“If you think health care is expensive now, wait until you see what it costs when it’s free.” -- P.J. O’Rourke I’ve written several times about the proven benefits of a family of cholesterol-lowering medicines called statins.  Statins include the medications Crestor, Zocor, Lipitor, Mevacor, Pravachol and others.  The group has a solid base of evidence showing that t...

“I can’t get no satisfaction” -- The Rolling Stones Many women after menopause experience decreased interest in sex and decreased satisfaction with sex.  Some women accept this as a natural part of the aging process, but other women are quite distressed by these symptoms.  The Diagnostic and Statistical Manual of Mental Disorders, the authoritative text on d...

My post last week created much confusion and worry.  I received many emails asking “What about me?  Should I keep taking aspirin or not?” Let me clarify the issue by explaining what we already knew before last week’s study in the British Medical Journal.  We knew that aspirin is valuable in:

• patients who have had a stroke
• patients who have had a heart attack

Aspirin has been a mainstay in the treatment and prevention of cardiovascular disease for decades. We know that in patients who have had a heart attack in the past aspirin prevents a second heart attack, and during a heart attack aspirin is life-saving.  We also know that in patients with a prior stroke aspirin prevents further strokes.  And in patients with symptomatic narrowing of the arteries,...

I beg your indulgence this week as I ignore medical news and offer some personal reflections. Unless you’ve been avoiding all news sources for the last few weeks, you know that a lot of people all over the world are scared.  Today’s headlines scream about the worst week ever on Wall Street, with trillions of dollars of assets evaporating.  No one is sure when the housing and credit markets will s...

The current issue of the Annals of Internal Medicine published a clinical practice guideline from the American College of Physician on drug treatment for low bone density.  It contains a valuable review of the known benefits and risks of the medications used for osteoporosis which I summarize below. Bisphosphonates This family of medicines includes Fosamax, Didronel, Bo...

For the last couple of years I’ve made a commitment to donate blood every month or two at Cedars-Sinai.  Though I must admit the first few times I was scared by the whole experience, I almost look forward to it now.  The nurses treat the regulars like old friends, and the donors are treated to a mandatory break from their busy lives.  Since we can’t be productive, we listen to music, or watch TV, ...

The first day of fall is three days away.  The kids are back in school, temperatures are dipping lower and the leaves on the trees in LA are doing nothing.  In this magical season a doctor’s thoughts turn to flu shots. The flu shot is recommended for the following groups:

• Children aged 6 months until their 5th birthday,
• Pregnant women,
• People 50 years of age and olde...

Arthroscopic surgery is a common treatment for moderate to severe knee arthritis.  Through scopes inserted through small incisions the knee is irrigated and irregularities in the cartilage are shaved off. In fact, no study has ever demonstrated that this surgery is effective for arthritis.  Even worse, in a study in 2002 that randomized patients with knee arthritis to either arthroscopic surgery ...

Last month the Food and Drug Administration allowed food manufacturers to irradiate fresh lettuce and spinach to kill bacteria.  The decision resulted in some controversy and much press coverage.  (See link to LA Times article, below.)  The process involves shooting gamma rays through the produce in an amount enough to kill most bacteria but not enough to wilt the leaves ...