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How to Get Your Doctor to Translate the Medical-Speak
Tweet Share on Facebook January 29, 2010 Comment (2)All of us know that doctor-speak can sound like a foreign language. And even once we get a handle on all the medical jargon, we may wonder if our doctors are really listening to us, really hearing our health concerns—heck, even seeing into our psyche. (I was amazed a few weeks ago when an otolaryngologist that I took my daughter to for a consult didn't even introduce herself when we walked in the room.) Internist Danielle Ofri has focused intently on the art of communicating with her patients—even moving to Costa Rica for a year to become fluent in Spanish to better converse with the large population of Latino immigrant patients who visit her clinic at Bellevue Hospital in New York City. (She's also a professor of medicine at the New York University Medical School.) Her new book, Medicine in Translation, details the cultural, religious, and racial divides that doctors and patients must bridge in an effort to become healthcare partners. Check out my video with her and edited excerpts from our interview.
Video: Doctor speaking his own language? Physician Danielle Ofri finds solutions in her new book, Medicine in Translation.
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Reproductive Rights Groups Beg Obama Not to Cut Family Planning
Tweet Share on Facebook January 29, 2010 Comment (3)Remember when women's reproductive rights activists were joyously celebrating and fist-bumping each other over Barack Obama's election? What a difference a year makes. The morning after the president's State of the Union address, which included a call for a freeze in domestic spending in the 2011 budget, 21 women's groups dashed off a letter begging Obama not to cut funding for federally subsidized family planning clinics. A copy of the letter found its way into my hands.
The letter, also sent to key members of Congress, including House Speaker Nancy Pelosi, Senate Leader Harry Reid, and those in charge of deciding the final budget, points out that the taxpayer-funded family planning programs under Title X are "woefully underfunded." The letter says that "had Title X kept pace with inflation, it would now be funded at $787 million, instead of its FY 2010 funding level of $317.5 million." The groups were disappointed last year when Obama raised Title X funds by only $10 million instead of the $400 million that they had sought. Now they worry that funds will be frozen or even cut in the 2011 budget that Obama will present to Congress Monday.
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Will Sex Addict Treatment Save Tiger Woods's Marriage?
Tweet Share on Facebook January 27, 2010 Comment (28)Is sex rehab Tiger Woods's way back to a rehabilitated marriage and career? The pro golfer reportedly checked himself into such a clinic after a string of women—I've lost count—stepped forward claiming to have slept with him over the years. The latest news reports suggest that his estranged wife, Elin Nordegren, visited him at a facility in Hattiesburg, Miss., to participate in his therapy sessions.
What I'm wondering, though, is whether getting a diagnosis of sex addiction is simply an easy out for those caught cheating. Sorry, honey, but I just can't control my impulsive behaviors! Surely, there must be ways to differentiate between a real sex addict and a plain old crummy cheater. Yes, says psychologist Eli Coleman, director of the human sexuality program at the University of Minnesota Medical School, though he hates the label "sex addict" and prefers to use the scientific term "hypersexual disorder." Very few of the unfaithful actually have this mental condition, he says, but any couple grappling with infidelity can certainly benefit from professional counseling.
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Why Teen Pregnancies Are on the Rise
Tweet Share on Facebook January 26, 2010 Comment (14)Last year I reported that, after a decade of steady decline, teen birth rates were increasing in 26 states. So it's no great surprise that teen pregnancies are on the rise too, as a report issued Tuesday by the Guttmacher Institute, a nonpartisan research organization that focuses on sexual health, found. The report found that the pregnancy rate among American teens rose 3 percent in 2006 (the latest year for which statistics are available), teen birth rates rose 4 percent, and abortion rates were up 1 percent. Overall, about 7.2 percent of girls ages 15 through 19 became pregnant in 2006, compared with nearly 7 percent in 2005.
We're still doing better than we were in 1990, when nearly 12 percent of teenage girls became pregnant. (About 80 percent of teen pregnancies are unintended.) Still, some states, including New Mexico, Nevada, Arizona, and Texas, have current rates hovering near 10 percent, And in New York, which has the highest abortion rate, 4 percent of teens and nearly 9 percent of black teens have terminated a pregnancy.
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Birth Weights Drop, Surprising Researchers
Tweet Share on Facebook January 22, 2010 Comment (4)Babies are being born a little lighter these days. Not much—an average of 1.8 ounces less in 2005 than in 1990, meaning the average birth weight of a baby born at full term today is just shy of 7½ pounds instead of a smidgen over, according to a study published Thursday in the journal Obstetrics & Gynecology. So why is this even worth reporting?
Well, the finding signals a reversal of a trend towards bigger and bigger babies that began after World War II. And, quite frankly, the Harvard University researchers who conducted the study were surprised. More pregnant women have factors that should increase their baby's birth weight: being older than 35, gaining more than 45 pounds during pregnancy, having diabetes before or during pregnancy, and avoiding smoking. Yet birth weights are dropping, not rising—particularly among women who have the lowest risk of having low-birth-weight babies to begin with: white, well-educated nonsmokers who received early prenatal care. These women's babies were born weighing an average of 2.8 ounces less in 2005 than in 1990.
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Did Heidi Montag's Plastic Surgery Go Too Far?
Tweet Share on Facebook January 20, 2010 Comment (77)Was reality TV star Heidi Montag's decision to have 10 cosmetic procedures in one day a sign, as some tabloids claim, of her low self-esteem and addiction to plastic surgery? Or was it a brilliant PR move to land her on the cover of People and launch her singing career? I guess we'll never know, but she has certainly ignited a heated debate about whether, why, and how much women should elect to have themselves surgically altered for the sake of "beauty."
In an interview yesterday with ABC's Good Morning America, Montag's plastic surgeon, Frank Ryan, defended his decision to perform 10 hours of surgery on the 23-year-old. "I disagree that it's too much," he said. "Many of these were little tweaks." (See the interview with Montag and her surgeon.) The operations Ryan performed on Montag in November were a minilift of the brow, Botox in the forehead, nose job revision, fat injections in cheeks and lips, chin reduction, neck liposuction, ears pinned back, breast augmentation revision, liposuction on waist and thighs, and a buttocks augmentation. Notice the word revision after two of the procedures. Montag had a nose job and breast implants three years ago.
Heidi Montag in 2006 before her first surgery (left) and in 2009 before her second set of surgeries. -
With Obesity Rates Leveling Off, Banish the Belly Fat for Good
Tweet Share on Facebook January 13, 2010 Comment (7)News today on the obesity war front is mixed. Two thirds of Americans are overweight or obese, but at least we're leveling off from the steep climb that started developing in the late 1980s, according to a study published Wednesday in the Journal of the American Medical Association. And for women, the news seems particularly rosy. Our obesity rates remained virtually unchanged over the past decade.
I was also pleased to see another finding published Tuesday in the International Journal of Obesity indicating that having a little extra fat on the butt, hips, and thighs might actually protect against heart disease and diabetes. Hallelujah!
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Skip the Chemotherapy? Gene Tests Help Breast Cancer Patients Make That Decision
Tweet Share on Facebook January 12, 2010 Comment (5)Ask any woman with breast cancer if she'll do all that it takes to prevent a recurrence, and chances are she'll say, "Of course!" Yet she probably wouldn't choose to have chemotherapy—and the hair loss, nausea, fatigue, and potentially serious medical complications that come with it—if told that it probably wouldn't do much to lower an already low risk of relapse. Turns out, a genetic test called Oncotype DX that predicts a woman's chances of recurrence is, indeed, affecting doctors' and patients' decisions when it comes to chemotherapy, according to a study published Monday in the Journal of Clinical Oncology. About one third of the time, oncologists in the study changed their treatment recommendations after seeing the test result and about one quarter of the patients chose not to have unnecessary chemotherapy.
[Here's one woman who avoided chemo after paying for the test herself.]
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Do You Really Need That Antidepressant?
Tweet Share on Facebook January 6, 2010 Comment (7)Consider this: Antidepressants are the most widely prescribed drugs in the United States, with 10 percent of women and 4 percent of men taking them. Yet a new review published Tuesday in the Journal of the American Medical Association finds that some of the most popular drugs actually don't work better than a sugar pill in the majority of these folks. The study did find, however, that the medications do work effectively in those with really bad depression, the kind that completely interferes with the ability to work, feel any pleasure, sleep, eat normally, and engage in the normal routines of life.
What's shocking to me is how many people—especially women—are put on these drugs for mild mood problems that don't fall into the category of truly, utterly "black dog" depression. That's probably the fault of primary-care physicians, who often don't screen properly for depression before writing a prescription. Correct screening involves asking patients a series of questions about their symptoms in order to categorize the condition as mild, moderate, severe, or very severe. To assess the effectiveness of antidepressants in the new review of six studies, researchers relied on the Hamilton Depression Rating Scale, which defines "mild" as a score from 8 to 13, "moderate" as a score from 14 to 18, "severe" as a score from 19 to 22, and "very severe" as a score above 23.
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5 Barely Noticeable New Year's Resolutions
Tweet Share on Facebook January 5, 2010 Comment (8)I'm not a big fan of sweeping New Year's resolutions, given that I have little faith in my ability to actually sustain those promises. I'm not alone: Half of Americans break their resolutions in the first six months, and just 10 percent stick with them throughout the year. That said, I would like to make some effort to improve my and my family's health.
Resolved: Make tiny healthful lifestyle tweaks so barely noticeable that I won't be tempted to untweak them.
