HealthyConcerns.com

What a waste, and what are you thinking Yahoo?

Today a reader here at this poor neglected blog pointed out to me that a few of the links in my MedBlogs blog roll were defunct. One had changed URLs...easily fixed. Several were personal bloggers from various doctors or patients who had stopped blogging (and apparently stopped paying hosting fees to keep their archives live for the finding)...a shame, but understandable.

But one dead pool blog really surprised me. It was the Beat the Blues blog on Yahoo!'s health site, written by one of their Health Experts, Dr. David Neubauer.

OK, so times change, the economy is tough, I get that they may have cut back on their experts. But as far as I can tell the archives of this blog is gone. His most recent post was earlier this month, but searching by his name or by the last few topics he wrote about brings up nothin'!

Dr. Neubauer may not have blogged often (and who am I to judge on that?) but when he blogged it was simple, straightforward, easily digestible information for a lay audience on an important topic. Important because depression is realtively widespread, but still a pretty silent ailment.

So, apparently, the Internet isn't always forever. Isn't Yahoo! a search company? Shouldn't they get that people will still be searching for help with their depression long after the end of this one individual's contract? And that his info should be evergreen and ever-available? Perhaps there were contract issues at stake here. If not, I'd say Yahoo! blew it by wiping out a valuable archive of information.

I'd still like to have a good link to a medblog about depression in my blog roll. Any suggestions?

The continuing saga of Vitamin D deficiency

When you blog, your friends send you links. Links to stories similar to what you've been writing about. Sometimes stories they simply think you should be writing about.

Today my friend Maria NIles contributes to my ongoing series of posts about Vitamin D, or Vitamin D deficiency to be more specific.

The post: Why Black People Need More Vitamin D from TheRoot.com.

This I already knew, but the article goes into some detail about why.

Bottom line: The melanin in the skin of people of color does something great: It protects them from harmful UV rays. but it also does something not-so-great: It blocks Vitamin D production.

And since the medical community has evolved from thinking Vitamin D only impacts bone health, but also may lower the risk of diabetes, hypertension and other very common illnesses and conditions, they are thinking that epidemic Vitamin D deficiency is really not a great thing!

The article's bottom line is that it is very very difficult to get enough Vitamin D naturally from either our diet or from foods. They recommend supplements all the way.

Kind of a bummer, but there it is...

Surviving the system, courtesy of the ACS

The American Cancer Society has a lobbying arm called the Cancer Action Network [Read about it here.] The ACS CAN recently launched a big initiative for cancer patients called "Surviving the System". They launched it with a Lobby Day which took place on the 20th.

The idea was to get regular people sharing their stories...and reachng out to their elected officials to ask for health care reform, for cancer patients and in general.

While cancer isn't the number one killer in America, it does claim over half a million lives a year. And getting cancer can be devastating to families for more reasons than just the fear and anxiety over our lvoed ones' health. According to a study released to coincide with ACS CAN's Lobby Day:

•  Nearly one in three people diagnosed with cancer under the age of 65 has been uninsured since their cancer diagnosis.  Scientific research shows that being uninsured can adversely impact your chance of survival.
• One in five families affected by cancer have used up all or most of their savings because of health care costs and more than 40 percent have had difficulty affording their health care costs in the last two years. 
• More than two-thirds of Americans under age 65 who tried to find insurance outside their employer couldn’t afford a plan. 

Our family just went through a cancer scare or two ourselves, but luckily we are all covered, well-covered. Imagining the stress of having no or insufficient coverage, on top of the stress cancer brings on its own...well, I wouldn't want to experience that. 

And once again, it begs a fundamental question: Insufficient or non-existent coverage can impact someone's chance of survival. Is it OK that people live or die in this country based not on whether what they have is treatable or curable or not, but rather on their income level or class or employment status? All of which seems highly volatile in this economy. And what if we're talking about children, who surely aren't responsible for their parent's socio-economic status? 

California is experiencing record unemployment, and I'm guessing a lot of people are losing their coverage. Or being forced to choose between paying exorbitant COBRA payments vs. paying for other necessities, like food, shelter etc.

Those people may be very employable, may have new jobs with coverage waiting around the corner. Is it OK that they have to hope that nothing catastrophic happens to them...whether one-time, like a car accident, or chronic, like a cancer diagnosis...while they're toughing out this economy like we all are?

I continue to think it's not. You can read more about the ACS's perspective and their efforts for health care reform on their site and their blog.

In case you've been wondering: Being a bad patient works sometimes

I wrote about once I finally went to the doctor for my lingering plagues, I was the typical bad patient, wanting my doctor to drug me up.

So, how's that working out? Thanks for asking.

As I suspected, getting the steroid shot and prednisone treatment has made a huge difference. My allergies have gone from out of control and wearing me down, to barely a blip on my radar. How does that make a difference in day to day life?

How about this: The other night I went out for drinks with a friend who is leaving the country. About 7 years ago i developed an allergy to alcohol out of nowhere. Any kind of alcohol. I basically stopped drinking altogether. I visited an allergist who thought that being allergic to alcohol in such a sweeping way was unlikely. He instead subscribed to the bucket theory. My allergies are like a bucket, and when the bucket is full, lots of things can act as a trigger to push them to overflow...like alcohol. He suggested getting on Claritin, and that eventually that would bring my allergies under control. Well, i did take Claritin...and later switched to Zyrtec. And while my allergies are more under control taking a daily pill than taking nothing, I have not taken back up drinking. Occasionally I have a 1/2 glass of wine, maybe almost a full beer...but I always feel it when I do. Until a couple of evenings ago when I had one whole margarita. And felt nothing. No itchiness. No flushing/heat. No swollen eyes.

Or this: Friday evening I went to a book launch party for BlogBuddy Tara Hunt...which was held out in a beautiful backyard surrounded by lots of plant life. There have been countless times that I have left parties early, usually with two catalysts: Pets or outdoor plant life. But yesterday I hung out for about two hours and better yet: I didn't feel it. My eyes were a tiny bit red and icky this morning, but generally, I didn't sneeze, I didn't cough etc. etc.

Now my allergist back those few years ago isn't the only guy who subscribes to the "bucket" theory. I got an email the other day from a blog reader who said much the same thing. He represents the folks from a company called Phadia, who sponsor a site called Do I Have Allergies?.com

Their explanation of the bucket theory:

Allergy patients are often sensitive to a number of allergens, and allergy symptoms emerge only when cumulative exposure to these allergens pushes them over the symptom threshold.  As long as the cumulative exposure is below threshold, allergy symptoms are not present.  But once the threshold is breached all hell breaks loose.  
 
For example, a patient may be sensitive to three allergens, such as pet dander, dust mites, and pollen. For 11 months of the year, the cumulative load of the pet dander and house dust mites is just below the threshold.  No symptoms. But that one month when pollen is in the air, the patient is over the threshold and symptoms are unmanageable.   As a result, a patient suffering from terrible allergic symptoms during pollen season may be able to avoid these symptoms by targeting and reducing their exposure to other allergens, in short, rendering their sensitivity to pollens less than harmful.*

Sounds reasonable to me. And that's where I was a few weeks ago. I fully credit the steroid treatment for letting my enjoy life a little more.

I gotta do this every year!

*Thanks to Joseph Crivelli from Gregory | FCA Public Relations for sending me this description

Do patients have a *right* to visitors? Wow.

OK, when I saw the headline of this NY Times blog post, Do patients have a right to visitors?, I really thought it was going to be about something else. I thought perhaps there were cases of family members who were awful to hospital staff and banned, despite a patient wanting to see them. 

I didn't think it was actually about that well-worn cliche: Gay life partners being banned from their partners' bedsides. I mean, admit it, haven't you heard that a million times and wondered if it really still happened?

Call me naive, I thought that argument was more about the possibility, not the reality. I mean, in this day and age? In America? Oh, silly silly blogger!

Well, two such cases are becoming court cases, one in Florida and one in Washington state. The NY Times blog post points to a more detailed column about the cases. If you have a heart, you will feel terribly upset upon reading these accounts.

I don't care about your politics, what kind of people would basically force someone to die alone? Would prevent children from being able to say goodbye to a dying parent?

The phrase is "First, do no harm." There's nothing but harm in these stories. Harm to those poor dying souls. And irreparable harm to their partners and children.

Do you see some rationale I'm missing here?

Your heroes unveiled

Last month I blogged about a project from the folks at Our Bodies, Ourselves to name our Women's Health Heroes.

And on May 11th they announced the Heroes. 

From the release:

The 2009 inaugural inductees represent seven countries and a wide range of health fields and disciplines. Among them: Elisabeth Bing, founder of Lamaze International; Efua Dorkenoo, an activist against female genital mutilation; Jenni Prokopy, founder and editor of ChronicBabe.com; Susan Corrado, a community parish nurse in Wisconsin; and Bene E. Madunagu, a professor of botany in Nigeria.

Two nominees were selected for special honors: Lisa Copen, founder of Rest Ministries, received the Audience Choice Award, and the Fair Haven (Conn.) Community Health Center Midwifery Group was selected by OBOS.

This event marks OBOS's first annual effort to spotlight the diversity of care, education and activism in communities around the world. Within five years, at least 100 people who have made significant, long-lasting contributions to women's health will be honored for their work as Our Bodies Ourselves Women's Health Heroes.

The full list is here.

Kind of exciting that one of the honorees, Jenni Prokopy from ChronicBabe is speaking at BlogHer!

Congrats to all the winners.

My S.O. will be so happy

My S.O. gets infuriated with people who go to the office when they're sick...including me. I am definitely of the ilk that I will go in unless I'm on death's door. He will stay home with a hangnail.

Turns out, at least according to the NY Times, that he may have the better approach.

As a resident, my greatest pride was in never having missed a day for illness. I’d drag myself in and sniffle and cough through the day. Once, I’m embarrassed to admit, I trudged up York Avenue to the hospital making use of my own personal motion sickness bag every few blocks while horrified pedestrians looked on.

Now, though, I see the foolishness of this bravura. And I confront it almost daily in my primary care practice. No one can miss a day — a minute, even — of work, carpooling, volunteering, vacation, anything. “I don’t have time to be sick!” my patients wail. Everyone must soldier on, leaving sick days to those with less important things to do.

Yes, I agree there is a certain sense of arrogance inherent in the idea that people cannot live without me coming into the office. I already work from home one day per week, why not more when I'm sick?

But I also think it's a kind of denial. Like "...if I can make it to the office and work a full day, then I must not really feel so bad..." and it's mostly ourselves we're trying to convince. Combine that with the underlying belief that how sick you are can actually be influenced by how you feel mentally, then it would seem like good medicine to convince yourself you're not so bad off, and go to work.

It all seems pretty flimsy when I write it out in black and white, but time for true confessions...how many of you think exactly that way?

So, apparently I've been doing it wrong: Vitamin D and sunlight

Ever since I found out I have a Vitamin D deficiency (like half the population), I've been trying to get a little more sunlight into my life, unblocked by sunscreen

This consisted mostly of me exposing my face and lower arms to the sun when I got a little chance to. (Not for extended periods of time mind you, I was shooting for 10 minutes.)

Well, apparently, my approach is all wrong. 

Thanks to this link from Jack Norris, RD, I got this very different advice about sun exposure from a Vitamin D expert, Dr. Michael Holick:

“I typically recommend people go out for a period of time—depending on the time of the year, the time of day, the latitude, and the degree of skin pigmentation—if you know you’re going to get a mild sunburn after 30 minutes, I typically recommend about 10, no more than 15, minutes of arms and legs exposure, or if you’re in a bathing suit, abdomen and back exposure as well, 2 to 3 times a week. Always wear sun protection on your face because that’s the most sun-damaged area and it’s only about 9% of your body surface, so it doesn’t provide you with that much vitamin D. Go out, enjoy yourself, get some sensible sun exposure, then put sunscreen on if you plan to stay out for a longer period of time. People with a higher degree skin pigmentation, such as African Americans, are walking around with an SPF of 8 to 15. That’s why they need to be exposed for much longer periods of time and why people of color are at especially high risk of having vitamin D deficiency.”

So yeah, "always wear sun protection on your face". D'oh.

I've been doing it wrong :(

It's like when you buy a new car: Seeing Vitamin D deficiency everywhere!

You know how when you buy a new car, you suddenly see it everywhere?

Last Friday I went to the doctor and got a round of blood tests done. I'm very healthy, with one exception: I'm low on Vitamin D.

The doctor sent me a message this morning saying that half her patients have a Vitamin D deficiency, and that I should start supplementing.

Honestly, I was going to try the ten minutes of sunlight a day approach first.

Today, as I flipped on some Tivo to entertain myself before making dinner, the first segment on the Martha Stewart show i started out with was about...you guessed it...vitamin deficiency. Starting with the stat that about, yes, half of us have a deficiency.

The expert brought up an interesting fact that those of us who live further North are bound to develop this deficiency much easier because the sun rays are less direct. (I was kind of wondering if those way South have the same issue, but they didn't say so.)

He recommended 10 minutes of sunlight a day for lighter skinned people and 30 minutes of sunlight a day for darker skinned people. Acknowledging that we've all been trained to lather on the sunscreen per dermatologists, the strong message was that this short amount of time in the sun per day was not very risky, and would deliver the Vitamin D our bodies need to avoid problems with osteoporosis and even cardiovascular issues later!

How do you get your Vitamin D? And do you know your levels?

Unnecessarily stressful paranoia or good paranoia?

So today, a weekend when I was supposed to stay in, hermit-like, to recover from my ongoing decrepitness of the last 6-8 weeks, I had one errand I had to run.

And damned if I didn't get rear-ended at a stop light!

The guy in front of me wasn't going, so I finally honked at him. Just as he took off, bam! Someone who wasn't paying attention to the actual cars on the road, but only the color of the light, hit me. Two things happened: I bit my lip, and my head flipped back against my headrest. No airbag, no hitting the steering wheel, nothing very substantial.

In fact, when we pulled over, my car's rear bumper was merely scratched (thank you Honda!) His car's front bumper was much worse off, even cracked through at one place. Kind of serves him right, right?

Now, I haven't gotten into many accidents in my life, the worst one being within my very first year of driving when I in fact did bite the steering wheel and break some teeth.

It is always shocking and disorienting. And me with a head already a little fuzzy with congestion. 

But of course I'm thinking Natasha Richardson. Is one's head hitting the headrest of one's car (which is, in fact, the entire purpose of the headrest - to prevent whiplash) the kind of head injury that can seem innocuous, but really be life threatening?

Without Richardson's recent, tragic death I doubt I'd be giving this a second thought, but instead I'm waiting to see if a headache or blurred vision comes on.

So far, so good, three hours later.

So, the question is: Unnecessarily stressful paranoia? Or the good kind of paranoia? What has Natasha Richardson's skiing accident wrought?