Yes, unfortunately, we have already had several confirmed cases of the flu in the office by mid September 2018. Therefore, we are encouraging everyone to get their flu shots as soon as possible. We have the new 4 component vaccine available for all ages in the office right now. Any of our patients can walk in during office hours without an appointment and get the vaccine. It is not made with eggs so hopefully, there will be less sore arms or other reactions. As I mentioned above NO APPOINTMENT IS NEEDED, WALK IN FOR A FLU VACCINATION IS ENCOURAGED. We will be given shots until our supply runs out, so first come, first serve.
A recent study published in the Annuals of Internal Medicine in 2016, found that symptoms of shortness of breath or chest pain occurred in over half of patients who subsequently suffered an acute cardiac arrest. In addition, of those who had symptoms, in over 90% of these patient, their symptoms actually occurred within 24 hours of the event. This information was gathered by reviewing hospital records and clinic charts, interviewing patients, family and witnesses about 839 individuals who had the acute cardiac arrest during the period from 2002–2012.
Take home message: Don’t guess that the chest pain is indigestion or that the shortness of breath is only that you are “out of shape”, call immediately and don’t take a chance!!
Many individuals have asked when and how often should they receive a screening for an abdominal aneurysm. Actually, all men who are now 65 or older, and have ever smoked should be screened one time for this entity. This is a benefit for men who have smoked and have Medicare. Women and the black race have a lower risk for this condition, but anyone who has a family history of an aortic aneurysm have twice the risk of a person without that history. Unfortunately, smoking is another major risk factor.
If you have been identified as having an aneurysm, then it should be followed periodically with repeat screening depending on the size. If the aneurysm is 4 cm or smaller, repeating the ultrasound every 2-3 years is sufficient. However, if it is 5 cm, then it should be evaluated each year and surgery considered if it is 5.5 cm or larger.
Medical treatment has found that angiotensin-converting enzyme inhibitors (ACE inhibitors) have been shown to help reduce the progression and rupture of an aneurysm in a 2006 study in Canada, although beta blockers have traditionally been recommended. However, further research is still needed for this condition.
Magnesium is a very under appreciated mineral that is extremely important for everyone’s health, but very few individuals know anything about it. This includes physicians. I have only recently discovered its importance when I experienced first hand the symptoms associated with a deficiency which I have highlighted below.
Most individuals get enough magnesium in their diet IF they are consuming whole grains, green leafy vegetables, nuts, and fruits. However, our diet is often not sufficient, or other medications including diuretics for HBP, may actually cause our bodies to loose more magnesium than we consume and a deficiency will then occur. A deficiency can also be entirely asymptomatic, but could contribute to heart attacks, strokes and other major health events. In addition, measuring the magnesium level in the body may not really tell a person whether they are deficient or not. The serum concentration accounts for only 0.3% of the total body concentration.
So, what should one do? I recommend that everyone make sure that they eat a diet that is rich in whole grains, seeds, berries, green leafy vegetables, and probably take 1 magnesium tablet a day, or between 250-400 mg as a supplement if the kidney function (BUN and Creatinine) are normal. Too much magnesium can cause frequent and loose stools.
KEY SYMPTOMS of NOT ENOUGH MAGNESIUM:
- Muscle symptoms: weakness, cramps, fatigue, achiness, spasms, vibrations, severe fleeting pains, pins and needle sensations.
- Feeling cold, dizziness
- General fatigue, loss of interest in doing things, apathetic, change in personality, nervousness or depression
- Loss of desire to eat
- Heart irregularities: racing, skipped beats, shortness of breath
OVERVIEW ON MAGNESIUM IN THE BODY:
- Over 300 enzymes in the human body are dependent on magnesium.
- It is the second most abundant intracellular cation, and 4th most abundant cation in the body.
- The body usually contains 22-26 grams of magnesium. 60% in bone, of which only 30% is exchangeable with other areas of the body and therefore functions as a reserve to stabilize the serum concentration; 27% of the magnesium is found in muscle and soft tissue.
- The measurable serum magnesium accounts for only 0.3% of total body magnesium, may not really accurately reflect the total body stores, and the new test “blood cell magnesium” has not been found to more sensitive. Both of these tests have been found to be “normal” among patients who have subsequently been found to be deficient by measuring the urine output of magnesium after magnesium administration.
- The normal range of magnesium in serum is 1.7-2.4 mg and is carefully regulated by exchange from soft tissue and bones (exact mechanism not fully understood).
- Under normal conditions, 95% of magnesium in plasma (2 grams daily) is reabsorbed by the kidneys, resulting in a loss of only approx 100 mg. However, if the kidneys are not functioning normally, then too much magnesium may accumulate which could also cause health problems.
- Some chemotherapy agents, (particularly cisplatin) may damage the kidney’s ability to absorb magnesium which may last for months to years after the chemotherapy if completed. Such patients may have to consume 3-5x the daily dose of magnesium to maintain a normal serum level and control symptoms associated with low magnesium.