Will this be Dr. H by year's end?

Let’s go over my reasoning.

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

I am still trying to decide what my New Year’s health resolution will be.  Something I can keep, but have to work and focus on.  A long-term goal with short-term steps and rewards.  I have a few in mind, and thanks for your suggestions Sagan and Judy.

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by  James Hubbard, M.D., M.P.H.

I used to make New Year’s resolutions when I was very, very young.  They were bold and visionary.  I never kept them and forgot what they were by January 2.  Since my late teens, when people would ask me if had made a resolution, I would tell them something like sweat less, age a year or some other nonsense.

Maybe I should compromise and make one good resolution that I try my best to keep.  Something specific and doable.   Any ideas for me? (keep it civil now)  What is your resolution?

If you smoke, may I suggest to stop by the end of 2009?  Many patients I advise to stop smoking give me a frustrated look that implies easier said than done.  I know.  But what if you make it the one thing you resolve to do, your number one priority for 2009?

Here is one incentive.  Dr. Norman Edleman of the American Lung Association says half of smokers die of lung disease.  Have you ever seen anyone with chronic lung disease?  Most of you can imagine cancer, but there are other more long term diseases that slowly destroy your lungs to the point you become constantly short of breath and nothing (including oxygen) relieves you.  Fully half.  I know most of you think you will not be in that half.  Maybe, if you are lucky (sarcasm goes here), you may die of one of the many other associated cancers, or heart disease.

Here are some tips to help you stop.

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

Irritable Bowel Syndrome (IBS) affects 20 percent of U.S. adults.  Although it doesn’t actually harm the intestines, it can wreak havoc on the sufferer with any combination of abdominal bloating, cramping, diarrhea and constipation.  In a recent post I reported a study showing that the old standby treatments of fiber, peppermint oil and antispasmotics still work for most people.

The American College of Gastroenterologists has released updated treatment recommendations, as reported by the University of Michigan. New recommendations of note are:

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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.

We thought colonoscopy could prevent 90 percent of colon cancers.  We were wrong.  If the results in the new Annals of Internal Medicine hold up, it’s more like 60 percent.  A colonoscopy is still excellent for a screening test, but far from perfect, we discover.

The investigators did a case-control study.  That’s when you find people with a diagnosis and work your way backwards. In this case, the researchers found people with colorectal cancer and looked back to see whether they’d had a normal colonoscopy six months to seven years before their diagnosis. They compared them to similar people who didn’t have colorectal cancer.

What the investigators found surprised them so much, they asked that the data be looked at a second time.

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

Consumers Union is upset with the FDA, calling for an overhaul of the agency.

Consumers Union, which publishes the popular Consumer Reports magazine, describes itself as “an expert, independent, nonprofit organization whose mission is to work for a fair, just, and safe marketplace for all consumers and to empower consumers to protect themselves.” I have always found them to be just that.

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

The World Health Organization established World AIDS Day in 1988 to be observed every December 1 in order to raise awareness for the HIV/AIDS. You may be thinking it needs no more awareness, and you may be correct.

For a while, AIDS was publicized as the scourge of the earth, the plague that would bring down civilization, the scare of the century, if you will.  But then modern medicine stepped in and does what it does best, make medicine for it.

Since then, there have been newer scares (the media is always looking for the freshest scare of the day to get your attention), Magic Johnson looks strong and healthy after announcing he was HIV positive over 15 years ago and it is rare to hear that a public figure has died of the disease.  Many young people think of it as just another STD, if they think of it at all.

But a funny thing happened along the way.

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

Want to give your baby the best?  Feed him/her only mother’s milk for the first 12 months.  An added incentive is it helps the mother’s health, also.  I thought everybody knew breastfeeding was the ideal until a woman asked me if the new report from the Annals of Internal Medicine , which reiterates this, was accurate.  October’s Annals updates previous recommendations by the U.S. Preventive Services Task Force that health-care providers should do all they can to actively support breast feeding.

Why do they feel the need to call for more support?

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

Thanks to the Basil and Spice staff for allowing me to blog on their website yesterday. I wrote on the new recommendations by the CDC this year to give influenza immunizations to ages 6 months to 18 years old. The change is adding the 5- to 18-year-old group. I won’t repeat the post here, but a commenter posed an interesting question, “Why now?”

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