January 6th, 2017
Patients sometimes are dissatisfied with the communication offered by physicians. “He won’t answer my questions.” “He gets angry with me.” “He cuts me off.” “He won’t answer my calls.” “I can’t understand him.” “He scares me.” Sometimes they say, “You’re the only one who spends time with me.”
Our office schedule allots sufficient time for thorough explanations. In the current medical paradigm, insurance companies, including Medicare, pay physicians less and less for the work they do. Office overhead, however, only goes up. Doctors spend less time with patients because their income depends on seeing more patients. If physicians are employed by an HMO, only a limited amount of time is permitted for each office visit.
New requirements for electronic medical records (EMR) have aggravated the problem. According to reports, doctors now spend more time on the computer than they do with patients. In many offices there is a computer in the exam room, and the doctor focuses his attention on the screen, occasionally looking up to face the patient. The bureaucratic demand for endless documentation has made the situation much worse.
Yet underneath all of this is a more elemental problem. Many physicians have not learned the technology of communication. They should face the patient throughout the time of the visit. They should offer easy to comprehend explanations, then appeal to the patient’s intelligence and understanding, and not try to enforce obedience through fear. Fundamental to effective care is the nurturing of affinity between doctor and patient. The physician should be aware of the patient’s concerns, current stressors, and the family situation.
The physician should use words the patient will understand, and not be too technical. He should provide illustrations of relevant anatomy and procedures. He should define complex terms. Recommendations should be provided in writing, since patients otherwise may not remember what is said to them. Individuals who cannot understand instructions are unlikely to follow them. We should simplify our language.
It is also important to understand the patient’s point of view. A patient may have an intense fear of surgery or anesthesia, whether justified or not. Some individuals prefer to risk the consequences of their disease rather than the side effects of medications or the complications of surgery.
My purpose is to offer knowledge, experience, and judgment. It is up to the patient to decide what course he will choose. If I disagree I will say so. Throughout all discussions it is crucial to maintain affinity. Otherwise the communication line will wither.
Medicine in my lifetime has made astounding advances in knowledge and therapy. It has lost some ground in the practice of communication.
We need to rediscover the virtues of the old-time doctor-patient relationship. Have a doctor you can trust and who listens to you and talks to you.
Dr. Allan Sosin
December 17th, 2016
Colonoscopy, passage of a lighted flexible scope through the large intestine, is the gold standard procedure for detecting colon cancer and the polyps that develop into it. Many individuals, however, avoid colonoscopy because of the laxatives required for preparation, the anesthesia, the small risk of bowel perforation, or the risk of contamination and infection from the procedure itself.
Cologuard is a new screening test much more accurate than the old stool test for occult blood. There is no risk. A stool specimen is mailed to the testing facility and evaluated for the presence of specific protein secreted by intestinal polyps or tumors. The patient is then informed by the doctor’s office of the result. A positive result should be followed by colonoscopy. If a polyp is found, it can be excised during the procedure. If a cancer is found, surgery is needed.
The Cologuard test has 90% sensitivity in detecting polyps or tumors. One out of 8 patients tested, however, will have a false positive result. He will then require colonoscopy, which he would otherwise have needed for screening anyway. Read the rest of this entry »
September 24th, 2016
A large study published in 2013 reveals a markedly reduced incidence of breast cancer in women treated with testosterone compared to women who received no hormone replacement therapy. (Glaser et al, Maturitas 2013)
1268 women were enrolled in the study, with average follow-up of five years. Treatment was provided with testosterone pellets implanted under the skin of the buttock or abdomen under local anesthesia, repeated every 3-4 months. About half of the implants contained testosterone alone, while the rest included anastrozole as well. Anastrozole blocks the conversion of testosterone into estrogen, offering added safety.
The incidence of breast cancer in the testosterone-treated group was only half that of women who did not receive hormones.
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September 19th, 2016
The intestinal lining is subject to injury from many sources: the foods we eat, over-the-counter medications, alcohol, antibiotics, allergies, auto-immune conditions, and a multitude of infections, bacterial, viral, fungal and parasitic. It is no wonder that gastrointestinal symptoms comprise the most common maladies leading to doctor’s office visits.
The most common offending drugs are non-steroidal anti-inflammatory drugs used to treat pain, usually muscle and joint pain. Many people take these NSAIDs to start the day or prior to exercise. They are the drugs most commonly causing gastritis, ulcers in the stomach and intestines, and GI bleeding. Most of them are available in your local grocery store: Advil, Nuprin, Motrin, Aleve, and plain old aspirin. How can we heal or prevent this damage?
Immunoglobulins from colostrum are highly effective in protecting the gastrointestinal lining. Immunoglobulin G is the main component in this preparation. IgG enhances healing of lesions in the intestinal mucosa.
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August 11th, 2016
Ozone is a powerful and rapidly reacting super oxygen that is consumed within minutes after its production. It is produced from oxygen through the application of an electric current. When applied directly it kills bacteria, viruses, parasites and mold. When given systemically it has the effect of improving oxygen utilization and enhancing energy production. Also, by creating a mild oxidative stress, it stimulates the immune system to be more active. Because it is unstable, ozone must be utilized within several minutes of being produced, or it will no longer be effective.
We have been using ozone for several years to treat musculoskeletal problems as a component of prolotherapy. We have given ozone rectally to treat intestinal problems such as colitis. In its strongest systemic formulation, we have given ozone by major autohemotransfusion (MAH). The patient’s blood is withdrawn through a needle by gravity, heparinized so it doesn’t clot, then combined with an equal volume of ozone at high concentration, and infused back into the patient. This process has required about 40 minutes, or 80 minutes for a double-pass.
This year I learned about the 10-pass technique from Dr. Robert Rowan, who has been responsible for the proliferation of ozone therapy in the United States, along with Dr. Frank Shallenberger. Ten passes, or ten times the treatment of a single pass, can be given within 60-90 minutes by using a special ozone machine to vacuum the blood into a glass bottle, then return it rapidly by applying pressure into the bottle. Read the rest of this entry »
August 3rd, 2016
If you had any doubts about the benefits of eating whole fruit, you can put them to rest. A study out of China published in the New England Journal of Medicine (April 7, 2016, pp 1332-1343) reveals that a higher level of fruit consumption led to lower blood pressure and lower glucose levels. There was also a 30-40% reduction in death from heart disease, and of heart attack, and stroke, both from vessel occlusion and brain hemorrhage.
The greater the fruit intake, the lower was the risk. Apples, pears, and citrus fruits are the main fruits eaten in China, although average fruit consumption in China is generally quite low. Fruit is a rich source of potassium, magnesium, fiber, folate, antioxidants, and many phytochemicals with cardioprotective effects. Fruit is also low in calories, sodium, and fat. Raw vegetable intake in China is high, so it is interesting that adding fruits had substantial beneficial effect. Read the rest of this entry »
July 27th, 2016
Stem cell therapy is revolutionizing medicine. Stem cells are multipotential cells residing in various body tissues, especially adipose tissue and bone marrow, but also circulating in the blood stream. When activated and placed in different areas of the body, they are able to differentiate into functional cells to replace damaged tissues. Stem cells are being employed to heal the heart, repair the retina, and reverse various neurological disorders including multiple sclerosis and ALS. In all of these conditions technology is being developed.
Stem cell therapy is well established in the treatment of orthopedic disorders. Many studies have documented regrowth of cartilage and reduction of pain in damaged joints, especially knees and hips. Any joint can be treated, including the back, neck, wrists, elbows, shoulders, feet, fingers and toes. Injections can rebuild torn and degenerated tendons including the Achilles tendon. Partial tears can be reversed and individuals can return to prior activities without the prolonged healing time required after surgery.
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July 23rd, 2016
Blood clots cause heart attacks, strokes, phlebitis, blockage of lung arteries, often leading to severe illness or sudden death. Persons who spend hours in sitting positions, such as in plane flights or long distance driving, are especially susceptible to blood clots forming in their legs, then breaking off and going to the lungs. Symptoms include sudden shortness of breath, chest pain, cough, passing out, palpitations, and the possibility of cardiac arrest.
Hospital patients, especially post-operatively, are often immobile, therefore extremely susceptible to forming blood clots in their legs. In all of these instances, physicians routinely order blood-thinning agents, usually heparin, to avoid serious complications.
Atrial fibrillation, a heart irregularity causing blood clots that migrate from the heart to the brain, is a major cause of stroke, and eventually develops in 25% of adults.
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November 15th, 2015
There are so many diverse opinions about testosterone that it would be hard for anyone, physician or layman, to see a clear picture.
What is well established is that testosterone:
- Improves athletic performance
- Increases muscle mass
- Raises bone density
- Increases libido
- Often improves erectile function
- Reduces abdominal fat
- Increases red blood cell production
What has been argued is the effect of testosterone on heart disease, stroke, and mortality. A recent study reveals a powerful effect of testosterone in preventing heart attacks, stroke and death. (Normalization of Testosterone is Associated with Reduced Incidence of Myocardial Infarction and Mortality in Men, European Heart J. Aug 6, 2015) Read the rest of this entry »
October 29th, 2015
A new study* validates the powerful effect of intravenous vitamin C in recovery from infection.
Dr. Fowler described his study in the October 2015 issue of the Townsend Letter, the major alternative medicine journal. Twenty-four patients, all critically ill with severe sepsis, were treated in the intensive care unit. Sepsis is a disseminated infection that travels through the blood stream, causing damage to heart, kidneys, liver, lung and brain, often resulting in death or permanent organ impairment.
Sixteen patients were given medium or high dose intravenous vitamin C, and 8 patients were given placebo. There was rapid correction of organ failure in the vitamin C-treated patients, more impressive in those who received higher doses. No correction occurred in patients who were given placebo.
Biomarkers of inflammation were also measured, including C-reactive protein and procalcitonin, and these declined significantly, only in the vitamin C-treated patients. Another marker, thrombomodulin, is released into the blood as an indicator of severe vascular injury. It rose in the patients on placebo, but not at all in patients on intravenous vitamin C.
Mortality was 62% in the patients on placebo, and 38% in vitamin C-treated patients.
Both human and animal studies have demonstrated benefits of vitamin C in treating infection. High levels of vitamin C in the blood cannot be achieved with oral doses alone, because there is a limit on how much can be absorbed from the GI tract. Intravenous vitamin C is safe, easy to administer, and can be given in high doses.
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