Dr. D's Tips For Your Health

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CONTENTS:          

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1.   How Not to Die in Hawaii, if you're a tourist - part 3 (4 parts)

2.   Aging Well 

3.   Longevity Secrets

4.   MRI Accidents and Danger

5.    Are Some Organ Transplants Putting Donors at Risk?

6 .  Truth Revealed - Victims of Hiroshima and Nagasaki Atomic Bombing         

7.    Appendix Cancer Rising in Gen X and Millennials 

8.   HMSA - Hawaii's largest health insurance company       

9.   Getting Cancer? - chances are good

How not to die in Hawaii – if you're a Tourist - part 3 (4 parts)

One of the things many visitors who come to Hawaii want to do is snorkel. Snorkeling is swimming on the surface of the water while wearing a snorkel, mask, and fins to see underwater to explore coral reefs and marine life. Snorkeling is the leading cause of drowning among tourists in Hawaii. Beat of Hawaii – Hawaii Travel News warned, “Snorkeling deaths remain especially common because signs of distress often go unnoticed until it's too late.” One Hawaii visitor wrote, “I snorkeled in relatively calm water at a public beach. Suddenly, I could not breathe . . . I was within feet of others but could not speak. To them, I just looked like someone relaxing in the water.” [Click image to enlarge]

In Civil Beat's “Dying For Vacation” series, Part 2, Marian Riker and Nathan Eagle reported, “snorkeling is the most common cause of injury-related death in the islands. . . . a lot of the rescues and drownings occur in waist-deep water . . . when you're wearing fins, it's not an easy thing to stand up in . . . shallow water because this extended foot length that the fin causes makes it very difficult to get your feet under you when you're floating face down.” Most of the tourists who drowned while snorkeling in Hawaii have been men in their 50s and 60s. More than 40% had heart conditions. “Most deaths occurred in less than 3 feet of water.”

Dr. Mark Vu, an anesthesiologist, warned that breathing through a snorkel poses a unique challenge for swimmers. He explained that snorkels have a dead space of bad air, the air that's exhaled but stays in the snorkel tube. Snorkelers have to get fresh air by breathing through the dead space. That can increase carbon dioxide in the blood. “The rise in carbon dioxide in your body makes you sleepy. Sleepy snorkelers eventually drown.” According to Beat of Hawaii, “Tourists also may be dealing with jet lag, sun exposure, and sometimes alcohol---all factors that increase the risk of drowning or fatigue in the water.”

Beat of Hawaii recommends that you always wear flotation gear while snorkeling. “Many drownings involve confident 'free snorkelers' who lose orientation in the water. Float vests or belts can help keep your head above water and buy critical time.” Andy McComb, founder of Redline Rafting, a tour operator that runs snorkel excursions in Maui said some visitors mistakenly think a snorkel is a flotation device. It is not. [Click image to enlarge]

Aging Well

I subscribe to National Geographic. Hannah Singleton reported on how some things in our lives may improve as we age. Dr. Michelle Feng, chief clinical officer at Executive Mental Health and licensed psychologist specializing in geriatric psychology and medicine, said how you choose to think about aging makes a big difference in how you experience it. She said studies show people who have more positive beliefs about aging are more likely to have better cognitive health, fewer mental health issues, and longer lifespan. A study published in the Journal of Personality and Social Psychology found that people with a positive attitude toward aging lived an average of 7.5 years longer than those who internalized negative stereotypes.

Longevity Secrets

Merely living longer but in poor health or worsening health is not what most people want. People want to live longer and well. Some experts on healthy aging shared their wisdom on how to do that, which are not really secrets. Dana G. Smith reported for The NY Times that most aging experts believe “by practicing a few simple behaviors, many people can live healthier for longer, reaching 80, 90 and even 100 in good physical and mental shape.” Dr. Luigi Ferrucci, scientific director of the National Institute on Aging, said, “People are looking for the magic pill and the magic pill is already here.”

“The number one thing experts recommended was to keep you body active. . . . study after study has shown that exercise reduces the risk of premature death.” The American Heart Association said the best exercise is any activity you enjoy doing and will stick with. You don't have to do a lot. “Just walking a little more than 20 minutes a day is beneficial.”

Eat more fruits, vegetables, whole grains, legumes, nuts; and eat fewer processed foods. This is good advice for lowering your risk of heart disease, cancer, diabetes, and dementia. Getting enough good quality sleep can add several years to your life. A recent study found people who slept less than five hours a night had double the risk of developing dementia. Whether you smoke it or chew it, tobacco “raises your risk for all kinds of deadly diseases.” Alcohol raises your risk for heart disease, liver disease, and at least seven types of cancer. If you have chronic health conditions such as hypertension, diabetes, heart disease, high cholesterol, follow your doctor's advice to keep them under control.

Dr. Anna Chang, professor of medicine specializing in geriatrics at the University of California, San Francisco, warned, “Isolation and loneliness is as big a detriment to our health as smoking.” They are risk factors for dementia, heart disease, stroke. People who think positively live longer. Dr. Alison Moore, professor of medicine and chief of geriatrics, gerontology, and palliative care at the University of California, San Diego, said if you had to pick one healthy practice for longevity, “do some version of physical activity. If you can't do that, then focus on being positive.”

MRI Accidents and Danger

When I was growing up, back in the old days, we would hear about people having to undergo “exploratory surgery.” Something was wrong with them physically, but doctors could not determine what it was, so they cut the person open and searched around inside. Unless there was something obvious like cancer that could be seen spreading on internal organs, many times they could find nothing. Often they did not know what they were looking for. People, these days are so lucky because we have technology that can non-invasively look inside the body, with more precision. That means people do not have to be cut open to do this. One example is the MRI scan which is a wonderful invention, but there are some dangers.

I subscribe to Scientific American. Michaela Maya-Mrschtik reported, “When serious accidents happen in magnetic resonance imaging scanners, it's usually because people ignore one very important rule.” MRI is abbreviation for magnetic resonance imaging. The word magnetic should remind us it's a powerful electromagnet. This means metallic objects “close to a switched on MRI can become dangerous projectiles.” They “are attracted to it with a great deal of force.”

Here are some examples. Maya-Mrschtik said a man went with his wife to an MRI center for her knee to be scanned. His wife called him into the MRI room to help her stand after the scanning was completed. The machine was still on. The 20-pound metal chain he wore around his neck for weight training “was immediately attracted to the magnet in the MRI. It pulled the man's body with it, hurled him against the scanner and trapped him there. He sustained serious injuries.” He died. 

In another case, someone left an oxygen tank in the MRI room. When a boy was being scanned the tank flew across the room and slammed into the opening or bore of the machine where the boy was, killing the boy. 

A man accompanying his mother took a loaded gun into the MRI room. “The magnet pulled the gun out of his waistband, and a shot went off when it hit the scanner.” The bullet hit the man killing him.

“There can even be problems with tattoos that contain certain metallic inks. In one case, a tattooed professional football player sustained burns during a pelvic MRI scan.”

Maya-Mrschtik said, “In general, MRIs are very safe when used properly.” Tens of thousands of scans are performed every year. Serious accidents are rare. “But it's important that MRI patients follow one cardinal rule: leave the metal outside the scanning room.” 

Are Some Organ Transplants Putting Donors at Risk?

The NY Times published an article on organ transplants by Brian M. Rosenthal and Julie Tate, with contributions by Mark Hansen and Susan C. Beachy. Rosenthal is an investigative reporter for The NY Times. He said, “this was not a story I was eager to cover.” It started with reporting he had been doing on the organ transplant system which he had been investigating for over a year. He said he spoke with hundreds of people involved in the transplant system across the country. “This is a system that has a lot of safe guards built in to protect both donors and recipients, but throughout my reporting I kept hearing story after story of organ donation procedures gone horribly wrong.” He wanted to know how common these problems are so with his colleague, Julie Tate, they obtained records from hospitals, organ procurement organizations, and state medical boards. He talked to people who had been involved in cases he heard about.

For more, see the NY Times article: “A Push for More Organ Transplants is Putting Donors at Risk.”

Rosenthal said every year tens of thousands of lifesaving transplants are carried out across the US. “There is an organ waiting list in the US of more than 100,000 people who desperately need a transplant. [Many will not receive one.] To provide one, increasingly donor safety is being compromised.” Rosenthal and Tate revealed “a pattern of rushed decision-making that has prioritized the need for more organs over the safety of potential donors.” For example, a woman was removed from a ventilator and after 103 minutes, declared dead. “A surgeon made an incision in her chest and sawed through her breastbone. That's when the doctors discovered her heart was beating. She appeared to be breathing. They were slicing into [her] while she was alive.” This was most likely without anesthesia or pain medications because would that be given to a person presumed to be dead?

“Workers in several states said they had seen coordinators persuading hospital clinicians to administer morphine, propofol and other drugs to hasten the death of potential donors.” A 38-year-old woman was in a coma and on life support. Doctors told her family she would never recover. The family agreed to donate her organs. Then they saw tears in her eyes. Donation coordinators said the tears were an involuntary reflex. Her family saw her move. The doctor asked her to blink her eyes and she did. The procurement organization said it was just reflexes and suggested morphine to reduce movements. The hospital refused and she was taken back to her room. She eventually made a full recovery.

Rosenthal said, “Stories like these have emerged as the transplant system has increasingly turned to a type of organ removal called donation after circulatory death. It accounted for a third of all donations last year; about 20,000 organs.” He said most donated organs in the US come from people who are brain-dead---an irreversible state. “Circulatory death donation is different. These patients are on life support, often in a coma. Their prognoses are more of a medical judgment call.”

Truth Revealed - Victims of Atomic Bombing of Hiroshima and Nagasaki

This year is 80 years since the atomic bombing of Hiroshima (August 6, 1945) and Nagasaki (August 9, 1945). An estimated 90,000 to 120,000 people died in Hiroshima and 60,000 to 70,000 in Nagasaki. These numbers are rough estimates because there were no bodies to count near the hypocenter or ground zero. Those bodies were vaporized. [Click on image/photo to enlarge]

Dennis Normile reported for Science that in 1946, US President Harry Truman approved research into the effects of the radiation exposure. The Atomic Bomb Casualty Commission (ABCC) was created to seize this “unique opportunity for the study of the medical and biological effects of radiation.” For example, leukemia was a rare disease in those days but epidemiologist, Dr. Kotaro Ozasa said leukemia “was appearing a lot among the survivors.” Normile said, “ABCC showed the disease was especially prevalent among those closest to the hypocenter.”

Kimberly Applegate, a radiation health expert and member of the International Commission on Radiological Protection said findings of the studies have had an outsized influence on policies and practices to make use of ionizing radiation safer. Normile said, “The shielded rooms now routine for x-ray procedures and dosimetry badges that track accumulated exposure of health care and nuclear power plant workers are based in part on [that] data.”

Survivors of the atomic bombing of Hiroshima and Nagasaki are known as hibakusha 被爆者 [ひばくしゃ]. Normile revealed that survivors who participated in the studies “didn't reap benefits from the studies, at least at first.” Kunihiko Iida, a survivor, said many joined the studies expecting treatment for their ills. Normile said, “ABCC did not offer treatment because it might be seen as an admission of responsibility for their suffering by the United States.” Iida said, “ABCC did not have a good reputation among the hiakusha.” In 1975 ABCC was reorganized into Radiation Effects Research Foundation (RERF). “RERF now shares tests results and other individual data with study participants and provides them with counseling and referrals; the Japanese government subsidizes health care for most hibakusha.” On the 70^th anniversary of the commission's founding, Ohtsura Niwa,, chairman of RERF, “expressed regret that ABCC had studied bombing victims without treating them.”

Normile said the study participants left an important legacy. “Most of what is known today about the long-term health effects of radiation has come out of research with those survivors.” Akiko Naono, a sociologist at Kyoto University said the hibakusha feel they are the source of data but still see little in return.

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Appendix Cancer Rising in Gen X and Millennials

People born between 1965 and 1980 are Generation X. They are the generation after Baby Boomers. Millennials (Generation Y) are people born between 1981 and 1996.

A new study by researchers at Vanderbilt University Medical Center in Nashville, Tennessee, published in June 2025, in the Annals of Internal Medicine found appendix cancer is becoming more common among younger generations. This is a pattern that has been occurring with other cancers since the 1990s. In earlier generations, cancer tended to be a disease that occurred more commonly in old people. One reason tended to be the length of time of exposure to and accumulation of risk factors. The researchers found appendiceal adenocarcinoma (AA) diagnoses more than tripled in people born around 1980 and quadrupled in those born around 1985.

Nina Agrawal reported for The NY Times that cancer incidence rates among members of Generation X were two to three times higher compared to people born in the 1940s. Rates among older Millennials, born in the 1980s, were more than four times higher.

Maria Azzurra Volpe reported for Newsweek that the study was based on data from the National Cancer Institute SEER (Surveillance, Epidemiology, and End Results) Program.

Agrawal said, “The findings come at a time of growing concern about the earlier onset of certain cancers, including colorectal, breast and kidney cancers” among young people. Dr. Andrea Cercek, medical oncologist at Memorial Sloan Kettering Cancer Center, who was not involved in the study, said the new research describes what's known as “birth cohort” effect, or a disease becoming more common among successive generations. Such an effect lends credence to the idea that people born after a certain time have had similar exposures to something that is increasing their cancer risk more so than among people born decades before. What's often suggested are diet and processed food, but nearly everybody's eating processed food, including older people. What are young people exposed to more than any previous generation, their eyes continually focused on it, exposing their breast, bowels, and appendix to it while they talk, text and watch videos? It's their wireless devices, wifi, and EMF (electromagnetic fields).

Many people may not have noticeable symptoms when exposed to wireless devices. Whether you notice symptoms or not, there is growing evidence about biological effects from being exposed to radio frequency (RF) radiation. Healthline reported the International Agency for Research on Cancer (IARC) classified EMFs (electromagnetic fields) in the RF range as Group 2B, possible human carcinogen. These fields are produced by cell phones, smart devices, tablets. “The current IARC evaluation from 2011 pointed to a possible link between RF radiation and cancer in people. The multi-trillion-dollar wireless industry assures us the technology is safe. This is what industry does, produces its own biased research, as did tobacco, DDT, asbestos, glyphosate. They kept telling us their product was safe. They produced research to show it was safe. It took years of harm to many people before industry could no longer deny and hide the truth. Now the latest revelation is that glyphosate causes cancer. People are winning multi-billion-dollar lawsuits against glyphosate (Roundup) after decades of the public being told by the industry that glyphosate is safe.

HMSA – Hawaii's largest health insurance company

Daryl Huff, for Hawaii News Now, reported some doctors and families say, too often, HMSA [Hawaii Medical Service Association] is refusing to pay for care they need. Hilo attorney, Ted Hong “compiled the stories of more than 30 patients who say they were denied needed care by HMSA's pre-authorization process.” Tammy Souza told her husband, Craig McKinzie, HMSA refused to cover radiation treatment for her breast cancer. He said, before she died, “The last thing she wrote was, 'I want everyone to know that HMSA was basically responsible for my death.'”

Scott Norton was required by HMSA to get weeks of physical therapy before HMSA would approve an MRI or specialist care. His son said Norton “just got worse.” He was in a lot of pain, but no one knew he had cancer because HMSA denied the MRI. “The cancer was literally eating his bones at the time that he had to go through physical therapy.” After months of suffering, Norton died. “He was angry. He said we had been paying HMSA all these years.”

Charlene Orcino was examined by an OBGYN who prescribed medication to stop her premature labor. She went to two different pharmacies that told her HMSA refused to honor the prescription. She had to be medivaced to Honolulu for emergency delivery of an extremely premature baby at 25 weeks gestation. The baby is “substantially disabled.” 

Sophie Cocke, for StarAdvertiser, reported, HMSA executives “received hefty pay raises and bonuses during the COVID-19 pandemic” at the same time HMSA was eliminating and outsourcing the jobs of nearly 200 employees. 107 HMSA workers lost their jobs. Another 89 employees now provide customer service for HMSA as employees of a company based in Mumbai, India, or provide tech assistance for HMSA as employees of a company in Maryland and Bengaluru, India.

Total compensation to Mark Mugiishi, HMSA President and CEO, rose from $2.5 million in 2021 to $3 million in 2022 (18.6% increase).

Gina Marting, HMSA executive vice president and CFO: total compensation rose 20% from $902,402 in 2021 to $1.08 million in 2022.

Janna Nakagawa, HMSA vice president and chief administrative and strategy officer: total compensation rose from $788,287 to $995,633 (26% increase) in 2022.

David Herndon, HMSA executive vice president and chief business operations officer: total compensation rose to $817,361 (3.7% increase) in 2022. Jennifer Walker, HMSA senior vice president for data and analytics and general counsel: total compensation rose nearly 20% to $737,689 in 2022.

Nakagawa said compensation for the top officers is determined by HMSA's board of directors. The board “also voted to begin compensating itself.” Board Chair, Robert Harrison was paid $105,000 in 2022. HMSA has 14 directors. Elizabeth Hokada was paid $99,500; Lisa Sakamoto was paid $93,500. Other directors received between $67,000 and $88,000 in 2022. According to HMSA bylaws, the board is required to hold at least four regular meetings a year.

HMSA is a nonprofit organization. It reported profits of $48.9 million in 2021 and $26.9 million in 2022. In 2021 employee salary increases were capped at 1.5%. Average increase was 1%. In 2022 average employee raise was 3% according to HMSA.

Getting Cancer? – chances are good

Kate Kelland reported for Reuters that an analysis published in The Lancet found “people around the world are living longer, but many are also living sicker lives for longer.” The study of all major disease and injuries in 188 countries led by Dr. Theo Vos, a professor at the Institute of Health Metrics and Evaluation at the University of Washington, found general health has improved world wide, but healthy life expectancy has not increased as much, so people are living more years with illness and disability. One illness that detracts from quality of life and imposes heavy costs is cancer.

T.J. DeGroat reporting for Lifestyle News, said hearing your doctor say, “you have cancer” is something no one wants to experience. No one wants to hear that ever, but chances are good you and many other people will be hearing those words. Dr. Len Lichtenfeld, oncologist and former deputy chief medical officer for the American Cancer Society, said one in two men and one in three women in the US are expected to be diagnosed with cancer. You can keep your lifetime cancer risk lower than the numbers predict because lifestyle does play a role in raising or lowering your risk.

In addition to a healthy lifestyle you need to know how to protect yourself from toxic exposures. There are many different kinds of hazards. These are known to cause genetic damage and gene mutations that can lead to cancer. The gene mutation may appear random because it often takes time, even years before the result of the mutation or a cancer becomes apparent. Dr. David Katz, founder of Yale University's Yale-Griffin Prevention Research Center, said, “random mutations are not necessarily random at all,” they may arise as a result of lifestyle factors. He said, “Mutation rates are higher in those exposed to toxins and lower in those exposed to health-promoting conditions. Studies have already shown that cancer-promoter genes are turned off and cancer-suppressor genes turned on by healthy living.” In our zoom webinars, Dr. Shintani covers information on promoting health and I cover toxic exposures.  

Information in this blog is not intended for diagnosis or treatment of any health condition. It does not take the place of medical advice from your physician or healthcare provider. Obtain advice from your own healthcare provider before making changes in your decisions or actions pertaining to your health.

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