April 28, 2025 • 41 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, welcome, welcome, South East Texas Internet radio listeners.
Is doc Levine, doc Levine Medicloud. Thank you for joining
for another edition of the show. We are typically here
every Saturday between eight and nine Cross Street from program
all Live, that is live, no recordings, taking your phone calls,
(00:21):
trying to answer questions about healthcare and medicine and the
complications and the questions that come up all the time
in healthcare every single day, every hour, every minute. We're
here to try to help you figure that out, get
you some answers to all of the confusing questions. Phone
lines are open. We'd love to hear from your two
(00:43):
way radio. Hey done six kV I won one hundred
and three to three zero kov I give us a call.
Hopefully you're having a wonderful Saturday morning. Weather seems to
be doing wonderful as well. We're through our winter and
getting into our spring, and certainly we're having the yellow
(01:05):
dust everywhere at this time, and it is aggravating to
some allergay sufferers where they do have the itchy eyes,
running nose, cough, maybe the sore throat, and it has
generated some respiratory issues as well. So we have seen
(01:27):
a slight little spike with respiratory complaints as the yellow
dust can sometimes be irritating to patients and their lungs.
They come in with the chest congestion, coughing, wheezing. The
good thing is that there are an assortment of medications
that are available to allergay sufferers, and we call those
(01:52):
medicines non sedating antihistamines the old stambo, the old Grandpa
of antihistamines is a bena drill or a diphenhydramine is
sort of the more generic term for that, and again periodically,
I've mentioned to you if I had a medicine box,
(02:14):
which medicines would I have in it, and benadryl is
one of those medications. Aspirin is another. Just because these
two medicines aspin benadryl, they're over the counter, but they
have a long list of indications. Doctors are prescribing aspirin
as well as benadryl periodically for a lot of different
(02:37):
health elements and health diseases. So it's got a lot
of power and packs of punch, very effective medications to
use on a daily basis, and it's great that it's
affordable it's everywhere. You can get a whole box full
of bena drill or aspen for a very very low price.
(03:00):
Hopefully stays that way and keep that on hand, travel
with it. Yeah, just because all these things come up.
But right now it's the sneezing, watery eyes, sore throat, coughing,
chest congestion, and a lot of time spina drill can
be used for that purpose. But the bad thing about
(03:23):
benadrill or diphenhydromene, as I mentioned to you, are the
side effects of those are that medication, the big one
being it just it can cause you to get a
little bit tired and sleepy. And for some people who
are sensitive to medications in general, we have that population
(03:48):
here in this country where some patients are just really
sensitive to the impact of medications, whether it be over
the counter or prescription. And just to remind you, there
is a misconception about over the counter, and we have
an acronym we use OTC over the counter that they
(04:10):
are safer and less harmful than prescription medications, which is
totally untrue. Another medication that should be in your medicine
cabinet or medicine box or travel medicine emergency kit is
a seat of menefit or talinol. That's another blockbuster, a
(04:33):
chemical that is available. You know it as talanol and
there's benadru aspirin, talanol, all that stuff so over the
counter at one time another probably it was prescription way
before my time, which a lot of medicines that are
over the counter were at one time prescription. So we
(04:57):
talk a lot about address RA on this show, just
to help you understand that when you are prescribed a
medication by healthcare professional, yes it normally has a bit
more strength to it, but the idea in prescribing a
medication to you is to help you make you feel better,
(05:21):
make you feel neutral, fix or resolve some sort of
physical complaint that you're having so you can get back
to your normal routine and feel well. But things can
sometimes go left just all of a sudden, even though
you may have been taking the medication for a long
period of time. We do see that as well. You've
(05:42):
been being prescribed a blood pressure medicine or cholesterol medicine
for years and then all of a sudden you start
having physical complaints from the medication and you have to
get off the medication or it's a possibility that the
medicine is causing an adverse action, which can happen a
lot of times. Generic medications are made from different manufacturers,
(06:07):
and they might make it a little bit too different.
Maybe it's round instead of rectangular, or triangular instead.
Speaker 2 (06:16):
Of long or big.
Speaker 1 (06:19):
You sometimes get that concern when you go to the
pharmacy and you get to refill on your medications and
you open the bottle and it looks different. The name
on the bottle is the same, the dose is the same,
but it looks different. It might even have a different color.
And that is how it is with the generic market
(06:39):
out there, with different manufacturers producing these medications. The pharmacies
probably use the pharmacy or a company that gives them
the best deal so that they can get the most
for the least. And yes, they might make a little
bit differently. Something that one company uses that the company
(07:00):
doesn't might be irritating to your system. And it can
be difficult to figure out if you are having an
adverse reaction to medications.
Speaker 2 (07:11):
Sometimes, you know.
Speaker 1 (07:12):
It's always easy if the way it happens is you
start a medicine and then a week later, two weeks later,
maybe even a month later, you start feeling different or
something starts changing. You know, that's an easy situation, but
a lot of times there has been no change with anything.
You're just taking the same medications, and then something something
(07:36):
happens and you might be on multiple medicines that can
cause adverse reaction. That's always tough, and we have to
sort of sit down and look at the list and
see which one we want to tackle first.
Speaker 2 (07:51):
Just because, as.
Speaker 1 (07:52):
You know or may not know, and you go to
healthcare professional real like everybody else too, we want to
keep the day simple.
Speaker 2 (07:59):
We want to keep.
Speaker 1 (07:59):
It less complicated. We don't want any problems. And a
lot of times we see our patients and they're happy
with the way they feel. Their vital signs look good,
we review their labs.
Speaker 2 (08:13):
That looks good.
Speaker 1 (08:15):
We don't want to change anything. We want to keep
everything the way it is, just because we've probably worked
hard to get to that point where the patient is
feeling well, their numbers are looking good, are they're in
a good range, and we just want to sort of
keep the whole thing going. We don't want to change,
just because when you introduce change with some of these medications,
(08:39):
it can be very disruptive to the point that you're
running back and forth to the pharmacy.
Speaker 2 (08:46):
You're running back and forth to.
Speaker 1 (08:47):
The doctor's office, maybe even to minor care or even
have to be hospitalized when a medication has been stopped,
a new one has been introduced for whatever reason, and
it starts to cause a disruption in your system unknowingly,
and you then have to start dealing with that particular
(09:10):
conflict of your body and your physical symptoms, which, again,
patients are being introduced to a lot of different ideas
and thoughts and recommendations by, as they say, influencers on
your phone or wherever you're getting all of your information.
(09:31):
There seems to be more of those influencers, some with credentials,
most with not that sort of have a certain angle
or some sort of concept that they're promoting for the
for whatever reason, and it sounds good, it looks good,
and you sort of attached to it and maybe want
(09:52):
to follow or do some things that other people are
doing that you see on your media outlet again and
wherever you're getting your information, and you take that information
and you go to your doc and like, hey, I
think I want.
Speaker 2 (10:06):
To try this.
Speaker 1 (10:07):
I saw this person doing that or I heard this,
I heard that. You know, I find it interesting that
a lot of patients when they're at home or when
they're in public and they're talking with their friend or
their neighbor, that you know, their health comes up a lot,
and they sort of compare notes about who they see
(10:30):
or what testing they did, or what medicines they're on,
and what happened to them, and they use that sort
of information to help them make their decision, which I
think is sort of a natural thing. But nonetheless, they
take that concern that desire, bring it to your healthcare
professional and decide, hey, I think I might want to
(10:52):
change this, so I might want to add that, or
I might want to stop this, or I might want
to do this other thing, something that may be the
healthcare profession or was not really interested in doing. But again,
because healthcare now more than ever before, is a service,
(11:12):
it's part of the service industry, those are the dynamics
that are present with most healthcare encounters. Now you have
a provider, that provider is normally being employed by an entity.
There are still a few independent providers out there. Most
(11:32):
of the time that provider is being employed by someone,
and then you are paying a company to pay that
employer whoever is employing the physician, and the whole idea
of just sort of satisfaction and the dynamics of what
should happen when you go to visit, almost like when
you go to a restaurant or you go to a
(11:56):
local store to buy a product. There's certain things that
should have happen, and if they don't happen correctly, then
there's a reaction to that. So nonetheless, a lot of
healthcare providers feel like, Hey, I just want to keep
my patients happy. I want to work with them. I
want to make them feel as good as possible. What
(12:16):
do they have, what do they want to do? And
they sort of listen to it and make a decision
about whether or not they agree with that, and if
they do, then yeah, they'll change. And then next you know,
you got a rash PAM from Beaumont. How can we
help you?
Speaker 3 (12:32):
Good morning, doctor Levine, thanks for taking a call this morning.
I have a great grand David that's dealing with EMA,
is one years old, and I was like, you know,
what type of soap that most depict that we can use,
and also what does exhema rise from?
Speaker 1 (12:52):
Yes, Pam, thank you. That's a good question. Exima is
a term that we normally use to describe a skin
condition where the skin is inflamed, so it could be
red and itchy, as well as what we call flaky,
where it seems like the skin is sort of coming off.
(13:14):
But certainly it is very noticeable to most patients as
well as friends when they look at your the particular
part of your skin. We're not quite sure, Pam, where
why someone develops exema and others don't. We have a
few irritating known factors that can make eximma worse. And
(13:38):
you know, some of it makes sense, you know, smoking,
poor health, probably the environment that you're in. Sometimes soaps
perfumes can aggravate ezema. But because exima is sort of
this inflammatory disease of unknown ideology, it means your skin
(13:59):
is inflamed. We typically would use medicines that control inflammation.
The most common are steroids, so there's several steroid creams
that can be prescribed to you by normally the dermatologists,
which is who normally manages eccima. Just because it's a
(14:20):
condition that comes and goes. We see a lot of
rashes in the primary care physician market. But a lot
of times if the rash comes back and keeps coming
back and forth, or maybe the exima might jump to
a different location. I think most patients as well as
doctors are concerned that maybe something else is different or
(14:42):
going on, so they normally will refer you to a
skin doctor just to get a second opinion, and so
they are normally the ones who are managing that, so
they normally.
Speaker 2 (14:52):
Use topical steroids.
Speaker 1 (14:56):
There are development of other medications to con cotrolled inflammatory
system that are i V. There's probably some also some
tablet medicines out there that can control the inflammatory system
so that the exuma can be controlled. I'm unfamiliar with
some of those, just because i don't see exema every
single day. But in terms of you know, you asked
(15:19):
for foods, is that correct?
Speaker 3 (15:24):
It should be a stain from deorderant a safeguard.
Speaker 1 (15:31):
Yes, soaps and most of the time with working with
dermatologists and asking them questions, they want the soap to
be somewhat bland, b L, A and D. I know
a lot of us when we buy soaps, there are
a lot of chemicals in the actual soap product itself.
Speaker 2 (15:53):
You can just look at the.
Speaker 1 (15:55):
Silent, at the label and all these long technical names.
You'll see that a lot of the deodorants and the
fragrances that are put in these soaps can be irritating
to the skin in general. So most of the time
the dermatologists will recommend very bland, b LA and D
(16:15):
soap products, whether it be a bar or a gel
or liquid. I don't think they really care, but they
sort of wanted to be bland. And there are a
few brands out there that tend to be pretty bland soaps,
and some of them are more medicated soaps and gels.
(16:36):
I think Sepical or Separcal. I can't remember the name
of them, and I don't do it every day now.
I apologize about that, but you could.
Speaker 4 (16:43):
You know.
Speaker 1 (16:44):
But that's the wonderful thing about the internet is you
can probably look up sarass very easily, and that would
just have a list of some commonly recommended soaps that
most people agree on. This probably a doctor who's done
a podcast on ciiasis and some patients who have cerisis
(17:06):
and they're telling a story about what they do. So
that's a cool thing about the internet.
Speaker 2 (17:10):
Man.
Speaker 1 (17:10):
You can look up just about anything. But yeah, you
normally want to stick with bland soaps. You don't want
to heavy perfumed soap. You don't want a lot of
chemicals in the soap because it could be unknowingly irritating
to the skin, because crisis is skin inflammation at the
end of the day, So you don't want anything to
(17:31):
irritate it.
Speaker 3 (17:32):
Okay. One of the question is it I mean color,
I mean due to like using color tow was just
a white or because I do know that color TOIW
says dying appreciated it just as a white.
Speaker 1 (17:49):
You know, that's a good question as well. And I
don't know the answer to that. I think that if
you had csariasis and you were looking to just cover
all of your basis, that is certainly something good to
look into. You you're absolutely right, just because the chemicals
that they used to color the towels or to make
(18:10):
the towel, the fabric that is made. A lot of
these fabrics are synthetics, You're absolutely right, could be irritating
to the surface of the skin. So that is a
very good question. And I'm sure there you know it
makes a difference. I'm sure it makes a difference. I
just again, don't counsel patients enough to be an expert
(18:31):
on that, but I think that is a good idea
if you have serosis, to be sure that whatever towel
or whatever what you're using to apply soaps and wash
your body is as neutral and as soothing to the
skin layer as well. And again, don't know, I'm not
(18:52):
the expert and not quite sure what the pecking order is.
I know cotton comes up a lot as a good
material to use when you have irritated skin, but that
that sounds good to me as well, that hey, try
to stick to a towel with that's white, with not
a lot of things in the in the fabric.
Speaker 2 (19:11):
Yeah, absolutely good idea.
Speaker 3 (19:13):
Thank you, so okay, yes.
Speaker 1 (19:14):
Sir, all right, Pam, well, thank you appreciate all those questions.
We've got der Durm day today, kind of knocking those
knocking at rust off of that brain. You know, we
see rashes and just skin lesions all the time every
day in the clinic.
Speaker 2 (19:33):
Hey, doc, what about this.
Speaker 1 (19:34):
Area on here on my head or here here here,
And a lot of times it's you know, as you're
walking out of the door, you get those and a
lot of times don't get the proper time to look
at that. Hey, Leonard from Houston, how can we help you?
Speaker 5 (19:48):
On Tuesday, I've burned a bottle on my feet on
the hot pavement, and since then I've been popped the blisters,
got the puss off of it. I've been putting on
near spor and changing the dressing the padding three or
four times a day. Besides that, Is there anything else
I'm supposed to be doing?
Speaker 1 (20:11):
No? I you know, most of the time those burns
are what we call first degree burns. There's a first, second,
and third degree burns, third being the more serious type
of burn, firstger being the least serious. Normally, that's more
of a surface injury to the skin, meaning the protective layer,
the actual base layer of the skin remains intact and
(20:36):
it's only injured sort of the most top superficial layer
of the skin. Yes, it can look bad, it can hurt,
looks ugly, but you should have a full recovery a
lot of times from first degree burns. Maybe a little
bit of a second degree, but even then that's still
a good recovery. I think the main thing with any
(20:58):
sort of disrupt of the skin layer or inflammation of
the skin layer as we were talking with the other
collar is to make sure it's not infected and just
keep it clean and honestly.
Speaker 2 (21:10):
The body does the rest.
Speaker 1 (21:12):
To be honest with you, if you just sort of
get out of the way and let the body heal,
it'll heal that injury, no difference if it's the foot
or the face. But it sounds like you've done everything
about right. And yeah, there's some home remedies out there
that probably people have used to help with the sensation
(21:34):
of a burn and also to try and keep it
kind of clean and cleansed. Obviously, because it's your foot,
you're stepping on the surface of the ground, which tends
to be very nasty. Depending on where you're at, even
at someone's home, you might vacuum, you might sort of
(21:56):
brush or use the broomer every day and sweep your floor,
but it's just the floor is just a place where
a lot of things reside on a regular basis, and
it's a monumental effort to keep your floor clean all
the time, especially if you walk or wear shoes in
your house. Some people don't like to wear shoes in
your house. They just take their shoes off at the
(22:17):
doorstep and that does help and cut down on that
sort of thing as well.
Speaker 2 (22:22):
But yeah, the feed are tricky.
Speaker 1 (22:24):
It's got to be sure that they're not getting infected
and you're just keeping them clean and the body really
does the rest.
Speaker 2 (22:31):
I know, there's a lot of gels and.
Speaker 1 (22:33):
Creams and that sort of thing over the counter that
you can go and get and put on there, which
is fine for.
Speaker 2 (22:40):
The most part.
Speaker 1 (22:43):
So I think Leonard sounds like you've done everything right
and you just want to make sure that it keeps
getting better. Certainly, if there's any concern for infection, get
to your primary care provider, get to the foot doctor
of podiatrist, let them take a look at it, because
you know, you don't want to get into that mess.
Speaker 5 (23:04):
Okay, learn Would hydrogen peroxide do anything for me?
Speaker 1 (23:10):
Yeah, you know that's one of those like benadryl and
talnol and aspirin. Hydrogen peroxide is again would be in
my emergency medical medicine kit.
Speaker 2 (23:22):
A lot of people use it.
Speaker 1 (23:23):
To sanitize their skin or use it as a sanitizer
liquid sanitizer if you will, liquid cleanser. So yeah, I
think hydrogen peroxide can be helpful in those situations. Is
do you, I mean, do you have to always use
hydrogen peroxide in that situation. No, just go to a
plain soap and water a lot of times would help.
(23:45):
But there's also beta done. I think that's over the
counter as well. There's a product called hebicleanse is also
used in the surgical suites at most hospitals and other
surgery centers to sort of cut down on bacteria. That's
another product that's over the counter that you can use.
And hydroen peroxide is another alcohol. Forgot that when it burns,
(24:08):
but certainly can be used to help just control the
bacteria and limit the infection rates. So all of those
products are good products. Any questions, buddy.
Speaker 5 (24:22):
No, if that's it, I just was, you know, I
want to make sure I was doing what I was
supposed to be doing for the feet.
Speaker 1 (24:28):
Sounds like you're doing the right thing, all right, Lendad,
We'll appreciate that. Phone call phone lines are open eight
nine to six kvy I won one hundred three to
three zero kalf I'll be back in two minutes.
Speaker 4 (25:01):
All right, Welcome back to Dogophy.
Speaker 1 (25:03):
Medical phone lines to open eight nine to six kV
I one hundred and three to three zero kov.
Speaker 2 (25:07):
I speaking of burning off the feet.
Speaker 1 (25:14):
Again, if you have type one, type two diabetes is
certainly something that, man, we don't emphasize enough. We get
so bogged down with all the other things cholesterol, blood
pressure labs, vaccines. You know, we forget about that that
if you have type one or type two diabetes, it
(25:34):
is certainly a priority. It should be a priority. Again,
we don't talk about it enough in the office.
Speaker 2 (25:39):
I know I don't. It's something I need.
Speaker 1 (25:41):
To work on, is making sure that patients understand that
your foot hygiene and your foot care is very important
for diabetic patients and a lot of times you need
to follow up with a pediatrist to help you manage
(26:02):
your feet. And the reason that happens is because again
high sugar, which again when you have type point or
type two diabetes, is a common occurrence with the situation,
with that situation because of maybe foods or beverages or
just stress that we have, and it starts to affect
(26:24):
two things, the circulation that feeds your feet as well
as the nervous system that allows you to feel your feet,
and so as years go by and click by, if
your blood sugars are not managed very well, tend to
cause a development of plaque in the blood vessels, and
(26:49):
the high sugar is also very irritating and toxic to
the nervous system, and that will then allow your feet
to be vulnerable to infections as well as the formation
of ulcers. This is a lot of times how patients
are diagnosed with type two diabetes. Primarily is they develop
(27:13):
an ulcer on the bottom of their foot for some
odd reason, or they might wake up and see blood
on the bottom of their foot and look on the
bottom and there's a big ulcer sitting there. And again
it makes your feet sort of numb where you really
can't feel your foot entirely.
Speaker 2 (27:32):
Some people who.
Speaker 1 (27:33):
Have what they call peripheral neuropathy. You have heard us
talk about that again, that sort of tingling, numbness, pins
and needle sensation that you can get if your blood
sugar is not controlled very well. That is sort of
when your nervous system is being irritated for whatever reason.
(27:55):
And again, if the sugar is not controlled, it can
become a permanent fixture of your nervous system in your extremities.
And as the neuropathy progresses, your feet get more and
more numb and so you can't feel things. A lot
of times we have patients with type two diabetes that
(28:16):
come into the office as has come to the r
and there's foreign objects embedded in the bottom of their
foot just because they cannot feel it. So they might
have pins or all sorts of things. They step on rocks, pebbles,
debris that are just sitting there in their skin. They
(28:36):
don't even know it's there, and it rubs a big
ulcer in the bottom of their foot, and before you
know it, they have a nice little infection in their
bottom of their foot that they don't know about. Their
foot becomes swollen red, sometimes they can turn dark are black,
which is not a good sign. That means that the
(28:58):
soft tissue or the foot itself, because of the infection
and the severity of the infection, has basically destroyed are
killed the skin and the blood vessels and the nerves
and even the bone, which we call osteomylitis. A lot
(29:20):
of diabetic patients become familiar with that term. And again
that's because as the sugars remain high, the blood vessels
get damaged, the nervous system gets damaged, and every time
you walk on a surface with a shoe, of course,
you could cause micro injury to the surface of the
(29:41):
foot and just wear that surface down and then before
you know it, there's an ulcer, which is normally a
chronic opening of your skin or tearing your skin such
that that barrier mechanism, which is one of the most
important aspects of your skin, is a barrier between the
outside and inside. It's lost and so the outside world,
(30:03):
which would include dust to breed, fungus, bacteria, parasites can
then get in to that particular anatomical area and cause
inflammation and infection. And yes, before you know it, you
have to have a toe amputated. You might have to
get surgery to sort of release the infection from the
(30:25):
foot on the soft tissue, and so it's an extremely
important aspect. If you have type one type two diabetes,
make sure you examine your feet periodically. Look at the
bottom of your feet periodically. Sometimes you can use a
mirror with a handheld mirror so that you can see.
(30:45):
If you live by yourself, and for some people they
need to go to a foot specialist or adoctris just
to get a good thorough examination. Some of you may
have been to your healthcare professional offices. We used to
do this more often, but we haven't recently. We would
actually take the shoes often look at your feet. I
(31:09):
note that some of the intercronologists here in this area,
they sort of make it a part of their routine.
But it is something that you should be aware of
that you should look at your feet as often as possible,
once a day, once a week, that sort of thing
to make sure that you don't see anything. And again
(31:29):
the idea is if your sugars are controlled, you typically
never develop any of those issues with your feet because
again the sugar insult is not there, so you don't
get the plaque, you don't get the nervous system injury,
and so things continue to work. So normally we see
this in patients who just cannot control their sugar for
(31:53):
various reasons, and that damage starts to set in. And
it's a sort of a progressive of situations, not something
that normally happens over night. It's after again years of
not being able to get to sugar down in the
damage a cruise over several years. Again, it may start
off with the numbness and tingling, and then as it
(32:15):
gets worse, it just becomes kind of numb, and because
you can't feel, it doesn't hurt anymore, but it can
affect the way you walk. It can certainly increase your
chance of falling, which can they increase a chance of
injuring yourself, whether it be your face or your back
or your shoulder. Claviical Industries Head injuries. I've seen that
(32:37):
a lot of concussions, bleeding in your brain all starts
from the feet having neuropathy and not being able to
since where you're walking. You know how sometimes that when
you're out in public, the surface changes from step to step,
maybe on uneven ground, maybe there's a crack in the concrete,
(33:00):
have to step up on a curb and you don't
see that, or you step on something with an uneven
surface and before you know it, you're on the ground.
And again is if your nervous system in your feet
is not working, that's more likely to happen. So that's
why we say keep the sugar down. And because of
(33:21):
all of the monitoring devices out there now, in particular
the continuous glucose monitor, which is getting easier and easier
to get, the insurance companies are starting to buy into that.
You know, when these devices first came out some of
the names that we use. One it's called dex Com Dexcom.
(33:44):
The other one's called Freestyle Libre. They kind of came
out about four or five years ago, and at this
point in time, it's becoming easier and easier to get
a hold of these monitoring devices, and people for the
most part really feel like it helps them manage their disease.
So if you don't have well, maybe should get one.
(34:05):
Phone lines are open eight nine to six Kalvy I
won one hundred three three zero Kelvy, I'll be back
in two minutes. All right, welcome back to talk with
your medical Our phone lines are open eight none six
kova I one hundred three three zero oko v I
(34:27):
give us a call chatting about various topics, in particular,
if you are type one type two diabetic, get your
feet checked or look at your feet on a regular basis,
make sure everything looks good. With neuropathy, we all know
that term. You can get a lot of ulcers and
injuries to your feet that can turn into some major issues,
(34:51):
in particular amputations, even systemic infection which would call sepsis.
You've heard us talk about that patients get toe infections
and foot infections a lot.
Speaker 2 (35:02):
If you have a neuropathy, because the foot is.
Speaker 1 (35:04):
Vulnerable now with the loss of circulation, with the loss
of the nervous system. It's now more of a diseased
foot or diseased limb, if you will, and it's just injured,
are injury prone just because it's not healthy from the
lack of blood and the development of plaque. That you
(35:25):
just have to take care of them more frequently. And
I note that now all the monitoring devices out there
are the continuous glucose monitor. It's getting easier and easier
to know the state of affairs of your diabetes. You
don't have to prick your finger all the time. You
just put this little wafer of a device on your
(35:47):
arm and it just hangs out there for seven days,
ten days or so, and it talks to your phone
and it pretty much tells you what's going on with
your sugar, so that you can determine what's good what's
not good for you. A lot of our questions in
the office as well as here on the radio, have
a lot to do with should I eat this, should
I not eat that? Well, if you have that little
(36:10):
waifer on your arm and you can just look at
your phone. It'll tell you you just eat something, drink something,
and you just look to see what it does. I mean,
it's very straightforward, it's very simple, and then you have
your information and you know that if there's a certain
food substance, despite what everyone is saying about it, which
most of the time are general statements, even myself, we're
(36:32):
all individual and our bodies are our own and our
bodies react differently from your neighbor, your friend, your mom,
your dad, which is why sometimes you have to be
careful about asking those same people about what they would
do in particular situations as it becomes to your health,
or what medicines they would choose, what medicines they are on.
(36:53):
Because we now know that our systems are different. Our
liver behaves differently, our immune systems different, and so medicines
might have impact you differently. We're certainly willing to listen
to what you have to say about changing medicines, but
a lot of times, if medicines are working for even
if it's a new medicine in the market, if it's
working for you, doctors typically health professionals typically don't want
(37:17):
to change anything because we don't want to be disruptive
of your system, and sometimes that will introduce disruption when
you're changing medications. Phone lines open eight nine six v
I one one hundred three three zero Kalvi. I will
be back in two minutes in our last break, Welcome
(37:38):
back to the doctor the medical hor phone lines or
open eight nine six kov I want one hundred three
three zero O Kalvia. I'm just still in amazement and
how fast an hour goes by.
Speaker 2 (37:47):
I mean, this is crazy.
Speaker 1 (37:50):
We're having so much fun just chatting and talking about
health and trying to get you some answers.
Speaker 2 (37:56):
We did discuss today the.
Speaker 1 (37:58):
Importance of in your feet if you have type two
diabetes or type one diabetes and it is getting easier
because of these continuous glucose monitors or CGM for short.
And we did spend a little time just talking about
your medications and how a lot of times you have
(38:20):
to be careful about stopping and starting medications. Obviously, if
your healthcare provider wants to do that, by all means,
they normally have a good reason for that, but just
to start and to stop meds just because maybe something's
new or your friend is on it and they're doing better.
You know, we get that request often. You just have
(38:41):
to be careful because these medicines can cause harm. Even
that stuff for the counter, all the medicines that I
mentioned to you, benadryl, talenol, aspirin, they can harm your system.
We see it each and every day in the hospital,
in the office. Just because as it is over the
counter and available to you does not mean it cannot
(39:03):
harm you. So you don't necessarily have to check with
your healthcare provider every time you reach with something and
go to the pharmacy and get it again. Most of
this information is pretty straightforward and you can sort of
do your own homework with it very easily with the
use of the computer health system that is available to
(39:25):
you free of charge. Just get your smartphone and you
can sort of research things, and most of that information
is pretty basic. Not much has changed and is accurate. However,
if you're unsure, just reach out to your healthcare provider,
make an appointment, go and visit, or call the office
and just inquire. You can always do that. There are
(39:47):
more virtual platforms where insurance companies and insurance companies are
offering sort of this twenty four hours, seven day a week,
service to a healthcare provider sort of maybe a hotline
or a number you can call where you can actually
talk to a licensed healthcare provider, whether it be an
(40:09):
NP or a physician assistant or even an MDA DOO.
And it's not your primary but nonetheless it still is
a medical healthcare professional who has some insight into what
all this stuff should mean, and you can get some
advice from them as well. But as you know, as
the one thing that I promote very heavily on this show,
(40:31):
and if you're a patient of mine, I try to
just leave you with the little nugget of information about
what it is that is going on. The most important
thing is what you eat and drink. Gotta get the
diet down right. Not every day, but certainly each day.
You want to include something that's good for you. Vegetables, beans,
(40:55):
fresh fruit, and try to eat as fresh as possible.
Try to limit your exposure to the processed foods, just
because there's a bunch of additives in there that we
don't know what it's doing to you, and we want
to keep things as simple as possible, So more vegetables
and drink water. Limit your exposure to those sugary beverages again.
(41:19):
We talked about the feet, all that sugar, spikes and sugar.
It's very irritating. We'll see you guys next week. Thanks
for the phone calls.
Speaker 2 (41:27):
No drinking and driving. Take care,
All right, welcome, welcome, welcome, South East Texas Internet radio listeners.
Is doc Levine, doc Levine Medicloud. Thank you for joining
for another edition of the show. We are typically here
every Saturday between eight and nine Cross Street from program
all Live, that is live, no recordings, taking your phone calls,
(00:21):
trying to answer questions about healthcare and medicine and the
complications and the questions that come up all the time
in healthcare every single day, every hour, every minute. We're
here to try to help you figure that out, get
you some answers to all of the confusing questions. Phone
lines are open. We'd love to hear from your two
(00:43):
way radio. Hey done six kV I won one hundred
and three to three zero kov I give us a call.
Hopefully you're having a wonderful Saturday morning. Weather seems to
be doing wonderful as well. We're through our winter and
getting into our spring, and certainly we're having the yellow
(01:05):
dust everywhere at this time, and it is aggravating to
some allergay sufferers where they do have the itchy eyes,
running nose, cough, maybe the sore throat, and it has
generated some respiratory issues as well. So we have seen
(01:27):
a slight little spike with respiratory complaints as the yellow
dust can sometimes be irritating to patients and their lungs.
They come in with the chest congestion, coughing, wheezing. The
good thing is that there are an assortment of medications
that are available to allergay sufferers, and we call those
(01:52):
medicines non sedating antihistamines the old stambo, the old Grandpa
of antihistamines is a bena drill or a diphenhydramine is
sort of the more generic term for that, and again periodically,
I've mentioned to you if I had a medicine box,
(02:14):
which medicines would I have in it, and benadryl is
one of those medications. Aspirin is another. Just because these
two medicines aspin benadryl, they're over the counter, but they
have a long list of indications. Doctors are prescribing aspirin
as well as benadryl periodically for a lot of different
(02:37):
health elements and health diseases. So it's got a lot
of power and packs of punch, very effective medications to
use on a daily basis, and it's great that it's
affordable it's everywhere. You can get a whole box full
of bena drill or aspen for a very very low price.
(03:00):
Hopefully stays that way and keep that on hand, travel
with it. Yeah, just because all these things come up.
But right now it's the sneezing, watery eyes, sore throat, coughing,
chest congestion, and a lot of time spina drill can
be used for that purpose. But the bad thing about
(03:23):
benadrill or diphenhydromene, as I mentioned to you, are the
side effects of those are that medication, the big one
being it just it can cause you to get a
little bit tired and sleepy. And for some people who
are sensitive to medications in general, we have that population
(03:48):
here in this country where some patients are just really
sensitive to the impact of medications, whether it be over
the counter or prescription. And just to remind you, there
is a misconception about over the counter, and we have
an acronym we use OTC over the counter that they
(04:10):
are safer and less harmful than prescription medications, which is
totally untrue. Another medication that should be in your medicine
cabinet or medicine box or travel medicine emergency kit is
a seat of menefit or talinol. That's another blockbuster, a
(04:33):
chemical that is available. You know it as talanol and
there's benadru aspirin, talanol, all that stuff so over the
counter at one time another probably it was prescription way
before my time, which a lot of medicines that are
over the counter were at one time prescription. So we
(04:57):
talk a lot about address RA on this show, just
to help you understand that when you are prescribed a
medication by healthcare professional, yes it normally has a bit
more strength to it, but the idea in prescribing a
medication to you is to help you make you feel better,
(05:21):
make you feel neutral, fix or resolve some sort of
physical complaint that you're having so you can get back
to your normal routine and feel well. But things can
sometimes go left just all of a sudden, even though
you may have been taking the medication for a long
period of time. We do see that as well. You've
(05:42):
been being prescribed a blood pressure medicine or cholesterol medicine
for years and then all of a sudden you start
having physical complaints from the medication and you have to
get off the medication or it's a possibility that the
medicine is causing an adverse action, which can happen a
lot of times. Generic medications are made from different manufacturers,
(06:07):
and they might make it a little bit too different.
Maybe it's round instead of rectangular, or triangular instead.
Speaker 2 (06:16):
Of long or big.
Speaker 1 (06:19):
You sometimes get that concern when you go to the
pharmacy and you get to refill on your medications and
you open the bottle and it looks different. The name
on the bottle is the same, the dose is the same,
but it looks different. It might even have a different color.
And that is how it is with the generic market
(06:39):
out there, with different manufacturers producing these medications. The pharmacies
probably use the pharmacy or a company that gives them
the best deal so that they can get the most
for the least. And yes, they might make a little
bit differently. Something that one company uses that the company
(07:00):
doesn't might be irritating to your system. And it can
be difficult to figure out if you are having an
adverse reaction to medications.
Speaker 2 (07:11):
Sometimes, you know.
Speaker 1 (07:12):
It's always easy if the way it happens is you
start a medicine and then a week later, two weeks later,
maybe even a month later, you start feeling different or
something starts changing. You know, that's an easy situation, but
a lot of times there has been no change with anything.
You're just taking the same medications, and then something something
(07:36):
happens and you might be on multiple medicines that can
cause adverse reaction. That's always tough, and we have to
sort of sit down and look at the list and
see which one we want to tackle first.
Speaker 2 (07:51):
Just because, as.
Speaker 1 (07:52):
You know or may not know, and you go to
healthcare professional real like everybody else too, we want to
keep the day simple.
Speaker 2 (07:59):
We want to keep.
Speaker 1 (07:59):
It less complicated. We don't want any problems. And a
lot of times we see our patients and they're happy
with the way they feel. Their vital signs look good,
we review their labs.
Speaker 2 (08:13):
That looks good.
Speaker 1 (08:15):
We don't want to change anything. We want to keep
everything the way it is, just because we've probably worked
hard to get to that point where the patient is
feeling well, their numbers are looking good, are they're in
a good range, and we just want to sort of
keep the whole thing going. We don't want to change,
just because when you introduce change with some of these medications,
(08:39):
it can be very disruptive to the point that you're
running back and forth to the pharmacy.
Speaker 2 (08:46):
You're running back and forth to.
Speaker 1 (08:47):
The doctor's office, maybe even to minor care or even
have to be hospitalized when a medication has been stopped,
a new one has been introduced for whatever reason, and
it starts to cause a disruption in your system unknowingly,
and you then have to start dealing with that particular
(09:10):
conflict of your body and your physical symptoms, which, again,
patients are being introduced to a lot of different ideas
and thoughts and recommendations by, as they say, influencers on
your phone or wherever you're getting all of your information.
(09:31):
There seems to be more of those influencers, some with credentials,
most with not that sort of have a certain angle
or some sort of concept that they're promoting for the
for whatever reason, and it sounds good, it looks good,
and you sort of attached to it and maybe want
(09:52):
to follow or do some things that other people are
doing that you see on your media outlet again and
wherever you're getting your information, and you take that information
and you go to your doc and like, hey, I
think I want.
Speaker 2 (10:06):
To try this.
Speaker 1 (10:07):
I saw this person doing that or I heard this,
I heard that. You know, I find it interesting that
a lot of patients when they're at home or when
they're in public and they're talking with their friend or
their neighbor, that you know, their health comes up a lot,
and they sort of compare notes about who they see
(10:30):
or what testing they did, or what medicines they're on,
and what happened to them, and they use that sort
of information to help them make their decision, which I
think is sort of a natural thing. But nonetheless, they
take that concern that desire, bring it to your healthcare
professional and decide, hey, I think I might want to
(10:52):
change this, so I might want to add that, or
I might want to stop this, or I might want
to do this other thing, something that may be the
healthcare profession or was not really interested in doing. But again,
because healthcare now more than ever before, is a service,
(11:12):
it's part of the service industry, those are the dynamics
that are present with most healthcare encounters. Now you have
a provider, that provider is normally being employed by an entity.
There are still a few independent providers out there. Most
(11:32):
of the time that provider is being employed by someone,
and then you are paying a company to pay that
employer whoever is employing the physician, and the whole idea
of just sort of satisfaction and the dynamics of what
should happen when you go to visit, almost like when
you go to a restaurant or you go to a
(11:56):
local store to buy a product. There's certain things that
should have happen, and if they don't happen correctly, then
there's a reaction to that. So nonetheless, a lot of
healthcare providers feel like, Hey, I just want to keep
my patients happy. I want to work with them. I
want to make them feel as good as possible. What
(12:16):
do they have, what do they want to do? And
they sort of listen to it and make a decision
about whether or not they agree with that, and if
they do, then yeah, they'll change. And then next you know,
you got a rash PAM from Beaumont. How can we
help you?
Speaker 3 (12:32):
Good morning, doctor Levine, thanks for taking a call this morning.
I have a great grand David that's dealing with EMA,
is one years old, and I was like, you know,
what type of soap that most depict that we can use,
and also what does exhema rise from?
Speaker 1 (12:52):
Yes, Pam, thank you. That's a good question. Exima is
a term that we normally use to describe a skin
condition where the skin is inflamed, so it could be
red and itchy, as well as what we call flaky,
where it seems like the skin is sort of coming off.
(13:14):
But certainly it is very noticeable to most patients as
well as friends when they look at your the particular
part of your skin. We're not quite sure, Pam, where
why someone develops exema and others don't. We have a
few irritating known factors that can make eximma worse. And
(13:38):
you know, some of it makes sense, you know, smoking,
poor health, probably the environment that you're in. Sometimes soaps
perfumes can aggravate ezema. But because exima is sort of
this inflammatory disease of unknown ideology, it means your skin
(13:59):
is inflamed. We typically would use medicines that control inflammation.
The most common are steroids, so there's several steroid creams
that can be prescribed to you by normally the dermatologists,
which is who normally manages eccima. Just because it's a
(14:20):
condition that comes and goes. We see a lot of
rashes in the primary care physician market. But a lot
of times if the rash comes back and keeps coming
back and forth, or maybe the exima might jump to
a different location. I think most patients as well as
doctors are concerned that maybe something else is different or
(14:42):
going on, so they normally will refer you to a
skin doctor just to get a second opinion, and so
they are normally the ones who are managing that, so
they normally.
Speaker 2 (14:52):
Use topical steroids.
Speaker 1 (14:56):
There are development of other medications to con cotrolled inflammatory
system that are i V. There's probably some also some
tablet medicines out there that can control the inflammatory system
so that the exuma can be controlled. I'm unfamiliar with
some of those, just because i don't see exema every
single day. But in terms of you know, you asked
(15:19):
for foods, is that correct?
Speaker 3 (15:24):
It should be a stain from deorderant a safeguard.
Speaker 1 (15:31):
Yes, soaps and most of the time with working with
dermatologists and asking them questions, they want the soap to
be somewhat bland, b L, A and D. I know
a lot of us when we buy soaps, there are
a lot of chemicals in the actual soap product itself.
Speaker 2 (15:53):
You can just look at the.
Speaker 1 (15:55):
Silent, at the label and all these long technical names.
You'll see that a lot of the deodorants and the
fragrances that are put in these soaps can be irritating
to the skin in general. So most of the time
the dermatologists will recommend very bland, b LA and D
(16:15):
soap products, whether it be a bar or a gel
or liquid. I don't think they really care, but they
sort of wanted to be bland. And there are a
few brands out there that tend to be pretty bland soaps,
and some of them are more medicated soaps and gels.
(16:36):
I think Sepical or Separcal. I can't remember the name
of them, and I don't do it every day now.
I apologize about that, but you could.
Speaker 4 (16:43):
You know.
Speaker 1 (16:44):
But that's the wonderful thing about the internet is you
can probably look up sarass very easily, and that would
just have a list of some commonly recommended soaps that
most people agree on. This probably a doctor who's done
a podcast on ciiasis and some patients who have cerisis
(17:06):
and they're telling a story about what they do. So
that's a cool thing about the internet.
Speaker 2 (17:10):
Man.
Speaker 1 (17:10):
You can look up just about anything. But yeah, you
normally want to stick with bland soaps. You don't want
to heavy perfumed soap. You don't want a lot of
chemicals in the soap because it could be unknowingly irritating
to the skin, because crisis is skin inflammation at the
end of the day, So you don't want anything to
(17:31):
irritate it.
Speaker 3 (17:32):
Okay. One of the question is it I mean color,
I mean due to like using color tow was just
a white or because I do know that color TOIW
says dying appreciated it just as a white.
Speaker 1 (17:49):
You know, that's a good question as well. And I
don't know the answer to that. I think that if
you had csariasis and you were looking to just cover
all of your basis, that is certainly something good to
look into. You you're absolutely right, just because the chemicals
that they used to color the towels or to make
(18:10):
the towel, the fabric that is made. A lot of
these fabrics are synthetics, You're absolutely right, could be irritating
to the surface of the skin. So that is a
very good question. And I'm sure there you know it
makes a difference. I'm sure it makes a difference. I
just again, don't counsel patients enough to be an expert
(18:31):
on that, but I think that is a good idea
if you have serosis, to be sure that whatever towel
or whatever what you're using to apply soaps and wash
your body is as neutral and as soothing to the
skin layer as well. And again, don't know, I'm not
(18:52):
the expert and not quite sure what the pecking order is.
I know cotton comes up a lot as a good
material to use when you have irritated skin, but that
that sounds good to me as well, that hey, try
to stick to a towel with that's white, with not
a lot of things in the in the fabric.
Speaker 2 (19:11):
Yeah, absolutely good idea.
Speaker 3 (19:13):
Thank you, so okay, yes.
Speaker 1 (19:14):
Sir, all right, Pam, well, thank you appreciate all those questions.
We've got der Durm day today, kind of knocking those
knocking at rust off of that brain. You know, we
see rashes and just skin lesions all the time every
day in the clinic.
Speaker 2 (19:33):
Hey, doc, what about this.
Speaker 1 (19:34):
Area on here on my head or here here here,
And a lot of times it's you know, as you're
walking out of the door, you get those and a
lot of times don't get the proper time to look
at that. Hey, Leonard from Houston, how can we help you?
Speaker 5 (19:48):
On Tuesday, I've burned a bottle on my feet on
the hot pavement, and since then I've been popped the blisters,
got the puss off of it. I've been putting on
near spor and changing the dressing the padding three or
four times a day. Besides that, Is there anything else
I'm supposed to be doing?
Speaker 1 (20:11):
No? I you know, most of the time those burns
are what we call first degree burns. There's a first, second,
and third degree burns, third being the more serious type
of burn, firstger being the least serious. Normally, that's more
of a surface injury to the skin, meaning the protective layer,
the actual base layer of the skin remains intact and
(20:36):
it's only injured sort of the most top superficial layer
of the skin. Yes, it can look bad, it can hurt,
looks ugly, but you should have a full recovery a
lot of times from first degree burns. Maybe a little
bit of a second degree, but even then that's still
a good recovery. I think the main thing with any
(20:58):
sort of disrupt of the skin layer or inflammation of
the skin layer as we were talking with the other
collar is to make sure it's not infected and just
keep it clean and honestly.
Speaker 2 (21:10):
The body does the rest.
Speaker 1 (21:12):
To be honest with you, if you just sort of
get out of the way and let the body heal,
it'll heal that injury, no difference if it's the foot
or the face. But it sounds like you've done everything
about right. And yeah, there's some home remedies out there
that probably people have used to help with the sensation
(21:34):
of a burn and also to try and keep it
kind of clean and cleansed. Obviously, because it's your foot,
you're stepping on the surface of the ground, which tends
to be very nasty. Depending on where you're at, even
at someone's home, you might vacuum, you might sort of
(21:56):
brush or use the broomer every day and sweep your floor,
but it's just the floor is just a place where
a lot of things reside on a regular basis, and
it's a monumental effort to keep your floor clean all
the time, especially if you walk or wear shoes in
your house. Some people don't like to wear shoes in
your house. They just take their shoes off at the
(22:17):
doorstep and that does help and cut down on that
sort of thing as well.
Speaker 2 (22:22):
But yeah, the feed are tricky.
Speaker 1 (22:24):
It's got to be sure that they're not getting infected
and you're just keeping them clean and the body really
does the rest.
Speaker 2 (22:31):
I know, there's a lot of gels and.
Speaker 1 (22:33):
Creams and that sort of thing over the counter that
you can go and get and put on there, which
is fine for.
Speaker 2 (22:40):
The most part.
Speaker 1 (22:43):
So I think Leonard sounds like you've done everything right
and you just want to make sure that it keeps
getting better. Certainly, if there's any concern for infection, get
to your primary care provider, get to the foot doctor
of podiatrist, let them take a look at it, because
you know, you don't want to get into that mess.
Speaker 5 (23:04):
Okay, learn Would hydrogen peroxide do anything for me?
Speaker 1 (23:10):
Yeah, you know that's one of those like benadryl and
talnol and aspirin. Hydrogen peroxide is again would be in
my emergency medical medicine kit.
Speaker 2 (23:22):
A lot of people use it.
Speaker 1 (23:23):
To sanitize their skin or use it as a sanitizer
liquid sanitizer if you will, liquid cleanser. So yeah, I
think hydrogen peroxide can be helpful in those situations. Is
do you, I mean, do you have to always use
hydrogen peroxide in that situation. No, just go to a
plain soap and water a lot of times would help.
(23:45):
But there's also beta done. I think that's over the
counter as well. There's a product called hebicleanse is also
used in the surgical suites at most hospitals and other
surgery centers to sort of cut down on bacteria. That's
another product that's over the counter that you can use.
And hydroen peroxide is another alcohol. Forgot that when it burns,
(24:08):
but certainly can be used to help just control the
bacteria and limit the infection rates. So all of those
products are good products. Any questions, buddy.
Speaker 5 (24:22):
No, if that's it, I just was, you know, I
want to make sure I was doing what I was
supposed to be doing for the feet.
Speaker 1 (24:28):
Sounds like you're doing the right thing, all right, Lendad,
We'll appreciate that. Phone call phone lines are open eight
nine to six kvy I won one hundred three to
three zero kalf I'll be back in two minutes.
Speaker 4 (25:01):
All right, Welcome back to Dogophy.
Speaker 1 (25:03):
Medical phone lines to open eight nine to six kV
I one hundred and three to three zero kov.
Speaker 2 (25:07):
I speaking of burning off the feet.
Speaker 1 (25:14):
Again, if you have type one, type two diabetes is
certainly something that, man, we don't emphasize enough. We get
so bogged down with all the other things cholesterol, blood
pressure labs, vaccines. You know, we forget about that that
if you have type one or type two diabetes, it
(25:34):
is certainly a priority. It should be a priority. Again,
we don't talk about it enough in the office.
Speaker 2 (25:39):
I know I don't. It's something I need.
Speaker 1 (25:41):
To work on, is making sure that patients understand that
your foot hygiene and your foot care is very important
for diabetic patients and a lot of times you need
to follow up with a pediatrist to help you manage
(26:02):
your feet. And the reason that happens is because again
high sugar, which again when you have type point or
type two diabetes, is a common occurrence with the situation,
with that situation because of maybe foods or beverages or
just stress that we have, and it starts to affect
(26:24):
two things, the circulation that feeds your feet as well
as the nervous system that allows you to feel your feet,
and so as years go by and click by, if
your blood sugars are not managed very well, tend to
cause a development of plaque in the blood vessels, and
(26:49):
the high sugar is also very irritating and toxic to
the nervous system, and that will then allow your feet
to be vulnerable to infections as well as the formation
of ulcers. This is a lot of times how patients
are diagnosed with type two diabetes. Primarily is they develop
(27:13):
an ulcer on the bottom of their foot for some
odd reason, or they might wake up and see blood
on the bottom of their foot and look on the
bottom and there's a big ulcer sitting there. And again
it makes your feet sort of numb where you really
can't feel your foot entirely.
Speaker 2 (27:32):
Some people who.
Speaker 1 (27:33):
Have what they call peripheral neuropathy. You have heard us
talk about that again, that sort of tingling, numbness, pins
and needle sensation that you can get if your blood
sugar is not controlled very well. That is sort of
when your nervous system is being irritated for whatever reason.
(27:55):
And again, if the sugar is not controlled, it can
become a permanent fixture of your nervous system in your extremities.
And as the neuropathy progresses, your feet get more and
more numb and so you can't feel things. A lot
of times we have patients with type two diabetes that
(28:16):
come into the office as has come to the r
and there's foreign objects embedded in the bottom of their
foot just because they cannot feel it. So they might
have pins or all sorts of things. They step on rocks, pebbles,
debris that are just sitting there in their skin. They
(28:36):
don't even know it's there, and it rubs a big
ulcer in the bottom of their foot, and before you
know it, they have a nice little infection in their
bottom of their foot that they don't know about. Their
foot becomes swollen red, sometimes they can turn dark are black,
which is not a good sign. That means that the
(28:58):
soft tissue or the foot itself, because of the infection
and the severity of the infection, has basically destroyed are
killed the skin and the blood vessels and the nerves
and even the bone, which we call osteomylitis. A lot
(29:20):
of diabetic patients become familiar with that term. And again
that's because as the sugars remain high, the blood vessels
get damaged, the nervous system gets damaged, and every time
you walk on a surface with a shoe, of course,
you could cause micro injury to the surface of the
(29:41):
foot and just wear that surface down and then before
you know it, there's an ulcer, which is normally a
chronic opening of your skin or tearing your skin such
that that barrier mechanism, which is one of the most
important aspects of your skin, is a barrier between the
outside and inside. It's lost and so the outside world,
(30:03):
which would include dust to breed, fungus, bacteria, parasites can
then get in to that particular anatomical area and cause
inflammation and infection. And yes, before you know it, you
have to have a toe amputated. You might have to
get surgery to sort of release the infection from the
(30:25):
foot on the soft tissue, and so it's an extremely
important aspect. If you have type one type two diabetes,
make sure you examine your feet periodically. Look at the
bottom of your feet periodically. Sometimes you can use a
mirror with a handheld mirror so that you can see.
(30:45):
If you live by yourself, and for some people they
need to go to a foot specialist or adoctris just
to get a good thorough examination. Some of you may
have been to your healthcare professional offices. We used to
do this more often, but we haven't recently. We would
actually take the shoes often look at your feet. I
(31:09):
note that some of the intercronologists here in this area,
they sort of make it a part of their routine.
But it is something that you should be aware of
that you should look at your feet as often as possible,
once a day, once a week, that sort of thing
to make sure that you don't see anything. And again
(31:29):
the idea is if your sugars are controlled, you typically
never develop any of those issues with your feet because
again the sugar insult is not there, so you don't
get the plaque, you don't get the nervous system injury,
and so things continue to work. So normally we see
this in patients who just cannot control their sugar for
(31:53):
various reasons, and that damage starts to set in. And
it's a sort of a progressive of situations, not something
that normally happens over night. It's after again years of
not being able to get to sugar down in the
damage a cruise over several years. Again, it may start
off with the numbness and tingling, and then as it
(32:15):
gets worse, it just becomes kind of numb, and because
you can't feel, it doesn't hurt anymore, but it can
affect the way you walk. It can certainly increase your
chance of falling, which can they increase a chance of
injuring yourself, whether it be your face or your back
or your shoulder. Claviical Industries Head injuries. I've seen that
(32:37):
a lot of concussions, bleeding in your brain all starts
from the feet having neuropathy and not being able to
since where you're walking. You know how sometimes that when
you're out in public, the surface changes from step to step,
maybe on uneven ground, maybe there's a crack in the concrete,
(33:00):
have to step up on a curb and you don't
see that, or you step on something with an uneven
surface and before you know it, you're on the ground.
And again is if your nervous system in your feet
is not working, that's more likely to happen. So that's
why we say keep the sugar down. And because of
(33:21):
all of the monitoring devices out there now, in particular
the continuous glucose monitor, which is getting easier and easier
to get, the insurance companies are starting to buy into that.
You know, when these devices first came out some of
the names that we use. One it's called dex Com Dexcom.
(33:44):
The other one's called Freestyle Libre. They kind of came
out about four or five years ago, and at this
point in time, it's becoming easier and easier to get
a hold of these monitoring devices, and people for the
most part really feel like it helps them manage their disease.
So if you don't have well, maybe should get one.
(34:05):
Phone lines are open eight nine to six Kalvy I
won one hundred three three zero Kelvy, I'll be back
in two minutes. All right, welcome back to talk with
your medical Our phone lines are open eight none six
kova I one hundred three three zero oko v I
(34:27):
give us a call chatting about various topics, in particular,
if you are type one type two diabetic, get your
feet checked or look at your feet on a regular basis,
make sure everything looks good. With neuropathy, we all know
that term. You can get a lot of ulcers and
injuries to your feet that can turn into some major issues,
(34:51):
in particular amputations, even systemic infection which would call sepsis.
You've heard us talk about that patients get toe infections
and foot infections a lot.
Speaker 2 (35:02):
If you have a neuropathy, because the foot is.
Speaker 1 (35:04):
Vulnerable now with the loss of circulation, with the loss
of the nervous system. It's now more of a diseased
foot or diseased limb, if you will, and it's just injured,
are injury prone just because it's not healthy from the
lack of blood and the development of plaque. That you
(35:25):
just have to take care of them more frequently. And
I note that now all the monitoring devices out there
are the continuous glucose monitor. It's getting easier and easier
to know the state of affairs of your diabetes. You
don't have to prick your finger all the time. You
just put this little wafer of a device on your
(35:47):
arm and it just hangs out there for seven days,
ten days or so, and it talks to your phone
and it pretty much tells you what's going on with
your sugar, so that you can determine what's good what's
not good for you. A lot of our questions in
the office as well as here on the radio, have
a lot to do with should I eat this, should
I not eat that? Well, if you have that little
(36:10):
waifer on your arm and you can just look at
your phone. It'll tell you you just eat something, drink something,
and you just look to see what it does. I mean,
it's very straightforward, it's very simple, and then you have
your information and you know that if there's a certain
food substance, despite what everyone is saying about it, which
most of the time are general statements, even myself, we're
(36:32):
all individual and our bodies are our own and our
bodies react differently from your neighbor, your friend, your mom,
your dad, which is why sometimes you have to be
careful about asking those same people about what they would
do in particular situations as it becomes to your health,
or what medicines they would choose, what medicines they are on.
(36:53):
Because we now know that our systems are different. Our
liver behaves differently, our immune systems different, and so medicines
might have impact you differently. We're certainly willing to listen
to what you have to say about changing medicines, but
a lot of times, if medicines are working for even
if it's a new medicine in the market, if it's
working for you, doctors typically health professionals typically don't want
(37:17):
to change anything because we don't want to be disruptive
of your system, and sometimes that will introduce disruption when
you're changing medications. Phone lines open eight nine six v
I one one hundred three three zero Kalvi. I will
be back in two minutes in our last break, Welcome
(37:38):
back to the doctor the medical hor phone lines or
open eight nine six kov I want one hundred three
three zero O Kalvia. I'm just still in amazement and
how fast an hour goes by.
Speaker 2 (37:47):
I mean, this is crazy.
Speaker 1 (37:50):
We're having so much fun just chatting and talking about
health and trying to get you some answers.
Speaker 2 (37:56):
We did discuss today the.
Speaker 1 (37:58):
Importance of in your feet if you have type two
diabetes or type one diabetes and it is getting easier
because of these continuous glucose monitors or CGM for short.
And we did spend a little time just talking about
your medications and how a lot of times you have
(38:20):
to be careful about stopping and starting medications. Obviously, if
your healthcare provider wants to do that, by all means,
they normally have a good reason for that, but just
to start and to stop meds just because maybe something's
new or your friend is on it and they're doing better.
You know, we get that request often. You just have
(38:41):
to be careful because these medicines can cause harm. Even
that stuff for the counter, all the medicines that I
mentioned to you, benadryl, talenol, aspirin, they can harm your system.
We see it each and every day in the hospital,
in the office. Just because as it is over the
counter and available to you does not mean it cannot
(39:03):
harm you. So you don't necessarily have to check with
your healthcare provider every time you reach with something and
go to the pharmacy and get it again. Most of
this information is pretty straightforward and you can sort of
do your own homework with it very easily with the
use of the computer health system that is available to
(39:25):
you free of charge. Just get your smartphone and you
can sort of research things, and most of that information
is pretty basic. Not much has changed and is accurate. However,
if you're unsure, just reach out to your healthcare provider,
make an appointment, go and visit, or call the office
and just inquire. You can always do that. There are
(39:47):
more virtual platforms where insurance companies and insurance companies are
offering sort of this twenty four hours, seven day a week,
service to a healthcare provider sort of maybe a hotline
or a number you can call where you can actually
talk to a licensed healthcare provider, whether it be an
(40:09):
NP or a physician assistant or even an MDA DOO.
And it's not your primary but nonetheless it still is
a medical healthcare professional who has some insight into what
all this stuff should mean, and you can get some
advice from them as well. But as you know, as
the one thing that I promote very heavily on this show,
(40:31):
and if you're a patient of mine, I try to
just leave you with the little nugget of information about
what it is that is going on. The most important
thing is what you eat and drink. Gotta get the
diet down right. Not every day, but certainly each day.
You want to include something that's good for you. Vegetables, beans,
(40:55):
fresh fruit, and try to eat as fresh as possible.
Try to limit your exposure to the processed foods, just
because there's a bunch of additives in there that we
don't know what it's doing to you, and we want
to keep things as simple as possible, So more vegetables
and drink water. Limit your exposure to those sugary beverages again.
(41:19):
We talked about the feet, all that sugar, spikes and sugar.
It's very irritating. We'll see you guys next week. Thanks
for the phone calls.
Speaker 2 (41:27):
No drinking and driving. Take care,
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