Antibiotics for Chronic Low Back Pain??? Really???

Okay, this is, in my humble opinion, pretty damn interesting.

For years, I’ve felt (and discussed with my patients) my belief that there is just something fundamental that we (the collective “we” of the medical community) are missing when it comes to understanding back pain.

One of the fundamental truths of medical practice is that whenever you see a lot of different treatments being used for a problem, most likely all of them have pretty darned similar less-than-stellar results. It makes sense, when you think about it. If there was one treatment that had great results and stood out from the rest, well then that is the treatment that would be used almost all of the time. Since however, treatment A is little if any better than treatment B, which is little if any better than C, and D, etc., oftentimes the choice of treatment ultimately boils down to individual preference based upon factors such as where one trained, statistically insignificant anecdotal experiences, etc.

Well, back pain is a lot like that. Lots of different types of medical (and pseudo-medical) practitioners out there seeing patients for back pain, doing lots of different types of “treatments”, and for the most part results are pretty similar, and often pretty disappointing.

Fortunately, for acute back pain, most of the time, it gets better regardless of what is done or isn’t done. This occurs in about 90% of cases if I recall correctly (and I’m too lazy to google this right now). There are some general guidelines out there for conservative care, that if followed seem to work out pretty well for most folks, regardless of whether they go see the family medicine doctor, the neurosurgeon, the chiropractor, the school nurse, the local voodoo specialist, the massage therapist, their priest, etc., or if they go see nobody at all. It just gets better in most cases. In most cases it just doesn’t make a damn bit of difference.

Now that isn’t to say that if you have acute back pain you should avoid going to the doctor (If you’re wondering if you should go see your doctor for this, or any other cause, go see your doctor!). “Most” is not synonymous with “All”. Every once in a while, acute back pain is from some particular specific cause that may indeed respond quite differently depending upon what is or is not done for it. I know I’m biased as a family physician, but I think this is one of the great values of have a good relationship with a primary care doctor. He/she can help separate the zebras from the horses.

Anyway, it’s all well and fine to say “Thankfully most acute back pain will get better.” But what about those cases that don’t get better? What about those folks who go on to develop chronic back pain? Well that is a different kettle of fish altogether.

Chronic back pain is serious business. As with acute back pain, there is a veritable slew of various people offering all sort of treatments, etc. A lot of people suffer for great lengths of time. A whole lot of loss of quality of life, productivity, money,…you name it. People desperate for relief often find themselves repeatedly on the operating table being cut open, developing dependence upon habit forming narcotic pain medicines, etc. It really can ruin people’s lives. Some folks fortunately get relief with surgery, but for too many, their problems get no better and/or only get worse. It can lead to long term disability, loss of income, destroyed relationships, etc. It truly can be tragic.

As I mentioned at the start of this post, I’ve always been bothered with the nagging feeling that when it comes to back pain “We just aren’t getting something.” Heck, most likely it’s more like we just aren’t “getting” a bunch of somethings. I truly believe that when it comes to back pain (and a whole lot of other stuff), someday in the future, people will look back upon those of us practicing medicine today and snicker a bit, marveling at how stupid and silly we are about a lot of things. We do this ourselves, smugly looking back upon medical practice a century or two ago and laughing at some of the silly notions they had, so I suppose it is only fitting that folks in the future do the same to us.

So, what’s the point of this post? Why, after a pretty long period of inactivity has Dr. Sam decided to bother to log onto his blog and blather on like this?

It has to do with this article and this article.

You can go read them for yourselves (and I recommend you do, as it is quite fascinating), but in a nutshell, some (awesome) folks in the frozen north (Denmark), spent years looking into the possibility of bacterial infection being behind a substantial number of cases of chronic low back pain, and it looks like their hunch was correct. This is a BIG DEAL folks!!!! In that second article linked, it shows how they were able to successfully treat a pretty substantial number of chronic low back pain sufferers with a simple antibiotic.

This reminds me a lot of the story of the Aussie doctors who proved that most stomach ulcers are related to a bacterial infection (Helicobactor pylori). Completely changed the practice of medicine.

If this chronic low back pain stuff pans out, it too will be practice-changing and will make a HUGE difference in the lives of a HUGE number of people. Kudos to our Danish friends!!! I agree with the brit doc quoted in the first linked article who was talking about this stuff being potentially Nobel Prize worthy.

Anyway, go read the linked articles. This is good stuff!!! Yay Science!!!



Makes a great Christmas Gift!

Do you want to get a great Christmas gift for book lovers?

If so, then you should definitely go grab a copy of Liberty Frye and the Witches of Hessen, by J.L. McCreedy!

This is a modern-day fairy tale about a young girl from Mississippi who gets lured to a foreign land over her Christmas break, to meet relatives she never knew existed.  Unbeknownst to her, this is all part of a sinister plot by an evil witch and our heroine, Libby, falls right into her clutches.  Libby will have to rely on her wits and courage, and just a bit of luck if she hopes to save not only herself, but also those most dear to her.

If you’re looking for a fun and exciting Christmas thriller, then I can’t recommend this book strongly enough.  Available in both print and Kindle versions!

Go get your copy today, and remember to include it in your holiday gift shopping list!


Liberty Frye and the Witches of Hessen getting some notice

I’ve mentioned before that my wife has self-published her novel, Liberty Frye and the Witches of Hessen (link for it to your right. Go get your copy today!).

Well, in the vast sea of self-published books, it is difficult to get noticed, but her wonderful story is slowly starting to get some notice.

In April, it was featured at Note Worthy Releases. The reviewer (the site owner’s 15 year old daughter)  there had the following to say.

Four out of Five Stars –

I loved it, couldn’t put it down! I liked the innocence of the main character Libby.It is a very original story, fast paced and exciting. It was funny in some places that made me laugh out loud. The author created a magical and breathtaking world. I would love to see a sequel.

Thanks for such kinds words towards my wife’s story and I couldn’t agree more!

If you like to discover new authors and aren’t afraid to step into the world of exploring indie authors, you should really go pay a visit (or twenty) to Note Worthy Releases today.  It’s a great site that features a lot of great writers!  Thanks to Dawn Smith, who runs the site!  You’re doing a great job!

I also want to take a moment to say thanks to Glenn Reynolds who runs the Blog.  I’ve been a long time reader and fan of this blog and last week I sent an email to Glenn asking if he wouldn’t mind mentioning my wife’s book on his site.  He most graciously did mention it, and that day was by far the busiest sales day for my wife’s book at Amazon.  Thanks Glenn!!!


More Stem Cell Stuff

University of Georgia and Department of Defense have developed a gel the call “Fracture Putty” which contains stem cells. So far in lab rats, it has shown dramatic improvement in healing of fractures.

Read about it here

As a physician, I’m pretty excited about all of the recent stuff I’ve been seeing about stem cells.

I’m really hoping some of this stuff makes it into mainstream medicine soon.


Tropical Storm Jasmine

I get it.  This is the tropics and this is hurricane season in the Southern Hemisphere.

Still, this constant rain is starting to get a bit old.


My Awesome Wife Is Publishing Her Novel

As (both of the) regular readers of this blog know, my wife and I left the United States about a year ago in order to go live overseas for a while.  We had quite a few reasons for doing this, but overall, it was a desire to get out of the rat race of middle class America for a while and sort of “reset” our lives a bit.  We did this once before when we moved to Germany for a year and after being back in the U.S. for five years, we were overdue for a change.  So, in a bit of a whirlwind, we packed our bags, put our house on the market, and moved to a tiny island nation in the South Pacific.  To say the pace of life here is different than it was in the U.S. would be a bit of an understatement.

I’m still practicing medicine, but my patient population is quite a bit different than it was back in the states.

My wife is still doing consulting work for her clients back in the states (via really really slow and unreliable internet), but has scaled this back dramatically in order to pursue one of her main dreams in life, which is to be a writer.

She’s just put her debut novel “Liberty Frye and the Witches of Hessen” up on Amazon via the Kindle Direct Publishing program, and although my opinion is obviously somewhat biased, I gotta say I think she’s written a great story.

She got the inspiration for this story while we were living in Germany and walking and riding our bikes through the old stomping grounds of Jacob and Wilhelm Grimm (i.e. the Grimm Brothers).  A lot of people don’t realize that the original Grimm Brothers’ Fairy Tales were not the sugary cartoons full of sunshine and lollipops that were presented to us as kids.  In reality, the original tales were full of horrible people and terrifying creatures doing unspeakable things.  In a word, they were scary.

This story of my wife’s sort of returns to those original fairy tale roots a bit, but at the same time she keeps it just tame enough to be safe for kids to read (or have it read to them) without having bad nightmares.

If this sounds like a story you’d like to check out, just hit the link at the upper right of this page.  Amazon Prime members can download it for free via the Kindle Library Lending Program.  For everyone else, it’s still a heck of a bargain!

So go check it out and if you like the story as much as I do, leave some positive reviews for it and tell your friends, etc.  My beautiful wife would like to do this writing thing full time and I’d love for her to be able to do so.




Attacking Leukemia with T-Cells

A report published today in the New England Journal of Medicine details a potential new treatment not only for Leukemia but for other cancers as well.

Go read the full report for further details, but in a nutshell, researchers at Univ. of Pennsylvania harvested T-cells from patients with Chronic Lymphoid Leukemia.  They then genetically modified them to target the cancer cells, as well as modifying them so that, unlike in previous similar trials, the modified cells would proliferate and persisit in-vivo.  They then transfused the cells back into the patients.

While this is a VERY small trial, the results were beyond delightful. 

Lets hope the better funding they are almost certain to receive leads to something remarkable.

Kudos to science!!


Well Damn!

Although Mrs. DrSam and I have set sail on the lifeboat and are no longer residing on the Mississippi Gulf Coast, we still consider it home and are saddened whenever we hear of folks having a hard time there.

First Hurricane, Katrina, then the BP Oil Spill, Now the Oyster Harvest is getting drowned by Mississippi River flooding in the Mid-West.

To all my former neighbors getting hurt by this, I wish you only the best.  Here’s hoping you guys catch a break soon.  You’re long overdue!


Beer Washed Pillow Cases. Hmmm.

I just read an interesting post over at the Geeky Housewife blog.

Apparently she read in some magazine from Rachel Ray that if you wash your pillow cases in diluted beer, it’ll help you sleep better at night.  She is planning on conducting a home trial herself.

The very thought of thus wasting perfectly good beer already has me thinking I’ll probably be losing some sleep over this.  Here in the lifeboat, beer is a precious comodity and not to be wasted!

She also says that the article claims that the beer must be a “hops variety”. While I’m not a dogmatically strict prosthelytizer of the Reinheitsgebot, I do feel that if it ain’t got at least some hops involved, it ain’t really beer! (Now I know that some shiners also use the term “beer” to refer to the fermented mash prior to distillation, but we all know that ain’t the sort of beer we’re talking about here.)

Having not read the magazine article myself, I’m assuming they’re recommending a beer that has a more pronounced hoppiness such as an IPA , for instance.   These guys occassionally make some stuff that’s hoppy enough to erode the enamel off your teeth.  Just kidding.  But yeah, that’s a hoppy beer.

Rather than watering down and diluting beer for this purpose, I think the housewife should just save some time and use straight Budwiser or one of it’s many watery clones (Corona, Miller, PBR, Coors, etc).

Anyway, I am looking forward to reading the promised report of her findings from her home trial.


Hot Coffee and Hot Tea May Protect Against MRSA

This is an interesting study that was recently in the Annals of Family Medicine.

Basically, the researchers wanted to find out if there was any association between drinking Hot Tea and/or Hot Coffee and levels of nasal colonization with MRSA.

Their findings do suggest that drinking Hot Coffee and/or Hot Tea may decrease the likelihood of nasal MRSA colonization.

I think it would be premature based on this study to draw anything conclusive, particularly with regards to the “Why” of any such protective effect, but it’s an interesting study nonetheless, and I think one that warrants further investigation.


Onomatopoeia is when a word sounds like that which it describes.  Examples might be “Buzz” or “Rustle” or “Meow.”

I don’t know if there is a similar word which labels that which happens when a person describes something in such a way that his very description ends up being an example of that which he describes.  It’s sort of like circular logic in a way, I suppose.

Anyway, I observed this phenomenon in defintion number two for “Speak Truth To Power” over at  It made me laugh.  Those on the left may not find it so amusing.  Of course, power rarely does when having truth spoken to it. 🙂


Remote Control Endoscopy Camera

Researchers in japan have developed a remotely controlled miniature camera that can be used for endoscopy.

It looks a bit like a tadpole.  It appears very similar to the “capsule endoscopy” cameras that came on the scene several years ago.  With those, you basically swallowed a camera that was encased in a clear pill shaped container.  This thing passively moved along your gastrointestinal tract snapping pictures until you pooped it out.

With this new gizmo from Japan, it’s not a passive journey.  It has a little mechanical tail sticking out of it with which a doctor using a joystick can control it and basically pilot it through your GI tract.

It can apparently be inserted from either end….i.e. via your mouth or your “other end”.

According to this article, it was originally tested on dogs and is now ready for us.

Some potential advantages I see are the ability to get pictures within places not really reachable with current endoscopes…i.e. the small intestine, and also, I would imagine this procedure would likely need less anesthesia/sedation perhaps.

The potential negatives I see are 1. This thing getting stuck somewhere and requiring surgery to remove and 2. This thing causing a perforation, illeus or intususception.

Still, overall it looks like a pretty cool device to me.

FDA Chantix Warning

And right on the heels of my last post about the FDA warnings on Actos and Avandia and the inevitable lawsuits to come….here’s a new FDA warning about Chantix and increased cardiovascular risk.

Chantix lawsuit anyone?

Here’s my page on Chantix from a couple years ago.  Enjoy.


FDA Warning On Actos

The FDA has come out with some new warnings about Actos and it’s association with bladder cancer.

You can read about it here.

It wasn’t too long ago that they came out with warnings about another drug in the same family, Avandia. That one has serious cardiovascular concerns.

I’m sure it won’t be too long before we start seeing a bunch of advertisements from lawyers wanting you to join lawsuits related to Avandia and Actos.

I know lots of doctors will fear being named in these lawsuits related to Avandia and Actos and will stop prescribing them.  It’ll make life a little more difficult for the drug reps who are tasked with convincing doctors to use these drugs.


Lifeboat Calling

Hi Everyone! I’m still alive.

I realize I haven’t posted anything in what seems like forever. I think the last time I posted, the Saints had just won the Superbowl and as expected Hell froze over.

As some who know me know, I’ve long used the analogy of building a lifeboat in case the metaphorical ship I’m a passenger on goes down. That “Ship” basically represents life in America, life as a primary care physician in America, etc.

Well, over the past couple years, construction on the “lifeboat” has been in full swing. Finally a small prototype was felt to be ready for a test run about a year ago, and it was finally “put in the water” back in February of this year.

So far, the test run is going pretty well, and life is good floating out here in the middle of the Pacific Ocean.

Those who know me well, will understand all of the cryptic talk in this post.

Those who don’t know me well really ought to get to know me. I’m a nice guy, and I just might share some “lifeboat” plans.



How ‘Bout Dem Saints!!!!!


After many long years of hoping, praying, rooting, and ultimately echoing the chorus of “Just wait til next year!”, I am delighted to observe that “Next Year” has finally arrived!!!!

 What an awesome game to cap an awesome season.

 Way to geaux Saints!!!!  Way to Geaux!!!!

 Who Dat? Baby!!!!

Jim Morrison and Debbie Harry Collaboration. Who knew?

Just cool stuff here.  I like it.

Putting things into perspective

Dr. Crippen at NHS Blog Doctor has a pretty good post today.  (Well actually, he often has pretty good posts, but I sometimes have trouble getting through his British accent. 🙂

 Take a look here.

Ha ha ha. I know how you feel dude!

Is Multiple Sclerosis Caused By Low Vitamin D?

It has long been known that genetics and environment play a part in risk of developing MS.

It has also long been known that risk of MS goes up as people live further and further from the equator.

Now a study has come out showing that proteins activated by Vitamin D interact with genes on Chromosome 6 that have been shown to have the strongest effect on development of MS.

Specifically, people carrying a copy of the gene variant DRB1*1501 are more likely to develop MS.  Those carrying two copies of this variant are even more likely to develop this devastating disease.

This study suggests that the aforementioned proteins that are activated by Vitamin D bind to the DNA sequences adjacent to the DRB1*1501 gene and alter it’s function.

On the surface at least, this seems to make sense.

Adequate skin exposure to particular wavelengths of ultraviolet radiation in sunlight is a major source of Vitamin D in humans.  Folks living further from the equator tend to get less of this exposure, and tend to have lower levels of Vitamin D.

So, it certainly would not surprise me if Vitamin D is playing a role in the increased MS risk seen in these folks.

You can read more about this study here.

There is a lot of debate regarding Vitamin D, effects of low levels, appropriate testing guidelines, appropriate guidelines for “normal blood levels, appropriate treatment of high levels, etc.

Perhaps, if there is any interest, I’ll devote a future post to some of these issues.

How ’bout it readers?  Would you like to see a more detailed post about Vitamin D?



Sometimes You Just Shake Your Head In Amusement


The sad thing is that around here, this thing might actually work!

I think I’m Starting To Understand Joe Biden’s Enthusiasm

Saw this story when reading the news this morning.

It’s a story that I couldn’t help smiling at.  Basically it talks about all the hanky panky that is going on at The Villages.

To those who have never heard of The Villages, it is basically a gigantic gated retirement community in Florida, where wealthy older folks can spend their golden years hanging out by the pool, golfing, and apparently, according to this story, engaging in all sorts of lascivious behavior.  And why the heck shouldn’t they???

Dr. Sam says “Good for you Granny!”

Anyway, the story immediately made me think of this video that was making it’s rounds on the interwebs a few months ago.

Glad to know we have such sober leadership taking over in D.C.

He, She, It. Which is it???

Story here


Thanks, Dude!

I had a patient today tell me that he actually read fully my posts about weight loss and was putting the stuff there into action.

He even downloaded a program called Lose It for his iPhone that was helping him keep track of calories and weight.

I don’t own an iPhone, but he showed me his and the program looks pretty cool.

So far (only a couple weeks) he’s loosing weight right on track.

That was pretty gratifying.

Thanks, dude!

More Natural Cures for Blood Pressure

Hi Folks,

I know it’s been about forever and a day since I posted anything here.  Sorry about that.  No real excuse other than life just keeping me a little busy.

I keep telling myself, “Self, you need to get busy and post some stuff!”

Every now and then, I’ll see some news story or something and think to myself that it looks like a good topic for a post, but then it seems I get distracted and it slips into faded memory.

Anyway, I saw this interesting story about blood pressure and it gave me a bit of a laugh, so I thought this was as good a topic as any to break the drought of posts.

Enjoy.  Sorry for the smell.

I’ll try to do a better job with updates!



Smart bird!

Calico CatNot sure why exactly, but this story really made me smile

Lost Parrot Gives Vet His Name and Address

It made me think of an experience my wife and I had during my medical school days in Jackson, MS.

One day, my wife came home and discovered a calico cat on the front porch of our house. It was a really beautiful cat with an extremely sweet disposition.

She petted it a bit and then went inside, figuring it belonged to a neighbor and would go home soon.

Well, the cat continued to stick around….for a day or two, so we decided to see if we could track down it’s owners.

It had a collar with a rabies vaccination tag.

So my wife called the veterinary clinic that was listed on the tag to see if they could use the tag number to locate the owner.

The clinic was located in south Jackson in what is essentially a nearly exclusively African American neighborhood.

The receptionist answering the telephone took the tag number from my wife and put her on hold while she looked up the owners name in her records.

A few moments later she came back on the line and my wife heard her say “That’s not yo’ kitty.”

My wife responded “Oh, I know she’s not mine. That’s why I called you. I found her on my porch and I’m trying to locate her owner.”

My wife heard her start giggling and say “No, that’s not yo’ kitty.”

Realizing she was not being understood, my wife responded, speaking a little more slowly “I know it’s not my kitty. I’m trying to find out whose kitty it is.”

They went back and forth like this a few more times with the receptionist getting increasingly giggly and my wife getting increasingly frustrated.

Finally, the receptionist between giggles cleared things up by telling my wife, “You don’t understand. I’m trying to tell you the cat’s name. Her name is ‘Nacho-Kitty.’   If you bring her down to the clinic, we can contact the owner for you and return their cat to them.”

(Maybe you had to be there, but usually when my wife tells this story, people give her a funny look.

I think maybe in our overly-P.C. society they think she is being racist and making it up or something, but my wife is by far the least racist person I have ever known. I honestly know nobody with a more pure, kind, and accepting heart.

She’s just relaying the story as it happened.)

HT for the parrot story to BadHabit.
Picture credit.

Dr. Sam’s Modest Proposal (with apologies to Jonathan Swift)

You know, this whole sub-thread just gave me a great idea.

Everybody keeps complaining about the cost of health-care.

How bout if the govt just starts giving me a check every month to NOT see patients.

I’d give them a deep discount. They could pay me say 50 bucks for every patient that I don’t see, as opposed to what those patient visits would otherwise cost, which would usually be greater than 50 bucks.

So the govt. would save money on every patient by simply paying me to NOT see them.

If they agree to this, I could really ramp up my productivity a lot too.

I bet that once I get in a groove, I could probably NOT see at least a thousand patients a day.

I think I’ll write this up as a proposal for a demonstration project and submit it to Medicare.

Where’s your face?

Mail BoxDear Doctor Sam,

Why don’t you show your face on your website. What’s up with the pictures of the back of your head?



Well Curious, that’s a great question.

Other than the obvious answer which is that my face ain’t all that pretty, it’s all about preserving the thin veil of anonymity.

I know it isn’t much of a veil and that any truly determined person would have very little difficulty discovering my identity, but it’s something at least.

Let’s face it, there are a lot of nutjobs out there who might not like some opinion I write or whatever and I really don’t want some potential stalker or axe-murderer to know what I look like.

I suppose it could be argued that an axe-murderer would likely sneak up behind me in order to strike his blow and that I therefore am showing him exactly what to look for by showing the back of my head, but I guess that’s just a chance I’ll have to take.

Anyway, there’s no super secret here. Maybe someday I’ll reveal my full name and face, but for now, I prefer to maintain a little bit of privacy.

Hope that satisfies your curiosity!



Ask Dr. Sam

Mail BoxHi Folks,

Sorry it’s been a while since I’ve posted anything. I guess I’ve been a bit busier than usual recently.

Also, quite frankly, I just haven’t had much inspiration.

I did do a brief addition to the disease index with an article on Erectile Dysfunction, but otherwise, has been a pretty quiet place the past week or two.

I had hoped by now to have more articles in both the disease and medication indexes, but I think perhaps I’ve been a bit too ambitious here. Writing these articles is pretty labor and time consuming and there really is a virtually unending number of diseases and medications to cover.

All of this has caused me to do some thinking about the direction of this website.

One thing I find myself doing a lot of is answering people’s questions. This occurs in my clinic, on the internet, and just in my general life itself. People ask my advice and opinions on all sorts of things, not just their health care. In large part, this dynamic was some of my motivation for starting this website.

One of my main goals was to cut down my work over time. Rather than verbally answer the same questions over and over, I figured I could just create a website where I could put that information and then refer people there to find their answers.

In reality however, I find that this has increased my work. Now I am writing articles and still having people ask me the same questions. I also find myself receiving emails at my address from folks seeking my advice.

Until now, I’ve typically just been engaging in private correspondence with these folks by replying to their emails.

It dawned upon me however that some of these questions and queries for advice I receive might benefit others who read this blog so I thought I’d create a new blog category and occasionally post these questions and my responses to them as actual blog posts. I’ll call this category “Ask Dr. Sam”.

The beauty of this concept I think is that with the ability to leave comments on blog posts, other readers can also chime in with their input and advice.

The other thing that dawned upon me is the idea that perhaps other folks might like to try their hand at writing some articles for the disease and medication indexes.

I’ve already got some examples of the sort of format I’d like these articles to take. The goal with them is to put information in simple easy to understand words so that the average person can educate themselves a bit.

So what do you folks think?

Any of you interested in trying your hand at writing some articles?

Any of you interested in getting my thoughts on some particular subject?

If so, just shoot me an email at

If you submit an article or a question, I’ll take a look at it and if it seems like something appropriate for this website, I’ll publish it for you.

For the articles, if you wish to remain anonymous, then let me know. If however, you wish to receive credit for your work, I’ll be glad to put your name on it.

Anyway, I look forward to hearing from folks and seeing how this pans out.

Until then, cheers!


More On Spam (or should I say Moron Spam?)

Turkey SpamThis is a pretty new blog and I am a relatively very new blogger.

When I started this website and blog, one of my main goals was to simply expose myself to this cyber-world and get some experience and learn a bit about creating internet content.

Many/most of my blog posts have been excessively wordy, but I realize that this is part of my learning experience. All of them have been heartfelt. All of them represent countless hours of research and work.

As with most new blogs, my internet traffic has been less than stellar. This hasn’t really surprised me too much.

I read one statistic that stated that there are approximately 175,000 new blogs started every day. So, I know that no matter how great a writer I might be (which I know I am not), it’s going to take some time to get any sort of meaningful traffic.

So, with all that in mind, I must say that I was somewhat amused with my most recent post which I put up a little over a week ago. It was the one titled Fax Spam in which I briefly talked about an annoying though somewhat humorous fax I received advertising some sort of male sexual enhancement product being sold at the website

Of all my posts, this was the one I put the least effort or thought into. It was just a brief little blurb I typed out in about 10 minutes for fun.

Wouldn’t you know, it has garnered more traffic so far than all my other posts combined.

My traffic is still certainly pathetic, but this was a real head-shaker.

The most fun part of the whole thing was in the comments section of that post. I have learned that there are definitely some real loons out there in internet land.

Anyway, I thought I’d try a little experiment here and provide a small sample of the email spam I have received today just to see what happens.

If you are reading this, then thanks for your participation in this experiment in human behavior.

Here goes.

This first one is a spam email I received from “Anita Kaiser“. It’s subject line is titled BEST PRICE ! Buy Cialis, Viagra online NOW – and save 50% your money !!!

The body of the email reads as follows.

Hello !

Now you have the opportunity to save your time and money!

With US based online p,h,a,r,m,a,cy store you can buy any meds you

Forget about p/r/e/s/c/r/i/p/t/i/o/n/s and doctors. Now you save your

Forget about high prices at local stores.

M/e/n/’s H/e/a/l/t/h
A/n/t/i – D/e/p/r/e/s/s/a/n/t/s
P/a/i/n R/e/l/i/e/f
W/e/i/g/h/t l/o/s/s

Go visit:


Next in our experiment is the following spam email I received today from “Ernest Calloway“, though his return email address is

By the way Brian, if my publishing of your email address generates some spam for you, well you know, Karma.

Anyway, the title of Brian’s, er I mean “Ernest’s” email is “re: (no subject)

Ooh, now that’s original. Hey, do you think he was trying to fool me into thinking he was actually responding to an email I sent him? Oh Ernest, you’re so clever!

Anyway, the body of his email reads as follows.

Hey, want to get those bills under control for good, it’s easier than you think. We will help you.

Go here this is your solution.

Now, after “Ernest’s” scintillating email, I was really looking forward to the next one which looked suspiciously familiar. Its subject line was very similar to the one Ernest sent. It was simply titled “(no subject)” and was sent to me by Louise Hinson. Interestingly, like Ernest above, her email address,, didn’t really seem to match up with her name.

Oh and Sara, that Karma thing applies to you as well.

The body of her message is where she and Ernest bore the most striking resemblance however and it was as follows.

Hey, want to get those bills under control for good, it’s easier than you think. We will help you.

Go here this is your solution.

So these are three little slices of spam I’ve dined on today and thought I’d share them with you. I’m curious to see what sort of response they generate.

Let’s see!!



Fax Spam

Fax SpamWow.  This was a new one for me.

About 20 minutes ago, this came over the fax machine at my clinic.

I know the picture quality isn’t so good as I took the pic with my cell phone camera, so I’ll type what is written.

It is a fax from LBI, INC. of Toronto, Canada and was sent by “Tod

The subject is “Re: our last conversation

Under the comments section it says

“Sorry, my cell battery went on me.

The pills I use Work Better than Viagra & you don’t need a prescription because it’s herbal.  That alone saves you $100 for a doctor visit.

This website gives out FREE samples


I’t very, very effective, you’ll be happy you tried it.  The Free Sample offer can end anytime so I’d get it now while you can.”

For what it’s worth, I don’t know Tod, nor have I had any cell phone conversations with him.

At the risk of revealing too much information, I will also state here for the record, that I have no personal need for any product of this sort.  The plumbing is still fully functional so far!

I know a lot of folks routinely receive this sort of spam via email on a regular basis. This is the first time I’ve ever received any via the fax machine, however.

Since I am the only male working in my clinic, the girls all had a good laugh and told me that this fax was obviously for me.

I’d sure like to know who gave Tod our fax number.

You can’t really see it in the picture above, but Tod has wisely blocked his number from appearing on the fax copy.

Anyway, hope you all have a laugh at this, and I hope this isn’t the first in a new wave of spam.

On a positive note however, perhaps this is just the sort of thing to drag the medical profession kicking and screaming into the 21st century and convince us all to get rid of the fax machines.



In a Vial, Crocodile

SchnappiI saw a sort of neat story on the BBC News website about researchers in Louisiana who are taking proteins from alligator blood and trying to use them to develop new antibiotics.

Other than handbags and good eating, alligators are mostly just a bit of a nuisance in these parts.

I think it would be great if these researchers are successful in their quest.

Of course, natural selection being what it is, I’m sure that MRSA (Methicillin Resistant Staphylococcus Aureus) would likely eventually evolve into GRSA (Gator Resistant Staph Aureus).

By the way, the picture above of the little alligator is one I took back in 2003 at the Dauphin Island Sea Lab Estuarium.

He always sort of reminded me of Schnappi, the darling of German MTV, when my wife and I were living over there in 2004-2005.

(Oh, and before some smarty-pants feels the need to correct me, I do know the difference between alligators and crocodiles, but “See ya later, alligator” didn’t seem nearly as original for the title of this post.)

It’s a Teenage Wasteland

Teenage wastelandI think I’ve mentioned it before in other posts in this blog, and I tell it to my patients all the time. It bears repeating here.

The overwhelming majority of the stuff I tell my patients when it comes to staying healthy doesn’t require the letters “M” and “D” after one’s name.

Most of this stuff is basic common sense that the average fifth grader knows. Eat your vegetables, get enough sleep, exercise, don’t smoke, don’t do drugs, don’t sleep around with scuzzy strangers, etc., etc., etc.

I’d say probably 95% of what I do as a family physician falls into this category. (Now that other 5% however, well, that’s a different story. That other 5% represents years and years of hard work in medical school and residency and clinical practice experience.)

Anyway, there was an interesting article in the April issue of the journal Pediatrics titled Characteristics Associated With Older Adolescents Who Have a Television in Their Bedrooms.

The conclusions in this article seem to fit very nicely into my 95% “Duh, a fifth grader could tell you that,” category.

Basically, they compared older teenagers who had televisions in their bedrooms with those who did not.

In the words of Gomer Pyle, “Surprise, surprise, surprise!”

What they found was that those with televisions in their bedrooms tended to watch more television, have less physical activity, lousier eating habits, etc.

So parents, here’s a no-brainer for you: Do your kid a favor and get the television out of their bedroom.

Okay, so now here’s an even bigger no-brainer for you. Get the damn boob-tube out of your own bedroom as well.

Want to take it even a step further? Get the darned thing out of your house altogether.

Okay, I realize that may be too big a step for most folks. If it’s too big a step for you, then at least turn it off once in a while and go get some exercise.

(In the interest of full disclosure, I will say that my wife and I do have a television in our living room, but we almost never watch it. We used to have cable service, but we decided to have it disconnected about a year ago. We don’t have any sort of antenna and therefore we have absolutely no channels to watch.

I have to say, I’ve never been happier. We are saving money by not paying a cable bill and our lifestyle is much healthier. We eat better, exercise more, read more, interact with each other more, you name it. We do occasionally rent a movie and watch it, but our television otherwise remains off. We have no intention of ever going back!

I highly recommend this to anyone reading this blog.)



Hands Only Cardiopulmonary Resucitation (CPR)

L’Inconnue de la SeineThere was an interesting story on MSNBC.COM about hands-only CPR.

As a physician, every two years I get re-certified in Basic Life Support (BLS), which is essentially what most folks know as CPR,  as well as Advanced Cardiac Life Support (ACLS), which is essentially what they try to portray in shows like “E.R.” when everyone is dramatically yelling  stuff like “Give him an amp of epi, stat!”.

Since finishing residency, I no longer practice any obstetrics (for reasons discussed in my medical liability and malpractice reform blog post), so I no longer get re-certified in Advanced Life Support in Obstetrics (ALSO).

I have never gotten certified in Advanced Trauma Life Support (ATLS), which is something that the surgeons and ER docs all get certified in. I don’t do ER medicine, so I haven’t really been able to justify the extra expense and time involved with getting this certification. I keep thinking perhaps I will get it someday though, as moonlighting in the local ER may be something I’d like to pursue in the future.  For now though, I’ll leave the chest tubes and tracheotomies and such to others. Continue reading ‘Hands Only Cardiopulmonary Resucitation (CPR)’

Please Quit Smoking

Hi folks.

I still haven’t finished my series on health care reform which starts with A Plan For Intelligent Health Care Reform Part 1, and continues with parts 2-4. There are indeed more parts coming, but those posts tend to run long and are somewhat labor intensive not only for me to write, but I’m sure for you to read.

Also, mine is not a blog dedicated solely to health care system reform, but rather has a mission to touch on many more topics. I don’t want folks who are looking for advice on how to stay healthy, or who are looking for commentary of recent medical news and breakthroughs, etc. to get turned off of this blog by encountering a never ending stream of posts containing my long-winded pontifications about how to fix a health care system so broken that it’s repair has been the dominant topic of every presidential election for the past two decades.

So, this brief post will not be about health care reform. Rather it is a follow up post to my previous stop smoking post. This is probably my shortest post so far I think. It is here really to just provide you with a link to another blogger whose writings I find valuable and enjoy reading. He has written a post titled Smoke Scream.

If you are a smoker and are contemplating quitting, please read this post. I sincerely hope it will help influence you to quit.

That’s it for this post (told you it was short). More health care reform pontification coming up soon!



What you eat does matter!

whole wheat pasta and vegetablesHuh, this post title sounds different than what you emphasized in your last two weight-loss posts Dr. Sam?

I thought you said it was all about the calories.”

If that’s what you thought, go read those posts (The Hacker’s Diet and How to Lose Weight) again, a little more closely.

What I was emphasizing with those posts was that when it comes to losing weight (fat), it’s primarily all about the calories you consume.

I don’t want this message however to be misinterpreted as saying something along the lines of “As long as the calories are where they need to be, eat whatever the heck you want.”

That is most definately NOT my message.

Continue reading ‘What you eat does matter!’

More on How to lose weight. The Hacker’s Diet


If you remember in my How to lose weight post not too long ago, I gave you the zero dollar answer to that million dollar question.

That post ended up being about the equivalent length of a 13 page Microsoft Word document.

It seemed to me like an awful lot of writing to get across my basic message regarding fat loss, a message which is virtually overlooked in the myriad of diet books out there.

In a nutshell, my message is something along the lines of “While what you eat is important and you should definitely strive to make healthy foods the mainstay of your diet, and while getting plenty of exercise is important and you should definitely strive to get plenty of good exercise, when it comes to gaining or losing fat, all of that is trumped by the more important concept of how much you eat. When it comes to gaining or losing fat, it really is all about the calories you consume.”

Continue reading ‘More on How to lose weight. The Hacker’s Diet’

New Treatment for Alzheimer’s

Sometimes I like to surf around news sites in other parts of the globe to get a better feel for what’s going on in other countries, as well as how the foreign press is presenting what’s going on here in the U.S.

In my opinion, access to folks in all the far flung places of the world is the greatest thing about the Internet.

Anyway, I was buzzing around the website for England’s The Daily Telegraph the other day, reading all the news that’s “Fit for Brits,” when I came across an interesting story about some breakthrough medical research being done at UCLA on Alzheimer’s Dementia.

Here’s the story titled UCLA drug aids Alzheimer’s patient ‘in minutes’. Please give it a read, and then come back here. It’ll only take a minute or two.

Continue reading ‘New Treatment for Alzheimer’s’

Vacuum treatment for Heart Attacks

This will be a quick post, which I think is only fair considering the Epic War and Peace style dissertation I put the readers through with my last post on How to Lose Weight.

This is just a sort-of follow up to my post about Penumbra.  If you remember, at the end of that post, I posed a couple of questions about potential other uses for this technology.

One of those other uses I wondered about was whether or not this treatment could be used for occlusive arterial conditions other than strokes, such as heart attacks for instance.

Well, it seems I’m not the only one who considered this sort of idea.  A study published in today’s New England Journal of Medicine titled Thrombus Aspiration during Primary Percutaneous Coronary Intervention shows very promising results from a study in the Netherlands looking into just just this sort of thing.

As promised, I will keep this post short by avoiding going into a lot of details about this study.  Hit the link above if you wish to get into the nuts and bolts of it.

In a nutshell however, the Dutch researchers compared doing a conventional stent placement in a heart attack victim vs first using a device (that sounds very much like the Penumbra device) to vacuum the clot out of the blocked coronary artery prior to placement of a stent.

They found that using the vacuum technique resulted in better perfusion and outcomes compared to conventional stent placement alone.

How To Lose Weight

Bathroom Scale

Today is Mardi Gras, and down in these parts (less than an hour from The Big Easy), Mardi Gras is a big deal.

For those not in the know, Mardi Gras is French for Fat Tuesday, and in these parts Fat is something we are quite familiar with!

The U.S. has a huge and growing obesity epidemic and New Orleans is pretty much the tip of the spear.

Fat is something we have in abundance, not only around here, but pretty much nationwide. It’s not just a problem confined to the U.S. either. The obesity epidemic is starting to catch on in the rest of the world as well.

Fat is like an annoying relative that just doesn’t want to go away. So let’s talk about this.

It seems like everywhere you look, there’s a new diet plan or secret weight loss pill or hypnotic technique or special tea from the Far East.

Getting rid of fat is a national obsession!

So, how do you do it???

That’s the million dollar question.

Dr. Sam is here to give you the zero dollar answer!

Continue reading ‘How To Lose Weight’

Disease and Medication Index Added

Hi folks,

This is just a quick note to point out a couple new links in the sidebar on the right. These are the Disease Index and Medication Index.

Each of these will take you to a page which will (eventually) have alphabetically listed links to other pages which will have information about particular disease conditions and medications.

As of this writing, I have a sample page in each one.

For the Disease Index page, there is a link to a page describing Giardiasis. This is information that is a cut and paste that came from the Centers for Disease Control website.

For the Medication Index page, there is a link to a page describing Amoxicillin. This is info that is a cut and paste that came from wikipedia.

Continue reading ‘Disease and Medication Index Added’

Here’s the “One Semester of Spanish Love Song”

Okay, this post has absolutely nothing to do with medicine, the healthcare system, medical practice or anything of the sort.

In a sort of tangential, really-making-a-stretch way however, it does have to do with staying healthy.

There’s an old saying that says “Laughter is the best medicine.” There’s even a good bit of empirical evidence to back that up. Here’s just one example.

Continue reading ‘Here’s the “One Semester of Spanish Love Song”’

Future Plans for the Blog

I’m still in the total newbie stages of this blog thing.

Yesterday, I finally received my order from Amazon that included the book WordPress For Dummies.

I’m quite excited by this as I hope to be able to greatly expand my abilities with this software and make this blog much more useful and much more user friendly.

Right now, what I’m hoping to do is use the software for more than just blogging. I want to use it as a content management system.

I’m hoping to create indexed pages that aren’t blog entries but that are rather stand alone pages that provide information about specific subjects. Things like information about specific diseases, treatments, medications, etc. Continue reading ‘Future Plans for the Blog’


I just read an interesting story about a new treatment for occlusive strokes.

The device is known as Penumbra and is being put out by the company of the same name Penumbra, Inc.

From the story I read, and from my brief visit to the company website, it looks like it might have promise to treat some stroke victims who otherwise would be sort of out of luck.

Basically, from the description, this is a catheter type device that is threaded into the femoral artery (The great big artery in your groin that feeds blood to your leg), and is worked in retrograde fashion up the aorta and then into the appropriate arteries (carotid, etc.) until reaching the site of the blocked artery inside the skull. It then acts basically like a vacuum cleaner and sucks out the blood clot that is blocking the artery and causing the stroke.

Continue reading ‘Penumbra’

Yes, you CAN quit smoking!

“Doc,” he said to me with all sincerety, “I’d really like to quit smoking but I just can’t.”

How many times have I heard that ridiculous statement???

Of course you can quit smoking.

It may not be easy, but absolutely YES YOU CAN!

Continue reading ‘Yes, you CAN quit smoking!’

How to stay healthy

Okay, this will be a generalized, common sense post. It’s not intended to go into a lot of detail, but is intended to be more philosophical in nature.

Here’s the deal for staying healthy.

Think of your health as being like playing a hand of poker.

The cards you are dealt…..those represent your genetics, and those things life throws at you that are beyond your control.

How you play those cards represents your lifestyle…how you respond to life….in essence what you choose to do or not do with the body you have.

Continue reading ‘How to stay healthy’

Welcome to

Hi everyone. As you may have guessed, I’m Dr. Sam. See my “about me” link for further details.

This is the first of what I hope will be many posts.

This is my first foray into the world of blogging, so please bear with me as I learn the ropes.

My obvious goal with this blog is to reach people.

I’m a practicing physician and find that on an almost daily basis I seem to have less and less time to really discuss issues with my patients. Issues ranging from their specific medical problems to problems in society as a whole.

There is an endless flood of bureaucratic hurdles that get between me and my patients.

This is not just true for me, but for pretty much all doctors these days.

I think this is disastrous.

My goal for this blog is to make up for this somewhat.

Continue reading ‘Welcome to’

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