Purging Disorder

When I first saw the title of this AP article, I said to myself, "I know what this is. It's the binging and purging thing, right." Eating disorders is something I've written before on this blog. Pro-ana and pro-mia sites continues to be one of the most visited posts on this blog.

But, what I didn't realize is that the term purging disorder talks about being "compelled to purge, usually by vomiting, even after eating only a small or normal amount of food."

Apparently, purging disorder is not an officially recognized diagnosis according to the American Psychiatric Association. However, further study and research on this topic may support changing of the criteria for diagnosing eating disorders.

The dangers of purging disorder are similar to those of bulimia: psychological problems, dehydration, electrolyte imbalances that can affect the heart and kidneys, and potential dental problems because of self-induced vomiting.

Here is a pretty good link talking about eating disorders from WebMD. I didn't know that it's hard to even put a number on how many people suffer from eating disorders. Many of these are sad stories. Hopefully, more effective treatments can be developed to address this problem.

I'm A Web Resource!

I received an e-mail from Jimmy Atkinson who is from the Nursing Online Education Database. Apparently, they just put together 100 web resources for medical professionals. I was pleasantly surprised that this blog made the cut:

91. Doctor Anonymous — This is a humorous blog written anonymously by a doctor. It covers medicine in relation to politics, life and beyond. Doctor Anonymous also has an online radio show, broadcast from this blog.

Thanks so much to NOEDb for placing the blog on their list. I really appreciate it. I've even received some traffic from over there today - so thanks! I encourage you to check out this list. It's a pretty good group of links divided into 12 categories. Check it out!

Don't tase me, bro!

What is up with this? Apparently, this incident has received over a million views on youtube already. If you haven't heard about this already, here's an article from the Gainesville Sun. As I have said before, this not a political blog. I only make observations. And, this video is interesting on so many levels.

Wash Your Hands!

Do you wash your hands before your leave the restroom? C'mon, be honest. I won't tell anyone. Well, it seems that in a recent study, less people are washing their hands compared to 2005. Ew! What's up with that? The article is from WebMD.

Researchers who discretely observed men and women in public restrooms found that only 77% washed their hands with soap and water -- a 6% decline from 2005.

But not many people are admitting to slipping up: In a separate telephone survey, 92% of Americans claimed they always lather up in public restrooms. The findings were reported at a meeting of the American Society for Microbiology (ASM).

Who is more to blame? Men or women? What do you think? Here's the answer from the article.

The blame lies squarely with the men, says Brian Sansoni, a spokesman at the Soap and Detergent Association, which cosponsored the survey with the ASM.

The percentage of men observed washing their hands fell from 75% in 2005 to 66% in 2007. In contrast, hygiene habits basically stalled among women: 90% washed up in 2005, compared with 88% in 2007.

Now, as compared to yesterday when I talked about things like lab coats and neckties potentially spreading bacteria, I'm a huge advocate of hand washing in the hospital setting, before leaving the restroom, and other situations where bugs can spread. So, do us all a favor and just wash your hands, would ya?

Dr. A Live - 9/20 @ 4pm ET

I'm happy to announce that the next edition on the Doctor Anonymous Live show will occur on Thursday at 4pm ET. Mark your calendars now! I think (finally) that I've worked out the technical glitches so that I can focus (mostly) on show content. I'm excited about this project again!

Blog Talk Radio unveiled an entirely overhauled site on Monday morning (like the new logo?). I have got to tell you that it looks very nice! I encourage you to check it out.

There are also a few new features that I hope to be trying out for the show on Thursday. For example, they have installed a group chat function. Now you'll have to register as a BTR listener to enter the chat, but I think it would be fun if we got a few people in there chatting away during the show.

BTL has really added a social networking feel to their site now. You can now designate "friends" and sign up as "listeners" to specific shows (don't forget to do that to me when you get your BTL name!). You can also add text comments to specific shows and to my profile, if you like. Plus, there's a rating system for individual shows from 1-5. Hope you can join me in a couple of days!

Grand Rounds

Grand Rounds 3.52 is now up and running over at Six Until Me. Kerri has done a great job at putting this together. I encourage you to head on over there and check it out. It's been a while since I have submitted anything to GR. Thanks so much for including my post this week...

I need to warm up. Off to the bakery, where I can grab a nice, hot coffee. The lady in front of me is yapping away on her cell phone - doesn't she know too much cell phone use could cause cancer? Dr. Anonymous should give this lady a call (on her landline).

If you don't know what Grand Rounds is, it is a weekly compilation of the best posts from the medical blogosphere that moves to different sites each week. And, who doesn't like reading about medicine and science? Next week, GR moves to the one and only Kevin, M.D. Enjoy!

Doctors failing pregnant patients

Here's another glowing review of American health care. This time, docs fail to warn pregnant patients of the dangers of continuing prescription medications during pregnancy. (image credit) Here's the start of this AP article:

Philadelphia - Doctors aren't doing a very good job of warning young women to avoid getting pregnant when they're taking prescription drugs that can cause birth defects, a new study suggests.

Nearly half of the women taking the medicines didn't get counseling from their doctor about using contraceptives or other birth control measures, University of Pittsburgh Medical Center researchers found in a study of nearly 500,000 women.

Now, this didn't make any sense to me. I get asked a lot about prescription meds during pregnancy by my patients. And, I know during medical school and residency training, the issue of meds during pregnancy is emphasized heavily.

Later in the article, the glaring limitation of this study is exposed...

The researchers noted that the study might overestimate the problem because the data is from health plan billing codes, which don't have the same detailed medical histories as patient medical charts. Some doctors may have provided counseling but didn't bother to mark it with a billing code.

Ah HA! Of course, this study overestimates the problem - thereby falsifying their data. What kind of researcher would use billing codes from a physician office to track counseling? Everyone knows that insurance companies do not pay for most (if not all) counseling sessions done my medical physicians. That's the reason they're on on the billing form.

Now, some of you out there are probably saying, "Those greedy doctors. If they don't get paid for counseling, then they won't do it." On the contrary, counseling does happen. It's documented in the medical record (which the researchers here didn't bother to check). In addition, since insurance companies don't pay a counseling charge, as with other charges not paid by insurance, the bill would subsequently go to the patient. Who wants that to happen?

Don't get me wrong. Docs can do a better job in discussing medication reactions in pregnant patient. But, to come out and accuse docs of doing a bad job for patients and then have bad research data? That's disingenuous and lying to the public, but par for the course for the American press.

UK Physician Fashion Police

If you're a doctor in a British hospital, don't even think about wearing a necktie, long sleeves and jewelry to work. You can't even wear your traditional white coat. I've talked about docs wearing ties and lab coats in the past.

According to this AP article, the Department of Health in England issued a hospital dress code on Monday banning the above clothing. They say that it will decrease the spread of infection.

"Ties are rarely laundered but worn daily," the Department of Health said in a statement. "They perform no beneficial function in patient care and have been shown to be colonized by pathogens."

The new regulations taking effect next year mean an end to doctors' traditional long-sleeved white coats, Health Secretary Alan Johnson said. Fake nails, jewelry and watches, which the department warned could harbor germs, are also out.

I guess docs will have to dress like Dr. McDreamy above. (You knew I just had to bring back that picture at some point. Remember this post?) Getting back to this article, US physicians will not have to worry about silly dress codes like this...

Infection control societies in the U.S. don't recommend similar dress restrictions because there is no strong evidence that health care workers who don't wear ties or jewelry reduce the risk of infection, said Dr. James Steinberg, an Emory University infectious disease specialist.

Steinberg said that doctors and nurses who don't adequately wash their hands pose a far bigger risk to patients and that hand-washing should be the focus of infection control efforts in hospitals.

The [CDC] does have guidelines advising doctors and nurses against wearing artificial nails in operating rooms and around high-risk patients. It says there is evidence that health care workers who wear fake nails have more germs on their fingertips both before and after hand-washing than those with natural nails.

Now, let me get this straight. I can keep my tie and lab coat. But, I have to get rid of my artificial nails? What's up with that?

Hillary health care (part 2)

The press is abuzz today hyping up the fact that Hillary is going to unveil her health care plan today. (Of course, I'm a hypocrite for not only point this out but also making this a post of my own.) Here's the beginning of the AP article.

Des Moines, Iowa - Democratic presidential candidate Hillary Rodham Clinton is unveiling a sweeping health care proposal Monday that would require everyone to carry health insurance and offer federal subsidies to help reduce the cost of coverage.

Fulfilling a pledge to bring health care to all, Clinton's "American Health Choices Plan" has a price tag of about $110 billion per year. It represents her first major effort to achieve universal health coverage since 1994, when the plan she authored during her husband's first term collapsed.

Here's an interesting quote from today's CNN article citing why her first plan didn't work out...

As first lady in 1993 and 1994, Clinton spearheaded an effort that would have overhauled the provision of health care. Critics compared her plan to socialized medicine, and it was killed by opposition from special-interest groups -- including doctors and pharmaceutical companies.

I just love when docs are lumped together with pharmaceutical companies - and then blamed for the reason that the United States does not have "universal" health care - this is very Michael Moore-like. (Aside: It's always enjoyable to see MM being taken on by the main stream media like CNN and ABC.)

In case you were wondering, here is a decent AP article outlining the stated positions of the other presidential candidates. I'm no political pundit. But in just talking with people around town (supposed grassroots America), I believe that health care is the number one domestic issue that will shape next year's presidential election.

Terry Fox

Before I even thought of making medicine a career -- before I even was a teenager -- I remember seeing this movie about a guy - an amputee -- try to run across Canada -- for cancer research. "What's cancer?" I asked my parents.

They gave me some kind of explanation which I could not understand. What I did know is that "the cancer" caused this guy to lose his leg. I still remember this story, even today.

According to this article from CTV, the 27th annual Terry Fox Run was today in Toronto. I didn't know this, but his foundation has raised over $400 million worldwide for cancer research. Here is some background information, if you're not familiar with this story.

Fox set out on his Marathon of Hope in St. John's on April 12, 1980, to raise awareness for amputee capability and cancer funds. Born in Winnipeg and raised in Port Coquitlam, B.C., he was first diagnosed with bone cancer at the age of 18.

Three years before he started his run, Fox's right leg was amputated 15 centimetres above the knee, in an attempt to stop the disease from spreading throughout his body. He ran 42 kilometres a day through the Atlantic Provinces, Quebec and Ontario; the equivalent of a full marathon everyday.

After 143 days on Canadian roads, Fox was forced to stop running near Thunder Bay, Ont., because the cancer had reached his lungs. He passed away in June of 1981 at the age of 22.

Even as a child, I didn't understand why someone so young had to pass away from an illness. The youtube video above tells a little more of the inspiring, yet tragic story of this Canadian hero.