MD Stein
Our dominant medical ethic is one of shared decision-making. These days, the internet provides medical information about disease and treatment through authoritative sites (like the CDC) or through access to primary sources (NIH library) that can supplement the traditional doctor-patient relationship.
Receiving the lab report with your baseline blood test results offers only the beginning of an understanding of where you stand health-wise, but it is not fully personalized. Your glucose level, for example, is compared to results from across the general population and should, if “normal” (meaning it falls within the middle 95% of all values), give you the reassurance of health. But knowing that your glucose falls within the reference range is only useful to a certain degree. What’s more useful would be knowing yourpersonal reference range, established by the history of your results over time. Through this longitudinal description, you could see trends, and these trends might direct you to where to put your health behavior change energies.
Worried that you may have diabetes, your doctor sends you to have a blood glucose test. It’s 8 in the morning, you haven’t eaten since dinner the night before—it’s a “fasting” glucose, a simple and accurate way to determine your diagnosis. At your appointment later that day, your doctor shows you the report from the lab. There are two columns: on the left is your glucose (91) and on the right is the reference range of “normal” glucose values (67-99). The reference range for glucose (and every blood test) is established by one of a few reference laboratories, large corporations in the U.S. that dominate the blood drawing and testing market.
It’s the fifth American anniversary of electronic cigarettes, battery-powered nicotine atomizers that look like tobacco cigarettes. Lip pressure on the mouthpiece activates an electric circuit, nicotine is vaporized, and flavors are added to offer the sweet feel of smoking. E-cigarettes are marketed as substitutes for tobacco cigarettes, but without the combustion that produces high cancer risk. The truth is we really don’t know much about e-cigs, their safety, whether they can be used to quit smoking, or even whether their nicotine is delivered to the lungs (as with tobacco smoke) or only to the cheeks and throat (which means lower bodily concentration); what we do know is that they’ve been priced to be less expensive than a pack a day habit.
Is there an optimal number of hours that we should sleep every night? Or put another way, is conventional wisdom that adults should sleep 8 hours actually good advice? In fact, it’s not: across the population, those who report 7 hours of sleep live longer than those who regularly sleep 8 hours or more.
Hookah use dates back more than 500 years to Asia and the Middle East, but still relatively new in the United States, it has taken hold among young adults. Most college towns now have hookah lounges where meter-high water pipes stand among deep-backed sofa and overstuffed chairs, colorful hoses snaking. Along with smokeless tobacco (chewed or wedged inside a cheek), and electronic cigarettes, hookah is thought, by producers and users, to be a less harmful alternative to cigarettes. Distressingly, the majority of the collegiate hookah users I’ve talked to have no idea that hookah use even involves nicotine. But in fact, hookah exposes users to higher concentrations of carbon monoxide, nicotine and other toxic tobacco products than cigarettes.
The Food and Drug Administration designates salt as a food additive that is “generally regarded as safe.” But at the amounts used by the average American, it is anything but safe. If you’re eating fast food, Chinese take-out, deli meats, anything in a can, mustard/mayo/catsup/relish, anything that tastes salty, you’re overdosing. And if you eat these most days, you’re setting yourself up for a medication-filled cardiovascular future.
Taking a daily multivitamin has become a symbol of taking care of yourself, of showing you’re serious about good health. Where did this idea come from and is there any evidence supporting it? Taking a daily multivitamin has become a symbol of taking care of yourself, of showing you’re serious about good health. Where did this idea come from and is there any evidence supporting it?
For heavy smokers, good mood and clear-thinking begin to deteriorate within an hour after their last cigarette. These symptoms worsen over the next twenty-four hours. In daily life, there are more and more places where smokers are obliged not to smoke. To light up, smokers have to leave work, restaurants, and often their own homes. But sometimes they can’t leave to light up, and abrupt cessation of smoking can have meaningful effects on decision-making.
With rising cigarette prices, a lousy economy, and fewer places to smoke, Americans buy fewer cigarettes than they did a generation ago. There’s been a dramatic fall in the percentage of Americans who smoke: in 1970, it was 40%, now it’s 20%. That’s good news.
