medicine

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To tell people who are overweight that they need to move around more and count calories is kind of like telling Yogi Bear to leave tourists alone and avoid eating the contents of picnic baskets.  It ain’t gonna happen.

I have long ago surrendered to the fact that logic, reason, science and – yes, even the truth – have overcome the need to manipulate the population with misinformation in order to control them and to wring every bit of money out of them.

I give professional nutritionists the benefit of a doubt — even though two of them wrote this book.  After all, every dietitian I have ever known was “recovering” from at least one eating disorder.  And usually on the “lower serotonin” side of life, probably a little obsessive, maybe a little depressed.

Mostly, these are people who believe everything they are told without questioning, or exist on “wishful thinking.”  Or they have a political or professional agenda. Read more on How Many Calories in B.S.?…

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Sure, the malpractice system is broken.  And there are lots of suboptimal doctors out there.

I have told some what the correct diagnosis is and they have ignored me.  Some are too busy to take phone calls from me.  Institutions have refused to order tests that I’ve requested.

On the other hand, I have been lectured about the necessity for “cover your ass” medicine.  I could not practice it if I wanted to.  Nobody would pay for it.  In my specialty, I am always told to look for ways to cut costs while some patients cry to me they cannot afford their medicine.  We do our best. Read more on Capping Malpractice Damage Awards…

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Narcissistic men have raised cortisol – or physiological stress — from being these bully-others sorts. But women do not? Hmmm.

A narcissist is somebody who puts their needs above yours in any relationship.  I can count on one hand the times I have seen them in treatment.  They are “bullies” and we usually see their victims.

Cortisol – commonly known as the “stress” hormone — can be accurately measured with a mouth swab.  Because of this, people can do research — many of whom appear to be a great deal more open minded than doctors. Read more on Physiological Validation of Narcissism…

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“Concordance.”  That means doctor and patient wanting the same thing.  In psychiatry we call it a “therapeutic alliance.”  We work for it — assuming we have the time.  But if the time is not there, on some level we all know that nothing will happen.

Leave it to the pharmacists to at least touch on a reason for “lack of concordance” that nobody seems to discuss. “With increasing numbers of medications shown to do more good than harm when taken as prescribed, low compliance is a major problem in health care,” reads an unpretentious sentence in the abstract.

And people wonder why there is no “trust” between patient and doctor. Read more on Trusting Your Doctor…

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To paraphrase some recent political campaigns, the FDA was against Qnexa before they were for it.

I’ve written about this diet drug compound before —  HERE And HERE.

Last time I wrote about this “drug,” I thought it was down for the count. Aauugghh!!!!

Like a scene from “Night Of The Living Diet Drugs” – it is back from the grave.

You bet your life! (Literally if you take this) – our protective government watchdogs at the FDA originally said this was too dangerous to unleash on the public.  Then – as the politicians say – they did a “Flip Flop.” This No-Vowel remedy QNEXA (ok, it has a couple of vowels, but not enough) is not actually a drug — it is a combination of two drugs.

This is of course, the cheapest way to get a new product on the market and eliminate R&D costs as well as testing for safety and efficacy. The company takes two separate FDA-approved agents and combines – kind of like making Frankenstein out of left-over body parts.

(This is turning into a Halloween column, isn’t it?  Sorry.) Read more on They’re Ba-a-a-a-ck!!! Zombie Diet Drugs!!!…

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Many people are proud of the state from which they came. But I value the state they (we, all of us) can go to.

It’s called a “Resource State.”

Don’t bother looking on a map – unless it is a map of the cerebral cortex.  Yet, it isn’t clearly defined as a location in the brain either.

I know it sounds mysterious, but it is easy to access and the benefits once you get there are astronomical.  I think I need to give you some illustrations to make my point.

Once when I was in prison (that always gets attention – but actually I was employed as a prison psychiatrist and not serving time for criminal activities) I treated a young man of 28 who was doing time for armed robbery.  His problem was depression with occasional suicidal ideation. Read more on The Resource State — Your Magic Ticket To Happiness…

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When I was little, my Grandfather-of-Blessed-Memory (maternal) came to visit us at 6 am every Sunday morning, arising very early to drive about two hours from Springfield to our Boston suburb of Chelsea.

Springfield would be considered “way out west” as compared to civilized and urbanized Boston, so it is like the country mouse coming to the big city.

He said the road was not busy and drive was relaxing and pleasant for him. But his visits were anything  but relaxing and pleasant for us, who would much rather have tried to sleep in on Sunday.

The exception was my paternal Grandmother-of-Blessed-Memory – who was also an early riser. Older folks often seem to get up early.

(That’s how I know I’m not old yet – I still love to sleep late). These two senior members of our family seemed to get along well.  Grandfather called her “Mother Goldstein,” and even brought her a nice bottle of (coincidentally named) “Mother Goldstein” brand kosher wine. There was one incident that I recall that upset a peaceful Sunday morning when I was about five. I came downstairs in my best baby blue lace dress to hear Grandfather yelling at Grandmother never to serve him that “horrible drink” again. Read more on Chicory, Belgian Endives And Me…

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“There’s no such thing as a free lunch” – but there are plenty of free samples when you go to your doctor’s office for a prescription.

Be wary of free samples.

What? Am I asking you to look a gift pill in the mouth? Drugs are expensive, even the co-pay for drugs can be expensive.  What’s wrong with getting a freebie?

First, the drug companies that make them do not give them out forever.  Usually, they give out samples on a newer drug as part of a launch – kinda like a “grand opening” at a store.  The prices are really great that first week and it gets you trained to go to that store.

Another reason drug companies discontinue free samples is that, very often, the insurance companies or government programs may not have them on the “formulary” (the list of available drugs) right away.  As soon as the relevant insurance (mediCal in California) starts paying for them, you can say “Bye-bye” to free samples. Read more on Free Samples Might Carry Heavy Cost — Health…

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I was trying to remember when prescription drugs were allowed to advertise on television (called “Direct To Consumer Advertising, or DTCA”).  Fortunately, I didn’t have to bust my memory cells – I just had to “Google it.”

1995. The year all HHHHell broke loose.  At least if you were a doctor.

Suddenly, patients could make their own diagnoses and prescriptions and just phone the order in to their doctor.  At least, that’s how most patients thought it should work.  And – hoo boy! – were they upset when it wasn’t quite that easy.

Comedian Dennis Miller has a hilarious line: “I divide medical practitioners into two camps. Those who will give me a scrip for Vicodin over the phone, and those who won’t.”

Hilarious if you aren’t a doctor, that is. Read more on RX Package Insert — Just Read It!…

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Number 5 in the USA Today catalog of medical changes in the past 25 years is (imagine a drum roll playing – and CYMBAL CRASH!) — antidepressants are the most popular drugs. Read more on Antidepressants Are Popular — And Dangerous…

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