Dr. Greer’s medical tips for an optimal annual physical exam

By Steven Greer, MD

Many people schedule their annual physical for either the end of the year or the start of the year. Your doctor undoubtedly delegates most of the tests and data collection to the staff, and they are often improperly performed. Some common mistakes to watch for are:

• Make sure all of the staff washes their hands.
• Make sure the nurse actually measures your height and weight. You likely lie to yourself about both and the nurse should not take your word for it.
• Make sure the ECG leads are actually placed on the ankles and not on the abdomen. Nurses and most doctors often do not understand the artifacts caused by improper leads and they only glance at the ECG to look for obvious rhythm disorders. For an ECG to be of use in identifying old infarcts, the leads have to be properly placed across the chest, both arms, and both legs.
• When they draw the blood, have them penetrate the vein at a 90-degree right angle, not close to parallel to the skin at an acute angle. A right angle works better and is less painful.
• Make sure the doctor checks the soles of your feet the pulses in ankles. Ask your doctor to measure the “Ankle/brachial index” to pick up peripheral vascular disease in the legs.
• Make sure the doctor looks in your ears. You probably have cerumen (wax) and you will hear those iPods better if the canals are clean. Use hydrogen peroxide dipped in Q-tips to gently clean your ears without compacting the wax deeper, or see an ear doctor if you have the luxury.
• Particularly if you are Caucasian, make sure the doctor looks for nevi (moles) and signs of skin damage from the sun. If you are over age 40 or are younger with fair skin, this is very important. Have the doctor chart the lesions found. If you have any doubt, just go to a dermatologist and have the lesion removed. For widespread skin damage, photodynamic therapy works well.
• If you are over age 50, go to an eye doctor to have a real eye exam where your pupils are dilated by drops. Your primary care doctor is just going through the motions by looking in your undilated eyes and cannot see much at all other than cataracts. Signs of early eye disease that will lead to blindness can only be seen when the pupils are dilated.
• Ask about adult vaccinations for diseases such as shingles, flu, pneumonia, etc. Financial reasons have caused most primary care offices to stop administering vaccines.
• If your doctor recommends any form of medication to prevent a cardiology problem, such as high cholesterol or high blood pressure, get a second opinion and search http://www.currentmedicine.tv/ for the topic. In general, get a second opinion before starting any new therapy.

Weeks later, if the laboratory testing company tries to bill you, do not pay. They are not allowed to bill you for the balance of what insurance does not pay as long as your doctor is “in network”. Be generous with your doctor, however. Most primary care doctors are underpaid.

Emergency Medical Care (of TriBeCa)

(Post your opinions and experiences with this business in the comments section)

Open 24 hours, patients usually seen within 30-minutes, Board certified doctors, direct admissions to Beth Israel if necessary, CT-scan on site, lab on site

(212) 962-6600

Battery Park Dental Center

Post your opinions and experiences with this business in the comments section

Glenn J. Chiarello, DDS

(Post your opinions or experiences on this dentist in the comments section at the bottom)

ADVANCED DENTAL SOLUTIONS, PLLC
Glenn J. Chiarello, DDS
375 South End Ave., Ground Fl.
New York, NY 10280
P: (212) 321-1800
F: (212) 432 1047
E: drglennchiarello@nyc.rr.com

Battery Park Pediatrics

Post your opinions and experiences with this business in the comments section

(This shop is not rated)

400 Chambers Street,
New York, NY, 10282

Send all inquires to info@batteryparkpediatrics.com
or call us (212) 766-0005

Dr. Greer’s Medical Tip of the Week: Know when to decline a medical imaging study

By Steven Greer, MD

One of my parents recently had an abdominal ailment and was almost given a CT scan by mistake, despite my elaborate efforts to have an MRI scan ordered. If you have any relatives with an illness requiring surgery, there is a good chance that they underwent numerous medical imaging studies, such as CT scans.

All of us at some point will become ill and likely undergo some of these imaging studies. However, it is becoming more apparent to the medical community and public that many of these tests are harmful and unnecessary. This issue has been a concern of mine long before recent events that raised awareness. I will try to summarize the pertinent facts and let you know what your rights are as a patient.

Medical imaging studies that use large doses of radiation, such as CT scans, cardiology perfusion scans, etc. have been in the lay press over that last few years due to horrific stories of operators using ten times the radiation dosages and causing sever side effects and death. Less known to the public are the numerous academic publication in the New England Journal of Medicine, JAMA, and actions taken by the FDA and Medicare to curtail the overuse of CT scans and similar studies.

These medical publications and government actions have only begun within the last three years. Meanwhile, over the last two decades, medical imaging studies have more than doubled in usage and are a lucrative component to medical center and private practice office revenues. The latest trend is for cardiology practices to purchase their own CT scanner and perform routine scans of the heart to look for coronary artery disease (despite a lack of evidence that this does any good for the patient). The individual radiologists also profit from each CT scan that they read. The surgeon ordering the study gets some malpractice defense for ordering the tests.

All of these powerful factors have formed our current system whereby it is very possible for patients to receive multiple unnecessary CT scans, etc. during the course of diagnosis and ultimate therapy. Other than wasting money, what is the harm in unnecessary CT scans?

The medical literature is raising the concern that certain medical imaging studies increase the risk of cancer. One CT scan is equivalent to a hundred or more regular chest X-rays, depending on the type of CT scan.

How can you as a patient avoid being harmed by an unnecessary medical imaging study? The first step is to become informed of the basic facts by reading articles like this one, or the excellent series in The New York Times by Walt Bogdanich et al. Then, you need to ask your medical doctor if an alternative imaging study, such as portable ultrasounds or MRI scans, both of which deliver no radiation, would suffice. A new diagnostic skill set being taught to all medical student now is how to use handheld ultrasounds and obviate CT scans or other studies.

Every medical center should now be implementing plans to reduce radiation exposure to the patient, in the wake of the horrific accidents at Cedars Sinai, and elsewhere. If you sense that your doctor does not take your concerns seriously, or at the day of the scheduled imaging study, the radiologist tries to switch the order from an MRI to a CT scan, then simply walk out.

You have every right as a patient to tell your doctor, “No thanks”. Do not let the large number of people wearing scrubs and white coats intimidate you, although that is easier said than done. Hospital settings, combined with the fear of an unknown yet-to-be-diagnosed illness, create a formidable intimidating experience.

To read more about these matters, please refer to our prior works here:

Medical imaging is more dangerous than the Japan or Chernobyl accidents

These are other reports on this serious problem

Reza Fazel, MD: Radiation exposure from medical imaging studies

Steven Greer MD: A discussion with Bill O’Reilly about radiation risks

Courtney Coursey, MD: The utility of pre-op CT scans in rule out appy

Update: U.S. Radiation levels from Japan

Mahadevappa Mahesh, PhD: The cancer risk from CT scan exposure

Dr. Greer’s Medical Tip of the Week: Cleaning out your ears

November 26, 2011

By Steven Greer, MD

The ears are one of the most neglected parts of the body. Your primary care doctor might glance into the ear canal with an otoscope, if you are lucky. But in this screwed up healthcare system of ours, with everything compartmentalized, if a primary care doctor sees an impaction of ear wax (i.e. cerumen), they will refer you to a specialist ENT doctor. You will then, weeks later and only if you have good insurance, be seen by an ENT to have your ears cleaned out.

Most people do not bother with this time and expense and that is why many are walking around with partial hearing loss due to clogged up ear canals. Here is what you can do on your own to clean out your ears.

First, do NOT insert a cotton tip swab. That will just cram the ear wax farther into your ear. You need to dissolved the cerumen.

A very effective product is called Debrox (glycerin, propylene glycol, citric acid, and other ingredients). Follow the instructions. After about an hour, with your head tilted to allow for drainage, your ear canals should open up and you will be amazed at the improvement in hearing.

If you have any problems, we recommend seeing the nearby Urgent Care Clinic, where you will be seen within 30 minutes.

Battery Park Veterinary Hospital

Post your opinions and experiences with this business in the comments section

(This shop is not rated)

21 South End Avenue
New York, NY 10280
212-786-4444
212-786-4040  (Fax)
bpvh@dvmhospitals.com

Monday, Wednesday & Thursday
8:00am – 7:00pm
Tuesday & Friday 2:00pm – 7:00pm
Saturday 9:00am – 3:00pm

Their website here

Is sugar (fructose) is a poison?

April 20, 2011

Robert Lustig, MD of the UCSF division of endocrinology and metabolism has become one of the more vocal and credible critics of the pervasive dietary sugar, whether it be in the form of table sugar (sucrose, which is a glucose and fructose molecule bound) or high-fructose corn syrup (a manmade glucose and fructose product). In a viral video of one of his lectures, which we edited down to 30-minutes focusing on the fructose metabolism, he explains how fructose is a poison to the body and the cause of the obesity epidemic around the world.

Prior to 1975, humans were not exposed to high-fructose corn syrup. Sugar makes food sell better, so for profit and political reasons, the ingredient has wound up in most drinks and foods we consume, including foods one would not expect to have sugar, such as bread and meat. A recent lawsuit forcing Taco Bell to reveal the ingredients of its “meat” revealed that sugar is a component. Every item on the McDonald’s menu, with the exception of coffee, tea, fries, and McNuggets has fructose in them. A can of regular soft drink or sports drink has more than 8 table spoons of sugar in it.

Americans, on average, consume 63 pounds of sugar per year. Along with sugar increases, the reduction of fiber and addition of trans-fats is what Dr. Lustig calls the adulteration of our diet.

In his full-length lecture, Dr. Lustig gave a lengthy biochemistry explanation of how fructose is processed mostly in the liver, unlike glucose from starch that can be used by all organs of the body. Once in the liver, the main molecule that fructose is converted into is VLDL fat, which goes straight to one’s body fat storage depots and also causes atherosclerosis.

Another byproduct of fructose metabolism is uric acid, which results in lower nitric oxide (NO). NO is crucial for normal blood pressure as it causes vasodilation. Dr. Lustig asserts that fructose is a major cause of the hypertension epidemic as well as obesity.

It’s tough to interview a dead woman: The Avastin controversy

November 19, 2011

By Steven Greer, MD

The mainstream TV news is botching the coverage of the decision to revoke Roche’s Avastin to treat breast cancer. Most of the TV reports all started the same way, by interviewing a breast cancer survivor who swears that Avastin is the reason she is alive.

Of course, it is a well studied phenomenon for patients to incorrectly attribute cause and effect of therapies, and that is why scientists attempt to conduct more objective clinical trials. In doing so with Avastin, multiple studies revealed that Avastin not only was ineffective at prolonging life, but also increased death and serious adverse events related to blood clots and hypertension caused by Avastin.

If a terminal breast cancer patient has just a few years left to live, is it ethical to risk debilitating stroke in exchange for no survival benefit? Moreover, the $100,000 or more annual cost of Avastin causes many families to lose a significant amount of their savings and wealth, even if they have insurance. After the breast cancer patient passes away, the hospital bills keep coming to the next of kin.

It is tough to interview the women who have died from strokes and heart attacks related to Avastin. However, the TV news could at least mention that the adverse events outweigh the benefit. Only CBS’s Dr. LaPook did a good job at stating these risks. ABC has an excellent doctor on staff, Dr. Besser, but he was not assigned to this story, and the ABC coverage was subsequently egregious, beginning with the scenario described above (i.e. highlighting the Avastin survivor myth). NBC benched Dr. Nancy Snyderman and used Robert Bazell and a breast cancer expert.

To learn more about the actual clinical study data that do not support using Avastin for breast cancer, we refer you to our 2007 WSJ video and companion text.

Rockrose allows pedophile to move into 41 River Terrace

August 26, 2011

A few weeks ago, a resident of the northern part of Battery Park, a practicing cardiothoracic surgeon with young children, approached BatteryPark.TV with a concern over a registered sex offender

Registered pedophile Phillip Riback, now living in Battery Park

who had been allowed to move into a nearby high-rise condo directly adjacent to Stuyvesant High School: 41 River Terrace. In our preparation to cover the story, we became aware of some nice reporting already made by the Tribeca Tribune. We refer you to their articles for the details.

According to the Tribeca Tribune, Rockrose Development mistakenly allowed the registered sex offender, former pediatric neurologist Phillip Riback, to sign the lease without properly checking his background. The paper updated the story on August 18. Riback’s lawyer, famed defense attorney Paul Shechtman, a Tribeca resident, stated that Rockrose had terminated his lease and that Riback was not contesting he matter. It is unknown when Riback plans to move out, or whether these facts are correct at all.

41 River Terrace, by Carl Glassman

The Tribeca Tribune also reports that the New York City Department of Probation, charged with tracking sex offenders, was not answering any of their questions.

During our own investigation, Rockrose management completely stonewalled us. Our calls were not returned and the names of the managers, such as Richard Edmonds (listed by the Tribeca Tribune) were withheld from us.

To inquire for yourself as to whether the sex-offender Riback actually moves out, and to where, you can call Rockrose at (212) 847-3700. The Rockrose offices are at 666 5th Avenue if they do not return your calls. Riback’s attorney, Shechtman, can be reached at (212) 223-0200.

Attorney Paul Shechtman

Please send us an email if you have any updates to this story that you think should be covered.

One of Time Magazine’s “100 Most Influential People in the World”

July 25, 2011

Peter Pronovost MD PhD, gave us a tour of his work at the Johns Hopkins Hospital. His pioneering research has greatly reduced adverse outcomes, such as infections and OR, in hospitals around the world. For his work, Dr. Pronovost was named one of Time Magazine’s “Most Influential People in the World” and is a recipient of the MacArthur Foundation “Genius” award.

Dr. Steven Greer took a tour of his ICU and discussed his advances.

(In full screen 1080iHD)

Detecting nuclear fallout from Japan and elsewhere

July 18, 2011

Clifford Mitchell, MD of the State of Maryland health department discusses how they measure nuclear fallout, as well as how the federal government has an independent system run by the EPA.

- Which isotopes are the most dangerous?

- How are they detected?

- Are levels significant in US samples?

Is there a new street drug that triggers homicidal rages?

Update: July 17, 2011

The Sunday New York Times has a feature article on these new synthetic drugs.

February 14, 2011

Within the last 30-days, three high-profile mass murders have been associated with illicit drug use. First, Rep. Giffords was shot, and six others killed, by a mentally ill young man, Jared Lee Loughner, known to use marijuana and the new “synthetic pot”. By many accounts, he began a downward spiral into insanity.

The next case involved a drug-addicted mother in Tampa, Julie Powers Schenecker, who shot her teenage daughter and son because they were “mouthy”. Video of the woman being walked in handcuffs showed her shaking uncontrollably, possibly in withdrawal. The family had unsuccessfully attempted to get help with her drug addiction. Her preferred drug of choice has not been reported.

Now, in New York City, a crazed 23-year-old man, Maksim Gelman, stabbed his father and a young woman, killing them both, while also nonfatally stabbing several others over the course of a day-long rampage. The New York Post reported that he had built a bizarre shrine to the woman under a freight train overpass tunnel where he also went to use illicit street drugs.

What is going on? All of these cases could have occurred by complete coincidence, unrelated, and might not represent any new trend. Alternatively, a new street drug, or combination of prescription and street drugs, might be triggering homicidal rampages.

While many drugs are well known to increase suicide and have “black box” FDA warnings, attributing homicide as a “side effect” has much greater criminal and societal implications. Therefore, the FDA and press rarely comment on homicide as being related to any type of drug.

The New York Times recently reported on the common consumption of multiple prescription drug cocktails by members of the military. The skyrocketing suicide rate in the military might be caused by these medications since the risks are well-documented.

Several reports published over the last 12-months indicate that heavy marijuana use triggers schizophrenia. With “medicinal marijuana” making it much easier to obtain the drug in many States, usage has increased.

A new “synthetic pot“, also known as “K2″ or “spice”, is being banned by various governments as the mental side effects are becoming known. The crazed murderer in the Arizona Rep. Giffords case reportedly used synthetic pot.

Also in the news lately has been the bizarre practice of snorting “bath salts” for their intoxicating effects. Bath salts contain stimulants mephedrone and MDVP.  Senator Schumer of New York is trying to ban the unregulated sale of bath salts.

Jeff Lapoint, MD is a toxicologist with the NYC Poison Control and Bellevue Hospital. In a telephone interview, he said, “The people we see on (synthetic pot) tend to be sick, more on the unconscious, more on the seizing side of the spectrum than on the agitated delirium “I’m going to hurt someone” side, but (synthetic pot) definitely makes people more agitated, more tachycardic than just marijuana. You can’t get pure THC (the active ingredient of marijuana), but you can get pure powder form of (synthetic pot). Gram for gram, (synthetic pot) is more powerful than marijuana”

Dr. Lapoint was not aware of new State or CDC warnings being issued about any specific new street drug causing violence and homicide. However, if you know of anyone at the workplace, school, or neighborhood who is behaving strangely and takes illicit drugs, the authorities should be notified.

Update: U.S. Radiation levels from Japan

May 1, 2011

The radiation fallout levels in the U.S. from the Japan Fukushima reactors remain low. The EPA runs a national RadNet system that collects radiation samples from air, water, milk and other sources. In addition, most states (e.g. Maryland) have independent collection systems, as do nuclear regulatory agencies.

We spoke with Clifford S. Mitchell, MD, MPH, of the Maryland Department of Health and Mental Hygiene.

The data are collected by measuring the activity level of the disintegrating isotopes. Each isotope emits a unique spectrum of energy, so the type of radiation, as well as total energy is measurable in picocuries (pCi/m3). However, those measurements are not clinically relevant.

One needs to then estimate a clinical dosage, which depends on the length of exposure and route of ingestion (i.e. inhaled, drank, touched, etc). Sieverts (Sv), or millisieverts (mSv), are the units of dosage one needs in order to compare fallout to other types of radiation, such as CT scans or X-rays. We do not have estimates for the mSv dose data.

The encouraging aspects of the data collected so far are that:

A) The total activity is not accumulating significantly

B)  The long-half-life, most deadly, isotopes such as cesium and plutonium, are not yet detected, for the most part, in mainland U.S. Hawaii does have detectable levels of some of the more concerning isotopes, as does California rain water measurements (Te-132).

Given that I-131 has a short half-life of 8 days, one would not expect to see an accumulation of activity in pCi. However, a continued inhalation of low levels can translate into a greater dosage on terms of mSv.

Comparing radiation leaks from major nuclear events

March 15, 2011

Now that the multiple nuclear reactors in Japan are in meltdown, possibly on the scale of Chernobyl in 1986, the key safety questions are “How will this radiation accident compare to other previously documented events, such as Chernobyl and Three Mile Island, and will the radiation cause cancer?”

Using reports from our US NCR and the United Nations BEIR VII report, we tabulated rough estimates of radiation exposure and compared them to the gold standard of data, the WW2 Atom-bomb survivor studies (BEIR). The long-term cohort studies of the survivors of Hiroshima and Nagasaki are the best medical data available to correlate cancer risks to exposure.

It is premature to estimate the radiation amounts being leaked from Japan, but given that there are at least four reactors melting down, it is safe to assume that the Japan disaster will be on par, if not worse, than Chernobyl. Chernobyl contaminated areas of Europe thousands of miles away. Some areas were extremely high doses that were in cancer-causing range, but the average doses were not.

At this time, it is likely that radiation will reach Alaska and the continental U.S., but that the levels will be very low.

Click to enlarge graphic)

NBC’s Dr. Nancy Snyderman gets it wrong

March 15, 2011

NBC’s Dr. Nancy Snyderman gets it wrong when she tells America that they are essentially dumb for buying potassium iodide pills to prevent possibly radiation exposure and thyroid cancer.

Related, Fox News’ Bill O’Reilly singled out ABC pundit Michio Kaku for “hyping” the Japan reactor situation. Time will tell, but Dr. Kaku’s suggestion will likely be exactly what is required.

“Doctor” Drew has Narcissistic Personality Disorder

April 6, 2011

“Doctor” Drew Pinskey has given up all pretenses of professionalism and is now diagnosing celebrities based on short TV sound bites. Most notably, he did this with Charlie Sheen recently. The academic psychiatry community frowns upon this.

So, in fair turn, we thought that we would diagnose Drew.  He suffers from Narcissistic personality disorder in our opinion

How much sugar is in a Vitamin Water

February 3, 2011

You will be astonished at how much sugar is in a “healthy” Vitamin Water.

How to eliminate head injury in football

Op-Ed August 21, 2010

Serious head injury in American football is commonplace and has received national attention within the last two years. The New York Giants quarterback, Eli Manning, is sitting out a few games due to head injury. Last season, star quarterback for the Florida Gators and Heisman Trophy winner, Tim Tebow, suffered yet another concussion that was witnessed by millions of sports fans, as did Super Bowl champ Ben Roethlisberger and many others.

Bryant Gumbel of HBO’s Real Sports was an import factor in bringing this problem to the mainstream. As a result of his show and subsequent coverage in the press, the NFL was pressured to make changes. There is now a mandatory time-off for players suffering concussion, and new posters have been placed in locker rooms. The concern is extending to off-the-field injuries as well. In 2009, then Tonight Show host Conan O’Brien gave head injury more national attention with his on-air concussion.

A recent study commissioned by the NFL found an astonishingly greater prevalence of Alzheimer’s-like memory loss in ex-NFL players. Young athletes in high school or lower grades are even more vulnerable to permanent brain damage after the initial concussion than adults. In addition, there is now new credible evidence from the same scientists at Boston University that Amyotrophic Lateral Sclerosis, ALS, also known as Lou Gehrig’s disease, is caused by head injury.

Concussions are one of the dirty secrets of football. What can be done to make America’s favorite sport safer?

The cause of the vast majority of concussions in football is the lack of enforcement of the rules dictating proper tackling and blocking. The helmet is currently used as the primary ramming tool, particularly at the higher levels, when in fact the facemask and helmet should theoretically never be used in contact. It is against the rules for a defensive player to dip his head and tackle headfirst with his helmet. On the offense, a proper block should use the arms and hands as the initial point of contact, and runners should not dip down and ram headfirst. In reality, however, virtually every block on the interior line and every running play uses the facemask and helmet as battering rams.

It would be quite feasible to enforce the existing rules of football that dictate the helmet should not be used as a weapon and the quality of play as seen by the spectator would not be diminished. Running backs should run with their facemasks up at all times. If a running back were to dip his head and spear forward, it should be a 15-yard penalty and loss of down. Likewise, offensive and defensive linemen should be penalized if their helmets clash.

The ground collisions with helmeted heads that cause injury cannot be easily prevented. However, a simple enforcement of the blocking, tackling, and running rules should eliminate a significant portion of the head (and spine) injuries in football. Also, preventing the premature return of head injured players will help reduce further injury as well.

Hines Ward of the Pittsburgh Steelers can lay out some the most vicious and entertaining blocks in all of football just by using his shoulder pads. Using the helmet as a weapon is cheating, unnecessary, and should be banned.