Grand Rounds

Grand Rounds 4.21 is now up and running over at HealthBlawg: David Harlow's Health Care Law Blog. If you can believe it, this is a health care lawyer and consultant handling GR this week. But, not to worry, this Valentine's Day edition is well done.

In fact, it is so well done, that I have a post in this week's Grand Rounds, and I didn't even know it. On Sunday afternoon, I wrote the post called "Love Hormone," and I thought that it would be a great edition to GR. But, when I looked at the deadline, I read that I missed it. So, being a past GR host, I remember how annoyed I was when people tried to e-mail me something past the deadline.

But, this morning, I was checking my stats and found that I was getting referrals from this week's GR site. When I clicked over there, I was pleasantly surprised to find the following link to my blog (and even more pleasantly surprised to find it in the top 1/3 of the post - great location!)

Dr. Anonymous is blogging about "the love hormone" and will have a Valentine's Day edition of his BlogTalkRadio show -- which Dr. Val tells us will be an "estrofest" featuring several women medbloggers.

So, thank you David Harlow and Healthblawg for placing my post on GR this week and thanks for promoting The Doctor Anonymous Show this week. Just for that, you are awarded a spot on my prestigious blogroll. Who says that I don't give lawyers a fair shake? Enjoy Grand Rounds this week. Next week, GR will be hosted over at the Daily Interview blog.

Happy Valentine's Day

Welcome back to love week here on the blog. Yes, I know, Valentine's Day is not for a couple of days. But, why not try to start a little discussion on this topic. In my video post above, I talk a little bit about the "controversy" surrounding Valentine's Day. I think that asking people about Valentine's Day is more controversial than asking people about politics or religion.

Do you think I'm kidding? Well, ask someone about Valentine's Day and leave me a comment about your experience. I've encountered either really happy people or really bitter people. Let me know what you find out when you ask people.

Finally, direct from the category of over-promotion, I'm going again to tell everybody about the Valentine's Day Estrofest on The Doctor Anonymous Show - Thursday, February 14th at 9pm eastern time. It's going to be a great time. Get ready to be in the chat room and even call into the show. You don't need a date. Come as you are. See you then!

Love Tragedy

Welcome back to "love week" here on The Doctor Anonymous blog. Unfortunately, this is going go be a bad news post. In fact, quite a tragedy. I didn't believe it the first time I read this story. A bride has a dream being like the movie, "My Big Fat Greek Wedding." I've seen the film - good stuff.

According to this Associated Press story, here is what happened...

Kim Sjostrom carried blue and white flowers during the ceremony — the colors of the Greek flag — as she exchanged vows with Teddy Efkarpides, a 43-year-old carpenter and Navy veteran. They had met three years to the day before the Jan. 19 wedding.

During the couple's first dance, Sjostrom complained of being lightheaded. Efkarpides thought his wife, a diabetic, needed sugar, but she collapsed. Wedding guests, paramedics and doctors at a nearby hospital were unable to revive her.

My heart just goes out to this groom and the families involved. What a sad story.....

The Love Hormone

Ok, first of all, this is not a spam post. And, I have not become a spokesman for the latest craze in the treatment of sexual problems. But, you are reading this post, aren't ya? So, here's what this is about.

Researchers at the University of California, San Diego School of Medicine are theorizing that the hormone oxytocin can be used in the treatment of disorders like schizophrenia, autism, and anxiety. In quoting this UPI article, oxytocin "is a brain chemical associated with pair bonding, including mother-infant and male-female bonds and increased paternal involvement with children."

"That's why oxytocin is sometimes called 'the love hormone,'" [researcher Dr. Kai] MacDonald in a statement. "It's said that the eyes are the window to the soul ... they certainly are the window to the emotional brain. We know that the eye-to-eye communication -- which is affected by oxytocin -- is critical to intimate emotional communication for all kind of emotions -- love, fear, trust, anxiety."

People with schizophrenia or autism often avoid eye-to-eye gaze, focus on less relevant areas of the face, and avoid meaningful social contact. The researchers theorize that oxytocin might act on the brains of patients with schizophrenia and anxiety and may ultimately increase the level of trust or emotional contact between patient and physician, or with patients and significant others.

I have no idea why this is a news story. I just found it interesting that there is an association made between oxytocin and the term 'the love hormone,' because I have never heard that before. Has anyone else? But, this being Valentine's Week, I'm hoping to get a lot of Google searches (*waving to all of you who are here from a google search*)

Also, this is a great segue into reminding you about The Doctor Anonymous Show on Valentine's Day night - Thursday, February 14th at 9pm eastern time. It's going to be a great time with medical bloggers Dr. Val, Jenni from Chronic Babe, Crzegrl, and EE.

I have the number three listened to show in the health category on BlogTalkRadio, and I'm hoping to surge to number one with your help. So, tell your friends and neighbors to join us for The Doctor Anonymous Show: Valentine's Day Estrofest. You won't want to miss it!

Welcome back Cathy!

A few weeks ago, I was saddened to find that Cathy's Place to Blog was closed. I'm happy to report that Cathy has reopened her blog and wrote a new post yesterday. Welcome back, Cathy! Please click here, drop by, and welcome her back to blogging.

Thanks again for everyone who have listened to the show Thursday night with Dr. Schwab. I also appreciate the posts written about the show including from SeaSpray, EricThePragmatic, and Sid Schwab himself. Oops, I forgot Suture for a Living.

Look out for next week. I already appreciate the promos that have already been written by Dr. Val, Crzegrl, and the Chronic Babe newsletter. Spread the word. This is going to be a fun show!

Sid Schwab Show: Epilogue

Thanks so much to Sid Schwab for being on the show. It was a really fun interview. (video post above) We probably could have talked for another hour. I'll definitely have to bring him back on the show. There was talk in the chat room about bringing Mrs. Sid onto the next show. So, that should be interesting.

We talked about how be chose general surgery as a career. He also shared some stories from medical school, residency, and his 25 years of practice. At the end of the show, we briefly talked about his book: Cutting Remarks: Insights and Recollections of a Surgeon.

The chat room was as busy as it has ever been -at times as many as 22 people chatting. So, if you have never listened to the show live - you are missing "the show within the show." I did have a few small technical glitches, but I don't think that it affected the audio at all (you can let me know otherwise).

Thanks so much to the people who called in as well. Bongi called in all the way from South Africa where is was 4am. Sid has a dream of working with Bongi some day. Dr. Rob also called in and Sid called him "The Dave Barry of the Medical Blogosphere." It was great to hear from Dr. Rob again.

Enrico checked in to give a brief update on his situation. Suffice to say that he is going to have to find a new URL - maybe we can help him find a new name for his blog (leave me a comment if you would like to help - hehe). Enrico asked the question about how to balance work and life.

SeaSpray said that she never called into a show or was in a chat room before. Thanks so much for calling in. She is a regular reader and commenter on Sid's blog. She also shared a story of how Sid helped her last year. Finally, EricThePragmatic called in and told the story of how Sid was his mother's surgeon - a touching story.

So, if you didn't listen live - why didn't you? Sheesh! Well, listen in my sidebar or click here. Also, if I can ask a favor, after you listen to the show, please rate the show and leave a comment. It will really help my BlogTalkRadio ratings.

Next week - Look out, because The Ladies invade The Doctor Anonymous Show. It is the Valentine's Day Estrofest. My guests include Dr. Val, Jenni from Chronic Babe, Crzegrl, and EE. Call your friends and wake the neighbors - This will be a fun show. Who knows what we'll talk about and what will happen? Have a great weekend, everybody!

Dr. A live TONIGHT

Thursday, February 7th, 2008 at 9pm Eastern Time

Join us tonight for Sid Schwab. At the bottom on this post, you'll see an embed from ustream.tv. This week, BlogTalkRadio has been very interesting in that the sound has not been ideal. Some shows sound like they were under water they sounded so bad. Hopefully, that won't happen to me or my guest. We'll see what happens this week.

Take part in the chat room, which is the "show within the show." A great opportunity to interact with medbloggers you've only read about. You can even call into the show to talk and/or ask a question. See you tonight!

For first time Blog Talk Radio listeners:
*Although it is not required to listen to the show, I encourage you to register on the BlogTalkRadio site prior to the show. I think it will make the process easier.

*To get to my show site, click here. As show time gets closer, keep hitting "refresh" on your browser until you see the "Click to Listen" button. Then, of course, press the "Click to Listen" button.

*You can also participate in the live chat room before, during, and after the show. Look for the "Chat Available" button in the upper right hand corner of the page. If you are registered with the BTR site, your registered name and picture will appear in the chat room.

*You can also call into the show. The number is on my show site. I'll be taking calls beginning at around the bottom of the hour. Hope these tips are helpful!

"Normal" sugars may harm diabetics

I can't even imagine having diabetes. Every day, I talk with and take care of patients with diabetes. I'm just fascinated with the technology out there to monitor blood sugars and to deliver insulin. No longer are just the syringe and the needle. There are stuff like pre-filled insulin pens and even insulin pumps that can deliver the medicine now.

In diabetes treatment, the current thinking has always been to push your average sugar level to a lower and lower number. Now, I'm not talking about too low - like hypoglycemia - but a lower Hemoglobin AIC level (the three month blood sugar level).

In what can be characterized as a stunning move, a federal government study had to be stopped because of deaths NOT due to HIGH blood sugar levels - but because of possible too LOW blood sugar levels (Associated Press)

The government abruptly halted aggressive treatment in a major study of diabetes and heart disease after a surprising number of deaths among patients who pushed their blood sugar to super-lows — findings that call into question a growing movement in diabetes care.

The study was stopped a year and a half early because they found 257 deaths in the group of patients whose blood sugars were aggressively treated. In the article, aggressive treatment meant trying to bring the long range sugar number - the HbAIC - back to a normal range (meaning to the level of a non-diabetic). The other group who were treated with more standard care treatments using current diabetic HbAIC guidelines, only had 203 deaths. Why is this? At this point, researchers are unsure.

The findings contradict previous research suggesting that the lower diabetics can make their blood sugar, the better. That had specialists cautioning Wednesday that it's too soon to know if the finding among heart patients was a fluke, or a real sign of how exquisitely tailored to each patient's risk factors diabetes care must be.

The article goes on to say that as if this point, current treatment guidelines should not be changed until further study is completed. This definitely brings up the question: How aggressive is too aggressive when it comes to treatment of blood sugars in diabetes?

Virtual Office Visits? Not Really

A friend of mine sent me a link today in which the article uses the term "virtual office visit." What comes to your mind when you hear this phrase? Well, to me, this sounds like you type in your symptoms, the doc makes a diagnosis and sends a prescription to the pharmacy for you to pick up. Simple, right?

Well, not really. Again, this is a case of the press inaccurately describing something in the text article. If you watch the video clip, it's from a national morning news show. In the video piece, the anchor and the medical reporter talk about a computer program. Yes, a computer program. No, the computer doesn't diagnose and treat.

This program actually is a communication piece between the physician and the patient. I see it as a tool to be used to communicate things like routine lab work. One of the goals at the physician's office is to try to find a way to cut down on the number of phone calls.

We see this every day. You want to let the patient know that she/he has normal blood tests that were drawn at the office last week. The office calls the patient - the patient is not home - the office leaves a message to call the office - the patient gets home just before the office closes - the office has to get the chart from the stack of charts marked "left message with patient to call back" - the lab results are communicated - the patient has some questions - a message is taken - the message is communicated to the doctor - the office calls the patient back - leaves a message on the answering maching - etc - You get the point.

Well, this program gives the doc the opportunity to communicate those lab results via the internet and the patient can check these results anytime. Of course, there are internet security issues to deal with. But, for the most part, this program looks promising.

If you read the text article, it leaves the impression that this is an "office visit" that can serve as a substitute for an in person visit. Doctors can even charge for this visit. As kind of an afterthought, the article sticks in there, "if insurance covers it" - which it doesn't.

I guess my question is this - Would you, as a patient, like this type of communication made available to you? If your insurance company didn't pay for this service, would you pay for this type of service, or are you content with telephone communication with the office. I'm just curious....

The Sid Schwab Interview

This week The Doctor Anonymous Show welcomes one of the most widely read medical bloggers around: Sidney M Schwab, MD. He is author of the blog Surgeonsblog: Wherein a surgeon tells some stories, shares some thoughts, and occasionally shoots off his mouth. Like a surgeon.

Now, not only does Sid have a blog, he also has a podcast in which he reads parts of his book. I encourage you to check it out. Also, if you're never read anything by this guy before, check out the disclaimer on his blog below, and that's a great start:

What I say here is as true as I can make it, based on my experience as a surgeon. Still, in no way is it intended as specific medical advice for any condition. For that, you need to consult your own doctors, who actually know you. I hope you'll find things of interest and amusement here; maybe useful information. But please, please, PLEASE understand: this blog ought not be used in any way to provide the reader with ideas about diagnosis or treatment of any symptoms or disease. Also, as you'd expect, when I describe patients, I've changed many personal details: age, sex, occupation -- enough to make them into no one you might actually know.

Join us on Thursday, February 7th, 2008 at 9pm Eastern Time where we will be talking about his blog, his book, and a lot more. You can also join us in the live chat room or even call into the show to ask Dr. Schwab a question. Now, it's been a couple of weeks since I've had my show. Hopefully, I remember how to do the show. We'll see what happens this time. Tune in tomorrow for details!