Need cash? Lose weight!

You're probably going to think that I'm making this up. In the northern Italy town of Varallo, Mayor Gianluca Buonanno is offering cash rewards to its citizens not only to lose weight, but to keep it off as well. (Associated Press)

"We wanted to encourage people to lose weight, and we thought that both the money and the idea of joining a group could be stimulating," Buonanno said in a telephone interview Thursday.

Participants in the week-old Varallo initiative will be given $67 when they reach their ideal weight. If they don't gain any weight back after five months, they will receive $268.

If they maintain their ideal weight for a year, they will get $670 more. So far, 30 of the townsfolk have signed up, Buonanno said.

It's an intriguing idea, but will it work? People say that money is motivating. But, to maintain your ideal weight for one year for approximately $1000? Will the combination of less weight, increased health, and cold hard cash be the secret to success?

The baby formerly known as baby

Remember in the mid 1990's when Prince was mad as his record label and changed his name to that unpronounceable symbol? What happened? It really didn't do to much for his career and everyone called him "The Artist Formerly Known As Prince" or "The Artist." Meethinks that a Chinese couple has been listening to too many Prince albums lately.

BEIJING (Reuters) - A Chinese couple tried to name their baby "@", claiming the character used in e-mail addresses echoed their love for the child, an official trying to whip the national language into line said on Thursday.

The unusual name stands out especially in Chinese, which has no alphabet and instead uses tens of thousands of multi-stroke characters to represent words.

"The whole world uses it to write e-mail, and translated into Chinese it means 'love him'," the father explained, according to the deputy chief of the State Language Commission Li Yuming.

While the "@" simple is familiar to Chinese e-mail users, they often use the English word "at" to sound it out -- which with a drawn out "T" sounds something like "ai ta", or "love him", to Mandarin speakers.

Uh, yeah. I get it. In looking at weird baby names, one doesn't have to look to far. I mean, just look at Hollywood babies. Some of them are definitely scarred for life. I also did a quick Google search of changing names to people like Peyton Manning and Jesus Christ. What is the most unique baby name you've heard of?

Beginner's guide to medblogs

As you all know, I'm addicted to my stats, and I'm always interested in who is linking to this blog. When I was browsing through my Technocrati stats, I saw a post linked to this blog which I wanted to share with you. (image credit)

The post is called "New to medical blogs? Vitum's Beginner's Guide to Reading Medical Blogs." It was a long post (at least for me) to read. But, I thought it was well done.

It starts off with this question, "What is the Medical Blogging Community?" And, it goes on from there. This blog is not mentioned by name, but the blogger did put a link to my post about Flea in the "Medblog Gossip" section. (Thanks so much for the link)

So, if you're new to the medical blogosphere, or, even if you've been around a year (like me) or more, I encourage you to check out the link above. It's an interesting read. Who knows? You may learn something you didn't know before.

Doctors failing obese patients

Here's breaking news: Doctors are responsible for America's obesity epidemic. Did you know that? Well that's what the press in this country want you to believe. Here's the latest example. (image credit)

According to a study involving almost 10000 patients at the Mayo Clinic in Minnesota, only 20% of study subjects had their obesity formally documented. However, if this condition was documented, then patients were more likely to be given a treatment plan which included exercise and diet instructions. (Reuters)

Not surprisingly, [the principal investigator] noted, study patients who were severely obese were more likely to have a diagnosis and a treatment plan -- suggesting that doctors need to take a closer look at patients with less severe weight problems.

I have a few of problems with this. First, I never knew that I was responsible for the obesity epidemic continuing. Those of you conspiracy theory people out there probably even believe that docs are intentionally not treating obesity because it would decrease business for medicine. How ridiculous is that?

Second, this article appears to want doctors to label their patients as obese so that they can get the proper treatment. No one likes to be labeled. In fact, if I even hint at the word obesity with my patients, I know that they would leave my practice. Labeling is a big no-no - whether it's obesity, mental illness, or any other term with a negative perception.

Third, even if I give my patient a very specific treatment plan, am I responsible for them to follow it? Well, according to the concept of pay-for-performance, physician accountability is more important than patient accountability - meaning if the patient does not lose the weight, it is my fault and it will hit my pocketbook. I know you doctor haters out there don't care about this. But, I have an office full of staff and I care how much this would affect them.

So, now that I'm done rambling, this article is just part of my continuing frustration with the press in this country. Not that I care, but articles like this create a false perception. Perception is reality to some people. And, it is this false reality that makes it difficult for me to deliver adequate health care to my patients.

Antioxidants don't help heart

I'm probably going to get in trouble for saying this, but there are many homeopathy and complementary health professionals (image credit) who are scratching their heads following the latest study from the Archives of Internal Medicine. (abcnews.com)

A study released today in the Archives of Internal Medicine is the latest to put a dent in the theory that vitamins such as C, E and antioxidants such as beta carotene can reduce the risk of heart attack, stroke or other cardiovascular events.

Although previous research has come to similar conclusions, the study at hand is perhaps one of the largest to debunk the idea that these vitamins can lead to a healthier heart.

In the past, conventional wisdom (as well as some early research) stated that there was a protective effect that antioxidant vitamins had on the prevention of heart disease and stroke. In my opinion, there has been an entire alternative medicine industry built on this belief.

"Although theoretically these antioxidants would appear to be protective … these antioxidant vitamins have not lived up to their promises," says Dr. Carl Lavie, director of cardiac rehabilitation and prevention at Ochsner Medical Center.

"Studies of nutrients for disease prevention all indicate that the active ingredient in a healthful diet is a healthful diet, and not some isolated nutrient we can put in a pill," says Dr. David Katz, director of the prevention research center at Yale University.

Of course, research is ongoing. And, probably in 3-6 months, there will be another study published claiming to debunk this study. Don't get me wrong, I'm not saying that complementary medicine is bad and the type of medicine I practice is better.

I'll just be curious on the public reaction to this news. For example, when I mention any prescription drug, my patients can list all the side effects that they say on television. 

How about when I tell them, "You know, the $50 you spend every month on antioxidants may not help your heart as much as you think." Will people stop taking their antioxidant vitamins based on these study results?

Revisited: Blogging Personna

About a week ago, I wrote a post about the thoughts I had about how a blog reveals the type of person that you are. I very much appreciated everyone's comments on this. Today, A Mom Who Thinks Too Much wrote a post called, "Is This Blog, Me?" I usually place my comments in the 'comment section.' But, her post brought out an assortment of thoughts that would probably be better expressed in a conversational full post.

Some bloggers, like some "people," are simply more steady in the face they present to different people (these are the people who say "my blog is pretty much me"); others are more chameleon, showing a different face to different people. There's nothing wrong with either way. Personally, my blog is in many ways the core me---but it isn't the full me. Sometimes when I write an edgier post, that departs from my normal "sweet, but cerebral" self, I feel I am taking a risk.

At least for me, blogging is kind of like a window into the soul. What the heck do I mean by that? When we're with certain people, or in certain situations, we can (and do) reveal what we want to reveal about ourselves and our personality. I can be upbeat or more subdued when I'm with certain people or in certain situations. Writing posts are the same thing. But, when it comes to your core self, I believe that blogging, as in real life, there are certain qualities that you cannot hide.

But even our cores have more than one side. My friends would add "wicked" (and "funny"), my mother would add "stubborn---but sweet," my husband would agree with the "stubborn" part but would protest vehemently that I am not as sweet as I appear. (He is my spouse after all.) Casual friends would be surprised to find me as talkative and opinionated (even cutting) here than I am in their company. (Though it depends on the person. Some people "see" us better. Why is that?)

I believe that with certain people whom you "just click" with. There are some whom I immediately feel a connection with (granted this is a very small number). But, I definitely understand that some people just "see" us better. Here's a final comment that I will respond to:

I know some bloggers, when they feel a need to depart from their usual "face," or when they are moving into a different phase of their life, will start a new blog entirely. Often it is still even linked to their profile. (Naturally, we don't see easily those that aren't.) "This blog isn't me anymore. I've now moved to ...." It's interesting. I see that and I know exactly what they mean.

I'm so glad that you brought this up. I contemplated for a long time whether to close up this blog and start over - start over with a new blog name and a new blogger name - as a kind of transition to myself. Obviously, I elected not to to that.

Even if you change your clothes, or hair color, or where you live, or whatever external changes you want to make to yourself - or, even if you change your blog color, blog address, or whatever appearance changes to your blog - the essence of your blog comes from within. Your true blog readers and your true non-blog friends will accept you for who you are.

Thanks AWMTTM for your insightful post and your thoughtful response. I feel I'm more of a chameleon type like you...

USA: The World's Best Medical Care?

I seldom read the New York Times, because I pretty much know what I'm going to get even before picking up the paper. (image credit) But, in this morning's editorial section, there is an essay called, "World's Best Medical Care?" Here's the opening paragraph:

Many Americans are under the delusion that we have “the best health care system in the world,” as President Bush sees it, or provide the “best medical care in the world,” as Rudolph Giuliani declared last week. That may be true at many top medical centers. But the disturbing truth is that this country lags well behind other advanced nations in delivering timely and effective care.

Groups like the World Health Organization and the Commonwealth Fund have ranked the US low in certain areas. The NYT piece goes on to outlines eight areas in which the US could do better which include areas like lack of universal health care, high infant mortality rate, low life expectancy at age 60, poor patient satisfaction, and being slow to adopt electronic medical records.

I'm not going to dispute most of this article. There are some good points and it is a decent analysis of how the American health care system could improve. But, like most things in the New York Times, I took it as a political commercial as opposed to an informative piece of journalism.

After throwing the US health care system under the bus for two pages, the NYT does try to make a comeback with this kind of backhanded compliment - or maybe it's not a compliment.

Top-of-the-line care. Despite our poor showing in many international comparisons, it is doubtful that many Americans, faced with a life-threatening illness, would rather be treated elsewhere. We tend to think that our very best medical centers are the best in the world. But whether this is a realistic assessment or merely a cultural preference for the home team is difficult to say. Only when better measures of clinical excellence are developed will discerning medical shoppers know for sure who is the best of the best.

Is health care the most important issue in the upcoming US presidential election? Some people think yes and this editorial is proof of that. For me, it's just too early. It's a long 15 months until the election. However, I do appreciate that health care issues are probably getting a little more press than they did a year or two ago. Nothing will change without getting the public's attention. As I always say, we'll just have to see how this all plays out....

Paintball practice

In today's addition of Dr. A's small town news, here's a funny quote from the police blotter. It's always interesting to see what our citizens are doing around here.

A state Route 9, Salem, man reported Wednesday someone in a passing car fired paintballs that struck his son-in-law’s vehicle and nearly some children playing outside. Denny reportedly chased the vehicle into Perry Township, where it was stopped by police.

Viewing the video above, I never knew that paintball is such a big deal to some people. Of course, who am I to judge? I mean, for enjoyment and relaxation, I hit a little white ball around - but I love it!

Microburst

The weather experts were in town yesterday examining the damage (image credit) to declare if indeed a tornado went through here two days ago. In my meteorlogically naive mind, I thought it was self evident. I mean, there's wind and rain, and what looks like tornado damage. If it walks like a tornado and talks like a tornado, isn't it a tornado?

I guess not. In today's local paper, the official ruling is that what happened on Thursday is called a microburst. Huh? To me, that sounds like some like of science fiction term where Martians fly down, blow up your supermarket and gas station, and then leave.

“We were lucky,” Salem police Chief Robert Floor said after a Friday press conference on the storm damage at Eastgate Plaza.

“Yes, you were,” said Richard Kane of the National Oceanic and Atmospheric Administration.

Kane, a meteorologist based in Pittsburgh, was in Salem to advise city officials and the media that Thursday’s storm damage was not caused by a tornado but an 85 mile-per-hour microburst. Kane placed the event at 1:15 p.m.

Of course, being a skeptic on this, I did my own research on this. Don't get too excited. It was just a couple of Google searches. I did find some interesting information - at least for my education.

According to weather.com, here is the definition of a tornado: A tornado is a violently rotating column of air extending between, and in contact with, a cloud and the surface of the earth.

According to this article on the NOAA website, here is the definition of a microburst: A downburst is a strong downdraft which induces an outburst of damaging winds on or near the ground. Damaging winds, either straight or curved, are highly divergent. There are some interesting illustrations here.

Fortunately, there were no fatalities (there were rumors to the contrary) and there were no serious injuries -- just minor cuts and abrasions from flying glass and debris. Life is pretty much back to normal now.

The people around here (including me) will be trading "Where were you when it happened?" stories for a long time. Stuff like this never happens around here. Here's my favorite quote from the article.

No one was sucked out the door [of a local business during the microburst], the spokesperson said debunking a rumor, but a customer’s money was.

How funny is that? When I read that quote, I couldn't help but think of the 1996 movie called Twister with Helen Hunt (Ah... Helen Hunt...) and that what's his name guy. I remember seeing farm equipment and even animals being drawn up into the special effects tornados. Cool stuff - especially for 1996. Here's the trailer.

Tornado

This is what happened to my car (just kidding). Very weird here yesterday afternoon. I saw patients here at the office in the morning, and then actually had the afternoon off. This means that I went to the hospital and was in the medical records department doing some paperwork.

As the rain and wind got worse, at around 1:30pm, I said to myself, "At least I can finish more of my paperwork." I did hear some fire engines and police sirens outside. At the time, I didn't think it was that big of a deal. I mean, it is a hospital. There are sirens blaring around here all the time.

Little did I know what was going on outside. Less than a mile from where I was sitting, there as a possible tornado taking place. You'll see pictures of what was happening here, here, here, and here. Sheesh!

Where the picture was taken above was less than half a mile from our office. Authorities had to evacuate the area around the supermarket above because of a propane tank that came loose.

So, what our office staff told me today (because I wasn't here), was that authorities came into the office around 2:30pm yesterday afternoon and evacuated this entire medical complex/plaza. (I was at home at this point underneath my desk.)

It calmed down a bit for a couple of hours, then another line of storms came through. The winds were not as strong later in the afternoon - but a lot more rain. This storm will definitely be the talk of the town today. I may have an update for your later.

Update: Here's a quote from the AP story on the storm -- "Wind also damaged a restaurant and blew out car windows in a supermarket parking lot in Salem, about 15 miles southwest of Youngstown."