From the monthly archives: "July 2010"

Good news for weekend warriors: Rehab is shown to prevent knee surgery.*  This may seem like a no brainer to some, but common orthopedic wisdom is that ACL tears–a common type of knee injury in athletes–almost always require surgery. New research shows, however, that rehab-first may be a better option.

A study of Swedish amateur athletes–mostly soccer players–found that those who got anterior cruciate ligament (ACL) surgery right away plus physical therapy fared no better than those that got the knee rehab first; and although 50% of the rehab-first subjects eventually required surgery, they were not any worse off than had they gotten the surgery early on.

The implications of this study are that people suffering from ACL tears can and should try rehab before going under the knife.  If it isn’t obvious, all surgery has inherent risk due to the invasive nature of the procedure.  Also, at $10K+ per pop (no pun intended), these results are economically encouraging.  If you end up needing surgery later, you can still get it with little fear of turning out worse for waiting.

The anterior cruciate ligament (ACL) is one of four major ligament of the knee.  Its function is to prevent forward, or anterior, movement of the tibia (shin bone) on the femur (thigh bone).  It is the most commonly injured ligament in the knee.  Football, soccer and basketball players are particularly prone to ACL tears, as are skiers, as a result of the pivot and twist motions required in these sports.

Approximately 200,000 Americans go through ACL reconstruction each year, although many people can get by with a knee brace and rehab.  But, of course, getting the surgery depends on how the injury affects one’s lifestyle.

The study’s results showed that both the surgery-first and rehab-first groups fared about the same when it came to things like pain, performance in sports and how much their knee interfered with their lives.  Of those that received rehab first, about 40% needed to get the surgery later, and this group fared no better or worse than those that didn’t get the surgery at all.

One problem with the study is that the results were only measured after two years, so there could be some changes later.  The researchers will be doing a follow up at five years to study outcomes at that time.  Also, it appears that the rehabilitation group showed some signs of trouble with the meniscus, a cushioning disk in the knee joint, which some doctors think could increase the risks of degenerative arthritis in the future.

I find this study interesting and the results encouraging, because I was also under the impression that ACL tears pretty much required surgery.  Being a Los Angeles sports chiropractor, I see my fair share of knee injuries, and torn ACLs definitely limp into my office from time to time.  But now I’ll be a little less quick to refer the client out to an orthopedist.  Six months of rehab might be just fine in some of those cases.  Thank you, Swedes, for the great work!

*A Randomized Trial of Treatment for Acute Anterior Cruciate Ligament Tears

Richard B. Frobell, Ph.D., Ewa M. Roos, P.T., Ph.D., Harald P. Roos, M.D., Ph.D., Jonas Ranstam, Ph.D., and L. Stefan Lohmander, M.D., Ph.D.
N Engl J Med 2010; 363:331-342July 22, 2010

Ah New York–first in business, first in fashion and now first in…BEDBUGS!  Zoinks!  That’s right, bedbugs are taking a bite out of the Big Apple and all it’s inhabitants.  Blood sucking, creepy, crawling bedbugs…yeccch!

According to New York City officials, one out of every fifteen new Yorkers is getting chowed on by these nasty critters.  Anybody else itchy right now?  Despite their not being germ-carrying illness-spreaders, they do cause mental anguish in the people whose homes they have infested.  Some infestations have been so bad that more than a few apartment dwellers have had to throw out their belongings and start anew.  I swear I’m itching as I write this.  

I reported on the current national bed bug infestation last year.  It was one of my biggest hitting posts.  One well-known exterminator contacted me for links showing just how bad this bedbug epidemic has gotten.  As I reported in last year’s post, this is the biggest resurgence of bedbugs since World War II.

In New York City, bedbugs have been found in theaters, clothing stores, office buildings, housing projects and posh apartments.  And of course, they like to live in beds–in the cracks and crevices of mattresses.

Bedbug bites are often characterized by three raised, welt-like bumps in a row, which are indistinguishable from mosquito bites. They can be very itchy and hyper-irritating.  Most victims never actually see the bedbugs.  What they do see are the bites, blood on bedsheets and their waste, which looks like black pepper. They are known for being extremely difficult to eradicate and can go a year without feeding. 

NYC Mayor Michael Bloomberg’s administration submitted a community health survey to city inhabitants and nearly 6%, or 400,000 respondents, said they have battled bedbugs over the last year.  In 2004, residents filed 511 complaints, while in 2009 they filed 11,000.  Why the resurgence?  Experts believe that increased global travel and decreased use of some pesticides like DDT might be to blame, but they do admit that nobody is really certain.

“This is happening globally, and I don’t think anybody has figured out exactly why,” said Daniel Kass, the city’s deputy commissioner for environmental health. “So what we’re left with is managing them and keeping them from spreading. They’re going to be with us for some time.”

Oh, poor New Yorkers.  Although the resurgence of bedbugs is worldwide, New York does everything in a  big way.  Not exactly what they want to be known for.  My only advice, if you might be traveling to NYC, or anywhere for that matter, check your lodging’s bedbug status.  Just so you know…bedbugs love to travel too.

Find Facebook pointless? Step off: Facebook and other social media can be great for the health.  In fact, anything that gets people interacting regularly can impact health positively. So says a recent study showing that people with strong social relationships have 50% less chance of dying early than people without such support.

According to the study, a meta-analysis examining social relationships and their effects on health, low social interaction was

  • equivalent to being an alcoholic
  • equivalent to smoking 15 cigarettes/day
  • more harmful than not exercising
  • two times more harmful than obesity

And increasing one’s social interactions had a bigger impact on premature death than taking an adult vaccine to prevent pneumonia or taking drugs for high blood pressure.

The authors of the study, a team at Brigham Young University in Utah, suggest that government policymakers should look at ways to help people maintain social relationships as a way of keeping the population healthy. They speak specifically in relation to seniors, as that part of the population has the greatest chance of living in isolation.

May I suggest seniors’ play centers? Oh, people could go to these centers to play cards or board games, watch sporting events or exercise. They could hold classes, have speakers and host other fun events. I know that many communities have these clubhouse-type centers already—I know of a few in Florida, myself—but I think this might be a useful expenditure of government money. Why not? If social interactions have such a high impact on health, then why not spend a little money on it? Make the clubhouses nice and have one in every neighborhood.

Everybody dive into Facebook, Twitter and any other social media that allows people to interact 24/7—it’s good for the health!

A rare fungus is being blamed for fifteen deaths in the Pacific Northwest from British Columbia to California over the last six years.  Don’t worry grungers…not your magic mushrooms, but a fungus called Cryptococcus gattii, which grows on or around trees.  Breathing its microscopic spores can cause persistent cough, headache and shortness of breath, and even pneumonia or meningitis in some people.

Before you get too freaked about it, the risk is still very low.  First, it’s still a relatively rare species in North America–C. gattii is found primarily in the tropics.  Second, the people who have died from infection of the fungus in the U.S. and Canada all had predisposing illnesses.  Third, many more have likely contracted illness related to the fungus but it has been mild.  So you don’t have to avoid nature or the outdoors just yet.

The fungal illness showed up initially in British Columbia, Canada in 1999.  It has since migrated southward, and in 2004, there have been 43 cases in Oregon, 15 in Washington, one in California and one in Idaho, the CDC reported this week.  Canadian officials report 272 illnesses since cases were first detected.  The death rate there from the fungal infection have been reported at 9%.

Humans are not the only ones becoming infected, either.  To date more than 50 cases of cats, dogs, ferrets, elk and porpoises have been reported in the U.S.

Living in Southern California, I can’t help but think of Coccidioides immitis, the causative agent in Valley fever.  Hoping my brothers and sisters up in Vancouver, Seattle and Portland don’t have to deal with that type of scenario.  I, along with doctors in the region and public health officials, will be keeping eyes and ears open.  I’ll keep you informed.

Bravo to OBGYN!  They’re taking their heads out of their keesters and changing the guidelines to repeated C-sections.  “Once a cesarean, always a cesarean” is going the way of bloodletting.  According to a recent report, the American College of Obstetrics (ACOG) is easing restrictions on which women will be allowed to have a vaginal childbirth following a previous cesarean.

It has been the policy of the ACOG to deny women the choice of a vaginal childbirth in order to prevent uterine rupture at the scar from the previous surgery.  However, the chance of this actually happening is less than 1%.

Despite the low risk, most obstetricians and hospitals insist on performing the riskier surgery.  In fact, the number of women going through “vaginal birth after cesarean,” or VBAC, has gone from 3 in 10 fifteen years ago to less than 1 in 10 today.

“Why?” you might ask.  Because the rare uterine rupture could lead to emergency C-sections, and many smaller, rural hospitals are not equipped to perform them.  Emergency C-sections are much riskier than planned ones, and in ill-equipped small hospitals, it could be life-threatening.  Add to this a few high-dollar lawsuits and no surprises that the choice of VBAC has been denied to many women.

The numbers don’t lie though, and c-sections are expensive, so the National Institute of Health (NIH) strongly urged steps to reverse that trend that saw one third of hospitals and half of doctors banning VBAC.  Talk about no choice.

Dr. William Grobman of Northwestern University and co-author of the guidelines said women’s choice is “what we want to come through loud and clear….there are few times where there is an absolute wrong or an absolute right, but there is the importance of shared decision-making.”  Indeed, good doctor.

Nearly one third of all births is by cesarean, and even the most medical-worshiping patrons must admit…this number is very high.  Although C-sections can be lifesavers in some cases, they do, in fact, increase the possibility of complications in the next pregnancy, some life-threatening, like placental abnormalities or hemorrhage.

The ACOG in its wisdom states that C-section scars are now located on the lower part of the uterus, further diminishing chance of rupture during VBAC.  And of those who attempt VBAC, say the ACOG, between 60-80% will deliver vaginally.  Of the 20-40% that do not…well, they’ll get a C-section.  No harm, no foul.

I realize what a touchy subject this is among doctors and women.  I am reminded of a previous post where a reader lambasted me for not understanding the discomforts of pregnancy and labor because, had I, I would not be so glib in badmouthing C-sections.  Sheesh…I didn’t realize how some people just want a quick knife and be done with it.  I get it now.

But here’s the beauty of it for you women who despise the natural way of furthering the species: You can still have your choice of a planned cesarean.  Can’t fathom the push and contract?  No problem.  C-sections are available.  But for the women that actually would like to connect with nature, the restrictions were BS, and now they can try without some doctor denying them their rights.  So you get yours, they get theirs, and we’re all one big happy family.

ACOG did right.  Bravo to them.

Quite a blow being dealt to group therapy for drug rehab: Studies show it leads to greater drug use by teen abusersGo figure. According to one study, teenagers at high risk for drug use were more likely to smoke cigarettes and have disciplinary problems at school later in life if they had been enrolled in a teen focus group about drugs. In other words, the environment influenced behavior. Wow, groundbreaking!  In academic speak the phenomenon is known as deviancy training—the negative influence of friends on teen behavior or simply bad influence.

Researchers and some former teen group drug therapy members say that sitting in groups talking about drugs caused the teens to want to do more of the drugs they were abusing at the time. Even more counterproductive is that it made many of them want to try drugs they had never done before but had just heard about in therapy.  Ha ha ha ha ha ha ha….comedy.

Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA) says, “Just putting kids in group therapy actually promotes greater drug use.”

Okay so what’s a better solution? Experts suggest that private counseling for teen drug abusers with their families in tow may be a better option.  I couldn’t agree more. In 2000 one researcher from the University of Miami department of epidemiology and public health found that among teens assigned to peer-therapy groups (in treatment for a minimum of four weeks) 17% reduced their marijuana habit, but 50% ended up smoking more. Hmmm…and 57% of teens who were assigned to family therapy showed a significant decrease in drug use, while 19% used more. I’m sold, how ’bout you?

Experts believe that part of the problem is inherent in the philosophy of group drug therapy in general, as advocated by twelve-step programs like Alcoholics Anonymous (AA). The first step encourages participants to admit they are “powerless” over their addiction and to surrender to a higher force.

Although this approach does help many addicts overcome their addictions, some experts believe that teens have difficulty interpreting this message and see it as being doomed to a life of addiction; in other words, some teens may feel defeated and labeled, so they give in to their urges believing that attempted abstinence is futile.

Despite individual and family therapy trumping group rehab in studies, the twelve-step model is still favored by institutions. Why? The obvious reason is economics. Group sessions just bring in more money: when 10-20 individuals can be seen in one hour, it doesn’t take an accountant to add up the dollars. Add to that the wide-availability of 12-step programs, as well as the fact that many drug counselors are former drug abusers and stay true to the method that worked for them, it’s no wonder that it is the method of choice to break teens of their drug-abusing habits.

Oh well, just another story showing the inefficiency of the familiar. It’s so hard for people, institutions, societies and nations to change even in light of a proven better way.  That’s what this blog, Optimal Health, is all about—change—so I know how slowly it can drag sometimes. But I appreciate studies like these, and the unsung heroes that try to spread the word. It’s the only way.

I have been and continue to be critical of twelve-step programs, because I see them as just a substitution for the addicting substance. I guess if you have to choose an addiction, AA is a little less hard on the body, but definitely not easier on the mind, as the addictive personality often gets hopped up on meetings. Just my observation. I am certain without question that individual work can break an addiction, and having families participate should only solidify the benefit. Putting teens in a group with their drug-using peers only makes for a short term dry party—once released, they’ll be back to using with a vengeance. At least that’s what the data shows.

Finally a genetic excuse for obesity that actually makes sense.  Researchers show that an omega fatty acid imbalance can lead to obesity.  But even more interesting is that this imbalance, and the associated obesity, can be passed on from generation to generation.

A recent French study looked at the role of omega intake and fat deposition in mice.  Four generations of mice were fed a 35% fat diet with an omega imbalance now common in much of the developed world–that is, a high ratio of omega-6 fatty acids relative to omega-3s.  The results were progressively fatter mice at birth, generation after generation.

In my book, The Six Keys to Optimal Health, I discuss the importance of bringing the omega balance to 1:2 omega-6:omega-3.  Currently the typical imbalance in western cultures is 15:1 in much of Europe and up to 40:1 in the United States.  Omega-3s are important to many functions including cholesterol balance, blood pressure, reducing heart disease and stroke, preventing blood clots, preventing diabetes and much, much more.

Omega-3 fatty acids are found plentifully in fish and flax oils, although fish liver oils are a more potent source.  Omega-6s, on the other hand, are high in vegetable oils, breads, grains and poultry–things we eat copiously in the typical American diet.

But what about passing fatness on to successive generations?  Experts believe that the link between omega imbalance and obesity is epigenetic; in other words, the imbalance in mothers influences an offspring’s genes during development.  Whoa!  That’s right–the omega-6:omega-3 ratio in the breast milk of American women has gone from an average of 6:1 to 18:1.  Holy milkshakes!  Exactly.

I recommend a few things to bring the omega ratio back into healthy balance.  First and foremost is reducing your intake of high omega-6 containing foods.  So breads, high carbs, vegetable oil–cut ‘em.  Then I suggest you supplement with a good omega-3 fatty acid.  I carry a great brand in my Los Angeles, Beverly Hills and West Hollywood chiropractic office.  Check this article for all the information you need on omega-3 fatty acids.

Stop the cycle of obesity in your family–get your omega fatty acids balanced.  And don’t think it’s too late for your children, either.  Feed them well (healthily, not in hordes), get them moving, and give them omega-3 fatty acids–that should break the inheritance pattern.  Remember, health starts in the home.  Now how’s that for epigenetics!

New York Yankees owner George Steinbrenner, the Boss, died this morning of a heart attack at 80.  The boisterous owner of the famed Bronx Bombers was taken to St. Joseph’s Hospital in Tampa, Fla., and died at about 6:30 a.m.

Steinbrenner bought the Yankees in 1973 and was well known for his iron fist rule and public feuds with Billy Martin and Yogi Berra.  Steinbrenner went through 20 managers during his first 23 years as owner.  Despite these challenges, Steinbrenner’s Yankees won seven World Series, 11 American League pennants and 16 AL East titles, epitomizing greatness in sports.

Steinbrenner’s had been in decline for several years.  As his health declined, control of the team was handed over to his sons Hal and Hank.

He appeared at the new Yankee Stadium just four times: for the 2009 opener, the first two games of last year’s World Series and this year’s homer opener, when captain Derek Jeter and manager Joe Girardi went to his suite and personally delivered his seventh World Series ring.

“Winning is the most important thing in my life, after breathing,” Steinbrenner was fond of saying. “Breathing first, winning next.”

Steinbrenner is survived by his wife, Joan, four children and 12 grandchildren.

New York will be a little less lively without the Boss.

Here’s a spectacular story of nature and technological potential all rolled into one fascinating physiological process–the incredible human immune system.  Researchers have found previously unknown antibodies that might prevent HIV from entering cells.  This immune system soldier could potentially be the key to discovering a long-awaited vaccine against the illusive virus.  The magnificence of the human body never fails to amaze me.

According to researchers, the newly found antibodies (three to be exact) neutralize more than 90 percent of a group of HIV-1 strains, involving all major genetic subtypes of the virus.  They do so by acting as gumming agents tying up the lock that the HIV virus “picks” in order to enter a cell.

These antibodies only appear to exist in some people, and even in the fortunate carriers they fail to make enough to totally clear the virus.  Enter human technology: The idea scientists have is to coax the body, through a vaccine, to produce the virus-neutralizing antibody.

Scientists admit that they are several years away from fully developing the vaccine but remain hopeful.  “The goal is to vaccinate individuals and have their own immune systems make an antibody like this,” said Dr. John Mascola, a vaccine researcher and co-author of two new studies on the soldier antibodies. “To do that, we have to design a new vaccine, study it first in animal models and then try it in small scale human studies, and see if it does what we expect it to do. That takes a quite a bit of time and effort.”

I have no doubt we will be hearing more about these antibodies in the future.  They exist and have now been uncovered; we are sure to learn much more about where they come from, how they operate, and whether they are truly unique to some, or if we all have the potential to develop them.  Pretty cool, huh?

Get this: Geriatric gentlemen popping Viagra are more likely to have VD.  Doh!  Yes, it’s true–middle-aged and elderly men that take the erectile dysfunction (ED) med seem to be more likely to practice risky sexual behavior.  This the latest report in the recent issue of the Annals of Internal Medicine.

According to the report, individuals most likely to fall into this group are men that have sex with men.  The data comes from a study conducted at Massachusetts General Hospital and the University of Southern California, where researchers looked at a representative sample of privately insured older men.  The study was unable to determine if the men were primarily homosexual or bisexual.

Researchers examined health insurance claims records covering 1997 though 2006 from 44 large U.S. employers. The study group included about 34,000 male beneficiaries over 40 who used ED drugs, for whom the researchers collected data covering one year before and one year after the first prescription was filled, and nearly 1.37 million men over 40 who were non-users, for whom claims data was also collected.

They found that men using Viagra or other ED drugs were two to three times more likely than non-users to have sexually transmitted diseases (STDs).   The most frequently reported STD was HIV/AIDS, followed by chlamydia. The researchers did not know if ED drug use itself increased STD risk but they plan on investigating that in future studies.

The study’s authors conclude that:

  1. Drugs like Viagra are not only being prescribed to men with ED but also to those engaging in risky behavior.  This blog has reported for a long time the use of ED drugs to party.
  2. Age is not an inherent protection against STDs.  On the contrary, it appears that men (and women) partying with older men might want to carry their own protection (or demand health records).
  3. Doctors are doing a poor job of discussing STD risk with older gentlemen.
  4. HIV was probably most reported because its symptoms are most likely to bring men into doctors’ offices.
  5. Men that do not use condoms 100% of the time or are not in a mutually monogamous relationship need routine STD screening with repeated follow-ups.

All I can say is that I think it’s human nature to make assumptions, and most people probably don’t think of their gray-haired neighbor as the typical clap carrier.  But making assumptions is foolish.  Now you know.  Carry your own rubbers, doggone it.

This post has been on my mind for several days, but I was reminded of it while standing in the local CVS today.  There at the window was a sign: H1N1 flu shots are here!  Yay!  Might as well have said, “You’re stupid!” as federal health officials prepare to burn 40 million doses of the swine flu vaccine.  Excellent, right where the garbage belongs–in the incinerator.

This is just the latest chapter in the crock called swine flu.  Last week the Associated Press reported that 25% of swine flu vaccine stocks were preparing to burn, $260 million worth.  Add to that another 30 million doses that will expire soon and it totals 43% of the U.S. supply.

And to this I say: BRAVO America!  You did well on this one.  Didn’t fall for the sham of the new century.  Yes, yes, health officials have claimed it was “better to be safe than sorry,” thus overstocking was the prudent thing to do; however, word is out that World Health Organization (WHO) swine flu experts had financial ties to companies that stood to profit from the new pandemic.

You don’t say…government health officials linked to $$$?  Health emergency declared by “scientist” that stood to profit?  Well bite my H1N1.  Good job keeping your eyes open, America–keep them that way–there’s still much to see.

This just in: The City of Long Beach is considering taxing medical marijuanaJoinks!  Taxing pot?  Is that ethical?  Don’t know, but a public hearing to put this issue on the ballot for November was passed by the City Council 8 to 1.

According to the L.A. Times, medical marijuana collectives are looking at a possible 5% tax if the measure passes.  This could help a cash-strapped Long Beach put a dent in its $18.5-million deficit.

But medical Mary Jane proponents are throwing up their arms in protest.  They argue that marijuana is medicine, and exempt to tax as are all medications.  Hmmm…good point, stoners.  Counter point.

Oakland is one city already taxing chronic clinics, and Berkeley, Sacramento and San Jose are considering similar measures that would tax collectives 2.5% to 5%.

“We tax alcohol. We tax cigarettes. Why wouldn’t we look at taxing marijuana?” said Councilman Patrick O’Donnell. “We’re turning over every rock to find new revenues, and under one of those rocks may be marijuana.”  Oooh….nice comeback.  Stoners.

If a tax must be enacted, Americans for Safe Access (the nation’s leading medical marijuana advocacy group) spokesman Kris Hermes said, “the tax burden should be removed from the patient to the extent possible.” 

Well, I must admit I am miserably in the middle on this one.  I do think marijuana should be legal–both for medicinal purposes and for recreation (see my surefire get-elected-to-Congress plan here).  And I also think it should be taxed, like booze and tobacco.  But it is pretty hard to argue with the point that other doctor prescribed medicines are tax exempt.  In that situation…sorry, rigid-rectums…but I gotta side with the stoners.  Bottom line: marijuana is a prescribed drug, benign when compared to the likes of Vicodin and OxyContin, so…gotta give it equal protection.

As it turns out, if Proposition 19 to legalize marijuana for recreational use passes in California this year, a 10% tax (on pot dispensaries) is likely to be levied.  And good–’bout time this damn puritanical society got with it–legalize pot and earn off this cash crop.

(Dusting off hands) There ya go: simple economics–everybody’s happy.  Now was that so hard?

Are you a firm believer in medical care? Do you think medicine is the best bet at getting you healthy and keeping you that way? Do you think, for the most part, when done right, medical care is pretty darn badass—doctors can tell you what’s wrong with your body, and get you better fast? If you’ve answered yes unequivocally to any one of these questions, then you are likely a future plaintiff in a malpractice suit.

Oh yes, you heard me right—if you champion western medicine to the degree that you think it’s nearly infallible, you will probably one day consider a malpractice lawsuit against the doctor(s) or hospital that doesn’t live up to your fantasy. Don’t feel bad—you are definitely not alone. In fact, you belong to one of the largest groups in the country: The Disillusioned Medical Victim. (Read this article: 9 in 10 doctors blame lawsuit fears for overtesting)

You know who you are. You worship medicine. You think Dr. Oz is the smartest guy on T.V. (and quite the looker, too). You wouldn’t think of taking a lesser health care practitioner’s opinion on your serious health issues. Oh no, if it ain’t Harvard magna cum laude, you ain’t buying it. But if the doctor is a specialist, then, well…she may as well walk on water.

Except it’s all an illusion. Doctors are people like you and me (OK I’m a doctor; I mean like you and your sister).  They have some extra knowledge and training, but guess what? They don’t know as much as you think they do. And they eff up like we all do. And when you have an experience in which your almighty doctor fails to miraculously fix you, guess what you are going to do? You are going to blame him/her/them.


It’s their fault, right? Yes, their fault you have cancer, are de-conditioned and ripe for disk herniation, or have complications with your routine surgery. They failed to find the problem, test well enough, or prescribe the proper treatment. Right?

Yes that’s how it happens. And it’s why medical malpractice is through the roof. It’s why doctors order an inordinate amount of tests, whether you really need them or not—to protect their arses!  It’s why medical costs are astronomical (if you are still living by the illusion that medical costs are out of control because people don’t have federally funded health insurance, then there may be no hope for you…ever) and will continue to grow until something changes.

Sure we could push for tort reform and hope that the problem goes away. OR…how about you just a) take better care of yourself, b) stop living by the illusion that medical care is for anything other than crisis care, and that you are at risk every time you use it (doesn’t mean don’t use it—just know the risks), and c) YOU ARE RESPONSIBLE FOR YOUR OWN HEALTH! Nobody’s to blame but you if you put all your eggs into one health basket. So don’t go crying to your malpractice attorney when the doctors don’t live up to your illusion.

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