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VBPM Connection, #030-- News from your Doctor's Office.
February 11, 2013

The Virginia Beach Premier Medical Newsletter

February, 2013





Medical Myths

Some things just never go away like the health and medical myths that continue to be perpetuated by well-wishing folks on the Internet and among friends and family. Here are some common ones:

Flu vaccines cause the flu - The flu shots never cause the flu because they are made with killed viral particles. The nasal spray flu vaccines might cause the flu in certain individuals because they are made with attenuated (weakened) viruses. We never use the nasal spray vaccines in our practice.

The flu shots may cause an immune-type reaction that may make people feel like they have the flu for 24-48 hours.

Also if you're allergic to duck eggs, then you might get an acute allergic reaction with hives or major swelling around the injection site.

Getting cold and wet causes a cold - Only viruses can cause colds. You have to be exposed to a virus before you can "catch a cold". Does exposure to the elements effect your immune system. There's no scientific evidence that it does.

Vitamin C prevents or helps with colds - Again, this has been studied extensively and doesn't appear to be true, though there are many anecdotal reports to the contrary. Zinc does seem to have a slight benefit reducing the length of a cold by about 6-12 hours in some studies.

Antibiotics will cure my cold - Not true. The common cold is a viral infection that does not respond to antibiotics at all. The placebo effect of an antibiotic may help. Viral upper respiratory infections usually last about a week. If you take an antibiotic it lasts about 7 days ;-)

Vitamin B12 injections gives people immediate energy - Only by anecdotal reports, not able to be proven by randomized controlled studies. There is a strong placebo effect from getting an injection of any kind. If people think it's going to help, it will - at least 40% of the time.


At least once a year, everyone should review what they have done for prevention of illness and what they need to do in the future. The prevention checklist should include, but is not limited to, the following:

Immunizations - tetanus, diphtheria, pertussis, pneumonia, influenza, shingles

Cancer prevention - general physical exam, mammograms, colonoscopy, blood tests, Gyn checks, prostate checks, stool tests for blood

Blood tests to check for liver, kidney, bone marrow or metabolic/hormonal abnormalities.

Cardiac, Vascular, Lung diseases- general exam, EKG, blood tests. Evaluation of weight and exercise.

Bone health - blood tests and bone density evaluation.

Other regular tests may be required depending on your particular situation.

The best way to evaluate whether you are up to date on your preventive care is to set aside one certain time every year when you know you're going to sit down with your physician for an annual health evaluation and physical exam at which time all of these things can be addressed.

Your medical prevention list may differ somewhat from others. For example, if you have diabetes, you need to be sure you get a HgbA1c level regularly whereas those without diabetes don't have to worry about that. Your list will vary according to age, gender, family history and medical history.


Z drugs like Ambien, Lunesta and Sonata are medicines that are frequently requested and used for insomnia, although their effectiveness is not really clear. They do seem to help people get to sleep quicker but the risks may outweigh the benefit. When you consider the facts that all of these drugs have been shown to increase risk of accidents, increase mortality, decrease memory and impair balance, you may just decide to go back to milk and cookies at night instead of taking a pill.

Is There a Hereafter?

No matter what your faith or religion, at some time in your life you have probably asked yourself this question. I read a book recently called "Proof of Heaven", written by a Harvard-trained neurosurgeon, Eben Alexander III, living in Lynchburg, VA, who underwent a near-death experience during which he was in a coma and nearly brain dead for about 7 days before he miraculously regained consciousness. He tells of his vivid, ultra-real, very detailed, wonderfully pleasant experience during the time that his cerebral cortex was not functioning and should not have allowed any dreams or any other memorable experience.

After he returned to normal, he found that there was no way to explain his experience scientifically and was left with the conclusion that there must be another place where his consciousness went to - outside of his nonfunctioning brain. It makes for very interesting reading, and if nothing else, makes you think about it.

How ObamaCare Will Affect Our Practice

ObamaCare may not affect our practice as much as it will traditional doctors' offices, because we are not insurance-driven or volume-driven. Nevertheless, we will likely be influenced significantly in some respects.

I suspect that there will be more people who will want to get into concierge practices. Traditional practices will be overwhelmed with newly insured patients who will want to come in and utilize their new benefits. There won't be enough primary care doctors to go around, so waiting times to get into these regular practices will be long. Concierge practices will start to look better and better for those who have to wait long periods of time to see or even talk to their traditional doctors.

Even for our patients, it will take longer to get tests and procedures done. And it will take longer to get in to see specialists. Basically, everything will probable take longer, and I suspect the red tape will be more tangled than ever. It will be increasingly difficult to navigate through the medical system. There will be more restrictions on trying to get certain tests done that will be denied by insurance. There will be more restrictions on certain medications and greater need for cumbersome preauthorizations.

The need for better communication in spite of greater volumes of patients may have to be met by more effective use of communication technology - like email, texting, facetime and other video technologies that may take the place of office visits. Our doctors at VBPM will continue to be available using all forms of communication and will be ready for urgent office visits when necessary. We will never sacrifice quality of care and effective communication for volume.

Calcium Supplements

For many years, we have thought that calcium supplements help to increase bone density. There is actually very little evidence of that. High calcium diets rather than supplements are more likely to help bone density and are less likely to cause increased cardiovascular risk as has been the case with calcium supplements.


A new strain of Norovirus is moving across the US. There have been 6 outbreaks in Virginia so far. This is an enteric virus which causes nausea, vomiting, diarrhea. It infects 21 million people in the US every year and usually is responsible for about 800 deaths. There is no treatment for it other than maintaining hydration. Good handwashing and isolation are the best ways to prevent it. There is no vaccine for it yet.

Personal Health Records

Maintaining and updating a personal health record is something we should all do just like doing our taxes, reviewing our finances or getting our annual health examinations every year. If we all pay attention to this, then it will help us see where we are with regard our current health and can help us make decisions about our future.

We advocate and promote our patients' ability to have access to their records whenever they wish. We can download them to a disk or flash drive that you can take with you for safe keeping at home, to review whenever you wish and to take with you on vacation so they can be accessed if you become ill away from home. For more information about this, please refer to the website,

For Teachers

If you are a teacher, if you know one, if you have an interest in schools, in local history, or if you have anything to do with helping children, or even if you don't, you need to read this book - A Turning Point: School Integration, written by a local author and teacher, Dr. Lucy Spigel Herman.

The book is a memoir of stories and recollections from the days when school integration ("busing") began in the Norfolk school system - a very difficult, but arguably a necessary, time that proved to be a tremendous strain on children, teachers, parents and everyone involved. There are many stories in this book - some are heartwarming, some are very sad, some frustrating and maddening, but all very interesting, and told from the perspective of one kind and accomplished teacher who lived through it all. It is refreshingly honest and forthcoming about the good and the bad things about human nature, which is perhaps its greatest, most universal strength. I thoroughly enjoyed it, learned from it, and highly recommend it. Just recently published, it is currently only available at

What's New in the Journals?

Tattooing has been linked to the development of Hepatitis C infection independent of the usual risks like blood transfusions and IV drug use.

A recent study in the British Medical Journal found that vitamin and antioxidant supplements do not reduce the risk for cardiovascular disease.

Late life depression appears to increase the risk of cognitive dysfunction and dementia.

Low magnesium levels can increase risk of atrial fibrillation by 50%,

Unsuccessfully quitting smoking raises anxiety levels, but actually quitting smoking markedly decreases anxiety levels in the long run.

Fish oil supplements were found to not be effective in preventing stroke or heart attack in a recent study, despite prior suggestive evidence that it might be helpful. It doesn't do any harm, but it doesn't appear to help much either. It seems that the benefit of fish oil only occurs if you get it from your diet - by eating fish 3 times a week.

For patients with hyperlipidemia (high cholesterol levels), the risk of cardiovascular mortality decreases significantly for those who use statins and for those who exercise regularly. The effect of doing both - taking a statin AND exercising - is even better than either one alone. However, exercising by itself reduced mortality rates about the same amount as taking a statin. So if you really can't take a statin, regular exercise may be a reasonable alternative.

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