Category Archives: Resources
PATIENT EDUCATION: THE “2020 WEEKLY CROSSWORD PUZZLE CHALLENGE” (JUNE 7)
MEN’S HEALTH CHECKLIST
INFOGRAPHICS: “COVID-19 COMPARED TO OTHER DISEASES AND CONDITIONS”
INFOGRAPHICS: “DIGITAL HEALTH TECHNOLOGIES IMPROVING PATIENT CARE”
COMMENTARY
The technology of telemedicine will predictably and steadily get better.
Medical assistants, mostly human at present, are commonplace, notably in specialty offices, and machines using improving voice-to-text transcription are getting better.
Wearable devices are proliferating and hopefully coming down in cost, and platform technology is improving though still glitchy.
Patients generally accept Telemedicine. They like the saving of travel time and infection exposure.
Doctors may drag their feet because the increased effort and legal exposure is not compensated by increase in payment. On the contrary, pre-Covid compensation was LESS for a televisit. Continuing Parity would help.
The politicians at the state level should eventually make licenses valid across state borders.
The big wild card is the Legal Profession. Unless they develop restraint( and litigious patients reform), there could be a feeding Frenzy, which would delay implementation of a very good idea.
Eventually telemedicine deserves to be 50% or more of medical practice.
—Dr. C.
PATIENT EDUCATION: THE “2020 WEEKLY CROSSWORD PUZZLE CHALLENGE” (MAY 30)
DR. C’S MEDICINE CABINET: “OVERVIEW OF METABOLISM”
“Life is nothing but an electron looking for a place to rest”.
Albert Szent-Gyorgy
Overview of Metabolism – Seeing an Essence of Nanosystems in the Hum of a Vibrant City; the Skyscraper as Catalyst, and Thought as Electron
What did it take to bring the world to its’ knees? SARS-CoV2? We will never know, because we instituted DISTANCING to control the virus because the projected number of deaths were unacceptable.
The distancing and isolation did hold the number of deaths, still large, below projection. However, it DEVASTATED our Economy.
OUR WORLD is a massive, cooperative, interdependent system, with hubs, factories, supply chains and a myriad of products. It is a COMPLEX SYSTEM.
I would like to use the world as an analogy, and compare it to another Complex System, the HUMAN BODY.
Our bodies are essentially a large pile of chemicals (mostly proteins) in a sack, our skin. These chemicals are constantly interacting with each other. If they grow to larger, more complex chemicals in a process we call anabolism, we take in more chemicals and energy by eating, and get bigger. If our chemicals get less numerous and complex in a process we call catabolism, we lose weight and get smaller.
Some of the proteins in our bodies are ENZYMES, and bring other proteins CLOSER TOGETHER, so that they can LINK TOGETHER become more complex and PRODUCE things. Enzymes are a sine qua non of life. Without enzymes, life would slow so much as to be impossible.
Let’s go back to our Society, Before Covid.
Vast numbers of people are cooperating in close proximity, working together with machines, often supplied by other people far away, making things. This process takes place most efficiently in CITIES, where people are in closest proximity, doing things together.
Enter Covid. This interdependent process stops. What things that are produced are made to fight Covid. It is just like one of our cells infected by Covid: we have been HIJACKED by the virus!
Lets’ GO BACK TO OUR CELLS. Our METABOLISM is like our teeming, cooperative CITIES, with SUPPLY CHAINS, factories and products. Our PROTEINS NEED PROXIMITY to function.
Some Proteins are at a critical HUB, and comprise a RATE-LIMITING step in the production line.
Many Vitamins and nutrients are COENZYMES, and act to ACCELERATE critical supply lines.
If the Hubs are OUT OF BALANCE and OVERACTIVE, many MEDICATIONS act to BLOCK THE ACTION of an enzyme to bring the system closer to balance.
Thus coordination, cooperation and careful monitoring to PREVENT A PROBLEM is superior to letting it break down and correcting the imbalance.
I hope that this Overview will be helpful. I will go through my MEDICINE CABINET to discuss a few of the 20,000 or so Medications approved by the FDA. I will also VIEW THE TEST RESULTS from my LABORATORY TESTS. NORMAL results show a SYSTEM IN BALANCE. Abnormal results show inefficiencies in the metabolism (supply chains, hubs), which need correction to restore balance.
— Dr. C
PATIENT EDUCATION: THE “2020 WEEKLY CROSSWORD PUZZLE CHALLENGE” (May 26)
INFOGRAPHICS: “WHAT ARE, HOW WE GET AND WHY DO WE EAT FERMENTED FOODS”
This article gave an interesting classification of fermented foods, pointing out that with some, like bread and wine, we eat the products of fermentation without the living organisms, while with others like kefir and yogurt, we eat the viable critters also.
Lactobacilli are called probiotics, and are supposed to have health benefits. It is not proven that they do, but at least the lactobacilli use up some of the sugar we would otherwise be eating, and taste good.
The problem with the claim that they diversify and benefit our microbiome, and crowd out the bad germs, is that they do not generally attach to our intestinal walls, and go right through with the rest of our food. They don’t stick around long enough to do any good.
My late wife had a bad infection with a bad actor called Clostridium difficile, which caused her to have a severe, bloody enterocolitis. After the second hospitalization with this affliction, an Infectious disease doctor suggested “culturelle”, which contained a patented Lactobacillus rhamnosus GG, which WAS supposedly proven to attach for a while. My wife took this, and never had another attack.
I still take this daily, “on faith”. Gullible me. Fecal transplants are now used effectively for C. Dif. enterocolitis. Avoiding unnecessary antibiotics, which wipe out your normal microbiome, your “good guy competition”, is An even better idea, but seems risky.
BOTTOM LINE: Kefir and yogurt are calorie depleted, and taste good. What is not to like?
–Dr. C
THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #3: ITCHING WITH DRY SKIN
As I have aged, my skin has been more itchy. My allergy practice was loaded with Patients whose ECZEMA and HIVES itched. My favorite uncle developed intolerable itching (pruritis) in his 90’s, and died within a year of metastatic Prostate Cancer.
This gives you an idea of the Range of this annoying sensation. My emphasis here will be on CHRONIC ITCHING with DRY SKIN in otherwise HEALTHY PEOPLE without much rash or other skin condition. If you want extra discussion, look at Reference #1. If you are a Doctor, or a brute for punishment, see Ref.#2, a CME review.
Your skin is the largest organ in your body, and deserves respect right from birth. The skin of your child is wonderfly healthy in looks and self repair. EXCESSIVE SUN EXPOSURE is about the only thing you need to protect her from, and the only penalty is increased cancer risk in later life.
As your body ages, your skin looses some of its essential oils, and and becomes more dry (at least you don’t get acne any more). You become more sensitive to dry air, like in the winter, when the cold outside air (adiabatically) drops in relative humidity when warmed to inside temperature.
Do you notice the increase in static electricity shocks in the winter? If not, I’m sure that you do notice that your skin itches more. one treatment for the “winter itch” is to humidify the inside air. If you have a draughty old house like I do, it may be more convenient to use MOISTURIZING LOTIONS.
These were once mainstays of itch control in my former practice (before development of the effective modern medications). Eucerin and Cetaphil were very helpful. Maybe it is because of the name, but I now find myself using Curel “Itch Defense” all over my body twice daily,.
The itching is much less now, except for my EARS. My ear canals (they are skin too!) have recently been very dry and itchy, maybe because i listen to podcasts when walking or swimming.
Unwilling to give up my podcasts, I put some UNSCENTED Johnson’s baby oil with my little finger into my ear canals, as suggested by my ENT Doctor (I wanted to be sure i didn’t have a diagnosable condition like a fungal infection). If I have a small spot that itches a lot, I use some 1% Hydrocortisone cream, and I feel better.
Antihistamines don’t do much for me, but are effective if the itching is a real allergy (most of what people call allergy is not the IGE-MEDIATED, “real” variety). HISTAMINE is the quintessential provocateur of ITCH. Cetirizine (or atarax) is the strongest of available antihistamines, and diphenhydramine (benadryl) the old standby.
Chronic itching can be caused by a plethora of illnesses, as you will find if you choose to read the following papers.
Doctors Without Waiting Rooms 