A consumer reports study reveals that 24% Americans have health insurance that barely covers their medical needs and leaves them unprepared to pay for major medical expenses. This is in addition to the 16% that have no health insurance at all.

A recent study suggests that people who drink one or more diet sodas per day have higher risk for heart disease.

“How can something with zero calories that’s 99 percent water with a little flavoring in it…cause weight gain?” said Susan Neely, president of American beverage association, in response to this study.

Andis Robeznieks writes about personal health records (PHR) in Modern Healthcare, a weekly magazine. It discusses the technical, clinical, legal and operational headaches it can create for physicians. The patients create PHRs with the help of numerous electronic tools available. Some of these tools could create PHRs that are excruciatingly fancy and impractical from a health provider’s stand point.

A recent Wall Street Journal article by Avery Johnson discusses possible association between statins and Lou Gehrig’s disease. Lou Gehrig’s disease is a debilitating disease characterized by severe muscle weakness. The statins are a group of most commonly used cholesterol lowering medicines.

What is enlarged heart?

One of my doctors told me that I have enlarged heart. But another doctor recently told me that my heart is normal. I am confused.

If you were to ask people what disease they are afraid of the most, the large percentage of older adults will say- stroke. This is because most of the people have seen someone with stroke’s devastating and disabling effects. Still, most of us are not as aggressive about seeking medical attention for stroke as we are for chest pain. Some of the reasons for this are:

A recent study raises concerns about the safety of Avandia, a drug widely used for diabetes control. This has attracted a lot of (I think too much) attention. Here are my concerns:

Antibiotics are routinely prescribed prior to a dental procedure if you have a heart valve problem. This is done to prevent infection of the heart valves- disease called infective endocarditis (I.E.). The routine of giving antibiotics to prevent I.E. is called I.E. prophylaxis. Here is the who and when of I.E. prophylaxis according to new guidelines published in the online edition of the journal Circulation on April 19, 2007.
- Who needs it? The I.E. prophylaxis is needed only if you have the following heart problems: an artificial (‘pig’ or ‘plastic’) valve, previous history of infective endocarditis, certain (not all) congenital heart diseases, history of heart transplantation with damaged valves of the transplanted heart. No more antibiotics if you just have thick valves or even mitral valve prolapse (MVP).

The blockage of heart arteries is caused by a complex- not completely well understood- process called atherosclerosis. It is characterized by cholesterol deposits in the wall of the arteries that supply blood to the heart muscles. Why do some people have blockage of heart arteries and some do not? It could not just be the cholesterol we eat or manufacture in our body, because we do know that not everyone with high cholesterol has blocked heart arteries and some with perfectly normal cholesterol have heart attacks.

So what exactly causes blocked heart arteries? The simple answer is- we do not know for sure. Several theories have been suggested, however. Could this be due to some infection with a bug? Could this be inflammation? Studies that show that people with high level of C-reactive protein (CRP) are more likely to have heart problems seem to support inflammation theory.

I recently saw a patient in my office for the first time. While I was going over his medicines, he told me how he saved a lot of money by buying his medicines from Mexico. Nearly all the medicines he was on were available through Walmart and Target’s four dollar prescription program. He was not aware of this program. We determined that he will save tens of dollars buying his medicines from Walmart or Target- not to talk about expense and hassle going all the way to Mexico.
The chain stores Target and Walmart announced their $4 prescription programs several months ago. Several people around us are still unaware of these cheap prescription options. Some of these people are buying expensive medicines when they hardly have enough for daily needs. Others choose not to take these medicines because of ignorance of these cheaper options. Let us tell everyone around us about these options. Please e-mail this article to at least five people you know.