| 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. February 7, 2011  In This Issue...
 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.
Danger -- Your Computer Can Harm Your Health You know "Dr. Google," don’t you? He’s become the go-to guy for most folks wondering whether that odd and slightly painful bump on the shoulder is something to worry about... if queasiness that won’t quit might be a side effect of that new medication... or whether a headache that started a day and a half ago actually might be a lethal brain tumor. New research shows that 80% of regular Internet users now go online with their questions about health and medicine -- it’s easy, fast and free, and there’s a wealth of information. Most of us benefit greatly from having so much excellent information at our fingertips. But for some of us, online health information can become an obsession that turns us into "cyberchondriacs" who are not only tedious to sit next to at dinner parties but who actually end up suffering acutely from psychological distress. Being constantly worried about your health is a hallmark of the complex psychological syndrome doctors call hypochondriasis. For people with hypochondriac tendencies, being able to go online to rapidly gratify an urgent "need" for medical information can spiral out of control. They have an addiction-like difficulty controlling this behavior -- getting answers may help them feel calm for a little while, but the anxiety returns and so back they go to their computers. It never ends, and it makes life miserable for them and -- it must be said! -- for the people close to them. Brian Fallon, MD, MPH, MEd, professor of clinical psychiatry at Columbia University and director of the University’s Center for the Study of Neuroinflammatory Disorders & Behavioral Medicine, is coauthor with Carla Cantor of the book Phantom Illness: Shattering the Myth of Hypochondria. He told me that between 5% and 10% of the population have hypochondriacal tendencies. According to Dr. Fallon, their exaggerated fear of illness usually is the result of a chemical imbalance in the brain. This problem is found equally in men and women, though it is somewhat more prevalent in younger (teens and young adults) than in older people. The Internet Feeds the Fear Everyone is more aware of health news nowadays because it’s widely covered by the media and medications and medical services are aggressively advertised. This, too, feeds cyberchondria -- vulnerable people see or hear these stories and begin to think that they may have the conditions that are mentioned. Making matters worse: Dr. Fallon points out that a pitfall of seeking health information online is that it’s hard to know what’s true. Health-content providers may be selling products and may or may not check facts. Bloggers can say whatever they want, whether it’s true or not. Minor problems can be made to seem more dramatic. And, since cyberchondriacs often are quite intelligent, their awareness that not all the information they find online is reliable inspires them to conduct even more searches in a quest to verify or debunk what they’ve seen online... and the beat goes on. Though there’s surprisingly little research available about this condition, Dr. Fallon told me that he’s working to change that. Preliminary results from his research confirm what makes intuitive sense -- online health research hurts rather than helps these anxious and vulnerable people. "Cyberchondria can mess up your life," Dr. Fallon said. Handle with Care Anyone and everyone who searches online for health information needs to be judicious when choosing Internet sites. The best places to start are the ones that offer information provided by physicians and other well-trained health-care professional -- and, said Dr. Fallon, "all the better if these pros are affiliated with respected medical institutions." The most trustworthy information will be presented in a balanced way, even including alternative hypotheses. Dr. Fallon advises avoiding sponsored content, which is not objective, and health blogs, which often are neither objective nor entirely factual. Further, Dr. Fallon suggests that people who have a tendency to "catastrophize" in their lives -- imagining small items to be giant catastrophes -- may be well-advised to avoid using the Internet for health information altogether, since doing so is likely to lead to intense anxiety and distress. He said that people generally are aware of whether or not this advice applies to them. "If you have a high level of health anxiety, you already know it," he said, noting that if you have failed to recognize this trait in yourself, you will surely have heard about it from frustrated friends and loved ones who have commented on your gloom-and-doom tendencies. Going online for medical information can be a difficult habit to break, but the good news, Dr. Fallon said, is that for many people who quit the habit, the most intense feelings last for no more than a day or two. And if you can stop stoking your health fears with online research for one to three weeks by distracting yourself (try a walk, a talk with a good friend or some other activity to shift your focus), your anxiety will decrease, he added -- and then you may be able to successfully rely on information and advice from your doctors who know you. If you can’t stop the cyberchondria cycle on your own, there is one important bit of research you should do -- ask someone you trust for the name of a psychotherapist. According to Dr. Fallon, people who have severe health anxiety can be effectively treated with cognitive behavioral therapy and, if necessary, antidepression medication, such as fluoxetine (Prozac) or fluvoxamine (Luvox), to help restore the chemical balance in their brains. Source(s): Brian Fallon, MD, MPH, MEd, professor of clinical psychiatry and director, Center for the Study of Neuroinflammatory Disorders & Biobehavioral Medicine, Columbia University, New York City, and coauthor with Carla Cantor of Phantom Illness: Shattering the Myth of Hypochondria (Mariner).  Arthritis Vanishes So Fast I Am in a State of Shock! Free Recipe Requires Just Two Ingredients... Huh? How can a recipe for gin-soaked raisins qualify as the arthritis remedy of the century? Hey, this was your decision! In the past few months, savvy readers like yourself have been writing in stunned with amazement about their personal results from the Wilen Sisters' secret raisin remedy. But we can understand your skepticism. So, rather than tease you any longer, we're reproducing a short version of the recipe right here... Many Doctors Treat Uveitis the Wrong Way You suddenly find that you can’t see so well, your eye is red and has a stinging sensation, so you go see an ophthalmologist with the expectation that you will receive expert treatment in keeping with the best available evidence. If you have uveitis, that’s not always what you get. A recent study of ophthalmologists and rheumatologists in the US that was presented at the 2010 Meeting of the American Academy of Ophthalmology in Chicago found that 75% of the surveyed physicians who treat patients with uveitis (inflammation of the uvea, the layer between the sclera, or white of the eye, and the retina) do not follow recommended guidelines for managing the condition either because they are unaware of the guidelines or choose not to follow them. It’s no small divergence either -- the majority of these doctors are prescribing systemic steroids at far higher doses and for far longer than recommended. That can spell trouble, because ongoing use of steroids at high doses can lead to an extensive array of dangerous complications, including heart disease, diabetes, hypertension, bone loss, weight gain and depression. What Doctors Are Doing Wrong Uveitis affects about 0.2% of people worldwide and causes 10% to 20% of new cases of legal blindness each year. It is associated with a variety of conditions, including autoimmune disorders, inflammatory conditions (such as Crohn’s disease and ulcerative colitis) and infections. Symptoms include eye redness, pain, light sensitivity and blurred vision. Though it usually can be cleared up or controlled with proper treatment, uveitis needs to be taken seriously because it is one of the leading causes of irreversible vision loss and blindness, which sometimes can happen very quickly. The goal of treatment is to eliminate the inflammation in the eye, which usually is achieved with the use of the corticosteroid prednisone. The guidelines from the American Uveitis Society, several panels of uveitis experts and other scientific societies stipulate that corticosteroids should be prescribed at no more than 7.5 mg to 10 mg/day, and the duration of steroid therapy should be no more than two to three months. If the inflammation is not fully resolved, uveitis patients should then be on a combination of prednisone (at a dose of less than 10 mg/day) and a "steroid-sparing" agent, notably an immunomodulator (a drug that soothes symptoms by systemically suppressing the body’s immune response), such as methotrexate, mycophenolate mofetil or cyclosporine, among others... or an immunomodulator alone. But that’s not what’s happening: Some doctors responding to the survey reported that they prescribe steroid doses as high as 46 mg/day, sometimes for as long as 22 months! Only a small percentage of patients were being treated according to the guidelines. See a Uveitis Specialist I spoke with the study’s lead author, Quan Dong Nguyen, MD, MSc, associate professor of ophthalmology at the Wilmer Eye Institute of the Johns Hopkins University School of Medicine. He indicated that it may be acceptable to begin uveitis treatment with systemic corticosteroids -- but not to continue for prolonged periods and, most especially, not in such high doses. "Uveitis is usually a chronic disease that requires ongoing treatment," he said -- but "steroids should not be used chronically." According to Dr. Nguyen, a number of scientific studies have shown twice as many cardiovascular events in patients using steroids daily at doses of as little as 5 mg to 7.5 mg for extended periods. Therefore, Dr. Nguyen said, some experts currently suggest that even 10 mg of prednisone or the equivalent daily may be too high and advocate limiting the dosage to no more than 5 mg/day of prednisone (or its equivalent). According to Dr. Nguyen, immunomodulatory drugs may be safer than corticosteroids when used properly. Side effects of immunomodulatory therapy can include lowered white blood cell count, risk for infections, mouth sores, loss of appetite and bleeding, among others, but these side effects can be lessened or eliminated by careful monitoring of the dose and early detection of adverse events. If a doctor diagnoses you with uveitis, Dr. Nguyen recommends seeking evaluation and treatment as early as possible from an ophthalmologist who specializes in the condition so that your vision may be preserved. Uveitis specialists are ophthalmologists who have completed additional training (one to two years after a residency in ophthalmology) in uveitis and ocular immunology. Whoever you see, it is important to discuss how the doctor manages patients with uveitis. You can go to the Web site www.Uveitis.org to see a listing of uveitis specialists in your community. Source(s): Quan Dong Nguyen, MD, MSc, associate professor of ophthalmology at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore. Be well,
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