San Diego Magazine / October 2012 / Medical Advice From Our Top Doctors

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Medical Advice From Our Top Doctors

Health tips from a few of the long-standing top docs in San Diego

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Lawrence F. Eichenfield, M.D.

Chief, Pediatric and Adolescent Dermatology
Professor of Pediatrics and Medicine (Dermatology)
Rady Children’s Hospital and UCSD

What’s your stance on getting 20 minutes of sun without protection to make sure we have enough Vitamin D?
The evidence that 20 minutes of unprotected sun will yield good vitamin D levels is lousy. Unprotected sun exposure is a known carcinogen and skin cancer is incredibly common and increasing in San Diego. Vitamin D is essential for skeletal health, but the best way to get vitamin D is from a healthy diet that includes foods naturally rich in vitamin D, foods or beverages fortified with vitamin D, and/or vitamin D supplements. The amount of vitamin D a person receives from the sun is inconsistent and increases the risk of skin cancer.

Daniel Einhorn, M.D., F.A.C.P., F.A.C.E.

Medical Director, Scripps Whittier Diabetes Institute
President-Elect, American College of Endocrinology
Clinical Professor of Medicine, UCSD

Why is diabetes so prevalent, and what advice do you give your patients who suffer from it?
First, many people do not realize that they have diabetes or pre-diabetes because there are no symptoms early on and a blood test is required for diagnosis. According to the Centers for Disease Control and Prevention, more than 79 million Americans have pre-diabetes and 26 million Americans have diabetes. If you have risk factors such as a family history, being overweight, aged over 40, etc., it’s important to know your blood sugar levels. Second, many people may not realize how relatively easy and satisfying it is to prevent diabetes and its complications if the problem is discovered early; our patients are advised that the diagnosis should usher in the healthiest part of their adult lives and they do not need to be perfect to be fine. Finally, while living with diabetes requires courage and thoughtfulness, it has never been as successful as it is today, given the many advances in diagnostics and therapies.

Lee A. Kaplan, M.D.

Division of Dermatology
Scripps Clinic

What’s the most cutting-edge product or therapy in dermatology today?
“Biologics” have recently revolutionized the treatment of severe psoriasis. These new drugs, derived from cell cultures, not synthesized from chemical reagents, are highly targeted against specific immunologic mediators of psoriasis. Consequently, the biologics approved for psoriasis treatment, Enbrel, Humira, Remicade, and Stelara, are generally more potent, less toxic, and better tolerated than previously used traditional drugs. Typically, half of patients with severe psoriasis have 75 percent improvement within 12 weeks of starting biologics, a remarkable advance over prior therapies.

Bruce J. Kimura, M.D.

Medical Director, Cardiovascular Ultrasound Laboratory
Scripps Mercy Hospital

How have cardiac ultrasounds changed the way people are diagnosed?
Unfortunately, I think it’s best to assume that we are all at risk for some form of heart disease as we get older. Our challenge during life is to delay this “natural” progression by exercising, eating a healthy diet, and treating cardiac risk factors, such as hypertension, smoking, diabetes, and high cholesterol. The use of ultrasound at the bedside to enhance the physical examination will improve early diagnosis, encourage routine prevention, and reduce unnecessary testing. It very well may be that the ultrasound stethoscope is one of technology’s greatest contributions to medicine.

For a list of all 2012 San Diego Top Doctors, click here.