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FROM THE DOC
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"Man Bites Dog!"
That headline always will get attention, and in medicine, it is common to see inflammatory research that is controversial getting quoted in the popular press, no matter how marginal the scientific validity. If it gets your eyeballs, the website or newspaper will not think twice about this.
A recent example was the headline concerning the possible connection between Alzheimer's disease and the use of 'valium like' sleeping agents. That article, which was roundly disregarded in medical circles, made quite a splash in the popular press. Not only does it catch attention because so many people use sleeping aids, and because they are often older and worried about dementia, but it just seems 'right' to the moralizers out there that taking the 'easy road' to sleep must have some negatives; and the punishment of delayed dementia seems a bit excessive, but it satisfies some who have this odd sense of justice.
So, it comes as no surprise to me, and perhaps some relief to those patients who saw the previous study in the press, that a recent study completely contradicts this finding. It shows ZERO correlation between dementia and the use of valium and similar medications. Dr. Peter Roy-Byrne, Editor-in-Chief of NEJM Journal Watch Psychiatry, comments: "Most experts in both geriatrics and use of benzodiazepines never believed the previous poorly controlled study suggesting this relationship" It is worthwhile to keep this example in mind the next time you see an inflammatory medical headline in the popular press
Yours in good health, Dr. Lakin
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| VOL 12 / Issue: #1 | Winter/ 2016 |
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How to Stay Warm (and Keep Your Cool) When the Storm Leaves You Stranded. . . . .
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 Here's some advice on how to keep your cool and stay warm if you're caught in traffic or if public transport leaves you stranded: Always dress right Even if you don't think you'll get caught in the snow, be ready for it. Wear layers, have an extra coat or sweater in the car or in a bag with you, and have a pair of sensible shoes or boots. Your 10-minute commute could turn into a snowy hike if the roads back up. Keep your hands and toes warm. They're vulnerable to frostbite, and you might not feel it coming on. In extreme cold, the body diverts blood to the vital organs.
Skip the booze Alcohol may make you feel warm for a moment, but that comfortable flush means you're losing body heat to the outside air. And alcohol impairs your judgment so you might take unnecessary risks - like leaving a cozy car to walk.
Seek shelter Your house or car will likely be the safest place, even if it means being uncomfortable in a days-long traffic jam or an extended power outage. Keep your car ready
A blanket in the car can mean a lot if you slide off the road into a ditch. The Centers for Disease Control and Prevention has a long list of goodies to keep inside a car, just in case. They include a flashlight with extra batteries, water, a little snack food, chains or rope, booster cables, a first-aid kit, emergency flares and road salt or sand. Here's what to look for if you are outside for a long time in the cold: - Shivering, dizziness, nausea, fast breathing, rapid heart rate, trouble speaking and mental confusion are all signs of hypothermia and call for emergency action to get warm.
- A prickly feeling on the skin, fingers or toes can signal frostbite. Red or pink skin will turn white, which is a danger signal. Get that skin covered. Gentle - not brisk - rubbing can push blood into the affected area and warm it. Breathing gently on the affected area can help. Don't use direct heat from a stove or a fire on frostbitten skin - putting hands or feet under someone's armpit can help, and warm - not hot - water may also help.
- Shoveling snow can be dangerous, too. Watch your back, use a smaller shovel to make sure you're not lifting too much weight, don't eat a heavy meal before you go out to shovel, and call 911 if you feel sudden chest pain, arm weakness or sudden nausea under or after exertion.
- by Maggie Fox MSNBC Health
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Could A Mediterranean Diet Keep Your Brain From Shrinking?
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 Following a Mediterranean diet rich in fruits, vegetables, legumes, whole grains, fish and healthy fats may preserve a more youthful brain in old age, a U.S. study suggests. For the current study, researchers focused on elderly people with normal cognitive function to see if the diet might also be tied to losing fewer brain cells due to aging, Gu said by email.
"Among cognitively healthy older adults, we were able to detect an association between higher adherence to a Mediterranean type diet and better brain measures," Gu said.
To understand the relationship between the diet and brain health, Gu and colleagues reviewed surveys that 674 elderly people completed about their eating habits and then examined magnetic resonance imaging (MRI) scans of their brains.
Compared to the people who didn't regularly follow many aspects of the Mediterranean diet, the participants who adhered to this way of eating more often had larger total brain volume, as well as more gray and white matter. Higher fish intake and lower meat consumption, one aspect of a Mediterranean diet, was tied to larger total gray matter volume on the brain scans. Eating less meat was also independently associated with larger total brain volume.
Overall, the difference in brain volume between the people who followed a Mediterranean diet and those who didn't was similar to the effect of five years of aging, the researchers conclude in the journal Neurology. One limitation of the study is that it can't show whether the diet actually causes less brain atrophy over time, the authors acknowledge. For instance, it's also possible that the effect might operate in the opposite direction, with differences in brain structure resulting in behavioral differences that include dietary habits. It's also hard to separate the effect of eating more fish from the impact of consuming less meat, noted Dr. Victor Henderson, a neurology and health policy researcher at Stanford University in California. "Someone who eats a lot of fish probably doesn't eat a lot of meat," Henderson, who wasn't involved in the study, said by email. "Other research suggests that it is not just fish and meat that are important," he added.
While previous research has linked a Mediterranean diet to a reduced risk of heart disease and some cancers, as well as lower odds of developing Alzheimer's disease, scientists haven't conclusively proven that the diet itself is responsible, rather than other lifestyle choices made by people who eat this way. "It is safe to say that a well-balanced diet such as the Mediterranean diet is a healthy diet, and this research provides exciting new support for this common-sense perspective," Henderson said. "Still, from my perspective, more clinical trial results are needed for a more specific take-home message." |
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That Scary Movie Really Is Blood Curdling!
|  Scary movies really are blood-curdling, Dutch researchers have found.
That frisson of fear releases a little bit of the blood-clotting protein called Factor VIII, they report. The team at Leiden University Medical Center studied 24 healthy volunteers ages 30 and younger. "One group (of 14) were assigned to watch the horror movie 'Insidious' followed by the documentary 'A Year in Champagne,'" Dr. Banne Nemeth and colleagues report in the lighthearted holiday issue of the British Medical Journal."The other group watched the movies in reverse order." Blood samples were taken before and after and each volunteer rated the 90-minute-long films.
The horror movie was, not surprisingly, scarier than the educational movie, they found. And Factor VIII levels changed, going up in 57 percent of the volunteers during the horror move and falling in 86 percent when they watched the Champagne documentary. "Exposure of young and healthy adults to horror movies was associated with an increase in coagulant factor VIII levels," Nemeth's team concluded.
Other blood-clotting proteins weren't affected, no one suffered a blood clot and there is a simple cure, the researchers advised.
"A truly relaxing and winter holiday, without exposure to frightening situations, seems to be advisable to prevent venous thrombosis," they wrote. - by Maggie Fox, Health Back To Top |
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KEEP TRACK OF THE FLU IN ARIZONA. . . . . .
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 The Arizona Department of Health does a great job of tracking the data of Influenza and other respiratory viruses during the Flu Season. You can find this information at this site: Just click the latest influenza report...noted in RED....and you will see the data nicely graphed as well as the granular information as well.
 Do you have the flu? Well...the depends on symptoms as well as the time of the year. Although sporadic cases of FLU do occur, generally we see them widely during the seasonal outbreak and the likelihood of having flu increases enormously if you have classic flu symptoms during the outbreak as opposed to other times of the year.
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Traveling The World!
Our Patient's Trip To Japan. . ..
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 Ron & Jill Rubin traveled to Japan and shared their trip with the travel section in the Arizona Republic. "Last fall my wife, Jill, and I traveled to Japan, a nation whose unique culture blends centuries-old Far East tradition with a modern Western lifestyle. We began our journey in Tokyo, by far Japan's largest city. From its ancient temples to trendy boutiques Tokyo is an exciting metropolis of fascinating contrasts. We braved jam-packed subways to visit such diverse attractions as the venerable Shinto Meiji Jingo Shrine, the 7th century Sensoji Temple, the Tsukiji fish market (world's largest) and the futuristic Matsuya department store in Ginza. Leaving the bustle of Tokyo, we traveled to Hakone, an idyllic 300-year old rice-farming village noted for its thickly thatched roofed houses. Nearby, we caught our first glimpse of Mount Fuji poised majestically against a stark azure sky.  The following day we rode Japan's famous Shenzhen (Bullet) train to Takayama where we stayed at a ryokan, a traditional Japanese inn. From the outset we were pampered Japanese style: an in-room "onsen" (soaking tub), sumptuous meals served in our own private dining room luxurious massages and endless hot tea service. We timed our tour to attend the Takyama autumn festival. Streets were filled with throngs of celebrants, young and old, sampling the savory Japanese delicacies offered in the makeshift booths that encircled the festival area. On display were a parade of 30-foot high floats decorated with exotic lanterns and intricate motifs painted in the brightest hues. At night the streets came alive with shamisen (guitar) music, dancing "dragons" and the same colorful floats brightly illuminated in dazzling lights. In the morning, a ferry took us to Naoshima, a small island located just off the mainland. It's unique in that the entire island is dedicated to contemporary art. Even our hotel, the Benesse, doubled as a modern art museum. We visited many legendary Japanese gardens located throughout the country. These magnificently sculpted landscapes, such as the Katsura in Kyoto and Kenrokuen in Kanazawa are designed for silent contemplation and appreciation of nature.  As for getting around in Japan, we recommend an escorted tour or hiring a private guide. Given a limited amount of time, you will need help navigating Japan's extensive rail and bus system. Or, you can ask directions from the Japanese who are among the friendliest, most polite people you will ever encounter. "Lonely Planet" magazine rated Japan as the number two country to visit in 2016; we believe it should be number one." Back To Top
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Study Details Confirm Lower Blood Pressure Is Better
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 Decreasing blood pressure below current standards can indeed save lives and prevent more heart attacks, researchers confirmed Monday. Last September, a government-led team of experts created an uproar among heart disease experts when they stopped an ongoing study of blood pressure treatment to announce that patients who got more drugs to force their blood pressure lower were living longer and suffering fewer heart "events" such as heart attacks and strokes.
But they didn't have all the details yet. Now, they've released them at a meeting of the American Heart Association. And the details stand up. For blood pressure patients 50 and older, going for a reading of 120 millimeters of mercury (mm Hg) cuts events such as heart attack, stroke and heart failure by 25 percent. And people whose blood pressure was forced this low were 27 percent less likely to die over the three-year study than people whose blood pressures were at the current target of 140.
It was these findings that stunned the researchers and promoted a stop to the study so they could dig into the numbers. "When the benefits of the stronger intervention became apparent in SPRINT, we made a commitment to rapid public health communication and peer-reviewed publication of the study results," said Dr. Gary Gibbons, director of the National Heart, Lung, and Blood Institute (NHLBI), which sponsored the study.
The findings held up, the team told the meeting. "Regardless of whether the patients had cardiovascular disease or not, had kidney disease or not, were black or white, male or female, or above or below age 75 - all appeared to benefit similarly," Dr. Jackson Wright Jr., a blood pressure expert at University Hospitals Case Medical Center and Case Western Reserve University, told NBC News. Right now, people are told to get their blood pressure to 140 or lower. That's the top number in a blood pressure reading, known as systolic blood pressure.
It took, on average, three drugs to get a patient's blood pressure down to 120 - usually a diuretic, the first-line choice for lowering blood pressure, plus a drug called a calcium channel blocker and one called an ACE inhibitor. There are many choices within these classes of drugs. Each lowers blood pressure by a different mechanism.
Dr. Donald Lloyd-Jones of Northwestern University in Chicago, who was not involved in the study, welcomed the news. "This is a game-changer for many, but not all," he told NBC News. He said he'll look at working harder to get blood pressure lower in his healthy patients over 50. Certain bad side-effects became more common as blood pressure went lower. They include low blood pressure, fainting, abnormalities in compounds called electrolytes, and acute kidney damage.
But the researchers said people were not more likely to fall or suffer harmfully slow heart rates, and those with kidney disease did not see their condition worsen.
"The benefits of more intensive blood pressure lowering exceeded the potential for harm, regardless of gender or race/ethnicity," said Dr. Paul Whelton of Tulane University School of Public Health and Tropical Medicine, who helped lead the study.
But they're still following up to see if rates of dementia or other types of cognitive impairment might be different with lower blood pressure. Some studies have found some people have trouble thinking if they take too much blood pressure medication.
Cleveland Clinic's Dr. Steve Nissen said he wasn't sold yet. he said more analysis is needed, and predicted a great deal of "discussion". "I always worry that a rush to judgment - that an irrational exuberance will lead to over-treatment of people," Nissen told NBC News.
"We don't want to under-treat, and we don't want to ignore these results but we want to understand these results better before we change practice across the country."
Questions that need to be answered: Is it OK to get blood pressure to, say, 130? When do the benefits kick in between 120 and 140? Is it worth taking more drugs to get blood pressure lower?
"It's also important to remember that healthy lifestyle changes can make a difference in controlling high blood pressure," said NHLBI's Dr. Lawrence Fine.
The American Heart Association and the American Medical Association announced a joint initiative Monday to focus more attention on blood pressure.
A new target could be even harder to hit than the current blood pressure target.
"Currently, only about half of Americans with high blood pressure are achieving our recommended blood pressure reading of below 140/90 mm Hg," said Heart Association president Dr. Mark Creager, director of the Heart and Vascular Center at Dartmouth-Hitchcock Medical Center.
- by Maggie Fox, Health
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Be Sure You Have Our Correct Address!
| Paradise Valley Medical Clinic
Ninety Mountain View
9977 N. 90th Street, Suite 180
Scottsdale, AZ 85258
480.614.5800480.614.5800 (Phone)
480.614.6322 (Fax)
**Additional Top Floor Ramp Parking:
The 2nd floor ramp parking is very close to our door, but the entrance is at the VERY NORTH END of the parking area of the two buildings. You drive all the way North...enter at the NORTH END, then drive down to the SOUTH END of the 2nd FLoor Parking to get a space very near the entrance.
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Question On Your Lab Results?
Check out:
DoctorDoug's Academy 
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Dr. Lakin's guide videos on how to better understand your lab work results.....
Check the first edition here: | | DoctorDoug's Academy: Lesson #1 CBC |
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Important 2016 Note From
Dr. Lakin's Billing Supervisor. . .
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 This year all our patients will be asked to update their personal information before services are rendered. The front office staff plays a key role in obtaining patient information; the process can be made quicker by organizing your most current insurance cards and having your photo ID ready before your appointment. Each piece of requested information is important, a few minutes spent up-front will ensure information has been gathered accurately and your chart is properly prepared for the New Year. Having good information is a key piece in our ability to provide you excellent medical care. All of our patient forms are available online at www.doctordoug.com under the green patient information tab. From there go to New Patient Registration Forms and choose the form that needs to be updated. Remember, providing as much information as possible will reduce the need for our office to contact you a second time.
In 2016 Dr. Lakin will continue to participate with original Medicare only. The Medicare Part B deductible for 2016 is $166.00 and will be collected on the day of service. We also participate with Cigna PPO, Arizona Foundation for Medical Care, and CCN / First Health. Co-pays for all plans are payable at the time of your appointment.
Thank you in advance for your assistance. If you have any questions about the process you may contact me directly at the office. If e-mail is preferable I can be reached at veronica@doctordoug.com.
Best wishes for health and happiness in 2016.
Veronica
Billing Supervisor
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We Need Your Help!
|  Keeping you on your correct medication is as important to us as it is to you. With your help, we can be more efficient and be sure you are getting your refill requests on time and to your correct pharmacy.
Tips:
1. If you need a refill, be sure to call your pharmacy FIRST, not our office. They will know if you have more refills, and if not, they will call/fax/electronically message us with your request. Then we will contact you if there is a question or concern.
2. Remember to call your pharmacy in plenty of time so you do not run out of your medications. Sometimes we need up to 48 hours to complete a request and we do not want this to be a hardship for you.
3. Register and use our SECURE PATIENT PORTAL for refill requests. We monitor this continually and again will contact you if there is a problem.
4. Remember we do not refill pain or routine medications on Fridays or weekends and all pain medications must be picked up at our office. We cannot mail or any medications outside our office. Please plan ahead and make arrangements!
We are always here to help you and appreciate the opportunity to care for your healthcare needs!
Yours in good health,
Dr. Lakin & Staff
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Have You Scheduled Your Physical Yet?
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 As you all know, Dr Lakin is a strong supporter of annual physicals, and Spring is a time we can visit and explore any unresolved medical problems and any new health issues that need to be addressed. Annual physicals are one of the best ways to safeguard your health.
The American Medical Association recommends that if you are between the ages of 40 - 49 years, physicals should be done every two years. If you are 50 years plus, it is recommend you have yearly exams, especially if you have any chronic medical conditions that need to be monitored. Call to schedule your well care visit today!
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Are You Registered For Dr. Lakin's Secure Patient Portal?
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Now is the time!
For help on how to register and FAQ, check our these videos:
It's as easy as that!
**Please note that our Patient Portal is not 100% optimized for
Internet Explorer 11. Some of the functions will not work as intended. The software development team is working on it. Until then, please use Internet Explorer 8, 9, 10, or Mozilla Firefox, a free browser.
Please contact Nan at nan@doctordoug.com if you have further questions or concerns.
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AT THE MOVIES WITH BARB A.
|  GREAT + + + + ENTERTAINING + + + RENT THE MOVIE + + FORGET IT! + **EMAIL ME! ???
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BROOKLYN......
BOY THIS WAS A REAL SLEEPER FOR ME. I HAD READ A REVIEW IN PEOPLE AND THE SCOTTSDALE REPUBLIC AND DECIDED IT WAS A MUST SEE. SO.....I CALLED MY OLD BUDDIE JOAN AND OFF WE WENT TO BREAKFAST AND THE MOVIE. IT IS A LOVELY STORY ABOUT AN IRISH LASS WHO IMMIGRATES TO THE UNITED STATES. SHE HAS TWO LOVES AND TWO COUNTRIES AND DECISIONS TO BE MADE THAT WILL CHANGE HER LIFE. THE STAR SAOIRSE RONAN MUST RECEIVE AN AWARD FOR HER PART IN THE FILM. THE FILM CLEARLY BELONGS TO HER. WE BOTH LOVED IT. JOAN DID HER SHARE IN CRYING BUT THERE WERE LOTS OF LAUGHS AS WELL.
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CONCUSSION.....
A GREAT MOVIE REGARDING THE FIGHT OF A PATHOLOGIST AND THE N.F.L. DR. BENNET OMALU IS FROM NIGERIA PRACTICING PATHOLOGY AT THE ALLEGHENY COUNTY CORONERS OFFICE. AFTER DOING AN AUTOPSY ON MIKE WEBSTER (CENTER FOIR THE PITTSBURGH STEELERS), HE FINDS TAU PROTEINS IN HIS BRAIN. HIS DIAGNOSIS WAS CHRONIC TRAUMATIC ENCEPHALOPATHY, (CTE).DR. OMALU FIGHTS TO FORCE THE N.F.L. TO ACKNOWLEDGE THE TRUTH OF HIS FINDINGS AND IT'S RELATIONSHIP TO FOOTBALL CONCUSSIONS. WILL SMITH'S PORTRAYEL OF DR. OMALU IS ENGROSSING.
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SPOTLIGHT....
SPOTLIGHT IS T HE INVESTIGATIVE REPORTING UNIT OF THE BOSTON GLOBE. THEY DO NOT DISCUSS THEIR WORK WITH ANYONE..EVEN THEIR FAMILIES. THE STORY BEGINS IN THE 70'S WHEN A NEW EDITOR ASSIGNS THE ABUSE STORY OF 70 CATHOLIC PRIESTS WHO HAVE MOLESTED YOUNG CHILDREN. THE PORTRAYAL OF THE SPOTLIGHT'S NEWSMEN IS AN EXPERIENCE TO WATCH. THE INTERVIEWS WITH THE VICTIMS IS VERY TASTEFULLY DONE. THIS IS A TRUE STORY AND ONE HAS THE FEELING THAT THESE ARE NOT ACTORS BUT THE REAL PEOPLE WHO WORKED FOR MORE THAN A YEAR TO EXPOSE CARDINAL LAW FOR COVERING UP THE SEXUAL ALLEGATIONS. THE PRINCIPAL PLAYERS IN THIS FILM ARE MICHAEL KEATON, MARK RUFALO, RACHAEL MCADAMS AND BRIAN D'ARCY JAMES. THE ACTORS DISAPPEAR IN THEIR ROLES. THE NEW EDITOR WHO INSTIGTES THIS STORY IS PLAYED BY LIV SCHREIBER (MARELOUS) "AN UNMARRIED MAN OF THE JEWISH FAITH WHO HATES BASEBALL".
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THE REVENANT...
GOOD MOVIE BUT NOT THE BEST I HAVE SEEN LATELY. LEONARDO DI CAPRIO PLAYS THE MOUNTAIN MAN HUGH GLASS. ONE CAN SEE HOW AND WHY HE IS UP FOR AN ACADEMY AWARD, AS IS THE FILM ITSELF. THE SCENERY IS ABSOLUTELY SPECTACULAR AND I UNDERSTAND IT WAS FILMED IN CANADA AND ARGENTINA. I WAS WARNED ABOUT THE BLACK BEAR ATTACK AND I TELL YOU IT WAS AWESOME. I DIDN'T WANT TO LOOK BUT JUST HAD TO. THEY WILL NOT DIVULGE HOW IT WAS DONE BUT BELIEVE ME IT LOOKED REAL. THIS WAS EARKLY-19TH CENTURY NORTH AMERICA. THE ISSUE THAT SPOOILED THE MOVIE FOR ME WAS THE MUSIC. IT WAS SO LOUD THAT IT TOOK AWAY FROM THE FILM. DON'T PUT IN YOUR HEARING AIDS IF YOU WEAR THEM.
See you at the movies! |
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This fragrant, Italian-flavored soup takes advantage of quick-cooking ingredients-boneless, skinless chicken breast, bagged baby spinach and canned beans. It features a simple homemade basil pesto swirled in at the end to add a fresh herb flavor. If you are very pressed for time, you can substitute 3 to 4 tablespoons of a store-bought basil pesto.
Ingredients - 2 teaspoons plus 1 tablespoon extra-virgin olive oil, divided
- 1/2 cup carrot or diced red bell pepper
- 1 large boneless, skinless chicken breast (about 8 ounces), cut into quarters
Chicken Breasts Boneless Skinless
1 lb For $5.99
Thru 01/26
- 1 large clove garlic, minced
- 5 cups reduced-sodium chicken broth
- 1 1/2 teaspoons dried marjoram
- 6 ounces baby spinach, coarsely chopped
- 1 15-ounce can cannellini beans or great northern beans, rinsed
- 1/4 cup grated Parmesan cheese
- 1/3 cup lightly packed fresh basil leaves
- Freshly ground pepper to taste
- 3/4 cup plain or herbed multigrain croutons for garnish (optional)
Preparation - Heat 2 teaspoons oil in a large saucepan or Dutch oven over medium-high heat. Add carrot (or bell pepper) and chicken; cook, turning the chicken and stirring frequently, until the chicken begins to brown, 3 to 4 minutes. Add garlic and cook, stirring, for 1 minute more. Stir in broth and marjoram; bring to a boil over high heat. Reduce the heat and simmer, stirring occasionally, until the chicken is cooked through, about 5 minutes.
- With a slotted spoon, transfer the chicken pieces to a clean cutting board to cool. Add spinach and beans to the pot and bring to a gentle boil. Cook for 5 minutes to blend the flavors.
- Combine the remaining 1 tablespoon oil, Parmesan and basil in a food processor (a mini processor works well). Process until a coarse paste forms, adding a little water and scraping down the sides as necessary.
- Cut the chicken into bite-size pieces. Stir the chicken and pesto into the pot. Season with pepper. Heat until hot. Garnish with croutons, if desired.
Nutrition
Per serving: 204 calories; 8 g fat (2 g sat, 4 g mono); 29 mg cholesterol; 16 g carbohydrates; 18 g protein; 6 g fiber; 691 mg sodium; 529 mg potassium.
Nutrition Bonus: Vitamin A (110% daily value), Folate & Vitamin C (20% dv).
Carbohydrate Servings: 1/2
Exchanges: 1 starch, 1 vegetable, 2 lean meat, 1 fat
- By Eating Well
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We are all disappointed the Cardinals are not going to Super Bowl 50, but who is YOUR favorite!
 
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Have a safe and healthy Winter!
Dr. Douglas Lakin & Staff
Paradise Valley Medical Clinic PC
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