james-marcum

Risks cause FDA to take action

The Washington Post has reported on June 9, 2017, that the Food and Drug Administration (FDA) has asked a drug company to remove its opioid pain medication from the market. The FDA has concluded that the medication, Opana ER, has risks that outweigh the benefits. This drug was reformulated in 2012 to make it more difficult to snort, but now individuals are injecting this medication. The injections often occur with shared and unsterile needles.

The nation has an opioid crisis. In Tennessee in 2012-2015, the increased needle sharing of the drug has been linked to serious blood disorders and outbreaks of HIV and Hepatitis C in Indiana. Opioids have many side effects including addiction. From 2000-2015 nearly 180,000 Americans died of overdoses of prescription opioids and tens of thousands more have succumbed to heroin and fentanyl overdoses as the crisis has evolved. This is a crisis.

If the company declines, the FDA will take steps to formally require its removal by withdrawing agency approval. Last year Opana ER sales were around 158 million. I have written in the past about the dangers of narcotics in the book, Medicines that Kill (Tyndale Press). Medications pose dangers and all have side effects. In the case of narcotics, the numbers of deaths are staggering. Medications do have risks, some more than others.

This is a first step. We also need to, on an ongoing basis, assess the risks/benefits of all medications. If we can get at the causes of illness, this is far safer than treating symptoms. This discussion needs to start nationally and each individual needs to constantly evaluate medications. If you are interested in learning more about the risks of medications and an approach to use them more […]

Finding Evidence & Understanding Truth

We frequently receive questions regarding information gleaned from the internet. Often the information is false and has no substance. Just because a phrase is repeated many times over and over, or someone in authority makes a claim, does not mean the information is true. This seems to be a growing problem as anyone can write anything and claim it is the truth. In the current era of free-flowing information, I see problems developing. Where is the evidence?

I also have noted that many people say something that is true and exaggerate that truth. For instance, pesticides are not good, but the dangers of pesticides do not equate to the dangers of not eating fruits and vegetables. Not everyone can afford organic. I also see the benefits of certain medications exaggerated while the side effects are sometimes minimized. Be careful to look at the big picture. Take time to research what you hear or read. Also look at the reason why the claim is being made. Take time to evaluate unbiased evidence.

Not long ago I received a question regarding microwaves. There was great angst that microwaving food was dangerous to our health. This person read something that claimed microwaving food was dangerous removing nutrients and contributing to cancer.

Ionizing radiation which includes medical X-rays, nuclear radiation, ultraviolet rays from tanning booths, and gamma rays are high energy. This means the waves have enough energy to vibrate atoms in a molecule to remove electrons, a process called ionization which changes the nucleus, damaging DNA and contributing to cancer. Non-ionizing radiation which includes microwaves, sound waves, and visible light, does not have the energy to remove electrons. In theory, releasing energy is referred to as radiation. Human bodies release heat, radiation. This energy is low energy. This […]

Another Set of Eyes

Mayo clinic researchers published recent research on April 4, 2017 in the Journal of Evaluation in Clinical Practice. They concluded in their study group of 286 patients, that 88% of patients who seek a second opinion leave with a refined or new diagnosis. In this study, 66% received a redefined diagnosis while 21% were diagnosed with something completely different. This illustrates that another set of eyes looking at a patient and problem is a good idea.

A wrong diagnosis can lead to stress, delayed treatment, complications, and added expense. The National Academy of Medicine has concluded that a correct diagnosis is an important component in determining what makes up quality of care. With more and more problems in access to care, this will be a growing problem.

John recently related an experience that illustrates this. He went to a walk-in clinic with pain in his big toe. The provider diagnosed gout. John is a large man and could not see the underside of his large toe. He received medicine for gout because of the swelling. He did not get better. He sought a second opinion and a splinter was found embedded in the underside of his toe. I wish this were an isolated case, but it is not. This study shows that another set of eyes is a good idea.

Sometimes it takes time to make a correct diagnosis. Observing a patient over time, collecting data, and better defining symptoms are tools that our fast paced society does not value as much as in the past.  With the amount of stress related symptoms in our world, making a correct diagnosis is even more challenging.

I want to encourage all to have another opinion if you are not responding to […]

Boosting Energy

I frequently am asked about how to boost energy. What exactly does boosting energy mean? For most, this is very subjective. Does it mean not feeling tired? Does it mean being able to easily perform the activities you desire? Does it mean staying awake while you are reading this? Everyone wants more energy.

First, realize that often there are no “quick fixes” as you often read about in advertisements. These fixes might help your brain feel like you are doing something and this might help some, but I think a practical approach is a better way to start.

See your provider and make sure you do not have a medical condition causing fatigue. Old age is not a medical condition. Anemia, diabetes, hypo (low) thyroid, sleep apnea, depression, medications, weak heart, and damaged lungs, are places to look.

Let’s assume everything checks out fine. Here is a list of ten ways to boost energy.

Water: Drink it. Lack of water, dehydration, is one of the leading causes of fatigue. Cold water also might increase your adrenaline levels.
Rest: Go to bed earlier. Turn off the television and other media. Take a day off every week. Go on vacation. If your arms were tired, you would not keep lifting weights. Maybe you just need rest.
Breathing: Breathe deeply. Deep breathing delivers more oxygen to the brain, which helps you stay alert.
Movement: Move every hour. Take a walk outside. Start an exercise program. This gets your blood flowing, which improves circulation (oxygen delivery to the cells) and will help your brain function. This will also increase serotonin, dopamine, and norepinephrine. These are brain transmitters, which can increase energy.
Nutrition: Eat more plants and less processed foods. Processed sugar […]

Hippocrates was on to something

Throughout the last several decades, we have learned extensively about the different organ systems in the bod. But in the great scheme of things, we are just beginning to understand the complexity of the interactions. We have sequenced our DNA and are beginning to realize the important physiology of the intestines and immune system. However, we still know very little about our control center, the brain.
 
All inputs change our physiology to some degree. When I think about the inputs that come into our brain, I am overwhelmed. Nutrition, news and social media, our belief systems, and the environment around us are all inputs to the brain. These inputs can alter the brain and change the entire physiology of the body.
 
Many in our society suffer from chronic diseases. Type 2 diabetes, hypertension, obesity, coronary artery disease, and arthritis are the most commonly discussed. But what about mental health problems, such as depression? Shouldn’t mental health be added to the list? Mental health is the largest cause of disability in the world.
 
Every year the incidence of depression increases. The traditional treatments include medications. However, some have cast doubt on their effectiveness. Robert Whitaker in his much-acclaimed book, “The Anatomy of an Epidemic” examines the research and extent of the problem. So what other treatments might prove effective? A study recently conducted at Deakin University has shown that improving quality of nutrition can be successful in combating major depression.
 
In this study adults were randomly divided into two cohorts. One group consumed more vegetables, fruits, whole grains, fish, lean red meat, olive oils, and nuts, while reducing unhealthy foods such as sweets, refined cereals, fried food, fast-food, processed meats and sugary drinks. Results published in BMC Medicine (www.fooodandmoodcentre.com) […]

Genetics and Lifestyle Linked

At the November meetings in New Orleans of the American Heart Association Meetings, Dr. Sekar Kathiresan, chief of genetic research at Massachusetts General, discussed a recently published New England Journal of Medicine article. This study evaluated the risks of genetics and lifestyle on heart attacks or other heart problems.
The field of epigenetics, what factors turn “on and off” genes which govern our physiology, is growing and fascinating. In this recently published article, 55,000 individuals from four studies were evaluated. Fifty genes, known to be associated with heart risk were evaluated.
It was found that if you had favorable lifestyle factors including not smoking, exercising, eating well, and staying slim, these lifestyle factors affected heart health. If those lifestyle factors were favorable, even if a strong familial genetic risk was present, the risk of developing heart disease was cut in half when compared to those at high risk and unfavorable lifestyle. Why is this important?
For years, it has been thought that if you had a family history of heart disease, you were doomed. This is not the case. A healthy lifestyle is able to mitigate the genes. This study only evaluated fifty genes and four lifestyle factors. It only makes sense that based on this article the better the lifestyle, the better the genes, less mutations, less disease expression.
Lifestyle factors include everything we bring into our bodies.  More studies need to be performed. What about  whole food plant based diets and genetic expression? What about rest? Does the media play a role on gene expression. Studies have already been done on relaxation techniques and genetic expression. What about rest and worship as scientifically proven methods to lower the risk of heart disease? Heartwise is currently in […]

Learning from Football

Recently nearly 160,000 people came together to watch a football game in Bristol, Tennessee. This was a “big deal” as it was the largest attended football game in history, “The Battle of Bristol”. Was there something long lasting to be learned from the game?

In the weeks leading up to the game, the hype and talk were incredible. The Volunteers from the University of Tennessee and the Hokies from Virginia Tech University were analyzed in great detail. All the time and money spent in talking about, and preparing for, the game, was astounding. Regardless of whether this was a wise use of time and resources is another topic for another time, but what can we learn from this football game? What can we store in our brain from this event to trigger a helpful neural-pathway in the future?

Many of the commentators were speculating on the play calling, motivation, coaching, and talent being the keys to success. As I listened to the back and forth, who had the biggest and strongest players? Who had the smartest coaches? Who had the best plays? This sounded like astute analysis for upcoming success in the game.

However, one elderly analyst concluded that the team that demonstrated best, the football fundamentals, would have the greatest success during the game. These football fundamentals included blocking, tackling the ball carrier, catching the ball, and running with the ball. This sounded so obvious. Why weren’t others talking about this? Well, I admit this simple truth was not flashy. The other analysts probably thought they were being paid to make a much more detailed and cerebral comment. The elderly analyst was correct. The team that demonstrated the football fundamentals had the […]

Should Mobile Devices be classified as a Health Risk?

Every input that comes our way has an effect on physiology. This includes the food we eat, the environmental toxins, the words we hear and so much more.
In the 30’s cigarettes were not recognized as a health threat and were even recommended as a treatment for asthma. High fat diets have been linked to cardiovascular disease. We now have discovered that many chemicals once deemed as safe are dangerous. Medications have been pulled from the market. Sometimes learning about health and changing a mind-set takes time.

In 2008 an American spent, on average, 10.6 hours a day with the media. The time had increased to 11 hours a day by 2011 and I am sure in 2016 the time engaged in the media is similar. As time has progressed, more and more media is available on a mobile device. This includes the Internet, social media, texts, tweets, television, and even the dinosaurs of media, radio and print. Who needs anything but a mobile device? The world agrees.

As of January 2014, it is estimated there are 7 billion cell phones on the planet. The use of these mobile devices is on the rise. Today, there are three times as many mobile devices as in 2010. The use of mobile devices, as a proportion of the time spent in the media, has increased significantly. The average American spends 7.4 hours in screen time including 151 minutes on smart phones and 43 minutes a day on tablets according to Meeker’s Internet Trends. The trends are probably similar around the world. More time is spent with screens than in sleep. I think the question, “Should Mobile Devices be classified as a Health Risk?” is a legitimate question. If […]

Recognizing Poverty

The definition of poverty includes the lack of necessities. Most, when they think of poverty, equate this with physical items, money, housing, food, and physical “stuff.” Poverty includes much more than this. Our human needs include more than the physical. I want you to ask yourself, “Am I living in poverty?”
I began thinking about poverty during my recent mission trip to Oaxaca, Mexico. There I did see physical poverty. Our group was there giving shoes to the youth. The people did not have the material substances of others. The houses may not have been as nice. The food was not as plentiful. The roads needed repair, but I realized more than ever, poverty was more than physical needs. On my return to the states I began to notice the poverty all around me. In many instances this type of poverty is more dangerous. It is unrecognized.
Relational poverty, emotional poverty, health, and spiritual poverty seem to be rampant. Divorces are at an all-time high. We spend more time texting than talking. We are spending more time with the media and less time with each other. The computer is replacing person-to-person interaction. Even at work, I spend more time with a computer than the patients on many days. How can I have better relationships when I spend less and less time with people?
Then there is health poverty. Less can be more when it comes to health. We are acquiring too much weight. We are taking more and more pills for a plethora of symptoms. We are eating more and more processed foods and less greens and beans. The incidence of cancer, heart disease, diabetes, hypertension and lifestyle related chronic disease is on the rise.
Then there is […]