medicine
palmd | August 17, 2009I had a chance to watch the President take questions at town hall meetings this weekend. He sought out opposing views, and handled them brilliantly, responding to them rather than giving empty answers. He also didn't talk down to the audience. The pity is that the take home message in the news today is that he may abandon his push for a "public option". This would be a grave mistake.
This President is no dummy. He gets this issue. When a citizen asked how private insurers can possibly compete with a government plan, he responded in great detail, explaining how changes need to be phased…
palmd | August 17, 2009So, my exercise has fallen off a bit, but I think I'm getting back to it. I rode a bit this weekend but the heat drove me inside.
I tend to let myself eat just about whatever on weekends---turns out I don't like to eat that much. I get nauseated (not that it always stops me). Saturday morning I had my morning Irish oatmeal, but at the clinic everyone had brought snacks (including my DrPal's Yummy Salsa Fresca (TM)). I nibbled all day, then went out with friends to a big, Italian dinner.
Sunday I had cereal, and ate a healthy but somewhat too big lunch, and had folks over for burgers and…
oracknows | August 17, 2009Believe it or not, I happen to be on vacation this week. Fear not, it's a stay-at-home vacation (sometimes the best kind) and therefore my vacation doesn't mean I'll stop blogging. In fact, I consider blogging to be part of my recreation. What my vacation does mean is that I will probably slow down a bit and not do posts that force me to do a lot of background reading. It also means that, because I went to an actual rock concert last night (something I haven't done in years), not only did I sleep in a bit and therefore not have that post that usually goes up here by 8 or 9 AM, but I didn't…
palmd | August 16, 2009I'm passionate about medicine. I love practicing it, teaching it, learning it...everything about it. It's also damned scary sometimes. Knowledge changes; patients don't walk in with textbook diseases; and you have to be able to doubt yourself without drowning in indecision. Every time a patient brings me an article or monograph that looks relevant to their care, and it's new to me, I have to go through it and see if there really is something to it.
For example, there has been some data recently about popular medications for acid reflux (called PPIs, including such medications as…
oracknows | August 15, 2009It's amazing where anti-vaccine nuttery will metastasize to when you're not looking.
This time around, Tom Chick (who, I'm told but don't know for sure, is actually Jack Chick's son) warns us about a new Wii game by Ubisoft called Your Shape. It sounds as though it's nothing more than another of "personalized" exercise guides, but what it does have that other such exercise guides lack is a certifiably loony anti-vaccine wingnut as one of its "health experts." Indeed, as Tom points out, this is what Ubisoft says in its press release:
In addition to being the face of Your Shape featuring Jenny…
palmd | August 15, 2009This is, of course, an absurd question. Getting all 300 million of us to agree on this isn't going to be easy. But a parody circulating on the internet shows how misunderstood we Americans can be.
National social programs are relatively new in the States---Medicare, the plan that gives medical care to those over 65, is only forty years old. Social security, the national pension plan for people who have worked legally for a wage, is about sixty years old. Welfare programs for the poor are often tolerated at arm's length with the nose held.
But while many view these programs with disdain or…
palmd | August 14, 2009I've been blogging long enough now that it's hard for me to keep track of what I have or have not written, and on which particular blog. I used to be pretty compulsive about digging up old links to my first blog (now in storage) or to denialism, or even to this blog, but this can be paralyzing. I still try to make sure to link to other writer's pieces, whether on denialism blog, or at other blogs that I like, but if I were to be overly compulsive about this, I'd never get any writing done.
And with that in mind, it's time for a review of alternative medicine (one that is a bit more…
oracknows | August 14, 2009No comment other than I'm not surprised at the hypocrisy:
Visit msnbc.com for Breaking News, World News, and News about the Economy
No comment here either. As they say in law, res ipsa loquitur.
I've been intentionally vague regarding my position on the Obama health care reform initiative because, well, mainly I haven't entirely made up my mind about it. However, what I have made up my mind about is that I'm tired of seeing such obvious lies about it.
oracknows | August 14, 2009Effect Measure is a site I highly recommend with experienced epidemiologists in charge. In other words, it's run by adults. But scientists often disagree about things. This is apparently a secret to non-scientists and many reporters who assume that when two scientists disagree, one is lying or wrong. But it's true nonetheless. Whatever the subdiscipline, there are disagreements. If you pick up almost any issue of Science or Nature you will find plenty of them, usually (but not always) couched in polite language in the Introduction or Discussion section of a paper or in the Letters. So it's…
palmd | August 13, 2009The cupcake wasn't even that good.
Look, you can say whatever you want about satiety, but I WANT FUCKING CARBS ALL THE TIME!!!!!!
palmd | August 13, 2009So, it's not always easy, creating a new lifestyle. This morning I woke up later than I'd hoped, so I didn't have time to exercise. I didn't really have time to eat either, but I made myself slow down and have a small bowl of shredded wheat. I also forgot to bring a snack to the office.
Anyway, my office neighbor, a cardiologist, had a lunch brought in, as he does every Thursday. It was, unfortunately, one of my favorites---Star Deli. If I'd followed my strongest desires, I would have warmed up some of the corned beef and made a corned beef on twice-baked rye with Swiss cheese, cole…
oracknows | August 13, 2009I've been ragging a lot on some of the right wing critics of President Obama's health care reform initiative. Without a doubt, with their talk of "death panels" and their likening the health care reform bill to the beginning of another Nazi-like euthanasia program, they deserve it. But I just saw something on YouTube that has been spreading virally among surgeons, and, depressingly, it's President Obama engaging in a bit of nonsense of his own in support of his agenda:
Yes, it's our President contrasting what primary care docs make treating diabetes with what docs can make if a diabetic…
ejohnson | August 13, 2009
One week ago, physician PalMD of White Coat Underground began to document his day-by-day attempts to reduce his BMI through a combination of diet and exercise. Other ScienceBloggers were quick to jump in: Isis the Scientist, Janet Stemwedel, Bora Zivkovic and BikeMonkey have all offered dietary guidance to PalMD and related their own efforts to stay healthy. Dave Bacon of The Quantum Pontiff's advice is perhaps the most succinct. "Eat like a monk and run a lot," he suggests, with a chart of his own results to back it up. And Isis the Scientist took the opportunity to inform readers about a…
palmd | August 13, 2009There is no clear definition of "quackery". Stephen Barrett, founder of Quackwatch, discusses the slippery nature of the definition and the issues of intent and competence. Defining quackery of necessity involves some subjective judgment, but there are objective parameters we can apply. If someone is hyping a medical practice without adequate scientific evidence and is profiting from it, they are a quack.
Quackery differs from "fraud", which is a legal concept. In my state health care fraud is defined as:
Intentional deception or misrepresentation made by a person with the knowledge…
j7uy5 | August 13, 2009I haven't been a good blog-citizen lately. And no, it is not
because of fatigue. Anyway, I've going to try to get back to
looking at other people's blogs more, and not just here at
ScienceBlogs.
Dr. Serani kindly
href="http://drdeborahserani.blogspot.com/2009/08/5-reasons-you-may-be-tired.html">pointed
out an
href="http://www.parade.com/health/2008/10/5-reasons-you-may-be-tired">article
on common causes of fatigue. Sleep disorders, thyroid problems,
diabetes, depression, and anemia.
My comment of this has to do with how these problems are screened for
in general medical…
oracknows | August 13, 2009Let's face it, I've been at this "anti-antii-vax" thing for quite a while now. This December, this blog will have been in existence for five years. Even before that cold, gray Saturday afternoon nearly five years ago when, on a whim, I started up a blog on Blogspot that became the first incarnation of Respectful Insolence, I had been a regular presence on the Usenet newsgroup misc.health.alternative for at least three years before that. There, besides quackery, I got my first taste of the lies of the anti-vaccine movement from the likes of denizens of the newsgroup like Jan Drew and Ilena…
palmd | August 12, 2009Science is hard. Real science requires time, patience, modesty, and a high tolerance for failure. Good ideas can lead to better ideas, or to dead ends, and these dead ends actually help us map out our reality. Quite a while back, I wrote about a study of certain compounds in chocolate and their effect on the cardiovascular system. One of the things I liked most about the study was the authors' refusal to draw overly broad, immodest conclusions from their findings. That's how real scientists operate.
This is in stark contrast to undereducated pseudo-scientists---if they see a result…
oracknows | August 12, 2009I hadn't planned on writing about this topic again. Really, I hadn't. The reason is mainly that politics is usually not my bag. I've said it time and time again: political bloggers are a dime a dozen, and I have no reason to suspect that my pontifications and bloviations on politics would be any more valuable or worthy of your attention than anyone else's pontifications and bloviations on politics. Besides, I've made quite the little niche for myself in the blogosphere writing about skepticism, critical thinking, and science in medicine, in particular how unscientific or pseudoscientific…
palmd | August 12, 2009So last Wednesday, I weighed in at 212 pounds (which I rounded to 96kg for some reason). I've struggled, seen a lot of good and bad advice, increased my exercise, decreased my food intake, sinned gravely, and generally whined and moaned.
This morning, clothed and after breakfast, I'm 208 lbs.
Rock on.
palmd | August 11, 2009I woke up this morning and rode the stationary bike. Had a healthy breakfast, lunch, and snack. Took the kiddo for a bike ride.
Then came the carnitas.