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Doc Handal's Medical Common Sense

Wound Care Instructions

We all get cuts, scraps from minor injury. Our skin is a barrier and protection once it is ‘violated’ it is up to us to care for it. The following are a few important basic to ‘wound’ care when you are not given specific direction from a medical professional.

Supplies needed:

  • antibacterial soap (Lever 2000®, Dial®)
  • Vasoline petroleum jelly (NOT Neosporin® or Bacitracin®)
  • Q tips
  • Bandages size to cover wound

Actions till completely healed:

  • keep wound clean wash with soapy water gently
  • keep coated with thin layer of ointment
  • cover with clean bandage
  • clean at least twice a day and whenever get it wet
  • cover sun block (SPF30) for one year round to avoid scarring


I like and have repeatedly used Aquaphor® healing ointment (OTC) which protects against infection*, promote healing, avoids scab formation so decreases a scar forming.


*signs of infection increasing redness, swelling, pain or drainage

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Synthetic Marijuana – Dangerous

Goes By Many Street Names

Goes By Many Street Names

Synthetic marijuana (some street names include: sK2, diamond, Genie, Dawn, Spice) was never tested in humans, but used for research. It does decrease the flow of oxygen there by mimicking marijuana “high.” Can be smoked mixed with food/drink, it’s banned in many countries but not US at present.

A published study Philadelphia’s Children’s National Health System found in teenagers use can cause serious heart complications. No matter your age low oxygen levels are potentially catastrophic. This would be true even for the young.

Symptoms will include shortness breath, chest pain to name two.

The Partnership for Drug-Free America, Arizona chapter published a one page Marijuana Fact Sheet that you must read! Get the lowdown on synthetic marijuana, it is important!

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Poison Help Centers

In the case of accidental poisoning, if time permits, contact the Poison Help Center at 1-800-222-1222. Poison Help Centers operate around-the-clock and can provide you with FREE & confidential advice and treatment options so you can start before reaching the ER.[ois

You can dial this toll free number from anywhere in the US, including American Samoa, Puerto Rico, US Virgin Islands and Micronesia it will be routed based on your area code and exchange or your location to the one of the 55 U.S. poison centers that is designated to serve your region.

Remember dial 911 if a person cannot be awakened, has trouble breathing, collapses, or has a seizure.

You also can go online at to http://www.webpoisoncontrol.org

“There’s also a free app that allows you to scan the product barcode, which you can download at the Apple Store and at Google play. webPOISONCONTROL® was developed by poison control experts, and like calling, it’s free and confidential. At present, the app is powered by more than 1000 ingredient algorithms linked to household and pharmaceutical products and barcodes. More algorithms and products are being added every day.” *


*Personal communication with Toby Litovitz, MD?Executive & Medical Director?National Capital Poison Center


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Fractures That Do Not Heal

There are many reasons why fractures may not heal including:

Immobilization-conservative first round treatment for fractures

Immobilization-conservative first round treatment for fractures

  • ends of the bone are too far apart to grow back together
  • so much damage to or loss of blood supply around fracture
  • ‘reduction’ alignment of fracture ends is poor
  • infection

Naturally medical conditions such as diabetes, hypothyroidism, and anemia can contribute to ‘delayed’ slow or non-union. Lifestyle can contributes negatively from smoking, excessive alcohol intake.

Over doing the OTC anti-inflammatories and NSAIDs can decrease the inflammatory reaction as bone tries to get together. Inflammation is the first stage of bone healing (followed by ‘reparative’, and ‘remodeling’). Prescription immunosuppressants, and anticoagulants can also slow bone Every couple weeks an X-Ray is taken to see progress, if after 90 days there is no (‘non-union’) or poor fracture healing (‘delayed’) further treatment methods are necessary.

External Bone Stimulator Device

External Bone Stimulator Device

Treatment recommendations may include a bone stimulator application to fracture site daily. Placing the fracture site within the electronic ‘cage’ borders for 30′ daily  (up to 12 weeks in difficult fractures) has been proven (insurance pays for this) to heal fractures.

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SAVE On Health Care

None of us can say without a doubt that we will never visit a doctor. This blog offers insights for everyone with and without health insurance.MH900047805

If you are an out of pocket patient, please ask up front for the ‘cash pay rate’ then negotiate terms. Ask about partial payment, schedule, or a discount for all up front. Be sure to get a receipt that says paid in full, so no add-ons are mentioned later. It is smart to have an idea of the cost of medical condition treatments, so go to these 2 websites: clearhealthcosts.com and healthcarebluebook.com. Compare rates and procedures dependent on your location, from MRI to vasectomies.

BE aware that having a procedure/test in a hospital can cost 10-20 times more than at specialized facility out patient center. Many facilities are associated with hospitals but are off-site. Routine tests such as imaging studies, diagnostic procedures such as colonoscopy, gastroscopy can be done safely and efficiently at these facilities. Non-hospital facilities are audited and accredited by the Joint Commission. Ask and check if the facility meets standards for:

  • Ambulatory Health Care
  • Surgery Centers
  • Office-Based Surgery
  • Imaging Centers
  • Sleep Centers
  • Urgent Care Centers

The ordering physicians may have a preference, others will leave it up to you but your insurance has it’s preferences, so ask.

Filling a prescription? – When taking a generic drug, paying cash is more often than not less expensive than the co-pay of your prescription insurance plan. It is well worth checking the list for $4.00 medication on Target, Wal-Mart, Costco websites. Sadly if you are on Medicare you do not have this option. Comparison-shopping can save!

We welcome sharing your experiences from medical encounters.


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Never Bleed to Death

Credit: American Chemical Society

Credit: American Chemical Society

A new take on stopping someone from bleeding to death is almost here!

Wither traumatic injuries, serious car accidents, street violence, or field combat, large volume of blood loss causes death. In reality it is the leading cause of death in individuals under age 45 in the US.

A recent field test may significantly change how treatment transpires.

By using a biopolymer derived from the shells of shrimp, scientists have developed foam that once sprayed on open wounds becomes solid stopping bleeding. Successful testing on pigs was reported recently (5/29/15) in the Journal ACS Biomaterials Science & Engineering. On pigs a 90% decrease in blood loss was noted and pressure application was not needed.

Chitosan the biopolymer is already being used in 2 types of non–foam wound dressings approved by the FDA.


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Appendicitis: Antibiotics vs. Surgery



An increasing amount of evidence supports the use of antibiotics (Abx.) instead of surgical removal for treating patients with uncomplicated acute appendicitis.

From Finland comes research showing that uncomplicated acute appendicitis confirmed by computed tomography (CT) can be treated without going under the knife (scalpel)!

The uncomplicated appendicitis patients were divided into 2 groups: those given Abx. vs. those that underwent surgery. Abx was initially intravenous – Invan® (ertapenem)(1 g/d) for 3 days – followed by 7 days of oral – levofloxacin-Levoquin ® (500 mg once daily) and metronidazole -Flagyl® (500 mg 3 times per day).

The primary endpoint for antibiotic-treated patients was discharge from the hospital without the need for surgery and no recurrent appendicitis during a 1-year follow-up period.

Prompt the surgeon if antibiotics could save you the scalpel!

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Must Wear!

This isn’t a blog on ‘tech wearables’ the likes of ‘Fitbit®’ but about life saving wear. Screen Shot 2015-06-19 at 12.08.49 PMI hope that you have pertinent medical information on your Smartphone either in an app or in the form of your I. C. E. contact. Many individuals should have more obvious displayed alerts. When time is critical and you are unable to speak,  your medical ID(s) can speak volumes to the healthcare providers.

There are all types of jewelry, many of us choose as identifying piece(s). I suggest that there is one vital piece that you’ll want to wear if you have any type of medical issue(s).

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Reasonable priced (starting $19.99) an engraved band, charm, dog tag, necklace or bracelet can ID a medical condition(s), medication(s) and allergies.

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Breast Cancer- First Blood Test?

Breast abnormalities can be benign (non-cancerous not life threatening), cancerous, or even precancerous. Each diagnostic test finds different information  example mammogram, MRI, ultrasound each offers its  view.

FACTS:Screen Shot 2015-06-19 at 10.36.08 AM

-70-90% of the 1.7 million breast biopsies done each year are benign (not cancer)

– Screening mammograms miss approx. 20% of all breast cancer (esp. those in young women or those with dense breasts)

– More than 50% of women who get annual mammograms will have a false positive result after 10 years of screening

A new blood test is claiming to be able to differentiate benign breast disease from breast cancer. The results are either in terms of a ‘low protein signature’ or a ‘high protein signature’ being found in the blood. Biochemical clues – ‘biomarkers’ – have been found in the blood of breast cancer patients hence it may be linked to those individuals developing breast cancer. Now a simple blood test –Klarifyi ®Breast  to help guide the diagnosis and care of breast cancer.

Important: This test is recommended in conjunction with imaging tests.

If your recent mammogram showed a ‘suspicious’ or the finding are questionable perhaps your medical care provider will suggest a quick blood test (results within a week).



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Obese Mother Means Obese Child?

Screen Shot 2014-04-27 at 9.55.25 AM

Doomed From Birth?

Mothers in utero may be ‘programming’ fetal stem cells to accumulate extra fat according to a recent study taking umbilical cord stem cells from of normal weight babies of obese mothers & non-obese mothers. In the lab, cells from the baby with obese mothers grew and had more fat accumulation which can effect insulin resistance in the future.

It has been known for over a decade that women who have or become Diabetic during pregnancy pass on that potential  and other metabolic problems. Now it is would appear that obesity can also be passed on!

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