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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

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

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

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

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

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!

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

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)

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
 

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10814 Hickory Ridge Road
Columbia, Maryland 21044
13637 Route 1
Laurel, Maryland 20707
Contact: Cindy Battle
(410) 992-3266
(410) 992-0011