by James Hubbard, M.D., M.P.H.

Having a good family doctor whom you trust is an efficient way to fight high health costs. You can go for most of your family’s medical treatment. They will know you, answer questions and refer you when needed. In addition, your medical information can be kept in one place, you will have someone to keep up with your tests (less likely to be redundant and drugs (potentially less interactions of meds).

But will there be enough family doctors to treat us in the future?

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by James Hubbard, M.D., M.P.H

Don’t let the heat get you down. There are steps you can follow to avoid heat cramps, heat exhaustion, heat strokes.

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by Leigh Ann Hubbard, managing editor

When our publisher James Hubbard, M.D., M.P.H., wrote about the tomato/salmonella outbreak this week, blog reader “Deborah in Chicago” asked some fantastic questions about it. “I’ve read several articles…and look at how many questions I have!!” she wrote. We took that as a challenge.

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by James Hubbard, M.D., M.P.H

Life expectancy in the U.S. is at a record high according to a new report by the CDC. Death rates reported in 2006 were down in flu, pneumonia, aids, infants, heart disease, strokes, diabetes, hypertension, accidents.

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by James Hubbard, M.D., M.P.H

You must avoid the things to which you are allergic if you want to stop the sneezing, coughing, watery eyes, runny nose. Duh? Easier said than done? Yes, but there are some tips to follow that give you the advantage.

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by James Hubbard, M.D., M.P.H.

Don’t eat the tomatoes says the U.S. Food and Drug Administration (FDA), our nation’s watchdog for such things.  If you do, you may get salmonella.  A couple of years ago it was spinach,  this year tomatoes.  What’s next?   Well, at least they are watching out for us and it will be temporary.

What types of tomatoes?  Roma, round red and plum.   Even if they are cooked, the FDA says no.  Personally I would not eat any unless they were grown directly by me, or someone I trust.  Even at farmer’s markets you have to be careful that they haven’t been bought from a third party just to sell.

How does this happen?  The FDA has a detailed description of how they found the source of the spinach e. coli outbreak at http://www.fda.gov/fdac/features/2007/207_foodsafety.html.  The contamination could have occurred in the growing field (water, fertilizer, soil, animals), from the pickers, at storage, at transportation, at retail.  That’s just a short list, and I am sure I left out a lot.

What is Salmonella? It is a bacteria that causes diarrhea in humans.  It is found in some animals and humans and can live in dirt and water for months.  The diarrhea usually lasts for a few days and it gone, but it is easy to get dehydrated.  Some people get much sicker (septic) with the bacteria getting in their bloodstream.  Some have to be hospitalized.  As is in most of these types of illnesses, it can be serious in the very young, elderly or those without a good immune system.

Women are a major reason that men see a physician, according to an article on cnn.com- http://www.cnn.com/2008/HEALTH/06/09/hm.mens.doctors/index.html?eref=rss_latest

Being in family practice for 28 years I thought everyone knew this. Wives, daughters and other loved ones are always bringing men to the doctor for their own good. Also the women come back to the exam room with the men to make sure they “tell the doctor everything.” It is amazing how many times I have had this happen when the man should have come in weeks ago for his (take your pick, or feel free to add) high blood pressure, chest pain, shortness of breath, poor memory, lumps, bumps, dizziness, hearing loss, or just for a physical.

The article stresses that men should be seen after 50 for diabetes, blood pressure, cholesterol, prostate and colon screening. Except for prostate, that goes equally for women (add mammography, pap smears and osteoporosis screening). It is just that they are more likely to actually do it without a push.

by James Hubbard, M.D., M.P.H.

The last time I posted about my sleep apnea diagnosis, I was just starting to use the cpap machine. It blows air through the mask while the mask forms a seal around my nose. This keeps my airways open during my sleep.

The first week was pretty bad. It wore my patience thin. I woke up about 6-8 times a night just getting used to the mask. Wearing it made me feel like was about 10 feet under water due to the pressure. My ears popped, and I felt just as fatigued as without it. Knowledge did help. I knew that it might take several weeks of getting used to, and that not treating the sleep apnea increased my risk of heart disease and stroke significantly.

Finally, on about day 8, I actually saw improvement. I slept through the night, and felt a little better the following day. Now I am encouraged. I think I may be getting used to this, and it might help.

By James Hubbard, M.D., M.P.H.

Interpretation bias means that the same data in a study can be interpreted, or parts emphasized over others to come to different conclusions.  It is not necessarily intentional, but it is still one of the things you should look for.   When you add the interpretation by news media, then it gets even more muddy, some might say agenda driven.

A good example is the data that came out of a Center for Disease Control (CDC) study on risky behavior in youth called the Youth Risk Behavior Surveillance System (YRBSS)   USA Today: http://snurl.com/2ds7j had the headline “Risky behavior declines among teens”.  The AP: http://tinyurl.com/52n3bo headlined “Hispanic teens try drugs, suicide at higher rates”.  The actual report from the cdc just gives out a lot of statistics.  You know the old saying, “There are lies, d… lies and statistics.”

So which interpretation is correct.  Well both, but read the reports for yourself.  A lot of risky behavior did decline in whites, blacks and hispanics such as risky sexual behavior, marijuana  and alcohol use.  However some types of drug intake and suicide did not change in hispanics.  As a reporter, which do you emphasize?

There are all sorts of biases in studies such as selection bias (who is included),  investigator bias (they can inadvertently change results by attitude toward subjects, or what they choose to measure), and on and on.  Researchers realize this and try to compensate in various ways (ie, random selection).  Now you throw in the reporting it can really get confusing.  Hopefully, James Hubbard’s My Family Doctor can help you through the haze.

By Jill Weisenberger, M.S., R.D., C.D.E.

These days everyone is in a hurry. We’re juggling work, homework, family, friends, pets, fitness, soccer, gymnastics, field hockey, household chores and more, more, more. Getting dinner on the table can be a challenge.

No doubt that bagged salad and frozen vegetables can save you some hands on time in the kitchen. And these foods do offer a lot of nutrients. But UCLA researchers, who videotaped 32 families’ dinner routines, found that families who relied the most on convenience foods failed to get dinner on the table any faster than those who used convenience foods less or not at all. On average, meals took 52 minutes from start to supper table. Heavy users of convenience foods saved 10 to 12 minutes of hands-on prep time, however.

Packaged entrees such as hot dogs, stir-fry mixes and items similar to Hamburger Helper made frequent appearances. Use caution here: you may save a few minutes of chopping and stirring, but the trade-off is often more sodium, sugar and fat and less nutrients overall.

If you chose to use convenience foods - and most of us will - select the ones that really make throwing together a nutritious meal easier. Keep frozen and canned vegetables on hand. Buy bagged salads weekly or more often. Supplement your meal with canned mandarin oranges or other favorite fruit. Have the grocer steam some shrimp. But skip the sodium-laden boxed meals and fat-laden rice and pasta sides. Instead of saving 10 to 12 minutes of preparation time, spend those few minutes with your family stirring and cooking or simply enjoy the process of bringing a meal together.