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Two of the American hostages rescued from the jungles of Colombia have the disease leishmaniasis, according to U.S. Ambassador William Brownfield. Leishmaniasis is an illness American dermatologists are becoming more familiar with. It used to be considered rare in this country, except for a few cases occurring in the south part of Texas. But several doctors now say the disease is cropping up among troops who have served in Iraq and Afghanistan and among travelers.
Leishmaniasis is a parasitic disease spread by the bite of an infected sand fly. The most common form is called cutaneous. It causes a skin lesion that soldiers have taken to calling "Baghdad boil." Another form of the disease, called visceral, infects the organs, can be fatal if left untreated and is less common. Information on the disease can be found at this Centers for Disease Control and Prevention website.
It's important for anyone traveling out of the country to know about the disease and its symptoms. Doctors in this country may not necessarily look for it, and some people report having a hard time getting a correct diagnosis. See this story in the Boston Globe.
-- Shari Roan
Photo: Courtesy of Forsyth Medical Center
Talk about carrying a load! A North Carolina woman gave birth yesterday to twins who weighed a combined 23 pounds, 1 ounce. That happens to be a record for the state of North Carolina in twin poundage and is second nationally only to a 1924 twin birth in Arkansas that totaled 27 pounds, 12 ounces.
The girl, Abigail Rose Maynard, weighed in at 12 pounds, 3 ounces, and her brother, Sean William Maynard, weighed 10 pounds, 14 ounces. They are both in fine condition, according to officials at Forsyth Medical Center, where the babies were delivered.
What I really want to know is: How is the mother? No information was given on how much weight she gained during the pregnancy. But according to her obstetrician, she stayed "on a healthy diet."
- Shari Roan
If only the L.A. Times Health section would compile a list of the area's best doctors. Think of the reader convenience ... not to mention a fundamentally flawed judging process and inherent conflicts of interest.
Among the thousands of doctors in Los Angeles County, we simply couldn't be sufficiently familiar with all of them to decide who should be on the list -- and who shouldn't. Too many factors go into being "the best."
We could list those physicians we knew to have a good clinical reputation, to be experts in their particular specialty. But we'd be certain to miss many, many others. And even the most knowledgeable might not be willing, or able, to provide the kind of communication you or your condition need. One doctor may have more experience than a younger colleague but be too busy to listen to your particular concerns. Another physician may keep up with the cutting-edge treatments but not have the skill or wisdom to make them useful to you.
We could list those doctors we've seen personally, or interviewed professionally, but that opens up a wealth of potential and real conflicts of interest (on both our part and the physician's part) that I don't need to belabor. Suffice to say that readers deserve better than a doctor hoping for a mention on a "best doctor" list or a journalist who has gotten special treatment from said doctor.
We could ask readers to send us their preferences, but higher-volume docs and those more likely to push their patients toward such feedback could easily stack the deck.
We could use a research firm, as do many publications, including New York magazine. But let's take a look at how that list is compiled:
For starters, it's winnowed from a longer one. That longer list is based on a peer-review survey. That survey is based on those forms returned by medical professionals in the region. Those professionals include some randomly selected doctors (not all doctors), doctors from the previous guidebook (keep reading for those pitfalls) and the top officials at local hospitals (of course, they wouldn't be predisposed to vote for their own). The published list is further adjusted in various ways. Here's a rather thorough explainer.
Here's how a physician, writing for Slate, described that list a couple years back: "It's high school all over again, a life lived at the mercy of cruel arbiters of who is up and who is down."
He goes on to say: "Of course, the list isn't really about accuracy or quality. It's about sales -- not only of doctors' services but also of fancy plaques, directories, and pen-and-pencil sets fitted into paper weights."
Some of the most knowledgeable -- and caring -- doctors I've seen would never make a "best of" list, largely because their priorities are their patients, not publicity.
So instead, we prefer to tell you how to find the best physician for your particular needs. Check out Susan Brink's story How to find the best medical care in this week's Health section or the Ask Us question (a very good one) that prompted this post, Diagnosed with cancer? Here's how to find a doctor in your neighborhood.
Doing your own research isn't as easy as calling a number in a directory, but you'll be much likelier to get the "best" for you.
-- Tami Dennis
Illustration: Melinda Beck / For The Times
Chronic or recurrent pain affects more than 75 million Americans. That fact has received a lot of attention among health professionals in the last decade. But, according to a new study, doctors often aren't sure what treatments will help their individual patients.
The study, in the June issue of Journal of General Internal Medicine, drew several conclusions:
- None of the clinical trials on opioid pain-relievers, such as morphine, Percocet and Vicodin, lasted longer than four months, even though most people with chronic pain have symptoms for a long time (that's why they call it chronic) and are prescribed these drugs for long periods of time.
- There's a dearth of information on herbal remedies versus other pain medications in spite of the fact that management of chronic pain is one of the major reasons people turn to alternative medicine.
- Chronic pain often goes hand-in-hand with major depression, but little is known about the impact of treating both the pain and the depression together.
- Pain assessments, such as 0-to-10 scales, have become very popular. But studies suggest that using the assessments may have little effect on treatment of the patient's pain.
Says the study's author, Matthew J. Blair, of Indiana University School of Medicine: Many primary care doctors "have not been well trained in pain management. And while many are paying more attention to pain than ever before. . . they don't know what treatment will work for a given patient. They want guidance and we found very limited information."
The lesson here may be to turn to a pain specialist for help in managing chronic pain -- if you have health insurance that will cover that, of course.
- Shari Roan
 If elected president, Sen. John McCain, the presumptive Republican nominee, would be the oldest president to take office. That's why it was a big deal two weeks ago when McCain's personal doctors proclaimed him to be in excellent health. The assessment on McCain's health, however, was released in a tightly controlled news conference in which reporters were not provided with copies of McCain's medical records and were granted limited information in order, McCain's doctors said, to protect McCain's privacy. For example, his doctors wouldn't say whether McCain had tests to assess his cognitive status.
That's just not good enough, say two medical historians in an editorial published Wednesday in the Journal of the American Medical Assn. They say it's time for the nation to create a congressionally appointed, bipartisan, unbiased panel of medical, ethical and legal scholars to review the health history of all presidents, vice presidents and presidential candidates. The reports from this commission would be submitted to the White House and Congress and made public.
Polls show that Americans believe good health is essential to the president's performance. But the authors of the report, from the University of Michigan, say that history shows the public is often in the dark about the health of the country's chief executive. Moreover, the fact that Americans are living longer and are more comfortable electing age-70-and-older officials increases the need for more candor on the part of those elected officials. The recently tightened health-privacy rights afforded to all Americans, they say, simply shouldn't apply to the nation's top dogs. "Unlike patient confidentiality protections for private citizens, nominees and eventual winners of presidential and vice presidential elections are among the most public of patients in the world," the editorial states. "Today, voters are demanding and receiving more information about the lives of presidential nominees and elected presidents and vice presidents than ever before in U.S. history. The inescapable reality of 21st-century instantaneous communications is that those who aspire to the U.S. presidency surrender almost all privileges and prerogatives related to privacy whether they wish to or not."
There is one downside to such detailed disclosure, the authors note. The losing candidate may find himself or herself unable to obtain health insurance.
Some past presidents' hidden health problems:
Franklin D. Roosevelt's 1921 polio infection was well known but the extent of his paralysis was not. Many years after his death, historians raised the possibility that his many hidden health problems -- severe hypertension, chronic obstructive pulmonary disease and congestive heart failure -- may have affected his performance at the 1945 Yalta Conference. Dwight D. Eisenhower announced his candidacy for reelection without revealing the details of his 1955 near-fatal heart attack. Also secret were Eisenhower's battles with stroke, intestinal obstruction and motor aphasia during his second term. Although he said he did not have "real Addison's disease," John F. Kennedy did, indeed, have the adrenal disease and, unknown to the public at the time, received heavy doses of corticosteroids for the problem as well as painkillers for back pain throughout his presidency. Much debate has centered on Ronald Reagan's cognitive status during his last term as president. Though there is no evidence that his Alzheimer's disease symptoms began while in office, Reagan was not tested for the disease while serving as president even though his mother had suffered from dementia.
- Shari Roan
Photos: President Kennedy by HO/AFP/Getty Images, Presidents Roosevelt, Eisenhower and Reagan by Associated Press
 Ten years ago, neurobiologist Fred H. Gage of the Salk Institute in San Diego rocked the scientific world with a paper that said that the number of adult brain cells is not fixed at birth, as was commonly believed, but that brain cells could, in fact, regenerate. Now a company that Gage co-founded is ready to test that concept in the real world.
According to a report published this week in MIT's Technology Review, the San Diego company BrainCells Inc. has begun phase-two testing of a compound that is aimed at treating depression and anxiety by promoting neurogenesis -- the growth of new neurons -- in the brain. If successful, the drug would be an alternative to antidepressants that work by increasing levels of the neurotransmitter serotonin in the brain. "The fact that you might be able to take small molecules to stimulate specific cells to regenerate the brain is paradigm-shifting," Mayo Clinic neuroscientist Christopher Eckman told Technology Review. "[This approach] takes advantage of the body's innate ability to correct itself when given appropriate cues."
The article notes that some researchers are skeptical that depression can be treated by way of neurogenesis. BrainCells, however, intends to look for neurogenic compounds that can be targeted to the treatment of other brain disorders, such as psychoses, cognitive and memory disorders and other diseases of the central nervous system. To be sure, the research is in early stages. But BrainCells is one to watch.
-Shari Roan
Image: J.W. Burkey / Tony Stone Images
A recent episode of "Grey's Anatomy" depicted doctors treating a man who was encased in concrete. But real life is pretty interesting, too. Doctors at Hartford Hospital in Hartford, Conn., reported this week on a case in which a police officer provided the decisive treatment for a patient in need of help.
The patient was brought in by police after fleeing from them and hiding in a lake. When he was apprehended, he was hypothermic and had atrial fibrillation, an irregular heartbeat, of up to 145 beats per minute. During attempts to rewarm and treat him, however, the patient became agitated, ripping off his monitoring electrodes and intravenous line and threatening the hospital staff and the policeman who accompanied him.
That's when the officer stepped in, firing a Taser to the man's chest. The shock subdued the patient, but more important, it restored his heart rhythm to a safe 120 beats per minute.
Tasers have been accused of causing arrhythmias, which can sometimes even lead to sudden cardiac death, the doctors note in their paper, published in the Annals of Emergency Medicine. But this "fortuitous therapeutic" use of a Taser is the first known report of medical benefit. Says the lead author, Dr. Kyle A. Richards: "In this instance, the patient received a very low dose of electrical current, but it was still enough to restore him to regular heart rhythm. This is the law of unintended consequences at work, or so it seems."
-- Shari Roan
Illustration: 'Information Graphics' by Peter Wildbur and Michael Burke
Blood banks are always struggling to replenish their supplies. The best potential donors, healthy young or middle-age adults, often say they are too busy with their lives to take the time to donate. One very-willing pool of possible donors, however, is teenagers. According to a story today by NPR, blood banks have stepped up their recruitment of high school students. This is true in Southern California too. The Red Cross of Southern California reports on its website that more than 30,000 pints of blood are collected at local high schools each year. Dozens of high schools have youth Red Cross chapters that organize blood drives on campus. Some states are trying to support the trend by lowering the minimum age requirement for donating blood. In July, Minnesota will lower the donor age from 17 to 16.
But there's a potential problem. The Journal of the American Medical Assn. reported this week that 16- and 17-year-olds who donate blood have many more complications than older donors. Complications, such as bruising and fainting, occur in 10.7% of 16- and 17-year-olds compared with 2.8% of donors age 20 and older. Most of the complications are minor; but the study reported some gashes requiring stitches and a broken jaw from passing out and falling.
About this time last year, my daughter brought home a woozy friend who had passed out that afternoon while giving blood at school. He was ashen-faced and embarrassed to boot. His reaction convinced my daughter to wait until she was older to give blood even though she had been trying to gain weight for weeks in order to qualify as a donor. Teenagers are wonderfully altruistic human beings. But the authors of the JAMA study point out that when these kids suffer complications after giving blood, they may never come back. Kids should have thorough information about what blood donation involves and what they can do to minimize complications. See a list of tips here. Or, it might be better to wait until adulthood, when the experience is more likely to be a positive memory. The Red Cross of Southern California says its teen donors "become a base for a lifetime of life-saving blood donations." Maybe. But maybe not.
-- Shari Roan
Photo: Michael Paulson / Associated Press
The nine-month development of a human fetus is nothing short of wondrous. Equally astonishing, however, are the rare cases in which something in that development goes terribly awry. Doctors in the Greek city of Larissa reported last week that they had successfully removed an embryonic parasitic twin from the stomach of a 9-year-old girl.
The chances of a parasitic twin formation is extremely rare. According to a review of the case published in Medical News Today, it results from the same biological process that produces conjoined twins and vanishing twins (when one twin disappears early in the pregnancy). In the case of a parasitic twin, the twin embryo does not fully separate into two individuals. While one twin develops normally, the other twin is lodged inside the healthy twin.
Early in life, the healthy twin begins to show signs of an abnormal stomach growth and often pain. That's when the parasitic twin, which continues to grow like a tumor from blood supplied by the healthy twin, is discovered. The parasitic twin removed last week was a 2-inch-long embryo. Medical News Today reported one famous case in which a fetus was found in the stomach of a 7-year-old boy because his enlarged stomach showed movement inside. When the parasitic twin was removed, doctors found a nonviable but still highly developed twin brother.
-- Shari Roan
Attention all those with sporadic but crippling pain, recurrent infections, skin lesions and other symptoms of various stripes that baffle, even confound, doctors: The National Institutes of Health may be able to help.
The agency this week launched its Undiagnosed Diseases Program, in which physicians and researchers from a host of specialties will put their collective expertise to work studying patients with mysterious illnesses that have yet to be diagnosed.
Now the caveats: Only about 50 to 100 participants will be chosen annually. The competition is likely to be fierce. Over the years, it seems I've heard from at least that many people saying they've not been diagnosed properly. Of course, many of them probably couldn't get a physician to agree with that conclusion.
That brings us to the second caveat ... patients must be referred by a physician or healthcare provider. No self-diagnosing-as-undiagnosable this time around.
And that brings us to the Happy Hospitalist, an internist who doesn't seem that impressed with the focus on mystery diseases and who offers up "real world examples" of folks who believe they've not been diagnosed properly, including this one: "Ma'am, your 10 CT scans of your abdomen in the last twelve months, your three upper endoscopies, your two colonoscopies, your CT angiogram of your belly, your PET scan, your exploratory lap, your cholecystectomy, hysterectomy, spleenectomy and your 400 pages of lab tests have failed to give us an alternative diagnosis to your irritable bowel syndrome."
He adds: "To everyone up there at the National Sounds Important Institute, let me know if you need some help."
-- Tami Dennis
Photo: Lawrence K. Ho / Los Angeles Times
 Consumer empowerment has reached new heights -- with average Americans weighing in on professors, plumbers, just about everyone. Most people would say that's a healthy trend, one not without perils for individuals but nevertheless empowering for consumers overall. Now doctors are finding themselves subject to such ratings. And they're squeamish.
It's understandable. Physicians are morally compelled to provide care to even the most combative, unreasonable or irrational patients. And what might they get for their efforts? An anonymous attack for all the world to see.
Reporter Shari Roan had been noticing the growing number of doctor-rating sites (RateMDs.com, Vitals.com, DrScore.com and others) at the same time her eldest daughter was telling her how helpful RateMyProfessors.com is for college kids in signing up for classes. "I started thinking about whether the doctor ratings sites were useful, accurate and fair," she says.
What she found was a public hungry for more complete information about the men and women to whom they entrust their lives. Americans don't apparently believe that medical boards, insurance companies or doctors themselves will tell the truth. And so they've turned to each other.
"What surprised me once I got into reporting the story was how emotional many of the comments are," Roan says. "People are really angry, and my sense is that it reflects the state of healthcare in general."
We understand the pros and cons of this trend -- as, we're sure, do readers. The online world is a risky one, reputation-wise and in terms of accuracy. But patients want -- and need -- as much information as they can get when stepping blindly into the healthcare abyss. They also deserve accurate information.
Like it or not, ratings of everyone are likely here to stay. For them to be truly useful, however, our story suggests that more people -- not fewer people -- need to weigh in. Not just with the bad -- but with the good.
-- Tami Dennis
Photo: Ken Hively / Los Angeles Times
 Americans have woken up to the fact that conflicts of interest are rampant in medicine. Doctors may prescribe certain medications because they have financial interests in a pharmaceutical company or because they receive Lakers tickets or trips to Cabo from the drug representatives who visit their offices.
The problem exists in the orthopedic world, as UC Irvine spine surgeon Charles Rosen has often pointed out. Rosen is featured in BusinessWeek this week for his efforts to prevent conflicts of interest from affecting patient care in orthopedics. In February, he testified before a Senate committee and said he worries that some patients receive unnecessary artificial knee or hip joints or artificial discs because the manufacturers of these devices have cozy relationships with doctors. In 2006, Rosen founded the Assn. for Ethics in Spine Surgery. He is also a vocal supporter of a federal bill called the Physician Payments Sunshine Act of 2008 which would create a nationwide database listing payments and gifts to doctors.
The BusinessWeek article notes that Rosen isn't afraid to challenge his colleagues on ethics. "Activism hasn't made Rosen particularly popular, either on campus or in industry. His soft-spoken manner belies a combative intensity and a desire to shine, which may have been honed during the years he spent as a competitive figure skater. Often, he has found himself at odds with other professors over the appropriate role companies and their physician consultants should play in training other doctors."
Rosen's resume states that he entered college under an early admission program from his junior high. And, besides figure skating, he has expertise in tennis, piano and French. His biggest challenge may be in persuading his colleagues to change how they do business.
-- Shari Roan
Photo: UC Irvine
People generally check into hospitals to get well, not to get sicker. But hospital-acquired infections have become a major problem in this country and worldwide. Now a new study is pointing a finger of blame at hospital housekeeping staff and their cleaning techniques.
Researchers in Canada used a lotion that glows under ultraviolet light to show that up to one-third of patient toilets are not properly cleaned. The scientists checked for the dangerous bacterium Clostridium difficile, which causes diarrhea and can lead to blood poisoning and death. Even 40% of the samples taken from the cleanest toilets contained C. difficile spores, suggesting the cleaning agents may not be working so well either. The study was published in BMC Infectious Diseases.
Last month, the Agency for Healthcare Research and Quality reported that C. difficile cases in hospital patients increased by 200% between 2000 and 2005. Though no one relishes the thought of unclean hospital bathrooms, the repercussions of clinging C. difficile germs are profound. The healthcare agency reports that patients with the infection (which results after previous antibiotic therapy suppresses the normal bacteria of the colon) were hospitalized almost three times longer than uninfected patients and had an in-hospital death rate of 9.5% compared with 2.1% overall.
-- Shari Roan
Drawing: Paul Corio / For The Times
One of the most controversial topics in psychiatry over the last few years centers on the questions what is bipolar disorder, and how many people have it. Estimates on rates of the disease, which is marked by periods of depression alternating with episodes of euphoria, are heavily debated. A new study, however, suggests doctors are over-diagnosing bipolar illness.
The paper, presented today at the American Psychiatric Assn. meeting in Washington, D.C, and published online in the Journal of Clinical Psychology, found that fewer than half of the people who were previously diagnosed with bipolar disorder could be said to have the disorder when strict diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders-IV (the so-called bible for diagnosing mental disorders) were applied.
The study's lead author, Dr. Mark Zimmerman of Brown University, suggests drug company advertising is leading doctors astray. Doctors tend to believe they have arrived at a correct diagnose if the medication they prescribe shows some benefit, says Zimmerman, adding: "This bias is reinforced by the marketing message of pharmaceutical companies to physicians, which has emphasized the literature on the delayed and underrecognition of bipolar disorder..."
Or, as the author of the psych blog Furious Seasons points out: "he's saying that doctors -- you know, those rational, god-like creatures who do things based on Science --are being softened up by all those pharma ads saying bipolar is wildly underdiagnosed." Medication for bipolar often produces serious side effects.
The study is rich fodder for the just-appointed members of the American Psychiatric Assn.'s Work Group who will soon begin writing the fifth edition of the mental disorders manual. DSM-V will represent the first complete revision of the text since 1994, a period in which, psychiatric association experts note, "may prove to be the most scientifically productive era in the history of psychiatry." The final text is expected to be published in 2012. Let's hope it makes huge strides in clearing up some of the astonishing confusion surrounding bipolar disease -- along with many other perplexing questions about the diagnosis and treatment of mental illness in children and adults.
--Shari Roan
Illustration: Darren Booth / For The Times
Several recent scientific papers and conferences have made clear that male hormonal contraception is doable. The most recent paper, by Los Angeles researchers Ron Swerdloff and Christina Wang, says hormonal birth control for men appears to be safe, effective and reversible. The research, published this month in the Journal of Clinical Endocrinology and Metabolism, reveals that a combination of testosterone and progestin appears to be the most successful way to suppress sperm. But more research remains, Swerdloff says. For example, the effectiveness of the method appears to be higher in certain ethnicities, such as Asian men.
Whether a male birth control method can reach the market any time in the near future is, perhaps, the biggest question. Pharmaceutical companies are needed to step up to the plate to complete large clinical trials, says Swerdloff, chief of the endocrinology division at Harbor-UCLA Medical Center. Swerdloff and Wang are director and co-director of the government-funded Male Contraceptive Clinical Trial Network Center. "The concept has been validated," says Swerdloff. "We are convinced that new alternatives for family planning are needed. But a product is not yet ready to go to market."
Why not? Perhaps pharmaceutical companies are on the sidelines because they don't think men are enthusiastic about controlling their own fertility. What do you say, men?
-- Shari Roan
Young people often begin drinking alcohol because of environmental factors, such as peer pressure. But genes appear to be a significant factor in determining whether drinking progresses to problem drinking and alcoholism, according to a new study by researchers at Washington University School of Medicine in St. Louis.
The study of 3,546 female twins, ages 18 to 29, examined how genes and environment influence drinking at different stages of life. The researchers found that genes accounted for about 30% of the timing of the first drink and for about 47% of the speed at which women progressed to alcohol dependence. But environmental factors, overall, seemed more influential, particularly earlier in life. "That's good news in terms of modifying these behaviors and reducing the risk of developing alcohol dependence," says the study's lead author, Carolyn E. Sartor. "Genetics are not destiny, and our findings suggest that there are opportunities to intervene at all stages of alcohol use."
Most of the young women in the study curtailed their drinking before it advanced to problem drinking, maturing out of the behavior as they encountered lifestyle changes such as career moves, relationship commitments or starting a family. Those who don't may have genes that predispose them to alcoholism. Heavy partying into the late 20s may be a clue that a problem is developing, Sartor says. "What once was perceived as partying a little too much is now being recognized as a potentially serious problem."
A summary of the study is available online in the journal Alcoholism: Clinical and Experimental Research. The full report is available for a fee.
*UPDATE: And here's more about young people and problem drinking. My alma mater, the University of Iowa, has announced it will schedule an additional 100 courses on Fridays beginning this fall to discourage students from starting their weekends on Thursday nights, which are also known as thirsty Thursdays.
University of Iowa administrators decided on the new schedule after a study published last year by the University of Missouri showed that students with Friday classes consumed half as much alcohol as those who ended their week earlier. Of course, faculty and staff members don't enjoy Friday classes, either, so officials offered each department $20 per student per class that's switched to Friday. "It's not going to stop students that really want to go out, but the university is at least taking a stand," faculty member Mary Trachsel told The Daily Iowan.
-- Shari Roan
Photo: Thomas Unterberger / Associated Press
A tube worm from the bottom of the mid-ocean vents? Some Dr.-Seuss-inspired bagpipes?
Silly! It's a giant, fiberglass model of the ileocecal junction (part of the human gut where the ilium joins the colon) in a person with Crohn's disease. What else would it be?
The colon is the creation of Raleigh, N.C., resident Andrea Stevenson Won, who designed it not for kicks, but as a commission for a display at a medical meeting. Just goes to show: There are more ways to make a living in medicine than I knew of.
Trained as a commercial sculptor, Won got tired of fashioning toys. In her new life, she's done anatomical restorations for patients: helped make a partial foot while interning at the Duke University Anaplastology Clinic, made fingers and faces, just finished a pair of ears. She's crafted little model hearts and done digital face reconstructions for museum exhibits.
And then there is her latest project: A huge model of the cartilage of the nose. The cartilages are normally about an inch -- the ones in Won's model are two feet long.
Who, you ask, could possibly want one of those? The buyer is a rhinoplasty surgeon. With those nice big cartilages he can show people very clearly where he makes his cuts.
Hmm. How tempting: to quit the office grind for a glamorous life fashioning humongous body parts --hearts! livers! stomachs! spleens! "There's money to be made in making giant colons, but it's a tiny field," Won cautions. And then there's the tanking economy: "Many people might consider a giant heart to be a luxury item."
Oh well. Back to the trenches.
--Rosie Mestel
Photo: Andrea Stevenson Won / Biomodal
A survey by Self Magazine and the University of North Carolina released Tuesday asserts that 65% of American women, ages 25 to 45, display disordered eating behaviors. The survey found that an additional 10% of women report symptoms consistent with the traditional diagnoses of anorexia or bulimia. The survey described disordered eating behaviors as including attempts to lose weight when you're already at a normal weight; cutting out entire food groups from your diet and skipping meals.
The survey has generated some interesting Web chatter -- and not just because it's questionable whether actions such as skipping meals can be called "disordered" behavior. Bloggers such as Rachel Richardson, writing on The-F-Word.org, calls Self Magazine "not so selfless." Richardson is a recovering anorexic and bulimic and her site is an eating disorders awareness forum that discusses issues related to body size acceptance. "While I don't doubt the high levels of unhealthy relationships with food amongst a national cross section of women, I do have to point out that Self isn't exactly a paragon of body size acceptance. Every edition touts some kind of diet and weight loss plan, along with some half-naked airbrushed woman on its glossy cover."
Richardson cites such Self headlines as: "Drop Weight, Look Great and Never Go to the Gym," "Shortcut to your Best Body," and, my personal favorite: "Lose Weight Every Day!"
The survey author is Cynthia R. Bulik, a highly regarded eating disorders expert at UNC. Bulik will present the survey findings next month at the Academy for Eating Disorders' 2008 International Conference on Eating Disorders in Seattle. Perhaps by then the discussion will evolve to include the role of women's magazines in promoting unhealthy eating behaviors and misguided attitudes about body image.
-- Shari Roan
Photo: Mark Boster / Los Angeles Times
Why don't more men see a doctor for regular check-ups? They fear disrobing. That's got to be it! Why else would someone ignore simple tests or a little advice that could ultimately save their lives or at least make them feel a whole lot better?
The Agency for Healthcare Research and Quality, along with the Advertising Council, are poking a little fun at the male species while trying to draw attention to the fact that men are 25% less likely than women to have visited a doctor within the past year. And they pay a price for such waffling, with higher death rates from heart disease, cancer and lower-respiratory diseases. A new public service campaign, titled "Real Men Wear Gowns," urges men 40 and older to get regular, preventive healthcare such as cholesterol checks, blood pressure readings and BMI measurements. "...despite their increased health risks men aren't taking preventive steps and are often only visiting doctors when they experience symptoms," says Peggy Conlon, president and CEO of the AD Council.
The campaign includes television, radio, print and Web public service announcements showing men wandering about their daily lives wearing nothing but hospital gowns. You know, those thin gowns with little ties in the back that flap open and, well ... Maybe if someone designed better exam-room clothing, more men would get checkups. How about a guaranteed-no-clothes-off exam?
-- Shari Roan
Photo: Allen J. Schaben / Los Angeles Times
"Infertility, once referred to as the 'silent disorder,' has found a voice," says Washington, D.C.-based writer Cheryl Miller in a fascinating essay titled "Blogging Infertility" in the latest edition of The New Atlantis.
Blogging, says Miller, has provided a powerful outlet for the infertile, providing unlimited support and information. For the public, she says, the multitude of infertility blogs offers a unique perspective on the condition but in a way that is sometimes so personal it borders on voyeurism. "The openness and transparency encouraged by the Internet pose new challenges, particularly for something as intimate as human reproduction. Allowing the world to read about -- and comment on -- your political opinions is one thing. Allowing the world a front-row seat to witness your struggles to conceive is another."
Miller describes popular blogs such as Stirrup Queens, Coming2Terms and one of the few blogs written by a man, Maybe Baby. Maybe Baby is the story of Chicago writer Matthew M.F. Miller (no relation to Cheryl Miller) who, on Friday, announced that his wife, Constance, took her 10th negative pregnancy test in the last two years. On Monday, Miller blogged:
"Pregnancy isn't simpl
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