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First Full Month of Summer is Finally Here!
July feels especially wonderful this year! The Fourth of July, the All-star Game, family picnics, bicycling, fresh basil, and sweet corn have never been more welcome!
Rita and I have just returned from Rita's annual family reunion in Mahoney State Park west of Omaha, Nebraska. The corn was tasseling out and as "high as an elephant's eye". Puffs of air rippled across the vast fields of soybeans. The Blue Angels frolicked high above Offutt Air Force Base, the home of the Strategic Air Command (SAC). Our country is indeed vast and beautiful! We left refreshed and invigorated having renewed the ties that bind us together whether living in Austin, TX, Detroit, MI, Los Angeles, CA, Rochester, MN, Hilton Head, SC, Boston, MA, Raleigh, NC, Iowa City, IA, NY, NY, or Spring Lake Heights, NJ. The last address is ours - we moved to our renovated two bedroom condo in Fairway Mews on June 30!
John A. Schmidt, MD
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Now Hear This! Our Office Will Be Closed August 19-24!
Our daughter, Susan Marie, is to be married to a very wonderful fellow by the name of Nicolas in St. Michaels, MD, on August 23. The office will be closed, except for emergencies, from August 19-24. Please send refill requests and all other inquiries well before August 19, if at all possible. Thank you!
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American College of Physicians (ACP) Recommends Against Screening Pelvic Examination in Asymptomatic Women
As published in the July 1 issue of the Annals of Internal Medicine, the ACP found no evidence to support the widespread practice of regular bimanual pelvic examinations in asymptomatic women. As previously reported in this newsletter, pelvic examination is a failed screen for ovarian cancer. Uterine fibroids are common but should be left alone unless they bleed. Cervical cancer screening is critically important and requires a speculum examination, not a bimanual pelvic examination, every five years for most women. See if your gynecologist agrees!
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| Shapely and Colorful Pills
I use generic medications whenever possible to save money knowing that the Food and Drug Administration (FDA) only approves a generic when it demonstrates comparability to its patented counterpart. However, with so many generic versions available, each one must have a different size and shape to distinguish it from other generic versions of the same drug. Bottom Line: Do NOT rely on pill color and shape. Read the bottle label provided by your trusted pharmacist!! With so many generic drug manufacturers vying for your insurance dollars, and with insurance companies constantly searching for the lowest bidder, the shape and size of your most important medications will change again and again! Read the label on the bottle to make sure you know what is inside! Bring your bottles to your appointments so I know exactly what you are taking!
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Food Labels - It's Time for a Change!!
As reported in the July 17 issue of the New England Journal of Medicine, the FDA is about to revise its food labeling guidelines. Food companies hype their products on the front of the box while the key nutritional information is shown in fine print on the side of the box. The authors advocate that the key information be promoted to the front label. With tens of thousands of brands competing for scarce shelf space, I heartily agree! Read the labels and become an educated food consumer!
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Sugar Free May Lead to a Sweet Tooth!
As reported in the July 17 issue of the New England Journal of Medicine, the authors make the interesting point that sugar-free substitutes may have contributed to the obesity epidemic by cultivating our lust for sweetness. People who enjoy "sugar-free" products paradoxically consume more calorie-rich sweets. Why? Because they have become accustomed to intensely sweet foods, most of which are calorie-rich. The authors propose that front-of-the-box labels disclose the level of sweetness so that parents and wary consumers can avoid addictive extra-sweet products that indirectly lead to obesity, diabetes, and poor health outcomes. Be a smart consumer! Read the side of the box, not the front of the box, and be wary of sweetened products of all kinds!
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The ABCs of Chronic Hepatitis: Screening for Hepatitis B (HBV), the Other Hepatitis!
I have devoted considerable space in this newsletter to hepatitis C especially now that new curative treatments are rapidly coming to market. But what about the other chronic viral hepatitis, hepatitis B (HBV)? In the Unites States, 1.25 million persons are infected with HBV and those who develop chronic infection die an average of 22 years earlier than those without infection. The following groups are at risk: immigrants from highly endemic regions such as Southeast Asia, HIV-positive persons, injection drug users, household contacts of persons with HBV infection, men who have sex with men, those on hemodialysis, children born to HBV positive mothers, and diabetics. The rationale for increased screening is similar to that for hepatitis C: Good medicines are available and treatment is associated with improved outcomes. Let me know if you wish to be screened!
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Health Care Coverage under the Affordable Care Act (ACA) - Progress Report (from the July 17 issue of the New England Journal of Medicine)
Wherever you stand in the political spectrum (I am a registered Republican), one fact is clear: the ACA has led to a dramatic increase in coverage. I had mixed feelings about the ACA at first. However, now that I have seen many newly insured in the office, I believe that the ACA is a net positive. Most of the patients I have encountered are working but don't make enough to afford conventional insurance. Because the ACA allows persons to stay healthy, work, and contribute to the common good, I am committed to accepting patients insured by the ACA and Medicaid Expansion. My ads in Church Bulletins and the Coast Star have been modified accordingly.
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| Niacin - NO help in the fight against Heart Attack and Stroke!
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Hope for Patients with (CLL)
Chronic Lymphocytic Leukemia (CLL) is the commonest leukemia in my practice. As reported in the July 17 issue of the New England Journal of Medicine, there are two new treatments approaching the market which offer improved outcomes in patients who have failed conventional therapy. Ask your oncologist for more information or ask me for a referral.
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| Movie Suggestion:
With so much attention focused on retiring Derek Jeter (much to the chagrin of Valerie, a devoted Mets fan), I had to rewatch, "Pride of the Yankees" starring Gary Cooper. Though still a true-blue Phillies fan, I love this movie. The original Iron Man was an authentic baseball legend (and so are Cal Ripkin, Jr. and Jeter!)
Valerie and I wish you the warmth, relaxation and bounty of Summer!
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Internist
is one of the leading Internists in Monmouth County offering Medical Home Services
"A perfect summer day is when the sun is shining, the breeze is blowing, the birds are singing, and the lawn mower is broken."
James Dent
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