Tag Archives: Women’s Health

Healthcare: Pros & Cons Of Medicare Advantage

Medicare Advantage is an all-in-one managed care plan, typically an HMO or PPO. Advantage plans provide the benefits of Part A and B, and most also include Part D, or prescription drug coverage. Some offer extra benefits not available through Original Medicare, such as fitness classes or vision and dental care.

If you opt for Medicare Advantage, you typically continue to pay your Part B premium as usual, but you will pay little or no additional premiums for your coverage.  You generally have copays or coinsurance, but once you reach your out-of-pocket limit, the plan will pay 100 percent of your medical costs covered under Medicare for the rest of the year. The out-of-pocket limit does not apply to prescription drugs or extra benefits.

To keep premiums low, Advantage plans generally require you to get your care from a network of doctors, hospitals, and other providers, and you typically need pre-authorization for specialized care. 

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Type 1 Diabetes: How To Treat Hyperglycemia

In this video, you’ll learn the basics of how to treat a high blood glucose result with a Correction Dose of insulin, how to calculate the Correction Dose, and when not to give a Correction Dose.

Type 1 Diabetes: What Causes Hyperglycemia?

In this video, you’ll learn about what causes hyperglycemia, what symptoms to look for, and how it affects the health of people living with type 1 diabetes.

COMMENTARY:

Hyperglycemia refers to an excess of glucose in the blood stream. The fact that we do not all have hyperglycemia is a tribute to the fine-tuned regulation, or homeostasis, of the normal body,

Glucose is our main source of energy especially for the brain. When we eat, our intestinal tract breaks down the complex starches and sugars we eat  into glucose, which is absorbed into the bloodstream. This triggers the pancreatic beta cells to produce insulin, which allows glucose to get through the cell membrane and into our cells.

Hyperglycemia results mainly when pancreas produces insufficient insulin, or our cells exhibit insulin resistance. This can occur in diabetes, other diseases affecting the pancreas or stressful conditions which decreases insulin sensitivity.

Excess of glucose in the blood stream washes out water and salts with excessive urination, causing thirst, and drying out of the cells; the distorted vision of hyperglycemia is one such symptom thot results.

In the most common types of hyperglycemia, the cells are starved of glucose, and need to  breakdown fats for energy. This produces a ketosis, or acidosis of the bloodstream, increasing  the dehydration.

My wife suffered from diabetes, and had her only severe episode in Canada. She started vomiting before we discovered the high blood sugar, and couldn’t drink enough fluids by mouth. She was hospitalized in Canada and received excellent treatment with intravenous fluid and insulin.

Over the years, chronic excess of sugar attached to the protein of her cells, as manifested by excessive hemoglobin A-1 C, or glycohemoglobin, in her bloodstream. She passed away a decade ago.

A healthy lifestyle, with good sleep, diet and exercise is essential
Sugar should be considered a poison.

Regular vegetables fruits and cereal grains help avoid the excess sugar of fast foods. Exercise helps to utilize extra sugar and mitigate stress.

Please refer to the article on hyperglycemia by the Mayo clinic for a more complete discussion.

—Dr. C.

Read morehttps://www.mayoclinic.org/diseases-conditions/hyperglycemia/symptoms-causes/syc-20373631

‘HARVARD MEDICINE’: THE AGING ISSUE – AUTUMN 2021

COVID-19: MOLNUPIRAVIR – MERCK’S ANTIVIRAL DRUG

Molnupiravir (MK-4482, EIDD-2801) is an investigational oral antiviral medicine that significantly reduced the risk of hospitalization or death at a planned interim analysis of the Phase 3 MOVe-OUT trial in at risk, non-hospitalized adult patients with mild-to-moderate COVID-19. At the interim analysis, molnupiravir reduced the risk of hospitalization or death by approximately 50%; 7.3% of patients who received molnupiravir were either hospitalized or died through Day 29 following randomization (28/385), compared with 14.1% of placebo-treated patients (53/377); p=0.0012. Through Day 29, no deaths were reported in patients who received molnupiravir, as compared to 8 deaths in patients who received placebo.

DR. C’S JOURNAL: SIGNS AND SYMPTOMS OF APPENDICITIS

The appendix is a finger like projections at the origin of the colon in the right lower part of your abdomen. It may become inflamed, especially if there is a blockage. Appendicitis is best considered a medical emergency, since it may rupture and infect the entire abdominal cavity.

When I was a practicing pediatrician, appendicitis was one of the two conditions I refused to allow myself to overlook; the other one was meningitis, which is now mostly prevented by immunization.

Pain in the abdomen is almost invariably present as the main symptom of appendicitis. This pain often begins around the belly button and then migrates to the right lower part of the abdomen. The patient should try to notice whether jarring the abdomen by walking makes the pain worse; if so, this finding would favor an inflammatory condition like appendicitis.

A similar condition, diverticulitis, may cause similar symptoms in the left lower part of the abdomen, and other conditions may cause confusion. The doctor checks to see if it is more painful in the right lower belly area, and she may pull her hand away suddenly. If the pain intensifies, there may be inflammation around the appendix. Sometimes a vaginal examination or rectal examination will be needed to help with the diagnosis; the appendix is close to these areas.

Other symptoms and signs may be a low-grade fever, vomiting, add an elevated white blood cell count. In the modern medical era, ultrasound, CT scans, and MRIs are sometimes used to visualize the appendix to evaluate its size and possible inflammation.

Treatment used to consist only of surgery, but with imaging techniques available to prevent disaster, the condition can be treated with antibiotics. 30 to 50% of those so treated will still eventually require surgery. Removal of the appendix is now sometimes performed through a fiberoptic scope, leading to more rapid recovery.

A dilemma is present for individuals who go to the south pole to live for several months, and where weather may prevent them from getting proper medical help. Such  people may have their appendix removed as a preventative. Of course they also can take antibiotics if appendicitis develops, but it’s really scary to use medical treatment only, without the aid of modern imaging techniques.

Please consult the following Mayo clinic article for more information.

—Dr. C.

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THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #60: ADHD

Trouble with impulsivity and inadequate ability to pay attention characterizes most of the human race. It is particularly characteristic of childhood; while developing, all children are hyperactive and inattentive, compared with an adult standard.

Children and adults inflicted with extremes of these two neurodevelopmental problems have a particular difficulty in our complex, organized, and demanding society, and consequently“ excessive“ hyperactivity and inattention are presently considered a disease, with specific diagnostic criteria, and medicinal, psychiatric, and sometimes instrumental treatments.

ADHD is divided into predominantly inattentive, predominantly hyperactive/impulsive, and combined. I will concentrate on certain features of the attentive aspect.

I encourage you to read the excellent Mayo clinic article which covers most bases, including advice for parents and relatives who have to deal with these sometimes difficult individuals.

ADHD most commonly involves children. It leads to difficulty at school, and often suboptimal interpersonal relations. Drugs such as amphetamines and Ritalin are most commonly given, and seem to work; it is always amazing to see a stimulant quieting down an overactive child. Struggling college students often consume these same medications, since they seem to give a short term boost In concentration, ability to learn, and performance in tests.

Caffeine is the poor man’s drug and also sometimes helps. 60 years ago I worked in the UCLA clinic where we checked problem children for “split dominance”, where the children may throw with the right hand and kick with the left foot. There is no mention of this in the literature now, and indeed FADS have characterized the whole area.

My middle son had difficulty in school and was hard to get along with. I tried him on some amphetamine, but he wisely spit it out. He turned out to have dyslexia (poor reading ability), studied engineering in college,  and is running his own company; Entrepreneurs are often dyslexic.

Be very careful before labeling a child with the stigma of ADHD. Try loving and working with her more. If the situation is clear cut, make sure the least five of the nine criteria are present before agreeing to try drugs.

One of my grandchildren was very slow in learning, and was distracted easily. His mother persisted in sending him to a Montessori preschool, and when he went into his growth spurt (I like to think he myelinated his neural pathways), a miraculous change took place; He now seems very interested in many things and does excellent work at school.

You cannot lavish too much attention on developing children. ADHD thought present in somewhat less than 10% of children, particularly boys. It is also being increasingly recognized in adults, where it interferes with their personal, home, and occupational lives. Anxiety, depression, and other psychiatric problems may follow.

I wonder if inattention also afflicts some of my elderly friends; if they don’t pay attention to what they’re doing, they may well FALL, and curtail their lives. We could all pay better attention to what we are doing.

TOO MUCH ability to pay attention, however, could grade into obsessive compulsive disorder. In more extreme forms, ADHD is certainly real, and failure to intervene can result in distressing secondary problems. However, it is almost too convenient a category for assigning children. Haste in categorization may result in missing other problems.

When normal, our brains are amazingly fine tuned instruments. The best thing to do is keep them exercised, stimulated, and well nourished.

—Dr. C.

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