There is a story that is told in medical history about a milk delivery maid who was dubbed 'Typhoid Mary' because she single handed contributed to the biggest typhoid epidemic in England. An interesting story often told to very green medical students as an introduction to the term "carrier".
A patient of mine came in recently with the Swine Flu H1N1) he was very sick and was still wearing his Fedex uniform. I advised him that the type of work he was doing and his exposure to the elements would only make him sicker, needless to say I put him out of work for a week.
As I looked at this poor person with bloodshot eyes, sweating and coughing up a storm, I had cause to rethink our (the Health Establishment's) definition of 'High Risk' patients i.e those who are eligible to recieve the H1N1 vaccine. Surely the delivery man innocently delivering packages from one establishment to the next and potentially picking up infection at one and depositing it at the next, is at high risk. Not only that, he (or she) presents a risk to the community at large as he proffers his pen with a grin and the instruction to 'sign your name!' before darting off to the next densely populated building.
In my office we have been lucky enough to have had the H1N1 shot throughout the 'shortage' and we have religiously followed the Health departments instructions to limit its use to high risk individuals; children ages 6 months to 24 years, healthcare workers and pregnant women. As of this week I have opened it up to many more people that I consider high risk such as teachers and metro workers.
I have been struggling with the idea from the beginning that students need to be vaccinated but not those who teach them. Maybe I am more sypathetic because my husband is a professor or just because I have NEVER seen my 17 year old son as sick as he was with the Swine Flu. He rarely gets sick but this bug made him as sick as a dog! (He came down with it 3 days before I recieved my supply of vaccines ...........).
Anyway to cut a long story short, come on and get your H1N1 vaccine, lets curb this epidemic. It takes 2 weeks to develop a good immunity so hurry in, next week is Thanksgiving and yes, if you drive a UPS truck ................ you are welcome too!
Wednesday, November 18, 2009
Thursday, October 29, 2009
It really IS an epidemic this time!
Yes, we have H1N1 shots in our office and Yes, I recommend them!
We have been inundated with people who have flu-like symptoms as well as people coming in for the vaccine. It really qualifies as an epidemic this time around. The local school board is posting the percentages of absenteeism for every school that has at least 10% of the kids out sick and there are no schools that are NOT on the list! One school was recorded twice with almost 20% of the students out sick.
One of my patients came in today with a red eye, body aches, fever, headache and generally feeling yucky and mentioned that at her elementary school (she is a kindergarten teacher) 10 teachers were out sick on the same day which resulted in general chaos as they tried to move the teachers and volunteers around to fill in the gaps.
One anecdotal observation: I haven't seen a single patient who has tested positive for Swine flu on culture who doesnt have a cough and a fever. Interesting since with regular flu you dont always have a cough. Body aches and sore throat are also extremely prevalent symptoms.
What to do? Well, first of all if you have any of these symptoms Stay Home! Spray your door knobs and counter tops with Lysol or the equivalent. Cough into your elbow and put hand sanitizer on your hands frequently. Get treated early.
We treat all our patients aggressively with homeopathic remedies, vitamins and supplements along with prescription anti-virals. Almost all are better within 3 days ............... except for that cough! If you start treatment late that cough can drag on for weeks. Inhale steam as much as possible and avoid cold drinks.
Prevention: Always the best option.
Get your Flu shots, both regular and the H1N1 (call the office if you need one). Stop by and pick up your "Well Being" and Vitamin C and Cod Liver Oil take them thru the winter, its going to be a rough one.
Stay out of crowds.
Warning:
Beware The Flu is usually worse after Thanksgiving ( after all the hugs and kisses). This year it started really early and with a vengeance, and if it is going to get worse after Thanksgiving we all need to be pro-active!
We have been inundated with people who have flu-like symptoms as well as people coming in for the vaccine. It really qualifies as an epidemic this time around. The local school board is posting the percentages of absenteeism for every school that has at least 10% of the kids out sick and there are no schools that are NOT on the list! One school was recorded twice with almost 20% of the students out sick.
One of my patients came in today with a red eye, body aches, fever, headache and generally feeling yucky and mentioned that at her elementary school (she is a kindergarten teacher) 10 teachers were out sick on the same day which resulted in general chaos as they tried to move the teachers and volunteers around to fill in the gaps.
One anecdotal observation: I haven't seen a single patient who has tested positive for Swine flu on culture who doesnt have a cough and a fever. Interesting since with regular flu you dont always have a cough. Body aches and sore throat are also extremely prevalent symptoms.
What to do? Well, first of all if you have any of these symptoms Stay Home! Spray your door knobs and counter tops with Lysol or the equivalent. Cough into your elbow and put hand sanitizer on your hands frequently. Get treated early.
We treat all our patients aggressively with homeopathic remedies, vitamins and supplements along with prescription anti-virals. Almost all are better within 3 days ............... except for that cough! If you start treatment late that cough can drag on for weeks. Inhale steam as much as possible and avoid cold drinks.
Prevention: Always the best option.
Get your Flu shots, both regular and the H1N1 (call the office if you need one). Stop by and pick up your "Well Being" and Vitamin C and Cod Liver Oil take them thru the winter, its going to be a rough one.
Stay out of crowds.
Warning:
Beware The Flu is usually worse after Thanksgiving ( after all the hugs and kisses). This year it started really early and with a vengeance, and if it is going to get worse after Thanksgiving we all need to be pro-active!
Sunday, August 16, 2009
Peri-menopause is a tough one!
It has been my experience in the last 20 years that the Peri-menopausal period is actually harder than menopause itself.
I want to discuss some of my theories as to why this is so, but first what is Peri-menopause?
Peri-menopause is defined as the time during which a woman's body transitions into menopause, it can be from 6 to 10 years and ends 1 year after a woman has had her last period. It usually starts to occur in the 40's.
Many women are taken by surprise when they begin to experience peri-menopausal symptoms as they are unfamiliar with this phenomenon. Often they expect the cessation of their periods to be the first sign. Whereas period irregularities are often an early sign, they are more likely to become erratic and varied, longer or shorter in length and different each month.
Peri-menopause is a time when hormone levels are fluctuating wildly, and the changing symptoms demonstrate this. Moodiness and depression may set in because of unaccustomed feelings, people who have never had headaches before can develop migraines. The memory declines but not consistently and women may begin to feel a little 'fuzzy' and very vulnerable. The latter occurs particularly in professional women who are used to being able to make split decisions. And then there's the weight gain ! Almost invariably across the board there is more deposition of truncal fat in spite of regular exercise and weight control methods.
Inconsistent sleep and night sweats cause a lack of rest and this adds to the irritability and depression, women find themselves anxious for no specific reason and may lose their motivation.
Changes in the sexual arena can also be expected and once again may fluctuate with hormone levels.
Remember that this is also a transition for families who are suddenly surprised at the changes in a woman's persona but often are too tactful to mention it. The people around you are a good barometer they tend to notice a whole lot more than you give them credit for!
So why is it so tough?
Well, first of all because it is unexpected, it seems so sudden there is no time to adjust. It often occurs at a time when the woman has a lot of responsibilities, having achieved a certain professional level with a completed family to take care of. Stress is a huge aggravating factor in Peri-menopause and the sudden overwhelming sense of not being able to handle things is very common. For many women this is the first time they have ever had 'anything wrong' with them.
Secondly, it is not often discussed so women don't know where to seek help, they may not even be aware that there is help and so this generates a feeling of isolation. A reluctance to discuss the symptoms while attempting to handle it by themselves. They are not alone! Millions of women have the same problem they just dont talk about it. Whereas the syndrome of Menopause is well known the precursor is not.
Lastly, there maybe a sense of loss, women know something is changing and it may not be a state they are ready for. they know intuitively things will never be the same again. Skin changes, memory changes, lots of gas, dizziness and joint pains may also accompany this condition. One thing is for sure these are physical and physiological changes, its not all in your head!
In my next blog I will discuss ways to deal with these symptoms and how to improve the quality of life as you proceed to menopause.
Be well, lively and healthy until next time.........................
Dr Tuakli
I want to discuss some of my theories as to why this is so, but first what is Peri-menopause?
Peri-menopause is defined as the time during which a woman's body transitions into menopause, it can be from 6 to 10 years and ends 1 year after a woman has had her last period. It usually starts to occur in the 40's.
Many women are taken by surprise when they begin to experience peri-menopausal symptoms as they are unfamiliar with this phenomenon. Often they expect the cessation of their periods to be the first sign. Whereas period irregularities are often an early sign, they are more likely to become erratic and varied, longer or shorter in length and different each month.
Peri-menopause is a time when hormone levels are fluctuating wildly, and the changing symptoms demonstrate this. Moodiness and depression may set in because of unaccustomed feelings, people who have never had headaches before can develop migraines. The memory declines but not consistently and women may begin to feel a little 'fuzzy' and very vulnerable. The latter occurs particularly in professional women who are used to being able to make split decisions. And then there's the weight gain ! Almost invariably across the board there is more deposition of truncal fat in spite of regular exercise and weight control methods.
Inconsistent sleep and night sweats cause a lack of rest and this adds to the irritability and depression, women find themselves anxious for no specific reason and may lose their motivation.
Changes in the sexual arena can also be expected and once again may fluctuate with hormone levels.
Remember that this is also a transition for families who are suddenly surprised at the changes in a woman's persona but often are too tactful to mention it. The people around you are a good barometer they tend to notice a whole lot more than you give them credit for!
So why is it so tough?
Well, first of all because it is unexpected, it seems so sudden there is no time to adjust. It often occurs at a time when the woman has a lot of responsibilities, having achieved a certain professional level with a completed family to take care of. Stress is a huge aggravating factor in Peri-menopause and the sudden overwhelming sense of not being able to handle things is very common. For many women this is the first time they have ever had 'anything wrong' with them.
Secondly, it is not often discussed so women don't know where to seek help, they may not even be aware that there is help and so this generates a feeling of isolation. A reluctance to discuss the symptoms while attempting to handle it by themselves. They are not alone! Millions of women have the same problem they just dont talk about it. Whereas the syndrome of Menopause is well known the precursor is not.
Lastly, there maybe a sense of loss, women know something is changing and it may not be a state they are ready for. they know intuitively things will never be the same again. Skin changes, memory changes, lots of gas, dizziness and joint pains may also accompany this condition. One thing is for sure these are physical and physiological changes, its not all in your head!
In my next blog I will discuss ways to deal with these symptoms and how to improve the quality of life as you proceed to menopause.
Be well, lively and healthy until next time.........................
Dr Tuakli
Wednesday, July 1, 2009
Hi from Honduras
Last week our blog came from the Andes in the southern hemisphere and now we are coming to you from Central America. What a difference in weather, time, and culture---In Peru it was winter time and it was cold and drizzly, and in Honduras it was hot & humid.
My family and I were on the island of Roatan, which is part of the Bay Islands located north of mainland Honduras. It is known for its stunning beaches, pirate history, and a wonderful mix of natural and ethnic diversity. In all my travels I truly believe that Paya Bay in Roatan is one of the most tranquil and idyllic places on this planet. The Paya Bay Resort exudes a special energy that calms the soul and gives new meaning to relaxation and regeneration. Next summer, I plan to organize a weeklong retreat with free seminars on anti-aging and bio-identical hormone replacement at this resort. I would be happy to supply details to anyone who is interested.
One of Roatan's main attractions is its barrier reef (the second largest in the world) which attracts divers from all over the world. In addition, there is a host of other activities including yoga, kayaking, meditation, hiking, and just watching the sunset from your hammock on the beach. Paya Bay is a very secluded and private spot of the island, and it gives one the sensation of being at peace & harmony with yourself and nature.
I have been volunteering to work in Honduras for several years now, and three years ago went to Roatan to work at the Clinica Esperanza, a clinic established by a nurse from Ohio, Ms. Peggy Stranges, to provide basic health care to islanders regardless of their status. I came upon Paya Bay quite by happenstance, after working in the clinic for a week I decided to take a weekend on a part of the island more remote and less populated. What a discovery! I cannot wait to go back and hope that I can encourage others to experience this small slice of paradise known as Paya Bay, Roatan, Honduras.
All good things must come to an end---as we departed a military coup d'etat was taking place and we learned upon arriving in Washington, D.C. that the president of Honduras was exiled to Costa Rica and an interim government was established. Notwithstanding this unfortunate turn of events, the Bay Islands (Roatan, Guanaja, and Utila) are not a center of political unrest and they are culturally and geographically distinct from the mainland. Fortunately Paradise remains untouched!
Remember to find time to relax and to stay emotionally and physically healthy. Until we meet again, Dr. Tuakli
My family and I were on the island of Roatan, which is part of the Bay Islands located north of mainland Honduras. It is known for its stunning beaches, pirate history, and a wonderful mix of natural and ethnic diversity. In all my travels I truly believe that Paya Bay in Roatan is one of the most tranquil and idyllic places on this planet. The Paya Bay Resort exudes a special energy that calms the soul and gives new meaning to relaxation and regeneration. Next summer, I plan to organize a weeklong retreat with free seminars on anti-aging and bio-identical hormone replacement at this resort. I would be happy to supply details to anyone who is interested.
One of Roatan's main attractions is its barrier reef (the second largest in the world) which attracts divers from all over the world. In addition, there is a host of other activities including yoga, kayaking, meditation, hiking, and just watching the sunset from your hammock on the beach. Paya Bay is a very secluded and private spot of the island, and it gives one the sensation of being at peace & harmony with yourself and nature.
I have been volunteering to work in Honduras for several years now, and three years ago went to Roatan to work at the Clinica Esperanza, a clinic established by a nurse from Ohio, Ms. Peggy Stranges, to provide basic health care to islanders regardless of their status. I came upon Paya Bay quite by happenstance, after working in the clinic for a week I decided to take a weekend on a part of the island more remote and less populated. What a discovery! I cannot wait to go back and hope that I can encourage others to experience this small slice of paradise known as Paya Bay, Roatan, Honduras.
All good things must come to an end---as we departed a military coup d'etat was taking place and we learned upon arriving in Washington, D.C. that the president of Honduras was exiled to Costa Rica and an interim government was established. Notwithstanding this unfortunate turn of events, the Bay Islands (Roatan, Guanaja, and Utila) are not a center of political unrest and they are culturally and geographically distinct from the mainland. Fortunately Paradise remains untouched!
Remember to find time to relax and to stay emotionally and physically healthy. Until we meet again, Dr. Tuakli
Saturday, June 6, 2009
Travel Health
Hi from Peru!
I am in Lima at present and finally have a little time to Blog.
It is the winter time here and it really gets chilly in the evenings. Riding around in a cab is quite an experience, kind of like being on a speeding race track with a cacophony of horns as background music. The price of the taxis is equally amazing, no more than $5 to go all around the city, I must admit the price is right.
This is the time of year when many people travel and I would like to talk about some of the things I advise my patients to do before they embark on international travel. There’s nothing like getting sick to ruin a trip, it will make you wish you had never gone in the first place.
Having a travel consult with your doctor is always a good idea and plan ahead, sooner is better than later. Try and get your consultation done at least 60 days before leaving as some vaccines like hepatitis A are only useful if you get both shots and they cannot be taken closer than 30 days apart.
Believe it or not the leading cause of illness in travelers is Diarrhea not exotic diseases like Yellow Fever or Swine Flu even though shots for these conditions may be useful. Diarrhea mainly occurs because travelers are exposed to bacteria that their systems are not familiar with not because the people are dirty. When foreigners come to the US they get Diarrhea too.
Why is Diarrhea so important? Well, let’s say you get Diarrhea then become dehydrated (especially in a hot country). You would then need to be taken to a medical facility where the first step would be to give you an IV, is the needle clean? Is the fluid sterile? You have no way of knowing how hygienic the facility is and all of a sudden a ‘minor illness’ becomes a big deal. There is a protocol that we give our patients to all but eliminate the likelihood that Diarrhea will spoil their vacation.
When you go to some countries you may need special medications, such as medication to prevent altitude sickness. This may be the case for example if you plan to come to Peru and go to Macchu Pichu.
Remember that allergy season is different in different places, for that reason and the possibility of reacting to different foods take along some Benedryl if you have allergies.
Your doctor can review your medical history and suggest Preventive Health strategies specific to your condition. There is a lot more to staying healthy abroad than just taking shots. As far as shots are concerned there may be many that are helpful ranging from updating your Polio vaccination to Meningitis depending on where you are going but some are 'no brainers' for everyone such as up to date Tetanus and Influenza shots.
If you are going to a mosquito infected area remember to pack some long sleeves and pants to wear after dusk, that’s when they tend to bite. Remember if the mosquitoes don’t bite you, you CANT get Malaria or a whole host of vector borne diseases. Its pretty basic and well worth bearing in mind.
On the subject of insect bites, my favorite insect repellant is Skinsensations by Cutter. It doesn’t smell, is not greasy and easily sprays on without making you feel hot. Most hardware and drug stores have it.
Finally, Don’t forget your Sunblock! It should protect against both UVA and UVB rays.
I am in Lima at present and finally have a little time to Blog.
It is the winter time here and it really gets chilly in the evenings. Riding around in a cab is quite an experience, kind of like being on a speeding race track with a cacophony of horns as background music. The price of the taxis is equally amazing, no more than $5 to go all around the city, I must admit the price is right.
This is the time of year when many people travel and I would like to talk about some of the things I advise my patients to do before they embark on international travel. There’s nothing like getting sick to ruin a trip, it will make you wish you had never gone in the first place.
Having a travel consult with your doctor is always a good idea and plan ahead, sooner is better than later. Try and get your consultation done at least 60 days before leaving as some vaccines like hepatitis A are only useful if you get both shots and they cannot be taken closer than 30 days apart.
Believe it or not the leading cause of illness in travelers is Diarrhea not exotic diseases like Yellow Fever or Swine Flu even though shots for these conditions may be useful. Diarrhea mainly occurs because travelers are exposed to bacteria that their systems are not familiar with not because the people are dirty. When foreigners come to the US they get Diarrhea too.
Why is Diarrhea so important? Well, let’s say you get Diarrhea then become dehydrated (especially in a hot country). You would then need to be taken to a medical facility where the first step would be to give you an IV, is the needle clean? Is the fluid sterile? You have no way of knowing how hygienic the facility is and all of a sudden a ‘minor illness’ becomes a big deal. There is a protocol that we give our patients to all but eliminate the likelihood that Diarrhea will spoil their vacation.
When you go to some countries you may need special medications, such as medication to prevent altitude sickness. This may be the case for example if you plan to come to Peru and go to Macchu Pichu.
Remember that allergy season is different in different places, for that reason and the possibility of reacting to different foods take along some Benedryl if you have allergies.
Your doctor can review your medical history and suggest Preventive Health strategies specific to your condition. There is a lot more to staying healthy abroad than just taking shots. As far as shots are concerned there may be many that are helpful ranging from updating your Polio vaccination to Meningitis depending on where you are going but some are 'no brainers' for everyone such as up to date Tetanus and Influenza shots.
If you are going to a mosquito infected area remember to pack some long sleeves and pants to wear after dusk, that’s when they tend to bite. Remember if the mosquitoes don’t bite you, you CANT get Malaria or a whole host of vector borne diseases. Its pretty basic and well worth bearing in mind.
On the subject of insect bites, my favorite insect repellant is Skinsensations by Cutter. It doesn’t smell, is not greasy and easily sprays on without making you feel hot. Most hardware and drug stores have it.
Finally, Don’t forget your Sunblock! It should protect against both UVA and UVB rays.
Hasta Manana!
As always wishing you the best of health .............. wherever you are!
Dr Tuakli
Sunday, May 3, 2009
PANDEMIC , HERE???!!! WHOA, JUST A MINUTE!
As a proud alum of both Harvard and Johns Hopkins Schools of Public Health, I think I have been taught by the best to think information and issues through while not deserting 'common' sense.
The current level of alarm in the general population regarding the Swine Flu colloquially known as H1N1 seems unwarranted at the very least. Why?
A little research into influenza in the United States reveals that there are 200,000 hospitalizations and 36,000 Americans die annually from Influenza related complications. If that is the case and according to the CDC it is, 20 times more people died in the US this flu season than have died in Mexico during this 'epidemic'.
Also the people who have died in Mexico have been a small percentage of the people who actually contracted the virus down there. In fact so many people got the virus that there is increasing immunity there and the numbers of new cases are decreasing.
Initially, as I understand it from a top official from the CDC, it was only the cases that were hospitalized that got tested. As a result it looked as if everyone who had it was dying. whereas in truth it was only the sickest of the sick who were in hospital.
When you add to this, the fact that most people in Mexico do not get vaccinated against any flu viruses and that the nutritional status of the average Mexican is not as good as that of the average American one starts to wonder if the label 'Pandemic' might not have been a little hasty.
And then there's this new nomenclature for Swine Flu: 'H1N1' which sounds more high tech and
sci-fi than Porcine Influenza but actually the predominant Influenza A strain in this country during the 2006 -2007 season was a H1N1 virus just a different strain.
I could continue on with the science but I wont except to point out one more fact and that is that a person who contracts influenza A is most contagious for the first 4 days, lasting at most for a week after they develop symptoms. Do not be afraid of people who were in Mexico at Easter!
A group of 27 high school students in Colorado were apparently asked not to attend their high school graduation because they had been on a senior trip to Mexico. None of them were sick!
The point of this blog is the following:
let's not generate panic and deflect resources where they are not needed.
The strain of Influenza isolated so far is no more virulent than the strain that circulated here this winter. This is good news. We can anticipate far less morbidity and mortality from this Flu than we have in the average Flu season yet we don't close entire schools every time a student comes down with the Flu.
Hand washing and the other preventive measures I mentioned in my prior Blogs should make us all feel a lot safer. Its amazing how often the best solution is a low tech one with all due respect to my esteemed colleagues.
I would be interested to read your comments
As Always Stay Healthy.
Add years to your life and life to your years!
Dr Tuakli
The current level of alarm in the general population regarding the Swine Flu colloquially known as H1N1 seems unwarranted at the very least. Why?
A little research into influenza in the United States reveals that there are 200,000 hospitalizations and 36,000 Americans die annually from Influenza related complications. If that is the case and according to the CDC it is, 20 times more people died in the US this flu season than have died in Mexico during this 'epidemic'.
Also the people who have died in Mexico have been a small percentage of the people who actually contracted the virus down there. In fact so many people got the virus that there is increasing immunity there and the numbers of new cases are decreasing.
Initially, as I understand it from a top official from the CDC, it was only the cases that were hospitalized that got tested. As a result it looked as if everyone who had it was dying. whereas in truth it was only the sickest of the sick who were in hospital.
When you add to this, the fact that most people in Mexico do not get vaccinated against any flu viruses and that the nutritional status of the average Mexican is not as good as that of the average American one starts to wonder if the label 'Pandemic' might not have been a little hasty.
And then there's this new nomenclature for Swine Flu: 'H1N1' which sounds more high tech and
sci-fi than Porcine Influenza but actually the predominant Influenza A strain in this country during the 2006 -2007 season was a H1N1 virus just a different strain.
I could continue on with the science but I wont except to point out one more fact and that is that a person who contracts influenza A is most contagious for the first 4 days, lasting at most for a week after they develop symptoms. Do not be afraid of people who were in Mexico at Easter!
A group of 27 high school students in Colorado were apparently asked not to attend their high school graduation because they had been on a senior trip to Mexico. None of them were sick!
The point of this blog is the following:
let's not generate panic and deflect resources where they are not needed.
The strain of Influenza isolated so far is no more virulent than the strain that circulated here this winter. This is good news. We can anticipate far less morbidity and mortality from this Flu than we have in the average Flu season yet we don't close entire schools every time a student comes down with the Flu.
Hand washing and the other preventive measures I mentioned in my prior Blogs should make us all feel a lot safer. Its amazing how often the best solution is a low tech one with all due respect to my esteemed colleagues.
I would be interested to read your comments
As Always Stay Healthy.
Add years to your life and life to your years!
Dr Tuakli
Friday, May 1, 2009
Don't drink from that cup!
The latest (as of this morning) confirmed figure of cases of H1N1 (swine flu) in Maryland is 9, I have no doubt that it will be higher by this evening.
Try not to take young children into crowded places, this is not the best time to go to the ball game with them. Avoid crowded malls and shows.
If you are Catholic you should skip communion, it is not a good idea right now to drink from a common cup!
Remember hand washing is your best defense. Children cannot help touching everything, so keep them safe!
Be healthy
Dr Tuakli
Try not to take young children into crowded places, this is not the best time to go to the ball game with them. Avoid crowded malls and shows.
If you are Catholic you should skip communion, it is not a good idea right now to drink from a common cup!
Remember hand washing is your best defense. Children cannot help touching everything, so keep them safe!
Be healthy
Dr Tuakli
Thursday, April 30, 2009
SWINE FLU UPDATE !
The WHO has now upgraded the threat of the Pandemic to level 5. Which means that a global outbreak of the disease is imminent.
In the meantime there have now been 3000 cases with 168 deaths in Mexico. The number of cases in the US exceeds 100 and there are 19 in Canada. I understand that schools in Texas are closed.
Several patients have called to ask for prescriptions of Tamiflu. That is not a good idea, first of all if everyone started to take Tamiflu daily there may not be sufficient supplies for people who are actually sick. Secondly, we don't want to generate resistance to the medication by indiscriminate use.
The best bet is to wash your hands frequently and avoid obviously sick people. Wear a mask, if necessary, in health facilities and crowded places. Seek medical attention immediately for all fevers and flu-like illnesses.
Don't panic, stay informed and take charge of your health. Avoid risky exposures.
As always wishing you optimal health and happiness
Dr Tuakli
In the meantime there have now been 3000 cases with 168 deaths in Mexico. The number of cases in the US exceeds 100 and there are 19 in Canada. I understand that schools in Texas are closed.
Several patients have called to ask for prescriptions of Tamiflu. That is not a good idea, first of all if everyone started to take Tamiflu daily there may not be sufficient supplies for people who are actually sick. Secondly, we don't want to generate resistance to the medication by indiscriminate use.
The best bet is to wash your hands frequently and avoid obviously sick people. Wear a mask, if necessary, in health facilities and crowded places. Seek medical attention immediately for all fevers and flu-like illnesses.
Don't panic, stay informed and take charge of your health. Avoid risky exposures.
As always wishing you optimal health and happiness
Dr Tuakli
SWINE FLU UPDATE
As of yesterday the WHO had updated the Pandemic Alert level to phase 4. This means that there is actual evidence of person-to-person transmission of the swine influenza.
There were 91 confirmed cases in the US with one death in Texas. No cases have been confirmed in Maryland.
Remember, hand washing is of the utmost importance and keep some alcohol-based hand rubbing solution with you. Use it after being in public places like the bank and post office.
There IS treatment for this condition and it is important that it is started early.
If you have any of the typical symptoms of the flu, particularly if you have a high fever make an appointment with your primary care physician as soon as possible.
In the meantime, dont panic! Remember this is actually a preventable condition if you are diligent.
Its Spring! A wonderful time of renewal and optimism
Choose to be Healthy !!!!
Dr Tuakli
There were 91 confirmed cases in the US with one death in Texas. No cases have been confirmed in Maryland.
Remember, hand washing is of the utmost importance and keep some alcohol-based hand rubbing solution with you. Use it after being in public places like the bank and post office.
There IS treatment for this condition and it is important that it is started early.
If you have any of the typical symptoms of the flu, particularly if you have a high fever make an appointment with your primary care physician as soon as possible.
In the meantime, dont panic! Remember this is actually a preventable condition if you are diligent.
Its Spring! A wonderful time of renewal and optimism
Choose to be Healthy !!!!
Dr Tuakli
Monday, April 27, 2009
SWINE FLU, A Public Health Care Emergency !!!
Tonight I am going to talk about a potential health problem called the Swine Flu. Although the initial symptoms of Swine Flu are pretty similar to the Flu we are all used to it can rapidly get out of hand because humans don't have any immunity to it. It is called Swine flu because it is usually found in pigs.
Even when a person does not get a Flu shot, because of years of exposure to human Flu strains they have a certain ability to withstand the worst symptoms of the flu but with Swine flu there is no innate protection. This is why the World Health Organization has announced the possibility of a pandemic.
A pandemic is worse than an epidemic in the sense that it involves a much wider area of the globe and many more people and thus can take a lot longer to get under control.
There have been 40 confirmed cases of Swine Flu in the US so far. 7 in California, 2 in Kansas, 28 in New York City, 1 in Ohio and 2 in Texas. As you can see there is no defined geographic distribution of the spread and it is assumed that most cases are from travel or contact with a traveller, in these days where thousands of people fly from A to B daily it could just be a couple of days before we are in the throes of an epidemic. Currently this Swine Flu Outbreak is defined as a Public Health Emergency .
PREVENTION is always better than cure!
Wash your hands frequently, avoid sick people. Try to stay in good health, take vitamin C, get plenty of sleep. Drink plenty of fluids and eat nutritious food.
If you have an 'Flu-like" illness be seen quickly. Symptoms may include high fever, chills, sore throat , sweats, body aches and cough.
If you get sick antiviral medication can make the illness milder so you can feel better faster. They can also prevent the more serious complications. The problem is that if you don't start the medication within 48 hours it may not be effective. Because of this we will most often treat a patient 'empirically' before the culture result is obtained. It is important to avoid all aspirin products including peptobismol when you have the flu especially in children under 18.
The medicines that treat the Swine Flu, Tamiflu and Relenza are 70 to 90 percent effective at preventing the Swine Flu.
A person is contagious for 7 to 10 days with the Swine Flu.
In children, according to the CDC emergency warning signs are:
Fast breathing
Bluish skin color
Not drinking enough fluids
Lethargy
irritability
Fever with a rash
Seeming to get better and then return of fever and worsening cough
In adults, emergency signs requiring urgent medical attention include:
Chest pain
Shortness of breath
Sudden Dizziness
Confusion
Persistent vomiting
I hope this information is helpful. Please feel free to call our office for any further assistance you may need.
Dr Tuakli
Even when a person does not get a Flu shot, because of years of exposure to human Flu strains they have a certain ability to withstand the worst symptoms of the flu but with Swine flu there is no innate protection. This is why the World Health Organization has announced the possibility of a pandemic.
A pandemic is worse than an epidemic in the sense that it involves a much wider area of the globe and many more people and thus can take a lot longer to get under control.
There have been 40 confirmed cases of Swine Flu in the US so far. 7 in California, 2 in Kansas, 28 in New York City, 1 in Ohio and 2 in Texas. As you can see there is no defined geographic distribution of the spread and it is assumed that most cases are from travel or contact with a traveller, in these days where thousands of people fly from A to B daily it could just be a couple of days before we are in the throes of an epidemic. Currently this Swine Flu Outbreak is defined as a Public Health Emergency .
PREVENTION is always better than cure!
Wash your hands frequently, avoid sick people. Try to stay in good health, take vitamin C, get plenty of sleep. Drink plenty of fluids and eat nutritious food.
If you have an 'Flu-like" illness be seen quickly. Symptoms may include high fever, chills, sore throat , sweats, body aches and cough.
If you get sick antiviral medication can make the illness milder so you can feel better faster. They can also prevent the more serious complications. The problem is that if you don't start the medication within 48 hours it may not be effective. Because of this we will most often treat a patient 'empirically' before the culture result is obtained. It is important to avoid all aspirin products including peptobismol when you have the flu especially in children under 18.
The medicines that treat the Swine Flu, Tamiflu and Relenza are 70 to 90 percent effective at preventing the Swine Flu.
A person is contagious for 7 to 10 days with the Swine Flu.
In children, according to the CDC emergency warning signs are:
Fast breathing
Bluish skin color
Not drinking enough fluids
Lethargy
irritability
Fever with a rash
Seeming to get better and then return of fever and worsening cough
In adults, emergency signs requiring urgent medical attention include:
Chest pain
Shortness of breath
Sudden Dizziness
Confusion
Persistent vomiting
I hope this information is helpful. Please feel free to call our office for any further assistance you may need.
Dr Tuakli
Sunday, April 26, 2009
IS IT HOT IN HERE?? You bet!
Wow! Talk about spring fever, from 60 degrees to 92 overnight.
I was doing Soccer Mom duty today and I was burning up.
Yes, it was hot today and it certainly doesn't help those with hot flashes. If you thought you were going crazy at least no one noticed that you were sweating more than everyone else but remember there are ways to relieve the flashes and all the other symptoms of hormone imbalance.
For people who prefer not to use hormone replacement there are many herbal supplements which can be quite effective but far and away the most effective management is hormone balancing with bio-identical hormones.
Hormone replacement is not just for the over 50 crowd anymore it is used for younger women for severe PMS and other imbalance related disorders.
But this is not just about hormone imbalance, Spring is a great time to get your health in general well balanced and on a good path. One of the parents today proudly displayed that he had lost 25 pounds just by stopping sodas.
Just do it! Off with all the winter woolies, get off the couch and get moving! You can no longer use the weather as an excuse for not walking. If you don't already have a pedometer, you need one.
We always over estimate exactly how much we walk, shoot for 10,000 steps a day. It's a lot harder than it sounds. It's amazing how little we walk in this country, I often have a hard time making 6000 steps here and yet when I'm in Europe at the end of the day I realise I have done 12,000 just moving around and boy do I feel it.
The warm weather also ushers in the good fruit and vegetables in the supermarket. The prices of course have sky rocketed which means eating well and reasonably, takes a little more planning than previously but...... you are worth it. Try to drink some pomegranate juice during the week and some sort of salad daily.
Sunblock! What a dilemma. Over 80% of patients in my area are vitamin D deficient this time of the year and the best (for some the only)source of vitamin D is the sun. So weigh the pros and cons, if you can get half an hour of sun exposure a day it would help. Darker skin tones need more but if you are very fair skinned and at higher risk of skin cancer you may just have to break down and rely on the supplements. You are going to need at least 1000 units a day!
Either way keep your sunblock handy for prolonged sun exposures. They say any SPF above 45 is wasted. Dont forget to use your Stop Aging Skin Therapy twice a day, it is fantastic.
A little Heads Up. This summer I will be working at the Clinica Esperanza in Roatan, Honduras
and checking on one of my favorite seniors a former Dean of a Law School in Peru who is now 94!
I will also be in Europe later in the summer so the best time for appointments is before June.
Remember Spring time is about renewal. Get energized, get healthy, its not a dress rehearsal!
Add years to your life and life to your years!
Dr Tuakli
I was doing Soccer Mom duty today and I was burning up.
Yes, it was hot today and it certainly doesn't help those with hot flashes. If you thought you were going crazy at least no one noticed that you were sweating more than everyone else but remember there are ways to relieve the flashes and all the other symptoms of hormone imbalance.
For people who prefer not to use hormone replacement there are many herbal supplements which can be quite effective but far and away the most effective management is hormone balancing with bio-identical hormones.
Hormone replacement is not just for the over 50 crowd anymore it is used for younger women for severe PMS and other imbalance related disorders.
But this is not just about hormone imbalance, Spring is a great time to get your health in general well balanced and on a good path. One of the parents today proudly displayed that he had lost 25 pounds just by stopping sodas.
Just do it! Off with all the winter woolies, get off the couch and get moving! You can no longer use the weather as an excuse for not walking. If you don't already have a pedometer, you need one.
We always over estimate exactly how much we walk, shoot for 10,000 steps a day. It's a lot harder than it sounds. It's amazing how little we walk in this country, I often have a hard time making 6000 steps here and yet when I'm in Europe at the end of the day I realise I have done 12,000 just moving around and boy do I feel it.
The warm weather also ushers in the good fruit and vegetables in the supermarket. The prices of course have sky rocketed which means eating well and reasonably, takes a little more planning than previously but...... you are worth it. Try to drink some pomegranate juice during the week and some sort of salad daily.
Sunblock! What a dilemma. Over 80% of patients in my area are vitamin D deficient this time of the year and the best (for some the only)source of vitamin D is the sun. So weigh the pros and cons, if you can get half an hour of sun exposure a day it would help. Darker skin tones need more but if you are very fair skinned and at higher risk of skin cancer you may just have to break down and rely on the supplements. You are going to need at least 1000 units a day!
Either way keep your sunblock handy for prolonged sun exposures. They say any SPF above 45 is wasted. Dont forget to use your Stop Aging Skin Therapy twice a day, it is fantastic.
A little Heads Up. This summer I will be working at the Clinica Esperanza in Roatan, Honduras
and checking on one of my favorite seniors a former Dean of a Law School in Peru who is now 94!
I will also be in Europe later in the summer so the best time for appointments is before June.
Remember Spring time is about renewal. Get energized, get healthy, its not a dress rehearsal!
Add years to your life and life to your years!
Dr Tuakli
Wednesday, April 15, 2009
Susan Boyle! What an inspiration.
I am making a major departure from my normal blog to talk about Susan Boyle!
Wow! I am not one for television but I happened to see a blurb about Susan and watched a video of her performance on Britain's got Talent (or something of the sort!). I must admit I found it really inspiring. I can only imagine what guts it took for an unemployed 47 year old Scotswoman from a small village to travel down to London and follow a dream. When she got there she had to endure the snickers and thinly veiled insults of a host of people before she got her chance on the big stage.
Did I mention that she is somewhat uninspiring to look at, and according to her she has never been kissed?
Well, the old adage "you cant judge a book by its cover still holds true".
When Susan opened her mouth to sing her song about a dream she ROCKED the house including Simon Cowell and all the judges.
If you have not yet seen the video I highly recommend it, it is inspiring and very touching. guaranteed to melt your heart!
OK Susan, now on a professional note:
Life is just beginning at 47 you are going to need my help! I can help you become vital and self assured and optimistic. With a sharp mind and tons of energy.
Just like my patient MW who was in yesterday. She turns 90!!! next month and I am hoping to post a picture of her on my blog when she does (if she gives me permission).
She drove to my office yesterday and shuttles other seniors around. She bowls twice a week and is only on one medication, she really is quite amazing.
Life is full of great miracles and you are one.
Wishing you much success,
Add years to your life and life to your years.
Dr Tuakli
Wow! I am not one for television but I happened to see a blurb about Susan and watched a video of her performance on Britain's got Talent (or something of the sort!). I must admit I found it really inspiring. I can only imagine what guts it took for an unemployed 47 year old Scotswoman from a small village to travel down to London and follow a dream. When she got there she had to endure the snickers and thinly veiled insults of a host of people before she got her chance on the big stage.
Did I mention that she is somewhat uninspiring to look at, and according to her she has never been kissed?
Well, the old adage "you cant judge a book by its cover still holds true".
When Susan opened her mouth to sing her song about a dream she ROCKED the house including Simon Cowell and all the judges.
If you have not yet seen the video I highly recommend it, it is inspiring and very touching. guaranteed to melt your heart!
OK Susan, now on a professional note:
Life is just beginning at 47 you are going to need my help! I can help you become vital and self assured and optimistic. With a sharp mind and tons of energy.
Just like my patient MW who was in yesterday. She turns 90!!! next month and I am hoping to post a picture of her on my blog when she does (if she gives me permission).
She drove to my office yesterday and shuttles other seniors around. She bowls twice a week and is only on one medication, she really is quite amazing.
Life is full of great miracles and you are one.
Wishing you much success,
Add years to your life and life to your years.
Dr Tuakli
Resolving Headaches and other Symptoms
I had a patient come in today with surprisingly good news. "I feel great" she said
"almost all my symptoms are gone. I can now focus on my foot pain because I feel so good!"
When the patient was referred to me by the local health food store 2 weeks ago and she began to tell me all the things that ailed her, I wondered where to start. Her over-riding concern was the headache she was getting daily along with some dizzy spells but as the tale unraveled she had a host of other complaints too.
Given the number of physicians she had seen in the past I wasnt expecting miracles.But when all else fails start with the basics!
I put her on magnesium and gave her a book to read about self help for headaches, ran some routine tests and asked her to make a follow up appointment.
Magic! Apparently that's all she needed to get rid of her migraines,she completely changed her diet, stopped caffeine and wine and there they went!
Interestingly enough it seems a lot of the other symptoms she was having were tied in with her migraines so once we fixed them, everything else just fell into place.
As she said earlier today: Once I was given the information I had the tools to take control of my condition, and that's all I needed.
Aah! how nice if all my cases were that simple.
Its your life take control!
"almost all my symptoms are gone. I can now focus on my foot pain because I feel so good!"
When the patient was referred to me by the local health food store 2 weeks ago and she began to tell me all the things that ailed her, I wondered where to start. Her over-riding concern was the headache she was getting daily along with some dizzy spells but as the tale unraveled she had a host of other complaints too.
Given the number of physicians she had seen in the past I wasnt expecting miracles.But when all else fails start with the basics!
I put her on magnesium and gave her a book to read about self help for headaches, ran some routine tests and asked her to make a follow up appointment.
Magic! Apparently that's all she needed to get rid of her migraines,she completely changed her diet, stopped caffeine and wine and there they went!
Interestingly enough it seems a lot of the other symptoms she was having were tied in with her migraines so once we fixed them, everything else just fell into place.
As she said earlier today: Once I was given the information I had the tools to take control of my condition, and that's all I needed.
Aah! how nice if all my cases were that simple.
Its your life take control!
Sunday, April 12, 2009
Buying Blinds,Balancing Hormones and Trekking from Pennsylvania!
Having prescribed Bio-Identical Hormones for nearly 20 years, I have many amusing anecdotes that I tell from time to time. i thought I would share some of them on my blog.
When a new patient requests Bio-identical Hormone Replacement we perform a thorough review of their medical history and symptoms. In addition, I consult with them so that they have a good understanding of how Hormone Replacement works and together we determine if they would be a good candidate for Hormone Balancing.
One day, after a long discussion with a patient who had driven down from Pennsylvania, she stood up and said with a big smile on her face "I'm so glad I decided to buy those blinds!".
Baffled I asked her what she meant, the ensuing story was amusing:
She went on to explain that she had ordered some window treatments. The installer brought his wife along with him to the job. While he was installing the blinds, his wife noticed my patient fanning herself and sweating incessantly. This resulted in a conversation about menopause and the installer's wife referring the customer to me!
That story tickled me and I always chuckle when I recount it.
These days she tells another one that I like, she says her husband refers more patients to me than she does! She says when they go out to dinner with his friends and their wives he leans over to his friends and whispers "Your wife should see my wife's doctor!" or when his friends complain about their love life he tells them to fill up the car and drive down to Columbia.
Happy Easter! Still waiting for Spring.
Dr Tuakli
When a new patient requests Bio-identical Hormone Replacement we perform a thorough review of their medical history and symptoms. In addition, I consult with them so that they have a good understanding of how Hormone Replacement works and together we determine if they would be a good candidate for Hormone Balancing.
One day, after a long discussion with a patient who had driven down from Pennsylvania, she stood up and said with a big smile on her face "I'm so glad I decided to buy those blinds!".
Baffled I asked her what she meant, the ensuing story was amusing:
She went on to explain that she had ordered some window treatments. The installer brought his wife along with him to the job. While he was installing the blinds, his wife noticed my patient fanning herself and sweating incessantly. This resulted in a conversation about menopause and the installer's wife referring the customer to me!
That story tickled me and I always chuckle when I recount it.
These days she tells another one that I like, she says her husband refers more patients to me than she does! She says when they go out to dinner with his friends and their wives he leans over to his friends and whispers "Your wife should see my wife's doctor!" or when his friends complain about their love life he tells them to fill up the car and drive down to Columbia.
Happy Easter! Still waiting for Spring.
Dr Tuakli
Tuesday, April 7, 2009
More stuff on men
There are a host of complaints that men have that can be indicative of hormone deficiencies or Andropause. These complaints often include weight gain, and a lack of stamina.
For many men aged 35 to 50 the major concern is loss of lean body mass (muscle) around the middle and decreased libido. On occasion there may also be depression, sleep disturbances and loss of vitality.
I think the biggest surprise is how early men begin to manifest signs of hormone imbalance and deficiency. One often associates women with menopause starting in the late 40's not realizing that men can start a decade earlier.
The difference with men is that the changes are not as dramatic as Menopause and so men tolerate them better and gradually get acclimatized to feeling less than optimal.
What to do?
Well, first figure out your baseline in your early 30's.
Did you know that the average testosterone level in men is much lower than it was 50 years ago? Scientist's dont know why this is the case. It may have something to do with the food supply, fertilizers, hormones in meat etc.
Secondly , get a saliva test to check both your hormone levels in the tissues and the balance between them, this would include your sex hormones as well as the adrenal and thyroid hormones.
With this information your Growth Hormone level and the blood chemistry profiles you will be able to evaluate your risk factors for morbidity and mortality.
Many studies have shown a direct link between a man's testosterone level and his risk of early death from all causes including cancers.
We always knew testosterone was important for a man's well being and now we have proof!
Keep your hormone levels optimal, one of the best ways to:
Add years to your life and life to your years!
(Come in and get your levels checked, it could save your life)
For many men aged 35 to 50 the major concern is loss of lean body mass (muscle) around the middle and decreased libido. On occasion there may also be depression, sleep disturbances and loss of vitality.
I think the biggest surprise is how early men begin to manifest signs of hormone imbalance and deficiency. One often associates women with menopause starting in the late 40's not realizing that men can start a decade earlier.
The difference with men is that the changes are not as dramatic as Menopause and so men tolerate them better and gradually get acclimatized to feeling less than optimal.
What to do?
Well, first figure out your baseline in your early 30's.
Did you know that the average testosterone level in men is much lower than it was 50 years ago? Scientist's dont know why this is the case. It may have something to do with the food supply, fertilizers, hormones in meat etc.
Secondly , get a saliva test to check both your hormone levels in the tissues and the balance between them, this would include your sex hormones as well as the adrenal and thyroid hormones.
With this information your Growth Hormone level and the blood chemistry profiles you will be able to evaluate your risk factors for morbidity and mortality.
Many studies have shown a direct link between a man's testosterone level and his risk of early death from all causes including cancers.
We always knew testosterone was important for a man's well being and now we have proof!
Keep your hormone levels optimal, one of the best ways to:
Add years to your life and life to your years!
(Come in and get your levels checked, it could save your life)
Sunday, April 5, 2009
Its about Men too!
Many people are guilty of focusing a lot of the attention of hormone replacement on women and as a result men tend to come up as an after thought. I think one of the reasons for this is that the vast majority of patients we see are women.
Women have no problem seeking help once they realize it is available and they need it. Men on the other hand, are reluctant to seek care. They often need to be dragged in by a partner or a well meaning friend.
Surprisingly enough however, men need hormone replacement and anti-aging just as much if not more than women do. How so?
Well for starters women can be acutely aware when their hormones are not balanced and of course for many, the signs of Menopause are inescapable.
In men Andropause tends to be more subtle and the changes from insufficient hormones more insiduous but no less destructive. I have had patients who have tolerated impotence and loss of muscle strength and weight gain until the sudden arrival of Diabetes wakes them up to their predicament.
Men need hormone replacement, detoxification, vitamin supplementation and tune ups regularly and prevention is better than cure. There is so much science available now, NO ONE should settle for feeling less than optimal.
I realise that I too have been guilty of blogging mostly about women's issues, but now I will write a fair amount about men as well.
It is extremely gratifying when a man who was very skeptical at first returns with a big smile and firm handshake and says "Thank You" !
There is also a role of Hormone Replacement for men who are already diagnosed with a disease state.
GS is an 85 year old male. He has been coming to see me for a long time, I remember when I first met him he was frail and didnt breathe very well because of long standing emphysema. The doctors had not given him a happy prognosis and advised him that he would not be able to be independent or live without oxygen for long. This was seven years ago.
Fortunately, for both of us he is a fighter and we both had the same goals i.e make the time left functional and as disability free as possible. In other words, make the best of whatever lung tissue he had.
G stopped smoking and literally took control of his health, he changed his diet, took supplements and had a wonderfully positive atitude. He did really well and with good preventive care we kept him 'healthy'. I told him to keep his pulmonology follow ups and hadnt heard from him for a few months, I assumed all was well.
Late last year he called my office and told my staff he could not walk across a room without becoming extremely breathless and as a result he could not even make it in to my office. He had been given a slew of pharmaceutical agents and oxygen and was becoming weaker by the day. He asked if them to find out from me if I had any suggestions. That was a little challenging without seeing him but I suggested some supplements and medicine adjustments and hoped for the best.
Sure enough he became strong enough to come to the office and we now have him on Hormone Supplements as well, he looks and feels great. We are ready for another seven years!
there are several points to this story:
1, Don't wait until you are on your last leg
2, Men can be significantly helped by an anti-aging program
3, Even if you are frail from disease that is irreversible, you may be able to regain enough of your strength to improve the quality of your life.
4, Its never to late to take control of your health!
Have a great week, add years to your life and life to your years.
Its your health enjoy it!
Dr Tuakli
Women have no problem seeking help once they realize it is available and they need it. Men on the other hand, are reluctant to seek care. They often need to be dragged in by a partner or a well meaning friend.
Surprisingly enough however, men need hormone replacement and anti-aging just as much if not more than women do. How so?
Well for starters women can be acutely aware when their hormones are not balanced and of course for many, the signs of Menopause are inescapable.
In men Andropause tends to be more subtle and the changes from insufficient hormones more insiduous but no less destructive. I have had patients who have tolerated impotence and loss of muscle strength and weight gain until the sudden arrival of Diabetes wakes them up to their predicament.
Men need hormone replacement, detoxification, vitamin supplementation and tune ups regularly and prevention is better than cure. There is so much science available now, NO ONE should settle for feeling less than optimal.
I realise that I too have been guilty of blogging mostly about women's issues, but now I will write a fair amount about men as well.
It is extremely gratifying when a man who was very skeptical at first returns with a big smile and firm handshake and says "Thank You" !
There is also a role of Hormone Replacement for men who are already diagnosed with a disease state.
GS is an 85 year old male. He has been coming to see me for a long time, I remember when I first met him he was frail and didnt breathe very well because of long standing emphysema. The doctors had not given him a happy prognosis and advised him that he would not be able to be independent or live without oxygen for long. This was seven years ago.
Fortunately, for both of us he is a fighter and we both had the same goals i.e make the time left functional and as disability free as possible. In other words, make the best of whatever lung tissue he had.
G stopped smoking and literally took control of his health, he changed his diet, took supplements and had a wonderfully positive atitude. He did really well and with good preventive care we kept him 'healthy'. I told him to keep his pulmonology follow ups and hadnt heard from him for a few months, I assumed all was well.
Late last year he called my office and told my staff he could not walk across a room without becoming extremely breathless and as a result he could not even make it in to my office. He had been given a slew of pharmaceutical agents and oxygen and was becoming weaker by the day. He asked if them to find out from me if I had any suggestions. That was a little challenging without seeing him but I suggested some supplements and medicine adjustments and hoped for the best.
Sure enough he became strong enough to come to the office and we now have him on Hormone Supplements as well, he looks and feels great. We are ready for another seven years!
there are several points to this story:
1, Don't wait until you are on your last leg
2, Men can be significantly helped by an anti-aging program
3, Even if you are frail from disease that is irreversible, you may be able to regain enough of your strength to improve the quality of your life.
4, Its never to late to take control of your health!
Have a great week, add years to your life and life to your years.
Its your health enjoy it!
Dr Tuakli
Thursday, March 26, 2009
Needless suffering!
Everytime I see a new patient for HRT (Hormone Replacement Therapy) I am amazed at how much women are suffering with menopause and how few people are aware that there are alternatives.
A patient I saw today looked so unhappy I wanted to just reach out and tell her "It will be OK". Despair was written all over her face.
She must have felt my empathy because after the consultation she surprised me when she said
"at least someone cares!".
As strange as it may seem I am so used to being a woman's last resort, they come in devasted by how they feel and how difficult it is to find help.
It just boggles my mind that in 2009 the medical profession still refuses to acknowledge menopause for what it is : a syndrome that often requires treatment. No snide comments or knowing winks 'you know she is going through the change' or 'its a natural process suck it up' and do we really care who's mother went through menopause without so much as a hot flash? This is 2009 and we are baby boomers, working and juggling, stressed to the max, already out of balance before menopause deals us the final blow.
It occurred to me today where a large part of the problem lies: With us the doctors!
In medical school menopause is barely mentioned and then in passing with a reference to the bad health conditions that occur after it but not as a medical entity that itself should be taken seriously.
Until the medical establishment and then the public at large takes it seriously, patients will not feel comfortable discussing the full extent of their complaints.
I have said ad nauseum: there is more to menopause than hot flashes, there is more to a woman than a uterus! And not only can hot flashes be debilitating, menopause is a syndrome not a symptom. It is a constellation of symptoms affecting almost every organ in the body. It is a bona fide condition which should be handled as such and considered worthy of treatment. Women should not be made to feel apologetic because they 'can't handle it' nor should they randomly be given medications for sleep, depression and anxiety without having the benefit of a full evaluation and treatment of the underlying cause.
IT IS TIME TO START A CONVERSATION about those issues that affect the quality of the lives of women - Menopause can adversely impact the lives of those closest to us and it is time we gave this syndrome the public attention it deserves. The Public Health impact affects not only women but families and friends, workmates and relationships.
If you know someone who is suffering needlessly with menopausal symptoms please spread the word and let them know there are treatments available that will restore their quality of life.
Add life to your years and years to your life
Dr Tuakli
A patient I saw today looked so unhappy I wanted to just reach out and tell her "It will be OK". Despair was written all over her face.
She must have felt my empathy because after the consultation she surprised me when she said
"at least someone cares!".
As strange as it may seem I am so used to being a woman's last resort, they come in devasted by how they feel and how difficult it is to find help.
It just boggles my mind that in 2009 the medical profession still refuses to acknowledge menopause for what it is : a syndrome that often requires treatment. No snide comments or knowing winks 'you know she is going through the change' or 'its a natural process suck it up' and do we really care who's mother went through menopause without so much as a hot flash? This is 2009 and we are baby boomers, working and juggling, stressed to the max, already out of balance before menopause deals us the final blow.
It occurred to me today where a large part of the problem lies: With us the doctors!
In medical school menopause is barely mentioned and then in passing with a reference to the bad health conditions that occur after it but not as a medical entity that itself should be taken seriously.
Until the medical establishment and then the public at large takes it seriously, patients will not feel comfortable discussing the full extent of their complaints.
I have said ad nauseum: there is more to menopause than hot flashes, there is more to a woman than a uterus! And not only can hot flashes be debilitating, menopause is a syndrome not a symptom. It is a constellation of symptoms affecting almost every organ in the body. It is a bona fide condition which should be handled as such and considered worthy of treatment. Women should not be made to feel apologetic because they 'can't handle it' nor should they randomly be given medications for sleep, depression and anxiety without having the benefit of a full evaluation and treatment of the underlying cause.
IT IS TIME TO START A CONVERSATION about those issues that affect the quality of the lives of women - Menopause can adversely impact the lives of those closest to us and it is time we gave this syndrome the public attention it deserves. The Public Health impact affects not only women but families and friends, workmates and relationships.
If you know someone who is suffering needlessly with menopausal symptoms please spread the word and let them know there are treatments available that will restore their quality of life.
Add life to your years and years to your life
Dr Tuakli
Sunday, March 22, 2009
Vitamin and supplement testing
Oftentimes people ask me ''what would be a good vitamin regimen for me?" as if there is a fixed regimen that works for everyone and all I need to do is tell them what it is.
Unfortunately it is not quite that simple but the answer is important none-the-less. Vitamin and supplement deficiency cause a lot of symptoms ranging from deafness and macular degeneration to dizziness and hair loss. One of the commonest deficiency symptoms is fatigue, unfortunately this can be caused by iron deficiency, vitamin D deficiency, deficiency of zinc iron, iodine and thyroid, vitamin B12 deficiency, inadequate anti-oxidants, different hormone deficiencies and on and on!
As with all good medical care it is better if the regimen is tailored to the individual patient rather than a one size fits all approach.
Fortunately this question can be answered with a simple blood test, check out a list of some of the deficiencies that can be tested for on the Weight Control page of my website. That test, plus an evaluation of your hormone and iodine levels can be the key to a whole new quality of life.
Its your health, take control !
Have a great week
Helping you to add life to your years and years to your life....
Dr Tuakli
Unfortunately it is not quite that simple but the answer is important none-the-less. Vitamin and supplement deficiency cause a lot of symptoms ranging from deafness and macular degeneration to dizziness and hair loss. One of the commonest deficiency symptoms is fatigue, unfortunately this can be caused by iron deficiency, vitamin D deficiency, deficiency of zinc iron, iodine and thyroid, vitamin B12 deficiency, inadequate anti-oxidants, different hormone deficiencies and on and on!
As with all good medical care it is better if the regimen is tailored to the individual patient rather than a one size fits all approach.
Fortunately this question can be answered with a simple blood test, check out a list of some of the deficiencies that can be tested for on the Weight Control page of my website. That test, plus an evaluation of your hormone and iodine levels can be the key to a whole new quality of life.
Its your health, take control !
Have a great week
Helping you to add life to your years and years to your life....
Dr Tuakli
Sunday, March 15, 2009
BOTOX and FILLERS in time for Easter!
We will be having a special day to get ready for spring. Botox and Fillers on sale April 4th at our Columbia office.
If you used to think smoothing out wrinkles and looking bright is only for the rich and famous, think again. Its really not as major as other 'cosmetic procedures' and takes only about 30 minutes. Make a subtle yet noticeable difference.
See you there!
If you used to think smoothing out wrinkles and looking bright is only for the rich and famous, think again. Its really not as major as other 'cosmetic procedures' and takes only about 30 minutes. Make a subtle yet noticeable difference.
See you there!
The WISDOM study waiting for spring!
Hi welcome back.
Got the winter blues? Let's talk about the symptoms of menopause.
This week I want to mention a study that many in this country are not aware of regarding HRT. Most people know about the Women's health Initiative study (WHI) which was stopped at the NIH after the results of women taking Prempro and Premarin did not look good.
However it seems that when some positive studies come out there is not as much publicity.
The most recent large scale Hormone Replacement study published is the WISDOM study taken from a trial of 5000 women in the UK, Australia and New Zealand.
WISDOM st
ands for Women's International Studyof long Duration on Oestrogen after Menopause.
This study was actually going on at the same time as the WHI but the investigators decided not to stop it when the WHI study stopped.
You can read the full study in the British Medical Journal, part of it was discussed in May 2008
and part in the August 21 2008 edition (BMJ 2008:337 a 1190).
The May edition discusses the fact that there is much less risk of venous thrombosis (blood clots in the veins) especially in the first year when it is usually higher if the (O)estrogen is not taken by mouth.
The August article dwells on quality of life issues, something which is, to my mind at least, just as important as keeping people physically healthy.
The study essentially shows that hormone replacement improves the physical and emotional well being of menopausal women (big surprise!).
There was SIGNIFICANT improvement in 'vasomotor' symptoms (i.e hot flashes, night sweats etc), sexual functioning, sleep problems and aching joints and muscles (now that IS a surprise!).
I have to admit that does pretty much sum up my clinical experience over the past 2 decades.
The VAST majority of women who come in for hormone replacement are complaining of:
Hot flashes, zero sex drive, anxiety/depression, sleep disturbances and general malaise.
The unfortunate thing about the study is that they used the Premarin (yep, the horses urine) and Provera (yes, the one that can increase the incidence of breast cancer).
So what's the bottom line?
You CAN treat Menopause and feel better, you just have to do it safely. Every woman should choose what's RIGHT for her, no two women are the same. Stay away from things that are not natural to the HUMAN female and keep reading and educating yourself about your choices.
Remember:YOU CAN FEEL BETTER!!!! Yeah!
Have a good week, add years to your life and life to your years!
Dr Tuakli
Got the winter blues? Let's talk about the symptoms of menopause.
This week I want to mention a study that many in this country are not aware of regarding HRT. Most people know about the Women's health Initiative study (WHI) which was stopped at the NIH after the results of women taking Prempro and Premarin did not look good.
However it seems that when some positive studies come out there is not as much publicity.
The most recent large scale Hormone Replacement study published is the WISDOM study taken from a trial of 5000 women in the UK, Australia and New Zealand.
WISDOM st
ands for Women's International Studyof long Duration on Oestrogen after Menopause.This study was actually going on at the same time as the WHI but the investigators decided not to stop it when the WHI study stopped.
You can read the full study in the British Medical Journal, part of it was discussed in May 2008
and part in the August 21 2008 edition (BMJ 2008:337 a 1190).
The May edition discusses the fact that there is much less risk of venous thrombosis (blood clots in the veins) especially in the first year when it is usually higher if the (O)estrogen is not taken by mouth.
The August article dwells on quality of life issues, something which is, to my mind at least, just as important as keeping people physically healthy.
The study essentially shows that hormone replacement improves the physical and emotional well being of menopausal women (big surprise!).
There was SIGNIFICANT improvement in 'vasomotor' symptoms (i.e hot flashes, night sweats etc), sexual functioning, sleep problems and aching joints and muscles (now that IS a surprise!).
I have to admit that does pretty much sum up my clinical experience over the past 2 decades.
The VAST majority of women who come in for hormone replacement are complaining of:
Hot flashes, zero sex drive, anxiety/depression, sleep disturbances and general malaise.
The unfortunate thing about the study is that they used the Premarin (yep, the horses urine) and Provera (yes, the one that can increase the incidence of breast cancer).
So what's the bottom line?
You CAN treat Menopause and feel better, you just have to do it safely. Every woman should choose what's RIGHT for her, no two women are the same. Stay away from things that are not natural to the HUMAN female and keep reading and educating yourself about your choices.
Remember:YOU CAN FEEL BETTER!!!! Yeah!
Have a good week, add years to your life and life to your years!
Dr Tuakli
Wednesday, March 4, 2009
Welcome to our blog!
Hi everyone,
We have a new website and blog and I am excited about having a forum to provide valuable information about your health. In the coming weeks I will be discussing the benefits of Hormone Replacement Therapy (HRT), Cosmetic treatments, Weight-Control treatments, and interesting case studies of health topics that interest our community of bloggers.
In our office patients who are interested in HRT fill out a symptom monitor questionaire at their initial visit to measure their symptoms of hormone imbalance from 1-10, with 10 being the worst. This week I had a lady in her early forties who had a 10 out of 10 on 13 out of 15 symptom categories such as depression, estrogen dominance, sleeplessness, irritability, and low libido. Her symptoms imply that she has a severe hormonal imbalance which means that we need to conduct tests so that we can ascertain the cause of her problems. We sent her for saliva testing, urine iodine testing, blood work, and vitamin screening. We will follow her case on future blogs to track her treatment and results.
This weekend we Spring Forward an hour! Remember to set your clocks as we move towards Springtime.
As always, our goal is to add years to your life and life to your years,
Dr. Tuakli
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