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Wednesday, November 23, 2011

Radiation from Full Body Airport Scanners: Why I Opt for the Pat Down

X-rays are forms of radiation that are strong enough to damage and mutate DNA in such a way that it causes cancer. Many people believe that they are only exposed to radiation when they go to the dentist and get an X-ray. However, we live in a radioactive world, with radiation all around us such as in the very air we breathe. Our bodies are exposed to radiation every day. One source is cosmic rays from outer space and another is food. That’s right…food. All organic food (e.g., carrots, bananas) contains a small amount of radiation from radioactive potassium and radium. Even water contains small amounts of radiation.

Most human exposure to radiation is from medical procedures such as X-rays, CT scans, and mammograms. Radiation can be measured in a unit known as millirems. The According to the U.S. Nuclear Regulatory Committee, the average American is exposed to 620 millirems of radiation, with 310 miilirems coming from the environment. If you receive a whole body CT scan, you receive 1000 millirems of radiation, which is much more than the yearly exposure. Get a CT scan of the chest and you received 700 millirems, again more than the yearly dose. Dental x-rays? Well, they only give you 1.5 millirems. However, there is level of radiation that is technically “safe” since the health effects of radiation are cumulative. That is, the more radiation you are exposed to, the worse of an effect it has on your health.

So, there is some degree of radiation exposure you will get no matter what. But why expose yourself to any extra radiation? One source of needless radiation you can avoid are full body scanners at airports. These are known as backscatter scanners. It had traditionally been thought that these scanner expose you to very low levels of radiation (e.g., .005 to .01 millirems). The Transportation Safety Administration insists this level is safe (e.g., 1000 such scans is equal to 1 chest x-ray) , but the non-profit investigative journalism organization, ProPublica, insists that the U.S. government glossed over cancer concerns as it rolled out these scanners and that the radiation exposure level is much higher. Researchers at Columbia University have said that the machines emit 20 times more radiation that originally estimated. The Inter-Agency Committee on Radiation Safety indicated that pregnant women and children are particularly at risk by these scanners.

On 11/14/11, the European commission announced new policy that they would ban these types of scanners due to concerns about health and safety. Instead of using X-ray scanners, they are replacing them with millimeter-waver scanners, which use low energy radio waves. Due to the low energy, these scanners do not have the power to cause genetic mutations and thus should not cause cancer. On 11/21/11, the head of the TSA reneged on his prior plan to re-study the safety of the scanners, stating they were safe. Not being a radiation expert, I really don’t know who is right. But I do know that I can at least opt out of these scans and that is what I did the last time I went to the airport. The result is a pat down but I found the whole experience easy to deal with. At least I know  did not expose myself and my family to needless radiation. And just in case you were wondering, metal detectors at the airports do not expose you to x-rays or damaging forms of radiation.

Tuesday, November 22, 2011

Elderly Woman with Dementia Allegedly Waterboarded by Staff after Dispute Over Ice Cream

Besides abuse of children, abuse of the elderly is one of the most despicable crimes in society. A shocking example of this was revealed in a story about two nursing home employees who allegedly putting an elderly patient (age 89) with severe dementia through a mock drowning with a shower spray. Why? Because they got into an argument with her over…ice cream.  Pathetic.

Fortunately, a co-worker witnessed the abuse and reported it. But it makes you wonder what would have happened if the witness did not report it or if there was no witness. If the patient had severe dementia, she likely would not have the cognitive abilities to report the crime and if she did report it, it is likely that no one would have believed her due to her medical state.

Having more staff present in nursing homes increases the chances that a witness will be present. Having a witness present, though, is not enough if the witness is scared to report what he/she has seen. This is why hospitals, nursing homes, and other medical facilities should have anonymous abuse reporting mechanisms that are well publicized.

It is ideal to have responsible family members present to visit the elderly in medical facilities because staff would be less likely to abuse a patient who they know have family members who are keeping an eye on the patient and have a close relationship with hospital workers (particularly those in senior positions) and who are advocating for them. Unfortunately, patients with no family members who are isolated are the ones most vulnerable to abuse because they have no one to look out for them.  Checking over a loved on for unexplained bruises, cuts, or other marks on the body should be done regularly. Reasonable explanations (e.g., slip and fall) for marks on the body (e.g., black and blue) should have some confirmatory documentation in the medical record. Suspected abuse should be reported immediately so that it does not continue to occur.

Monday, November 21, 2011

Woman Injects Cement & Tire Sealant Into Ladie's Backside

When I was in training, I remember once evaluating a former physician who had lost his license partly due to finishing his surgical procedures with wood screws from Home Depot instead of standard surgical screws. In addition, he used rubber cement instead of the standard surgical adhesives. He proudly defended his actions and stated that the wood screws worked better and saved him money. He did not seem to have any regrets over what he had done, despite the fact that patients were harmed. This was the case that came to mind today when I read about a woman who had gone to a person who she thought was a plastic surgeon to get a curvier body. Given that plastic surgery is expensive, she tried to save money and saw someone referred by a friend. After paying $700, she reportedly received toxic injections of cement, mineral oil, and flat tire sealant! This caused her to develop serious medical problems. You can read more about this story here.

While trying to save money is generally a good idea, it is not a good idea when it comes at the expense of picking someone not qualified to provide the desired medical service – in this case, plastic surgery. When trying to find a new doctor, I have put together a brief set of tips on how to do this in a way to minimize dealing with a charlatan. One of the tips I did not mention in that article was to walk away if the person does not physically appear professional to you. This is admittedly subjective and starts to enter into somewhat controversial territory, but if I am going to a plastic surgeon and she walks in with giant feathers dangling from her ears, I am likely walking away. I say this based on a picture of the person (Oneal Ron Morris) above who allegedly posed as a plastic surgeon and injected the concoction of toxic substances. Of course, I don’t know if she was wearing these earrings or some other odd form of apparel when the patient met her, but if so, it is a red flag.

I have used the word “she” above but “he” is the more accurate word to use because Morris was a man who identifies as a woman. Given that Morris was allegedly presenting as someone who can improve another person’s body curvature, I would personally be concerned if I saw that the doctors own body curvature looked like this.

When seeking a plastic surgeon, it is best to have one who is board certified because this provides an additional safety net. A board certified doctor (from a reputable organization) is one who has been vetted by his/her peers to have the appropriate training and education to perform a specialized service and has passed a rigorous examination(s) in the particular specialty area. For physicians, the main board certifying authority is the American Board of Medical Specialists, which oversees the American Board of Plastic Surgery.

Another tip is to find out if the plastic surgeon has privileges at the hospital. This is important because hospitals do background checks on their doctors. If the doctor says he/she has hospital privileges at a particular hospital, call the hospital and confirm this if you have doubts.

Sunday, November 20, 2011

Why Healthcare Providers Should Not Hug Their Patients

Imagine this scenario. You are a male health care provider and you complete an evaluation of a woman close to your age. You establish good rapport as you always do, she laughs at some of the same jokes you make with all patients, and she expresses delight that you are listening to her problems (unlike those other providers she says she has seen), feels you are helping her, and is looking forward to the next appointment with you. At the end of the visit, she walks up to you and opens her arms to give you a hug. What do you do?

Many may feel that they do not want to offend the patient and so they go on and give the hug even though they may not feel comfortable. In my opinion, this is the wrong choice. For starters, hugs, unlike handshakes, are sometimes intimate gestures. You hug your spouse during intimate moments but you do not shake your spouse’s hand. A hug is much more informal compared to the handshake, which results in a slippery slope.

As health care providers who need to be objective, it is important to maintain some boundaries that maintain the doctor-patient relationship (add any healthcare provider you want to in place of doctor). Hugging patients blurs those boundaries. For example, it will be more difficult to tell patients news they may not want to hear (but need to hear for their sake) if they begin to see you more like a friend or family member than a professional.

Another problem is that in this day and age, concerns about lawsuits and patient complaints are more prevalent than ever. The concern in this case is that the meaning of a hug can be misconstrued by a patient as meaning something more intimate than was intended. In addition or alternatively, some accidental touching to sensitive body area can occur during a hug that is misinterpreted by either person. This can raise concerns of sexual harassment as the person can claim that the touch was unwelcome. This is more likely to occur if the health care provider initiates the hug. It is more likely to occur when the hugger is a male health care provider and the recipient is a woman or a child. Female to female and female to child sexual harassment claims are much less common. This means that female health care providers do not need to worry as much about a sexual harassment claim based on hugging patients but the crossing of professional boundary lines issue remains. 

When a patient tries to initiate a hug, my response is to simply say in a nice and respectful way that I am not allowed to hug patients because it crosses a boundary line. Then I offer my hand for a handshake. This can admittedly result in some slight embarrassment on both sides, but it is better to be safe than sorry. This solution is better than one that a supervisor once told me he used, which was to say “I think you need to get your hugs from somebody else,” which sounded too rejecting to me. If the patient insists on hugging you and lunges on you, it is best to document this clearly in your clinical note and explain that this cannot occur again.

The advice I provided above also applies when interacting with patient family members. That being said, there may always be a rare exception depending on the case and circumstances.

Friday, November 18, 2011

10 Ways to Protect Your Children from Child Sex Offenders

Tonight, I sit here in Syracuse, NY, shocked to hear sexual abuse allegations against long-term Syracuse University assistant men’s basketball coach, Bernie Fine. You see, I am a HUGE Syracuse Orange Fan. I do NOT want to believe this is true. Head coach, Jim Boeheim says the allegations are false but we will need to await the results of the police investigation.

For anyone watching the news in the past few weeks, these allegations come in the wake of the Notre Dame child sex abuse scandal that rocked the country. People have once again been reminded about the dangers of sexual abuse. The ways sexual predators operate were best exposed, in my opinion, during the recurring MSNBC special known as “To Catch a Predator” by Chris Hansen.  In it, Hansen documented how sexual predators lured child victims online and came to their home to engage in sexual relations, thinking that the children’s parents were gone.

Regardless of whether the allegations against Bernie Fine are true, people must be wondering what they can do to keep their children safe some sexual predators. A few suggestions are listed below.

1. TALK TO YOUR CHILDREN: If a child is inappropriately touched, he/she needs to feel comfortable discussing it with you. It is an uncomfortable topic for sure, but if you have an established relationship with your child such that the child can feel free to come to you and discuss any topic, good or bad, the child is more likely to come forwards if something inappropriate occurs. From a young age, children need to be told that if anyone touches their private parts or touches them in a way that makes them feel uncomfortable that they need to tell you about it as soon as possible. Make sure your children know never to go somewhere with a stranger and that if a stranger grabs them, that they should try to scream, get away, and run to an area of safety. Let your child know in advance that if a predator threatens to harm the parent if he/she tells of any abuse, that the parent will actually be ok and to tell someone anyway.

2. SEARCH ON-LINE SEXUAL OFFENDER REGISTRIES: Check your state’s online sexual offended registry, such as this one in New York. These registries allow you to see if there are sexual offenders living in your area, what their names are, where they live, and what they were charged with. Once you know where they are, you can make sure your child knows not to go there.

3. BE VIGALENT: Be mindful of where your children are. Do not let them stand at a bus-stop alone. Do not let them spend alone time with adults you do not know. Do not let them veer away from you in public places, such as the mall.

4. COMBATING GETTING LOST: If your children get lost in a public place, they can become easy pretty for a sexual predator. Make sure they know what to do if lost, such as seeking out a cashier or police officer and providing that person with a name, address, and phone number.

5. SPEND TIME WITH YOUR CHILDREN: Sexual predators try to prey on the most vulnerable children, which includes people who do not see their parents much. Thus, if you spend frequent time with your child, that is time that no one else will be doing so.

6. COMPUTER AND PHONE USE: Be aware of what websites your children are viewing (e.g., check the history log), install filters that prevent visits to adult websites, limit, ban, or closely monitor participation in social media sites (Facebook, Google+, MySpace, Twitter) based on the child’s age, and tell them to not develop relationships with strangers on-line, give out their phone number/address, or meet strangers from on-line (or the newspaper) in person. Make sure your child knows that strangers on-line may pretend to be people they are not. Monitor text messages and pictures your child sends for inappropriate content.

7. DO NOT GET OVERLY COMFORTABLE WITH STRANGERS: Sexual predators are typically charming. You may believe that you know the person and feel comfortable because he/she is nice, but neighbors, babysitters, priests, teachers, coaches, and even family members can be sexual predators in your midst. Do not let your guard down and be very careful who you chose to leave your child alone with. Do not allow taps on the buttocks, touching of the legs, tickling, or other inappropriate touching to go on if your feel it is inappropriate.

8. USE FEMALE BABYSITTERS: Sexual predators are almost always men. Thus, your child is likely to be safer with a female babysitter.

9. TEACH SELF DEFENSE: Teach your child some self-defense strategies to use if a sexual predator makes threatening physical advances to a child.

10. SECURE YOUR HOME: Keep doors and windows locked. This is crucial. Many sex offenders state after being caught that if a door entering the house was locked that he/she would likely have moved on. If you can, have a dog or dogs that bark when strangers come. 

Thursday, November 17, 2011

10 Easy Ways To Improve Your Mood and Outlook on Life

The next time you go to a book store or search for books online, you will notice that you will not find any books on how to think negatively. The reason is because it is very easy to do. However, there are many books on the power of positive thinking and ways to improve your motivation. Like dieting, positive thinking can sometimes be difficult but it does not have to be. Below are my 10 easy ways to improve your mood and outlook on life.

1. REMEMBER THAT THINGS CAN BE MUCH WORSE: No matter what type of situation you find yourself, you can almost always think of a way in which it could be much worse. For example, if you get into a car accident and your door gets dented in, you can be upset about the damage, receiving a ticket, and the inconvenience of filing an insurance claim. It’s easy to focus on these problems but not keep in mind that you and the other driver were not injured in the accident, that you did not need to go to the hospital, that the car is still drivable, and that there was not more expensive damage. When you take the time to recognize that there are so many things you have to be fortunate about, it helps put stressful situations in proper perspective. 

2. REMEMBER THAT THERE IS ALMOST ALWAYS A SILVER LINING: Bad situations happen but there is almost always a silver lining present, even if you can’t see it right away.  For example, when I was first shopping for a house, the deal ended at the last minute because the home inspector found mold in the attic. It was a very bad day for sure, but it caused me to expand the house search and find a much better house in a better development. Try to keep the silver lining in mind when something bad happens.

3. WORK SOME FUN INTO YOUR WEEK: At least a few times a week, you should work some type of fun activity into your week, such as watching a movie or favorite TV show, going to a game, listening to good music or a favorite talk show, socializing with friends, going to a favorite restaurant, etc.

4. HAVE SOMETHING TO LOOK FORWARD TO EACH DAY: While you should at least do something fun a few days a week, try to have something to look forward to each day that you like to do from the section above.

5. HAVE A HOBBY: Hobbies make life interesting and they usually provide a good escape from the doldrums of daily life. Great hobbies include collecting things, doing something creative, video games, sports, reading, and much more.

6. SMILE & LAUGH: Try to find something that makes you smile laugh. It does not need to be public laughter if you are not comfortable with that, but try to watch a comedy, listen to a comedian, listen to a comedic radio show, pick up a joke book, or spend time with someone who makes you laugh. Laughing just makes you feel good.

7.  STAY AWAY FROM PEOPLE WHO BRING YOU DOWN: We all know who these people are. The ones who love to say things to push your buttons, people who are insulting, people who tell you that you are not good enough. Stay away from these people as much as possible and stay near people who are nice, encouraging, and generally have positive things to say.

8. EAT WELL: It is difficult to define “eating well” because by using that term, you may assume all I mean is to eat fruits and vegetables. Actually, what I mean by it is to eat a generally healthy diet with natural foods and avoiding artificial chemicals. Keeping your body as pure as possible helps you feel better. BUT, I also strongly believe people should be allowed to treat themselves and get that pepperoni pizza they have been craving or ending the week with a cookie dough ice cream Sundae. You only live once, should not completely deprive yourself, but should also not overdo it. As the Greek philosophers said, moderation is the key in life.

9. REMEMBER WHO IS IN CONTROL: Always remember that while you cannot always control what happens to you, that you are the only person in charge with how you think about it and react to it. A feeling of loss of control is a major reason why many people develop significant emotional disorders. Remember that the way you choose to think about something will determine how you feel about it.

10. STAY AWAY FROM NEGATIVE LANGUAGE: Remove extreme negative words such as “can’t,” “impossible,” and “must not” from your vocabulary. For example, if you tell yourself that you “can’t” accomplish your goals, that it’s “impossible” to succeed at something, or that you “must not” make a mistake, you will create self-fulfilling prophecies and be very upset when you make an error. The fact is that most goals are attainable with hard work and that everyone makes mistakes. View mistakes as opportunities to learn and improve yourself in the future rather than as long-term sources of grief. Try to move on fast, remember that tomorrow is another day, and that

Wednesday, November 16, 2011

Is it Bad to Have Undigested Food In Your Poop?

If food appears in the feces looking very similar to how you it was when you ate it, this means that the food has not been digested (broken down and absorbed) by the body. Believe it or not, many foods that we eat cannot be digested by the enzymes in our digestive system. An enzyme is a type of protein that helps produce chemical reactions in the body.

RECOMMENDED BOOK: Everybody Poops 410 Pounds a Year

Foods that cannot be digested by the human body usually contain a high amount of dietary fiber. Dietary fiber is a term for chemical substances in the cells of plants that cannot be digested by the human body. Dietary fiber cannot be digested by the human body because it lacks the necessary enzymes to do so. More specifically, dietary fiber is resistant to hydrolysis. Hydrolysis is a process in which a substance is broken down by splitting its chemical bond and adding water to it. Since dietary fiber cannot be digested, it passes through the body virtually unchanged and cannot be used as an energy source. Although humans cannot digest dietary fiber, some of it is broken down by bacteria to produce gas and acids.

Examples of foods that are not digested well by the human body include corn, peanuts, peas, carrots, cereals, and beans. If the bacteria in the body are successful, some of the carbohydrates in these foods may be broken down. If not, however, we will see these foods in the feces. Carbohydrates are a group of substances present in certain types of foods (such as sugar) that provides the body with energy.

Research also suggests that the more a food is cooked, the more difficult it is for the body to digest it. This is generally true of most foods. The higher the temperature that the food is cooked, the longer it will stay in the digestive system, and the more difficult it will be for the body to digest. Why does this happen? To begin with, all foods are made up of chemicals that are arranged in certain patterns. Our digestive system is generally able to break down foods that fit these general patterns. However, the chemical patterns of all foods can be changed when they are heated past a certain point. Thus, foods that are deep-fried and barbecued often have their chemical pattern changed. As a result, the body does not understand how to deal with these new chemical patterns and the food can pass out of the body undigested because the body does not have the necessary enzymes to digest it properly.
If the above reasons are not causing food to be undigested, this could indicate a problem in the digestive system. In a healthy person, it should take between 24 and 36 hours to digest food. If the food comes out of the body faster than this, this usually means that there is a build up of debris (the remains of something broken down) that is preventing the colon from digesting food.

The colon is the major part of the large intestine, that absorbs water and some types of salts from the digested material that passes through it. The intestine is a tube shaped structure that is part of the digestive tract, and is located in the belly. The large intestine absorbs moisture from the matter that is left after it is digested in the small intestine, and releases the waste from the anus (the area that feces comes out of). The small intestine is a part of the intestine that takes in all of the nutrients (healthy substances) that the body needs.

A healthy piece of feces is about one foot long. Shorter sized feces suggest that the colon is not able to process the food correctly and that the feces produced does not have the correct amount of moisture in it.

Monday, November 14, 2011

Does Your Kids’ Cereal Contain BHT or BHA – An Ingredient in Jet Fuels? Mine Did.

When examining the foods in my home, I took a look at the cereal boxes and found that the following cereals contained something called BHT: Rice Krispies, Frosted Flakes, Froot Loops, Apple Jacks, Boo Berry, Frosted Mini Wheats (three types), Raisin Brain Xtra, and even Total. The only cereal that did not have it was Grape Nuts.

So I decided to do a little research into what this BHT stuff is, especially since my kids are eating it. Turns out that BHT is an abbreviation for butylated hydroxytoluene. As someone who has a profession in the neurosciences, the word that jumped out to me was “toluene” because toluene is a solvent that can cause neurological effects when inhaled. BHT is not toluene, but the fact that it shares a chemical name with it was cause for initial concern.

Additional readings in BHT show that it is used as a component in jet fuel, rubber petroleum products, cosmetics, electrical transformer oil, and embalming fluid (the stuff they put in dead people to replace blood) and preserve the body. Anyone hungry yet?

When food is exposed to oxygen, it can spoil. When BHT is added to foods containing fats and oils, oxygen reacts preferentially with BHT as opposed to the fats and oils, which preserves the food from spoiling as fast. So, BHT is an anti-oxidant, but it is an artificial anti-oxidant.

The key question is whether BHT (or the related BHA) is harmful to human health? It depends on what you read and what your source of information is. Some will say that it is used in such small amounts (parts per million or billion) that it is most likely safe. But to me, this is not very reassuring because if someone said they were going to add a miniscule amount of jet fuel into my cereal, I would say no, not matter how small. Some will say that is an anti-oxidant, has been used to treat herpes and other viruses, and decrease cancer risk. However, others can cite information that it increases cancer risk, at least in laboratory animals given very high doses of the substance.

Tired of reading the conflicting accounts, I turned to the only objective source of information I could think of. Every commercial chemical substance that people can be exposed to needs to have a Material Safety Data Sheet (MSDS) which contains detailed information about the substance, including information on human health effects and toxicity. You can find the MSDS for BHT here and read it for yourself. I particularly focus on this section:

Special Remarks on other Toxic Effects on Humans:
Acute Potential Health Effects: Skin: Causes mild to moderate skin irritation. Eyes: Causes moderate eye irritation. Inhalation: May cause respiratory tract (nose, throat) irritation. Ingestion: May be harmful if swallowed. The clinical manifestations of acute are not well known. May cause gastritis, vomiting, hypermotility, diarrhea. May affect behavior/central nervous system (dizziness, weakness, somnolence, slurred speech, ataxia, visual and auditory hallucinations, headache, confusion, temporary loss of consciousness), respiration (respiratory depression), blood (reduced ability to clot) Chronic Potential Health Effects: Ingestion: Prolonged or repeated ingestion may affect the liver, kidneys, thyroid, adrenal gland, behavior/central nervous system and learning ability, blood (reduced ability to clot), and may cause weight loss. Ingestion or skin contact may also cause allergic reaction (dermatitis, asthma).

Special Remarks on Chronic Effects on Humans:
May affect genetic material (mutagenic). May cause cancer based on animal test data. No human data found. May cause adverse reproductive effects and birth defects (teratogenic).

Chronic Effects on Humans:
CARCINOGENIC EFFECTS: A4 (Not classifiable for human or animal.) by ACGIH, 3 (Not classifiable for human.) by IARC. MUTAGENIC EFFECTS: Mutagenic for mammalian somatic cells. Mutagenic for bacteria and/or yeast. May cause damage to the following organs: blood, liver, central nervous system (CNS).

The bottom line for me is that I personally do not want to consume products that contain BHT or BHA much less feed them to my kids. There are other tasty cereals out there that do not contain this substance, particularly in the organic food section. Some of these natural food products have found ways to use natural preservatives that do not use jet fuel ingredients. Typically, they use what are known as tocopherols -- a technical word for a totally natural substance in vitamin E.

Sunday, November 13, 2011

The SHOCKING Ingredients In a Mountain Dew

When I wrote the popular blog entry, The SHOCKING Ingredients in a McRib Sandwich, I figured that the chemicals I found were mostly limited to fast food restaurants. I then began to look at some of the foods in my home explored the ingredients. I was shocked at what I found.


I believe that we have become accustomed when selecting food to do so based on name brand, taste, type of food, and perhaps a glance at the nutrition label (e.g., calories, fat, salt content). If we do look at the ingredients, we may see some with some long names, shrug our shoulders, and figure they are safe. They may be safe in small quantities, but I have to wonder if consuming large quantities of artificial chemicals over time causes health problems. Most of us are busy and want food that is already prepared to speed things up. But in order for that to happen, many manufacturers also cut corners to deliver foods and drinks in mass because it is much more efficient to do so. This is why all natural products usually cost more money.

I am going to begin documenting on this blog some of the troubling ingredients in foods and drinks I have had in my house, have regularly consumed in the past, and that I have now thrown out and replaced with other natural products. Most people do not have the time or energy to research what these products are, so I will do the work for you. All you need to do is spread the word (email, Facebook, Twitter), consider the information, and make an informed decision about what you want to put in your body. Without further ado, the product I am going to begin with is…

MOUNTAIN DEW: This popular drink is known for its high level of caffeine and fruity taste. But it also contains…

1. EDTA (ethylenediaminetetraacetic acid). This is sometimes uses as a preservative in foods (under the name calcium disodium EDTA) to prevent food discoloration. I remember hearing about it in the OJ Simpson when it was discussed as chemical used in test tubes to prevent blood from clumping together. To be fair, EDTA has some positive health benefits in specific situations (e.g., treatment of lead and mercury poisoning), since it removes metals from the body. However, the chemical is known to be a persistent organic pollutant, which means that they do not naturally degrade in the environment, are capable of accumulating in living tissue, and causing negative health effects. Studies with laboratory animals have found that EDTA is toxic to cells, is slightly toxic to genes, and that consuming the material orally has negative effects on reproduction and development.

2. BROMINATATED VEGETABLE OIL (BVO): This is a perfect example of a tricky ingredient because most people will read it and thing it is not a problem since it is vegetable oil, skipping over the word "brominated." Brominated means that this is vegetable oil that contains the chemical, bromine. It is used as an emulsifier in many citrus-flavored soft drinks. An emulsifier is a substance that allows foods to mix together. It does this by thickening the oil so that it is as dense as the water in the drink. India has banned the use of BVO from its soft drinks and it is not an approved additive in Europe.

Bromine and/or forms of bromine are used in pesticides, disinfectants, flame retardants, as a gasoline additive, and for swimming pool maintenance. Its use has been limited in the U.S. but is still contained in some food products. Bromine has no known essential role in human health.

3. SODIUM BENZOATE: A food preservative that has been inconsistently associated with hyperactivity and is theorized to cause cell malfunction. In response to health concerns, the Coca Cola company is phasing it out of Diet Coke and some of its other beverages.

4. YELLOW # 5: This is a type of man-made chemical food coloring. Many companies try to avoid using it because of potential health effects. First, it is known to cause allergies, particularly among people with asthma and aspirin intolerance. It is associated with anxiety, asthma attacks, hives (fewer than 1 in 10,000 people), clinical depression, migraines, blurry vision, itching, general weakness, heatwaves, feeling of suffocation, purple skin patches, and sleep disturbance. It may also be associated with hyperactivity, irritability, restlessness, thyroid tumors, and chromosome damage. Health effects can occur even in very small doses. About 360,000 Americans are sensitive to yellow #5, which is about 0.12% of the population. Although yellow #5 is associated with the problems above, whether yellow #5 causes some of the more extreme health effects is controversial, especially among people who are not intolerant to it.

In laboratory animals, yellow #5 affects behavior, inflames the stomach lining, and affects and alters chemical in vital organs (e.g., liver and kidney). The latter is true even at low doses. In England, the Food Standards Agency called on the voluntary removal of yellow # 5 from food and drink due to concerns over possible health effects. In the U.S., the Food and Drug Administration is so concerned about yellow #5 that it mandates that it be listed as an ingredient, insists on the batch of coloring be pre-approved by the FDA, and will actually seize products that do not list it in the ingredients when they soon have or did not have the batch pre-approved. Yellow # 5 was banned in Norway, Austria, and Germany but the ban was eventually overturned.

Friday, November 11, 2011

The Rick Perry Brain Freeze Examined

If you did not see the Republican Presidential debate the other night, you have probably heard by now about candidate Rick Perry’s “brain freeze” moment during the debate. No matter what side of the political spectrum you fall on, it was painful to watch.

The point of this entry is not to examine this issue from a political perspective but to look at it from a neuropsychological perspective and present ways to prevent something like this happening to you if you need to give an oral presentation without Powerpoint slides. If you have not seen the video or do not care to, Perry was not able to name the third of three federal government agencies that he stated he would eliminate. The first was the Department of Education. The second was the Department of Commerce. And the third was…ummmm….the third was….Ooops. See for yourself here:

I have done a great deal of group presentations in my life. Most of them involve use of Powerpoint slides in my professional career, which allow you to easily reference information so you do not need to solely rely on your memory. However, sometimes you need to make the off the cuff remarks when responding to questions and other times you need to do a more spontaneous presentation of information in life (e.g., best man speech, accepting an award, presenting to a group over a teleconference).

One thing I try to (unless I know the topic in detail) is avoid citing a specific number of points that need to be made and then try to rattle off those points based purely on memory. This is because if you cannot retrieve one of the points, it will look very bad and is if you do not know what you are talking about. You lose the audience and they lose confidence in you. It looked even worse for Perry because he has a history of poor debate performances due to milder retrieval difficulties, characterized by brief but long enough pauses that they indicate he is struggling with finding the correct information he wants to say.

As alluded to earlier, retrieval of information is enhanced when the person is very familiar with the topic area. This is because brain cells form stronger and stronger connections with each other the more well-known the information is. The technical name for this is having strong synaptic connections. Synapses are the connections between nerve cells and those bridges become strengthened when learning is enhanced, improving the memory trace.

Clearly, Perry did not have detailed and specialized knowledge of this particular topic. It is possible that he may have rehearsed the information ahead of time, even many times, but sometimes pure rote rehearsal is not enough, especially when there are so many other pieces of information being rehearsed at the same time. We have all experienced this when cramming for a test. Something similar is likely the case for Rick Perry who made a last minute decision to run for the Presidency and thus had to try to memorize answers in many different areas.

There are some ways around using rehearsal as a way to improve memory efficiency and retrieval. One of the best methods is called chunking, in which you reduce lengthy pieces of information to remember into small, discrete units. An example is using an acronym. If Perry would have done this, he could have saved himself a lot of grief. For example, he could have used the acronym CEE (pronounced see) for which agencies he would like to “see” eliminated. In this case, the acronym CEE is one unit of information but it stands for three words: Commerce, Education, and Energy. These first letters basically serve as prompts for the department names.

Another technique is to make the information emotionally significant as this contextual significance improves the memory trace. Thus, if he could think of one significant example of something severely wrong with each of these three agencies (preferably personalized as much as possible) it would improve his chances of remembering the three groups.

Sometimes, you can know the material well but anxiety can interfere with performance. However, as a general rule of thumb, anxiety should decrease the more familiar one is with the task at hand. In Perry’s case, there likely was some anxiety due to his poor prior debate performances. He was intimately aware of this as he has been widely criticized in the past, spoke about it openly, and was publicly floating the idea of skipping the debates. While anxiety can lead to a word recall problem, anxiety will then increase further when the recall prolem occurs, which further interferes with coming up with the correct word. It is like a road block exists and that road block needs to be cleared before the frontal lobe (prefrontal cortex) can execute an effective search and help the medial temporal lobe access the correct information. The medial temporal lobe acts as a memory retrieval and storage center.

If anxiety or some other emotion interferes with recall, it is good to have a backup plan, such as notes. Being familiar with the notes is key because you need to remember where to look very quickly if you plan to recover form a brain freeze during a speech. Perry did not do this either because despite exploring his nodes on the podium, he could not come up with the correct word.

Thursday, November 10, 2011

Why Neuropsychological Testing Is Helpful in Dementia Evaluations

If you or a loved one is concerned that dementia may be present, a neuropsychological evaluation can be critical to confirming this, specifying the exact type, and guiding treatment. Dementia is a general term referring to a significant loss of intellectual and cognitive (thinking) abilities without impairment of perception or consciousness. There are many different types of dementia, with Alzheimer’s disease being the most common. Most forms of dementia are progressive and irreversible (such as Alzheimer’s disease and fronto-temporal dementia) although some forms are non-progressive (static) and reversible. An example of a static form of dementia is dementia due to severe traumatic brain injury. An example of reversible dementia is dementia due to unrecognized thyroid disease or vitamin deficiency.

Most forms of dementia begin with memory loss but other cognitive difficulties (naming problems, getting lost) can also serve as the initial symptoms. Sometimes, behavioral symptoms are the initial prominent symptom such as the decline in personal and social conduct that is typical of fronto-temporal dementia. Usually, a person with these symptoms will initially be evaluated by a primary care physician. This typically results in sending the patient for blood tests and a brain MRI (magnetic resonance imaging) to search for reversible causes of dementia and determine if there are any visible abnormalities in the brain. The MRI may show tissue loss (atrophy), abnormal areas of tissue (known as lesions), a mass such as a brain tumor, or other types of abnormalities.

The person may also be sent to a neurologist, which is a type of physician specializing in the neurological system. The neurological exam will typically consist of a brief interview and a physical exam focusing on the cranial nerves, reflex testing, and sensory-motor functioning. There will usually be some brief testing of thinking skills. This could merely involve asking the date and/or memory for a few words but can involve the use of a brief formal screening test of thinking such as the Mini-Mental State Examination. These screening measures are broad tests of thinking skills that are designed to pick up on red flags that may prompt a referral for more detailed cognitive testing. While screening measures may detect some difficulties that support a diagnosis of dementia, these tests are fairly easy, are not meant to replace a comprehensive neuropsychological evaluation, and are not good at differentiating between types of dementia.

There are several advantages to a neuropsychological evaluation. First, a neuropsychologist specializes in understanding the relationship between brain functioning, thinking, emotions, and behaviors. This is important because there are psychological conditions that are common in the elderly (e.g., major depressive disorder) that can mimic a neurologically progressive dementia (e.g., Alzheimer’s disease). Thus, an expert in how psychological and neurological conditions present is very important and neuropsychology offers that level of expertise.

Second, neuropsychologists spend hours upon hours with their patients to understand the history, obtain and thoroughly review relevant medical records, perform a detailed clinical interview (with the patient and a close informant[if possible]) and detailed testing. This degree of detail cannot be obtained in a physician’s office due to significant time constraints.

Third, neuropsychologists apply specialized procedures to formally estimate the estimated intellectual status before a suspected dementing condition began. Additional specialized tests include measures of memory, learning new information, attention/concentration, expressive and receptive language (e.g., naming, vocabulary, command following), IQ, visual-spatial and visual constructional skills, motor and sensory functioning, information processing speed, and executive functioning. Executive functioning refers to higher-level thinking skills such as abstract thinking, multi-tasking, planning, judgment, problem-solving, and organizational skills. Test performance is compared to groups of people who are in the same age group as the patient with have no history of brain damage. Some tests are also compared to groups of normal controls with the same/similar educational backgrounds and also for gender. Some tests of personality and emotional functioning can also be administered.

Neuropsychologists review the objective information from the testing and look for areas of impairment, the degree (level) of impairment, and patterns of performance. Specific thinking and sensori-motor skills are controlled by  different areas of the brain. The neuropsychologist then integrates this information with the information obtained from the clinical interview, medical records review, behavioral observations, and knowledge of how various neurological and psychological conditions present. These results can help determine the specific diagnosis, which leads to specific treatment recommendations as not all dementias are treated identically. These recommendations not only may include medication suggestions but also include practical suggestions to improve daily functioning. Treatment is drastically different if dementia is due to Alzheimer’s disease, a reversible thyroid condition, malnutrition, or a severe psychological disorder.

It is also worth noting that neuropsychological testing may not reveal dementia but instead show Mild Cognitive Impairment, which is stage between normal aging and dementia. This is important to know as it also effects treatment and not all of these cases convert to dementia.

One needs to be careful in selecting a neuropsychologist and some guidance on how to do so is offered here.

Wednesday, November 09, 2011

Living to 106 by Eating Pizza and French Fries

As I pointed out in a prior blog entry entitled "Exercise & Eat Fruits & Veggies All You Want: You're Still Going to Die," the belief that you are going to be able to eat your way to a long wife with healthy foods and that you will die early for eating unhealthy foods does not always hold true. This is likely because genetics plays a major role in determining whether certain abnormal health conditions will develop that can lead to death.  This does not mean that the types of food you consume play no role in your health. But food choices likely interact with genetics to determine risk. If your genetics are strong enough, traditional health guidelines regarding food selection may not apply to you. Also, if your genetics are poor, what you eat may not matter much at all.

In the blog entry noted above, I discussed the death of fitness guru Jack LaLane, who lived to 96 after a life filled with exercise and healthy food. Many cite that lifestyle as the reason for his long life but as I pointed out, there was likely a genetic component to this since his mother lived to age 89. To be fair, if people are going to use Jack LaLane as a model  for how lifestyle choices can lead to a long life, they need to account for another case as well…that of Margaret Moores.

Who is Margaret Moores you ask? Well, she outlived Jack LaLane by 10 years, living to age 106 based on a diet consisting largely of pizza, French fries, sweets, salt beef, and very little water. Apparently, the only medication she takes is Tylenol for arthritis. Other favorite and preferred foods of people known to live over age 100 includes bacon, coffee, red wine, dumplings, chocolate, and honey. To read more, see this article at The Huffington Post. I’m not saying to go out and have a diet consisting largely of these foods, but the point is that traditional health guidelines regarding food clearly do not apply to everyone equally.

Monday, November 07, 2011

The Absurdity of Using Facebook to Send Real Illnesses via Mail

It’s one thing to have concerns about the possible harmful effect of vaccines and/or not vaccinate one’s children due to these fears. While the anti-vaccine community will vigorously defend their concerns and choices, other will strongly criticize the need for these fears and the decision not to vaccinate with standard vaccines.

Regardless of what side you come down on, the decision not to vaccinate is not illegal if the parent(s) cites a religious objection or health reason that contra-indicates the need for a vaccine. But it is quite another thing for parents to take vaccination fears to such an extreme that they purchase lollipops, saliva, Q-tips, or other items over the internet that are infected with chicken pox and other bacteria in an attempt to vaccinate their children against the disease.

Although this may sound unbelievable, it is true. There is a Facebook page entitled “Find a Pox Party in Your Area” that allows people to connect who want to share viruses through the mail to naturally vaccinate their children. Here is what one of the messages on the page says from the administrator of the page: "Warning. The mailing of infectious items, such as lollipops, rags, etc, is a federal offense. This page is not private and can been seen by members and non members alike. You may post on the page that you have the pox and are willing to share but please keep your specifics in private messages between members.”

I’m not a lawyer, but it seems to me that the administrator is readily acknowledging that mailing these viruses are a federal crime but endorses people using the page to find others to carry out a crime. Some of the posters are charging $50.00 for infected materials. The page is not limited to people seeking natural immunity to chicken pox, however, as some posters have actively sought items tainted with measles. This is more concerning because measles is a more serious disease as it is more deadly and has more complications.

Regardless of the bacteria (or virus), no one should be sending these materials through the mail. The infected materials could contain other serious diseases that the parent is unaware of, such as hepatitis. How effectively these diseases can be transmitted is questionable, but it is possible, particularly when one proposed method is drinking another child’s saliva sent through the mail.

While social media has so many positive benefits to offer patients and healthcare providers, this is one of the negative sides. Healthcare providers need to be aware of this issue and dissuade parents from taking this route. For parents caught doing this, regardless of how correct they believe their views to be, they will likely find themselves facing serious federal charges in addition to the health hazards potentially inflicted on innocent people.

When I wrote this entry on 11/6/11, the Facebook page mentioned above was still open to the public. Later that night, it was gone, perhaps due to fears the administrators and participants had about federal prosecution.

Sunday, November 06, 2011

The SHOCKING Ingredients in a McRib Sandwich

The older I get, the more likely I am to just eat at home so I have greater control over the ingredients that go into my food. These days, the ingredients that go into some foods are downright shocking.

Just so people do not think I am only picking on vegetables, take McDonald’s McRib sandwich, which is recently making its way onto menus nationwide again and has gained a lot of media attention. I remember this sandwich many years ago and bought one. It tasted good but when I ate it, I had no idea what the ingredients were besides assuming it was rub meat. So, before buying one this time around, I looked into the ingredients posted on the McDonald’s website and report my finding below.

First, let’s start with the meat. Technically it is made of pork, but it is a "restructured meat product." This means you are not getting a pure cut of meat. You are getting a bunch of different parts mixed together, which reportedly includes pig heart and pig stomach. The meat also contains water, salt, dextrose (a type of sugar), citric acid (a natural preservative), and…

  1. Butylated hydroxyanisole (BHA): This is a preservative in food, but is also used as a preservative for food packaging, animal feed, rubber, cosmetics, and petroleum products. The National Institute of Health has listed it as a likely carcinogen, meaning that it likely causes cancer, especially in high doses with some experimental animals. In mice, it is not known to cause cancer and may even protect against cancer from other chemicals. In humans, it is not known to cause cancer when consumed in low levels. Nevertheless, California considers it a recognized carcinogen and a suspected toxin to the endocrine system, gastrointenstinal system, liver, immune system, nervous system, respiratory system, skin, and sense organs.
  1. Propyl gallate: A food preservative also used in cosmetics, adhesives (glues), lubricants, and hair products. Some rat studies have found that it may cause cancer. It can irritate the stomach and skin, cause allergic reactions that affect breathing, and cause liver and kidney problems. Some countries have banned it or only allow limited use of it.
II. The bun actually has the most ingredients. Of these, the most concerning are:

1.   Azodicarbonamide: A synthetic chemical, which is used as a food additive to flour to improving baking functionality. However, its main use is actually as an additive to make foamed plastics. It is banned as a food additive in Australia and Europe as a precaution due to unknown health effects in humans.

  1. Ammonium sulfate: This is a type of salt that is most commonly used as a soil fertilizer, explosives, and as a flame retardant.
  1. Calcium propionate: This is used to inhibit mold growth. When infused directly into rats, it causes reversible neurological changes in behavior and brain functioning.
III. The sauce contains mostly natural ingredients but does contain:

    1. Sodium benzoate: A food preservative that has been inconsistently associated with hyperactivity and is theorized to cause cell malfunction. In response to health concerns, the Coca Cola company is phasing it out of Diet Coke and some of its other beverages.
IV: The pickles contain natural ingredients but also contain:

1. Polysorbate 80: This is an emulsifier, which is a substance that allows foods to mix together. It is often used in ice cream but is also used in eye drops, to dilute flu vaccines, to stabilize for certain liquid medications, in tuberculosis cultures, and as an emulsifier for a cardiac medication (i.e., amiodarone) that stabilizes the heart beat.

My basic rule is that if I can’t pronounce the ingredients in my food, I try to stay away from it. I’m not perfect yet at applying that rule, but I’m paying more and more attention. However, if I want ribs, I definitely go to a genuine rib joint.

Suggested reading: McDonald's: Behind The Arches

Related blog entry: The SHOCKING Ingredients in a Mountain Dew.

Friday, November 04, 2011

How Exercise Can Kill You

While exercise is generally a good part of balanced healthy life style, many people do not realize that it can also be a risky and deadly activity. This is generally by taking unnecessary risks while exercising. As an example, I continue to be surprised at how many people are willing to jog on the shoulder of a road with cars speeding by at 55 to 70 mph with absolutely no physical barrier separating them from the vehicle. All it takes is one carless mistake on the part of the driver or jogger and serious injury or death can occur.  Unfortunately, I have seen many patients with severe brain injuries and/or paralysis as a result of these types of accidents.

As a recent example in the news, a man in North Carolina was recently killed while jogging along a roadway after an SUV lost control and crashed into him. A group of five joggers were recently killed when a drunk driver of a Mercedez Benz crashed into them. Sometimes, joggers make the mistake of deciding to dash across a street, are not paying attention (e.g., listening to music), and get killed by a car that crashes into them. This is exactly what happened to a young woman in Texas this month. This is why when I go for a jog, I stick to parks, residential areas where cars are going slow, and treadmills.

Another problem I see is that far too many people are pushing their body to extreme limits and trying to participate in triathalons. The result is premature death for some people. For example, a few months ago two people died after suffering cardiac arrest during triathalons. One was from the city I grew up in – Freehold, New Jersey. The ages were 40 and 64. Both died during the swimming event. The risk of dying from these extreme exercise activities is less if you are young and healthy, but the older you are, the more you risk a catastrophe like this from happening, particularly if you do these activities in extreme weather conditions such as 90 degree heat. A 2009, Minneapolis Heart Institute study that found that athletes participating in triathlons have twice the risk of sudden death.

Overall, it is important that people use common sense when exercising and not put themselves at unnecessary risk of serious injury or death. This involves avoiding exercising near 4,000 pounds of steel traveling towards you at high speeds, avoiding exercise in extreme temperatures, not jogging in the dark with dark clothes on, wearing a helmet when riding a bike, and avoiding extreme physical activity particularly if you are older. Some days, it’s better to just stay inside, relax in the recliner chair, eat some buttered popcorn, and watch a movie.

Update: See How Jogging Can Kill You.

Thursday, November 03, 2011

How Fruits and Vegetables Killed Steve Jobs

One of the themes of the MedFriendly Blog has been to combat the notion that a diet filled with fruits and vegetables and frequent exercise automatically guarantees a long, healthy life. This was explored in detail in a thought-provoking blog entry

The blog entry was entitled, “Exercise & Eat Fruits & Veggies All You Want: You’re Still Going toDie.” While all of this may seem like common sense to some people, it does not seem apparent to everyone, including people who are geniuses in other aspects of life such as Steve Jobs.

A new book on Steve Jobs by Walter Isaacson details some strange health habits he had which were clearly guided by false beliefs. To begin with, Jobs would consume a diet consisting only of a certain fruit or vegetable for weeks at a time, such as apples and carrots. The only reason I can think of that Jobs would do this is because he was told that apples and carrots were good for him and so he decided that if this was all he ate for a long period of time, that would be even better. However, while these foods have some positive qualities, they are not supposed to be the sole source of a diet.

For example, while apples are a good source of vitamin C, vitamin A, and fiber, they barely contain any protein or fat and most of the calories come from sugar. No fat is a good thing you say. Not true if you have a diet that completely excludes fat because your body needs to use fat for energy storage. Not having enough protein is a major problem as well because proteins also provide energy, supports the growth of muscles and body tissue.

Jobs reportedly also believed that his fruit, vegetable, nut, seed, and grain diet rid his body of toxins that would cause body odor. Thus, he felt there was no need to shower or wear deodorant regularly. Coworkers strongly disagreed. The irony of all of this is that the lack of certain proteins in a diet can interfere with detoxification and cause more bodily odor.

No one can ever say for sure whether this type of extreme dieting contributed to Jobs developing pancreatic cancer but once he did develop pancreatic cancer, he again turned to diet and other alternative medicine techniques to treat the condition rather than conventional surgery that can offer a cure. These alternative techniques included the same type of diet noted above, acupuncture, online herbal treatments, and psychic consultations.

Once the tumor grew, Jobs finally gave in and decided to have the surgery 9-months later. But it was too late. After consuming hundreds and thousands of carrots, fruits, nuts, and seeds, Steve Jobs is dead…at only 56-years-of age. According to Harvard medical doctor, Ramzi Amri: “'Given the circumstances, it seems sound to assume that Mr. Jobs' choice for alternative medicine has eventually led to an unnecessarily early death.'

The moral of the story is not to be extreme with your diet, eat sensibly, treat yourself once in a while, and if diagnosed with a serious medical illness, use common sense and mainstream science to guide treatment not unproven methods (such as treating Alzheimer’s disease with coconut oil) that lack peer-reviewed scientific support.

Wednesday, November 02, 2011

Even More and More EXTREME Body Images: Part 3

Back by popular demand, I am happy to bring back one of the most popular features of the MedFriendly Blog…EXTREME BODY PARTS. This is the third installment of this feature. For other extreme body parts, see the original article here and part 2 here. And now, without further ado, here is the…

WORLD’S LARGEST EYES: This is Kim Goodman. It’s not how she normally looks, but she contains an amazing ability to pop her eyes out about half of an inch. 

  1. LONGEST EAR HAIR: This is Radhakant Bajpai of India, who has 5.19 inches of ear hair. Looks like he actually styles it. 

  1. STRETCHIEST SKIN: This is Garry Turner of England, who can stretch his skin 6.25 inches. This is due to a rare condition of the connective tissues, known as Elhers-Danlos syndrome.

  1. WORLD’S HAIRIEST CHILD: This is Supatra “Nat” Sasuphan. Seeing is believing.

  1. WORLD’S MOST FLEXIBLE MAN: This is Daniel Browning Smith who hold many world records for incredibly flexible poses like this one:

  1. WORLD’S LARGEST BICEPS: This is Gregg Valentino, who had 28 inch arms.

  1. WORLD’S LARGEST PALMS: This is the palm of Leonid Ivanovych Stadnyk, believed to be the largest in the world.

  1. LARGEST COLLECTION OF BELLY BUTTON LINT: This is the only one that actually gave me chills for some reason, probably because it is just so bizarre. This is a 26 year collection of belly-button lint! The collection is from Graham Barker of Australia.