January 8, 2023 • 26 mins
01/08/23
The Healthy Matters Podcast
Season 2 - Episode - 03 - Hilden's House Calls - An AMA with the MD MPH FACP
Ever wondered - Why does it hurt when I do this? Or, what happens if I don't sweat? And what does Dr. Hilden do for self care?
We've all got questions for the doctor, and now you have a doctor for all of those questions!
In Episode 3, we kick off the new year with another deep dive into the wide (and often times puzzling) world of healthcare. Dr. Hilden fields questions from actual podcast listeners about brittle fingernails, antibiotics, hernias - and a whole slew of other healthcare topics. Join us!
Got a question for the doc? Or an idea for a show? Contact us!
Email - healthymatters@hcmed.org
Call - 612-873-TALK (8255)
Twitter - @drdavidhilden
Find out more at www.healthymatters.org
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:04):
Welcome to the Healthy Matters podcast with Dr.
David Hilden, primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health, healthcare and
what matters to you.
And now here's our host, Dr.
David Hilden.
Speaker 2 (00:20):
Hey, everybody.
Happy New Year.
It's Dr.
David Hilden, your host of theHealthy Matters podcast.
Welcome to episode three ofSeason two, and to start the new
year off right, we're gonna doanother episode of Hilton's
House calls.
To help me out, I have JohnLucas, one of the producers of
the Healthy Matters podcast, andhe's gonna help us get through
some of the questions we've beenaccumulating over the past few
months.
(00:40):
John, take it away.
Speaker 3 (00:42):
All right.
Okay.
So here goes, our first questioncomes from Miranda in St.
Paul.
She's wondering what's yourroutine as a doctor?
It's kind of a personalquestion, but okay, let's roll
with it.
Uh, do you
Speaker 2 (00:53):
Well, I get up, I comb my hair sometimes,
Speaker 3 (00:55):
So she asks more specifically, do you drink
alcohol?
Do you take a multivitamin?
I can assume you're pretty busy,but what do you do for
self-care?
That's a pretty
Speaker 2 (01:03):
Good question.
That is a great question.
It's a question probably everyone of us could or should ask
ourselves, regardless of whatyou do for a living or what your
daily life.
Absolutely.
It's like, mine is, I'm a nightperson.
Uh, so I, um, I have do, likethe caller says, I have very
busy days and so I try to findtimes for self-care when I can.
(01:24):
That is not often the advice Igive to patients.
I say, schedule a time, do yourworkout.
Sure.
Monday, Wednesday, Friday.
At the same time, make time foryourself.
I don't do that.
Uh, my schedule is too variable.
Uh, okay.
So I do try to work out at leastthree or four times a week by
running, I'm an outdoor runner,even in Minnesota.
I ran around one of ourMinneapolis lakes yesterday as a
(01:46):
little aside.
There were people swimming and ahole in the ice and it was four
degrees out.
Um, but that's a Minnesotathing.
Yeah.
Um, I do a exercise bike in mybasement.
Uh, do I drink alcohol?
I do.
You know, an interesting thingabout my, my work friends is
that, uh, uh, it's fairly commonI think for physicians to, um,
have a glass of wine with dinneror a, a cocktail, but it doesn't
(02:10):
necessarily mean physicians areany different.
In fact, we're not.
They're just as susceptible toalcohol abuse and, and using
alcohol medicinally and whenyou're feeling stressed.
And so I find myself having totell myself that very thing.
Do I want this glass of wineright now or am I just
habitually reaching for it?
Cuz it was a stressful day.
(02:30):
And that is something that allpeople should do.
If you come home withoutthinking and crack a beer every
single day, you're not thinkingabout it.
Right.
That's not a good routine.
None of us should be doing that.
If it's a special day or it's,uh, you're thinking about it and
it's like, wow, I'd really likea beer right now and you don't
have alcohol abuse problems, goahead and have that beer.
That's what I try to do.
(02:50):
Be more intentional.
Okay.
Um, and maybe not have it be,well, it's Tuesday I'm having a
beer.
Sure, sure.
That's not a good way to go.
So I'm trying to fit exercise,trying to fit healthy diet into
my, uh, into my life.
I've learned a lot about healthydiet from doing this podcast
through Yeah,
Speaker 3 (03:05):
Me too, me too.
The
Speaker 2 (03:06):
Last episode, for instance.
Yeah.
Go listen to Kate Shafto talkabout diet on the very last
episode.
And, uh, I'm learning a lotabout diet as well.
So diet, exercise, moderatealcohol, and then that's what I
try to do.
Gotcha.
Speaker 3 (03:17):
Okay.
So doctors are people too.
Speaker 2 (03:19):
Exactly.
Yeah.
Hard to believe.
And then I also believe, and Ididn't mention this strongly in
the value of art and the arts,whatever that is for you, for
me, it, it is classicalorchestral music.
So I go to, uh, the orchestra at, in Minnesota as one of the
world's best orchestras.
We do, we do.
And I go hear that all the time.
(03:39):
Um, I, I'm there frequently andI am also at the other end of
sort of the genre spectrum.
I'm a huge Bruce Springsteenfan.
I consider that to be darn neara religious ex experience.
Oh yeah.
So self-care through the art,whatever it is that you like,
doesn't have to be Springsteenor classical music.
It can be anything.
I think the arts make ushealthier.
Speaker 3 (03:59):
The, the healing properties of music and art.
I huge.
Speaker 2 (04:01):
It can be hiphop hop, I'm unbeliev.
It can be dance, it can be goingto your local art institute.
It can be going to a coffee shopand listening to one guy strum a
guitar, whatever it is.
Speaker 3 (04:10):
Art oftentimes better than that beer, often
Speaker 2 (04:12):
Better than the beer.
I'm with you, John.
Speaker 3 (04:14):
Okay.
So onto our next question.
And this came in from Teddy inMadison.
He says, I'm in my mid fortiesand I recently chipped two teeth
fairly easily, and I've alsonoticed that my fingernails are
a bit more brittle now.
I've never been in my midforties before, so I'm not sure
what to expect as I age.
Is there something to this, doteeth weaken over time or is
(04:34):
there anything I can do to helpstrengthen my teeth and nails?
It
Speaker 2 (04:37):
Is true that the, the nails and the teeth and even
your hair, these things dochange as you age.
They tend to get more dry andbrittle.
Your teeth have a tough enamelcoating that can, uh, age as you
age.
And so there are some things youcan do.
The first thing I would suggestyou do though is find out if
(04:58):
there is an underlyingreversible cause or if you're
just gonna chalk this up to thepassing of the years, there are
some things that cause yourfinger and toenails and to get
more brittle and soft.
It can be either excessivemoisture, like maybe you are
work as a dishwasher for aliving, or your hands are always
wet.
It can be excessive dryness.
(05:19):
And it, both of those casesreverse that.
Cause if they're excessivelydry, make'em less dry.
Moisturizer.
If, if you are around wetenvironments a lot, wear gloves,
dry them off a lot.
You also should look forunderlying causes like thyroid
disease, perhaps some autoimmunedisorders, nutritional
deficiencies like anemia thatcan lead to problems mostly with
(05:40):
nails.
As for your teeth, it's largelya self-care issue.
Make sure you're brushing yourteeth, you're flossing your
teeth, and that you're gettingadequate calcium and vitamin D
in your diet.
If all of those things are true,it could well be that you're
just, you're getting morebrittle as you age and those
kind of self cares will be yourbest bet for, uh, uh, protecting
yourself going
Speaker 3 (06:00):
Forward.
Gotcha.
Okay.
So you could chalk it up torust, but in the meantime, let's
look into these things.
Exactly.
Gotcha.
All right.
Very good.
Excellent.
Uh, well, thanks for thatquestion, Teddy.
All right.
This one is from Alex in Duluth.
She says, my feet get reallycold, which I assume is from
poor circulation.
And I also recently noticed thatI've been getting spikes in my
heart rate.
(06:21):
Is there a chance these twocould be related, as in, does my
heart pump faster to try to keepmy extremities warm?
That's an interesting question.
It
Speaker 2 (06:28):
Is an interesting question, and it is possible
that they're related but notcertain.
Okay.
I'll say a little bit more aboutthat.
Um, cold feet can be due to badcirculation.
It can be due to somethingcalled ray nodes phenomenon,
where your little bitty bloodvessels kind of constrict people
get that in their, in theirhands and feet.
And, uh, that can be somethingthat is unrelated to anything
else.
(06:48):
And, uh, you don't have to worryso much about that.
Again, like the previousquestion, I would look for
underlying causes like thyroiddisease.
People who have cold extremitiesoften, um, not often, but can
have thyroid disease, anemia,things like that.
Now, whether or not the heartrate is related is, uh, not
quite so clear.
It is true that your heartresponds to all kinds of
(07:11):
physiologic changes, um, in, inyour environment.
If your cold, your, your bodytries to shunt blood to the
areas to warm it up.
If your, if a certain part ofyour body isn't getting enough,
uh, blood, the blood vessels eexpand and the heart can beat
faster to try to do that.
But the heart and the bodysomehow is quite smart.
It knows that there are fourplaces the blood needs to go
(07:33):
preferentially.
It needs to go to your brain,your heart itself, your liver,
and your kidneys.
Those four things get themajority of your blood supply at
the expense sometimes of yourfeet.
Okay.
Uh, you can frankly live withoutyour feet.
You can't live without thosefour organs.
So, um, it's complicated.
Let's just say that.
(07:54):
Um, sure it's quite complicated.
It's
Speaker 3 (07:55):
Never easy.
But,
Speaker 2 (07:56):
But, uh, you know, causes of a fast heart rate
dehydration.
Um, some of these vascularchanges we've just been talking
about, it could be due to, um,uh, anxiety or palpitations just
because you're aware of it.
Some people are simply aware ofyour heartbeat, a condition
called palpitations.
It doesn't necessarily meanthere's anything wrong, it's
just that it freaks the humanbody out to be aware of your own
(08:19):
heartbeat.
You're not supposed to be awareof it.
Right.
So I would suggest to you have asmall evaluation, get a couple
blood tests, make sure you'renot anemic.
Make sure you don't have thyroidproblems.
I would ask the doctor to get anEKG to make sure your heart is
doing everything it's supposedto, and then put on a really
good pair of socks.
Speaker 3 (08:36):
All right.
Well, in Minnesota, those are,uh, worth their weight and gold.
Mm-hmm.
.
Hopefully that helps.
Alex.
Well, let's, uh, sneak one morein before our break here.
And this one came in from Karenand she says, I keep reading
about the benefits of sweating abit each day, which, hey, this
is kind of in line with theexercise question we got.
Okay.
Uh, what if you don't sweat?
I just get a red face.
What can one do?
(08:57):
What
Speaker 2 (08:57):
If you just glow
Speaker 3 (08:59):
What you know,
Speaker 2 (09:00):
?
Do you ever hear that?
I don't sweat, I glow.
Glow.
I know.
Well, um, that's a veryinteresting question that I
haven't thought about lately.
But sweating is your body'snormal mechanism for cooling
itself off.
That's the whole point of it.
As liquid evaporates, it takesheat with it.
So liquid on your skin takesheat away and you literally
(09:23):
radiate heat off of your body.
That's why the human body ishot, thereby cooling yourself.
The problem is, is that theprice to pay for perspiration is
loss of fluid inside your body.
So your heart has to beat fasterand faster and faster to keep up
with it.
So that's why you are supposedto drink water when you're
perspiring.
So that's the whole deal withpers perspiration.
(09:43):
What if you don't sweat?
Well, first of all, if it isjust a little bit here and
there, if you're one thatdoesn't drench the clothing, but
you sweat a little bit andyou're not symptomatic, you can
exercise, you can work out.
You don't, you're notembarrassingly, um, sweaty, but
you're otherwise okay.
It's probably nothing to worryabout.
Okay?
But if you truly are dry, younever sweat.
(10:05):
That is a condition called anhy
Speaker 3 (10:08):
Anh hydrosis.
Speaker 2 (10:09):
Okay?
Anh hydrosis.
It can be the sign of anunderlying autoimmune disorder
like lupus or something likethat.
Wow.
It can be the sign of skinproblems, neurologic problems,
and then your body cannot coolitself off because you lack the
main mechanism of sweating.
It's interesting.
Dogs don't sweat they pant.
Right?
And it's the same thing.
They're, they're, they're tryingto relieve heat.
(10:30):
So if you don't sweat at all,tri paning and your face gets a
little flushed, uh, your bodyisn't quite responding as it was
supposed to.
So I would have that looked atby your primary doctor, maybe a
neurologist, maybe arheumatologist to see if you
have some autoimmune disorder.
Okay?
Because Anh hydrosis isgenerally a lifelong condition.
Most of us don't have that.
(10:51):
Most of us just have a minimalamount of perspiration.
Um, but you don't have someunderlying disorder, but you
should look into it if, if youreally, truly don't sweat at
Speaker 3 (11:00):
All.
Yeah.
I mean, the truth is, is somepeople sweat more than others,
right?
Yeah.
Speaker 2 (11:03):
Some people, you know, you just see like some guy
working out and they've got somegray sweatpants and shirt on it.
It's all drenched.
Speaker 3 (11:09):
Yes.
It's a very dark gray.
Oh,
Speaker 2 (11:10):
It's a very dark gray .
We're not all like that.
Everybody sweats a little bit,but if you don't have it looked
at.
Speaker 3 (11:14):
Okay, well, I think that earns us a break and maybe
even a glass of water just tomake sure.
All right,.
Uh, so, okay.
We'll be right back at rightafter this break with a couple
more questions.
Stay with us.
Speaker 1 (11:26):
You are listening to the Healthy Matters podcast with
Dr.
David Hilden.
Got a question or comment forthe doc, email us at Healthy
Matters hc m e d.org, or give usa call at six one two eight
seven three talk.
That's 6 1 2 8 7 3 8 2 5 5.
And now let's get back to morehealthy conversation.
Speaker 2 (11:48):
And we're back with the Hilton's house calls,
answering your questions abouthealth and wellness.
Wellness.
John, what else you got?
Speaker 3 (11:54):
All right.
Well, our next question comes infrom Carrie in Minneapolis.
She asks, is it true that youshould change your toothbrush
after having the flu?
Am I going to reinfect myself oram I already inoculated to the
strain of flu I've alreadysuffered through?
Speaker 2 (12:08):
The latter part is true once you are relatively
secure from getting the same fluvirus you just had, okay, your
body does have the defense inthat.
Now there are a zillion otherstrains when you can get another
strain, but should you changeyour toothbrush?
The, there's probably not justtons of data on this, but I did
do some reading on that, um, acouple years ago.
(12:31):
And there are people who changetheir toothbrushes, and I had
not heard of that.
Theoretically, it is possiblefor germs to live on your
toothbrush generally as long asit's wet.
Okay?
And maybe a little bit longerfor some of them, but here's the
deal, as long as it's you justusing it, I would not go use
your partner's wet toothbrush,gross, even if they don't have
(12:53):
the flu, just because it has ahigh nasty but oo factor.
Um, but because germs, bacteria,and viruses and the light can
live on those surfaces, if youwanna be super duper careful
with your own toothbrush, uh,habits maybe have two
toothbrushes.
Okay.
Speaker 3 (13:09):
Yeah.
I, I think we've talked aboutthat.
Yeah.
I
Speaker 2 (13:11):
Think maybe we've even talked about in previous
episode, put one on the counteror in a toothbrush holder and
when you use it, let it dry andthen use the other one the next
time and replace yourtoothbrushes.
Um, often, but the reason fordoing that is not cuz of germs,
it's because it's for yourdental care.
Gotcha.
But I think in the grand schemeof things you can do for your
health, this isn't high on whatI would recommend, if you're
(13:32):
really super, kind of obsessiveabout, about this kind of stuff,
use two toothbrushes.
But if you're not that person, Iwould just not
Speaker 3 (13:39):
Worry about it.
All right.
Okay.
Cool.
Speaker 2 (13:40):
There's certain things you just can't worry
about.
Speaker 3 (13:41):
Sure.
Well, tell that to someof us, right?
Speaker 2 (13:44):
, yeah.
Easy for you
Speaker 3 (13:46):
To say.
Cool.
And we've got one from Kevin inLakeville.
Uh, he says, I've got anappointment with the her
neologist at the beginning ofnext year.
Ooh.
Um, I'm not scared, but I alsodon't know what to expect.
Can you talk me off the ledge?
Speaker 2 (13:59):
Yeah.
Uh, uh, first of all, I'm notsure I used the word her
neologist, but I kind
Speaker 3 (14:03):
Of like it.
That's a$5 word.
Speaker 2 (14:04):
There are surgeons who specialize in hernia repair.
Okay?
But, uh, I, I'm not sure I'veever used that word.
A hernia anywhere in your bodyis one body part bulging out
into another.
So you can have a hiatal herniawhere a portion of your stomach
bulges through your diaphragminto your chest cavity.
You can have an umbilical herniawhere the defect in the muscles
(14:28):
of your abdominal wall causes alittle break in that right
around your belly button and thecontents of your belly.
Read that as your intestinesSure.
Can bulge their way through.
You can have what is the mostcommon kind, and that would be
an inguinal hernia.
This is present in both men andwomen.
A certain kind is very common inmen.
And an your inguinal area isyour groin.
(14:50):
Okay?
That's what that is.
And in men, when your body wasdeveloping, your reproductive
organ started in your belly.
They, they descended yourtesticles into your scrotum, and
they came through your belly,that belly, the hole they came
through closed up.
Okay?
And it, the, the muscles grewtogether later in life.
(15:12):
Uh, I don't even know what thecauses are in increased pressure
can do it or it can just be, uh,just, it just happened.
Okay?
That hole isn't so stronganymore, and the intestines
bulge through again, as long asyou can push your intestines
back in.
I know that sounds weird, but ifyou have a little teeny bulge,
it's real, the size of a golfball or something kind of in
your groin area, and you canpush it in and it doesn't hurt,
(15:35):
it is not dangerous.
Okay?
At that moment, the when itcould be dangerous is if you
can't push it back in, yourintestines could get stuck in
the hole.
This is not common, but it doeshappen.
Okay?
And, and it's not gonna getbetter.
This attorney is not likely toget better.
So this is one of the mostcommon surgeries done in the
(15:55):
world, I think.
I'm not a surgeon, but it's socommon that most of your
surgeons are not losing sleepover how they're gonna pull off
this amazing surgery.
This is what they do day in andday out.
And they simp There's two waysto do it.
There might be more sure.
But the two I know about is theycan simply take your abdominal
muscles and, and fascia andconnective tissue and sew'em
back together.
(16:15):
They can just sew'em together.
But sometimes that hole getskind of big and they reinforce
it.
The second method, theyreinforce it with a surgical
mesh, which looks like windowscreen, but costs a whole lot
more.
Wow.
, I think of itlike I asked the surgeon one.
So do you just like, go down toHome Depot, buy a bunch of
window screen and cut it with ascissors?
And they don't, but it's not somuch different than that, and
(16:38):
they put it over the hole andthey sew in that window screen
to hold your contents of yourbelly in your belly.
So this is a minor surgery.
I do recommend that men or womenwho get a hernia, have a look,
have a talk with a surgeon.
It's a minor surgery, and youcan be done with it forever.
And then you can eliminate thepossibility of in the future,
that thing gets stuck in theircondition called, uh,
(17:01):
incarceration or strangulationof the hernia.
Speaker 3 (17:03):
And, uh, just curious recovery time.
How, how long are you out?
Yeah.
Speaker 2 (17:07):
A few days of the acute recovery, and then after a
few weeks, you're walking alittle gingerly, but, uh, you're
not in agony.
Gotcha.
You'll have a little sorenessfor a few weeks, and then
you're, you're
Speaker 3 (17:16):
Good to go.
Gotcha.
All right.
Well, that's some good intelthere.
Thank you very much.
Let's, uh, take a look at ournext one.
This is one that came into usfrom Jane in Smyrna, Georgia,
and she wrote to us and wascurious about celiac disease,
had made a suggestion that we doan episode around it, which I
think is a great idea, Jane,we're on it.
But in the meantime, maybe wecould just shed some light as to
what's celiac disease and what'sa quick primer around that.
Speaker 2 (17:38):
Jane, thanks for listening and thanks for sending
in this suggestion.
I love that idea.
I'm gonna get one of mycolleagues and talk about celiac
disease.
You may or may not have heard ofceliac disease, but it, it is
being diagnosed way more than itwas, right?
A few decades ago.
Now that's not clear.
Why are we simply looking for itmore mm-hmm.
, or is the actualprevalence rising over the
(18:02):
decades?
Right.
And it could be both.
We do have better ways to lookfor it.
There's simply a blood test youcan do now to see if you might
have it, and then, uh, so it'seasier to diagnose.
But it also could be that ourdiets have changed from the
fifties and is causing moreproblems.
But celiac disease is yourbody's inability to process
gluten.
Gluten is a protein that isfound in many grains, including
(18:25):
the big one, wheat.
And there are wheat products inso much of what we eat.
It is everywhere.
Even if you didn't think you'reeating a wheat product, there
are fillers and preservativesand thickeners, and it's in
everything.
And so people with celiacdisease simply cannot eat
gluten.
The treatment isn't amedication, the treatment is to
(18:45):
a 100% eliminated.
Eliminated, okay.
Which is really hard.
You, every restaurant you go to,if the server doesn't know if
there's gluten in it, you can'teat it, right?
So, so it's hard to do.
Um, what happens in celiacdisease is that, uh, the lining
of your intestine gets, um,destroyed and it can't process
that.
But what I'm gonna talk aboutwhen we do this show is people
(19:06):
who maybe don't have celiacdisease, but they have a
sensitivity to gluten, right?
That is also on the rise.
And we're gonna delve into thatwhen we do this show.
So that's what, that's whatwe'll say now about celiac and
gluten.
That's a great topic thataffects a zillion people.
And that's a, that's the correctfigure.
It's
Speaker 3 (19:22):
A zillion, it's a zillion.
A proper zillion,
Speaker 2 (19:23):
Okay.
Yeah.
It's, it's very prevalent.
Speaker 3 (19:25):
It sure is.
And that show is now on thedocket.
Thank you for the suggestion,Jane.
Uh, all right, moving on.
We got one from Charlene.
She says she's been takinghydralazine and losartan,
something like that.
Yeah, that's good.
For around four to five yearsfor blood pressure.
Uh, she says, I've noticed anincrease in joint pain in my
shoulder and arm, as well aslower back and leg.
(19:45):
No other issues.
Now my blood pressure is runninglow and has been for some time.
Can this be related to thismedication?
And I was wondering if a lowerdose might help any word for
Charlene.
Speaker 2 (19:56):
Yeah, there's a lot there.
Um, and, and of course I can'tget specifics about Charlene's
dosing, but there's a lot thereto, to talk about.
I'll, I'll, I'll say a fewthings.
One, if you are having newsymptoms of any kind in your
body after starting amedication, yes, it is always
possible that it's themedication.
And hydralazine particularly isknown to have some joint pains.
(20:17):
Okay?
On the other hand, if you havebeen on hydralazine for five
years and your joint painsstarted last week, it's probably
not.
The hydralazine is probablysomething else because there's
dozens of reasons people havejoint pain and the hydralazine
is only one of them.
So I think it's probably not,but it's possible.
Okay.
The joint pains, as for themedications, you are on two
blood pressure medicines.
(20:39):
One of them is considered afirst line medicine.
There are three or four classesof medicines that are considered
first line.
First thing you should take,losartan would be in that group
that is very common.
It's called an, um, it's a, areceptor blocker.
The other one, hydralazine isnot considered first line.
It is effective for bloodpressure, but it has some
drawbacks.
One drawback is you have to takeit two to three times a day.
(21:01):
Most people are taking it threetimes a day.
Any medication that you have totake that often is far less
likely to be effective becausethere is, I've yet to meet the
human being that can take amedicine three day, 10 a day.
That really is without fail,I've yet to meet that person.
We always try to reduce dosingto once a day or less if we can.
So that's a drawback.
The other drawback is it's notall that potent.
(21:22):
Um, it, it has not, doesn't havethe scientific, um, uh, evidence
that the other ones do.
So hydralazine is good to be onif you've exhausted all the
other ones.
Okay.
So for this listener, if yourblood pressure is low, it is
clear to me that the one I wouldat least look at is your
hydralazine.
Now, you as, as one to cut backthe dose or eliminate I, um, I
(21:44):
don't care how you get yourblood pressure down so much is
that you do, but this listenersaid the blood pressure is low,
right?
And hydralazine would be awonderful one to consider
stopping.
But again, I'm gonna say veryclearly, I can't give specific
advice, but talk to your doctor.
Should I, my blood pressure'slow, do I need all these
medications?
And if you could eliminate,wanna eliminate the one you have
to take three times a day.
(22:05):
Sure,
Speaker 3 (22:06):
Sure.
And as always, yeah, if youdon't need it, if
Speaker 2 (22:08):
You don't need it, if you don't need it at all, yeah.
Oh, that would be the one first.
Less medication.
The best, the one you shouldstop is the hydralazine.
It, it's a vasodilator.
It makes blood vessels dilate,and that helps your blood
pressure.
Speaker 3 (22:19):
Gotcha.
The important part would just bekeeping that as low as we can.
Yep.
Speaker 2 (22:24):
Keeping hypertension is the leading cause, uh,
leading risk factor for stroke.
It is a major risk factor forheart disease and kidney
disease.
So get your blood pressure down.
Preferably the top number shouldbe in the one twentie s and the
bottom number should be in theseventies or
Speaker 3 (22:37):
Lower.
Very good.
All right, well let's wrap it uphere.
We got one more with David fromNew Jersey, because of course it
wouldn't be a q and a showwithout something related to
Covid.
Right?
So Right.
Speaker 2 (22:45):
And, and from our, our listener base in New Jersey.
Speaker 3 (22:47):
Yeah, of course, of course.
Yeah.
And thanks to David, we've gotboth here.
Uh, okay, so he says, I've had asore throat and a slight fever
the other day and went to urgentcare, although flu and covid
tests were negative when I wasthere, they gave me an
antibiotic just in case.
Seems like pretty standardpractice.
And then he says, I've sincetested positive for covid.
Should I still take theantibiotic?
Speaker 2 (23:09):
Ooh.
Yeah.
It is standard practice and itshouldn't be.
Okay.
Um, they never should have given'em that antibiotic.
They
Speaker 3 (23:14):
Give
Speaker 2 (23:14):
'em all the time.
You know, I, I often, um, soantibiotics don't treat viruses
and I, I don't know the exactnumber, but it's something like
90%, nine 0% of the upper headsymptoms that people come in for
are caused by viruses.
That would be sore throat,snuffy, nose sinusitis is 90%
viral.
Everyone says, yeah, but I havea sinus infection.
(23:35):
Yeah, you do.
It's viral.
Okay.
.
Alright.
Um, but my stuff is green thatcomes outta my nose.
Yep.
It sure is.
It's viral.
Um, those are not predictors ofa, a bacterial infection.
And so this person who came in,David, when you went in and you
had these symptoms, they thoughtit was viral, and yet they gave
you the antibiotic anyway.
(23:56):
And so that I, that isproblematic.
That is problematic for youpersonally because taking an an
antibiotic puts you at risk forall kinds of things.
Um, for you personally, thebiggest risk is for
gastrointestinal complications.
You're gonna get diarrhea.
Wow.
And you are at risk for what youreally, really don't want to
get.
And that's clostridium difficilec diff so that, so you don't
(24:17):
take'em unless you have to.
Okay.
So it's not good for you.
It's also not good for theearth.
It is not good for all ofhumanity because, uh, the
bacteria are outsmarting us.
And pretty soon, over the courseof years, every year, some
bacteria becomes resistant tothe antibiotics we have and we
need to save the antibiotics forwhen we really need them.
Now, David went in the next dayand had covid.
So his symptoms the first daywere covid.
(24:38):
And it's just that the testwasn't positive yet.
So I wouldn't take thatantibiotic.
You do not need it.
It's gonna do nothing for your cand it's just gonna put you at
risk for gastrointestinal sideeffects, nausea, diarrhea.
And so I would simply not takeit.
If you took one or two, I wouldstop it right now.
Okay.
Speaker 3 (24:53):
You don't need to taper off or,
Speaker 2 (24:54):
Well, we do hear all the time about if you have this
taken'til they're gone.
That is a true statement.
When you have an infection, thatis true.
Um, if you have a real truebacterial infection, let's say
pneumonia, and you only take oneor two doses, you've killed off
all the weak bacteria.
Think of an army.
You killed off all the weakones, right?
You left a few of the strongbacteria to live another day.
(25:17):
So you want to continue yourantibiotics till they're gone.
All
Speaker 3 (25:21):
The tough
Speaker 2 (25:22):
Guys are out.
That's right.
In this case, however, youdidn't eat'em in the first
place, they're, they're notkilling anything except
beneficial bacteria.
So I think in your case, if youhaven't started it, don't.
And if you have, stop
Speaker 3 (25:33):
It.
Well, I think that's pretty muchwrapping it up for today for us.
Speaker 2 (25:36):
Thanks for helping out, John.
These were great questions.
Uh, absolutely.
Thank you listeners for tuningin.
I hope your 2023 New Year'sresolutions are off to a great
start, and I hope you'll join usfor our next episode as well.
In the meantime, be healthy andbe well.
Speaker 1 (25:52):
Thanks for listening to the Healthy Matters podcast
with Dr.
David Hilden.
Got a question or a comment forthe show, email us at Healthy
Matters hc m e d.org or call 6 12 8 7 3 talk.
There's also a link in the shownotes.
The Healthy Matters Podcast ismade possible by Hennepin
Healthcare in Minneapolis,Minnesota, and engineered and
(26:13):
produced by John Lucas Athighball Executive producers are
Jonathan Comito and ChristineHill.
Please remember, we can onlygive general medical advice
during this program, and everycase is unique.
We urge you to consult with yourphysician if you have a more
serious or pressing healthconcern.
Until next time, be healthy andbe well.
Welcome to the Healthy Matters podcast with Dr.
David Hilden, primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health, healthcare and
what matters to you.
And now here's our host, Dr.
David Hilden.
Speaker 2 (00:20):
Hey, everybody.
Happy New Year.
It's Dr.
David Hilden, your host of theHealthy Matters podcast.
Welcome to episode three ofSeason two, and to start the new
year off right, we're gonna doanother episode of Hilton's
House calls.
To help me out, I have JohnLucas, one of the producers of
the Healthy Matters podcast, andhe's gonna help us get through
some of the questions we've beenaccumulating over the past few
months.
(00:40):
John, take it away.
Speaker 3 (00:42):
All right.
Okay.
So here goes, our first questioncomes from Miranda in St.
Paul.
She's wondering what's yourroutine as a doctor?
It's kind of a personalquestion, but okay, let's roll
with it.
Uh, do you
Speaker 2 (00:53):
Well, I get up, I comb my hair sometimes
Speaker 3 (00:55):
So she asks more specifically, do you drink
alcohol?
Do you take a multivitamin?
I can assume you're pretty busy,but what do you do for
self-care?
That's a pretty
Speaker 2 (01:03):
Good question.
That is a great question.
It's a question probably everyone of us could or should ask
ourselves, regardless of whatyou do for a living or what your
daily life.
Absolutely.
It's like, mine is, I'm a nightperson.
Uh, so I, um, I have do, likethe caller says, I have very
busy days and so I try to findtimes for self-care when I can.
(01:24):
That is not often the advice Igive to patients.
I say, schedule a time, do yourworkout.
Sure.
Monday, Wednesday, Friday.
At the same time, make time foryourself.
I don't do that.
Uh, my schedule is too variable.
Uh, okay.
So I do try to work out at leastthree or four times a week by
running, I'm an outdoor runner,even in Minnesota.
I ran around one of ourMinneapolis lakes yesterday as a
(01:46):
little aside.
There were people swimming and ahole in the ice and it was four
degrees out.
Um, but that's a Minnesotathing.
Yeah.
Um, I do a exercise bike in mybasement.
Uh, do I drink alcohol?
I do.
You know, an interesting thingabout my, my work friends is
that, uh, uh, it's fairly commonI think for physicians to, um,
have a glass of wine with dinneror a, a cocktail, but it doesn't
(02:10):
necessarily mean physicians areany different.
In fact, we're not.
They're just as susceptible toalcohol abuse and, and using
alcohol medicinally and whenyou're feeling stressed.
And so I find myself having totell myself that very thing.
Do I want this glass of wineright now or am I just
habitually reaching for it?
Cuz it was a stressful day.
(02:30):
And that is something that allpeople should do.
If you come home withoutthinking and crack a beer every
single day, you're not thinkingabout it.
Right.
That's not a good routine.
None of us should be doing that.
If it's a special day or it's,uh, you're thinking about it and
it's like, wow, I'd really likea beer right now and you don't
have alcohol abuse problems, goahead and have that beer.
That's what I try to do.
(02:50):
Be more intentional.
Okay.
Um, and maybe not have it be,well, it's Tuesday I'm having a
beer.
Sure, sure.
That's not a good way to go.
So I'm trying to fit exercise,trying to fit healthy diet into
my, uh, into my life.
I've learned a lot about healthydiet from doing this podcast
through Yeah,
Speaker 3 (03:05):
Me too, me too.
The
Speaker 2 (03:06):
Last episode, for instance.
Yeah.
Go listen to Kate Shafto talkabout diet on the very last
episode.
And, uh, I'm learning a lotabout diet as well.
So diet, exercise, moderatealcohol, and then that's what I
try to do.
Gotcha.
Speaker 3 (03:17):
Okay.
So doctors are people too.
Speaker 2 (03:19):
Exactly.
Yeah.
Hard to believe.
And then I also believe, and Ididn't mention this strongly in
the value of art and the arts,whatever that is for you, for
me, it, it is classicalorchestral music.
So I go to, uh, the orchestra at, in Minnesota as one of the
world's best orchestras.
We do, we do.
And I go hear that all the time.
(03:39):
Um, I, I'm there frequently andI am also at the other end of
sort of the genre spectrum.
I'm a huge Bruce Springsteenfan.
I consider that to be darn neara religious ex experience.
Oh yeah.
So self-care through the art,whatever it is that you like,
doesn't have to be Springsteenor classical music.
It can be anything.
I think the arts make ushealthier.
Speaker 3 (03:59):
The, the healing properties of music and art.
I huge.
Speaker 2 (04:01):
It can be hiphop hop, I'm unbeliev.
It can be dance, it can be goingto your local art institute.
It can be going to a coffee shopand listening to one guy strum a
guitar, whatever it is.
Speaker 3 (04:10):
Art oftentimes better than that beer, often
Speaker 2 (04:12):
Better than the beer.
I'm with you, John.
Speaker 3 (04:14):
Okay.
So onto our next question.
And this came in from Teddy inMadison.
He says, I'm in my mid fortiesand I recently chipped two teeth
fairly easily, and I've alsonoticed that my fingernails are
a bit more brittle now.
I've never been in my midforties before, so I'm not sure
what to expect as I age.
Is there something to this, doteeth weaken over time or is
(04:34):
there anything I can do to helpstrengthen my teeth and nails?
It
Speaker 2 (04:37):
Is true that the, the nails and the teeth and even
your hair, these things dochange as you age.
They tend to get more dry andbrittle.
Your teeth have a tough enamelcoating that can, uh, age as you
age.
And so there are some things youcan do.
The first thing I would suggestyou do though is find out if
(04:58):
there is an underlyingreversible cause or if you're
just gonna chalk this up to thepassing of the years, there are
some things that cause yourfinger and toenails and to get
more brittle and soft.
It can be either excessivemoisture, like maybe you are
work as a dishwasher for aliving, or your hands are always
wet.
It can be excessive dryness.
(05:19):
And it, both of those casesreverse that.
Cause if they're excessivelydry, make'em less dry.
Moisturizer.
If, if you are around wetenvironments a lot, wear gloves,
dry them off a lot.
You also should look forunderlying causes like thyroid
disease, perhaps some autoimmunedisorders, nutritional
deficiencies like anemia thatcan lead to problems mostly with
(05:40):
nails.
As for your teeth, it's largelya self-care issue.
Make sure you're brushing yourteeth, you're flossing your
teeth, and that you're gettingadequate calcium and vitamin D
in your diet.
If all of those things are true,it could well be that you're
just, you're getting morebrittle as you age and those
kind of self cares will be yourbest bet for, uh, uh, protecting
yourself going
Speaker 3 (06:00):
Forward.
Gotcha.
Okay.
So you could chalk it up torust, but in the meantime, let's
look into these things.
Exactly.
Gotcha.
All right.
Very good.
Excellent.
Uh, well, thanks for thatquestion, Teddy.
All right.
This one is from Alex in Duluth.
She says, my feet get reallycold, which I assume is from
poor circulation.
And I also recently noticed thatI've been getting spikes in my
heart rate.
(06:21):
Is there a chance these twocould be related, as in, does my
heart pump faster to try to keepmy extremities warm?
That's an interesting question.
It
Speaker 2 (06:28):
Is an interesting question, and it is possible
that they're related but notcertain.
Okay.
I'll say a little bit more aboutthat.
Um, cold feet can be due to badcirculation.
It can be due to somethingcalled ray nodes phenomenon,
where your little bitty bloodvessels kind of constrict people
get that in their, in theirhands and feet.
And, uh, that can be somethingthat is unrelated to anything
else.
(06:48):
And, uh, you don't have to worryso much about that.
Again, like the previousquestion, I would look for
underlying causes like thyroiddisease.
People who have cold extremitiesoften, um, not often, but can
have thyroid disease, anemia,things like that.
Now, whether or not the heartrate is related is, uh, not
quite so clear.
It is true that your heartresponds to all kinds of
(07:11):
physiologic changes, um, in, inyour environment.
If your cold, your, your bodytries to shunt blood to the
areas to warm it up.
If your, if a certain part ofyour body isn't getting enough,
uh, blood, the blood vessels eexpand and the heart can beat
faster to try to do that.
But the heart and the bodysomehow is quite smart.
It knows that there are fourplaces the blood needs to go
(07:33):
preferentially.
It needs to go to your brain,your heart itself, your liver,
and your kidneys.
Those four things get themajority of your blood supply at
the expense sometimes of yourfeet.
Okay.
Uh, you can frankly live withoutyour feet.
You can't live without thosefour organs.
So, um, it's complicated.
Let's just say that.
(07:54):
Um, sure it's quite complicated.
It's
Speaker 3 (07:55):
Never easy.
But,
Speaker 2 (07:56):
But, uh, you know, causes of a fast heart rate
dehydration.
Um, some of these vascularchanges we've just been talking
about, it could be due to, um,uh, anxiety or palpitations just
because you're aware of it.
Some people are simply aware ofyour heartbeat, a condition
called palpitations.
It doesn't necessarily meanthere's anything wrong, it's
just that it freaks the humanbody out to be aware of your own
(08:19):
heartbeat.
You're not supposed to be awareof it.
Right.
So I would suggest to you have asmall evaluation, get a couple
blood tests, make sure you'renot anemic.
Make sure you don't have thyroidproblems.
I would ask the doctor to get anEKG to make sure your heart is
doing everything it's supposedto, and then put on a really
good pair of socks.
Speaker 3 (08:36):
All right.
Well, in Minnesota, those are,uh, worth their weight and gold.
Mm-hmm.
Hopefully that helps.
Alex.
Well, let's, uh, sneak one morein before our break here.
And this one came in from Karenand she says, I keep reading
about the benefits of sweating abit each day, which, hey, this
is kind of in line with theexercise question we got.
Okay.
Uh, what if you don't sweat?
I just get a red face.
What can one do?
(08:57):
What
Speaker 2 (08:57):
If you just glow
Speaker 3 (08:59):
What you know,
Speaker 2 (09:00):
Do you ever hear that?
I don't sweat, I glow.
Glow.
I know.
Well, um, that's a veryinteresting question that I
haven't thought about lately.
But sweating is your body'snormal mechanism for cooling
itself off.
That's the whole point of it.
As liquid evaporates, it takesheat with it.
So liquid on your skin takesheat away and you literally
(09:23):
radiate heat off of your body.
That's why the human body ishot, thereby cooling yourself.
The problem is, is that theprice to pay for perspiration is
loss of fluid inside your body.
So your heart has to beat fasterand faster and faster to keep up
with it.
So that's why you are supposedto drink water when you're
perspiring.
So that's the whole deal withpers perspiration.
(09:43):
What if you don't sweat?
Well, first of all, if it isjust a little bit here and
there, if you're one thatdoesn't drench the clothing, but
you sweat a little bit andyou're not symptomatic, you can
exercise, you can work out.
You don't, you're notembarrassingly, um, sweaty, but
you're otherwise okay.
It's probably nothing to worryabout.
Okay?
But if you truly are dry, younever sweat.
(10:05):
That is a condition called anhy
Speaker 3 (10:08):
Anh hydrosis.
Speaker 2 (10:09):
Okay?
Anh hydrosis.
It can be the sign of anunderlying autoimmune disorder
like lupus or something likethat.
Wow.
It can be the sign of skinproblems, neurologic problems,
and then your body cannot coolitself off because you lack the
main mechanism of sweating.
It's interesting.
Dogs don't sweat they pant.
Right?
And it's the same thing.
They're, they're, they're tryingto relieve heat.
(10:30):
So if you don't sweat at all,tri paning and your face gets a
little flushed, uh, your bodyisn't quite responding as it was
supposed to.
So I would have that looked atby your primary doctor, maybe a
neurologist, maybe arheumatologist to see if you
have some autoimmune disorder.
Okay?
Because Anh hydrosis isgenerally a lifelong condition.
Most of us don't have that.
(10:51):
Most of us just have a minimalamount of perspiration.
Um, but you don't have someunderlying disorder, but you
should look into it if, if youreally, truly don't sweat at
Speaker 3 (11:00):
All.
Yeah.
I mean, the truth is, is somepeople sweat more than others,
right?
Yeah.
Speaker 2 (11:03):
Some people, you know, you just see like some guy
working out and they've got somegray sweatpants and shirt on it.
It's all drenched.
Speaker 3 (11:09):
Yes.
It's a very dark gray.
Oh,
Speaker 2 (11:10):
It's a very dark gray .
We're not all like that.
Everybody sweats a little bit,but if you don't have it looked
at.
Speaker 3 (11:14):
Okay, well, I think that earns us a break and maybe
even a glass of water just tomake sure.
All right,
Uh, so, okay.
We'll be right back at rightafter this break with a couple
more questions.
Stay with us.
Speaker 1 (11:26):
You are listening to the Healthy Matters podcast with
Dr.
David Hilden.
Got a question or comment forthe doc, email us at Healthy
Matters hc m e d.org, or give usa call at six one two eight
seven three talk.
That's 6 1 2 8 7 3 8 2 5 5.
And now let's get back to morehealthy conversation.
Speaker 2 (11:48):
And we're back with the Hilton's house calls,
answering your questions abouthealth and wellness.
Wellness.
John, what else you got?
Speaker 3 (11:54):
All right.
Well, our next question comes infrom Carrie in Minneapolis.
She asks, is it true that youshould change your toothbrush
after having the flu?
Am I going to reinfect myself oram I already inoculated to the
strain of flu I've alreadysuffered through?
Speaker 2 (12:08):
The latter part is true once you are relatively
secure from getting the same fluvirus you just had, okay, your
body does have the defense inthat.
Now there are a zillion otherstrains when you can get another
strain, but should you changeyour toothbrush?
The, there's probably not justtons of data on this, but I did
do some reading on that, um, acouple years ago.
(12:31):
And there are people who changetheir toothbrushes, and I had
not heard of that.
Theoretically, it is possiblefor germs to live on your
toothbrush generally as long asit's wet.
Okay?
And maybe a little bit longerfor some of them, but here's the
deal, as long as it's you justusing it, I would not go use
your partner's wet toothbrush,gross, even if they don't have
(12:53):
the flu, just because it has ahigh nasty but oo factor.
Um, but because germs, bacteria,and viruses and the light can
live on those surfaces, if youwanna be super duper careful
with your own toothbrush, uh,habits maybe have two
toothbrushes.
Okay.
Speaker 3 (13:09):
Yeah.
I, I think we've talked aboutthat.
Yeah.
I
Speaker 2 (13:11):
Think maybe we've even talked about in previous
episode, put one on the counteror in a toothbrush holder and
when you use it, let it dry andthen use the other one the next
time and replace yourtoothbrushes.
Um, often, but the reason fordoing that is not cuz of germs,
it's because it's for yourdental care.
Gotcha.
But I think in the grand schemeof things you can do for your
health, this isn't high on whatI would recommend, if you're
(13:32):
really super, kind of obsessiveabout, about this kind of stuff,
use two toothbrushes.
But if you're not that person, Iwould just not
Speaker 3 (13:39):
Worry about it.
All right.
Okay.
Cool.
Speaker 2 (13:40):
There's certain things you just can't worry
about.
Speaker 3 (13:41):
Sure.
Well,
Speaker 2 (13:44):
Easy for you
Speaker 3 (13:46):
To say.
Cool.
And we've got one from Kevin inLakeville.
Uh, he says, I've got anappointment with the her
neologist at the beginning ofnext year.
Ooh.
Um, I'm not scared, but I alsodon't know what to expect.
Can you talk me off the ledge?
Speaker 2 (13:59):
Yeah.
Uh, uh, first of all, I'm notsure I used the word her
neologist, but I kind
Speaker 3 (14:03):
Of like it.
That's a$5 word.
Speaker 2 (14:04):
There are surgeons who specialize in hernia repair.
Okay?
But, uh, I, I'm not sure I'veever used that word.
A hernia anywhere in your bodyis one body part bulging out
into another.
So you can have a hiatal herniawhere a portion of your stomach
bulges through your diaphragminto your chest cavity.
You can have an umbilical herniawhere the defect in the muscles
(14:28):
of your abdominal wall causes alittle break in that right
around your belly button and thecontents of your belly.
Read that as your intestinesSure.
Can bulge their way through.
You can have what is the mostcommon kind, and that would be
an inguinal hernia.
This is present in both men andwomen.
A certain kind is very common inmen.
And an your inguinal area isyour groin.
(14:50):
Okay?
That's what that is.
And in men, when your body wasdeveloping, your reproductive
organ started in your belly.
They, they descended yourtesticles into your scrotum, and
they came through your belly,that belly, the hole they came
through closed up.
Okay?
And it, the, the muscles grewtogether later in life.
(15:12):
Uh, I don't even know what thecauses are in increased pressure
can do it or it can just be, uh,just, it just happened.
Okay?
That hole isn't so stronganymore, and the intestines
bulge through again, as long asyou can push your intestines
back in.
I know that sounds weird, but ifyou have a little teeny bulge,
it's real, the size of a golfball or something kind of in
your groin area, and you canpush it in and it doesn't hurt,
(15:35):
it is not dangerous.
Okay?
At that moment, the when itcould be dangerous is if you
can't push it back in, yourintestines could get stuck in
the hole.
This is not common, but it doeshappen.
Okay?
And, and it's not gonna getbetter.
This attorney is not likely toget better.
So this is one of the mostcommon surgeries done in the
(15:55):
world, I think.
I'm not a surgeon, but it's socommon that most of your
surgeons are not losing sleepover how they're gonna pull off
this amazing surgery.
This is what they do day in andday out.
And they simp There's two waysto do it.
There might be more
But the two I know about is theycan simply take your abdominal
muscles and, and fascia andconnective tissue and sew'em
back together.
(16:15):
They can just sew'em together.
But sometimes that hole getskind of big and they reinforce
it.
The second method, theyreinforce it with a surgical
mesh, which looks like windowscreen, but costs a whole lot
more.
Wow.
So do you just like, go down toHome Depot, buy a bunch of
window screen and cut it with ascissors?
And they don't, but it's not somuch different than that, and
(16:38):
they put it over the hole andthey sew in that window screen
to hold your contents of yourbelly in your belly.
So this is a minor surgery.
I do recommend that men or womenwho get a hernia, have a look,
have a talk with a surgeon.
It's a minor surgery, and youcan be done with it forever.
And then you can eliminate thepossibility of in the future,
that thing gets stuck in theircondition called, uh,
(17:01):
incarceration or strangulationof the hernia.
Speaker 3 (17:03):
And, uh, just curious recovery time.
How, how long are you out?
Yeah.
Speaker 2 (17:07):
A few days of the acute recovery, and then after a
few weeks, you're walking alittle gingerly, but, uh, you're
not in agony.
Gotcha.
You'll have a little sorenessfor a few weeks, and then
you're, you're
Speaker 3 (17:16):
Good to go.
Gotcha.
All right.
Well, that's some good intelthere.
Thank you very much.
Let's, uh, take a look at ournext one.
This is one that came into usfrom Jane in Smyrna, Georgia,
and she wrote to us and wascurious about celiac disease,
had made a suggestion that we doan episode around it, which I
think is a great idea, Jane,we're on it.
But in the meantime, maybe wecould just shed some light as to
what's celiac disease and what'sa quick primer around that.
Speaker 2 (17:38):
Jane, thanks for listening and thanks for sending
in this suggestion.
I love that idea.
I'm gonna get one of mycolleagues and talk about celiac
disease.
You may or may not have heard ofceliac disease, but it, it is
being diagnosed way more than itwas, right?
A few decades ago.
Now that's not clear.
Why are we simply looking for itmore mm-hmm.
(18:02):
decades?
Right.
And it could be both.
We do have better ways to lookfor it.
There's simply a blood test youcan do now to see if you might
have it, and then, uh, so it'seasier to diagnose.
But it also could be that ourdiets have changed from the
fifties and is causing moreproblems.
But celiac disease is yourbody's inability to process
gluten.
Gluten is a protein that isfound in many grains, including
(18:25):
the big one, wheat.
And there are wheat products inso much of what we eat.
It is everywhere.
Even if you didn't think you'reeating a wheat product, there
are fillers and preservativesand thickeners, and it's in
everything.
And so people with celiacdisease simply cannot eat
gluten.
The treatment isn't amedication, the treatment is to
(18:45):
a 100% eliminated.
Eliminated, okay.
Which is really hard.
You, every restaurant you go to,if the server doesn't know if
there's gluten in it, you can'teat it, right?
So, so it's hard to do.
Um, what happens in celiacdisease is that, uh, the lining
of your intestine gets, um,destroyed and it can't process
that.
But what I'm gonna talk aboutwhen we do this show is people
(19:06):
who maybe don't have celiacdisease, but they have a
sensitivity to gluten, right?
That is also on the rise.
And we're gonna delve into thatwhen we do this show.
So that's what, that's whatwe'll say now about celiac and
gluten.
That's a great topic thataffects a zillion people.
And that's a, that's the correctfigure.
It's
Speaker 3 (19:22):
A zillion, it's a zillion.
A proper zillion,
Speaker 2 (19:23):
Okay.
Yeah.
It's, it's very prevalent.
Speaker 3 (19:25):
It sure is.
And that show is now on thedocket.
Thank you for the suggestion,Jane.
Uh, all right, moving on.
We got one from Charlene.
She says she's been takinghydralazine and losartan,
something like that.
Yeah, that's good.
For around four to five yearsfor blood pressure.
Uh, she says, I've noticed anincrease in joint pain in my
shoulder and arm, as well aslower back and leg.
(19:45):
No other issues.
Now my blood pressure is runninglow and has been for some time.
Can this be related to thismedication?
And I was wondering if a lowerdose might help any word for
Charlene.
Speaker 2 (19:56):
Yeah, there's a lot there.
Um, and, and of course I can'tget specifics about Charlene's
dosing, but there's a lot thereto, to talk about.
I'll, I'll, I'll say a fewthings.
One, if you are having newsymptoms of any kind in your
body after starting amedication, yes, it is always
possible that it's themedication.
And hydralazine particularly isknown to have some joint pains.
(20:17):
Okay?
On the other hand, if you havebeen on hydralazine for five
years and your joint painsstarted last week, it's probably
not.
The hydralazine is probablysomething else because there's
dozens of reasons people havejoint pain and the hydralazine
is only one of them.
So I think it's probably not,but it's possible.
Okay.
The joint pains, as for themedications, you are on two
blood pressure medicines.
(20:39):
One of them is considered afirst line medicine.
There are three or four classesof medicines that are considered
first line.
First thing you should take,losartan would be in that group
that is very common.
It's called an, um, it's a, areceptor blocker.
The other one, hydralazine isnot considered first line.
It is effective for bloodpressure, but it has some
drawbacks.
One drawback is you have to takeit two to three times a day.
(21:01):
Most people are taking it threetimes a day.
Any medication that you have totake that often is far less
likely to be effective becausethere is, I've yet to meet the
human being that can take amedicine three day, 10 a day.
That really is without fail,I've yet to meet that person.
We always try to reduce dosingto once a day or less if we can.
So that's a drawback.
The other drawback is it's notall that potent.
(21:22):
Um, it, it has not, doesn't havethe scientific, um, uh, evidence
that the other ones do.
So hydralazine is good to be onif you've exhausted all the
other ones.
Okay.
So for this listener, if yourblood pressure is low, it is
clear to me that the one I wouldat least look at is your
hydralazine.
Now, you as, as one to cut backthe dose or eliminate I, um, I
(21:44):
don't care how you get yourblood pressure down so much is
that you do, but this listenersaid the blood pressure is low,
right?
And hydralazine would be awonderful one to consider
stopping.
But again, I'm gonna say veryclearly, I can't give specific
advice, but talk to your doctor.
Should I, my blood pressure'slow, do I need all these
medications?
And if you could eliminate,wanna eliminate the one you have
to take three times a day.
(22:05):
Sure,
Speaker 3 (22:06):
Sure.
And as always, yeah, if youdon't need it, if
Speaker 2 (22:08):
You don't need it, if you don't need it at all, yeah.
Oh, that would be the one first.
Less medication.
The best, the one you shouldstop is the hydralazine.
It, it's a vasodilator.
It makes blood vessels dilate,and that helps your blood
pressure.
Speaker 3 (22:19):
Gotcha.
The important part would just bekeeping that as low as we can.
Yep.
Speaker 2 (22:24):
Keeping hypertension is the leading cause, uh,
leading risk factor for stroke.
It is a major risk factor forheart disease and kidney
disease.
So get your blood pressure down.
Preferably the top number shouldbe in the one twentie s and the
bottom number should be in theseventies or
Speaker 3 (22:37):
Lower.
Very good.
All right, well let's wrap it uphere.
We got one more with David fromNew Jersey, because of course it
wouldn't be a q and a showwithout something related to
Covid.
Right?
So Right.
Speaker 2 (22:45):
And, and from our, our listener base in New Jersey.
Speaker 3 (22:47):
Yeah, of course, of course.
Yeah.
And thanks to David, we've gotboth here.
Uh, okay, so he says, I've had asore throat and a slight fever
the other day and went to urgentcare, although flu and covid
tests were negative when I wasthere, they gave me an
antibiotic just in case.
Seems like pretty standardpractice.
And then he says, I've sincetested positive for covid.
Should I still take theantibiotic?
Speaker 2 (23:09):
Ooh.
Yeah.
It is standard practice and itshouldn't be.
Okay.
Um, they never should have given'em that antibiotic.
They
Speaker 3 (23:14):
Give
Speaker 2 (23:14):
'em all the time.
You know, I, I often, um, soantibiotics don't treat viruses
and I, I don't know the exactnumber, but it's something like
90%, nine 0% of the upper headsymptoms that people come in for
are caused by viruses.
That would be sore throat,snuffy, nose sinusitis is 90%
viral.
Everyone says, yeah, but I havea sinus infection.
(23:35):
Yeah, you do.
It's viral.
Okay.
Alright.
Um, but my stuff is green thatcomes outta my nose.
Yep.
It sure is.
It's viral.
Um, those are not predictors ofa, a bacterial infection.
And so this person who came in,David, when you went in and you
had these symptoms, they thoughtit was viral, and yet they gave
you the antibiotic anyway.
(23:56):
And so that I, that isproblematic.
That is problematic for youpersonally because taking an an
antibiotic puts you at risk forall kinds of things.
Um, for you personally, thebiggest risk is for
gastrointestinal complications.
You're gonna get diarrhea.
Wow.
And you are at risk for what youreally, really don't want to
get.
And that's clostridium difficilec diff so that, so you don't
(24:17):
take'em unless you have to.
Okay.
So it's not good for you.
It's also not good for theearth.
It is not good for all ofhumanity because, uh, the
bacteria are outsmarting us.
And pretty soon, over the courseof years, every year, some
bacteria becomes resistant tothe antibiotics we have and we
need to save the antibiotics forwhen we really need them.
Now, David went in the next dayand had covid.
So his symptoms the first daywere covid.
(24:38):
And it's just that the testwasn't positive yet.
So I wouldn't take thatantibiotic.
You do not need it.
It's gonna do nothing for your cand it's just gonna put you at
risk for gastrointestinal sideeffects, nausea, diarrhea.
And so I would simply not takeit.
If you took one or two, I wouldstop it right now.
Okay.
Speaker 3 (24:53):
You don't need to taper off or,
Speaker 2 (24:54):
Well, we do hear all the time about if you have this
taken'til they're gone.
That is a true statement.
When you have an infection, thatis true.
Um, if you have a real truebacterial infection, let's say
pneumonia, and you only take oneor two doses, you've killed off
all the weak bacteria.
Think of an army.
You killed off all the weakones, right?
You left a few of the strongbacteria to live another day.
(25:17):
So you want to continue yourantibiotics till they're gone.
All
Speaker 3 (25:21):
The tough
Speaker 2 (25:22):
Guys are out.
That's right.
In this case, however, youdidn't eat'em in the first
place, they're, they're notkilling anything except
beneficial bacteria.
So I think in your case, if youhaven't started it, don't.
And if you have, stop
Speaker 3 (25:33):
It.
Well, I think that's pretty muchwrapping it up for today for us.
Speaker 2 (25:36):
Thanks for helping out, John.
These were great questions.
Uh, absolutely.
Thank you listeners for tuningin.
I hope your 2023 New Year'sresolutions are off to a great
start, and I hope you'll join usfor our next episode as well.
In the meantime, be healthy andbe well.
Speaker 1 (25:52):
Thanks for listening to the Healthy Matters podcast
with Dr.
David Hilden.
Got a question or a comment forthe show, email us at Healthy
Matters hc m e d.org or call 6 12 8 7 3 talk.
There's also a link in the shownotes.
The Healthy Matters Podcast ismade possible by Hennepin
Healthcare in Minneapolis,Minnesota, and engineered and
(26:13):
produced by John Lucas Athighball Executive producers are
Jonathan Comito and ChristineHill.
Please remember, we can onlygive general medical advice
during this program, and everycase is unique.
We urge you to consult with yourphysician if you have a more
serious or pressing healthconcern.
Until next time, be healthy andbe well.
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