The Future of Medicine
57

Out with the Old and In with the New

Is the Placebo Effect Real?

A recent survey suggests that many doctors believe that by giving their patients a placebo, a treatment or medication without a known scientific clinical effect, it will have the same, if not better, result than actual medicine.

“People come to the doctor, and they want to hear an answer, and they want to hear a solution,” Dr. Ordon says.

Dr. Lisa points out, “If you use that as a treatment, that’s a lie to the patient ... If you just start giving patients fake medication, then they’re going to stop believing in doctors. That’s just not right.”

Dr. Ordon clarifies that he means the placebo effect of alternative forms of treatment like massage or exercise.

Dr. Travis adds, “Just thinking a placebo will work is oftentimes enough to induce our own natural painkillers.”

Dr. Jim points out that placebo medication has been shown to decrease coughs, headaches, backaches and depression and even lower blood pressure and cholesterol.

“It’s mind over matter,” Dr. Ordon says.

The Doctors agree that they never prescribe fake medicine to their patients and never tell them they are giving them a medicine they are not.

“There are effective means of using the placebo effect without lying to your patient,” Dr. Travis concludes.



Hypothermia Therapy for Heart Attack Victims

Some doctors are using a new hypothermic treatment on patients who go into cardiac arrest following a heart attack. Though the number of physicians using the procedure is still small, the American Heart Association recommends it.

“What you’re doing is you’re basically slowing down your body’s metabolism, and when you do that, your brain — the most essential organ of all — requires less oxygen and fewer nutrients,” Dr. Travis explains. The brain will survive for a longer period of time in this state, known as hypothermia.

Dr. Jim adds that hypothermia is a common condition in drowning victims. “If you drown in a warm pool, you’re much more likely to suffer brain damage from oxygen deprivation, as opposed to a really cold pool where you’ve got a lot better chance,” he explains.

The Doctors warn that if you’re near a person who has suffered a heart attack, the most important move to make is to first call 911. “[Hypothermia treatment] is only affective once the heart has regained its rhythm,” Dr. Travis says. “This isn’t what you’re going to do before you start CPR and your life-saving procedures.”



A Cure for the Common Cold?

During cold season, most adults suffer two to five colds, while kids can come down with 10. A new study sponsored by Vicks, in conjunction with the University of Virginia and the University of Calgary, examines the rhinovirus — the virus that often causes the common cold. Researchers inoculated volunteers with the rhinovirus and took samples of the infected cells. They discovered that certain genetic materials were being activated in these cells. Next they will research whether there’s a way, at the cellular level, to prevent the body’s response. “It’s the body’s response that causes the runny nose, the cough, the congestion,” Dr. Travis explains.

Dr. Jim adds that cold symptoms result from the body’s immune system overreacting. He adds that in the future, we may be able to affect the genes that control the immune response so our bodies don’t respond with an out-of-proportion reaction.



Painless Root Canal?
If you’ve ever had a root canal, you know it can be a dreadful experience. But developers of a new laser claim their beam of light makes the procedure painless and easy. Cosmetic dentist Dr. Bill Dorfman explains that Biolase Technology recently introduced the Waterlase laser for root canals. “The cool thing about this is usually there’s no pain, no shots, and we’re using a combination of the laser plus water to clean out the root instead of using Clorox and files like we used to use,” he says. Using an animation, Dr. Bill explains that teeth have a hard surface on the outside and a soft area inside which is the nerve. If bacteria eats into a tooth, the tooth can become infected, and the infection can affect the nerve. “When that becomes infected, we need to remove the nerve, otherwise your face just blows up,” he says. “So it’s really important to do a root canal when you start having pain like that.”

Visiting dentist Dr. Darrell Chun uses three new technologies while performing the first televised laser root canal in the procedure room on patient Kenya. He uses a handheld NOMAD Pro X-ray machine, the Waterlase laser to clean out the tooth and remove the nerve, decay and infection, and a HotShot to fill the root canal.

At the end of the show, Kenya declares, “It was absolutely painless, and I’m not afraid to go to the dentist now. It was wonderful.”

Dr. Bill explains Kenya’s condition. “When you have a normal, healthy tooth, the nerve is pink and healthy,” he says. Pointing to a model of teeth he explains, “But what happened with Kenya is she started to get decay in here.

That decay grew and grew and grew, and then the nerve died. Once the nerve dies, we have to take it out. If you don’t take the nerve out, you get this big abscess.” Dr. Chun removed Kenya’s nerve, cleaned the area with a laser and then filled the canal with gutta-percha. “That gutta-percha is like a resin, and that will stay there for the rest of her life.”


Find
a dentist who does this laser root canal.


Is Hysterectomy the Only Option?
Twenty years have gone by since Sheila last visited her OB/GYN for an examination when her physician informed her that she had uterine fibroid tumors. The doctors told her not to worry about the growths, and that they could remove them when she had children. Sheila never became a parent and now suffers pain and discomfort from the masses. “As the years keep passing, it gets worse and worse,” she says. “It’s a sharp pain. I can’t get rid of this bloated feeling.” The only option doctors have offered her to remove the tumors is a hysterectomy, a surgery she’s not willing to undergo for a fear of losing her femininity.

Holding up a model of a uterus with fibroids attached, Dr. Lisa explains that they are benign growths on the uterus. “This is very, very common. Almost every single woman in her lifetime will have a fibroid,” she says.

“There are no known supplements for fibroids. There are some known treatments.”
Using animated graphics, Dr. Lisa explains the different types of hysterectomies. “You have to pick the right patient for the right surgery,” she tells Sheila.

Dr. Lisa performs an ultrasound onstage to find out the condition of Sheila’s fibroids. She determines that the masses are small. She tells Sheila that new procedures are available for women who have fibroids but don’t want to undergo a hysterectomy. One procedure is uterine fibroid embolization, where a radiologist inserts coils into the uterus via arteries on the thigh.

“Those coils cut off blood supply to the fibroids,” Dr. Lisa explains. “This is good for very small fibroids that may be causing a little bit of problems.” This is not the best option for a woman with bigger fibroids or someone who wants to have children. Another treatment is endometrial ablation, an outpatient procedure where heat is used to cauterize the endometrial lining of the uterus. “That’s really a procedure where you don’t have fibroids, and your problem is really bleeding,” she says.

“I don’t really think you are a hysterectomy candidate,” Dr. Lisa says to Sheila. She encourages her to see her doctor and have a pelvic exam to determine the cause of her pain.



Ask Our Doctors

Beth from New Mexico says she read that it’s safe to drink a glass of red wine while pregnant. She asks, “What is the limit of alcohol consumption before it affects a baby’s development?”

“We do know about fetal alcohol syndrome, and that can be very serious. It can cause a lot of facial defects, as well as mental retardation,” Dr. Lisa says. “We also know that a certain amount of alcohol will actually decrease the IQ of a baby, too, and we don’t know at what point that changes from nothing, to decreasing the IQ, to fetal alcohol syndrome, so it is still no alcohol.”

Cathy writes to Dr. Sears, “I had my daughter four years ago, and I missed the opportunity to save the stem cells from my umbilical cord. Is there another way that I could save my daughter’s stem cells?”

Dr. Sears explains that stem cells offer the potential for future treatment of serious ailments. Another source of stem cells is the pulp inside your child’s tooth. He suggests planning ahead for a dentist visit. “There’s a company called StemSave, and they will send you this kit,” he explains holding up a metal container.

When the dentist pulls your child’s tooth, he or she puts the tooth in a special solution that preserves it. You send the tooth in the special container back to the company for storage. The total cost is $600 for the kit and preservation and $100 per year for continued storage.

“We can also get stem cells when we do liposuction,” Dr. Ordon adds. “Fat does have stem cells in it.”


Erase Years from Your Face

Growing up in California, Stephanie spent many days basking in the sun. Now, 41, she notices discolorations on her facial skin. She recently paid Dr. Ordon a visit to undergo a procedure using the Pearl laser.

Dr. Travis asks Stephanie, “Have you noticed a difference?”

“I have. I’m really happy,” she replies.

Dr. Ordon explains that the treatment addressed Stephanie’s brown and red spots, improved the texture of her skin by eliminating her fine lines and reduced her pore size. “By treating you with this laser, we replaced all of your outer skin — the epidermis — and at the same time, we put heat into your dermis, which causes your own skin to produce collagen and tighten up the elastin,” he says.

Stephanie adds that the procedure was virtually painless, and she only had three days of downtime.

Dr. Ordon also used VISIA Complexion Analysis to take ultra-violet images of Stephanie’s skin before the treatment. “She had a ton of freckles. She had fine lines affecting her texture, and she had significant and large pores on her skin,” Dr. Ordon explains. Onstage, Stephanie gets in front of the VISIA machine for new pictures. “Huge difference from the before and after,” Dr. Ordon says.



Cochlear Implant

When Kelli and Michael’s 10-month-old daughter, Landry, was born deaf, the couple faced a difficult decision: let her grow up deaf, or allow her to undergo a controversial surgery to have a cochlear implant placed in her ear. The FDA does not approve of the implants until a child is 1 year old, but studies have shown that the earlier a child starts hearing, the better he or she adapts. Another concern is that once the implants are placed, they cannot be undone. “It ruins any residual hearing that she may or may not have,” Kelli says.

After trying many alternative therapies, the couple decided to have the implants placed in their daughter’s ears. “We pray we’re making the right decision by doing this,” Michael shares.


The Doctors
cameras go inside the operating room and capture the surgery on tape. It is extremely rare for a baby to undergo this procedure, and Landry is one of the first babies her age to have the implants. The Doctors cameras were also there when Landry’s device was turned on one week after surgery. After a few tests, Landry responds to the sounds.

In the studio, Dr. Travis asks Kelli and Michael, “How has Landry done post-op?”

“She’s done better than we ever could have imagined,” Kelli says. “She was back to her old self three days after the surgery.”

Dr. Jim explains how the surgery is performed. “The cochlea is the part of the middle ear that converts the sound waves into nerve impulses that the brain can understand,” he says. “This is an implanted device that restores the damaged structures with a wire implanted into the cochlea.

The sound waves are received by a microphone that goes over the back of the ear. The sound then travels over a wire to a speech processor which converts it into a digital signal which is sent back to the transmitter and then goes down the wire into the cochlea, basically a digital signal that the brain perceives.” The device is turned on by placing a magnet on the child’s head.

“Is she more talkative now?” Dr. Travis asks.

“Oh, yeah,” Michael says.

“Do you really see a difference in how she interacts?” Dr. Jim asks.

“Hugely,” Kelli says.

“She’s already starting to mimic sounds,” Michael adds.



Could a Gadget Save Your Life?

Dr. Lisa shows off the Cue, a gadget that goes in the shower that reminds women to perform their monthly breast exams. “You program in here the first day of your last menstrual period, and then it goes off about seven days after that — when your breasts are the least dense and least tender — and tells you it’s time to do your breast self-exam,” she explains. “It can also be programmed to tell you when your doctor’s appointment is needed.”

CVS Prescription for Health
Tips on Reading Your Child’s Symptoms
• Pulling or Poking at the Ears
This may mean that your child has an infection or pressure caused by a cold. It could also signify teething. To ease the discomfort, apply a warm compress to the ear.
• Rubbing of the Tummy
This could be a sign of a stomachache. The best way to help is to have your child lie down, put a warm heating pad on the belly and have him or her drink plenty of fluids.
• Rubbing of Legs and Complaining of Pain
Chances are your child is suffering growing pains. This is most common at night. Have your child soak in a warm bath and massage his or her legs before bed. This will also help your kid fall asleep quicker.


If your child’s symptoms don’t go away or get worse, consult your physician.







 

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OAD 1/8/09

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