Family Medicine

The Teenage Brain

This month's issue of Scientific American contains an interesting article entitled, The Amazing Teenage Brain. It seems that the teenage brain is no longer viewed as an incomplete, poorly developed adult brain but is characterized by flexibility or plasticity in its ability to readily adapt to changes in thought patterns and socialization. However, this flexibility brings with it susceptibility to dangerous behaviors and in some cases mental disorders. 

New Blood Pressure Guidelines

In December 2013 an expert panel on hypertension published its latest recommendations in the Journal of the American Medical Association. In essence these are the recommendations:  1. The target BP for patients over 60 is now 150/90. It used to be 140/90.  2. There is insufficient evidence to support a target systolic blood pressure for people under the age of 60.  3. Reduction of one risk factor (in this case hypertension)  for heart attacks, strokes and premature death by using a drug does not in and of itself mean that patients are less likely to suffer these events. These recommendations make sense to me because as we age, the compliance of our blood vessels decreases, they become less flexible and our blood pressure rises over time. To try and maintain an otherwise healthy patient over 60 to a BP of 120/80 never made much sense to me. 

Fishy Research

Last week, the mainstream press reported a study that linked consumption of fish oil to prostate cancer. A closer look at the study, however, calls the headline into question. The results were taken from a study that was designed to answer the association between selenium and vitamin C and cancer risk. The study was not initially designed to study the link between omega 3 oils and prostate cancer risk. The researchers included one (just one) measurement of blood levels of omega 3 oils. It is always dangerous to use a study designed for a specific purpose, such as selenium and vitamin C intake and cancer risk in general to answer a specific question about another factor such as fish oil consumption. One measurement in time gives no information about any subject's daily intake in a disease that takes years to develop. The difference between the two groups, those with increased risk and the control was 4.66% vs. 4.48%.  This is at best a weak correlation and not causation. 

All In The Family

These days with constantly shifting insurance coverage, its difficult to keep the same doctor from year to year let alone for a lifetime. So it is that we forget what the word "family" in family medicine can mean.  It means you treat families, generation to generation not just all members of one generation.  And so it is with little Maggie here. She's weeks old and had a rather difficult birth.She underwent vacuum extraction just 2 weeks earlier that left her bruised and swollen. During her mom's pregnancy it looked like an inflamed appendix was going to lead to surgery during pregnancy. Homeopathy to the rescue.

What is Holistic Medicine?

First, let me say what it is not. Holistic medicine is not alternative medicine whereby alternative substances such as herbs, vitamins, minerals and other supplements are used in place of conventional drugs. Neither is it complementary medicine whereby non-conventional therapies are added to mainstream medical practice. It is a philosophy, a way of practice in which understanding the entire person is required in order to prescribe a medication, in this case a homeopathic remedy.