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THE TRAVEL KIT
December 09, 2012 07:41 AM PST
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Travelling can have its travails and being prepared with proper medication is key for your safe and enjoyable vaciationing. This list of medications to take for travel complements the HOME MEDICAL KIT and provides additional assistance as you require.
Read more about this in my upcoming book THE GUIDE, which will be available after January 1st on the website and in our office.

Dr Sunil Ram: MRI Neuro-Quant To Diagnose Alzheimer's Disease
November 11, 2014 07:53 PM PST
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Dr. Sunil Ram is a radiologist at SMIL Radiology in Scottsdale www.esmil.com
Using the latest in MRI imaging, he describes the Neuro-Quant imaging technique that allows him to provide specific diagnostic information about dementia and Alzheimer's Disease.

THYROID DISEASE DISCUSSED BY EXPERT DR. HOWARD BAUM
January 26, 2014 08:20 PM PST
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DR. HOWARD BAUM IS A FRIEND OF MINE FROM MY HOPKINS DAYS AND IS CURRENTLY ON THE FACULTY OF VANDERBILT MEDICAL SCHOOL IN THE DEPARTMENT OF ENDOCRINOLOGY. HE IS A MASTER CLINICIAN.
THIS IS THE FIRST IN A SERIES OF PODCASTS ABOUT HORMONE ISSUES, AND THIS ONE FOCUSES ON HYPOTHYROIDISM. DR. BAUM PROVIDES HIS COMMON-SENSE APPROACH TO IMPORTANT CONSIDERATIONS IN THYROID TREATMENT IN AN EASILY UNDERSTANDABLE MANNER, WHILE BRINGING TO THE TOPIC THE HIGHEST LEVEL OF CLINICAL KNOWLEDGE. ENJOY AND LEARN.

GET THE SHINGLES VACCINE
July 08, 2012 08:35 AM PDT
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Learn about the vaccine, it's benefits and indications.

UPPER RESPIRATORY TRACT INFECTIONS THIS TIME OF YEAR...WHAT TO DO....BY DOCTOR LAKIN
December 30, 2011 05:57 AM PST
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This is a quick review of the symptoms and recommended treatment for respiratory infections this time of year.
Generally, in the fall or winter, we will get one of these milder infections and this is some general rules for how to feel best, how to avoid spreading it to others, and when to see me in the office or call for antibiotics.

COUMADIN.....YOUR BLOOD THINNER
July 15, 2013 04:12 PM PDT
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COUMADIN/WARFARIN INFORMATION

Coumadin is a blood thinner that works by blocking the effects of Vitamin K in the liver. Vitamin K allows for production of clotting factors—Coumadin blocks this effect.

Coumadin begins to work 3-5 days after first starting the dose. Prior to that, it can cause alterations in the Protime (blood test for blood thickness that is monitored for Coumadin), but it will not actually thin the blood.

Coumadin is used to prevent blood clots in:

• Atrial fibrillation (goal protime 2.0-3.0)
• Pulmonary Embolism—blood clots in the lungs (goal protime 2.0-3.0)
• DVT (Deep Venous Thrombosis)—blood clots in the legs (goal protime 2.0-3.0)
• Congestive Heart Failure (goal protime 2.0-3.0)
• Peripheral Vascular Disease (goal protime 2.0-3.0)
• Strokes (goal protime 2.0-3.0)
• Mechanical Heart Valve(goal protime 2.5-3.5)
• Post-operative blood clot prevention (goal protime 2.0-3.0)

Facts and Recommendations for taking Coumadin:

THE PROTIME BLOOD TEST:

The name of the blood test for monitoring Coumadin is called the Protime. This test is expressed as a ratio of normal blood clotting vs. blood clotting in your body on Coumadin.

GOAL NUMBERS (SEE ABOVE)

Normal people have a PROTIME=1.0

Atrial Fibrillation: Goal PROTIME=2.0-3.0

Blood Clot Prevention (leg or lung): Goal PROTIME= 2.0-3.0

Artificial Heart Valve (mechanical): Goal PROTIME= 2.5-3.5

KNOW YOUR DOSE OF COUMADIN/WARFARIN---KNOW YOUR COLORS (COMMON DOSES):

1MG=PINK
2MG=PURPLE
2.5MG=LIGHT GREEN
5MG=PEACH
7.5MG=YELLOW

DIET:

I do not make any specific recommendations and dietary restrictions. We will adjust your Coumadin dose to your diet. That said, if you eat a very large and unusual quantity of Vitamin K-containing vegetables (See list below) then a check of your protime may be indicated.

TESTING FREQUENCY—HOW OFTEN DO YOU CHECK THE PROTIME?

Generally speaking, monthly blood tests are appropriate. Special exceptions are:

1. When you begin Coumadin, at first, blood level testing is frequent until your baseline is established
2. If you are demonstrating wide fluctuations in the Protime.
3. If you have consistently perfect Protimes, you can go to every other month testing
4. Home monitoring can be arranged if you are interested…ask us about this

INTERACTION WITH OTHER MEDICATIONS:

Coumadin does interact with other medications often, but the amount of interaction tends to be mild. Testing the PROTIME if you are on an antibiotic for a week is a reasonable thing to do, but is not required.
Often the pharmacist will mention interactions of other medications with Coumadin. This is rarely a concern.

ASPIRIN AND COUMADIN:

Aspirin is not to be used with Coumadin unless you ask specifically and get the OK. We do combine them on occasion in patients with heart disease, but only for specific purposes

TYLENOL AND COUMADIN:

This is fine to combine. No worries. Tylenol is the preferred mild pain medication for patients on Coumadin. If you use high dosages (4000mg daily) for over a week, then checking the protime blood test is sensible, as it can interact with high dosages of ongoing Tylenol.

ADVIL/ALEVE AND COUMADIN:

Generally, these medications are avoided when you are on Coumadin, but they can be used at times. Generally, this should be under my direction. If you choose to use these medications, the safest way to do so it to take a ‘stomach protector’ pill like PRILOSEC or PREVACID. This will prevent excessive bleeding in the stomach. Ranitidine (Zantac) and Famotidine (Pepcid) will not prevent such bleeding and are not used as a stomach protector in this situation generally.

HIGH VITAMIN K CONTAINING VEGETABLES:

• Brussel Sprouts
• Collard Greens
• Green Onoins
• Kale
• Mustard Greens
• Parsley
• Spinach
• Swiss Chard
• Turnip Greens

Doctor Doug Interviews Personal Health Coach Lindsay Hunt
November 11, 2014 07:29 PM PST
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Lindsay is a health coach and personal trainer who can provide you with actionable information on how to improve your health, nutrition, and physical condition. Listen to how she can help you be your best. Lindsay's information is right here at http://www.walkonthehealthyside.com/

OSTEOPOROSIS TREATMENT OPTIONS AND INSIGHTS FROM DR. HOWARD BAUM
January 26, 2014 09:00 PM PST
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DR. HOWARD BAUM IS A GOOD FRIEND OF MINE WHO CURRENTLY IS A PROFESSOR OF ENDOCRINOLOGY AT VANDERBILT UNIVERSITY MEDICAL CENTER. IN THIS INTERVIEW HER PROVIDES COMMON SENSE INSIGHTS INTO TREATMENT OPTIONS FOR THOSE WHO HAVE DOCUMENTED OSTEOPOROSIS AND WANT TO UNDERSTAND THE PRO'S AND CONS OF CURRENTLY AVAILABLE TREATMENTS.

DIABETES INSIGHTS FROM DR. HOWARD BAUM FROM VANDERBILT UNIVERSITY
January 26, 2014 08:24 PM PST
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DR. HOWARD BAUM IS A MASTER CLINICIAN AND PRACTICES ENDOCRINOLOGY AT VANDERBILT UNIVERSITY MEDICAL CENTER. HERE HE DISCUSSES WITH ME SOME CRITICAL INSIGHTS FOR PATIENTS WITH DIABETES. HIS COMMON-SENSE INFORMATION PROVIDES THE BASIS FOR CONFIDENT MANAGEMENT OF YOUR CONDITION.

Enjoy Some Words of Reassurance from Doctor Lakin
December 28, 2011 03:33 PM PST
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Here's a simple affirmation that you are healthy......here it is. Most of us are!

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