The Checkup

RECENT POSTS

The Checkup: Talking Back To Your Doctor

Welcome to the The Checkup. Our sixth episode “Talking Back to Your Doctor,” opens with a question: Why do so many of us find it so hellishly hard to speak freely with our doctors? What is it about a white coat that makes even normally assertive people clam up?

(To listen to The Checkup now, click on the arrow above; to download and listen later, press Download; and to get it through iTunes click here.)

We begin with the dramatic story of Alicair Peltonen, an administrative assistant diagnosed with a rare cancer who had to have a chunk the size of a baseball removed from her thigh. Throughout her medical saga, she found that she often had urgent questions echoing in her mind, but felt too inhibited to voice them. She set out to find out why. The Checkup

We speak with Dr. Jo Shapiro of Brigham and Women’s Hospital in Boston about what she calls “Conversation Deficit Disorder” among doctors. And we hear from Dr. Annie Brewster, who has special insight into doctor-patient communication because she’s both a practicing doctor and a multiple sclerosis patient who decided not to follow her doctor’s recommendations about taking a particular medication.

Each episode of the Checkup features a different topic—previous topics included college mental health, sex problems, the Insanity workout and vaccine issues.

This is the closing episode of our first season of The Checkup. Please tell us what you liked and disliked and what you want more of. Like CommonHealth on Facebook or drop a note to podcasts@slate.com.

We’ll keep you posted here on all our plans for future podcasts.

The Checkup On Shots: Vaccine Updates, Facts And Fictions

Somehow, over the last few years, one of modern medicine’s greatest achievements has turned into one of modern American parents’ most fraught subjects.

In this episode of The Checkup, our podcast on Slate, we offer Shots: Vaccine Facts And Fictions, in which we attempt to have a rational, fact-based discussion about some of the vaccines you may encounter in the immediate future: the flu vaccine and, if you have pre-adolescent children, the HPV vaccine.

(To listen to The Checkup now, click on the arrow above; to download and listen later, press Download; and to get it through iTunes click here.)

This year’s flu vaccines offer consumers more choices than ever: there’s a nasal version, a quadrivalent (four-strain) option, a “short-needle” option and an egg-free vaccine for people with allergies, among others. And even though it still feels like summer in some parts of the country, doctors are urging people to get their flu shots early.

The HPV vaccine was introduced seven years ago but, according to the CDC, only about half of girls are getting one or more doses, and only about one-third are getting the full three-dose course. This despite word from public health officials that it’s highly effective for preventing HPV — the most common sexually transmitted infection in the U.S. and a principal cause of cervical cancer — and so far, pretty safe. (It’s recommended for boys as well as girls, both because boys can spread HPV and because there’s a notable rise in HPV-related cancers in older men. See: Michael Douglas and oral sex. )

Doctors say a variety of obstacles stand in the way of more widespread use of the HPV vaccine. There remains the stigma of a vaccine for a sexually transmitted infection.  Also, when you’re talking about an 11-year-old,  preventing cervical cancer may seem less urgent than, say, preventing measles. Finally, there’s a general sense of “vaccine fatigue” among parents bombarded with so many official recommendations and competing agendas.

 

For more info, check out this HPV fact sheet created by our intern, Rachel Bloom:

gardasil-fact-sheet-image

Readers, please let us know how you’re handling vaccines for your family this year. Anything we can learn from your experience?

The Checkup: Flunking The Insanity Workout But Coming Away Wiser

It’s getting embarrassing. Week after week, month after month, this post — Flunking The Insanity Workout But Coming Away Wiser — tends to top the WBUR Web traffic stats.

It’s no mystery why: The inescapable Insanity infomercials continue to populate the late-night TV airwaves, and viewers tantalized by their amazing before-and-after photos, and the charismatic energy of trainer Shaun T., proceed to google “Insanity workout” to try to discern whether the set of DVDs is really worth more than $140. And there, on the first Google search page, is our CommonHealth post, and the lively, long, occasionally rough exchange of pro-and-con comments that follow.

The CheckupThis week, The Checkup, our podcast on Slate, revisits the Insanity workout, with a brief recap of Carey’s sad tale of flunking it and additional wisdom from experts. In particular, we spoke with Dr. John Richmond, chair of orthopedics at New England Baptist Hospital, which specializes in orthopedics. The original post mentions fear of injury, but Dr. Richmond delves into the nitty-gritty of which particular moves are most dangerous, particularly for older exercisers.

And for an added dose of sanity, the podcast also features Dr. Eddie Phillips, director of the Institute of Lifestyle Medicine, and his data-driven depiction of the overwhelming health benefits of exercise — even in far lower doses than you might expect.

(To listen to The Checkup now, click on the arrow above; to download and listen later, press Download; and to get it through iTunes click here.)

Below, a full transcript of Dr. Richmond, lightly edited:

CG: So I hear that orthopedic specialists are often very grateful to workouts like Insanity because they send you a lot of customers. Is that true?

JR: It definitely drives business. There’s no question that there are a number of people that end up in offices and actually, ultimately in operating rooms because they’ve torn things or worn things out by doing over-aggressive exercise.

So what would be your top tips of what to avoid?

There’s a couple. One that we see a lot of is lunges, or deep-knee bends, deep squats . . . Continue reading

The Checkup: Meltdown U. And Mental Health Tips For Parents Of College Kids

For all those freshman just settling into dorm life this fall, college can be exhilarating, mind-blowing, the best years of their lives. But many parents don’t realize that their children are also facing a potential double whammy. Not only must new students navigate an entirely unfamiliar social, emotional and intellectual landscape, but they’re also entering a time in their lives — the ages between 18 and 21 — when many mental illnesses, from anxiety to depression to eating disorders, peak.

This week, The Checkup, our podcast on Slate, explores the mental health of college students. Here’s one sobering statistic: up to 50% of college-age kids have had or will have some kind of psychiatric disorder. That’s why we’re calling this episode “Meltdown U.” (To listen to The Checkup now, click on the arrow above; to download and listen later, press Download; and to get it through iTunes click here.)

The Checkup

Consider some more scary numbers:

–80% of college students who need mental health services won’t seek them

–50% of all college students say they have felt so depressed that they found it difficult to function during the last school year

–Suicide is the second leading cause of death among college-age youth – over 1000 deaths per year.

–The rate of student psychiatric hospitalizations has tripled in the past 20 years.

We asked Dr. Eugene Beresin, M.D., a child psychiatrist at Massachusetts General Hospital and professor of psychiatry at Harvard Medical School, to offer some guidance on what parents should know about helping their college-age kids cope with the high stress of undergraduate life. Here’s his advice: Continue reading

The Checkup: Yes, Really. One-Third Of Women Have Pain During Sex

A while back we wrote about a national sex survey that found one-third of women experienced pain during sex. There were skeptics back then who thought, nah, that can’t be possible, otherwise we’d be having a nationwide conversation about how to fix such a huge problem. But now, the lead author of that study, Debby Herbenick, a researcher at Indiana University, co-director of the Center for Sexual Health Promotion, and a sexual health educator at the Kinsey Institute, confirms those numbers in a follow-up survey.

The Checkup

We discuss these surprisingly high numbers, and other new findings, in the second episode of our new podcast, The Checkup, which is just out at Slate.com here. (To listen to The Checkup now, click on the arrow above; to download and listen later, press Download; and to get it through iTunes click here.)

The theme of podcast #2: “Matters Below The Waist.” This segment features frank talk about sex problems — and some solutions. We delve into Herbenick’s fascinating research on pain during sex and more (including personal insights from one of our hosts…) and speak with a physical therapist who specializes in various treatment options that can help women deal with this rarely discussed but incredibly widespread problem.

Not to leave men out, we also explore a little-known disorder called Peyronie’s disease, in which the erect penis becomes crooked, sometimes making it difficult to have intercourse. (Yes, this came up during the Bill Clinton impeachment era, and there’s more on that in the podcast.)

Herbenick’s initial survey of sex in America was the largest nationally representative study of sex in the country; her team surveyed 6,000 men and women, ages 14-94, and asked them about their sexual behavior.

Results of the latest survey (which Herbenick says were presented at an International Society for the Study of Women’s Sexual Health annual meeting) are expected to be published in several months.

In the meantime here, lightly edited, is more from my interview last week with Herbenick, also the author of several books, including Read My Lips: A Complete Guide to the Vagina and Vulva and Sex Made Easy: Your Awkward Questions Answered-For Better, Smarter, Amazing Sex:

DH: We did another national survey of sex in America. And this time, knowing that we had this stark difference between how women and men experience pain during sex – only 5% of men reported any degree of pain, and most of theirs was mild, too. We did ask a series of follow-up questions. This time, for people who did experience pain, we collected information about how long the pain lasted, where in their body it was located, whether they told their partner, what they did in response to the pain, and we also separated it by vaginal and anal intercourse.

RZ: What else did you find?

So the first thing that was important is the 30% number is still there. And that’s important because it does show that it’s a stable and reliable estimate, which some people in the media had questioned [whether] it could really be that that number of people experienced pain — Continue reading

Check Out ‘The Checkup’: Our New Health Podcast On Slate

You’ve read our posts. Now we invite you to listen to our podcast.

Beginning today, we’re launching a new podcast called The Checkup, a partnership between WBUR and Slate. (We wanted to call it Goldberg and Zimmerman, but they told us it sounded like an accounting firm.) We’re thrilled to announce that for the next six weeks, Slate will be posting it weekly among its extremely popular “Gabfests” and other ear fodder. (To listen to The Checkup now, click on the arrow above; to download and listen later, press Download and to get it through iTunes click here. )

The Checkup

Regular CommonHealth readers will be familiar with our blend of solidly reported, somewhat opinionated health-related news you can use (at least we think you can use it, since we can and have). Each segment will focus on a different topic — from sex problems and students’ mental health as they head back to school, to fitness snake oil and vaccine controversies.

Our first episode is “Three Myths of Pregnancy and Childbirth,” a subject near to our motherly hearts. It features interesting, relevant new research on bed rest during pregnancy, labor pain and cutting the baby’s umbilical cord, including information you may not read much about in the best-selling pregnancy bible “What To Expect When You’re Expecting.”

So download the podcast, produced by WBUR’s wizardly sound engineer George Hicks, give it a listen and let us know what you think.