause was thought to be a condition called commotio cordis, in which the heart stops beating normally when struck at a vulnerable moment during the heartbeat cycle.  I had never heard of this condition before, but have since learned it is not that uncommon in certain sports, such as hockey, baseball and lacrosse.  It has led to a number of deaths on the field of play.  It most often happens to young teen males and young men whose musculature over the heart is not fully developed.  Organizations in charge of these sports have addressed the issue with changes in style of play and development of better protective equipment to prevent blows to this specific area.  They have also attempted to develop a greater awareness of the condition, called for the presence of defibrillators on the sideline and more CPR training for coaches and officials.  With a prompt CPR response and the prompt use of a defibrillator to return the heart to its normal rhythm, most athletes experiencing this event can survive with little, if any, impairment.

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January 5, 2023

More news on the exercise front.  If you have a sedentary job that involves sitting for most of the day, that stretch of relative inactivity during the work day can undo the effects of a daily exercise program.  Here is a quote from a longer article that appeared today in the Washington Post.

“New research shows exercise ‘snacks,’ which consist of brief spurts of exertion spread throughout the day, can improve metabolic health, raise endurance and stave off some of the undesirable changes in our muscles that otherwise occur when we sit too long.”

Just because you have a daily exercise routine, don’t get complacent and think that you have accounted for sitting for long periods while at your day job.  Get up and move around there too.

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