Monthly Archives: July 2009

Theory Offered: Why Smokers Prefer Marlboro

TriskelionAZ reponded to my question regarding why smokers seem to prefer Marlboro’s. Thanks Triskelion! Your comments seem like reasonable explanations to me. I will see what my Marlboro smoking patients think of your ideas.

TriskelionAZ offers the following thoughts to

Thankfully I am not a smoker . I tried when I was 18 but with asthma that prevented me from gaining an addiction. From what I hear from my friends who smoke they said they started smoking when they were quite young and that marlboro was the “strongest” and had the most flavor(very true in Europe though!). So that became a standard for them. After the years went by i think they dilluted the tobacco with other fillers.

An ex friend of mine who was in marketing told me once. The color RED is used on a lot of stores and ads that deal with food (or hand to mouth) since it subsconsciously has been known through studies to make people want to eat, drink etc. Thats why a lot of fast food use red as the color for them. The color BLUE is relaxing therefore its mainly used to calm people. Places where sleeping beds are sold use a lot of blue but most eateries use red or more red than anythign else. Same with cigarette boxes and Marlboro uses a lot of it and so do other cigarettes but a lot of them didnt start using red until later on.

Those are my theories as to why people use Marlboro as a trend. Bulletin boards(Marlboro Man etc) reinforced sales too of course.

Leslie Looks for a Solution for Weight Gain with Underactive Thyroid

Leslie writes to about the effect hypothyroidism has had on her life, her energy and her weight. Her experience raises the notion that her metabolic problems may not be totally resolved despite what appears to be an adequately low TSH level while on Armour thyroid.

Leslie writes:

I am at a total loss as to how to loose weight! Five years ago, I became chronically fatigued, and had lots of other symptoms that led me to believe that I was hypothyroid. My Dr. tested me, and declared that I was not, and suggested that I should excersise more. My symptoms continued, and I began to gain weight at an alarming rate. I went back several times, presenting with hypothryroid symptoms, and he finally admitted that I was “borderline hypo with a TSH over 5″ but “we don’t treat that.” I lived the next two years with debilitating symptoms and weight gain that I simply could not control with diet and excersise. By the time I found a doctor who was willing to treat me, I had gained over 50 pounds and had developed fibromyalia as well. Even then, it was difficult to get treatment – but finally he relented. Now my TSH is below 1, and my fatigue is not quite so so debilitating, however my weight loss efforts are dismal. I know that my metabolism is very slow – because my temp. in the morning is usually under 96. I’ve been on Adkins for six months now – keeping my carbs under 20 grams a day, and relying on lots of fiber to keep me from being terribly hungry – but I’ve only managed to lose about 13 lbs. I know there has to be help for me, but I just don’t know what to do. Five and a half short years ago I weighed 140 lbs, had energy to burn and felt great, and looked pretty good too!. Now I weigh 180 lbs, live with chronic pain, and fatigue, and I’m unable to work. I’ve done a huge amount of research into hypothyroid and all the problems it causes – and bringing my TSH down has brought my glucose, triglicerides and cholesterol down, but not my weight. I am fearful of developing diabeties and really need help. I take Armour Thyroid, which has been much better for me than Synthroid was, but still – I am startled and upset when I see a picture of myself – looking fat and puffy instead of toned and slim. Please help me!

Brian Dean Responds to Weight Gain Request

On our message board, Rowan shared his frustration with obtaining weight gain advice. His efforts so far have not produced the desired results so he wonders what can offer.

Brian Dean a skilled RD and frequent contributor to takes up the issue and posts the following response on our forum.
You can visit the forums yourself at . If you want to join in the discussion simply register if a first timer or sign in using your existing member name and password.

Brian offers his take on the weight gain issue:

Hi Rowan,

Thanks for sharing your story.

I first want to emphasize that you’re not alone. Even though the emphasis always seems to be on “how to lose weight”, there are plenty in your position as well.

Fortunately, there are a number of strategies you can do to gain weight-no matter what you’ve tried thus far.

It sounds like you are making a concerted effort to gain weight by eating foods high in calories. This isn’t a bad idea, but you can gain weight without having to eat nothing but junk food. Not only does eating junk food all the time make you feel tired and run down, but it could set you up for health problems down the road.

One of the first things I’d try is a supplement like Boost or Ensure. These don’t fill you up, have a lot of calories, and is much healthier than junk food. Drink 2-3 per day after meals and you will almost certainly gain weight.

I’d also try to eat high-calorie foods that are healthy. By far the best in this regard are healthy fats.

Here are a few healthy fat foods:

1. Avocados
2. Nuts
3. Olive Oil

This should get you started on the right track. Please post with any questions you have!

Brian Dean MS, RD

Shortage of Armour Thyroid Strikes Home

In my medical practice I have many individuals taking Armour thyroid for treatment of hypothyroidism and doing well on it. In the past few weeks I have had numerous requests from pharmacies and prescription supply services requesting I rewrite my prescriptions of Armour due to lack of availability of certain pill strengths. Until this week I have been able to get around this obstacle by utilizing the available Armour strengths in various combinations to arrive at the correct total dose. In the last few days the Armour shortage became so severe that several drug supply companies said they were totally out of all Armour dosages and that an alternative treatment was required.

In some cases of hypothyroidism it has taken many visits over many months to arrive at a satisfactory thyroid replacement plan. It is a great feeling for the patient to know that their symptoms will be controlled on their specific medication plan. It is upsetting to have to change prescriptions at this point in treatment because the medication is no longer available. Making matters worse is that I am unable to explain why this shortage has occurred and when, if ever, the medication will be available. The responsible pharmaceutical company has been elusive in providing answers to these questions and supplies no guidance to prescribing physicians.

I am aware that other preparations of dessicated thyroid are available and that several contributing members of expressed their satisfaction with these preparations. I am investigating the alteratives as fast as possible but it is another frustrating failing in our system to have patients and physicians placed in this position.

Gary Pepper, M.D. Editor-in-Chief,

New Rankings of the Best US Hospitals

“Medscape Today”
from WebMD — a health information Web site for patients
Bill Hendrick

July 20, 2009 — U.S. News & World Report has released its annual “honor roll” of America’s best medical centers, and Johns Hopkins Hospital in Baltimore is at the top of the list for the 19th straight year.

The top 21 hospitals all earned high scores in at least six of 16 specialties, ranging from cancer and geriatric care to orthopaedics and urology.

Scores were based on both objective measures — such as mortality rates, patient safety, and other care-related factors — and subjective measures, such as reputation.

“I think these rankings are extremely meaningful to an extremely small number of patients, relatively speaking, who represent a very small piece of the patient population but whose need for a very high quality of care is extreme,” Avery Comarow, the U.S. News & World Report statistician who compiled and analyzed the data, tells WebMD. “These rankings are not at all intended for those who need relatively routine procedures.”

The ‘Best Hospitals’ for 2009

Hospitals are listed below by total points. Here are the 21 hospitals that made the magazine’s honor roll (two are tied for 10th place):

1. Johns Hopkins Hospital, Baltimore
2. Mayo Clinic, Rochester, Minn.
3. Ronald Reagan UCLA Medical Center, Los Angeles
4. Cleveland Clinic
5. Massachusetts General, Boston
6. New York-Presbyterian University Hospital of Columbia and Cornell
7. University of California-San Francisco Medical Center
8. Hospital of the University of Pennsylvania, Philadelphia
9. Barnes-Jewish Hospital/Washington University, St. Louis
10. Brigham and Women’s Hospital, Boston
11. Duke University Medical Center, Durham, N.C.
12. University of Washington Medical Center, Seattle
13. UPMC-University of Pittsburgh Medical Center
14. University of Michigan Hospitals and Health Centers, Ann Arbor
15. Stanford Hospital and Clinics, Stanford, Calif.
16. Vanderbilt University Medical Center, Nashville, Tenn.
17. New York University Medical Center
18. Yale-New Haven Hospital, New Haven, Conn.
19. Mount Sinai Medical Center, New York
20. Methodist Hospital, Houston
21. Ohio State University Hospital, Columbus

Top Hospitals by Specialty

Here are the No. 1 hospitals in each specialty, according to U.S. News and World Report:

* Cancer: M.D. Anderson Center, University of Texas, Houston
* Diabetes and endocrine disorders: Mayo Clinic, Rochester, Minn.
* Digestive disorders: Mayo Clinic
* Ear, nose, throat: Johns Hopkins Hospital, Baltimore
* Geriatric care: Ronald Reagan UCLA Medical Center, Los Angeles
* Gynecology: Brigham and Women’s Hospital, Boston
* Heart and heart surgery: Cleveland Clinic
* Kidney disorders: Brigham and Women’s Hospital
* Neurology and neurosurgery: Mayo Clinic
* Ophthalmology: Bascon Palmer Eye Institute, University of Miami
* Orthopaedics: Mayo Clinic
* Psychiatry: Massachusetts General, Boston
* Rehabilitation: Rehabilitation Institute of Chicago
* Respiratory disorders: National Jewish Hospital, Denver
* Rheumatology: Johns Hopkins Hospital
* Urology: Johns Hopkins Hospital

Best Hospital Lists: How Useful Are They?

American Hospital Association Senior Vice President Rick Wade tells WebMD that hospitals that made the honor roll and those that were ranked in the 16 specialty groups were generally teaching hospitals “with the most cutting-edge research and technology.”

Wade says that hospitals that didn’t score enough points to make a list should be avoided.

“You can investigate on your own,” he says. “For people who don’t live near a Hopkins, there are many community hospitals that have very good records.”

Arthur Caplan, PhD, director of the Center for Bioethics at the University of Pennsylvania, tells WebMD that lists for most people “are almost useless. The only data of value is on specific doctors, treating cases analogous to your own.”

Rankings “are a quality perspective from 75,000 feet when what the prospective patient needs is precision at ground level about particular doctors doing particular things in situations close to the one the patient has,” Caplan says.


News release, U.S. News & World Report.

U.S. News & World Report: “America’s Best Hospitals.”

Avery Comarow, health rankings editor, U.S. News & World Report.

Arthur Caplan, PhD, director, Center for Bioethics, University of Pennsylvania.

Rick Wade, senior vice president, American Hospital Association.

Ella Quit Smoking, Gained Weight and Lives to Tell About It

Ella shares her experience with smoking cessation. When someone succeeds even with a few set backs thrown in, it is great inspiration for others who haven’t quite taken the plunge.

A point of intererst here. I always ask my smokers what their brand is, just to educate myself and look for trends. I find that the majority are Marlboro smokers. Does anyone have an idea why Marlboro is such a popular choice?

Ella writes to with her story:

Yes, thanks to everyone. It was a relief to read all of the posts. I quit one year ago this last 7/7, and I am one of the unlucky ones–from 138 to the 150s. I smoked for 15 yrs and am 32. I run 4-5 miles/week, lift weights and other machines at the gym at least 5 times a week. I was also very active, with boxing, aerobics and other stuff for 5 years prior to quitting. It’s been difficult to deal with 30 pounds. But I am also taking the advice of some of the other posts and gonna come clean about my caloric intake and my ALCOHOL consumption (hey–misery loves company–a smoke in one hand and a drink in the other and now, without one, well keep pouring ….) Anyway, I have taken a month off the hooch pledge and am back on a diet. I am also going to up my 45 minutes at the gym to at least a full hour. Hopefully I will make a dent before the end of the summer.

Yes, thanks to everyone. It was a relief to read all of the posts. I quit one year ago this last 7/7, and I am one of the unlucky ones–from 138 to the 150s. I smoked for 15 yrs and am 32. I run 4-5 miles/week, lift weights and other machines at the gym at least 5 times a week. I was also very active, with boxing, aerobics and other stuff for 5 years prior to quitting. It’s been difficult to deal with 30 pounds. But I am also taking the advice of some of the other posts and gonna come clean about my caloric intake and my ALCOHOL consumption (hey–misery loves company–a smoke in one hand and a drink in the other and now, without one, well keep pouring ….) Anyway, I have taken a month off the hooch pledge and am back on a diet. I am also going to up my 45 minutes at the gym to at least a full hour. Hopefully I will make a dent before the end of the summer.

Building bridges

Metabolism related disorders can really sneak up on you with no warning. Actually almost any disease can, the question is what you can do to prevent it or to manage it. There are many articles around how to prevent various disorders but, really, there are so many of them you don’t even want to know. Plus, it can create an anxiety to think about that. Before attending Chinese medicine school I had no idea about the variety of diseases, and at some point in the western medicine section of my education, particularly pathology, I even freaked out looking at all these scary photos. The bottom line is you never know what your genetic blueprint is exactly going to produce, what new flu is about to emerge, and which next food choice would be proved dangerous. I’m not even mentioning numerous prescription and over-the-counter drugs with various issues. However the reality, there is not so much you can do to control external environment, even by washing your hands and buying organic. Don’t take me wrong, please by all means take precautions – watch your diet, visit your doctor for regular checkups, follow the news on health and nutrition. And whatever happens – stay calm. It is your internal environment you can control to make decisions from the balanced and educated mood.

Many of us experienced scary moments when dreadful news are delivered to us and loved ones about the disease that has no cure and at the best can be managed with medications or nothing at all – just wait and see. Probably the scariest of all is placing your fate to the hands of your doctor while “googling” for hours, asking friends, pacing back and forth, screaming at heavens, feeling powerless. Then you have to make a decision – either disease has you – or – you have been diagnosed with the disease. I would strongly advocate for the second choice simply because it leaves you with the power to choose what to do from the place of your own unique constitution – on all levels. The disease never manifests exactly the same for everyone, and never can be treated exactly the same. The limitation here is what you already know vs what you don’t know yet.

The rule of thumb: never give up. The miraculous cures are recorded over and over again – while you have a hope you have a chance. Don’t believe a doctor who takes hope away from you, it is your health and your body – you have the right to press for answers, demand explanations, copies of your medical records, and consultations about other choices. Turn your attention to alternative medicine. A good medical doctor never blindly dismisses an alternative option – he will study it and give you his/her opinion. Some doctors don’t have time to educate themselves about other kinds of medicine and you can encourage them to do so. More and more medical doctors embrace acupuncture, nutrition, homeopathy, and other modalities in their practice or in collaboration with other practitioners. It all comes down to what patient will benefit from the most, and the safety of therapies integration. It is equally important to provide your alternative medicine doctor with copies of your lab results, especially if you are looking to benefit from herbal medicine or nutrition care.

We are lucky to live now – the age of technology. Modern and ancient medicines are dancing together building bridges between top-notch machines and dried herb decoctions, brain surgeries and homeopathy. Using it all you can expand your choices and the most important – build a well-defined plan to heal yourself using the expertise of doctors and specialists you trust.