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  • Differences between technologies in MRI and CAT scans
    2/18/2020 Last week I had a young patient ask me what the difference is between an MRI and a CAT scan. Not long after that, I noticed an error in a newspaper article that mixed up the two technologies.
    Radiologic imaging of the human body has revolutionized our diagnostic accuracy. However, it also has the negative effect of reducing our reliance on a good medical history and physical examination.
  • Hot flashes and the many problems associated with menopause
    2/11/2020 Sometimes I get asked questions in unusual places. A few months ago at church I was pulled aside and asked if I could write my column on the menopausal malady of hot flashes.
    Hot flashes are usually described as a feeling of intense heat, usually with sweating and a rapid heartbeat. They can last a few minutes up to a half hour or so. The feeling usually starts on the face or upper chest but can also be on the neck and even spread over the entire body. Many women experience flushing of the skin over the involved area, hence they may also be called hot flushes.
  • If your shoulder hurts these may be some reasons why - part two
    1/27/2020 Welcome back to my two-part series on shoulder pain. First, I want to do a quick review of shoulder anatomy (see diagram of a view of the right shoulder from the front). The upper arm bone (humerus) joins to the scapula at the glenoid and is held in place by two structures: (1) a rim of cartilage (glenoid labrum) that forms a shallow cup for the head of the humerus to sit in, and (2) the rotator cuff which is made up of four tendons that wrap around the head of the humerus.
  • If your shoulder hurts these may be some reasons why
    1/20/2020 The next two weeks, I’d like to address shoulder pain and injuries. Most people experience shoulder pain at some point in their life. Doctors typically see it in athletes, people who overuse their shoulders, and others who may have fallen directly on their shoulder or on an outstretched arm.
    To understand shoulder pain, it’s important to know the basic anatomy of the shoulder joint itself (see diagram of the front view of the right shoulder). The shoulder joint is one of the most complex in the body. Most joints permit only a fairly limited range of motion. The anatomy of the shoulder joint, in contrast, allows for a vast range of movements. To be so versatile, It has to be relatively unstable compared to our other joints.
  • Antibiotics are Good – Right?
    1/6/2020 There is no doubt that antibiotics have saved millions of lives. But, is it all good news? I hope our readers have been noting the increasing number of news stories related to problems with the overuse of antibiotics and the development of resistant bacteria. We have known this was coming since Alexander Fleming who discovered penicillin warned of it in his Nobel Prize speech in 1945. Dr. Sally Davies, the former Chief Medical Officer of the United Kingdom, equated the critical health threat of antibiotic resistance to the risk of terrorism.
  • Hearing Trouble?
    12/10/2019 A patient whose mother is having hearing difficulties asked me to write about the best way to purchase hearing aids. I’d like to begin with some background on hearing.
  • 11/19/2019 This week I’d like to write about a problem that costs taxpayers billions of dollars each year – Medicare fraud and abuse. Medicare paid out $582 billion in payments for services and medications in 2018, accounting for 14% of the federal budget. The Office of Management and Budget (OMB) reports that 8.12% of those payments were “improper,” meaning the services were not necessary, did not meet Medicare guidelines, or were downright fraudulent (a decrease from 9.51% in 2017).
  • 11/12/2019 This week I want to address a specific variant of a condition that I’ve been seeing a lot of lately – dizziness. Primary Care doctors in the U.S. see about six million patients a year with dizziness. 
  • 11/5/2019 Someone told me the other day that they thought “restless leg syndrome” (RLS) was a conspiracy created by pharmaceutical companies to sell more medications. You may have seen the commercials for Requip® and Mirapex®, both drugs used to treat this condition.
    People have described symptoms suggestive of restless legs since the 17th Century. The Swedish neurologist Erik Ekborn initially coined the term in the 1940’s. We estimate that between ten to fifteen percent of Americans suffer from restless leg syndrome to some degree. The incidence in women is about twice that of men. About 40 percent of people develop symptoms prior to age twenty. Since symptoms tend to be mild initially and worsen with age, most sufferers are not diagnosed for 10 to 20 years after they start having symptoms.
    The symptoms of RLS are highly variable, but most people describe a bothersome, irresistible urge to move their legs. This urge is worse during periods of inactivity and often interferes with sleep. About 85 percent of sufferers have difficulty falling asleep. Stress and fatigue can also exacerbate the symptoms.
  • 10/30/2019 I’m starting to see a few cases of head lice now that kids have been in school awhile. The critters are white and about the size of a sesame seed. They are known as "obligate ectoparasites." Obligate means they require a placental mammal host to survive (i.e. humans) and ectoparasites means they live outside the human body and need a host to survive.
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Monday, February 24, 2020

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