Blog

I need to let you know, to prepare yourself should it occur – when your doctor starts with that phrase ‘By the Way..’ or ‘And also..’

You may have had or know someone who had a medical test for looking for one thing but found ‘an incidental finding’. Doctors relay the information in many ways but bottom line ‘we were looking for such and such but also found …..’

The term we affectionately use (pretty sad) is ‘incidentalomas’.

In an analysis of previous studies (BMJ, online June 18), showed unexpected findings including the number of ‘incidentals’ dependent of which parts of the body were scanned.

For example, incidentalomas happened:

just 2% of the time with certain whole-body PET scans and with chest computed tomography (CT)
45% of the time in the throat, abdomen, spine, or heart. CT colonoscopy
22% of the time a brain MRIs may find incidentalomas in the brain

Today’s imaging devices are revealing smaller and smaller structures then even last year. Most incidentals are harmless but earlier recognition of cancers was noted especially imaging of the brain and chest done in the emergency room (ER).

Obesity now affects 1 in 6 children and adolescents in the US, according to the Centers for Disease Control and Prevention. A clear and direct relationship exists, the more sedentary time, the greater the risk of heart disease, diabetes, and obesity. A 2015 study by nonprofit organization Common Sense Media found that US teens spend 6 hours 40 minutes per day on screens, including about two hours of TV, and younger kids spend just over 4.5 hours per day on screens. Even addiction occurs with video gaming, now a recognized disease, see DocHandal’s previous blog worth a read if you missed it.

Seems straightforward enough – more sitting (sedentary) a child the more likely obesity will set in. Sedentary behavior is not just screen time it encompasses is sitting in a car, reading a book, and sitting around ‘shooting the breeze’. Remember there are lots of sitting at school and that is unlikely to change.

Seems easy for parents to have an impact on.

No surprise the American Heart Association (AHA) has an Obesity Committee and they have published a recommendation.  AHA Guidelines recommend screen time of fewer than 2 hours per day, no TVs or screens of any kind in the bedroom and during meals.  Researchers are looking at sedentary behavior when variable physical activity is present. Stay tuned.

Device-free time’ is new mantra while pushing children outdoors.  Also, parents need to do it!

Get out with your kids!

Lately the label ‘healthcare provider’ has replaced medical doctor and physician.  At present physician assistants and nurse practitioners have been recognized as ‘equivalent’ guardians of your health, whichever professional you go to please as applies to you, have them answer some or all the questions below.  Be sure you get an understandable answer. If at first, you do not, demand one!

It is not a one-sided conversation when you seek medical care questions.

Demand a satisfactory answer from Your Healthcare Provider for these :

• What website(s) do you like as a resource for my condition?
• What website(s) do you like as a resource for medications?
• How many calories a day should I have?
• What is an abnormal blood pressure for me?
• What are the side effects of this new prescription? When is it best to take – morning night, with or w/o food
• How much alcohol can I drink to have beneficial effects?
• How much cholesterol a day should I have since on cholesterol-lowering medicine?
• Travel restrictions -there is a minimal realization of the changes that occur to every ‘body’ at flying altitude. Dependent on your health issues flying can be disastrous.

Just a bit of background info for you to go in with:

• How much coffee can I drink a day? FYI- that drinking coffee greater than 3 cups/day ( study found ) decreased in pancreatitis DM and obesity, but more importantly prolonged life.

 

• Should I take aspirin prophylactic and how much?  FYI – low dose has been recommended in many for prevention of stroke and other cardiovascular conditions. New research show it is not one size fits all. The dosage needs to be weight dependent after finding if you weigh more than 70kg & on low dose more likely to die if have a cardiovascular event. Bottom line: low dose is okay for those less than 154.3 (70)kg).

 

• What is the worst thing I should watch for with this new prescription medication (esp. antibiotic)?FYI – fluoroquinolones ( used in humans and animals as Avelox, Cipro,  Floxin, Levaquin, Noroxin, Tequin, Maxaquin) can effect mental health and decrease your sugar level. If he/she mentions frightful side effects feel free to ask ‘Is it really necessary’? Then always read information that accompanies your prescription. One better if you have concern go to drugs.com and read up on the medication.

 

 

Health care settings are not social venues; this is especially true for an emergency room (ER).

Recently a dear friend’s elderly mother was rushed to the ER with high blood pressure 220/120 from her cardiologist’s office where she had been undergoing a heart stress test. I drove to the ER when I heard as a ‘physician’ friend to advocate on her behalf, something no family member could do. After all, as an ER doc talking to her ER doc flow may be different.

What this post focuses on is who and when is it appropriate to ‘visit’ a patient who is in the ER.

Anyone having a medical crisis does not need to be entertained, distracted or be ‘putting’ out to whoever wants to visit. We go to the ER for quick medical attention, not anyone else’s attention. Quiet rest and interaction with those who can help are important. Medical staff can focus on the patient not walk around and repeat the status to a parade of ‘visitors’.

If you do not have a doctor friend I suggest one person should be agreed upon to be the designated spokesperson to the staff as well as on the patient’s behalf.

Please limit ‘company’ for ER patients. The designated visitor can contact those interested with the patient’s status wither they are reached by phone or out in the waiting area.

Considering this can help both the patient and staff.

 

Quite a few of us 7 in 10 Americans take prescription drugs. Ten percent of these prescribed are tainted and unsafe. The counterfeit drug industry amounts to $217 billion worldwide. No surprise given over a dozen hands change before you pick up your prescription.

In recent weeks antihypertensive Valsartan (antihypertensive) generic was found to have a carcinogen contaminate. A few days later the FDA announced a recall of thyroid tablets (levothyroxine and liothyronine)  for adulteration.

Everyone is familiar with the term ‘blockchain’ introduced with rising of cryptocurrency but this turbocharged accounting system is perfect for monitoring a drug supply chain. Blockchain software allows for an encrypted, record that stores all transactions data and monitors each access point. Blockchain means transparency, multiple computers can trace any product using blockchain.  Time is needed to fix all the fraud but security in the prescription drug supply chain is coming.

Diets high in nitrates put one at a higher risk for experiencing a manic episode, according to new research. This was found for both subjects that had and did not have past psychiatric issues.

Three types of meat were found to significantly increase the odds of having a manic episode. The dry cured meat was implicated such as meat sticks and beef and turkey jerky. Eating cured meats prepared through dehydration, such as prosciutto and salami, were not associated with mania. Also observed was that undercooked fish or meat did not increase the risk of mania.

This is worth noting especially for those with psychiatric problems.

 

The future in wound care is almost here! 

A bandage that wirelessly monitors healing, recognizing infection, and carries medication to release should there be a problem with healing.

“This is a way to deliver medicine more effectively,” Dr. Sameer R. Sonkusale and the Nano Lab at Tufts University team had their results in the July 6 Journal – Small.

Part disposable, part reusable this bandage still in lab testing responds to adjusting the temperature to trigger antibiotic release. A ‘drug’ antibiotic patch is capable of destroying growing wound bacteria.

Fewer bandage changes (they can be painful) and less frequent medical office visits a win-win for patients and medical staff.

Next, the bandage goes from the lab to the animals before applying to us.

This study was funded by the National Science Foundation, the National Institutes of Health, and others.

 

The number 1 mood disorder in the US is depression also it is no. 1 cause for missing work, cause for suicide. Specialists believe only 50% of people respond to medication, unsure whether it is the many side effects or long-term compliance.

Our bodies produce many chemicals that can effect our nervous system and even our mental state. Depression is long been attributed and found conclusively to be caused by a decrease of a naturally produced neural transmitter chemical – ‘acetyl-L-carnitine. Recognized in the past that this over the counter substance, an amino acid, has an anti-aging effect. Stanford Univ. researchers found low levels of this substance in people diagnosed with depression. Published July 30th in the ‘Proceedings of the National Academy of Sciences‘ an animal study showed improvement when given this supplement