Falling Rock

While on family road trips when a kid, we would relentlessly ask my dad to tell us the story of "Falling Rock". He had an elaborate story on how this native american indian boy was to find the name that fit him. He ended up disappearing. So, THAT is the reason we have so many signs in Colorado to look out for Falling Rock.

Well...Looks like he decided to finally show up, with a BANG.

Rockfall in Glenwood Canyon I-70 closed to all traffic in both directions between Glenwood Springs and Dotsero

GLENWOOD CANYON – Just after midnight, on March 8, a large rockfall incident hit I-70 in Glenwood Canyon , near mile marker 125 just west of Hanging Lake Tunnel. (The rockslide on Thanksgiving Day, November 25, 2004, was in the same general area, though rocks came from a different location on the hillside.) I-70 is closed in both directions to all traffic at Glenwood (mm 116) and at Dotsero (mm 133). While there is no estimate for a re-open time, Colorado Department of Transportation will blast and break up larger boulders today and continue work to assess when a portion of the roadway may be opened for travel. CDOT will implement emergency contracting procedures and meet with contractors over the next couple of days as crews develop repair plans. It is estimated that this slide brought 20 boulders onto the interstate, ranging in size from 3 feet to10 feet in diameter. The largest is estimated to weigh about 66 tons. The rocks have made holes in the elevated sections of roadway—the largest being in the westbound lanes (closest to the hillside) and measuring 20 feet by 10 feet. Another hole in the lower eastbound lanes measures 6 feet by 6 feet. There are a half a dozen other holes and “dips” in the roadway, as well as areas where rocks are embedded. Most of these repair areas appear to be approximately 5 feet by 5 feet. Rocks are scattered over 100 yards of roadway. Also damaged are three sections (about 120 linear feet) of steel guard rail and 100 linear feet of median barrier. The damage is similar to that resulting from the 2004 rockfall incident. ALTERNATE ROUTES: from westbound I-70: exit at US 40/Empire to State Highway 13 and back to I-70; exit in Silverthorne and take State Highway 9 to US 40 and State Highway 13; exit at Wolcott/State Highway 131 to US 40 and State Highway 13. From eastbound I-70: exit at Rifle/State Highway 13 to US 40 and back to I-70. Travelers may also wish to use US highways 160, 285 and 50 if traveling to destinations south. I-70 is not expected to open any time soon. CDOT appreciates the patience of travelers and want everyone to be assurred that crews are doing everything possible to get the roadway safely open to traffic. Video of the rockfall site can be found at www.cotrip.org

Exercise, keep on sista's!

After just presenting to the fabulous women of women's conference about exercise and nutrition, I read about an added benefit. It is extremely bothersome for those women to age and feel the effects of those blasting flashes of heat, "night sweats, cardiac symptoms, muscle and joint pain, sleeping disorder symptoms, depressive mood, irritability, anxiety, exhaustion, sexual problems, and urinary symptoms" of menopause.

How integral is a good exercise program? See for yourself.

Long-term exercise reduced menopausal symptoms

February 12, 2010

By Sherry Boschert

Postmenopausal women improved their physical fitness and reported reductions in the severity of menopausal symptoms after 12-24 weeks of aerobic exercise in three 70-minute sessions per week.

The 65 women (mean age 50.1 years) rated the severity of menopausal symptoms on the self-administered Menopause Rating Scale questionnaire at baseline, 12 weeks, and 24 weeks in the uncontrolled study. The program of aerobic and calisthenic exercise aimed for 75%-80% of maximal heart rate according to the Karvonen method and consisted of 10 minutes of warm-up exercises; 40 minutes of aerobics; 15 minutes of exercise targeting the abdomen, hip, and leg muscles; and 5 minutes for cool-down and stretching.

Participants reported significant decreases in the severity of hot flushes, night sweats, cardiac symptoms, muscle and joint pain, sleeping disorder symptoms, depressive mood, irritability, anxiety, exhaustion, sexual problems, and urinary symptoms between the start and the end of the study, Dr. Selma Karacan of Selcuk University in Konya, Turkey reported in Science & Sports.

Some of the symptoms showed improvement by 12 weeks and further significant improvements by 24 weeks, including vasomotor symptoms, muscle and joint pain, psychological symptoms, and sexual problems. The women reported no significant change in vaginal dryness (Sci. Sports 2009 [doi:10.1016/j.scispo.2009.07.004]).

Significant improvements also were seen in resting heart rate, systolic and diastolic blood pressures, flexibility, aerobic power, and the ability to perform sit-ups, push-ups, and right or left hand grips. Body weight, body mass index, body fat percentage, and fat weight decreased significantly, with no change in lean body mass values.

The findings support results from previous observational studies of physically active postmenopausal women compared with age-matched, sedentary control women. No randomized controlled trials have looked at the efficacy of exercise in managing hot flushes.

A decline due to safety concerns in recent years in the use of hormone replacement therapy to manage the vasomotor symptoms of menopause adds to the importance of finding that evidence-based lifestyle modifications can help menopausal symptoms. The current study suggests that a high level of cardiorespiratory fitness may help reduce menopausal symptoms, Dr. Karacan concluded.

STOP THE ENERGY DRINKS!!!!

Hello friends, family and countrymen.

The Word of wisdom has once again come through to help us. We all know that it says not to drink hot drinks suggesting black tea and coffee since that was what it was at the time the revelation was given to the prophet Joseph Smith. Many ask why? Well, because it was a commandment. Pretty simple really. If your doctor asks you to stop picking your nose, it's probably for a good reason. If that's not good enough for you, then look into it. It's a DRUG! Drugs have their place don't get me wrong. What do Energy drinks have in them? Drugs and "vitamins".

Just today, there was released a study where Energy drinks are linked to cardiovascular problems that could lead to a heart attack, such as heightened blood pressure, increased platelet clotting, and a hindered blood vessel lining.

Further studies will come out in regards to what exactly it is in the energy drink whether it's the caffeine, taurine, or other ingredients. So keep an eye out for those results.

In a cohort of otherwise fit and healthy subjects, the present study demonstrated endothelial dysfunction and platelet hyperaggregability 1 hour after energy drink consumption, with an associated increase in blood pressure.

The energy drink used in this study contains caffeine, taurine (an amino acid), and glucuronolactone (a glucose metabolite). Additional substances incorporated in the drink include vitamins (B2, -5, -6, -12) along with sweeteners and thickeners. It remains uncertain which of these compounds are responsible for the above findings. Of the individual ingredients, caffeine is the best characterized; however, there are still conflicting results due to variable doses of caffeine used and different techniques used to measure platelet function. While no effect on platelet aggregation, or even improved effects on endothelial function has been observed, it is important to note that there is no evidence to date to support the suggestion that chronic coffee consumption has any impact on cardiovascular events. Taurine is seen in high concentration in platelets. Interestingly, the exact function of taurine in the platelet remains uncertain. Supplemental taurine has been felt to have potential beneficial effects on the cardiovascular system via mediating redox stress. The potential effect of taurine to explain the detrimental effects of energy drink consumption on platelet and endothelial function therefore seems unlikely. No data exist about the impact of glucuronolactone on platelet or endothelial function. As endothelial dysfunction and impaired platelet function are associated with elevated glucose levels, it is possible that glucuronolactone might contribute to the observed detrimental effects of energy drinks.

Ear wax

I think one of the most common questions I've heard ask of ENT physicians in general and especially Otologists (those in the ENT profession that just work on ears), is in regards to cerumen or ear wax.

To understand why we have it I'll explain...

1)God made us that way. Yes, it's absolutely incredible.

2)Some say it acts as a lubricant...I say, for what?

3) It's pH (scale of acidity or how basic), is slightly acidic. This is to keep the bugs (bacteria and fungus) at bay. Hence if too much of it is removed, you have a whole slew of problems popping up in those lil' canals.

So, the next question is how to deal with it.

Here is the list from least invasive to most invasive, and as long as there isn't a hole in the ear drum

1)Drop oil into the EAC (external auditory canal), these include Extra Virgin Olive oil, sweet oil, baby oil, mineral oil.

2)Wash it out in the shower

3)Don't use Q-tips, this over time shoves wax deep into the EAC causing an eventual impaction against the drum

4) Have your friendly neighborhood ENT doc pick, pull, scrape, wash it out on a yearly or so basis depending on the symptom accretion.

There are those with tiny ear canals...

Same as in previous steps 1-4.

5)Canalplasty-where the canal is opened wider surgically.

Those who produce lots and lots of it...

More often with steps 1-4

Dry ears...

Steroid cream works well here. Ask your doctor how often and for how long to use it. Also, there may be a fungal component to this. Lamasil drops usually work really well here as long as there isn't a hole in the drum.

Wet ears...

Skip the step #2

You can use 1/2 Acetic acid (vinegar) and 1/2 Everclear grain alcohol and put the drops in each ear after showers/bathing. This keeps the pH in the EAC balanced.

Last of all, DON'T USE EAR CANDLES! That is, unless you are into voodoo and that kind of jazz. Just look at Wikipedia for the explanation... or go to my super old post on the matter.

Why it gets dark?

When wax it produced down in the canal, it us almost clear. As it works it's way out the wax loses it's moisture and darkens to almost a black or very dark orange color. It is usually hard and crusty at this point.

Oh, the two faces with their "Transparency"

As physicians, we've been asked by the great B.O. and his thugs to be more transparent. What does this mean? It means that every physician in a group practice is obligated to switch their medical records to an electronic form so information can be more easily shared to other physicians. An idea of which sounds really really great. I've always felt this was what medicine with someday become several years ago.

The problems with this mandatory switch by 2012 are at least a couple. First, this lends to government care. And if you don't remember what B.O. said about your ENT surgery, and I paraphrase, "maybe a tonsillectomy isn't necessarily cost efficient. Because as surgeons we don't always have what's best for the patient as a top priority". Yeah, just read some of the current bills the Senate and House have proposed, and you will see who has YOU'RE interests at heart. It's laughable! Let's see you take the Hippocratic oath! And by the way, this "off the cuff" statement was so far from the truth, he has globally lost the faith and trust of the ENT physicians. See previous posting for details.

Second, it will take more time rather than less, (studies have shown this believe it or not), meaning less time for the patient, or less time for the physician to spend at home with his family (but who cares about the greedy doctors who just spent 11 to 13 post high school years studying to be part of the profession). On top of that, like my mother said, "Having a doctor type into a computer while talking to you makes the office visit so non-personable and disruptive". Some of this will have to be adjusted because lets face it, computers are the wave of the medical future.

So, we as physicians will inevitably become more transparent. What I want to know it WHY! WHY is the government so demanding of everyone else to be compliant, yet the rules of the game don't apply to themselves. It's like playing a made up game with a 5 year old! The rules change on a whim to accommodate them winning.

This article has the point I'm trying to make...

Don't you hate it when a politician says one thing when running for office and then does something else once elected! For example: In March 2008, then presidential candidate Obama promised the health care debate would be open and transparent saying: "I am going to do it all on C-SPAN so that the American people will know what's going on." (Town hall meeting, Lancaster, PA, 3/31/08) Fast forward to 2010 (and, if truth be told, all throughout 2009) and the Democrats are holding secret meetings to negotiate the health care reform bill - and they want to keep the cameras out. They want to keep us -- the American people-- from learning about their backroom deals and negotiations until after they are done- and we get to pay the price tag! In fact, on Tuesday, January 5, 2010, C-SPAN wrote a letter to congressional leaders asking that TV cameras be allowed to film negotiations to reconcile the House and Senate versions of the health care reform legislation. In what is a laughable response, House Speaker Nancy Pelosi (D-CA) defended Congress' work on the health care bill saying the process has displayed historic transparency. "There has never been a more open process for any legislation," Pelosi said - with a straight face - at a press conference. Senate Majority Leader Harry Reid's (D-NV) spokesman said that although he respects C-SPAN's "commitment to ensuring transparency," there is no plan to allow the network access to health care talks. President Obama has also been silent on the issue. They all know, and in fact the whole darn country knows, that this historic transparency is a big, bold, in-your-face lie. Sen. Ben Nelson's special deal to exempt Nebraska from paying its share of Medicare payments; Sen. Mary Landrieu's special $300 million "Louisiana Purchase"; $100 million for the University of Connecticut health care facility, and hundreds and hundreds of millions of dollars were all "backroom deals." We say to the Congress and White House: Stop your devious secret health care high jinks and let C-SPAN cover the meetings. No more secret sessions. No more sweetheart deals. The American people have a right to know. If you don't have anything to hide, then Let The Cameras In. Sincerely, Patients First Team

Overweight women, breast cancer, and drinking...bad combo

Speaking of breasts...

A recent study came out just recently adding another comorbidity to those who have a weight problem. If you drink alcohol 3-4 glasses of wine/or cans of beer per week, you have been previously diagnosed with breast cancer, you are at a higher (1.3 times higher) risk of getting a recurrence of your breast cancer.

They said in the article that estrogen sensitive cancer didn't have a role in the study, which I believe to be true. However, you need to know that having extra adipostiy (fat), increases the estrogen in your body due to the fat cells secreting estradiol. So, if you don't believe in hormone therapy due to having BC run in your family, then I suggest you lose the weight as to not predispose yourself to the disease.

The study showed that the more the women drank, the more predisposed of getting a recurrence. So, happy holliday's. Go now and encourage those post menopausal loved ones to live the word of wisdom and start a new years resolution.

Speaking of weight loss. There is another way besides the bariatric surgery where 1 in 10 people die as a cause from this operation. Look into the beta HCG diet. As with any diet and addiction (meaning eating), there is a need for will-power. But, it is a great way to lose weight to become eligible for the much safer "gastric lap band" procedure.

The answer is...

A CHICKEN!

Just kidding. It was a big ball of fat called a LIPOMA which encompassed the omohyoid muscle, which ran through the middle of it.

It weighed 494 grams or a little over one pound. Since it acted like a tissue expander, extra skin you see on the specimen had to be remove for a nice cosmetic result. That is one photo I wish I had taken.

Case of the week...the extra breast

Photo taken with permission

Okay not really an extra breast... but who can guess what this is? I think I will start compiling slides for a future presentation using this blogger format. We'll give it a test run.

This is a male, who had this soft fluctuant mass on the front of his neck for about the past 12 years. It has been slowly growing all of these years. The red dots are blood droplets where I injected the local anesthetic agent. Any takers? The answer soon to follow...

Religion...the people's way

E Tu Brute? So God falls out of religion... or at least the Evangelical Lutheran church. After all, isn't moral and ethical codes so unfashionable? I mean, why don't we go with the flow? Why not just let women hold the priesthood. Whoa! Just dodged a bolt of lightening. IT SHOULD BE THE SAME CHURCH PEOPLE! God and his commandments don't change. The prophets of old such as Moses were MEN. Sodom and Gomorra BURNED TO THE GROUND FROM THIS TYPE OF WELCOMED BEHAVIOR!

CHICAGO - The presiding bishop of the Evangelical Lutheran Church in America is suggesting that the Bible isn't the last word on homosexuality.

In a town hall meeting Sunday, Bishop Mark Hanson said, "the understanding we have of homosexuality today does not seem to be reflected at all in the context of the biblical writers." Therefore, he said, Lutherans should consider more modern views on sexual orientation.

At its churchwide convention in August, the ELCA lifted its ban on partnered gay and lesbian clergy, prompting some traditional congregations to withhold funds and begin forming a separate denomination.

But Hanson insisted the ELCA can accommodate both views. In his words, "God is still speaking to us." He also suggests that more homosexual-friendly policies may help the denomination grow.

Hucky softy

Is Huckleberry the next "Jesus"? I mean, haven't we had enough of our current presidential savior? All we need is instead of a guy that can't make decisions, one that makes them wrong. (Okay, okay, I just gave Obama WAY TOO MUCH CREDIT!)

In regard to his answer as to his decision in 2000...It's one thing to say, "ya know, he seemed like he had a change of heart but turned out to be a scoundrel out and I'll be a bit more judicious next time." It's another thing to say, "if I were to do it all over again, I would do it again".

Why does a governor have so much power? So a governor is all of a sudden more omniscient, and has more experience than a judge? Do governors/presidents realize how hard it is to get someone booked in the slammer anyway? Just ask someone in law enforcement. It's hard scraping baked slime off the streets.

Huckabee's past may taint his future

by Jim Brown

A leading conservative pundit says fairly or not, former Republican presidential candidate Mike Huckabee's political future has been badly damaged by fallout from an executive decision he made in 2000.

Conservative bloggers and pundits have been taking Mike Huckabee to task after a man whose sentence he commuted while Arkansas governor killed four police officers in Washington state over the weekend.

In a post on the conservative website Redstate.com yesterday, Huckabee expressed regret that he commuted the sentence of Maurice Clemmons and made him eligible for parole. However, Huckabee said the decision was based on evidence before him in 2000, and "if presented the same facts today, I would have acted in the same manner."

Huckabee also says that some of his fellow conservatives "don't seem to want to take responsibility for the facts surrounding the case," and are using "misinformed words" when accusing him of being weak on crime.


Erick Erickson, the editor of Redstate.com, believes perception is hurting Huckabee worse than the facts of the Clemmons case.

"I think the facts as known are not that bad, in that he gave clemency to the guy [Clemmons] when he was a teenager and was put in jail for over a hundred years for a simple burglary," Erickson notes. "The problem is that...this is now the second person [Huckabee] granted clemency to who went on to kill someone, and he's granted over a thousand pardons and clemencies, including 12 murderers. That taken together paints the picture of basically [Democratic presidential candidate] Michael Dukakis in 1988 -- someone who's soft on crime."

Even though Huckabee says all of the clemencies he granted were based on the facts of each individual case, Erickson points out that some Arkansas prosecutors and others who know the governor well say he had a propensity to grant clemency or give pardons to people who "found God in jail" and wanted to show mercy to them. According to Erickson, such an approach "would not fly