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Update June 2017


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Update by Natrakorn Paewsoongnern
 
 
 

Doctor's Consultation  by Dr. Iain Corness

 

Update June 24, 2017

Take the flowers outside – they use the oxygen

There are many wonderful examples of pseudo-medical “truths”. However, it is in living memory that nurses took the flowers out of the wards because of oxygen being gobbled up by the flowers.

Shaving legs is another myth. Sorry, shaving does not make hair grow back thicker, stronger and darker. And there is no magic shampoo that improves hair growth. (If there were, I would be using it.)

However, there is a more serious side to medical myths and superstitions. To look at this we must first go to the bible where you will find (Matthew 7:7) which states ‘Seek and you will find”.

Unfortunately this has more than a slight ring of truth to it. We appear to be turning up more “cancers” than ever before. There must be a reason for this pseudo-epidemic. What else has increased? Smartphones, that’s it!

The doomsayers say exposure to the electromagnetic radiation (RF and ELF) emitted by cell phones and cordless phones are contributing to a worldwide thyroid cancer epidemic? Isn’t it time for our government to fund research on the risk factors underlying this epidemic?

According to the American Cancer Society, although some thyroid cancers can be linked to exposure to ionizing radiation, “the exact cause of most thyroid cancers is not yet known.”

Now far be it for me to suggest that this could be a giant waste of money, researching something that produces asymptomatic cancers. The old adage, “If it ain’t broke, don’t fix it” comes to mind.

I do have a cancer or two, part of the seek and ye will find, but they are minor and will never kill me, so why should I get excited by it? Or even worse, were I to throw my cancer producing smartphone in the river where it could kill shoals of fish and bring the Friday night’s fish and chip shops into receivership?

But back to the “Seek and you will find!” Are we turning up cancers that would never have been a problem if we had just left them alone? In other words, are we looking just too intently?

I have written before about the adverse health effects of mobile phones, and to be honest, I do not believe there are any. It seems that all over the world there are groups of scientists devoting their laboratory lives to study the effects of radiation from mobile phones. One group even went so far as to suggest that pregnant women should not place their mobile phones on their abdomens as the radiation can get as far as the developing brain in the fetus as the skull is so much thinner than adults.

If that was not chilling enough, Australian scientists are investigating if children really are more vulnerable than adults to the effects of radiation from mobile phones.

Apparently, a study of 110 adults at the Australian Centre for Radiofrequency Bioeffects Research, partly funded by the Federal Government, confirmed mobile phones cause a change in brain function by altering brainwaves known as alpha waves.

“Although there’s a tiny effect on healthy young adults, there is a possibility that it could be much stronger in children or the elderly,” said Professor Rodney Croft. However, there was no indication from the adult tests if the effect on health was positive or negative.

There have been claims that using mobile phones produces brain cancer because people with brain cancer have used mobiles, and that is about as stupid as claiming that shoes are the greatest killer in the western society because 99 percent of people who died last year wore shoes. Lies, damned lies and statistics.

Now one of the articles I read admitted that scientists worldwide agreed there is no evidence linking electromagnetic radiation emitted by mobile phones to adverse health effects, but claims still persist that frequent use can cause headaches, nausea, problems with concentration, cancer and brain tumors, and I think you can pop thyroid cancer in there too.

Australian studies using unborn or newborn mice had failed to find significant changes in growth rate, brain function and behavioral development. However, I also believe we should keep mobile phones away from mice as they can play havoc gnawing on the cases.


Update June 17, 2017

Ducks will eat tonight

Another successful transplant reported in the popular press. Not another ‘Bobbit’ operation, and this time not from the wielding of a marital razor, but following a previous operation which had removed most of the penis.

Operations such as these, no matter what the cause, are very exacting micro-surgical procedures taking many hours and a team of surgeons.

However, there are many other surgical procedures which also require micro-surgery, and replacement of fingers is high on the list. There are about 10,000 cases of job-related amputations in the United States each year; 94 percent of these involve fingers. Few statistics are available for the outcome of replantations, but with modern surgery the success rate is increasing.

I did come across a report on a series of 208 digital replantations from the frigid zone within the People’s Republic of China. The extremely cold climate (down to 30 degrees below) presents the additional problem of warming the amputated digits prior to replantation. An overall replantation survival rate of 94 percent was reported, and this included 45 cases of multiple digit amputation.

Now, to successfully sew the finger(s) back on needs the patient to appear fairly smartly at the hospital, and to bring the missing digit. Despite some claims to the contrary, we are not yet at the stage of being able to grow new fingers for you.

I was reminded of this where an injured person arrived at ER with his nine good fingers, but without the 10th one that had been lopped off. The wound was clean and so the hand surgeon sent the patient’s friends off to find the missing finger, as there was a good chance of successful replantation. They appeared later with a bag of chicken giblets straight from the refrigerator, proclaiming the missing digit was inside. When the surgeon looked, the bag of chicken had not been opened! There was certainly no finger inside with the giblets, and all that could be done was to trim up the traumatic amputation, and hope that the patient was not an accountant.

So, how should you transport missing body parts (people get more than fingers lopped off)? To save the tissue from further damage, keep the amputated bit wrapped in cling film, preferably in a jar or cup with a lid. Do not put it directly in water as this will cause it to shrivel up and become unusable for the surgeon trying to reattach the finger. Put the container with the finger or whatever inside another large bag with cold water, to keep the amputated part cold.

Be sure to gather up all parts of a severed digit, no matter how small. The body cannot grow a new nail bed, the tissue directly under the nail, so being able to use the original tissue makes a big difference to whether a full reconstruction can take place.

Generally, the tissues will survive for about six hours without cooling, and if the part is cooled, tissue survival time is approximately 12 hours. Fingers, by the way (and not chicken giblets) have the best outcome for transportation survival, since fingers do not have a large percentage of muscle tissue.

The micro-surgery required to successfully replant fingers (and the other bits that were lopped off and offered to the ducks) is very exacting, as nerves, arteries and veins all have to be reconnected. Very often the surgeon has to shorten the finger, so that there is no tension on the sewn up structures. All this takes an enormous amount of time and patience. With one celebrated case in the UK, a woman lost six fingers and it took a team of surgeons working in relays to reattach all six fingers during 17 hours of microsurgery. It is said to be the first time so many fingers have been replanted in one operation.

Many other factors are involved in whether there is a successful outcome. Generally, severe crushing or avulsion (tearing away) injuries to the fingers make replantation difficult. Additionally, older persons may have arteriosclerosis impairing circulation, especially in small vessels.

But if you are unfortunate enough to cut off a finger, remember to bring it with you, not the chicken giblets!


Update June 10, 2017

Growing old disgracefully

As we all get older, trying to counteract aging becomes important. There are also people like my father who was only afraid of one thing – growing old. So he didn’t. He died aged 56 of a massive heart attack.

Fact: we are all getting older. Not wiser nor necessarily richer, just older. However, getting on in years still beats the alternative. Just keep your place reserved in God’s waiting room and you’ll be right.

World-wide the retirement age is creeping up. Even in Thailand’s civil service the retirement age looks like becoming 64. In Australia it is now 67. The world is becoming an old age retirement home!

OK, so we are all living longer, what can we do to get our arthritic hands on the elixir of youth? If you believe the popular press, the answer to aging is multivitamins. Peddling mega-vitamins is a megabuck industry, credited with improving your health, your love life and fixing everything from falling chins to falling stock markets.

Should you take daily doses of antioxidants such as beta carotene, vitamin A and C or selenium to protect yourself against cancer, heart disease or signs of premature ageing? There is some scientific ‘proof’ that people who have a high level of antioxidants in their diet have a lower risk of heart disease and certain cancers. That is why the nutritionists say we should eat at least five portions of fruit and vegetables a day. However, other studies also seem to suggest that taking those same antioxidants in pill form may not have the same effect and may even be harmful. Who do you believe?

Cancer Research UK says, “These products don’t seem to give the same benefits as vitamins that naturally occur in our food.”

The British Heart Foundation agrees, “Research does not support the claim that taking extra antioxidants in the form of supplements will benefit the heart.”

Let us listen to some experts in the field, and not the back of the cereal box. Catherine Collins, chief dietitian at St George’s Hospital in London says, “The whole idea that you must meet some vitamin and mineral target every day of your life is a marketing myth. You can eat lots of fruit and veg one day and not much the next but over a week you will still get the right amount of nutrients. There is very little scientific evidence that there is any benefit whatsoever in taking a daily multivitamin - even in old people. You cannot exist on a poor diet then shore yourself up with a multivitamin. The idea that taking high quantities of vitamins will give you a health boost - like putting premium petrol in your car - is complete nonsense.”

Dr Toni Steer, nutritionist with the British Medical Research Council’s Human Nutrition Research in Cambridge, states supplements cannot compete with real food because when we eat fruits and vegetables the vitamins and nutrients interact with other chemicals to produce positive effects on the body. “If these same vitamins are pulled out and isolated in pill form, there is no guarantee at all that they will have the same effect.”

Another nail in the multivitamin pill coffin came from the US journal of the National Cancer Institute which found that men with prostate cancer who took more than seven multivitamins a week were 30 percent more likely to get an advanced and fatal form of the disease.

The American Medical Association found that people who took antioxidant vitamin tablets (particularly vitamins A and E, and beta-carotene) were more likely to die earlier than those who did not. Oops! That isn’t something you will read on the back of the multivitamin bottle.

Let’s look at the old Vitamin C to ward off the common cold, as proposed many years ago by Linus Pauling. Common claim: one gram doses will ward off or even cure the common cold. Reality check: the human body can absorb only 500 milligrams of vitamin C and will excrete the excess. Vitamin C reduces the average length of a common cold from five days to four and a half – if you are lucky.

The answer is to stay active, keep the mind exercised and do things you enjoy. Just do it!


Update June 3, 2017

Will your blood pressure blow the top of your head off?

It is standard practice in my hospital to take your weight, temperature and blood pressure before you see the doctor. It is standard practice all over the world. Medical associations tell GP’s they should take a patient’s blood pressure every time the patient visits the doctor, no matter what the complaint. So is your blood pressure (written as BP) that important?

The answer is yes and no! And I am not backing all the horses in the race.

The big problem is that BP is not a static measurement which goes up and down all the time. Here is an example from my own readings. I was due for my medical, but was rather rushed, however the nurse ignored my pleas that I was too rushed. She took the pressure and it was something like 160/75. “Too high” she said, waiting for me to explode I think!

I left and after settling down, I popped into one of the Out Patients Clinics and got the nurse to take my BP. It was 118/70. Much better. So was the first machine wrong? No, this is normal fluctuations.

This is why, if your doctor tells you that you have “hypertension” (high BP) on just one reading – don’t believe him (or her).

So how do you find out if your BP is too high? Quite simply by repeated measurements. Just as one swallow doesn’t make a summer, one elevated reading does not necessarily mean hypertension.

You should get your BP done at least twice a year. Rising or elevated readings do mean you should get medical advice.

So why is BP important? Because if you don’t you don’t have BP you are definitely dead! However, if your BP is too high, it can mean you could be claiming early on your life insurance.

High BP is otherwise known as the “silent killer” as there are very few symptoms of the increase in blood pressure, until a vessel bursts somewhere, generally catastrophically! The good thing is you are dead within minutes, so you won’t linger.

Blood is needed to keep all the organs of the body supplied with oxygen. This is done by the red blood cells which carry the oxygen, with the pump to drive the system being the heart. The tubes from the heart heading outbound are the arteries, and those returning the blood to the heart are the veins.

This heart-arteries-veins-heart system is a “closed” circuit. In other words, no leaks, otherwise you would be continually losing the life-preserving blood, but to make it go around, there has to be a pumping pressure.

The heart squeezes the blood inside itself and pumps it out into the arteries. This squeezing pressure is called the Systolic, and is the upper number quoted when we measure your blood pressure.

After the squeeze, the heart relaxes to allow the blood to fill the chamber, ready for the next squeeze. The pressure does not return to zero, because there has to be some pressure to refill the chamber. This resting or ambient pressure is the lower number quoted and is called the Diastolic. BP is then typically quoted as 120/70, being 120 (systolic) / 70 (diastolic). The actual pressure number is measured in a millimeters of mercury scale.

So what is the “correct” BP? The following table shows the categories of BP measurements.

Optimal: less than 120/80

Normal: less than 130/80

High-normal: 130–139/85–89

Repeated high blood pressure (hypertension):

Stage 1: 140–159/90–99

Stage 2: 160–179/100–109

Stage 3: 180 or higher/110 or higher

The problem with running at high pressure is that the heart is having to work harder, and therefore may be subject to heart failure. The arteries are also subjected to higher pressures than they were designed to cope with and can burst, making the risk of stroke so much higher. Other organs don’t like working at the high pressures either, and kidneys, in particular, can go into failure mode.

No, if you really have hypertension, get it treated – but remember to have repeated measurements done, and don’t let the doctor classify you as being “hypertensive” until repeated measurements confirm that your BP is too high.


HEADLINES [click on headline to view story]

Take the flowers outside – they use the oxygen

Ducks will eat tonight

Growing old disgracefully

Will your blood pressure blow the top of your head off?
 

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