Tuesday, 07 November 2017 19:37

How Doctors Can Prevent Burnout

A new study from the American Medical Association (AMA), the Mayo Clinic and Stanford University finds 1 in 5 physicians plan to cut back their hours next year and 1 in 50 will leave the profession completely within the next 2 years.

 

Burnout is cited to be the main cause and is one of the biggest threats to health care today. According to AMA President Dr. David Barbe, “An energized, engaged, and resilient physician workforce is essential to achieving national health goals.”

 

And burnout affects all fields of medicine, surpassing 50%, in those including primary care and specialties such as gynecology, neurology, urology, emergency medicine, anesthesiology, cardiology and critical care to name a few.

 

Patients are at risk because if doctors aren’t at the top of their game, things get missed.  

 

Moreover the keen instinct of a clinician is imperative to diagnosing correctly, and this gets blunted when one is emotionally fatigued, or burned out.

Why are Doctors Burning Out?

 

A variety of factors can lead to physician burnout but the following appear to be the most cited:

 

  1. Electronic medical records – these are time-consuming to learn and implement, take time away from patients and may be financially burdensome due to their cost and lack of revenue for those who struggle to type and work with computers.

  2. High patient insurance deductibles – with insurance companies not paying until patients reach their deductible, it forces doctor’s offices to work harder to collect the income needed to run a practice.  Physicians do not want to get into the financial aspect of patient collections and it adds undue stress on an already stressful field.

  3. Red tape – ICD 10 code changes, insurance authorizations, referral forms turn the average day of a physician to less patient care and more bureaucracy.

  4. Less respect – in the old days, doctors were considered heroes and revered greatly.  Today they are frequently blamed for issues such as rising healthcare costs and the opioid epidemic.

  5. Malpractice suit fears – doctors are human and can only combat nature so much.  When one is diagnosed with cancer a physician has to fear that one will accuse him of not diagnosing it “quickly enough”.  When a lab gets ordered, the clinician has to hope that his staff is ensuring that every lab value comes across his desk.  When a prescription is written, he has to hope that the correct medicine is dispensed, works effectively and does not cause an adverse reaction.  And when a referral is made to a specialist, he has to hope all the above issues go well with the second physician or he can be sued for the referral.  And since a doctor sees thousands of patients a year, the odds that he will be sued for something is higher than any other profession.  Moreover, one lawsuit is a enough to bankrupt him.  Pretty darn stressful.

 

What are the signs of burnout?

 

In any profession, the following may be signs of burnout:

 

  • Apathy

  • Exhaustion

  • Poor sleep

  • Negative attitude at work

  • Absence from work

  • Being irritated

  • Feeling empty

  • Dreading going to work

  • Feeling underappreciated

  • Feeling you don’t matter

  • Blame others for mistakes

  • Low energy

  • Thinking about quitting




burnout

 

How to prevent burnout?

 

  1. Find the humor – As Milton Berle once said, “Laughter is an instant vacation”.  Watching a comedy or taking a 10 minute break to watch some funny YouTube clips offers immediate relief and energizes you.  A day without laughter is a day wasted. Charlie Chaplin

  2. Take care of yourself – how can one heal others when he himself needs healing?  So what can you do?  Try Massage, Meditation, Yoga, Exercise, Stress diary, Sleep, Mini vacations, Staycations but most of all…..Take breaks!!

  3. Learn to say “No” – It’s OK to take a day off. Why not take off early on Friday’s?  Or better yet, work a half day on Wednesday to break up the week?  Learn the 4 D’s…..Deflect, Defer, Deter, Delegate…..

  4. Make small goals – too many times we burnout because we failed to meet a goal that was unattainable in the first place.  So we toil for years to become “promoted”, or “wealthy”, or “slim”, or “married”, or “see the world”.  Instead, make smaller attainable goals (find a partner, open auxiliary office, lose 10 lbs, take a trip).

  5. Quit comparing yourself to others – we watch Shark Tank and then wonder what we are doing wrong, not being millionaires.  It’s unrealistic to think you should be “rich by now”.  We will always be inferior to someone else.  So get over it and love who you are and what you’ve accomplished.

  6. Have fun at work – contests, pot luck lunches, lunch room decorating, accent days, dress up days, and end of the week happy hour can spice things up at work.  Plus it increases morale among coworkers and staff.

  7. Be charitable – Doing community service is so rewarding and energizing that having a pet project helping out a local charity may be just what this doctor orders.  You can choose a cause, fundraise, attend charity events or walks, or even create a campaign.

  8. Get a hobby – tap into your artistic side by writing a book, song, article; paint; cook; build; teach; sing; dance; or even ride.

  9. Work on your bucket list- whether its going to a foreign country, learning to speak a new language, buying a vacation property, or even starting a second business, don’t let job burnout deter you.  This may give you the energy and perspective you need.

 

Finally, be around others and have a Bitch and Moan session – it feels so good to complain and gripe. Find others in similar situations as you and you’ll realize that you may have it better than you think.

 

Remember you have to come first and doing so will make you more of a help to others.  Feel great and you’ll make others feel great!

 

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

Published in News & Information
Tuesday, 31 October 2017 15:54

Halloween Safety Tips

 

Ghosts, goblins, Mommy yelling – Halloween can be pretty scary.  But the candy, the costumes, decorations and running door to door threatening all your neighbors with a “trick” makes it one of the most exciting days of the year!

 

Unfortunately, the more fun and immersed into the festivities, the more dangerous for our little ones. 160,000 injuries occur on this day each year, and even scarier, Halloween is the deadliest for pediatric pedestrians with 6100 fatalities reported annually by the National Safety Council.  No holiday should end so tragically.

 

In addition to this, parents need to be aware of fire and choking hazards.  We therefore recommend the following to keep our kids safe.

 

  1. Make sure your child’s mask allows him/her to see clearly.  If not, replace with non-toxic makeup, that is tested a few days before on a small area of skin on their arm to ensure they are not allergic.  The makeup should be washed off before bedtime.

  2. Avoid long costumes, such as ghost-themed, that may trip your child while they walk/run.

  3. Use bright-colored costumes. If your child insists on a dark costume, such as Batman, put a belt of glow sticks around him or add reflective tape to their costume and trick or treat bags

  4. Make sure all costumes and hats are flame resistant and teach your kids how to avoid tripping over jack-o-lanterns with candles in them.

  5. Avoid costume contact lenses as they may decrease visual acuity, scratch the eye and cause infection.

  6. Use the sidewalk.  Your child will want to zigzag across the street when they see everyone else doing it.  You need to be the parent like me who yells at everyone to get back on the sidewalk.

  7. Watch out for drunk drivers.  Many are coming back from a “trick or drink” party and could be impaired.

  8. Make the “no eating candy until you get home” rule.  Allows you to check the candy for open wrappers and dangerous things that don’t belong.  Then steal your favorite treats when the child is taking his/her potty break

  9. Teach your child to not enter a stranger’s home – even if it is in full decoration

  10. Stay in a group and follow your children. You can leave a safe distance behind while still supervise. And it’s fun when we parents compete for who can yell at our kids the loudest.

  11. Carry Walkie Talkies.  Halloween streets get loud and kids may not hear you if they start walking down a different street and turn into a housing complex.  Walkie talkies are fun and keep you connecting with your younglings’ even if they are a few feet away.

  12. Parents should avoid “Trick-o-Drink!!”ing where we walk around with our red plastic cup and rather than ask for candy, we opt for some spirits poured in.  Parents giggle, feeling apart of the festivities, but unfortunately will be sloshed by the fourth home they hit and won’t be able to effectively supervise the children.  We need to be at the top of our game this Halloween.  Cut the booze.

  13. And drivers, be wary of trick-or-treaters even before it gets dark.  Drive slowly and pay attention!  Let’s have a Happy and Safe one!!!

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information
Tuesday, 24 October 2017 16:44

New Type of Diabetes Discovered: Type 3c

A third type of diabetes has been identified by researchers. Type 3c diabetes may be mistaken for Type 2 diabetes, causing delay of proper treatment.

 

Researchers from the University of Surrey found Type 3c diabetes to be more common in adults than Type 1 diabetes.  Moreover they found that those with Type 3c were twice as likely to have poor blood sugar control than those with Type 2 diabetes.

 

They believe, discussed below, that the diabetes occurs years after injury to the pancreas, the organ that produces insulin.  So a person with Type 3c diabetes will most likely need insulin rather than an oral medication that treats insulin resistance



Study author, Andrew McGovern, writes: …our latest study has revealed that most cases of type 3c diabetes are being wrongly diagnosed as type 2 diabetes. Only 3% of the people in our sample – of more than 2m – were correctly identified as having type 3c diabetes.

 

So if many Type 2 diabetics fail to maintain control with their oral medications that address insulin resistance, they may actually have Type 3c and need insulin instead as low insulin is the cause of their diabetes.  Identifying this early will hopefully prevent some of the complications that occur with long term diabetes.

 

What is diabetes?

 

Diabetes is a disease in which the body doesn’t utilize and metabolize sugar properly.  When we consume food, it’s broken down into proteins, nutrients, fats, water, and sugar. These components are necessary for cell growth and function. They get absorbed in the small intestine and make it to the blood stream.   In order for a cell to utilize sugar, it needs the hormone insulin to help guide it in.  It’s similar to a key that fits in the keyhole of the “door” of the cell, opening it up so sugar can enter.  Insulin is produced in the pancreas, an organ that receives signals when one eats to release insulin in preparation of the sugar load coming down the pike

 

Diabetes explained.

 

So I imagine our mouth like a waiting room, the blood stream like a hallway, and the cells of the body the rooms along the hallway.  Insulin is the key to open the cells’ “doors” allowing sugar to enter.  If the sugar does not get in, it stays in the bloodstream “hallway” and doesn’t feed the cell.  

 

Weight loss occurs, and individuals may become more thirsty as the sugar in the blood makes it fairly osmotic, something the body wants to neutralize, reduce. The kidneys are going to want dump the excess sugar, so to do so, one would urinate more, again causing thirst. So when a diabetic loses weight, urinates more frequently and becomes thirsty, you now understand why.

Type I vs. Type II vs. Type IIIc Diabetes.

 

Type I Diabetes, previously called insulin dependent or Juvenile diabetes, occurs when the pancreas doesn’t produce insulin, possibly from the immune system destroying the cells that produce the hormone. When this occurs there is rapid weight loss and death could occur if the cells don’t get the sugar they need.  Insulin has to be administered regularly.

 

Type II Diabetes, previously called non-insulin dependent or adult-onset diabetes,  occurs in those who began with a fully functioning pancreas but as they age the pancreas produces less insulin, called insulin deficiency, or the insulin produced meets resistance.  This is the fastest growing type of diabetes in both children and adults.

 

Type IIIc diabetes may occur in individuals who suffered damage to their pancreas.  Inflammation/infection of the pancreas (pancreatitis), a pancreatic tumor, or surgery affecting the pancreas may destroy the beta cells that produce insulin.



Complications of Diabetes

 

Cardiovascular disease – Sugar is sticky, so it can easily add to atherosclerotic plaques.



Blindness – high sugar content draws in water to neutralize and small blood vessels in the eye can only take so much fluid before they burst.  Moreover, high blood sugar weakens blood vessels.

 

Kidney disease – the kidneys work overtime to eliminate the excess sugar. Moreover, sugar laden blood isn’t the healthiest when they themselves need nourishment.

 

Infections – pathogens love sugar. Its food for them.  Moreover blood laden with sugar doesn’t allow immune cells to work in the most opportune environment.

Neuropathy – nerves don’t receive adequate blood supply due to the diabetes-damaged blood flow and vessels, hence they become dull or hypersensitive causing diabetics to have numbness or pain.

 

Dementia – as with the heart and other organs, the brain needs healthy blood and flow.  Diabetes has been found to increase risk of Alzheimer’s as well.

 

What is insulin resistance?

 

Insulin resistance, if using our hallway and door analogy, is as if someone is pushing against the door the insulin is trying to unlock. As we know, those with obesity are at higher risk for diabetes, hence fat can increase insulin resistance.  It’s also been associated with an increase in heart disease.

Blood sugar numbers

 

If your fasting blood sugar (glucose) is greater than 126 mg/dl, or your non fasting blood sugar is greater than 200 mg/dl, you may be considered diabetic. Pre-diabetes occurs when the fasting blood sugar is between 100 and 125 mg/dl. If ignored, and the sugar rises, pre-diabetics may go on to develop diabetes.

 

dmp-blood-sugar-levels-chart



SOURCE DIABETESMEALPLANS.COM

Preventing/Controlling Diabetes.

1/3 of American adults are currently pre-diabetic.  Experts predict 1/3 of US Adults will be diabetic by the year 2050.  Although genetics plays a big role, decreasing one's sugar intake and maintaining an active lifestyle can help ward of diabetes.

 

Foods high in sugar and carbohydrates increase one’s risk, so a diet rich in vegetables and lean meats is preferred.

 

For more on the study visit here.

 

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information

Donald Trump’s executive order he declared killed Obamacare hasn’t actually changed any laws, but if Trump cuts subsidies paid to health insurance companies like he proposed, it would increase premiums for middle-class Americans and increase the federal deficit by $194 billion over the next decade, according to the nonpartisan Congressional Budget Office.

The $19.4 billion that would be added to the federal deficit annually on average is $12.4 billion more than the government is currently paying to subsidize health insurance discounts for low-income Americans. That $7 billion the federal government pays in annual subsidies to cover the discounts insurers are required to offer under the Affordable Care Act insures helps about 7 million Americans afford health insurance.

Since insurers are required to offer those discounts by law, that $7 billion in lost income (and any in lost premiums due to more Americans choosing to go uninsured) will fall on the backs of middle-class Americans who don’t receive insurance through their employers. Individuals making around $48,000 or a family of four earning almost $100,000 annually are expected to see their premiums increase 20 percent next year.

While Senators came to a bipartisan agreement to float Obamacare for the next two years, Trump said he opposes any measure that “bails out” health insurance companies. But if Trump is so concerned about the $7 billion paid annually to health insurance companies to make health insurance more affordable for low-income Americans, what about the $92 billion the government spends on corporate welfare, according to research by the Libertarian Cato Institute done in 2006? The federal government spends $6.18 billion more subsidizing Boeing aircraft production than it does to make health insurance more affordable to low-income Americans.

Trump's Obamacare Executive Order Explained

While Donald Trump’s executive order he claimed killed Obamacare hasn’t actually changed any laws, it could eventually allow associations to skirt state rules so employers can provide employees health insurance that covers next to nothing.

Under the new executive order, an association of businesses offering similar products or services could choose which state’s marketplace they want to use to provide health insurance to all the association’s employees -- regardless of location. The association could and likely would pick a state offering the cheapest option providing the fewest benefits for its employees, resulting in less money paid in premiums and, therefore, higher premiums for individuals and families who don’t get insurance through their employer.

These associations would be considered large employers, which aren’t subject to the same rules as individual or small group plans under the Affordable Care Act. They are not required to cover all the ACA’s essential health benefits nor are they required to offer insurance that covers a minimal percentage of their employees’ medical bills. This puts the bulk of the medical risk and expense burden on the employee instead of the insurance company while also lowering expenses for employers. This will also result in individuals and families picking up more of the tab when it comes to premiums paid.

The executive order also expands short-term insurance plans, which were designed for people temporarily out of work for a limited amount of time. Like insurance plans for large businesses, these insurance plans are not required to meet ACA regulations of providing essential health benefits, not charging sick people more than healthy people for health insurance or denying people insurance based on preexisting conditions or medical history.

The executive order will lift the burden of insurance premiums off the shoulders of businesses and onto the shoulders of individuals and families, which will result in more under- and uninsured Americans and higher premiums.

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If you like this, you might like these Genesis Communications Network talk shows: USA Prepares, Building America, Free Talk Live, The Easy Organic Gardener, American Survival Radio, Jim Brown’s Common Sense, Good Day Health, MindSet: Mental Health News and Information, Health Hunters, America’s Health Advocate, The Bright Side, The Dr. Daliah Show, Dr. Asa On Call, The Dr. Bob Martin Show, Dr. Coldwell Opinion Radio, The Dr. Katherine Albrecht Show

Published in News & Information

Despite Donald Trump declaring Obamacare dead after signing an executive order on Thursday, United States Senators came to a bipartisan agreement on Tuesday to float Obamacare for the next two years. That doesn’t mean Obamacare is in the clear, but it is still the law of the land, and with open enrollment beginning on Nov. 1, it’s time you understood your healthcare options so you can make the right choice for you and your family.

First Thing’s First: Check if You’re Eligible for Medicaid

Medicaid expansion has been implemented in 32 states, and if you’re a citizen of Louisiana, your state expanded Medicaid in July of 2016, so check to see if you qualify. If you make less than $16,040 annually and are single, you do. Here’s the breakdown of the Federal Poverty Level for households of multiple people and here’s where you can find your state’s income requirements. Medicaid in any state will be considerably cheaper than a Bronze plan on the Obamacare marketplace.

Louisianans are already taking advantage of the Medicaid expansion, with enrollment in the program increasing 42 percent since Obamacare debuted in 2013. The state’s 21.7 percent uninsured rate in 2013 has fallen to 12.7 percent.

Weighing the Risk of Going Uninsured

Going uninsured only increases premiums for your family, friends and neighbors, and if you were to require medical care, you would incur considerable medical debt for which you could end up paying the rest of your life. A 2016 study by the National Bureau of Economic Research found those who visit the hospital without insurance double their chance of declaring bankruptc within four years.

Even if your hospital visit doesn’t burden you with medical debt, any “uncompensated care” the hospital provides, it makes up by raising rates on medical care for everyone. So going uninsured raises medical costs for everyone and is not advised.

That said, if you haven’t been to the doctor in years, don’t do dangerous work or have dangerous hobbies and are healthy -- you can determine whether it would be cheaper to pay the penalty for going uninsured than it would be to pay a health insurance premium.

The penalty for going uninsured in 2017 is 2.5 percent of your income or $695 -- whichever is higher. So if you make less than $27,750 annually, you’d pay $695, which would likely be cheaper than any health insurance plan you could purchase on the Obamacare marketplace. In fact, if you make less than $45,000 annually, the penalty for going uninsured ($1,125) is likely less than your premiums would be for the year. Keep in mind that premium payments are only part of your potential healthcare costs, though. It only takes one accident or illness to make you regret going uninsured.

If You’re Healthy and Under 30 (or not), Get a Catastrophic Plan

Catastrophic health insurance plans cover the same essential health benefits marketplace plans cover, including preventative care and three primary care visits. They’re also cheap and protect you from both the penalty for going uninsured and the medical debt that could bankrupt you in the future. You might even qualify for a catastrophic plan if you’re over 30 years old.

If you have experienced any one of the hardships listed here in the past year, you could qualify for a catastrophic health insurance plan. Some examples would be death of a family member, increased expenses due to caring for a sick family member, or damage to property due to natural disaster. You might even qualify if you experienced a hardship applying for health insurance not listed on the website.

You could also be eligible for a catastrophic health plan if your employer doesn’t offer affordable health insurance and Obamacare is prohibitively expensive for you, or if your state didn’t expand Medicaid, for which you would qualify. Be sure to investigate your eligibility for a catastrophic health insurance plan thoroughly, especially if you live in one of the 18 states that didn’t expand Medicaid.

Finding the Best Health Insurance Plan for You and Your Family

If you and your family is healthy and has no history of medical problems, a Bronze health insurance plan is probably all you need. Bronze plans only cover up to 60 percent of medical costs, though. Silver health insurance plans cover up to 70 percent of expenses, Gold plans cover 80 percent and Platinum plans cover up to 90 percent of medical expenses.

Based on you and your family’s medical history and current health, you can determine which plan best fits into your budget while also covering your expected medical costs for the year. If you are injury-prone or have a history of visiting the hospital regularly, a Gold or Platinum plan might actually save you money in a bad year health-wise.

So there’s your checklist for understanding your options prior to Obamacare open enrollment starts on Nov. 1. Exhaust all of your healthcare options before giving up and taking the penalty, because you never know what could happen.

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If you like this, you might like these Genesis Communications Network talk shows: USA Prepares, Building America, Free Talk Live, The Easy Organic Gardener, American Survival Radio, Jim Brown’s Common Sense, Good Day Health, MindSet: Mental Health News and Information, Health Hunters, America’s Health Advocate, The Bright Side, The Dr. Daliah Show, Dr. Asa On Call, The Dr. Bob Martin Show, Dr. Coldwell Opinion Radio, The Dr. Katherine Albrecht Show

Published in News & Information

A new study out of Pennsylvania State University College of Medicine links textured breast implants to BIA-ALCL, anaplastic large cell lymphoma.

 

Although a rare cancer. researchers believe the lifetime risk is 1 out of every 30,000 women with breast implants and if the numbers are underreported, could be as common as 1 out of every 4000 women with implants.

 

Although the implants are used to augment breast tissue, the malignancy is not a breast cancer but rather a lymphoma.

 

Lymphomas make up the most common of the blood cancers.  The cancer begins in the lymphocytes, cells crucial for maintaining one’s immune system. Two main types of lymphoma are Hodgkin’s and Non Hodgkin's.  Non Hodgkins is more common, and anaplastic large cell lymphoma is a subset if it.

 

 

anaplastic-large-cell-lymphoma-[3-ln072-3].jpg

ANAPLASTIC LARGE CELL LYMPHOMA/PATHPEDIA.COM

In this study, researchers reviewed 115 scientific articles from 1997 – January 2017.  Unlike the report released earlier this year by the FDA, the researchers did not find a link between BIA-ALCL and smooth breast implants.  Of the articles reviewed, 93 cases were cited and the cancer appeared 10 years after the textured implants were placed.

 

According to the American Society of Plastic Surgeons, there are currently 160 cases in the US and a total of 391 worldwide as of September 2017.

 

Last March the FDA reported 9 women had died from anaplastic large cell lymphoma (BIA-ALCL) possibly associated with their breast implant use.  The FDA received 359 reports of BIA-ALCL,  a rare type of non-Hodgkin's lymphoma, 9 of whom died as of February 1, 2017.

This is not the first time a link has been suggested.  6 years ago the World Health Organization suggested a link.  Then in 2011, the FDA identified a possible association between the two.  In 2016, the  Australian Therapeutic Goods Administration reported 46 confirmed cases with 3 deaths relating to breast implants.

 

The report last spring suggested that BIA-ALCL affected both smooth and textured implants. According to the FDA report, 231 of the 359 cancer cases provided information on implant type.   203 were reported to be textured implants and 28 reported to be smooth implants. When it came to silicone vs. saline implants, the FDA said 312 of the 359 reports provided these specifics and of those 186 reported implants filled with silicone gel and 126 reported implants filled with saline.

 

TEXTURED.jpg

 

So neither implant type appeared immune to the risk of BIA-ALCL but it appears the silicone, textured implants carried the most risk.

 

Now the cancer occurred within the breast and the FDA advises physicians to consider the possibility of BIA-ALCL if there appears to be a seroma (fluid filled cavity around the implant) or a contracture (pulling of the skin and tissue) near the implant.

 

In most cases the cancer is treatable, with removal of the implant and the surrounding tissue curative.  In some cases however, radiation of the area or chemotherapy is required.

 

Although 50,000 cases of non-Hodgkin’s lymphoma occurs annually in the US, it is unknown how many cases of BIA-ALCL occur each year.  Moreover, many countries may not have avid reporting systems of breast implant related cancers as we do.  According to the American College of Plastic Surgeons, close to 300,000 women receive breast implants each year, some of which for breast reconstruction after mastectomy for breast cancer.

 

The FDA reminds us that BIA-ALCL is rare and prophylactic breast implant removal is NOT recommended. However we need to be aware and evaluate if one develops swelling, pain, new lumps or asymmetry in the breasts….just as we do for those without implants.

For more on the study, visit here.

 

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 Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information

On Sunday, Green Bay Packers Quarterback Aaron Rodgers suffered a collarbone fracture and may be out for the season.  Here are your questions answered.

What exactly is a collarbone?

 

The collarbone is another name for the clavicle.  It’s the bone that connects the scapula (shoulder-blade) to the sternum (breastbone).  We have one on each side and it runs horizontally providing shoulder girdle support.  Not only does it provide upper skeletal strength and support but it also protects many major vessels that run underneath it.

 

 

clavicle

Image from AAOS

What’s a collarbone fracture?

 

The clavicle (collarbone) is one of the most common types of bones to fracture during sports injuries.  There are three major Groups or Types of clavicle fractures.

 

Type I – is the most common and occurs in the middle third of the clavicle

 

Type II – is the second most common and occurs distally, or closer to the shoulder.

 

Type III – is the most rare and occurs the most medially, or closer to the rib cage/sternum.

clavicle fractures

 

What are the signs/symptoms of a clavicle fracture?

 

Before bruising and swelling ensue, one will have sharp pain in the area of the collarbone and have difficulty moving his shoulder.

 

So signs of a clavicle fracture include:

 

  • Pain

  • Loss of range of motion of the shoulder

  • A bulge at the fracture site

  • Swelling

  • Bruising

  • Tenderness at the fracture area

  • In young children, not wanting to move the arm on the affected side

 

How are collarbone fractures treated?

 

If the bone has not shifted too significantly, clavicle fractures can be treated non- surgically. Arm slings will be given to decrease the movement of the shoulder girdle.  Pain medication and antiinflammatories may be prescribed, and physical therapy will be instituted immediately to improve range of motion and strength.

 

If the clavicle is displaced significantly from the injury then surgery will be needed to reunite the ends using plates, rods and screws.

 

How long does it take collarbone fractures to heal?

 

In adults, healing could take anywhere from 6-12 weeks.  For children, clavicle fractures may heal sooner.

How does one prevent a collarbone fracture?

 

During sports, protective equipment is key to avoiding injuries from falls and tackles.  As in Aaron Rodger’s and Tony Romo’s cases, being sacked by another large player barreling towards them must be avoided at all costs.

 

Just say NO to sugar.  This will be a hard one for me but if you do it, I will.

 

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 Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information

The World Health Organization (WHO) finds the number of obese children in the world to be 10 times greater than what it was 4 decades ago.

 

They estimate currently 50 million girls and 74 million boys are obese worldwide.

 

Back in 1975 only 11 million children worldwide were obese. Now the number sits at 124 million.

True, population has grown since then, but the percentage of children obese is exploding -- 19% of girls and 22.4% of boys in the US are considered obese.

 

Adult obesity is skyrocketing as well. In 1975 there were 100 million obese adults worldwide. This jumped to 671 million in 2016 and doesn’t include the 1.3 billion “overweight” adults.

 

The Center for Disease Control and Prevention (CDC) states the following:

 

Obesity is defined as having excess body fat. Overweight is defined as having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors. Body mass index, or BMI, is a widely used screening tool for measuring both overweight and obesity. BMI percentile is preferred for measuring children and young adults (ages 2–20) because it takes into account that they are still growing, and growing at different rates depending on their age and sex. Health professionals use growth charts to see whether a child’s weight falls into a healthy range for the child’s height, age, and sex.

  • Children with a BMI at or above the 85th percentile and less than the 95th percentile are considered overweight.

  • Children at or above the 95th percentile have obesity.

 

Why such a rise in obesity?

 

  1. We’re successfully fighting the war on tobacco. Adults especially can’t turn to a stick of nicotine as easily as they once could to curb their appetite.  Teen smoking is down as well, so their appetites may be up.

  2. We like fast food.  Its cheap, yummy and convenient.  For 99 cents you can get a small burger that is served to you in a matter of minutes and can be eaten before your next meeting or class.  Fast food contains excess calories, fat and preservatives that our body doesn’t need.

  3. We eat too quickly.  The speed at which we eat may affect our metabolism.  Eating too quickly prevents a satiety signal from reaching the brain, hence we will gulp down more food than is needed.  For more on this read here.

  4. We don’t move around as much.  We can all agree that children and adults these days don’t play outside as much as we did in previous generations.  And even if we did get some exercise in each day during PE or at the gym, we lose much of the ground gained when we sit on our computers at night for hours on end.

  5. More hormones are in our food.  Hormones such as steroids and recombinant bovine growth hormone (rBGH) that enhance food production in our food-producing animals may affect our metabolism.

  6. Sugar isn’t a treat anymore, it’s considered a food group.  In the 70’s if you got dessert one night at dinner it would be a rare treat.  Today kids have dessert at lunch and even breakfast has sugar levels over flowing the cereal bowl.  Excess sugar leads to fat storage.

  7. Our portions have gotten bigger.  Remember when the Quarter Pounder came out in the early 70’s and we thought it was the biggest burger ever?  Now people will eat two in one sitting.

 

Below is a table showing the difference in portion sizes today vs. the 1950’s.

 

portion sizes.jpg
Image from Daily Mail

 

What can we do to combat the obesity epidemic?

 

  1. Make exercise not a choice but a daily necessity. Schools should have English class conducted on walks around the school rather than sitting in desks. A 30 minute workout should be a given every morning without excuses. We brush our teeth, we wash our hair, we gas up our truck, we exercise.

  2. Eat fresh, avoid fast food.  The more junk food the more junk in your trunk.  Avoid preservatives and processed foods. Your body was designed to eat the basics. Give it what it needs.

  3. Eat slowly.  No need to chow down on the run. If you’re in a hurry then eat half the sandwich as save the rest for later. Which brings us to…

  4. Eat smaller portions. Get rid of the platters you call plates these days and eat your dinner off of a saucer dish. You’ll still fill up your tummy.

  5. Swap vegetables for carbs. It’s healthier, filling, and helps you poop.

Just say NO to sugar.  This will be a hard one for me but if you do it, I will.

 

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 Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information

Investigators believe the Las Vegas Route 91 Harvest Concert shooter, Stephen Paddock, suffered from severe mental illness that was never diagnosed. This seems obvious to us, as anyone who would kill 59 innocent people and wound hundreds more could never be of sound mind.

 

However, one would think a person this mentally unstable would leave a pattern of behavior footprints that would have been picked up earlier in his life.

 

Although no motive has been established in the shooting, investigators have interviewed multiple acquaintances who knew the 64-year-old real estate investor and were told he was disconnected, stand-offish, and lacked multiple social interactions. However, he easily flew under the radar as he had a girlfriend, appeared to be close to his mother, and had successful real estate dealings that funded his gambling habits.

 

Most mass shootings are committed not by those who spent time in mental institutions but by those who dined, shopped, and lived near their victims. And many have been under the care of medical providers, being prescribed medications that address psychological symptoms.  So how do mass shooters evade proper diagnosis?

They don’t fit the stereotype

 

To the layman, the average person with severe mental illness appears highly erratic, confused, unpredictable.  To a trained medical professional, the same symptoms would trigger their suspicions as well.

 

But the average killer may be a psychopath, being impulsive, antisocial, and exhibiting violent behavior.  If they don’t act violent or violently impulsive, they can elude the interviewer.

They may hide from the public

 

A mass shooter will plan their attack, may stake out locations, and but will overall remain isolated to avoid arousing suspicions. And a psychopath, may exhibit antisocial behavior.  So as they stay remain isolated and introverted, they allow less opportunity to be “made.”

They fly under the radar

 

As in Stephen Paddock’s case, he flew under the radar as he did not avoid the public.  He would drink, gamble, frequent casinos and appear to be very successful in his business/real estate dealings. With lack of a criminal record and violent interactions, the average person wouldn’t deem him suspicious of committing such a heinous act.

They don’t want to be treated medically

 

Many people with mental illness may have symptoms they wish to control, but will stop short of admitting they have a medical condition that needs treatment.  Those who suffer from delusions or psychosis may believe others are exhibiting the abnormal behavior, so why would they want to undergo treatment themselves?

 

Moreover, if they fear being “turned in” by the medical provider interviewing them and revealing homicidal ideation, they will be less inclined to seek medical help.

They may not have health insurance

 

If an individual with severe mental illness has difficulty maintaining a job, he/she most likely will be without employer-paid health insurance.  This limits access to seeking medical help all the more.

 

The chilling truth is we have killers who live among us who may plot and plan right under our noses.  Let’s pray they leave enough clues that they get caught before they carry out their plans.

 

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 Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in News & Information
Thursday, 05 October 2017 19:16

October is Breast Cancer Awareness Month

Celebrities such as Julia Louise-Dreyfus, Olivia Newton-John, Christina Applegate and Rita Wilson have revealed their breast cancer diagnoses, helping raise awareness for the most common cancer to affect women.  It’s the second most common cause of cancer death in females.

How common is breast cancer?

 

1 in 8 women will develop invasive breast cancer of the course of their lifetime. According to BreastCancer.org, an estimated 252,710 cases of invasive breast cancer are expected to be diagnosed in women in the US with 63,410 cases of non-invasive breast cancer.

40,610 of these women are expected to die this year of breast cancer.

How is breast cancer staged?

 

Breast cancer is staged based on size of the tumor, if lymph nodes are affected and whether the cancer has spread to distant areas of the body.  Prognosis varies greatly on the stage.

Screen-Shot-2012-09-27-at-9.59.51-AM.png

IMAGE ABOVE FROM JOHNSTON HEALTH

 

Is family history a huge factor?

 

85% of breast cancer cases occur in women with NO family history.

Screening of breast cancer

 

Mammograms are the first line screening tool for breast cancer and are currently recommended biennial for women aged 50-74.  However for those at higher risk, mammogram screening should start earlier, with possible follow-up ultrasound, and be performed more regularly.

FullSizeRender (1)

3-D MAMMOGRAM IMAGE

What are the risk factors for breast cancer?

 

Risk factors for breast cancer include:

  • Age greater than 50

  • Family History

  • BRAC1 and BRAC2 genetic mutations

  • Alcohol use

  • Never been pregnant or becoming pregnant for the first time over 35 years old

  • Early menarche at age 11 or younger

  • Obesity, especially after menopause

  • Dense breasts

  • Lack of physical activity

  • Use of oral contraceptives

  • Previous “precancerous” tumors such as atypical hyperplasia

  • DES exposure

  • Previous radiation therapy

 

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 Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.    The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in News & Information

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