VACCINES IN THE WAR AGAINST CANCER

Vaccines proving yet again how important they are in keeping us all alive and healthy.  Boys should be routinely vaccinated against HPV (human papillomavirus ) at age 11-12.  Why?  To protect them against cancer and to protect their future sexual partners.  If we're ever going to win the war against cancer prevention is key.  This is a great step forward.  I encourage every parent to get their children, boys and girls, vaccinated against HPV.     

The Politics of Medicine

Society frequently medicalizes tough social problems.  In Ireland when I was a new graduate the conservative government gave doctors the power of the condom.  Doctors and doctors alone were allowed decide if you got condoms and if you didn't and then only for bona fide contraceptive purposes.  If you weren't married forget it.  No condoms for you.  I kid you not.  As a single man back then I could decide if you were allowed get condoms and how many but I wasn't allowed use them.  Utterly absurd.  Of course I never prescribed condoms.  I'm a doctor not the morality police.  And besides there were lots of clinics that sold condoms to any and all.  Thankfully this ridiculous law didn't last long.  I bet you're smiling.  Such nonsense could never happen here.  Right? Wrong!

In California you want to get high on marijuana you must have a doctor's permission.  You have to have a prescription as the government in all its wisdom has decided that marijuana can only be used for bona fide medicinal purposes.  Does anyone with half a brain really believe that all the pot smoking around us is done for bona fide medicinal reasons?  Last week the California Medical Association (CMA) stated the obvious.  They pooh poohed the medicinal effects of marijuana and came out for its legalisation.  They reckon the consequence of legalization will be way less than the price we're paying now.  They're not advocating a free for all, however, they want it treated and regulated like alcohol.  And I agree on all counts.  Who smokes marijuana is not a doctor's business.  It's a personal decision not a medical decision.   Time to end the charade. 

Finally, a couple of disclaimers.  I'm not a member of the CMA and I have never smoked, do not smoke and have no desire to smoke dope.  I do, however, make up for it with chocolate and red wine.  To each their own.  

 

Flu Shots

Yeah it's that time of the year.  Time to get a flu shot.  Flu shots are pretty much available anywhere from your doctor's office to your local pharmacy to "flu shot clinics".  This years' vaccine protects against Influenza A H3N2, Influenza B and H1N1.  Remember it takes up to two weeks to become fully effective so the sooner you get "shot" the better.  

Everyone aged six months and older should get vaccinated especially high risk groups such as young children, pregnant women, asthmatics/COPD, diabetics and if 65 or older.

Don't forget everyday prevention including frequent hand washing and if you do get sick stay out of the office or school until your 24 hours without fever - of course without using a fever reducer.

For more info: cdc.gov

 

The Show Today

Dr. Chambers On Call is live today 4-5 PM on KFWB News Talk 980.  

What the Dr. Murray/Michael Jackson trial says about the ever evolving doctor patient relationship and what we can all learn from it.  And as always your questions answered live on the air plus the email of the week from Paula DeCapua on dye toxicity and renal failure.  The number to call is 888 539 2980 or email anytime drchambersoncall@gmail.com

To PSA or not?

Okay if you heard the show yesterday you know I'm with The United States Preventive Services Task Force and am essentially abandoning PSA as a screening tool for prostate cancer in healthy men.  I'm not going to get it done myself and will not recommend it to my healthy patients.  If they want a second opinion I'll refer them on.   No sweat, no worries.

Each and everyone of us should decide personally if it's still wise to get this test.  If you do decide to get it remember you may be putting yourself at risk for aggressive unnecessary treatment for a cancer that may never really affect your health.  Anyhow, for all the details listen to yesterday's show.  

As always, before you make a final decision discuss it with your health care provider.  

Talking to your doctor - a tip

Yesterday one of the callers, Steve was his name, buried the lead.  He asked me about several symptoms and as I was wrapping up dropped a bomb.  He was three weeks post major heart surgery.  This changed everything.  And I mean everything.  All of a sudden his symptoms including night sweats had all kinds of other possibilities totally different than what we had talked about.  The reason I bring this up today is simple.  What you tell your doctor in the first few minutes of any consult dictates everything.  It’s never the time to hold juicy information back.  You will lead him down the wrong path much to the detriment of your own health.  Not a good idea.  Don’t do it.  Never do it.

Barefoot running -- good or bad?

I'm one of those people who thinks two of the greatest inventions/discoveries since time began is fire and shoes.  Fire lead to cooking and hot wonderful food.  Enough said.  And shoes, well the ground is hard and lots of nasty stuff lying around just waiting to mess you up.  This hasn’t stop raw food and barefoot running becoming fashionable and downright popular here in Los Angeles.  Raw food is a nonstarter for me with the obvious exceptions of fruits and vegetables.  Barefoot running is more intriguing.  There may actually be something in it. 

Most are not going totally “nude” but are using barefoot shoes. Vibram FiveFingers glove like shoes is the biggest selling brand.  They are ultra light - weighing only about five ounces.  Remember running affects everything from your toes up to your lower back.  You don’t just run with your feet.  This so-called kinetic chain is easily damaged if your form is bad.  Form is how you run.  What part of your foot you land on.  How bent your knees are. The question is do you need to change form when switching from shoes to barefoot?

The American Council On Exercise recently looked at this very question.  They got a bunch of young women runners and monitored what happened after they switched over to Vibram FiveFingers shoes.  Unsurprisingly they found correct form was vital or injuries resulted.  You see shod runners land on the heel, barefoot runners should land on the forefoot.  If you switch to barefoot running and keep landing on your heels you will injure yourself.  Also they found it best to switch over slowly.  In fact literally walk before you run and initially for only a fraction of your regular work out.

Personally I don’t see the need to go barefoot unless you’re sustaining a lot of injuries when you run shod.  If you’re not getting a lot of injuries leave well enough alone.  If you do switch, change your running form even if this means getting help from a trainer.  Also of course if you’re diabetic or otherwise have special feet going barefoot is a big NO.  Even a minor abrasion on a diabetic foot can lead to nasty problems.    

Big Ticket Medical Technology Overused - AGAIN!

Regular listeners know I'm very skeptical about aggressive interventional cardiology procedures.  In these procedures a cardiologist inserts a tube that goes all the way into the coronary artery itself and then balloons it it wide open so blood can flow and bring oxygen to the heart muscle.  Frequently a stent, think scaffolding, is inserted too.  

New study out claims that angioplasty/stents over used in stable patients.  One doc set a record and implanted 30 stents in a single day. The drug company rewarded him with a $1407 dollar pig roast!

Money Quotes:

"This tends to confirm concerns that many people have expressed—that there are many thousands of patients who undergo coronary interventions for very questionable indications," said Steven Nissen, head of cardiovascular medicine at the Cleveland Clinic.

One big warning sign that stents were likely being implanted unnecessarily in some patients came in 2007 when the New England Journal of Medicine published a study known as "Courage" by a Buffalo, N.Y. cardiologist named William Boden. The Courage study, which tracked 2,287 patients for five years, showed stents weren't any better than a cocktail of medicines to treat patients suffering from chronic but stable chest pain."

All I'm saying is if your heart disease is stable think before you undergo an angioplasty.  Make sure you need it. Get a second opinion.