Healthsifter by mary desmond pinkowish, since 2003

A Brain Injury Doctor Talks About Boston--And It's Not Good

Ford Vox, MD, works in and around Boston treating people with traumatic brain injuries, and his blog post over at The Atlantic is a stunner. Noting that The Daily Beast just named Boston the booziest city in America, he describes some of his injured patients. He estimates that alcohol is tied to about 75% of the brain injury cases he sees that are serious enough to land people in brain-rehab hospital. He makes a point of saying that many of these people showed no signs of alcohol-related problems until they had the booze-related accident, fall, or bar fight that changed their lives. So he says:

"So when I see some media outfit has named Boston America's Drunkest City, I think that sounds right. I see the aftermath every day."

Chilling. But is it worse in Boston/New England than elsewhere?

 

Doctor to the Stars: Not a Cake Walk

If you thought that being a doctor to the stars was an enviable scene, the trial this week of Conrad Murray, MD, Michael Jackson's personal physician, has probably changed your mind. No thank you. AMEDNews, a publication by the American Medical Association, has a great article today in which they interview docs who serve the stars. It's tricky, as Drew Pinsky, MD, explains in this excerpt:

"You really have to assess your own liability," Dr. Pinsky said. "Are you seduced by the opportunity to bask in the glow of celebrity? Is it particularly appealing to you to have a powerful person say you did a good job? Will you be able to sustain that same person saying, 'I can't believe you won't give me what I want'? You had better be prepared, because that is exactly what you'll get. You have to do what's best for the patient and not be seduced by the fame."

Gary Brazina, MD, an orthopedic surgeon for some of the LA teams, reports on his experiences, too:

Some celebrities "are really, really nice" but "others are extremely manipulative, and there is a lot of drug-seeking behavior," Dr. Brazina said. "They have a true sense of entitlement where there's a sense of, 'I'm special, I'm different; I don't have to follow the rules.' "

Dr. Brazina recalled one famous patient who refused to fill out paperwork, saying, "Oh, my assistant does that." The physician took a stand.

"Well, then, I guess I'll have to treat your assistant, because I'm not going to treat you until you fill it out," he told the star.

Still, the doctor admits to getting starstruck at times. "Sometimes you do just pinch yourself," Dr. Brazina said. "I'm a small-town kid from eastern Pennsylvania and I have movie stars coming into the office. ... You have to be wary of not being caught up in the celebrity."

The stories are as old as Hollywood itself. Sad.

What Kills More Americans Than Car Wrecks?

If you guessed drugs, you're right according to this article and analysis published by the LA Times. Wow. According to the Times, drugs kill one person every 14 minutes in this country, and the death toll has doubled in the past 10 years. If you think heroin an cocaine are primarily to blame, you're wrong. Drugs like Vicodin, Soma, Fentanyl patches/pops, Oxycontin, and Xanax kill twice as many people as heroin and cocaine combined.

The other eye-opener here is the lack of a drug victim stereotype, as they describe in the article:

A review of hundreds of autopsy reports in Southern California reveals one tragic demise after another: A 19-year-old Army recruit, who had just passed his military physical, took a handful of Xanax and painkillers while partying with friends. A groom, anxious over his upcoming wedding, overdosed on a cocktail of prescription drugs. A teenage honors student overdosed on painkillers her father left in his medicine cabinet from a surgery years earlier. A toddler was orphaned after both parents overdosed on prescription drugs months apart. A grandmother suffering from chronic back pain apparently forgot she'd already taken her daily regimen of pills and ended up double dosing.

The other startling observation is that Vicodin is now the single most frequently prescribed drug in this country--more common than any cholesterol drug or antibiotic. And it is also the most commonly abused drug.

Click here to read the entire article. Thanks, LA TImes.

Are You Getting Enough (Alcohol) to Drink?

I had to get your attention so you'd read this article by Stanton Peele that appeared in the Wall Street Journal earlier this week. He commented on the USDA's 2010 Dietary Guidelines for Americans, released just a few days ago (1/31/2011):

But here's one thing that might surprise you. Chapter Three, titled "Foods and Food Components to Reduce," deals with alcohol. The Guidelines, created by America's leading health researchers, state: "Alcohol consumption may have beneficial effects when consumed in moderation (up to two drinks daily). Strong evidence from observational studies has shown that moderate alcohol consumption is associated with a lower risk of cardiovascular disease. Moderate alcohol consumption also is associated with reduced risk of all-cause mortality among middle-aged and older adults and may help to keep cognitive function intact with age."

What was that again?

Mr. Peele gives a quick overview of what's known about the health benefits of alcohol in moderation (I won't insult you with a recitation of all the well-documented detrimental effects of over-consumption) and imagines what would happen if health organizations were less squeamish about the health data around moderate alcohol consumption. MayoClinic.com has a reasonable article on the topic of moderate drinking and provides some definitions of "moderate" so you don't go foolin' yourself.

GRAPHIC Antismoking Labels Proposed

The FDA is looking for public comments on some new warnings, including intensely graphic illustrations, that they propose putting on cigarette packs. In one scenario, the gross photo and warning takes up the entire top half of the package. Read more about this at the FDA Web site. Check out the graphics--what do you think? See even more of the proposed graphics at Gawker. And quit smoking!

Romantic Rejection: Does it Trigger Addict-Like Behavior?

This isn't necessarily news you can use, but it may prove that modern medical imaging techniques often reinforce the wisdom of the ages...

eScience News! reports on a study published in the Journal of Neurophysiology that was conducted in 15 heterosexual college-age students who'd experienced a seismic romantic bust-up within the past 63 days. Seismic? These folks reported spending 85% of their time thinking about the person who rejected them, said they remained "intensely in love" with the person, and fervently hoped for a reconciliation. The researchers were hoping for insight into why people in this condition are sometimes involved in stalking behavior, suicide, and homicide. 

The study participants were examined using functional MRI (fMRI) to determine which parts of their brain became more active when they looked a pix of the beloved, played distracting math games, or looked at pictures of a benign roommate. Looking at pictures of the ex caused more stimulation in three areas of the brain: one area that controls motivation and reward has been linked to romantic love feelings in other studies, another that is associated with craving and addiction, and another area that operates under conditions of actual physical pain and suffering. This is how e!ScienceNews explains the findings:

The researchers note that their findings supply evidence that "the passion of 'romantic love' is a goal-oriented motivation state rather than a specific emotion" and that their results are "consistent with the hypothesis that romantic rejection is a specific form of addiction." Those who are coping with a romantic rejection may be fighting against a strong survival system that appears to be the basis of many addictions. The data help to explain why the beloved is so difficult to give up.

But, as your ancient relatives may have told you repeatedly, time wounds all heels and heals all wounds: As time went on and fMRIs were repeated, new areas of the brain came online in the same people when they looked at pix of the ex--brain areas that are usually associated with the appraisal and management of difficult emotional situations...uhhh...the return of common sense.

Alcoholics Anonymous: What We Don't Know, and Why It Doesn't Matter

Brendan Koerner writes at Wired about the long history of AA's successes and failures and huge unknowns and what the implications may be for modern alcoholism treatment. Here's a snippet of the article quoting Drew Pinsky, MD:

“In my 20 years of treating addicts, I’ve never seen anything else that comes close to the 12 steps,” says Drew Pinsky, the addiction-medicine specialist who hosts VH1’s Celebrity Rehab. “In my world, if someone says they don’t want to do the 12 steps, I know they aren’t going to get better.” 

Koerner closes the article with a story about a guy who describes himself as an agnostic geek with alcohol and drug problems who recovered with help from AA: 

Maybe one day we’ll discover that there’s a quirk in Gary’s genetic makeup that made his prefrontal cortex particularly susceptible to the 12 steps. But all that really matters now is that he’s sober.

Addicts in Recovery Should Deal With Stress--Not Avoid It

You might think that addicts who are struggling to stay in recovery should probably lie low and avoid stress. But the results of a study conducted at Penn State and Texas Tech suggests that recovering addicts who work through stresses and try to learn to deal with them actually experience fewer cravings for alcohol, a drug, whatever, than those who won't deal with stress. This is an excerpt from ScienceDaily (Dr. Cleveland is one of the investigators):

According to Cleveland, the findings suggest the impulse to avoid stress is never going to help recovering addicts because stressful experiences cannot be avoided.

"If your basic life strategy is to avoid stress, then your problems will probably end up multiplying and causing you more problems," he added.

 

Stress management is a huge business right now, and lots of people are ready to take your money to help you "relax." There's lots you can do on your own, though. This deceptively simple advice in an article from WebMD may help.And here’s a collection from Discovery Health and another from Villanova University.

Eat fish? Yeah! Go Fish! GoFishn!

This isn't my usual beat, but I have a great site for you: GoFISHn.com. Like fish? Like to fish? Check out GoFISHn.com, and network with fellow ichthyologically inclined sportspeople. Swap fishing stories, and probably some fishing lies. Swap photos. Pick up tips. What a great encyclopedia they have, with comprehensive information on species, techniques, gear, and locations. Best of all, you can find a fishing guide. Full disclosure: This site belongs to my brother, and that's a great thing! The guy was born with gills. 

 

Your Kid and Skunk, the Super-Potent Marijuana

Read Dominique Browning's review of The Lost Child, A Mother's Story by Julie Myerson In today's New York Times Book Review. Chilling. An excerpt:

“I am flattened, deadened. I have nothing in my mind except the deep black hole that is the loss of my child,” she writes in “The Lost Child: A Mother’s Story.” Myerson undergoes a crash course in drugs. Her son is smoking skunk, she learns, a strain of cannabis whose THC content is much more potent than garden-­variety pot — except that it has become garden variety. I had never heard of skunk either, but a quick search online led me to a souk of seeds for the home farmer, advertising up to a toxic 22 percent tetrahydrocannabinol (THC) content in some strains. My shopping cart remained empty as I browsed in disbelief. Even as stronger varieties are being bred and marketed, medical research is linking cannabis use to behavioral and cognitive changes reminiscent of psychiatric disorders like schizophrenia, bipolar disorder, major depression and anxiety disorder. And yet we find ourselves arguing about whether pot is addictive or a gateway drug or should be legalized. We are collectively losing our minds. “The Lost Child” is a cry for help and a plea for a clear acknowledgment of the toll this drug is taking on our children. [empaphsis is healthsifter's]