Planning to live and die

Dr. Victor Sierpina

Dr. Victor Sierpina

A strange story was in the news last week that I have been using as a talking point about end-of-life planning.

A deer hunter in his 40s fell 16 feet out of a tree and broke his neck. As a result, he could not breathe on his own and was placed on a ventilator. The doctors told the family he would be dependent on this device for the rest of his life. The family knew he likely would not make this choice if given the option.

So, he was awakened from his sedated state and presented with the situation. He ultimately decided that he did not want to live hooked up to a ventilator for the rest of his life, asked that it be disconnected and died a few hours later. I might have made the same choice.

This true story brings to focus the importance of having patients and their families consider, discuss and sign advance directives, medical power of attorney, and out-of-hospital do-not-resuscitate orders. Continue reading

A real tricorder for your smartphone

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Many people may soon have a piece of “Star Trek” sitting at home in their own medicine cabinets. It’s not a Captain Kirk costume, Spock ears or a model of the Starship Enterprise, but a real-life tricorder.

When “Star Trek” began in 1967, the character Dr. Leonard “Bones” McCoy used this medical device in his work. Now, the Scanadu company has brought this fictional tool to life and called it the Scout.

To use it, a person holds the round, palm-sized tricorder to his or her temple, and it measures temperature, heart rate, respiratory rate, systolic and diastolic blood pressure, blood oxygen saturation and stress level and performs an electrocardiogram.

It does all this with optical sensors in 10 seconds with 99 percent accuracy. It sends the readings via Bluetooth to a smartphone, where apps track and analyze the data. Continue reading

Use antibiotics judiciously to preserve power to heal your child

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

Despite a growing concern in the medical community over antibiotic resistance, parents still request that pediatricians prescribe such medications for their children even when the antibiotics are unnecessary, according to a study published by the American Academy of Pediatrics.

Researchers surveyed 400 parents and 61 pediatricians and found that 18 percent of parents give their children antibiotics without consulting a physician.

Nine out of 10 parents thought antibiotics were needed for ear infections, eight out of 10 thought antibiotics were needed for throat infections and six out of 10 thought antibiotics were needed for cough and fever.

On the other hand, the physicians surveyed felt like the medication was not needed in most cases. Most coughs, ear infections and sore throats are caused by viruses. Continue reading

Staving Off Dementia

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

“When I was younger, I could remember anything, whether it had happened or not; but my faculties are decaying now and soon I shall be so I cannot remember any but the things that never happened.”

While American novelist Mark Twain can invariably add his iconic sense of humor to any situation, it is no laughing matter when patients lose their memories and cognitive function to dementia. And for their family members, there is hardly anything harder than caring for a loved one who can no longer remember them or any shared experiences. But lowering a person’s risk of dementia may be as simple as changing his or her lifestyle.

The incidence of dementia increases with age. As the average age of Americans increases, the number of people with dementia also increases. In 2010, more than 30 million people worldwide had dementia, and this figure is estimated to more than triple by 2050. Continue reading

How to make the most of a doctor visit

Dr. Victor Sierpina

Dr. Victor Sierpina

If you have an ear infection, a laceration, broken bone or other acute problem, the answer to this question is easy. You expect and likely will receive immediate, competent and focused care of your condition.

However, in the primary care arena in which I work, these kinds of visit are a relatively minor, simple part of our daily work. Much more time and effort is dedicated to the management of chronic diseases, doing annual physicals and attending to preventive and screening issues. Trying to manage these larger issues is not usually possible during an acute care visit so another appointment generally needs to be scheduled.

So how do you make best use of these more complicated visits? In the words of the Boy Scout motto, “Be prepared.” Continue reading

Choose which health insurance plan is best for your family

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

The American Academy of Pediatrics recently reported in their Parent Plus column some information about the Affordable Health Insurance Act.

Starting Jan. 1, almost all Americans must have health insurance. If you do not have health insurance, you may have to pay a fee.

Now is a good time to see what health insurance benefits are best for your family and whether you qualify for a lower cost plan.

If your family already has health insurance through an employer, there is no need to change anything. Children 26 and younger can be covered on their parents’ health plan.

If you do not have health insurance, you can find options through your state’s Health Insurance Marketplace. You can sign up for an insurance plan during the open enrollment period through March 31. Continue reading

5 steps toward contentment

Dr. Victor Sierpina

Dr. Victor Sierpina

What does it mean, to be content? Is it even possible?

I will be the first to admit that attaining a mental or spiritual state of feeling truly content is challenging in this busy world.

In our era, the stock market, consumer indexes and virtually the whole economy is keyed around how much stuff we buy and how much we spend. Christmas is an economic failure if we don’t spend enough money.

To feed the open maw of this insatiably hungry beast, we are constantly barraged with ads, images, glamour shots, fashions, toys for old and young, amusements and other titillations encouraging us always to want more, need more and therefore spend more.

It seems we are systematically encouraged to be dissatisfied with our lot in life. This is the opposite of contentment.

Instead, we are encouraged to acquire the latest gadget, bauble or status symbol. There is always something new to buy or some new thrill to distract us and make us feel satisfied, at least for the moment. Continue reading

Breast cancer awareness is more than mammograms

Dr. Tristi Muir

Dr. Tristi Muir

Our Bodies, Our Lives

Breast cancer awareness means more than mammograms

This month my scrub cap for surgery is decorated with pink ribbons. Football players are wearing hot-pink cleats. During October, a variety of products and events encourage us to commit financially to finding a cure for breast cancer.

One in 8 women will be diagnosed with invasive breast cancer in our lifetimes. While men can develop breast cancer, it is 100 times more common in women. The American Cancer Society estimates that in the year 2013, there will be 232,340 new diagnoses of invasive breast cancer.

Each of these “cases” is a daughter, mother, sister or friend. Continue reading

Where does itchiness come from?

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Anyone ever bitten by a mosquito can attest to its itchy consequences.

New research has discovered just how our bodies detect and process itching, leading to a better understanding of our reaction to itching and hopefully better treatments for it.

The clinical term for an itch is “pruritus,” and at least 16 percent of people experience an itch that just doesn’t go away.

Long-term itching is the most common dermatologic complaint and can be caused by chronic renal disease, cirrhosis, some cancers, multiple sclerosis, diabetes, shingles, allergic reactions, drug reactions and pregnancy.

Prolonged itching and scratching can increase the intensity of the itch, possibly leading to neurodermatitis, a condition in which a frequently scratched area of skin becomes thick and leathery. The patches can be raw, red or darker than the rest of the skin. Continue reading

Tips to follow for a safe Halloween for children

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

It’s almost Halloween again. Before sending your little ones out in search of candy, consider the following to ensure that he or she has a trick-free Halloween:

• Don’t buy a costume unless it’s labeled “flame-retardant.”

• Make sure that wigs and beards don’t cover your child’s eyes, nose or mouths.

• Encourage your child to choose a costume without a mask. Masks can make it difficult for your child to breathe. Use face paint instead.

• Suggest a light-colored costume for your child or add glow-in-the dark tape on the front and back of a dark costume.

• Avoid oversized or high-heeled shoes that can cause your child to trip and fall.

• Make sure that accessories, such as swords or wands, are flexible.

• Put a name tag with your phone number on or inside your child’s costume.

If your child will be trick-or-treating: Continue reading