Doc Gurley

It’s been a big week for celebrity sorrow. As you’re contemplating the loss of Farrah Fawcett and Michael Jackson, be sure to head over to SFGate to check out the Doc Gurley health tips we can all learn from celebrity health coverage.

1) First, there’s Farrah’s Gift: Outing the Tumor That Dare Not Speak Its Name – which covers an important issue that has been, by and

large, neglected by the media-discussions. While you’re there, you can also discover whether or not Doc Gurley knows her anatomy – and how many people wrote in, concerned that perhaps she didn’t!

2) Second, get some insider information at “Lay him on the ground” – What Was That Jackson 911 Advice? Why would a 911 operator tell a person to “get him on the ground”? Read it and find out the medical reason – plus be reminded about an important health tip in case the worst happens at your home, and you need to consider CPR for a loved one.

Let’s hope for more joyful ways to learn health tips in the coming weeks.

Got a thingie on your doohickey? Or are you pondering how to tell your doctor he’s a jerk? Send your burning healthcare questions to Doc Gurley by emailing docgurleyatgmaildotcom. Doc Gurley cannot answer every question, and she cannot practice medicine through a keyboard (not even with her stethoscope pressed firmly against the monitor) but be assured – your questions will be kept strictly confidential and identifying traits are changed.

A well-designed recent study showed just how important sleep is to your blood pressure. Other studies in the past have revealed an association between time-spent-sleeping, and high blood pressure, but none of those studies actually measured a person’s sleep (they were, instead, based on self-report) and almost none looked at blood pressure over time.

This recent study did both – and found some eye-opening (so to speak) results:

• Every hour LESS you sleep, you increase your risk of high blood pressure by 37%
• Much of the difference between, say, African-American men (who have long been shown to suffer from more high blood pressure) and white women, can be attributed to differences in their sleep. African-American men slept much less than white women
• Over five years, less than 8 hours of sleep a night resulted in both more high blood pressure among people, and worse high blood pressure when they got it
• Finally, here’s the read-it-and-weep number: only 1% of people got eight or more hours of sleep a night

The study authors pointed out to heartwire/Medscape some important observations: first, that their study could not address the role of sleep-disordered breathing (or sleep apnea, and, second, that “those individuals who appear to need only three or four hours of sleep each night may be fooling themselves. ‘People who sleep for short times do not do well in performance tests, even if they think they are well rested. Even these people should try to increase their sleep times,’ she said.”

Sleep is a free, no-side-effects intervention (well, except for those pillow-crease marks on my cheek). Despite the longer days of summer, set a goal to make sleep a priority. Turn off those glowing screens (even this one! even the tiny ones on your phone!) – then lie in the dark and let yourself drift. For your health.

This week’s Grand Rounds is over at ACPInternist. Since the AMA is in the news so much this week, it’s good to head over and visit the ACP (American College of Physicians) to remind yourself that there are several important (and large) doctor organizations in this country. The American College of Physicians has some great sites to bookmark – one of the prime being Ryan Dubosar’s recurring articles on “Research of the Obvious” – it’s sure to get you both smiling AND shaking your

head in disbelief. This week’s Grand Rounds is a great compilation – you’ll weep, you’ll laugh, you’ll learn! Check it out!

We’ve all had the experience – that perky voice on the other end of the phone who says “sure, we can give a new-patient appointment with your assigned primary care doctor – how’s eight months from now? Does that work for you?”

Even then, most of us look around the packed waiting rooms, seething during our two hour appointment delay – and we assume all this is just another sign that healthcare is going to hell in a handbasket – right?

Instead, there’s a nasty little secret behind this problem – one that patients know almost nothing about. It’s called panel size.

Do you know what your doctor’s panel size is? (and we’re not talking about a new form of tummy-control) Do you have a right to know – if it impacts every aspect of your patient care? For the answer to these questions, and an insider look at exactly why it is you can’t get an appointment with your doctor before the end of the year – read this Doc Gurley article at SFGate. Then weigh in with our comments section. Should your doctor tell you up front how many other patients she’s promised to take care of? Do you have a right to know – or not?

Got a thingie on your doohickey? Or are you pondering how to tell your doctor he’s a jerk? Send your burning healthcare questions to Doc Gurley by emailing docgurleyatgmaildotcom. Doc Gurley cannot answer every question, and she cannot practice medicine through a keyboard (not even with her stethoscope pressed firmly against the monitor) but be assured – your questions will be kept strictly confidential and identifying traits are changed.

Here’s a great, medically accurate article about sex myths – safe sex and sexual health. Kudos to author Amanda MacMillan at Health.com for a job well-done. The article points out that many people – especially teens – rely on websites for sex information. Unfortunately, a lot of that online info is wrong. Check out the article’s myth-busters, and read to the end to find some excellent, recommended accurate sites that

you can share with friends, teens, and loved ones. Heck, some of them are even fun to read.

There’s an (ahem) eye-opening study this week looking at the reasons why Americans aren’t getting enough sleep. Turns out that, of those not getting enough of the good stuff, 50% of us are losing approximately 2 hours of sleep a night due to…TV. The article also notes that many of us are also getting up too early, in order to get to work. In classic science-geek-understatement, the authors point out that “the timing of work may not be flexible,” so cutting back on TV should be a first step. How important is it for you to TiVo Conan right out of your bed? Check out these nightmare-inducing stats:

“Getting less than seven to eight hours of sleep daily can lead to impaired alertness and has been linked to higher rates of obesity, illness and death. Even so, up to 40 percent of Americans are not getting the recommended amount of sleep at night, according to the news release.”

Setting a goal for yourself and your loved ones to turn it all off two hours before your nightly deadline for being asleep is a cheap, (relatively) easy, and painless way to massively boost your health. Definitely Well Worth It material.

Bottom line: No matter how funny he is, he ain’t worth it. Click the Conan and get some shut-eye.

Here’s a nice alternative and effective intervention for teens exhibiting early signs of depression – cognitive behavioral therapy. There’s a lot to like in this study, and its results. Cognitive behavioral therapy is different from what most of think of as “therapy” – CBT is focused on coping strategies, and changing both your thinking and your response to situations. It’s also unlike traditional psychotherapy in that CBT is a defined, limited course that you take – not an endless series of one-on-one visits that many of us, frankly, can’t afford indefinitely. The question this study set out to

answer: Is there anything a parent can do to prevent depression? What’s a parent to do for the kid who seems down, perhaps caught in a negative spiral, but not (yet) clinically depressed? The answer: CBT is an effective first step for many.

CBT in this study “consisted of eight weekly 90-minute group sessions followed by six monthly 90-minute sessions. The sessions were led by a therapist who taught problem-solving skills and other strategies designed to help the teens recognize and change unrealistic and overly negative thinking.” So how effective was this focused, time-limited intervention?

As WebMD reports: ”

Compared to participants who did not get this intervention:

• Those who did were less likely to develop depression during the course of the study, with about one in five (21%) experiencing new depressive episodes compared to one in three (33%).
• The impact of the intervention was most dramatic in adolescents who did not have a parent who was depressed at the time, with 12% of these teens developing depression vs. 40% of teens who did not go through the program.
• The researchers estimated that the intervention prevented one episode of depression for every nine teens treated — a risk reduction similar to that which has been reported for antidepressants.

That’s a big positive, with great results for an intervention that has absolutely no side effects, other than cost and time.

There was one big down side to the results: “Having a parent who was actively depressed at the start of the study significantly reduced the effectiveness of the intervention, lead researcher Judy Garber, PhD, tells WebMD. ‘It may be that there is more conflict at home or that the parent is just too depressed to help them or it may be a marker of greater genetic vulnerability,’ she says.”

Given the relatively steep price for even time-limited, group CBT, some of us might be wondering – couldn’t we teach our kids this ourself? The Doc Gurley bias here is that 1) when it comes to my kid’s health/mind, I want the best if I can stretch and afford it – licensed CBT therapists are experienced and highly-trained professionals for a reason; and 2) when anyone’s kids get to a certain age, tweens and teens need more good adults in their lives – and, at a certain age for each kid, some things they just can’t hear when it’s coming from their parents – or, if they can still hear “it” from you, hearing it from more than one source may increase your effectiveness. A good CBT therapist is a god-send.

Take Home Message: Sometimes it’s worth the price to get effective help for your teen who seems to be struggling. Your biggest challenge, unfortunately, may be finding a licensed CBT practitioner for teens in your area. But the results appear to indicate that, for most teens, finding one would be Well Worth the effort!

Been through this family challenge yourself? Share your thoughts in the comments section below.

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• Prevent Depression in Teens With Cognitive Behavioral Therapy (health.usnews.com)

Excellent news on the Well Worth It front – a superbly-designed study shows that even small amounts of ginger, taken three days before the start of chemotherapy, can significantly reduce nausea. For many patients, nausea is a profound form of suffering associated with chemotherapy – anything that can help is a Halleluyah moment.

The study showed that 0.5 mg to 1.0 mg of ginger were most effective, and reduced nausea (especially the worst – first day nausea) as much as 40%, with rapid decreases in nausea after the first day. There were no documented drug interactions or side-effects, making ginger a Three-Stethoscopes-Up winner in the Doc Gurley rating scale of Well Worth It interventions. No one knows exactly how ginger works its magic, but the belief is that ginger reduces inflammation, making it an excellent chemo-accompaniment. What may be harder to prove is ginger’s effectiveness in other forms of nausea, where you don’t get three-day’s warning that its going to hit. Ginger has long been suggested as an anti-nausea approach to the nausea of pregnancy. However, as with any substance, ginger too is a drug, so don’t

mega-dose or take concentrated amounts in early pregnancy (when a developing fetus is most vulnerable). But it’s probably (based on cultural cuisines) safe to use ginger in normal food amounts.  If you’re storing ginger root at home, here are two kitchen tips – one, keep your ginger buried in sandy-dirt (but wash carefully before using!). Ginger root will keep growing and stay fresher that way. Second, store some ginger root in the freezer. It’s much easier to grate when frozen.

Pass the word – without a large for-profit motive, this type of news often gets lost!

Got a comment? Or a great ginger recipe? Share it in the comments section below…