When discussing the potential side effects of drugs, risks must be viewed within a realistic context. Indeed, my last column on Ecstasy, or MDMA, and today’s on GHB (gamma-hydroxybutyrate), Rohypnol (flunitrazepam) and ketamine, contain information that is factually correct.

Recently, one of my patients with bipolar disorder took Ecstasy at a rave. Within 60 minutes she had collapsed on the dance floor from dehydration.

If your doctor offered the option of a blood test to determine what diseases your child will develop in their lifetime, what would you do? This option is soon to be a reality.

The thrill of the winter sojourn to warmer climes and ocean activities like scuba diving, surfing and snorkeling, among others, can lead many to overlook other notable health and safety precautions.

Watching someone we love lose their sense of self has become an all-too-common occurrence in Canada and, indeed, in many parts of the world. Even as adults, our childhood image of our parents is firmly imprinted into our minds. The piece-by-piece loss of this image is painful to witness and frightening to the afflicted.

Mad cow disease (bovine spongiform encephalopathy, or BSE) remains in the news, with two more cases reported in cattle this month in Alberta.

All the ingredients for a potential health calamity are present

The tsunami survivors face great health challenges. To date there have not been reports of epidemics of cholera or other infectious diseases. However, the massive aid pouring into the affected regions is designed to address the health risks that have the potential to cause further harm.

I thought it might be fun and interesting to present some of the medical stories of 2004 that did not make the front page, yet illustrate an undercurrent of fantastic potential.

According to the Heart and Stroke Foundation of Canada, stroke accounted for 20 per cent of the 79,389 deaths from cardiovascular diseases in 1998. The Canadian statistics are indeed disconcerting, reflecting tremendous suffering and financial burdens to families and society.

What is a drug interaction? Many believe it occurs when one or more medications directly affect the effectiveness of another. But how does it happen?

Originally published in The Ottawa Citizen Friday, November 12, 2004 Original Title: Infection control for dummies Infection control can be a complicated matter, especially for viruses that spread as easily as the flu. The flu can spread through direct hand-to-hand contact, via airborne droplets (fomites) after a sneeze, and with contact with recently touched surfaces [...]

Originally published in The Ottawa Citizen October 18, 2004 Original Title: The HN factor New information and reports of bird flu have shifted attention to the possibility of a new flu pandemic. The most lethal pandemic in our history occurred from 1917 to 1919 killing an estimated 20 million to 50 million people.

On Oct. 3, I reviewed why hyperpigmentation (dark skin spots) occurs, as well as some of the common causes and conditions. But it does not end there. Indeed, there are more skin conditions that raise many questions from concerned patients.

Originally published in The Ottawa Citizen October 3, 2004 Original title: Out, Out Damn Spot: Part 1 The formation of dark skin spots, or hyperpigmentation, can either be a benign condition or the development of a serious local or systemic disease. In this two-part series, we will look at the causes and types of hyperpigmented [...]

Originally published in The Ottawa Citizen September 20, 2004 Young men rarely see their family doctor (if they have one). There is a tendency to think that nothing can really go wrong in your late teens or 20s. Yet there is one cancer in men that occurs exactly when men avoid their doctor: testicular cancer.

Originally published in The Ottawa Citizen September 20, 2004 Original Title: The Testes of Time Young men rarely see their family doctor (if they have one). There is a tendency to think that nothing can really go wrong in your late teens or 20s. Yet there is one cancer in men that occurs exactly when [...]

What are some of the problems breastfeeding mothers face when they return to work or school? What are the solutions available to help them continue to breastfeed or provide breast milk to their infants

With the beginning of the school year, cold viruses, potential allergens and other infections are ready to greet our children at the door.

Originally published in The Ottawa Citizen August 31, 2004 Original Title: Stop that swimmer! What do you think are the most effective contraceptive options aside from complete abstinence (no intercourse)?

There are numerous causes for abdominal pain and cramps, warranting a thorough evaluation; diagnoses include peptic ulcer disease, acid reflux, colitis and bowel cancer, among others.

The pressure and stress exerted upon the feet and lower extremities can be substantial. A common class of sports-related injury is stress fractures.

Shortness of breath (dyspnea) strikes deep at a person’s self-preservation instincts. The fear of suffocation commonly leads to a feeling of panic. The ability to diagnose and treat the condition depends upon past medical history, the ability to gather a good medical history of the acute condition and prompt evaluation of the patient’s physical findings.

Originally published in The Ottawa Citizen July 27, 2004 Original Title: Cozy up to Co-Q An early study released recently by the Michigan Head Pain and Neurological Institute in Ann Arbor, Michigan, showed that co-enzyme Q10 (CoQ) may be another treatment approach for migraines.

Hippocrates (460?-377 BC) described it in his written observations. Ancient Chinese, Egyptian and Middle Eastern cultures refer to this disease. Outbreaks often coincide with warfare, mass migrations and other societal disruptions. The British blamed “bad air” in the mid 1800’s India for a disease that killed many of their nationals. This mala aria (from the Italian) has killed more soldiers in the 20th century wars than bullets. The World health Organization reported 270 million worldwide cases and one million deaths in 1998.

How many asthmatics think their asthma is under control? If you are like most Canadians, 91 per cent believe so. Indeed, perception is not a mirror of reality.

Originally published in The Ottawa Citizen June 11, 2004 Original Title: Stay away from Puss ‘n Boots We live with a multitude of bacteria and parasites in our environment. Many do not cause disease in healthy individuals.

They have exotic names but they are less than endearing. Intestinal parasites come in all shapes and sizes. Each has its own way of taking advantage of the body’s metabolism and anatomy.

Known as Fuga Demonum or Devil’s Scourge, its original use was to ward off evil spirits and prevent demonic possession. Sixth century Gaelic legend makes reference to St. Columba who carried a piece of the flowering plant in deference to St. John the Baptist around whose birthday the flower would bloom.

Increasing numbers of adolescents, especially girls, are adopting vegetarian diets. Their reasons for choosing a vegetarian diet vary from animal welfare, health benefits and food safety to environmental and sociopolitical concerns. Surveys suggest that approximately 8% of adolescents in the United Kingdom and 6% of older elementary and high-school students in the midwestern United States consume a vegetarian diet.

Do herbal preparations really live up to their claims?

There are many anecdotal reports that they do make a difference and help people with a variety of ailments. Many websites purport to give information but, for the average consumer, it can be difficult to separate the facts from bias.

Alopecia or hair loss is a distressing turn of events for women. The scalp is often afflicted but it can occur on any part of the body. Why does this happen? Are there different types of hair loss?

A change in your diet may not be enough to boost vitamin levels

In medicine, there is an old adage that the most common medical complaints are caused by the most common medical problems. Many of my patients have complained about fatigue. This nebulous creature is one of the most common problems faced by family doctors.

Osteoporosis is defined as a loss of bone calcium more than expected for a person’s age, sex, and race. It is a major health problem that robs people of their independence. The areas predisposed to fracture include the spine, hip and upper arm.

It seems that every week there is another diet or celebrity offering the Holy Grail of diet and health nirvana. Indeed, nutritional science researchers are casting healthy skepticism on their claims.

Originally published in The Ottawa Citizen March 6 , 2004 Original Title: Nighttime waterworks Bedwetting or nocturnal enuresis affects more than 200,000 Canadians between the ages of five and 19. It occurs three times more often in boys than in girls. This problem causes great parental angst and distress. Children often feel humiliated and ashamed [...]

Originally published in The Ottawa Citizen February 29, 2004 Originally titled: “Common Skin Infections” Bacterial skin infections are a common reason why people consult their family doctor. Each infection has its own specific treatment.

Many people are unaware of the proper management of burns. Is there a need to apply creams, antibiotics, salves or natural products to promote healing? What are the first steps to prevent or minimize skin damage in the immediate aftermath of a burn?

Deborah decided she had had enough of smoking marijuana. Last week’s column reviewed how her addiction affected her psychosocial development. Deborah was pondering why she continued to smoke four to 10 joints a day to the detriment of her health, desires and life goals.

A common student question asked at Canterbury High School focuses upon the melange of moral, ethical and consequential aspects of smoking cannabis.

We are living in an exciting age of new therapies and medical technological advancement. This advancement is due to ongoing research and development in areas such as microchip design, medical imaging (e.g. MRI and PET scans), materials science, biological agents, genetics, virology, microbiology, tissue receptor identification, stem cells and nanotechnology among others.

Southern vacations beckon during the long winter months. Depending on the destination, there may be certain vaccination and malaria- prevention measures that will reduce the traveller’s risk of debilitating disease. Many, however, wait too long before they visit a doctor for a travel medicine consultation.

From time to time I receive mail from readers asking about various medical conditions. One such letter contained numerous questions about asthma and lung disease that I wish to address in this column.

Originally published in The Ottawa Citizen December 30, 2003 Original Title: The top medical news stories of the year The December issue of the Harvard Health Letter reviews the top 10 significant medical achievements and events for 2003 and their potential impact.

Originally published in The Ottawa Citizen December 19, 2003 Original Title: Cycling the virtual highway WARNING: Before you read any further, I have to confess that I am a cycle nut. Forgive my indulgence in sharing my love of this world with you in one column.

What do some of the B vitamins and antioxidants do? Are we dealing with marketing hype?

What are vitamins? Do they provide extra energy or boost to your metabolism? Do they help prevent cancer and other chronic diseases? How much is too much? A multibillion-dollar industry relies on the public perception that they are a gateway to better health and disease prevention. This two-part series will look at the facts and myths about vitamins based on the latest research.

Richard (not his real name) was a happy one year-old infant. After his first birthday he developed bloating and diarrhea and lost weight. His growth slowed. This condition persisted for months.

The history of medicine is fascinating. Today we have the means to combat vicious infectious childhood diseases. New cancer therapies and cancer vaccine research hold tremendous promise. Technological advances have improved our society’s ability to produce food in record amounts.

Mandy (not her real name) came to the office complaining of nausea and intense abdominal cramping with bloody mucousy diarrhea. She could not sleep or eat because of the severe pain. Investigations led to a diagnosis of Crohn’s disease.