The People's Perspective on Medicine

943 When Less Is More in Medical Care

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943 When Less Is More in Medical Care

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Tune in to our radio show on your local public radio station, or sign up for the podcast and listen at your leisure. Here’s what it’s about:

The new guidelines brought forth by the American Heart Association and the American College of Cardiology call for a large proportion of senior citizens to take statin-type cholesterol-lowering drugs, almost regardless of their cholesterol levels. We speak with Rita Redberg, MD, editor of JAMA Internal Medicine, about whether that is a wise approach.

Often, doctors and patients alike seem to assume that using all the medical tests, tools and techniques at our disposal is a good thing. But for several years, a series of articles in the highly respected medical journal JAMA Internal Medicine (formerly the Archives of Internal Medicine) have been focusing attention on situations where Less Is More. The outspoken editor of the journal has also written essays for the popular press about the risks of over-utilizing some diagnostic technology and medications. In addition to statins, she reviews the often unrecognized risks of CT scans. 

Does a diagnosis of appendicitis necessarily mean a rush to surgery? New research suggests that other approaches may be viable for some children.

Call in your questions and comments at 888-472-3366 or email between 7 and 8 am EDT.

Guest: Rita Redberg, MD, MS, is professor of medicine at the UCSF School of Medicine in San Francisco and editor in chief of JAMA Internal Medicine. Her medical specialty is cardiology.

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free for four weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.




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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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This show was thought provoking – Think about the typical skim milk being mandated as is currently forced by USDA, and school lunch programs. Cornucopia has tried to show what various dairies are doing to skim milk which makes it hazardous. The hazardous molecules which I have seen on skim milk products include; carrageenan, titanium dioxide, mono and diglycerides (oxidized and hydrogenated fatty acids of uncertain source) – I will not let my child consume skim milk for this reason. Many family docs have noted the patients who use skim milk products are less healthy over time.
Three stories: 42 year old man shows up in a rural ER with a heart attack documented by EKG and enzymes – too late for interventional therapy. He changes, off cigarettes to occasional cigars, walks 3 miles a day, cuts down on fried food – switches to olive oil, takes and tolerates 80mg Zocor and an antiinflammatory blood pressure medication, Vit C500 +Vit E 400, low dose aspirin. 22 years later he has no atherosclerosis seen on ultrasounds and has no restrictions of activity and is taking a lower maintenance dose of Zocor and blood pressure medication. Multiple risk reduction worked.
60 year old engineer is being forced to retire because of dementia worsening for 2 years. He also has less ability to walk and his legs hurt. 3 years previously has was started on Lovastatin 40 for high cholesterol without other modifiable risk factors and no evaluation for actual vascular disease. 2 months after stopping Lovastatin (Mevacor) he is back at normal work and function. Docs quit using Mevacor in the 80’s when Zocor became available because of almost universal sleep disturbance with Mevacor and less than 5 to 10% with Zocor.
55 year old man being treated for high cholesterol with a statin. The patient is having some leg pains and weakness but improved from a previous statin which caused marked disability and discomfort. This man has not had any evaluation for vascular disease, has an above average HDL, lives in a strictly vegan household, bicycles to work and plays tennis, and has no other modifiable risk factors. Should he try to follow doctor’s orders?

I listened today 4/26/14. You stated to go into the internet type in I tried various of this and could not get in. The following is what I would like to share briefly.
I just finished reading Grain–Brain, The Surprising Truth About Wheat, Carbs and Sugar–Your Brain’s Silent Killers, David Perlmutter, M.D.
This went along but was very much deeper than what was mentioned on your program. More research, etc. Gluten is a real problem I believe he said about 30% of the people are intolerant. Celiac is the far end of the problem. He mentioned the various other diseases that gluten, carbs and sugar are causing. He also emphasized the need for more of the good fats in our diets for the brain and to help us regulate body fat and not be over fat (Olive and coconut oils) and other fats from meats that were good too and much more. I hope you will read it and comment on it. There are many more good things/info in the book that I cannot recall.
I don’t get to listen all the time. Never on Sundays when your program is repeated.
Thanks for the interesting information.
I would also like to know what people can do to keep their joints healthy and not to have replacement surgery which is only temporary at best.

* Be nice, and don't over share. View comment policy^