Posts by Daniel Pendick
One key instruction in the operating manual for healthy aging is remaining ever vigilant about osteoporosis. The quest to identify osteoporosis early has led to widespread testing of bone mineral density (BMD), the key measure of bone strength. Medicare pays for the gold-standard test, dual-energy X-ray absorptiometry (DEXA), every two years, regardless of whether their previous scan was normal or not. A study published today found that repeat bone-density testing after four years improved the ability to identify those at higher risk by only 4%. This study raises the fundamental question: Is repeating testing of older people with normal bone strength every two years too much?
In many men diagnosed with prostate cancer, the cancer cells grow so slowly that they never break free of the gland, spread to distant sites, and pose a serious risk to health and longevity. Instead of embarking on immediate treatment, a growing number of men choose active surveillance, in which doctors monitor low-risk cancers closely and consider treatment only when the disease appears to make threatening moves toward growing and spreading. A new Harvard study shows that the aggressiveness of prostate cancer at diagnosis remains stable over time for most men. If confirmed, then prompt treatment can be reserved for the cancers most likely to pose a threat, while men with slow-growing, benign prostate cancer—which is unlikely to cause problems in a man’s lifetime—can reasonably choose active surveillance.
Hemorrhoids are swollen blood vessels on the outer rectum and anus. They can turn bowel movements into intensely painful experiences. Classic symptoms include rectal pain, itching, bleeding, and possibly prolapse (protrusion of hemorrhoids into the anal canal). Although hemorrhoids are rarely dangerous, they can be a painful recurrent bother. Simple self-help measures can ease the ordeal of most hemorrhoids and allow healing. These include: Step up the fiber. Lubricate the process. Don’t delay having bowel movements. Try over-the-counter remedies. And sit in a sitz.
Birth, childhood, adulthood, and death span the book of life. Unfortunately, many people tend to avoid thinking or talking about how they want the final chapter to read. For the seriously ill or elderly—and even those who aren’t—not expressing wishes and desires about health care at the end of life can lead to getting care you wouldn’t have chosen for yourself. Families often bear the brunt of delaying or avoiding a discussion about a loved one’s end-of-life preferences. That often leaves family members making decisions without knowing what their loved one would have wanted. Doctors in Canada just published recommendations for starting the end-of-life conversation. The Conversation Project offers a “starter kit” to help people prepare to discuss their end-of-life wishes. Another resource is Five Wishes, a planning document distributed by the Aging with Dignity Foundation.
Each year, nearly a quarter of a million American men learn they have prostate cancer. Most are diagnosed with early-stage cancer that has not spread beyond the prostate gland. Traditional treatments include surgery, radiation therapy, and a “watch and wait” strategy called active surveillance. A new study published online this week in JAMA Internal Medicine indicates that diet may be an important add-on. The study, part of the ongoing Harvard-based Health Professionals Follow-up Study, suggests that eating more foods that deliver healthy vegetable oils can help fight the second leading cause of cancer death in men. Earlier studies have implicated the traditional Western diet, which is relatively high in red meat and other sources of animal fats, with a higher risk for developing prostate cancer in the first place, while eating more vegetable oils and vegetable protein may help prevent it.
• Fast-food restaurants deliver filling, inexpensive meals and snacks. But there’s usually a hidden added cost: a wallop of salt (sodium) that isn’t good for cardiovascular health. Even with the current clamor for reducing sodium in the American diet, and industry promising to do just that, the amount of sodium in prepared foods hasn’t changed much since 2005, according to a report published in the latest issue of JAMA Internal Medicine. The average sodium in chain restaurant items increased 2.6% between 2005 and 2011. In packaged foods, it fell on average 3.5%. While some are calling for tighter government regulation on the sodium content in processed and restaurant foods, you can take action now.
Is red meat bad for your heart? A new study suggests it is, but not for the reasons you might expect—like the saturated fat or cholesterol in red meat. A team from a half dozen U.S. medical centers says the offending ingredient is L-carnitine, an amino acid that is abundant in red meat. Their work shows that eating red meat delivers L-carnitine to bacteria that live in the human gut. These bacteria digest L-carnitine and turn it into a compound called trimethylamine-N-oxide (TMAO), which has been shown to cause atherosclerosis, the disease process that leads to cholesterol-clogged arteries, in mice. There’s still a long way to go before we know the full story about L-carnitine and heart disease, but this work suggests that cutting back on L-carnitine (and avoiding L-carnitine supplements) may be good steps for heart health.
Chronic pain in the muscles and joints can make life miserable. Standard treatments like ice and heat, anti-inflammatory medications, physical therapy, and appropriate exercises can often ease the pain. But when they don’t, acupuncture is an option with a good track record that’s worth considering. Research from an international team of experts adds to the evidence that it does provide real relief from common forms of pain. The team pooled the results of 29 studies involving nearly 18,000 participants. Overall, acupuncture relieved pain by about 50%. The study isn’t the last word on the issue, but it is one of the best quality studies to date and has made an impression. For new pain, an acupuncturist should not always be the first stop. It’s important to get a clear diagnosis of what is causing the pain to rule out serious medical conditions that should be treated right away—and then seek out acupuncture if appropriate.
If you or a loved one has a latex allergy or sensitivity, think twice before reaching for a product that says “latex free” or “does not contain latex.” That’s the latest advice from the FDA, which says no existing tests can show that a product is completely free from latex. Labeling that suggests a product doesn’t contain the substance could cause trouble for individuals with a latex allergy or sensitivity. Natural latex is used to make a host of stretchy products, including adhesive bandages, condoms, gloves used in health care and dishwashing, balloons, rubber band, elastic used in waistbands and socks, baby bottle nipples, pillows, and more. This kind of latex contains proteins that set off some people’s immune systems, leading to an allergic reaction. The FDA’s warning highlights that products advertised as “latex-free” may not always live up to the claim. That’s because products that are made without latex can be contaminated with latex proteins during the manufacturing or packaging process.
Memory slips are aggravating, frustrating, and sometimes worrisome. When they happen more than they should, they can trigger fears of looming dementia or Alzheimer’s disease. But there are many mundane—and treatable—causes of forgetfulness. Here are seven common ones: lack of sleep, some medications, an underactive thyroid, drinking too much alcohol, stress, anxiety, and depression. If memory lapses are bugging you, it’s worth a conversation with your doctor to see if any reversible causes are at the root of the problem. Something like getting more sleep, switching a medication, or a stress reduction program could get your memory back on track.