Things to think about Covid-19

Worrisome issues with Covid-19

I raise these just so you can be aware of the issues and think about them.

This Pandemic is NOT a one and done issue. I hope most people realize that. It came out of a small shop in Wuhan but the genie is never going back in the bottle. After this phase we will have waves of infections just as we have with influenza. One of the reasons influenza is not so deadly is that many people have some immunity to it and this gives us some herd immunity. Also the influenza viruses in general these days are not as virulent and don’t have quite the predilection  for the lungs that the virus causing Covid-19 has.

How do we dispose of the bodies of people who die from Covid?

This is a big question that hopefully health departments around the country are taking care of. I know in one place in New York they have prisoners digging graves and trying to keep up with the demand. Remember the corpses are contagious.

People are being separated from there loved ones, I’m hoping those who want them cremated are allowed to have their ashes but I’m not sure how it is working in this particular war time scenario.

The politicization of a public health problem. Here’s the link to my video if you are interested: https://youtu.be/fjc00g-sCiM

The mission of the World Health Organization is to allow all people to attain the highest possible level of health and to respond to International health emergencies. They believe Health is a basic human right. The US government now wants to be able to dictate policy to them because we are the biggest 'donor' and we screwed up our response to the Covid pandemic. It is wrong to tell ignorant people that the WHO does nothing but suck up our money. Scientist all over the world are exchanging data through the WHO.

Racial disparities in death rates from Covid-19. Quite frankly this is absolutely no news. There was a whole commission working on racial disparities in health care 20 years ago.  One more thing we should have seen coming. Let’s not allow ourselves to be distracted but to spread appropriate information so less informed people can be protected. Help to bust some of the myths in your community and focus on reliable sources.

Many of the people who are dying are under 50 years old with no underlying conditions. Please rid yourself of those early ideas that made you feel you weren’t at risk. We all are!

As always follow the recommendations for prevention. Let me know if you have any symptoms you are concerned about.

Stay well, Stay inside, be informed.

Food Attack! How to keep the weight off for good

Did you know that eating animal protein is as harmful to your health as carbohydrates (sugar, potatoes, bread)?
Did your parents tell you that dairy products and cheese are 'good for you'? They are not!
Did you know that you increase your risk of cancer by eating animal protein whether it is red meat, white meat, chicken or fish?
Do you know that adding raw fruit (not blended) and nuts to what you are already eating, you can lose weight and reduce your cholesterol?
Have you bought into the myth that Olive oil is healthy oil, meanwhile it is making you sick and helping to hold onto weight?
These facts and  many others can be found in an amazing book by Dr. Joel Fuhrman called "Eat to Live". I strongly suggest you read it as soon as possible.

In the meantime, weight loss is on everyone's New Year's resolution list so here are some tips to help you lose weight and keep it off:

Throw away butter and margarine (solid oils), only eat the amount of these that you are comfortable depositing in your arteries because that is where it is going as soon as it leaves your mouth. The more solid it is at room temperature the more it will deposit in your arteries.

Do not buy things you know you don't want to eat. If it isn't in the house you probably won't eat it.

Limit animal protein to no more than 3 days a week, this includes chicken, fish and pork.

Start every evening meal with a massive salad and then eat whatever you want afterwards until you feel full.

Eat a handful of nuts and beans daily.

Do not snack.

Eat 3 to 4 fruits a day as raw fruit. Do not drink your fruit!

 Do at least 5 to 10 minutes of exercise  of some sort every 2 hours.

Try this for 6 weeks and see what happens to your weight and cholesterol.

If you need to do the weight reduction program for 6 weeks to lose 20 to 40 pounds as a jump start please call the office. There is a 5% discount until February.

Doctors commit suicide too!

Doctors have the highest suicide rate.

Patients may be surprised to realize that doctors get depressed and commit suicide. But what may be even more surprising is the fact that doctors have the highest rate of suicide in the country. Physicians in America have the highest rate of any profession: twice the number of suicides as the general population. 

According to Medscape: physicians have at least one completed suicide daily despite the fact that they are surrounded by other medical professions. 

A doctor at the CDC recently killed himself by drowning. This illuminates the fact  that if you don’t  seek out the signs or ask, depression can be masked.  

If you suspect someone maybe suicidal you must act.

 54% of people who commit suicide have no known prior mental health condition. 

The commonest method is with firearms, followed by hanging or strangulation. Montana has the highest incidence of suicide and Washington DC the lowest, in the United States.

I had planned to write this blog a couple of months ago when I read about a doctor and a  final year medical student, at the same hospital in New York, committing suicide in the same week. 

I didn’t get around to it because I was extremely busy and getting ready for my safari to South Africa.

But, in less than the 2 weeks that I was gone: two well known celebrities hung themselves. It is becoming an urgent issue: according to the CDC the rates are definitely increasing, having risen 25% since 1999.

Whenever someone kills themselves I always think about what a waste of a life it is, and I often wonder if they are aware of the pain and suffering they bring to their loved ones and friends. 

The people left behind feel like failures, they feel helpless and empty, soul searching for what they could have done differently.

Doctors, clearly, must do a better job of suicide prevention both for our patients and ourselves. Doctors are taught the symptoms of depression which should give them an advantage yet they too succumb to suicide. How much more people who don't understand what they maybe going through. It is up to us to assure them that the cloud will lift, even if it doesn't feel like it.

Please look at the suicide prevention website or call the national suicide prevention lifeline for more information and educate yourself.

In a nutshell: if you are depressed seek assistance from your doctor immediately. If you are on anti-depressant medication follow up with your doctor regularly even if you think nothing has changed. 

Learn the signs of depression and if your friends, family or co-workers exhibit them, encourage them to get help. Do not be afraid to ask people you care about, you will not give them an idea too commit suicide if they haven't already considered it.

Depression is like any other medical condition and there should not be a stigma attached to it. By understanding the condition and removing the stigma, people will be more willing to share how they are feeling with others.

Dr. Anne Schuchat, principal deputy director of the CDC said there are simple steps anyone can take to help someone at risk. "Beginning a conversation, helping keep them safe, helping them connect and then follow up with them," she said. "We don't think every single suicide can be prevented, but many are preventable."

How to get help: In the US, call the National Suicide Prevention Lifeline at 1-800-273-8255. The International Association for Suicide Prevention and Befrienders Worldwide also provide contact information for crisis centers around the world.

Together we can all save lives!

FLU SHOTS

FLU SHOTS

Its time to get your flu shot. Unfortunately flu shots have to be taken annually. Many people say they are not sure if they are worth paying for, well fortunately after Obamacare almost all insurances pay for them.

Why get a shot?

Apart from the obvious discomfort of being ill, think about all the other inconveniences getting the flu in the winter causes : time out of work, the expense of buying medicines and trips to the doctor, making other people and your family sick etc.

Flu season usually begins with regularity the Monday after Thanksgiving after ‘sharing the love’ and everything else in abundance. The idea is to be adequately protected before then.

School children and certain professions are at particularly high risk of contacting the flu. The elderly and very young are most susceptible to the more severe complications of the disease like pneumonia and death.

Conditions like Diabetes, COPD and Asthma also increase you risk.

Every year I hear a plethora of excuses and rumors as to why people don’t want to get a flu shot:

“I have never had one”, “I don’t get the flu”,  “I got one before and I still got the flu” but I often think they have not really taken the time to understand why the medical profession advocates them.

Every year the most likely strains to cause disease are determined and these are included in that year’s shot. The researchers could be wrong or leave out a strain that could be a problem as its not an exact science but either way you will have an opportunity to boost your immunity to some strains. The downside is minimal.

Every hospital and health care facility now requires all its staff to get that year’s strain of flu shot, they do this based on research and the fact that it works.

Unfortunately you don’t know which year is a particularly bad season until you are right in the middle of it which does not allow time to generate immunity. Every year we have a new viral epidemic, SARS, Chikungunya, Ebola, Zika and no idea what's next. At least protect yourself from things that are known and give your body a chance against things that are not.

If you would rather not get your flu shot at the same place as you pick up your milk, veggies and meat please feel free to stop by the office and get one, you don’t need an appointment. Prevention is always better than cure.  Sincerely, 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

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