Ira Breite's Sirius Doctor Radio Show for June 16th, 2008

One of the great things that I have discovered while being a host on Doctor Radio is that there is no shortage of interesting topics to talk about: whether its the problems your own patients are having, stories in the news, or interesting calls that we receive on the show.  Even a question you get from a friend over dinner can become a great show topic.  This weekend I was talking with friends and one of them asked me a question, which I realized I had talked about on the show with one of the world's experts on the subject. Another asked me a question about their chronic heartburn, which I thought was interesting and important topic to speak about on the show.

Unfortunately, we started today's show on a sad note, the death of Tim Russert. Fortunately, to help explain sudden death and how it could happen to a man who, by report, exercised and had a physical, including a cardiac stress test was NYU-Langone's Clinical Chief of Cardiology and the Harold Snyder Family Professor of Cardiology, Judith Hochman, MD. We discussed some of the risk factors for heart disease, the importance of the appropriate use of the automated external defibrillator, and how even a well done, well read, and well intrepreted stress test can not predict every cardiac event. It was a sobering talk, and extremely important. I used this opportunity to introduce Brendon McDermott a Certified Athletic Trainer from the National Athletic Trainers’ Association. He is also an Laboratory Instructor in the Department of Kinesiology at the University of Connecticut. I love certified athletic trainers...they know so much about safe exercise for elite atheletes and, more importantly, for the rest of us. We spoke about hydration and fluids. I was chagrined to find out that my workout was not on the level of elite athelete and I would do fine replacing my lost fluids with water. OK, I knew that I wasn't an elite athelete, but I wasn't sure if a sweaty middle aged man needed Gatorade or not.  We also took calls, of which there were many. As the summer goes on, and we all need to stay in shape, I will continue to have certified trainers and registered dieticians on the show.

Then it was on to GERD. Reflux is a common problem, and often responds well to medication. But what if you need to take the medicines for years and years? One alternative is surgery, and to discuss this I brought Dr. Costas Bizekis into the studio. Dr. Bizekis is an Assistant Professor of Cardiothoracic Surgery here at NYU-Langone and expert on performing anti-reflux surgery. We talked about how we decide who should get an operation, and a little bit on how the surgery is performed. The audience called in with some great questions to help us along.

Our second hour opened with a bang...about Viagra and similar drugs.  I thought I knew a decent amount about sports, and even about doping.  Boy, was I wrong.  Educated by Urologist, NYU-Langone Faculty member, and fellow Doctor Radio show host Andrew McCullough, MD and also one of the hosts of "Mens Health (live 6-8 PM on Sirius 114) and also by Dr. Don Catlin, who is the founder of Anti-Doping Research, which is a non-profit organization devoted to help level the sports playing field, I learned that, theoretically, the ability of drugs such as Viagra to increase pulmonary blood flow may increase an athlete's performance.  Dr. Catlin told us that, until proven in a study to increase performance, these drugs would not be banned. My advice: keep using Viagra to improve the performance that its approved for!

We finished the show talking about teeth and pregnancy.  My own fear of dentists not assuaged by her warmth, intelligence and good humor, I brought Dr. Stefanie Russell, D.D.S., M.P.H., Ph.D, an Assistant Professor in the Department of Epidemiology and Health Promotion, NYU College of Dentistry into the studo to talk about the study she just published showing that pregnancy is an independent risk factor for losing teeth, and that the more pregnancies you have, the more teeth you are at risk to lose.  We talked about the importance of keeping up with your dental care while pregnant.  

Finally, kudos to me The segment we did on tomatoes and salmonella last week SCOOPED all of the mainstream media: yet another reason to listen to Doctor Radio.  If you don't have Sirius, you can hear me at www.Sirius.com/doctorradio and then sign up for a free trial.  Its worth it (even if I wasn't there!)

(photo from wikipedia -->http://upload.wikimedia.org/wikipedia/commons/9/97/Viagra_in_Pack.jpg)

Ira Breite's Sirius Doctor Radio Show for June 9, 2008

Summer is coming, and in fact, at 90 degrees before I even started broadcasting this morning, its already here in New York City. Fortunately traffic is light, and the Vespa provides its own natural form of a/c, in addition to like 55 miles per gallon in NYC traffic. Today, we had several summery topics as well as some important cancer information. We also spoke to a young, newly minted physician on his time trying to help the medical system in Ghana!

Shawn Talbott, PhD. is an author, an athlete, and an expert on the the use of vitamins and supplements in health. He just wrote a book called "The Metabolic Method," which describes how small changes in diet, lifestyle, exercise and sleep (how I wish I could get more!) can help you lose weight and be healthier.  Shawn and I talked about how sleep is important to dieting, and many callers had questions for both of us on the importance of sleep in controlling weight.  

We switched gears after this.  Colon Cancer is, unfortunately, still extremely common in the US, with about 150,000 new cases diagnosed every year and 50,000 deaths.  While colonoscopy may save a significant percentage of these cases from occurring, not everyone does this when they should.  

Genetic differences in people with a family history of colon cancer may play a role in how people react to various therapies, such as chemotherapy.  This was demonstrated in a recent study in the Journal JAMA.  Leonard Saltz, MD, of Memorial Sloan Kettering Cancer Center came on the air and we talked about this study, of which he is one of the authors.   The other, really interesting thing we talked about is how, in patients with a known history of colon cancer, exercise may improve overall prognosis.  Although this is a very preliminary finding, it certainly is worthy of more study.  There were several calls on the colonoscopy prep, which is terrible, but a worthwhile price to avoid getting colon cancer!

After the break we really changed gears.  I spoke with the freshly minted Dr. Brian Levine, who is a recent graduate of the NYU School of Medicine and also a Reynolds Scholar.  Reynold's scholars are designated because of their interest in public service and entrepreneurship.    Brian actually set up a phone system amongst doctors in Ghana, helping the 2000 doctors in this country of 22 million people communicate with each other.  Although Brian is about to get buried as an intern and resident, I am sure we will be hearing more from him as the years to on.

Finally, it was about tomatoes.  Not the Killer Tomatoes, but normal plain old tomatoes with salmonella in them and on them.  Not good.  The FDA has an OK (to busy, in my opinion) website with a link to current tomato warnings and news.  I spoke on the telephone with Dr. Casey Barton Behravesh,  an epidemiologist and lead investigator for the Center for Disease Control in Atlanta.  She answered many interesting questions on how the disease detectives from the CDC try to isolate the source of an infection such as this one.  We also answered listener questions about the outbreak.  The links in this paragraph should lead to up to date information from the FDA and CDC.

Ira Breite's Sirius Doctor Radio Show, Monday June 2, 2008

Today was an extremely exciting day in Doctor Radio land: we officially launched! My Intro was done by none other than Cousin Brucie! which I think is just about the best thing ever. I met him when I was at Sirius Studios, but I am amazed that he is doing our intros. Media is cool!

This was also my first show in our new studio in the NYU-Langone Medical Center Lobby. I'm no expert on radio technology, but its a pretty space with apparently every bell and whistle you could want. Just like The Today Show, there is a glass partition where you can see everyone and they can see you. The only hard part was to stop waving at people I know and keep talking!

As befits the first show in a new studio, this one was, in my humble opinion, great. Interesting topics, great guests, and a plethora of calls made this an interesting and educational show.

We started off by talking about supplements and vitamins. Many doctors (including myself) do not know enough about this topic, which is a pity, because up to half of all Americans use them. Steven Lamm, MD, a physician here at NYU-Langone and the author of "The Hardness Factor," a book about men's sexual health, joined me on the line. We talked a little bit about a recent article in the Journal of the National Cancer Institute by Vicki Brower stating that, in cancer patients, many supplements may do more harm than good. Dr. Lamm pointed out that poor communication between doctors and patients may have a lot to do with the use or misuse of many supplements. We then answered many calls from our listeners asking specific questions about supplements.

Onto osteoporosis. But not in women. Yes, men get this disease as well, and there are new guidelines for what to do about them published by the American College of Physicians. We talked about them with Dr. Steven Honig, Director, The Osteoporosis Center Department of Rheumatology and Medicine, Hospital for Joint Diseases. As men live longer, this is becoming a more important issue (6% of men greater than 65 have osteoporosis) and prevention is key before a fracture occurs.

After the break, we shifted gears. To bloggers (gotta love those bloggers). I had seen a piece on Gawker a while back which pointed to a NY Times article noting that two bloggers had heart attacks and died (I can't be as snarky as our friends at Gawker, and its worth reading their post). And while most of us aren't professional bloggers, many of us do work at jobs with lousy desks, poorly placed computers, mice that should be called "rats" and improperly adjusted chairs. I spoke with Ms. Angela Lis, physical therapist and Assistant Director the NYU Occupational and Industrial Center about making your workplace less likely to give you a repetitive strain injury. We started off by seeing how I was doint in the new studio, and other than the heights of the monitors (which, to be honest with you, are adjustable) we did pretty well! There were some great listener calls as well.

Finally a bit on gastric bugs to end our morning. I talked with Dr.Marya Zilberberg, M.D., Epidemiologist at University of Massachusetts School of Public Health and Health Sciences in Amherst, Mass – She’s a researcher & lead author of a study appearing in the June Issue of the CDC’s publication, “Emerging Infectious Diseases" about the rise of c difficile, the leading cause of fatal diarrhea, in hospitals. Scary stuff, but it was important to hear about. The take home message if you visit anyone in the hospital is wash your hands with soap and water! Then I talked a bit about new treatments for H. pylori, the ulcer causing bacteria.

Remember, you can email me (see link on the top of the page) if there are any topics you want to hear about. I want to hear about any questions that you wanted to ask your doctor, but, for whatever reason couldn't.

Ira Breite's Memorial Day Sirius Doctor Radio Show: Monday May 25th, 2008

Although Memorial Day is a holiday where we remember those who have fallen in service to our country, as a physician I thought it was important to speak about those who served, sacrificed and survived. I dedicated my show to honor those who have helped us during our wars.

We started off by talking with Mr. Alex Kershaw, who has written a fascinating book describing the survival of 9 sailors from the United States Submarine Tang, which was downed by her own errant torpedos. This book, Escape from the Deep: A Legendary Submarine and Her Courageous Crew, is a fascinating story of courage under extreme duress.  We talked about the medical issues involved in escaping from a hot, posion gas filled tin can 180 feet below the surface of the Pacific Ocean, about the extreme hardships these men endured under captivity, and about their readjustment to life after surviving the war.  Since the Japanese never informed the Red Cross that the crew members were alive, several of their spouses, assuming they were dead, had remarried.  The book promises to be an amazing read this summer.

You can visit Alex's website or the book's website for his book for more information.  

One of the big health questions of the last Gulf War revolves around ways to more easily make the diagnosis of Gulf War Illness.  I was honored to talk with Dr. Robert Haley, from UT Southwestern, one of the leading experts on this illness.  We talked about the cognitive issues Gulf War Vets are having, and about some of the tests being developed to more accurately diagnose this condition.  He asked me to say, and I say again, that if you are a Gulf War Vet, and are approached by members of his team about a research study, please participate!

After finishing with Dr. Haley, I talked with Mr. Michael Bann, a veteran of the first Gulf War, who talked of his experiences on the battlefield and after the war.  

Medical care has improved markedly in the field during the current Gulf War, and many more soldiers are surviving horrific injuries.  However, they are often left with either amputations or traumatic head injuries.  I spoke with Dr. Alex Moroz of NYU-Langone's prestigious Rusk Institute of Rehabilitation about advances in artificial limb technology.  After talking with him, I hope to get some of the inventor's of this new technology on the air!

Finally, it was time to talk about one of the most important issues for people who have been in war zones: post traumatic stress disorder.  We spoke with Dr. Lynn Delisi, a professor in NYU Langone's Department of psychiatry.  We also spoke with two relatives of Gulf War Veterans about the difficult, and tragic times, that they faced when their loved one's came home from the war.  They were Stacey Hafley and April Somdahl.   The family member's were from Military Families Speak Out, which is an organization of relatives of soldiers and veterans opposed to the War in Iraq.  Regardless of your opinion of the War, it is clear that PTSD is exacting a toll on soldiers, veterans, and their families and hearing their stories was important and moving.  

Ira Breite's Doctor Radio Show on Sirius 114: May 19, 2008

We started off the show today by doing a little speculating on Senator Kennedy. I spoke with Dr. Orin Devinsky, the head of NYU Langone's Epilepsy Center, on what might of happened. Although we speculated that the Senator's people may have been hiding something (boy, were they!), we spoke about how subclinical vascular events (super mini strokes) are a common reason for older people to have new onset seizure activity.

Then onto dieting! Keri Gans, registered dietitian, ADA spokesperson and the Diet Diva, about diet blogs, dieting websites, and even the use of Facebook applications to diet. We both agreed that it could work as a motivational tool, and I relayed my (not overly successful) efforts to try to use the internet tools. The best one I found is "My Diet" on Facebook.

One interesting fact that has come out recently is that a good nights sleep can help you lose weight. But who sleeps? Many people who can't get to sleep use sleeping medications and a recent report noted that there have been more formal complaints about the newer types of sleeping aids than the older ones. So I brought in the expert: Joyce Walsleben, RN, Ph.D. , a noted expert on sleeping disorders, who is an associate professor at NYU-Langone School of Medicine and also a member of Sleep Medicine Associates of New York City. We had a highly entertaining and educational talk, which led to a large number of viewer calls.

Although not a great way to stay asleep, many people do drink before going to sleep. I had a good conversation with Susan Foster, the Vice President and Director of Policy Research and Analysis at the Center on Addiction and Substance Abuse at Columbia University about a recent study indicating that, when stressed, women get anxious and men want a drink. This led to an interesting discussion about women's attitudes toward alcohol, and how doctors underdiagnose alcohol problems in women. Based on our discussion, I am determined to think more about this important problem!

Finally, realizing what a lack of sleep and alcohol may lead too... we talked about sex. Starting off with HERPES, I started what I hope will be a continuing series of "non-AIDS" std discussions on Doctor Radio. Joined by infectious disease expert Brent Wise, MD, we talked about everything from the non-std mouth sore that you get in herpes type I to treatment of recurrent disease. There were some interesting tales as well; some not suitable for presentation on a family blog!

Ira Breite's Sirius Radio Show: May 12, 2008

How can you not listen to a show that deals with the pain of tattooing and the agony of da feet? Or tells you more about our little friend at the left than you ever wanted to know (but need to!!) You can't! In case you didn't catch the show this is a brief overview of what you missed.

The Agony of Da Feet: Although I am not overly excited by the forthcoming "Sex and The City Movie," it appears every woman I know is gearing up as if they were actually going to have Cosmo's with Sarah Jessica Parker and the other ladies. But what about those shoes? Well, after talking to Dr. Michael Pliskin, the Chief of Podiatry at North Shore/LIJ, I learned a bit about those 5" Manolos, and I am happy that I look great (at least I think so) in work boots.

For those of you who think video games are nothing but a huge waste of time and energy, I had the voice of the oppositon on the line today. Ben Sawyer, the Co-Director of the Games For Health Conference spoke to me and told me about some of the exciting developments in video games to promote health. There is a lot going on in terms of exercise training, rehabiliation, training games for health professionals, and large insurance companies are coming on board. I hope to be covering some of these games in more detail on future shows.

After the break, we got funky. Tattoo funky, that is. I talked about how to get them on, and what types of things to avoid when getting inked (or pierced). There is a little handout from the FDA you can look at if you are interested. Remember, MRI's are considered safe for tattooed individuals.

If you don't like your tattoo, its possible to get it removed, although expensive, time consuming, and a bit painful. I spoke with Tina Alster, MD, the Director of the Washington Institute of
Dermatologic Laser Surgery, a Clinical Professor of Dermatology at Georgetown University Medical Center and the author of, “Skin Savvy: The Essential Guide to Cosmetic Laser Surgery”. She also spoke about a new anesthetic product that can be used when getting laser procedures and botox. Interesting.

Finally, it was time for the bed bugs. The NY POST had a recent article on bed bugs in the subways last week, and how could we resist following up on this topic that even I find gross. I spoke with Philip Tierno, Ph.D., the Director of Clinical Microbiology at NYU-Langone and an Associate Professor in the Departments of Microbiology and Pathology at the NYU School of Medicine. He’s also the author of "The Secret Life of Germs." I also spoke with Mr. Carl Massicott, the owner of Advanced K9 Detectives, a company that uses specially trained dogs to find the little buggers. After hearing from my experts, I may never sleep again...

Ira Breite's Sirius Radio Show, May 5, 2008

Another week and another great show.  I think I am finally getting the handle on this whole radio thing; it not easy!  As I tell my patient's, its easier for me to do 7 colonoscopies in a row rather than two hours of radio.  Which is fortunate for all of those getting colonoscopies.  But I digress.

We've been talking a lot about exercising and avoiding injury while exercising on the radio since the weather has been improving here in NYC.  This week, we took it to the next level.  My producer, Melanie Kron, just completed her first half marathon on the Sunday before my show.  We reviewed her training and performance with one of the World's foremost experts on the subject of running health, Dr. Lewis Maharam, who is medical director of the New York Road Runners, ING New York City Marathon, all of Elite Racing’s Musical Marathons, and The Leukemia & Lymphoma Society’s Team in Training program. Dr. Maharam also serves as Chairman of the Board of Governors, International Marathon Medical Directors Association.  We reviewed Melanie's training techniques, shoe choices, and even the little "bat girl belt" full of liquid that she schlepped with her.    I learned a lot, and will be more ready than I have been for the onslaught of pre-marathon injuries that we see at my office at Westside Medical Associates.

Then onto baseball!  Yes, I was honored to speak with Don Sutton, the hall of fame pitcher and currently the announcer for the Washington Nationals baseball team.  Don found out that he had kidney cancer, and has been receiving treatment for this. We spoke with him and with a specialist physician about the treatments he is receiving.   He is now involved with a program called "Stay in the Game!," for patients with advanced kidney cancer.  

From there, we talked a little about the intersection of medicine and politics.  Several years ago, the City of New York started tracking hemoglobin A1c, a lab test that generally monitors overall success of diabetes glucose treatment for a period of months.  The City is able to track this data, and to contact patients and providers as they see fit.  This is a departure from normal procedures, when public health officials only become involved with individual patients because of infectious diseases, such as tuberculosis.  The Archives of Internal Medicine had a series of "pro and con" articles on this issue which were understandable to the layperson.  I talked about these issues with our resident endocrinology expert, Stuart Weiss, MD.  It was a spirited debate about the line between public health and individual privacy.  

After the break, I talked a little bit with caller Vinnie from Los Vegas about weight loss, including the gastric bypass and the lap band.  This is an important issue that I will keep brining up in a variety of ways.

Irritable bowel syndrome was next.  There is a new drug for IBS-C (or irritable bowel syndrome with constipation predominant symptoms, for non gastroenterologists) out there: Amitiza was just approved at a new, lower dose for this purpose in women.  But is it right for you?  I talked with Doctor David Bernstein, a clinical professor at NYU and the Chief of Gastroenterology at NSLIJ Hospital, about this.  The answer....read about it and then see your doctor!

Finally, it was time for my favorite: Grand Theft Auto!!!  Now, I happen to love video games, and was actually excited when GTA IV came out last week (and yes I own it, and no, I don't want my kids to play it).  But was all my posturing that video games were fine just me making excuses for my own behavior?  NO.  Joining me on the line was Cheryl Olson, ScD. who is Principle Investigator for research for the study of the effects of Electronic Games on Pre-teens and Teens at the Center for Mental Health and Media in Boston, MA.  Along with her husband, Larry Kutner, PhD. they have written a book called "Grand Theft Childhood: The Surprising Truth About Video Games and What Parents Can Do."  Bottom line: the games are not as bad as you think, but there are a lot of things you need to know, particularly if you are not a gamer yourself.  Buy this book.