It’s been a while since I stated my core beliefs and give my reasons for taking up this patch of real estate on the Internet. Here is one that I produced just this very morning.
Filed under Doctors by on Aug 23rd, 2011. Comment. 
Recently, a patient’s widow called to cancel a routine assessment because the patient suddenly died. There had been no freak heart attack and it had not been one of those undiagnosed cancers. He just “died, suddenly, in his sleep, I guess,” she said. That got me thinking.
The first class of drugs I think about, when I think of sudden death, are the stimulants. I remember when someone decided that everyone who was going to get stimulants needed to have a “cardiocentric” examination first. Doctors asked a lot of questions about chest pain, and administered an electrocardiogram. These precautions were especially interesting because they were – of course – used before prescribing Ritalin. Many child psychiatrists had laughed at me when I cautioned usage of this job, claiming it was the safest medication ever invented. Once – at the peak of my massive weight — an endocrinologist offered me a prescription of Meridia, to get rid of my excess weight. He did not think the fact that there had been a “few” reports of sudden death should get in the way of my using it. Read more on Sudden Death in Psych Patients — From Medicine…
Filed under depression, Diagnosis, End Of Life, medicine, prescription drugs by on Aug 19th, 2011. Comment.
I’m nowhere near what anyone would call a “News Junkie.” My husband, a former newspaper man, often calls my attention to articles of interest and I see headlines occasionally on various web pages, such as Yahoo or Google. But this type of story seems to come up pretty regularly any more.
Yes, most people in our country are in terrible shape. I probably harp about it more than I need to. But remember what Mark Twain (another newspaper man) once said:
“Everybody talks about the weather, but nobody does anything about it!” Read more on Who Needs Wonder Drugs? We Have Vitamin C!…
Filed under medicine, News, prescription drugs, weight by on Aug 19th, 2011. Comment.
I think everybody loves to eat. Eating can be pure, sensual delight. And those that don’t like eating – well, they come see somebody like me because that can be a real problem. It can be a problem for those that REALLY love to eat also – like the 700 lb. woman that not only makes her living in eating contests, but wants to be a record holding “Most Obese Woman” in the world.
I’ve seen some patients who could be in the running for this. Sometimes they have medical treatment to blame. Many medicines can add weight even if you eat nothing but air and water – seriously. I have seen people gain weight regularly, usually 15 to 20 pounds a month or so. Steroids, psychotropics and some other drugs can make you gain weight and keep you losing weight. Even treatments for diabetes – like insulin. Read more on Will Your Doctor Help You Lose Weight? Fat Chance!…
Filed under Alternative Medicine, medicine, weight by on Aug 18th, 2011. 1 Comment.
“Old Marley was as dead as a doornail.”
— A Christmas Carol (1843)
Thank you, Charles Dickens, for creating such a wonderful, enduring story, and such an apt simile. If you hadn’t heard it before, that’s probably because it is usually omitted from the children’s versions of the oft-told (and filmed and broadcast) tale. With everyone from Michael Caine to (my favorite) Mr. Magoo starring as the wickedest man who ever snorted “Bah Humbug!” and was converted to the most ardent celebrant of Christmas by the end of the story.
A wonderful, happy story — and it deserves to live forever. But death is not terribly suitable material with which to start a children’s story.
Young women (and men) — some no older than children and many who could be termed “recent children” — were ardent fans of singer Amy Winehouse — who is now “dead as a doornail.” Read more on Amy Winehouse Proved Drugs Aren’t Glamorous…
Filed under abuse, Addictions, End Of Life, Substance Abuse by on Aug 18th, 2011. Comment.
The next person to see me made a dramatic entrance. First, she had gotten a head start on her crying in the waiting room. But more than the sound of her crying and sobbing, she could barely make it through the waiting room door. I am no good at guessing someone’s weight. She later admitted to being 380 pounds. I took her word, as our clinic’s scale only went to 300. Her general appearance was that she was swollen with water – a human sponge. The edema bloated every part of her body, and her crying eyes were nearly swollen shut. I started by asking her when her problems began. She was now 42, and said she had thought everything was okay until age 15, when she had been raped by a “friend of the family.” This man was not really a friend, he was a person who went to the same church. Moreover, he was a Sunday school teacher. You would think that by now everyone would know that being a Sunday school teacher does not make someone a saint. But this family had not yet figured it out. In many such cases, this type of person is shielded by the religious community, and even the victim’s parents are often in denial. This woman was lucky. Her parents told her that they were going to prosecute this sinner to the extent of the law.
There was a trial, and she had testified. She thought everything had turned out great, and so did her parents. The rapist was convicted and sent to jail. Again, those who are experienced in these things know that this type of trauma is never over quite so easily. The woman went on with her life and ended up in a really abusive relationship — the kind where someone locks you up and won’t let you leave the house and beats you if you look out the window. By the time she got the courage to escape this living hell and seek a shelter, had a peck of kids. They lived in this shelter for over a year before she found that she had what it takes to start over. She went to school, gained some clerical skills, and started over. She was actually doing pretty well until something happened that triggered a demon she didn’t know had possessed her. She was called for jury duty and went, with pride, wanting to do her civic duty. She couldn’t. She had a panic attack as soon as she entered the courtroom. She ran to the ladies’ room, threw up, and tried to enter the courtroom again – and it was even worse. People thought she was having a heart attack, and they sent an ambulance for her. I do not recommend this means of getting out of jury duty, although it sure worked for her. Read more on Murphy’s Law Of Medicine At Work…
Filed under depression, Diagnosis, Doctors, prescription drugs by on Aug 17th, 2011. Comment.
Why would a pharmaceutical manufacturer want to change a drug from prescription to over the counter (OTC)?
Well, one thing I’ve learned in my lifetime is – When the Question is “WHY?” then the answer is “MONEY.”
In this case, the most obvious reason is more money for pharmaceutical companies. I certainly cannot think of anything — I mean any way shape or form — that can benefit patients.
Oh, sure – in our economically-ignorant country, many people think – “Whee! I can buy any drug I want without spending money on a doctor’s appointment and without having to get a prescription! ”
These people are prime candidates for the Darwin Awards.
Yes, believe it or not, the “RX to OTC Switch” can actually HURT patients.
Drug patents expire relatively quickly, competitors are waiting at the gates with generic equivalents, and when a drug becomes OTC, there is a chance that insurance does not cover it.
This makes insurance companies and government programs (Medicare, Medicaid/Medi-Cal, etc.) very happy. They are so strapped for cash that even paying for a cheaper generic is a strain on the budget. When this kind of money is involved, you can bet that lobbyists are pressuring the government to ease their restrictions so that drugs once considered risky enough to warrant a prescription so that not just anybody can have access will be available to anyone who can walk into a drug store or click on a shopping cart on the web.
Patients will have to pay for OTC meds in cash money and doctors usually do not bother prescribing an equivalent drug. If they do not already know of an equivalent, they will probably — and generally do — just tell a patient to go buy it over the counter.
A patient who cannot afford the drug will go off it.
OK – so what’s the big deal if a cold medicine, allergy remedy or hair-restoring pill is no longer a prescription drug?
Filed under prescription drugs by on Aug 14th, 2011. Comment.
Once my husband found one of those funny videos that is called “Viral” because of the way it spreads across the internet like wildfire. This one was an episode of a 1950s game show.
Like many shows of the era, it had a sponsor’s name and logo prominently displayed in every camera shot – the backdrop of the set where the panel sat and I think even the desk fronts of the panelists. The sponsor was Raleigh cigarettes.
The show had made the rounds of the video sites because it was so hilariously biased. The simple quiz format always yielded the same answer –
“What is the capital of North Carolina?” Read more on Infiltrating Medical School and Continuing Education…
Filed under big pharma by on Jul 20th, 2011. Comment.
I recently initiated what I call “The Renegade Doctor’s Massive Weight Loss” support group for people who must lose 100 lbs or more for health reasons.
Registration is free and I will be sending regular messages by email about how I achieved my 160-lb weight loss withough diet, exercise, drugs or surgery, as well as recent research, myth-busting facts, nutritional supplement news,and general encouragement and support for those who are undertaking a major weight loss.
Most diet articles, books and programs are for people who want to lose ten or twenty or maybe as much as 50 lbs. However, the majority of obese Americans are well over that. Carrying around 100 lbs or more of extra weight is often called “The American Disease,” and foreigners make jokes about fat Americans and their cheeseburger-culture of overeating and obesity.
It’s terrible to be shamed and made to feel guilty because of your weight. It’s not only cruel strangers, but family members and even doctors who perpetrate such behavior.
Nothing is simple if you do it alone, and massive weight loss is a difficult project. In fact, it’s generally considered hopeless and overweight people are advised to get surgery or take drugs that have harmful side effects.
I’m making my support group available to anyone who is interested, and to make sure that you aren’t getting spammed, I’m making it by subscription only.
Of course, like my subscription newsletter, it is free to sign-up and you can discontinue at any time.
With so much focus on weight and body image in our culture, it is no wonder that people who are heavy get depressed and develop all kinds of physical and emotional symptoms.
Here is the web page where you can read what the support group is all about and sign up for the mailing list.
There will also be free phone conferences, brochures and other support material to help you.
I know how difficult it is — I know how painful living as an obese person can be. And I know the solution.
Take care and be happy — and healthy.
Estelle Toby Goldstein, MD
The Renegade Doctor
Filed under weight by on Jul 20th, 2011. 1 Comment.
Several conversations fly into my mind, separated widely in time and space, about what college is supposed to mean and do. I remember one of the few social outings of my college years, a cocktail party with other advanced chemistry students and a few professors, where mostly everyone but me was drunk. We were at the house of a chemistry professor of Kiwi (New Zealand) origin, who was probably the drunkest of the lot.
Another chemistry professor asked me why I was in college. I told him, with sober placidity, that I was simply doing the things I had to do before I got to medical school — medicine being my passion. He launched into a tirade about how I was in college in order to learn. I should learn all I could about anything I could because this would be the last chance in my life to do so, before I went into that sickly-overblown trade school that is medical school, where I would be restricted to learning things that would make me more money. During my childhood, my father rhapsodized about his Harvard experience and how he wanted me to have one equally fulfilling — hopefully at Harvard. Growing up in Harvard it is not hard to generate negative feelings about perceived elitism, more financial than intellectual, dominated by a heavy veneer of snobbery, which my father joyously promulgated.
I was busy spending most of youth being overweight and thus largely a social pariah. Unfortunately, I got little recognition for these twin achievements – unlike the deliciously funny portrait of “Overweight Achievers” in Woody Allen’s film “Celebrity.” Read more on Is College A Waste of Time?…
Filed under Doctors, Education, News by on Jul 19th, 2011. Comment.