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Breast Cancer Screening Recommendations Revisited

Are you confused about breast cancer screening recommendations? If you are, you are not alone.

Multiple organizations have come out with conflicting studies, data, and recommendations. Those advocating for reduced screening argue that screening does not improve the death rate from breast cancer; that women who have biopsies that are found to be benign suffer significant psychological harm; and that cancers are found that would never cause death.

Significant flaws have been found in these arguments by physicians who have committed their careers to understanding and treating breast cancer. There are multiple problems with the scientific methodology, assumptions, endpoints and analyses used in these critiques of mammogram screening recommendations. One problem is that medical science currently does not have the ability to distinguish between lethal cancers and those that will not cause death. Based on rigorous scientific data, we do know that the best way to improve survival from breast cancer is to detect it before it becomes clinically obvious and to treat it early.

None of the major oncology organizations support the guidelines calling for reduced screening. A letter to the New England Journal of Medicine ....

High blood pressure in the doctor’s office

“I don’t get it! Everytime I come to your office my blood pressure is high. It’s never like that anywhere else!”

“White Coat Hypertension” is very common and affects many people, even those who feel at ease with their physician. But whether your blood pressure is low or high at the doctor’s office, if you’ve been told you might have hypertension, you are likely to find yourself at home, or in a grocery or drug store with your arm in a cuff trying to figure out if your blood pressure is reasonable. A key to successful self-measurement is knowing the proper technique.

The big studies of blood pressure in the population upon which we base all our definitions of normal and high values were careful to take their measurements in a standardized way. The patient should avoid coffee, tea, nicotine, and other stimulants for at least 30 minutes prior to the test. She should sit quietly for a full 10 minutes reading or softly conversing before measurement. Even reaching across the table to pull the BP cuff near is to be avoided. (Get the machinery next to you when you first sit down.) Use an upper arm cuff. Forearm and finger devices are not reliable. Feet should be flat on the floor, clothing comfortable, and a bare arm may be needed for some machines. Two or three measurements a few minutes apart may be averaged.

A few caveats to mention: if one arm is higher than the other, you have to go by the higher side. Humans have a natural ‘diurnal’ variation, with most of us having a little higher blood pressure in the morning compared with later in the day. Blood pressure rises with physical and mental exertion and takes some time to come down, so don’t expect a resting value if you’ve not been at rest for 10 minutes or more.

Blood pressure is dynamic and always changing. The majority of values should be in a good range; your physician can help you determine if your numbers are in the range you need for optimal health.

Croup: coughs that go bark in the night

Croup is a common childhood illness that can be very frightening to a parent or child. It often starts with the symptoms of a mild cold, such as a runny nose, or sore throat. The child goes to bed as usual and then wakes suddenly in the middle of the night with a barking cough. Often they gasp in between the coughs and make a high-pitched noise called stridor when they breathe in.

Thankfully, croup is rarely dangerous. Most children can be treated at home. But it can be a scary illness for both the parent and the child.

It is important to know how to treat croup at home and when to seek help from your doctor or the emergency room....

Caring for your child's cast

Kids of all generations from all walks of life have one thing in common and that is the love of play and imagination. Play structures, a couch turned to a fort, or their sworn innate ability to fly can take a sour turn. As much as we would like to wrap our little Spider Mans, Incredible Hulks and Wonder Women in bubble wrap, unfortunately life’s little incidences are inevitable.

If ever the time comes where your Super Hero suffers from an injury and needs a cast, it is time to put on your Super Parent costume.

Here are some helpful tips on cast care for the Super Parent:

  • Bathing: Absolutely no showers. We ask parents to give kids a bath instead, keeping the casted limb outside of the tub. In addition, we suggest wrapping the cast with a towel and covering with a newspaper bag or bread bag and closing it off with a rubber band at the top for added protection.
  • Itching: The golden rule of having a cast is DO NOT STICK ANYTHING IN THE CAST! Scratching an itch with an object can cause the skin to break underneath the cast, leaving room for infection. If your child has itching, tapping on the outside of the cast or using a hair dryer set on cool can help.
  • If a cast...

Tips for getting the most out of your inhalers

“Darn! My inhaler is out and I am going to have to call today, a Sunday, to get a refill…”

Spring is here! And that means asthma season is back, and with the nicer weather, pollen counts are high. Flowers are wonderful and the trees beautiful, but if you are like me, some of those plants have your number. The beautiful smells come with itchy eyes, sneezes, and for some, a serious amount of wheezing.

Patients are reaching for their inhalers more often, and sometimes getting into serious respiratory trouble, especially if their medication is running short. Inhalers are expensive, too, and so using them optimally is both financially and healthfully important.

Fortunately, a couple of tricks can really help maximize an asthma spray’s value.

The medication comes out fast and hard when you squeeze the canister, and it can be difficult to time your breath to inhale the dose well, plus with the energy of the release being so high, a lot of misted drug can zoom right out of your mouth. The trick is to use a ‘spacer’, and the simplest is a rolled up piece of paper, to about a one inch diameter. Tuck the sprayer in the far end, wrap your lips around the outside of the other end, and take your leisure squeezing and breathing! The tube holds the mist in place for a few seconds, letting you better coordinate your inhalation and improve substantially the amount of drug you get to where it is needed.

The second tip is to use a steroid inhaler daily if you need your rescue inhaler more than a few times a week. The rescue inhaler will become less effective the more you use it if you don’t directly treat the inflammation of the allergic response in your bronchial tubes with a low dose of cortisone type medication. The dose of the latter is small and will not cause harm to the rest of your system if used according to directions, but it will keep your rescue medication most beneficial!

Two years in the life of the Swedish blog

For those of you who don't know, today is the official two year anniversary of the Swedish blog - this means Swedish has been blogging several times a week for two full years!

What have we been blogging about this year?

Who's been blogging?

We've had people from across Swedish blogging (more than 100 the last time we checked), including:

  • Surgeons

  • Nurses

  • Family Medicine and Primary Care Physicians

  • Dietitians

  • Educators

  • (And many others!)

Why are we blogging?

We started the blog as a way to connect with you (our community), whether you're a current patient, a past patient, a future patient…or just someone who stumbled across our site looking for health information. We believe our role is to be a resource of information, both online and off. Blogging gives us an easy way to keep you up to date, informed, and engaged on a number of health topics

MS Roadshow coming April 26 to Skagit Valley

The MS Center at Swedish Neuroscience Institute will present the MS Roadshow April 26 in Mt. Vernon, Washington. The MS Roadshow is a free, half-day educational workshop about living well with multiple sclerosis (MS).

Knowledge really is power when it comes to managing your health. For people living with MS, learning as much as possible about the disease makes it easier to make informed decisions about your care.

Whether newly diagnosed or looking for more information to help improve your health, the MS Roadshow offers a look at leading-edge research and tips for living a full life. Topics and speakers include:

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