Hottest Health Career of the Future by Maria Dorfner

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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.

Really?

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.

NADA.

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.

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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. 

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

FUTURE IN HEALTH CAREERS:

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.   

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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

DEMAND. DEMAND. DEMAND.

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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

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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.

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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.

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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.

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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.

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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.

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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.

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

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

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

Cleveland Clinic: http://my.clevelandclinic.org/staff_directory/default.aspx

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

Water Safety Tips for a Healthy Fourth of July!

LOTS OF PEOPLE SPEND THE 4TH OF JULY IN THE WATER, BUT DROWNING IS THE SECOND LEADING CAUSE OF ACCIDENTAL DEATHS FOR PEOPLE 15 – 44 YEARS OLD.

AND MOST PEOPLE DROWN WITHIN 10 – 30 FEET OF SAFETY.

DR. TOM TALLMAN IS AN EMERGENCY ROOM PHYSICIAN AT CLEVELAND CLINIC.
HE SAYS THERE IS ONE THING ALMOST EVERYONE SHOULD KNOW BEFORE GETTING IN THE WATER.

CG: Dr. Tom Tallman/Cleveland Clinic
“Everybody should know basic CPR because when someone has had a water-related injury, such as that, resuscitation can be rather simple.

CLICK ON PHOTOS TO ENLARGE

TO MINIMIZE THE RISK YOU SHOULD NEVER SWIM ALONE.

ALSO, NEVER DIVE INTO A LAKE OR RIVER BECAUSE WATER LEVELS FLUCTUATE.

CHILDREN AND NON-SWIMMERS SHOULD ALWAYS WEAR A LIFEJACKET.

AND DON’T OVERESTIMATE YOUR SWIMMING ABILITY.

AND IF YOU’RE PLANNING TO SPEND YOUR HOLIDAY POOLSIDE, DR. TALLMAN HAS A MESSAGE FOR PARENTS.

CG: Dr. Tom Tallman/Cleveland Clinic
“When parents are taking young children to swimming pools don’t rely on just the lifeguards who are there to save them. They still need to keep an eye on the kids and watch them very carefully.”

BOATERS SHOULD ALSO BE ON HIGH ALERT.  COAST GUARD RESEARCHERS SAY DROWNING WAS THE REPORTED CAUSE OF DEATH IN ALMOST THREE-FOURTHS OF RECREATIONAL BOATING FATALITIES LAST.

HAVE A GREAT DAY, EVERYONE!

DON’T FORGET YOU CAN USE RED, WHITE AND BLUE FRUITS TO CREATE A HEALTHY, CREATIVE MASTERPIECE!! 🙂

 

 

All About Sleep Apnea

SLEEP APNEA IS A COMMON SLEEP PROBLEM THAT CAN BEGIN AT ANY AGE. BREATHING IS REPEATEDLY INTERRUPTED DURING SLEEP. 

THE TIME PERIOD FOR WHICH THE BREATHING STOPS OR DECREASES IS USUALLY BETWEEN 10 AND 30 SECONDS.  WHEN THESE EPISODES OCCUR REPEATEDLY, SLEEP APNEA CAN SERIOUSLY DISRUPT THE QUALITY OF SLEEP.

 IT AFFECTS MILLIONS OF PEOPLE AND HAS BEEN LINKED TO HIGH BLOOD PRESSURE, HEART ATTACK, AND STROKE, and JUST LAST WEEK, CANCER (SEE ARTICLE LINK BELOW).

DR. CHARLES BAE TREATS SLEEP APNEA PATIENTS AT CLEVELAND CLINIC’S SLEEP DISORDERS CENTER .

HE SAYS MANY PEOPLE WITH SLEEP APNEA DON’T EVEN KNOW THEY HAVE IT.

“There is, throughout the night, a collapse of the upper airway. So, essentially you stop breathing multiple times, while you’re sleeping, even if you’re not aware of it.”

DR. BAE SAYS PEOPLE WHO HAVE SLEEP APNEA DON’T ALWAYS WAKE UP WHEN THEY STOP BREATHING.

HE SAYS OFTENTIMES, PEOPLE MAY NOT EVEN KNOW THEY HAVE IT, AND THAT THEY’RE USUALLY TOLD BY THEIR SLEEP PARTNER THAT THEY EITHER STOP BREATHING OR SNORE LOUDLY.

DR. BAE SAYS ONCE SLEEP APNEA IS DIAGNOSED, TREATMENT USUALLY INVOLVES A CONTINUOUS POSITIVE AIRWAY PRESSURE, OR CPAP MACHINE.

Dr. Charles Bae says, “Depending on how serious the sleep apnea is that would determine when you need the machine, but it really, oftentimes, doesn’t matter. Someone with severe sleep apnea may not be sleepy, but they definitely need the machine. Someone with mild sleep apnea may be super sleepy, so certainly, that would be the time to consider it.”

DR. BAE ALSO SAYS IF YOU’RE GETTING 8 HOURS OF SLEEP, BUT STILL FEEL TIRED, OR ARE WAKING UP FOR UNKNOWN REASONS, TALK TO YOUR DOCTOR.  For more information, visit: www.clevelandclinic.org

English: The Cycle of Obstructive Sleep Apnea ...
English: The Cycle of Obstructive Sleep Apnea – OSA (Photo credit: Wikipedia)

NEW TREATMENTS FOR SLEEP APNEA

The Center for Minimally Invasive and Robotic Surgery at The Mount Sinai Medical Center—a pioneer in robotic surgery—now offers a procedure to patients with sleep apnea, whose obstructive breathing prevents them from sleeping normally.

Mount Sinai is one of only a few programs in the world to use transoral robotic surgery (TORS) to remove excess tissue or fix a collapsed airway that causes sleep apnea.

Through the robotic procedure, a laser removes the extra tissue in the throat that contributes to the airway obstruction in sleep apnea patients.

Patients typically return home the next day, and are back to work in 10 days, sleeping and breathing normally.

During sleep apnea, a person’s breathing is blocked and then restored when the brain sends a signal that awakens the patient to a lighter level of sleep.

This process can happen hundreds of times each night, leaving the patient exhausted during the day and at risk for many health complications, including cardiovascular disease and hypertension.

Many patients opt for a treatment called continuous positive airway pressure (CPAP), delivered through a mask that the patient wears at night to force his or her airway open for the duration of sleep.

However, some feel the mask hinders their quality of life, and look for better options.

“Over time many patients grow frustrated with CPAP or stop using the device, causing their sleep apnea to return and leaving them anxious for a better solution,” said Fred Lin, MD, Assistant Professor of Otolaryngology and Director of the Mount Sinai Sleep Surgery Center.

 “In the past, surgery had been a last resort. Now, using robotic surgery, we can remove the tissue that contributes to the airway blockage in a brief procedure with no external incisions and have patients home the next day, sleeping healthfully.”

During the robotic procedure, a surgeon sits at a console directly controlling a robotic arm that extends a small surgical instrument through the patient’s mouth. Using a high-powered 3-D camera, he or she has a clear view of the surgical field.

The previous surgical technique was less precise and potentially less effective because the surgeon was only able to use one hand, and had limited maneuverability.

“Mount Sinai is one of the original adopters of robotic surgery and we have seen first-hand the dramatic quality of life improvements it provides our head and neck cancer patients,” said Eric Genden, MD, Professor and Chair of Otolaryngology, Mount Sinai School of Medicine.

Causes

There are three types of respiratory events:

  • Obstructive apnea—caused by a temporary, partial, or complete blockage of the airway
  • Central apnea—caused by a temporary failure to make an effort to breathe
  • Mixed apnea—combination of the first two types

Risk Factors

These factors increase your chance of developing sleep apnea. Tell your doctor if you have any of these risk factors:

  • Sex: male
  • Overweight
  • Large neck circumference
  • Age: middle to older age
  • Family history of apnea
  • Structural abnormalities of the nose, throat, or other part of the respiratory tract. Examples include:
  • Hypothyroidism
  • Medicines: sedatives and sleeping aids
  • Alcohol consumption
  • Smoking

Symptoms

Symptoms include:

  • Fatigue and sleepiness during waking hours
  • Loud snoring
  • Breathing that stops during the night (noticed by the partner)
  • Repeated waking at night
  • Unrefreshing sleep
  • Morning headaches
  • Poor concentration or problems with memory
  • Irritability or short temper

People with chronic untreated sleep apnea may be at risk for:

Diagnosis

An overnight sleep study is used to help diagnose sleep apnea.

Overnight Sleep Study (Polysomnography)

This testhelps detect the presence and severity of sleep apnea. During sleep, it measures your:

  • Eye and muscle movements
  • Brain activity ( electroencephalogram)
  • Heart rate
  • Breathing (pattern and depth)
  • Percent saturation of your red blood cells with oxygen

Other Studies

In addition to sleep studies, your doctor may order:

Treatment

There are a number of treatment options for sleep apnea, including:

Behavioral Therapy

  • Lose weight if you are overweight.
  • Avoid using sedatives, sleeping pills, alcohol, and nicotine, which tend to make the condition worse.
  • Try sleeping on your side instead of your back.
  • Place pillows strategically so you are as comfortable as possible.
  • For daytime sleepiness, practice safety measures, such as avoiding driving or operating potentially hazardous equipment.

Mechanical Therapy

Continuous positive airway pressure (CPAP) entails wearing a mask over your nose and/or mouth during sleep. An air blower forces enough constant and continuous air through your air passages to prevent the tissues from collapsing and blocking the airway. In some cases, dental appliances that help keep the tongue or jaw in a more forward position may help.

Surgery

In some cases, surgery may be recommended. It is most often beneficial in pediatric patients.

Types of surgery that may be done to treat severe cases of sleep apnea include:

  • Uvulopalatopharyngoplasty—The doctor removes excess soft tissue from the nose and/or throat.
  • Maxillomandibular advancement—The jawbone is repositioned forward.
  • Tracheotomy—For life-threatening cases of sleep apnea, an opening is made in the windpipe to allow for normal breathing.

Bariatric surgery may help with weight loss in some people who are obese. This surgery may reduce many of the complications that are related to obesity, including sleep apnea.

Medications

Only used in central apnea, acetazolamide (Diamox) may help improve the ability to regulate breathing. Overall, there is not a lot of evidence to support the use of medicines to treat sleep apnea.

Supplemental oxygen may be given if blood levels of oxygen fall too low during sleep, even after opening the airway.

Prevention

You may be able to prevent the onset of sleep apnea by maintaining a healthy weight . Avoid alcohol, nicotine, and sedatives, which may contribute to airway obstruction.

RESOURCES:

American Academy of Sleep Medicine

http://www.sleepeducation.com/

American Sleep Apnea Association

http://www.sleepapnea.org/

National Sleep Foundation

http://www.sleepfoundation.org/

CANADIAN RESOURCES:

Canadian Lung Association

http://www.lung.ca/home-accueil_e.php

Canadian Sleep Society

http://www.css.to/

References:

American Academy of Sleep Medicine. The International Classification of Sleep Disorders. 2nd ed. Westchester, IL; American Academy of Sleep Medicine; 2005.

American Sleep Apnea Association website. Available at: http://www.sleepapnea.org. Accessed July 9, 2009.

Smith I, Lasserson TJ, Wright J. Drug therapy for obstructive sleep apnea. Cochrane Database Syst Rev. 2006;19:CD003002.

Obstructive sleep apnea. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Accessed October 22, 2007.

Kushida CA, Littner MR, Hirshkowitz M, et al. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adults with sleep-related breathing disorders. Sleep. 2006;29:375-380.

Littner MR, Kushida C, Wise M, et al. Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep. 2005;28:113-121.

Morgenthaler TI, Kapen S, Lee-Chiong T, et al. Practice parameters for the medical therapy of obstructive sleep apnea. Sleep. 2006;29:1031-1035.

Pack AI, Maislin G. Who should get treated for sleep apnea? Ann Intern Med. 2001;134:1065-1067.

Sleep apnea: treatment and drugs. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/sleep-apnea/DS00148/DSECTION=treatments-and-drugs. Updated June 29, 2010. Accessed April 4, 2011.

Last reviewed September 2011 by Marjorie Bunch, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Copyright © 2012 EBSCO Publishing. All rights reserved.

 “This minimally invasive procedure has the potential to fundamentally change the treatment paradigm for people battling sleep apnea.”

For more information, visit http://www.mountsinai.org/.

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