Buy single serving bottles?

For those of you who missed it, check out my daily dilemmas indressing like a doctor.

I hope that most took my article on the beneficial effects of dark chocolate with a grain of humor and took my suggestion to eat a dark chocolate candy bar for breakfast in the 'tongue-in-cheek' manner that it was meant. My bottom line there was first of all to highlight how blood vessels respond to what we eat, and then to lightheartedly suggest that if one were to reach for confections, dark chocolate is the way to go.

I love your recipe for sugar-free chocolate sauce. Yum!

Thanks for writing,
Judy

Thanks!

As those athletic-type folks would say, “Just Do It!”

Thanks again.

Kathy

PS - Buying walnuts tomorrow.

I'm going to stay with annual smears! It seems the younger you are the faster cancer grows. This was the second female friend in her 30s I lost to fast-growing cancers. The other was 34 and had a metastisized breast cancer. She was gone in three weeks.

First of all I'd like to thank you for publishing this newsletter. I find it very helpful and informative.

Regarding the issue below of what motivates patients, I can certainly tell you what will NOT motivate people. When someone walks into a doctor's office and the first thing the doctor says is that you need to lose weight, that is number one on the demotivating list. This is especially harmful when the doctor offers no suggestions other than eat less and exercise more. Duh!

What would help would be to provide some suggestions for healthier living. Suggest that they should try to get in 30 minutes of walking 2 days a week to start, and work up from there. Or suggest that they cut down on their food intake by substituting a piece of fruit for that candy bar or bag of chips in the afternoon. If it is presented as a way to help that person instead of just telling them they are a fat lazy slob, that might help. I just find it terribly insulting when a doctor assumes I don't know I'm overweight. Like I don't own a scale, or a mirror, or that I haven't noticed my clothes don't fit anymore.

There is so much conflicting information published every day that it is difficult to sort through it. I realize doctors are busier than ever, but so is everyone else. Maybe spending that extra 5 minutes to help someone start to make a couple of changes will save everyone time in the long run.

I apologize for the length of this. You just touched on a bit of a sore spot!

Therese M.

Bottom line: I'm glad to hear you'll keep feeling boobs regardless of what the (other sort of) boobs say at the USPSTF. Please continue to urge your patient/readers to do the same. Its too easy in this life to rely on others to take care of you when you're really the one responsible for your own health.

I believe we all need to take an active role in our health care, but too often I see patients take that role from a position of distrust and negativity. Never seems to get the patient the additional "touch" from the health care professionals. It is all in how we ask the questions, not that we ask the questions.

I think that caring for a patient is kind of like managing a project at work. You need a project supervisor (care coordinator) who can supervise the work of the other managers (specialists) and be responsible for making sure things get done when and how they are supposed to. This applies to in-patient and out-patient care, as well as post-hospitalization follow-up. Where I work, projects without project supervisors tend to get fouled up…something tells me this is happening in the world of medicine as well.

Just my 2 cents.

Answer: The nasty chemicals from hair dye must contact your scalp in order to be absorbed and cause any harm. This sounds like a safe way to color your hair.

The doctor's statement was "Why do you think I spent 8 years getting a medical degree?"

I was appalled to hear such a thing from a young doctor in today's computer age. Particularly since the information I had gathered was from a medical encyclopedia.

So thank you for delving into the world of computers and setting up this newsletter and your web page.

I have been enjoying your Femail Health Newsletter very much. Thank you for your efforts to provide helpful and clear information on health matters.

I do want to comment on your condemnation of the herb ma huang. It is important to warn consumers of potentially harmful substances. However, it is also important to tell the whole story. Lumping ma huang together with dangerous street drugs may warn off those who are tempted to reach for that bottle of "herbal ecstasy," but it does a disservice both to those of us who are professionals working with herbs daily, and to an herb that can be helpful in the right circumstances. I wish that your message had been that people need to respect these substances, and not use them indiscriminately and without guidance, rather like pharmaceutical drugs.

Ma huang (the stem portion of Ephedra sinica Stapf. or Ephedra equistestina Bge.) has been used in traditional Chinese herbal medicine, safely and effectively, for many centuries. While it does display sympathomimetic actions, the scope of its application is traditionally quite different from the abuse we are seeing now. The herb is *not* used traditionally to promote weight loss or stimulate metabolism or the sympathetic nervous system in otherwise healthy subjects, and is categorized as a "spicy, warm, exterior releasing" (diaphoretic) herb. It treats specific types of common colds with acute cough or wheezing, a tight superficial pulse and an absence of sweating, and is used, by well-trained, responsible practitioners of traditional Chinese medicine, for a short time and in combination with other medicinals that restrain ma huang's harsher (stimulant) effects. A competent practitioner of Chinese medicine would know to avoid the use of ma huang for anyone with signs of or a history of heart disease, hypertension, or insomnia, and would recommend the patient avoid other stimulants as well, including coffee. Ma huang's therapeutic properties and contradindications are, quite literally, the first thing one learns about Chinese herbal medicine in formal training.

The herb itself is not to blame; the fault lies with those who, innocently or not, would exploit for profit others who want to lose weight without eating sensibly and exercising more, or who want a "quick fix" of energy. Many people mistakenly believe that just because a substance is natural, it is harmless. One need look no further than our old nemesis, tobacco, to see that this is not so. Tobacco is directly or indirectly responsible for far more illnesses and fatalities each year than all other crude herbs and pharmaceutical drugs combined, and has never demonstrated any beneficial, therapeutic effects. Surgeon General's warnings aside, as a society we continue to condone, even glorify its use. Oxycontin, a legal prescription drug, relieves pain with few side effects and little likelihood of abuse when properly administered, yet has also become known as a harmful street drug. Shall we deprive those who are suffering from pain of its benefits in order to prevent its abuse by others?

My point is that while ma huang is a potent herbal medicine, in the hands of someone trained in traditional Chinese herbal medicine, it can be used safely, and its appropriate use can benefit people. That is true for many natural substances that exercise a potent physiological effect, among them ginseng, safflower (hong hua), cinnamon, and dang gui (Radix angelica sinensis).

I fear that broad condemnations of individual medicinals such as ma huang may lead to a misinformed and reactionary restriction of their use for legitimate purposes by legitimate practitioners. It is a shame that some have suffered from the abuse of ma huang, but there is not one sad story of ma huang abuse that could not have been avoided if people had been informed and had chosen to act responsibly based on that information. If, one by one, all the "effective" natural medicinals are outlawed, herbal medicine will be rendered useless; indeed, our kitchen cupboards will be empty of spices. As a fellow health care professional, I would urge you to wield your authority carefully.

Sincerely,

Galen Williams, RAc, Dipl Ac, Dipl CH (NCCAOM)

I also find it ironic that Viagra keeps the trees soft, while the non-Viagra trees are stiff (and brittle).

Wonder what the rats trees look like?

Editor's note: I have written on this subject before. Here is my note to readers in April, 2001. Scroll down these readers' comments to May, 2001 for the replies that I received. Feel free to send along your experience for inclusion.

"The latest concept in office medicine is making headlines in this month's medical journals--"Same-Day Visits Free Up Schedules." This new scheduling philosophy sounds more like a return to a simpler time when patients could call their doctors and be offered prompt access to their physicians. Many doctors report feeling more satisfied and less hurried with such an open access system, and patients are happy with the increased attention and convenience of same-day service. One practice consultant reminds doctors of the business aspect of our profession by warning "If you don't do it (same-day visits), your competitor will." I would be interested in hearing your experience in making appointments with your doctor, including how far in advance must you schedule and how long do you sit in the waiting room."

Dear Diane, This hair loss thing is certainly a bother isn't it? I don't have any good answers for you. I would wonder, however, about the wisdom of Estratest. Is your doctor treating your lab values or are you specifically having some problems that may relate to testosterone deficiency? Those would include a loss of stamina, energy, and some decrease in your sense of well-being. These are vague symptoms and could occur for lots of reasons but do tend to come up several years after menopause as a result of androgen deficiency. Part of the reason your free testosterone may be low is that your hormone therapy has induced an increase in sex hormone binding globulin which binds up testosterone, reducing the free fraction that's available for the cells to use. Premarin does this much more avidly than estradiol and hormone therapy by patch doesn't do it at all.

The problem with your hair is that you are converting testosterone to a more potent form called dihydrotestosterone right at the hair follicle level. Who really knows why some hairs do this more than others and why some people have much more problem than others. Propecia (for men) prevents this conversion but doesn't seem very effective in women. Saw Palmetto (over the counter herb sold for prostate troubles) can help, maybe in women, so you might try that. It gives me the hiccups! Evening primrose oil may also help. Nothing really does much near as I can tell. Develop a sense of humor and maybe no one will notice your hair. That's about all I'm doing for my sad hair right now.

Hope this helps, Judy P.

I had a problem with my left leg for 20 months altogether, where I couldn't walk or stand for more than about 3 minutes without acute pain. A short sit would help, and then I could go on. After having this for 18 months a friend said that she had a similar problem, and with her it was vascular. I went to the doctor, who said "spinal claudication." I looked it up on the Internet, and having seen that I seemed to be a textbook case, I further discovered that the condition could be caused by a build-up of cholesterol inside the artery supplying the leg. I decided that I might be able to work on the firred-up artery on my own. I simply visualised it, and just pushed the cholesterol through by thinking of cleaning it out with the effort of something like an electrical impulse from my mind. I wish I could explain it more clearly - it was vaguely as though I had a mental broom to push. After doing this twice a day for 2 days, at the beginning of December, I have been able to walk for up to 2 hours at a stretch with no pain at all.

The next time was when I had a cyst on my ovary - this time I put my hand over the place and visualised just rubbing it down until it disappeared. I've been told by doctors that things like cysts and back problems can spontaneously disappear, but it seems odd to me that 2 days after I started "working" on them, in the case of the leg and the eye, they were gone. With the ovarian cyst, it was 3 months between the time that I was diagnosed and when the cyst was confirmed to be gone.

Looking back at the above, it does sound rather long-winded, but I hope you find it valuable.

The effect seems to be cumulative--I've been taking it for about a year (first prescribed by specialist for RAD/asthma), then later by the neurologist for migraine. The migraines have decreased in both frequency and intensity. I have even been able to make it through a day with a migraine without having to withdraw totally from society.

Happy poo-free swimming - but it is hard to find isn't it?

I am putting together a book from the viewpoint of people who have IC, as well as their family struggles with this illness. I'm also hoping to have stories from men suffering from IC.

If you know anyone who would be interested in sharing their story please have them contact me at my e-mail address.

I also appreciate the clean and easy to navigate design of your website!

From Framingham, MA: -I recently switched doctors because of the hassle of getting appointments. Once I did get an appt I would sit in the waiting room for a hour sometimes. My new interist/endocrinologist is great! I can call and get in the same day if need be. I never wait longer than 15 minutes in the waiting room. It is so refreshing to have this change!! I love it!

From Denver, CO: -My former internist is notorious for long wait times. My last appointment with her was her "last" appointment of the day. I called 15 minutes prior to my appointment at 4:30 and was told two patients were ahead of me. We went over at 4:30 and waited until 8:30. I changed internists after that. For a lot of years I felt like I had "victim" tattooed on my forehead. Now, when I am not treated nicely, I have learned to complain loudly and switch doctors.

My last appointment with another internist was when I went into her exam room and noticed a sign on the back of the door. "Patients. Your appointment time has been scheduled according to the symptoms you discussed when you made your appointment. Please do not discuss any additional symptoms with the doctor that may have occurred since you made your appointment. Please call for another appointment to discuss any other symptoms."

From Cicero, Indiana: -My children's pediatrician blocks out time for "sick kids," "well visits" and "other problems" daily. In addition, she offers an hour before and after regular office hours for walk-ins for sick kids. I have ALWAYS been able to have my sick child seen the same day I requested. That's part of the reason I drive 30 minutes to take my kids there, even though there are plenty of pediatricians near my house. As far as my physician goes, I stopped seeing her a few years ago because her wait times were 45 minutes. As a working mom, every minute is precious to me, and I was extremely annoyed at having to take time off from work to sit in the waiting room.

From Lawrence Kansas: -I go to a woman doctor who is a member of a family practice group. I am almost assured of getting an appointment on the day I need it (if it is a pressing problem such as urinary tract infection, sinus infection, etc.) and I have never waited longer than about 5 minutes to be seen. Of course, I don't know what her patient load is. She is relatively new to the area and new to doctoring, so maybe she's not as busy because of that.

My sister discovered a way to continue with the junk food and still have a much improved complexion by washing her face with "Desert Essence Thoroughly Clean Face Wash" and then, instead of using a store-bought moisturizer, mixing a dime-sized squirt of pure aloe vera gel with a couple drops of pure jojoba oil and applying that after washing. She almost always had one or more big bright red spots on her face and that's not the case now. Her face cleared up in about two weeks. When I tried it, my pores even seemed smaller, for whatever reason, and my complexion is a lot nicer than it has been for a long time, even though I indulge in a bit of junk food now. I still get a pimple or two but they're small and heal fast when I use the Desert Essence blemish stick. No more cystic type acne since I started this regimen.

Yoga is good, although I don't think most older people are either willing or able to enroll in a class. I think they just need to have some simple sheets like the others given out in your office, to show them some stretching exercises. And I really think it's critical for your male patients. They are, in my estimation, more likely than women to let their flexibility go over the years--just judging from my sons, they are never taught the value of flexibility in the first place!