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

Once, I told a perfectly sane, intelligent and otherwise coherent patient to wait in the exam room to have blood work drawn. He smiled, said thanks and followed me out the door. I told him again he needed to come back into the room and wait to have blood drawn. He smiled, said thanks again and walked down the hall to leave. When he opened the door to go to the reception area, I had to gently restrain him so he would actually listen to what I was telling him. He had no fear of the lab work itself. He was just nervous about being in an unfamiliar setting and didn’t comprehend what I was saying.

If you’re like a lot of patients, you forget much of the advice your doctor gives by the time you walk out the door. You’re nervous, traumatized or more concerned about getting out of the building in one piece. Either that or the doctor was too rushed to give you the information in the first place.

We have a new article that provides general instructions on what to do after treatment for some common ailments. (The advice is generic. Always get specifics for your case.) I also wrote a follow-up on common misconceptions I see in my office.

Have you ever made any mistakes treating yourself at home?

James Hubbard, M.D., M.P.H., is the publisher of www.MyFamilyDoctorMag.com, a Web site written by health-care providers for the general public.

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by Leigh Ann Otte, managing editor

We’re tired of wondering.

As the world’s governments prepare for a potentially huge outbreak of H1N1 this fall, we regular people are left to wonder, what’s the big deal?  Are we supposed to be worrying?  Running around in mass panic?  Moving to caves in the hills?  Or is this all just a bunch of sensationalism?

So we’re going straight to the experts—to ask them our questions, and yours.

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by Leigh Ann Otte, managing editor

It’s time for our monthly Twitter roundup. This time, we have a ton of tweeters and bloggers to highlight. If you’re not on Twitter but like reading health blogs, just skip to the second section.

But before I get to that: a quick plug for our free preview issue since the offer ends Sunday. My Family Doctor is a unique, fun-to-read, trustworthy, magazine written by health-care providers for the general public. We feature the latest information on how to prevent and treat disease, tell you which alternative remedies really work, and tackle widespread myths and rumors.

Now, on to the Twitter fun.

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by Leigh Ann Otte, managing editor

In our blog post about Twitter this week, we’re linking to interesting health articles and blogs, so even if you’re not on Twitter, you can benefit.

For those of you on Twitter, we thought it would be interesting to see who we tweeted about the most in June.  We’ve included a few of the posted links.  Enjoy!

Some People We Retweeted Most:

@2ndhelping
Recipes to make your own spice mixes. Fun!

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

Pop quiz:

1. Why are some outdoor workers more prone to heat strokes after the first hot spell in early summer than later when it gets even hotter?
2. Why are there more heat strokes in Chicago when the temperature may be hotter elsewhere at the same time?

Answer:

Much has to do with your body having time to adapt, otherwise called acclimatization.  It takes between eight and 12 days for your body to acclimate to higher temperatures so when those hot days hit, you’re not ready.  The body acclimates to heat by: (more…)

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

Summertime comes with lots of tips on how to stay cool. But for you how-stuff-works buffs out there, here’s the science behind why those tips work.

First, some basics on your body and heat.

• Heat is energy and is generated.  Cold is not generated, but is the absence of heat.
• Your body generates heat from metabolism even while you’re at rest (called the basic metabolic rate or BMR).  In fact, it usually creates more than you need.  Mechanisms explained below regulate you around 98.6 F.
• You generate as much as three to six times more heat with exercise.
• Just resting in the hot sun can increase your BMR 50 percent more than resting in the shade.
• Stimulant drugs like amphetamines and cocaine also cause you to generate more heat.

Now, here are the whys behind some of the dos.
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James Hubbard, M.D., M.P.H.

I always dread seeing chainsaw injuries.  It is never a clean cut.  Even if the blade barely nicks the skin, it causes a nasty, dirty, macerated laceration leaving an ugly scar.  Of course the less you use the saws the more likely you are to get cut when you do, but experience is not immunity.  I have seen bad cuts in old pros.  Most of the time the the saw kicks back so fast and with such force you can’t stop it, and it cuts really well through flesh.

The CDC has good tips for preventing injuries.  Mostly take your time and stay focused on what you are doing.  Remove excess debris and wear goggles.  Keep your body out of the way of a kickback as best you can.  Have a partner within hollering distance and know where the limb will fall.  If you are helping, stay clear of danger.  You may think “duh”, but once I saw a patient (more…)

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

Lawn mower accidents can be pretty devastating.  They can mangle a hand or foot, or injure an eye.  The American Academy of Orthopedic Surgeons released these tips to avoid lawn mower injuries this summer.  Even though they are simple and obvious, they are worth a read.  Every year I see someone who has something in their eye thrown from a lawn mower and occasionally I see more serious injuries due to rocks.

Often I see someone with a mangled finger or hand who tried to remove debris from the blades before they had completely stopped, or gets a bare foot or toe caught underneath.  I know of children being killed when they fall off the larger tractor type mowers.

Invariably the victims say they feel so dumb, but really they just had a lapse of judgement. 

Read these tips and keep them in the back of your mind.

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

H1N1 influenza documented cases in the U.S. are closing in on 7000 but the CDC is reporting fewer new cases.  Good news, but there are several caveats.

Usually you can multiply by 10 to get a reasonable estimate of the total actual cases since not all are reported and documented by the CDC.  My understanding locally is the health department is now only interested in documenting new cases which require hospitalization.

In the 1918 pandemic, which killed 500,000 in the U.S and 50 million worldwide, the first wave was mild and died down in the summer.  By fall it had mutated into a deadly virus.

The CDC will probably suggest getting the usual flu vaccine early this fall so you can get a second H1N1 immunization a few weeks later.

An interesting sideline is H1N1 has only infected a small percent of U.S. people over age 65.  Speculation is these seniors were infected by a distant H1N1 relative some time before 1957 and have a few antibodies left to fight off the current virus.

I only practice part-time but have not seen any swine flu cases.  Have any of you?

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

If you have ever seen Steve Martin’s dentist protrayal in “Little Shop of Horrors”, or Lawrence Olivier asking Dustin Hoffman, “Is it safe?” in “Marithon Man”, you know my initial reaction of a dental appointment.  Once I get there, it is not nearly as bad and dentists are trying their best to make the visit comfortable if not downright please.

We asked dentists for their thoughts on trends and one is making the visit more enjoyable.  I never thought I would put spa and root canal in the same sentence, but see our article on The Modern Dentist.