Monthly Archives: April, 2011

Choosing The Right Doctor

When it comes to finding out which doctor or hospital is the best for one’s needs, many are quite at a loss. In fact, I’ve been asked this question many times. Here are some pointers:

  • Look for a hospital with a good safety record as well as those possessing a recognised accreditation standard (such hospitals voluntarily undergo screening by a recognised review body, such as the JCI, in order to provide services of a certain minimum quality).
  • Find out from your doctor where he sends his relatives to. What’s good enough for a doctor is usually a stamp of approval. Why, even nurses in the hospital may be able to suggest the right doctor if one cares to ask.
  • Look for a doctor who’s busy. Sure, it means long waiting times, but this might be worth it in the long run.
  •  Some health department websites do provide statistics on how many specific operations are done in a year and what the complication rates are. This way one can opt for the best hospitals for a particular procedure. Here’s a  website that provides info of the best hospitals in the US, for instance –  click here.

    This magazines does yearly surveys to seek out the best

  • At the end of the day, its important that you click with the doctor – a good doctor-patient relationship is extremely important  and contributes a long way to a good outcome..

A Medical Mistake – Liz Taylor

Was browsing recently at the local bookshop when the April 11 issue of the National Enquirer caught my eye:

The first thought that came to my mind (and I’m sure yours as well) is what mistake did the doctors do? Read on..

Liz Taylor passed away March 23rd at the age of 79 at the famed Cedars-Sinai Medical Centre, Los Angeles. The Hollywood legend, noted for her 8 marriages, had reportedly been hospitalised over a 100 times in her life ,for various problems including diabetes,a brain tumour, stroke  and had had both of  her hips replaced.

Apparently, six months before she passed away, doctors wanted to perform bypass surgery and heart-valve replacement on her heart as it had badly leaking valves which had resulted in her heart-size grossly ballooning out (what doctors call congestive cardiomyopathy). It was reported that the actress declined surgery as she could no longer find the will to fight.

Experts believe her decision to forego surgery may have led to her earlier demise, as in the 6 weeks prior to her death, she lost weight drastically (doctors call this cardiac cachexia) to a mere 94 pounds (42.7 kg) and became so weak that she had to use a respirator. Towards the end, her heart had stopped twice and a cardiac defibrillator had to be used to restore the heart-beat.

Hospital doctors working in the ICU setting will be familiar with this setting..at the end of the day, the patient will rightly be the one to decide on what healthcare decision to take, despite the medical teams’ best intentions.

A medical mistake? I’m not sure Liz Taylor made one..she loved life and hated no longer being able to enjoy it. She probably just lost the will to live..

Radiation – What’s The Problem?..(2)

No words…just a diagram 🙂

Alcohol on squirrels, sight and sex

The Malaysian Tree Shrew - commonly wrongly called the house squirrel

Who would have thought Malaysia would make a name for itself as having the world’s greatest drinker?  This relates to the ability of one of nature’s creatures being able to imbibe the equivalent of one case of beer every night without getting drunk!

The Malaysian tree shrew, belonging to the squirrel family and the size of a small rat, has been featured  in countless newspapers throughout the world ( here’s one ) and also in several blogs ( tiny malaysian tree shrews live on alcohol but never gets drunk) and is touted as the world’s heaviest drinker. It also has the dubious reputation of being able to consume large amounts of alcohol without ever getting drunk.  What’s their secret? These animals have an unusual metabolism that can convert alcohol quickly into nontoxic ethyl glucuronide (EtG).This stuff EtG is deposited into the animal’s fur, out of harm’s way. Needless to say, human beings are unable to do this.

Which is why in humans, as more alcohol is consumed, one progresses through various degrees of intoxication. One well-known phenomenon is beer-goggles, the phenomenon used to describe the situation that happens when, as one imbibes more and more, there is a perception that  people around you become increasingly attractive. This is humorously illustrated here:

Which brings us to the effect of alcohol on sex – its been wrongly believed that alcohol has aphrodisiac properties. This is a fallacy as all it does is to lower inhibitions and raises irrational behaviour. In fact, taken regularly , it is a known to even cause erectile dysfunction. Even William Shakespeare knew of its effect when the porter in Macbeth said words to the effect that:

“Alcohol increases the desire but diminishes the performance”.

High Blood Pressure? No, Its Not!

Quite a number of patients were referred to me the last few weeks for the management of high blood pressure (hypertension) which had proved somewhat resistant to medications.  Their blood pressures had been recorded high by their attending doctors. Those with their own blood pressure machines had protested that their readings were quite normal at home although their doctors insisted otherwise.

Having blood pressure checked by a doctor can make the reading artificially high

 

Fact: A third of hard-to-treat high blood pressure may actually be ‘fake’ and instead a patient’s nervous response to being seen by a doctor, as reported recently (here). This phenomenon has been known for some time and fondly called white-coat hypertension, in reference to the fact that quite a number of people with normal blood pressure developed nervous tension or stress when they were confronted by a doctor; which in turn is reflected by raised blood pressure readings, albeit temporary. When they were removed from the stress situation, blood pressure quickly reverted to normal levels, which accounts for the normal readings such patients obtain  with their own machines when at home.

Portable wrist monitors can measure BP readings over 24 hours

In some of these patients, blood pressure medications were actually prescribed which caused severe side-effects when they returned home and blood pressure normalised. Medications are quite unnecessary in such cases.

How does one make sure that one’s blood pressure is truly high and not due to stress-induced causes? Simple, in most hospitals, doctors can ask patients to wear a device that monitors the blood pressure regularly over 24 hours (24-hour portable ambulatory blood pressure monitoring). Today’s devices are not so bulky and cumbersome and can often resemble a wrist-watch.

The really bigger problem is trying to get those who have not gotten a blood pressure reading for many years on the mistaken belief that they did not have symptoms (hypertension is usually silent – hence the acronym ‘silent killer’) or were simply unaware that they were at risk.

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