The Medical Insider

When antibiotics are worse for our guts then salmonella

Sophia, a 47-year-old math professor, is in good health. Earlier this year, a brush with COVID-19 cascaded into a drug-induced nightmare.

After the viral infection, she developed a sinus infection and a tooth abscess. She underwent 10 days of amoxicillin – twice, 3 weeks of clindamycin, and a tooth extraction. Just when she thought she was in the clear, the diarrhea started.

Fortunately, before she started clindamycin, her sinus doctor warned her about “C. diff colitis,” a colon infection caused by antibiotic use (more later). So when she developed belly pain, bloody and watery stools 5 times a day, she immediately thought of C. diff colitis and went to her primary care doctor.

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Volume 15, Issue 21, Posted 8:28 AM, 11.21.2023

Thyroid: When to worry

I get this question often: “I’ve been gaining weight, feeling sluggish. Do I have a thyroid problem? My aunt has it.”

Or if you’re in the habit of consulting Dr. Google, I bet the word “thyroid” pops up lots. What’s the chance?

First, about thyroid. It’s a tiny organ at the base of our neck. It looks like a moth and weighs about 1 tablespoon of butter.

Despite its size, it is a powerful regulator of metabolism, that is, how our body burns energy. Like a general contractor, the thyroid gland oversees most of our body functions.

It produces one hormone. But when it goes wrong, anything can go wrong.

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Volume 15, Issue 19, Posted 9:11 AM, 10.17.2023

What you need to know about Ozempic, the new diet drug

We, doctors and patients, have been hoping for a solid weight-loss drug for all of human history. Currently, obesity affects 42% of Americans; by 2030, the number will reach 50%. We need help.

The problem is complex. It’s social, biological, environmental. Thus, success of the new diet, GLP-1 like drugs (Ozempic, Mounjara, Saxenda, etc.) deserves the rave. But they aren’t a panacea.

I hear celebrity claims – like Sharon Osbourne, Ozzy Osbourne’s wife – of losing a whopping 42 pounds on Ozempic yet warning others not to use it.

What’s up? 

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Volume 15, Issue 18, Posted 8:53 AM, 10.03.2023

Complementary medicine: Time to ditch your doctor?

In our Pill Nation, between the tender ages of 18 and 29, 40% take prescription medications. By 65, almost all (90%) are on something.

Then we hear these stories:

"M," age 21, has anxiety and insomnia. She started taking an antidepressant. It helped her sleep, but she developed blurred vision and was tired all the time. She stopped the drug (without telling her doctor) and tried meditation.

"Ms. G," 82, has had progressive foot pain and numbness for decades. Many doctors later, she had no diagnosis or prognosis. She gave me the names of several herbs. “In your experience, what works?”

Embarrassingly, I didn’t know. I’ve only heard of turmeric, and that’s from cooking. 

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Volume 15, Issue 13, Posted 8:40 AM, 07.18.2023

Rescue from Canadian wildfire air

This morning I got up, took a deep breath, expecting the faint fragrance of my lilies and mock orange. I smelled burnt glue. By noon, headlines are like NPR’s: “Air quality plummets as Canadian wildfire stretches the Midwest.”

It was worse than the air in Uganda. Years ago, I worked at a remote, rural clinic. Villagers used coal to cook and boil water. Boda-boda, a small motorcycle and their major mode of transportation, expelled gray clouds of exhaust and kicked up orange dust everywhere. In the morning, the little village was baked in a haze of smoke. I was wheezing daily.

For the past few days, our air quality has nosedived and reached levels worse than India and China. As of June 30, Canada is fighting close to 500 wildfires. The West Coast – just getting started – is battling 112 wildfires. With climate change, scientists predict the pattern is likely to repeat and worsen.

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Volume 15, Issue 12, Posted 9:18 AM, 07.05.2023

Stirring the pot on pot

With cigarette smoking, I know where I stand. “It’s legal, but not good for you. Will you consider quitting?”

Marijuana use is tricky. Some take it for fun. Others swear by it because it helps their anxiety, back and belly pain, insomnia …

I get it.

To make matters worse, rules differ between the federal government and the states; opinions vary among my medical colleagues.

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Volume 15, Issue 11, Posted 8:27 AM, 06.20.2023

Social connection is a statin for the lonely heart

“It takes a village to raise a child,” the old saying goes. Recently, the Surgeon General’s Advisory warned about the devastation of social isolation and loneliness; it seems our need for “villages” doesn’t stop with childhood.

One in two Americans reports feeling lonely. Some prefer solitude. But most of us aren’t polar bears, who prefer the company of a chunk of ice to that of another bear. Social connection sustains and enhances our mental, physical, cognitive, and financial health. It helps to forge healthier behavior.

“I’m on my own” can be very stressful. A 2017 study showed prolonged social isolation is as harmful as smoking 15 cigarettes a day. It’s more harmful than drinking 6 alcoholic drinks daily – and much, much more harmful than obesity or air pollution.

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Volume 15, Issue 10, Posted 8:44 AM, 06.06.2023

Hi, about STD...

A young man asked to get tested for sexually transmitted infections (STI or STD). He and his girlfriend are in their early 20s, healthy, and updated on vaccines – including human papilloma virus (HPV), hepatitis B. Recently, she saw her gynecologist, who did a pelvic exam and checked her for chlamydia, gonorrhea, and HPV.  

“It’s routine,” her gynecologist said. So, his girlfriend asked him to do the same.

I was touched by their strong sense of shared responsibility, but I said, “We don’t routinely test men for STD.”

“Oh, she’s going to be mad,” he said.

I’ve been chewing on that comment for a while; I’d like to elaborate on this apparent double standard. For almost a decade, three STDs – chlamydia, gonorrhea, and syphilis – have been rising at an alarming, unrelenting rate.

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Volume 15, Issue 9, Posted 9:54 AM, 05.16.2023

How much weight can you lose by sleeping in?

When I wrote about the new diet drug semaglutide (Wegovy) years ago, I did not foresee how the nutty rich and famous would embrace it. Who is prescribing this drug to Elon Musk and Chelsea Handler?

This class of drugs mimics a natural hormone and tricks our brains to feel less hungry. It’s expensive and in short supply. While we wait for the fad and price to settle down, I want to bring up other natural and healthy appetite suppressants – dietary fiber, healthy oil, stress management ... and sleep – a big appetite influencer that people consistently overlook. Probably nobody knows just how serious a player it is.

We’ve all heard or experienced food craving after a poor night’s sleep. A recent study puts a caloric number to that craving.

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Volume 15, Issue 7, Posted 8:22 AM, 04.18.2023

My first presidential order: Pay to exercise

I’m thinking about running for U.S. president in 2024.

We, the biggest healthcare spender in the world, have little to show. For one, we have the highest death rate in avoidable and treatable conditions.

Today I’ll give you my first declaration: "I will pay everybody $30 per hour to exercise."

How do I justify this?

Exercise delays and mitigates 40 chronic diseases – anything from diabetes to depression to dementia to cancer. The question really is “What doesn’t exercise benefit?”

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Volume 15, Issue 5, Posted 10:19 AM, 03.21.2023

How doctors guess your heart attack risk

Recently, I read some news about a man who was scheduled for a hip replacement and ended up getting a 4-vessel heart bypass.

Apparently, a 57-year-old man saw his surgeon days before surgery. Because of a heart murmur, he was referred to cardiologists. After a cascade of tests (starting with a not-routine heart test that measures heart calcium score – more about that later), he ended up getting his heart fixed. He thanked the orthopedic surgeon for saving his life.

Wait, I thought, What happened?

While I don’t have a problem with whom he credited for saving his life, I don’t want you to think you need the threat of impending surgery to shed light on a serious heart condition.

So let’s talk about what we do, including the cardiac artery calcium score (CACS) that started everything.

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Volume 15, Issue 4, Posted 9:54 AM, 03.07.2023

Do you snore? Read this.

Is your bedroom a symphony? You snore; your spouse snores; Noodles, your pug, snores. Noodles, with a short snout, was bred for a disorder called obstructive sleep apnea (OSA). But when should you worry about your snoring?  

OSA afflicts about 1 in 4 people. It’s pervasive, and its symptoms can be evasive. Most people with OSA are not diagnosed.

So how does this sleep disorder “obstruct”? When we sleep, we go from light to deep sleep. Our muscles become relaxed, at times temporarily paralyzed.

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Volume 15, Issue 2, Posted 10:11 AM, 02.07.2023

The new Alzheimer's drugs are not perfect, but...

Many things go wrong in Alzheimer’s dementia. It’s the 50-car pileup on I-90 last month – ice, high winds, the decision to drive in bad weather. Today, we might have a cure for one of these conditions.

We have three treatment approaches.

1. Traditionally, we use drugs like donepezil, (brand name Aricept), rivastigmine (Exelon), memantine (Namenda), etc. They adjust chemicals that promote neuron communication. For some, they temporarily improve memory, thinking, behavior. Like taking ibuprofen during a cold, we may get relief from fever and aches, but the cold will run its course, regardless.

2. For behavioral issues, we use medications – antipsychotics, antidepressants, etc. – to help with sleeping, agitation, delusion.

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Volume 15, Issue 1, Posted 9:59 AM, 01.17.2023

A quick and dirty guide to survive this winter

The respiratory bugs are piling up.

Last month, it was RSV; now it’s flu. COVID is surging again. But they’re just the leaders of the pack; there are many others. People, especially with young children, may feel like they’re chasing one runny nose after another.

To make our lives easier:

First, I want to put one question to rest, “Can you tell what infection I have based on symptoms?”

No.

And COVID is the only virus you can test at home. You need to call doctors to get tested for flu or RSV. At-home flu tests are not FDA approved.

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Volume 14, Issue 24, Posted 11:27 AM, 12.20.2022

Interview with the Virus: Herpes

Me: Tell us who you are?

HSV-1: Oral herpes or herpes simplex virus 1 here. I cause cold sores. Sitting next to me, hiding behind a mask of shame, is my sibling herpes simplex 2…

HSV-2: I can speak for myself.

HSV-1: Sorry.

HSV-2: I’m the dreaded genital herpes – but for the record, these days HSV-1 causes as many herpes in the genital area as I do.   

Me: How’d that happen?

HSV-2: Most people get HSV-1 as children. About 7 out 10 people have cold sores. People get HSV-2 later with sexual activity. Because HSV-1 can cause both oral and genital herpes, those without natural immunity to HSV-1 can develop HSV-1 genital herpes through oral sex.   

HSV-1: Speaking for me and HSV-2 (HSV-2 groaned under its mask), we have an unjust rep because of where we go – not what we do. Yeah, I get it – nobody wants me on their date nights or vacation photos, but nobody wants COVID, either. Yet, we, and other STDs, are cemented in the Walk of Shame. Somebody said, “Life is sexually transmitted.” (HSV-1 looks at HSV-2 nervously.) HSV-2 have been relationship breakers. To me, infections are infections. COVID likes lungs, Staph likes skin, we like nerves and skin. Like our cousin, chicken pox/shingles, we spent most of our lives traveling, multiplying, and sleeping in nerves. Yes, I deserve respect. No, I will not live in whispers.

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Volume 14, Issue 22, Posted 10:11 AM, 11.15.2022

Mom's dementia saves our relationship

When I was young, I fell in school and got a deep gash, covered in black gravel, on my knee. The staff rushed me to a clinic. I screamed through the picking and stitching – the worst moments of my life.

Afterward, waiting to be picked up by school staff, I heard my name called. I turned and saw my mother, hands full of groceries, looking at me with huge, concerned eyes. I felt so safe.

I have no idea how she happened to be there, but she’s always managed to be there.  

After my father died, she moved in with me and my husband, Mark.

Two years ago, she suffered a stroke. She woke up, paranoid and delusional, as if in the midst of a psychological thriller.

She accused us of abusing our grownup kids and my brother's in-laws of cheating and stealing her money, of scheming to murder him. She thought she owned multiple houses. She told the stroke unit nurses how I tried to kill her by infusing poison into her skull.

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Volume 14, Issue 20, Posted 10:48 AM, 10.18.2022

My first colonoscopy: A tale of tiramisu and disappointment

Being a patient makes me a better doctor. But being a doctor does not make me a better patient.

For my 60th birthday, my family guilted me into booking a screening colonoscopy. My first, ever. Don’t judge me. Yes, I should’ve done it earlier, like when I was 45 as the guideline recommends. Because a colonoscopy is as much fun as filing back taxes, all I can say is – better late than never.

I picked colonoscopy instead of the easier annual stool cards, every-5-year sigmoidoscopy or colon scan, not for its excellent cancer detection rate but for its long interval between tests – 10 years.

Three months before the colonoscopy:

I called scheduling. The lady apologized that the next first-in-the-morning appointment was months away and scheduled it right after my birthday.

The next day, I picked up my gallon-jar bowel prep from the pharmacy and conveniently blocked it out of my mind. 

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Volume 14, Issue 19, Posted 11:27 AM, 10.04.2022

Can a polio vaccine give you polio?

The tip of an iceberg

In July, hell broke loose with the discovery of one locally acquired case of paralytic polio in a 25-year-old healthy but unvaccinated man in New York. So how can a single case of polio roil the public health sector – similar to or worse than 22,000 cases of monkeypox?

Background story

With an aggressive vaccine program, the U.S. eliminated polio in 1979. (Yup, I drew the graph.)   

Most people who are infected have no symptoms. Some suffer a few days of stomach flu-like illness. Only 1 in 200 to 2,000 develops paralysis. Experts estimate that for each case of paralysis, hundreds to thousands have been infected and just don’t know.

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Volume 14, Issue 18, Posted 9:31 AM, 09.20.2022

The positive side of the monkeypox crisis

About monkeypox, you can be concerned – curious even – but don’t lose sleep over it.

And good things can come out of a bad situation. Here are my three positive takes:

1. Few merits come with being older. But here’s one. If you’re 50 years old or over, you could be protected from the worst of monkeypox due to the smallpox vaccine.

Monkeypox is in the same family as smallpox. (By the way, they have nothing to do with chickenpox.) Data from Africa suggest most (85%) of those smallpox-vaccinated are protected or partially protected from monkeypox. We have no data from the current outbreak.

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Volume 14, Issue 16, Posted 9:54 AM, 08.16.2022

A secret to better transgender youth health

Janet was a Cleveland schoolteacher for decades. Now happily retired, she blogs about her rural life in Pennsylvania, quilt hearts, town council, surprise bear visits, and her three rescued barn cats. Given the transgender debate, she shares her stories.

Story #1: A self-portrait

I helped a first-grade boy with beginning reading in the late '90s. His parents told his teacher that he talked about wanting to be a girl. The teacher shared that with staff who worked with him so that we could support him if he needed us, but he didn't talk about his feelings at school.

For an art project, the art teacher traced each child’s full body outline, and the children colored their portraits with crayons. Afterward the classroom teacher wrote names on the portraits to hang them in the room.

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Volume 14, Issue 14, Posted 10:31 AM, 07.19.2022

Four must-know medical facts about abortion

A similar version of this column first appeared in the September 2021 issue of the Observer.

Overturning Roe v. Wade does not change medical facts.

Fact #1:

What does “you’re 6 weeks pregnant” mean?

Ohio has a 6-week abortion ban. You may think you have 6 weeks to plan after you miss your first period – WRONG. You have 2 weeks, at best.

Doctors date pregnancy starting the first day of your last actual period. Let’s say your periods are a perfect 28 days. The first day you miss your period – that is, the first time you’re clued in that you’re pregnant – you’re already 4 weeks pregnant.

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Volume 14, Issue 13, Posted 9:36 AM, 07.06.2022

'Tumor just vanished': Facts and hype

After months of bird flu, monkeypox, the never-ending COVID-19 omicron variants, we need great news:

“Small cancer drug trial sees tumors disappear in 100% of the patients,” Washington Post headlined.

“Rectal cancer drug trial of dostarlimab cures all patients,” Fox News.

“Tumor just vanished,” CNN.  

You’re excited, I’m excited, but I’m sure at the back of our heads, we’re all thinking: What’s the catch?

Here’s the big happy picture without the hype.

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Volume 14, Issue 12, Posted 10:01 AM, 06.21.2022

When vaccine scares more than smallpox

Pondering vaccine hesitancy, I thought, “If COVID-19 disfigured like smallpox, people would be more vaccine-inclined.”

Well, history proves me wrong.

Deadly, highly contagious, and mutilating, smallpox plagued mankind since prehistoric times.

In 18th century Europe, most were infected. Of those, 1/3 would die; many went blind.   

Between the 16th and 18th centuries, smallpox traveled with European settlers and decimated native populations in America and Africa.

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Volume 14, Issue 11, Posted 10:10 AM, 06.07.2022

Passing over some reasons you may be passing out

Years ago, a fluke happened.

I finished running on my treadmill. Feeling good, I decided to walk Rosie, my old German shepherd mix. At the end of the block, we ran into our neighbor Isla and her black Lab, Moose. We got talking – animatedly. After a while, I began to feel tsunamis of nausea and stomach pain.

Next thing I knew, I was staring at the great blue sky and wet dog noses.

I turned my head and saw another curiosity – in the distance, Isla was weaving and waving frantically in the middle of the street.

My first thought: She’s going to get herself killed.

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Volume 14, Issue 9, Posted 10:34 AM, 05.03.2022

Recognize the cancer troublemakers around us

We have trillions of cells in our body. They grow, multiply, and die following a strict genetic code. Damaged cells face three fates: repair, die, or get killed by our immune cells.   

Cancer starts with one or a few cells with damaged genetic materials. One reason we don’t get cancer daily: this cell needs to survive numerous rounds of mutations. Eventually it acquires the ability to evade our immunity and to multiply uncontrollably. The process is long and complicated. For example, from the time of infection, cervical cancer takes 10 to 30 years to develop.

Hereditary cancers are unusual (5% to 10% of all cancers are inherited). Most cancers develop because of environmental insults.

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Volume 14, Issue 8, Posted 9:26 AM, 04.19.2022

The cancer screen a few know

My friend Sharon, 72, was diagnosed with two cancers. The worse one was discovered by accident.

She has an abdominal tumor that began to bother her after decades of slow growth. As part of the workup, she got a total-body CT, which showed a suspicious spot on her lung.

A biopsy confirmed it was lung cancer. Because the cancer was small and limited to one area, she underwent surgical removal. We sighed with relief.

Unfortunately, at her one-year followup, more lung nodules appeared on CT. It seems the cancer had been more extensive. Her oncologist, who has a predilection for unadorned numbers, said, “You have a 25% chance of surviving 5 years.” Sharon said, “He can’t help himself.”

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Volume 14, Issue 7, Posted 10:56 AM, 04.05.2022

DIY COVID is here

Four months ago, Ela, 79, and her husband, Jake, 83, tested positive for COVID-19. A tough Polish lady who doesn’t like going to doctors, she waited. But when she passed out in the living room, her family was alarmed. Her daughter scrambled to find a clinic that was an hour away but could give them the monoclonal antibody infusion that day.

Jake got the infusion. But Ela was told, “Your oxygen is too low. It’s too late for the infusion treatment.” She was admitted to the hospital.

Hopefully soon, a new drug Paxlovid and a new Test and Treat Initiative will change this outcome. Paxlovid isn’t widely available yet, but it’s among the most effective of the four or five drugs that target early COVID-19 infections.

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Volume 14, Issue 6, Posted 10:39 AM, 03.15.2022

Biden's 'Moonshot' in the dark or reality?

On Feb. 2, 2022, President Biden “reignited” the Cancer Moonshot, a program he started in 2016, one year after he lost his son, Beau, to an aggressive brain tumor. The goal: Halve cancer deaths in 25 years. Is he, or the science, grounded in reality?

Maybe, but you and I need to lend a hand.

Here’s the current cancer landscape in the U.S.: About half of us (40%) will develop cancer in our lifetimes; of those diagnosed, half (20%) will die from it.

Cancer is the second leading cause of death in the U.S., behind heart disease.

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Volume 14, Issue 4, Posted 9:58 AM, 02.15.2022

Take another look at prediabetes

Last week, I did a glucose test on a 57-year-old patient because of urinary symptoms. The elevated number suggested she had diabetes. She wasn’t surprised. All her paternal aunts have diabetes. Until then, she was hoping she’d taken after her mom’s side of the family.

Later, I reviewed her old blood tests. A thought gnawed. While her previous glucose levels had been “normal,” they’d crept up into the prediabetic range. Had I told her that she was a prediabetic, could it delay her developing diabetes?

A sobering fact: Almost one in two Americans over the age 18 are either diabetic or prediabetic. Prediabetics make up 70% of that group. By the way, I’m talking about type 2 diabetes, or adult-onset diabetes, which is 90 to 95% of all diabetics.

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Volume 14, Issue 3, Posted 10:14 AM, 02.01.2022

Planting a New Year's resolution

Are you still sticking to your New Year’s resolution?

Kind of? Well, I last stepped on the scale three days ago. But you know what: Tomorrow is a new day. 

But may I suggest adding another one? One that will halve your risk of heart attack, mostly by lowering your blood pressure, cholesterol, sugar and reducing inflammation.

Studies suggest it may also reduce your risk of many cancers, especially colon, prostate, and breast. They, my friend, are currently among the top five causes of cancer deaths in the U.S. Many health effects like lowering blood pressure, glucose, cholesterol are apparent in days to weeks. I’m going to stop now because you get the point.

So what is this new New Year’s resolution? A plant-based diet.

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Volume 14, Issue 2, Posted 10:06 AM, 01.18.2022

VAERS: The angel is in the details

In the past year, I’ve learned to shut up and accept people’s refusal to be vaccinated – unless you’re my patient, then we still need to discuss it.

I respect:

“I don’t trust government (or health) bureaucrats.”

“Got COVID already.”

“I’m afraid of needles.”

“I’d like to wait a little longer to make sure.”

“COVID is like the flu.” (Umm, no.)

But there’s one alarming piece of misinformation that I’ve heard again and again – long before COVID-19 – that I must clarify:

“COVID-19 vaccines are linked to thousands of deaths. It’s reported on VAERS, a government site. And everybody knows vaccine reactions are grossly unreported.”

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Volume 13, Issue 23, Posted 10:34 AM, 12.07.2021

Is an aspirin a day right for you?

Last year, my younger brother turned 56, gained a few pounds. His blood pressure was up. Diabetes runs in our family. He started taking a baby aspirin a day because he read somewhere it’s good for his heart.

At the time, I thought nothing of it. What harm can a baby aspirin a day do? But after reading the draft of the U.S. Preventive Services Task Force’s (USPSTF) new guidelines on aspirin, I’m having second thoughts.

For almost a century, cardiovascular disease, mostly heart attacks and strokes, has been the leading cause of deaths in the U.S. It accounts for one in three deaths.   

Those who suffer one event are at high risk of having a second one. Study after study showed that aspirin can significantly reduce the chance of a second heart attack or stroke. Aspirin works by reducing inflammation and, more importantly, impairing blood clot formation. It’s so effective that low-dose or baby aspirin (81 mg) works just fine.

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Volume 13, Issue 22, Posted 10:24 AM, 11.16.2021

Abortion talk for pro-life and pro-choice

It doesn’t matter where you sit on the spectrum of abortion. You do you, but we all need facts.

Last month, Texas began banning abortions after 6 weeks of pregnancy. Planned Parenthood estimates they turned away 85-90% of women mostly because they were too far along in their pregnancies. With abortion a 'hot topic' in the news lately, I thought I'd use this column to add a medical perspective to the discussion.

First, what does “you’re six weeks pregnant” mean?

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Volume 13, Issue 19, Posted 9:59 AM, 10.05.2021

Ivermectin: From dirt to Nobel Prize

Is it me or is the medical world upside down and sideways these days?

I can live with the “It’s a hard no on the vaccine.”

What bothers me: Muddy information from doctors. Recently, an Arkansas doctor headlined for giving jail prisoners (and himself and his family, apparently) a multi-drug cocktail including ivermectin, a deworming pill, to treat – and prevent – COVID-19.

He’s the tip of the iceberg. The CDC reports ivermectin prescriptions went from 3,600 per week pre-pandemic to “88,000 prescriptions in the week ending Aug. 13, 2021.”

I’m not here to trash talk ivermectin. Quite the opposite, ivermectin colors my world sky blue.

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Volume 13, Issue 17, Posted 10:43 AM, 09.08.2021

The buzz around a new weight-loss pill

I am (or should be) studying for my medical board recertification exam.

Instead of immersing myself in acid-base disorders, again, I’m learning:

  1. A mosquito’s mouthpiece has six needles.
  2. Cauliflower are actually flowers.
  3. Dr. Joseph Mercola, who's heavy on vitamins and light on facts and who's been warned multiple times by the FDA for his "unapproved and misbranded" products including COVID-19 treatment, makes a lot more money than any doctors I know.

But one newly FDA-approved, weight-loss drug – semaglutide (brand name Wegovy) – caught my attention.

I’ve read the studies and believe it has potential.

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Volume 13, Issue 16, Posted 10:13 AM, 08.17.2021

Part 3: It takes a village

This is the third article in a three-part series on harm reduction in drug overdoses.

The first time we saw Omi in the free clinic, she was in the throes of a heroin withdrawal. Her face was pale and sweaty; hands swollen and quivering. She was rocking gently – pampering waves of pain and nausea.

Her sister-in-law, who found her in Chicago the day before, was crying. “She’s family. She deserves another chance.”

Omi refused to go to the ER. I understood: There’s only so much the ER could do. Our clinic manager started calling drug rehab programs. On a Friday afternoon, everything was about to close.

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Volume 13, Issue 15, Posted 9:58 AM, 08.03.2021

Part Two: Meet the 'truck lady'

This is the second article in a three-part series on harm reduction in drug overdoses.

Omi, a 47-year-old heroin and cocaine addict, lived on the streets in Chicago for years. To survive, she had help.

Meet the “truck lady”

Melissa Hernandez, 39, born and raised in Chicago, describes her abusive childhood as “horrible, painful, and confusing.”

At age 12, she started using drugs, “just about everything.” Addled by drugs, abuse, and a bleak future, she couldn’t care whether she lived or died.

At 19, she had her son. She was shocked: “I can’t believe I can love somebody this much.” She quit drugs and never looked back.

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Volume 13, Issue 14, Posted 10:25 AM, 07.20.2021

Meet Omi

This is the first installment in a series of articles on harm reduction in drug overdoses.

Omi, as her family calls her, is a 47-year-old cocaine and heroin addict. She shares her story so you and I can understand and, hopefully, help her and others like her.

Her candor can be brutal: She stole, she robbed, she sold her body. “People whisper,” she said, and she wanted to tell her story her way.

An anything-but-routine gynecology visit

Weeks ago, at the clinic, my midwife colleague saw a new patient scheduled for a routine gynecology exam.

Alarmed, she called me in.

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Volume 13, Issue 13, Posted 10:28 AM, 07.06.2021

Worried about the new COVID-19 vaccines?

Two weeks ago, I got my first dose of the Moderna COVID-19 vaccine. I felt bad, but for a different reason than you might think.

Today, we have effective vaccines targeting over 20 infections. Some infections can lead to cancer. Vaccines for HPV and Hepatitis B have significantly reduced the incidence of cervical cancer and liver cancer, respectively. So, yeah, I believe in vaccines.

But I’d be lying if I said I’m not worried about these new COVID-19 vaccines which seemed to have popped out overnight.  

Are they safe?

To alarm our immune system, older vaccines use weakened/dead viruses or part of the virus. The first two FDA-approved vaccines use a new technology. They deliver a sliver of genetic material that codes for just one protein – the spikes on the COVID-19 virus.

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Volume 13, Issue 2, Posted 10:01 AM, 01.19.2021

Bearers of the great pandemics

I once heard: Pandemics produce one thing reliably – amnesia.

Unless, of course, you are the bearer of the disease.

Bob, 67, was born in London, England. When he was 2½ years old, he contracted polio. The ordeal lasted a few weeks; back then all doctors could do was “wait and see … what muscles come back.” He survived, but his legs were partially paralyzed.

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Volume 12, Issue 24, Posted 9:54 AM, 12.15.2020