Common Things

Regular Check Ups for Men
Health News journalist Gary Schwitzer beat me to the punch in his critique about the Washington Post's article on health care screening for men in his post Disease-mongering by the Washington Post: here we go again.
Mr. Schwitzer correctly points out that many of these recommendations are not uniformly agreed upon or evidenced based, and yet they are treated "as if they were handed to Moses on stone tablets ."
Being from Minnesota, I am guessing Gary reads the online version, and would probably be even more miffed to know that the print version (which I get being in DC) has pictures of celebrities for the various age ranges (Justin Timberlake for 20's, Will Smith for 40's, Harrison Ford for 60's) as if these celebrities get these studies done or endorse the information.
My favorite piece of misinformation is the testicular exam which the Post claims is recommended for men 20-35, including regular self-testicular exams. Except the U.S. Preventive Services Task Force (USPSTF) actually recommends against this, giving it a Grade D recommendation. This means not that it is controversial or their is evidence lacking like prostate cancer screening, but that there is actually evidence that it may even be harmful. Testicular cancer is one of the most curable cancers we have. Lance Armstrong had metastasis to the brain, and look how well he did. Guys who are checking their testicles regularly are likely to find something that is not harmful/normal and will only cause them needless worry, and in some cases, a few unnecessary tests.

I highly recommend the USPSTF's pocket guide to screening. Though there are some things that are controversial that they don't recommend that I will often do (like prostate cancer screening), this is a very good starting point for what men and women should be doing.

Common Colds
My university's newspaper interviewed me for an article about myths regarding the common cold. The questions the young reporter asked were quite good and common questions asked by patients. Here's the link to the full article, a quick summary:

• The flu shot does not give you the flu, but can cause mild symptoms
• Vitamin C does not help prevent or treat the common cold
• A wet head in cold weather will not cause a cold, but can increase your susceptibility to catching a virus that will cause a cold
• Chicken soup actually works (with evidence to prove it)

A few things she left out:

• Colds are caused by viruses. Please don't ask your doctor for antibiotics just because you feel "really sick." They will not help, and an only increase strains of resistant bacteria.
• The flu shot is only protective of influenza which is one of many, many bugs that can make you sick. Just because you got the flu shot and then caught a cold does not mean it didn't work.
• All pill forms of decongestants are now over the counter. This is part due to money issues and part due to FDA regulatory changes. The bottom line is that for a cold, there is little I can offer you in the way of a prescription that you can't get over the counter.
• Fever is not necessarily bad. It is the body's natural response to fighting a cold. You are literally burning up the virus. Don't treat a number. If your temperature is 101, but you're not miserable, not taking a Tylenol might be a good idea. However, if you simply feel rotten, taking this will probably not hurt and can certainly make you feel better.
• Most cold medicines come in combination. It is often disorienting to try to figure out what the active ingredients are in each variety of Robitussin. Most colds cause congestion, so you want something with a decongestant in it. In general, antihistamines just make you sleepy and can thicken secretions, thus making congestion worse. Antihistamins should be mainly reserved for allergies. Guaifenesin, the active ingredient in plain Robitussin, may or may not help, but probably doesn't hurt. Dextromethorphan (the DM part of Robitussin DM) does reduce a cough. Thus for a simple cold, I would take a plan decongestant +/- Guaifenesin, and add DM if a cough is present. I would avoid combinations that contain antihistamines. I would also take my pain medicines/anti-pyretics like acetaminophen and ibuprofen separately and not in combination.