Samples of Medical Articles on Wide Range of Topics
| Gland Doctors & Prostate & Breast Cancer
| Bleebieology / Dermatology
| Macular Degeneration & Eye Care
| Nuts in Your Diet | Sense of Smell Power |
Fish Oil Supplements - Omega-3 fatty acids |
Morton’s neuroma
Painful Pain of Foot & Morton’s neuroma
Don’t look now but your body is being brutally damaged by something you are wearing.
Tongue stud? Tight Fruit of the Looms?
Barry Manilow T-shirt? Sure, but even worse are your loafers, pumps and stilettos.
A study conducted in China several years ago compared the relationship between footwear and foot problems. It concluded that umpteen billion Chinese who did not wear shoes seldom had foot problems while the other umpteen billion who wore shoes suffered bunions, ingrown toenails, corns and painful swollen nerves called “neuromas”.
A neuroma of the foot, known as a Morton’s neuroma, is a painful pain or a numbing numbness involving the ball of the foot and the 3rd and 4th toes (sometimes the 2nd and 3rd toe).
When the nerve that meanders through the foot, en route to the toes, get squished between the bones of the foot, a neuroma develops. This pressure irritates the nerve and, much like an oyster’s irritated sand pebble turns into a lovely lump known as a pearl, the nerve turns into a nasty lump known as a neuroma. Eighty percent of those with Morton’s neuroma are female, a result of high heels and tight toe boxes that incarcerate their dainty wee hoof.
The foot nerves can also be irritated by trauma, as when a wheelie-poppin’ teenage terror operating the fork lift at Costco screams around a corner and runs over your foot. Literally gets on your “nerves”.
Treatment of this condition requires changing footwear to that of shoes with a more spacious toe box. Adding the highly popular orthotics (shoe inserts) is highly effective at battling most of the archenemies of several foot problems. Since the foot bone is connected to the leg bone, these same orthotics can correct ankle, knee, hip and back problems and even alleviate some forms of headache.
If orthotics fail the next step of treatment involves a painful cortisone shot directly into the neuroma.
I have decided to feet-ure neuromas in this week’s column, because...well I have one myself. Yes, my name is Dave and....I am a Morton’s neuromic.
Though my condition has improved since giving up the high heels (just kidding, to be virile and honest my very rugged manly hockey skates squeeze my foot) the pain was bad enough for me to undergo the cortisone procedure.
I went to my colleague and trusted surgeon Dr. “Butch” Butcher.
First the necessary acknowledgements.
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“Doctor.”
“Doctor.”
“Doctor, I need a Morton’s neuroma doctored.”
“Well doctor, we’ll doctor that right up.”
“Thank you, I trust you are still trusted as in the intro I gave you 6 lines ago.”
“Trust me doctor, I’m a trusted doctor.”
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Why do doctors make such lousy patients? Is it because they can visualize the worst possible scenarios?
In medical school we were all convinced we had whatever disease we happened to be studying that week. We checked ourselves for lymphoma lumps, testicular tumors and syphilis sores. Prostate cancer week was not a pretty site on our campus. Our feet swelled and we devoured pistachio dill pickle ice cream during obstetrics training.
So do I handle this procedure of having a needle jammed between my toes like a man or like a doctor? I tell myself that as a doctor I can visualize the afferent nerve conduction pathways as the plexus of nerve cells succumb to the membrane channel blocking ion exchange proton pump inhibitor. As a man I search the room desperately for Pooh bear because this is going to be one big owwie.
A week later while at home licking my wounds (figuratively speaking), I ponder my new resolution to improve my foot health. Though I’m now asked to leave restaurants, my pew at church is deserted and patients peer at me suspiciously, I think going barefoot has been therapeutic. It really is the best thing you can do for your feet.
Trust me, I’m a doctor.... signing off ... your trusted doctor, Dave Hepburn, MD
"Gland Doctors" and Prostate & Breast Cancer Survivors' Views
by: Dr. Dave Hepburn, M.D.
Along with his and her towels, his and her cars, his and her razors, his and her negligees, please add his and her cancers. The prostate and the breast, both capable of harboring hormone-sensitive cancers, possess some intriguing similarities.
At birth, the prostate gland is about the size of a pea, while a newborn brain is the size of a ripe avocado. By adulthood, the prostate resembles more the avocado, while the male brain (as I'm repeatedly reminded by numerous females in my life) apparently tends to resemble the pea.
The prostate's job is to provide a fluid that nourishes sperm. Eighteen nanoseconds after nourishment, the well-fed sperm will cheerfully head off to work on an egg hunt, never to return. The breast's job is to provide a fluid that nourishes children. Eighteen years later the well-nourished child will reluctantly be egged on to find work, always to return.
STATS
Perhaps the most unfortunate similarity between the breast and the prostate is the fact that this year 200,000 women and 200,000 men in North America will be diagnosed with breast and prostate cancer respectively. Of these, 44,000 women will succumb to their disease while 37,000 men with prostate cancer will not survive their illness. Prostate cancer is now the most commonly diagnosed cancer in men. It is the second leading cause of cancer death in males, trailing only lung cancer for that dubious distinction. Breast cancer is the most commonly diagnosed cancer in women. One woman in eight will develop breast cancer in their lifetime. Both cancers can be made more aggressive by our so-called sex hormones. Testosterone can speed up the spread of prostate cancer and a select group of breast cancers are made worse by estrogen. Both cancers are more apt to occur in relatives of those who have had the cancer. Oddly, both prostate and breast cancers are a rarity in Japan.
CLINICAL PRESENTATION
Both cancers present with PAINLESS lumps in their respective gland. When a woman presents to the office with a sore breast, my first job is to reassure her that breast cancer generally is not painful until the very later stages. Most painful breast lumps are cysts or teeth left by a weaning child. Similarly, when a man presents to the office stating his prostate is sore, my first job is to reassure him that he probably has no idea where his prostate is.
DIAGNOSIS
Here the similarities tend to diverge. Women are encouraged to conduct Breast Self Exams. Rubber gloves are not necessary. A Prostate Self Exam, on the other hand, tends to be a tad awkward and is frowned upon in most social circles. A prostate exam, called a DRE (Digital Rectal Exam), should be performed only by a trained pro. Attempt this at home and even your dog will likely leave home. Current recommendations are for men to have an annual DRE after the age of 45.
The Breast Self Exam (BSE) should be performed monthly, about a week after a period. The best method for BSE involves moving the fingers up and down rapidly on the breast while moving the hand up and down the breast. This is called the lawnmower.
Men could also attempt the lawnmower, but only on lawns.
After age 40, a woman should have a screening mammogram every 1-2 years and annually after the age of 50. The mammogram is a diagnostic test wherein the breast in placed between two paddles and squeezed and squished flat. (Realizing that this is a column focussing on similarities between prostates and breasts, most men, by now, have recoiled in horror, tossing the newspaper across the room should any comparable test exist for the prostate.) Fear not brave lads, the prostate will not be squished flat in any machine. Instead, if a suspicious prostate lump is detected on DRE, a really sharp needle is jammed into the prostate, and a piece of it is torn out for a biopsy. Feel better?
signing off.. Dr. Dave Hepburn, M.D.
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Bleebieology -or- What Is Dermatology?
By: Dr. Dave Hepburn, M.D.
Motto for hypochondriacs "There is no such thing as JUST a mole!" Fran Lebowitz
If you could be a doctor for a day, what kind of doctor would you be? Surgeon, GP, cardiologist, George Clooney, Dr. Hook? What if you had to decide on the type of doctoring you would malpractice every day for the rest of your life? Such a decision is one that all medical students must make as they edge closer to actually obtaining their MD (Masters of Deception). Those who don’t mind spending a total of 47 seconds per week with their family choose surgery. Those who feel sleep is a waste of time go into obstetrics. Those who enjoy working for $1.67/hour become GP’s. But the smart ones become dermatologists, the rare breed of doctor who enjoys a 9-5 lifestyle, big beautiful bodacious sports cars and pustular acne. A ruptured pimple, even at 3AM on the night before an audition for say, Survivor-Winnipeg, seldom carries with it the same degree of urgency as a ruptured aorta. Extricating excess lint from a belly button is seldom as critical as extricating a harpoon from a carotid. A raging wart doesn’t isn’t the same fear as an outbreak of purulent PMS.
Yet abdominal pain and rashes tend to be the toughest problems for most GP’s to solve. A patient can often be panic stricken about an intense rash, one that I might not recognize. Adding, "Wow, I have never seen one that colour before, at least not on a live patient!" tends to convert their panic into frenzied terror. So I call up a helpful dermatologist, the nicest of all specialists (something to do with eight hours sleep), who calmly solves the carcass conundrum. They are expert rashologists, toenailologists and bleebieologists. Knowing about a few common bleebies may save you unnecessary panic. So, while I close my eyes, remove all of your clothes, get out a mirror and check for:
Seborrheic Keratosis
Commonly mistaken for moles or warts, SK’s are, next to moles, the most common skin lesion. Seen in the aging population (ie. those whose actions creak louder than their words) SK’s are found primarily on the trunk, back, face and hands. They have a tan colour and a stuck-on appearance, meaning that they are part of the outer layer of skin (epidermis). Those with several SK’s look as though they have rolled naked in a field of light brown gum. An SK might be a large thick hard wad of gum, or a small thin piece. And like gum, SK’s can virtually be scraped off the skin with a dinner knife and flicked across the table for a little dining fun. If you consider scraping them off to be uncouth then try gnawing them off with your teeth (for those hard to reach SK’s, remove denture and start champing). Should you be blessed with a more refined upbringing than my own, see a doctor who will freeze them off with liquid nitrogen or scrape them off with a cheese grater.
Skin Tags
Do not turn into cancer. 50% of these wee cauliflawers are found in the armpits, 35% on the neck and the rest in the groin. Tags typically hang on a stalk like a floppy little mushroom and get caught on clothing or necklaces, camera straps, purse straps, Right Guard, backpacks, fingernails, the cat, pony tails, Ban roll-on, tree branches, ZZ top beards, mink stoles and the like. A good-sized tag can tear into grandma’s pearl necklace like it was silly string. Have those tags snipped or frozen off.
Basal Cell Cancer
I recall a dermatologist taking me for a stroll and pointing out numerous people walking about sporting BCC’s on their mugs. This most common of the skin cancers has a pearly white border and occurs only in the white population. They are sun-sensitive tumors, 85% of which occur on the face, 30% on the nose alone. Not an aggressive cancer that can metastasize, this basal cell cancer invades the skin eating away at the nose, like Michael’s plastic surgeon.
But if at all in doubt about a bleebie or any mysterious lumps or bumps be sure to have it checked out by a professional such as George Clooney. He can be reached at www.drdavelookalike.com.
signing off: Dr. Dave Hepburn, M.D.
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Macular Degeneration -or- degenerate eye problems
By: Dr. Dave Hepburn, M.D.
I caught the Perseid meteor showers last summer, or at least I watched them, or at least I tried to. August’s celestial showcase, performed on the northeast stage of heaven’s amphitheatre, is an exercise in aggravation to many of us who would actually like to see this shooting star spectacle.
Lying flat on the long grass with my young son, while dew, dirt and various vile invertebrates violated my ear canals, he would point quickly "See that one, Dad!" Yeah! Well, almost. More like "not really but I think I just got bit". By the time I directed my gaze to the streak that I thought I saw in my peripheral vision, the show would be over. Travelling at 60 km per second, or just slightly slower than my eldest son’s pickup truck and pickup lines, these streaking stars are not always easy for these old degenerate eyes to track.
To 10% of those older than 65 years of age and to 30% of those beyond 75, peripheral vision may be all that actually works anymore. The macula, a small area in the back of the eye (the retina) responsible for central vision, can degenerate all too easily. In fact, far too many of the Edsel/Eisenhower/Elvis generation are now in a general state of de-generation. Bones, joints, memory, muscles, hearing, vision and other organs of various size and function all begin to shrivel as we begin our free fall into the world of senescence, one we all too often have not prepared properly for. Even the invincible Britney generation needs to prepare now to eventually join the degenerate generation.
Macular Degeneration (MD), (also known as “smackular” degeneration given the many times that foreheads become intimately acquainted with telephone poles, baseballs and oncoming wheelchairs) causes loss of “straight ahead” vision in both eyes. This makes simple tasks like reading, driving and ogling intolerable. The macula can be wrecked in two ways. It may be invaded by a horde of leaky blood vessels that destroy the macula, the so-called “wet” macular degeneration. Or, in “dry” degeneration, which accounts for 90% of MD, the macula may just start to shrivel and break down, slowly causing vision to blur and dark patches to emerge in the middle of a sentence.
For example, if this health column were juxtaposed to a gardening column there might be large gaps in the center of your vision, leading to sentences like:
to prevent nose bleeds · · · · · · · · don’t pick too early and always check for beetles
the eye surgeon might· · · · · · · · · · · · · · · · use a large-toothed 22 horsepower rototiller
if not circumcised, a boy might discover · · · · · · · · an aggressive Venus fly trap
side effects include · · · · · · · · spreading a large amount of manure and worms about the bed
Wet MD causes a more profound blindness and is actually responsible for 80% of legally blind eyes. But caught early, there is a chance that thermal laser treatment, and hours of fervent prayer may be able to slow wet destruction of the macula. Macular degeneration may not always render its victims blind but it might reduce them from fully sighted to partially sighted. Still, loss of central vision can lead to loss of driver’s license, loss of autonomy and loss of joie de vive. Although sun exposure, high blood pressure and lack of Zinc have all been named as suspects as a possible cause of MD, the only proven risk factor is our old friend, smoking. After smoke gets in your eyes, don’t it make your brown eyes blue.
For this reason it is recommended you should:
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Not ignore any blind spots, blurriness, wavy lines or decrease in color vision. See a doctor who will test your central vision with an Amsler grid. You can easily find an Amsler grid on the internet and test your central vision at home.
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Have an eye exam (both eyes) every two years if you are over age 65, every year if you smoke.
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Don’t sit in the foul ball section as you begin to age.
But most importantly, remember that you will invariably go blind unless you ask your doctor to · · · · · · · · clip your begonias each fall.
Signing off: Dr. Dave Hepburn, M.D.
WiseQuacks.org
See also
"TOP TEN WAYS TO PREVENT MACULAR DEGENERATION"
- Monitor your vision annually with the aid of an Amsler Grid
.simple test that can be used at home
.google and download test to your computer screen
- Take a multiple vitamin with lutein
.lutein, zinc and other anti-oxidants are essential nutrients for a healthy retina
.in established macular degeneration, the AREDS formulation of supplements is especially useful
- Eat lots of dark leafy green vegetables
.food such as spinach, collard greens, kale and turnip greens
.these vegetables should be cooked to reap the benefits
- Wear sunglasses with UV protection
.ultraviolet rays may cause damage to the pigment cells of the retina
- Quit smoking
.smoking decreases the efficiency of blood vessels in the retina by impairing circulation in the body
- Get regular exercise
.exercise improves the body's overall health and increases circulation
- See an eye doctor on a regular basis
.most individuals under the age of 65 should seek the attention of an optometrist every 1-2 years for an eye exam
.people over the age of 65 should see an eye doctor on an annual basis
.if a person has been diagnosed with macular degeneration (or other chronic illnesses such as diabetes and hypertension) they should be referred to an ophthalmologist at least once a year
- Don't ignore visual changes
.any change of vision warrants attention and explanation by a physician
.acute (and possibly permanent) visual loss may be seen in "wet" macular degeneration
- Get your cholesterol reduced
.elevated cholesterol is a risk factor for development of macular degeneration
.healthy diet and exercise essential (medications may even be necessary)
- Follow a low-glycemic index diet
.a reduction of sugar in the foods that we eat is also helpful in preventing the onset of macular degeneration
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P.S. "...thank you for email from our listener suggesting re post the above 10 points on this website for others reference" [2008.08.06 email]
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Medical Article: Nuts in your diet - or- Health benefits of Brazil Nuts, Almonds, Cashews, Walnuts, Filberts Peanuts etc. for reducing cholesterol, cardiovascular disease, prostate cancer, diabetes etc.
By: Dr. Dave Hepburn, M.D.
"...Nut snackers actually eat less, lose weight and have less diabetes."
On rare occasions, when I find that my pantry is low on the essential food groups such as Cocoa Puffs, Snickers and Dr.Pepper, I go grocery shopping. Not one to linger too long in the tofu and wheat germ aisle I slink over to the bulk food section, salivating fondly over these massive barrels of massive calories. When it comes to the cases of nuts, admittedly, I am a bit of a nutcase. I scoop up a large mixture of nuts, flick aside the ugly Brazil nuts, flick in a few more cashews and make for my pantry. But I happen to have two teenage sons/squirrels nesting in my home. By the time I get around to treating myself I notice that all of the cashews have mysteriously fallen out of the bag. My "Keep your hands off my nuts!" command does nothing but garner snickers, which as I mentioned is, in fact, one of the more essential and lovely food groups. Returning later, the almonds have been selectively extricated and are gone. Finally the walnuts are freed from the mix, leaving me with nothing but a bag of filberts and salt. This drives me...exactly.
Nuts, though unquestionably chockfull of fat, just might be the healthiest snack in your cupboard.
ALMONDS
A handful of almonds a day will keep the cardiovascular surgeon away. The lowering of LDL cholesterol, known as the mother of all evil cholesterol, is essential for routine heart pump maintenance. In fact, in those who are at risk of heart disease, the aggressive lowering of LDL cholesterol is necessary. According to the nutty professors at Harvard who study these things, a daily handful of almonds can lower LDL cholesterol enough to reduce cardiovascular disease by a whopping 20%! In some cases a handful of almonds may be used instead of cholesterol-lowering medication. Almonds are also rich in folate, a vitamin important in keeping hearts, fetuses, bone and brain healthy.
CASHEW
Gesundheit. These luxurious nuts are nothing to sneeze at. Cashews are rich in selenium, a mineral shown to protect against prostate cancer. (This being the case my sons should have the healthiest prostates south of Spitzbergen.) Cashews, like most nuts are best eaten unsalted and raw while the oil is fresh. Like almonds, these nuts are loaded in monounsaturated fats, which is good fat. If "good fat" makes as much sense as "slumber party or "cat owner," realize that, like good cholesterol, unsaturated fat acts biochemically to reduce the risk of cancers and coronaries.
WALNUTS Rich in omega 3 fatty acids, walnuts are, like fish, beneficial in lowering cholesterol. They are also rich in arginine, an amino acid important in the synthesis of nitric oxide, which helps relax tense blood vessels.
PISTACHIOS. These nuts have been known to cause an unfortunate disease known in the medical field as Pistachio nail. Wrestling vigorously to get at a pistachio may cause scrapes under the tender thumbnail skin, which when further irritated with salt will cause its victim to insert the injured thumb deep into the mouth. Sucking vigorously at the thumb, the victim is often seen simultaneously sifting through the bag for easier pistachios.
PEANUTS. Peanuts are not your normal nut. In fact, peanuts are no more a nut case than Michael Jackson isn’t. They are legumes. But as we can salt them, roast them and sell them in the bulk food containers, let’s consider them nuts. The average child will eat 1500 peanut butter sandwiches by the time they graduate from high school. This is not necessarily bad as peanuts are high in fiber, niacin and a powerful antioxidant called reservatol, the same flavenol that gives red wine its reputation as a protector of hearts. Same benefit, less hangover at recess.
So as I sit here with my bag of filberts and salt, my everlasting-prostate sons are fully sated. While a corn doodle or other empty carb snack leaves the snacker hungry again in 30 minutes, a handful of nuts satisfies hunger pangs for several hours. Nut snackers actually eat less, lose weight and have less diabetes.
Satisfying, fat, tasty and highly nut----ricious.
© 2008 Dave Hepburn M.D.
WiseQuacks.org
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"SMELL YOU LATER !" Medical Article: The power of the sense of smell.
By: Dr. Dave Hepburn, M.D.
My grandfather’s name was Dah. His real name, I’m told, was George, but to his grandkids he was good ol’ Dah. As a wee lad I would spend hours sitting on Dah’s lap, watching the oft-resurrected Wyle E. Coyote [cartoon character] rocket through another Acme disaster, while the burning embers from ol’ Dah’s cigar would fall into his snowy white chest hair or directly onto my cornea. Finally he would say, "David, you’re 15 years old. Get off my lap and give me back the cigar." I loved ol’ Dah and when he passed away it was for me a cruel joke.
Thirty years after his passing I received an unexpected phone call. “Hi, my name is Bugsy and I fought alongside your grandfather George in Italy.” “You knew Dah?” I exclaimed, thrilled at being reminded of my childhood pal.
As Bugsy went on to relate some of Dah’s legendary military feats, which usually featured greased pigs, five aces or stolen jeeps, I began to notice a strange odor at my desk, stranger than normal. I glared at the dog who glared back with a stupid yet innocent grin on his mug, but it wasn’t him. Suddenly this strange yet familiar smell twanged the memory cells of my brain. It was Dah’s cigar. So clearly could I smell that smoke that I had to look around the room twice to insure that no such cigar was smoldering. Smelling a man dead thirty years may seem a tad Beetlejuicy and perverse, but in the part of my mind responsible for smell he was very much fresh and alive. Such is the power of the sense of smell.
"Doc, I don’t smell too good."
"Well Bloggins, I’ve got a cold so I really didn’t notice..."
"No I mean I can’t smell anything anymore. On occasion it’s a blessing but for the most part it drives me nuts. And when I eat I can’t tell if I’m eating the pizza or the cardboard box. I’m about as interested in food as I am vacationing in Chechnya. Worse yet, it’s really getting me down. Life seems to have lost its zest for me lately."
At the roof of our nose, in a happy little bone called the cribriform plate, sits the olfactory bulb, an organ that is lined by kazillions of glomeruli. These amazing specific smell files can detect, differentiate and process 10,000 different smells.
While taste buds have four basic tastes: salty, sweet, sour and Snickers, it is the sense of smell that allows us to identify exactly what it is that we have just placed in our mouth.
When an odor, nice or nasty, wafts into our nostrils, past assorted hairs, chalk and peas, the glomeruli processes the odor, packs up the information and fires it along the olfactory nerve to some place in the brain right next to the It-Wasn’t-Me! denial center.
Anosmia refers to the complete loss of smell. The commonest causes of anosmia include:
- Sinus disease (either allergic or infectious)
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Upper respiratory infections, which is why normally evil tasting beasts such as Buckley’s or Fisherman’s Friend can actually be tolerated when we have a cold.
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Head trauma, which can disrupt the cribriform plate in the nose.
[Age Factors & Smell]
Half of those over age 60 have some olfactory dysfunction not necessarily related to any disease, unless you term aging as a disease. As we age, our sense of smell joins the vision and hearing in a gradual decline. Rather than young vibrant cells working hard in the olfactory center, old factory workers now go on strike. Smoking helps to wear down the old factory workers even further. A lack of smell is associated with increased depression and a lower quality of life. Thus it can be concluded that smoking contributes to depression.
Astonishingly, loss of smell can also be an early marker for certain neurodegenerative diseases such as Parkinsons, Alzheimers and even Multiple Sclerosis. In fact, anosmia may be the first symptom to signal the onset of these diseases.
As for you Dah, thanks for knocking some “sense” back into me. Smell ya’ later.
[signing off] - your grandson David
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FOOTNOTES etc.
REFERENCE INFORMATION
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Credits & © Copyright Information
The stories and comments on this website are, unless otherwise noted, written by Dr. Dave Hepburn and/or Dr. Rob Sealey and owned by Web Quacks Ltd.
Medical-Legal Disclaimer
Quotes from websites and publications on this website in no way implies endorsement of this website by the source of the quotes, unless otherwise noted. Materials referred to or cited on this website are intended to provide viewers with potentially useful information sources for their own personal use and is not intended to replace direct consultation/examination from a qualified medical doctor or related certified/licensed health professional.
This website is intended as a humour based education tool and not intended to replace consultation in person with a medical doctor or a specialist(s) that they may have referred you to.
If you note any errors or ommissions contact us - however note - we reserve the right to not add content to our website if it conflicts with our professional code of ethics and internal guidelines.
Copyright 2008-2009 Dr. Dave Hepburn & Dr. Rob Sealey
updated
2008.11.19
Their extremely popular HITS and MYTHS segment reveals some of the common and intriguing myths in the world of medicine and discusses some of the exciting recent medical discoveries and how they affect your world.
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