Self – Testing Revolution & Insights

Did You Know

Let me start by saying I believe there are situations where you should order a test online. You may already be familiar with in-home testing if you’ve used a Home Pregnancy test or your doctor has ordered an in-home colon cancer screening test that is mailed to a lab.   Not all tests require a blood sample. Most online ordering goes through either LabCorp or Quest Diagnostics, the two major testing companies. However, in certain states, you are unable to order online and must get a provider order for the test. Labs are prohibited from operating on behalf of patient ordering in the following states:  LabCorp in NY, NJ, RI, MA, MD  & Quest Diagnostics in NY, NJ, RI.

COVID-19

In this pandemic time, at-home testing is booming. Want to know whether you are carrying the antigen for the SARS-CoV-2 virus-infected, simply order the test! Wonder if you have antibodies to the virus, order a different test. There is a particularly growing number of COVID-19 self-testing resources.

Self-testing positive versus negative

Positive(L) – Negative (R) images

A new layperson self-test from Siemens won approval in February for use in Germany. The CLINITEST Rapid COVID-19 Antigen Self-Test takes a nasal swab and examines for antigen. Direction on the box: “Wash swab in a reagent, dissolving a specific protein from the surface of the virus. This liquid is dropped into a well in the test cassette. Within 15 minutes, the test sample flows into the field of view of the cassette and becomes visible by a dash. The position and number of lines indicate whether the test result is positive or negative, or whether something was done incorrectly during the test procedure and the test must be repeated”. See image.

General Testing

Other situations for patient’s online ordering of tests might include one of the following scenarios. What if you do not want your insurance company to know that you have high cholesterol or a sexually transmitted disease?   You may bypass going to a physician and order the test online. Often lack of insurance and lack of a medical caregiver could prompt someone who is suspicious of recurrent urinary tract infection to go online and order a urine analysis and culture.

At this time insurance companies do not pay for patient-ordered online tests but will be told by the lab ‘you may still want to submit the charge’. 

Doc’s Insights

I don’t have a specific site that I would recommend, but based on your need and location, you may find the URLs I’ve listed below helpful in finding an online lab.  I also encourage you to consult your physician to see what’s available in your community. It’s worth comparing if you don’t already have a go-to resource.

https://www.labwork365.com

https://www.health-tests-direct.com

https://www.testing.com

https://www.walkinlab.com/why-walk-in-lab

https://selfdiagnostics.com – antigen test for SARS-CoV-2 only

http://www.healthlabs.com

 

 

 

 

 

Follow The Science – Fruits and Vegetables Rule

fruitDo you stop at an apple a day to keep a doctor away? Follow the science – studies that asked what is the Magic Number for Daily Fruit and Vegetable Intake found the 5 a day rule works. 

Reveal

Two servings per day of fruit and three vegetables conferred the greatest benefit; eating more servings did not yield additional mortality risk reduction, published in Circulation. That’s 5 a day! They also found that eating more will not increase your longevity.

Follow The Science

In two well-known prospective studies over 30 years with more than 100,000 participants discovered that five-a-day” was, in fact, better than two servings per day in terms of lower risk of death from any cause (13%), a lower risk of death from heart disease (12%), lower risk of death from cancer (10%) and lower risk of death from respiratory disease (35%).fruits and vegtables

Noted was that starchy vegetables (e.g., peas, corn), fruit juices, and potatoes, were not associated with decreased mortality over 3 decades of follow-up.
Read the previous blog on diet.

If you have high blood pressure also consider the MIND diet, read a recent blog on this.

Viral Divulge of the Latest on Pandemic

Below the latest, at this writing, on scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the novel SARS-CoV-2 virus.

‘The numbers of new cases are down’. There’s a lot of sweet little lies that we tell ourselves, “It will be okay.” It is not okay. Recent U.S. numbers (3/24/21):

  • The number of new COVID-19 cases reported each day is hovering at a high level of 50,000 to 60,000.
  • New hospital admissions have also plateaued at 4,500 to 5,000 admissions a day.
  • Deaths from COVID-19 are declining but remain high, and the rate of decline is slowing.

Add to this new evidence shows variants to date have escaped at least 2 of 3 types of human antibodies. Researchers looked at how mutations in coronavirus variants affect antibodies’ ability to target a key region on the virus spike called the receptor-binding domain (RBD), which has been mutating rapidly. This evidence may explain reinfection in individuals as most likely from a variant virus -but not proven as yet.

Many fully vaccinated (more than 3 weeks) medical professionals, felt to have ‘full’ immunity, have been contracting COVID-19! Are they the % that can’t develop immunity from the vaccine? Or is it that the vaccines do not protect us from contracting COVID-19? Or did they contract a variant virus? Recall the vaccines were developed presuming the so-called ‘wild virus’ before it ever mutated. The vaccines were touted as keeping us alive as well as out of the hospital from COVID-19. At the time of emergency use authorization, it was unknown as to whether or not immunized individuals could contract and/or transmit the virus. 

Yep, it is a dynamic rapidly changing viral scene, new variants become the predominant spreading strain. It is alphabet soup with the numbering of the multiple variants circulating in our air. Currently, there is no agreed-upon system for naming the variants! Regretfully several to date, the new variants spread easier and cause more severe illness. 

It was so simple a year ago one virus the “wild-type” (or natural) strain of the coronavirus, now hang on for the new spreading* ones :

B.1.429, .427 CA, USA

B.1.1.7  (UK)

B.1.351 Zambia “South African” 50% more transmissible

P.1 Manaus “Brazil” also in Japn prevalent

B.1.525 Nigeria

B.1.526 NYC -60% on new cases NYC (3/21/21) also in TX, WY, and MD

I want to elaborate a bit on B.1.526, as it is for all intense purposes acting as a double variant, featuring a pair of common mutations known as E484K and S477N. At this posting, it remains unclear if more transmissible and if more lethal. At this posting, it remains unclear if it is more transmissible and/or more lethal.

NEWS flash on 3/24/21 – a NON-assigned number – new “double mutant” variant of the coronavirus was detected from samples collected in India. One of the mutations is present from the South African variant – E484Q position change in S protein appears to make it potent that is more dangerous.

After a retrospective review, researchers have noticed in post-Moderna vaccine candidates, 12.4 times less effective against the South African variant (7.6% protective), and Pfizer’s was found to have reduced effectiveness by about 10.3 times ( 9.4% protective). 

The good news is that the mRNA vaccines (Moderna & Pfizer) held up well against the UK Covid-19 variant.

 

Impressive Hypertension in Adults & Children

Are you below 120/80?  If you are higher you have high blood pressure – hypertension (HBP) – no matter your age!Hypertension

As in adults, for children, the definition is 120/80 mm Hg and is in the 95th percentile or greater, then the patient has hypertension. Like podcast form, check out my podcast channel – Doc Handal Speaks! Listen up! specifically on HBP on iTunes or the RSS feed. Also re-read the blog offering more background data.

Are you one of the 75 million American adults (29-32.6% according to CDC), the is 1 in 3 adults, who have high blood pressure?  17.2% of sufferers, almost half, don’t know they have elevated pressure in their arteries doing big-time damage. Sadly of those that know they have high blood pressure half do not have it under control.* BTW you will always have it as you take meds to control. It is true you might get off meds if you lose dramatic weight but even with that once your vessels harden even diet and exercise may not lower your’ numbers’.

Children with Hypertension (HBP)?

Children can develop HBP, as a matter of fact, the American Academy of Pediatrics recommends annually checking blood pressure starting at age 3. Once found the child with HBP, is recommended a DASH diet and along with moderate to vigorous physical activity at least 3 to 5 d per week (30–60 min per session) to help reduce BP. Consider the MIND diet, check out a past blog.  Back to diet sodium is an accepted culprit Chronic Disease Risk Reduction (CDRR) sodium  levels defined by the National Academies (2020-2025) suggests consumption of :Causes Hypertension

1,200 mg/day for ages 1 through 3;

1,500 mg/day for ages 4 through 8;

1,800 mg/day for ages 9 through 13; and

2,300 mg/day for all other age groups.

The CDRR for sodium was established using evidence of the benefit of reducing sodium intake on cardiovascular risk and hypertension risk.

Hypertension

AHA Guidelines

The incidence of HBP in ages is too prevalent worldwide. A recent study in Pakistan aged between 4 and 7 years (19.2%) and there is a strong association between high BMI (body mass index), family history of HTN, and high-fat diet intake with HTN in children. There was no significant variation of prevalence between both genders.

2017, CDC Study detected that 1 in 25 youth ages 12 to 19 have hypertension, and 1 in 10 has elevated blood pressure. data from more than 12,000 participants ages 12 to 19 who responded to the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2016.

Secondary HBP is a common result as is the direct result of obesity, possibly medications but also you can inherit this medical problem.

Again no surprise, same as for adults, sedentary behaviors during childhood increases the risk of developing HBP. You can imagine missing the presence of this will cause irreversible damage in so many body organs that life expectancy will drop. 

Check your and your youngsters’ numbers, Trust me they will enjoy monitoring especially if they can record on their smartphones.

GET INVOLVED!

*Executive Summary: Heart Disease and From the American Heart Association. D Mozaffarian, EJ Benjamin, AS Go, DK Arnett… – Circulation, 2016

Gripping Medical News

medical newsI want to communicate some recent gripping medical news, specifically what’s up with sugar and new SARS-CoV-2 variants.

SUGAR

I wish Biden would alter the results of the sugar lobbyists and change the new 2020-2025 USDA dietary guidelines — released under the Trump

About 40% of American adults are obese, which predisposes them to type 2 diabetes, heart disease, cancer, and premature death. Moreover, obesity rates are higher among Black and Hispanic adults compared with white and Asian adults. The prevalence is highest among adults with low income and limited education.

Nearly three-quarters of Americans are overweight or obese, conditions directly related to sugar consumption. Some 128 million Americans are diabetic or pre-diabetic, and 90% of those with pre-diabetes don’t know they have it. Nine of the 10 leading causes of death in the U.S. are a result of or made worse by, poor blood sugar. Children are developing increasing rates of fatty liver disease and chronic liver dysfunction — up 62% in the past 10 years. Have a read on a recent past blog on children and diabetes.

COVID-19 has been shown to be significantly more lethal in individuals with high blood sugar, and diabetes and obesity are key drivers of mortality.

The recommendations for added sugar in the 2020-2025 USDA dietary guidelines — released under the Trump administration — a result I believe from the sugar industry lobbying, also the processed food industry, and financial gains.

 These recommendations were made despite the science and will continue to cause significant harm to American children and adults, with unfortunate health and financial ramifications for years to come. 

USDA Guidelines recommend a sugar quota to less than 6% of total calories, from its current level of 10%, and give Americans a fighting chance at health. The Committee suggests that “less than 6% of energy from added sugars is more consistent with a dietary pattern that is nutritionally adequate.” The suggested 4% drop in total calories from added sugar (from 10% to 6%) might not seem like a lot, but it represents 20 grams of sugar per person, per day, which adds up to roughly 2,400,000,000,000 — that’s two trillion four hundred billion — extra grams of sugar per year consumed in the U.S.

Power of Advertising @1960s

NEW VARIANTS IN MEDICAL NEWS

Will continue until spread can be stopped! It is only as the virus travels into someone else-infects another human host that it can change its sequencing. These changes which can be multiple determine its transmission rate and severity of illness it can cause.

At this writing, there are at least 6 concerning variants. customarily given names like ‘B1526’ first reported in NYC, or B1351 from South Africa. B117, the variant first detected in Kent, England. Newest from Nigeria B1525.

Stay tuned medical news will continue to share new variants. We must along with getting the ‘jab’- continue to follow social distancing and mask-wearing. The pharmaceutical companies are already trying to guess which variants contain dangerous changes to its code that vaccines must target.

Little Known: The Immune System Wires Personality, Which Rules Death

immunity & personalityThe immune system is front and center with this pandemic raging. It is not a simple system, have a read of a recent blog dealing with COVID-19immunity. Also, have a listen to Immunity podcast and enjoy this insight. Little Known -the immune system directly links personality to the long-term risk of death. Sounds scary?  A recent study sheds new light on why people who are more conscientious tend to live longer.

Results from the new international study published in the Journal Brain, Behavior, and Immunity have found that the immune system plays a previously unknown role in the link between personality traits and long-term risk of death. Recall from previous blog activities of the immune system.IN YOUR DNA

The question is how is there a biological pathway? One that can be altered? Personality rules your risk of early death. Thru observation, it was shown that people scoring lower on the personality trait of conscientiousness (a tendency to be responsible, organized, and capable of self-control) can be at a 40% increased risk of future death compared to their higher scoring counterparts. Conscientious individuals – you know the personality – live longer as a result of their immune system, specifically due to lower levels of a biological marker called interleukin-6. Present in one of our genes and enhances antibody production. 

The study was drawing on data from the Midlife in the United States Longitudinal Study carried out on 957 adults who were examined over a 14-year period. Other centers were in Humboldt University, Berlin but principals worked at the University of Limerick, Ireland.

Aging Badass for The Immune System Age

It truly is badass, aging’s effect on our immune system! As the years pass, everything changes within and on the outer of our bodies. This blog, hopefully, will increase your knowledge of how the area of immunity! We hear from all caring sources – exercise no matter how long – move! Our body’s defenses are altered – and not for the better! Age brings inflammation and chronic inflammation reaps havoc throat our bodies’ systems. Not always bad inflammation is a natural part of the immune response and occurs when our body is healing or needs to fight infection.Aging Immune system

The immune system especially has a problem with chronic inflammation. Also, abnormally high levels of inflammation will occur with any affront to our system, including vaccination.

We begin to lose control over the immune system, now you know why the seniors need to be at a priority for vaccinations, even the healthy ones.

Inflammation part of the immune response also happens when our body is healing or needs to fight infection. Now you understand the title describing with age comes ‘badass’ issues. And when these high levels linger over a long period of time, it can cause tissue damage, which can even lead to the development of cancer.  Plain and simple! REfresh your background knowledge by listening to Doc’s podcast on Immunity.

aging Long-term inflammation also is known to cause shortening of telomeres (protective structures located at the ends of chromosomes), you’ve heard of them? 

The 2009 Nobel Prize went to Elizebeth Blackburn, Ph.D., the author of a must-read book – The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier, Longer 

Lifestyle including diet, sleep, and exercise can alter the length of the telomeres. Longer telomeres are good and shorter telomeres are not good at all and associated with increased risk of cancer, with the liver being particularly susceptible to these changes. The fewer damaged telomeres, the less fat in the liver and longer you could live. Exercise surprises inflammation-driven cellular aging and tumor development.

Now to what got me going on this badass concept – a new study! Regular gentle exercise could play a role in reversing liver damage that can lead to cancer. The study was done in mice and next to be studied is us, humans.

A modest amount of aerobic exercise in mice reduced the levels of inflammation in the liver that develops from adding years, but was reversed and went on to prevent tumors from developing. Also noted that fat in the liver was reduced.

The lungs of the mice were also studied and found to decrease inflammatory markers including T and B lymphocytes that are integral to the proper function of the immune system. 

You may have heard them mentioned as memory cells once vaccination or infection occurs. They can recall the SARS-CoV-2 virus and make antibodies usually years later. However, with the current virus pandemic, it is not yet known how long our ‘immunity’ will last. 

This was published in the Journal of Immunology, was funded by Cancer Research UK.

Beware Preventable Medical Errors

BEWARE!

BEWARE!

While most medical errors/adverse events occur in the hospital setting, beware they can occur in any outpatient medical care setting. Worldwide, as many as 4 in 10 patients are harmed in primary and outpatient healthcare settings, with up to 80% of those medical errors preventable, according to the nonprofit Foundation for the Innovation and Development of Health Safety. Think your doctor’s office, walk-in clinic, pharmacy clinic. you recall from an earlier blog  3-17% of all hospital admission suffer an adverse event and medical error is the third leading cause of death in the US (2016).  

Errors in outpatient settings generally fall into one of these 3 categories:

  • Diagnostic – such as an error or delay in diagnosis
  • Treatment – error in an operation, procedure, medication, or test
  • Preventive – inadequate monitoring or follow-up of treatment

Common medical errors that occur in ambulatory settings – that includes your doc’s office are prescribing errors 39%, transcribing 11% dispensing 12% administering 38%. Preventable errors include not giving you an earlier appointment, for a potentially serious problem -ex. foot pain or cut on foot in a diabetic. Beware, a leading cause of the error is delayed treatment accounting for over 50% of cases that result in death. Establishing a rapport with support staff is critical, even if they are new how you introduce your need for an appointment can ensure timely care.

For example, after your name state your condition(s) for which you see the doctor, then what your problem presently is: “Hi, this is Ann Richard birthday 6/11/1957,  I’m one of Dr. T’s diabetic patients and he told me whenever I have a problem with my skin to get in as soon as possible. Yesterday I cut myself in the garden and bled for a while it still doesn’t look good.’ don’t overdo it and say no need for an emergency room visit. Also if you can’t get in soon ask for the nurse. another option is to have the scheduling person check with Dr. T on your behalf. Another in your armamentarium is “Doc, hates me running to the ER and he told me to insist on getting into his office to be seen”.

Don’t think the responsibility falls on everyone else but yourself! Don’t presume because they gave you an appointment three weeks out that you can really wait three weeks to be seen. Beware, when you have an upcoming visit, start planning, gather what you want them to see from another visit or a study, do not presume your records got to your caregiver. Having your exact issues-what when and how in your condition brought you to be ‘seen’ written. All medical folks seem rushed sticking a copy of your typed issues goes further than the multiple pages you complete on ‘intake’. Believe me! bring more than one copy, present it on signing in and ask to have it put in your record.

Listen well, ask if you think you may become anxious ask if you can record with your phone or take written notes. Most important is that you leave there with exactly the diagnosis or condition even if the doctor isn’t sure he or she should mention what he or she is considering and what the plan is: test(s), medication(s), and referral. It’ll be so important to have this information. If you call by scheduling to have a CAT scan of your right elbow when indeed you need your left elbow or you need your left knee not your elbow -you see why it’s important to have your notes of the ‘plan’. Hence you will not be second-guessing yourself.

The ACA required electronic records in the healthcare setting, no surprise given16% of physicians have illegible handwriting -turbocharge error and a common cause of a prescription error. Now mostly electronic transmission to pharmacies occurs. but if you find that you are giving a handwritten prescription try to read it if you have any questions ask the doctor and if he has already scrambled out of the room ask the nurse then write it down yourself so you’re sure that you get the correct medication. Don’t be shy ask exactly how to spell it. The pharmacist can make mistakes by miss reading and misinterpreting a scratch on the pad

If you had a test don’t think no news is good news, when you have an x-ray the radiologist has to interpret it within 24 hours and get a report out so waiting weeks is a bit ridiculous. The more you sound informed the more you gonna be respected in the better care I believe you will end up getting. Remember you are your own best advocate against the system. when comes to waiting for the medical office to get back to you with the results.

This is an introductory sensitizing blog on a critical topic I wish you to aware of – BEWARE!

The Serious Burden of Migraine Headaches

Migraine sufferers have a serious burden. A condition that is not easily recognized nor improved.

Background:
-40 million folks in the US are impacted by these headaches (HA).
-1 in 4 households is impacted by someone suffering from migraines.
– sufferers are twice as likely to use opioids
-over $6000 additional direct healthcare costs per year
-commonly suffers are 18-65 with the peak at ages 30-50
60% taking recommended treatment
60% are at the poor treatment

Those with migraines, women two to three times more than men, have a lower quality of life, are poorly functioning while those with severe cases having a disability. While everyone’s body is unique, certain triggers may explain that women with hormonal fluctuation suffer more.

They are classified as episodic or chronic dependent on frequency, characteristics, and accompanying symptoms. Episodic migraines are defined as at least 5 attacks/month lasting 4-72 hours (untreated or not successfully treated), having characteristics that can include: unilateral location, pulsatile quality, moderate to severe pain aggravated by activity. Also during an attack at least one of the following occurs, nausea vomiting, light and noise sensitivity (photophobia and photophobia).

Chronic migraines defined as HA on more than 15 days/month for 3 months as well as having occurred in someone who has had at least 5 attacks w/o aura or with aura.
New medication and techniques specifically neuromodulation, non-invasive devices have become available as an alternative therapy to medications. In general expensive, the FDA’s recent approval (Jan. 25, 2021) of one neuromodulation device that can link to a smartphone. Also as of Oct. 2020, an over-the-counter ‘Cefaly Dual neuromodulation‘ device in pharmacies, not inexpensive though

Therapy is aimed at prevention as well as treating breakthrough migraines.

While this condition can be frustrating till the correct treatment for you is arrived up – do not despair, new medications and devices are almost monthly for your healthcare provider to share.