Can’t Swallow That?

Difficulty swallowing, known medically as “dysphagia”, is a very common complaint. In fact, up to nearly a quarter of patients seen in primary care settings will suffer from this problem. Dysphagia is definitely more common in the older population, whether they are in nursing homes or living independently.

What causes dysphagia? The most common cause depends on the age. In small kids, there may be structural problems present from birth that may need surgical correction. In adults, however, the cause is often something that can be fixed more simply, with medications and/or behavior changes.

Smoking, excess alcohol, and obesity all … Read more

Hormones: Should We Take Them or Not?

Hormone replacement therapy (HRT) for menopausal women has been back in the news. In medicine, we’ve swung from placing virtually every post-menopausal woman on estrogen to barely allowing even the most miserable, hot-flashing, night-sweating woman to have any (after the Women’s Health Initiative- WHI). What’s the answer? Is estrogen safe or not?

As always, the devil is in the details. The WHI never said that we shouldn’t be using estrogen (and progesterone) for women who had menopausal symptoms (such as hot flashes and night sweats). In fact, this is an excellent use of estrogen, and physicians and patients need … Read more

Gardasil: Not for the FAINT…

Continuing my discussion this week about the HPV vaccine Gardasil, I’d like to address side effects. At this point in the United States, there have been over 46 million doses of HPV vaccine administered (the vast majority Gardasil), which implies over 15 million people (since a series includes three shots.) Unfortunately, when you start involving a population this large, within that group there will be uncommon diseases that occur in the general population. For example, a disease that occurs in only one out of 500,000 will have 30 cases in this group. Sorting out which of these rare occurrences are … Read more

Gardasil: What’s IN it?

Continuing the discussion about the HPV (Human Papillomavirus) Vaccine Gardasil...I’d like to step back and talk about exactly what is IN this vaccine. Much of the fear about immunizations surrounds concerns about the makeup of the vaccine, and what peripheral damage could potentially be caused from the content.

First of all, can you “catch” HPV from the vaccine? NO. Absolutely NOT. There are vaccines (like chicken pox or measles) that contain essentially watered-down versions of live virus, and as such, can in the course of an appropriate response cause a mild version of the disease as the body reacts … Read more

Gardasil and Increased Promiscuity? NOT an Issue

The Gardasil vaccine is back in the news. Gardasil is the vaccine recommended for both boys and girls to protect them against the Human Papillomavirus (HPV), which causes genital warts and cervical cancer) Yesterday, an article published in Pediatrics confirmed that girls who had received this vaccine did not, in fact, have any increased sexual promiscuity compared with their peers who did not receive the vaccine. Why was this study done? One reason for lower vaccination rates with this recommended vaccine (compared to other vaccines recommended in this age group) was parental concern that giving their preteen and teenage daughters … Read more

Teen Sexting & Risky Behavior

In 2009, headlines already noted that one in five teens “sext” despite knowing the risks. Teens sexting may be old news, but as the percentage of teens involved in cell phone based sending and receiving of sexually explicit pictures and texts increase, the links from this behavior to end points such as sexually transmitted infections and/or pregnancy need to be assessed. Last month in Pediatrics, a new study focused on teens & sexting: “Sexually Explicit Cell Phone Messaging Associated with Sexual Risk Among Adolescents“. Nearly 2,000 students from Los Angeles high schools were surveyed to try and determine … Read more

What’s This Little White Pill?

I’m guessing that I am not the first person to stumble across a stray pill – whether it’s in the bottom of the purse, on the bathroom floor, or maybe in a pill bottle where you tossed together all your meds for a trip.  Certainly it can be alarming if you find a stray pill in your house- whether you are worried about your pet accidentally eating it or wondering if your teen/spouse/roommate is using a new medication. Today I simply want to share that if YOU find one of these strays somewhere and want to know what it is, … Read more

Go Purple – Help End Alzheimer’s Disease!

The heart remembers…Today, September 21, 2012, is Alzheimer’s Action Day– so put on your PURPLE and help to raise awareness for this devastating disease. Over 35 MILLION people worldwide and 5.4 MILLION Americans are living with Alzheimer’s disease (AD). $200 BILLION will be spent in the US alone this year caring for people suffering with AD. This disease slowly invaded my amazing mother’s brain, creeping along for over a decade, steadily pulling her away from our family. As we don our purple today, we stand together with every other family who has helplessly witnessed this “long goodbye”. I hope … Read more

New Study Offers Hope for Alzheimer Prevention

A glimmer of hope shines in the devastating world of Alzheimer’s Disease (AD), as this week a study published in the Archives of Neurology journal reveals that a class of blood pressure medications (Angiotensin Receptor Blockers, known as ARBs) may reduce the risk of developing Alzheimer’s. Although the mechanism of Alzheimer’s is not fully understood, we do know that abnormal deposits of amyloid (a protein) occur early in brain as an early stage in the disease process. This new study, the Impact of Angiotensin Receptor Blockers on Alzheimer Disease Neuropathology in a Large Brain Autopsy Series, looked post-humously at … Read more

It’s BACK – the Cursed Halloween Candy

Yes, we’ve just got our kids starting to settle into their school routine, and yet what has already appeared in the grocery stores? That’s right- Halloween Candy. I swear this is the start of the fall fattening project…

Don’t get me wrong, I love Halloween! I adore seeing all the kids in costumes and frankly, I pull out a witch or Mrs. Incredible costume for myself each year. But here is the catch- candy to the max on one night per year is no big deal (brush & floss those teeth afterwards, of course.) Unfortunately, what happens in many … Read more