Hi, friends! See that sign in the picture? Those signs are all over the campus at Hennepin Healthcare. Let’s just say my co-workers have shown no mercy in teasing me about them.
But hey – we have something to celebrate! I’m super pumped to be launching “Decade with Dave” – our celebration of 10 years of our Healthy Matters broadcast!
We’re starting with a live broadcast of Healthy Matters from the atrium at Hennepin Healthcare’s Clinic and Specialty Center complete with a LIVE audience. That’s where you come in. I’m inviting you – my Healthy Matters listening friends – to be that live audience on Sunday, June 10. Denny Long will be there, I’ll be there, and I hope YOU will be there.
Here’s what we’re planning for the live broadcast of Decade with Dave . . .
Diabetes and the Sweet Life. I’ve invited an old friend from my medical training, Dr. Laura LaFave, to introduce her to Healthy Matters listeners. Dr. LaFave recently rejoined the Hennepin Healthcare faculty in Endocrinology – in fact I don’t even have a link to her picture yet! She’s a friend, a smart doctor, and a genuinely good person. She’s been practicing for over a decade but only been back to Hennepin for a few months, so to welcome her back to our family I’m putting her in front of a live audience. She’s a good friend, eh? We’ll talk about diabetes and other hormone-y topics.
Arthritis Treatment Options: Moving from Pain to Gain.Dr. Rawad Nasr is Hennepin’s Director of Rheumatology and another colleague with whom I go way back. We dragged him back from his practice in Bemidji to join our Hennepin faculty. His recent show about arthritis was a huge hit with listeners so he’s coming back to chat with me about arthritis and joint questions. You’ll love this guy.
Sleep Health: What Keeps You Up at Night. Another really popular topic – in fact, perhaps the most popular topic – is sleep. We all need it, we all want it. Many of us struggle to get the best sleep we can. Another Healthy Matters veteran, Dr. Ranji Varghese, will be at the broadcast to meet you, to help us understand sleep, and to answer a few questions.
Following the broadcast, we’ll have a bit of Q&A and show you around the place a bit. We’ll have coffee and munchies (donuts, anyone?).
After kicking off the summer with “Decade with Dave” we are launching an exciting new health education program for the curious and inquisitive among you. “Here 4 Health” is a series of three educational sessions on a variety of health topics sort of like a mini Medical School. Except more fun. And not nearly as grueling. Come to learn about health topics from cool experts from Hennepin.
You can attend 1, 2, or all 3 sessions. They’re all free of charge, but you do need to send your RSVP by clicking here. All events are at the Hennepin Healthcare Clinic and Specialty Center.
Here’s what we have planned for “Here 4 Health” (subject to change if any of these colleagues chicken out):
Session 1: Thursday, July 12, 5-7 p.m
How to live to 100 or die trying. Dr. David Hilden (that’s me) will be updating a popular session I’ve been giving for years. I’ll take you behind the scenes at a state-of-the-art working clinic with insider tips on staying healthy.
The Ins and Outs of GI Health. OK, some smart aleck (probably the same guy who decided to make a career of doing colonoscopies) made up the name for this informative session about colon cancer. Learn from Hennepin gastroenterologist Dr. Jake Matlock about colon cancer and colonoscopies! I know Jake. Great guy. Ask him to show you a colonoscope. Then ask him why the heck he thought it would be cool to look at people’s intestines all day. You’ll also get the special chance to tour a colonoscopy suite – when you’re NOT on the cart getting your own colonoscopy
Session 2: Saturday, August 11, 9-11 a.m
Dermatology – your skin questions answered. Hennepin dermatologists Dr. Sara Hylwa and Dr. Jenny Liu will be on hand. You’ll never get a better chance to tap into a skin doctor’s expertise. They are smart and they know skin like the back of your hand – literally. Just don’t ask them if you can skip wearing sunscreen. (Spoiler alert. . . you can’t . . these two are so stingy on that point).
The Ancient Art and Modern Practices of Integrative Medicine – Acupuncture and Chiropractic. A certified acupuncturist and chiropractor will show you around the world of integrative medicine. Maybe you’ll come away just a little less mystified at these ancient practices. Ask to see an acupuncture needle. Dr. Richard Printon and acupuncturist Jessica Brown will be on hand!
Session 3: Saturday, September 15, 9-11 a.m.
You Gotta Have Heart. Recent Healthy Matters guest and cardiologist Dr. Michelle Carlson will show you around the world of heart health. You’ll learn from her particular expertise in women’s heart health and the link between heart health and cancer. You may want to check out the recent post I did with Dr. Carlson here.
Best Practices in Breast Health. Leah Hahn is the supervisor of the mammography program at Hennepin. See a mammogram machine for yourself. Men, you too should attend this session. It will give you a new appreciation for the women in your life. And men get breast cancer too! Check out this post I did with Leah Hahn from a few months ago.
A Little Help for your Friends. Hennepin has the best Physical Therapists AND therapy facilities in the region. Come see a PT gym and look at the amazing possibilities for therapy. This is state-of-the-art stuff which you can learn from Senior Physical Therapist Beth Stegora.
Attend all three sessions or pick and choose the ones you want. They’re all free and all at the Hennepin Healthcare Clinic and Specialty Center in downtown Minneapolis Probably the most important part of all . . . the parking is right there underground. Could not be simpler.
Why should I go learn something?
Here’s why I think you should attend the LIVE Decade with Dave broadcast and why you should attend the Here 4 Health series . . .
You could sit home and watch TV. Or stare at the grass and watch it grow. Or sit on your couch and get bad health information from the Internet.
Or you could get out of the house, come to the Here 4 Health series, and learn from fun, smart, and reliable doctors and health professionals. All while taking in the art-filled and warm setting of a state-of-the-art health facility.
As promised in my April 2 post, I plan to do a series of short posts about specific medical topics since I recently returned from “doctor’s school” in San Diego at the American College of Physicians meeting. Missed that post? Re-visit it at “Should you trust the latest medical advice?”
Today’s post will cover C. difficile infections, or CDI. This may be the ickiest post I’ve yet done!
First, a warning. What you about to read may make you go “Ewwww” and may make you wonder what kind of people actually talk about this stuff in polite company. I’ll tell you who talks about it . . . a bunch of doctors in a classroom on a sunny San Diego day. That’s who talks about it. Lucky for you, I’ll summarize here. Continue reading “Quick tips: C. difficile infection will gross you out”→
Quick reminder about the upcoming #ColonChat. It is THIS FRIDAY, March 24, from Noon to 1:00 p.m. Central Time. My colleague, Dr. Jake Matlock, will join me and others from the HCMC GI Lab for a fast-paced hour using Twitter to answer questions and bust myths about colon cancer. These are people who look inside intestines all day long so you know they are party-type of people.
It’s fun and informative! All you need to do is follow me on Twitter @DrDavidHilden during the hour. Tweet me your comments or questions during the hour using the hashtag #ColonChat, or if you tend toward the whimsical, you can use #ScopeItOut instead. Look for Dr. Matlock’s responses in real time during the hour. We’re bringing some nurses from the GI Lab to answer questions as well since we all know it is nurses who are the real experts!
Here’s a couple of myths we will shred to pieces during ColonChat hour:
Myth: Colon cancer is deadly so there is no point in looking for it. Wrong. We will tell you why it is important to screen for colon cancer.
Myth: Colon cancer is not preventable. The heck it ain’t! Find out why during #ColonChat.
Myth. Colon cancer is mostly a man’s disease. Nope. Women get it just about as often.
Myth: I feel fine and have normal bowel movements so I can’t have colon cancer. Most colon cancer doesn’t cause symptoms!
Myth: No one in my family had colon cancer so I’m not at risk. No no no! Although there is some genetic risk, most people who get colon cancer did not have a family member with it.
For lots more information on colon cancer, I invite you to check out my two recent previous posts on the subject. Here’s the links to them for you to check out, share on social media, and so forth.
And be sure to tune in to #ColonChat this Friday, March 24, Noon – 1:00 p.m. on Twitter @DrDavidHilden
Hey, everybody. March is Colon Cancer Awareness Month and we’re going all in (bad choice of words when talking about colonoscopies, perhaps) here at Healthy Matters.
Here’s what we’re doing for Colon Cancer Awareness Month
On Friday, March 3, I wore blue clothes in recognition of #DressInBlueDay which kicks off #ColonCancerAwarenessMonth.
On Sunday, March 5, our live Healthy Matters radio broadcast will feature my colleague Dr. Jake Matlock. He’s a gastroenterologist who will help us unravel colon cancer screening and talk us through a colonoscopy from the guy at the fun end of the colonoscope. (In case you’re wondering, that would be you, my friend, at the no-fun end of the colonoscope!). Read more about Dr. Matlock later in this post. And be sure to tune in to the radio show Sunday, March 5, 7:30 a.m. Central time on WCCO 830 AM in the upper Midwest. It also streams live at WCCO.COM so you can listen anywhere in the world.
Right here on MyHealthyMatters.org, I’m doing posts to help keep you informed about colon cancer. If you missed my recent post (complete with pictures of me in a hospital gown), check it out – it was a popular post called “The one where I get a colonoscopy.” That post has lots of information about the various types of colon cancer screening.
Twitter chat. Later in March (date and time to be announced) we’ll be doing another Twitter chat in which we answer your questions in rapid fire tweet tweet tweet format. It’s fun and (hopefully) informative!
Here’s a guy you should meet
Check out my guest from the March 5 Healthy Matters radio broadcast:
That’s Dr. Jake Matlock. He’s a gastroenterologist at Hennepin County Medical Center and one of the best in the business at treating your various intestinal problems, among them colon cancer. He is an expert with a variety of scopes and skilled at what we call “advanced endoscopy” which means if anybody can get a scope into some dark and remote part of your innards, Jake can. He’s also a great teacher and “explainer of things.”
He was good enough to let me into the GI Lab where he works where I snapped a few pictures. Yes, that’s a real scope. It’s not as long as it looks. Yes it is. I lied.
So I’m fired up to have Dr. Matlock on the radio broadcast tomorrow (March 5). If you missed the show, the podcast will be available here so you can listen on your own device on your own time.
Jake and I did residency together quite a few years ago. I remember him as being the one who made us all just a little less anxious when he entered the room – he’s smart, good with a scope, and a good guy overall. You just get the sense that your patients are in good hands with him.
Famous people with colon cancer
In my last post about colon cancer, (which again, you can visit by clicking here) I described the why and how of getting checked for colon cancer. That post has lots of information, including the various types of tests you may consider. Be sure to read that post if you want to know more.
In this post, I won’t give any more medical information about colon cancer. Rather, I’m going to do something completely different and simply show you a few well-known folks who had colon cancer. Some of them died from it, others got test, treated, and are still going strong today. I think it is sort of interesting.
I’ve included a fact or two about each that I didn’t know but I found cool. I hope you do as well.
Charles M. Schulz
The Minneapolis native and creator of Charlie Brown, Snoopy, and the gang had been having a serious of strokes from blood clots in his aorta. As part of his medical evaluation, they discovered colon cancer which had already spread into his body. You see, the presence of a malignancy (cancer) makes a person’s blood form clots more readily. I don’t know the details in Mr. Schulz’s case, but a big ‘ol clot in a huge artery seems like it was caused, in part, by the cancer. So the stroke could actually have been a manifestation of the cancer.
He died on February 12, 2000 and the last original Peanuts cartoon was published the very next day. He made it clear that he never wanted anyone else to draw his characters after he died.
Probably the greatest coach in the history of football, or maybe any sport, the great Vince Lombardi died of colon cancer when he was just 57 years old. He apparently said to his priest when near death that he regretted not having accomplished more in his life. Guess all those national championships weren’t enough!
I didn’t know this: Coach Lombardi demanded acceptance of everyone in his locker rooms, especially gay football players (he had a gay brother). In a book, his son said his father would “tolerate nothing but acceptance” on his teams. What an example from a true American icon – even back in the 1960s.
That’s the coach with Bart Starr. And though I’m a Minnesota Vikings fan now, I was born in Wisconsin and my mom has a picture of me as a toddler with a “Put me in, Vince” sweatshirt on.
Ruth Bader Ginsburg
Yup, “Notorious RBG” (a name I just love) was diagnosed with colon cancer in 1999. She underwent treatment, including chemotherapy and radiation. And get this . . . after all this she embarked on a new strenuous fitness program. By her 80th birthday, RBG could do 20 pushups. She is so dedicated to her workouts that she calls her personal trainer the “most important person in my life” (since her husband died). Apparently this workout would challenge someone half her age. Go get ’em, RBG!
And RBG is still going strong, even after she had a second cancer, this time pancreatic. I want to be like her in so many ways.
From her birth on a cotton plantation in South Carolina, Eartha Kitt became a national treasure. Singer, actor, activist. You know the song “Santa Baby”? That was Ms. Kitt. She won three Emmys for her acting and she played Helen of Troy under the direction of Orson Welles. You know the song “C’est si bon”? Listen to Eartha’s version here:
Eartha Kitt was much more than the woman Orson Welles called “the most exciting woman in the world.” She also was a social activist and became involved in issues ranging from working with inner city kids in Los Angeles to peace issues to LGBT rights.
Eartha Kitt died of colon cancer on Christmas Day 2008.
I love the music of Debussy, even though I still remember struggling to learn “Clair de Lune” like so many people learning to play piano. Our son, Alex, can play “Prelude to the Afternoon of a Faun” – well at least he used to be able to (still practicing the piano, Alex?)
Debussy was a French composer in the late 19th and early 20th centuries and he wrote sounds that not many had heard before. But don’t call him an “Impressionist” – he hated the term!
Listen to Clair de Lune while reading the rest of this post:
Debussy was diagnosed with rectal cancer (a type of colorectal cancer) in 1909 and in 1915 he underwent one of the first colostomy procedures ever attempted. It didn’t go well and he was in quite a bit of suffering when he died at the young age of 55 in his Paris home during a German aerial bombardment.
You know who else had colorectal cancer . . . ?
Here’s who: 136,000 people in the United States. In just one year. People like you and me.
You can get this done. If you missed my overview of the ways you can get tested for colorectal cancer, see my earlier post by clicking here. It’s not as hard as you think!
If you live in Minnesota, Dr. Matlock and his team at the HCMC GI Lab would be happy to help you. Call ’em at 612-873-6963. Trust me, there is no one more skilled at this that Dr. Matlock and his team. All kidding and funny pictures aside . . . he’s really good!
Thanks for listening, for stopping by, and for hanging out with me at myhealthymatters.org. Go ahead and subscribe by e-mail if you like, and follow me on Twitter @DrDavidHilden
See that brave patient in the picture? Yup, that’s me, just minutes from getting my colonoscopy at HCMC last year. I’ve been meaning to do a post about that experience and now seems as good a time as any. What with turmoil in the country and all, what could be better than to re-live the day somebody put a 5-foot long tube inside me to have a peek?
It must be on lots of minds if last week’s radio broadcast was any indication. The phone and text and Twitter (@DrDavidHilden) lines were full of questions about colon cancer and how to avoid it.
Here’s the podcast of that show for you to listen to if you missed it (Healthy Matters show #420 – 1/22/2017)
I like to have a little fun with most medical topics, and I gotta say that if there ever was a medical topic worthy of humor, it has to be getting a colonoscopy. I mean, really, think about it. It has all the ingredients of a comedy routine:
Gross part of the human anatomy. Check.
Flushing out the entire contents of your intestines. Check.
Baring your rear end to complete strangers while lying curled up on your side wishing you were literally anyplace else at that moment. Check.
Complete surrender of any sense of dignity you had walking in the door. Check.
Passing gas all day when it is over. Check.
What could be more fun?
But colorectal cancer really is no joke. In this post, I hope to accomplish three things:
Convince you that getting screened for colorectal cancer makes sense.
Introduce you to the various ways you can get screened.
Allay any anxiety you may have over the whole subject.
Colorectal cancer: the bad news
In all seriousness, getting a screening test for colon cancer is among the most effective things you can do for your health. In fact, amid all the unpleasantries people endure in an effort to stay healthy, this one ranks way up there in importance. So let me repeat, getting screened for colon cancer is important and potentially lifesaving.
Check out the sobering news on colorectal cancer:
It is common. Colorectal cancer is the 3rd most common cancer in men and women (skin cancers excluded).
It can be deadly. Colorectal cancer is the second most common cause of cancer death in men (behind lung cancer), and the third most common cause of cancer death in women (behind lung and breast cancer).
It is potentially treatable (and dare I say?),curable. Check this fact out – for those whose colorectal cancer is caught early, fully 90% will likely still be alive in 5 years. But for those with advanced cancer, only 15% will still be alive in 5 years.
A quick plug for some of the best medical information on the Internet. It comes from the Centers for Disease Control. For more on colon cancer from the CDC, click here.
It is largely because of that last bullet point that you should get screened for colorectal cancer. There is a dramatic difference in your chances of survival if you can only catch the cancer early on. That is true for most cancers, but it is especially true with this one.
This is a good time to point you toward the American Cancer Society’s Cancer Statistics Center. If you are curious about colorectal or any other cancer statistics, it is a great site to check out. You can sort the stats by your state of residence or type of cancer. It’s cool.
Ways to get screened
Hopefully I’ve convinced you of the importance of getting screened. Or maybe you didn’t need convincing in the first place! Let’s turn now to the various ways you can get the job done.
What you may not know is there are several ways to get your colon checked out. The one we all know and love is the colonoscopy but you may not know that it is not the only way to go. That surprises some people when I tell them that. There is a misconception floating around that the “best” way to go is the colonoscopy and that all the other methods are inferior. Not so, not so. It is the test of choice for many people (it is what I did) but it isn’t for everybody. And if the thought of an invasive procedure leads you to proscratinate forever in getting it, you are not getting the benefit of the test anyway.
As a wise person once said, “The best test for colon cancer screening is the one that the patient will actually do.”
So let’s look at the various tests you can consider:
FOBT and FIT tests
These are the tests in which you submit a little tiny stool sample and the test looks for blood in your stool that you can’t even see (hence the word “occult”). They are similar in that you usually can collect the sample at home, they are not invasive, and they are pretty good at finding hidden blood. They work under the principle that cancers and the pre-cancerous polyps in the colon tend to bleed.
FOBT stands for Fecal Occult Blood Test and sometimes has a little “g” in front of it (g = guaiac, so it looks like gFOBT). It’s the older one of the two and we’re seeing it used quite a bit less today. I think it will fade into oblivion . . . in favor of . . . FIT testing.
FIT stands for Fecal Immunochemical Test (sometimes written iFOBT with the little “i” = immunochemical). It is newer and uses a fancier approach to detecting blood proteins. It has the same advantages as the gFOBT but it has additional advantages over gFOBT in that it is probably more accurate and no dietary restrictions are needed prior to doing the test. Here’s a bit more on the FIT test.
Both of these stool tests need to be done every year. And if they find blood in your stool, you may need a colonoscopy after all! But they are a good choice for many people.
This is the newest of the bunch. It works in a similar way to the FIT test above, but rather than look for blood, it looks for abnormal DNA in your stool. In other words, it is looking for the genetic “fingerprint” of cancer cells. Pretty cool, high-tech stuff here! The picture at left, though not of the DNA itself, is a biopsy specimen showing colon cancer cells. They are the angry looking cells throughout this piece of tissue.
This test needs to be done every three years but the data is not too certain on this yet since it is so new. It also may not be covered by your insurance. It is really promising though! We will be seeing a lot more of this one in the future, I think.
I’m not seeing too much of this method lately. It is sort of like a “mini-colonoscopy” in that a camera on a flexible tube is inserted into the colon. It doesn’t require the extensive colon flush, doesn’t need as much sedation, and complication rates are lower. Since it only looks at the lower part of the colon, however, it can miss any cancers that are higher up.
This test needs to be done every 5 years and lots of people get the stool tests in addition to it.
This is the one most of us think about. A specially trained doctor (a gastroenterologist – basically a really talented person with an inexplicable tolerance for looking at the nether regions of people) inserts a long-flexible camera into your intestines, all the way to the point where your large intestine (your “colon”) begins. Which is about 5 feet up there. Believe me, they are able to get a good look and simply see with their own eyes if you have a lesion (cancer or polyp). The advantage is that if they see something bad, they can either remove it entirely (like a polyp) or take a biopsy (to see if it is a cancer).
Cool picture time. Here’s a normal intestine as seen by your gastroenterologist (this one is actually in the rectum):
Here’s an intestine with a polyp (don’t know if it is the pre-cancerous kind or not, but that’s why we take them out!)
The other advantage is that for most people, colonoscopy only needs to be done every 10 years, perhaps every 5 years if they see something concerning.
But there are disadvantages to the colonoscopy. There is a small, but real, risk of perforation, which is where the colon wall gets a hole in it. And this is bad. Remember, your colon is full of bacteria and other unpleasantness. The outside of your colon (in your abdominal cavity) is sterile. You really don’t want the contents of your intestines to spew out into your belly. That can lead to a condition called peritonitis which can lead to sepsis which can be very serious.
Fortunately, this is a rare complication (estimates range from 1 in 500 all the way down to 1 in 6000). And although big perforations usually require surgery right away, many small perforations can heal themselves.
I feel like I should mention this one (technically called CT colonography). It uses x-rays (a CT scan) to look at the colon non-invasively. Super tempting to go this route as it eliminates the invasiveness and thus the risk of colonoscopy. But I don’t see too many people getting the virtual test done. After all, it does expose you to radiation (albeit not a whole lot), and if it finds something abnormal, you still have to get the colonoscopy anyway.
I’ll end with my own story. I figure doctors who are counseling patients to get tested better be doing it for themselves, eh?
So I turned the magic age of 50 a while back and for most people, that is the age where all this colon talk gets real, real fast. I’m talking people at average risk. Others at higher risk (say your dad had cancer at an early age, for example) should do it sooner.
So I decided to go for it on a winter day last year. I saw my doctor (yup, I actually have a doctor that I see, though I have to admit it was turning 50 that prompted me to finally get a doctor of my own. Tsk-tsk, I know). He prescribed all the prep stuff which I faithfully did.
Have you ever done the colon prep? Many of you remember getting such a large volume of the prep solution that you practically needed a grocery cart to get it home. You’d go to the pharmacy to pick it up, and they would push to you across the counter like a zillion gallons of the stuff in big jugs. You’d swear there was a mistake, that you were only getting the prep for one person not the whole family. But it was real. That was the way we used to do it (and still do for some people as it does actually work). You drank the solution the night before the colonoscopy until it came out the bottom end looking just like it did going in the top end – like clear water.
My prep was of the newer kind. Instead of gallons of prep solution, I went the route where you pour an entire bottle of a laxative powder into a bottle of sports drinks and drink it down in a few sittings. Then you wait for the action to begin. And you spend most of the next 12-24 hours in the bathroom. This is a good time to get a supply of reading material and to tell your family to clear out of the place – for their own good.
Sometimes I think the people who devise these prep schemes are deranged.
So I did all that the night before my test. Then I show up for my colonoscopy to the GI Lab at HCMC, which is the hospital where I work. A couple points about that. First, why do they have to call it the GI Lab? Are they doing experiments in there? Second, it does take a bit of self-assurance to get your colonoscopy at your own workplace. I’m sitting there in a hospital gown with my rear end exposed for all the world to see when 2 or 3 people I see in the hallways all the time come in. Tough to maintain any sense of workplace decorum in that situation, I think.
So being the talker that I am, I try to make small talk with the nurse whom I know I will see a few hours later in the cafeteria line. He’s all professionalism, thankfully. And the doctor comes in, but I don’t make much eye contact with her, my backside being the side of interest, after all.
I assure the team that I will be watching my entire colonoscopy on the video monitor, just like Katie Couric did on live television a few years ago. And I really intended to watch because I was genuinely curious to take a gander at my own intestines from the inside out. That’s actually a pretty cool opportunity when you think about it. I thought I did a pretty good job staying awake. But then at one point I looked at the screen only to find out that the doctor was just finishing the whole procedure. She had done my entire colonoscopy and I dozed off for the whole of it!
I went home, had an uneventful day and made it to work the next day as good as new.
My point being: this was no big deal. To prove it, here I am giving two thumbs up:
Sure, the prep was not a walk in the park. But it was not that bad. The colonoscopy itself? Heck I slept through all of it. Did it hurt? Not in the least. Was it embarrassing? Naw. (Yours is not the first nor the last rear end they will see and trust me, they don’t care at all what yours looks like).
I should point out that for some people, the prep really is miserable. For some, the sedation is not as effective as they would like. The procedure can be uncomfortable for some people, even painful. And as I mentioned above, for some (thankfully not too many) there are complications. So your experience may not be just like mine.
But I find that most people, even those who worried about it in advance, the colonoscopy turned out to be much less unpleasant that they imagined.
So if you are over 50 and have not done this yet: my parting advice is to pick one of these tests and DO IT. So many illnesses that afflict us can’t be prevented. This is not one of them.
Drop me a comment below if you want. And subscribe by e-mail if you like what you see. I promise, no spam or junk mail!
Another great Healthy Matters show this week -thanks to the listeners who are up on a Sunday morning – getting dressed, eating breakfast, going to church, drinking their coffee – and tuning in to listen to me talk about fungus and pus. So a heartfelt THANK YOU to Healthy Matters listeners and for your terrific questions by text and phone.
If you have not heard the show yet, you can do so a few ways:
Live radio broadcast: WCCO 8-3-0 AM dial – Sundays 7:30 a.m. Central
Live streaming on your computer/mobile: WCCO.COM – Sunday 7:30 a.m. Central
This week’s post features quick answers to questions I received on the show. These are quick and incomplete, so make sure to talk to your own doctor to learn more.
I’ll also be doing some video posts where I can answer questions by talking rather than typing . . . look for those soon.
From the Healthy Matters mailbag
Several questions this week about cholesterol numbers, like this one . . .
“My doctor recommended coming back in 6 months for repeat of cholesterol numbers and tweaking my lifestyle. Is there an alternative to statins?”
Short answer: Dyslipidemia, which basically means your cholesterol is out of whack, is a risk factor for developing cardiovascular problems in the future. Statins remain the medications with the most scientific evidence to prove that they work. There are alternatives, but none with such strong proof to back them up.
LDL = low-density lipoprotein. LDL = bad. You want this one low.
HDL = high-density lipoprotein. HDL = good. You want this one high.
Triglycerides = fats floating around your blood stream. You want this low.
Total cholesterol = a combination of the above (but you can’t simply add up the 3 of them to get your total cholesterol – it is a more complicated formula).
Your body actually requires cholesterol for life since it is part of cell membranes and an important part of the normal steroid hormones that your body makes. Most cholesterol is manufactured in your liver, with only a modest amount coming from your diet.
The trouble for many of us is that our cholesterol factories (aka your liver) don’t have an “off” switch. It simply makes too much. Think of statin medications as the “off” switch. Yes, they have side effects (the most common one is muscle problems) and as science progresses, we will undoubtedly learn more about these medications. But for now, for the right people, if you have cholesterol problems statins are the best way to reduce your risk of heart disease.
Who are the right people for statins? Here are the latest guidelines (new in 2015):
People who do not have known cardiovascular disease and are between 40 and 75 years old and have a 7.5 percent or higher risk for heart attack or stroke within 10 years.
This is cool and you should do this –> to find out your 10-year risk of heart disease, click here.
People with a history of heart attack, stroke, stable or unstable angina, peripheral artery disease, transient ischemic attack, or coronary or other arterial revascularization. (Basically if you have known cardiovascular disease).
People 21 and older who have a very high level of bad cholesterol (190 or higher).
People with Type 1 or Type 2 diabetes who are 40 to 75 years old.
There are a LOT of people who could be taking these medications and receiving the benefit of reduced risk of heart disease. Click here for a nice discussion of the guidelines.
Read on for another related question . . .
“I thought the higher the HDL cholesterol the better. My HDL was 100, LDL was 128, triglycerides 27. Doctor expressed concern that sometimes an HDL at either extreme can be a problem . . and ordered a VAP test.”
Here is an analogy that works for me. Bear with me, I made this up . . .
Think of LDL and triglycerides as “garbage” floating around your bloodstream and attaching itself to your blood vessel walls, like garbage accumulating on the curb.
Too much garbage = a mess of badness.
Now think of HDL as the “garbage trucks” driving around, picking up the garbage from the curb (vessel walls), and delivering it back to your liver where it can be processed and removed.
You want lots of garbage trucks.
So in general, you want an HDL that is high (preferably 50-60 or more). But can it be too high, as this questions asks? Well, yes, it is true that HDL that is not working properly is not only ineffective in its garbage truck duties, but may actually be harmful. However, we really don’t know what to do with that information.
The VAP test is a series of advanced tests that can more accurately pinpoint your cholesterol situation. As I mentioned on the radio, however, we still don’t know what to do with the information since getting the test will usually not lead to any change in treatments. After all, we don’t really have any additional proven treatments. So you can get the VAP test if your doctor recommends it, but be prepared to hear the same advice when it is back: eat healthy, exercise, don’t smoke, take a statin if indicated.
And choose your parents carefully.
On to a new topic from the mailbox . . .
“Do acid control medications cause Alzheimer’s Disease?”
Short answer. We don’t know.
Longer answer: This one has been in the news as of late since a group of German researchers published the results of their study which showed an association between proton-pump inhibitor use (PPI) and the development of dementia. The study was in people over 75 who did not have dementia at the outset, but who were taking one of the common acid-suppressing agents called PPIs. Examples (among many others) of these drugs are omeprazole (Prilosec) and lansoprazole (Prevacid).
The study showed that more people on these medications developed dementia than those not taking them. Why this may be the case is not known. But it is really important to note that the association between these medications and dementia is not proof of causation. In other words, these medical studies do not prove that doing one thing (taking the acid-suppressing medications) actually causes the other thing (getting dementia). Here’s a link to the actual study if you are super into medical journal articles with subtitles like “A Pharmacoepidemiological Claims Data Analysis” – I’m not joking, that is the actual subtitle of this real page-turner.
Bottom line: this is not a reason to stop taking your acid-suppressing medications if you have a strong indication to do so (you have proven acid-reflux disease, for instance). I should add that many people take acid-suppressing medications for shakier reasons and probably don’t need them in the first place.
One more for the good measure . . .
“Paryonychia on thumb. Causes?”
Paronychia is an inflammation around the finger- or toenails. It is sometimes chronic (long-lasting) but often acute (comes on quickly and resolves). It is usually due to a bacteria or fungus getting in the grooves around your nails. It shows up as a sore, red, and swollen area around the nail. The acute kind may be due to minor daily-living types of activities (dishwashing, trimming nails, minor trauma . . . ) and may not need any specific treatment other that putting warmth or topical anti-inflammatories on it.
If there is pus oozing out of it, you may need antibiotics or drainage by your doctor. Chronic paronychia may be due to a fungal or allergic type of dermatitis, and may require topical treatments with anti-inflammatories or anti-fungals.
The rest of the mailbox
To give you a sense of the range of topics on a typical Healthy Matters Open Lines show – I’ll show you a partial and condensed list of the topics listeners raised this week but that I did not get to cover. I’m struck by the range of questions – and also just how legitimate they all are! Doing the radio show really makes me aware of the shared human condition – I bet most of us can relate to something on this list . . . !
Febrile seizures in infants.
What is neuropathy?
Clostridium difficile infections.
Cold sores in a young adult.
Epilepsy in children.
Testing for Diabetes type 2.
What is pre-diabetes?
Causes of dry tongue?
Carpal tunnel syndrome.
High calcium in blood tests.
Keep listening, keep checking out the blog . . . and if you have a preference for what I should cover in the future please leave me a comment and I’ll do my best!
Regular listeners to Healthy Matters know that I often can’t get to all the questions that come from listeners via phone or text message, or I can’t answer the questions as thoroughly as I’d like when doing live radio. So every so often I’m going to use this blog to post a few “quick tips” in response to listener questions. Nothing in-depth, just a few tips I think are interesting.
And you can always listen to old shows by clicking the “Listen to podcasts” link in upper right of this blog.
Remember, these are just quick tips and are not complete medical advice. Be sure to click the link in each section for more information!
These are from the Sunday, February 7 show.
One texter this morning asked about angina – what is it, does it mean there is heart disease, and what to do about it.
Angina pectoris is a mix of Greek (“strangling”) and Latin (“chest”) and is the term we use to describe pain in your chest which is due to coronary heart disease. This is the blockage of your coronary arteries by plaque that some of us know as “hardening” of the arteries. Coronary heart disease also leads to heart attacks – an unstable, emergency situation, but angina is the stable condition that comes when your heart isn’t getting enough blood to meet the demands being asked of it. In other words, the heart is doing fine when at rest, but doesn’t have the reserve required for exertion or stress.
Angina occurs with exertion, stress, and hot or cold temperatures and is relieved with rest or nitroglycerin.
It usually feels like a pressure or squeezing in the chest (hence the name which means “strangling”).
There are lots of variations in symptoms, particularly in women, and may also feel like nausea, indigestion, or include arm, neck, and jaw pain.
Angina usually lasts just a few minutes.
Symptoms are usually predictable – not coming out of the blue at unexpected times. Onset with exertion/stress, relief with rest/medications.
If you think you may be having angina, then you should be seen by your doctor for tests. There are good medications and other treatments for angina. Importantly, if the symptoms are becoming more frequent or severe, or occur at rest, then you may have unstable angina which requires urgent attention. Like right now attention, not tomorrow or next week.