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Health Talk: Health Websites
Hosted by Craig Stoltz
Washington Post Health Editor

Tuesday, March 20, 2 p.m. EST
Craig Stoltz
Craig Stoltz

Finding health and medical information is one of the most popular, and most important, uses people make of the Internet. Reporters and editors at The Post's Health section go online constantly. But, as we've all discovered, the quality and credibility of the sites--and the information they convey--varies widely.

This week, we're asking readers to share their experiences finding and using health information online--the bad, the good, the horrific, the life-changing. The sites can be those of government agencies, health care providers, supplement and drug makers, independent publishers, interest groups, universities or other entities.

The Health section will be taking a critical look at online health sites in a series of stories to appear in a future issue; by participating today, you can let Health reporters and editors know about your concerns, questions and ideas. And if you're looking for information on a particular topic, we'll be happy to recommend sites we're familiar with that may (or may not) be good sources for you to check. And if you see a question or comment from a fellow reader, feel free to respond with any helpful information and insights you have.

Please read the transcript below.

dingbat

Craig Stoltz: Good afternoon, everyone, and welcome to another edition of Health Talk. This week we're changing formats a bit. Rather than having a medical expert handle questions, we're asking you to share your questions, thoughts, frustrations and successes regarding using the Internet to find Health information. If you have questions about sites, we'll handle those, but we're also hoping you have some instructive tales from your own searches that others can learn from.

All that said, let's get right into today's comments and questions.


Potomac, MD: Would like to know some good sites for info on recommended amounts of soy to take to help with "hot flashes" and other soy advantages in general.

Craig Stoltz: The Office of Women's Health at HHS has a very good and comprehensive site on women's issues at www.4woman.gov.

You can always try www.healthfinder.org, the Federal Government's integrated gateway to all sorts of health information.

In the private sector, I'm a fan of www.drweil.com. Andrew Weil, a Harvard M.D. who also knows how to go alternative, is a good source of information on nutrition, including nutrition with medical intent (as with soy).

www.menopause.org (you'd have to figure somebody bought that Internet address), is the site operated by the North American Menopause Society.

Any one else have sites to recommend?


Reston, VA: I like the teaching college Websites, & anything I find thru Dogpile or Google.
asa.org & asanv.org are very helpful to parents of autistics such as myself. Also sciam.com (Sci. American)
Which brings me to my disappointment with your summary of autism after article about Chris. No mention of recent research (i.e. Dr. Rodier in 2-2000 Scientific American) or Jama on Prozac for preschoolers.
Colleen

Craig Stoltz: Thanks, Colleen. I should point out that Dogpile and Google (not, alas, Googol) are both new-generation search tools that try to use various types of "smart" technology to help you find what you're looking for. (Google, for instance, a partner of washingtonpost.com, provides results based partly on the sites that have been visited by others doing the same search.)

As for today's story, thanks for the feedback. We will take a look at that Scientific American story. The asanv.org site you name is an excellent local source for autism information.


washingtonpost.com: Craig, many HMO's and health care providers are now providing online access for members. For instance, members can get prescription information and their records through a login screen. What do you think about this new approach? Don't you think it's very impersonal?

Craig Stoltz: I think it's great, with a couple of caveats.

1. While I'm quite comfortable with the security of internet technology, I'm not very confident that commercial operators like HMOs and hospitals will keep my information as confidential as the technology permits. There have already been cases where health sites have sold information about individuals, without their consent, to advertisers and marketers.

2. To the extent the Internet can provide people with faster access to simple but important information--i.e., hey, what were my triglycerides on my last blood panel?--that's very good. But my hunch is that, always under pressure to cut costs, providers won't see the value in providing services like that, but only in things that reduce appointments or other costs. In other words, customer service online is good; medical service online may not be.

Anybody have thoughts to share?


washingtonpost.com: Do you think it's safe to have access to (prescription) drugs available online such as www.drugstore.com? How do they prevent kids from getting them?

Craig Stoltz: Legit pharmacies that require legit prescriptions online are great, as far as I can tell. Many folks have been renewing via phone for years, and many folks fax in their prescriptions and now pick them up at drive-through windows. Pharmacies are doing more to make it easier to get prescriptions, and using the Internet is one more way to do it. Bully, I say.

The problem is the rogue pharmacies that provide "online physician consultation." They claim an M.D. reviews your online request, performs a "diagnosis," and writes a prescription the online pharmacy then fulfills. A few attorneys general have investigated these places and found they'll sell Viagra to a nine-year-old, or a weight-loss drug to someone who is underweight. They should be shut down, though I don't know how regulators can pull that off.


Lanham, MD: I heard Dr. Koop online was a great resource. Is he valid and should I just avoid the long waits at my doctor's and use his site?

Craig Stoltz: Drkoop's not particularly good or bad among general interest health Web sites. It started off very strong but has lost a following in the past few months, and onhealth.com has sort of run away as the leading site among consumers.

Drkoop got some bad publicity when the good Dr. was accused of conflict of interest problems--failing to disclose a financial relationship that may have compromised his work on a medical panel.



Frederick, MD: Good afternoon.

Do you know of any good sites that would have information on diseases of the colon?

I've been to three different doctors and they all tell me different things. Maybe a reputable site will help me decide which doctor is correct.

Thank you.

Craig Stoltz: For my money, I like the National Cancer Institute information. Try http://cancernet.nci.nih.gov/, and click into the area on colon cancer. They keep their stuff current and fairly accessible.


Springfield VA: I have some sites to share for those who know people or themselves have Lymphoma or Leukemia. Last year I found the following sites excellent while I traversed the cancer highway.

Granny Barb and Art's Leukemia Links at
www.acor.org/diseases/hematology/leukemia/sitemap.html

A good one on clinical trials is:
cancernet.nci.nih.gov/pdqfull.htm

If you or someone you love is considering a bone marrow transplant or stem cell transplant, a good resource is
www.bmtnews.org

If you or someone you love is facing lymphoma (Hodgkin's or non-Hodgkin's) a good site is
www.lymphoma.org

The best site for lymphoma that I have found is:
www.lymphomainfo.net/hodgkins/resources.html
The above site contains many, many excellent links on the subject of lymphoma and leukemia.

The best support group for Hodgkin's lymphoma I've found is:
hodgkins@solar.org (e-mail address)

Another good lymphoma site is:
www.remission.org

The National Cancer Institute's web site is
www.nci.nih.gov

Craig Stoltz: That's great stuff, Springfield. I particularly like the reference to Granny Barb and Art's (though I confess ignorance about it specifically). But it proves the fact that, often, inspired individuals can put together the most useful information aimed at people like them--i.e., folks dealing with a condition. Very often, institutions find themselves in the habit (or with the obligation) of promoting certain points of view or sources of information and avoiding others. Often real people are the most honest information brokers.


Rockville, MD: Neutrizac, an herbal remedy has 10 ingredients: zinc,B6,B12,St.Johns Wart, Kava Kava, Schisandra, Siberian Ginseng, Feverfew, L-tyrosine and Suma. Is this a beneficial or dangerous supplement to take for antidepression and insomnia? (Taken without prescription drugs for one year).

Craig Stoltz: We can't help you with information about Nuetrizac, Rockvillle--this is the first we've heard of it--but we can steer you to a Web site that might be able to help you.

www.odp.od.nih.gov/ods/databases/ibids.html

is run by the NIH Office of Dietary Supplements; it's a large database of supplements that permits you to look up interactions and other information about what's in your pill.


Woodbridge VA: Does anyone know of a website providing information about varicose veins? My doctor recommended wearing support stockings but I'd like to know whether there is anything else I can do to prevent them getting worse.

Craig Stoltz: Sorry, Woodbridge, but you've given us the perfect opportunity to discuss one of the real hazards of medical and health information online. Because varicose veins are treatable with a variety of approaches, from surgery to nutritional supplements--and because most people who offer treatment offer only one variety--it's a topic that reflects the biases of whoever is providing the information.

For instance: the American Society for Dermatological Surgery has a nicely informative site--that, no surprise, looks favorably at surgical approaches. A British site that supports Natural approaches recommends, by contrast. . .a juice fast as a first line of response. Those who sell support hosiery recommend. . .oh, you know where this is going.

For reasonably unbiased information, I use InteliHealth (confession: a Post online partner) or Onhealth.com (by my taste, it's among the most ambitious and current general health sites.

Anybody have thoughts on this?


Arlington, VA: What are your favorite websites? What are the ones that we should avoid that are bogus?

Craig Stoltz: I tend to stick to popular sites, partly as a journalistic discipline, so I stay in touch with the sites many people in our readership have contact with.

I like WebMD and Onhealth; I also use drweil.com for alternative stuff, and I stay pretty current with NIH and its Office of Alternative Medicine sites. The Berkeley Wellness Letter (one of my favorite ink-on-paper consumer resources) just launched online(though, to get to the good stuff, you have to be a subscriber). And I pay my $2.95 a month to get Consumer Reports online; they do some very good health surveys.

As for sites to avoid: Any site whose primary purpose is to sell things (most drugstore .coms have information sources, but they are (perhaps obviously) not going to be very clear-eyed on products they sell). Put differently: Disqualify any site that makes commerce too prominent. It's sending you a message that it exists primarily to sell, not to inform you.


McLean, VA: Should I be concerned if I decide to purchase Propecia or Minoxodil online? Are there any websites that you recommend?

Craig Stoltz: Buying them online, presuming you have a prescription, is no problem as far as I know (assuming you're getting the brand name). If you don't have a prescription, or get your prescription via one of those shady online "physician screenings," you're essentially self-medicating with controlled substances--and exposing yourself to the associated risks. I wouldn't do it (and, as my photo shows only too well, haven't, at least with those drugs).


Springfield, VA: Craig, I agree that people with a specific disease often times are some of the best sources for information. For example, while my oncologist gave me some tips on what to do about avoiding constipation - a common problem- during chemotherapy, I received many more ideas on what to do from the folks in my Hodgkin's support group because they had they had "been there, done that."

I also found, through my internet support group, that people can and do carry false beliefs. People keep posting that having a massage actually increases cancer cells in those with cancer. I talked with my oncologist about this at Walter Reed, and he told me he's heard a lot of false information about cancer cures-causes, but this had to be the most ridiculous misinformation he's heard yet. He then proceeded to give me the names of some great places to get a massage. So, support boards can raise good questions to take to one's doctor.

Craig Stoltz: Great point, Springfield. Connecting people with like interests--and who often know things first hand even their doctors don't--is a great benefit of the Internet. Do check out several groups, though, as (it quickly becomes clear) some have a higher quality of discourse and information than others. And, yes, cranks and paranoids leave their mark in many groups online too.


Craig Stoltz: Well, we're already out of time for the day. I'd like to thank everybody who pitched in, including those whose comments and questions we didn't get to. We'll be covering the proliferation of Web health information regularly in the Health section, and I'd like to encourage you to send notes about particularly useful and useless sites to us at health@washpost.com, so we can continue to learn what's working and what's not for real people.

We'll be back again next week at 2 p.m., when we'll be discussing (I hope and trust) kidney disease and transplants. Look forward to hearing from you then.

Meantime, eat well and put in some time away from that computer screen, OK?


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