Category: Medicine Hat News

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Ten reasons for Klein to butt out!

Ten reasons for Klein to butt out!

An open letter was sent to Mr. Klein and it was published in the Medicine Hat News on Monday, August 25th, 2003, Page B4.

From: Dr. Noorali Bharwani [mailto:bharwani@monarch.net]
Sent: Friday August 22,2003 12:17 PM
To: premier@gov.ab.ca
Cc: Letters- Medicine Hat News
Subject: Open letter to Premier Klein – time to stop smoking!

Dear Mr. Klein:

I am shocked and disappointed to read in to-day’s Medicine Hat News (Klein slams butt bylaw) that you smoke. I was very proud of you when you publicly accepted that you were addicted to alcohol and took action to rid yourself of that evil. Now it is time for you to go public and say smoking is an evil which not only destroys your health but drains our health care system of precious dollars which can be put to better use.

In your recent statement you gave several reasons why you think smoking is a lesser evil than alcohol. I beg to disagree. And I think many Albertans and Canadians are going to be disappointed that you chose to make a statement which will encourage people to justify their smoking. As a premier who cares about the health of Albertans and how every dollar is spent in the health care system, I would have expected that you would have given the following ten reasons (well publicized in Health Report to Albertans 2003; AADAC’s It’s time to tell the truth about tobacco; and Alberta Cancer Board’s Cancer in Alberta, January, 2003) why all Albertans should stop smoking and discourage others to start smoking:

1. Albertans smoke more than the national average.

2. In 2000-2001, 683,900 Albertans were smokers.

3. Tobacco causes one in five deaths in Alberta.

4. Tobacco use is the leading cause of preventable illness, disability and death in Alberta and Canada.

5. Tobacco is the cause of an average of 3,400 premature deaths each year in Alberta.

6. Smokers have two to four times the risk of heart attack and sudden death from coronary artery disease than non-smokers.

7. Smoking around children can negatively impact their health.

8. Smoking during pregnancy is associated with low birth weight and health problems in infancy and later on.

9. Exposure to second-hand smoke can increase non-smokers’ likelihood of developing asthma, heart disease and lung cancer and

10. Nicotine is addictive.

I hope these are ten good reasons to declare smoking a monstrous evil and call on all Albertans to quit smoking. And you may want to set an example by throwing all your cigarettes in the garbage. I am sure many Albertans and Canadians will be grateful to you and be proud of their premier who always sets a good example when it comes to self-discipline.

Yours Sincerely,

Dr. Noorali Bharwani
(A concerned citizen)
Medicine Hat, AB
www.nbharwani.com
bharwani@monarch.net

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Celebrating 5th Anniversary

My purpose in writing a column……is to stimulate people
to think about what I consider fairly important issues.
It does not matter to me if people agree or disagree.
I don’t pretend to be omniscient, and, in fact,
I am no smarter than anybody else.
Charley Reese, Orlando Sentinel
December 27th, 1998

This week marks the fifth anniversary of “What’s up doc?”

It is hard to believe that five years have gone by.

It was the summer of 1998, when I had a meeting with Gordon Wright, the then Managing Editor of the Medicine Hat News. With his help and encouragement, the first column appeared in the News on August 13th, 1998.

Since then, and as of last Thursday, we have published 190 columns. That is 38 columns per year, 3.16 columns per month or 0.73 column per week.

The column first appeared every second Thursday. Currently it appears every Thursday except the third Thursday of the month.

The purpose of the column is to help the reader understand the various aspects of health care spiced with a local touch.

I look at the medical journals and listen to people’s health concerns and discuss what is new and what is important.

I try to explain to readers why it is important to take certain proactive preventive measures to live a happy, stress free and healthy life.

I try to explain that medicine is not a perfect science and doctors are like any human beings – from time to time vulnerable and prone to making mistakes.

My columns have been sometimes serious, sometimes lighthearted but hopefully simple, educational and current. I hope they have not been outrageous or divisive. I apply the principles of 4Cs – the column has to be clear, concise, correct, and complete.

Writing the column has also been a selfish endeavor. Teaching is the best way to learn. Sharing knowledge is the best way to improve one self. In the process I have learnt a lot about myself, my health and my own deficiencies.

I have tried to follow what I write and in the process I have made significant changes in my own lifestyle. One change at a time has added up to a better and satisfactory lifestyle so far. Rome wasn’t built in a day. So there is still hope to achieve nirvana – an ideal condition of rest, harmony, stability, and joy.

One column which generated the most response and comments from the readers was the one about my mother – her brief life history and battle with a large benign brain tumor
(May 4th, 2000). Old age can be cruel and right now she is praying very hard for nirvana.

ELMOSS (exercise, laughter, meditation, organic healthy foods, stress relief, and do not smoke) has been my guiding principle. I have written many columns on this subject.

Many other subjects have been covered in these columns. Space does not allow me to mention them all. But my web site is under construction and I plan to put all my columns on the internet. Hopefully, by the end of this month, you may be able to browse it.

Writing is a dangerous and contagious disease and I am infected with it! But the point of good writing is knowing when to stop (L.M.Montgomery). So, let me end this column by saying “thank you” to the Medicine Hat News and to the readers for your support.

The column will be back in two weeks!

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Screening Mammography

Screening mammography – is it harmful or helpful?

Hard to think that it could be harmful when so many women go through the procedure.

In Medicine Hat, 1989 was the first full year of mammography when 1046 mammograms were done at the Medicine Hat Regional Hospital (MHRH). These were mostly for screening (women with no palpable breast lump or symptoms) and some were diagnostic (women with breast lumps or with symptoms).

In the last four years, MHRH has transferred mammography services to the private clinic (Blair Stubbs and Associates Radiology Inc.). In 2001, Blair Stubbs did total of 5229 mammograms. In 2002, they did 7454 mammograms (screening 5857, diagnostic 1597).

An article in the New England Journal of Medicine (NEJM) says that 71 per cent of women in the United States who were 40 years of age or older have undergone mammography during the previous two years – an increase from 54 per cent in 1989.

Good news is that since 1973, mortality from breast cancer has been decreasing steadily. Is this due to treatment or due to early diagnosis from screening? Experts are not sure. Could be due to both.

For almost 20 years, there is a uniform agreement among the experts that screening mammography saves lives (20 to 35 per cent reduction in mortality) among women in their 50s and 60s, although the disagreement persisted about the usefulness of screening mammography in other age groups, says the NEJM article.

For many years, there has been controversy over the use of screening mammography for women in their 40s. Analysis of multiple studies show that screening in this age group decreased 15-year mortality from breast cancer by about 20 percent.

What about older women? Studies in the Netherlands found that screening women between 65 and 74 years of age led to a 55 percent decrease in mortality from breast cancer, says the NEJM article.

Sounds wonderful. But are there any risks associated with mammograms?

False positive mammograms and over diagnosis can be harmful. Here are the numbers:

-An average of 11 percent of screening mammograms is read as abnormal and necessitates further diagnostic evaluation.

-Breast cancer is found in about three percent of women with an abnormal mammogram (representing 0.3 percent of all mammograms).

-On average, a woman has about a 10.7 percent chance of a false positive result with each mammogram.

-After 10 mammograms, about half of women will have had a false positive result, which will have led to a needle biopsy or an open biopsy in 19 percent of cases.

-False positive mammograms increase patients’ anxiety.

-12 months after a false positive mammogram, women initiated more health care visits for both breast-related and non–breast-related problems.

Some women find mammography painful, there is a small radiation exposure, and false negative interpretations are possible in about 15 per cent of mammograms.

Like any screening and diagnostic test, mammography is not a perfect science. It should be interpreted with care in combination with clinical examination, needle biopsy, and any other tests which may become necessary to come to a diagnosis.

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Vitamin Poisoning

Are you taking too many vitamins? Do you know the harmful effects of consuming excessive vitamin and mineral supplements?

Vitamin deficiency syndromes are uncommon in Western countries. Overeating is more prevalent than starvation.

Then why 30 per cent of the population consumes over-the-counter vitamin and mineral supplements?

The answer is simple. They hope to improve their health and prevent disease. For healthy individuals, experts recommend the following vitamin supplements:

1. folic acid (400 ug/day) – reduces the risk of heart disease, colon and breast cancer and birth defects during pregnancy,
2. vitamin B6 (2 mg/day) – keeps homocystein levels down and reduces the risk of heart disease,
3. vitamin B12 (6 ug/day), – same as B6 plus reduces the risk of cancer,
4. vitamin D (400 IU/day) – minimizes risk of osteoporosis and fractures,
5. omega-3 fatty acids (1000 mg/day or eat fish two to three times a week) – reduces the risk of sudden heart attack by 50 to 80 per cent, and
6. a multivitamin will ensure an adequate intake of other vitamins for which the evidence of benefit is indirect.

Regular use of vitamin E and C remains controversial.

Recently, the UK Food Standards Agency reviewed 36 vitamins and minerals and discussed the potential harms that can come from consuming such supplements. This information is summarized in the Canadian Medical Association Journal by Dr. Eric Wooltorton.

If a person consumes high doses of some vitamins, especially taking them on a regular basis, may suffer from side effects. The side effects generally involve the liver, stomach and bowel. Such as: nausea, vomiting, diarrhea, liver damage, visual problems, nerve damage etc.

The CMAJ article says that minerals taken as supplements can also be toxic. For example:
-magnesium can cause diarrhea at doses above 400 mg/d;
-phosphorus can cause diarrhea at doses above 750 mg/d, and mild nausea and vomiting at lower doses;
-iron can cause constipation, nausea and vomiting, reduced zinc uptake, and iron overload;
-zinc can cause nausea and vomiting, immunosuppression and impaired copper uptake; and
-selenium at doses above 0.91 mg/d can cause brittle hair and nails, peripheral neuropathies and gastrointestinal upset.

Is it possible to prevent vitamin and mineral toxicity?

Yes, regular screening enquiries about the use and dose of vitamin and mineral supplements may help to optimize a patient’s nutrient intake and avoid potential harm from inappropriate use of supplements (e.g., intake of beta carotene by smokers may increase the risk of lung cancer), says CMAJ article.

The article says that the European Union recently moved to adopt strict labeling standards for vitamin and mineral supplements, including having manufacturers list the percentage of a person’s daily intake that is represented by one dose of the product, as well as toxicity warnings when they are appropriate.

Will Canada adopt similar standards? asks Dr. Wooltorton. Only time will tell. In the mean time, do not over dose yourself with vitamins and minerals. Eat a healthy diet, eat lots of fruits and vegetables, exercise regularly and take vitamins as described above.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!