Kamis, 13 Juli 2017

5 Common Medical Myths Debunked

Myths can be frustrating for those of us practicing medicine. In the age of the internet, it's a challenge to compete with Google University. Unfortunately, much of what you read online is inaccurate. Therefore, medical myths tend to spin out of control, more rapidly than we can sometimes control as physicians.

Here are five of the most common medical myths debunked:

Myth #1: Drink 8 glasses of water a day

Who decided that we need to specifically consume 8 glasses of water a day? And how large of a glass are we talking about anyway? The truth is: this number is arbitrary.

We absorb a good portion of our bodily fluid intake from our foods. And drinking excessive amounts of water can mess with our cellular electrolyte balance. Recently I saw a patient with a very low sodium level in her routine blood work. I was a tad surprised, because she was healthy and not on any medications. I repeated it, and it was still low. We worry about sodium levels when it’s too low, it can make us feel fatigued, confused and can potentially land us in the hospital.

So I asked her to come in to my office. Believe it or not, in addition to excessively fluid intake, dehydration is a cause for low sodium. (Confusing, right?) Quantifying the amount of fluid intake is very useful in these situations.

After inquiring about her fluid intake, she revealed that she drinks 6 bottles of 32 oz water bottles each day. If we assume that each “glass” of water is about 8 oz, this means she was drinking 24 glasses of water a day.

"I’m trying to shed just a few extra pounds. And I hear from the ‘Dr. So and So’s show’ that water is good for you," she told me.

Yes, water is certainly required for the functioning of each one of our cells and organs. However, there’s no need for excess. And in fact it can do harm. So I told her what I tell all my patients – drink to thirst. Your body will let you know when you need water. You don’t need more than that.

After some fluid restriction, this particular patient’s sodium level went back to the normal range.

I have to admit, for whatever reason, I see this much more commonly in my elderly patients.

Myth #2: You can catch a virus from the cold weather

You may have heard it over and over again from your mother: “Put on a jacket! You’re going to catch a cold!” This is a phrase I heard frequently in my household growing up. And to be honest, it still baffles me when patients reiterate it in my office after so many years.

To be fair, it’s not 100% incorrect. Viruses tend to survive, flourish, and reproduce more efficiently in lower temperatures. This is why we tend to see them spike in the wintertime. However …you can’t catch it simply from the “cold” weather. Viruses are contracted from another carrier who is infected with one. Think of that the next time you shake hands, kiss, or hug. Or more than likely, you will catch a virus from someone in your vicinity who coughed or sneezed in the open air.

Viruses jump from host to host, and that is the only way they survive. Sure, when an infected person sneezes or coughs in the air, it releases those viral particles; but without being exposed to those droplets, you can’t really “catch” a cold otherwise.


Myth #3: Antibiotics can cure a cold

Listening to my podcast, you likely know that this is one of my greatest pet peeves: antibiotic overuse. Why are antibiotics “overused” exactly? Because they are being requested and/or prescribed for anything and everything under the sun, including viruses, which they do not even touch.

We all play a role in this. Because it’s due to both the physician’s inability to say “no” and/or take the time to explain the reasons why antibiotics won’t do a thing for viruses (see my prior episode on this one), and also because sometimes patients who erroneously believe their “cold” can be cured, demand the prescription, and curse the doctor if they leave without one. Truth be told, this is ultumately the medical community’s responsibility. We need to provide the education and take the time to explain this one. It’s a cultural change, but we need to take the time.

Bottom line: antibiotics only help treat bacteria. They do not do a thing for viral illnesses.  And they cause harm when prescribed unnecessarily.

Myth #4: Antibiotic eye drops can cure pink eye

I also tackled this one recently. One of those cultural myths we must debunk: pink eye is also viral. Unlike some other viruses, such as the common cold, there is an actual physical, tangible symptom. The "pink" eye is clearly a visible symptom. Why do people freak out over this? The common cold is quite an annoyance, but it certainly isn’t life threatening. Neither is pink eye.

And as I mentioned, antibiotics cannot eradicate viruses. But preschools and daycares everywhere still require, not only a doctor’s note to return to school but a prescription for “antibiotic drops.”  This leads to missed days at work for the parents, missed days at school for the kids even though they may not even be contagious, and unnecessary time and money spent at the doctor’s office.

If this sounds familiar to you in any way, please check out my prior podcast on what pink eye really is, how it should be treated, and my own rather frustrating personal experience with my daughters' pink eye adventure at their preschool.

Myth #5: You need a knee MRI

This is also a huge medical myth: that “if I only had an MRI,” it would help me and my chronic knee pain in any way. As I’ve discussed prior, an MRI does not typically offer any useful information … unless the patient is considering surgery as an option to treat the knee pain.

The truth is that knee meniscal and ligament tears are quite common. And with age, we have a higher tendency for these types of tears due to normal wear-and-tear. And even a small injury (or frankly often none at all) is enough to tear these knee structures. But does that mean you need surgery?

Studies show that conservative treatment, such as anti-inflammatories, ice, activity modification, knee splints, steroid injections, and physical therapy fair just as well as surgery…if not better.

So, I ask of you – what’s the point of an MRI? Let’s say that you do have a tear (which you very likely may have)…so what? The pain itself will likely improve on its own anyway. So what’s the point of getting an MRI? “Just to know, Doc,” I often hear.  But obtaining an MRI simply for curiosity is contributes to our exponentially-increasing cost of health care in this country. An MRI is not an inexpensive expense – in fact, it’s one of the most costly tests we can order.  If it brings useful information that can change the management of a medical condition, then that’s one thing. But if it’s “just to know,” is another.

Share your ideas and learn more quick and dirty tips with us on the House Call Doctor’s FacebookTwitter, and Pinterest pages! If you learned anything here today, or simply enjoy all-things-medical, you can also listen and subscribe to the House Call Doctor podcast on Apple PodcastsSpotifySoundcloud, and Stitcher.

Please note that all content here is strictly for informational purposes only.  This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider.  Please always seek a licensed physician in your area regarding all health related questions and issues.



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