Lessons learned by health insurance executive

We need to read this story and pass it to our friends and family. The art of medicine is different from the science of medicine. http://www.bloomberg.com/news/2010-12-24/my-wife-s-cancer-holds-lesson-for-health-care-commentary-by-david-klein.html

Hair Loss 101

When I write for this blog, it is often because I am inspired by real life events. Today, I am sitting in the hair salon, trying not to eavesdrop on a conversation that is taking place near me!
A client entered the shop. She seems to be new, and gives the owner a detailed account of her problem with her hair loss. Even if I could not hear her words, my eyes tell me what the problem is ( or at least what a significant part of it is). Client X wants to see if she can buy something to "make her hair grow". I get asked this same question EVERY DAY that I am in the office seeing patients.
What client X has in common with my patients , 9 times out of 10, is a pattern of hair care that is detrimental to keeping ones hair on ones head. First, the home permanent. Client X buys something from the beauty supply shop and puts it on. Even if she has advanced degrees in cosmetology, this is not a good idea once you are losing your hair. Stop. Walk away from the perm, even if it is labeled Kiddie Perm Safe For Newborns! It isnt.
Second, Client X seems to enjoy lighter, blonder, bleached hair. When you remove color from your hair you can count on it being weaker and more susceptible to breakage. Stop. Let Tina Turner have the blonde and you go back to being brown, black or some combination of the two.
There is some good, basic information about the common causes of hair loss in all women. I refer you to the American Hairloss Council, via the following link.
www.ahlc.org

Moles Before and After

BEFORE
AFTER

Every time I see a photo of Morgan Freeman taken in the last several years, I am reminded how much improved the skin looks when the moles, called DPN's are removed. The name Dermatosis Papulosa Nigra described these dark brown, warty growths that can be pinpoint or flat and as large as quarters, usually on the face, chest or back. Patients ask, "Why me?" The answer? Because you were born in your family. These lesions run in families, are genetic and you certainly do not get to choose your family!

The treatment is relatively quick and is done with topical anesthetic if necessary. Usually an ice pack is all that is needed. We dry the lesions with the quick application of an "electric pen" called a hyfrecator. The moles fall off later that day or in several days. No scarring is associated with the treatment if the patient follows the treatment plan....ie doesn't try to make the moles hurry up and fall off by scrubbing or exfoliating. If left alone to fall off slowly, the dpn treatment is not going to cause scars to form.

Ethnic Skin and Hair Care

Is there a secret formula for taking care of skin of color? I may alone in believing that there is not one secret, but many! As there is no ONE SIZE FITS all solution to the problems that my ethnic skin ( read, non white) patients present with. I mean, havent you ever put a "flesh colored" band aid on after an injury and then wondered whose flesh it was designed for?

I believe that as long as the correct diagnosis is made, then anyone with education and experience can treat skin of color. Yes, diagnoses can present differently in different skin types and the explanation is not always the difference in melanin. If you think only white patients will get skin cancer, then its hard to make the diagnosis when a dark skinned patient has a "funny looking mole". I had a teacher once tell me that there were only two diagnoses I could never make. The one I didn't know about and the one I did not think about!!

It is absolutely necessary to NOT put everyone, brown, black or white into the same stereotypical framework for practicing dermatology. If a patient is concerned about "dark spots" they are probably not going to undergo a treatment that will leave the spots darker afterwords. If a physician ignores the plea for help with the blemishes then that practitioner is likely to lose that patient! The differences are probably most apparent when discussing hair care with patients who straighten their hair. Products that dry the hair more, or require frequent shampooing will not be used and there is a good chance that the patient will seek help from someone who is knowledgeable and experienced with hair that may be breaking due to hair styling methods.

Younger Looking Men?

It is no longer an unusual day when several new patients are men who "want to look better". While patients of both sexes usually want help with diseases or disorders ( ie non cosmetic issues), it used to be the norm for women to ask for my help with changes in appearance . The man will ask, what can I do to make these marks go away? I used to have acne and I don't now but the scarring is really not attractive so what do I do?
Another frequent question men ask is "what can I do to get rid of shaving bumps"? The answer, if you aren't ready to grow a beard, may be laser hair removal. It takes at least six treatments, spaced 3 to 4 weeks apart. Even if some of the hairs regrow, they are usually miniature versions of themselves (vellus hair) that will not grow inward causing shaving bumps.
The third issue that brings the guys to the office is complexion blending or "getting rid of the dark spots". Darkness caused by hypertension medicines, sunlight without sunscreen can make some people look old before their time. We prescribe creams or make other suggestions to turn back the clock, or at least, keep it from ticking so loudly! I am glad that so many men are trying to look as well as they can for their age. Its really not about the pursuit of YOUTH as much as the quest for being attractive at any age!