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

News flash.  Medicine is not perfect.  A few years ago, I finished my advice to a patient by saying, I might be wrong.  She sarcastically said she was going to go straight home and call her doctor son-in-law to give him the news. “A doctor said he might be wrong. Who knew?”

Reading the recent news about colonoscopies made me think of this.  Why do we need scientific studies to document that therapies work?  Because we can’t rely on our intuitions and preconceived notions.  Every diagnostic test and treatment needs to be scrutinized objectively.  Even the ones we’re sure of.

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

The benefits of vitamin D are many.  Fighting off rickets, osteoporosis, cancers, type 2 diabetes and heart disease are just a few.  Used to, everyone got enough vitamin D from sunshine.  But, now, there is a problem.  Skin cancers, including the deadly melanoma, are on the rise, and UV sunlight is a major risk factor.  We don’t know how much sun we can get, if any, without an increased risk.  We are also not sure how much vitamin D is ideal, but the trend is for more.

What is a person to do?

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

Former first lady Nancy Reagan fell and fractured her pelvis.  She is 87, recuperating at home and expected to recover in about eight weeks.  She had fallen a few months ago, also.  Unfortunately, falls resulting in fractures are all too common at ages 65 and older.  The risk of another fall after the first one is high.  Fractures are devastating, especially of the hip.  The brittle bones of osteoporosis play a role. (Experts debate whether most falls cause the fracture or vice versa.)

Dr. Mary E. Tinetti has studied falls in the elderly for a long time.  In her latest findings, published in the July 17, 2008, New England Journal of Medicine, she notes that previous studies have revealed that in people over 65, falls caused 10 percent of emergency room visits and 6 percent of hospitalizations. They were also a major cause of nursing home placement.

Do you know if you or an elderly family member is at risk? Several factors increase it.

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

If you ask most dermatologists how much sun should you get, they’ll probably say “none.” In fact, a dermatology professor at a medical school was fired a few years back after publicly touting sun exposure for vitamin D a little too much.

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

The American College of Sports Medicine and the American Heart Association have published 2007 exercise recommendations for older adults in the August, 28, 2007, issue of Circulation.

Their definition of older adults is:

• people over 65
• people aged 50 to 64 with chronic conditions (such as high blood pressure or other treated or untreated ongoing issues) or functional limitations (something that “impairs the ability to engage in physical activity”). (more…)