Saturday, March 28, 2009


As a medical physician for over 50 years, I strive to give you the best medical information on controversial medical subjects and let you the reader come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary with astounding results.
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We have all heard about radiologists, urologists, and even pathologists, but what is a hospitalist?  Is it a CEO that runs a hospital?


Well, actually, it is a redesigned internist who works only in a hospital managing medical care for other doctors.  Internists that never became sub-specialized, now have found their niche in hospitals.

Hospitalists now can be found in almost all areas of our country.  The dynamics of medical care over the last 10 years has resulted in a tripling of the number of doctors that identify themselves as hospitalists.  Medical claims for evaluation and management services in the hospital by these new specialists called hospitalists have increased almost 400%.

The odds of you being treated by a hospitalist vary by regions, with more than a 70% chance in some hospital-referral regions.  Forty percent of community hospitals now have a hospitalist program;  California is leading the way with 60% of their hospitals having such programs. 

Over 45% of hospitals have at least three hospitalists, with an average of 11 in major teaching hospitals and 3 in non teaching hospitals.  If you live in St. Cloud Minnesota, Mesa Arizona, Appleton Wisconsin or Austin Texas you have an 80% chance of being treated by a hospitalist.  

Hospitalists are now in 85% of teaching hospitals and 40% of non-teaching hospitals.  Over 85% of hospitalists are trained internists, and they do over 96% of their work in hospitals.  The other 15% are general practitioners and pediatricians.  They care now for more admissions from the emergency room, and do referral work for orthopedic doctors, and patients with neurological problems. 

In the past, a newly trained cardiologist took a part time job in the hospital, as he was developing his outpatient practice.  The career stability of hospitalists seems now established, with over 90% of hospitalists staying in their new specialty and find no need to have an outpatient practice.

This means internists will see you more quickly when you arrive at a hospital.  You will, however,be treated by a doctor that does not know your problems as well as your own doctor.  If you are going to have a hip or knee replacement, you will get an evaluation and medical care from a hospitalist, not your busy cardiologist.

Being a hospitalist is now a fine way to finish a medical career after private practice.  Is the hospitalist, however,  abreast of current subspecialty problems?  Who will the hospitalist call  when he does not know the answer to your perplexing medical problem?

 Time will tell, in the ever-changing medical world. 

Visit for more medical blogging on controversial current problems in medicine.  As always, your comments are always appreciated.

Source: NEJM Mar.12, 2009


Sunday, March 22, 2009


As a medical physician for over 50 years, I strive to give you the best medical information on controversial medical subjects and let you the reader come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary with astounding results.
Visit http;/
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Early exposure to food allergens can compromise an immature immune system.  Over 25% of Americans have symptoms of food allergies, but only 3% actually have food allergies.  The food allergies are water-soluble glycoproteins of plants and animals.  They stay stable with heat, acid, and proteases.

Milk and egg allergies are the two most common food allergies in the United States, affecting 3 percent and 2 percent of children.  Young kid have allergies to cow’s milk, hen’s eggs, peanuts, sesame and tree nuts.  By age 7, over 75% of these allergies disappear One does not, however,  outgrow allergies to peanuts, tree nuts and sesame seed. Rarely are wheat and soy allergens.  Adults are allergic to shellfish, peanuts, tree nuts and fish.

Egg allergy is one of the eight most common food allergens. The FDA has labeling regulations, in bold print, that require “egg” appear on the label.  Unfortunately, you must learn the different names eggs can appear on labels.


Food allergies can cause  localized hives to life threatening anaphylaxis.  The skin can get hives, flush, and get angioedema.  The bowel can react with vomiting, pain, cramping and diarrhea.  The lungs can become asthmatic and the nose may run.

Young children can get mood changes and an aversion to a food.  Suspect a problem is there is wheezing shortly after eating.  Once there is sensitization, respiratory allergies as asthma and rhinitis can develop, and must be suspected if, as a child, there was an egg allergy. Not only do more kids have allergies, but also fewer of them outgrow their allergies, and those who do, do so later than before. The higher the level of antibodies, the less likely it is that a child would outgrow the allergy any time soon.

Eczema and food allergies often resolve in children.  Suspect a food allergy if your baby has severe eczema, and it might clear by eliminating eggs and other food allergens.   If asthma develops after food allergies, anaphylactic reactions are possible but extremely rare.

The kind of symptoms and the timing after exposure to the food allergen are very important.   Inhalation exposure during cooking can lead to wheezing.  Oral exposure generally causes bowel symptoms.  Over a third of kids with egg allergies will develop allergies to peanuts, tree nuts, and sesame seeds.

Vaccines:  Since influenza vaccine is made in chicken egg cultures, it should be avoided or given in tiny doses under supervisions in children with egg allergy.  Mumps and rubella vaccinations are ok (MMR).    Recent treatment with monoclonal antibodies is used for adults with peanut allergies and is also effective for allergic asthma and rhinitis.


Eggs are in macaroni and tubed shaped pastas, but rarely in flat noodles.  Cholesterol lowering egg replacements in the refrigerator sections almost all are made from eggs.  Eggs are used in cakes as a leavening agent; in cookies it serves as a binder and to add moisture. 


Quiches can be made from tofu. Bananas and applesauce can replace eggs to add the moisture; baking soda can help leaven cakes.  Adding a bit of mustard, to tofu can give your quiche a yellow color.  In a pinch, vinegar and water or soda can be a good egg replacer.

Food allergens can compromise an immature immune system. Eczema and food allergies often resolve in children.  Suspect an allergy if shortly after eating your child develops, hives, excema, or wheezing. Eliminate eggs and milk and most of the time it will disappear.  By age seven,  75% of the children will outgrow their allergies to milk and eggs.  Do not allow an influenza vaccination be given until you discuss it with your doctor.

 Visit for more controversial medical blogging.  Your comments are always appreciated.

Sources:,,, NEJM Sept. 18,2008


Friday, March 20, 2009


As a medical physician for over 50 years, I strive to give you the best medical information on controversial medical subjects and let you the reader come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary with astounding results.
Visit http;// for more valuable medical information.


Gastroesophageal reflux disease, called GERD, occurs in 20% of Americans.  The stomach acids, with the same acidity as battery acid, help you digest the food you eat.  The stomach acids splash up to the esophagus, causing heartburn.  Many of you may simply have laryngitis or chronic dry cough, and it is uncertain that this is gastric reflux.

Inflammation of your esophagus occurs when acid and pepsin cause ulcers in the lining of your esophagus.  Belching is a normal release of some gastric juices.  Other causes include hiatus hernias, abdominal obesity, and overeating.

It seems there is a poor correlation between reflux and esophagitis.  Only a third of people with esophagitis complain of heartburn and reflux symptoms, and two thirds of those who do complain, don’t’ have esophagitis.  One must consider heartburn possibly a symptom of coronary disease, gallbladder disease, cancers of the stomach, or a peptic ulcer.

Lifestyle changes are the best treatment for reflux.  Avoid acidic spicy foods that irritate the stomach.  Raising the head of the bed may prevent nighttime heartburn and sleep disturbances and of course losing some weight.

You are told that it could cause cancers of the esophagus if not controlled.  Yet 40% of these cancers never had reflux at all.  Since there are about 8000 cases a year, only 4800 are due to reflux.  There is a very low risk of cancer in patients with reflux. Not many cases for all the medications and endoscopies performed.

The Canadian guidelines do not advocate screening endoscopies stating: ‘the procedure has not shown to reduce mortality from adenocarcinoma”.  The American College of Gastroenterology hedges, saying ‘ there is not enough evidence to recommend for or against endoscopy to screen for esophageal cancers or diminish the risks of esophageal adenocarcinoma. 

Restaurants are often responsible for your GERD.

Drinks with chocolate, alcohol, caffeine, cola, lemonade and orange juices, tea, all add to reflux events.

Problems increase with foods that are fried: as burgers, fried chicken and fish, club sandwiches, French fries, gravies, mayo, creamy soups, pizza with extra cheese all cause havoc.  Avoid catsup, onions, peppers, chili, and tomato and spaghetti sauces.

Solution foods:  white lean meats, turkey chicken or roast beef on whole grain bread, grilled foods, broth based soups, steamed veggies, baked potatoes without high fat dressings, low fat salad dressing, and light deserts.

You will lose weight, save money, and can quit taking Beano, antacids, and proton pump medications as Prilosec.  Endoscopy will not be in your future.

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Source: NEJM Oct. 16, 2008



Wednesday, March 18, 2009


As a medical physician for over 50 years, I strive to give you the best medical information on controversial medical subjects and let you the reader come to your own conclusions. I have no ties to any organization, pharmaceutical, nor lobby group. As an acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary with astounding results.
Visit for more wonderful information.


Girls, pick your sports with care, especially if you have knock-knees.  Over 175,000 ACL tears were operated on in 2000, costing over 2 billion dollars.  The injury rate is 2-6 times more common in female athletes; in basketball it is 8 times more common in women.  Over 90% of these injuries occur without contact in women, as compared to 67% in men.

Females tend to have different leg alignment with an increase in knock-knees and a widened notch resulting in less space for the ACL.  While still young, after 10-20 years, over 50% of injured patients will get osteoarthritis.

Most sports need a functioning ACL to allow sudden turns, pivoting and cutting.  To do one’s daily activities. a normal ACL is not necessary. 

The anterior cruciate ligament (called the ACL) is one of four ligaments that stabilize the knee joint.  Other are the posterior cruciate ligament (where the knee is overextended by a player falling on it), the medial( where the outside of the knee is clipped and the inside of the knee is opened up) and lateral collateral ligaments

If one can continue to play, and there is no swelling,  you probably have a partial posterior tear or collateral ligament tear.  If swelling occurs the next day,  you have a meniscus tear.

 A ligament is a tough fibrous material that controls excess motion by limiting your joint mobility.   The ACL prevents the shinbone, tibia, from sliding too far forward.  The thigh bone, femur,  sits on top of the shinbone and stabilizes the rotation at the knee.

When the ACL is injured, the knee becomes unstable, and can’t make sudden pivoting movements.  The knee feels like it will give out, because the joint is sliding forward too much.  The tear often results in a popping sound, early swelling, because of bleeding, and inability to keep playing. 

Immediate treatment is” RICE”: rest, ice, compression, and elevation of the leg.  Noninflammatory drugs are prescribed, and physical therapy is instituted to regain normal range of knee motion, quad muscle control, and a normal gait.

You don't need a normal ACL to walk normally and climb stairs, bike, and jog.  Usually you can’t pivot and cut 90 degrees, and find soccer, basketball, lacrosse, tennis singles, football, gymnastics, hockey, and mogul skiing to be problems.

 If you can’t do the normal things or want to continue your sport. you may need ACL restoration surgery. Surgery involves drilling into the tibia and femur and attaching a tendon graft, from your hamstring or patella, to both ends.  Care is taken to avoid nerve damage, infection and deep blood clots.  Chain-based and weight exercises are done for 6 months until recovery.

Be good to your knees when you are young, and they will be good to you when you age.  

Visit for more information on medical controversial subjects.  Your comments are always appreciated.

There are currently no published professional guidelines to manage these ACL tears.  Souce: NEJM Nov.13, 2008



Tuesday, March 17, 2009


As a medical physician for over 50 years, I strive to give you the best medical information on controversial medical subjects and let you the reader come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary with astounding results.
Visit http;// for more super information.


Everyone seems to be looking for more energy.  You work long hour’s play hard, and are deprived of sleep, but your energy levels always seem mighty low.  Caffeine, Red Bull, and Gator aide don’t seem to help.

You live with unfulfilled dreams, guilt, and anger.  You are exhausted trying to cope with unresolved childhood problems.  Your defenses are beginning to collapse, and you have reached the breaking point.   Still, you keep trying to heal yourself, but are stuck in the past and cannot look ahead.

Your thoughts are very powerful, constantly focusing on feelings of shame, rage, fear, and sorrow in your life. You can’t skip over all the messy wounds, conflicts, and charged memories from your past.

As a child you were taught the world was divided with good and bad people, kind or selfish, rich or poor, healthy or sick. and smart or stupid people. Hopefully you have moved beyond this all black or all white thinking.

Your anxious mind only has thoughts of regrets and guilt from the past, and worries, fears, and dreams of the future.  You are not grounded in reality.

You condemn yourself and suppress your positive life force energies.  You forget how to feel the energy within yourself.   All this suffering and alienation, is causing you to live in disharmony.  You are attracted to other unhappy people, as yourself, who also have negative energies.


Energy is called by many names:  essence, Ki by the Japanese, Chi by the Chinese, God by the Christians, consciousness by the Buddhists, and Tao by Lao Tsu. 

Mainstream science has no interest in the unseen and hard to quantify energies.  Science has dehumanized your world.  You feel isolated in the cosmos, no longer involve yourself in nature, and don’t participate in any natural events.

The energy concept is the basis of acupuncture, and has been around for 5000 years. Essence is another name for life energy. Energy medicine results in the vibration of our energy and that of the world.

By rebalancing  your  life forces, known as chi. you can redirect your energy and promote healing.   As an acupuncturist for 27 years, I have seen  energy rebalancing restore health to many patients.

Chi enters your body by breathing and by talking, which is an audible form of breath.  Placing needles at select body points altering the patterns of chi stimulates chi.  Taoist meditations with its mantras and deep breathing, chanted in deep low-pitched tones, also restores Chi energy. 

Sound and breath are repositories of your life energy.  They can be positively manipulated, resulting in your becoming centered again, and be “in the zone”.

Your essence is a fine harmonious vibration that lives forever and is indestructible.  The vibrational energy of this essence,, however, can be  altered and compressed by  your ego, denying the luminous energy of your soul.



Energy is like a guitar string with two ends.   One end is worldly and controlled by your ego.  The other end is infinite and spiritual, and controlled by your chi or spirit. 

Do you often find yourself going in opposite directions?  You are trapped between the connections to the infinite and your obsession with the finite.  Your goal should be to tune in and bring the infinite into the finite world.

When you are tuned into the finite material world, your wounds and those of others imprison you.  It is your birthright to be tuned into the infinite, bringing you into the present moment, free from depression, obsessivenss and chronic ill health.

You are faked out into believing you need specific thoughts to survive.  By fear and loss of identity, you cling to all these nasty thoughts, fearful you yourself will  be eliminated. Since your desires are satisfied, you feel safe and secure.  You must break out and “Be what you are”.

Your ego defines your world, by  giving you a set of thoughts.   You see the world from a little room with windows, your prison, where you are safe and secure as long as you don’t walk outside.

Your ego is always right, and everything else is wrong. Acting from your ego, you constantly notice conflict both inside and outside your body.  Ideas about yourself, fueled by your parents, teachers, and religious leaders, are repressed and unacceptable; but you stay in line.

Keeping your life meaningless, you stay isolated and disconnected. Your ego tells you the world is causing your suffering.    Despair and physical illness finally set in. You can’t connect with your universe, because of family problems and work pressures..  You must find peace within yourself; but how?


Positive life energy is the “stuff” of the soul; it permeates all your cells and higher organ systems.  To exist in the present, without being imprisoned by your wounded ego, you must tune into the infinite side of your energy, and synchronize it to your own true nature.  By loving from your essence, your life becomes a beautiful concerto, with the joy reflected back to you.

Your feelings are all connected with the infinite energy of all the forces of the universe.   Reacting from a peaceful mind and heart, you find calmness  that  leads you into a peaceful inner place, called your essence or home.

Negative emotions keep you stuck in the mud.  To move beyond your ego, you must embrace your essence, and trust  in your infinite nature.  To embrace your consciousness and move on, you must accept this dual polarization, by seeing things with a new insight and perspective.   Shifting out and focusing on  your essence, you again restore true healing and homeostasis in to your life.

Look at your thoughts as they float through your consciousness.  Quiet your thinking and the constant chatter of your mind.   Don’t try to force yourself into a positive mode at once;  rise above the negative emotions that are undermining your essence. 

You are what you become.

Recognize that life is to be experienced, not condemned.  Anchor yourself in the present moment.  Truth is present and it is an energy that can always be tapped into.  Feel the essence of life’s force.  Reclaim your spirit,  realize  you are strong in spirit, and you will gain trust and independence.  You are empowered to change some thing s about yourself: your health, your environment, and your living conditions.

Break from the past.  You are just a condition that can be changed.  Transform yourself and get harmony back.  Shift your viewpoint, and replace the emotions that are ego based with feelings of respect and compassion.

Replace intolerance with tolerance: sadness with happiness, lack of self-esteem with love of yourself, fear of  the future with trust.  Change your angry feelings and the fear of your future by developing an awareness of your trusting and compassionate spirit.

Let go of the negative energy you have been carrying from childhood.  Replace your anger with forgiveness, with a sense of trust in what lies ahead.   Replace your low self-esteem by loving yourself.  See the world from the perspective of essence instead of from your ego.

Tap into your infinite energy by getting into the present moment: meditation, yoga, prayer, imaging techniques, hypnosis, and acupuncture  often  achieve this awareness.  The healing energy inside you can heal you. 

The bottom line is to learn to let go, get in the present moment, spend more time with nature, and be the person you think you are. When you reach this balance, your mind will be at peace, your body will be healthy, and your energy will soar.

Visit for more blogging of medical controversial subjects.  And as always, your comments are deeply appreciated.


Saturday, March 14, 2009


As a medical physician for over 50 years, I strive to give you the best medical information on controversial medical subjects and let you the reader come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary with astounding results.
Visit http;// for more super information.


Men’s grooming, skin care. and the use of makeup to look good has always been a part of our male history.   Mother Nature chose to endow the male species with great color and splendor.  All through history, the more man stood out from his competition, the greater was his chance of attracting a mate.  American men are catching up to the polished grooming skills of European men.

Industry statistics show that men are increasingly likely to use personal grooming products as: moisturizers, hair gels, toiletries, cosmetics, and lotions, to stand out from fellow prowlers.  Over $20 billion of these products are sold annually.


Eye shadow was used in Egyptian burials as far back as 10,000 BC.   Roman men used scented oils and ointments to clean and soften their skin.  To hide their body odor, their slaves bathed them in perfume.

Makeup began with dyes and paints to color the skin, body, and hair.   Even the nails were stained using henna.  A dark colored powder, called Kohl, made of crushed antimony, burnt almond, lead, oxidized copper, ochre and ash was used to line the eyes, eyelids, and eyebrows; it extended over the sides of the face for an almond effect.  This Kohl powder also helped reduce the glare of the sun, and was thought to reduce eye infections.

As far back as 300 BC. hygiene and health played an important role  in the life of  Egyptians,   Chamomile, lavender, lily, peppermint, rosemary, cedar, rose, aloe, olive oil, sesame oil and almond oil all provided the basic ingredients of ointments and perfume. 

Later, red ochre clay was mixed with water and applied to man’s lips, cheeks and nails.  Chalk was used to whiten the complexion and rouge was applied to the cheeks.  Hair removal depilatories were used, and pumice helped clean the teeth.   

Makeup was common practice, by the middle of the 1st century AD.    This resulted in an increased demand for roses, sweet flag, narcissus, saffron, mastic, oak moss, cinnamon, cardamom, pepper, nutmeg, ginger, aloe wood, grasses and gum resins.

Around 100 AD, the hedonistic Romans took men’s grooming makeup to a higher level.  Men’s makeup included the use of barley flour and butter on pimples, sheep’s fat and blood for fingernail polish, and even crocodile excrement for mud baths. The hair was frequently dyed blond the preferred color of the times.  These dyes, however, were so caustic they caused the hair to fall out.

During the reign of Elizabeth I of England, men’s grooming makeup became very popular.  Elderflower ointment was used for the skin, , and  egg and honey masks were used to smooth away wrinkles; bathing in wine also became popular,

To suggest health, wealth and gaiety, the men used geranium petal rouge, lipstick, rosemary water for the hair,  and even sage to whiten their teeth.   Hair was bleached with lye, causing it to fall out, thus popularizing the need for wigs.

Pale skin also became a very popular.  Unknowingly, the makeup used to whiten the skin was made with lead and arsenic, which resulted in many early deaths.


These days, you too are just as concerned about looking and feeling your best in all areas of your life. You know that everything-- from a great haircut to how you look and feel about yourself-- has a large impact on your life.

When you feel good about yourself you are motivated to succeed in life, and feel better mentally, physically, and emotionally. 
It is important for men to be able to both feel and look good.   The media is constantly feeding you the information you need to implement positive changes in your life.  You are daily reminded that you can and should look and feel better than you do.

Just imagine a new life where you look your very best, feel great about yourself, attract the soul mates you desire, and have a better chance at achieving your dream job.   You are now irresistible.


Are you happy?  I mean 100% happy, with how you look when you look in the mirror.  Who are you? What do you like? What do you feel good in?  What colors do you gravitate toward?

Your skin sure needs help.   Since you work out frequently and wash and showers often, your sin is drying out.    Gone are the days when you could just wash with a harsh soap and face the day.

Today’s, skin care products will make your skin feel fresh, smooth, and moisturized. They are available in subtle scents that both you and your soul mate will find attractive, but not overwhelming.

Real men don't cry -- they moisturize with nice smelly stuff.

Moisturize your face and get rid of those little dry patches.  Get a refreshed look that lets you stand out from the crowd.  Invest in an exfoliating face wash and scrub away those odd unsightly black heads that give off a nasty smell.

Your ears and nose may never stop growing, but that's no excuse for letting the hair that pops out of both areas  go crazy.    Why not invest in a nasal hair trimmer and pluck out those stray hairs with a set of tweezers. Your manly- ruddy face also needs skin lotions.

Your hair needs help too!

To get the hair on you’re head looking just right, you must have the right shampoo and conditioner.   And, since your hair now that it is getting gray, have you thought about dying or coloring your hair?

The key to choosing a perfect hairstyle is not fad.   It is understanding and knowing the shape of your face. Check out the latest trends to help inspire you.

In your lifetime, you remove on average 24 feet of hair.   Fortunately you have found the perfect haircut, after paying a silly amount of money at a high-end salon, and were sold some gooey hair gel product to put on it every morning.

You say you are bald?  Great!

Towel your  baldhead before and after shaving your head.   Put on your head a special aromatherapy formula--it has all natural ingredients to  replace the natural oils lost in your scalp.   It has a natural protection that reduces sweat and gives your head a clean glowing look.   You might want to consider moving to Atlanta, which has more Bald Men per capital than any other city.  Georgians know all the latest trends.


In 2000, American men began focusing on grooming, skin care, and makeup-- your appearance is improved and you are in sync with the jet set.   The details of how you look  speaks volumes about you.

Make sure your shoes are polished and use all your best accessories – a nice belt, your best watch, and a good wallet.

Today, luxury is a culture; your view of the world and your relationship to society is judged by how you look at your relationship toward possessions.

You might check that there is no aluminum in your underarm deodorant. You don’t need Alzheimer’s down the road. 

Oh, by the way, check that there is no lead in the anti graying lotion you are using.  It  coul d cause you some neuroligic lead poisioning problems.  Watch out also for the thing we call dandruff.

With the economy in default mode, it may important to slow down and groom the old fashioned way-- just soap and water as you did n the 80s.  After all, food is also important.

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