Cancer is the abnormal proliferation of cells in the body. Normally we have genes that stops this abnormal proliferation of cells. Some people are predisposed because of a family history of cancer, environmental factors that triggers these changes, unhealthy lifestyle (smoking), occupational hazards (exposure to chemicals, radiation). Patients diagnosed with cancer affects not only the health of the individual but also puts a strain on finances, emotional and psychological well being not just the patient but also his/her family. Over the years there have been many medications to combat cancer but not without its downsides. Patients have to contend with side effects, from loosing hair to target organ damage like the heart. Decrease in their immune system making them prone to infection. Some even tried food supplements.
Recently I have come across an article in Popular Science of a rodent (a mole rat) that is immune to cancer. Visit the Popular Science for the full story. They even labeled it as hideous creature. These lovely animals could be hideous to others but hope to patients with cancer. Another story from Electric Fields Halt the Spread of Brain Tumor uses electric field to halt the spread of cancer. They say this could eventually be use to other form of cancer. This may give cancer patients a fighting chance since the aggressiveness of the cancer or the rate at which it spread and multiply fast is one factor we consider if the disease is treatable or not. This will give the medications a chance to really eradicate cancer cells. Nothing is more devastating to a person than being diagnosed with cancer. To know that your time has been cut short, the pain they experience because of the tumor. These news of hope could alleviate their pains even just a little. In our day and age, the next trend in medicine is manipulating proteins and genes that will cure diseases. This may be the beginning for the cure of cancer and in the near future, we may treat cancer the same ease as treating the common cold.
Saturday, October 31, 2009
Plaque regression wiht Niacin versus Placebo
Patients has been asking me if taking medications for dyslipidemia like statins will relieve the stenosis in the coronary arteries. People are always looking for a quick fix. Atherosclerosis is a process that takes years to accumulate and is affected by physiologic and environmental factors. Once you are diagnosed with atherosclerotic heart disease, cardiovascular disease like heart attack or brain attack, the process of atherosclerosis has been going on for a long time. It has only recently been shown that statins can halt or even regression of atherosclerosis. But taking medications for a month will not regress all the atherosclerosis you accumulated for so many years eating those fatty food and not lack of exercise and poor health habits.
There is a new study ARBITER-HALTS 6 thats about to come out with its results on the use of niacin in the regression of plaques (caused by atherosclerosis) compared to placebo by measuring the intima media thickness of the carotid. This will add to our current medical strategy in treating dyslipidemia and target regression of aterosclerotic plaque. This may have a big impact on Filipinos since it has been shown in studies that Filipino patients who had cardiovascular disease like myocardial infarction (heart attack) had normal or low LDL cholesterol, tryglycerides. However, these patients also had low HDL. The addition of niacin in the treatment of Filipino patients with cardiovascular disease could have a very big impact on morbidity and mortality. For more information visit Hearwire.
There is a new study ARBITER-HALTS 6 thats about to come out with its results on the use of niacin in the regression of plaques (caused by atherosclerosis) compared to placebo by measuring the intima media thickness of the carotid. This will add to our current medical strategy in treating dyslipidemia and target regression of aterosclerotic plaque. This may have a big impact on Filipinos since it has been shown in studies that Filipino patients who had cardiovascular disease like myocardial infarction (heart attack) had normal or low LDL cholesterol, tryglycerides. However, these patients also had low HDL. The addition of niacin in the treatment of Filipino patients with cardiovascular disease could have a very big impact on morbidity and mortality. For more information visit Hearwire.
Friday, October 30, 2009
Internet Advantage on Old Peoples Brains
Elderly people especially Filipinos have this mentality that they cannot do something or anything because they are already old and I hear this from people who are only aged 60. They do less work, they don't exercise and they pretty much become sedentary. But I have observed that elderly people who are more active physically and mentally looks younger compare to people of the same age. One of my mentors in cardiology is 86 years old and he is still active and I see patients 65 years old and they are already senile. Elderly people who are active physically and mentally tend to healthier. Studies have shown that elderly people who continuously use their mind (whether word puzzle or sudoku) had better memory and less likely to be senile.
A researcher found out that elderly people who were taught to use the internet or those who were using the internet can enhance the brains function. For more information visit WebMD Health News and Fewer Dsiease for retiree....
A researcher found out that elderly people who were taught to use the internet or those who were using the internet can enhance the brains function. For more information visit WebMD Health News and Fewer Dsiease for retiree....
Statins Becoming a Wonder Drug?
The benefits of statins on patient has been well documented in large randomized controlled trials. Over the years it also shows pleotrophic effects like its anti inflammatory effects. This means aside from lowering cholesterol it has other good effects like the anti-inflammatory properties especially on the cardiovascular system. In other words for you out there with some medical background, the drug is beneficial to those with indications to take the drug. But the benefits does not stop there. A recent study showed that people who were hospitalized for flu and were taking statins, were 50% less likely to die of flu. For more details, visit WebMD Health News.
Wednesday, October 28, 2009
Starting to Look Like Mom? A Quick Fix
Starting to Look Like Mom? A Quick Fix posted at WebMD Health News
Women are more often conscious about how they look. The slightest wrinkle here and there would start them in a panic and starts surfing the net for solutions or going to the mall for cosmetic solutions. Others undergo surgery to to eliminate these wringkles. Younger women now a days is fearful that they may look like their moms at a young age.
A new research confirms this. At least they say when it comes to your lower eyelids. They say they can precisely say what part of the eyelid you will age and by how much offering early correction for the affected individuals. If the mother develop wrinkles in their lower eyelids, there is a good chance that the daughters may develop wrinkles as well. But mothers who have taut skin, they say these are the women who age well.
So ladies, don't try to stare to much at your mom. Its rude. ;-)
Women are more often conscious about how they look. The slightest wrinkle here and there would start them in a panic and starts surfing the net for solutions or going to the mall for cosmetic solutions. Others undergo surgery to to eliminate these wringkles. Younger women now a days is fearful that they may look like their moms at a young age.
A new research confirms this. At least they say when it comes to your lower eyelids. They say they can precisely say what part of the eyelid you will age and by how much offering early correction for the affected individuals. If the mother develop wrinkles in their lower eyelids, there is a good chance that the daughters may develop wrinkles as well. But mothers who have taut skin, they say these are the women who age well.
So ladies, don't try to stare to much at your mom. Its rude. ;-)
"Smoking's Damage Swift and Ireversible"
I remember when I first started smoking when I was in college. I did it to look cool and appear older when we went on gimmick with my friends. Peer pressure and culture shock of college life. We had this feeling of being invincible because we were young and felt we could do anything. Recent studies however shows that smoking even 1 stick can cause irreversible damage to the arteries. It stiffens instead of its normal elasticity as reported recently in WebMD Health News Oct. 27, 2009. The study showed that 1 stick of smoking stiffened the arteries of 18-30 year old smokers by 25% after teadmill exercise test. In non-smokers, it dropped to 3.6%.
Normally, arteries dilate during exercise to accommodate for the increase in the metabolic requirements of the body. It dilates so more blood with the oxygen and nutrients goes to the muscles in an efficient, optimal manner. Smoking apparently stiffens the arteries as reported and the effect of this is the muscles gets tired easily due to accumulation of lactic acid.
Also stated in the report is that if you stop smoking, the elasticity becomes better compared to continued smoking but it will never return to normal.
So, we were not invincible after all. I will never have a normal artery compared to my high school or elementary years. So my advise to you people, stop smoking and start living healthy.
Normally, arteries dilate during exercise to accommodate for the increase in the metabolic requirements of the body. It dilates so more blood with the oxygen and nutrients goes to the muscles in an efficient, optimal manner. Smoking apparently stiffens the arteries as reported and the effect of this is the muscles gets tired easily due to accumulation of lactic acid.
Also stated in the report is that if you stop smoking, the elasticity becomes better compared to continued smoking but it will never return to normal.
So, we were not invincible after all. I will never have a normal artery compared to my high school or elementary years. So my advise to you people, stop smoking and start living healthy.
"Cell Phones on Hip May Weaken Bone"
We have seen youtube videos of 4 cell phones ringing simultaneously arranged in a circle could pop corns placed smack in the middle. It may be cool to look at and maybe fun to try with friends but it brings a serious question up front. Does cell phones (or its radio signal, or electromagnetic emissions) affect the human body in one form or another?
A report by Salynn Boyles on (WebMD Health News Oct 27, 2009) in a study done Turkey's Suleyman Demireli University showed that cell phones may affect the human body. The researchers of the said institution measured the pelvic bone density in 150 men who carried their cell phones regularly attached to their belts. They carried it for an average of 15 hours everyday for 6 years and found that bone mineral density was slightly less on the side of the pelvis where the mobile phones where carried. The overall results were not significant and was not as much as that seen in people with osteoporosis. The mean average age of the men was 32 years of age. The researchers reiterated that the results are prelimenary.
There is however conflicting issues regarding electromagnetic fields since experimentally it showed that EM waves has been found to strengthen the bones in patients with osteoporosis. But the EM wave frequency used in the above experiments on patients with osteoporosis was 15-72 Hz. Cell phone EM frequencies is in the range of 900-1800 MHz
At the moment, there is no definite conclusions on the effect of cell phone on the human body. There is an ongoing study, the Interphone study being conducted in 13 countries to see if cell phone use can cause brain tumors.
On a personal note, we have a SPAN bayantel phone (Huawei) is the brand and it heats up 10 minutes into using the phone and then my head starts throbbing and a full blown headache in 20 min. My siblings experience the same thing. This concerned us a lot and we stopped using it. For now, lets wait for the result of the Interphone study.
A report by Salynn Boyles on (WebMD Health News Oct 27, 2009) in a study done Turkey's Suleyman Demireli University showed that cell phones may affect the human body. The researchers of the said institution measured the pelvic bone density in 150 men who carried their cell phones regularly attached to their belts. They carried it for an average of 15 hours everyday for 6 years and found that bone mineral density was slightly less on the side of the pelvis where the mobile phones where carried. The overall results were not significant and was not as much as that seen in people with osteoporosis. The mean average age of the men was 32 years of age. The researchers reiterated that the results are prelimenary.
There is however conflicting issues regarding electromagnetic fields since experimentally it showed that EM waves has been found to strengthen the bones in patients with osteoporosis. But the EM wave frequency used in the above experiments on patients with osteoporosis was 15-72 Hz. Cell phone EM frequencies is in the range of 900-1800 MHz
At the moment, there is no definite conclusions on the effect of cell phone on the human body. There is an ongoing study, the Interphone study being conducted in 13 countries to see if cell phone use can cause brain tumors.
On a personal note, we have a SPAN bayantel phone (Huawei) is the brand and it heats up 10 minutes into using the phone and then my head starts throbbing and a full blown headache in 20 min. My siblings experience the same thing. This concerned us a lot and we stopped using it. For now, lets wait for the result of the Interphone study.
Monday, October 26, 2009
A Tale of Excuses 3
" I did not seek medical consult when I started feeling bad because I was afraid I might have a disease and start taking medications. I thought it was just stress or I was tired."
" I don't have money for consultation with a doctor."
I hear this often from interviews with patients when I ask them why they did not seek consult when they were feeling something bad. I tell them we could have caught this early on when complications could have been prevented. But regrets always comes last. Maybe its the "mamaya na" habit of the Filipinos. Why did we get such a bad habit? Is it the environment we live in? Habits passed on from generation to generation just because people around us do it every time?
Majority of the patients I see already have target organ damage when they finally seek medical consultation. That is the time they feel exhausted, shortness of breath, easy fatigability, loss of appetite. In the extreme, the only time a doctor see them is when they already present with acute myocardial infarction, stroke and sadly sudden death, severe pneumonia. In short, they come to you when their disease state has "SEVERE connected to it."
I'm a cardiologist so most of my examples here are cardiovascular in nature. As a cardiologist, it would be nice if we get the patient in the early stages of their condition. In my opinion, it is much more fulfilling as a doctor when we could prevent complications of cardiovascular disease than to get them when they already have target organ damage. To know that we decreased the risk of developing complications. Notice that I said "decrease the risk" and not prevent. "Prevention" starts early in life by living healthy. As previously mentioned in my earlier blogs of finances being an excuse for not buying maintenance medications, the cliche ""an ounce of prevention is better than a pound of cure." (Please tell me if that is the right phrase). We could have saved the trouble of spending all that money for expensive medication. But nothing beats the genes (for now). Majority of the risk for cardiovascular disease in hereditary. The environment plays an important role in contributing to the risk.
These are the risk factor for cardiovascular disease:
1. age >45 years of age
2. sex being a male is a risk factor
3. Hypertension
4. Diabetes being diabetic is a coronary artery disease equivalent. Meaning your risk of having a heart attack even if you haven't had one is the same as an individual who is not diabetic but had a heart attack before.
5. Dyslipidemia High cholesterol, high LDL, high triglyceride and low HDL
6. Smoking accelerates the accumulation of cholesterol in the arteries, disrupts the normal function of the arteries
7. Obesity
8. family history of early cardiac death or disease in the family <45 years f age.
Hypertension, diabetes, dyslipidemia are disease that are asymptomatic in the early stages. Common statements of patient "I feel fine even if I have blood pressure." Yes they feel fine but if it remains untreated, sooner rather than later you're going to feel something and when you do, it means you already have target organ involvement.
"I don't have money to see a doctor." in their quest, (if that is a quest) to save up money they put their health out of the priorities list. The initial consultation with a doctor will entail a certain amount of money because you will go through tests, routine test to evaluate your current health state. after that the least number of follow up is every month. If you feel better, every 3 months or more. You don't go to the doctor everyday. Compare that if you already develop the complications. You will have more medication to take and you have to buy them. In the long run it wouldn't be cheap any more now would it. "An ounce of prevention is better than a pound of cure.
Think about it.........
" I don't have money for consultation with a doctor."
I hear this often from interviews with patients when I ask them why they did not seek consult when they were feeling something bad. I tell them we could have caught this early on when complications could have been prevented. But regrets always comes last. Maybe its the "mamaya na" habit of the Filipinos. Why did we get such a bad habit? Is it the environment we live in? Habits passed on from generation to generation just because people around us do it every time?
Majority of the patients I see already have target organ damage when they finally seek medical consultation. That is the time they feel exhausted, shortness of breath, easy fatigability, loss of appetite. In the extreme, the only time a doctor see them is when they already present with acute myocardial infarction, stroke and sadly sudden death, severe pneumonia. In short, they come to you when their disease state has "SEVERE connected to it."
I'm a cardiologist so most of my examples here are cardiovascular in nature. As a cardiologist, it would be nice if we get the patient in the early stages of their condition. In my opinion, it is much more fulfilling as a doctor when we could prevent complications of cardiovascular disease than to get them when they already have target organ damage. To know that we decreased the risk of developing complications. Notice that I said "decrease the risk" and not prevent. "Prevention" starts early in life by living healthy. As previously mentioned in my earlier blogs of finances being an excuse for not buying maintenance medications, the cliche ""an ounce of prevention is better than a pound of cure." (Please tell me if that is the right phrase). We could have saved the trouble of spending all that money for expensive medication. But nothing beats the genes (for now). Majority of the risk for cardiovascular disease in hereditary. The environment plays an important role in contributing to the risk.
These are the risk factor for cardiovascular disease:
1. age >45 years of age
2. sex being a male is a risk factor
3. Hypertension
4. Diabetes being diabetic is a coronary artery disease equivalent. Meaning your risk of having a heart attack even if you haven't had one is the same as an individual who is not diabetic but had a heart attack before.
5. Dyslipidemia High cholesterol, high LDL, high triglyceride and low HDL
6. Smoking accelerates the accumulation of cholesterol in the arteries, disrupts the normal function of the arteries
7. Obesity
8. family history of early cardiac death or disease in the family <45 years f age.
Hypertension, diabetes, dyslipidemia are disease that are asymptomatic in the early stages. Common statements of patient "I feel fine even if I have blood pressure." Yes they feel fine but if it remains untreated, sooner rather than later you're going to feel something and when you do, it means you already have target organ involvement.
"I don't have money to see a doctor." in their quest, (if that is a quest) to save up money they put their health out of the priorities list. The initial consultation with a doctor will entail a certain amount of money because you will go through tests, routine test to evaluate your current health state. after that the least number of follow up is every month. If you feel better, every 3 months or more. You don't go to the doctor everyday. Compare that if you already develop the complications. You will have more medication to take and you have to buy them. In the long run it wouldn't be cheap any more now would it. "An ounce of prevention is better than a pound of cure.
Think about it.........
A Tale of Excuses
"I stopped taking my medications because there was just too many of them. I'm afraid my liver will be fried."
This is one of the excuses patients tell me when they stop taking their maintenance medications. But when you ask them if they drink alcohol to oblivion, they just give me that smile. Ladies and gentleman and whoever is lucky enough to read this blog, medications that are given by your doctor are in the therapeutic range. Why would we give medications that would fry our patients liver?! Medications are given at the optimum dose that would give the maximum benefit. Take not of the word OPTIMUM. When drugs are taken over the dosage prescribed by the doctor, thats the time you worry about your liver getting fried. Some of the drugs when overdosed can KILL YOU. Sometimes patient double their dose for that day because they missed a dose yesterday which is the stupid thing to do. Again, thats when your liver get fried.
When we prescribe medications, we take into consideration their drug to drug interactions. I would advise against self medicating especially with cardiac and neuro medications. So consult your doctor before taking any medications. For people who can't understand, here's why. When your car breaks, do you do it yourself or do you go to a mechanic? When you want to buy a good jewelry, do you ask the brick maker?Do you build your own house or do you call an engineer? So people, think about it.
This is one of the excuses patients tell me when they stop taking their maintenance medications. But when you ask them if they drink alcohol to oblivion, they just give me that smile. Ladies and gentleman and whoever is lucky enough to read this blog, medications that are given by your doctor are in the therapeutic range. Why would we give medications that would fry our patients liver?! Medications are given at the optimum dose that would give the maximum benefit. Take not of the word OPTIMUM. When drugs are taken over the dosage prescribed by the doctor, thats the time you worry about your liver getting fried. Some of the drugs when overdosed can KILL YOU. Sometimes patient double their dose for that day because they missed a dose yesterday which is the stupid thing to do. Again, thats when your liver get fried.
When we prescribe medications, we take into consideration their drug to drug interactions. I would advise against self medicating especially with cardiac and neuro medications. So consult your doctor before taking any medications. For people who can't understand, here's why. When your car breaks, do you do it yourself or do you go to a mechanic? When you want to buy a good jewelry, do you ask the brick maker?Do you build your own house or do you call an engineer? So people, think about it.
Sunday, October 25, 2009
A Tale of Excuses
One Sunday morning a friend of my fiancee asked me if I could do a mini-medical mission in her community. She started a daily morning exercise routine for interested individuals in her community. Apparently those who were in attendance were in the age range of 35-80 years of age. When we arrived in the community they had just finished their daily exercise ( which started at 6AM). The participants started lining up for my mini-medical mission. With me were 2 nurses and 1 midwife (one of them was my fiancee which is a nurse) and they started taking the vital signs before I saw each of the participants. I took their history and did physical examination and gave them present medical condition. Most of them were hypetensive, almost half were diabetics. Of the 40 people I saw, only 2-4 persons had adequate medications with good compliance in taking their medicine. Majority of them had uncontrolled hypertension and diabetes. They had previous check ups with doctors and they were given appropriate medications but they were not able to maintain them. Living in our country, the most common reason for poor maintenance of medication was financial constraints above all else. But you'll be surprised about what each of this individuals say when asked why they couldn't take their maintenance medications.
Take Mr. M (not his real name or initials). He is a 50 something male who was diagnosed with hypertension when he had his blood pressure taken when he went to his local health center. His blood pressure was 170/100. He then sought consult with a doctor and he was prescribed Aspirin, amlodipine, ISMN and simvastatin. Apparently during his check up the doctor elicited symptoms of chest pain and when he was worked up he also had high cholesterol. He took the medications religiously everyday for the next 3 months. He checked his blood pressure and saw that it had gone down to 120/80. He started talking to some friends and told them about his condition. One of them asked if he was taking any medications and he told them. The friend went on to tell him that he was taking too many medications. (Mind you, this friend of his has no medical background whatsoever). This friend of his started telling them about this wonderful product that cures whatever disease a person has. A tea, with different neon color and tantalizing designs for separate kind of tea for some disease. At that moment, Mr. M started taking the tea and discontinued his amlodipine, simvastatin and ISMN because he had never felt better than before. (Totally discounting the fact that he has been taking those medications for three months). When I saw him the first time that sunday, he has been experiencing easy fatigability, shortness of breath and chest heaviness and his blood pressure was 170/100. During the course of the interview, I asked him why he stopped his medications. He said, "I don't have enough money to buy the rest of the medication, but I take the aspirin regularly." He said this with confidence that everything will be fine with the tea and aspirin. Be that as it may, I felt the responsibility to give him more information about his condition and the medications he was taking before. A least he would have an informed decision on whether to continue taking his medication or not. Then I started to get the prices of the medications he was taking. At present, the Philippine Pharmaceutical markets have decent, low priced generic medications that are affordable. All in all, the total of all the medications he was taking regularly was about a hundred pesos ( which is around $2.13). That would be around 3000 pesos per day. I told him thats the cost of all his medications every month comparing it if he did not take any medication and he was hospitalized for an acute myocardial infarction (which is a complication of untreated hypertension plus he has been having chest pains). Each day he would be spending more than 3000 pesos each day and he would stay in the hospital for 5-7 days.Then he started pulling something and voila! The beautifully colored tea. He said he has been taking the tea for the last 3 months and he said he feels great when he just tolde me he has been experiencing easy fatigability, shortness of breath and chest pain. I asked him how much it cost. He said 900 pesos for 7 sachets! 900 pesos! Thats 3600 pesos every month with no approved therapeutic claims! The POWER OF MARKETING AND ADVERTISEMENTS ON THE FILIPINO MINDS! Wow, he is willing to spend for something with no therapeutic claims even if he does not have the money to buy medications with evidence based literature for something that celebrities take on televisions.
So........... is financial constraints an excuse? Maybe for some, but definitely not for others.
Take Mr. M (not his real name or initials). He is a 50 something male who was diagnosed with hypertension when he had his blood pressure taken when he went to his local health center. His blood pressure was 170/100. He then sought consult with a doctor and he was prescribed Aspirin, amlodipine, ISMN and simvastatin. Apparently during his check up the doctor elicited symptoms of chest pain and when he was worked up he also had high cholesterol. He took the medications religiously everyday for the next 3 months. He checked his blood pressure and saw that it had gone down to 120/80. He started talking to some friends and told them about his condition. One of them asked if he was taking any medications and he told them. The friend went on to tell him that he was taking too many medications. (Mind you, this friend of his has no medical background whatsoever). This friend of his started telling them about this wonderful product that cures whatever disease a person has. A tea, with different neon color and tantalizing designs for separate kind of tea for some disease. At that moment, Mr. M started taking the tea and discontinued his amlodipine, simvastatin and ISMN because he had never felt better than before. (Totally discounting the fact that he has been taking those medications for three months). When I saw him the first time that sunday, he has been experiencing easy fatigability, shortness of breath and chest heaviness and his blood pressure was 170/100. During the course of the interview, I asked him why he stopped his medications. He said, "I don't have enough money to buy the rest of the medication, but I take the aspirin regularly." He said this with confidence that everything will be fine with the tea and aspirin. Be that as it may, I felt the responsibility to give him more information about his condition and the medications he was taking before. A least he would have an informed decision on whether to continue taking his medication or not. Then I started to get the prices of the medications he was taking. At present, the Philippine Pharmaceutical markets have decent, low priced generic medications that are affordable. All in all, the total of all the medications he was taking regularly was about a hundred pesos ( which is around $2.13). That would be around 3000 pesos per day. I told him thats the cost of all his medications every month comparing it if he did not take any medication and he was hospitalized for an acute myocardial infarction (which is a complication of untreated hypertension plus he has been having chest pains). Each day he would be spending more than 3000 pesos each day and he would stay in the hospital for 5-7 days.Then he started pulling something and voila! The beautifully colored tea. He said he has been taking the tea for the last 3 months and he said he feels great when he just tolde me he has been experiencing easy fatigability, shortness of breath and chest pain. I asked him how much it cost. He said 900 pesos for 7 sachets! 900 pesos! Thats 3600 pesos every month with no approved therapeutic claims! The POWER OF MARKETING AND ADVERTISEMENTS ON THE FILIPINO MINDS! Wow, he is willing to spend for something with no therapeutic claims even if he does not have the money to buy medications with evidence based literature for something that celebrities take on televisions.
So........... is financial constraints an excuse? Maybe for some, but definitely not for others.
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