April 21, 2025 • 42 mins
- Listen Saturday mornings at 8 as Dr. Msonthi Levine discusses medical issues and takes your calls on News Talk 560 KLVI. Dr Levine is board certified in Internal Medicine and Geriatrics. His office is located at 3080 Milam in Beaumont, Texas. He can be reached at 409-347-3621.
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Episode Transcript
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Speaker 1 (00:00):
All right, welcome South East Sex Internet radio listeners. This
is doctor Levine, Doctor Levine Medical out here live in
a series of klv I in beau My, Texas cross
Street from Parkdale Mall, taking your phone calls, answering questions
about healthcare and medicine so that you can stay alive
as long as possible and be as healthy as possible
(00:22):
while you are alive. Who wants to be sick and
ill and having to take a bunch of meds in
order to feel halfway decent, halfway normal. We will try
to answer some of your questions, make it clear for
you see what you need to be doing on a
(00:43):
daily basis to help you stay alive and be healthy.
It's confusing out there, I understand, and sometimes hard to
be healthy out there. I understand that as well, and
so give us a call phone lines or open eight
nine six kV W one hundred three three zero klv I. Typically,
(01:04):
while we wait on phone calls, we will sort of
jump into some topics of choice, whatever's floating through my
head this morning, or whatever topic we get into on
depending on the phone calls that we get. So we'd
love to hear from you. It's just two weight radio.
(01:26):
So again, if there's a topic that you would like
me to prioritize or that you're interested in, we'll be
more than happy to entertain that as well. Keep hearing
things about measles. Seems like this little outbreak sort of
has stayed around a little bit longer than most people
(01:48):
expect it. And as you know, measles is a virus,
and it's been around for a long time. It's it's
a long term player in the environment. But because of vaccines,
vaccination vaccine programs, we sort of got to handle on
(02:08):
the measles virus years ago. But in depending on where
you live and the laws and regulations, there are some
pockets here in this country where people don't get the vaccine.
I think in some areas there's a choice if you
(02:30):
can get it, or if you have to have it,
or there's an opt out clause or excuse clause where,
depending on who you are and your beliefs, maybe you
don't have to subject yourself to the measles vaccine. And
so you basically are unprotected against this particular virus. And
(02:52):
as I've mentioned to you multiple times before, when you're
unprotected against certain organisms, you have no defense to protect
yourself so that when this organism gets inside your body
and starts doing what it's supposed to do, a severe
reaction can occur because you're not ready. You're not prepared,
(03:17):
almost like a surprise attack on the human body. And
you sort of understand military terminology and sort of military dynamics.
When you don't have radars, you don't have tanks and
ships and planes and things of that nature, and you
(03:39):
are invaded, then you basically have no defense and it's
very easy for that entity to sort of come in
and take charge and run over you because you weren't ready.
You're sleeping, And that's sort of how the body is
when you have no defense already built into your system
(04:00):
against certain organisms. Being a kid and growing up, not me,
I'm just saying in general, when you're outside playing and
you're in the dirt and you're in the water, and
you're just getting exposed to all these different organisms and
viruses and bacteria, your body is learning how to defend
(04:25):
itself and generating these antibodies that I've mentioned to you before.
This is the name of the multiple proteins and molecules
that are sort of floating through your system. All the time,
ready to do its job. If something gets inside your bloodstream,
it's there sort of ready to react. And as we're
(04:48):
growing up and doing all the things that we do.
When you're young, I mean, you're more adventurous and you
take chances, and you know, getting outside, being around your friends,
going to school, going maybe to a daycare, and you're
exposed to a lot of different people. That's when you're
(05:10):
sort of getting your exposure, and that's when your human
your immune system is learning or producing these antibodies such
that as you get older, you get stronger and stronger
and you're less likely to get sick. There's been a
huge debate over the past several years in the pediatric
(05:31):
population about this very fact where sometimes parents, certain families
are nervous about their child getting sick, and so they
try to protect them by keeping them excluded or exclude
(05:52):
them from those sort of activities and out of harm's way,
thinking they're sort of doing a good thing. But experts
is saying it's sort of setting them up for future
problems because their immune system never reaches full maturity when
you try to limit their exposure to all of these
(06:13):
activities that actually helped immune system become stronger and healthier
as they get older. So it is a toss up.
But certainly a lot of us I'm fifty three, fifty four,
and man, we were outside all the time, and we
just never really had that conversation I even thought about
things like that, And a lot of us didn't really
(06:38):
have that sort of experience either. We had that exposure
and we were outside all the time, and like I said,
plant in the dirt, the water and rubbing our nose
just didn't really matter. And you know, we did all right.
But certainly with the resurgence of the concern of the
(07:00):
organism world out there with viruses and bacteria, you know,
growing up during COVID, certainly I can understand the fear
of that can get inside your head about that sort
of thing. And you have a young child or young person.
You don't want anything bad to happen to them, and
so you sort of try to protect them in the
best way you know how. But it does, in experts opinion,
(07:24):
leaves them vulnerable for future infections. So we're seeing this
measles I'll break And then no one's really asked me,
really in my office, my patients about getting a measles vaccine,
and I think certainly my position on that is, if
(07:45):
you're ever concerned about needing a vaccine, just go ahead
and get a booster. It's really my answer to that,
just because sometimes you don't remember when you've had your vaccines.
And again, our immune system, as you know on this
show I talked about a lot, it's part of our
system in general, and it declines as we get older,
(08:07):
and so we get more infections. I talked about sepsis
last time on the show, and we hear a lot
about cancer and cardiovascal disease for good reasons, but infections
is right on their tail in terms of causing a
lot of morbidity and mortality a lot of different sources
of infections. But we become more immuno compromised as we
(08:31):
get older, just natural. And these vaccines are a way
to strengthen your immune system, to bolster your immune system
and give you some added protection against certain organisms, certainly
not all of them, but certain organisms. And the concern
(08:52):
about adverse reaction, yes, there's always a need to be
concerned about that. Anything you put in your mouth or anything,
and you inhale prescription medication over the counter I mean
even if you talk about talanall or see amnifit. Benadryl
is over the counter, aspirin, a lot of the anti inflammatories, advil, motrin,
(09:15):
naperson a lave on the surface. Yeah, these are strong,
powerhouse general medications that you would have in your first
aid kit if you needed something. These medicines do multiple
different things for multiple different diseases and acute processes. It's
(09:35):
always a good thing to have, but they can cause
harm when we do see it in the office, we
see it in the hospital. Even talking about our favorites. Antibiotics,
we love them, right, we get a little sick, we
get a little ill, little sniffly, and we would like
(09:56):
a course of antibiotics. And you may you may not
know this, but you know, in other countries, antabotics are
over the counter. Yes, you can go to your local
grocery store or supermarket or wherever and you can get
your antibiotics yourself. You don't need the doctor to get
(10:19):
the antibotics. Yeah, in other countries, that's the way it is.
In this country, you need to get a prescription for
your antibiotics. You need to go through a healthcare professional
to help you make that decision about whether or not
you need those antibiotics or not, because certainly antibiotics have
(10:40):
revolutionized or did revolutionize, our ability to control the micro
organism world, which I've mentioned to you before. That's what
killed Americans at the beginning of our country. Not heart disease,
not cancer. We didn't live long enough. Infections, that's what
it was to burculos, tuberculosis, typhus, all sorts of viruses. Again,
(11:06):
because we were new to the area, didn't have that protection, right,
So there's certain viruses in bacteria on this land that
are not present from the land they came from. They
had no protection. It killed a lot of people because
at that time didn't have the know how or the
knowledge about micro organism world. It was not even discovered
(11:28):
about viruses and bacteria. But they were doing their duty
and doing their job and man causing a lot of harm.
So your lifespan was pretty short if you were new
to this country back in the day. I mean, it
would be difficult to get to your seventies or eighties
back in the day. I think the lifespan back in
(11:49):
the day was forty or fifty. It was how long
you lived. But because of things like vaccines and antibiotics,
which we eventually discovered it allow it allowed us to
mitigate the impact of infections and control infections such that
you can get beyond that crisis and continue to live.
(12:12):
And so it's something that we need to protect and
something we need to make sure that those antibiotics continue
to work long term. And the misuse or overuse of
antibiotics tends to generate what we call resistant organisms, these bacteria,
(12:37):
which that's what antibiotics are for, right, They're not for viruses.
So cannot use an antibiotic for covid, cannot use an
antibiotic for the flu. And just to remind you, a
lot of times those coals and sniffles that you get,
the sore throat, the running nose, filling achey, maybe that
(13:00):
dry cough, the congestion that you get in your lungs,
that typically is a viral infection. It's a virus, and
there's multiple viruses out there and we only check for
a few, you know, we check for fluid, we check
for covid, but is probably over one hundred. Virus is
(13:21):
easy out there in the community that cause these running nose,
sore throat, achey, dry cough, symptoms that we get periodically
throughout the year, and the first reaction for most of
our patients is I need an antibiotic. And in other
countries where the antibiotics are over the counter, that's what happens.
(13:46):
They go and get their antibotic, like you go and
get your motrin or your talanol or your benadryl. And
other countries where antibiotics over the counter, they go and
get their antibiotic and they start them. And I just
cringe when I hear that, just because I know for
a fact that frequent, sort of reckless exposure to all
(14:09):
sorts of different antibiotics will eventually generate or increase the
chances of generating organisms bacteria that are resistant to the
mechanisms of the antibiotic. It's a poison typically, and that's
how you should look at antibiotics towards bacteria. It poisons
(14:29):
the bacteria basically through certain mechanisms and how the bacteria
function their little machinery in terms of how they operate
and how they stay alive, and how they replicate and
duplicate and grow. Antibiotics basically poison those systems so that
they cannot live, so that it breaks down the cell wall,
(14:53):
or it breaks down the inner workings of the bacterium
so it dies. And that's basically what antibotics are. They're
poisons for certain organisms, but they're alive. They're organisms, they
have genes and things of that nature. They sort of
develop over time ways to defend themselves. They mature, they
(15:18):
evolve with us. So the bacteria that we're around hundreds
of years ago, they're different now. They're smarter just because
they evolve with us and not go anywhere. We can't
get rid of them. So they evolve with us, and
no matter what we're doing, they're sort of reacting to
what we do in terms of the mechanisms they use
(15:41):
to grow and ways to defend themselves. Just like any
living organism, you sort of learn how to stay alive.
It's sort of built into your platform. It's built into
your program that you get in terms of how to learn, defend,
and do things differently in order to stay alive. Right,
(16:02):
So organisms are no different viruses bacteria, but exposing your
human body to Bacti, I'm sorry. Antibiotics on a regular
basis frequent overuse, misuse, that sort of thing, which is
more likely in areas where there's no control over the
(16:22):
prescribing of antibotics or the use of antibiotics, which is
supposed to be the idea. When you go to a
healthcare professionalist, they're supposed to present the latest understanding of
the use of these poisons to you to decide at
that point, do we feel like you deserve to take this,
(16:45):
or maybe it's something else, Maybe what you have does
not require antibiotics. And what that does is it keeps
the current antibiotics that we have strong and useful because
the organist are not learning how to defend themselves because
it's limiting the exposure of those organisms to the antibiotic
(17:06):
we're using it appropriately. In the medical world, we call
that Antibiotic stewardship is the term that's used in the
medical world, and it's been a growing concern over the
past several years. Have been a physician for over twenty years.
Didn't really hear a whole lot about it when I finished,
(17:27):
but certainly over the past several years you continue to
hear more and more about that, and especially in the
hospital setting. Pharmacists, the pharmacy world has really stepped up
and become more of a leader in terms of helping
prescribing healthcare professionals, whether it be the nurse practitioner or
(17:51):
physician's assistant or even a medical doctor. They have really
stepped up their game and become more involved in their
prescribing of antibiotics in terms of choosing the right one
or limiting the use of certain antibotics in the hospital
as well as the outpatient setting. If you've ever got
(18:12):
a prescription from one of the local pharmacies, sometimes at
the point of getting the medication, the pharmacists will talk
with you and try to educate you about the medicine
you're getting, possible side effects, maybe even suggestions on what
to do if certain things happen, which again they are
(18:33):
healthcare professionals themselves. They go to school, they get a degree,
they learn about these meds, and they help us determine
if this is a necessary product, because again, antibotics can harm.
Prescription medicines can harm. We see this all the time.
You know or may have known about this bacterial gastrointestin
(18:57):
infection call Claustridium difficy infection are C DIFF for short.
If you've ever received antibotics causes this nasty, explosive diarrhea,
abdominal pain. You can become severely dehydrated, very rapidly, but
that comes from exposure to antibotics. And in these countries
(19:17):
where antibiotics just sort of loosely given are gotten by
its citizens and it's just sort of being tossed around
in the community, there's more resistance in those areas where
you might get an infection. And because of that previous
exposure to these antibiotics, the organisms are smarter, they're stronger,
(19:43):
and those tablets don't work anymore. Now you need intravenious
antibotics in order to figure that out or in order
to get better, and that is not a situation you
want to be in. Phone lines are opened eight nine
six kovy at one one hundred three three zero kaleva
I give us a call. We'll be back in two minutes.
(20:15):
All right, welcome back to the doctor Mane Medical. Our
phone lines are open eight nine six kal here I
won one hundred and three to three zero kill ya
talking about the measles little outbreak there and the use
of antibiotics and our reasons for while we try to
limit those antibiotics. Missus Lvene wanted me to tell everybody
(20:35):
happy Easter out there, getting the finest of clothes ready
and getting on those Easter egg hunts. I remember that
growing up, such a fun time, sort of family time,
go to church and then afterwards get that Easter egg hunt,
going and preparing the eggs with that die and the
(20:59):
vinegar and oh my god, a little wire thing that
used to have picking up the eggs. It was a
lot of fun. And certainly getting all that chocolate, those
Easter egg bunny chocolates, that was always delicious as well.
But talking about the measles outbreak there and whether or
not you should get a vaccine, certainly, if you feel vulnerable,
(21:20):
you don't feel like you maybe have the protection need,
certainly go ahead and get that measles vaccine. You know,
call the local pharmacy. Those are normally not in doctors' offices.
You may or may not know. We do have some
vaccines available in our office, not all of them, but
certainly measles vaccine we don't have there. But certainly call
(21:41):
the pharmacists. They pharmacies, they've been providing vaccines for a
long time, and it just gives you some protection. I
have not. I don't really see a lot of patients
coming in with overdose of vaccines, meaning they got a
vaccine maybe too soon or early, and they come in
(22:03):
with severe symptoms. Certainly with vaccines, you can get that
local reaction on the arm or the rear area wherever
they injected the area. Just soreness and pain, sometimes some
retness and swelling of the injection site, which is again
expected with some of these vaccines, and normally that can
(22:23):
be treated with steroids or anti inflammatory medicines or talinol
that is a good thing to try. Sometimes topical anti inflammatories,
the medication called DIKLOPHONEC or voltin that's over the county.
You can pick that up. You can sometimes rub it
on the area that hurts and sort of the achiness
(22:46):
that you might feel. Again, it's your body's reaction to
the vaccine. It's normally most vaccines are what they call
they're not live l ive of vaccines basically take certain
particles of the organism of choice and sort of inject
it into your bodies so that your body reacts to
(23:08):
what it sees it. But it's not an active, live infection,
but nonetheless it's enough for your body to generate these
antibodies to generate the tanks and the ships and the
weaponry that you need to defend itself. If you do
get infected or somebody tries to invade your human body,
(23:29):
you're ready to go. So measles is no different. It's
a virus, and certainly if you feel like you're vulnerable,
go ahead and get a booster, right And a lot
of times, the latest vaccine is safer, it's more specific,
and it's a better product than the one years ago. Again,
(23:50):
because vaccine technology has continued to evolve in the background, quietly,
you don't hear much about vaccine production. We heard a
lot during the COVID vacsine of the COVID pandemic, but
prior to that you really didn't hear too much about it.
But yeah, that industry is alive and well, and they've
(24:12):
really pioneered some awesome techniques that allow them to very
quickly engineer vaccines more specifically than they did maybe fifteen
twenty years ago, such that whatever is floating around in
the environment, they can take that information to the lab
(24:32):
and they can engineer vaccines more quickly, efficiently, cleaner, and
get it to the market faster so that we can
then take it and protect ourselves. Because remember, when these
vaccines are hopping around from one host to the next,
they're sort of changing a lot of times their machinery
(24:55):
because as they grow, they sort of naturally evolve. They mutate,
as that term that you may hear. Sometimes they mutate,
just like from one human to the next, the genes
decide to maybe add this or delete that, and all
of a sudden you have a different person, different characteristics, tall, big, large,
(25:17):
I mean all these different variables, viruses, bacteria, they're no different.
They have sort of those same mechanisms in place, and
so anytime they're growing or splitting or dividing as if
you will, potentially mutants are mutations of that first virus
(25:40):
can form. We again saw this during the pandemic. Hot
started with one covid virus and it mutated into five
or six others. And that's going to continue to happen, right,
It's going to continue to happen because the virus is
now a resident virus and there are patients people that
decided not to get vaccinated for various reasons, and they
(26:03):
have no protection. They get that covid virus in them,
and then they get sick and they start coughing and
spewing out these respiratory droplets, and other people around they
don't know it's covid yet Again, that's the most infectious
point of the covid infection and its dynamic of how
(26:23):
it works, that's the most infectious part. The patient doesn't
know and people around them they don't know. And so
the respirator drop is get in the environment. Other people
inhale that it gets into their system, and it is
a lot of times it can be a mutation, a
different virus that's new. This cycle just sort of keeps going,
(26:45):
and so you get sort of this little outbreak of
a particular organism. But because there are other people who
have maybe had the presence of COVID either from a
previous infection, are being vaccinated, they are are somewhat protected,
and they're ready to go against this mutation even though
(27:05):
it's a mutation. They've had other exposure, they have antibodies
that are against certain can part certain parts of the virus,
and they're able to defend themselves better. So it sort
of shuts it down faster and there's less opportunity for
it to mutate and change into something else. And then
plus when you get the virus shut down, you're not
(27:28):
coughing or spewing out all of those infectious particles, and
so other people can't get so it just sort of
shuts it down, you know, sort of like a blanket
on No, I shouldn't say a blankets that's a bad example. Extinguisher,
that's what I was trying to get to. It extinguishes
the infection quicker, quick, quicker, and you don't have such
(27:52):
this outbreak. Well, there's issues with those with meals, and
we hear it every now and then, every now and then,
and we hear that and again, the worst case scenario
of measles virus infection is what we call encephalitis or meningitis,
the brain infection. Right, we don't really get that with COVID.
(28:13):
That's more of a pulmonary infection, and you can live
or you can be sort of saved by being put
on a breathing machine. But man, when your brain is infected,
we don't really have anything to replace that. It can
be a devastating infection. It can leave you with some
significant neurological defects that you can never recover from. So
(28:37):
it can really get terrible. With a measless vaccine. So
if you feel vulnerable, go get your booster. Phone lines
are open eight nine six kalva I won one hundred
three three zero kova. I'll be back in two minutes.
(29:01):
All right, Welcome back to the Doctaly Medical Our phone
lines are open eight nine to six k LVII or
twenty one hundred and three three zero KLVI. One topic
that comes up a lot in the office as well
as in the hospital is swelling. Doctor. My legs are swollen,
my face is swollen, my arms are swollen, my hands
(29:23):
are swollen, my belly is swollen. What is going on
with that? So that is a very frequent complaint in
the office as well as the hospital. So I thought
I would spend a little bit of time with that.
And we've mentioned this before over the years, and it's
(29:44):
a frequent issue. The medical term we use is called edema.
Is the medical term that we use when when you
look at your legs or the top of your foot,
it just has a lot of size to it looks
like a sausage. It's tight and you can sometimes put
your finger in and press down. It leaves that dent
(30:06):
in your skin, the dimple in your skin. We call
that edema. Most people just say I'm swollen, and you
feel that way. You feel heavy, you feel tight, your
skin feels tight. It can be a very uncomfortable place
to be when you wake up and you can't put
your church shoes on, you can't put your favorite shoes
(30:28):
on because your feet are swollen. They're heavy, and it
affects the way you walk as well because of the
discomfort because they're a little bit heavy, it makes you
walk a certain way. So what are some of the
causes of that, Because we get that a lot in
the office. It could honestly mean a lot of different things,
(30:50):
And most of the time for me, there's certain things
that I try to prioritize. When someone says they're swollen,
and I look and I can see the swelling and
their ankle or their foot or their leg. Most of
the time we do have to get blood work because
there are a couple of different metabolic problems that can
(31:11):
cause swelling. One in particular metabolic problem is kidney failure,
and that's a very common problem in our country as
well as Southeast Texas. For a couple of different reasons.
Number one is hypertension, high blood pressure, right, one of
(31:34):
the major risk factors for cardiovascal disease, which is what
kills most Americans plaque right. High pertension over years tends
to feed into vascular disruption, vascular dysfunction, vascular decline, which
(31:56):
then causes kidney failure. And when your kidneys don't work, Basically,
the kidney filters your blood deliver is the other human filter.
The kidney is the other. But when your filter doesn't work,
then you retain fluid, and you also retain other metabolites
(32:19):
of your metabolic function, which can then cause its own problems.
But when your kidneys don't work, you start to develop
fluid in the extremities from again hypertension one of the
biggest risk factors for that. The second biggest risk factor
for kidney failure is type two diabetes or type one,
(32:42):
but mainly type two diabetes. So those two diseases, high pertension,
type two diabetes in my experience, the biggest risk factors
in this country to develop kidney failure. Now, as we
all get older, I treat a lot of elderly patients.
Natural process of aging, kidney function declines. It's just natural,
(33:06):
it's built into it. It's our program and again, as
your kidney function declines, you can start to retain a
little fluid because the kidneys are not working as well.
Not that you did anything wrong. You may not have
had any our pretension, no diabetes in your history, you
take zero medications. But there is a natural decline of
(33:29):
the kidney to function efficiently, and a symptom of that
is retention of fluid. And so yes, you will start
to develop swelling in your hands, in your face, and
your legs. You also gain weight because again that fluid
that you're sticking onto, that you're accumulating, will start to
(33:52):
cause some weight gain. So you'll feel heavy, and you
can measure this by getting on the scale and you'll
be able to see that, yes, you are more heavy.
Even though you haven't changed anything about what you eat
or drink, you're more heavy. So most doctors know this
pattern of presentation and understand what that is. So anytime
you have swelling, you need to get some blood work
(34:14):
to check your kidney function. You also need to check
your thyroid function. That's a very common problem in this country.
And thyroid is a hormone that sort of floats around
and checks on all the other metabolic activity and helps
those other metabal activities work as efficiently as possible. So
(34:35):
I said, if you don't have enough thyroid hormone in
your body, those metabolic machines and those metabolic pathways that
keep us functioning cannot function efficiently. So you will start
to see some decline in their function, in particular maybe
the heart or again the kidneys, and that will then
(34:57):
potentially cause some weight gain because your body is not
functioning efficiently because there's no thyroid hormone floating arts less
thyroid hormone floating around. So a lot of times we
will check your thyroid. We will also check your hemoglobin level, which,
again if it's low, we call that anemia. And your
(35:19):
hemoglobin is part of the blood system that carries oxygen
to other vital organs like your heart, your nervous system,
and your brain, your kidneys, and so if there's not
enough hemoglobin floating around and oxygen's not getting to the
human body, then those organs can't function as well. And
the symptom of that, especially as pertains to the heart,
(35:44):
is fluid accumulation. So normally, if you go into your
primary care decision's office or you go into the er,
you're going to get blood work, which you need because
we need to check all of these metabolic issues to
see if there's any kidney failure or thyroid problem, or
anemia problem, or even your liver. Liver problems, yes, contribute
(36:08):
to swelling of the lower extremities, in particular liver cirrhosis. Now,
a lot of times with liver cirrhosis, the bloodwork can
be somewhat normal and we might have to do a
little bit more digging to finally figure out that your
liver is the ideology of your swelling. But a lot
(36:29):
of times there will be some pattern of irregularity on
your lab work that would suggest to the provider that
maybe this is a liver problem that you have. We
have blood tests called liver function tests, which these are
blood tests that sort of are direct reflection of your
(36:49):
liver function, and if they're high or low or depending
on the pattern, it sort of suggests that maybe there's
a liver problem. Then we will normally proceed with imaging
of the liver to look at it, and crroosis has
a certain look on an X ray. The radiologists can
help us out with that. Soosis tends to shrink the
(37:13):
liver and it generates in bumps, bunps, we call them nodules.
But the contour, let's back up. A normal liver has
a very smooth surface. If you've ever seen liver, it's
very smooth surface. But as it gets scarred down, it shrinks,
(37:33):
it gets a very bumpy surface surface. And you can
see that on X ray. You know it's smaller, it's bumpy,
and they can sort of figure that out. That looks serotic.
And most of the time that comes from just exposure
to alcohol, which a lot of Americans are consuming alcohol
on a regular basis, and it can lead to liver
(37:56):
cerrosis over a long period of time as well as
it can condition called fatty liver. Right, you may have
been told that before you have fat in your liver,
normally picked up on cat scans or ultrasounds, and in
the immediate timeframe, there's really nothing to do about it
other than a lot of times get that weight down. Right.
(38:19):
It's a direct reflection a lot of times of being overweight,
as well as eating a diet with a lot of
sugar and starches. Right, we talk about that A lot
phone lines are open eight nine to six kalvy I
one hundred three three zero O Kalvia. I'll be back
in two minutes. All right, welcome back to the Doka
(38:39):
Medical Hour. Man an hour goes by so so fast.
I want to thank all the listeners. No calls today,
but no big deal. I'm glad that you are listening
and talking about measles vaccine as well as antibotics and
our need to control the use of antibiotics, and then
talking about swelling or edema, which is a very common complaint.
(39:02):
And I didn't mention a few kidney failure, liver cirrhosis, anemia,
thyroid disorders as well as heart failure that is another
big cause of swelling. Again for the reasons I mentioned
to you about the kidney failure, hypertension, diabetes, higher pretension diabetes. Right.
(39:24):
And a good thing is that with all of the
monitoring equipment out there that's available to you, with all
the medicines that are now in the market, and the
access that we have to proper food and beverage choice,
it should be easy. But it's still very difficult to
get that pressure down and get that sugar down. So
(39:47):
much interference with the average citizen achieving those goals. We're
fighting every day to try and make it as easy
as possible, but still the struggle for a lot of people.
Joe from Bay Town, real quick, what's up? Yes, or
swelling the feet? I quit taking ibuprofen and my spoiling
went away. Sure. Absolutely, it's a long list, Joe, and
(40:11):
I appreciate you bringing that one up because that's a
it's a common one, and we'll appreciate Joe's coming. That's right. Ibuprofen,
anti inflammatories, motri and advit leave. I talked to you
about adverse reaction right doing harm. It's over the counter.
Everybody's got access to it. We get aches and pains,
(40:31):
and we go to the CVS, we get that ibuprof
when we start popping those, and yeah, a couple of
weeks ago by and all of a sudden, your ankles
a fat. That's absolutely right. We appreciate you, Joe mentioning
that the list is long in terms of what causes swelling.
But anti inflammatories, all those, motion, Advita leaves, mobic, maloxicam, celebres, Ibuprofen,
(40:55):
which I still write a lot's a great drug for
acute pain and chronic pain. And we try to have
a conversation with the patients when we prescribe these medicines.
These are the issues that can come up if you
take them long term. And the reason that happens is
because of how it impacts kidney function. Again, the kidneys
a filter, and medications can interfere with the kidney's proper function,
(41:19):
and so you start to retain fluid because of the
impact of the ibuprofen. And once you get off that's
a cool thing for most people. Once they get off
of it, all of the symptoms go away. Sometimes sometimes
with the chronic use of an inflammatories, it can cause
some permanent injury to your kidney, so you have to
be careful with that and have that discussion with your
(41:42):
healthcare provider. But certainly again heart failure, so a lot
of times you need to do an ultrasound of your
heart to figure that out. And blood clots. Blood clots
are very common in terms of causing the swelling in
your legs, so a lot of times you need to
get an ultrasound of your vein of your leg if
you see that swelling. I sort of hit some of
(42:04):
the high points of swelling, but there are others as
Joe mentioned, but certainly very very common it's a very
abnormal physical symptom requires a little work up, so don't
ignore that. Go to your healthcare provider and get a
proper work up, just so that you're properly docnosed and
you can maybe get off something or get on something
(42:26):
to help with the swelling. Diuretics we use all the time,
Lasix hydro chlorothisac chlorthalidone. Just to make a few thank
you for joining for another edition of the show, don't
drink and drive, God blessed. We'll see you next week.
All right, welcome South East Sex Internet radio listeners. This
is doctor Levine, Doctor Levine Medical out here live in
a series of klv I in beau My, Texas cross
Street from Parkdale Mall, taking your phone calls, answering questions
about healthcare and medicine so that you can stay alive
as long as possible and be as healthy as possible
(00:22):
while you are alive. Who wants to be sick and
ill and having to take a bunch of meds in
order to feel halfway decent, halfway normal. We will try
to answer some of your questions, make it clear for
you see what you need to be doing on a
(00:43):
daily basis to help you stay alive and be healthy.
It's confusing out there, I understand, and sometimes hard to
be healthy out there. I understand that as well, and
so give us a call phone lines or open eight
nine six kV W one hundred three three zero klv I. Typically,
(01:04):
while we wait on phone calls, we will sort of
jump into some topics of choice, whatever's floating through my
head this morning, or whatever topic we get into on
depending on the phone calls that we get. So we'd
love to hear from you. It's just two weight radio.
(01:26):
So again, if there's a topic that you would like
me to prioritize or that you're interested in, we'll be
more than happy to entertain that as well. Keep hearing
things about measles. Seems like this little outbreak sort of
has stayed around a little bit longer than most people
(01:48):
expect it. And as you know, measles is a virus,
and it's been around for a long time. It's it's
a long term player in the environment. But because of vaccines,
vaccination vaccine programs, we sort of got to handle on
(02:08):
the measles virus years ago. But in depending on where
you live and the laws and regulations, there are some
pockets here in this country where people don't get the vaccine.
I think in some areas there's a choice if you
(02:30):
can get it, or if you have to have it,
or there's an opt out clause or excuse clause where,
depending on who you are and your beliefs, maybe you
don't have to subject yourself to the measles vaccine. And
so you basically are unprotected against this particular virus. And
(02:52):
as I've mentioned to you multiple times before, when you're
unprotected against certain organisms, you have no defense to protect
yourself so that when this organism gets inside your body
and starts doing what it's supposed to do, a severe
reaction can occur because you're not ready. You're not prepared,
(03:17):
almost like a surprise attack on the human body. And
you sort of understand military terminology and sort of military dynamics.
When you don't have radars, you don't have tanks and
ships and planes and things of that nature, and you
(03:39):
are invaded, then you basically have no defense and it's
very easy for that entity to sort of come in
and take charge and run over you because you weren't ready.
You're sleeping, And that's sort of how the body is
when you have no defense already built into your system
(04:00):
against certain organisms. Being a kid and growing up, not me,
I'm just saying in general, when you're outside playing and
you're in the dirt and you're in the water, and
you're just getting exposed to all these different organisms and
viruses and bacteria, your body is learning how to defend
(04:25):
itself and generating these antibodies that I've mentioned to you before.
This is the name of the multiple proteins and molecules
that are sort of floating through your system. All the time,
ready to do its job. If something gets inside your bloodstream,
it's there sort of ready to react. And as we're
(04:48):
growing up and doing all the things that we do.
When you're young, I mean, you're more adventurous and you
take chances, and you know, getting outside, being around your friends,
going to school, going maybe to a daycare, and you're
exposed to a lot of different people. That's when you're
(05:10):
sort of getting your exposure, and that's when your human
your immune system is learning or producing these antibodies such
that as you get older, you get stronger and stronger
and you're less likely to get sick. There's been a
huge debate over the past several years in the pediatric
(05:31):
population about this very fact where sometimes parents, certain families
are nervous about their child getting sick, and so they
try to protect them by keeping them excluded or exclude
(05:52):
them from those sort of activities and out of harm's way,
thinking they're sort of doing a good thing. But experts
is saying it's sort of setting them up for future
problems because their immune system never reaches full maturity when
you try to limit their exposure to all of these
(06:13):
activities that actually helped immune system become stronger and healthier
as they get older. So it is a toss up.
But certainly a lot of us I'm fifty three, fifty four,
and man, we were outside all the time, and we
just never really had that conversation I even thought about
things like that, And a lot of us didn't really
(06:38):
have that sort of experience either. We had that exposure
and we were outside all the time, and like I said,
plant in the dirt, the water and rubbing our nose
just didn't really matter. And you know, we did all right.
But certainly with the resurgence of the concern of the
(07:00):
organism world out there with viruses and bacteria, you know,
growing up during COVID, certainly I can understand the fear
of that can get inside your head about that sort
of thing. And you have a young child or young person.
You don't want anything bad to happen to them, and
so you sort of try to protect them in the
best way you know how. But it does, in experts opinion,
(07:24):
leaves them vulnerable for future infections. So we're seeing this
measles I'll break And then no one's really asked me,
really in my office, my patients about getting a measles vaccine,
and I think certainly my position on that is, if
(07:45):
you're ever concerned about needing a vaccine, just go ahead
and get a booster. It's really my answer to that,
just because sometimes you don't remember when you've had your vaccines.
And again, our immune system, as you know on this
show I talked about a lot, it's part of our
system in general, and it declines as we get older,
(08:07):
and so we get more infections. I talked about sepsis
last time on the show, and we hear a lot
about cancer and cardiovascal disease for good reasons, but infections
is right on their tail in terms of causing a
lot of morbidity and mortality a lot of different sources
of infections. But we become more immuno compromised as we
(08:31):
get older, just natural. And these vaccines are a way
to strengthen your immune system, to bolster your immune system
and give you some added protection against certain organisms, certainly
not all of them, but certain organisms. And the concern
(08:52):
about adverse reaction, yes, there's always a need to be
concerned about that. Anything you put in your mouth or anything,
and you inhale prescription medication over the counter I mean
even if you talk about talanall or see amnifit. Benadryl
is over the counter, aspirin, a lot of the anti inflammatories, advil, motrin,
(09:15):
naperson a lave on the surface. Yeah, these are strong,
powerhouse general medications that you would have in your first
aid kit if you needed something. These medicines do multiple
different things for multiple different diseases and acute processes. It's
(09:35):
always a good thing to have, but they can cause
harm when we do see it in the office, we
see it in the hospital. Even talking about our favorites. Antibiotics,
we love them, right, we get a little sick, we
get a little ill, little sniffly, and we would like
(09:56):
a course of antibiotics. And you may you may not
know this, but you know, in other countries, antabotics are
over the counter. Yes, you can go to your local
grocery store or supermarket or wherever and you can get
your antibiotics yourself. You don't need the doctor to get
(10:19):
the antibotics. Yeah, in other countries, that's the way it is.
In this country, you need to get a prescription for
your antibiotics. You need to go through a healthcare professional
to help you make that decision about whether or not
you need those antibiotics or not, because certainly antibiotics have
(10:40):
revolutionized or did revolutionize, our ability to control the micro
organism world, which I've mentioned to you before. That's what
killed Americans at the beginning of our country. Not heart disease,
not cancer. We didn't live long enough. Infections, that's what
it was to burculos, tuberculosis, typhus, all sorts of viruses. Again,
(11:06):
because we were new to the area, didn't have that protection, right,
So there's certain viruses in bacteria on this land that
are not present from the land they came from. They
had no protection. It killed a lot of people because
at that time didn't have the know how or the
knowledge about micro organism world. It was not even discovered
(11:28):
about viruses and bacteria. But they were doing their duty
and doing their job and man causing a lot of harm.
So your lifespan was pretty short if you were new
to this country back in the day. I mean, it
would be difficult to get to your seventies or eighties
back in the day. I think the lifespan back in
(11:49):
the day was forty or fifty. It was how long
you lived. But because of things like vaccines and antibiotics,
which we eventually discovered it allow it allowed us to
mitigate the impact of infections and control infections such that
you can get beyond that crisis and continue to live.
(12:12):
And so it's something that we need to protect and
something we need to make sure that those antibiotics continue
to work long term. And the misuse or overuse of
antibiotics tends to generate what we call resistant organisms, these bacteria,
(12:37):
which that's what antibiotics are for, right, They're not for viruses.
So cannot use an antibiotic for covid, cannot use an
antibiotic for the flu. And just to remind you, a
lot of times those coals and sniffles that you get,
the sore throat, the running nose, filling achey, maybe that
(13:00):
dry cough, the congestion that you get in your lungs,
that typically is a viral infection. It's a virus, and
there's multiple viruses out there and we only check for
a few, you know, we check for fluid, we check
for covid, but is probably over one hundred. Virus is
(13:21):
easy out there in the community that cause these running nose,
sore throat, achey, dry cough, symptoms that we get periodically
throughout the year, and the first reaction for most of
our patients is I need an antibiotic. And in other
countries where the antibiotics are over the counter, that's what happens.
(13:46):
They go and get their antibotic, like you go and
get your motrin or your talanol or your benadryl. And
other countries where antibiotics over the counter, they go and
get their antibiotic and they start them. And I just
cringe when I hear that, just because I know for
a fact that frequent, sort of reckless exposure to all
(14:09):
sorts of different antibiotics will eventually generate or increase the
chances of generating organisms bacteria that are resistant to the
mechanisms of the antibiotic. It's a poison typically, and that's
how you should look at antibiotics towards bacteria. It poisons
(14:29):
the bacteria basically through certain mechanisms and how the bacteria
function their little machinery in terms of how they operate
and how they stay alive, and how they replicate and
duplicate and grow. Antibiotics basically poison those systems so that
they cannot live, so that it breaks down the cell wall,
(14:53):
or it breaks down the inner workings of the bacterium
so it dies. And that's basically what antibotics are. They're
poisons for certain organisms, but they're alive. They're organisms, they
have genes and things of that nature. They sort of
develop over time ways to defend themselves. They mature, they
(15:18):
evolve with us. So the bacteria that we're around hundreds
of years ago, they're different now. They're smarter just because
they evolve with us and not go anywhere. We can't
get rid of them. So they evolve with us, and
no matter what we're doing, they're sort of reacting to
what we do in terms of the mechanisms they use
(15:41):
to grow and ways to defend themselves. Just like any
living organism, you sort of learn how to stay alive.
It's sort of built into your platform. It's built into
your program that you get in terms of how to learn, defend,
and do things differently in order to stay alive. Right,
(16:02):
So organisms are no different viruses bacteria, but exposing your
human body to Bacti, I'm sorry. Antibiotics on a regular
basis frequent overuse, misuse, that sort of thing, which is
more likely in areas where there's no control over the
(16:22):
prescribing of antibotics or the use of antibiotics, which is
supposed to be the idea. When you go to a
healthcare professionalist, they're supposed to present the latest understanding of
the use of these poisons to you to decide at
that point, do we feel like you deserve to take this,
(16:45):
or maybe it's something else, Maybe what you have does
not require antibiotics. And what that does is it keeps
the current antibiotics that we have strong and useful because
the organist are not learning how to defend themselves because
it's limiting the exposure of those organisms to the antibiotic
(17:06):
we're using it appropriately. In the medical world, we call
that Antibiotic stewardship is the term that's used in the
medical world, and it's been a growing concern over the
past several years. Have been a physician for over twenty years.
Didn't really hear a whole lot about it when I finished,
(17:27):
but certainly over the past several years you continue to
hear more and more about that, and especially in the
hospital setting. Pharmacists, the pharmacy world has really stepped up
and become more of a leader in terms of helping
prescribing healthcare professionals, whether it be the nurse practitioner or
(17:51):
physician's assistant or even a medical doctor. They have really
stepped up their game and become more involved in their
prescribing of antibiotics in terms of choosing the right one
or limiting the use of certain antibotics in the hospital
as well as the outpatient setting. If you've ever got
(18:12):
a prescription from one of the local pharmacies, sometimes at
the point of getting the medication, the pharmacists will talk
with you and try to educate you about the medicine
you're getting, possible side effects, maybe even suggestions on what
to do if certain things happen, which again they are
(18:33):
healthcare professionals themselves. They go to school, they get a degree,
they learn about these meds, and they help us determine
if this is a necessary product, because again, antibotics can harm.
Prescription medicines can harm. We see this all the time.
You know or may have known about this bacterial gastrointestin
(18:57):
infection call Claustridium difficy infection are C DIFF for short.
If you've ever received antibotics causes this nasty, explosive diarrhea,
abdominal pain. You can become severely dehydrated, very rapidly, but
that comes from exposure to antibotics. And in these countries
(19:17):
where antibiotics just sort of loosely given are gotten by
its citizens and it's just sort of being tossed around
in the community, there's more resistance in those areas where
you might get an infection. And because of that previous
exposure to these antibiotics, the organisms are smarter, they're stronger,
(19:43):
and those tablets don't work anymore. Now you need intravenious
antibotics in order to figure that out or in order
to get better, and that is not a situation you
want to be in. Phone lines are opened eight nine
six kovy at one one hundred three three zero kaleva
I give us a call. We'll be back in two minutes.
(20:15):
All right, welcome back to the doctor Mane Medical. Our
phone lines are open eight nine six kal here I
won one hundred and three to three zero kill ya
talking about the measles little outbreak there and the use
of antibiotics and our reasons for while we try to
limit those antibiotics. Missus Lvene wanted me to tell everybody
(20:35):
happy Easter out there, getting the finest of clothes ready
and getting on those Easter egg hunts. I remember that
growing up, such a fun time, sort of family time,
go to church and then afterwards get that Easter egg hunt,
going and preparing the eggs with that die and the
(20:59):
vinegar and oh my god, a little wire thing that
used to have picking up the eggs. It was a
lot of fun. And certainly getting all that chocolate, those
Easter egg bunny chocolates, that was always delicious as well.
But talking about the measles outbreak there and whether or
not you should get a vaccine, certainly, if you feel vulnerable,
(21:20):
you don't feel like you maybe have the protection need,
certainly go ahead and get that measles vaccine. You know,
call the local pharmacy. Those are normally not in doctors' offices.
You may or may not know. We do have some
vaccines available in our office, not all of them, but
certainly measles vaccine we don't have there. But certainly call
(21:41):
the pharmacists. They pharmacies, they've been providing vaccines for a
long time, and it just gives you some protection. I
have not. I don't really see a lot of patients
coming in with overdose of vaccines, meaning they got a
vaccine maybe too soon or early, and they come in
(22:03):
with severe symptoms. Certainly with vaccines, you can get that
local reaction on the arm or the rear area wherever
they injected the area. Just soreness and pain, sometimes some
retness and swelling of the injection site, which is again
expected with some of these vaccines, and normally that can
(22:23):
be treated with steroids or anti inflammatory medicines or talinol
that is a good thing to try. Sometimes topical anti inflammatories,
the medication called DIKLOPHONEC or voltin that's over the county.
You can pick that up. You can sometimes rub it
on the area that hurts and sort of the achiness
(22:46):
that you might feel. Again, it's your body's reaction to
the vaccine. It's normally most vaccines are what they call
they're not live l ive of vaccines basically take certain
particles of the organism of choice and sort of inject
it into your bodies so that your body reacts to
(23:08):
what it sees it. But it's not an active, live infection,
but nonetheless it's enough for your body to generate these
antibodies to generate the tanks and the ships and the
weaponry that you need to defend itself. If you do
get infected or somebody tries to invade your human body,
(23:29):
you're ready to go. So measles is no different. It's
a virus, and certainly if you feel like you're vulnerable,
go ahead and get a booster, right And a lot
of times, the latest vaccine is safer, it's more specific,
and it's a better product than the one years ago. Again,
(23:50):
because vaccine technology has continued to evolve in the background, quietly,
you don't hear much about vaccine production. We heard a
lot during the COVID vacsine of the COVID pandemic, but
prior to that you really didn't hear too much about it.
But yeah, that industry is alive and well, and they've
(24:12):
really pioneered some awesome techniques that allow them to very
quickly engineer vaccines more specifically than they did maybe fifteen
twenty years ago, such that whatever is floating around in
the environment, they can take that information to the lab
(24:32):
and they can engineer vaccines more quickly, efficiently, cleaner, and
get it to the market faster so that we can
then take it and protect ourselves. Because remember, when these
vaccines are hopping around from one host to the next,
they're sort of changing a lot of times their machinery
(24:55):
because as they grow, they sort of naturally evolve. They mutate,
as that term that you may hear. Sometimes they mutate,
just like from one human to the next, the genes
decide to maybe add this or delete that, and all
of a sudden you have a different person, different characteristics, tall, big, large,
(25:17):
I mean all these different variables, viruses, bacteria, they're no different.
They have sort of those same mechanisms in place, and
so anytime they're growing or splitting or dividing as if
you will, potentially mutants are mutations of that first virus
(25:40):
can form. We again saw this during the pandemic. Hot
started with one covid virus and it mutated into five
or six others. And that's going to continue to happen, right,
It's going to continue to happen because the virus is
now a resident virus and there are patients people that
decided not to get vaccinated for various reasons, and they
(26:03):
have no protection. They get that covid virus in them,
and then they get sick and they start coughing and
spewing out these respiratory droplets, and other people around they
don't know it's covid yet Again, that's the most infectious
point of the covid infection and its dynamic of how
(26:23):
it works, that's the most infectious part. The patient doesn't
know and people around them they don't know. And so
the respirator drop is get in the environment. Other people
inhale that it gets into their system, and it is
a lot of times it can be a mutation, a
different virus that's new. This cycle just sort of keeps going,
(26:45):
and so you get sort of this little outbreak of
a particular organism. But because there are other people who
have maybe had the presence of COVID either from a
previous infection, are being vaccinated, they are are somewhat protected,
and they're ready to go against this mutation even though
(27:05):
it's a mutation. They've had other exposure, they have antibodies
that are against certain can part certain parts of the virus,
and they're able to defend themselves better. So it sort
of shuts it down faster and there's less opportunity for
it to mutate and change into something else. And then
plus when you get the virus shut down, you're not
(27:28):
coughing or spewing out all of those infectious particles, and
so other people can't get so it just sort of
shuts it down, you know, sort of like a blanket
on No, I shouldn't say a blankets that's a bad example. Extinguisher,
that's what I was trying to get to. It extinguishes
the infection quicker, quick, quicker, and you don't have such
(27:52):
this outbreak. Well, there's issues with those with meals, and
we hear it every now and then, every now and then,
and we hear that and again, the worst case scenario
of measles virus infection is what we call encephalitis or meningitis,
the brain infection. Right, we don't really get that with COVID.
(28:13):
That's more of a pulmonary infection, and you can live
or you can be sort of saved by being put
on a breathing machine. But man, when your brain is infected,
we don't really have anything to replace that. It can
be a devastating infection. It can leave you with some
significant neurological defects that you can never recover from. So
(28:37):
it can really get terrible. With a measless vaccine. So
if you feel vulnerable, go get your booster. Phone lines
are open eight nine six kalva I won one hundred
three three zero kova. I'll be back in two minutes.
(29:01):
All right, Welcome back to the Doctaly Medical Our phone
lines are open eight nine to six k LVII or
twenty one hundred and three three zero KLVI. One topic
that comes up a lot in the office as well
as in the hospital is swelling. Doctor. My legs are swollen,
my face is swollen, my arms are swollen, my hands
(29:23):
are swollen, my belly is swollen. What is going on
with that? So that is a very frequent complaint in
the office as well as the hospital. So I thought
I would spend a little bit of time with that.
And we've mentioned this before over the years, and it's
(29:44):
a frequent issue. The medical term we use is called edema.
Is the medical term that we use when when you
look at your legs or the top of your foot,
it just has a lot of size to it looks
like a sausage. It's tight and you can sometimes put
your finger in and press down. It leaves that dent
(30:06):
in your skin, the dimple in your skin. We call
that edema. Most people just say I'm swollen, and you
feel that way. You feel heavy, you feel tight, your
skin feels tight. It can be a very uncomfortable place
to be when you wake up and you can't put
your church shoes on, you can't put your favorite shoes
(30:28):
on because your feet are swollen. They're heavy, and it
affects the way you walk as well because of the
discomfort because they're a little bit heavy, it makes you
walk a certain way. So what are some of the
causes of that, Because we get that a lot in
the office. It could honestly mean a lot of different things,
(30:50):
And most of the time for me, there's certain things
that I try to prioritize. When someone says they're swollen,
and I look and I can see the swelling and
their ankle or their foot or their leg. Most of
the time we do have to get blood work because
there are a couple of different metabolic problems that can
(31:11):
cause swelling. One in particular metabolic problem is kidney failure,
and that's a very common problem in our country as
well as Southeast Texas. For a couple of different reasons.
Number one is hypertension, high blood pressure, right, one of
(31:34):
the major risk factors for cardiovascal disease, which is what
kills most Americans plaque right. High pertension over years tends
to feed into vascular disruption, vascular dysfunction, vascular decline, which
(31:56):
then causes kidney failure. And when your kidneys don't work, Basically,
the kidney filters your blood deliver is the other human filter.
The kidney is the other. But when your filter doesn't work,
then you retain fluid, and you also retain other metabolites
(32:19):
of your metabolic function, which can then cause its own problems.
But when your kidneys don't work, you start to develop
fluid in the extremities from again hypertension one of the
biggest risk factors for that. The second biggest risk factor
for kidney failure is type two diabetes or type one,
(32:42):
but mainly type two diabetes. So those two diseases, high pertension,
type two diabetes in my experience, the biggest risk factors
in this country to develop kidney failure. Now, as we
all get older, I treat a lot of elderly patients.
Natural process of aging, kidney function declines. It's just natural,
(33:06):
it's built into it. It's our program and again, as
your kidney function declines, you can start to retain a
little fluid because the kidneys are not working as well.
Not that you did anything wrong. You may not have
had any our pretension, no diabetes in your history, you
take zero medications. But there is a natural decline of
(33:29):
the kidney to function efficiently, and a symptom of that
is retention of fluid. And so yes, you will start
to develop swelling in your hands, in your face, and
your legs. You also gain weight because again that fluid
that you're sticking onto, that you're accumulating, will start to
(33:52):
cause some weight gain. So you'll feel heavy, and you
can measure this by getting on the scale and you'll
be able to see that, yes, you are more heavy.
Even though you haven't changed anything about what you eat
or drink, you're more heavy. So most doctors know this
pattern of presentation and understand what that is. So anytime
you have swelling, you need to get some blood work
(34:14):
to check your kidney function. You also need to check
your thyroid function. That's a very common problem in this country.
And thyroid is a hormone that sort of floats around
and checks on all the other metabolic activity and helps
those other metabal activities work as efficiently as possible. So
(34:35):
I said, if you don't have enough thyroid hormone in
your body, those metabolic machines and those metabolic pathways that
keep us functioning cannot function efficiently. So you will start
to see some decline in their function, in particular maybe
the heart or again the kidneys, and that will then
(34:57):
potentially cause some weight gain because your body is not
functioning efficiently because there's no thyroid hormone floating arts less
thyroid hormone floating around. So a lot of times we
will check your thyroid. We will also check your hemoglobin level, which,
again if it's low, we call that anemia. And your
(35:19):
hemoglobin is part of the blood system that carries oxygen
to other vital organs like your heart, your nervous system,
and your brain, your kidneys, and so if there's not
enough hemoglobin floating around and oxygen's not getting to the
human body, then those organs can't function as well. And
the symptom of that, especially as pertains to the heart,
(35:44):
is fluid accumulation. So normally, if you go into your
primary care decision's office or you go into the er,
you're going to get blood work, which you need because
we need to check all of these metabolic issues to
see if there's any kidney failure or thyroid problem, or
anemia problem, or even your liver. Liver problems, yes, contribute
(36:08):
to swelling of the lower extremities, in particular liver cirrhosis. Now,
a lot of times with liver cirrhosis, the bloodwork can
be somewhat normal and we might have to do a
little bit more digging to finally figure out that your
liver is the ideology of your swelling. But a lot
(36:29):
of times there will be some pattern of irregularity on
your lab work that would suggest to the provider that
maybe this is a liver problem that you have. We
have blood tests called liver function tests, which these are
blood tests that sort of are direct reflection of your
(36:49):
liver function, and if they're high or low or depending
on the pattern, it sort of suggests that maybe there's
a liver problem. Then we will normally proceed with imaging
of the liver to look at it, and crroosis has
a certain look on an X ray. The radiologists can
help us out with that. Soosis tends to shrink the
(37:13):
liver and it generates in bumps, bunps, we call them nodules.
But the contour, let's back up. A normal liver has
a very smooth surface. If you've ever seen liver, it's
very smooth surface. But as it gets scarred down, it shrinks,
(37:33):
it gets a very bumpy surface surface. And you can
see that on X ray. You know it's smaller, it's bumpy,
and they can sort of figure that out. That looks serotic.
And most of the time that comes from just exposure
to alcohol, which a lot of Americans are consuming alcohol
on a regular basis, and it can lead to liver
(37:56):
cerrosis over a long period of time as well as
it can condition called fatty liver. Right, you may have
been told that before you have fat in your liver,
normally picked up on cat scans or ultrasounds, and in
the immediate timeframe, there's really nothing to do about it
other than a lot of times get that weight down. Right.
(38:19):
It's a direct reflection a lot of times of being overweight,
as well as eating a diet with a lot of
sugar and starches. Right, we talk about that A lot
phone lines are open eight nine to six kalvy I
one hundred three three zero O Kalvia. I'll be back
in two minutes. All right, welcome back to the Doka
(38:39):
Medical Hour. Man an hour goes by so so fast.
I want to thank all the listeners. No calls today,
but no big deal. I'm glad that you are listening
and talking about measles vaccine as well as antibotics and
our need to control the use of antibiotics, and then
talking about swelling or edema, which is a very common complaint.
(39:02):
And I didn't mention a few kidney failure, liver cirrhosis, anemia,
thyroid disorders as well as heart failure that is another
big cause of swelling. Again for the reasons I mentioned
to you about the kidney failure, hypertension, diabetes, higher pretension diabetes. Right.
(39:24):
And a good thing is that with all of the
monitoring equipment out there that's available to you, with all
the medicines that are now in the market, and the
access that we have to proper food and beverage choice,
it should be easy. But it's still very difficult to
get that pressure down and get that sugar down. So
(39:47):
much interference with the average citizen achieving those goals. We're
fighting every day to try and make it as easy
as possible, but still the struggle for a lot of people.
Joe from Bay Town, real quick, what's up? Yes, or
swelling the feet? I quit taking ibuprofen and my spoiling
went away. Sure. Absolutely, it's a long list, Joe, and
(40:11):
I appreciate you bringing that one up because that's a
it's a common one, and we'll appreciate Joe's coming. That's right. Ibuprofen,
anti inflammatories, motri and advit leave. I talked to you
about adverse reaction right doing harm. It's over the counter.
Everybody's got access to it. We get aches and pains,
(40:31):
and we go to the CVS, we get that ibuprof
when we start popping those, and yeah, a couple of
weeks ago by and all of a sudden, your ankles
a fat. That's absolutely right. We appreciate you, Joe mentioning
that the list is long in terms of what causes swelling.
But anti inflammatories, all those, motion, Advita leaves, mobic, maloxicam, celebres, Ibuprofen,
(40:55):
which I still write a lot's a great drug for
acute pain and chronic pain. And we try to have
a conversation with the patients when we prescribe these medicines.
These are the issues that can come up if you
take them long term. And the reason that happens is
because of how it impacts kidney function. Again, the kidneys
a filter, and medications can interfere with the kidney's proper function,
(41:19):
and so you start to retain fluid because of the
impact of the ibuprofen. And once you get off that's
a cool thing for most people. Once they get off
of it, all of the symptoms go away. Sometimes sometimes
with the chronic use of an inflammatories, it can cause
some permanent injury to your kidney, so you have to
be careful with that and have that discussion with your
(41:42):
healthcare provider. But certainly again heart failure, so a lot
of times you need to do an ultrasound of your
heart to figure that out. And blood clots. Blood clots
are very common in terms of causing the swelling in
your legs, so a lot of times you need to
get an ultrasound of your vein of your leg if
you see that swelling. I sort of hit some of
(42:04):
the high points of swelling, but there are others as
Joe mentioned, but certainly very very common it's a very
abnormal physical symptom requires a little work up, so don't
ignore that. Go to your healthcare provider and get a
proper work up, just so that you're properly docnosed and
you can maybe get off something or get on something
(42:26):
to help with the swelling. Diuretics we use all the time,
Lasix hydro chlorothisac chlorthalidone. Just to make a few thank
you for joining for another edition of the show, don't
drink and drive, God blessed. We'll see you next week.
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