Wise Ideas

Swine Season

Can you imagine being the receptionist in a doctor's office this week (unless of course, you ARE a receptionist in a doctor's office)?  If our pediatrician's office is any indication -- you'd better hope your child doesn't actually get really sick, develop a rash, or blow up from a bee sting this week - because getting through the jammed phone lines is impossible.

It's much easier getting through to Dr. Google....although sorting through the nearly one million results for the search term "swine flu symptoms" could be the death of you. 

What's making this swine flu outbreak even trickier for health care professionals is that flu season - of the non-swine variety - is still in its last throws.  According to the CDC's website, "the symptoms of swine flu in people are expected to be similar to the symptoms of regular human seasonal influenza and include fever, lethargy, lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea."

Which begs the question -- what's the difference between the two?!  Thus, the jammed phone lines at every doctor's office across the country.  Front-line health care professionals, many of whom admit they were just as surprised by this outbreak and the speed of its transmission as you and I, are overwhelmed.  And questions are mounting while cases are doubling. 

Although I am not panicked (despite the fact that our family traveled to San Diego for spring break and spent some quality time at public places like the Zoo and SeaWorld)  - I am comforted by the fact that "it was a routine call last Thursday from a diligent high school nurse that put health detectives in New York City on the trail of a swine flu outbreak," as the NYTimes reports.

Unfortunately, public school nurses went the way of public school P.E. teachers here in California long ago.

So if my child has a runny nose, vomitting, and diarrhea -- should I be calling her doctor?  "That's a very good question," Dr. Kathleen Neuzil, chair of the Influenza Working Group of the Centers for Disease Control Committee on Immunizations Practices, kept telling every caller on NPR's Talk of Nation yesterday. 

A good question, with no answer.  Just like what happens when you call your doctor's office.  Because what's even more scary than an actual flu pandemic, is finding out whether or not we're prepared for one.

Doctor's Orders?

You'll pardon me, but I'm going to veer off the marketing/media/advertising trail today because to be honest, I'm a little stunned after a visit to my doctor yesterday.

Everything's fine - which I suppose should actually be the headline. 

But as we were discussing my newly reached milestone (turning 50), the normal, female-related issues that come with age, and the five stress-related pounds I've gained in the past three months --she pinched my newly sprouted love handles and calmly said "you should consider liposuction."

WHOA!  You turn 50, gain a little weight that still puts you in the lower range of BMI for your age, height and weight --- and a primary care physician with YEARS of experience suggests liposuction?  Was she serious?  "I had a little done," she said smiling -- and then moved onto taking my blood pressure.  And that was the end of that.

The liposuction-bomb has had me reeling ever since.

When I got home, I immediately consulted Dr. Google and started my educational process on fat-sucking.  Within a half hour I had learned that there's a new, quicker, less painful and less invasive form of liposuction called SmartLipo or LaserLipo - which also reduces a patient's recovery time.  

I started reading testimonials by doctors and other plastic surgery "experts" on sites I'd never heard of before, like this one on MakeMeHeal.com:  "one of the disadvantages of (traditional liposuction) is its tendency to leave behind unattractive, loose skin. This is where Smartlipo, an innovative laser-assisted device, enters the playing field. It is also one of the reasons it is rapidly becoming the gold standard for the removal of unwanted body fat."

""Smartlipo works well as a standalone body contouring option, but it is also very effective when combined with traditional liposuction, a tummy tuck, or other cosmetic procedures," a Los Angeles plastic surgeon says in this PR release issued by his practice.  

And - if you can stomach it (pardon the pun) - you can read a "review" on RealSelf.com from a San Francisco woman who walks readers through her entire SmartLipo procedure including her recovery:  "I don't have much bruises on front and back, just 2 spots like quarter sizes. and they are mostly gone."  She posts "before and after" pictures to back her claims.

(FYI, since RealSelf is a review site, "76% say Smart Lipo was worth it.  24% say Smart Lipo was not worth it.")

According to this press release from the American Society for Aesthetic Plastic Surgery, over 10.2 million cosmetic surgical and nonsurgical procedures were performed in the United States in 2008. The most popular nonsurgical procedure was (not surprisingly) Botox injections.  But in the surgical category, there was a surprise.  For the first time since the ASAPS began keeping statistics, liposuction slipped to the second most popular cosmetic surgery - behind breast augmentations.

Liposuction has an excellent chance to regain it's Number One ranking however, as word spreads about SmartLipo, which is exactly what my doctor was doing today when she dropped the Lipo-bomb.  Not coincidentally, the offices next to hers are those of some high-end plastic surgeons.

Come to think of it, I guess I'm not as stunned by the suggestion as I thought, because as you can tell, I DID end up talking about marketing and advertising today. 

420 Day

You might want to look more closely into the eyes of your teenager today.  The redness and sensitivity to light may be more than just spring allergies.

I learned over the weekend from a teen-in-the-know that today is 420 ("four-twenty" in teen parlance), the day teens across the country show up at school stoned.   Not all teens, mind you.  Just the ones who probably get stoned in the morning in the first place.  Still, the parents I was with when we learned of this "tradition," (and who incidentally did their fair share of stupid things in high school,) were pretty surprised that :  A)  there was such a thing as 420 Day, and B)  that none of us had heard about it before.

My curiousity peaked, I googled "420" and instantly came up with this Huffington Post piece saying that 420 actually takes pot smoking beyond high school kids, and puts it right into the mainstream - or at least the mainstream that still uses rolling papers, pipes and bongs.   April 20 is "National Pot Smoking Day," according to the HuffPost.  "A day where people across the world celebrate in the conspicuous consumption of the magical herb, marijuana. It's an unofficial counterculture holiday that is based on the simple concept of smoking some cannabis and being happy."

My teen informant, however, did not have a clue why 420 - and not 615 or more likely 711 -- a brightly lite place where many a stoner has snuffed their munchies with packages of Hostess SnoBalls and Funyons, washed down with a ginormous Slurpee. 

However, leave it to the SFChronicle to trace the legend to a group of stoners at San Rafael High School.  According to High Times editor Steven Hager, back in 1971 there was "a group of about a dozen pot-smoking wiseacres who called themselves the Waldos. The term 420 was shorthand for the time of day the group would meet, at the campus statue of Louis Pasteur, to smoke pot.  The term took root, and flourished, and spread beyond San Rafael with the assistance of the Grateful Dead and their dedicated cohort of pot-smoking fans."

Fast forward 38 years, and an estimated 40-percent of Americans have smoked pot according to The National Institute on Drug Abuse, including our current President as well as his two predecessors.  Medical marijuana can currently be prescribed to ease the pain and symptoms of many tortuous ailments.  And there's actually serious talk in political circles about limited legalization or limiting prosecution.  In fact, today's headline in the NYTimes says that "For Marijuana Advocates, Not-So-Secret Holiday Hints at Change."

But although I'm perfectly willing to give 23-year old Michael Phelps the benefit of the doubt after getting caught on a camera phone toking up at a college frat party during his off-season, and wouldn't hesitate to to ask for a pot prescription were I in pain from cancer treatments --- I'm not nearly so cool when it comes high school kids showing up at school stoned - on April 20th or any other day. 

It's the great parenting paradox of the baby boomer and beyond generations -- do as I say and not as I did, or in some cases, still do.

Why do you think they call it dope?  Remember?

Of Peanuts, Pills and Who's Keeping Us Safe (not so much....)

What do peanut products and pills have in common - besides the fact that both are ingested?  Not much. 

However, despite the fact that food and drugs are entirely separate beasts, and that oversight of either one is a massive, complicated, intricate and extremely crucial public health and safety job - we continue to trust just one government agency to handle both.

"Trust" however, might be a bad way to describe it.  The current peanut crises that has now claimed 9 lives, sickened 600 people and resulted in the recall of nearly 2,000 food products, is just the latest nationwide health scare to beset the overwhelmed federal Food and Drug Administration.  

The FDA's ability to keep our food supply safe in recent years has been about as effective as Congress's attempt yesterday to grill Mr. Peanut Corp. of America about how his tainted company contaminated our food chain.  In a discussion on the Room For Debate blog at NYTimes.com, Former FDA commissioner David Kessler says bluntly that "the tools and resources that the agency has at its disposal are so limited that it’s no surprise that problems go undetected."

But it hasn't just been the FDA's tardiness in tracking tainted food products to their source -- but also its reluctance - politically-motivated and otherwise - to press the drug industry on issues that put millions at risk, as occurred a few years back with the painkiller Vioxx.

"The agency is at a tipping point," William Hubbard, an FDA administrator for 14 years tells NPR's All Things Considered.  "The budget is in terrible shape, and the challenges are escalating," (although you could say that about any federal agency these days).

So while the Obama Administrator looks for someone to appoint commissioner of the FDA (a position that is currently unfilled and ranks right up there with U.S. President as "worst job in America"), calls are growing louder to split the FDA into two separate agencies.  Democrat Rosa L. DeLauro of Connecticut is planning to re-introduce a bill to Congress proposing just such a split.  The "Food Safety Modernization Act" would divide the FDA into two distinct agencies—one for food safety, and the other to oversee pharmaceuticals and medical devices.

Standing next to the mother of a boy killed by salmonella-tainted peanut products, DeLauro says "the tragedies are preventable if we have the will to fix the system.  The push for change could not be more urgent."

But change, as we've witnessed, is glacier-like in Washington.  And the cost of splitting a behemouth agency into two smaller, swifter ones?  Unknown.  But the cost of not doing it is becoming more and more evident.

As Jon Stewart said on The Daily Show this week: "Funding for regulatory agencies?  Please.  Now if you'll excuse me, I have a peanut butter, spinach, tomato and Chinese toy sandwich to finish."

Procrasti-Nation

If you are reading this blog instead of doing something else waaaaaay more important on your To-Do list....you may be suffering from a chronic and serious disease.

At least that's the belief of Professor Joseph Ferrari of DePaul University in Chicago, who says the art of time-wasting has become an affliction that is now ruining millions of lives - threatening careers, relationships and health. 

In an article that's got the procrastinator-rich blogosphere buzzing, Professsor Ferrari tells the UK's Observer that "chronic procrastination is now so serious a condition it needs to be recognized by clinicians."  In a study to be published later this year, Ferrari estimates that one in five of us classify as chronic procrastinators.

And because we are a people that always seeks to lay blame - this increasing number of uber-procrastinators is being blamed on technology.  It seems the conventional wisdom among experts in this field is that computers, the Internet, mobile phones, iPods and the like are providing too many distractions for us humans to concentrate on more important matters.

And while procrastination is part of the fabric of this nation (Congress is the definition of the word), Ferrari says this is no laughing matter.  "It encourages depression, lowers self-esteem, causes insomnia, and indirectly affects health by discouraging visits to the dentist or doctor. Sufferers are also more likely to have accidents at home involving unmended appliances," the Observer notes.

But it's not the health impact of procrastination that causes the most concern.  It's the economic impact.  As Yahoo's "Working Guy" blogger Christopher Null notes, "that little chime that rings when an email message arrives, says research from Calgary University, causes a 0.5 percent drop in the Gross Domestic Product here in the United States, costing the country $70 billion a year, as employees are distracted from the task they're supposed to be focused on."

But not everyone who procrastinates does so by wasting time online.  I, for instance, often pick a home cleaning task to "waste" my time on while I put off other business.  If it wasn't for my procrastination tactics, my house would be a pigsty!  Little did I know that this is known as "structured procrastination," and is the subject of an essay (and website) by Stanford philosophy professor John Perry.

"The key idea is that procrastinating does not mean doing absolutely nothing," Perry writes.  "Procrastinators seldom do absolutely nothing; they do marginally useful things, like gardening or sharpening pencils or making a diagram of how they will reorganize their files when they get around to it."  Perry's website, StructuredProcrastination.com, even features a picture of the author "jumping rope with seaweed while work awaits."  Perry is my new hero.

I'd like to see Professor Ferrari and Professor Perry square off in a debate on this issue --- which I think I can safely say ALL of us can relate to.  For now though, you can listen to this recent discussion of procrastination on NPR's Talk of the Nation.

But then again, that would be procrastinating, wouldn't it. 

I Love to Go a Wandering.....

Without any regular schedule to grasp onto, the mind wanders easily during these dog days of summer.

For instance....

Which is going to kill me first: my shower curtain or my cell phone.  Forget the toxic plastic the curtain is made from.  I'm more likely to kill myself slipping in the tub.  And forget the cancer-causing emissions from my cell phone.  I'm more likely to die in a car crash caused by some guy or gal chatting on their cell phone.  See for yourself on the National Safety Council's Odds of Dying chart, which is fascinating statistical reading.  Oh, and BTW -- The NY Times is reporting that your granite counter top is apparently out to get you, too. 

How in the world did Ford not see this coming - reporting an astonishing $8.67 billion dollar loss in the second quarter due to the drop in sales of its SUVs and trucks.  It plans to retool two SUV/truck plants in the coming years to make more smaller, fuel-efficient cars - but those vehicles won't make it off the line and onto the lots until 2010.....too little, to late.  It seems a lot of American auto executives have been asleep at wheel for the past decade.

Americans are back to quietly sipping up their suds, after being up in arms last week about the takeover of Budweiser by Belgium beverage giant InBev.  "National brands (of beer) either acquired or wiped out regional brewers after World War II. Now the biggest of them all has itself been gobbled up like so many pretzels during happy hour. What's next? McDonald's taken over by the French? Starbucks by the Italians?" asks The Baltimore Sun.  The answer came yesterday when it was revealed that Chateau Montelena, a California winery famed for stunning the wine world in 1976 when it beat French vintages in a famous Paris tasting, is being sold....to the French.  And not just any Frenchman.  Michel Reybier, owner of Chateau Cos d'Estournel in Bordeaux.  Yes - THE legendary Bordeaux. 

Sacrebleu!

And while that may say a lot about the quality of California wines and the respect they've gained worldwide...it says even more about the desperate state of the American dollar - and the Let's Make a Deal mentality currently sweeping the globe.  Behind door number three - Genentech, the world largest biotech firm located here in the Bay area....and the $43 billion dollar bid to buy it from the Switzerland-based Roche.

Time to get another glass of wine, or bottle of beer, and ruminate on these and other issues.  That is, unless my mind wanders again.  Happy Friday.

Killer Curtains and Other Household Hazards

Summer brings with it lots of seasonal health hazards:  poison oak and ivy, water accidents, sunburn, dehydration, drinking from a BPA-based water bottle, salmonella outbreaks, shower curtain smells.....wait......WHAT THE...?

In a newly released report the Center for Health, Environment and Justice says there's a threat lurking in your shower much greater than that of a cross-dressing Anthony Perkins with a knife.  The report, titled "Volatile Vinyl," claims that vinyl shower curtains sold at major U.S. retailers emit toxic chemicals linked to serious health problems.  These killer curtains, sold at Bed Bath & Beyond, Kmart, Sears, Target and Wal-Mart among others, are made of polyvinyl chloride, or PVC....a known human carcinogen that can cause liver cancer.

The smell of a new vinyl shower curtain is the dead giveaway (pardon the bad pun).  The CHEJ commissioned this study two years ago to determine what, exactly, causes that oh-so recognizable odor.  "This smell can make you feel sick, give you a headache, make you feel nauseous or [cause] other health effects," Michael Schade, a coauthor of the report, is quoted as saying in the LATimes.

Lo and behold -- dozens of the chemicals used to make the curtains contain known health hazards.  "Seven of these chemicals have been identified by the Environmental Protection Agency as hazardous air pollutants" Stephen Lester, CHEJ's science director and study co-author tells the Kansas City Star.  "“Nobody really looked to see what these chemicals were or whether they were toxic, and what risk they posed,” he says.

However, it should also be noted that the companies making these curtains have been aware of the potential hazard, and have been working to phase out PVC-based curtain altogether according to the study's authors. 

Now...I prefer to steer clear of toxic chemicals as much as the next person....maybe even more since come-from-nowhere cancers run in my immediate family.  But I gotta be honest with you, I have to think that there's greater chance that I'll fall in the bathroom and crack my head on some porcelain, than I will of contracting liver cancer from a new shower curtain.

According to Home Channel News, 70 percent of all household accidents - or 200,000 per year - happen in the bathroom.  These statistics are taken very seriously by all the people who make the stuff that goes in your bathroom...particularly the hardware manufacturers of so called "grab bars," those things you reach out for as you're slipping to your death in the tub. 

So really, is it the smell of the shower curtain that's gonna kill you....or being electrocuted when your plugged-in hairdryer accidentally falls into the tub while you're in it?

Your life is at risk from the moment you step out of bed in the morning, until the moment you get back into it at night.  What do you think has a greater chance of killing you - your shower curtain, or that double-cheese burger with tomato that you ordered today?  Because if that tomato doesn't get you first....that heart-stoppping burger you get twice a week just might.  The shower curtain doesn't stand a chance.

The Sex & Cereal Connection

The next time you go to the grocery store, don't be surprised if you find a number of women in their prime children-bearing years stocking up on Cheerios, Shredded Wheat and Frosted Flakes.

That's because yesterday, some surprising news hit the wires saying that researchers have for the first time, found a link between a woman's diet prior to pregnancy and her future baby's gender.  Or, as the study, printed in a British medical journal, more simply puts it, "you are what your mother eats." 

As The Associated Press reports, "having a hearty appetite, eating potassium-rich foods including bananas, and not skipping breakfast all seemed to raise the odds of having a boy."  And because cereal is the most common breakfast food eaten in England (and probably here in the U.S., too), the study revealed that "women who ate at least one bowl of breakfast cereal daily were 87 percent more likely to have boys than those who ate no more than one bowlful per week."

Put another way, the women in the study who who had a higher calorie diet tended toward having boys, while the majority of those with a low cal diet had girls.  You can read more on The WaPost's health blog, Check Up.

Other fertility experts caution that although the study's results are plausible, it's no reason for women to pig out if they want a boy, and starve themselves if they want a girl.

As one UCLA OB says, ""The bottom line is, we still don't know how to advise patients in how to make boys."
That is, unless you buy into the old "boxers make boys" theory....one among many you can read at HowToHaveABoy.com. 

But you've gotta admit, the new study brings a whole new meaning to "Lucky Charms."

A FEW MORE FOOD NOTES TODAY:
The theory that Starbucks has become an economic bellwether gained grounds today, as the coffee chain issued a warning that it's first quarter earnings are weaker than expected, and it doesn't look so good for the rest of the year, either.  The company says its business has been particularly bad in two of its largest markets, Florida and California, where the housing market  has been hardest hit.

Just this week I wrote in Grocery Woes about how we didn't have it so bad here in the US, as the rest of the world grapples with a grain and rice shortage that's causing food riots and destabilizing governments.  It seems we are not immune. A run on rice here in the states has prompted big box stores Sam's Club and Costco to start rationing rice.  As you can read here in the San Jose Mercury News, rice prices have  soared and prompted a number of people to begin stockpiling.  Costco's CEO  blames the media.

 

Pharma Fools Day

Did you hear the news?  The pharmaceutical companies that manufacture the leading brands of "the pill" have just announced that, although it eases the discomforting symptoms and length of the user's menstrual cycle, research shows the pill is really NOT effective in preventing pregnancy.

April Fools! 

Thank your lucky stars and modern chemistry that you don't have a dozen kids right now.

However, the news from a panel of cardiology experts this week, in response to a report on the popular cholesterol drugs Vytorin and Zetia, was no joke.  The panel, along with editorials in The New England Journal of Medicine, recommend that doctors prescribe the two drugs only as a last resort because the research shows they basically don't work. 

Needless to say, the news - which incidentally was first reported back in January and which I wrote about here on Wise Ideas - has already resulted in a congressional investigation, and has turned into a kind of "bad cholesterol" on Wall Street for Merck and Schering-Plough.

And while politicians, physicians, scientists, investors, traders and TV doctors debate who knew what when and why they kept it to themselves for so long...one of the most interesting takes on this comes from BusinessWeek magazine, which says this whole incident "may go down as a seminal lesson in the dangers of over-aggressive drug-industry marketing." 

Together, Zetia and Vytorin raked in more than $5 billion in sales last year.  But it's not like consumers were just seeing the ads and buying it off drug store shelves.  Doctors have to prescribe those drugs...and they bought into the marketing of the drugs as much as the rest of us who don't have medical degrees. 

But despite the outcry and publicity the Vytorin and Zetia story is creating -- experts say it's very unlikely that drug marketing tactics will change anytime soon -- including the controversial practice of advertising newly approved prescription drugs which have not undergone longer term testing to prove their effectiveness (or their dangers).

"Frankly, the AMA knows the reality that this is a First Amendment issue and you can't ask for a blanket ban on direct-to-consumer drug ads," AMA spokesperson Robert Mills told AdAge last February.  However, "the evidence suggests there might be some use in having (an advertising) moratorium on new drugs."

"Might be some use"?  If doctors are giving us that kind of mumbo-jumbo...imagine what the pharmas will say. 

Even the venerable New England Journal of Medicine, which took a bold position on the Zetia-Vytorin issue this week, has in the past failed to make a stand on drug marketing and advertising.  The closest you'll come to The Journal's opinion on the matter, according to a spokesperson who talked to AdAge, came in a 2002 Journal editorial which said that "although advertising does inform patients, it should not be confused with medical advice given in the best interest of the patient by a learned intermediary."

Unless, of course, that "learned intermediary" is being paid or compensated in some manner by the pharmas.

Which in that case, makes every day April Fools for the average American seeking solid medical advice.

RX Needed for Big Pharma

It hasn't been a good year for the big drug companies.  Which doesn't bode well for the pharmaceutical industry, since we're only 22 days into the new year.

Pfizer, Merck and Schering-Plough all suffered costly embarrassments last week.  First it was Pfizer, whose $2 billion dollar drug Lyrica was panned in a front page article in The NYTimes titled "Drug Approved: Is Disease Real?"

You've no doubt seen the TV ads featuring an obviously pained woman reading from her diary about her struggle with "fibromyalgia," a chronic, painful condition of unknown origin that affects middle-aged women.  It turns out, according to the Times, that there are a number of experts -- including the doctor who first defined the disease in 1990 -- who doubt its existence.

This divergence of opinion in the medical community didn't seem to matter to the FDA, which approved Lyrica (originally a treatment for diabetic nerve pain and seizure) for use on fibromyalgia patients.  Eli Lilly and Forest Laboratories hope to follow suit - but may have some trouble now due in large part to the Times article.

Curiously, the pain caused by fibromyalgia or whatever it is, may actually worsen due to known side effects of Lyrica, including severe weight gain, dizziness and edema. That's a decision best left to the sufferers of this invisible pain, who are looking for real answers and relief, rather than becoming Pfizer's next gravy train. (read more about this affliction at the website of the National Fibromyalgia Association)

However, Pfizer's troubles seemed small compared to those involving Merck and Schering-Plough's cholesterol drug, Vytorin.  As Time Magazine, among others reports, the drug makers finally fessed up that while its studies prove Vytorin reduces levels of LDL or bad cholesterol, "the medication, which has been on the market since 2004, had little effect on the buildup of plaque in the arteries, a harbinger of heart attack and stroke." 

The bottom line, as a cardiovascular expert at the Cleveland Clinic said, is that we just don't know yet what Vytorin does...even though Merck and Schering-Plough sell more than a billion dollars worth of it, and spend $100 million marketing it as a cholesterol lowering drug.

Making matters worse, it seems Merck and Schering-Plough kept that little bit of bad news to themselves for more than a year!  Coming on the heels of the Lyrica story, "the Vytorin news is fanning the flames of public mistrust for the $5 billion direct-to-consumer drug industry -- and the ad business in general," says Advertising Age. 

Imagine that -- people not trusting big drug companies. "They're just above Congress and used-car salesmen," brand expert Rob Frankel tells AdAge.  But this isn't anything new.  Despite what they do, the big pharma crowd isn't often put in the "good guy" category.  Every time a presidential candidate demonizes the drug companies for high prescription drug costs and killing health care reform - a standing ovation erupts. 

Damage control is nothing new for big pharma, which goes through embarrassments like Lyrica and Vitorin all the time. The thing is, we're living longer, better lives thanks to chemistry.  The old saying "can't live with 'em, can't live without 'em" seems apt here.

Except wouldn't it be nice to trust the people who are working to save your life?