Cochin Cardiac Club

Health Blog by Dr.Uday Nair

THROAT AND CHEST INFECTIONS


Throat infections




  • Pharyngitis: inflammation in the mouth - the back of the mouth and throat is sore, red and inflamed.
  • Tonsillitis: again the tonsils can be easily seen in some people, especially children, as cherry red lumps at the back of the mouth (so long as the mouth can be opened wide enough). With acute tonsillitis (or glandular fever) they may have white spots of pus on them. If the tonsillitis does not settle within a week, then blood test for glandular fever. Recurrent tonsillitis is often a symptom of allergy to dairy products.
  • Epiglottitis: a nasty and dangerous throat infection which may cause severe difficulty breathing, noisy breathing (stridor), hoarseness, drooling and difficulty swallowing. Don't try to look in the throat: just movement of the jaw can precipitate a serious relapse. Professional help needed urgently.
  • Laryngitis causes a hoarse voice in adults and often croup in children. Again croup is a nasty thing, once the cough is heard it is instantly recognisable. Treatment is with inhaled steroids (or oral steroids, say 20-40 mgs, but takes 2-6 hours to work) to reduce the laryngeal oedema. Sometimes just steam will relieve the cough (hot steamy bathroom or basin of hot water and towel over the head!).
  • Otitis media: ear infections. Sometimes I think all mums should be issued with auroscopes so they can check ears! An ear infection is a common cause of illness in children, often secondary to chronic catarrh. Again I usually treat with antibiotics. Try to avoid using pain killers because they have the undesirable effect of bringing the temperature down: running a temperature is the body's way of killing infection. Warm olive oil poured into the ear often relieves pain.
If any of these problems are recurrent think of allergy! The commonest cause is dairy products. Indeed a colleague of mine who is a paediatrician considers it medical negligence to perform a tonsilectomy in a child without first doing a dairy free diet.

Chest infections


  • Bronchiolitis: children only. Causes fast breathing rate and fever and other respiratory symptoms. May need hospital admission. Contact a doctor if there is respiratory distress.
  • Bronchitis: often follows a cold "which goes onto the chest". Presents with productive cough, illness, fever and sometimes shortness of breath.
  • Bronchiectasis: usually an acute flare on a chronic condition. Patients with bronchiectesis I give an emergency supply of antibiotics so they can take them at the first sign of a flare.
  • Pneumonia: may present with fever, cough, shortness of breath, feeling very ill, pleuritic chest pain and signs of collapse or shock.Pneumonia can be fatal: get a doctor to see.
  • Pleurisy: characterised by pain in the chest when a deep breath is taken. Pleuritic type chest pain can also be caused by pulmonary embolus or pneumonia, so professional help should be sought!
  • Tuberculosis: can present with any of the above symptoms.




Are antibiotics needed?



One obvious sign is hallitosis. Often the patient notices this first: a foul smelling breath on exhalation. 

It is impossible to say whether infection is due to virus or bacteria just by looking.
Sputum changing colour: if the patient coughs up discoloured sputum, either yellow or green or rusty coloured, this suggests infection.Sputum culture: this is worth doing because if antibiotics are prescribed on a "best guess" basis and the patient is no better then at least one can see from the sputum culture whether there is a bug and if so to which antibiotic it is sensitive

Which antibiotic?




Sometimes it is an "old friend" rearing its ugly head and the patient knows exactly which antibiotic does the trick. I usually prescribe on a best guess and take sputum cultures so that if there is no response, I can check to see if an appropriate antibiotic has been prescribed. I like all my patients who are prone to chest infections to hold a supply of the correct antibiotic so they can use it to nip problems in the bud!
Antibiotics are a two edged sword. Whilst they do have side effects, untreated bacterial lung infections leave damaged lung behind which is more likely to get infected in the future. Antibiotics do have a role to play! 

  • Antibiotic treatment of upper respiratory tract infection (URTI) does not prevent LRTI/pneumonia.
  • However, it can be difficult to distinguish between viral and bacterial infection and young children can deteriorate rapidly, so consider antibiotic therapy depending on presentation, and likelihood of bacterial aetiology.
  • Choice of agent appears to be largely arbitrary 
  • A penicillin, such as amoxicillin in a child-friendly formulation, should be used first-line, unless there is reason to suspect a penicillin-insensitive organism (particularly pneumococcal disease). Recent research indicates that children with non-severe pneumonia on amoxicillin for 3 days do as well as those who receive it for 5 days.
  • If a child is genuinely allergic to penicillin, consider using a cephalosporin, macrolide or quinolone, depending on any local antibiotic prescription guidelines, patterns of resistance and suspected organism.
  • Vancomycin may be added to treatment of toxic-looking children when there is a high rate of penicillin resistance.
  • Aciclovir is used for herpes virus pneumonia.

When to use steroids?


Again these are a two edged sword because they may be essential in reducing "useless" and life threatening swelling as can occur in acute allergic attacks, acute asthma and occasionally croup. However they also suppress the immune system and stop the body responding appropriately to infections: therefore often antibiotic cover is required. Seek professional advice!

Viral infections(Cold,fever,flu) and treatments.



Obviously one cannot avoid all viruses, but do your best. There tends to be a mini-epidemic of colds at the start of every school term as every virus acquired is shared around!
Vaccinations can certainly trigger flares of CFS(Chronic Fatigue Syndrome) – some are probably essential and less likely to cause CFS such as tetanus and oral polio. Most other vaccinations have the potential to flare CFS.
My view is that the nutritional approach is so effective at protecting against viral infection that vaccination against seasonal 'flu is not necessary. Vaccination has the potential to trigger other problems such as CFS.
The best defence against viral infections is a healthy body and healthy immune system. Indeed I believe that if you have a perfect immune system you should never get a cold. Getting a cold is a symptom of a poorly functioning immune system.
I am further concerned by the possible erosion of the immune system by excessive use of hygiene, antibiotics, vaccinations and exposure to toxic chemicals such as pesticides. There is a place and necessity for antibiotics and vaccinations but in my opinion they are overused. A recent study indicated that the rising incidence of asthma was due to over-prescribing of antibiotics in early life. Excessive hygiene (too many baths, hand washing, use of disinfectants etc) is also associated with increased risk of allergy. Recurrent infections are a real problem for some CFS patients who simply go from one illness to the next without remission. Furthermore, viruses often cause a mild immuno-suppression which then opens the door for other infections to get in – not an easy situation! 
Actually immune suppression I suspect is a very common problem. The immune system is particularly susceptible to micronutrient deficiencies and toxic stress. Clinically this manifests as susceptibility to viral infections. Indeed if the immune system was working perfectly then an upper respiratory tract infection at worst should cause very minor symptoms for just a day or two. We all know of people who never catch a cold – these are the people with perfectly functioning immune systems. This should not be confused with CFS patients who do not get the local symptoms required to blast the virus out – ie acute rhinitis (runny nose) but just get a flare of all their CFS symptoms. In this event the immune system is so poor it cannot mount a local acute response to physically flush out the virus.

  • Ensure good micronutrient status.
  • Take vitamin D. Why we tend to see more coughs,colds and flu in the Winter compared to the Summer. The answer is vitamin D – the only significant source is sunshine and vit D is highly protective against infections of all sorts. My advice is we should take at least 2,000 iu daily on days where we get less than 20 minutes of good sunshine directly on our skins.
  • Allow inflammation. The body reacts against viruses with inflammation and the result of inflammation is either directly toxic to the virus, or helps to physically expel virus from the body. For example, viruses are very temperature sensitive – for the body to run a fever is a good thing – fever kills viruses (and bacteria). A good snotty nose helps to wash out virus from the nose and a hacking cough blasts the bugs from the lungs. Symptoms may be uncomfortable but should be welcomed as an appropriate way to get rid of virus. This is why I hate to see symptom-suppressing cold remedies such as paracetamol, antihistamines, alcohol, decongestants, cough mixtures which interfere with the body\’s natural mechanisms of killing and expelling virus. SO DO NOT SUPPRESS SYMPTOMS – THEY ARE NATURE’S WAY OF EXPELLING INFECTIONS.
  • Run a temperature – there is no doubt that people who tend to run cold all the time are more prone to picking up infections and indeed this is the basis of the age old tradition to wrap up well in cold weather or you will catch a "cold". It would be interesting to measure your basal temperature. Low temperature can be indicative of borderline hypothyroidism and this can certainly present with recurrent infections. Children are very good at running a temperature at the first sign of virus, but adults less good.
The only exception to using paracetamol for fevers is in some children who tend to get fits if their temperature goes up too high. In this event paracetamol and tepid sponging should be used to prevent this happening. It is therefore doubly important in these children that micronutrients are used to improve the immune response.
  • Rest and warmth sound like common sense but are ignored by many. Rest allows the immune system to work unhampered whilst warmth kills bugs.
    • Take high dose vitamin C. Vitamin C kills all bacteria and viruses, but is remarkably non-toxic to human cells! Firstly use the neutral form of vitamin C (magnesium ascorbate – does not dissolve tooth enamel), open a capsule a tip into the mouth. It quickly dissolves in saliva. Hold in the mouth for as long as you can – this gets rid of all microbes in the mouth including dental plaque. Secondly take large doses of vitamin C (as ascorbic acid – acidifies the stomach and kills microbes there) dissolved in water or fruit juice. I suggest 10 grams initially and then more or less according to symptoms. Aim to cause diarrhoea – this is called taking vitamin C to bowel tolerance. One’s bowel tolerance increases with illness as more vitamin C is needed.
    • Zinc drops 10mgs four times daily into the mouth kills microbes. Zinc is probably the most common deficiency resulting in poor immunity.
    • Check for hypochlorhydria (low stomach acid). Most bacteria and viruses get into our bodies either by inhaling them or swallowing them. One interesting exception is measles virus which gets in through the conjunctivae of the eye. Those inhaled are caught in the mucous which lines the respiratory tract, are swept up and swallowed. All end up in the stomach where they should be killed by stomach acid. However, where there is low stomach acid ie HYPOCHLORHYDRIA the bugs will survive to cause infection. 
    • Consider a detox regime. There is no doubt that chemicals have immuno-suppressive effects – they also depress the bone marrow and this could explain borderline anaemia and low white cell counts.Increasingly I am coming to the view that we should all do detox regimes. First of all we should avoid chemicals as much as we possibly can, secondly take good micronutrients to improve the liver detoxification of chemicals and thirdly sweating regimes. Obviously the most physiological sweating regime is to take exercise.
    • Think allergy – allergy to dairy products often presents with recurrent infections, especially tonsillitis. Sometimes allergy symptoms can present with symptoms of an acute cold – ie rhinitis and cough.
      • Think thyroid – hypothyroidism may present with a tendency to infection because the body runs cold and the immune system goes slow.
      • Avoid female sex hormones, which are immunosuppressive and increase susceptibility to viral infections
      There are some very useful antiviral herbal preparations on the market such as  lime tea etc. but it is really a case of trying as many things as you can until you find a combination that suits you.

      So the basic principles are:

      • Rest, keep warm.
      • Get your micronutrient status as good as possible. Think vitamin D, zinc and C.
      • Do not symptom suppress! Allow a temperature. Aggressively attack viruses at the first symptom with heat, high dose vitamin C as ascorbic acid (swallowed) and magnesium ascorbate (dissolved in mouth) or whichever herbal preparations you find suit you.
      • Check for hypochlorhydria
      • Detoxify as much as possible – including sweating regimes
      • Identify any allergies you may have – think dairy
      • Correct thyroid hormone abnormalities – for this you need to test a free T4 a T3 and a TSH.
      If the symptoms of a virus do not improve after 3-4 days, then it is possible that a secondary bacterial infection has developed. A healthy body and immune system can deal with most bacterial infections, but call for professional help for less than healthy people such as the very young, old, smokers, diabetics, heart failures, people with a history of chest infections, etc.





Advice to all Parents-Smoking in the home is a major risk factor for all childhood respiratory infection.





SOME CHEAPER MEDICINES FOR CARDIAC PATIENTS


We come across medicines of different companies which are highly priced and patients especially the poor find it very difficult to cope up with the daily requirements of medicines.

Hence for heart patients i give an alternative to some medicines used regularly which are cheaper than the other medicines available.Please understand that cheaper medicines does not mean that the medicines are not good or potent.
The following medicines are priced in Rupees and for 10 tablets(1 strip).This is for the information of the public to let them know that cheaper alternatives are available.Please judge by yourself and think why such a big margin exists?

List of important Cardiac drugs:

1.Atorvastatin  10mg                
  • Avas (Micro)-100+rupees
  • Storvas(Ranbaxy)-100+
  • Tonact(Lupin)-100+
  • Tg-Tor(Unichem)- 100+
  • Atocor(Micro)-80+
  • Stator(Piramal)-35+
  • Atorfit(Ajantha)-35+
  • Lipikind(Mankind)-18+
2.Atorvastatin+Fenofibrate(10mg:160mg)
  • Tonact TG(Lupin)-130+
  • Lipicard AV(USV)-120+
  • Storfib(Ranbaxy)-120+
  • Atorlip F(Cipla)-100+
  • Diplitor(Glenmark)-100+
  • Fibitor(Sun)-100+
  • Stator F(AHPL)-60+
  • Zivast F(Proxima)-60+
3.Rosuvastatin 10mg
  • Rovalip(Cadila)-240+
  • Rosuvas(Ranbaxy)-120+
  • Razel(Glenmark)-120+
  • Rolistat(Proxima)-45+
  • Rozat(Dr.Reddys)-45+
4.Simvastatin 10mg
  • Simvotin(Stancare)-140+
  • Simstat(Emcure)-90+
  • Sim 10(Orchid)-90+
  • Simvas(Micro)-60+
  • Simvin(Medley)-45+
  • Starstat(Lupin)-25+
5.Clopidogrel   75mg
                            
  • Plavix(Aventis)- 100+
  • Stromix(Nicholas)-100+
  • Plagerine(Micro)-40+
  • Clopilet(Sun)-50+
  • Deplatt(Torrent)- 40+
  • Clopivas(Cipla)-40+
6.Olmisartan medoxomil 20mg
  • Winbp(Piramal)-80+
  • Olmighty(Merck)-60+
  • Olmetor(Torrent)-50+
7.Losartan Potassium - 50mg
  • Repace(Sun)-80+
  • Losar(Unisearch)-40+
  • Tozaar(Torrent)- 40+
  • Zaart(Cipla)-40+
  • Losakind(Mankind)-18+
  • Czar(Argus)-18+
8.Losartan potassium hydrochlorothiazide(50mg:12.5mg)
  • Hysartas(Intas)80+
  • Repace H(Sun)50+
  • Losar H(Unisearch)48+
  • Tozaar H(Torrent)48+
  • Losakind H(Mankind)19+
9.Telmisartan 20 mg
  • Lipisar20(Indus)-60+
  • Telsartan(Dr.Reddys)-50+
  • Telista20(Lupin)-40+
  • Tmax(wockhardt)-40+
  • Telsite(Aventis)-30+
  • Cresar(Cipla)-30+
  • Inditel(Zydus)-20+
10.Telmisartan  Hydrochlorothiazide(40mg:12.5mg)
  • Telma H(Glenmark)-90+
  • Tellzy H(Alembic)-60+
  • Telday H(Torrent)-60+
  • Telpres H(Piramal)-60+
11.Amlodipine 5mg
  • Amlogard(pfizer)-75+
  • Stamlo(Dr.Reddys)-50+
  • Amlopres(Cipla))-40+
  • Amlocor(Torrent)-20+
  • Amtas(Intas)-20+
12.Atenolol  50mg
  • Tenormin(AHPL)-40+
  • Betacard(Torrent)-40+
  • Aten(Cadilla)-30+
  • Hipres(Cipla)-20+
13.Carvedilol 12.5mg
  • Carca(Intas)-50+
  • Cardivas(Sun)-50+
  • Carvil(Zydus)-50+
  • Carloc(Cipla)-40+
  • Carvetrend(Nicholas)-30+
  • Carvedil(Mediva)-20+
14.Ramipril 5mg
  • Cardace(Aventis)-90+
  • Ramace(Astra Zaneca)-90+
  • Ramipres(Cipla)-70+
  • Cardiopril(Dr.Reddys)-40+
  • Artere(Alchemist)-40+
15.Lisinopril 5mg
  • Lisotec(Sun)-100+
  • Lipril(Lupin)-100+
  • Listril(Torrent)-90+
  • Hipril(Micro)-60+
  • Lisitec(Cipla)-30+
  • Normopril(Aristo)-20+
16.Metoprolol 50mg
  • Kingbeta50(Panacea)-90+
  • Cardibeta(Ranbaxy)-70+
  • Lopresor(Novartis)-40+
  • Betaloc(Astra Zaneca)-30+
  • Metolar(Cipla)-30+
  • Bluemet(Bluecross)-20+
  • Embeta(Intas)-20+
17.Prazosin  2.5mg
  • MinipresXL(Pfizer)-100+
  • CzopressXL(Biotech)-70+
  • PrazoclipXL(Cipla)-40+
  • PrazopressXL(Sun)-40+


Some non cardiac drugs:


18.Glimepiride 2mg
  • Amaryl(Aventis)-100+
  • Glimer(AHPL)-100+
  • Glypride(Sun)-70+
  • Diapride(Micro)-60+
  • Glimy(Dr.Reddy)-50+
  • Betaglim(Panacea)-40+
  • Euglim(Zydus)-30+
19.Glimepiride+Metformin(2mg:500mg)
  • Amaryl M(Aventis)-120+
  • Gimibay(Bayer)-60+
  • Obimet GX2(Abbot)-50+
  • Glimaday(Wockhardt)-50+
  • Gemer2(Sun)-50+
  • Azulix MF(Torrent)-40+
  • Metride(Unisearch)-30+
  • Isryl M(Systopic)-15+
20.Pioglitazole+Metformin(30mg:500mg)
  • Mopaday(Wockhardt)-60+
  • Pioglit M30(Sun)-50+
  • Pionorm-M(Carsyon)-50+
  • Bioglita M30(Biochem)-40+
  • G-Tase M(Unisearch)-40+
  • Piokind M30(Discovery Mankind)-30+
21.Rabeprazole 20mg
  • Razo(Dr.Reddys)-70+
  • Happi(Zydus)-70+
  • Rolant(Anthus)-30+
  • Rabekind(Mankind)-15+
22.Pantoprazole 40mg
  • Pantocid(Sun)-70+
  • Pansped40(Torrent)-60+
  • Pantagon(Piramal)-60+
  • Zovanta(Dr.Reddys)-60+
  • Pan 40(Alkem)-40+
  • Pantop(Aristo)-30+
  • Pantakind(Mankind)-20+
  • Pop40(Winsome)-20+
23.Salmeterol 50mcg+Fluticasone Propionate 250mcg

Metered dose inhalers
  • Seretide Accuhaler(GSK-60md)-900+
  • Seroflow(Cipla-120md)-400+
  • Esiflow(Lupin-30md)-200+


This is an incomplete list,i will be updating this frequently.Please understand that there are medical shops that give you from 1% to 8% discount.So i request all to identify a medical shop in your locality and get the maximum benefit.


Be Smart Act Wisely.






                                                             


                                                              

APPENDICITIS


What is appendicitis?

Appendicitis is a painful swelling and infection of the appendix.

What is the appendix?

The appendix is a fingerlike pouch attached to the large intestine and located in the lower right area of the abdomen. Scientists are not sure what the appendix does, if anything, but removing it does not appear to affect a person's health. The inside of the appendix is called the appendiceal lumen. Mucus created by the appendix travels through the appendiceal lumen and empties into the large intestine.

What causes appendicitis?


Obstruction of the appendiceal lumen causes appendicitis. Mucus backs up in the appendiceal lumen, causing bacteria that normally live inside the appendix to multiply. As a result, the appendix swells and becomes infected. Sources of obstruction include
  • feces, parasites, or growths that clog the appendiceal lumen
  • enlarged lymph tissue in the wall of the appendix, caused by infection in the gastrointestinal tract or elsewhere in the body
  • inflammatory bowel disease, including Crohn's disease and ulcerative colitis
  • trauma to the abdomen
An inflamed appendix will likely burst if not removed. Bursting spreads infection throughout the abdomen—a potentially dangerous condition called peritonitis.

What are the symptoms of appendicitis?

The symptoms can be extremely variable but often take the following classic pattern. The first sign is usually a pain or discomfort in the centre of the abdomen. This pain comes and goes in waves and is often thought at first to be a simple stomach upset.
After a few hours, the pain becomes more noticeable and constant in the lower right part of the stomach. It is increased by movement or coughing. The patient often loses their appetite, feels sick, and vomits. The temperature is raised and the complexion becomes flushed. The breath .may smell offensive

How is appendicitis diagnosed?

The doctor takes a medical history from the patient and checks their temperature.Blood and urine tests are performed to look for infection.
The doctor examines the patient by pressing on the lower right part of the abdomen and sometimes by inserting a finger in the anus (back passage) in order to exclude other causes of pain. Women are often given a vaginal examination.
There is no one test that will diagnose appendicitis with certainty. Surgery is performed on the basis of the doctor's examination and results of the tests. Many diseases can cause the same symptoms as appendicitis which is why surgeons find a normal appendix in 3 out of 10 operations.
How is appendicitis treated?

Surgery
Typically, appendicitis is treated by removing the appendix. If appendicitis is suspected, a doctor will often suggest surgery without conducting extensive diagnostic testing. Prompt surgery decreases the likelihood the appendix will burst.
Surgery to remove the appendix is called appendectomy and can be done two ways. The older method, called laparotomy, removes the appendix through a single incision in the lower right area of the abdomen. The newer method, called laparoscopic surgery, uses several smaller incisions and special surgical tools fed through the incisions to remove the appendix. Laparoscopic surgery leads to fewer complications, such as hospital-related infections, and has a shorter recovery time.
Surgery occasionally reveals a normal appendix. In such cases, many surgeons will remove the healthy appendix to eliminate the future possibility of appendicitis. Occasionally, surgery reveals a different problem, which may also be corrected during surgery.
Sometimes an abscess forms around a burst appendix—called an appendiceal abscess. An abscess is a pus-filled mass that results from the body's attempt to keep an infection from spreading. An abscess may be addressed during surgery or, more commonly, drained before surgery. To drain an abscess, a tube is placed in the abscess through the abdominal wall. CT is used to help find the abscess. The drainage tube is left in place for about 2 weeks while antibiotics are given to treat infection. Six to 8 weeks later, when infection and inflammation are under control, surgery is performed to remove what remains of the burst appendix.

Nonsurgical Treatment



Nonsurgical treatment may be used if surgery is not available, if a person is not well enough to undergo surgery, or if the diagnosis is unclear. Some research suggests that appendicitis can get better without surgery. Nonsurgical treatment includes antibiotics to treat infection and a liquid or soft diet until the infection subsides. A soft diet is low in fiber and easily breaks down in the gastrointestinal tract.

Recovery

With adequate care, most people recover from appendicitis and do not need to make changes to diet, exercise, or lifestyle. Full recovery from surgery takes about 4 to 6 weeks. Limiting physical activity during this time allows tissues to heal.

Points to Remember

  • Appendicitis is a painful swelling and infection of the appendix.
  • The appendix is a fingerlike pouch attached to the large intestine and located in the lower right area of the abdomen.
  • Symptoms of appendicitis may include abdominal pain, loss of appetite, nausea, vomiting, constipation or diarrhea, inability to pass gas, low-grade fever, and abdominal swelling.
  • A doctor can diagnose most cases of appendicitis by taking a person's medical history and performing a physical examination. Sometimes laboratory and imaging tests are needed to confirm the diagnosis.
  • Appendicitis is typically treated by removing the appendix.
  • Appendicitis is a medical emergency that requires immediate care.


MYTHS AND FACTS OF MEDICINE








The Myth: Teething causes a fever
Scientific studies have been done in the area of teething which show no correlation at all between fever and teething. If your baby is suffering from a new tooth and they also have a fever, it is advisable to check for other causes of the fever. The same is true of diarrhea which is also often blamed on teething in infants. It is always better to be safe than sorry when dealing with the health of children.
The Myth: Back pain should be treated with bed rest
The opposite is actually true in this case. Bed rest can prevent the lower back from fully recovering – or at the very least, delay the recovery significantly. Patients who continue to engage in ordinary activities recover faster and usually have fewer problems with recurring pain and other back troubles. Interestingly, many studies have shown that this is not just true of back problems, but also many other medical problems. Thirty-nine independent studies found bed rest to be more harmful than good in a broad range of illnesses.
The Myth: Eating at night makes you fat
Secret snackers rejoice! This is a complete myth. It doesn’t matter what time of day you eat, as long as you eat only the total calories that you burn each day, you will not gain weight. If you eat fewer calories than you burn, you will lose weight, and if you eat more calories, you will gain. It is as simple as that. Having said that, the routine of three meals a day at the same time each day can have other benefits in life (routine is good and it helps humans work more effectively), but snacks at night are no worse than snacks in the morning or afternoon.
The Myth: It is harder to lose weight than to gain weight
Actually – once you get your head around a new eating pattern, math and science are working in your favor. It is mathematically easier to lose than to gain. For example, if you eat 3,500 calories more than you burn, you will gain 0.3 pounds (0.14 kg), but if you burn 3,500 calories more than you eat, you will lose 1 pound (0.45 kg). Also, if you want to lose weight, you can expose yourself to significant changes in temperature which speeds up your metabolism. Finally, the above information is based on a pure fat diet – variations to the math occur when you introduce other types of food.

The Myth:Chocolate and Fried Foods Give You Acne 


Some speculate that this myth dates back to the baby-boom generation, who had worse acne than their parents and also more access to chocolate and fried foods. Wherever this idea came from, it's wrong. Pimples form when oil glands under the skin produce too much of a waxy oil called sebum, which the body uses to keep skin lubricated. But when excess sebum and dead skin cells block pores, that area of the skin gets irritated, swollen, and turns red -- the telltale signs of a pimple. It is unknown why sebaceous glands produce excess sebum, but hormones are the prime suspects, which explains why teenagers are affected more than others. Stress and heredity may also be factors, but chocolate bars and onion rings are off the hook
.

The Myth: Eating spicy food causes ulcers



A type of bacteria causes ulcers. Helicobacter pylori causes almost two-thirds of all peptic ulcer cases. Taking non-steroidal anti-inflammatory drugs, such as aspirin or ibuprofen, causes most of the other cases. Using tobacco and drinking alcohol also increase the risk for ulcers.
Spicy foods can only worsen the effects of existing ulcers, as can stress.
If you have symptoms of dyspepsia or ulcer disease, such as a burning pain in the gut that comes and goes for days or weeks, you should see a doctor to be tested for the bacteria. Current medication treatments that include antibiotics have an 80 to 90 percent success rate in treating ulcers.



 Myths  patients have!!!


Diabetic patients who refuse to take insulin
:They believe that if they take insulin, then they are admitting that have diabetes, but if they just take pills, then they only have a "sugar problem".





Patients whose blood pressure is normalized with medicine asking if they can stop their medicine now that their blood pressure is under control, or stop taking their statin now that their cholesterol is below 200. 




Thousands of wives telling their husbands what to eat, not realizing that eating cholesterol (egg yolks) does not raise your cholesterol as much as eating animal fat does. For that matter, french fries and potato chips, both of which contain no cholesterol, contain enough fat to raise your cholesterol, and when Frito-Lay wanted to advertise their potato chips as having absolutely no cholesterol (which is a true statement for any vegetable product), the FTC made them pull the ad, because they were afraid that the public would equate "no cholesterol" with " "no fat".




Patients also think that the less medicine they take, the less sick they are. So when 40mg of Zocor was replaced with the equipotent dose of 10mg of Lipitor, they were very happy, and even happier with 5mg of Crestor. And Vytorin is one pill, not two, which is also good. They also think that the less asthma medicine they can take, the less serious their asthma is, and they are forever skipping doses of inhaler and believing that their breathing is not affected.


Along with the above, the most surprised patients are those who survive a heart attack and go home on five new medicines. These many medicines do not mean that you are very ill, but rather that physicians know from experimental studies that each of these five medicines will reduce your chance of a second heart attack (and remember that the single greatest risk for having a heart attack is already having had one). The medicines are: a platelet blocker (aspirin, Plavix, or Coumadin), a beta-blocker, a statin to lower your cholesterol and stabilize any atheromatous plaques in your coronary arteries, an ACE inhibitor or an ARB, and, if you are in any heart failure at all, spironalactone. Again, these are all to reduce your chance of having a second heart attack, and should be taken exactly as prescribed.




I don't believe there is any such thing as "junk food" or "useless calories", but rather eating too much or to little. I don't care what you eat so long as you gain no weight, and have a daily multivitamin to cover whatever you may be missing


Some patients will always see the glass as half full, and others as half empty. (And I see the glass as too large, but I generally think "out of the box".)


The bottom line: When it comes to your health, get the facts.