“The first principle is that you must not fool yourself – and you are the easiest person to fool.” -- Richard FeynmanThis month brought more bad news for coronary artery stents. To understand how far coronary stents have fallen, we have to understand what we’ve been using them for. But first I should explain that coronary stents are life-saving treatments during a heart attack. That has been well established and is not changed by anything in this post. T...
My longtime readers know that I love to inform you about ways that Mother Nature tries to hurt us. Since it’s winter, norovirus deserves our attention as it wreaks its seasonal havoc and occasionally closes down schools. Norovirus causes inflammation of the stomach and intestines. It’s commonly referred to as a “stomach virus” or “stomach flu”. (But it’s not related to the influenza virus. So let’s stop calling it the stomach flu. It just confuses people and makes them think that the flu ...More
In 1964 the Surgeon General issued a report on smoking, summarizing the scientific evidence demonstrating the health risks of tobacco use. Scientifically, nothing in that report was new. It was a review of what was already known. But it had a profound societal effect by publicizing a health risk that had been until then largely ignored. Education, health policy, and the advice of many individual doctors were transformed. This week the Surgeon General released More
Every year I write a post in the late summer letting you know that flu season is approaching and to get a flu shot. I try to keep my posts informative and evidence-based, but I don’t have anything new to tell you about that. Actually, I do have one bit of news. Some of you may have heard of FluMist, the flu vaccine given by nasal spray. It’s especially popular with children and with patients with needle phobias because it’s not injected. The Centers for Disease Control and Prevention (CDC...More
We’ve known for over a generation that using medications to lower high blood pressure can decrease the risk of strokes, heart attacks, and kidney failure. National guidelines have recommended using medications to get the systolic blood pressure (the higher blood pressure number) below 140. So for my whole career a systolic in the 130s would lead to me pat the patient on the back and declare victory, while a systolic in the 140s would lead me to increase a dose of a medication or stress to th...More
Last week our office received our batch of flu shots for the upcoming flu season. Every fall I urge my readers to get a flu shot. If you'd like to know the different kinds of flu vaccines available, and which is right for you, read my post from la...More
Smoking is a major cause of heart attacks, strokes, emphysema, and lung cancer. Smoking rates have steadily declined in the US in the last 50 years, but about a fifth of US adults still smoke. Helping them quit would make a major contribution to their health. A study in the current issue of the New Englan...More
Food allergies are commonly misunderstood, so please bear with me while I first explain what food allergies are and are not. Various foods can cause all sorts of unpleasant effects. Most of these are not allergies. Allergies are only reactions caused by a specific antibody (called IgE) that results in hives, trouble breathing, or a life-threatening condition called anaphylaxis. So, if yogurt gives you diarrhea, that’s not an allergy. It might be lactose intolerance. If coffee gives you palpi...More
It’s a world of measles, a world of flu. It’s a world of mumps and pertussis too. It’s a world that we share, but please stand over there. It’s a small world after all. -- My new proposed lyrics for the ride It’s A Small WorldIn December I wrote that 2014 was a banner year for measles in the U.S.. Take a moment to read that post if you want a refresher on the symptoms and history of m...