Protect Tricksters and Treaters this Halloween

Have you carved your pumpkin yet?

We used to live in a much warmer climate where carved jack-o-lanterns disintegrated overnight. Here's a great tip: coat the inside of the carved pumpkin with Lysol spray and it will survive long enough to be smashed by mischievous teens!

Halloween...how bizarre!

The unique thing about Halloween is that I cannot think of another holiday that combines so much fun with the prospect of so much danger:

• Tampered candy
• Child abductions
• Drunk driving (yes, Halloween is #1 beer sales day in USA taverns)
• Accidental falls
• Pedestrian injuries
• Costume fires
• Eye infections

By now every household should be familiar with all the necessary Halloween safety precautions:

• Supervised trick-or-treating
• Fireproof costumes
• Flashlights and reflective garments
• Careful treat inspection afterwards
• ...and ignore the cosmetic contact lenses!

Click here for my warning about cosmetic contacts from Halloween past. The message remains important. Fun seekers want to complete their costume with wild decorative contact lenses. Ghosts and goblins, beware! Without careful fitting and thoughtful handling these contact lenses may contribute to a serious eye infection.

BOOOOO! I hope you have a fun and sensible Halloween!

Related Topics:

• Ghoulishly Healthy Halloween Snacks
• 5 Halloween Character Case Files

Technorati Tags: Halloween, safety, contact lenses, costume

Wash Hands Before Pushing MRSA Panic Button

Every so often an alarming health story erupts onto the media landscape with such intensity, such ferocity that specialist and subspecialist physicians need to climb out of their cozy, secure enclaves and join forces with the entire medical community to share what they know.

As someone who is deeply nested within the health care matrix, it's good to get out of my cubbyhole and enjoy some fresh air. So long as the air isn't contaminated with MRSA!

MRSA is a familiar abbreviation for Methicillin Resistant Staphylococcus Aureus. Translation: A bacteria that is very hard to kill. Resistance means the bacteria adapted and it developed a way to prevent the antibiotic Methicillin from interfering with cell wall synthesis. Imagine a neighbor who was trying to prevent you from erecting a sturdy privacy fence on your property. Wouldn't you adapt and devise a scheme to get your privacy fence built?

The whole topic of drug-resistant bacteria has been around for decades. It was discussed when I was in medical school (think Jimmy Carter), but at the time it was mostly theoretical - clinical examples were fairly uncommon and manageable.

When an organisim becomes resistant to antibiotic #1 go with antibiotic #2, right? Originally, there were alternative antibiotics to treat these stubborn infections but over time more and more resistant strains evolved. Eventually the medicine cabinet can become empty.

So long as physicians prescribe antibiotics in a judicious manner and alternate antibiotics for those being treated for chronic infections, the problem with drug resistance can be greatly minimized (forgive the oxymoron...greatly minimized!)

In dangerous environments where there are lots of infections and lots of antibiotics the prospects for the emergence of drug resistant strains become very real. We call this dangerous environment a hospital!

For many years MRSA thrived in hospitals. Folks recovering from surgery were the prime MRSA targets because healing wounds are an easy passageway for germs. MRSA infections extend hospitalizations, generate huge expenses, and cause life-threatening complications.

Global warming did not cause MRSA. Illegal immigrants do not cause MRSA. Adaptive genetics inside the bacteria's DNA permitted the germ to develop drug resistance.

Stop yawning, here comes the exciting part! It now appears that the threat of MRSA has checked-out of the hospital and is prevalent in many new environments like schools, offices, and clinics. Staphylcoccus aureus is a very common bacteria responsible for pimples and ordinary skin infections. A few days of any popular broad-spectrum antibiotic would usually fix the problem. Not any more! People who were never near a hospital are contracting MRSA infections. As expected, routine antibiotics are ineffective, forcing physicians to prescribe newer and more powerful drugs.

I've got two helpful recommendations to alleviate your MRSA anxiety:

1. Frequent handwashing and use of hand sanitizers are the best ways to protect yourself from MRSA at home, at work, anywhere; and



2. If you develop any kind of infection (infected wound, abscess, cellulitis, pneumonia, etc) go ahead and ask the doctor, "Do you think this might be MRSA?" It never hurts to prompt your doctor and give both of you a headstart to full recovery.

Related Topics:

• MRSA Rising: Who's At Risk?
• Understanding MRSA Prevention

Technorati Tags: MRSA, staph, infection, community infection, hygiene

Will Your Macular Degeneration Drug Disappear?

Many older Americans with advanced (wet form) Age-Related Macular Degeneration (ARMD) have benefited enormously from the introduction of injectable drugs that block the abnormal proliferation of blood vessels underneath the retina.

The drug Lucentis is FDA approved for treatment of advanced ARMD patients. It is injected every month or so and it is very expensive. Guess what? There is a very similar injectable compound available as cancer chemotherapy - it's called Avastin. Using Avastin to treat ARMD is much cheaper but head-to-head comparison studies have never been performed. Nevertheless, many ophthalmologists offer Avastin to the ARMD patients as "off-label use".

To learn more about injectable therapies for ARMD, please read one of my earlier posts on this subject.

Genentech makes both Avastin and Lucentis, and it loses money every time the cheaper drug is used. Accordingly, Genentech is outlawing the sale of Avastin to compounding pharmacists who reconstitute Avastin for intraocular injection. As expected, there has been a fierce backlash by ophthalmologists.

Here is an excerpt from a press release issued by the American Academy of Ophthalmology:

The American Academy of Ophthalmology believes that Genentech's decision to stop sales of Avastin® (bevacizumab) to compounding pharmacies could have a significant impact on the care of patients with age-related macular degeneration (AMD).

"Our main concern is for our patients with macular degeneration, who have come to rely on Avastin in their fight against potential vision loss," said Charles "Pat" Wilkinson, MD, president of the Academy. "Together with the retinal community, the Academy is evaluating how this decision will affect patient care."

Both Avastin and the FDA-approved Lucentis® (ranibizumab injection), another drug sold by Genentech, share a similar method of action by inhibiting vascular endothelial growth factor (VEGF). However, Lucentis was designed and tested specifically for treatment of wet AMD, while Avastin has only been FDA-approved for oncology indications. Prior to Lucentis' approval, many ophthalmologists had been using Avastin to treat wet AMD, and many doctors continue to use it, citing good clinical results for patients. The National Institute of Health is sponsoring a head-to-head trial between the two drugs starting this year.

"The primary concern of ophthalmologists is preserving the sight of our patients. Because Avastin has also been used off-label to treat diabetic retinopathy, macular edema and various other sight-threatening disorders, Genentech's decision to restrict availability of the drug has much wider implications than just for AMD patients," said H. Dunbar Hoskins Jr., MD, executive vice president of the Academy.

The Academy is seeking information from the FDA and Genentech to determine an appropriate and safe solution for patients and their doctors.

According to Genentech, Avastin will continue to be made available directly to physicians and hospital pharmacies through authorized wholesale distributors. However, ophthalmologists need compounding pharmacies to divide vials of Avastin into smaller doses for the treatment of AMD and other eye disorders.

Bottom line: Clinicians do not want to be told how to practice medicine, not by government and certainly not by drug companies.

You can expect to hear more about this in the days ahead.

Related Topics:

• Age-Related Macular Degeneration Treatment
• Inflammation Linked to Eye Disease

Technorati Tags: macular degeneration, medication, Avastin, Lucentis, vision

Flash Focus: Can You Improve Your Vision?

There was a time when many parents believed (hoped) that video games were simply a fad - not unlike an expensive Mood Ring. Face it, a generation later, video games and other portable online entertainment systems are here to stay.

Technology transfer: The science used to develop the video game that destroys a space invader or tosses a football has found many other useful applications. ATM touch screens are a good example as well as those dashboard GPS locators. Notice that I did not mention airport check-in kiosks? For some reason they do not like me! Every time I try to check-in for a flight it nearly always denies me a boarding pass and redirects me to the ticket counter.

Skills transfer: It appears that video gamers enjoy heightened hand-eye coordination. Not long ago I posted a blog about published research demonstrating that laparoscopic surgeons who played lots of video games completed their procedures faster and with greater precision.

Visual rehabilitation: Amblyopia researchers now suspect video games may help accelerate the vision recovery in children with lazy eye.

So let's see, beyond providing countless hours of mindless entertainment, those demon video games simplify our lives, improve surgeons' outcomes, and help children regain clear eyesight. Maybe we were wrong!

Now the next advance in video game technology has arrived - handheld vision training. The product is called Flash Focus and is available for the Nintendo DS portable system.

According to Nintendo, Flash Focus users complete daily training activities to challenge hand-eye coordination, peripheral vision, dynamic visual acuity, momentary vision and eye movement, then track their results with a calendar and easy-to-understand charts.

For years trainers and sport physiologists have relied on various vision training devices to help athletes with high speed visual tasks like batting a fastball and defending a hockey goal. Video game technology makes it portable and more accessible. Oh, it will also be much less expensive than any vision training clinic! Flash Focus features a variety of visual performance exercises. Not all are sports oriented - some exercises rely on dots and other simple symbols. No, you do not need to know anything about Zelda, Mario, or even Metroid Prime 3!

Do you already own a Nintendo DS handheld game console? Whether or not you are convinced that vision training leads to measurable, enduring vision skills, it might be fun to try Flash Focus. If nothing else it could become a fun party game...that is, if you're an eye doctor!

Related Topics:

• Action Video Games May Boost Vision
• Natural Vision Correction: Does It Work?

Technorati Tags: video games, Nintendo Flash Focus, vision training

To-Do List: Brush Teeth! Floss! Scrub Lids?

It seems that someone is tampering with your personal hygiene checklist. In addition to caring for your dandruff, perspiration, and halitosis, now you need to pay more attention to your eyelid margins.

Sounds silly, but it is really a good idea. Oh, if you think this is a sales pitch you should review the disclosure printed below.

The product is called SteriLid. It is a topical foam that is applied to the eyelid margins with the fingertip.

Many folks with dry, red and irritated eyes often have an eyelid problem. The eyeball is merely an innocent bystander, bathed in a toxic tear film.

Here's the scoop: Healthy human skin is coated with bacteria. These germs usually live peacefully on the skin surface and bother nobody. Inflammation will begin if there is an overgrowth of bacteria or if the immune system gets agitated by the bugs. This inflammation interferes with healthy tear production, specifically the oil component. SteriLid kills the bacteria that normally inhabit the eyelids.

People with chronic blepharitis and acne rosacea should consider using this product in addition to whatever lid hygiene routine that has been prescribed for them. Of course, never make changes to any medical treatment plan without first consulting your doctor.

Did you know that endophthalmitis, a serious eye infection that can occur after intraocular surgery, is most often caused by the patient's own eyelid bacteria. Yep, those germs were inadvertently introduced into the sterile eye during the surgical procedures. To prevent this tragic complication, eye surgeons routinely instruct their preoperative patients to cleanse their lids at home prior to surgery, simply to reduce the overall number of bacteria. Pre-surgical scrubbing with a disinfectant usually finishes the job in the operating room. Again, this innovative product can help lower the risk of postoperative infection.

DISCLOSURE: Dr. Lloyd has nothing to disclose except advancing male-pattern baldness. Another balding physician, Dr. 'Inventor of the Artificial Heart' Jarvik, is a paid spokesman for the drug Lipitor. However, unlike Dr. Jarvik, Dr. Lloyd hates paid M.D. endorsements almost as much as he hates eye infections! Dr. Lloyd received nothing from the makers of SteriLid - not even free samples.

Related Topics:

• Caring for Your Contact Lens
• Dry Eyes

Technorati Tags: SteriLid, eyelids, blepharitis, acne rosacea, dry eye, health and wellness

CLAIM: They Didn't Hear that Prius Coming!

Where's King Solomon when you need him?

A fascinating new controversy has arisen. At lease four influential advocacy groups are drawing swords. Wisdom is urgently needed or this time it doesn't look good for the screaming baby!

Blind people claim it is no longer safe to cross the street because they cannot hear low-speed hybrid vehicles.

The National Foundation for the Blind (NFB) is pushing automakers to install some type of noisemaker on these eco-friendly vehicles in order that blind pedestrians avoid getting that run-down feeling.

NFB announced results of an unscientific test wherein blind participants claimed they were unable to hear low speed hybrid vehicles crossing their path. Maybe so, but I bet their Guide Dogs would have heard those cars!

Honk if you've already heard this story. I found two previous versions dating back to late 2005.

Wait! This conflict has room for more plaintiffs. Meet NoiseOFF, a nongovernmental organization established to raise awareness about the hazards of noise pollution. Its founder argues that Americans need less traffic noise, not more. Nevertheless, the Association of International Auto Manufacturers is studying the feasibility of establishing minimum noise level standards for hybrid vehicles.

This complex dispute is approaching biblical proportions. (Sorry, I can't stop myself!)

Blessed are the peacemakers. Couldn't they just clip a baseball card to the hubcap so it clicks every time it strikes the fender? That's what I did with my 27" Schwinn Deluxe Racer back in 1964?

Wait, Old Sol, don't divide the infant yet. There's more!

Prius owners approach the throne. They contend that all automotive drivers (operating on diesel, gas, hybrid, biofuel, or whatever) have a universal responsibility to drive carefully at all times and to give all pedestrians the right of way. Every day drivers strike pedestrians, most of whom could clearly see and hear the oncoming car. Maybe they need to put the noisemaker or a flashing signal on the blind pedestrian's cane to alert drivers.

Your Highness, that blade is getting mighty close. Whose rights take precedence?

Hey, the auto makers have yet to weigh in. Detroit (er, ...Tokyo) is resistant to adding anything that will increase manufacturing costs and jeopardize profits, especially if it only going to help a small number of people who can never be their customers.

His Highness is losing his royal patience.

"Please, everybody, sit down and put away the swords. Common sense must prevail." Every activity in life carries risks and everybody has personal responsibilities. Slow-speed hybrid drivers need to remain watchful for all pedestrians. If you are the only car in town you may want to open the window and turn up the radio a bit. Worried about noise pollution? Drive faster but make sure you don't get a speeding ticket.

Your Highness? Your Highness? Where did he go?

If he were still alive today I suspect King Solomon would sprint to the parking lot, jump into his brand new Lexus LX570 SUV (remember, he IS royalty), carefully check the rear view camera monitor before backing out, and drive away as fast as possible. Wise people know that some disputes are unsolvable.


Related Topics:

• WebMD Video: Background Noise Can Jumble Brain
• WebMD Video: Stress-Free Driving

Technorati Tags: Prius, hybrid vehicle, noise, blindness, controversy

Talking Trash

One of the earliest lessons taught to medical students involves professional conduct: Never speak ill of a fellow physician.

Alright conspiracy theorists, settle down! This is not some kind of lame defense for unethical physicians who conceal the mistakes of other doctors.

Doctors should not trash other physicians, plain and simple.

A recent visitor to the WebMD Vision & Eye Disorder Message Board related how a new contact lens provider criticized the contact lens prescription from a predecessor. It appeared to be a transparent effort by Doctor #2 to effectively assign blame to Doctor #1 for the patient's current eye discomfort. It's a tempting proposition.

Maybe it was true, perhaps Doctor #1 is a troll.

Then again, perhaps that contact lens prescription was exactly what the patient needed back in 1998! Things change.

It's hard to know, isn't it?

Here's why badmouthing is unacceptable in the medical profession:

• It does not elevate the quality patient care or the practice of medicine


• It may unfairly harm the reputation of innocent physicians


• Such comments are often inaccurate or based on limited information


• Badmouthing is disrespectful to the patient (who may still harbor favorable feelings for the previous doctor)


• It does not inspire confidence, merely cynicism, as patients begin to suspect the competency of all health care providers


• It is unnecessarily alarming to patients (If Doctor #2 badmouths Doctor #1 then what must Doctor #2 have to say about me?)

Truth be told, although badmouthing may be used to escape a temporary conflict, over the long haul it will create far more problems for all concerned.

What about the real-world situation when Doctor #2 discovers a problem likely attributable to Doctor #1? There is a truthful, accurate, non-hurtful way to explain everything. Trashing a colleague is dangerous - it wastes time, it usually generates hostility and it does not advance the patient's care. In cases of suspected malpractice, physicians know the proper steps to take to notify authorities and to thoughtful ways educate any injured parties.

Oh, yeah, this advice applies not only to physicians. Badmouthing is a bad habit for everyone. Instead, speak well, speak what you know to be true. Can you handle the truth?

Related Topics:

• Choosing an Eye Doctor
• Medical Errors Still a Problem

Technorati Tags: badmouthing physicians, vision, health and wellness