Monday, November 2, 2009

November Blog

OK.  Some scheduling notes.  I will be closed SATURDAY 11/7/09 and will close early at 5 PM on FRIDAY 11/6/09 to catch a flight to Houston.  Also, I will be closed on the Thanksgiving weekend Thursday, Friday and Saturday as I am going to California to see my grandsons and daughter.  Have a safe and enjoyable Thanksgiving.  I will be back the following Monday normal hours.

Alternative Health/Nutrition News:
  • Energy Supplements:  boosting one's energy usually requires different approaches.  You can use stimulants, boost metabolism, or increase calories.  Stimulants in general work.  However, there's the down side of crashing when they wear off.  Many work no better than a cup of coffee or tea.  Metabolism boosters work if you are deficient or in certain conditions.  However, things lkie C0Q10, carnitine, etc. May be of little use to boost metabolism.  They do work in a sense by boosting the energy process.  Increased calories work but only short term.  They can increase your blood pressure and blood sugar.  This can cause your insulin to spike.  Energy drinks as an example are high in carbs especially sugars and  there is the issue of how effective they are vs. the complications (weight gain,  diabetes, etc.).  Several combine caffeine and sugars to really light your fire-then you crash.
  • Future Medicine:  medical tourism is getting noticed.  When one can get an operation by American Doctors for $30K including transportation which would cost $400K here.  It's projected to be a $40 billion business.  Remote devices may be able to monitor your health via the internet.  Nanotechnology will allow us to fix our organs from the inside out by repairing sick cells.  ALTERNATIVE MEDICINE will become mainstream.  37% of US hospitals now integrate complementary and alternative services with conventional procedures.  Video games may be used to improve mental health.  The internet will help put medical specialists within reach (one doctor has already dictated complicated surgery from 3500 miles).  New artificial skin could be rapidly produced.  CENTANARIANS are on the rise.  Us older folks, at least the ones who live to 100 will continue growing quickly and move from 1 in 10K to 1 in 5K of the population.  Professions in general and in healthcare will become hyperspecialized.  The hottest healthcare jobs:  home health aides, personal and home care aides, and veternary techs.
Medical News:
  • Use of ACE inhibitors may cause some liver toxicity (hepatotoxicity).
  • Low doses of naproxen (Aleve, Anaprox, Naprosyn, Naprelan) may increase the risk of upper gastrointestinal uclers.  MY NOTE:  If you are using an NSAID on a regular basis the risk for ulcers is increased signficantly.  I personally think this is under reported due to people taking meds like over the counter prilosec, tums, etc. to mask the stomach complaints.  My alternative is an anti-inflammatory diet (cut out the red meats and complex carbs) plus boswellic acids and fish oils.  To my patients with arthritis I recommend Osteo-biflex (glucosamine + boswellic acids or 5-loxin) and fish oils to control inflammation.
  • From the American Heart Association, "Diabetes tends to lower "good" cholesterol and raise triglyceride and "bad" cholesterol levels, which increases the risk for heart disease and stroke."
  • Some Key Health Tests for Women
    • Breast cancer exam
    • Cervical cancer exam
    • Skin cancer exam
    • HIV screening
    • Cholesterol screening
    • Blood pressure
    • Bone density testing
  • Washing your hands.  Men and women react differently to signs suggesting they wash their hands.  Women tend to respond better to signs telling them the risk factors of not doing it.  Men reacted better to be told the disgusting consequences like:  soap it off or eat it later.   Interesting.
  • Complications of Diabetes on the small blood vessels (microvascular):  Diabetes has considerable effects of the small vessel circulation and can cause problems with the kidneys, eyes and extremities due to accelerate atherosclerosis.
    • Diabetic peripheral neuropathy is a major concern.  This causes loss of sensation in the toes and fingers.  In the feet, it can lead to things like ulcers and gangrene left untreated.  It is the result of a progressive loss of nerve fibers.  It may give a "stocking and glove" appearance.  It can also affect the nerves to internal organs (autonomic nerves) and affect the gastrointestinal tract, bladder and blood vessels.  Symptoms can be sensory or motor related and can affect awareness of touch, temperature, vibration (one of the earliest things to be lost), proprioception (balance or position sense).  Lack of awareness of one's extremities can lead to undetected injuries.  An ingrown toenail for example could become infected and gangrenous.  Loss of nerve supply to a joint can also cause destruction of the joint (Charcot joint).
    • Diabetic vascular complications can also lead to erectile dysfunction.
    • Diabetic retinopathy can lead to progressive loss of vision and blindness.  Microaneurysms occur and fats and protein exudates leak into the retina.  Damage to the macular leading to macular edema also leads to blindness.
    • Diabetic nephropathy is the leading cause of kidney failure.  These changes occur slowly over time and may show up as increased albumin in the urine, decreased glomerular filtration rates and hypertension.

Going Green
  • compact florescents (CFLs) can save significantly on electrical bills.  They are a bit more expensive upfront than florescent bulbs but will usually pay for themselves in a few months.  
  • Window blankets can be used to keep the heat in during the winter and the cold out during the summer.  Essentially, these are made by getting the foil type insulation that comes in rolls with the bubbles between layers (air barrier).  To make the blanket more attractive you can sew on a covering of cloth.  Velcro can be used to attach the blanket over windows during the day in summer and during the day or at night in winter.  It forms a reflective barrier, reflecting internal heat back in and external cold out.  The blankets can be removed and put on easily with the velcro.
  • Sealing doors and windows with weather stripping will help keep leaks down and cold air and critters out.  It reduces your electric bills.  Sealing leaky areas such as switches and outlets also helps.