E online / Dr. Damon Raskin Why Jennifer Lawrence, Hugh Jackman and Anne Hathaway Got the Flu and You Didn’t January 18, 2013

Why Jennifer Lawrence, Hugh Jackman and Anne Hathaway Got the Flu and You Didn’t

Why do so many stars have the flu right now? Don’t they have better docs and meds than the rest of us?
–Alien Face, via Twitter

You speak of Jennifer Lawrence, who made the flu her personal bitch during the Golden Globes. There was also, of course, Meryl Streep, whose flu was revealed via an Amy Poehler joke; and Hugh Jackman, whose particular strain of flu has an amazing singing voice. (It also leaped into the lungs of Anne Hathaway.)

Yep, stars do get better medical treatment compared with most of the rest of us, what with on-set doctors available 24-7 and B-12 shots on demand. But does that give them an advantage over this season’s epidemic? Oh, you might be surprised.

“They’re actually more vulnerable to the flu than the average person,” child-actor-turned internist Dr. Damon Raskin tells me. “It’s a matter of being in contact with so many people.”

That’s right. According to doctors with a celebrity clientele, it’s actually a small wonder that more actors aren’t laid up with this season’s infamous sickness this month–because of the sheer number of flunkies, handlers, fans, reporters and glam squads they have surrounding them during every waking moment.

Yes celebrities have had an easier time accessing flu shots, and, increasingly, producers are insisting their stars get immunized against the flu before taking a gig this year.

But several other factors trump those advantages, making the average star more likely to get the flu than you, says Dr. Max Lebow, who sees plenty of celebrities through his practice at Reliant Immediate Care near the Los Angeles International Airport.

“This year’s flu vaccine isn’t quite so effective as it has been in years past,” he points out, calling this current batch only “moderately effective” with about a 60 percent chance of working.

Plus, Lebow adds, “the only way to really defeat the flu is if your immune system gets fired up enough to defeat it,” and right now, stars’ immune systems are constantly being challenged: Think jet lag, lack of sleep, dehydration, red-carpet diets, extra-long work hours, awards-season stress and other factors particular to Hollywood in mid-January.

And oh: Those B-12 energy shots that the stars love? “Worthless” when it comes to the flu, Lebow says.

Maybe it’s not so bad being a civilian after all.

Original Article

Dr. Damon Raskin

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The Blaze / Dr. Damon Raskin Doctors Dish to TheBlaze on Bloomberg’s New Rule Limiting Painkillers in the ER: ‘Ridiculous’ January 17, 2013

Doctors Dish to TheBlaze on Bloomberg’s New Rule Limiting Painkillers in the ER: ‘Ridiculous’

Last week, Mayor Michael Bloomberg announced that public hospitals in New York City would adopt his new guidelines that restrict emergency room doctors from dishing out opiate painkillers in an effort to curb abuse. But just what do medical professionals have to say about this?

“The fact that Mayor Bloomberg is suggesting that hospitals limit supplies of prescription pain killers in ERs is ridiculous,” Dr. Damon Raskin, a board certified internist and addiction specialist who works with Cliffside Malibu Treatment Center, said in an email to TheBlaze. ”Limiting opiate prescriptions will not change the drug problem and only cause problems with the patients who really need them.”

And that was a common theme among the medical professionals we spoke to.

The problem

A report by the Senate Caucus on International Narcotics Control says prescription painkillers accounted for 20,044 of 26,450 overdose deaths in 2008, more than those from heroine or cocaine combined. DrugFree.org pointed out that 70 percent of people who were abusing prescription drugs got them from a relative or friend.

Map shows an AP analysis of Drug Enforcement Administration data highlighting the increased use of the addictive pain killer oxycodone across the U.S. from 2000 to 2010.

According to the press release from Bloomberg’s office, the rate of opioid painkiller-related emergency room visits nearly tripled in the city between 2004 and 2010.

The new guidelines will be used in all of New York City’s public hospitals. Specifically, the guidelines prevent emergency departments from prescribing long-acting opioid painkillers, like oxycodone, fentanyl patches and methadone. Doctors will be able to prescribe up to a three-day supply of opioids but will not refill lost, stolen or destroyed prescriptions.

“Prescription opioid painkillers can be just as dangerous as illegal drugs,” Health Commissioner Thomas Farley said in a statement. “These new guidelines will help reduce prescription drug misuse while also making sure that patients coming to emergency departments have access to safe and appropriate pain relief options.”

Is government intervention needed?

Dr. Joshua Kugler, the chief medical officer and former chairman of the emergency services department at South Nassau Communities Hospital in Long Island, New York, said he agrees with Bloomberg’s efforts and called it a “necessary evil.”

“I applaud the concept, the philosophy behind it,” Kugler said to TheBlaze in a phone interview. “But also am cautiously optimistic about how this will truly affect patient care.”

Still, Kugler noted that there might be times when the guidelines could leave a legitimate patient in considerable pain. He said, for example, if a patient lost a prescription on a Friday evening after their doctor had gone for the weekend, they could be out of luck until Monday.

He added that although similar guidelines wouldn’t necessarily infringe upon how he or his department practices medicine, he does believe physicians need to have the ability to address patient care on a case-by-case basis.

Dr. Alex Kudisch, the chief medical officer at the Texas-based Origins Recovery Centers, expounded on this sentiment in an email to TheBlaze saying that “medicine must heal itself and without government intervention.”

“Yes, the Oxy for a toothache mentality must end, but the medical community will lose its rights to perform medicine if government intervenes,” Kudisch continued.

And what about the doctor’s roll in providing the drugs in the first place potentially contributing to the problem itself? Glenn Beck earlier this week said that if doctors providing the drugs can’t tell the difference between real pain and a drug addict, “then we have a problem with the doctors.”

Dr. Michael Michael with a rehabilitation clinic in Michigan told TheBlaze in a phone interview that for a long time physicians themselves didn’t do a good enough job managing patients’ use of the drug.

“A lot of it has to do with options — what options the doctor had at managing a patient’s pain,” Michael said, noting that even short term use of opiates as a painkiller is associated with an addiction risk.

He called opiates the “be-all-end-all in pain relief,” but noted there are other treatments now that doctors can use to avoid the drug completely.

“We’ve become better educated about it and are doing better at managing it, but are still not doing well enough,” he said.

Watch Beck share his thoughts regarding Bloomberg’s guidelines and the mayor’s comment that people using the ER as their source of primary care might have to “suffer a little bit”:

Treating the addiction

While Michael, who works specifically with patients suffering from addiction, agrees that something needs to be done to help curb the problem in the short term and that Bloomberg’s guidelines might cut down on overdose situations, he told TheBlaze that he doesn’t think it will have a significant, long-lasting effect.

Why? Because treatment of the addition is more than just cutting off the source. Part of the problem is the treatment in and of itself. Michael said the most popular way to wean an opiate addict off the drug is to put them on another, more controlled opiate, which would then be reduced over time. Although Michael said he respects those who provide this type of treatment, he said it’s not only painful for the addict but also not entirely effective as it often leads them to become addicted to this other opiate.

As a doctor at the Eagle Advancement Institute, Michael takes a different, 100-percent non-opiate approach at treating patients. In fact, the Clarity Detox Program was named one of the top five technologies to reduce prescription drug abuse by the Center for Lawful Access and Abuse Deterrence.

Michael said four out of five patients going through their program are successful at overcoming their addiction.

And even if addiction is being addressed, what is to be done about overdoses, which are still bound to occur? Kugler pointed out that Naloxone, an injectable drug used to reverse opiate overdoses, is being distributed to sources beyond emergency responders. New York and a few other states have programs expanding the distribution of Naloxone kits. Reuters reported on a study last year that found it would be life-saving and cost-effective to put the Naloxone kits directly in the hands of known heroine users.

Overall though, Kugler said stifling the problem goes all they way back to parents and schools having a real dialogue with children about the risks associated with prescription narcotics.

In other words, personal responsibility is just what the doctor ordered.

Orignal Article

Cliffside Malibu

Dr. Damon Raskin

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Celebzter / Dr. Damon Raskin Lance Armstrong Doping Scandal: Long-term abuse of anabolic steroids can definitely increase the risk of cancer, says expert January 16, 2013

Lance Armstrong Doping Scandal: Long-term abuse of anabolic steroids can definitely increase the risk of cancer, says expert

On Thursday (and Friday) the world will finally hear the truth for once come out of Lance Armstrong’s mouth as he reveals all to Oprah Winfrey.

A new reports from USA Today suggests the disgraced cyclist will admit he started using performance-enhancing drugs to gain an edge in cycling in the mid-1990s, before he was diagnosed with cancer.

On Tuesday’s “The View”, Whoopi Goldberg got into a heated debate with Barbara Walters when she questioned the correlation between steroid use and cancer. [In Oct. 1996, Armstrong  was diagnosed with testicular cancer that had spread to his brain and lung]

“I don’t know but the question really is: Do the steroids cause cancer? That’s the question. Did he get the cancer because of the steroids? That’s what we need to know,” Goldberg asked.

And it is a good question to ask.

In preparation of Armstrong’s no holds barred interview with Oprah, Dr. Damon Raskin, a board certified internist Los Angeles and men’s health specialist, has spoken to Celebzter about the effects of steroids and blood doping.  Dr. Raskin in the supervising MD for Ageless Men’s Health, a nationwide facility dealing with men’s health and anti-aging issues and he has worked with many patients who have long-term steroid usage.

“Long term abuse of anabolic steroids can definitely increase the risk of cancer, (it is unclear whether this many have been a contributing factor to his testicular cancer) as well as atherosclerosis (increased plaque in arteries and risk of heart attacks and strokes), and lower the good cholesterol in the body (HDL),” Dr Raskin explains.  ”Steroids can also contribute to higher blood pressure, acne, and aggressive behavior.”

He adds: ”In addition, blood doping, which involves blood transfusions and/or taking a hormone called eryrthropoetin which increases red blood cells and thus more oxygen to muscles, can also lead to strokes by making the blood too thick.”

We also asked Dr. Raskin about what the long-term ramifications on Armstrong’s body will be after prolonged use of steroids and blood doping.

“Long term, doping can lead to structural changes in the heart which could  lead to increased risks of heart attacks, heart failure and stroke.” he says. ”High blood pressure, low amounts of HDL (good cholesterol), acne, infertility, and possibly prostate cancer are also major risks.”

And what happens when you suddenly stop taking steroids after years of abuse?

“When someone suddenly stops taking steroids after prolonged use, they may experience mood swings, depression and anxiety, muscle and joint pain, and insomnia. For men, the steroid abuser has turned off his own body’s making of testosterone, so a sudden withdrawal will also lead to lack of sex drive,” Dr. Raskin explains.

Interestingly, Livestrong also has an article about the long-term effects of doping.

And at least one board member of Armstrong’s Livestrong Foundation said he feels betrayed by Armstrong’s years of deceit. “Yes, I do. And I think he’s got a lot of apologies,” Mark McKinnon said in a CNN interview.

Perhaps, Armstrong should have named his organization ”Liestrong”.

Original Article

Cliffside Malibu

Dr. Damon Raskin

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Celebzter / Dr. Damon Raskin Lance Armstrong Doping Scandal: Long-term abuse of anabolic steroids can definitely increase the risk of cancer, says expert January 16, 2013

Lance Armstrong Doping Scandal: Long-term abuse of anabolic steroids can definitely increase the risk of cancer, says expert

On Thursday (and Friday) the world will finally hear the truth for once come out of Lance Armstrong’s mouth as he reveals all to Oprah Winfrey.

A new reports from USA Today suggests the disgraced cyclist will admit he started using performance-enhancing drugs to gain an edge in cycling in the mid-1990s, before he was diagnosed with cancer.

On Tuesday’s “The View”, Whoopi Goldberg got into a heated debate with Barbara Walters when she questioned the correlation between steroid use and cancer. [In Oct. 1996, Armstrong  was diagnosed with testicular cancer that had spread to his brain and lung]

“I don’t know but the question really is: Do the steroids cause cancer? That’s the question. Did he get the cancer because of the steroids? That’s what we need to know,” Goldberg asked.

And it is a good question to ask.

In preparation of Armstrong’s no holds barred interview with Oprah, Dr. Damon Raskin, a board certified internist Los Angeles and men’s health specialist, has spoken to Celebzter about the effects of steroids and blood doping.  Dr. Raskin in the supervising MD for Ageless Men’s Health, a nationwide facility dealing with men’s health and anti-aging issues and he has worked with many patients who have long-term steroid usage.

“Long term abuse of anabolic steroids can definitely increase the risk of cancer, (it is unclear whether this many have been a contributing factor to his testicular cancer) as well as atherosclerosis (increased plaque in arteries and risk of heart attacks and strokes), and lower the good cholesterol in the body (HDL),” Dr Raskin explains.  ”Steroids can also contribute to higher blood pressure, acne, and aggressive behavior.”

He adds: ”In addition, blood doping, which involves blood transfusions and/or taking a hormone called eryrthropoetin which increases red blood cells and thus more oxygen to muscles, can also lead to strokes by making the blood too thick.”

We also asked Dr. Raskin about what the long-term ramifications on Armstrong’s body will be after prolonged use of steroids and blood doping.

“Long term, doping can lead to structural changes in the heart which could  lead to increased risks of heart attacks, heart failure and stroke.” he says. ”High blood pressure, low amounts of HDL (good cholesterol), acne, infertility, and possibly prostate cancer are also major risks.”

And what happens when you suddenly stop taking steroids after years of abuse?

“When someone suddenly stops taking steroids after prolonged use, they may experience mood swings, depression and anxiety, muscle and joint pain, and insomnia. For men, the steroid abuser has turned off his own body’s making of testosterone, so a sudden withdrawal will also lead to lack of sex drive,” Dr. Raskin explains.

Interestingly, Livestrong also has an article about the long-term effects of doping.

And at least one board member of Armstrong’s Livestrong Foundation said he feels betrayed by Armstrong’s years of deceit. “Yes, I do. And I think he’s got a lot of apologies,” Mark McKinnon said in a CNN interview.

Perhaps, Armstrong should have named his organization ”Liestrong”.

Original Article

Cliffside Malibu

Dr. Damon Raskin

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CMAJ / SignatureMD Paying for an open medical door January 10, 2013

January 10, 2012

Paying for an open medical door

Michael Campagna finally had enough of the jammed waiting room at the orthopedic surgeon’s office, the rapid-fire exams once he got in and the lack of results with his chronic ankle and knee problems. He’d gone 25 years without health insurance, got it shortly before a motorcycle accident, then wondered why he’d bothered.

“It was a nightmare,” he said of the three-month regimen of twice monthly visits in Alexandria, Virginia. So he entered a small but fast-growing segment of American health care, paying US$1500 a year to see a doctor who offers a “personalized” approach known as concierge medicine.

Now the waiting room he visits has two chairs, one for him and another empty. Instead of seven minutes with the doctor, he gets at least 30, plus email consultations day and night, an annual physical lasting 2.5 hours, appointments within 24 hours, follow-up when he’s referred to a specialist and an intense focus on preventive care. “It’s like old times,” says Campagna, in his mid-60s, “when the family knew the doctor and we had house calls. … This allows a doctor to be a good doctor. It unleashes the inner doctor.”

The personalized approach is variously known as direct care or retainer-based, membership or even cash-only medicine, and involves a “direct” financial relationship between a patient and a physician in the form of an annual or monthly fee. It’s typically charged for some manner of additional care in addition to the fees charged for the normal procedures that are provided. Some providers of concierge medicine do not accept insurance of any manner, whether private or from the government under the federal Medicare and Medicaid programs for the elderly and poor respectively. They’re cash-only (or cheque or credit card) but are still considered concierge if they charge a monthly or annual fee, instead of, or in addition to, the fees they charge for each medical procedure they perform. Most providers of concierge medicine, however, accept insurance. But the fee for retaining the concierge doctor comes out of the patient’s pocket.

For patients, the appeal is more ready access, while for physicians, the lure appears to be a lighter workload. A Congressional advisory committee found that the number of concierge physicians had risen fivefold between 2005 and 2010 to more than 750. Those doctors were serving 100 to 425 patients each, down from more than 2000 they saw while working in a traditional practice. Most were internal medicine specialists or family physicians

Many fear the growth of concierge medicine, should it continue apace, will exacerbate the growth of a two-tiered system under which attentive physicians delivering quality care are available primarily to the well-heeled. But proponents argue that it was ever thus and that concierge medicine is increasingly becoming more affordable to the middle class, even if it does constitute a substantial hit on their wallets.

Although annual fees are increasingly being charged by Canadian physicians, they are typically for services not covered by Medicare plans, such as providing proof of a visit to the doctor’s office or providing an expert opinion Some Canadian physicians now charge an annual administration (block) fee that covers immunizations, completion of medical forms, photocopying of files and returning calls.

The growth of concierge medicine in the United States has left the chairman of the MedPAC advisory committee, Glenn Hackbarth, fretting about the potential impact on access to primary care for the average American. Many doctors could bail from Medicare completely in favour of a concierge practice, he once told a public hearing . “There’s too much money to pass up,” he said. And the result could be a “dramatic erosion in access in a very short period of time” in traditional care, particularly Medicare. “So that’s my nightmare.”

Critics of concierge medicine say that it’s essentially a cash grab by physicians, who are being paid a hefty premium to do the job they are supposed to do anyway.

But advocates say that it’s not quite so cut and dried, particularly when it comes to physician workloads. As the population ages and President Barack Obama’s health care reforms expand access to care for millions more people, practitioners are racing to keep up and sometimes getting burned out. Exasperated by rising costs and complex regulations, physicians appear to be abandoning private practice in droves, with many opting to work for hospitals or large networks instead.

Among those left in traditional care, concierge medicine has become very tempting. “As the doctor shortage worsens, you see family docs step out and go into concierge medicine,” says Dr. Doug Pittman, a family and sports medicine practitioner in Whitefish, Montana, in the heart of ski country five hours south of Calgary, Alberta. “It’s the closest thing to a primary doctor strike. We are withdrawing because we can’t get paid for what we do, and our patients are going to outlive us because we are killing ourselves to try to keep up.”

Pittman switched to concierge medicine in 2009 after family practice left him stressed and bored. “All I was doing was putting out fires.” Instead of seeing 25 patients daily, he’s limited his practice to 100 patients overall. He charges each $1900 for a year’s services. Married couples get a discount ($3400), while snowbirds who are gone for the winter pay $1300 apiece or $2500 per couple. Pittman also throws in “scholarships” to cut the fee to $1100 for some older patients, teachers and folks who work on the mountain.

Instead of seeing patients for eight minutes, each now gets 80 minutes, he says. “You have control of everything. I answer the phone, take out the garbage. No matter where I am, they can get a hold of me.”

“It restores a physician’s independence, and you get paid an equitable wage for what you’re doing, preventing illness. It allowed me to pursue the type of medicine that I did the first 10 or so years.”

It also results in improved care, says Dr. Floyd Russak, an internal and geriatric physician in Denver, Colorado, who runs a personalized practice limited to 300 patients paying $1000 to $1500 annually. Russak had been seeing 30 to 40 patients a day and decided to “get off the hamster wheel” in 2010 because he felt he wasn’t “doing an exceptionally good job with any of them.”

His clients now get a half hour of his time during a routine visit and round-the-clock access. If they go to the hospital, so does Russak. “For patients that can afford it, it’s much better care,” he says.

There’s no question the care is improved, claims the California-based SignatureMD, a network of concierge practices involving 50 doctors in 14 states which was launched seven years ago. “The goal was to create a more direct relationship between patient and physician, a more direct financial relationship which facilitates better health care,” says CEO Matt Jacobson.

Is it elitist?

Not in Jacobson’s mind. “Should we send our kids to private school if that’s something we value?” he asks. “Some people put value on health care, and want to put investment in health care. We have a democratic society.”

For its part, the American Medical Association’s stance on concierge medicine is equivocal. On the one hand, it offers advice on establishing a concierge practice.  But its code of ethics suggests that the quality of care should not be dependent on a patient’s ability to pay extra fees .

“Physicians have a professional obligation to provide care to those in need, regardless of ability to pay, particularly to those in need of urgent care,” the code states. “Physicians who engage in retainer practices should seek specific opportunities to fulfill this obligation.”

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SignatureMD

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