HOMEOPATHY: HEALTH CARE OR VOODOO?

    Aren't you lucky, dear reader: 2 new posts in one day!   The truth is, I have a ton of new topics to cover, because I have been out of touch with the blog and have left my readers hanging for weeks without a new entry.   I apologize for this.    I think in return for the wonderful support and interest I've gotten from my readers, I owe it to you to put up a new entry at least a couple times per week- even if it's a quick note about fashion that my friends will riducule.

READER QUESTION: WHAT IS HOMEOPATHY?

     Homeopathy is a branch of medicine which started in Europe not long ago- hundreds of years ago, not thousands of years ago like acupuncture or some other modalities.   It gained wide acceptance in Europe and America starting in the 1800s and going well into the early 1900s, until the American Medical Association (the AMA) launched a concerted effort to discredit homeopathy and ostracize its practitioners.   As a result, homeopathy really fell to the wayside as a "fringe" practice, offered by clinicians that the AMA widely ridiculed as "quacks."

      Without getting too political or straying from the subject, let me first give you Dr. Tofuhead's take on the AMA: this is one of the dirtiest, most corrupt organizations in the history of medicine.    Never afraid of taking huge amounts of money from tobacco and firearms companies, the AMA until very recently spent much of this money trying to increase the power and prestige of high-paid, private medical specialists, at the expense of all and sundry alternative medical practitioners.   Even primary care doctors like your beloved Dr. Tofuhead have suffered from the malignant antics of the AMA.   So when the AMA widely comes out AGAINST something like homeopathy, it makes me think: THERE MUST BE SOMETHING TO HOMEOPATHY!

HOMEOPATHY: BASIC CONCEPTS

1. Toxic or disease causing entities, in very small amounts that do not cause harm, can be introduced into the human body and actually compel the body to fight those entities and overcome disease.

2. Toxic entities must be serially diluted in a very specific and time-consuming way in order to produce effective homeopathic remedies.

3. The homeopathic serial dilution method not only yields a remedy with a tiny amount of a toxic substance, but the chemical makeup of the solution itself (in which the toxin is dissolved), is itself altered in the process, in a clinically significant way.  This point has been supported by some very complex and surprising experiments, done by physical chemists in recent years.

HOMEOPATHY: DOES IT WORK?

      The most honest answer is: we don't really know.   To date, there have not been many good scientific studies looking at homeopathic remedies and whether or not they really work.   My own opinion is that homeopathy, like any branch of health practice, will turn out to work for some things, and to not work for others.   What I hope to see in future research is studies that will help us pinpoint just what homeopathy can treat.   For the time being, I would not rely on homeopathic remedies to treat conditions for which their are proven treatments: for example, strep throat (which is treated with antibiotic drugs).    

       However: small studies have been compelling when it comes to treating viral respiratory illnesses with homeopathic remedies.    For example, there is a homeopathic medication called "Occillococcinum" which many of my patients swear by, for fighting colds and flus.   Years ago, when I worked in an acupuncture and homeopathic practice, I had access to this medication for free.   My own experience here is not worth much, but I do believe that if I took occillococcinum at the onset of a cold, it either disappeared completely or the duration of the cold was shortened.   It's worth looking into; after all, traditional western medicine or "allopathic medicine" has nothing that can cure or prevent a cold.   If any of my readers have had experience with this or another homeopathy remedy, please share.

WHERE CAN I FIND HOMEOPATHIC REMEDIES?

     You can find popular homeopathic medicines such as Occillococcinum at health food stores, vitamin shops, and even some grocery stores.   My optometrist even gave me a homeopathic eye drop recently, which really worked for me.   But keep in mind that there are thousands of homeopathic remedies with odd names; names that don't really reflect the condition they are designed to treat.   So except for a few exceptions, see someone who knows what they are doing.   I recommend seeing a homeopathic doctor for advice and for remedies if you want to treat something other than a cold or flu.   And if you're taking a homeopathic remedy for an illness and it's not working, please: see your allopathic primary care doctor!

BOTTOM LINE: My take on homeopathy is that there IS something to it.   I also think it's an exciting field, in which we will see some compelling new research in our lifetimes.   So watch these pages- I'll return to the topic again in the future.

RECENT READER QUESTIONS ON FASCINATING TOPICS

     To all my friends who pointed out my own fashion mistakes when I posted my last blog choc-full of essential fashion tips, I just want to give this reasonable feedback: dress as I say you should dress, not as I do dress. I'll admit- I take a special pleasure in occasionally wearing hideous or outdated clothes, just to elicit reactions. That doesn't mean you should, unless you enjoy people laughing at you.

READER QUESTION: WHAT IS HYPOCHONDRIASIS?

Or more specifically, "what causes someone to be a hypochondriac?"

     This was a tough question for me to answer. In fact, it took me weeks to find information that I felt was reliable. Essentially, being a hypochondriac means that you have an "exxagerated concern or worry about having a health problem or health problems, despite evidence to the contrary." This actually used to be classified in the psychiatric literature as a form of a "personality disorder," in other words a mental illness all its own. That was probably both innaccurate and unhelpful, since personality disorders are not often treatable. Currently, hypochondriasis is generally seen as a symptom of a treatable mental illness, the most common illnesses being depression, anxiety disorders, and post-traumatic stress disorder (PTSD). Hypochondriasis can also be seen in other mental illnesses such as obsessive-compulsive disorder (OCD), and psychotic syndromes.

     By far the most common underlying illness in someone who is a hypochondriac is depression. Part of that is because we are recognizing, with increasing frequency, that major depression can cause physical symptoms, which are often ill defined. Another factor is that a majority of depressed patients are very resistant to being diagnosed as having depression, and depressed patients are often hard to convince that their physical symptoms are coming from a psychological rather than a physical source.  Hypochondriacs  who are depressed and are treated for depression do very well, and are able to overcome their hypochondriasis is most cases.

    This is also true for patients who have hypochondriasis in the context of an anxiety disorder, PTSD, or other mental illnesses.

MORE QUESTIONS AND ANSWERS ABOUT HYPOCHONDRIASIS

1. DOES EVERYONE WITH HYPOCHONDRIASIS HAVE A MENTAL ILLNESS?

No.   Honestly, I think many hypochondriacs just have too much time on their hands, or they're too focused on their own needs.   In these folks, it tends to be a temporary problem.   After a few doctor's visits and normal tests, and hopefully some encouragement from a doctor, they realize that they are wasting their time- and that rather than worrying about non-existent health problems, they should use their mental energy to work, have fun, and pursue more productive hobbies.  

     There are also hypochondriacs who are justified in their hypochondria, in my opinion.   For example, cancer survivors often become hypochondriacs, and for good reason.   The last time they thought they had a serious illness, they did!   I don't even think it's fair to call cancer survivors hypochondriacs.    It's better just to offer them the tests they want, whenever they want, to help reassure them that they don't have cancer again.   At least, that's what I do.

2. WHAT'S WRONG WITH BEING A HYPOCHONDRIAC?

I think the biggest problem for hypochondriacs is that they are unhappy, and their hypochondria keeps them that way.   It's really no fun to think you have an undiscovered illness.   Not only does the hypochondriac worry about his or her health, but he or she wastes a lot of time- time in doctor's appointments, getting tests, searching for health information on the internet, and seeing various health practitioners.   Hypochondriacs put a big time and financial burden on themselves, and they also can make their loved ones and family members unhappy or frustrated with them.

3. WHAT IF OTHER PEOPLE THINK I'M A HYPOCHONDRIAC, BUT I REALLY HAVE A SERIOUS HEALTH PROBLEM?

See a doctor.   If your doctor treats you with annoyance or insults you, get another doctor.   If there are tests that are reasonable to do, ask your doctor to run them.   But you should trust your doctor's judgement to some degree- demanding complex tests that your doctor doesn't think you need will generally get you nowhere.    And keep in mind the most important fact here: there are very few health conditions out there that "no one can detect" or "multiple doctors can't diagnose."   A recent book on the subject reviewed a number of studies of patients with "hard to diagnose, undiscovered health problems."   The studies revealed that only a tiny fraction of these patients turned out to have a real physical ailment; most had either stress-related conditions or depression.    So if you've been to a few doctors, had a number of tests, and "no one can figure out what's wrong with you," the painful truth is this: there probably is nothing wrong with you, physically.   You might do yourself a favor and seek a therapist.

EASILY DIGESTIBLE FASHION TIPS FOR MEN

Here's another short, easy-to-read, digestible blog. Don't worry if you've submitted a reader question this week; I assure you, I'm working on those. I will be blogging on those only after I've done the comprehensive research required. I don't answer any question "off the top of my head." But I can comment on men's fashion off the top of my head. That's because "men's fashion" is an oxymoron. It's like talking about "Mormon cocktails" or "fun skin rashes." Men's fashion leaves much to be desired. Here's how you can avoid making it even worse. All you have to do is avoid making the following common men's fashion mistakes.

LAME MEN'S FASHION HABITS TO AVOID:

1. Oakley blades. In fact, just because they invented Oakley blades, I recommend that you avoid purchasing any Oakley product, unless it's BMX bike grips, which Oakley actually made exclusively when the company started, before they started making ugly sunglasses.

2. Pants without a belt. Only wear these if they are sweats. But do yourself a favor: don't wear sweats. There are much nicer sloppy clothes to wear.

3. Brown belt with black shoes or vice versa. You can wear this combination if you're colorblind and you have a large sign around your neck that says, "HI, I'M COLORBLIND."

4. The upside-down visor. In case it's not obvious, this simply sends the message, "My I.Q. is lower than yours."j

5. Puffy white shoes with jeans. In fact, if you have white shoes you should be:

-a nurse

-a guest at a disco party

-working out at the gym

6. Socks with sandals. You can wear socks with sandals if you have a broken foot and you're wearing an "orthopedic sandal," which is basically a shoe that makes it obvious that you have a broken foot. Make sure you have at least one crutch with you at all times.

7. Dress slacks with black athletic shoes or hiking shoes. Do you really want people to mistake you for a primary care doctor? If you do, go for it! Also, consider wearing a plaid shirt with a knit tie.

8. Pants with flip-flops. See my earlier blog on this subject.

9. Short running shorts. Why do men still wear these to Safeway? These are of questionable integrity even if you're actually running. Opt for something more aesthetically pleasing, like a Swedish thong or a Spandex body suit.

10. Windbreakers. Is there even any such thing as a "windbreaker" anymore? Unfortunately, yes. Feel free to wear one if you live in the Wyoming plains or if you're at a 70's party. In short, you should wear a windbreaker in any situation in which you might normally wear a "Members Only" jacket, or a plastic "poncho."

11. Flannel shirts with the sleeves cut off. I know it's shocking, but people in Denver still wear these, believe it or not. NOTE: these are still cool if you're a gay lumberjack with nice arms.

12. No underwear. There is a reason underwear was invented. It's called "civilization." If you don't wear underwear, consider adult diapers or checking yourself into a mental facility.

Sorry to be so harsh. I don't know why men's clothing concerns me so much. Women are just better dressers, at least most of them are.

HOW DO I KNOW I DON'T HAVE CANCER?

I see new patients every day, and some of them ask me to be "tested to make sure I don't have cancer." The truth is, there is really no test that can do this. The problems are:
1. There are too many cancers, and one test can't evaluate for all of them.
2. Most cancers are diagnosed by complicated imaging tests and biopsies, both of which are not completely safe. So it's generally not a good idea to do these tests unless your doctor has a high suspicion that you have cancer.
3. Some of the tests for cancer, particularly CT or CAT scans, can actually cause cancer. So again, you shouldn't get one unless you really need it.
However, there are "screening tests" for cancer- these are tests that are performed on healthy people to try to detect certain cancers early. There are only a few of them, because only a few tests have been shown to save lives by providing reliable information about cancer at an early stage. All people should get cancer screening tests, starting at various ages depending on the test. Please note: IF YOU HAVE A FAMILY HISTORY of cancer, your doctor may want to start doing screening tests on you at an early age. The below applies only to people who do not have a family history of cancer. Also: FAMILY HISTORY of an illness like cancer, in most cases, means that you have a parent or sibling with the disease in question, usually at a certain age. I know it sounds complicated. For example, if your mother had breast cancer before age 50, you have a family history of breast cancer. If your aunt had breast cancer at age 70, you don't have a family history of breast cancer. You really need to talk to your doctor about your family history to know what's relevant.
CANCER SCREENING TESTS YOU SHOULD HAVE:
1. Pap smears: this may actually be the single best cancer screening test in terms of lives saved. You need to start getting this test:
-if you're a woman
-at age 19
-at an earlier age if you're sexually active (within the year of becoming sexually active)
-how often? Yearly at first, but if you have 3 normal pap smears in a row and you're monogamous, you can then change to every 2-3 years.
2. Mammograms: there is controversy over whether to start these for women at age 40 or 50. I get them every 2-3 years in women 40-50, and yearly after that. If you want to make it easy to remember, just do one at the same time every year starting at age 40. All women should get mammograms, even if no one they even remotely know has ever gotten breast cancer!
3. Colon cancer screening. There are actually 3 total tests and you need at least 2 of them at various intervals. It works like this:
-start getting colon cancer tests at age 50.
-EVERY YEAR you should do a "stool card test", which detects blood in your stool.
-HAVE YOUR FIRST COLON SCOPE AT AGE 50. This may be what's called a "flexible sigmoidoscopy," a "colonoscopy," or a "virtual colonoscopy." Ask your doctor which is right for you, but do it at age 50.
-After your first colon scope, you need to do it again every 5 to 10 years, depending on what they found on the first scope. If you have any precancerous "colon polyps," you'll need to get a scope every 5 years.
-People seem terrified of colon scopes. But the whole thing takes 20-30 minutes and you can be sedated for the procedure. It's easy to do!
FOR THE GENERAL POPULATION, that's it, believe it or not. There are other cancer screening tests, and some of them are worth doing if you have a family history of cancer. But these 3 are the only ones in wide use for the general population. Beating cancer is not easy. But as you can see, getting your cancer screening done is.

MORE INFO ON RECENT TOPICS

1. WHY NO PICTURES LATELY?
My brother Randy does the photos, and he's been staying with me. We haven't been blogging much. So there is a temporary hiatus from pictures on Dr. Tofuhead. Sorry for all those waiting eagerly for a visual image of a douchebag. While waiting, check the Oprah show: she has douchebags as guests on her show all the time!
2. REALLY NO CAFFEINE IN DECAF?
Randy dug up some fairly interesting study that compared decaf levels at various coffee shops. It turns out I was wrong- some purveyors of decaf actually do have a significant amount of caffeine in their decaf beans. Starbuck's was the highest- some of their decaf drinks approach 30% as much caffeine as in regular caffeinated coffees. And caffeine amounts seem to be highly variable in different types of beans. So if, for some reason, your doctor has told you to completely avoid caffeine, you probably need to avoid decaf coffee most of the time. Or you can drink Sanka, that 70s powdered instant decaf coffee that has survived the test of time. Sanka ain't that bad, and it's caffeine quantity is not noticeable. I bring it camping frequently and enjoy it immensely. But I'm not that picky about coffee.
3. IF I PEE A LOT, DO I HAVE DIABETES?
Frequent urination can be a sign of diabetes, especially if it is accompanied by frequent thirst and visual blurring. Just remember that most people who pee a lot, or think they pee a lot, don't have diabetes. People also tend to overestimate how much they pee. If your pee is clear and you pee a lot, chances are it's because you are drinking a copious, and HEALTHY, amount of water. There are a number of benign conditions that cause people to pee a lot, such as "overactive bladder," prostate enlargement, nervousness, some allergy medications, and yes, even caffeine. Caffeine does not actually dehydrate you, but it probably stimulates the bladder to contract a bit more frequently, and some people find they are peeing a lot when they drink it. If you are concerned that you are peeing too much, talk to your doctor- there are easy tests to run that can tell you if your frequent urination is a serious problem.
4. MORE QUESTIONS PLEASE
Presumably because it's summer and you are all exercising all day, eating well, sleeping like babies, and feeling fantastic, I haven't gotten many health-related questions lately. Even in my office, I'm seeing fewer patients and many of them are healthier than me. My medical brain is undergoing atrophy. You, dear reader, can help me: post a health related question in the comments! Remember, no question is stupid and all questions are answered anonymously.

WHAT'S WRONG WITH DOUCHEBAGS?

The term "douchebag" is so commonly used as a term of derision, or in the context of an insult, that it's hard to remember that a true douchebag is a health care product. That's right- if you don't have enough "douchebags" in your life already, you can actually go down to Walgreen's and buy yourself one. Not only that, but they are cheap and come with a variety of pleasant-smelling concoctions.
WHY DO DOUCHEBAGS EXIST?
Douchebags have probably been around for thousands of years, like beer or giant pyramids. They came into common use in the Victorian era, and at that time they were primarily used as a form of birth control. Condoms at that time were not very reliable, and birth control pills and IUDs did not yet exist. Short of the "rhythm method," in which couples tried to avoid intercourse around a woman's ovulation, douchebags were really all someone could count on in days of yore. They were also used in preparation for intercourse, a use that was popularized by prostitutes- this was to keep the vagina "fresh." So you can think of douchebags historically as functioning as a sort of perfume before sex, and as a way to wash out semen after sex, to prevent pregnancy.
THE PROBLEM WITH DOUCHEBAGS
Though "douching" has become more sanitary, the problems is that douchebags don't really accomplish either of their historical functions very well. In addition, they can create problems of their own. Here's why you should avoid douching if at all possible:
1. Using douchebags is a terrible way to prevent pregnancy. Sperm are fast, and they hang on tight to the reproductive system. It can take less than a second for a sperm to make its way up to the Fallopian tube, where it is difficult to flush out. Douching will only flush out the stragglers, leaving a few million sperm unharmed.
2. Douching may actually flush something bad IN: the vagina and uterus do a very respectable job inhibiting the growth of harmful bacteria and other microbes, the kind that can cause sexually transmitted diseases (STDs). Many STDs are able to get through these defenses, causing an annoying and painful infection. But these same STDs, particularly gonorrhea, can cause a much more dangerous infection called Pelvic Inflammatory Disease if they get beyond the uterus and into the Fallopian tubes. Because of the fluid pressure douchebags cause, they can actually push infectious organisms higher into the reproductive tract. There is a higher risk of Pelvic Inflammatory Disease, or severe reproductive infections, in women who douche; never mind the fact that douching does not prevent any STDs.
3. Douching has little to no affect on vaginal odor. The vagina is colonized by good, healthy bacteria, and it is these bacteria and your own natural vaginal secretions that produce odor, if you want to call it that. The vagina is also very active in maintaining its own fluid and chemistry. While douching may temporarily flush the vagina with a nice aromatic floral rinse, any resulting scent will be removed within minutes, not hours. Even frequent douching is unlikely to have any substantial impact on vaginal odor.
In short: unless you go through a time machine and find yourself in Victorian times, don't mess around with douchebags!

THE GYM

     Today I went to "the gym."   I don't go that often, these days.   Going to the gym, after all, is a pain in the ass.    However, I simply can't deny it, nor do I wish to: I really feel fantastic after a trip to the gym.

     I'm easy to spot at the gym.   I'm the guy with old, out-of-fashion gym clothes and a farmer's tan, sweating a lot on the treadmill or the exercise bike.   Once in a while I'll even lift some weights, and because I'm down with "hydration," I'm always surrounded by water bottles.   When my workout is over, I'm one of the 2-3 patrons who still likes so soak in the hot tub afterward.    I suppose I get my money's worth.    As with anything that costs money, "the gym" has its advantages and disadvantages.

THE GYM: DISADVANTAGES

1. Evenings and late afternoons: just like the doctor shortage in America, there must be a gym shortage.   Every gym I have ever been to is so packed between 5 and 8 PM as to almost make it not worth going.     You don't get much exercise when you're just standing around waiting to exercise.

2. The music: why must music at the gym always suck?   Solution: bring your own.

3. The people at the front desk asking, "did you bring your workout towel today?" before they let you in.   I have a feeling that's an absurdity unique to 24 Hour Fitness.

4. Parking.    But you can get around this by biking to the gym, which I did.  Once.

5. The cheap, weak gel-like soap substance in the showers that smells like chlorine.

6. Dudes who shave in the bathroom at the gym.   I'm not sure why, but they annoy me.   Maybe they live in trash cans behind the gym or something, like Oscar on Sesame Street.   If so, I can understand shaving at the gym.

THE GYM: ADVANTAGES

1. It's hard NOT to get some pretty good exercise at the gym, even during peak hours.

2. Mainstream gyms are pretty diverse these days.   Probably because all sorts of people have doctors telling them to go to the gym, all sorts of people go to the gym.   Even if you look terrible in spandex and you sweat like a pig, trust me: there will be many people at the gym who look more horrifying than you do.   No one cares.

3. Exercise equipment has gotten much, much better.  And it ain't cheap.   The treadmills at the gym have fans to keep you cool, instructions to get you going, and when you're done they tell you exactly how many calories you burned.   Unless you have a ton of cash, it's difficult to get machines that good to use at home.

4. A full workout and cool-down: where else but the gym offers you the ability to work your muscles with some weights, whip your heart into shape with a cardio machine, then get the muscles relaxing with a hot tub or sauna?   

5. Off hours: try going to the gym early in the morning, late at night, or mid-day.   You'll have access to whatever you want, without the crowds.

6. Classes: I'm not big on classes at the gym, but recently I started doing a spin class every now and then.   I can hardly walk the next day, but in a good way.    It was a brutal workout but the teacher kept the pace fast and it went by quickly...and it was fun.   Most gyms have a ton of classes.

7. Fashion exploration: you can wear anything at the gym.   And people do.   It is strangely liberating to wear fluorescent, breathable plastic gymwear and hideous shoes sometimes.  Try throwing in a headband to let people know what decade you were born in.   Just don't try to run on the treadmill in Crocs.

8. Mental improvement.   Don't discount the emotional benefits of a workout.   If you work out hard, you will leave the gym feeling content, or maybe even happy.   Perhaps even "euphoric."  Even if it wasn't so good for your body, a gym experience can be fantastic for your mind.  Try it. Don't worry if you don't own a "workout towel."