Aspirin for people over 70? New science right here.

Photo: NIAID

I know many people who take a daily aspirin in an effort to stay healthy.  I even know many doctors who recommend it.  But you may be surprised to know about what the actual medical science says about aspirin.

Back in 2016, I wrote a post that proved to be one of the most-popular that whole year.  In that post I described the guidelines for who, and who should not, be taking a daily aspirin.  Fortunately, that post is still largely accurate and these guidelines have not changed in the past two years.  You can read that 2016 post here.

But there is now a massive new study about a group of people for which there was no medical science one way or the other.  The new study, called ASPREE (ASPirin in Reducing Events in the Elderly) was just published in September 2018 and it specifically looked at healthy people over age 70.

The one thing you need to know

There is no data to support healthy people 70 and older for taking a daily aspirin, and in fact, it likely has more risks than any potential benefit.

I will expand a bit on this new data in this post.

Continue reading

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Posted in Geriatrics and aging, Medical research, Pearls from Medical Science, Preventive care, Tips from Healthy Matters radio broadcast | Tagged , , , | 1 Comment

Music and wellness

In this post I’m going to diverge slightly from my usual medical writing to talk about a different part of being healthy and well.  So I’m going to ask you to read an essay I wrote this past summer for the Minnesota Orchestra.  The link is repeated below after a few introductory comments.

How does music – or art in general –  relate to health and wellness?

There is a notion in healthcare that I think we need to explore further.  In brief, it is likely true that stress in our lives may lead to health problems, probably via some complex inflammatory changes in our bodies.  So reducing stress in our lives is probably a good idea.  Art can certainly do that.

But beyond that rather nerdy physiologic reason, I think it is vitally important that each of us find beauty in our world.  Our national discourse is so ugly and uncivil that it is making us sick.  Our daily lives are filled with screen time, busy schedules, bills to pay, and the daily tasks of life.  All of this makes music and art and beautiful things all the more important.

I often turn to orchestral music.  I spend lots of evenings at Orchestra Hall in downtown Minneapolis and I am privileged to have met some of the talented people at the Minnesota Orchestra.  They have graciously published my thoughts on music on the orchestra’s website and I invite you to read it by clicking below.

For my essay, click on “A Life with Music” at the Minnesota Orchestra website.

I also wrote a piece in August 2016 about my trek to Europe with the Orchestra in which I talk about saunas full of naked people, Beethoven, bicycles in Europe and my thoughts on being abroad with a world-class orchestra.  Read about all that in “The Finer Things” here.

Comments are welcome below.  Subscribe by e-mail to MyHealthyMatters if you wish to receive non-commercial health and wellness info!

David

 

 

 

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Posted in Humanities and Medicine | Tagged , , , | 2 Comments

OK what’s a hernia and how do you get rid of it

Anybody know what a hernia is and how to get rid of it?   Well, I’ll tell ya!

Many think of hernia as something old men get.  Reminds me of a TV show that I watched repeatedly years ago.  The show was “Cheers” and it followed the gang from the Boston bar where “everybody knows your name.”  In one episode, Sam Malone (played by Ted Danson) develops a hernia and he’s struggling since he considers it a condition old men get and it called into question his youthful virility.  There must be something with men and aging and our fragile egos.  Or so says my wife.

Technically speaking, and I know how smart and techy all you MyHealthyMatters readers are, a hernia is when an organ or other body tissue gets squeezed through a weak spot in the surrounding tissue or muscle.  This can happen in lots of places in your body, among them (warning the following few sentences may make you go “ewwww”):

  • Intestines poking through a weak part of the abdominal wall (inguinal, umbilical, abdominal hernia).
  • Stomach getting pushed through the diaphragm so part of it lands in the chest instead of the abdomen (hiatal hernia).
  • Even the brain can herniate, which is a fatal condition in which the stem of the brain gets forced out of the base of the skull due to swelling, inflammation, bleeding, or trauma.

I’m going to focus on the first kind of hernia.  I’m doing so because on a recent Healthy Matters broadcast, we had a great discussion about hernias with my two guests, both terrific surgeons at Hennepin Healthcare.

Read on to meet those surgeons, to learn a bit more about hernia, and especially to learn of a great opportunity to attend an event in Minneapolis.  For the aurally inclined, you can listen to our hernia show via the podcast here:

See that 16th century hernia surgery in the picture above?  Thankfully, hernia surgery is much more civilized now.  Read on . . .  Continue reading

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Posted in Surgery | Tagged , | Leave a comment

No amount of alcohol is safe. Oh, c’mon now.

Hi, friends!  I’ve been gone on a bit of a hiatus but am back and ready to weigh in on the health care news of the day.  Like this eye-catching headline I recently read:

“No amount of alcohol is safe, health experts warn”

A new study was recently published that pretty much came to that conclusion.  The authors did a big retrospective look at previous medical research into alcohol use and concluded that there was no amount of alcohol consumption that could be considered safe.  This really made the news all over the place, like this sobering 30-second blurb:

Due to my unending dedication to finding sound medical advice . . . and even more because I had just enjoyed a nice glass of a dry rose wine on a hot summer evening and didn’t want a bunch of egghead researchers to spoil it for me . . .  I had to investigate further.   Read on for my take on the latest alcohol brouhaha. Continue reading

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Posted in Diet and exercise, Health in the News, Medical research | Tagged , | 3 Comments

Alicia’s incredible story. Read this post, save a life.

Alicia Bravo, BAN RN CEN TCRN CPEN
Brad Bart, MD

Be brave.  That is Alicia’s message.

This is undoubtedly the most powerful story we’ve yet told in 10 years of Healthy Matters broadcasts.

If you missed last week’s show, you missed a doozy of a personal story.  Alicia Bravo is a nurse at Hennepin’s Emergency Department and just one year ago this healthy triathlete experienced a sudden cardiac arrest while swimming.  Her dad and husband saved her life with CPR and now she is spreading the word about it.  You’re going to want to listen to her tell the story on the podcast by clicking Listen to Podcasts at the right of this page.

To give us additional expertise, we were joined in the studio by Dr. Brad Bart, Director of Cardiology at Hennepin Healthcare.    As a follow-up to the show, I asked each of them to respond to some written questions.   What follows is from Alicia and Dr. Bart.  There are powerful and wise words in this post, some links to helpful sites, a way you can donate to CPR education, and even an event that involves drinking beer.

I encourage you to read it through.  You may save a life someday.

Please share this post on Facebook, Instagram, and with your friends by clicking the icons above.  This is a message we need to get out!  

Continue reading

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Posted in Cardiology, Tips from Healthy Matters radio broadcast, Trauma and emergency | Tagged , , , | 3 Comments

Diabetes Part 2 with Dr. Laura LaFave

By www.Pixel.la, public domain photo

Hi, everybody and thanks for stopping by.  This is Part 2 of our look at diabetes, aided by my colleague, endocrinologist Dr. Laura LaFave.  Click on Part 1 here if you missed it from last week.

 

 

 

In this part, I’ll cover:

  • Risk factors for developing diabetes.  (Includes a BMI calculator that you should try).
  • Complications of diabetes.
  • Tips for reducing your chance of getting diabetes.

Here we go!

Continue reading

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Diabetes Part 1 with Dr. Laura LaFave

Endocrinologist Dr. Laura LaFave

This week we did a Healthy Matters show about diabetes and I wanted to write a post about that topic while it is fresh in my head.  So I sat down to write but quickly realized that diabetes is probably the most wide-ranging medical condition of them all.  It has complex causes, different types, multiple risk factors, numerous complications, and lots of treatments.  It is a chronic illness that requires a team of health care professionals and dedicated patients to manage.  So I really can’t cover diabetes in a blog post.

At least one that isn’t of Tolstoy-like length.

Then I remembered a comment from a caller to last Sunday’s show.  Betty had called in with a question about diabetes, and she noted on the air that she had learned more in the previous 15 minutes of our broadcast than in all the years she had been living with diabetes.  (I love our listeners!)

So I thought, hey, I don’t have to cover all of diabetes, I’ll just summarize what we talked about in those 15 minutes, putting it in progressive levels of detail.  Sort of like college.  Except without the tuition.

Of course, those first 15 minutes of diabetes discussion didn’t come from me.  It was my guest, Dr. Laura LaFave, who skillfully broke it down for us.  That’s Laura in the photo above, taken just before we went on the air from the WCCO studios in downtown Minneapolis.  Dr. LaFave is an friend and colleague with whom I did my training at Hennepin County Medical Center many years ago.  Recently, she re-joined our clinical and teaching faculty at Hennepin.  (Hint:  you, too, can see Dr. LaFave as a patient if you need an Endocrinologist by clicking this link).

For the aurally-inclined among you, I really encourage you to listen to the podcast of the broadcast by clicking the banner here.  For those drawn to the written word, I’ll summarize the key learning points in the the following paragraphs.  Your choice!

Continue reading

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Posted in Diabetes | Tagged , , , , , , | Leave a comment

MRI: a (hi-def) glimpse inside the human body

Five MRI images of the brain, all obtained in under 13 minutes. Photo courtesy Dr. Chip Truwit

CT, PET, MRI, IR, X-ray . . .  the world of radiology!  Perhaps you’ve encountered some of these tests, maybe had some of them yourself, maybe you even know what these letters mean.   For those of us in medicine, imaging studies are a critical and daily part of our work.  I order these tests all the time, and when the images show up on my computer screen, I take a look at them and marvel at them.  But then I call my radiology colleagues to tell me what I’m really looking at.

At Hennepin Healthcare in downtown Minneapolis the department of Radiology just installed the most advanced MRI machine in the country.  Before we launched the new magnet into public use – and “launch” seems the right word since the thing looks like something from NASA – the staff needed to warm the thing up.  So I volunteered to have an MRI done.

I had an MRI once before.  It was a couple decades ago for a running knee injury.  I remember it being cold, loud, lengthy, and rather claustrophobia-inducing.

Not anymore.

By Tobias from Wikimedia Commons

The new 3-Tesla MRI scanner at Hennepin’s Clinic and Specialty Center is awesome.   First of all, I was welcomed by the staff, then I changed into nice cloth gowns.  I got to pick the environment I wanted to be in from a touch screen on the wall.  Let’s see, do I want to be on a tropical island, in a forest with pandas, or maybe in an undersea fish scene?  I touched “Seychelle Islands” then entered the scanner.  The technicians put a visor-like thingie on my face, covered me with a blanket, then the woman with the British accent talked me through the scan while I watched the sea gently roll on the sand of the Seychelles on the screen in front of me.

I never even realized that my body was inside a huge magnet tube.  If fact, I fell asleep during my scan.

Three sections in this post if you read on:

  • Building the best radiology department right here in downtown Minneapolis.  What being patient-centered really means.
  • Like wheat in a field.  A short physics lesson.
  • The role of imaging in a public safety net hospital.  Something to get you thinking about healthcare for all people.

Continue reading

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Posted in HCMC, Radiology | Tagged , , | 2 Comments

The intersection of physical and mental health

“Despair” (public domain art)

A good part of my medical practice at Hennepin Healthcare is in mental health.  Although I’m a general internist, meaning I specialize in chronic diseases of adults, I have a special interest in the intersection of medical and mental illness.  Consequently, I spend a hefty portion of my days on the inpatient psychiatry units.  So when a piece came out in the New York Times this week, I was immediately drawn to it.  Written by Dr. Dhruv Khullar from New York-Presbyterian Hospital, it is entitled The Largest Health Care Disparity We Don’t Talk About.  I strongly encourage you to read it.

This is particularly of interest to me since I have also been part of a group of five medical systems across the country who have recently published our own experience in caring for people with mental illness. You can read our very brief paper at the Annals of Internal Medicine.

In this post I’ll talk a bit about my own experience in caring for patients with mental health conditions.  I’ll end with a few suggestions. Continue reading

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Posted in Dr. Hilden's reflections, Ethics and philosophy, Health in the News, Mental Health, Psychiatry | Tagged , , , , , | 5 Comments

Register here for live audience show “Decade with Dave”

Meet me and WCCO personality Denny Long at our live show on June 10!

It’s coming fast and seats are almost full!  But, dear friends, you still can RSVP for our live audience Healthy Matters radio broadcast on June 10, 2018 at 7:30 am.  The show will be done “on location” at Hennepin Healthcare’s Clinic and Specialty Center, right in the atrium.

Plan to arrive around 7:00 to get a coffee and a seat, listen in to the show from the audience, then stick around for brief tours of Minnesota’s most modern and patient-friendly clinical facility.

I’d love to meet you!

 

 

The show and on-site parking are FREE!  Register by clicking the logo here:

We’ll have coffee and snacks for you, plenty of seats, and a live show featuring three special physician guests:

  • Dr. Laura LaFave, Hennepin endocrinologist, will chat with us about diabetes.
  • Dr. Rawad Nasr, Hennepin’s Director of Rheumatology, will talk arthritis.
  • Rounding out the program will be Dr. Ranji Varghese, sleep doctor, who will share his expertise about sleep problems.

But mostly, it will be a fun chance to see a live radio show and share a cup of coffee.

Event and underground on-site parking are FREE but you need to RSVP by clicking the picture above. 

While you are there, sign up for the Here 4 Health public education series.  We have fun, informational, and hands-on sessions for all you inquisitive folks out there.  There is one session each in July, August, and September.  These are also free and held at the Clinic and Specialty Center in downtown Minneapolis.  Lot’s more information and registration links by clicking the Here4Health graphic above.

And see those coffee mugs Denny and I are holding . . . come to the show and get one for yourself!  Sure to be a collector’s item, eh?

See you on June 10!

Dr. H

 

 

 

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Posted in Tips from Healthy Matters radio broadcast | Tagged , , , | Leave a comment