| Don't miss any of Bottom Line's Daily Health News. Add our address, dailyhealthnews@edhn.bottomlinesecrets.com, to your Address Book or Safe List. Learn how here. January 25, 2011  In This Issue...
 The Memory Miracle Your Doctor Doesn't Know About Experts are alarmed by the sharp rise in the rates of cognitive decline in this country. If you plan on living into your 80s (which most of us do), then your chances of suffering from cognitive decline are as high as 50%. It doesn’t have to be this way. There’s a breakthrough solution that could change all the odds, keeping your mind sharp and your memories intact as you age. Keep Reading... Why Doctors Need to Get Physical Many Daily Health News stories focus on what’s new in modern medicine (for better or worse), while many others explore ancient healing traditions -- but today’s story is different from both of those. We’re looking back to the relatively recent past and discussing the demise of something so basic that it’s hard to believe it is fading away -- the physical exam. The hands-on exam that doctors once relied upon as a diagnostic tool now seems positively quaint when compared with ultramodern, state-of-the-art technologies such as genetic testing and MRI scanning. In medical circles, the trend is moving definitively in the direction of technology and the more the better -- the thinking is that high-tech, in-depth electronic, chemical and nuclear tests can provide the information that doctors need with far greater precision than simple touch. But, according to Henri Roca, MD, medical director at the Greenwich Hospital Center for Integrative Medicine in Cos Cob, Connecticut, this may not be providing the best care for patients. Dr. Roca shared his concern that today’s doctors are devaluing the physical exam. He told me that he is worried that our reliance on tests and technology has gone too far. "We’re so dependent on technology that it is as though we’re blind without it," Dr. Roca said, recounting his experience working in New Orleans after Hurricane Katrina had decimated the area’s hospitals and medical clinics. "We didn’t have access to labs, CT scans or MRIs -- and without the technology that modern medicine has come to rely on, many of the people who were the brightest shining stars in their respective fields of medicine were pretty helpless." Dr. Roca added, "I’m not speaking against technology, but I am questioning whether medicine should come to rely solely on technology." Hands-On Exam Has Unique Benefits According to Dr. Roca, the physical exam has benefits that can’t be overlooked, including... It strengthens the doctor-patient bond. It’s impossible to overstate the importance of the relationship between a doctor and a patient, Dr. Roca points out, noting that it’s a way to establish "trust and security that will help healing occur." Performing a physical exam means that a physician is taking the time to listen to you, to ask questions about your symptoms and to touch you instead of simply ordering a battery of tests. It saves money. Dr. Roca readily admits that physical exams take time -- much more than it takes to simply write a prescription for tests -- but a comprehensive physical exam often can provide information that renders expensive tests such as MRIs and CT scans unnecessary. It keeps symptoms in focus. According to Dr. Roca, a pitfall of sophisticated imaging studies performed without the contextual information of a physical exam is that they often deliver more information than actually is helpful, perhaps even identifying new issues that are distracting rather than meaningful. Dr. Roca said that these "incidental findings" can create anxiety for patients and lead to yet more invasive and expensive tests that ultimately prove unnecessary. For instance, he said, MRIs often reveal what appear to be abnormalities but are "normal findings for that patient -- they aren’t the cause of the problem." It’s interactive. Today’s patients often are better informed about medical problems and treatments than those of yesteryear, but this can sometimes complicate a doctor’s work. For example, if you’re telling a doctor about a friend’s similar symptoms or discussing a fact or opinion you read online instead of your own experiences, you may omit important information that can help with a diagnosis, Dr. Roca said. If the doctor performs a thorough physical exam, he/she will notice relevant signs and question you about your symptoms in a way that gets to the root of the problem -- even if the problem isn’t what you thought it might be. Three Types of Physicals Dr. Roca told me that there are three different types of physical exams, each of which has an important place in modern medicine:
And what should a patient expect with the aforementioned "thorough physical exam?" Dr. Roca says it should be a complete head-to-toe look. Though it quickly gets technical -- each step has at least 10 substeps that look for various problems -- at the very least your doctor should...
Does Your Doctor Make the Grade? Dr. Roca urges people who feel dissatisfied with a doctor’s technique in performing a physical exam to voice their concerns. For instance, if you’ve complained about a symptom that your doctor hasn’t checked out, ask to have that part of your body examined. "This will require additional time, but it will lead to the experience that you want," Dr. Roca said. The end result will likely be a more detailed physical and a stronger relationship with your doctor -- and that’s a win-win situation. Source(s): Henri J, Roca III, MD, LAc, DABHM, DAAFP, medical director, Greenwich Hospital Center for Integrative Medicine, Cos Cob, Connecticut. Dr. Roca is a board-certified family physician, medical acupuncturist, hypnotherapist, massage therapist and biofeedback practitioner.  Forever Young Getting old can be awful. Aches... pains... illness... constant bouncing from doctor to doctor. We all dread it. You can't stop the clock, but you can banish the miseries that sometimes come with it.
What Went Wrong with Darvon? Darvon is such a common prescription painkiller -- and it has been for such a long time -- that I was somewhat surprised when the FDA pulled it off the market a few months ago. The matter was treated with a great sense of urgency -- the FDA announcement explained that "new clinical data" shows that patients taking Darvon are at risk for potentially serious or even fatal heart rhythm abnormalities. But Darvon (propoxyphene) has been on the market since 1957! Is it really possible that this is a new problem that no one noticed before? Darvon Dangers Well, actually it turns out that they did. When I started digging around, I learned that there were questions about the safety of this popular drug as long ago as the 1970s. In the UK, use of Darvon was discontinued altogether in 2005 due to the number of patient deaths associated with it... but here in the US, where Darvon was "grandfathered" in 1962 (meaning that it didn’t have to pass the same stringent safety requirements of newer drugs), many doctors continued prescribing it even in the face of its apparent dangers! In fact, 10 million prescriptions were written as recently as 2010. To learn more about how this happened, I called clinical pharmacist Melissa Murfin, PA-C, PharmD, assistant professor at the LECOM Bradenton School of Pharmacy in Bradenton, Florida. She told me that only very recently did the concerns about Darvon’s safety rise to the level where the FDA required proof of the drug’s safety in a mandated clinical trial. This was the research that linked Darvon with the potentially fatal heart-rhythm abnormalities and led the FDA to demand that the manufacturer, Xanodyne Pharmaceuticals, withdraw it immediately from the market. Bad Chemistry Dr. Murfin explained that propoxyphene becomes dangerous when the body breaks it down, creating a metabolic product called norpropoxyphene that is harmful to the heart. Making matters even worse, norpropoxyphene remains in the body a long time, from 30 to 36 hours -- even longer in older people. Darvon (and its sister drug Darvocet, which also has been taken off the market) were meant to be taken every four hours, facilitating a dangerous buildup of norpropoxyphene in the body and creating an escalating risk of arrhythmia. Again adding insult to injury, arrhythmia is an especially dangerous condition for the elderly, says Dr. Murfin, as well as for people with kidney problems. Also, certain medications, such as antifungals... the antibiotic erythromycin... and the herb Saint-John’s-wort... along with grapefruit juice lead to even greater amounts of norpropoxyphene, potentially making matters even worse. More outrageousness yet: The FDA research review found that this deadly drug isn’t even all that effective -- researchers reported that its painkilling effectiveness is approximately equal to aspirin and other over-the-counter (OTC) analgesics. The difference appears to be that as an opiate, Darvon also induced a euphoric effect that patients liked. There are a number of other painkillers that you can take that are both safer and more effective including, possibly, an OTC drug. Your doctor can provide advice on what products might be good choices for you... and if you have any Darvon or Darvocet left in your medicine cabinet, take it to the pharmacy and ask to have it disposed of safely. This drug is too dangerous to keep in the house. Source(s): Melissa Murfin, PA-C, PharmD, assistant professor of pharmacy practice, LECOM Bradenton School of Pharmacy, Bradenton, Florida. Be well,
Making Peace with Your Parents It saddens me to see how many people I know are struggling in their relationships with their parents. And I don't mean youngsters. These are all people in their mid-40's or older so they have been suffering a very long time. It is heartbreaking to witness... and sad to know that these people are just a microcosm of the country and that there are millions of others in similar situations. Read on... You received this free E-letter because you have requested it. You are on the mailing list as healthwellness82@gmail.com. Or... a friend forwarded it to you. Click here to easily subscribe. You can easily unsubscribe by clicking here. To change your e-mail address click here To update your e-mail preferences click here Important: Help your friends live more healthfully -- forward this E-letter to them. Better: Send it to many friends and your whole family. This is a free e-mail service of BottomLineSecrets.com and Boardroom Inc. Need to contact us? Boardroom Inc. Privacy Policy: Required Disclaimer: The information provided herein should not be construed as a health-care diagnosis, treatment regimen or any other prescribed health-care advice or instruction. The information is provided with the understanding that the publisher is not engaged in the practice of medicine or any other health-care profession and does not enter into a health-care practitioner/patient relationship with its readers. The publisher does not advise or recommend to its readers treatment or action with regard to matters relating to their health or well-being other than to suggest that readers consult appropriate health-care professionals in such matters. No action should be taken based solely on the content of this publication. The information and opinions provided herein are believed to be accurate and sound at the time of publication, based on the best judgment available to the authors. However, readers who rely on information in this publication to replace the advice of health-care professionals, or who fail to consult with health-care professionals, assume all risks of such conduct. The publisher is not responsible for errors or omissions. Bottom Line's Daily Health News is a registered trademark of Boardroom, Inc. Copyright (c) 2011 by Boardroom Inc. |
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