The kids were out, Mr TBTAM was downstairs grading final exams, and I figured I was going to be spending a rainy Friday evening alone in my room. Turns out I had wonderful company till sunset.
Any bird lovers out there who can tell me what kind of bird my garden guest was? (You can’t see the bird in this video – but I was hoping someone knew bird calls and could figure it out that way…)
In their Newsweek Cover story whose link is entitled “Why Oprah’s Health Advice Can make You Sick“, writers Pat Wingert and Weston Kovsova have finally broken the cone of mainstream media silence that surrounds Oprah, letting everyone else in on the dirty little secret that we doctors have known for some time now – Oprah is practicing bad medicine without a licence.
Because the truth is, some of what Oprah promotes isn’t good, and a lot of the advice her guests dispense on the show is just bad. The Suzanne Somers episode wasn’t an oddball occurrence. This kind of thing happens again and again on Oprah….She has the power to summon the most learned authorities on any subject; who would refuse her? Instead, all too often Oprah winds up putting herself and her trusting audience in the hands of celebrity authors and pop-science artists pitching wonder cures and miracle treatments that are questionable or flat-out wrong, and sometimes dangerous.
Oprah’s Response
Oprah’s response to the Newsweek article is self-serving and disingenuous. She hides behind what she calls the ‘intelligence” of her viewers to sift through the crap she presents them to find what’s right for them.
For 23 years, my show has presented thousands of topics that reflect the human experience, including doctors’ medical advice and personal health stories that have prompted conversations between our audience members and their health care providers. I trust the viewers, and I know that they are smart and discerning enough to seek out medical opinions to determine what may be best for them.
I believe my viewers understand the medical information presented on the show is just that—information—not an endorsement or prescription.
Drs Northrup and Oz – Not just innocent bystanders
Wingert and Kosova also take on Christian Northrup, Oprah’s menopause Guru, for her new age medical opinions that are just plan bad advice. Northrup recommends iodine supplementation, unnecessary in almost anyone, and soy, which actually interferes with thyoid hormone absorption. Worse still are her theories about the causes of thyroid disease.
As she explains in her book, “in many women, thyroid dysfunction develops because of an energy blockage in the throat region, the result of a lifetime of ‘swallowing’ words one is aching to say.
Like Northrup, Dr Oz sat by unquestioning while Suzanne Somers and Dr Hall have spouted incorrect medical information.
One could argue that Oprah is the victim of bad advice from these two doctors, whose need for her endorsement has led to their unwillingness to challenge her in public. But I disagree. What would happen if Dr Northrup Or Oz were to actually argue with Suzanne Somers on Oprah’s show? I’ll tell you what – they’d get relegated to a seat in the audience along with the rest of the good doctors who dare to speak the truth to the emperor. Oprah would find some other quack to sit next to Suzanne Somers while she spews her fallacies. Don’t kid yourself. This is, after all, the woman who gave the entire CDC a whopping 30 second written statment in response to Jenny McCarthy’s anti-vaccine nonsense.
No, Oprah is no victim here – she is utterly in control.
Should Dr Oprah be Sued for Malpractice?
I think it’s time Dr Oprah deals with what every other doctor in America has to deal with – a malpractice case. In fact, I’m shocked that someone hasn’t sued her by now for an adverse outcome related to a treatment she has touted (or in the case of vaccines, advised them to avoid). Here’s one suit she may have narrowly avoided –
In March 2007, the month after the first two shows on The Secret, Oprah invited a woman named Kim Tinkham on the program. She had been diagnosed with breast cancer, and her doctors were urging surgery and chemotherapy. But Tinkham wrote Oprah to say that she had decided to forgo this treatment and instead use The Secret to cure herself. On the show, Oprah seemed genuinely alarmed that Tinkham had taken her endorsement of The Secret so seriously. “When my staff brought this letter to me, I wanted to talk to her,” Oprah told the audience. “I said, get her in here, OK?” On air, Oprah urged the woman to listen to her doctors. “I don’t think that you should ignore all of the advantages of medical science and try to, through your own mind now because you saw a Secret tape, heal yourself,” she said. A few weeks earlier, Oprah could not say enough in praise of The Secret as the guiding philosophy of her life. Now she said that people had somehow gotten the wrong idea. “I think that part of the mistake in translation of The Secret is that it’s used to now answer every question in the world. It is not the answer to all questions,” she instructed. “I just wanted to say it’s a tool. It is not the answer to everything.”
While Oprah did the right thing and brought that woman onto her show to tell her to get to a conventional doctor, are there women who missed the follow up recant? How about those women out there taking hormones without being advised of their risks, or failing to vaccinate a child who subsequently becomes ill from a vaccine-preventable disease?
Maybe some clever lawyer will see dollar signs in Newsweek’s cover and get a class action suit going on behalf of Oprah’s viewers whose trust she has betrayed. After all, those are some deep pockets there at Harpo Productions.
I wouldn’t hold my breath.
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Previous posts about Oprah on this blog
My newest fave place to bike ride is Prospect Park in Brooklyn.
Prospect Park is to Central Park as Brooklyn is to Manhattan. (Well, was – before some parts of Brooklyn got almost too hip for themselves.) Same great Olmstead bones, just as beautiful but a little less polished and manicured, even a bit tousled in places, filled with real folks doing real things, all of it less like a movie set and more like real life.
The Park is flanked by Grand Army Plaza and Park Slope in the north, the Botanical Garden and Brooklyn Museum of Art to the east, and the south? well, between 3 and 8pm on Sundays, that’s the best part of all, as musicians gather in Drummers Grove to strike the beat of a Caribbean/African drum to drive you on your way as you bike the 3.35 mile loop just one more time…
As far as a work out, the Prospect Park Loop is a good one. Heading South from Grand Army Plaza (that’s counter clockwise on the loop) are some lovely downhills on the Western slope mixed with a few straight stretches and strategically placed water fountains.
The south loop is flat and skirts the lake and then heads north again at Drummers Grove. (Careful – there’s a short stretch at the bottom where cars are still allowed on weekends.) Then the road heads on a wonderful uphill – Wait- Did I just say wonderful uphill? – I did, and it is! A moderately long, nicely curving hill with a low mid section for relief before heading up the bit steeper upper section that plateaus out just as you are starting to think that your legs might be hurting but is never too steep to stop the conversation. Ending with a rolling north section that energizes you for just one more loop around….
Go ahead – Try it. You’ll want to do at least two, and maybe even three loops as we did – it’s that much fun. Maybe combine it with a trip to the Brooklyn Museum or Botanical Gardens, or with lunch in Park Slope, or if it’s Saturday, a visit to the Farmer’s Market at Grand Army Plaza. Better yet, if it’s Sunday, grab an early dinner from the Caribbean food carts at Drummer’s Grove and enjoy the music before heading home.
I can’t think of a better way to end a weekend.
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Suggested Links
Bacteria-coated vaginal epithelial cells in Bacterial Vaginosis
Bacterial vaginosis (or BV for short) is the most common vaginal infection in women, and in pregnancy has been linked to premature labor and delivery. Despite this, interventions to diagnose and treat BV in pregnancy have had only modest impact, and then only in the subgroup of women with a history of previous preterm birth.
The results of this study, if confirmed in larger trials, would suggest that vitamin D deficiency may be the cause for bacterial vaginosis in pregnancy, and that supplementation of this vitamin might be worth investigating as an intervention to prevent preterm birth.
It’s an interesting idea, but just a hypothesis at this point. Although the study is well-done, it does not prove causality. Both BV and vitamin D deficiency are incredibly common conditions, both in pregnant and non-pregnant women. To find them together in the same patient would not be unexpected given their relatively high frequency in general. (In this study, almost half the women had BV – that’s a very high incidence.)
On the other hand, the researchers did find a dose-response relationship between vitamin D levels and BV incidence, and that would support a real effect rather than mere association. Interestingly, vitamin D deficiency has also been linked to periodontal disease, another condition that is found to be associated with preterm labor and delivery.
The most intriguing aspect of this study lies in the fact that all three conditions – vitamin D deficiency, preterm birth and BV – occur more often in African American women, individuals whose darker skin requires longer sun exposures to convert vitamin D to its active form. Preterm labor in this group has been especially hard to explain because this increased risk is independent of socioeconomic status. Could Vitamin D deficiency in African American women be the common factor that explains this increased risk? Wouldn’t it be neat if correcting that deficiency were to prevent preterm labor and delivery?
Unfortunately, most things in medicine these days don’t present solutions that are so neatly packaged as this one. Not to mention the fact that BV was present in almost a quarter of the group with the highest vitamin D levels in this study, which would argue that something other than vitamin D is at play. So while it is intruguing, it is much too soon to jump on this bandwagon. But I will be watching the parade closely.
By the way, most prenatal vitamins carry about 400 IU of vitamin D. Emerging data are beginning to suggest that higher doses of vitamin D may be necessary, but this remains controversial. I am comfortable recommending vitamin D supplementation doses up to 800-1000 IU daily in my non-pregnant patients. These doses are safe, and in my experience, usually result in vitamin D levels in the mid 30’s ng/dl.(equivalent to the highest levels in this study). If you are pregnant and have questions about vitamin D, it’s best to talk to your doctor before going above current dose recommendations (200-400 IU daily).
Eldest daughter won her high school’s drama award, which in this town means you get to go to the Drama Desk Awards ceremony with your parents and get your scholarship presented to you by Brian D’Arcy James, the star of the Broadway production of Shrek. Not to mention share your school auditorium stage with the likes of Harvey Fierstein, Liza Minelli, Stockard Channing, John Lithgow, Geoffrey Rush, Victor Gerber, Jane Fonda, Audra McDonald and Angela Landsbury (just to name a few).
This is not a design blog, and I’m not plugging products for profit, but I just have to tell you about these 365+ Lunta lamps I got last week at IKEA. I am so in love with them!
These are incredibly solid, functional and most importantly for those of us with New York City apartments, they fit into narrow spaces. In my case, that’s next to the den sofa where my previous lamps’ shade dimensions precluded opening the closet door all the way. (Guess I’ll have to come up with another reason now for why that closet is such a mess…)
These lamps give great light, can officially handle up to a 100 W bulb (as opposed to me using the 100W even though they say don’t use anything higher than 75W and feeling nervous that I am going to blow it up or start a fire) and the switch (which is easily reached about halfway up the lamp) is also a dimmer! With a price tag of $99 apiece, they out-function, out-style and outshine every other lamp I have ever bought, some which came at a much higher price tag.
Of course, all of this could just be me over-reacting to the fact that I no longer have to crawl next to the sofa to pull or put the plug out of or into the surge protector, which was how we were turning our previous lamp on and off since the switch broke over a year ago …
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UPDATE- We have had to replace each lamp once since I posted this, due to spontaneous shorting out of the bulb. We had the electrical outlet changed, use a surge protector and it still happened again. Our building insists it is a lamp issue and not an outlet problem. I have no idea which it is. If anyone else has had similar issues with these lamps, let me know. To Ikea’s credit, they replaced the first one free of charge, but we were on our own the second time.
With an approximate 35-year life span after surgery, one additional death would be expected for every nine oophorectomies performed.
That’s a significant risk, I’d say.
As expected, women whose ovaries were removed had a lower risk of ovarian cancer, probably the most common reason some doctors give for removing normal ovaries at the time of hysterectomy. But this benefit was far outweighed by the cardiovascular risks conferred by removing the ovaries.
A surprising new finding in this study was an increased risk of lung cancer in women whose ovaries were removed. There is not obvious biologic reason for this, so it remains unexplained (and could be a statistical aberration).
The overall study findings were not surprising
Previous studies have found that removal of the ovaries confers increased risk of death from cardiovascular disease, which also occurs more frequently in women who undergo premature menopause. A decision analysis published in 2005 using data available at that time suggested age 65 as the cutoff for leaving the ovaries in place, since after that age, there was no added benefit. This more recent study suggests there should be no upper age limit.
What I found interesting in this study was that removal of the ovaries at the time of hysterectomy for benign disease did not appear to confer protection against future ovarian in women with a family history of ovarian cancer. This stands in direct contrast to well done prospective randomized data showing a clear benefit to prophylactic oophorectomy in this group. The authors suggest that their findings support a benefit from hysterectomy alone in preventing ovarian cancers, perhaps from a disruption of the influx path for potential carcinogens or changes in hormonal or triggering pathways. This would suggest that a randomized trial of hysterectomy without oophorectomy in women at high risk for ovarian cancer might be in order. (Currently, when prophylactic oophorectomies are done, the uterus is frequently kept in place.) It’s an interesting idea, but one that would need to be well-studied before suggesting anything other than current practice for these women.
Is there ever a reason to remove the ovaries?
Absolutely. If a woman has cancer of the ovary, the risk for death far, far outweighs any benefit to leaving the ovaries. (The exception is the young women with very early stage unilateral or borderline ovarian cancer – more limited surgery is generally offered to these women.)
Uterine cancer is also an indication for oophorectomy. Again, exceptions are often made in premenopausal women with early stage uterine cancers, and some of these women are being treated hormonally rather than with surgery. It will be interesting to see if anyone uses these study findings to recommend against removal of the ovaries in older women with very early stage uterine cancer.
I find the more difficult women to counsel are those having a hysterectomy for endometriosis with ovarian involvement, or for pelvic abscess or adhesions trapping a normal ovary and causing severe pain. For these women, the risk of continued pain and stress related to it, as well as the potential risks for additional surgery needs to be weighed against their risks for cardiovascular disease. The stress associated with chronic pain should not be minimized. For some of these women, removal of the ovaries may continue to be appropriate.
What if you’ve had your ovaries out?
It’s important to remember that oophorectomy is not the only modifiable risk factor for heart disease – diet, exercise, and treatment for underlying conditions such as hypertension and elevated cholesterol are just as important (and may be even more so). There is still an awful lot you can do to be sure you maximize your odds of beating heart disease as you age.
Oophorectomy is not the same as a hysterectomy
Hysterectomy is removal of the uterus. Oophorectomy is removal of the ovaries. Other than the risks associated with having surgery itself, hysterectomy alone does not confer an increase risk of mortality, and, unlike oophorectomy, does not increase long term heart disease risks. For many women, hysterectomy remains an important option for treatment of benign conditions such as uterine fibroids.
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Image from Wikpedia Commons
It’s a meal I never get tired of – the fish brunch. It’s the family meal you have when everyone gets together on a weekend morning, either for Mother’s Day (like today) or someone’s birthday, or just because you’re all in the same place at the same time.
I suppose every Jewish family has their version of the fish brunch, and this is Mr TBTAM’s family’s –
In the past few years, we’ve added an amazing item to the meal – lobster salad from Sable’s. Of course, it’s not Kosher, but neither is Mr TBTAM’s family. And I’m telling you, the stuff is like heroin…
Today we also had Nancy’s homemade yogurt (excellent with the kugel) and ginger cake with whipped cream for her birthday. If it’s one of the kid’s birthdays, it’ll be the chocolate chip cake. And if it’s Mr TBTAM’s birthday weekend, they’ll be a sour cream coffee cake instead of the Kugel. (One of these days I’ll have to post that sour cream coffee cake recipe…) A little fresh fruit is nice too.
How to make a fish brunch
You’ll need a supplier of fine fish. Sable’s and Russ & Daughter are our faves, but if we lived on the Upper West Side, it’d be Zabar’s or Barney Greengrass. If you’re in Philly, head to Abe’s & Sons. (Irene – feel free to add more recommendations in the comments.) If you decide to branch out and experiment with a new fish supplier, be prepared to discuss the relative merits of their whitefish salad compared to others you have known.
You’ll also need great bagels. For us, that’s H&H or Hot&Fresh Bagels or better yet, have Irene bring them up from Rolings Bakery in Philly. But bagels are a very personal thing, and you should buy the ones you love the best.
Finally, you’ll want to have a knock-’em dead recipe for Kugel. Make it that morning so it’ll still be warm when you serve it.
Serving the fish brunch
You’ll be serving everything except the dessert cake family style. Arrange the sliced Nova and sable nicely on a big platter. Warm the bagel in the oven and slice before serving them up in a big bowl. Cut the kugel into little squares and serve on a pretty plate. Serve the whitefish and lobster salads, herring and cream cheese in their plastic containers. (If it’s a special occasion, you can serve them in nice little bowls, but don’t get too carried away.) Bring out the coffee pot and OJ and call everyone to the table to eat.
Take your time eating, and be prepared to be asked repeatedly to pass something or other. Save some lobster salad for someone else.
Serve the birthday or coffee cake after you’ve finished eating, cleared the table and sat around drinking coffee for awhile. You’ll slice the cake up and serve everyone on a nice little plate. Have some more coffee
After the fish brunch
Clean up is easy. Put your dirty dishes in the dishwasher, wrap the fish well and distribute leftovers if anyone is heading out. If you’re still staying together for the afternoon, plan something nice to do together.
But don’t stray too far from a fresh water supply – you’ll be thirsty.
and once again, I am a bit late in submitting my entry to the Bulwar-Lytton Writing Contest. But since the deadline appears to be a floating one, I have nonetheless sent in this tasty little nugget for consideration as the worst opening sentence to a badly written novel –
The last person to see Eveline Massuer alive was her gynecologist, who, coincidentally was also the first person to see her alive, since he also happened to have been her mother’s obstetrician.
I think I may stand a chance at winning with this one…
I’ll admit, I’m not a ribbon sort of person. But this is one ribbon I feel compelled to display in support of journalist Roxana Saberi, who has been imprisoned in Teheran and convicted of espionage in a kangaroo court there. Both Hillary Clinton and President Barack Obama have demanded her release.
“Be not afraid of greatness: some are born great, some achieve greatness and some have greatness thrust upon them.”
Washington, DC has never looked more beautiful, and I never felt so proud to be an American as I did when spending time in this wonderfully cosmopolitan, cultural and international city. It’s a great place to take your kids, especially in their teens when they have a grasp of history and politics and can appreciate all there is to learn here.
Where we stayed
We stayed at the Melrose Hotel in Foggy Bottom, just two blocks from the Metro, a short walk from Georgetown and right on the Circulator and MetroBus routes. The Melrose is a not very large, older but nicely renovated hotel that is well-run by a small, attentive and friendly staff who became familiar faces to us during our 3 night stay. Most importantly for me, it was reasonably priced ($140 a night on Hotwire.com, with wireless an additional $10 and valet parking $35 a day), and had room windows that open (I hate being trapped in a room with no fresh air). The nearby Aroma Cafe, a small coffee shop with excellent croissants, sandwiches and coffee, was our daily breakfast stop.
What we did
We also saw the controversial Obama “Hope” collage – the original has beautiful graphic detail that the mass-produced poster does not capture.
The museum’s central enclosed atrium reminds me of the one at the the Chicago Museum of Art, and is a wonderful spot for an afternoon tea or coffee break. Located right across the street from the Spy Museum, so you could combine the two museums with lunch at one of several local restaurants, the Spy Cafe or in nearby Chinatown.
The Kreeger Museum – This former home of David and Carmen Kreeger was designed by architect Philip Johnson to house the Kreeger’s expansive art collection and provide a venue for the musical concerts the couple often hosted. The art collection is fabulous and varied, including Impressionists, Picassos and other modern paintings and sculptures, and a small African art room.
Where We Ate
More Americans visit Disneyworld each year than Washington DC. I encourage you to reverse that statistic and visit this wonderful city. I certainly plan to head back again soon. There’s so much we did not do.
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Great site for finding hotels near the Metro
Susan Boyle has taken what is probably the world’s only slot in the big time for an overweight middle-aged newbie singer. Good thing I kept the day job….
The Daily Record has unearthed that recording up there of Susan singing “Cry Me a River” for a charity CD in 1999. She’s no one-hit wonder.
Female circumcision leads to obstructed labor and birth trauma due to scarring of the genitals. I learned early in my career that if I was delivering a women who had had a previous clitorectomy, I needed to cut a good episiotomy, even if she had had prior children, because the scarred upper portion of her genital tract would massively tear at delivery.
The most tragic consequence of female genital mutilation is the formation of fistulas – holes between the bladder or rectum and the vagina that cause a woman to constantly leak urine or feces. It is estimate that over 200,000 women in Niger suffer from fistulas, which causes them to be ostracized by their villages and abandoned by their husbands. The risk for fistula is compounded among young women who are married and give birth in their teens – in Niger, half of all girls are married by age 15. Unicef is working to persuade the Niger government to raise the marriage age to 18. In the meantime, educating fathers about the health risks of early childbearing for their daughters has prevented early marriage in some families.
This sort of approach, which respects the dignity of villagers and uses education rather than punitive methods, appears to be effective in moving groups away from tribal customs that negatively impact the lives of women. Kudos to Unicef and other NGO’s involved in the campaign to end female genital mutilation.