How To Tell If You Have A Vitamin B12 Deficiency



As many as one in five adults are vitamin B12 deficient. 


Many people don’t recognize symptoms or understand the risk.


If left untreated, B12 deficiency can cause damage to nerve cells and serious neurological problems, such as memory loss and dementia.


Those most at risk include:


  • People over the age of 60 (2 in 5 adults over 60 are deficient)


  • Women, especially pregnant women on a vegetarian diet


  • People with gastrointestinal disorders such as Crohn’s and celiac disease


  • Those with diabetes who are taking metformin


Vitamin B12 deficiency is a serious medical problem that affects an estimated 48 million Americans.


If left untreated, this condition can cause irreversible damage to nerve cells and other co-morbidities.


Most people – even those who are at highest risk like the elderly and those with gastrointestinal problems – aren’t aware of the detrimental effects that a deficiency in vitamin B12 can have on their overall health.


Here to tell you more is Ralph Green, M.D. Ph. D. and Peter Shaw, M.D. who I had the pleasure to interview here:


Ralph Green, M.D. Ph.D., of the UC Davis Health System, is considered one of the top global experts on the topic of vitamin B12 deficiency. Dr. Green discusses in-depth the importance of understanding and managing vitamin B12 deficiency.

Peter Shaw, M.D., is the Chief Medical Officer of Emisphere discusses specifics about a new oral option to manage B12 deficiency without the need for an injection.
Now, there is a new oral  option to manage B12 deficiency without the need of an injection.

Ralph Green, M.D., Ph.D., FRCPath, Medical Director and Distinguished Professor in Pathology and Medicine, UC Davis Health System Medical Diagnostics Outreach Laboratory
Peter Shaw, M.D., Chief Medical Officer, Emisphere joins him to answer questions.
Did you know?
·       It is estimated that 48 million adults/1 in 5 adults may have B12 deficiency.
·       As many as 25 million or 43 percent (2 in 5) of people over the age of 60 may have B12 deficiency.
·       B12 is particularly important for pregnant women and the development of a fetus’ neurological function.
·       B12 deficiency can occur with a range of conditions in which there is an impaired capacity to absorb vitamin B12, including pernicious anemia, Crohn’s disease, and celiac disease, which are common in women.
·       B12 deficiency is often overlooked, yet early detection and management is crucial because, if not treated, it can lead to permanent nerve damage and serious neurological problems, such as memory loss and even dementia.
Dr. Ralph Green is internationally renowned and considered one of the top in his field in the world. In this satellite interview, he will educate viewers about medical B12 deficiency – what it is, who is most at risk, and why physicians should be more frequently checking for this deficiency. Dr. Green will be joined by Dr. Peter Shaw, Chief Medical Officer, Emisphere, who will discuss recent advances in this area and discuss a new treatment option available that can normalize B12 levels without the need for an injection.
Ralph Green is a clinical pathologist, specializing in diseases of the blood. Immediate past chair of the Department of Pathology and Laboratory Medicine at the University of California, Davis, Dr. Green serves as Medical Director of the UC Davis Health System Medical Diagnostics Outreach Laboratory. He is internationally recognized for his research, which focuses on studying how deprivation or metabolic disruption of B-complex vitamins, iron, and other micronutrients affect the blood, cardiovascular system, nervous system, and the aging process. He has studied the role of nutrient deficiencies in dementia, coronary artery disease, and stroke. Dr. Green has served as an adviser to National Institutes of Health, U.S. Food and Drug Administration, Centers for Disease Control, and the American Heart Association.
Peter Shaw serves as Chief Medical Officer at Emisphere. Dr. Shaw has 25 years’ experience as a practicing physician in the UK. He retired from his Primary Care practice in 2007 with considerable experience in many different specialties including; general and orthopedic surgery, urology, obstetrics and gynecology, general medicine, cardiology, chest medicine, and transplant medicine.
headshot  Maria Dorfner is the founder of MedCrunch.

Rare Fatal Lung Disease: What You Need to Know


 In 2000, John Morthanos from New Haven, CT was feeling winded and he thought he was having a heart attack because he was having trouble breathing; doctors found that his heart was fine, but there was a mysterious spot on his lung.


After numerous doctor’s visits and tests, his breathing problems were attributed to acid reflux, stress and even allergic reactions to his cats. A lung biopsy also found mild scarring.


However, John’s breathing problems became progressively worse, to the point that he couldn’t walk up the stairs without being winded and taking the trash out felt like pushing a car up a hill. It was then that John knew something was really wrong.


Finally, in 2011 after being referred to experts at Yale University, John received devastating news: he had idiopathic pulmonary fibrosis, a life-threatening disease that causes permanent and progressive scarring of the lungs.


Immediately, John, his wife Paula and his medical team developed a treatment plan, including supplemental oxygen and pulmonary rehabilitation. Because his condition was getting worse, John later received a single-lung transplant. Today, John is focused on raising awareness about IPF so others can hopefully avoid the struggles he faced securing a timely diagnosis.


A new survey uncovers the emotional and physical impact of this rare and fatal lung disease called, Idiopathic Pulmonary Fibrosis. 

Less than 1 in 3 patients and caregivers are prepared for how IPF will affect their daily life.
Imagine being diagnosed with a deadly disease you have never heard of.
A disease that your family and friends have never heard of.
A disease with no colored ribbons, no 5k runs to help people who face the disease band together.
One like IPF – a rare and fatal lung disease that permanently scars the lungs and causes difficulty breathing.
 There are symptom management options, and now FDA approved medications to help patients suffering from IPF.
Even so, patients and caregivers living with IPF experience an unexpected emotional toll prior to and after diagnosis.
The recent survey illuminates the IPF patient and caregiver experience.
The survey, conducted in 100 self-reported IPF patients and 100 caregivers, offers key insights into this orphan disease, including:
  • On average, patients experience IPF symptoms for nearly two years before being diagnosed 


  • More than three-quarters of patients and caregivers affected by coughing caused by IPF say that people often keep a distance because of it; and more than half of patients and caregivers using supplemental oxygen feel that it is embarrassing to be seen with the equipment


Dr. Jeffrey Swigris, Pulmonologist, and John Morthanos, IPF patient, discuss:
  • Signs and symptoms of IPF



  • Impact of IPF on the everyday lives of patients and caregivers, according to the survey


  • Why education and support may help address the needs of patients, caregivers and their doctors


LINK TO INTERVIEW with Dr. Jeffrey Swigris, Pulmonologist, and John Morthanos, IPF patient:



About Jeffrey James Swigris (pulmonologist):

National Jewish Health

 Jeffrey Swigris, DO, MS, is an Associate Professor of Medicine at National Jewish Health and the University of Colorado. His clinical interest is in evaluating and caring for patients with interstitial lung disease (ILD) of any cause. Dr. Swigris’s individual research program focuses on how patients perceive living with ILD, how to assess those perceptions and how caretakers might improve quality of life in patients suffering from ILD. He was recently awarded funding for a nationwide research project: The Participation Program for Pulmonary Fibrosis or P3F ( He is a member of the American Thoracic Society, American College of Chest Physicians and is on the Pulmonary Fibrosis Foundation’s Medical Advisory Board.




If you suspect you have any of the same symptoms as John, please visit: for more information on IPF.


Rare Gene Discovery: Protects Against Bipolar


bipolar4UMMS researchers uncover genetic pathway that could lead to better treatment for bipolar.

bipolar1A team of scientists led by researchers at the UMass Medical School and the University of Miami Miller School of Medicine (UMMSM) have identified what is likely a key genetic pathway underlying bipolar disorder, a breakthrough that could lead to better drugs for treating bipolar affective disorder, as well as depression and other related mood disorders.

bipolar6The new findings, published online this week in Nature Molecular Psychiatry, show that a rare genetic dwarfism called Ellis van-Creveld (EvC) syndrome protects against bipolar affective disorder.


The discovery was made thanks to decades of translational research in a few Old Order Amish families of Pennsylvania with a high incidence of both diseases.

bipolar2Forty years of documented research across multiple generations showed that no person with EvC has been reported with bipolar disorder.


“No one doubts that bipolar affective disorder has an important, disease causing genetic component,” said neurologist and geneticist Edward I. Ginns, MD, PhD, professor of psychiatry at UMMS and lead author of the study.


“In our search for the causes of bipolar affective disorder, this is a paradigm changing discovery that could lead to better treatments.”

bipolar11Bipolar affective disorder is a common psychiatric illness characterized by recurring swings from periods of high energy and mania to periods of low energy and sadness.

bipolar12During periods of mania, the need for sleep is reduced and a person feels or acts abnormally happy, energetic and impulsive.

bipolar7They often make poorly thought-out decisions with little regard for the consequences. Cycles of depression may include crying, poor eye contact with others, and a negative outlook on life.

bi3Patients suffering from bipolar disorder have a higher risk for suicide and self-harm and suffer from other ailments, such as heart disease, related to poor lifestyle choices.

bipolar5Though many factors likely contribute to onset of the disease, various studies over the years have provided ample evidence that there is an important genetic component to the illness.

bi9However, previous attempts to isolate individual genes connected to bipolar disorder have been unsuccessful.

bi6In her research among the Old Order Amish, which extends back more than 40 years, Janice A. Egeland, PhD, professoremerita of psychiatry and behavioral sciences at UMMSM and co-author of the current study, found that both EvC and bipolar were prevalent in an extended family descended from the same progenitor.


Both conditions clearly travelled together over the generations in a few families extending from this same pioneer. Yet no person with EvC was ever reported with bipolar disorder despite decades of research across multiple generations.


“Few research efforts can claim to have extended over half a century using various building stones to reach a goal,” said Dr. Egeland.

bi5EvC dwarfism results from genetic mutations that disrupt the signaling pathway known as sonic hedgehog (Shh). Statistical analyses confirmed the significant negative association between EvC and bipolar disorder.

bi2This further suggested that the Shh pathway plays a role in bipolar disorder.


“Since mutations causing EvC do so by disrupting Shh protein function, linking abnormal Shh signaling to major affective disorders provides a concrete molecular and medical basis for patients’ symptoms that should help break down the stigma associated with mental illnesses,” said Dr. Ginns.

“If we can understand more details of the Shh signaling pathway in bipolar disorder, it could dramatically change the way we diagnose and treat these conditions.”

bi32According to Ginns, drugs already in clinical trials for other medical conditions that target Shh protein signaling may have the potential to be better treatments for bipolar disorder.

“Importantly, it’s possible that drugs that modulate Shh signaling may offer a new strategy for treating some patients with affective disorders,” he said.

bi31The current findings are supported by an earlier genome-wide search for genetic loci linked to mental health wellness in relatives at high risk for bipolar disorder among the Old Order Amish, published by Ginns and colleagues in PNAS(1998).


“Revisiting our work from the late 90s has paid off. There’s a joy of following up linkage work as new information becomes available,” said Robert C. Elston, professor of epidemiology and biostatistics at Case Western Reserve University.

“I wish for the patient’s sake that we could have put this puzzle together a decade ago, but some of the pieces were not known until more recently,” said Marzena Galdzicka, PhD, clinical assistant professor of pathology at UMMS.

bi8Ginns cautioned that although “we have a good idea of potential novel drug target(s) that could stop symptoms, it’s still unclear what changes along the Shh pathway lead to bipolar disorder.


The Shh pathway involves more than a dozen other molecules, and interacts with over 100 other genes.

brainhealth21It’s likely that other genes or proteins in this pathway may participate in determining the various symptoms and sometimes catastrophic outcomes seen in patients with affective disorders, including suicide.”


Ginns and his collaborators are already working to unravel more details of the puzzle and identify changes in the Shh signaling and related pathways that correlate with disease symptoms.


“Even though the symptoms of bipolar affective disorder can be quite varied and complicated, the underlying genetics might actually have a more simple cause than we could have imagined,” said Ginns.




Please check back next week as I’ll share an interview with Edward I. Ginns, MD, PhD, professor of psychiatry at UMMS and lead author of the study.



No Flu For You! How To Tell If Your Kid Has the Flu or Worse


It’s that time of year.   Fun.  Fun.  Fun.


In the Cold, Cold, Cold.   Right?  Or NOT.   Freezing temps can lead to not so fun aches from a cold, the flu or worse.


When it’s your child feeling lousy, you’ll want to pay extra attention to their symptoms.

Sniffles.  Sneezes.  Coughs.  Temperatures.
flu5 flu6
Pay attention for wheezing. Dr. Carolyn Clear tells me that’s the warning sign.
 Keeping kids healthy is a priority.
               flu65   flu61 flu60     flu40 flu32    
When kids get sick it can spread to make the whole family miserable.
First, let’s distinguish between a cold or the flu.
Since a lot of folks confuse the two, here is a comparison of symptoms:
Next, let’s look at what to do if you get either:
 How can you tell if your kid has something WORSE than the flu?
TODAY, I talk to Dr. Carolyn Clear fromWest Depford Pediatrics in West Depford, NJ and parent advocate Lindsay Mathis to discuss the flu, RSV, and the differences between the viruses. 
They provide essential information about seasonal viruses and how all parents can protect their children this winter.
Learn how to tell if your child is suffering from flu symptoms or different seasonal contagious virus.   
At the height of winter and cold and flu season, children are at an increased risk for contagious seasonal viruses.
By following a simple checklist, parents can be proactive about their family’s health and renew their commitment to healthy living.
According to the recent announcement by the Centers for Disease Control and Prevention, the flu is now at epidemic levels, with more than 21 pediatric deaths as a result of the virus across the country.
The CDC says the epidemic is spreading and the number of states with a high amount of influenza-like activity increasing. Children are especially vulnerable.
While the flu and Enterovirus have been at the forefront of the infectious disease conversation, what may not be top-of-mind is RSV, a common virus contracted by nearly 100 percent of babies by their second birthday.
Often mistaken as a common cold, RSV can bring serious complications, is the leading cause of infant hospitalization, and is responsible for approximately 8 times more infant deaths each year than the flu.
Doctors say it’s typical to see a spike in RSV cases in the winter, as we’re in the height of “RSV season,” which typically runs from November through March.
While every baby is at risk of contracting RSV, premature babies are at an increased risk for developing severe RSV disease due to their underdeveloped lungs and immature immune systems.
RSV is very contagious and can live on skin and surfaces for hours.
So parents should remember to:
·       Wash your hands and ask others to do the same
·       Keep toys, clothes, blankets, and sheets clean
·       Avoid crowds and other young children during RSV season
Parents can fulfill their commitment to better health this winter by educating themselves about common circulating viruses and following a simple checklist to help protect their families:
 See your children’s primary care physician for an annual checkup Work with your children’s doctor to determine what seasonal vaccinations, such as the flu vaccine, your children are eligible for.
Know the signs and symptoms of several of the most common winter illnesses, including:
o   Cold
o   Flu
o   Enterovirus
o   Sore throat
o   Respiratory Syncytial Virus (RSV)
Remember a strong immune system is built by eating right, avoiding sugars, junk food and processed food, toxic beverages, getting enough sleep each night, daily exercise and good hygiene.
 You CAN make it through with NO flu or virus for you!!!
For more information please visit
headshot1  Maria Dorfner is the founder MedCrunch, a division of Healthy Within Network (HWN).

Rising Opioid Addiction: What Is It and How to Treat It


More than 2.5 million Americans are opioid dependent and opioid addiction has tripled over a 10-year period.  As the nation’s fastest growing drug problem, the Obama administration calls opioid addiction an epidemic and a major public health and public safety crisis.  But who is suffering may surprise you.
A new survey conducted by the nonprofit organization National Alliance of Advocates for Buprenorphine Treatment (NAABT) shows that, while drug addiction may start early on in one’s life, it affects people of all ages and economic standing.  And, not so surprisingly close to 60 percent of respondents’ opioid addiction began with treatment of acute or chronic pain. 
The good news is that novel new treatments may help make it easier for people with addictive disorders to go into remission from this potentially deadly disorder because of more convenient formulations and improved side effect profiles.  Experts hope the options will improve treatment compliance and help patients stay off opioids so they can begin the process of rebuilding their lives.
Unfortunately, the survey also showed that 40 percent of patients who were seeking medical treatment for their addiction did not find a physician for weeks or months, and once they did there was a waiting list for 58 percent of respondents and over 25 percent reported obtaining treatment without a prescription.
For anyone struggling with addiction, experts urge them to get help.
Tim Lepak, president of the nonprofit organization National Alliance of Advocates for Buprenorphine Treatment (NAABT)
Richard Soper, MD, JD, MS, FASAM, Diplomat- ABAM; has treated, consulted, advised, taught, mentored and counseled for over eighteen years in private practice, Nashville, Tennessee. Dr. Soper is founding editor and current Editor-in-Chief of the American Society of Addiction Medicine e-weekly news journal with 16,000 subscribers.  His areas of expertise include childhood trauma, psychopharmacology of addiction, the scientific basis of addiction, substance abuse and medical-legal issues of treatment and addiction. He currently serves on several regional and national medical organizations committees and advisory boards.
Click here for answers to:
·       What is an opiate and why is it so addictive?
·       Who is suffering from opioid dependence and why the surge in recent years?
·       Why is opioid addiction so difficult to treat?  Why do so many patients relapse?
·       How is opioid dependence treated? What can you tell us about new treatment options?
·       Why is it so difficult for some patients to find doctors who can/will prescribe this new class of drugs?
·       How do you know if you or someone you love is experiencing an active addiction to opioids?
·       What is the first step someone can take if they think they’re experiencing an active addiction to opioids?
·       Where can our viewers/listeners go to for more information?
 Visit for more tips and information on available resources as well as more detailed survey results. Click here for interview with experts discussing how to overcome opioid dependence:
Stay healthy!  -Maria
 headshot1     MARIA DORFNER is the founder of MedCrunch, a division of Healthy Within Network (HWN).

Hottest Health Career of the Future by Maria Dorfner


If your kids are graduating from college wondering what to do with the rest of their lives, and they’re interested in the health field, but avoid it to make more money elsewhere, keep reading.  If not, keep reading anyway!  Thank you.

Today, “kids” are encouraged to be entrepreneurs. Start a company at the age of 3!

All before they EVEN know what to do with money (reminds me of a blog Brian Cuban wrote about why sports figures or celebs  end up broke). I think the future is going to include founders. How many “founders” are there today and where will they be in 20 years?

I understand why it’s happening.  You get fired up every time you read about a dumb idea getting millions of dollars in funding. It’s frustrating because you think your ideas are FAR BETTER.

Those articles encourage kids to quit their jobs or not attend college at all.   The unhealthy message they get is just come up with the next great thing, get funded and you’ll be fine.


Let’s peak behind-the-scenes. Some crappy idea getting millions in investments may be one college buddy who is now a VC helping another college buddy. No intention to “save the world” which a lot use as their mission statement. That buddy VC attracts others, who have no idea they are going to lose money because it was just a gift to a friend, and not a real investment in anything real. The Nancy Drew in me can spot scams before they become public.   We need a delete/block in life for folks who try to take advantage or exploit others.  Lots of snake oil salesmen out there feeding off of hungry entrepreneurs.

There’s also other little factors you can’t control. So, your idea being better means nothing.


Additionally, even if it’s legitimate, the majority of those companies will fail. Proven fact. Even if you get funding, expect to work your you know what off for one VERY expensive lesson.

I digress.  Back to HOTTEST HEALTH CAREER of the FUTURE.


If you REALLY want to change the world and have an interest in health –take a look at the future and where there will be ACTUAL demand.

HERE’S A GLIMPSE through my eyes.  My parents always say, “Maria has a big heart.” So, if eyes are the windows of the soul…my green peeps would be shaped like this. 


They’re not, but thanks to the San Diego Eye Institute my vision is 20/20 to see the future:


20% of all U.S. physicians are 55 or older, including more than HALF of the 5,000 active board-certified thoracic surgeons. Approximately 70% are expected to retire in the next 13 years, dramatically shrinking the provider pool leading to a critical work shortage JUST when aging baby boomers are sick and tired of stomping on grapes.   


Most of these sick baby boomers will suffer from heart disease creating quite a demand for well-trained heart surgeons, even if that surgeon is in another room or at home while doing this robotic or digital surgery.  In real estate they say, Location, Location, Location.   When it comes to a career in health, I say it’s



By 2025, some experts predict the number will be almost 2,000 short of what’s needed in the U.S. The demand for heart surgeons will explode. They battle both heart disease AND lung cancer –another baby boomer problemo. 

Average starting salary for a heart /lung surgeon? 350K


That’s right. Your kid makes 350K right out of college.  CA-CHING!

How long do they need to study? Residency required is 5 years followed by 2 fellowship years. You may work 50 hours a week, but you’ll do that if you’re entrepreneur too. Only you’re creating crazy things in the HOPES of creating demand.

Even if there IS a demand, you HAVE to convince friends, family or PWM (People. With. Money) you haven’t lost your marbles.  Does the product or service create the demand or vice versa?  I say when people need something it’s subconscious. When it shows up, they recognize it because the need (demand) was already there. It does NOT exist first.  I aced marketing in college with one other person. That tells me 2 out 10 people in a room understand.  The other 8 wait to “see” something first.   They lack vision.


Now, let’s look at a man with all his marbles AND vision in tact. He is one of the best cardiothoracic surgeons in the world.   I say THE best.  His name is Delos “Toby” M. Cosgrove. I am honored to call Mr. and Mrs. Cosgrove friends. When I first met them in 2001, Toby was Chief Cardiothoracic Surgeon at the Cleveland Clinic.

Today, he is Chairman. Under his leadership, the Cleveland Clinic’s heart program is consistently ranked NUMERO UNO. He presides over the $6B healthcare system that is The Cleveland Clinic. Calling him an innovator is also an understatement. He holds 30 patents and is absolutely brilliant.


I spoke with Toby about what it takes to be a resident at the #1 heart program and will share that later.

I followed him and went behind-the-scenes as he interviewed the best and brightest students to be selected for a residency at The Cleveland Clinic. Since it’s ranked #1, it attracts the smartest students from around the world. Interestingly enough, there was only one woman in the group. In general, 66% of physicians are male. Only 29% are female. Another shortage and demand for the future.

Tie this with the current obesity epidemic, a leading cause of heart disease.


Most recently, Cosgrove warned people about the link between heart disease connected to the foods you eat. You know when a man who would profit from your heart disease issues a warning –it’s time to listen.


May 2, 2013 How Our Guts – and What We Eat – Contribute to Heart Disease, Stroke and the National Debt

by Delos M. Cosgrove

We’re gorging ourselves into an epidemic of chronic disease, the costs of which will soon overwhelm our ability to pay and continue to be a contributing factor to the ever-increasing national debt. More proof of this has emerged with two studies that have uncovered new links between common foods and heart disease, stroke and death.

The culprit is a little-known substance called TMAO, or trimethylamine-N-oxide. It’s created when bacteria in the gut interact with two specific dietary nutrients – carnitine (found in red meat and dairy products) and lecithin (found in egg yolks, liver, beef, pork and wheat germ).

We now know that TMAO helps fatty substances in the blood to accumulate in the walls of the coronary arteries. These accumulations, called plaques, are the frequent cause of chest pains and heart attacks.

These findings were made in two recent studies by researchers in the Cleveland Clinic Lerner Research Institute and reported in the New England Journal of Medicine and Nature Medicine. It’s interesting to note the usual bad guy in heart disease, dietary fat, is not the person of interest here. Carnitine, the substance that gut bacteria convert into TMAO, is not in the fatty part of the meat. It’s in the red, meaty part. So it doesn’t matter if you cut the fat off your steak, or if you buy lean cuts.

So there’s no getting away from it. We have to be more careful about what we put in our mouths. We need to be aware of the foods that contain high amounts of carnitine and lecithin. But the real message of this research is broader – each person’s unique gut flora has a tremendous impact in how our bodies react to these nutrients. Those with TMAO levels among the top 25 percent had 2.5 times the risk of a heart attack or stroke compared to people in the bottom 25 percent.

Such a finding could change the way we prevent and treat heart disease, by using TMAO blood levels as a marker of cardiovascular risk and possibly a treatment target.

No one is suggesting the complete elimination of red meat and egg yolk from your diet. Like so much in life, moderation is key. You can continue to enjoy a good steak, but you may want to limit it to about 4 to 6 ounces every other week.

We’re facing an avalanche of chronic disease in the coming years. Anything we can do to mitigate this avalanche of heart disease — and other chronic conditions like cancer and diabetes — will not only give us longer and happier lives, it will improve the economic outlook for our children and grandchildren who will ultimately have to pay for our poor lifestyle choices.


Here is another interesting finding:

According to the U.S. Census Bureau, as of 2010, there were over 850K licensed physicians in the United States. In the United States, there are approximately 24,000 physicians for every 10,000 people.

I wanted to find out how many physicians per people there were in the healthiest countries. Turns out, the average is 34.9 physicians for every 10,000 people.

So, the shortage isn’t just in the field of cardiovascular surgery. I am a HUGE fan of preventing disease instead of treating it. Will we no longer need physicians or surgeons if we are able to prevent disease?

Too late. Even if you are healthy today, you still exposed an inordinate amount of toxins in the environment AND stress caused by factors you can’t control. Staying healthy involves continually being educated on what toxins to avoid AND learning and relearning healthy strategies and HOW to remain calm in the face of adversity.

There is A LOT of adversity in the world.   Enough to make you sick.

So, any disease that exists now or in the future has already been created and needs to either be REVERSED or TREATED. It will take as long as it did to create this disease to rid it from the existing population in the world. The only people who can completely benefit from PREVENTION are those who are A) already healthy or B) newborns.

And these two groups still need to be consistently educated on prevention from people like Delos M. Cosgrove.

So, if you’re smart and want to help change the world, it’s a field that will have an opening for you when you graduate with a good starting salary.

Of course, I know everyone isn’t “cut” out to be a heart surgeon or can be.  All I’m saying is if you CAN, do it.  The only question is do you have the academic grades for it? If yes, you can find financial resources.  If you don’t have the grades for it or it’s too late to select this field –then encourage a smart kid to explore it as a career.

I know recent college grads who make between $7 to $15 an hour or $20K, which was the starting salary THIRTY years ago AND the economy was thriving then. So, if you or your kid is smart –think longterm.

You need patience to be an entrepreneur OR a heart surgeon.  The latter guarantees success & innovation as dexterity is now a criterion as robotics and computers enter operating rooms. Think of it as fun playing video games while saving lives.


More importantly, it’s a career with HEART that won’t have you screaming, “I can’t take it anymore!” at the end.


p.s.  I was a founder before it was cool or part of a herd mentality.


Speaking of leaders, be sure to FOLLOW DELOS M. COSGROVE as a THOUGHT LEADER on Linked In.

Cleveland Clinic:


Click FOLLOW button on upper-right-hand corner of this blog to be alerted by email when there’s a new post, thanks.

“Baby, It’s Cold Outside…” by Maria Dorfner


Imagine walking around all day with a handful of ice cubes in your hands and in your socks.

THAT is what it feels like for children and adults with Raynaud’s.

It happens when they are exposed to extreme temperatures.  Sinatra singing, “Baby, it’s c-o-l-d outside…” takes on a whole new meaning for sufferers.

People with Raynaud’s suffer a lot more than the average bloke in cold temps.  Extremities like the nose, feet, hands and lips become extra, extra sensitive during this time.   Raynaud’s phenomenon (RP) can cause a series of changes in extreme hot or cold temperature, or even severe emotional events.   It’s actually painful because spasms of the blood vessels will cause not enough blood to get to local tissue in fingers and toes.   Some people aren’t even aware they have it.  Here’s a telltale sign.
It’s a patriotic montage of colors.  First, the skin turns white because of the diminished blood supply, then blue because of prolonged lack of oxygen, then red when the blood vessels reopen.  This American flag three-phase color sequence is characteristic of RP.

Raynaud’s phenomenon affects adults and children in the same way. It most frequently affects women, especially in the second, third, or fourth decades of life. People can have Raynaud’s phenomenon alone or as a part of other rheumatic diseases.  When it occurs alone, it is referred to as “Raynaud’s disease” or primary Raynaud’s phenomenon. When it accompanies other diseases, it is called secondary Raynaud’s phenomenon.


The causes of primary and secondary RP are unknown.  That doesn’t help anyone suffering from it, so below are a few items that can help.  The best thing you can do is bundle up when it’s cold.  For people with Raynaud’s, even walking past the frozen food section in the grocery store can be a trigger for spasms.

Picture of Raynaud's phenomenon

Raynaud’s phenomenon is a condition that affects blood flow to the extremities and causes pain, numbness and tingling. Extreme temperatures in Winter or Summer (shifts in any Season) or severe stress can trigger it. Some sufferers can’t walk past the frozen food section in a grocery store without it causing painful tingling or numbness or spasms.

Raynauds with Skin Lesions
Raynauds with Skin Lesions (Photo credit: Wikipedia)

Here’s what happens.

A sudden chill may cause blood vessels to spasm, shutting off circulation and turning affected parts a ghostly shade of white or blue. Fingers, toes, hands, feet, lips and the tongue are most commonly afflicted, and they may become painfully cold, tingling or numb.


Icy cold feet, hands, toes, fingers, less commonly nose and ears, sometimes with pain and numbness. Skin color changes of white/blue/red as peripheral blood flow is reduced by the spasmodic contraction of the muscles in the blood vessel walls (the digits are usually affected), tissues become starved of oxygen (cyanosis), and blood flow returns (rubor). Not all color changes may be present or in that order nor are color changes necessary to be diagnosed with Raynaud’s, but they may develop later.

Raynaud’s Phenomenon At A Glance

  • Raynaud’s phenomenon is characterized by a pale to blue to red sequence of color changes of the digits, most commonly after exposure to cold.
  • Raynaud’s phenomenon occurs because of spasm of blood vessels.
  • The cause of Raynaud’s phenomenon is unknown, although abnormal nerve control of blood-vessel diameter and nerve sensitivity to cold are suspected of being involved.
  • Symptoms of Raynaud’s phenomenon depend on the severity, frequency, and duration of the blood-vessel spasm.
  • There is no blood test for diagnosing Raynaud’s phenomenon.


  • Treatment of Raynaud’s phenomenon involves protection of the digits, medications, and avoiding emotional stresses, smoking, cold temperature, and tools that vibrate the hands.

Good News: A new gel is being studied which might promote local production of nitric oxide in involved digits. The local nitric oxide, it seems, may open the blood vessels and improve the impaired circulation.

Until then, instead of wishing it away, below are the Best Gadgets for Raynaud’s to help keep you warm:



HOT HANDS! Traditional winter gloves don’t work with touchscreens, forcing smartphone users to freeze their fingers when they answer their phones, post to Facebook or send a text or tweet. But Agloves®, America’s best winter touchscreen gloves and the ultimate fusion of fashion and technology, work with all touchscreen devices and they can be worn indoors or out if you suffer from Raynaud’s. Cost $23.99. Available online at and at selected retailers, including Best Buy and Verizon Wireless.

  • Heated Socks
  • G3 Gloveliners
  • WT2 Gloveliners
  • Heatdevil
  • Hotmitts
  • Heated Vest
  • G4 Fingerheaters
  • sports injury hot cold pain relief
  • Heated Socks

Warm mouse, warm hands, warm outlook

A company called ValueRays, sells heated keyboard wrist pads, mouse pads, and other computer peripherals, all emitting USB infrared heat. They specialize in heated computer gadgets. These products are used by regular folks, as well as suffers of Raynauds, arthritis, carpal tunnel, and a host of other ailments.

Here’s a website with all the products.

TheFatcat ChargeCarddistributed by Mango International is just-under 2-x4-inch device, billed as the lightest, slimmest portable charger available, allows you to charge your gadgets on the go, especially helpful if you can’t find a power source, don’t have time to sit there while charging, or are in a country or outdoor setting where power is unavailable.

The card weighs 2 ounces and is a quarter of an inch thick. It has a 2000 mAh lithium battery, twice the capacity of the typical cell phone battery, and comes outfitted with tips to fit a variety of popular cell phones, smartphones, iPods, GPS units, etc.

If you are usually working on the road, this is a product to consider purchasing. It’s sold online from $30 to $50. Of course you have to keep the charger charged, and you have to remember to bring it with you.

Wessel’s parents have the most amazing solution for cold feet of the literal kind — an electric “voetenwarmzak” — a “warm sack” for your feet.

Here’s a new Dutch modelonline, for $47.

Usb_glovesThese USB-heated gloves might be good for the blogger with Raynaud’s Syndrome.
The heated slippers don’t match the gloves, but who cares if your tootsies are toasty.

FIR Raynaud’s Gloves, Hottest Product for Raynaud’s Symptom
The Far Infrared therapy Raynauds gloves have been proven in clinical trials to improve blood circulation and relieve pain associated with Raynaud’s disease, currently on sale at Far Infrared Clothing Market of .

Heatbands are a brand new product, designed specifically for Raynaud’s sufferers to help keep the hands warm. They can be worn all day around the wrists and unlike heated gloves or many types of hand warmer, they work by preventing heat loss from the wrists, the most vulnerable area directly effecting the hands. Heatbands are attractive (available in a choice of 4 colours), convenient and unobtrusive and can be worn with your normal clothing and are inexpensive at £12.95 for a months supply (pack of 60).

Heatbands can help to keep your hands warm during any activity including: walking, shopping, running, cycling, tennis, golf, fishing, mountain biking, gardening, horse-riding, working on the computer, etc etc. For more information visit

For the best doctors, tips around the web and latest news on Raynaud’s, please visit THE RAYNAUD’S ASSOCIATION at



Hope this helps you or someone you love.  Stay toasty!!!  🙂



If you like the Sinatra print, visit  

Nursing Stereotypes in Media

I recently watched NYMED.  Good show.  One nurse looked directly into the camera to let viewers know that the most common question she is asked by patients in the ER is if she is single.  Other scenes involved patients commenting on the anatomy of nurses with them turning to the camera with an I can’t believe he just said that look.  NYMED is reality television.  This article was already a draft when THE DOCTORS (a fav show along with Dr. Oz)  conducted man-in-street interviews showing random people two photos –one of a nurse wearing blue medical scrubs; the other showing a scantily clad so-called hot nurse. They randomly asked people which nurse would you want treating you? Most picked the hot nurse.  I wondered if the perception of the nursing profession in the media affects or distorts reality.
Sandy and Harry Summers think it most certainly does. They co-wrote a series in 2010 called, “The Image of Nursing: Does nursing’s media image matter?” They are also the authors of “Saving Lives: Why the Media’s Portrayal of Nurses Puts Us All At Risk.”
The authors write: “In these ubiquitous media products nurses are portrayed as ‘no more than submissive helpers of the physicians who do everything that matters.'”

Benissa Salem, a former news freelancer at ABC is a Masters prepared Registered Nurse (RN).  She is currently a PhD candidate at the UCLA School of Nursing. She agrees saying calling nursing handmaidens undervalues their contributions to academia, research, and evidence-based practice. As a research nurse, she is on the front lines in Los Angeles, screening, educating homeless populations about Hepatitis A, B and C transmission, as well as HIV.
As a public health nurse, she teaches her clients how to protect themselves from communicable diseases, navigate healthcare systems, and reduce risky behaviors, which is contrary to what recent news suggests is a sexy or stupid stereotype garnered from YouTube or other television programs. Her dual background in journalism and nursing has undoubtedly prepared her to communicate effectively, educate, and raise awareness. Salem says, “Nurses comprise the largest group of healthcare providers; yet, many do not know what our profession encompasses. Nurses are academicians, researchers and clinical experts. However, the image of the nurse in the popular press is often limited in scope.”
Nurses are not only clinical experts, but health educators, teaching patients how to manage chronic disease processes, navigate healthcare systems and are ultimately patient advocates.  Sandy Summers, co-author of “Saving Lives” was an emergency department and intensive care nurse herself for many years and now runs a nonprofit advocacy organization called The Truth About Nursing. Her co-author, Harry Jacobs Summers, is a lawyer and senior adviser for the group.  “Saving Lives” delineates how ubiquitous negative portrayals of nursing are in today’s media, particularly three common stereotypes of nurses — the “Angel,” the “Sexy or Naughty Nurse” and the “Battle Axe.”  They argue these images of nursing degrade the profession by portraying nurses as vixens, saints, not college-educated health care workers with life and death responsibilities.
The popular medical television shows “ER,” “House,” “Grey’s Anatomy,” “Private Practice” and “Scrubs” receive the bulk of the authors complaints. They list numerous examples of nurses acting as “helpers” in these TV programs rather than autonomous and knowledgeable professionals.  Another problem is that popular television shows often show doctors doing nurse’s jobs: giving medications, checking intravenous (IV) medications, educating patients about treatment, and providing ongoing emotional support from shift to shift. Of course, the focus of the storyline is often on the physician, so it may simply be easier to write and follow if the doctors do all the work. But in real life, nurses are at the patient’s bedside for the majority of the time, helping to manage their care and provide adequate education and discharge planning.
Is all this hoopla simply a matter of semantics? Defining nurses as “helpers” is easier to say than “health educators.” Is it simply linguistic laziness? Afterall, we live in an LOL world with time deadlines necessitating that we say everything in 140 characters or less.  The New York Times also ran a story by Theresa Brown, R.N. blogged on Well blog about why stereotypes of nurses is bad for your health.  Brown also mentions the book “Saving Lives: Why the Media’s Portrayal of Nurses Puts Us All at Risk.” 
“One of nurses’ most important professional roles is to act as an independent check on physician care plans to protect patients and ensure good care,” writes co-author, Sandy Summers. 
The popular medical television shows “ER,” “House,” “Grey’s Anatomy,” “Private Practice” and “Scrubs” receive the bulk of the authors complaints. They list numerous examples of nurses acting as “helpers” in these TV programs rather than autonomous and knowledgeable professionals.  One media caption is “Nurse Jackie,” airing on Showtime, which features Edie Falco as a capable nurse, although she’s also highly dysfunctional and hardly a role model.
Salem is passionate about health promotion/prevention and adamantly believes the perception of nurses in media should be composed of an understanding of the pillars of the profession, as well as, a realistic portrayal of the responsibilities, realities and challenges which nurses are confronted with in this health care climate. But, she says nurses need to be more vocal, share their knowledge and expertise, as well as, be afforded opportunities to have a voice in the media.  She certainly rises above the prevailing images and stereotypes.
 The Los Angeles-based Hollywood, Health & Society studies and manages health messages in media.  The Kaiser Family Foundation has also tackled how the public sees healthcare issues due to media.  There is a shortage of nurses, which is unsettling because there is a high demand for them. In an economy where jobs are scarce, educators should be highlighting the benefits of becoming a nurse. It’s a profession that not only deserves respect, but demands it.  The challenge to educate nurses may include a lack of educators or ones that are retiring.  The majority of the education is being broadcast by medical doctors, and not nurses. In fact, we see that nurses are overlooked as experts when news programs or media outlets need an opinion on a health issue. 
The media is a powerful entity, setting the tone and pace for our sociopolitical environment. Let’s develop realistic depictions on how nurses are portrayed, sending a positive message to young children and the community at large about the profession.
“It is imperative that the community at large is aware of the role and responsibilities of the nursing profession, as well as their clinical expertise, and contributions to academic research and evidence based practice,” Salem says. 
 Maybe it’s time for a television show called, THE NURSES.

Kaiser Leads Mobile Healthcare

Nearly 9 Million Kaiser Permanente Health Records Securely Available on Mobile Devices

Kaiser Permanente already has the largest electronic medical record system in the world.

The Pew Internet Project reported that 40 percent of American adults access the Internet via their mobile phones, and in some cases, mobile phones are their primary source of Internet access.

Twenty-five percent of smart-phone owners go online primarily using their phone; of these, roughly one-third have no high-speed home broadband connection.

Three months ago, the health care organization announced that 9 million Kaiser Permanente patients now can easily access their own medical information anywhere in the world on mobile devices through a mobile-optimized website.

An additional app for iPhone will be released in the coming months.  Meantime, iPhone users can download a shortcut icon to

In 2011 alone, more than 68 million lab test results were made available online to Kaiser Permanente patients.

Kaiser Permanente patients will have 24/7 access to lab results, diagnostic information…

direct and secure email access to their doctors, and will also be able to order prescription refills.

Kaiser Permanente had more than 12 million e-visits in 2011 alone, and they expect that number to rise.

The Android app is available now in the Android Market at no charge.

Users of other mobile devices can access the same set of care-support tools at no charge through the new secure, mobile-optimized member website, which is available through smart-phone Internet browsers.

Kaiser Permanente patients or family members who can act on their behalf, now have 24/7 access from their mobile devices to view their secure personal health record, email their doctors, schedule appointments, refill prescriptions and locate Kaiser medical facilities on

“This is the future of health care. Health care needs to be connected to be all that it can be. This new level of connectivity is happening real time, and it is happening on a larger scale than anything like it in the world,” said George Halvorson, chairman and chief executive officer of Kaiser Permanente.

“The fact that a Kaiser Permanente patient in an emergency room in Paris or Tokyo can simply pull out their mobile device and have immediate and current access to their own medical information is an evolutionary and revolutionary breakthrough for medical connectivity.”

“Our members love our current connectivity tools,” said Christine Paige, senior vice president of marketing and Internet services.

“Now we will extend our entire connectivity tool kit for patients through a mobile phone. Our mobile-optimized site and app take connectivity to the next level by making the mobile experience easy and enjoyable. We believe that convenience, paired with a great user experience, will meet members’ needs and will ultimately result in improved health and patient-physician relationships.”


  • Go to on your iPhone mobile Web browser
  • Click on the middle icon at the bottom of your screen
  • Choose “Add to Home Screen
  • A short cut will be added to your iPhone icons

Members using the Android app have access to their accounts by touching the app icon on their phones.

Those visiting from a mobile phone Internet browser are seamlessly redirected to the mobile-optimized website, which was designed for optimal viewing on a mobile-phone screen.

In both cases, a streamlined menu of mobile-optimized features helps members find what they need quickly and easily with minimal taps.

“Providing our patients with clear and convenient access to their health information is a step forward in connectivity and improving the health care experience for patients, no matter where they are,” saidJack Cochran, MD, executive director of The Permanente Federation.

“We already have complete connectivity among Kaiser Permanente care sites through Kaiser Permanente HealthConnect®. This new level of connectivity extends the reach of information to our patients in a more convenient and user-friendly format. This new app and mobile-optimized site is very good for patient care and will revolutionize connectivity by bringing health care for the first time to the level of connectivity other parts of our economy have achieved.”

Users’ personal health information is safe and secure while using the new app and the mobile-friendly, which employ the same security safeguards that protect patient information on the traditional website, including secure sign-on and automatic sign-out after a period of inactivity.

“The benefits of mobile extend beyond member engagement,” said Philip Fasano, executive vice president and chief information officer of Kaiser Permanente.

“Mobile solutions can have a positive impact on health. Health care, itself, will be much more convenient for many people. The mobile-friendly site and app are also a springboard for new innovations that will inspire members to be aware of their health and take steps to improve it.”

“There has been an explosion in the growth of mobile devices and users are looking for new and improved ways to manage their lives online,” Halvorson said.

“It is time to make health information easily accessible from mobile devices.”

This is a major new connectivity offering, but it is not Kaiser Permanente’s first mobile app. Other, more targeted tools, were released earlier. Kaiser Permanente launched its first mobile application, KP Locator for iPhone, in July 2011.

The facility-finder app has been downloaded 42,000 times.

KP Locator combines the power of’s robust facility directory and the iPhone’s GPS capabilities to make searching for Kaiser Permanente facilities fast and easy for patients on the go.

It answers three of the most basic, but vital, user questions thoroughly and simply — where are the Kaiser Permanente locations close to me, how can I contact and get to them, and what departments and services can I access there? Kaiser Permanente also released its Every Body Walk! app two months ago to help encourage people to walk and maintain healthy activity levels, and that app was rated No. 5 in the Top 100 Green Apps by Eco-Libris.

Kaiser Permanente is known for its leadership in the use of health information technology. The Kaiser Permanente electronic health record is the largest non-governmental medical record system in the world. KP HealthConnect enables all of Kaiser Permanente’s nearly 16,000 physicians to electronically access the medical records of all 8.9 million Kaiser Permanente members nationwide and serves as a model for other care systems.

Kaiser Permanente has received numerous awards for its health IT expertise, including four 2011 eHealthcare Leadership Awards.

You can learn more about how patients, clinicians and researchers are using My Health Manager and KP HealthConnect by checking out Kaiser Permanente’s YouTube channel: Kaiser Permanente also has what might be the world’s most complete electronic medical library to support its caregivers by providing convenient access to the best and most current medical science. That electronic medical library is for internal use only.

Nearly 9 Million Kaiser Permanente Health Records Securely Available on Mobile Devices

Kaiser Sunset Hospital in Los Angeles, CA
Kaiser Sunset Hospital in Los Angeles, CA (Photo credit: Wikipedia)