Breast cancer surgery began long before radiation therapy, chemotherapy or hormonal therapy existed. At that time surgery was the only available treatment. The standard of care was radical mastectomy – removal of the entire breast tissue with the underlying muscle and removal of all the lymph nodes from the arm pit. The surgery is terribly disfiguring and debilitating, but was the only thing stand...

Benzonatate is a cough suppressant available by prescription as a generic medication or under the brand Tessalon. It is chemically related to medicines used as local anesthetics and works by numbing the nerves in the lungs which trigger a cough reflex. It was approved by the FDA in the 1950s. A recent issue of The Medical Letter briefly highlighted an FDA warning about benzonatate. (Links to The ...

Rickets is a childhood bone disease caused by severe vitamin D deficiency. It causes bone pain, weak bones and bone deformities in growing children. In the 1920s the link between rickets and vitamin D was discovered and within a couple of decades rickets largely disappeared from the developed world. Until now. A flurry of articles in the media this week (links below) reports a resurgence of rick...

In 1998 the British medical journal Lancet published a study led by Dr. Andrew Wakefield that changed public opinion about vaccination ever since. The study described twelve children with autism and colitis whose symptoms began shortly after they received the MMR vaccine. Public panic was immediate and sustained. Vaccination rates plummeted in England and measles incidence climbed thereafter. Meas...

… Or, You Might Think That it’s Funny, But it’s Snot As I mentioned last week, a miserable cold is striking lots of my patients, spreading grief across the land.  The typical symptoms are nasal congestion, cough and the mother of all malaise.  Since there is nothing proven to significantly decrease the duration of the common cold, the best doctors can do is treat the symptoms and encourage patien...

Many of my patients have come down with a nasty cold in the last two weeks – runny nose, cough, hoarseness, sore throat and the kind of fatigue that makes lifting your head off the pillow seem unnecessarily ambitious.  And just in time the Annals of Internal Medicine published a study to give them valuable advice. The effects of echinacea on the common cold have been studied many times previously...

(Please excuse this short post during this short week.  If you feel deprived of health education, I’ve listed some educational links for you below.) You better watch out.  The flu is coming to town, and it doesn’t care if you’ve been naughty or nice.  It looks like flu season is starting later this year than usual, but both the CDC data and Google Flu Trends suggest that illnesses due to the flu ...

My longtime readers know that I’m not one to panic when the media does.  I wasn’t very worried about anthrax in the mail.  I didn’t think swine flu was going to be a big deal.  (See link below.)  And I’m not concerned about the health effects of airport X-ray back-scatter machines. But there’s plenty of stuff that worries me.  Most of it is scary on time scales longer than the typical media atten...

Aspirin was hailed as a wonder-drug in the 1800s when it was first purified – the first anti-inflammatory medication that did not have the severe side effects of steroids.  More recently aspirin’s benefits in stroke and heart attack prevention have been proven.  This week another possible benefit of aspirin has been uncovered. An important study published in The Lancet attempted to find any effec...

Every now and then some vitamin or dietary supplement becomes all the rage.  A couple of generations ago vitamin C was the miracle drug that could prevent all diseases, despite lots of evidence to the contrary.  Lots of my patients still take it for colds, demonstrating its persistent mythology.  Vitamin B12 became the wonder-drug a few decades ago, leading to a whole generation of patients gettin...