Answers from Autopsy?

The saga of Bobbi Kristina Brown has prompted many columns, and much speculation.  Now that she has passed, one wonders if the postmortem examination, the autopsy, will shed any light on the cause of her sudden illness and ultimate death.  Here's an article from Newsmax which takes a look at that question:

Bobbi Kristina Autopsy:

Will It Solve Mystery of Her Death?

Bobbi can rest in peace

After almost six months in a comatose state, Bobbi Kristina Brown, the daughter of Whitney Houston, succumbed to her prolonged illness.  The nature of a prolonged coma, dealing with the confusing signs and situations, as well as the emotional turmoil can be very difficult for a family involved in such a case.  Here is an article from Newsmax in which this picture is examined.

Bobbi Kristina Brown Suffered No Pain at the End: Doctor

Breathing Trouble or Trouble with Breathing?

Language is a difficult issue when it comes to medicine, and so much of what a physician learns about a patient's problems are through the words used in describing the issue.  One might say "shortness of breath" or "trouble with breathing" or the medical term "dyspnea," and they all have different nuances of meaning.  The task is to accurately communicate the problems that the person is having, because the range of pathology that can affect the ease of breathing is incredibly broad.  Here is just one look at the topic, in the Scary Symptom post:

Shortness of Breath vs.

Trouble Breathing

Turn up or tune out your nose?

It seems as though it's common to "tune out" or ignore an irritating sound, whether background noise or music.  But can you do the same to an odor?  Understand that when you work in an environment with a background odor, you often don't smell it after a while, but that is called "olfactory fatigue," in which your nose kind of wears out for that smell.  Can you do that willfully?  And if not, why not?  Here's an article from Scary Symptoms that explores that situation.

Noise vs. Odor Sensitivity:

Which Should You Tune Out?

Gotta go when you run?

We looked at this question, and it's a real one, years back in medical school with an experiment involving all of us running around the block.  Some basic thoughts about an often observed phenomenon, from the Scary Symptom site:

Why Does Running Increase Urge to Urinate?

Is it a good twitch, or a bad twitch?

We all know the feeling.  You're sitting at your desk and a muscle twitches; your leg, your side, or even your eye.  What does it mean?  Might it be something terrible?  Here is an article from Scary Symptoms in which I help the author explore the facts behind the troubling twitch.

Muscle Twitching:

Why You Should Feel Good About Twitching Muscles

Number Nine Nods

Keeping with the billiards theme for now, I note the hitting of the 9000 view mark, about six weeks after we hit 8000.  Will it keep going at this rate or speed up?  Thanks to all of you who have viewed and shared my posts, and I look forward to posting more in the coming weeks.

Bush falls - Are you in danger?

The recent fall at home of President George H.W. Bush and his subsequent injury highlights the danger that older individuals face in their most familiar surroundings.  While we hope for a full recovery for our 41st President, there are many other seniors that need to pay attention to this event, and look around to be sure that they remain safe.  Here is an article from Newsmax which looks into this picture:

George HW Bush's Broken Neck

Spotlights Home Fall Dangers

Supplements ... my thoughts and advice

No doubt about it, dietary supplements are big news, and big business.  You’ll hear about various supplements when you are at the gym, around the coffee pot at work, in various columns in the newspaper, and in endless commercials and advertisements.  They are touted as providing near infinite benefits with no risk nor side effects by celebrity pitchmen, and come in a dazzling array of products and forms.  Where did they come from, and are any of them worth the money, sometimes a lot of money, that they cost?

I’m old enough to have been practicing before many of the most popular current prescription pharmaceuticals were developed, and in those days various supplements were often used as a form of treatment.  While I don’t feel that they are nominally potent enough to deal with severe or significant issues, they are typically accepted by patients who fear medications.   Using such products which have been found to be safe, they may, in fact,  provide benefits to a number of patients.  Whether those benefits are based on pharmacologic effectiveness or acceptance and internalization of anecdotal reports of the products’ effects, such benefits can be useful for many in need.  Having a patient acknowledge that there is an issue to be treated, even treated with a supplement, may act as a stepping stone to further therapy if desired goals are not reached.

The most effective supplement I use would have to be Vitamin D, which really is a critical nutrient which is deficient in a significant number of people.  Adding either over the counter or prescription doses of Vitamin D clearly benefits these patients.  Although bone density is a clear marker used with Vitamin D, there are many studies which have suggested much more widespread effects of the vitamin.

In addition, I am likely to look favorably to the use of Glucosamine/Chondroitin products in patients looking to help with knee pain, and have pointed out to those expecting more global relief that there is a some evidence to support such use.  Unfortunately, there is also a growing body of work that points to flaws in former proofs. In addition, studies highlighted in some consumer magazines have pointed out that many preparations of Glucosamine/Chondroitin do not contain the amount of active product advertised on the label.  This may be true for other products, as well, and a word to the wise should be taken under advisement.

And then there’s melatonin.  Although some years ago, there were concerns about trace contaminants in some formulations, this no longer appears to be the case, and melatonin for the most part appears to be a safe product that can be useful for sleep disorders.  It has been used both to induce sleep, as well as to help reset sleep after travel, helping with jet lag.  A businessman patient of mine related to me that he was able to use melatonin with his cross-country flights to lessen the jet lag of the flight, allowing him to be more productive at work.  

If you are looking at supplements, fish oil always seems to bubble up to the surface.  Widely used in years past for a variety of ailments, the product has come under fire lately, with real questions raised as to whether or not the supplement form of fish oil, in capsule, tablet or liquid form, can improve one’s health.  There are studies, though, that say that fish oil that is still in the fish -- eating fish three times a week -- is clearly a healthy thing to do.  Certainly, constraints on types of fish with regards to mercury or other concerns, within reason, may come into play; but it is likely healthier to eat fish than take the processed oil contained in a capsule.  After all, there are many more nutrients in fish than just that oil.

Further, many supplements in popular use, such as Creatine, Vitamin C, mixes of B vitamins, general use of multiple vitamins, caffeine or ginko infused products, or those multi-element mixes often marketed for muscle building or weight loss do not hold any place in my medicine cabinet.  While there are many spokesmen pushing these products, including high profile television doctors, there is no convincing evidence that they offer any positive effect and may, in some cases, do quite the opposite.

Yes, there are micronutrients, also called phytonutrients, in plants, and they are good for you.  But rather than taking a supplement with several hundred of them, better to eat the fruit or vegetable which has them all, numbering in the scores of thousands.  Besides, it’s less expensive and tastes better!

Please understand that these are my beliefs and opinions, and others are free to differ with me, and probably do.  As always, consult your physician or healthcare professional before starting or stopping any medication or supplement, and understand that we are all unique, and what is good for one person may not help another.  Ask questions, look at the evidence, and act in the best interest of your health.

© 2015 - Marc I. Leavey, M.D. - Baltimore, MD - All Rights Reserved

Fast asleep .. or asleep fast?

For many people, turning out the light and slipping into bed is enough to whisk them off to a good night's sleep.  Others are not so lucky.  There are some simple tips to pay attention to and changes in behavior that can help promote a restful night.  Here is a little article with some of my thoughts:

How to Fall Asleep Fast