Medicine Is Not an Exact Science

Everyone is different you have heard this regarding many issues, but this especially comes into the forefront as the healthcare system responds to the novel virus pandemic. Medicine is an art not a precise field of science. I listen to so many concerns, confusion, and complaints regarding all aspects of the pandemic. It is not fake, it is gravely real! In this blog, I want to offer some medical insights in an attempt to clarify and hopefully not confuse you more. Let’s start with recognizing the illness, well it is a virus, it is everywhere, and it needs a living ‘host’, us humans to multiple and then making us ill – ‘attack’ our organs. Allot more complicated than the common cold virus (there are many of them). We are all unique so how our bodies respond is different. How long it takes feel ill, if it causes illness at all varies – husband may get it bad and wife never turns positive! This brings me to the myriad of tests for the presence of the virus – SARS- CoV-2. There are so many all have varying accuracy. You can be sneezed upon by a COVID-19 ill person and it can take anywhere from 5-14 days for your test to turn positive.* Why? Well, for a test to pick up the presence of this virus it has to have multiplied a specific number of times, and how quickly it does that depends on our individual immunity. Has your body been primed by small dose exposures to the virus? No way to tell, I’m afraid. Why can a mother contract COVID-19 and feel better after 2 weeks yet not have a  positive antibody test for 45 days, yet her son can have measurable antibodies  – tested within 10 days of feeling better. You get the sense there is no fixed formula.

*CDC is considering at the time of this blog to shorten quarantine after finding that 50% become ill with symptoms in 5-6 days, 9% in 10 days while only 2% in 14 days.

Medicine is an art not an exact body of knowledge that can apply to all.

What As Well As When You Eat Matters

What you eat and also when you eat are important factors in your health.

A researcher scientist (Nour Makarem) at Columbia University Irving Medical Center in New York studied weekday vs. weekend dietary habits. She found that waist circumference, body fat, blood pressure, and blood sugar were all affected. These are all important heart health risk factors.

Studying women age 20-64, she found for every 10% increase in inconsistency in calories consumed after 5 p.m, blood pressure and blood sugar (measured by HbA1c) were negatively altered.

Earlier research by this scientist had shown that eating more in the evenings negatively affected the heart risk for disease.

The present COVID-19 pandemic could be further contributing to the disruption of eating and sleeping cycles and hence our health. I find heeding the suggestion from these results that especially now we reduce evening intake. Please, as we cocoon to decrease virus spread, follow a routine that ensures time for exercise,

Best Time To Exercise

Yes, exercise whenever you can. However, have a quick read for some insight into the optimal timing of this important health activity. As with so many other human bodily functions and activities attention to our biological rhythms; is also known as circadian or diurnal rhythms is important.

Let’s first think about aerobic exercise which helps with weight loss management and enhances peak maximal oxygen consumption – studies vary in findings, one showed the best time is in the morning and another best in the evening. Both studies were men cyclists participating. For resistance training again findings for optimal timing differed night vs. morning.

Authors of another review, published in the Journal of Strength and Conditioning Research, found differences in the morning vs evening exercise, these researchers hormones variations as a possible reason. Testosterone and cortisol to be specific, testosterone an anabolic hormone and cortisol the stress catabolic hormone. Cortisol can peak in the morning, night, or both according to the research, with testosterone peaking at similar times, thus potentially offsetting cortisol’s catabolic effects. Yes, quite confusing but how do you apply this information to your routine? Plain and straight forward, exercise is always good no matter the time.

The American Council of Exercise (ACE) goes a step further recommending to record your temperature every couple of hours for 5 or 6 consecutive days to determine body temperature variation, which typically fluctuates by plus or minus 1.5 degrees throughout the day. Then exercise three hours before and after your highest temperature. If you are competing at a specific time, then train at that time.

Yes more studies need to be done!

 

Flu or COVID-19 or Twindemic?

Unless you have been living under a rock, you know about the ‘novel’ virus and also know flu season is upon us. I feel I need to share some clues to help you tell the difference. Typical flu season runs from October to April, and flu vaccines, washing hands, and isolating when you are ill is so important. Both are highly contagious and these precautions apply to both viral illnesses. Several of the symptoms, the way you feel, are exactly the same when both one of these viruses infect you.

Overlapping symptoms include exhaustion (fatigue), diffuse body aches, fever, chills, cough, difficulty breathing. but also minor sore throat runny noses headache. Sound exactly similar?  BUT flu, does not give you a change in or loss of smell and taste. COVID-19 illness does!

That said realize some of us might have no or only a few symptoms. May be mild in some and in others symptoms may be quite severe. By now you realize that in most cases in order to accurately find out which you have a test is necessary.

Realizing there is no ‘cure’ but supporting medications exist for both. But once you are thinking flu or COVID infection, please self isolate immediately and call your doctor.

Flu is caught easier than COVID-19. Catching the flu shows within 1- 4 days.COVID-19 symptoms may start anywhere from 5 -14 days after exposure.

We need to remember that there are many asymptomatic carriers of COVID-19. They are not unwell but can pass it on to you, should you not be keeping a safe distance as well as wearing a mask. Sharing living space increases the likelihood of spread for both illnesses.

A flu shot will not prevent COVID-19 actually many people who receive the flu shot will get the flu. Recall the 4 viruses it protects against might not be what is around this season.

Already individuals are infected with both at the same time! Twindemic! Both are respiratory viruses. So you can imagine the fear medical personnel have in treating patients with the one drug that exists to fight the flu.

Disinfecting measures curb the spread of flu & COVID-19. Efforts to mitigate COVID-19 include handwashing, mask-wearing, and social distancing – I believe need more than 6 feet.

Copper Kills Germs

I want to share good health news about a metal that has been around for a very long time. As far back as 2600 BC the ancients knew copper sanitized water and used to treat wounds. Currently poorer countries use copper containers for drinking water. A low-cost way to prevent infection in wounds.

Cooper is considered ‘biocidal’, that is it can kill bacteria upon contact. So important, in this day of over-prescription antibiotics and merging antibiotic resistance by bacteria. At the start of the pandemic, you may have heard the observation that on copper surfaces the SARS-CoV2 can’t die.  It was already known that E. coli (tested was E. coli O157) while lasting 28 days on stainless steel surfaces only lasts minutes on copper ones.

It has been proven that copper can kill several different bacteria, including Legionella, Escherichia coli, Clostridium difficile, methicillin-resistant Staphylococcus aureus, and even antibiotic-resistant bacteria – vancomycin-resistant Enterococcus. In the 1990s  Philadephia outbreak of Legionnaire’s disease, it was noted that the bacteria were less likely to grow on copper pipes (vs. steel or plastic).

Researchers deduced that “..copper is capable to inhibit, inactivate, reduce, and irreversibly destroy coronavirus, influenza virus, and other pathogenic agents in a matter of minutes.”

Not just bacteria but viruses, succumb to copper. Earlier this year in The New England Journal of Medicine, researchers showed that SARS-CoV-2 was viable on plastic and stainless steel surfaces for up to 3 days, but was eliminated on copper after 4 hours.

Other respiratory viruses that succumb to the effects of copper are influenza H1N1 and influenza A.

What to do with what we have learned? Think why not infuse textiles, with copper? Well, it has been done and a publication of the results showed high-risk respiratory patients using bed linen, towels, and clothing with copper in them had less fever need for antibiotics.

Not much has been done to evaluate if copper can affect fungus. But there are positive suggestions in the literature.

FYI cooper fabric does not cause skin irritation 

 

Napping Is Good

Are you one of the many humans who can’t focus well and tired around midafternoon? It is quite common. UNsure if it is your from circadian rhythm or age. Napping is a solution, documented that a quick midday snooze can benefit your mental and physical performance. Don’t believe me, then why is the US Army for the first time ever encouraging soldiers to take a nap? You can find it in the Army new fitness training manual. This may have resulted from a study in cadets reported in July 2018.

Restorative, a quick 30 min nap could get you an edge on an intense workout, or a big game. Yes NBA & NFL teams swear by pregame naps. Also, it has been found to improve your mental performance before an important meeting or function.

The science comes from yet another study supporting this valuable ‘habit’. A study published in Medicine & Science in Sports & Excercise examined karate athletes. Random 30 min naps or no naps followed by measurements of capabilities found naps gave athletes a measurable and significant improved alertness.

I was unable to find the best duration for an effective nap but the literature suggests 25-45 minutes. A study in napping and performance in 5-meter shuttle run test compared 25,35,45 min naps before practice and competition. Results point to as much as a 9% improvement when a 45 min. nap was taken!

I have been talking about mental and physical performance for which a nap helps healthy individuals. If you are always tired and needing frequent napping it may be the result of a health issue. Worth a talk to your healthcare provider.

 Get a leg up with a midday lie-down!

Maskne – From Wearing Masks

Maskne. What is it?

A breakout on face from mask-wearing. Actually quite common. Acne is due to many things including clogged pores, hormones, and C. acnes bacteria, also from mechanical insult to the skin.

Termed ‘acne mechanica  Repeated friction leads to skin irritation in the short term. Over time, continued friction leads to inflammation that can block pores, and here comes ‘break-out’! As we try to avoid serious illness by wearing a mask, untold negatives can occur. Moisture and sweat become trapped, the area corresponding to the mask can erupt with lesions.

Prevention

Avoid makeup, humidity, and in cold weather, our skin drys and can contribute negatively. Use lightweight sunscreen or facial moisturizer, so as not to plug pores.

Our skin has microscopic layers of protection in form of oils and fats. This can be broken down by mask-wearing. So use petroleum-based moisturizer.

The lips require your attention, use lip balm under the mask, protective petroleum jelly. I use the Desert Essence Tea Tree stick. 

Reusable masks must be washed and if possible use UV-C light to clean, once any mask is damp it must be discarded if non-reusable or washed is reusable.

Wash reusable masks, by soaking in soapy water for 20 min. then let air dry. 

Reusing disposable masks isn’t ideal from an efficacy standpoint nor to prevent skin concerns. 

Research out of University Illinois showed one layer face mask of regular cotton blend t-shirt material can decrease respiratory droplets by 40% and a double layer of these breathable materials offers 98% droplet reduction. * 

simplify skincare, you don’t want products under your skin to contribute to clogged pores, sweating. Avoid harsh products, use petroleum-based products.

Pay special attention to your facial appearance now that mask use is so pervasive.

Should you have had skin problems prior to mask-wearing you must be extra vigilant and as necessary see a dermatologist.

*University of Illinois conducted by mechanical science professor Taher Saif and two graduate students, Onur Aydin and Bashar Emon

 

Virus On The Skin

Just when you think scientists have learned all there is to know about the new coronavirus spread that is by aerosol and droplets, another concerning bit of info hits the medical journals. This time it is how stubborn and long-lasting this virus can be on human skin! 

Preformed on cadaver skin researchers noted that Influenza A survived less than 2 hours while the virus causing COVID-19 is infectious for more than 9 hours!

Recall the CDC recommends 60-90% alcohol-based hand rubs with air dry OR a thorough wash with hand soap for at least 20 seconds.PLEASE Count!

Take away – you must be vigilant, carry a small bottle of hand sanitizer, and use it.

Near Death Experiences & After Life

I feel I would not be a responsible physician nor a good medical blogger if I did not discuss aspects of death. I prefer to discuss near-death experiences that can occur during the Lazarus Syndrome or autoresuscitation chronicled in the medical literature. End-of-life experiences abound but as with any information it must be reviewed and reading authoritative accounts are helpful. Sooner or later we all look for information on this topic. I turn to those who have near-death experiences. There are psychics and physicians, many published. My research has led me to a podcast and a few books I want to share in this blog.
A podcast (NearDeathExperiencePodcast.org) co-hosted by the anesthesiologist, John Meser, DO is the official podcast and audio source for the Near-Death Experience Research Foundation (NDERF.org) is a great starting place. The NDERF was founded in 1999 by a radiation- oncologist, Jeffery Long, MD. Also in your search be sure to listen to Debra Diamond, Ph.D. She has authored Life After Near Death. I particularly value her print (audio available) publication, Diary of A Doula, 25 Lessons the Dying Teach Us About Afterlife.