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1. Bring a long list of complaints.  Many popular articles I’ve seen recently encourage patients to bring a long list of problems to their doctor appointments.  Don’t.  Physicians just do not have time to appropriately address numerous complaints during one office visit.  If you try to do to much, each complaint does not receive the attention and evaluation it deserves.  Instead, make a list of your complaints and health issues at home, and prioritize it.  Try to address the top two at your next office visit, and schedule a follow up visit soon after to address the next two.  On the other hand, a list of questions pertaining to a single problem is o.k., but wait to start firing them off until your doctor has had his or her say, as he’ll likely answer a number of them in the course of the initial evaluation and discussion.
2. Become irate when you’re doctor is running late.  Understand that your physician is doing his best to stay on time.  Many factors contribute to your doctor running behind schedule.  Emergencies, office visits running longer than expected, multiple patients arriving late, and the constant stream of test results and phone calls that flow in are just a few.  If you’re still in the waiting room thirty minutes after your appointment time and don’t feel like waiting any longer, politely ask to reschedule.  Making a scene or becoming angry with the receptionist will achieve nothing, and trust m Read the rest of this entry »
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Cholesterol metabolism is a very complicated field. 

Lipids are the different forms of fat and cholesterol which perform a variety of functions within human physiology. There are many different types and subtypes of lipid particles, each with different yet interrelated functions and effects.  There is much basic science that’s not well understood. 

When this basic science is applied to the clinical care of patients, many more complicated issues arise.  The role of various lipid particles in contributing to atherosclerosis, the underlying cause of heart attacks and strokes, is still being determined.  It’s well-documented that many patients who have heart attacks or strokes have normal traditional lipid levels, which illustrates the fact that there are many other factors at work in determining whether your arteries become clogged with plaques and you subsequently suffer a heart attack or stroke.

The media coverage of cholesterol reflects this complexity, and is filled with confusing and conflicting reports of benefits and risks associated with cholesterol levels, as well as the diets, supplements, and (especially) the drugs used to modify lipid levels. The drug companies and supplement makers constantly run adds which sometimes seem contradictory.

For many people like yourself, it’s all very confusing.

Let me make it simple for you.  While there is much that’s not known when it comes to cholesterol, there is one statement that is as rock solid as any truth in all of medicine.  Write this down, and commit it to memory.  I promise, you can take it to the bank.

If your lipid levels are not ideal, you can dramatically lower your risk of heart attack, stroke, and death by optimizing your cholesterol numbers with diet, drugs, or both.

That statement has been proven over and over again.  There are so many large, powerful, well-designed studies Read the rest of this entry »

“Scientific studies have shown. . .”

“Recent research suggests. . .”

“A study presented recently reported. . .”

These types of phrases are used daily in the popular media to report on medical and scientific studies which produce results the general population may find interesting. They’re also used regularly by those trying to convince you to buy certain products (e.g., supplements), follow certain diet plans, or take prescription drugs. Unfortunately, such references to scientific evidence are frequently misleading.

In medicine, there are many different types of studies and reports that are used as evidence to support a given treatment recommendation. The thing that most people (especially those writing media reports) don’t seem to realize is that some types of evidence are considered much stronger than others. Many times the media doesn’t seem willing or capable of distinguishing very weak evidence from very strong. Those who’re trying to sell you snake oil are much worse, and will often mislead you by using such phrases while really referring to virtually nonexistent or at least extremely limited evidence.

Some general categories of clinical medical evidence, presented from weakest to strongest, are reviewed below.

Anecdotal evidence. This is literally when recommendations are just based on the experiences of a few patients. A Read the rest of this entry »

I’m not talking about “survival” in the cutesy sense of how to feel good and thrive while in your 20’s and early 30’s; I mean how not to die before the age of 35, literally.

The primary killers of young people are very different from the leading causes of death of people over age 35. In order to improve your odds of survival, you need to know what you’re up against.

The Leading Causes of Death for people aged 16-35:

1. Motor Vehicle Accidents
2. Homicide Read the rest of this entry »
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No, I’m not talking about an ex-girlfriend.  

Heart disease is the leading killer of Americans and the ultimate heartbreaker.  If you combine all the deaths caused by the number 4 through 10 leading causes of death in this country, the total is still less than heart disease alone.  In your quest to improve your life odds, anything you can do to lower your risk for heart disease is worth your while, since it’s by far the most likely reason you’ll die.

Heart attacks (the fancy doctor term is myocardial infarction) are responsible for many of the deaths in this general category of heart disease.  A heart attack is usually caused when one of the coronary arteries becomes blocked, which interrupts the supply of blood flow carrying necessary oxygen and nutrients to your heart’s muscle.  What happens is cholesterol-filled narrowed areas called “plaques” form within the inside linings of your arteries in a process called atherosclerosis.  These Read the rest of this entry »

This will be a quick one.  I know you’re anxious to start your weekend. 

A simple piece of advice you’ve heard at least a thousand times before:  don’t operate a motor vehicle after drinking alcohol.  This message is so ubiquitous that it’s almost become part of the background noise in our society.  If you’re interested in improving your life odds however, you need to understand why this message is so important.

A general category titled “Accidents” is ranked number 5 on the top ten hit list of things that kill us.  A large percentage of those accidents are motor vehicle accidents.  Now if you want to function in modern society and you don’t live in NYC, Chicago, London, or another city with practical public transit, you’re probably going to be stuck getting behind the wheel, so you can’t avoid the risk of a motor vehicle accident entirely.  However, you can dramatically reduce your risk for dying in a car accident by not getting behind the wheel after drinking alcohol.  And that includes any amount of alcohol.  We’re all notoriously bad at judging our own blood alcohol content just based on how we feel or how much we’ve had to drink. Read the rest of this entry »

Many people are constantly looking for a magic pill that’ll endow them with a long, healthy life.  Wouldn’t that be nice, if we could just pop a pill and not worry about anything else?  While the “fountain of youth in a bottle” doesn’t exist, there certainly seem to be a few supplements that will improve your life odds substantially.  These few are mixed among a morass of pills with misleading advertising that have little evidence of doing anything and may well be harmful to you.  From time to time I plan to discuss various popular supplements and help you differentiate the beneficial from the useless and dangerous.

Probably my favorite popular dietary supplement of them all is “fish oil,” which really refers to omega-3-fatty acids, found in high concentrations in fatty fish like salmon/tuna, and in lower concentrations in certain plants like flax seed and soy.  This remarkable oil may provide you with a bigger improvement in your odds of living a long, healthy life than any other supplement.

The benefits of fish oil came to light after researchers noticed that Eskimos have a much lower incidence of cardiovascular disease (such as heart attacks and abnormal heart rhythms) than the average American or European.  They began studying the dietary difference between these groups, and found that since a large percentage of an Eskimo’s diet is comprised of seafood, their intake of omega-3-fatty acids is between 5-50 times higher than the average American.  This subsequently led to a Read the rest of this entry »

A patient called me on the phone while I was on call recently demanding a “Z-pak.”  A Z-pak, as many of you may know, is a popular prepackaged course of antibiotics commonly used for respiratory infections.

“Hello Ma’am, I’m Dr. Odom, what can I do for you?”  I asked.

“I need a Z-pak.”  Remarkably, this was her chief complaint.

“And what makes you think so?” I said.

“Well, I woke up this morning with a scratchy throat and runny nose.  Everyone in my office has been sick and they’ve called their doctor’s office and are taking Z-paks of antibiotics.  I don’t have time to be sick, so I need you to call in a Z-pak for me.”

After a few more questions to make sure she didn’t have any other symptoms or underlying conditions that would raise my concern level, I told her that her symptoms sounded viral and I didn’t think antibiotics of any kind would do her any good, but that she was welcome to come to the office the next day for further evaluation in person, or to go to a nearby walk-in clinic with weekend office hours.

Unfortunately, she then became quite agitated.  As I tried to explain my decision to her calmly and rationally, she interrupted with a few rude comments questioning my medical knowledge, then hung up on me.

A few useful points you can take away from this exchange: Read the rest of this entry »

So says the media.

In this blog I plan to address mainstream medical news articles you might hear about or find interesting.  I’ll give you my own opinion and interpretation of the info, with an obvious interest in figuring out whether there’s relevant info in the article relating to what this site is all about:  trying to improve your odds of living a long, healthy life. 

It turns out the media is not very good at accurately presenting medical information for the most part.  What they generally are good at is using a bit of medical information, or even misinformation, to generate a compelling or sensationalistic story.  Now I’m not saying it’s always intentional; often I’m sure the media simply misunderstands or misses the point of what they’re trying to report on.  The frequency with which the media presents medical information in a misleading way however is frightening to me, since it makes me wonder how many other media reports on topics other than medicine that I’m reading are full of misinformation and I’m simply too ignorant to recognize it.

Here’s one from today.  An article from the AP regarding minute, trace amounts of prescription drugs which are detectable in some water supplies.  Sounds pretty scary, right?  I mean, after all, you don’t want to be taking any prescription drugs unless you really need them and they’re prescribed and monitored by your doctor, particularly not if they’re unknowingly mixed into your tap water.  The article focuses on the potential for possible toxic long-term effects on humans due to decades of such exposure. Read the rest of this entry »

Now if that title to this post doesn’t make me sound like a snake oil salesman, I don’t know what would. 

But hold on a minute.  I guarantee you, without selling you anything, I can provide some of you with all three of those things by recommending one simple decision.

Stop smoking.

Now, if you’re reading this blog, I assume you’re interested in your health and longevity, and so perhaps not many of you are smokers.  But for those of you that are, listen to me carefully.  There is no single decision you can make that will have a more positive effect on your odds of living a long healthy life than deciding to stop smoking.  Forget about the rest of the information in this blog, if you’re a smoker, quitting is absolutely, positively, top priority, job number one.

The first step toward giving up tobacco use is actually wanting to quit.  I’ve had smokers in my Internal Medicine practice who reported half-hearted attempts to stop smoking, but when I really questioned them I discovered they didn’t truly want to stop.  They enjoyed it to much.  They rationalized it by claiming they had no other vices, they needed it to relax, or they were too stressed to try to quit.  These are all excuses.

If you’re honest with yourself and you fall in this category, let me see if I can give you some motivation to quit, based on the title of this article:  more money, better looks, longer life. Read the rest of this entry »