When the ECG is more revealing than the HPI
Written by Alex Bracey with edits from Pendell Meyers and Steve SmithA woman in her 60s presented to the ED as a referral from an urgent care for weakness. When I interviewed her, she reported that she had experienced several months of shortness of breath and fatigue, which had worsened in the last several days. She had also experienced new dyspnea on exertion, along with a non-productive cough and fatigue. The only medical problem she was aware of was hypertension treated with hydrochlorothiazide. An ECG was performed as follows:Sinus tachycardiaConvex, upward ST elevation in V1-V4 with subsequent T wave inversionRi...
Source: Dr. Smith's ECG Blog - May 30, 2021 Category: Cardiology Authors: Bracey Source Type: blogs
The Art of Asking: What Else is Going on?
By HANS DUVEFELT
Walter Brown’s blood sugars were out of control. Ellen Meek had put on 15 lbs. Diane Meserve’s blood pressure was suddenly 30 points higher than ever before.
In Walter’s case, he turned out to have an acute thyroiditis that caused many other symptoms that came to light during our standard Review of Systems.
Ellen, it turned out, was pretty sure her husband was having an affair with one of his coworkers. And, since this wasn’t the first time, she was secretly working on a plan to move out and file for divorce. She admitted she’d always had a tendency to stress eat.
Diane’s daughter h...
Source: The Health Care Blog - March 15, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Primary Care Hans Duvefelt health communication Source Type: blogs
The Art of Prescribing (Or Not)
By HANS DUVEFELT
I have learned a few things about prescribing medications during my 42 years as a physician. Some are old lessons, and some are more recent. I thought I’d share some random examples.
First: I don’t like to have to use medications, but when they seem necessary, I choose, present and prescribe them with great care.
CHOOSING MEDICATIONS
Medications are like people. They have personalities. With so many choices for any given diagnosis or symptom, I consider their mechanism of action, possible beneficial additional effects and their risk of unwanted side effects when selecting which one to presc...
Source: The Health Care Blog - February 1, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Patients Physicians Primary Care Hans Duvefelt Source Type: blogs
Can gout be prevented?
To many people, gout seems like a disease of the past. Cartoons from 200 years ago depicted it as a condition afflicting the wealthy (“the disease of kings”), whose gluttonous consumption of food and drink was thought to bring on the attacks of debilitating arthritis.
All these years later, much about gout is still misunderstood. Shame, derision, and the belief that the gout sufferer deserves the condition linger. And rather than being a disease of the past, gout is quite common — and rates are rising. Estimates suggest gout affects nearly 4% of the adult population in the US, an increase from prior decades. And it...
Source: Harvard Health Blog - January 8, 2021 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Arthritis Bones and joints Health Men's Health Source Type: blogs
Bread, paper, and other indigestible objects
Olivia posted this incredible story of wheat-free release in the comments on this blog some time back. Her story so powerfully encapsulates how far off course health can go by consuming this thing called “wheat,” that I thought it was worth sharing with everybody again. During her wheat-consuming days, Olivia was clearly suffering body-wide inflammation and other effects that were being ineffectively “treated” by her doctor, effects largely due to the indigestible or only partially-digestible proteins from the seeds of grasses AKA wheat. As often happens, she managed to reverse the entire collection...
Source: Wheat Belly Blog - April 29, 2020 Category: Cardiology Authors: Dr. Davis Tags: Open gluten-free grain-free grains wheat belly Source Type: blogs
Are polypills and population-based treatment the next big things?
Cardiovascular disease (CVD), such as heart attack and stroke, is a leading cause of death and disability in the US. High blood pressure and high cholesterol are major risk factors for CVD, and even though they are quite common and highly treatable, they tend to be undertreated. This is especially true among those who are poor or members of a minority. It’s estimated that thousands of lives could be saved each year if more people with high blood pressure and high cholesterol received treatment for these conditions.
The appeal of the polypill
One reason that high blood pressure and high cholesterol are poorly treated is t...
Source: Harvard Health Blog - January 13, 2020 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Drugs and Supplements Health Heart Health Hypertension and Stroke Source Type: blogs
Fight Aging! Newsletter, September 2nd 2019
In conclusion, in the absence of obesity, visceral adipose tissue possesses a pronounced anti-inflammatory phenotype during aging which is further enhanced by exercise.
Methods of Inducing Cellular Damage are Rarely Relevant to Aging, and the Details Matter
https://www.fightaging.org/archives/2019/08/methods-of-inducing-cellular-damage-are-rarely-relevant-to-aging-and-the-details-matter/
One of the major challenges in aging research is determining whether or not models of cellular or organismal damage and its consequences are in any way relevant to the natural processes of aging. One can hit a brick wit...
Source: Fight Aging! - September 1, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
A Large Polypill Clinical Trial Shows a Third Reduction in Cardiovascular Events
The research and medical communities are slow to undertake work on combination therapies. Regulation makes it exceedingly expensive to assess multiple combinations, and there are numerous other perverse incentives to challenge any effort to build combination therapies with components developed and manufactured by different groups. Short of working around the existing system of regulation, and methods of doing this at scale are lacking at the present time, this is a challenging problem to solve. People follow incentives. Given this, it it is entirely plausible that there are many largely unexplored instances in which existi...
Source: Fight Aging! - August 30, 2019 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Where did all the magnesium go?
We pay special attention to restoration of magnesium in the Wheat Belly lifestyle. This is because magnesium deficiency is universal, affecting virtually everyone, is severe, and has substantial implications for health.
But why? Why has everyone become so depleted in magnesium in the modern world? There are five major reasons:
Water filtration—We filter our water out of necessity, since modern waterways are contaminated by sewage runoff, pesticide/herbicides, algal overgrowth, etc. So, rather than drinking from a nearby stream or river that runs freely over rocks and minerals rich in magnesium, we drink water filter...
Source: Wheat Belly Blog - May 30, 2019 Category: Cardiology Authors: Dr. Davis Tags: Magnesium grain-free phytates undoctored wheat belly Source Type: blogs
What causes kidney stones (and what to do)
Stone disease has plagued humanity since ancient times. Kidney stones have been identified in Egyptian mummies. The Hippocratic oath describes their treatment: “I will not use the knife, not even verily, on sufferers from stone, but I will give place to such as are craftsmen therein.”
Who gets kidney stones and why?
The lifetime risk of kidney stones among adults in the US is approximately 9%, and it appears that global warming may be increasing that risk. (As the climate warms, human beings are more likely to get dehydrated, which increases the risk of stone formation.) There are four major types of kidney stones: cal...
Source: Harvard Health Blog - May 17, 2019 Category: Consumer Health News Authors: Kevin R. Loughlin, MD, MBA Tags: Health Healthy Aging Kidney and urinary tract Source Type: blogs
Live the Wheat Belly lifestyle, get off prescription medications
Take a look at the list of medications people have been able to stop by following the Wheat Belly lifestyle.
These represent medications prescribed by doctors to, in effect, “treat” the consequences of consuming wheat and grains. They prescribe drugs to treat inflammation, swelling, skin rashes, gastrointestinal irritation, high blood sugars, airway allergy, joint pain, high blood pressure, leg edema and other abnormal effects caused by wheat and grains.
The list includes anti-inflammatory and pain medication, acid reflux drugs, injectable and oral drugs for diabetes, numerous anti-hypertensive agents, asthma i...
Source: Wheat Belly Blog - October 27, 2018 Category: Cardiology Authors: Dr. Davis Tags: News & Updates autoimmune blood sugar bowel flora cholesterol Gliadin gluten-free grain-free grains Inflammation undoctored Weight Loss wheat belly Source Type: blogs
Stroke Risk Nearly Halved by Some Combinations of Medications to Lower Blood Pressure and Cholesterol
The data here gives a fairly good idea of the bounds of the possible and plausible when lowering blood pressure and blood cholesterol, putting some numbers to the degree to which stroke risk can be reduced. Strokes occur due to breakage or blockage of blood vessels, and the roots of that lie in (a) the stiffening of blood vessels that breaks the feedback mechanisms determining blood pressure, and (b) the processes of atherosclerosis that produce fatty plaques in blood vessel walls, narrowing and weakening them.
Blood pressure medications don't address the roots of the problem, but force a lower blood pressure, which...
Source: Fight Aging! - January 26, 2018 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
MKSAP: 64-year-old man with diabetes
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 64-year-old man is evaluated for his quarterly diabetes care follow-up visit. Point-of-care HbA1c level is not at goal for this patient, who has high function, long life expectancy, few comorbidities, good support, health literacy, and access to care. Medical history is significant for hypertension, hyperlipidemia, and obesity. His family history is notable for type 2 diabetes mellitus in his mother and hypertension and chronic kidney disease in his father. Medications are metformin, glipizide, hydrochlorothia...
Source: Kevin, M.D. - Medical Weblog - December 30, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Diabetes Endocrinology Source Type: blogs
MKSAP: 38-year-old woman with a HbA1c value of 9.1%
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 38-year-old woman is evaluated after laboratory study results show an HbA1c value of 9.1%. Her HbA1c goal is less than 7% because she has high function, long life expectancy, few comorbidities, good support, health literacy, and access to care. Medical history is significant for morbid obesity, obstructive sleep apnea, hypertension, and hyperlipidemia. Family history is notable for her mother, sister, and brother with type 2 diabetes, obesity, hypertension, and hyperlipidemia. Medications are insulin glargine ...
Source: Kevin, M.D. - Medical Weblog - September 2, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Diabetes Endocrinology Primary Care Source Type: blogs
Why is magnesium so important?
One of the six core strategies in the Undoctored Wild, Naked, and Unwashed program for health and weight loss is restoration of magnesium.
Magnesium deficiency is alarmingly common in today’s world. Why? Our reliance on filtered water that has had all of the magnesium removed, the reduced content of magnesium in modern crops, and the widespread use of proton pump inhibitors—-drugs prescribed to treat acid reflux and ulcers while reducing magnesium absorption.
Remember those darned phytates in wheat and other grains that bind magnesium and other positively charged minerals in the intestinal tract, preventing absorp...
Source: Wheat Belly Blog - July 18, 2017 Category: Cardiology Authors: Dr. Davis Tags: Undoctored Wheat Belly Lifestyle a fib constipation Dr. Davis grain-free grains health healthcare heart rhythm hydrochlorothiazide kidney stones oxalate sudden death Source Type: blogs
