Medical websites

Where to look for authoritative medical information

“I have been bleeding from the gums for the past few days,” my friend Audrey blurted out when I telephoned her. “You know I am taking the blood thinner warfarin, and my INR (a test to evaluate the effectiveness of blood-thinning medications) was normal a week ago. I am really worried.”

“Are you taking any new medication,” I asked.

“Oh, yes, my internist put me on cranberry pills just five days ago to prevent recurrent bladder infections.”

“Let me look up if the cranberry pills are interacting with the warfarin. I will call you back in a short while.”

I logged on to www.mayoclinic.com, where I discovered that both cranberry juice and cranberry pills indeed increase the action of warfarin.

Audrey called her internist, who was unaware of this interaction. He immediately ordered another INR, which was way above normal, explaining the gum bleeding. The physician instructed Audrey to discontinue the pills and to stop the warfarin for five days, which, he assured her, would bring the laboratory values back into the normal range.

Audrey’s experience reinforces the importance for every one of us to become actively involved in our medical care and to learn as much as possible about our conditions and medications.

For computer-savvy readers

To accomplish this, I compiled a list of appropriate medical websites, each of which had to conform to the following prerequisites.

1. It had to originate from a prestigious clinic, a medical school or a trusted government site.

2. It had to have a user-friendly interface (an easy way to navigate and retrieve the desired information).

3. It had to explain medical conditions in nontechnical language that is easily understood by the general public.

4. It had to be free of commercialization.

5. It had to be up to date.

To ensure each recommended site used layman’s terms, I looked for headings such as “blood pressure” instead of “hypertension” and “bladder infection” instead of “cystitis.”

Recommended sites

The following six sites fulfill the above prerequisites.

1. The Mayo Clinic (www.mayoclinic.com) — The fastest way to maneuver through this site is to click on “Diseases and Conditions” or “Drugs and Supplements.” Either brings up an exhaustive A-Z list. Opening any listed heading brings up detailed information about the disease in question or the requested drug. You will find support groups under the heading “Coping Skills.”

2. MedicineNet.com (www.medicinenet.com) — To bring up an A-Z list, similar to the one mentioned above, go to one of its four subheads: “Diseases and Conditions,” “Symptoms and Signs,” “Procedures and Tests” or “Medications.” Refrain from typing in the search box, since it may lead you to a quagmire of advertisements.

3. MedlinePlus (medlineplus.gov) — MedlinePlus provides such comprehensive medical information from the National Library of Medicine that you will be able to find everything (well, almost everything) on this website.

The homepage offers the self-explanatory headings “Health Topics A-Z,” “Drug information A-Z,” “Medical Encyclopedia” and “Dictionary” as well as the “Directories” subhead, which lets you find doctors, dentists, clinics, hospitals and other health care facilities.

Clicking on “Other Resources” on the same homepage leads you to the following subheads:

a. Local libraries, international sites and databases.

b. MEDLINE/PubMed — the National Library of Medicine’s database of reference articles.

c. Organizations — providing links to an exhaustive array of medical associations, each one offering symposia on a wide variety of problems. I have listed a number of these associations below.

Visit all the sites and you will become a full-fledged M.D. in no time.

4. National Institutes of Health (www.nih.gov) — supplies authoritative information from the U.S. government.

Links will lead you to the following:

a. The National Center for Complementary & Alternative Medicine (http://nccam.nih.gov/clinicaltrials), the government’s clearing house of information about nonconventional medicine.

b. The National Cancer Institute (www.cancer.gov), with extensive data about every imaginable cancer.

c. The National Institute of Neurological Disorders & Stroke (www.ninds.nih.gov), which discusses disorders of the nervous system, albeit in a somewhat technical fashion.

5. Centers for Disease Control (www.cdc.gov) — Go here for an exhaustive list of infectious diseases. The site also discusses a number of other disorders.

6. CDC Traveler’s Health (www.cdc.gov/travel) — a site familiar to ITN readers.

Where to start

You probably wonder where you should begin your search.

For a thorough overview of an unfamiliar condition, start with www.mayoclinic.com or www.medicinenet.com. Afterward, for more detail, visit MedlinePlus (No. 3 above) at “Medical Encyclopedia” and select the appropriate item on the A-Z list. (Here, you also will find national support groups. Local support groups, for selected states only, are found under “Directories” —“Go Local.”) For additional in-depth information, hit the “Health Topics A-Z” tab.

If you are looking for infectious diseases, go to the Centers for Disease Control homepage (No. 5 above) and for travel information, the “CDC Traveler’s Health” (No. 6 above).

Other sites listed on MedlinePlus

You also may be interested in navigating one or more of the following sites, which are available on Medline-Plus as links of “Other Resources” (choose “Organizations”), although a number of them have a paucity of layman’s terms.

1. American Academy of Dermatology (www.aad.org) — an excellent site to look up afflictions of the skin.

2. American Autoimmune Related Disorders Association (www.aarda.org) — An autoimmune disease is an abnormal condition caused when the body produces antibodies, or proteins produced by the immune system, in response to the presence of antigens, which are substances that are foreign to the body, such as bacteria, toxins, transplants, etc.

For diseases, select “Patient information.” While the site is easily navigable, it has a dearth of nontechnical language.

3. American Diabetes Association (www.diabetes.org) — tells you all you want to know about diabetes. (See also Joslin Diabetes Center, farther down in this article.)

4. Food & Nutrition Information Center (www.nal.usda.gov/fnic) — an excellent site from the National Agricultural Library, Agricultural Research Service and U.S. Department of Agriculture.

5. American Heart Association (www.americanheart.org) — the place to learn about heart maladies.

6. American Lung Association (www.lungusa.org) — Go here in your search for lung conditions.

7. American Obesity Association (www.obesity.org) — This website tells you all you want to know about obesity.

8. American Social Health Association (www.ashastd.org) — top information on STDs (sexually transmitted diseases).

9. Arthritis Foundation (www.arthritis.org) — The interface is somewhat difficult. To navigate, go to “Conditions and Treatment,” then click on “Disease Center.”

10. Asthma & Allergy Foundation of America (www.aafa.org) — Click the “Asthma” and “Allergies” tabs.

11. Center for Devices & Radiological Health (www.fda.gov/cdrh/consumer/index.html) — an FDA site with data on medical devices, such as pacemakers. It also describes a number of procedures.

12. American Academy of Family Physicians (www.familydoctor.org) — furnishes good advice.

13. American Podiatric Medical Association (www.apma.org) — provides good data about foot ailments.

14. Genetic & Rare Diseases Information Center (www.genome.gov/10000409) — The name speaks for itself.

15. National Sleep Foundation (www.sleepfoundation.org) — has thorough information about sleep disorders.

16. The Organ Procurement & Transplantation Network (www.optn.org) — furnishes complete information about transplants.

17. Partnership for a Drug-Free America (www.drugfreeamerica.org) — an excellent website.

18. American Society of Plastic Surgeons and the Plastic Surgery Educational Foundation (www.plasticsurgery.org) — all you want to know about plastic surgery.

19. Institute For Safe Medication Practices (www.ismp.org) — an excellent organization which specializes in helping to prevent medication mixups.

Other sites, NOT listed on MedlinePlus

The following websites, although they are not on the list accessible from MedlinePlus, are definitely worth perusing.

1. Joslin Diabetes Center (www.joslin.harvard.edu) — a world-renowned clinic.

2. Clinical Trials (www.centerwatch.com) — clinical trials (also called clinical studies, research protocols or medical research) are research studies done to check out new medical treatments and medications. Before joining one of the listed programs, make sure you carefully evaluate all of the pros and cons (especially the latter).

Keep in mind that side effects from a drug may show up only after it has been in widespread use for a number of years. Therefore, if possible, don’t use a new drug until it has been on the market for quite a while.

3. Healthfinder (www.healthfinder.gov) — provides consumer health information from the U.S. government.

4. HealthPlanDirectory (www.healthplandirectory.com) — furnishes complete nationwide lists of health plans (HMOs), doctors, hospitals, medical schools and clinical trials.

5. Healthweb (www.healthweb.org) — easily navigable, far-ranging website with many relevant links.

6. HIVInsite (http://hivinsite.ucsf.edu/insite) — comprehensive, online textbook of HIV disease from the University of California San Francisco and San Francisco General Hospital.

7. Kids Health (http://kidshealth.org/index2.html) — authoritative information for children, adolescents and parents.

8. NORD, the National Organization for Rare Disorders (www.rarediseases.org) — supplies general descriptions of over 1,000 rare diseases and includes referrals to related support organizations.

9. Oncolink (oncolink.upenn.edu) — This superb cancer site hails from the University of Pennsylvania.

10. Planned Parenthood (www.plannedparenthood.org) — furnishes excellent information on sexual health as well as birth control.

11. RadiologyInfo (www.radiologyinfo.org) — an authoritative although somewhat technical site, to learn about x-rays, MRIs or scans.

12. Whonamedit (www.whonamedit.com) — a reference of all medical eponyms (medical terms which are named after people, e.g., “Achilles’ tendon”).

13. Women’s Cancer Network (www.wcn.org) — The title speaks for itself.

14. Genetic Conditions/Rare Conditions (www.kumc.edu/gec/support/grouporg.html) — an excellent and exhaustive site with a user-unfriendly interface.

For computerless readers

Those of you who are not computer-savvy can take the information presented above to a librarian, who can assist you in getting the desired facts.

You also can phone the Agency for Healthcare Publications at 800/358-9295 for brochures on specific disorders or call the National Health Information Center at 800/336-4797 for referral to the proper agency dealing with a specific disease.

In addition, you can look in the phone book for the appropriate medical association, foundation or society, such as the American Heart Association, the Arthritis Foundation or the American Cancer Society.

Happy hunting!

‘Obtaining visas’ follow-up

In my May 2005 column, part two in the series “How to Obtain the Necessary Entry Visas,” I mentioned that when ordering a new passport you will have to pay for shipping it both ways and for expediting service, if needed. Recently, I encountered a problem in mailing my passport to the passport office, so I would like to suggest the following.

Shipping to the passport office is best done by Express Mail (guaranteed overnight) through the post office. You can have your passport returned the same way by enclosing a prepaid Express Mail postal envelope. The passport office also accepts prepaid FedEx envelopes (but not UPS) for returning your passport.

Expediting, which means a turnaround time at the passport office of approximately three days instead of six weeks, requires a check of $60. Despite the hefty sum you paid, your passport will be returned by first-class mail unless you also enclose an Express Mail prepaid envelope. To obtain the tracking numbers for your Express Mail return, call 877/487-2778 and press 3 to speak to an agent.

If you want to expedite or change the method of return shipping after you have sent the passports without “expediting,” call the above number and you can make any changes you want by paying with a credit card.

—The Discerning Traveler is written by Philip Wagenaar.