Douglas Lakin's Podcast

MRSA infections do get patients worried, but generally, they are readily managed and not a cause for concern.
They do require proper treatment and follow-up.
Prevention is also important and see this CDC site for additional information.

http://www.cdc.gov/mrsa/prevent/personal.html

C Diff diarrhea is becoming more common and problematice.

This summary provides you information on the condition, it's treatment, and prevention.

Here is additional information from NIH on this topic:
http://www.nlm.nih.gov/medlineplus/clostridiumdifficileinfections.html

And here is information on Florastor, a product to prevent recurrent infection http://florastor.com/

This short podcast describes the simple methods for dealing with this common issue.

Below are some links to other sources of information, including my video on constipation...which has a good bit of humor as well as useful information.
http://vimeo.com/25634858

A like to Sphinx Date Ranch....as I love dates as a great source of natural fiber and Sphinx is 'the place' for the Medjool Dates here in Scottsdale.
http://www.sphinxdateranch.com/

And....some good information on Fiber from the University of Wisoconsin.
www.uhs.wisc.edu/docs/uwhealth_fiber_190.pdf

In this talk, I focus in on a common complaint: Constipation. I review the history of issues related to the condition, our misconceptions about it, and common methods of treatment that are worthwhile considering.

If you'd rather see the slides and complete video lecture, please go here:

http://vimeo.com/25634858

DIET:
NAUSEA, VOMITTING & DIARRHEAL ILLNESS

Acute GastroIntestinal (GI) illness is generally caused by either a virus or food poisoning, and results in the three cardinal symptoms of acute GI distress:

• Nausea (feeling sick to the stomach)
• Vomiting (regurgitating food)
• Diarrhea (excess fluid via the rectum)

During the acute phase of these issues it can be difficult to nearly impossible to keep food and liquids down, but is critical that this be attempted and accomplished, or dehydration will develop and the illness will begin a downward spiral, requiring either an Emergency Room visit for IV fluids, or hospitalization for correction of fluid and electrolyte (mineral) imbalances.

The KEYS are:

1. Settling the Stomach…so that liquids can be taken
2. Focusing on Liquids…so that dehydration does not set in

3. Eating light foods… if possible (to provide energy for healing). This is not a requirement for healing from an acute GI illness; so don’t feel that the sick person needs to eat food. The only requirement is liquid intake!

Settling the Stomach (treating nausea):

This is the most difficult issue to treat at home as there is very little one can do to settle the stomach during the acute phase. Coca-Cola with the carbonation eliminated (Flat Coke), Ginger Ale, or Ginger Root….can be tried, but these are often inadequate, and the key to getting the stomach to settle is getting a good nausea medication.

If the vomiting does not stop after 4 hours, then calling for a prescription medication is often a good idea. Compazine (prochlorperazine), Phenergan (Promethazine)…are the most commonly prescribed medications and they work by quieting the ‘nausea center’ in the brain. Best given as suppositories (rectally), they will break the vomiting cycle.

Alternatively, these medications can be given as pills but often this is useless as the medications themselves are thrown up and unable to be effective. That said, sometimes the oral form will work, and in addition to the above medications, there are others including Reglan (metoclopramide) and Zofran (ondansetron). These can be quite effective if they are kept down for 15-30 minutes, but if thrown up immediately, then a suppository is necessary.

Liquids:

Preventing dehydration is of utmost importance in this situation, so focusing on the liquids is the key to successful resolution of the acute phase of the GI illness.

Clear liquids (any liquid that light can easily shine through) are the best liquids to use. This includes:
• Plain Water
• Gatorade (or other electrolyte solutions that are similar)….do not use sugar-free versions of these drinks as the calories in these drinks are helpful is treating the illness and may be the only calories the person can absorb for the first hours or days
• Tea
• Cranberry Juice, Apple Juice (watered down…mixed ½ & ½ with water), White Grape Juice
• Broth from Chicken Soup, Matzo Ball Soup, Bullion
• Popsicles

Sipping liquids ..sip, sip, sip….and pushing the fluids progressively with time is the most important treatment provided. Focus on this above all else!

Eating Light Foods:

When the stomach has remained settled enough to consider foods, then trying simple to digest items is worthwhile. That said it is not imperative that a person eat at all during the acute phase of illness. So long as they are taking in good amounts of fluids that have calories in them (sugary drinks are fine when sick) then there is no need to worry about the timing of starting on solid foods

Light Foods include:

• Toast (plain white bread)
• Crackers
• Plain Noodles
• Macaroni (no cheese)
• Plain Rice
• Bananas
• Apple Sauce

As the acute phase resolves, diarrhea may persist for a few weeks. This is commonplace and not a concern. Increase the diet as you tolerate, back to your ‘normal’ foods. Over time, the digestive system will ‘right’ itself, but do not be concerned about ongoing diarrhea if it lasts for 3-4 weeks, but if going on longer that that it is best to come in to review the particulars surrounding your illness and confirm that there are no other issues at play.

This is a summary about diverticulosis and diverticulitis. Commonplace, but something you would know nothing about if you've never had a case of it, it is important to recognize the symptoms and get treatment early to avoid a more complicated infection.

Lots of resources of information for you on this topica, primarily on the disease itself:
http://digestive.niddk.nih.gov/ddiseases/pubs/diverticulosis/

and also information on preventing constipation, one of the sources of developing diverticulitis. So....learn about preventing constipation and high fiber foods below:

www.uhs.wisc.edu/docs/uwhealth_fiber_190.pdf

http://vimeo.com/25634858

Rectal and groin irritation are commonplace. This Podcast gives you 4 simple steps for TCB (Taking Care of your Bottom)

Hemorrhoids & TCB (Taking Care of your Bottom):

Hemorrhoids can be very bothersome if they become painful or if they start to bleed a lot. If you are reading this, it’s likely that you’ve finally had a ‘run in’ with this problem and can now better understand what all the fuss is about when people mention hemorrhoids or complain about them. Before that, you probably wondered why all the talk and advertisements.

Hemorrhoids are swollen veins in the rectal area and can occur inside the rectum (bottom portion of the colon) or outside the anus (the opening from the rectum). Typically, then occur during times of changes in bowel habits…in particular with constipation or straining to move the bowels. That said, they may come on ‘out of the blue’ or related to other issues that irritate the backside (sitting for prolonged periods, sitting on an irritating surface).

If you’ve tried on your own and failed to achieve resolution of this issue, I have listed below the simple methods you should use as the next steps in treatment.

BASICS OF T.C.B.

1. DO NOT USE SOAP. This may come as a surprise, but this is not a problem OF your ‘cleanliness’. There is no way to sterilize the area and generally speaking, your bottom is happiest when it has some germs around, as this is its normal situation. Trying to use soap will irritate the hemorrhoids, which are only veins that are covered with a thin layer of skin.
2. WASH YOUR BACKSIDE WITH EITHER PLAIN WATER OR CETAPHIL LIQUID CLEANSER (available over-the-counter at any CVS, Waglreens, etc.….) Avoiding soap will prevent harsh irritants from perpetuating the irritation in the area and it will prevent the area from getting ‘dried out’ as soaps often do.
3. DRY YOUR BOTTOM THOROUGHLY. Probably the best way to do this is to use a hair blower on medium heat. Alternatively, you can ‘pad’ the area dry with a dry towel or air dry by leaving your bottoms off and letter nature dry things up.
4. SOAK IN A BATH OF PLAIN WARM WATER. This is the simplest and most effective method to stop pain, irritation, and bleeding. Sitting in a plain tub of warm water (or a sitz bath….a device that goes in the toilet bowl) will provide immediate relief that is impressive. Do this one to several times a day…as often as you need. You cannot do this too much. Do realize that a hot tub is not good for hemorrhoids and will cause increased symptoms due to the chemicals in the water. As well, a warm pool will not do well either.
5. APPLY A TOPICAL CREAM, such as ANUSOL HC (prescription) in a small amount to the inflamed area around the rectum. This works much much better than Preparation H (a product that I think is not very effective). If you would rather use a home cream, you can try a mild cortisone cream such as CORTAID 10 Cream, which is available at any pharmacy or grocery store.
6. KEEP THE BOWEL MOVEMENTS SOFT. Use either a softener such as Colace (Docusate Sodium), Metamucil (fiber product), or Mirilax (over the counter constipation aid) to keep the bowels moving easily. This prevents straining at movement, which can perpetuate the hemorrhoids.
7. USE SUPPOSITORIES IF SYMPTOMS OR BLEEDING IS MORE BOTHERSOME. These are ANUSOL HC SUPPOSITORIES (prescription) and they are sometimes necessary for more vexing cases of irritation or bleeding.

This combination of treatments will generally handle most mild to moderate hemorrhoids when used consistently for a few to several days. If symptoms continue despite these efforts, then its time to come in for a check and possible referral to a proctologist (rectum specialist).

So…try these simple steps before worrying about coming into the office for a check on things; if it resolves the situation….you’re all set.

Elvis lived by the moniker TCB….Taking Care of Business. Now you too can TCB (only a in a little different way!)

This is a brief overview of the HbA1C (or glycohemoglobin) blood test used in diagnosing diabetes and following-up for diabetic control.

Sugar is fine in moderation, but the average American is eating 160 pounds per year! Let's find out its history and the reasons we crave it so.

If you are interested in the video, you can watch it here:

http://vimeo.com/34528566

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