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2010 Cancer Updates: Screening and Avoiding Cancer with Dr. Susan Escudier

Joseph Galati — Sun, 07 Mar 2010 19:00:00 GMT

This Sunday evening on Your Health First, Dr. Susan Escudier with Texas Oncology will be joining Dr. Joe Galati in a discussion covering cancer risk, prevention, and lifestyle changes that can reduce your cancer risks.

Susan M. Escudier, M.D., F.A.C.P. specializes in medical oncology and hematology with special interest in colon cancer. She is board certified in internal medicine, oncology and hematology. Dr. Escudier serves on the Texas Oncology Medical Oncology Quality Committee. Dr. Escudier has received Chief Resident’s Outstanding Medical Resident Award. She is currently a Clinical Associate Professor of Medicine at Baylor College of Medicine and chairs the Granting Committee for the American Cancer Society’s event "Making Strides Against Breast Cancer". She previously served as Assistant Professor at M.D. Anderson Cancer Center where she was involved in Leukemia research.

Cancer Links of Interest

American Cancer Society: Diet and Cancer

The 15 Super Foods

Colon Cancer Screening

2009 Cancer Statistics (Excellent Information)

Breast Cancer Risk Reduction

Should I Be Tested For Prostate Cancer?

Nutrition and Physical Activity

Cancer Screening Guidelines

Diet and your cancer risk is an evolving area of research. Certain foods have been shown to reduce your cancer risk.

Dietary Fats: Diets high in fat have been linked to increased risk of various cancers, particularly breast, colon, prostate, and possibly pancreas, ovary, and endometrium (USDHHS, 1988; National Research Council, 1989). Studies of populations in countries consuming high-fat diets compared to low-fat diets have consistently shown higher incidence and mortality rates for breast, colon, and prostate cancer. There is substantial, but not conclusive, evidence that the international association between fat intake and the risk of breast and colon cancer is much stronger for total fat intake compared to the specific type of fat, i.e., saturated, monounsaturated, or polyunsaturated fat (Hursting et al., 1990). However, a combined analysis of 12 case-control studies showed a significant positive association between breast cancer risk and saturated fat intake in postmenopausal women (Howe et al., 1990). Recent studies in the same population of U.S. women reported that increased intakes of total saturated and monounsaturated fats were associated with increased colon cancer but not breast cancer (Willett et al., 1990, 1992).

Fat consumption in the United States is much higher than that needed to meet the physiological needs for energy and essential fatty acids. The average U.S. diet is estimated to contain approximately 37 percent of calories from fat. Dietary recommendations are to decrease total fat intake to 30 percent of calories. The major sources of fat in the American diet are added fats and oils used as spreads, cooking fats, and salad oils as well as the fat in meats and whole milk dairy products.

Because dietary fat intake is highly correlated with calorie intake, the question has been raised as to whether fat intake or calorie intake is the major dietary factor affecting cancer risk. However, the few studies that have addressed the relative importance of fat intake versus calorie intake suggest that both fat and calorie intake have independent effects. Dietary fat is the most concentrated source of energy of all the nutrients and supplies nine calories per gram compared to four calories per gram from either carbohydrate or protein. In general, a reduction in dietary fat intake is accompanied by a decrease in total calorie intake and body weight (Boyd et al., 1990; Henderson et al., 1990).

Dietary Fiber: Dietary fiber falls into two categories, water-soluble fiber and water-insoluble fiber, and is generally defined as those components of food plants resistant to the enzymes produced by the human digestive tract.

Increasing evidence suggests that diets high in fiber-containing foods are associated with a reduced risk for cancer, especially cancer of the colon (Trock et al., 1990). A few studies have also shown a reduced risk for cancers of the breast, rectum, oral cavity, pharynx, stomach, and other sites with diets rich in fruits, vegetables and grain products (Lanza et al., 1992). Because these foods contain other nutrients as well as fiber, and are usually lower in fat, it has not been possible to determine whether the protective effect is attributable to dietary fiber.

Fruits and Vegetables: Populations consuming diets high in fruits and vegetables tend to have a lower cancer risk. Fruits, vegetables, and grains contain a number of nutrients, including carotenoids, vitamin A, and vitamin C. The cancers for which there is evidence of a protective effect include those of the lung, colon and rectum, breast, oral cavity, esophagus, stomach, pancreas, uterine cervix, and ovary. For most cancer sites, especially epithelial cancers of the respiratory and digestive tracts, persons with low fruit and vegetable intake had about twice the risk of cancer as those with high intake (Block et al., 1992).

Carotenoids and Vitamin A: Numerous studies have found evidence that carotenoids reduce the risk of some cancers. The evidence is particularly strong for lung cancer (Ziegler, 1989), even after taking smoking into account. Every study that examined the role of carotene-rich foods found reduced lung cancer risk with higher intake, and about 20 of 25 studies yielded statistically significant results. Five of six studies of blood carotenoids found that persons with higher levels had reduced risk. There is no question that smoking is the strongest risk factor, and quitting smoking is the most important step to reduce risk. It appears, however, that there may be additional benefit to increasing the consumption of foods containing carotenoids.

Carotenoids are found in dark yellow/orange vegetables and fruits such as carrots, sweet potatoes, and cantaloupe and in deep green leafy vegetables such as broccoli, spinach, and collard greens. There are many different carotenoids in such foods, including beta-carotene, alpha-carotene, and lutein.

While the current dietary recommendation is for five servings of fruit and vegetables a day, Americans fall somewhat short of this goal. A recent survey showed that only 23 percent of the population is achieving this goal; the average daily intake is about three and a half servings of fruits and vegetables (Subar et al., 1992).

Vitamin C: Vitamin C is found in fruits, particularly citrus fruits and juices, and in green vegetables, as well as in some fortified foods. Of a group of epidemiologic studies investigating the role of vitamin C, three-fourths found that vitamin C, or fruit rich in vitamin C, provides significant protection (Block 1991). The evidence is most consistent for cancers of the esophagus, oral cavity, and stomach, but protective effects have been reported for cancers of the pancreas, rectum, and cervix. There is increasing evidence for a role in lung cancer, and an analysis combining results of studies of diet and breast cancer found that vitamin C had a strong and significant negative association (Howe et al., 1990).

Other Nutrients: Fruits, vegetables, and grains contain other vitamins and minerals associated with a protective effect against cancer.

Vitamin E has inhibited tumors in experimental animals and been linked to reduced risks of oral, stomach, and other cancer in epidemiologic studies. Selenium also may have a protective effect. In a recent randomized large-population trial testing the effectiveness of vitamin/mineral supplementation among persons in high risk areas of China, those who received daily supplements with a combination of beta-carotene, vitamin E, and selenium for 5 years had a significantly lower cancer death rate (Blot et al., 1993). The findings do not automatically translate to Western populations--in that the Chinese population studied was chronically deficient in a number of nutrients--but offer a hopeful sign that certain vitamins and minerals may lower risk of some cancers. However, two other recent large randomized trials of supplements, one testing the effect of supplemental beta-carotene or alpha-tocopherol in the prevention of lung cancer among smokers and the other testing the effect of supplemental beta-carotene and vitamins C and E in the prevention of adenomatous polyps (a precursor lesion for colorectal cancer), suggest that supplemental use of these nutrients does not reduce the risk of either lung or colorectal cancer (The ATBC Study Group, 1994; Greenberg et al., 1994). In the study of the effect of beta-carotene or alpha-tocopherol on lung cancer among smokers, dietary intake of these nutrients from foods was associated with a reduced risk for lung cancer (The ATBC Study Group, 1994). Some studies suggest that calcium may play a protective role in colon cancer. A 19-year prospective study in men showed the risk for colon cancer was lower in those with the highest calcium intake (Garland, 1985). In addition to dairy products, certain vegetables are good sources of calcium, notably roots, okra, and dark green leafy vegetables such as collard greens.

7-Mar-10 1:00 PM

Michael Weiner, M.D.: Patient Referral Problems

Joseph Galati, M.D. — Sun, 28 Feb 2010 14:00:00 GMT

This week, Michael Weiner, M.D., will be joining Dr. Joe Galati to discuss a recent article investigating patient referrals to specialiists. Dr. Weiner is Associate Professor of Medicine at Indiana University School of Medicine, and Director of the Indiana University Center for Health Services and Outcomes Research. The full article can be downloaded here. Additionally, Dr. Weiner has published research on the use of technology and patient care. This article can also be downloaded here.

The most frequent error in medicine seems to occur nearly one out of three times a patient is referred to a specialist. A new study found that nearly a third of patients age 65 and older referred to a specialist are not scheduled for appointments and therefore do not receive the treatment their primary care doctor intended.

According to a new study appearing in the February 2010 issue of the Journal of Evaluation in Clinical Practice, only 71 percent of patients age 65 or older who are referred to a specialist are actually scheduled to be seen by that physician. Furthermore, only 70 percent of those with an appointment actually went to the specialist’s office. Thus, only 50 percent (70 percent of 71 percent) of those referred to a specialist had the opportunity to receive the treatment their primary care doctor intended them to have, according to the findings by researchers from the Regenstrief Institute and the Indiana University School of Medicine.

The Institute of Medicine, in its seminal report “To Err is Human,” defines a medical error as a “wrong plan” or a failure of a planned action to be completed.

Patients fail to complete referrals with specialists for a variety of reasons, including those that the health care system can correct, such as failure of the primary care doctor’s office to make the appointment; failure of the specialist’s office to receive the request for a consultation—which can be caused by something as simple as a fax machine without paper – or a failure to confirm availability with the patient,” said Michael Weiner M.D., M.P.H., first author of the study.

“There will always be reasons – health issues or lack of transportation, for example – why a referred patient cannot make it to the specialist he or she needs, but there are many problems we found to be correctable using health information technology to provide more coordinated and patient-focused care. Using electronic medical records and other health IT to address the malfunction of the referral process, we were able to reduce the 50 percent lack of completion of referrals rate to less than 20 percent, a significant decrease in the medical error rate,” said Dr. Weiner.

The JECP study followed 6,785 primary care patients seen at an urban medical institution, all over age 65, with a mean age of 72. Nearly all (91 percent) of the patients were covered by Medicare.

“This is not necessarily the fault of patients or doctors alone, but it may take both working together – along with their health system – to correct this problem. Our study highlights how enormous a problem this is for patients who were not getting the specialized care they needed. Although our findings would likely differ among institutions, unfortunately overall trends are similar in other parts of the country” said Dr. Weiner.

Dr. Weiner is director of the Regenstrief Institute's Health Services Research Program, director of the Indiana University Center for Health Services and Outcomes Research, and director of the VA Health Services Research and Development Center of Excellence on Implementing Evidence-Based Practice at the Roudebush VA Medical Center.

Co-authors of the study are Anthony J. Perkins, M.S., of the Regenstrief Institute and the IU Center for Aging Research, and Christopher M. Callahan, M.D., a Regenstrief Institute investigator and Cornelius and Yvonne Pettinga Professor in Aging Research at the IU School of Medicine. Dr. Callahan is founding director of the IU Center for Aging Research.

This study was supported by the National Institute on Aging.

28-Feb-10 8:00 AM

Childhood Obesity: The Tools You Need

Joseph Galati — Sun, 14 Feb 2010 19:00:00 GMT

Michelle Obama this past week launced the "Let's Move" program, geared to address childhood obesity. For more information, click here.

This week, a favorit of Your Health First, Chuck Garcia will be joining Dr. Galati to discuss Michelle Omama's plan, and what the everyday family can do to tackle obesity in their children.

Childhood obesity is a threat to our children, and research shows that they may not live as long as their parents.

Below are important links to review and share.

Active Family Time

Reduce Screen Time for Kids and Adults

It's All About Portion Control

How Many Calories Do You Need?

Better Food Choices

Healthy Weights

Food Atlas

Physical Activity Guidelines

Kids Walk to School Program

14-Feb-10 1:00 PM

Thyroid Disease Awareness: Daniel Duick, M.D.

Joseph Galati — Sun, 24 Jan 2010 19:00:00 GMT

This week, Dr. Daniel Duick will join Dr. Joe Galati in discussing thyroid disease, a common, but very misunderstood organ in the human body.

In January, the American Association of Clinical Endocrinologists (AACE) kicked off its twelfth annual Thyroid Awareness Month. This year's theme, "Thyroid Imbalance" Target Your Numbers, highlights the importance of the TSH (thyroid-stimulating hormone) and Free T4 tests, simple blood tests that measure the appropriateness of the thyroid gland's hormone production. Once again, the American Thyroid Association (ATA) is working in cooperation with AACE to spread the message of thyroid health.

The thyroid gland is a small, butterfly-shaped gland found just below the Adam's apple. It makes thyroid hormones, which are chemicals that affect the function of many of the body's organs including the heart, brain, liver, kidneys and skin.

"Symptoms often associated with thyroid hormone imbalance, including weight changes, mood swings, and menstrual disturbances, can be rather subtle," commented AACE President Bill Law, Jr., MD, FACE. "Patients are often unaware that they should ask their doctor to check thyroid blood tests. Thyroid diseases can develop quite slowly and many patients do not realize that they are ill until they begin treatment and start to feel more energetic and healthy."

According to AACE Medical Guidelines for Clinical Practice for Evaluation and Treatment of Hyperthyroidism and Hypothyroidism, the sensitive TSH test has become the single best screening for thyroid dysfunction. To further evaluate the appropriateness of a patient's TSH level, AACE recommends that a Free T4 test be conducted along with a TSH test. "It is very important for patients with thyroid hormone imbalance to know their TSH and Free T4 numbers. The optimal goal TSH level for patients on treatment ranges between 0.3 to 3.0 mIU/L. Patients should talk to their doctors about their Free T4 numbers, since reference ranges can vary somewhat between different laboratories," stated Dr. Law.

More information on thyroid disease can be found at the following links.

www.aace.com
www.powerofprevention.com

www.thyroid.org.

24-Jan-10 1:00 PM

CysticFibrosis: Update from UTMB Experts

Joseph Galati — Sun, 10 Jan 2010 22:00:00 GMT

This week, Dr, Vincent Valentine from UTMB will be joining Dr. Galati to discuss cystic fibrosis, and the advances being made at UTMB in Galveston, TX. Dr. Valentine is the Medical Director of the Lung Transplant program at UTMB, and is a leading authority in all facets of lung disease, including cystic fibrosis.

Cystic fibrosis is an inherited disease that causes thick, sticky mucus to build up in the lungs and digestive tract. It is one of the most common type of chronic lung disease in children and young adults, and may result in early death.

Links of interest are listed below:

UTMB

Cysticfibrosis.com

What is Cystic Fibrosis?

American Lung Association

Custic Fibrosis Foundation

10-Jan-10 4:00 PM

Amy P. Abernethy, M.D.: Symptoms Never To Be Ignored

Joseph Galati — Sun, 03 Jan 2010 23:00:00 GMT

This week, Dr. Amy Abernethy, Program Director of the Duke Cancer Care Research Program, will join Dr. Galati and discuss symptoms that may seem harmless, but can all be red flags for cancer.

Dr. Abernethy is the Program Director of the Duke Cancer Care Research Program, Associate Professor of Medicine with Tenure in the Division of Medical Oncology, Department of Medicine at Duke University Medical Center Associate Director - Information Technology and Acting Program Leader - Cancer Control Program, Duke Comprehensive Cancer Center. Medical Director - Oncology Quality, Outcomes, and Patient-centered Care, Duke University Health System. Dr. Abernethy is also an Assistant Professor of Nursing at Duke University School of Nursing, and adjunct Associate Lecturer at Flinders University, South Australia. An NIH-funded investigator, she co-directs both the Duke Quality Cancer Care Initiative and the Duke Integrative Oncology Program; she holds affiliations with the Duke Clinical Research Institute, Duke Comprehensive Cancer Center Cancer Control Program, and Duke Center for Clinical Health Policy Research.

Dr. Abernethy's Clinical Interests include melanoma, cancer pain management, symptom control, supportive oncology, general hematology/oncology, and palliative medicine. Dr. Abernethy’s research program – the Duke Cancer Care Research Program (DCCRP) – handles all aspects of high-quality clinical trials that generate evidence-based solutions for common problems in supportive oncology. DCCRP studies investigate novel agents and approaches to alleviate common cancer-related symptoms such as pain, dyspnea, mucositis, and insomnia, and new health service delivery models to optimize patients’ symptoms, experience of illness and care, and quality of life. DCCRP trials incorporate and test new methods to increase the feasibility of clinical research in supportive oncology and palliative care.

Dr. Abernethy has keen interest in evidence-based medicine and its application to oncology. She was lead author of the report to CMS and AHRQ on the use of compendia to support funding of chemotherapeutics for off-label indications. She is also lead author on several CMS/AHRQ reports on the efficacy and toxicity of oral cancer drugs and behavioral therapies for cancer-related pain; new projects studying targeted antibodies and small molecule therapies will be completed in 2008. She is also the lead investigator on an AHRQ funded study evaluating the role of third party payment in clinical trials accrual.

Dr. Abernethy obtained her medical degree and post-graduate training in Internal Medicine, Hematology, and Medical Oncology at Duke University; she pursued concentrated training in Evidence-based Medicine, Palliative Medicine, and Cancer Pain Management at Flinders University in South Australia.

Here are the key symptoms you need to be aware of:

Unexplained weight loss
Stumbles and falls
Skin changes
Persistent cough
Lumps
Fever and night sweats
Exhaustion
Excessive bleeding or bruising
Difficulty swallowing

3-Jan-10 5:00 PM

2009 Healthy Holiday Gift Ideas from the Your Health First Team

Joseph Galati — Sun, 06 Dec 2009 21:00:00 GMT

With Christmas and the Holiday season upon us, gift giving becomes the topic of discussion. The problem we all face is what kind of gift to give out this year? Do you go the route of fun and enjoyment, practical, or something that is "healthy" for the gift recipient? Since we are interest in healthy living on Your Health First, we've put together some ideas for everyone. Tonight, we will have some of our favorite guests comment on what to consider this season. Remember, "healthy" can still be fun. Below are a few ideas to consider. If you have your own thoughts, send us a message in the form below.

Jack LaLanne's Power Juicer

Whether you're juicing vegetables, fruits or grasses, juicing is the best and quickest way to take in high volumes of fruits and veggies. Your body absorbs the juice within 20 minutes. Juicing vegetables gives you all the good enzymes, minerals, vitamins, co-factors, chlorophyll, anti-oxidants, phytonutrients and all other nutrients your body craves. I don't know of any better way to energize and alkalize your body naturally.

Pedometer (Counting your steps)
A pedometer is a pager-sized device worn on your belt that simply records the number of steps you take based on your body's movement. Some pedometers are analog devices that simply measure steps. Some are fancier digital models that track the distance you walk, plus the calories you burn. But keep in mind, the calorie counters are notoriously inaccurate and those models are more expensive. All you really need is a simple step counter so you can monitor if you walk the recommended 10,000 steps per day.

A pedometer is great for the gadget lovers out there. It's also ideal for the person who simply can't find a hunk of 30 minutes-or even three chunks of 10 minutes-in a day for walking. Just be sure to put a safety string through the pedometer's waist clip and pin it or loop it through a belt loop, so the pedometer isn't dropped down a toilet.

Medicine Ball
A medicine ball (also known as an exercise ball, a med ball, or a fitness ball) is a weighted ball roughly the diameter of the shoulders (approx. 14 inches). Often used for rehabilitation and strength training, it serves an important role in the field of sports medicine. It should not be confused with the larger, inflated exercise ball. Medicine balls are usually sold as 2–25 lb. balls and are used effectively in plyometric weight training to increase explosive power in athletes in all sports. Some medicine balls are in the form of weighted basketballs.

Medicine balls are used by boxing professionals to improve the strength of abdominal muscles. This is done by dropping the ball onto the abdomen of the boxer, simulating a punch coming from an opponent. Other athletes use medicine balls to increase their core strength. One common activity is to have athletes hold the ball against their chest and thrust it at another athlete, who catches it against their chest. This strengthens arm, chest, and leg muscles.

Medicine balls throws are also implemented as part of the SPARQ rating, a test of sport-specific athleticism, to assess core strength, total body power and coordination. Different tests involve an athlete throwing the ball behind them and over their head as far as they can, or kneeling and pushing the ball out from their chest for maximum distance.

They are also extensively used by secondary schools as a fitness aid. Example exercises include: lifting the ball or performing different exercises (such as sit-ups and leg raises) with the ball in order to increase the stress on a particular muscle.

Consumer Report-Health (A Healthy Newsletter Every Month)

Nutrition Action Newsletter

Since 1971, the Center for Science in the Public Interest has been a strong advocate for nutrition and health, food safety, alcohol policy, and sound science. Its award-winning newsletter, Nutrition Action Healthletter, with some 900,000 subscribers in the United States and Canada, is the largest-circulation health newsletter in North America. Founded by executive director Michael Jacobson, Ph.D. and two other scientists, CSPI carved out a niche as the organized voice of the American public on nutrition, food safety, health and other issues during a boom of consumer and environmental protection awareness in the early 1970s. CSPI has long sought to educate the public, advocate government policies that are consistent with scientific evidence on health and environmental issues, and counter industry’s powerful influence on public opinion and public policies.

Hale Groves: Fresh Fruit
Navel Oranges, Ruby Red Grapefruit, Honeybell Tangelos and many more varieties of citrus fruits - a Florida tradition since 1947. Select from Hale Groves' finest fresh fruit and premium citrus, guaranteed to "Wow" family, friends and associates. Hale's premium Florida citrus varieties are always fresh from the groves and are brimming with juicy sweetness. Our many varieties of Florida Citrus Fruits include: Navel Oranges, Honeybell Tangelos, Ruby Red Grapefruit, Tangerines and a whole lot more. Try them all.

Fruit of the Month
Whether you’re giving a gift, entertaining your family and friends, or making an ordinary day just a little more special, you can depend on us to make your gift-giving and entertaining more personal and meaningful. We make it easy to have the kind of celebration everyone loves.

The End of Overeating-The Book
In a wide-ranging look at eating habits, David Kessler, the former head of the Food and Drug Administration, addresses America's ever-increasing waistlines in his new book, "The End of Overeating: Taking Control of the Insatiable American Appetite."

Former FDA Commissioner David Kessler speaks to WSJ's Jeffrey Trachtenberg about eating habits to avoid.

He interviews the overweight, who say that just the sight of a favorite snack food is enough to make them feel hungry, as well anonymous food executives who admit that fat, salt and sugar are often the building blocks of successful food products. The book was prompted by a question that had long nagged Dr. Kessler: Why is it that Americans continue to crave such foods as potato chips and candy bars long after they feel full? "No one has ever explained what's happening to them and how they can control their eating," he writes. "That's my goal in this book."

Dr. Kessler, a 57-year-old pediatrician, was commissioner of the FDA from 1990 to 1997. He is probably best known for his opposition to tobacco interests and efforts to better label food products. He is currently a professor of pediatrics at the University of California, San Francisco.

The Wall Street Journal: What most surprised you while researching this book?

David Kessler: I wanted to understand why it was so hard to control what we eat. I thought I was going to end up in the world of nutrition and endocrinology. I ended up inside the brain and inside the food industry. The metaphor for the book was: Why did the chocolate chip cookie have such power over me? I saw a woman on Oprah who said she ate when she was happy, when she was sad, before her husband left for work and then after he left. I wanted to understand what was driving her behavior. It was not just that she was eating too much -- she was eating when she didn't want to eat. And nobody could explain why. I wanted to know, how could we help her? What was driving her? The greatest surprise was understanding how highly palatable foods had hijacked her brain.

WSJ: Early on in the book, you suggest that that major food companies know what motivates shoppers.

Dr. Kessler: They know what drives demand, and they were able to design foods to be hot stimuli. The food industry says they only give consumers what they want. But what they want excessively activates the rewards circuits of the brain. They aren't selling just any commodity. They've designed highly stimulating products, and consumers come back for more. Nothing sells as much as something that stimulates the rewards-circuitry of the brain. It's all about selling product.

WSJ: What about restaurant eating?

Dr. Kessler: Much of what we eat in restaurants is fat on fat on sugar on fat with salt. Pick any dish in any mid-American restaurant. What is spinach dip? Fat on salt with green stuff. Look at the average salad we're eating. If you look at the bacon, the croutons, the cheese…it's fats, salts and a little lettuce.

Health Monitoring Gadgets
Blood Pressure Monitor

Heart Rate Monitor

Scale/Body Fat Monitor

6-Dec-09 3:00 PM

Dr. Galati on Fox TV

Joseph Galati — Wed, 18 Nov 2009 05:00:00 GMT

Watch Video Here

HOUSTON - No one doubts the importance of health insurance, without it serious illnesses can become financial catastrophes. But many doctors say they're seeing insurance companies taking a bigger role in deciding what medicine you're prescribed and even how long therapy can last for a life threatening illness.

"In 95 percent of the cases, the commercial insurance companies are doing what they set out to do. pay the bill," said Dr. Joseph Galati, who specializes in liver disease, liver transplants and liver cancer. "But it's that 5 percent of the time let's say that you get into these situations where they're in a sense over riding what you'd like to do."

Galati says he's seeing more and more instances in which insurance companies want to stop a patients' therapy. The insurance company bases it's decision on medical journals and not the advice of the patient's doctor.

"My sense is and my colleagues feel on these serious clinical decisions leave the decision to us," Galati said.

Could your insurance company make a decision about your health care and not even tell you about it?

"I was a well informed consumer and still got taken by surprise," Karl Ittman said.

Ittman's 10-year-old daughter Neve was diagnosed with epilepsy at three months old.

"For the first year of her life it was all about the seizures and controlling the seizures," Ittman said. "It took us almost a year to control them within a certain amount."

A name brand seizure medication cut Neve's seizures down to about 10 a day. But when Neve started averaging as many as 40 seizures a day, her father discovered his insurance company was substituting Neve's seizure medication with a generic brand.

"I really didn't think about them just making me do generic and not name brand," Ittman said.

Many insurance companies have the right to switch name brand prescription drugs with generic ones without the patients consent or knowledge.

"What really upset me is my doctor is an expert and knows in medical terms what's best for Neve and his word was not enough for them to change their policy and make an exception," Ittman said.

Ittman says his out of pocket expenses to get the name brand drug went up about 200 percent.

"It's like a power struggle and part of the power struggle is about money obviously," Ittman said.

"The day of just going to the doctor, getting a prescription and getting it filled at the corner drugstore in many cases that day is gone," Galati said.

Even your pharmacy can overrride your doctor's decision on what medicine is best for you.

"They're taking the decision making away from me" Dr. Joel Goffman said.

For years the American Medical Association has fought against theraputic substitution by pharmacists without doctor approval.

Insurance companies will tell you their involvement can save patients money and they are not in the business of telling doctors how to treat their patients.

"I've never seen a situation where I could say point blank to you right now that the insurance carrier stepped in between the doctor and the patient and said we're not going to do that."

Still some physicians say insurance companies are putting profit before a patient's health.

"It's unfortunate that all of this is being based on economics, not care" Goffman said.

17-Nov-09 11:00 PM

Hepatitis C Research Opportunities

Herman Ortiz — Sun, 15 Nov 2009 20:00:00 GMT

Herman Ortiz, LVN, CCRC, who is the Clinical Research Manager at Research Specialists of Texas, will discuss with Dr. Galati opportunities for participating in clinical research studies investigating new drugs for hepatitis C.

Clinical studies are now underway for patients with hepatitis C who have never been treated, or who in the past have received PEG-interferon and Ribavirin, but who failed to fully clear the virus. All of the studies are being conducted in patients with genoytpe 1 HCV.

To contact Herman Ortiz, call Research Specialists of Texas at 713-634-5110.

If accepted into a study, all testing, medications, and visits are paid for by the sponsors of the study, with no cost to the patient.

15-Nov-09 2:00 PM

Rocco Caruso, M.D. : Medical Hematologist/Oncologist

Joseph Galati — Sun, 15 Nov 2009 19:00:00 GMT

This week Dr. Rocco caruso, a hematologist and oncologist, will be joining Dr. Galati to discuss Chronic myelogenous leukemia, a cancer that starts inside bone marrow, the soft tissue inside bones that helps form blood cells. The cancer grows from cells that produce white blood cells. Dr. Caroso practices in New York, and is an expert in the diagnosis and management of leukemia.

Basketball great Kareem Abdul-Jabbar said today he had been living with leukemia for nearly a year but no longer considered the disease a death sentence. Abdul-Jabbar, 62, told "Good Morning America" that he'd been diagnosed in December with Philadelphia chromosome-positive chronic myeloid leukemia, or PH+CML, a rare cancer of the blood and bone marrow. "I heard the world 'leukemia,' and I thought this was definitely a death sentence," Abdul-Jabbar said.

Links of interest on chronic leukemia are listed below.

Chronic Leukemia

Chronic Myelogenous Leukemia (CML)

Leukemia in Children

Leukemia Classifications (American Cancer Society)

15-Nov-09 1:00 PM

Your Health First Newsletter November 2009

Joseph Galati — Mon, 09 Nov 2009 12:50:03 GMT

Volume 5 Number 11 November 2009

Welcome to the Your Health First newsletter of upcoming events, articles, and more from our membership.

Articles
Recent Content Manager Updates

Caring for the Caregivers: Jeffifer Pate, M.D.

Update from the Liver Meetings 2009

The 2009 annual meeting of the American Association for the Study of Liver Disease was last week in Boston. At this meeting, liver physicians and researchers from around the world converge to share the lastest information on liver disease, liver transplantation, and new drug development. This meeting is the largest of its kind, anywhere in the world. Listed below are some of the more interesting findings presented at the meeting. A full review of articles can be found here. New... [More Info]

Oatmeal 101 with Chuck Garcia

The perfect breakfast. Chuck Garcia, regular contributer to Your Health First, and lifelong pal of Dr. Joe Galati, shares his secret oatmeal recipe with Your Health First listeners.. Chuck's Perfect Oatmeal: 1/2 cup water 1/4 cup Stell Cut Oats 1 tbsp. coconut oil 1 scoop protein powder 1 tbsp wheat germ 2 tbsp flax seed fruit (preferably fresh, as much as you want). I am partial to berries and bananas but any will do. If apples, add cinnamon or nutmeg. Bring water and coconut oil to a... [More Info]

New Therapy for H1N1 Flu Complications

The week, Dr. Harish Seethamraju and Dr. Matthias Loebe, will be joining Dr. Galati to discuss new therapies to treat the most serious cases of H1N1 Swine Flu epidemic we are all now facing. The use of extracorporeal membrane oxygenation, also known as ECMO, is a procedure that attempts to increase the amount of oxygen in the blood in these critical patients when the lungs are unable to do so, due to the extreme degree of damage and inflammation. Dr. Seethamraju is the Medical Director of... [More Info]

October: Talk About Prescriptions Month

October is Talk About Prescription Month across America. Our theme this year, Communication is Key! reflects the fact that better medicine communication between consumers and their healthcare providers can lead to safe and appropriate medicine use – and better health. Implicit in this year's theme is that high-quality communication about medicines – at every teachable moment – must occur to better ensure that consumers derive maximum benefit (and minimum risk) from their prescription and... [More Info]

Pieter Cohen, M.D.: Contaminated Supplements

Dr. Pieter Cohen this month wrote an article on contaminated supplements that was published in the New England Journal of Medicine, outlining the concers many healthcare professionals have regarding the use of over the counter supplements. He will be a guest with Dr. Joe Galati this week on Your Health First. In one of the most dangerous cities in the United States, one portly police sergeant has more to worry about than crime. His doctor had been encouraging him for years to lose weight,... [More Info]

Heart Rate Monitors: Update

I am a huge fan of heart rate monitors. As I explain to patients, these devices keep you honest when you exercise. You get immediate feedback regarding your heart rate, which is a reflection of how hard you are working. Exercising at the proper rate leads to more efficient exercise and metabolic benefit. Aerobic exercise, also known as cardio or endurance activity, is the cornerstone of most fitness training programs. Aerobic exercise causes you to breathe faster and more deeply, which... [More Info]

Otis Brawley, M.D. American Cancer Society

Dr. Otis Brawley, Chief Medical Officer, American Cancer Society, will be joining Dr. Galati this week to discuss the effect of gender on your cancer risk. Besides breast and prostate cancer, it is generally thought that other cancers effect men and women equally. This is not true. Bladder cancer is found in more men, and colon cancer occurs in women slightly less to to differences in colon length in women. Cancer of the esophagus is found almost three times more often in men, compared to... [More Info]

America on the Move Week: Adding 2000 Steps per Day

America On the Move Week with the YMCA is a nationwide event to inspire individuals and families to incorporate healthy activities into their daily routines. In partnership with the America on the Move Foundation, YMCA’s across the country will provide a variety of opportunities for those in their communities to engage in activities that individuals and families how small changes where you live, work, learn and play can lead to big success. America On the Move Week with the YMCA is part of... [More Info]

Resveratrol: Supper Supplement? Interview with Dr. Maroon

This week on Your Health First, Dr. Joseph Maroon will be joining Dr. Joe Galati to discuss a dietary supplement that has wide ranging positive effects on health: resveratrol. Dr. Maroon is Professor of Neurological Surgery at University of Pittsburg, as well as team neurosurgeon for the Pittsburg Steelers. Dr. Maroon has authored the book The Longevity Factor: How Resveratrol and Red Wine Activate Genes for Longer and Healthier Life. Resveratrol might be a key ingredient in red wine that... [More Info]

Content Manager Pages Updated for 10-Oct-09 to 9-Nov-09

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Updated: Sunday 8-Nov-09 4:11 PM

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Updated: Tuesday 3-Nov-09 2:52 PM

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For information on Hepatitis C research, contact
Research Specialists of Texas, and Herman Ortiz at 713-794-0700.

9-Nov-09 6:50 AM

Caring for the Caregivers: Jeffifer Pate, M.D.

Joseph Galati — Sun, 08 Nov 2009 23:00:00 GMT

Almost everyone is a caregiver to someone. With care giving comes a variety of rewards and inevitable stress. Compassion Fatigue is a consequence of expending energy day in and day out caring for others and affects every aspect of a person’s life including their physical, emotional and spiritual wellbeing. . Those most at risk for Compassion Fatigue include physicians or veterinarians, nurses, mental health professionals, clergy, attorneys, judges, military personnel, volunteers, first responders such as police, paramedics or firefighters, and even “first responders” at home such as those caring for an ill family member.

Compassion fatigue comes on gradually. The symptoms may start with subtle mood changes such as sadness, irritability or anger , or anxiety . Other symptoms may include fatigue that is not improved by a night of sleep or a weekend off, disrupted sleep patterns, loss of interest in work or care giving, difficulty concentrating, absenteeism from work, weight gain or loss and physical symptoms such as upset stomach or headache. Activities at work or at home may be avoided. Our care giving work may seem pointless. Some may turn to tobacco, drugs or alcohol to cope.

We often shortcut the very activities that may help Compassion Fatigue. People often erroneously believe that working harder will solve the problem. The best solution includes recognizing the following:

1. A single person can’t be all things to all people.

2. If we don’t first care for ourselves, we are unable to care for others.

3. Set aside time for relaxation and reflection. For example, eat a meal with your family.

4. Include time for exercise as this can be a powerful antidepressant.

5. I often remind patient’s families that caring for an ill family member is often “More a marathon than a sprint.” It is essential to share the burden with family and friends.

6. Join support groups in person or on-line.

7. In caring for ill patients on the front line of medicine, I have found it is helpful to redefine success. If our definition of success is that every patient survives, we will inevitably lose 100% of the time. Success may include helping a patient recognize their own goals for treatment.

Jennifer Pate, MD

8-Nov-09 5:00 PM

Update from the Liver Meetings 2009

Joseph Galati — Sun, 08 Nov 2009 21:45:00 GMT

Listed below are some of the more interesting findings presented at the meeting. A full review of articles can be found here.

New Hepatitis C Drugs Show Promise

Antibiotics Top Cause of Liver Failure

Vitamin E for Fatty Liver

Coffee Protective of the Liver

Acetaminophen Dosed Properly Save for the Liver

Acid Medicine May Promote Infection in Cirrhosis Patients

Obese Patients Do Well with Transplant

8-Nov-09 3:45 PM

Oatmeal 101 with Chuck Garcia

Joseph Galati — Sun, 25 Oct 2009 23:00:00 GMT

1/2 cup water

1/4 cup Steel Cut Oats

1 tbsp. coconut oil

1 scoop protein powder

1 tbsp wheat germ

2 tbsp flax seed

fruit (preferably fresh, as much as you want). I am partial to berries and bananas but any will do. If apples, add cinnamon or nutmeg.

Bring water and coconut oil to a boil. Add oatmeal and stir over medium heat for 10 seconds. Cover the oatmeal and shut off the heat. Allow oatmeal to cook untouched for 30 minutes.

Uncover, over low to medium heat add: Protein powder, wheat germ,flax seed, cinnamon (if desired). Stir all ingredients and spoon into bowl. Add fruit and nuts. This will sustain your hunger for hours and suppress any desire to snack on man food until lunch, when you should eat God food again.

25-Oct-09 6:00 PM

New Therapy for H1N1 Flu Complications

Joseph Galati — Sun, 25 Oct 2009 19:00:00 GMT

The week, Dr. Harish Seethamraju and Dr. Matthias Loebe, will be joining Dr. Galati to discuss new therapies to treat the most serious cases of H1N1 Swine Flu epidemic we are all now facing.

The use of extracorporeal membrane oxygenation, also known as ECMO, is a procedure that attempts to increase the amount of oxygen in the blood in these critical patients when the lungs are unable to do so, due to the extreme degree of damage and inflammation. Dr. Seethamraju is the Medical Director of the Lung Translant Program at The Methodist Hospital, and Dr. Loebe is the Surgical Diector of the Lung Transplant Program at The Methodist Hospital, in Houston, Texas.

25-Oct-09 2:00 PM

October: Talk About Prescriptions Month

Joseph Galati — Sun, 18 Oct 2009 21:00:00 GMT

October is "Talk About Prescription Month" across America.

Our theme this year, "Communication is Key!" reflects the fact that better medicine communication between consumers and their healthcare providers can lead to safe and appropriate medicine use – and better health. Implicit in this year's theme is that high-quality communication about medicines – at every teachable moment – must occur to better ensure that consumers derive maximum benefit (and minimum risk) from their prescription and over-the-counter (OTC) medicines. Our theme this year also is intended to recognize the great job that NCPIE member organizations are doing — as well as others — to improve the dialogue about medicines.

We are pleased this October – and beyond – to cast the spotlight on those organizations who are committed to safe and appropriate medicine use by deed and example, including NCPIE members and others. We encourage you review all the products, programs, or services available to help you support proper use of medicines all year long.

Below you will find articles, factoids, and links to several new NCPIE resources as well as medicine information and education resources/programs from a number of NCPIE members, partners and others committed to safe medicine use through better medicine communication. These include electronic media, PowerPoint presentations, new downloadable leave-behind handouts, and more. Please visit these sites and make use of the all the messages and materials that fit your organizational purpose and function.

Links of interest are posted below.

Tylenol and Liver Injury

Over Use of Pain Medications

Are You Medicine Smart?

Making You Medicine Smart

My Medication Record (download form to keep)

Teen Awareness of Prescription Drug Dangers

18-Oct-09 4:00 PM

Pieter Cohen, M.D.: Contaminated Supplements

Joseph Galati — Sun, 18 Oct 2009 16:00:00 GMT

In one of the most dangerous cities in the United States, oneportly police sergeant has more to worry about than crime. Hisdoctor had been encouraging him for years to lose weight, andlike millions of other Americans, he decided to try a weight-losssupplement to help him shed his extra pounds. But instead oflosing weight, he lost his job. According to the label, hisdiet pills, which were imported from Brazil and sold in theUnited States, contained vitamin E, centella, senna, and cascara,among other "natural" ingredients. Not included on the labelwas the amphetamine detected in his urine drug screen. The now-unemployedsergeant is not alone. Such contaminated supplements representan emerging risk to public health.

In August 2009, the U.S. Food and Drug Administration (FDA)discovered more products, most of them labeled as dietary supplements,that contain a wide variety of undeclared active pharmaceuticalingredients. Now, more than 140 contaminated products have beenidentified, but these represent only a fraction of the contaminatedsupplements on the market. Unfortunately, lenient regulatoryoversight of dietary supplements, combined with the FDA's lackof resources, has created a marketplace in which manufacturerscan introduce hazardous new products with virtual impunity.Although manufacturers have since 2007 been required to reportserious supplement-related adverse events to the FDA, the greatmajority of the estimated 50,000 adverse events that occur annuallyremain unreported.

Read the complete article

18-Oct-09 11:00 AM

Your Health First Newsletter 4-Oct-09

Joseph Galati — Sun, 04 Oct 2009 22:27:37 GMT

Hello Listeners of Your Health First:

Welcome to the Your Health First newsletter of upcoming events, articles, and more from our membership.

Tune in every Sunday evening on 740 KTRH at 7:00 p.m. (CST) or listen on the web at www.ktrh.com for live streaming audio. Podcasts of past programs are also available on the KTRH website.

Articles for 5-Aug-09 to 4-Oct-09

Heart Rate Monitors: Update

Otis Brawley, M.D. American Cancer Society

Resveratrol: Supper Supplement? Interview with Dr. Maroon

America on the Move Week: Adding 2000 Steps per Day

Dr. Galati and a Popuri of Health Topics: September 6, 2009

Every so often, there are a handful of health topics to discuss with the listeners of Your Health First. These are random topics that are simply interesting to share and discuss with everyone. We are sure that there is a topic listed below for everyone. Feel free to share these links and topics with your firends and family. Whole Grain Month is celebrated in September. The Whole Grains Council helps consumers find whole grain foods and understand their health benefits; helps manufacturers... [More Info]

Aaron E. Carroll, M.D. : Understanding Healthcare Reform Myths

Dr. Aaron Carroll will be joining Dr. Galati this week to discuss a recent survey he authored regarding various myths American believe regarding the healthcare reform debate. Do Americans believe controversial assertions about health care reform including death panels, threats to Medicare, abortions, illegal immigrants, and other claims which the White House have labeled as untrue myths? Findings from a new national survey of Americans by researchers from Indiana University... [More Info]

Herbert L. DuPont, M.D.: H1N1 Flu Update

This week, Dr. DuPont will join Dr. Galati to provide an up to the minute update on H1N1 (swine) flu. With the start of the flu season only a few weeks away, we need to clarify all of the information-and misinformation-regarding both seasonal flu and H1N1. Dr. DuPont, as an infectious disease physician, is an expert on this topic. Dr. DuPont’s major research goals are to define the epidemiology, immunology, genetic resistance, clinical features, control, prevention and therapy of enteric... [More Info]

The End of Overeating: David Kessler, M.D.

Obesity is the central driving factor is excessive healthcare costs, diabetes, heart disease, and cancer. The cost for caring for the complication of obesity are in the billions of dollars every year. This week, Dr. David Kessler will join Dr. Galati to discuss the obesity problem as well as his new book on the subject. David A. Kessler, MD, served as commissioner of the US Food and Drug Administration under presidents George H. W. Bush and Bill Clinton. He is a pediatrician and has... [More Info]

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4-Oct-09 5:27 PM

Heart Rate Monitors: Update

Joseph Galati — Sun, 04 Oct 2009 21:00:00 GMT

Aerobic exercise, also known as cardio or endurance activity, is the cornerstone of most fitness training programs. Aerobic exercise causes you to breathe faster and more deeply, which maximizes the amount of oxygen in your blood. The better your aerobic fitness, the more efficiently your heart, lungs and blood vessels transport oxygen throughout your body — and the easier it is to complete routine physical tasks and rise to unexpected challenges, such as running to your car in the pouring rain. Aerobic exercise includes any physical activity that uses large muscle groups and increases your heart rate. Try walking, jogging, biking, swimming, dancing, water aerobics — even leaf raking, snow shoveling and vacuuming. Aim for at least two hours and 30 minutes a week of moderate aerobic activity or one hour and 15 minutes a week of vigorous aerobic activity — preferably spread throughout the week.

Training in this zone will develop your lactic acid system. In this zone, your individual anaerobic threshold (AT) is found - sometimes referred to the point of deflection (POD). During these heart rates, the amount of fat being utilised as the main source of energy is greatly reduced and glycogen stored in the muscle is predominantly used. One of the by-products of burning this glycogen is lactic acid. There is a point at which the body can no longer remove the lactic acid from the working muscles quickly enough. This is your anaerobic threshold (AT). Through the correct training, it is possible to delay the AT by being able to increase your ability to deal with the lactic acid for a longer period of time or by pushing the AT higher.

Below are some reviews on products that are available.

Polar Brand Heart Rate Monitors

REI Heart Rate Monitors

Selecting the Proper Monitor

Target Heart Rate

Value of Target Heart Rate

Calorie Counter

Consumer Search Review: Heart Rate Monitors

4-Oct-09 4:00 PM