REPORTING POINT 03-05
HEALTH NEWS
“Live healthy...live well”
by Larry Kline
SWAPA Voice Mailbox 4337/email: livehealthy-livewell@cox.net
(Past issues of “Health News” are available on my son’s website, which includes a word-search engine - just go to the site with your browser and insert the key word to find past articles: http://home.earthlink.net/~candace_ball/healtharticles/frameset.htm) – LK
HAVE A ‘STACHE AND ALLERGIES? – if you suffer from allergies and have a mustache, wash it twice a day with liquid soap. One study found that patients who did this used fewer antihistamines and decongestants as the cleaning got rid of stuck pollen grains. Men’s Health 11/03.
MRIs VS. MAMMOGRAMS - when it comes to detecting breast cancer, new research suggests the MRI scans find nearly twice as many tumors as mammograms.
Ordinary mammograms are still recommended for screening most women starting at age 40, but the benefit of better detection from an MRI (magnetic resonance imagine), may outweigh its drawbacks for those with a strong family history of breast cancer. MRIs also may make monitoring a less dangerous option for women who choose them instead of having healthy breasts and ovaries removed as a preventive measure.
The value of mammograms for women at average risk of breast cancer has been debated recently, though most doctors agree that the test still saves lives in women over 50. The new study involved women with a higher than average risk, such as those with a genetic predisposition for the disease such as having a mother or sister who had breast cancer.
The researchers compared mammograms, which are breast X-rays, to MRIs, which use magnets to make detailed images without radiation. An MRI costs $700-$1,000, about 10 times the cost of a mammogram. Associated Press 7/29/04.
NUTRITIONAL QUIZ 16 – if you want to enjoy poultry that is low in fat, always
a) buy free-range organic
b) remove the skin before eating
c) opt for the breast over dark meat
d) avoid duck
Answer is below.
ANOTHER BACK PAIN OPTION – a study published in the American Journal of Pain Management shows that a single shot of Botox may reduce back pain. Patients who received just one injection into their neck or back muscles reported 40 percent less pain after 8 weeks, and more than half of the subjects reported complete relief after 12 weeks. By relaxing muscles, Botox helps patients progress more rapidly in therapy. Men’s Health 6/04.
“I must be getting absentminded. Whenever I complain that things aren’t what they used to be, I always forget to include myself” George Burns.
HIGH BLOOD LIPIDS? – high blood triglycerides (fats in the bloodstream) may be lowered by adding flaxseeds, walnuts, and canola oil to the diet. These are all rich in an omega-3 fat called alpha-linolenic acid, which appears to lower triglyceride levels. Extensive research has shown that alpha-linolenic acid helps protect the heart, although scientists have not understood how exactly this happens. Now, by reducing triglyceride levels in the blood, alpha-linolenic acid could lower the risk of heart disease. University of California Berkeley Wellness Letter 3/04.
NUTRITIONAL QUIZ ANSWER: b) and c) How the poultry was raised is not relevant nutritionally. Removing the skin can cut the fat content by three-quarters and the calories by half. Skinless dark-meat chicken has two to three times as much fat as breast meat. Skinless duck breast contains slightly less fat per ounce than skinless chicken breast. University of California Berkeley Wellness Letter 6/03.
AIR FRESHENERS = HOUSE “SMOG”- air fresheners don’t eliminate bad smells, but simply cover them up with other odors. The plug-in variety of air freshener is becoming more popular with increased marketing in the media. Air fresheners come in other forms, including aerosol sprays, wicks, heated pots, but the plug-ins now dominate the market. Often scented with pine or lemon smells, these fresheners look like night lights and when plugged into an electrical outlet, use a small electric motor to generate the freshening smells.
The “freshening" odors released are usually pinene, limonene, and other volatile organic chemicals that can promote cancer at higher levels. A recent EPA study found that the emissions from plug-in air fresheners can combine with ozone to produce formaldehyde and other substances known to cause respiratory problems and trigger asthma attacks.
Household ozone occurs on a day when outdoor air pollution enters the home through open windows. Also, some air purifying machines generate ozone. Table models with electrostatic precipitors emit ozone. Machines marketed as generating “superoxygen” or “mountain fresh air” usually emit ozone. Some ads even tout that the product (such as the Airtech 2000) produces ozone to eliminate odors! These machines, when used with air fresheners can actually produce household “smog."
Another hazard associated with plug-ins is fire hazard. Some products have been recalled as a result of increased fire risk. University of California Berkeley Wellness Letter 8/04.
BREAST CANCER BASICS – breast cancer is the most common malignancy in women, and the second leading cause of cancer deaths for females, after lung cancer. In 2004 some 215,000 new cases have been diagnosed in women while another 59,000 more women will learn they have a noninvasive type of breast cancer called ductal carcinoma in situ. With earlier detection and better drugs, mortality rates have declined 2.3 percent a year since 1990. Still 40,000 women will have died in 2004. Mammograms are still the best way to find tumors early. The American Cancer Society recommends annual screenings starting at age 40, plus routine exams.
Lumpectomy with radiation is as successful as mastectomy for most women. Other therapies include a relatively new treatment, which combines the cancer-fighting toxic drugs in fat-coated droplets that only release the toxic drugs when they are heated to 102 degrees – a higher temperature than the body normally reaches. By gently warming breast tissue to this higher temperature, the cancer-fighting chemotherapy drugs are released only near tumors without poisoning the rest of the body. The patient lies facedown on a padded table with the affected breast protruding through an opening into a tub of warm water.
A new test recently became available that can determine how aggressive detected tumors are. The test can determine if a tumor is “node negative” (the cancer has not spread to any lymph nodes) and “estrogen positive” (two-thirds of breast cancers are fueled by estrogen). Within this group, only 15 percent of women who take the estrogen-receptor blocker tamoxifen have their cancer recur after surgery. Conservative medical therapies also call for chemotherapy since it will further reduce the incidence of cancer recurrence to 11 percent. That is an additional benefit to only four out of 100 women. The new detection test assesses 21 key genes in a tumor-tissue sample and rates the tumor on a zero to 100 scale, with the higher numbers indicating a greater need for chemotherapy to follow up tamoxifen treatment. The test is very expensive ($3400) but is cheap compared to chemotherapy.
While tamoxifen is very effective in fighting tumor recurrence, its effectiveness only seems to last about 5 years. Newer drugs like aromatase inhibitors may extend disease-free survival after tamoxifen therapy. This class of drugs only seems to work in postmenopausal women
Another new therapy in the war against breast cancer is being tested at M.D. Anderson Cancer Center in Houston. This technique uses radio frequency waves to destroy small tumors in older women. A radio probe is inserted into the breast and guided to the tumor site by ultrasound. When energized, radio waves from the probe heat the tumor until its proteins are “fried." This therapy is not an option for younger women with denser breasts and more aggressive cancer or those with large tumors. Newsweek 5/10/04.
From the Flight Surgeon:
"SNAGS & DRAGS"
by Joe Battersby, D.O.
FAA Medical Examiner
(insert picture of Joe here, please-LK)
(Margaret, Joe, and Mary Jane)
(edited for this publication from ”America’s Flyways,” 6/04-LK)
Experience has shown me that many airmen do not have adequate knowledge of F.A.A. medical standards. For this reason, I have listed (perhaps as a review) the conditions that preclude the AME from issuing medicals directly at the time of examination. I’ve called these “snags” because they require greater evaluation in order to clarify certificate issues. Note that isn’t the same as my saying that they are “dead ends.”
Stated bluntly, the AME is not the Enemy, and the physical exam is not an obstacle course. When I meet an airman for the first time and find a lean, mean young six-footer sweating under the arms in fear of the physical, something is definitely wrong with the system!
Perhaps it’s that the airman doesn’t really know about disqualifying medical standards. Because his livelihood is at stake, he can be made to feel he is walking alone in a minefield, so that is why I want to clarify the standards and maybe turn this situation around - hopefully, a lot.
First, the FAA's criterion for disqualification is “any condition that could lead to sudden incapacity…” If that’s all you learn from this article, I’ll be a little disappointed, but we will have at least made a beginning.
What are these conditions that preclude the AME from issuing a medical certificate?
- Diabetes requiring insulin or other medication
- Angina pectoris (chest pain due to heart disease)
- Coronary disease that has required treatment or, if untreated, has been symptomatic or clinically significant
- Myocardial infarction (heart attack)
- Psychosis (major mental disease)
- Severe personality disorders repeatedly manifested by overt acts
- Alcoholism or drug dependency
- Epilepsy
- Disturbances of consciousness lacking satisfactory medical explanation
Basically then, we’ve described an insane drunk who also abuses other drugs, has a bad ticker, is a diabetic epileptic who passes out every once in a while for no apparent reason. Sound like your captain? Very bad joke!
Having listed these problems and drawn a profile of sorts, are we saying that airmen with any of these conditions are like Clementine, “lost and gone forever"? No. Diabetes can revert to diet-only control, alcoholics can recover, and heart disease can often be successfully resolved. Time can reveal previously hidden explanations for problems.
The “sudden incapacity” issue raised by these problems places a heavier burden on the airmen to prove to the F.A.A. that they are now OK. That’s understandable.
To this point I’ve been talking about Mandatory Denial as listed above. The AME cannot issue a certificate at the point of examination. Should these conditions subsequently be resolved to the FAA’s satisfaction, the medical may then be issued. That’s it for “sudden incapacitation.” Now I’ve got another one that I call “so do you!”
A number of other conditions require medical documentation that they are under control or no longer deter the satisfactory performance of an airman’s duties. These include high blood pressure and duodenal ulcers, to name just two. Here, the FAA spells out to the AME what it considers appropriate medical evidence that these problems present no realistic obstacle to any airman’s operation of the equipment.
The FAA wants to know your blood pressure in OK, your ticker is OK, and that the medications your doctor has you using aren’t bothering you. So do you. They want to be sure you’re not likely to have another big kidney stone episode…so do you! I’m sure you get the idea.
A caring and knowledgeable AME will advise your own doctor of the formal federal data required in each case. He’ll review and pass on its acceptability. The AME may then, at his discretion, issue a certificate. I think only an idiot would urge his A & P not to do a compression check on his engine during an annual because the numbers might not be good. So do you!
To wrap this up, just remember “sudden incapacity” and “so do you," along with the differences.
Acting on my advice will save you a great deal of time and hassle!
The issue of “drags” is a matter of attitude. Some conditions, i.e., high blood pressure and glaucoma, for example, require periodic re-evaluation and submission of these follow-ups with the exam results. I think that for the most part, these requirements are justified and easy to meet. They represent the proper follow-up on the part of the Doc who is taking care of you. Any “drag” aspect of this probably arises because the airman did not think to check with his AME to see if he needed any extra data to present before scheduling his medical. The AME, ALPA, SWAPA, or AOPA medical guys will be happy to provide you with necessary information. Should you check with the FAA? Sure, if you don’t mind being put in a holding pattern.
Best,
Joe
