Podcasts about Naproxen

On this episode of the Real Life Pharmacology Podcast, I cover 5 more medications of the top 200. Fenofibrate is a medication used primarily to reduce triglycerides. This medication differs from statins which tend to focus on LDL management. Doxazosin is an alpha-blocker. The primary indications of doxazosin are hypertension and BPH. Naproxen is an NSAID. Of all the NSAIDs, naproxen is one of the lower-risk agents with regard to cardiovascular risk. Spironolactone is an aldosterone antagonist and also classified as a potassium sparing diuretic. Memantine is an NMDA antagonist that is indicated for the management of Alzheimer's dementia. If you are looking for study materials and our list of popular Amazon books, check out meded101.com/store!

Sources: MayoClinic, Kidshealth, Kaplan NCLEX Medication, Saunders–Pharmacology can be pretty tricky, and this is especially true when you're studying it (and stressing about it) in order to pass the NCLEX.But I am here, and that means I can help.In this week's episode of NCLEX Ready, I'll be sharing with you 50 super important pharmacology facts you need to know if you want to pass the NCLEX with flying colors.I'll be discussing when not to use Naproxen, what the antidote for magnesium sulfate is, what not to take with lisinopril, the difference between miotics and mydriatics, and more.Are you ready for this?Tune in now!Key Takeaways:  Introduction (00:00)Facts 1 to 10 (00:44)Facts 11 to 20 (02:35)Facts 21 to 30 (04:27)Facts 31 to 40 (06:45)Facts 41 to 50 (08:40)Additional Resources:

Did you know the over the counter pain killers like Advil, Naproxen and Asprin are literally destroying your gut one layer at a time? Not only that, but they can even affect your brain, leading to leaks in the blood brain barrier, creating cognitive issues and mental health concerns. In thos short episode, we're exposing these extremely dangerous drugs for what they really are. TOPICS DISCUSSED: How NSAIDS like Ibuprofen work The true dangers of them, and how they destroy your gut and your brain What diseases they are well known and documented to create Who should avoid them Alternative options for pain relief   Join the Community: Click here to learn more about how to reverse IBD inside our community!   Contact us: reversablepod.com/tips    Leave us a Review: https://www.reversablepod.com/review   SOCIAL MEDIA: Instagram  Facebook  YouTube  

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog I bet you have heard the idiom, “There is no free lunch”, or  “There is no medication without a side effect”, but did you know that medications that are prescribed by your doctor can have negative effects on your health that are never even discussed with you….so you should protect yourself by replacing the nutrients that your medications  remove from your body, and that must be replaced for you to be healthy. Statins -→ COQ 10 DEFICIENCY= fatigue and depression Beta Blockers -→ COQ-10 DEFICIENCY= fatigue and depression Oral contraceptives and oral estrogen/progestins-→ COQ-10 DEFICIENCY= fatigue and depression Antidepressants called SSRIs-→ COQ-10 DEFICIENCY= fatigue and depression Dosage: If you take any of these medications you need to take COQ10 200-400 mg/day every day! Thiazide Diuretics=HCTZ -→ Magnesium and Zinc Deficiency muscle spasms, prostate issues, constipation Take 50 mg of Zinc and 400-600 mg of Magnesium Glycinate a day to replace what is lost. NSAIDS (Motrin, Advil, Aleve, Ibuprofen, Meloxicam, Naproxen, Indomethecin, Daypro, Mefenamic acid, Voltaren)-→ malabsorption, depression, anxiety, and the vitamin and mineral deficiencies listed: Folic Acid Deficiency- Take Methyl- Folate 500 mg Iron Deficiency—Take Iron Bisglycinate (Ferrabsorb) Vitamin C deficiency—Take Vitamin C 500-1000 mg/day Amino acid deficiency—take Arginine +/- Ornithine. OR change your medication to Celebrex 200-400 BID  PPIs=Proton Pump Inhibitors (Omeprazole, Prilosec, Pantoprazole, Lansoprazole, Protonix) are taken for stomach ulcers, H. Pylori infection and gastric reflux PPIs Increase Homocysteine which increases your risk of stroke, MI, and Pulmonary embolism.  PPIs decrease the absorption of many nutrients.  They actually cause malabsorption of essential nutrients.   Replace these nutrients with supplements, but much of what you take won't be absorbed unless you take daily Probiotics:  B12 – take methyl B12 1000 mcg/day Folate – take as methyl folate 5,000mcg/day Vitamin D – take 5,000 IU/day Note: PPIs can even cause the growth of dangerous gut bacteria causing chronic Hemophilus. If you have chronic vaginitis that smells fishy, it could be your PPIs! If you have this stop the PPI, take Pepcid instead (histamine receptor blocker) or nothing and take probiotics to repair the damage the PPIs have caused. These nutrients need to be replaced to keep you healthy, however it is better for most patients to only take PPIs for 2 weeks at a time or substitute a histamine receptor blocker like: Pepcid, Zofran. Surgery It is not just the medications doctors prescribe for their patients; sometimes surgical procedures can cause chronic diseases through preventing nutritional nutrients to enter your body.   Removal of the gall bladder must be done, yet patients are not told what they can do to be healthy after the surgery. The gall bladder provides enzymes that help you breakdown foods, primarily fats and absorb fatty vitamins from your food and supplements.  If you have had your gallbladder removed you can become nutritionally deficient in A, D, E fat soluble vitamins, and you will promote the growth of abnormal gut bacteria and are at risk for leaky gut, Celiac disease, autoimmune diseases and malnutrition. Everyone who has their gallbladder removed should take digestive enzymes with every meal and take Probiotics daily. Bariatric Surgery for Obesity The last iatrogenic nutritional deficiency that I will discuss is Bariatric surgeries, all kinds that remove part of the stomach, or band the stomach or in any way physically makes the stomach smaller is related to nutritional deficiencies caused by malabsorption of vitamins and minerals.  The way to combat these deficiencies include taking: a probiotic daily digestive enzymes with every meal and all vitamins should be chewable or sublingual to be absorbed from the mucosa of the mouth  In Conclusion: Remember I am a physician, and my job is to promote wellness in my patients.  It is sometimes more important and lifesaving to take the above medications or have these surgeries, than to prevent a nutritional deficiency in the future.  We must follow those medical decisions with trouble shooting addition of nutritional supplementation to replace what these necessary medications and surgeries remove.  That is preventive medicine and why supplementation is often needed for our health.  

‍‍How does a dedicated dentist navigate her way to owning her own practice while facing an array of personal and professional challenges? This episode provides a close look at the journey of Dr. Ana Santana Guerrero, a fiercely resilient dentist who left her home country, dealt with educational re-equivalence, braved high-stake exams, grappled with intense competition, and still managed to realize her dream of owning a dental clinic. We dissect Ana's transition from an associate to an owner in depth, illuminating her unwavering focus on goal setting and how an "unfortunate event" acted as a catalyst for her to leap into the world of self-owned practice, offering a relatable, deeply inspiring tale.Navigating the nitty-gritty of running a practice isn't easy, even more so when it's in a foreign country. Learn the ropes as Dr. Ana Santana Guerrero shares her experiences on various aspects of managing a dental clinic - from selecting an optimal location to staff management, from dealing with financial nuances to creating a unique, patient-centered practice. We also delve into her marketing strategies and discuss how humanizing her approach and prioritizing personalized communication played a key role in patient retention.What You'll Learn in This Episode:How to balance bills, staff salaries, and personal compensation in the early stages of practice.Importance of goal setting for personal and professional growth.Effective strategies for creating a patient-centric experience.The power of word-of-mouth and real-world interactions in marketing.How to navigate ethical dilemmas in the dental industry.Insights on dealing with companies in the dental arena.Don't miss out on this enlightening conversation packed with actionable insights and inspiration!‍‍Guest: Dr. Ana Santana GuerreroPractice Name: Astra DentalCheck out Ana's Media:Website: https://www.astradental.ca/Email: info@astradental.caInstagram: https://www.instagram.com/astra.dentalFacebook: https://www.facebook.com/ASTRA.DENTAL.CLINIC‍Other Mentions and Links:‍Software/Services:Google AdsBusinesses/Vendors:Patterson DentalHenry ScheinMGEAlign TechnologyNobel Biocare3MProducts/Brands:MaciTeroInvisalignNaproxenMcDonaldsTV/Publications:Wheel of FortuneEstablishments:Dalhousie UniversityCentral University of Venezuela‍Host: Michael Arias‍Website: The Dental Marketer Join my newsletter: https://thedentalmarketer.lpages.co/newsletter/‍Join this podcast's Facebook Group: The Dental Marketer Society‍Please don't forget to share with us on Instagram when you are listening to the podcast AND if you are really wanting to show us love, then please leave a 5 star review on iTunes! [Click here to leave a review on iTunes]‍p.s. Some links are affiliate links, which means that if you choose to make a purchase, I will earn a commission. This commission comes at no additional cost to you. Please understand that we have experience with these products/ company, and I recommend them because they are helpful and useful, not because of the small commissions we make if you decide to buy something. Please do not spend any money unless you feel you need them or that they will help you with your goals.‍‍‍

In this episode Dr. Jen the vet and Dr. Jason Chatfield dive into a crucial discussion about the often-overlooked dangers of common over-the-counter medications for pets. Joined by the knowledgeable and passionate Dr. Renee Schmid from Pet Poison Helpline, they shed light on the potential toxicities lurking in our homes.From seemingly harmless pain relievers to everyday supplements, our furry friends are susceptible to a range of clinical signs and poisonings from substances we might not think twice about. Through engaging conversation and expert insights, listeners gain a deeper understanding of how to safeguard their beloved pets from harm and what to do if your pet ingests these medications.Dr. Schmid shares her expertise, drawing from her experience in veterinary toxicology to highlight key warning signs and preventative measures every pet owner should know. Join Dr. Jen the vet, Dr. Jason Chatfield and Dr. Renee Schmid for an enlightening discussion that empowers pet owners to become vigilant advocates for their furry companions' health and well-being. Because when it comes to keeping our pets safe, knowledge truly is our best defense.Helpful inks:Pet poison helpline: https://www.petpoisonhelpline.comToxin Tails: https://www.petpoisonhelpline.com/toxintails-overview/ More about Dr. Renee Schmid: https://www.petpoisonhelpline.com/about/staff/renee-schmid-dvm/ Share this episode with a friend who needs to hear it...or might be interested in the topic...or just to make their day brighter! :)

Non-steroidal anti-inflammatory drugs (or NSAIDs for short), like Ibuprofen and Naproxen, what we call  are extremely popular with runners because they get rid of lots of aches and pains.  We often think inflammation results from hard exercise, so it stands to reason a non-steroidal anti-inflammatory will actually help after a long run. I don't normally recommend runners take NSAIDs as a part of a training routine. But there are a couple of alternatives that I would recommend over non-steroidal anti-inflammatory drugs. What's better to take than non-steroidal anti-inflammatory drugs for a stress fracture in a runner?  Well, that's what we're talking about today on the Doc On The Run Podcast.

Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track! Check out today's questions:    Chris: Hello, An orthopedic surgeon has determined that my xray states I need a knee replacement. I am in pain every day and am on Naproxen and have not worked since May 9, 2023. 1. Should I get a 2nd opinion on my knee? 2. Is naproxen killing my microbiome?   Joopie: hi dr i do have psoriasis my head is all over with scalp and i do have blisters on my body if leave the blisters to long i get infections but i do open them and then i put cream on i use persivate cream and pills is there a diet what i must take thanks joopie   Mandy: Hi doctor Cabral. My question is about muscle definition. I've been lifting for about 10 years, and can definitely feel that I've gained a lot of muscle, but I can't see them. There's not much definition. I would love to hear your thoughts about what could be some of the reasons why. To give you some background: I am a 47 year old female. I lift 5 days/week and for cardio I walk 15-20K steps/day. I am not overweight, eat a healthy diet of about 2000 calories/day. My hormones and thyroid are a bit lower, but I've been getting treatment for this. Thanks so much for your answer!   Antoine: Hi im new here and loving it because my doc dont help me and i try to find a cause of my hormones problèmes thyroid and testostérone and now digestive probleme for 5 month. I am a 21 athlétique men and since 2 and a half years i started to feel bad , low énergie brain fog no libido feeling depress after that i start to loose muscle strengh and muscle pain (trigger point). For the last 5 month i started to have food sensitives like lactose and other do i dont known witch food because i continue to have diahrrea every morning . I have done blood test urine test and poop test and what it show it very low testostérone hypothyroid and a bit a anémia. I dont drink im lean « healthy » really good diet and little bit a supplementation zinc magnésium omega 3. Now i feel like im dying .  I started to have hypothyroid and low testostérone for 2-3 years and i dont know why and my doc just what to give me drug without looking what the cause i did irm brain scan and no cancer here Im 21 years old and athletic   Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!    - - - Show Notes and Resources: StephenCabral.com/2878 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

Paracetamol, Ibuprofen, Diclofenac, Naproxen, Metamizol, Acetylsalicylsäure und Etoricoxib. So heißen die am häufigsten in Deutschland eingenommenen Wirkstoffe gegen Schmerzen. In dieser Folge wird der Apothekenschrank aufgeräumt und Cordelia entführt dich in die Welt der gängigen Schmerzmittel, die nicht nur, aber auch bei Kopfschmerzen helfen sollen. Du erfährst, warum es gar keine klassischen Kopfschmerztabletten gibt und was du über die sieben bekanntesten Schmerzmittel wissen solltest. Welche Wirkstoffe gibt es? Wie wirken sie? Was ist generell bei der Einnahme von Schmerzmitteln zu beachten? Welche Präparate kannst du unter Umständen sogar kombinieren und mit welchen Nebenwirkungen kannst du bei welchem Wirkstoff rechnen? Wenn du dir diese Fragen auch schon mal gestellt hast oder einfach bewusster im Umgang mit Schmerzmitteln sein möchtest, dann ist diese Folge genau richtig für dich. Mythen, wie „mehr hilft mehr“ werden heute enttarnt und durch Wissen ersetzt, damit du in Zukunft sicherer weißt, welche Wirkstoffe und Dosierungen sinnvoll für dich sind. Außerdem erläutert Cordelia den Ceiling-Effekt. Was das damit zu tun hat, dass es nicht hilft, in ein volles Glas noch mehr Wasser zu füllen? Das und noch viel mehr erfährst du in dieser Folge von „Gesundheit kannst du lernen“.

You can also check out this episode on Spotify!Did you know things like sugar-free gum, Advil, or simply eating too fast can cause gas and bloating? Everything we put into our ecosystem affects our gut health.Our gut often reflects our emotional health, too. In today's solo podcast, Dr. McBride explains the practical framework she created to help patients conceptualize their health, integrating medical evidence, the patient's story, and real life.She calls it the FOUR “I”s:* Information & data = the elements of our health that we can measure and see.* Inputs = everything that we put into our health ecosystem.* Infrastructure = the vehicle (i.e., the skeleton) that drives us through life.* Insight = the process of laddering up from self-awareness to acceptance to agency over our health and well-being.It turns out that this framework can help explain and trouble-shoot common gastrointestinal woes.Health is about more than the absence of disease. Health is about having awareness of data and the stories we tell ourselves, acceptance over the things we can't control, and agency over our life.Join Dr. McBride every Monday for a new episode of Beyond the Prescription.You can subscribe on Apple Podcasts, Spotify, or on her Substack at https://lucymcbride.substack.com/podcast. You can sign up for her free weekly newsletter at lucymcbride.substack.com/welcome.Please be sure to like, rate, review — and enjoy — the show!The full transcript of the show is here!Intro: Hello and welcome to my home office. I'm Dr. Lucy McBride, and this is Beyond the Prescription. Today it's just you and me. Every other week this season, I'll talk to you like I do my patients, pulling the curtain back on what it means to be healthy, redefining health as a process of self-awareness, acceptance, and agency.[00:00:28] In clinical practice for over 20 years, I have found that patients generally want the same things: a framework to evaluate their risks; access to the truth and data; and tools and actionable information to be healthy mentally and physically. We all want to feel more in control of our health. Here, I'll talk to you about how to be a little more okay tomorrow than you are today. Let's go.[00:00:56] Today is a deep dive into gastrointestinal health. There is no possible way I could cover every crevice of the vast amount of knowledge we have on the gut, but I will focus on common things I see and common causes for gastrointestinal distress that often are missed. You may remember from a couple of months ago that I explained in detail the visual representation of how I think about patients.[00:01:26] I call it the four I's. It's a two by two grid. Imagine a box with four squares in it. And today what I want to do is talk about the gut and how the different I's inform gastrointestinal health using some patient examples, things that I see commonly in my office. You can listen to that 15 minute podcast about the four I's for more of a dance remix version of the concept. But briefly, the four i's, are this: the top left square is information. Information and data. Things we can measure, things we can see like lab tests and colonoscopy reports. The top right corner is inputs; things we put in our body from kale and quinoa to alcohol and recreational drugs.[00:02:15] The bottom left box is infrastructure. Our skeleton, literally the skeleton, literally the vehicle we drive through life, the container of all of our parts. And then finally, the bottom right box is insight. Awareness of the stories that we tell ourselves. Awareness of how our stories manifest in our bodies, and our understanding of our mental health, our anxiety, our moods, our relationships with food, alcohol, each other, and so on.[00:02:45] So let's talk about a common complaint I see. I don't think a day goes by in my clinic where I don't see someone who has gastrointestinal complaints like bloating, irregular stools, gas or abdominal discomfort. Now the list of possible diagnoses for these complaints is vast, from diverticulitis to colon cancer to I ate a hot chili pepper. [00:03:11] But common things are common. That's a very favorite expression that doctors use all the time. And so I wanted to go through how I might conceptualize thinking about the diagnosis or how to help a patient troubleshoot these symptoms when it's sort of bread and butter. Take a middle-aged guy who comes in complaining of bloating, gas, and irregular bowel movements.[00:03:32] When I think about the top left square, that information, I want to know, what do his lab tests look like? If he's over the age of 45, has he had a colonoscopy? Because 45 is the age where we start screening colonoscopies. By the way, if you have a family history, you should start earlier. So I want to know what's going on internally.[00:03:52] What's his information? For example, if his lab tests show that he has hyperthyroidism or liver enzyme abnormalities, or a pancreas problem or celiac disease, that may directly inform how I'm going to recommend treatment. In other words, the data and the things we can measure are very important. So let's say he had a normal colonoscopy.[00:04:14] Let's say his liver tests are normal, his pancreas is normal, his gallbladder is normal, and his blood counts show no evidence of infection or inflammation, and he's negative for celiac disease. So those are just some broad brush stroke tests I might order. I also might not order tests because sometimes it's a simple solution, but let's say that his information is normal.[00:04:35] Then we'd move over to the inputs. That's the one I'm most interested in. When people have these kinds of complaints, I want to know, how much alcohol do they drink? What is the cadence of their eating? Are they eating a lot of processed, greasy food? Are they consuming a lot of sugar? What's the level of acidity in their diet and how fast do they eat? People who eat fast often swallow a lot of air and can get gas in the colon. Do they drink a lot of soda? Do they chew gym? Sugar-free gum is notorious for causing gas and bloating. So I would do a thorough history of what the patient's inputs are. What are they putting in their ecosystem?[00:05:15] Sometimes people can get gas and bloating from taking too much fiber. I think most people know that fiber is healthy and fiber can help with digestion. But if people escalate the dose of their fiber intake too quickly, that can backfire and they can get bloating and gas. This is a common phenomena. The other thing I would ask in the input department is, are they taking any supplements or vitamins? Because even though supplements and vitamins are considered natural, sometimes they contain fillers or the supplement itself can accidentally cause bloating and gas. Magnesium, for example, which people often take to help them sleep, can cause diarrhea. [00:05:50] It's important to think about all the different things you put in your ecosystem and how they might affect your digestive health. One of the most helpful interventions I find for patients with this kind of complaint is to keep a food journal. It sounds really boring and it sounds kind of onerous, but writing down every single thing you eat is kind of an interesting exercise.[00:06:12] People often connect the dots between their digestive health, their mood, their energy, and their bloating and gas when they look at the things they're eating. It's really interesting how mindlessly we consume foods, supplements, vitamins, and how little attention we pay to the things we pop into our mouth all day long. So I would suggest writing things down if you haven't done it already and you have this complaint.[00:06:35] The next quadrant I would look at is infrastructure, our skeleton. So it's not uncommon for people who have a bum hip, a bum knee, an aching back to pop an Advil, to take Tylenol, to take supplements that are over the counter that they think will help with their achy joints and skeletal health. One of the more common triggers of gastrointestinal stress is NSAID's, non-steroidal anti-inflammatory medications. Advil is one of them. Aleve. Naproxen. So we want to think about are we taking any medicines to treat our skeletal woes? And then we can also think about pain and how pain itself can cause distress. Distress can show up in the gut.[00:07:17] The other thing we need our skeleton for is just basic, everyday mobility. If we have some sort of limitation in our mobility, or we're just living a sedentary lifestyle, like we sit behind a desk most days, then that can affect our gut function, too. Often, one of the solutions for a chronic constipation is just regular walking, regular exercise, hydration, and movement to get our motor running. Our infrastructure really does matter. Sometimes just moving our bodies, hydrating and avoiding Advil is the way to keep our gut healthy. [00:07:49] Moving over to the insight quadrant, it never ceases to amaze me how patients will report to me these terrible gastrointestinal woes. We will think it may be an appendicitis, a diverticulitis. They will have a colonoscopy, they'll have extensive lab work and maybe even a CAT scan. And some of the times we find a diagnosis, someone has diverticulitis and I put them on ciprofloxacin and Metron dissolve for 10 days and they get better. Other people have a diagnosis that we can name through blood work like celiac disease or inflammatory bowel disease like Crohn's or ulcerative colitis.[00:08:24] When a patient has gastrointestinal distress and we have no obvious cause, tis is when I get my mojo on because I love talking about how our gut is often the home for our emotional health. It sounds kooky to many people, but I see it every day. Stress and anxiety in particular can manifest itself in our gastrointestinal tract. So when I have a patient who has a normal set of labs, normal imaging, a normal colonoscopy, and they're still suffering, we default to calling this irritable bowel syndrome. Now, patients often don't like having that diagnosis because they consider it a throwaway diagnosis. And I totally understand that because being diagnosed with IBS or Irritable Bowel Syndrome feels like the medical establishment is dismissing the patient.[00:09:13] It's like, we can't figure it out. We're gonna slap a diagnosis of IBS on it, and say, “see you next time, good luck.” But irritable bowel syndrome is a real phenomenon. It is literally the spasm and irritability of our colon, and it's from something. Just because it's IBS doesn't mean it's not real. IBS, however, is not a life-threatening diagnosis. It is not a result of inflammation. It is simply a functional issue that is often driven by emotional distress. One of my favorite exercises with patients is to take inventory of where they are on the continuum of anxiety. Where are they on the continuum of mood? Where are they on the continuum of their relationship with work, parenting, caregiving and just being alive in the modern world.?[00:10:03] In other words, we all have fears. We all have moods, we all have relationships to food, alcohol, our work, and to each other. When those things are on the fritz, when our anxiety is out of proportion to the actual threat; when our moods are not stable, despite our best effort to get sleep and to get exercise; and when our mental health is not in balance; those are often the triggers for gastrointestinal distress. So sometimes, dare I say, often the solution for gastrointestinal woes, if we can't find an obvious cause again, to identify thoughts, feelings, and behaviors that are causing us to feel distressed. In the short term, I will recommend to a patient that they try this, I don't wanna call it a diet because diet to me implies weight loss, but there's a diet, or actually call it a framework called the low FODMAP Diet.[00:10:55] You may have heard of the FODMAP Diet from a friend or on the internet or on Instagram. And when people say the FODMAP diet, they often mean a diet that is low in FODMAPs, F-O-D-M-A-P-S. And the diet is really designed to help people with irritable bowel syndrome, and one of the problems I think people run into is I give them the list of foods and they accidentally hear me say, cut all these foods out of your diet and good luck.[00:11:20] That's not my plan. All I want people to do is use that list of foods that are potentially irritating to the gut, that potentially accelerate that gastrointestinal spasticity and see if they can connect the dots between what they're eating by that journal we talked about and how they feel in their gut. FODMAP stands for Fermentable, oligosaccharides, disaccharides, monosaccharides, and Polyols.[00:11:45] What that basically means is that these are some foods that the small intestine absorbs very poorly, and people can experience cramping, diarrhea, constipation, bloating, and gas. So one of the occupational hazards of recommending the low FODMAP diet to patients is that people often go and restrict and then feel worse.[00:12:03] Maybe their diarrhea and cramping is better, but they're hungry. So the other potential occupational hazard of recommending the low FODMAP diet is people using the diet as a panacea and not then addressing the other triggers of their irritable bowel in the first place. From work stress to the Advil they took for the headache to the alcohol they overdid and kind of forgot they did because they didn't count it because it was the weekend.[00:12:29] In other words, there's really no one size fits all prescription for IBS/irritable bowel syndrome. But in my experience, it's usually a little bit of a lot of things and it's usually one little piece of something from the information quadrant. Maybe you have a predisposition to constipation or diarrhea given your family history.[00:12:51] It's one little piece from the inputs, like maybe you had too much alcohol and you didn't really register it, or maybe you're eating too much tomato or Brussels sprouts. Maybe it's in the infrastructure space where your body isn't moving enough. You need to give your body and your colon a little more time and space for activity.[00:13:09] And then sometimes it's in the insight. We need to recognize that our stories live in our bodies, and that self-awareness is often the key to health and wellbeing. So that is my little spiel about gastrointestinal health. It's pretty basic, but I find often that when we have these symptoms, we tend to overdo and over-test and over-worry when actually some of the solutions that I find the most helpful are really, really simple.[00:13:35] It's paying attention to thoughts, feeling. Taking stock of what we're putting in our body and our everyday habits, and then thinking from the ground up about how to be more self-aware and how to problem solve using a very basic set of tools we already have inside us. I hope that's helpful. If you enjoyed this podcast, I would be so happy if you liked it, if you subscribed, and if you recommended it to a friend. Thank you so much for joining me, and I'll see you next time. Get full access to Are You Okay? at lucymcbride.substack.com/subscribe

Forby mørkekjøring - Naproxen mot øyeproblemer Episoden kan inneholde målrettet reklame, basert på din IP-adresse, enhet og posisjon. Se smartpod.no/personvern for informasjon og dine valg om deling av data.

Download the cheat: https://bit.ly/50-meds  View the lesson: https://bit.ly/NaproxenAleveNursingConsiderations    Generic Name naproxen Trade Name Aleve Indication pain, dysmenorrhea, fever, inflammation Action inhibits prostaglandin synthesis Therapeutic Class nonsteroidal anti-inflammatory agents, nonopioid analgesics, antipyretics Pharmacologic Class none Nursing Considerations • use caution with GI bleeding • may increase risk for stroke and MI • can cause GI bleeding, anaphylaxis, Steven's Johnson syndrome • aspirin can decrease blood levels and effectiveness • assess pain • patients should remain up-right for 30 minutes after administration

Did you know that hydrogen-rich water (hrw) can protect your body? It can help you improve sleep, overall health, and recovery from muscle soreness. Hydrogen has a regulatory role in our cells. In fact, our mitochondria evolve from a hydrogen-dependent organelle, and every cell in our bodies has a base level of hydrogen gas in it. That is not all; a lot of bacteria in our bodies also produces hydrogen while other consumes hydrogen, which shows the integral role of hydrogen. Most of us aren't healthy all the time, and hydrogen can help us address chronic conditions and different stresses on a day-to-day basis. If you work out too hard, hydrogen might help you recover from that. If you didn't sleep well enough, hydrogen helps you be your best and improve sleep outcomes.  In this episode, Alex Tarnava, the founder and CEO of Drink HRW, talks about the science behind hydrogen, why it's so effective and how you should take it. He also discusses their products and how we should fight all those free radicles and optimize our health for longevity.     Snapshot of the Key Points from the Episode: [01:43] Alex shares his journey and how he discovered the power of hydrogen.  [09:22] How hydrogen works in our bodies, and why is it so effective?  [14:59] Hydrogen's role in reducing oxidative stress and why oxidative stress every once in a while is good for our health. [17:59] What is autophagy, and how hydrogen enhances the process to promote health? [19:18] How hydrogen impacts overall wellness, and the specific instance where it's best to take hydrogen to improve your outcome? How long do you have to wait to see a difference after taking hydrogen? [23:56] Alex's advice on how often to take hydrogen and tailor it to your needs to benefit  [25:21] Alex's Drink HRW products, how they work, and how to use them for maximum benefit.  [28:29] Ageless Defense capsules and how they stop the formation and protect us from the effect of AGES (Advanced glycation end-products) [33:14] Boost and how it helps build and maintain muscle mass and provides mental and physical stimulation without creating reliance  About Alex Tarnava -  Alex Tarnava has a passion for health and fitness, learning, and self-improvement. After a lifetime of sports activity, he was shocked to find he'd developed osteoarthritis while still in his physical prime. Unwilling to give up his way of life, he dosed himself regularly with Naproxen to counter the pain and discomfort he lived with every day. Over time, the drug's effects lessened while the gastrointestinal side effects increased. Searching for alternatives, Alex scoured the internet medical sites looking for emerging treatments that would help, reading hundreds of published articles in the process. This was where he happened upon the potential of molecular hydrogen. Skeptical at first, the more he read, the more interested he became in its potential. Testing every available commercial product on the market, he was disillusioned by their claims and lack of effectiveness. None of the companies came close to providing a product that was even close to what was being tested in human studies across the scientific world. None had the hydrogen saturation he knew from reading the science was necessary to effect results. Motivated by pain and the hope he garnered from his research, he began to experiment with ways of replicating the dosage levels being used successfully across the scientific community. After a time, he realized he needed real expertise and sought out Dr. Richard Holland's counsel. After a thrilling ride through discovery, multiple experimentations, and finally success, Rejuvenation hydrogen tablets are finally ready for the public. Alex remains committed to bringing relief through Rejuvenation and several other planned products to not just other sufferers but anyone interested in preventative health and longevity. Together, his team wants to ensure that everyone has the chance to experience the tremendous benefits of daily use of molecular hydrogen in a safe and effective manner.   Resources Mentioned - 10% off for Modern Aging viewers! Use code: MODERNAGING https://bit.ly/3Ez2jDa   How to connect with Alex Tarnava: Website: https://drinkhrw.com/ Instagram: https://www.instagram.com/drinkhrw/ Facebook: https://www.facebook.com/drinkhrw About Risa Morimoto  Founder and CEO of Modern Aging, Risa is a certified integrative nutrition health coach. She is passionate about ensuring people live the second half of their life feeling strong, fulfilled, and empowered. Though Risa is the host of the Modern Aging YouTube Channel, she has spent most of her career behind the camera as a producer and director of documentaries (Wings of Defeat, Broken Harmony: China's Dissidents) and TV (HGTV – House Hunters International, Selling NY, Animal Planet, A&E).  Through Modern Aging, she deep dives and shares her findings on alternative, global approaches to holistic health and wellness.    How to Connect Risa Morimoto: Website - https://thisismodernaging.com/ Instagram - https://www.instagram.com/thisismodernaging/ Youtube - https://www.youtube.com/c/ModernAging Facebook - https://www.facebook.com/thisismodernaging/

Author, doctor and college professor John Abramson joins Tim to talk about his book called, “Sickening: How Big Pharma Broke American Health Care and How We can Repair It.” John has been on the faculty of Harvard Medical School for over 25 years, and prior to that spent many years in private practice. In this episode, John about America's healthcare system, which often traces its roots to how drugs are approved for use and marketed to both doctors and consumers. https://traffic.libsyn.com/secure/shapingopinion/John_Abramson_Sickening_auphonic.mp3 Prior to the pandemic, most Americans knew much less, or even cared about how drugs were approved. Vaccines, drugs, medicines and other medical treatments are approved by the Food and Drug Administration, the FDA.  Before the pandemic, most Americans assumed that the FDA and the federal government had their best interests at heart, and that anything approved by the FDA was good for them. When TV viewers watched ads for pharmaceuticals, they assumed that these new drugs had to pass the test of innovation, of efficacy, and that in the end, the new drugs were improvements over the old drugs. The pandemic changed all of that for some, not because of lost trust in the mission of the FDA or other regulatory bodies. And not because of lack of faith in the ability for pharmaceutical companies to provide lifesaving and health-improving treatments. Or their ability to be innovative. What has happened is that America has gotten a peak behind the curtain, and it's not sure it likes what it sees. That's exactly what our guest in this episode has spent much of his life doing. John Abramson is a medical doctor. He's a former expert witness in numerous legal proceedings over the questionable practices of some pharmaceutical companies or executives. Like so many, he entered the medical profession to help people get better or stay healthy. Then he got his own glimpse behind the curtain. Links Sickening: How Big Pharma Broke American Health Care and How We Can Repair It, by John Abramson (Harper Collins' website) Overdo$ed America, by John Abramson (Harper Collins' website) Comparison of Upper Gastrointestinal Toxicity of Rofecoxib and Naproxen in Patients with Rheumatoid Arthritis, New England Journal of Medicine (November 23, 2000) Risk of cardiovascular events associated with selective COX-2 inhibitors, Journal of the American Medical Association (August 2001) Vioxx Lawsuits, Drugwatch.com Health Technology Assessment, PubMed.gov E-Mails Suggest Merck Knew Vioxx's Dangers at Early Stage, Wall Street Journal (November 1, 2004) Withheld Study on Vioxx Published This Week in Lancet, Kaiser Health News (June 11, 2009) Diabetes Prevention Program New England Journal Of Medicine 2002, DiabetesTalk.net About this Episode's Guest John Abramson John Abramson MD, MS, has served as a family physician for 22 years. He was twice voted “best doctor” in his area by readers of the local newspapers and three times selected by his peers as one of a handful of best family practitioners in Massachusetts. He has been on the faculty at Harvard Medical School for 16 years, where he has taught primary care and currently teaches health care policy. He currently consults as an expert in litigation involving the pharmaceutical industry and has served as an unpaid consultant to the FBI and Department of Justice. Dr. Abramson has appeared on more than 65 national television shows, including two appearances on the Today Show, and more recently on the Dr. Oz Show. He was written op-ed pieces in the New York Times LA Times and others. In addition to his book, Sickening, He is the author of the national best-selling book Overdo$ed America.

As therapists, some of you will be aware of the controversy that surrounds the use of NSAIDs (non-steroidal anti-inflammatory drugs) like Ibuprofen and Naproxen, particularly if taken prior or during endurance events such as triathlon, marathons & ultras. The organizers of the Ultra-Trail du Mont-Blanc (UTMB) World Series recently announced that they will be banning the use of painkillers within 24 hours and during all races. In Ep.71 of the Sports Therapy Association Podcast, we welcome back special guest Dr Fiona Higgs of move-well.co.uk, a Sport & Exercise Scientist, Educator, Sports Massage & Exercise Therapist and published scientific author. During an online discussion about the UTMB announcement, Fiona raised the point that for some athletes, NSAIDs play a vital part in allowing participation, eg. those with physical disability and also athletes suffering from pain related to their menstrual cycle. This developed rapidly into a discussion about how this decision by the UTMB happened without female members of the organisation not speaking up. Were there women involved in this management decision? Did they speak up? Were the many many female endurance runners who participate in these races asked for their input? Did they speak up? We also discussed reports that when women are invited to speak on for example public podcasts or forums, the take up is often disappointingly low, including a surprising number of no replies to invitations. Is that women are too busy? Lack confidence? Have less desire to argue points in public? Or are we in danger of generalising and adding to gender stereotypes?  We are keen to hear from anyone stimulated by this episode to add share experience and add comment, either anonymously or in person. Please feel free to email: matt@thesta.co.uk fiona@move-well.co.uk Websites/Social Media move-well.co.uk Twitter: @fiona_higgs1 Enjoyed the episode? Please take a couple of minutes to leave us a rating & review on Apple Podcasts. It really does make all the difference in helping us reach out to a larger audience. iPhone users you can do this from your phone, Android users you will need to do it from iTunes. All episodes are streamed live to our YouTube channel and remember all soft tissue therapists (non members included) are welcome to join us for the LIVE recording on Tuesdays at 8pm (UK time) on the Sports Therapy Association Facebook Page Questions? Email: matt@thesta.co.uk

“If you feel the pain is abnormal, you don't have to rationalize it— you can just ask for help.” - Yancy Chery This week, I am joined by a multidisciplinary artist and educator in intimacy, relationships, and sex Yancy Chery. Yancy shares the importance of validating the pain she felt and trusting her body when it signaled to her that something was abnormal. She tells us about how her paralyzing abdominal pain sent her into a state of panic and how the nervousness and hysteria of the people around her simply exacerbated the situation. After being rushed to the hospital doctors couldn't identify the cause of the pain and sent her home with a prescription for Naproxen. Shockingly, Yancy later learns that her pain may have been caused by a double ovarian cyst rupture and that this phenomenon was “common” amongst many women. Without the proper sexual and reproductive education, many women can suffer from anxiety caused by the lack of information about their bodies. Many women may also learn to minimize their pain caused by the fear of drawing too much attention to themselves forcing them to push aside their own pain to console the people attempting to console them. Let's normalize sexual and reproductive conversations with our family and friends. It can legitimately save lives. Connect with us: @officalboxowner @fullcourtpumps officialboxowner.com Connect with our guest: @yancy.chery www.yancychery.com ================== Official Box Owner: Visit us at www.officalboxowner.com

Today's Question: An assembly line employee reports aching pain in his hands to the third party Occupational Health Nurse that works on site. The nurse instructs the employee to take over the counter Naproxen per the instructions on the packaging and also encourages the employee to adhere to the company stretching program that he has been trained and is considered a condition of employment upon hire. The nurse also has the employee soak his hands in warm wax on each break and at the end of the employee's shift. Is it recordable? Become a Sponsor: To become a sponsor of this podcast visit isitrecordable.com/sponsorships or email your inquiry to redbeard@isitrecordable.com. Become a Member: Join up as a member at isitrecordable.com/memberships for as little as $1.08!! Get exclusive access to the blog, downloadable files including toolbox talks, and more! By becoming a member you will be helping us give back to the safety community. Support what you like - join today! Music Credit: https://soundcloud.com/daataa (Mitch Murder)

Over the Counter Ibuprofen and Naproxen are wonderful medicines with so many uses. But, there are some things to keep in mind to use them safely. In this episode, Rose Wolbrink, M.D. and Christopher Tookey, M.D. break down what all patients should know before using these medicines  A disclaimer, we're providing general guidance but everyone is different and you should always discuss with your health care professional management of any disease and therapy before trying anything you discover from a source on the internet (including this podcast) 

Today's Question: Upon elbow pain setting in at work, a vehicle seat assembler reports the pain to her supervisor. In the First Aid Office, the site Injury Prevention Specialist (Certified Athletic Trainer) evaluates the employee and puts her on a conservative treatment regimen of over the counter strength Naproxen per directions and cold compress treatments twice per day for three weeks. The icing treatments take place during one 45 minute job rotation per treatment. In addition, the Injury Prevention Specialist applies kinesiology tape to the employee's elbow on a daily basis. The employee continues her routine job functions at full duty, accomplishing all tasks in her job description more than once per week while her condition is monitored. Is it recordable? Become a Sponsor: To become a sponsor of this podcast visit isitrecordable.com/sponsorships or email your inquiry to redbeard@isitrecordable.com. Become a Member: Join up as a member at isitrecordable.com/memberships for as little as $1.08!! Get exclusive access to the blog, downloadable files including toolbox talks, and more! By becoming a member you will be helping us give back to the safety community. Support what you like - join today! Music Credit: https://soundcloud.com/daataa (Mitch Murder)

My conversation with Dr Eduardo Vilar Sanchez from the University of Texas MD Anderson Cancer Center about Living with Lynch Syndrome, immunotherapy and the Naproxen study.  Of course we talk Real Madrid, MD Anderson, the Houston Dynamo, and fellow colleagues in CGAIGC and the return to conferences in person.  Stick around for the shoutouts and name-dropping.  

Today’s episode is going to be relevant to you if you (or your daughter) suffers from very heavy periods. Helen Wills talks to Fi Star Stone, who suffered with extreme heavy periods from the age of 15 when her periods began, to the point where it was affecting her quality of life, and her ability to be at school. She was eventually diagnosed with endometriosis and polycystic ovaries, but she says that not all heavy bleeding like hers will have the same causes. Fi talks about how much is too much, what the symptoms of endometriosis are, and what help is available to young girls who have heavy periods with no clinical cause. It’s a really honest chat, and Fi gives a lot of hope to teenage girls who might be feeling like they have to suffer in silence. What medications help with heavy periods? Your GP might first of all prescribe Tranexamic Acid, which helps to slow down bleeding, and Naproxen, a strong anti-inflammatory to help with the pain. If these don't help sufficiently, girls might be put on the pill to either reduce the severity of periods, or stop them altogether. Why it's important to go to the doctor if your periods are unmanageable Very heavy, painful periods might be a sign of an underlying condition like endometriosis, which can damage your fertility if left untreated. A simple ultrasound scan can see whether this, or polycystic ovarian syndrome (PCOS) might be an issue. Who is Fi Star Stone? Fi Star-Stone is a bestselling author, qualified parenting advisor, child sleep consultant, and regular contributor to parenting media. She’s also a mum of two little ones born less than a year apart. Fi is a specialist speaker on childcare and parenting issues on the BBC, and a regular face on Mother&Baby IGTV lives. Fi also co-hosts a podcast ‘Self(ish)’ which takes a look at the importance of finding ‘me time’ when there is no time!You can find more from Fi below: Fi's books on Amazon (affiliate link)TwitterInstagramFi's website The Regular ParentThe Self(ish) Podcast Regular Parent Podcast More teenage parenting tips from Helen Wills: Helen wills is a teen mental health podcaster and blogger at Actually Mummy a resource for midlife parents of teens. Thank you for listening! Subscribe to the Teenage Kicks podcast to hear new episodes. If you have a suggestion for the podcast please email teenagekickspodcast@gmail.com. There are already stories from fabulous guests about difficult things that happened to them as teenagers - including losing a parent, becoming a young carer, and being hospitalised with mental health problems - and how they overcame things to move on with their lives. You can find more from Helen Wills on parenting teenagers on Instagram and Twitter @iamhelenwills. For information on your data privacy please visit Podcast.co. Please note that Helen Wills is not a medical expert, and nothing in the podcast should be taken as medical advice. If you're worried about a teenager, please seek support from a medical professional.

Episode 48: Acute Low Back Pain. Stephanie and Veronica explain common causes of acute low back pain, including lumbar strain, disc herniation, and spondylosis; spontaneous human combustion; question of the month about pneumonia. Introduction: Spontaneous Human CombustionBy Hector Arreaza, MDToday is April 19, 2021.  I’ve been trying to keep this podcast very academic and clinically relevant, with a touch of humor but very professional. I hope after this intro, you do not stop listening to us. Recently I was playing a trivia game at a friend’s house. The question was: How many spontaneous human combustion cases have been published in medical journals between 1600 and 1900? What would be your answer? I did not know the answer, but it woke up my curiosity.I did what’s expected of a normal PCP, exactly, I looked it up in Up-to-Date. The only reference to “spontaneous combustion”, I found was on the article about long-term supplemental oxygen therapy (LTOT). “Facial and upper airway burns are an infrequent complication of LTOT, but can be severe and potentially life-threatening. The main cause of burns is exposure to open flames while wearing supplemental oxygen. However, spontaneous combustion may occur with exposure to a spark source rather than an open flame. Certain factors may contribute to the risk of combustion in the absence of open flames, such as facial hair and use of hair products containing oils or alcohol.” This “spontaneous combustion” does not match the definition given the non-medical community.Spontaneous human combustion, also known as preternatural combustion, refers to a rare episode where the complete body, or significant parts of it, are reduced to ashes with no apparent source of ignition. Other items around the body of the victim are intact, making people believe that the fire originated from inside the body. This phenomenon has been described in fictional movies, documentaries, books, novels, and even medical journals. In 1984, Nickell and Fischer[3] investigated cases from the last 3 centuries. They concluded that in those cases of presumed “spontaneous human combustion” possible sources of ignition were ignored on the reports. A common characteristic among victims of spontaneous combustion was intoxication with alcohol or other substances.More recently, the American Burn Association looked into this topic and published in 2012[2] an article titled “Spontaneous Human Combustion in the Light of the 21st Century”. They state that a literature search retrieved 12 case reports between 2000 and 2012. They concluded that the so-call “spontaneous human combustion” is a reality, however, it is not exactly how people think it is. People are not just sitting around and get consumed alive in flames. The term “fat wick burns” was suggested to provide a more exact definition. The article explains that the burn victim must die for the body fat to start melting, then a break in the skin allows melted fat to impregnate clothes and produce a wick effect that allows fire to be on for a long time causing a complete carbonization of tissues. In case you are curious, the number of spontaneous human combustion cases published in medical journals between 1600 and 1900 is ninety-six (96). Citation needed.This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it’s sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. __________________________Question of the Month: Cough and FeverWritten by Hector Arreaza, MD, read by Jacqueline Uy, MDThis is a 69-yo male patient, who has history of controlled hypertension. He comes to an urgent care clinic for acute onset of fever (102 F), cough, and shortness of breath which has progressively worsened over the last 3 days. He does NOT smoke, but uses recreational marijuana once a month, and drinks 1-2 beers a week. He goes to the doctor once a year for check-ups. He takes benazepril 10 mg daily for his hypertension. He does not believe in vaccines and his last shot was a tetanus shot 5 years ago. No surgical history. He retired as an accountant 5 years ago. Vital signs are normal except for tachycardia of 110 (his baseline is 85) and temperature of 101.5 F (38.6 C). He has bibasilar crackles on auscultation. You perform labs in clinic and he has a white count of 13.5, and a chest x-ray shows a right lower lobe consolidation. He has a negative rapid COVID-19 test. What are your top 3 differential diagnoses and what is the acute management of this patient’s condition?Let’s repeat the question: What are your top 3 differential diagnoses and what is the acute management of a 69-year-old male, non-smoker, who has fever, cough, shortness of breath, tachycardia, bibasilar crackles, elevated WBCs, a right lower lobe consolidation, and a negative rapid COVID-19 test?Send us your answer before May 7, 2021, to rbresidency@clinicasierravista.org and the best answer will win a prize!____________________________Acute Low Back Pain. By Stephanie Rubio, MS3, and Veronica Phung, MS3. Acute low back pain definition and statistics.  Eighty percent (80%) of Americans will experience back pain at some point in their lifetime.  Low back pain is the 5th most common reason for all doctor visits in the US. Most cases of low back pain are acute and 90% resolve within 1 month. Recurrence rate for back pain is high at 35% to 75%.  Acute back pain is defined as pain in the lumbar area for less than 3 months. The sources of low back pain are extensive. We would like to discuss some of the more common causes and important considerations when a patient presents with acute low back pain.  With such an extensive differential for acute low back pain, we want to briefly discuss three common causes: lumbar strain, disc herniation, and degenerative arthritis of the spine; AND three causes that require special attention: cauda equina, malignancy, and prostatitis.     Lumbar strainLumbar strain is the most common cause of acute low back pain in adults. Presentation can be acute or sub-acute after an injury or strenuous activity such as moving heavy furniture. Paraspinal muscles are typically the source of pain and can be unilateral or bilateral with or without radiation down the leg. Pain increases after immobility and specific movements depending on strain location. Patient will have a negative straight leg test.  Treatment: Patient education is key for treatment. It includes explaining that acute back pain is often benign in nature and reassurance. Advise your patients to stay active; to avoid twisting and bending, particularly when lifting; and to return to normal activities as soon as possible.  NSAIDs or muscle relaxants will help the pain process. Muscle relaxants combined with NSAIDs may have additive benefit for reducing pain. “Moderate evidence suggests that no one NSAID is superior, and switching to a different NSAID may be considered if the first is ineffective.” In clinic: Ibuprofen and Naproxen are our “go-to” medications. Acetaminophen is also an option.  “Moderate-quality evidence supports that non-benzodiazepine muscle relaxants (such as cyclobenzaprine, tizanidine, and metaxalone) are beneficial in the treatment of acute low back pain in the first seven to 14 days with effects for up to 28 days. However, muscle relaxants do not affect disability status. Make sure you warn your patient about drowsiness, dizziness, and nausea. Diazepam and Soma (carisoprodol) have the potential for abuse, so use them cautiously and for a short period only.  We also have to mention the controversial opioids. Due to the opioid epidemic, prescribe opioids only for patients with severe acute low back pain for a short period; however, there is little evidence of benefit when compared to NSAIDs.  Epidural steroid injections are not so beneficial for isolated acute low back pain, they may be helpful for radicular pain that does not respond to two to six weeks of noninvasive treatment. Transforaminal injections appear to have more favorable short- and long-term benefit than traditional interlaminar injections. Ok, we are done with lumbar strain. Disc herniationDisc herniation may also be acute or subacute with a variety of pathologies involving the displacement of disc material into the spinal cord or nerve roots. Presentation: Sudden injury could precipitate pain such as a sharp, burning, stabbing pain radiating down the posterior or lateral aspect of the leg and it is made worse when hips are flexed such as sitting. Radicular pain in the dermatome of the compressed nerve root is common. Herniation at L5-S1 is the most common location, and it would present as a loss of sensation on the dorsolateral thigh, lower leg, and dorsal foot. Patients can also have motor deficits on the lateral side of the foot which can cause a problem in tilting the sole of the foot away from the midline or difficulty toe walking. Use neurologic deficits to determine the location of herniation.Radicular pain and radiculopathy are not the same. Radicular pain is a single symptom (pain) that follows the distribution of a nerve root. Radiculopathy is a group of symptoms including, paresthesia, hypoesthesia, motor dysfunction and pain. Symptoms may be the result of compression of more than one nerve root.Nerve RootDermatomal areaMyotomal areaReflexive changesL1Inguinal regionHip flexors L2Anterior mid-thighHip flexors L3Distal anterior thighHip flexors and knee extensorsDiminished or absent patellar reflexL4Medial lower leg/footKnee extensors and ankle dorsiflexorsDiminished or absent patellar reflexL5Lateral leg/footHallux extension and ankle plantar flexorsDiminished or absent Achilles reflex S1Lateral side of footAnkle plantar flexors and evertorsDiminished or absent Achilles reflex (Source: Physio-pedia.com, https://www.physio-pedia.com/Lumbar_Radiculopathy)  Treatment: Please tell patients to keep moving as much as possible. Bed rest is not helpful and may prolong the pain process. NSAIDs should be used to decrease inflammation. Neurosurgery consultation may be needed for large herniation, especially if there is spinal canal compression, causing severe or progressive motor deficit. Use of steroids may be beneficial, but the available evidence suggests limited or no benefit. I’ve seen prednisone prescribed by neurosurgeons frequently when surgery is being delayed. If used, prednisone (60 to 80 mg daily) for five to seven days for patients who do not respond well to analgesics and activity modification. This is followed by a rapid taper to discontinuation over the following 7 to 14 days.Degenerative arthritisSpondylosis is more common in patients with advanced age. Osteophyte impingement of a nerve root can cause radicular symptoms following the nerve’s dermatome distribution as well. Presentation: Onset tends to be more insidious and posture dependent. For example, extension of the lumbar spine, like standing or walking upright causes pain. Symptoms are related to posture, patient may mention leaning on the shopping cart alleviates the pain.Neurogenic claudication is typical of spinal stenosis: pain, numbness, tingling, cramping, weakness of the lower back and extremities; which are exacerbated by walking or exertion, worse walking downhill, not worsened by biking. Neurogenic claudication is not to be confused with vascular intermittent claudication, which is pain, cramping, and tightness on the lower extremities relieved by rest, NOT relieved by walking flexed with a shopping cart. Treatment: Conservative physical therapy is an appropriate treatment. Cycling exercises can be recommended to keep your patients moving because hip flexed activities do not induce pain.  Consider a pain management clinic referral for treatment of foraminal stenosis with steroid injections. From personal experience, I can tell you, those shots really work! However, the response is not 100% effective in all patients. You do not send patients to pain management just because they are requesting chronic opioids. You send them for real treatment of pain with procedures. Cauda equina syndrome: This condition should always be considered due to the seriousness of the consequences. Symptoms may present as saddle anesthesia, loss of anal sphincter tone, and major motor weakness. Decompression should be performed within 72 hours to avoid permanent damage. Clinical suspicion is low if patient denies problems with bowel or bladder control. The most common symptom is actually neurogenic bladder, evidenced by acute urinary retention or incontinence.  Malignancy: Cancer is a serious cause of back pain. Your patient may complain of a dull, throbbing pain that progresses slowly and increases with recumbency or cough. Non-radiating pain is worse at night. More common in patients over 50 and history of cancer in the past.Genital organs: Prostatitis can cause referred low back pain. Expect to find evidence of infection in the history. So, a prostate exam and a genital exam may be needed in older males with acute or chronic low back pain.  Females may also have referred low back pain in the setting of pelvic inflammatory disease and endometriosis. So, a pelvic exam may be needed, based on your clinical judgment.     Overview of Acute Low Back Pain:   Patients with acute LBP without any red flags such as: infections, fever, or weight loss should start conservative therapy for up to 6 weeks with NSAIDS and/or muscle relaxants. Localized cold therapy for direct injury first to constrict blood vessels, reduce swelling, decrease inflammation and potentiate a numbing effect. Then heat therapy can be used after inflammation has subsided. Reevaluate in 1-3 weeks, if significant pain or neurologic complications persist or if there is no improvement in pain. If there is spinal pathology detected, then surgical evaluation is needed. Advise patients to stay active. Physical therapy may prevent recurrence. Studies showed that early physical therapy, after primary care consultation was associated with reduced risk of subsequent health care compared with delayed physical therapy. However, it is still unclear which patients with LBP should get referred to physical therapy.Depending on severity of pain and presentation of the patient, diagnostic studies such as MRI and labs can be ordered if findings are suggestive of serious pathology, such as bilateral radicular signs, urinary retention, saddle anesthesia or suspicion of a high-risk mechanism (cancer, hematoma, abscess), presence of fever, night sweats, nocturnal pain, older patients, and more.For prevention, remember proper lifting techniques should be used when moving heavy objects. Bend at the knees with a straight back and use the leg muscles to lift instead of bending at the waist to prevent injury. Maintaining a healthy weight is important for back health.Back-strengthening and stretching exercises at least 2 days a week help prevent back pain. exercise by using the proper equipment and techniques. Remember motion is lotion. Encourage patients to keep moving even as patients progress in age. Because you know you’re getting old when your back goes out more than you do.____________________________Conclusion: Now we conclude our episode number 48 “Acute Low Back Pain”. Veronica and Stephanie did a great job explaining three common causes: Lumbar strain, disc herniation, and spondylosis. Be aware of signs of cauda equine syndrome, malignancy and prostate in men and pelvic organs in women. Initial imaging and labs are not needed in most patients, but make sure to order an MRI and labs depending on the presence of red flags. Don’t forget to send us your answer to the question of the month: What are your top 3 differential diagnoses and explain the acute management of a 69-year-old male with fever, cough, tachycardia, right lower lobe consolidation, and negative COVID-19 test.Remember, even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Stephanie Garcia, Veronica Phung, and Jacqueline Uy. Audio edition: Suraj Amrutia. See you next week!   References:Tiep, Brian L, MD; Rick Carter, PhD, MBA; Long-term supplemental oxygen therapy, Up-to-Date, Last updated: May 08, 2019. https://www.uptodate.com/contents/long-term-supplemental-oxygen-therapy. Accessed on March 25, 2021.  Virve Koljonen, MD, PhD, Nicolas Kluger, MD, Spontaneous Human Combustion in the Light of the 21st Century, Journal of Burn Care & Research, Volume 33, Issue 3, May-June 2012, Pages e102–e108, https://doi.org/10.1097/BCR.0b013e318239c5d7 Nickell, Joe; Fischer, John F. (March 1984). "Spontaneous Human Combustion". The Fire and Arson Investigator. 34 (3). Casazza BA. Diagnosis and treatment of acute low back pain. Am Fam Physician. 2012 Feb 15;85(4):343-50. PMID: 22335313. https://www.aafp.org/afp/2012/0215/p343.html. Lumbar Radiculopathy, Physiopedia, https://www.physio-pedia.com/Lumbar_Radiculopathy, accessed on April 9, 2021.  Fritz JM, Childs JD, Wainner RS, Flynn TW. Primary care referral of patients with low back pain to physical therapy: impact on future health care utilization and costs. Spine (Phila Pa 1976). 2012 Dec 1;37(25):2114-21. doi: 10.1097/BRS.0b013e31825d32f5. PMID: 22614792. https://pubmed.ncbi.nlm.nih.gov/22614792/  

This episode is hosted by Dr. Thomas Slavin (T.J.) and features Dr. Eduardo Vilar-Sanchez. Dr. Vilar-Sanchez is a medical oncologist at MD Anderson Cancer Center. Together they discuss “Naproxen chemoprevention promotes immune activation in Lynch syndrome colorectal mucosa,” which was published in Gut and found here: https://pubmed.ncbi.nlm.nih.gov/32641470/ This episode was recorded on March 26, 2021 and reflects expert opinion at the time of the recording.

On this episode of the Real Life Pharmacology Podcast, I discuss naproxen pharmacology. Naproxen can raise the concentrations of lithium and increase the risk for toxicity. Compared to most other NSAIDs, naproxen tends to have a lower cardiovascular risk. Naproxen can contribute to renal insufficiency, GI bleed risk, and CHF exacerbations.

Pain can be incredibly inconvenient. But what we seem to forget is that pain is our body’s way of alerting us to a problem. Or it can be part of the natural healing process. This is not to say that chronic pain can’t be incredibly debilitating. However, we need to stop reaching for that cheap bottle of over the counter anti-inflammatories. They are doing more harm than good. Welcome to Fatal Conveniences™ This is a bite-sized segment that parallels The Darin Olien Show. In these segments, we get into society's Fatal Conveniences™. I define these as the things we may be doing because the world we live in makes us believe we have to. These things save us time and trick us into thinking they're actually good for us. But it's those same things that are breaking down our health, and the health of the environment around us. I've spent most of my adult life obsessively researching these "conveniences." On every show, I pick one topic, and we dive into it. My goal is to make you more aware of these traps so that you can push back on them. Remember, it starts with you and the choices you make.  So, if you're willing to look at your world from a different perspective and make little tweaks that amount to big changes, then this segment is for you. Americans spend $50 Billion a year on Over the Counter (OTC) Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) When I say OTC NSAIDs, I’m talking about common painkillers like Advil (ibuprofen), Aleve, Naproxen and high-dose aspirin. All these drugs are easily found in pharmacies, grocery stores and even gas stations. They’re so commonly used that many of you probably have them stored in your purses or backpacks right now, just in case. We are trained to pop a couple of these pills at the first sign of a headache or any sort of pain. It’s as American as apple pie.  I’m here to tell you that this is a bad habit we need to break. These meds are doing way more harm than good. They’re tearing apart our stomach lining, messing with our body’s ability to produce antibodies and conditioning us to treat symptoms instead of addressing pain at the source. In this Fatal Conveniences™ segment, we go into the history of NSAIDs and how they’ve become our drug of choice. I get into the awful truth behind what they’re doing to our health. And of course, I give you a plethora of alternative options when it comes to pain relief. I’m not trying to knock the seriousness of chronic pain, guys. I just want you to deal with it in ways that aren’t counterproductive to your health. Take back your power, and turn to plants. Other topics in this segment: The number one cause of bleeding stomach ulcers NSAIDs and the heart Pain’s role in healing The history of Bayer and big Pharma The risk to water and the environment from NSAIDs The reason for inflammation NSAIDs and the immune system The risks of NSAIDs on pregnancy and fertility Natural anti-inflammatory foods Healthy ways to deal with pain CBD Links & Resources: History of Felix Hoffman Facts about Bayer Effects of Nonsteroidal  Anti-Inflammatories at the Molecular Level FDA Beefs up Warning on NSAIDs NSAIDs: How Dangerous Are They For Your Heart? Study on Ibuprofen Time Magazine: Ibuprofen May Not Be as Safe as You Think 10 Foods That Fight Pain Netflix’ Down To Earth’ Official Trailer Download my amazing new lifestyle app and get 3 days free at 121Tribe.com Barukas Nuts 15% discount with code “DARIN” Want more great info on how to detoxify your life? Sign up for my Fatal Conveniences™ emailsThe Darin Olien Show is produced by the team at Must Amplify. If you’re looking to give a voice to your brand, and make sure that it’s heard by the right people, head to www.mustamplify.com/darin to see what Amplify can do for you.

FDA 连续批准2个血小板生成素受体激动剂术前治疗慢性肝病引起的血小板减少LANCET 使用阿司匹林预防Lynch综合征患者发生结直肠癌Science Advance 在体内将脾脏转化为类肝脏器官艾曲波帕（lusutrombopag）艾曲波帕（Lusutrombopag）是一种小分子的血小板生成素受体激动剂。2018年7月，FDA批准艾曲波帕.（lusutrombopag）治疗计划手术的、慢性肝病引起的血小板减少症。《L-PLUS2研究：艾曲波帕Lusutrombopag用于治疗正在接受侵入性治疗的慢性肝病患者血小板减少症》Hepatology，2019年10月 (1)该研究的目的是评价艾曲波帕用于慢性肝病合并血小板减少患者中，手术前提高血小板计数的疗效。这项全球性的、随机、双盲、安慰剂对照的第3期研究中，招募215名患者，患有慢性肝病且基线血小板计数

FDA 连续批准2个血小板生成素受体激动剂术前治疗慢性肝病引起的血小板减少LANCET 使用阿司匹林预防Lynch综合征患者发生结直肠癌Science Advance 在体内将脾脏转化为类肝脏器官艾曲波帕（lusutrombopag）艾曲波帕（Lusutrombopag）是一种小分子的血小板生成素受体激动剂。2018年7月，FDA批准艾曲波帕.（lusutrombopag）治疗计划手术的、慢性肝病引起的血小板减少症。《L-PLUS2研究：艾曲波帕Lusutrombopag用于治疗正在接受侵入性治疗的慢性肝病患者血小板减少症》Hepatology，2019年10月 (1)该研究的目的是评价艾曲波帕用于慢性肝病合并血小板减少患者中，手术前提高血小板计数的疗效。这项全球性的、随机、双盲、安慰剂对照的第3期研究中，招募215名患者，患有慢性肝病且基线血小板计数

In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves discuss one of the most commonly utilized medications, non-steroidal anti-inflammatory drugs (NSAIDs).   NSAIDs are medications with anti-inflammatory, analgesic, and anti-pyretic properties.  The mechanism of action of NSAIDs is predominantly through inhibition of cylo-oxygenase, but there are multiple other pathways by which NSAIDs exert their therapeutic effect including but not limited to modulation of neutrophil function and cell membrane function.  It is important to understand that there are multiple different classes of NSAIDs, and each NSAID has its own unique properties resulting in differences in regards to safety and efficacy.     Listen as the doctors discuss important topics including: -drug-drug interactions concerning NSAIDs including NSAIDs interaction with aspirin and SSRI medications.   -research including the PRECISION trial addressing the question of whether or not Celecoxib (a selective COX-2 inhibitor) has increased cardiovascular risk relative to relatively non-selective NSAIDs. -optimal utilization of NSAIDs in the setting of acute musculoskeletal injuries. This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.   References: 1. Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis. N Engl J Med;  2016. 2. Pharmacology of Nonsteroidal Antiinflammatory Drugs and Opioids. Pharmacology in Interventional Radiology; 2010. 3. New insights into the use of currently available non-steroidal anti-inflammatory drugs. Journal of Pain Research; 2014. 4. Cardiovascular outcomes in high risk patients with osteoarthritis treated with ibuprofen, naproxen or lumiracoxib. Ann Rheum Dis;  2007. 5. Efficacy and safety of oral NSAIDs and analgesics in the management of osteoarthritis: Evidence from real-life setting trials and surveys. Seminars in Arthritis and Rheumatism; 2016. 6. COX-2 inhibition impairs mechanical stimulation of early tendon healing in rats by reducing the response to microdamage. Journal of Applied Physiology; 2015.

Sign up for the free newsletter: chrismasterjohnphd.com/covid19-updates Support the service by purchasing a copy of The Food and Supplement Guide for the Coronavirus: chrismasterjohnphd.com/coronavirus DISCLAIMER: I am not a medical doctor and this is not medical advice. I am also not an infectious disease epidemiologist and I am not speaking on behalf of infectious disease epidemiologists. I have a PhD in Nutritional Sciences and my expertise is in conducting and interpreting research related to my field. Please consult your physician before doing anything for prevention or treatment of COVID-19, and please seek the help of a physician immediately if you believe you may have COVID-19. SUBSCRIBE This series is based on my free daily newsletter, COVID-19 Research Updates. As a result of the time it takes to produce an video or podcast from a newsletter I wrote up, there's a slight delay between when I publish the newsletter and when you watch or listen to this. When you subscribe to the newsletter, you get the latest of my research every single day as soon as it's ready to come out. You get references and links to the sources for all the information, and you immediately get an archive of all the past issues. You can sign up at chrismasterjohnphd.com/covid19-updates SUPPORT It would mean the world to me if you support this service by purchasing a copy of my ebook, The Food and Supplement Guide to the Coronavirus. The guide contains my most up-to-date conclusions about what we should be doing for nutritional and herbal support on top of hygiene and social distancing for added protection. Due to the absence of randomized controlled trials testing nutritional or herbal prevention, these are my best guesses for what is likely to work without significant risk of harm, based on the existing science. Many people have asked why I am charging for this instead of giving it away for free, given that this is a time of crisis and people are in need. Unfortunately, I have not been immune to the effects this virus has had on the economy. My revenue from my other offerings started falling in February, and by mid-March I had days where my revenue was zero. I have three people who work for me full-time, and I am doing everything I can to avoid laying any of them off. By mid-March I had depleted 75% of my emergency fund in order to avoid any layoffs, and without charging for the guide I would not have been able to hold out much longer. Charging for the guide has allowed me to keep everyone working, replete some of my savings, and devote myself to researching COVID-19 full-time. As a result I now publish this daily COVID-19 series and the free newsletter, am involved in the design of several clinical trials that are in the process of being submitted for registration now, and am able to continually update the guide for free whenever my research warrants it. By purchasing the guide, you are enabling me to continue devoting my skills to the most important issue we now face. I am genuinely grateful for your contribution. You can purchase a copy at chrismasterjohnphd.com/coronavirus PLEASE NOTE: As a result of the COVID-19 crisis and the time I am committing to staying on top of relevant research, as well as the high volume of questions I receive, it may take me extra time to respond to questions here. For an up-to-date list of where I respond to questions most quickly, please see the contact page on chrismasterjohnphd.com.

Todays Episode 11 is valuable as it covers resources that could alter your life for the better.  Here are some on this hot topic of hearing loss:www.HearCommunication.comTBarnes@HearCommunication.com Noise discrimination and Daniel Fink's comment about second hand smoke:https://www.nytimes.com/2020/01/21/dining/restaurant-noise-level-loud.htmlhttps://www.washingtonpost.com/lifestyle/food/for-those-with-hearing-impairments-restaurant-noise-isnt-just-an-irritation-its-discrimination/2019/06/14/0223d722-8def-11e9-adf3-f70f78c156e8_story.htmlCanadian  Nora Keenan gets tinnitus at 8 years from bathroom hand dyers. "Do bathroom hand dryers hurt kids hearing?"https://www.nytimes.com/2019/07/01/us/hand-dryers-children.html 

Thanks for tuning in to the Armor Men's Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.In this segment, Donna Lee and Dr. Yang of NAU Urology welcome special guest ER Physician Dr. Brenner, who describes the condition of hospital emergency rooms during the current epidemic of Covid-19 (also known as Coronavirus). Helpful information covered in this segment includes which symptoms to look out for, what constitutes a "low-grade" vs. "high" fever, and whether you should rush off to the ER or an urgent care facility if you only have mild symptoms (spoiler: you shouldn't). Additionally, Dr. Brenner explains under what circumstances gloves and masks are appropriate precautions to take and why you shouldn't take Advil, Naproxen, or any other NSAID pain relievers to treat your Covid-19 symptoms. NAU Urology Specialists is pleased to offer the latest treatment methods coupled with a holistic approach to men's (and women's) health and excellent providers and staff. If you have a urology and health-related question that you would like to hear answered on the air, please email your questions to armormenshealth@gmail.com. Questions are answered anonymously, unless otherwise specified, and the answers will likely benefit many people with the same concerns. If you enjoyed today's episode, don't forget to like, subscribe, and share us with a friend! As always, be well!Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.We enjoy hearing from you! Email us at armormenshealth@gmail.com and we'll answer your question in an upcoming episode!Phone: (512) 238-0762Email: Armormenshealth@gmail.comWebsite: Armormenshealth.comOur Locations:Round Rock Office970 Hester's Crossing Road Suite 101 Round Rock, TX 78681South Austin Office6501 South Congress Suite 1-103 Austin, TX 78745Lakeline Office12505 Hymeadow Drive Suite 2C Austin, TX 78750Dripping Springs Office170 Benney Lane Suite 202 Dripping Springs, TX 78620Episode is LivePublished: Mar. 21, 2020 @ 2PM EditUnpublishAmplify this EpisodeAdd Chapter MarkersTranscription AvailableView/Edit TranscriptLast updated 3 days ago.Update now or delete this transcriptPromote this EpisodeCreate a Video SoundbiteShare on FacebookShare on TwitterShare on LinkedInEmail Link to EpisodeDirect Link to MP3Embed this ONE EpisodeView Episode Stats

Today I'm here with Alex Tarnava, CEO of Drink HRW. After a lifetime of being active, Alex found out that he'd developed osteoarthritis while still in his physical prime. Unwilling to give up his way of life, he dosed himself regularly with Naproxen to counter the pain and discomfort he lived with every day. Over time, the drug’s effects lessened while the gastro-intestinal side-effects increased. Searching for alternatives, Alex scoured the internet medical sites looking for emerging treatments that would help, reading hundreds of published articles in the process. This was where he discovered the potential of molecular hydrogen. Listen to find out the effects that Hydrogen Water had on his life.

As many as 18% of women with menstrual cramps get minimal to no relief from NSAIDs (ie Advil, Naproxen)

Let's talk about Endometriosis... On this week's episode of the Lunch and Learn with Dr. Berry we have Dr. Anila Ricks-Cord, a wife, mother of 3 hilarious children and a board-certified obstetrician-gynecologist. She is a motivational speaker, a 2-time bestselling author of The New Laws of Mommyhood & Marriage: From A New School Mom With An Old School Hustle and the co-author of The Making of a Medical Mogul. She is a media personality whose passion is to encourage women to address their health care concerns and fears, giving them a voice and empowering their best lives, mind, body, and spirit. This week she is on the show to talk about endometriosis, a disease that affects 11% of women, can responsible for painful menstrual cycles and even infertility. Listen to how Dr. Ricks-Cord has to deal with this problem in her current practice. Text LUNCHLEARNPOD to 44222 to join the mailing list. Remember to subscribe to the podcast and share the episode with a friend or family member. Listen on Apple Podcast, Google Play, Stitcher, Soundcloud, iHeartRadio, Spotify Sponsors: Lunch and Learn Community Online Store (code Empower10) Pierre Medical Consulting (If you are looking to expand your social reach and make your process automated then Pierre Medical Consulting is for you) Dr. Pierre's Resources – These are some of the tools I use to become successful using social media My Amazon Store – Check out all of the book recommendations you heard in the episode Links/Resources: Facebook Instagram Twitter Social Links: Join the lunch and learn community – https://www.drberrypierre.com/joinlunchlearnpod Follow the podcast on Facebook – http://www.facebook.com/lunchlearnpod Follow the podcast on twitter – http://www.twitter.com/lunchlearnpod – use the hashtag #LunchLearnPod if you have any questions, comments or requests for the podcast For More Episodes of the Lunch and Learn with Dr. Berry Podcasts https://www.drberrypierre.com/lunchlearnpodcast/ If you are looking to help the show out Leave a Five Star Review on Apple Podcast because your ratings and reviews are what is going to make this show so much better Share a screenshot of the podcast episode on all of your favorite social media outlets & tag me or add the hashtag.#lunchlearnpod Download Episode 132 Download the MP3 Audio file, listen to the episode however you like. Episode 132 Transcript... Episode 132 Transcript...  Introduction   Dr. Berry:  Welcome to another episode of the Lunch and Learn with Dr. Berry. I’m your host, Dr. Berry Pierre, your favorite Board Certified Internist. Founder of DrBerrypierre.com as well as Pierre Medical Consulting. Helping you empower yourself with better health with the number one podcast, for patient advocacy. Today I get to bring you a special guest today Dr. Anila Ricks-Cord which is a good friend of mine and an expert in women's health and what she calls vagina land. She is hilarious, first of all. But she is really an expert because you guys know I'm not the biggest women's health discussion, right? Because there was a reason why I went into medicine but so I figured. Let's bring someone on who can kind of help me, kind of grasp what is knowledge and I really kind of avoid it when I was a medical student in medical resident. So today we're gonna be talking about endometriosis which depending on when you listen to gets its entire month of awareness March is Endometriosis Awareness Month. So I figured if a disease gets a whole entire month, it has to be important. And if it has to be important let's bring an important guest on. So I just want to talk. I'm just gonna give a little bit of a bio just so you can kind of understand exactly the person we gonna talking to. First of all she’s hilariously funny. You definitely gonna enjoy today's episode. Dr. Anila Ricks-Cord is a wife, mother three hilarious children. She's a board certified obstetrician gynecologist. She's a motivational speaker. She's a two time bestselling author.  She's a media personality whose passion is to encourage women to address their health care concerns and fears giving them a voice in empowering their lives, mind, body and spirit. Can you know the theme: Empower yourself a Better Health. She currently resides in Texas where for loving spouse, three children and two lizards. She attended college at Indiana University. While there she performed research and published articles on rats in order to help curb alcohol behaviors in humans which is absolutely hilarious. She did move to Baltimore to perform research and publish articles at John Hopkins University. This time investigating acute respiratory distress random at the molecular level. She attended graduate school at Johns Hopkins and pursue a master's degree in biotechnology. She was accepted at the University of College Medicine. Experience significantly shaped how she practice medicine culminating her receipt of the Leroy Week's Award for Outstanding clinical skilled bedside manner and commitment to service.  Again, she is absolutely amazing and I get again especially from my fellows who are probably not sure this is a podcast. I listen to this is a disease process that could affect your mom, could affect your sister, it could affect your cousins. So this is something you may well listen to just be able to kind of pass it on, right? Especially if you have a female friend or spouse or a wife or a sister who has these very vague complaints and no one seems to know what's wrong with her. And then you start kind of attributing it to maybe in her head. This is a disease process that may make you think different right. So sit back for another great episode again if you have not had a chance, make sure you subscribe to the podcast. Leave a five star review for the podcast. So we are on the radar of everybody so everyone can be empowered for better health. So again thank you. Let's listen to another amazing episode this week with Dr. Dr. Anila Ricks-Cord. Episode   Dr. Berry: All right. Lunch and Learn community. So you heard that amazing intro with Dr. Anila and we're gonna, you know, really let her speak and introduce yourself to the community. And of course, you know guys, I've said this before, I am not no women's health expert. One of the reasons why I went and turned on medicine is because I kept getting kicked out of their rooms when I was a medical student, right? So I figured if we're going to be talking about women's health, especially disease course like endometriosis, right? I figure let's get the expert to talk and I'm just going to sit here and listen. So really, I'm actually going to be listening along with you guys and you know this, this expert kind of expand her knowledge on this and tell us what endometriosis in the show. But first and foremost, Dr. Anila, please again, thank you for coming to the Lunch and Learn with Dr. Berry. Dr. Anila Ricks-Cord Thank you Dr. Berry so much for allowing me to be able to be graced by your presence and share a little bit of knowledge. Dr. Berry: Just the feeling is, oh, a hundred percent mine. I've told Dr. Anila, a friend of mine and I told her, I said, I'm gonna get you on a podcast. Like you can't be given all that amazing information out to the community on Facebook and everywhere else and not give it to Lunch and Learn community. So I already, I had already pre-warn she would be on the show. Dr. Anila Ricks-Cord That’s you did, that’s you did. And I'm honored to be here. So. Dr. Berry: For those who may not know, you may not be following you, you give a little bit, you know, outside of the bio, little bit about yourself. Tell us why you do what you do and you know, kinda how you got to where you at now. Dr. Anila Ricks-Cord Sure. So I am a board certified obstetrician/gynecologist. I'm a wife of 22, going on 23 years. Praise God, Lord willing. I’m a mother of three awesome kids and I'm a two time best-selling author and a speaker. So through my books, my patient care, and my coaching programs, I encourage women to address their health care concerns and fears, giving them a voice and empowering them to live their best lives, mind, body, and spirit. So I'm originally east coast native. I'm the eldest of three children and a big science geek. I openly where their pin. I attended school in Indiana University, Purdue University at Indianapolis. And that was where I met my love and my biggest cheerleader perform research at Hopkins before having the privilege of attending Howard University College of Medicine and then completed my residency at WellSpan York, Pennsylvania. So I was inspired to practice medicine and led to become an obstetrician gynecologist secondary to the death of my mom. She was last 22 years old. She was misdiagnosed with the flu and subsequently died of Septicemia. For those who don't know what that is, it's essentially a bacterial infection in the blood, which basically causes massive organ failure and death. So this is why I do what it is I do. So. Dr. Berry: I love it. And you know, thank you for sharing that story with us because I think a lot of times people outside of in fact very, you know, full disclosure, we're actually recording this on like, you know, national doctor's Day, right? And I love this day. Because a lot of times physicians really aren't getting a lot of the fanfare and the good light that they should be getting. Right? You know, a lot of times there's a lot of misconceptions of why we became physicians. For some reason people think it's all about the money. I keep trying to tell you, trust me. (Most assuredly is not. Fannie Mae, Sallie Mae, she visits me on a regular). Can you chat and tell folks that, and it's really the love of wanting to see that next person get better. Right? And understanding that is, you know what, I wasn't there. I wasn't able to maybe make the steps I wanted to. It's like for my mom. Right? But maybe I can do for someone else. Right. And I, I'm, you know, I'm totally feeling that because I remember being a second year medical student and getting a phone call that my father was in the hospital and again, I'm a second year medical student. I didn't even know my dad had like medical problems. But you know, that's a whole another discussion. They don't, you know, patient guys don't like to talk about nothing. Right? And you know, subsequently from that he passed away and I said, you know what, there's no way that I'm not going to let people know, like, hey I only, I’m physician but I can't help you right from that day forth, I just kind of took that man once again, thank you for kind of taking your mantle and kind of really running with it. Dr. Anila Ricks-Cord It is what I was called to do. I feel like knowledge is power and my angelus says, when you know better, you do better. And my goal is to make it so that people know better so they can do better. Dr. Berry: I love it. So the topic at hand today is endometriosis. And I could tell you from a, I'll be honest, I'm an internist. I take care of patients than I used to take care of patients outpatient where I knew a little bit about it. But once I went inside the hospital, you know, my knowledge of it was very, very weak. Right? So I know that again in March where it's actually National Endometriosis Month, right? So any disease process that gets a whole month is one that I feel like the Lunch and Learn community needs  to know. Dr. Anila Ricks-Cord So I happily, I will tell you about endometriosis. So before I can tell you what it is, allowing me to describe what's normal. First told you I'm a big fan of that Geek and women who become their menstrual cycles every month. The body attempts to get itself ready for the possibility of pregnancy. So I like to describe it as your brain calls her ovaries and says, hey girl, we're trying to get pregnant this month. Under the influence of your brain. Your ovaries make estrogen and progesterone, which causes the lining of your uterus to get nice and thick and fluffy, and it causes you to ovulate. The thickness of this lining. This thing happens every single month where every month we get nice and thick and fluffy, so we actually do get pregnant. There's a nice and nourishing space for a fertilized egg to implant and grow. If you don't get pregnant, that lining dies and peels off. And that peel, that lining is actually your menstrual blood, and so if you don't get pregnant, it starts all over again. Better luck next month. Maybe it'll work out next month. Exactly. Just like we bleed out of our uteruses and out of our vaginas and owns or whatever, you know, products you used. There's also something called the theory of retrograde flow where we actually need backwards too. So if you imagine that this uterus has like this cavity on the inside, and whenever I talked about my lives, whenever I do them, I use my face as the uterus and I take my laps and I separate and pull them up to the side and said this is the fallopian tubes. You bleed backwards into the uterus are actually from the uterus into the fallopian tubes and into the pelvis. You know, this is where it's an issue and some of us, that tissue, that lining, endometrial lining, the supposed to regenerate itself every month. Some of that tissue takes residents actually in your pelvis and your abdomen and so come next cycle, the tissue does what it does and it sickens to try and make a lining where it is, but it's in the wrong place.  Yes, exactly right. Right. So you've got this out of bounds, bleeding going on, which triggers inflammation. Kind of like if you hit your elbow, you hit your knee and it swelled up. Right. Nice. And is sore. Your body responds to this perceived injury and your immune system kicks in and gets involved. And this is where scarring happens. So what is endometriosis is when you have your period in places other than in your uterus. And these endometrial cells, once they get access to your pelvis, they can then travel to other places and get access to your blood vessels and your root system and go outside your covas, to other places. So it is primarily a disease of your pelvis, but because they don't have any limitations and they don't know down, they can go other places too.  Dr. Berry: So once that I retrograde bleeding happens. There's really like, oh all fair in love and war pretty much. Dr. Anila Ricks-Cord Yes. For some of us, we all do it. Not all of us, we all have this, this retrograde flow, but not all of us have tissue that are like boundaries. I don't know things like no boundaries. And so there's a, there's a thought that there's a genetic predisposition where there's a subset of people who have tissue that decides, Oh yeah, I'm going to be a topic, I'm going to grow wherever it is I wanted to go. Maybe, maybe it's like living in a large city, you need to get to some places not so highly populated. So you decide, a lot of people live like on the pelvic. The actual prevalence of endometriosis is not exactly known. So they say that you see it in between 25 to 38% of adolescents that have chronic pelvic pain and in 10 to 15% of women that are reproductive age. And so there's a substance and we talk about this theory of retrograde flow and then there's also a thought process to or told you big baggy claim. I apologize. I put disclaimer on it. Dr. Berry: We trust. We're just, we're all here for this. I'm sitting there, I'm listening. I'm like, okay. Okay. All right. All right. Dr. Anila Ricks-Cord Cool beans. So from an embryo logic perspective, I know you remember, you don't tucked it back in the rule that dig somewhere because it doesn't serve you anymore. But those of us who are women, when we actually go about being formed in our mother's womb, we have got a fallopian tube and a uterus and another fallopian tube and a uterus. And what happens is these two halves come together to make a hole. The center hollows out. And you've got, if you're lucky, you have one normal functional cavity. There's a subset of people who have what are called Mullerian anomalies where the two little pieces and uterus don't get together where they're supposed to. It doesn't hollow out the center and become one. And so these people are also a set up for endometriosis because they have topic endometrial tissue that ends up in other places. And so about 40% of these children that have these genital check defects will have issues with individuals. As they say, 50% of women that have infertility's had endometriosis and 70% of women and adolescents that have pelvic pain actually have endometriosis. Dr. Berry: And because we don't know the true figures, do you feel like the figures maybe higher than what we're even picking up? Dr. Anila Ricks-Cord I would say so because unfortunately it takes about nine years to diagnose endometriosis because it's a disease of exclusion. And so when people present, so you have a patient that will come and see you in and they've got these vague multitude of symptoms. So like in women in grownups, people who are not adolescents and adolescents have defined 10 to 19 years old. So reproductive age women, you can have a lady that comes to see you with a complaint of pelvic pain either with her periods or with sex. And so if it's pelvic pain with her periods and call a dysmenorrhea, which is this dull crampy pelvic pain, that might start about two days before your cycle starts last. The entire length of cycle might occur a couple of days afterwards. Or if it's chronic, we're, it's been present for more than six months. It can be dull or throbbing or sharp or even in one of my patients, she has a burning sensation every month on her cycle shows up. She's got a spot in her left lower quadrant or her anterior abdominal wall where it's like a hot poker. That's how hers that she has pain all the time, but when her period's shows up, it just burns in this one little spot. So that's what cycle you're paying with your period. If you have pain with sex, you will have patients that have complaints of pain with penetration, particularly deep penetration, and so when you go see your Ob-Gyn, one of the ways that you can kind of mimic this is the thought is when you get these endometrial implants in such a personal space, you can get these. It starts off as a microscopic disease and you can get nodules or uterus has got this support system inside our pelvis is kind of like the ladies who wear bras, kind of like a bra strap. So you've got the same call, uterine staples that supported on the inside of your pelvis. You can take your fingers in a lady who has endometriosis, put them in the back part of her vagina, separate them like a peace sign and stroke and practically make her leap off the table because she has nodular implants in the back. So you can simulate this, this pain with sex when you stroke on these easier to cycles on the back issues that nodules implanted inside. Ladies who present with infertility and so infertility technically is defined is a chick, is less than 35 years old, has been trying for a year to have, has been having regular sex for a year and trying to get pregnant and hasn't. If you're over 35 is six months essentially, but they say the 30 to 50% of women who have infertility had endometriosis. If you have a lady that presents and she has an incidental finding on ultrasound which has got some pain and you do an ultrasound, she's got a mass on her ovaries, there's a particular. Endometriosis implants can actually implant anywhere inside your pelvis, on your bow, on your bladder, inside the wall of the uterus to, and I'll come back to that one. And inside the ovary you can get what it called Endometrioma where when you look at them on an ultrasound where essentially the equivalent of blood clots inside the ovary, a lady that's got an ovarian mass and is an Endometrioma, if you have a high index of suspicion that she has endometriosis, you know, also present in ladies and have bladder issues. Like if you have a feeling like when you do not have a UTI but you feel like you go into the bathroom all the time or you feel like you've got to go right now or you have pain when you go to the bathroom. That could be a sign of endometrial implants in your bladder. If you have bowel issues where you have issues with diarrhea or waxing and waning diarrhea and constipation or pain when you desiccate or colicky bow, that can be a sign of endometrial implants in your bow. There is a version of endometriosis called adenomyosis. Which is what Actually Gabrielle Union had. Heavy menstrual bleeding is is a possible sign of endometriosis and by heavy menstrual bleeding. Allow me to clarify. A regular period is supposed to be no more than 80 cc's so in simple terms in an English Dr. Berry: Talk to the men. I hear. Dr. Anila Ricks-Cord Right. I'm about to say so. A normal period is for hotel bottles of lotion. That’s 2.7 fluid ounces or it's about a third cup. That Mixing Cup that you have in the kitchen when you make us up on one third cup size, that's ATC seats. Anybody who has more than that and some of the patients that don't have had that have had heavy menstrual bleeding, they making crosses and ease and the underpants they've got multiple two, three second. I'm like mattresses. Or they're use tampons. If you can use a super plus tampon and that thing falls out in an hour or two you have heavy menstrual bleeding. For Gabrielle Union. When she was talking about her fertility struggles, what she suggested was that she was in it to her doctor with heavy menstrual bleeding. Traditionally put her on OCP is birth control pills in order to be able to regulate her flow.  She subsequently was found after having her struggles with fertility so she could, she had gone through some ivs cycles. She got pregnant a couple of, actually, she’s pregnant more than a couple of times. I think she suggested maybe nine times. She got pregnant, something along those lines, seven to nine times. But with her, she has endometriosis in the walls of her uterus. And so you've got this glandular tissue that's supposed to do right and be nice and fluffy like a comfort in the winter time for this egg that's on fertilizer on the wall. But it has a place where it's supposed to be. It's only supposed to be on the lining of the inside of the shoe is not deep with them. A muscle for people who have the endometriosis inside the wall of the uterus or the Adenomyosis. They actually have bleeding that occurs within the muscle itself. And this leads to inflammation and issues with fertilization and implantation and being able to carry a pregnancy. So again, heavy menstrual bleeding was also a sign as well as irregular menstrual bleeding. Endometriosis can also make itself manifest in the form of low back pain or chronic fatigue. This is why it's so nondescript and it takes forever to diagnose. Dr. Berry: That’s I think about. Nine years? Dr. Anila Ricks-Cord Nine years. Yeah. In adolescence, which is that group between ages 10 to 19 and there had been some documented cases of little girls who didn't have Mullerian anomalies I talked about what you just didn't come together. Right. They had the babies that have been documented to have endometriosis as young as eight and a half years old. Those little girls will have symptoms that are, that can be cyclic, like only a time with your pain and not having anything to do a period. But they can get pain that gives worsening and more severe when they actually start having periods and they can have rectal pain, they can have constipation, they can have pain with defecation when they go to the bathroom associated with their cycle. Rectal bleeding, pain with urination, and even blood in the urine or that need to go right now and so is so nondescript. You can see how a physician would run through a litany of tests before finally getting to the point where you even considered endometriosis at all. Dr. Berry: Nine year seems so long. (It is). Should it not be like more ahead of the line or do you really have to kind of rule out some big stuff first before you can say like, okay, let me let's think about endometriosis inside of them. No, cross my t's of everything else. Dr. Anila Ricks-Cord So I think that because it was a diagnosis of exclusion for the longest time to truly diagnose it, you need a tissue staff and so the thought process, (Tissue it's in the muscle. How do you get, wow, okay). Right and endometriosis, you only get, if you have a uterus of the path lab, that's how you diagnose that otherwise is I take you to the operating room. I do a diagnostic laparoscopy where I poke a hole inside your belly button, do you up the carbon dioxide, took another two holes inside your belly in order to be able to get camera inside there and some graspers to move around and look to see if I can see signs of disease. And it's not four stages to what you could have minimal disease, which is microscopic, and you don't see nothing to stage four disease where you have everything stuck like chuck on the inside. But ideally if you get to the point where you have to do laparoscopy, then you go inside and you biopsy this different parts of the pelvic sidewall underneath the uterus cycles. If it's on the ovary where ever you see there'll be, sometimes it looks chocolate, sometimes it looks white, and so any abnormalities you see you're biopsying them in order to be able to confirm the presence of disease and that's part of it. A lot of us who are conservative would want to try. I think old school thought was if you had endometriosis, let me try all these other things to make sure it's not that before I'd used last resort and take you to the operating room. (Which is operating room. When I talked to some people and say operating room, what? ). Exactly and yes, just when you think about that, if at any time you poke a hole inside anybody, anytime you performed surgery, there's a risk of it. It’s a disease thereafter and so it's a risk versus benefits kind of thing. But I think that the thought process, I think more people are becoming more aware about how much of a big deal this is. Because you think about how often do when you were seeing patients that were women, you joked that you got put out of the room all the time, that it's a comfort level that's got to exist between you and your physician and I'm sure you've seen the commercials talking about the meds and the chick the study have had endometriosis. When people don't feel comfortable talking about what's going on with their period, how much they bleed. Like you'd be surprised the number of women that have gotten Menorrhagia or heavy menstrual bleeding where they practically write their name on the floor in blood and cursing every time their period shows up and they think it's normal and they ask anybody about anything.  Dr. Berry: Wow. Have you have trouble in the past and tried to even pull that type of information out of your patients? Dr. Anila Ricks-Cord You know, I think for me I'm fortunate in that I laugh and joke with my patients and then because I have also had issues with Menorrhagia like so black people are real good at making fibroids. Sidebar, I have a fibroid. Uterus is about the size of a 12 week pregnancy. And as a consequence, I think God has got a funny sense of humor cause at the Ob-Gyn, if somebody thinks that I have experienced it, I can relate to with my patients. And having been one of those chicks that has been a Menorrhagia without, not that people want to know what my contraceptive option is, but I use a Mirena IUD in order to control my Menorrhagia. Without my Mirena IUD, I can use a super plus tampon and it falls out every two hours. And I could write my name on the floor of blood curse using a regular tampon. Using a regular tampon, about Mirena. I don’t know what that was.  And so I use humor in what are the bridge the gap in order to be able to ask those kinds of questions. So tell me about your menstrual cycle. How long does it last? What products do you use, how often do you change them? Because a large number of these people who have, who should have hemoglobin hematocrit of six. They eyeball rolling because they believe, they think that's absolutely normal. They think that's absolutely normal. And then because it's, it's your period and you're not comfortable talking about that stuff anyway. It's a don't ask, don't tell, unless you have the kind of relationship with your physician where you feel like you can talk about.  Dr. Berry: Can you talk about it and if you can't, if I want to say you can't take their relationship isn't there to talk to it with your OB, you definitely not talking to the hospitalist. Dr. Anila Ricks-Cord Of course not. If the person see it on the bottom, you can to the physician. Why talk to people that you are not close? Exactly.  Dr. Berry: Okay. All right. All right. So let's see. So you mentioned liking me and I told you I was going to get some learning today. I already let her know, oh we're going to do some learning today. Cause again this is, I'm taking those right along, which I'll be going again. I've experienced in taking care of patients with this disorder. But of course you know me, I'm referring out to the OB clinic when I, well I think is what you got. Go ahead. See my OB friends, see if that's the case. So definitely. Wow. Okay. So what about, so we talked about it. I, I hear somebody, you know, some of the signs and symptoms kind of really associated with it. Now, is there anything that these patients are doing that may have attributed to getting any endometriosis? I mean because I guess they have to have a menstrual cycle, right? So it's not all about the retrograde bleeding, but is there… Dr. Anila Ricks-Cord Well in theory, remember there are some babies eight and a half and haven't had periods that have issues with the document in endometriosis. Wow. The vast majority of us have this menstrual, heavy menstrual cycle related signs and symptoms. We were, we're cycling and we've got this retrograde flow, but you don't necessarily have to have a period. You can have these, these girls. So when you're talking about risk factors for it in the materials, as we talked again about the, the developmental conditions that predispose you to basically having your belly tampered with endometrial tissue. We talked also about the fact that there are some people who are believed to have the genetic predisposition. So if you have a first degree relative that has endometriosis and by first degree relative is either your mom or your sister or your children, if you have a first degree relative that has endometriosis, you have an increased likelihood of having it too. And there's a thought process that, and these people who have a genetic predisposition for endometriosis, there's something about the way their cells signal that they don't respect boundaries and go from one place to another. Like tutors, I'm going to the pelvic. And then there's also a thought to that if you started your period early, like 10 or less that you're an increased risk for endometriosis. And then it has unfortunately has awful side effects too. Awful side effects. Dr. Berry: Now are, those are the, especially because we would kind of lean on, they're kind of starting to period early. So of course, you know, we're talking about like kids and then obviously this is an issue that a dose deal with as well. But I'm always kind of fascinated, especially as I'm an internist, I really only see 18 and up, you know, as an OB, you know, you're seeing all kinds of ranges. Do the complications associated with it? Like are they much worse off in the child than adult or is it still kind of tight? I gets bad either way. Like we know the rectal bleeding, we know the urinated, we know all this. But like if you, if you had to I guess choose, right? Like when would you rather start dealing with these problems? Would you rather deal with it as you know, in, in the younger age or more of that old, they're 35 40? Dr. Anila Ricks-Cord Well, oh, sorry. That's interesting. Thank you for reminding me. I forgot about that. One might tell you a little sidebar about that one. So in theory with children, the thought process is again, 40 days, 40% of adolescents with general tract anomalies, 50% of them have issues with infertility and 70% of women and adolescents with pelvic pain, it's got it. But the thought is that you've got longer in, would it be repetitive or your belly with these things? And so as a child, outside of the symptoms that we discussed beforehand, okay, the issue is think about all the years particularly undiagnosed, that you've got your belly, your abdomen, and your pelvis, your bowel, your bladder being peppered by these implants inside your personal space that then may not reflect or respect boundaries. Hop a ride on your vasculature or in your lymph system and go to other places. You can actually have endometriosis implants in your chest. Dr. Berry: The chest wall? Dr. Anila Ricks-Cord Yes, you can actually, it's this thing with, with so you know, cells and how they're supposed to respect boundaries and go to confluence and owning by protein signaling. Endometriosis implants can end up inside your lungs. You can actually get a collapsed lung as a consequence of endometrial implants. You can actually have Hemolysis when you cough blood for people don't know where that is. Yes. Or you can actually have, what is the other one is there's the collapsed lung, this coughing up of blood. And there's one other, I'm gonna circle back. When you talked about the difference between adults and children from the standpoint of what it is they have, you think about you have longer to be able to develop the side effects which are infertility. And if he's a disease which distorts the tubes and the ovaries, you have inflammation which is going to cause scarring and you've got pain and so you've got a longer time in order to be able to do this. So yeah, it can give you chest pain, collapsed lung, a blood in the lungs and coughing up few months. And then also with endometriosis, which I'm a sidebar in people who don't have one, you talked about the difference between adult versus children. You can be a perfectly normal lady who went to go have a C section. And as a consequence of having a c section because the uterine lining was disrupted, you can get into endometriosis impulse anywhere along that incision line. So where when I do C section, so we, after the scan we cut that we cut through the Fascia, separate the muscles cut. So the organs are online with this peritoneum is what he's got his own thought casing. Your bladder sits on top of your uterus and there's this thing called the physical uterine peritoneum that you cut your, put some letter out of the way you cut inside the uterus, you deliver the humans, you close uterus one layer and then folded back on itself. You can get into the endometriosis implants from the opening of that uterus being out in the abdomen, in the Fascia, in the anterior abdominal wall, and in the incision site. In my residency program, we had a lady who had a complaints of pain every single time her periods showed up. And actually when we imaged her, you found what looked like a small little one meter hole and it was actually much larger when you got inside her and started dissecting out where it could be. Endometrial lining had implanted in her incision and every single time she had a period it would bleed in her anterior wall and that incision site. I had a lady who when she was a child she had, I can't remember what her particular condition was. She had some kind of condition where she ended up having anomalies with her legs. One was rotated backwards, the other was rotated in a strange way and so she ended up having to have one of an amputated and was a compromise. Actually had that, she had booked a mandated bilateral amputees and there was something going on with her belly when she had some kind of surgery or maybe there was a challenge or something that was playing. She presented with complaints of belly button pain at one point in time and on further inquiry when you talked to her, she said that she could milk her belly button around the time of her period, showed up and get a round discharge to come out. And sure enough she had endometrial implants in her belly wall were when she started cycling because she had surgery when she was a child. It was enough to disrupt stuff and literally she blown through her interior wall where there was a defect of a wall with the implants would bleed right inside there. She'd get a little know what’s inside. Another chick who came to office, same kind of thing, complaints of just barely walk. She had an endometrial coma in her anterior wall as well. And so you, you go to the treatment modalities for endometriosis cause she's got endometriosis. And then outside of what it does from a standpoint of being a child and you having all this time to pepper your belly and being able to get it being a normal chick who just had a c section or a disruption in the lining of the uterus. Now you have it causes all kinds of pregnancy complications. We causes miscarriage, increased restricts topic pregnancy. You can get bleeding during pregnancy and hemorrhage afterwards sets you up for Preeclampsia. You can have a Placenta Previa where ideally placement of the placenta is hanging from the top of the readers like a chandelier. It increases your risk for a preview where it covers the opening of your cervic for a c section, such your upper preterm labor and delivery, a c section and low birth weight babies. So it's just all unpleasant. (Oh Wow. Okay).  And the thought is that because you have got these ectopic implants, this endometrial tissue inside your pelvis within triggers an inflammatory response. As women when we get pregnant. So we have relations, the sperm travels up of vagina for the rest of, it's through our uterus, Fallopian to define the egg, fertilizes the egg, and then the Fallopian tube pulls the egg, desperate lives towards itself. And then in the tube you got these hairs, these silly or that kind of push the egg through the tube and into the wall of the uterus. It is a thought process that with people who have endometriosis, that'd be inflammatory. Mediators are chemicals and their pelvis are so high that it's toxic to sperm. And that's part of the compromise with your fertility too, that this from getting sad then go. Dr. Berry: It's just not the place for me. Right? Dr. Anila Ricks-Cord No, I can't work on these conditions. I cannot be. So, no, it's crazy. Dr. Berry: That's and I guess the question is like, especially in your stance, like how, what's the likelihood that you're going to, you know, you see a young who is complaining of a lot of these issues and say, you know what, let me let, let's open you up and see. Right? Like let's do a laparotomy, right? Like is that, does that also ate into it as well that you know maybe the surgeons aren't likely to open them up to check because of like I don't want to put a surgeon. I don't want to put a kid through that. Dr. Anila Ricks-Cord And you think about the fact that if it's a child, some of us are comfortable with adolescents, some of us are not. There is a branch of gynecology that is specific to pediatrics and so you think about asking about whether or not people are even listening to what the complaints are. How many people with a child who complains of having constipation would ever think that has endometriosis and that you just eat too much junk or you need to drink some more water. I think that there's such a vague complaints that unless the child has been complaining about them the entire time and you've done a complete workup and I can't tell you the number of times where we'd endometriosis, it comes down to the gastroenterologist and the Ob-Gyn they've been sent and would it be able to get a colonoscopy in order to be able to be assessed to see what's going on with this presumed abdominal pain that once they ruled them not that is not GI in origin. Then it becomes, well the only other thing you got left down there is your reproductive organs. So it's either your guts or your uterus, which is where the attachments to it. Dr. Berry: I'm scared, scared for you. I don't have any of those issues with it being clearly, clearly this is why the disease process like this needs whole month. Right? Because it average nine years to like that, we got to move this out, right? We got to move this up quickly. That should not be the case. I'm sorry. I'm so sorry for you. Dr. Anila Ricks-Cord I think things are getting better. Again, we used to treat it like it was a zebra and you go through everything before you, and even from the same point of you ask about what's the like of somebody performing surgery. So ideally the founder to do laparoscopic surgery, but you think about people who manage conservatively, they would put you on everything first. Exactly. Birth control down to see what exactly you would. You would go through all the other conservative options before definitively going to surgery and, and the data suggests that even if you do surgery alone and that’s it, there are people who have defended over get relief with surgery, particularly if you have adhesions where you imagine that you've got with a good example of an adhesions? Where you have an abnormal connection of one thing to another. Maybe like imagine a ribbon and not inside your uterus but still if you had a connection between your uterus and your bowel or your uterus was stuck to your anterior abdominal wall because this inflammation causes this scarring and this is music disease that take place. If you want surgery, you just… Dr. Berry: Almost like a fly trap where like it's like it's stuck to that. Dr. Anila Ricks-Cord Yes. That’s a good analogy. Yes. Minus the dead flies. Exactly. Well you have things sticking from one point to another and it causes for the people who have chronic pelvic pain and have that disease, just going to the bathroom causes them problems. If they have issues with constipation and near bowel is stuck to the anterior abdominal wall or stuck to their uterus. A contorted in some way, shape or form. Can you think about how though the bow has got this motion where kind of squeezes fecal matter from one point to another? Just being constipated is enough to cause you wicked pain. And so people who have chronic pelvic pain secondary to disease, secondary to endometriosis, have to do things to alter their lifestyle to make it so the consistency of their stool is more like saucers. So the bowel doesn't get over distended and pissed off and cause pain. Dr. Berry: Wow. So we didn't scared Lunch and Learn community enough. They want to hear now. Like all right, you scared us. We believe you. We notice issue. Please tell me how to treat it or at least prevent it, right? Because I guess that's a two part question, right? Is this a way? Again, little kids is getting even before there, you know, they're menstruating, right? Is there an actual way that you could do anything about this? And if there is like how do I treat it? Like I, I know we've mentioned a little bit about the oral contraceptives, which again, I'm an internist. I don't know none of those things.   Dr. Anila Ricks-Cord Oh that's hilarious. So I'm trying to be really, really good. But all I could hear you say…Nope, and I don't do that. So treatment options and prevention, unfortunately at this point, because we understand its mechanism of action, but we don't really understand what causes it. So because we don't really understand what causes it, we've seen the clusters of people that look like this and clusters of people that look like that, we don't know how to prevent it. And so the thought now is with treatment options, there are a couple. They thought ideally as you want to decrease your inflammation, and initially I didn't mean to scare anyone. Knowledge is power. I wouldn’t scaring anybody at all.  Dr. Berry: Lunch and Learn community knows that you know, we're going to talk about a lot of disease courses. That you know what, if you're not, if it's not taken care of, it can cause a lot of problems. Yes, yes. Yeah. Take care of the problem. If you don't know that the problem is out there. Dr. Anila Ricks-Cord This is true. You're absolutely correct. And so with treatment, so ideally, first line is nonsteroidal anti-inflammatories, Ibuprofen and Naproxen. Back in the day we used to give people for chronic pelvic pain narcotics. And unfortunately we turned them into crack heads. So ideally the goal is to stay away from opioids. You want to do what you can do to increase, decrease, I'm sorry, inflammation. That's first one. Second is you use hormones. So you either have a couple of choices. You can either use birth control for non-birth control reasons. If you're not sexually active and you just have wicked pain or you get a two for trying to decrease your pain and make it said that you don't get any unplanned babies. The thought as you can use birth control pills, you can use injectable, which would be depot, you can use the implant, which is the next one on the ring. Do you either use them continuously when you get on a method and you stay on a method or use it cyclically in order to be able to make them. Dr. Berry: And from a, you know, from a non OB, I'll even talk about the guy on the guy's perspective, right? When y'all take birth control pills, so that it bleed less? So, yeah. Dr. Anila Ricks-Cord So yes. Ok I got you. Thank you for asking. In my case, I can write my name on the floor in blood and curse if mine is definitely about, not having or bleeding less. And so earlier when we talked before about how the brain calls the ovaries and tells the ovaries, we tried to have a baby and the ovaries go about thickening of the lining of the uterus and making it so you ovulate. Your body doesn't care how the hormones are made. You can either make them or take them. Your body just wants them to be present. And so the thought with the use of birth control pills or contraception, depending on which condom use is to thin the lining of the uterus. So you don't have a nice fluffy learning for an egg to implant. And some of them that modalities actually shut your ovaries down so you don't ovulate. In this case, the goal is to be able to thin the lining of the uterus and if you're using it continuously to shut down those ovaries so that that you don't have that tissue, that's another places. It's getting nice and thick and then after it gets nice and thick, it dies and you've got all this inflammation. You're trying to stop that process. Just shut it down. Thank you very much. Where you, you're in these other locations. Yes. Where you're living, where you've traveled abroad with this issue… Dr. Berry: We trying to starve those areas off. (That is exactly right). All right. All right guys, trust me guys. I got, y'all are here. I know. This is a woman's cell phone. Trust me. Dr. Anila Ricks-Cord Yes. From the standpoint of endometriosis, the goal is to starve that estrogen sensitive tissue that sitting out in the periphery. So you can either use hormones in the form of birth control or they're another batch of medicines you can use called GNRH agonist. I'm not going to have moment over this cause this term too much. But old school, there was a medicine called Lupron, which was a shot that you could get. New school, is this the one that you've seen on TV called Orilissa. They're both GRNH agonist and what they do is they cause the equivalent of a medical menopause. They shut you down, allow the implants to starve and die. But they can only be used short term, like the Orilissa. Depending on what your symptoms off, you can only use a six months to 24 months. And the same with Lupron because there's some side effects that go with it because it puts you into a medical menopause. It can actually decrease your bone mineral density and make it like a little old lady. The snap. Exactly. So those are treatments and if you do hormones that thought as if you do hormones, you do insets to so hormones and insets. And the goal was if you use the hormones when the same one of the contraception, the goal is to trick your body into this sort of false pregnancy state. Shut down your ovaries and make the implants die or go into a coma and decrease that inflammation. The next option would be surgery. Like we talked about laparoscopic. Laparoscopic surgery where you fill the belly up with carbon dioxide, drop the camera on the inside, put in some graspers in order to move things around. See if you can find some tissue to biopsy to confirm the diagnosis. If there adhesions, you disconnect those adhesions. And then if there are lesions that you can see, you do what's called ablation, you literally go and you burn these adhesions on the inside of the belly. Now, the lovely thing about surgery, but the bad thing about surgery is that anytime you have surgery, God makes all of our organs have their own organ case to them. Even your belly, it's got aligning cause like the inside of your mouth, anytime you pop inside somebody's belly, you risk the possibility of causing them adhesions as a consequence of the surgery. And if the surgery alone… Dr. Berry: With a c section? Dr. Anila Ricks-Cord Yes. Well, the endometriosis actually tracks. So all of these layers that you put together, it actually tracks into all of these. So imagine anywhere your nice touch, your skin fat Fascia, peritoneum, the endometrial cells can be in any of that line. From the inside of the uterus all the way out from the incision site in the uterus to the peritoneum, to the Fascia and the muscle wall in the back, all the way through in the skin itself, all the way through. And the lady I was talking about in residency, she had a tiny little lesion in her skin. But when you went to go dissect this thing out, it was huge. And it was in her Fascia. So it was like a mountain top. You just saw the top of the mountain. And when he got up on the news, right, you saw the rest of this mountain down inside, they were like icebergs. Now that…so. Dr. Berry: I'm not gonna lie, I might not wish endometriosis as my enemy. That's what I'm hearing. Dr. Anila Ricks-Cord It’s not a pretty thing to have at all. And the problem with surgery is that if you just do surgery here within a year, you've got symptoms that returned. Yeah, definitive treatment for endometriosis once you have done having your baby. So ideally for ladies who are reproductive age, the goal is to shut you down so you're ready to get pregnant, you get pregnant, then we shut it back down again. And then when you're done, depending on the severity of your disease process, some people respond well to hormones, some people don't. And definitive treatment for endometriosis is removing your uterus, tubes and ovaries being without hormone for a period of time to allow the implants to die off. And then restarting the hormones afterwards because you really need to be on hormones. Still menopause up in this country and average age is 52 otherwise you look like a man about to blood vessels and you snap crackle, pop in, all kinds of stuff. So outside of that, there's a thought process that there are some alternative medicine options that may or may not work. Now traditional data says it doesn't work. But you have to bear in mind that we are unique individuals. We have bio individuality. And so what works for one person may not work for somebody else but may work for the person that's using it. So this on is that acupuncture, herbal remedies and homeopathic May. I worked for some people outside of that. From the standpoint of you asked if there's anything you can do to prevent it. No. The thought process is to try and make yourself as healthy as you can be and to have coping mechanisms for the pain. So exercise. Dr. Berry: Health wise, you're talking about food or? Dr. Anila Ricks-Cord Right. We talking about food. We talking about balanced diet with very little processed food in it. We thought, I'm like getting enough sleep because you feel yourself when you sleep at night. We're talking about exercise and what it be able to decrease inflammation and meditation in order to be able to help cope with the pain. There's also in the DDA goes a suggestion to they're people who have endometriosis are deficient in vitamin D and so when we talk about how this tissue response and how we can say, Oh, you have to say the curb, but I'm going to go outside the boundaries and do other stuff. And these people who have endometriosis and are found to have vitamin D deficiencies. Folks believe this supplementation of vitamin D you might make a difference in any woman who is of reproductive age needs 800 international units of vitamin D a Day. Anyway, some of US Brown people don't spend a whole lot of time in the sun and don't generate the vitamin D and I'll give you an example. A lot of people who drink milk, they get milk and eat cheese. Drink milk and eat cheese. They get all the calcium and vitamins they need, I don't drink milk because I'm lactose intolerant. The last time I had my labs on, I'll tell you my vitamin D level with 17.  I'm the surprised Dr. Berry laughing at me. Normal is considered to be normal to be 30 and in Vagina land as the OB Gyn. We lasted to be around 6. And so vitamin comes supplement outside of of finding that people who have endometriosis are deficient in vitamin D. There's also a thought process that vitamin D and depression have a role with deficiencies in vitamin D and colon cancer. There are deficiencies in vitamin D, so just bone up on your vitamin D. Dr. Berry: Get your Vitamin D. Right. Like I say that again. I kind of scoffed at first. I was like, what is this little thing had his own month? This ain't heart disease. This ain't, you know, verbally like, okay, all right. Dr. Anila Ricks-Cord It affects quality of life. Talked about seriousness of disease. The reality is the endometriosis isn't going to kill anybody at all. There's a thought process that when I talked earlier about the ovarian masses that you can get the Endometriomas. The endometrial tissue that invades into the ovary and obviously takes residents can actually give you so with ladies who held a Sidebar, I'm making a correlation. I apologize, I coming back. For the Ovarian Syndrome who don't have regular menstrual cycles are at increased risk range and mutual cancer because at lining become can become atypical and find it. That same kind of thing can happen in the ovary where the endometrial tissue that is implanted in the ovary this now cause this chocolate fiscal of blood, which is the endometriomas. He can take on abnormal qualities just like the lining of the uterus when it is a typical he ladies are at PCOS.  They haven't found words actually become for lung cancer, but it has the capability to change cause it's inter-mutual tissue crazy stuff. Right. The bad thing about endometriosis is, like I said, if you, if you have it, it's everything. Unfortunately it can cause infertility. It can dictate whether or not you can move your house and function without pain. The patients that I have had that have had chronic pelvic pain secondary to endometriosis sometimes have to be selective about the kind of jobs that they take. Because if you have a pain syndrome that's present, say 21 days out of the month where you might have eight had a 10 pound most days. But maybe you get a break in on some other days, you've got five out of 10 pain interferes with your ability to be able to live. If you can’t get up to bed and get functioning because your belly is his feels like his demonically possessed and it's telling you all kinds of things from a pain standpoint and you can't function.  Pain was, and how can you hold a decent job? There are people who, because they have issues with endometriosis and the pelvic pain is exacerbated when they have relations. If you are single and not all of you in an intimate relationship, you have a difficulty with engaging in relationships and if you're married, it can interfere with your ability to be able to have an intimate relationship with your spouse. And then that over time leads to depression because is a chronic pain syndrome. Intimacy is a huge part of having relations or we're having a relationship and imagine not being able to be intimately associated with the person that you've vowed to spend the rest of your life with because it hurts so bad you can't stand it, but it's like having a nails in the back of your personal space and so you'd much rather that than have an intimate relationship. Dr. Berry: Wow. Okay. All right. You and Endometriosis. Before we let you go. Right. I got a couple more questions are, you know, but more on a, on a lighter note, right. Because endometriosis is scary. Again, I might have to tell my residents like hey, that patient who comes in for this vague abdominal pain. We might've needed to move it up a couple notches on the differential. Now can you talk about how what you do can help women take just take better control? Not necessarily just for this show, but it's just in general. Right? And this is a question I like to ask. I just want to, and I want to kind of get my guesses thoughts on like what do they do to help people empower, especially in your world, women empower themselves for better health.  Dr. Anila Ricks-Cord Sure. So what I like to do with all of my encounters be an individually as a patient, either in the hospital or in coaching or when I was in private practice in private practice is I encouraged them to be their own healthcare advocate. When you're looking for a physician, the purpose is to find somebody that you can partner with, with the ultimate goal of optimizing your health. Medicine is no different than customer service. It actually is like customer services for women. For those of us who like to drop some coins every now and then in places like say Nordstrom. Nordstrom is pricey as all get out, but the one thing that you can bank on with Nordstrom is they have customer service on luck. You know, they're rumored to have taken back a tire from somebody who said that they bought it there even though they don't feel tight. Medicine is no different than that. If you don't have a relationship with someone who listens to you and is genuinely vested in you being successful, you being healthy and your money someplace else, this also puts the onus of your health care on you. So I think when I think about my patients and they come and they talk to me, they say that nobody has listened to them and I think that's crucial. I think that you have to bear in mind that however old you are, you have had that body and know how that body works for however many years God has allowed you to live on the face of the earth.  Dr. Berry: No one gonna knows better than you. Dr. Anila Ricks-Cord Right. You are your own healthcare advocate. You got this on lock. If you go see somebody and you were trying to talk to them about what you're experiencing and then listen to what it is you say, go ahead and pick up and walk right on out the door and take you off your money and your insurance card with you. Because you wouldn't take bad customer service at a restaurant. You wouldn't take bad customer service in a product that you purchased. (Nope). So why would you take it with your health care, which is more important and lasting than product you going to buy, meal that you eat and pass on through it. Dr. Berry: Please tell Lunch and Learn how can they find you? Right? Because I know some people are probably energized right now. You know, and I kind of alluded to your Facebook, like give them all the ditails because I need people to be able to kind of track you. Dr. Anila Ricks-Cord Sure. On the sly, I'm a firm believer that food is medicine that tells the body what to do. And so I have invested in becoming a health coach. So in addition to being an Ob-Gyn, I'm a health coach. And with that said, I love answering questions that Dr. Berry's alluded to. So on Wednesday evening, 7:00 PM CST cause I'm in Texas, I do Facebook live on women's health topics and you can find me across all social media At D R A N I L A O B Gyn, that’s Doctor Anila OB Gyn. You can also find more information on my website, which is also www.drnilaobgyn.com. That's D R A N I L A O B G Y N.com. And if you tune into any of my lodge will find that I love answering questions. I think that as I alluded to earlier, my mom died because there was nobody there to advocate for her. And at 22 years old I didn't know the questions to ask. My goal as a health provider is to make it so that you know what I know. So your arm to take better care of yourself. Dr. Berry: I love it. Absolutely love it. And of course Lunch and Learn community, like always, if you're running out, you're in the car, you're driving, wherever you doing, you don't have to worry. All the, all of her information will be in the show notes. So you we will make sure and, and you really just got to watch one of her Facebook lives because she gets very animated, right? Like she really make like, okay, yeah, this one was health really is, that's why I say that, you know, you're going to be on my show because I need someone animated to educate me. A women's health to really educate y'all. So again, she is always, which she seems to be when you listen to her and you could just tell the love that's there. I like that and have everything right. You could just tell the love that is there to educate, to help you. Right? Get to where you need to be. And that's what I love about her. Right. She's absolutely amazing. Again, we're going to make sure she will be a repeat regular on this show, especially again at ya'll. Y'all ask me a lot about women's health stuff and I'd be like, I'd be like, hey they, and this, I know what I know and I know that I don't know. Once I realized I know what I don't know. That's when I get the console. Dr. Anila Ricks-Cord It has been my privilege and it would most assuredly be my pleasure for wherever it is you'd like for me to talk about from vagina land cause I have it on low. Dr. Berry: All right. Again, I appreciate everything that you do for your community. Appreciate everything you do for just the world and allowing you to take your amazing talents outside of the clinic and outside of the one on one and being able to talk to the master. So again, thank you Dr. Anila for coming on the show this week. Dr. Anila Ricks-Cord Thank you so very much Dr. Berry. I appreciate it.

On this episode, Mark and Dr. Gladden welcome Alex Tarnava, CEO at NMW and Drink HRW, to chat about a myriad of topics pertaining to health and longevity.   They start off by discussing the trend of diets that mimic fasting and what outcome they have on our health. Because fasting “resets” our bodies, it has been shown to have great effect in aiding such things as DNA repair, gut health, and autophagy. Alex gives insight into the correlation between fasting and cancer treatments. He explains how fasting leads to a lack of sugar in the body, which can actually weaken cancer cells, making chemotherapy and other treatments more effective at targeting cancerous cells.  Next, the group moves on to discussing molecular hydrogen and the incredible studies that are gaining popularity and notoriety. Molecular hydrogen can help to mitigate the biggest contributors to aging, which is making it appealing to those striving for longevity. It has also been shown to reduce liver fat and improve conditions associated with mitochondrial impairments, diabetes, and metabolic issues.  The uses of hydrogen are becoming so renowned that even athletes have begun to utilize it to help their bodies respond better to exercise and increase their overall energy.  Special Guest Alex Tarnava Alex has a passion for health, fitness, learning and self-improvement. After a lifetime of sports activity, he was shocked to find he’d developed osteoarthritis while still in his physical prime. Unwilling to give up his way of life, he dosed himself regularly with Naproxen to counter the pain and discomfort he lived with every day. Over time, the drug’s effects lessened while the gastro-intestinal side-effects increased. Searching for alternatives, Alex scoured medical journals looking for emerging treatments that would help, reading hundreds of published articles in the process. This was where he happened upon the potential of molecular hydrogen. Skeptical at first, the more he read the more interested he became in its potential. Motivated by pain and the hope he garnered from his research, he began to experiment with ways of replicating the dosage levels being used successfully across the scientific community. After a time, he realized he needed real expertise and sought out Dr. Richard Holland’s counsel. After a thrilling ride through discovery, multiple experimentation, and finally success, Drink HRW open cup hydrogen tablets were finally ready for the public. Alex remains committed to bringing relief through Rejuvenation and several other planned products to not just other sufferers, but anyone interested in preventative health and longevity. Together, his team wants to ensure that everyone has the chance to experience the tremendous benefits of daily use of molecular hydrogen in a safe and effective manner.  To learn more about Alex and his work with molecular hydrogen, click here: https://drinkhrw.com/

I AM CURIOUS AT TIMES AS TO WHY THE FDA HAS ALLOWED VARIOUS MEDICATIONS TO BE AVAILABLE OVER THE COUNTER..THE LONGER THEY ARE OUT THERE AND BEING USED BY SO  MANY PEOPLE, THE MORE POTENTIAL SIDE EFFECTS WE ARE SEEING. NOW NSAIDS LINKED TO WORSENING OF HEART AND KIDNEY ISSUES IN A BIG WAY. SO WHAT CAN ONE USE?  TUNE IN FOR DETAILS. Tune in every day to hear Dr. Len Brancewicz of The Nutrition Shoppe discuss today's hottest health topics and news from a complimentary perspective.  From colds to cancer and everything in between, Dr. Len can offer honest advice that makes sense. As a Registered Pharmacist (RPh), Certified Clinical Nutritionist (CCN), Doctor of Naturopathic Medicine (NMD), and a homeopath, Dr. Len has over 35 years experience in helping to keep you and your family healthy and happy. Call the show today to ask about your most pressing health concerns! Visit us on the web at www.TheNutritionShoppe.net or call  678-228-8900    to set up a personalized consultation, shop products, or ask questions! ---- Tags: health, natural health, supplements, vitamins, prescriptions, medications, pharmacist, naturopath,

Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I’m looking forward to sharing with you some of our community’s questions that have come in over the past few weeks… Let’s get started!   Gretchen: Hi Dr Cabral, Can you tell me if the ionic foot bath helps to detox? I hear controversy whether it is actually removing toxins or not. Thank you! Anonymous: Hi Dr. Cabral, I’m a massage therapist and I believe that I’ve picked up a skin fungus from one of my clients via contact dermatitis. I have eczema on my hands and when it flares up, I can go into scratch mode w/o thinking about it. Because of this, I probably had small open sores on my hands that I couldn’t see which, I’m sure, contributed to making me susceptible to any skin pathologies. What do you suggest as a cure for skin fungus? I’ve been using OTC creams like Lamisil and Lotrimin for coming up on a month now and while the bumps, oozing and itchiness have subsided a great deal, there are still a few stubborn spots. I’ve also started drinking sarsaparilla in the form of a tea to also target the fungus internally since I read that sarsaparilla is a detoxifier. Any help you can give would be greatly appreciated! Thanks very much! Casey: Hi Stephen, massive fan of your podcast I tell everyone about them here in Australia. Could you do a podcast on placenta encapsulation or eating your placenta & your thoughts on it. Iv heard very mixed reviews. Kathleen: Hello, I’ve recently heard about you from listening to the Melissa Ambrosini podcast. Since having my child 18months ago I’ve suffered chronic inflammation, pain in my joints, depression, low mood, etc. My inflammation markers were so high that my gp arranged for me to go to hospital for an appointment with a Rhuematologist. After various blood tests for arthritis, lupus, etc they all came back negative. The rheumatologist couldn’t tell me what was causing the inflammation but prescribed me the following; Naproxen, Plaquenil, Sulfasalazine & now recently Methoblastin. They told me I need to take these to reduce the inflammation so my joints don’t go deformed. All of these meds are immunosuppressants. Having a small child who attends day care I am constantly sick & rundown. Two weeks ago I had to have two iron infusions (ferrinject) as I had anemia. I would love to stop taking these medications and heal by body naturally. I’m in Australia, & I’m unsure which test I need? If you can please recommend the right one for me that would be wonderful. Thank you for your time. Regards Kathleen. Ps. I’m 35, 4-5 years ago I was competing in triathlons, now I can’t even run. Eliana: Hi, I would love to hear what you think of tanning beds! I’ve heard most doctors say it leads to skin cancer and others say it’s actually beneficial once a week for a short length of time. Also, are berries better to have after a workout because of antioxidants cleaning up free radicals, or are the benefits just as good if eaten before the workout? Mary: Hi, I would like to find out more about the upcoming program to become a "coach" or "integrative practitioner," unsure if I'm identifying it correctly. Can you please direct me as to where to learn more? Currently, I am an RN, Certified Diabetic Educator and Credentialed School Nurse. I also have my own personal journey towards wellness and would love to learn more. thank you!! Maureen: Hi there, I am a listener of the podcast and I am eager to hopefully work with you in the future and have been doing a lot of research. I have a ton of health issues that have been going on for a little over two years and still haven't solved anything. However, I live in NYC - and I keep seeing the messages that lab sales are prohibited to those that live in NY state. My question is - why is this and is there anything I can do about it? I can't accept that because I live in NY I won't be able to get the tests I need to heal myself - is there any way I can work around this or figure this out? Have you worked with anyone from NY before? Thank you in advance! Maureen Valerie: Hi goodmorning, so I'm 21 and have been trying to lose body fat (not weight) for a bit over 3 years now. Iv done trial and error both in food and exercise. I got my RMR studied at a local university using the oxygen mask and have been eating at that deficit for months now. I weigh my food on a digital food scale and log it into the calorie counting app and pay attention to my macros. I eat healthy and I havnt seen any progress instead iv seen weight gain which has been through higher fat. I got my blood work done it came back normal my GP said I should do more exams such as hair tissue exams and such but 1) idk where to take it and 2) ur packets are expensive for me to get so I need ur help through advice please iv gone around and asked everyone Antony: Hi Dr. Cabral! Question about Accutane (Isotretinoin) Thank you so much for your message at the end chapters of Rainbarrel effect. It's made a profound difference in my life. What are your thoughts on detoxifying Accutane? I took it 5 years ago when I was 18, on a high 80mg dose everyday from an unaware dermatologist. It has wrecked my eyes and caused burning dry eyes with severe meibomian gland dysfunction and gland atrophy. I am able to cope by taking high dose Omega 3's thanks to a PubMed study I found myself. I'm not sure if the glands will regenerate (conventional opthamologists says no) but I have other health issues as well after taking Accutane. Accutane also caused me my first depressive episode and panic attack. I've since had generalized anxiety since then, fatigue, and brain fog, which I still experience to this day. Besides working on the liver with coffee enemas, broccoli sprouts, and beet juices, do you have any targeted detoxifying modality for fat soluble pharmaceuticals like Accutane (Assuming it is stored)? I've taken it for 5 months in the past at incredible high doses. I've heard of the niacin sauna potentially eliminating any 'stored' fat-soluble Accutane. What are your thoughts Dr. Cabral? Please keep doing what you do :) Thank you for tuning into this weekend’s Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right! - - - Specific Show Notes & Resources: http://StephenCabral.com/1038 - - - Dr. Cabral's New Book, The Rain Barrel Effect https://amzn.to/2H0W7Ge - - - Join the Community & Get Your Questions Answered: http://CabralSupportGroup.com - - -   Dr. Cabral’s Most Popular Supplements: > “The Dr. Cabral Daily Protocol” (This is what Dr. Cabral does every day!) - - - > Dr. Cabral Detox  (The fastest way to get well, lose weight, and feel great!) - - - > Daily Nutritional Support Shake  (#1 “All-in-One recommendation in my practice) - - - > Daily Fruit & Vegetables Blend  (22 organic fruit & vegetables “greens powder”) - - - > CBD Oil  (Full-spectrum, 3rd part-tested & organically grown) - - - > Candida/Bacterial Overgrowth, Leaky Gut, Parasite & Speciality Supplement Packages - - - > See All Supplements: https://equilibriumnutrition.com/collections/supplements  - - -   Dr. Cabral’s Most Popular At-Home Lab Tests: > Hair Tissue Mineral Analysis (Test for mineral imbalances & heavy metal toxicity) - - - > Organic Acids Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Thyroid + Adrenal + Hormone Test  (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Adrenal + Hormone Test (Run your adrenal & hormone levels) - - - > Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Omega-3 Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - > Stool Test (Use this test to uncover any bacterial, h. Pylori, or parasite overgrowth) - - - > Genetic Test (Use the #1 lab test to unlocking your DNA and what it means in terms of wellness, weight loss & anti-aging) - - - > Dr. Cabral’s “Big 5” Lab Tests (This package includes the 5 labs Dr. Cabral recommends all people run in his private practice) - - - > View all Functional Medicine lab tests (View all Functional Medicine lab tests you can do right at home for you and your family!)

Commentary by Dr. Valentin Fuster

Opiates vs nonopiates for chronic arthritic pain, TXA for epistaxis in patients taking antiplatelet drugs, clinical bundles to reduce hypoxia in prehospital intubation, peripheral catheters in the ED (really needed?), flecainide for chemical cardioversion of AF, HEMS for head trauma patients, treatment of Cannabinoid hyperemesis syndrome, ACEI induced visceral angioedema, Prehospital EtCO2 and mortality, detecting critical illness in drunk patients, Opioid prescribing in the ED, Naproxen with or without muscle relaxants for acute low back pain, reviews of TIA and sudden onset headache evaluation and management in the ED.

The post Naproxen (Aleve) Nursing Pharmacology Considerations appeared first on NURSING.com.

In this episode with Lor you'll learn: - The dangers of long term antibiotic use - How early bad eating habits triggered psoriasis - The shocking side effects prednisone can cause - How reactions to NSAID's like Naproxen can occur - Challenges of Plaquenil, Sulfasalazine and Methotrexate - How Cimzia had to be stopped due to it's side effects NOW: No more psoriasis, RA a fraction of it's previous self, drug free  

This week we discuss a bit about back pain and specifically, lumbar radiculopathy with a focus on causes and red flags. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_83_0_Final_Cut.m4a Download One Comment Tags: Back Pain, Low Back Pain, Musculoskeletal, Steroids Show Notes Read More St. Emlyn's: Back to Basics: Back Pain in the ED Edlow JA. Managing nontraumatic acute back pain. Ann Emerg Med 2015; 66: 148-53. PMID: 25578887 Goldberg H et al. Oral steroids for acute radiculopathy due to a herniated lumbar disk: a randomized clinical trial. JAMA 2015; 313 (19): 1915-23. PMID: 25988461 Friedman BW et al. Naproxen with cyclobenzaprine, oxycodone/acetaminophen, or placebo for treating acute low back pain: a randomized clinical trial. JAMA 2015; 314 (15): 1572-80. PMID: 26501533 Read More

This week we discuss a bit about back pain and specifically, lumbar radiculopathy with a focus on causes and red flags. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_83_0_Final_Cut.m4a Download One Comment Tags: Back Pain, Low Back Pain, Musculoskeletal, Steroids Show Notes Read More St. Emlyn’s: Back to Basics: Back Pain in the ED Edlow JA. Managing nontraumatic acute back pain. Ann Emerg Med 2015; 66: 148-53. PMID: 25578887 Goldberg H et al. Oral steroids for acute radiculopathy due to a herniated lumbar disk: a randomized clinical trial. JAMA 2015; 313 (19): 1915-23. PMID: 25988461 Friedman BW et al. Naproxen with cyclobenzaprine, oxycodone/acetaminophen, or placebo for treating acute low back pain: a randomized clinical trial. JAMA 2015; 314 (15): 1572-80. PMID: 26501533 Read More

On this week's News & Views we cover: NSAIDs like Ibuprofen, Celebrex, and Naproxen; new research that suggests high HDL is not heart protective; and how worrying about health can actually affect your health. The food for thought continues in the Moment of Paleo segment, which explores the things we cannot do when we must do them. After the Bell features a talk by Alan Watts on the topic of Double Binds. Links for this episode:Why & How to Support Latest in PaleoRecommended Food & Other ProductsRecommended Books & Audio BooksComment on this Episode or Share a News LinkCardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis — NEJMCelebrex arthritis drug just as safe as NSAIDs for pain relief, with fewer side effects, study finds - CBS NewsSurprise! Arthritis Drug Celebrex Shown As Safe As Ibuprofen And NaproxenIbuprofen May Not Be As Safe As You Think | TIMENew Study Reveals Ibuprofen and Naproxen Health RisksHigh-Density Lipoprotein Cholesterol and Cause-Specific Mortality in Individuals Without Previous Cardiovascular Conditions: The CANHEART Study | Journal of the American College of Cardiology | American College of Cardiology FoundationDoes 'Good' Cholesterol Matter in Heart Disease Risk?: MedlinePlus Health NewsWhat you need to know about "good" HDL cholesterol - CBS NewsLow levels of HDL (the “good” cholesterol) appear connected to many health risks, not just heart disease - Harvard Health Blog - Harvard Health PublicationsBombshell health study: Raising HDL "good" cholesterol does not help prevent heart disease | Genetic Literacy ProjectHealth anxiety and risk of ischaemic heart disease: a prospective cohort study linking the Hordaland Health Study (HUSK) with the Cardiovascular Diseases in Norway (CVDNOR) project -- Berge et al. 6 (11) -- BMJ OpenWorrying about health increases heart disease risk - Medical News TodayCan worrying about your health make you ill? | Life and style | The GuardianWorried sick? Stressing that you'll get an illness can make you sick, study says - NBC NewsAlan Watts: The Double Bind - YouTubeVisit PuraKai to shop for eco-friendly clothing and stand-up paddle boards. Be sure to use coupon code "latest in paleo" for 15% off all clothing purchases.

Kyla Ross by Christy Linder Dr. Caroline Just (00:01:15) She studied psychology and neuroscience in university, and then went to medical school at McMaster University. She is currently in the middle of her training as a neurology resident physician in London, Ontario, Canada. She has an interest in preventative medicine and public health awareness. She talked to us about concussions in gymnastics: Euphemisms for concussions from "rocked," "shaken up," "bell rung," "loopy" to "seeing stars." Second Impact Syndrome Blain Wilson's 2004 Olympic fall and all of the euphemisms that were used to describe his traumatic brain injury. Best Practices for for coaches, parents and teammates: ANY head injury during practice or a meet should be investigated with a concussion checklist, because if you keep going without it, the second concussion could make things much worse.  Print out a checklist and put it on the wall of the gym or download the Heads Up App Take Tylenol not aspirin, Ibuprofen, Advil, Motrin, Naproxen or Aleve. Most concussions resolve within two weeks, but if you don’t go through the appropriate steps, waiting to be symptom-free for 24 hours before you advance stages, you risk not healing properly, which increases risk of long-term neurocognitive symptoms Go see a doctor if you are worried! It’s pretty unlikely that the doctor will tell you to quit, or to take a long break.  Doctors are required, in most states and provinces, to inform authorities if the welfare of a child is in danger, including by coaches. If you think a coach is negligent – don’t be silent. Get parents involved, get head coaches involved, get athletic directors involved. The right people will take this very seriously. Gymnasts are tough. They are used to focusing on the goal and working through the pain. However, sometimes the toughest thing is to do what is right for your health, or your friend’s health. It’s better to miss the meet than miss the season, or miss out on your life.   In the news, Uncle Tim, Spencer, and Jessica chat about: Gymternet News (23:37): Is it a surprise that Kyla Ross has retired from elite? Bryestians finally hired some bar coaches! Olympic Champion Alexi Nemov was in a street fight in Russia Shawn Johnson is writing a young adult novel International assignments from camp!  Trinidad & Tobago gymnasts are being slut shamed by an anonymous complainer and their own federation.  Is the Under Armour commercial amazing, exploitative or just a missed opportunity to showcase the diversity of US gymnasts.  Rio Test Event news and the Zika virus, shouldn't everyone be warned, not just pregnant women?  Meet News (1:04:43): Baku World Cup: our thoughts on Flavia's beam and new floor routine.  Winter Cup: Why do they have this meet and do Kenzo and Kohei just watch the live stream and laugh?  Storylines to watch at this weekends American Cup! NCAA Roundup (1:33:46)  with Spencer including Nicki Shaprio's "play it off" moment and Nikki Guerrero's excellent save on beam    USA Gymnastics University has concussion materials here as well as a list of concussion safety laws. Help us pay out bills!  Join Club Gym Nerd here. Buy one of our awesome shirts here. T-shirt Design Contest Winners: Winner #1 FlipFlyTumble  for  "The Princess"  Winner #2 Romina Castellini  for "Bilingual" Return to Gymnastics Following Concussion (International Journal of Sports Physical Therapy, Vol 9, No.2, April 2014, Pg. 242)   187: McKayla Maroney 186: Amanda Borden 185: 2008 Olympic All-Around Finals (Commissioned) 148: Shannon Miller 63: Doctor Larry Nassar    

In today's VETgirl online veterinary CE podcast, we review Herring et al's recent publication in Journal of Veterinary Emergency Critical Care called "Intravenous lipid emulsion therapy in three cases of canine naproxen overdose." Naproxen, an OTC or prescription human NSAID, has a narrow margin of safety in dogs and cats. As little as 5 mg/kg can result in gastrointestinal distress (e.g., vomiting, diarrhea, etc.) while doses > 10-25 mg/kg can result in acute kidney injury (AKI). Doses > 50 mg/kg can result in central nervous system signs (e.g., tremors, coma, etc.).

In today's VETgirl online veterinary CE podcast, we review Herring et al's recent publication in Journal of Veterinary Emergency Critical Care called "Intravenous lipid emulsion therapy in three cases of canine naproxen overdose." Naproxen, an OTC or prescription human NSAID, has a narrow margin of safety in dogs and cats. As little as 5 mg/kg can result in gastrointestinal distress (e.g., vomiting, diarrhea, etc.) while doses > 10-25 mg/kg can result in acute kidney injury (AKI). Doses > 50 mg/kg can result in central nervous system signs (e.g., tremors, coma, etc.).

Today in FirstWord:

Colin Baigent discusses the vascular and gastric effects of long-term use of high-dose non-steroidal anti-inflammatory drugs.

Definition of PAINa : a state of physical, emotional, or mental lack of well-being or physical, emotional, or mental uneasiness that ranges from mild discomfort or dull distress to acute often unbearable agony, may be generalized or localized, and is the consequence of being injured or hurt physically or mentally or of some derangement of or lack of equilibrium in the physical or mental functions (as through disease), and that usually produces a reaction of wanting to avoid, escape, or destroy the causative factor and its effects  b : a basic bodily sensation that is induced by a noxious stimulus, is received by naked nerve endings, is characterized by physical discomfort (as pricking, throbbing, or aching), and typically leads to evasive action  Source: Miriam-Webster (http://www.merriam-webster.com/medical/pain) Everyone has experienced pain of some kind. Most project managers have experienced pain on projects as well - and if you haven't yet, you must be just getting started in your career. Pain can come in many forms - physical pain, mental distress, concern and worry over things that you may (or may not) have any control over.  In fact, pain can be good for you, as it is principally designed as a protection mechanism. Brush your hand against a hot frying pan? Your body quickly tells you to get yourself away by triggering pain sensors. Step on a nail or cut yourself? Pain tells you to stop doing what you are doing and take care of your injury.But not all pain is the same. Some pain says "Stop that!" and yet some pain you need to ignore, like runners pushing through to get their second wind.In early 2005, I damaged my right knee - I tore my meniscus. The pain while walking right after the injury was quite bad - but of course, I still had to walk. Before I could start Physio, I had to take a flight back to the head office. Walking from the farthest gate to the main terminal was a very, very long and painful process. From there I caught one of those courtesy trams that go from gate to gate. The entire trip was measured in short walking distances and rest spots, and Naproxen was on the daily menu for a while.I returned from the trip to my project in the US and started Physio, which helped a lot, but I still had regular pain through the next year, if I overdid it or stood too long in one position. Once the inflammation settled down, walking was Ok - but standing was not, as it put pressure in mainly one spot. But I managed, and started to get better and much more mobile - once again measuring walks in miles/km instead of dozens of feet or minutes standing up. In 2006 I twisted my left knee when I fell into a hole, damaging it as well. You think I would have been smarter and re-injured the bad knee, but no. The pain from this injury was quite different - and worse. Walking or standing was painful for any duration or distance. But I got along, by not walking too much and avoiding standing still for very long. I went to the doctor - and was put on a waiting list for an MRI in Vancouver. I waited for 14 months, and finally had the scan. Then I had to wait a few more months to see the specialist who went over the results. The whole time my knees (both of them acting up in sympathy for each other) limited my freedom of movement as a result of the annoying pain.At one point I actually bought a folding cane to carry in my bag, and had to use it a few times.When I finally met the specialist, he went over the results with me, discussed "pain management" as the only near-term option and then sent me to physio. He also gave a picture of the long-term prospects which I was not terribly happy about. I left the office feeling quite discouraged. Osteochondrital impaction? Big words for "can't fix it".So I started physio. It made things hurt more, frankly - for a while. Then it hurt a bit less. But at the same time we were preparing to sell our house prior to moving - so I found myself up on the stepladder and tall ladder (generally, just plain upright for long periods), standing and moving as I repainted the entire inside of the house, including ceilings.During the several weeks of prep and painting in the evenings and weekends my knees were on fire, but the job had to be done. However, after the third week I began to notice something interesting.1) There were actually two types of pain, not just one.2) I was hurting a bit less and less every day as I forced myself onto the ladders to paint. By the time I went in for my followup visit with the specialist who had had little hope for me other than pain management, I was walking nearly pain-free, and not only that - I was able to stand in place for long periods as well.Over two years of suffering, and nobody told me I just had to get off my butt and move! Sometimes, pain is a sign to stop doing what you are doing or you will further damage things (pain #1), such as actual joint pain. Other times, it is simply a message that you need to persist, and things will get better if you push through and keep going (pain #2). This tricky type of pain was merely muscle fatigue - a sign that my knees were growing a little bit stronger again, and the next day would be a little bit better than today.In the case of my knees, the odd bit I learned about joint mechanics is that when you exercise your muscles and tone them up, they actually pull your joints apart - reducing wear and pressure on the cartilage between the bones. If you let things go and rest because it hurts, you lose muscle tone and your joints experience more direct pressure from the weight of your body. Weird, but true.On your projects, you will also experience two types of pain - good pain and bad pain. The key is learning to identify each type of pain and then respond to them appropriately. Listen to the podcast, or read the full article on Gazza's Corner blog.