How does gun violence affect your health?

What do guns have to do with health? Actually a lot. Health is measured in two ways: Mortality (Duration of Life) and Morbidity (Degree of Illness) both of which are being severely impacted by Gun Violence. I actually started this blog a while ago but the events in the Navy Yard today caused me to resurrect it. Are we not yet tired of this violence and the thing that begets it : Uncontrolled Access to weapons? There are age groups were gun violence is the leading cause of death and young people have more to fear from Gun Violence than actual diseases we can be immunized against. The incidence of gun related suicide is directly related to ease of gun access.I'm not a politician and I am not trying to be one but let's get real, look at the numbers, Gun Control has become a Public Health issue and is working its way to the top of the list. Soon we will be more concerned about stopping a bullet than getting cancer. Nail me to the stake if you have to but as a Public Health professional allow me to say what needs to be said. More important PLEASE stop and educate yourself on the situation and be glad it wasn't someone in your family who got killed this year. However would you not rather act before it hits closer to home? I was initially moved to write this blog earlier this year when I read about a University of Maryland student who got killed by another student over some frivolous incident. The first thing that came to mind was: "Yet another parent who thought they had finally got their kid in college, only to turn around and they are gone in a puff of smoke" (How many since Virginia Tech?) Just food for thought. Please Be Well, Oh, and stay alive !

Originally Published in 2013 by Dr. Tuakli

Pap smears

A patient said to me last week “I do believe you saved my life for the second time Dr. Tuakli” And I thought Wow! You know what, she is right. People thank me for saving their lives from time to time and not to sound cavalier but I often think that it is nice to hear but I was just doing my job. Any qualified physician could have been credited with doing the same thing. But this time was different and very stark. This 50 something year old lady has been in my practice for perhaps 3 or 4 years. She has a variety of medical issues that we have been working on and from time to time I would suggest she have a pap. She had told me previously that she had been told that she didn’t need one because she had had a hysterectomy. Interestingly enough whenever I probed further she never seemed sure about exactly what had been done. Was the uterus completely gone including the cervix? How about the ovaries? Why was the surgery done in the first place? It never ceases to amaze me how many times I ask those questions and the answer is “I don’t know”, particularly in over 40 year old women. I eventually convinced her that it would be a good idea to just do a routine check up even though she had no symptoms and so I did a pap. As soon as I started her pap I knew from the look of the lesion in her vagina that it was cancerous. Putting cells on a slide and sending it to the lab quite frankly was a formality and I had her schedule an appointment with a gynecology oncologist pending the results. She told me when she came in last week that the specialist walked into the room and the first thing he said to her was “What is a women your age doing still getting pap smears?!” (I wont be referring any more patients to him). The arrogance dissolved when he saw the cytology report and the patient has since had the appropriate surgery. So why do I tell this cautionary tale? Well, for one thing, the current guidelines imply that she did not need a pap smear, simply based on her age. Secondly, I think that many women are walking around thinking that because they have had a hysterectomy they are immune to genital cancers. Thirdly, standard recommendations are just that, written for the common good but not by someone who knows you. Do not take them as gospel. You could argue that this is the exception to the rule and that is probably true but it also means that someone’s mother and sister will still be alive 3 years from now and she also managed to avoid the trauma of cancer therapy that would have resulted had she found it later. In medicine it is not always easy to argue with “official recommendations” and specialists who don’t know the patients. I believe that I taught myself something with this case, not everything has to be rational, and care must be individualized regardless. I am a strong believer in learning from past experience even if its not written anywhere. I derive no satisfaction from my patient being diagnosed with cancer but I am sure glad I followed my gut. When in doubt get a pap, it sure beats the alternative!

Originally published in 2013 by Dr. Tuakli

ARTHRITIS

PREVENTION, CONTROL AND CURE OF ARTHRITIS Have you ever heard that there is nothing that can be done about Arthritis? Its not true! An Aunt of mine was having a terrible time earlier this year with bad arthritis of her spine causing so much pain she couldn’t move.  I do believe that arthritis can be prevented, contained and cured! But not by managing it the way we are taught in medical school. i.e take anti-inflammatories to decrease the inflammation while your joints get worse and you suffer from the side effects. Oh, and then when it completely breaks down replace the joint with an artificial one. I now believe that the non pharmaceutical measures you can take are much more powerful than drugs for the treatment and prevention of arthritis. These do not suppress the symptoms while the disease gets worse, they stop it. So here’s a summary of what may be needed: Oral Hygiene measures. Dietary changes. Healthy Oils Supplements Vitamins Exercises Maintain a healthy weight Antimicrobials when indicated Allergy testing Balance your Hormones Nothing invasive! If you have an interest in generating a personalized program for arthritis treatment then please feel free to schedule a consultation. If you have arthritis personally or in your family I would strongly encourage you to do so SOONER than later.  Yours in health Dr. Tuakli

Originally published in 2013 by Dr. Tuakli

Need more time with your doctor?

Need more time with your doctor? In today’s hurried world both the doctor and the patient can feel frustrated by the amount of time available to speak with each other. Did you know that the insurance company rarely pays for more than a 15 minute visit with a primary care physician (PCP) unless the patient has a diagnosis they think should take longer. Even then extra documentation is required to show why it would take so long. Its ironic that they pay specialists for more time (even when it is a pop in and “keep taking the same medicine” visit) than they do for PCP’s who are supposed to be on the frontline and have a deeper understanding of you and your family’s overall health. I recently admitted a critically ill patient who had just returned from overseas and the insurance company refused to pay for my hospital visits to take care of him. Even though they saved a bundle by not having to pay specialists. They said his care is covered by the $20 a month they pay me for capitation. Small wonder most doctors don’t bother to take care of their own patients in the hospital anymore. They simply turn them over to a hospitalist who doesn’t know anything about them, kind of like a mechanic who only handles exactly what is in front of him. I recently returned from a conference (way out in the Boonies!) on alternative medicine and once again learned fascinating information I would love to share with my patients. But where is the time? While I am at conferences I keep thinking “wow! So and so may really benefit from that”. “I wish I had known that before so and so had that surgery” “I have a zillion patients who complain of fatigue, fibroids etc…If only I could have more time with them” When I come back I always like to meet with my VIP patients to discuss how new information may help them and what changes we can make to their vitamin regimens. Unfortunately I cant do that with everyone, however, if you feel that you would like to schedule a private self pay consultation with me please call the office. I am bursting to share the great news of how to improve health with everyone. Believe me my own regimen changed last weekend! Here’s to real health 

Originally published by Dr. Tuakli 6th october 2015

Good Health and the Ravens!

GO RAVENS! Last night I had the privilege of speaking to a group of people at the Ravens Performance Center in Owings Mills. This is a huge (200,000 sq ft) facility with 3 outdoor and one full sized indoor practice fields, TV studio, offices, basketball court, the world’s largest gym, you name it. Not your average home away from home. All very interesting and their wonderful PR guy Edward Burchell, Jr. described the Ravens philosophy and how the Ravens are creating their brand. He even let me hold his super bowl ring. “Wait a minute! Are these real diamonds?” Wow, that is quite a ring and I am not even a football fan! So after all this fun, we got down to business it is always so interesting to realize the importance of health to everyone no matter who they are. The popular and very charismatic sportscaster Gerry Sandusky shared with me how some of the topics I raised were relevant to him and his family. A celebrity chef described his strategy for managing what sounded like a grueling travel schedule. Isn’t it a wonderful thing to know that using today’s technology and knowledge we can all live a long healthy life without illness weighing us down? It’s right there within your reach but you do have to take charge and grab it. I am passionate about passing on this simple message. It may not have the ‘wow factor’ of that ring but it’s really powerful when you think about it. As the New Year beckons I would like to share some of the tips I gave last night on how to stay healthy. Take charge, you know your body better than any doctor. Form a partnership with your doctor with open communication. Once the two of you have come up with a game plan, stick to it. Pencil in at least 2 ‘health days’ on next year’s calendar right now! If you are over 35 get your hormone levels checked. Control your weight, draw a line in the sand that can’t be crossed under any circumstances. Be in tune with your body and don’t put things off. Remember that mental health is just as important as physical health and put in the time and energy to optimize your health and ultimately your life. You can change your health and achieve your goals if you really want to. Season’s Greetings, Go Ravens!

Originally published October 6 2016 by dr. Nadu Tuakli