People are not wired the same.

Individual differences are the spice of life and medicine.  I love people, their verbal discourses, because they are so delightfully individual.

To me, the biggest problem with medicine is something I actually never heard anybody else discuss.  I call it “norming.”

Maybe there is no other way to get started on developing a new treatment that could help many people who have similar afflictions.

But people are so different that what is life-saving for one may be poison for another. Read more on Dangers of Energy Drinks…

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My field is health – which is radically removed from bodybuilding.  Oh, the work-out gurus will tell you they are experts in nutrition and health, but their knowledge is often flawed (to put it charitably).  And they view someone like me with “Book Learning” as a real kill-joy.

There is something special about bodybuilding supplements — allegedly natural ones.  I remember a fairly brittle bipolar – a young and pumped-up muscular male model — who refused, as both I and his girlfriend pleaded with him, to give up a body building supplement. I told him the contents seemed strange and unknown to me.  This supplement had made him go angry and seemingly psychotic and she was ready to break up with him if he did not stop this strange supplement.

The girlfriend trusted me.  The young man was lost in wishful thinking (and perhaps an adverse drug reaction bordering on psychosis). Read more on Deadly Health Supplements…

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Well, it turns out there aren’t really gators in Gatorade.  The drink was named as such because a University of Florida coach – team name Gators – worked with a researcher to find a way to replenish fluids in his heat exhausted, wilting athletes.  And Gatorade was born. Read more on What’s In Gatorade? Gators?…

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I had a patient once, long ago and far away, who was the worst “Caffeine Fiend” – properly known as “caffeinism” in medical lingo — I had ever heard of. 

He was only 27 but depression and obesity added ten or fifteen years to his appearance. He was single and did not have much of a social life, but he did not much care.  He was one of the earlier generation of people to build himself a career doing something with computers, with some sort of techie abilities which I could not understand at all. That enabled him to work from home at least part of the time, and only occasionally would he have to make a mad run to and from his employers’ office. This was in rural northern California, somewhat removed from the Silicon Valley mainstream of this type of activity.

The “from” part was important, as he did not much like to hang around with other humans, much preferring the company of his computer. Read more on Tale Of A Caffeine Fiend…


Who should be worried about bath salts abuse?

I mean, what’s the worst that could happen?  You should start smelling great?  Believe me, I’ve had some people in my office that could use some abusive bathing.

But on a serious note, there have been some street drugs that are sold as bath salts and those can cause a lot of problems.

As far as the FDA is concerned, soap, bath oil, and legitimate bath salts aren’t regulated.  As for the Fair Trade Commission, there are some labeling requirements for products that make a claim (such as moisturizing the skin).

But the bath salts that have the feds worried now are a legal high – and they want to make all “highs” illegal. Read more on Stimulating Bath Salts — Avoid At All Costs…

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She was 29 years old and so obese that she had to walk through the door to my office sideways.  She had put on most of the weight, she said, after she had
been date-raped.

She did not remember much about what happened.  She knew the guy who had been with her, and avoided him as best she could, although she still had thoughts of him, that intruded into either her nighttime dreams or her daytime thoughts.  And she had the characteristic “hyper-arousal.”  I have learned, the hard way, never to think of slamming the door or clapping my hands to test this one.  I only did that once or twice and always regretted it.  I just asked her if a sudden noise made her jump in the air, ever, and she nodded.  “How did you know?”  she asked. Read more on Roofies, Ruffies, or Mexican Valium: It Doesn’t Say “I Love You.”…


People who have panic disorder go to doctors to take care of it.  I have had maybe hundreds of patients, more than I can count over my years of practice, who have come to me with this.  Most of them do well. Usually the panic disorder runs its course.

That is not to say that panic disorder is not terrifying.  Often people believe that their first panic attack is a heart attack.  Often they have come to me already addicted to benzodiazepines by emergency room physicians who (understandably) worry a lot more about the immediate comfort of the patient than about the long term situation. Here is the official government take on panic disorder. Yes, find a psychiatrist you can trust. Yes, they recommend family and support groups.  Good stuff, but free and easy to recommend. Yes, there is some exciting new research but as long as insurance companies and HMOs determine how people get treated, it is unlikely that research will be quickly translated into treatment.

Most people who go with the mainstream treatment do pretty well. Here is another description of mainstream treatment, a little more complete. Read more on A Real Doctor — Like House MD…


She was 33, blonde and attractively dressed.  She had been stable on some medications for bipolar illness for many months before seeing me for a renewal.  She told me her marital relationship was wonderful.  They ran a little boutique together in the historic part of downtown.  Not getting rich, but doing what she loved.

Coffee JittersOnly one problem — her husband said she became difficult when she drank too much coffee.  I asked for some description of the “difficult.”  She noticed she was nervous and had trouble cooling down later.  She had “panic attacks,” which had not been a problem before.

They sounded exactly like the description of that disorder in DSM-IV – the one nobody likes applied to them – the “B” word.  The things she said her husband had said about her sounded like the criteria for mania.  No sleep, loud arguing, anger, nerves, etc.  “Let’s look at cutting out the coffee,” I told her.

She normally drank as much as a half-pot in the morning at home before opening the boutique.  That may not sound like much, but others have had similar symptoms from less.  She had figured out herself that coffee in the afternoon messed up her sleep beyond description.

Caffeine has a LOT of effects on the body.  If it had been a modern discovery, instead of the old myth about some frisky goat in the near east chewing berries off a tree and surprising a young shepherd by omitting sleep, caffeine would have caused the FDA a struggle to pass it because it does so many things.

First, coffee is absolutely NOT the only beverage that has it.  There is generally more in caffeine-containing cola drinks. Read more on Caffeine As A Bipolar Trigger…

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