DOC'S DESK tag:mcbridemd.com,2008:/blog/1 2008-09-10T01:52:13Z OFFICIAL BLOG OF MCBRIDEMD.COM Movable Type 3.2ysb5-20051201 Urinary Tract Infections tag:mcbridemd.com,2008:/blog//1.37 2008-09-10T01:52:13Z 2008-09-10T01:52:13Z webmaster      I'm back after a longer than desired hiatus from my Blog.  Summer is finally over, the kids are back in school, and I finally have a breather for about two weeks.  I've had a very busy Summer and not enough time off.  Now, back to work on my Blog.  I thought I'd start the early fall off with this article concerning urinary tract infections.  If you've had just one, you never forget the symptoms.  It's not as bad as your first kidney stone, but almost in some instances.  I was reminded today of how many bladder infections I treat annually in my office or when on call for my group.  In one weekend I can treat several bladder infections.  I found a very comprehensive article on urinary tract infections that I've provided a link to.  Urinary Tract Infections.  Please read this article, especially if you suffer from these on a frequent basis.  There are some preventive measures you can do that may prevent your next infection.  I will offer two final words of advise.  First of all, treat it early to avoid further complications.  Secondly, if you've had more than two of these in one year, you should see a urologist to rule out treatable causes.  Doc ]]> Mercury Levels In Fish tag:mcbridemd.com,2008:/blog//1.36 2008-05-03T23:51:14Z 2008-05-04T00:16:49Z webmaster      I thought this would be a good topic to revisit since this subject is constantly a source of inquiries by my patients.  I published an article on this topic a long time ago, and when I started my blog, Doc's Desk, I shuffled this article into an archives section of my website.  Well, it's time to place it on Doc's Desk.  I would recommend reading the article on Mercury Levels in Fish first and then read the following commentary I took from my archives. 

Commentary:

     My take on this article is that it does clear up some previous concerns about mercury and fish.  One minor deficiency with this article was that it did not include all specific deep-water fish that people eat.  Is a Chilean sea bass safe to eat?  I just love that fish.  Is that the same as saltwater bass?  I also concluded from this article that the longer the fish lives, the more dangerous it is to eat.  Those fish have more years to accumulate this methyl mercury in their systems.  I also concluded that a shark, which is a predator, feeds on other fish.  These fish that are eaten have had time to accumulate their share of methyl mercury.  The shark builds up the methyl mercury exponentially because of their feeding habits.

     In conclusion, avoid consumption of shark, swordfish, king mackerel and tilefish.  I'll continue to eat my sea bass.  Doc

]]> Great Quote!!! Worth Sharing tag:mcbridemd.com,2008:/blog//1.35 2008-02-28T03:16:13Z 2008-02-28T03:16:13Z webmaster Always keep people in your life that charge your battery,
     not those who will drain it.
]]> Cancer In Women tag:mcbridemd.com,2008:/blog//1.34 2008-02-28T02:48:21Z 2008-02-28T02:50:42Z webmaster      I thought this general topic should be revisited.  I found this interesting presentation in pdf format from The American College of Obstetricians and Gynecologist and thought I'd provide a link to it for your perusal.  It's an basic overview of common female cancers and how to possibly protect or detect them.   Doc 

Link:  Protect & Detect  From ACOG

                                                                              

]]> Total Laparoscopic Hysterectomy tag:mcbridemd.com,2008:/blog//1.33 2008-01-11T03:47:30Z 2008-02-28T03:36:45Z webmaster      I've now added a new dimension to my surgical practice.  It's total laparoscopic hysterectomy (TLH or LTH).  It's the newest and ultimate way to perform a total hysterectomy with shorter hospital stay and return to normal activity.  It's required my extending my training further up the ladder to be able to perform this operation.  I've been performing hysterectomies for 32 years as well as laparoscopies, but this operation is the ultimate melding of the two procedures.  Hysterectomies have been performed for many decades, mostly abdominally and vaginally.  I was trained initially in doing both back in the 1970's, but over the last few years, the laparoscopic approach added more choices for the surgeon and the patient.  The different types of hysterectomies (with or without removal of the ovaries) being done today are as follows:

Total Abdominal Hysterectomy(TAH): Performed with a large incision (laparotomy) (2-3 day stay in hospital)

Total Vaginal Hysterectomy (VH):  Performed vaginally with no visible incisions (1-3 day stay)

Laparoscopic Assisted Vaginal Hysterectomy(LAVH): Performed vaginally with laparoscopic assistance.  This surgical procedure designed initially to convert a difficult hysterectomy perhaps done abdominally into a safer and easier vaginal hysterectomy.  Most of the operation is done initially thru the laparoscope down to the cervix with the cervix being removed by the vaginal approach.  (usually 3-4 small abdominal incisions) (1-2 day stay)

Laparoscopic Supracervical Hysterectomy(LSH or LSCH): Performed laparoscopic only with just removal of the body of the uterus and leaving the cervix behind.  Uterus is morcellated thru the laparoscopic incision.  All surgery is performed laparoscopically. (Outpatient-1 day stay)  (Still have cervix and must have pap smears)

Total Laparoscopic Hysterectomy(TLH or LTH):  Complete removal of uterus via laparoscopy surgery.  All the surgery is done laparoscopically most of the time.  Uterus is removed vaginally after hysterectomy is complete and most, if not all suturing is performed laparoscopically to complete the closure of the vaginal vault. (1 day stay)

Confused yet?  The type of hysterectomy to be performed depends on many variables including the patient's physical findings and desires as well as the doctor's training and recommendations for what's best and safest for the patient.  Not all patients are good candidates for VH, LAVH, LSH, or TLH.  I hope this has been informative.  Doc 

]]> Medical Check List For Year-End 2007 tag:mcbridemd.com,2007:/blog//1.32 2007-11-27T02:31:27Z 2007-11-27T02:33:37Z webmaster      By now, everyone has finally consumed those last remnants of the big bird and maybe already done a little Christmas shopping.  This is a good time to go through a medical check list before the year ends.  Some of you have a fairly significant medical insurance deductable that has been met for the year, and because of that, any medical expenses incurred before the year ends would be a lot cheaper for you than waiting until this January to do.  I will go down a list of medical procedures you still have four weeks to complete if you can.

1.  Annual Exam-  Are you due or overdue for this?  When was your last pap smear?

2.  Mammogram-  Some places are already booked into January, but there are still centers that have openings

3.  Annual Lab Work-  Lipid profiles, Liver profiles, Thyroid testing and Metabolic profiles

4.  Radiologic Procedures such as chest X-rays, ultrasounds, C-T scans or MRI's you are required to do because of pre-existing medical conditions.  Were you required to do a follow up on any of these procedures this year and did not do it?

5.  Other Lab Testing such as EKG's, treadmill, angiograms either as primary testing or follow- up testing.

6.  Procedures such as colonoscopy, gastroscopy, and other endoscopies.  Are you over 50 and still not had a colonoscopy? 

7.  Other specialized medical exams such as dermatologic, hematologic, oncologic, urologic, etc.

You still have time, if you want it done before the end of the year.  Otherwise, there's always next year.   

]]> Colon Polyps tag:mcbridemd.com,2007:/blog//1.31 2007-09-03T20:47:47Z 2007-09-03T20:47:47Z webmaster      This is a good topic to follow my last one.  Nearly all colon cancers develop from a pre-existing colon polyp.  This adds further credence to screening for colon polyps.  The majority of polyps are benign.  Adenomatous polyps have malignant potential and most hyperplastic polyps do not.  Adenomatous polyps, in the greater majority of cases, are the precursors to most colon cancers.  By removing them, we should lower the risks of colon cancer in that individual.  It apparently takes some time before an adenomatous polyp undergoes malignant change.  I encourage my patients over 50 to get their colonoscopy.  Get your screening if you have not.  Doc]]> High Fiber Diet tag:mcbridemd.com,2007:/blog//1.30 2007-06-18T17:57:19Z 2007-06-18T17:57:19Z webmaster      This is a good topic to post on my blog.  It is a necessary part of maintaining good colon health for each and everyone of you.  I found a good link for you to peruse concerning what exactly is a high fiber diet.  It is essential to us living in this country to increase our daily intake of a high fiber diet, since a lot of us have gotten off tract with the current American diet we are exposed to daily.  I know that I'm very guilty of that.  Sure love those cheese burgers.  However, I try to eat them on a whole wheat bun.  Maintaining a high fiber diet can be beneficial in treating certain G.I. problems and even help reduce the risk of colon cancer.  Please review the article on high fiber diet that I've created a link to for more information on this topic.  Doc ]]> May Is Osteoporosis Awareness Month tag:mcbridemd.com,2007:/blog//1.29 2007-05-21T21:50:09Z 2007-05-21T21:50:09Z webmaster      May is Osteoporosis Awareness Month.  If you have not had a screening bone density yet and you are over the age of 45, you might want to get one.  We provide them on site at my office.  They take approximately 15-20 minutes to perform.  Visit my Bone Density Site on my website.  Call to make an appointment for your screening.  ]]> Gardasil-The HPV Vaccine tag:mcbridemd.com,2007:/blog//1.28 2007-02-21T02:32:09Z 2007-02-21T02:32:09Z webmaster      Well, it's been out for several months.  Have your young daughters been vaccinated yet?  Have you suggested it to your adult daughters?  Have you considered it?  I have not been impressed with the enthusiasm to get this vaccine.  I have a significant number of inquiries about it weekly, but have not seen the numbers I thought would be coming in to actually get the vaccination.  I believe the clinical trials done on the vaccine prove the effectiveness and safety in preventing infections with HPV subtypes 6,11,16,and 18.  I have told patients that I do believe we will have more different vaccines coming out.  Maybe, that is the reason for the hesitancy to get vaccinated with Gardasil.  The cost of it and whether the insurance will cover it are other possible reasons.  I do not believe the vaccine should be mandated to any age group.  I do believe at this present time, it should be recommended to parents of minors.  The parents should have the final decision on the vaccine if their daughters are minors.  Gardasil is probably just the beginning of the vaccines to come.  I believe in the near future there will be a more multivalent vaccine more inclusive of the other High Risk HPV subtypes besides 16 and 18.  Gardasil is a good start though when you consider that subtypes 16 and 18 are responsible for 70% of cervical cancers in this country.  Parents of young minors should discuss the vaccine with the pediatrician and parents of teenage daughters should consider talking with a gynecologist for further advice.  I hope this has been helpful.  For more information on Gardasil visit there website at Gardasil.com.  Doc]]> Handwashing-An Ounce Of Prevention tag:mcbridemd.com,2007:/blog//1.27 2007-02-14T23:16:42Z 2007-02-14T23:16:42Z webmaster      This is a topic I've been discussing in my practice for the last several weeks with my patients.  If you take a good look at my hands you'll realize that I adhere to fairly rigid handwashing techniques.  I'm probably an obsessive-compulsive individual when it comes to handwashing.  You should read this interesting historical overview of how the practice of handwashing in hospitals began to save womens' lives after childbirth in the 1800's.  It was actually safer back then to deliver at home rather than a hospital due to the high post-partum infection rates in hospitals.  Good and frequent handwashing during the day can lower your chances of viral and bacterial infections.  That's the ounce of prevention.  You don't have to get obsessive-compulsive about it.  Next time you're at a public function, count how many times you shake someone's hand.  Then ask yourself where those hands have been.  They've been shaking other hands.  Right?  Great way to spread a virus and bacteria.  Wash you hands when you get a chance.  You may then notice a significant reduction in you own infection rate.  Good luck and don't become OC about it.  Doc       Here's another website of interest on this subject:  http://www.StopGerms.org   ]]> Genital Herpes-No Cure Yet tag:mcbridemd.com,2007:/blog//1.26 2007-01-17T21:37:14Z 2007-01-17T21:37:14Z webmaster      This is a topic I've been wanting to talk about for quite a while.  Genital Herpes is caused by two separate viruses, HSV-1 and HSV-2.  HSV stands for Herpes Simplex Virus.  It is estimated that almost 20% of individuals aged 12 or older in this country are seropositive (blood test positive) for HSV-2.  I've heard much higher figures quoted for adults in this country.  I've been around long enough to remember that back in the early 1970's, there were experts prognosticating that a vaccine would be found for the prevention and maybe cure of this incapacitating and sometimes lethal virus.  Well, it's 2007 and where is it?  We have several drugs that do work for suppression and treatment of the outbreaks, but there is no vaccine for prevention or cure.  Please visit this CDC site on Genital Herpes for more detailed information.  Doc ]]> Abnormal Uterine Bleeding tag:mcbridemd.com,2006:/blog//1.25 2006-11-17T03:01:27Z 2006-11-17T03:01:27Z webmaster      This is a very common problem I encounter in my office sometimes several times a week.  It seems that I've seen more of this problem this year than ever before.  I've included an interesting link on abnormal uterine bleeding that you should read.  I like it because it covers all age groups including premenopausal, perimenopausal and postmenopausal women.  I would urge you not to ignore this problem if you have it.  I would also suggest to you that until you have an exam and perhaps workup, the source of the vaginal bleeding is not really known.  The bleeding may also be originating from vaginal or cervical sources rather than the uterus.  See your doctor if abnormal vaginal bleeding is persistent if you are premenopausal or perimenopausal.  Any vaginal bleeding in a postmenopausal women not on hormones definitely needs evaluation.  Finally, any bleeding while taking hormone replacement therapy at least deserves a phone call to your doctor and perhaps a visit for evaluation.  Doc ]]> Prostate Cancer Screening-Something For Men tag:mcbridemd.com,2006:/blog//1.24 2006-10-06T02:24:33Z 2006-10-06T02:24:34Z webmaster      I have wanted to discuss this topic for a long time.  So, here goes.  Even though this is a male topic, I believe it's important to disseminate this information out to you wives, girlfriends and daughters.  Maybe you can make a difference by playing a role in encouraging your significant other to get his PSA (prostate-specific antigen) screening.  It could save his life.  If your husband, boyfriend, or significant other is over the age of 50, you may want to encourage him to get the blood test.  This blood test coupled with an exam are the most important screening tools for diagnosing this cancer in it's early stages.  This early diagnosis can effect a cure in most males.  Check this link out for more information.  Doc

http://www.prostatecancerfoundation.org/site/c.itIWK2OSG/b.47285/k.CCF1/Detection__Screening.htm

]]> Choosing Your Doctor tag:mcbridemd.com,2006:/blog//1.23 2006-09-17T18:37:06Z 2006-09-17T18:37:06Z webmaster      I thought this would be an interesting topic to discuss so you can get my views on this subject.  I'm very opinionated on this matter.  When choosing a doctor for your health care, what do you do?  Health care has changed so much in the last two decades with the emergence of managed health care.  That has also had it's effect on access to healthcare, sometimes presenting roadblocks to providers.  Some suggestions for choosing a provider are as follows:                                      

1.  Ask your friends, family and co-workers for suggestions.  I believe this is how the majority of patients choose a doctor.

2.  Get referrals from hospitals that you would go to for health care.  Most hospitals have a list of doctors who are credentialled at their facility.  I would suggest you should inquire about the doctor's hospital affiliations.  The doctor you choose may be very qualified, but perhaps practices at a hospital you would care not to go to. 

3.  Call local, state, and national medical and specialty societies for referrals.  Many county medical societies have a referral center.  The physicians on this referral list will be in good standings with the medical society.

4.  On-line referrals from different websites can also be very useful.  There are a growing number of these sites on the internet.  My website has a link on the Home Page to one of these on-line referral services.

5.  Check out your insurance provider book or on-line service for referrals.  You might do this after you get a provider name to determine if this provider is on your insurance and not out of your network.

6.  Get a referral from another doctor.  I seem to do this service a lot in my practice.  So, don't hesitate to ask me or my staff. 

7.  Check out the provider's credentials.  I would suggest choosing a specialist or generalist who is board-certified or at least, board-eligible.  Some physicians maintain a website that will offer more information about their education, training and interest.  

8.  Finally, one can always call the doctor's office and make further inquiries before scheduling an appointment.  I hope this has been helpful.  Doc 

Oh, I forgot.  There's always the Yellow Pages. Ha!

  

 

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