Do statin drugs reduce all-cause mortality in patients with high LDL?

Yes!  Let me explain this.  When your doctor checks your cholesterol lab work and says “Your bad cholesterol level is high.”  That means that the LDL cholesterol is elevated.  LDL is bad.  Period.

Statin drugs can be used for all patients with a high LDL : those who have had cardiovascular disease or for those who have not had any events.  Studies have shown that statins help reduce ALL-CAUSE-MORTALITY (that means overall death rate from any problem) compared to those who have a high LDL and do not take a statin drug.

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I am not a dentist. But, I do want overall health for my patients.

flickr.com/ photos /jcolman/4196672998

flickr.com/ photos /jcolman/4196672998

Dental care is the most common unmet health need.  Oral disease can severely affect systemic health.

Poor oral health is so important and commonplace:

  • dental cavities are the most common chronic disease of childhood (5 times more common than asthma) and
  • affects 50% of low-income children.
  • Severe gum disease affects 19% of adults aged 25-44.
  • 30,000 oral cancers diagnosed yearly.
  • Oral health is important during pregnancy, too, as gum infections during pregnancy may cause premature labor.
  • There is strong evidence that gum disease and diabetes may be linked.

What to do?

See a dentist twice a year for preventive exams, more often if needed.  For a less expensive dental option, search for nearby dental schools or dental hygienist programs to perform your exam.

Limit sugary snacks.  Increase the time between sugary snacks so the tooth can heal.

Brush twice daily beginning as soon as teeth erupt.  (Bedtime is most critical due to decreased nighttime salivary flow).  Spit out fluoride, do not rinse.  This will increase topical fluoride exposure.

Take care of those pearly whites!

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Are prunes an effective alternative to fiber for constipation?

flickr.com/photos/ spektrograf/ 8195465189

flickr.com/photos/ spektrograf/ 8195465189

Yes!  Prunes are a great food to help with chronic constipation.  Six prunes eaten twice a day will help bowel movement frequency double.  It will also help improve stool consistency and constipation symptoms.  Prunes are as effective as psyllium (Metamucil) for chronic constipation.

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How long should oral bisphosphonates (an osteoporosis medicine) be taken?

flickr.com/ photos/chrisd2006/ 3057545293

flickr.com/ photos/chrisd2006/ 3057545293

Short answer: Five years or less.

Studies found little, if any, benefit in reducing fractures after taking bisphosphonates (a class of osteoporosis medicine) for more than five years.

Furthermore, oral bisphosphonate use for longer than five years is associated with significantly increased risk of “atypical hip and femur fractures.”

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Can probiotics decrease irritable bowel symptoms?

flickr.com/photos/ vinceandjoy/ 319681936/

flickr.com/photos/ vinceandjoy/ 319681936/

Yes!  The probiotic Bifidobacterium bifidum MIMBb75 is normally found in the GI tract (along with several hundred other organisms).  And, this strain is found in several over the counter probiotics.  This is an inexpensive safe alternative found to decrease overall bowel symptoms in patients with irritable bowel syndrome.

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When should a patient with low back pain get an xray/MRI?

I love this question.  The research-tested answer is that routine imaging for patients with low pain is not warranted.  In fact, routine x-rays are associated with increased cost, poorer health in recipients, increased risk of surgery, and no reduction in patient anxiety.

Imaging is needed if there are “red flags.” If cancer is a possibility, inability to control bowel or bladder functioning, fever, or severe neurological deficits.

X-rays should be performed if trial of therapy hasn’t worked, ankylosing spondylitis (an inflammatory problem) is suspected,or older patients with risk factors for a spinal fracture.

MRI imaging should be limited to patients with nerve pain or symptoms of spinal stenosis–when symptoms do not respond to therapy.

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How many blood pressure readings are needed to accurately diagnose high blood pressure?

Answer:  Several.  The blood pressure measurements should be taken over time.  Your doctor will want the individual blood pressures, but may also average them to get your “true” blood pressure.  Use of a single blood pressure to determine whether blood pressure is controlled will yield a false result more than 20% of the time.

Take home thought: Between physician visits take your blood pressure at differing times of the day (most pharmacies have a self-starting blood pressure cuff), record all the blood pressures, and bring that list to your next office visit.

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Want weight loss?

“Success travels in the company of very hard work. There is no trick, no easy way.” John Wooden (former long-time successful UCLA basketball coach)

Food is for fuel. Eat when hungry, not by the clock. Resist advertising. Be aware of portion size.

Need encouragement? Nearly 45% of adults have pre-diabetes or diabetes. 90% of type 2 diabetes can be prevented with lifestyle changes and weight loss.

How to start…

  • Consider the first month eating ½ of the amount you used to eat.
  • Don’t drink your calories.
  • Then second month continue eating ½, but exchange sugary/fried foods for healthful foods.
  • And, start exercising 30-45 minutes 4 times a week.

This is a start. Your mindset (with regard to your diet and exercise AND health) must change for long-lasting health results.

Start today!

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Is stopping smoking on your New Years resolution list?

20% of US population smokes, 100% know that smoking is bad.

Smokers use 18% more healthcare costs.

The number of times smokers tried to quit before they were habit-free:

  • 1 time: 40%,
  • 2-3 times 38%,
  • 4+ times 22%.

Stay in there!  Be persistent! Have a plan.

Nicotine replacement may cost $40/month, some pills to help stopping cost $100/month (the same cost as a one ppd habit).

Consider environmental changes  (get rid of cigarettes, ashtrays, lighters), Perform routine changes, Consider substitutes (gum, candy, straws) to keep your mouth and hands busy.  List rewards (financial, health, family).

Sources of help.  1-866-KANSTOP, 1-800-QUITNOW, http://www.familydoctor.org

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Hypnosis for hot flashes? Hooray for complementary medicine.

Hypnosis may ease severe postmenopausal hot flashes. Five sessions reduced severity of postmenopausal hot flashes by 80%. Wow! This study had 184 women with moderate to severe hot flashes. Hot flash frequency and severity fell by 70% at 5 weeks and even further to 80% at 12 weeks (which was 7 weeks after the intervention ended).

This intervention entailed hypnotic induction with relaxation and direct and indirect suggestions, dissociation, and mental imagery evoking coolness (such as visualizing yourself walking down a mountain path on a cool day). Emphasis was placed on teaching patients self-hypnosis and patient empowerment.

I love it!

“Give a man a fish; you have fed him for today. Teach a man to fish; and you have fed him for a lifetime”—Author unknown

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